Search Results (224)

Objective: Traumatic brain injury (TBI) is disproportionately prevalent in incarcerated populations, yet the potential impact on cognitive functioning remains underexplored. This study examined the relationship between TBI history and cognitive performance in a male prison population. Method: Sixty-three participants from Tongariro Prison completed a comprehensive neuropsychological assessment including measures of executive function, memory, processing speed, and perceptual reasoning, with embedded performance validity metrics. TBI history was assessed using the Ohio State University TBI Identification Method (OSU-TBI ID), premorbid function was assessed using the Speed and Capacity of Language Processing (SCOLP) Spot-the-Word task, mood was assessed using the Depression, Anxiety and Stress Scales (DASS-21), and alcohol and substance use were measured using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Regression analyses explored the relationship between TBI history and cognitive functioning, controlling for premorbid function, mood, alcohol and substance use, and ethnicity. Results: Contrary to hypotheses, TBI frequency and severity were not associated with poorer cognitive performance in this population. However, a self-reported history of pervasive TBI—defined as repeated head impacts over a narrow time frame—was significantly associated with reduced performance on the Color–Word Interference Test (CWIT) inhibition task, indicating links to greater cognitive disinhibition. Conclusions: Findings suggest that experiencing at least one period of pervasive TBI may be associated with an impact on inhibition (but not other aspects of executive functioning) in men in prison. These results underscore the importance of nuanced TBI history assessment and highlight inhibition as a potential target for rehabilitation in incarcerated individuals exposed to repetitive head trauma. Full article

Enlarged vestibular aqueduct (EVA) is a common inner ear malformation that causes sensorineural hearing loss. It is frequently associated with pathogenic variants in the SLC26A4 gene. This study aimed to investigate the genetic basis of hearing loss in Mongolian patients with EVA. Whole-exome sequencing was performed in 19 Mongolian patients from 15 unrelated families diagnosed with EVA with or without cochlear incomplete partition type II. All patients underwent high-resolution computed tomography of the temporal bone to confirm the diagnosis. Biallelic SLC26A4 pathogenic variants were identified in all 15 families, achieving a 100% diagnostic yield. The most frequent variant was c.919-2A>G (40%), followed by c.2027T>A (23.3%) and c.1318A>T (16.7%). The spectrum of variants includes population-specific variants found in East Asians (c.919-2A>G), North Asians (c.2027T>A), and Southwest Asians (c.716T>A), suggesting a unique mutation spectrum in this Mongolian cohort characterized by variants prevalent across various Eurasian populations, which remains to be confirmed in larger studies. Furthermore, correlation analyses on multi-ethnic allele frequencies of biallelic SLC26A4 genotypes demonstrated positive correlations with deaf cohorts of East Asian, North Asian, Northeast Asian, and Western Asian groups. Digenic inheritance (with pathogenic variants in FOXI1, KCNJ10, or EPHA2) was not observed, and there was no clear genotype–phenotype correlation between specific SLC26A4 genotypes and hearing levels or inner ear malformations. This study provides a comprehensive overview of the genetic landscape of EVA in the Mongolian population. The identification of biallelic SLC26A4 pathogenic variants in all families underscores the clinical role of this gene in EVA pathogenesis. The observed pan-ethnic mutation spectrum likely reflects the genetic diversity resulting from historical migrations of Mongolians. Full article

Background: Obstetric anal sphincter injuries (OASIS) are a major cause of long-term maternal morbidity. Identification of risk factors is central to prevention strategies. Methods: A retrospective cohort study was conducted including all singleton, term, cephalic vaginal births over a four-year period (September 2018 to September 2022) at a UK tertiary maternity unit. OASIS was defined as third- or fourth-degree perineal tears according to RCOG criteria. Multivariable logistic regression analysis was used to identify independent predictors. A pre-specified sensitivity analysis restricted to nulliparous women was performed. Secondary outcomes included postpartum haemorrhage (PPH), defined as blood loss >1 L. Reporting follows the STROBE statement for cohort studies. Results: Among 9586 vaginal births, 270 OASIS cases were identified, corresponding to an incidence of 2.82%. Independent predictors included nulliparity (aOR 7.12, 95% CI 5.07–10.01), Asian ethnicity (aOR 3.50, 95% CI 2.55–4.81), shoulder dystocia (aOR 3.45, 95% CI 1.89–6.32), and birthweight ≥4000 g (aOR 1.85, 95% CI 1.16–2.95). Maternal age ≥35 years showed a borderline association (aOR 1.34, 95% CI 0.99–1.80, p = 0.056). Using forceps as the reference, ventouse (aOR 0.28, 95% CI 0.17–0.47) and spontaneous vaginal delivery (aOR 0.23, 95% CI 0.13–0.39) were associated with lower OASIS odds. Episiotomy (recorded as a binary variable) was associated with lower adjusted odds of OASIS (aOR 0.27, 95% CI 0.17–0.44). PPH occurred in 21.5% of women with OASIS versus 6.5% without (p < 0.001). Conclusions: OASIS risk is driven by a combination of maternal, fetal, and intrapartum factors. Selective mediolateral episiotomy was associated with lower adjusted odds of OASIS in this cohort, but this is an observational finding and does not constitute proof of a causal protective effect. It should be interpreted cautiously given the retrospective design, the recording of episiotomy as a binary variable without procedural detail, and the substantial potential for residual confounding by indication. The findings support targeted perineal protection strategies and selective rather than routine episiotomy use. Full article

Background/Objectives: Osteoporosis-related fragility fractures are sentinel events that should trigger timely secondary prevention, yet post-fracture care remains inconsistent. Leveraging the NIH All of Us Research Program, we quantified initiation of osteoporosis pharmacotherapy after fragility fracture and explored associations by age, sex at birth, race, and ethnicity. Methods: Retrospective cohort study using All of Us Controlled Tier data (v8) included adults aged 45 to 100 years with an index fragility fracture using prespecified OMOP concept sets intended to capture fractures commonly associated with osteoporosis. A new-user design excluded participants with any osteoporosis pharmacotherapy in the 365 days before fracture; participants required at least 180 days of follow-up. The primary outcome was initiation of osteoporosis pharmacotherapy (bisphosphonates, denosumab, or anabolic agents) within 180 days. Secondary outcomes were completion of dual-energy x-ray absorptiometry (DXA) and bone-health laboratory testing within 180 days. Multivariable logistic regression estimated adjusted odds ratios (OR) for each outcome by age at fracture, sex at birth, race, and ethnicity. Results: Among 1492 eligible participants, 87 initiated pharmacotherapy within 180 days (5.83%). After adjustment, older age was associated with higher odds of initiation (OR 1.04 per year; 95% CI 1.02 to 1.05). Male participants had markedly lower odds of pharmacotherapy initiation (OR 0.20; 95% CI 0.11 to 0.37) and DXA screening (OR 0.22; 95% CI 0.15 to 0.32) compared with female participants. In exploratory adjusted models, we did not detect an independent association between race and pharmacotherapy initiation (White vs. Black/African American OR 1.01; 95% CI 0.49 to 2.09), while White participants had higher odds of DXA screening than Black/African American participants (OR 1.79; 95% CI 1.02 to 3.28). Conclusions: In this diverse national EHR-based cohort, initiation of osteoporosis pharmacotherapy after fracture was uncommon, highlighting a substantial secondary prevention gap. In exploratory adjusted models, male sex was associated with lower odds of pharmacotherapy initiation and DXA receipt, while White participants had higher odds of DXA receipt than Black participants. System-level post-fracture pathways, including fracture liaison services and EHR-based prompts, may improve equitable identification and treatment of osteoporosis for All of Us participants and their communities. Full article

Background: The Pech ethnic group, comprising approximately 6024 individuals in northeastern Honduras, represents one of the country’s smallest indigenous communities with a rich cultural heritage extending to pre-Columbian times. Despite their historical significance, no population genetic studies have been conducted on this group, and population-specific databases are essential for accurate forensic applications. Methods: Allele frequencies for 23 autosomal short tandem repeat (STR) loci were determined in 100 unrelated Pech individuals (58 females, 42 males) from communities in the departments of Olancho, Colón, and Gracias a Dios. DNA was extracted from blood samples collected on FTA cards and amplified using the PowerPlex Fusion 6C System. Statistical parameters were calculated using Genepop v4.2 and Arlequin v5.3.2.2. Results: All loci exhibited substantial polymorphism. No statistically significant deviations from Hardy–Weinberg equilibrium were detected after Bonferroni correction (α = 0.0022). Expected heterozygosity ranged from 0.4033 (TH01) to 0.8563 (FGA). The combined power of discrimination exceeded 99.9999%, and the combined chance of exclusion was 99.9999%. Conclusions: This study presents the first genetic characterization of the Pech population, providing essential reference data for forensic identification, paternity testing, and population genetics research. The dataset fills a critical gap in the Honduran forensic genetic infrastructure and contributes to understanding indigenous Central American genetic diversity, enabling accurate forensic analyses for individuals of Pech ancestry in compliance with CODIS and ESS standards. Full article

Background/Objectives: Global estimates suggest that approximately 43% of individuals living with diabetes remain undiagnosed, underscoring the need for early identification of adults at high risk of type 2 diabetes mellitus (T2DM) to support timely preventive interventions. This scoping review aimed to map and summarize existing non-invasive screening tools for identifying adults at high risk of T2DM. Methods: PubMed (MEDLINE), Web of Science, ScienceDirect, and Scopus were searched in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR). Studies published between 1995 and 2026 that described screening tools for adult populations were included. Results: A total of 58 studies describing screening tools were identified. The tools were developed and applied across diverse populations and ethnic groups. Most were questionnaire-based, easy to administer, and low cost. Commonly included variables comprised demographic characteristics, anthropometric measures, lifestyle factors, and clinical indicators associated with increased T2DM risk. Substantial heterogeneity was observed in tool structure and reported predictive components. Conclusions: This scoping review provides an overview of available screening tools for the early identification of adults at high risk of T2DM. The mapped evidence may inform future validation studies and support context-specific implementation in public health and clinical practice settings, including integration into digital platforms. Full article

In the face of increasing pressure on agriculture and the effects of climate change, as well as the increasing popularity of Western foods, the enhancement of local food resources stands out as an essential strategy to strengthen food security and to slow down the erosion of traditions. Buprestid beetles are customarily consumed by some people in Togo, but these beetles remain poorly documented. This study explores the nutritional value of Buprestids consumed in Ecological Zone I of Togo. In total 630 individuals representing 7 ethnic groups from 14 localities, with 45 respondents in each, were interviewed. Buprestids were collected in the surveyed areas for identification, and specimens of Sternocera interrupta (Olivier, 1790) were specifically selected for biochemical analyses. Ash, amino and fatty acids, vitamins and fibre contents were determined using AOAC and AFNOR methods. Mineral content was determined by spectrophotometry; fatty acid composition by gas chromatography and amino acid composition by Biochrom 30+ analyzer. The results show that three species of Buprestids are still consumed in Togo, but that this practice is becoming increasingly rare among younger people. The decline can be attributed to a combination of ecological, sociocultural, and economic factors. The analysis of S. interrupta revealed the following composition (dry weight): 58.02 ± 0.18% protein, 6.63 ± 0.28% lipid, and 12.81 ± 0.49% fibre. From a micronutritional standpoint, the species is rich in vitamins and minerals, highlighting the need to conserve Buprestids for their nutritional value and role in food security amidst ecological transition, as well as their contribution to biodiversity. Full article

Background/Objectives: Lung cancer is one of the major causes of mortality worldwide despite breakthroughs in screening, diagnosis, and treatment. These advances have not been evenly spread, and discrepancies between populations remain concerning. This article examines lung cancer discrepancies in epidemiology, risk factors, screening, diagnosis, treatment access and quality, and survival outcomes, and identifies the main causes. Methods: An extensive narrative evaluation of peer-reviewed literature, national cancer surveillance reports, and large population-based research was searched. The evidence on lung cancer disparities by race, ethnicity, socioeconomic status, sex, geography, and healthcare access was synthesized. Disparities in prevention, early identification, treatment, and outcomes were organized into this paper. Results: Lung cancer incidence, stage, treatment, and survival showed persistent differences. Racial and ethnic minority groups, people on low-incomes, uninsured people, and rural or resource-limited people had higher disease burden and worse outcomes. Access to low-dose computed tomography screening, rapid diagnostic follow-up, surgical resection, molecular testing, targeted medicines, immunotherapy, palliative care, and clinical trials was unequal. When guidelines are followed, survival outcomes are similar across races and ethnicities. Conclusions: Lung cancer disparities are mostly caused by structural, social, and healthcare system factors, not biology. Coordinated measures to provide equitable screening, prompt and high-quality treatment, research inclusion, and culturally sensitive and policy-driven actions are needed to enhance lung cancer outcomes. Full article

Food insecurity (FI) may lead to lower academic achievement, yet college students with inadequate food underutilize campus food pantries. This research aimed to identify predictors of academic success among pantry shoppers (PSs) to inform outreach. Data from AY 2021–2022 (N = 847) and 2022–2023 (N = 951) were derived from swipes of student identification cards, merged with university student-provided data, and de-identified. Multiple regression, logistic regression, and Least Absolute Shrinkage and Selection Operator (LASSO) were employed to create and validate models using Machine Learning. Grade Point Averages (GPAs) were compared by two-sample t tests. The PSs demonstrated higher GPAs in the fall term than non-pantry shoppers (p = 0.04). Validation of the models indicated strong performance. Multiple regression yielded a low prediction error (0.05), and logistic regression achieved 71% accuracy (AUC = 0.776). LASSO identified positive predictors of academic success, including graduate and honors status, junior and senior classification, females, international residency, and frequency of pantry shopping. Negative predictors included part-time status, first-year status, Black or Hispanic ethnicity, and Pell Grant eligibility. Findings underscore the complex interplay between sociodemographic and academic factors that should be considered when planning pantry outreach programs and highlight the need for standardized measures of student pantry utilization, which may aid resource allocation and sustainability. Full article

This article addresses a key evidence gap in urban safety policy in Colombia: the absence of publicly accessible microdata that jointly measure victimization, perception of security, and probability of sanctions among socioeconomically vulnerable residents. It aims to provide a clean, linkable dataset that enables analysis of variations in these issues across demographic and territorial groups in Cali (recently classified as the 29th most dangerous city worldwide, with 1028 and 1065 homicides in 2024 and 2025, respectively). It reports face-to-face survey data collected from 22 July to 16 August 2024, at Sistema de Identificación de Potenciales Beneficiarios de Programas Sociales (SISBEN) service points. The final dataset includes 2139 adults (aged 18–95 years) and combines (i) primary responses on perceived safety (e.g., public space safety and surveillance cameras), perceived likelihood of sanction, victimization, and self-protection measures with (ii) selected sociodemographic and household characteristics drawn from SISBEN IV records. Individual-level linkage was implemented using respondent identification at interviews, yielding an integrated anonymized file suitable for replication and secondary analysis. The dataset enables distributive analyses of insecurity (e.g., by sex, age, and ethnicity—including Afro-descendant populations) within a policy-relevant target group and supports evaluation and targeting of local interventions by providing individual-level indicators. Full article

Research on men’s mental health points out gender differences in help-seeking and access to care. Traditional masculine norms (i.e., emotional repression, self-reliance, “being strong”) and gender bias might conceal distress, delay treatment, and help to explain higher burdens of addiction, violence, and suicide alongside lower recorded affective/anxiety diagnoses. An exploratory narrative review was conducted. PubMed, Scopus, and Web of Science were searched for 2015–2025 studies using MeSH and terms on men’s mental health, masculinities, and stigma. Eleven studies identified attitudinal barriers (i.e., self-stigma, shame, symptom minimization, mistrust, etc.) and structural barriers (i.e., limited tailored services, navigation difficulties, costs, bureaucracy, etc.) that delay identification of psychological distress symptoms, weaken therapeutic alliance, and increase dropout, especially when therapy is perceived as impersonal or ineffective. Intersectional factors (i.e., class, age, ethnicity) further contribute to access and they need to be included in the field of men’s mental health. Gender-sensitive approaches and alternative masculinity role models have the potential to enhance engagement and legitimize emotional experience. To sum up, hegemonic masculinity-related gender norms, acquired through gender-differentiated socialization, are associated with adverse mental health outcomes among men. A lack of gender-sensitive awareness campaigns to reduce stigma around men’s mental health may hinder prevention, delaying early identification and timely intervention. Therefore, men’s mental health care should integrate gender and intersectionality transversally to improve prevention, access, diagnosis, treatment, adherence, and outcomes, supported by professional training and tailored therapeutic tools in clinical routine practice. These findings underscore the need to promote healthier, more egalitarian masculinities and to deconstruct stigmas associated with help-seeking and mental health service. Full article

Background: Breast cancer remains a leading cause of morbidity and mortality among women in Latin America. Mammography is the most effective population-based tool for early detection; however, its impact is limited by persistent social, geographic, and structural inequities. Evidence from the region indicates that ethnicity, rural residence, and health system organization play a central role in shaping unequal access to screening services. Methods: We conducted a narrative review informed by a systematic search strategy, following PRISMA 2020 recommendations. Searches were performed in 17 international and regional databases in English and Spanish, covering publications from 2015 to 2025. Eligible studies included non-interventional quantitative designs reporting mammography access, utilization, or coverage among women residing in Latin American countries. Three reviewers independently screened records, extracted data, and classified determinants of inequality into sociodemographic, geographic, and health-system domains. Results: Of 532 records identified, 12 studies met the inclusion criteria, primarily from Mexico, Brazil, Peru, and Chile. Most analyses were based on nationally representative surveys. Mammography coverage ranged from approximately 20% to 60%, with consistently lower uptake among Indigenous women, rural populations, and women without health insurance. Reduced screening was associated with low educational attainment, socioeconomic disadvantages, rural residence, ethnic self-identification, and fragmented health system affiliation. Structural barriers, including concentration of diagnostic infrastructure in urban areas, reliance on opportunistic screening models, and limited capacity for systematic follow-up, were recurrent across countries. Conclusions: Inequities in mammography access and utilization in Latin America reflect deeply rooted social and structural determinants rather than a lack of screening technology alone. Reducing preventable breast cancer mortality requires strengthening organized, population-based screening programs, decentralizing diagnostic services, improving continuity of care, and implementing culturally appropriate strategies tailored to Indigenous, rural, and uninsured populations. Full article

Ethnic identity is a central psychological construct that shapes social perception, intergroup behavior, and everyday decision making, yet its influence on support for minority-owned businesses remains insufficiently understood. This research examines how variations in ethnic identification predict consumer preferences, evaluations, and loyalty, and whether these effects depend on product involvement. Two empirical studies were conducted among members of an ethnocultural minority group. Study 1 assessed preferences for minority versus majority-owned businesses across four purchase scenarios differing in involvement level. The findings show that ethnic identity predicts supportive choices primarily in low-involvement contexts: individuals with stronger ethnic identification were more likely to prefer minority-owned supermarkets, and indicators of cultural attachment predicted preference for minority-owned restaurants. No identity effects emerged in high involvement decisions, where utilitarian considerations dominated. Study 2 examined whether ethnic identity predicts store evaluations and loyalty toward a minority-owned retail chain. Across both involvement conditions, stronger ethnic identification was associated with more positive store evaluations, greater perceived value, higher fairness assessments, and stronger loyalty intentions, while product involvement and its interaction with identity were nonsignificant. Together, the results demonstrate that ethnic identification meaningfully shapes consumer support for minority enterprises and clarify the conditions under which identity-based processes guide marketplace behavior. Full article

Background/Objectives: Gestational exposure to substances (GES) is associated with adverse developmental outcomes. Early identification is limited by reliance on self-reported data. This study assessed the incidence and predictors of discordance in GES reporting between birth certificates and Medicaid claims among Medicaid-covered births in Nevada from 2022 to 2024. Methods: A statewide, hospital-clustered, cross-sectional analysis was conducted using linked Medicaid billing and birth record data. Discordance was defined as GES identified in one source but not the other. Incidence per 1000 live births was stratified by demographic characteristics. Multilevel logistic regression assessed patient- and hospital-level predictors, with random hospital intercepts. Results: Among 50,394 live births, the discordance rate was 95.09 per 1000 (95% Confidence Interval: 92.5–97.7). Substantial disparities were observed by race/ethnicity, socioeconomic status, and geography, with higher discordance among White non-Hispanic mothers, those residing in rural or frontier counties, and individuals with lower educational attainment or living in lower-income areas. Modest but meaningful variation was also observed across hospitals, including differences by hospital size and teaching or research status. Conclusions: Findings highlight substantial discordance in GES reporting and underscore the limitations of single-source surveillance. Findings also have clear policy relevance, indicating that improved cross-system data integration would strengthen statewide surveillance, enhance early detection, and support more equitable resource allocation and intervention strategies. Full article

Background: Stage B heart failure (SBHF) increases the risk of symptomatic HF. Current guideline criteria for SBHF lack sex and ethnic thresholding and cardiac magnetic resonance (CMR) imaging cut-offs. We aimed to assess the prevalence of SBHF in a large cohort of people with type 2 diabetes (T2D) and healthy controls and propose a refined CMR definition for SBHF. Methods: Sex- and ethnic-specific thresholds for imaging criteria were derived from 373 healthy controls, who underwent CMR cine imaging. The current definition for SBHF and refined criteria was applied to our prospectively recruited and intensively phenotyped cohort of asymptomatic people with T2D and no evidence of cardiovascular disease. The prevalence of SBHF by different definitions was calculated and patient characteristics, including exercise capacity, were compared between those classified as Stage A vs. B HF. Finally, the refined criteria were also applied to the following two historical cohorts with symptomatic cardiovascular disease: severe aortic stenosis (AS n = 70) and HF with preserved ejection fraction (HFpEF n = 136). Results: A total of 423 people with T2D and a subset of 102 healthy controls who underwent echocardiography were prospectively recruited. Current guideline criteria classified 91% of those with T2D and 69% of the healthy controls as SBHF, suggesting a lack of specificity. Applying derived sex- and ethnicity-specific thresholds, combining echo and CMR measures, the prevalence of SBHF was reduced to 30% in those with T2D. Using the refined definition, those with Stage B HF had lower exercise capacity than those with Stage A HF (percentage predicted maximal oxygen consumption 81 ± 16% vs. 91 ± 20%, p < 0.001). Applying the refined definition to symptomatic AS and HFpEF participants classified 89% and 85% with abnormal cardiac remodelling. Conclusion: Current guideline criteria for SBHF are non-specific and likely of limited value in clinical practice. Refining these criteria with sex- and ethnic-specific thresholds may improve identification of those at risk of developing symptomatic disease. Further research is required to validate these criteria. Full article