Asian Continental Ancestry Group

Strum lipoprotein(a) (Lp( a)) and its correlates were studied in African Aboriginal Pygmies (n = 146) and Bantus (n = 208) f rom Cameroon. Geometric mean Lp(a) levels were 274 and 289 mg/l in Bantu males and females, respectively, and 220 and 299 mg/l in Pygmy males and females, the gender difference being significant in Pygmies (p = 0.024). In Pyg mies 41% and 52% of the males and females, respectively, had Lp(a) levels above 300 mg/l, compared with 47% and 55% in Bantus. Overall, Lp(a) 1 evels did not significantly differ between Pygmies and Bantus, and did not correlate with age, body mass index (BMI), systolic and diastolic blood pressure. Compared with healthy Asian and Caucasian population samples, age-and BMI-adjusted geometric Lp(a) means were 2.3-to 5.0.fold high er in Pygmy and Bantu males, and 2.9-to 3.6-fold higher in Pygmy and Bantu females (e 5 0.05). A cross the population samples studied ethnicity predicted 12% and 17% of serum Lp(a) variance in males and females, respectively.

What is a mental illness or a psychiatric disorder? Do people in different cultures suffer from the same kinds of mental illnesses? Do mental disorders present with similar symptoms in various parts of the world? How are mental distress and suffering identified and treated in different countries or societies? These questions underpin the development of cultural psychiatry . Besides the so-called "culture-bound syndromes," neurasthenia ("shenjing shuairuo" in Mandarin) is one of the most well-known and well-studied diagnostic categories in this interdisciplinary domain. Coined by the Boston-based physician George M. Beard in 1868, neurathenia includes a broad array of symptoms such as fatigue, anxiety, inattention, insomnia, impotence, neuralgia, and many others, all attributed to nervous exhaustion due to the pressures of modern life. It was fashionable in the U.S. during the late 19th century and early 20th century, a period marked by rapid urbanization and industrialization . Neurasthenia has traveled far from its American origins; as a disease closely tied to modernization, it has become a global phenomenon. In the U.S. and Europe, its popularity was shortlived. By the 1920s or 1930s, it became faded into an obsolete diagnosis. But its presence in other parts of the world is more enduring, and East Asia stands out as a region where the disease is particularly well-received . Since the rise of cultural psychiatry in the post-war era, the evolution of neurasthenia in this region has captivated more than two generations of psychiatrists, anthropologists, and historians. The foundation of this scholarship is laid by psychiatrist-anthropologist Arthur Kleinman. Kleinman, one of the principal initiators of medical anthropology, is also a leading figure in cultural psychiatry, global mental health, medical humanities, and Chinese studies. His early work on neurasthenia, conducted successively in Taiwan and China, has become a cornerstone in understanding the complex interplay between local illness experiences and global psychiatric categories. This article revists Arthur Kleinman's seminal contributions to the cross-cultural research on neurasthenia. Recently, he visited Taipei again to receive the award of Honorary Academician from Academia Sinica. The trip also marks the 55th anniversary of his initial journey to Taiwan in 1969 as a National Institute of Health fellow assigned to the U.S. Naval Medical Research Unit No. 2. In the subsequent sections, I will examine the place of neurasthenia in his two major ethnographic projects: the Taiwan study in the 1970s and the Hunan study in the 1980s. The former study discovers the popularity of neurasthenia in Taiwan, makes a tentative connection with depression and other conditions, and highlights somatization as the underlying mechanism. The latter study fosters a debate on the correlation between neurasthenia and depression in China and provides rare empirical insights into the traumatic impacts of the Cultural Revolution. Finally, I will briefly discuss the implications of these studies and their relevance to psychiatry today.

There is an increased prevalence of anxiety and depression in Asian patients diagnosed with cancers; these are known to interfere with treatment, treatment adherence and mortality. This study sought to investigate the prevalence and predictors of subsyndromal anxiety and depression in first-year Asian cancer patients. A total of 206 patients newly diagnosed with cancer in Singapore completed the Hospital Anxiety and Depression Scale (HADS) at T1 (baseline; on average 2 months post-diagnosis), T2 (3 months post-baseline) and T3 (6 months post-baseline). Subsyndromal anxiety and depression were identified using locally validated cut-offs (HADS-A ≥5 and HADS-D ≥7). Adjusted odds ratios were calculated using baseline predictors. Across the three time points, 68-69% of participants were identified as having subsyndromal anxiety and close to 27-38% participants were identified as having subsyndromal depression. Multivariate logistic regressions revealed a lack of predictors for T1 subsynd...

Objective: To examine the factors associated with hope and hopelessness in patients with cancer in Asian countries, and the instruments used to measure hope and hopelessness. Methords: A comprehensive systematic review was conducted with search terms, including cancer, hope, hopelessness and individual Asian country names, on CINAHL, Embase, PsycINFO, PubMed and Scopus databases. Only quantitative studies on adult cancer populations in Asia examining hope or hopelessness were included. Results: A total of 2062 unique articles were retrieved from the databases, and 32 studies were selected for inclusion in this review. Hope and hopelessness were most frequently measured with the Herth Hope Index and the Mental Adjustment to Cancer Scale, respectively. The biopsychosocial factors that were most consistently associated with hope and hopelessness included sociodemographic variables (education, employment and economic status); clinical factors (cancer stage, physical condition and symptoms); and psychosocial factors (emotional distress, social support and connections, quality of life, control or self-efficacy, as well as adjustment and resilience). Discussion: There is a need for more studies from South and Southeast Asia as most studies hailed from East Asia. This review highlighted the possibility of cultural differences influencing factors related to hope, suggesting that cross-cultural studies specifically would facilitate understanding behind these variations, although future reviews on hope should also include studies on hopelessness for a comprehensive understanding of the concept. Finally, more longitudinal research could be conducted to assess whether the factors associated with hope and hopelessness change over time and disease progression.

The projection data from multiple centers were successfully transferred to a common format for SPECT reconstruction. When the average values were analyzed using a 17-segment model, myocardial counts in the septal segment differed signifi cantly between 180° and 360° rotation acquisitions. Regional differences were observed between men and women in the inferior and anterior regions. A tracer difference between 99m Tc and 201 Tl was also observed in some segments. The attenuation patterns differed signifi cantly between subjects from the United States and those from Japan. Conclusions Myocardial perfusion data that were specifi c for the Japanese population were generated. The normal database can serve a standard for nuclear cardiology work conducted in Japan.

Objective: Standards for myocardial single-photon emission computed tomography (SPECT) adapted for a Japanese population have not been available. The purpose of this project was to create standard files approved by the Japanese Society of Nuclear Medicine and to make known the characteristics of the myocardial perfusion pattern of this population. Methods: With the collaboration of nine hospitals, a total of 326 sets of exercise-rest myocardial perfusion images were accumulated from subjects with a low-likelihood of cardiac diseases. The normal database included a 99m Tc-MIBI/tetrofosmin myocardial perfusion study with 360-degree (n=80) and 180-degree (n=56) rotations, 201 Tl study with 360-degree (n=115) and 180-degree rotations (n=54) and a dual-isotope study with 360-degree rotation (n=27). The projection images were transferred by DICOM (Digital Imaging and Communications in Medicine) format and reconstructed and analyzed with polar maps. Results: The projection data from multiple centers were successfully transferred to a common format for SPECT reconstruction. When the average values were analyzed using a 17-segment model, myocardial counts in the septal segment differed significantly between 180-degree and 360-degree rotation acquisitions. Regional differences were observed between males and females in the inferior and anterior regions. A tracer difference between 99m Tc and 201 Tl was also observed in some segments. The attenuation patterns differed significantly between subjects from the United States and Japanese populations. Conclusion: Myocardial perfusion data that were specific for the Japanese population were generated. The normal database can serve a standard for nuclear cardiology work conducted in Japan.

Assuming that no human had any previously acquired immunoprotection against severe acute respiratory syndrome coronavirus (SARS-CoV) during the 2003 SARS outbreak, the biological bases for possible difference in individual susceptibility are intriguing. However, this issue has never been fully elucidated. Based on the premise that SARS patients belonging to a given genotype group having a significantly higher SARS infection rate than others would imply that genotype group being more susceptible, we make use of a compartmental model describing disease transmission dynamics and clinical and gene data of 100 laboratory confirmed SARS patients from Chinese Han population in Taiwan to estimate the infection rates of distinct candidate genotype groups among these SARS-infected individuals. The results show that CXCL10(-938AA) is always protective whenever it appears, but appears rarely and only jointly with either Fgl2(+158T/*) or HO-1(-497A/*), while (Fgl2)(+158T/*) is associated with higher susceptibility unless combined with CXCL10/IP-10(-938AA), when jointly is associated with lower susceptibility. The novel modeling approach proposed, which does not require sizable case and control gene datasets, could have important future public health implications in swiftly identifying potential high-risk groups associated with being highly susceptible to a particular infectious disease.

FTO is the strongest known genetic susceptibility locus for obesity. Experimental studies in animals suggest the potential roles of FTO in regulating food intake. The interactive relation among FTO variants, dietary intake and body mass index (BMI) is complex and results from previous often small-scale studies in humans are highly inconsistent. We performed large-scale analyses based on data from 177,330 adults (154 439 Whites, 5776 African Americans and 17 115 Asians) from 40 studies to examine: (i) the association between the FTO-rs9939609 variant (or a proxy single-nucleotide polymorphism) and total energy and macronutrient intake and (ii) the interaction between the FTO variant and dietary intake on BMI. The minor allele (A-allele) of the FTO-rs9939609 variant was associated with higher BMI in Whites (effect per allele = 0.34 [0.31, 0.37] kg/m(2), P = 1.9 × 10(-105)), and all participants (0.30 [0.30, 0.35] kg/m(2), P = 3.6 × 10(-107)). The BMI-increasing allele of the FTO varia...

The aim of this study was to identify regional structural differences in the brains of native speakers of a tonal language (Chinese) compared to nontonal (European) language speakers. Our expectation was that there would be differences in regions implicated in pitch perception and production. We therefore compared structural brain images in three groups of participants: 31 who were native Chinese speakers; 7 who were native English speakers who had learnt Chinese in adulthood; and 21 European multilinguals who did not speak Chinese. The results identified two brain regions in the vicinity of the right anterior temporal lobe and the left insula where speakers of Chinese had significantly greater gray and white matter density compared with those who did not speak Chinese. Importantly, the effects were found in both native Chinese speakers and European subjects who learnt Chinese as a non‐native language, illustrating that they were language related and not ethnicity effects. On the ba...

The identification of activating mutations in the epidermal growth factor receptor (EGFR) gene is one of the most intriguing recent discoveries in the field of lung cancer research, and they are more commonly found in adenocarcinoma occurring in females, never/light smokers, and East Asian patients. Why such certain patients are susceptible to the development of EGFR-mutant tumors is currently unknown. Methods: This study evaluated the medical records of 437 patients with adenocarcinoma of the lung who underwent a surgical resection. The genetic status of the EGFR gene was investigated by polymerase chain reaction-based analyses. The serological typing of histocompatibility leukocyte antigen (HLA) class I was performed using a microcytotoxicity test of lymphocytes or polymerase chain reaction-sequence-specific oligonucleotides, and the correlation between the EGFR mutation and HLA alleles was analyzed. Results: An EGFR mutation was found more frequently in females and never/former smokers than their counterpart. In females, the incidences of EGFR mutation were 61.0% and 41.7% in HLA-A2 (ϩ) and A2 (Ϫ) patients with adenocarcinoma of the lung, respectively (p ϭ 0.008). The EGFR mutation was found more frequently in female patients with HLA-A2. However, no significant correlation was identified between the frequencies of other HLA alleles and EGFR mutations in the same patients group. Conclusions: EGFR mutations are associated with HLA-A2 in female patients with adenocarcinoma of the lung. Further research was needed to elucidate the other relevant factors in the histogenesis of lung cancer with an EGFR mutation.

Single nucleotide polymorphisms (SNP's) in the epidermal growth factor receptor (EGFR) play a crucial role in head and neck cancer (HNC) disease progression and targeted therapies. Hence the present study aims to identify the mutations in EGFR gene (exon 20) in HNC considering their exposure to tobacco and alcohol habits. Mutational analysis was carried out by polymerase chain reaction (PCR) followed by single stranded confirmatory polymorphism (SSCP) techniques on the study group comprising of 129 HNC cases and 150 healthy volunteers. Four different SNP's (R776H, G779G, Q787Q, and L798H) were observed with the overall mutation rate of 75.19% in HNC cases and 46% in controls. Q787Q was found to be more prevalent (p , 0.05) and its genotypes GG, GA, and AA were 24.80%, 61.24%, and 13.95%. The study concluded that EGFR was found to be a polymorphic gene associated with HNC disease, and these SNPs were also prevalent in healthy volunteers with tobacco and alcohol habits.

Restless legs syndrome (RLS) is a sensorimotor disorder with an age-dependent prevalence of up to 10% in the general population above 65 years of age. Affected individuals suffer from uncomfortable sensations and an urge to move in the lower limbs that occurs mainly in resting situations during the evening or at night. Moving the legs or walking leads to an improvement of symptoms. Concomitantly, patients report sleep disturbances with consequences such as reduced daytime functioning. We conducted a genome-wide association study (GWA) for RLS in 922 cases and 1,526 controls (using 301,406 SNPs) followed by a replication of 76 candidate SNPs in 3,935 cases and 5,754 controls, all of European ancestry. Herein, we identified six RLS susceptibility loci of genome-wide significance, two of them novel: an intergenic region on chromosome 2p14 (rs6747972, P = 9.03 6 10 211 , OR = 1.23) and a locus on 16q12.1 (rs3104767, P = 9.4 6 10 219 , OR = 1.35) in a linkage disequilibrium block of 140 kb containing the 59-end of TOX3 and the adjacent non-coding RNA BC034767.

Background: Non-motor symptoms are detrimental to health-related quality of life (HRQoL) of Parkinson's disease patients. In this study, the Non-Motor Symptoms Scale (NMSS) was used to assess the impact of the non-motor symptoms on HRQoL of Parkinson's disease patients. Methods: In a multicenter, international, cross sectional study on 411 Parkinson's disease patients, the NMSS was applied along with clinical (Hoehn and Yahr staging and SCOPA-Motor) and HRQoL measures (PDQ-39, and EQ-5D). Prevalence of non-motor symptoms was determined also through the NMSS. The association of NMSS and SCOPA-Motor with HRQoL measures and the differences in HRQoL scores between patients with and without nonmotor symptoms in each NMSS domain were estimated by non-parametric statistics. Predictors of HRQoL were sought through multiple linear regression analyses. Results: Nocturia (68.4% of the sample), fatigue (65.9%), and dribbling saliva (56.7%), were the most frequent complaints. Total NMSS score: (1) showed a higher correlation coefficient (r S 5 0.70) with the PDQ-39 Summary Index (SI) than SCOPA-Motor (r S 5 0.58); (2) showed high-moderate correlation (r S 5 0.60 2 0.38) with all PDQ-39 domains; and (3) was the best predictor of HRQoL as measured by the PDQ-39 SI. For each NMSS domain, patients with symptoms had significantly worse HRQoL scores than patients without symptoms. Discussion: To our knowledge, this is the first study to determine in a holistic manner the impact of the nonmotor symptoms on HRQoL of Parkinson's disease patients. The results show that non-motor symptoms have, as a whole, a greater impact on HRQoL than motor symptoms and non-motor symptoms progression contributes importantly to HRQoL decline in patients with Parkinson's disease. V

Retinitis pigmentosa (RP) is a heterogeneous group of inherited retinal diseases. The prevalence of RP and the mutation spectrum vary across populations. Hispanic people account for approximately 17% of the United States population, and the genetic etiologies of RP of this ethnic group still remain not well defined. Utilizing next-generation sequencing (NGS), we screened mutations in known retinal diseasecausing genes in an RP cohort of 35 unrelated Hispanic probands from the Miami area. We achieved a solving rate of 66% and identified 15 novel putative pathogenic mutations, including a frequent founder mutation disrupting PRPF31 splicing. Our data show that the mutation spectrum of Hispanic RP receives a significant impact from disease-causing alleles of Spanish origin and may also contain population-specific alleles. Retinitis pigmentosa (RP; MIM #268000) affects 1 in 3,000 to 5,000 people worldwide. It is one of the most common forms of inherited retinal degenerations 1 . RP typically starts with night blindness during the first two decades of life and progresses gradually to tunnel vision and eventual complete blindness in some patients. These clinical manifestations result from progressive dysfunction and death of rod photoreceptors followed by cone photoreceptors throughout the retina. The clinical features of RP are highly variable and may overlap with other inherited retinal degenerations, such as cone-rod dystrophy (CRD), Leber congenital amaurosis, and Usher syndrome. In addition to the clinical heterogeneity, the genetic etiologies of RP are also complex. RP may present various modes of inheritance including autosomal dominant, autosomal recessive, X-linked and digenic in rare cases 1 . To date, mutations in at least 80 genes have been associated with RP (RetNet, ). Therefore, accurate molecular diagnosis of RP patients is challenging but essential for better patient management and personalized treatment. In recent years, a number of studies have applied next-generation sequencing to understand the molecular basis of human Mendelian disorders including RP 2-4 . Specifically, customized target capture sequencing was used to screen mutations in known disease-causing genes with high efficiency. By this method, novel disease-causing alleles as well as genotype-phenotype correlations have been identified, leading to a substantial enhancement of our understanding of allele pathogenicity, protein function and population genetics. Hence, NGS-based molecular diagnosis has been proven as a robust approach for assessing Mendelian disease on a molecular level. Hispanic Americans are residents of the United States (US) descending from Latin America countries or Iberian peninsula 5 . They account for 17% of US population and represent a fast-growing ethnic group 6 , highlighting a need for understanding the molecular basis of genetic disorders. However, the mutation spectrum of RP in this population has not been evaluated before except in isolated cases. We collected 35 unrelated Hispanic RP probands from the Miami area and performed next-generation sequencing-based mutation screening using a

The study aims to describe the characteristics and etiologic causes of intermediate uveitis (IU) patients seen by a tertiary eye center in Singapore over 8 years. Methods: This was a retrospective analysis of the clinical records of consecutive new cases of IU that presented to the uveitis subspecialty clinic from 2004-2011 at Tan Tock Seng Hospital. Data collected included demographics, clinical and laboratory findings. Diagnoses were based on standardized clinical history, ophthalmological examination and investigations. Results: There were 66 new cases of IU, comprising 5.7% of 1168 new uveitis patients. The median age of diagnosis was 40 years (mean 39.4615.9), with largest subgroup of the patients in the age group of 41-60 years (36.4%). The majority was Chinese (57.6%), followed by Asian Indians (18.2%) and Malays (16.7%). The ethnicity distribution was dissimilar to our ethnic distribution in Singapore (p,0.001) with an increased incidence of IU in the Asian Indian population. Most were idiopathic (59.1%) in etiology, followed by tuberculosis (TB) (15.2%). Ocular complications developed in 21 patients (31.8%), with cystoid macular edema (CME) being the commonest (28.8%). Severe vitritis occurred in 9.1% of patients, and was significantly associated with TB-associated IU (p,0.001). There was a downward trend for the incidence of the proportion of IU patients over the total uveitis patients (p = 0.021), with Spearman's rho of 20.786. Conclusions: Despite the downward trend, TB-associated IU was still of higher prevalence compared to less endemic areas, emphasizing the need for increased TB surveillance. A high index of suspicion for TB-associated IU is required in patients with severe vitritis. Comparisons with other countries revealed disparities in the IU etiologies, indicating possible geographical differences. Prevalence of known immune-mediated etiologies of IU is less compared to the western population. Our study also suggests a probable predisposition of the Singapore local Indian population for IU.

Background: This study reports the surgical outcomes of acquired immunodeficiency syndrome (AIDS) patients with Cytomegalovirus retinitis (CMVR) -related retinal detachments(RD) in an Asian population. Methods: Review of CMVR characteristics, surgical outcomes and complications in 19 eyes with CMVR-related RD that underwent surgery from January 2000 to June 2011. Results: CMVR was inactive in 73.7% of the eyes at time of surgery. Anatomical success was achieved in 14 eyes. Seven eyes (36.8%) had improvement of two or more lines in visual acuity (VA) and 8 eyes (42.1%) maintained VA. Thirteen eyes presented with worse than 6/120 vision, with 30.8% of them achieving ambulatory vision or better. Five eyes had re-detachments. Median durations from CMVR and immune recovery uveitis (IRU) diagnoses to RD were 2.7 and 1.0 months respectively. Conclusions: Surgery for CMVR-related RD is associated with good anatomical outcomes with most eyes maintaining or having improved vision. CMVR lesion size of <50% retinal area is associated with better outcomes. Eyes with CMVR and IRU require close monitoring for RD.

Osteoarthritis of the hip is five to ten times more common in white people than in Chinese people. Little is known about the true prevalence of femoroacetabular impingement or its role in the development of osteoarthritis in the Chinese population. A cross-sectional study of both white and Chinese asymptomatic individuals was conducted to compare the prevalences of radiographic features posing a risk for femoroacetabular impingement in the two groups. It was hypothesized that that there would be proportional differences in hip anatomy between the white and Asian populations. Pelvic computed tomography scans of 201 subjects (ninety-nine white Belgians and 102 Chinese; 105 men and ninety-six women) without hip pain who were eighteen to forty years of age were assessed. The original axial images were reformatted to three-dimensional pelvic models simulating standardized radiographic views. Ten radiographic parameters predisposing to femoroacetabular impingement were measured: alpha ang...

The human occupation history of Southeast Asia (SEA) remains heavily debated. Current evidence suggests that SEA was occupied by Hòabìnhian hunter-gatherers until ~4000 years ago, when farming economies developed and expanded, restricting foraging groups to remote habitats. Some argue that agricultural development was indigenous; others favor the &quot;two-layer&quot; hypothesis that posits a southward expansion of farmers giving rise to present-day Southeast Asian genetic diversity. By sequencing 26 ancient human genomes (25 from SEA, 1 Japanese Jōmon), we show that neither interpretation fits the complexity of Southeast Asian history: Both Hòabìnhian hunter-gatherers and East Asian farmers contributed to current Southeast Asian diversity, with further migrations affecting island SEA and Vietnam. Our results help resolve one of the long-standing controversies in Southeast Asian prehistory.

Research has indicated that individuals of Asian descent, relative to other racial groups, demonstrate reduced emotional responding and lower prevalence rates of several anxiety disorders. It is unclear though whether these group differences extend to biomarkers of anxiety disorders and whether genetic differences play a role. The present study compared self-identified Caucasians, Latinos, and Asians (total N = 174) on startle response during a baseline period and while anticipating unpredictable threat-a putative biomarker for certain anxiety disorders-as well as predictable threat. In addition, the association between genetic ancestry and startle response was examined within each racial group to determine potential genetic influences on responding. For the baseline period, Asian participants exhibited a smaller startle response relative to Caucasian and Latino participants, who did not differ. Within each racial group, genetic ancestry was associated with baseline startle. Furthermore, genetic ancestry mediated racial group differences in baseline startle. For the threat conditions, a Race × Condition interaction indicated that Asian participants exhibited reduced startle potentiation to unpredictable, but not predicable, threat relative to Caucasian and Latino participants, who did not differ. However, genetic ancestry was not associated with threat-potentiated startle in any racial group. The present study adds to the growing literature on racial differences in emotional responding and provides preliminary evidence suggesting that genetic ancestry may play an important role. Moreover, reduced sensitivity to unpredictable threat may reflect a mechanism for why individuals of Asian descent are at less risk for particular anxiety disorders relative to other racial groups.

Recent genome-wide association studies (GWASs) have identified common genetic variants at 5p15.33, 6p21 -6p22 and 15q25.1 associated with lung cancer risk. Several other genetic regions including variants of CHEK2 (22q12), TP53BP1 (15q15) and RAD52 (12p13) have been demonstrated to influence lung cancer risk in candidate-or pathway-based analyses. To identify novel risk variants for lung cancer, we performed a meta-analysis of 16 GWASs, totaling 14 900 cases and 29 485 controls of European descent. Our data provided increased support for previously identified risk loci at 5p15 (P 5 7.2 3 10 216 ), 6p21 (P 5 2.3 3 10 214 ) and 15q25 (P 5 2.2 3 10 263 ). Furthermore, we demonstrated histology-specific effects for 5p15, 6p21 and 12p13 loci but not for the 15q25 region. Subgroup analysis also identified a novel disease locus for squamous cell carcinoma at 9p21 (CDKN2A/p16 INK4A /p14 ARF /CDKN2B/p15 INK4B /ANRIL; rs1333040, P 5 3.0 3 10 27 ) which was replicated in a series of 5415 Han Chinese (P 5 0.03; combined analysis, P 5 2.3 3 10 28 ). This large analysis provides additional evidence for the role of inherited genetic susceptibility to lung cancer and insight into biological differences in the development of the different histological types of lung cancer.

The promotion of smoking cessation is a worldwide Public Health priority. OBJECTIVE: To estimate the budget impact on the Italian National Health Service (NHS) of the access to reimbursement of varenicline for the treatment of high risk patients with bronchopulmonary, diabetic and cardiovascular diseases. METHODS: A closed-group Markov model was developed in order to compare the costs incurred by the NHS to promote smoking cessation with cessation-related savings, using an alternative scenario in which aids to cessation are not reimbursed by the NHS. The analysis was conducted over a 5-year time horizon, in the perspective of the Italian NHS. Efficacy was expressed in terms of smoke abstinence for at least one year, and data was derived from clinical trials; the savings associated with smoking cessation were derived from cost-of-illness studies. RESULTS: The results show how costs would concentrate in the first year: they are estimated at € 200.6 million, of which € 162.4 million for drug therapy and € 38.2 million for counseling. Average annual savings over the first five years are estimated at € 77.7 million, with a cumulative net impact at 5 years of € -188.0 million (cost-saving). The analysis appears to be robust: sensitivity analyses show that the covering of initial costs occurs in any case between the third and fourth year, and that the treatment remains cost-saving at 5 years. CONCLUSIONS: The financial impact on the Italian NHS of the reimbursement of varenicline for the treatment of high risk smoking population would be a sustainable healthcare policy, resulting in cost savings starting from the fourth year.

Background: Although alcohol-related disorders (ARD) have been shown to be accompanied by comorbid depressive and anxiety disorders, and alcohol metabolic enzyme genes, ADH1B and ALDH2 polymorphisms, have been associated with an increased risk of ARD, no studies have been conducted to evaluate the associations between these genetic polymorphisms and anxiety or depression. Method: A total of 1944 Japanese workers were interviewed regarding their depressive and anxiety disorders, including suicidality, by a brief psychiatric structured interview (MINI). We investigated the relationship of ADH1B rs1229984 and ALDH2 rs671 polymorphism combinations with mental disorder risks. Logistic regression analysis was used to evaluate the associations between those polymorphisms and anxiety/depressive disorders, adjusting for sex, age, and job rank. The degree of alcohol sensitivity was classified into five groups according to the combination of two enzyme genotypes (Group I-V, in order from the lowest alcohol sensitivity). Results: Those with ALDH2 * 1/ * 1 and ADH1B * 1/ * 1 were likely to be at an increased risk of depressive and anxiety disorders as well as ARD. This tendency was more apparent among non-drinkers (OR 9.20,. No adverse effects of ALDH2 or ADH1B alone were observed with mental disorder risks. Likewise, analyses conducted combining job rank and genetic alcohol sensitivity showed no material associations with such risks. Conclusions: Genetic alcohol sensitivity, especially that with the genotype combination of ALDH2 * 1/ * 1 and ADH1B * 1/ * 1, was significantly associated with an increased risk of depressive and anxiety disorders as well as ARD.

Recent research suggests that the inference of others&#39; intentions from their observed actions is supported by two neural systems that perform complementary roles. The human putative mirror neuron system (pMNS) is thought to support automatic motor simulations of observed actions, with increased activity for previously experienced actions, whereas the mentalizing system provides reflective, non‐intuitive reasoning of others&#39; perspectives, particularly in the absence of prior experience. In the current fMRI study, we show how motor familiarity with an action and perceptual familiarity with the race of an actor uniquely modulate these two systems. Chinese participants were asked to infer the intentions of actors performing symbolic gestures, an important form of non‐verbal communication that has been shown to activate both mentalizing and mirror neuron regions. Stimuli were manipulated along two dimensions: (1) actor&#39;s race (Caucasian vs. Chinese actors) and (2) participant...

Objectives: Patients with type 2 diabetes exhibit subclinical inflammation and nearly all signs of systemic inflammation, which characterized by high circulating levels of inflammatory parameters. The present study aimed to assess the levels of the inflammatory markers such as C-reactive protein (CRP) in patients with type 2 diabetes mellitus and to correlate their values with the hemoglobin A1c (HbA1c) levels. Methods: This cross-sectional study was conducted on 78 patients with type 2 diabetes in Patna Medical College and Hospital, Patna. All patients had laboratory investigations including HbA1C and CRP, patients were assessed according to glycemic status, patients with under control of diabetics (HbA1C level was equal to or <6.5%), and patients with poorly-controlled diabetics (HbA1c level was >6.5%). Results: Statistically significant association was observed between CRP levels and level of HbA1c. The CRP level was significantly higher in poorlycontrolled diabetic patient than who with well-controlled diabetics (p=0.017). Conclusions: There is positive correlation between the level of glycemic control (HbA1c) and CRP levels; better glycemic control results in significant reduction in the highly sensitive C-reactive protein levels.

Historical discourses about the Caribbean often chronicle West African and European influence to the general neglect of indigenous people's contributions to the contemporary region. Consequently, demographic histories of Caribbean people prior to and after European contact are not well understood. Although archeological evidence suggests that the Lesser Antilles were populated in a series of northward and eastern migratory waves, many questions remain regarding the relationship of the Caribbean migrants to other indigenous people of South and Central America and changes to the demography of indigenous communities post-European contact. To explore these issues, we analyzed mitochondrial DNA and Y-chromosome diversity in 12 unrelated individuals from the First Peoples Community in Arima, Trinidad, and 43 unrelated Garifuna individuals residing in St. Vincent. In this community-sanctioned research, we detected maternal indigenous ancestry in 42% of the participants, with the remainder having haplotypes indicative of African and South Asian maternal ancestry. Analysis of Y-chromosome variation revealed paternal indigenous American ancestry indicated by the presence of haplogroup Q-M3 in 28% of the male participants from both communities, with the remainder possessing either African or European haplogroups. This finding is the first report of indigenous American paternal ancestry among indigenous populations in this region of the Caribbean. Overall, this study illustrates the role of the region's first peoples in shaping the genetic diversity seen in contemporary Caribbean populations.

This study investigated whether eye contact perception differs in people with different cultural backgrounds. Finnish (European) and Japanese (East Asian) participants were asked to determine whether Finnish and Japanese neutral faces with various gaze directions were looking at them. Further, participants rated the face stimuli for emotion and other affect-related dimensions. The results indicated that Finnish viewers had a smaller bias toward judging slightly averted gazes as directed at them when judging Finnish rather than Japanese faces, while the bias of Japanese viewers did not differ between faces from their own and other cultural backgrounds. This may be explained by Westerners experiencing more eye contact in their daily life leading to larger visual experience of gaze perception generally, and to more accurate perception of eye contact with people from their own cultural background particularly. The results also revealed cultural differences in the perception of emotion f...

Objective The purpose of this study is to determine the association between fetal nasal bone length (NBL) and gestational age (GA), biparietal diameter (BPD) and head circumference (HC) in women undergoing prenatal assessments and Down syndrome screening. Methods Cross-sectional data were obtained from 3,003 women with singleton pregnancies who underwent a prenatal ultrasound examination at the Department of Obstetrics and Gynecology, Cheng Hsin General Hospital between August 2006 and July 2009. Results Statistical analyses involved linear regression. NBL with GA, BPD and HC as measured between 14 ?0 and 35 ?6 weeks of gestation were linearly related. Conclusions Using multiple parameters(GA, BPD and HC) to estimate NBL is more accurate than using than using GA or BPD or HC alone, as indicated by the higher predictive value.

The aim of this study is to identify the types of gambling among adolescents and provide basic prevention information regarding adolescents&#39; gambling problems. Secondary data from representative national survey on 2015 Youth Gambling Problems of Korea Center on Gambling Problems were used. Using latent class analysis (LCA), 13 gambling types such as offline and online games of 14,011 adolescents were classified, and gambling experiences and characteristics were analyzed. The subgroups of adolescent gambling were identified as four latent classes: a rare group (84.5% of the sample), a risk group (1.0%), an offline group (11.9%), and an expanded group (2.6%). The types and characteristics of gambling among the latent classes differed. In the risk group, adolescents participated in online illegal sports betting and internet casino, and gambling time, gambling expenses, and the number of gambling types were higher than other groups. Gambling frequently occur among adolescent, and th...

Background Suicide is a major public health problem worldwide. In the UK suicide is the second most common cause of death in people aged 15-24 years. Self harm is one of the commonest reasons for medical admission in the UK. In the year following a suicide attempt the risk of a repeat attempt or death by suicide may be up to 100 times greater than in people who have never attempted suicide. Research evidence shows increased risk of suicide and attempted suicide among British South Asian women. There are concerns about the current service provision and its appropriateness for this community due to the low numbers that get involved with the services. Both problem solving and interpersonal forms of psychotherapy are beneficial in the treatment of patients who self harm and could potentially be helpful in this ethnic group. The paper describes the trial protocol of adapting and evaluating a culturally appropriate psychological treatment for the adult British South Asian women who self h...

The present study investigated verbal recall of semantically preserved and degraded words and nonwords by taking into consideration the status of one's semantic short-term memory (STM). Two experiments were conducted on 2 Chinese individuals with aphasia. The first experiment showed that they had largely preserved phonological processing abilities accompanied by mild but comparable semantic processing deficits; however, their performance on STM tasks revealed a double dissociation. The second experiment found that the participant with more preserved semantic STM had better recall of known words and nonwords than of their unknown counterparts, whereas such effects were absent in the patient with severe semantic STM deficit. The results are compatible with models that assume separate phonological and semantic STM components, such as that of R. C. Martin, M. Lesch, and M. . In addition, the distribution of error types was different from previous studies. This is discussed in terms of the methodology of the authors' experiments and current views regarding the nature of semantic STM and representations in the Chinese mental lexicon.

Chloroquine-induced itch in black-skinned African malaria patients is common and frequently leads to poor compliance or treatment defaulting. To assess the frequency and severity of chloroquine-induced pruritus in an Asian population, we reviewed case records of 1189 Plasmodium vivax malaria patients treated with chloroquine (25 mg/kg over 3days) at the Bangkok Hospital for Tropical Diseases from 1992 through 1997. The majority of patients were Thais or ethnic Burmese (light brown skin), referred from the western border of Thailand. Overall, there were 23 patients (1.9%) with complaints of pruritus during chloroquine therapy. Of these, 12 (52%) had palm and sole involvement, eight (35%) had generalized pruritus including the palms and soles, and three (13%) had palm itching only. One patient developed pruritus on the palms and soles on two consecutive admissions. The pruritus did not interfere with daily activity, was reduced in intensity by anti-histamine therapy, and did not affec...

Tibetan natives have lived on the Tibetan plateau (altitude ∼4,000 m) for at least 25,000 years, and as such they are adapted to life and reproduction in a hypoxic environment. Recent studies have identified two genetic loci, EGLN1 and EPAS1, that have undergone natural selection in Tibetans, and further demonstrated an association of EGLN1/ EPAS1 genotype with hemoglobin concentration. Both genes encode major components of the hypoxia-inducible factor (HIF) transcriptional pathway, which coordinates an organism&#39;s response to hypoxia. Patients living at sea level with genetic disease of the HIF pathway have characteristic phenotypes at both the integrative-physiology and cellular level. We sought to test the hypothesis that natural selection to hypoxia within Tibetans results in related phenotypic differences. We compared Tibetans living at sea level with Han Chinese, who are Tibetans&#39; most closely related major ethnic group. We found that Tibetans had a lower hemoglobin con...

Individuals with mild cognitive impairment (MCI) are at increased risk for Dementia of Alzheimer's type (DAT), vascular dementia (VaD), Lewy Body (LBD) and Fronto-temporal dementias (FTD). Risk factors and conversion rates of MCI to dementia have not been thoroughly investigated in developing countries. Chinese and English versions of Mini-Mental State Examination were administered serially among well-matched subjects from two clinics located in Xi'an, China and Houston, USA. Subtle cognitive impairments were weighed according to MCI criteria as defined previously. Subjects with MCI were followed for an additional 3 years after their identification. Diagnoses of VaD and DAT were made according to established criteria. During screening period, 73 American and 65 Chinese individuals were identified with MCI. After 3 years of MCI follow-up, of the 73 American MCI subjects, 35 (47.9%) developed DAT and 15 (20.5%) developed VaD. Of the 65 Chinese MCI subjects, 12 (18.5%) developed DAT and 19 (29.2%) developed VaD. According to Kaplan-Meier analysis, Chinese MCI subjects, despite their lower educational level, are 1.7 times less likely to progress to DAT and 2.3 times more likely to progress to VaD than American subjects within 3 years of MCI being identified (p<0.01). Data suggest that progression rates of MCI vary considerably among subjects from two countries. American MCI subjects are more prone to DAT, while Chinese subjects are more prone to VaD. Differences in genetic factors, cultures, educational levels, and preventive treatments of vascular risk factors are proposed as responsible for this uneven geographic distribution for different types of dementia.

Maternal folate, vitamin B-12, and vitamin B-6 concentrations during pregnancy have been shown to influence birth outcomes, but the evidence is inconclusive. We aimed to examine the associations of maternal B-vitamin status with gestational age, birth weight, and length in a birth cohort study in Singapore. Maternal blood samples (n = 999) collected during weeks 26-28 of gestation were assayed for plasma folate, vitamin B-12, and vitamin B-6 concentrations. Birth weight and gestational age data were obtained from hospital records, and other anthropometric variables were measured within 72 h after birth. Relations between B-vitamin status and birth outcomes were assessed by linear or logistic regression with adjustment for potential confounders. Median (IQR) plasma concentrations were 34.4 (24.5-44.6) nmol/L for folate, 209 (167-258) pmol/L for vitamin B-12, and 61.8 (25.9-113) nmol/L for vitamin B-6. We found that higher plasma folate concentrations were associated with a longer ges...

Femoral-gluteal adipose tissue (AT) may be cardioprotective through fatty acids uptake. Femoral-gluteal AT has previously been defined as leg fat measured by dual energy x-ray absorptiometry (DXA); however, subcutaneous adipose tissue (SAT) and intermuscular adipose tissue (IMAT) are inseparable using DXA. This study investigated the independent relationships between femoral-gluteal SAT, femoral-gluteal IMAT, and cardiovascular disease (CVD) risk factors [fasting serum measures of glucose, total cholesterol (TC), high density lipoprotein cholesterol (HDLC), triglycerides (TG) and insulin] and whether race differences exist in femoral-gluteal AT distribution. Adult Caucasians (56 men and 104 women), African-Americans (37 men and 76 women), and Asians (11 men and 35 women) had total AT (TAT) including femoral-gluteal AT (upper leg SAT and IMAT) and visceral AT (VAT) by magnetic resonance imaging (MRI). General linear models identified the independent effects of femoral-gluteal SAT and...

Accumulating evidence showed that brain-derived neurotrophic factor (BDNF) may be involved in the pathophysiology of schizophrenia. Recent studies have reported that the Val66Met polymorphism of the BDNF gene may be associated with susceptibility for schizophrenia and age of onset of this disease, with mix results. In the present study, the BDNF Val66Met gene polymorphism was examined in 387 inpatients (259 men and 128 women) meeting the DSM-IV criteria for schizophrenia and unrelated 365 healthy controls (255 men and 110 women). The schizophrenia symptomatology was assessed by the Positive and Negative Syndrome Scale (PANSS). Age of onset was defined as the age at which the psychotic symptoms first appeared. Our results showed that genotype frequency distributions and allelic frequencies did not differ between patients and controls. No interaction was found between sex and genotypes. Analysis of covariance (ANCOVA) showed a significance of the BDNF Val66Met genotypes on the age of onset (F = 3.76, p b 0.02), after adjusting sex, age and duration of illness. Furthermore, ANCOVA showed that the significance of the BDNFVal66Met genotypes on age of onset was increased comparing the Val66Met heterozygotes with the combination of Val66Val and Met66Met homozygotes (F = 5.85, p b 0.01). Our results suggest that the BDNF Val66Met polymorphism may not contribute directly to the susceptibility to schizophrenia, but to the onset of the disease. Furthermore, our results show the heterozygous effect of the BDNF Val66Met gene on the clinical variability of schizophrenia phenotype.

Schizophrenia is associated with a greater probability of ever smoking daily and with higher rates of initiation of daily smoking after age 20 in Caucasian populations. The aims of the current study were to replicate that schizophrenia is associated with smoking and higher risk of initiating daily smoking before schizophrenia starts among a large sample of male Chinese patients. A survival analysis of onset age for daily smoking compared 776 DSM-IV male inpatients with schizophrenia to 560 male controls. The results showed that the cumulative hazard curves for age of smoking initiation in schizophrenia and controls were significantly different (p b 0.001), even after controlling for education (p b 0.001). After excluding the patients who started smoking within 5 years before schizophrenia started, the cumulative hazard curve for schizophrenia was significantly different from ever-smoked controls (p b 0.001), even after adjusting for education (p b 0.001). These findings suggest that schizophrenic patients have a higher risk of starting daily smoking suggesting that vulnerability to schizophrenia may be associated with a higher risk of becoming a daily smoker.

The gene encoding Catechol‐O‐methyltransferase (COMT), a dopamine catabolic enzyme, has been associated inconsistently with schizophrenia in spite of consistent evidence for dopaminergic dysfunction in the prefrontal cortex (PFC) of schizophrenia. Since one contribution to this inconsistency might be genetic heterogeneity, this study investigated whether the COMT gene was associated with the development and symptoms of schizophrenia in relatively genetically homogeneous Chinese schizophrenic patients. We analyzed two polymorphisms (rs740603 and rs4818) of the COMT gene in a case‐control study of 604 Han Chinese (284 patients and 320 controls). The patients&#39; psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). We found no significant differences in the rs740603 and rs4818 genotype and allele distributions between the patient and control groups. Quantitative trait analysis by the UNPHASED program showed that the rs740603 and rs740603(G)‐rs4818(G) ha...

The present study aimed to investigate the distribution of total serum immunoglobulin E (IgE) levels in Korean schoolchildren and to evaluate its utility in the prediction of atopy and allergic diseases. A nationwide, cross-sectional survey was conducted in first grade students from randomly selected elementary and middle schools. Total IgE levels were measured by ImmunoCAP. Skin prick tests were performed for 18 common inhalant allergens to determine the presence of atopy. Children aged 12-13 years and parents of children aged 6-7 years were asked to complete questionnaire assessing allergic diseases. The cut-off levels of total IgE were determined by analyzing receiver operating characteristic curves. The median total IgE level was 86.7 kU/L (range: 1.5-4,523.1) in 3,753 children aged 6-7 years and 94.7 kU/L (range: 1.5-3,000.0) in 3,930 children aged 12-13 years. Total IgE concentrations were higher in children with atopy or allergic diseases than in those without (all P &lt; 0.0...