Minimally invasive resection of heart valve papillary fibroelastoma: two case reports and review of the literature.

BACKGROUND: Cardiac papillary fibroelastomas are rare, accounting for approximately 10% of all cardiac tumors, with 44% of cases located on the aortic valve and only 15% of cases located on the tricuspid valve. However, the optimal management of papillary fibroelastomas remains varied. CASE PRESENTATION: We present two successful instances of treating heart valve papillary fibroelastomas through minimally invasive surgery. These cases involved heart valve papillary fibroelastomas located in two common sites: the aortic valve on the left heart, which was accessed via an upper hemi-sternotomy, and the tricuspid valve on the right heart, which was accessed via beating heart total thoracoscopy. CONCLUSION: The article consistently demonstrates the effectiveness of a minimally invasive surgical approach in managing heart valve papillary fibroelastomas. This study provides further evidence by presenting two cases of heart valve papillary fibroelastomas - one on the aortic valve and the other on the tricuspid valve - that were successfully treated using this approach, resulting in favorable outcomes.

Risks & Protective Factors for Depression & Suicide Among Hawai'i Agricultural Producers.

Studies have consistently shown that agricultural producers in the continental United States have disproportionately high rates of depression and suicide as compared to other occupations. It is not known whether this is true in Hawai'i, which is both geographically distinct and ethnically diverse. To examine rates of depression and suicide as well as potential risk and protective factors, a state-wide mental health needs assessment was conducted from November 2021 to September 2022. We conducted a survey with a nonprobability-based convenience sample targeting agricultural producers across Hawai'i, and performed descriptive statistics and logistic regression analyses. In a sample of 408 respondents, 35% (n = 143) had clinical depression symptomatology, and 8% (n = 33) had suicidal ideation based on the Patient Health Questionnaire-9. Older age was slightly protective in that every year of increase in age was associated with 0.98 times (95% CI: 0.96, 0.99) reduced odds of depression symptomatology, and 0.96 times (95% CI:0.94, 0.98) reduced odds of suicidal ideation. Identifying as East Asian had 2.04 times (95% CI: 1.16, 3.61) higher odds of depression symptomatology, and Southeast Asian had 3.04 times odds (95% CI:1.15, 8.00) of suicidal ideation. However, in the presence of stress and coping variables, the demographic factors became statistically non-significant. Instead, feeling stressed, uncertainty as the stressor, and media-focused coping were significant risk factors in increasing two to eight times the odds of depressive symptoms. For suicidal ideation, depression symptomatology increased odds by 31.95 (95% CI: 5.60-182.32), using media-focused coping increased 5.20 odds (95% CI: 1.66, 16.27), but problem-focused coping decreased 0.32 times odds (0.10, 0.99). Culturally specific prevention and intervention measures should be tailored for Hawai'i agricultural producers with an emphasis toward younger, East, and Southeast Asian producers and attention toward providing skillful coping strategies for effective stress regulation and management.

Sense of Meaning and Purpose Making Mitigates the Experience of Stress Among Hawai'i Farmers.

Farming is widely acknowledged as being extremely challenging and stressful, yet also potentially very meaningful as farming is an important element of any society and connected to our cultural heritage. Only a few studies have empirically examined the association between sense of purpose in farming and well-being/happiness. This study explored whether a sense of meaning and purpose in being a farmer could mitigate the experience of stress. A cross-sectional survey between November 2021-September 2022 was conducted with a sample of 408 Hawai'i agricultural producers. Descriptive statistics and logistic regressions were conducted to explore factors that predicted farmers' endorsement of high meaning and purpose, and whether meaning and purpose could dampen the impact of stressors on the experience of stress. Results revealed that Hawai'i farmers were highly stressed but also had high sense of meaning and purpose. Predictors of meaning and purpose included operating smaller farms of 1-9 acres and having 51% or greater percentage of income from farming. Meaning and purpose in turn decreased odds of stress, and showed an interaction with stressor intensity such that the stress buffering effect of meaning was more salient for those with lower stressors than those with higher stressors OR = 1.12 (CI = 1.06,1.19). One possible stress management and resilience technique is to highlight and strengthen farmers' sense of meaning and purpose in the farming endeavor.

Apolipoprotein A-II Plus Lipid Emulsion Enhance Cell Growth via SR-B1 and Target Pancreatic Cancer In Vitro and In Vivo.

BACKGROUND: Apolipoprotein A-II (ApoA-II) is down regulated in the sera of pancreatic ductal adenocarcinoma (PDAC) patients, which may be due to increase utilization of high density lipoprotein (HDL) lipid by pancreatic cancer tissue. This study examined the influence of exogenous ApoA-II on lipid uptake and cell growth in pancreatic cancer (PC) both in vitro and in vivo. METHODS: Cryo transmission electron microscopy (TEM) examined ApoA-II's influence on morphology of SMOFLipid emulsion. The influence of ApoA-II on proliferation of cancer cell lines was determined by incubating them with lipid+/-ApoA-II and anti-SR-B1 antibody. Lipid was labeled with the fluorophore, DiD, to trace lipid uptake by cancer cells in vitro by confocal microscopy and in vivo in PDAC patient derived xenograft tumours (PDXT) by fluorescence imaging. Scavenger receptor class B type-1(SR-B1) expression in PDAC cell lines and in PDAC PDXT was measured by western blotting and immunohistochemistry, respectively. RESULTS: ApoA-II spontaneously converted lipid emulsion into very small unilamellar rHDL like vesicles (rHDL/A-II) and enhanced lipid uptake in PANC-1, CFPAC-1 and primary tumour cells as shown by confocal microscopy. SR-B1 expression was 13.2, 10.6, 3.1 and 2.3 fold higher in PANC-1, MIAPaCa-2, CFPAC-1 and BxPC3 cell lines than the normal pancreatic cell line (HPDE6) and 3.7 fold greater in PDAC tissue than in normal pancreas. ApoA-II plus lipid significantly increased the uptake of labeled lipid and promoted cell growth in PANC-1, MIAPaCa-2, CFPAC-1 and BxPC3 cells which was inhibited by anti SR-B1 antibody. Further, ApoA-II increased the uptake of lipid in xenografts by 3.4 fold. CONCLUSION: Our data suggest that ApoA-II enhance targeting potential of lipid in pancreatic cancer which may have imaging and drug delivery potentialities.

Feasibility of a mindfulness-based intervention to address youth issues in Vietnam.

Youth problems including risky sex, drug use, violence and mental health issues are on the rise in Vietnam. Mindfulness is proposed as one way to address unskillful responses to stress that give rise to these behavioral and psychosocial issues in Vietnam. This study explores the feasibility of a mindfulness program for adolescents and young adults in a central city in Vietnam. The mindfulness-based intervention was comprised 1-h daily session over 3 weeks that was conducted at two different sites, one with handicapped adolescents/young adults at the Vocational School for Handicapped and the other with at-risk youth at a semi-private high school. Forty-two Vietnamese youth participants and five Vietnamese teachers/facilitators who were trained in the mindfulness program provided personal reflections of their experiences. Analyses of the qualitative data suggest that mindfulness was enthusiastically received and accepted by both youth and teachers. There is strong indication that mindfulness is promising as a prevention strategy to help with stress and to build important life skills among Vietnamese youth.

Strength in numbers? Cognitive reappraisal tendencies and psychological functioning among Latinos in the context of oppression.

The typically positive relationship between cognitive reappraisal and psychological functioning may be nullified for Latinos embedded within multiple contexts of oppression (Perez & Soto, 2011). Multiply oppressive contexts are characterized by exposure to oppression at a societal level (distal oppression), in the immediate environment (proximal oppression), and at an individual level (personal oppression). We replicated and extended Perez and Soto's (2011) findings by examining whether the reappraisal-psychological functioning association was moderated by (a) relative numerical representation of Latinos within the environment (proximal oppression) and (b) personal perceptions of discrimination (personal oppression) among 425 Latino college students throughout the United States. For Latinos in high-Latino counties, greater use of reappraisal was associated with better psychological functioning, regardless of perceived discrimination; this relationship was absent for Latinos in low-Latino counties who perceived greater discrimination. Findings highlight the importance of considering how contextual factors can alter the adaptive functions of emotion regulation strategies.

The relationship between school multiculturalism and interpersonal violence: an exploratory study.

BACKGROUND: Multiculturalism has been purported to be supportive of positive youth development and outcomes. This study examined the relationship between perceived school multiculturalism-whether youth felt and thought that their school and teachers supported and provided activities for diverse intergroup interactions-and serious interpersonal violence, and explored whether this relation was mediated by civic engagement, ethnic identity, ethnocultural empathy, and positive peers. METHODS: An ethnically diverse sample of 324 middle-school youth (mean age: 12.5 years; range: 11-15 years; sex: 50% female) from a city in northern California participated in the study. Analyses consisted of structural equation modeling with bootstrapping. RESULTS: The results revealed a negative association between school multiculturalism and interpersonal violence that was fully mediated by positive peers and civic engagement. Although school multiculturalism was positively associated with ethnic identity, ethnic identity, in turn, was not significantly associated with interpersonal violence. CONCLUSIONS: School multiculturalism is an important protective factor against youth violence by facilitating positive peer relationships and community engagement among youth. Teachers, administrators, and health officials need to consider the ways in which they can facilitate and encourage greater understanding, openness, and respect for diversity, and promote harmonious interactions among different groups at schools. Greater institutional support for school multiculturalism through implementation of tolerance curriculum and activities, for example, could in turn facilitate favorable youth outcomes.

The influence of school demographic factors and perceived student discrimination on delinquency trajectory in adolescence.

PURPOSE: The purpose of this study was to examine the effects of school demographic factors and youth's perception of discrimination on delinquency in adolescence and into young adulthood for African American, Asian, Hispanic, and white racial/ethnic groups. METHODS: Using data from the National Longitudinal Study of Adolescent Health (Add Health), models testing the effect of school-related variables on delinquency trajectories were evaluated for the four racial/ethnic groups using Mplus 5.21 statistical software. RESULTS: Results revealed that greater student ethnic diversity and perceived discrimination, but not teacher ethnic diversity, resulted in higher initial delinquency estimates at 13 years of age for all groups. However, except for African Americans, having a greater proportion of female teachers in the school decreased initial delinquency estimates. For African Americans and whites, a larger school size also increased the initial estimates. Additionally, lower social-economic status increased the initial estimates for whites, and being born in the United States increased the initial estimates for Asians and Hispanics. Finally, regardless of the initial delinquency estimate at age 13 and the effect of the school variables, all groups eventually converged to extremely low delinquency in young adulthood, at the age of 21 years. CONCLUSION: Educators and public policy makers seeking to prevent and reduce delinquency can modify individual risks by modifying characteristics of the school environment. Policies that promote respect for diversity and intolerance toward discrimination, as well as training to help teachers recognize the precursors and signs of aggression and/or violence, may also facilitate a positive school environment, resulting in lower delinquency.

Community mobilization and community-based participatory research to prevent youth violence among Asian and immigrant populations.

Many community mobilization activities for youth violence prevention involve the researchers assisting communities in identifying, adapting, and/or tailoring evidence-based programs to fit the community needs, population, and cultural and social contexts. This article describes a slightly different framework in which the collaborative research/evaluation project emerged from the community mobilization activities. As will be discussed, this collaborative, sustained partnership was possible in the context of the Center on Culture, Immigration and Youth Violence Prevention's (UC Berkeley ACE) community mobilization activities that brought the issue of youth violence, particularly among immigrant and minority populations, to the forefront of many of the community partners' agendas. The East Bay Asian Youth Center (EBAYC) was one of the partners that came to the table, which facilitated the community-based engagement/mobilization. UC Berkeley ACE collaborated with EBAYC to evaluate an after-school program and an alternative probation program serving a diverse youth and immigrant population, including African Americans, Asians, and Hispanics. This article describes UC Berkeley ACE's community mobilization activity and the collaborative partnership with EBAYC, discusses how the evaluations incorporated community-based principles in design and practice, and presents some findings from the evaluations.

Multiculturalism as a dimension of school climate: the impact on the academic achievement of Asian American and Hispanic youth.

Multiculturalism constitutes an important element of school climate, but the relation between perceived multiculturalism and academic achievement has not been widely studied. This study examined the influence of students' perceptions of school support for multiculturalism on academic achievement among 280 Asian American and Hispanic youth, including ethnic identity and ethnocultural empathy as potential mediators. Results of structural equation modeling revealed that perceived multiculturalism was significantly positively related to ethnocultural empathy for Asian Americans and Hispanics, and that ethnocultural empathy, in turn, was predictive of academic achievement for Hispanics only. Results of bootstrapping to test for mediation effects revealed ethnocultural empathy to be a salient mediator for Hispanic youth. Although ethnic identity did not mediate the link between multiculturalism and academic achievement, ethnic identity was significantly predictive of achievement for Hispanics. On the whole, these findings suggest that fostering a school climate supportive of multiculturalism may improve empathy toward ethnic out-groups. Furthermore, schools that promote compassion and tolerance for diverse ethnic groups may achieve better academic outcomes among Hispanic youth.

Multiculturalism and subjective happiness as mediated by cultural and relational variables.

A diverse ethnic context and an increasing immigrant youth population will soon become the reality across the entire U.S. demographic landscape. Research has suggested that a multicultural context positively influences ethnic minority and immigrant youth by fostering ethnic identity and psychosocial development. However, it is unknown whether and how perceived multiculturalism can affect positive youth outcomes such as life satisfaction and subjective happiness. This study explored perceived school multiculturalism among 338 ethnic minority and immigrant youth, and found a positive relation between perceived school multiculturalism and subjective happiness with full mediation by ethnocultural empathy for African Americans, Asians, males, and females. Although school multiculturalism was also predictive of ethnocultural empathy for Hispanics, ethnocultural empathy in turn, was not significantly predictive of subjective happiness. Taken together, these results suggest that one way to facilitate psychological growth and flourishing among ethnic minority youth is to encourage multiculturalism in school settings.

Acculturation factors and substance use among Asian American youth.

In this study of 329 Cambodian, Chinese, Laotian/Mien, and Vietnamese youth in Oakland, California, acculturation factors of individualism-collectivism and acculturative dissonance were examined as risk and protective factors for substance use. Results of structural equation modeling and bootstrapping revealed that peer substance use was a robust mediator between individualism and youth's self-reported substance use, particularly among Vietnamese and males. Peer substance use also significantly mediated the relation between collectivism and substance use for females. As such, there appears to be ethnic and gender group variations in the saliency of cultural/acculturation factors with respect to substance use. Implications for substance use prevention programs for ethnic and immigrant youth are discussed.

Risks of non-familial violent physical and emotional victimization in four Asian ethnic groups.

BACKGROUND: There is a paucity of research addressing victimization among Asian and Southeast Asian youth. METHODS: A community-based sample of 329 Chinese, Cambodian, Lao/Mien, and Vietnamese youth were interviewed in a face-to-face format. Non-familial physical and emotional victimization were explored in relation to risk factors. RESULTS: Results revealed that reporting of violent physical victimization was generally greater among males than females, and greater among females than males for emotional victimization. Southeast Asian youth were more likely to experience victimization than Chinese youth. Violent offending, drug use, and delinquent peer affiliation significantly increased the odds of physical victimization, whereas more distal influences such as neighborhood exerted less influence. For emotional victimization, self-esteem and dating abuse was most salient. DISCUSSION: Study highlighted the need to consider victimization disaggregated by ethnicities as well as cultural factors that have thus far been eclipsed in most empirical studies of youth victimization.

Cultural values, life experiences, and wisdom.

Wisdom is considered one ideal endpoint of human development across cultures. Studies have provided evidence for certain facilitating conditions such as challenging and stressful life events because they increase differentiation through accommodative changes, resulting in greater tolerance for uncertainty, and less projection tendencies and self-centeredness. Positive experiences may also facilitate wisdom by fostering integration and coherence. However, cultural values, particularly conservation and openness, may moderate these experiences for older adults. In a sample of middle-aged to older community dwelling European American adults (n = 97), results suggested that experiencing a macrosocial event as a negative experience, and spiritual/existential as a positive experience, interacted with conservation value to predict transcendent wisdom. Among Vietnamese American adults (n = 102), macrosocial event alone was negatively related to transcendent wisdom. These results suggest that not endorsing conservation value as one grows older and experiences different life events is beneficial for wisdom.

Acculturative dissonance, ethnic identity, and youth violence.

Studies suggest that the process of acculturation for immigrant youth, particularly for second-generation youth, is significantly associated with delinquency and violence. This study explored the acculturation-violence link with respect to acculturative dissonance and ethnic identity. The results revealed in a sample of 329 Chinese, Cambodian, Mien/Laotian, and Vietnamese youth that acculturative dissonance was significantly predictive of serious violence, with full mediation through peer delinquency. Ethnic identity was not significantly associated with peer delinquency or serious violence. Although acculturative dissonance and ethnic identity accounted for a small percentage of variance in violence compared with peer delinquency, it cannot be discounted as trivial. Structural equation analyses provided support for both measurement and structural invariance across the four ethnic groups, lending support for cross-cultural comparisons. The results also lend support for the inclusion of cultural factors in youth violence prevention and intervention efforts.

Stressful life events, culture, and violence.

This study explored the contributions of stressful life events and their interactions with social support and cultural factors in predicting serious violence among American adolescent immigrants of Chinese and Southeast Asian origins. Youth differed in their exposure to stressors and how they responded to them. Cambodian and Laotian youth reported the highest levels of stressors, except for emotional abuse. Only physical abuse was an independent predictor of serious violence for all groups, except Chinese. Perceived social support buffered the effects of some stressors, whereas increased levels of acculturation, intergenerational/intercultural conflict, and individualism placed youth at increased risk for serious violence. The results suggest that the moderating effects of culture and social support need to be considered when examining the association between life stressors and serious violence for Chinese and Southeast Asian youth.

Parent refugee status, immigration stressors, and Southeast Asian youth violence.

PURPOSE: To assess the effects of parents' experience of traumatic events on violence among Southeast Asian and Chinese youth. The study examines independent effects of parents' refugee camp experiences and immigration stress on serious or family/partner violence among youth. Findings contribute evidence on the intergenerational effects of community-level trauma that can help policy makers better integrate family and community strategies to reduce youth violence. METHODS: Obtained cross-sectional, face-to-face interview data including peer delinquency, parental engagement, parental discipline, serious violence, and family/partner violence from a sample of 329 Chinese and Southeast Asian adolescents. Measures of socioeconomic status, refugee status, and immigration stressors were collected from their respective parents. Data were analyzed using LISREL 8.54 for structural equation modeling. RESULTS: Findings show that parents' refugee status facilitated serious violence, and was fully mediated by peer delinquency and parental engagement, but for Vietnamese only. Parents' refugee status was also significantly related to family/partner violence, and mediated by peer delinquency. This relationship was not observed among the other Asian ethnic groups. The immigration stress variable had no significant effects on either serious violence or family/partner violence. CONCLUSIONS: Refugee communities may not transform easily into stereotypical immigrant Asian communities characterized by little youth violence. Results suggest that the refugee process, as experienced second-hand through the children of refugees, has a strong effect on externally oriented violence (serious violence) and on family/partner violence for particular subgroups. Therefore, community-oriented policy makers should join social workers in developing programs to address youth violence in Southeast Asian families and communities. Findings have implications for other forms of community trauma such as natural disasters.

The role of peer, parent, and culture in risky sexual behavior for Cambodian and Lao/Mien adolescents.

PURPOSE: The purpose of this study was to investigate the role of age, gender, peer, family, and culture in adolescent risky sexual behavior for Cambodian and Laotian (Lao)/Mien youth. METHODS: We obtained cross-sectional, in-home interview data including measures of individualism, collectivism, acculturation, risky sexual behavior, peer delinquency, parent engagement, and parent discipline from a sample of mostly second-generation Cambodian (n = 112) and Lao/Mien (n = 67) adolescents. Data were analyzed using step-wise, hierarchical multiple regressions. RESULTS: Peer delinquency and age (older) were significant predictors of risky sexual behavior in both groups. Parent discipline also significantly predicted risky sexual behavior, but only for Lao/Mien adolescents. Vertical and horizontal individualism were associated positively with risky sexual behavior for Cambodian youth whereas collectivism (horizontal) was associated negatively with risky sexual behavior for Lao/Mien youth. Acculturation was nonsignificant in both groups. CONCLUSIONS: In addition to age, parents, and peer groups, the findings suggest that culture also matters in risky sexual behavior, particularly for Cambodian and Laotian youth.

Individualism, collectivism, and delinquency in Asian American adolescents.

Although the study of delinquency has previously focused on identifying individual, family, peer, and social risk and protective factors, little empirical research has studied cultural factors and their relations to delinquency. In a large community sample of 329 Chinese, Cambodian, Laotian/Mien, and Vietnamese youths, individualism was positively related to, and collectivism negatively related to, self-reported delinquency, with partial mediation through peer delinquency (PD). Although the percentage of variance in delinquency attributable to individualism-collectivism was small compared to PD, it cannot be discounted as trivial. The results also supported the measurement and structural invariance of these associations across the 4 ethnic groups.