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Background: Intraindividual variability in lipid profiles is recognized as a potential predictor of cardiovascular events. However, the influence of early adulthood lipid profile variability along with mean lipid levels on future coronary artery calcium (CAC) incidence remains unclear., Methods: A total of 2395 participants (41.6% men; mean±SD age, 40.2±3.6 years) with initial CAC =0 from the CARDIA study (Coronary Artery Risk Development in Young Adults) were included. Serial lipid measurements were obtained to calculate mean levels and variability of total cholesterol, low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and triglycerides. CAC incidence was defined as CAC >0 at follow-up., Results: During a mean follow-up of 9.0 years, 534 individuals (22.3%) exhibited CAC incidence. Higher mean levels of total cholesterol, LDL-C, and non-HDL-C were associated with a greater risk of future CAC incidence. Similarly, 1-SD increment of lipid variability, as assessed by variability independent of the mean, was associated with an increased risk of CAC incidence (LDL-C: hazard ratio, 1.139 [95% CI, 1.048-1.238]; P =0.002; non-HDL-C: hazard ratio, 1.102 [95% CI, 1.014-1.198]; P =0.022; and triglycerides: hazard ratio, 1.480 [95% CI, 1.384-1.582]; P <0.001). Combination analyses demonstrated that participants with both high lipid levels and high variability in lipid profiles (LDL-C and non-HDL-C) faced the greatest risk of CAC incidence. Specifically, elevated variability of LDL-C was associated with an additional risk of CAC incidence even in low mean levels of LDL-C (hazard ratio, 1.396 [95% CI, 1.106-1.763]; P =0.005). These findings remained robust across a series of sensitivity and subgroup analyses., Conclusions: Elevated variability in LDL-C and non-HDL-C during young adulthood was associated with an increased risk of CAC incidence in midlife, especially among those with high mean levels of atherogenic lipoproteins. These findings highlight the importance of maintaining consistently low levels of atherogenic lipids throughout early adulthood to reduce subclinical atherosclerosis in midlife., Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00005130., Competing Interests: None.

Background: The AHA has recently introduced a novel metric, Life's Essential 8, to assess cardiovascular health (CVH). Nevertheless, the association between varying levels of LE8 and the propensity for CKD is still unclear from a large prospective cohort. Our objective is to meticulously examine the relationship between LE8 and its associated susceptibilities to CKD., Methods: A total of 251,825 participants free of CKD from the UK Biobank were included. Cardiovascular health was scored using LE8 and categorized as low, moderate, and high. Cox proportional hazard models were employed to evaluate the associations of LE8 scores with new-onset CKD. The genetic risk score for CKD was calculated by a weighted method., Results: Over a median follow-up of 12.8 years, we meticulously documented 10,124 incident cases of CKD. Remarkably, an increased LE8 score correlated with a significant reduction of risk in new-onset CKD (high LE8 score vs. low LE8 score: HR = 0.300, 95% CI 0.270-0.330, p < 0.001; median LE8 score vs. low LE8 score: HR = 0.531, 95% CI 0.487-0.580, p < 0.001). This strong LE8-CKD association remained robust in extensive subgroup assessments and sensitivity analysis. Additionally, these noteworthy associations between LE8 scores and CKD remained unaffected by genetic predispositions to CKD., Conclusions: An elevated degree of CVH, as delineated by the discerning metric LE8, exhibited a pronounced and statistically significant correlation with a marked reduction in the likelihood of CKD occurrence., (© 2023. The Author(s), under exclusive licence to Japanese Society of Nephrology.)

Objective: Emerging research challenges the one-factor model of the future time perspective (FTP) scale by demonstrating two- and three-factor models of the FTP scale., Method: Three samples (i.e., Switzerland and the United States; N = 2022) explored the factor structure, age pattern differences, tested the link between FTP factors, psychological well-being, and life satisfaction, as well as age as a moderator., Results: We distinguished FTP into opportunities, extension, and constraint factors that corroborated previous research. We did not find a replicable curvilinear age pattern difference on any of the FTP factors. The association between extension and life satisfaction was stronger among younger than older adults. Alternatively, the association between constraint and life satisfaction was stronger among younger than older adults in Samples A and C, and the pattern was reversed in Sample B. Lastly, the association between constraint and environmental mastery was stronger among older adults than younger adults in Sample B and the pattern was reversed in Sample C., Conclusion: This variation in the perception of the future is different for people at different periods in life and has an important consequence for living life well, especially a focus on extension and lack of constraint., (© 2023 Wiley Periodicals LLC.)

Literature regarding the impacts of heavy metal exposure on erectile dysfunction (ED) is scarce. We aimed to evaluate the correlation between 10 urinary metals and ED in a large, nationally representative adult male sample. The dataset was extracted from the National Health and Nutrition Examination Survey (NHANES) during the period of 2001-2002 and 2003-2004. Weighted proportions and multivariable logistic regression analysis adjusted for confounding variables were utilized to determine the relationship between metal exposure and ED. Weighted quantile sum (WQS) regression was utilized to evaluate the impact of a mixture of urinary metals on ED. A total of 1328 participants were included in our study. In multivariable logistic regression analysis, cobalt (Co) and antimony (Sb) were positively associated with ED (odds ratio [OR]: 1.36, 95% confidence interval [CI]: 1.10-1.73, P = 0.020; and OR: 1.41, 95% CI: 1.12-1.77, P = 0.018, respectively) after full adjustment. Men in tertile 4 for Co (OR: 1.49, 95% CI: 1.02-2.41, P for trend = 0.012) and Sb (OR: 1.53, 95% CI: 1.08-2.40, P for trend = 0.041) had significantly higher odds of ED than those in tertile 1. Furthermore, the WQS index was significantly linked with increased odds of ED after full adjustment (OR: 1.31, 95% CI: 1.04-1.72, P < 0.05). Our study expanded on previous literature indicating the possible role of heavy metal exposure in the etiology of ED. The evaluation of heavy metal exposure should be included in the risk assessment of ED., Competing Interests: None

Ethnopharmacological Relevance: Licorice is a multi-purpose plant raw material, which is widely used in the pharmaceutical industry and food industry, cosmetic industry, etc. It has a wide application in various countries and regions around the world., Aim of Study: This paper studied the trade situation of licorice-related products among major countries and regions in the world, providing a practical reference for the sustainable development of the global licorice industry., Materials and Methods: The licorice trade data of licorice-related products came from the United Nations Commodity Trade Database and China Customs data. We analyzed the world's major trading countries by using international market share (IMS), trade competitiveness index (TC), average export price (AEP) and average import price (AIP), and analyzed global trade flows with chord diameter., Results: Uzbekistan, Kazakhstan and Iran mainly export licorice raw materials and low value-added products. China is both a producer and a consumer of licorice raw materials and licorice products. The processing trade of the licorice industry in China has advantages, and the structure of import and export trade has been continuously improved. The United States, France, Germany and other developed countries are still important consumers who rely on the intellectual property rights and brand advantages of licorice products, which have stronger global trade radiation capacity., Conclusions: China's trade structure has been optimized and its industrial competitiveness has been enhanced. China's experience can be used for reference by other countries, especially those with rich licorice resources among the SCO members., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Disulfiram (DSF), a Food and Drug Administration (FDA)-approved drug for the treatment of alcoholism, has been found to have antitumor activity. DSF showed better antitumor efficiency when it was used in combination with certain antitumor drugs. DSF plays an important role in cancer treatment. It has been used as multidrug resistance (MDR) modulator to reverse MDR and can also combine with copper ions (Cu 2+ ), which will produce copper diethyldithiocarbamate (Cu[DDC] 2 ) complex with antitumor activity. The synergistic targeted drug delivery for cancer treatment based on DSF, especially the combination with exogenous Cu 2+ and its forms of administration, has attracted extensive attention in the biomedical field. In this review, we summarize these synergistic delivery systems, in the hope that they will contribute to the continuous optimization and development of more advanced drug delivery systems. Furthermore, we discuss the current limitation and future directions of DSF-based drug delivery systems in the field of tumor therapy. Hopefully, our work may inspire further innovation of DSF-based antitumor drug delivery systems., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: We saw a steady increase in the number of bibliographic studies published over the years. The reason for this rise is attributed to the better accessibility of bibliographic data and software packages that specialize in bibliographic analyses. Any difference in citation achievements between bibliographic and meta-analysis studies observed so far need to be verified. In this study, we aimed to identify the frequently observed MeSH terms in these 2 types of study and investigate whether the highlighted MeSH terms are strongly associated with one of the study types., Methods: By searching the PubMed Central database, 5121 articles relevant to bibliometric and meta-analysis studies were downloaded since 2011. Social network analysis was applied to highlight the major MeSH terms of quantitative and statistical methods in these 2 types of studies. MeSH terms were then individually tested for any differences in event counts over the years between study types using odds of 95% confidence intervals for comparison., Results: In these 2 studies, we found that the most productive countries were the United States (19.9%), followed by the United Kingdom (8.8%) and China (8.7%); the most number of articles were published in PLoS One (2.9%), Stat Med (2.5%), and Res Synth (2.4%); and the most frequently observed MeSH terms were statistics and numerical data in bibliographic studies and methods in meta-analysis. Differences were found when compared to the event counts and the citation achievements in these 2 study types., Conclusion: The breakthrough was made by developing a dashboard using forest plots to display the difference in event counts. The visualization of the observed MeSH terms could be replicated for future academic pursuits and applications in other disciplines using the odds of 95% confidence intervals., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Objectives: The aim of this study was to compare transcaval and transaxillary artery access for transcatheter aortic valve replacement (TAVR) at experienced medical centers in contemporary practice., Background: There are no systematic comparisons of transcaval and transaxillary TAVR access routes., Methods: Eight experienced centers contributed local data collected for the STS/ACC TVT Registry (Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry) between 2017 and 2020. Outcomes after transcaval and axillary/subclavian (transaxillary) access were adjusted for baseline imbalances using doubly robust (inverse propensity weighting plus regression) estimation and compared., Results: Transcaval access was used in 238 procedures and transaxillary access in 106; for comparison, transfemoral access was used in 7,132 procedures. Risk profiles were higher among patients selected for nonfemoral access but similar among patients requiring transcaval and transaxillary access. Stroke and transient ischemic attack were 5-fold less common after transcaval than transaxillary access (2.5% vs 13.2%; OR: 0.20; 95% CI: 0.06-0.72; P = 0.014) compared with transfemoral access (1.7%). Major and life-threatening bleeding (Valve Academic Research Consortium 3 ≥ type 2) were comparable (10.0% vs 13.2%; OR: 0.66; 95% CI: 0.26-1.66; P = 0.38) compared with transfemoral access (3.5%), as was blood transfusion (19.3% vs 21.7%; OR: 1.07; 95% CI: 0.49-2.33; P = 0.87) compared with transfemoral access (7.1%). Vascular complications, intensive care unit and hospital length of stay, and survival were similar between transcaval and transaxillary access. More patients were discharged directly home and without stroke or transient ischemic attack after transcaval than transaxillary access (87.8% vs 62.3%; OR: 5.19; 95% CI: 2.45-11.0; P < 0.001) compared with transfemoral access (90.3%)., Conclusions: Patients undergoing transcaval TAVR had lower rates of stroke and similar bleeding compared with transaxillary access in a contemporary experience from 8 US centers. Both approaches had more complications than transfemoral access. Transcaval TAVR access may offer an attractive option., Competing Interests: Funding Support and Author Disclosures This work was supported by the Emory Structural Heart and Valve program intramural funds, and by National Institutes of Health Z01-HL006040. Drs Babaliaros and Greenbaum have served as consultants for Edwards Lifesciences and Abbott Vascular; have an employer with research contracts for clinical investigation of transcatheter aortic, mitral, and tricuspid devices from Edwards Lifesciences, Abbott Vascular, Medtronic, and Boston Scientific; and own equity interest in Transmural Systems. Drs Lederman and Rogers are coinventors on device patents, assigned to the National Institutes of Health, for closure of transcaval access ports. Dr Rogers has served as consultant and physician proctor for Edwards Lifesciences and Medtronic; has been on the advisory board for Medtronic; and has equity interest in Transmural Systems. Dr Mahoney has served as a proctor and consultant and has received institutional research support from Edwards Lifesciences, Medtronic, and Abbott. Dr Foerst has served as a proctor for Edwards Lifesciences and Medtronic. Dr Depta has served as a consultant or advisory board member for Edwards Lifesciences, Boston Scientific, Abbott, V-Wave-Ltd, and WL Gore & Associates. Dr Muhammad has served as a proctor and consultant for Edwards Lifesciences and Medtronic. Dr McCabe has served as a consultant and has received honoraria from Boston Scientific, Cardiovascular Systems Inc, Edwards Lifesciences, and Medtronic. Dr Pop is a consultant for Edwards Lifesciences and Shockwave Medical. Dr Khan has served as a proctor for Edwards Lifesciences and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Published by Elsevier Inc.)

Ambulatory blood pressure (BP) monitoring (ABPM) is vital for screening cardiovascular activity. The American College of Cardiology/American Heart Association guideline for the prevention, detection, evaluation, and management of BP in adults recommends measuring BP outside the office setting using daytime ABPM. The recommendation to use night-day BP measurements to confirm hypertension is consistent with the recommendation of several other guidelines. In recent studies, ABPM was used to measure BP at regular intervals, and it reduces the effect of the environment on BP. Out-of-office measurements are highly recommended by almost all hypertension organizations. However, traditional ABPM devices based on the oscillometric technique usually interrupt sleep. For all-day ABPM purposes, a photoplethysmography (PPG)-based wrist-type device has been developed as a convenient tool. This optical, noninvasive device estimates BP using morphological characteristics from PPG waveforms. As measurement can be affected by multiple variables, calibration is necessary to ensure that the calculated BP values are accurate. However, few studies focused on adaptive calibration. A novel adaptive calibration model, which is data-driven and embedded in a wearable device, was proposed. The features from a 15 s PPG waveform and personal information were input for estimation of BP values and our data-driven calibration model. The model had a feedback calibration process using the exponential Gaussian process regression method to calibrate BP values and avoid inter- and intra-subject variability, ensuring accuracy in long-term ABPM. The estimation error of BP (ΔBP = actual BP-estimated BP) of systolic BP was -0.1776 ± 4.7361 mmHg; ≤15 mmHg, 99.225%, and of diastolic BP was -0.3846 ± 6.3688 mmHg; ≤15 mmHg, 98.191%. The success rate was improved, and the results corresponded to the Association for the Advancement of Medical Instrumentation standard and British Hypertension Society Grading criteria for medical regulation. Using machine learning with a feedback calibration model could be used to assess ABPM for clinical purposes.

Background: It remains unclear whether triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, is prospectively associated with incident peripheral arterial disease (PAD)., Methods: We included 12,320 Atherosclerosis Risk in Communities Study participants (aged 54.3 ± 5.7 years) free of a history of PAD at baseline (visit 1: 1987-1989). The TyG index was determined using ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2), and measured at 5 visits between 1987 and 2013. Incident PAD was defined as the first hospitalization with PAD diagnosis or a new onset of measured ABI < 0.90 during follow-up visits. We quantified the association of both baseline and trajectories of TyG index with incident PAD using Cox regression and logistic regression analysis, respectively., Results: Over a median follow-up of 23 years, 1300 participants developed PAD. After adjustment for traditional PAD risk factors, each 1-SD (0.58) increase in TyG index was associated with an 11.9% higher risk of incident PAD [hazard ratio, 1.119 (95% CI, 1.049-1.195)]. Results were similar when individuals were categorized by TyG index quartiles [hazard ratio, 1.239 (95% CI, 1.028-1.492); comparing extreme quartiles]. Four distinct trajectories of stable TyG indexes at various levels along the follow-up duration were identified [low (22.2%), moderate (43.2%), high (27.5%), and very high (7.1%) trajectory groups]. Compared with those with a TyG index trajectory at a low level, those participants with TyG index trajectories at high and very high levels had an even greater risk of future incident PAD [odds ratio (95%CI): 1.404 (1.132-1.740) and 1.742 (1.294-2.344), respectively] after multivariate adjustments for traditional PAD risk factors., Conclusions: Higher TyG index is independently associated with an increased risk of incident PAD. Long-term trajectories of TyG index help identify individuals at a higher risk of PAD who deserve specific preventive and therapeutic approaches., Trial Registration: Clinical trial registration number: The ARIC trial was registered at clinicaltrials.gov as NCT00005131.

Importance: Married patients with cancer have better cancer-specific survival than unmarried patients. Increasing the early diagnosis and definitive treatment of cancer among unmarried patients may reduce the survival gap., Objectives: To evaluate the extent to which marriage is associated with cancer-specific survival, stage at diagnosis, and treatment among patients with 9 common solid cancers and to recommend methods for reducing the survival gap., Design, Setting, and Participants: This retrospective, population-based cohort study included patients older than 18 years who were diagnosed with 1 of 9 common cancers between January 1, 2007, and December 31, 2016. Patient data were retrieved from the Surveillance, Epidemiology, and End Results Program. Statistical analyses were performed from August 1 to October 1, 2020., Exposures: Marital status, classified as married and unmarried (including single, separated, divorced, widowed, and unmarried patients or domestic partners)., Main Outcomes and Measures: The primary outcome was the time ratio (TR) of cancer-specific survival (married vs unmarried). Mediation analyses were conducted to determine the extent to which the association of marriage with cancer-specific survival was mediated by stage at diagnosis and treatment., Results: This study included 1 733 906 patients (894 379 [51.6%] women; 1 067 726 [61.6%] married; mean [SD] age, 63.76 [12.60] years). Multivariate analyses found that those who were married were associated with better cancer-specific survival than unmarried patients (TR, 1.36; 95% CI, 1.35-1.37). Early diagnosis in breast cancer, colorectal cancer, endometrial cancer, and melanoma mediated the association between marital status and cancer-specific survival (breast cancer: proportion mediated [PM], 11.4%; 95% CI, 11.2%-11.6%; colorectal cancer: PM, 10.9%; 95% CI, 10.7%-11.2%; endometrial cancer: PM, 12.9%; 95% CI, 12.5%-13.3%; melanoma: PM, 12.0%; 95% CI, 11.7-12.4%). Surgery mediated the association between marital status and cancer-specific survival in lung (PM, 52.2%; 95% CI, 51.9%-52.4%), pancreatic (PM, 28.9%; 95% CI, 28.6%-29.3%), and prostate (PM, 39.3%; 95% CI, 39.0%-39.6%) cancers. Chemotherapy mediated the association of marital status with cancer-specific survival in lung (PM, 37.7%; 95% CI, 37.6%-37.9%) and pancreatic (PM, 28.6%; 95% CI, 28.4%-28.9%) cancers. Improved cancer-specific survival associated with marriage was greater among men than women (men: TR, 1.27; 95% CI, 1.25-1.28; women: TR, 1.20; 95% CI, 1.19-1.21). The contribution of receiving an early diagnosis and treatment with surgery or chemotherapy to the association between marital status and cancer-specific survival was greater among men than women (early diagnosis: PM, 21.7% [95% CI, 21.5%-21.9%] vs PM, 20.3% [95% CI, 20.2%-20.4%]; surgery: PM, 26.6% [95% CI, 26.4%-26.7%] vs PM, 11.1% [95% CI, 11.0%-11.2%]; chemotherapy: PM, 6.8% [95% CI, 6.7%-6.8%] vs PM, 5.1% [95% CI, 5.0%-5.2%])., Conclusions and Relevance: In this study, survival disparities associated with marital status were attributable to early diagnosis in breast, colorectal, and endometrial cancers as well as melanoma and to treatment-related variables in lung, pancreatic, and prostate cancers. The findings also suggest that marriage may play a greater protective role in the cancer-specific survival of men than of women.

Background : This study aimed to develop nomograms predicting the overall survival (OS) of patients younger than 50 years old with esophageal cancer. Methods : We selected patients included 2004-2015 in the Surveillance, Epidemiology, and End Results (SEER) database. Nomograms were constructed using significant variables from multivariable Cox analyses. The discrimination and calibration power of the models were evaluated using concordance indexes (C-indexes) and calibration curves. Decision curve analysis was used to assess the clinical net benefits of the nomograms. Results : Of 1,997 selected patients, 53.2% had advanced-stage tumor. Race, grade, T stage, N stage, and treatment were independent factors affecting OS in early-stage patients. The C-indexes of the corresponding nomogram were 0.710 (95% CI = 0.684-0.736) and 0.681 (95% CI = 0.640-0.722) in training and validation sets, respectively. Grade, marital status, and treatment were independent factors affecting OS in advanced-stage patients. The C-indexes of the corresponding nomogram were 0.677 (95% CI = 0.653-0.701) and 0.675 (95% CI = 0.638-0.712) in training and validation sets, respectively. Calibration curves demonstrated high consistency between predicted and actual survival. Conclusion : We constructed and verified nomograms that could accurately predict the survival rate of esophageal cancer in patients younger than 50 years old. This may help clinicians better understand prognostic factors.

To study the effect of combined ultraviolet (UV) chloramine disinfection on viruses in a drinking water supply system, a full-scale experiment was conducted to analyze the distribution, variability, community structure, and hosts of viruses using metagenomics. The results showed that the combined UV chloramine process reduced the number of virus species (6.13%) and gene abundance (51.97%) but did not completely remove the viruses from the water. The United States Environmental Protection Agency (USEPA) report that virus removal efficiencies from water can reach 99%-99.99% based on culturing methods. However, in this study, metagenomic analysis indicated a total virus removal rate of only 93.46%. Therefore, the detection of viruses in water using culturing method cannot reliably detect viruses in drinking water. Caudovirales are the most abundant type of virus in water supply systems and are sensitive to chloramine disinfection. Lentivirus , as a virus that can infect humans and vertebrates, has strong resistance to UV and chloramine disinfection. The main virus hosts in the studied water supply system were bacteria (61.50%). The viruses in the raw water were mainly parasitic in Synechococcus . The dominant virus host was Pseudomonas in both the effluent water and pipe network water. The gene abundance of the Pseudomonas aeruginosa host in the pipe network increased by 342.62%, which requires further attention as a virus risk in pipe network systems. Overall, combined UV chloramine disinfection was more effective at the removal of virus hosts than single UV disinfection (51.97% compared to 0.79%).

Objective: To investigate whether low-carbohydrate diets (LCDs) were associated with coronary artery calcium (CAC) progression. Approach and Results: We included the participants who completed computed tomography assessment of baseline CAC in 2000 to 2001 (year 15) and follow-up (year 20 or 25) and food frequency questionnaire (years 0, 7, and 20) in the CARDIA study (Coronary Artery Risk Development in Young Adults). CAC progression was defined as CAC >0 at follow-up among participants with baseline CAC of 0 and an annualized change of 10 or percent change of ≥10% for those with 0

Objective: To investigate a reasonable lymph node (N) staging system for gastric cancer patients with ≤15 retrieved lymph nodes (LNs)., Methods: The clinicopathological and follow-up data of patients with ≤15 LNs were obtained from the US Surveillance, Epidemiology, and End Results (SEER) database to analyze the impact of the number of retrieved LNs and metastatic status on the prognosis. In addition, external validation was achieved with data from two medical centers in China., Results: A total of 18,139 gastric cancer patients with 1-15 retrieved LNs from the SEER database were enrolled and randomly divided into the training group and the internal validation group. A new LN staging system, mNr staging (mNr0-4; 5 stages), was established according to the number of retrieved LNs and the metastatic rate. Compared with the TNM and TNrM staging systems (established by Wang J; misclassification rates of 50.4% and 62.5%, respectively), the mTNrM staging system had a lower misclassification rate (23.4%). Furthermore, there was a significant difference in the 5-year overall survival (OS) rate between the mTNrM staging subgroups (p < 0.05); however, no significant difference was found in the 5-year OS rate of partial adjacent stages in the TNM (8th edition) and TNrM (p > 0.05) staging systems. Similar results were obtained in the external validation cohort., Conclusion: mNr and mTNrM staging systems can efficiently distinguish a survival difference in patients who undergo gastrectomy with ≤15 retrieved LNs, with more accurate predictions of the 5-year OS rate of patients compared with the TNM and TNrM staging systems., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)

BACKGROUND Studies have shown that thiamine intake is associated with cervical cancer, but the relationship between thiamine and HPV infection remains unclear. In the present study, we used the National Health and Nutrition Examination Survey (NHANES) database to investigate whether HPV infection was associated with thiamine intake. MATERIAL AND METHODS A total of 13 471 women ages 18-59 years were selected from the NHANES database from 2003 to 2016. Using thiamine intake as the independent variable, HPV infection as the dependent variable, and sociodemographic data and other data as the covariates, we analyzed the relationship between thiamine and HPV infection by conducting a weighted logistic regression model in a cross-sectional research design. RESULTS The two-piecewise linear model indicated the inflection point of thiamine intake was 2.07 mg. On the left side of the inflection point, the difference in the thiamine intake of log2 conversion was related to the difference of 0.82 in HPV infection, which means that the increase of every 1 unit increase in thiamine intake is associated with the decrease of the HPV infection by 18%. On the right side of the inflection point, we did not observe a correlation between HPV infection and thiamine intake. CONCLUSIONS Thiamine intake is negatively correlated with HPV infection. Intake of an appropriate amount of thiamine can prevent HPV infection. The best preventive effect can be achieved when the intake is about 2 mg, and excessive intake will not increase the preventive effect.

Purpose: To determine the indications for adjuvant chemotherapy (AC) in patients with stage IIa gastric cancer (T3N0M0 and T1N2M0) according to the 7th American Joint Committee on Cancer (AJCC)., Methods: A total of 1593 patients with T3N0M0 or T1N2M0 stage gastric cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database for the period 1988.1-2012.12. Cox multiple regression, nomogram and decision curve analyses were performed. External validation was performed using databases of the Fujian Medical University Union Hospital (FJUUH) (n = 241) and Italy IMIGASTRIC center (n = 45)., Results: Cox multiple regression analysis showed that the risk factors that affected OS in patients receiving AC were age > 65 years old, T1N2M0, LN dissection number ≤ 15, tumor size > 20 mm, and nonadenocarcinoma. A nomogram was constructed to predict 5-year OS, and the patients were divided into those predicted to receive a high benefit (points ≤ 188) or a low benefit from AC (points > 188) according to a recursive partitioning analysis. OS was significantly higher for the high-benefit patients in the SEER database and the FJUUH dataset than in the non-AC patients (Log-rank < 0.05), and there was no significant difference in OS between the low-benefit patients and non-AC patients in any of the three centers (Log-rank = 0.154, 0.470, and 0.434, respectively). The decision curve indicated that the best clinical effect can be obtained when the threshold probability is 0-92%., Conclusion: Regarding the controversy over whether T3N0M0 and T1N2M0 gastric cancer patients should be treated with AC, this study presents a predictive model that provides concise and accurate indications. These data show that high-benefit patients should receive AC.

Little information is available on associations between different lumbar interbody fusion (LIF) surgeries and postoperative outcomes. The present study aims to comprehensively investigate whether different LIF techniques are associated with postoperative outcomes such as complications and length of hospital stay. The United States Nationwide Inpatient Sample (NIS) was searched for patients diagnosed with recurrent lumbar disc herniation who underwent lumbar interbody fusion (LIF) surgeries between 2005 and 2014. Patients were categorized based on LIF approaches: anterior lumbar interbody fusion (ALIF); lateral lumbar interbody fusion (LLIF); or posterior lumbar interbody fusion/transforaminal lumbar interbody fusion (PLIF/TLIF). A total of 2625 patients were included in this study. After adjusting for age, severity of illness, and comorbidities, patients who received LLIF and PLIF/TLIF approaches had significantly shorter hospital stays than those receiving ALIF (LLIF vs. ALIF, β = -0.64; PLIF/TLIF vs. ALIF, β = -0.40). In addition, patients who received LLIF and PLIF/TLIF approaches had significantly lower risk of digestive system complications compared to those receiving ALIF (LLIF vs. ALIF, aOR = 0.25; PLIF/TLIF vs. ALIF, aOR = 0.18). In conclusion, in patients with recurrent lumbar disc herniation, LLIF and PLIF/TLIF approaches are associated with shorter hospital stays and lower risk of digestive system complications than ALIF. However, LIF approaches do not correlate significantly with the risk of postoperative bleeding or nervous system complications., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Understanding the sectoral contribution of emissions to fine particulate matter (PM 2.5 ) offers information for air quality management, and for investigation of association with health outcomes. This study evaluates the contribution of different emission sectors to PM 2.5 in 2013 for Canada using the GEOS-Chem chemical transport model, downscaled with satellite-based PM 2.5 . Despite the low population-weighted PM 2.5 concentrations of 5.5 μg m -3 across Canada, we find that over 70% of population-weighted PM 2.5 originates from Canadian sources followed by 30% from the contiguous United States. The three leading sectoral contributors to population-weighted PM 2.5 over Canada are wildfires with 1.0 μg m -3 (17%), transportation with 0.96 μg m -3 (16%), and residential combustion with 0.91 μg m -3 (15%). The relative contribution to population-weighted PM 2.5 of different sectors varies regionally with residential combustion as the leading contributor in Central Canada (19%), while wildfires dominate over Northern Canada (59%), Atlantic Canada (34%), and Western Canada (18%). The contribution from U.S. sources is larger over Central Canada (33%) than over Western Canada (17%), Atlantic Canada (17%), and Northern Canada (<2%). Sectoral trend analysis showed that the contribution from anthropogenic sources to population-weighted PM 2.5 decreased from 7.1 μg m -3 to 3.4 μg m -3 over the past two decades.

Theory and research converge to suggest that authenticity predicts positive psychological adjustment. Given these benefits of authenticity, there is a surprising dearth of research on the factors that foster authenticity. Five studies help fill this gap by testing whether self-compassion promotes subjective authenticity. Study 1 found a positive association between trait self-compassion and authenticity. Study 2 demonstrated that on days when people felt more self-compassionate, they also felt more authentic. Study 3 discovered that people experimentally induced to be self-compassionate reported greater state authenticity relative to control participants. Studies 4 and 5 recruited samples from multiple cultures and used a cross-sectional and a longitudinal design, respectively, and found that self-compassion predicts greater authenticity through reduced fear of negative evaluation (Study 4) and heightened optimism (Study 5). Across studies, self-compassion's effects on authenticity could not be accounted for by self-esteem. Overall, the results suggest that self-compassion can help cultivate subjective authenticity.

Background: Young survivors of gastric cancer (GC) have better prognoses than elderly patients, yet their disease-specific survival (DSS) has received little attention., Patients and Methods: Data on young patients (aged ≤40 years) with GC undergoing resections at three Chinese institutions ( n = 542) and from the SEER database ( n = 533) were retrospectively analyzed. Three-year conditional disease-specific survival (CS3) was assessed. The effects of well-known prognostic factors over time were analyzed by time-dependent Cox regression., Results: Overall, young Chinese patients with GC had a better 5-year DSS than U.S. patients (62.8% vs. 54.1%; p < .05). The disease-specific mortality likelihood of the entire cohort was not constant over time, with most deaths occurring during the first 3 years after surgery but peaking at 1 and 2 years in China and the U.S., respectively. Based on 5-year survivorship, the CS3 rates of both groups were similar (90.9% [U.S.] vs. 91.5% [China]; p > .05). Cox regression showed that for Chinese patients, site, size, T stage, and N stage were independent prognostic factors at baseline ( p < .05). For U.S. patients, grade, T stage. and N stage significantly affected DSS at baseline ( p < .05). In both groups, only T stage continuously affected DSS within 3 years after gastrectomy. However, for both groups, the initial well-known prognostic factors lost prognostic significance after 5 years of survival (all p > .05). Although the 5-year DSS rates of young Chinese patients with T3 and T4a disease were significantly better than those of young U.S. patients, in each T stage, the CS3 of both regions trended toward consistency over time., Conclusion: For young patients with GC, the factors that predict survival at baseline vary over time. Although the initial 5-year DSS is heterogeneous, insight into conditional survival will help clinicians evaluate the long-term prognoses of survivors while ignoring population differences., Implications for Practice: With the increasing number of young survivors of gastric cancer (GC), it is essential for clinicians to understand the dynamic prognosis of these patients. Based on large data sets from China and the U.S., this study found that the prognostic factors that predict survival for young patients with GC at baseline vary over time. Although the initial 5-year disease-specific survival is heterogeneous, insight into conditional survival will help clinicians evaluate the long-term prognoses of survivors while ignoring population differences. This knowledge may be more effective in helping young patients with GC to manage future uncertainties, especially when they need to make important life plans., Competing Interests: Disclosures of potential conflicts of interest may be found at the end of this article., (© AlphaMed Press 2018.)

Background: The aim of this study is to investigate trends in the incidence and survival of patients with gastric neuroendocrine neoplasms (g-NENs)., Methods: and methods: Patients diagnosed with g-NENs (n = 3523) were identified from the Surveillance, Epidemiology and End Results (SEER) database. Patients diagnosed with g-NENs (n = 199) in our department were designated as a validation dataset. Nomograms were adopted to predict disease-specific survival (DSS) and overall survival (OS)., Results: The incidence of g-NENs is steadily increasing over time at a rate higher than any other cancer [annual percentage change (APC) = 6.3%, 95% confidence interval (CI) 5.6-7.0]. The 1-, 3-, and 5-year DSS rates were 87%, 78.6% and 70.6%, respectively, and the corresponding OS rates were 84.3%, 71.9%, and 53.7%, respectively. The multivariate analysis identified age, sex, T stage, M stage, and histological type as independent prognostic factors for both DSS and OS (all P < .05). The concordance indexes of the nomograms for DSS and OS in the training dataset were superior to those of the traditional tumor-node-metastasis (TNM) staging system [0.899 and 0.849 versus 0.864 and 0.783]. Calibration plots of the nomograms showed that the probability of DSS and OS closely corresponded to the actual observations in both the SEER-based training dataset and our inpatient validation dataset., Conclusion: The incidence of g-NENs has been steadily increasing at a rapid rate over the past four decades. The nomograms based on the analysis of the SEER database were superior to the TNM staging system in predicting the clinical outcomes for g-NEN patients., (Copyright © 2018. Published by Elsevier Ltd.)

Background: The aim of this work is to compare the prognostic ability between the 7th and 8th editions of the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) classification for gastric cancer (GC)., Methods: A total of 10,194 noncardia GC patients were identified from the Surveillance, Epidemiology, and End Results database from 1988 to 2008. Concordance index (C-index), bayesian information criterion (BIC), and time-dependent receiver operating characteristic (t-ROC) analyses were used. External validation was performed using a dataset (n = 2355) derived from Fujian Medical University Union Hospital., Results: Overall survival for all five AJCC N categories differed significantly when patients were subgrouped into ≤ 15 versus >15 examined lymph nodes (eLNs). The prognostic ability of the 8th edition (C-index 0.716) was not improved over the 7th edition (C-index 0.716). Subgroup analysis showed superior performance of the 8th over the 7th edition in patients with > 15 eLNs (C-index 0.742 vs. 0.735); however, the two editions showed similar performance for patients with ≤ 15 eLNs (C-index 0.713 vs. 0.713). The BIC and t-ROC analyses were consistent. To better predict the prognosis of patients with ≤ 15 eLNs, we established a novel prognostic model based on independent prognostic factors (C-index 0.735). BIC analysis showed that this new model was better than the 7th and 8th editions. Similar results were obtained from the validation set., Conclusions: The 8th edition of the AJCC TNM classification shows better prognostic ability than the 7th edition in noncardia GC patients with > 15 eLNs, but no improvement was found in patients with ≤ 15 eLNs; therefore, a novel prognostic model is proposed.

Objectives: Consumer values, including but not limited to materialism, have received much less attention than other topics within research on Asian Americans., Methods: Across 3 studies (N = 6,955), the author explored the difference between Asian Americans and White/European Americans on materialism, and the mediating and moderating mechanisms., Results: Studies 1a-1c found Asian Americans, compared to White/European Americans, more strongly endorsed materialistic values. In Study 2, the author tested a multiple mediation model and demonstrated that Asian Americans, compared to White/European Americans, more strongly endorse materialistic values because they reported higher extrinsic aspirations (i.e., stronger desires for money, image, and popularity). Finally, in Study 3, the author tested a moderation model and found that Asian Americans who are higher on a general tendency to adhere to norms endorse a greater level of materialism than White/European Americans., Conclusions: The author discussed how these results have implications for expanding the research topics within research on Asian Americans, consequences for mental health and provide future directions to counteract materialism. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Background: The dynamic prognosis of patients who have undergone curative surgery for gastric cancer has yet to be reported. Our objective was to devise an accurate tool for predicting the conditional probability of survival for these patients., Methods: We analyzed 11,551 gastric cancer patients from the Surveillance, Epidemiology, and End Results database. Two-thirds of the patients were selected randomly for the development set and one-third for the validation set. Two nomograms were constructed to predict the conditional probability of overall survival and the conditional probability of disease-specific survival, using conditional survival methods. We then applied these nomograms to the 4,001 patients in the database from Fujian Medical University Union Hospital, Fuzhou, China, one of the most active Chinese institutes., Results: The 5-year conditional probability of overall survival of the patients was 41.6% immediately after resection and increased to 52.8%, 68.2%, and 80.4% at 1, 2, and 3 years after gastrectomy. The 5-year conditional probability of disease-specific survival "increased" from 48.9% at the time of gastrectomy to 59.8%, 74.7%, and 85.5% for patients surviving 1, 2, and 3 years, respectively. Sex; race; age; depth of tumor invasion; lymph node metastasis; and tumor size, site, and grade were associated with overall survival and disease-specific survival (P <.05). Within the Surveillance, Epidemiology, and End Results validation set, the accuracy of the conditional probability of overall survival nomogram was 0.77, 0.81, 0.82, and 0.82 at 1, 3, 5, and 10 years after gastrectomy, respectively. Within the other validation set from the Fujian Medical University Union Hospital (n = 4,001), the accuracy of the conditional probability of overall survival nomogram was 0.76, 0.79, 0.77, and 0.77 at 1, 3, 5, and 10 years, respectively. The accuracy of the conditional probability of disease-specific survival model was also favorable. The calibration curve demonstrated good agreement between the predicted and observed survival rates., Conclusion: Based on the large Eastern and Western data sets, we developed and validated the first conditional nomogram for prediction of conditional probability of survival for patients with gastric cancer to allow consideration of the duration of survivorship., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Criteria for determining brain death (BD) vary between China and the United States. We reported the results of an investigation designed to compare procedures to determine BD in two countries., Methods: The latest criteria in the United states were published in 2010. The latest criteria in China were published in 2009. We used these two types of BD criteria to evaluate patients who were considered to be BD. The time, cost, and accuracy of the diagnosis were compared., Results: From January 1, 2012 to October 8, 2013, there were 37 patients which were applied for BD evaluation in the Neurological Intensive Care Unit of Beijing Tiantan Hospital. The cause of coma were known as subarachnoid hemorrhage (18 patients, 48.6%), intracerebral hemorrhage (8 patients, 21.6%), cerebral ischemia (9 patients, 24.3%), brain stem tumor (1 patient, 2.7%), and intracranial infection (1 patient, 2.7%). The clinical examinations were done for all of the patients except 1 patient who had low blood pressure. Three patients had brainstem reflexes that were excluded from BD. Twenty-five patients had apnea tests, and 20 tests were completed that were all positive. Confirmatory tests were completed differently: Transcranial Doppler (30 patients, positive rate 86.7%), electroencephalogram (25 patients, positive rate 100%), and somatosensory evoked potential (16 patients, positive rate 100%). Thirty-three patients were diagnosed BD by criteria of the United States. Only 9 patients were diagnosed BD by Chinese criteria. The use of time and money in the USA criteria was obviously fewer than those in Chinese criteria (P = 0.000)., Conclusion: Compared with BD criteria of the United States, Chinese criteria were stricter, lower positive rate, more cost in money and time, and more reliable by families and doctors.

Aim: To verify that the T stage has greater weight than the N stage in the staging of colorectal cancer., Methods: Open data from the Surveillance, Epidemiology, and End Results program were reviewed and analyzed according to the T stage, N stage, and patients' observed survival (OS). The relative weights of the T and N stages were calculated by multiple linear regressions based on their impact on survival. Risk scores for 25 TN categories were then calculated from the T and N stage relative weights, and a rearranged tumor node metastasis (TNM) staging system was proposed via a cluster analysis of the TN scores., Results: Both T and N stages significantly affect the OS of patients with colorectal cancer. Moreover, the T stage has greater weight than the N stage in the TNM staging system of colorectal cancer. For colon cancer, the relative T and N stage weights were 0.58 and 0.42, respectively, and for rectal cancer, the relative T and N stage weights were 0.61 and 0.39, respectively. On the basis of cluster analysis of the TN scores, T1N1a was classified to stage I, and T2N1a-1b and T1N1b-2a were classified to stage II in our revised TNM staging system for both colon and rectal cancer. For colon cancer, T4bN0 was classified to stage IIIa, but for rectal cancer, it was classified to stage IIIb., Conclusion: As the T stage affects colorectal cancer survival more significantly than the N stage, the TNM staging should be revised by relative T stage weight.

It remains unclear whether exposure to low-level mercury (Hg) is associated with impaired renal function, and whether omega-3 fatty acid (FA) intake could affect the association of interest. The current study examined the association of blood Hg and omega-3 FAs with renal function using data from 1046 subjects aged 40 or above from the 2003-2004 National Health and Nutrition Examination Survey. Kidney function was assessed by estimated glomerular filtration rate (eGFR) and occurrence of albuminuria. Logistic regression analyses were applied to assess the association of interest with confounding variable adjustment. The analyses indicated that blood Hg was associated with reduced eGFR (<60mL/min/1.73m(2)) in a dose-response fashion (p<0.05). The association was particularly apparent with adjustment for blood omega-3 FA levels. The adjusted odds ratio for having reduced eGFR was 2.94 (95% confidence interval=1.04-8.33) in the highest tertile of blood Hg as compared with the lowest tertile. There was no significant association between Hg exposure and albuminuria. In summary, this study demonstrates that Hg exposure is associated with increased odds of having lower GFR in the US population aged 40 or above. A statistical association with albuminuria was not apparent. We also observed that omega-3 FA intake may play a preventive role in Hg-induced nephrotoxicity. Additional studies are warranted to determine the sources, exposure routes, and forms of Hg most responsible for observed associations., (Published by Elsevier GmbH.)

Cadmium (Cd) exposure has been associated with increased cancer risk, and zinc (Zn) appears to reduce that risk. However, little is known about the combined influence of Cd and Zn on cancer risk. The aim of this study was to examine relationships between Cd exposure, Zn intake, and cancer mortality risks. The analyses used 5204 subjects aged 50 yr or older from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) and the mortality follow-up through December 31, 2006. Cox proportional hazards models were used to test associations. In total, 569 cancer deaths were recorded during an average follow-up of 12.4 yr, including 155 from lung, 61 from prostate, and 26 from breast cancer. A positive association between Cd and cancer mortality risk was identified for both genders. Despite limited cause-specific deaths, the increased risk associated with Cd was significant for lung cancer in men. All-cause cancer mortality risk was significantly elevated among women with Zn intakes below the recommended dietary allowance (RDA) compared with women who met the RDA. The effect of low dietary Zn was not observed in men. Similar trends for prostate and breast cancer deaths were not significant. There was a significant inverse association between cancer deaths and the Zn-to-Cd ratio for both genders. Cd exposure is an important independent risk factor of cancer mortality in older Americans and the risk appears exaggerated in those with inadequate dietary Zn. Additional studies are required to elucidate the mechanism(s) by which Zn participates in the carcinogenic influence of Cd.

Objective: The objective was to evaluate the association of a panel of renal biomarkers with long-term mortalities., Methods: Participants in the Third National Health and Nutrition Examination Survey (NHANES III) aged 35 years and above were included and Framingham risk scores were calculated. Renal-related biomarkers, including creatinine-based estimated glomerular filtration rate (eGFR), cystatin C, uric acid, C-reactive protein (CRP), fibrinogen, urinary cadmium, albuminuria, homocysteine, and vitamin D were tested by Cox-regression model for their association with all-cause, cardiovascular (CV), and non-CV mortality obtained from the 2006 NHANES III-linked follow-up data, stratified by sex and Framingham risk., Results: In the 4873 men and 5372 women, 36.3%, 28.1%, and 35.6% of men and 67.2%, 25.8%, and 7.0% of women were classified into low-, intermediate-, and high coronary risk groups. With an average follow-up of 13.2 years, a total of 3632 deaths and 1657 CV deaths were recorded. Albuminuria was associated with all-cause mortality in both sexes across coronary risk groups. Creatinine-based eGFR provided additional differential capacity only in the women with intermediate-to-high coronary risk. Cystatin C was associated with all-cause mortality in the men with intermediate-to-high coronary risk and with CV mortality in the women with low coronary risk. Urinary cadmium was positively related to non-CV mortality. High vitamin D was protective against cardiovascular mortality in a limited category of men and women., Conclusions: Albuminuria is associated with long-term all-cause mortalities independent of Framingham risks. Adding the panel of renal biomarkers provides limited advantages for predicting risk when compared to FRS alone., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Objectives: The objective was to test the association of cystatin C (Cys-C) with long-term mortality risk in the subjects with normal creatinine-based estimated glomerular filtration rates (eGFR)., Background: Cys-C has been proposed as a sensitive indicator of renal dysfunction that is associated with cardiovascular events. The predictive value of Cys-C for mortality risk (both cardiovascular and noncardiovascular) and its utility among persons with normal kidney function remains unclear., Methods: The analysis included 2,990 subjects over 40 years of age with normal eGFR who participated in NHANES III (Third National Health and Nutrition Examination Survey). Normal eGFR was defined by Modification of Diet in Renal Disease (MDRD) equation ≥60 ml/min/1.73 m(2). Serum Cys-C was categorized as high, medium, or low. In 1 analysis, the high and low groups were the top and bottom 10%, and in the second analysis, they were the upper and lower thirds. All-cause and cause-specific mortality were obtained from the NHANES III-linked follow-up file through December 31, 2006. Multivariate Cox regression models were applied to assess the association of interest., Results: Within an average of 13.7 years follow-up, 488 cardiovascular and 719 noncardiovascular deaths occurred. When the first and last deciles were compared, the relative risks were all increased statistically as follows: all-cause, 4.36 (95% confidence interval [CI]: 2.52 to 7.82); cardiovascular, 7.44 (95% CI: 3.06 to 18.1); cancer, 2.45 (95% CI: 0.85 to 7.04); and noncardiovascular 3.15 (95% CI: 1.53 to 6.49) mortalities. Relative risks all moderated to lower values when the comparisons were expanded to include the upper and lower thirds. Similar associations were still present when Cys-C was modeled on a continuous scale, suggesting a linear relationship between Cys-C and mortality outcomes., Conclusions: Serum Cys-C is prognostic of long-term mortality in the subjects with relatively normal renal function, independent of MDRD eGFR and albuminuria., (Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study was to measure the fluoride concentrations in ready-to-eat infant food, and to determine if significant differences exist among flavors and brands., Methods: One hundred fifty samples of 5 infant food flavors from an organic infant food manufacturer and the largest infant food manufacturer were compared using the Taves microdiffusion method. Total fluoride ingestion per serving was calculated based on average amounts consumed and container size of individual products., Results: Fluoride concentrations ranged from 0.01 to 0.60 ppm (mean = 0.170 +/- 0.125 [SD] ppm) for all samples, with both the highest and lowest fluoride concentrations found in processed banana infant food (Gerber, mean = 0320 +/- 0.167 ppm; Earth's Best, mean = 0.030 +/- 0.013 ppm). Significant differences were noted when comparing the 2 infant food manufacturers for all flavors., Conclusions: The fluoride concentrations in ready-to-eat infant food varied among the 5 flavors tested. All infant foods tested were found to provide less fluoride than the Institute of Medicine tolerable upper daily intake. No trends in fluoride concentrations for different flavors or brands were noted. Fluoride in infant foods should be considered when determining total fluoride intake.

Background and Objective: This study examined whether zinc intake was associated with lower risk of smoking-induced obstructive lung disorder through interplay with cadmium, one of major toxicants in cigarette smoke., Methods: Data were obtained from a sample of 6,726 subjects aged 40+ from the Third National Health and Nutrition Examination Survey. The forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured using spirometry. Gender-, ethnicity-, and age-specific equations were used to calculate the lower limit of normal (LLN) to define obstructive lung disorder as: observed FEV1/FVC ratio and FEV1 below respective LLN. Zinc intake was assessed by questionnaire. Logistic regression analysis was applied to investigate the associations of interest., Results: The analyses showed that an increased prevalence of obstructive lung disorder was observed among individuals with low zinc intake regardless of smoking status. The adjusted odds of lung disorder are approximately 1.9 times greater for subjects in the lowest zinc-intake tertile than those in the highest tertile (odds ratio = 1.89, 95% confidence interval = 1.22-2.93). The effect of smoking on lung function decreased considerably after adjusting for urinary cadmium. Protective association between the zinc-to-cadmium ratio (log-transformed) and respiratory risk suggests that zinc may play a role in smoking-associated lung disorder by modifying the influence of cadmium., Conclusions: While zinc intake is associated with lower risk of obstructive lung disorder, the role of smoking cession and/or prevention are likely to be more important given their far greater effect on respiratory risk. Future research is warranted to explore the mechanisms by which zinc could modify smoking-associated lung disease.

Aims: Duck enteritis virus (DEV) is a member of the family Herpesviridae, the genome of which is not completely analyzed. In order to provide further insights into the genomic organization, we decided to amplify the unknown sequence in the US region since three key glycoproteins are coded in this region. Glycoprotein D encoded by US6 gene is essential for virus entry and plays an important role in protecting animals from lethal challenge. Glycoprotein I and E encoded by US7 and US8 gene are required for cell-to-cell spread., Methods: Single oligonucleotide nested polymerase chain reaction was adopted to amplify the unknown sequence. The open reading frames (ORF) were predicted by Editseq program. Then the sequence was submitted to an online program to search promoter, polyadenylation signal and potential N-glycosylation sites. The phylogenetic analysis was performed by MEGA4.1, while multiple alignments were performed by ClustalX., Results: Three complete ORFs including US6, US7 and US8 were determined. The three genes shared the same polyadenylation signal. Phylogenetic analysis showed that DEV was closed to mardivirus of alphaherpesvirus., Conclusion: These results extend our understanding of the DEV genome and its classification, and also provide further basic knowledge for functional investigations on the proteins in the US region., (2010 S. Karger AG, Basel.)

The genome organization of the novel human papillomavirus type 108 (HPV108), isolated from a low-grade cervical lesion, deviates from those of other HPVs in lacking an E6 gene. The three related HPV types HPV103, HPV108, and HPV101 were isolated from cervicovaginal cells taken from normal genital mucosa (HPV103) and low-grade (HPV108) and high-grade cervical (HPV101) intraepithelial neoplasia (Z. Chen, M. Schiffman, R. Herrero, R. DeSalle, and R. D. Burk, Virology 360:447-453, 2007, and this report). Their unusual genome organization, against the background of considerable phylogenetic distance from the other HPV types usually associated with lesions of the genital tract, prompted us to investigate whether HPV108 E7 per se is sufficient to induce the above-mentioned clinical lesions. Expression of HPV108 E7 in organotypic keratinocyte cultures increases proliferation and apoptosis, focal nuclear polymorphism, and polychromasia. This is associated with irregular intra- and extracellular lipid accumulation and loss of the epithelial barrier. These alterations are linked to HPV108 E7 binding to pRb and inducing its decrease, an increase in PCNA expression, and BrdU incorporation, as well as increased p53 and p21(CIP1) protein levels. A delay in keratin K10 expression, increased expression of keratins K14 and K16, and loss of the corneal proteins involucrin and loricrin have also been noted. These modifications are suggestive of infection by a high-risk papillomavirus.

Background: This study was designed to elucidate the relationship between chronic kidney disease (CKD), atherosclerotic complications, and the effects on functional performance in the elderly., Methods: A total of 2431 subjects aged 65 and above from the National Health and Nutrition Survey (NHANES) 1999-2002 were included to formulate a population-based observational study. A structural equation model (SEM) was constructed to validate the relationship between renal impairment, atherosclerotic complications, and cognitive and physical function., Results: The results showed that renal impairment was independently associated with physical and cognitive function after adjustment of potential confounding factors (B=-0.12, p=0.02). Renal impairment was positively associated with atherosclerotic complications (B=0.26, p<0.001), which was in turn negatively associated with functional performance (B=-0.24, p<0.001). Variance analysis showed that 57% of the differences in physical and cognitive function could be attributed to CKD, CKD-associated atherosclerosis, and other cardiovascular risk factors., Conclusions: CKD may have impacts on the cognitive and physical function either directly or indirectly via atherosclerotic complications.