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 rapi...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.展开更多
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 parti...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.展开更多
Objective To investigate the incidence of nasopharyngeal carcinoma (NPC) and the clinical characteristics in this family through a long term follow up, and to seek the hereditary factor of NPC. This research was al...Objective To investigate the incidence of nasopharyngeal carcinoma (NPC) and the clinical characteristics in this family through a long term follow up, and to seek the hereditary factor of NPC. This research was also designed to provide some clincial data for etiological study.Methods A genealogical tree of Ye Liang's family was drawn and reported in 1972 after a complete survey. Further follow up from that time to 1997 was performed. Human leucocyte antigens (HLA) were investigated, and physical follow up was done in domestic members of this family. For oversea members of this family, correspondence follow up was performed.Results In the last 25 years, the incidence of malignancies in Ye Liang's family increased from 10 cases to 18 cases, and incidence of NPC increased from 9 cases to 15 cases. In this family, not only multiple malignancies have been found in the second generation, but also NPC has been found in the third generation. HLA haplotype was correlated with occurrence of NPC.Conclusions Dominant racial predilection and family cluster in NPC implied that NPC is a heredity related cancer which might involve multifactorial disorders in carcinogenesis. Further research on etiology of NPC should be focused on hereditary factor. Detection of inherited factors should be performed for forecast of carcinogenesis and reduction of NPC occurrence.展开更多
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)instit...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.展开更多
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 en...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 oppor展开更多
Iris biometrics is a phenotypic biometric trait that has proven to be agnostic to human natural physiological changes.Research on iris biometrics has progressed tremendously,partly due to publicly available iris datab...Iris biometrics is a phenotypic biometric trait that has proven to be agnostic to human natural physiological changes.Research on iris biometrics has progressed tremendously,partly due to publicly available iris databases.Various databases have been available to researchers that address pressing iris biometric challenges such as constraint,mobile,multispectral,synthetics,long-distance,contact lenses,liveness detection,etc.However,these databases mostly contain subjects of Caucasian and Asian docents with very few Africans.Despite many investigative studies on racial bias in face biometrics,very few studies on iris biometrics have been published,mainly due to the lack of racially diverse large-scale databases containing sufficient iris samples of Africans in the public domain.Furthermore,most of these databases contain a relatively small number of subjects and labelled images.This paper proposes a large-scale African database named Chinese Academy of Sciences Institute of Automation(CASIA)-Iris-Africa that can be used as a complementary database for the iris recognition community to mediate the effect of racial biases on Africans.The database contains 28717 images of 1023 African subjects(2046 iris classes)with age,gender,and ethnicity attributes that can be useful in demographically sensitive studies of Africans.Sets of specific application protocols are incorporated with the database to ensure the database’s variability and scalability.Performance results of some open-source state-of-the-art(SOTA)algorithms on the database are presented,which will serve as baseline performances.The relatively poor performances of the baseline algorithms on the proposed database despite better performance on other databases prove that racial biases exist in these iris recognition algorithms.展开更多
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 suf...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.展开更多
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 tru...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.展开更多
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 a...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 pre展开更多
Objective To analyse comparatively the relevant data from bone tumor registries in China, Japan, and the United States Methods The data of 38?959 histologically confirmed primary bone tumors collected by the Chines...Objective To analyse comparatively the relevant data from bone tumor registries in China, Japan, and the United States Methods The data of 38?959 histologically confirmed primary bone tumors collected by the Chinese Bone Tumor Registry 1957 1988, 20?272 collected by the Japanese Bone Tumor Registry 1972 1990, and 11087 diagnosed and treated at Mayo Clinic, USA were used for comparative analysis by race, age, sex and skeletal distribution For reliability, we used ratios of different tumors to osteosarcoma for frequency analysis We also included some data from the SEER 1973 1987 as well as from Memorial Sloan Kettering Cancer Center, USA Results The relative frequency of osteosarcoma (OS) is higher in China and Japan than in the United States There were only limited number of OS patients aged over 50 years in Chinese and Japanese groups, which might be due to the lower incidence of OS subsequent to Paget's disease in Asians More osteosarcoma occurred in the flat bones in the Americans than in the Chinese and Japanese The relative frequency of chondrosarcoma (CS) was higher in the American group than in the Asian groups The average age of CS patient was younger in the Chinese than in the Japanese and the Americans The data confirmed the previous report that the incidence of Ewing sarcoma was higher in western people than in Asians The data showed that the comparative frequency of chordoma is higher in the Americans than in the Asians and that the incidence of giant cell tumor of bone is higher in the Chinese and Japanese than in the Americans Conclusion The findings from this analysis provide useful information for the epidemiologic study and the clinical diagnosis of bone tumors展开更多
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 analys...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 展开更多
Racial discrimination remains a prevalent issue in the contemporary U.S.despite efforts to promote equality.Many young African American and Hispanic males are easy target for law enforcement agents.Minorities experien...Racial discrimination remains a prevalent issue in the contemporary U.S.despite efforts to promote equality.Many young African American and Hispanic males are easy target for law enforcement agents.Minorities experience a higher and more unfair form of racial discrimination,racial profiling,police brutality,unfair sentencing,and mass incarceration for offences which are the same or less than those committed by White males.The rate of incarceration in the United States is five to eight times higher than most developed countries,and Black males constitute the largest percentage of inmates in the U.S.prison system.Once arrested,Black Americans are more likely to remain in prison longer,and await trial for minor offenses at a higher rate than Whites.Black and Latino males sentenced in state and federal courts face significantly greater odds of incarceration than White offenders for the same or even higher crimes.Vagins and McCurdy in a 2006 ACLU on“cracks in the system”reported that“There is no rational medical or penological reason for the 100:1 disparity between crack and powder cocaine and instead it causes an unjustified racial disparity in our penal system”(p.7).There is a racial disparity in the proportion of Black males in prison serving sentences of life without the possibility of parole(LWOP).In addition,The United States Criminal Justice System needs to be carefully examined as a top priority agenda needing immediate call of action that needs reform to guarantee the constitutional rights accorded to every American“with liberty and justice for all”.展开更多
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP) is the recommended technique for biliary decompression in pancreatic cancer. Previous studies have suggested racial, socioeconomic and geographic differe...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, tho展开更多
BACKGROUND: To assess whether insurance status has an effect on emergency department(ED) length of stay(LOS) and likelihood for admission or transfer to an operating room.METHODS: This was a retrospective cross-sectio...BACKGROUND: To assess whether insurance status has an effect on emergency department(ED) length of stay(LOS) and likelihood for admission or transfer to an operating room.METHODS: This was a retrospective cross-sectional study of all encounters from January 2011 through October 2013 at an urban, academic trauma center. Analysis included multi-variable linear regression for ED LOS and logistic regression for the likelihood of admission.RESULTS: Overall, 201 535 patients met the inclusion criteria, for which the mean age was 43.8 years, 55.9% were female, 23.4% were uninsured and 8% were of non-black race. Admission rate was 24.5% and operative rate was 1.4%. After adjusting for age, sex, triage acuity and race, the presence of insurance coverage was associated with an increased ED LOS of 575(95%CI 552–598) vs. 567(95%CI 543–591) minutes(P<0.01) among admitted patients and a decreased ED LOS of 456(95%CI 381–531) vs. 499(95%CI 423–575) minutes(P<0.01) among those transferred to an operating room. Adjusting for these same predictors, insured status remained a predictor for admission(odds ratio 1.24, 95%CI 1.20–1.28, P<0.01) and a negative predictor for transfer to the operating room(odds ratio 0.84, 95%CI 0.77–0.92, P<0.01).CONCLUSION: The insured experienced a clinically insignificant increase in ED LOS when admitted and a 43-minute decrease in ED LOS when being transferred to the operating room. The insured were more likely to be admitted and less likely to be transferred to an operating room.展开更多
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 ...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.展开更多
To Kill a Mockingbird is the masterpiece of Harper Lee,who created an important black man named Tom Robinson in it.Although hard-working and kind-hearted,Tom Robinson becomes a victim of racial discrimination with the...To Kill a Mockingbird is the masterpiece of Harper Lee,who created an important black man named Tom Robinson in it.Although hard-working and kind-hearted,Tom Robinson becomes a victim of racial discrimination with the tragic death.He is the epitome of the era and the tragedy of the individual.Based on the rape trial in To Kill a Mockingbird,this paper analyzes the injustice and inequality for black people in the white-dominated society from the perspective of racism,interpreting the tragic fate of Tom Robinson under the racial discrimination.展开更多
Purpose: To examine salivary cortisol responses to a racially-charged stimulus in a group of African-American individuals. Methods: A nonrandom sample of 245 (age: 43.8 ± 11.1 years;64% female) African-American i...Purpose: To examine salivary cortisol responses to a racially-charged stimulus in a group of African-American individuals. Methods: A nonrandom sample of 245 (age: 43.8 ± 11.1 years;64% female) African-American individuals was recruited by advertisements. Specifically, salivary cortisol was assessed prior to and after being exposed to a racially-charged movie clip. In addition, the salivary cortisol was assessed in?the morning and evening of the day following exposure to the racially-charged movie clip. Results: A statistically significant increase in cortisol was found (P 0.005) in the whole sample. High cortisol responders (highest tertile) and low cortisol responders (lowest tertile) were compared. The high cortisol responders had an elevated cortisol level the following morning (P 0.05) that abated by the evening sample (P > 0.20). In addition, the high cortisol responders who were younger, had lower waist to hip ratios, and experienced less lifetime discrimination than the low cortisol responders (P’s 0.05). Conclusions: The findings of an increase in cortisol in response to a racial provocation may provide a potential explanatory factor for the increased rates of cardiovascular disease in African-American individuals.展开更多
To Kill A Mockingbird is a novel written by Harper Lee. In the novel, Lee reveals the situation happened in Maycomb city and depicts Arthur(Boo) Radley, a mysterious hermit who is recognized as a madman by citizens. M...To Kill A Mockingbird is a novel written by Harper Lee. In the novel, Lee reveals the situation happened in Maycomb city and depicts Arthur(Boo) Radley, a mysterious hermit who is recognized as a madman by citizens. My paper is going to argue for Boo that he is not a madman, being locked out by his father; instead, he chooses to be a hermit due to the awfulness of the city:its prevalent gossip, its racial inequality and its lawless policies.展开更多
基金supported by the Program for Changjiang Scholars and Innovative Research Team in University scheme of the Ministry of Education of China(NO.IRT1111)the National Basic Research Program of China(2012CB518300)+2 种基金the National Natural Science Foundation of China(81101946)the Shanghai Pujiang Program(12PJD008)Prostate Cancer Foundation Young Investigator Award,Shanghai Municipal Health and Family Planning Commission Outstanding Young Investigator(XYQ2013077).
文摘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.
基金supported by the National Natural Science Foundation of China [Grant No. 81973112 and Grant No.9204930002]
文摘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.
文摘Objective To investigate the incidence of nasopharyngeal carcinoma (NPC) and the clinical characteristics in this family through a long term follow up, and to seek the hereditary factor of NPC. This research was also designed to provide some clincial data for etiological study.Methods A genealogical tree of Ye Liang's family was drawn and reported in 1972 after a complete survey. Further follow up from that time to 1997 was performed. Human leucocyte antigens (HLA) were investigated, and physical follow up was done in domestic members of this family. For oversea members of this family, correspondence follow up was performed.Results In the last 25 years, the incidence of malignancies in Ye Liang's family increased from 10 cases to 18 cases, and incidence of NPC increased from 9 cases to 15 cases. In this family, not only multiple malignancies have been found in the second generation, but also NPC has been found in the third generation. HLA haplotype was correlated with occurrence of NPC.Conclusions Dominant racial predilection and family cluster in NPC implied that NPC is a heredity related cancer which might involve multifactorial disorders in carcinogenesis. Further research on etiology of NPC should be focused on hereditary factor. Detection of inherited factors should be performed for forecast of carcinogenesis and reduction of NPC occurrence.
文摘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.
文摘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 oppor
文摘Iris biometrics is a phenotypic biometric trait that has proven to be agnostic to human natural physiological changes.Research on iris biometrics has progressed tremendously,partly due to publicly available iris databases.Various databases have been available to researchers that address pressing iris biometric challenges such as constraint,mobile,multispectral,synthetics,long-distance,contact lenses,liveness detection,etc.However,these databases mostly contain subjects of Caucasian and Asian docents with very few Africans.Despite many investigative studies on racial bias in face biometrics,very few studies on iris biometrics have been published,mainly due to the lack of racially diverse large-scale databases containing sufficient iris samples of Africans in the public domain.Furthermore,most of these databases contain a relatively small number of subjects and labelled images.This paper proposes a large-scale African database named Chinese Academy of Sciences Institute of Automation(CASIA)-Iris-Africa that can be used as a complementary database for the iris recognition community to mediate the effect of racial biases on Africans.The database contains 28717 images of 1023 African subjects(2046 iris classes)with age,gender,and ethnicity attributes that can be useful in demographically sensitive studies of Africans.Sets of specific application protocols are incorporated with the database to ensure the database’s variability and scalability.Performance results of some open-source state-of-the-art(SOTA)algorithms on the database are presented,which will serve as baseline performances.The relatively poor performances of the baseline algorithms on the proposed database despite better performance on other databases prove that racial biases exist in these iris recognition algorithms.
基金supported by the National Natural Science Foundation of China(Nos.51977113,62293500,62293501 and 62293505).
文摘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.
文摘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.
文摘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 pre
文摘Objective To analyse comparatively the relevant data from bone tumor registries in China, Japan, and the United States Methods The data of 38?959 histologically confirmed primary bone tumors collected by the Chinese Bone Tumor Registry 1957 1988, 20?272 collected by the Japanese Bone Tumor Registry 1972 1990, and 11087 diagnosed and treated at Mayo Clinic, USA were used for comparative analysis by race, age, sex and skeletal distribution For reliability, we used ratios of different tumors to osteosarcoma for frequency analysis We also included some data from the SEER 1973 1987 as well as from Memorial Sloan Kettering Cancer Center, USA Results The relative frequency of osteosarcoma (OS) is higher in China and Japan than in the United States There were only limited number of OS patients aged over 50 years in Chinese and Japanese groups, which might be due to the lower incidence of OS subsequent to Paget's disease in Asians More osteosarcoma occurred in the flat bones in the Americans than in the Chinese and Japanese The relative frequency of chondrosarcoma (CS) was higher in the American group than in the Asian groups The average age of CS patient was younger in the Chinese than in the Japanese and the Americans The data confirmed the previous report that the incidence of Ewing sarcoma was higher in western people than in Asians The data showed that the comparative frequency of chordoma is higher in the Americans than in the Asians and that the incidence of giant cell tumor of bone is higher in the Chinese and Japanese than in the Americans Conclusion The findings from this analysis provide useful information for the epidemiologic study and the clinical diagnosis of bone tumors
基金National Key R&D Program of China,No.2017YFC0908300.
文摘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
文摘Racial discrimination remains a prevalent issue in the contemporary U.S.despite efforts to promote equality.Many young African American and Hispanic males are easy target for law enforcement agents.Minorities experience a higher and more unfair form of racial discrimination,racial profiling,police brutality,unfair sentencing,and mass incarceration for offences which are the same or less than those committed by White males.The rate of incarceration in the United States is five to eight times higher than most developed countries,and Black males constitute the largest percentage of inmates in the U.S.prison system.Once arrested,Black Americans are more likely to remain in prison longer,and await trial for minor offenses at a higher rate than Whites.Black and Latino males sentenced in state and federal courts face significantly greater odds of incarceration than White offenders for the same or even higher crimes.Vagins and McCurdy in a 2006 ACLU on“cracks in the system”reported that“There is no rational medical or penological reason for the 100:1 disparity between crack and powder cocaine and instead it causes an unjustified racial disparity in our penal system”(p.7).There is a racial disparity in the proportion of Black males in prison serving sentences of life without the possibility of parole(LWOP).In addition,The United States Criminal Justice System needs to be carefully examined as a top priority agenda needing immediate call of action that needs reform to guarantee the constitutional rights accorded to every American“with liberty and justice for all”.
基金American Cancer Society Grant,No.129387-MRSG-16-015-01-CPHPS(to Lucas AL)
文摘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, tho
文摘BACKGROUND: To assess whether insurance status has an effect on emergency department(ED) length of stay(LOS) and likelihood for admission or transfer to an operating room.METHODS: This was a retrospective cross-sectional study of all encounters from January 2011 through October 2013 at an urban, academic trauma center. Analysis included multi-variable linear regression for ED LOS and logistic regression for the likelihood of admission.RESULTS: Overall, 201 535 patients met the inclusion criteria, for which the mean age was 43.8 years, 55.9% were female, 23.4% were uninsured and 8% were of non-black race. Admission rate was 24.5% and operative rate was 1.4%. After adjusting for age, sex, triage acuity and race, the presence of insurance coverage was associated with an increased ED LOS of 575(95%CI 552–598) vs. 567(95%CI 543–591) minutes(P<0.01) among admitted patients and a decreased ED LOS of 456(95%CI 381–531) vs. 499(95%CI 423–575) minutes(P<0.01) among those transferred to an operating room. Adjusting for these same predictors, insured status remained a predictor for admission(odds ratio 1.24, 95%CI 1.20–1.28, P<0.01) and a negative predictor for transfer to the operating room(odds ratio 0.84, 95%CI 0.77–0.92, P<0.01).CONCLUSION: The insured experienced a clinically insignificant increase in ED LOS when admitted and a 43-minute decrease in ED LOS when being transferred to the operating room. The insured were more likely to be admitted and less likely to be transferred to an operating room.
文摘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.
文摘To Kill a Mockingbird is the masterpiece of Harper Lee,who created an important black man named Tom Robinson in it.Although hard-working and kind-hearted,Tom Robinson becomes a victim of racial discrimination with the tragic death.He is the epitome of the era and the tragedy of the individual.Based on the rape trial in To Kill a Mockingbird,this paper analyzes the injustice and inequality for black people in the white-dominated society from the perspective of racism,interpreting the tragic fate of Tom Robinson under the racial discrimination.
文摘Purpose: To examine salivary cortisol responses to a racially-charged stimulus in a group of African-American individuals. Methods: A nonrandom sample of 245 (age: 43.8 ± 11.1 years;64% female) African-American individuals was recruited by advertisements. Specifically, salivary cortisol was assessed prior to and after being exposed to a racially-charged movie clip. In addition, the salivary cortisol was assessed in?the morning and evening of the day following exposure to the racially-charged movie clip. Results: A statistically significant increase in cortisol was found (P 0.005) in the whole sample. High cortisol responders (highest tertile) and low cortisol responders (lowest tertile) were compared. The high cortisol responders had an elevated cortisol level the following morning (P 0.05) that abated by the evening sample (P > 0.20). In addition, the high cortisol responders who were younger, had lower waist to hip ratios, and experienced less lifetime discrimination than the low cortisol responders (P’s 0.05). Conclusions: The findings of an increase in cortisol in response to a racial provocation may provide a potential explanatory factor for the increased rates of cardiovascular disease in African-American individuals.
文摘To Kill A Mockingbird is a novel written by Harper Lee. In the novel, Lee reveals the situation happened in Maycomb city and depicts Arthur(Boo) Radley, a mysterious hermit who is recognized as a madman by citizens. My paper is going to argue for Boo that he is not a madman, being locked out by his father; instead, he chooses to be a hermit due to the awfulness of the city:its prevalent gossip, its racial inequality and its lawless policies.
