Asian Indian Research Articles

Personalized management of hepatic glycogen storage disorders: The role of continuous glucose monitoring.

Glycogen storage disorders (GSD), inherent disorders of carbohydrate metabolism, feature hypoglycemia as a hallmark. Normoglycemia and glucose monitoring are pivotal in disease management. Conventional glucometer-based monitoring may overlook hypoglycemic trends. This study assesses glycemic control in Asian Indian GSD children using continuous glucose monitoring (CGM) and its role in facilitating dietary adjustments. A pre-post study enrolled molecularly confirmed GSDI, GSDIII, GSDVI, and GSDIX patients for baseline dietary compliance and CGM-based glycemic status evaluation. Hypoglycemic patients were stratified into diet-compliant and diet-noncompliant groups. Noncompliant patients received dietary reinforcement; compliant individuals underwent dietary adjustments. Repeat CGM (rCGM) was performed 6 weeks to 6 months postadjustments. Clinical and metabolic parameters were re-evaluated at 6 months. Of the 20 patients assessed at baseline, 11 were diet compliant. Six among these exhibited hypoglycemia, prompting diet adjustments. Among nine noncompliant patients, eight experienced hypoglycemia and received diet reinforcement. rCGM in 10 patients (five GSDI, three GSDIII, and two GSDIXc) showed a significant reduction in hypoglycemia duration in all. An improvement in height and body mass index was observed in all GSDI and GSDIII patients. Triglyceride levels, raised at baseline in two GSDI and one GSDIII, showed a substantial decline in one GSDI patient. Hepatic transaminase levels decreased in both GSDIXc patients. Plasma lactate levels decreased in all GSDI patients. CGM is an efficacious adjunct in the personalized management of hepatic GSD patients, in the Asian Indian population. The study also underscores the need for long-term follow-up to determine the role of glycemic management in growth, general well-being, and metabolic control in the GSD subtypes.

Chemical weathering in the Mekong River Basin: Clay mineralogy and element geochemistry of lower-reach river sediments

Chemical weathering of parent rocks in river basins plays a significant role in controlling the global geochemical cycle and climate change, especially in the world’s largest river basins such as the Mekong River Basin in tropical regions. However, the chemical weathering process of the Mekong River Basin is still not well understood. In this study, clay mineralogy and major/trace-element geochemistry of fluvial sediments (clay, silt, and sand fractions) collected from the lower Mekong River Basin (Cambodia and Vietnam) were utilized to investigate the sediment provenance and chemical weathering process. The major-element compositions of the clay, silt, and sand fraction sediments from both the mainstream and tributaries consist of dominant SiO2, Al2O3, and Fe2O3, (84 wt.%, 89 wt.%, and 95 wt.%, respectively) and minor K2O, Na2O, MgO, CaO, TiO2, P2O5, and MnO. The clay mineral assemblages in mainstream sediments are high in illite (36 wt.%), moderate in kaolinite (28 wt.%) and chlorite (26 wt.%), and low in smectite (10 wt.%), whereas those in tributary sediments are high in smectite (37 wt.%), moderate in kaolinite (26 wt.%) and chlorite (22 wt.%), and low in illite (15 wt.%). The different clay mineral assemblages between mainstream and tributary sediments can be significantly related to the parent rock lithology and/or the weathering process in the source region. On the basis of clay mineralogy and elemental geochemistry, river sediments of the mainstream in the lower reach may be derived mainly from felsic rocks in the lower part of the middle reach of this basin, with secondary contributions from the upper and lower reaches as well as the upper part of the middle reach. Sediments in the Kampi and Speu tributaries highly originate from felsic rocks, whereas sediments in the Srepok, Ter, and Chhiong tributaries can be mostly weathering products of mafic rocks. The clay mineral proxies (smectite/(illite + chlorite) and kaolinite/(illite + chlorite)) combined with the elemental geochemistry (CIA, αAlE values, and weathering trends) of the clay fraction sediments indicate intensive chemical weathering in the lower and middle reaches. The high-relief topography and cold and dry climatic conditions in the upper reach result in high illite and chlorite contents in the soil and moderate chemical weathering. The chemical weathering intensity increases from the upper to middle reaches and further to the lower reach. Tectonics in the middle and upper reaches of the Mekong River Basin play the most important role in controlling weathering and erosion processes, whereas East Asian–Indian monsoon climate conditions with warm temperature and predominant rainfall throughout the year and lithology are the main forcing factors for the intensity of chemical weathering in the lower reach.

Cardiovascular risk factors and disease mortality among asian american subgroups

Abstract Background Asian Americans are the fastest growing racial group in the United States. Although Asian subgroups have distinct cardiovascular (CV) risk profiles, they are often aggregated together for public health surveillance. Purpose We provide the first comprehensive national estimates of CV and CV risk factor mortality in Asian American subgroups to assess differences in CV risk. Methods We used CDC WONDER, which captures all death certificates in the US (2018-2020), as well as the American Community Survey for demographic data. Adults aged ≥18 years were included. Estimates of age-adjusted overall CV mortality, as well as heart disease, hypertension, and stroke-related mortality, were determined by ICD-10 codes. To compare the contribution of each cause of mortality among subgroups with different baseline all-cause mortality rates, proportional mortality rates were determined by race. Proportional mortality was defined as the mortality rate of each condition divided by the all-cause mortality for that race group. Differences in proportional mortality by race and ethnicity, compared with White American adults, were assessed with age-sex adjusted linear regression. Results The US population consisted of 12,950,565 Asian Americans (53.7% female). Among the Asian American subgroups, 25.4% were Asian Indian, 28.5% Chinese, 19.7% Filipino, 5.3% Japanese, 9.6% Korean, and 11.8% Vietnamese. A total of 160,282,147 adults were White. Age-adjusted baseline mortality rates are shown in the Table. Compared with White adults, Asian Indian (34.5% vs 29.3%; adjusted difference 5.2%, [95% CI: 1.8%, 8.6%], P=0.009) and Filipino (32.8% vs 29.3%; adjusted difference 3.5%, [95% CI: 0.1%, 6.9%], P=0.04) adults had significantly higher proportional mortality from all CV causes. Asian Indian (26.0% vs 22.6%; adjusted difference 3.2%, [95% CI: 0.3%, 6.2%], P=0.04) adults had higher proportional mortality from heart disease than White adults, while Korean (17.3% vs 22.6%; adjusted difference -5.2%, [95% CI: -8.1%, -2.2%], P=0.01) and Vietnamese (17.5% vs 22.6%; adjusted difference -5.1%, [95% CI: -8.0%, -2.1%], P=0.01) adults had lower proportional mortality. Every Asian American subgroup had higher proportional mortality from hypertension causes compared with White adults, except for Asian Indians (Figure). In addition, every Asian American subpopulation had higher proportional mortality from stroke compared with White adults (Figure). Conclusions CV risk factor and disease-related mortality varies substantially among Asian American subgroups. Public health efforts targeted to address CV health disparities among the diverse group of Asian Americans are needed.

Quality of life and mental health due to COVID-related lifestyle changes and sociodemographic characteristics among Asian Indians

PurposeTo examine quality of life (QoL) and mental health among Asian Indians in Southwest and Central-west Florida by COVID-related lifestyle changes, and demographic characteristics.MethodsQoL was assessed using SF-12 questionnaire while mental health/healthcare was assessed using the household pulse survey. Face-to-face interviews and self-administered online surveys were conducted among 151 participants in 2021–22. F and Chi-square statistics were used to examine the differences in QoL scores and mental health/mental healthcare by sociodemographic factors and COVID-related lifestyle changes.ResultsMental Component Summary (MCS) scores were lower for those who experienced changes in work expectations (p 0.041), sleep (p 0.002), exercise (p < 0.001), meditation (p.004) and connecting with family (p 0.007) and among those with family testing COVID positive (p.012). Mean Physical Component Summary (PCS) scores were lower for caregivers (p .008). PCS scores were lower for certain income groups (p 0.006), retired (p 0.004), older age groups (p 0.002). Lower MCS scores with college education (p .005), those who were students (p <0 .001), younger age groups (p < 0.001). Those who helped with homeschooling felt anxious (p 0.049), couldn’t stop worrying (p 0.046) and took medications (p < 0.001). Participants’ families who tested COVID positive were anxious (p = 0.019) and worried (p = 0.015). Those with greater work expectations sought counseling (p = 0.009) and those who connected more with their family were anxious (p = 0.008).ConclusionThe pandemic affected QoL, especially the mental component and increased anxiety and worrying. Mental health services for younger individuals, those with caregiving responsibilities and facing increased job demands must be prioritized.

The polar vessel sign: insights from CT imaging analysis in Asian Indian primary hyperparathyroidism.

Data on the polar vessel sign (enlarged feeding vessel terminating in parathyroid lesions) on four-dimensional computed tomography (4D-CT) is limited. We performed a retrospective analysis to determine the prevalence, predictors, and adjunctive utility of polar vessel sign in pre-operative 4D-CT of patients with primary hyperparathyroidism (PHPT). One radiologist blinded to the patients' details reported the 4D-CT of eighty-four operated patients with histopathology-proven single-gland PHPT. Two protocols were used to obtain arterial-phase images: timed via bolus tracking (n = 41) or fixed at 20 s after contrast injection (n = 43). Seventy-one patients were symptomatic for PHPT, with median serum calcium 12.1 mg/dL. On the arterial phase of 4D-CT, 88.1% of lesions had the polar vessel sign, including 7/9 asymptomatic patients, 6/6 parathyroid carcinomas, and 3/4 ectopic(1:mediastinum, 2:thyro-thymic ligament). Predictors of polar vessel sign were maximum lesion dimension (2.2 vs. 1.4 cm; P = 0.03), solid-cystic CT morphology (47.3% vs. none; P = 0.004), and bolus tracking-timed arterial phase (55.4% vs. none; P = 0.001). Of these, bolus tracking improved the polar vessel's visualization (100% vs. 76.7%; P = 0.001) independent of lesion dimension and solid-cystic morphology. The latter two predicted polar vessel sign in images obtained at a fixed interval (20 s). A significantly lower proportion of bolus tracking-timed scans had lesion percentage arterial enhancement (PAE) < 128.9% (2/41 vs. 9/43; P = 0.04). Even with suboptimal PAE, the polar vessel helped identify 9/11 lesions. The polar vessel sign demonstrated an additive role to PAE during CT reporting. Bolus tracking is valuable in optimizing vessel and tumor arterial enhancement and is easily incorporated into parathyroid 4D-CT protocol.

Pulmonary embolism in a hemophiliac patient with factor V and VIII deficiency: a case report

BackgroundThis is an interesting and unexpected thromboembolic event in a hemophiliac patient.Case presentationThis is a case of a 33-year-old primigravidarum of Indian Asian origin with Factor V and Factor VIII deficiency who developed a case of pulmonary embolism during the course of her pregnancy after presenting to the emergency department in Leicester, United Kingdom, with hemoptysis, tachycardia, and tachypnea. Patient was subsequently diagnosed with pulmonary embolism after a computed tomography pulmonary angiogram and was treated with therapeutic daltaparin, a low-molecular-weight heparin.ConclusionIn conclusion, a thromboembolic event is not an improbable event in a hemophiliac patient and should be considered despite a low Well’s score.

Code-switching in South Asian English CMC

Abstract This paper analyses the use of indigenous language elements including code-switching in two contrasting genres, i.e. group chats and Twitter memes along with tweets, in the English communication of South Asian (Bangladeshi, Indian, Pakistani, and Sri Lankan) internet users. The results from group chats show that one of the most common lexical indigenous elements are tags, for example, address forms like yaar, machan, and da which all can be translated to English as ‘dude’ or ‘buddy’. The analysis of Twitter memes along with tweets shows that despite the tweet text being in English, the South Asian users tend to employ memes with indigenous text more often as compared to English memes for political satire. Overall, the study finds that code-switching and indigenous resources are used to create a sense of localness in English communication, whether it is group chats or Twitter memes and tweets.

Neonatal mortality among disaggregated Asian American and Native Hawaiian/Pacific Islander populations.

We compared neonatal (<28 days) mortality rates (NMRs) across disaggregated Asian American and Native Hawaiian/Pacific Islander (AANHPI) groups using recent, national data. We used 2015-2019 cohort-linked birth-infant death records from the National Vital Statistics System. Our sample included 61,703 neonatal deaths among 18,709,743 births across all racial and ethnic groups. We compared unadjusted NMRs across disaggregated AANHPI groups, then compared NMRs adjusting for maternal sociodemographic, maternalclinical, and neonatal risk factors. Unadjusted NMRs differed by over 3-fold amongst disaggregated AANHPI groups. Native Hawaiian/Pacific Islander neonates in aggregate had the highest fully-adjusted odds of mortality (OR: 1.08 [95% CI: 0.89, 1.31]) compared to non-Hispanic White neonates. Filipino, Asian Indian, and Other Asian neonates experienced significant decreases in odds ratios after adjusting for neonatal risk factors. Aggregating AANHPI neonates masks large heterogeneity and undermines opportunities to provide targeted care to higher-risk groups.

Ethnic disparities in perceived racism, patient-provider communication and healthcare utilization: Asian Americans

ABSTRACT Background Race is a consequential sociocultural cue in healthcare contexts. Racism is associated with health disparities by influencing patient-provider communication and utilization of healthcare services. Objective This study aimed to investigate how Asian American subgroups differ in their perception of everyday racism, internalized racism, and perceived racism in healthcare settings and whether these perceptions predict their interactions with their health care providers and their utilization of healthcare services. Methods An online survey study was conducted. ANOVA tests were employed to compare the differences in perceptions of everyday racism, internalized racism, and perceived racism in the healthcare system among Filipino (N = 310), Japanese (N = 242), Chinese (N = 287), Asian Indian (N = 304), Korean (N = 199) and Vietnamese (N = 151) participants. Multiple regression analyses assessed whether perceptions of everyday racism, internalized racism, and perceived racism in the healthcare system predicted healthcare service utilization and patient-provider communication among the Asian subgroups sampled. Results There were significant group differences in perceived everyday racism (F = 8.56, p < .001), internalized racism (F = 3.46, p < .01), perceived racism in healthcare (F = 4.57, p < .001). Perceptions of racism and socioeconomic variables were found to predict patient-provider communication and utilization of healthcare services disparately across various Asian subgroups. For instance, the perception of everyday racism was a significant predictor of patient-provider communication for each of the subgroups, excluding the Vietnamese participants. Internalized racism was a significant predictor only for Filipino and Chinese participants. Surprisingly, perceived racism in healthcare was not a predictor for any of the subgroups. Conclusion Findings highlight the complex interplay of sociodemographic factors and perceived racism in shaping patient-provider communication and healthcare service utilization within the Asian American community. Implications are suggested for addressing the unique challenges faced by different Asian American subgroups and for promoting equitable healthcare access and fostering positive patient-provider relationships among the Asian American subgroups.

Exploring lipodystrophy gene expression in adipocytes: unveiling insights into the pathogenesis of insulin resistance, type 2 diabetes, and clustering diseases (metabolic syndrome) in Asian Indians.

Studying the molecular mechanisms of lipodystrophy can provide valuable insights into the pathophysiology of insulin resistance (IR), type 2 diabetes (T2D), and other clustering diseases [metabolic syndrome (MetS)] and its underlying adipocentric disease (MetS disease). A high-confidence lipodystrophy gene panel comprising 50 genes was created, and their expressions were measured in the visceral and subcutaneous (both peripheral and abdominal) adipose depots of MetS and non-MetS individuals at a tertiary care medical facility. Most lipodystrophy genes showed significant downregulation in MetS individuals compared to non-MetS individuals in both subcutaneous and visceral depots. In the abdominal compartment, all the genes showed relatively higher expression in visceral depot as compared to their subcutaneous counterpart, and this difference narrowed with increasing severity of MetS. Their expression level shows an inverse correlation with T2D, MetS, and HOMA-IR and with other T2D-related intermediate traits. Results also demonstrated that individualization of MetS patients could be done based on adipose tissue expression of just 12 genes. Adipose tissue expression of lipodystrophy genes shows an association with MetS and its intermediate phenotypic traits. Mutations of these genes are known to cause congenital lipodystrophy syndromes, whereas their altered expression in adipose tissue contributes to the pathogenesis of IR, T2D, and MetS.

Predictors of Colonoscopy Use Among Asian Indians in New York City, 2003 to 2016.

Asian Americans have the lowest colorectal cancer screening uptake of any racial and ethnic group in the United States. Asian Indians are among the most under-screened Asian American subgroups, but there is limited data for this population. We sought to characterize predictors of colonoscopy use among Asian Indians in New York City. Using 2003 to 2016 data from the New York City Community Health Survey, we identified all Asian Indian participants aged 50 years or older. We examined the association between sociodemographic and medical factors and up-to-date colonoscopy use (defined as colonoscopy within the last 10y) using logistic regression over 4 time periods: 2003 to 2008, 2009 to 2012, 2013 to 2014, 2015 to 2016. On multivariable analysis, language, age, income, recent exercise, body mass index, and influenza vaccination were associated with colonoscopy uptake in 1 time period. Compared with participants who preferred English, those who preferred an Indian language were less likely to have been up-to-date in 2013 to 2014 (odds ratio 0.12, 95% CI 0.02-0.66). Individuals older than 65 years were more likely than those aged 50 to 64 years to have received a colonoscopy in 2009 to 2012 (odds ratio 3.91, 95% CI 1.49-10.24), although the risk estimates were also consistently positive in the other 3 time periods. Among Asian Indians living in New York City, several demographic, socioeconomic, and health-related characteristics predict colonoscopy use. These findings highlight the importance of examining determinants of colonoscopy uptake in this understudied population to inform future public health interventions.

Gestational weight gain and body mass index in Asian Indian women: Impact of timing and amount on fetomaternal outcomes

ABSTRACT Background: The aim of the study was to describe pre-pregnancy body mass index (BMI), total gestational weight gain (TGWG), and trimester-specific gestational weight gain (TSGWG) among Asian Indians and examine their association with adverse fetomaternal outcomes (AFMO). Methods: Using a prospective cohort study design, 557 pregnant women were recruited in the first trimester and followed up until delivery. Maternal BMI, TGWG and TSGWG were assessed and categorised according to the World Health Organisation (WHO) Asia Pacific BMI guidelines and the Institute of Medicine (IOM) recommendations, respectively. Maternal clinical characteristics and pregnancy and neonatal outcomes were assessed to predict AFMO. Logistic regression models in univariate and multivariate analysis were performed to estimate the odds ratios (OR) and 95% confidence intervals (CI). Results: The median BMI was 23.5 kg/m2. Moreover, 24.6% were overweight and 31.2% were obese, according to WHO Asia Pacific BMI cut points. The mean TGWG was 10.8 ± 1.9 kg and the mean TSGWG in the first, second and third trimesters were 1.7 ± 0.7 kg, 4.3 ± 1.1 kg and 4.8 ± 1.2 kg, respectively. We found a significant association of BMI, TGWG and TSGWG with various AFMO. Furthermore, excess third-trimester GWG has been demonstrated as a predictor of adverse maternal outcomes like hypertension and gestational diabetes mellitus. Conclusions: Our study reinforces the importance of optimal BMI and TGWG and further emphasises on assessment of TSGWG, which allows for early diagnosis of weight deviations, when prompt interventions can still improve pregnancy outcomes. We also suggest the adoption of BMI categories and GWG recommendations, specific to the socio-demographic characteristics of the population, to optimise the prevention, early diagnosis, and timely management of AFMO.

MRNA expression of vitamin D receptor, calcium-sensing receptor, cyclin D1, and PTH in symptomatic and asymptomatic primary hyperparathyroidism.

The exact underlying mechanism for the differential clinical profiles of symptomatic and asymptomatic primary hyperparathyroidism (PHPT) patients has not been fully elucidated, and efforts to define the molecular mechanisms underlying the phenotypic heterogeneity of PHPT have been limited. The aim of this study was to explore the underlying molecular mechanisms involved in the pathogenesis of symptomatic and asymptomatic sporadic PHPT in Asian Indians. A prospective cohort study was conducted at a tertiary care hospital in North India. PHPT patients who underwent parathyroidectomy were included. The main outcome was the comparison of vitamin D receptor (VDR), calcium-sensing receptor (CaSR), cyclin D 1 (CD1), and parathyroid hormone (PTH) mRNA levels between symptomatic and asymptomatic PHPT patients and controls determined via quantitative real-time polymerase chain reaction (qRT-PCR). Forty-two PHPT patients were studied. The mean (SD) age was 49.7 (12.8) years. Twenty patients were asymptomatic. The median PTH levels were significantly greater in the symptomatic group than in the asymptomatic group (878 vs 653 pg/mL). CaSR and VDR mRNAs were significantly lower in both symptomatic and asymptomatic patients than in controls. CD1 and PTH mRNAs were significantly increased in symptomatic patients, but not in asymptomatic PHPT patients compared with controls. Symptomatic PHPT patients had significantly greater CD1 mRNA expression and reduced CaSR expression than asymptomatic patients. Symptomatic PHPT patients had significantly greater CD1 mRNA expression and lower CaSR expression than asymptomatic patients, underscoring the importance of the molecular mechanisms underlying the phenotypic heterogeneity of PHPT.

Exploring ethnic diversity and clinical outcome variabilities in well-differentiated thyroid cancer among the Asian population

BackgroundWell-differentiated thyroid cancer includes papillary thyroid, follicular thyroid, and Hurthle cell cancers, comprising approximately 95% of all thyroid cancers in the United States. This study aims to understand well-differentiated thyroid cancer in the Asian population. MethodsWe analyzed the National Cancer Database from 2004 to 2019, categorizing the Asian population based on the available ethnicities. Multivariable logistic regression assessed the associations between ethnic groups and disease stage/nodal positivity. Survival outcomes were evaluated using the Kaplan-Meier and Cox regression analyses. ResultsA total of 364,604 adult patients were analyzed. The Asian ethnic groups included were Chinese (n = 3,851), Japanese (n = 740), Filipino (n = 3,466), Korean (n = 1,567), Vietnamese (n = 1,517), Laotian (n = 101), Hmong (n = 50), Kampuchean (n = 166), Thai (n = 160), Asian Indian (n = 1,526), Pakistani (n = 167), and Pacific Islander (n = 446). Japanese, Korean, and Laotian had higher percentages of stage III disease, whereas Japanese, Filipino, and Laotian had higher proportions of stage IV disease than the White population. Most Asian ethnicities had more patients with metastasis than the White population. Korean patients exhibited a 15% increased likelihood of metastasis (odds ratio: 1.15, confidence interval: 1.03–1.28, P < .05), whereas Pakistani patients were at 40% higher odds (odds ratio: 1.40, confidence interval: 1.03–1.91, P < .05), compared with White patients. Japanese, Laotian, and Kampuchean patients experienced worse 5- and 10-year overall survival than the White population. ConclusionOur study revealed substantial variation in well-differentiated thyroid cancer characteristics and outcomes among diverse Asian ethnicities. This challenges the notion of Asians as a homogeneous population, emphasizing tailored disease management for this heterogeneous group of patients.

Survival Difference of Colorectal Adenocarcinoma Among Racial and Ethnic Minority Groups: A SEER Database Study.

Despite advances in diagnosis and treatment, racial disparities continue to exist in colorectal cancer (CRC) survival. This study aims to characterize the CRC survival differences among racial and ethnic minority groups. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify adults diagnosed with CRC from 2015 to 2019. Demographics, disease characteristics, surgical treatment, stages, and survival data for individuals who are Hispanic, Black, Southeast Asian, Chinese, American Indian and Alaskan Native (AIAN), Asian Indian and Pakistani (AIP), and Native Hawaiian and Other Pacific Islanders (NHOPI) were extracted. Survival analysis was done using the Kaplan-Meier survival curve. Multivariate analysis was done with the Cox proportional hazard model. There were 40 091 individuals with CRC. NHOPI had the youngest median age of 59 years, while Chinese individuals had the oldest median age of 65 years. From the total sample of their respective subgroups, 43.8% of Black patients and 36.7% of AIAN patients had a median household income of <$60 000, while 55.3% of Southeast Asian patients, 59.7% of Chinese patients, 55.8% of AIP patients, and 65.6% of NHOPI patient had a median household income >$70 000. The 1-year survival rate was lower for patients who were Hispanic (62.0%), Black (60.9%), and AIAN (63.1%). Even after multivariate analysis, Black patients had a significant hazard ratio (HR) of 1.21 (95% confidence interval [95% CI]: 1.05-1.38), while AIP had a HR of 0.68 (95% CI 0.55-0.84), compared to AIAN. Other significant variables that were linked with survival included older age, advanced stage of CRC, a median household income <$60 000, male sex, no surgery, subtotal colectomy/hemicolectomy, and total colectomy. Further studies are needed to elucidate the specific causes of these differences and create appropriate strategies to reduce this survival disparity.

Treatment patterns of goserelin 3.6 mg once monthly and 10.8 mg every three months in women with breast cancer: A real-world analysis.

391 Background: Goserelin is a gonadotropin-releasing hormone agonist used for ovarian function suppression in the treatment of pre- and peri-menopausal patients with breast cancer. Goserelin, administered as a subcutaneous implant, is available in doses of 3.6 mg once monthly or 10.8 mg every three months; goserelin 3.6 mg is approved in the US, and both the 3.6 mg and 10.8 mg doses are approved by Health Canada and the European Medicines Agency. A study utilizing US real-world evidence was conducted to characterize treatment patterns of patients treated with goserelin 3.6 mg and/or 10.8 mg. Methods: Electronic health record data of adult patients with a history of breast cancer and with ≥2 prescriptions of goserelin between 1 January 2017 – 31 December 2022 were identified through TriNetX. Index date was the initiation of goserelin administration. Patients were followed until 15 March 2024. Patient demographics, treatment adherence, and healthcare resource utilization (HCRU) were examined and summarized using descriptive analytics. Results: Overall, 3,620 patients were identified: 2,870 treated with goserelin 3.6 mg, 410 with goserelin 10.8 mg, and 340 who switched from goserelin 3.6 mg to 10.8 mg. Peak utilization of goserelin 10.8 mg (36.6%) and peak dosage switching (26.5%) occurred in 2020. Across groups, mean age at index date was 42.2–44.4 years, and patients were white (64.1–67.6%), black (11.8%–13.9%), Asian (8.0%–11.8%), and American Indian and/or Alaskan native (0.3%–2.9%). Of patients with known BMI, BMI mostly ranged between 18.5–24.9 kg/m 2 in all groups. Patients who switched from goserelin 3.6 mg to 10.8 mg had the longest median treatment duration (776 days) (Table). Patients treated with goserelin 10.8 mg remained on treatment for a median of 426 days; 74.4% of these patients were treatment-adherent (Table). In comparison, patients treated with goserelin 3.6 mg had a shorter median treatment duration (226 days) and were less adherent (56.4%) (Table). HCRU during the 12 months after index date was broadly similar across groups. Conclusions: Treatment with goserelin 10.8 mg every three months is associated with greater adherence and longer treatment duration, compared with 3.6 mg once monthly, in patients with a history of breast cancer. Patients who switched from goserelin 3.6 mg to 10.8 mg were treatment-adherent for nearly two years, consistent with clinical recommendations. Goserelin 3.6 mg (n = 2,870) Goserelin 10.8 mg (n = 410) Switched from goserelin 3.6 mg to 10.8 mg (n = 340) Median duration of treatment (days) 264 429 776 Median time to switch (days) — — 218 Patients adherent* to dosing schedule 1,608 (56.4%) 306 (74.4%) — Status as of March 15, 2024 Discontinued goserelin 2,018 (70.8%) 261 (64.3%) 173 (50.9%) Death 88 (3.1%) 10 (2.5%) 3 (0.9%) *Defined as: ≤36 days between prescriptions (3.6 mg) or ≤108 days between prescriptions (10.8 mg).

Abstract A066: Unmasking differences in adolescent HPV vaccine uptake in six Asian American subgroups: data from the national immunization survey-teen (2015-2019)

Abstract Introduction: The HPV vaccination rates among Asian American adolescents were found to be below optimal levels. Understanding the high-risk demographics and the various factors influencing HPV vaccine acceptance is essential for addressing disparities and enhancing vaccination rates in this population. This study aimed to investigate HPV vaccine uptake in adolescents aged 13 to 17 across six major Asian American ethnic groups using nationally representative data. Methods: The study analyzed data from the National Immunization Survey- Teen (2015-2019), comprising 3,968 Asian American adolescents from Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese backgrounds. Provider and practice characteristics were examined alongside HPV vaccine initiation and completion rates within each subgroup. Results: Findings revealed that while the overall initiation rate among Asian American adolescents was 66.65%, significant variations existed among subgroups, ranging from 57.3% in Asian Indians to 71.22% in Chinese adolescents. Similarly, completion rates ranged from 30.89% in Asian Indians to 48.14% in Chinese adolescents, with an aggregated completion rate of 40.37% for the total Asian American sample. Household survey data generally showed lower initiation and completion rates compared to provider-reported data but still reflected subgroup disparities. Conclusion: Across all ethnic groups, a common barrier to HPV vaccination was the lack of physician recommendation. However, slight variations in this barrier were observed among subgroups. These findings underscore the importance of considering socioeconomic, cultural, and acculturation-related factors in designing effective public health and clinical interventions to promote HPV vaccination among Asian American adolescents. Citation Format: Lin Zhu, Elaine Z. Liu, Philip Siu, Chun Pan, Grace X. Ma. Unmasking differences in adolescent HPV vaccine uptake in six Asian American subgroups: data from the national immunization survey-teen (2015-2019) [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A066.

Use of Hematopoietic Cell Transplant for Hematologic Cancers by Race, Ethnicity, and Age.

Utilization of hematopoietic cell transplantation (HCT) for hematologic cancers previously demonstrated race, ethnicity, and age-based disparities. To evaluate utilization over time by race, ethnicity, and age to determine if disparities persist in light of recent significant increases in HCT volume. This US population-based retrospective cohort study includes patients who received transplants from January 2009 to December 2018. Data collection and cleaning occurred from February 2019 to November 2021, and data analysis occurred from January 2022 to October 2023. Method 1 restricted the analysis to Surveillance, Epidemiology and End Results (SEER) reporting areas for cases and transplants. Method 2 applied SEER age-, race-, and ethnicity-specific incidence rates to corresponding US census population and included all transplants reported to the Center for International Blood and Marrow Transplant Research. Race and ethnicity groups were hierarchically defined as Hispanic (any race), non-Hispanic White, non-Hispanic Black, and non-Hispanic Other (Asian and American Indian). Receipt of HCT. Utilization rate of autologous or allogeneic HCT for patients with hematologic cancers by age, race, and ethnicity. From 2009 to 2018, 136 280 HCTs were analyzed for 6 hematologic cancers comprising 16.7% pediatric/adolescent/young adults (0-39 years), 83.3% adults (40-84 years), 58% male, 10.3% Hispanic, 11.4% non-Hispanic Black, 3.8% non-Hispanic Other, and 74.5% non-Hispanic White patients, with 49 385 allogeneic and 86 895 autologous HCTs performed. HCT utilization increased over time for all disease, age, race, and ethnic groups. From 2017 to 2018, adult (40-84 years) allogeneic transplant utilization for acute myeloid leukemia and myelodysplastic syndrome (MDS) was similar for Hispanic and non-Hispanic White or Other patients but was lower for non-Hispanic Black patients (acute myeloid leukemia: 19% vs 13%; MDS: 9%-10% vs 5%). Similarly, autologous transplant utilization for lymphoma was similar for all race and ethnicity groups; however, autologous transplant for multiple myeloma was highest for non-Hispanic White patients and lower for all other groups (31% vs 26%-27%). In patients aged 0 to 39 years, utilization of allogeneic transplant for acute lymphoblastic leukemia was highest in Hispanic patients, followed by non-Hispanic White, Black, and Other races (acute lymphoblastic leukemia: 19%, 18%, 17%, and 16%, respectively). In this cohort study of autologous and allogeneic transplant utilization for hematologic cancers, disparities persisted for non-Hispanic Black patients. Hispanic, non-Hispanic Other, and younger age groups had increased utilization over time that was on par with non-Hispanic White patients in the most recent cohort.

The effects of health beliefs and acculturation on the acceptance of human papillomavirus vaccination among Asian Indian parents in the United States.

The available limited literature and Centers for Disease Control data suggest that human papillomavirus (HPV) vaccination acceptance is lower among Asian Indians than the general population in the United States. The purpose of the study was to determine the effects of health beliefs, subjective norms, acculturation, and demographics on HPV vaccination acceptance among Asian Indian parents. Using a comparative descriptive cross-sectional study design, immigrant and first-generation Asian Indian parents of 9- to 16-year-old children were recruited (N = 171). The survey comprised the Health Belief and Subjective Norms instrument and the Suinn-Lew Asian Self-Identity Acculturation Scale. The analysis included parametric and nonparametric tests. Participants who expressed higher levels of perceived barriers were less likely to accept HPV vaccination (odds ratio [OR] = 0.47, p = .016). Spousal opinion negatively correlated with HPV vaccination acceptance (OR = 0.57, p = .006). However, subjective norms positively predicted HPV vaccination acceptance (OR = 1.69, p = .039). Participants who perceived that friends and family approved of the vaccination also had significantly higher rates of vaccination acceptance (OR = 11.99, p = .001). The results revealed unique factors in the acceptance of HPV vaccination in Asian Indians that were not examined or understood before. The applied Health Beliefs and Subjective Norms theoretical framework suggested that perceived barriers, subjective norms, and the opinions of spouses, friends, and family predicted HPV vaccination acceptance. Educational interventions targeting providers, spouses, family, and community members with influential effects on parents may positively affect HPV vaccination acceptance. Providers should note that this population welcomes the provider's recommendations.

Myocardial Infarction Quality of Care and Outcomes in Asian Ethnic Groups in the United States.

National-level differences in myocardial infarction (MI) quality of care among Asian patients in the United States are unclear. We assessed the quality of MI care in the 6 largest US Asian ethnic groups. Patients aged ≥18 years with ST-segment-elevation MI or non-ST-segment-elevation MI in the Get With The Guidelines-Coronary Artery Disease registry (711 US hospitals, 2015-2021) were assessed. The odds of MI-related quality of care and process outcomes were evaluated in Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, and other Asian adults compared with non-Hispanic White adults. Sex-stratified logistic regression models were adjusted for age and clinical characteristics. There were 5691 Asian patients (1520 Asian Indian, 422 Chinese, 430 Filipino, 114 Japanese, 283 Korean, 553 Vietnamese, and 2369 other Asian) and 141 271 non-Hispanic White patients, overall 30% female, and mean age of 66.5 years. Relative to non-Hispanic White adults, among patients with ST-segment-elevation MI, door-to-ECG time ≤10 minutes was less likely in Asian Indian (adjusted odds ratio [aOR], 0.64 [95% CI, 0.50-0.82]), Chinese (aOR, 0.65 [95% CI, 0.46-0.93]), and Korean (aOR, 0.57 [95% CI, 0.33-0.97]) men and in other Asian women (aOR, 0.61 [95% CI, 0.41-0.90]). Door-to-balloon time ≤90 minutes was less likely in Asian Indian men (aOR, 0.71 [95% CI, 0.56-0.90]) and Filipina women (aOR, 0.48 [95% CI, 0.24-0.98]). In patients with ST-segment-elevation MI or non-ST-segment-elevation MI, optimal medical therapy for MI was less likely in Korean men (aOR, 0.65 [95% CI, 0.47-0.90]) and more likely in Asian Indian men (aOR, 1.22 [95% CI, 1.06-1.40]) and women (aOR, 1.32 [95% CI, 1.04-1.67]) and Filipina women (aOR, 1.84 [95% CI, 1.27-2.67]). MI quality of care varies among US Asian patients with ST-segment-elevation MI and non-ST-segment-elevation MI. Quality improvement programs must identify and address the factors that result in suboptimal MI quality of care among US Asian patients.