Hepatitis C Virus in Mexican Americans: a population-based study reveals relatively high prevalence and negative association with diabetes

This study aimed to estimate the prevalence and risk factors for hepatitis C virus (HCV) infection in Mexican Americans living in South Texas. We tested plasma for the presence of HCV antibody from the Cameron County Hispanic Cohort (CCHC), a randomized, population-based cohort in an economically disadvantaged Mexican American community on the United States/Mexico border with high rates of chronic disease. A weighted prevalence of HCV antibody of 2·3% [n = 1131, 95% confidence interval (CI) 1·2-3·4] was found. Participants with diabetes had low rates of HCV antibody (0·4%, 95% CI 0·0-0·9) and logistic regression revealed a statistically significant negative association between HCV and diabetes (OR 0·20, 95% CI 0·05-0·77) after adjusting for sociodemographic and clinical factors. This conflicts with reported positive associations of diabetes and HCV infection. No classic risk factors were identified, but important differences between genders emerged in analysis. This population-based study of HCV in Mexican Americans suggests that national studies do not adequately describe the epidemiology of HCV in this border community and that unique risk factors may be involved

Liver and other Gastrointestinal Cancers are frequent in Mexican Americans

Background Disease patterns in Mexican-American health-disparity populations differ from larger United States populations. Aims Determine frequency of gastrointestinal cancers in Mexican Americans. Methods We analyzed self-reported data from the Cameron County Hispanic Cohort where we find high rates of risk factors for cancer: obesity (48.5%), diabetes (30.7%). Participants provided cancer histories about themselves and first and second degree relatives. Logistic regression models assessed risk factors. Frequencies of cancer sites were ranked and validated using concurrent age local cancer registry data. Results Among 9,249 individuals (participants and their relatives) there were 1,184 individuals with reports of cancer. Among cohort participants under 70 years of age the most significant risk factor for all-cause cancers was diabetes (OR 3.57, 95% CI 1.32, 9.62). Participants with metabolic syndrome were significantly more likely to report cancer in relatives (1.73 (95%CI 1.26, 2.37). Among cancers in fathers, liver cancer was ranked third, stomach fourth, colorectal sixth and pancreas tenth. In mothers, stomach was third, liver fourth, colorectal seventh and pancreas eleventh. The unusual prominence of these cancers in Mexican Americans, including liver cancer, was supported by age-adjusted incidence in local registry data. Conclusions Gastrointestinal system cancers, particularly liver cancer, in a Mexican American health disparity cohort and their relatives rank higher than in other ethnicities and are associated with high rates of diabetes and metabolic syndrome. Effective prevention of diabetes and low-tech, high-quality screening strategies for gastrointestinal cancers are needed in health disparity communities

Frequency of Nonalcoholic Fatty Liver Disease and Subclinical Atherosclerosis Among Young Mexican Americans

Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of the metabolic syndrome, whose criteria are risk factors for atherosclerotic cardiovascular disease. We aimed to evaluate the prevalence of NAFLD, its association with subclinical atherosclerosis, and factors that may account for this association in Mexican Americans. In a population based cross-sectional sample drawn from the Cameron County Hispanic Cohort in Texas, carotid intima media thickness (cIMT), an indicator of subclinical atherosclerosis, was measured. Abnormal carotid ultrasound study was defined as mean cIMT \u3e75th percentile for age and gender and/or plaque presence. NAFLD was defined as steatosis by ultrasound in absence of other causes of liver disease. Multivariable weighted regression analyses were performed to evaluate associations between NAFLD and cIMT. Mean age was 50.4±1.2 years with 58.3% females. Mean body mass index (BMI) was 31.0 ± 0.4 kg/m2, and 54.0% had the metabolic syndrome. NAFLD was highly prevalent (48.80%); subjects with NAFLD had greater BMI, central obesity, fasting glucose levels, and dyslipidemia, and were more likely to have the metabolic syndrome. Nearly one third of subjects with NAFLD also had evidence of subclinical atherosclerosis (31.2%). After adjusting for covariates, there was an independent association between NAFLD and increased cIMT only in younger subjects \u3c45 years (p=0.0328). Subjects with both abnormal liver and carotid ultrasound studies tended to be obese, diabetic, and have the metabolic syndrome. In conclusion, NAFLD is highly prevalent in this Mexican American cohort, with an independent association between NAFLD and subclinical atherosclerosis among younger subjects; clustering of diabetes, obesity, and metabolic syndrome in this health disparity cohort increases the risk of both liver disease and early atherosclerosis in young adults

Trends and predictors of changes in pulmonary function after treatment for pulmonary tuberculosis

OBJECTIVES: The present study aimed to investigate the trends in changes in pulmonary function and the risk factors for pulmonary function deterioration in patients with pulmonary tuberculosis after completing treatment. INTRODUCTION: Patients usually have pulmonary function abnormalities after completing treatment for pulmonary tuberculosis. The time course for changes in pulmonary function and the risk factors for deterioration have not been well studied. METHODS: A total of 115 patients with 162 pulmonary function results were analyzed. We retrieved demographic and clinical data, radiographic scores, bacteriological data, and pulmonary function data. A generalized additive model with a locally weighted scatterplot smoothing technique was used to evaluate the trends in changes in pulmonary function. A generalized estimating equation model was used to determine the risk factors associated with deterioration of pulmonary function. RESULTS: The median interval between the end of anti-tuberculosis treatment and the pulmonary function test was 16 months (range: 0 to 112 months). The nadir of pulmonary function occurred approximately 18 months after the completion of the treatment. The risk factors associated with pulmonary function deterioration included smear-positive disease, extensive pulmonary involvement prior to anti-tuberculosis treatment, prolonged anti-tuberculosis treatment, and reduced radiographic improvement after treatment. CONCLUSIONS: After the completion of anti-tuberculosis TB treatment, several risk factors predicted pulmonary function deterioration. For patients with significant respiratory symptoms and multiple risk factors, the pulmonary function test should be followed up to monitor the progression of functional impairment, especially within the first 18 months after the completion of anti-tuberculosis treatment

Autoimmune Hepatitis in Patients with Human Immunodeficiency Virus Infection

Background: Liver disease in patients with HIV is common and typically has complex and multifactorial presentations that represent a major cause of morbidity and mortality. Autoimmune hepatitis (AIH) is rarely reported in patient with HIV and the disease course and clinical outcomes for treatment have not been well characterized. We are aiming to determine the patient characteristics, disease prevalence, and treatment outcomes from published articles of patients with HIV and AIH. Method: A systematic search of PubMed, Web of Science, and Google Scholar through February 20th, 2019 identified 15 studies that reported the outcomes of AIH in patients with HIV. Because of the small sample sizes and skewed distributions, resampling tests of mean differences using permutation distributions (MAXn = 10,000 permutations) were utilized; analyses were performed using R (v. 3.5.1). Categorical differences were calculated using Fisher exact test for odds ratio = 1 (equal odds), and Cramer V was calculated for effect size; analyses were completed in SPSS (v. 25). Results: By reviewing 15 studies reporting a total of 35 patients with AIH and HIV, male patients were found to have significantly higher aspartate transaminase and alanine transaminase levels at time of diagnosis. No other significant findings identified. The CD4 count and viral load did not show significant correlation with AIH diagnosis or its prognosis. All patients but one who presented with severe immune deficiency and responded to highly active anti-retroviral therapy received immunosuppressive treatment without side effects and achieved remission except 2 lost to follow-up and 3 expired. Conclusion: Although rare, but AIH can develop in patients with HIV and physicians should consider it in the differential diagnosis for HIV patients presented with abnormal liver function tests, especially after excluding hepatitis C virus and drug-induced liver injury. Patients with immune deficiency disorders who present with AIH can be treated safely with steroid either as monotherapy or in combination with another immune suppressant therapy

Population-based risk factors for elevated alanine aminotransferase in a South Texas Mexican-American population

Background and aims: Elevated alanine aminotransferase (ALT \u3e40 IU/mL) is a marker of liver injury but provides little insight into etiology. We aimed to identify and stratify risk factors associated with elevated ALT in a randomly selected population with a high prevalence of elevated ALT (39%), obesity (49%) and diabetes (30%). Methods: Two machine learning methods, the support vector machine (SVM) and Bayesian logistic regression (BLR), were used to capture risk factors in a community cohort of 1532 adults from the Cameron County Hispanic Cohort (CCHC). A total of 28 predictor variables were used in the prediction models. The recently identified genetic marker rs738409 on the PNPLA3 gene was genotyped using the Sequenom iPLEX assay. Results: The four major risk factors for elevated ALT were fasting plasma insulin level and insulin resistance, increased BMI and total body weight, plasma triglycerides and non-HDL cholesterol, and diastolic hypertension. In spite of the highly significant association of rs738409 in females, the role of rs738409 in the prediction model is minimal, compared to other epidemiological risk factors. Age and drug and alcohol consumption were not independent determinants of elevated ALT in this analysis. Conclusions: The risk factors most strongly associated with elevated ALT in this population are components of the metabolic syndrome and point to nonalcoholic fatty liver disease (NAFLD). This population-based model identifies the likely cause of liver disease without the requirement of individual pathological diagnosis of liver diseases. Use of such a model can greatly contribute to a population-based approach to prevention of liver disease

When males live longer: Resource-driven territorial behavior drives sex-specific survival in snakes.

Phylogenetic analysis has shown that males' propensity to engage in aggressive encounters is associated with females having greater longevity. Here, we confirm the causal link between aggression and reduced longevity by looking at an egg-eating snake (Oligodon formosanus) in which females defend territories in the presence of sea turtle eggs. We monitored aggressiveness and survival at two sites: a control site with a stable supply of turtle eggs, and a second site where we collected data before and after a storm that eroded the beach on which turtles nested, thus leading to a loss of territoriality. We show that territoriality was the driver behind higher injury rates in females. Territorial females also had lower survival and decreased longevity compared with the nonterritorial males, but these differences disappeared when females were not territorial. Our study demonstrates how resource availability can influence the evolution of sex-specific patterns of survival across vertebrates

Quantitative determination of interlayer electronic coupling at various critical points in bilayer Mo S 2

Tailoring interlayer coupling has emerged as a powerful tool to tune the electronic structure of van der Waals (vdW) bilayers. One example is the usage of the “moiré pattern” to create controllable two-dimensional electronic superlattices through the configurational dependence of interlayer electronic couplings. This approach has led to some remarkable discoveries in twisted graphene bilayers, and transition metal dichalcogenide (TMD) homo- and hetero-bilayers. However, a largely unexplored factor is the interlayer distance, d, which can impact the interlayer coupling strength exponentially. In this letter, we quantitatively 2 determine the coupling strengths as a function of interlayer spacing at various critical points of the Brillouin zone in bilayer MoS2. The exponential dependence of the coupling parameter on the gap distance is demonstrated. Most significantly, we achieved a 280% enhancement of K-valley coupling strength with an 8% reduction of the vdW gap, pointing to a new strategy in designing a novel electronic system in vdW bilayers. gning a unique electronic system in vdW bilayers.This research was primarily supported by the NSF Materials Research Science and Engineering Centers (MRSEC) under DMR-1720595. We also acknowledge support from the Welch Foundation (F-1672 and F-1662), the US NSF (DMR-1808751) and the U.S. Air Force (FA2386-18-1-4097). C.-R.P., P.-J.C., and M.-Y.C. acknowledge the support from Academia Sinica, Taiwan. W.-H.C. acknowledges the support from the Ministry of Science and Technology of Taiwan (MOST-110-2119-M-A49-001-MBK) and the support from the Center for Emergent Functional Matter Science (CEFMS) of NYCU supported by the Ministry of Education of Taiwan. W.-T.H. acknowledges the support from the Ministry of Science and Technology of Taiwan (MOST-110-2112-M-007-011-MY3) and the Yushan Young Scholar Program from the Ministry of Education of Taiwan. C.K.S. also acknowledge the Yushan Scholar Program from the Ministry of Education of Taiwan.Center for Dynamics and Control of Material

Prevalence of Metabolic Syndrome and Risks of Abnormal Serum Alanine Aminotransferase in Hispanics: A Population-Based Study

Study the prevalence of metabolic syndrome (MS) and risk factors for and association with elevated alanine aminotransferase (ALT) as markers of hepatic injury in a large Hispanic health disparity cohort with high rates of obesity.Analysis of data from a prospective cross-sectional population based study. From 2004-7, we randomly recruited 2000 community participants to the Cameron County Hispanic Cohort collecting extensive socioeconomic, clinical and laboratory data. We excluded 153 subjects due to critical missing data. Pearson chi-square tests and Student's t-tests were used for categorical and continuous variable analysis, respectively. Logistic regression analysis was performed to determine the risk factors for elevated ALT.The mean age of the cohort was 45 years and 67% were females. The majority of the cohort was either overweight (32.4%) or obese (50.7%). Almost half (43.7%) had MS and nearly one-third diabetes. Elevated ALT level was more prevalent in males than females. Obesity was a strong risk for abnormal ALT in both genders. Hypertriglyceridemia, hypercholesterolemia and young age were risks for elevated ALT in males only, whereas increased fasting plasma glucose was associated with elevated ALT in females only.We identified high prevalence of MS and markers of liver injury in this large Mexican American cohort with gender differences in prevalence and risk factors, with younger males at greatest risk