Magnitude Of Disparity Research Articles

Visual short-term memory for crossed and uncrossed binocular disparities.

Previous work on visual short-term memory (VSTM) has encompassed various stimulus attributes including spatial frequency, color, and contrast, revealing specific time courses and a dependence on stimulus parameters. This study investigates visual short-term memory for binocular depth, using dynamic random dot stereograms (DRDS) featuring disparity planes in front of or behind the plane of fixation. In a delayed match-to-sample paradigm, we employed four distinct reference disparities (17.5', 28.8' either crossed or uncrossed) at two contrast levels (20%, 80%), spanning interstimulus intervals (ISI) of up to 4 s. Test stimuli represented a range of equally spaced values centered around the reference disparity of the ongoing trial. In addition, the impact of a memory masking stimulus was also tested in a separate experiment. Accuracy and point of subjective equality (PSE) served as performance markers. The performance, indicated by the accuracy of responses, was better for smaller reference disparities (±17.5') compared to larger ones (±28'), but both deteriorated as a function of ISI. The PSE demonstrated a consistent shift with increasing ISIs, irrespective of the magnitude of the initial disparity, converging gradually toward the range of 20-22' and deviating from the reference disparity. Notably, the influence of masking stimuli on the PSE was more marked when the mask disparity diverged from the reference value. The findings from our study indicate that the retention of absolute disparity in memory is imprecise, it deteriorates with retention time or due to perturbation by dissimilar masking stimuli. As a result, the memory trace is gradually replaced by a default depth value. This value could potentially signify an optimal point within low-level perceptual memory, however, our results are better explained by perceptual averaging whereby the visual system computationally derives a statistical summary of the presented disparities over time. The latter mechanism would aid in the computation of relative disparity in a dynamically changing environment.

Underestimating the Relationship: Unpacking Both Socioeconomic Resources and Cognitive Function and Decline in Midlife to Later Life.

Although there is robust evidence that socioeconomic position influences later-life cognitive function, two issues limit knowledge regarding the nature and magnitude of these relationships and potential policy interventions. First, most social science research tends to treat cognition as a unitary concept despite evidence that cognitive outcomes are not interchangeable. Second, most biomedical research focuses exclusively on education, with limited attention to economic resources despite robust social science theoretical and empirical rationales for their role. Relatedly, there has been limited attention to how these relationships may vary across cohorts, even as educational and economic contexts have changed. Using the Health and Retirement Study (N = 36,494), we show that failing to attend to different facets of cognition, socioeconomic resources, and cohort differences leads to underestimates in the magnitude of educational and economic disparities in cognitive function and decline. This has important implications for appropriate policy interventions to address these disparities.

Social Risk Factors, Health Insurance Coverage, and Inequities in Access to Care.

Social risk factors are associated with worse access to care. This study measured the prevalence of social risk factors among low-income adults, assessed the relationship between number of social risk factors and access to care, and examined heterogeneity by health insurance type. Using 2022 Behavioral Risk Factor Surveillance Survey data from 39 states, the association between number of SRFs (0, 1, 2-3, 4, or more) and three access to care measures (having a personal doctor, having a routine checkup, and inability to see doctor because of cost) were measured using multivariable linear probability models. The analysis was stratified by health insurance coverage type (private, Medicare, Medicaid, or uninsured) to assess whether effects were differential. Analyses were conducted in 2024. Among 90,208 low-income adults, 46.6% reported at least one SRF. Compared to people who reported no SRFs, those who reported four or more were more likely to report being unable to afford care (28.21 percentage points [PP], p<0.001) and less likely to have a personal doctor (-4.98 PP, p<0.001) or routine checkup in the last two years (-4.29 PP, p<0.001). The magnitude of disparity by number of SRFs in inability to afford care was larger among privately insured and uninsured people compared to those with Medicare or Medicaid coverage. Higher levels of SRFs were associated with worse access to care among low-income adults. Policies that minimize cost-related barriers to care, coupled with care delivery reforms and social policies that address SRFs, may improve access to care.

Feature-specific divisive normalization improves natural image encoding for depth perception.

Vision science and visual neuroscience seek to understand how stimulus and sensor properties limit the precision with which behaviorally-relevant latent variables are encoded and decoded. In the primate visual system, binocular disparity-the canonical cue for stereo-depth perception-is initially encoded by a set of binocular receptive fields with a range of spatial frequency preferences. Here, with a stereo-image database having ground-truth disparity information at each pixel, we examine how response normalization and receptive field properties determine the fidelity with which binocular disparity is encoded in natural scenes. We quantify encoding fidelity by computing the Fisher information carried by the normalized receptive field responses. Several findings emerge from an analysis of the response statistics. First, broadband (or feature-unspecific) normalization yields Laplace-distributed receptive field responses, and narrowband (or feature-specific) normalization yields Gaussian-distributed receptive field responses. Second, the Fisher information in narrowband-normalized responses is larger than in broadband-normalized responses by a scale factor that grows with population size. Third, the most useful spatial frequency decreases with stimulus size and the range of spatial frequencies that is useful for encoding a given disparity decreases with disparity magnitude, consistent with neurophysiological findings. Fourth, the predicted patterns of psychophysical performance, and absolute detection threshold, match human performance with natural and artificial stimuli. The current computational efforts establish a new functional role for response normalization, and bring us closer to understanding the principles that should govern the design of neural systems that support perception in natural scenes.

Equity in Heart Failure Care: A Get With the Guidelines Analysis of Between- and Within-Hospital Differences in Care by Sex, Race, Ethnicity, and Insurance.

Disparities in guideline-based quality measures likely contribute to differences in heart failure (HF) outcomes. We evaluated between- and within-hospital differences in the quality of care across sex, race, ethnicity, and insurance for patients hospitalized for HF. This retrospective analysis included patients hospitalized for HF across 596 hospitals in the Get With the Guidelines-HF registry between 2016 and 2021. We evaluated performance across 7 measures stratified by patient sex, race, ethnicity, and insurance. We evaluated differences in performance with and without adjustment for the treating hospital. We also measured variation in hospital-specific disparities. Among 685 227 patients, the median patient age was 72 (interquartile range, 61-82) and 47.2% were women. Measure performance was significantly lower (worse) for women compared with men for all 7 measures before adjustment. For 4 of 7 measures, there were no significant sex-related differences after patient-level adjustment. For 20 of 25 other comparisons, racial and ethnic minorities and Medicaid/uninsured patients had similar or higher (better) adjusted measure performance compared with White and Medicare/privately insured patients, respectively. Angiotensin receptor neprilysin inhibitor measure performance was significantly lower for Asian, Hispanic, and Medicaid/uninsured patients, and cardiac resynchronization therapy implant/prescription was lower among women and Black patients after hospital adjustment, indicating within-hospital differences. There was hospital-level variation in these differences. For cardiac resynchronization therapy implantation/prescription, 278 hospitals (46.6%) had ≥2% lower implant/prescription for Black versus White patients compared with 109 hospitals (18.3%) with the same or higher cardiac resynchronization therapy implantation/prescription for Black patients. HF quality measure performance was equitable for most measures. There were within-hospital differences in angiotensin receptor neprilysin inhibitor and cardiac resynchronization therapy implant/prescription for historically marginalized groups. The magnitude of hospital-specific disparities varied across hospitals.

Methodologic considerations in estimating racial disparity of mortality among very preterm infants.

This review explores methodological considerations in estimating racial disparities in mortality among very preterm infants (VPIs). Significant methodological variations are evident across studies, potentially affecting the estimated mortality rates of VPIs across racial groups and influencing the perceived direction and magnitude of racial disparities. Key methodological approaches include the birth-based approach versus the fetuses-at-risk approach, with each offering distinct insights depending on the specific research questions posed. Cohort selection and the decision for crude versus adjusted comparison are also critical elements that shape the outcomes and interpretations of these studies. This review underscores the importance of careful methodological planning and highlights that no single approach is definitively superior; rather, each has its strengths and limitations depending on the research objectives. The findings suggest that adjusting the methodological approach to align with specific research questions and contexts is essential for accurately assessing and addressing racial disparities in neonatal mortality. IMPACT: Elucidates the impact of methodological choices on perceived racial disparities in neonatal mortality. Offers a comprehensive comparison of birth-based vs. fetuses-at-risk approaches in the context of racial disparity research. Provides guidance on the cohort selection and adjustment criteria critical for interpreting studies on racial disparities in very preterm infant mortality.

The Role of Race in Deaths of Despair in Brazil: Is it a White People Problem?

A new paradigm has been discussed regarding the impact of economic cycles on the mortality pattern from specific causes. These causes are called deaths of despair, and they selectively impact specific demographic groups. Also, low- and middle-income countries are most affected due to their economic and social instability. In this sense, the objective of study was to compare the magnitude of disparity in deaths from despair according to sex, age, and race in Brazil. We performed Poisson regression modeling to estimate the magnitude of the association between sex, age group, race, and deaths from despair. Also, we estimated the relationship of time as a proxy of economic crisis phase and deaths of despair. We found an association between mortality from despair and male sex (PR = 6.15, 95%CI 6.09-6.22); emphasis on the age groups from 40 to 49years old (PR = 2.45, 95% CI 2.41-2.48) and 50 to 59years old (PR = 2.39, 95% CI 2.36-2.43); and brown (PR = 1.21, 95% CI 1.20-1.22) and black race (PR = 1.36, 95% CI 1.34-1.37). The present study preliminarily presents the effect of the economic crisis and mortality in the population, with demographic differences. Association with race was opposite to that verified in the original study in the USA, which suggests that this variable should be analyzed in the light of structural context.

The burden of cirrhosis mortality by county, race, and ethnicity in the USA, 2000–19: a systematic analysis of health disparities

Cirrhosis is responsible for substantial health and economic burden in the USA. Reducing this burden requires better understanding of how rates of cirrhosis mortality vary by race and ethnicity and by geographical location. This study describes rates and trends in cirrhosis mortality for five racial and ethnic populations in 3110 US counties from 2000 to 2019. We estimated cirrhosis mortality rates by county, race and ethnicity, and year (2000-19) using previously validated small-area estimation methods, death registration data from the US National Vital Statistics System, and population data from the US National Center for Health Statistics. Five racial and ethnic populations were considered: American Indian or Alaska Native (AIAN), Asian or Pacific Islander (Asian), Black, Latino or Hispanic (Latino), and White. Cirrhosis mortality rate estimates were age-standardised using the age distribution from the 2010 US census as the standard. For each racial and ethnic population, estimates are presented for all counties with a mean annual population greater than 1000. From 2000 to 2019, national-level age-standardised cirrhosis mortality rates decreased in the Asian (23·8% [95% uncertainty interval 19·6-27·8], from 9·4 deaths per 100 000 population [8·9-9·9] to 7·1 per 100 000 [6·8-7·5]), Black (22·8% [20·6-24·8], from 19·8 per 100 000 [19·4-20·3] to 15·3 per 100 000 [15·0-15·6]), and Latino (15·3% [13·3-17·3], from 26·3 per 100 000 [25·6-27·0] to 22·3 per 100 000 [21·8-22·8]) populations and increased in the AIAN (39·3% [32·3-46·4], from 45·6 per 100 000 [40·6-50·6] to 63·5 per 100 000 [57·2-70·2] in 2000 and 2019, respectively) and White (25·8% [24·2-27·3], from 14·7 deaths per 100 000 [14·6-14·9] to 18·5 per 100 000 [18·4-18·7]) populations. In all years, cirrhosis mortality rates were lowest among the Asian population, highest among the AIAN population, and higher in males than females for each racial and ethnic population. The degree of heterogeneity in county-level cirrhosis mortality rates varied by racial and ethnic population, with the narrowest IQR in the Asian population (median 8·0 deaths per 100 000, IQR 6·4-10·4) and the widest in the AIAN population (55·1, 30·3-78·8). Cirrhosis mortality increased over the study period in almost all counties for the White (2957 [96·9%] of 3051 counties) and AIAN (421 [88·8%] of 474) populations, but in a smaller proportion of counties for the Asian, Black, and Latino populations. For all racial and ethnic populations, cirrhosis mortality rates increased in more counties between 2000 and 2015 than between 2015 and 2019. Cirrhosis mortality increased nationally and in many counties from 2000 to 2019. Although the magnitude of racial and ethnic disparities decreased in some places, disparities nonetheless persisted, and mortality remained high in many locations and communities. Our findings underscore the need to implement targeted and locally tailored programmes and policies to reduce the burden of cirrhosis at both the national and local level. US National Institutes of Health (Intramural Research Program, National Institute on Minority Health and Health Disparities; National Heart, Lung, and Blood Institute; Intramural Research Program, National Cancer Institute; National Institute on Aging; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Office of Disease Prevention; and Office of Behavioral and Social Sciences Research).

Differences across race and ethnicity in the quality of antidepressant medication management.

To illustrate the importance of a multidimensional view of disparities in quality of antidepressant medication management (AMM), as well as discriminating "within-facility" disparities from disparities that exist between facilities. We used data from the Veterans Health Administration's (VA) Corporate Data Warehouse (CDW) which contains clinical and administrative data from VA facilities nationally. CDW data were used to measure five indicators of AMM quality, including the HEDIS Effective Acute-Phase and Effective Continuation-Phase measures. Mixed effects regression models were used to examine differences in quality indicators between racial/ethnic groups, controlling for other demographic and clinical factors. An adaptation of the Kitagawa-Blinder-Oaxaca (KBO) method was used to decompose mean differences in treatment quality between racial and ethnic groups into within- and between-facility effects. Demographic, clinical, and health service utilization data were extracted for patients in fiscal year 2017 with a diagnosis of depression and a new start of an antidepressant medication. The decomposition of the overall differences between White and Black patients on receiving an initial 90-day prescription (46.7% vs. 32.7%), Effective Acute-Phase (79.7% vs. 66.8%), and Effective Continuation-Phase (64.0% vs. 49.6%) HEDIS measures revealed that most of the overall effects were "within-facility," meaning that Black patients are less likely to meet these measures regardless of where they are treated. Although the overall magnitude of disparities between White and Hispanic patients on these three measures was very similar (46.7% vs. 32.7%; 79.7% vs. 69.2%; 64.0% vs. 53.6%), the differences were more attributable to Hispanic patients being treated in facilities with overall lower performance on these measures. Discriminating within- and between-facility disparities and taking a multidimensional view of quality are essential to informing efforts to address disparities in AMM quality.

Social disparities in flood exposure and associations with the urban environment in 44,698 neighborhoods in 276 cities in eight Latin American countries.

Climate change is expected to greatly increase exposure to flooding, particularly in urban populations in low- and middle-income countries. We examined within-city social disparities in exposure to flooding in 276 Latin American cities and associated features of the neighborhood urban environment. We used a spatially granular dataset of historical flood events from 2000 to 2018 to describe neighborhood flooding within cities across eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Guatemala, Mexico, and Panama). We estimated the percentage of the population living in flooded neighborhoods, described social disparities in flooding based on neighborhood educational attainment, and compared the magnitude of disparities across and within cities. We used multilevel models to examine how city- and neighborhood-level factors are related to neighborhood flooding. We examined 44,698 neighborhoods in 276 cities from eight countries with a total of 223 million residents and 117 distinct flood events from 2000-2018. One in four residents in neighborhoods in the lowest education quintile lived in neighborhoods with flooding, compared to one in 20 residents of the highest neighborhood education quintile. Greater neighborhood flooding was associated with lower neighborhood-level educational attainment and with neighborhoods that were coastal, less dense (population or intersection), further from the city center, greener, and had steeper slopes. There was no association between city-level educational attainment and flooding. There are large social disparities in neighborhood flooding within Latin American cities. Residents of areas with lower education attainment face substantially higher risks of flooding. Policymakers must prioritize flood adaptation and recovery efforts in neighborhoods with lower socioeconomic position.

Constructing Confidence Intervals for BIFSG Disparity Estimates

This paper describes a method to construct confidence intervals for estimates of disparities in outcomes between racial/ethnic groups when race and ethnicity are estimated using Bayesian Improved First Name and Surname Geocoding (BIFSG). Standard errors produced by regression packages understate the uncertainty in these estimates because they fail to incorporate noise arising from estimating race and ethnicity. This can produce false confidence when assessing the direction and magnitude of disparities. Conversely, the bootstrapping approach introduced in this paper incorporates uncertainty arising from the use of BIFSG. However, this procedure does not correct for any statistical bias associated with using BIFSG.

Disparities in the protagonism of oral health teams in the work process of Primary Healthcare.

Evaluate and compare the protagonism of Oral Health teams (OHt) in the teamwork process in Primary Healthcare (PHC) over five years and estimate the magnitude of disparities between Brazilian macro-regions. Ecological study that used secondary data extracted from the Sistema de Informação em Saúde para a Atenção Básica (SISAB - Health Information System for Primary Healthcare) from 2018 to 2022. Indicators were selected from a previously validated evaluative matrix, calculated from records in the Collective Activity Form on the degree of OHt's protagonism in team meetings and its degree of organization concerning the meeting agendas. A descriptive and amplitude analysis of the indicators' variation over time was carried out, and the disparity index was also calculated to estimate and compare the magnitude of differences between macro-regions in 2022. In Brazil, between 3.06% and 4.04% of team meetings were led by OHt professionals. The Northeast and South regions had the highest (3.71% to 4.88%) and lowest proportions (1.21% to 2.48%), respectively. From 2018 to 2022, there was a reduction in the indicator of the "degree of protagonism of the OHt" in Brazil and macro-regions. The most frequent topics in meetings under OHt's responsibility were the work process (54.71% to 70.64%) and diagnosis and monitoring of the territory (33.49% to 54.48%). The most significant disparities between regions were observed for the indicator "degree of organization of the OHt concerning case discussion and singular therapeutic projects". The protagonism of the OHt in the teamwork process in PHC is incipient and presents regional disparities, which challenges managers and OHt to break isolation and lack of integration, aiming to offer comprehensive and quality healthcare to the user of the Unified Health System (SUS).

Abstract P307: Differences in Cardiovascular Disease Burden, Screening, Education, and Care by Clinic Type in the 2022 Health Center Patient Survey (HRSA)

Background: Persons experiencing homelessness (PEH) have a 2-3-fold risk for cardiovascular disease (CVD) mortality. Evidence has repeatedly shown elevated chronic disease burden, reduced access to care, and lower utilization of medication to control CVD risk factors in this setting. Migrant communities also experience reduced access to care and the impacts from deferring care. There are targeted, federally-funded health clinics in place for both settings. However, these systems are frequently overwhelmed and limited by their scope of care to primary care. There is scarce evidence on differences between access, quality, and experiences of care delivered relative to other safety-net models. Method: The 2022 Health Center Patient Survey (HCPS) was collected on behalf of the Health Resources and Services Administration (HRSA). The HCPS is a nationally-representative, three-staged, sample-based survey collected via 1:1 interviews with clinic patients. The survey assessed sociodemographics, health conditions and behaviors, access to and utilization of care, and patients’ experiences with comprehensive services they received at HRSA-funded health centers, including: community health centers (CHC), healthcare for the homeless (HCH) clinics, migrant health centers (MHC), and public housing primary care (PHPC) clinics. A total of 103 unique awardees and 318 health center sites were recruited, and 4,414 patient interviews were completed. Investigators analyzed patient characteristics and multiple survey items related to AHA’s Essential 8 metrics for differences across clinic type. Results: MHC and HCH clinics had fewer elderly patients (~7%) than CHC and PHPC clinics (~17%). There were differences across sex, race, and ethnicity across all four clinic types. Cardiovascular disease history ranged from 4.9% (MHC) to 14.7% (HCH). Reported 7-day physical activity measures, average sleep below 7 hours per day, and Lifetime smoking (&gt;100 cigarettes; OR=4.2, p&lt;0.001) were all greatest among HCH patients. Fewer HCH and MHC patients reported ever having or recent lipid tests (both p&lt;0.001). HCH patients were more likely to report hypertension (p=0.003), but less likely to report receiving nutrition advice (all p&lt;0.05). MHC patients were less likely to be prescribed hypertension medication (p=0.044) and HCH patients were less likely to be taking medication even if it was prescribed (p&lt;0.001). Adjustment for differences in age or CVD history were able to explain some observed differences, but increased the magnitude of other disparities. Conclusion: CVD burden differs across the various HRSA funding mechanisms for clinics, as do demographics and multiple metrics of health behaviors and biomarkers of cardiovascular health. Greater disease burden in HCH and MHC patients is likely compounded by increased risk factors and under performance in providing health education interventions.

Examining cancer screening disparities by race/ethnicity and insurance groups: A comparison of 2008 and 2018 National Health Interview Survey (NHIS) data in the United States.

Pervasive differences in cancer screening among race/ethnicity and insurance groups presents a challenge to achieving equitable healthcare access and health outcomes. However, the change in the magnitude of cancer screening disparities over time has not been thoroughly examined using recent public health survey data. A retrospective cross-sectional analysis of the 2008 and 2018 National Health Interview Survey (NHIS) database focused on breast, cervical, and colorectal cancer screening rates among race/ethnicity and insurance groups. Multivariable logistic regression models were used to assess the relationship between cancer screening rates, race/ethnicity, and insurance coverage, and to quantify the changes in disparities in 2008 and 2018, adjusting for potential confounders. Colorectal cancer screening rates increased for all groups, but cervical and mammogram rates remained stagnant for specific groups. Non-Hispanic Asians continued to report consistently lower odds of receiving cervical tests (OR: 0.42, 95% CI: 0.32-0.55, p<0.001) and colorectal cancer screening (OR: 0.55, 95% CI: 0.42-0.72, p<0.001) compared to non-Hispanic Whites in 2018, despite significant improvements since 2008. Non-Hispanic Blacks continued to report higher odds of recent cervical cancer screening (OR: 1.98, 95% CI: 1.47-2.68, p<0.001) and mammograms (OR: 1.32, 95% CI: 1.02-1.71, p<0.05) than non-Hispanic Whites in 2018, consistent with higher odds observed in 2008. Hispanic individuals reported improved colorectal cancer screening over time, with no significant difference compared to non-Hispanics Whites in 2018, despite reporting lower odds in 2008. The uninsured status was associated with significantly lower odds of cancer screening than private insurance for all three cancers in 2008 and 2018. Despite an overall increase in breast and colorectal cancer screening rates between 2008 and 2018, persistent racial/ethnic and insurance disparities exist among race/ethnicity and insurance groups. These findings highlight the importance of addressing underlying factors contributing to disparities among underserved populations and developing corresponding interventions.

How Education Shapes Indigenous Health Inequalities in the USA and Mexico.

Indigenous peoples around the world face significant health disparities relative to the dominant groups in their countries, yet the magnitude and patterns of health disparities vary across countries. We use data from the National Health Interview Survey and Mexican Family Life Survey to examine the health of Indigenous peoples in Mexico and American Indians and Alaska Natives in the USA and to evaluate how they fare relative to the majority populations in their countries (non-Indigenous Mexicans and non-Hispanic Whites, respectively). We assess disparities in self-rated health and activity limitations, with a focus on how Indigenous health disparities intersect with educational gradients in health. Regression analyses reveal three primary findings. First, Indigenous health disparities are larger in the USA than in Mexico. Second, differences in educational attainment account for most of the differences between Indigenous and non-Indigenous populations in Mexico, but less than half in the USA. Third, in both countries, health is moderated by educational attainment such that between-group disparities are largest at the highest levels of education. However, for Indigenous Mexicans there is a "cross-over" in which Indigenous Mexicans report better health at the lowest level of education. Overall, this study finds a weak relationship between education and Indigenous health, and raises the question about the validity of using traditional measures of SES in Indigenous contexts.

σ-Hole Site-Based Interactions within Hypervalent Pnicogen, Halogen, and Aerogen-Bearing Molecules with Lewis Bases: A Comparative Study.

σ-Hole site-based interactions in the trigonal bipyramidal geometrical structure of hypervalent pnicogen, halogen, and aerogen-bearing molecules with pyridine and NCH Lewis bases (LBs) were comparatively examined. In this respect, the ZF5···, XF3O2···, and AeF2O3···LB complexes (where Z = As, Sb; X = Br, I; Ae = Kr, Xe; and LB = pyridine and NCH) were investigated. The electrostatic potential (EP) analysis affirmations outlined the occurrence of σ-holes on the systems under consideration with disparate magnitudes that increased according to the following order: AeF2O3 < XF3O2 < ZF5. In line with EP outcomes, the proficiency of σ-hole site-based interactions increased as the atomic size of the central atom increased with a higher favorability for the pyridine-based complexes over NCH-based ones. The interaction energy showed the most favorable negative values of -35.97, -44.53, and -56.06 kcal/mol for the XeF2O3···, IF3O2···, and SbF5···pyridine complexes, respectively. The preferentiality pattern of the studied interactions could be explained as a consequence of (i) the dramatic rearrangement of ZF5 molecules from the trigonal bipyramid geometry to the square pyramidal one, (ii) the significant and tiny deformation energy in the case of the interaction of XF3O2 molecules with pyridine and NCH, respectively, and (iii) the absence of geometrical deformation within the AeF2O3···pyridine and ···NCH complexes other than the XeF2O3···pyridine one. Quantum theory of atoms in molecules and noncovalent interaction index findings reveal the partially covalent nature of most of the investigated interactions. Symmetry-adapted perturbation theory affirmations declared that the electrostatic component was the driving force beyond the occurrence of the considered interactions. The obtained findings will help in improving our understanding of the effect of geometrical deformation on intermolecular interactions.

Racial and Ethnic Disparities in Excess All-Cause Mortality in the First Year of the COVID-19 Pandemic

Research on the COVID-19 pandemic in the United States has consistently found disproportionately high mortality among ethnoracial minorities, but reports differ with respect to the magnitude of mortality disparities and reach different conclusions regarding which groups were most impacted. We suggest that these variations stem from differences in the temporal scope of the mortality data used and difficulties inherent in measuring race and ethnicity. To circumvent these issues, we link Social Security Administration death records for 2010 through 2021 to decennial census and American Community Survey race and ethnicity responses. We use these linked data to estimate excess all-cause mortality for age-, sex-, race-, and ethnicity-specific subgroups and examine ethnoracial variation in excess mortality across states and over the course of the pandemic's first year. Results show that non-Hispanic American Indians and Alaska Natives experienced the highest excess mortality of any ethnoracial group in the first year of the pandemic, followed by Hispanics and non-Hispanic Blacks. Spatiotemporal and age-specific ethnoracial disparities suggest that the socioeconomic determinants driving health disparities prior to the pandemic were amplified and expressed in new ways in the pandemic's first year to disproportionately concentrate excess mortality among racial and ethnic minorities.

Understanding causes of racial/ethnic survival disparity in 47,178 patients with colorectal cancer: A quantitative evaluation of molecular, socioeconomic, and clinical covariates.

20 Background: A disparity in overall survival (OS) of colorectal cancer (CRC) patients based on self-reported race has been observed. Separately, differing frequencies of driver gene mutations among racial groups have been observed. The contribution of these molecular differences to disparity in outcomes is not well understood. We conducted a systematic investigation of molecular, socioeconomic (SES) and clinical covariates to quantitate the degree to which each influences the OS disparity. Methods: The Foundry software platform was used to query electronic health records to identify CRC patients and extract clinical and molecular data. The relative contribution of each variable to OS disparity was determined using mediation analysis consisting of sequential multivariate Cox regression models. Results: 47,178 patients with CRC diagnosed between 1973 and 2023 with self-reported race were identified. Relative to Non-Hispanic white (NHW), African American (AA) had worse OS (HR=1.16, P= 1.5E-6), while Asians and Hispanics had better OS (HR=0.66, P=4.2E-13 and HR=0.86, P=3.4E-6, respectively). The magnitude of disparity between AA and NHW was greater in metastatic disease (HR 1.2, P=1.7E-4). Among 7,628 patients with clinical molecular testing, five genes differed significantly in mutation frequencies; APC (54% NHW, 62% AA, 57% Hispanics, 46% Asian, FDR= 0.01), KRAS (45%, 58%, 50%, 44%, FDR=8.4E-9), PIK3CA (17%, 23%, 17%, 12%, FDR=0.006) were higher in AA, while BRAF (8%, 3%, 4%, 7%, FDR=2.4E-8), KIT (4%, 1%, 2%, 3%, FDR=0.013) were higher in NHW. In multivariate analysis mutations of BRAF (HR= 1.9, P=1.2E-8), KRAS (HR= 1.39, P=1.7E-7), and APC (HR= 0.81, P= 5E-4) were significantly associated with OS as was national area deprivation index (HR= 1.07, P=0.004), marital status (HR= 1.16, P=0.03), performance status (HR= 1.42, P= 5.3E-29), disease stage (HR= 1.502, P=4.4E-26), right sided tumors (HR= 1.23, P=0.003), tumor differentiation (HR= 1.22, P=0.004) and MSI-high (HR= 0.37, P=1.8E-7). Mediation analysis identified neighborhood SES as the greatest contributor to disparity (38%), followed by primary tumor side (10%), and molecular characteristics (MSI-status, KRAS and BRAF mutations, 10%). After including all covariates, 39% of disparity remained unaccounted. Conclusions: Systematic evaluation of a large cohort from a single institution confirmed substantial racial disparity in survival and frequencies of driver mutations. SES factors have the largest contribution but account only for forty percent of the disparity, with tumor molecular features also contributing. Molecular characteristics should be incorporated in multicentric studies of racial survival disparity. Future clinical studies should ideally account for genetic ancestry and molecular features when evaluating chemotherapy outcomes.

σ-Hole, lone-pair-hole, and π-hole site-based interactions in aerogen-comprising complexes: a comparative study.

Herein, the potential of ZO3 and ZF2 aerogen-comprising molecules (where Z = Ar, Kr, and Xe) to engage in σ-, lp-, and π-hole site-based interactions was comparatively studied using various ab initio computations. For the first time, a premier in-depth elucidation of the external electric field (EEF) influence on the strength of the σ-, lp-, and π-hole site-based interactions within the ZO3/ZF2⋯NH3 and ⋯NCH complexes was addressed using oriented EEF with disparate magnitude. Upon the energetic features, σ-hole site-based interactions were noticed with the most prominent preferability in comparison to lp- and π-hole analogs. This finding was ensured by the negative interaction energy values of -11.65, -3.50, and -2.74 kcal mol-1 in the case of σ-, lp-, and π-hole site-based interactions within the XeO3⋯ and XeF2⋯NH3 complexes, respectively. Detailedly, the strength of the σ- and lp-hole site-based interactions directly correlated with the atomic size of the aerogen atoms and the magnitude of the positively oriented EEF. Unexpectedly, an irregular correlation was noticed for the interaction energies of the π-hole site-based interactions with the size of the π-hole. Interestingly, the π-hole site-based interactions within Kr-comprising complexes exhibited higher negative interaction energies than the Ar- and Xe-comprising counterparts. Notwithstanding, a direct proportion between the interaction energies of the π-hole site-based interactions and π-hole size was obtained by employing EEF along the positive orientation with high strength. The present outcomes would be a fundamental basis for forthcoming progress in studying the σ-, lp-, and π-hole site-based interactions within aerogen-comprising complexes and their pertinent applications in materials science and crystal engineering.

Health Insurance Coverage and Access to Care by Sexual Orientation During the COVID-19 Pandemic: United States, January 2021-February 2022.

Objectives. To compare health insurance coverage and access to care by sex and sexual minority status during the COVID-19 pandemic and assess whether lack of insurance hindered access to care by sexual minority status. Methods. Using Behavioral Risk Factor Surveillance System data (January 2021-February 2022), we examined differences by sex and sexual orientation among 158 722 adults aged 18 to 64years living in 34 states. Outcomes were health insurance coverage type and 3 access to care measures. Results. Sexual minority women were significantly more likely to be uninsured than were heterosexual women, and lack of insurance widened the magnitude of disparity by sexual minority status in all measures of access. Compared with heterosexual men with health insurance, sexual minority men with health insurance were significantly more likely to report being unable to afford necessary care. Conclusions. During the pandemic, 1 in 8 sexual minority adults living in 34 study states were uninsured. Among sexual minority women, lack of insurance widened inequities in access to care. There were inequities among sexual minority men with health insurance. Public Health Implications. Sexual minority adults may be disproportionately affected by the unwinding of the COVID-19 public health emergency and may require tailored efforts to mitigate insurance coverage loss. (Am J Public Health. 2024;114(1):118-128. https://doi.org/10.2105/AJPH.2023.307446).