A Data Science Approach to Analyze the Association of Socioeconomic and Environmental Conditions With Disparities in Pediatric Surgery

Background: Scientific evidence confirm that significant racial disparities exist in healthcare, including surgery outcomes. However, the causal pathway underlying disparities at preoperative physical condition of children is not well-understood.Objectives: This research aims to uncover the role of socioeconomic and environmental factors in racial disparities at the preoperative physical condition of children through multidimensional integration of several data sources at the patient and population level.Methods: After the data integration process an unsupervised k-means algorithm on neighborhood quality metrics was developed to split 29 zip-codes from Memphis, TN into good and poor-quality neighborhoods.Results: An unadjusted comparison of African Americans and white children showed that the prevalence of poor preoperative condition is significantly higher among African Americans compared to whites. No statistically significant difference in surgery outcome was present when adjusted by surgical severity and neighborhood quality.Conclusions: The socioenvironmental factors affect the preoperative clinical condition of children and their surgical outcomes.

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Cranial crassicaudiasis in two coastal dolphin species from South Africa is predominantly a disease of immature individuals

Diseases of Aquatic Organisms ◽

10.3354/dao03468 ◽

2020 ◽

Vol 139 ◽

pp. 93-102 ◽

Cited By ~ 3

Author(s):

MF Van Bressem ◽

P Duignan ◽

JA Raga ◽

K Van Waerebeek ◽

N Fraijia-Fernández ◽

...

Keyword(s):

South Africa ◽

Bone Development ◽

Bottlenose Dolphins ◽

Fatal Outcome ◽

Population Level ◽

Cape Coast ◽

Osteolytic Lesions ◽

Immune Mediated ◽

Significant Difference ◽

The Difference

Crassicauda spp. (Nematoda) infest the cranial sinuses of several odontocetes, causing diagnostic trabecular osteolytic lesions. We examined skulls of 77 Indian Ocean humpback dolphins Sousa plumbea and 69 Indo-Pacific bottlenose dolphins Tursiops aduncus, caught in bather-protecting nets off KwaZulu-Natal (KZN) from 1970-2017, and skulls of 6 S. plumbea stranded along the southern Cape coast in South Africa from 1963-2002. Prevalence of cranial crassicaudiasis was evaluated according to sex and cranial maturity. Overall, prevalence in S. plumbea and T. aduncus taken off KZN was 13 and 31.9%, respectively. Parasitosis variably affected 1 or more cranial bones (frontal, pterygoid, maxillary and sphenoid). No significant difference was found by gender for either species, allowing sexes to be pooled. However, there was a significant difference in lesion prevalence by age, with immature T. aduncus 4.6 times more likely affected than adults, while for S. plumbea, the difference was 6.5-fold. As severe osteolytic lesions are unlikely to heal without trace, we propose that infection is more likely to have a fatal outcome for immature dolphins, possibly because of incomplete bone development, lower immune competence in clearing parasites or an over-exuberant inflammatory response in concert with parasitic enzymatic erosion. Cranial osteolysis was not observed in mature males (18 S. plumbea, 21 T. aduncus), suggesting potential cohort-linked immune-mediated resistance to infestation. Crassicauda spp. may play a role in the natural mortality of S. plumbea and T. aduncus, but the pathogenesis and population level impact remain unknown.

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Household and Population-Level Behavioural Changes Due to COVID-19 Pandemic: A Smart Thermostat Based Comparative Data Analysis

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care ◽

10.1177/2327857921101057 ◽

2021 ◽

Vol 10 (1) ◽

pp. 1-6

Author(s):

Kirti Sundar Sahu ◽

Arlene Oetomo ◽

Niloofar Jalali ◽

Plinio P. Morita

Keyword(s):

Data Analysis ◽

Population Level ◽

World Health ◽

Motion Sensors ◽

Household Level ◽

Work From Home ◽

Significant Difference ◽

Health Organization ◽

Smart Thermostat ◽

The Impact

The World Health Organization declared the coronavirus outbreak as a pandemic on March 11, 2020. To inhibit the spread of COVID-19, governments around the globe, including Canada, have implemented physical distancing and lockdown measures, including a work-from-home policy. Canada in 2020 has developed a 24-Hour Movement Guideline for all ages laying guidance on the ideal amount of physical activity, sedentary behaviour, and sleep (PASS) for an individual in a day. The purpose of this study was to investigate changes on the household and population-level in lifestyle behaviours (PASS) and time spent indoors at the household level, following the implementation of physical distancing protocols and stay-at-home guidelines. For this study, we used 2019 and 2020 data from ecobee, a Canadian smart Wi-Fi thermostat company, through the Donate Your Data (DYD) program. Using motion sensors data, we quantified the amount of sleep by using the absence of movement, and similarly, increased sensor activation to show a longer duration of household occupancy. The key findings of this study were; during the COVID-19 pandemic, overall household-level activity increased significantly compared to pre-pandemic times, there was no significant difference between household-level behaviours between weekdays and weekends during the pandemic, average sleep duration has not changed, but the pattern of sleep behaviour significantly changed, specifically, bedtime and wake up time delayed, indoor time spent has been increased and outdoor time significantly reduced. Our data analysis shows the feasibility of using big data to monitor the impact of the COVID-19 pandemic on the household and population-level behaviours and patterns of change.

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Efficacy of Benson’s Relaxation Technique on Anxiety and Depression among Patients Undergoing Hemodialysis: A Systematic Review

Clinical Nursing Research ◽

10.1177/10547738211024797 ◽

2021 ◽

pp. 105477382110247

Author(s):

Haya Ibrahim Ali Abu Maloh ◽

Kim Lam Soh ◽

Mohannad Eid AbuRuz ◽

Seng Choi Chong ◽

Siti Irma Fadhilah Ismail ◽

...

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Scientific Evidence ◽

Relaxation Technique ◽

Anxiety And Depression ◽

Controlled Trials ◽

Randomized Controlled ◽

Significant Difference ◽

Depression Level ◽

Ebsco Host

This study aimed to evaluate the efficacy of Benson’s relaxation technique on anxiety and depression among patients undergoing hemodialysis. A systematic review of randomized controlled trials was conducted. Searching databases included EBSCO Host, PubMed, ProQuest, Science Direct, Sage Journals, Ovid, and Google Scholar from January 2000 to September 2020. Five randomized controlled trials were identified. Findings revealed a statistically significant decrease in anxiety score. Concerning depression; one RCT showed a statistically significant decrease and two RCTs revealed a non-significant difference in depression level. The overall quality of the RCTs was not high. Despite that the RCTs showed benefits of BRT in managing anxiety. However, this is not the same for depression. The lack of high-quality scientific evidence supporting its retinue use indicates that additional well designed randomized controlled trials in multiple countries are warranted to support the efficacy of Benson’s relaxation technique on anxiety and depression among patients undergoing hemodialysis.

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Cataract surgery practice patterns worldwide: a survey

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2020-000464 ◽

2021 ◽

Vol 6 (1) ◽

pp. e000464

Author(s):

Tommaso Rossi ◽

Mario R Romano ◽

Danilo Iannetta ◽

Vito Romano ◽

Luca Gualdi ◽

...

Keyword(s):

Cataract Surgery ◽

Practice Patterns ◽

Scientific Evidence ◽

Public Hospitals ◽

P Value ◽

Evidence Based ◽

Surgical Volume ◽

Significant Difference ◽

Type Of Institution ◽

Surgical Setting

ObjectiveTo report the results of a global survey on cataract practice patterns related to preoperative, intraoperative and postoperative care, surgical setting and personnel allocation.Methods and analysisAn online 28 questions survey was sent to 240 ophthalmologists asking to describe prevailing trends in their institutions across 38 countries and 5 continents. Questions inquired country, institution, surgical volume and setting, anaesthesia, preoperative and intraoperative examination and postsurgical care. Statistical analysis used crosstabs lambda statistics for non-parametric nominal variables. P value less than 0.05 was considered statistically significant.Results209/240 (87%) ophthalmologists responded: 38% representing public hospitals, 36% private practices and 26% academic sites; overall surgical volume was between 241 700 and 410 500 cataracts per year. There was a significant correlation between type of institution and surgical volume. Complete results available in online (https://freeonlinesurveys.com/r/W6BcLLxy).ConclusionCataract surgery related patterns of perioperative care showed significant difference among respondents, regardless to type of institution, surgical volume and country. Many evidence-based procedures are unevenly practiced around the world and some widespread and expensive habits lack solid scientific evidence while consuming enormous amount of resources both monetary and human. There is a need to reach consensus and share evidence-based practice patterns.

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Transcriptomic analysis of atopic dermatitis in African Americans is characterized by Th2/Th17-centered cutaneous immune activation

Scientific Reports ◽

10.1038/s41598-021-90105-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Shannon Wongvibulsin ◽

Nishadh Sutaria ◽

Suraj Kannan ◽

Martin Prince Alphonse ◽

Micah Belzberg ◽

...

Keyword(s):

Atopic Dermatitis ◽

African Americans ◽

Immune Activation ◽

Population Level ◽

Research Network ◽

Variation Analysis ◽

Immune Signature ◽

Key Drivers ◽

Blood Eosinophils ◽

Level Analysis

AbstractAtopic dermatitis (AD) often presents more severely in African Americans (AAs) and with greater involvement of extensor areas. To investigate immune signatures of AD in AAs with moderate to severe pruritus, lesional and non-lesional punch biopsies were taken from AA patients along with age-, race-, and sex-matched controls. Histology of lesional skin showed psoriasiform dermatitis and spongiotic dermatitis, suggesting both Th2 and Th17 activity. Gene Set Variation Analysis showed upregulation of Th2 and Th17 pathways in both lesional versus non-lesional and lesional versus control (p < 0.01), while Th1 and Th22 upregulation were observed in lesional versus control (p < 0.05). Evidence for a broad immune signature also was supported by upregulated Th1 and Th22 pathways, and clinically may represent greater severity of AD in AA. Furthermore, population-level analysis of data from TriNetX, a global federated health research network, revealed that AA AD patients had higher values for CRP, ferritin, and blood eosinophils compared to age-, sex-, and race-matched controls as well as white AD patients, suggesting broad systemic inflammation. Therefore, AA AD patients may feature broader immune activation than previously thought and may derive benefit from systemic immunomodulating therapies that modulate key drivers of multiple immune pathways.

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Race and Networks in the Job Search Process

American Sociological Review ◽

10.1177/0003122419883255 ◽

2019 ◽

Vol 84 (6) ◽

pp. 983-1012 ◽

Cited By ~ 6

Author(s):

David S. Pedulla ◽

Devah Pager

Keyword(s):

Social Networks ◽

Labor Market ◽

African Americans ◽

Racial Disparities ◽

Job Search ◽

Search Process ◽

Job Seekers ◽

Employment Opportunities ◽

Black And White ◽

Job Offers

Racial disparities persist throughout the employment process, with African Americans experiencing significant barriers compared to whites. This article advances the understanding of racial labor market stratification by bringing new theoretical insights and original data to bear on the ways social networks shape racial disparities in employment opportunities. We develop and articulate two pathways through which networks may perpetuate racial inequality in the labor market: network access and network returns. In the first case, African American job seekers may receive fewer job leads through their social networks than white job seekers, limiting their access to employment opportunities. In the second case, black and white job seekers may utilize their social networks at similar rates, but their networks may differ in effectiveness. Our data, with detailed information about both job applications and job offers, provide the unique ability to adjudicate between these processes. We find evidence that black and white job seekers utilize their networks at similar rates, but network-based methods are less likely to lead to job offers for African Americans. We then theoretically develop and empirically test two mechanisms that may explain these differential returns: network placement and network mobilization. We conclude by discussing the implications of these findings for scholarship on racial stratification and social networks in the job search process.

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Goals-of-Care Consult and Future Costs, Acute Care and Hospice Use in Matched Cohorts of African Americans and Whites

Innovation in Aging ◽

10.1093/geroni/igaa057.1681 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 521-521

Author(s):

Lauren Starr ◽

Connie Ulrich ◽

Scott Appel ◽

Paul Junker ◽

Nina O’Connor ◽

...

Keyword(s):

African Americans ◽

End Of Life ◽

Acute Care ◽

Secondary Analysis ◽

Care Utilization ◽

Goals Of Care ◽

Palliative Care Consultation ◽

Significant Difference ◽

Hospice Use ◽

Care Costs

Abstract African Americans receive less hospice care and more aggressive end-of-life care than Whites. Little is known about how palliative care consultation to discuss goals-of-care (“PCC”) is associated with future acute care utilization and costs, or hospice use, by race. To compare future acute care costs and utilization and discharge to hospice between propensity-matched cohorts of African Americans with and without PCC, and Whites with and without PCC, we conducted a secondary analysis of 35,154 seriously-ill African American and White adults who had PCC at a high-acuity hospital and were discharged 2014-2016. We found no significant difference between African Americans with or without PCC in mean future acute care costs ($11,651 vs. $15,050, P=0.09), 30-day readmissions (P=0.58), future hospital days (P=0.34), future ICU admission (P=0.25), or future ICU days (P=0.30), but found greater discharge to hospice among African Americans with PCC (36.5% vs. 2.4%, P<0.0001). We found significant differences between Whites with PCC vs. without PCC in mean future acute care costs ($8,095 vs. $16,799, P<0.001), 30-day readmissions (10.2% vs. 16.7%, P<0.0001), future days hospitalized (3.7 vs. 6.3 days, P<0.0001), and discharge to hospice (42.7% vs. 3.0%, P<0.0001). Results suggest PCC decreases future acute care costs and utilization in Whites and, directionally but not significantly, in African Americans; and increases discharge to hospice in both races (15-fold in African Americans, 14-fold in Whites). Research is needed to understand how PCC supports end-of-life decision-making and hospice use across races and how systems and policies can enable effective goals-of-care consultations across settings.

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Pan cancer analysis of the intra-tumoral microbiome’s correlation with racial disparities.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.2519 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 2519-2519

Author(s):

Wei Tse Li ◽

Matthew Uzelac ◽

Jaideep Chakladar ◽

Lindsay M. Wong ◽

Aditi Gnanasekar ◽

...

Keyword(s):

Bladder Cancer ◽

African Americans ◽

Racial Disparities ◽

Racial Differences ◽

Asian Americans ◽

Environmental Influence ◽

Microbial Abundance ◽

Risk Of Death ◽

Incidence And Mortality ◽

Starting Point

2519 Background: Microbiome composition can influence cancer development and is moderated by diet, hygiene, sanitation, and other environmental variables. For example, a Mediterranean diet could increase breast Lactobacillus abundance, while the gut microbiome changes dramatically with fructose intake. Recent studies have revealed correlations between microbial abundance and racial disparities in cancer. Given these reports, it is critical to examine whether environmental influences on the microbiome contribute to racial disparities in cancer incidence and prognosis. Methods: We examined the intra-tumoral microbiome in the lungs, breasts, bladder, colon, rectum, cervix, head and neck, prostate, and pancreas (n = 4,169). Raw tumor RNA sequencing data were downloaded from The Cancer Genome Atlas (TCGA) and aligned to bacterial genomes. Microbial abundance was correlated to race, ethnicity, and prognostic variables (Kruskal-Wallis test or Cox regression, p< 0.05). Results: We identified several microbes correlated with racial disparities for breast and bladder cancer, two microbes for lung squamous cell carcinoma, and one microbe for colon cancer. For breast cancer, African Americans have the highest mortality rate, followed by white Americans and Asian Americans. We found that four microbes, all under the order Burkholderiales, were positively correlated with poor prognosis and were most abundant in African Americans and least abundant in Asian Americans. Therefore, increased abundance of these microbes may contribute to the observed mortality differences between races. For bladder cancer, Asian Americans have the lowest incidence and mortality rates. Seven microbes, including two Geobacillus, two Pseudomonas, and two Burkholderiales, positively correlate with good prognosis and are upregulated in Asian Americans. High Pseudomonas fluorescens abundance is positively correlated with decreased risk of death (HR: 0.57, 95% CI: 0.38-0.85). High abundance of the Burkholderiales R. pickettii (HR: 0.62, 95% CI: 0.42-0.92) and V. paradoxus (HR: 0.59, 95% CI: 0.36-0.98) also exhibit the same trend. Geobacillus and Pseudomonas are both present in food, while Burkholderiales can cause nosocomial infections and are altered by diet. Conclusions: Our study is the most comprehensive to date investigating racial differences in the intra-tumoral microbiome. Our data serve as a starting point for exploring whether environmental influence of microbial abundance contributes to racial disparities in cancer.

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African American Clergy Perspectives About the HIV Care Continuum: Results From a Qualitative Study in Jackson, Mississippi

Ethnicity & Disease ◽

10.18865/ed.28.2.85 ◽

2018 ◽

Vol 28 (2) ◽

pp. 85 ◽

Cited By ~ 4

Author(s):

Amy Nunn ◽

Sharon Parker ◽

Katryna McCoy ◽

Mauda Monger ◽

Melverta Bender ◽

...

Keyword(s):

African American ◽

African Americans ◽

Hiv Infection ◽

Racial Disparities ◽

Hiv Care ◽

Hiv Care Continuum ◽

Care Continuum ◽

Adherence To Medication ◽

African American Clergy ◽

American Clergy

Mississippi has some of the most pronounced racial disparities in HIV infection in the country; African Americans comprised 37% of the Mississippi population but represented 80% of new HIV cases in 2015. Improving outcomes along the HIV care continuum, including linking and retaining more individuals and enhancing adherence to medication, may reduce the disparities faced by African Americans in Mississippi. Little is understood about clergy’s views about the HIV care continuum. We assessed knowledge of African American pastors and ministers in Jackson, Mississippi about HIV and the HIV care continuum. We also assessed their willingness to promote HIV screening and biomedical prevention technologies as well as efforts to enhance linkage and retention in care with their congregations. Four focus groups were conducted with 19 African American clergy. Clergy noted pervasive stigma associated with HIV and believed they had a moral imperative to promote HIV awareness and testing; they provided recommendations on how to normalize conversations related to HIV testing and treatment. Overall, clergy were willing to promote and help assist with linking and retaining HIV positive individuals in care but knew little about how HIV treatment can enhance prevention or new biomedical technologies such as pre-exposure prophylaxis (PrEP). Clergy underscored the importance of building coalitions to promote a collective local response to the epidemic. The results of this study highlight important public health opportunities to engage African American clergy in the HIV care continuum in order to reduce racial disparities in HIV infection. Ethn Dis.2018; 28(2): 85-92; doi:10.18865/ed.28.2.85.

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