White Women Research Articles

Ethnic inequalities in primary care experiences for people with multiple long-term conditions: Evidence from the general practice patient survey

ObjectivesTo examine the relationship between ethnicity and experiences of primary care for people with multiple long-term conditions (MLTCs) and assess the relative importance of demographic, practice, and area-level factors as influences on primary care experiences across ethnic groups. Study designA retrospective study using 2018–19 GP Patient Survey data linked to General Practice Workforce data and small area data published by the Office for National Statistics. MethodsWe conducted multilevel regression analysis to assess the relationship between ethnicity and experience of accessing primary care and interacting with healthcare professionals. We built separate regression models for each outcome and included (i) each covariate separately, (ii) demographic factors and (iii) demographic, practice, and area-level factors. ResultsUpon full adjustment Arab, Bangladeshi, Chinese, Indian, Pakistani, other Asian, mixed white and Asian, and other white people with MLTCs have lower levels of satisfaction with primary care access and interacting with healthcare professionals compared with white British people. The influence of demographic, practice and area-level factors is not uniform across ethnic groups; demographic factors account for the inequalities in levels of satisfaction with access to primary care between white British people and Black other, mixed other, mixed white & Black Caribbean and Gypsy & Irish Travellers. However, practice and area-level factors strengthen inequalities in the experience of accessing primary care for Bangladeshi, Indian and Pakistani people. ConclusionsGiven the link between patient satisfaction and patient-related health outcomes, the lower levels of satisfaction with accessing primary care and interacting with healthcare professionals among the aforementioned minoritised ethnic groups are concerning and require further scrutiny. Qualitative studies are required to understand and address the sources of poor experiences in primary care for minoritised people with MLTCs to improve patient-centred healthcare and outcomes.

Cardiovascular disease risk reduction for all-cause mortality benefit in low-risk individuals

Background: Current recommendations for the primary prevention of cardiovascular disease (CVD) are based solely on 10-year CVD risk assessment. However, CVD mortality is not compared with all-cause mortality, which could provide insights into the potential benefits of CVD risk interventions on overall mortality. Methods: CVD risk for average American white and black males and females is calculated using the 2013 American Heart Association equations. CVD death risk is determined by combining CVD risk with the death rate following a CVD diagnosis. This CVD death risk is then compared with all-cause mortality data from National Vital Statistics Reports. A larger ratio indicates that most deaths are attributed to CVD, suggesting that intervention may be more beneficial. Results: The CVD mortality ratio is highest for white men and lowest for black men, indicating that white male likely to benefit most from CVD risk modification, while black males will benefit the least. Additionally, the ratio, and the potential benefit, decreases with age for all groups, especially after the age of 70. Conclusion: For the average U.S. population without a CVD diagnosis, the potential mortality benefit from interventions targeting CVD risk factors varies significantly based on patient characteristics such as race, age, and gender. The potential benefit is greatest for white males and decreases with age for all groups.

Investigating the causal association between serum uric acid levels and gastric cancer risk: a Mendelian randomization study

The causal link between serum uric acid (SUA) levels and gastric cancer susceptibility remains inadequately elucidated. This investigation employed a two-sample Mendelian randomization (MR) framework to assess the potential causative link between SUA concentrations and the propensity for developing gastric cancer. To further explore potential racial differences, this MR analysis was conducted on cohorts of both European and East Asian descent. Data from a large-scale GWAS in 343,836 Europeans and 92,615 East Asians were screened for 206 and 45 SNPs significantly linked to SUA levels, respectively, as genetic variants. Subsequently, four distinct MR methodologies were deployed to determine how SUA levels affected gastric cancer risk. Using the fixed-effects IVW approach, our analysis revealed no significant association between SUA levels and gastric cancer risk, with P-values exceeding the threshold of significance in both populations (European P = 0.778; East Asian P = 0.245). The findings were supported by three additional MR methods. The reliability of these results was substantiated by comprehensive sensitivity analyses. In summary, our data do not support a significant causal linkage between SUA levels and gastric cancer risk.

Lethal Prostate Cancer in Mexico: Data from the Can.Prost Mexican Registry and a Project for Early Detection

Introduction: Epidemiological data are crucial for adopting primary and secondary prevention strategies and to develop screening protocols against prostate cancer (PCa). Despite the comprehensive characterization of PCa across White and Black men, there is a lack of data from the Mexican population. This manuscript presents data from the Can.Prost registry that captures PCa trends over the past two decades in Mexico City; furthermore, we aimed to compare clinical differences and oncological outcomes before and after the promotion of early detection actions through a campaign against PCa that occurred in 2014. Methods: A retrospective observational study on newly diagnosed Mexican PCa patients was carried out at the Instituto Nacional de Cancerología (INCan) in Mexico City. During 2014 and 2015, a project for the early diagnosis of PCa (“OPUS program”) was launched in the aforementioned tertiary hospital. Starting at the age of 45 years, all men were invited for a PSA measurement and a specialist urologist consultation. All individuals with clinical or biochemical suspicion of PCa (PSA > 4 ng/mL), in the context of age and prostate volume, underwent ultrasound-guided transrectal prostate biopsy. Then, patients with pathologically confirmed prostate cancer were stratified according to the year of diagnosis: Group A accounted for those diagnosed between 2000 and 2014 and Group B for those patients diagnosed in the timeframe of 2015–2021. Comparisons of PCa characteristics, treatment modalities and oncologic outcomes between Group A and B were performed. Results: Overall, we collected data from 2759 PCa patients from 2000 to 2021. The median PSA at baseline was 32 ng/mL, and 25% had a family history of PCa. Overall, 25.8% were asymptomatic and 46% had a non-metastatic presentation. After the OPUS campaign, PSA at diagnosis was significantly lower across all age groups. The incidence of PCa diagnosis in asymptomatic men was higher (31.4% vs. 19.9%) and a higher proportion of men were diagnosed with organ-confined, palpable disease (46% vs. 28%) (p < 0.001). The rate of patients eligible for active/radical treatment was higher after the OPUS campaign (patients who received surgery increased from 12.78% to 32.41%; patients who underwent radiation increased from 28.38% to 49.61%). The proportion of patients diagnosed with non-clinically significant disease was negligible and remained stable across time. Conclusions: PCa in Mexican patients displays aggressive features at diagnosis, whereas the rate of non-significant disease is negligible. The introduction of early detection strategies may lead to lower symptomatic and metastatic PCa and higher opportunities for radical treatment. This emphasizes the need for public awareness and for adjustment of screening strategies to the peculiarities of the Mexican population.

Emergency Medical Services and Police Utilization for Pediatric Mental and Behavioral Health Concerns Within a Large Hospital System.

This study aimed to compare emergency medical services (EMS) and police utilization trends, epidemiology, and emergency department (ED) outcomes between pediatric patients with mental or behavioral health (MBH) emergencies and those with non-MBH concerns transported to a large children's hospital system. This was a retrospective cohort study of patients aged 5 to 18 years transported via EMS and police to two EDs affiliated with a children's hospital from January 2012 through December 2020. Data were abstracted from electronic hospital records. Encounters for MBH emergencies were identified using diagnostic codes and chief complaints. Trends of EMS and police transports of patients with MBH emergencies were examined. Patient demographics and ED outcomes were compared between children presenting with MBH emergencies and those with non-MBH concerns. During the 9-year study period, out of 40,663 transports to the EDs, 36,137 (89%) arrived via EMS, and 4,526 (11%) arrived via police. A total of 10,250 (28.4%) EMS transports were for MBH emergencies. The volume of patients transported by EMS for MBH emergencies increased by 1.4% per year (P < 0.01) with no significant change in total EMS patient volumes. Patients with MBH emergencies transported by EMS were more likely to be older, female, of White race, and publicly insured; require restraint in the ED; and be admitted (P < 0.001). Of police transports, 4153 (91.8%) were for MBH emergencies, with no statistical change in the proportion of police transports that were for MBH emergencies. Police-transported MBH patients compared to non-MBH police-transported patients were more likely to be younger, female, and of White race (P < 0.001); 8.7% required mechanical/physical restraints in ED, 6.7% required pharmacologic restraint medications in ED, and 53% were admitted. The proportion of pediatric transports for MBH emergencies by EMS is rising and comprises the majority of police transports. Distinct from non-MBH pediatric patients transported, MBH patients necessitate significant ED resources, including ED-administered restraints and admission, highlighting their unique burden on the prehospital and ED systems.

Are there differences in overall survival among older breast cancer patients by race and ethnicity?

BackgroundNon-Hispanic Black women have lower breast cancer incidence but twice the mortality of non-Hispanic White women. Recent data suggest that the overall survival difference may not be observed in older women. This study aims to determine overall survival in women aged ≥70 years with operable breast cancer by race and ethnicity and factors contributing to overall survival. MethodsThe National Cancer Database was queried to identify women aged ≥70 years with stage 0–III breast cancer from 2004 to 2018. Patients were separated by race and ethnicity: non-Hispanic White, non-Hispanic Black, Hispanic, and Other. To examine overall survival, a Cox proportional hazards model was created, and overall survival was calculated using the Kaplan-Meier method. ResultsThere were 304,345 eligible patients. The mean age was 76.8 years (standard deviation 5.5 years), and most were non-Hispanic White (85.2%), had Medicare (86.8%), had hormone receptor–positive breast cancer (78.7%), and underwent partial mastectomy (64.5%). Compared with non-Hispanic White women, non-Hispanic Black women had a higher prevalence of stage III disease (10.8% vs 7.5%, P < .001) and triple-negative breast cancer (16.7% vs 8.7% P < .001), and a longer time to treatment initiation (39.2 vs 32.3 days, P < .001). Median follow-up was 5.38 years (interquartile range: 3.83–7.46 years). Non-Hispanic Black women had the lowest median survival time compared with non-Hispanic White women (9.7 vs 10.4 years, P < .001). After adjusting for insurance type, receptor status, stage, comorbidity, time to treatment, and facility type, there was no increased risk of death for non-Hispanic Black patients (hazard ratio: 0.99, 95% confidence interval: 0.96–1.01, P = .29). ConclusionAlthough overall survival was lower in older non-Hispanic Black women, this difference resolved on multivariate modeling, suggesting that other factors likely influence overall survival for this cohort.

Intersectionality of sex and race in COVID-19 mortality and vaccination inequities in Massachusetts

BackgroundInequities in COVID-19 incidence, morbidity, and mortality between racial and ethnic groups in the United States (U.S.) have been documented since the start of the pandemic in early 2020. Similarly, disparities by sex for COVID-19 morbidity and mortality have emerged, with men dying at a higher rate than women. Little research has been done to understand how the intersection of sex and race impacts COVID-19 inequities in Massachusetts (MA). This cross-sectional study examined how COVID-19 mortality rates (February 2020- May 2023) and vaccination rates (December 2020-February 2023) varied by sex across racial groups in MA.MethodsUsing Massachusetts Department of Public Health data of all COVID-19 mortality cases and primary series vaccinations in MA from 2020 to 2023, we calculated both age-specific and age-adjusted COVID-19 mortality rates in order to account for differences in age distributions across sex-race groups.ResultsOverall, men across all age-race groups consistently had a higher mortality rate compared to their female counterparts. The age-standardized mortality rate difference between White men and White women is the smallest, with the rate for White men being 1.3 times higher than White women. The age-standardized mortality rate between Hispanic men and Hispanic women varies the largest, with the rate for Hispanic men being 1.7 times higher than Hispanic women. Notably, Black women and White women have similar vaccination rates, yet the age-standardized mortality rate for Black women is 1.4 times the rate of White women.ConclusionsOur findings show that there are disparities at the intersection of sex and race for COVID-19 mortality and vaccination in MA. This highlights the importance for targeted COVID-19 interventions at the intersection of sex and race and the need for detailed COVID-19 reporting by sex within race groups.

Getting by with a little help from my antiracist White friends: Can White antiracism counteract the demobilizing effect of positive contact?

Recent research indicates that positive intergroup contact with advantaged groups (e.g., White Americans) may decrease ingroup collective action amongst marginalized groups (e.g., Black, Hispanic/Latinx Americans). However, we hypothesized that seeing White Americans—and specifically one’s friends—as antiracists who actively oppose racial inequality could boost collective action in marginalized groups, counteracting this effect. Four studies and an internal meta-analysis revealed that positive contact was associated with less collective action, but perceiving one’s White friends as antiracist was associated with greater engagement. This effect was specific to White friends; perceiving White people as antiracist was not mobilizing. Further, anger about inequality and movement identification (social identity model of collective action [SIMCA]) mediated these associations. This research reveals that although positive contact can be demobilizing for marginalized racial groups, Whites’ vocal allyship within intergroup friendships can enhance social change behaviors.

Liars, scammers and cheats: con(fident) women and post-authentic femininities on television

ABSTRACT In this paper, we analyze the conjuncture framing the recent rise of media representations of female con artists, looking at two recent examples of the trope on television: Inventing Anna (a fictionalized account of con artist Anna Delvey) and The Dropout (a fictionalized account of Theranos founder Elizabeth Holmes). We situate the new visibility of women who lie, scam and cheat on television within a set of distinct yet interlocking cultural anxieties: about the “believability” of women’s speech in the aftermath of the #MeToo movement; about the capacities for inauthenticity, artifice, and deception inherent to digital media culture; about the con logics of contemporary global capitalism; and about the pernicious role that white women’s believability plays within everyday operations of white supremacy in the United States. Read through this lens, the “post-authentic” con woman becomes legible as an ambivalent backlash text: a parable that warns about what happens when (white) women are taken at face value and allocated the benefit of the doubt. In a contemporary popular feminist context where women have been implored to be confident, self-assured, and self-possessed “girlbosses”, shows like Inventing Anna and The Dropout reposition the con(fident) woman as a figure of necessary cultural suspicion.

Perinatal mortality in women in minority ethnic groups in Ireland (2011-2021)

Abstract Women in minority ethnic groups (MEG) have been consistently overrepresented in the National Perinatal Epidemiology Centre (NPEC) Perinatal Mortality (PM) reports in Ireland (IE). International research, report similar findings. A secondary analysis of NPEC PM national clinical audit data (2011-21) examined factors associated with PM in women in MEG and differences between these and white women. Maternal sociodemographic and obstetric characteristics, maternal medical history, infant characteristics and PM outcomes of women in MEG were analysed and compared with women of white ethnicity with χ2 tests. There were 4314 PMs in IE from 2011-21; 2896 stillbirths (SB) and 1418 early neonatal deaths (ENND). Women in MEG who experienced PM were younger (p &amp;lt; 0.001) and 46% were employed (vs 75% of white women, p &amp;lt; 0.001). A greater proportion of women in MEG had previous pregnancies (77% vs 68%, p &amp;lt; 0.001), and more than twice as many had ≥3 previous completed pregnancies versus white women (26% vs. 12%, p &amp;lt; 0.001). Women in MEG also had more previous pregnancy medical issues (49% vs 38%, p = 0.001). Twice as many women in MEG had their first prenatal appointment after 20 weeks’ gestation or never received prenatal care (p &amp;lt; 0.001). Analysing by type of PM, statistically significant differences persisted for all these variables in both SB and ENND groups. Women in MEG experienced more placental conditions and obstetric factors as causes of PM, but fewer congenital anomalies compared to white women (p = 0.047). These differences only persisted in the SB group when data was analysed by type of PM. Factors highlighted in this study such as employment, parity, and prenatal care access may explain the over-representation of women in MEG in PM. These findings provide further knowledge useful to create targeted interventions (e.g. initiatives to improve maternal health literacy for women in MEG). Further studies are needed to promote change that would specifically address these systemic inequities. Key messages • Data shows systemic inequities that may contribute to the over-representation of women in minority ethic groups in perinatal mortalities. Clear and tangible changes are needed to address these issues. • Further research needs to clarify factors restricting access of women in minority ethic groups to prenatal care and promote interventions to ensure adequate prenatal care is available and accessible.

Class and Ethno-Gender Differences in Education and Labour Market Position—An Intersectional Analysis of Ethnic Integration in the UK

This paper analyses the socio-economic disadvantages of women from different ethnic minority heritages in the UK. Using data from the Labour Force Survey (2014–2023), which contains detailed information on parental class and respondents’ socio-economic conditions, we examine four domains of life chances which are crucial for ethnic integration: educational attainment at the degree level, risks of unemployment, access to professional-managerial (salariat) position and earning power. We proceeded with the gross differences and then examined the differences by ethno-gender status and parental class combinations, controlling for many confounding factors. We also examined the net ethno-gender differences over the life course and the trends of social fluidity over the period covered and across the ethno-gender groups. We found that women from all ethnic origins were doing well in education but faced multiple disadvantages in the labour market, especially in access to the salariat and in earning power. Women of Pakistani/Bangladeshi heritages faced pronounced unemployment risks, especially at the earlier life stages. There is a significant increase in fluidity over the period covered, but this is marked by considerable ethnic and class differences, with Black Caribbean, Black African, Pakistani and Bangladeshi women from more advantaged class origins being unable to secure advantaged class positions and those from working-class families unable to make long-range upward mobility as effectively as White men. Overall, Bangladeshi, Pakistani, Black African and Black Caribbean women are found to be considerably disadvantaged, but there are also signs of social progress.

Association of serum testosterone levels with left atrial size, function, and risk of atrial fibrillation in adult men: observational and mendelian randomization analyses

Abstract Background Numerous studies have investigated the association between serum testosterone levels, testosterone replacement therapy (TRT), and cardiovascular risk. However, research examining the relationship between testosterone levels and atrial fibrillation (AF) risk remains limited. We comprehensively analyzed the association between total testosterone (TT) levels, intermediary phenotypes such as left atrium (LA) size and function, and the risk of AF in middle-aged and older men. Methods We utilized data from the UK Biobank, a population-based prospective cohort, focusing on 179,988 White men who had complete serum TT level data and no AF history. Observational associations between TT levels and LA imaging traits, as well as AF risk, were estimated using multivariable regression and time-dependent Cox regression models, treating TT levels as a time-varying variable. Genetic associations were examined by Mendelian randomization (MR), using both UK Biobank and external large consortia genome-wide association study data. Results During the median follow-up of 11.8 years (IQR 10.9–12.5), we observed 13,847 incident AF cases (7.7%). Participants with normal TT levels (≥ 300 ng/dL) showed a 15% reduced risk of AF (HR of 0.85 [95% CI, 0.82–0.89]) compared to those with low TT (&amp;lt; 300 ng/dL). Interestingly, participants undergoing TRT experienced a 51% higher risk of AF (1.51 [1.09–2.07]). Furthermore, each 1-standard deviation increase in TT levels was associated with a reduced AF risk (OR of 0.91 [0.89–0.93]) and an improved LA emptying fraction (1.29 [1.06–1.58]). Applying age-specific cutoff values for low TT levels highlighted a more pronounced AF risk reduction in participants with normal TT. MR analyses supported these observations, suggesting potential causal relationships between TT levels and both LA function and AF risk. Conclusions Our findings suggest that low TT levels are associated with reduced LA function and increased risk of AF, both observationally and genetically, indicating that serum TT could serve as a surrogate marker or even a potential causal mediator in the development of AF.Abstract tableAbstract figure

Inequalities in preterm birth by deprivation and ethnicity: A national cohort study in England

Abstract Background Preterm birth has decreased in the UK; however, the extent of inequalities remains unclear. This study aimed to quantify socioeconomic and ethnic inequalities in preterm birth rates using routinely collected maternity data in England. Methods Retrospective analysis of cohort data from the NHS England Hospital Episode Statistics (HES). All women aged 13-55 with a singleton livebirth (April 2018 to March 2021) at 24-42 weeks were included. Multivariate Poisson regression was used to estimate the rate of preterm birth (livebirth between 24 + 0 and 36 + 6 weeks’) for each ethnic and deprivation postcode group, these were compared to white women from the least deprived 20% of areas. We iteratively developed the model, adjusting for covariates associated with preterm birth. A post-hoc calculation identified the rate of preterm birth for each ethnic group at each level of deprivation. Results We identified 1,111,045 livebirths between April 2018 and March 2021. The rate of preterm birth increased with socioeconomic deprivation and was highest at 7.1% per 100 livebirths (95%CI:7.00-7.20) in women living in the 20% most deprived areas, compared to 5.6% (95%CI:5.50-5.74) in women in the 20% least deprived areas. White women had the lowest preterm birth rate at 6.5% (95%CI:6.47-6.58) and South Asian women had the highest rate at 6.9% (95%CI:6.76-7.04) (Table 2). The rate of preterm birth increased according to increased area-level deprivation across all ethnic groups. In areas of high deprivation, the preterm birth rate was similar across ethnic groups. Whereas in less deprived areas, there were marked inequalities between ethnic groups. Conclusions Inequalities in preterm birth remain, despite overall decreases in preterm birth. We found area deprivation and individual ethnicity interact to increase the risk of preterm birth in marginalized communities. Interventions need to holistically consider the structural and socioenvironmental determinants of preterm birth. Key messages • Area deprivation and ethnicity remain key drivers of inequalities in preterm birth, despite overall decreases in preterm birth. • To reduce inequalities tailored prevention strategies are needed to address socioenvironmental and structural determinants of preterm birth in high deprivation areas and minoritized ethnicity groups.

White Americans who perceive themselves to be “last place” in the racial status hierarchy are most drawn to alt-right extremism

Economic inequality and alt-right extremism have reached historic highs in the U.S. We propose that high economic inequality may uphold stereotypes that white people are wealthy which may lead some white Americans to feel in the precarious position of falling behind their racial group’s high status. For white Americans who also feel that they are being passed in status by People of Color, such perceptions may make ideologies that aim to benefit white people particularly appealing. Across two studies (Pilot: N = 465; Study 1: N = 1,449), using representative quota sampling of non-Hispanic, white Americans, we combine a measure of subjective status with latent profile analysis to identify white Americans who feel they are in “Last Place” (i.e., falling behind most white, Black, Asian, and Latinx Americans). Controlling for objective status, white Americans in this “Last Place” profile were most likely to support alt-right ideology, politicians, and events.

Supplemental Material for Children’s Beliefs About Black and White Men’s and Women’s Scientific Knowledge: An Intersectional Approach

Supplemental Material for Children’s Beliefs About Black and White Men’s and Women’s Scientific Knowledge: An Intersectional Approach

Association of race with incidence, characteristics, and mortality from incidental prostate cancer: Analysis of two North American contemporary cohorts.

Non-Hispanic Black (NHB) men are at higher risk both for incidence and mortality from prostate cancer (PCa) compared to Non-Hispanic White (NHW) men, but these findings arise from biopsy-detected PCa reports. We aimed to compare the incidence, subsequent management and cancer-specific mortality (CSM) of incidental PCa among NHB and NHW men, using two different North American cohorts. The Surveillance, Epidemiology and End-Result (SEER: 2004-2017) and our institutional Henry Ford Health (HFH: 1995-2022) databases were queried to identify men diagnosed with incidental PCa. Cumulative incidence estimates were used to calculate CSM differences between NHB and NHW men. Competing-risk multivariable regression analysis tested the impact of race on CSM, after accounting for all available covariates. A total of 418 and 6,124 incidental PCa cases were recorded in HFH and SEER database respectively. No pathological differences were observed between NHB and NHW men in both the cohorts, except for prostate-specific antigen (PSA) value at diagnosis, which was higher in NHB men. At 10-years, the CSM rates were 5.5% vs 7.2% in our cohort and 8.6% vs 10.3% in the SEER cohort for NHW and NHB men, respectively (all Gray's test p-value > 0.05). At multivariable, race was not an independent predictor of CSM in our HFH cohort (HR: 1.46, 95% CI: 0.57-3.71, p = 0.6). In the SEER cohort, NHB men were 34% less likely to die from PCa from 1 year to the next (95% CI: 0.49-0.90, p = 0.008), when compared with NHW men. In the comparison of incidental PCa findings between NHB and NHW men, both groups had similar pathological characteristic and survival outcomes. These findings are different from the 'conventional' screening-detected PCa and suggest that racial differences have minimal to no adverse effects on PCa-specific mortality after incidental diagnosis.

How to Unlearn White Supremacy?

The article pursues the question of how solidarity between white and non-white people can be possible in the face of centuries of dehumanization of non-white life. It focuses on the construction of whiteness as supposedly ‘superior’ and the question of how whiteness can be unlearned. The authors base their reflections on the philosophical concept Ubuntu, in order to clarify what would be necessary to escape from this deep imbalance back to a humanity that is not subject to hierarchization.

Does PhenoAge acceleration impact adverse outcomes following major surgery (rehospitalization or death)? A genome-wide association study and mendelian randomisation

Abstract Background Biological aging reflects the state of an individual's cellular and molecular function, and is distinct from chronological age; which reflects the passage of time[1]. Validated measures of biological aging, such as Phenotypic aging (PhenoAge) estimated from nine routine clinical biomarkers, have been associated with increased risk of age-related diseases and mortality in cohort studies[2]. However, the potential causal relationship between them remains unclear. In this study, we aim to identify genetic variants associated with PhenoAge Acceleration (PhenoAgeAccl) and adverse outcome after surgery (rehospitalisation or death within 365-days] and assess the causal relationship between these two phenotypes using Mendelian Randomization framework. Objectives -Perform a genome-wide association study(GWAS) on adverse outcomes following major surgery. -Assess the potential causal relationship between PhenoAgeAccl and adverse outcomes following major surgery using Mendelian randomization analysis. Methods We conducted a GWAS via plink using participants from the UKBiobank (Application 77596) to generate summary statistics for 6509 participants who had undergone major surgery within 365 days of their baseline assessment date(3). For quality control, SNPs were excluded if they didn't meet the following criteria: (1) imputation information score &amp;lt;0.3 (2) minor allele frequency &amp;lt;1%, (3) Hardy–Weinberg equilibrium test p-value significant at the Bonferroni-corrected level. Summary statistics for PhenoAgeAccl was obtained from a previous GWAS of European descents[4]. Gene enrichment analysis was performed using Multi-marker Analysis of GenoMic Annotation (MAGMA) in Functional Mapping and Annotation (FUMA). Then, genetic instruments for PhenoAgeAccl and adverse outcomes following surgery were identified to conduct a summary-based Mendelian Randomisation [Assumptions are listed in Figure 1]. Results GWAS for adverse outcomes following major surgery identified 3 lead SNPs (rs1360618, rs11848297, rs7978) [Figure 2]. Gene-set analysis showed enrichment in the immune system, cell migration, fear response, and iron metabolism. For PhenoAge Acceleration, gene-set analysis showed enrichment in immune system, and cell signalling pathways. 17 SNPs were selected which were used for the Two-Sample MR. We found no causal relationship, as the beta coefficient for Inverse variance weighted was -0.308 [standard error - 0.075, p=0.68]. For every 5-year increase in PhenoAge compared to chronological age, the risk of emergency re-hospitalisation or death increased by 21% (HR 1.16 – 1.3, p &amp;lt; 0.001). Conclusion Gene-set analysis for adverse outcomes following major surgery showed enrichment in immune system, iron metabolism, and fear response which have all recently been associated with mortality post-surgery in cohort studies(4,5). No causal relationship between PhenoAgeAccel and mortality post-surgery was established.Mendelian Randomisation assumptionsManhattan plot adverse-outcomes post-sur

Utility of the triglycerides/HDL cholesterol ratio in older adult patients in Colombia

Abstract Introduction Alterations in lipid metabolism are responsible for atherogenesis and an increased risk of atherosclerotic cardiovascular disease. The triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C) is used to assess the risk of cardiovascular diseases; however, it has not been evaluated in older adults. The aim of the present study is to evaluate the TG/HDL-C ratio in elderly patients and analyze its correlation and discriminatory capacity with cardiovascular risk factors according to data from the SABE Colombia survey. Purpose Describe the sociodemographic characteristics, cardiovascular history, lifestyle, and cardiovascular risk score in the older adult population included in the SABE Colombia Study.Describes the distribution of triglyceride levels, cholesterol, and the TAG-HDL ratio in the older adult population included in the SABE Colombia Study. Evaluate the relationship between the TAG/HDL Cholesterol Index and cardiovascular risk factors such as hypertension, prediabetes, type 2 diabetes mellitus, cardiovascular disease, cerebrovascular disease Determine if there is a correlation and the degree of correlation between the TAG/HDL Cholesterol ratio and variables related to higher cardiovascular risk and stablish cutoff points of the triglyceride to HDL cholesterol ratio as indicators of the onset of risk factors Materials and Methods Cross-sectional study in adults aged 60 years and older included in the national SABE Colombia survey (National Survey of Health, Well-being, and Ageing conducted in Colombia in 2015), which included 244 municipalities from all departments of the country. A correlation test was performed to assess the presence and degree of correlation between the TAG/HDL index and cardiovascular risk factors, and ROC curve analysis was conducted to evaluate the performance of the TAG/HDL index in identifying risk factors. Results A total of 23,694 patients with the necessary information for the study were included. The median age was 69 years, 57.3% were women, and 34.3% were of white race. 23.5% had hypertension, and 16.4% had diabetes mellitus. 13.4% had a history of cardiovascular disease, and 2.5% had cerebrovascular disease. While the specific correlation between the index and different cardiovascular risk factors is generally low to moderate, good discriminatory capacity was found for diabetes and metabolic syndrome with the following values: diabetes, with an area under the curve (AUC) of 0.871 and a cut-off point of 9.17; and for metabolic syndrome, the AUC was 0.840, with a cut-off point of 8.81. Conclusions Our findings show that the TG/HDL ratio has intermediate correlation for different cardiovascular risk factors; however, it has excellent predictive ability for the presence of diabetes and metabolic syndrome. These findings are very useful in the clinical evaluation, screening, and detection of cardiovascular risk factors in the population aged 60 years and older in Colombia.Scatter plots of TAG/HDL ratio comparedROC curves for diabetes and metabolic s

Media Representation of Scientists in Jornal Nacional: Reaffirmation of Stereotypes During the First Year of the COVID-19 Pandemic

ABSTRACT In response to the COVID-19 pandemic, scientific authorities were routinely consulted by mainstream media outlets through interviews, statements and/or supporting images. In this framework, our goal in this study was to analyze the media representation of scientists in Brazil during the first year of this global public health crisis. To this end, we applied a research protocol and, using statistical techniques, quantitatively analyzed newscasts on the country’s main TV news program, Jornal Nacional. On this program, scientists were interviewed about “vaccination,” a topic of broad interest given that the vaccine had been described from the onset of the COVID-19 pandemic as a response to cope with the public health crisis. We discuss information about gender, age, and race, the speaking time and screen time of these social actors, the format in which scientists are inserted into news reports, and the presence/absence of science icons. The data reveal that the predominant image of the scientist transmitted to the audience – a mature white man – reinforces stereotypes that persist in the media and in the public understanding of science.