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Item BrainAGE Estimation: Influence of Field Strength, Voxel Size, Race, and Ethnicity(medRxiv, 2023-12-05) Dempsey, Desarae A.; Deardorff, Rachael; Wu, Yu-Chien; Yu, Meichen; Apostolova, Liana G.; Brosch, Jared; Clark, David G.; Farlow, Martin R.; Gao, Sujuan; Wang, Sophia; Saykin, Andrew J.; Risacher, Shannon L.; Alzheimer’s Disease Neuroimaging Initiative; Radiology and Imaging Sciences, School of MedicineThe BrainAGE method is used to estimate biological brain age using structural neuroimaging. However, the stability of the model across different scan parameters and races/ethnicities has not been thoroughly investigated. Estimated brain age was compared within- and across- MRI field strength and across voxel sizes. Estimated brain age gap (BAG) was compared across demographically matched groups of different self-reported races and ethnicities in ADNI and IMAS cohorts. Longitudinal ComBat was used to correct for potential scanner effects. The brain age method was stable within field strength, but less stable across different field strengths. The method was stable across voxel sizes. There was a significant difference in BAG between races, but not ethnicities. Correction procedures are suggested to eliminate variation across scanner field strength while maintaining accurate brain age estimation. Further studies are warranted to determine the factors contributing to racial differences in BAG.Item Correction: Symptomatic, clinical and biomarker associations for mortality in hospitalized COVID-19 patients enriched for African Americans(BMC, 2022-08-29) Ashktorab, Hassan; Pizuorno, Antonio; Adeleye, Folake; Laiyemo, Adeyinka; Dalivand, Maryam Mehdipour; Aduli, Farshad; Sherif, Zaki A.; Oskrochi, Gholamreza; Angesom, Kibreab; Oppong-Twene, Philip; Challa, Suryanarayana Reddy; Okorie, Nnaemeka; Moon, Esther S.; Romos, Edward; Jones-Wonni, Boubini; Kone, Abdoul Madjid; Rankine, Sheldon; Thrift, Camelita; Scholes, Derek; Ekwunazu, Chiamaka; Banson, Abigail; Mitchell, Brianna; Maskalo, Guttu; Ross, Jillian; Curtis, Julencia; Kim, Rachel; Gilliard, Chandler; Ahuja, Geeta; Mathew, Joseph; Gavin, Warren; Kara, Areeba; Hache-Marliere, Manuel; Palaiodimos, Leonidas; Mani, Vishnu R.; Kalabin, Aleksandr; Gayam, Vijay Reddy; Garlapati, Pavani Reddy; Miller, Joseph; Chirumamilla, Lakshmi Gayathri; Jackson, Fatimah; Carethers, John M.; Kamangar, Farin; Brim, Hassan; Medicine, School of MedicineCorrection to: BMC Infectious Diseases (2022) 22:552 https://doi.org/10.1186/s12879-022-07520-1Item Depressive Disorder Subtypes as Predictors of Incident Obesity in US Adults: Moderation by Race/Ethnicity(Oxford, 2017-05-01) Polanka, Brittanny M.; Vrany, Elizabeth A.; Patel, Jay; Stewart, Jesse C.; Psychology, School of ScienceWe compared the relative importance of atypical major depressive disorder (MDD), nonatypical MDD, and dysthymic disorder in predicting 3-year obesity incidence and change in body mass index and determined whether race/ethnicity moderated these relationships. We examined data from 17,787 initially nonobese adults in the National Epidemiologic Survey on Alcohol and Related Conditions waves 1 (2001-2002) and 2 (2004-2005) who were representative of the US population. Lifetime subtypes of depressive disorders were determined using a structured interview, and obesity outcomes were computed from self-reported height and weight. Atypical MDD (odds ratio (OR) = 1.68, 95% confidence interval (CI): 1.43, 1.97; P < 0.001) and dysthymic disorder (OR = 1.66, 95% CI: 1.29, 2.12; P < 0.001) were stronger predictors of incident obesity than were nonatypical MDD (OR = 1.11, 95% CI: 1.01, 1.22; P = 0.027) and no history of depressive disorder. Atypical MDD (B = 0.41 (standard error, 0.15); P = 0.007) was a stronger predictor of increases in body mass index than were dysthymic disorder (B = -0.31 (standard error, 0.21); P = 0.142), nonatypical MDD (B = 0.007 (standard error, 0.06); P = 0.911), and no history of depressive disorder. Race/ethnicity was a moderator; atypical MDD was a stronger predictor of incident obesity in Hispanics/Latinos (OR = 1.97, 95% CI: 1.73, 2.24; P < 0.001) than in non-Hispanic whites (OR = 1.54, 95% CI: 1.25, 1.91; P < 0.001) and blacks (OR = 1.72, 95% CI: 1.31, 2.26; P < 0.001). US adults with atypical MDD are at particularly high risk of weight gain and obesity, and Hispanics/Latinos may be especially vulnerable to the obesogenic consequences of depressions.Item Does Acculturation Matter? End-of-Life Care Planning and Preference of Foreign-born Older Immigrants in the United States(Oxford Academic, 2019-05-01) Grace Yi, Eun-Hye; School Of Social WorkAbstract Background and Objectives Advance care planning (ACP) is a critical component of health care affecting the quality of later life. Responding to the increase in the older immigrant population in the United States, this empirical study explored the racial/ethnic gaps in ACP behaviors among older immigrants and examined the end-of-life (EOL) care planning and preferences of foreign-born immigrant older adults focusing on race/ethnicity, acculturation, health need factors, and enabling social factors (financial capability, public assistance, and informal supports) after controlling predisposing factors (sociodemographic characteristics). Research Design and Methods Using a subsample from the National Health and Aging Trends Study 2011 and 2012, hierarchical logistic regression models of the EOL plan and preferences were examined with 50 multiple imputation data sets (n = 232). Results Descriptive statistics reveal lower ACP engagement of immigrants from racial/ethnic minority groups. In logistic models, however, only Black immigrants were less likely than Whites to have EOL conversations. Among acculturation factors, age at immigration was only negatively associated with having a durable power of attorney for health, but not significantly associated with other ACP behaviors. Instead, health and social factors, primarily need in health and informal support (i.e., number of coresidents and receiving financial help from family members), were associated with different types of ACP components. Receiving public assistance (i.e., receiving Medicaid and SSI) were positively associated with EOL treatment preferences. Discussion and Implications Older foreign-born immigrants, in general, showed lower ACP engagement than the overall older population. Moreover, minority immigrants were lower on ACP engagement than both White immigrants. This study highlights the need for formal and informal assistance for enhancing EOL planning for older immigrants. Adding to the culturally competent approach, policy efforts should address social and health factors that accrued throughout individuals’ life spans and affect older immigrants’ EOL preparation and care.Item Graduation and Academic Placement of Underrepresented Racial/Ethnic Minority Doctoral Recipients in Public Health Disciplines, United States, 2003-2015(SAGE Publications, 2018-11-30) Jackson, Joanna R.; Holmes, Ann M.; Golembiewski, Elizabeth; Brown-Podgorski, Brittany L.; Menachemi, Nir; Health Policy and Management, School of Public HealthObjectives: Given public health’s emphasis on health disparities in underrepresented racial/ethnic minority communities, having a racially and ethnically diverse faculty is important to ensure adequate public health training. We examined trends in the number of underrepresented racial/ethnic minority (ie, non-Hispanic black, Hispanic, American Indian/Alaska Native, Native Hawaiian, and Pacific Islander) doctoral graduates from public health fields and determined the proportion of persons from underrepresented racial/ethnic minority groups who entered academia. Methods: We analyzed repeated cross-sectional data from restricted files collected by the National Science Foundation on doctoral graduates from US institutions during 2003-2015. Our dependent variables were the number of all underrepresented racial/ethnic minority public health doctoral recipients and underrepresented racial/ethnic minority graduates who had accepted academic positions. Using logistic regression models and adjusted odds ratios (aORs), we examined correlates of these variables over time, controlling for all independent variables (eg, gender, age, relationship status, number of dependents). Results: The percentage of underrepresented racial/ethnic minority doctoral graduates increased from 15.4% (91 of 592) in 2003 to 23.4% (296 of 1264) in 2015, with the largest increase occurring among black graduates (from 6.6% in 2003 to 14.1% in 2015). Black graduates (310 of 1241, 25.0%) were significantly less likely than white graduates (2258 of 5913, 38.2%) and, frequently, less likely than graduates from other underrepresented racial/ethnic minority groups to indicate having accepted an academic position (all P < .001). Conclusions: Stakeholders should consider targeted programs to increase the number of racial/ethnic minority faculty members in academic public health fields.Item Impact of Body Mass Index on Prognosis for Breast Cancer Patients(JScholar, 2017) Tan, Fei; Xiao, Hong; Gummadi, Sriharsha; Koniaris, Leonidas G; Feldman, Jason David; Ali, Ayalew; Adunlin, George; Huang, Youjie; Mathematical Sciences, School of ScienceThis study investigates the impact of body mass index (BMI) on the prognosis for patients with breast cancer within the context of race (African-American versus Caucasian) and ethnicity (Hispanic versus Non-Hispanic). Overall, this study included 1,368 female breast cancer patients diagnosed between 2007 and 2010 with electronic medical record data accrued from a large Florida hospital network. Non-Hispanic black patients comprised 8.77% of the cohort and Hispanic patients made up 7.56%. Multivariate analysis revealed that breast cancer death rate was increased over 2.6-fold for underweight patients ubiquitously, regardless of race or ethnicity. Patients overweight or obese did not have an increased hazard rate compared to those of normal weight. Importantly, the mechanism for the poorer prognosis for underweight patients needs to be defined. We suggest the use of a low BMI as a high-risk factor for breast-cancer mortality in all racial and ethnic populations.Item Race/Ethnicity, and Behavioral Health Status: First Arrest and Outcomes in a Large Sample of Juvenile Offenders(Springer Nature, 2018-04) Lau, Katherine S.L.; Rosenman, Marc B.; Wiehe, Sarah E.; Tu, Wanzhu; Aalsma, Matthew C.; Pediatrics, School of MedicineThe objective of this study was to assess the simultaneous effects of gender, race/ethnicity, and pre-arrest behavioral health (BH) service-use on age at first arrest, and first arrest outcomes. Between January 2004 and December 2011, arrest and medical records were collected on a retrospective longitudinal cohort of 12,476 first-time offenders, ages 8-18 years. Black youth were arrested at younger ages than white or Hispanic youth. Youth with psychiatric problems were arrested at younger ages than youth with substance-use, dual-diagnoses, or no BH problems. Compared to white males, black males had lower odds of detention and BH referrals. Compared to white females, black females had higher odds of release and lower odds of probation, detention, and BH referrals. A significant gender-by-BH problem interaction revealed males and females with previous psychiatric problems were arrested at younger ages than youth with substance, dual-diagnosis, or no prior problems. Implications are discussed.Item Racial-Ethnic Differences in Health-Related Quality of Life among Adults and Children with Glomerular Disease(Karger, 2021) Krissberg, Jill R.; Helmuth, Margaret E.; Almaani, Salem; Cai, Yi; Cattran, Daniel; Chatterjee, Debanjana; Gbadegesin, Rasheed A.; Gibson, Keisha L.; Glenn, Dorey A.; Greenbaum, Laurence A.; Iragorri, Sandra; Jain, Koyal; Khalid, Myda; Kidd, Jason M.; Kopp, Jeffrey B.; Lafayette, Richard; Nestor, Jordan G.; Parekh, Rulan S.; Reidy, Kimberly J.; Selewski, David T.; Sperati, C. John; Tuttle, Katherine R.; Twombley, Katherine; Vasylyeva, Tetyana L.; Weaver, Donald Jack; Wenderfer, Scott E.; O’Shaughnessy, Michelle M.; Pediatrics, School of MedicineIntroduction: Disparities in health-related quality of life (HRQOL) have been inadequately studied in patients with glomerular disease. The aim of this study was to identify relationships between race/ethnicity, socioeconomic status, disease severity, and HRQOL in an ethnically and racially diverse cohort of patients with glomerular disease. Methods: Cure Glomerulonephropathy (CureGN) is a multinational cohort study of patients with biopsy-proven glomerular disease. Associations between race/ethnicity and HRQOL were determined by the following: 1. Missed school or work due to kidney disease; 2. Responses to Patient Reported Outcomes Measurement Information System (PROMIS) questionnaires. We adjusted for demographics, socioeconomic status, and disease characteristics using multivariable logistic and linear regression. Results: Black and Hispanic participants had worse socioeconomic status and more severe glomerular disease than White or Asian participants. Black adults missed work or school most frequently due to kidney disease (30% versus 16-23% in the other three groups, p=0.04), and had the worst self-reported global physical health (median score 44.1 versus 48.0-48.2, p<0.001) and fatigue (53.8 versus 48.5-51.1, p=0.002), compared to other racial/ethnic groups. However, these findings were not statistically significant with adjustment for socioeconomic status and disease severity, both of which were strongly associated with HRQOL in adults. Among children, disease severity but not race/ethnicity or socioeconomic status were associated with HRQOL. Conclusions: Among patients with glomerular disease enrolled in CureGN, the worse HRQOL reported by Black adults was attributable to lower socioeconomic status and more severe glomerular disease. No racial/ethnic differences in HRQOL were observed in children.Item Relation of Atrial Fibrillation to Cognitive Decline (from the REasons for Geographic and Racial Differences in Stroke [REGARDS] Study)(Elsevier, 2021) Bailey, Margie J.; Soliman, Elsayed Z.; McClure, Leslie A.; Howard, George; Howard, Virginia J.; Judd, Suzanne E.; Unverzagt, Fred; Wadley, Virginia; Sachs, Bonnie C.; Hughes, Timothy M.; Psychiatry, School of MedicineThe association of atrial fibrillation (AF) with cognitive function remains unclear, especially among racially/geographically diverse populations. This analysis included 25,980 black and white adults, aged 48+, from the national REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, free from cognitive impairment and stroke at baseline. Baseline AF was identified by self-reported medical history or electrocardiogram (ECG). Cognitive testing was conducted yearly with the Six Item Screener (SIS) to define impairment and at 2-year intervals to assess decline on: animal naming and letter fluency, Montreal Cognitive Assessment (MoCA), Word List Learning (WLL) and Delayed Recall tasks (WLD). Multivariable regression models estimated the relationships between AF and baseline impairment and time to cognitive impairment. Models were adjusted sequentially for age, sex, race, geographic region, and education, then cardiovascular risk factors and finally incident stroke. AF was present in 2,168 (8.3%) participants at baseline. AF was associated with poorer baseline performance on measures of: semantic fluency (p<0.01); global cognitive performance (MoCA, p<0.01); and WLD (p<0.01). During a mean follow-up of 8.06 years, steeper declines in list learning were observed among participants with AF (p<0.03) which remained significant after adjusting for cardiovascular risk factors (p<0.04) and incident stroke (p<0.03). Effect modification by race, sex and incident stroke on AF and cognitive decline were also detected. In conclusion, AF was associated with poorer baseline cognitive performance across multiple domains and incident cognitive impairment in this bi-racial cohort. Additional adjustment for cardiovascular risk factors attenuated these relations with the exception of learning.