American Indian Or Alaska Native

美洲印第安人或阿拉斯加原住民
  • 文章类型: Journal Article
    乳腺癌(BC)是女性癌症死亡的第二大原因,不列颠哥伦比亚省的死亡率因种族而异,尤其是黑人女性的早发性BC。许多指南建议从50岁开始进行BC筛查;然而,目前一刀切的政策,从一定年龄开始对所有女性进行筛查,可能是不公平的,公平,或最佳。
    根据当前BC死亡率的种族和民族差异数据,提供适应种族和民族的BC筛查起始年龄。
    这项全国性的基于人群的横断面研究是使用2011年至2020年因BC死亡的美国女性患者的BC死亡率数据进行的。
    使用代理报告的种族和种族信息。根据BC特异性死亡的10年累积风险来测量按种族和种族划分的BC筛查的风险适应起始年龄。根据特定年龄组死亡率数据计算特定年龄的10年累积风险,无需建模或调整。
    女性患者中由侵袭性BC引起的疾病特异性死亡率。
    在415277名女性患者(1880名美洲印第安人或阿拉斯加原住民[0.5%]中,有BC特异性死亡。12086亚洲或太平洋岛民[2.9%],62695黑色[15.1%],28747西班牙裔[6.9%],2011年至2020年,美国有309869名白人[74.6%];115214名患者在60岁之前死亡[27.7%])。40至49岁的每100万人年BC死亡率是黑人女性的27例死亡,15名白人女性死亡,美洲印第安人或阿拉斯加原住民有11人死亡,西班牙裔,和亚洲或太平洋岛民女性。当建议从50岁开始进行BC筛查时,所有10年累计BC死亡风险为0.329%的女性,黑人女性在8年前达到了这个风险阈值水平,42岁时,而白人女性在51岁时达到了这一水平,57岁的美洲印第安人或阿拉斯加原住民和西班牙裔女性,11年后,亚洲或太平洋岛民女性,61岁。黑人女性的种族和种族适应的起始年龄在40岁时进行大规模筛查的时间为6岁,在45岁时进行大规模筛查的时间为7岁。
    本研究为BC筛查提供了基于证据的种族适应起始年龄。这些发现表明,卫生政策制定者可能会考虑一种适应风险的BC筛查方法,即在建议的大规模筛查年龄之前,对高危人群进行早期筛查,以解决由于早发性BC引起的死亡率。
    Breast cancer (BC) is the second leading cause of cancer death in women, and there is a substantial disparity in BC mortality by race, especially for early-onset BC in Black women. Many guidelines recommend starting BC screening from age 50 years; however, the current one-size-fits-all policy to start screening all women from a certain age may not be fair, equitable, or optimal.
    To provide race and ethnicity-adapted starting ages of BC screening based on data on current racial and ethnic disparities in BC mortality.
    This nationwide population-based cross-sectional study was conducted using data on BC mortality in female patients in the US who died of BC in 2011 to 2020.
    Proxy-reported race and ethnicity information was used. The risk-adapted starting age of BC screening by race and ethnicity was measured based on 10-year cumulative risk of BC-specific death. Age-specific 10-year cumulative risk was calculated based on age group-specific mortality data without modeling or adjustment.
    Disease-specific mortality due to invasive BC in female patients.
    There were BC-specific deaths among 415 277 female patients (1880 American Indian or Alaska Native [0.5%], 12 086 Asian or Pacific Islander [2.9%], 62 695 Black [15.1%], 28 747 Hispanic [6.9%], and 309 869 White [74.6%]; 115 214 patients died before age 60 years [27.7%]) of any age in the US in 2011 to 2020. BC mortality per 100 000 person-years for ages 40 to 49 years was 27 deaths in Black females, 15 deaths in White females, and 11 deaths in American Indian or Alaska Native, Hispanic, and Asian or Pacific Islander females. When BC screening was recommended to start at age 50 years for all females with a 10-year cumulative risk of BC death of 0.329%, Black females reached this risk threshold level 8 years earlier, at age 42 years, whereas White females reached it at age 51 years, American Indian or Alaska Native and Hispanic females at age 57 years, and Asian or Pacific Islander females 11 years later, at age 61 years. Race and ethnicity-adapted starting ages for Black females were 6 years earlier for mass screening at age 40 years and 7 years earlier for mass screening at age 45 years.
    This study provides evidence-based race-adapted starting ages for BC screening. These findings suggest that health policy makers may consider a risk-adapted approach to BC screening in which individuals who are at high risk are screened earlier to address mortality due to early-onset BC before the recommended age of mass screening.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:我们的目的是评估种族/民族对COVID-19大流行期间肝硬化相关过早死亡的影响。
    方法:我们从美国国家生命统计系统获得了肝硬化相关的死亡数据(n=872,965,2012年1月1日至2021年12月31日),以计算年龄标准化死亡率和年龄为25-64岁的过早死亡的潜在寿命损失(YPLL)。
    结果:注意到与肝硬化相关的年龄标准化死亡率存在明显的种族/族裔差异,但在大流行期间有所扩大,非西班牙裔美国印第安人/美国原住民的YPLL最高(2020年:41.0%;2021年:68.8%),其次是其他少数群体(28.7%-45.1%),非西班牙裔白人最低(2020年:20.7%;2021年:31.6%)。2020年,COVID-19占西班牙裔和非西班牙裔美国印第安人/美国原住民的过量YPLL的30%以上,而非西班牙裔白人为11.1%。
    结论:患有肝硬化的少数民族在2020-2021年经历了不成比例的超额死亡和YPLLs。
    Our aim was to evaluate the impact of race/ethnicity on cirrhosis-related premature death during the COVID-19 pandemic.
    We obtained cirrhosis-related death data (n = 872,965, January 1, 2012-December 31, 2021) from the US National Vital Statistic System to calculate age-standardized mortality rates and years of potential life lost (YPLL) for premature death aged 25-64 years.
    Significant racial/ethnic disparity in cirrhosis-related age-standardized mortality rates was noted prepandemic but widened during the pandemic, with the highest excess YPLL for the non-Hispanic American Indian/American Native (2020: 41.0%; 2021: 68.8%) followed by other minority groups (28.7%-45.1%), and the non-Hispanic White the lowest (2020: 20.7%; 2021: 31.6%). COVID-19 constituted >30% of the excess YPLLs for Hispanic and non-Hispanic American Indian/American Native in 2020, compared with 11.1% for non-Hispanic White.
    Ethnic minorities with cirrhosis experienced a disproportionate excess death and YPLLs in 2020-2021.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    我们是一群考古学家,人类学家,代表不同全球社区和31个国家的策展人和遗传学家。我们所有人都在2020年11月举行的致力于古代DNA研究伦理学的虚拟研讨会上见面。人们普遍认为,需要全球适用的道德准则,但是,最近以讨论北美人类遗骸研究为基础的建议并不总是在世界范围内推广。在这里,我们提出以下全球适用的指导方针,考虑到不同的背景。这些观点认为:(1)研究人员必须确保在工作场所和遗骸来源的地方遵守所有法规;(2)研究人员必须在开始任何研究之前制定详细的计划;(3)研究人员必须最大程度地减少对人类遗骸的损害;(4)研究人员必须确保在发布后提供数据,以便对科学发现进行严格的重新检查;(5)研究人员必须从研究开始就与其他利益相关者接触,并确保对利益相关者我们承诺遵守这些准则,并期望它们将促进人类遗骸DNA研究的高道德标准。
    We are a group of archaeologists, anthropologists, curators and geneticists representing diverse global communities and 31 countries. All of us met in a virtual workshop dedicated to ethics in ancient DNA research held in November 2020. There was widespread agreement that globally applicable ethical guidelines are needed, but that recent recommendations grounded in discussion about research on human remains from North America are not always generalizable worldwide. Here we propose the following globally applicable guidelines, taking into consideration diverse contexts. These hold that: (1) researchers must ensure that all regulations were followed in the places where they work and from which the human remains derived; (2) researchers must prepare a detailed plan prior to beginning any study; (3) researchers must minimize damage to human remains; (4) researchers must ensure that data are made available following publication to allow critical re-examination of scientific findings; and (5) researchers must engage with other stakeholders from the beginning of a study and ensure respect and sensitivity to stakeholder perspectives. We commit to adhering to these guidelines and expect they will promote a high ethical standard in DNA research on human remains going forward.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    人类白细胞抗原(HLA)基因座是非常有据可查的平衡选择的目标,然而,很少有研究探索选择如何影响这些基因座的群体分化。在本研究中,我们通过比较全基因组分布的微卫星与MHC区域的微卫星的分化来研究HLA基因的遗传分化。我们的研究使用了来自30个人群的494个人样本,其中28人是美洲原住民,所有这些都是全基因组和MHC区域微卫星的类型。我们发现MHC的分化比基因组的其余部分更大(FST-MHC=0.130和FST-基因组=0.087),并使用置换方法来表明这种差异具有统计学意义,而不是由混杂因素造成的。这一发现与平衡选择减少人口分化的期望相反。我们将我们的发现解释为证据,表明选择有利于不同地区的不同等位基因集,导致分化加剧。因此,HLA基因的平衡选择同时增加了美洲原住民的种群内多态性和种群间分化。
    The Human Leukocyte Antigen (HLA) loci are extremely well documented targets of balancing selection, yet few studies have explored how selection affects population differentiation at these loci. In the present study we investigate genetic differentiation at HLA genes by comparing differentiation at microsatellites distributed genomewide to those in the MHC region. Our study uses a sample of 494 individuals from 30 human populations, 28 of which are Native Americans, all of whom were typed for genomewide and MHC region microsatellites. We find greater differentiation in the MHC than in the remainder of the genome (FST-MHC = 0.130 and FST-Genomic = 0.087), and use a permutation approach to show that this difference is statistically significant, and not accounted for by confounding factors. This finding lies in the opposite direction to the expectation that balancing selection reduces population differentiation. We interpret our findings as evidence that selection favors different sets of alleles in distinct localities, leading to increased differentiation. Thus, balancing selection at HLA genes simultaneously increases intra-population polymorphism and inter-population differentiation in Native Americans.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

  • 文章类型: Journal Article
    在全世界,肝细胞癌(HCC)仍然是肝癌的主要类型。肝癌患者的自杀风险高于普通人群。因此,这项研究的目的是确认自杀率,标准化死亡率(SMR),以及与HCC患者自杀相关的潜在危险因素。
    从监测中收集HCC患者,流行病学,和1975-2016年的最终结果(SEER)数据库。计算了这些患者的自杀率和SMR,和1975-2016年美国(U.S.)的一般人口被用作参考.采用单变量和多变量Cox回归分析肝癌患者自杀的危险因素。
    在102,567例HCC患者中发现70例自杀,观察时间为160,500.88人年。自杀率为每10万人年43.61,SMR为2.26(95%CI:1.78-2.84)。关于Cox回归,诊断年份(1975-1988年vs.2003-2016年,HR:3.00,95%CI:1.01-8.89,P=0.047;1989-2002年vs.2003-2016年,HR:1.92,95%CI:1.10-3.34,P=0.021),性别(男性vs.女性,HR:8.72,95%CI:2.73-27.81,P<0.001),诊断年龄(63-105岁与0-55岁,HR:2.28,95%CI:1.21-4.31,P=0.011),种族(白色种族与美洲印第安人/阿拉斯加原住民,亚洲/太平洋岛民,HR:3.02,95%CI:1.35~6.76,P=0.007)是HCC患者自杀的独立危险因素。
    在早期(1975-2002年)被诊断,男性,年龄较大(63-105岁),白人种族,肝癌患者的生存月(<2个月)与自杀显著相关.为了防止自杀行为,政府,临床医生,家庭成员应采取适当措施降低自杀率,尤其是有自杀高危因素的患者。
    Throughout the world, hepatocellular carcinoma (HCC) remains the primary type of liver cancer. The suicide risk was higher among patients with HCC than the general population. Hence, the purpose of this study was to confirm the suicide rates, standardized mortality ratios (SMRs), and the potential risk factors associated with suicide among HCC patients.
    HCC patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database during 1975-2016. Suicide rates and SMRs among these patients were calculated, and the general population of the United States (U.S.) during 1975-2016 was used as a reference. Univariable and multivariable Cox regression were taken to find out the underlying risk factors of suicide in HCC patients.
    There were 70 suicides identified among 102,567 individuals with HCC observed for 160,500.88 person years. The suicide rate was 43.61 per 100,000 person-years, and SMR was 2.26 (95% CI: 1.78-2.84). On Cox regression, year of diagnosis (1975-1988 vs. 2003-2016, HR: 3.00, 95% CI: 1.01-8.89, P = 0.047; 1989-2002 vs. 2003-2016, HR: 1.92, 95% CI: 1.10-3.34, P = 0.021), gender (male vs. female, HR: 8.72, 95% CI: 2.73-27.81, P < 0.001), age at diagnosis (63-105 years old vs. 0-55 years old, HR: 2.28, 95% CI: 1.21-4.31, P = 0.011), race (white race vs. American Indian/Alaska Native, Asian/Pacific Islander, HR: 3.02, 95% CI: 1.35-6.76, P = 0.007) were independent risk factors of suicide among HCC patients.
    Diagnosed in the early years (1975-2002), male sex, the older age (63-105 years old), white race, survival months (<2 months) were significantly associated with suicide among HCC patients. For the sake of preventing suicide behaviors, the government, clinicians, and family members should take adequate measures to decrease the rate of suicide, especially in patients with high-risk factors of suicide.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

公众号