BACKGROUND: There is no normative craniofacial anthropometric data for the Kenyan-African population. The purpose of this investigation was to determine normative anthropometric craniofacial measurements and proportional relationships for Kenyans of African descent and to compare the data with African Americans (AA), North American Whites (NAW), and neoclassical canons. METHODS: Twenty-five direct facial anthropometric measurements, and 4 angular measurements, were taken on 72 Kenyan-African participants (age range 18–30 years) recruited at the University of Nairobi in Kenya. The data were compared with AA and NAW populations, and neoclassical canons. Descriptive statistics of the variables were computed for the study population. RESULTS: Significant differences between both Kenyan males and females were detected in forehead height (~ 5 mm greater for males, ~ 4.5 mm for females), nasal height (reduced by ~ 4 mm in males, ~ 3 mm in females), nasal width (8–9 mm greater), upper lip height (> 3 mm), and eye width (greater by ~ 3 mm) compared to NAW subjects. All vertical measurements obtained were significantly different compared with NAW. Differences were observed in comparison with AA subjects, but less marked. Mouth width was similar in all groups. Angular measurements were variable. Neoclassical canons did not apply to the Kenyan population. CONCLUSIONS: Anthropometric measurements of NAW showed clear differences when compared with the Kenyan population, and variations exist with comparative AA data. The anthropometric data in terms of linear measurements, angular measurements, and proportional values described may serve as a database for facial analysis in the Kenyan-African population.
African Americans ; Anthropometry ; Female ; Forehead ; Humans ; Kenya ; Lip ; Male ; Mouth

African Swine Fever (ASF) is a highly contagious and deadly viral disease affecting both domestic pig and wild boar populations. Once introduced, it is a terrible disease that can devastate the swine industry in many countries. ASF has spread most recently beyond China to Southeast Asia, and parts of the Korean Peninsula. The majority of Asian countries consume pork as the primary source of meat compared to all other meat products. Particular emphasis is on the spread of ASF within North Korea and on future perspectives including protective guidelines. Thus far, the Korean peninsula has endured an extensive history of diseases, most notably from foot and mouth disease. For this reason, the Korean swine industries are familiar with the detrimental impacts of such a disease. On the other hand, exposure to a disease like ASF will decimate the swine industry even further. Therefore, it is crucial to bring urgent awareness to the spread of ASF.
African Swine Fever ; Animals ; Asia, Southeastern ; Asian Continental Ancestry Group ; China ; Democratic People's Republic of Korea ; Epidemiology ; Foot-and-Mouth Disease ; Hand ; Humans ; Meat ; Meat Products ; Red Meat ; Sus scrofa ; Swine ; Virus Diseases

STUDY DESIGN: Retrospective chart review. PURPOSE: We sought to determine the differences in pedicle diameter (PD) in the lumbar spine between various races: ‘Asian,’ ‘Black,’ ‘White,’ and ‘Other.’ These data could aid in perioperative planning during instrumented spinal fusion. OVERVIEW OF LITERATURE: Recent literature underscores the importance of understanding diverse pedicle isthmus morphology to perform successful transpedicular procedures. These studies suggest that more detailed and reliable measurements of pedicles should be undertaken. However, none of the current literature comprehensively compares average PDs between diverse racial populations with a standardized study design. METHODS: Coronal cuts of 5,060 lumbar spine pedicles were inspected to obtain their transverse outer cortical PD as measured through the isthmus at L1–L5. Data were collected and categorized on the basis of patient-reported race. We examined average PD and PD range at each level for each race. To determine the significance, we used a mixed analysis of variance and a post hoc analysis. RESULTS: The Asian cohort consistently had a significantly smaller PD at L1–L5 than Blacks or Whites (p<0.001), as did the ‘Other’ group compared with Blacks (p<0.001) and Whites (p=0.032). At L1–L2, the ‘Other’ group showed the least variability in PD. At L3–L5, the Asian population showed the smallest range, and the Black population had the largest variability in PD except at L5. There was a significant difference in PD between the various races. CONCLUSIONS: The Asian population consistently has significantly smaller pedicles in the lumbar spine than the Black or White populations. This information could prove useful for surgical planning. We suggest using preoperative computed tomography for pedicle screw templating as a safe method for pedicle screw instrumentation with the highest pullout strength given the wide range of PD in the Black population and the variability of PD between races.
African Continental Ancestry Group ; Asian Continental Ancestry Group ; Cohort Studies ; Continental Population Groups ; Demography ; Humans ; Methods ; Orthopedics ; Osteology ; Pedicle Screws ; Retrospective Studies ; Spinal Fusion ; Spine

BACKGROUND: Fetuin-A is a hepatokine that involved in the pathogenesis of insulin resistance. Previous epidemiological studies have found a positive association between blood fetuin-A and type 2 diabetes mellitus (T2DM) risk among Caucasians and African Americans. We aimed to investigate the prospective relationship between fetuin-A and T2DM in an Asian population for the first time. METHODS: A nested case-control study was established within a prospective cohort of Chinese living in Singapore. At blood collection (1999 to 2004), all participants were free of diagnosed T2DM and aged 50 to 79 years. At subsequent follow-up (2006 to 2010), 558 people reported to have T2DM and were classified as incident cases, and 558 controls were randomly chosen from the participants who did not develop T2DM to match with cases on age, sex, dialect group, and date of blood collection. Plasma fetuin-A levels were measured retrospectively in cases and controls using samples collected at baseline. Conditional logistic regression models were used to compute the odds ratio (OR) and 95% confidence interval (CI). Restricted cubic spline analysis was used to examine a potential non-linear association between fetuin-A levels and T2DM risk. RESULTS: Compared with those in the lowest fetuin-A quintile, participants in the highest quintile had a two-fold increased risk of developing T2DM (OR, 2.06; 95% CI, 1.21 to 3.51). A non-linear association was observed (P nonlinearity=0.005), where the association between fetuin-A levels and T2DM risk plateaued at plasma concentrations around 830 µg/mL. CONCLUSION: There is a positive association between plasma fetuin-A levels and risk of developing T2DM in this Chinese population.
African Americans ; alpha-2-HS-Glycoprotein ; Asian Continental Ancestry Group ; Case-Control Studies ; Cohort Studies ; Diabetes Mellitus, Type 2 ; Epidemiologic Studies ; Epidemiology ; Follow-Up Studies ; Humans ; Insulin Resistance ; Logistic Models ; Odds Ratio ; Plasma ; Prospective Studies ; Retrospective Studies ; Singapore

The Tuskegee Study of Untreated Syphilis in the Negro Male was an observational study on African-American males in Tuskegee, Alabama between 1932 and 1972. The U. S. Public Health Service ran this study on more than 300 people without notifying the participants about their disease nor treating them even after the introduction of penicillin. The study included recording the progress of disease and performing an autopsy on the deaths. This paper explores historical backgrounds enabled this infamous study, and discusses three driving forces behind the Tuskegee Study. First, it is important to understand that the Public Health Service was established in the U. S. Surgeon General's office and was operated as a military organization. Amidst the development of an imperial agenda of the U.S. in the late 19th and early 20th centuries, the PHS was responsible for protecting hygiene and the superiority of “the American race” against infectious foreign elements from the borders. The U.S. Army's experience of medical experiments in colonies and abroad was imported back to the country and formed a crucial part of the attitude and philosophy on public health. Secondly, the growing influence of eugenics and racial pathology at the time reinforced discriminative views on minorities. Progressivism was realized in the form of domestic reform and imperial pursuit at the same time. Major medical journals argued that blacks were inclined to have certain defects, especially sexually transmitted diseases like syphilis, because of their prodigal behavior and lack of hygiene. This kind of racial ideas were shared by the PHS officials who were in charge of the Tuskegee Study. Lastly, the PHS officials believed in continuing the experiment regardless of various social changes. They considered that black participants were not only poor but also ignorant of and even unwilling to undergo the treatment. When the exposure of the experiment led to the Senate investigation in 1973, the participating doctors of the PHS maintained that their study offered valuable contribution to the medical research. This paper argues that the combination of the efficiency of military medicine, progressive and imperial racial ideology, and discrimination on African-Americans resulted in the Tuskegee Syphilis Experiment.
African Continental Ancestry Group ; Alabama ; Autopsy ; Discrimination (Psychology) ; Eugenics ; Humans ; Hydrogen-Ion Concentration ; Hygiene ; Male ; Military Medicine ; Military Personnel ; Observational Study ; Pathology ; Penicillins ; Philosophy ; Public Health* ; Sexually Transmitted Diseases ; Social Change ; Syphilis ; United States Public Health Service ; United States*

OBJECTIVES: End-stage renal disease (ESRD), which is primarily a consequence of diabetes mellitus, shows an exemplary health disparity between African American and Caucasian patients in the United States. Because diabetic chronic kidney disease (CKD) patients of these two groups show differences in their medical problems, the markers leading to ESRD are also expected to differ. The purpose of this study was, therefore, to compare their medical complications at various levels of kidney function and to identify markers that can be used to predict ESRD. METHODS: The data of type 2 diabetic patients was obtained from the 2012 Cerner database, which totaled 1,038,499 records. The data was then filtered to include only African American and Caucasian outpatients with estimated glomerular filtration rates (eGFR), leaving 4,623 records. A priori machine learning was used to discover frequently appearing medical problems within the filtered data. CKD is defined as abnormalities of kidney structure, present for >3 months. RESULTS: This study found that African Americans have much higher rates of CKD-related medical problems than Caucasians for all five stages, and prominent markers leading to ESRD were discovered only for the African American group. These markers are high glucose, high systolic blood pressure (BP), obesity, alcohol/drug use, and low hematocrit. Additionally, the roles of systolic BP and diastolic BP vary depending on the CKD stage. CONCLUSIONS: This research discovered frequently appearing medical problems across five stages of CKD and further showed that many of the markers reported in previous studies are more applicable to African American patients than Caucasian patients.
African Americans ; Blood Pressure ; Diabetes Mellitus ; Glomerular Filtration Rate ; Glucose ; Hematocrit ; Humans ; Kidney Failure, Chronic ; Kidney* ; Machine Learning* ; Obesity ; Outpatients ; Renal Insufficiency ; Renal Insufficiency, Chronic ; United States

BACKGROUND: The aim of this study was to determine if there were significant differences in glenohumeral joint morphology between North American and East Asian populations that may influence sizing and selection of shoulder arthroplasty systems. METHODS: Computed tomography reconstructions of 92 North American and 58 East Asian patients were used to perform 3-dimensional measurements. The proximal humeral position was normalized in all patients by aligning it with the scapular plane utilizing anatomic landmarks. Measurements were performed on the humerus and scapula and included coronal and axial humeral head radius, humeral neck shaft and articular arc angles, glenoid height and width, and critical shoulder angle. Glenohumeral relationships were also measured and included lateral distance to the greater tuberosity and acromion, abduction lever arm, and acromial index. Parametric and nonparametric statistical analyses were used to compare population metrics. RESULTS: East Asian glenohumeral measurements were significantly smaller for all linear metrics (p < 0.05), with the exception of acromial length, which was greater than in the North American cohort (p < 0.001). The increase in acromial length affected all measurements involving the acromion including abduction lever arms. No difference was found between the neck shaft and articular angular measurements. CONCLUSIONS: The East Asian population exhibited smaller shoulder morphometrics than their North American cohort, with the exception of an extended acromial overhang. The morphologic data can provide some additional factors to consider when choosing an optimal shoulder implant for the East Asian population, in addition to creating future designs that may better accommodate this population.
African Americans/*statistics & numerical data ; Aged ; Anthropometry ; Asian Continental Ancestry Group/*statistics & numerical data ; European Continental Ancestry Group/*statistics & numerical data ; Female ; Humans ; Male ; Prosthesis Design ; Republic of Korea/epidemiology ; Shoulder/*anatomy & histology ; Shoulder Joint/*anatomy & histology ; Shoulder Prosthesis ; United States/epidemiology

OBJECTIVETo explore the race- and gender-specific distribution characteristics of rs1891385A/C and rs10975519C/T polymorphism of interleukin-33 (IL-33) gene in Zhuang and Han populations.

METHODSThe polymorphisms of rs1891385A/C and rs10975519C/T of IL-33 gene in 283 subjects from Guangxi Zhuang Autonomous Region were analyzed with single base extension (PCR-SEB) and DNA sequencing to analyze the differences in their distribution frequencies between genders and between Zhuang and Han populations.

RESULTSThree genotypes (AA, AC and CC) were found in rs1891385A/C with frequencies of 64.3%, 32.5% and 3.2%, respectively. The genotype and allele frequencies of rs1891385A/C in this Guangxi population showed no significant difference between Zhuang and Han subpopulations and between genders (P>0.05), but differed significantly from those in European and African black populations (P<0.01). Three genotypes (CC, CT and TT) were identified in rs10975519C/T with frequencies of 34.3%, 53.0%, and 12.7%, respectively, showing no significant ethnic or gender-specific differences in this population (P>0.05). The genotype frequency of rs10975519C/T in this population differed significantly from those in the European and Japanese populations (P<0.01), but the allele frequencies only showed significant differences from those in the European population (P<0.01).

CONCLUSIONrs1891385A/C and rs10975519C/T polymorphisms of IL-33 gene show a race-specific difference.

African Continental Ancestry Group ; genetics ; Asian Continental Ancestry Group ; genetics ; China ; Ethnic Groups ; genetics ; European Continental Ancestry Group ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Interleukin-33 ; genetics ; Male ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Sequence Analysis, DNA

OBJECTIVE: To investigate the impact of pelvic radiation on survival in patients with uterine serous carcinoma (USC) who received adjuvant chemotherapy. METHODS: Patients with stage I-IV USC were identified from the Surveillance, Epidemiology, and End Results program 2000 to 2009. Patients were included if treated with surgery and chemotherapy. Patients were divided into two groups: those who received chemotherapy and pelvic radiation therapy (CT_RT) and those who received chemotherapy only (CT). Kaplan-Meier curves and Cox regression proportional hazard models were used. RESULTS: Of the 1,838 included patients, 1,272 (69%) were CT and 566 (31%) were CT_RT. Adjuvant radiation was associated with significant improvement in overall survival (OS; p<0.001) and disease-specific survival (DSS; p<0.001) for entire cohort. These findings were consistent for the impact of radiation on OS (p<0.001) and DSS (p<0.001) in advanced stage (III-IV) disease but not for early stage (I-II) disease (p=0.21 for OS and p=0.82 for DSS). In multivariable analysis adjusting for age, stage, race and extent of lymphadenectomy, adjuvant radiation was a significant predictor of OS and DSS for entire cohort (p=0.003 and p=0.05) and in subset of patients with stage III (p=0.02 and p=0.07) but not for patients with stage I (p=0.59 and p=0.49), II (p=0.83 and p=0.82), and IV USC (p=0.50 and p=0.96). Other predictors were stage, positive cytology, African American race and extent of lymphadenectomy. CONCLUSION: In USC patients who received adjuvant chemotherapy, adjuvant radiation was associated with significantly improved outcome in stage III disease but not for other stages. Positive cytology, extent of lymphadenectomy and African race were significant predictors of outcome.
Adult ; African Americans/statistics & numerical data ; Aged ; Aged, 80 and over ; Carcinoma, Papillary/pathology/radiotherapy/*therapy ; Chemoradiotherapy, Adjuvant ; Chemotherapy, Adjuvant ; Female ; Humans ; Hysterectomy ; *Lymph Node Excision ; Middle Aged ; Neoplasm Staging ; SEER Program ; Survival Rate ; Uterine Neoplasms/pathology/radiotherapy/*therapy

Disparities between African American and Caucasian men in prostate cancer (PCa) diagnosis and treatment in the United States have been well established, with significant racial disparities documented at all stages of PCa management, from differences in the type of treatment offered to progression-free survival or death. These disparities appear to be complex in nature, involving biological determinants as well as socioeconomic and cultural aspects. We present a review of the literature on racial disparities in the diagnosis of PCa, treatment, survival, and genetic susceptibility. Significant differences were found among African Americans and whites in the incidence and mortality rates; namely, African Americans are diagnosed with PCa at younger ages than whites and usually with more advanced stages of the disease, and also undergo prostate-specific antigen testing less frequently. However, the determinants of the high rate of incidence and aggressiveness of PCa in African Americans remain unresolved. This pattern can be attributed to socioeconomic status, detection occurring at advanced stages of the disease, biological aggressiveness, family history, and differences in genetic susceptibility. Another risk factor for PCa is obesity. We found many discrepancies regarding treatment, including a tendency for more African American patients to be in watchful waiting than whites. Many factors are responsible for the higher incidence and mortality rates in African Americans. Better screening, improved access to health insurance and clinics, and more homogeneous forms of treatment will contribute to the reduction of disparities between African Americans and white men in PCa incidence and mortality.
African Americans ; Diagnosis* ; Disease-Free Survival ; Genetic Predisposition to Disease ; Healthcare Disparities ; Humans ; Incidence ; Insurance, Health ; Male ; Mass Screening ; Mortality ; Obesity ; Passive Cutaneous Anaphylaxis ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Risk Factors ; Social Class ; United States ; Watchful Waiting