Plant-based diets have been linked to slower cognitive decline, but data on long-term dietary changes and from diverse populations are limited. The primary aim of this study was to examine plant-based dietary patterns and their change over time in relation to Alzheimer disease and related dementias (ADRDs). This prospective longitudinal analysis of the Multiethnic Cohort Study, based in Hawaii and California (primarily Los Angeles County), included data on African American, Japanese American, Latino, Native Hawaiian, and White participants who completed food frequency questionnaires at baseline (1993-1996; age 45-75 years) and at 10-year follow-up (2003-2008) and whose Medicare claims were linked to identify incident ADRDs. A priori indices for the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI) were analyzed in Cox regression models for ADRD. The analysis included 92,849 participants (mean age 59.2 years, 55.1% female, 21,478 with ADRDs) for the baseline diet and 45,065 participants (8,360 with ADRDs) for the 10-year dietary change. For the baseline diet, comparing the highest vs lowest quintile, PDI and hPDI were associated with 12% (hazard ratio [HR] 0.88; 95% CI 0.85-0.92) and 7% (HR 0.93; 95% CI 0.89-0.97) lower risks of ADRD, respectively, whereas uPDI was related to a 6% higher risk (HR 1.06; 95% CI 1.01-1.10). For the dietary change over time, the strongest association with ADRD was observed for uPDI rather than for PDI or hPDI. Compared with those with a stable score (<0.5 SD change), participants with a large increase in uPDI (≥1 SD) showed a 25% higher risk (HR 1.25; 95% CI 1.15-1.36) and those with a large decrease in uPDI showed an 11% lower risk (HR 0.89; 95% CI 0.84-0.94). The associations between the plant-based diet indices and ADRD were generally similar by age group (<60 vs ≥60 years at baseline), race and ethnicity, or APOE ℇ4 carrier status. These findings suggest that adopting plant-based diets, specifically refraining from low-quality plant-based diets, even at an older age, is associated with a lower risk of ADRDs.

The Eating Disorder Inventory (EDI) is one of the oldest and most widely used surveys of eating disorder thoughts and behaviors. Its recent and frequent use to study differences in eating pathology across ethnoracial groups underscores importance of establishing its measurement invariance across groups. However, mixed evidence has emerged, and studies have focused on Black, mixed-race Hispanic/Latino, and White women. The present study aimed to establish the measurement invariance of the EDI Drive for Thinness, Bulimia, Perfectionism, Maturity Fears, and Interpersonal Distrust subscales across four ethnoracial groups in a sample of women and men. Participants (N = 2,931) were Hispanic White (7%), non-Hispanic Asian (18%), non-Hispanic Black or African American (7%), and non-Hispanic White (68%) college students (67% female) recruited in a cohort-based epidemiological, longitudinal study of health and eating patterns. First, multigroup confirmatory factor analysis examined whether the EDI performed comparably across ethnoracial groups in the full sample. Next, the same approach was followed in sensitivity analyses within each sex. Evaluation of changes in comparative fit index indicated that full metric invariance, scalar invariance, and uniqueness were supported across ethnoracial groups in the full sample and in women (change in comparative fit index ≤ .01). Only partial measurement invariance was supported in analyses of non-Hispanic Asian and non-Hispanic White men. Analyses support use of the EDI in ethnoracially diverse samples including women and men or only women. Limited score variance in men suggests the need for tests of measurement invariance in larger samples. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Self-reported race and ethnicity in relation to oral potentially malignant disorders and oral cancer.

Using a cross-sectoral partnership to improve colorectal cancer screening and follow-up among African Americans in the United States: A protocol and preliminary results.

To report the injury profile of gunshot wounds (GSWs) to the humerus along with treatment, fracture-related infection (FRI), and nonunion. Retrospective review. Multicenter, 12 academic hospitals. All patients ≥18 years old who presented to the emergency room with GSW-related humerus fractures (Orthopaedic Trauma Association classifications 11-13, types A-C) were included from January 2016 to October 2021. Patients were compared based on surgical management (SM) and nonsurgical management (NoSM). Data on patient demographics, injury presentation, treatment received, and outcomes including FRI and nonunion were collected. FRI was split into confirmatory and suggestive diagnoses. Multivariable logistic regression evaluated differences between the SM and NoSM groups in FRI after controlling for indicators of injury severity. Six hundred fifty-four patients were included with a mean age of 31 years (range: 18-74 years). Five hundred seventy-five patients (88%) were male, and 512 (79%) were Black or African American. Intra-articular fractures were more likely to be managed surgically (SM: 33.4%, NoSM: 17%, P < 0.0001). The rate of vascular injury was significantly higher in SM patients (SM: 16.8%, NoSM: 5.4%, P < 0.001); this was also true for nerve injury (SM: 45.6%, NoSM: 23.9%, P < 0.0001). Among all 654 patients, there was a significant difference in confirmatory FRI (SM: 5.4%, NoSM: 0.4%, P = 0.004) and suggestive FRI (SM: 19.9%, NoSM: 4.4%, P < 0.0001). In the subgroup of 307 patients with at least 90 days of follow-up, a significant difference was observed in suggestive FRI (SM: 22.5%, NoSM: 2.4%, P < 0.0001), but not in confirmatory FRI (SM: 6.8%, NoSM: 1.2%, P = 0.080). The rate of nonunion did not differ significantly between groups in the full cohort (SM: 8.4%; NoSM: 5.3%, P = 0.148) and subgroup with at least 90 days of follow-up (SM: 14.4%; NoSM: 12.9%, P = 0.739). After controlling for indicators of injury severity, the SM group had a significantly higher odds of suggestive FRI than the NoSM group both in the overall cohort (adjusted odds ratio = 2.54; 95% confidence interval: 1.14-5.64; P = 0.023) and among patients with at least 90 days of follow-up (adjusted odds ratio = 5.62; 95% confidence interval: 1.22-25.8; P = 0.027). In this study, humerus GSWs managed with surgery were associated with a higher prevalence of suggestive FRI, vascular injury, and nerve injury than GSWs managed without surgery; management (surgery vs. no surgery) was not associated with risk of nonunion. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Family influences on type 2 diabetes self-management: Perspectives of African American adults with food insecurity.

In An American Health Dilemma (2000), W. Michael Byrd and Linda A. Clayton synthesized historical scholarship to trace the devastating health impacts of chattel slavery, White supremacy, and racial science. Their study exposed disparate levels of death and illness experienced by generations of enslaved African Americans. My retrospective review of An American Health Dilemma demonstrates how subsequent scholarship has reinforced Byrd and Clayton's analysis of the roots of African American health disparities but also illuminated some of the limitations of the authors' physician perspectives. By decentering biomedical frameworks and introducing new interdisciplinary approaches, historians of enslaved health and healing complicate the authors' conceptualization of the "slave health deficit" and challenge their assumptions about the "slave health subsystem." New studies of slavery and capitalism, gender, reproduction, and disability expand the account of slavery's full impact on African American health. Furthermore, rather than viewing enslaved healers as members of a subsystem of superior Euro-American professional training, a new body of literature today explores the spiritual and intellectual worlds of Black healers grounded in Black mobility and the cultures of the African diaspora. (Am J Public Health. 2026;116(5):649-656. https://doi.org/10.2105/AJPH.2026.308422).

Thematic Teaching About Race and American Politics in a Seventh-Grade Social Studies Classroom

Suture the Future: Evaluating the Impact of Early Surgical Exposure for High School Students.

Major heart failure (HF) registries are limited by manual chart abstraction and to hospitalized patients. Using artificial intelligence (AI) approaches and electronic health record (EHR) data from the Veterans Affairs (VA) healthcare system, we have assembled the National DCVA-HF Registry, which includes both ambulatory and hospitalized HF patients. In the current study, we descriptively compared these patients with those identified using International Classification of Diseases (ICD) codes. We identified 1,416,512 Veterans with at least one ICD code for HF in the VA national EHR from 1999 to 2017. The first date of an ICD code for HF was considered the index HF date. We used validated encounter-based AI approaches based on machine learning and natural language processing models, and ICD code-based approaches based on ≥1 hospitalization or ≥2 outpatient encounters due to HF, to assemble the AI-HF and ICD-HF cohorts, respectively. The two cohorts were compared using absolute standardized differences, with values ≥10% indicating clinical significance. All analyses were descriptive, and no inferential or causal claims were made. The AI and ICD approaches assembled 1,031,970 and 614,828 patients, respectively, after a mean of 0.4 and 1.0 years from the index HF date. Patients in the AI-HF (vs. ICD-HF) cohort had a mean age of 71.4 (vs. 70.5) years, 98.1% (vs. 98.0%) were men, 13.9% (vs. 16.1%) were African American, and 7.7% (vs. 13.4%) had index HF hospitalization, with absolute standardized differences of 8%, 1%, 6%, and 18%, respectively, which were <10% for 66 other baseline characteristics. One-year post-index HF hospitalization occurred in 10.7% and 15.6% of patients in the AI-HF and ICD-HF cohorts, respectively. One‑year mortality was lower in the ICD-HF cohort, reflecting expected immortal‑time bias due to later cohort qualification. The findings from this descriptive study demonstrate that the AI approach assembled a substantially larger cohort that included most patients identified using the ICD code approach, suggesting broad consistency between the two approaches. Future external validation is needed to determine its potential utility as a robust tool for improving patient care, health services operations, and clinical research in HF.

Ranger patrols are a cornerstone of wildlife protection efforts around the world and occur across all ecological governance systems. Evidence that patrols reduce threats to wildlife and enable their recovery has not been systematically examined previously. Without evidence of patrol effectiveness in varying contexts, protected area managers risk wasting limited conservation resources and lack information required to improve the effectiveness of patrols. We conducted a meta-analysis evaluating the effectiveness of terrestrial patrols for conserving African, Asian, and Latin American wildlife directly threatened by exploitation. After filtering 57 studies, we calculated effect sizes from each of the remaining 15 studies that included a comparator and measurement of wildlife abundance and calculated standardised mean difference and % change in wildlife species abundance. Results suggest tentative support that areas implementing patrols (alongside other interventions) were associated with higher wildlife abundance levels compared to time periods or locations without patrols. We were unable to confirm causality between patrols and changes in wildlife population abundance because studies were inadequately designed to evaluate and report on effectiveness. Studies commonly lacked a comparator or counterfactual event, temporal or spatial replication, and consistent and/or long-term monitoring of population abundance, and had study designs that confounded conservation actions. Further, of the 15 included studies linking wildlife abundance to patrol efforts, five also reported a reduction in a poaching threat, but only three of these used a comparator in the threat reduction evaluation. Without monitoring threat trends alongside wildlife abundance, it is difficult to be confident that patrols resulted in increases in wildlife abundance. To help evaluate patrol interventions (i.e. not only whether they work but where and under what conditions they work), we identify opportunities to improve future patrol effectiveness research and provide recommendations on how to improve the evidence base.

The disparity in tooth decay among young children has long been demonstrated in national surveillance data. While various factors including family, culture, access to health insurance, and medical infrastructure have been studied, the global transcriptomic perspective remains underexplored. Employing RNA-Seq technology, we examine functional and taxonomic differences in caries-associated microbial activity between two high-risk populations. Besides a core set of well-established cariogenic organisms, we observed significant and consistent differences in the active microbial communities between these two high-risk populations, African American (AA) and Latin American Hispanic (LAH) children. In AA children, Pseudopropionibacterium propionicum and Cardiobacterium hominis consistently showed the highest caries-related gene expression. In contrast, among LAH children, Propionibacterium acidifaciens, Selenomonas sp., Rothia dentocariosa, Atopobium parvulum, and Streptococcus sanguinis were the primary drivers of gene expression in caries lesions. By identifying the unique microbial mechanisms and pathways active in each population, we can better define the core factors required for caries development and uncover how differences in microbial function contribute to persistent disparities.

ABSTRACT Environmental identity safety cues (ISCs), such as safe space posters, are used to signal support for marginalized groups. While environmental ISCs increase belonging and reduce identity threat, less is known about how they function alongside higher‐cost ISCs such as prejudice confrontations. Across two experimental studies with Black Americans ( n = 272), and Asian Americans ( n = 279), we examined how environmental ISCs and confrontations jointly shape perceptions of Identity Threat and Ally Sincerity using a 2 (ISC: Present, Absent) × 2 (Confrontation: Present, Absent) between‐subjects design. Results revealed that while ISCs can reduce Identity Threat and increase Ally Sincerity, prejudice confrontations are more consistent and effective. Additionally, there is no evidence for a backlash effect whereby having an ISC without a confrontation is worse than doing nothing. Results suggest US racial minorities value confrontations and environmental ISCs, highlighting the importance of using both high‐ and low‐cost prejudice reduction strategies.

Multiple mini interview (MMI) is a widely used component of holistic evaluation for medical school admissions; limited studies have evaluated performance of MMI based on applicant sociodemographic characteristics. To evaluate differences in MMI performance by medical school applicants of various racial and ethnic groups based on age, gender, and socioeconomic status. Retrospective cross-sectional study of applicants who participated in MMI from 2020 to 2024 at a large, public medical school in the US. Participation in MMI. Compared differences in MMI performance based on sociodemographic characteristics by racial and ethnic groups. Performed t tests to conduct bivariate comparisons of scores across various groups. Performed multiple linear regression to analyze how independent demographic variables were associated with MMI scores. There were 3447 applicants who participated in MMI (56 [2%] American Indian or Alaskan Native; 853 [25%] Asian; 650 [19%] Black or African American; 660 [19%] Hispanic or Latino; 31 [1%] Native Hawaiian or Pacific Islander; 1502 [44%] White; 1968 [57%] aged 23 and younger; 1798 [52%] women; and 1198 [35%] with disadvantaged status). The mean (SD) MMI score was 3.77 (0.43) on a scale of 1 to 5 for 3447 applicants. Black or African American (mean [SD] MMI, 3.85 [0.44]; [data]; P < .001), compared with other racial groups, and women (mean [SD] MMI, 3.82 [0.41]; [data]; P < .001), compared with other gender identities, applicants scored higher. White (mean [SD] MMI, 3.74, [0.43]; [data]; P = .001), compared with other racial groups, and disadvantaged (mean [SD] MMI, 3.74 [0.43]; [data]; P = .009), compared with not disadvantaged, applicants scored lower. Younger American Indian or Alaskan Native applicants scored higher compared with other racial groups (coefficient [C] = 0.23; SE, 0.11; P = .045). Men (C = -0.06; SE, 0.03; P = 0.02), compared with other gender identities, and disadvantaged (C = -0.07; SE, 0.03; P = .04), compared with not disadvantaged, Asian applicants scored lower. Younger (C = -0.08; SE, 0.03; P = .03), compared with older applicants, and men (C = -0.09; SE, 0.04; P = .009), compared with other gender identities, Black or African American applicants scored lower. Men (C = -0.97; SE, 0.02; P < .001), compared with other gender identities, and disadvantaged (C = -0.68; SE, 0.02; P = .007), compared with not disadvantaged, White applicants scored lower. Men Hispanic or Latino applicants (C = -0.11; SE, 0.03; P = .002) compared with other ethnicities scored lower. In this study of MMI performance, there were differences in scores by various sociodemographic groups. These results can add to the current understanding of the use of MMI as one tool in the holistic evaluation of medical school applicants.

Breast cancer (BC) brain metastases (BM) treatment involves radiotherapy (RT), surgery, and CNS-penetrating systemic therapies. This study evaluated treatment patterns in brain RT and corresponding survival outcomes among patients with BC BM using the National Cancer Database (NCDB). Patients diagnosed with BC BM between 2010 and 2021 were identified. RT was categorized as whole brain (WBRT) vs. stereotactic (SRT). We fitted Overlap Propensity Score Weighting (OPSW) Cox models to account for confounders affecting OS. Variables included age, race, ethnicity, Charlson-Deyo score, insurance, molecular subtype, facility type, and systemic therapy. Of 8909 patients with BC BM, 43.4% received brain RT (74.1% WBRT, 25.9% SRT). Patients that are African American, lower income, urban, triple-negative, or at community facilities were more likely to receive WBRT over SRT (p < 0.05). Median OS for the entire cohort was 10.9months (95% CI 10.4-11.5). Systemic therapy alone (HR 0.40, 95% CI 0.36-0.43) or combined with RT (HR 0.38, 95% CI 0.35-0.42) improved OS; however RT alone did not improve survival on MVA (HR 0.96 (95% CI 0.91-1.02). Among RT recipients, SRT was associated with improved OS vs. WBRT (HR 0.76, 95% CI 0.69-0.83). Older age, comorbidities, lack of insurance, community facilities, and aggressive subtypes were associated with worse OS. Treatment patterns, particularly access to SRT, differ among BC BM patients therefore highlighting the need for strategies to promote equitable implementation of evidence-based guidelines. More prospective trials are also needed to establish evidence-based treatment standards for BC BM.

Abstract This article examines how scientific research on lactose digestion from 1950 to 1980 became entangled in shifting discourses on race, heredity, and population. It traces how scientific framings of lactose digestion changed during this period—initially racialized as a disorder (lactase deficiency) affecting Black Americans, later reclassified as an ethnic trait, and ultimately reinterpreted as a biomarker of European ancestry. Drawing on medical research on “lactose science” and archival sources, this study explores how geneticists, medical researchers, and anthropologists jointly navigated the complexities of race and human variation in the postwar period. Using Peter Galison’s concept of trading zones , the paper traces how ethnicity and population emerged as strategic alternatives to race, facilitating interdisciplinary collaboration while preserving racialized assumptions about biological difference. The paper argues that despite efforts to align with UNESCO’s post-racial scientific agenda, research on lactose digestion came to produce a normative discourse around whiteness. In doing so, it raises a critical question: how did an ostensibly anti-racist science inadvertently revive older racial biologisms?

ABSTRACT The ongoing debate over universal access to full-day kindergarten (FDK) persists in various states. Previous research lacks consensus on its effects, especially beyond the kindergarten year and among various student groups. Studying FDK within specific state contexts is beneficial because FDK experiences vary vastly across contexts. This study examines the impact of FDK in Utah using multiple years of student and school data. Research Findings: Our analysis reveals that FDK attendance is associated with enhanced literacy skills during kindergarten, especially benefiting students from marginalized backgrounds (e.g. Hispanic, African American, English Language Learners, and students from low-income families). However, the initial academic benefits of attending FDK were not sustained beyond the kindergarten year; by first and second grade, performance differences had largely disappeared, and by third grade even showed modest reversal effects. The favorable differential effects of FDK on students from marginalized backgrounds also largely faded out. Nevertheless, it is premature to dismiss FDK’s long-term benefits, as educational factors such as barriers and/or additional support and resources post-kindergarten are not considered in the current study. Practice or Policy: To sustain the benefits of FDK over time, continued support for FDK students beyond the kindergarten year may be essential.

Renal cell carcinoma (RCC) is the most common type of kidney cancer, but its genetic architecture has not been fully characterized, particularly in Asian populations. Here, we perform a multi-ancestry meta-analysis of 33,712 RCC cases and 845,786 controls, including individuals of East Asian (5,313 cases and 96,912 controls), European (25,890 cases and 743,585 controls), African American (897 cases and 3,109 controls), and Latin American ancestry (1,612 cases and 2,180 controls), which unveils 10 novel RCC-associated loci and a Chinese-specific locus at 12p13.33. Leveraging genome-wide association study (GWAS) data and cross-ancestry expression quantitative trait loci (eQTLs) mapping from 266 kidney tissues, we refine the identification of putative causal variants and genes implicated in RCC. These findings are substantiated through CRISPR-based screenings and multiplexed single-cell perturbations. Additionally, we functionally validate a novel association between rs28684409 and the oncogene RPL4 at the complex genetic locus 15q22.31. This comprehensive genetic investigation underscores the utility of integrating cross-ancestry GWASs, QTLs, and functional screens to elucidate the genetic underpinnings of complex diseases.

Hepatorenal syndrome (HRS) is characterized by severe renal dysfunction associated with decompensated liver cirrhosis, leading to high morbidity and mortality. This study aims to assess disparities in HRS-related mortality stratified by sex, race/ethnicity, and geographic location in the U.S. We analyzed death certificate data from the CDC WONDER database for adults aged ≥ 15 years. Age adjusted mortality rates (AAMRs) per 1,000,000 population were calculated. Joinpoint regression was used to assess annual percent change (APC) in AAMRs, with P < .05 considered significant. A total of 95,537 deaths were attributed to HRS-related mortality between 1999 and 2020. The overall AAMR declined from 1999 to 2007 (APC: -3.70; 95% CI: -5.14 to -2.84) followed by stable trend till 2018 (APC: 0.13; 95% CI: -0.74 to 0.87) and then showed a sudden increase till 2020 (APC: 9.16; 95% CI: 3.48-11.89). Men had higher AAMR than women. Non-Hispanic (NH) American Indians or Alaska Natives displayed the highest AAMR, followed by Hispanic or Latinos, NH Whites, NH Black or African Americans and NH Asian or Pacific Islander. Variations were evident across regions with the West region having highest AAMR, followed by South, Northeast and Midwest regions. Mortality was the highest in nonmetropolitan areas. HRS-related mortality in the U.S. has increased since 2018, with significant disparities across sex, race/ethnicity and region. Improving healthcare access in underserved areas is essential to addressing disparities and reducing the burden of HRS-related mortality among high-risk populations in the U.S.

Background: Adults with disabilities living in low-resource communities experience persistent inequities in access to healthcare, mental health services, and community participation. However, qualitative data capturing lived experiences in the Deep South remain limited. This study aimed to identify priority needs among adults with mobility disabilities residing in economically distressed communities near Birmingham, Alabama, to inform future telehealth programming. Methods: Fifteen adults (mean age = 60 ± 10 years), predominantly African American and female, completed semi-structured phone interviews exploring basic needs, neighborhood accessibility, health priorities, and perceived supports. Interviews were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s six-phase thematic analysis. Results: Five themes emerged: (1) seeking stability amid severe mental health strain and inadequate supports; (2) constrained food environments shaped by cost, location, and safety; (3) feeling forgotten: systemic neglect and restricted participation in community life; (4) physical health deprioritized by competing needs and structural barriers; and (5) remote support as a viable but unrealized option. Participants described how safety concerns, transportation barriers, and rising food costs constrained daily functioning, while unmet mental health needs compounded isolation. Despite widespread cardiometabolic disease, immediate needs related to mental health, food, and housing consistently superseded physical health. Mental health support was identified as the most feasible area for remote delivery, though poor awareness of available resources limited engagement with any service model. Conclusions: Findings demonstrate that disability-related disparities in low-resource communities are driven largely by structural and environmental factors rather than individual choice. Telehealth and mobile-based services may provide a feasible access strategy for mental health and supportive care in under-resourced settings, particularly when integrated with broader community supports. Addressing foundational needs is essential for advancing health equity among people with disabilities in the Southeast.