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Open Access June 02, 2025

Residual Sets and the Density of Binary Goldbach Representations

Abstract A residual-set framework is introduced for analyzing additive prime conjectures, with particular emphasis on the Strong Goldbach Conjecture (SGC). For each even integer En4, the residual set [...] Read more.
A residual-set framework is introduced for analyzing additive prime conjectures, with particular emphasis on the Strong Goldbach Conjecture (SGC). For each even integer En4, the residual set (En)={Enp p<En,p} is defined, and the universal residual set E=En(En) is constructed. It is shown that E contains infinitely many primes. A nontrivial constructive lower bound is derived, establishing that the number of Goldbach partitions satisfies G(E)2 for all E8, and that the cumulative partition count satisfies ENG(E)N2log4N. An optimized deterministic algorithm is implemented to verify the SGC for even integers up to 16,000 digits. Each computed partition En=p+q is validated using elliptic curve primality testing, and no exceptions are observed. Runtime variability observed in the empirical tests corresponds with known fluctuations in prime density and modular residue distribution. A recursive construction is formulated for generating Goldbach partitions, using residual descent and leveraging properties of the residual sets. The method extends naturally to Lemoine's Conjecture, asserting that every odd integer n7 can be expressed as n=p+2q, where p,q. A corresponding residual formulation is developed, and it is proven that at least two valid partitions exist for all n9. Comparative analysis with the Hardy-Littlewood and Chen estimates is provided to contextualize the cumulative growth rate. The residual-set methodology offers a deterministic, scalable, and structurally grounded approach to additive problems in prime number theory, supported by both theoretical results and large-scale computational evidence.
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Article
Open Access May 13, 2025

Geochemistry distributions and statistics analysis of REE in stream sediments from the watershed west of Mambaka (Adamawa Plateau, Cameroun)

Abstract The Mambaka watershed is extends between latitudes 1 3°45'E and 14°15'E and longitudes 7°16'N and 6°45'N. The geology, various tectonic and structural events that have affected the Adamawa Plateau in Cameroon make it rich in multi-substance mining. The objective of this study is to map rare earth (REE) geochemical anomalies in the sediments of the watershed streams west of Mambaka, and to trace [...] Read more.
The Mambaka watershed is extends between latitudes 1 3°45'E and 14°15'E and longitudes 7°16'N and 6°45'N. The geology, various tectonic and structural events that have affected the Adamawa Plateau in Cameroon make it rich in multi-substance mining. The objective of this study is to map rare earth (REE) geochemical anomalies in the sediments of the watershed streams west of Mambaka, and to trace their origins and geochemical processes. Predictive maps from inverse distance interpolations (IDW), factor analysis (F1) or principal component analysis (PCA) and hierarchical bottom-up classification maps provided a better understanding of the central tendency, distribution and dispersion of REE in the samples and in the study area, based on standard deviation and variance values that generated two factors F1 (Ho-Tm-Er-Yb-Lu-Dy-Tb-Gd-Eu-Sm) and F2 (Pr-Nd-Ce-La-Sm) representing 92.44% of the total cumulative variance. The ratios Ce/Ce* > 0.78 and Eu/Eu* > 1 demonstrate positive anomalies in Ce and Eu, and clear differentiation. The normalized concentrations used to calculate fractionation ratios show that the values for LaN/YbN (0.58 to 1.34), LaN/SmN (0.61 to 0.88) and LaN/LuN (0.62 to 1.43) suggest higher fractionation in SS09 and lower fractionation in SS01. Similarly, the ratios La/Lu (61.71 to 143.46), La/Yb (9.00 to 20.72), La/Sm (4.02 to 5.83) and La/ Lu (61.71 to 143.46) confirm these higher ratios in SS09 and lower in SS01. The REE in the study area comes from hydrothermal processes based on high lineament densities at sampling points in igneous rocks with a mean ∑REE value of between 174-219 ppm.
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Open Access January 02, 2025

A review of Opuntia ficus-indica (L.) Mill. ethnobotany in Italy and North Africa

Abstract Opuntia ficus-indica (L.) Mill., commonly known as prickly pear, is a versatile plant widely used for food, medicinal, and cosmetic purposes in various regions of the Mediterranean and North Africa. This study provides a comparative ethnobotanical review of prickly pear uses in Algeria, Morocco, Tunisia, and Italy. In total, 74 articles were selected from ethnobotanical uses in Italy, Algeria, Morocco and Tunisia. In the Maghreb, the plant is used for fruit production and processed products, such as jams, oils, and flours, as well as for traditional medicinal purposes. In Algeria and Morocco, the fruits and cladodes are used to treat digestive disorders, diabetes, and skin diseases. In Tunisia, products derived from O. ficus-indica are also applied in the cosmetic industry and for erosion control. In Italy, particularly in Sicily and Calabria, the prickly pear is a vital resource, used for both food consumption and for medicinal purposes. The cladodes, rich in mucilage, are applied as topical remedies for skin problems, while the fruits are a key ingredient in the preparation of traditional desserts. Furthermore, O. ficus-indica [...] Read more.
Opuntia ficus-indica (L.) Mill., commonly known as prickly pear, is a versatile plant widely used for food, medicinal, and cosmetic purposes in various regions of the Mediterranean and North Africa. This study provides a comparative ethnobotanical review of prickly pear uses in Algeria, Morocco, Tunisia, and Italy. In total, 74 articles were selected from ethnobotanical uses in Italy, Algeria, Morocco and Tunisia. In the Maghreb, the plant is used for fruit production and processed products, such as jams, oils, and flours, as well as for traditional medicinal purposes. In Algeria and Morocco, the fruits and cladodes are used to treat digestive disorders, diabetes, and skin diseases. In Tunisia, products derived from O. ficus-indica are also applied in the cosmetic industry and for erosion control. In Italy, particularly in Sicily and Calabria, the prickly pear is a vital resource, used for both food consumption and for medicinal purposes. The cladodes, rich in mucilage, are applied as topical remedies for skin problems, while the fruits are a key ingredient in the preparation of traditional desserts. Furthermore, O. ficus-indica has historically been used as forage and to produce natural dyes. Results indicate that the versatility of this species, combined with its ability to adapt to extreme climates, makes it a valuable resource for the development of new nutraceutical and cosmetic products. However, further scientific research is necessary to explore the bio-functional potential of this plant and to promote its broader and more sustainable use, especially in arid and semi-arid regions.
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Review Article
Open Access November 15, 2024

Education Does Not Equally Increase Financial Well-being for All

Abstract Background: Financial well-being is a key domain of overall well-being, encompassing an individual's ability to meet financial obligations, secure their financial future, and maintain a sense of financial freedom. Education is often viewed as a critical pathway to enhancing financial well-being. However, the returns of education on financial well-being are not uniform across racial, ethnic, [...] Read more.
Background: Financial well-being is a key domain of overall well-being, encompassing an individual's ability to meet financial obligations, secure their financial future, and maintain a sense of financial freedom. Education is often viewed as a critical pathway to enhancing financial well-being. However, the returns of education on financial well-being are not uniform across racial, ethnic, and nativity groups. The theory of Minorities’ Diminished Returns (MDRs) suggests that the positive effects of education on outcomes such as income and financial security are weaker for marginalized groups, including Black individuals, Latinos, and immigrants. Objective: This study examines the diminished returns of education on financial well-being among Black, Latino, and immigrant populations in the United States. We aim to investigate how structural inequalities contribute to weaker financial returns on education for these groups compared to their White and native-born counterparts. Methods: We utilized data from the Understanding America Study (UAS 2014) to conduct a cross-sectional analysis of adult respondents. The study assessed financial well-being outcomes (e.g., income, savings, and financial security) and their association with educational attainment across racial, ethnic, and nativity groups. Regression models were employed to test for interaction effects between education and race/ethnicity/nativity, adjusting for sociodemographic factors such as age, gender, employment, and family structure. Results: Our analysis included 8,121 individuals. The mean age of the respondents was 48 years (SD = 16). High education was associated with higher financial well-being (B = 1.284, 95% CI: 1.157, 1.410). The interaction terms between education and immigrant status (B = -0.507, 95% CI: -0.930, -0.084), race (Black) (B = -0.770, 95% CI: -1.208, -0.331), and ethnicity (Hispanic) (B = -0.589, 95% CI: -0.969, -0.210) were all significant, suggesting that immigrant, Black, and Hispanic individuals experience diminished returns on education in terms of financial well-being, relative to US-born non-Hispanic White individuals. The significant negative interactions between education and minority statuses (Black, Hispanic, and immigrant) indicate that while education generally improves financial well-being, the magnitude of this improvement is substantially smaller for these marginalized groups. Conclusion: Understanding how education translates to financial well-being across different racial, ethnic, and nativity groups is critical for addressing persistent financial disparities.
Article
Open Access October 03, 2023

Pharmaceutical Drug Serialization: A Comprehensive Review

Abstract A persistent problem in the pharmaceutical industry that has existed for centuries is the prevalence of counterfeit drugs, and the World Health Organization (WHO) estimates that millions of people are affected by this issue each year. In particular, 4 out of 10 drugs in poor or underdeveloped countries may be adulterated, which can lead to severe adverse events. To address this problem, many [...] Read more.
A persistent problem in the pharmaceutical industry that has existed for centuries is the prevalence of counterfeit drugs, and the World Health Organization (WHO) estimates that millions of people are affected by this issue each year. In particular, 4 out of 10 drugs in poor or underdeveloped countries may be adulterated, which can lead to severe adverse events. To address this problem, many countries have implemented regulatory compliance measures such as pharmaceutical drug serialization, which requires the unique identification of every drug package manufactured. This enables tracking and tracing of individual packages throughout the supply chain and helps to prevent counterfeit drugs from entering the market. In this paper, we conduct a systematic review of the serialization process evaluation and its impact on the pharmaceutical industry. We discuss the benefits of pharmaceutical drug serialization, including its ability to improve drug security and reduce adverse events and investigations. We also examine the challenges associated with implementing serialization processes and the regulatory requirements necessary for compliance. Finally, we explore the various tracking and tracing technologies used in serialization processes and their effectiveness in preventing the distribution of counterfeit drugs. Overall, this paper highlights the importance of pharmaceutical drug serialization in ensuring the safety and efficacy of drugs in the healthcare industry, particularly in poor or underdeveloped countries where the problem of adulterated drugs is especially prevalent.
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Review Article
Open Access November 24, 2022

Contribution to the Ethnobotanical Knowledge of Serre Calabre (Southern Italy)

Abstract This work presents the results of an ethnobotanical research carried out in the territory of Serre Calabre, province of Vibo Valentia (Calabria, southern Italy). In this territory, the bond between the residents and the rural environment is still strong, because the small urban centers are placed in a predominantly agricultural and forestry environment still managed in a traditional way. The [...] Read more.
This work presents the results of an ethnobotanical research carried out in the territory of Serre Calabre, province of Vibo Valentia (Calabria, southern Italy). In this territory, the bond between the residents and the rural environment is still strong, because the small urban centers are placed in a predominantly agricultural and forestry environment still managed in a traditional way. The survey took place between January 2019 and July 2021. Data were collected through semi-structured interviews with locals. As many as 17 informants were interviewed and a total of 185 interviews were recorded. Plant specimens were collected under the indication of the informants and then deposited at the herbarium of the Mediterranean University of Reggio Calabria (REGGIO). The data were stored on a digital database and then statistically analyzed some synthetic indexes have also been calculated, such as Relative Frequency of Citation (RFC) and the Cultural Importance Index (CI). The investigation allowed to identify 84 taxa belonging to 39 different families, among which the most represented are Lamiaceae (23 interviews, 9 taxa), Asteraceae (22 interviews, 12 taxa). The identified taxa were prevalently cited for alimentary (46 interviews, 32 taxa) and healing (55, 27) uses. The results obtained show how the traditional knowledge about plants in the Serre Calabre area is still alive, however it is exclusive heritage of elderly people and often only in one or just a few informants. In fact, many practices are no longer in use and will not be transferred to the new generations.
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Open Access October 29, 2022

Patient Perspectives on Factors Influencing Initiation of Gynecologic Care

Abstract Addressing adolescent and sexual reproductive healthcare is essential to providing young patients with the resources they need to navigate and empower themselves with. However, there is limited data about how often this occurs. Several studies have previously indicated that there is a large gap in accessing this gap in low-income neighborhoods. Our study aims to identify the establishment of [...] Read more.
Addressing adolescent and sexual reproductive healthcare is essential to providing young patients with the resources they need to navigate and empower themselves with. However, there is limited data about how often this occurs. Several studies have previously indicated that there is a large gap in accessing this gap in low-income neighborhoods. Our study aims to identify the establishment of gynecologic care among adolescent cisgender women and elucidate potential reasons for seeking or not seeking out care. We approached women in the pediatric emergency room that matched the inclusion criteria set out. Qualitative surveys were conducted until thematic saturation was reached and a cross-section study design was employed. Interviews were analyzed through modified ground theory. The study was conducted at the pediatric emergency department at University Hospital located in Newark, NJ. In 2018 estimates, the Newark population consists of 47.0% Black and 39.2% Hispanic or Latinos. Semi-structured interviews were conducted with 27 cisgendered, English-speaking females between ages 18 to 25 presenting to the pediatric emergency room who may or may not have previously established primary care with a gynecologist. Transcriptions were analyzed using modified grounded theory and themes were identified using inductive coding of patient interviews.
Article
Open Access October 12, 2022

Effects of Illicit Financial Flows on Economic Growth and Development in Sub-Saharan Africa

Abstract Using a desktop review of literature, the effect of illegal capital flows on the economic performance of Sub-Saharan Africa is examined. The review focus on articles with attention to illegal capital flows and their effects on the economic performance of Sub-Saharan Africa as a whole. By way of sampling method, purposive sampling was used, and so the desktop review focused purposively on articles [...] Read more.
Using a desktop review of literature, the effect of illegal capital flows on the economic performance of Sub-Saharan Africa is examined. The review focus on articles with attention to illegal capital flows and their effects on the economic performance of Sub-Saharan Africa as a whole. By way of sampling method, purposive sampling was used, and so the desktop review focused purposively on articles published on issues of illicit financial flows and their effects on the economic performance of Ghana and Sub-Saharan Africa as a whole. The review found a high propensity of trade mis-invoicing and thus high illicit financial flows, transactions across boarders from developing countries and for that matter Sub-Saharan Africa to the developed economies. Therefore, the research recommends that customs divisions in sub-Saharan Africa should have up-to-date commodity-level world pricing information to make relatively better comparisons to detect mis-pricing and avoid such falsification and manipulation in trade. Given the high propensity of trade mis-invoicing resulting in high illicit financial flows, we recommend that cross-border transactions from developing sub-Saharan African countries be subjected to heightened scrutiny to curtail any potential traces of falsification in trade for tax evasion.
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Open Access September 01, 2022

Expanded Design between Design Activism and Collectible Design

Abstract The last three decades have witnessed in Europe an increasing interest from institutions, and creative communities in independent research connected to crafting, DIY, maker culture, and design activism. A new generation of designers has focused on the experimentation of processes, materials, and technologies used as a vehicle for socio-political and environmental messages and as the starting point [...] Read more.
The last three decades have witnessed in Europe an increasing interest from institutions, and creative communities in independent research connected to crafting, DIY, maker culture, and design activism. A new generation of designers has focused on the experimentation of processes, materials, and technologies used as a vehicle for socio-political and environmental messages and as the starting point of solid narrative projects. This paper aims to analyse this phenomenon inside the niche of Collectible Design, a field in recent years of great interest by galleries and institutions for its ability to embrace material and technological research as well as craftsmanship and art. We investigate the phenomenon, through a series of interviews with designers such as Shahar Livne, Eugenia Morpurgo, Pleun van Dijk, Tellurico, and Standard 404, selected for their ability to use experimental materials and technologies, as communicative media for reflections on systemic issues.
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Case Study
Open Access May 04, 2022

First contribution to the ethnobotanical knowledge in the Peloritani Mounts (NE Sicily)

Abstract This paper presents the results of an ethnobotanical survey carried out in the Peloritani Mounts (NE Sicily). This investigation aims to illustrate the first record known of the traditional uses of plants in this territory through the case study of a small rural suburb named Tipoldo (Messina). The data were collected from 20 informants over the age of 66, who were mainly farmers and shepherds, and were analyzed using two quantitative ethnobotanical indicators. For each plant was reported the Latin name, life form, vernacular name, parts used, ethnobotany category, claimed uses, status, and their relative indexes. Based on semi-structured interviews carried out between February 2017 and May 2018, a listing was compiled of 126 wild plants belonging to 51 families, the most predominant being Asteraceae (19 species) and Fabaceae (15 species). The most common ethnobotanical uses reported are medicinal (30%) and agropastoral use (19%). Among the preparation methods indicated, leaves (39%) were the most commonly used parts of the plants, while the species most mentioned in connection with ethnobotanical applied indexes were: Crepis vesicaria, Dittrichia graveolens, Hypochaeris radicata, Salvia Rosmarinus and Clinopodium nepeta [...] Read more.
This paper presents the results of an ethnobotanical survey carried out in the Peloritani Mounts (NE Sicily). This investigation aims to illustrate the first record known of the traditional uses of plants in this territory through the case study of a small rural suburb named Tipoldo (Messina). The data were collected from 20 informants over the age of 66, who were mainly farmers and shepherds, and were analyzed using two quantitative ethnobotanical indicators. For each plant was reported the Latin name, life form, vernacular name, parts used, ethnobotany category, claimed uses, status, and their relative indexes. Based on semi-structured interviews carried out between February 2017 and May 2018, a listing was compiled of 126 wild plants belonging to 51 families, the most predominant being Asteraceae (19 species) and Fabaceae (15 species). The most common ethnobotanical uses reported are medicinal (30%) and agropastoral use (19%). Among the preparation methods indicated, leaves (39%) were the most commonly used parts of the plants, while the species most mentioned in connection with ethnobotanical applied indexes were: Crepis vesicaria, Dittrichia graveolens, Hypochaeris radicata, Salvia Rosmarinus and Clinopodium nepeta. These practices are presently performed only by a few elderly people, who rely on plants solely for a few activities. Furthermore, ethnobotanical studies are fundamental to clear up the knowledge on the traditional plant uses that are still current in this part of Sicily, to preserve this cultural heritage for future generations.
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Article
Open Access March 05, 2026

For My Family, I Take It’: A Phenomenological Study of Antihypertensive Medication Use Among Filipino Adults

Abstract Hypertension remains a leading cause of cardiovascular morbidity and mortality. Although effective antihypertensive therapies are available, sustained blood pressure control remains suboptimal due to inconsistent medication use. Most adherence research is quantitative and offers limited understanding of how individuals interpret lifelong treatment within daily life, particularly in culturally [...] Read more.
Hypertension remains a leading cause of cardiovascular morbidity and mortality. Although effective antihypertensive therapies are available, sustained blood pressure control remains suboptimal due to inconsistent medication use. Most adherence research is quantitative and offers limited understanding of how individuals interpret lifelong treatment within daily life, particularly in culturally grounded contexts. To explore the lived experiences of Filipino adults taking antihypertensive medication. A qualitative study grounded in Heideggerian interpretive phenomenology was conducted. Ten Filipino adults diagnosed with hypertension were purposively recruited from outpatient clinics in Manila, Philippines. In-depth semi-structured interviews were transcribed verbatim and analyzed using the six-step IPA framework. Analysis revealed six interconnected themes describing how participants interpreted and sustained medication use: (1) Diagnosis as Disruption; (2) Medication as Protection and Responsibility; (3) The Paradox of the Silent Illness; (4) Everyday Barriers to Sustained Treatment; (5) Constructing Routine and Adaptive Self-Management; and (6) Family as Anchor within Cultural Contexts. These themes reflected emotional adjustment, symptom-driven adherence, financial and work-related barriers, adaptive coping strategies, and strong family-centered motivation. Medication-taking was experienced as an ongoing negotiation shaped by bodily cues, daily demands, and relational obligations. Conclusion: Antihypertensive medication use is shaped by relational, cultural, and socioeconomic contexts, underscoring the need for family-inclusive and culturally responsive hypertension care.
Article
Open Access January 25, 2026

Meigs’ syndrome presenting with pleuritic chest pain and dyspnea: rapid resolution after resection of an ovarian fibroma

Abstract Meigs’ syndrome is a rare triad of a benign ovarian fibroma (or fibroma‑like tumor), ascites, and pleural effusion that resolves after tumor resection. A 53‑year‑old multiparous woman presented with progressive exertional dyspnea and right‑sided pleuritic chest pain. Respiratory and cardiac evaluations were initially unrevealing. Bedside assessment identified mild right basal dullness, and [...] Read more.
Meigs’ syndrome is a rare triad of a benign ovarian fibroma (or fibroma‑like tumor), ascites, and pleural effusion that resolves after tumor resection. A 53‑year‑old multiparous woman presented with progressive exertional dyspnea and right‑sided pleuritic chest pain. Respiratory and cardiac evaluations were initially unrevealing. Bedside assessment identified mild right basal dullness, and point‑of‑care abdominal ultrasound demonstrated mild free fluid and a solid right adnexal mass. Chest radiography confirmed a small right pleural effusion. Without computed tomography and without diagnostic paracentesis or thoracentesis, Meigs’ syndrome was suspected. The patient underwent laparotomy with total abdominal hysterectomy and bilateral salpingo‑oophorectomy. Histopathology confirmed an ovarian fibroma. Postoperatively, symptoms resolved dramatically, and follow‑up imaging demonstrated complete resolution of the pleural effusion and ascites. This case highlights the importance of considering gynecologic etiologies in unexplained pleural effusion and dyspnea, especially when accompanied by abdominal distension or pelvic pressure.
Case Report
Open Access November 06, 2025

Ventral Attention Network Resting State Functional Connectivity: Psychosocial Correlates among US Adolescents

Abstract Background: Resting-state functional MRI (rsfMRI) provides insights into large-scale brain network organization associated with cognitive control, emotion regulation, and attentional processes. The ventral attention network (VAN) is a key salience-driven network that supports attentional re-orienting to behaviorally relevant stimuli. However, little is known about how VAN [...] Read more.
Background: Resting-state functional MRI (rsfMRI) provides insights into large-scale brain network organization associated with cognitive control, emotion regulation, and attentional processes. The ventral attention network (VAN) is a key salience-driven network that supports attentional re-orienting to behaviorally relevant stimuli. However, little is known about how VAN resting state functional connectivity varies by demographic, socioeconomic, psychosocial, and behavioral factors during early adolescence. Objective: To examine associations between VAN rsfMRI connectivity and multiple demographic, socioeconomic, psychosocial, and behavioral characteristics. Methods: Data came from the baseline and early follow-up waves of the Adolescent Brain Cognitive Development (ABCD) Study. The analytic sample included youth with high-quality baseline rsfMRI data and complete socioeconomic and psychosocial measures. The primary outcome was mean resting-state functional connectivity within the VAN across subcortical and cortical regions of interest (ROIs). Bivariate correlations were computed between VAN connectivity and demographic (age, sex, puberty, race/ethnicity), socioeconomic (income, parental education, marital status, neighborhood income), psychosocial (trauma, discrimination, financial difficulty), trait (impulsivity), and behavioral variables (body mass index, depression, suicide, prodromal symptoms, and substance use). Unadjusted bivariate correlations and adjusted logistic regressions were used for data analysis. Results: VAN connectivity showed small but significant correlations with multiple contextual factors. Higher household income, parental education, and neighborhood affluence were associated with greater connectivity, whereas Black race and Hispanic ethnicity were related to lower connectivity. Youth reporting higher discrimination and financial difficulty exhibited weaker VAN connectivity. Greater VAN connectivity was negatively associated with impulsive reward-driven trait (drive), prodromal symptoms, BMI, and marijuana and alcohol use. Associations between VAN connectivity and suicide, depression, marijuana use, and alcohol use remained significant in age and sex adjusted models. Conclusions: VAN connectivity reflects subtle neural correlates of socioeconomic and psychosocial context in early adolescence. Our results underscore the importance of integrating structural and contextual factors in interpreting brain-behavior associations across diverse populations. These findings are suggestive of stable socioeconomic and psychosocial correlates of network efficiency.
Article
Open Access October 27, 2025

Electronic Cigarette Perception in Baltimore High Schools

Abstract Background: Electronic cigarette (e-cigarette) use among adolescents is a growing public health concern, particularly in low-income and Black communities. However, little is known about how social determinants of health shape e-cigarette perceptions in this population. Aims: This study examined social determinants associated with perceptions of e-cigarette safety among Baltimore high [...] Read more.
Background: Electronic cigarette (e-cigarette) use among adolescents is a growing public health concern, particularly in low-income and Black communities. However, little is known about how social determinants of health shape e-cigarette perceptions in this population. Aims: This study examined social determinants associated with perceptions of e-cigarette safety among Baltimore high school students. Methods: A cross-sectional survey (CEASE Youth: School Survey) was conducted with 604 Baltimore high school students aged 14–20. Participants completed a questionnaire assessing perceptions of e-cigarette safety, as well as parental education, race/ethnicity, parental employment, household composition, and community tobacco use. Results: Higher parental education was associated with lower perceived e-cigarette safety among students. Students in higher grades also reported lower perceived e-cigarette safety. In contrast, male students—particularly those in upper grades—were more likely to perceive e-cigarettes as safe. Race/ethnicity, household composition, parental employment, and community tobacco exposure were not associated with perceived e-cigarette safety. Conclusion: Higher parental education, female gender, and being in higher grades were associated with perceiving e-cigarettes as unsafe. These findings highlight the need for targeted interventions to address vaping perceptions among youth in urban settings.
Article
Open Access October 21, 2025

Trends in Smoking and Flavored Tobacco Use in California: Black–White Disparities, 2003–2023

Abstract Background: Tobacco control policies nationwide have contributed to a substantial decline in cigarette and tobacco use, with particularly sharp reductions observed in states such as California that have implemented restrictive bans, strong prevention measures, and high excise taxes. While these policies have led to overall decreases in tobacco use, progress has not necessarily been [...] Read more.
Background: Tobacco control policies nationwide have contributed to a substantial decline in cigarette and tobacco use, with particularly sharp reductions observed in states such as California that have implemented restrictive bans, strong prevention measures, and high excise taxes. While these policies have led to overall decreases in tobacco use, progress has not necessarily been distributed equally across racial groups. Understanding long-term trends by race is critical for addressing equity gaps in tobacco prevention and control. Evidence suggests that some racialized groups may experience slower or delayed declines, raising concerns about equity in public health gains. Methods: We analyzed data from the California Health Interview Survey (CHIS) spanning 2003–2023. Trends in current smoking were examined separately for non-Latino Black and non-Latino White adults. We also assessed current use of flavored tobacco products, given California’s statewide ban enacted in 2021. Changes were evaluated in both absolute terms (percentage point declines) and relative terms (percent reduction from baseline). Results: Smoking prevalence declined from 17.2% in 2003 to 5.2% in 2023 among White adults and from 19.9% to 9.0% among Black adults. This represents a 12.0 percentage point (69.8%) decline for Whites compared with a 10.9 percentage point (54.8%) decline for Blacks. For flavored tobacco use, prevalence decreased from 8.0% to 4.7% among White adults but only from 11.9% to 10.8% among Black adults. This corresponds to a 3.3 percentage point (41.3%) decline for Whites compared with a 1.1 percentage point (9.2%) decline for Blacks. Conclusions: Although both Black and White adults in California experienced reductions in smoking over the past two decades, White adults showed larger declines in both absolute and relative terms. Disparities were even more pronounced for flavored tobacco use, where declines were minimal among Black adults despite the statewide ban. These findings suggest that Black populations in California may have been left behind by tobacco control progress, especially regarding flavored products. Given the history of targeted marketing by the tobacco industry, the role of flavors in increasing dependence, and reduced access to cessation resources in Black communities, targeted policies and culturally tailored interventions are needed to ensure equitable reductions in tobacco use. Greater attention to flavored tobacco in Black communities may help narrow these disparities and advance California’s tobacco endgame goals.
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Article
Open Access October 09, 2025

Simulation-Based Learning in Nursing Education: Perspectives of Student Nurses in the Philippines

Abstract Simulation-based learning (SBL) is widely recognized as an effective educational approach that bridges theory and practice in nursing education. Despite its global adoption, limited research has examined the experiences of Filipino nursing students with SBL, particularly in resource-constrained settings. This study explored the perspectives of Bachelor of Science in Nursing students from a [...] Read more.
Simulation-based learning (SBL) is widely recognized as an effective educational approach that bridges theory and practice in nursing education. Despite its global adoption, limited research has examined the experiences of Filipino nursing students with SBL, particularly in resource-constrained settings. This study explored the perspectives of Bachelor of Science in Nursing students from a university in Metro Manila, Philippines, on the impact of SBL on their skills, emotional responses, and challenges encountered. A descriptive qualitative design was employed using purposive sampling of ten students who had participated in at least one SBL activity. Data were collected through semi-structured interviews and short written reflections and analyzed thematically following Braun and Clarke’s framework to capture nuanced experiences. Three major themes emerged from the analysis. First, students reported initial anxiety, nervousness, and stress during their early SBL experiences, which gradually transformed into confidence, adaptability, and resilience as they gained familiarity and competence. Second, SBL enhanced technical and cognitive skills such as clinical judgment, decision-making, teamwork, and patient-centered care, supporting students’ readiness for real-world practice. Third, students identified resource limitations, insufficient equipment, and time constraints as significant barriers to optimal learning, though these challenges also fostered creativity and perseverance. The findings demonstrate that SBL fosters technical competence, critical thinking, and professional growth but requires institutional support to address resource constraints and faculty development needs. This study underscores the importance of expanding SBL in Philippine nursing curricula to align with international best practices and to contribute to Sustainable Development Goals 3 (good health and well-being), 4 (quality education), and 5 (gender equality).
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Open Access October 04, 2025

Unequal Burden of Loss of a Loved One in Non-Hispanic Black and White Californians

Abstract Purpose: Although the effect of loss of a loved one on depression is well established, very limited knowledge exists on racial differences in this effect. Aim: In the current study we compared Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) Californians for the effects of loss of a loved one on depression in a representative sample of adults in California. Methods: This cross-sectional study used data from the Survey of California Adults on Serious Illness and End-of-Life 2019. Overall, 1603 people entered our study. We compared 901 (56.2%) NHB and 702 (43.8%) NHW adults (age 18 and older). Race/ethnicity, demographics (age and gender), socio-economic factors (education, income, employment, and marital status), religiosity, and health (self-rated health and number of chronic medical conditions), and depression were measured. To perform data analysis, we used logistic regression models. Results: In the pooled sample, loss of a loved one was not associated with self-reported depression, net of all covariates. Race, however, interacted with loss of a loved one on depression, suggesting a larger association for NHBs compared to NHWs. In race-specific models, loss of a loved one predicted depression for NHBs (OR = 1.54) but not NHWs (OR [...] Read more.
Purpose: Although the effect of loss of a loved one on depression is well established, very limited knowledge exists on racial differences in this effect. Aim: In the current study we compared Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) Californians for the effects of loss of a loved one on depression in a representative sample of adults in California. Methods: This cross-sectional study used data from the Survey of California Adults on Serious Illness and End-of-Life 2019. Overall, 1603 people entered our study. We compared 901 (56.2%) NHB and 702 (43.8%) NHW adults (age 18 and older). Race/ethnicity, demographics (age and gender), socio-economic factors (education, income, employment, and marital status), religiosity, and health (self-rated health and number of chronic medical conditions), and depression were measured. To perform data analysis, we used logistic regression models. Results: In the pooled sample, loss of a loved one was not associated with self-reported depression, net of all covariates. Race, however, interacted with loss of a loved one on depression, suggesting a larger association for NHBs compared to NHWs. In race-specific models, loss of a loved one predicted depression for NHBs (OR = 1.54) but not NHWs (OR = 0.99). Conclusion: There are differences between NHBs and NHWs in the effect of loss of a loved one on depression. NHBs show a stronger association between loss of a loved one and depression than NHWs. This result is not in line with the NHB mental health paradox or with NHB resilience but is consistent with the notion that social relations may be more salient for NHBs than for NHWs.
Article
Open Access September 28, 2025

Gut-Brain Axis in Autism Spectrum Disorder: A Bibliometric and Microbial-Metabolite-Neural Pathway Analysis

Abstract The gut-brain axis (GBA) has emerged as a central focus in the study of neurodevelopmental disorders, particularly autism spectrum disorder (ASD). Research suggests that microbial composition and its metabolic byproducts influence neural development, synaptic plasticity, and behavior [1,2,3]. A structured bibliometric analysis of Scopus and Web of Science records was performed using Bibliometrix [...] Read more.
The gut-brain axis (GBA) has emerged as a central focus in the study of neurodevelopmental disorders, particularly autism spectrum disorder (ASD). Research suggests that microbial composition and its metabolic byproducts influence neural development, synaptic plasticity, and behavior [1,2,3]. A structured bibliometric analysis of Scopus and Web of Science records was performed using Bibliometrix and VOSviewer to trace trends and thematic evolution of GBA–ASD literature [7,8]. In parallel, a data-driven pathway modeling approach maps microbial metabolites (e.g., short-chain fatty acids, tryptophan catabolites) to host signaling pathways including vagal stimulation, immune cytokine modulation, and blood–brain barrier (BBB) permeability [4,5]. Simulations implemented in Python’s NetworkX illustrate how perturbations in metabolite flux may influence CNS outcomes. The findings reveal growing emphasis on butyrate, serotonin, microglial priming, and maternal immune activation in ASD-related GBA studies, and highlight the need for rigorous empirical validation of computational predictions [9,10,11].
Brief Report
Open Access April 10, 2025

Advancements in Pharmaceutical IT: Transforming the Industry with ERP Systems

Abstract The pharmaceutical industry is undergoing a profound transformation driven by advancements in Information Technology (IT), with Enterprise Resource Planning (ERP) systems playing a pivotal role in reshaping operations. These systems offer integrated solutions that streamline key business processes, such as production, inventory management, supply chain optimization, regulatory compliance, and data [...] Read more.
The pharmaceutical industry is undergoing a profound transformation driven by advancements in Information Technology (IT), with Enterprise Resource Planning (ERP) systems playing a pivotal role in reshaping operations. These systems offer integrated solutions that streamline key business processes, such as production, inventory management, supply chain optimization, regulatory compliance, and data integration, contributing significantly to operational efficiency and organizational agility. This paper explores the evolution and impact of ERP systems within the pharmaceutical sector, highlighting their contributions to overcoming the industry’s inherent challenges, including complex regulatory requirements, the need for accurate and real-time data, and the demand for supply chain resilience. The integration of cloud-based ERP solutions, the incorporation of emerging technologies like Artificial Intelligence (AI), Machine Learning (ML), and the Internet of Things (IoT), and enhanced data analytics capabilities have revolutionized pharmaceutical IT. These advancements not only reduce operational costs, improve forecasting accuracy, and enhance collaboration but also ensure compliance with stringent global regulations, such as Good Manufacturing Practices (GMP) and FDA guidelines. Moreover, ERP systems have been instrumental in managing the pharmaceutical supply chain, ensuring product traceability, and improving inventory control and order fulfillment processes. This manuscript examines how ERP systems enable pharmaceutical companies to maintain high standards of product quality, improve decision-making, and ensure the safety and efficacy of drugs through robust tracking and auditing mechanisms. A case study of a pharmaceutical company that implemented an ERP system demonstrates the tangible benefits, including increased operational efficiency, improved compliance rates, and enhanced customer satisfaction. However, despite the clear advantages, challenges such as customization complexities, data integration issues, and resistance to change remain. As the pharmaceutical industry continues to evolve, ERP systems will remain a cornerstone of digital transformation, facilitating smarter decision-making, better resource management, and enhanced collaboration across global operations. This paper also identifies future trends, including the potential of AI and blockchain technologies in further strengthening ERP systems and transforming the pharmaceutical landscape.
Review Article
Open Access March 09, 2025

Place-Based Diminished Returns of Parental Education on Adolescents’ Inhalant Use in Rural Areas

Abstract Background Adolescent substance use is often influenced by socioeconomic and geographical factors. While higher parental education is typically associated with lower substance use, these protective effects may be weaker for marginalized groups facing structural disadvantages that limit the utility and returns of their economic and social resources. Rural areas, characterized by fewer [...] Read more.
Background Adolescent substance use is often influenced by socioeconomic and geographical factors. While higher parental education is typically associated with lower substance use, these protective effects may be weaker for marginalized groups facing structural disadvantages that limit the utility and returns of their economic and social resources. Rural areas, characterized by fewer employment opportunities and limited recreational activities, may contribute to marginalization-related diminished returns (MDRs) of parental education on adolescent substance use, including inhalant use. Objectives This study applies the MDRs framework to examine whether the protective effect of higher parental education on current inhalant use (past 30 days) among 12th-grade American adolescents varies by geographic location. Specifically, we assess whether youth from highly educated families in rural areas are at a disproportionate risk of inhalant use compared to their urban and suburban peers. Methods Using data from the 2024 Monitoring the Future (MTF) study, a nationally representative survey of 12th-grade adolescents in the U.S., we tested main effects and statistical interactions between parental education and residence (rural vs. urban/suburban) in predicting the odds of inhalant use over the past 30 days. Logistic regression models, both with and without interaction terms, were applied to evaluate whether the protective effects of parental education varied by residence location, controlling for relevant demographic and socioeconomic factors. Results Findings indicate a significant interaction between parental education and rural residence. While higher parental education was associated with lower odds of inhalant use in urban and suburban areas, this protective effect was substantially weaker in rural settings. Adolescents from highly educated families in rural areas exhibited a higher-than-expected risk of inhalant use, suggesting that geographic marginalization attenuates the benefits of parental socioeconomic resources. Conclusions These results highlight the role of place-based marginalization in shaping adolescent substance use disparities, demonstrating that MDRs extend beyond race and ethnicity to location-based disadvantages. Rural youths from highly educated families may face unique structural and social challenges that counteract the protective effects of parental education. Public health efforts should consider place-based interventions that address the economic, recreational, and social limitations of rural environments to reduce substance use risk among high-SES adolescents residing in rural areas.
Article
Open Access February 26, 2025

Innovations and Challenges in Pharmaceutical Supply Chain, Serialization and Regulatory Landscape

Abstract The pharmaceutical supply chain has become increasingly complex and vulnerable to various risks, including counterfeit drugs, diversion, and fraud. As these challenges threaten patient safety and the integrity of global healthcare systems, serialization has emerged as a pivotal innovation in pharmaceutical logistics and regulatory compliance. Serialization involves assigning unique identifiers to [...] Read more.
The pharmaceutical supply chain has become increasingly complex and vulnerable to various risks, including counterfeit drugs, diversion, and fraud. As these challenges threaten patient safety and the integrity of global healthcare systems, serialization has emerged as a pivotal innovation in pharmaceutical logistics and regulatory compliance. Serialization involves assigning unique identifiers to individual drug packages, enabling precise tracking and authentication at every stage of the supply chain. This process provides unprecedented transparency, enhances product security, and facilitates real-time monitoring of pharmaceutical products as they move from manufacturers to end consumers. Despite its potential to revolutionize pharmaceutical traceability, the integration of serialization technologies faces numerous obstacles. These include high implementation costs, regulatory inconsistencies across regions, and the technological challenges of managing vast amounts of data. Moreover, the complex, multi-tiered nature of the global supply chain introduces additional risks related to data integrity, cybersecurity, and interoperability between systems. As pharmaceutical companies seek to navigate these challenges, innovations in serialization technology—such as blockchain, artificial intelligence (AI), the Internet of Things (IoT), and radio frequency identification (RFID)—are providing promising solutions to enhance efficiency, reduce fraud, and increase visibility. This manuscript explores both the innovative advancements and the key challenges associated with the integration of serialization in the pharmaceutical supply chain. It delves into the evolving regulatory landscape, highlighting the need for global harmonization of serialization standards, and examines the impact of serialization on securing pharmaceutical distribution networks. Additionally, the paper emphasizes the importance of collaboration among manufacturers, technology providers, and regulatory bodies in overcoming implementation barriers and realizing the full potential of serialization. As the pharmaceutical industry moves towards a more interconnected and data-driven future, serialization promises to play a central role in shaping the next generation of drug safety and supply chain management. By addressing the hurdles to adoption and leveraging emerging technologies, the pharmaceutical sector can create a more secure, transparent, and efficient supply chain that better serves public health and fosters greater trust among consumers and healthcare professionals alike.
Review Article
Open Access February 25, 2025

Resting-State Functional Connectivity Between the Cingulo-Opercular and Default Mode Networks May Explain Socioeconomic Inequalities in Cognitive Development

Abstract Background: The Cingulo-Opercular Network (CON) is a crucial executive control network involved in regulating actions and facilitating higher-order cognitive processes. Resting-state functional connectivity between the CON and the Default Mode Network (DMN) plays a vital role in cognitive regulation, enabling the transition between internally focused and externally directed tasks. This [...] Read more.
Background: The Cingulo-Opercular Network (CON) is a crucial executive control network involved in regulating actions and facilitating higher-order cognitive processes. Resting-state functional connectivity between the CON and the Default Mode Network (DMN) plays a vital role in cognitive regulation, enabling the transition between internally focused and externally directed tasks. This study investigates whether resting-state functional connectivity between the CON and DMN mediates the effects of social determinants, such as educational opportunities and family structure, on cognitive outcomes in youth. Aims: This study aims to explore how CON-DMN connectivity influences the relationship between social gradients and cognition in youth. Specifically, it examines whether resting-state functional connectivity between these networks mediates the effects of educational opportunities and family structure on cognitive outcomes and seeks to uncover the neural mechanisms underlying these social gradients. Methods: Data were derived from the Adolescent Brain Cognitive Development (ABCD) study, a large longitudinal dataset of over 11,000 children aged 9–10 years. Cognitive outcomes were assessed using standardized NIH toolbox measures: Total Composite, Fluid Reasoning, Picture Vocabulary, Pattern Recognition, and Card Sorting. Social determinants were operationalized using indicators such as parental education, family composition, and neighborhood educational opportunities (COI). Resting-state functional connectivity (rsFC) between the CON and DMN was measured using functional magnetic resonance imaging (fMRI). Structural equation modeling (SEM) was employed to test whether CON-DMN rsFC mediated the relationship between social determinants and cognitive outcomes, adjusting for potential confounders such as age, sex, and race/ethnicity. Results: Stable family structure and greater educational opportunities were significantly associated with improved cognitive performance. These relationships were mediated by reduced functional connectivity between the CON and DMN. Conclusion: Reduced functional connectivity between the CON and DMN serves as a neural mechanism linking social gradients, such as educational opportunities and family structure, to better cognitive outcomes in youth.
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Open Access February 17, 2025

Gender Differences in the Association Between Socioeconomic Status and Cardiometabolic Health: National Health and Nutrition Examination Survey

Abstract Background: Socioeconomic status (SES) is a well-established determinant of health, often associated with lower risk of cardiometabolic diseases (CMD). However, the extent to which SES influences CMD may vary by gender due to differences in social roles, health behaviors, and biological susceptibilities. This study examined the relationship between SES, measured by the [...] Read more.
Background: Socioeconomic status (SES) is a well-established determinant of health, often associated with lower risk of cardiometabolic diseases (CMD). However, the extent to which SES influences CMD may vary by gender due to differences in social roles, health behaviors, and biological susceptibilities. This study examined the relationship between SES, measured by the poverty-to-income ratio (PIR), and CMD indicators—including obesity, diabetes, and cardiovascular disease (CVD)—among men and women using data from the National Health and Nutrition Examination Survey (NHANES). Methods: This cross-sectional study utilized NHANES data (1999-2018), adjusting for race/ethnicity and age. SES was operationalized using PIR, with CMD outcomes (obesity, diabetes, and CVD) as dependent variables. Generalized linear models (GLM) were employed to evaluate the main effects of SES on CMD, with gender included as a moderator. Results: Higher SES was associated with lower overall CMD risk. However, the protective effects of SES were more pronounced in women than in men for all outcomes. These findings suggest that gender-specific pathways may mediate the relationship between SES and CMD. Women may derive greater health benefits from higher SES due to factors such as reduced stress exposure, healthier behaviors, and increased healthcare utilization. Conversely, the weaker association observed in men may reflect differences in social hierarchy sensitivity, responses to unemployment, or other contextual factors. Conclusion: The findings highlight the importance of gender-specific considerations when addressing SES-related disparities in CMD outcomes. Policies and interventions aimed at reducing CMD burden should account for these gender differences to promote equitable improvements in cardiometabolic health. Further research is needed to unravel the mechanisms driving these differences and to inform targeted strategies.
Article
Open Access February 14, 2025

Trauma Erodes Financial Returns of Educational Attainment

Abstract Background: Educational attainment is often regarded as a pathway to economic stability and social mobility. However, the Minorities’ Diminished Returns (MDRs) framework has demonstrated that the effects of educational attainment on various economic, behavioral, and health outcomes are weaker for marginalized populations, including racial/ethnic minorities, immigrants, LGBTQ+ individuals, [...] Read more.
Background: Educational attainment is often regarded as a pathway to economic stability and social mobility. However, the Minorities’ Diminished Returns (MDRs) framework has demonstrated that the effects of educational attainment on various economic, behavioral, and health outcomes are weaker for marginalized populations, including racial/ethnic minorities, immigrants, LGBTQ+ individuals, and those living in disadvantaged areas. While MDRs have been documented for various marginalized demographic groups, the role of trauma in moderating socioeconomic outcomes remains underexplored. Objective: This study examines whether lifetime trauma exposure diminishes the positive association between educational attainment and poverty-to-income ratio (PIR), a key indicator of economic well-being. Methods: Using data from the National Survey of American Life (NSAL), we analyzed a nationally representative sample of 6,008 adults, including Black, White, Latino, and Other racial/ethnic groups. We employed linear regression models to evaluate the association between the independent variable educational attainment and the outcome PIR. We then tested lifetime trauma as a moderator of this association. Models controlled for age, gender, employment, and race/ethnicity. Results: Educational attainment was positively associated with PIR across all groups, but the strength of this association was significantly attenuated for individuals with a history of lifetime trauma. These effects were independent of covariates. Conclusions: These findings extend the MDRs framework by highlighting trauma as a potential contributor to diminished returns of education on socioeconomic wellbeing. Structural inequities that increase trauma exposure in minoritized populations may also limit the economic benefits of education, particularly for groups with multiple trauma exposures. Policies aimed at addressing economic inequality must integrate social policies that reduce trauma and stress.
Article
Open Access February 13, 2025

Psychosocial Correlates of Childhood Body Mass Index: Racial and Ethnic Differences

Abstract Objective: To examine racial/ethnic differences in the associations of family socioeconomic status (SES), neighborhood SES, and inhibitory control with body mass index (BMI) in 9-10-year-old children using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods: This cross-sectional study included a diverse sample of children aged 9-10 years, representing [...] Read more.
Objective: To examine racial/ethnic differences in the associations of family socioeconomic status (SES), neighborhood SES, and inhibitory control with body mass index (BMI) in 9-10-year-old children using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods: This cross-sectional study included a diverse sample of children aged 9-10 years, representing non-Latino White, Black, Latino, Asian, and Other racial/ethnic groups. BMI was the primary outcome. Key predictors were family SES, neighborhood SES, and inhibitory control. Multivariable regression models were stratified by race/ethnicity to identify group-specific associations. Results: Race/ethnic groups differed in psychosocial correlates of childhood BMI at age 9 and 10. Among non-Latino White children, higher family income (B = -0.086, p < 0.001), higher parental education (B = -0.069, p < 0.001), and living in a married household (B = -0.079, p < 0.001) were associated with lower BMI. Additionally, the presence of healthy food options in the zip code (B = -0.030, p = 0.032) was linked to lower BMI, while lack of planning (B = 0.032, p = 0.030) was associated with higher BMI. For non-Latino Black children, positive urgency (B = -0.068, p = 0.022) was negatively associated with BMI, while other factors such as family SES and neighborhood SES did not show significant associations. For Latino children, higher family income (B = -0.093, p = 0.001) and parental education (B = -0.099, p < 0.001) were associated with lower BMI. In this group, male gender (B = 0.043, p = 0.033) was associated with higher BMI. Among Asian children, higher family income (B = -0.199, p = 0.006) and parental education (B = -0.144, p = 0.037) were significantly associated with lower BMI. For children in the "Other" racial/ethnic category, higher family income (B = -0.101, p = 0.023), living in a married household (B = -0.076, p = 0.026), and higher median income in the zip code (B = -0.083, p = 0.013) were associated with lower BMI. In this group, male children had lower BMI compared to females (B = -0.089, p = 0.001). Conclusion: The findings highlight substantial racial/ethnic differences in the psychosocial and socioeconomic correlates of BMI in children. There is a need for tailored interventions that target social determinants of childhood high BMI. One size does not fit all.
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Open Access February 12, 2025

Unequal Benefits: How Parental Education Falls Short for Black and Latino Youth

Abstract Background: Parental education is a key determinant of academic performance, yet its protective effects may differ by race and ethnicity. The concept of Minorities’ Diminished Returns (MDRs) highlights the weaker association between socioeconomic resources and outcomes for marginalized populations, including Black and Latino youth. Objective: To investigate whether the [...] Read more.
Background: Parental education is a key determinant of academic performance, yet its protective effects may differ by race and ethnicity. The concept of Minorities’ Diminished Returns (MDRs) highlights the weaker association between socioeconomic resources and outcomes for marginalized populations, including Black and Latino youth. Objective: To investigate whether the positive association between parental education and school performance (letter grades) is weaker for Black and Latino youth compared to non-Latino White youth. Methods: Data were drawn from the Monitoring the Future (MTF) 2023 study. The sample included Black, Latino, and non-Latino White youth. The outcome was a nine-level continuous measure of academic performance based on self-reported letter grades, with higher scores indicating better performance. Multivariate regression models tested interactions between parental education and race/ethnicity in predicting grades, adjusting for confounders such as family income, gender, and school characteristics. Results: A total number of 7584 12th graders entered the study. Parental education was positively associated with school performance across all groups, but the magnitude of this association was significantly smaller for Black and Latino youth compared to non-Latino White youth. Even after controlling for socioeconomic and contextual factors, the racial and ethnic differences in the strength of this association persisted. Conclusions: Our findings provide evidence of Minorities’ Diminished Returns (MDRs) in the academic domain, with Black and Latino youth experiencing weaker benefits of parental education on school performance. These disparities suggest that structural barriers and systemic inequities undermine the translation of parental educational attainment into academic success for marginalized groups. Policy interventions must address these structural barriers to promote equity in educational outcomes.
Article
Open Access January 10, 2025

Extreme Heat Exposure is Associated with Lower Learning, General Cognitive Ability, and Memory among US Children

Abstract Background: The increasing frequency and intensity of extreme heat exposure is a significant consequence of climate change, with broad public health implications. While many health risks associated with heat exposure are well-documented, less research has focused on its impact on children’s cognitive function. Objectives: This study examines the [...] Read more.
Background: The increasing frequency and intensity of extreme heat exposure is a significant consequence of climate change, with broad public health implications. While many health risks associated with heat exposure are well-documented, less research has focused on its impact on children’s cognitive function. Objectives: This study examines the relationship between extreme heat exposure and various domains of cognitive function in children. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study. Key variables included race/ethnicity, age, gender, family socioeconomic status (SES), heatwave exposure, and multiple cognitive domains: total composite score, fluid composite score, crystallized intelligence, reading ability, picture vocabulary, pattern recognition, card sorting, and list recall. Structural equation modeling (SEM) was used for data analysis. Results: A total of 11,878 children were included in the analysis. Findings revealed significant associations between extreme heat exposure and lower cognitive performance across multiple domains. The strongest adjusted effects were observed in pattern recognition (B = −0.064, p < 0.001) and reading ability (B = −0.050, p < 0.001), both within the learning domain, as well as total composite cognitive ability (B = −0.067, p < 0.001), fluid composite (B = −0.053, p < 0.001), and crystallized intelligence (B = −0.061, p < 0.001), all within general cognitive ability. Weaker but still significant associations were found for list recall (B = −0.025, p = 0.006) and card sorting (B = −0.043, p < 0.001) within the memory domain, as well as picture vocabulary (B = −0.025, p = 0.008) within general cognitive ability. These associations remained significant after controlling for demographic factors, race/ethnicity, family SES, and neighborhood SES. Conclusions: This study underscores the impact of climate change on cognitive function disparities, particularly in learning and general cognitive ability among children exposed to extreme heat. Findings highlight the need for targeted interventions to mitigate the cognitive risks associated with heat exposure in vulnerable populations.
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Open Access February 10, 2025

Diminished Returns of Educational Attainment on Welfare Receipt of American Indian/Alaska Native People: National Health Interview Survey (NHIS) 2023

Abstract Background: Educational attainment is generally associated with reduced reliance on Social Security and disability benefits; however, the Minorities' Diminished Returns (MDRs) theory suggests that the socioeconomic benefits of education are weaker for minoritized populations. This study investigates the relationship between educational attainment and welfare receipt among American [...] Read more.
Background: Educational attainment is generally associated with reduced reliance on Social Security and disability benefits; however, the Minorities' Diminished Returns (MDRs) theory suggests that the socioeconomic benefits of education are weaker for minoritized populations. This study investigates the relationship between educational attainment and welfare receipt among American Indian/Alaska Native (AIAN) and White adults in the United States. Objective: Using the MDRs framework, we analyzed data from the National Health Interview Survey (NHIS) 2023 to examine how educational attainment impacts welfare receipt among AIAN and White adults. Methods: We analyzed a nationally representative sample of AIAN and White adults from the NHIS 2023 dataset. Welfare receipt was assessed as the receipt of any public assistance or welfare payments from state or local welfare offices. Educational attainment was categorized into three levels: less than high school (reference), high school diploma to some college, and college degree or higher. Logistic regression models were used to assess the relationship between educational attainment and welfare receipt, with separate analyses for AIAN and White adults to evaluate differential effects. Results: Higher educational attainment (high school diploma to some college and college degree or higher) was associated with lower odds of welfare receipt across both groups. However, the protective effect of a college degree was significantly weaker for AIAN adults compared to White adults. Consequently, AIAN adults remain at a higher risk of welfare reliance even with higher education, consistent with the Minorities' Diminished Returns (MDRs) framework. Conclusions: Although educational attainment generally reduces welfare reliance, this protection is less pronounced for AIAN adults than for White adults. This discrepancy suggests that structural factors, segregation, and social stratification may undermine the economic and health benefits of education for racialized groups in the U.S. Addressing these disparities requires policy interventions that extend beyond education, emphasizing quality job opportunities, healthcare access, and reduced labor market discrimination for individuals with advanced educational credentials, regardless of race.
Article
Open Access January 24, 2025

High Socioeconomic Status Black Adolescents Attend Worse Schools than Whites

Abstract Background: School characteristics — including poverty levels, teacher experience, graduation rates, and college enrollment — are essential determinants of students’ academic outcomes and long-term success. Families often use their socioeconomic resources, such as parental education and household income, to secure access to high-quality schools with favorable attributes. However, [...] Read more.
Background: School characteristics — including poverty levels, teacher experience, graduation rates, and college enrollment — are essential determinants of students’ academic outcomes and long-term success. Families often use their socioeconomic resources, such as parental education and household income, to secure access to high-quality schools with favorable attributes. However, Minorities’ Diminished Returns (MDRs) theory suggests that Black families may not experience the same benefits of high family SES due to structural barriers. This study examines the association between family SES and school characteristics, focusing on racial disparities in access to high-quality educational environments. Objective: To investigate the relationship between family SES (parental education and household income) and multiple school characteristics (poverty, teacher experience, graduation rates, and college enrollment), and to assess racial differences in these associations. Methods: Data from the Adolescent Brain Cognitive Development (ABCD) study, a national sample of US adolescents, was analyzed. We used multivariate regression models to examine associations between family SES and school characteristics and to test for interactions by race, specifically comparing Black and White adolescents. Results: Higher family SES was associated with positive school characteristics overall, including lower school poverty, greater teacher experience, and increased graduation and college enrollment rates. However, these positive effects of high family SES on school characteristics were significantly weaker for Black adolescents than for White adolescents. Black adolescents from high-income families were more likely than White adolescents from similar backgrounds to attend schools with higher poverty rates, less experienced teachers, and reduced graduation and college enrollment rates. Conclusion: Our findings highlight persistent racial inequities in access to educational opportunities, even among families with comparable socioeconomic resources. The diminished returns of family SES for Black adolescents underscore the role of structural barriers in limiting access to high-quality schools. These findings emphasize the need for policy interventions to address systemic inequalities that hinder Black families from fully leveraging their SES to access favorable educational environments.
Article
Open Access January 23, 2025

Population Diversity Matters: Heterogeneity of Biopsychosocial Pathways from Socioeconomic Status to Tobacco Use via Cerebral Cortical Volume in the ABCD Study

Abstract Background: Most neuroscience research has predominantly focused on White, middle-class populations, leading to gaps in understanding how socioeconomic status (SES) influences brain development and health behaviors in racially diverse groups. Tobacco use, a major public health concern, is influenced by both family and neighborhood SES, with early initiation during adolescence predicting [...] Read more.
Background: Most neuroscience research has predominantly focused on White, middle-class populations, leading to gaps in understanding how socioeconomic status (SES) influences brain development and health behaviors in racially diverse groups. Tobacco use, a major public health concern, is influenced by both family and neighborhood SES, with early initiation during adolescence predicting long-term health outcomes. The Adolescent Brain Cognitive Development (ABCD) study provides a unique opportunity to examine racial disparities in the pathways from SES to brain development and behavior, especially through the lens of Marginalization-Related Diminished Returns (MDRs), where the effects of SES are attenuated for minority groups. Objective: This study investigates racial variation in the associations between SES, cerebral cortical volume, and tobacco use initiation, comparing Black and White youth over 4-6 years of follow-up. Methods: Data from the ABCD study were analyzed to assess pathways from family income to adolescents’ cortical volume via the needs-to-income ratio, and from cortical volume to tobacco use initiation. Structural equation modeling was used to evaluate these pathways, stratified by race, with a focus on comparing Black and White participants. Covariates included family and neighborhood SES, demographic factors, and baseline behavioral measures. Results: We found that the positive association between income (via the needs-to-income ratio) and total cortical volume was significantly weaker for Black youth compared to White youth. Additionally, the link between larger total cortical volume and reduced risk of tobacco initiation was also weaker in Black adolescents. These findings were consistent over 4-6 years of follow-up, suggesting that Black youth experience diminished returns from higher SES in terms of brain development and behavioral outcomes. Conclusions: Our findings highlight significant racial disparities in the pathways from SES to brain development and tobacco use initiation, supporting the Marginalization-Related Diminished Returns (MDRs) framework. While higher SES is associated with larger cortical volumes and lower tobacco use risk in White youth, these associations are attenuated in Black adolescents.
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Open Access January 23, 2025

Diminished Returns of Educational Attainment on Hypertension Prevalence among American Indian and Alaska Native Adults: National Health Interview Survey 2023

Abstract Background: Research on Minorities’ Diminished Returns (MDRs) consistently reveals that social determinants of health, especially educational attainment, do not yield equal health benefits across racial and ethnic groups in the United States. MDRs suggest that social stratification, segregation, lower education quality, and labor market discrimination contribute to diminished health returns [...] Read more.
Background: Research on Minorities’ Diminished Returns (MDRs) consistently reveals that social determinants of health, especially educational attainment, do not yield equal health benefits across racial and ethnic groups in the United States. MDRs suggest that social stratification, segregation, lower education quality, and labor market discrimination contribute to diminished health returns of education among minoritized groups. However, few studies have tested the relevance of MDRs in American Indian and Alaska Native (AIAN) populations compared to non-Hispanic White adults. Objectives: This study aimed to examine the strength of the inverse association between educational attainment and hypertension prevalence, hypothesizing that the protective effect of education on hypertension risk is reduced among AIAN adults relative to non-Hispanic Whites. Methods: Using data from the 2023 National Health Interview Survey (NHIS), we analyzed a nationally representative sample of adults aged 18 and older. Logistic regression models examined the association between educational attainment and self-reported hypertension diagnosis, stratified by racial/ethnic group (AIAN vs. non-Hispanic White). Models were adjusted for key covariates, including age, gender, income, and insurance status. Results: Higher educational attainment was associated with a lower prevalence of hypertension in the combined sample of AIAN and non-Hispanic White adults. However, this protective association was significantly weaker among AIAN adults compared to non-Hispanic White adults, as evidenced by a significant interaction between race and education. Conclusion: AIAN adults exhibit a higher prevalence of hypertension even at higher levels of educational attainment compared to non-Hispanic White adults, supporting the relevance of MDRs for AIAN populations. This finding underscores the need for public health interventions that address structural barriers and contextual factors unique to AIAN populations. Policies focused solely on educational access may be insufficient to reduce hypertension risk among AIAN adults without addressing broader social and structural inequities.
Article
Open Access January 23, 2025

Trauma and Early Puberty May Be Stronger Predictors of Early Tobacco Initiation in Girls Compared to Boys

Abstract Objective: This study investigates the pathways linking socioeconomic status (SES), trauma, early puberty, and tobacco use, with a focus on how these relationships differ by sex. Using data from the Adolescent Brain Cognitive Development (ABCD) study, we explore how SES and race contribute to trauma exposure, which in turn may influence early puberty and tobacco use. The study also examines [...] Read more.
Objective: This study investigates the pathways linking socioeconomic status (SES), trauma, early puberty, and tobacco use, with a focus on how these relationships differ by sex. Using data from the Adolescent Brain Cognitive Development (ABCD) study, we explore how SES and race contribute to trauma exposure, which in turn may influence early puberty and tobacco use. The study also examines potential mediating effects of trauma and early puberty on the association between SES and tobacco use, while comparing these pathways for males and females. Methods: Data were drawn from the ABCD study, and structural equation modeling (SEM) was employed to test direct and indirect pathways between SES, trauma, early puberty, and tobacco use. The sample was stratified by sex to assess differences in these relationships for males and females. Key predictors included SES, race, and age, while outcomes were trauma, early puberty, and tobacco use. The model assessed mediating effects of trauma and early puberty on tobacco use. Results: Trauma was a significant predictor of early puberty for females (B = 0.032, SE = 0.015, p = 0.039) but not males. Early puberty was significantly linked to tobacco use for females (B = 0.048, SE = 0.015, p = 0.001) but not for males. Additionally, trauma had an effect on tobacco use among females (B = 0.048, SE = 0.014, p < 0.001) but not males. Lower SES was significantly associated with higher trauma exposure for both males (B = -0.109, SE = 0.014, p < 0.001) and females (B = -0.110, SE = 0.015, p < 0.001). Conclusions: The findings suggest that trauma and early puberty play more significant roles in the pathways from SES to tobacco use for females than for males. While trauma and early puberty are crucial mediators for females, these factors are less predictive for males. These results highlight the importance of sex-specific interventions targeting trauma and early puberty as pathways to early tobacco use.
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Open Access January 16, 2025

Extreme Heat Exposure and Adolescent Cognitive Function

Abstract Background: Extreme heat exposure is an increasing public health concern, particularly in the context of climate change. Limited research has explored its impact on children's cognitive outcomes. This study investigates the association between extreme heat exposure and cognitive function in 9–10-year-old children, using data from the Adolescent Brain Cognitive Development (ABCD) study. [...] Read more.
Background: Extreme heat exposure is an increasing public health concern, particularly in the context of climate change. Limited research has explored its impact on children's cognitive outcomes. This study investigates the association between extreme heat exposure and cognitive function in 9–10-year-old children, using data from the Adolescent Brain Cognitive Development (ABCD) study. Additionally, we assess whether this effect is independent of socio-demographic factors such as race, family socioeconomic status (SES), and neighborhood SES. Methods: Data were drawn from the ABCD study, comprising over 10,000 children aged 9–10 years. Cognitive function was assessed through standardized cognitive tests, while extreme heat exposure was estimated using geographic and climate data. Structural equation modeling (SEM) was employed to examine the direct effects of heat exposure on cognitive outcomes and to account for potential confounding variables, including race, family SES, and neighborhood SES. Results: Black families, low SES households, and children from low SES neighborhoods were disproportionately exposed to extreme heat. Extreme heat exposure was significantly associated with lower cognitive function in children, and this association remained robust even after adjusting for socio-demographic factors. Conclusions: Extreme heat exposure is linked to diminished cognitive function in children, particularly among socio-economically disadvantaged and marginalized populations. Given the increasing frequency of extreme heat events due to climate change, future research should further explore these implications for children’s cognitive outcomes. Policy interventions that improve access to cooling infrastructure, expand green spaces, and prioritize at-risk populations are critical to mitigating the adverse cognitive effects of extreme heat in low SES communities.
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Open Access January 16, 2025

Heat Exposure Predicts Earlier Childhood Pubertal Initiation, Behavioral Problems, and Tobacco Use

Abstract Background: Climate change has raised significant concerns about its impact on health, particularly for vulnerable populations such as children and adolescents. While extensive research has examined physical health effects, limited attention has been given to the influence of extreme heat on developmental and behavioral outcomes. Objectives: This study investigates the association [...] Read more.
Background: Climate change has raised significant concerns about its impact on health, particularly for vulnerable populations such as children and adolescents. While extensive research has examined physical health effects, limited attention has been given to the influence of extreme heat on developmental and behavioral outcomes. Objectives: This study investigates the association between extreme heat exposure and early puberty initiation (ages 9-10), using data from the Adolescent Brain Cognitive Development (ABCD) study. It further explores how early puberty correlates with behavioral problems and tobacco use initiation. Methods: Data from 11,878 participants in the ABCD study were analyzed to examine the relationship between extreme heat exposure (independent variable) and puberty initiation (outcome). Behavioral problems and tobacco use initiation were evaluated as downstream outcomes of early puberty. Covariates included age, sex, and race/ethnicity, and behavioral problems were assessed using the Child Behavior Checklist (CBCL). Structural equation modeling (SEM) was employed for analysis. Results: Extreme heat exposure was significantly associated with earlier puberty initiation at ages 9-10. Early puberty, in turn, correlated with higher levels of behavioral problems and an increased likelihood of tobacco use initiation. Conclusions: These findings underscore the importance of addressing environmental factors such as extreme heat to reduce risks associated with early maturation, including behavioral and substance use challenges. Targeted interventions and policies are needed to mitigate the impact of extreme heat on child development, and longitudinal studies are essential to confirm these results and inform effective prevention strategies.
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Open Access January 16, 2025

Puberty Onset and Positive Urgency Explain Diminished Returns of Family Income on Tobacco and Marijuana Use

Abstract Background: Puberty is a crucial developmental milestone that involves significant physiological, emotional, and behavioral changes. Early puberty onset, influenced by both biological and social factors, is associated with an increased risk of engaging in substance use, such as tobacco and marijuana. While high family income is generally linked to delayed puberty onset and lower behavioral [...] Read more.
Background: Puberty is a crucial developmental milestone that involves significant physiological, emotional, and behavioral changes. Early puberty onset, influenced by both biological and social factors, is associated with an increased risk of engaging in substance use, such as tobacco and marijuana. While high family income is generally linked to delayed puberty onset and lower behavioral risks, these benefits may not be equally protective for Black youth due to the phenomenon of Minorities' Diminished Returns (MDRs). MDRs suggest that higher family income does not offer the same protective effects for Black youth as it does for White youth, potentially leading to earlier puberty and increased substance use among high-income Black adolescents. Objective: This study aimed to investigate whether early puberty onset and associated positive urgency (impulsivity) mediate the relationship between family income and the initiation of tobacco and marijuana use over a six-year follow-up period among adolescents. Additionally, the study examined whether the effects of family income on early puberty onset differ by race, testing the hypothesis that high-income Black youth would experience earlier puberty onset compared to their high-income White peers. Methods: Data were sourced from the Adolescent Brain Cognitive Development (ABCD) Study. Participants were 9-10-year-old adolescents at baseline, followed over a period of six years. Structural equation modeling (SEM) was used to assess whether early puberty onset mediated the effects of family income on substance use behaviors. Interaction terms between race and family income were included to test whether the impact of family income varies by race. Results: Early puberty onset and associated positive urgency partially explained the relationship between family income and the initiation of tobacco and marijuana use. High-income Black youth showed earlier puberty onset compared to their White counterparts. Earlier puberty onset then predicted higher positive urgency. These factors, in turn, were linked to higher rates of tobacco and marijuana initiation. Conclusions: This study provides additional evidence that the benefits of high family income do not extend equally to Black adolescents, particularly regarding delaying puberty onset and its consequences for substance use.
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Open Access January 15, 2025

Too Much Heat May Make You Smoke

Abstract Background: The rising concerns surrounding climate change have drawn attention to its potential impact on health, particularly among vulnerable groups such as children and older adults. Despite extensive research on health consequences, limited studies have explored the connection between extreme heat exposure and tobacco use initiation among adolescents in the United States. [...] Read more.
Background: The rising concerns surrounding climate change have drawn attention to its potential impact on health, particularly among vulnerable groups such as children and older adults. Despite extensive research on health consequences, limited studies have explored the connection between extreme heat exposure and tobacco use initiation among adolescents in the United States. Objectives: This study examines the relationship between extreme heat exposure and the initiation of tobacco use in adolescents, using data from the Adolescent Brain Cognitive Development (ABCD) study. It also evaluates the mediating roles of major depressive disorder (MDD) and childhood behavioral problems. Methods: Data from 11,878 participants in the ABCD study were analyzed to explore the link between extreme heat exposure (independent variable) and tobacco use initiation (dependent variable). Covariates included age, sex, and race/ethnicity, while MDD and behavioral problems (measured using the Child Behavior Checklist, CBCL) were assessed as potential mediators. Structural equation modeling (SEM) was applied for analysis. Results: The findings indicated a significant association between extreme heat exposure and an increased likelihood of tobacco use initiation in adolescents aged 9 to 15. MDD and behavioral problems partially mediated this relationship. Conclusions: These results underscore the importance of targeted interventions aimed at mitigating the impact of extreme heat on adolescent health, including its influence on tobacco use initiation. Addressing mental health and behavioral challenges could help reduce these risks. Future longitudinal research is needed to confirm these findings and evaluate the efficacy of strategies to protect vulnerable youth populations.
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Open Access January 09, 2025

Advances in the Synthesis and Optimization of Pharmaceutical APIs: Trends and Techniques

Abstract The synthesis and optimization of Active Pharmaceutical Ingredients (APIs) is fundamental to pharmaceutical drug development, directly influencing drug efficacy, safety, and cost-effectiveness. Over recent years, significant advancements in synthetic methodologies and manufacturing technologies have transformed API production. This manuscript provides an overview of the latest innovations in API [...] Read more.
The synthesis and optimization of Active Pharmaceutical Ingredients (APIs) is fundamental to pharmaceutical drug development, directly influencing drug efficacy, safety, and cost-effectiveness. Over recent years, significant advancements in synthetic methodologies and manufacturing technologies have transformed API production. This manuscript provides an overview of the latest innovations in API synthesis, focusing on key techniques such as green chemistry, continuous flow chemistry, biocatalysis, and automation. Green chemistry principles, including solvent substitution and catalytic reactions, have enhanced sustainability by reducing waste and energy consumption. Continuous flow chemistry offers improved reaction control, scalability, and safety, while biocatalysis provides an eco-friendly alternative for synthesizing complex and chiral APIs. Additionally, the integration of automation and advanced process control using machine learning and real-time monitoring has optimized production efficiency and consistency. The manuscript also discusses the challenges associated with regulatory compliance and quality assurance, highlighting the role of advanced analytical techniques such as HPLC, NMR, and mass spectrometry in ensuring API purity. Looking ahead, personalized medicine and smart manufacturing technologies, including blockchain for traceability, are expected to drive further innovation in API production. This review concludes by emphasizing the need for continued advancements in sustainability, efficiency, and scalability to meet the evolving demands of the pharmaceutical industry, ultimately enabling the development of safer, more effective, and environmentally responsible medicines.
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Open Access November 21, 2024

Financial Strain Partially Explains Diminished Returns of Parental Education in the ABCD Study

Abstract Background: Previous research shows that socioeconomic status (SES) positively impacts children's development, yet the benefits are not equally distributed across racial groups. According to the Minorities’ Diminished Returns (MDRs) framework, Black children tend to experience smaller gains from parental education compared to White children. Objective: Building on the MDRs framework, [...] Read more.
Background: Previous research shows that socioeconomic status (SES) positively impacts children's development, yet the benefits are not equally distributed across racial groups. According to the Minorities’ Diminished Returns (MDRs) framework, Black children tend to experience smaller gains from parental education compared to White children. Objective: Building on the MDRs framework, this study examines whether high financial strain contributes to the diminished returns of parental education for Black children, using data from the Adolescent Brain Cognitive Development (ABCD) Study. We hypothesized that: (1) there would be a positive effect of parental education on total cortical volume, (2) this effect would be weaker for Black than White children, and (3) higher household financial strain in Black families would mediate the diminished returns of parental education on total cortical volume for Black children. Methods: Data were drawn from the baseline ABCD Study, focusing on 7,936 9- and 10-year-old children identified as either Black (n = 1,775) or White (n = 6,161). Parental education was the key independent variable, covariates included age, sex, household income, and marital status, race was the moderator, financial strain was the mediator, and total cortical volume was the outcome. Structural Equation Models (SEMs) were employed to examine the associations between parental education and cortical volume, with financial strain as a mediator and race as a moderator. Results: Higher parental education was associated with greater cortical volume in the pooled sample. However, this effect was significantly weaker for Black children. Financial strain partially mediated the observed diminished returns of parental education. Conclusion: High financial strain experienced by middle-class Black families partially explains why the association between parental education and child development is weaker in Black than White families. Interventions aimed at enhancing educational quality, increasing employability, expanding access to higher-paying jobs, and reducing labor market discrimination against Black individuals may help address racial inequities in child development in the U.S. Efforts to reduce financial strain should extend beyond low-income populations to also support higher-educated minority families.
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Open Access November 21, 2024

Unequal Returns: Education Fails to Fully Prepare Black and Latino Americans for Retirement

Abstract Background: Retirement is a universal life stage, marking the culmination of an individual's working years. However, many people face financial challenges during retirement due to insufficient financial planning. Retirement preparedness is essential for ensuring economic security and maintaining a high quality of life in later years. Education is often viewed as a key driver of retirement [...] Read more.
Background: Retirement is a universal life stage, marking the culmination of an individual's working years. However, many people face financial challenges during retirement due to insufficient financial planning. Retirement preparedness is essential for ensuring economic security and maintaining a high quality of life in later years. Education is often viewed as a key driver of retirement preparedness, as it is linked to higher earnings, better financial literacy, and improved decision-making. However, the Minorities' Diminished Returns (MDRs) theory suggests that the economic, cognitive, and behavioral benefits of education are weaker for racial and ethnic minorities compared to non-Latino Whites. Objective: This study aims to examine the relationship between educational attainment and retirement preparedness, focusing on whether this association differs among Black, Latino, and non-Latino White individuals, using data from the Understanding America Study (UAS). Methods: Data were drawn from the UAS, a nationally representative internet-based panel survey. The sample included participants from diverse racial and ethnic backgrounds. Linear regression models were used to evaluate the association between educational attainment, measured in years of schooling, and retirement preparedness. Interaction terms were included to test whether the association varied by race and ethnicity. Models were adjusted for potential confounders, including age, sex, marital status, employment status, and immigration. Results: In the overall sample, higher educational attainment was significantly and positively associated with better retirement preparedness (p < 0.001). However, consistent with the MDRs framework, the strength of this association was significantly weaker for Black and Latino participants compared to non-Latino White participants (p < 0.05). Non-Latino Whites with higher education levels reported substantially better retirement preparedness, while the same level of education yielded smaller gains in retirement preparedness for Black and Latino individuals. Conclusion: The findings support the Minorities' Diminished Returns theory, showing that although educational attainment enhances retirement preparedness for all groups, Black and Latino individuals derive fewer benefits compared to their non-Latino White counterparts. These disparities point to persistent structural inequalities and systemic barriers within the education system and labor market, as well as the effects of segregation and discrimination, which undermine the economic benefits of education for marginalized populations. Addressing these disparities requires targeted policy interventions aimed at eliminating racial and ethnic inequalities in retirement outcomes and ensuring equitable benefits from educational attainment for all groups.
Article
Open Access November 19, 2024

The Cost of Opportunity: Anti-Black Discrimination in High Resource Settings

Abstract Objective: Inequalities exist in children’s educational outcomes—including reading proficiency, school discrimination, and school disciplinary actions—across zip codes with different levels of educational childhood opportunity index (COI). This study examines the interaction between race and educational environment on children’s educational outcomes. We hypothesize that race, parental [...] Read more.
Objective: Inequalities exist in children’s educational outcomes—including reading proficiency, school discrimination, and school disciplinary actions—across zip codes with different levels of educational childhood opportunity index (COI). This study examines the interaction between race and educational environment on children’s educational outcomes. We hypothesize that race, parental education, and their interaction are associated with perceived school discrimination, which in turn reduces their cognitive, academic, and emotional wellbeing. We also hypothesize that Black children with high socioeconomic status (SES) report high perceived school discrimination in high-COI settings. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study, which measures a wide range of educational, cognitive, and emotional outcomes. At the same time, the ABCD children are sampled across areas with vast differences in COI rankings, that can be classified into these five categories: very high, high, average, low, and very low educational COIs. Our structural equation models (SEM) tested the additive and interactive effects of race and educational attainment on perceived school discrimination, and the effects of school discrimination on various cognitive abilities (reading proficiency, picture vocabulary, and list sorting working memory), school suspension, as well as depressed mood. Our multi-group SEM assessed how these relationships vary across educational COI levels. Results: Our findings showed that high SES Black children report highest school discrimination in residential areas with highest COIs. This is based on the observation that the interaction between race and parental education on experiences of school discrimination were only significant in areas with highest COI. Across residential areas with different COI levels, students who experienced higher school discrimination had higher suspension, worse depression, and worse cognitive performance. Conclusion: While higher COIs are associated with better academic outcomes, Black-White gaps exist in the role of increased COI through increased racial bias that children perceive. These findings underscore the complexity of educational equity, suggesting that improving COI alone is insufficient for eliminating racial disparities in school experiences. Policies should be in place to reduce school-based discrimination against Black students in high COI settings.
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Open Access November 19, 2024

Social Epidemiology of Dual Use of Electronic and Combustible Cigarettes Among U.S. Adults: Insights from the Population Assessment of Tobacco and Health (PATH) Study

Abstract Background: The dual use of e-cigarettes and combustible cigarettes poses significant public health concerns due to the compounded risks associated with the use of both products. Understanding the predictors of dual use can inform targeted interventions and tobacco control strategies aimed at reducing nicotine dependence and health risks among adults. Objective: This study [...] Read more.
Background: The dual use of e-cigarettes and combustible cigarettes poses significant public health concerns due to the compounded risks associated with the use of both products. Understanding the predictors of dual use can inform targeted interventions and tobacco control strategies aimed at reducing nicotine dependence and health risks among adults. Objective: This study aims to identify the sociodemographic predictors of dual use of e-cigarettes and combustible cigarettes among U.S. adults using baseline data from the Population Assessment of Tobacco and Health (PATH) Study. Methods: We analyzed baseline data from the PATH Study, focusing on adult participants who reported the use of both e-cigarettes and combustible cigarettes. Logistic regression models were used to identify the associations between dual use and key sociodemographic variables, including age, gender, race/ethnicity, and education level. Results: The analysis revealed that dual use of e-cigarettes and combustible cigarettes was predominantly observed among young, female, non-Latino, White, and highly educated adults. Younger adults were more likely to engage in dual use compared to older age groups. Females showed higher rates of dual use compared to males. Non-Latino White individuals were more likely to be dual users than individuals from other racial/ethnic backgrounds. Additionally, higher educational attainment was associated with increased dual use, contrary to traditional smoking patterns. Conclusion: The findings highlight specific demographic groups that are at higher risk of dual use of e-cigarettes and combustible cigarettes, particularly younger, highly educated, non-Latino White females. These insights suggest the need for tailored public health interventions that address the unique needs and behaviors of these populations. Future research should explore the underlying motivations and contextual factors contributing to dual use to enhance the effectiveness of tobacco control policies and cessation programs.
Article
Open Access November 19, 2024

High Education, Low Returns: Financial Literacy Challenges for African Americans and Hispanics

Abstract Background: Education is widely regarded as a key driver of financial literacy, yet racial and ethnic disparities persist. Even among highly educated individuals, African American and Hispanic populations may face challenges in financial literacy, likely due to structural racism and socioeconomic inequalities that diminish the benefits of education. This study examines the relationship [...] Read more.
Background: Education is widely regarded as a key driver of financial literacy, yet racial and ethnic disparities persist. Even among highly educated individuals, African American and Hispanic populations may face challenges in financial literacy, likely due to structural racism and socioeconomic inequalities that diminish the benefits of education. This study examines the relationship between education and financial literacy among African American and Hispanic individuals compared to their White counterparts, focusing on how structural factors contribute to these disparities. Objective: To determine whether highly educated African American and Hispanic individuals exhibit lower financial literacy compared to similarly educated White individuals and to explore the role of structural factors in explaining these disparities. Methods: Data from the 2016 Understanding America Study (UAS) were used to evaluate financial literacy among U.S. adults. The sample was stratified by race/ethnicity (African American, Hispanic, and White) and educational attainment. Financial literacy was assessed using standardized financial knowledge tests. Multivariate regression models were employed to investigate the relationship between race/ethnicity, education, and financial literacy, adjusting for socioeconomic factors such as income, employment, and household wealth. Results: African American and Hispanic individuals with higher levels of education demonstrated significantly lower financial literacy scores than their White peers (p < 0.001). The positive association between education and financial literacy was notably stronger for White individuals than for African American and Hispanic individuals. Further analyses suggest that structural barriers, including systemic discrimination in access to financial resources and disparities in educational quality, contribute to these diminished returns on education for racial and ethnic minorities. Conclusion: This study highlights persistent financial literacy disparities among highly educated African American and Hispanic individuals, underscoring the limitations of education alone in overcoming structural inequalities. The findings emphasize the need for targeted policies to address systemic barriers that restrict the financial knowledge and opportunities typically associated with higher education for racial and ethnic minority groups.
Article
Open Access November 14, 2024

When Common Becomes Normal: Weaker Association Between Neighborhood Stress and Body Mass Index Among Black Adolescents Compared to White Adolescents

Abstract Objective: This study explores the relationship between neighborhood stress and Body Mass Index (BMI) in adolescents, while also examining whether this association differs between Black and White adolescents. Methods: Data from the Adolescent Brain Cognitive Development (ABCD) Study were analyzed using linear regression models to examine the association between neighborhood stress [...] Read more.
Objective: This study explores the relationship between neighborhood stress and Body Mass Index (BMI) in adolescents, while also examining whether this association differs between Black and White adolescents. Methods: Data from the Adolescent Brain Cognitive Development (ABCD) Study were analyzed using linear regression models to examine the association between neighborhood stress (defined as a composite score based on three items measuring perceived safety and neighborhood fear) and BMI in adolescents, controlling for demographic and socioeconomic variables. We tested models both with and without interaction terms to assess whether race moderated the association. Stratified analyses were conducted to further explore potential differences between Black and White adolescents. Results: A positive association was observed between neighborhood stress and BMI across the overall sample. However, this association was weaker for Black adolescents compared to White adolescents, even after adjusting for potential confounders. Conclusions: The contribution of neighborhood stress to higher BMI in adolescents may vary by race. Our findings suggest that while neighborhood stress is associated with increased BMI, Black adolescents appear to be less affected by these stressors than their White peers. This weaker association could be due to the normalization of stress in environments where it is pervasive (what is common becomes normal) or the presence of other significant risk factors affecting BMI in Black youth, such as poverty, limited food access, food culture, and food deserts. Future research should explore processes of habituation, inoculation, or even sensitization to stress among Black populations, who are often exposed to a wide range of stressors throughout the life course.
Article
Open Access November 09, 2024

Educated but Unhealthy? Examining Minorities' Diminished Returns

Abstract Background: Educational attainment is known to improve self-rated health; however, research suggests that these benefits may be less pronounced for racial and ethnic minority groups. The Minorities' Diminished Returns (MDRs) theory posits that the protective effects of resources such as education are weaker for marginalized populations, such as Black and Latino individuals, compared to [...] Read more.
Background: Educational attainment is known to improve self-rated health; however, research suggests that these benefits may be less pronounced for racial and ethnic minority groups. The Minorities' Diminished Returns (MDRs) theory posits that the protective effects of resources such as education are weaker for marginalized populations, such as Black and Latino individuals, compared to their White counterparts. Objective: This study aims to investigate racial and ethnic disparities in the association between years of schooling and self-rated health among U.S. adults, with a focus on understanding the reduced health benefits of education for Black and Latino individuals. Methods: Using data from the Understanding America Study (UAS; 2014), we conducted a cross-sectional analysis of adults aged 18 and older (N = 6,785). Self-rated health was the outcome, and years of schooling was the primary independent variable. We controlled for sociodemographic factors including age, gender, employment status, immigration status, and marital status. Stratified analyses were conducted by race/ethnicity (Non-Latino White, Non-Latino Black, and Latino). Linear regression models were used to examine the association between years of schooling and self-rated health, and interaction terms were included to assess variation in this relationship across racial/ethnic groups. Results: While years of schooling was positively associated with better self-rated health overall, the magnitude of this effect was weaker for Black and Latino individuals compared to White individuals. After adjusting for sociodemographic factors, Black and Latino adults reported worse self-rated health for each additional year of schooling, compared to their White counterparts, supporting the MDRs hypothesis. Conclusion: The findings suggest that while higher educational attainment is protective against worse self-rated health, this protection is not equally distributed across racial and ethnic groups. Black and Latino individuals experience diminished returns from their years of schooling in terms of self-rated health, likely due to structural barriers and social inequalities. Policies addressing health disparities must consider these diminished returns and aim to reduce structural racism and discrimination that undermine the benefits of education for minoritized populations.
Article
Open Access November 09, 2024

Educated but on Social Security Disability Insurance: Minorities’ Diminished Returns

Abstract Background: Educational attainment is widely regarded as a key predictor of economic and social outcomes in later life, including the likelihood of receiving Social Security Disability Insurance (SSDI). According to the Minorities' Diminished Returns (MDRs) theory, however, the benefits of education may be less pronounced for racial and ethnic minorities compared to non-Latino [...] Read more.
Background: Educational attainment is widely regarded as a key predictor of economic and social outcomes in later life, including the likelihood of receiving Social Security Disability Insurance (SSDI). According to the Minorities' Diminished Returns (MDRs) theory, however, the benefits of education may be less pronounced for racial and ethnic minorities compared to non-Latino Whites. This study investigates whether the effects of education on the likelihood of receiving SSDI differ by race and ethnicity, focusing on Black and Latino Americans. Objective: The primary aim of this study was to examine the relationship between educational attainment (measured in years of schooling) and the likelihood of receiving SSDI, with a specific focus on exploring how this relationship varies by race and ethnicity, in line with the MDRs framework. Methods: Data were drawn from the Understanding America Study (UAS), a nationally representative, internet-based panel survey. The sample included Black, Latino, and non-Latino White U.S. adults. Our sample size was 12,975 adults over the age of 18. Logistic regression models were used to assess the association between educational attainment and receiving SSDI, adjusting for demographic variables such as age, sex, employment status, and marital status. Interaction terms between race/ethnicity and educational attainment were included to explore whether the returns on education varied across racial and ethnic groups. Results: Higher educational attainment was significantly associated with a lower likelihood of receiving SSDI in the overall sample. However, consistent with the MDRs framework, the protective effect of education was significantly weaker for both Black and Latino individuals compared to non-Latino Whites. Black and Latino participants with similar levels of education as their non-Latino White counterparts were more likely to receive SSDI, reflecting diminished returns on educational attainment for these groups. Conclusion: This study provides strong evidence supporting the MDRs theory, demonstrating that the protective effects of education on the likelihood of receiving SSDI are not equally distributed across racial and ethnic groups. Black and Latino Americans experience weaker returns on their education when it comes to avoiding SSDI, likely due to structural inequalities and systemic barriers. These findings highlight the need for policies that address not only educational disparities but also the broader societal factors that limit the benefits of education for racial and ethnic minorities.
Article
Open Access November 05, 2024

Black-White Gap Across Levels of Educational Childhood Opportunities: Findings from the ABCD Study

Abstract Objective: This study examines racial disparities in educational outcomes—including reading proficiency, grade point average (GPA), school discrimination, and school disciplinary actions—across regions with different levels of educational childhood opportunity index (COI). Our aim is to explore how these racial gaps between Black and White students vary in areas with differing educational [...] Read more.
Objective: This study examines racial disparities in educational outcomes—including reading proficiency, grade point average (GPA), school discrimination, and school disciplinary actions—across regions with different levels of educational childhood opportunity index (COI). Our aim is to explore how these racial gaps between Black and White students vary in areas with differing educational opportunities. We hypothesize that higher COI is associated with smaller academic achievement gaps but may also correspond with greater racial bias in unfair school treatment. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study, which provides comprehensive measures of educational outcomes, cognitive performance, and COI. National COI rankings were used to classify regions into five categories: very high, high, average, low, and very low educational opportunity. We analyzed racial gaps in reading proficiency, and experiences of discrimination and suspension across these COI categories. Multi-group Structural Equation Models (SEM) were used to assess how the relationship between race and educational outcomes varies across COI levels. Results: Our findings confirmed that Black-White gaps in reading proficiency and cognitive test performance (Flanker task) were less pronounced in regions with higher COI. However, racial disparities in school disciplinary actions and experiences of discrimination were more pronounced in higher-opportunity areas. Specifically, the effect of Black race was stronger in regions with the highest COI, where Black students experienced a disproportionately higher rate of unfair school treatment, including both school discrimination and suspensions, compared to their White peers. Conclusion: This exploratory study supports that while higher educational opportunities are associated with smaller academic achievement gaps between Black and White students, they might be linked to increased racial bias in school disciplinary actions and discriminatory treatment. These findings underscore the complexity of educational equity, suggesting that improving access to quality education alone is insufficient to eliminate racial disparities in school experiences. Addressing school-based bias and discrimination must accompany efforts to enhance educational opportunities.
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Open Access November 04, 2024

In-Person versus Virtual CEASE Smoking Cessation Interventions

Abstract Background: Smoking cessation interventions are critical for underserved populations, particularly among low-income individuals who may benefit from tailored support. However, the effectiveness of different intervention formats remains unclear, particularly as virtual and hybrid models gain popularity. Aims: This study compares the effectiveness of three smoking cessation intervention [...] Read more.
Background: Smoking cessation interventions are critical for underserved populations, particularly among low-income individuals who may benefit from tailored support. However, the effectiveness of different intervention formats remains unclear, particularly as virtual and hybrid models gain popularity. Aims: This study compares the effectiveness of three smoking cessation intervention arms in a quasi-experimental design: Self-help group (Arm 1), In-person group (Arm 2), and Virtual/hybrid group (Arm 3). The primary outcome was the rate of successful quit across these different intervention modalities. Methods: The study utilized a community-based intervention approach, controlling for potential confounders. The communities were randomized, and this process was blinded. The effectiveness of the In-person group and the Virtual/hybrid group was compared to the Self-help group. The odds ratio (OR) for successful quit rates was calculated for each group, with corresponding 95% confidence intervals (CIs). Results: Participants included 50.4% of women, 82.8% were Black Americans, 11.6% Whites, and 3.4% other races. In-person group (Arm 2) showed a higher rate of successful quit compared to the Self-help group (OR = 2.67, 95% CI = 1.05, 6.79). Virtual/hybrid group (Arm 3) was not associated with a significantly higher quit rate compared to the Self-help group (OR = 1.48, 95% CI = 0.57, 3.83). Conclusion: The In-person group, which utilizes the CEASE curriculum and incorporates peer motivation, proved to be significantly more effective than both the Self-help and Virtual/hybrid groups. The findings suggest that low-income, underserved smokers may not be fully prepared to benefit from virtual interventions, or the current curriculum may need adaptation to better serve their needs in a virtual format.
Article
Open Access November 03, 2024

School Poverty Partially Mediates the Effects of Structural Racism on Youth Tobacco Use Initiation

Abstract Background. Although youth from high socioeconomic status (SES) backgrounds are generally protected against tobacco use, this protection is weaker for racialized and marginalized families, particularly Black youth. While Minorities' Diminished Returns (MDRs) of household income on tobacco use have been documented for Black youth, the mechanisms underlying these effects are not well understood. [...] Read more.
Background. Although youth from high socioeconomic status (SES) backgrounds are generally protected against tobacco use, this protection is weaker for racialized and marginalized families, particularly Black youth. While Minorities' Diminished Returns (MDRs) of household income on tobacco use have been documented for Black youth, the mechanisms underlying these effects are not well understood. Objective. This study investigates whether school poverty and associated peer deviance and delinquent behaviors explain the disproportionately higher tobacco use among Black youth from high-income backgrounds, using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods. We conducted a longitudinal analysis of Black youth from high-income families within the Adolescent Brain Cognitive Development (ABCD) study. A total of 8,777 youth was included in our analysis. We examined the associations between household income and tobacco use, with school poverty and associated peer deviance and delinquent behaviors as mediators. Race was considered as a moderator. Results. Compared to their high-income White counterparts, Black youth from high-income backgrounds were more likely to live in areas with higher school poverty, which exposed them to increased levels of peer deviance and delinquent behaviors compared to their White counterparts. These exposures, in turn, were associated with higher rates of tobacco use among Black youth. Thus, higher school poverty, along with the related peer deviance and delinquent behaviors, contributed to the elevated tobacco use observed among Black adolescents from high-income backgrounds. Conclusion. The study suggests that residing in areas with school poverty, peer deviance, and youth delinquency may explain Minorities' Diminished Returns, which are defined as the weaker protective effects of socioeconomic status on tobacco use among Black youth. Interventions aiming to prevent tobacco use need to include structural components addressing these broader social determinants of health.
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Open Access October 31, 2024

The Long Shadow of Early Poverty: Poverty at Birth, Epigenetic Changes at Age 15, And Youth Outcomes at Age 22

Abstract Background: Early life socioeconomic conditions and race/ethnicity are critical determinants of long-term health and behavioral outcomes. Epigenetic changes, particularly those measured by the GrimAge biomarker, may mediate the impact of these early adversities on later life outcomes. This study investigates the relationships between race/ethnicity, poverty at birth, epigenetic aging at age [...] Read more.
Background: Early life socioeconomic conditions and race/ethnicity are critical determinants of long-term health and behavioral outcomes. Epigenetic changes, particularly those measured by the GrimAge biomarker, may mediate the impact of these early adversities on later life outcomes. This study investigates the relationships between race/ethnicity, poverty at birth, epigenetic aging at age 15, and subsequent self-rated health, school discipline, depression, and school dropout at age 22. We explored sex differences in these paths. Methods: Data were drawn from the Fragile Families and Child Wellbeing Study (FFCWS), which included 733 youth with comprehensive follow-up data up to age 22. Structural Equation Modeling (SEM) was employed to assess the pathways from race/ethnicity and poverty at birth to epigenetic aging (GrimAge) at age 15, and subsequently to self-rated health and school discipline at age 22. The model controlled for potential confounders including sex, family structure, and parental education. Results: Race/ethnicity and poverty at birth were significantly associated with higher GrimAge scores at age 15 (p < 0.05). Higher GrimAge scores were predictive of poorer self-rated health (β = -0.08, p < 0.05) and increased instances of school discipline (β = 0.13, p < 0.01) at age 22. The indirect effects of race/ethnicity and poverty at birth on self-rated health and school discipline through GrimAge were also significant (p < 0.05), suggesting that epigenetic aging partially mediates these relationships. Sex differences were also observed. Poverty at birth predicted faster epigenetic aging at age 15 for males not females. We also observed that faster epigenetic aging at age 15 was predictive of school discipline of male not female participants at age 22. In contrast, faster epigenetic aging at age 15 was predictive of self-rated health (SRH) of female not male participants at age 22. Conclusions: This study provides evidence that with some sex differences, race/ethnicity and poverty at birth contribute to accelerated epigenetic aging (GrimAge) by age 15, which in turn predicts poorer self-rated health and increased school discipline issues by age 22. These findings emphasize the importance of early interventions targeting social determinants to mitigate long-term health and behavioral disparities. Addressing these early life conditions is crucial for improving health equity and outcomes in young adulthood.
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