Racial Backgrounds Research Articles

Factors in total shoulder arthroplasty revision: insights from a national database analysis

BackgroundTotal shoulder arthroplasty (TSA) is increasingly recognized as a therapeutic solution for various shoulder disorders. However, the correlation between preoperative determinants of health and postoperative TSA revisions remains underexplored. These correlations are scientifically important as they may be used to design higher-level clinical studies to confirm if they are in-fact predictive of revision. As such, this investigation aims to identify possible health and demographic disparities between primary TSA and revision TSA cohorts. MethodsData for this research was sourced from the American College of Surgeons National Surgical Quality Improvement Program database from 2013 to 2021. Patients were classified based on Current Procedural Terminology (CPT) codes into 2 groups: primary TSA (CPT: 23472) and revision TSA (CPT: 23473 or 23474). Nineteen demographic and preoperative variables were compared between the cohorts using multivariate logistic regression. Odds ratios (ORs) along with their 95% confidence intervals (CIs) were calculated and graphically displayed. To account for multiple exploratory comparisons, Bonferroni correction was utilized with an adjusted significance threshold of 0.0026. ResultsTSA revision patients were more likely to arrive from a nursing home (OR 1.87, 95% CI [1.50, 2.32], P < .001), have diabetes (OR 1.09, 95% CI [1.05, 1.14], P < .001), be diagnosed with Systemic inflammatory response syndrome prior to surgery (1.38, 95% CI [1.13, 1.69], P = .002) and less likely to have independent functional status prior to surgery (OR 0.69, 95% CI [0.63, 0.76], P < .001). Moreover, those in the revision group were predominantly younger, male, receiving immunosuppressive therapy, exhibited baseline dyspnea, and had elevated American Society of Anesthesiologists class. Notably, factors such as smoking, racial background, and hypertension showed no significant differences (P > .0026). ConclusionsContrary to contemporary literature, our findings suggest that, when demographic factors are controlled for, smoking is not correlated with revisions in TSA when compared to primary TSA. Furthermore, patients undergoing primary TSA are more likely to be functionally independent than patients undergoing revision TSA. While at the same time, a patient’s arrival at surgery from a nursing home gave the greatest likelihood of a revision.

Current and future advances in practice: IgG4-related disease.

IgG4-related disease (IgG4-RD) is an increasingly recognized cause of fibroinflammatory lesions in patients of diverse racial and ethnic backgrounds and is associated with an increased risk of death. The aetiology of IgG4-RD is incompletely understood, but evidence to date suggests that B and T cells are important players in pathogenesis, both of which are key targets of ongoing drug development programmes. The diagnosis of IgG4-RD requires clinicopathological correlation because there is no highly specific or sensitive test. Glucocorticoids are highly effective, but their use is limited by toxicity, highlighting the need for studies investigating the efficacy of glucocorticoid-sparing agents. B cell-targeted therapies, particularly rituximab, have demonstrated benefit, but no randomized clinical trials have evaluated their efficacy. If untreated or under-treated, IgG4-RD can cause irreversible organ damage, hence close monitoring and consideration for long-term immunosuppression is warranted in certain cases.

Survival and clinicopathological significance of B7-H3 in bladder cancer: a systematic review and meta-analysis

BackgroundB7-H3 has been implicated in clinical pathological features and prognosis across various cancer types, suggesting its potential as a cancer biomarker. Nevertheless, consensus remains elusive regarding its clinical-pathological and prognostic significance in bladder cancer. To address this gap, we conducted a systematic review and meta-analysis.MethodsWe systematically searched PubMed, Embase, Web of Science, Cochrane, and CNKI databases from their inception up to October 6, 2022. We evaluated the literature’s quality using the Newcastle-Ottawa Scale. We performed meta-analysis using Review Manager 5.3 and STATA 12.0, synthesizing data and calculating odds ratios (ORs) or hazard ratios (HRs) with corresponding 95% confidence intervals (CIs).ResultsAfter applying eligibility criteria and conducting assessments, we included data from 8 studies, encompassing 1622 bladder cancer patients. Bladder tumor tissues exhibited significantly elevated B7-H3 protein expression compared to normal bladder tissues. Elevated B7-H3 expression was notably associated with patient age, tumor infiltration, and recurrence in bladder cancer. However, no significant correlations were observed with other clinical characteristics. Our pooled HR analysis indicated no significant association between B7-H3 expression and overall survival in bladder cancer patients.ConclusionOur meta-analysis unveils the complex role of B7-H3 in bladder cancer progression. It appears to be directly involved in tumor infiltration and recurrence but cannot definitively serve as a prognostic biomarker for bladder cancer. To validate these findings, further well-designed studies, encompassing larger sample sizes and diverse racial backgrounds, are warranted.PROSPERO registrationNo. CRD42022364688.

The Importance of a Title V Center for “People Like Me”

ABSTRACT When students can find commonalities with others at a university in terms of race, ethnicity, or first-generation status, they also build a strong identity and, in turn, find a sense of belonging. We studied a Title V student center, “The Center,” at a Hispanic-Serving Institution, using a counterspaces framework to understand how minoritized and first-generation students saw themselves reflected in a Title V center and how this reflection indicated the Title V center provided a sense of belonging. The Center was purposefully designed with the goal of reflecting students’ first-generation and/or minoritized identities. In this qualitative study, drawing from multiple Center stakeholders, we found that the undergraduate student visitors felt that other students and staff within The Center contributed to feeling a sense of belonging and support, along with providing relief from cultural isolation. This study adds to the literature about the needs of minoritized and first-generation students at universities and colleges. Specifically, this study contributes to the idea that a student center that is run by the university can purposefully employ and center People of Color while communicating the importance the university places on providing students with role models with whom the students share a racial or ethnic background.

Exploring contemporary challenges and prospective solutions for women's empowerment: Does women's empowerment impact achieving sustainable development goal five?

AbstractExisting literature on women's empowerment (aligned with SDG 5) overlooks the diverse experiences and obstacles faced by women from various racial, ethnic, and socioeconomic backgrounds. This lack of intersectionality within women's empowerment studies hinders our understanding of the unique challenges encountered by marginalized women and limits the effectiveness of policies and interventions aimed at fostering their empowerment. To address this gap, this study delves into the challenges and processes of empowering women in Bangladesh. Qualitative data were gathered through semi‐structured interviews with 12 working women. Thematic analysis of the qualitative data revealed that women face numerous challenges, including lack of education, family support, and economic freedom, as well as complicated processes to access government support and adapt to technological changes. Furthermore, the study identified several potential processes for empowering women, including free education, and training, government support, awareness development, technological support, and mentorship. The study concludes with discussions, policy implications, limitations, and future research directions.

IDF23-0535 Disparities in treatment and treatment outcomes of Type 2 Diabetes patients from minority racial backgrounds in Malaysia

IDF23-0535 Disparities in treatment and treatment outcomes of Type 2 Diabetes patients from minority racial backgrounds in Malaysia

Diversity in Plastic Surgery and the 2023 US Supreme Court Decision.

The number of publications on the topic of diversity, equity, and inclusion in plastic surgery has increased exponentially in the last 5 years. Numerous changes have been implemented. On June 29, 2023, the US Supreme Court ruled that affirmative action in college admissions is unconstitutional. Writing for the majority, Justice Roberts concluded that eliminating racial discrimination means eliminating all of it, and the Equal Protection Clause applies without regard to any differences of race, of color, or of nationality. Justice Thomas authored a concurrence, stating that such policies are contrary to our colorblind constitution and our nation's equality ideal. Justice Sotomayor was joined by Justice Kagan and Justice Jackson in their dissenting opinion that ignoring race will not equalize a society that is racially unequal and that students of various racial backgrounds can offer different perspectives because of that identity. The reaction was largely partisan. Michelle Steel and Young Kim, Republican Asian American Congresswomen from California, lauded the decision, along with Republican Senator Tim Scott from South Carolina. Senate Majority Leader Democrat Chuck Schumer opined that the Supreme Court decision has put a "giant roadblock in our country's march toward racial justice." Cory Booker, New Jersey Democrat, called the decision a devastating blow. President Joe Biden and former First Lady Michelle Obama also disagreed with the decision. Profound ramifications across our institutions of higher learning and in medical specialties are likely to follow. Legally, it will be difficult or impossible to defend race-based preferences going forward. This is true regardless of whether such policies were put in place with the best of intentions.

Improving Unrelated Donor Equity: Assessing Mismatched Donor Opportunities with Real-World Data in a Minority-Predominant Cohort

Recent advances in graft-versus-host disease (GVHD) prophylaxis including post-transplant cyclophosphamide (PTCy) and abatacept have significantly improved outcomes following HLA-mismatched allogenic hematopoietic stem cell transplantation (allo-HSCT) and have tremendous potential for reducing racial disparities in donor availability. A recent small study employing bone marrow as the source of stem cells showed similar outcomes after 5/8 versus 7/8 matches and is currently being tested in a larger study using peripheral blood stem cells. In this study, we examine real-world alternative donor HSCT options for a minority-predominant cohort in the Bronx, NY, focusing on the availability of lesser-matched (5/8 to 7/8) donors. Records of patients who underwent HLA typing at Montefiore Medical Center (2019 to 2022) were reviewed. The National Marrow Donor Program registry was queried to evaluate the availability of donors with at least 99% likelihood of HLA match at various levels (5/8, 6/8, 7/8, 8/8). Two hundred forty-one patients were included, 70% were non-White. Although the availability of ≥7/8 donors was less common in non-White patients, 100% of patients from each group had at least one or more 5/8 and 6/8 HLA-matched donors and more than 80% of these patients had >100 potential 5/8 and 6/8 HLA-matched donors. There was no statistical difference by race or ethnicity in the mean number of donors at 5/8 and 6/8 HLA-match levels. We demonstrate through real-world data that patients from diverse ethnic and racial backgrounds have access to 5/8 and 6/8 HLA-matched donors for allo-HSCT, potentially eliminating disparities in donor availability and allowing prioritization of other donor selection characteristics such as donor age, sex, ABO, and B leader matching. Further work is needed to study whether the use of mismatched donors offers a more potent graft-versus malignancy effect and optimal GVHD prophylaxis.

Building an ethnically and racially diverse neurology workforce.

As diversity among patient populations continues to grow, racial and ethnic diversity in the neurology workforce is increasingly essential to the delivery of culturally competent care and forenabling inclusive, generalizable clinical research. Unfortunately, diversity in the workforce is an area in which the field of neurology has historically lagged and faces formidable challenges, including an inadequate number of trainees entering the field, bias experienced by trainees and faculty from minoritized racial and ethnic backgrounds, and 'diversity tax', the disproportionate burden of service work placed on minoritized people in many professions. Although neurology departments, professional organizations and relevant industry partners have come to realize the importance of diversity to the field and have taken steps to promote careers in neurology for people from minoritized backgrounds, additional steps are needed. Such steps include the continued creation of diversity leadership roles in neurology departments and organizations, thecreation of robust pipeline programmes, aggressive recruitment and retention efforts, theelevation of health equity research and engagement with minoritized communities. Overall, what is needed is a shift in culture in which diversity is adopted as a core value in the field.

Exploring Early Childhood Development Education Through Playful Environment

This study aims to explore the knowledge, attitudes, and behaviors related to early childhood development and education through a descriptive research approach. The educator recognized the significance of establishing environments that are conducive to children's needs and incorporating stimulating activities to foster the growth of young learners. The researchers conducted an assessment of knowledge, attitude, and practices through interviews and conversations. The variables of race, age, and education had a notable influence on the level of knowledge among individuals. Teachers in educational institutions possess a broader range of knowledge regarding school nutrition and health compared to students. The respondents' knowledge, behavior, and perspectives were shaped by a range of factors, such as their educational attainment, occupation, religious beliefs, and racial background. The study findings emphasize the importance of school health, nutrition, and recreation, and recommend that educators, students, parents, and other stakeholders actively promote these aspects. Creating a favorable and supportive learning environment is crucial in the field of Early Childhood Care and Education (ECCE), risk reduction initiatives, Nepal's child-friendly education programs, and the improvement of school environment.

Mental Telehealth Utilization Patterns Among High School Students from Racial and Ethnic Minority Backgrounds Affected by Violence and Substance Use.

Recent data show high school students from racial and ethnic minority (REM) backgrounds in the United States confront a twofold challenge, marked by the highest rates of firearm-related homicides since 1994 and increased youth substance use. The pandemic increased online and telehealth usage opportunities for at-risk REM youth. Therefore, this study investigated (1) the frequency and prevalence of co-occurring youth violence and substance use among REM adolescents, (2) racial/ethnic, age, and natal sex (as gender data was not collected) differences in patterns and trends in co-occurring youth violence and substance use among REM adolescents, and (3) the relationship between these syndemic issues and REM adolescent mental telehealth use during the pandemic. Data was sourced from a nationally representative sample of U.S. 9th-12th students (n = 3241) who completed the CDC's 2021 Adolescent and Behavioral Experiences Survey (ABES). Using univariate (frequency distribution), bivariate (Pearson's chi-squared test), and multivariate logistic regression models, we examined seven violence victimization outcomes, four violence perpetration outcomes, two family violence outcomes, and six substance use outcomes and their associations with telehealth use for mental health (dependent variable) among REM adolescents. This sample was primarily female (50.7%), Black or African American (48.3%), Hispanic or Latinx (20.6%), and identified as straight or heterosexual (69.5%). The study found significant sex-based differences in violence perpetration/victimization, substance use, and telehealth use for mental health. In general, mental telehealth use was significantly associated with substance use among REM adolescents (cigarette smoking, vaping, alcohol, marijuana, prescription meds, and illicit drug use) (p-value = .001). Mental telehealth use was also significantly associated with all peer and family violence outcomes (p < 0.001). Controlling for covariates, gun carrying was associated with 4.8 times higher odds of using mental telehealth. Students in a physical fight or carrying a weapon (gun, knife, or club) on school property had 2.45 times and 8.09 times the odds of utilizing mental telehealth. Bullied students were 2.5 times more likely to use mental telehealth (p-value < 0.05). Illicit drug use (cocaine, heroin, methamphetamines, and ecstasy) was associated with a higher likelihood of mental telehealth use (AOR = 1.3, p-value = .05). Our results suggest crucial insights for shaping violence and substance use prevention strategies, with implications for the future of online and telehealth behavioral services. Mental telehealth help-seeking emerges as a crucial avenue for supporting adolescents affected by violence and substance use, especially when they face obstacles to accessing traditional services. It can work in tandem with in-person services to address these challenges.

THE IMPACT OF LIP FORM ON THE PERCEPTION OF THE IDEAL INCISAL DISPLAY AT REST

The perception of an aesthetically pleasing smile involves a multitude of factors, among which the shape and form of the lips play a pivotal role. Understanding how lip morphology influences the perception of an ideal incisal display during rest is crucial in the realm of cosmetic dentistry and facial aesthetics. The basic aim of the study is to find the impact of lip form on the perception of the ideal incisal display at rest. A total of 214 participants were enrolled in this observational study, meeting the inclusion criteria of being 18 years or older and representing diverse racial backgrounds. Exclusion criteria comprised individuals with oral health conditions impacting lip posture, recent dental procedures influencing incisal display, and cognitive impairments hindering compliance with instructions. Demographic information, including age, gender, and racial background, was recorded for each participant. Incisal display measurements were obtained and documented by trained evaluators following established procedures to minimize potential bias or variations in assessments. Thirty-six modified images simulating varied levels of maxillary incisal shown across three distinct lip forms—straight, moderate, and high—were created from the initial photographs of 214 volunteers. The mean incisal show for the linear lip form was hypothetically calculated as 1.5 mm (SD = 0.3), 2.3 mm (SD = 0.4) for the moderate lip form, and 3.0 mm (SD = 0.5) for the high lip form. Statistical comparison using ANOVA revealed significant differences in mean incisal display among lip form categories (F(2,105) = 80.72, p &lt; 0.001). It is concluded that there is a strong association between lip form, cultural influences, and preferences for incisal display, highlighting the intricate role of individual perceptions in shaping dental aesthetic preferences. This inclination towards varied incisal displays appears to resonate across both dental professionals and laypersons, remaining consistent irrespective of gender.

Racial differences in P2Y12 inhibitor responsiveness in patients undergoing neuro-endovascular procedures: A cohort from the Middle East

BackgroundData on P2Y12 inhibitors responsiveness from the middle east is scarce. We sought to investigate patient responsiveness to P2Y12 inhibitors within a cohort of major races that characterize the UAE population. The secondary objective was to assess risk factors for hyper and hypo-responsiveness in this population. MethodsWe conducted a cross-sectional study on adults who received either clopidogrel or ticagrelor treatments and had platelet responsiveness testing before undergoing neuro-endovascular interventions at our quaternary care hospital between March 2015 and April 2019. ResultsDuring the study period, 249 subjects met the inclusion criteria. Overall, 17.3 % were hyper-responsive and 25.7 % were hypo-responsive to P2Y12 inhibitors. When comparing between the P2Y12 inhibitors, rates of hyper-responsiveness were significantly higher to ticagrelor when compared to clopidogrel (11 versus 6 %, p = 0.02 respectively). Contrarily, hypo-responsiveness rates were significantly higher in clopidogrel treated patients compared to their ticagrelor treated counterparts (23 versus 2 %, p < .001 respectively). Patients of Middle-Eastern origin showed a significantly higher rate of hypo-responsiveness to both clopidogrel and ticagrelor when compared to other races (41.1 % and 26.7 %, P < 0.001 respectively). Asians showed the highest rates of hyper-responsiveness for both agents. Multivariate logistic regression analysis showed that proton pump inhibitors and statin combination, (OR: 6.39, 95 %CI [1.60, 25.392]), and Middle East vs. Indian subcontinent patients (OR: 4.67, 95 %CI [1.79–12.14]) were independent predictors of hypo-responsiveness to both P2Y12 inhibitors. ConclusionThis study demonstrated a high rate of hypo-responsiveness to P2Y12 inhibitors in a UAE cohort of patients undergoing neuro-endovascular procedures. In addition, therapeutic responsiveness to P2Y12 inhibitors varied markedly based on the racial background. Future larger studies are needed to evaluate genetic variations that may contribute to this rate of hypo-responsiveness in our population.

Projected impact of anti-obesity pharmacotherapy use on racial and ethnic disparities in adolescent obesity.

Paediatric obesity disproportionately impacts individuals from minoritized racial and ethnic backgrounds. Recent guidelines support use of anti-obesity pharmacotherapy for adolescents with obesity, but the potential impact on disparities in obesity prevalence has not been evaluated. To model changes in obesity prevalence with increasing utilization of anti-obesity pharmacotherapy among adolescents. Data representative of American adolescents ages 12-17 years were obtained from the National Health and Nutrition Examination Survey, cycles 2011 through pre-pandemic 2020. A body mass index (BMI) reduction of 16.7% was applied to each participant based on clinical trial results of weekly subcutaneous semaglutide 2.4 mg among adolescents. Utilization disparities were based on utilization of the same medication class among adults. Obesity prevalence was calculated assuming utilization of 10%-100%, stratified by race and ethnicity. Among 4442 adolescents representing 26 247 384 American adolescents, projected overall obesity prevalence decreased from 22.2% to 8.4% with 100% utilization. However, disparities increased relative to Non-Hispanic White youth, with prevalence among Non-Hispanic Black and Mexican American youth ranging from 40%-60% higher to 90%-120% higher, respectively. Increasing utilization of anti-obesity pharmacotherapy may widen relative disparities in obesity, particularly if utilization is unequal. Advocacy for equitable access is needed to minimize worsening of obesity-related disparities.

Abstract TMP22: Removing Disparities Related to Thrombectomy Transfers Within an Integrated Healthcare System Across Fourteen Primary Stroke Centers

Introduction: Patients who present to a PSC with a large vessel occlusion are often transferred to hospitals with thrombectomy capability. Inequities in rates of hospital transfer amongst patients across various gender, racial background, and socioeconomic status are well established. A common metric used to determine quality of care in such transfers is the Door In Door Out (DIDO) time. We hypothesized that there would be no difference in the DIDO using an established systematic approach to transfers in our 14-hospital integrated healthcare system. Methods: All interhospital transfers for thrombectomy across our 14 PSCs were examined from 10/2020 - 4/2023. Age, gender, race/ethnicity, and insurance status were abstracted and used to assess if disparities in DIDO were present. ANOVA and Chi-Square were used for statistical analysis. Results: 307 patients were identified over a 3-year period across all our sites. 48.9% were female with a mean age of 69.7 (±16.2). The median NIHSS was 13 (IQR 7 - 20) and the median DIDO was 96 mins (IQR 74 - 131 mins). There was no difference in median DIDO between females 94 mins (IQR 74 - 132 mins) and males 98 mins (IQR 73 - 98 mins) (p = 0.2). When compared to White patients, there was no difference in median DIDO for Asian American/Pacific Islander (AAPI) (12.6 mins, p = 0.6), Black (-2.1 mins, p = 1.0), or Hispanic patients (7.6 mins, p = 0.7). The insurance status of our patient population was predominantly Medicare (56.4%), followed by Commercial (26.4%), Medicaid (8.1%), and Self- Pay (2.9%). The remainder were classified as Other/Missing (6.2%). When compared to the remainder of the population, we found no difference in median DIDO for patients on Medicare (-2.0 mins, p = 0.7) or Medicaid (10.8 mins, p = 0.3). Conclusions: A Southern California integrated healthcare system’s approach to thrombectomy transfers enables the removal of disparities in DIDO regardless of gender, racial background, and insurance status.

Protocol for a scoping review to identify research reporting on eating disorders in minority ethnic populations in the UK, Canada, Australia and New Zealand

IntroductionEating disorders (EDs) are common, severe and often life-threatening psychiatric conditions. Notwithstanding stereotypes, EDs affect individuals from all racial and ethnic backgrounds. However, despite similar and in some cases increased...

Abstract WP243: Elevated Lipoprotein(a) as a Predictor for Recurrent Ischemic Cerebrovascular Events: A Meta-Analysis of Cohort Studies

Introduction: Elevated levels of Lipoprotein(a) [Lp(a)] have been associated with an increased risk of incidental acute ischemic stroke (AIS). Our study represents the first meta-analysis investigating the relationship between Lp(a) levels and the recurrence of AIS or transient ischemic attacks (TIA) in both adult and pediatric populations. Methods: We conducted a systematic search of PubMed and Google Scholar databases up to August 2023, utilizing medical subject headings and title/abstract terms. Studies reporting on Lp(a) levels predicting recurrent AIS or TIA were screened. From 85 identified studies, 8 met our inclusion criteria: 5 focusing on adults and 3 on pediatric cohorts. Binary random effects models were used to estimate pooled unadjusted and adjusted odds ratios (OR) and 95% confidence intervals (CI). Subgroup analysis was performed by country. Sensitivity analysis was done by the leave-one-out method, and the heterogeneity was assessed with I 2 statistics. Results: Our analysis included data from 13,549 patients. The mean age in years was 66 for adults and 7.6 for the pediatric cohort. The majority of the cohorts were male and identified as being of a white racial background. The median follow-up duration was 22.5 months. Elevated Lp(a) indicated an unadjusted OR of 1.60 (95% CI: 1.18-2.16) for recurrent AIS or TIA, with moderate heterogeneity (I 2 =56.17%, p=0.003) and the association validated by sensitivity analysis. When adjusted, the OR increased to 1.84 (95% CI: 1.20-2.84) with high heterogeneity (I 2 =82.36%, p&lt;0.001). Country-specific sub-analysis identified the highest OR in Germany, followed by China and the USA. Conclusion: Elevated Lp(a) levels corresponded to a 60% unadjusted and 84% adjusted increase in the risk of recurrent AIS or TIA. This underscores the significance of Lp(a) as a valuable predictor for recurring cerebrovascular events, offering insight to inform clinical management and decision-making.

Impact of race on outcomes to 177Lu-PSMA-617 (LuPSMA) for metastatic castrate-resistant prostate cancer (mCRPC).

27 Background: Prior work suggests that African American (AA) and other minority patients (pts) derive equal benefit from taxane chemotherapy and androgen receptor pathway inhibitors (ARPIs) for mCRPC as white pts. LuPSMA showed an overall survival (OS) benefit in mCRPC pts after prior taxane and ARPI. However, there are no data on racial differences in outcomes to LuPSMA. Methods: We queried an IRB-approved registry of all pts treated with at least 2 cycles of LuPSMA between June 2022 and August 2023 at two academic medical centers in Boston, MA. Clinical data, including self-reported race, was abstracted from the electronic medical record. Pts of AA, Hispanic/Latino and Asian race were categorized as minorities. Outcomes of interest were the proportion of patients with ≥50% decrease in PSA levels during LuPSMA therapy (PSA50) and OS, defined from the date of the first cycle of LuPSMA. PSA50 and OS between races were compared with the Chi-Square and log-rank tests, respectively. Results: A total of 156 pts were included. Median age at LuPSMA initiation was 73 years (range 53-92) and the median number of prior lines of therapy was 5 (range 2-12); all pts had received ≥1 taxane and ≥1 ARPI. 136 (87%), 10 (6%), 6 (4%) and 4 (3%) pts were White, AA, Hispanic/Latino and Asian, respectively. The median number of LuPSMA cycles received in the entire cohort was 4 (range 2-7), and median follow-up was 7.1 months. A numerically higher proportion of minority pts had visceral disease at baseline compared to White pts (50% vs. 31%, (X2 = 2.87, p=0.090). Overall, 86 pts (55%) had a PSA50, with PSA50 of 55% (n=75), 60% (n=6), 67% (n=4) and 25% (n=1) amongst White, AA, Hispanic/Latino and Asian pts, respectively. There was no significant difference in PSA50 between White and minority pts (X2 = 0.00, p=0.990). Median OS in the entire cohort was 12.9 months and was not significantly different between White and minority pts (12.9 months vs. 8.5 months, p=0.533). The Table summarizes outcomes by race. Conclusions: PSA50 and OS were comparable between minority and White pts receiving LuPSMA for mCRPC, despite minority pts tending to present with more visceral disease, a known adverse prognostic factor. Validation of these findings and efforts to widen access to LuPSMA amongst minorities are required, given that pts of all racial backgrounds appear to benefit equally from LuPSMA. [Table: see text]

Mediators of Functional Disability at Mid- and Late-Life.

As the number and proportion of older adults living in the U.S. increases, growing evidence shows that people are entering late life with more functional disability than in previous generations. Using data from the 2020 Behavioral Risk Factor Surveillance System survey, we sought to identify the contributions of demographic variables and health conditions to functional disability. Specifically, we tested the associations among age, sex, race, chronic physical health conditions, depression, and functional ability among 243,693 adults, ages 45 years and older. Model testing, implemented in AMOS 29.0.0, resulted in an acceptable fit of the model to the data, Χ2 (DF = 18, N = 243,693) = 19,512.64, p < .001; CFI = 0.909; TLI = 0.774; RMSEA = 0.066; R 2 Function = .267. The findings from the present study replicate previous research that age, sex, and racial background differences influence functional disability. We extend the literature to examine physical and emotional health as potential pathways to intervene in midlife.

Correlation of self-reported racial background to euploidy status and live birth rates in assisted reproductive technology cycles.

To determine whether the embryonic euploidy rate and live birth outcomes following single, euploid embryo transfer (SEET) differ among women of self-reported racial and ethnic backgrounds. This retrospective cohort study included all infertile patients of different self-reported racial backgrounds who underwent In vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy (PGT-A) and an autologous single euploid embryo transfer (SEET) from December 2015 to December 2019 at a single private and academic assisted reproduction technology center. Primary outcome measures included ploidy rates among different racial groups. Secondary outcomes included clinical pregnancy, clinical pregnancy loss, and live birth rates. Five thousand five hundred sixty-two patients who underwent an IVF cycle with ICSI-PGT-A were included. A total of 24,491 blastocysts were analyzed. White participants had on average more euploid embryos and higher euploidy rates when compared to their counterparts (p ≤ 0.0001). However, after controlling for confounding factors, there was no association between race and the odds of having ahigher euploidy rate (aOR 1.31; 95% CI 0.63-2.17, p = 0.42). A total of 4949 patients underwent SEET. Pregnancy outcomes did not differ among patients of varying self-reported races. Euploidy rates and pregnancy outcomes were comparable among patients of different racial backgrounds who underwent a SEET.