Minority Representation Research Articles

A Content Analysis of the Portrayal of Under-Represented Minorities in Introductory Accounting Textbooks

ABSTRACT This study examines the depiction of under-represented minorities “URMs” (Black, Hispanic/LatinX, and Native Americans) in introductory accounting textbook images. It is widely acknowledged that URMs are under-represented in the accounting profession. This under-representation is pervasive throughout the talent pipeline, from students to accounting firms. We conduct a content analysis of introductory accounting textbook imagery because retention of URM students is especially important during introductory courses and textbooks have the potential to foster students’ sense of belonging. We find that URM inclusion in images is less than their proportionate share of the U.S. population. Results also show that when URMs are included, they are rarely depicted without non-URMs. Encouragingly, however, when URMs are included, they are depicted in professional attire. This study provides critical insights into the visual representation of under-represented minorities in accounting education. JEL Classifications: I23; M41.

TARGETING UNDERREPRESENTED POPULATIONS IN PRECISION MEDICINE: A FEDERATED TRANSFER LEARNING APPROACH.

The limited representation of minorities and disadvantaged populations in large-scale clinical and genomics research poses a significant barrier to translating precision medicine research into practice. Prediction models are likely to underperform in underrepresented populations due to heterogeneity across populations, thereby exacerbating known health disparities. To address this issue, we propose FETA, a two-way data integration method that leverages a federated transfer learning approach to integrate heterogeneous data from diverse populations and multiple healthcare institutions, with a focus on a target population of interest having limited sample sizes. We show that FETA achieves performance comparable to the pooled analysis, where individual-level data is shared across institutions, with only a small number of communications across participating sites. Our theoretical analysis and simulation study demonstrate how FETA's estimation accuracy is influenced by communication budgets, privacy restrictions, and heterogeneity across populations. We apply FETA to multisite data from the electronic Medical Records and Genomics (eMERGE) Network to construct genetic risk prediction models for extreme obesity. Compared to models trained using target data only, source data only, and all data without accounting for population-level differences, FETA shows superior predictive performance. FETA has the potential to improve estimation and prediction accuracy in underrepresented populations and reduce the gap in model performance across populations.

A Comprehensive, Community‐Engaged Recruitment Strategy to Increase Minority Representation in New IDEAS – an Amyloid Imaging Study

AbstractBackgroundAlthough Black and Hispanic/Latino people have higher rates of clinical Alzheimer disease (AD), evidence indicates lower proportions and odds of positive amyloid positron emission tomography (PET). This may indicate differences in etiology of cognitive impairment, which has implications for prevention and treatment (ie, anti‐amyloid treatments). Unfortunately, Black and Hispanic/Latino people are underrepresented in AD research.MethodTo evaluate amyloid PET in a diverse sample, we designed culturally‐informed, community‐engaged recruitment strategies for New IDEAS (Imaging Dementia—Evidence for Amyloid Scanning), an observational, open‐label, longitudinal cohort study of beta‐amyloid PET. New IDEAS intends to recruit 7,000 U.S. Medicare beneficiaries with mild cognitive impairment (MCI) or dementia including 2,000 Black/African American and 2,000 Latino/Hispanic individuals. To ensure diversity, we developed a comprehensive recruitment strategy using a diverse, culturally‐trained staff that includes:• Identifying Dementia Specialists experienced recruiting minorities• Embedding high‐impact community engagement in select regions• Increasing capacity of specialists and PET facilities to engage minorities• Increasing pipeline of referrals to Dementia Specialists• Creating a culturally‐informed awareness campaignResultNew IDEAS has enrolled 4,524 participants including 954 (21.1%) Black/African American, and 842 (18.6%) Hispanic/Latinx. Median age is 76 years; 54% are female. More Black/African American (46.6%) and Hispanic/Latinx (42.6%) participants had a dementia diagnosis compared to the overall cohort (33.9%). More Black/African American (37.4%) and Hispanic/Latinx (37%) participants were enrolled in Medicare Advantage compared to the overall cohort (19.5%).During implementation, we encountered additional barriers to minority participation including: dementia specialists and PET facilities located greater distance from minority neighborhoods, lack of transportation to visits, fewer academic medical sites registered, concerns about co‐pays, and dementia specialists not accepting new patients. New strategies are being implemented to address some of barriers including coverage of co‐pays and assistance with transportation.ConclusionNew IDEAS has enrolled more Black/African American and Hispanic/Latinx participants than any amyloid PET study published to date. Despite some success with minority enrollment, recruitment has been hampered by underlying structural barriers such as lack of access to dementia care in minority communities and higher Medicare Advantage rates. Additional resources and policy changes are needed to allow more equitable access to research and dementia care.

Abstract A054: Leveraging the power of Hope Leaders for enhancing diversity in clinical trials via a bi-directional cancer health information model

Abstract Introduction: Despite increasing recognition of the need for diversity in clinical trials, participation from racial and ethnic minorities, particularly from low socioeconomic communities, remains dismally low. This underrepresentation hinders the generalizability of trial results and perpetuates health disparities. Low socioeconomic environments, characterized by economic instability, restricted healthcare access, food scarcity, and deficient educational resources, exacerbate these challenges. Residents of such communities often lean on "Hope Leaders" - trusted community figures - as a strategy to navigate through these adversities. Recognizing the pivotal role of these Hope Leaders, we advocate for a community-centered bi-directional cancer health information flow model, which positions these Leaders at the core of community engagement endeavors. This model fosters a bi-directional health information exchange that synergizes Hope Leaders with the scientific community, thereby promoting improved health equity within clinical intervention research. The implementation of this model commences with a pre-engagement phase, a respectful approach where we familiarize ourselves with the community and its dynamics, without imposing any specific demands or expectations. Approach: The University of Illinois Cancer Center has had 6 community engagement specialists that have engaged with community members through numerous pre-engagement events that encompass activities ranging from mental health, cancer prevention, survivorship events, education, health fairs and community meetings. Based on these insights, we established a dedicated working group to identify hope leaders and to create targeted engagement strategies for specific areas of our catchment region through the bi-directional cancer health information flow model. These strategies are tailored to address the unique challenges and barriers these communities face regarding enrollment in cancer clinical trials. Additionally, the community-driven health communication model was implemented to identify Hope Leaders and engage them with cancer researchers as a part of our phase I activities for this model. Conclusion: This innovative approach aims to leverage the unique position of Hope Leaders in underserved communities to amplify community voices, improve engagement, and ultimately, increase minority representation in cancer clinical trials. The model provides a promising strategy to address the persistent disparity in clinical trial participation, facilitating more equitable and inclusive research outcomes. Citation Format: Joseph Dufraine, Yamile Molina, Jeanette Gonzalez, Maria Olivero, Theresa Mobley, Saria Lofton, Dedra Reis. Leveraging the power of Hope Leaders for enhancing diversity in clinical trials via a bi-directional cancer health information model [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A054.

Enrollment and Scientific Progress of the Multisite SuperAging Research Initiative

AbstractBackgroundThe SuperAging Research Initiative is a multisite consortium focused on identifying factors promoting extraordinary cognitive aging. The designation of SuperAger is reserved for individuals age 80+ who have episodic memory capacity that would be considered at least average for those 2‐3 decades younger. The presence of such outliers raises questions of fundamental importance to the neurobiology of brain aging, resilience, resistance, and avoidance of cognitive decline caused by Alzheimer’s disease. The original study of SuperAgers emerged at Northwestern and helped establish the phenotype. The SuperAging Research Initiative was established in 2021 and is focused on increasing minority representation and expanding deep phenotyping of this unique population.MethodsHarmonized data collection has been initiated across the five sites including behavioral, health, biologic, genetic, environmental, socioeconomic, psychosocial, neuroanatomic, and neuropathologic factors. Here we summarize the initial recruitment progress and baseline characteristics of the current cohort.ResultsWe will present the organizational structure, progress, and baseline characteristics of the cohort to date. The SuperAging Research Initiative includes three Cores (Administrative/Biostatistics, Clinical/Imaging, and Biospecimen/Neuropathology) and two Research Projects. Enrollment (target, n = 500) has commenced across four U.S. Sites located in Illinois, Wisconsin, Michigan, and Georgia, and a Canadian Site in Southwest Ontario, with a focus on enrollment of Black SuperAgers and Cognitively Average Elderly Controls with similar demographics. Project 1 uses state‐of‐the‐art wearable technology to obtain quantitative measurements of daily life including, sleep, physical activity, autonomic responsivity, and social engagement to determine whether SuperAgers have relatively preserved physiologic and behavioral ‘complexity’ compared to Controls. Project 2 focuses on transcriptomic, genetic, and protein profiling to examine central and peripheral immune and inflammatory system parameters of SuperAgers.ConclusionsBy identifying factors contributing to superior memory performance in old age, outcomes may help isolate modifiable factors that promote healthspan and perhaps also prevent age‐related brain diseases such as Alzheimer’s disease.

Effect of dietary phytase on water and fecal prokaryotic and eukaryotic microbiomes in a hybrid tilapia (Oreochromis aureus x O. niloticus) mixotrophic biofloc production system

In this study we evaluated feed and temporal effects on prokaryotic (16S) and eukaryotic (18S) microbiome dynamics in an outdoor mixotrophic biofloc system used to grow hybrid tilapia (Oreochromis aureus x O. niloticus) to market size. The dicalcium phosphate -free practical feed treated with 6-phytase (3000 FTU/kg; P-Free+Phytase) and positive (Control) and negative (P-Free) control practical feeds used were formulated to contain 27.7% digestible protein and 4% lipid. Sex reversed, all-male hybrid tilapia (28.9 g/fish) were stocked (29 fish/m3) in 9 outdoor rectangular tanks (16.6 m3) and grown for 154 days. The Control feed was fed to all fish during the 14-day acclimation period after which each test feed was fed to fish in three tanks/feed. Biofloc water and fecal samples were collected from all tanks at time 0 (T0, study day 15) and T7, T70, and T140; prokaryotic and eukaryotic abundance and diversity were assessed using high-throughput amplicon sequencing of the 16S and 18S rRNA genes, respectively. Fecal 16S microbiome in all treatments was dominated by Fusobacteria (namely Cetobacterium) with minority representation by Proteobacteria, Firmicutes, Bacteroidetes, and Planctomycetes. Opisthokonts (namely Capsaspora) were the dominant eukaryote detected overall in all fecal samples. Fecal 16S and 18S relative abundances varied significantly with time. Relative abundance of fecal 16S differed significantly between Control and P-Free+Phytase feed treatments only at T140 (harvest). Fecal 18S relative abundance differences among feed treatments were detected only at T0 and T7 and only at the supergroup taxonomic level. Prokaryotic communities in biofloc water among feed treatments and across times were highly diverse and dominated by Proteobacteria, Bacteroidetes, Fusobacteria, Chloroflexi, Planctomycetes, and Actinobacteria. High relative abundances of Capsaspora across time characterized eukaryotic communities. Relative abundances of 16S and 18S taxa in water varied significantly over time. Control and P-Free feed 16S relative abundances in water differed significantly at T0 and T7. Time was the factor that explained most of the variation observed for 16S and 18S beta diversity. Overall, results of the present experiment suggest minimal influence of phytase-treated or dicalcium phosphate-free feeds on hybrid tilapia 16S and 18S water and fecal microbiomes throughout the experiment, particularly because the base feed formulation was the same for all treatments. During this experiment and at harvest tilapia in all treatments appeared healthy and robust, and no known pathogenic bacteria or eukaryotes were detected in any sample, suggesting the observed microbiomes may represent system-specific “healthy” core microbiomes.

The racial gap in entrepreneurship and opportunities inside established firms

AbstractResearch SummaryRacial disparities in entrepreneurship have been widely discussed in the literature, with most studies focusing on mechanisms that amplify such disparities. However, less attention has been devoted to factors that promote inclusion. We propose that intrapreneurship—launching and operating new ventures inside established organizations—represents a more inclusive entrepreneurial pathway than entrepreneurship involving a standalone venture. We predict that relative to White employees, Black employees will (1) be more likely to engage in intrapreneurship than entrepreneurship and (2) achieve greater financial performance as founders of internal ventures than standalone ventures. Using data on a representative sample of American new business founders in 2005, we found evidence for our theory. Our study highlights the importance of intrapreneurship in leveling the playing field for racial minorities pursuing entrepreneurial activities.Managerial SummaryDespite the persistent inequalities in the representation of racial minorities in entrepreneurship, how to make the entrepreneurial path more inclusive remains less well understood. In this study, we find that intrapreneurship—or launching and running a new venture within an already established firm—holds the potential to offering a more inclusive route to entrepreneurship, compared to the traditional way of starting a standalone business. Using data from a representative sample of American business founders in 2005, we find that Black employees are more likely to take the intrapreneurship route rather than starting their own independent businesses. We also find that, conditional on founding a new venture, Blacks are more likely to achieve financial success as intrapreneurs than entrepreneurs. Finally, when discrimination is more prevalent and other indicators of quality are lacking, the gaps in founding rates and new‐venture performance between Blacks and Whites are less likely to widen in intrapreneurship compared to standalone entrepreneurship. Overall, these findings have important implications for practices that can help address the racial disparities we see in entrepreneurship.

Race and Gender Representation in Myelodysplastic Syndrome Clinical Trials in the US: A Cohort Study

Introduction: Clinical trials in the US frequently under-enroll racial/ethnic minorities, and demographic reporting of minority enrollment is variable and often incomplete. Underrepresentation of minorities in clinical trials deprives these patients (pts) of the benefits of novel therapies and impacts the generalizability of clinical trial findings. Little is known about the disparities in enrollment of racial and ethnic minorities in myelodysplastic syndromes (MDS) clinical trials in the US and their trends over time. Methods: We used the aggregate analysis of ClinicalTrials.gov database to obtain records of interventional, randomized phase II and phase III studies conducted in US that reported completed results to the database using the search terms “myelodysplastic syndromes” or “MDS” with start and completion dates between January 1, 2000, to December 31, 2022. “Race/ethnicity” was adapted in accordance with US Census and Department of Health and Human Services guidelines and grouped into five categories for this analysis - White, Black/African American, American Indian or Alaska Native (AI/AN), Asian, and Other. We analyzed the reporting of race/ethnicity in clinical trials benchmarked with the passage of federal mandatory reporting requirements in September 2007 and January 2017. The proportions of enrollees by each racial group in all the MDS trials reporting on all 5 racial groups were computed for the entire study period and the distributions of these proportions were plotted in the density plots (Fig 1). Additionally, we calculated the odds ratios (OR) with 95% CI of enrollment by race and gender in clinical trials (Fig 2). All calculations were done using R version 4.2.0. Results: We identified 299 MDS clinical trials using our search criteria. After excluding phase I/II non-randomized clinical trials and trials with less than 20 pts, we included a total of 206 clinical trials (174 phases II & 32 phase III) for analysis. Of the 21,645 pts initially enrolled in the 206 trials, 20,709 pts with complete data were analyzed. With the institution of federal reporting requirements in the late 2000s, enrollment reporting by race and ethnicity has vastly improved, with 100% of MDS clinical trials reporting these demographics since 2017. In trials reporting race enrollment for all five groups, Whites had the highest enrollment proportions in all trials conducted within the study period, with a median enrollment of 85.8% (Fig 1). This level of clinical trial representation exceeded the estimates of proportion of Whites among the US population (70.3%, p < 0·001). In contrast, Blacks, AI/AN, Asian and other racial categories were significantly underrepresented relative to their US populations ( p < 0·001). Figure 2 shows a forest plot of OR of enrollment by race and gender. Blacks, Asian and AI/AN had significantly lower odds of enrollment compared to Whites. Females had significantly higher odds of enrollment compared to males. Conclusion: Our analysis highlights substantial disparities in representation of racial minorities in MDS clinical trials in the US. Unless efforts are taken to systematically address these enrollment disparities, MDS outcomes for these historically disadvantaged groups will continue to lag due to incomplete understanding of biologic and individual factors that impact treatment effectiveness in these groups.

Language and Power: How Democracy and Pluralism Shape Patterns of Minority Political Representation in Bali, Indonesia

This study aims to portray the political representation of minorities using discourse analysis as a tool to analyse the 2019 legislative election in Bali province. Bali is a province with the largest Hindu population in Indonesia. It is necessary for minority groups to take strategic steps to express their participation and existence in political contestation. The power of language and the strength of minority political candidates have led to successful competition for seats in the legislature. The ethnically and religiously heterogeneous electorate sympathized with the candidate. Using a linguistic semiotic approach, the analysis results are obtained, and the use of language as a representation of Muslim power is aimed at the diction of “Khadimul Ummah”, or servant of the public. While this study uses a qualitative approach to semiotic analysis, the diction of servant of the public is interpreted using a binary opposition approach. The results of this study show that language creates its identity and becomes a figure of interest to the Balinese people as a representation of Indonesian legislative members in the electoral district of Bali. For most people in Bali, there is a belief that this diction is something that strengthens inter-religious harmony between societies. The significance of this study lies in the fact that language may have symbolic power for both ethnic minority and majority groups.

Discursive representations of sexual minorities in China’s English-language news media: a corpus-based study

In contemporary China, sexual minorities (SMs) are still a marginalized community. Prior studies have accorded SMs a great deal of attention, but little research has been conducted on the representations of lesbian, gay, bisexual, and trans people in Chinese English-language news media. This article uses corpus linguistic tools to examine popular views on SMs in a larger corpus of 354 news articles, filling the gap in research. Based on data collected from four English-language newspapers in mainland China and informed by discursive strategies, the article concludes that Chinese SMs are prominently represented as unhealthy individuals, but also victims and progressionists. The findings also indicate that conservative and liberal perspectives on SMs co-exist in the English-language newspapers. In addition, potential contributing factors to these representations are discussed.

Rising Tides or Political Ripcurrents? Gentrification and Minority Representation in 166 Cities

Transformative changes in urban economies are raising vital questions about minority representation. Given that cities are sites of political power for communities of color, gentrification and the housing affordability crisis threaten to deteriorate decades of progress. This article considers the impact of these economic and demographic shifts on minority candidate supply and success. Collecting data on 166 city councils across several decades, we find that White population growth is associated with reductions in local political power for Black and Latino councilors. We also observe modest evidence that local economic improvements may not have deleterious effects on the diversity of city councils. We probe these findings using data on local elections, as well as over 380,000 tweets from city councilors, and uncover evidence of a candidate supply mechanism in the case of “racial gentrification” and a credit-claiming mechanism in the case of “economic gentrification.” We conclude by discussing the political implications of the cross-cutting effects we observe.

Cardiovascular surgery trials in the United States: representation of women and minorities

Cardiovascular surgery trials in the United States: representation of women and minorities

Do Danish voters discriminate against women and ethnic minority candidates? Insights from a survey experiment

Representation of women and ethnic minorities is a recurring topic in connection with Danish elections. One possible explanation for the consistent underrepresentation is that voters evaluate women and ethnic minority candidates less favorably than men with an ethnic Danish background. Theoretically, this possibility might be particularly pronounced among conservative voters high in Social Dominance Orientation (SDO). Analyses from a survey experiment with 1116 representative Danish citizens show that Danes, on average, do not evaluate women and ethnic minority candidates less favorably. However, nuanced exploratory analyses show that growing SDO and conservatism cause voters to evaluate ethnic minority candidates more negatively, while a similar pattern does not obtain with respect to candidate gender. Consequently, issues about underrepresentation of women and ethnic minorities relate differently to SDO and political ideology. The theoretical and normative implications of the results are discussed.

Visual Representations of Sexual Minorities in Chinese Newspapers

Same-sex sexuality remains a prevalent taboo in many cultures and societies globally. In the past decade, scholars from various fields have increasingly examined how sexual minorities (SMs) are represented. The present paper contributes to this growing research by addressing two notable gaps. First, since much of the existing research centers on Western contexts, there is limited study on the portrayal of SMs within the Chinese cultural framework. Second, past studies emphasize verbal portrayals, often sidelining the importance of visual representations. This article will report and analyze the photos gathered from two prominent Chinese newspapers, China Daily and Global Times, pertaining to SMs in mainland China. By drawing on Van Leeuwen’s visual social actor network, the article reveals that Chinese SMs most often are visually represented as victims, disguisers, warriors, and elitists. Finally, we explore the socio-cultural influences behind these representation patterns.

Turnout Turnaround: Ethnic Minority Victories Mobilize White Voters

In Western democracies, like the United States, the United Kingdom, and Germany, the number of ethnic minority representatives has been steadily increasing. How is this trend shaping electoral behavior? Past work has focused on the effects of minority representation on ethnic minorities’ political engagement, with less attention to the electoral behavior of majority-group members. We argue that increased minorities’ representation can be experienced as a threat to a historically white-dominant political context. This, in turn, politically activates white constituents. Using data from four U.K. general elections and a regression discontinuity design, we find that the next election’s turnout in constituencies narrowly won by an ethnic minority candidate is 4.3 percentage points larger than in constituencies narrowly won by a white candidate. Consistent with our argument, this turnout difference is driven by majority-white constituencies. Our findings have implications for intergroup relations and party politics and help explain recent political dynamics.

Making Whiteness and the Racialisation of Australian Youth Citizenship

ABSTRACT Rather than apprehending race or ethnicity as a predetermined social fact that then informs young people’s experiences of engagement or inclusion, youth citizenship studies would benefit from more critical perspectives that enable investigation of the racialised construction of what is legible as civic participation or national belonging. Processes of racialisation operate in the production of youth as citizen-subjects in Australian nation-making through approaches in youth policy and research that simultaneously centre and invisibilise whiteness. This paper considers the role of racialisation in ways of knowing and regulating Australian youth as citizens through a critical review of the ways different groups of young people become meaningful and knowable as racialised citizens. It explores the representation and constitution of Indigenous, ethnic minority and white youth citizenship in youth research and policy as in turn non-existent/provisional, integrative/integratable, and vulnerable/healthy, to contribute to deepened understandings of the social construction of youth in the service of white nation-making.

To conceal or reveal: Identity‐conscious diversity ideologies facilitate sexual minority identity disclosure

AbstractSexual minorities continue to face workplace discrimination, which leads to them experiencing concerns about disclosing their own sexual identities. Despite the benefits of disclosure, relatively little research has examined what organizational factors can work together to foster disclosure of a sexual minority identity. Across five experiments (N = 1662), we examined two main factors: diversity ideologies and information about diversity climate. Sexual minorities were more willing to disclose in organizations with diversity messages conveying that they value group differences (an identity‐conscious ideology) relative to those that downplay differences (an identity‐blind ideology). Identity‐conscious ideologies also increased belonging, perceptions of fair treatment and perceptions of LGBTQ+ representation. Despite expectations that contradictory evidence demonstrating a negative diversity climate might create mistrust and impede disclosure, the benefits of an identity‐conscious ideology persisted in the face of a negative diversity climate. These findings point to the complexities of facilitating visible sexual minority representation in many workplace environments.

Dynamic Amygdala Nuclei Alterations in Relation to Weight Status in Anorexia Nervosa Are Mediated by Leptin

The amygdaloid complex is a subcortical limbic group of distinct nuclei. In a previous patient-control study, differential amygdala nuclei alterations were found in acute anorexia nervosa (AN); rostral-medial nuclei involved in fear and reward processing were substantially reduced in volume and associated with hypoleptinemia, a key neuroendocrine characteristic of AN. Here, longitudinal amygdala nuclei alterations in AN were investigated in relation to weight status and their associations with leptin levels. T1-weighted structural magnetic resonance imaging scans were longitudinally processed with FreeSurfer. Amygdala nuclei volumes in young female patients with acute AN before and after short-term weight restoration (n= 110, >14% body mass index increase over 3 months) and female participants with a history of AN (n= 79, long-term [mean 5 years] weight recovered) were compared with female healthy control participants (n= 271) using linear mixed effects models. Rostral-medially clustered amygdala nuclei volumes, accessory basal, cortical, medial nuclei, and corticoamygdaloid transition, increased during short-term weight restoration (Cohen's d range 0.18-0.30). However, volumetric normalization across nuclei was heterogeneous. Right cortical, medial nuclei, bilateral corticoamygdaloid transitions, and anterior amygdaloid areas were only partially normalized following short-term weight restoration. Right anterior amygdaloid area remained reduced after long-term weight recovery compared with control participants (d= 0.36). Leptin increase, accompanying short-term weight restoration, mediated the effect of weight gain on volumetric increase in left corticoamygdaloid transition and bilateral medial nuclei. Rostral-medially clustered amygdala nuclei show pronounced volumetric increase but incomplete normalization in AN during and after short-term weight restoration. Leptin increase may be relevant for the recovery of specific amygdala nuclei in addition to nutritional rehabilitation, indicating links between amygdala substructure and leptin dynamics of potential pathophysiological and clinical relevance in AN. The amygdala plays a critical role in processing fearful and rewarding stimuli, and alterations in the amygdala are associated with anorexia nervosa. In this study, the authors measured amygdala nuclei volumes in female patients with acute anorexia nervosa undergoing weight-restoration treatment (n = 110), long-term weight-recovered individuals with anorexia (n = 79), and healthy control participants (n = 271). Structural magnetic resonance imaging revealed that volumes of specific nuclei, clustered in the rostral-medial amygdala, were substantially reduced in acute anorexia nervosa and only partially normalized following weight restoration treatment. Residual reductions in volume persisted even after long-term weight-recovery, compared to healthy control participants. Short-term weight restoration was associated with increases in the neurohormone leptin, and increasing leptin levels were found to mediate the positive impact of weight gain on increased amygdala volume over the treatment course. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.

Demographic Representation in Clinical Trials Sponsored by the United States Department of Veterans Affairs

Non-White racial and ethnic groups remain underrepresented in oncology clinical trials within the United States and face ongoing barriers to participation. Previous reports cite positive attitudes toward clinical trials (CTs) among veterans, with altruism and a strong sense of community posited as driving forces for participation. Our objective was to characterize demographic representation among CTs sponsored by the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) compared to trials with no VA/DoD sponsorship. We incorporated data from U.S. CTs registered in ClinicalTrials.gov between March 2000 and March 2020 using the Aggregate Analysis of ClinicalTrials.gov database, and stratified CTs by sponsorship into the following groups: (1) VA, (2) DoD or (3) non-VA/DoD sponsorship. We extracted CT enrollment data for gender and four race/ethnicity categories: White, Hispanic/Latinx, Black, and Asian. After calculating gender and race-specific proportions for each CT, we compared the median proportion of White, non-White, Black, Asian, and Hispanic participants between (a) VA and non-VA/DoD CTs, (b) DoD and non-VA/DoD CTs, and (c) VA CTs and the Veterans Health Agency (VHA) patient population using Wilcoxon signed rank tests. This study included 13942 CTs; of these, 490 (94%) VA, 38 (95%) DoD, and 12574 (95%) non-VA/DoD sponsored CTs reported race/ethnicity data. Non-VA/DoD entities sponsored a greater relative number of oncology CTs (29%) than did the VA (5%) or DoD (3%). Characterization of CTs by participant race/ethnicity demonstrated median non-White enrollment was 68% greater in VA CTs (p<0.001) and 34% greater in DoD CTs (p = 0.138) than non-VA/DoD CTs. Increased non-White VA CT enrollment was driven largely by the higher median proportion of Black participants (24%)-more than double that of non-VA/DoD CTs (10%) (Table 1). Comparison between the median proportion of Black participants in VA CTs and VHA patient demographics (15.8% Black) revealed that VA CTs enroll a greater percentage of Black participants than reflected in the VHA patient population (p<0.001). This characterization of veteran involvement in CTs demonstrates that VA sponsored CTs feature significantly greater representation of minorities, a pattern driven exclusively by greater enrollment of black patients. This work prompts further exploration into modeling VA enrollment strategies in non-VA CTs and increasing VA sponsorship of cancer trials to stimulate inclusion of underrepresented populations in oncology CTs.

TimesUpPRS: A Social Media Movement for Promoting Diversity, Equity, and Inclusion in Plastic Surgery

Minority representation and promotion in medicine is lacking. Social media can facilitate change by raising awareness of biases, empowering others, and cultivating connections. The TimesUpPRS Instagram account was created in March 2020 to foster diversity, equity, and inclusion (DEI) in plastic surgery by celebrating surgeons of diverse identities and emphasizing the need to create safe, fair, and equitable workplaces. We aim to characterize its content, audience demographics, engagement, and impact. All TimesUpPRS posts published until March 2022 were reviewed for content analysis. Audience demographics were assessed through Instagram Insights. Engagement was assessed through likes, comments, and posts tagging @TimesUpPRS. Three hundred fifty-five posts have been published, with 45.9% original content. These posts discuss representation or treatment of women (39.7%), Black (24.2%), Asian and Pacific Islander (14.4%), LGBTQ+ (12.7%), LatinX (6.5%), people of color overall (4.8%), first generation-low income (1.7%), and Native American (1.1%) individuals. 45.1% aimed to raise social awareness, 19.4% spotlighted plastic surgery figures, 16.3% highlighted research, and 5.6% advertised opportunities for community involvement. The mean (SE) number of hashtags utilized was 10.9 (0.6), with #ilooklikeasurgeon used most. There were 2052 followers, but 10,025 accounts reached. Of reached accounts, 66.8% were women, 71.8% were from the U.S., and 55% were aged 25 to 34. The mean (SE) number of likes and comments per post was 62.2 (3.4) and 2.6 (0.2). 85.0% of comments were supportive. Three hundred sixty-six posts tagged @TimesUpPRS. TimesUpPRS has also garnered industry and private sponsorship, inspired DEI programming, and collaborated with multiple other organizations. In 2 years, TimesUpPRS has generated 350+ posts and reached 10,000+ accounts. Content highlighted figures of diverse identities and cultivated high, positive engagement. Now with 20 content creators, TimesUpPRS will continue increasing content, expanding its audience, and fostering impactful discussion that helps shift the existing culture to one of inclusivity and equity.