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Search Results (542)

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18 pages, 955 KiB  
Article
Unequal Burdens: Exploring Racial Disparities in Cardiovascular and SLE Outcomes Using National Inpatient Database 2016–2021
by Freya Shah, Siddharth Pravin Agrawal, Darshilkumar Maheta, Jatin Thukral and Syeda Sayeed
Rheumato 2025, 5(3), 10; https://doi.org/10.3390/rheumato5030010 - 30 Jul 2025
Viewed by 291
Abstract
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 [...] Read more.
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
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26 pages, 333 KiB  
Article
Financial Discrimination: Consumer Perceptions and Reactions
by Miranda Reiter, Di Qing, Kenneth White and Morgen Nations
Int. J. Financial Stud. 2025, 13(3), 136; https://doi.org/10.3390/ijfs13030136 - 24 Jul 2025
Viewed by 320
Abstract
Access to traditional financial institutions plays a key role in enhancing positive financial outcomes. However, some consumers within the United States experience discrimination from these same institutions. In particular, discrimination based on race and gender has historically been tied to outcomes such as [...] Read more.
Access to traditional financial institutions plays a key role in enhancing positive financial outcomes. However, some consumers within the United States experience discrimination from these same institutions. In particular, discrimination based on race and gender has historically been tied to outcomes such as lower service quality and a lack of access to credit. While the previous literature has discussed some of the discriminatory practices that these groups have faced, there is a lack of research on how these groups respond to discrimination from financial institutions. Through a series of logistic regressions, the authors analyzed how race, ethnicity, and gender are related to reporting experiences of discrimination. The authors then explored how consumers react to discrimination by looking at five reported reactions. Primary results show that Black consumers were more likely than most other racial groups to experience financial discrimination. Additionally, women were less likely than men to report financial discrimination. Race was shown to be a significant factor in four of the five reactions to discrimination, while gender was a factor in two of the reactions. The findings further show that after experiencing financial discrimination, most individuals turned to non-traditional financial services as a direct result of the bias or racism. Full article
18 pages, 346 KiB  
Article
Stereotyped L1 English Speakers: Attitude of US Southerners Toward L2-Accented English
by Romy Ghanem, Yongzhi Miao, Shima Farhesh and Emil Ubaldo
Languages 2025, 10(8), 178; https://doi.org/10.3390/languages10080178 - 23 Jul 2025
Viewed by 342
Abstract
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 [...] Read more.
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
(This article belongs to the Special Issue L2 Speech Perception and Production in the Globalized World)
18 pages, 1420 KiB  
Review
Unequal Gains? A Literature Review on the Affordable Care Act’s Effects on Healthcare Utilization Across Racial and Ethnic Groups
by Ahmad Reshad Osmani
Int. J. Environ. Res. Public Health 2025, 22(7), 1059; https://doi.org/10.3390/ijerph22071059 - 2 Jul 2025
Viewed by 634
Abstract
The Affordable Care Act (ACA), implemented in 2010, aimed to expand healthcare access, reduce costs, and address long-standing disparities in the U.S. healthcare system, particularly among racial and ethnic minorities. This paper reviews the ACA’s impact on healthcare utilization for these populations, with [...] Read more.
The Affordable Care Act (ACA), implemented in 2010, aimed to expand healthcare access, reduce costs, and address long-standing disparities in the U.S. healthcare system, particularly among racial and ethnic minorities. This paper reviews the ACA’s impact on healthcare utilization for these populations, with a focus on insurance coverage, preventive services, and health outcomes. While Medicaid expansion significantly reduced uninsured rates and increased access to care in states that adopted the expansion, millions of low-income individuals, many of whom are racial and ethnic minorities, remain uninsured in non-expansion states. The elimination of cost-sharing for preventive services under the ACA contributed to increased utilization of cancer screenings, vaccinations, and other preventive measures among minority groups. However, challenges persist, including affordability barriers, geographic disparities, and cultural and linguistic obstacles. This review also highlights the ongoing need for policy interventions, such as nationwide Medicaid expansion, and future research on the long-term effects of the ACA on health outcomes for minority populations. Full article
(This article belongs to the Section Global Health)
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20 pages, 336 KiB  
Review
End-of-Life Cancer Care Interventions for Racially and Ethnically Diverse Populations in the USA: A Scoping Review
by Carolyn J. Yee, Aashritha Penumudi, Terri Lewinson and Inas S. Khayal
Cancers 2025, 17(13), 2209; https://doi.org/10.3390/cancers17132209 - 1 Jul 2025
Viewed by 483
Abstract
Introduction: Racial and ethnic disparities in end-of-life (EOL) cancer care persist, leading to lower rates of advance care planning (ACP), reduced access to palliative care, and poorer patient outcomes for minority populations. While previous research has documented these inequities, less is known [...] Read more.
Introduction: Racial and ethnic disparities in end-of-life (EOL) cancer care persist, leading to lower rates of advance care planning (ACP), reduced access to palliative care, and poorer patient outcomes for minority populations. While previous research has documented these inequities, less is known about the specific interventions developed to address them, necessitating a comprehensive review of existing strategies aimed at improving EOL care for racial and ethnic populations. The objective of this scoping review is to examine the extent and characteristics of interventions and their outcomes designed to address racial and ethnic disparities in EOL cancer care in the United States. Methods: A comprehensive search of EOL cancer care interventions for minority populations was conducted in Ovid MEDLINE, CINAHL with Full Text (EBSCOhost), and Scopus (Elsevier) in September 2024. Two independent reviewers screened titles, abstracts, and full texts following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with inclusion limited to studies conducted in the US and published in English. Results: Of 3104 screened studies, 10 met the inclusion criteria. Participants enrolled were only from Latino (n = 6 studies) or Black (n = 4 studies) populations. We identified four types of interventions, including communication skills for patients, caregivers, researchers, and clinicians (n = 2), education programs for patients (n = 1), navigation and support programs for patients and caregivers (n = 3), and training programs for health workers and community leaders (n = 4). The most effective interventions were those that addressed linguistic barriers, integrated cultural values, and involved trusted community figures. Faith-based models were particularly successful among African American patients, while bilingual navigation and family-centered ACP interventions had the greatest impact in Latino populations. Conclusions: This review highlights (1) the importance of culturally tailored interventions for specific minority populations and (2) the limited number of such interventions, which primarily target only the largest minority groups. Full article
(This article belongs to the Special Issue The Impact of Community Context and Cancer Disparities)
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20 pages, 433 KiB  
Review
Mental Health Impacts of the COVID-19 Pandemic on College Students: A Literature Review with Emphasis on Vulnerable and Minority Populations
by Anna-Koralia Sakaretsanou, Maria Bakola, Taxiarchoula Chatzeli, Georgios Charalambous and Eleni Jelastopulu
Healthcare 2025, 13(13), 1572; https://doi.org/10.3390/healthcare13131572 - 30 Jun 2025
Viewed by 498
Abstract
The COVID-19 pandemic significantly disrupted higher education worldwide, imposing strict isolation measures, transitioning learning online, and exacerbating existing social and economic inequalities. This literature review examines the pandemic’s impact on the mental health of college students, with a focus on those belonging to [...] Read more.
The COVID-19 pandemic significantly disrupted higher education worldwide, imposing strict isolation measures, transitioning learning online, and exacerbating existing social and economic inequalities. This literature review examines the pandemic’s impact on the mental health of college students, with a focus on those belonging to minority groups, including racial, ethnic, migrant, gender, sexuality-based, and low-income populations. While elevated levels of anxiety, depression, and loneliness were observed across all students, findings indicate that LGBTQ+ and low-income students faced the highest levels of psychological distress, due to compounded stressors such as family rejection, unsafe home environments, and financial insecurity. Racial and ethnic minority students reported increased experiences of discrimination and reduced access to culturally competent mental healthcare. International and migrant students were disproportionately affected by travel restrictions, legal uncertainties, and social disconnection. These disparities underscore the need for higher education institutions to implement targeted, inclusive mental health policies that account for the unique needs of at-risk student populations during health crises. Full article
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24 pages, 312 KiB  
Article
Social Ecological Influences on HPV Vaccination Among Cape Verdean Immigrants in the U. S.: A Qualitative Study
by Ana Cristina Lindsay, Celestina V. Antunes, Aysha G. Pires, Monica Pereira and Denise L. Nogueira
Vaccines 2025, 13(7), 713; https://doi.org/10.3390/vaccines13070713 - 30 Jun 2025
Viewed by 411
Abstract
Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (U.S.) and a major contributor to several cancers, including cervical, anal, penile, and oropharyngeal cancers. Although a safe and effective vaccine is available, HPV vaccination rates remain suboptimal, [...] Read more.
Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (U.S.) and a major contributor to several cancers, including cervical, anal, penile, and oropharyngeal cancers. Although a safe and effective vaccine is available, HPV vaccination rates remain suboptimal, particularly among racial, ethnic, and immigrant minority groups. This study explored multiple factors, such as cultural, social, and structural influences, influencing HPV vaccine decision-making among Cape Verdean immigrant parents in the U.S., a population currently underrepresented in HPV research. Methods: Qualitative study using individual, in-depth interviews with Cape Verdean immigrant parents of children aged 11 to 17 years living in the U.S. Interviews were transcribed verbatim and analyzed thematically using the social ecological model (SEM) to identify barriers and facilitators at the intrapersonal, interpersonal, organizational, community, and policy levels. Results: Forty-five Cape Verdean parents (27 mothers, 18 fathers) participated. Fathers were significantly older than mothers (50.0 vs. 41.1 years, p = 0.05). Most were married or partnered (60%), had at least a high school education (84.4%), and reported annual household incomes of US$50,000 or more (66.7%), with no significant gender differences. Nearly all spoke Creole at home (95.6%). Fathers had lower acculturation than mothers (p = 0.05), reflecting less adaptation to U.S. norms and language use. Most parents had limited knowledge of HPV and the vaccine, with gendered beliefs and misconceptions about risk. Only seven mothers (25.9%) reported receiving a provider recommendation; all indicated that their children had initiated vaccination (1 dose or more). Mothers were the primary decision-makers, though joint decision-making was common. Trust in providers was high, but poor communication and the lack of culturally and linguistically appropriate materials limited informed decision-making. Stigma, misinformation, and cultural taboos restricted open dialogue. Trusted sources of information included schools, churches, and Cape Verdean organizations. While parents valued the U.S. healthcare system, they noted gaps in public health messaging and provider engagement. Conclusions: Findings revealed that HPV vaccine uptake and hesitancy among Cape Verdean immigrant parents in the U.S. were influenced by individual beliefs, family dynamics, healthcare provider interactions, cultural norms, and structural barriers. These findings highlight the need for multilevel strategies such as culturally tailored education, community engagement, and improved provider communication to support informed vaccination decisions in this population. Full article
(This article belongs to the Special Issue Vaccine Strategies for HPV-Related Cancers: 2nd Edition)
9 pages, 821 KiB  
Article
Nativity, Race, Ethnicity, and Hypertensive Disorders During Pregnancy
by Madeline R. Fram, Jeff M. Denney and Kristen H. Quinn
J. Clin. Med. 2025, 14(13), 4594; https://doi.org/10.3390/jcm14134594 - 28 Jun 2025
Viewed by 282
Abstract
Background: Previous research has examined the idea of the healthy immigrant effect and its potential application to pregnancy-related hypertensive disorders, particularly inracial and ethnic minority groups. The aim of this study is to examine how nativity, race, and ethnicity are related to prevalence [...] Read more.
Background: Previous research has examined the idea of the healthy immigrant effect and its potential application to pregnancy-related hypertensive disorders, particularly inracial and ethnic minority groups. The aim of this study is to examine how nativity, race, and ethnicity are related to prevalence of pregnancy-related hypertensive disorders. Methods: A retrospective cohort study was conducted using data from the PRAMS CDC dataset. These data were analyzed via Χ2 comparisons of prevalence of pregnancy-related hypertensive disorders in foreign and US-born mothers, including subgroup analyses for Black and Hispanic women. Results: A sample size of 63,648 was analyzed, and revealed significant differences in the prevalence of gestational hypertension between US-born vs. foreign-born Black mothers (12.6% vs. 8.0%, Χ2 (1, N = 12,046) = 36.92, p < 0.001), Hispanic mothers (9.5% vs. 7.2%, Χ2 (1, N = 11,524) = 18.236, p < 0.001), and the larger sample of mothers across all reported racial and ethnic backgrounds (11.0% vs. 7.0%, Χ2 (1, N = 63,648) = 163.835, p < 0.001). The results also revealed a significant difference in the prevalence of hypertension eclampsia between US-born and foreign-born Hispanic mothers (0.8% vs. 0.3%, Χ2 (1, N = 11,152) = 8.480, p = 0.004). Conclusions: The study results showed evidence of significantly lower prevalence of pregnancy-related hypertensive disorders among foreign-born mothers as compared to their US-born counterparts, both in the full study sample and specifically in the subsamples of women who self-identified as Black and women who self-identified as Hispanic. These variances by nativity, race, and ethnicity provide further insight into how the healthy immigrant effect can apply to pregnancy-related hypertensive disorders, particularly for women of racial and ethnic minorities. Full article
(This article belongs to the Special Issue Innovations in Preeclampsia)
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20 pages, 429 KiB  
Article
Exploring Vaccine Hesitancy, Structural Barriers, and Trust in Vaccine Information Among Populations Living in the Rural Southern United States
by Alice R. Richman, Abby J. Schwartz, Sarah B. Maness, Leslie Sanchez and Essie Torres
Vaccines 2025, 13(7), 699; https://doi.org/10.3390/vaccines13070699 - 27 Jun 2025
Viewed by 527
Abstract
Introduction: In the United States, vaccine hesitancy is higher among rural and racially and ethnically diverse communities, and messaging from trusted individuals may increase vaccine acceptance. The purpose of this study is to understand vaccine hesitancy, messaging from trusted individuals, and vaccine acceptance [...] Read more.
Introduction: In the United States, vaccine hesitancy is higher among rural and racially and ethnically diverse communities, and messaging from trusted individuals may increase vaccine acceptance. The purpose of this study is to understand vaccine hesitancy, messaging from trusted individuals, and vaccine acceptance strategies among racially and ethnically diverse, medically underserved rural populations. Methods: The researchers conducted 12 in-person focus groups, each consisting of 5 to 12 participants, with community members and trusted leaders from three rural counties in Eastern North Carolina (n = 119). Thematic analysis was used to synthesize insights from the discussions, allowing for the identification of recurring patterns and community-specific considerations regarding vaccine perceptions and messaging. Results: The researchers identified seven key themes within the primary focus areas of the study: factors influencing vaccine hesitancy, messaging from trusted individuals, and strategies to improve vaccine acceptance. Participants reported differences in trust based on how long a vaccine has been available, concerns about becoming sick after a vaccine, seeing the symptoms of vaccine-preventable diseases, and misinformation on social media. Overall, participants reported trust in messages from medical providers. Trusted leaders advised people to conduct their own research on vaccines when determining whether to receive vaccinations. Lastly, social determinants such as cost, education, and transportation were identified as key barriers to vaccination. Conclusions: Our findings indicate that medical providers are trusted messengers for vaccine information and the promotion of vaccine uptake. However, distrust linked to fear, misinformation, and structural barriers persist. Public health efforts to increase vaccination confidence among rural, racially and ethnically diverse populations in the United States Southeast should address these factors in future vaccine interventions and educational efforts. Full article
(This article belongs to the Section Vaccines and Public Health)
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17 pages, 627 KiB  
Review
Major Allele Frequencies in CYP2C9 and CYP2C19 in Asian and European Populations: A Case Study to Disaggregate Data Among Large Racial Categories
by Horng-Ee Vincent Nieh and Youssef Malak Roman
J. Pers. Med. 2025, 15(7), 274; https://doi.org/10.3390/jpm15070274 - 27 Jun 2025
Viewed by 990
Abstract
CYP2C9 and CYP2C19 are major CYP450 enzymes that heavily influence the hepatic metabolism and bioactivation of many medications, including over-the-counter and narrow therapeutic index drugs. Compared to the wild-type alleles, genetic variants in either gene could potentially alter the pharmacokinetics of widely used [...] Read more.
CYP2C9 and CYP2C19 are major CYP450 enzymes that heavily influence the hepatic metabolism and bioactivation of many medications, including over-the-counter and narrow therapeutic index drugs. Compared to the wild-type alleles, genetic variants in either gene could potentially alter the pharmacokinetics of widely used medications, affect the desired therapeutic outcomes of a drug therapy, or increase the risk of undesired adverse events. The frequency of genetic polymorphisms associated with CYP450 enzymes can widely differ across and between racial and ethnic groups. This narrative review highlights the differences in CYP2C9 and CYP2C19 allele frequencies among European and Asian population subgroups, using published literature. Identifying the substantial differences across European and Asian populations, as well as within Asian subgroups, indicates the need to further scrutinize general population data. Clinical scientists and healthcare providers should advocate for more inclusive clinical pharmacogenomic data and racially and ethnically diverse pharmacogenomic databases. Clinical trials of limited racial and geographical diversity may not necessarily have strong external generalizability for all populations. Furthermore, clinical trials that designate an all-inclusive Asian population consisting of multiple ethnicities may not be adequate due to the perceived genetic differences among Asian subgroups. Gravitating towards a more comprehensive approach to utilizing pharmacogenomic data necessitates granular population-level genetic information which can be leveraged to improve how drug therapies are prescribed, achieve health equity, and advance the future of precision medicine. Full article
(This article belongs to the Special Issue New Trends and Challenges in Pharmacogenomics Research)
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15 pages, 2209 KiB  
Article
Trends in the Incidence of Ovarian Cancer Among Premenopausal and Postmenopausal Women in the United States, 2001 to 2021
by Victor Adekanmbi, Abbey B. Berenson, Batul Shakir, Christine D. Hsu, Thao N. Hoang, Itunu O. Sokale, Tolulope T. Sajobi and Fangjian Guo
Cancers 2025, 17(13), 2119; https://doi.org/10.3390/cancers17132119 - 24 Jun 2025
Viewed by 396
Abstract
Background: Ovarian cancer remains the deadliest and leading cause of gynecological cancer-associated mortality in the US. The aim of this study was to characterize the trends in the incidence of ovarian cancer between premenopausal and postmenopausal women to inform future targeted interventions. Methods: [...] Read more.
Background: Ovarian cancer remains the deadliest and leading cause of gynecological cancer-associated mortality in the US. The aim of this study was to characterize the trends in the incidence of ovarian cancer between premenopausal and postmenopausal women to inform future targeted interventions. Methods: This population-based cross-sectional study analyzed data from the US Cancer Statistics (USCS) database, which covered the whole of the US population between 2001 and 2021. Joinpoint regression was used to compute the average annual percentage change (APC) with 95% confidence interval (CI) and age-standardized incidence rates per 1,000,000 population. Results: The results showed that the IR of ovarian cancer declined between 2001 and 2021. Postmenopausal women had greater decreases in the IR of ovarian cancer compared to premenopausal women who showed a small decline. When stratified by race/ethnicity, non-Hispanic American Indian/Alaska Native women aged 20–49 years experienced an increase in the IR of ovarian cancer (APC = 2.4; 95% CI 0.9 to 4.1) compared to other racial/ethnic groups which showed a decline. Joinpoint trend analyses identified one inflection point in localized ovarian cancer incidence trends among all three age groups: an initial decline from 2001 to 2011 among women 20–49 years old and 65+ years old, and from 2001 to 2012 among women 50–64 years old, followed by an upward trend thereafter to 2021. Similarly, there was one inflection point in the IR of ovarian cancer for the clear cell and endometrioid types among women aged 20–49 years old. Conclusions: The IR of ovarian cancer in the US declined significantly among postmenopausal compared to premenopausal women, for whom the IR of ovarian cancer decreased only slightly. Although encouraging, these findings show a need for continued efforts to improve early detection and prevention strategies to mitigate the burden of this deadly disease. Full article
(This article belongs to the Section Cancer Epidemiology and Prevention)
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27 pages, 3066 KiB  
Review
Beyond Barriers: Achieving True Equity in Cancer Care
by Zaphrirah S. Chin, Arshia Ghodrati, Milind Foulger, Lusine Demirkhanyan and Christopher S. Gondi
Curr. Oncol. 2025, 32(6), 349; https://doi.org/10.3390/curroncol32060349 - 12 Jun 2025
Viewed by 1980
Abstract
Healthcare disparities in cancer care remain pervasive, driven by intersecting socioeconomic, racial, and insurance-related inequities. These disparities manifest in various forms such as limited access to medical resources, underrepresentation in clinical trials, and worse cancer outcomes for marginalized groups, including low-income individuals, racial [...] Read more.
Healthcare disparities in cancer care remain pervasive, driven by intersecting socioeconomic, racial, and insurance-related inequities. These disparities manifest in various forms such as limited access to medical resources, underrepresentation in clinical trials, and worse cancer outcomes for marginalized groups, including low-income individuals, racial minorities, and those with inadequate insurance coverage, who face significant barriers in accessing comprehensive cancer care. This manuscript explores the multifaceted nature of these disparities, examining the roles of socioeconomic status, race, ethnicity, and insurance status in influencing cancer care access and outcomes. Historical and contemporary data highlight that minority racial status correlates with reduced clinical trial participation and increased cancer-related mortality. Barriers such as insurance coverage, health literacy, and language further hinder access to cancer treatments. Addressing these disparities requires a systemic approach that includes regulatory reforms, policy changes, educational initiatives, and innovative trial and treatment designs. This manuscript emphasizes the need for comprehensive interventions targeting biomedicine, socio-demographics, and social characteristics to mitigate these inequities. By understanding the underlying causes and implementing targeted strategies, we can work towards a more equitable healthcare system. This involves improving access to high-quality care, increasing participation in research, and addressing social determinants of health. This manuscript concludes with policy recommendations and future directions to achieve health equity in cancer care, ensuring optimal outcomes for all patients. Full article
(This article belongs to the Section Oncology Nursing)
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15 pages, 1631 KiB  
Article
Altered Expression of NK Receptors in Racially/Ethnically Diverse and Risk-of-Relapse Pediatric Acute Lymphoblastic Leukemia Patients
by Stephen Mathew, Roslin Jose George, Alexsis Garcia, Sheila Powers, Subhash Aryal and W. Paul Bowman
Biomedicines 2025, 13(6), 1412; https://doi.org/10.3390/biomedicines13061412 - 9 Jun 2025
Viewed by 519
Abstract
Background/Objectives: Acute Lymphoblastic Leukemia (ALL) is a cancer that predominantly affects white blood cells within the blood and bone marrow of adults and children. Currently, ALL is one of the most prevalent malignancies in pediatric patients and is most seen among Caucasian and [...] Read more.
Background/Objectives: Acute Lymphoblastic Leukemia (ALL) is a cancer that predominantly affects white blood cells within the blood and bone marrow of adults and children. Currently, ALL is one of the most prevalent malignancies in pediatric patients and is most seen among Caucasian and Hispanic descent, with lower incidence in African American children. The goal of the study was to investigate the expression of immune cell receptors in racial/ethnic populations and risk factors for relapse that could potentially influence the pediatric ALL outcomes. Methods: Twenty healthy subjects and forty-two pediatric ALL subjects were enrolled in the study and whole-blood was collected at diagnosis and post-chemotherapy, and the cell surface expression of various immune receptors, including 2B4, CS1, LLT1, Nkp30, and NKp46, was determined by flow cytometry. Results: Very high-risk and high-risk of relapse ALL subjects showed increased expression of LLT1 on NK cells, T cells, and monocytes at diagnosis compared to healthy subjects. CS1 was also significantly overexpressed on monocytes of very-high risk ALL subjects both at diagnosis and after the end of chemotherapy as compared to healthy subjects. Also, there was a significantly increased expression of NKp30 on T cells of Caucasians as compared to Hispanics and African Americans at diagnosis, and downregulation of CS1 and LLT1 on T cells of Caucasians post-induction chemotherapy. Conclusions: The altered expression of immune receptors in racial/ethnic and risk stratified groups may provide insights into the immune surveillance mediated by T cells and NK cells against pediatric ALL. Full article
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30 pages, 2841 KiB  
Review
Progress in the Genetics of Myelodysplastic Syndromes with a Latin American Perspective
by Ana Lisa Basquiera, Verónica Andreoli, Sofía Grille and Carolina Bárbara Belli
Genes 2025, 16(6), 687; https://doi.org/10.3390/genes16060687 - 2 Jun 2025
Viewed by 1080
Abstract
Myelodysplastic syndromes (MDS) are a heterogeneous group of hematological malignancies characterized by ineffective hematopoiesis, resulting in cytopenias, morphologic dysplasia in hematopoietic lineages, and a variable risk of progression to acute myeloid leukemia. Significant advances in the understanding of MDS have been made in [...] Read more.
Myelodysplastic syndromes (MDS) are a heterogeneous group of hematological malignancies characterized by ineffective hematopoiesis, resulting in cytopenias, morphologic dysplasia in hematopoietic lineages, and a variable risk of progression to acute myeloid leukemia. Significant advances in the understanding of MDS have been made in recent years, largely due to the implementation of molecular tools. Latin America is a highly diverse region, both ethnically and racially, and often faces resource limitations that challenge the broad applicability of recent advances in MDS. In this review, we discuss the key genes implicated in the pathogenesis and classification of MDS, and their relevance to diagnosis, prognosis, and potential therapeutic targets. We also explore the challenges associated with the identification of germline predisposition to MDS in Latin America and discuss the current availability and limitations of molecular diagnostic tools in the region. Full article
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17 pages, 2385 KiB  
Article
Associations Between Eating Disorders and Sociodemographic Factors in Adolescent Patients Since the Start of the COVID-19 Pandemic
by Janet Lee, David Miller and Paulina Rugart
Children 2025, 12(6), 730; https://doi.org/10.3390/children12060730 - 31 May 2025
Viewed by 514
Abstract
Background/Objectives: The COVID-19 pandemic has been associated with significant increases in mental-health-related concerns in adolescents, including eating disorders. Disparities in screening, diagnosis, and treatment impact adolescents with eating disorders. This study aimed to describe the patterns in the prevalence and the associations between [...] Read more.
Background/Objectives: The COVID-19 pandemic has been associated with significant increases in mental-health-related concerns in adolescents, including eating disorders. Disparities in screening, diagnosis, and treatment impact adolescents with eating disorders. This study aimed to describe the patterns in the prevalence and the associations between eating disorder diagnoses and demographic factors in adolescent patients since the start of the COVID-19 pandemic. Methods: We performed a retrospective cohort study examining adolescent patients (aged 12 to 21) with an eating disorder (ED) diagnosis documented between January 2019 and July 2023 using Epic Systems Corporation’s Cosmos, a de-identified dataset aggregated from electronic health record (EHR) data. We examined the differences in demographic factors by utilizing chi-square and Kruskal–Wallis rank sum tests. Results: A total of 82,435 distinct adolescent and young adult patients with eating disorder diagnoses were included in the analytical dataset. The overall prevalence of EDs has increased since 2019. The median age of patients with an ED decreased between 2019 and 2023. There was a decrease in other eating disorder diagnoses and an increase in avoidant-restrictive food intake disorder (ARFID) during the study period. There was a decrease in the proportion of individuals who identified as White and an increase in the proportion of adolescents from historically minoritized racial and ethnic groups (i.e., African American or Black and Hispanic). There was also an increase, during this study period, in the proportion of adolescents with an ED diagnosis who were from more socially vulnerable communities. Conclusions: Our study describes the changes in the prevalence of sociodemographic factors in adolescent patients with EDs since the start of the COVID-19 pandemic. Further studies should address screening, diagnostic, and treatment barriers for EDs in historically underserved communities. Full article
(This article belongs to the Section Global Pediatric Health)
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