Craniofacial anthropometric norms of Malaysian Indians

Objective: This study was done to establish the craniofacial anthropometric norms of the young adult (18-25 years) Malaysian Indian. Materials and Methods: The study group consisted of convenient samples of 100 healthy volunteers, with equal number of female and male subjects who had no history of mixed racial-parentage. Twenty-two linear measurements were taken twice from 28 landmarks over six craniofacial regions. The methodology and evaluation of indices of the craniofacial region was adapted from Hajnis et al. Results: The minimum measurements are always contributed by the female Indian except for the nose height (n-sn), (left) eye fissure length (ex-en), upper vermillion height (ls-sto), and lower vermillion height (sto-li). There is a gender difference in all the measurements except the (left) eye fissure height (independent t-test; P {\ensuremath{<}} 0.05). The Malaysian Indians exhibit some North American White Caucasian (NAWC) features in all regions. The cephalic index indicates a brachycephalic or relatively short wide head with a tendency towards mesocephaly. From the low nasal index, the Malaysian Indian female have a nose that is narrow or leptorrhin similar to the NAWCs. The lower value of the upper lip height to mouth width index in the Indian female indicates a relatively shorter upper lip height compared to the mouth width, also similar to the NAWC. Conclusion: This study establishes the craniofacial anthropometric norms of the Malaysian Indian over 22 parameters. Male in general has a significantly higher measurement than female. The Malaysian Indians do exhibit some NAWC features

Hegemonic knowledge structures in MeSH: implications for medical librarianship

Objective Controlled vocabularies are necessary for clinical research and clinical practice. When medical librarians use the same language to describe the same phenomena, scientific knowledge advances and best practices can be developed. MeSH is never objective. These headings always reflect some ways of understanding the world and exclude others. This project attempts to understand how bias is embedded in the controlled terms that structure medical knowledge and implications for medical librarians. Methods The project team analyzes exemplar headings related to race and ethnicity and gender and sexuality to understand and reflect on the problem of hegemonic knowledge structures in MeSH. Results Race and ethnicity MeSH terms are found under “Ethnic Groups” and “Continental Population Groups”. Clinical and public health research has used predefined population labels, particularly those defined by the Office of Management and Budget. However, MeSH terms do not precisely match these categories. Additionally, the absence of terms for 1) European Americans as an ethnic group and 2) Middle Eastern as a continental population group reflect normative and othering structures. “Gender and Sexual Minorities” is the official MeSH term used as an umbrella phrase to describe research on queer, gay, trans and other people from the LGBTQI community. This term presents a misleading representation of gender and sexuality. The terms included under “Gender and Sexual Minorities” include “dissident, sexuality” and “non-heterosexuals” which makes heterosexuality appear to be the default in medical research and reflects an inherent bias. There are numerous examples of misleading, biased, and discriminatory MeSH language for trans, intersex, gay, and queer people. Conclusions Adding relevant headings and improving automatic term mapping could increase the findability of health disparities/health inequities research, enabling evidence syntheses and identification of gaps in the research

Integrative genomic analysis identifies ancestry-related expression quantitative trait loci on DNA polymerase β and supports the association of genetic ancestry with survival disparities in head and neck squamous cell carcinoma

BACKGROUND: African Americans with head and neck squamous cell carcinoma (HNSCC) have a lower survival rate than whites. This study investigated the functional importance of ancestry-informative single-nucleotide polymorphisms (SNPs) in HNSCC and also examined the effect of functionally important genetic elements on racial disparities in HNSCC survival. METHODS: Ancestry-informative SNPs, RNA sequencing, methylation, and copy number variation data for 316 oral cavity and laryngeal cancer patients were analyzed across 178 DNA repair genes. The results of expression quantitative trait locus (eQTL) analyses were also replicated with a Gene Expression Omnibus (GEO) data set. The effects of eQTLs on overall survival (OS) and disease-free survival (DFS) were evaluated. RESULTS: Five ancestry-related SNPs were identified as cis-eQTLs in the DNA polymerase β (POLB) gene (false discovery rate [FDR] &lt; 0.01). The homozygous/heterozygous genotypes containing the African allele showed higher POLB expression than the homozygous white allele genotype (P &lt; .001). A replication study using a GEO data set validated all 5 eQTLs and also showed a statistically significant difference in POLB expression based on genetic ancestry (P = .002). An association was observed between these eQTLs and OS (P &lt; .037; FDR &lt; 0.0363) as well as DFS (P = .018 to .0629; FDR &lt; 0.079) for oral cavity and laryngeal cancer patients treated with platinum-based chemotherapy and/or radiotherapy. Genotypes containing the African allele were associated with poor OS/DFS in comparison with homozygous genotypes harboring the white allele. CONCLUSIONS: Analyses show that ancestry-related alleles could act as eQTLs in HNSCC and support the association of ancestry-related genetic factors with survival disparities in patients diagnosed with oral cavity and laryngeal cancer. Cancer 2017;123:849-60. © 2016 American Cancer Society

Fatty acid profile in peri-prostatic adipose tissue and prostate cancer aggressiveness in African-Caribbean and Caucasian patients

BACKGROUND: Genetic and nutritional factors have been linked to the risk of aggressive prostate cancer (PCa). The fatty acid (FA) composition of peri-prostatic adipose tissue (PPAT), which reflects the past FA intake, is potentially involved in PCa progression. We analysed the FA composition of PPAT, in correlation with the ethno-geographical origin of the patients and markers of tumour aggressiveness. METHODS: From a cohort of 1000 men treated for PCa by radical prostatectomy, FA composition of PPAT was analysed in 156 patients (106 Caucasians and 50 African-Caribbeans), 78 with an indolent tumour (ISUP group 1 + pT2 + PSA &lt;10 ng/mL) and 78 with an aggressive tumour (ISUP group 4-5 + pT3). The effect of FA extracted from PPAT on in-vitro migration of PCa cells DU145 was studied in 72 patients, 36 Caucasians, and 36 African-Caribbeans. RESULTS: FA composition differed according to the ethno-geographical origin. Linoleic acid, an essential n-6 FA, was 2-fold higher in African-Caribbeans compared with Caucasian patients, regardless of disease aggressiveness. In African-Caribbeans, the FA profile associated with PCa aggressiveness was characterised by low level of linoleic acid along with high levels of saturates. In Caucasians, a weak and negative association was observed between eicosapentaenoic acid level (an n-3 FA) and disease aggressiveness. In-vitro migration of PCa cells using PPAT from African-Caribbean patients was associated with lower content of linoleic acid. CONCLUSION: These results highlight an important ethno-geographical variation of PPAT, in both their FA content and association with tumour aggressiveness

Manchas Mongólicas Múltiplas e Sobrepostas numa Criança Caucasiana

Mongolian spots are common birthmarks in newborns and their incidence and prevalence vary considerably between races, being the lowest in caucasian infants. Although traditionally regarded as benign, some reports suggested that extensive and multiple mongolian spots at aberrant locations and persistent beyond early childhood may co-exist with inborn errors of metabolism. However, this association is not well established. Besides, very few cases in literature reported a particular type of superimposed mongolian spots, whose physiopathological mechanism and clinical significance are unknown. We report a case of a 7-months-old caucasian male infant with multiple, extensive and progressive mongolian spots and also a superimposed mongolian spot located on the right hip.A mancha mongólica é uma forma de melanose dérmica comum em recém- nascidos, tendo uma incidência e prevalência variável consoante a raça, sendo menos frequente em crianças caucasianas. Apesar de tradicionalmente interpretadas como benignas, várias publicações têm vindo a sugerir que manchas mongólicas extensas, múltiplas, presentes em locais atípicos e persistentes ao longo da primeira infância podem estar associadas a algumas doenças metabólicas. Contudo, esta associação não está ainda bem esclarecida. Por outro lado, casos pontuais reportados na literatura têm descrito um tipo particular de mancha mongólica sobreposta a outra de pigmentação diferente, não sendo conhecido o mecanismo fisiopatológico e a relevância clínica deste achado. Os autores reportam o caso de um rapaz caucasiano com 7 meses de idade com manchas mongólicas múltiplas, extensas, de agravamento progressivo nos primeiros meses de vida, uma das quais mais pigmentada sobreposta a outra, localizada na anca direita

Prognosis of angina and myocardial infarction in South Asian and white populations in the United Kingdom

Background: Coronary mortality rates amongst South Asian populations are higher than in White populations in the UK. The contribution of incidence and prognosis of coronary disease to the higher coronary mortality rates amongst South Asian populations is unknown. Incident coronary disease commonly presents as angina and non-fatal myocardial infarction rather than as fatal events. Aim: This thesis sought to investigate the incidence and prognosis of differing clinical presentations of coronary disease such as angina and myocardial infarction in South Asian compared to White populations in the UK. Methods: Four new prospective studies, one aetiologic (South Asian N=580 initially healthy) and three prognostic (N=2189 with suspected new-onset stable angina, N=502 undergoing coronary angiography and N=3037 with acute coronary syndromes) were examined, using multi-variate regression analyses. A systematic review and meta-analysis of these and previously published studies was performed. Results: • Incidence of angina was higher in South Asian than in White people in a healthy population, and angina was similarly valid in predicting a poor prognosis in both ethnic groups compared to those with no chest pain. • In those with chronic angina, South Asian patients did not have a higher future risk of myocardial infarction and death than White patients, but had a worse symptomatic prognosis following coronary revascularisation when compared to White patients. • South Asian patients had no worse a prognosis for mortality than White patients after myocardial infarction • On meta-analysis, incidence of fatal and non-fatal coronary disease was higher in South Asian populations compared to White populations whilst prognosis of coronary disease in South Asian populations was not worse than in White populations. Conclusions: Increased coronary mortality rates in South Asian populations compared to the White populations are due to the higher incidence of fatal and non-fatal coronary disease in South Asian people, as the prognosis of manifest coronary disease in South Asian people is not worse than in White people

Racial Differences in Surgeons and Hospitals for Endometrial Cancer Treatment

PURPOSE: To determine whether (1) black and white women with endometrial cancer were treated by different surgical specialties and in different types of hospitals and (2) differences in specialty and hospital type contributed to racial differences in survival. METHODS: Retrospective cohort study of 12,307 women aged 65 years and older who underwent surgical treatment of endometrial cancer between 1991 and 1999 in the 11 Surveillance Epidemiology and End Results registries. RESULTS: Black women were more likely to have a gynecologic oncologist to perform their surgery and to be treated at hospitals that were higher volume, larger, teaching, National Cancer Institute centers, urban, and where a greater proportion of the surgeries were performed by a gynecologic oncologist. In unadjusted models, black women were over twice as likely as white women who died because of cancer (hazards ratio [HR]: 2.33), but nearly all of the initial racial difference in survival was explained by differences in cancer stage, and grade as well as age and comorbidities at presentation (adjusted HR: 1.10). Surgical specialty was not associated with survival and, of the hospital characteristics studied, only surgical volume was associated with survival (P \u3c 0.005). Adjusting for hospital characteristics did not change the racial difference in survival (HR: 1.10). Adjustment for the specific hospital where the woman was treated eliminated the association between race and surgeon specialty and slightly widened the residual racial difference in survival (HR: 1.23 vs. 1.10). CONCLUSIONS: In contrast to several studies suggesting that blacks with breast cancer, colon cancer, or cardiovascular disease are treated in hospitals with lower quality indicators, black women diagnosed with endometrial cancer in Surveillance Epidemiology and End Results regions between 1991 and 1999 were more likely to be treated by physicians with advanced training and in high volume, large, urban, teaching hospitals. However, except for a modest association with hospital surgical volume, these provider and hospital characteristics were largely unrelated to survival for women with endometrial cancer. The great majority of the difference in survival was explained by differences in tumor and clinical characteristics at presentation

Prevalence of Advanced, Precancerous Colorectal Neoplasms in Black and White Populations: A Systematic Review and Meta-analysis

Background & Aims Colorectal cancer (CRC) incidence and mortality are higher in black vs white populations. The reasons for these disparities are not clear, yet some guidelines recommend screening black persons for CRC starting at ages 40–45 years. We performed a systematic review and meta-analysis to compare the prevalence of advanced adenomas (AAs) and advanced, precancerous colorectal neoplasms (ACNs) between asymptomatic black and white screen-eligible adults. Methods We searched Ovid MEDLINE, PubMed, Embase, and the Cochrane Library to identify articles (published from 1946 through June 2017) that reported prevalence values of AA or ACN in average-risk black and white individuals undergoing screening colonoscopy. Two authors independently assessed study quality and risk for bias using a modified validated quality assessment instrument. Following the PRISMA guidelines, 2 authors independently abstracted descriptive and quantitative data from each study. We performed a random effects meta-analysis to determine risk differences and odds ratios (ORs). Results From 1653 articles, we identified 9 studies for analysis, comprising 302,128 individuals. Six of the 9 studies were of high methodological quality, had a low risk for bias, and were included in the meta-analysis. In these 9 studies, the overall prevalence values for AA and ACN did not differ significantly between back (6.57%) and white screened individuals (6.20%; OR, 1.03; 95% CI, 0.81–1.30). Among a subgroup of 5 studies, the prevalence of proximal AA and ACN was significantly higher in black (3.30%) than in white screened individuals (2.42%; OR, 1.20; 95% CI, 1.12–1.30). Excluding the largest study did not affect overall prevalence (OR, 0.99; CI, 0.73–1.34) but eliminated the difference in prevalence of proximal AA or ACN (OR, 1.48; 95% CI, 0.87–2.52). Conclusions In a meta-analysis, we found the overall prevalence of AA and ACN did not differ significantly between average-risk black and white persons, indicating that the age at which to begin CRC screening need not differ based on race

Ethnic inequalities in healthcare use and care quality among people with multiple long-term health conditions living in the United Kingdom: a systematic review and narrative synthesis

Indicative evidence suggests that the prevalence of multiple long-term conditions (i.e., conditions that cannot be cured but can be managed with medication and other treatments) may be higher in people from minoritised ethnic groups when compared to people from the White majority population. Some studies also suggest that there are ethnic inequalities in healthcare use and care quality among people with multiple long-term conditions (MLTCs). The aims of this review are to (1) identify and describe the literature that reports on ethnicity and healthcare use and care quality among people with MLTCs in the UK and (2) examine how healthcare use and/or care quality for people with MLTCs compares across ethnic groups. We registered the protocol on PROSPERO (CRD42020220702). We searched the following databases up to December 2020: ASSIA, Cochrane Library, EMBASE, MEDLINE, PsycINFO, PubMed, ScienceDirect, Scopus, and Web of Science core collection. Reference lists of key articles were also hand-searched for relevant studies. The outcomes of interest were patterns of healthcare use and care quality among people with MLTCs for at least one minoritised ethnic group, compared to the White majority population in the UK. Two reviewers, L.B. and B.H., screened and extracted data from a random sample of studies (10%). B.H. independently screened and extracted data from the remaining studies. Of the 718 studies identified, 14 were eligible for inclusion. There was evidence indicating ethnic inequalities in disease management and emergency admissions among people with MLTCs in the five studies that counted more than two long-term conditions. Compared to their White counterparts, Black and Asian children and young people had higher rates of emergency admissions. Black and South Asian people were found to have suboptimal disease management compared to other ethnic groups. The findings suggest that for some minoritised ethnic group people with MLTCs there may be inadequate initiatives for managing health conditions and/or a need for enhanced strategies to reduce ethnic inequalities in healthcare. However, the few studies identified focused on a variety of conditions across different domains of healthcare use, and many of these studies used broad ethnic group categories. As such, further research focusing on MLTCs and using expanded ethnic categories in data collection is needed