Background Atherosclerotic cardiovascular disease, defined as nonfatal myocardial infarction (MI), coronary heart disease death, or fatal or nonfatal stroke, is the leading cause of death in the United States. MI and stroke symptom awareness and response reduce delays in hospitalization and mortality. Methods and Results We analyzed cross‐sectional data from the 2014 and 2017 National Health Interview Surveys on US‐ and foreign‐born adults from 9 regions of birth (Europe, South America, Mexico/Central America/Caribbean, Russia, Africa, Middle East, Indian subcontinent, Asia, and Southeast Asia). The outcomes were recommended MI and stroke knowledge, defined as knowing all 5 symptoms of MI or stroke, respectively, and choosing “call 9‐1‐1” as the best response. We included 63 059 participants, with a mean age 49.4 years; 54.1% were women, and 38.5% had a high school education or less. Recommended MI and stroke knowledge were highest in US‐born people. In both 2014 and 2017, MI knowledge was lowest in individuals born in Asia (23.9%±2.5% and 32.1%±3.3%, respectively), and stroke knowledge lowest for the Indian subcontinent (44.4%±2.4% and 46.0%±3.2%, respectively). Among foreign‐born adults, people from Russia and Europe had the highest prevalence of recommended MI knowledge in 2014 (37.4%±5.4%) and 2017 (43.5%±2.5%), respectively, and recommended stroke knowledge was highest in people from Europe (61.0%±2.6% and 67.2%±2.5%). Improvement in knowledge was not significant in all groups between 2014 and 2017. Conclusions These findings suggest a disparity in MI and stroke symptom awareness and response among immigrants in the United States. Culturally tailored public health education and health literacy initiatives are needed to help reduce these disparities in awareness.

Hyperpigmentation of the skin is an important condition which is difficult to treat. It is caused by many factors such as sun exposure, aging, inflammation and genetic background. Correction of hyperpigmentary condition requires control of all stages of melanin lifecycle including melanocyte activation, melanosome development, melanin production, melanin distribution and epidermal turnover. We have developed a new product with a combination of ingredients that can modulate these key pathways. The goal of the study was to evaluate the effect of pigmentation correcting serum (LYT2) on various pathways involved in the melanin lifecycle. MEL-300-B (MatTek) constructed skin tissues were used for this study. Samples were collected after two weeks and evaluated for melanin quantification, gene expression of key targets and histological assessments. LYT2-treated tissues showed a reduction in melanin content by 45%AE7.65% compared to control. The expression of proopiomelanocortin (POMC) and microphthalmia transcription factor (MITF) genes which are involved with melanocyte activation showed down-regulation by 67.7% and 53.9%, respectively. Key genes of melanosome development, Melan-A, showed a 39.9% down-regulation. Melanin synthesis genes tyrosinase (TYR), tyrosinase related protein 1 (TYRP1) and TYRP2 also showed down-regulation of 53.4%, 57.5% and 34.8% respectively. Melanosome transfer inhibitory genes dickkopf-related pretein-1 (DKK-1) showed a 1236% upregulation. Histological analysis with Fontana Masson staining showed reduction of melanin particles compared to controls. These results indicate that newly developed pigmentation correcting serum (LYT2) is targeting multiple key pathways to control hyperpigmentation in the skin.