Search Results (6,158)

Background/Objectives: Racial and ethnic disparities in cesarean birth and labor management persist in the United States, including among individuals considered low risk. Understanding variation in labor progression and cesarean indications within low-risk nulliparous, term, singleton, vertex (NTSV) births may help clarify potential contributors to inequities. This study examined differences in cesarean rates, cesarean indications, and labor duration by race and ethnicity in a low-risk NTSV cohort. Methods: We conducted a retrospective secondary analysis of electronic medical record data from 13,231 low-risk NTSV births within a Midwestern academic health system. Multivariable logistic regression models were used to evaluate the likelihood of cesarean birth and cesarean indications by race and ethnicity, adjusting for maternal age, gestational age, body mass index, insurance type, and labor onset. Linear regression models examined differences in first-stage, second-stage, and total labor duration. Interaction terms assessed whether associations varied by labor onset. Results: The overall cesarean rate was 29%. Absolute cesarean rates were higher among non-Hispanic Black and Hispanic individuals compared with non-Hispanic White individuals; however, these differences were not statistically significant after adjustment. Labor duration differed significantly by race and ethnicity. Non-Hispanic Black and Hispanic individuals experienced longer median first-stage and total labor durations compared with non-Hispanic White individuals; however, second-stage duration was markedly shorter among non-Hispanic Black individuals. Among induced labors resulting in cesarean birth, non-Hispanic Black and Hispanic individuals had increased odds of cesarean for early arrest of dilation, although these findings should be interpreted as hypothesis-generating, given data limitations in labor onset documentation. Body mass index was positively associated with likelihood of cesarean. Conclusions: In this low-risk NTSV cohort, adjusted cesarean rates did not differ significantly by race or ethnicity; however, differences in labor duration and cesarean indication were observed. These findings underscore the importance of continued investigation into labor management practices and structural contributors to obstetric inequities. Full article

Physical exercise represents a physiological stressor capable of activating the acute-phase response (APR) in horses. However, the relative contribution of exercise intensity versus duration to acute-phase protein (APP) dynamics remains incompletely defined. This study compared the effects of short, high-intensity gallop exercise (2400 m flat race; n = 12) and prolonged, low-intensity endurance exercise (40 km; n = 13) on serum amyloid A (SAA), haptoglobin (Hp), and ceruloplasmin (Cp) in Thoroughbred racehorses. Blood samples were collected before exercise and at defined post-exercise time points. Between-group comparisons were performed at shared time points (72 h and 96 h post-exercise) using mixed-effects modeling and effect size analysis. The significant Group × Time interaction for SAA indicates that exercise duration plays a key role in determining the magnitude and persistence of the late-phase systemic inflammatory response. Serum amyloid A emerged as the most sensitive biomarker of cumulative physiological stress following prolonged exercise. These findings support the use of SAA monitoring during recovery to assist training management in equine athletes. Because early post-exercise sampling was not performed in the gallop group, conclusions primarily reflect differences in late-phase (72–96 h) APP kinetics. Full article

Social categorization often occurs automatically, shaping whom we notice, remember, and group together. The present study examined how visual cues indicative of sex, race, and facial anomaly guide spontaneous categorization, testing the hypothesis that anomaly-based categorization is more malleable than categorization by race or sex. Using a within-subjects Who-Said-What (WSW) paradigm, participants viewed faces that varied by sex, race, and presence of a facial scar, each paired with self-descriptive statements. A surprise recall task required matching statements to faces. Categorization strength was computed from recall errors. Participants showed the strongest categorization by sex, weak categorization by race, and very weak categorization by facial anomaly. Regression analyses revealed that scar-based categorization was negatively associated with sex- and race-based categorization. When sex or race was strongly encoded, scar-based categorization was sharply diminished, and the cue appeared only under relatively weak and infrequent conditions. Thus, although visually salient, facial anomalies did not function as an independent or stable basis for social grouping. These findings demonstrate that the categorization system prioritizes evolutionarily primary cues such as sex, treats race as a comparatively weaker cue, and assigns facial anomalies to a minimal and malleable role. Overall, the results highlight the fragile, low-priority, and easily overshadowed nature of anomaly-based categorization in social memory. Importantly, the fragility of scar-based categorization suggests that negative evaluations of anomalous faces (anomalous-is-bad stereotyping) are not automatically translated into robust memories or categorical organization. Full article

There are limited data on sequential computed tomographic (CT) evaluation and objective CT assessment of the metacarpal condyles in Thoroughbred racehorses. This longitudinal study aimed to document changes in attenuation of the metacarpal condyles during the first two years of training and racing. Fan-beam CT examination of the metacarpophalangeal regions was performed on 40 non-lame Thoroughbred yearlings, and repeated four more times, approximately six months apart. Mean Hounsfield Unit (HU) measurements were obtained on sagittal reconstructions of the dorsal and palmar halves of the medial and lateral condyles and parasagittal grooves. One-way ANOVA with a post hoc Tukey’s Test was used to investigate differences between mean HU values over time at the different regions of interest. Multivariable mixed-effects linear regression models assessed the association between dorsal and palmar HU and potential explanatory variables. Mean HU increased significantly with training, especially during the first six months, with a maximal sequential mean increase found in the medial parasagittal groove (119.8 [95% confidence interval 85.3, 154.30], p < 0.001). Dorsal regions had higher HU than palmar regions, with the highest HU recorded in the dorsal aspect of the medial condyle at time 3 (mean HU 1120.1 ± 63.4). Condyles had higher HU than parasagittal grooves (p < 0.001), the palmar half of the right condyles had higher HU than the left (p = 0.045) and the dorsal aspect of the medial condyle had higher HU than the lateral (p < 0.001). An increasing number of race starts and higher body weight:height ratio were associated with higher HU (p < 0.001). The main limitation was the loss of horses to follow-up as the study progressed. In conclusion, density of most regions of the metacarpal condyles increased with time spent in training, reflecting adaption to racehorse training. Full article

Background: Timely treatment is critical for patients with bone and soft tissue tumors, but access to care may not be equitable across all populations. While treatment delays have been well studied in other cancers, disparities in time to treatment remain underexplored in orthopaedic oncology. This study aimed to determine whether racial or ethnic disparities exist in the timing of surgery, chemotherapy, or radiation for patients with sarcoma or metastatic bone disease. Methods: A retrospective cohort study was conducted using the TriNetX US Collaborative Network, a multi-institutional electronic health record database. Adult patients undergoing biopsy and subsequently diagnosed with bone sarcoma, soft tissue sarcoma, or metastatic bone disease were identified. Time to treatment was defined as the number of days between biopsy and the first recorded surgery, chemotherapy, or radiation. Patients were stratified by race and ethnicity, and statistical comparisons were performed using Mann–Whitney U tests and t-tests. Results: A total of 63,087 patients met inclusion criteria (55,697 with metastatic bone disease/bone sarcoma and 7390 with soft tissue sarcoma). In the metastatic/bone sarcoma cohort, Hispanic patients had shorter mean time to resection (58 ± 94 vs. 82 ± 239 days, p = 0.008) and fixation (35 ± 142 vs. 72 ± 315 days, p < 0.001) compared to non-Hispanic patients, although median times did not differ significantly. Among black patients, time to fixation was shorter than in White patients (mean 22 ± 103 vs. 114 ± 468 days, p < 0.001; median 0 days in both groups), while delays were observed in time to radiation (median 13 vs. 7 days; mean 85 ± 284 vs. 43 ± 203 days, p < 0.001). In the soft tissue sarcoma cohort, Black patients experienced longer mean times to resection (142 ± 293 vs. 79 ± 216 days) and radiation (141 ± 514 vs. 96 ± 364 days), though comparisons were limited by sample size. Conclusions: This large, multi-institutional study demonstrates that disparities in orthopaedic oncology differ by treatment modality and clinical context. Shorter wait times to surgery among Hispanic and Black patients in metastatic disease likely reflect more advanced disease presentation and barriers to early access, whereas delays in resection and radiation highlight inequities in accessing non-emergent, coordinated oncologic care. Reporting both means and medians provides a more complex understanding of treatment delays and underscores the need for interventions that expand early access to orthopaedic oncologists and ensure timely, equitable care. Full article

A recent study of World Trade Center Health Registry enrollees found that about one- third experienced post-traumatic growth (PTG) in the wake of the 9/11 attacks and that PTG was associated with social support and social integration. However, the implications of PTG for the enrollees’ overall quality of life are unknown. The present study investigated the prevalence of PTG and its association with the SF-12 physical and mental function quality of life scales in a sample of 2786 enrollees from the Registry’s Health and Quality of Life Study (HQoL) who completed the first four surveys, were older than 18 on 9/11, reported English as their primary spoken language, and provided consistent self-report of 9/11 physical injury at the Registry’s baseline and HQoL surveys. We employed multivariable linear regression to evaluate the association between PTG and the SF-12 physical and mental scales, controlling for sex, age, race, education, income, employment, social support, threatening events, post-9/11 mental health, number of post-9/11 physical health conditions, and drug/alcohol misuse. We found that 31% of the sample enrollees experienced PTG and that PTG exhibited a clinically and statistically significant association with the SF-12 mental scale but not the physical scale (physical: β = −0.01 (−0.61, 0.65), mental: β = 3.92 (2.89, 4.95)). Those who were physically injured during 9/11 showed larger improvements in mental function than those who were not. PTG has implications for the overall mental quality of life that should be further investigated. Full article

Telework has expanded rapidly, yet its determinants and temporal dynamics remain insufficiently documented in developing countries. This study examines the evolution of telework in Brazil from 2022 to 2025 using machine learning models applied to nationally representative microdata from the Continuous National Household Sample Survey, based on approximately 210,000 households per reference period. A standardized pipeline was implemented across four time windows, including preprocessing, missing-data handling, class balancing via random under-sampling, feature encoding and normalization, and stratified data splitting with 5-fold cross-validation. Nine classification algorithms were evaluated and hyperparameter-tuned using ANOVA racing, with model performance assessed primarily through the ROC AUC metric. The results indicate consistently high discriminative performance across all analyzed periods (ROC AUC > 0.80). The temporal evaluation further reveals overlapping confidence intervals among the predictive models, indicating statistically comparable performance over time and no evidence of a universally dominant algorithm. Variable-importance analyses show that the set of the eight most relevant predictors remained stable, although their relative rankings changed, with gender increasing in importance in the most recent periods. Overall, telework in Brazil is jointly shaped by sociodemographic and occupational factors, highlighting its selective nature and the relevance of temporal monitoring to inform research and policy. Full article

Background/Objectives: People with mobility limitations face disproportionately high rates of chronic health conditions and demonstrate lower adherence to wellness interventions. Digital programs such as MENTOR offer accessible alternatives but often face high rates of attrition. This study applied machine learning (ML) methods to predict adherence to the eight-week MENTOR telewellness program and identify key predictors of participant attendance. Methods: Data were drawn from 1218 adults enrolled in MENTOR (2023–2024). Adherence was defined as the percentage of 40 sessions attended. Baseline demographic, socioeconomic, psychosocial, mindfulness, resilience, health status, and physical activity variables were included as predictors. Following preprocessing and imputation, 13 ML regression models were trained using an 80/20 train–test split. The best-performing model was identified using mean absolute error (MAE), followed by feature selection and SHAP interpretability analyses. Pairwise synergy analysis quantified interactions between top predictors. Results: Model performance was modest overall. Bayesian ridge regression achieved the best performance (MAE 20.98; RMSE 25.26; R² = 0.12). SHAP analyses revealed that education, race, emotional support, Area Deprivation Index, household size, mindfulness, life satisfaction, and disability onset were the strongest predictors of adherence. Higher emotional support, mindfulness, and life satisfaction were associated with greater adherence, while socioeconomic disadvantage predicted lower adherence. Synergy analyses showed the strongest predictive interactions between low education and psychosocial resources (emotional support and life satisfaction). Conclusions: Baseline characteristics alone modestly predicted adherence to a digital wellness program. However, psychosocial and socioeconomic factors emerged as meaningful predictors, underscoring the need for personalized support strategies to reduce dropout among participants with mobility limitations. Full article

This study aimed to investigate the relationship between water intake and post-race gastrointestinal illness in triathletes. Following a post-event survey approach, we evaluated the association between water intake and gastrointestinal illness in triathletes. We collected data among participants of six different triathlons in the Netherlands using an online questionnaire about personal characteristics (age, sex, swimming experience, chronic illness, and athletic level), the completed triathlon (length and duration), water intake, and illnesses during the 7 days following the triathlon. The associations between water intake and gastrointestinal illness were analyzed using generalized estimating equations logistic regression. In total, 1294 athletes participated in this study. The average rate of gastrointestinal illnesses per triathlon was 5.1%. In total, 75.3% of the athletes reported water intake during the race. The associations between water intake and gastrointestinal illnesses were significant. Triathletes with one to three sips of water intake reported 3.7 times more gastrointestinal illnesses (OR = 3.672, 95%CI: 1.316–10.242, p = 0.013) compared to those who did not ingest water. Triathletes with four or more sips of water intake reported 5.1 times more gastrointestinal illnesses (OR = 5.070, 95%CI: 1.740–14.767, p = 0.003). In conclusion, water intake was associated with an increased risk of post-race gastrointestinal illness. The results advocate for improved water quality monitoring and preventive measures in triathlon. Full article

Social capital has been well established to have beneficial effects on a variety of behavioral, developmental, and health outcomes across the life course. In particular, social capital has been proven to be a protective factor benefiting health, particularly among young people. However, we know little about whether or how social capital might provide a protective effect against a very specific mental health challenge of young and mid-adult life: experiencing postpartum depression. Using linear regression models and restricted-use data from the National Study of Adolescent to Adult Health (five waves conducted beginning in 1995 when respondents were in grades 7–12 and following them into adulthood) on women who gave birth during early adulthood, and controlling for a variety of demographic factors (such as race, parental and partner social capital, SES), we aim to understand potential associations between social capital derived from families and romantic partners and postpartum depression symptomology. Our findings suggest the need for approaches that help pregnant women build and maintain key social connections and resources with fathers and partners. Full article

Background: Hydration and electrolyte strategies are critical in mountain ultra-endurance events, yet field-based evidence from trail races remains limited. This study examined the relationship between fluid intake, sodium consumption, and body mass changes in trail runners competing under real environmental conditions. Methods: A cross-sectional field study was conducted during La Misión Brasil 2024. Athletes of both sexes competing in the endurance race (35 km; EG: n = 15; age = 37.0 [29.5–46.0] years; 12 men and 3 women) and the ultra-endurance race (80 km; UEG: n = 13; age = 42.0 [37.0–46.0] years; 11 men and 2 women) were included in the study. Pre- and post-race body mass were assessed, and in-race fluid and food intake were collected using an adapted 24-h dietary recall. Water and sodium intake were expressed as total (L and mg, respectively) and per-hour (mL/h and mg/h, respectively) values. Environmental temperature and humidity were obtained from a local weather station. Group comparisons were performed using the Mann–Whitney U test, and associations were examined with Spearman’s correlation (p < 0.05). Results: EG (n = 15) and UEG (n = 13) showed similar absolute and relative body mass changes (2.6% to −3.0%; p > 0.05). EG runners presented greater weight loss rate (−270 vs. −115 g/h; p = 0.002), while UEG consumed higher total water (7.11 vs. 4.14 L; p = 0.008) and sodium (5789 vs. 2857 mg; p = 0.003). Water intake per hour was higher in EG (626 vs. 427 mL/h; p = 0.017). Body Mass Index was negatively correlated with hourly weight loss (r = −0.605; p < 0.001). Water and sodium intake per hour were positively correlated (r = 0.607; p < 0.001), though neither predicted hourly weight loss. Conclusions: Hydration responses may differ according to environmental stress and pacing demands. Changes in body mass may not necessarily reflect hydration adequacy, suggesting a possible multifactorial nature of hydroelectrolyte balance during mountain endurance events. Full article

Background: Pulse oximetry is widely used to estimate arterial oxygen saturation, yet accuracy may vary for a number of reasons. Data on children with functionally univentricular circulation are limited. The primary aim of this study was to evaluate the agreement between arterial oxygen saturation measured by blood gas and pulse oximetry in children with functionally univentricular circulations. Methods: A retrospective analysis was performed of paired arterial blood gas and pulse oximetry oxygen saturation measurements following Norwood, Glenn, or Fontan procedures. Signed difference was defined as arterial oxygen saturation by blood gas—arterial oxygen saturation by pulse oximetry. Bland–Altman analyses, multivariable regressions, and generalized additive modeling were performed. Results: Mean bias was −4.9 percentage points, indicating pulse oximetry overestimated arterial saturation. The 95% limits of agreement were wide, from −20.7 to 10.8. The agreement was similar in Black and White patients. Fontan physiology demonstrated reduced overestimation by pulse oximetry by multivariable regression. Nonlinear modeling demonstrated more bias in agreement at lower arterial oxygen saturation levels, with arterial oxygen saturation levels explaining 50% of the variance. Conclusions: In functionally univentricular patients, pulse oximetry using the Nellcor MAXN-NS pulse oximeter (Medtronic, Dublin, Ireland) systematically overestimates arterial saturation, particularly in the setting of hypoxemia. Saturation level, rather than race, was the dominant determinant of bias. Full article

Grounded in a Critical Race Theory framework, this study explores the racial microaggressions experienced by Faculty of Color at one four-year university in California during what Bell would call a “peak of progress” for racial justice—where equity and inclusivity took center stage in the institutional agenda. We engaged a Critical Race Feminista Methodology, using group pláticas to gather stories of Faculty of Color from diverse racial and generational backgrounds to understand how they experienced everyday racism within the context of racial realism—the acknowledgement of the permanence of racism in U.S. society. Our findings revealed that despite the institutional focus on equity, Faculty of Color experiences with racial microaggressions were connected by threaded histories of imposed racial hierarchies, marginalization, and structural inequities. Faculty of Color across age, gender, and rank described the everyday racism that impacted academic trajectories and personal lives across time, from the late 1990s for the most senior faculty to the present for the most junior. However, we also found that faculty responded to those microaggressions through racial microaffirmations—the everyday ways People of Color affirm each other’s dignity, integrity, and shared humanity that make them feel seen and supported. Indeed, we found that Faculty of Color engaged powerful strategies of racial microaffirmations with each other across generations that supported their well-being and their careers. Full article

The common bean (Phaseolus vulgaris L.) cultivar Jalo Vermelho carries the Co-12 gene, which confers resistance to both Andean and Mesoamerican races of Colletotrichum lindemuthianum. Despite its importance for breeding programs, the genomic location and candidate genes underlying this resistance remain poorly defined. The Co-12 locus was fine-mapped using a biparental population derived from the cross Jalo Vermelho × Crioulo 159. A total of 172 F₂ plants were used to generate 172 F_2:3 families, which were phenotyped after inoculation with race 1545 of C. lindemuthianum. Segregation analysis confirmed a 1:2:1 Mendelian ratio, consistent with a single dominant resistance gene. Genotyping of resistant and susceptible plants using the BARBean6K_3 Illumina BeadChip (5398 SNP markers) mapped Co-12 to chromosome Pv04, between 1695 bp (ss715649768) and 9,651,954 bp (ss715646644). Subsequent fine mapping with simple sequence repeat (SSR) markers delimited the locus to a 41 kb genomic interval flanked by BARCPVSSR04557 and BARCPVSSR04570. Within this region, three candidate genes were identified, including one encoding a gamma-glutamyl-GABA enzyme and two encoding lipid transfer proteins (LTP2). Lipid transfer proteins are widely recognized components of plant defense; however, their association with anthracnose resistance in the common bean has not been previously reported. The identification of LTP2 genes within the Co-12 interval suggests a previously unrecognized resistance mechanism and expands the current understanding of host defense pathways in Phaseolus vulgaris. The markers identified here provide valuable tools for marker-assisted selection and will facilitate efficient introgression of Co-12 into common bean cultivars. Full article

Background: We aimed to (i) identify the factors associated with performance in non-elite runners, (ii) present the terms and definitions/attributes used to characterize runners, and (iii) identify how performance has been operationalized. Methods: Our search was conducted using the databases PubMed, Web of Science, Medline Ovid, Cochrane, PsycInfo, Scielo, Scopus, and SportDiscus in October 2023 and updated in February 2026. Original articles that assessed factors associated with performance in non-elite runners competing in distances ranging from 5 km to ultramarathons were included. The findings were summarized by race distance. The Joanna Briggs Institute Analytical Cross-Sectional Studies critical appraisal tool was used for quality assessment. Results: A total of 4151 studies were identified, and 66 studies were included in the final selection. “Recreational” and “athletes” were the most used terms, and finish time was the most common indicator of performance. Performance decline was influenced by arm circumference and mid-axillary skinfold thickness, smoking, body mass index, alcohol consumption, and weather characteristics. Training variables, physiological determinants, and social variables were positively related to performance. Conclusions: The field struggles with a lack of clarity regarding the nomenclature and criteria used to categorize runners. The relevance of a predictor differs according to race distance, with physiological aspects becoming less important at higher distances (i.e., marathon and ultramarathon). Full article