Disaggregating the Asian-American Breast Cancer Population: Disparities in Reconstruction Rates.

INTRODUCTION: Breast cancer (BC) incidence has been increasing among Asian-Americans (AsAms); recent data suggest these patients are less likely to undergo postmastectomy breast reconstruction (PMBR) compared to non-Asian women. Historically, AsAm BC patients are reported in aggregate, masking heterogeneity within this population. We aim to identify patterns of postmastectomy reconstruction among disaggregated AsAm BC patients at our institution. METHODS: A retrospective chart review was performed for BC patients who underwent mastectomy between 2017 and 2021. Patient demographic and clinical information was collected including self-reported race/ethnicity and reconstruction at time of mastectomy. Self-identified Asian patients were disaggregated into East Asian, Southeast Asian, South Asian, and 'Asian Other.' We examined rates of reconstruction between the different races and the disaggregated Asian subgroups. Univariable and multivariable analysis was performed to examine patient factors associated with PMBR. RESULTS: Six hundred and five patients met inclusion criteria. Forty seven percent of patients identified as Asian, 36% of which as East Asian. Forty four percent of all patients underwent PMBR. Southeast Asian and South Asian women were least likely to undergo reconstruction, while Hispanic and non-Hispanic Black women were most likely to pursue PMBR (P = 0.020). On multivariable analysis, Hispanic, non-Hispanic White, and non-Hispanic Black women were more likely to undergo reconstruction compared to Asian women. Other factors associated with reconstruction were coverage with private insurance and diagnosis of noninvasive disease. CONCLUSIONS: Rates of PMBR are lower among AsAms than non-Asian patients and vary between Asian ethnic subgroups. Further investigation is needed to identify patterns of reconstruction among the disaggregated AsAm population to address disparities.

Breast Cancer Incidence Among Asian American Women in New York City: Disparities in Screening and Presentation.

BACKGROUND: Asian American (AsAm) women have some of the lowest rates of up-to-date breast cancer screening, and lack of disaggregated racial/ethnic data can mask disparities. We evaluated presentation patterns among AsAms at two hospitals with distinct communities: New York Presbyterian-Queens (NYPQ), in Flushing, Queens and Weill Cornell Medical Center (WCM), on the Upper East Side (UES) neighborhood of Manhattan. PATIENTS AND METHODS: Patients with newly diagnosed breast cancer between January 2019 and December 2022 were identified using a prospective database and clinical data collected. Patients were categorized as self-reported Asian versus Non-Asian. The Asian group was disaggregated as Chinese-Asian versus Other-Asian. Physician workforce data were obtained from public records. RESULTS: A total of 3546 patients (1162 NYPQ, 2384 WCM) were included. More NYPQ patients identified as Asian compared with WCM (49 vs. 14%, p < 0.001). Asian patients were mostly East Asian Chinese (NYPQ 61%, WCM 53%). More Chinese patients at NYPQ reported Chinese as their preferred language (81 vs. 33%, p < 0.001). Greatest differences of screen-detected disease frequency were seen between NYPQ and WCM Chinese patients (75 vs. 59%, p < 0.001). Eighty percent of NYPQ Chinese patients presented with stage 0/I disease versus 69% at WCM (p = 0.007), a difference not observed between Other-Asian patients (75% NYPQ, 68% WCM, p = 0.095). 3% of UES physicians versus 16% in Flushing reported speaking Chinese. CONCLUSIONS: Chinese patients residing in a neighborhood with more Chinese-speaking physicians more frequently presented with screen-detected, early-stage breast cancer. Stage distribution differences were not apparent among the aggregated pool of Other-Asian patients, suggesting cancer disparities may be masked when ethnic groups are studied in aggregate.

Optical pulse interharmonic extraction and repetition rate division based on a microwave photonic phase detector.

Microwave photonic phase detectors (MPPDs) can extract ultrastable microwaves from a mode-locked laser (MLL), but their frequencies are often limited by the pulse repetition rate. Few works studied methods to break the frequency limitation. Here, a setup based on an MPPD and an optical switch is proposed to synchronize an RF signal from a voltage-controlled oscillator (VCO) to an interharmonic of an MLL and to realize the pulse repetition rate division. The optical switch is employed to realize pulse repetition rate division, and the MPPD is followed to detect the phase difference between the frequency-divided optical pulse and the microwave signal from the VCO, which is then fed back to the VCO via a proportional-integral (PI) controller. Both the optical switch and the MPPD are driven by the signal from the VCO. When the system reaches its steady state, the synchronization and repetition rate division are achieved simultaneously. An experiment is conducted to verify the feasibility. The 80½th, 80⅓rd, and 80⅔rd interharmonics are extracted, and pulse repetition rate division factors of two and three are realized. The phase noises at offset frequency of 10 kHz are improved by more than 20 dB.

Cancer screening educational interventions in rural and farmworker communities: a systematic literature review.

OBJECTIVES: Men and women living in rural communities of the United States (US) are less likely than those in urban or suburban communities to be up to date with cancer screenings. Delayed screening contributes to later stage at diagnosis and higher cancer mortality for individuals living in rural areas. These effects may be compounded in some rural subpopulations (e.g. migrant and seasonal farmworkers). This systematic review examines educational interventions aimed at increasing colorectal, breast, prostate, oral, and/or cervical cancer screening in the rural US, with special consideration for the farmworker subpopulation. DESIGN: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, our systematic literature review employed the following databases: Ovid MEDLINE, CINAHL Complete, Embase, and Web of Science. Search terms included, but were not limited to 'rural,' 'cancer screening,' 'farmworker,' and 'cancer prevention.' Eligible studies featured an educational intervention implemented in agricultural or rural US settings with a cancer screening behavioral outcome, male and/or female participants, and were published in English between 2002 and 2020. Article screening and data extraction were conducted by two independent reviewers. RESULTS: Twenty-six articles were eligible. Of the six studies focused on the farmworker population (n=2,732), 61.75% of participants reported Hispanic ethnicity. Of the sixteen studies on unspecified rural communities reporting participant race/ethnicity (n=10,442), 39.29% reported Black/African American race. Efficacious interventions included culturally-targeted educational materials, lay health advisors (LHAs), and components that addressed practical barriers (e.g. financial or logistical). CONCLUSION: Results demonstrate the value of LHAs and targeted education to increase screening for multiple cancer types in rural communities. Prospective research should incorporate and facilitate access to screening and provider-level and/or organizational-level interventions to increase overall impact. ABBREVIATIONS: HPV: human papillomavirus; LHA: lay health advisors; MeSH: Medical Subject Headings; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; RCT: randomized controlled trial; US: United States.

Fluffy-Like Cation-Exchanged Prussian Blue Analogues for Sodium-Ion Battery Cathodes.

Prussian blue (PB) and its analogues are considered as promising cathode materials for sodium-ion batteries (SIBs) owing to their low cost and high capacity. However, it is still a huge challenge to avoid obvious capacity decay during cycling due to the structural collapse. Herein, we design a method to replace parts of Fe ion sites in PB with Ni ions to prepare fluffy-like nickel PB (PB-Ni) by cationic solution immersion, which improves cycling stability for sodium storage. The content of Ni in PB-Ni is explored by regulating the soaking time in the Ni-containing solution, which results in different effects on the electrochemical performance as cathodes of SIBs. Especially, PB-Ni-1d (soaking in NiCl2 solution for 1 day) exhibits an initial capacity of 114.2 mA h g-1 at 50 mA g-1 and a stable cycling performance of 800 cycles at 300 mA g-1. Furthermore, the reversible phase transformation and small volume variation for PB-Ni-1d are revealed by in situ X-ray diffraction characterization. The nickel hexacyanoferrate in outer layer maintains the cubic phase to stabilize the crystal structure. The cation-exchange strategy provides a facile idea to fabricate high-quality PB cathodes with superior stability for high-performance SIBs.

Insight on Cathodes Chemistry for Aqueous Zinc-Ion Batteries: From Reaction Mechanisms, Structural Engineering, and Modification Strategies.

By virtue of low cost, eco-friendliness, competitive gravimetric energy density, and intrinsic safety, more and more attention has increasingly focused on aqueous zinc ion batteries (AZIBs) as a promising alternative for scalable energy storage. However, plagued by a complex interfacial process, sluggish dynamics, lability of electrodes and electrolytes, insufficient energy density, and poor cycle life heavily restrict practical applications of AZIBs, indicating that profound understandings on cathode storage chemistry are necessarily needed. Hence, this paper comprehensively summarizes recent advance in cathodes with critical insight on the energy storage mechanism. Furthermore, the issues and challenges for high-performance cathodes are meticulously explored, presenting inspiring structural engineering and modification strategies. Finally, rational evaluations on representative cathodes are rendered, suggesting the potential development direction of AZIBs.

Delivery of Curcumin Using Zein-Gum Arabic-Tannic Acid Composite Particles: Fabrication, Characterization, and in vitro Release Properties.

The application of curcumin (Cur) in fat-free food is limited due to its poor water solubility, stability, and bioaccessibility. In this study, zein-gum arabic-tannic acid (zein-GA-TA) composite particles with high physical stability were fabricated to deliver Cur (ZGT-Cur). Their stability and in vitro release properties were also evaluated. The results showed that the thermal and photochemical stability of Cur was improved after loading into composite particles. Meanwhile, the retention rate of Cur in ZGT-Cur composite particles was enhanced compared with Z-Cur or ZG-Cur particles. Fourier transform infrared (FTIR) spectroscopy confirmed that the hydrogen bond within the particles was greatly enhanced after the addition of tannic acid (TA). The in vitro antioxidant activity of Cur in ZGT-Cur composite particles was higher in terms of 2,2'-azino-bis (ABTS) (93.64%) and 1,1-diphenyl-2-picrylhydrazyl (DPPH) (50.41%) compared with Z-Cur or ZG-Cur particles. The bioaccessibility of Cur in ZGT-Cur composite particles was 8.97 times higher than that of free Cur. Therefore, the particles designed in this study will broaden the application of Cur in the food industry by improving its stability and bioaccessibility.

Polarization-insensitive coupled optoelectronic oscillator with low spurious tones and phase noise.

A coupled optoelectronic oscillator (COEO) based on σ-shaped fiber ring structure and intra-cavity semiconductor optical amplifier (SOA) is proposed and experimentally demonstrated. The σ-shaped fiber ring structure is skillfully utilized in COEO to eliminate the harmful influence of polarization disturbance. The SOA is embedded for super-mode suppression due to the fast gain saturation effect. The eximious phase noise performance of COEO could be maintained by operating the SOA at the unitary gain regime. The stable operation of COEO is guaranteed by the immunity to polarization fluctuation and the greatly suppressed spurious-mode competition. As a result, a 10-GHz signal is generated featuring high spectral purity and ultra-low spurious tones as soon as the system is power-on, and can hold steady even if the polarization changes dramatically. The single sideband phase noise of the proposed COEO is about -133 dBc/Hz at 10-kHz offset frequency, and the spurious suppression ratio reaches more than 95 dB, which is 60-dB superior than the conventional COEO.

Delayed diagnosis of butyrylcholinesterase deficiency with insufficient neuromuscular monitoring and a confounding effect of SedLine® brain function monitoring: a case report.

Intraoperative monitoring has always been a vital part of the care of an anaesthetised patient. Neuromuscular monitoring is important to use when patients have received neuromuscular blocking agents. Quantitative neuromuscular monitors are preferred over qualitative monitors and clinical judgement alone in reducing residual neuromuscular block and the associated respiratory complications. Additionally, brain function monitors can be utilised to assess the level of consciousness in anaesthetised patients. These monitors can be useful during surgical procedures and at the conclusion of a procedure to show the progress of a patient emerging from anaesthesia. We describe a case where a lack of neuromuscular monitoring after a single dose of succinylcholine coupled with an overemphasis on SedLine® brain function monitor values delayed the diagnosis of butyrylcholinesterase deficiency in a patient undergoing a mastectomy for breast cancer. This case shows the fundamental importance of using neuromuscular monitors in patients who receive neuromuscular blocking agents. It also stresses the necessity to utilise brain function monitors as clinical aids, but not allow them to hinder thinking about broader differential diagnoses when faced with challenging clinical scenarios.

Baseline Characteristics of Mitochondrial DNA and Mutations Associated With Short-Term Posttreatment CD4+T-Cell Recovery in Chinese People With HIV.

Background: Mitochondrial DNA (mtDNA) profiles and contributions of mtDNA variants to CD4+T-cell recovery in Euramerican people living with HIV (PLWH) may not be transferred to East-Asian PLWH, highlighting the need to consider more regional studies. We aimed to identify mtDNA characteristics and mutations that explain the variability of short-term CD4+T-cell recovery in East-Asian PLWH. Method: Eight hundred fifty-six newly reported antiretroviral therapy (ART)-naïve Chinese PLWH from the Comparative HIV and Aging Research in Taizhou (CHART) cohort (Zhejiang Province, Eastern China) were enrolled. MtDNA was extracted from peripheral whole blood of those PLWH at HIV diagnosis, amplified, and sequenced using polymerase chain reaction and gene array. Characterization metrics such as mutational diversity and momentum were developed to delineate baseline mtDNA mutational patterns in ART-naïve PLWH. The associations between mtDNA genome-wide single nucleotide variants and CD4+T-cell recovery after short-term (within ~48 weeks) ART in 724 PLWH were examined using bootstrapping median regressions. Results: Of 856 participants, 74.18% and 25.82% were male and female, respectively. The median age was 37 years; 94.51% were of the major Han ethnicity, and 69.04% and 28.62% were of the heterosexual and homosexual transmission, respectively. We identified 2,352 types of mtDNA mutations and mtDNA regions D-loop, ND5, CYB, or RNR1 with highest mutational diversity or volume. Female PLWH rather than male PLWH at the baseline showed remarkable age-related uptrends of momentum and mutational diversity as well as correlations between CD4+T <200 (cells/µl) and age-related uptrends of mutational diversity in many mtDNA regions. After adjustments of important sociodemographic and clinical variables, m.1005T>C, m.1824T>C, m.3394T>C, m.4491G>A, m.7828A>G, m.9814T>C, m.10586G>A, m.12338T>C, m.13708G>A, and m.14308T>C (at the Bonferroni-corrected significance) were negatively associated with short-term CD4+T-cell recovery whereas m.93A>G, m.15218A>G, and m.16399A>G were positively associated with short-term CD4+T-cell recovery. Conclusion: Our baseline mtDNA characterization stresses the attention to East-Asian female PLWH at risk of CD4+T-cell loss-related aging and noncommunicable chronic diseases. Furthermore, mtDNA variants identified in regression analyses account for heterogeneity in short-term CD4+T-cell recovery of East-Asian PLWH. These results may help individualize the East-Asian immune recovery strategies under complicated HIV management caused by CD4+T-cell loss.

Ultrathin Surface Coating of Nitrogen-Doped Graphene Enables Stable Zinc Anodes for Aqueous Zinc-Ion Batteries.

Owing to the high volumetric capacity and low redox potential, zinc (Zn) metal is considered to be a remarkably prospective anode for aqueous Zn-ion batteries (AZIBs). However, dendrite growth severely destabilizes the electrode/electrolyte interface, and accelerates the generation of side reactions, which eventually degrade the electrochemical performance. Here, an artificial interface film of nitrogen (N)-doped graphene oxide (NGO) is one-step synthesized by a Langmuir-Blodgett method to achieve a parallel and ultrathin interface modification layer (≈120 nm) on Zn foil. The directional deposition of Zn crystal in the (002) planes is revealed because of the parallel graphene layer and beneficial zincophilic-traits of the N-doped groups. Meanwhile, through the in situ differential electrochemical mass spectrometry and in situ Raman tests, the directional plating morphology of metallic Zn at the interface effectively suppresses the hydrogen evolution reactions and passivation. Consequently, the pouch cells pairing this new anode with LiMn2 O4 cathode maintain exceptional energy density (164 Wh kg-1 after 178 cycles) at a reasonable depth of discharge, 36%. This work provides an accessible synthesis method and in-depth mechanistic analysis to accelerate the application of high-specific-energy AZIBs.

High-performance millimeter-wave synergetic optoelectronic oscillator with regenerative frequency-dividing oscillation technique.

A novel millimeter-wave synergetic optoelectronic oscillator based on regenerative frequency-dividing oscillation and phase-locking techniques is proposed and experimentally demonstrated. The regenerative frequency-dividing oscillator is embedded for millimeter-wave frequency division, and then synergistically oscillates with the optoelectronic oscillator (OEO) due to injection-locking effect. The phase-locking stabilization technique is skillfully utilized in millimeter-wave OEO via commercial analog phase shifter. As a result, a 40-GHz signal is generated featuring low phase noise, high stability and low spurs. The single-sideband phase noise is about -117 dBc/Hz at 10-kHz offset frequency and the spurious suppression ratio reaches more than 80 dBc. The measured overlapping Allan deviation of the proposed synergetic OEO reaches lower than 10-13 at 1024-s averaging time, which is five orders of magnitude lower than free-running millimeter-wave OEO.

Frequency-demultiplication OEO for stable millimeter-wave signal generation utilizing phase-locked frequency-quadrupling.

A novel scheme for the generation and stabilization of the millimeter-wave (mmW) signal employing a frequency-demultiplication optoelectronic oscillator (FD-OEO) has been theoretically analyzed and experimentally demonstrated. The FD-OEO can keep sustaining without optical first-order sidebands, which would help to simplify the photonic-assisted frequency multiplication process and provide a wide frequency compensation range for the mmW system simultaneously. The stability of the generated 40-GHz mmW signal reaches 1.38 × 10-12 at the average time of 100s. Besides, the measured single-sideband phase noise of the generated mmW signal exhibits as low as -103 dBc/Hz at 10-kHz offset frequency, maintaining a spurious level of -97 dBc.

The Prevalence of Attention Deficit/Hyperactivity Disorder among Chinese Children and Adolescents.

Updating the worldwide prevalence estimates of attention-deficit hyperactivity disorder (ADHD) has significant applications for the further study of ADHD. However, previous reviews included few samples of Chinese children and adolescents. To conduct a systematic review of ADHD prevalence in Mainland China, Hong Kong, and Taiwan to determine the possible causes of the varied estimates in Chinese samples and to offer a reference for computing the worldwide pooled prevalence. We searched for PubMed, Embase, PsycINFO, Web of Science, China National Knowledge Infrastructure, VIP, WANFANG DATA, and China Science Periodical Database databases with time and language restrictions. A total of 67 studies covering 642,266 Chinese children and adolescents were included. The prevalence estimates of ADHD in Mainland China, Hong Kong, and Taiwan were 6.5%, 6.4%, and 4.2%, respectively, with a pooled estimate of 6.3%. Multivariate meta-regression analyses indicated that the year of data collection, age, and family socioeconomic status of the participants were significantly associated with the prevalence estimates. Our findings suggest that geographic location plays a limited role in the large variability of ADHD prevalence estimates. Instead, the variability may be explained primarily by the years of data collection, and children's socioeconomic backgrounds, and methodological characteristics of studies.

Supermode noise suppression with mutual injection locking for coupled optoelectronic oscillator.

The coupled optoelectronic oscillator (COEO) is typically used to generate high frequency spectrally pure microwave signal with serious sidemodes noise. We propose and experimentally demonstrate a simple scheme for supermode suppression with mutual injection locking between the COEO (master oscillator with multi-modes oscillation) and the embedded free-running oscillator (slave oscillator with single-mode oscillation). The master and slave oscillators share the same electrical feedback path, which means that the mutually injection-locked COEO brings no additional hardware complexity. Owing to the mode matching and mutually injection locking effect, 9.999 GHz signal has been successfully obtained by the mutually injection-locked COEO with the phase noise about -117 dBc/Hz at 10 kHz offset frequency. Besides, the supermode noise can be significantly suppressed more than 50 dB to below -120 dBc.

CTLA-4/CD80 pathway regulates T cell infiltration into pancreatic cancer.

The ability of some tumors to exclude effector T cells represents a major challenge to immunotherapy. T cell exclusion is particularly evident in pancreatic ductal adenocarcinoma (PDAC), a disease where blockade of the immune checkpoint molecule CTLA-4 has not produced significant clinical activity. In PDAC, effector T cells are often scarce within tumor tissue and confined to peritumoral lymph nodes and lymphoid aggregates. We hypothesized that CTLA-4 blockade, despite a lack of clinical efficacy seen thus far in PDAC, might still alter T cell immunobiology, which would have therapeutic implications. Using clinically relevant genetic models of PDAC, we found that regulatory T cells (Tregs), which constitutively express CTLA-4, accumulate early during tumor development but are largely confined to peritumoral lymph nodes during disease progression. Tregs were observed to regulate CD4+, but not CD8+, T cell infiltration into tumors through a CTLA-4/CD80 dependent mechanism. Disrupting CTLA-4 interaction with CD80 was sufficient to induce CD4 T cell infiltration into tumors. These data have important implications for T cell immunotherapy in PDAC and demonstrate a novel role for CTLA-4/CD80 interactions in regulating T cell exclusion. In addition, our findings suggest distinct mechanisms govern CD4+ and CD8+ T cell infiltration in PDAC.

Estimation of disease burdens on preterm births and low birth weights attributable to maternal fine particulate matter exposure in Shanghai, China.

BACKGROUND: Studies have shown that maternal exposure to particulate matter ≤2.5µm in aerodynamic diameter (PM2.5) was associated with adverse birth outcomes such as preterm birth (PTB) and low birth weight (LBW). However, the burdens of PTB and LBW attributable to PM2.5 were rarely evaluated, especially in developing countries. OBJECTIVES: To estimate the burdens of PTBs and LBWs attributable to outdoor PM2.5 in Shanghai, China. METHODS: We collected annual-average PM2.5 concentrations, concentration-response relationships between PM2.5 exposure during pregnancy and PTBs and LBWs, rates of PTB and LBW, number of live births, and population sizes in grids of 10km×10km in Shanghai in 2013. Then, they were combined to estimate the odds ratios (ORs), relative risks (RRs), attributable fractions (AFs), and numbers of PTBs and LBWs associated with PM2.5 exposure. RESULTS: The population-weighted annual-average concentration of PM2.5 in Shanghai was 56.19µg/m3 in 2013. According to the first-class limit of PM2.5 (15µg/m3) in the Ambient Air Quality Standards of China, the weighted RRs of PTBs or LBWs associated with PM2.5 in Shanghai were 1.49 [95% confidence interval (CI): 1.16-1.80] and 1.31 (95% CI: 1.04-1.67), respectively. There might be 32.61% (95% CI: 13.93%-44.42%) or 4160 (95% CI: 1778-5667) PTBs and 23.36% (95% CI: 3.86%-40.02%) or 1882 (95% CI: 311-3224) LBWs attributable to PM2.5 exposure. The estimates varied appreciably among different districts of Shanghai. CONCLUSIONS: Our analysis suggested that outdoor PM2.5 air pollution might have led to considerable burdens of PTBs and LBWs in Shanghai, China.