Perceptions of the osteopathic profession in New York City’s Chinese Communities

Objective The purpose of this study was to assess knowledge of and barriers to osteopathic medicine in Chinese immigrant communities in New York City(NYC).Design A cross-sectional study was designed in which a culturally appropriate survey in Chinese and English versions was administered anonymously to measure immigrant perceptions and knowledge of osteopathic medicine.setting Data collection occurred in the municipal delineations for the Chinatown neighbourhood within the New York,New York borough of Manhattan.Participants Community members were selected using convenience sampling from high-density areas to participate.Information gathered from the survey included demographics,education level,healthcare habits and knowledge of the osteopathic profession.results 120 surveys were conducted with 68 males and 52 females,with an average age=40.Respondents in the age range of 18-29 years,those with fluent English-language proficiency,and participants with graduate-level education status demonstrated a higher proportion of knowledge of osteopathic manipulative medicine and osteopathic physicians(doctors of osteopathic medicine)among the study variables.Conclusion Compared with research on the general US population,a general lack of knowledge of osteopathic medicine exists within NYC’s Chinese immigrant community.Although this difference may be ascribed to linguistics and ethnosociological factors,greater outreach and education is needed in urban minority communities to make immigrants aware of all healthcare resources available during the current shortage of US primary care physicians.

Barriers in the Transition of Care for Heart Failure Patients Attending Clinics in Mwanza City, Tanzania

Introduction: Transition of care strategies have shown to improve quality of lives of heart failure patients, but it has little implemented in clinical settings. Objective: To evaluate context-specific perceived barriers and experiences of heart failure patients during their admission and after they were discharged from hospital. Methods: A cross-sectional qualitative study was conducted among 13 heart failure patients at two large referral hospitals in northwestern Tanzania. In-depth interviews among heart failure patients, in line with the Consolidated Criteria for Reporting Qualitative research checklist, were used to collect data. Interviews were audio recorded, transcribed, and translated into English. Results: Three key barriers were identified, as well as possible solutions that could improve the transition of care for heart failure patients. These include strengthening healthcare provider communications, organizing medication management, and assisting with follow-up appointments. Conclusion: The barriers identified are real and challenging in clinical resource- limited settings. Findings suggest they can be overcome when realistic and tailor-made interventions are in place.

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.

Spontaneous Tumor Lysis Syndrome Secondary to Iatrogenic Acute Kidney Injury: A Case Report

Spontaneous Tumor Lysis Syndrome (STLS) is a rare oncologic condition caused by the breakdown of neoplastic tissue in the absence of traditional anti-tumor therapy. It is postulated that cancers with rapidly dividing cells lead to increased cell turnover which exceeds the kidneys’ ability to adequately filtrate by-products of cellular breakdown (i.e., phosphate, potassium, anduric acid), leading to end organ damage. It has been reported in the past that kidney failure is a sequelae of Tumor Lysis Syndrome (TLS), but there have been no reports that demonstrate acute kidney injury (AKI) preceding TLS. The case presented here demonstrates TLS in a patient with no formal cancer diagnosis, who had received no chemotherapy or radiation that was precipitated by an iatrogenic AKI with chlorthalidone and ibuprofen. This unusual pattern of AKI preceding STLS may provide insight into the pathophysiology of the condition and could possibly lead to greater understanding of this phenomenon.

A New Approach: About the Appearance of “Dark Matter” Effects in the Process of Expansion of the Universe*

The paper considers cosmological objects belonging to fundamentally different classes that do not intersect with each other. Firstly, these are objects that make up a pure Hubble stream. Secondly, these are objects that have constant proper distances. These include planets, stars, and galaxies in gravitationally coupled systems. They all do not participate in the Hubble stream as independent objects. It is shown that the commoving reference system and proper reference system standardly used in cosmology change places with each other when switching from considering Hubble objects to “planets”. The features of the evolution (more precisely, devolution, degradation, reverse development) of the latter were analyzed and it was found that the cosmological acceleration of all “planets”, in contrast to Hubble objects, coincides in order of magnitude with the fundamental value of H2R. As applied to the Pioneers anomaly, this approach allowed us to obtain the calculated value of cosmological acceleration, which coincides in order of magnitude with the observed value. It seems that this approach is applicable also to other local gravitationally coupled systems and allows us to explain the characteristic flattened shape of the orbital curves of stars and galaxies by the fact that the influence of the fundamental cosmological acceleration H2R is added to the system’s own gravitational field.

Implications of obesity in patients with foot and ankle pathology

Obesity is a growing problem defined as a body mass index of greater than 30 kg/m2.It is predicted that by 2030,48.9%of adults will be classified as obese which expands surgical risk factors to a broad population while increasing healthcare costs at the same time in different socioeconomic groups.This specific population has been widely studied in multiple surgical fields and published studies have shown the implications in each of these fields.The impact of obesity on orthopedic surgical outcomes has been previously reported in several total hip and knee arthroscopy studies,with evidence indicating that obesity is strongly associated with an increased risk of post operative complications together with higher revision rates.In line with increasing interest on the impact of obesity in orthopedics,there has been a similar output of publications in the foot and ankle literature.This review article evaluates several foot and ankle pathologies,their risk factors associated with obesity and subsequent management.It provides an updated,comprehensive analysis of the effects of obesity on foot and ankle surgical outcomes,with the ultimate aim of educating both surgeons and allied health professionals about the risks,benefits,and modifiable factors of operating on obese patients.

Innovating Pedagogical Practices through Professional Development in Computer Science Education

Recent advancements in technology have opened up new avenues for educators to facilitate teaching and leverage more learning access in the digital age.As the demand for computational skills continues to grow in preparation for future careers,both teachers and students face the challenge of developing problem-solving,critical thinking,communication,and collaboration skills within an emerging digital landscape.Technology adoption,big data,cloud computing and artificial intelligence pose ongoing challenges for both teachers and students in adapting to the changing workforce development landscape.To tackle these challenges,the paper highlights the importance of exploring the implications of learning sciences in classroom teaching,developing a holistic vision for professional development in education,and understanding the complexities of teacher change.To effectively implement these components,it is crucial to adopt design approaches that prioritize student ownership in education and embrace the principles of inclusive education to reconceptualize the teaching practices in education and technology.

Particle elasticity influences polymeric artificial antigen presenting cell effectiveness in vivo via CD8+T cell activation,macrophage uptake,and the protein corona

Adoptive cell therapy(ACT)is an immunotherapy strategy for cancer that has seen widespread clinical success.During ACT,patient-derived lymphocytes are stimulated with the antigen of interest ex vivo,proliferated,then returned to the patient to initiate an antigen-specific antitumor response.While effective,this process is resource-intensive and logistically impossible for many patients.Particulate artificial antigen presenting cells(aAPCs)offer a potential“off-the-shelf”alternative to ex vivo ACT.While particulate aAPCs perform well in vitro,they have had limited success in vivo due to poor bioavailability after injection.Barriers to bioavailability include rapid clearance,unfavorable biodistribution,and inadequate interactions with CD8+T cells at sites of interest.Biomaterial properties such as elasticity have been shown to vastly impact the bioavailability and particle-cell interactions,but this has yet to be investigated in the context of aAPCs for in vivo T-cell stimulation.Previous literature likewise indicates that biomaterial properties,especially elasticity,can modulate T-cell activation in vitro.With the goal of creating a more biomimetic,next-generation particulate aAPC,we developed a poly(ethylene)glycol hydrogel particle platform with tunable elasticity to investigate the impact of elasticity on antigen-specific T cell activation for in vivo adoptive transfer.Using this knowledge,we were able to gain more precise control over in vivo T cell activation and investigate possible mechanisms including the effects of aAPC elasticity on T cell binding,macrophage uptake,and the protein corona.

全球农作物生产水利用效率地区差异分析及建议

粮食安全和水安全已成为当前全球最紧迫的问题之一。农作物生产水利用效率(CWUE)较低的国家如何提高其CWUE,减小区域CWUE差异,也成为实现区域协调发展中亟待解决的重要问题。本文结合87个国家1990-2007年的相关数据,基于随机前沿生产函数构建并估计了CWUE模型;在洲间、洲内和全球各国间三维度对CWUE差异进行方差分解,并分析差异及其因素值的变化情况、差异因素的贡献份额及其变化情况;列出各区域内部CWUE较低的国家现时改善CWUE、减小区域CWUE差异时应关注的重要因素,包括该区域(各洲或全球范围)内CWUE差异的最主要贡献因素、波幅较大或波幅不断变大的因素、以及贡献份额波动幅度较大或波幅不断变大的因素;通过情景分析验证了改善最主要贡献因素对减小CWUE差异的效果,展示了在改善最主要贡献因素后各区域为进一步减小CWUE差异应重点关注的因素;最后,本文对提高CWUE的具体措施提出了相关政策建议,包括改善全要素生产率、要素结构相对不合理的国家优化生产要素投入等。

非小细胞肺癌的个体化治疗进展

肺癌是全球癌症相关死亡的最常见原因.在过去20年中,分子靶向治疗和免疫治疗显著改善了非小细胞肺癌(non-small-cell lung cancer,NSCLC)患者的预后.然而,绝大多数的晚期NSCLC会对目前治疗产生耐药,最终出现疾病进展.基于此,本综述就近年来出现的一些突破性NSCLC治疗方法,尤其是免疫治疗和靶向治疗展开讨论.同时强调了目前我们对耐药机制的理解以及将基因组分析纳入临床研究以进一步理解机制的重要性.我们认为新辅助和联合的维持治疗在未来有可能使早期阶段疾病得到治愈.合理的联合治疗未来发展所面临的主要挑战是如何通过可靠的预测性生物标志物将患者清晰分层.本文阐述了我们对未来十年可能影响NSCLC治疗策略的临床研究领域的观点.

Cancer in inflammatory bowel disease

Patients with long-standing inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer (CRC). Many of the molecular alterations responsible for sporadic colorectal cancer, namely chromosomal instability, microsatellite instability, and hypermethylation, also play a role in colitis-associated colon carcinogenesis. Colon cancer risk in inflammatory bowel disease increases with longer duration of colitis, greater anatomic extent of colitis, the presence of primary sclerosing cholangitis, family history of CRC and degree of inflammation of the bowel. Chemoprevention includes aminosalicylates, ursodeoxycholic acid, and possibly folic acid and statins. To reduce CRC mortality in IBD, colonoscopic surveillance with random biopsies remains the major way to detect early mucosal dysplasia. When dysplasia is confirmed, proctocolectomy is considered for these patients. Patients with small intestinal Crohn’s disease are at increased risk of small bowel adenocarcinoma. Ulcerative colitis patients with total proctocolectomy and ileal pouch anal- anastomosis have a rather low risk of dysplasia in the ileal pouch, but the anal transition zone should be monitored periodically. Other extra intestinal cancers, such as hepatobiliary and hematopoietic cancer, have shown variable incidence rates. New endoscopic and molecular screening approaches may further refine our current surveillance guidelines and our understanding of the natural history of dysplasia.

Prevalence of HPV Infection And Cervical Intraepithelial Neoplasia And Attitudes towards HPV Vaccination among Chinese Women Aged 18-25 in Jiangsu Province

Objective：Few data are available on the epidemiology of HPV and cervical cancer among Chinese women younger than 25 years old.This study aimed to estimate the HPV infection rate and the prevalence of cervical intraepithelial neoplasia（CIN） in women aged 18-25,as well as their knowledge of and attitudes towards HPV vaccination.Methods：A population-based cervical cancer screening study was conducted on women aged 18-25 in Jiangsu province in 2008.Participants provided socio-demographic,reproductive and behavioral information and completed a survey about their knowledge of and attitudes towards HPV vaccination.Women then underwent a gynecologic exam to provide two cervical exfoliated cell samples for high risk HPV DNA testing and liquid-based cytology（LBC） as well as visual inspection with acetic acid（VIA）.Women testing positive for any test were referred to colposcopy and biopsy.The gold standard for diagnosis of cervical lesions was directed or random biopsies.Results：Within the sample of 316 women,3.4% of them were diagnosed with CIN grade 2 or worse lesions and 17.1% were found to be positive for HPV DNA.Among these young women,extra-marital sexual behavior of them（OR=2.0,95%CI：1.1-3.8） or their husbands（OR=2.6,95%：1.4-4.7） were associated with an increased risk of HPV positivity.Although overall HPV awareness was low,after a brief educational intervention,98.4% reported they would electively receive HPV vaccination and would also recommend that their daughters be vaccinated.However,most urban and rural women reported their ideal maximum out-of-pocket contribution for HPV vaccination to be less than 500 RMB and 50-100 RMB,respectively.Conclusion：Our study indicates cervical disease burden is relatively high among sampled Chinese women aged 18-25.Appropriate educational interventions for female adolescents and strategies to subsidize vaccine costs are definitely needed to ensure the effectiveness of vaccination campaigns in China.

Similar efficacy and safety of tenofovir in Asians and non-Asians with chronic hepatitis B

AIM:To compare the efficacy and safety of tenofovir disoproxil fumarate(TDF)in Asian and non-Asian chronic hepatitis B(CHB)patients.METHODS:The efficacy and safety of the initial 48wk of treatment with TDF was compared in a posthoc analysis of combined data from 217 Asians and299 non-Asians included in Studies 102 and 103and a post-approval,open-label trial(Study 123).Patient groups were compared according to baseline hepatitis B e antigen(HBe Ag)status and viral load.The main outcome measures included the proportion of patients who achieved a hepatitis B virus(HBV)DNA level<400 copies/m L at Week 48 of treatment.Secondary measures included:HBV DNA and alanine aminotransaminase(ALT)levels over time;proportion of patients with normal ALT levels;proportion of patients with HBe Ag loss/seroconversion and proportion of patients with hepatitis B surface antigen loss/seroconversion;changes in liver histology.Safety and tolerability were evaluated by the occurrence of adverse events(AEs),serious AEs,laboratory abnormalities,discontinuation of the study drug due to AEs,or death.The primary efficacy and safety analysis set included all patients who were randomly assigned to treatment and received at least one dose of study drug.RESULTS:At week 48,similar proportions of Asians and non-Asians reached HBV DNA<400 copies/m L(96%of Asian and 97%of non-Asian patients with HBe Ag-negative CHB and 83%of Asian and 79%of non-Asian patients with HBe Ag-positive CHB had HBV DNA)and normal ALT(78%of Asian and 81%of nonAsian patients with HBe Ag-negative CHB and 71%of Asian and 74%of non-Asian patients with HBe Agpositive CHB had normal ALT).On-treatment HBV DNA decline rates were similar between Asians and nonAsians regardless of baseline HBe Ag status and viralload.HBV DNA decline during the first four weeks was2.9 log10 copies/m L in HBe Ag-negative Asians and nonAsians,and in HBe Ag-positive non-Asians,and 3.1log10 copies/m L in HBe Ag-positive Asians.HBe Ag loss and seroconversion was achieved in 14%of Asians vs 26%and 24%,respectively,in non-Asians.Liver histology improved in 77.2%of Asians and 71.5%of non-Asians.No resistance to TDF developed.No renal safety signals were observed.CONCLUSION:TDF demonstrated similar viral suppression,normalization of ALT,improvements in liver fibrosis,and no detectable resistance in Asian and non-Asian patients regardless of baseline HBe Ag status.

A rare cause of drug-induced hepatitis in an immunocompromised patient and the role of glutathione

The Food and Drug Administration (FDA) has issued a warning on numerous herbal drugs, including many popular products at General Nutrition Centers (GNC), regarding unstudied hepatotoxicity. There have been recent reports of GNC products such as hydroxycut and herbalife, causing drug-induced hepatitis. Herbal medications are over-the-counter products and are not investigated thoroughly by the FDA. Given that the mostcommon outpatient laboratory abnormality is elevated liver transaminases, a sign of hepatocellular toxicity; it is not surprising that some of these products end up causing hepatic dysfunction, especially when taken in large volume. There are numerous herbal supplements that are hepatotoxic, however, these medications have a much more significant effect in human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome patients, which is secondary to depleted glutathione. We present a rare case of drug induced hepatitis secondary to herbal medications used to treat HIV and elucidate the role of glutathione depletion in immunocompromised patients.

Probiotic Therapy for Treating Behavioral and Gastrointestinal Symptoms in Autism Spectrum Disorder:A Systematic Review of Clinical Trials

The therapeutic potentials of probiotics in autism spectrum disorder(ASD)remains controversial,with the only existing systematic review on this topic published in 2015.Results from new trials have become available in recent years.We therefore conducted an updated systematic review,to assess the efficacy of probiotics in relieving behavioral symptoms of ASD and gastrointestinal comorbidities.Our review includes two randomized controlled trials,which showed improvement of ASD behaviors,and three open trials,all which exhibited a trend of improvement.Four of these trials concluded from subjective measures that gastrointestinal function indices showed a trend of improvement with probiotic therapy.Additional rigorous trials are needed to evaluate the effects of probiotic supplements in ASD.

缅怀中国著名的人兽共患病学专家范明远教授

范明远教授1929年4月生于辽宁省大连市。1947年毕业于关东医学院（大连医科大学的前身），1950年就职于大连生物制品研究所斑疹伤寒研究室，师从微生物学家魏曦教授．行始立克次体病科学研究生涯。1957-1998年在中国预防医学科学院流行病学微生物学研究所、中国疾病控制中心传染病所工作·1981年起任立克次体病研究室主任，研究员，至1998年退休。2011年11月10日居家仙逝，享年83岁。

Doppler effect of the rupture process of the great M_W7.9 Wenchuan earthquake

In this study we performed a classical spectrum analysis of seismic waveforms recorded at far field stations of the great MW7.9 Wenchuan earthquake to observe the shifts of the corner frequency with azimuth due to the Doppler effect.Our results show that this damaging great earthquake had a dominating rupture propagation direction of 64.0°.The equivalent radius of the fault rupture surface was estimated to be 33 km,yielding the rupture area of about 3 500 km2.Thus the length of the rupture fault surface is about 230 km if the depth（or width） extent is 15 km.The computer program developed in this study can quickly provide the information about the source of a future large（damaging） earthquake,which could be very useful for predicting aftershocks and planning the rescue operations.

Protective effect of hydroxychloroquine on rheumatoid arthritis-associated atherosclerosis

Background: Patients with rheumatoid arthritis (RA) have an increased risk for cardiovascular disease. We examined the effect of gut microbiota in a mouse model of RA that develops atherosclerosis. Methods: We created three groups of K/BxN female mice that were positive for the anti‐glucose‐6‐phosphate isomerase (GPI) antibody: control diet (CD), high fat diet (HFD), and HFD with hydroxychloroquine (HFD + HCQ). Serological tests were used to detect the serum levels of total cholesterol (TCHO), low‐density lipoprotein cholesterol (LDL‐C), triglyceride (TG), high‐density lipoprotein cholesterol (HDL‐C), anti‐ GPI antibody titers, and serum cytokines. Atherosclerotic plaque was determined by histological analysis, and gut microbiota were determined by 16sV4 sequencing. Results: Relative to mice given the CD, those receiving the HFD had increased serum levels of LDL‐C, TCHO, and TG, decreased serum levels of HDL‐C, increased atherosclerotic lesions in the aortic root, and altered gut microbiota. Addition of HCQ to HFD decreased the serum levels of LDL‐C, TCHO, and TG, increased serum levels of HDL‐C, and decreased the atherosclerotic lesions in the aortic root. Mice receiving HFD + HCQ also had the greatest bacterial diversity among the three experimental groups. Moreover, HCQ treatment significantly increased the abundance of Akkermansia and Parabacteroides, and decreased the abundance of Clostridium sensu stricto cluster 1, and therefore may be responsible for the reduced RA‐associated atherosclerosis and dyslipidemia. Conclusion: Our mouse model of RA indicated that HFD increased ankle width and aggravated a therosclerosis a nd d yslipidemia, a nd t hat H CQ a lleviated t he d yslipidemia and atherosclerosis, but had no effect on ankle width.

Does Checklist Implementation Improve Quantity of Data Transfer: An Observation in Postanesthesia Care Unit (PACU)

Background: Omission of patient information in perioperative communication is closely linked to adverse events. Use of checklists to standardize the handoff in the post anesthesia care unit (PACU) has been shown to effectively reduce medical errors. Objective: Our study investigates the use of a checklist to improve quantity of data transfer during handoffs in the PACU. Design: A cross-sectional observational study. Setting: PACU at Memorial Sloan Kettering Cancer Center (MSKCC);June 13, 2016 through July 15, 2016. Patients, other participants: We observed the handoff reports between the nurses, PACU midlevel providers, anesthesia staff, and surgical staff. Intervention: A physical checklist was provided to all anesthesia staff and recommended to adhere to the list at all observed PACU handoffs. Main outcome measure: Quantity of reported handoff items during 60 pre- and 60 post-implementation of a checklist. Results: Composite value from both surgical and anesthesia reports showed an increase in the mean report of 8.7 items from pre-implementation period to 10.9 post-implementation. Given that surgical staff reported the mean of 5.9 items pre-implementation and 5.5 items post-implementation without intervention, improvements in anesthesia staff report with intervention improved the overall handoff data transfer. Conclusions: Using a physical 12-item checklist for PACU handoff increased overall data transfer.