National Trend Research Articles

Profiles of Death Penalty Attitudes: A Latent Class Approach

ABSTRACT Objectives This study examines the heterogeneity in the demographic, normative, and experiential features of those who support, oppose, and are undecided on capital punishment to determine the complexity of characteristics that exist beyond the “averages.” This study also evaluates macro-level changes in death penalty supporter, opposer, and undecided sub-types in the U.S. over time. Methods Drawing upon national trend data from the General Social Survey (1972–2016), a series of Latent Class Analyses (LCA) are employed to identify the number, size, and compositional profile of emergent subtypes of supporters, opposers, and undecideds on the death penalty. We also examine variation in the size and relative distribution of these latent classes over five decades. Results Substantial heterogeneity among death penalty supporters and opposers was found, yielding nine and seven distinct sub-types of each, respectively. Two unique sub-types of undecideds were also uncovered. Conclusion Variation in the composition and size of these latent classes over time provides important insights into the variation in death penalty support over the past 50 years. This is the first study of which we are aware to employ an LCA to national trend data of public opinion toward the death penalty across multiple decades in the United States.

Carbon footprint of hospital laundry: a life-cycle assessment

ObjectivesTo assess greenhouse gas (GHG) emissions from a regional hospital laundry unit, and model ways in which these can be reduced.DesignA cradle to grave process-based attributional life-cycle assessment.SettingA large hospital...

Flipping Tradition on Its Head: A Single-Institution Study on United States Medical Licensing Examination Step Order.

Given the recent change in Step 1 grading, medical students are faced with decisions surrounding the optimal Step examination order and timing. There is a current lack of guidance outside commonly used United States Medical Licensing Examination study blogs. The aim of this study was to characterize current practices in Step examination order and understand the factors influencing student examination preference. To gather data, we used a 24-item survey and electronically distributed it through three separate email requests to medical students. Participants included medical students (MS1-4) attending a single institution, interested in a surgical residency. In total, 56 students responded to the survey (response rate of 20%). Most students (63.6%) opted to take Step 2 before Step 1. Justifications included the perceived importance of Step 2 for residency applications (33.3%), the change to pass/fail grading (27.0%), the relevance of Step 2 after rotations (27.0%), and a desire to obtain a Step 2 score earlier (7.9%). Step examination order did not lead to differences in Step 2 score (P = 0.459), time used to prepare for Step 1 (P = 0.396), or time used to prepare for Step 2 (P = 0.078). Due to the perceived importance of Step 2, most medical students at our institution who are interested in pursuing a surgical residency are reversing the traditional Step examination order. As this may represent a national trend, additional work needs to be done to provide guidance to medical students and identify the optimal step examination testing strategy.

Increasing ratio of opportunistic infections associated with sunshine exposure and economic level burdening Chinese inflammatory bowel disease hospitalized patients: the first nationwide survey from 2014 to 2019

BackgroundThe rising prevalence of opportunistic infections (OIs) in inflammatory bowel disease (IBD) in conjunction with the use of biologics/immunosuppressive agents has garnered attention. However, there is a dearth of research on OIs in Mainland China. This study seeks to evaluate the national ratio trend of OIs in IBD and elucidate the influence of economic and climate factors on IBD patients with OIs and their outcomes.MethodsThe nationwide data was obtained from the Inpatient medical record home page via the Health Statistics and Information Reporting System (HSRS). Patients diagnosed with IBD were enlisted for participation, and their demographic and clinical information, encompassing infection type, surgical procedures, and expenses, were gathered. The National Bureau of Statistics provided data on monthly sunshine exposure hours and yearly Gross Domestic Product (GDP).ResultsFindings indicate that between 2014 and 2019, a total of 381,752 patients with IBD were admitted to hospitals, with 364,249 patients lacking OIs and 17,503 patients presenting with OIs. The annual proportion of OIs exhibited an upward trend, rising from 3.54% in 2014 to 4.81% in 2019. There was a significant correlation observed between individuals who identified as male, those who visited hospitals in southern regions, or those originating from areas with lower GDP or shorter sunshine exposure hours, and a higher incidence of OIs. Among patients diagnosed with either Crohn’s disease (CD) or ulcerative colitis (UC), Clostridium difficile was found to be the most prevalent infection, followed by Epstein-Barr virus and cytomegalovirus. Furthermore, the occurrence of OIs was found to be associated with an increased rate of surgical interventions in UC patients.ConclusionsThe rising prevalence of OIs among hospitalized patients with IBD necessitates heightened attention towards mitigating associated risk factors, particularly among IBD patients residing in less developed regions or experiencing limited exposure to sunlight. This approach aims to minimize hospital stays and associated costs.

Shanghai Tourism Carbon Footprint Measurement Based on Final Consumption and Suggestions for Improvement of Urban Tourism Facilities

As a major tourist city in China, Shanghai's tourism industry generates a great deal of carbon emissions. However, China is now actively practicing measures to reduce carbon emissions in order to protect the environment. Therefore, it is particularly important to measure Shanghai tourism carbon footprint. The results of this study can help characterize the carbon emission of Shanghai's tourist industry, so that the government can better improve Shanghai's tourism - based on its characteristics and reduce the carbon emissions in a more effective manner, which can better respond to the national and global low-carbon trend. This research utilizes the "from bottom to up" approach, collects data from Shanghai's tourism final consumption, measures the sub-industrys carbon footprint using the carbon emission coefficients, and then performs a superposition calculation to determine the characteristics of Shanghai's overall tourism and sub-industry carbon footprint, and the composition of carbon footprint in transportation. It shows following problems: the national environmental protection awareness has not yet been formed, and the tourism's related technologies and service facilities have not been able to guide tourists to reduce carbon emissions. In view of the characteristics and problems, this paper puts forward three suggestions, including the innovation of tourism-related technologies, the transformation of tourism service facilities and the enhancement of national low-carbon awareness.

Study on Marketing Strategy of Florasis Beauty Makeup in the Chinese Market

In the context of the influence of the national trend, as a representative brand of domestic beauty the Florasis products rose and developed rapidly. This study of its marketing strategy contributes to the brand development of this product and enhances its sales profitability, popularity, and competitiveness. The public is very active in purchasing domestic beauty products through online platforms. The brand of Florasis beauty makeup has left a deep impression on people by having oriental aesthetics and elegant and dignified appearance and packaging. Here are four drawbacks in the marketing strategy of Florasiss products: (i) Expensive product prices. (ii) The beauty products are too nationalized, and the products are not practical. (iii) The singularity of the product marketing channel. (iv) Limitations in the types of beauty products. The corresponding suggestions are: (a) can increase the products sales volume by relatively lowering the price to get more revenue. (ii) Focusing on the beauty effect of the product itself and removing the cumbersome appearance and packaging. (iii) Develop multiple offline stores to increase the emotional interaction between customers and the product. (iv) Expand to a wider beauty industry line to reduce the limitations of Florasiss products. Understanding how Florasis and domestic beauty brands have utilized the influence of the national trend to develop and market their brands is something that people should learn and think about.

RESULTS OF HONEY BEE COLONY LOSSES MONITORING IN UKRAINE IN THE CONDITIONS OF WAR AFTER THE WINTER OF 2022-2023

Losses of Western honey bee colonies (Apis mellifera L.) represent a globally significant phenomenon with profound ecological and economic implications, yet the underlying causes remain a subject of ongoing investigation (Insolia et al., 2022). This study aimed to evaluate colony losses following the 2022–2023 wintering season in Ukraine in the conditions of the ongoing war, as part of the annual international monitoring effort coordinated by the COLOSS. The survey was conducted employing the standardized COLOSS protocol and covered all physiographic zones of Ukraine except for the Crimean Mountains, with data from 751 valid protocols synthesized for analysis. The average overall loss rate after the 2022-2023 wintering season in Ukraine was 10.8 %, slightly exceeding the previous year's rate (8.9% after the 2021-2022 wintering season). Notably, the loss of bee colonies (6.55 %) nearly doubled compared to the previous year (3.72% after the 2021-2022 wintering season), while losses due to unsolvable queen problems (3.07 %) remained consistent with the previous year (3.07% after the 2021-2022 wintering season), and losses attributable to adverse natural phenomena (1.27%) decreased by over 1.5 times (2.08% after the 2021-2022 wintering season). The highest overall loss rate of bee colonies was observed in the steppe zone (17.0%), with significantly lower losses in the Ukrainian Carpathians (7.3%), mixed (8.6%), and broad-leaved (9.0%) forest zones. The distribution of loss components across different physiographic zones mirrored the national trend: dead/missing colonies (4.19 % - 10.13 %), unresolved queen issues (2.16 % - 5.24 %), losses due to adverse natural events (0.74 % - 1.85 %). Among the reported characteristics of lost colonies, starvation-induced mortality (19 %) and unexplained bee deaths (17.8 %) were most frequently cited, while bee disappearances (9.1%) and dead bees within hives despite available food (10.4 %) were less common. Over 12% of analysed beekeeping operations were situated in areas affected by armed conflict, with some experiencing direct damage to apiaries (2.4%) and associated equipment (0.1% - 0.5%). Once again, the inverse relationship between apiary size and total losses was reaffirmed, though no correlations between colony losses and migratory beekeeping were identified. 76.4 % of respondents monitored their colonies for Varroa mite infestations, with 97.5% treating for varroosis. Notably, 19.6% of respondents treated their colonies without prior monitoring of mite infestation levels. Amitraz-based veterinary products remained the most commonly used acaricides in Ukraine, applied through fumigation or aerosols (32.2 %) and strips (21.7 %). Additionally, 22.9 % of surveyed beekeepers practiced drone brood removal. The applying of traditional beekeeping methods increased (10,4% this year, compared to 2.18 % and 3.60 % before the wintering seasons of 2020-2021 and 2019-2020, respectively). Keywords: honey bee, Apis mellifera, colony losses, monitoring, mortality, beekeeping, varroosis

Explaining the Extraordinary Decline in Chicago’s Homicide Arrest Rates, 1965 to 1994 and Beyond: Trends in Case Mix Versus Standards for Arrest

Chicago’s homicide arrest rate dropped from 91% in 1965 to 57% in 1994 and dropped still lower in recent years. This pattern mirrors the trend in the national homicide clearance rate. A plausible explanation for this great decline is the trend in homicide case mix, which arguably has made it intrinsically more difficult to solve homicide cases. Our analysis describes the change in case mix for the period 1965 to 2020 and analyzes the effect on the arrest rate for the first 30 years of this period, all by use of a unique homicide case microdata set. We document the large changes in case mix: for example, the percentage of all homicides in which a male victim was shot outdoors increased from 18% (1965) to 69% (2020). But the change in case mix does not account for Chicago’s great decline during the earlier decades, as we demonstrate by use of a novel arrest rate index. In fact, the arrest rates in each of the categories defined by location, sex, and weapon type exhibited similar declines through 1994. (Subsequent years of arrest data are unavailable for now.) Our preferred explanation for the great decline is that the operational standard for making an arrest increased during this period. That interpretation is well supported by evidence explaining the corresponding national trend, though direct evidence is lacking for Chicago. This interpretation challenges the use of the arrest rate as a police performance indicator and offers a positive interpretation of the great decline.

Analysis of Digital Transformation of Financial Management in the Era of Artificial Intelligence

The advent of artificial intelligence has set off a climax of digital transformation for many industries. As the foundation of the operation in business, the digital transformation of financial management raises wide concerns. Therefore, this paper analyzes the literature of the last five years regarding artificial intelligence, and the application of digital technology in financial management, etc. to explore the necessity, challenges, and general path of digital transformation in financial management. The national trend and the need for enterprises to improve competitiveness prove the necessity of digital transformation of financial management. However, the weak support of awareness, technology, and human resources obstructs this process. Also, the use of digital platforms poses a high risk of data leakage. A transformation path is designed in response to these issues. The most important steps are to change concepts, establish and improve information platforms, strengthen financial personnel training, and establish data risk prevention mechanisms.

Long term nitrofurantoin induced interstitial lung disease: a case series and literature review.

In the UK, prophylactic use of nitrofurantoin is recommended in women who have 3 or more UTI per year. Reported cases of nitrofurantoin-induced pulmonary toxicity are limited and the exact mechanism of chronic nitrofurantoin induced lung reaction is unclear. In England, the national trend for prescribing Nitrofurantoin has gone up significantly in the last 10 years. We reviewed 10 cases of nitrofurantoin-induced pulmonary fibrosis diagnosed in last 8 years at our ILD Service. We aimed to reviewe patient demographics, time to presentation, lung function and imaging characteristics. We reviewed our ILD database from the year 2012 to 2020. 10 patients were identified diagnosed as Nitrofurantoin Induced Interstitial Lung Disease. All the cases were reviewed in MDT comprising Radiologists and clinicians with interest for ILD. We documented age, sex, initial renal function, eosinophil count, spirometry and radiology findings. In this case series, we focus on various CT findings and reversibility of radiological abnormality following cessation of Nitrofurantoin. The mean age of our patient cohort is 80 years and all were female. The mean time to presentation from prescription was 17 months. Pre-treatment mean eGFR was 76ml/min/1.73m2.7 out of 10 patients had CT findings of ground glass opacity and traction bronchiectasis. 4 patients were treated with prednisolone. The patients in this series improved symptomatically with or without treatment with steroid following cessation of nitrofurantoin therapy, but irreversible changes in the chest imaging may contribute to long term morbidity. Cautious counselling should be undertaken prior to nitrofurantoin prescription regardless of renal function.

Abstract C140: A population-based analysis of awareness and knowledge of HPV and HPV vaccine among Asian American adults by origin group, 2014-2019

Abstract Background: Awareness and knowledge of human papillomavirus (HPV) and HPV vaccine are critical antecedents of HPV vaccine uptake. While emerging literature has examined racial and ethnic differences in these areas, most either exclude Asian Americans, subsume them under the category of “other,” or aggregate all origin groups under a single category of “Asians.” To fill this gap in the literature regarding data disaggregation, we conducted an analysis of awareness and knowledge of HPV, the HPV vaccine, and HPV-related cancers among six Asian origin groups (Chinese, Filipinos, Indians, Japanese, Koreans, and Vietnamese), using nationally representative samples. Methods: We performed a pooled cross-sectional study utilizing the Health Information National Trend Survey data (HINTS-4 cycle 4 [2014], HINTS-5 cycles 1-3 [2017-2019]), a nationally representative survey administered by the National Cancer Institute. We analyzed questions about knowledge of HPV, the HPV vaccine, and the facts that HPV causes cervical, oral, anal, and penile cancers by race and/or ethnicity. The sample included those who self-reported as Chinese, Filipino, Indian, Japanese, Korean, or Vietnamese origins; non-Hispanic White (NHW) respondents were the reference group. We used survey-design adjusted Wald chi-square tests. Results: A total of 8,865 non-Hispanic White respondents and 623 Asian respondents were included in this study. Significantly lower proportions of most Asian origin groups (Chinese 45.5%; Indian 45.6%; Korean 39.7%; and Vietnamese 43.5%) had heard of HPV compared with NHW counterparts (69.4%). Significantly lower proportions of Chinese (50.9%), Filipino (47.0%) Korean (46.1%), and Vietnamese (38.8%) respondents had heard of the HPV vaccine compared with NHW respondents (68.1%). Significantly lower proportions of Chinese (41.0%), Indian (36.2%), Korean (32.9%), and Vietnamese (30.6%) respondents knew that HPV causes cervical cancer compared with NHW (55.7%). Significantly lower proportions of Chinese and Vietnamese respondents knew that HPV causes anal and oral cancers, and significantly lower proportions of Indian respondents knew that HPV causes penile cancer, when compared to NHW counterparts. Discussion: Most Asian origin groups had lower knowledge of HPV-related facts, with varying magnitudes, compared with NHW counterparts. Vietnamese and Chinese respondents had significantly lower knowledge compared with NHW respondents for 5 out of 6 questions. For most questions, Vietnamese was the group with the lowest proportions of respondents reporting knowledge. Heterogeneity in HPV-related knowledge suggests the need to culturally tailor interventions about the HPV vaccine in appropriate languages to effectively reach different Asian origin groups, with particular attention to those with low awareness. Continued monitoring of HPV-related knowledge with disaggregated data collection for Asian origin groups is critical for efforts to increase educational outreach, combat vaccine misinformation, and improve HPV vaccine uptake. Citation Format: Milkie Vu, Yenan Zhu, Duy D. Trinh, Young-Rock Hong, Ryan Suk. A population-based analysis of awareness and knowledge of HPV and HPV vaccine among Asian American adults by origin group, 2014-2019 [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 C140.

The frequency of using wearable activity trackers is associated with minutes of moderate to vigorous physical activity among cancer survivors: Analysis of HINTS data

BackgroundDespite the health benefits, cancer survivors tend to exercise less after diagnosis and treatment. Wearable activity trackers (WATs) can provide avenues for self-monitoring and may enhance exercise motivation and enjoyment. However, less is known about the relationship between how often survivors use wearables and their amount of moderate to vigorous physical activity (MVPA). MethodsData was utilized from the National Cancer Institute’s Health Information National Trend Survey 5 Cycles 3–4 (January 2019 – June 2020). To account for overdispersion and excessive zeros in the outcome variable (weekly minutes of MVPA), a zero inflated negative binomial regression model was used. ResultsThe majority of the sample (n = 1369) were female (n = 735, 53.7 %), non-Hispanic White (n = 961, 70.2 %) and 34.3 % (n = 664) were between the ages of 65–74 years. Non-melanoma skin cancer was the most frequently reported cancer type (n = 334, 24.4 %) and 48.5 % (n = 664) reported that it had been 11 + years since their diagnosis. Survivors who reported daily WAT use were estimated to have 3.53 times higher number of MVPA minutes per week compared to survivors who reported non-daily WAT usage (RR: 3.53, 2.76–4.53, p = <0.001). Based on the model, daily WAT users had an expected mean MVPA of 202 min per week (95 % CI: 191.15–226.59) compared to non-daily users (132 min, 95 % CI: 119.81–140.22) and non-WAT users (88 min, 95 % CI: 84.46–92.50). ConclusionAccording to this model, survivors who reported daily WAT use were estimated on average to have weekly MVPA minutes that meet or exceed MVPA recommendations (>= 150 min of MVPA per week) compared to survivors who reported infrequent or no WAT use. Wearables may provide an opportunity for survivors to engage in self-monitoring and can potentially support exercise tracking and engagement.

Prevalence and pattern of mental disorders in the state of West Bengal: Findings from the National Mental Health Survey of India 2016.

West Bengal, situated in eastern India, comprising 19 districts as of 2016 and consisting of 9.13 crore population, had been one of the participating states in the National Mental Health Survey, 2015-16. To estimate the prevalence and pattern of mental disorders in a representative population in West Bengal. Based upon a multi-stage stratified random cluster sampling with probability proportionate to each stage, 2646 eligible individuals were interviewed. Standard validated instruments in Bengali like socio-demographic profiles and Mini International Neuropsychiatric Interview (MINI) version 6 were used by trained data collectors with quality monitoring as per a standardized protocol. The current prevalence of mental illness in the state of West Bengal is 13.07% (12.9-13.24 95% CI), which is more than the current national average of 10.56% (10.51-10.61 95% CI). The prevalence of severe mental illness of 2.32% and suicide risk of 1.75% (1.68-1.81 95% CI) is higher than the national average. The common mental illness prevalence is 11.29 (11.13-11.45 95% CI), which is similar to the national weighted average. In West Bengal, severe mental illness is more concentrated in the rural areas in contrast to the national trend. Also, the prevalence of alcohol use disorder is 3.04 (2.96-3.13 95% CI) and epilepsy is 0.03 (0.27-0.29 95% CI), which is less than the national average. The prevalence of mental disorders in the state of West Bengal is higher than the national average, and for severe mental illness, the prevalence is the highest as compared to the national average.

Abstract A074: Cancer fatalism among Asian American adults by origin group, 2014-2022

Abstract Background: Cancer fatalism encompasses beliefs about external causes of cancer and the perceived inability of humans to prevent it. Existing research suggests that individuals with higher levels of cancer fatalism are less likely to engage in cancer prevention behaviors or adhere to cancer screening practices. However, limited information exists regarding the prevalence of cancer fatalism within various Asian origin groups. Understanding whether this prevalence varies by origin group can offer valuable insights for developing strategies to enhance beliefs and knowledge about cancer among these populations, ultimately leading to improved health outcomes. To fill this gap in the literature, we conduct a disaggregated analysis of cancer fatalism among Asian origin groups (Chinese, Filipino, Indian, Vietnamese, and other Asian respondents), using nationally representative samples. Methods: We performed a pooled cross-sectional study utilizing the Health Information National Trend Survey data (HINTS-4 cycle 4 [2014], HINTS-5 cycles 1-3 [2017-2019], and HINTS-6 [2022]), a nationally representative survey administered by the National Cancer Institute. We analyzed respondents’ agreement to two items: “It seems like everything causes cancer”; and “There’s not much you can do to lower your chances of getting cancer.” We used a survey-design adjusted Wald chi-square test for bivariate analyses. Results: The sample included 234 Chinese respondents, 173 Filipino respondents, 185 Indian respondents, 97 Vietnamese respondents, and 222 other Asian respondents (e.g., Korean, Japanese). Significantly lower proportions of Indian respondents (38.9%; 95% CI 26.1 – 51.8%) endorsed the statement “It seems like everything causes cancer,” when compared with Vietnamese respondents (70.4%; 95% CI 54.9% – 86.0%) and Filipino respondents (76.2%; 95% CI 65.1% – 87.4%). Additionally, lower proportions of Indian and Chinese respondents endorsed the statement “There’s not much you can do to lower your chances of getting cancer” when compared with Vietnamese and Filipino respondents, though these differences did not reach statistical significance. Conclusions: Our study represents one of the first efforts to use nationally representative data to explore disaggregated prevalence of cancer fatalism beliefs among Asian American origin groups. Filipino adults exhibit nearly double the prevalence of one of the cancer fatalism beliefs compared to Indian adults. Vietnamese adults also have a high level of cancer fatalism beliefs. These findings highlight the heterogeneity among Asian American origin groups and emphasize the importance of culturally tailored interventions, specifically targeting those groups with higher levels of fatalism beliefs. Data collection that is disaggregated by Asian origin group should be prioritized to gain a comprehensive understanding of these beliefs and design effective interventions. Citation Format: Milkie Vu, Yenan Zhu, Ryan Suk. Cancer fatalism among Asian American adults by origin group, 2014-2022 [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 A074.

Chinese Women and Habeas Corpus Hearings in California, 1857–1882

Abstract: This article examines how Chinese women and men used habeas corpus proceedings in California to contest transpacific relations of gender, commerce, law, and power. The first section looks at habeas hearings about runaway or allegedly kidnapped Chinese women already in the United States. The second chronicles how these hearings correlated with and diverged from the habeas proceedings involving the detention of Chinese women immigrants upon arrival. The California judges' approach to these cases mirrored Congress's concern over "the enormous diversity of domestic arrangements" in slavery by the end of the Civil War, when lawmakers introduced monogamous marriage and dependency on a male head of household as the most acceptable conditions for a nonwhite woman's freedom. The habeas proceedings concerning Chinese women thus revealed a Pacific, subnational practice of governance that was consonant with the national trend of reconstructing nonwhite women's sociolegal status in the Civil War era.

Racial/Ethnic Disparity for Hematologic Malignancies in Different Healthcare Systems in the U.S

Introduction: Various studies have shown that Black and certain minority patients with hematologic malignancies have worse survival outcomes than White patients in the United States. In the current study, we compared the survival outcomes of Non-Hispanic Black (NHB), Hispanic, and NH Asian/Pacific Islander (API) to Non-Hispanic White (NHW) across different types of hematologic malignancies in multiple different healthcare settings. Methods: We identified adult patients with newly diagnosed lymphoma, myeloma, or leukemia from 2011-2020 in Surveillance, Epidemiology, and End Results Program (SEER), as well as respective cancer registries linked to electronic data warehouses at Veterans Affairs (VA) national healthcare system and Harris Health System (HHS). VA is a unique single-payer system with patients covered by veteran benefits. HHS is a large safety-net county hospital system in the Houston metropolitan area with &amp;gt;80% of uninsured and charity care. These hospital systems were chosen to represent opposite ends of the spectrum of healthcare access; however, we explicitly chose not to compare survival outcomes across institutions due to inherent differences. For each patient cohort, we built unadjusted and adjusted multivariable Cox regression models to assess the impact of race/ethnicity on overall survival. The adjusted factors included age, sex, marital status, rurality, median household income, diagnosis year, cancer histologic subtype, and cancer stage (for lymphoma). Type and time to treatment were not included as these were associated with access to care. In a sensitivity analysis, we also included NCI comorbidity index and ECOG performance status (PS) in VA and HHS (not available in SEER). Results: Patient characteristics from the 3 cohorts are shown in Table 1. SEER patients (n=339,351) were more representative of the US census (71% NHW, 14% Hispanic, 8% NHB, 7% API). In contrast, VA patients (n=27,388) were mostly male (97%) with lower median income ($45,000) and with more NHB (16%); HHS patients (n=2,141) were notably younger (median 53) with lower median income ($47,409) and more Hispanic (57%) and NHB (25%). On unadjusted analysis, significant variables associated with mortality in all cohorts included older age, male sex, lower income, aggressive histology, advanced stage, higher PS, and more comorbidities. Race/ethnicity had variable association with mortality depending on the healthcare setting. On multivariable analysis adjusted for other confounders (Figure 1), race/ethnicity continued to exhibit variable association with overall mortality depending on cancer type and healthcare setting. Across all cancers, minority groups had similar or worse adjusted survivals than NHW in SEER, while they had similar or better adjusted survivals than NHW in VA. With exception of NHB vs. NHW in lymphoma, minority groups had no significant differences than NHW in HHS. Since both VA and HHS were enriched with NHB patients, we next focused on the comparison between NHB vs. NHW. For lymphoma, the adjusted hazard ratio (HR) for mortality was 1.41 (95% CI 1.36-1.45), 1.47 (95% CI 1.04-2.07), and 0.96 (95% CI 0.88-1.04) in SEER, HHS, and VA, respectively. For leukemia, the adjusted HR was 1.07 (95% CI 1.04-1.11), 1.07 (95% CI 0.65-1.75), and 0.95 (95% CI 0.87-1.03) in SEER, HHS, and VA, respectively. For myeloma, the adjusted HR was 0.99 (95% CI 0.95-1.03), 1.00 (95% CI 0.52-1.93), and 0.88 (95% CI 0.80-0.96) in SEER, HHS, and VA, respectively. The other minority groups followed a similar trend. In the sensitivity analysis where ECOG PS and NCI comorbidity index were included for HHS and VA, the overall observations by race/ethnicity were not significantly different. In additional subgroup analyses limited to older patients or males, the overall finding was also not different. Conclusions: In summary, racial/ethnic disparity persists at-large in the US (SEER) for most hematologic malignancies, even after accounting for cancer-, patient-, and socioeconomic factors. However, minority status has neutral or protective effect vs. NHW in healthcare system without barrier to access (VA), while its impact appears similar to the national trend in healthcare system with significant barriers to access due to the lack of insurance (HHS). Healthcare access may contribute to the ongoing racial/ethnic disparity for survival outcomes observed in hematologic malignancies in the US.

Increasing the Volume of Outpatient Total Joint Arthroplasty Procedures: An Evaluation of a Novel Rapid Recovery Pathway Program Within an Academic Medical Center.

There has been a national trend toward shifting joint arthroplasty procedures to the outpatient setting. These cases are often performed in freestanding ambulatory surgery centers (ASCs), which are often not accessible to surgeons within academic practices. We sought to investigate a novel rapid recovery program used to transition arthroplasty patients to an outpatient-based care system within an academic medical center. All patients undergoing hip or knee arthroplasty between November 2019 and April 2021 were retrospectively evaluated for their eligibility for a rapid recovery pathway through the Extended Stay Unit (ESU) based on clinical and social criteria. Once admitted, patients were evaluated for whether they were discharged from the unit or if hospital admission was necessary. Out of the 444 patients deemed candidates for the rapid recovery program, 188 patients were admitted to the ESU (42.3%); 18 (9.6%) required inpatient hospital admission, with the majority of these due to failing physical therapy (16; 88.9%). Of the ESU patients who were successfully discharged home, 55 (32.4%) were discharged on postoperative day (POD) 0 and 115 (67.6%) on POD 1 (<23 hours). As total joint arthroplasties shift toward the outpatient setting, surgeons in academic institutions must employ strategies to increase their volume of patient candidates for outpatient procedures. Our retrospective study of prospectively collected data suggests the feasibility of creating a separate rapid recovery unit within the hospital that can be an effective method by which to eventually transition to the ASC setting.

Research on Cross-border Joint Marketing Strategy of National Brands Under the Background of "New National Trend"

In recent years, "new national trend" has become a unique phenomenon in China's consumer market. While "new national trend" has become the consumption fashion and aesthetic style of Chinese people, it has also become the focus and growth point of Chinese brands in the context of new consumer culture. This paper explores the impact of cross-border joint marketing strategies of national brands on consumers' purchasing behavior against the background of the "New National Wave". Through reviewing relevant literature and analyzing the current situation, it is found that the cross-border association of national brands has gained certain development. In addition, this paper adopts questionnaire research to study the consumers' purchase intention of cross-border joint national products. After comprehensive analysis, it puts forward the strategic suggestions of cross-border marketing of national product brands to provide ideas for promoting cross-border marketing of national product brands.

Local Brands Use Traditional Ethnic Culture to Shape Consumer Stickiness: Taking Huaxizi Brand as an Example

In modern society, domestic consumption is constantly upgrading. After experiencing the climax of the development of foreign culture, national cultural self-confidence begins to awaken, and "national tide fever" comes into being. In this social environment, research on how major domestic beauty brands stand out in the tide of the "national trend". This article takes the domestic beauty brand Huaxizi as the research object and uses literature analysis to identify the main reasons for the success of Huaxizi brand. Huaxizi's brand's reference to traditional culture is not a mechanical collaboration. It simply replicates traditional culture and deeply explores the excellent traditional culture that gradually disappears from the public's perspective. Then, starting from the nature and function of its own products, using modern craftsmanship and production technology, it cleverly integrates traditional culture into its own products and creates its own cultural symbol. Hua Xizi chose a brand recommendation officer in marketing, launched brand songs, and created unique Chinese style makeup. Through various cross-border marketing, she ultimately became a leader in the domestic beauty industry. Huaxizi has not formed its own user pool, and its sales methods are only limited to online sales. In order to achieve greater benefits, it is recommended to create its own exclusive app, establish a physical portal, and choose a marketing method closer to traditional culture.

Examining the Impact of Selected Sociodemographic Factors and Cancer-related Fatalistic Beliefs on Patient Engagement via Health Information Technology among Older Adults - A Cross-Sectional Analysis.

Despite the role of Health Information Technology (HIT) in patient engagement processes and government incentives for HIT development, research regarding HIT is lacking among older adults, with a high burden of chronic diseases like cancer. This study examines the role of selected sociodemographic factors and cancer-related fatalistic beliefs on patient engagement expressed through HIT usage for patient engagement in adults 65 or older. We controlled cancer diagnosis to account for its potential influence on patient engagement. This study has two aims 1- To investigate the role of sociodemographic factors of race, education, poverty index, and psychosocial factor of cancer fatalistic beliefs on accessing and utilizing HIT in older adults. 2- To examine the association of access and utilization of HIT to the self-management domain of patient activation that serves as a precursor to patient engagement. This is a secondary data analysis of a subset of the Health Information National Trend Survey (HINTS 4, Cycle 3). The subset includes individuals 65 and older with and without a cancer diagnosis. The relationships between access to and utilization of HIT to several sociodemographic variables and psychosocial factors of fatalistic beliefs were analyzed. Logistic regression and linear regression models were fit to study these associations. In this study, the total number of individuals over 65 years of age with a cancer diagnosis was 180 and without a diagnosis was 398. This analysis indicated that having less than a college education level, being nonwhite, and living in poverty were significantly associated with decreased access to HIT. Reduced HIT utilization was associated with less than a college education level and poverty. This analysis also indicated that cancer fatalistic beliefs were significantly associated with lower HIT utilization. Specifically, a one-point increase in cancer fatalistic belief score is associated with a 36% decrease in HIT utilization. We found that controlling for cancer diagnosis did not affect the outcome for sociodemographic variables. However, the self-management domain of patient activation was significantly associated with the higher utilization of HIT and patients with a prior cancer diagnosis. Sociodemographic factors (education, race, poverty, and cancer fatalistic beliefs) impact HIT access and utilization in older adults, regardless of prior cancer diagnosis. HIT users among older adults report higher self-management, essential for patient activation and engagement.