PURPOSE Helicobacter pylori (H. pylori) is the leading cause of gastric cancer. High antibody levels to H. pylori virulence factors Vacuolating cytotoxin A (VacA) and Cytotoxin-associated gene A (CagA) have been suggested as gastric cancer risk markers. In the USA, H. pylori sero-prevalence is twofold higher in African Americans compared to whites. We sought to assess whether African Americans also exhibit higher antibody levels to VacA and CagA. METHODS Antibody responses to H. pylori proteins were measured by multiplex serology in 686 African Americans and whites of the Southern Community Cohort Study. Among VacA- and CagA-seropositives, we analyzed the association of race with antibody level using logistic regression models to produce odds ratios (OR) and 95% confidence intervals (CI). RESULTS Sero-positive African Americans had significantly higher mean antibody levels to both VacA and CagA, which resulted in increased odds for the highest quartile of antibody levels compared to sero-positive whites (VacA, OR 6.08; 95% CI 3.41, 10.86; CagA, OR 3.77; 95% CI 1.61, 8.84). CONCLUSION Our findings support future studies to assess the association of differential antibody responses by race with risk of gastric cancer in the USA, which could then aid in developing targeted H. pylori eradication strategies.PURPOSE Cytomegalovirus (HCMV) is a common viral infection that shapes lifelong immunity. A history of infection with HCMV has been associated with many chronic diseases, including cancer. In addition, prospective cohort studies have established that HCMV is associated with all-cause mortality. However, there are limited data regarding HCMV and cancer mortality. METHODS Data were obtained from the National Health and Nutrition Examination Survey (NHANES) III study (1988-1994) subjects aged 18 to 98, who had HCMV serology results, did not report having cancer at baseline, and were eligible for mortality follow-up (n = 14,498). Mortality was ascertained until December 2011 using National Death Index (NDI) linkage. RESULTS The unadjusted risk of all-cancer mortality was higher in HCMV seropositive individuals (HR 2.74, 95% CI 2.05-3.64). This association was attenuated after adjusting for age (HR 1.39, 95% CI 1.02-1.92), and other covariates (age, sex, race/ethnicity, smoking status, BMI, education, and C-reactive protein (CRP); HR 1.21, 95% CI 0.91-1.81). There was a statistically significant interaction between HCMV and sex (p = 0.01) HCMV seropositivity was associated with increased cancer mortality in men (HR 1.65, 95% CI 0.99-2.73) but not in women (HR 0.95, 95% CI 0.59-1.54). CONCLUSION(S) Consistent with prior reports, HCMV seropositivity may be associated with an increased risk of cancer-related mortality but the association is partially driven by socioeconomic status and other risk factors. Future research is needed to determine whether HCMV is a risk factor for cancer, as well as identify the specific cancer types where HCMV increases mortality.Mental health in urban environments is often treated from a healthcare provision perspective. Research in recent decades showed that mental illness in cities is a result of dysfunctional coordination between different city systems and structures. Given the nature of the city as a system of systems, this work builds through a participatory method, a general system dynamic model of factors that affect mental health in urban and regional environments. Through this method, we investigated the challenges of the application of such methodology to identify essential factors, feedback loops, and dependencies between systems to move forward in planning for mental health in cities. The outcome is a general model that showed the importance of factors that vary from individuals, families to communities and feedback loops that span multiple systems such as the city physical infrastructures, social environments, schools, labor market, and healthcare provision.PURPOSE The purpose of this study was to investigate whether it is possible to estimate systemic inflammation and intestinal ischemia in incarcerated hernias using the lymphocyte-C-reactive protein ratio (LCR). METHODS A total of 116 patients who underwent an emergency operation due to incarcerated abdominal wall hernia were investigated retrospectively. The patients with incarcerated hernias were divided into two groups those who did not undergo intestinal resection and those who underwent intestinal resection due to strangulation. The two groups were analyzed based on sex, surgical operation (open, laparoscopic), length of stay, complications and mortality rates as well as preoperative period laboratory analyses, such as white blood cell, neutrophil, thrombocyte, and lymphocyte counts and C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR) and LCR values. RESULTS Twenty-five patients (21.6%) underwent intestinal resection due to strangulated hernia. Neutrophil count, lymphocyte count, CRP, platelet count, NLR, and LCR were significantly different in the strangulated hernia group. Receiver operating characteristic (ROC) analysis results showed that an LCR level below 0.02 had 80% sensitivity (58-92%) and 80.2% specificity (70-87%) for the diagnosis of strangulation. CONCLUSION A low preoperative LCR level in incarcerated hernias could be used as a bioindicator that helps to estimate the intestinal ischemia.Li-Fraumeni Syndrome (LFS) is characterized by risk of multiple primary malignancies in diverse sites, pediatric onset, near complete penetrance by age 70 years, limited options for prevention, and substantial uncertainty regarding disease manifestation and prognosis. Forty-five families, including 117 individuals aged 13-81 years, enrolled in the US National Cancer Institute's Li-Fraumeni Syndrome Study completed 66 interviews regarding their LFS experiences. An interdisciplinary team used modified grounded theory to examine family distress regarding expectations of loss and change due to likely cancer diagnoses, and the consequences of this likelihood across physical, social, and emotional domains. Disease-free periods were characterized by fearful anticipation of diagnosis or recurrence, uncertainty regarding post-treatment quality of life, and planning for shifts in family dynamics to enable caregiving.  https://www.selleckchem.com/products/Dapagliflozin.html  The chronicity of waiting for these changes incited dread and inhibited effective coping with the pragmatic, emotional, and existential challenges of the syndrome.