Atopic dermatitis (AD) is a chronic itchy inflammatory disease of the skin. Genetic studies have identified multiple risk factors linked to the disease; however, most of studies have been derived from European and East Asian populations. The admixed genome of African American (AA) may provide an opportunity to discovery ancestry-specific loci involved in AD susceptibility. Herein, we present joint analysis of ancestry and genotype effects followed with validation using differential gene expression analysis on AD using 710 AD cases and 1015 non-AD controls from the AA population, genotyped using MEGA followed by imputation using the CAAPA reference panel. The joint analysis identified two novel AD-susceptibility loci, rs2195989 in gene ANGPT1 (8q23.1) and rs62538818 in the intergenic region LURAP1L-MPDZ (9p23). Admixture mapping (AM) results showed potential genomic inflation, and we implemented genomic control and identified five ancestry-of-origin loci with European ancestry effects. The multi-omics functional prioritization of variants in AM signals prioritized the loci SLAIN2, RNF39, and FOXA2. GWAS identified variants significantly associated with AD in the AA population, including SGK1 (rs113357522, OR = 2.81), EFR3A (rs16904552, OR = 1.725), and MMP14 (rs911912, OR = 1.791). GWAS variants were common in the AA but rare in the European population, which suggests an African ancestry-specific risk of AD. Four genes (ANGPT1, LURAP1L, EFR3A, and SGK1) were further validated using qPCR from AD and healthy skin. This study highlighted the importance of genetic studies on admixed populations, as well as local ancestry and genotype-ancestry joint effects to identify risk loci for AD.

BACKGROUND: Breast cancer continues to pose a significant public health challenge, with its incidence and disproportionate impact on underserved populations in the United States. The relationship between obesity and clinicopathological characteristics at presentation remains a critical area of investigation. Safety-net hospitals caring for underserved communities provide a unique setting to explore these associations. This study seeks to explore a critical gap in knowledge on obesity and breast cancer characteristics in underserved populations in the United States.
METHODS: In this retrospective study, 927 breast cancer patients were included. Analysis was conducted to assess the association between body mass index (BMI), age of diagnosis, tumor clinicopathologic characteristics, and molecular types stratified by menopausal status at diagnosis. Analysis was performed using the Statistical Package for Social Sciences version 29.
RESULTS: A significant association was found between BMI and menopausal status (P < .05). Disease stage at presentation was significantly associated with BMI (P < .05). Further investigation into BMI categories and tumor characteristics revealed a significant correlation in postmenopausal women, with obesity linked to tumor size and lymph node status (P < .05). No significant associations were observed between HER-2 status, ER/PR status, and obesity in either premenopausal or postmenopausal groups.
CONCLUSIONS: This observational retrospective hypothesis-generating study revealed the association between obesity and disease stage and menopause status at diagnosis. In postmenopausal patients, obesity correlated with larger tumor size and advanced lymph node disease involvement. Additionally, ethnic variations were observed, with a higher prevalence of obesity among African American patients.

OBJECTIVE: Black women are less likely to receive screening mammograms, are more likely to develop breast cancer at an earlier age, and more likely to die from breast cancer when compared to White women. Affordable Care Act (ACA) provisions decreased cost sharing for women\'s preventive screening, potentially mitigating screening disparities. We examined enrollment of a high-risk screening program before and after ACA implementation stratified by race.
METHODS: This retrospective, quasi-experimental study examined the ACA\'s impact on patient demographics at a high-risk breast cancer screening clinic from 02/28/2003 to 02/28/2019. Patient demographic data were abstracted from electronic medical records and descriptively compared in the pre- and post-ACA time periods. Interrupted time series (ITS) analysis using Poisson regression assessed yearly clinic enrollment rates by race using incidence rate ratios (IRR) and 95% confidence intervals (CI).
RESULTS: Two thousand seven hundred and sixty-seven patients enrolled in the clinic. On average, patients were 46 years old (SD, ± 12), 82% were commercially insured, and 8% lived in a highly disadvantaged neighborhood. In ITS models accounting for trends over time, prior to ACA implementation, White patient enrollment was stable (IRR 1.01, 95% CI 1.00-1.02) while Black patient enrollment increased at 13% per year (IRR 1.13, 95% CI 1.05-1.22). Compared to the pre-ACA enrollment period, the post-ACA enrollment rate remained unchanged for White patients (IRR 0.99, 95% CI 0.97-1.01) but decreased by 17% per year for Black patients (IRR 0.83, 95% CI 0.74-0.92).
CONCLUSIONS: Black patient enrollment decreased at a high-risk breast cancer screening clinic post-ACA compared to the pre-ACA period, indicating a need to identify factors contributing to racial disparities in clinic enrollment.

Integrative Behavioral Couple Therapy (IBCT) posits that couple distress can, in part, be attributed to four factors labeled with the acronym DEEP: natural Uifferences between partners in their perspectives, beliefs, interests, and personalities, partner\'s Emotional sensitivities related to these differences, the External, contextual stressors that often exacerbate their differences and sensitivities, and the resultant Patterns of distressed interaction. Although an extensive assessment process captures these four components and thus tailors targets for intervention based on the unique characteristics of each couple, it does not explicitly consider the uniqueness of African American couples. Given the historical and contemporary realities that African American couples face (e.g., anti-Black racism), the purpose of this article is to help clinicians use IBCT with African American couples in a culturally responsive way. We begin this article by highlighting the unique needs of African American couples. We then provide a broad overview of the benefits of adopting a multicultural lens of awareness, knowledge, and skills in clinical work, present an atheoretical overview of IBCT, and offer specific recommendations to attend to the unique cultural experiences of African American couples. Finally, we present a case study to exemplify our suggestions and highlight implications of using IBCT with African American couples in a culturally responsible way.

BACKGROUND: Differences in the MS course between White and Black populations is well accepted. The existence of a large Somali immigrant population in Minnesota facilitates a study of MS characteristics in this immigrant native African population. The objective of this study was to compare Somali American (SA), African American (AA), and White American (WA) persons with MS (pwMS) regarding clinical features and disease modifying therapy (DMT) use.
METHODS: This single center (Mayo Clinic) geographically-restricted retrospective cohort study (residing within 250 miles of Rochester, MN, USA) included participants seen before May 2023. Age at immigration to the USA; age at MS onset; DMT use/type; MS phase/phenotype; age at progressive MS (PMS) onset; and proportion with severe MS (expanded disability status scale-EDSS ≥6) were examined.
RESULTS: 18 SApwMS, 92 AApwMS, and 94 WApwMS were included. Of the 15 SApwMS not born in USA, 3/15 immigrated pre-puberty, 3/15 peri‑puberty, 8/15 post-puberty, and 1/15 at an unknown date. SApwMS were younger at MS onset (median years, interquartile range (IQR)=25, 22-33 vs. AApwMS: 31, 25-38; p = 0.049 vs. WApwMS: 35, 27-41; p = 0.022). DMT use frequencies were 13/19 SApwMS, 69/92 AApwMS, 80/94 WApwMS (p > 0.05). SApwMS were treated with DMT earlier than AApwMS (HR 2.16, p = 0.012) and WApwMS (HR 1.86, p = 0.041). SApwMS were less commonly treated with natalizumab (SApwMS 0 %, AApwMS 13 %, WApwMS 25 %; p = 0.035) and anti-CD20 therapies (SApwMS 23 %, AApwMS 23 %, WApwMS 48 %; p = 0.005). PMS occurred in 3/19 SApwMS, 28/92 AApwMS and 29/94 WApwMS (p > 0.05). Age of PMS onset in SApwMS (47 years, 34-57) was similar to WApwMS (47 years, 31-71; p > 0.05) but older than AApwMS (41 years, 18-7; p = 0.008).
CONCLUSIONS: SApwMS that recently immigrated to the USA have similar disease course to WApwMS, and better than AApwMS from the same geographical region.

Despite a growing number of research outputs on the importance of nature contact during the COVID-19 pandemic, we know of no longitudinal research conducted prior to and during the pandemic among low-income and minority ethnicity populations, i.e. those that might be most affected. Furthermore, we have scant information about how and to what degree contact with nature might protect mental health or mitigate worsening of mental health during the pandemic. We filled these gaps using a subset of a longitudinal study of n = 86 individuals in low-income, predominantly African American, neighborhoods in Detroit, MI, USA. The study addressed the following research questions: 1) did self-reported use and perceived value of nature change during, versus prior to, the pandemic; 2) did perceived access to outdoor spaces buffer people against mental health issues such as stress, anxiety and depression symptoms; or 3) did objectively measured quality of nature views from home buffer people against mental health issues, taking into account relevant covariates and pandemic experiences (e.g., loss of employment, death of a friend/relative)? While attitudes to nature improved slightly from pre- to during the pandemic, we also observed significant decreases in most types of outdoor physical activity and passive enjoyment of nature (e.g., smelling plants/rain). We found a positive association between visibility of greenspace and perceived stress and anxiety, which not only contradicts previous research findings, but was especially surprising given that overall there was a decrease in perceived stress from 2019-2020. We did not detect associations between perceived access/use of nature and mental health. However, higher depressive symptoms were associated with exposure to more COVID-19-related stressors (lost employment, death of friends from COVID-19, etc.). Taken together, our results indicate that COVID-19 may serve to prolong or exacerbate mental health issues, rather than create them, in this population and that low quality greenspace may perhaps limit the ability for nature view to buffer mental health during the pandemic.

OBJECTIVE: Suicides continue to increase among youth, with substantial disparities among Black youth. Culturally responsive evidence-based interventions for Black youth are urgently needed to disrupt these inequities. This study aims to identify evidence-based psychotherapy interventions for suicidal thoughts and behaviors (STBs) among Black youth and examine how existing intervention manuals have integrated culturally- relevant content to Black youth.
METHODS: Literature searches were conducted to identify relevant articles comparing the effectiveness of interventions for STBs, study population with >30% Black youth, and youth participants up to the age of 25. Published articles and therapy manuals were analyzed on cultural adaptation and on seven content domains for cultural adaptation. Meta-analysis used a random-effects model and explored potential moderators.
RESULTS: Of the 755 screened records, 13 studies met eligibility criteria and featured eight manualized interventions. Meta-analysis revealed significant effects in reducing STBs between treatment groups (Hedges\' g=1.08 with 95% CI [.07, 2.09])) but low-quality evidence, significant heterogeneity, small sample sizes, and inconsistencies in outcome measures. Only one intervention, Adapted Coping with Stress (A-CWS), specifically focused on Black youth. Culturally relevant content was predominantly absent or contained brief descriptions. The most frequently included content was provider cultural competency training.
CONCLUSIONS: The lack of representation of Black youth in treatment studies and sparse literature on culturally responsive treatments for Black youth and their families continues to stall significant advancements to disrupt current suicide trends disproportionately impacting Black youth. We identified several opportunities for implementing cultural adaptations of suicide interventions among Black youth.

UNASSIGNED: The objective of this paper is to explore how telephone-delivered mindfulness training impacts family conflict and communication within the informal dementia caregiving team, including primary caregivers, their care partner, and the care recipient.
UNASSIGNED: Primary caregivers and their care partners participated in an eight-week telephone-delivered mindfulness-based intervention (MBI). This study used mixed methods and a pre-post design to evaluate the intervention\'s effect on family satisfaction, perceived support, and family conflict.
UNASSIGNED: Both family satisfaction and perceived informational support increased significantly, and qualitative analysis revealed four key themes illustrating how the mindfulness intervention served to positively impact family conflict and communication among participating caregivers.
UNASSIGNED: This study provides preliminary evidence for the beneficial effects of an MBI on family functioning among rural African American caregivers of people with Alzheimer\'s disease and related dementias.

Background: Some commentators and several professional medical associations have expressed concern that legalizing medical aid in dying (\"MAID\") will undermine patient trust in the medical profession, particularly among historically disadvantaged patient populations. While this concern remains influential, it has been subject to limited empirical scrutiny. Objectives: This study aims to empirically assess whether MAID legalization undermines patient trust, with considerations of potential trust/demographic correlations in marginalized and minority patient populations. Design: We developed an RCT survey study that assessed patients\' trust in the medical professional using the Abbreviated Wake Forest Scale (\"AWFS\"). Two versions of the survey were used, each distributed at random to half of participants. One survey version included notification that MAID had been legalized in the jurisdiction where patients were receiving care and the other version omitted this information. Setting/Population: We surveyed capacitated, English-speaking adult patients who were receiving care at a not-for-profit, 912-bed academic and research hospital in Washington, D.C. Of those invited to participate, 494 patients (63.2%) completed all AWFS questions, and 70.1% identified as Black or African American and 32.9% as having a physical or mental disability. Conclusions: Most of the participants not notified that MAID was legal in DC were not aware of this fact (92.5%). Patients who were notified that MAID was legal in DC were significantly more likely to report approval of MAID legalization (p = 0.0410), but showed no significant difference in AWFS score for trust in their physicians. The study did not substantiate concerns that legalizing medical aid in dying undermines patient trust in the medical profession.

UNASSIGNED: Gastric cancer is a health concern and contributes to cancer-related deaths. Gastric intestinal metaplasia (GIM) is a premalignant lesion of gastric cancer. Currently, factors associated with GIM regression are under-investigated. This study aims to assess the rate of GIM regression and identify factors associated with it.
UNASSIGNED: This study was conducted at Medstar Washington Hospital Center. We included patients who had GIM between January 2015 and December 2020. Population was divided into GIM persistence or regression. Data included demographics, esophagogastroduodenoscopy findings, Helicobacter pylori status, and laboratory results. Statistical analyses included Kaplan-Meier and Cox proportional models to explore predictors of GIM regression.
UNASSIGNED: Among 2375 patients, 9.1% had GIM. Notably, 85 patients had GIM regression and 132 patients had persistent GIM. African Americans constituted (75%) of the regression group and (76%) of the persistence group. Peptic ulcer disease (PUD) was noted in 12.9% of the regression group at baseline, and 5.9% at follow-up; the persistence group showed 11.4% at baseline and 5.3% at follow-up (P = 0.89). Regression analysis revealed that the presence of PUD was associated with a higher rate of regression (hazard ratio [HR] 2.46, P = 0.013). Smoking status showed lower rates of regression (HR 0.54 and 0.62, P = 0.038 and 0.169). On gastric mapping, African Americans, Hispanics, and individuals of other races/ethnicities displayed lower rates of GIM regression (HR 0.68, 0.78 and 0.69).
UNASSIGNED: PUD was associated with a higher rate of GIM regression, while smoking showed lower regression rates. Results provide insights into factors influencing GIM regression in African American population and may inform future surveillance and treatment strategies.