Search Results (1,615)

Background/Objectives: Race-based cardiac screening criteria in sports cardiology, including the “Black athlete’s heart” concept, assume biological distinctions that may not reflect physiological reality. This systematic review evaluates whether geographic ancestry provides more clinically relevant predictors of cardiac adaptation than racial categorization. Methods: PubMed was searched (January 2005–July 2025) for studies examining cardiac adaptations in athletes by ethnicity. Data extraction captured demographics, geographic origin, cardiac assessments, and outcomes. Narrative synthesis was employed due to methodological heterogeneity. Results: Forty-seven studies (n = 66,130) revealed substantial within-race heterogeneity. The “Black athlete repolarization variant” prevalence ranged from 1.8% (Brazilian) to 30% (Ghanaian) Black athletes. Left ventricular wall thickness >12 mm (normal <11 mm) occurred in 7.1% of Black versus 0.4% of White athletes, yet varied significantly within Black populations—10.8 ± 1.2 mm in Sub-Saharan versus 9.4 ± 1.1 mm in African-American athletes (p < 0.001). Relative wall thickness ≥0.44 (normal ≤0.42) was presented in 43% of West/Middle African, 23% of East African, and 7% of White athletes. T-wave inversion showed four-fold variation within Black populations (3.6–8.5% West African versus 0.5–2.0% African-American/Caribbean). Current International Criteria demonstrated inequitable specificity: 3.3% false-positive rate in Black versus 1.4% in White athletes. Conclusions: Geographic ancestry explains more cardiac variation than racial categories, supporting contemporary understanding of race as a sociopolitical construct. The persistent diagnostic disparities in ECG screening specificity highlight the need for reform. Transitioning toward protocols incorporating continental origin, anthropometric factors, and social determinants of health—while eliminating terminology like “Black athlete’s heart”—represents an important step toward achieving equity in cardiovascular care for diverse athletic populations. Full article

Background/Objectives: Cesarean section (C-section) is a common surgical procedure associated with an increased risk of 30-day postpartum hospital readmissions. This study utilized machine learning (ML) to predict readmissions using a nationwide database. Methods: A retrospective analysis of the National Surgical Quality Improvement Project (2012–2022) included 54,593 patients who underwent C-sections. Random Forests (RF) and Extreme Gradient Boosting (XGBoost) models were developed and compared to logistic regression (LR) using demographic, preoperative, and perioperative data. Results: Of the cohort, 1306 (2.39%) patients were readmitted. Readmitted patients had higher rates of being of African American race (17.99% vs. 9.83%), diabetes (11.03% vs. 8.19%), and hypertension (11.49% vs. 4.68%) (p < 0.001). RF achieved the highest performance (AUC = 0.737, sensitivity = 72.03%, specificity: 61.33%), and a preoperative-only RF model achieved a sensitivity of 83.14%. Key predictors included age, BMI, operative time, white blood cell count, and hematocrit. Conclusions: ML effectively predicts C-section readmissions, supporting early identification and interventions to improve patient outcomes and reduce healthcare costs. Full article

This review article aims to provide an overview of the pathophysiology, diagnosis, and contemporary management of cardiac amyloidosis (CA) as well as identify the knowledge gaps and areas of potential research. CA can be divided into two main groups: transthyretin cardiac amyloidosis (ATTR-CA) and light chain cardiac amyloidosis (AL-CA). The former further separates into wild-type transthyretin (ATTRwt) and hereditary transthyretin (ATTRv). African Americans, males, and people older than 75 are the most common demographics affected by this disease. Thanks to an increased understanding of this disease combined with better diagnostic techniques, there is growing awareness and a surge of clinical trials aimed at improving outcomes of CA. The diagnosis and treatment of CA is multifaceted and complex, relying on multiple imaging modalities and the cooperation of specialists to deliver effective treatments. While some disease-modifying agents have been introduced recently, their extraordinary cost limits their benefit or they are supported by limited evidence. Other agents are currently undergoing phase 3 trials. To date, there is scarce data surrounding optimal diagnostic and treatment strategies, including a potential role for combination therapies. Critically, it is imperative that physicians develop close relationships with the patient that addresses not only their individual health needs but also their unique psychosocial situation. Therefore, more clinical trials, protocols and patient resources are needed to better inform and guide providers managing these complex patient needs. Full article

Background: Obesity is a well-established risk factor for numerous chronic diseases, including heart disease and type 2 diabetes, and its impact is particularly acute among Black/African American men. According to the Centers for Disease Control and Prevention (CDC), 70.9% of Black men aged 20 and older are overweight or obese. Despite this alarming prevalence, there remains a limited number of studies that specifically investigate the root causes of obesity in this population. Addressing this gap is critical to developing culturally relevant interventions that promote health equity. The purpose of this study was to assess dietary patterns, that are associated with overweight/obesity, in Black men aged 18–65 across the United States of America, to gain an in-depth understanding of variables influencing BMI in Black men. Methods: This study utilized a quantitative approach to collect information from participants. A survey questionnaire was developed and administered via Qualtrics to participants using a web link. The survey collected information across 18 dietary variables. Data was exported to Microsoft Excel for statistical analysis. A simple linear regression was used to determine dietary variables correlation strength and significance with BMI. A significance level of p < 0.05 was used to determine if a variable was statistically significant. Variables were then organized based on significance vs. non significance and correlation strength. Result: The study sample consisted of 466 Black men aged 18 to 65 years. The mean BMI was 30.21. Approximately 19% (n = 87) had a BMI within the healthy range (18.5–24.9), 41% (n = 190) were categorized as overweight (BMI 25.0–29.9), and another 41% (n = 189) were classified as obese (BMI ≥ 30.0). The findings revealed that fruit and vegetable consumption and whole grain cereal consumption were significantly and positively correlated with BMI. Other variables, such as fried foods, processed foods, and sugary drinks, though historically associated with obesity, did not show statistical significance in this population. Conclusions: Results suggest that while multiple dietary factors influence BMI, fruit, vegetable, and whole grain consumption are significantly correlated with BMI in Black men living in America. The findings from this study serve as a foundational step for designing targeted, culturally sensitive interventions aimed at reducing obesity-related health disparities. Future research should further explore how tailored public health messaging and community-based programming can address the specific needs of this population. Full article

Forest fire risk assessment methodologies vary considerably, presenting challenges for adaptation to specific local contexts. This study provides a systematic analysis of forest fire assessment approaches across the Mediterranean basin, American, African, and Asian regions through a comprehensive review of 112 peer-reviewed studies published from 2015 to 2025. Statistical significance testing (Chi-square tests, p < 0.05) confirmed significant regional variation in methodological preferences and indicator usage patterns. Key findings revealed that Multi-Criteria Decision Analysis dominates the field (44% of studies, n = 49), with Analytical Hierarchical Process being the most utilized method (39 studies). Machine learning approaches represent 25% (n = 28), with Random Forest leading significantly (22 applications). The analysis identified 67 indicators across seven major categories, with topographic factors (slope: 105 studies) and anthropogenic indicators (road networks: 92 studies) showing statistically significantly highest usage rates (p < 0.001), representing a statistically significant critical gap in vulnerability assessment (p < 0.01). Organizational factors remain severely underrepresented (a maximum of 14 studies for any factor), representing a statistically significant critical gap in risk assessments (p < 0.01). Statistical analysis revealed that while Mediterranean approaches excel in integrating historical and cultural factors, American methods emphasize advanced technology integration, while Asian approaches focus on socio-economic dynamics and land-use interactions. This study serves as a foundation for developing tailored assessment frameworks that combine remote sensing analysis, ground-based surveys, and community input while accounting for local constraints in data availability and technical capacity. The study concludes that effective forest fire risk assessment requires a balanced integration of global best practices with local environmental, social, and technical considerations, offering a roadmap for future forest fire risk assessment approaches in different regions worldwide. Full article

Child growth in South America results from a complex interplay of genetic, environmental, and socioeconomic factors. The region’s high ancestral diversity—stemming from Native American, European, and African admixture—shapes growth patterns in ways not fully captured by international standard curves such as World Health Organization (WHO) charts, which are primarily based on European population. This mismatch may cause misclassification, especially among Native American and other underrepresented groups, and reduce the effectiveness of interventions like growth hormone (GH) therapy. Evidence from national surveys, cohort studies, and genetic analyses reveals persistent ethnic and socioeconomic disparities, with Native American children showing higher stunting prevalence even after adjusting for wealth and residence. Differences between WHO and national growth curves further contribute to inconsistent prevalence estimates due to methodological and contextual variants. Regional genomic studies, although limited, have identified population-specific variants, such as FBN1 (E1297G) in Peru, and modulators of GH therapy response, including GHR exon 3 deletion, ACAN, and NPR2, highlighting the role of genetic background, treatment timing, and adherence in height outcomes. These findings underscore the need to move toward precision growth medicine, integrating anthropometry, genetic, environmental, and socioeconomic data to design population-specific growth references, optimize pharmacogenetic approaches, and reduce inequities in pediatric growth care. Full article

Background/Objectives: A combination of cervical cancer prevention education and the provision of HPV self-collection kits has been found to increase the uptake of HPV testing among women. However, there is limited research evaluating the perspectives and experiences of women who have participated in a cancer prevention education and received a complimentary HPV self-collection kit. We report the experiences of women who took part in Health is Wealth: a cervical health intervention and received a complimentary HPV self-sampling kit for cervical cancer screening. Methods: This pilot qualitative study enrolled twenty-four women who participated in one-on-one semi-structured interviews to provide feedback and recommendations for improving future iterations of the intervention. Results: Overall, themes related to women’s experiences include empowerment and connections; enlightenment; and accessibility and engagement. In addition, themes related to HPV self-collection include, not as difficult as I thought; convenience; and fear. Our findings suggest that a tailored intervention, which delivers cervical cancer education alongside complementary HPV self-sampling kits while addressing unique barriers experienced by minoritized groups, was well received by African American and African-born Black women. Conclusions: The study demonstrates that a culturally adapted intervention combining cervical cancer education with HPV self-sampling kits was positively received by African American and African-born Black women. This emphasizes the interventions’ potential to improve screening uptake by addressing unique barriers and promoting empowerment, convenience, and accessibility. Full article

Triple-negative breast cancer (TNBC) is an aggressive, heterogeneous subtype of breast cancer. miRNAs play an essential role in TNBC pathogenesis and prognosis. Obesity is linked with an increased risk for several cancers, including breast cancer. Obesity is also related to the dysregulation of miRNA expression in adipose tissues. However, there is limited knowledge about race- and obesity-specific differential miRNA expression in TNBC. We performed miRNA sequencing of 48 samples (24 tumor and 24 adjacent non-tumor tissues) and RNA sequencing of 24 tumors samples from Black (AA) and White (EA) TNBC patients with or without obesity. We identified 55 miRNAs exclusively associated with tumors in obese EA patients and 33 miRNAs in obese AA patients, each capable of distinguishing tumor tissues from obese from lean individuals within their respective racial groups. In EA, we detected 41 significant miRNA–mRNA correlations. Notably, miR-181b-5p and miR-877-5p acted as negative regulators of tumor-suppressor genes (e.g., HEY2, MCL2, HAND2), while miR-204-5p and miR-143-3p appeared to indirectly target oncogenes (e.g., RAB10, DR1, PTBP3, NCBP1). Among AA patients, we found 28 significant miRNA–mRNA interactions. miR-195-5p, miR-130a-3p, miR-130a-5p, miR-424-5p, miR-148a-3p, miR-374-5p, and miR-30a-5p each potentially downregulated two or more genes (e.g., CLCN4, PLCB1, CDC25B, AEBP2, ERBB4). Pathway enrichment analysis highlighted KRAS, ESR1, ESR2, RAB10, TNRC6C, and NCAN as the most commonly differentially expressed in EA, whereas ERBB4, PLCB1, and SERPINE1 were most frequently in AA. These findings highlight the importance of considering race-specific miRNA–mRNA signatures in understanding TNBC in the context of obesity, offering insights into biomarker-driven patient stratification for targeted therapeutic strategies. Full article

Background/Objectives: Sanfilippo Syndrome type B or Mucopolysaccharidosis type IIIB (MPS IIIB, OMIM 252920) is a lysosomal storage disease caused by deficiency of alpha-N-acetylglucosaminidase (NAGLU, E.C. 3.2.1.50) due to pathogenic variants in the NAGLU gene (17q21.2). The disease is characterized by progressive neurological manifestations, marked by cognitive decline, with relatively mild somatic involvement. We aim to present relevant information on a cluster of MPS IIIB identified in Ecuador, particularly regarding their clinical, biochemical, genetic, demographic, and ancestry characteristics. Methods: We present a characterization of a clinical, biochemical, genetic and demographic cluster of MPS IIIB patients in Ecuador, located in four main regions: Manabí, Guayas, Los Ríos, and Santo Domingo de los Tsáchilas. The patients included were diagnosed due to increased levels of urinary glycosaminoglycans (uGAG), plus deficient activity of NAGLU, and/or identification of biallelic pathogenic mutations in the NAGLU gene. Patients’ charts were reviewed for biochemical findings, medical history, clinical manifestations and assessments. Results: We present the results of clinical, biochemical, genetic and demographic characterization of a cluster in Ecuador with 24 patients identified with Sanfilippo syndrome type IIIB, resulting in an estimated incidence of 1.5/100,000. The mean age at diagnosis was 8.8 years, with symptom onset at 4.5 years on average. All patients exhibited elevated levels of uGAG and undetectable NAGLU activity, and all of them presented the c.1487T>C (p.Leu496Pro) variant in the NAGLU gene in homozygosis, indicating a possible founder effect, with the exception of one heterozygous one (p.Leu496Pro/p.Arg482Gln). A positive correlation between age of diagnosis and the concentration of one isoform of heparan sulfate (HS-OS) was found (p < 0.05). Clinical findings included neuropsychomotor developmental delay (75%), neurological regression (65%), hepatomegaly (55%), growth deficiency (50%), coarse facies (45%) and hernia (40%). Male patients presented earlier onset of symptoms. Maternal ancestry was successfully determined for 21 of the 24 patients. The majority were of Native American ancestry (71.4%), followed by European (19%), African (4.8%), and Asian (4.8%) lineages. Haplogroup A was the most prevalent (42.9%), followed by haplogroups D (19%), C, U, and H (each 9.5%), and R and L2 (each 4.8%). Conclusions: Ancestry can indicate a possible mechanism to explain the heterogeneous symptomatic presentation. These findings highlight the need for further research on genetic and environmental influences on disease severity in this population. Full article

Background/Objectives: This paper presents cranial MMS data for an American Indian (AI) sample from New Mexico. We compare these data to other population reference samples to understand biological distance and classification patterns. Methods: Cranial MMS data was collected from CT scans of AI individuals (n = 839) in the New Mexico Decedent Image Database. We used 12 traits following a published protocol for CT data and excluded nasal bone contour. The AI sample is compared to other samples of African American or Black, Asian, Hispanic, and White individuals to assess biological distance and classification accuracy. Results: Biological distance analysis indicated similarity among the AI, Hispanic, and Black samples, but dissimilarity among the Asian and White samples to the AI sample. Classification accuracy was low for the overall model, with Hispanic and Black individuals frequently misclassifying as AI. Conclusions: As is true everywhere, ideas about identity are complex in New Mexico. AI and Hispanic individuals in NM self-ascribe to one or both social groups. We found that biological data cannot meaningfully differentiate between these social groups, as crania are morphologically similar when examining cranial MMS traits. These results, coupled with New Mexican identity and genetics, contributes to the difficulty in group attribution in forensic casework. Nevertheless, the reference data for AI presented here can provide more robust statistics that support the likelihood of AI and Hispanic affinity in population affinity analysis. We underscore the need for an understanding of regional population history and structure and reference samples while assessing population affinity in forensic casework. Full article

This study explores the impact of gender, engineering experiences, and role models on high school students’ overall STEM interests and perceptions of engineering. A survey with Likert-scale and open-ended questions was given to 96 high school students (51 female, 45 male; 83% African American, 8% white, and 8% other races) in grades 9–12. We developed a scale measuring STEM interest, mathematical problem-solving confidence, misconceptions about engineering, perceptions of STEM, and self-efficacy. The STEM Dimension Survey (SDS) has a strong Cronbach alpha (= 0.96) and inter-coder agreement (Cohen’s Kappa = 0.77). ANOVA analysis on open response categories and the survey indicates that gender had a relatively small but statistically significant effect on STEM interest, with female students reporting slightly lower interest levels than male students. Students with prior engineering-related experiences demonstrated significantly higher STEM interest and more positive perceptions of engineering, but did not differ in self-efficacy or misconceptions. Notably, 63% of students reported no role model in STEM, and these students consistently reported lower interest, confidence, and self-efficacy. In contrast, those who identified role models reported significantly more positive STEM outcomes across all dimensions. The findings highlight the importance of recognizing students’ lived experiences and their definitions of engineering rather than relying solely on adult-defined narratives. Engineering-related experiences and role model presence are strongly linked to students’ interest and confidence in STEM. Full article

Background: The coronavirus disease 2019 (COVID-19) pandemic exacerbated food insecurity in the United States, with older adults facing heightened vulnerability due to fixed incomes, chronic illness, and limited mobility. Methods: A cross-sectional online survey was conducted with 4961 urban U.S. adults aged 65 and older. Food insecurity was assessed using the USDA Six-Item Short Form. Paired sample t-tests, chi-square tests, and multivariate logistic regression were used to examine demographic predictors of food insecurity before and during the pandemic. Results: Logistic regression indicated that race and income were significant predictors of food insecurity. African American and Hispanic participants were 92.1% and 126.4%, respectively, more likely to experience food insecurity than White participants (p < 0.001). Compared with those earning less than USD 50,000, participants earning USD 50,000–USD 100,000 and USD 100,000+ were 32.4% and 63.8% less likely to experience food insecurity (p < 0.001). Bivariate analyses showed that food insecurity increased most among African Americans (9.2%) and middle-income participants (USD 50,000–USD 100,000: 11.0%). Education did not remain significant in the adjusted model. Conclusions: Older adults of color and those with lower incomes were disproportionately impacted by food insecurity during the pandemic. The findings highlight the need for targeted, equity-driven policy responses to mitigate food insecurity in older adulthood. Full article

Background/Objectives: In Ecuador, the prevalence of type 2 diabetes mellitus (T2DM) is the second leading cause of death after ischemic heart disease. Genetic variability in protein-coding genes, single nucleotide variants (SNVs), influences the response to antidiabetic drugs. The frequency of SNVs varies among different populations, so studying the ancestral proportions among SNVs is important for personalized medicine in the treatment of T2DM. This study aimed to evaluate the distribution of Native American, European, and African (NATAM, EUR, and AFR) ancestry in 23 allelic variants of the seven genes that encode the relevant enzymes that metabolize antidiabetic drugs in an Ecuadorian population. Methods: Twenty-three allelic variants of seven genes were analyzed in 297 patients with T2DM from Ecuador, and the molecular ancestry of the samples was analyzed considering three ancestral groups, NATAM, EUR, and AFR using 90 ancestry informative markers (AIMs). Allele and ancestry distributions were analyzed using Spearman’s correlation. Results: The Ecuadorian population presents NATAM (61.33%), EUR (34.48%), and AFR (2.60%) ancestry components. CYP2C8*1 and CYP2C9*1 were positively related to NATAM ancestry, while CYP2C8*4 and CYP2C9*2 were positively related to EUR ancestry. CYP2C19*17 was positively correlated to AFR ancestry. The correlation of SLC22A1 variants such as A in rs594709 was positively correlated with NATAM, while GAT in rs72552763 was positive for EUR. The G variant of rs628031 of the SLC22A1 gene was positively correlated with NATAM and negatively correlated with EUR. The C variant of rs2076828 of the SLC22A3 gene was positively correlated with NATAM ancestry. Conclusions: In the Ecuadorian population, a predominance of Native American ancestry has been observed. Among the allelic variants related to enzymes that metabolize antidiabetic drugs, a relationship has been observed between this ancestral component and variants of the CYP2C8*1, CYP2C9*1, SLC22A1 (rs594709 and rs628031), and SLC22A3 (rs2076828) genes. This information is fundamental for the development of strategies for the implementation of personalized medicine programs for Latin American patients. Full article

Karen Tei Yamashita’s Tropic of Orange (1997) and Paul Beatty’s The White Boy Shuffle (1996) evoke the act of listening to music as a way to dismantle stereotypical representations of urban resistance and to paint a diverse picture of how communities throughout Los Angeles were impacted by unrest in 1992. From Yamashita’s Buzzworm, a character always tuned into the radio, to Beatty’s Nicholas Scoby, the protagonist’s best friend who is on a mission to listen to every jazz song ever made, these writers render secondary characters who are most concerned with the consumption of music and the act of listening as a form of culture sharing. In fact, these characters utilize portable devices, particularly the Walkman, to bring personal music and media consumption into public spaces. In this paper, I argue that characters like Buzzworm and Scoby facilitate the creation of specific sonic textures that allow authors to break down artificial barriers of racial representation in the aftermath of urban unrest. These writers highlight the act of listening in order to limn the cross-cultural impact that the 1992 unrest had throughout the Southern California region. Full article

Understanding the factors that influence the mental health of family caregivers is essential. This study examines the impact of caregiving intensity, operationalized as caregiving hours, on depressive symptoms, with a focus on racial differences and gender effects. We analyzed data from n = 2112 unique spousal caregivers across 6622 person-years of observations from the Health and Retirement Study (HRS) longitudinal data (2008–2014). We estimated the impact of caregiving hours on depressive symptoms, controlling for race, gender, and education. Random intercepts accounted for household-level variance. We assessed interaction terms to evaluate differential effects across racial groups. Depressive symptoms were positively associated with caregiving hours $\beta$ = 1.74, SE = 0.24, suggesting that increasing caregiving hours is likely to lead to emotional distress. We observed a significant negative interaction effect among African American caregivers ($\beta =$ −1.25, p = 0.013), indicating that increased caregiving hours led to a reduction in depressive symptoms. Gender was not significantly associated with caregiving hours ($\beta$ = −0.36, p = 0.715). The random effects model demonstrated substantial household-level variation (var(_cons) = 266.07, p < 0.0001). Findings highlight racial differences in the effects of caregiving hours on depressive symptoms and point to the importance of culturally responsive interventions designed to mitigate depressive symptoms among caregivers. Future research should explore protective factors that mitigate psychological distress and promote resilience. Full article