Displaying publications 101 - 120 of 690 in total

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  1. YEE, ELSIE Y. S., ZAINAL ZAHARI, AHMAD ISMAIL, YAP, C.K., TAN, S. G.
    MyJurnal
    The blood of the Painted Storks (Mycteria leucocephala) and the Milky Storks (M. cinerea) from Malaysia were collected
    invasively from the breeding site. The blood was dropped on to FTA® cards and stored at room temperature. DNA was isolated from
    the FTA® cards through a modification of the Wizard DNA Purification kit (Promega) procedure and PCR was performed with 11 pairs
    of microsatellite primers of the American Wood Stork (M. americana). The collection of a drop of blood onto the card is superior to the
    usual practice of collecting about five ml of blood into a vacuum tube as it causes fewer traumas to these sensitive birds. Moreover, this
    collection procedure can be adopted for use in various wild animal species which are usually found in the remote areas of Malaysia as
    the sample collection cards can be transported back to the laboratory at room temperature. Our procedure allows the typing of several
    molecular genetic markers from just a drop of blood collected in the field and stored at room temperature alleviating the need for storage
    in expensive deep freezers or liquid nitrogen tanks.
    Matched MeSH terms: United States
  2. Anderson W
    Bull Hist Med, 1996;70(1):62-7.
    PMID: 8850070
    Matched MeSH terms: United States
  3. Heng WL, Wang QW, Sornarajah R, Tremblay J, Putri NM, Hamid SSA, et al.
    Burns Trauma, 2020;8:tkaa019.
    PMID: 33123605 DOI: 10.1093/burnst/tkaa019
    Currently, there are no harmonized guidelines which govern skin banking in the Asia Pacific region. Therefore, skin banks are either unregulated or rely on their nation's legislation or international accreditation to uphold their quality standards. A new set of skin banking guidelines was developed through a comprehensive review and collation of best international practices for the Asia Pacific Burn Association (APBA) members, from donor screening and testing, to skin recovery, processing, storage and distribution, and quality assurance. National regulatory requirements reviewed include the European directives, Australia's Therapeutic Goods Administration and Singapore's tissue banking standards. Further technical and quality management recommendations are referenced from the American Association of Tissue Banks (AATB), the United States Food and Drug Administration standards and guidance documents, various relevant European guides, Japanese Society of Tissue Transplantation guidelines and the Asia Pacific Association of Surgical Tissue Banking. Adapted mainly from the AATB standards, the new Asia Pacific Burn Association Guidelines for Skin Banking in Therapeutic Applications offer a comprehensive manual, addressing: governance and contracts; staff responsibilities; quality management; facilities, equipment and supplies management; donor consent and testing; and recommendations of good practices pertaining to skin recovery, processing, storage and distribution. Besides complementing current generic regulations, they provide technical specifications of major aspects unaddressed in most legislations. This inaugural set of new regional skin banking guidelines would be a start for regional members of the APBA to adopt, and will hopefully culminate in a set of standards so that, in the long run, skin allografts from this region can be of similar quality, which can simplify import process and facilitate the exchange of allografts between members.
    Matched MeSH terms: United States; United States Food and Drug Administration
  4. Clements JD, Connell ND, Dirks C, El-Faham M, Hay A, Heitman E, et al.
    CBE Life Sci Educ, 2013;12(4):596-603.
    PMID: 24297287 DOI: 10.1187/cbe.13-09-0184
    Numerous studies are demonstrating that engaging undergraduate students in original research can improve their achievement in the science, technology, engineering, and mathematics (STEM) fields and increase the likelihood that some of them will decide to pursue careers in these disciplines. Associated with this increased prominence of research in the undergraduate curriculum are greater expectations from funders, colleges, and universities that faculty mentors will help those students, along with their graduate students and postdoctoral fellows, develop an understanding and sense of personal and collective obligation for responsible conduct of science (RCS). This Feature describes an ongoing National Research Council (NRC) project and a recent report about educating faculty members in culturally diverse settings (Middle East/North Africa and Asia) to employ active-learning strategies to engage their students and colleagues deeply in issues related to RCS. The NRC report describes the first phase of this project, which took place in Aqaba and Amman, Jordan, in September 2012 and April 2013, respectively. Here we highlight the findings from that report and our subsequent experience with a similar interactive institute in Kuala Lumpur, Malaysia. Our work provides insights and perspectives for faculty members in the United States as they engage undergraduate and graduate students, as well as postdoctoral fellows, to help them better understand the intricacies of and connections among various components of RCS. Further, our experiences can provide insights for those who may wish to establish "train-the-trainer" programs at their home institutions.
    Matched MeSH terms: United States
  5. Lei-Injo LE, Tsou KC, Lo KW, Lopez CG, Balasegaram M, Ganesan S
    Cancer, 1980 Feb 15;45(4):795-8.
    PMID: 6244075
    An abnormal, fast-moving 5'-nucleotide phosphodiesterase isozyme was found in 90.0% of 20 Malaysian patients with primary hepatoma and in 23.5% of 391 Malaysian patients with various malignant diseases; it was also discovered in 42.9% of 14 Malaysian and American patients with clinically active hepatitis B infection; in 16.7% of 18 healthy American blood bank donors who were positive for hepatitis B surface antigen (HBsAg); in 13.9% of 287 healthy Malaysian blood bank donors, some positive for HBsAg; and in none of 160 healthy American donors who were negative for HBsAg. A correlation of this abnormal isozyme with hepatoma and with infectious hepatitis B is clearly evident.
    Matched MeSH terms: United States
  6. Joishy SK, Bennett JM, Balasegaram M, MacIntyre JM, Falkson G, Moertel C, et al.
    Cancer, 1982 Sep 15;50(6):1065-9.
    PMID: 6286085
    Twenty Malaysian patients with unresectable primary liver cell cancer were prospectively studied at the General Hospital, Kuala Lampur, and were compared for clinical features with an equal number each of African and American patients being studied by the Eastern Cooperative Oncology Group. The patients received intravenous 5-FU and oral MeCCNU which was used for the first time in an Asian country. Most of the Malaysian patients were Chinese, belonged to younger age groups, and presented with massive hepatomegaly, jaundice, and fever. Toxicity to MeCCNU invariably occurred in the form of leukopenia or thrombocytopenia, but none life threatening. Partial response was seen in 20% of Malaysians as compared to 16% in Americans and none in Africans. Malaysians achieved a median survival of 16 weeks compared to 28 weeks in Americans and only eight weeks in Africans. Malaysian Chinese patients were all HBc Ab + ve. Other factors which may have played an etiologic role in the induction of primary liver cancer included alcohol, Chinese herbal medicines, aflatoxin and habitual use of medicated rubbing oils.
    Matched MeSH terms: United States
  7. Murayama A, Ueda M, Shrestha S, Tanimoto T, Ozaki A
    Cancer Cell, 2021 09 13;39(9):1165-1166.
    PMID: 34358449 DOI: 10.1016/j.ccell.2021.07.008
    Matched MeSH terms: United States; United States Food and Drug Administration
  8. Jankovic N, Geelen A, Winkels RM, Mwungura B, Fedirko V, Jenab M, et al.
    Cancer Epidemiol Biomarkers Prev, 2017 Jan;26(1):136-144.
    PMID: 27793797 DOI: 10.1158/1055-9965.EPI-16-0428
    BACKGROUND: It is unknown whether dietary recommendations for cancer prevention are applicable to the elderly. We analyzed WCRF/AICR recommendations in cohorts of European and U.S. adults ages 60 years and above.

    METHODS: Individual participant data meta-analysis included 362,114 participants (43% women), from seven prospective cohort studies, free from cancer at enrollment. The WCRF/AICR diet score was based on: (i) energy-dense foods and sugary drinks, (ii) plant foods, (iii) red and processed meat, and (iv) alcoholic drinks. Cox proportional hazards regression was used to examine the association between the diet score and cancer risks. Adjusted, cohort-specific HRs were pooled using random-effects meta-analysis. Risk advancement periods (RAP) were calculated to quantify the time period by which the risk of cancer was postponed among those adhering to the recommendations.

    RESULTS: After a median follow-up of 11 to 15 years across cohorts, 70,877 cancer cases were identified. Each one-point increase in the WCRF/AICR diet score [range, 0 (no) to 4 (complete adherence)] was significantly associated with a lower risk of total cancer [HR, 0.94; 95% confidence interval (CI), 0.92-0.97], cancers of the colorectum (HR, 0.84; 95% CI, 0.80-0.89) and prostate (HR, 0.94; 95% CI, 0.92-0.97), but not breast or lung. Adherence to an additional component of the WCRF/AICR diet score significantly postponed the incidence of cancer at any site by 1.6 years (RAP, -1.6; 95% CI, -4.09 to -2.16).

    CONCLUSIONS: Adherence to WCRF/AICR dietary recommendations is associated with lower risk of cancer among older adults.

    IMPACT: Dietary recommendations for cancer prevention are applicable to the elderly. Cancer Epidemiol Biomarkers Prev; 26(1); 136-44. ©2016 AACR.

    Matched MeSH terms: United States/epidemiology
  9. Pathan RK, Biswas M, Khandaker MU
    Chaos Solitons Fractals, 2020 Sep;138:110018.
    PMID: 32565626 DOI: 10.1016/j.chaos.2020.110018
    SARS-CoV-2, a novel coronavirus mostly known as COVID-19 has created a global pandemic. The world is now immobilized by this infectious RNA virus. As of June 15, already more than 7.9 million people have been infected and 432k people died. This RNA virus has the ability to do the mutation in the human body. Accurate determination of mutation rates is essential to comprehend the evolution of this virus and to determine the risk of emergent infectious disease. This study explores the mutation rate of the whole genomic sequence gathered from the patient's dataset of different countries. The collected dataset is processed to determine the nucleotide mutation and codon mutation separately. Furthermore, based on the size of the dataset, the determined mutation rate is categorized for four different regions: China, Australia, the United States, and the rest of the World. It has been found that a huge amount of Thymine (T) and Adenine (A) are mutated to other nucleotides for all regions, but codons are not frequently mutating like nucleotides. A recurrent neural network-based Long Short Term Memory (LSTM) model has been applied to predict the future mutation rate of this virus. The LSTM model gives Root Mean Square Error (RMSE) of 0.06 in testing and 0.04 in training, which is an optimized value. Using this train and testing process, the nucleotide mutation rate of 400th patient in future time has been predicted. About 0.1% increment in mutation rate is found for mutating of nucleotides from T to C and G, C to G and G to T. While a decrement of 0.1% is seen for mutating of T to A, and A to C. It is found that this model can be used to predict day basis mutation rates if more patient data is available in updated time.
    Matched MeSH terms: United States
  10. Ng HW, Doughty SW, Luo H, Ye H, Ge W, Tong W, et al.
    Chem Res Toxicol, 2015 Dec 21;28(12):2343-51.
    PMID: 26524122 DOI: 10.1021/acs.chemrestox.5b00358
    Some chemicals in the environment possess the potential to interact with the endocrine system in the human body. Multiple receptors are involved in the endocrine system; estrogen receptor α (ERα) plays very important roles in endocrine activity and is the most studied receptor. Understanding and predicting estrogenic activity of chemicals facilitates the evaluation of their endocrine activity. Hence, we have developed a decision forest classification model to predict chemical binding to ERα using a large training data set of 3308 chemicals obtained from the U.S. Food and Drug Administration's Estrogenic Activity Database. We tested the model using cross validations and external data sets of 1641 chemicals obtained from the U.S. Environmental Protection Agency's ToxCast project. The model showed good performance in both internal (92% accuracy) and external validations (∼ 70-89% relative balanced accuracies), where the latter involved the validations of the model across different ER pathway-related assays in ToxCast. The important features that contribute to the prediction ability of the model were identified through informative descriptor analysis and were related to current knowledge of ER binding. Prediction confidence analysis revealed that the model had both high prediction confidence and accuracy for most predicted chemicals. The results demonstrated that the model constructed based on the large training data set is more accurate and robust for predicting ER binding of chemicals than the published models that have been developed using much smaller data sets. The model could be useful for the evaluation of ERα-mediated endocrine activity potential of environmental chemicals.
    Matched MeSH terms: United States; United States Environmental Protection Agency; United States Food and Drug Administration
  11. Qadir D, Idris A, Nasir R, Abdul Mannan H, Sharif R, Mukhtar H
    Chemosphere, 2023 Jan;311(Pt 1):136987.
    PMID: 36306961 DOI: 10.1016/j.chemosphere.2022.136987
    This study explains the modeling of synthesized membranes using the Donnan Steric Pore model (DSPM) based on the Extended Nernst Planck Equation (ENP). Conventionally, structural parameters required to predict the performance of the membranes were determined through tedious experimentation, which in this study are found using a new MATLAB technique. A MATLAB program is used to determine the unknown structural parameters such as effective charge density (Xd), effective pore radius (rp), and effective membrane thickness to porosity ratio (Δx/Ak) by using the single solute rejection and permeation data. It was found that the model predicted the rejection of studied membranes accurately, with the E5C1 membrane exceeding the others (E5, E5C5) for rejection of single and divalent salt's aqueous solutions. The rejection of 100 ppm aqueous solution of NaCl for E5C1 was around 60%, whereas, for an aqueous solution of 100 ppm, CaCl2 rejection reached up to 80% at 10 bar feed pressure. The trend of salt rejection for all three membranes was found to be in the following order: E5C1 > E5C5 > E5, confirming that their structural parameters-controlled ion transport in these membranes. The structural parameters, such as effective pore radius, effective membrane thickness to porosity ratio, and effective charge density for the best performing membrane, i.e., E5C1, were determined to be 0.5 nm, 16 μm, and -6.04 mol/m3,respectively. Finally, it can be asserted that this method can be used to predict the real performance of membranes by significantly reducing the number of experiments previously required for the predictive modeling of nanofiltration-type membranes.
    Matched MeSH terms: United States
  12. Zakaria R, Ahmi A, Ahmad AH, Othman Z
    Chronobiol Int, 2021 01;38(1):27-37.
    PMID: 33164592 DOI: 10.1080/07420528.2020.1838534
    This study presents a bibliometric analysis of the publications on melatonin research from the Scopus database during the period 2015-2019. Based on the keywords used, which are related to melatonin in the article title, the study retrieved 4411 documents for further analysis using various tools. We used Microsoft Excel to conduct the frequency analysis, VOSviewer for data visualization, and Harzing's Publish or Perish for citation metrics and analysis. This study reports the results using standard bibliometric indicators such as the growth of publications, authorship patterns, collaboration, and prolific authors, country contribution, most active institutions, preferred journals, and top-cited articles. Based on our findings, there is a continuous growth of publications on melatonin research for 5 years since 2015. China was the largest contributor to melatonin research, followed by the United States. The Journal of Pineal Research published the most number of publications related to melatonin research. Our findings suggest that the role of melatonin in plant and food sciences, as well as in cancer, may in later years take over the clusters that earlier dominated melatonin research.
    Matched MeSH terms: United States
  13. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al.
    Circulation, 2019 03 05;139(10):e56-e528.
    PMID: 30700139 DOI: 10.1161/CIR.0000000000000659
    Matched MeSH terms: United States/epidemiology
  14. Raghuveer G, Hartz J, Lubans DR, Takken T, Wiltz JL, Mietus-Snyder M, et al.
    Circulation, 2020 08 18;142(7):e101-e118.
    PMID: 32686505 DOI: 10.1161/CIR.0000000000000866
    Cardiorespiratory fitness (CRF) refers to the capacity of the circulatory and respiratory systems to supply oxygen to skeletal muscle mitochondria for energy production needed during physical activity. CRF is an important marker of physical and mental health and academic achievement in youth. However, only 40% of US youth are currently believed to have healthy CRF. In this statement, we review the physiological principles that determine CRF, the tools that are available to assess CRF, the modifiable and nonmodifiable factors influencing CRF, the association of CRF with markers of health in otherwise healthy youth, and the temporal trends in CRF both in the United States and internationally. Development of a cost-effective CRF measurement process that could readily be incorporated into office visits and in field settings to screen all youth periodically could help identify those at increased risk.
    Matched MeSH terms: United States
  15. Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al.
    Circulation, 2021 Feb 23;143(8):e254-e743.
    PMID: 33501848 DOI: 10.1161/CIR.0000000000000950
    BACKGROUND: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

    METHODS: The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease.

    RESULTS: Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

    CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

    Matched MeSH terms: United States/epidemiology
  16. Lloyd-Jones DM, Ning H, Labarthe D, Brewer L, Sharma G, Rosamond W, et al.
    Circulation, 2022 Sep 13;146(11):822-835.
    PMID: 35766033 DOI: 10.1161/CIRCULATIONAHA.122.060911
    BACKGROUND: The American Heart Association recently published an updated algorithm for quantifying cardiovascular health (CVH)-the Life's Essential 8 score. We quantified US levels of CVH using the new score.

    METHODS: We included individuals ages 2 through 79 years (not pregnant or institutionalized) who were free of cardiovascular disease from the National Health and Nutrition Examination Surveys in 2013 through 2018. For all participants, we calculated the overall CVH score (range, 0 [lowest] to 100 [highest]), as well as the score for each component of diet, physical activity, nicotine exposure, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure, using published American Heart Association definitions. Sample weights and design were incorporated in calculating prevalence estimates and standard errors using standard survey procedures. CVH scores were assessed across strata of age, sex, race and ethnicity, family income, and depression.

    RESULTS: There were 23 409 participants, representing 201 728 000 adults and 74 435 000 children. The overall mean CVH score was 64.7 (95% CI, 63.9-65.6) among adults using all 8 metrics and 65.5 (95% CI, 64.4-66.6) for the 3 metrics available (diet, physical activity, and body mass index) among children and adolescents ages 2 through 19 years. For adults, there were significant differences in mean overall CVH scores by sex (women, 67.0; men, 62.5), age (range of mean values, 62.2-68.7), and racial and ethnic group (range, 59.7-68.5). Mean scores were lowest for diet, physical activity, and body mass index metrics. There were large differences in mean scores across demographic groups for diet (range, 23.8-47.7), nicotine exposure (range, 63.1-85.0), blood glucose (range, 65.7-88.1), and blood pressure (range, 49.5-84.0). In children, diet scores were low (mean 40.6) and were progressively lower in higher age groups (from 61.1 at ages 2 through 5 to 28.5 at ages 12 through 19); large differences were also noted in mean physical activity (range, 63.1-88.3) and body mass index (range, 74.4-89.4) scores by sociodemographic group.

    CONCLUSIONS: The new Life's Essential 8 score helps identify large group and individual differences in CVH. Overall CVH in the US population remains well below optimal levels and there are both broad and targeted opportunities to monitor, preserve, and improve CVH across the life course in individuals and the population.

    Matched MeSH terms: United States/epidemiology
  17. Cameron NA, Freaney PM, Wang MC, Perak AM, Dolan BM, O'Brien MJ, et al.
    Circulation, 2022 Feb 15;145(7):549-551.
    PMID: 35157521 DOI: 10.1161/CIRCULATIONAHA.121.057107
    Matched MeSH terms: United States/epidemiology
  18. Lloyd-Jones DM, Allen NB, Anderson CAM, Black T, Brewer LC, Foraker RE, et al.
    Circulation, 2022 Aug 02;146(5):e18-e43.
    PMID: 35766027 DOI: 10.1161/CIR.0000000000001078
    In 2010, the American Heart Association defined a novel construct of cardiovascular health to promote a paradigm shift from a focus solely on disease treatment to one inclusive of positive health promotion and preservation across the life course in populations and individuals. Extensive subsequent evidence has provided insights into strengths and limitations of the original approach to defining and quantifying cardiovascular health. In response, the American Heart Association convened a writing group to recommend enhancements and updates. The definition and quantification of each of the original metrics (Life's Simple 7) were evaluated for responsiveness to interindividual variation and intraindividual change. New metrics were considered, and the age spectrum was expanded to include the entire life course. The foundational contexts of social determinants of health and psychological health were addressed as crucial factors in optimizing and preserving cardiovascular health. This presidential advisory introduces an enhanced approach to assessing cardiovascular health: Life's Essential 8. The components of Life's Essential 8 include diet (updated), physical activity, nicotine exposure (updated), sleep health (new), body mass index, blood lipids (updated), blood glucose (updated), and blood pressure. Each metric has a new scoring algorithm ranging from 0 to 100 points, allowing generation of a new composite cardiovascular health score (the unweighted average of all components) that also varies from 0 to 100 points. Methods for implementing cardiovascular health assessment and longitudinal monitoring are discussed, as are potential data sources and tools to promote widespread adoption in policy, public health, clinical, institutional, and community settings.
    Matched MeSH terms: United States
  19. Pedamallu H, Zmora R, Perak AM, Allen NB
    Circ Res, 2023 Jun 09;132(12):1570-1583.
    PMID: 37289908 DOI: 10.1161/CIRCRESAHA.123.321998
    Since it was first defined by the American Heart Association in 2010, cardiovascular health (CVH) has been extensively studied across the life course. In this review, we present the current literature examining early life predictors of CVH, the later life outcomes of child CVH, and the relatively few interventions which have specifically addressed how to preserve and promote CVH across populations. We find that research on CVH has demonstrated that prenatal and childhood exposures are consistently associated with CVH trajectories from childhood through adulthood. CVH measured at any point in life is strongly predictive of future cardiovascular disease, dementia, cancer, and mortality as well as a variety of other health outcomes. This speaks to the importance of intervening early to prevent the loss of optimal CVH and the accumulation of cardiovascular risk. Interventions to improve CVH are not common but those that have been published most often address multiple modifiable risk factors among individuals within the community. Relatively few interventions have been focused on improving the construct of CVH in children. Future research is needed that will be both effective, scalable, and sustainable. Technology including digital platforms as well as implementation science will play key roles in achieving this vision. In addition, community engagement at all stages of this research is critical. Lastly, prevention strategies that are tailored to the individual and their context may help us achieve the promise of personalized prevention and help promote ideal CVH in childhood and across the life course.
    Matched MeSH terms: United States
  20. Perak AM, Baker-Smith C, Hayman LL, Khoury M, Peterson AL, Ware AL, et al.
    Circ Cardiovasc Qual Outcomes, 2023 Sep;16(9):e000120.
    PMID: 37548024 DOI: 10.1161/HCQ.0000000000000120
    Cardiovascular disease risk factors are highly prevalent among youth in the United States and Canada. Pediatric preventive cardiology programs have independently developed and proliferated to address cardiovascular risk factors in youth, but there is a general lack of clarity on best practices to optimize and sustain desired outcomes. We conducted surveys of pediatric cardiology division directors and pediatric preventive cardiology clinicians across the United States and Canada to describe the current landscape and perspectives on future directions for the field. We summarize the data and conclude with a call to action for various audiences who seek to improve cardiovascular health in youth, reduce the burden of premature cardiovascular disease, and increase healthy longevity. We call on heart centers, hospitals, payers, and policymakers to invest resources in the important work of pediatric preventive cardiology programs. We urge professional societies to advocate for pediatric preventive cardiology and provide opportunities for training and cross-pollination across programs. We encourage researchers to close evidence gaps. Last, we invite pediatric preventive cardiology clinicians to collaborate and innovate to advance the practice of pediatric preventive cardiology.
    Matched MeSH terms: United States/epidemiology
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