Behavioral verification and risk factors of HIV cross-population transmission in China: analysis of national surveillance data 1989-2022.

INTRODUCTION: The dynamic HIV/AIDS epidemic significantly impacts China, particularly affecting injection drug users (IDUs), former plasma donors (FPDs), men who have sex with men (MSM), and those engaging in high-risk heterosexual behavior (HRHB). This study specifically focuses on identifying the risk factors and influences that drive the spread of HIV among these population groups by performing a comprehensive analysis of contact histories of individuals diagnosed with HIV. METHODS: Data for this research were gathered from China's HIV/AIDS Comprehensive Response Information Management System (CRIMS). Contact histories were described using bar and venn diagram. Trend in engaging in HBRB among MSM were identify potential change using the Cochran-Armitage test. Logistic regression was employed to analyze the factors influencing HBRB in MSM. RESULTS: From 1989 through to 2022, a total of 1,457,218 individuals aged 15 years or older in China, who reported being infected with HIV, indicated they had one or more types of contact histories including injecting drug use, male homosexual behavior, commercial plasma donation, and high-risk heterosexual behavior. Among these, 97.0% reported a single type of contact history, while 3.0% reported having multiple contact histories. Of those with multiple contact histories, 98.0% (42,258 individuals) had engaged in HRHB. Among all HIV-infected IDUs, MSM, and FPDs, their respective proportions of engagement in HRHB were 11.8%, 5.7% and 6.2%. Prior to 2012, most were reported to be IDUs; however, subsequent to this, most reported being MSM. Factors that heightened the risk of engaging in HRHB among HIV-infected MSM included being of age between 25-34 years [adjusted odds ratio (AOR) = 1.29] or 35-44 years (AOR = 1.22), marital status such as being married (AOR = 1.23) or being divorced/widowed (AOR = 1.17), belonging to an ethnic minority (AOR = 1.29), receiving diagnosis in hospitals (AOR = 1.81), residing in rural areas (AOR = 1.12), among others. However, the risk of HRHB decreased when age ≥ 55 years (55-64 years: AOR = 0.82; ≥ 65 years: AOR = 0.64). CONCLUSION: The potential for HIV transmission among diverse populations is substantial. As such, it is imperative that strategies are implemented to mitigate the propagation of HIV to the general populace via heterosexual intercourse.

Interpersonal Communication Strategies to Increase Iron-Folic Acid Supplement Consumption: Reduction in Anemia Through Normative Innovations (RANI) Project.

More than half of women of reproductive age in India are anemic. This study investigates the role of interpersonal communication in increasing the consumption of iron-folic acid supplements. Interventions that increase interpersonal communication may influence and empower individuals and the larger community in promoting behavior change. This investigation uses data from a cluster randomized intervention to understand the pathways by which interpersonal communication mediates the consumption of iron-folic acid supplements. Longitudinal data from control and intervention arms in rural Odisha, India, were collected at baseline (N = 3,691) and 20 months later at end-line (N = 3,394). Structural equation models highlighted the positive role of interpersonal communication in mediating iron-folic acid supplement use. This study illustrates that even during social distancing due to COVID-19, strategic interpersonal communication can improve iron-folic acid supplement use. Our results elucidate two key interpersonal communication pathways at play, namely the ritualistic and instrumental pathways in improving health behavior change in the community.

Excess mortality and associated factors among people living with HIV initiating highly active antiretroviral therapy in Luzhou, China 2006-2020.

BACKGROUND: To estimate crude mortality, excess mortality, and standardized mortality rates (SMR) among people living with HIV (PLHIV) initiating highly active antiretroviral therapy (HAART) in Luzhou, China 2006-2020, and assess associated factors. METHODS: PLHIV initiating HAART in the HIV/AIDS Comprehensive Response Information Management System (CRIMS) in Luzhou, China 2006-2020 were included in the retrospective cohort study. The crude mortality, excess mortality, and SMR were estimated. Multivariable Poisson regression model was used for analyzing risk factors associated with excess mortality rates. RESULTS: The median age among 11,468 PLHIV initiating HAART was 54.5 years (IQR:43.1-65.2). The excess mortality rate decreased from 1.8 deaths/100 person-years (95% confidence interval [CI]:1.4-2.4) in 2006-2011 to 0.8 deaths/100 person-years (95%CI:0.7-0.9) in 2016-2020. SMR decreased from 5.4 deaths/100 person-years (95%CI:4.3-6.8) to 1.7 deaths/100 person-years (95%CI:1.5-1.8). Males had greater excess mortality with the eHR of 1.6 (95%CI:1.2-2.1) than females. PLHIV with CD4 counts ≥ 500 cells/µL had the eHR of 0.3 (95%CI:0.2-0.5) in comparison to those with CD4 counts < 200 cells/µL. PLHIV with WHO clinical stages III/IV had greater excess mortality with the eHR of 1.4 (95%CI:1.1-1.8). PLHIV with time from diagnosis to HAART initiation ≤ 3 months had the eHR of 0.7 (95%CI:0.5-0.9) compared to those with time ≥ 12 months. PLHIV with initial HAART regimens unchanged and viral suppression had the eHR of 1.9 (95%CI:1.4-2.6) and 0.1 (95%CI:0.0-0.1), respectively. CONCLUSIONS: The excess mortality and SMR among PLHIV initiating HAART in Luzhou, China decreased substantially from 2006 to 2020, but the mortality rate among PLHIV was still higher than general population. PLHIV who were male, with baseline CD4 counts less than 200 cells/µL, WHO clinical stages III/IV, time from diagnosis to HAART initiation ≥ 12 months, initial HAART regimens unchanged, and virological failure had a greater risk of excess deaths. Early and efficient HAART would be significant in reducing excess mortality among PLHIV.

Potential clinical utility of liquid biopsy in early-stage non-small cell lung cancer.

BACKGROUND: Liquid biopsy has been widely researched for early diagnosis, prognostication and disease monitoring in lung cancer, but there is a need to investigate its clinical utility for early-stage non-small cell lung cancer (NSCLC). METHODS: We performed a meta-analysis and systematic review to evaluate diagnostic and prognostic values of liquid biopsy for early-stage NSCLC, regarding the common biomarkers, circulating tumor cells, circulating tumor DNA (ctDNA), methylation signatures, and microRNAs. Cochrane Library, PubMed, EMBASE databases, ClinicalTrials.gov, and reference lists were searched for eligible studies since inception to 17 May 2022. Sensitivity, specificity and area under the curve (AUC) were assessed for diagnostic values. Hazard ratio (HR) with a 95% confidence interval (CI) was extracted from the recurrence-free survival (RFS) and overall survival (OS) plots for prognostic analysis. Also, potential predictive values and treatment response evaluation were further investigated. RESULTS: In this meta-analysis, there were 34 studies eligible for diagnostic assessment and 21 for prognostic analysis. The estimated diagnostic values of biomarkers for early-stage NSCLC with AUCs ranged from 0.84 to 0.87. The factors TNM stage I, T1 stage, N0 stage, adenocarcinoma, young age, and nonsmoking contributed to a lower tumor burden, with a median cell-free DNA concentration of 8.64 ng/ml. For prognostic analysis, the presence of molecular residual disease (MRD) detection was a strong predictor of disease relapse (RFS, HR, 4.95; 95% CI, 3.06-8.02; p < 0.001) and inferior OS (HR, 3.93; 95% CI, 1.97-7.83; p < 0.001), with average lead time of 179 ± 74 days between molecular recurrence and radiographic progression. Predictive values analysis showed adjuvant therapy significantly benefited the RFS of MRD + patients (HR, 0.27; p < 0.001), while an opposite tendency was detected for MRD - patients (HR, 1.51; p = 0.19). For treatment response evaluation, a strong correlation between pathological response and ctDNA clearance was detected, and both were associated with longer survival after neoadjuvant therapy. CONCLUSIONS: In conclusion, our study indicated liquid biopsy could reliably facilitate more precision and effective management of early-stage NSCLC. Improvement of liquid biopsy techniques and detection approaches and platforms is still needed, and higher-quality trials are required to provide more rigorous evidence prior to their routine clinical application.

Aberrant FBXW7-mediated ubiquitination and degradation of ZMYND8 enhances tumor progression and stemness in bladder cancer.

ZMYND8, an epigenetic regulator, was identified as a common oncogene across various tumors. However, little was reported about the association between ZMYND8 and bladder cancer. Besides, aberrant mechanisms that contribute to abnormal ZMYND8 expressions still remain unclear. In the current study, we first found that ZMYND8 protein levels were significantly elevated in Bca samples versus normal tissues, but not the mRNA levels. We then utilized the Cell Counting Kit-8 (CCK-8) assay, clone formation assay and transwell analysis to confirm that ZMYND8 could remarkably promote the tumor progression in vitro, including growth capacity and migration. Bioinformatic predictive analysis revealed that E3 ubiquitin ligase FBXW7 interacts directly with ZMYND8 and degrades ZMYND8 in a polyubiquitination manner. Low FBXW7 was a hazard factor for promoting and depending on accumulated ZMYND8 proteins to promote Bca progression. Gene set enrichment analysis (GSEA) further indicated that ZMYND8 was notably associated with stemness process, which was well functionally validated. Lastly, ZMYND8 deficiency was observed to inhibit tumor growth of Bca in vivo, revealing a promising translational significance in Bca treatment. In conclusion, our study for the first time provided evidence for a novel mechanism of FBXW7/ZMYND8 axis in Bca, providing therapeutic vulnerability for individualized cancer treatment.

Partnering with immigrant families to promote language justice and equity in education.

Despite US federal legislation mandates institutions to provide meaningful access and participation to students and families in educational settings, culturally and linguistically diverse (CLD) families and caregivers of children in special education experience cultural and linguistic barriers. A Community Advisory Team (CAT) of parents, advocates, community interpreters and translators, researchers, and teachers explored CLD families' experiences and advocacy efforts. Critical bifocality and circuits of dispossession, privilege, and resistance informed the documentation of inequities and resistance to understand the linkages of structural arrangements of power. Focus groups with families (n = 21) speakers of Spanish, Portuguese, and Cantonese were conducted. Findings indicate perceived discrimination, poor and inadequate interpretation and translation services impact children's access to special education services, hinder family's communication with schools and reduce the perceptions of schools as trustworthy institutions. Families advocate relentlessly for their children and recommend schools listen to families and hire culturally and linguistically competent interpreters and translators. Community psychologists can make significant contributions to promote language justice in education settings through participatory approaches to inquiry that value CLD families' knowledge and expertise.

Dietary Diversity and Its Associations with Anemia among Women of Reproductive Age in Rural Odisha, India.

The aim of this study is to examine diet diversity, predictors associated with it, and its associations with anemia among non-pregnant women of reproductive age in rural India. Baseline data from the Reductions in Anemia through Normative Innovations (RANI) project were used and included 980 non-pregnant women aged 15-49 years from Odisha, India. The Food and Agriculture Organization's Minimum Dietary Diversity for Women (MDD-W) was used to assess diet diversity. Anemia was determined by hemoglobin level and categorized as normal (hemoglobin ≥ 12 g/dL), mild (11 ≤ hemoglobin <12 g/dL) and moderate/severe (hemoglobin < 11 g/dL). Multivariable logistic regression was used to examine factors associated with diet diversity, and multinomial logistic regression for associations between diet diversity and anemia. Forty-four percent of women were classified as having a diverse diet (MDD-W ≥5). Women with higher education level, belonging to a scheduled caste (vs. tribe), and higher body mass index had higher odds of a diversified diet (p < .05 for all). A more diverse diet was associated with 30% of lower odds of mild anemia (odds ratio = 0.7, 95% confidence interval: 0.5-0.98, p = .035), however, no statistically significant associations were found for moderate/severe anemia. Diet diversity was inversely associated with prevalence of mild anemia among non-pregnant women of reproductive age in rural India.

Vegetarian diet is inversely associated with prevalence of depression in middle-older aged South Asians in the United States.

Objective: To investigate associations between a vegetarian diet and depression among South Asians in the United States.Design: Data from 892 South Asians (age range 40-83 y, 47% women) enrolled in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study were included. A vegetarian diet was defined as no intake of meat, poultry or fish in the previous year as reported on a validated food frequency questionnaire. Depressive symptomology was assessed using the Center for Epidemiologic Studies-Depression Scale (CES-D) and depression was classified as CES-D score ≥16. Multivariable logistic regression was used and covariates included age, sex, study site, education, smoking, body mass index, acculturation, intentional exercise, alcohol and energy intake, and antidepressant medication use.Results: Our study demonstrated 43% lower odds of depression among vegetarians (p = 0.023).Conclusions: Vegetarian diet was found to be inversely associated with the prevalence of depression. Longitudinal examinations confirming these findings are needed.

Differences in Diet Quality among Multiple US Racial/Ethnic Groups from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study and the Multi-Ethnic Study of Atherosclerosis (MESA).

BACKGROUND: Diet quality is an important risk factor for type 2 diabetes (T2D) and cardiovascular disease (CVD). Little is known about the diet quality of South Asians in the United States, a group with higher rates of T2D and CVD compared with other racial/ethnic groups. OBJECTIVE: This study determined whether diet quality differs between South Asian adults in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study and whites, Chinese Americans, African Americans, and Hispanics in the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS: Cross-sectional data from 3926 participants free of CVD from MESA visit 5 (2010-2011) and 889 South Asian participants from MASALA visit 1 (2010-2013) were pooled. Diet quality was assessed using the Alternative Healthy Eating Index (AHEI-2010) derived using FFQs. Multivariable linear regression models adjusted for age, sex, and total energy intake were used to compare mean differences in diet quality between the racial/ethnic groups. RESULTS: MESA participants were, on average, 14 y older than MASALA participants. The adjusted mean (95% CI) scores for the AHEI-2010 were 70.2 (69.5, 70.9) among South Asians, 66.2 (66.3, 68.2) among Chinese Americans, 61.1 (60.7, 61.6) among whites, 59.0 (58.4, 59.7) among Hispanics, and 57.5 (56.9, 58.1) among African Americans. The mean AHEI scores among South Asians were 3.1 (1.8, 4.3), 9.2 (8.3, 10.1), 11.2 (10.2, 12.3), and 12.8 (11.8, 13.7) points higher compared with Chinese Americans, whites, Hispanics, and African Americans, respectively. CONCLUSIONS: South Asian adults in the United States have a higher diet quality compared with other racial/ethnic groups. This paradoxical finding is not consistent with the observed higher rates of T2D and CVD compared with other groups. This is further evidence of the importance of studying the South Asian population to better understand the causes of chronic disease not explained by diet quality.

Evaluation of a pragmatic trial of a collaborative school-based obesity prevention intervention in a low-income urban district.

Broader adoption of effective school-based obesity prevention interventions is critical to the success of ongoing efforts to address the childhood obesity epidemic. School-level barriers to adopting evidence-based interventions may be overcome by empowering school-level leaders to select appropriate intervention components. We used a quasi-experimental pragmatic trial design to evaluate a tailored obesity prevention intervention in 9 schools in a mid-sized urban school district in upstate New York from fall 2013 to spring 2016. We analyzed repeated height and weight measurements from an existing district screening system on 5882 students from intervention and control schools matched using propensity score methods. We assessed diet and physical activity changes in intervention schools using surveys and direct observation. The intervention led to a change of -0.27 (p = 0.026, 95% Confidence Interval (CI): -0.51, -0.03) and -0.28 (p = 0.031, 95% CI: -0.54, -0.03) BMI units in spring 2014 and fall 2014, respectively. There were no significant differences between intervention and control from spring 2015 to spring 2016. Despite the lack of sustained effects on BMI, we demonstrated the potential of supporting school leaders in a low-income district to implement supportive policy and practice changes and of using an existing BMI screening system to reduce the burden of health promotion evaluation.

Diet quality and hearing loss among middle-older aged adults in the USA: findings from National Health and Nutrition Examination Survey.

OBJECTIVE: To examine the associations between overall diet quality and hearing function among middle-older aged adults in the USA. DESIGN: Cross-sectional analysis. Diet quality was examined using the Mediterranean Diet Score (MDS), using data from a single 24 h dietary recall. Hearing function was objectively measured by audiometry assessments and hearing loss, including high- and low-frequency hearing loss, was defined as pure-tone averages at specific ranges of hearing frequencies >25 dB. Weighted logistic regression analyses were performed to examine the associations of MDS (scored 0-9, categorized at the median as ≤3 or >3) with hearing loss and high- and low-frequency hearing loss. SETTING: National Health and Nutrition Examination Surveys 2000-2006 and 2009-2012. PARTICIPANTS: Adults aged ≥50 years (n 1639) with valid dietary and audiometry assessments. RESULTS: After adjusting for potential confounders, a non-significant trend for a protective association of higher MDS was observed for hearing loss (OR = 0·78; 95 % CI 0·49, 1·23). A significant inverse association was observed for high-frequency hearing loss (OR = 0·64; 95 % CI 0·43, 0·95). No association was found for low-frequency hearing loss among women; however, higher MDS was significantly associated with higher odds of low-frequency hearing loss among men (OR = 2·63; 95 % CI 1·39, 4·95). CONCLUSIONS: Among middle-older aged adults, adherence to a Mediterranean-style diet was inversely associated with hearing loss, including those at high hearing frequencies, among older adults. However, a detrimental association was observed at low hearing frequencies among men. Future investigations with a longitudinal design are needed to clarify the associations between diet quality and hearing loss.

Sexual Abuse Prevention Education for Preschool-Aged Children: Parents' Attitudes, Knowledge and Practices in Beijing, China.

The purpose of this study was to investigate Chinese parents' attitudes, knowledge, and practices with their preschool-aged children on sexual abuse prevention education, and to explore the associated factors of parental educative practices on child sexual abuse (CSA) prevention. Four hundred and forty parents of young children from 16 classes in 3 preschools in Beijing completed the questionnaire anonymously and voluntarily (response rate = 80%). Less than one third of parents believed that children most often were sexually abused by familiar persons, and less than 30% of parents believed that if a child has been sexually abused, there will usually be no obvious physical evidence. Parents were reluctant to discuss CSA protective skills with their young children. Less than half of the parents had told their children that if sexual abuse happens, parents or other trusted adults should be told. The multivariate linear regression equation showed that both parents' knowledge (B = 0.11, SE B = 0.05, p = 0 .03) and attitudes (B = 0.27, SE B = 0.10, p = .01) were significant factors for parents' communication about CSA prevention with their children. Findings from this study suggest that it is urgent to implement the sexual abuse prevention education with Chinese parents of preschoolers. Applications and limitations of these findings are discussed.

The joint associations of weight status and physical activity with mobility disability: The NIH-AARP Diet and Health Study.

BACKGROUND/OBJECTIVES: The purpose of this study was to determine the joint associations of weight status and physical activity with mobility disability in older men and women. SUBJECTS/METHODS: We analyzed prospective data from 135,220 participants in the NIH-AARP Diet and Health Study between 1995-1996 and 2004-2005. METHODS: Height and weight, as well as light- and moderate-to-vigorous-intensity physical activity typical of the past 10 years (h/week) were self-reported at baseline, and body mass index (BMI: kg/m2) was categorized into normal weight (BMI 18 to <25 kg/m2); overweight (BMI 25 to <30 kg/m2); and obese (BMI ≥ 30 kg/m2). Mobility was assessed by self-report at follow-up and mobility disability was defined as reporting "unable to walk" or an "easy usual walking pace (<2 mph)". Multivariable logistic regression determined the independent and joint associations of weight status and total physical activity with the odds of mobility disability. RESULTS: Twenty-one percent of men and 37% of women reported a mobility disability at follow-up. We observed a curvilinear dose-response association between increasing categories of weight status and mobility disability within each tertile of physical activity, with the highest odds experienced by men and women with overweight (OR = 2.45; 95%CI: 2.25, 2.67 for men and OR = 2.99; 95%CI: 2.78, 3.22 for women) and obesity (OR = 3.93; 95%CI: 3.58, 4.32 for men and OR = 5.08; 95% CI: 4.65, 5.54 for women) in combination with low physical activity. Moreover, among those reporting 7 or fewer hours/week of total physical activity, being of normal body weight did not eliminate the excess odds of mobility disability. CONCLUSIONS: These findings highlight the combined importance of obesity prevention and physical activity promotion to mobility in older age. Given aging demographics and the global economic burden associated with aging- and disuse-related disability, there is tremendous public health benefit to understanding how various modifiable determinants of mobility disability can interact in older age.

Knowledge, Attitude and Practice of Child Sexual Abuse Prevention among Parents of Children with Hearing Loss: A Pilot Study in Beijing and Hebei Province, China.

This study aimed to examine the knowledge, attitude, and practice (KAP) of child sexual abuse (CSA) prevention among parents of children with hearing loss. The study involved 127 pairs of parents with deaf and hard of hearing children from three special education schools in Beijing and Hebei province, China. The findings revealed that the parents lacked knowledge about CSA prevention, such as the character of perpetrators and child victims. Parents were supportive about potential CSA prevention education in schools. Most parents told children much about personal safety, but topics on CSA prevention were still insufficient. The study also found that education level was significantly associated with knowledge and attitude. Elder parents knew more and talked more about CSA prevention. Mothers and girls' parents were more willing to communicate with children about CSA prevention. The conclusion of the study was that parents appeared to have gained a positive attitude, but poor knowledge and practice. Their knowledge and skills of effective communication should be strengthened to promote CSA prevention practice.

Vegetarian Diets Are Associated with Selected Cardiometabolic Risk Factors among Middle-Older Aged South Asians in the United States.

Background: Following a vegetarian diet is considered to be beneficial for overall health and is associated with a lower risk of chronic disease. Objective: This study examined whether South Asians in the United States who consume a vegetarian diet have a lower prevalence of cardiometabolic risk factors. Methods: Data from the Mediators of Atherosclerosis in South Asians Living in America study, which included 892 South Asians (47% women), with an age range of 40-83 y and a mean ± SD age of 55 ± 9.4 y, were used. Participants were classified as vegetarian if they reported no consumption of meat, poultry, or fish in the previous year on a validated and culturally appropriate food-frequency questionnaire. Adjusted linear and logistic regression models were used to examine associations of a vegetarian diet with cardiometabolic risk factors. Results: Thirty-eight percent of the cohort participants were classified as vegetarian. Vegetarians reported more frequent weekly eating occasions of whole grains (median frequency/wk: 10 compared with 9, P = 0.012) and beans and legumes (median frequency/wk: 8.5 compared with 5.1, P < 0.001), and less frequent weekly eating occasions of sweets and desserts (median frequency/wk: 1.9 compared with 2.3, P < 0.001). Consuming a vegetarian diet was associated with lower body mass index (P = 0.023), fasting glucose (P = 0.015), insulin resistance (P = 0.003), total cholesterol (P = 0.027), and LDL cholesterol (P = 0.004) and lower odds of fatty liver (OR: 0.43; 95% CI: 0.23, 0.78, P = 0.006). The odds of having any coronary artery calcium were lower for vegetarian men (OR: 0.53; 95% CI: 0.32, 0.87, P = 0.013); however, no significant associations were observed among women. Conclusions: Among US South Asians, a vegetarian diet was associated with fewer cardiometabolic risk factors overall and with less subclinical atherosclerosis among men.

Prevalence of low-calorie sweetener intake in South Asian adults.

BACKGROUND: Consumption of low-calorie sweeteners (LCS) has increased in the US and is associated with cardiometabolic risk. No data exist on LCS consumption in South Asians. AIM: The aim of this study was to assess the prevalence of LCS use across socio-demographic characteristics, chronic disease status, and cardiometabolic risk factors. METHODS: Cross-sectional analyses were conducted using data from the Mediators of Atherosclerosis in South Asians Living in America study (N = 892; 47% women; mean age = 55 (standard deviation = 9.4) y). Chi-squared and ANOVA tests were used to compare LCS consumption across socio-demographic characteristics and cardiometabolic risk factors. RESULTS: Twenty-two percent of participants reported LCS use, with higher consumption among men and those with longer residency in the US. LCS use was associated with adiposity and higher odds of hypertension, high cholesterol, and diabetes. CONCLUSIONS: LCS use is prevalent among South Asians, emphasizing the need for long-term, prospective studies to investigate its role in incident cardiometabolic risk in an already metabolically vulnerable population.

Cardiovascular health metrics among South Asian adults in the United States: Prevalence and associations with subclinical atherosclerosis.

South Asians, a fast growing ethnic group in the US, have an increased risk for cardiovascular disease compared to the general population. We examined the prevalence and distribution of the American Heart Association's Life's Simple 7 cardiovascular health (CVH) metrics using data from Mediators of Atherosclerosis in South Asians Living in America (MASALA) study, and cross-sectional associations between number of CVH metrics in the ideal range with subclinical atherosclerosis assessed using coronary artery calcium (CAC) measured using cardiac computed tomography and carotid intima media thickness (CIMT) measured using high-resolution B-mode ultrasonography. CAC was modeled as Agatston scores=0, 1-400 and >400; CIMT was examined continuously and as internal CIMT>1.5mm. In the MASALA cohort (N=875; mean age: 55years; 53% men; living in greater San Francisco and Chicago areas; October 2010-March 2013) without prevalent coronary heart disease, no participant had all 7 metrics in ideal range; approximately 20% of the participants had at least 5 metrics in ideal range. Higher number of CVH metrics in the ideal range was inversely associated with subclinical atherosclerosis. A 1 unit increase in the number of CVH metrics in the ideal range was associated with 32% lower odds of CAC=1-400 (vs. CAC=0; OR=0.68, 95% CI: 0.60, 0.78) and 28% lower odds of internal CIMT>1.5mm (OR=72, 95% CI: 0.61, 0.85). These data show the prevalence of CVH metrics among South Asians in the US, and provide empirical evidence on inverse associations of meeting ideal levels for higher number of metrics and subclinical atherosclerosis.

Knowledge and Skills of Sexual Abuse Prevention: A Study on School-Aged Children in Beijing, China.

To examine the level of child sexual abuse prevention knowledge and skills in a sample of school-aged children, a total of 559 children from first to fifth grade were recruited from one primary school in Beijing, China. Participants were asked to finish a questionnaire surveying their knowledge and skills of child sexual abuse prevention. Results showed that accurate rate of knowledge on child sexual abuse prevention were between 44.0% and 80.0%. Percentage of participants having applied the self-protection skills of "saying 'no,'" "going away," and "telling adults" properly in hypothetical situations was 57.4%, 28.3%, and 48.3%, respectively. Third-to-fifth graders had a better performance than first-to-second graders, and girls performed better than boys. Findings suggest that Chinese school-aged children are in need of knowledge and skills related to child sexual abuse prevention, and education programs should be developed as soon as possible.

Associations between family income and children's physical fitness and obesity in California, 2010-2012.

INTRODUCTION: Socioeconomic status may influence childhood obesity prevalence and children's fitness level. The purpose of this study was to assess the association between family income and children's physical fitness level and obesity prevalence for 8 racial/ethnic groups. METHODS: Data for 1,617,400 fifth-, seventh-, and ninth-grade children who took a physical fitness test from 2010 through 2012 in California were used in this cross-sectional study. Multiple linear and log-binomial regressions were used to test whether low family income (as indicated by eligibility for National School Lunch Program) was associated with physical fitness level or obesity prevalence. Differences were tested by race/ethnicity while adjusting for age and sex. Fitness score was measured on a scale from 0 (least healthy) to 6 (most healthy). RESULTS: Average fitness score was 4.45 (standard deviation, 1.47). Prevalence of obesity was 20.3%, and 56% of children were classified as having lower family income. Lower family income (vs higher) was associated with lower fitness score (coefficient = -0.57; 95% confidence interval [CI], -0.62 to -0.53). Lower-income children had higher prevalence of obesity (relative risk = 1.81; 95% CI, 1.72-1.89) compared with higher-income children. These inverse associations were seen among American Indian, Asian, Pacific Islander, Filipino, Hispanic/Latino, African American, and white children and among children who were identified as being of 2 or more races/ethnicities. CONCLUSION: Children with lower family incomes tend to have less healthy physical fitness status and have higher risk of obesity than children with higher family incomes. This information can be used to help set policies and provide programs aimed at improving fitness and decreasing obesity risk among low-income children.