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Background: Anthocyanidins encompass a diverse array of compounds that possess notable anti-inflammatory and antioxidant properties with pharmacological activity. However, the correlation between the consumption of anthocyanidins through diet and its impact on depression has yet to be investigated. Methods: This study utilized the Food and Nutrient Database for Dietary Studies (FNDDS) expanded flavonoid intake database, as well as data from the National Health and Nutrition Examination Survey (NHANES) from the years 2007 to 2010 and 2017 to 2018. The analysis of the collected data was conducted in R, following the guidelines outlined in the official NHANES user guide "Stratified Multi-stage Probability Sampling". Three different models were developed using logistic regression to assess the protective effects of T3 (representing the highest intake of anthocyanidins) against depression. Additionally, the study aimed to investigate whether there existed a non-linear relationship between the dietary intake of anthocyanidins and the prevalence of depression by employing restricted cubic spline (RCS) analysis. Results: A total of 6,845 eligible participants were included in this cross-sectional study, with their data appropriately weighted to represent a population of 89.8 million people in the United States of America. The results demonstrated that individuals diagnosed with depression had a significantly lower dietary intake of anthocyanidins compared to those without depression (P < 0.0001). Moreover, significant differences were observed among different participant groups regarding socioeconomic status and the presence of chronic physical illnesses (such as hypertension, glucose status, and chronic kidney disease risk, etc.) (P < 0.05). After adjustment for covariates, participants with the highest intake of anthocyanins (T3) demonstrated a significantly reduced risk of depression [ORT3 = 0.67, 95%CI: (0.48–0.95), (Ptrend= 0.02]. Furthermore, the RCS analysis revealed a significant linear relationship between dietary anthocyanidin intake and depression (P for non-linear = 0.5876). Conclusion: Our findings reveal a negative association between dietary anthocyanidin intake and depression. [ABSTRACT FROM AUTHOR]

Background and Aims: The pathways model is a highly cited etiological model of problem gambling. In the past two decades, a number of studies have found support for the model's utility in classifying gambling subtypes. The aims of this paper were to refine empirically the model subtypes and to revise and update the model based on those findings. Design and Measurement: Observational study using data collected from treatment‐seeking problem gamblers using the Problem Gambling Severity Index (PGSI) and the Gambling Pathways Questionnaire (GPQ). Setting: Treatment clinics in Canada, Australia and the United States. Participants: A convenience sample of 1168 treatment‐seeking problem gamblers, aged 18 years or older. Findings Empirically validated risk factors were analyzed using latent class analyses, identifying a three‐class solution as the best‐fitting model. Those in the largest class (class 1: 44.3%, n = 517) reported the lowest levels of all etiological risk factors. Participants in class 2 (39.5%, n = 461) reported the highest rates of anxiety and depression, both before and after gambling became a problem, as well as childhood maltreatment, and a high level of gambling for stress‐coping. Those in class 3 (16.3%, n = 190) reported high levels of impulsivity; risk‐taking, including sexual risk‐taking; antisocial traits; and coping to provide meaning in life and to alleviate stress. Conclusions: The revised pathways model of problem gambling includes three classes of gamblers similar to the three subtypes in the original pathways model, but class 3 in the revised pathways model is distinct from class 2, showing higher levels of risk‐taking and antisocial traits and gambling motivated by a desire for meaning/purpose and/or to alleviate stress. Class 2 in the revised pathways model demonstrates high levels of childhood maltreatment as well as gambling for stress‐coping. [ABSTRACT FROM AUTHOR]

Context: Lipodystrophy syndromes are rare disorders of deficient adipose tissue, low leptin, and severe metabolic disease, affecting all adipose depots (generalized lipodystrophy, GLD) or only some (partial lipodystrophy, PLD). Left ventricular (LV) hypertrophy is common (especially in GLD); mechanisms may include hyperglycemia, dyslipidemia, or hyperinsulinemia.Objective: Determine effects of recombinant leptin (metreleptin) on cardiac structure and function in lipodystrophy.Methods: Open-label treatment study of 38 subjects (18 GLD, 20 PLD) at the National Institutes of Health before and after 1 (N = 27), and 3 to 5 years (N = 23) of metreleptin. Outcomes were echocardiograms, blood pressure (BP), triglycerides, A1c, and homeostasis model assessment of insulin resistance.Results: In GLD, metreleptin lowered triglycerides (median [interquartile range] 740 [403-1239], 138 [88-196], 211 [136-558] mg/dL at baseline, 1 year, 3-5 years, P < .0001), A1c (9.5 ± 3.0, 6.5 ± 1.6, 6.5 ± 1.9%, P < .001), and HOMA-IR (34.1 [15.2-43.5], 8.7 [2.4-16.0], 8.9 [2.1-16.4], P < .001). Only HOMA-IR improved in PLD (P < .01). Systolic BP decreased in GLD but not PLD. Metreleptin improved cardiac parameters in patients with GLD, including reduced posterior wall thickness (9.8 ± 1.7, 9.1 ± 1.3, 8.3 ± 1.7 mm, P < .01), and LV mass (140.7 ± 45.9, 128.7 ± 37.9, 110.9 ± 29.1 g, P < .01), and increased septal e' velocity (8.6 ± 1.7, 10.0 ± 2.1, 10.7 ± 2.4 cm/s, P < .01). Changes remained significant after adjustment for BP. In GLD, multivariate models suggested that reduced posterior wall thickness and LV mass index correlated with reduced triglycerides and increased septal e' velocity correlated with reduced A1c. No changes in echocardiographic parameters were seen in PLD.Conclusion: Metreleptin attenuated cardiac hypertrophy and improved septal e' velocity in GLD, which may be mediated by reduced lipotoxicity and glucose toxicity. The applicability of these findings to leptin-sufficient populations remains to be determined. [ABSTRACT FROM AUTHOR]

Here, we present a method for measuring dimensions of nanostructures using specular reflection of electrons from an electronically opaque surface. Development of this method has been motivated by measurement needs of the semiconductor industry [International Technology Roadmap for Semiconductors 2.0. Metrology (http://www.itrs2.net, accessed 5 January 2017, 2015); Vaid et al., J. Micro/Nanolithogr., MEMS, MOEMS 13, 041410 (2014); Bunday, Proc. SPIE 9778, 97780E–97780E-34 (2016); Bunday et al., Proc. SPIE 10585, 105850I (2018)], and it can also be more broadly applicable to any periodic, pseudoperiodic, or statistically stationary nanostructures or nanopatterns on an opaque substrate. In prior work [Friedman et al., Appl. Phys. Lett. 111, 123106 (2017); Wu et al., U.S. patent 9,390,888 (12 July 2016)], it was demonstrated through the presentation of proof of concept experiments and simulated examples that Reflective Small Angle Electron Scattering (RSAES) can meet certain dimensional metrology requirements of the semiconductor industry. In RSAES, an entire reflected scattering pattern is measured, with the scattered electrons being of primary interest. Later, in the process of further simulating RSAES, it was serendipitously discovered that dimensional measurements using reflected electrons might be greatly simplified by Electron Reflectometry (ER), whereby the intensity of the specularly reflected electron beam is measured and the scattered beams are ignored [Friedman and Wu, U.S. patent application 2019/0057834 A1 (21 February 2019)]. This innovation may allow faster and cheaper development and deployment or at the very least provide an alternate pathway to exploit the phenomenon of reflected electrons for the dimensional measurements. Here, we discuss how ER complements existing dimensional measurement techniques and show simulated applications with an emphasis on defect detection and linewidth measurements. [ABSTRACT FROM AUTHOR]

We empirically examined citizen views on climate change in China and the United States, including an analysis of factors affecting public support for joining an international climate change treaty. We conducted face-toface intercept surveys of Chinese adults (N=2,047) and online surveys of American adults (N=1,306) between September and November 2013. Overall, Chinese adults were more likely to accept the realities of anthropogenic climate change. Although a supermajority of respondents in both countries support an international climate treaty, support for such action was significantly greater among Chinese respondents compared to Americans. Additionally, a variety of variables reflecting climate change views, including awareness and understanding, were positively correlated with support for a climate treaty in both countries. All else being equal, we also found that more exposure to media content on climate change increased support for a treaty. Lastly, political affiliation was found to have an important influence on support for an international climate treaty in the United States. [ABSTRACT FROM AUTHOR]

li w.-w., wallhagen m.i. & froelicher e.s. (2010) Factors predicting blood pressure control in older Chinese immigrants to the United States of America. Journal of Advanced Nursing 66(10), 2202–2212. Aim. This paper is a report of a study of the extent to which demographic characteristics, medication-related factors, hypertension-related knowledge and medication adherence predict systolic and diastolic blood pressure. Background. Little is known about predictors of hypertension control in Chinese elders. Methods. A longitudinal study with a 3-month follow-up was conducted with 90 Chinese immigrants to the United States of America aged ≥65 years and recruited from 2006 to 2007. The independent variables were measured at baseline. Blood pressure was measured at 3 months. Multiple linear regression analysis was used to evaluate the independent effects of seven variables on change in blood pressure at 3 months. Results. Participants ranged in age from 66 to 92 years (Mean 76·7,sd 6·6). The overall regression model for systolic blood pressure was statistically significant ( R2 = 0·32, F = 4·37, P < 0·01). A higher number of prescribed oral medications (sr2 = 0·06, t = 2·42, P = 0·02) and lower medication adherence (sr2 = 0·07, t = −2·60, P = 0·01) were statistically significant determinants of an increased systolic blood pressure. The overall regression model for diastolic blood pressure was statistically significant ( R2 = 0·21, F = 2·39, P = 0·03). Male gender (sr2 = 0·06, t = 2·26, P = 0·03) and lower medication adherence (sr2 = 0·11, t = −3·03, P < 0·01) were statistically significant determinants of an increased diastolic blood pressure. Conclusion. A greater number of prescribed medications and lower adherence predicted higher level of systolic blood pressure. Male gender and lower adherence were significantly associated with higher level of diastolic blood pressure. These predictors should be considered when designing interventions to help Chinese elders achieve better hypertension management. [ABSTRACT FROM AUTHOR]

Background: Depression and anxiety frequently co-occur with pain and may affect treatment outcomes. Early identification of these co-occurring psychiatric conditions during routine pain screening may be critical for optimal treatment.Objective: To determine aspects of pain related to psychological distress, and, among distressed patients, to determine whether pain factors are related to provider identification of distress.Design: Cross-sectional interview of primary care patients and their providers participating in a Veteran's Administration HELP-Vets study.Subjects: A total of 528 predominately male VeteransMeasurements and Main Results: We measured self-reported pain, including a 0-10 numeric rating scale and interference items from the Brief Pain Inventory. To evaluate distress, brief indicators of depression, anxiety and PTSD were combined. A substantial number of patients had psychological distress (41%), which was even higher (62%) among patients with moderate-severe current pain. Only 29% of those with distress reported talking to their provider about emotional problems during their visit. In multivariate analyses, other pain factors related to distress included interference with enjoyment of life and relationships with others, pain in multiple locations and joint pains. Prior diagnoses of depression and anxiety were also related to current distress. Only prior diagnosis and patient reported headaches and sleep interference because of pain were related to provider identification of distress.Conclusions: VA patients with moderate-severe pain are at high risk for psychological distress, which often goes unrecognized. Providers need to be more vigilant to mental health problems in patients experiencing high pain levels. Targeted screening for co-occurring conditions is warranted. [ABSTRACT FROM AUTHOR]

This paper develops a general equilibrium three-goods Ricardian model that extends Samuelson's example on the impact of productivity progress. Our model highlights Samuelson's insight that productivity progress can change the pattern of trade and in turn can have dramatic welfare implications. It also shows that while Samuelson is correct that productivity growth in one country can hurt another, the loss is not as permanent as his example appears to suggest. Continuing productivity growth in one country is likely to benefit all trading countries in the long run. [ABSTRACT FROM AUTHOR]

Chinese immigrants in the United States have a moderate to high prevalence of hypertension, but little is known about antihypertensive medication compliance in Chinese immigrants. This study presents some first-generation measures of antihypertensive medication compliance in a sample of Chinese immigrants. A literature review and two qualitative pilot studies were conducted to generate culturally sensitive instruments. Items were developed to assess cultural factors and medication compliance in Chinese immigrants receiving antihypertensive medications. Cultural factors included measures of cultural health perception of hypertension, health perceptions of Chinese herbs, health perceptions of Western medications, beneficial self-care behaviors, and social support. Four medication compliance scales were developed. The applicability of these scales was tested in a Chinese immigrant population (n = 200). Cronbach's alpha for the cultural factors scales ranged from .57 to .91. Two of the medication compliance scales had Cronbach's alphas above .60. Results showed that most of the scales are applicable and acceptable in a Chinese immigrant population and had good reliability. However, further testing with a larger sample in other regions of the country is indicated. [ABSTRACT FROM AUTHOR]

Importance: Due to the evolving variants of coronavirus disease 2019 (COVID-19), it is important to understand the relationship between the disease condition and socioeconomic, demographic, and health indicators across regions., Background: Studies examining the relationships between infectious disease and socioeconomic variables are not yet well established., Design: A total of 3042 counties in the United States are included as the observation unit in the study. Two outcome variables employed in the study are the control of disease spread and infection prevalence rates in each county., Method: Data are submitted to quantile regression, hierarchical regression, and random forest analyses to understand the extent to which health outcomes are affected by demographics, socioeconomics, and health indicators., Results: Counties with better control of the disease spread tend to have lower infection rates, and vice versa. When measuring different outcome variables, the common risk factors for COVID-19 with a 5% level of statistical significance include employment ratio, female labor ratio, young population ratio, and residents' average health risk factors, while protective factors include land size, housing value, travel time to work, female population ratio, and ratio of residents who identify themselves as mixed race., Conclusions: The implications of the findings are that the ability to maintain social distancing and personal hygiene habits are crucial in deterring disease transmission and lowering incidence rates, especially in the early stage of disease formation. Relevant authorities should identify preventive factors and take early actions to fight infectious diseases in the future.

Background: Patients with prior cancer history are commonly excluded from clinical trial. However, the impact of prior cancer on survival of patients with gastric cancer remains largely unknown. The aim of this study was to evaluate the prevalence of prior cancer and assess its impact on survival of patients diagnosed with gastric cancer., Methods: Patients with gastric cancer as the primary or second primary malignancies diagnosed from 2004 to 2010 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was conducted to balance baseline characteristics. Kaplan-Meier method, multivariate Cox proportional hazard model, and multivariate competing risk model were performed for survival analysis., Results: A total of 28,795 eligible patients with gastric cancer were included, of whom 2695 (9.35%) had a history of prior cancer. Prostate (35%), breast (12%), colon (8%), and urinary bladder (7%) malignancies were the most common prior cancer types. Patients with prior cancer history had slightly inferior overall survival (AHR = 1.06; 95% CI [1.00-1.12]; P = 0.043) but superior gastric cancer-specific survival (AHR = 0.82; 95% CI [0.76-0.88]; P < 0.001) compared with those without prior cancer. The subgroup analysis determined that a prior cancer history did not adversely affect gastric patients' clinical outcomes, except in those with prior cancer diagnosed within one year, at distant stage, or originating from lung and bronchus., Conclusion: A substantial proportion of gastric cancer patients with a history of prior cancer had non-inferior clinical outcome to those without prior cancer. These patients should be considered in clinical trials., Competing Interests: Declaration of competing interest The authors declare that there are no conflicts of interest associated with the publication of this manuscript., (Copyright © 2021. Published by Elsevier Ltd.)

Background: The relationship between the size of the primary tumor and the prognosis of patients with metastatic renal cell carcinoma (mRCC) is unclear. In this study, we aimed to investigate the significance of the size of the primary tumor in mRCC., Methods: We retrospectively reviewed the data of patients with mRCC who underwent cytoreductive nephrectomy (CN) from 2006 to 2013 in a Chinese center (n = 96) and those in the Surveillance, Epidemiology, and End Results (SEER) database (from 2004 to 2015, n = 4403). Tumors less than 4 cm in size were defined as small. Prognostic factors were analyzed using univariate and multivariate Cox proportional hazards regression analyses., Results: Patients with small tumors had a longer overall survival than other patients, both in the Chinese cohort (median, 30.0 vs 24.0 months, P = 0.026) and the SEER cohort (median, 43.0 vs 23.0 months, P < 0.001). After adjusting for other significant prognostic factors, small tumor size was still an independent protective factor in the Chinese cohort (adjusted hazard ratio [HR], 0.793; 95% confidence interval [CI]: 0.587-0.998, P = 0.043). In the SEER cohort, multivariate analysis showed that small tumor size was also an independent protective factor (HR, 0.880; 95% CI: 0.654-0.987, P = 0.008). In addition, as a continuous variable, a 1 cm elevation in tumor size translated into a 3.8% higher risk of death (HR, 1.038; 95% CI, 1.029-1.046; P < 0.001)., Conclusion: Patients with small tumors may have a favorable prognosis after CN for mRCC. Although CN is not a standard protocol in mRCC, small tumor size may be a candidate when we are deciding to perform CN because of the potential benefit for OS.

Venous thromboembolism (VTE; deep venous thrombosis and pulmonary embolism) is a known complication following primary total knee arthroplasty (TKA). The aim of this study was to investigate the trends of the incidence of VTE after primary TKA and identify associated risk factors for the occurrence of VTEs in a large cohort of TKA patients. We performed a retrospective study in which the Nationwide Inpatient Sample (NIS) database was used to identify all patients who underwent primary TKA over a period of 13 consecutive years (between 2002 and 2014) in the United States. The occurrence of a symptomatic VTE was identified with the use of ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis codes. A total of 1,460,901 primary TKA procedures were identified in the NIS from 2002 to 2014, and 12,944 of these patients were recorded as having 13,855 VTEs, consisting of 7,609 deep venous thromboses (0.52%) and 6,246 pulmonary emboli (0.43%). The overall VTE incidence in patients undergoing TKA in the United States from 2002 to 2014 was 0.89%. Patient-related risk factors for VTEs include an older age (odds ratio [OR]: 1.44; 95% confidence interval [CI]: 1.31-1.59), black race (OR: 1.34; 95% CI: 1.25-1.44), and Medicare insurance (OR: 1.18; 95% CI: 1.13-1.22). Most of the comorbidities were associated with an increased risk of VTE following TKA. Particularly, cardiac arrhythmias, coagulopathy, fluid and electrolyte disorders, pulmonary circulation disorders, and weight loss increased the risk of VTE by more than twofold. After adjusting for confounders, VTE was associated with a longer hospital stay (2.81 ± 0.02 day), increased costs (US$14,212.16 ± US$255.64), and higher mortality rate (OR: 13.04; 95% CI: 11.08-15.35). This nationally representative study of inpatients in the United States identified several independent risk factors for VTE perioperatively in TKA patients and provided evidence that VTE patients after TKA are likely to have worse results than non-VTE patients with regard to the length of hospital stay, hospital costs, and inhospital mortality. This is a level III, prognostic study., Competing Interests: None declared., (Thieme. All rights reserved.)

Allergen immunotherapy (AIT) for allergic rhinitis (AR), asthma, and other allergic diseases has developed quickly. House dust mite (HDM), Artemisia (wormwood), Humulus japonicus (Japanese hop), Alternaria alternata, and Cladosporium herbarum are the five most common inhalant allergens in China. AIT has been performed in China for over 60 years. With the support of the Chinese Medical Association (CMA) and the Chinese Medical Doctors Association (CMDA), the Chinese College of Allergy and Asthma (CCAA) was established in 2016 as a specialized branch of CDMA and is the main certification authority for AIT. Chinese allergists and scientists have made tremendous progress in the development of AIT. There have been many publications by Chinese allergists and scientists worldwide encompassing original research studies, systematic reviews, case studies, and clinical trials. Currently, conventional subcutaneous immunotherapy (SCIT) is the preferred AIT in China, but sublingual immunotherapy (SLIT) is beginning to gain recognition. An increasing number of clinical trials have been conducted to investigate the clinical efficacy and side effects of SLIT and SCIT. In China, HDM is the only commercial standardized allergen extracts in clinical use, whereas the others are crude allergen extracts. Besides standardized allergen extracts, other forms of hypoallergenic extracts are still being investigated and developed in China. Immunotherapy in China is similar to that in the USA in which allergen extracts can be mixed for SCIT. However, allergen extracts cannot be mixed for SCIT in Europe.

Context: Perfluorooctanoic acid (PFOA) and perfluorooctane sulfate (PFOS) are used in a variety of products worldwide. However, the relationship among serum PFOA, PFOS concentration, bone mineral density (BMD), and the risk of fractures has never been addressed., Objectives: The study examined the association among serum PFOA, PFOS concentration, and lumbar spine and total hip BMD in the general US population., Design and Participants: We analyzed data on 2339 adults (aged ≧20 y) from the National Health and Nutrition Examination Survey conducted in 2005-2006 and 2007-2008 to determine the relationship among serum PFOA, PFOS concentration, and total lumbar spine and total hip BMD measured by dual-energy x-ray absorptiometry and history of fractures cross-sectionally., Results: After weighting for sampling strategy, a 1-U increase in the natural log-transformed serum PFOS level was associated with a decrease in total lumbar spine BMD by 0.022 g/cm(2) (95% confidence interval -0.038, -0.007; P = .006) in women not in menopause. There was no association among PFOA, PFOS concentration, and self-reported fracture in adults., Conclusion: Serum PFOS concentration is associated with decreased total lumbar spine BMD in women not in menopause. However, the potential biological significance of this effect is marginal and subclinical in the general US population. Further studies are warranted to clarify the causal relationship between perfluorinated chemical exposure and BMD.

Background: Blood transfusion after traumatic injury can result in microchimerism (MC) of donor white cells (WBCs) in the recipient as late as 2 to 3 years postinjury, the longest prospective follow-up to date. The purpose of this study was to determine how long transfusion-associated MC lasts after traumatic injury., Study Design and Methods: A group of US combat veterans who received transfusions who responded to a recruitment notice was retrospectively evaluated. Their blood was sampled, and MC was assessed by quantitative allele-specific polymerase chain reaction detection of differences at the HLA-DR locus or a panel of insertion-deletion polymorphism loci. Results of veterans were compared to those from an age- and gender-matched blood donor control group, from whom WBCs were retrieved from leukoreduction filters., Results: Among 163 combat veterans who received transfusion and 150 control subjects who did not receive transfusions, 16 (9.8%) of the veterans and 1 (0.7%) control subject had evidence of MC (relative risk, 14.7; 95% confidence interval, 2.0-110). The veterans with MC included 3 who served in WWII (7% of subjects from that conflict), 5 in Korea (18%), and 6 in Vietnam (7%)., Conclusions: Transfusion for combat-related injury can result in MC that lasts for 60 years, suggesting that it may involve permanent engraftment. MC is rare among male blood donors who did not receive transfusions, who are probably representative of individuals who have not had postnatal allogeneic exposures.

Understanding natural variation in the composition of conventional crop germplasms is critical in establishing a baseline for comparison of biotechnology-derived crops. This is particularly relevant to such traits as tolerance to drought stress. Thus, there is both a need to understand the contribution of stress conditions to natural variation in plant nutritional components and to determine whether levels of small molecule metabolites such as osmoprotectants and stress metabolites are also affected. As a first step in developing such information for maize, seven conventional hybrids were grown under different moisture regimens and the impact of moisture on composition was assessed. The regimens included well-watered conditions, water restriction during the vegetative phase, and water restriction during grain fill. Compositional analyses of the harvested grain included assessments of the levels of proximates (moisture, protein, oil, starch) and small molecule metabolites such as fatty acids, free amino acids, organic acids, sugars, total glycerol, glycine betaine, and abscisic acid. Ranges for these analytes were determined across all moisture regimens, and the effect of the different water regimens on these analytes was also evaluated. The number and type of grain analytes that showed statistically significant differences in levels between different water regimens differed quite markedly by maize hybrid. However, the magnitude of mean differences between well-watered and water-restricted samples was typically small, and statistically significant differences for any given analyte were typically observed in only one to three of the seven maize hybrids. Only two analytes, free glutamine and free proline, showed a significant drought-induced difference in at least four maize hybrids.