Search Results (683)

Aortic and iliac artery aneurysms are potentially fatal conditions requiring precise timing for intervention. Current guidelines for repair, including those from SVS, ESVS, and ACC/AHA, rely on fixed diameter thresholds primarily derived from Western populations. However, growing evidence shows that both aortic and iliac dimensions vary significantly among racial and ethnic groups. East Asian individuals generally present with smaller baseline vessel diameters and may be at risk of rupture at smaller sizes, while African American and Hispanic populations exhibit distinct remodeling patterns and risk profiles. This narrative review synthesizes the current literature on variations in aortic and iliac artery diameters, aneurysm prevalence, and rupture risk across racial groups. It examines the limitations of universal thresholds for repair, highlights the underrepresentation of non-Caucasian populations in early imaging registries, and introduces alternative, population-specific definitions of aneurysmal disease. Full article

Background/Objectives: Ethnic disparities in type 2 diabetes (T2D) outcomes remain a significant public health challenge in Aotearoa New Zealand (NZ), but are not accurately reported in large datasets. This cross-sectional study used linked regional health records to examine ethnic inequities in glycaemic control and achievement of clinical targets among adults with T2D in the Waikato and Auckland regions. Methods: A cross-sectional analysis was conducted on 57,734 adults aged 18–75 years with confirmed T2D enrolled in four Primary Healthcare Organisations. Clinical and sociodemographic data from February 2021 to December 2023 were linked via National Health Index numbers. Key outcomes included the percentage of patients at target for HbA1c, blood pressure, lipid profiles, renal and liver function tests. Logistic regression assessed associations between ethnicity, socioeconomic deprivation, and clinical target attainment. Results: The mean age was 56.5 ± 12.4 years, and 86.8% of the cohort were overweight or obese. Overall, only 46.3% achieved the HbA1c target (<53 mmol/mol) in their most recent test, with Māori (OR 1.35) and Pacific (OR 1.84) ethnicities, higher deprivation, obesity, and younger age independently associated with elevated HbA1c. Hypertension affected two-thirds of participants (71.9% above target), notably Asians and Pacific peoples. Māori and Pacific peoples had over twice the odds of renal impairment and were 2.5 times more likely to have elevated albumin-to-creatinine ratios. Abnormal liver function test decreased with age (OR ≤ 0.65), though Asians had over twice the odds of elevated ALT and AST compared to Europeans. Conclusions: Significant ethnic inequities exist in glycaemic and clinical target attainment among people with T2D in NZ. These findings highlight critical gaps in diabetes management and underscore the urgent need for targeted, equity-focused interventions addressing both socioeconomic and ethnic disparities to improve outcomes and reduce health inequities. Full article

While face recognition systems are increasingly deployed in critical domains, they remain vulnerable to presentation attacks and exhibit significant demographic bias, particularly affecting African populations. This paper presents a fairness-aware Presentation Attack Detection (PAD) system using Local Binary Patterns (LBPs) with novel ethnicity-aware processing techniques specifically designed for African contexts. Our approach introduces three key technical innovations: (1) adaptive preprocessing with differentiated Contrast-Limited Adaptive Histogram Equalization (CLAHE) parameters and gamma correction optimized for different skin tones, (2) group-specific decision threshold optimization using Equal Error Rate (EER) minimization for each ethnic group, and (3) three novel statistical methods for PAD fairness evaluation such as Coefficient of Variation analysis, McNemar’s significance testing, and bootstrap confidence intervals representing the first application of these techniques in Presentation Attack Detection. Comprehensive evaluation on the Chinese Academy of Sciences Institute of Automation-SURF Cross-ethnicity Face Anti-spoofing dataset (CASIA-SURF CeFA) dataset demonstrates significant bias reduction achievements: a 75.6% reduction in the accuracy gap between African and East Asian subjects (from 3.07% to 0.75%), elimination of statistically significant bias across all ethnic group comparisons, and strong overall performance, with 95.12% accuracy and 98.55% AUC. Our work establishes a comprehensive methodology for measuring and mitigating demographic bias in PAD systems while maintaining security effectiveness, contributing both technical innovations and statistical frameworks for inclusive biometric security research. Full article

Recent policy reports and state briefs continue to highlight the trend of out-migration from California. This outflow has been pronounced over the last three years, revealing a substantial net loss (i.e., net migration) of approximately 740,000 residents. However, there has been comparatively less emphasis on new residents moving to California. Over the past decade, California has attracted substantial in-migration from both domestic and international sources with annual inflows often exceeding 300,000 individuals. As such, studying in-migration is noteworthy as it shapes economic, political, and social landscapes. In-migration can alter the demographic profiles of regions, thereby impacting community dynamics, cultural diversity, and the provision of social services. Using pooled data from the American Community Survey (ACS) from 2021 to 2023 and employing a two-way fixed effects regression framework, I study how temporal changes in racial and ethnic composition, age structure, educational attainment, and economic indicators influence in-migration rates per 1000 residents at the public use microdata level (PUMA). The analysis reveals that higher proportions of Asian and Hispanic populations, as well as an increased share of college-educated residents, are positively associated with in-migration. Notably, higher supplemental poverty rates are also associated with greater in-migration, a counterintuitive finding that may reflect mobility toward affordable housing markets. These findings emphasize the importance of recognizing demographic and intra-regional variability, which can aid policymakers and planners in assessing and delivering public services. Full article

Mitochondria, which have critical roles in energy metabolism and oxidative regulation, also have a role in immune regulation including T cell activation, NET formation, inflammation, and apoptosis. More than 50% of those with systemic lupus erythematosus (SLE) have lupus nephritis due to kidney damage from immune complex deposition. Disease severity is reported to be greater in certain lineages. Mitochondrial DNA (mtDNA) haplogroups, which reflect maternal lineages, may modulate immune balance and disease outcomes in SLE. Methods: DNA was extracted from 25 consecutive, consenting pediatric patients that fulfilled the 1997 criteria for SLE and their maternal mitochondrial DNA (mtDNA) haplogroups were determined through next-generation sequencing (NGS). Results: This study evaluated the associations between mtDNA haplogroups, lupus nephritis, and organ damage in four mtDNA haplogroups: African (n = 5), Amerindian (n = 12), Asian (n = 4), and Caucasian (n = 4). Clinical data, SLE Disease Activity Index (SLEDAI-2K), SLICC Damage Index (SDI), and renal biopsy findings were analyzed. Median SLEDAI-2K scores were higher in Amerindian (10) and African (8) patients than in the Caucasian (5.5) and Asian (3) groups, with significant differences between Amerindian vs. Caucasian (p = 0.045) and Amerindian vs. Asian (p = 0.008). Irreversible organ damage (SDI > 1) was more frequent in Amerindian (54%) and African (40%) patients. Lupus nephritis occurred most often and most severely (Class III–IV, CKD) in the Amerindian (85%) and African (80%) groups, while Caucasian and Asian patients more often showed milder, membranous disease without CKD. Conclusion: Although limited by the small sample size, pediatric SLE severity and renal involvement were found to be greater in Amerindian and African mtDNA haplogroups, suggesting that mitochondrial lineage may contribute to ethnic disparities in SLE. Full article

Background: Despite significant advances in assisted reproductive technology (ART), disparities in clinical outcomes persist. While patient-related factors are well-studied, the role of partner ethnicity remains understudied. We hypothesized that partner ethnicity affects ART outcomes. This study examined the association between partner ethnicity and ART outcomes. Methods: We conducted a retrospective cohort study among patients and their partners undergoing IVF treatment in the United Kingdom between 2017 and 2018. The exposure was partner ethnicity. Outcomes included biochemical pregnancy, clinical pregnancy, pregnancy loss, and live birth. We calculated risk ratios (RR) and 95% confidence intervals (CI) using multivariable regression models to estimate the association between partner ethnicity and IVF outcomes, adjusting for female patient age, partner age, patient ethnicity, gravidity, infertility diagnosis, treatment type, preimplantation genetic testing for aneuploidy, and number of prior in vitro fertilization (IVF) cycles. Results: Among 158,813 IVF cycles, live birth rates per cycle were 26.3% for couples with White partners and 23.1% for those with non-White partners. Non-White partners were associated with a 5% lower clinical pregnancy rate (RR 0.95, 95% CI 0.92–0.97) and a 6% lower live birth rate (RR 0.94, 95% CI 0.92–0.97). Specifically, Black (RR 0.82, 95% CI 0.77–0.87) and Asian (RR 0.67, 95% CI 0.59–0.76) partners had significantly reduced live birth rates, though these associations were attenuated after adjusting for patient ethnicity. Couples in which both the partner and patient were Black or Asian had 24–42% lower live birth rates compared with White couples (Black: RR 0.76, 95% CI 0.70–0.82; Asian: RR 0.58, 95% CI 0.49–0.68). Conclusions: Partner ethnicity is independently associated with IVF outcomes, with non-White partners showing lower rates of these outcomes. These findings suggest the clinical relevance of partner ethnicity in reproductive outcomes. Further research is warranted to elucidate the mechanisms underlying these associations. Full article

The impacts of microaggressions and the Model Minority Myth on self-rated mental health among Asian American (AA) women are unclear. A total of 152 AA women completed an online questionnaire including select items from the Racial and Ethnic Microaggressions Scale (REMS) and the Internalization of the Model Minority Myth Measure (IM-4). Logistic regression was used to estimate associations (odds ratios and 95% confidence intervals) between the REMS and IM-4 with fair/poor mental health. Experiencing frequent microaggressions was significantly and consistently associated with fair/poor mental health, particularly those experiences involving exclusion or dismissal during interpersonal or professional interactions. Women who reported more microaggressions (>10), compared to those who reported fewer (<5), had more than twice the odds of fair/poor mental health (OR: 2.70, CI: 1.12, 6.49). For the IM-4, compared to those who were undecided, women who agreed with statements such as “Asian Americans have stronger work ethics” had lower odds of poor or fair/poor mental health: (OR: 0.39, CI: 0.15, 0.99) than those who were undecided. Gaining a greater understanding and acknowledgement of the impacts of subtle microaggressions and stereotyping, including internalization of stereotypes, is necessary to support psychological wellbeing and design effective mental health interventions for Asian American women. Full article

Objective: This study on children in low-income families explored whether their mental health problems are attributable to distress from five socioeconomic disadvantage factors playing roles in the multiple disadvantage model. These factors are social disorganization, social structural factors, social relationships, health/mental health, and access to care factors. Methods: The present study employed data extracted from the 2021 National Survey of Children’s Health, describing 7540 low-income children. Weighted logistic regression was conducted (with robust standard errors). Results: It showed that such children were more likely to have mental health problems when seven variables were present. The variables were argumentative children, parents’ difficulty with parenting, children’s difficult peer relations, children being bullied, families’ problematic substance use, families’ use of public health insurance, and families’ difficulty accessing mental health services. In turn, children were less likely to have mental health problems in the presence of six variables: a rundown neighborhood, an unsafe neighborhood, children’s Hispanic ethnicity, children’s Asian ethnicity, children’s general good health, and parents’ good mental health. The present study’s findings support the multiple disadvantage model. Conclusions: That is, the five types of factors key to the model (social disorganization, social structural, social relationships, health/mental health, and access to care) were observed to be related to low-income children’s mental health problems. These findings’ three main implications for practice are that it is crucial to (a) ensure children receive mental health services they need; (b) facilitate effective parent–child communication; and (c) provide low-income families with psychoeducation. Their main implications for policy involve two domains. Improving physical environments and safety in poor neighborhoods is necessary, as is enforcing schools’ anti-bullying rules and using schools to foster students’ assertiveness. Full article

Background/Objectives: Iodine intake influences thyroid-related and metabolic diseases that have important public health implications. However, longitudinal evidence of the association between iodine intake and mortality remains scarce and limited to Western populations. Given the markedly high iodine intake among Asians and possible ethnic or regional differences in iodine sensitivity, population-based data from Asian cohorts are needed. Methods: We analyzed 5497 adults from the Korean National Health and Nutrition Examination Survey (2013–2015) linked with mortality follow-up through 2021. Urinary iodine concentration (UIC) was quantified from spot urine samples using inductively coupled plasma mass spectrometry. Iodine intake was estimated from UIC and categorized into four groups: below the estimated average requirement, low-normal, high-normal, and above the tolerable upper level (UL). The primary outcome was all-cause mortality. Cardiovascular disease-specific and cancer-specific mortality were also assessed. Multivariable Cox proportional hazards models accounting for the complex survey design were used to estimate hazard ratios and 95% confidence intervals. Sensitivity analysis excluded participants with thyroid disease or early death, and subgroup analyses by age and sex were also conducted. Results: During a median 8.4-year follow-up, 139 deaths occurred. Compared with the low-normal intake group, excessive iodine intake (above UL) was not associated with all-cause mortality (HR 1.09, 95% CI 0.36–3.27), cardiovascular mortality (HR 1.27, 95% CI 0.21–7.61), or cancer mortality (HR 1.71, 95% CI 0.40–7.29). No significant trends were observed across intake categories (p > 0.2), and similar findings were obtained when UIC levels were analyzed. Excluding participants with thyroid disease or early death did not change the results, and no significant interaction was observed by age or sex. Conclusions: In this first population-based Asian study on iodine intake to mortality, neither estimated iodine intake nor UIC was associated with all-cause mortality. These results suggest that the relationship between iodine exposure and mortality may differ across populations, underscoring the need for further large-scale studies. Full article

Background: Pregnancy induces substantial cardiovascular remodeling, yet whether maternal cardiac adaptation differs across ethnic groups remains unclear. Body size, ventricular geometry, and thoracoabdominal configuration may modulate key functional indices such as left ventricular ejection fraction (LVEF) and global longitudinal strain (LV-GLS). This systematic review compared echocardiographic characteristics between Asian and Western healthy pregnant women in late gestation and explored physiological mechanisms underlying observed differences. Methods: A comprehensive search of PubMed, Scopus, and EMBASE identified studies reporting transthoracic echocardiography in healthy singleton third-trimester pregnancies across Asian and Western populations. Extracted variables included anthropometry, ventricular dimensions and volumes, LVEF, and LV-GLS. Pooled estimates were calculated using inverse-variance weighting, with heterogeneity quantified using the I² statistic. Study quality was assessed with the NIH Case–Control Quality Assessment Tool. Comparative forest plots visualized population differences. Results: Twenty studies involving 1431 participants (578 Asian and 853 Western women) met inclusion criteria. Asian women consistently exhibited smaller ventricular chambers, higher LVEF, and more favorable LV-GLS. Importantly, these differences persisted after indexing LV-GLS to BSA, indicating that body-size normalization attenuates—but does not eliminate—population differences in myocardial deformation. Western women demonstrated slightly attenuated GLS despite preserved LVEF, plausibly attributable to larger cardiac size, higher wall stress, greater diaphragmatic elevation, and increased extrinsic thoracic compression. Between-study heterogeneity was substantial (I² > 95%) due to variation in imaging platforms, strain software, and population characteristics. Methodological quality was fair, with frequent lack of sample-size justification and incomplete confounder adjustment. Conclusions: Healthy Asian pregnant women display a hyperdynamic systolic phenotype, whereas Western women show a physiologically appropriate, load-related attenuation of LV-GLS with preserved LVEF. These findings highlight the need for ethnicity-associated and anatomy-aware echocardiographic reference values and support incorporating thoracic geometric indices, such as the modified Haller Index, into strain interpretation during pregnancy. Full article

Background/Objectives: This study mapped parent/guardian–child physical activity (PA) inequities across racial and ethnic groups in the Americas. Method: A systematic scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute guidelines. Searches were carried out in January 2025 in the following databases: SciELO, LILACS, Web of Science, MEDLINE, EMBASE, Scopus, Web of Science, SPORTDiscus, and PsycINFO. Eligible studies were original articles that jointly assessed parents/guardians and children from diverse racial and ethnic backgrounds. Results: 4195 articles were found, and a total of 25 studies were included (cross-sectional design n = 20). Among these, 18 studies reported that higher parental/guardian PA was associated with greater child PA, regardless of race and ethnic background. Only seven studies provided explicit race and ethnic comparisons (six cross-sectional and one cohort). In four studies Black/African American parents/guardians and children were less physically active than their White counterparts; one study of Latino families showed lower participation in sports compared with African Americans; in one study Hispanic, African American, and Asian families had lower odds of engaging in PA compared with White peers; and one study of African American and Mexican American families reported lower participation in non-competitive individual sports than Anglo families. Conclusions: This review demonstrates consistent associations between parental/guardian and child PA, although a few studies reported null or inverse findings. Moreover, racial and ethnic inequalities in intergenerational PA reflect broader structural health inequities, where access to time, space, and resources for movement remains unevenly distributed. Full article

Research demonstrates that discrimination is detrimental to health. However, most discrimination research does not examine Latino ethnic differences and often relies on unidimensional alpha scales. Such an analytic strategy obscures ethnic differences, can mask the multidimensional nature of discrimination, inflate reliability estimates, produce attenuated or spurious relationships, and bias parameters. To address these issues, we use data from the National Latino and Asian American Study to (1) examine group differences on the Everyday Discrimination Scale (EDS), (2) conduct a confirmatory factor analysis of the EDS to assess its fit and dimensionality for each Latino ethnic group, and (3) evaluate how alternative scaling approaches affect the relationship between discrimination, depression, and chronic health conditions. Results reveal significant group differences in perceived discrimination and show that a second-order factor with two dimensions—subtle and overt discrimination—fits well across all Latino groups. The relationship between discrimination and health is stronger when discrimination is modeled as a second-order factor. These findings indicate that (1) alternative scaling approaches may be more appropriate than alpha scales, (2) more precise measurement of discrimination can better capture its impact on health, and (3) disaggregating panethnic categories such as “Latino” that is essential for understanding ethnic stratification and health. Full article

Background/Objectives: We aimed to determine sex and racial/ethnic disparities in associations between Acute Ischaemic stroke (AIS) with co-morbid heart failure (HF) and in-hospital outcomes, using the US National Inpatient Sample (NIS) in this retrospective observational study based on administrative data. Methods: AIS admissions from January 2016 to December 2019 were extracted from the NIS. Logistic regressions analysed relationships between HF and in-hospital mortality, length of stay >4 days, thrombectomy, thrombolysis, and complications at discharge adjusted for age and comorbidities. Additional models examined interactions between HF and sex, and HF and race/ethnicity. Results: Among 1,744,390 AIS hospitalizations, 16.36% had HF. 69.00% were White, 17.86% Black, 7.42% Hispanic, 2.79% Asian. No significant sex or racial/ethnic differences were found for in-hospital mortality. Patients with co-morbid HF had increased odds of complications at discharge in both sexes (odds ratio (95% confidence interval) 1.32 (1.27–1.37) in women and 1.21 (1.17–1.25) in men). HF (cf. no HF) showed stronger associations with increased complications at discharge in White (1.36 (1.32–1.40)) patients, compared to other racial/ethnic groups (Black 1.08 (1.03–1.13), Hispanic 1.10 (1.01–1.20), and Asian 1.13 (0.97–1.32)). HF was not significantly associated with thrombolysis in White patients (0.98 (0.95–1.02)) but was in Black (1.20 (1.13–1.28)), Hispanic (1.27 (1.14–1.40)), and Asian (1.36 (1.14–1.62)). Additionally controlling socioeconomic variables did not change the relationships except in Hispanic patients for complications, which has become insignificant (1.07 (0.98–1.17)). Conclusions: The association between HF and post-stroke outcomes differs by race/ethnicity and sex, even when adjusting for key predictors of outcomes. Further research is required to identify the drivers of these disparities. Full article

Background: Aortic stenosis (AS) represents a prevalent valvular condition in older adults, associated with significant morbidity and mortality. The objective of the study was to examine trends in mortality related to AS in the United States (U.S.). Methods: The U.S. CDC WONDER dataset was analyzed, extracting age-adjusted mortality rates (AAMR) per 100,000 and calculating annual percentage change (APC) through Joinpoint regression. The results were stratified to identify temporal, sex-specific, racial/ethnic, and regional differences. Results: From 1999 to 2020, 267,515 deaths among older adults (>65 years old) were attributed to AS, with the AAMR declining from 28.00 to 23.69. Males had a higher AAMR (30.35) compared to females (27.42), though more deaths occurred in females (164,104 vs. 103,411). Non-Hispanic (NH) Whites exhibited the greatest AAMR (31.61), trailed by NH American Indian/Alaska Native individuals (16.62), whereas NH Asians/Pacific Islanders had the least (11.50). Significant state-wise variations were noted, with AAMRs ranging from 60.55 in Oregon to 17.23 in Mississippi, and 19 states depicting a concerning rise over the study duration. Regionally, the Northeast (32.09) had the highest AAMRs, while the South (23.06) had the lowest. Micropolitan (32.28) and noncore (28.43) areas reported higher AAMRs compared to large central metropolitan areas (24.32). Conclusions: While there is a trend towards decreased mortality due to AS in the U.S., significant disparities based on race, sex, and region persist and may be worsening. The underlying causes of these discrepancies require further investigation, and targeted strategies must be developed to address them effectively. Full article

Background: This study’s objective was to be the first to explore the ethnicity/cultural origins, gender identity, ability/disability, sexual orientation, socioeconomic background, and harassment/discrimination experiences of Canadian radiation oncologists (ROs). Methods: Following a literature review and input from content experts, an ethics-approved national cross-sectional electronic survey was developed in English and French and electronically distributed to all ROs in Canada (n = 598). Descriptive statistics summarized responses. Comparisons between groups were performed using Chi-square tests, and content analysis was performed on open-ended responses. Results: The survey was completed in full by 42.5% of ROs (254/598). Most respondents were male (62.9%), 35–44 years old (39.2%), and heterosexual (94.3%). 41.2% identified as belonging to a racialized group, which is higher than the overall Canadian population (27%), but Black, Indigenous, and Southeast Asian ROs were underrepresented (1.9% vs. 4%, <1% vs. 5% and 1.6% compared to 4%, respectively). A significant subset analysis showed that only 20% (21/105) of racialized ROs were women, whereas Caucasian women comprised 49.3% (74/150) of Caucasian respondents (p < 0.001). While 75.4% of respondents reported job satisfaction, 42.1% reported experiencing workplace discrimination/harassment within the past 5 years; most commonly, this was perpetrated by fellow faculty (31.7%; 58/183) or patients or their family members (31.7%; 58/183). Respondents felt that gender, race/ethnicity, and age were the three top reasons for discrimination/harassment, with double the amount of racialized ROs reporting harassment compared to White ROs (p < 0.001). Nearly half (45.2%; 114/252) did not understand how to report, or felt uncomfortable reporting, workplace discrimination/harassment. Conclusions: This study highlights high harassment and discrimination rates amongst Canadian ROs, especially amongst racialized women, which may affect career satisfaction and attrition rates. Compared to census data, Black, Indigenous, and Southeast Asian ROs were underrepresented, and amongst racialized ROs, racialized women were significantly underrepresented. These findings underscore the need for targeted diversity initiatives, improved mentorship programs, and stronger institutional policies to address harassment and foster an inclusive work environment. Full article