Ethnic Differences Research Articles

Racial and Ethnic Disparities in Perceived Health Status Among Patients With Cardiovascular Disease.

Understanding health outcomes among people with cardiovascular disease (CVD) is crucial for improving treatment strategies and patient quality of life. This study investigated racial and ethnic disparities in perceived health status among non-Hispanic Black, Hispanic, and non-Hispanic White adults with CVD. The study had a retrospective cross-sectional design and used data from the Medical Expenditure Panel Survey spanning 8 calendar years (2014-2021). The study population consisted of adults diagnosed with various CVDs. We used ordinal logistic regression models adjusted for demographic and socioeconomic characteristics, CVD severity, comorbidities, and health care expenditures to assess racial and ethnic differences in perceived health status. Among the 11,715 (weighted frequency, 15,431,283) adults with CVD, we observed significant differences in perceived health status across racial and ethnic cohorts. The unadjusted analysis showed that non-Hispanic Black adults had significantly higher odds than non-Hispanic White adults of perceiving their health as poorer (odds ratio [OR]= 1.89; 95% CI, 1.74-2.07; P < .001), with a similar observation among Hispanic adults (OR = 2.05; 95% CI, 1.85-2.26; P < .001). Although female sex, higher education, and better income had protective effects on perceived health status independent of race, we found significant racial and ethnic differences in the effect of older age, physical and cognitive limitations, and health insurance status on perceived health status. This study revealed substantial racial disparities in perceived health status among adults with CVD, with notable differences in the effects of predictive factors. Addressing these disparities requires targeted interventions to improve health care access and enhance socioeconomic conditions tailored to the needs and experiences of racial and ethnic populations.

Modeling longitudinal change patterns of self-regulation from early to middle childhood: Methodological innovations and individual differences.

Patterns of change in self-regulation from the ages of 2.5 to 12 years were modeled using repeated measures of self-regulation for a sample of 399 African American (n = 180, 45%) and Latinx (n = 219, 55%) children from families experiencing low income. Measures included both direct assessment and parent report. Results confirmed four components of self-regulation: working memory, inhibitory control, complex response inhibition, and set shifting. Furthermore, these components of self-regulation were more differentiated at younger ages but grew increasingly integrated as children developed. During early childhood, Latinx children displayed greater levels of working memory and higher levels of inhibitory control, and African American children displayed greater complex response inhibition and set shifting, but these ethnic differences reversed by early elementary school. By late middle childhood, ethnic differences in self-regulation had virtually disappeared altogether. Few differences by child gender or family poverty status were identified. Recommendations are provided to facilitate the modeling of self-regulation over extended periods of development including (a) utilizing measures that overlap time points, (b) standardizing the measurement scales, and (c) utilizing a flexible latent variable model. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Abstract 4129075: Racial and Ethnic Differences in Semaglutide Prescriptions in the Veterans Affairs Healthcare System

Introduction: Recent advances in obesity treatment added incretin-based injectables like semaglutide to treatments ranging from lifestyle modification to bariatric surgery. While the burden of obesity in the United States is high and disproportionately affects minoritized individuals, obesity interventions may not be equitably distributed. Insurance coverage is often cited as a barrier to accessing novel treatments. Research Question: Do inequities in semaglutide use among patients with obesity persist without insurance barriers to care? Goals: Characterize the role of race and ethnicity in the receipt of semaglutide among Veterans with obesity. Methods: Among VA patients with BMI ≥27 from 2018-2023, we used a hierarchical multivariable mixed effects logistic regression model to evaluate the association between race and ethnicity (White, Non-Hispanic Black, Hispanic, Asian/Native Hawaiian/Pacific Islander, American Indian/Alaska Native) and receipt of semaglutide prescriptions. We adjusted for age, gender, diabetes status, Charlson Comorbidity Index, education, and urbanicity, with a random effect for diagnosis year. Results: Among Veterans with BMI ≥27 (n=2,423,070), 38.8% had Class I obesity (BMI 30-34.9), 18.2% had Class II obesity (BMI 35-39.9), and 9.8% had Class III obesity (BMI&gt;40), with differences by race and ethnicity (p&lt;0.01). Across the cohort, 184,690 (7.6%) received at least one prescription for semaglutide during the study period. Higher severity of obesity was associated with odds of semaglutide prescription (Figure). Compared to White Non-Hispanic patients, Black and Hispanic/Latino Veterans were less likely to receive a semaglutide prescription, with adjusted odds ratios (AOR) of 0.63 (95% confidence interval [CI]): 0.60-0.68) and 0.81 (95% CI: 0.74-0.90), respectively. Receipt of a semaglutide prescription was also highly associated with diabetes status, with an AOR of 35.2 (95% CI 32.5-38.0) for those with a diagnosis of diabetes compared to those without. Conclusions: Racial and ethnic minority Veterans with obesity are less likely to receive prescriptions for semaglutide in VA, suggesting that challenges to equitable obesity care are more complex than financial coverage alone.

Abstract 4119613: Evaluation of Gender, Racial and Ethnic Differences in Time to PCI in the Pre and Post Covid-19 Era

Introduction: Percutaneous Coronary Intervention (PCI) is recommended for reperfusion of patients presenting with ST-segment myocardial infarction (STEMI) within 90 minutes. In this study, we sought to identify differences in PCI timing based on gender, race and ethnicity in the pre- and post-COVID era. Methods: We collected retrospective data on 760 patients admitted with STEMI at our quaternary academic medical center from 2018-2022. We defined our binary outcome as time to PCI less than 90 minutes, and adjusted for transfers from outside hospitals. We utilized univariate logistic regression analysis to analyze the association of demographic, clinical, and cardiac catheterization details on our outcome. We then utilized multivariate logistic regression analysis to determine the association of our covariates of interests with time to PCI. The logistic regression model was adjusted for collinearity which were deemed not significant. Results: Among our study population, COVID did not significantly impact whether or not a patient had a diagnostic cardiac catheterization on univariate analysis (OR 2.68, 95% CI 0.61-18.40, p=0.23). However, the post-COVID era was significantly associated with a delayed time to PCI on multivariate analysis [OR 1.62, 95% CI 1.04-2.55, p=0.035) [Figure 1]. In addition, females were 1.8x more likely to have a delayed PCI than males on multivariate regression [OR 1.80, 95% CI 1.10-2.95, p= 0.019) [Figure 1]. Interestingly, on multivariate analysis, females were more likely to have delayed reperfusion in the pre-COVID era (OR 2.92, 1.29-6.77,p= 0.01) but not the post-COVID era (OR 1.54, 0.78-3.06,p=0.2134). Patients in the post-COVID era had increased risk of having their culprit coronary not revascularized on multivariate analysis (OR 2.85, 1.2-8.03, p= 0.03). Conclusions: At our center, COVID did not significantly impact cardiac catheterization rates. However, COVID was significantly associated with delayed reperfusion timing and not revascularizing culprit vessels. Females were much more likely to have a delayed PCI than males in the pre-COVID era which was not seen following COVID-19.

Abstract Su908: Unfavorable prognostic features and temporal trends in Out-of-Hospital Cardiac Arrests (OHCA) presenting to an Academic Center at the Border in El Paso

Introduction: Early recognition of cardiac arrest with bystander cardiopulmonary resuscitation (CPR), and early defibrillation when appropriate, can improve outcomes after Out of Hospital Cardiac Arrest (OHCA). Data from the national registries indicate there are both regional as well racial and ethnic differences in rates of bystander CPR in witnessed OHCA cases with significantly lower rates of bystander CPR in non-white persons. However, Hispanic as well border populations are underrepresented in these studies. University Medical Center (UMC) El Paso, Texas is an academic medical center located 1 mile from the US- Mexico border which is also the only not for profit safety net hospital with a Level1 trauma center. Research Question: Outcomes after OHCA are strongly affected by peri-arrest circumstances including bystander CPR and certain features portend poor outcomes. We performed a descriptive observational study of OHCA cases presenting to UMC to analyze temporal trends in these factors in our community as local data from El Paso is currently not reported in any registries. Methods: We collaborated with the El Paso Fire Department (EPFD) to obtain resuscitation data on patients who suffered OHCA and were brought to the University Medical Center (UMC)Emergency Department (ED) and created a registry of patients who suffered OHCA in El Paso FROM 2017 to Nov 2021. Results: Initial analysis identified around 698 predominantly Hispanic patients who suffered OHCA. Of these 115 were due to non-cardiac causes such as trauma, and 583 were possible cardiac etiology. OHCA cases peaked in 2020 coinciding with COVID 19 surge. Less than one third (31.5%) had bystander CPR with only 11.9% having a shockable rhythm. 64% did not achieve Return of spontaneous circulation in the field. 39% expired in the ED or in the field. We also performed a temporal analysis of these features and bystander CPR rates peaked in 2019 (38.1%to 24.8% in 2021). Conclusion: In our Hispanic underserved population in El Paso, we identified poor outcomes after OHCA, with non-shockable rhythm being the most common adverse feature and decreased rates of bystander CPR (31.5%) with further decrease after 2019. Local community level data which is critical for appropriate local resource allocation to improve OHCA outcomes is missing from underserved populations and additional resources are required improve outcomes.

Abstract 4118777: Outcomes Of Patients With Hypertrophic Cardiomyopathy In Academic Versus Non-Academic Centers: Analysis from the National Inpatient Sample Database 2012-2020

Introduction: Hypertrophic Cardiomyopathy (HCM) is an uncommon heart condition associated with serious complications. Advances in medicine have improved its prognosis. Despite this, such potentially life-saving improvements concerning the implementation of best practices are not ubiquitous; guidelines recommend management at specialized centers. Unfortunately, not all hospitals have specialized HCM centers. However, given that a sizeable portion of these specialists are also in academic centers (ACs), we hypothesize that ACs may be better positioned than non-academic centers to provide the highest quality care for HCM patients. Purpose: Our study aimed to assess in-hospital outcomes and healthcare burdens among patient admissions with HCM diagnoses, comparing those treated at academic centers with those receiving care at non-academic centers. We examine all-cause in-hospital mortality, length of stay (LOS), hospital costs, and investigate ethnic differences in patients with HCM. Methods: The National Inpatient Sample database was utilized to obtain HCM patient hospitalizations from 2012 through 2020 in the United States. Patient hospitalizations for which adult patients had a primary diagnosis of HCM were identified. Outcomes included all-cause in-hospital death, LOS, and hospital costs. All-cause in-hospital mortality was evaluated using multivariable logistic regression analysis. Multivariable lognormal regression models were used to estimate LOS and inflation adjusted cost outcomes. Results: All-cause mortality unadjusted rates were 2.2% in non-teaching hospitals compared with 1.7% at teaching hospitals; however, this difference was not statistically significant ( p =.235). Both unadjusted and adjusted hospital LOS were 32% shorter for non-teaching hospitals ( p &lt;.001). Both unadjusted and adjusted hospital costs were 46% lower for non-teaching hospitals compared to teaching hospitals ( p &lt;.001; $37,829 vs $70,216). For both LOS and cost, the overall interaction between race and teaching status was statistically significant ( p &lt; .001.) Conclusion: Our study shows variations in hospital outcomes and costs between teaching and non-teaching hospitals. Non-teaching hospitals displayed shorter stays and lower costs. Additionally, the interaction of race and teaching status significantly impacted length of stay and costs. These results underscore the necessity of tailored interventions to address healthcare delivery and resource inequities, especially in teaching hospitals.

Exploring Associations Between Urban Youth’s Race and Ethnicity, Social–Emotional Well-Being, and Health-Promoting Behaviors

Multiple aspects of social–emotional well-being have been identified as influential factors in adults’ and children’s physical activity and nutrition. However, the associations between social–emotional well-being, race and ethnicity, and health-promoting behaviors among urban youth remain understudied. This cross-sectional pilot study examines the relationships between social–emotional well-being and health-promoting behaviors. The study also explores how race and ethnicity affect physical activity and consumption of nutrient-dense foods among urban youth ages 11–19 ( N = 100) in a small Northeastern city in the United States. The results do not indicate any associations between social–emotional well-being measures and health-promoting behaviors measured as fulfilling physical activity and fruit and vegetable intake guidelines. However, we found significant racial and ethnic differences in health-promoting behaviors. These findings indicate that prevention programs and policies aimed at enhancing urban youth’s engagement in physical activity and consumption of nutrient-rich foods need to be tailored based on racial, ethnic, and cultural contexts.

PATH-09. CLINICAL CHARACTERISTICS AND MOLECULAR CHARACTERISTICS OF 244 MEDULLOBLASTOMAS IN JAPAN

Abstract BACKGROUND Medulloblastomas are at least classified into four core subgroups, including WNT-activated, SHH-activated, group 3 and group 4. These molecular subgroups have been introduced in the WHO classification, which has become fundamental and indispensable. The JPMNG is co-organized by the Japan Society for Neuro-Oncology and the Japanese Society for Pediatric Neurosurgery, and we have summarized clinical and molecular characteristics of Japanese MBs. METHODS We enrolled 267 cases of medulloblastoma from 44 centers participating in the JPMNG study. Central histopathological diagnosis was performed by three neuropathologists, and molecular genetic diagnosis was performed by NanoString nCounter system or DNA methylation array, and their single nucleotide mutations and copy number aberrations have been also examined. RESULTS A total of 244 cases were finally analyzed, and the 4-subgroup classification was WNT: 39 (16%), SHH: 61 (25%), group3: 42 (17%), and group4: 102 (41.8%), respectively. In cases of less than 3 years old, no WNT have been found and 62.2% cases were SHH. In cases of WNT-MB, the majority being children (6-18 years) (31/39: 79.5%), and 8 cases (8/39: 20.5%) in adults older than 18 years. In cases between 3 to 17 years old, Group 4 is the most (48.6%), and these trends is almost consistent with published. references. Metastatic or MYC gain Group 3 MBs were poor prognosis, while Group 4 MBs with loss of chromosome 11 or whole chromosomal aberration were good prognosis. CONCLUSIONS Clinical and molecular characteristics of Japanese WBT-MB were almost consistent with those reported in other countries, and the relationship between molecular properties and prognosis of group3/group4 MBs were also reproducible. These findings suggest importance of molecular properties of MBs are preserved beyond ethnic differences, and will contribute to develop new therapeutic strategies.

Multicultural Education and Its Relevance to the Goals of Islamic Education

Islamic education prioritizes how to develop cognitive, affective, and also human emotions while still based on Islamic teachings. It is all for no other purpose than to explore Islam in individual and group life. The connection between Islamic and multicultural education will be a solution to the reality of various cultures as a form of potential development process that respects plurality and heterogeneity as a consequence of cultural, ethnic, tribal, and religious diversity. The existence of cultural plurality in Indonesia makes multicultural education very urgent. The focus of this research is on how the nature of multicultural education and its relevance to the goals of Islamic education. This is based on research that has been done before on Multicultural Education and the Nature of Islamic Education Goals, the author took the initiative to conduct research by analyzing the two studies to find common ground between multicultural education and Islamic education goals so that it can be known how the relevance between the two. The results of this study show that multicultural education is relevant to the goals of Islamic education, which essentially both have the aim of forming a peaceful and harmonious life in the midst of a society where there are differences in religion, ethnicity, tribe, language, and culture.

Investigating racial differences in mortality and survival outcomes following radical prostatectomy: a systematic review and meta-analysis

BackgroundNotable variations in cancer rates, survival rates, mortality exist among certain populations in the US. We aim to examine how prostate cancer prognosis differs among black and white men from various ethnic backgrounds undergoing radical prostatectomy.MethodsWe performed a comprehensive search across MEDLINE and Google Scholar databases from inception to March 2023 for observational studies including black and white men undergoing radical prostatectomy. Outcomes of interest included either overall survival, prostate cancer survival, biochemical recurrence, or all-cause mortality. Studies were pooled using hazard ratios (HR) with 95% confidence intervals (CIs) using Review Manager (RevMan) version 5.4.1.ResultsIn patients undergoing radical prostatectomy, the risk of all-cause mortality was significantly greater in blacks in comparison to whites ([HR] 1.16, 95% CI 1.12–1.21; I2 = 51%; p < 0.00001). Pooled analysis shows higher rate of prostate-specific mortality in blacks treated compared to whites ([HR]: 1.08, 95% CI 0.86–1.37; I2 = 81%; p = 0.50). The risk of biochemical recurrence was significantly higher in blacks undergoing radical prostatectomy than in whites (HR: 1.27; 95% CI 1.11–1.45; I2 = 58%; p = 0.0007). On regional subgroup analysis, the mid-west and multi-institutional centers revealed a higher rate of biochemical recurrence in blacks than in whites. No significant difference was noted between blacks and whites for overall survival.ConclusionsOur research demonstrated elevated rates of all-cause mortality, prostate-specific mortality, and biochemical recurrence, with no significant differences in overall survival between blacks and whites. Further research is warranted to assess ethnic and geographic differences at a large scale.

Evaluation of the clinical utility of NIPT-plus and analysis of adverse pregnancy outcomes.

To evaluate the performance of NIPT-plus in detecting fetal aneuploidies and CNVs and analyze the factors influencing adverse pregnancy outcomes. The retrospectively analyzed 8726 pregnant women who underwent NIPT-plus for fetal screening were classified into low- (who tested voluntarily) and high-risk (women with advanced age, abnormal ultrasound, abnormal serological screening, or a combination of indications) groups. Basic maternal information, prenatal findings, and pregnancy outcomes were recorded. NIPT-plus performance was assessed for various chromosomal abnormalities and the association between the fetal fraction and adverse pregnancy outcomes. Thirty-six (0.4%) patients had failed tests; 144 (1.65%) positive cases were detected, of which, 107 (74.31%) opted for invasive testing, and 51 were verified as true positives. The total positive predictive value was 45.45% and 48.65% in the low- and high-risk groups, respectively, and the difference was not significant. Among the subsequent cases with abnormal ultrasound monitoring, two false-negative cases were identified, and pathogenic CNV diagnosis was confirmed through amniocentesis, resulting in pregnancy termination. Fetal fraction was not associated with an increased adverse pregnancy outcome risk; however, ethnic differences may affect pregnancy outcomes. NIPT-plus technology use is no longer restricted to high-risk pregnant women, and it may produce false-positive results. The stakeholders should be aware of this limitation. The uncertainties and potential risks of the test results should be explained to the test takers to enable informed decision making and to minimize unnecessary anxiety and concerns. Ethnicity may influence adverse pregnancy outcomes in local multiracial settings.

Ethnic Inequalities in the Functional Dentition Among British Adults: A Multilevel Analysis.

To explore the role of socioeconomic factors, area deprivation and behaviours in explaining ethnic differences in the functional dentition among East London adults using multilevel modelling. Data from a community-based health survey in East London included information on 1898 adults aged between 16 to 65 years old and belonging to 9 ethnic groups. Supervised questionnaires gathered information on demographic characteristics, socioeconomic indicators, dental behaviours and area deprivation (IMD 2007). A functional dentition was defined as having all 6 anterior plus at least 4 posterior contacts in clinical examination. The multilevel logistic regression showed that Black Africans were 75% (95%CI: 1.21-2.52) and Black Caribbean 77% (95%CI: 1.05-2.98) more likely to have a non-functional dentition than White British participants in fully adjusted models. Other factors associated with a non-functional dentition were older age and no educational attainment. Black adults are at greater risk of non-functional dentition independently from sociodemographic characteristics, oral health-related behaviours and area-level characteristics. Proportionate universalism could be effective in reducing these health gaps.

Cultural Diversity, Communication, Inclusivity and Collaboration in Nigerian Workplaces: A Review

The increasing cultural diversity in Nigerian workplaces has intensified the need for effective communication strategies to manage intercultural interactions and foster inclusiveness. This study examines the implications of cultural and linguistic diversity within Nigerian organizations, addressing the complexities of navigating ethnic, religious, and linguistic differences. The Communication Accommodation Theory (CAT), Social Identity Theory (SIT), and Intergroup Contact Theory provide foundational frameworks for understanding and managing these dynamics, with CAT highlighting how convergence and divergence in communication styles can bridge or amplify social divides. Through a detailed analysis of Nigerian workplace environments, this paper identifies key communication challenges, including language barriers and identity-driven in-groups, while proposing strategies rooted in CAT, SIT, and Intergroup Contact Theory to enhance collaboration and reduce tensions. Recommendations for organizational management, such as language training and structured intergroup activities, aim to foster a more inclusive and productive environment, acknowledging both the opportunities and challenges posed by Nigeria’s unique socio-cultural landscape.

Racial and Ethnic Differences in Prostate Cancer Epidemiology Across Disease States in the VA.

Prostate cancer (PC) care has evolved rapidly as a result of changes in prostate-specific antigen testing, novel imaging, and newer treatments. The impact of these changes on PC epidemiology and racial disparities across disease states remains underexplored. To characterize racial and ethnic differences in the epidemiology of PC states, including nonmetastatic hormone-sensitive PC (nmHSPC), metastatic HSPC (mHSPC), nonmetastatic castration-resistant PC (nmCRPC), and metastatic CRPC (mCRPC). This is a retrospective, population-based cohort study of male US veterans aged 40 years and older with known race and ethnicity and no non-PC malignant neoplasm before study entry receiving care through the Veterans Health Administration. The study period was from 2012 to 2020, with follow-up through 2021. To identify active users, data capture included visits 18 months before and after the study period. Data analysis was performed from March to August 2023. Self-identified race and ethnicity, classified as Black, White, or Hispanic. The primary outcomes were annual age-adjusted incidence rates (IRs) and point prevalence for PC states by race and ethnicity. Trends were evaluated using joinpoint regression. Time to disease progression or death was estimated using nonparametric cumulative incidence. Competing risk models adjusted for age assessed the association of race and ethnicity on disease progression. The study included 6 539 001 veterans (median [IQR] age, 65 [56-74] years), of whom 476 227 had PC (median [IQR] age, 69 [63-75] years). IRs varied by time frame and disease state. Across all states and years, the relative risk among Black vs White patients ranged from 2.09 (95% CI, 2.01-2.18; P < .001) for nmHSPC in 2012 to 4.12 (95% CI, 3.39-5.02; P < .001) for nmCRPC in 2017. In nmHSPC, hazard ratios for progression to mHSPC and nmCRPC were 1.36 (95% CI, 1.33-1.40) and 1.60 (95% CI, 1.51-1.70), respectively, for Black patients and 1.38 (95% CI, 1.31-1.45) and 1.55 (95% CI, 1.40-1.72), respectively, for Hispanic patients vs White patients. In contrast, in mCRPC, the hazard ratio for death was lower for Black (0.84; 95% CI, 0.81-0.88) and Hispanic (0.76; 95% CI, 0.69-0.83) patients compared with White patients. This cohort study of veterans found that Black patients had more than 2-fold higher incidence of all disease states vs White patients. Progression risk was higher for Black and Hispanic patients in early-stage disease, but lower in later disease stages. Despite equal access, Black patients disproportionately experience PC, although progression risks relative to White patients differed according to disease state.

Ethnic differences in the relationship between ectopic fat deposition and insulin sensitivity in Black African and White European men across a spectrum of glucose tolerance.

To examine the hypothesis that there would be ethnic differences in the relationship between ectopic fat and tissue-specific insulin resistance (IR) across a spectrum of glucose tolerance in Black African (BA) and White European (WE) men. Fifty-three WE men (23/10/20 normal glucose tolerance [NGT]/impaired glucose tolerance [IGT]/type 2 diabetes [T2D]) and 48 BA men (20/10/18, respectively) underwent a two-step hyperinsulinaemic-euglycaemic clamp with infusion of D-[6,6-2H2]-glucose and [2H5]-glycerol to assess hepatic, peripheral and adipose tissue IR. Magnetic resonance imaging was used to measure subcutaneous adipose tissue, visceral adipose tissue (VAT) and intrahepatic lipid (IHL). Associations between ectopic fat and IR were assessed using linear regression models. There were no differences in tissue-specific IR between ethnic groups at any stage of glucose tolerance. VAT level was consistently lower in the BA population; NGT (p = 0.013), IGT (p = 0.006) and T2D (p = 0.015). IHL was also lower in the BA compared with the WE men (p = 0.013). VAT and IHL levels were significantly associated with hepatic IR in the BA population (p = 0.001) and with peripheral IR in the WE population (p = 0.027). The present study suggests that BA and WE men exhibit the same degree of IR across a glucose tolerance continuum, but with lower VAT and IHL levels in the BA population, suggesting that IR may be driven by a mechanism other than increased ectopic fat accumulation in BA men.

Are there racial and ethnic differences in outcomes following left main PCI?

Are there racial and ethnic differences in outcomes following left main PCI?

11521 Racial and Ethnic Differences in Patients Who Underwent a Myomectomy or Hysterectomy in 2022

11521 Racial and Ethnic Differences in Patients Who Underwent a Myomectomy or Hysterectomy in 2022

Racial and Ethnic Differences in Liver Transplantation and Post-Liver Transplant Survival Among Patients With Hepatocellular Carcinoma.

Racial and ethnic disparities in diagnosis and overall outcomes for HCC are well known. We present updated real-world data on racial or ethnic differences in LT and post-LT survival among patients with HCC in a large population-based database. We used the TriNetX database to retrospectively identify patients who had HCC (ICD-10 C22.0, C22.8) and underwent LT (CPT codes 47,135, 47,140, 47,140, 47,141, 47,142) from 2012 to 2022 and compared outcomes across racial and ethnic subgroups. Majority of the patients were Caucasians (2403/2901, 84.8%), followed by African Americans (267/2901, 9.2%) Hispanic/Asian (231/2901, 7.9%). At follow up of 5 years, we noted no significant difference in mortality between AA and Caucasian patients [HR = 1.087 (95% CI 0.76, 1.56, p = 0.59)] as well as Hispanic/Asian and Caucasian patients [HR = 1.14 (95% CI 0.73, 1.78, p = 0.10)]. These results indicate that stringent implementation of policies aimed at ensuring equitable access to LT may contribute to bridging disparities in overall outcomes in HCC.

Baltisaksa huumor ja pastorianekdoodid

Baltic German humour and anecdotes about clergymen Keywords: anecdotes, Baltic Germans, humour Baltic German anecdotes (Pratchen) are a relatively unexplored part of Estonian folk humour, much like Baltic German culture within Estonian culture as a whole. This study focuses on anecdotes about Lutheran clergymen, which offer material for comparison with the more thoroughly researched Estonian counterparts. These humorous tales provide valuable insights into the cultural history, mentality, language as well as everyday life of the Baltic German community. Older Estonian anecdotes about clergymen often emphasize the social and ethnic differences between Estonian peasants and the clergy. In contrast, Baltic German anecdotes provide an internal perspective, exploring the role of the clergy within the Baltic German community and their outreach beyond it. The anecdotes can offer explanations for certain aspects that remain obscure and are therefore ridiculed in Estonian anecdotes. Two key features of Baltic German humour are its oral nature and the tradition of competing in witticisms (pliggern), a “national sport” possibly rooted in student culture. Initially shared orally, these anecdotes often referenced known people and places. They were later written down to preserve the memory and cultural history of the community. Older anecdotes published between the world wars, became classics that kept appearing in various forms in later collections. World War II added a final layer, with humour providing a way to encapsulate and process epochal events. In Baltic German anecdotes, clergymen are depicted in everyday activities and relationships, often taking on the role of the trickster parson. Unlike in Estonian jokes, the dynamic between the nobility and the church features prominently. This often takes the form of a humorous tug of war between the clergyman and the noble patron of the church, who may have attended school together in the past. The parson’s attitude towards parishioners is usually benevolent but patronizing, with the parish clerk, sexton, and coachman often playing supporting roles. Another central theme is the clergyman as a political figurehead, reflecting the tensions caused by the official campaigns of Russification and conversion to Russian Orthodoxy.

Regional and ethnic factors of obesity and diabetes mellitus in women of re-productive age in the Pribaikal region

Introduction. Overweight is currently one of the leading global medical problems. Overweight and obesity contribute significantly to the development of diseases such as diabetes, cardiovascular disorder and can also cause premature death. Obesity has a negative impact on reproductive function; almost a quarter of women of childbearing age are overweight and about a third of them are obese.Aim. To study the characteristics of carbohydrate metabolism, hormonal indicators, and clinical-metabolic profiles, as well as to assess the potential risk of developing diabetes mellitus in women of fertile age with overweight and obesity residing in the Baikal region.Materials and methods. The study involved 60 overweight and obese women of reproductive age in the Pribaikalye region, including 33 women of Russian nationality (group 1) and 27 women of Buryat nationality (group 2). Anthropo-metric, sociodemographic and behavioural criteria were analysed, as well as questionnaires using the FINDRISC Scale. General clinical analyses of blood and urine were performed, lipid profile parameters, glucose, insulin, creatinine, transaminases, estradiol, thyroid hormone, leptin levels in blood plasma were studied. In addition, an oral glucose tolerance test was performed and the insulin resistance index (HOMA-IR) was calculated.Results. In the group of Buryat women with lower body weight as compared to Russians, higher levels of leptin, HOMA- IR index, and larger waist circumference are observed. In Buryat women, low physical activity makes a significant contribution to the development of overweight and obesity, while for Russian women, excessive caloric intake is more important. In accordance with the results of the FINDRISC scale survey, the greatest contribution to the potential development of diabetes mellitus in the Russian group is body mass index (weight), and in the Buryat group, in addition to these indicators, waist circumference and reduced physical activity.Conclusions. The results of the study will be of great help in the development of pro-grammes for the prevention of diabetes and obesity, taking into account regional and ethnic differences among the population.