Somatic and germline aberrations in homologous recombination repair genes among Chinese high-risk breast cancer patients by multi-gene next-generation sequencing.

INTRODUCTION: Recently, genes involved in homologous recombination repair (HRR) pathway have been extensively studied. However, the landscapes of HRR gene mutations remain poorly defined in Chinese high-risk breast cancer (BC) patients. Our study aims to identify the status of germline and somatic HRR gene mutations and their association with clinicopathological features in these patients. MATERIALS AND METHODS: A total of 100 high-risk BC patients from our institution who underwent paired peripheral blood germline and BC tissues somatic 26 genes next-generation sequencing (NGS) from January 2018 to July 2023 were enrolled for retrospective analysis. RESULTS: Out of 100 high-risk BC patients, 55 (55%) had at least one germline or somatic mutation in HRR genes. Among them, 22% carried germline pathogenic variants (19 BRCA1/2 and 3 non-BRCA genes), 9% harbored somatic pathogenic mutations (3 BRCA1/2 and 6 non-BRCA genes). Among high-risk factors, family history and early onset BC showed a correlation with HRR gene mutations (p < 0.05). BRCA1 germline and HRR gene somatic mutations showed a correlation with TNBC, but BRCA2 germline mutations were associated with Luminal B/HER2-negative BC (p < 0.05). Patients with HRR gene somatic pathogenic variant more likely had a lympho-vascular invasion and distant metastasis (p < 0.05). CONCLUSION: The prevalence of HRR gene germline and somatic mutations were higher in Chinese BC patients with high risk factors. We strongly recommend that these high-risk BC patients receive comprehensive gene mutation testing, especially HRR genes, which are not only related to genetic consultation for BC patients and provide a theoretical basis for necessary prevention and individualized treatment.

The mechanism of mitochondrial metabolic gene PMAIP1 involved in Alzheimer's disease process based on bioinformatics analysis and experimental validation.

OBJECTIVES: This study explored novel biomarkers that can affect the diagnosis and treatment in Alzheimer's Disease (AD) related to mitochondrial metabolism. METHODS: The authors obtained the brain tissue datasets for AD from the Gene Expression Omnibus (GEO) and downloaded the mitochondrial metabolism-related genes set from MitoCarta 3.0 for analysis. Differentially Expressed Genes (DEGs) were screened using the "limma" R package, and the biological functions and pathways were investigated by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. The LASSO algorithm was used to identify the candidate center genes and validated in the GSE97760 dataset. PMAIP1 with the highest diagnostic value was selected and its effect on the occurrence of AD by biological experiments. RESULTS: A sum of 364 DEGs and 50 hub genes were ascertained. GO and KEGG enrichment analysis demonstrated that DEGs were preponderantly associated with cell metabolism and apoptosis. Five genes most associated with AD as candidate central genes by LASSO algorithm analysis. Then, the expression level and specificity of candidate central genes were verified by GSE97760 dataset, which confirmed that PMAIP1 had a high diagnostic value. Finally, the regulatory effects of PMAIP1 on apoptosis and mitochondrial function were detected by siRNA, flow cytometry and Western blot. siRNA-PMAIP1 can alleviate mitochondrial dysfunction and inhibit cell apoptosis. CONCLUSION: This study identified biomarkers related to mitochondrial metabolism in AD and provided a theoretical basis for the diagnosis of AD. PMAIP1 was a potential candidate gene that may affect mitochondrial function in Hippocampal neuronal cells, and its mechanism deserves further study.

Associations and gender differences between OHI-seeking behaviors and eHealth literacy among Chinese university students.

OBJECTIVE: to explore associations and gender differences between OHI-seeking (online health information seeking) behaviors and eHealth (electronic health) literacy among Chinese university students. METHODS: Online questionnaires of eHealth literacy scale and OHI-seeking behaviors created in software Wenjunxing were used in this survey. Chi-squared tests, t-test, and Pearson correlation analysis were performed using SPSS for data analysis. RESULTS: Among 5,383 participants, 72.4% were girls, 77.5% lived in rural areas, 51.2% majored in liberal arts, 76.6% with low education parents. The average C-eHEALS scores of boys and girls were 26.53 ± 5.861 and 26.84 ± 5.816, respectively, with no significant difference (P = 0.084). The top three OHI-seeking behaviors for boys and girls, as well as for the C-eHEALS low and high groups, were "finding information about physical exercises" "reading or sharing health information via social media" "finding information about nutrition and diet", all of which had significant gender and eHealth literacy differences. CONCLUSIONS: Gender and eHealth literacy differences should be focused for intervention when developing and implementing eHealth intervention training for parents and adolescents in schools and communities.

Bibliometric analysis of childhood-onset systemic lupus erythematosus from 2000 to 2022.

BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disorder. When SLE occurs in individuals under the age of 18, it is referred to as childhood-onset SLE (cSLE). Currently, there is a dearth of bibliometric research pertaining to cSLE. METHOD: Relevant studies in the field of cSLE from 2000 to 2022 were screened from the Web of Science Core Collection (WoSCC). CiteSpace and VOSviewer software were used to visualize the annual publications, countries, institutions, authors, journals, keywords, and references, after which the authors conducted the scientific analysis. RESULTS: A total of 2857 articles were included in this study, and the number of articles published in the past 20 years showed an overall upwards trend. The most prolific countries are the United States, China, and Brazil; however, the United States, Canada, and the United Kingdom are clearly superior in terms of literary influence, and there is more cooperation between them and their institutions. LUPUS (n = 389) contributed the most to the variance. Brunner, HI's contribution in the field of cSLE is outstanding. The words related to 'lupus nephritis' and 'antibodies' are important words reflected in the keyword network diagram. The keywords included 'evidence-based recommendation', 'validation', 'diagnosis' and 'adult' from 2019, and 'continuous bursts' to the present. CONCLUSION: This study examined the research status of cSLE patients, discussed and analysed the research hotspots and trends in this field, and provided a reference for further research in this field to promote the development of cSLE research.

The mechanism of mitochondrial metabolic gene PMAIP1 involved in Alzheimer's disease process based on bioinformatics analysis and experimental validation

Abstract Objectives This study explored novel biomarkers that can affect the diagnosis and treatment in Alzheimer's Disease (AD) related to mitochondrial metabolism. Methods The authors obtained the brain tissue datasets for AD from the Gene Expression Omnibus (GEO) and downloaded the mitochondrial metabolism-related genes set from MitoCarta 3.0 for analysis. Differentially Expressed Genes (DEGs) were screened using the "limma" R package, and the biological functions and pathways were investigated by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. The LASSO algorithm was used to identify the candidate center genes and validated in the GSE97760 dataset. PMAIP1 with the highest diagnostic value was selected and its effect on the occurrence of AD by biological experiments. Results A sum of 364 DEGs and 50 hub genes were ascertained. GO and KEGG enrichment analysis demonstrated that DEGs were preponderantly associated with cell metabolism and apoptosis. Five genes most associated with AD as candidate central genes by LASSO algorithm analysis. Then, the expression level and specificity of candidate central genes were verified by GSE97760 dataset, which confirmed that PMAIP1 had a high diagnostic value. Finally, the regulatory effects of PMAIP1 on apoptosis and mitochondrial function were detected by siRNA, flow cytometry and Western blot. siRNA-PMAIP1 can alleviate mitochondrial dysfunction and inhibit cell apoptosis. Conclusion This study identified biomarkers related to mitochondrial metabolism in AD and provided a theoretical basis for the diagnosis of AD. PMAIP1 was a potential candidate gene that may affect mitochondrial function in Hippocampal neuronal cells, and its mechanism deserves further study.

Associations and gender differences between OHI-seeking behaviors and eHealth literacy among Chinese university students / Associações e diferenças de gênero entre comportamentos de busca de OHI e letramento em e-Saúde entre estudantes universitários chineses / Asociaciones y diferencias de género entre las conductas de búsqueda de OHI y conocimientos sobre e-Salud entre estudiantes universitarios chinos

ABSTRACT Objective: to explore associations and gender differences between OHI-seeking (online health information seeking) behaviors and eHealth (electronic health) literacy among Chinese university students. Methods: Online questionnaires of eHealth literacy scale and OHI-seeking behaviors created in software Wenjunxing were used in this survey. Chi-squared tests, t-test, and Pearson correlation analysis were performed using SPSS for data analysis. Results: Among 5,383 participants, 72.4% were girls, 77.5% lived in rural areas, 51.2% majored in liberal arts, 76.6% with low education parents. The average C-eHEALS scores of boys and girls were 26.53 ± 5.861 and 26.84 ± 5.816, respectively, with no significant difference (P = 0.084). The top three OHI-seeking behaviors for boys and girls, as well as for the C-eHEALS low and high groups, were "finding information about physical exercises" "reading or sharing health information via social media" "finding information about nutrition and diet", all of which had significant gender and eHealth literacy differences. Conclusions: Gender and eHealth literacy differences should be focused for intervention when developing and implementing eHealth intervention training for parents and adolescents in schools and communities.

RESUMO Objetivo: Visa explorar associações e diferenças de gênero entre comportamentos de busca de OHI (busca de informações de saúde on-line) e letramento em e-Saúde (saúde eletrônica) entre estudantes universitários chineses. Métodos: Questionários on-line da escala de letramento em e-Saúde e comportamentos de busca de OHI criados no software Wenjunxing foram utilizados nesta pesquisa. Testes qui-quadrado, teste t e análise de correlação de Pearson foram realizados utilizando SPSS para análise de dados. Resultados: Dos 5.383 participantes, 72,4% eram meninas, 77,5% viviam em áreas rurais, 51,2% eram formados em artes liberais, 76,6% tinham pais com baixa escolaridade. As pontuações médias do C-eHEALS de meninos e meninas foram 26,53 ± 5,861 e 26,84 ± 5,816, respectivamente, sem diferença significativa (P = 0,084). Os três principais comportamentos de busca de IHO para meninos e meninas, bem como para os grupos baixo e alto do C-eHEALS, foram "encontrar informações sobre exercícios físicos"; "ler ou compartilhar informações de saúde através das redes sociais"; "encontrar informações sobre nutrição e dieta", todos com diferenças significativas de gênero e de letramento em e-Saúde. Conclusões: As diferenças de gênero e de letramento em e-Saúde devem ser focadas na intervenção ao desenvolver e implementar formação de intervenção em e-Saúde para pais e adolescentes em escolas e comunidades.

RESUMEN Objetivo: Explorar las asociaciones y las diferencias de género entre el comportamiento de búsqueda de OHI (información sanitaria en línea) y los conocimientos sobre e-Salud (salud electrónica) entre estudiantes universitarios chinos. Métodos: Se utilizaron cuestionarios en línea de la escala de conocimientos en e-Salud y conductas de búsqueda de OHI creadas con el software Wenjunxing. En el análisis de los datos, se utilizó el programa SPSS para llevar a cabo las pruebas de chi-cuadrado, pruebas t y análisis de correlación de Pearson. Resultados: De los 5.383 participantes, el 72,4% estaba formado por muchachas, el 77,5% vivía en zonas rurales, el 51,2% era licenciado en Humanidades y el 76,6% tenía padres con bajo nivel educativo. Las puntuaciones medias del C-eHEALS para chicos y chicas fueron 26,53 ± 5,861 y 26,84 ± 5,816, respectivamente, sin diferencias significativas (P = 0,084). Las tres conductas principales de búsqueda de la OHI para muchachos y muchachas, así como para los grupos de C-eHEALS bajo y alto, fueron "encontrar información sobre ejercicio físico"; "leer o compartir información sobre salud a través de las redes sociales"; "encontrar información sobre nutrición y dietas", todos ellos con diferencias significativas de género y de aprendizaje sobre e-Salud. Conclusiones: Las diferencias de género y de conocimientos en e-Salud deben centrarse en la intervención a la hora de desarrollar e implementar la formación en cibersalud para padres y adolescentes en escuelas y comunidades.

Development and validation of a practical prognostic nomogram for evaluating inpatient mortality of cirrhotic patients with acute variceal hemorrhage.

INTRODUCTION AND OBJECTIVES: Cirrhotic patients with acute variceal hemorrhage (AVH) have high short-term mortality. Established prognostic scores are seldom applicable clinically, partially because they need external validation or contain subjective variables. We aimed to develop and validate a practical prognostic nomogram based on objective predictors to predict prognosis for cirrhotic patients with AVH. PATIENTS AND METHODS: We enrolled 308 AVH patients with cirrhosis from our center as the derivation cohort to develop a new nomogram using logistic regression and validated it in cohorts of patients from Medical Information Mart for Intensive Care (MIMIC) III (n = 247) and IV (n = 302). RESULTS: International normalized ratio (INR), albumin (ALB) and estimated glomerular filtration rate (eGFR) were identified as predictors for inpatient mortality and a nomogram was constructed based on them. The nomogram discriminated well in both derivation and MIMIC-III/-IV validation cohorts with the area under the receiver operating characteristic curves (AUROCs) of 0.846 and 0.859/0.833, respectively and showed a better agreement between expected and observed outcomes (Hosmer-Lemeshow tests, all comparisons, P > 0.05) than other scores in all cohorts. Our nomogram had the lowest Brier scores (0.082/0.114/0.119 in training/MIMIC-III/MIMIC-IV) and highest R2 (0.367/0.393/0.346 in training/MIMIC-III/MIMIC-IV) compared to the recalibrated model for end-stage liver disease (MELD), MELD-hepatic encephalopathy (MELD-HE) and cirrhosis acute gastrointestinal bleeding (CAGIB) scores in all cohorts. CONCLUSIONS: We developed a practical prognostic nomogram using easily verified indicators available in initial patient evaluation, which may serve as a reliable tool to accurately predict inpatient mortality for cirrhotic patients with AVH.

Effects of stretching on lower limb strength in basketball athletes / Efeitos do alongamento sobre a força dos membros inferiores nos atletas de basquetebol / Efectos de los estiramientos en la fuerza de las extremidades inferiores en atletas de baloncesto

ABSTRACT Introduction: Basketball players depend on excellent explosive power in the lower limbs for training and competition activities such as starting, braking, accelerating, decelerating, running, and jumping instantly and quickly. The level of Chinese athletes in this aspect is lower than world powers, and formulating training focused on explosive strength can enhance the training of these athletes. Objective: Study the effects of stretching on lower limb strength in basketball athletes. Methods: 20 young male basketball players selected as volunteers for the research were randomly divided into an experimental and control group, with 10 people in each group for retrospective analysis. The effect of rapid stretching compound training on the explosive power of lower limbs in basketball players was evaluated using the comparative method of literature data, expert interviews, experimental methods, and mathematical statistics. Results: After 8 weeks of training, the scores of each test index in the control group were significantly improved, including the standing jump and long-distance scores (P < 0.01). Unipodal takeoff and post-run long-range scores were significantly improved (P < 0.05). Conclusion: Both traditional resistance and compound lower limb stretching training can improve explosive power in young basketball players, but compound training showed more prominent results. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: Os jogadores de basquetebol dependem de um excelente poder explosivo nos membros inferiores para as atividades de treinamento e competição como iniciar, frear, acelerar, desacelerar, correr e pular instantânea e rapidamente. O nível dos atletas chineses neste aspecto é inferior ao de potências mundiais e a formulação de um treinamento focado em força explosiva pode aprimorar o treinamento desses atletas. Objetivo: Estudar os efeitos do alongamento sobre a força dos membros inferiores nos atletas de basquetebol. Métodos: 20 jovens jogadores de basquete masculino selecionados como voluntários para a pesquisa foram divididos aleatoriamente em grupo experimental e grupo de controle, com 10 pessoas em cada grupo para análise retrospectiva. O efeito do treinamento composto de alongamento rápido sobre o poder explosivo dos membros inferiores dos jogadores de basquetebol foi avaliado usando o método comparativo de dados da literatura, entrevistas com especialistas, métodos experimentais e estatísticas matemáticas. Resultados: Após 8 semanas de treinamento, as pontuações de cada índice de teste no grupo de controle foram significantemente aprimoradas, incluindo o salto em pé e as pontuações de longa distância (P < 0,01). A decolagem unipodal e as pontuações de longo alcance pós corrida foram significativamente melhoradas (P<0.05). Conclusão: Tanto o treinamento tradicional de resistência quanto o treinamento composto de alongamento dos membros inferiores podem melhorar o poder explosivo nos jovens jogadores de basquete, porém o treinamento composto apresentou maior destaque em seus resultados. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Los jugadores de baloncesto dependen de una excelente potencia explosiva en los miembros inferiores para las actividades de entrenamiento y competición, como arrancar, frenar, acelerar, desacelerar, correr y saltar de forma instantánea y rápida. El nivel de los atletas chinos en este aspecto es inferior al de las potencias mundiales y la formulación de un entrenamiento centrado en la fuerza explosiva puede mejorar la formación de estos atletas. Objetivo: Estudiar los efectos de los estiramientos en la fuerza de las extremidades inferiores en atletas de baloncesto. Métodos: 20 jóvenes jugadores de baloncesto seleccionados como voluntarios para la investigación fueron divididos aleatoriamente en grupo experimental y grupo de control, con 10 personas en cada grupo para el análisis retrospectivo. Se evaluó el efecto del entrenamiento compuesto de estiramiento rápido sobre la potencia explosiva de las extremidades inferiores de los jugadores de baloncesto mediante el método comparativo de datos bibliográficos, entrevistas a expertos, métodos experimentales y estadística matemática. Resultados: Después de 8 semanas de entrenamiento, las puntuaciones de cada índice de prueba en el grupo de control mejoraron significativamente, incluyendo las puntuaciones de salto de pie y de larga distancia (P < 0,01). Las puntuaciones de despegue unipodal y de largo alcance tras la carrera mejoraron significativamente (P < 0,05). Conclusión: Tanto el entrenamiento de resistencia tradicional como el entrenamiento compuesto de estiramiento de las extremidades inferiores pueden mejorar la potencia explosiva en jóvenes jugadores de baloncesto, pero el entrenamiento compuesto mostró mayor protagonismo en sus resultados. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

The association and intervention effect between eHealth literacy and lifestyle behaviors among Chinese university students.

OBJECTIVE: Our aim was to evaluate the association between eHealth literacy and lifestyle behaviors to intervene among Chinese university students. METHOD: The Chinese eHealth Literacy Scale (C-eHEALS) questionnaire was used to investigate the eHealth literacy level and association with lifestyle behaviors among Chinese university students. Independent sample t-test and Pearson's correlation coefficient were used by statistical software SPSS v20. RESULTS: In the first round, 5,151 university students participated in the study, including 71.46% female and 28.54% male, aged 18-22 (93.13%).The average eHealth literacy score was 26.81 ± 5.83. Four lifestyle behaviors (e.g., exercise, smoking, drinking and sleeping) were all significantly correlated with eHealth literacy scores and demonstrated significant differences. In the second investigation (N = 2,939), the average eHealth literacy score was 31.64 ± 6.44, a notable improvement compared with the first investigation. CONCLUSION: Those in the group with high eHealth literacy scores have a healthier lifestyle than those in the low-score group. Training in eHealth-related resources is a positive measure to improve university students' eHealth literacy.

Agaricus macrochlamys, a New Species from the (Sub)tropical Cloud Forests of North America and the Caribbean, and Agaricus fiardii, a New Synonym of Agaricus subrufescens.

Agaricus is a genus of fungi in the family Agaricaceae, with several highly priced edible and medicinal species. Here we describe Agaricus macrochlamys, a new species, in A. sect. Arvenses, sympatric and morphologically cryptic with the edible and medicinally cultivated mushroom, A. subrufescens. Phylogenetic analyses showed that A. macrochlamys is closely related to A. subrufescens, and that A. fiardii is a new synonym of A. subrufescens. Despite being morphologically cryptic, A. macrochlamys can be distinguished from A. subrufescens by several ITS and tef1α species-specific markers and a 4-bp insertion in the tef1α sequence. Furthermore, A. subrufescens is a cosmopolitan species, while A. macrochlamys distribution is so far restricted to Mexico, the Dominican Republic, and the United States.

The association and intervention effect between eHealth literacy and lifestyle behaviors among Chinese university students / A associação e o efeito da intervenção entre a alfabetização em saúde e os comportamentos de estilo de vida entre estudantes universitários chineses / Asociación y efecto de la intervención entre la alfabetización en salud y los comportamientos de estilo de vida de estudiantes universitarios chinos

ABSTRACT Objective: Our aim was to evaluate the association between eHealth literacy and lifestyle behaviors to intervene among Chinese university students. Method: The Chinese eHealth Literacy Scale (C-eHEALS) questionnaire was used to investigate the eHealth literacy level and association with lifestyle behaviors among Chinese university students. Independent sample t-test and Pearson's correlation coefficient were used by statistical software SPSS v20. Results: In the first round, 5,151 university students participated in the study, including 71.46% female and 28.54% male, aged 18-22 (93.13%).The average eHealth literacy score was 26.81 ± 5.83. Four lifestyle behaviors (e.g., exercise, smoking, drinking and sleeping) were all significantly correlated with eHealth literacy scores and demonstrated significant differences. In the second investigation (N = 2,939), the average eHealth literacy score was 31.64 ± 6.44, a notable improvement compared with the first investigation. Conclusion: Those in the group with high eHealth literacy scores have a healthier lifestyle than those in the low-score group. Training in eHealth-related resources is a positive measure to improve university students' eHealth literacy.

RESUMO Objetivo: Nosso objetivo foi avaliar a associação entre alfabetização em saúde e comportamentos de estilo de vida para intervir entre estudantes universitários chineses. Método: O questionário Chinese eHealth Literacy Scale (C-eHEALS) foi usado para investigar o nível de alfabetização em saúde e a associação com comportamentos de estilo de vida entre estudantes universitários chineses. O teste t de amostra independente e o coeficiente de correlação de Pearson foram usados pelo software estatístico SPSS v20. Resultados: Na primeira etapa, participaram 5.151 estudantes universitários, sendo 71,46% do sexo feminino e 28,54% do sexo masculino, com idades entre 18 e 22 anos (93,13%). Quatro comportamentos de estilo de vida (exercícios, fumar, beber e dormir) foram todos significativamente correlacionados com os escores de alfabetização em saúde e demonstraram diferenças significativas. Na segunda investigação (N = 2.939), a pontuação média de alfabetização em saúde foi de 31,64 ± 6,44, uma melhoria notável em comparação com a primeira investigação. Conclusão Aqueles do grupo com pontuações altas de alfabetização em saúde têm um estilo de vida mais saudável que aqueles do grupo com pontuação baixa. A formação em recursos relacionados com a saúde é uma medida positiva para melhorar a alfabetização em saúde dos estudantes universitários.

RESUMEN Objetivo: Evaluar la asociación entre la alfabetización en salud y los comportamientos de estilo de vida para las intervenciones de estudiantes universitarios chinos. Método: Para investigar el nivel de alfabetización en salud y su asociación con los comportamientos de estilo de vida se utilizó el cuestionario Escala de Alfabetización China en Cibermedicina (C-eHEALS). La prueba t de la muestra independiente y el coeficiente de correlación de Pearson se llevaron a cabo con el software estadístico SPSS v20. Resultados: En la primera etapa participaron 5.151 estudiantes universitarios, 71,46% mujeres y 28,54% hombres, con edades comprendidas entre los 18 y los 22 años (93,13%). Cuatro conductas de estilo de vida (ejercicio, fumar, beber y dormir) se correlacionaron significativamente con las puntuaciones de Alfabetización en Salud y mostraron diferencias significativas. En la segunda investigación (N = 2.939), la puntuación media de la alfabetización sanitaria fue de 31,64 ± 6,44, lo que supone una notable mejora en comparación con la primera investigación. Conclusión: Los estudiantes del grupo con puntuación alta de alfabetización en salud tienen un estilo de vida más saludable que las del grupo con puntuación baja. La instrucción sobre recursos relacionados con la salud es una medida positiva para mejorar la alfabetización sanitaria de los estudiantes universitarios.

Inequities in Access to Care and Health Care Spending for Asian Americans With Cancer.

BACKGROUND: Asian Americans have lower cancer screening rates than non-Latino "Whites," suggesting inequities in cancer prevention among Asian Americans. Little is known about inequities in cancer treatment between Whites and Asian Americans with cancer. METHODS: Using the 2002-2017 Medical Expenditure Panel Survey, we examined inequities in access to care and health care spending between Whites and Asian Americans with and without cancer. Our outcomes included 3 measures of access to care and 3 measures of health care spending. We used multivariable regressions while adjusting for predisposing, enabling, and need factors and estimated the mean adjusted values of the outcomes for each group. We then examined the differences in these adjusted mean outcomes among Asian Americans relative to Whites. RESULTS: We observed evidence of inequities that Asian Americans without cancer experienced limited access to care due to a lack of a usual source of care. The likelihood of having a usual source of care was lower among Asian Americans without cancer than Whites without cancer. Inequities were not observed among Asian Americans with cancer. Compared with Whites with cancer, Asian Americans with cancer had similar or better levels of access to care. No or marginal differences in health care spending were detected between Whites and Asian Americans with cancer. These findings were consistent in both nonelderly and elderly groups. CONCLUSION: While Asian Americans without cancer have unmet medical needs due to limited access to care, access to care and spending are relatively equitable between Whites and Asian Americans with cancer.

Future global socioeconomic risk to droughts based on estimates of hazard, exposure, and vulnerability in a changing climate.

A consistent and equitable global drought risk assessment for multiple regions, populations, and economic sectors at the gridded scale under future diverse climate change scenarios has been the subject of scarce research. Climate change is projected to increase the future hazard of drought and cause consequential damages to socioeconomic systems. The risk assessment of drought caused by climate change can be a bridge between impacts and adaptation. To assess the socioeconomic risk to droughts in a base period and two future periods (2016 to 2035 and 2046 to 2065), the projections of five general circulation models and population and gross domestic product (GDP), land cover, and water resources data were used to analyze the socioeconomic risk under three scenarios combining representative concentration pathways (RCPs) and shared socioeconomic pathways (SSPs). The socioeconomic risk was calculated as the product of three determinants: hazard, exposure, and vulnerability. The risk of the global population to drought was projected to be highest in 2046 to 2065 under scenario RCP8.5-SSP3, with up to 1.45 × 109 persons affected, a 63% increase compared with the base period. The highest risk to GDP (4.29 × 1013 purchasing power parity $) was possibly in 2046 to 2065 under scenario RCP2.6-SSP1, with the risk increasing 5.64 times compared to the base period. Regions with high socioeconomic risk were primarily concentrated in the East and South Asia, Midwestern Europe, eastern US, and the coastal areas of South America. With climate change, the inequality in future socioeconomic risk to drought among countries is predicted to increase. The ten countries with the highest risks to population and GDP accounted for nearly 70% of the global risk.

Effects of the prophylactic use of escitalopram on the prognosis and the plasma copeptin level in patients with acute cerebral infarction.

This study aimed to investigate whether the routine administration of escitalopram for three months would improve the prognosis of patients with ischemic stroke and decrease the plasma copeptin level. A total of 97 patients with acute cerebral infarction were randomly allocated to receive escitalopram (5-10 mg once per day, orally; n=49) or not to receive escitalopram (control group; n=48) for 12 weeks starting at 2-7 days after the onset of stroke. Both groups received conventional treatments, including physiotherapy and secondary prevention of stroke. The National Institutes of Health Stroke Scale (NIHSS) score was used to evaluate the disability of patients at the initial evaluation and at the monthly follow-up visits for three months. Impairment in the daily activities was assessed using the Barthel Index (BI), while cognitive impairment was assessed using Mini-Mental State Examination (MMSE) score. The psychiatric assessment included the administration of the Present State Examination modified to identify Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) symptoms of depression. The severity of depression was measured using the 17-item Hamilton Rating Scale for Depression (HAMD). During the 3-month follow-up period, 95 patients were included in the analysis (two patients withdrew from the escitalopram group). NIHSS and BI improvement at the 90th day were significantly greater in the escitalopram group (P<0.05), while HAMD and plasma copeptin levels significantly decreased, compared to the control group (P<0.01). In patients with acute ischemic stroke, the earlier administration of escitalopram for three months may improve neurological functional prognosis and decrease copeptin level.

Comprehensive analysis of gene expression and DNA methylation data identifies potential biomarkers and functional epigenetic modules for lung adenocarcinoma.

Lung cancer has one of the highest mortality rates of malignant neoplasms. Lung adenocarcinoma (LUAD) is one of the most common types of lung cancer. DNA methylation is more stable than gene expression and could be used as a biomarker for early tumor diagnosis. This study is aimed to screen potential DNA methylation signatures to facilitate the diagnosis and prognosis of LUAD and integrate gene expression and DNA methylation data of LUAD to identify functional epigenetic modules. We systematically integrated gene expression and DNA methylation data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO), bioinformatic models and algorithms were implemented to identify signatures and functional modules for LUAD. Three promising diagnostic and five potential prognostic signatures for LUAD were screened by rigorous filtration, and our tumor-normal classifier and prognostic model were validated in two separate data sets. Additionally, we identified functional epigenetic modules in the TCGA LUAD dataset and GEO independent validation data set. Interestingly, the MUC1 module was identified in both datasets. The potential biomarkers for the diagnosis and prognosis of LUAD are expected to be further verified in clinical practice to aid in the diagnosis and treatment of LUAD.

Profile of renal artery embolization (RAE) for renal trauma: A comparison of data from two major trauma center

ABSTRACT Objective To evaluate usage of renal artery embolization (RAE) for renal injuries and discuss the indications for this treatment. Materials and Methods A retrospective study was performed evaluating the electronic medical records of all patients with renal trauma admitted to two major comprehensive hospitals in Shantou city from January 2006 to December 2015. Results There were 264 and 304 renal traumatic patients admitted to hospital A and B, respectively. LGRT was the reason for presentation in the majority of patients (522, 91.9%). A total of 534 (94.0%) patients were treated conservatively. RAE was performed in 9 patients from 2012 to 2015 at hospital A, including in 6 patients (6/9, 66.7%) with LGRT, and 3 patients (3/9, 33.3%) with HGRT. No patient underwent interventional therapy (RAE) at hospital B during the same period. No significant differences in the operative rate of hospital A were observed between the two time periods (2006-2011 and 2012-2015). The operative rate for LGRT between the two hospitals from 2006 to 2011 and 2012 to 2015 was not significantly different. Hospital A showed a significant decrease in the rate of conservative treatment for patients with LGRT. In the univariate and multivariate analyses, the AAST renal grade both were significantly associated with undergoing RAE. Conclusions LGRT was present in the majority of patients, and most cases of renal trauma could be treated with conservative treatment. RAE was well utilized for the treatment of renal trauma. However, some patients with LGRT were treated with unnecessary interventional therapy.

Profile of renal artery embolization (RAE) for renal trauma: A comparison of data from two major trauma center.

OBJECTIVE: To evaluate usage of renal artery embolization (RAE) for renal injuries and discuss the indications for this treatment. MATERIALS AND METHODS: A retrospective study was performed evaluating the electronic medical records of all patients with renal trauma admitted to two major comprehensive hospitals in Shantou city from January 2006 to December 2015. RESULTS: There were 264 and 304 renal traumatic patients admitted to hospital A and B, respectively. LGRT was the reason for presentation in the majority of patients (522, 91.9%). A total of 534 (94.0%) patients were treated conservatively. RAE was performed in 9 patients from 2012 to 2015 at hospital A, including in 6 patients (6/9, 66.7%) with LGRT, and 3 patients (3/9, 33.3%) with HGRT. No patient underwent interventional therapy (RAE) at hospital B during the same period. No significant differences in the operative rate of hospital A were observed between the two time periods (2006-2011 and 2012-2015). The operative rate for LGRT between the two hospitals from 2006 to 2011 and 2012 to 2015 was not significantly different. Hospital A showed a significant decrease in the rate of conservative treatment for patients with LGRT. In the univariate and multivariate analyses, the AAST renal grade both were significantly associated with undergoing RAE. CONCLUSIONS: LGRT was present in the majority of patients, and most cases of renal trauma could be treated with conservative treatment. RAE was well utilized for the treatment of renal trauma. However, some patients with LGRT were treated with unnecessary interventional therapy.

Effects of the prophylactic use of escitalopram on the prognosis and the plasma copeptin level in patients with acute cerebral infarction

This study aimed to investigate whether the routine administration of escitalopram for three months would improve the prognosis of patients with ischemic stroke and decrease the plasma copeptin level. A total of 97 patients with acute cerebral infarction were randomly allocated to receive escitalopram (5-10 mg once per day, orally; n=49) or not to receive escitalopram (control group; n=48) for 12 weeks starting at 2-7 days after the onset of stroke. Both groups received conventional treatments, including physiotherapy and secondary prevention of stroke. The National Institutes of Health Stroke Scale (NIHSS) score was used to evaluate the disability of patients at the initial evaluation and at the monthly follow-up visits for three months. Impairment in the daily activities was assessed using the Barthel Index (BI), while cognitive impairment was assessed using Mini-Mental State Examination (MMSE) score. The psychiatric assessment included the administration of the Present State Examination modified to identify Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) symptoms of depression. The severity of depression was measured using the 17-item Hamilton Rating Scale for Depression (HAMD). During the 3-month follow-up period, 95 patients were included in the analysis (two patients withdrew from the escitalopram group). NIHSS and BI improvement at the 90th day were significantly greater in the escitalopram group (P<0.05), while HAMD and plasma copeptin levels significantly decreased, compared to the control group (P<0.01). In patients with acute ischemic stroke, the earlier administration of escitalopram for three months may improve neurological functional prognosis and decrease copeptin level.

The Effects of the Affordable Care Act on Health Care Access and Utilization Among Asian American Subgroups.

OBJECTIVES: We examined changes in health care access and utilization associated with the Patient Protection and Affordable Care Act (ACA) for different Asian American subgroups relative to non-Latino whites (whites). RESEARCH DESIGN: Using 2003-2017 California Health Interview Survey data, we examined changes in 4 health care access measures and 2 utilization measures among whites and 7 Asian American subgroups. We estimated the unadjusted and adjusted percentage point changes on the absolute scale from the pre-ACA to post-ACA periods. Adjusted estimates were obtained from multivariable logistic regression models that controlled for predisposing, enabling, and need factors. We also estimated the pre-ACA to post-ACA changes between whites and Asian American subgroups using a difference-in-difference approach. RESULTS: After the ACA was implemented, uninsurance decreased among all Asian American subgroups, but improvements in disparities relative to whites in these measures were limited. In particular, Koreans had the largest absolute reduction in uninsurance (-16.8 percentage points) and were the only subgroup with a significant reduction in terms of disparities relative to whites (-10.1 percentage points). However, little or no improvement was observed in the other 3 access measures (having a usual source of care, delayed medical care in past year, or delayed prescription drug use in past year) and 2 utilization measures (having a physician visit or emergency department visit in past year). CONCLUSIONS: Despite coverage gains among Asian American subgroups, especially Koreans, disparities in access and utilization persisted across all Asian American subgroups.

Increased Clinical Sensitivity and Specificity of Plasma Protein N-Glycan Profiling for Diagnosing Congenital Disorders of Glycosylation by Use of Flow Injection-Electrospray Ionization-Quadrupole Time-of-Flight Mass Spectrometry.

BACKGROUND: Congenital disorders of glycosylation (CDG) represent 1 of the largest groups of metabolic disorders with >130 subtypes identified to date. The majority of CDG subtypes are disorders of N-linked glycosylation, in which carbohydrate residues, namely, N-glycans, are posttranslationally linked to asparagine molecules in peptides. To improve the diagnostic capability for CDG, we developed and validated a plasma N-glycan assay using flow injection-electrospray ionization-quadrupole time-of-flight mass spectrometry. METHODS: After PNGase F digestion of plasma glycoproteins, N-glycans were linked to a quinolone using a transient amine group at the reducing end, isolated by a hydrophilic interaction chromatography column, and then identified by accurate mass and quantified using a stable isotope-labeled glycopeptide as the internal standard. RESULTS: This assay differed from other N-glycan profiling methods because it was free of any contamination from circulating free glycans and was semiquantitative. The low end of the detection range tested was at 63 nmol/L for disialo-biantennary N-glycan. The majority of N-glycans in normal plasma had <1% abundance. Abnormal N-glycan profiles from 19 patients with known diagnoses of 11 different CDG subtypes were generated, some of which had previously been reported to have normal N-linked protein glycosylation by carbohydrate-deficient transferrin analysis. CONCLUSIONS: The clinical specificity and sensitivity of N-glycan analysis was much improved with this method. Additional CDGs can be diagnosed that would be missed by carbohydrate-deficient transferrin analysis. The assay provides novel biomarkers with diagnostic and potentially therapeutic significance.