Fecal microbes, short chain fatty acids, and colorectal cancer across racial/ethnic groups

AIM:To investigate differences in microbes and short chain fatty acid(SCFA) levels in stool samples from Hispanic and non-Hispanic African American,American Indian,and White participants.METHODS:Stool samples from twenty participants were subjected to analysis for relative levels of viable bacteria and for SCFA levels.Additionally,the samples were subjected to 16 S r RNA gene pyrosequencing for identification of bacteria present in the stool.We used a metagenome functional prediction technique to analyze genome copy numbers and estimate the abundance of butyrate kinase in all samples.RESULTS:We found that African Americans had significantly lower levels of acetate,butyrate,and total SCFAs than all other racial/ethnic groups.We also found that participant microbial profiles differed by racial/ethnic group.African Americans had significantly more Firmicutes than Whites,with enriched Ruminococcaceae.The Firmicutes /Bacteroidetes ratio was also significantly higher for African Americans than for Whites(P =0.049).We found Clostridium levels to be significantly and inversely related to total SCFA levels(P =0.019) and we found Bacteroides to be positively associated(P =0.027) and Clostridium to be negatively associated(P =0.012) with levels of butyrate.We also identified a correlation between copy number for a butyrate kinase predicted from 16 S r RNA gene abundance and levels of butyrate in stool.CONCLUSION:The identified differences in gut flora and SCFA levels may relate to colorectal cancer mortality differentials and may be useful as targets for future clinical and behavioral interventions.

Ulcerative colitis in a multiracial Asian country: Racial difference and clinical presentation among Malaysian patients

AIM： To determine the prevalence of ulcerative colitis （UC） in Malaysian patients and to establish the spectrum of the disease seen in Malaysian patients. METHODS： Data were obtained retrospectively from a review of the medical records of in- and out-patients with a diagnosis of UC at the University Hospital, Kuala Lumpur between 1985 and 1998. RESULTS： There were 45 confirmed cases of UC, of which 3 were foreigners, who were excluded from analysis. Thirty new cases of UC were diagnosed during the study period. Their mean age at presentation was 33.0±10.0 years. The highest prevalence of UC was 17.9/100 000 hospital admissions in the Indians, followed by 11.2/100 000 hospital admissions in the Chinese. The lowest prevalence was 3.7/100 000 hospital admissions in the Malays. The prevalence of UC was significantly higher in the Indians and the Chinese when compared with the Malays with an OR of 4.89 （CI = 2.02-12.24; x^2 = 15.45, P〈0.001） and 3.06 （CI = 1.24-7.78; x^2= 6.30; P= 0.012） respectively. The extent of colonic disease Was similar in the Malay and Indian patients. In contrast, distal or left-sided colitis predominated in the Chinese with an OR of 8.17 （95%CI = 1.31-64.87; x^2 = 5.53, P = 0.02）. Extraintestinal manifestations were uncommon （11.9%）. CONCLUSION： UC is an uncommon disease in Malaysia, but racial differences exist. The Indians had the highest prevalence of UC with the Chinese demonstrating the least extensive disease.

Racial and gender-based disparities and trends in common psychiatric conditions in liver cirrhosis hospitalizations:A ten-year United States study

BACKGROUND Chronic liver disease is associated with various neuropsychiatric conditions.There are currently no large studies assessing and comparing the prevalence of psy-chiatric illnesses based on patient profiles and the etiology of cirrhosis.AIM To examine the trends of hospitalizations among psychiatric conditions in cirrhosis.METHODS We used the National Inpatient Sample database 2016-2019 for the primary diagnosis of liver cirrhosis.The outcomes included the prevalence,trends,and associations of psychiatric diagnoses in these hospitalizations.Chi-square for categorical variables and the Wilcoxon rank test for continuous variables were utilized.RESULTS The prevalence of generalized anxiety disorder(GAD)in liver cirrhosis hospitalizations increased from 0.17%in 2009 to 0.92%in 2019(P<0.001).The prevalence of depression increased from 7%in 2009 to 12%in 2019(P<0.001).Attention deficit hyperactivity disorder(ADHD)prevalence increased from 0.06%to 0.24%.The prevalence of schizophrenia increased from 0.59%to 0.87%(P<0.001).Schizoaffective disorder prevalence increased from 0.10%to 0.35%(P<0.001).Posttraumatic stress disorder(PTSD)prevalence displayed increasing trends from 0.36%in 2009 to 0.93%in 2019(P<0.001).The prevalence of suicidal ideation increased from 0.23%to 0.56%in 2019.Cirrhosis related to alcoholic liver disease[adjusted odds ratios(aOR)1.18,95%CI 1.08-1.29,P<0.001]and non-alcoholic fatty liver disease(NAFLD)(aOR 1.14,95%CI 1.01-1.28,P=0.025)was associated with depression more than other causes.Alcohol-and NAFLD-associated cirrhosis had a stronger link to psychiatric disorders.Females had a higher association with GAD(aOR 2.56,95%CI 2.14-3.06,P<0.001),depression(aOR 1.78,95%CI 1.71-1.84,P<0.001),bipolar disorder(aOR 1.64,95%CI 1.52-1.77,P<0.001]and chronic fatigue(aOR 2.31,95%CI 1.31-4.07,P<0.001)when compared to males.Blacks,Hispanics,and Asian/Native Americans had a significantly lower association with GAD,depression,bipolar disorder,PTSD,and ADHD when compared to the white race.CONCLUSION The prevalence of psychiatric comorbidities in liver cirrhosis hospitalizations has increased over the last decade.Females had a higher association with psychiatric disorders compared to males.Blacks,Hispanics,and Asian/Native Americans had lower associations with psychiatric comorbidities compared to the white race.

Microbiome and colorectal carcinogenesis:Linked mechanisms and racial differences

Various studies have shown the interplay between the intestinal microbiome,environmental factors,and genetic changes in colorectal cancer(CRC)development.In this review,we highlight the various gut and oral microbiota associated with CRC and colorectal adenomas,and their proposed molecular mechanisms in relation to the processes of“the hallmarks of cancer”,and differences in microbial diversity and abundance between race/ethnicity.Patients with CRC showed increased levels of Bacteroides,Prevotella,Escherichia coli,enterotoxigenic Bacteroides fragilis,Streptococcus gallolyticus,Enterococcus faecalis,Fusobacterium nucleatum(F.nucleatum)and Clostridium difficile.Higher levels of Bacteroides have been found in African American(AA)compared to Caucasian American(CA)patients.Pro-inflammatory bacteria such as F.nucleatum and Enterobacter species were significantly higher in AAs.Also,AA patients have been shown to have decreased microbial diversity compared to CA patients.Some studies have shown that using microbiome profiles in conjunction with certain risk factors such as age,race and body mass index may help predict healthy colon vs one with adenomas or carcinomas.Periodontitis is one of the most common bacterial infections in humans and is more prevalent in Non-Hispanic-Blacks as compared to Non-Hispanic Whites.This condition causes increased systemic inflammation,immune dysregulation,gut microbiota dysbiosis and thereby possibly influencing colorectal carcinogenesis.Periodontal-associated bacteria such as Fusobacterium,Prevotella,Bacteroides and Porphyromonas have been found in CRC tissues and in feces of CRC patients.Therefore,a deeper understanding of the association between oral and gastrointestinal bacterial profile,in addition to identifying prevalent bacteria in patients with CRC and the differences observed in ethnicity/race,may play a pivotal role in predicting incidence,prognosis,and lead to the development of new treatments.

Racial disparity in colorectal cancer: Gut microbiome and cancer stem cells

Over the past two decades there has been remarkable progress in cancer diagnosis, treatment and screening. The basic mechanisms leading to pathogenesis of various types of cancers are also understood better and some patients, if diagnosed at a particular stage go on to lead a normal pre-diagnosis life. Despite these achievements, racial disparity in some cancers remains a mystery. The higher incidence, aggressiveness and mortality of breast, prostate and colorectal cancers(CRCs) in AfricanAmericans as compared to Caucasian-Americans are now well documented. The polyp-carcinoma sequence in CRC and easy access to colonic epithelia or colonic epithelial cells through colonoscopy/colonic effluent provides the opportunity to study colonic stem cells early in course of natural history of the disease. With the advent of metagenomic sequencing, uncultivable organisms can now be identified in stool and their numbers correlated with the effects on colonic epithelia. It would be expected that these techniques would revolutionize our understanding of the racial disparity in CRC and pave a way for the same in other cancers as well. Unfortunately, this has not happened. Our understanding of the underlying factors responsible in African-Americans for higher incidence and mortality from colorectal carcinoma remains minimal. In this review, we aim to summarize the available data on role of microbiome and cancer stem cells in racial disparity in CRC. This will provide a platform for further research on this topic.

Racial Disparities in Survival Outcomes of Prostate Cancer Patients after Surgery for Bone Metastases

Introduction: This study reviewed patients’ demographic, clinical and treatment characteristics to identify prognostic factors associated with survival of prostate cancer after developing bone metastases. We explored the racial disparities in these factors and how they relate with survival. Methods: We conducted a retrospective study on 79 men diagnosed with bone metastasis secondary to prostate cancer who underwent surgery at a single institution?from November 1977 to June 2011. Descriptive statistics were used to summarize patients’ characteristics. The Kaplan-Meier method was used to estimate characteristics of the survival distribution using two origination points—diagnosis and surgery. Cox hazard regression explored the relationship between prognostic factors and overall survival. Results: The majority of men were White (n = 63;80%) followed by Black (n = 7;9%), Hispanic (n = 7;9%), and Asian (n = 2;2%). Multivariate factors associated with poorer survival after bone metastasis surgery included race (Black), Gleason score > 8, and radiation treatment. Patients not receiving radiation had a longer survival experience relative to patients who received radiation before or after surgery (10.3 vs 6.5 months;P = 0.030). There was an association of PSA level at the time of bone metastasis diagnosis with survival following diagnosis but prior to surgery. The median time interval (Tm in months) between prostate cancer diagnosis and bone metastasis diagnosis was 39.1 (White), 31.2 (Hispanic), 15 (Blacks) and 43 (Asians). Patients with Tm m > 35 months (HR = 3.22;P Conclusion: The median survival and time interval from prostate cancer diagnosis to bone metastasis diagnosis was shorter in Blacks with respect to other races. The more aggressive nature of the disease in Blacks is likely due to the biology of the disease rather than access to treatment.

Racial Demographics in an Urban Movement Disorders Clinic

Objective: To assess the prevalence of Parkinson’s disease (PD) among African- Americans compared to non-Hispanic Whites in a tertiary urban Movement Disorders center. Background: Contributing factors in the prevalence of Parkinson’s disease (PD) based on race may improve health disparities in the United States. According to the largest study analyzing prevalence and incidence of PD among Medicare beneficiaries, the ratio of African-Americans (AA) to Caucasians in the general Medicare population is 9%, while the prevalence ratio of PD among AA compared to Caucasians is approximately 5%. Methods: We performed a retrospective analysis of African-American patients with PD in the movement disorders database at Boston Medical Center, which is the largest safety net hospital in New England. The demographics of the patients seen in the general neurology clinic are 30.57% AA and 38.06% non-Hispanic Caucasian. Results: The Movement disorders database included 488 patients, 327 of whom had PD. Of these, 287 were Caucasians and 18 were of African descent. Based on our clinic population the expected PD case ratio among AA compared to Caucasians was approximately 49%. The actual race ratio in patients of African descent compared to Caucasian was 6%, which was substantially lower than expected at Boston Medical Center. Conclusion: The demographics of the PD patients in our movement disorders clinic do not reflect the population at Boston Medical Center, or the demographics of our neurology clinic as a whole.

Racial Provocation Induces Cortisol Responses in African-Americans

Purpose: To examine salivary cortisol responses to a racially-charged stimulus in a group of African-American individuals. Methods: A nonrandom sample of 245 (age: 43.8 ± 11.1 years;64% female) African-American individuals was recruited by advertisements. Specifically, salivary cortisol was assessed prior to and after being exposed to a racially-charged movie clip. In addition, the salivary cortisol was assessed in?the morning and evening of the day following exposure to the racially-charged movie clip. Results: A statistically significant increase in cortisol was found (P 0.005) in the whole sample. High cortisol responders (highest tertile) and low cortisol responders (lowest tertile) were compared. The high cortisol responders had an elevated cortisol level the following morning (P 0.05) that abated by the evening sample (P > 0.20). In addition, the high cortisol responders who were younger, had lower waist to hip ratios, and experienced less lifetime discrimination than the low cortisol responders (P’s 0.05). Conclusions: The findings of an increase in cortisol in response to a racial provocation may provide a potential explanatory factor for the increased rates of cardiovascular disease in African-American individuals.

Racial disparities in nonalcoholic fatty liver disease clinical trial enrollment: A systematic review and meta-analysis

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)has a heterogeneous distribution across racial and ethnic groups,with a disproportionate burden among Hispanics.Although there are currently no approved therapies for treatment of NAFLD,several therapies have been investigated in clinical trials.AIM To analyze the inclusion of racial and ethnic minority groups in clinical trials for NAFLD.METHODS We performed a systematic review of North American,English-language,prospective studies for NAFLD therapies published from 2005 to 2019.Racial and ethnic enrollment data were recorded for each eligible study.Meta-analysis was performed to compute pooled prevalence of different racial and ethnic groups,followed by further subgroup analyses.These analyses were based on diagnosis of non-alcoholic steatohepatitis(NASH)and timing of study on enrollment by ethnicity.Descriptive statistics were performed to compare racial and ethnic study enrollment to previously reported NAFLD population prevalence.RESULTS Thirty-eight studies met criteria for inclusion in the systematic review.When reported,median age of enrolled subjects was 49 years(range 41.5-58)with 56%female participants.NAFLD was defined through biopsy findings in 79%(n=30)of the studies.Of the included articles,treatment modalities ranged from medications(n=28,74%),lifestyle interventions(n=5,13%),bariatric surgery(n=4,11%)and phlebotomy(n=1,2%).Twenty-eight studies(73%)included racial and/or ethnic demographic information,while only 17(45%)included information regarding Hispanic participation.Of the 2983 patients enrolled in all eligible trials,a total of only 346(11.6%)Hispanic participants was reported.Meta-analysis revealed a pooled Hispanic prevalence of 24.3%(95%confidence interval 16.6-32.0,I294.6%)among studies documenting Hispanic enrollment.Hispanic enrollment increased over time from 15%from 2005-2014 to 37%from 2015-2019.CONCLUSION In a meta-analysis of NAFLD trials,documentation of racial/ethnic demographic data occurred in less than half of studies.Standardization of reporting of race/ethnicity and targeted interventions toward minority recruitment are needed to improve diversity of enrollment.

Racial Disparities in the United States Criminal Justice System:“With Liberty and Justice for All?”

Racial discrimination remains a prevalent issue in the contemporary U.S.despite efforts to promote equality.Many young African American and Hispanic males are easy target for law enforcement agents.Minorities experience a higher and more unfair form of racial discrimination,racial profiling,police brutality,unfair sentencing,and mass incarceration for offences which are the same or less than those committed by White males.The rate of incarceration in the United States is five to eight times higher than most developed countries,and Black males constitute the largest percentage of inmates in the U.S.prison system.Once arrested,Black Americans are more likely to remain in prison longer,and await trial for minor offenses at a higher rate than Whites.Black and Latino males sentenced in state and federal courts face significantly greater odds of incarceration than White offenders for the same or even higher crimes.Vagins and McCurdy in a 2006 ACLU on“cracks in the system”reported that“There is no rational medical or penological reason for the 100:1 disparity between crack and powder cocaine and instead it causes an unjustified racial disparity in our penal system”(p.7).There is a racial disparity in the proportion of Black males in prison serving sentences of life without the possibility of parole(LWOP).In addition,The United States Criminal Justice System needs to be carefully examined as a top priority agenda needing immediate call of action that needs reform to guarantee the constitutional rights accorded to every American“with liberty and justice for all”.

Racial Disparities in Parkinson Disease: A Systematic Review of the Literature

Racial differences in the prevalence of Parkinson’s disease (PD) have been reported for decades. Many of the earliest reports were flawed because they were based on crude datasets, such as hospital databases, death certificates, door-to-door surveys and records of Medicare beneficiaries. These studies provided conflicting results and were found to have numerous biases. Publications with improved study designs in recent years have yielded higher quality findings that are worth reviewing. We reviewed studies published between 2005 and 2014 that analyzed the racial differences in Parkinson’s disease diagnosis, treatment—including deep brain stimulation—and access to care. Literature searches were conducted in PubMed and EBSCO. These studies highlight advances in the field and explore differences in PD among ethnic and racial groups. Our literature review focused on prevalence, treatment and diagnosis discrepancies, and racial variations in the perceptions of aging. An appraisal of twelve reviewed studies determined a decrease in prevalence and incidence of PD in Americans of African descent compared to Caucasians. The studies also showed multiple health disparities, including lack of access to care, treatment, and inclusion in research. More studies are needed to address the causes and prevention of health disparities, as well as solutions, such as community outreach.

Research on the Change of American Racial Discrimination from Studying The Twilight

The Twilight has achieved a great success since its showing in America. It tells a love triangle story among a human-Bena, a vampire-Adward and a werewolf-Jacob. At the beginning of the movie, Adward and Jacob are in mutually hostile-dependent relationship because of their love for Beria, and this girl finally chooses Adward as her husband which greatly exacerbates the conflicts between them. But this choice is not only a choice of love but also a choice of race. Since Adward is white while Jacob is a native American. What is hidden behind this love fight is actually the struggle between the races in America. Therefore, discrimination still exist in American society. However, the relationship between Adward and Jacob has changed a lot in the third series of The Twilight when Beria is in danger. At that time, they band together and try their best to protect her. A lot of stories happen between them, and at the end of the movie, Adward and Jacob finally become good friends which indicates that American racial discrimination has also been eased with the development of society and other factors. Therefore, people can learn about the change of American racial discrimination through studying the change of relationship between Adward and Jacob.

An Analysis of Visible Racial Discrimination In Invisible Man

Invisible Man by Ralph Ellison is regarded as one of the classical works in contemporary Black American Literature.By briefly analyzing the causes and effects of racial discrimination,the study aims to explore the blacks' responses to it.It is concluded that the hero,as an"invisible man",should accept his black identity,admitting the blacks' tradition and cultural identity,then he can find his self-belonging in the black community.

The Racial Prejudice in City in Paul Auster’s Novels

In Auster’s novels,the racial prejudice occupies a vital part;the whites presently take a majority privileged position in the mainstream culture;both the blacks and Jews become the target of racial prejudice which is vividly embodied in City of Glass:The Graphic Novel,Ghosts,Man in the Dark,In the Country of Last Things.

Visual Narrative of Racial Identity and double Consciousness in Because It Is Bitter,and Because It Is My Heart

The issue of race is the focus of Oates’novel Because It Is Bitter,and Because It Is My Heart.The racial identity metaphors in the photos in the novels show the characteristics of racial ideology.This paper argues that photographs are no longer used as external cultural metaphors,but as invisible references to racial prejudice and racial contradictions.This article re-examines Oates’racial issue writing in the form of visual narratives and considers the ambivalence of the dual identities and double consciousness of blacks in New York City in the late 1950s from the visual ethical interpretation of black identity awareness,and the perception of cruelty and violence of social inequality.The historical limitations of the harsh reality of racism make a critical intervention in visual ethics.

从“后种族社会”论的由来看美国社会的分裂

种族歧视是美国历史上一个不可抹去的污点。然而,随着奥巴马在2008年当选总统,美国社会上出现了一股“后种族社会”论的思潮。“后种族社会”论的源头可以追溯到20世纪60年代,当时联邦政府推出了《平权法案》,旨在改善少数族裔在就业和教育方面处于劣势的状况。而白人群体则宣称,针对少数族裔整体的歧视已经被铲除,升学和就业需靠自身努力,而不应该依赖政府的政策。虽然否定美国依然存在种族歧视的观点有明显缺陷,但诸多白人仍坚持这一看法,因为其有助于推翻《平权法案》。同时,强调种族歧视依然存在并以此来支持《平权法案》的阵营,也不会从自己的立场后退。上述现象反映了美国社会在种族问题上难以弥合的分裂。

Introductory Remarks by H.E. Duan Jielong,Head of Chinese Delegation,at the Consideration of the Committee on Elimination of All Forms of Racial Discrimination on China's 10th to 13th Periodic Reports

Madam Chairwoman, Mr. Rapporteur, Distinguished Members of the Committee, First of all, I would like to extend, on behalf of the Chinese delegation, our heartfelt greetings and respects to all the distinguished members of the Committee. The Committee has made enormous efforts and played an important role in promoting the objectives and principles of the International Convention on Elimination of All Forms of Racial Discrimination. The Chinese Government appreciates your endeavour and will continue to support the work of the Committee.

小说《木鱼歌》中的种族界限与融合

小说《木鱼歌》是华裔女性作家林露德继《千金》之后的又一力作。小说体现的多个主题中,种族这个主题备受关注。《木鱼歌》通过描写吕金功到美国生活的境遇以及他从美国再次回到祖国后的遭遇,凸显了不同种族界限间的不可逾越性,这也符合种族隔离对抗的观点。

玛丽安·摩尔诗中的赫拉克勒斯式黑人形象

通过斯图亚特·霍尔和霍米·巴巴的文化身份理论,深入分析了玛丽安·摩尔在爵士年代创作的诗歌《赫拉克勒斯的劳作》。文章发现摩尔通过将黑人身份与古希腊英雄赫拉克勒斯联系起来,构建了一种“新黑人”文化身份。这种身份解构了黑人个体的物化表征,颠覆了以白人视角为中心的话语框架,构建了文明的赫拉克勒斯式黑人形象。这首诗表明了摩尔反对种族刻板印象、建立文明共同体的理想。摩尔的诗歌超越了传统界限,倡导种族平等和文化多样性,激发了对克服种族主义、解决文化冲突、实现多元文化融合和建设文明共同体的深刻思考。

《相助》中的饮食叙事与再现伦理

《相助》自出版以来一直受到两种截然对立的评论,争执的焦点在于,身为白人的作家斯多克特是否公正准确地再现了种族隔离时期美国南方黑人女佣的生活经历。研究从饮食批评这个新兴的理论视角出发,结合有关美国南方饮食与黑人女佣的史料文献,从食物意象、厨娘形象与厨房空间三个层面对小说中的饮食叙事和再现伦理加以深入探讨,指出斯多克特试图通过客观再现黑人女佣经历来揭露该群体遭遇的种族歧视,但是她的无意识偏见和美化叙事又使得其再现未能颠覆反而强化了读者对黑人女佣的刻板印象。