BabySens: An Ethical Framework for Developmentally-Aligned Infant-Technology

Changes in Survival in Acute Myeloblastic Leukemia by Racial and Ethnic Group: Greater Improvement for Non-Hispanic Whites and Increase in the Disparity for Minority Patients in the Early 21st Century

Adolescent sexuality and reproductive health: where are we in 2004?

Background: Li-Fraumeni Syndrome (LFS), caused by pathogenic/likely pathogenic (P/LP) variants in TP53, is a cancer predisposition syndrome that increases the risk for numerous cancer types in both children and adults. Many studies have shown that cancer rates can vary between races and ethnicities. For example, the 2024 Cancer Statistics published by the American Cancer Society reported the incidence for breast cancer to be highest for White individuals and lowest for Hispanic/Latino individuals. One LFS study showed East Asian individuals were more frequently diagnosed with gastric cancer compared to North Americans and Europeans. Other studies identified P/LP TP53 variants associated with specific populations, such as the South and Southeast Brazil founder variant, p.Arg337His. However, there lacks extensive research on the variable expressivity of cancers within the LFS population, based on genotype, race, and/or ethnicity. This study aims to describe the specific TP53 germline variants, cancer rates, and cancer types among individuals of different racial and ethnic groups diagnosed with LFS. Methods: A retrospective chart review of individuals with germline P/LP TP53 variants at the University of Texas MD Anderson Cancer Center was completed. Data collected includes race, ethnicity, number of cancer diagnoses, cancer types, and location of the TP53 variant (exon and codon). Individuals with a suspected somatic TP53 variant were excluded from this study. Racial groupings included Asian, Black or African American, White, and Other/Unspecified. Ethnicity was categorized as Hispanic, Non-Hispanic, and Other/Unspecified. There were also six cancer type categories: adrenocortical carcinoma, brain cancer, breast cancer, osteosarcoma, soft tissue sarcoma, and non-core LFS cancers. Descriptive and statistical analyses, including chi-squared or Fisher’s exact tests and pairwise comparisons, were performed using R software (v4.4.1). Results: Two hundred and fifty individuals with a confirmed P/LP TP53 variant were included in the analysis. Breast cancer was the most common cancer type diagnosed for all ethnic and racial groups, except Asian individuals, who most frequently had non-core LFS cancer diagnoses. There was a significant difference in the rate of breast cancer across racial groups (p = 0.037), with Black or African American individuals with LFS having the highest rate of breast cancer at 76.5%. Additionally, individuals who identified as Black or African American were 1.87 times more likely to develop breast cancer in comparison to those who identified as White. For cancer rates, most individuals in each racial and ethnic group were diagnosed with one primary cancer. Statistical analysis did not identify a significant difference in cancer rates across groups defined by race or ethnicity. Regarding the location of variants within the TP53 gene, there was a significant difference in the rate of variants in exon four (p = 0.021) and exon six (p = 0.016) across racial groups, with variants in exon four being more common in Asian individuals (33.3%) and variants in exon six being more common in Black or African American individuals (35.3%). Conclusion: This study highlights similarities in the rates and types of cancers seen across racial and ethnic groups within a cohort of individuals with LFS. However, this study also identified potential differences in the rates of breast cancer and variant location across racial populations within the cohort. The results of this study provide information that can lead to more personalized counseling for patients and train risk models to accurately predict cancer risk for individuals with LFS of differing races and ethnicities. Citation Format: H. Esplen, B. Arun, C. DiNardo, H. Abdel-Salam, K. Richardson, C. Peterson, J. Corredor. Evaluating Cancer Rates, Cancer Types, and Variant Hotspots Across Races and Ethnicities in Individuals with Li-Fraumeni Syndrome [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS3-01-13.

1. Race is difficult to define at best and references to groups are more accurately made on the basis of ethnic groups that are bound by some common bond, such as Swedish Whites, American Whites, etc. 2. The quantifiable differences in the somatic craniofacial region of ethnic groups residing for several generations in the same or similar geographic areas are small. 3. The evidence supports a geographical effect on the most frequently used quantifiable angular measurements of the somatic facial profile of the major racial groups. 4. Cephalofacial morphology is affected by many factors including genetics, function and temperature. 5. There are mean differences in the quantifiable traits of the face of some ethnic groups. The differences in means within ethnic or racial groups are often greater than the differences in means among ethnic or racial groups. 6. The differences in means of traits of the somatic facial skeleton among or between ethnic groups are usually very small with an enormous degree of overlap. 7. The parameters of the face that are closer to the alveolar and dental areas show the greatest differences among ethnic and racial groups.

Honoring Asian diversity by collecting Asian subpopulation data in health research.

Since 1993 guidelines issued by the US National Institutes of Health (NIH) have mandated the proportionate representation of patients by race and ethnic group in clinical research funded by the...

BackgroundIndividuals from diverse racial and ethnic groups are severely underrepresented in AD trials in part due to disproportionate biomarker ineligibility. Evidence from recent studies support plasma phosphorylated tau (P‐tau217) as an early marker for brain Aβ pathology and a reliable marker in predicting elevated brain amyloid PET in cognitively unimpaired adults. We examined the relationship between P‐tau217 and florbetapir PET standard uptake value ratios (SUVR) by self‐reported racial and ethnic groups in preclinical AD studies.MethodsWe examined the relationship between baseline florbeptair PET SUVR and plasma P‐tau217 levels (as determined by the electrochemiluminescence immunoassay), in cognitively unimpaired adults ages 65‐85 with elevated amyloid PET (A4 Study, placebo arm, N=522) and participants who did not display elevated amyloid but were otherwise eligible for the A4 Study (LEARN, N=471). Given the small numbers across each subpopulation, participants were grouped into racial and ethnic underrepresented groups (RE‐URG; N=100) and non‐RE‐URG (N=893), based on their self‐identified race and ethnicity. A linear regression model was fit to determine differences in the relationship between plasma P‐tau217 and florbetapir PET SUVR by RE‐URG status, adjusting for age, and APOE ϵ4 carrier status.ResultsDemographic characteristics of RE‐URG (N=100) and non‐URG (N=893) are displayed in the Table. Groups were balanced across, age, sex, and education, with a higher proportion of APOE ℇ4 carriers among non‐RE‐URG (38.8%) vs RE‐URG (24.0%). Mean plasma P‐tau217 levels were the same across groups (Table). Results from the linear regression model suggest that the relationship between P‐tau217 and florbetapir PET SUVR was similar across groups (p=0.22). Furthermore, APOE ℇ4 carrier status did not influence the relationship in either group (RE‐URG p=0.61; non‐RE‐URG p=0.09).ConclusionThese findings suggest that there is no difference in the relationship between plasma P‐tau217 and elevated amyloid on florbetapir PET across racial and ethnic groups. Future analyses should corroborate these findings in a larger sample size, across different RE‐URG sub‐populations and examine whether plasma P‐tau217 reflects the differential amyloid prevalence previously reported for other biomarkers of amyloid.Acknowledgment: Lilly Clinical Diagnostics Laboratory for the performance of P‐tau217 testing.

This study compared the prevalence and odds of mental health service utilization among people of Asian ancestry with lifetime DSM-IV mood, anxiety, alcohol, and drug use disorders with utilization by members of other racial and ethnic groups with similar disorders. Between 2001 and 2002, a total of 43,093 noninstitutionalized individuals were assessed by the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) study of lifetime prevalence of DSM-IV psychiatric disorders and mental health service utilization among various ethnic and racial groups. Among individuals with lifetime mood disorders, Asians had significantly lower mental health service utilization compared with whites (odds ratio [OR]=.31, 95% confidence interval [CI]=.21-.46), Hispanics (OR=.49, CI=.33-71), and Native Americans (OR=.27, CI=.15-.48) but similar utilization compared with blacks. There were no statistically significant differences in lifetime mental health service utilization for alcohol and drug use disorders among racial and ethnic groups. Asians with lifetime mood disorders underutilized mental health services even after adjustment was made for socioeconomic variables and years of residency in the United States. Future studies of culture-specific attitudes, correlates, and barriers to mental health service utilization are warranted.

BackgroundThere is a limited understanding of the impact of coronavirus disease 2019 (COVID-19) on the Latinx population. We hypothesized that Latinx patients would be more likely to be hospitalized and admitted to the intensive care unit (ICU) than White patients. MethodsWe analyzed all patients with COVID-19 in 12 Massachusetts hospitals between February 1 and April 14, 2020. We examined the association between race, ethnicity, age, reported comorbidities, and hospitalization and ICU admission using multivariable regression. ResultsOf 5190 COVID-19 patients, 29% were hospitalized; 33% required the ICU, and 4.3% died. Forty-six percent of patients were White, 25% Latinx, 14% African American, and 3% Asian American. Ethnicity and race were significantly associated with hospitalization. More Latinx and African American patients in the younger age groups were hospitalized than whites. Latinxs and African Americans disproportionally required the ICU, with 39% of hospitalized Latinx patients requiring the ICU compared with 33% of African Americans, 24% of Asian Americans, and 30% of Whites (P < .007). Within each ethnic and racial group, age and male gender were independently predictive of hospitalization. Previously reported preexisting comorbidities contributed to the need for hospitalization in all racial and ethnic groups (P < .05). However, the observed disparities were less likely related to reported comorbidities, with Latinx and African American patients being admitted at twice the rate of Whites, regardless of such comorbidities. ConclusionsLatinx and African American patients with COVID-19 have higher rates of hospitalization and ICU admission than White patients. The etiologies of such disparities are likely multifactorial and cannot be explained only by reported comorbidities.

Authors' Reply: Race and the Public Health Impact Potential of Pre-Exposure Prophylaxis in the United States.

Racial and ethnic minority groups disproportionately experience food insecurity. During the COVID-19 pandemic, the US enacted temporary food assistance policies, including emergency allotments for Supplemental Nutrition Assistance Program (SNAP) benefits. The effects of the pandemic and these policies on food insecurity by race and ethnicity are unclear. To examine prevalence trends in food insecurity by racial and ethnic groups and SNAP use before and during the pandemic. This cross-sectional survey study analyzed National Health Interview Survey data before (January 2019 to March 2020) and during the COVID-19 pandemic (April 2020 to December 2022). Participants were noninstitutionalized US adults (≥18 years) with low income (<200% federal poverty level). Statistical analysis was performed from September 25, 2023, to February 27, 2024. COVID-19 pandemic time period. Food insecurity was measured using the 10-item US Department of Agriculture Adult Food Security Survey module, categorizing participants as food secure (high or marginal food security) or insecure (low or very low food security). Survey-weighted Poisson regressions were modeled to examine changes in food insecurity prevalence over time by race and ethnicity (Asian, Black, Hispanic, and White) and by race and ethnicity and SNAP use (yes or no) including a 3-way interaction term (time × race and ethnicity × SNAP). Among 30 396 adults with low income, approximately one-half were female (56.0% [95% CI, 54.7%-57.2%] during the pre-COVID-19 time period; 57.4% [95% CI, 56.4%-58.4%] during the COVID-19 time period). Food insecurity prevalence decreased from 20.9% (95% CI, 19.9%-22.0%) before the COVID-19 pandemic to 18.8% (95% CI, 17.9%-19.7%) during the pandemic (P < .001). SNAP use prevalence increased overall (from 31.5% [95% CI, 30.1%-32.9%] to 36.0% [95% CI, 34.8%-37.3%]; P < .001) and for each racial and ethnic group. There were no significant differences in food insecurity changes over time by racial and ethnic group (Wald test F = 1.29; P = .28 for 2-way interaction). Among SNAP participants, food insecurity decreased for Asian, Hispanic, and White adults but did not change for Black adults; among non-SNAP participants, food insecurity did not change for Black, Hispanic, and White adults but increased for Asian adults (Wald test F = 4.43; P = .02 for 3-way interaction). During the COVID-19 pandemic, food insecurity decreased among SNAP participants in most racial and ethnic groups but did not decrease among non-SNAP participants in any group. These results suggest that during the pandemic, increased SNAP benefit amounts were associated with ameliorating food insecurity for many US adults who were able to access SNAP but did not reduce racial and ethnic disparities in food insecurity.

PurposeThis paper extends current propensity score weighting methods for causal inference to better understand disparities in healthcare access across multiple racial groups. By treating each racial group as a distinct entity (or “treatment”) in the causal inference framework, we can assess and evaluate heterogeneity in healthcare outcomes across various racial or ethnic categories. Furthermore, we leverage modern propensity score weighting techniques to address the challenges inherent to multiple group evaluations, such as violations of the positivity assumption, and compare the performance of different propensity score weights.MethodsWe use generalized propensity score methods to assess racial disparities across 4 specific racial or ethnic groups: Whites, Hispanics, Asians, and Blacks. We first calculate weights that standardize the participants’ characteristics and then compare their weighted outcomes. We consider four distinct measures (i.e., causal estimands) and estimation methods: the conventional average treatment effect on the treated (ATT), the ATT trimming, the ATT truncation, and the overlap weighted ATT (OWATT). These estimands are applied under a multi-valued “treatment” framework, where the said “treatment” is defined by non-manipulable racial or ethnic group memberships. Using data from the Medical Expenditure Panel Survey (MEPS), we assess disparities in healthcare expenditures across the 4 racial and ethnic groups.ResultsWe found significant disparities in healthcare expenditure between White participants and all the other racial or ethnic groups when using OWATT and ATT truncation. Conventional ATT and ATT trimming could indicate non-significant difference due to larger variance estimates. Moreover, the conventional ATT was found to be the least efficient estimation method, even when its variance was estimated via non-parametric bootstrapping. Overall, the OWATT emerges as a promising estimation method; it retains the available information from all samples, avoids subjectivity (inherent to choosing thresholds by its competitors) and mitigates judiciously pernicious inferential effects (such as the inflated variance estimates) by extreme propensity score weights.ConclusionWe found that generalized propensity score weighting (GPSW) methods are valuable quantitative tools to standardize and compare characteristics as well as outcomes of non-manipulable groups. This helps assess disparities across multiple racial and ethnic groups, as demonstrated in this study. These methods offer flexible and semi-parametric analysis on the primary causal parameters of interest (such as the racial disparities), with straightforward and intuitive interpretations. In addition, when there is violation of the positivity assumption, OWATT serves as an excellent alternative due to its greater efficiency, evidenced by relatively smaller variance. More importantly, the OWATT uses the entire dataset by assigning weights to all participants, regardless of their propensity score values. This feature of OWATT circumvents the need to specify user-defined thresholds, as required in ATT trimming or truncation, and retains as much data information as possible, leading to more reliable estimation results.

Long-standing systemic social, economic, and environmental inequities in the United States have put many communities of color (racial and ethnic minority groups) at increased risk for exposure to and infection with SARS-CoV-2, the virus that causes COVID-19, as well as more severe COVID-19-related outcomes (1-3). Because race and ethnicity are missing for a proportion of reported COVID-19 cases, counties with substantial missing information often are excluded from analyses of disparities (4). Thus, as a complement to these case-based analyses, population-based studies can help direct public health interventions. Using data from the 50 states and the District of Columbia (DC), CDC identified counties where five racial and ethnic minority groups (Hispanic or Latino [Hispanic], non-Hispanic Black or African American [Black], non-Hispanic Asian [Asian], non-Hispanic American Indian or Alaska Native [AI/AN], and non-Hispanic Native Hawaiian or other Pacific Islander [NH/PI]) might have experienced high COVID-19 impact during April 1-December 22, 2020. These counties had high 2-week COVID-19 incidences (>100 new cases per 100,000 persons in the total population) and percentages of persons in five racial and ethnic groups that were larger than the national percentages (denoted as "large"). During April 1-14, a total of 359 (11.4%) of 3,142 U.S. counties reported high COVID-19 incidence, including 28.7% of counties with large percentages of Asian persons and 27.9% of counties with large percentages of Black persons. During August 5-18, high COVID-19 incidence was reported by 2,034 (64.7%) counties, including 92.4% of counties with large percentages of Black persons and 74.5% of counties with large percentages of Hispanic persons. During December 9-22, high COVID-19 incidence was reported by 3,114 (99.1%) counties, including >95% of those with large percentages of persons in each of the five racial and ethnic minority groups. The findings of this population-based analysis complement those of case-based analyses. In jurisdictions with substantial missing race and ethnicity information, this method could be applied to smaller geographic areas, to identify communities of color that might be experiencing high potential COVID-19 impact. As areas with high rates of new infection change over time, public health efforts can be tailored to the needs of communities of color as the pandemic evolves and integrated with longer-term plans to improve health equity.

Background and Objectives: Clinical practice guidelines (CPGs) have significantly influenced medical practice worldwide. Nevertheless, the authorship of CPGs produced by several medical societies has not been representative of the field and population they address, as women and individuals from racial and ethnic minority groups have been underrepresented as authors. We hypothesized that women and individuals from minoritized racial and ethnic groups would also be underrepresented as authors of CPGs produced by the American Academy of Pediatrics (AAP). Methods: In this cross-sectional study, the gender, race, and ethnic composition of authors and subcommittee participants of AAP-produced CPGs published from January 2010 through May 2023 were analyzed and compared to the 2010 and 2021 U.S. population and 2010 and 2022 U.S. medical school pediatric faculty. Results: Women (39.7%, 127/320 of all positions, and 42.5%, 85/200 of named author positions) and women physicians (35.2%, 101/287 of all positions, and 36.4%, 64/176 of named author positions) were significantly underrepresented-while men and men physicians were significantly overrepresented-from their respective composition in the U.S. Census and pediatric faculty. Women and women physicians from all racial and ethnic groups and men and men physicians from minority racial and ethnic groups were significantly underrepresented-from their respective composition in the U.S. Census and pediatric faculty. No Black man was identified as an author. Conclusions: Medical societies that produce CPGs should be cognizant of these inequities and ensure appropriate authorship diversity.

Eating disorders are recognized to occur across ethnic and racial groups. The aim of the present review was to examine recent advances in the understanding of the development, presentation, and intervention approaches specific to eating disorders among ethnic and racial minority groups. An increasing number of measures have been found to be useful tools for assessing eating disorder risk and symptoms among ethnic and racial minority populations. In addition, further evidence has emerged supporting the relationship between higher levels of eating disorder symptoms and acculturation stress, as well as investment in appearance ideals. In contrast, the relationship between ethnic identity and eating disorder symptoms is less consistent, although several studies suggest that positive ethnic identity may be protective. Finally, increasing efforts have been made to develop and implement culturally sensitive interventions by tailoring evidence-supported treatments. Our understanding of and capacity to treat eating disorders among ethnic and racial minority groups continues to improve. However, further research is needed, particularly among neglected groups, such a smaller ethnic and racial groups, males, and intersecting minority statuses.