A Data Intrusion Tolerance Model Based on an Improved Evolutionary Game Theory for the Energy Internet

Malicious attacks against data are unavoidable in the interconnected,open and shared Energy Internet(EI),Intrusion tolerant techniques are critical to the data security of EI.Existing intrusion tolerant techniques suffered from problems such as low adaptability,policy lag,and difficulty in determining the degree of tolerance.To address these issues,we propose a novel adaptive intrusion tolerance model based on game theory that enjoys two-fold ideas:(1)it constructs an improved replica of the intrusion tolerance model of the dynamic equation evolution game to induce incentive weights;and (2)it combines a tournament competition model with incentive weights to obtain optimal strategies for each stage of the game process.Extensive experiments are conducted in the IEEE 39-bus system,whose results demonstrate the feasibility of the incentive weights,confirm the proposed strategy strengthens the system’s ability to tolerate aggression,and improves the dynamic adaptability and response efficiency of the aggression-tolerant system in the case of limited resources.

Disparities in the impact of economic well-being on self-esteem in adulthood:Race and ethnicity

BACKGROUND Most studies have defined economic well-being as socioeconomic status,with little attention given to whether other indicators influence self-esteem.Little is known about racial/ethnic disparities in the relationship between economic wellbeing and self-esteem during adulthood.AIM To explore the impact of economic well-being on self-esteem in adulthood and differences in the association across race/ethnicity.METHODS The current study used data from the National Longitudinal Survey of Youth 1979.The final sample consisted of 2267 African Americans,1425 Hispanics,and 3678 non-Hispanic Whites.Ordinary linear regression analyses and logistic regression analyses were conducted.RESULTS African Americans and Hispanics were more likely to be in poverty in comparison with non-Hispanic Whites.More African Americans were unemployed than Whites.Those who received fringe benefits,were more satisfied with jobs,and were employed were more likely to have higher levels of self-esteem.Poverty was negatively associated with self-esteem.Interaction effects were found between African Americans and job satisfaction predicting self-esteem.CONCLUSION The role of employers is important in cultivating employees’self-esteem.Satisfactory outcomes or feelings of happiness from the workplace may be more important to non-Hispanic Whites compared to African Americans and Hispanics.

Characteristics and distinct prognostic determinants of individuals with hepatosplenic T-cell lymphoma over the past two decades

BACKGROUND Hepatosplenic T-cell lymphoma(HSTCL)is a rare and aggressive peripheral T-cell lymphoma with historically dismal outcomes,representing less than one percent of non-Hodgkin lymphomas.Given its rarity,the true incidence of HSTCL is unknown and most data have been extrapolated through case reports.To the best of our knowledge,the largest and most up to date study addressing the epidemiology and outcomes of patients with HSTCL in the United States covered a period from 1996 to 2014,with a sample size of 122 patients.AIM To paint the most updated epidemiological picture of HSTCL.METHODS A total of 186 patients diagnosed with HSTCL,between 2000 and 2017,were ultimately enrolled in our study by retrieving data from the Surveillance,Epidemiology,and End Results database.We analyzed demographics,clinical characteristics,and overall mortality(OM)as well as cancer-specific mortality(CSM)of HSTCL.Variables with a P value<0.01 in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors,with a hazard ratio of greater than 1 representing adverse prog-nostic factors.CONCLUSION Overall,the outlook for this rare malignancy is very grim.In this retrospective cohort study of the United States population,non-Hispanic blacks and the elderly had a higher CSM.This data highlights the need for larger prospective studies to investigate factors associated with worse prognosis in one ethnic group,such as treatment delays,which have been shown to increase mortality in this racial/ethnic group for other cancers.

Prevalence and resistance of Helicobacter pylori in a predominantly Hispanic population

BACKGROUND Helicobacter pylori(H.pylori)is the most common chronic bacterial infection in humans.The risk of acquiring H.pylori is related to socioeconomic status and living conditions early in life.Treatment regimens must consider local antibiotic resistance patterns.Adventist Health White Memorial Hospital serves a predominantly indigent population in east Los Angeles with a large number of immigrants from South and Central America.Data regarding the prevalence and resistance of H.pylori in this population is scant.AIM To evaluate the prevalence and resistance of H.pylori and correlate with country of origin.METHODS All gastric biopsies were obtained by a single gastroenterologist at the hospital in a consecutive manner from patients with gastritis from 2017 to 2022 and sent to various labs for evaluation.RESULTS Two hundred and sixty-six patients are born in the United States,450,171,70,and 30 patients are immigrants from Mexico,Central and South America(CSA),Asia,and other countries respectively.Overall,14.65%were found to be infected with H.pylori.Rates of infection in United States-born citizens,immigrants from Mexico,CSA,and Asia are 9.02%,18.67%,13.45%,and 11.43%respectively,with Mexican immigrants having a relative risk of 2.3889[95%confidence interval(CI):1.4789-3.8588,P=0.0004]compared to those born in United States.No correlation seen between infection and length of time immigrants were in United States.Relative risk of infection in patients with no proton pump inhibitor use within the past 30 days found to be 1.9276(95%CI:1.3562-2.7398,P=0.0003).Rates of resistance for clarithromycin and levofloxacin are 21.43%and 31.11%.CONCLUSION H.pylori infection appears to be associated with low socioeconomic status and poor living conditions early in life.Clarithromycin and levofloxacin based treatment regimens should be avoided as first line therapy in this region,particularly in patients of Latin American origin.

Digital Disparities:How Artificial Intelligence Can Facilitate Anti-Black Racism in the U.S.Healthcare Sector

This paper delves into the intricate interplay between artificial intelligence(AI)systems and the perpetuation of Anti-Black racism within the United States medical industry.Despite the promising potential of AI to enhance healthcare outcomes and reduce disparities,there is a growing concern that these technologies may inadvertently/advertently exacerbate existing racial inequalities.Focusing specifically on the experiences of Black patients,this research investigates how the following AI components:medical algorithms,machine learning,and natural learning processes are contributing to the unequal distribution of medical resources,diagnosis,and health care treatment of those classified as Black.Furthermore,this review employs a multidisciplinary approach,combining insights from computer science,medical ethics,and social justice theory to analyze the mechanisms through which AI systems may encode and reinforce racial biases.By dissecting the three primary components of AI,this paper aims to present a clear understanding of how these technologies work,how they intersect,and how they may inherently perpetuate harmful stereotypes resulting in negligent outcomes for Black patients.Furthermore,this paper explores the ethical implications of deploying AI in healthcare settings and calls for increased transparency,accountability,and diversity in the development and implementation of these technologies.Finally,it is important that I prefer the following paper with a clear and concise definition of what I refer to as Anti-Black racism throughout the text.Therefore,I assert the following:Anti-Black racism refers to prejudice,discrimination,or antagonism directed against individuals or communities of African descent based on their race.It involves the belief in the inherent superiority of one race over another and the systemic and institutional practices that perpetuate inequality and disadvantage for Black people.Furthermore,I proclaim that this form of racism can be manifested in various ways,such as unequal access to opportunities,resources,education,employment,and fair treatment within social,economic,and political systems.It is also pertinent to acknowledge that Anti-Black racism is deeply rooted in historical and societal structures throughout the U.S.borders and beyond,leading to systemic disadvantages and disparities that impact the well-being and life chances of Black individuals and communities.Addressing Anti-Black racism involves recognizing and challenging both individual attitudes and systemic structures that contribute to discrimination and inequality.Efforts to combat Anti-Black racism include promoting awareness,education,advocacy for policy changes,and fostering a culture of inclusivity and equality.

The Black American Church: A Reactionary and Ideological Apparatus of Slavery

This work argues that Denmark Vesey,Nat Turner,Gabriel Prosser,David Walker,Henry Highland Garnet,amongst a few others were the reactionary(dialectical)exceptions to the black church,not the norm,an(ideological)institution established to interpellate and indoctrinate blacks to accept their conditions in slavery.In other words,the aforementioned were the enslaved who used Christian dogma to(negative dialectically)respond to the barbarity of slavery by violently convicting white Christian society for not living up to its values,ideas,and ideals given the treatment of African people by so-called Christians.In the latter sense it was reactionary;in the former,it was an ideological apparatus of domination and control for the institution of slavery.The contemporary attempt to racially vindicate the black church as a sui generis revolutionary institution overflowing with Africanisms is ahistorical and ideological reaped in pseudoscientific propositions stemming from postmodern and post-structural theories.

Racial and gender-based disparities and trends in common psychiatric conditions in liver cirrhosis hospitalizations:A ten-year United States study

BACKGROUND Chronic liver disease is associated with various neuropsychiatric conditions.There are currently no large studies assessing and comparing the prevalence of psy-chiatric illnesses based on patient profiles and the etiology of cirrhosis.AIM To examine the trends of hospitalizations among psychiatric conditions in cirrhosis.METHODS We used the National Inpatient Sample database 2016-2019 for the primary diagnosis of liver cirrhosis.The outcomes included the prevalence,trends,and associations of psychiatric diagnoses in these hospitalizations.Chi-square for categorical variables and the Wilcoxon rank test for continuous variables were utilized.RESULTS The prevalence of generalized anxiety disorder(GAD)in liver cirrhosis hospitalizations increased from 0.17%in 2009 to 0.92%in 2019(P<0.001).The prevalence of depression increased from 7%in 2009 to 12%in 2019(P<0.001).Attention deficit hyperactivity disorder(ADHD)prevalence increased from 0.06%to 0.24%.The prevalence of schizophrenia increased from 0.59%to 0.87%(P<0.001).Schizoaffective disorder prevalence increased from 0.10%to 0.35%(P<0.001).Posttraumatic stress disorder(PTSD)prevalence displayed increasing trends from 0.36%in 2009 to 0.93%in 2019(P<0.001).The prevalence of suicidal ideation increased from 0.23%to 0.56%in 2019.Cirrhosis related to alcoholic liver disease[adjusted odds ratios(aOR)1.18,95%CI 1.08-1.29,P<0.001]and non-alcoholic fatty liver disease(NAFLD)(aOR 1.14,95%CI 1.01-1.28,P=0.025)was associated with depression more than other causes.Alcohol-and NAFLD-associated cirrhosis had a stronger link to psychiatric disorders.Females had a higher association with GAD(aOR 2.56,95%CI 2.14-3.06,P<0.001),depression(aOR 1.78,95%CI 1.71-1.84,P<0.001),bipolar disorder(aOR 1.64,95%CI 1.52-1.77,P<0.001]and chronic fatigue(aOR 2.31,95%CI 1.31-4.07,P<0.001)when compared to males.Blacks,Hispanics,and Asian/Native Americans had a significantly lower association with GAD,depression,bipolar disorder,PTSD,and ADHD when compared to the white race.CONCLUSION The prevalence of psychiatric comorbidities in liver cirrhosis hospitalizations has increased over the last decade.Females had a higher association with psychiatric disorders compared to males.Blacks,Hispanics,and Asian/Native Americans had lower associations with psychiatric comorbidities compared to the white race.

Survival benefit of younger gastric cancer patients in China and the United States:A comparative study

BACKGROUND The impact of racial and regional disparity on younger patients with gastric cancer(GC) remains unclear.AIM To investigate the clinicopathological characteristics, prognostic nomogram, and biological analysis of younger GC patients in China and the United States.METHODS From 2000 to 2018, GC patients aged less than 40 years were enrolled from the China National Cancer Center and the Surveillance Epidemiology and End Results database. Biological analysis was performed based on the Gene Expression Omnibus database. Survival analysis was conducted via Kaplan-Meier estimates and Cox proportional hazards models.RESULTS A total of 6098 younger GC patients were selected from 2000 to 2018, of which 1159 were enrolled in the China National Cancer Center, and 4939 were collected from the Surveillance Epidemiology and End Results database. Compared with the United States group, younger patients in China revealed better survival outcomes(P < 0.01). For race/ethnicity, younger Chinese cases also enjoyed a better prognosis than that in White and Black datasets(P < 0.01). After stratification by pathological Tumor-Node-Metastasis(pTNM) stage, a survival advantage was observed in China with pathological stage Ⅰ, Ⅲ, and Ⅳ(all P < 0.01), whereas younger GC patients with stage Ⅱ showed no difference(P = 0.16). In multivariate analysis, predictors in China involved period of diagnosis, linitis plastica, and pTNM stage, while race, diagnostic period, sex, location, differentiation, linitis plastica, signet ring cell, pTNM stage, surgery, and chemotherapy were confirmed in the United States group. Prognostic nomograms for younger patients were established, with the area under the curve of 0.786 in the China group and of 0.842 in the United States group. Moreover, three gene expression profiles(GSE27342, GSE51105, and GSE38749) were enrolled in further biological analysis, and distinctive molecular characteristics were identified in younger GC patients among different regions.CONCLUSION Except for younger cases with pTNM stage Ⅱ, a survival advantage was observed in the China group with pathological stage Ⅰ, Ⅲ, and Ⅳ compared to the United States group, which might be partly due to differences in surgical approaches and the improvement of the cancer screening in China. The nomogram model provided an insightful and applicable tool to evaluate the prognosis of younger patients in China and the United States. Furthermore, biological analysis of younger patients was performed among different regions, which might partly explain the histopathological behavior and survival disparity in the subpopulations.

From the Eyes of the Soul to the Sense of the Body： An Interpretation to the Philip Roth＇s The Human Stain

The Human Stain （2000） is a novel full of the characteristics ofvisualism, making the readers imagine the fair skin of Coleman as a black, as well as the black identity hidden under his fair skin. Black and white, these two colors create the general ideology of the book. Coleman revels in his personal feeling of the body because of the vision of his skin color, thus leading to his irreplaceable desire, emotion, and inner spiritual experience, This paper tries to analyze and explore the racialism existing in the novel by applying the gaze theory and offering a philosophical interpretation to the Coleman＇s tragedy. Coleman feels the pressure of betraying himself from time to time, and confounds himself with the virtual image in other＇s gaze. In order to seize back the subjectivity lost in the adversarial gaze from the white, Coleman resists it at the cost of cutting off relationship with his mother, which impressively shows the solitude and alienation of the black race in the American modem civilization.

Analysis on Morality of the Protagonist of The Adventures of Huckleberry Finn

The Adventures of Huckleberry Finn is honored as the most typical novel of American literature after the Civil War. This story unveils the hypocrisy of religion and scoffs at the conventional social principle. Affected by the deep-rooted racial discrimination, Huck pays little respect to the black slaves as other white people do at first. After embarking on the raft with Jim together, he has got the chance to know more about what the black slave truly is. He never stops struggling inside, and eventually Jim's kindness and loyalty helps Huck to waken humanity in his heart and defeat his moral conflict. Therefore through the deepened analysis of the plot and the author, the reasons for the change of Huck's morality can boil down to social conventions, Huck's complicated character, and moreover the democratic ideal of Twain.

Cultural Identity and Representation in David Henry Hwang’s Yellow Face

David Henry Hwang,the first and the only Asian American playwright ever to win Tony Award for Best Play,is best known for M.Butterfly.In his plays,David Henry Hwang shows concern on race,gender politics and identity.Yellow Face,the latest play of Hwang,is a mockumentary drama which deals with cultural identity of Asian-Americans,and few researches and studies has been done on this play in China so far.This essay attempts to analyze the racial representations manifested in this play in order to explore its theme of the fluidity of cultural identity.

Prostate cancer in Asia:A collaborative report

The incidence of prostate cancer(PCa)within Asian population used to be much lower than in the Western population;however,in recent years the incidence and mortality rate of PCa in some Asian countries have grown rapidly.This collaborative report summarized the latest epidemiology information,risk factors,and racial differences in PCa diagnosis,current status and new trends in surgery management and novel agents for castration-resistant prostate cancer.We believe such information would be helpful in clinical decision making for urologists and oncologists,health-care ministries and medical researchers.

The Use of Lipoprotein-Associated Phospholipase A2 in a Chinese Population to Predict Cardiovascular Events

Objective To explore associations between lipoprotein-associated phospholipase A2(Lp-PLA2)and the risk of cardiovascular events in a Chinese population,with a long-term follow-up.Methods A random sample of 2,031 participants(73.6%males,mean age=60.4 years)was derived from the Asymptomatic Polyvascular Abnormalities Community study(APAC)from 2010 to 2011.Serum Lp-PLA2 levels were determined by enzyme-linked immunosorbent assay(ELISA).The composite endpoint was a combination of first-ever stroke,myocardial infarction(MI)or all-cause death.Lp-PLA2 associations with outcomes were assessed using Cox models.Results The median Lp-PLA2 level was 141.0 ng/m L.Over a median follow-up of 9.1 years,we identified 389 events(19.2%),including 137 stroke incidents,43 MIs,and 244 all-cause deaths.Using multivariate Cox regression,when compared with the lowest Lp-PLA2 quartile,the hazard ratios with95%confidence intervals for developing composite endpoints,stroke,major adverse cardiovascular events,and all-cause death were 1.77(1.24–2.54),1.92(1.03–3.60),1.69(1.003–2.84),and 1.94(1.18–3.18)in the highest quartile,respectively.Composite endpoints in 145(28.6%)patients occurred in the highest quartile where Lp-PLA2(159.0 ng/m L)was much lower than the American Association of Clinical Endocrinologists recommended cut-off point,200 ng/m L.Conclusion Higher Lp-PLA2 levels were associated with an increased risk of cardiovascular event/death in a middle-aged Chinese population.The Lp-PLA2 cut-off point may be lower in the Chinese population when predicting cardiovascular events.

Fecal microbes, short chain fatty acids, and colorectal cancer across racial/ethnic groups

AIM:To investigate differences in microbes and short chain fatty acid(SCFA) levels in stool samples from Hispanic and non-Hispanic African American,American Indian,and White participants.METHODS:Stool samples from twenty participants were subjected to analysis for relative levels of viable bacteria and for SCFA levels.Additionally,the samples were subjected to 16 S r RNA gene pyrosequencing for identification of bacteria present in the stool.We used a metagenome functional prediction technique to analyze genome copy numbers and estimate the abundance of butyrate kinase in all samples.RESULTS:We found that African Americans had significantly lower levels of acetate,butyrate,and total SCFAs than all other racial/ethnic groups.We also found that participant microbial profiles differed by racial/ethnic group.African Americans had significantly more Firmicutes than Whites,with enriched Ruminococcaceae.The Firmicutes /Bacteroidetes ratio was also significantly higher for African Americans than for Whites(P =0.049).We found Clostridium levels to be significantly and inversely related to total SCFA levels(P =0.019) and we found Bacteroides to be positively associated(P =0.027) and Clostridium to be negatively associated(P =0.012) with levels of butyrate.We also identified a correlation between copy number for a butyrate kinase predicted from 16 S r RNA gene abundance and levels of butyrate in stool.CONCLUSION:The identified differences in gut flora and SCFA levels may relate to colorectal cancer mortality differentials and may be useful as targets for future clinical and behavioral interventions.

Ulcerative colitis in a multiracial Asian country: Racial difference and clinical presentation among Malaysian patients

AIM： To determine the prevalence of ulcerative colitis （UC） in Malaysian patients and to establish the spectrum of the disease seen in Malaysian patients. METHODS： Data were obtained retrospectively from a review of the medical records of in- and out-patients with a diagnosis of UC at the University Hospital, Kuala Lumpur between 1985 and 1998. RESULTS： There were 45 confirmed cases of UC, of which 3 were foreigners, who were excluded from analysis. Thirty new cases of UC were diagnosed during the study period. Their mean age at presentation was 33.0±10.0 years. The highest prevalence of UC was 17.9/100 000 hospital admissions in the Indians, followed by 11.2/100 000 hospital admissions in the Chinese. The lowest prevalence was 3.7/100 000 hospital admissions in the Malays. The prevalence of UC was significantly higher in the Indians and the Chinese when compared with the Malays with an OR of 4.89 （CI = 2.02-12.24; x^2 = 15.45, P〈0.001） and 3.06 （CI = 1.24-7.78; x^2= 6.30; P= 0.012） respectively. The extent of colonic disease Was similar in the Malay and Indian patients. In contrast, distal or left-sided colitis predominated in the Chinese with an OR of 8.17 （95%CI = 1.31-64.87; x^2 = 5.53, P = 0.02）. Extraintestinal manifestations were uncommon （11.9%）. CONCLUSION： UC is an uncommon disease in Malaysia, but racial differences exist. The Indians had the highest prevalence of UC with the Chinese demonstrating the least extensive disease.

Free radicals, apparent activation energy, and functional groups during low-temperature oxidation of Jurassic coal in Northern Shaanxi

Correlations among free radicals, apparent activation energy, and functional groups during lowtemperature oxidation of Jurassic coal in Northern Shaanxi were investigated by examining three coal samples collected from the Ningtiaota, Jianxin, and Shigetai coal mines. Free radical concentrations at less than 120 ℃ were investigated by electron spin resonance experiments while the thermogravimetric experiments were conducted to analyze apparent activation energies. In addition, Fourier transform infrared spectroscopy was employed to study the spectrum of functional groups generated in coal. The results indicated that, in decreasing order, the apparent activation energies were Shigetai 〉Jianxin 〉 Ningtiaota, indicating that, from 50 to 120 ℃, the Ningtiaota coal sample most easily absorbed and reacted with oxygen while the most resistant was the Shigetai coal sample. Free radical concentrations and line heights increased with increased temperature, and the line width and Lande factor showed irregular fluctuations. Functional group variations were different among these coals, and the phenol and alcohol-associated OHs, carboxyls, and aromatic ring double bonds might have had a major impact on free radical concentrations. These results were meaningful for better consideration and management of coal oxidation at low temperatures.

Age, socioeconomic features, and clinical factors predict receipt of endoscopic retrograde cholangiopancreatography in pancreatic cancer

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP) is the recommended technique for biliary decompression in pancreatic cancer. Previous studies have suggested racial, socioeconomic and geographic differences in diagnosis,treatment and outcomes of pancreatic cancer patients.AIM To examine geographic, racial, socioeconomic and clinical factors associated with utilization of ERCP.METHODS Surveillance, Epidemiology and End Results and linked Medicare claims data were used to identify pancreatic cancer patients between 2000-2011. Claims data were used to identify patients who had ERCP and other treatments. The primary outcome was receipt of ERCP. Chi-squared analyses were used to compare demographic information. Trends in use of ERCP over time were assessed using Cochran Armitage test. Adjusted odds ratios(aORs) and 95% confidence intervals(CIs) for receipt ERCP were calculated using logistic regression,controlling for other characteristics.RESULTS Among 32510 pancreatic cancer patients, 14704(45.2%) underwent ERCP.Patients who had cancer located in the head of the pancreas(aOR 3.27, 95%CI:2.99-3.57), had jaundice(aOR 7.59, 95%CI: 7.06-8.17), cholangitis(aOR 4.22,95%CI: 3.71-4.81) or pruritus(aOR 1.42, 95%CI: 1.22-1.66) and lived in lower education zip codes(aOR 1.14, 95%CI: 1.04-1.24) were more likely to receive ERCP. In contrast, patients who were older(aOR 0.88, 95%CI: 0.83, 0.94), not married(aOR 0.92, 95%CI: 0.86, 0.98), and lived in a non-metropolitan area(aOR0.89, 95%CI: 0.82, 0.98) were less likely to receive ERCP. Compared to white patients, non-white/non-black patients(aOR 0.83, 95%CI: 0.70-0.97) were less likely to receive ERCP. Patients diagnosed later in the study period were less likely to receive ERCP(aOR 2004-2007 0.85, 95%CI: 0.78-0.92; aOR 2008-2011 0.76,95%CI: 0.70-0.83). After stratifying by indications for ERCP including jaundice,racial differences persisted(aOR black patients 0.80, 95%CI: 0.67-0.95,nonwhite/nonblack patients 0.73, 95%CI: 0.58-0.91). Among patients with jaundice, those who underwent surgery were less likely to undergo ERCP(aOR0.60, 95%CI: 0.52, 0.69).CONCLUSION ERCP utilization in pancreatic cancer varies based on patient age, marital status,and factors related to where the patient lives. Further studies are needed to guide appropriate biliary intervention for these patients.

African Americans are less likely to receive curative treatment for hepatocellular carcinoma

AIM To determine if racial disparities continue to exist in the treatment of hepatocellular carcinoma(HCC).METHODS A retrospective database analysis using the Nationwide Inpatient Sample was performed including patients with a primary diagnosis of HCC. Univariate and multivariate analyses were utilized to determine racial disparities in liver decompensation, treatment, inpatient mortality, and metastatic disease.RESULTS A total of 62604 patients with HCC were included consisting of 32428 Caucasian, 9726 African-American, 8988 Hispanic, and 11462 patients of other races. Caucasian patients were more likely to undergo curative therapies of liver transplant(OR: 2.66, 95%CI: 1.92-3.68), resection(OR: 1.82, 95%CI: 1.48-2.23), and ablation(OR: 1.77, 95%CI: 1.36-2.30) than African-American patients. Hispanic patients were more likely to undergo transplant(OR: 2.18, 95%CI: 1.40-3.39) and ablation(OR: 1.46, 95%CI:1.05-2.03) than African-American patients. Patients of other races were more likely to receive a liver transplant(OR: 2.41, 95%CI: 1.62-3.61), resection(OR: 1.79 95%CI: 1.39-2.32), and ablation(OR: 2.03, 95%CI: 1.47-2.80) than African-American patients. There are no differences in the rates of transarterial chemoembolization between races.CONCLUSION Racial disparities in HCC treatment exist despite emphasis to support equality in healthcare. African-American patients are less likely to undergo curative treatments for HCC.

Obesity paradox in patients undergoing coronary intervention:A review

There is strong relationship between obesity and cardiovascular disease including coronary artery disease(CAD). However, the literature has shown better outcomes in higher obese patients who undergo percutaneous cardiovascular interventions for CAD, a phenomenon known as the obesity paradox(OX). In this review, we performed extensive search for OX in patients undergoing percutaneous coronary intervention. We also discussed possible mechanism OX and disparities in different race and sex.

Microbiome and colorectal carcinogenesis:Linked mechanisms and racial differences

Various studies have shown the interplay between the intestinal microbiome,environmental factors,and genetic changes in colorectal cancer(CRC)development.In this review,we highlight the various gut and oral microbiota associated with CRC and colorectal adenomas,and their proposed molecular mechanisms in relation to the processes of“the hallmarks of cancer”,and differences in microbial diversity and abundance between race/ethnicity.Patients with CRC showed increased levels of Bacteroides,Prevotella,Escherichia coli,enterotoxigenic Bacteroides fragilis,Streptococcus gallolyticus,Enterococcus faecalis,Fusobacterium nucleatum(F.nucleatum)and Clostridium difficile.Higher levels of Bacteroides have been found in African American(AA)compared to Caucasian American(CA)patients.Pro-inflammatory bacteria such as F.nucleatum and Enterobacter species were significantly higher in AAs.Also,AA patients have been shown to have decreased microbial diversity compared to CA patients.Some studies have shown that using microbiome profiles in conjunction with certain risk factors such as age,race and body mass index may help predict healthy colon vs one with adenomas or carcinomas.Periodontitis is one of the most common bacterial infections in humans and is more prevalent in Non-Hispanic-Blacks as compared to Non-Hispanic Whites.This condition causes increased systemic inflammation,immune dysregulation,gut microbiota dysbiosis and thereby possibly influencing colorectal carcinogenesis.Periodontal-associated bacteria such as Fusobacterium,Prevotella,Bacteroides and Porphyromonas have been found in CRC tissues and in feces of CRC patients.Therefore,a deeper understanding of the association between oral and gastrointestinal bacterial profile,in addition to identifying prevalent bacteria in patients with CRC and the differences observed in ethnicity/race,may play a pivotal role in predicting incidence,prognosis,and lead to the development of new treatments.