Evaluating the disparity of female breast cancer mortality among racial groups - a spatiotemporal analysis

Background The literature suggests that the distribution of female breast cancer mortality demonstrates spatial concentration. There remains a lack of studies on how the mortality burden may impact racial groups across space and over time. The present study evaluated the geographic variations in breast cancer mortality in Texas females according to three predominant racial groups (non-Hispanic White, Black, and Hispanic females) over a twelve-year period. It sought to clarify whether the spatiotemporal trend might place an uneven burden on particular racial groups, and whether the excess trend has persisted into the current decade. Methods The Spatial Scan Statistic was employed to examine the geographic excess of breast cancer mortality by race in Texas counties between 1990 and 2001. The statistic was conducted with a scan window of a maximum of 90% of the study period and a spatial cluster size of 50% of the population at risk. The next scan was conducted with a purely spatial option to verify whether the excess mortality persisted further. Spatial queries were performed to locate the regions of excess mortality affecting multiple racial groups. Results The first scan identified 4 regions with breast cancer mortality excess in both non-Hispanic White and Hispanic female populations. The most likely excess mortality with a relative risk of 1.12 (p = 0.001) occurred between 1990 and 1996 for non-Hispanic Whites, including 42 Texas counties along Gulf Coast and Central Texas. For Hispanics, West Texas with a relative risk of 1.18 was the most probable region of excess mortality (p = 0.001). Results of the second scan were identical to the first. This suggested that the excess mortality might not persist to the present decade. Spatial queries found that 3 counties in Southeast and 9 counties in Central Texas had excess mortality involving multiple racial groups. Conclusion Spatiotemporal variations in breast cancer mortality affected racial groups at varying levels. There was neither evidence of hot-spot clusters nor persistent spatiotemporal trends of excess mortality into the present decade. Non-Hispanic Whites in the Gulf Coast and Hispanics in West Texas carried the highest burden of mortality, as evidenced by spatial concentration and temporal persistence.

Discrete Improvement in Racial Disparity in Survival among Patients with Stage IV Colorectal Cancer: a 21-Year Population-Based Analysis

Purpose Recently, multiple clinical trials have demonstrated improved outcomes in patients with metastatic colorectal cancer. This study investigated if the improved survival is race dependent. Patients and Methods Overall and cancer-specific survival of 77,490 White and Black patients with metastatic colorectal cancer from the 1988–2008 Surveillance Epidemiology and End Results registry were compared using unadjusted and multivariable adjusted Cox proportional hazard regression as well as competing risk analyses. Results Median age was 69 years, 47.4 % were female and 86.0 % White. Median survival was 11 months overall, with an overall increase from 8 to 14 months between 1988 and 2008. Overall survival increased from 8 to 14 months for White, and from 6 to 13 months for Black patients. After multivariable adjustment, the following parameters were associated with better survival: White, female, younger, better educated and married patients, patients with higher income and living in urban areas, patients with rectosigmoid junction and rectal cancer, undergoing cancer-directed surgery, having well/moderately differentiated, and N0 tumors (p<0.05 for all covariates). Discrepancies in overall survival based on race did not change significantly over time; however, there was a significant decrease of cancer-specific survival discrepancies over time between White and Black patients with a hazard ratio of 0.995 (95 % confidence interval 0.991–1.000) per year (p=0.03). Conclusion A clinically relevant overall survival increase was found from 1988 to 2008 in this population-based analysis for both White and Black patients with metastatic colorectal cancer. Although both White and Black patients benefitted from this improvement, a slight discrepancy between the two groups remained.

A Convex Solution to Disparity Estimation from Light Fields via the Primal-Dual Method

We present a novel approach to the reconstruction of depth from light field data. Our method uses dictionary representations and group sparsity constraints to derive a convex formulation. Although our solution results in an increase of the problem dimensionality, we keep numerical complexity at bay by restricting the space of solutions and by exploiting an efficient Primal-Dual formulation. Comparisons with state of the art techniques, on both synthetic and real data, show promising performances.

Acute onset incomitant image disparity modifies saccadic and vergence eye movements.

New-onset impairment of ocular motility will cause incomitant strabismus, i.e., a gaze-dependent ocular misalignment. This ocular misalignment will cause retinal disparity, that is, a deviation of the spatial position of an image on the retina of both eyes, which is a trigger for a vergence eye movement that results in ocular realignment. If the vergence movement fails, the eyes remain misaligned, resulting in double vision. Adaptive processes to such incomitant vergence stimuli are poorly understood. In this study, we have investigated the physiological oculomotor response of saccadic and vergence eye movements in healthy individuals after shifting gaze from a viewing position without image disparity into a field of view with increased image disparity, thus in conditions mimicking incomitance. Repetitive saccadic eye movements into a visual field with increased stimulus disparity lead to a rapid modification of the oculomotor response: (a) Saccades showed immediate disconjugacy (p < 0.001) resulting in decreased retinal image disparity at the end of a saccade. (b) Vergence kinetics improved over time (p < 0.001). This modified oculomotor response enables a more prompt restoration of ocular alignment in new-onset incomitance.

Ethnic disparity in defensive coping endothelial responses: The SABPA study

OBJECTIVES Defensive coping (DefS) in Blacks has been associated with greater cardiovascular risk than in their White counterparts. We examined associations between endothelial function mental stress responses and markers of vascular structure in a bi-ethnic cohort. METHODS We examined vascular function and structure in 368 Black (43.84±8.31years) and White Africans (44.78±10.90years). Fasting blood samples, 24h blood pressure, left carotid intima-media thickness of the far wall (L-CIMTf), and left carotid cross-sectional wall area (L-CSWA) values were obtained. von Willebrand factor (VWF), endothelin-1 (ET-1) and nitric oxide metabolite (NOx) responses to the Stroop mental stress test were calculated to assess endothelial function. DefS was assessed using the Coping Strategy Indicator questionnaire. Interaction between main effects was demonstrated for 283 participants with DefS scores above the mean of 26 for L-CIMTf. RESULTS Blunted stress responses for VWF (men 16.71% vs. 51.10%; women 0.85% vs. 42.09%, respectively) and NOx (men -64.52% vs. 74.89%; women -76.16% vs. 113.29%, respectively) were evident in the DefS Blacks compared to the DefS Whites (p<0.001). ET-1 increased more in Blacks (men 150% and women 227%, p<0.001) compared to the Whites (men 61.25% and women 35.49%, p<0.001). Ambulatory pulse pressure, but not endothelial function markers, contributed to L-CIMTf (ΔR(2)=0.11 p<0.001), and L-CSWA (ΔR(2)=0.08, p<0.001) in DefS African men but not in any other group. CONCLUSIONS Blunted stress-induced NOx and VWF responses and augmented ET-1 responses in DefS Blacks indicate endothelial dysfunction. DefS may facilitate disturbed endothelial responses and enforce vascular remodelling via compensatory increases in pulse pressure in Black men. These observations may indicate an increased risk of cardiovascular incidents via functional and structural changes of the vasculature in DefS Blacks.

Temporally Coherent Disparity Maps Using CRFs with Fast 4D Filtering

State of the art methods for disparity estimation achieve good results for single stereo frames, but temporal coherence in stereo videos is often neglected. In this paper we present a method to compute temporally coherent disparity maps. We define an energy over whole stereo sequences and optimize their Conditional Random Field (CRF) distributions using mean-field approximation. We introduce novel terms for smoothness and consistency between the left and right views, and perform CRF optimization by fast, iterative spatio-temporal filtering with linear complexity in the total number of pixels. Our results rank among the state of the art while having significantly less flickering artifacts in stereo sequences.

Crack and powder cocaine federal legislation: A sentencing disparity and potential for policy improvement

Since its introduction into the United States in the 1980s, crack cocaine has been a harsh epidemic that has taken its toll on a countless number of people. This highly addictive, cheap and readily available drug of abuse has permeated many demographic sectors, mostly in low income, lesser educated, and urban communities. This epidemic of crack cocaine use in inner city areas across the Unites States has been described as an expression of economic marginality and “social suffering” coupled with the local and international forces of drug market economies (Agar 2003). As crack cocaine is a derivative of cocaine, it utilizes the psychoactive component of the drug, but delivers it in a much stronger, quicker, and more addictive fashion. This, coupled with its ready availability and cheap price has allowed for users to not only become very addicted very quickly, but to be subject to the stringent and sometimes unequal or inconsistent punishments for possession and distribution of crack-cocaine. ^ There are many public health and social ramifications from the abuse of crack-cocaine, and these epidemics appear to target low income and minority groups. Public health issues relating to the physical, mental, and economic strain will be addressed, as well as the direct and indirect effects of the punishments that come as a result of the disparity in penalties for cocaine and crack-cocaine possession and distribution. ^ Three new policies have recently been introduced into the United Stated Congress that actively address the disparity in sentencing for drug and criminal activities. They are, (1) Powder-Crack Cocaine Penalty Equalization Act of 2009, (HR 18, 111th Cong. 2009), (2) The Drug Sentencing Reform and Cocaine Kingpin Trafficking Act of 2009, (HR 265, 111th Cong. 2009) and (3) The Justice Integrity Act of 2009, (111th Cong. 2009). ^ Although they have only been initiated, if passed, they have potential to not only eliminate the crack-cocaine disparity, but to enact laws that help those affected by this epidemic. The final and overarching goal of this paper is to analyze and ultimately choose the ideal policy that would not only eliminate the cocaine and crack disparity regardless of current or future state statutes, but will provide the best method of rehabilitation, prevention, and justice. ^

Sources of Regional Income Disparity in Rural Vietnam: Oaxaca-Blinder Decomposition

This paper investigates determinants of regional income disparity in rural Vietnam, with special emphasis placed on the roles of human capital and land. We apply a decomposition method, suggested by Oaxaca and Blinder. We found that returns to assets rather than endowments, especially those of human capital, are one of the leading factors to account for income differences across regions. We also found that substantial improvements of returns to human capital in the Red River delta region are a driving force to catch up with Mekong River delta region. Unexpectedly, differences in land endowment do not strongly correlate with regional income disparity because better access to land in a region was partially offset by lower returns.

Income disparity among persons with disabilities assessed by education and sex : findings from a field survey conducted in Metro Manila, the Philippines

How do persons with disabilities (PWDs) earn a living? From the view point of poverty reduction, this question is quite critical in developing countries. This paper presents an investigation of economic activities of PWDs in the Philippines where, among developing countries, disability-related legislation is relatively progressive. In 2008, a field survey was conducted in cooperation with Disability People’s Organizations (DPOs) using a tailor-made questionnaire in four representative cities of Metro Manila. The level and determinants of income of PWDs were examined with Mincer regression. Conclusions are as follows: (1) The incidence and depth of poverty are greater among sample PWDs than that of the total population in Metro Manila. (2) There is remarkable income disparity among PWDs which is associated with education and sex. (3) After controlling individual, parental, and environmental characteristics, it was found that female PWDs are likely to earn less than male PWDs due to fewer opportunities to participate in economic activities. It is suggested that female PWDs are doubly handicapped in earning income.

Factor decomposition of income inequality change : Japan's regional income disparity from 1955 to 1998

We propose a method for the decomposition of inequality changes based on panel data regression. The method is an efficient way to quantify the contributions of variables to changes of the Theil T index while satisfying the property of uniform addition. We illustrate the method using prefectural data from Japan for the period 1955 to 1998. Japan experienced a diminishing of regional income disparity during the years of high economic growth from 1955 to 1973. After estimating production functions using panel data for prefectures in Japan, we apply the new decomposition approach to identify each production factor’s contributions to the changes of per capita income inequality among prefectures. The decomposition results show that total factor productivity (residual) growth, population change (migration), and public capital stock growth contributed to the diminishing of per capita income disparity.

Refined facial disparity maps for automatic creation of 3D avatars

We propose a new method to automatically refine a facial disparity map obtained with standard cameras and under conventional illumination conditions by using a smart combination of traditional computer vision and 3D graphics techniques. Our system inputs two stereo images acquired with standard (calibrated) cameras and uses dense disparity estimation strategies to obtain a coarse initial disparity map, and SIFT to detect and match several feature points in the subjects face. We then use these points as anchors to modify the disparity in the facial area by building a Delaunay triangulation of their convex hull and interpolating their disparity values inside each triangle. We thus obtain a refined disparity map providing a much more accurate representation of the the subjects facial features. This refined facial disparity map may be easily transformed, through the camera calibration parameters, into a depth map to be used, also automatically, to improve the facial mesh of a 3D avatar to match the subjects real human features.

Ocular residual astigmatism and topographic disparity vector indexes in normal healthy eyes

Purpose: To define a range of normality for the vectorial parameters Ocular Residual Astigmatism (ORA) and topography disparity (TD) and to evaluate their relationship with visual, refractive, anterior and posterior corneal curvature, pachymetric and corneal volume data in normal healthy eyes. Methods: This study comprised a total of 101 consecutive normal healthy eyes of 101 patients ranging in age from 15 to 64 years old. In all cases, a complete corneal analysis was performed using a Scheimpflug photography-based topography system (Pentacam system Oculus Optikgeräte GmbH). Anterior corneal topographic data were imported from the Pentacam system to the iASSORT software (ASSORT Pty. Ltd.), which allowed the calculation of the ocular residual astigmatism (ORA) and topography disparity (TD). Linear regression analysis was used for obtaining a linear expression relating ORA and posterior corneal astigmatism (PCA). Results: Mean magnitude of ORA was 0.79 D (SD: 0.43), with a normality range from 0 to 1.63 D. 90 eyes (89.1%) showed against-the-rule ORA. A weak although statistically significant correlation was found between the magnitudes of posterior corneal astigmatism and ORA (r = 0.34, p < 0.01). Regression analysis showed the presence of a linear relationship between these two variables, although with a very limited predictability (R2: 0.08). Mean magnitude of TD was 0.89 D (SD: 0.50), with a normality range from 0 to 1.87 D. Conclusion: The magnitude of the vector parameters ORA and TD is lower than 1.9 D in the healthy human eye.

Clinical utility of ocular residual astigmatism and topographic disparity vector indexes in subclinical and clinical keratoconus

Purpose. We aimed to characterize the distribution of the vector parameters ocular residual astigmatism (ORA) and topography disparity (TD) in a sample of clinical and subclinical keratoconus eyes, and to evaluate their diagnostic value to discriminate between these conditions and healthy corneas. Methods. This study comprised a total of 43 keratoconic eyes (27 patients, 17–73 years) (keratoconus group), 11 subclinical keratoconus eyes (eight patients, 11–54 years) (subclinical keratoconus group) and 101 healthy eyes (101 patients, 15–64 years) (control group). In all cases, a complete corneal analysis was performed using a Scheimpflug photography-based topography system. Anterior corneal topographic data was imported from it to the iASSORT software (ASSORT Pty. Ltd), which allowed the calculation of ORA and TD. Results. Mean magnitude of the ORA was 3.23 ± 2.38, 1.16 ± 0.50 and 0.79 ± 0.43 D in the keratoconus, subclinical keratoconus and control groups, respectively (p < 0.001). Mean magnitude of the TD was 9.04 ± 8.08, 2.69 ± 2.42 and 0.89 ± 0.50 D in the keratoconus, subclinical keratoconus and control groups, respectively (p < 0.001). Good diagnostic performance of ORA (cutoff point: 1.21 D, sensitivity 83.7 %, specificity 87.1 %) and TD (cutoff point: 1.64 D, sensitivity 93.3 %, specificity 92.1 %) was found for the detection of keratoconus. The diagnostic ability of these parameters for the detection of subclinical keratoconus was more limited (ORA: cutoff 1.17 D, sensitivity 60.0 %, specificity 84.2 %; TD: cutoff 1.29 D, sensitivity 80.0 %, specificity 80.2 %). Conclusion. The vector parameters ORA and TD are able to discriminate with good levels of precision between keratoconus and healthy corneas. For the detection of subclinical keratoconus, only TD seems to be valid.