Epstein-Barr virus (EBV) is necessary for the development of nasopharyngeal carcinoma (NPC). By adulthood, approximately 90% of individuals test EBV-positive, but only a fraction develop cancer. ...Factors that identify which individuals are most likely to develop disease, including differential antibody response to the virus, could facilitate detection at early stages when treatment is most effective.
We measured anti-EBV IgG and IgA antibody responses in 607 Taiwanese individuals. Antibodies were measured using a custom protein microarray targeting 199 sequences from 86 EBV proteins. Variation in response patterns between NPC cases and controls was used to develop an antibody-based risk score for predicting NPC. The overall accuracy area under the curve (AUC) of this risk score, and its performance relative to currently used biomarkers, was evaluated in two independent Taiwanese cohorts.
Levels of 60 IgA and 73 IgG anti-EBV antibodies differed between stage I/IIa NPC cases and controls (
< 0.0002). Risk prediction analyses identified antibody targets that best discriminated NPC status-BXLF1, LF2,BZLF1, BRLF1, EAd, BGLF2, BPLF1, BFRF1, and BORF1. When combined with currently used VCA/EBNA1 IgA biomarkers, the resulting risk score predicted NPC with 93% accuracy (95% CI, 87%-98%) in the general Taiwanese population, a significant improvement beyond current biomarkers alone (82%; 95% CI, 75%-90%,
≤ 0.01). This EBV-based risk score also improved NPC prediction in genetically high-risk families (89%; 95% CI, 82%-96%) compared with current biomarkers (78%; 95% CI, 66%-90%,
≤ 0.03).
We identified NPC-related differences in 133 anti-EBV antibodies and developed a risk score using this microarray dataset that targeted immune responses against EBV proteins from all stages of the viral life cycle, significantly improving the ability to predict NPC.
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This study examined whether culturally-valued or non-culturally-valued majors moderated the relation between educational channeling (or guiding and directing individuals) towards math and science and ...major satisfaction through internalized stereotyping and parental expectation fulfillment among 226 Asian American college students. Culturally-valued majors are defined as those in science, technology, engineering and math (STEM) or business which tend to have a large Asian American presence. Moderated mediation models demonstrated that parental expectation fulfillment mediated a positive relation between educational channeling and major satisfaction for Asian Americans with culturally-valued majors but not for those with non-culturally-valued majors. In contrast, internalized stereotyping mediated a negative relation between educational channeling and major satisfaction for Asian Americans with non-culturally-valued majors but not for those with culturally-valued majors. Findings suggest educational channeling towards math and science may be associated with major satisfaction via different cultural mediators across Asian American college students of culturally-valued versus non-culturally-valued majors.
When Asian Americans are steered towards math and science or culturally-valued majors, factors including their major choice, perceptions of whether they are fulfilling parental expectations, and whether their major aligns with Asian stereotypes are associated with their major satisfaction. The study's results stress the importance of considering culturally-specific factors in the context of Asian Americans' career development and encourage practitioners to consider these factors in career counseling with these students.
•Expectation fulfillment mediates educational channeling and major satisfaction for AAs with culturally-valued majors.•Internalized stereotyping mediates educational channeling and major satisfaction for AAs with non-culturally-valued majors.•AAs with culturally-valued majors report more internalized stereotyping and educational channeling, less major satisfaction.•Internalized stereotyping is negatively correlated with major satisfaction for AAs with non-culturally-valued majors.
Based on Berry’s (1997) model of acculturation, the current study examined whether gratitude would moderate the association between intolerance of uncertainty (IU) and acculturative stress (i.e., ...moderation hypothesis), and mitigate the positive association between IU and psychological distress through acculturative stress (i.e., moderated mediation hypothesis). Participants were 171 international students with Chinese heritage from a Midwest public university. Results from PROCESS supported these hypotheses. First, the positive association between IU and acculturative stress was attenuated to a greater extent at higher compared to lower levels of gratitude. Second, the mediation effect of IU on psychological distress through acculturative stress was weaker among those with higher compared to lower levels of gratitude. Findings demonstrate the protective role of gratitude and the role of IU as a risk factor for psychological distress through acculturative stress. Implications for practice, training, and research are discussed.
Perceived discrimination is a risk factor for mental health problems among sexual minority individuals. An increasing number of research studies have investigated the mechanisms through which ...stigma-related stressors such as perceived discrimination are linked with adverse mental health outcomes for sexual minority populations. The integrative mediation framework proposed by Hatzenbuehler (2009) underscores the importance of identifying mediators in the association between stigma-related stressors and mental health outcomes. This study tested 3 mediators-expectations of rejection, anger rumination, and self-compassion-in the perceived discrimination-distress link. Moreover, it examined associations among these mediators. A nationwide sample of 265 sexual minorities responded to an online survey. Structural equation modeling results supported the mediator roles of expectations of rejection, anger rumination, and self-compassion. More specifically, perceived discrimination was associated with expectations of rejection, which, in turn, was associated with increased anger rumination and less self-compassion, resulting in greater psychological distress. The findings suggest several avenues for prevention and intervention with sexual minority individuals.
The current study investigated whether a cultural factor (i.e., social connectedness) and a dispositional characteristic (i.e., intolerance of uncertainty) would serve as risk factors or protective ...factors in the association between perceived racial microaggressions and anxiety symptoms in a sample of 126 Black American individuals. Results demonstrated that perceived racial microaggression was positively associated with anxiety symptoms in Black Americans. In addition, hierarchical regression analyses identified ethnic social connectedness and intolerance of uncertainty as moderators for anxiety symptoms. Specifically, social connectedness to one's ethnic community served as a buffer and intolerance of uncertainty acted as an exacerbating factor in the relationship between perceived racial microaggressions and anxiety symptoms. Future research directions and clinical implications are discussed.
Screening with anti-Epstein-Barr Virus (EBV) serology and endoscopy decreased nasopharyngeal carcinoma (NPC) mortality in Guangdong in a randomized trial. We conducted a secondary analysis of this ...trial using local incidence and cost data to optimize screening programs, hypothesizing that screening could be cost-effective in southern China.
Screening costs and life-years after NPC diagnosis were obtained from the Guangdong trial's intent-to-screen population (men and women age 30-69). Seropositive subjects were rescreened annually for five years. Thereafter, we evaluated 12 screening strategies in Guangdong and Guangxi using a validated model. Strategies used combinations of serology, nasopharyngeal swab PCR (NP PCR), endoscopy, and MRI from trial sub-cohorts. Incidence data and costs were obtained from local cancer registries and the provincial healthcare system.
In the intent-to-screen population, screening with serology and endoscopy was cost-effective (¥42,366/life-year, 0.52 GDP per-capita). Screening for 5-15 years between ages 35-59 met a willingness-to-pay threshold of 1.5 GDP/QALY in all modeled populations. Despite doubling costs, adding MRI could be cost-effective via improved sensitivity. NP PCR triage reduced endoscopy/MRI referrals by 37%. One lifetime screen could reduce NPC mortality by pproximately 20%.
EBV-based serologic screening for NPC is likely to be cost-effective in southern China. Among seropositive subjects, the preferred strategies use endoscopy alone or selective endoscopy triaged by MRI with or without NP PCR. These data may aid the design of screening programs in this region.
These findings support population-based screening in southern China by defining the target population, cost effectiveness, and optimized screening approach.
Human leukocyte antigen (HLA) gene variation is associated with risk of cancers, particularly those with infectious etiology or hematopoietic origin, given its role in immune presentation. Previous ...studies focused primarily on HLA allele/haplotype-specific associations. To answer whether associations are driven by HLA class I (essential for T-cell cytotoxicity) or class II (important for T-cell helper responses) genes, we analyzed GWAS from 24 case-control studies and consortia comprising 27 cancers (totaling >71,000 individuals). Associations for most cancers with infectious etiology or of hematopoietic origin were driven by multiple HLA regions, suggesting that both cytotoxic and helper T-cell responses are important. Notable exceptions were observed for nasopharyngeal carcinoma, an EBV-associated cancer, and CLL/SLL forms of non-Hodgkin lymphomas; these cancers were associated with HLA class I region only and HLA class II region only, implying the importance of cytotoxic T-cell responses for the former and CD4
T-cell helper responses for the latter. Our findings suggest that increased understanding of the pattern of HLA associations for individual cancers could lead to better insights into specific mechanisms involved in cancer pathogenesis. SIGNIFICANCE: GWAS of >71,000 individuals across 27 cancer types suggest that patterns of HLA Class I and Class II associations may provide etiologic insights for cancer.
Although perceived language discrimination (PLD) is associated with negative psychological outcomes among international students with Chinese heritage, existing research on PLD is scarce. This study ...aims to address this gap. Given that many Chinese cultures are characterized as shame-based, we examined whether PLD would be associated with interpersonal shame (i.e. mediator) which in turn would predict depressive symptoms. We also investigated whether collective self-esteem, a culturally relevant variable, would buffer against the negative effects of PLD on interpersonal shame and attenuate the mediation effect from PLD through interpersonal shame to depressive symptoms (i.e. moderated mediation). This cross-sectional study utilized self-report surveys and collected data from 222 international students with Chinese heritage from different regions of the U.S. The results showed that interpersonal shame mediated the association between PLD and depressive symptoms. In addition, membership collective self-esteem moderated the association between PLD and interpersonal shame. The results also indicated that the mediation effects from PLD to depression through interpersonal shame were significant at low and moderate levels but not significant at high levels of membership collective self-esteem. Findings highlight the protective role of membership collective self-esteem for those who have experienced PLD and are struggling with interpersonal shame and depressive symptoms.
Background & Aims Little is known about the change in risk conferred by family history of colorectal cancer (CRC) as a person ages. We evaluated the effect of family history on CRC incidence and ...mortality after 55 years of age, when the risk of early onset cancer had passed. Methods We collected data from participants in the randomized, controlled Prostate, Lung, Colorectal and Ovarian cancer screening trial of flexible sigmoidoscopy versus usual care (55–74 years old, no history of CRC), performed at 10 US centers from 1993 to 2001. A detailed family history of colorectal cancer was obtained at enrollment, and subjects were followed for CRC incidence and mortality for up to 13 years. Results Among 144,768 participants, 14,961 subjects (10.3%) reported a family of CRC. Of 2090 incident cases, 273 cases (13.1%) had a family history of CRC; among 538 deaths from CRC, 71 (13.2%) had a family history of CRC. Overall, family history of CRC was associated with an increased risk of CRC incidence (hazard ratio HR, 1.30; 95% confidence interval CI, 1.10–1.50; P <.0001) and increased mortality (HR, 1.31; 95% CI, 1.02–1.69; P = .03). Subjects with 1 first degree relative (FDR) with CRC ( n = 238; HR, 1.23; 95% CI, 1.07–1.42) or ≥2 FDRs with CRC ( n = 35; HR, 2.04; 95% CI, 1.44–2.86) were at increased risk for incident CRC. However, among individuals with 1 FDR with CRC, there were no differences in risk based on age at diagnosis in the FDR (for FDR <60 years of age: HR, 1.27; 95% CI, 0.97–1.63; for FDR 60–70 years of age: HR, 1.33; 95% CI, 1.06–1.62; for FDR >70 years of age: HR, 1.14; 95% CI, 0.93–1.45; P trend = .59). Conclusions After 55 years of age, subjects with 1 FDR with CRC had only a modest increase in risk for CRC incidence and death; age of onset in the FDR was not significantly associated with risk. Individuals with ≥2 FDRs with CRC had continued increased risk in older age. Guidelines and clinical practice for subjects with a family history of CRC should be modified to align CRC testing to risk. ClinicalTrials.gov number, NCT00002540.
This study examined 3 coping strategies (reflective, suppressive, and reactive), along with self-esteem, as moderators of the relation between perceived discrimination and depressive symptoms. ...International students (
N
= 354) from China, India, Korea, Taiwan, and Hong Kong provided data via an online survey. The role of perceived general stress was statistically controlled. Hierarchical regression analyses indicated a significant direct effect of perceived discrimination, a significant 2-way interaction of perceived discrimination and suppressive coping, and a significant 3-way interaction of perceived discrimination, reactive coping, and self-esteem in predicting depressive symptoms. An increased tendency to use suppressive coping appeared to strengthen the association between perceived discrimination and depressive symptoms. In contrast, the association between perceived discrimination and depressive symptoms was not significant when reactive coping was infrequently used, but only for students with relatively high self-esteem.
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