Health Disparities in Minority Populations

Abstract Introduction and Background: Minority populations struggle to gain access to equitable healthcare due to cultural variations and language barriers. It is paramount for providers to accommodate to the differing needs of underserved minority groups. Purpose Statement: We analyzed information on the effects of community-based interventions aimed at improving healthcare access for minorities. Literature Review: We used PubMed as our main database. For our search, we looked up the keywords “Healthcare Access AND Minorities.” Next, we filtered articles that had been published since 2017 and sorted to include clinical trials, randomized control trials, and meta-analyses. After that, we came across ninety-eight total articles, and picked five of the most critical. Findings: From the first two articles, patient navigators have been shown to be effective in helping minorities navigating the information and decisions presented to them in healthcare. The researchers in the third study found that minority groups are at a greater risk for a health literacy deficit. Our next article found that African Americans treated with computerized cognitive behavioral therapy saw a significant decrease in anxiety and depression. Our final document found that lack of access to healthcare resources decreased dementia outcomes by missing the early onset of symptoms. Conclusions: It is evident that minorities face healthcare disparities that keep them from receiving access to equitable healthcare. As a nurse, it is important to identify gaps in access to healthcare in minority patients. Interventions aiming to increase health literacy and access in minorities have shown to be effective

Pain-Related Rumination, But Not Magnification or Helplessness, Mediates Race and Sex Differences in Experimental Pain

Compared with white individuals and men, black individuals and women show a lower tolerance for experimental pain stimuli. Previous studies suggest that pain catastrophizing is important in this context, but little is known about which components of catastrophizing contribute to these race and sex differences. The purpose of the current study was to examine the individual components of catastrophizing (rumination, magnification, and helplessness) as candidate mediators of race and sex differences in experimental pain tolerance. Healthy undergraduates (N = 172, 74% female, 43.2% black) participated in a cold pressor task and completed a situation-specific version of the Pain Catastrophizing Scale. Black and female participants showed a lower pain tolerance than white (P < .01, d = .70) and male (P < .01, d = .55) participants, respectively. Multiple mediation analyses indicated that these race and sex differences were mediated by the rumination component of catastrophizing (indirect effect = −7.13, 95% confidence interval (CI), −16.20 to −1.96, and 5.75, 95% CI, .81–15.57, respectively) but not by the magnification (95% CI, −2.91 to 3.65 and −1.54 to 1.85, respectively) or helplessness (95% CI, −5.53 to 3.31 and −.72 to 5.38, respectively) components. This study provides new information about race and sex differences in pain and suggests that treatments targeting the rumination component of catastrophizing may help mitigate pain-related disparities

Prevalence of established and emerging biomarkers of immune checkpoint inhibitor response in advanced hepatocellular carcinoma.

The clinical deployment of immune checkpoint inhibitors (ICIs) has created a tandem drive for the identification of biomarkers linked to benefit. Comprehensive genomic profiling was performed to evaluate the frequency of genomic biomarkers of ICI response in 755 patients with advanced hepatocellular carcinoma (HCC). Median age was 62 years' old, 73% were male, 46% had extrahepatic disease, 107 had documented hepatitis C, 96 had hepatitis B and 4 patients were coinfected. Median tumor mutation burden (TMB) was 4 mutations/Mb and only 6 tumors (0.8%) were TMB-high. Out of 542 cases assessed for microsatellite instability (MSI), one (0.2%) was MSI-high and TMB-high. Twenty-seven (4%) patients had POLE/D alterations. One patient had a pathogenic POLE R762W mutation but TMB was 4 mutations/Mb. Forty percent had DNA damage response gene alterations. In a small case series (N=17) exploring the relationship between biomarkers and ICI response, one patient (TMB 15 mutations/Mb, MSI-low) had a sustained complete response to nivolumab lasting &gt; 2 years. Otherwise there were no significant genomic or TMB differences between responders, progressors, and those with stable disease. Overall, markers of genomic instability were infrequent in this cohort. Larger clinically annotated datasets are needed to explore genomic and non-genomic determinants of ICI response in HCC

Advocating for and Providing Quality Adaptive Physical Education

Ideally, as put across by the Disability &amp; Human Rights guide, the Convention on the Rights of Persons with Disabilities (CRPD) does not give a detailed description of disability but rather gives a wide range of features that intend describe disability. The truth is, despite being incapacitated in a certain way, people living with disabilities should be given the same opportunities as those without. Our separate literature analysis discovered that different efforts had been put in place to present equal opportunities for people living with disabilities. One of these efforts is adaptive physical education. As its name suggests, adaptive physical education is a physical education that has been adapted to create equal opportunities for persons with disabilities as it is for people without disabilities. To this effect, this paper and its entirety will focus on presenting the different themes observed from the different pieces of literature separately

Murine obscurin and Obsl1 have functionally redundant roles in sarcolemmal integrity, sarcoplasmic reticulum organization, and muscle metabolism.

Biological roles of obscurin and its close homolog Obsl1 (obscurin-like 1) have been enigmatic. While obscurin is highly expressed in striated muscles, Obsl1 is found ubiquitously. Accordingly, obscurin mutations have been linked to myopathies, whereas mutations in Obsl1 result in 3M-growth syndrome. To further study unique and redundant functions of these closely related proteins, we generated and characterized Obsl1 knockouts. Global Obsl1 knockouts are embryonically lethal. In contrast, skeletal muscle-specific Obsl1 knockouts show a benign phenotype similar to obscurin knockouts. Only deletion of both proteins and removal of their functional redundancy revealed their roles for sarcolemmal stability and sarcoplasmic reticulum organization. To gain unbiased insights into changes to the muscle proteome, we analyzed tibialis anterior and soleus muscles by mass spectrometry, uncovering additional changes to the muscle metabolism. Our analyses suggest that all obscurin protein family members play functions for muscle membrane systems

Letter to the Editor Concerning Simultaneous, Single-Particle Measurements of Size and Loading Give Insights into the Structure of Drug-Delivery Nanoparticles

The vexing error of excess variance in the sizing of single particles degrades accuracy in applications ranging from quality control of nanoparticle products to hazard assessment of nanoplastic byproducts. The particular importance of lipid nanoparticles for vaccine and medicine delivery motivates this comment on a publication$^{\textrm{1}}$ in ACS Nano. In ref 1, the benchmark measurements of a nanoparticle standard manifest large errors of the size distribution that contradict the claim of validation. Such errors can bias the correlation of fluorescence intensity as an optical proxy for the molecular loading of lipid nanoparticles and give misleading insights from power-law models of intensity$-$size data. Looking forward, measurement error models have the potential to address this widespread issue.Comment: Peer reviewed and pending acceptance by ACS Nan

Quinolone Allergy

Quinolones are the second most common antibiotic class associated with drug-induced allergic reactions, but data on quinolone allergy are scarce. This review article discusses the available evidence on quinolone allergy, including prevalence, risk factors, diagnosis, clinical manifestations, cross-reactivity, and management of allergic reactions. Although the incidence of quinolone allergy is still lower than beta-lactams, it has been increasingly reported in recent decades, most likely from its expanded use and the introduction of moxifloxacin. Thorough patient history remains essential in the evaluation of quinolone allergy. Many diagnostic tools have been investigated, but skin tests can yield false-positive results and in vitro tests have not been validated. The drug provocation test is considered the test of choice to confirm a quinolone allergy but is not without risk. Evidence regarding cross-reactivity among the quinolones is limited and conflicting. Quinolone allergy can be manifested either as an immediate or delayed reaction, but is not uniform across the class, with moxifloxacin posing the highest risk of anaphylaxis. Quinolone should be discontinued when an allergic reaction occurs and avoided in future scenarios, but desensitization may be warranted if no alternatives are available

A lateral nanoflow assay reveals nanoplastic fluorescence heterogeneity

Colloidal nanoplastics present technological opportunities, environmental concerns, and measurement challenges. To meet these challenges, we develop a lateral nanoflow assay from sample-in to answer-out. Our measurement system integrates complex nanofluidic replicas, super-resolution optical microscopy, and comprehensive statistical analyses to measure polystyrene nanoparticles that sorb and carry hydrophobic fluorophores. An elegant scaling of surface forces within our silicone devices hydrodynamically automates the advection and dominates the diffusion of the nanoparticles. Through steric interaction with the replica structure, the particle size distribution reciprocally probes the unknown limits of replica function. Multiple innovations in the integration and calibration of device and microscope improve the accuracy of identifying single nanoparticles and quantifying their diameters and fluorescence intensities. A statistical model of the measurement approaches the information limit of the system, discriminates size exclusion from surface adsorption, and reduces nonideal data to return the particle size distribution with nanometer resolution. A Bayesian statistical analysis of the dimensional and optical properties of single nanoparticles reveals their fundamental structure-property relationship. Fluorescence intensity shows a super-volumetric dependence, scaling with nanoparticle diameter to nearly the fourth power and confounding basic concepts of chemical sorption. Distributions of fluorescivity - the product of the number density, absorption cross section, and quantum yield of an ensemble of fluorophores - are ultrabroad and asymmetric, limiting ensemble analysis and dimensional or chemical inference from fluorescence intensity. These results reset expectations for optimizing nanoplastic products, understanding nanoplastic byproducts, and applying nanoplastic standards

The Grizzly, September 27, 2018

Ursinus Downs Moravian 21-14, Capping Off a Festive Homecoming Weekend • Ursinus Earns a Spot in the Top 100 Liberal Arts Colleges • Materializing Religious Hatred: The Gospel and the KKK in America • Redesign of Students Page on Ursinus Website • The Grizzly\u27s Forebears: Caffeine Pills and Togas • Fringe Fun: Ursinus\u27 19th Annual Fringe Festival • Opinion: A Personal Perspective on #PlateGate; The Floy Lewis Bakes Center Renovations • Women\u27s Soccer Team Shows Improvement • Volleyball Impresses vs. Tough Teams • Legendary Coach Racich Passes Awayhttps://digitalcommons.ursinus.edu/grizzlynews/1937/thumbnail.jp