Minority Groups Research Articles

Normal Gut Microbiomes in Diverse Populations: Clinical Implications

The human microbiome is a sensor and modulator of physiology and homeostasis. Remarkable tractability underpins the promise of therapeutic manipulation of the microbiome. However, the definition of a normal or healthy microbiome has been elusive. This is in part due to the underrepresentation of minority groups and major global regions in microbiome studies to date. We review studies of the microbiome in different populations and highlight a commonality among health-associated microbiome signatures along with major drivers of variation. We also provide an overview of microbiome-associated therapeutic interventions for some widespread, widely studied diseases. We discuss sources of bias and the challenges associated with defining population-specific microbiome reference bases. We propose a roadmap for defining normal microbiome references that can be used for population-customized microbiome therapeutics and diagnostics.

Early Impact of the COVID-19 Pandemic on Public Benefits Recipients

AbstractThe COVID-19 pandemic has severely impacted employment, housing, and food security for low-income public benefits recipients. The present study seeks to understand public recipients’ self-reported critical and ongoing needs at the outset of the COVID-19 pandemic. This study uses logistic regression to analyze survey data gathered on 10,089 public benefits recipients in the early stage of the pandemic to better understand their self-reported critical and ongoing needs. We also explored variations in need among different racial/ethnic groups and public benefits receipt status. Our research found that respondents from most racial/ethnic minority groups indicated a significant need for food, housing, and back-rent, with variation among different racial/ethnic groups in expressing specific needs for finding employment and help with applying for public benefits. Our findings also identify SNAP/CalFresh recipients as a particularly vulnerable group, and they were more likely to need help with food insecurity, finding employment, applying for public benefits, and paying backrent. While numerous federal, state, and local programs and initiatives were created to address widespread need, this study identifies potential gaps in these efforts and increases understanding of how to target aid for low-income populations in times of crisis.

A prospective multicenter birth cohort in China: pregnancy health atlas.

The China Prospective Multi-Center Birth Cohort Study was launched in 2022. In collaboration with medical centers in 12 cities, it aims to establish a high-quality, multidimensional cohort comprising 20,000 natural pregnancy and assisted reproductive families. As of June 26, 2024, 12,911 pregnant women have participated in this study, and 161,122 biological samples have been collected. These samples cover four critical periods (early pregnancy, mid-pregnancy, late pregnancy, and postpartum) and comprise 10 different types such as serum, plasma, and urine. The study has collected comprehensive information from early pregnancy to newborns. The participants have an average age of 29.76years, an average height of 160.46cm, an average pre-pregnancy BMI of 23.11, and an average BMI of 27.25 before delivery. The cohort includes individuals from 26 ethnic groups, with 25 minority groups comprising 5.03% of the population. Guizhou Province exhibits the highest percentage of ethnic minorities at 24.96% and Guangdong Province owns the highest proportion (12.22%)of women with two or more children. The prevalence of thalassemia in Guangdong Province is seven times higher than in other provinces. Among pregnant women over 35years old, the prevalence of gestational diabetes mellitus is twice that of women under 35. Additionally, the prevalence of preeclampsia in women with assisted reproductive pregnancies is more than twice that of those with natural pregnancies. The study extensively collected diverse data and biological samples, making this cohort an ideal candidate for DOHaD field and multi-omics research.

How should trial teams make decisions about the proportions and diversity of the ethnic groups in their trial?

The benefits of randomised trials are not shared equally, and people from ethnic minority groups are a key constituency under-served by clinical research and clinical care. The STRIDE project aimed to give trialists practical information about how to decide which ethnic groups should be in their trials, and at what proportion. We considered trials in six clinical areas: cancer, cardiovascular, diabetes, maternal health, mental health, and smoking cessation. We created a summary for each, including participants-intervention-comparators-outcomes, and data on disease prevalence by ethnicity. These were discussed with panels with clinical expertise, trial and methodology expertise, lived experience, funding, and experience of working with and on behalf of ethnic communities. For each trial, we asked panel members to decide which ethnic groups should have been involved and at what proportion. We discussed 23 trials with 40 individual panel members. Panels found our questions difficult to answer. The lack of publicly available data on prevalence by ethnicity was central to this. Where data were available, decision-making was easier but not simple. The discussions led to eight STRIDE recommendations. We recommend that discussions involve diverse teams and that discussions need time, with access to the best available data. In the absence of data or consensus, we recommend the adoption of 'default' minimum rates of inclusion, with oversampling considered. These discussions should inform site selection, and the practical challenges of recruitment and retention should not determine which groups are to be included. We also suggest five policy initiatives to support implementation of the recommendations. Broadly, these are (1) funders need to signal that ethnic diversity is expected, (2) trial teams need access to better data, (3) funders and others need to signal that ethnic diversity means better science, (4) more funding is needed for evaluation, and (5) Good Clinical Practice training should cover ethnic diversity. Agreeing targets for which ethnic groups to involve in a trial is essential but difficult. Our eight recommendations could help to make trials more ethnically diverse if followed, and we suggest five policy initiatives that would create a supportive environment for their implementation.

Professional cultural institutions and the community? Lessons from the first community production of the Barcelona opera house

ABSTRACT Large cultural institutions have been given goals that go well beyond their conventional artistic endeavours. Opera houses are no exception. One strategy they attempt is to stage community productions, but how does this activity match with institutions that seek “artistic excellence”? We focus on a case study of the Gran Teatre del Liceu, Barcelona, and firstly see to what extent productions staged by large cultural institutions can be considered community-based programmes. Secondly, we analyse if these programmes are realistic in terms of reaching their target population. Lastly, we study the degree of participation achieved. In order to do so, we review the concepts of access and participation to build our own analytical framework. We also follow a qualitative and quantitative methodology, performing interviews and fielding a questionnaire to participants. We think that our research and results are relevant from both an analytical point of view and an empirical perspective: in terms of access, the Liceu worked towards correcting the underrepresentation of minority groups in artistic forms that obtain public funding, but these efforts were limited; regarding participation, the opera was developed for, with and by the community depending on the action analysed, and it combined crowd-sourcing, co-creation and audience-as-artist actions.

A Systematic Review and Meta-Analysis of Interventions Targeted to Parents for Improving the Oral Health of Children from Culturally and Linguistically Diverse (CALD) Backgrounds.

A high prevalence of dental caries is a significant health problem, especially in the pediatric population. Low-income minority groups, including the refugee and immigrant populations, are at higher risk of compromised oral health. It has been suggested that migrant parents do not have enough understanding of oral health, risk factors associated with dental caries, or the progress of dental decay. This systematic review aims to study quantitative literature on oral health interventions, health promotion programs, or behaviour change interventions targeting the parents/ caregivers of culturally and linguistically diverse (CALD) children. A systematic search of electronic databases, including MEDLINE, EMBASE, PUBMED, CINAHL, SCOPUS, WEB OF SCIENCE, COCHRANE, and PROQUEST, was conducted until August 2023. Randomised (RCT) or non-randomised controlled trials (NRCTs) were included. Two reviewers independently assessed the quality of the included studies using the Cochrane Risk of Bias (RoB) 2.0 and ROBINS-I tools. Meta-analysis was performed as appropriate. The initial search from the databases retrieved 2073 articles. After the removal of duplicates, 1683 articles remained. Finally, 69 articles were reviewed in full text, and 15 articles were considered eligible in this review. The RoB assessment for RCTs rated three as low-risk and three as high-risk. The serious RoB in these NRCTs mostly pertained to measurement bias based on self-reporting oral health behaviours. The meta-analysis pooling of results (for RCTs and NRCTs) favoured interventions for CALD parents' oral health knowledge [0.73 (95% CI, 0.08 to 1.38) for RCTs, 1.73 (95% CI; 1.45 to 2.02) for NRCTs] and attitudes [0.86 (95% CI, 0.31 to 1.42)]. Relatively high heterogeneity was observed. Oral health educational interventions can be effective in improving the oral health literacy of CALD parents' oral health knowledge and attitudes, especially when facilitated by lay health advisors. However, the low quality of evidence due to high heterogeneity and high RoB further highlighted the need for well-designed RCTs targeting CALD parents.

Abstract 4137188: Racial and Ethnic Disparities in Catheter Ablation for Atrial Fibrillation: A Systematic Review and Meta-Analysis

Background: Atrial fibrillation (AF) is the most prevalent arrhythmia globally, with an escalating incidence in the United States. It is known that racial and ethnic disparities exist in the management of AF. Although current guidelines recommend catheter ablation (CA) as one of the most effective rhythm control strategies, recent data suggest that minority populations, including Black, Hispanic, and Asian individuals with AF, are less likely to undergo CA, and aggregate data are lacking in this area. Aims/Hypothesis: To determine differences in CA rates and the likelihood of undergoing CA for AF in racial/ethnic minority populations compared to Caucasians. We hypothesized that minorities are less likely to undergo CA for AF than their non-minority counterparts. Methods: A systematic search of PubMed, EMBASE, and Cochrane Library, based on an a priori registered protocol (PROSPERO Registration CRD42024496174), from January 1st, 2010, to January 2nd, 2024, was conducted to identify studies with ≥ 500 participants assessing CA use in AF in at least two racial/ethnic groups. Data were combined using a random-effects model meta-analysis. Results: A total of 431 non-duplicate records were identified. After independent screening based on inclusion/exclusion criteria, 19 studies comprising 12,598,109 patients were included. Among them, 9,577,652 (76.0%) were White, 789,954 (6.3%) were Black, 476,216 (3.8%) were Hispanic, 113,005 (0.9%) were Asian, while 1,641,282 (13.0%) were classified as other or were missing race/ethnicity data. The proportion of White subjects who underwent CA for AF was 4% (95% CI 3-5%). In contrast, the proportion of Black, Hispanic, and Asian individuals with AF who underwent CA was 2% (95% CI 1-3%), respectively, for each group. Pooled odds ratios (OR) of having CA for AF compared to Whites were 0.68 (95% CI 0.56 - 0.83), 0.72 (95% CI 0.63 - 0.82), 0.64 (95% CI 0.48 - 0.86) for Blacks, Hispanics, and Asians, respectively. Conclusions: The use of CA among the total AF population was low across all ethnic groups. Moreover, racial/ethnic minority groups were significantly less likely to undergo CA compared to White patients.

Abstract 4128187: Does Health-related Quality of Life Differ by Race over time in Older Patients with Heart Failure from Before to After Heart Transplantation or Long-term Mechanical Circulatory Support?

Background: Minority patients are disproportionately affected by heart failure. Therefore, we aimed to determine the impact of race on health-related quality of life in three groups of older patients (60-80 years) with heart failure who underwent advanced surgical therapies (within race and by surgery group): (1) heart transplantation (HT, with pre-transplant mechanical circulatory support [HT MCS]), (2) HT without pre-transplant MCS (HT Non-MCS), or (3) long-term MCS, if ineligible for HT. Methods: Secondary analyses were conducted using data from the Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Support study. From 10/1/15 to 12/31/18, 396 patients with heart failure were recruited at 13 U.S. medical centers, of which 305 patients underwent HT (n=161 [68 HT MCS and 93 HT Non-MCS]) or long-term MCS (n=144) and had data through 1 year follow-up. Analysis included non-inferiority testing (Long-term MCS vs HT MCS; Long-term MCS vs HT Non-MCS). To demonstrate non-inferiority, the surgical strategies by race needed to show a difference of at least 5 percentage points, with a 95% lower confidence boundary and a two-tailed p-value<0.05 in health-related quality of life, using the Kansas City Cardiomyopathy-12 Questionnaire Overall Summary Score at baseline and 3-, 6-, and 12 months. Results: The entire cohort was on average 66.2±4.7 years, 78% male, and 84% White. All three surgical groups experienced improved health-related quality of life from before to 1 year follow-up; with the largest gain through 3-months. Using non-inferiority testing, the long-term MCS minority group did not demonstrate non-inferiority when compared to both the HT MCS minority group and HT Non-MCS minority group confidence limits above the non-inferiority margin of -5 (Figure). Also, the White long-term MCS group did not demonstrate non-inferiority when compared to the White HT MCS and White HT Non-MCS groups. Conclusion: Differences in health-related quality of life among groups based on race were not statistically significant. Per non-inferiority testing, HT is superior to long-term MCS for health-related quality of life, regardless of race.

Sleep Health Disparities.

Sleep is an important and potentially modifiable determinant of many severe health outcomes. Sleep health disparities exist and are exemplified by reported differential rates of prevalence, severity, and outcomes among minority groups and low-socioeconomic-status backgrounds. In this review we highlight the concept of sleep health, review the evidence for disparities in sleep health, examine risk factors and consequences of poor sleep health, and discuss policy implications.

Abstract 4126895: Bridging the Gap in San Joaquin Valley LGBTQ+ Cardiovascular Disease and Mental Health Disparities

Introduction: LGBTQ+ adults experience discrimination and violence that lead to stressors in daily life. Homophobia affects the mental health of the growing San Joaquin Valley (SJV) LGBTQ+ community leading to psychological distress and mental health concerns which can further lead to High Blood Pressure (HBP) and cardiovascular disease (CVD). SJV has a growing rate of LGBTQ+ migrants from the Bay Area who may be at risk for psychological distress and CVD. With a diverse community of low income and minority groups, the lack of physicians do not represent the workforce of SJV. Objectives: Trainees conducted Kessler psychological distress tests, HBP and CVD screenings across college campuses and community events to reduce the risk of CVD and spread awareness about mental health, CVD and its implications in the LGBTQ+ population due to environmental racism in the most underserved region for health care, SJV. Methods: I trained and provided mentorship to medically ambitious diverse low-income high school to instill a passion in them to come back after their medical education to practice medicine and promote LGBTQ+ health equity in SJV. Students conducted weekly Kessler psychological distress tests, HBP screenings and serve as a health technology coach. Each student monitored 2 hypertensive and psychological distressed patients. Kessler psychological distress tests and CVD screenings were conducted at college campuses to spread awareness about LGBTQ+ mental health and heart health and track psychological distress and HBP in the LGBTQ+ community. Findings: -About 88% (98 of 112) experienced some form of discrimination from a health care professional -About 57% (64 of 112) of SJV LGBTQ+ population are at risk for CVD -About 14% (16 of 112) of SJV LGBTQ+ population are Stage 1 hypertensive -About 76% (83 of 112) of SJV LGBTQ+ population are at risk for hypertension and are psychologically distressed Direct Outcomes: -Youth learned the value of empathy and service to disadvantaged LGBTQ+ communities through the program and volunteering -LGBTQ+ empowerment and students are determined to pursue medicine and address community concerns -Awareness, education among LGBTQ+ community for better heart and mental health -Better understanding in how to manage and seek referral for mental health and health systems concerns -Students learned about SJV health disparities and applied precision medicine to their own health inequity projects in SJV -Improved LGBTQ+ patient provider trust

Abstract 4138220: Traditional and HIV-specific Risk Factors Are Associated with Incident Non-valvular Atrial Fibrillation and Atrial Flutter among Underrepresented Racial and Ethnic Minority Groups Living with HIV

Introduction: With effective antiretroviral therapy (ART), HIV can now be managed as a chronic disease. Chronic disease and cardiovascular risk factor management is especially important for underrepresented racial and ethnic minority groups (UREG). Non-valvular atrial fibrillation and atrial flutter (NVAF) have not been adequately studied in UREG with HIV. Research Questions: Among UREG with HIV, what is the incidence of NVAF? What factors are associated with incident NVAF? Aims: To narrow an evidence gap among UREG with HIV by 1) describing the incidence of NVAF and 2) identifying factors associated with incident NVAF. Methods: This is an ancillary study of the Pathways to Cardiovascular Disease Prevention and Impact of Specialty Referral in Underrepresented Racial and Ethnic Minorities with HIV (PATHWAYS) study, a retrospective population-based study of HIV care patterns among UREG with HIV. Patients without a known history of NVAF entered our study cohort at the date of their first documented HIV diagnosis. We computed the cumulative incidence of NVAF over five years of follow-up (mean 3.4, SD 1.6), handling death as a competing risk. Cox regression analysis was used to examine the univariate associations between characteristics at HIV diagnosis and incident NVAF, adjusting for site and date of HIV diagnosis. Results: From 2015-2019, 10,945 UREG meeting entry criteria were identified. On average, patients were 67.1% male, 94.4% Black, and 8.5% Hispanic. Average CHA2DS2VASc score was 0.92 (SD 1.1) and 63.4% were on ART. Cumulative incidence of NVAF at one and five years after HIV diagnosis were 0.48% (95% CI 0.36-0.63) and 2.16% (95% CI 1.85-2.51), respectively. HIV-related factors associated with incident NVAF included baseline CD4 count <200 (HR 1.84, 95% CI 1.20-2.80) and initial ART including protease inhibitors (HR 1.56, 95% CI 1.14-2.13) and/or integrase strand transfer inhibitors (HR 1.47, 95% CI 1.08-1.99). Additional associated factors included older age, Medicare, cardiology visit(s) in prior year, and co-morbid diseases including hypertension, hyperlipidemia, coronary and peripheral artery disease, prior stroke/transient ischemic attack, heart failure, and chronic kidney disease. Conclusions: In a large cohort of UREG living with HIV, both traditional and HIV-specific risk factors are associated with increased risk of incident NVAF. Interventions to mitigate NVAF risk in this population will require interdisciplinary, team-based approaches.

University students who were men who had sex with men (MSM) in Sichuan, China had a higher prevalence of insomnia and probable depression than their non-MSM counterparts: mediation via emotional dysregulations.

Men who have sex with men studying in universities (MSM-US) frequently face multiple sexual minority stressors that potentially lead to maladaptive emotional regulations and mental problems. This study compared the prevalence of depression/insomnia between MSM-US and non-MSM male university students (NUS) and hypothesized that the potential differences would be mediated via emotional dysregulation styles (rumination and catastrophizing). The study design was a cross-sectional study. NUS were recruited from a university-based survey using cluster sampling in three universities in China from June to October 2018, while MSM-US from the same university-based survey and the other community-based survey using convenience sampling. The effective samples size was 2,531 (292 MSM-US and 2,239 NUS). Structural equation modeling (SEM) was performed. MSM-US had significantly higher prevalence of both probable depression (55.1% versus 35.7%; OR = 4.85, 95% CI: 3.38-6.94) and moderate-to-severe clinical insomnia (17.3% versus 4.1%; OR = 2.21, 95% CI: 1.73-2.83) than NUS. MSM-US were also more likely than NUS to use emotional dysregulation styles (rumination/catastrophizing), which were correlated with probable depression/insomnia (r = 0.17 to 0.31). In the SEM, the differences in depression/insomnia between MSM-US and NUS were partially mediated by the latent variable of emotional dysregulation (rumination and catastrophizing), with effect sizes of 55.0% for probable depression and 33.6% for insomnia, respectively. Depression and insomnia were prevalent among male university students in Sichuan, China. Furthermore, MSM-US were at increased risk than NUS for both mental problems; emotional dysregulation partially explained such differences. Future studies are warranted to confirm the findings, develop tailored interventions to address general and MSM-specific stressors and reduce rumination and catastrophizing, and examine whether similar patterns exist in other sexual minority groups.

Impact of a digital relationship intervention for jailed individuals.

Not surprisingly, incarceration's extreme separation and stress have significant negative effects on romantic relationships. Unfortunately, few programs have been developed to improve jailed individuals' romantic relationship with their non-incarcerated partner. The present study investigated the effectiveness of the individual version of the digital OurRelationship program for incarcerated individuals. The current study is a program evaluation of services provided by PayTel Inc. (a provider of eLearning and communication devices in US jails) between June 2020 and November 2021. Of the 5411 individuals in a romantic relationship who started the program, 3034 completed it. Following completion of the program, 78% reported feeling "Mostly" or "Very Satisfied" with the program, and 77% reported "Slight" to "Strong" agreement that their relationship benefited from the program. Individuals' relationship confidence (d = 0.36) and relationship knowledge (d = 0.33) significantly improved during the program. Women and Latino/Hispanic and Asian/PI individuals experienced the largest pre-post gains in relationship functioning. Furthermore, racial/ethnic minority groups tended to report higher satisfaction with the program. Overall, the high rates of program satisfaction and significant pre-post changes-combined with their reduced barriers to dissemination-support the delivery of digital relationship programs for jailed individuals interested in strengthening their relationship.

Impostor phenomenon short scale (IPSS-3): a novel measure to capture impostor feelings in large-scale and longitudinal surveys

The Imposter Phenomenon (IP) is gaining increasing attention in academia, not only as an overall attractive research topic but also as a concern that especially affects members of minority groups. Nevertheless, there is little evidence for the occurrence and socio-structural correlates of the IP. Against the backdrop of a pressing need to contextualize the IP, this paper provides (1) an overview of the existing empirical evidence on the IP from a perspective that incorporates the role of social contexts, (2) highlights shortcomings in both existing theoretical approaches and methodological tools, (3) introduces the Impostor Phenomenon Short Scale (IPSS-3) as a novel, time-efficient and universally applicable IP measure, and (4) underscores that the IP, in fact, does not occur in a social vacuum but is closely intertwined with socio-structural characteristics. To this end, the paper draws on three distinct data sets gathered among German adolescents and adults for the development of the IPSS-3 (Study 1: n = 271), its validation (Study 2: n = 427), and to assess the IP’s socio-structural correlates (Study 3: n = 865). The findings demonstrate that the IPSS-3 represents the first time-efficient and universally applicable instrument suitable for capturing the IP in large-scale and longitudinal research designs, e.g., initiated in adolescence. Thus, the IPSS-3 can address key open questions related to age effects, the role of transitions in the life course, and systematic variations in IP intensity among different social groups.

Abstract 4138813: The Use of Direct Oral Anticoagulants for Valvular Atrial Fibrillation in Central Australia

Background: In developed countries, valvular atrial fibrillation (vAF) in the setting of rheumatic heart disease (RHD) disproportionately impacts minority groups. In Australia, Indigenous Australians account for 92% of cases despite only representing 3.8% of the population. Studies to date, such as the INVICTUS trial, support the use of Vitamin K antagonists (VKAs) over direct oral anticoagulants (DOACs) in vAF. However, this assumes consistent adherence and regular clinic follow up. Reduced access to monitoring and dispensing clinics in Central Australia remains a challenge in the provision of VKAs and the use of DOACs may address this. Hypothesis: DOACs may be comparably effective with VKAs in preventing major adverse cardiac and cerebrovascular events (MACCE) in a real-world vAF population. Aim: To conduct a real-world retrospective observational study examining rates of MACCE for patients on VKAs or DOACs for vAF in Central Australia over a five-year period. Methods: The Northern Territory RHD Register was accessed to identify patients with RHD and vAF in January 2019. Demographic and five-year outcome data (until January 2024) were collected. The primary outcome was MACCE, a composite of ischaemic stroke, systemic embolism, non-fatal myocardial infarction, cardiovascular death and all-cause mortality. The primary safety endpoint was major bleeding. Statistical analyses were conducted as both intention-to-treat (ITT) based on initial anticoagulation and as-treated (AT) based on anticoagulation prior to MACCE or trial endpoint, each excluding patients without anticoagulation. Results: 61 patients were included. The mean age was 61.9 ± 13.9 years and 68.9% were female. At baseline, 65.6% received VKA, 14.8% DOAC and 19.7% were not anticoagulated. 30.6% of patients crossed over from the ITT analysis, with a non-significant trend favouring switch to DOAC (11 vs 0, p=0.09). In the ITT analysis (n=49), there was no significant difference in MACCE (25.0% vs 22.2%, p=0.86) or major bleeding (20.0% vs 11.1%, p=0.53) between VKA and DOAC groups. In the AT analysis (n=51), there was no significant difference in MACCE (27.3% vs 16.7%, p=0.39) or major bleeding (18.2% vs 22.2%, p=0.73) between VKA and DOAC groups. Conclusion: Over a five-year period, there was a trend towards use of DOACs over VKAs in vAF. This study demonstrates that DOACs may be as effective as VKAs for reducing MACCE in a real-world vAF population however further investigation is required.

Attitudes of Newly Recruited Icelandic Police Students Towards Diversity

Scholars have described prejudice towards various minority groups as one of the negative characteristics of police culture. Visible prejudice within the police has serious consequences for trust and legitimacy, thus reducing the willingness of the public to cooperate with them. However, little is known about the attitudes of police students towards police work in a diverse society in the Nordic context. This paper focuses on newly recruited police students in the Icelandic police university program. Police students’ attitudes towards diversity are analyzed in the context of various possible work-related scenarios. The study is based on a survey of all newly recruited police students in Iceland, conducted yearly from 2018 until 2023. The findings indicate that police students are generally positive towards at least certain types of diversity measures in policing, although support for diversity has declined slightly in the most recent year.

DISP-18. RACIAL DISPARITY IN THE UTILIZATION OF MOLECULAR DIAGNOSTIC AS A PROXY FOR SUB-OPTIMAL CLINICAL CARE IN GLIOBLASTOMA PATIENTS

Abstract BACKGROUND Molecular characterization of IDH mutation and MGMT-promoter methylation (MGMTm) are standard-of-care (SOC) diagnostics and essential to diagnosis, treatment, and prognosis of glioblastomas. Here, we determined the extent to which racial disparity occurs in this dimension of oncologic care. METHODS 31,439 glioblastoma patients were derived from the National Cancer Database (NCDB,2018-2021), with 20,736 IDH-wildtype patients with defined MGMT-status. Accessibility to SOC diagnostics was defined as whether patients got IDH/MGMT testing or not. Race/Ethnicity was grouped into Non-Hispanic White (NHW), Non-Hispanic Black, Asian/Pacific Islander, Hispanic, and Others. Receipt of SOC diagnostics and treatments, post-operative outcomes, and overall survival (OS) were explored using multivariable logistic regression, Kaplan-Meier method, and Cox proportional hazards models. RESULTS Relative to NHWs, all racial minority groups were less likely to have undergone IDH or MGMT-testing. These effects remain robust after adjusting for economic status, insurance, and facility type. Patients who received neither IDH nor MGMT-testing were 38% less likely to undergo SOC concurrent chemo-/radiation therapy (cCRT) relative to those having both testing. Further, patients having neither IDH nor MGMT-testing showed significantly higher risk of 30-day mortality (aOR:2.20), 90-day mortality (aOR:1.60), and hazard of death (median OS:8.9-mon,aHR:1.09,p=0.002) than those having both testing (median OS:12.9-mon). Of those tested for both IDH/MGMT, the odds of bearing a methylated MGMT-promoter remained relatively constant across five racial groups. Non-NHW glioblastomas patients were significantly less likely to receive SOC-modality. Of the patients who underwent IDH/MGMT-testing and cCRT, median OSs were 23.7 and 14.4-mon for MGMT-methylated and unmethylated glioblastoma, respectively. No significant difference in hazards of death for racial/ethnic minorities compared to NHWs was detected, regardless of MGMT-methylation status. CONCLUSIONS Our findings suggest that non-NHW glioblastoma patients are less likely to undergo SOC diagnostic (IDH/MGMT) testing, which serves as a proxy for receipt of sub-optimal clinical care. For glioblastoma patients who underwent SOC molecular testing and treatment, survival is similar across racial groups.

State of Play in the Implementation of the Principles of Inclusive Leadership in Fintech Companies in Lithuania

The multifaceted challenges posed by globalization, medical advancements, conflicts and crises necessitate a critical examination of social and organizational inclusion. Despite the acknowledged advantages of inclusive leadership (IL), there remains a significant research gap concerning the perceptions of IL among diverse employee groups, particularly within heterogeneous organizations. This study aims to bridge this gap by exploring the perceptions of IL across various sociodemographic groups within fintech companies in Lithuania. By concentrating on this rapidly evolving sector, this research enhances the understanding of IL by assessing how sociodemographic variables influence perceptions of inclusive leadership practices. A total of 236 responses were analyzed using the Mann–Whitney U and Kruskal–Wallis tests, supplemented by the Bonferroni correction to ensure statistical robustness. The findings elucidate the dynamics of IL within the fast-paced fintech environment, revealing unique challenges and opportunities to foster organizational inclusivity. The implications of this research provide actionable insights for industry leaders striving to implement IL strategies that empower minority groups and enhance overall organizational performance. Although the results indicate that fintech organizations have made strides in embedding IL principles, these advancements are not uniformly experienced across diverse employee demographics. Specifically, this study identifies significant disparities in IL perceptions between employees of other genders and those with health-related impairments. Acknowledging certain limitations, particularly the small sample sizes of some examined employee subgroups, this study advocates for further research to yield generalizable findings that can inform and improve inclusive organizational practices.

The Comparative Study of Bilingualism in East and Southeast Asia

The comparative study of bilingualism in East (Taiwan) and Southeast Asia (Vietnam) includes two interrelated investigations. This study provides valuable insights into the processes of language and literacy development among children from minority groups and examine patterns of language acquisition within school-age populations in bilingual communities. The research contributes to a deeper understanding of how bilingualism affects educational outcomes in these distinct cultural and linguistic contexts. Study A involved in-depth interviews with 62 Vietnamese immigrant participants and aimed to explore their language learning experiences and related issues of adaptation to Taiwanese culture. Study B, which was located in the Thái-speaking district of Bá Thước in Thanh Hóa province, involved fieldwork that primarily focused on the development of bilingual children in first grade. In the Chinese-speaking community of Taiwan, evidence suggests that immigrant parents make significant progress in the second language learning of Chinese. In turn, first generation children appear to be making progress that is parallel to that of their Chinese native-speaking peers. Similarly, in the Thái-speaking communities, progress in mastering the national language, Vietnamese, as a second language is comparable to that in Vietnamese-speaking communities (Kinh monolingual children).

Survival and Life: A Study on Cultural Adaptation of Ethnic Minority Groups from the Perspective of Dietary Anthropology

Abstract: In the process of globalization and modernization, the diet culture of minority groups is undergoing profound changes and adjustments. Therefore, through the perspective of food culture, this paper studies the identity of ethnic minorities in cultural adaptation, cross-cultural integration and their resistance to foreign cultures. It is found that diet is not only an important carrier of cultural inheritance of ethnic minorities, but also a core way of cultural self-expression and social interaction. In the process of cultural adaptation, ethnic minorities not only maintain the uniqueness of traditional culture through the inheritance and change of eating habits, but also carry out innovation and integration under the influence of foreign cultures to ensure the continuation of culture and self-identity. At the same time, eating rituals in festivals and religious occasions have also become an important way for ethnic minorities to express their cultural identity. In addition, the commercialization of diet and the development of tourism have enabled the ethnic diet culture to spread widely in the context of globalization and brought economic benefits. Studies have shown that diet plays a key role in ethnic minorities' response to the impact of globalization, maintaining cultural identity and promoting cultural inheritance, and is an important tool and symbol in cultural adaptation.