This study assessed serious psychological distress (SPD), unmet mental health treatment needs, and help-seeking among Asian American adults (AAs) in New York City (NYC), examining their associations with psychosocial factors. We also identified barriers to mental health treatment access and help-seeking sources. The 2023 Neighborhood Wellness Survey data, a representative sample of NYC adults, were analyzed. SPD was assessed using the Kessler Psychological Distress Scale (K6≥13). Multivariable regression models, adjusted for demographics, examined associations between psychosocial factors, SPD, unmet needs, and help-seeking. Among 6,648 AAs, the weighted and age-adjusted prevalence of SPD, unmet needs, and help-seeking were 7.4 %, 9.2 %, and 39.1 %, respectively. Racial/ethnic discrimination and social isolation were linked to higher odds of SPD and unmet needs, as well as greater probabilities of help-seeking. Financial strain was only associated with higher odds of SPD; stop/search/questioning by police was only associated with higher odds of unmet needs; and witnessing neighborhood violence was only associated with higher likelihood of help-seeking. Intimate partner violence and higher psychological distress severity were associated with higher odds of unmet needs and higher probabilities of help-seeking. Main barriers to mental health care among those with unmet needs were self-reliance without treatment (51.1 %), cost (46.4 %), and unawareness of available resources (41.7 %). Family/friends (30.0 %) were the primary support sources. AAs with higher levels of psychological stressors and psychological distress reported higher unmet needs and greater help-seeking. Enhancing mental health literacy and awareness of resources, reducing stigma, and improving access to affordable, culturally competent care is crucial, particularly for AAs facing violence, racial/ethnic discrimination, and police interactions.

BackgroundGenerative artificial intelligence (GAI) has developed rapidly and been increasingly used in scholarly publishing, so it is urgent to examine guidelines for its usage. This cross-sectional study aims to examine the coverage and type of recommendations of GAI usage guidelines among medical journals and how these factors relate to journal characteristics. MethodsFrom the SCImago Journal Rank (SJR) list for medicine in 2022, we generated two groups of journals: top SJR ranked journals (N = 200) and random sample of non-top SJR ranked journals (N = 140). For each group, we examined the coverage of author and reviewer guidelines across four categories: no guidelines, external guidelines only, own guidelines only, and own and external guidelines. We then calculated the number of recommendations by counting the number of usage recommendations for author and reviewer guidelines separately. Regression models examined the relationship of journal characteristics with the coverage and type of recommendations of GAI usage guidelines. ResultsA higher proportion of top SJR ranked journals provided author guidelines compared to the random sample of non-top SJR ranked journals (95.0% vs. 86.7%, P < 0.01). The two groups of journals had the same median of 5 on a scale of 0 to 7 for author guidelines and a median of 1 on a scale of 0 to 2 for reviewer guidelines. However, both groups had lower percentages of journals providing recommendations for data analysis and interpretation, with the random sample of non-top SJR ranked journals having a significantly lower percentage (32.5% vs. 16.7%, P < 0.05). A higher SJR score was positively associated with providing GAI usage guidelines for both authors (all P < 0.01) and reviewers (all P < 0.01) among the random sample of non-top SJR ranked journals. ConclusionsAlthough most medical journals provided their own GAI usage guidelines or referenced external guidelines, some recommendations remained unspecified (e.g., whether AI can be used for data analysis and interpretation). Additionally, journals with lower SJR scores were less likely to provide guidelines, indicating a potential gap that warrants attention. Collaborative efforts are needed to develop specific recommendations that better guide authors and reviewers.

Using cross-sectional data from the United States, England, China, and India, we examined the relationship between education and frequent pain, alongside the modification role of gender in this relationship. We further examined patterns of 3 pain dimensions among participants who reported frequent pain, including pain severity, interference with daily activities, and medication use (these pain dimension questions were not administered in all countries). Our analytical sample included 92,204 participants aged 50 years and above. We found a high prevalence of frequent pain across the 4 countries ranging from 28% to 41%. Probit models showed that higher education was associated with lower risk of pain (United States: -0.26, 95% CI: -0.33, -0.19; England: -0.32, 95% CI: -0.39, -0.25; China: -0.33, 95% CI -0.41, -0.26; India: -0.18, 95% CI -0.21, -0.15). Notably, in China and India, the negative association between higher education and frequent pain was less pronounced among women compared with men, which was not observed in the United States or England. Further analysis showed that individuals with higher education experiencing frequent pain reported less severity, fewer daily activity interferences, and less medication use compared with those with lower education. In the United States, these associations were stronger among women. Our findings highlight the prevalent pain among middle-aged and older adults in these 4 countries and emphasize the potentially protective role of higher education on frequent pain, with nuanced gender differences across different settings. This underscores the need for tailored strategies considering educational and gender differences to improve pain management and awareness.

Background A thorough and in-depth examination of generative artificial intelligence (GAI) usage guidelines in medical journals will inform potential gaps and promote proper GAI usage in scholarly publishing. This study aims to examine the provision and specificity of GAI usage guidelines and their relationships with journal characteristics. Methods From the SCImago Journal Rank (SJR) list for medicine in 2022, we selected 98 journals as top journals to represent highly indexed journals and 144 as whole-spectrum sample journals to represent all medical journals. We examined their GAI usage guidelines for scholarly publishing between December 2023 and January 2024. Results Compared to whole-spectrum sample journals, the top journals were more likely to provide author guidelines (64.3% vs. 27.8%) and reviewer guidelines (11.2% vs. 0.0%) as well as refer to external guidelines (85.7% vs 74.3%). Probit models showed that SJR score or region was not associated with the provision of these guidelines among top journals. However, among whole-spectrum sample journals, SJR score was positively associated with the provision of author guidelines (0.85, 95% CI 0.49 to 1.25) and references to external guidelines (2.01, 95% CI 1.24 to 3.65). Liner models showed that SJR score was positively associated with the specificity level of author and reviewer guidelines among whole-spectrum sample journals (1.21, 95% CI 0.72 to 1.70), and no such pattern was observed among top journals. Conclusions The provision of GAI usage guidelines is limited across medical journals, especially for reviewer guidelines. The lack of specificity and consistency in existing guidelines highlights areas deserving improvement. These findings suggest that immediate attention is needed to guide GAI usage in scholarly publishing in medical journals. Question What are the provision and specificity of generative artificial intelligence (GAI) usage guidelines for scholarly publishing in top and whole-spectrum medical journals and their relationships with journal characteristics? Findings Author guidelines were more abundant and specific in top journals than in whole-spectrum journals. However, reviewer guidelines were extremely scarce in both groups of journals. Journal ranking score was associated with both provision and specificity of GAI usage guidelines in whole-spectrum journals while no significant relationship was found in top journals. Meaning The lack of provision and specificity as well as the inconsistencies in existing guidelines suggest that immediate attention is needed to guide GAI usage in scholarly publishing and safeguard integrity and trust in medical research. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement None ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data relevant to the study are included in the article or included as supplementary materials. Full data and analytical code are available from the corresponding author at chihuali{at}umich.edu.

This study investigated the mental health help-seeking intentions and its correlates among Chinese international students in the U.S. higher education system. An analytic cross-sectional study was conducted. Recruitment of participants occurred via a social media campaign, and participants were invited to complete an online anonymous survey. A total of 222 Chinese international students participated in the study. The majority of the participants were female (65.3%), graduate students (84.7%), and the only child in the family (83.8%). The participants had a mean age of 23.75 years old. When encountering mental health-related problems, participants reported the highest help-seeking intentions for an intimate partner, parent, and friend. A higher level of general mental health help-seeking intentions was associated with a higher level of coping self-efficacy, a higher level of social support, a lower level of stigma, being undergraduate students, and having no history of full-time employment. These findings indicated the preferred sources for mental health help seeking and the need to improve the general mental health help seeking among Chinese international students. Culturally tailored programs are needed that take into consideration Chinese cultural attitudes and beliefs with regard to mental and emotional symptoms of distress.

To describe the level of subjective hepatitis C virus (HCV) knowledge among clinical staffs included in methadone maintenance treatment programs and explore how different factors are correlated with their subjective knowledge. We conducted a cross-sectional survey among staffs from three methadone maintenance treatment organizations in the USA from 2013 to 2014. Using data from 102 clinical staffs (72.55% female and 27.45% male), we performed descriptive analysis and linear regression models with and without adjusting for staff social demographics, HCV-related factors, and program-related characteristics. Staffs included in treatment programs had a moderate level of subjective knowledge related to HCV. The mean knowledge score was 2.40 ± 0.82 (SD) out of 4.00. A higher level of subjective HCV knowledge was associated with higher awareness of HCV testing-related training, more learning resources, and more discussion of HCV-related topics during staff meetings. Other program-level factors associated with a higher level of subjective HCV knowledge included information sharing being encouraged in the facility and having a forum to meet with and learn from clients. Our findings highlight the need to improve subjective HCV knowledge among staffs included in methadone maintenance treatment programs. There is also a need for more comprehensive examination of factors at different levels associated with HCV knowledge among them.

Abstract Introduction. Cancer 101, a cancer education program, is a critical resource to increase cancer knowledge, awareness, and cancer prevention activities to improve cancer health and survival rates. The purpose of this study was to test the feasibility of delivering the Cancer 101 curriculum to incarcerated adult males to improve cancer knowledge and increase cancer prevention activities. Methods. Cancer 101 curriculum was pilot tested for adaptation with representatives from the target audience in a New York and Pennsylvania prison facilities and based on their feedback modifications were implemented. Three prison facilities participated in adapting Cancer 101 for this study; participation in the Cancer 101 educational intervention was limited to individuals who were current smokers or former smokers. Pre-test and post-test surveys were used to assess knowledge of, perceived attitudes regarding and benefits of cancer prevention activities at baseline and immediately after completing the Cancer 101 educational intervention. To determine whether cancer knowledge improved after participating in the Cancer 101 program, a paired t-test procedure was conducted; since improvement was expected, a one-tailed alpha of .05 was specified. Results. The mean cancer knowledge scores differed prior to and after completing the Cancer 101 intervention, t(165) = -14.65, p < .000. Mean cancer knowledge scores prior to the Cancer 101 intervention (M = 28.42, SD = 4.21) were significantly lower than after the intervention (M = 32.68, SD = 3.36). Therefore, the intervention had a positive effect on cancer knowledge. Participants also reported that the primary reasons for participating in the Cancer 101 intervention were to develop knowledge about cancer and the skills to participate in cancer prevention activities and to educate other inmates and family members about cancer. Participants demonstrated significant increases in cancer knowledge and interest in partaking in cancer prevention activities. Discussion. A prison-based Cancer 101 educational intervention provides opportunities for inmates to increase cancer knowledge, as well as promote action for cancer control during incarceration. Citation Format: Pamela Valera, Daniel Mackey, Zi Lian, William McLaughlin. The feasibility of delivering a cancer education program in correctional facilities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr LB-179.

Objective: This study examined the prevalence of past-year mental disorders and its correlates among Chinese international students in US higher education. Participants: A total of 222 Chinese international students participated in the study. Methods: Participants were recruited via a social marketing campaign and participated in an online survey. Results: The majority of the participants were female (65.3%) and graduate students (84.7%) with a mean age of 23.75 years. Of the sample, 77.9 and 74.3% reported having experienced depression and anxiety symptoms in the past year, respectively. Predictors of a higher past-year global mental health status were: not having a steady partner; being more likely to return China after graduation; a higher level of stress about the returning plan; and, a lower rating of cultural humility of key college/university personnel. Conclusions: These results suggest that mental health is a pressing issue facing Chinese international students and correlated with other psychosocial factors.

African-American and Hispanic men are disproportionately affected by cancer experiencing higher rates of cancer-related morbidity and mortality for many cancers (but not all). These challenges may be magnified for a subpopulation of African-American and Hispanic men who have been incarcerated. A survey assessing demographics, incarceration experience, psychosocial, behavioral, and cancer health information seeking was administered to 230 previously incarcerated men aged 35years and older. Data analysis was performed to assess the association between fatalism, perceived susceptibility, and health information seeking in this population. This study revealed the following: the majority of the participants (68.7%) held the fatalistic belief: When I think of cancer, I automatically think of death. Second, the fatalistic belief, There's not much you can do to lower your chances of getting cancer, is more prevalent among those who perceived a higher risk of developing cancer. Third, older participants (those between 55 and 70years old) and widowed are less likely to think of death when they think of cancer. In addition, those who use the Internet to look for health or medical information (i.e., engaging in health information seeking) are less likely to agree with the fatalistic belief: It seems like everything causes cancer. Given the high incidence of certain cancers among African-American and Hispanic men and the vulnerability of those involved in the criminal justice system, our findings highlight the importance of understanding perceived susceptibility to cancer, fatalistic beliefs about cancer, and information seeking in formerly incarcerated men.

China has the world's largest high-speed railway (HSR) network, but while HSR is meeting high transportation demand, the Decide-Announce-Defend approach to infrastructure policy and projects still prevails in China and is often criticized for not addressing public concerns of environmental and social risks. In recent years, researchers have investigated the economic and environmental impacts of HSR, yet few studies have evaluated the public's views on HSR risks or their views on the trustworthiness of key information sources, which are believed to be critical in predicting public behavior and reaction to infrastructure projects. Using random survey data from communities along the Beijing-Shenyang and Beijing-Shanghai high-speed railway lines, our study shows that perceived risks of HSR are higher in the operating stage rather than during construction. We also find that in the construction stage, risk-related information is often obtained through informal channels, while the government becomes a more trusted information provider only after HSR goes into operation. Furthermore, we confirm that the public's perception of the level of knowledge, transparency, and attention to risk of the information sources11These are broad terms used in the survey to refer to information sources' general level of environmental knowledge, level of transparency with the decision-making process and information disclosure, and level of concern for environmental risks perceived by the public. are key determinants of their perceived trustworthiness. Lastly, this study reveals that socioeconomic characteristics are more important than project phase in explaining the regional differences in risk perception and trustworthiness of key information sources. This key finding calls for a strategy of stakeholder engagement that is carefully tailored to the demographics of the affected population in the decision-making and implementation process of HSR, as well as other infrastructure projects.

HIV prevalence in correctional populations is approximately five times that of the general adult population. This systematic review examines the broad question of HIV prevention and interventions to reduce inmate HIV-related risk behaviors in U.S. federal and state prisons. We conducted a systematic review of multiple databases and Google Scholar to identify behavioral, biomedical, social, and policy studies related to HIV among U.S. prison populations from 1980-2014. Studies were excluded if they did not focus on HIV, prison inmates, if they were conducted outside of the U.S., if they involved juvenile offenders, or if they included post-release outcomes. Twenty-seven articles met the study criteria. Evidence suggests that research related to the HIV care continuum, risk behaviors, gender, prevention (e.g., peer education), and policy are key topics to enhance HIV prevention interventions in the criminal justice system. This review provides a prison-specific overview of HIV in U.S. correctional populations and highlight effective interventions, including inmate peer education. There is an urgent need to continue to implement HIV prevention interventions across all prisons and improve the quality of life among those at heightened risk of HIV infection.