Search Results (19)

Background: We recently reported that the transcutaneous bilirubinometer (TCB) tends to underestimate the severity of neonatal jaundice (NJ). We hypothesize that the cumulative ambient light exposure contributes to the discrepancy. Objectives: This study aimed to identify factors that affect the TCB underestimation. Methods: We analyzed prospectively collected data over a twenty-month period at a level III medical facility. Neonates at risk for NJ who couldn’t secure an appointment with the primary practitioner were followed by the nursery team. Neonates who had phototherapy or forehead bruises were excluded. Concurrently collected total serum bilirubin (TSB) was determined by the diazo method. The primary endpoint was the discrepancy between TCB and the corresponding TSB (TCB-TSB). A mixed-effects model was used to assess the correlation between (TCB-TSB) and potential contributors, including visit age (in hours), gestational age (GA), sex, TSB, season, birth weight, and race. Results: There were 795 visits for 559 neonates, including 341 males, 179 white, 235 black, 103 Hispanic, 41 Asian, and one unrecorded race. The TSB ranged between 1.8 and 33.9 mg/dL. The (TCB-TSB) ranged between −20.0 and 6.4 mg/dL. The median GA and birth weight were 38.7 weeks and 3214.5 g. The visits occurred between 48 and 381 h of age. 133, 148, 132, and 146 visits were in Spring, Summer, Autumn, and Winter, respectively. Fifty-four neonates (9.7%) were admitted for management. 500 sternum TCB readings were also collected from 350 neonates together with the corresponding forehead TCBs. We found that the forehead (TCB-TSB) was significantly less in winter than in spring and summer (p = 0.0014 and 0.0003, respectively). There was a negative correlation between forehead (TCB-TSB) and visit age in hours (p = 0.0006). After adjusting for visit age and season, the (TCB-TSB) is significantly correlated with TSB (p < 0.0001). Similar findings were also seen in the sternum (TCB-TSB) except for the season (p = 0.0808). Conclusions: Cumulative ambient light exposure and the severity of NJ may contribute to (TCB-TSB). Full article

Background: Clinical trials should benefit all people. Consequently, the National Cancer Institute expects cancer centers to accrue individuals to clinical trials in proportion to the cancer burden experienced by populations that live in their respective catchment areas; unfortunately, many cancer centers fail to meet this expectation. The person who gives consent for individuals in clinical trials frequently has significant contact with potential trial participants. We hypothesized that the race, ethnicity, and language of the consenter may have an important bearing on whether an individual chooses to participate in a clinical trial. Methods: We used mixed methods to investigate the impact of the socio-cultural background of the consenter on the decision of a potential research subject to participate in a clinical trial. Between 01/2018 and 02/2020, 205 women were approached in the sequential order they appeared in our breast clinic; of the 181 participants who agreed to complete the survey questionnaire, 94 (52%) were Northern European, non-Hispanic White (NE White), and 87 (48%) were Women-of-Color (WOC); this category includes participants who self-identified as Asian, Black, Hispanic/Latina, or Native American. Results: There were statistically significant differences according to the importance of the consenter’s characteristics in the decision to enroll or decline participation in the BCT. No NE White enroller (0%, n = 0) reported that consenter race was important versus 11% (n = 9) of WOC enrollers (p = 0.0009). Similarly, none of the NE White enrollers rated the consenter “looking like people in my community” as important versus 12% (n = 10) of the WOC enrollers (p = 0.0004). Conclusions: We find that consenter race and ethnicity are important for clinical trial diversity. Larger studies are needed to evaluate the generalizability of this finding. Full article

Background: Urothelial carcinoma (UC) is one of the most common cancers diagnosed worldwide. However, minority populations, such as female, elder, and Black patients, may have disparate outcomes and are commonly neglected in randomized prospective trials. This review aims to study the relationship between age, sex, and race on urothelial cancer prognosis, particularly focusing on contemporary therapy and its effect on overall survival. Methods: Phase III prospective trials since 2016 of immune checkpoint inhibitors, antibody-drug conjugates, or targeted therapies in urothelial carcinoma were identified from PubMed. Trials that did not report on survival by race, sex, or age distribution were excluded, and remaining trials (n = 17) were compared by subgroup. Results: Women were reported to have inferior OS on investigational agents compared to men in 9/17 trials. In a meta-analysis, women had inferior OS to men (OR 0.89 [95% CI: 0.78–0.99]; p = 0.04). Asian/Pacific Islander patients had inferior outcomes to White patients on investigational agents in 3/5 trials. In a meta-analysis, OS was not significant by race (OR 1.18 [0.90–1.46], p = 0.38). Black patients composed <2% of all trial patients, and no subgroup data were reported. Both 65 (n = 7) and 75 (n = 2) were reported as age cut-offs in trial subgroups, and survival data were mixed. Conclusions: Women in UC trials may have inferior survival outcomes to men. Racial diversity was poor and thus limited any conclusions on survival disparities. Full article

Multiracialism, or the concept of “mixed-race”, remains a key racial discourse within twenty-first-century North American societies. Scholarly and mainstream studies of multiracial people often highlight the function of speech in theorizing mixed-race experiences, where interviews or other first-person narratives resist racialized stereotypes and express complex multiracial identities. Yet these studies often overlook the body as a comparable analytical site, ignoring how the body’s mobilization—in dance, choreography, and everyday actions—might further nuance mixed-race subjecthood. My article emphasizes experimental dance and choreography as alternative methods for imagining multiracial subjects, where these body-based approaches reject both stereotypical depictions of multiracial people in mainstream media and “transparent” representations in interviews. Drawing on the concept of “opacity,” which describes unknowable, illegible difference, I propose that experimental dance enables the expression of “opaque” multiracial subjectivities. This article then offers a choreographic analysis of Glenn Potter-Takata’s Yonsei f*ck f*ck, an experimental dance that produces opacities for its performers, who are of mixed Japanese heritage. Through movement scores, stand-up comedy, and a re-created “late-night” talk show, the dance invites audiences to move beyond the desire to recognize, categorize, and “know” the mixed-race Asian American performer. Full article

The image of the Apsara, a celestial dancer in Cambodian myth, is closely associated with Cambodian cultural preservation practices like Cambodian classical dance. The Apsara, its aesthetic features and its association with Cambodian cultural preservation have taken on new meaning in Cambodia’s diasporic communities. In the diaspora, Apsara aesthetics have come to symbolize Cambodian heritage, history and identity, becoming a major feature of performances by Cambodian diasporic artists. However, orientalist expectations of Asian performers in the diaspora, paired with both the forgotten history of colonial intervention in Cambodian arts and state-sanctioned initiatives towards Cambodian nationalism, contributes to orientalist (and thus racialized) expectations of Cambodian diasporic performance. Mixed-race artists fail to fit neatly into the dominant narratives of Cambodian performance and have been marginalized by the Cambodian diasporic community’s dominant conceptions of performance that are rooted in cultural preservation. As people that sit outside of the aestheticized markers of Cambodian-ness, mixed-race artists often struggle to have their work and their subjectivities recognized by their communities. To circumvent questions of their racial legibility, mixed-race Cambodian American artists construct performances that are strategically padded with markers of Khmer identity by engaging with Apsara aesthetics. This article will explore how three different SoCal-based artists have negotiated their Cambodian American identity and cultural politics through performance and/or performance related materials (ads, images, etc.). I will be using examples from the work of music artist and violinist Chrysanthe Tan, theater practitioner Kalean Ung, and autoethnographic engagement with my own creative projects to show how examining the work of multi-racial Cambodian American performing artists can bring forth the complex dynamics of Cambodian diasporic cultural politics and belonging. Full article

Background: One aspect of the distancing measures imposed in response to the COVID-19 pandemic is that telemedicine consultations have increased exponentially. Among these consultations, the assessment and follow-up of patients with chronic diseases in a non-presential setting has been strengthened considerably. Nevertheless, some controversy remains about the most suitable means of patient follow-up. Objective: To analyze the impact of the telemedicine measures implemented during the COVID-19 period on chronic patients. Material and Methods: A systematic review was carried out using the following databases: PubMed, Pro-Quest, and Scopus. The systematic review followed the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search equation utilized descriptors sourced from the Medical Subject Headings (MeSH) thesaurus. The search equation was: “hypertension AND older AND primary care AND (COVID-19 OR coronavirus)” and its Spanish equivalent. Results: The following data were obtained: 14 articles provided data on 6,109,628 patients and another 4 articles focused on a study population of 9684 physicians. Telemedicine was less likely to be used by elderly patients (OR 0.85; 95% C.I. 0.83–0.88; p = 0.05), those of Asian race (OR 0.69; 95% C.I. 0.66–0.73; p = 0.05), and those whose native language was not English (OR 0.89; 95% C.I. 0.78–0.9; p = 0.05). In primary care, lower use of telemedicine was associated with residents of rural areas (OR 0.81; p = 0.05), patients of African American race (OR 0.65, p = 0.05), and others (OR 0.64; p = 0.05). A high proportion (40%) of physicians had no prior training in telemedicine techniques. The highest quality in terms of telephone consultation was significantly associated with physicians who did not increase their prescription of antibiotherapy during the pandemic (OR = 0.30, p = 0.05) or prescribe more tests (OR 0.06 p = 0.05), i.e., who maintained their former clinical criteria despite COVID-19. Conclusions: Telemedicine is of proven value and has been especially useful in the COVID-19 pandemic. A mixed remote–presential model is most efficient. Appropriate training in this area for physicians and patients, together with correct provision, is essential to prevent errors in implementation and use. Full article

To solve the research–practice gap and take one step forward toward using big data with real-world evidence, the present study aims to adopt a novel method using machine learning to pool findings from meta-analyses and predict the change of countermovement jump. The data were collected through a total of 124 individual studies included in 16 recent meta-analyses. The performance of four selected machine learning algorithms including support vector machine, random forest (RF) ensemble, light gradient boosted machine, and the neural network using multi-layer perceptron was compared. The RF yielded the highest accuracy (mean absolute error: 0.071 cm; R²: 0.985). Based on the feature importance calculated by the RF regressor, the baseline CMJ (“Pre-CMJ”) was the most impactful predictor, followed by age (“Age”), the total number of training sessions received (“Total number of training_session”), controlled or non-controlled conditions (“Control (no training)”), whether the training program included squat, lunge, deadlift, or hip thrust exercises (“Squat_Lunge_Deadlift_Hipthrust_True”, “Squat_Lunge_Deadlift_Hipthrust_False”), or “Plyometric (mixed fast/slow SSC)”, and whether the athlete was from an Asian pacific region including Australia (“Race_Asian or Australian”). By using multiple simulated virtual cases, the successful predictions of the CMJ improvement are shown, whereas the perceived benefits and limitations of using machine learning in a meta-analysis are discussed. Full article

Background: Multiple myeloma (MM) is the second most common hematologic malignancy. African Americans are more likely than Whites to be diagnosed with and die of MM, but they experience the same survival times in clinical trials, suggesting that differences in survival may be attributed to differences in receipt of treatment or differences in access to new treatments. We undertook this study to identify the reasons and needs underlying disparities in treatment among patients diagnosed with MM. Methods: We conducted in-depth interviews in 2019–2020 with patients diagnosed with MM between 2010 and 2014 who were identified as eligible for transplant and maintenance therapy and having experienced delays in or underuse of treatment for MM. Underuse was defined as the lack of a particular treatment that the patient was eligible to receive, not being transplanted if eligible, and/or not receiving maintenance therapy. Underuse included patients’ decision to delay harvest or autologous stem cell transplant (ASCT) for the time being and return to the decision in the future. All interviews were audio-recorded and transcribed verbatim. Four investigators independently coded transcripts through inductive analysis to assess reasons for treatment decisions. Results: Of the 29 patients interviewed, 68% experienced treatment underuse: 21% self-identified as African American, 5% as Hispanic, 10% as mixed race, 57% as White, and 16% as Asian. There were no racial differences in reasons for underuse or delay. Themes relating to treatment underuse included: perceived pros and cons of treatment, including potential harm or lack thereof in delaying treatment; physician recommendations; and personal agency. Conclusion: Patients’ decision making, delays, and underuse of MM treatment are influenced by social, personal, medical, and contextual factors. Patients consider their relationship with their physician to be one of the most significant driving forces in their decisions and treatment plans. Full article

Diasporic intimacies between Asian and Latinx groups have converged across the world for centuries; the mixing of these cultures and, as a result, mixed individuals are the effect of centuries of interactions with each other. In this article, I review the literature across Critical Mixed Race Studies (CMRS) and Asian and Latinx interethnic relations to situate an AsianLatinx intervention to understand how AsianLatinxs have continually been relegated to the subaltern despite their strong presence in the U.S. I argue that it is necessary to center the AsianLatinx lived experience to understand the interconnectedness of global Asian and Latinx communities. An AsianLatinx intervention disrupts monoracial frameworks of diaspora, mixed identity and interethnic relations to (re)imagine a reality that situates the complexities of mixedness tangential to racialization processes, identity formation and transnationalism. Full article

The diagnosis of cystic fibrosis has improved in the last few years due to greater access to diagnostic tools and the evolution of molecular biology; the knowledge obtained has contributed to the understanding of its death profile. In this context, an epidemiological study was developed focusing on deaths from cystic fibrosis in Brazil from 1996 to 2019. The data were collected from the Data-SUS (Unified National Health System Information Technology Department from Brazil). The epidemiological analysis included patients’ age groups, racial groups, and sex. In our data, between 1996 and 2019, Σ3050 deaths were recorded, totaling a ≅330% increase in the number of deaths resulting from cystic fibrosis. This fact might be related to a better diagnosis of the disease, mainly in patients from racial groups that are not commonly associated with cystic fibrosis, such as Black individuals, Hispanic or Latino (mixed individuals/Pardos) individuals, and American Indians (Indigenous peoples from Brazil). Regarding of race, the Σ of deaths was: nine (0.3%) in the American Indian group, 12 (0.4%) in the Asian group, 99 (3.6%) in the Black or African American group, 787 (28.6%) in the Hispanic or Latino group, and 1843 (67.0%) in the White group. The White group showed the highest prevalence of deaths, and the increase in mortality was ≅150 times in this group, while, in the Hispanic or Latino group, it was ≅75 times. Regarding sex, the numbers and percentage of deaths of both male (N = 1492; 48.9%) and female (N = 1557; 51.1%) patients were seen to be relatively close. As for age groups, the >60-year-old group presented the most significant results, with an increase of ≅60 times in the registered deaths. In conclusion, in Brazil, despite the number of deaths from cystic fibrosis being prevalent in the White group, it increased in all racial groups (Hispanic or Latino, Black or African American, American Indian, or Asian individuals) and was associated with older age. Full article

Food insecurity (FI) prevails in Sub-Saharan Africa. Yet, in South Africa, although many people, including the elderly, are vulnerable to FI, little is known about the experiences of older persons (OPs) with FI and the interventions thereof. In South Africa, Meals on Wheels Community Service (MOWCS) provides readymade home meal deliveries for OPs through 209 branches across the country. Therefore, this study investigated MOWCS’ role in the promotion of food security among the OPs at the Brooklyn branch, Cape Town. The study was grounded within the food security framework and focused on the availability, accessibility, utilization, and stability of food at Brooklyn MOWCS. Using qualitative research methods, 10 semi-structured interviews and one focus group discussion (N = 5) were conducted with Brooklyn MOWCS beneficiaries, in addition to three key personnel interviews conducted with staff. Data were analysed using Open Code 4.03. The findings showed Brooklyn MOWCS as a stable source of affordable and nutritious meals to OPs. The portion size satisfied hunger; occasionally, one portion sufficed for two meals. Respondents admitted the meal ingredients represented various food groups and rated them as “healthy”. However, some financial challenges hindered the extension of MOWCS services to the wider community. For instance, they only had three paid employees and were overcrowded within church premises. Findings also showed race and gender disparity among respondents; 90% were White and 10% were of Mixed Ancestry, with no Black or Asian OPs represented, and only 10% were male. These outcomes are typical of the current ethnic profile of the overall Brooklyn MOWCS beneficiaries in SA. This calls, therefore, for such interventions to be extended to all South African demographic groups as an initiative to alleviate food and nutrition insecurity among all OPs. Full article

The objective of this study was to evaluate the impact of selected sociodemographic factors on childhood vaccination hesitancy and to define their role according to specific exemptions. This population-based cohort study utilized vaccination rate and sociodemographic data from 1st to 12th grade from 2017 to 2021 for all school districts in Colorado. Data included immunization status and exemptions for each vaccine, race, ethnicity, and free and reduced meal status. Data were evaluated through dimensional analysis and Generalized Linear Mixed Models. School districts with a higher representation of White students had lower immunization rates and use more personal exemptions while school districts with larger Hispanic populations and higher proportions of free and reduced lunches had higher vaccination rates and used more religious exemptions. Black and Pacific Islander populations had higher rates of incomplete vaccination records while Asian American population displayed increased vaccination compliance. Colorado is a robust example of how socioeconomic and cultural differences are important factors with a direct influence on vaccination rates. Future childhood vaccination campaigns and legislation should consider complex socioeconomic and cultural factors. Full article

Athlete ECG interpretation criteria have been developed and refined from research in athlete populations; however, current guidelines are based on available data primarily from Caucasian and Black athletes. This study aimed to assess the impact of ethnicity on ECG interpretation in athletes. A systematic review was conducted of the MEDLINE, EMBASE, Scopus, SPORTDiscus, and Web of Science databases, for papers that assessed athlete screening ECGs and compared findings on the basis of ethnicity. Fifty-one papers which compared ECGs from various ethnicities were included. Most studies assessed Black athletes against Caucasian athletes and found a greater prevalence of T-wave inversion (TWI) (2.6–22.8% vs. 0–5.0%) and anterior TWI (3.7–14.3% vs. 0.6–2.0%). Black athlete subgroups in Africa had TWI (20–40%) and anterior TWI (4.3–18.7%) at a higher prevalence than other Black athletes. Athletes who were defined as mixed-race, Asian, and Pacific Islander are potentially more like Black athletes than Caucasian athletes. Black ethnicity is known to have an impact on the accurate interpretation of athlete ECGs; however, there is nuance related to origin of both parents. Asian and Pacific Islander origin also may impact athlete ECG interpretation. Further research is required to assist in distinguishing abnormal and normal athlete ECGs in different ethnic populations. Full article

Today, identity expression and acceptance represent an important area of political advocacy and representation. Yet, how responsive are voters to new racial identity cues promoted by political leaders? Using candidates with interracial backgrounds as a case study, we assess whether voters are responsive to candidates who assert a mixed-race identity or if voters primarily rely on other traits, such as the candidate’s family background, in determining their support of that candidate. Using an experimental design, this study presents participants with various hypothetical candidates who vary both in their racial heritages (i.e., candidates with Asian and White interracial parents or Black and White interracial parents) and identity choices (i.e., as single-race minority, single-race White, or biracial). We then compare how the mixed-race, single-race minority, and White participants evaluate the candidate. We expect that the mixed-race participants will be most supportive of candidates who signal a common in-group identity by identifying specifically as “biracial”. On the other hand, the single-race minority and White participants should be more likely to adhere to the one-drop rule or hypodescent in their evaluations, meaning they will provide more positive evaluations of interracial candidates who identify as a single-race minority. Our study finds that the single-race minority and White participants completely overlook racial identity cues and instead focus on the description of the candidate’s family heritage along with their own assumptions about hypodescent. The mixed-race participants, on the other hand, show strong support for biracial-identified, in-group political candidates This study adds to a burgeoning literature on racial perception and on political representation. Full article

Mixed-race identification may be complex, in that people with mixed-race ancestry may or may not identify as multiracial. Social experiences, such as experiencing racial discrimination, believing that your fate is connected with specific racialized others, and personal characteristics, such as skin color, all have been theorized to play a role in identification. The Mixed-Race Ancestry Survey (2019) conducted on Mechanical Turk allows me to ask unique questions with a large enough sample of this understudied population to disaggregate by racial ancestries. Only people with mixed-race ancestry are included in this study, but respondents may identify mono- or multiracially. Binary logistic regression models reveal that increased linked fate with a specific racial group is associated with greater odds of racially identifying, at least in part, with that group (e.g., among Asians, greater linked fate with Asians is associated with greater odds of identifying as mono- or multiracially Asian). Increased linked fate with multiracials as a group is also connected to greater odds of identifying as multiracial. In addition, personally experiencing racial discrimination is associated with a greater likelihood of identifying as Black and slightly lower odds of identifying as White or as Latinx. Finally, as skin tone darkens the odds of identifying as Black increase three-fold and the odds of identifying as multiracial increase by 1.3 times. I discuss these findings by racial ancestry groups, noting that being aware of having mixed-race ancestry does not in and of itself predict multiracial identification. Rather, in a social structure that uplifts Whiteness, feeling linked fate, experiencing discrimination, and having darker skin tone are important predictors of identification. These findings highlight the mechanisms connected to racial identification for a population that may feel tied to multiple racial groups and is navigating identification within a White-centric nation. Full article