Search Results (1,764)

Introduction: Medication adherence is essential for treatment and recovery following hematopoietic stem cell transplantation (HSCT). However, limited data exist on the most effective methods to measure adherence and the factors influencing it in HSCT patients. Materials and Methods: A prospective longitudinal study assessed immunosuppressant medication adherence in 150 patients with hematologic malignancies undergoing allogeneic HSCT. Adherence was assessed using pill counts, immunosuppressant medication levels, patient-reported medication logs, and the Medication Adherence Response Scale-5 (MARS-5) at 30, 100, and 180 days post-HSCT. We evaluated adherence rates, agreement between methods, and sociodemographic and clinical predictors. From patient-reported logs, we calculated dose adherence (comparing reported doses to expected doses) and timing adherence (comparing medication intake within ±3 h of the prescribed time). Kappa analysis assessed agreement among methods. Results: Of 190 eligible patients, 150 (78.9%) enrolled. The mean age was 57.5 years (SD = 13.5); 41.3% (n = 62) were female, 85.3% (n = 128) were non-Hispanic White, and 73.3% (n = 110) were married or living with a partner. Medication adherence varied across the three timepoints and by measurement type: 52–64% (pill counts), 18–24% (medication levels), 96–98% (medication log dose adherence), 83–84% (medication log timing adherence), and 97–98% (MARS−5). There was minimal agreement between measures (Kappa range: 0.008–0.12). Conclusions: Despite the feasibility of leveraging objective and patient-reported measures to assess medication adherence in HSCT patients, there was little agreement between these measures. Patient-reported measures showed high adherence, while objective measures like pill counts and medication levels revealed more modest adherence. The complexity of medication regimens likely contributes to this discrepancy. A rigorous approach to understanding medication adherence in the HSCT population may entail both objective and subjective measures of medication adherence. Full article

Background/Objective: Dry eye syndrome affects 16 million Americans with USD 52 billion in annual healthcare costs. With large language models (LLMs) increasingly used for healthcare information, understanding their performance in delivering equitable dry eye guidance across diverse populations is critical. This study aims to evaluate and compare five major LLMs (Grok, ChatGPT, Gemini, Claude.ai, and Meta AI) regarding dry eye syndrome information delivery across different demographic groups. Methods: LLMs were queried using standardized prompts simulating a 62-year-old patient with dry eye symptoms across four demographic categories (White, Black, East Asian, and Hispanic males and females). Responses were analyzed for word count, readability, cultural sensitivity scores (0–3 scale), keyword coverage, and response times. Results: Significant variations existed across LLMs. Word counts ranged from 32 to 346 words, with Gemini being the most comprehensive (653.8 ± 96.2 words) and Claude.ai being the most concise (207.6 ± 10.8 words). Cultural sensitivity scores revealed Grok demonstrated highest awareness for minority populations (scoring 3 for Black and Hispanic demographics), while Meta AI showed minimal cultural tailoring (0.5 ± 0.5). All models recommended specialist consultation, but medical term coverage varied significantly. Response times ranged from 7.41 s (Meta AI) to 25.32 s (Gemini). Conclusions: While all LLMs provided appropriate referral recommendations, substantial disparities exist in cultural sensitivity, content depth, and information delivery across demographic groups. No LLM consistently addressed the full spectrum of dry eye causes across all demographics. These findings underscore the importance for physician oversight and standardization in AI-generated healthcare information to ensure equitable access and prevent care delays. Full article

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder with significant racial and ethnic disparities in prevalence, disease severity, and outcomes. Cardiovascular complications, including pericarditis, myocarditis, valvular disease, and conduction abnormalities, contribute to increased morbidity and mortality in SLE patients. This study examines racial and ethnic disparities in cardiovascular outcomes among hospitalized SLE patients in the United States. Methods: This retrospective study utilized the National Inpatient Sample (NIS) database from 2016 to 2021 to analyze hospitalizations of adult patients (≥18 years) with a primary or secondary diagnosis of SLE. Patients were stratified into racial/ethnic groups: White, Black, Hispanic, Asian, Native American, and Other. Primary outcomes include major adverse cardiovascular events (MACEs), which are a composite of in-hospital mortality, myocardial infarction (MI), sudden cardiac death, and other SLE-related outcomes including cardiac, pulmonary, and renal involvement. Statistical analyses included multivariable logistic regression models adjusted for demographic, socioeconomic, and hospital-related factors to assess racial disparities. Results: The study included 514,750 White, 321,395 Black, and 146,600 Hispanic patients, with smaller proportions of Asian, Native American, and Other racial groups. Black patients had significantly higher odds of in-hospital mortality (OR = 1.17, 95% CI = 1.08–1.26, p < 0.001) and sudden cardiac death (OR = 1.64, 95% CI = 1.46–1.85, p < 0.001) compared to White patients. Asian patients also exhibited increased mortality risk (OR = 1.37, 95% CI = 1.14–1.63, p = 0.001) as compared to Whites. Conversely, Black (OR = 0.90, 95% CI = 0.85–0.96, p = 0.01) and Hispanic (OR = 0.87, 95% CI = 0.80–0.96, p = 0.03) patients had lower odds of MI. Racial disparities in access to care, socioeconomic status, and comorbidity burden may contribute to these differences. Conclusion: Significant racial and ethnic disparities exist in cardiovascular outcomes among hospitalized SLE patients. Black and Asian individuals face higher in-hospital all-causes mortality and sudden cardiac death risks, while Black and Hispanic patients exhibit lower MI rates. Addressing social determinants of health, improving access to specialized care, and implementing targeted interventions may reduce disparities and improve outcomes in minority populations with SLE. Full article

In the Hispanic world, the analysis of discourse particles from a microdiachronic perspective has emerged as a relatively recent area of research that has already demonstrated its efficacy, particularly in the context of Spain. However, in the case of Mexico, this type of study is still marginal. The objective of this paper is to analyze hacer de cuenta in Mexican Spanish during the 20th and 21st centuries to illustrate its processes of grammaticalization and pragmatization. To this end, a comprehensive analysis of the CREA and CORDE corpora, as well as six corpora of Mexican Spanish, was conducted. This methodological approach was proposed for three reasons. Firstly, it facilitated the acquisition of a diverse sample of examples. Secondly, it ensured the inclusion of corpora from different decades. Thirdly, it obtained examples that approximate orality. The findings suggest that during this period, hacer de cuenta was undergoing a process of pragmatization. Consequently, it can be regarded as a discourse particle that primarily encodes an intersubjective value, through which the speaker attempts to share with the interlocutor the way she/he conceptualizes a particular event. Full article

Background/Objectives: While ocular albinism (OA) is usually associated with reduced vision, nystagmus, and foveal hypoplasia, there is phenotypic variability in iris and fundus hypopigmentation. Hemizygous pathogenic/likely pathogenic (P/LP) variants in GPR143 at X: 151.56–151.59 have been shown in the literature to be associated with OA. The purpose of this study was to report the case of a Hispanic male with X-linked inherited OA associated with a hemizygous GPR143 variant and to review the literature relating to genotype–phenotype associations with GPR143 and OA. Methods: After consent to an IRB-approved protocol, a 14-year-old Hispanic male patient with OA and his parents underwent whole genome sequencing (WGS) in 2023. Two maternal uncles with nystagmus underwent targeted variant testing in 2024. A literature review of reported GPR143 variants was completed. Results: A male with reduced visual acuity, infantile-onset nystagmus, foveal hypoplasia, and iris hypopigmentation was identified to have the variant GPR143, c.455+3A>G, which was also present in his mother and two affected maternal uncles. This variant has been previously identified in other Hispanic patients of Mexican descent. Additionally, 127 variants were identified in the literature and reported to be associated with OA. All patients had reduced visual acuity (average 0.71 ± 0.23 logMAR), 99% had nystagmus, 97% foveal hypoplasia, 79% fundus hypopigmentation, and 71% iris hypopigmentation. Of those patients with reported optotype best corrected visual acuity (BCVA), eight (9%) had VA from 20/25 to 20/40, 24 (24%) had VA from 20/50 to 20/80, and 63 (67%) had VA from 20/100 to 20/200. The most frequent type of variant was missense (31%, n = 39). Frameshift and nonsense variants were associated with the lowest rates of iris hypopigmentation (50% [n = 11] and 44% [n = 8], respectively; p = 0.0068). Conclusions: This case represents phenotypic variability of GPR143-associated OA and highlights the importance of repeat genetic testing and independent analyses of test results for accurate variant classification, particularly in non-White and Hispanic patients. Further studies in more diverse populations are needed to better develop genotype–phenotype associations for GPR143-associated OA. Full article

Seafood processing byproducts (SB) such as bones and skin can be safely used as food ingredients to increase profitability for the seafood sector and provide nutritional value. An online survey of 716 US adult seafood consumers was conducted to explore SB trial intent, responsiveness to health and safety information, and associated elicited emotions (nine-point Likert scale). Consumers’ SB-elicited emotions were defined as those changing in reported intensity (from a baseline condition) after the delivery of SB-related information (dependent t-tests). As criteria for practical significance, a raw mean difference of >0.2 units was used, and Cohen’s d values were used to classify effect sizes as small, medium, or large. Differences in willingness-to-try, responsiveness to safety and health information, and SB-elicited emotions were found based on self-reported gender and race, with males and Hispanics expressing more openness to SB consumption. SB-elicited emotions were then used to model consumers’ willingness-to-try foods containing SB via logistic regression modeling. Traditional stepwise variable selection was compared to variable selection using raw mean difference > 0.2 units and Cohen’s d > 0.50 constraints for SB-elicited emotions. Resulting models indicated that extrinsic information considered at the point of decision-making determined which emotions were relevant to the response. These new approaches yielded models with increased Akaike Information Criterion (AIC) values (lower values indicate better model fit) but could provide simpler and more practically meaningful models for understanding which emotions drive consumption decisions. Full article

Background/Objectives: Latinos, particularly those of Mexican ancestry, experience high rates of type 2 diabetes and sleep disturbances, exacerbating adverse health outcomes. This study aimed to examine the prevalence of excessive daytime sleepiness and its associations with diet, cardiometabolic risk factors, and glycemic control in this population. Methods: This cross-sectional study utilized data from the El Banco por Salud biobank, including 1685 participants (aged 52.6 ± 14.5 years, BMI: 32.4 ± 7.0 kg/m²) recruited from Federally Qualified Community Health Centers. Excessive daytime sleepiness was assessed using the Epworth Sleepiness Scale, while dietary information was obtained via the Brief Dietary Assessment Tool for Hispanics. Primary outcomes included cardiometabolic risk factors and glycated hemoglobin (HbA1c) levels. Results: Excessive daytime sleepiness (Epworth Sleepiness Scale > 10) was present in 22.0% of participants and was associated with higher BMI (p < 0.001), larger waist circumference (p = 0.002), poorer diet quality, increased dyslipidemia (p = 0.036), and elevated HbA1c (p = 0.007). Linear regression analyses confirmed that excessive daytime sleepiness was significantly associated with higher HbA1c levels, both in unadjusted (R² = 0.011; p < 0.001) and adjusted for demographic, anthropometric, and socioeconomic factors (R² = 0.107; p = 0.004) models. Conclusions: Excessive daytime sleepiness among Latinos of Mexican ancestry is associated with unhealthy dietary patterns and poor glycemic control, highlighting the need for targeted interventions addressing sleep and dietary habits in this vulnerable population. Full article

This study investigates the effect of code-switching (CS) on the processing and attachment resolution of ambiguous relative clauses (RCs) like ‘Bill saw the friend of the neighbor that was talking about football’ by heritage speakers of Spanish. It checks whether code-switching imposes a prosodic break at the place of language change, and whether this prosodic break affects RC parsing, as predicted by the Implicit Prosody Hypothesis: a high attachment (HA) preference results from a prosodic break at the RC. A prosodic break at the preposition ‘of’ in the complex DP ‘the friend of the neighbor’ entails a low attachment (LA) preference. The design compares RC resolution in unilingual sentences (Spanish, with a default preference for HA in RC, and English, with the default LA) with the RC parsing in sentences with CS. The CS occurs at the places of prosodic breaks considered by the IPH. The results show sensitivity to the place of CS in RC attachment. CS prompting LA causes longer response times. The preference for HA in Spanish unilingual sentences is higher than in English ones. Heritage speakers are sensitive to the prosodic effects of CS. However, there is high variability across speakers. Full article

Social adversity is linked to poorer physical health in breast cancer survivors, highlighting the urgency of addressing health equity. Simultaneously, identifying individual-level factors that mitigate these effects may provide more immediate relief for survivors. This study examined whether four modifiable psychosocial factors—emotion dysregulation, physical activity, sleep disturbance, and social support—moderate the relationship between place-based social adversity and physical health in 255 breast cancer survivors (Mage = 56.03, 74.5% non-Hispanic White) within six months post-treatment. Linear regression analyses with 5000 bootstrapped estimates revealed that sleep disturbance significantly moderated the relationship between place-based social adversity and physical health (B = −0.014, SE = 0.001, bootstrapped 95% CI = −0.027, −0.001). Specifically, greater place-based social adversity was associated with poorer physical health at high levels of sleep disturbance (B = −0.22, p = 0.004), but not at low (B = 0.01, p = 0.94) or average (B = −0.10, p = 0.07) levels. Emotion dysregulation, physical activity, and social support did not moderate this relationship. Findings suggest that improving sleep quality may buffer the negative impact of social adversity on physical health, identifying sleep as a potential target for interventions aimed at reducing disparities among breast cancer survivors. Full article

Previous studies about the COVID-19 pandemic on STEMI patient outcomes have conflicting results. It remains unclear if this may be attributed to regional differences and/or differences during COVID-19 wave periods. Using the American Heart Association Get With The Guidelines–Coronary Artery Disease registry data, we evaluated (1) time metrics related to STEMI system goals and (2) regional variation in STEMI incidence and in-hospital mortality during pandemic wave time periods. The study included all patients 18–100 years old admitted with STEMI (n = 72,516) to 1 of 435 American Heart Association Get With The Guidelines–Coronary Artery Disease hospitals (1 October 2019–31 December 2021). Of these, 70.8% were male and 73.0% non-Hispanic White, with a median age of 63 (IQR 18) years. Compared to pre-pandemic time frames, patients with STEMI had a higher risk profile, delayed time to treatment, were treated with fibrinolytic therapy or primary PCI, and were transferred for primary PCI at similar rates, and had higher adjusted in-hospital mortality (during the second wave in the South and Midwest). Preservation of STEMI systems of care resulted in an overall lower in-hospital mortality rate than predicted, although opportunities exist to improve treatment delays. Regional differences in mortality rates require further study. Full article

Background/Objectives: Gut-derived tryptophan (Trp) metabolites play important roles in metabolic and cardiovascular regulation. Although animal studies suggest their protective effects against metabolic dysfunction, data in adolescents, particularly those with obesity, remain limited. The objective of this study was to evaluate associations between circulating gut-derived Trp metabolites and markers of cardiometabolic, vascular, and platelet health in adolescents with obesity. Methods: Data were analyzed from 28 adolescents (ages 13–18; mean BMI = 36 ± 6.4 kg/m²). Fasting blood was collected to assess lipid profiles using a clinical analyzer and insulin resistance using the homeostatic model assessment for insulin resistance (HOMA-IR). Gut-derived Trp metabolites were measured by UPLC–mass spectrometry, peak oxygen uptake (VO_{2 peak}) by gas exchange during an incremental cycle ergometer test, and body composition by dual-energy X-ray absorptiometry. Platelet spare respiratory capacity (SRC), endothelial function, and liver fat were measured using high-resolution respirometry, flow-mediated dilation (FMD) of the brachial artery, and magnetic resonance imaging respectively. Results: Indole-3-propionic acid was inversely associated with diastolic blood pressure (rho = −0.39, p = 0.047), total cholesterol (rho = −0.55, p = 0.002), and LDL-C (rho = −0.57, p = 0.0014), independent of sex and obesity severity. Indoxyl sulfate was positively correlated with fasting glucose (rho = 0.47, p = 0.012), and adolescents with impaired fasting glucose had 1.6-fold higher IS levels. Indole-3-acetaldehyde declined with age (rho = −0.50, p = 0.007), and Indole-3-acetic acid and indole were higher in Hispanics vs. non-Hispanics. No significant associations were observed between Trp metabolites and FMD, VO₂ peak, or SRC. Conclusions: Gut-derived Trp metabolites, particularly indole-3-propionic and indoxyl sulfate, are associated with markers of cardiometabolic risk in adolescents with obesity. These findings support their potential relevance in early-onset cardiovascular disease risk. Full article

This paper presents the development, implementation, and outcomes of the ELEVATE-US-UP (Engaging Learners through Exploration of Visionary Academic Thought and Empowerment in UnderServed and UnderPrivileged communities) teaching methodology, an equity-centered, culturally responsive pedagogical framework designed to enhance student engagement, academic performance, and science identity among underrepresented learners. This framework was piloted at Northern New Mexico College (NNMC), a Hispanic- and minority-serving rural institution. ELEVATE-US-UP reimagines science education as a dynamic, inquiry-driven, and contextually grounded process that embeds visionary scientific themes, community relevance, trauma-informed mentoring, and authentic assessment into everyday instruction. Drawing from culturally sustaining pedagogy, experiential learning, and action teaching, the methodology positions students not as passive recipients of content but as knowledge-holders and civic actors. Implemented across upper-level environmental science courses, the method produced measurable gains: class attendance rose from 67% to 93%, average final grades improved significantly, and over two-thirds of students reported a stronger science identity and a newfound confidence in their academic potential. Qualitative feedback highlighted increased perceptions of classroom inclusivity, community relevance, and instructor support. By centering on cultural context, student voice, and place-based application, the ELEVATE-US-UP framework offers a replicable and scalable model for educational transformation in underserved regions. Full article

The quality of life (QoL) perception has been studied in neurological diseases; however, there is limited information linking brain morphological characteristics, QoL, and cognition. Human behavior and perception are associated with specific brain areas that interact through diffuse electrochemical networking. We used magnetic resonance imaging (MRI) to analyze the brain region volume (BRV) correlation with the scores of Rand’s 36-item Short Form Survey (SF-36) and cognitive domains (memory and dementia status). We analyzed data from 420 adult participants in the Maracaibo Aging Study (MAS). Principal component analysis with oblimin axis rotation was used to gather redundant information from brain parcels and SF-36 domains. Canonical correlation was used to analyze the relationships between SF-36 domains and BRV (adjusted for intracranial cavity), as well as sex, age, education, obesity, and hypertension. The average age (±SD) of subjects was 56 ± 11.5 years; 71% were female; 39% were obese; 12% had diabetes, 52% hypertension, and 7% dementia. No sex-related differences were found in memory and orientation scores, but women had lower QoL scores. The 1st and 2nd canonical correlation roots support the association of SF-36 domains (except social functioning and role emotional) and total brain volume, frontal lobe volume, frontal pole, lateral orbital lobe, cerebellar, and entorhinal areas. Other variables, including age, dementia, memory score, and systolic blood pressure, had a significant influence. The results of this study demonstrate significant correlations between BRV and SF-36 components, adjusted for covariates. The frontal lobe and insula were associated with the mental health component; the lateral-orbital frontal lobe and entorhinal area were correlated with the physical component. Full article

Background/Objectives: Hispanic adolescents experience elevated rates of disordered eating behaviors and body dissatisfaction, yet limited research has examined how gender and weight status interact to shape these risks within this population. Methods: A cross-sectional survey was conducted among 680 Hispanic adolescents (ages 9–15) from a predominantly Mexican-American middle school. Participants completed the Modified Kids Eating Disorder Survey (M-KEDS), and height and weight were objectively measured to determine BMI-for-age percentile. Chi-square tests, Mann–Whitney U tests, and logistic regression were used to assess differences by gender and weight status, including interaction effects. Bonferroni correction was applied for multiple comparisons. Effect sizes (Cramér’s V, odds ratios with 95% CI) were reported. Results: Approximately 73% of participants reported body dissatisfaction, with significant differences observed by gender and weight status. Adolescents with overweight/obesity reported significantly higher negative weight attitudes and extreme weight control behaviors than healthy-weight peers (p < 0.001), with large effect sizes. Females endorsed more disordered attitudes and behaviors, except for exercise to lose weight, which was more common among overweight/obese males. Conclusions: These findings underscore the high prevalence and significance of disordered eating behaviors in Hispanic adolescents, including those at a healthy weight. Results highlight the importance of culturally tailored, gender-sensitive screening and prevention strategies. Schools serve as critical settings for early identification, and tools like the M-KEDS can help address disparities in care access and improve outcomes among Hispanic youth. Full article

The present study investigates how US Southerners perceive second language (L2) speech by recruiting 170 undergraduate students who spoke Southern American English to listen to recordings of four speakers (US, Bangladeshi, Chinese, and Saudi Arabian) and evaluate their attributes. The listeners were grouped based on their ethnic affiliation: African American, Anglo-American, and Asian/Hispanic/multi-racial. A random half were primed, being asked questions about whether/how other people had negatively commented on their accents. Results showed no effect of priming on speech ratings. Moreover, whilst African American and Anglo-American listeners rated L2 speakers lower than the L1 speaker in almost all aspects, Asian/Hispanic/multi-racial listeners did not. Full article