Hepatocellular carcinoma (HCC) is one of the most severe complications in chronic hepatitis B virus (HBV) infection. HCC can still develop in patients with chronic HBV (CHB) infection undergoing ...antiviral therapy. Several effective scoring systems for the prediction of HCC risk in CHB patients have been established. However, very few of them are designed for CHB patients receiving nucleos(t)ide analogues (NAs) therapy. Furthermore, none are available for HCC risk prediction in CHB patients receiving finite periods of antiviral therapy.
This study enrolled 790 consecutive treatment-naïve patients with CHB infection who had visited our liver clinics from 2008 to 2012 for pretreatment assessment before receiving antiviral therapies. The treatments were provided at finite periods according to the National Health Insurance Policy in Taiwan. The last follow-up date was 31 December 2021. We analyzed the virological and clinical factors in these 790 CHB patients receiving finite periods of NA treatments and identified the most significant risk factors for HCC to establish a novel predictive scoring system. By using stepwise selection in a multivariate Cox proportional hazards model, we divided the patients into three risk groups.
Our predictive scoring system included five independent variables: genotype C (adjusted HR aHR = 2.23), NA-withdraw-related hepatitis relapse (aHR = 6.96), male (aHR = 4.19), liver cirrhosis (aHR = 11.14), and T1768A core promoter mutation (aHR = 3.21). This model revealed significant differences in HCC incidence among the three risk groups. The 5-year cumulative HCC risk significantly differed among the three risk groups (low risk: 1.33%, moderate risk: 4.99%, and high risk: 17.46%), with log-rank test
< 0.001.
Our predictive scoring system is a promising tool for the prediction of HCC in CHB patients receiving finite NA treatments. Genotype C, NA-withdraw-related hepatitis relapse, male gender, liver cirrhosis, and the T1768A HBV core promoter mutation were significant independent risk factors.
Financial challenges, social and material instability, familial problems, living conditions, structural issues, and mental health problems have been shown to contribute to youth homelessness. Based ...on the paucity of literature on mental illness as a reason for youth homelessness, the current study retrospectively evaluated the association between the timing of homelessness onset (youth versus adult) and mental illness as a reason for homelessness among homeless adults living in homeless shelters and/or receiving services from homeless-serving agencies. Homeless participants (
= 919; 67.3% men) were recruited within two independent studies from Dallas and Oklahoma. Covariate-adjusted logistic regressions were used to measure associations between homelessness onset and mental illness as a reason for current homelessness, history of specific mental illnesses, the historical presence of severe mental illness, and severe mental illness comorbidity. Overall, 29.5% of the sample reported youth-onset homelessness and 24.4% reported mental illness as the reason for current homelessness. Results indicated that mental illness as a reason for current homelessness (AOR = 1.62, 95% CI = 1.12-2.34), history of specific mental illnesses (Bipolar disorder-AOR = 1.75, 95% CI = 1.24-2.45, and Schizophrenia/schizoaffective disorder-AOR = 1.83, 95% CI = 1.22-2.74), history of severe mental illness (AOR = 1.48, 95% CI = 1.04-2.10), and severe mental illness comorbidities (AOR = 1.30, 95% CI: 1.11-1.52) were each associated with increased odds of youth-onset homelessness. A better understanding of these relationships could inform needs for early interventions and/or better prepare agencies that serve at-risk youth to address precursors to youth homelessness.
We present measurements of two-particle angular correlations of charged particles emitted in high-energy collisions using data collected by the ALEPH detector at LEP between 1992 to 2000. The ...correlation functions are measured over a wide range of pseudorapidity and azimuthal angle as a function of charged particle multiplicity. Previous measurement with LEP1 data at √S = 91 GeV shows no significant long-range correlations in either lab coordinate or thrust coordinate analyses, with associated yield distributions in agreement with predictions from the PYTHIA v6.1 event generator. The use of higher collision energy LEP2 data allows access to not only higher event multiplicity but also additional production channels beyond the e + e - → y * / Z → q ¯ q process. Notably, the highest multiplicity bin (N trk ≥ 50) suggests a tantalizing disagreement with MC and implies the potential to search for collective phenomena in small systems. This measurement is pushing the studies of long-range correlation to the smallest collision system limit and includes the first flow coefficient ( v n ) measurement in e + e − collisions, which uses a Fourier decomposition analysis to quantify the anisotropy in the azimuthal two-particle correlation as a function of charged particles’ transverse momentum. This work supplements our understanding of small-system references to long-range correlations observed in proton-proton, proton-nucleus, and nucleus-nucleus collisions.
Minority children and children living in under-resourced households are at the greatest risk for obesity and diet-related disparities. Identifying effective strategies to reduce these risks is an ...important step in child obesity prevention. Parents influence the home environment and play a critical role in child obesity prevention. Eighteen parent-child dyads living in under-resourced Houston area communities participated in a mixed methods study (online surveys, telephone interviews). The purpose of the research reported here was to conduct a secondary analysis of the qualitative data to explore Black/African American and Hispanic parent and child perspectives of the ways in which parents could help their children make healthy food choices. Descriptive statistics were calculated for parent and child demographic characteristics; hybrid thematic analysis was used to code and analyze the interview transcripts. Frequencies were calculated for children's interview responses to rating scales and the grade they gave their eating habits. Mothers' responses were grouped into two broad categories: facilitators (modeling, availability, and teaching) as ways parents could help their child eat healthy, and barriers (lack of time, cost of healthy foods, and lack of knowledge) to helping their child eat healthy. Alternatively, child responses focused on ways in which parents could provide support: environmental support (home availability, home cooking, and introducing new foods) and personal support (providing child choice, teaching, and encouragement). Most children reported that eating healthy was easy, and most rated their personal eating habits as an A or B. These findings suggest that understanding the perspectives of Black/African American and Hispanic parent-child dyads can provide insight into the development of culturally and economically relevant healthy eating strategies and interventions for families living in under-resourced communities.
•Smoking rates are high among the homeless, and interventions are needed.•Anxiety sensitivity = fear of behaviors/sensations related to experiencing anxiety.•Anxiety sensitivity and pain interacted ...to predict increased cigarette dependence.•Anxiety sensitivity treatment may address pain and dependence comorbidities.
Pain and cigarette smoking are reciprocally related. Domiciled smokers with higher anxiety sensitivity (AS) - the fear of behaviors/sensations associated with the experience of anxiety - consume more cigarettes and report greater tobacco dependence than smokers with lower AS. AS treatment can reduce chronic pain and facilitate smoking cessation. Here, we examine the potentially moderating role of AS in the association between past-month pain (PMP) and heaviness of smoking (HS) among smokers experiencing homelessness.
Participants (N = 461; 64.9% men, Mage = 43.1 ± 11.8) were smokers recruited from 6 homeless serving agencies in Oklahoma City, OK. Participants self-reported the presence and severity of PMP (“How much bodily pain have you had during the past four weeks?”), HS was measured via the heaviness of smoking index (HSI), and AS was measured via the Anxiety Sensitivity Index-III (ASI-III) and its 3 subscales: physical, cognitive, and social concerns. Linear regressions were used to examine potential ASI moderation controlling for age, sex, race, education, health insurance, perceived stress, and major depression.
ASI-III total, cognitive, and physical concerns each significantly moderated associations of PMP and HSI (ps < 0.05), whereas social concerns did not. Individuals with high AS had greater cigarette dependence as PMP values increased.
Similar to research with domiciled smokers, current results suggest that smokers experiencing homelessness who have high AS may benefit from AS-based interventions to reduce the association between PMP and HS, which may facilitate smoking cessation among this vulnerable group.
Active video games (AVGs) capable of inducing physical activity offer an innovative approach to combating childhood obesity. Unfortunately, children's AVG game play decreases quickly, underscoring ...the need to identify novel methods for player engagement. Narratives have been demonstrated to influence behaviors.
The objective of this study was to test the hypothesis that a narrative would motivate increased AVG play, though a feasibility study that investigated the motivational effect of adding a previously developed narrative cutscene to an originally nonnarrative AVG, Nintendo Wii Sports Resort: Swordplay Showdown.
A total of 40 overweight and obese 8- to 11-year-olds equally divided by sex played the AVG. Half (n=20) were randomly assigned to a narrative group that watched the narrative cutscene before game play. The other half played the game without watching it.
Children in the narrative group had significantly (P<.05) more steps per 10-second period (mean 3.2, SD 0.7) and overall (mean 523, SD 203) during game play compared with the nonnarrative group (10-second period: mean 2.7, SD 0.7; overall: mean 366, SD 172).
The AVG with narrative induced increased physical activity. Additional research is needed to understand the mechanisms through which narrative increases physical activity during AVG game play.
This study initially validates the Chinese version of the Physical Activity Questionnaire for Older Children (PAQ-C), which has been identified as a potentially valid instrument to assess ...moderate-to-vigorous physical activity (MVPA) in children among diverse racial groups.
The psychometric properties of the PAQ-C with 742 Hong Kong Chinese children were assessed with the scale's internal consistency, reliability, test-retest reliability, confirmatory factory analysis (CFA) in the overall sample, and multistep invariance tests across gender groups as well as convergent validity with body mass index (BMI), and an accelerometry-based MVPA.
The Cronbach alpha coefficient (α=0.79), composite reliability value (ρ=0.81), and the intraclass correlation coefficient (α=0.82) indicate the satisfactory reliability of the PAQ-C score. The CFA indicated data fit a single factor model, suggesting that the PAQ-C measures only one construct, on MVPA over the previous 7 days. The multiple-group CFAs suggested that the factor loadings and variances and covariances of the PAQ-C measurement model were invariant across gender groups. The PAQ-C score was related to accelerometry-based MVPA (r=0.33) and inversely related to BMI (r=-0.18).
This study demonstrates the reliability and validity of the PAQ-C in Chinese children.
Tobacco use is exceedingly high among those who are homeless or at risk of homelessness but not commonly addressed by clinicians. Taking Texas Tobacco Free (TTTF) is a tobacco control program that ...addresses known clinician barriers to intervention (e.g., low training receipt, limited resources). Here, we examine the process and outcomes of TTTF's adaptation within four agencies that provide housing or other services to individuals who are homeless or vulnerably housed. Pre- and post-implementation data were collected from clinicians (
= 68) to assess changes in training receipt, knowledge, and intervention behaviors, relative to program goals. Results indicated significant gains in clinicians' receipt of training in 9 (of 9) target areas (
's ≤ 0.0042) and a 53% knowledge gain (
< 0.0001). From pre- to post-implementation, there were mean increases in the use of the 5As (ask, advise, assess, assist, and arrange) and other evidence-based interventions for tobacco cessation, with significant gains seen in assisting residents/clients to quit, arranging follow-ups, and providing or referring for non-nicotine medications (
's ≤ 0.0491). All program goals, except gains related to advising smokers to quit and the use of specific interventions (behavioral counseling), were met. Overall, TTTF improved clinicians' capacity to address tobacco use among homeless and vulnerably housed individuals and can serve as a model for tobacco control efforts in similar agencies.
Abstract Objective Low-income Hispanic women are at greater risk for dietary deficiencies and obesity. We assessed the association between Supplemental Nutrition Assistance Program participation and ...dietary intake among 661 Hispanic women aged 26–44 years living in Texas. Methods Cross-sectional data was collected using standard methods. Analysis of variance and logistic regression examined the influence of Supplemental Nutrition Assistance Program on diet after adjusting for household characteristics, body mass index, and food security status. Results Most women did not meet recommended dietary guidelines. Supplemental Nutrition Assistance Program participants consumed higher amounts of total sugars, sweets–desserts, and sugar-sweetened beverages than Supplemental Nutrition Assistance Program nonparticipants. High sodium intakes and low dairy consumption were observed in both groups. Only 27% of low-income eligible women received Supplemental Nutrition Assistance Program benefits. Discussion Low-income Hispanic women participating in Supplemental Nutrition Assistance Program reported less healthful dietary patterns than nonparticipants. This may contribute to the increased obesity prevalence and related comorbidities observed in this population. Conclusion Supplemental Nutrition Assistance Program should play an important role in enhancing the overall dietary quality of low-income households. Policy initiatives such as limiting the purchase of sugar-sweetened beverages and education to enable women to reduce consumption of high sodium processed foods deserve consideration as means to improve the dietary quality of Supplemental Nutrition Assistance Program participants. Effective measures are needed to increase Supplemental Nutrition Assistance Program participation rates among Hispanics.
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