Asian Participants Research Articles

Cultural Reflections in Virtual Reality: The Effects of User Ethnicity in Avatar Matching Experiences on Sense of Embodiment.

Matching avatar characteristics to a user can impact sense of embodiment (SoE) in YR. However, few studies have examined how participant demographics may interact with these matching effects. We recruited a diverse and racially balanced sample of 78 participants to investigate the differences among participant groups when embodying both demographically matched and unmatched avatars. We found that participant ethnicity emerged as a significant factor, with Asian and Black participants reporting lower total SoE compared to Hispanic participants. Furthermore, we found that user ethnicity significantly influences ownership (a subscale of SoE), with Asian and Black participants exhibiting stronger effects of matched avatar ethnicity compared to White participants. Additionally, Hispanic participants showed no significant differences, suggesting complex dynamics in ethnic-racial identity. Our results also reveal significant main effects of matched avatar ethnicity and gender on SoE, indicating the importance of considering these factors in VR experiences. These findings contribute valuable insights into understanding the complex dynamics shaping VR experiences across different demographic groups.

Race in heart failure: a pooled participant-level analysis of the global PARADIGM-HF and PARAGON-HF trials

Abstract Background Mechanisms of disease pathobiology, prognosis, and potentially treatment responses might vary by race in patients with heart failure (HF). Early experiences with neprilysin inhibition suggested possible increased risks of angioedema, especially among Black individuals. We aimed to examine the safety and efficacy profile of sacubitril/valsartan in a pooled participant-level dataset of 2 large cohorts of patients with HF by self-reported race. Methods PARADIGM-HF and PARAGON-HF were multicenter, randomized clinical trials testing sacubitril/valsartan against a renin-angiotensin system inhibitor (RASi, enalapril or valsartan, respectively) in patients with HF and LVEF ≤40% (PARADIGM-HF) or LVEF ≥45% (PARAGON-HF). We included all patients with available data on self-reported race and categorized patients as White, Asian, or Black. We assessed adjudicated outcomes including the composite of first HF hospitalization (HFH) or cardiovascular (CV) death, its components, and angioedema by racial group. Results Among 12,097 included participants, 9,451 (78.1%) were White, 2,116 (17.5%) were Asian, and 530 (4.4%) were Black. Asian participants were from 19 countries, with highest enrollment from India, China, and the Philippines. Black participants were from 18 countries, with highest enrollment from the US, South Africa, and Brazil. Black patients had the worst baseline health status (adjusted KCCQ-OSS mean 70.3), while White (71.4) and Asian patients (76.4) had better health status; P<0.001. Over 2.4-years of median follow-up, Black (adjusted HR 1.67; 95% CI 1.37-1.89; P<0.001) and Asian patients (adjusted HR 1.32; 95% CI 1.16-1.50; P<0.001) experienced higher risks of the primary outcome compared with White patients (Figure 1). The treatment effects of sacubitril/valsartan vs. RASi on the primary endpoint were consistent among White (HR 0.84; 95% CI: 0.77-0.91), Asian (HR 0.92; 95% CI: 0.78-1.10), and Black patients (HR 0.79; 95% CI: 0.58-1.07; Pinteraction = 0.39). In light of higher baseline risks, Black patients accrued the greatest absolute risk reduction with sacubitril/valsartan (Figure 2). Consistent treatment benefits by race were also observed for the individual components (CV death alone and first HFH alone). Rates of any adjudicated angioedema were numerically higher with sacubitril/valsartan vs. RASi across race groups (White 0.4% vs. 0.2%; Asian 0.6% vs. 0.2%; Black 2.3% vs. 0.8%), however no patient in either trial experienced airway compromise or required mechanical airway protection. Conclusions In a pooled experience of over 12,000 participants enrolled in 2 trials conducted across 56 countries, Black and Asian patients exhibited a higher risk of CV events than White patients. Rates of non-serious angioedema were numerically higher with sacubitril/valsartan across race groups. The relative CV benefits of sacubitril/valsartan were consistent across races, with greatest absolute benefits observed in Black patients.

Color Ranges and Distribution of Human Teeth: A Prospective Clinical Study.

This study investigated the in vivo color range of human teeth using a research-grade noncontact spectroradiometer, analyzing the effects of gender, age, ethnicity, and lifestyle factors, including diet, smoking, and oral hygiene. A total of 1004 participants were recruited at two research sites and stratified by gender, age, and ethnicity, and data on their dietary and oral habits were collected. Noninvasive color measurements of an upper central incisor were performed using a spectroradiometer and a fiber-coupled Xe-Arc light source. Color differences were computed using the CIELAB and CIEDE2000 color difference formulas, statistically analyzed, and interpreted through comparisons with 50:50% perceptibility (PT) and acceptability (AT) thresholds for dentistry. CIELAB and CIEDE2000 color coordinate values varied significantly. Female teeth appeared lighter and less yellow than men's. Age correlated with darker, more chromatic teeth, stabilizing only after Age 46. Significant ethnic differences were observed, particularly between African-American and Asian participants. Coffee consumption impacted teeth yellowness and chromaticity, while tea had no significant effect. Frequent tooth brushing led to lighter teeth, and tooth whitening considerably influenced color, emphasizing the effect of cosmetic dental treatments. Smoking showed minimal impact, with slight discoloration noted among light smokers compared to nonsmokers. Color coordinate values by gender, age, and ethnicity exhibited statistically significant differences and, in most cases, noticeable color differences. With exceptions, the dietary/oral habits of the patient had a significant impact on the color of human teeth. The findings from this study provide detailed information and understanding of the color range and distribution of human teeth, which can help enhance the esthetic outcome of dental care and, consequently, the patient's satisfaction.

Dementia risk scores, apolipoprotein E, and risk of Alzheimer's disease: One size does not fit all.

Evaluating the generalizability of dementia risk scores, primarily developed in non-Latinx White (NLW) participants, and interactions with genetic risk factors in diverse populations is crucial for addressing health disparities. We analyzed the association of the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) and modified CAIDE (mCAIDE) scores with dementia risk using logistic regression models stratified by race/ethnicity in National Alzheimer's Coordinating Center (NACC) and Alzheimer's Disease Neuroimaging Initiative (ADNI), and assessed their interaction with apolipoprotein E (APOE). Higher CAIDE scores were associated with an increased risk of dementia in Asian, Latinx, and NLW participants but not in Black participants. In contrast, higher mCAIDE scores were also associated with an increased risk of dementia in Black participants. Unfavorable mCAIDE risk profiles exacerbated the apolipoprotein E*ε4 (APOE*ε4) risk effect and attenuated the APOE*ε2 protective effect. Our findings underscore the importance of evaluating the validity of dementia risk scores in diverse populations for their use in personalized medicine approaches to promote brain health. Dementia risk scores demonstrate race/ethnic-specific effects on dementia risk. Unfavorable modifiable risk profiles moderate the effect of APOE on dementia risk. Dementia risk scores need to be validated in diverse populations.

Ethnic Differences in Response to Oral Vitamin D Supplementation: A Systematic Review and Meta-analysis.

Individual variability in oral vitamin D supplement response hinders the understanding of its clinical impact, and while ethnicity has been implicated in this variability it has not been well described. The aim was to systematically assess the impact of ethnicity on response to oral vitamin D supplementation. The Web of Science and PubMed databases were searched for articles published from 1960 to the end of 2020. All trials in adults measuring 25(OH)D3 blood levels were included. Two reviewers independently extracted the data from the eligible studies. The change in 25(OH)D3 blood levels (95% CI) and P values were extracted, and grouped according to ethnicity, then subjected to random-effects meta-analysis. The primary outcome measurement was mean serum 25(OH)D3 levels and the secondary outcome was dose-adjusted mean serum 25(OH)D3 levels, both compared with baseline. A total of 18 studies were identified, and data from 1131 participants were extracted. Body mass index (BMI) and dose were significant covariates (Pearson correlation coefficient, P = .016 and .017) and were normalized in the meta-analysis to minimize heterogeneity, but latitude was not (P = .66). Meta-analysis showed an effect of ethnicity on dose and BMI-adjusted mean serum 25(OH)D3 levels compared with baseline (P < .00001, I2 = 98%). Asian and White study participants demonstrated a statistically higher increase in dose and BMI-adjusted 25(OH)D3 blood levels (183 nmol/L [95% CI, 163-203] and 173 nmol/L [95% CI, 152-194], respectively), compared with Arab and Black study participants (37 nmol/L [95% CI, 35-39] and 99 nmol/L [95% CI, 90-108]) using repeated t tests. Sensitivity analysis demonstrated that these findings were not impacted by potential study bias or the inclusion of immigrant populations. Ethnicity had an impact on oral vitamin D response. Further prospective studies should examine if ethnicity-based dose stratification in both clinical practice and clinical trials is warranted. PROSPERO registration no. CRD42023410076.

Diversity perceptions and neighborhood preferences for visual representations of mixed racial groups

Although the term “diversity” is ubiquitous in modern day society, the meaning of the term is not well understood, and it is unclear when people perceive groups to be more or less diverse. Across five experiments, we examined perceptions of racial diversity and preferences for living in diverse contexts related to visual representations of groups. While recent theorizing suggests that a greater number of low-status racial minorities may contribute to perceiving more diversity and determine living preferences, our findings indicate the importance of the race of the perceiver in these processes. Although White and Black participants rated majority Black compared to majority Asian groups as more diverse, followed by majority White targets (cf. Experiment 4), Asian participants did not differ in their diversity ratings across the different racial compositions. Notably, White and Asian participants rated majority White and majority Asian compared to majority Black neighborhoods as more desirable. Black participants, in contrast, consistently rated majority Black compared to majority White and majority Asian neighborhoods as more desirable and did not distinguish between the latter two contexts. Together these findings provide new evidence about how people define diversity and the importance of target-level factors, perceiver-level factors, and the interplay between these factors on perceptions of racial diversity and inclusivity.

Referral Sources Across Racial and Ethnic Groups at Alzheimer's Disease Research Centers.

Despite the need to increase engagement of underrepresented groups (URG) in Alzheimer's disease and related dementias (ADRD) studies, enrollment remains low. Compare referral sources across racial and ethnic groups among participants enrolled in ADRC studies. Data for this cross-sectional secondary analysis were extracted from the National Alzheimer's Coordinating Center Uniform Data Set. We performed mixed effects logistic regression models using generalized estimating equations for professional referral versus non-professional referral by racial and ethnic group, adjusted for age, gender, education, visit year, and Clinical Dementia Rating scale (CDR) with a random effect for study site. Included in the analysis were 48,330 participants across 46 ADRCs (mean [SD] age, 71.3 [10.5] years; 20,767 female [57%]; 4,138 Hispanic [8.6%]; 1,392 non-Hispanic Asian [2.9%]; 6,766 non-Hispanic Black [14%] individuals; and 676 individuals [1.4%] of other races. Non-Hispanic Black and Asian participants had lower odds of being referred by a professional contact compared to non-Hispanic White participants (Black: adjusted OR = 0.61, 95% CI = 0.44-0.86, p = 0.005; Asian: adjusted OR = 0.65, 95% CI, p = 0.004). In participants who had completed an MRI, there was no significant difference in referral source across ethnic and racial groups. Further studies are needed to better understand the systemic and structural factors that contribute to differences in referral sources and disparities in recruitment of URG into ADRD studies.

Participant Personal Characteristics and Adherence to Oral Capsules: A Secondary Analysis of a Randomized Placebo-Controlled Trial of Antenatal Probiotics.

Adherence to study interventions is critical to the conduct of randomized controlled trials (RCTs). The relationships between participant characteristics and intervention adherence are understudied in pregnant populations. The purpose of this study was to conduct a secondary analysis of adherence to study capsules in a double-masked, placebo-controlled RCT of a probiotic intervention to reduce antenatal Group B Streptococcus colonization, in relationship to participant characteristics. We analyzed the relationship between capsule adherence rates and demographic characteristics among 81 RCT participants. Categorical variables were reported using counts and percentages, and continuous variables were expressed as means along with their standard deviations. For the univariate analyses, we compared demographic variables with adherence scores. A multivariate linear regression model was used to identify predictors of adherence. Average adherence was similar for control and probiotic group participants (P =.86) Univariate analysis showed that average adherence increased directly with age, education, and income. Participants who were partnered or living with others had higher average adherence compared with those who were single and living alone. Asian and White participants had the highest and Black participants had the lowest average, and there was no difference based on Hispanic ethnicity. Adjusting for all the variables in the regression, participants who identified as Black were significantly less likely to adhere to capsules than White participants, and those who were married or living with partners were more likely to adhere than the single participants. Diverse participants are critically important to RCTs. This secondary analysis provides evidence that participant characteristics and the social determinants of health play an important role in adherence to self-administered interventions in RCTs, although more research is needed. Our findings suggest that intentional consideration of RCT participant characteristics may allow for the development and tailoring of strategies to enhance intervention adherence. The study was registered on ClinicalTrials.gov (NCT03696953) on January 10, 2018.

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.

Mapping the electric field of high-definition transcranial electrical stimulation across the lifespan

Transcranial electrical stimulation (tES) is a non-invasive technique widely used in modulating brain activity and behavior, but its effects differ across individuals and are influenced by head anatomy. In this study, we investigated how the electric field (EF) generated by high-definition tES varies across the lifespan among different demographic groups and its relationship with neural responses measured by functional magnetic resonance imaging (fMRI). We employed an MRI-guided finite element method to simulate the EF for the two most common tES montages (i.e., targeting the dorsolateral prefrontal cortex and motor cortex, respectively) in two large cohorts of white and Asian participants aged 12 to 100 years. We found that the EF intensity decreased with age, particularly in individuals under 25 years of age, and was influenced by gender and ethnicity. We identified skull thickness, scalp thickness, and epidural cerebrospinal fluid thickness, as the primary anatomical factors accounting for the inter-individual EF variability. Using a concurrent tES-fMRI approach, we observed a spatial consistency between the simulated EF and the brain activity changes induced by tES in the target region. Finally, we developed an open-source toolbox incorporating age-stratified head models to facilitate efficient EF calculations. These findings characterize and quantify the individual differences in tES-induced EF, offering a reference for implementing personalized neuromodulation strategies.

Casting a Long Shadow: Examining the Relationships between Vicarious and Direct Racism and Generalized Trust among Asian Communities in New Zealand during COVID-19

Utilizing a social learning perspective, this study investigated the associations between vicarious and direct racism and generalized trust among Asian communities in New Zealand during COVID-19, highlighting the comparability of their effects. Data from a cross-sectional online survey conducted in 2021 (N=1,377), were utilized to estimate the prevalence of vicarious and direct racism experiences and the distribution of since-COVID generalized trust. Linear regression was used to assess the association between experiences of racism and shifts in generalized trust. Findings indicate that almost 40% of participants experienced racism, with vicarious experiences of physical violence and unfair treatment being more prevalent, while direct experiences of microaggressions and verbal/written abuse were more common. Female, younger, Chinese, and South East Asian participants, those for whom English is a first language, and students reported disproportionate reductions in generalized trust. Negative associations were identified between vicarious and direct racism experiences and changes in generalized trust. Crucially, our analysis reveals that vicarious microaggression experiences have a greater negative association with generalized trust than direct experiences, challenging prevailing perceptions of their significance. Emphasizing a comprehensive approach to eliminating all forms of racism, the findings support the need for critical scrutiny of media reporting of racism and its influence on trust.

Tap water filtration and purification usage and their impact on the concentrations of fluoride and other minerals – A community-based study

ObjectiveThis study investigated the prevalence of water filtration and purification system (WFPS) use among residents of central Indiana (USA) and determined the effects of WFPS on the concentrations of fluoride, calcium, magnesium, potassium, and sodium in tap water. MethodsA census-based questionnaire collected data on demographics, water use, and water sources. Participants were also asked to provide water samples from their tap water or the WFPS they used. Water samples were analyzed using ion-specific electrodes (fluoride) and atomic absorption spectrometry (metals). Mineral concentration comparisons between water sources used nonparametric tests; questionnaire associations were testing using correlations, chi-square tests, and nonparametric tests. ResultsOne hundred and one participants completed the study, of which 71 % used some type of WFPS. Blacks were less likely to use WFPS than Asian or White participants (p = 0.045). Those with bachelor's degrees or higher were more likely to use WFPS (p = 0.003). The most used WFPS were pitcher filters (31 %), water softeners (21 %), reverse osmosis systems (11 %), faucet-mounted filters (4 %), and whole-house carbon filters (1 %). Reverse osmosis systems resulted in the lowest mineral concentrations (median, ppm; F-0.08, Ca-2.30, Mg-0.46, Na-4.60, P-0.35). Pitcher filters were largely comparable to unfiltered tap water. Water softeners resulted in the highest sodium concentrations (78.40 ppm). ConclusionA large proportion of study participants use WFPS, with pitcher filters being the most common. Reverse osmosis systems had the most significant impact on reducing mineral levels in tap water, while pitcher filters do not adversely affect mineral concentrations. Clinical SignificanceUnderstanding how different WFPS affect the various minerals in tap water is essential for helping consumers in choosing the right system and for oral care providers to guide patients on water consumption and the need for fluoride supplementation, especially for those at high risk of dental caries.

Does the palpebral morphology influence the tear meniscus height between Caucasian and Asian eyes?

The central lower TMH is used as a clinical measure of tear volume in the assessment of contact lens candidates and patients with dry eyes. Ethnic differences in eyelid morphology may influence the measurement of the TMH. Furthermore, with the advent of larger contact lenses, such as scleral lenses, it would be of clinical value to assess the TMH centrally and peripherally. The purpose of this study was to evaluate and compare the TMH at different positions along the palpebral margin between Caucasian and Asian eyes. This prospective study evaluated the lower TMH in five positions (central, temporal and nasal limbus and temporal and nasal periphery) of the right eye using the Keratograph 5M (Oculus) instrument in Caucasian and Asian participants between 10 am and 12 pm. The TMH at each position was taken three times and averaged and analyzed using a 5 × 2 repeated-measures analysis of variance. Central TMH did not differ significantly (F = 0.02, p=0.88) in Caucasians (n = 20, aged 24.45 [2.30] years, TMH 0.320 [0.052] mm) and Asians (n = 20, aged 22.25 [3.43] years, TMH 0.325 [0.048] mm). A difference was noted with respect to TMH positions along the lid margin (F = 64.17, p<0.001), independent of ethnicity (F = 2.15, p=0.15). A post hoc analysis revealed a significantly higher TMH temporally when compared with centrally or nasally (p<0.001). This study demonstrated the similarity of the central TMH and the differences in the peripheral TMH within Caucasian and Asian eyes. This may be clinically relevant when using the Tear Film & Ocular Surface Society Dry Eye Workshop II diagnostic algorithm for dry eyes and when fitting scleral contact lenses. Future studies need to consider that ethnic differences may exist for certain tests in order to personalize the care and management of each patient.

Abstract B086: Increasing clinical research participation and input from underserved communities: Results from community engagement studios inform clinical study design

Abstract Underrepresentation of marginalized racial and ethnic groups has been a consistent challenge in clinical trials. With an intent to increase trial accessibility for underserved communities, we conducted community engagement studios (CES) to understand the various cultures, values, worldviews, and lived experiences from different communities that might affect clinical trial participation. We report on the CES discussions and how they modified the design of an early cancer detection clinical study. CES were developed in partnership with an academic community engagement expert, OHSU and via the patient advocacy group, Touch4Life, which focuses on decreasing cancer disparities in the BIPOC (Black, Indigenous, and people of color) population. Four CES were conducted: 1 with members of Asian (n=11), 2 with members of African American (AA) (n=16), and 1 with members of rural (n=7) communities. One AA CES was conducted with members of the Touch4Life network, with whom we piloted a subsequent oral debrief session to review CES thematic results and relay the impact it had on clinical study implementation, the results of which led to a corollary CES to be initiated in this network (n=7) to evaluate recruitment messages in the BIPOC population. Common themes for clinical trial recruitment strategies included the importance of messaging from trusted sources. While clinicians were a shared trusted source, Asian CES members preferred a personal connection, rural CES members preferred non-profit foundations, and AA CES members highlighted community networks (church and patient advocacy groups with shared experiences). Asian CES participants were hesitant to engage with pharmacists for clinical study recruitment due to a lack of personal relationships, but rural and AA communities would be open to hearing about clinical studies at their pharmacy, combined with consultation with their doctor. All communities expressed shared barriers for trial participation (time commitment, transportation, cost) and unique barriers were also expressed: childcare and distrust in biopharma in the AA CES; language in the Asian CES. All CES expressed interest in receiving updates on clinical trial progress and outcomes. Themes from the CES have been used to inform changes to both our recruitment and education strategies and outreach efforts for this clinical study for the early detection of cancer. One such modification included adding recruitment channels focused on engaging participants through patient advocacy groups and specific clinical study sites. Following guidance from both CES participants and our CES partners, and by sharing the CES results with the Touch4Life community, we developed a bidirectional flow of information and fostered a joint mission to deepen our working relationship with the community. Our research demonstrated that early collaboration between industry-sponsored researchers, community experts, and patient advocacy groups is an ideal model for gaining insights into specific communities and fostering relationships that can improve access to clinical studies. Citation Format: Monique Gary, Laura Crandon, Tiffani L. Howard, Paul Bollinger, Natalie Bonilla, Jackilen Shannon, Shifra Krinshpun, Sarah Sawyer, Sara L. Bristow, Meenakshi Malhotra, Adham Jurdi, Alexey Aleshin, Breeana L. Mitchell. Increasing clinical research participation and input from underserved communities: Results from community engagement studios inform clinical study design [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 B086.

Different features for different races: Tracking the eyes of Asian, Black, and White participants viewing Asian, Black, and White Faces.

The own-race bias (ORB) is an effect in which humans remember faces from their own race better than faces from another race. Where people look when processing faces of different races plays a role in this effect, but the exact relationship between looking and the ORB is debated. One perspective is that the same facial features are important for memory for faces of all races and the ORB emerges when people look longer at the useful features for own- than other-race faces. Another perspective is that different facial features are useful for faces of different races and the ORB emerges when people look longer at features that are useful for their own race than at features that are useful for other-race faces. The present study aimed to discriminate these perspectives by examining looking patterns in Asian, Black, and White participants while they learned and later recognized Asian, Black, and White faces. Regardless of their race, participants looked at different facial features depending on the race of the face. In addition, different features were useful for memory depending on the race of the face. As such, results are in line with the perspective that different facial features are useful for different race faces.

The Importance of Racially and Ethnically Inclusive Gait Speed Reference Values in Individuals 90 Years and Older: LifeAfter90.

Clinicians use reference values to contextualize physical performance scores, but data are sparse in individuals 90years and older and racial/ethnic diversity is limited in existing studies. Gait speed provides valuable information about an individual's health status. Slow gait speed is associated with falls, cognitive decline, and mortality. Here, we report gait speed reference values in a racially/ethnically diverse oldest-old cohort. LifeAfter90 is a multiethnic cohort study of individuals 90years and older. Participants are long-term members of an integrated healthcare delivery system without a dementia diagnosis at enrollment. We assessed gait speed using the 4-m walk test and calculated means, standard deviations, and percentiles by age, sex, assistive device use, and device type. We used linear regression to compare means by sex, age, device use and type, living situation and arrangement, and race/ethnicity. The mean age of the 502 participants was 92.9 (range 90.1-102.8) years. Of these, 62.6% were women, 34.7% were college educated, 90.8% lived in a private residence, 20.9% self-reported as Asian, 22.5% as Black, 11.8% as Hispanic, 35.7% as White, and 9.2% as multiple, "other," or declined to state. The overall mean gait speed was 0.54 m/s (women=0.51 m/s, men=0.58 m/s). Mean gait speeds were 0.58 m/s, 0.53 m/s, and 0.48 m/s in the 90 to 91, 92 to 93, and 94+ age categories, respectively. In those without a device, mean gait speed was 0.63 m/s compared to 0.40 m/s in those with a device (cane=0.44 m/s, walker=0.37 m/s). Mean gait speed was significantly slower in women compared to men, age category 94+ compared to 90 to 91, participants with a device compared to those without, participants with a walker compared to a cane, and Black participants compared to Asian and White participants. However, differences by race/ethnicity were attenuated when chronic health conditions were considered. Reference values developed from this multiethnic 90+ cohort will help clinicians interpret gait speed measures and tailor recommendations toward a 90+ population that is growing in number and in racial/ethnic diversity.

Criminality, foreignness, and illness stereotypes underlie racial minorities' social identity threat wearing different face masks during COVID-19.

During the COVID-19 pandemic, Black and Asian, compared to White, people experienced unique social identity threats (SITs) while wearing face masks (Kahn & Money, 2022). This study examines specific racial stereotypes (criminality, foreignness, illness) and mask types (bandanas, surgical masks, maskless) that underlie SIT while wearing masks and their effect on safety. Black, Asian, and White participants (N = 591) completed a cross-sectional survey about SIT experiences wearing different face masks during the COVID-19 pandemic. Results demonstrated that criminality, foreignness, and illness stereotypes each mediated the effects of race on SITs while masked. Criminality stereotypes were generally the strongest. Black individuals were most concerned with being stereotyped as criminals when wearing masks, particularly bandanas. Asian individuals feared being stereotyped as foreign while masked,mostly with surgical masks, compared to Black and White individuals. Black and Asian, compared to White, people reported fears of being perceived as ill with COVID-19 when wearing masks. In a parallel mediation, criminal stereotypes and SIT while masked mediated the relationship between race and anticipated interactions with police. In the United States, Black and Asian individuals weigh concerns for their health along with safety in the face of race-based stereotypes that wearing masks prime. Racial minorities' safety during viral pandemics necessitates remediating these societal biases. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Disparities Exist in Knowledge of Hip Fracture Compared With Stroke and Myocardial Infarction.

This study sought to answer the following questions: (1) Are there differences in knowledge on time to treatment (TTT) between stroke, myocardial infarction (MI), and hip fractures in the general population? (2) Are there differences in condition-specific knowledge across these conditions? (3) Are there underlying demographic factors that may contribute to differences in hip fracture-specific knowledge? This was a cross-sectional cohort analysis. Participants were acquired using an online survey distribution platform, Amazon Mechanical Turk (MTurk). Individuals older than 18 years with English fluency and literacy were included. A total of 913 participants who completed a survey with questions on TTT knowledge, condition-specific knowledge, history of hip fracture, and demographics were recruited. On comparing TTT knowledge, the MI mean score was 36.92% higher than that of hip fractures (P<.0001). On comparing condition-specific knowledge, the MI-specific mean score was 8.24% higher than that of hip fractures (P<.0001). Hip fracture knowledge was associated with demographic factors. Asian and Black participants and participants with Medicaid or Medicare as their primary insurance type were associated with significantly lower hip fracture knowledge. Hip fracture knowledge was significantly lower than MI knowledge in the study population. Just as professional societies have invested resources in public education campaigns on the importance of TTT for stroke and MI, public education campaigns on the importance of TTT for hip fractures may support earlier TTT for populations vulnerable to delays (Asian and Black). [Orthopedics. 20XX;4X(X):XXX-XXX.].

Comparing the Diagnostic Yield of Germline Exome Versus Panel Sequencing in the Diverse Population of the Texas KidsCanSeq Pediatric Cancer Study.

To evaluate the relative diagnostic yield of clinical germline genomic tests in a diverse pediatric cancer population. The KidsCanSeq study enrolled pediatric cancer patients across six sites in Texas. Germline analysis included both exome sequencing and a therapy-focused pediatric cancer gene panel. The results were categorized by participants demographics, the presence of pathogenic or likely pathogenic (P/LP) variants, and variants of uncertain significance (VUS) in cancer predisposition genes (CPGs). Pediatric actionable CPGs were defined as those with cancer surveillance recommendations during childhood. Cancer P/LP variants were reported by at least one platform in 103 of 578 (17.8%) participants of which 76 were dominant cancer genes (13.1%) with no significant differences by self-described race or Hispanic ethnicity. However, the proportion of participants with VUS was greater in Asian and African American participants (P = .0029). Diagnostic yield was 16.6% for exome versus 8.5% for panel (P < .0001) with 42 participants with concordant germline results. Exome-only results included P/LP variants in 30 different CPGs in 54 participants, whereas panel-only results included seven participants with a copy number or structural P/LP variants in CPGs. There was no significant difference in diagnostic yield limited to pediatric actionable CPGs (P = .6171). Approximately 18% of a diverse pediatric cancer population had germline diagnostic findings with 50% of P/LP variants reported by only one platform because of CPGs not on the targeted panel and copy number variants (CNVs)/rearrangements not reported by exome. Although diagnostic yields were similar in this diverse population, increases in VUS results were observed in Asian and African American populations. Given the clinical significance of CNVs/rearrangements in this cohort, detection is critical to optimize germline analysis of pediatric cancer populations.

Addressing Hypertension Disparities via Systems Dynamics: Insights From Community Health Connections.

Background and objective Hypertension remains a major public health challenge in the United States, disproportionately affecting various demographic groups. Significant disparities persist in hypertension prevalence and control due to interactions between socioeconomic factors, healthcare access, and systemic inequities. In this study, we aimed todetermine the impact of socioeconomic and healthcare factors on hypertension control among patients at Community Health Connections (CHC), a Federally Qualified Health Center serving 36 communities in North Central Massachusetts, and identify effective interventions using systems dynamics modeling to promote health equity. Materials and methods This was a retrospective observational study using data from 2023 CHC patients, and the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Systems dynamics modeling was employed to visualize interactions among factors influencing hypertension outcomes. The study included 4,870 CHC patients. Participants were selected based on clinical records and comprised 3,690 White participants (76%), 464 Black/African American participants (10%), 108 Asian participants (2%), and 608 classified as Other/Non-reported (12%). The cohort included 2,490 males (51%) and 2,380 females (49%). Socioeconomic factors (e.g., race, age, insurance status) and healthcare access were the study variables. The primary outcome was hypertension control, defined as a blood pressure reading of <140/90 mmHg. The study measured control rates across different demographic groups and assessed the impact of socioeconomic and healthcare factors on these rates. Results Among the 4,870 CHC patients, 3,007 (62%) achieved hypertension control. The overall hypertension control rate varied significantly by race: White: 68.6%, Black/African American: 61.6%, Asian: 63.2%, and Other/Non-reported: 65.6%. Insured patients had a control rate of 67.7%, compared to 37.5% for uninsured patients (p<0.001). Systems dynamics models illustrated how socioeconomic disparities and healthcare access issues amplify health inequities. Key interventions identified include, but are not limited to, multidisciplinary care teams, community health worker programs, and telehealth services. Conclusions Addressing hypertension disparities among CHC patients requires a systemic approach integrating socioeconomic, healthcare, and policy-related interventions. Systems dynamics modeling provides a framework for designing and implementing targeted interventions, enhancing health equity, and improving hypertension control outcomes in underserved populations. Further research is needed to test the effectiveness of these interventions before their broad implementation.