Heterogeneity within the Asian American community

BACKGROUND: Educational interventions are grounded on scientific data and assumptions about the community to be served. While the Pan Asian community is composed of multiple, ethnic subgroups, it is often treated as a single group for which one health promotion program will be applicable for all of its cultural subgroups. Compounding this stereotypical view of the Pan Asian community, there is sparse data about the cultural subgroups' similarities and dissimilarities. The Asian Grocery Store based cancer education program evaluation data provided an opportunity to compare data collected under identical circumstances from members of six Asian American cultural groups. METHODS: A convenience sample of 1,202 Asian American women evaluated the cultural alignment of a cancer education program, completing baseline and follow-up surveys that included questions about their breast cancer knowledge, attitudes, and screening behaviors. Participants took part in a brief education program that facilitated adherence to recommended screening guidelines. RESULTS: Unique recruitment methods were needed to attract participants from each ethnic group. Impressions gained from the aggregate data revealed different insights than the disaggregate data. Statistically significant variations existed among the subgroups' breast cancer knowledge, attitudes, and screening behaviors that could contribute to health disparities among the subgroups and within the aggregate Pan Asian community. CONCLUSION: Health promotion efforts of providers, educators, and policy makers can be enhanced if cultural differences are identified and taken into account when developing strategies to reduce health disparities and promote health equity

Evaluation of novel coagulation and platelet function assays in patients with chronic kidney disease

BACKGROUND: Hemostasis evaluation in chronic kidney disease (CKD) is critical for optimal management of thrombotic and bleeding events. Standard coagulation screens are inadequate for predicting coagulopathy in CKD. OBJECTIVE: To evaluate hemostasis parameters in patients with different stages of CKD using novel coagulation assays. PATIENTS/METHODS: Cross‐sectional study of 30 healthy controls (HC) and 120 CKD patients (10 Stage 2, 20 Stage 3, 20 Stage 4, 20 Stage 5 not requiring renal replacement therapy, 20 transplant, 10 newly started on hemodialysis [HD], 20 established on HD). Standard laboratory tests were performed in addition to rotational thromboelastometry (ROTEM), multiple electrode aggregometry (MEA), thrombin generation assays, D‐dimer, and markers of thrombogenesis (thrombin‐antithrombin [TAT]), fibrinolysis, and endothelial activation (intercellular adhesion molecule‐1 [ICAM‐1]). RESULTS: D‐dimer, TAT, and ICAM‐1 concentrations were significantly higher in patients with CKD than HC (P < .01). ROTEM maximum clot firmness was significantly higher in patients than in HC (P < .01). In CKD Stage 5 patients (pre‐HD and started HD) adenosine diphosphate and thrombin receptor activating peptide MEA tests were significantly lower than HC indicating platelet aggregation defect (P < .05). Multivariate analysis confirmed the direct effect of estimated glomerular filtration rate (eGFR) in the variance of ROTEM and MEA tests. Endogenous thrombin potential and peak thrombin were not statistically different between groups, but Stage 5 CKD patients had prolonged lag time (7.91 vs. 6.33, P < .001) and time to thrombin peak (10.8 vs. 9.5, P < .05) compared to HC. CONCLUSIONS: Patients with CKD exhibit features of concomitant hypercoagulability measured by ROTEM and platelet dysfunction measured with MEA. eGFR was an independent determinant of platelet dysfunction and hypercoagulability

Flow control of circular cylinders with longitudinal groove surfaces

Flow around circular cylinders with different grooved surfaces (U and V shaped) was investigated experimentally. The drag force, mean velocity, and turbulence intensity profiles of the wake behind the cylinders were measured for Reynolds numbers based on the cylinder diameter (D = 60 mm) in the range ReD = 8 × 103 ~ 1.4 × 105 . Flow around the cylinders was visualized using a particle tracer technique to see the flow structure qualitatively. The results were compared with those for a smooth cylinder of the same diameter D. At ReD = 1.4 × 105, the U-type groove surface reduced the drag coefficient by 18.6% compared with the smooth cylinder, whereas the drag reduction of V-type grooves was only 2.5%. For the circular cylinder with a U-grooved surface, as the Reynolds number increases, the location of peak turbulence intensity moves downstream, and the turbulence intensity is decreased. The two longitudinal-grooved surfaces tested in this study show different surface pressure distributions at high Reynolds numbers due to their different flow structures near the cylinder surface. Flow visualization results show that the U-grooved cylinder elongates the vortex formation region more than 50% compared with the smooth cylinder. This is consistent with the results of turbulence intensity distribution measured along the wake centerline. The large-scale longitudinal vortices formed behind the grooved cylinders seem to be broken into smaller ones due to the existence of longitudinal grooves. On average, the scale of longitudinal vortices behind the U-grooved cylinder is much smaller in size compared with the other two cases