Asian Indian Research Articles

Disease characteristics and clinical outcomes of endometrial cancer in Asian Indian and Pakistani American (AIPA) women

Disease characteristics and clinical outcomes of endometrial cancer in Asian Indian and Pakistani American (AIPA) women

Diabetes-Related Cardiovascular and All-Cause Mortality in Asian American Subgroups

BackgroundAsian Americans experience heterogeneity in cardiovascular risk factors and cardiovascular disease, with a particularly high burden of diabetes in several Asian subgroups. ObjectivesThe objectives of this study were to quantify diabetes-related mortality in Asian American subgroups and compare this with Hispanic, non-Hispanic Black, and non-Hispanic White individuals. MethodsUsing national-level vital statistics data and concurrent population estimates, age-standardized mortality rates and proportional mortality from diabetes-related mortality were calculated for non-Hispanic Asian (and subgroups: Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese), Hispanic, non-Hispanic Black, and non-Hispanic White populations in the United States, 2018-2021. ResultsDiabetes-related deaths numbered 45,249 in non-Hispanic Asian, 159,279 in Hispanic, 209,281 in non-Hispanic Black, and 904,067 in non-Hispanic White individuals. Among Asian Americans, age-standardized mortality rates of diabetes-related mortality with cardiovascular disease as underlying cause ranged from 10.8 (95% CI: 9.9-11.6) per 100,000 in Japanese females to 19.9 (95% CI: 18.9-20.9) per 100,000 in Filipina females, and from 15.3 (95% CI: 13.9-16.8) per 100,000 in Korean males to 37.8 (95% CI: 36.1-39.5) per 100,000 in Filipino males. The proportion of all deaths related to diabetes was higher in all Asian subgroups (9.7%-16.4% for females; 11.8%-19.2% for males) compared with non-Hispanic Whites (8.5% for females; 10.7% for males). The highest proportion of diabetes-related deaths occurred in Filipino adults. ConclusionsThere was an approximately 2-fold variation in diabetes-related mortality among Asian American subgroups, with Filipino adults experiencing the greatest burden. All Asian subgroups experienced higher proportional mortality for diabetes-related mortality compared with non-Hispanic White individuals.

Toward precision sleep medicine: variations in sleep outcomes among disaggregated Asian Americans in the National Health Interview Survey (2006-2018).

Asian Americans report higher rates of insufficient sleep than non-Hispanic Whites (NHWs). It is unclear how sleep outcomes differ among disaggregated Asian subgroups. The National Health Interview Survey (2006-2018) was used to analyze self-reported sleep duration and quality measures for Asian American subgroups (Chinese [n = 11,056], Asian Indian [n = 11,249], Filipino [n = 13,211], and other Asians [n = 21,767]). Outcomes included hours of sleep per day, the number of days reporting trouble falling asleep, staying asleep, waking up rested, and taking sleep medication in the past week. Subsetted multivariate logistic regression was used to assess factors impacting sleep outcomes by ethnicity. 29.2% of NHWs, 26.4% of Chinese, 24.5% of Asian Indians, and 38.4% of Filipinos reported insufficient sleep duration. Filipinos were less likely to report sufficient sleep duration (odds ratio 0.55, [confidence interval 95% 0.50-0.59]) and more likely to report trouble falling asleep (1.16 [1.01-1.33]) than NHWs. Chinese and Asian Indians had less trouble staying asleep (0.67 [0.58-0.77], 0.51 [0.44-0.59]) and falling asleep (0.77 [0.66-0.89], 0.72, [0.62-0.82]) than NHWs, and Asian Indians were more likely to wake feeling well rested (1.66 [1.48-1.87]). All Asian subgroups were less likely to report using sleep medications than NHWs. Foreign-born status had a negative association with sufficient sleep duration in Filipinos but a positive association in Asian Indians and Chinese. Filipinos report the highest burden of poor sleep outcomes, and Asian Indians report significantly better sleep outcomes. These findings highlight the importance of disaggregating Asian ethnic subgroups to address their health needs. Wang RZ, Jamal A, Wang Z, etal. Toward precision sleep medicine: variations in sleep outcomes among disaggregated Asian Americans in the National Health Interview Survey (2006-2018). J Clin Sleep Med. 2023;19(7):1259-1270.

Channeling and Wages Among New US Immigrants from Mexico, India, and the Philippines

National — and local — conversations about immigration are often centered on immigrants’ integration into the US society. One factor that shapes immigrants’ integration is their pre-migration work experience, skills, and training and a series of studies have used “channeling” as a concept to identify immigrants who have worked in the same occupation and/or industry in the destination labor market as they had in the origin labor market, prior to migration. Using the New Immigrant Survey (NIS) and a simultaneous equation model (SiEM) approach, this article expands on this research by exploring the impact of channeling on wages for Asian Indians, Filipino/as, and Mexicans with lawful permanent resident (LPR) status. Contrary to prior findings on the effects of channeling within specific industries, we find that channeling is associated with lower, not higher, immigrants’ wages. The findings are robust to different definitions of channeling, as the negative effects of channeling hold within industrial sectors and occupational groups. Moreover, the results indicate that channeling is not exclusive to the Mexico–US migration stream, but instead may be a feature of various US-bound immigration streams, including those from India and the Philippines.

Linkage between the India–Asia collision and far-field reactivation of the Altai mountains

The present northwest-trending Altai mountains, as far as ∼2000 km north of the Indian–Asian collision front, are dominated by a transpressional strike-slip fault system, and are generally considered as one of distant tectonic effects of the ongoing India–Asia collision. However, the Cenozoic reactivation of the Altai and its linkage with the tectonic evolution of the Tibet plateau remain mechanically challenging. Here, we constructed large-scale 2D numerical models with inherited lithospheric heterogeneities from India to Altai representing the onset of the India–Asia collision. The sensitivity of model results to variable thermo-mechanical and geometric properties of the orogen-like Tibet and Altai as well as variable thermal state of the craton-like India and Junggar reveals that both the particular lithospheric architecture of western Tibet and basement structural inheritance of central Asia regulate the long-distance deformation propagation from the India–Asia plate boundary to the Altai–Sayan region. The model results indicate that the direct collision of the underthrusting Indian lithosphere with the rigid Tarim block beneath western Tibet plays a dominant role in the ultra-long-distance deformation propagation to central Asia. As less-deformed rigid blocks, the Tarim and Junggar basins with Precambrian basements serve as secondary indenters that transfer the compressive stresses extensively to the Altai–Sayan region. Constrained by substantial surface geology and geophysical observations, this numerical study recognizes the linkage between the evolving lithospheric structure of western Tibet with the northward younging trend of reactivation of the orogenic belts in central Asia. By means of the rigid Indian–Tarim lithospheric mantle collision, the plate-convergence stress can be effectively transmitted through Tarim to Tian Shan and subsequently through Junggar to Altai, leading to successive reactivation of the Tian Shan and Altai mountains. The locations of reactivation are determined by the inherited structural zones of lithospheric weakness that formed during the Paleozoic assembly of the Central Asian Orogenic Belt.

Abstract P3-03-11: Racial and Ethnic Disparities in Screening Mammography During COVID-19

Abstract Purpose: Studies conducted prior to COVID-19 suggested that racial/ethnic disparities in breast cancer screening percentages have substantially reduced over time. COVID-19 has had devastating effects on racial/ethnic minorities and resulted in delays in preventive breast cancer screening. Our purpose was to determine if racial/ethnic minorities were less likely to receive recommended breast cancer screening after the resumption of preventive care during the COVID-19 pandemic. Methods: HIPAA-compliant, institutional review board exempt retrospective cohort study was performed at a multi-location academic medical center located in the Midwest. Patients included women aged 50-74 years old between June 2021 and May 2022, derived from the electronic medical records. Primary outcomes variables included receipt of screening mammogram within the last two years. Primary exposure variables included race (American Indian/Alaska Native, Asian/Native Hawaiian/Other Pacific Islander, Black or African American, White) and ethnicity (Hispanic/Latino, and Not Hispanic/Latino). Binary outcomes were analyzed using logistic regression, adjusted for potential confounders (insurance, age, preferred language, employment status, rural status). Results: 37,509 female patients without histories of mastectomies were included (mean age 63.1). 73.8% of eligible patients received a mammogram within the last two years. By race, 74.7% of White patients, 57.6% of Black patients, 67.0% of Asian/Pacific Islander patients, and 60.1% of American Indian patients received a screening mammogram within the last two years. In our unadjusted analyses, Black (OR 0.46, 95% CI 0.41 to 0.52, p < 0.001), Asian (OR 0.69, 95% CI 0.60 to 0.79, p < 0.001), and American Indian patients (OR 0.51, 95% CI 0.39 to 0.66, p < 0.001) were less likely to receive recommended mammography screening. In our adjusted analyses, Black (OR 0.54, 95% CI 0.47 to 0.61, p < 0.001), Asian (OR 0.79, 95% CI 0.68 to 0.92, p = 0.003), and American Indian patients (OR 0.63, 95% CI 0.48 to 0.82, p = 0.001) were less likely to receive recommended mammography screening. By ethnicity, 74.1% of Non-Hispanic patients and 64.2% of Hispanic patients received a screening mammogram within the last two years. In our unadjusted analyses, Hispanic patients (OR 0.62, 95% CI 0.55 to 0.71, p < 0.001) were less likely to receive recommended mammography screening. In our adjusted analyses, Hispanic patients (OR 0.92, 95% CI 0.79 to 1.08, p = 0.338) were comparably likely to receive recommended mammography screening. Patients with non-English preferred languages, uninsured or Medicaid patients, and patients living in rural areas were less likely to receive recommended mammography screening (p < 0.001). Conclusions: Racial/ethnic minority patients were less likely to receive recommended cancer screening after the resumption of preventive breast cancer screening during the COVID-19 pandemic. Targeted outreach efforts are required to ensure equitable access to breast cancer screening for racial/ethnic minorities, patients with non-English preferred languages, uninsured, Medicaid, and rural patients. Citation Format: Arissa Milton, Ryan Woods, Mai Elezaby, Kelly Hackett, Joan Neuner, Anand Narayan, Roberta Strigel. Racial and Ethnic Disparities in Screening Mammography During COVID-19 [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-03-11.

Colonial mentality, racism, and depressive symptoms: Asian Indians in the United States.

Colonial mentality, racism, and depressive symptoms: Asian Indians in the United States.

Abstract P6-05-32: Does Aggregation Hide Place of Death Disparities for Asians with Breast Cancer?

Abstract Introduction: Place of death (PoD) studies are often used to motivate and monitor progress on health inequities for persons with cancer. It remains unclear whether aggregation of Asian race masks disparities in health equity for care at the end of life. Methods: De-identified death certificate data were obtained via the National Center for Health Statistics. All adult (>18 years of age) breast cancer deaths from 2018 to 2019 were included. Multinomial logistic regression was used to test for differences in place of death associated with sociodemographic variables. Results: From 2018 through 2019, 81,772 died from breast cancer in the United States. Overall, persons of Asian descent were less likely to die at home compared to White patients. Disaggregation noted significant differences in likelihood of hospice facility use. For example, Filipino race was approximately 5 times more likely to utilize hospice facilities (CI 3.764, 8.718; p< 0.001) compared to Whites, whereas Chinese race was significantly less likely (OR 0.49, 95% CI 0.307 to 0.627, p< 0.001). American Indian (OR 0.006), Asian Indian (OR 0.016), and Samoan (0.011) were the least likely to die in a nursing facility. While trends were overall similar when compared to White, Black and Hispanics, the likelihood of PoD among Asian subgroups were significantly different. Conclusion: Our data highlights notable differences in PoD only apparent with disaggregation of Asian race. While this study remains exploratory in nature, and reasons to explain these disparities are necessary, disaggregation of the Asian Pacific Island category is imperative to unmask disparities to improve health equity among all indigenous populations. Association Between Race and Place of Death for Patients with Breast Cancer Table 1. Number of deaths due to breast cancer in 2018 and 2019, by race. Odds ratios for the association between race and place of death from multinomial regression. Citation Format: Naveena Lall, Alexandra Noveihed, Qasim S. Hussaini, Amanda L. Blackford, Arjun Gupta, Ramy Sedhom. Does Aggregation Hide Place of Death Disparities for Asians with Breast Cancer? [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-32.

Rationalizing the Use of COVID-19 Questionable Efficacy Drugs in a Low Middle-income Country: A Hospital Tocilizumab Committee Experience.

Only corticosteroids have confirmed mortality benefits in coronavirus disease of 2019 (COVID-19). Rational use of costlier drugs with questionable benefits poses a great concern to hospital pharmacies in low middle-income countriesAim: The present study aimed to assess the rational utilization of hospital supply tocilizumab and understand its clinical benefits in hospitalized COVID-19 pneumonia patientsMethods: The Hospital Tocilizumab Committee (HTC) decision support system framework was developed to make patients eligible or ineligible for tocilizumab procurement from the hospital pharmacy. A total of 33 consecutive patients receiving tocilizumab were analyzed retrospectively in the 3-month study period. The records of the inpatient stay of the patients were observed for pulse, blood pressure, respiratory rate (RR), oxygen saturation (SpO2), fraction of inspired oxygen (FiO2) laboratory work-up, hospital stay duration, and mortality benefit, if any. Patients were analyzed as "died," "survived," and "composite" subgroupsResults: The study observed death as a final outcome in 48% of patients. The study observed a significant effect of tocilizumab on C-reactive protein (CRP) (p = 0.02) and ferritin (p = 0.018) levels on a 10-day follow-up when all patients were analyzed together. Rising and declining trends of RR and FiO2 were observed among the "died" (RR, p = 0.02; FiO2, p = 0.03) and survived (RR, p = 0.03; FiO2, p = 0.05) subgroups. The second dose of tocilizumab was received by 88% of survivors as against 50% of patients who died (p = 0.04)Conclusion: Hospital Tocilizumab Committee (HTC) was successfully established to continue the assessment of the costlier drug with uncertain treatment benefits. A repeat dose of tocilizumab may provide a mortality benefit in Asian Indians.

“Break down these walls”: Stories of mental health service access by Asian Indian Americans.

“Break down these walls”: Stories of mental health service access by Asian Indian Americans.

IDF2022-1259 Energy expenditure patterns and Insulin resistance in Asian Indian women with Gestational Diabetes – A prospective study

IDF2022-1259 Energy expenditure patterns and Insulin resistance in Asian Indian women with Gestational Diabetes – A prospective study

Abstract P333: Asian-Specific BMI Cutoffs as a Predictor for Mortality Risk

Introduction: Prior studies have found a U-shaped association between body mass index (BMI) and mortality. The WHO has recommended Asian-specific BMI guidelines to better screen for BMI-related diseases among Asians. Little is known about patterns between BMI and mortality rates in Asian subgroups. We used Asian-specific BMI cutpoints to determine whether BMI was associated with mortality among disaggregated Asian subgroups. Methods: A sample of Asians (n=26,831) was obtained from the 1999-2018 National Health Interview Survey (NHIS) linked to the National Death Index. BMI was calculated with self-reported height and weight. Individuals were grouped into 4 BMI classes by Asian-specific BMI cutpoints: underweight (BMI <18.5), normal (BMI >18.5-22.9), overweight (BMI > 23-24.9), and obese (BMI ≥ 25) categories. Using Poisson models, we calculated the age-standardized mortality rate (ASMR) per 1,000 person years (PY) for All Asian adults and specific sub-groups (Asian Indian, Chinese, Filipino, Other Asian) with normal weight as a reference. Results: Our sample was comprised of 20.6% Chinese (n=5517), 22.8% Filipino (n=6111), 19.5% Asian Indian (n=5232), and 37.2% Other Asian (n=9971). Compared to normal BMI, underweight individuals had significantly higher ASMR among all Asians and more specifically among Chinese, Filipinos, and Asian Indians, but not among Other Asians. Compared to normal BMI, risk of mortality was not significantly different among overweight or obese individuals across any Asian subgroup. Conclusion: We found that low BMI was consistently associated with increased mortality among all Asian subgroups. In contrast to what has been described in Non-Hispanic White adults, we found that overweight or obesity was not associated with increased mortality among Asian American subgroups utilizing Asian-specific cutpoints.

Abstract P631: Association Between Suboptimal Sleep Duration and Cardiovascular Disease Prevalence Among Asian Americans

Importance: Cardiovascular disease (CVD) risk and prevalence is widely varied among Asian Americans. The American Heart Association recently added healthy sleep to its metrics used to define ideal cardiovascular health. Little is known about the association between sleep and CVD prevalence among Asian subgroups. Hypothesis: The association between suboptimal sleep duration and CVD risk prevalence will differ by Asian American subgroup. Methods: We analyzed results from the National Health Interview Survey (2012-2018, N=234,126), a nationally representative sample. Participants (age>40 years old) included 214,956 non-Hispanic Whites (NHWs), 3,043 Asian Indians, 3,993 Chinese, 4,719 Filipinos, and 7,603 other Asians. Suboptimal sleep was self-reported and defined as <7 or >9 hours. CVD was defined as self-reported stroke, heart attack, coronary artery disease, or angina. We used multivariable logistic regression models to ascertain the association. All analyses included complex survey design considerations. Results: Suboptimal sleep duration was associated with higher CVD prevalence for NHWs and all Asians, but in Asian subgroup stratified analyses, suboptimal sleep was only associated with higher CVD prevalence among Other Asians. Conclusions: Our results show heterogeneity in the association between sleep duration and CVD prevalence among Asian subgroups, however further research is needed to better understand these relationships.

Abstract P558: Association of Reproductive Characteristics With Cardiometabolic Risk Factors in Women in India an Analysis of Nationally Representative Data

Introduction: In addition to established risk factors for cardiovascular disease, women have unique biological characteristics related to reproduction that may further contribute to their CV risk. Among South Asian Indians, this aspect has been understudied. This study addresses this gap by evaluating the relationship between reproductive characteristics and cardiometabolic risk factors (CMRF) among women in India. Methods: We analyzed data from a community-based nationally representative sample of women aged 15-49 in the National Family Health Survey-5 (N= 724,115). Primary exposures (self-reported) included age at union and first delivery, use of contraception and history of pregnancy loss. Study outcomes (self-reported, objectively measured) were prevalent hypertension (HTN), diabetes mellitus (DM) and obesity. We estimated the association between each exposure and outcome using survey-weighted multivariable Poisson regression models adjusted for age, religion, caste, location, education and employment. Results: Prevalence (95% CI) of HTN (measured blood pressure of >=140/90 mm Hg), DM (self-reported or on medications to lower blood glucose levels) and obesity (body mass index > 25kg/m 2 ) was 25.8 (25.5, 26.2)%, 1.9 (1.8, 1.9)% and 24 (23.8, 24.2)%, respectively. Younger age at union and first delivery and, use of contraception [PR (95% CI): 1.13 (1.11, 1.16)] were associated with higher obesity. Pregnancy loss (due to miscarriage or abortion) was associated with higher prevalent DM [PR (95% CI): 1.21 (1.03, 1.41)] and obesity [PR (95% CI): 1.26 (1.22, 1.31)] ( Table ). Conclusion: Reproductive characteristics (age at union and first delivery, and pregnancy loss) are linked to higher prevalence of CMRF. These results provide impetus for screening for reproductive history and its inclusion in risk prediction algorithms for cardiovascular risk among Indian women. Table: Cross-sectional associations between reproductive characteristics with cardiometabolic risk factors, in the NFHS-5 (N= 724,115)

Abstract P363: Knowledge of COVID-19-Related Risk Factors and Conditions Among Asian American, Native Hawaiian, and Pacific Islander Adults, February-April 2022

Introduction: Communities of color, including Asian Americans (AAs), Native Hawaiians and Pacific Islanders (NH/PIs), experienced higher rates of COVID-19 infection, hospitalization and death compared to white populations during the early pandemic. Further, there are known disparities in cardiovascular disease (CVD) risk factors among AA and NH/PI groups that existed pre-pandemic (e.g., greater prevalence of diabetes among Filipino and Asian Indian compared to white adults). These outsized risks are combined with the increased experience of anti-Asian racism in this period along with historical distrust of health institutions, and legacies of structural racism that have made communities of color vulnerable to the pandemic. The purpose of this study was to understand knowledge of COVID-19-related conditions among AA and NH/PI ethnic groups, in order to anticipate and mitigate further COVID-19 and CVD disparities. Hypothesis: We hypothesize that knowledge of post-COVID-19 conditions and variants would vary by disaggregated AA and NH/PI ethnic group. Methods: The National COVID-19 Rapid Needs Assessment was conducted among AA and NH/PI adults from February to April 2022 with the help of ten community partners (n = 1,358; 1,197 AAs and 153 NH/PIs). The survey was primarily administered online in English and 11 Asian languages. We examined the following COVID-19 knowledge outcomes: vaccine breakthrough infections, COVID-19 variants, and long COVID. Responses included: ‘I know a lot about it,’ ‘I know a moderate amount about it,’ ‘I have heard of it, but don’t know much about it,’ and ‘I haven’t heard of it.’ Outcomes were disaggregated by seven AA (Chinese, Taiwanese, Filipino, Japanese, Korean, Vietnamese, South Asian) and two NH/PI (Polynesian, Micronesian) subgroups. Additional analyses will examine differences in knowledge based on misinformation and disinformation in the absence of timely, language concordant COVID-19 information. Results: Among AAs overall, 14.0% had not heard of vaccine breakthrough infections; 7.4% had not heard of COVID-19 variants; and 11.7% had not heard of long COVID. South Asian adults reported the lowest knowledge of COVID-19, while Filipinos reported the highest knowledge. Among NH/PI adults, 27.2% had not heard of vaccine breakthrough infections; 6.6% had not heard of COVID-19 variants; and 28.4% had not heard of long COVID. Both NH/PI subgroups reported very low knowledge of breakthrough infections and long COVID. Conclusion: Findings indicate COVID-19-related knowledge disparities across AA and NH/PI ethnic subgroups which may be more pronounced among South Asian and NH/PI communities. The COVID-19 pandemic will exacerbate known CVD health disparities if the pandemic mitigation strategies (e.g., disaggregated racial/ethnic data collection) are not inclusive of communities of color, immigrants and limited English fluent populations.

THE EFFICACY OF BALANCE TRAINING TO REDUCE FALL RISK IN OLDER ADULTS

There are a number of accepted definitions for the risk of falls (ROF). But the almost all of these agree that in the event of a fall rate in the person comes to the lower level or on the ground unintentionally rates are increasing. According to the original research analysis with our results obtained from our experiences and data bases (2019-2023). Here we have find out more than (90-95%) the balance training is quite helpful for the older adults from fall risk in Asian Indian countries and the World wide.

Disaggregating Racial and Ethnic Data: A Step Toward Diversity, Equity, and Inclusion

Disaggregating Racial and Ethnic Data: A Step Toward Diversity, Equity, and Inclusion

Body fat patterning in lean Asian Indians with diabetes: Case-control study

AimTo perform body fat patterning in Asian-Indian individuals with T2D. MethodsA total of 53 patients with recent-onset diabetes and 106 non-diabetic controls were included from screened 261 individuals. Data was divided into 2 groups; overweight/obese [(BMI ≥23 kg/m2); 45 diabetic, 84 non-diabetic] and lean [(BMI <23 kg/m2); 8 diabetic, 22 non-diabetic]. Anthropometry (weight, height, BMI, waist, hip circumference, waist-hip ratio) and lipids, adiponectin and hsCRP were measured. Body composition (BC) was assessed by bioimpedance analysis (BIA) and Dual Energy X-ray absorptiometry (DEXA). We analyzed the association of visceral adipose tissue (VAT) with anthropometric measures to identify predictors of diabetes. ResultsTotal body fat percentage was comparable between patients with T2D and non-diabetic controls in both, obese [35.0 ± 9.1% vs 36.8 ± 8.4%, p = 0.29 (BIA), 40.1 ± 6.7 vs 46.6 ± 4.1%, p = 0.052 (DEXA) and lean [25.1 ± 5.6% vs 26.0 ± 6.7%, p = 0.74 (BIA), 35.3 ± 4.8% vs 34.1 ± 6.3%, p = 0.72 (DEXA) study group. Individuals of T2D (obese or lean) had significantly higher visceral fat rating (BIA), VAT area, volume, mass and VAT corrected for total body fat percentage (DEXA). Obese T2D had lower muscle mass (57.0 ± 6.4% vs 60.0 ± 5.5%, p = 0.03) than obese controls. Intra-abdominal visceral fat (IAVF) [(VFR, VAT (mass/area/volume) and VAT mass corrected for body fat)] had the best sensitivity (71%) for incident diabetes. ConclusionHigher Intra-abdominal visceral fat and not total body fat is associated with incident diabetes independent of BMI. IAVF estimation by either BIA or DEXA should be performed to predict diabetes especially in lean individuals.

The association between maternal stature and adverse birth outcomes and the modifying effect of race and ethnicity: a population-based retrospective cohort study

There are known differences in the risk of perinatal and maternal birth outcomes because of maternal factors, such as body mass index and maternal race. However, the association of maternal height with adverse birth outcomes and the potential differences in this relationship by race and ethnicity have been understudied. This study aimed to examine the association between maternal stature and adverse perinatal outcomes and the potential modification of the association by race and ethnicity. This retrospective cohort study was conducted using data on all singleton births in the United States in 2016 and 2017 (N=7,361,713) obtained from the National Center for Health Statistics. Short and tall stature were defined as <10th and >90th percentiles of the maternal height distribution (<154.9 and >172.7 cm, respectively). Race and ethnicity categories included non-Hispanic White, non-Hispanic Black, American Indian or Alaskan Native Asian or Pacific Islander, and Hispanic. The primary outcomes were preterm birth (<37 weeks of gestation), perinatal death, and composite perinatal death or severe neonatal morbidity. Logistic regression was used to obtain adjusted odds ratios and 95% confidence intervals with adjustment for confounding by maternal age, body mass index, and other factors. Multiplicative and additive effect modifications by race and ethnicity were assessed. The study population included 7,361,713 women with a singleton stillbirth or live birth. Short women had an increased risk of adverse outcomes, whereas tall women had a decreased risk relative to average-stature women. Short women had an increased risk of perinatal death and composite perinatal death or severe neonatal morbidity (adjusted odds ratios, 1.14 [95% confidence interval, 1.10-1.17] and 1.21 [95% confidence interval, 1.19-1.23], respectively). The association between short stature and perinatal death was attenuated in non-Hispanic Black women compared with non-Hispanic White women (adjusted odds ratio, 1.10 [95% confidence interval, 1.03-1.17] vs 1.26 [95% confidence interval, 1.19-1.33]). Compared with average-stature women, tall non-Hispanic White women had lower rates of preterm birth, perinatal death, and composite perinatal death or severe neonatal morbidity (adjusted odds ratios, 0.82 [95% confidence interval, 0.81-0.83], 0.95 [95% confidence interval, 0.91-1.00], and 0.90 [95% confidence interval, 0.88-0.93], respectively). The association between tall and average stature with perinatal death was reversed in Hispanic women (adjusted odds ratio, 1.27; 95% confidence interval, 1.12-1.44). Compared with average-stature women, all tall women had lower rates of preterm birth, particularly among non-Hispanic Black and Hispanic women. Relative to average-stature women, short women have an increased risk of adverse perinatal outcomes across all race and ethnicity groups; these associations were attenuated in Hispanic women and for some adverse outcomes in non-Hispanic Black and Asian women. Tall mothers have a lower risk of preterm birth in all racial and ethnic groups, whereas tall non-Hispanic White mothers have a lower risk of perinatal death or severe neonatal morbidity compared with average-stature women.

Understanding search autocompletes from the perspectives of English and Spanish speakers during the early months of the COVID-19 pandemic.

The purpose of the study was to explore differences in Google search autocompletes between English and Spanish-speaking users during the first wave of thecoronavirus disease 2019 (COVID-19) pandemic. Twenty-nine individuals who were in areas with shelter-in-place state orders participated in a virtual focus group meeting to understand the algorithm bias of COVID-19 Google autocompletes. The three focus group meetings lasted for 90-120 minutes. A codebook was created and transcripts were coded using NVivo qualitative software with a 95% intercoder reliability between two coders. Thematic analysis was used to analyze the data. Among the 29 participants, six self-identified as White, seven as Black/African American, five as American Indian or Alaska Native, four as Asian Indian, and three as Native Hawaiian or Pacific Islander. In terms of ethnicity, 21 participants identified as Hispanic/Latino. The themes that emerged from the study were: (1) autocompletes evoked fear and stress; (2) skepticism and hesitation towards autocomplete search; (3) familiarity with COVID-19 information impacts outlook on autocomplete search; (4) autocompletes can promote preselection of searches; and (5) lesser choice of autocomplete results for Spanish-speaking searchers. Spanish speakers expressed concerns and hesitation due to social factors and lack of information about COVID-19.