Chronic Hepatitis B in Indian Americans: Lack of Screening and Poor Linkage to Care

Background: Chronic hepatitis B (CHB) is a major cause of liver-related morbidity and mortality in the United States (US) and globally. CHB disproportionately affects Asian Americans and many other immigrant minority populations, primarily owing to the high prevalence of CHB in their countries of origin. India is a country with a medium-to-high prevalence of hepatitis B (HB) (>2%) and has over 40 million people infected with hepatitis B virus (HBV), with more than 115,000 deaths annually from HBV-related complications. Indian Americans are one of the largest immigrant populations in the US but remain underdiagnosed and poorly linked to clinical care. We, therefore, assessed the HBV prevalence and evaluated the linkage-to-care (LTC) among Indian Americans to develop strategic plans to reduce the impact of HBV in the US. Methods: Between April 2022 and January 2024, serologic screening and surveys were provided to 328 Indian American adults (age 20 - 80) in New York City. All participants were tested for a triple panel consisting of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core IgG antibody (anti-HBc). A survey was conducted on the subjects chronically infected with HBV regarding their histories of infection. Self-administered questionnaires were employed to evaluate demographic and epidemiologic characteristics. Results: Of 328 screened and evaluated (246 males and 82 females), 10 (3.0%) were HBV-infected, 222 (67.7%) were susceptible to HBV, and 96 (29.3%) were immune. The prevalence of chronic HBV varied between the age groups: 4.6% (age 20 - 40), 3.4% (age 41 - 60), and 1.7% (age 61 - 80). Of 10 chronically infected, only two subjects had been previously diagnosed but were not engaged in care. Conclusion: HBV disproportionately affects Asian Americans, primarily owing to immigration from parts of the world where the disease is endemic. Indian Americans belong to an intermediate-risk group, with an HBV prevalence of >2%, but remain underdiagnosed and poorly linked to care. Our pilot study on Indian American populations, the first of its kind, demonstrates a 3% prevalence of CHB, none of whom are linked to care. In addition, this population has a high percentage of unimmune subjects, creating a large reservoir for future infection. With the growing population of Indian Americans, our findings can be used to develop community-based strategies for HBV screenings and LTC that target high-risk groups.

Pro-Environmental Civic Participation in the USA: The Effects of Social Media, Pro-Environmental Lifestyle and Climate Experiences

This study addresses the link between social media use and pro-environmental civic participation considering the moderating effect of social media affordances (public realm) on one hand, and lifestyle behaviors and climate change experiences (personal realm) on the other. We combine communication theory and behavioral models and using a sample of USA individuals (N = 7225) based on the American Trends Panel to predict variations in pro-environmental behavior. We show that social networks rather than information are more effective in predicting pro-environmental behavior. Moreover, a pro-environmental lifestyle as well as climate change experiences at the community level increase the likelihood for pro-environmental participation. However, affordances related to socioeconomic variations generate variations to pro-environmental civic participation. We conclude that in order to capture the depth of pro-environmental civic participation, it is necessary to theoretically and empirically bridge between private and public expressions of pro-environmental awareness.

American tegumentary leishmaniasis mimicking myiasis and granulomatous vasculitis:A case report

Rationale:American tegumentary leishmaniasis comprises cutaneous and mucocutaneous manifestations caused by parasitic infections by various Leishmania species.This report details the clinical interventions for a patient with American tegumentary leishmaniasis in Mendoza,Argentina,a non-endemic region.Patient concerns:A 43-year-old male was admitted to a tertiary care hospital in Mendoza,Argentina Republic with a history of progressive nasal discharge,septal perforation,facial pain,and pruritus.Despite treatment for presumed nasal myiasis and vasculitis with granulomatosis,symptoms persisted.Diagnosis:American tegumentary leishmaniasis.Interventions:Intravenous liposomal amphotericin B.Outcomes:Follow-up at 30 days showed no recurrence of symptoms with a remarkable clinical improvement of the nasal lesion.Lessons:This case sheds light on the necessity of accurate identification for timely intervention and the need to recognize the diverse manifestations of American tegumentary leishmaniasis to avoid misdiagnosis.

Community-Based Hepatitis B Campaign in Asian Americans

Chronic hepatitis B (CHB) disproportionately affects minority groups in the US, particularly Asian Americans, with numerous factors contributing to this disparity. Of the 2.4 million people living with chronic HBV in the US, 60% are Asian American. Many are unaware of their status and lack access to proper clinical care, with less than ten percent receiving necessary antiviral treatment. Barriers to screening and care include lack of disease awareness, language and cultural barriers, and financial constraints. Additionally, healthcare providers and systems in the US often overlook the importance of CHB, leading to inadequate care. In response, the Center for Viral Hepatitis (CVH) has implemented a community-based outreach program over the past sixteen years, employing a multifaceted approach involving all sectors of society and various organizations to combat health disparities in CHB. This grassroots campaign has proven highly effective, leveraging CVH’s leadership in spearheading numerous collaborative activities with community members, healthcare professionals, and policymakers. We have summarized the key points of CVH's efforts and their significance in combating CHB-related health disparities. The CHB Screening and Awareness Campaign, tailored to the Asian American community, serves as a successful model for increasing CHB screening, linkage-to-care, and addressing socio-cultural barriers and health literacy. Insights from these outreach programs have guided the development of culturally relevant resources and education initiatives. These findings suggest that such community-driven approaches are essential for addressing health disparities. The strategies and outcomes of CVH’s efforts can inform future health initiatives for other minority communities in the US and globally.

Analysis on Bicultural Identities of Chinese Americans Based on Acculturation Theory

In the context of globalization,the communication between countries is gradually enhanced and the immigration is increasing.Chinese Americans,as a unique ethnic group,are easy to fall into the difficult problem of self-identity construction when facing the bicultural identity conflict between Chinese and American.This paper selects the film The Farewell created by a Chinese American director as the research object,analyzes the cultural identity crisis of Chinese Americans,introduces the cultural adaption strategy adopted by Chinese Americans from the perspective of Acculturation Theory,and provides reference for Chinese Americans about how to realize the bicultural identities in the cultural diaspora.

Comparison of German and American Higher Education Accreditation Systems and Implications for Quality Management of Higher Education in China

At the present stage,China’s higher education has experienced continuous reform and enhancement,the scale of education has jumped to the forefront,and the quality of education has been continuously improved,which has made gratifying achievements.The development of China’s higher education has entered the critical node of improving quality and efficiency,and the importance of quality management as the central link in improving the quality of higher education is self-evident.Accreditation as an effective means of quality assurance,in Germany and the United States has formed a mature and perfect system and procedures.Therefore,analysing and learning from the quality management system of higher education in Germany and the United States has an important reference value for promoting the further development of quality management of higher education in China.

A Study on the Infiltration Methods of British and American Literature in High School English Reading Teaching

Reading is the key content of high school English teaching,which can improve students’mastery of words,grammar,and other knowledge,and can expand their horizons.British and American literature is the essence of British and American culture,and its application in high school English reading teaching can help improve students’English proficiency.This paper outlines the problems of high school English teaching,analyzes the role of British and American literature in high school English reading teaching,and explores the infiltration methods of British and American literature in high school English reading teaching,in order to provide references for teachers.

A Corpus Study of Acupuncture from the Perspective of Mass Media Based on the Corpus of Contemporary American English

Based on the Corpus of Contemporary American English(COCA),this study examines acupuncture from the perspective of mass media.Acupuncture has been circulating throughout the Chinese Cultural Circle since the Qin and Han Dynasties,and has since spread directly or indirectly to the rest of the world.The United States boasts the world’s second-largest acupuncture market,with its laws,regulations,industry growth,research,and education all positively influencing the development of acupuncture in other nations.This study uses COCA to analyze the form and content of acupuncture’s dissemination in eight different types of media.The findings show that acupuncture appears in COCA a total of 1,788 times,with the highest frequency in magazines,followed by blogs,and the lowest frequency in fiction.These findings reveal the popularity of acupuncture in mass media in the United States and provide empirical data and insights for the future dissemination and development of acupuncture in the United States.

Comparative Studies on Education in China and the USA——Differences between American and Chinese College Students

Awareness of differences between American and Chinese college students is surely important for us in international communication. The historical, social, economic, linguistic and spiritual contexts of China and America are profoundly different. Consequently, college students have shaped their lives and their identities in profoundly different ways, for example, academic studies, independence, teacher-student relationships, and life on campus. Though college students in different countries, he or she has their own mind and spirit with the cultural context in unique ways. We should respect their culture. Knowing the differences will help us communicate and understand the American college students better. Furthermore, we can learn from other’s strong points to offset our weakness. This paper discusses the differences between American and Chinese college students, it includes two parts, first one is a brief introduction, and second one is giving some ideas on differences between American and Chinese college students.

Body mass index versus percentage body fat in Chinese, African-American and Caucasian postmenopausal women

Objective: The aim of the study was to investigate in postmenopausal women whether the relationship between percentage body fat (PBF) and body mass index (BMI) differs between Asians living in Beijing (BA) and African-Americans (AA), and Caucasians (Ca) living in New York City. Methods: Healthy postmenopausal women (231 BA; 113 AA, 95 Ca), aged 50-80 years, were studied. Weight, height and PBF by dual energy X-ray absorptiometry (DXA) were measured. The relationship between PBF and BMI was assessed by multiple regression analysis. Results: Race, reciprocal of BMI (1/BMI) and the interaction between race and 1/BMI were all significantly (P<0.05) related to PBF in this sample. The slope of the line relating 1/BMI to PBF was different for BA compared to AA (P=0.01) and Ca (P=0.003) while the slopes for AA and Ca were not different (P>0.05). At lower levels of BMI, Asians tended to have higher PBF comparable to AA and Ca, while at BMI >30 BA tended to have less PBF than the other groups. Conclusion: The relation between PBF and BMI in BA postmenopausal women differs from that of AA and Ca women in this sample.

Bone density, microarchitecture and stiffness in Caucasian and Caribbean Hispanic postmenopausal American women

Hispanic Americans of Caribbean origin are a fast-growing subset of the US population, but there are no studies on bone density, microstructure and biomechanical integrity in this minority group. In this study, we aimed to compare Caucasian and Caribbean Hispanic postmenopausal American women with respect to these characteristics. Thirty-three Caribbean Hispanics were age-matched to thirty-three Caucasian postmenopausal women. At the lumbar spine, the Hispanic women had significantly lower areal bone mineral density （aBMD）. At the radius by high-resolution peripheral quantitative computed tomography （HR-pQCT）, there were minimal differences between Hispanic and Caucasian women. At the tibia, Hispanic women had lower trabecular volumetric bone density and trabecular number, and higher trabecular separation. Individual trabecula segmentation （ITS） analyses indicated that at the tibia, Hispanic women not only had significantly lower bone volume fraction, but also had significantly lower rod bone volume fraction, plate trabecular number, rod trabecular number and lower plate-plate, plate-rod and rod-rod junction densities compared to Caucasian women. The differences in bone quantity and quality contributed to lower whole bone stiffness at the radius, and both whole bone and trabecular bone stiffness at the tibia in Hispanic women. In conclusion, Hispanic women had poorer bone mechanical and microarchitectural properties than Caucasian women, especially at the load-bearing distal tibia.

Refusal Speech Acts in Chinese and American English

Refusals are frequently performed in our daily lives.Based on the speech act theory of Austin and Searle,with the theoretical frame of the politeness theory put forward by Brown and Levinson,It presents a comparative study of speech acts of refusal in Chinese and American English.The results show that refusals vary in directness with situations and cultures;On the one hand,both languages employ the three directness types,namely the direct refusal speech act,ability of negation and indirect refusal speech act,and prefer indirect refusals.The situational variability of directness in both languages follows a similar trend.On the other hand,Americans are more direct than Chinese.Furthermore,Chinese shows the lower degree of situational variation in the use of the three directness types.People' s choices of refusal strategies are influenced by social power and social distance.From all these evidence,we maintain that the cross-linguistic differences are due to basic differences in cultural values.

Cross-cultural Pragmatics within Speech Act:Refusal in Chinese and American Culture

This essay concentrates on the differences in one cross-cultural pragmatics within one speech acts-refusal in both Chinese culture and American culture.Some background theories are introduced at the beginning,followed by specific pragmatics situations of refusal.At the end of the essay,some concepts of cross-cultural pragmatics speech acts teaching are also discussed.

Gender differences of lower urinary tract symptoms in older Chinese Americans

Objective To describe whether or not there are gender differences in lower urinary tract symptoms(LUTS)prevalence and risk factors in community-dwelling older Chinese Americans.Methods We performed a secondary analysis of a prospective cross-sectional population-based survey of Chinese Americans aged 60 years and older between January 2011 and December 2013 in English,Mandarin,Cantonese,Taishanese,or Teochew.A clinical review of systems was used to assess LUTS,which included urinary frequency,urgency,burning and/or pain,blood in urine,and urinary incontinence.Results Of the total 3157 people queried,42%were men and 58%were women.More men reported LUTS compared to women(32.9%vs.28.6%,p=0.01).In a multivariable analysis,female gender(adjusted odds ratio[aOR]0.60,95%confidence interval[CI]0.49-0.73),being married(aOR 0.79,95%CI 0.65-0.97),and smoking(aOR 0.66,95%CI 0.49-0.88)were found to be protective,while traditional Chinese medicine use(aOR 1.51,95%CI 1.28-1.78),heart disease(aOR 1.54,95%CI 1.24-1.91),and anxiety(aOR 1.69,95%CI 1.25-2.28)were most strongly associated with increased odds of LUTS.When examining genders separately,being married was found to be protective only in women.Meanwhile,unique factors found in men were hypertension,heart disease,and practice of Tai Chi.Conclusion In this large population-based study,LUTS were more prevalent in older Chinese American men than women.We also found gender-specific factors that influenced the odds of reporting LUTS;however,traditional Chinese medicine use was the only factor that was shared by both genders.Future longitudinal investigations are needed to elucidate these underlying mechanisms to provide evidence-based and culture-specific guidelines for this rapidly growing population.

The COVID-19 Pandemic: A Double Threat to Chinese Americans’ Mental Health

Objective:To explore the double psychosocial threats of the COVID-19 pandemic,targeted behavior toward Chinese Americans,and the correlates to their mental health.Methods:A quantitative,cross-sectional,and descriptive design was utilized by using a purposive convenience sample of 301 Chinese Americans over the age of 18 residing in the United States.Online data collection was conducted through the social media platform WeChat from April 8–21,2021.Descriptive statistical analysis was used for the participants’demographic charac-teristics,Multidimensional Scale of Perceived Social Support(MSPSS),Double Threat Situations,COVID-19 Racial Discrimination,and General Anxiety Disorder-7(GAD-7).Stepwise logistic regression was conducted to verify predictors for anxiety levels by GAD-7.Results:In this sample(N=301),127(42.19%)were male and 174(57.81%)were female.The average age was 41.67(SD=5.89).Among MSPSS subscales,social support from family(MSPSS-Fam,79.73%,n=240)and social support from significant others(MSPSS-SO,73.75%,n=222)were high.231(76.74%)reported threats due to their Chinese ethnic background during the COVID-19 outbreak.Predictors for the high anxiety level by GAD-7 were COVID-19 racial discrimination from the local community(OR=0.47,95%CI=0.39–0.71,p<0.001),media/online(OR=0.36,95%CI=0.26–0.53,p<0.001),the perceived threat from the COVID-19 virus(OR=0.33,95%CI=0.23–0.51,p<0.001)and Perceived racism threat from Chinese back-ground related to COVID-19(OR=0.31,95%CI=0.21–0.49,p<0.001).Conclusions:COVID-19 double-threats(The virus and racial discrimination)situations are significantly related to the high level of anxiety among Chinese Americans.The sense of belonging and social perceptions of Chinese immigrants is closely related to public health problems in Western societies and needs to be addressed at all levels.Ourfindings call for the attention of health-care workers to specific racism double-threatened situations and high mental health risks,as well as direct and indirect ethnic discrimination that Chinese Americans are experiencing during this pandemic,the long-term influ-ences and effective coping ways related to this issue should be explored in further research.

Status Quo and Application of North American Wisteria in Shijiazhuang

The introduction and planting of three cultivars of North American wisteria in Shijiazhuang were observed.By comparing the inflorescences of Chinese wisteria,Japanese wisteria and North American wisteria,it is concluded that North American wisteria has compact inflorescence,rich color and late flowering period,and can prolong the ornamental time of wisteria when collocating with Chinese wisteria and Japanese wisteria in landscape application.The application of North American wisteria in Chinese gardens can not only enrich the species diversity of the region,but also have positive significance for improving the landscape effect of the whole city.

In Her Mother’s House:Mother-Daughter Dissonance in Post-1990s Chinese American Fiction

This paper attempts to examine the trope of“home”and the depiction of mother-daughter dissonance“in her mother’s house”in post-1990s Chinese American fiction.The research selects four novels in the case study and focuses on how mother-daughter dissonance“in her mother’s house”is presented,what cultural connotations the trope of“home”carries and how they are affected by such extra-contextual factors as racism,sexism and classism.In comparison with two representative mother-daughter narrative works in pre-1990s period,the new characteristics and connotations of“home”in mother-daughter dissonance in post-1990s Chinese American fiction are revealed.

A Comparative Study of British Gentleman Culture and American Cowboy Culture

This paper makes a comparative analysis by selecting British gentleman culture and American cowboy culture,the two distinctive cultures,to trace their roots,explore their connotations,and search for their similarities and differences,so as to better understand the respective characteristics of British and American cultures.The result shows that although the two cultures have different styles,which can interpret two different ethnic cultures,they are related by blood and have certain commonalities.

Discourse Construction of the Belt and Road Initiative in British and American Media:The Perspective of Proximization Theory

This study takes the reports on China’s“One Belt,One Road”in the British and American media as the object of study,mainly by collecting more than 10,000 words from the relevant reports published in the British media The Times,The Daily Telegraph and The Guardian from 2019-2022,to create a British corpus.A number of US media outlets,such as the New York Times,Los Angeles Times and Washington Post,were also collected to extract over 10,000 words of relevant corpus to create a US corpus.The BFSU Qualitative Coder 1.1,AntConc 3.5.7 and the LLX2 chi-square test were used to analyse the perceptions of the British and American corpora on China’s“One Belt,One Road”initiative,and to explore the temporal,spatial and value convergence of speakers and addressees in the corpus in the context of convergence theory.In this paper,we explore the specific distribution and pragmatic functions of the convergence of speakers and addressees in the corpus,in order to explore and reveal the different features of the application of convergence strategies in the British and American corpora in relation to China’s“One Belt,One Road”initiative.

CARLSON不等式与一个USAMO试题的另解

2004年USAMO有这样一个试题:题目:α,b,c为正数,证明:(a^(5)-α^(2)+3)(b^(5)-b^(2)+3)(c^(5)-c^(2)+3)≥(a+b+c)3.在[1]的解答中,先将α^(5)-α^(2)+3缩小为α^(3)+2,再利用如下结论。