Diurnal Cortisol Slope and Nighttime Blood Pressure: A Study in European Americans and African Americans

Objectives: African Americans (AAs) have higher nighttime blood pressure (BP) than European Americans (EAs). Stress has been suggested to play a role in this difference, but the mechanism is not well-understood. Flatter diurnal cortisol slope (DCS) is a well-known biological marker of stress. The objectives of this study were to: 1) examine ethnic differences in DCS; 2) evaluate the association between DCS and nighttime BP; and 3) determine the extent to which ethnic differences in nighttime BP can be explained by ethnic differences in DCS.Methods: A total of 510 participants (age range: 14-35 years; 49.6% AAs, 54.5% females) provided four salivary cortisol samples at bedtime, wakeup, 30-minutes post-wakeup, and 60-minutes post-wakeup. Additionally, participants wore an ambula­tory BP monitor for 24 hours. DCS was cal­culated as the average of the three morning samples minus the bedtime measurement.Results: After adjustment for age, sex, BMI, and smoking, AAs had blunted DCS (P=.018) and higher nighttime systolic BP (SBP) and diastolic BP (DBP) (Ps<.001) compared with EAs. The DCS was inversely related to nighttime SBP and this relation­ship did not depend on ethnicity. The ethnic difference of nighttime SBP was significantly attenuated upon addition of DCS to the model. Mediation test showed that 9.5% of ethnic difference in nighttime SBP could be explained by DCS (P=.039).Conclusion: This study confirms ethnic differences in DCS and nighttime BP and further demonstrates that the ethnic differ­ences in DCS can, at least partially, explain the ethnic differences found in night­time BP. Ethn Dis. 2021;31(4):481-488; doi:10.18865/ed.31.4.481

Hmong (Forever) on the Margins

Ethnic minorities in Laos form a key part of narratives of the Lao population as the ‘Lao multi-ethnic people’. This involves the creation and clear delineation of ethnic difference in which ethnic difference is celebrated within a framework of lowland Lao hegemony. With specific reference to the Hmong, I argue that the Hmong can never really escape assumptions from the lowland Lao that, were they able to choose, that they would choose to live in an independent state. By making use of Scott’s ideas of Zomia I argue further that the idea of Zomia as an alternative to living in the Lao state may exist in the minds of some Hmong, an idea widely assumed by the Lao state and many lowland Lao to be held by all Hmong. Ethnic minorities continue to have an ambiguous relationship vis-à-vis the Lao state to which they belong, but at the same time, are considered outsiders.

Angiotensin–Converting Enzyme (ACE) 1 Gene Polymorphism and Phenotypic Expression of COVID-19 Symptoms

The renin–angiotensin–aldosterone system (RAAS) appears to play an important role in SARS-CoV-2 infection. Polymorphisms within the genes that control this enzymatic system are candidates for elucidating the pathogenesis of COVID-19, since COVID-19 is not only a pulmonary disease but also affects many organs and systems throughout the body in multiple ways. Most striking is the fact that ACE2, one of the major components of the RAAS, is a prerequisite for SARS-COV-2 infection. Recently, we and other groups reported an association between a polymorphism of the ACE1 gene (a homolog of ACE2) and the phenotypic expression of COVID-19, particularly in its severity. The ethnic difference in ACE1 insertion (I)/deletion (D) polymorphism seems to explain the apparent difference in mortality between the West and East Asia. The purpose of this review was to further evaluate the evidence linking ACE1 polymorphisms to COVID-19. We searched the Medline database (2019–2021) for reference citations of relevant articles and selected studies on the clinical outcome of COVID-19 related to ACE1 I/D polymorphism. Although the numbers of patients are not large enough yet, most available evidence supports the notion that the DD genotype adversely influences COVID-19 symptoms. Surprisingly, small studies conducted in several countries yielded opposite results, suggesting that the ACE1 II genotype is a risk factor. This contradictory result may be the case in certain geographic areas, especially in subgroups of patients. It may also be due to interactions with other genes or to yet unexplained biochemical mechanisms. According to our hypothesis, such candidates are genes that are functionally involved in the pathophysiology of COVID-19, can act in concert with the ACE1 DD genotype, and that show differences in their frequency between the West and East Asia. For this, we conducted research focusing on Alu-related genes. The current study on the ACE1 genotype will provide potentially new clues to the pathogenesis, treatment, and diagnosis of SARS-CoV-2 infections.

String of Relationship in the Sky of Multiculturalism: A Reading of Khaled Hosseini’s The Kite Runner

This paper proposes how the relationship that exists between different characters in his novels is experimented in diverse conditions and the characters are tested and tried to discover their unique paths of assimilation with their loved ones to the completion of their circle. Despite the spatial differences, each character is connected with a string of bond which portrays the ‘similarity’ of difference, yet humanity in need of understanding. The physical space and emotional space of Baba’s beautiful house in the Wazir Akbar Khan district is contrasted with the shack of Hassan and Ali breaks the dichotomy of contentment and dissatisfaction. Simultaneously with the diversity of multiculturalism it creates fantasies of escape from ideological and cultural divisions altogether. Interconnected relationship and affections blur the ethnic, social, geographical and economic variances in individual.The characters all experience a personal journey for love in their own way through their words and actions. The genetic ties to the geographies of privilege, ethnic difference and social status often challenged through the personal affinity. Troubled relationship like Baba and Amir, or an enigmatic friendship like Amir and Hassan or passive bond like Ali and Hassan or even a romantic relationship like Amir and Soraya are circulating the web of ontology. Relationship, assimilation and struggle of people cross path with desperate societies resulting a relief from haunting memories. The longing for love and to be loved draw the characters to find the web of their completeness and ultimately that give them the strength to fight back with their vulnerabilities , surpass their limitations, and eventually to purify their guilt through overwhelming acts of self-sacrifice.

Multiple Chronic Conditions Explain Ethnic Differences in Functional Outcome Among Patients With Ischemic Stroke

Background and Purpose: Mexican Americans (MAs) have worse stroke outcomes and a different profile of multiple chronic conditions (MCC) compared with non-Hispanic White people. MCC has implications for stroke treatment, complications, and poststroke care, which impact poststroke functional outcome (FO). We sought to assess the contribution of MCC to the ethnic difference in FO at 90 days between MAs and non-Hispanic White people. Methods: In a prospective cohort of ischemic stroke patients (2008–2016) from Nueces County, Texas, data were collected from patient interviews, medical records, and hospital discharge data. MCC was assessed using a stroke-specific and function-relevant index (range, 0–35; higher scores greater MCC burden). Poststroke FO was measured by an average score of 22 activities of daily living (ADLs) and instrumental ADLs at 90 days (range, 1–4; higher scores worse FO). The contribution of MCC to the ethnic difference in FO was assessed using Tobit regression. Effect modification by ethnicity was examined. Results: Among the 896 patients, 70% were MA and 51% were women. Mean age was 68±12.2 years; 33% of patients were dependent in ADL/instrumental ADLs (FO score >3, representing a lot of difficulty with ADL/instrumental ADLs) at 90 days. MAs had significantly higher age-adjusted MCC burden compared with non-Hispanic White people. Patients with high MCC score (at the 75th percentile) on average scored 0.70 points higher in the FO score (indicating worse FO) compared with those with low MCC score (at the 25th percentile) after adjusting for age, initial National Institutes of Health Stroke Scale, and sociodemographic factors. MCC explained 19% of the ethnic difference in FO, while effect modification by ethnicity was not statistically significant. Conclusions: MAs had a higher age-adjusted MCC burden, which partially explained the ethnic difference in FO. The prevention and treatment of MCC could potentially mitigate poststroke functional impairment and lessen ethnic disparities in stroke outcomes.

"Spiritually seeking the Maya"

This article is a theoretical essay that offers an approach to the study of new age spiritual seeking in general and to the study of New Age Maya spiritualism in particular. The theoretical framework of “spiritual seeking” and “cultic milieu” has been productive, especially regarding the relationship between emergent spiritual technologies of subjectivity, forms of modernity, and capitalist logics of consumerism. This article, however, identifies shortcomings to this research paradigm: It does not provide either the analytical focus or conceptual tools for understanding seeking spirituality through the alterity of other cultures and communities marked by racial-ethnic difference. This article explains the contradictory and confusing use of Maya and Mayan as a point of entry to illustrate the need to attend to transcultural processes and the politics of transculturation. By drawing from established work in the sociology of religion on cult typologies, I offer criteria by which to create an analytical ideal types framework that can both begin to address questions of politics, transcultural exchange, and seeking/community dynamics as well as allow for productive comparison and contrast of different emergent spiritualities and religiosities in the Americas and elsewhere. The first steps toward developing this ideal-types framework is presented by thinking through issues in establishing new age Maya spiritual seeking as objects of study.

Ethnic Differences in Serum Levels of microRNAs Potentially Regulating Alcohol Dehydrogenase 1B and Aldehyde Dehydrogenase 2

Ethnic difference is known in genetic polymorphisms of aldehyde dehydrogenase 2 (ALDH2) and alcohol dehydrogenase 1B (ADH1B), which cause Asian flushing by blood vessel dilation due to accumulation of acetaldehyde. We investigated ethnic differences in microRNAs (miRNAs) related to ALDH2 and ADH1B. miRNA levels in serum were totally analyzed by using miRNA oligo chip arrays and compared in Austrian and Japanese middle-aged men. There were no ALDH2- and ADH1B-related miRNAs that had previously been reported in humans and that showed significantly different serum levels between Austrian and Japanese men. With the use of miRNA prediction tools, we identified four and five miRNAs that were predicted to target ALDH2 and ADH1B, respectively, and they had expression levels high enough for comparison. Among the ADH1B-related miRNAs, miR-150-3p, -3127-5p and -4314 were significantly higher and miR-3151-5p was significantly lower in Austrian compared with Japanese men, while no significant difference was found for miR-449b-3p. miR-150-3p and miR-4314 showed relatively high fold changes (1.5 or higher). The levels of ALDH2-related miRNAs (miR-30d-5p, -6127, -6130 and -6133) were not significantly different between the countries. miR-150-3p and miR-4314 are candidates of miRNAs that may be involved in the ethnic difference in sensitivity to alcohol through modifying the expression of ADH1B.