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Narrow escape theory deals with the first passage of a particle diffusing in a cavity with small circular windows on the cavity wall to one of the windows. Assuming that (i) the cavity has no size anisotropy and (ii) all windows are sufficiently far away from each other, the theory provides an analytical expression for the particle mean first-passage time (MFPT) to one of the windows. This expression shows that the MFPT depends on the only global parameter of the cavity, its volume, independent of the cavity shape, and is inversely proportional to the product of the particle diffusivity and the sum of the window radii. Amazing simplicity and universality of this result raises the question of the range of its applicability. To shed some light on this issue, we study the narrow escape problem in a cylindrical cavity of arbitrary size anisotropy with two small windows arbitrarily located on the cavity side wall. We derive an approximate analytical solution for the MFPT, which smoothly goes from the conventional narrow escape solution in an isotropic cavity when the windows are sufficiently far away from each other to a qualitatively different solution in a long cylindrical cavity (the cavity length significantly exceeds its radius). Our solution demonstrates the mutual influence of the windows on the MFPT and shows how it depends on the inter-window distance. A key step in finding the solution is an approximate replacement of the initial three-dimensional problem by an equivalent one-dimensional one, where the particle diffuses along the cavity axis and the small absorbing windows are modeled by delta-function sinks. Brownian dynamics simulations are used to establish the range of applicability of our approximate approach and to learn what it means that the two windows are far away from each other.

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OBJECTIVE: To evaluate the prevalence, trends, and factors associated with psychotropic medication use and polypharmacy among children and adolescents initiating intensive behavioral therapy for severe challenging behavior over a 10-year period. STUDY DESIGN: In this retrospective observational study, we examined data from caregiver interviews and patient medical records on the number and types of psychotropic medications prescribed to patients initiating intensive behavioral therapy between January 1, 2013, and December 31, 2022. Trends in medication use and polypharmacy across the 10-year period were analyzed using regression analysis, while differences in demographics and clinical factors for patients with use and polypharmacy were analyzed using nonparametric statistical analysis with odds ratios presented for significant factors. RESULTS: Data from all 302 pediatric patients initiating intensive behavioral therapy across the 10-year period were analyzed. Among all patients and all years, 83.8% were taking at least 1 psychotropic medication and 68.2% experienced polypharmacy. There were no changes in the prevalence of use, mean number of medications taken, or polypharmacy across the 10-year period. Patients diagnosed with attention-deficit/hyperactivity disorder or anxiety disorder, as well as those exhibiting self-injurious behavior had higher use of psychotropic medication and polypharmacy and were taking more medications overall. CONCLUSIONS: Psychotropic medication use and polypharmacy were extremely high for children and adolescents with severe challenging behavior, but use and polypharmacy did not change over the 10-year period of data collection. Further research is needed to establish the generality of these findings to other regions of the US.

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Ocular chemical burns are a significant cause of visual impairment. This study aims to characterize the ocular chemical burns in a southwestern Colombia referral center and identify associated factors with low vision. A retrospective cohort study was carried out based on the review of medical records of patients diagnosed with chemical eye burns who consulted the emergency ophthalmology service between January 2016 and December 2019. Descriptive statistics were performed. Associations with low vision (Best-Corrected Visual Acuity, ≥20/70 in Snellen chart) in the last follow-up appointment were identified using a multivariate logistic regression with odds ratios (OR) and 95% confidence intervals (95% CI). About 219 eyes affected by chemical burns were identified from 174 patients with a mean age of 39 years (SD ± 20), of which 57.5% (n = 100) were men. We ran a multivariate model adjusted by sex, eye wash, type of chemical, and Dua's classification. We found that the odds of low vision for patients without eyewash before the consult were 3 times the odds of those who had it (adjusted OR [aOR] = 3.5, 95% CI = 1.3-9.4) and almost 5 times for those with Dua's classification >1 (aOR = 4.7, 95% CI = 1.7-12.9). The ocular chemical burns reported in this study occurred more in young people of productive age. Acids were the principal causal agent. The association between lack of early management and the severity of the chemical burn with low vision has been highlighted. Ocular burns remain a relevant cause of consultation on the ophthalmology service in Cali, and prevention strategies are required.

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Mayaro virus (MAYV) is a mosquito-borne Alphavirus that is widespread in South America. MAYV infection often presents with non-specific febrile symptoms but may progress to debilitating chronic arthritis or arthralgia. Despite the pandemic threat of MAYV, its true distribution remains unknown. The objective of this study was to clarify the geographic distribution of MAYV using an established risk mapping framework. This consisted of generating evidence consensus scores for MAYV presence, modeling the potential distribution of MAYV in select countries across Central and South America, and estimating the population residing in areas suitable for MAYV transmission. We compiled a georeferenced compendium of MAYV occurrence in humans, animals, and arthropods. Based on an established evidence consensus framework, we integrated multiple information sources to assess the total evidence supporting ongoing transmission of MAYV within each country in our study region. We then developed high resolution maps of the disease's estimated distribution using a boosted regression tree approach. Models were developed using nine climatic and environmental covariates that are related to the MAYV transmission cycle. Using the output of our boosted regression tree models, we estimated the total population living in regions suitable for MAYV transmission. The evidence consensus scores revealed high or very high evidence of MAYV transmission in several countries including Brazil (especially the states of Mato Grosso and Goiás), Venezuela, Peru, Trinidad and Tobago, and French Guiana. According to the boosted regression tree models, a substantial region of South America is suitable for MAYV transmission, including north and central Brazil, French Guiana, and Suriname. Some regions (e.g., Guyana) with only moderate evidence of known transmission were identified as highly suitable for MAYV. We estimate that approximately 58.9 million people (95% CI: 21.4-100.4) in Central and South America live in areas that may be suitable for MAYV transmission, including 46.2 million people (95% CI: 17.6-68.9) in Brazil. Our results may assist in prioritizing high-risk areas for vector control, human disease surveillance and ecological studies.

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BACKGROUND: Anti-PD-1 therapy (PD1) either alone or with anti-CTLA-4 (CTLA4), has high initial response rates, however 20% of patients (pts) with complete response (CR) and 30% with partial response (PR) within 12 months of treatment experience subsequent disease progression by 6 years. The nature and optimal management of this acquired resistance (AR) remains unknown. METHODS: Pts from 16 centres who responded to PD1-based therapy and who later progressed were examined. Demographics, disease characteristics and subsequent treatments were evaluated. RESULTS: 299 melanoma pts were identified, median age 64y, 44% BRAFV600m. 172 (58%) received PD1 alone, 114 (38%) PD1/CTLA4 and 13 (4%) PD1 and an investigational drug. 90 (30%) pts had CR, 209 (70%) PR. Median time to AR was 12.6 mo (95% CI, 11.3, 14.2). Most (N = 193, 65%) progressed in a single organ site, and in a solitary lesion (N = 151, 51%). The most frequent sites were lymph nodes (38%) and brain (25%). Management at AR included systemic therapy (ST, 45%), local therapy (LT) +ST (31%), LT alone (21%), or observation (3%). There was no statistical difference in PFS2 or OS based on management, however, PFS2 was numerically superior for pts treated with ST alone who progressed off PD1 therapy than those who progressed on PD1 (2-year PFS2 42% versus 25%, p = 0.249). mOS from AR was 38.0 months (95% CI, 29.5-NR); longer in single-site versus multi-site progression (2-year OS 70% vs 54%, p < 0·001). CONCLUSIONS: Acquired resistance to PD1 therapy in melanoma is largely oligometastatic, and pts may have a favorable survival outcome following salvage treatment.

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ABSTRACT Purposes: To describe the clinical characteristics and factors associated with keratitis in patients with corneal foreign bodies in Colombia. Methods: This cross-sectional study was based on a clinical records review of patients who had corneal foreign bodies and were admitted to the emergency department between June 2018 and June 2019 in Cali, Colombia. The primary outcome was the presence of keratitis diagnosed based on clinical criteria. Univariate and multivariate logistic regression models were used to identify associated factors. Results: A total of 381 corneal foreign bodies in 372 patients were analyzed (median age, 40.0; interquartile range, 29.0-53.0 years; male, 94.7% (n=352). Ninety-five patients developed keratitis (24.9%, 95% confidence interval [CI] 20.8%-29.5%). In the multivariate analysis, age 30 years (odds ratio [OR] 2.15, 95% CI 1.06-4.36), finding of aqueous flare (OR 2.81, 95% CI 1.39-5.66]), and a foreign body in the peripheral cornea (OR 2.05, 95% CI 1.19-3.50] were associated with an increased risk for keratitis. Sex, time between injury and admission, and corneal edema were not related to keratitis (p>0.05). Conclusion: In Cali, Colombia, a high proportion of keratitis was reported in patients with corneal foreign body. Age, an aqueous flare, and a foreign body in the peripheral cornea were the factors associated with keratitis.

RESUMO Objetivo: Descrever as características clínicas e os fatores associados à presença de ceratite em pacientes com corpos estranhos na córnea em uma população colombiana. Métodos: Trata-se de um estudo transversal baseado na revisão dos registros clínicos de pacientes com corpos estranhos na córnea admitidos em um departamento de emergência em Cali, Colômbia, entre junho de 2018 e junho de 2019. O desfecho primário foi a presença de ceratite diagnosticada através de critérios clínicos. Foram utilizados modelos de regressão logística univariada e multivariada para identificar os fatores associados. Resultado: Neste estudo, foi analisado um total de 381 corpos estranhos na córnea em 372 pacientes (idade média: 40,0 anos, intervalo interquartil: 29,0-53,0; sexo masculino: 94,7% [352 casos]). Noventa e cinco casos desenvolveram ceratite (24,9%, intervalo de confiança de 95% — IC 95%: 20,8%-29,5%). Na análise multivariada, para idade ≤30 anos (razão de chances — RC: 2,15, IC 95%: 1,06-4,36), o achado de flare aquoso (RC: 2,81, IC 95%: 1,39-5,66]) e a presença de corpo estranho na periferia da córnea (RC: 2,05, IC 95%: 1,19-3,50) foram associados a um risco aumentado de ceratite. Sexo, tempo entre a lesão e a internação, e edema da córnea não foram relacionados à ceratite (p>0,05). Conclusão: Há uma proporção elevada de ceratite em casos de corpos estranhos na córnea em Cali, Colômbia. Os três fatores associados à ceratite foram a idade, o achado de flare aquoso e a presença de corpo estranho na periferia da córnea.

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Background: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an inflammatory disorder of the CNS with a variety of clinical manifestations, including cerebral edema. Case Summary: A 7-year-old boy presented with headaches, nausea, and somnolence. He was found to have cerebral edema that progressed to brainstem herniation. Invasive multimodality neuromonitoring was initiated to guide management of intracranial hypertension and cerebral hypoxia while he received empiric therapies for neuroinflammation. Workup revealed serum myelin oligodendrocyte glycoprotein antibodies. He survived with a favorable neurologic outcome. Conclusion: We describe a child who presented with cerebral edema and was ultimately diagnosed with MOGAD. Much of his management was guided using data from invasive multimodality neuromonitoring. Invasive multimodality neuromonitoring may have utility in managing life-threatening cerebral edema due to neuroinflammation.

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PURPOSE: To describe the epidemiology, incidence, mortality and survival of ocular cancer in Cali between 1962 and 2019. METHODS: Ecological population-based study analyzing data of incidence, mortality, and 5-years survival of malignant ocular tumors from the Populational Cancer Registry of Cali between 1962 and 2019. RESULTS: Between 1962 and 2019, 586 ocular tumors were found, 50.5% occurred in females, the mean age at diagnosis was 45 years (standard deviation = 25), 70.3% of ocular malignancies occurred in >14 years. The average annual incidence rate was 7.8 per million for male and 6.9 per million for females. Retinoblastoma (21%), squamous cell carcinoma (20%), melanoma (16%) and lymphoma (8%) were the most common neoplasm. In those <15 years, the most frequent malignant tumors were retinoblastomas (85.7%), followed by non-specified malignant neoplasm (NOS, 7.9%), and rhabdomyosarcoma (3.6%). In those >14 years, there were NOS (30%), followed by squamous cell carcinomas (28%), melanomas (23%), and lymphomas (9.7%). Conjunctiva (38.2%), retina (21%) and orbit (10%) constituted the majority of anatomical sites of ocular tumors. The survival rate was about 83.2% and mortality did not show a decreasing trend over time (p > .05). CONCLUSIONS: The incidence of ocular cancer in Cali has a slightly increasing trend, with stable behavior in the last decades. Squamous cell carcinoma, retinoblastoma, melanoma and lymphoma are the most frequent ocular cancers, with being retinoblastoma more frequent than melanoma. In general, ocular cancer had good survival rates in Cali.

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PURPOSES: To describe the clinical characteristics and factors associated with keratitis in patients with corneal foreign bodies in Colombia. METHODS: This cross-sectional study was based on a clinical records review of patients who had corneal foreign bodies and were admitted to the emergency department between June 2018 and June 2019 in Cali, Colombia. The primary outcome was the presence of keratitis diagnosed based on clinical criteria. Univariate and multivariate logistic regression models were used to identify associated factors. RESULTS: A total of 381 corneal foreign bodies in 372 patients were analyzed (median age, 40.0; interquartile range, 29.0-53.0 years; male, 94.7% (n=352). Ninety-five patients developed keratitis (24.9%, 95% confidence interval [CI] 20.8%-29.5%). In the multivariate analysis, age 30 years (odds ratio [OR] 2.15, 95% CI 1.06-4.36), finding of aqueous flare (OR 2.81, 95% CI 1.39-5.66]), and a foreign body in the peripheral cornea (OR 2.05, 95% CI 1.19-3.50] were associated with an increased risk for keratitis. Sex, time between injury and admission, and corneal edema were not related to keratitis (p>0.05). CONCLUSION: In Cali, Colombia, a high proportion of keratitis was reported in patients with corneal foreign body. Age, an aqueous flare, and a foreign body in the peripheral cornea were the factors associated with keratitis.

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The geometry of ion and metabolite channels in membranes of biological cells and organelles is usually far from that of a regular right cylinder. Rather, the channels have complex shapes that are characterized by the so-called vestibules and constriction zones which play roles of molecular filters determining the channel selectivity. In the present paper we discuss several channel structures with varying radius that approximate most of the cases found in nature, specifically, channels of smoothly varying radius and channels composed of multiple cylindrical sections of different lengths and radii including channels containing very thin circular constrictions. We consider diffusive transport of electrically neutral molecules driven by the concentration gradient and derive analytical expressions for the diffusion resistance - the integral parameter that describes steady-state transport properties of membrane channels.

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Patients with diabetes mellitus (DM) are at increased risk of complications following ankle fracture surgery. Previous research suggests that patients of low socioeconomic status are at increased risk of amputation following orthopedic complications. The purpose of this research was to determine if low socioeconomic status increases risk of below-knee amputation (BKA) following ankle fractures among patients with DM. The National Inpatient Sample (NIS) was queried from 2010 to 2014 to identify 125 diabetic patients who underwent ankle fracture surgical fixation followed by BKA. Two cohorts (BKA vs no BKA) and a multivariate logistic regression model were created to compare the effects of independent variables, including age, sex, race, primary payer, median household income by ZIP code, hospital location/teaching status, and comorbidities. The most predictive variables for BKA were concomitant peripheral vascular disease (odds ratio [OR] 5.35, 95% confidence interval [CI] 3.51-8.15), history of chronic diabetes-related medical complications (OR 3.29, CI 2.16-5.01), age in the youngest quartile (OR 2.54, CI 1.38-4.67), and male sex (OR 2.28, CI 1.54-3.36). Patient race and median household income were not significantly associated with BKA; however, risk of BKA was greater among patients with Medicaid (OR 2.23, CI 1.09-4.53) or Medicare (OR 1.85, CI 1.03-3.32) compared to privately insured patients. Diabetic inpatients with Medicaid insurance are at over twice the odds of BKA compared to privately insured patients following ankle fracture. Furthermore, peripheral vascular diseases, uncontrolled diabetes, younger age, and male sex each independently increase risk of BKA.

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PURPOSE: The purpose of this study was to evaluate whether a short-form computerized adaptive testing (CAT) version of the Philadelphia Naming Test (PNT) provides error profiles and model-based estimates of semantic and phonological processing that agree with the full test. METHOD: Twenty-four persons with aphasia took the PNT-CAT and the full version of the PNT (hereinafter referred to as the "full PNT") at least 2 weeks apart. The PNT-CAT proceeded in two stages: (a) the PNT-CAT30, in which 30 items were selected to match the evolving ability estimate with the goal of producing a 50% error rate, and (b) the PNT-CAT60, in which an additional 30 items were selected to produce a 75% error rate. Agreement was evaluated in terms of the root-mean-square deviation of the response-type proportions and, for individual response types, in terms of agreement coefficients and bias. We also evaluated agreement and bias for estimates of semantic and phonological processing derived from the semantic-phonological interactive two-step model (SP model) of word production. RESULTS: The results suggested that agreement was poorest for semantic, formal, mixed, and unrelated errors, all of which were underestimated by the short forms. Better agreement was observed for correct and nonword responses. SP model weights estimated by the short forms demonstrated no substantial bias but generally inadequate agreement with the full PNT, which itself showed acceptable test-retest reliability for SP model weights and all response types except for formal errors. DISCUSSION: Results suggest that the PNT-CAT30 and the PNT-CAT60 are generally inadequate for generating naming error profiles or model-derived estimates of semantic and phonological processing ability. Post hoc analyses suggested that increasing the number of stimuli available in the CAT item bank may improve the utility of adaptive short forms for generating error profiles, but the underlying theory also suggests that there are limitations to this approach based on a unidimensional measurement model. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.22320814.

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Arboviral mosquito vectors are key targets for the surveillance and control of vector-borne diseases worldwide. In recent years, changes to the global distributions of these species have been a major research focus, aimed at predicting outbreaks of arboviral diseases. In this study, we analyzed a global scenario of climate change under regional rivalry to predict changes to these species' distributions over the next century. Using occurrence data from VectorMap and environmental variables (temperature and precipitation) from WorldClim v. 2.1, we first built fundamental niche models for both species with the boosted regression tree modelling approach. A scenario of climate change on their fundamental niche was then analyzed. The shared socioeconomic pathway scenario 3 (regional rivalry) and the global climate model Geophysical Fluid Dynamics Laboratory Earth System Model v. 4.1 (GFDL-ESM4.1; gfdl.noaa.gov) were utilized for all analyses, in the following time periods: 2021-2040, 2041-2060, 2061-2080, and 2081-2100. Outcomes from these analyses showed that future climate change will affect Ae. aegypti and Ae. albopictus distributions in different ways across the globe. The Northern Hemisphere will have extended Ae. aegypti and Ae. albopictus distributions in future climate change scenarios, whereas the Southern Hemisphere will have the opposite outcomes. Europe will become more suitable for both species and their related vector-borne diseases. Loss of suitability in the Brazilian Amazon region further indicated that this tropical rainforest biome will have lower levels of precipitation to support these species in the future. Our models provide possible future scenarios to help identify locations for resource allocation and surveillance efforts before a significant threat to human health emerges.

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Exercise is a nonpharmacological intervention that improves health during aging and a valuable tool in the diagnostics of aging-related diseases. In muscle, exercise transiently alters mitochondrial functionality and metabolism. Mitochondrial fission and fusion are critical effectors of mitochondrial plasticity, which allows a fine-tuned regulation of organelle connectiveness, size, and function. Here we have investigated the role of mitochondrial dynamics during exercise in the model organism Caenorhabditis elegans. We show that in body-wall muscle, a single exercise session induces a cycle of mitochondrial fragmentation followed by fusion after a recovery period, and that daily exercise sessions delay the mitochondrial fragmentation and physical fitness decline that occur with aging. Maintenance of proper mitochondrial dynamics is essential for physical fitness, its enhancement by exercise training, and exercise-induced remodeling of the proteome. Surprisingly, among the long-lived genotypes we analyzed (isp-1,nuo-6, daf-2, eat-2, and CA-AAK-2), constitutive activation of AMP-activated protein kinase (AMPK) uniquely preserves physical fitness during aging, a benefit that is abolished by impairment of mitochondrial fission or fusion. AMPK is also required for physical fitness to be enhanced by exercise, with our findings together suggesting that exercise may enhance muscle function through AMPK regulation of mitochondrial dynamics. Our results indicate that mitochondrial connectivity and the mitochondrial dynamics cycle are essential for maintaining physical fitness and exercise responsiveness during aging and suggest that AMPK activation may recapitulate some exercise benefits. Targeting mechanisms to optimize mitochondrial fission and fusion, as well as AMPK activation, may represent promising strategies for promoting muscle function during aging.

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PURPOSE: Small-N studies are the dominant study design supporting evidence-based interventions in communication science and disorders, including treatments for aphasia and related disorders. However, there is little guidance for conducting reproducible analyses or selecting appropriate effect sizes in small-N studies, which has implications for scientific review, rigor, and replication. This tutorial aims to (a) demonstrate how to conduct reproducible analyses using effect sizes common to research in aphasia and related disorders and (b) provide a conceptual discussion to improve the reader's understanding of these effect sizes. METHOD: We provide a tutorial on reproducible analyses of small-N designs in the statistical programming language R using published data from Wambaugh et al. (2017). In addition, we discuss the strengths, weaknesses, reporting requirements, and impact of experimental design decisions on effect sizes common to this body of research. RESULTS: Reproducible code demonstrates implementation and comparison of within-case standardized mean difference, proportion of maximal gain, tau-U, and frequentist and Bayesian mixed-effects models. Data, code, and an interactive web application are available as a resource for researchers, clinicians, and students. CONCLUSIONS: Pursuing reproducible research is key to promoting transparency in small-N treatment research. Researchers and clinicians must understand the properties of common effect size measures to make informed decisions in order to select ideal effect size measures and act as informed consumers of small-N studies. Together, a commitment to reproducibility and a keen understanding of effect sizes can improve the scientific rigor and synthesis of the evidence supporting clinical services in aphasiology and in communication sciences and disorders more broadly. Supplemental Material and Open Science Form: https://doi.org/10.23641/asha.21699476.

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Recent progress in biophysics (for example, in studies of chemical sensing and spatiotemporal cell-signaling) poses new challenges to statistical theory of trapping of single diffusing particles. Here we deal with one of them, namely, trapping kinetics of single particles diffusing in a half-space bounded by a reflecting flat surface containing an absorbing circular disk. This trapping problem is essentially two-dimensional and the question of the angular dependence of the kinetics on the particle starting point is highly nontrivial. We propose an approximate approach to the problem that replaces the absorbing disk by an absorbing hemisphere of a properly chosen radius. This replacement makes the problem angular-independent and essentially one-dimensional. After the replacement one can find an exact solution for the particle propagator (Green's function) that allows one to completely characterize the kinetics. Extensive testing of the theoretical predictions based on the absorbing hemisphere approximation against three-dimensional Brownian dynamics simulations shows excellent agreement between the analytical and simulation results when the particle starts sufficiently far away from the disk. Our approach fails and the angular dependence of the kinetics is important when the distance of the particle starting point from the disk center is comparable with the disk radius. However, even when the initial distance is only two disk radii, the maximum relative error of the theoretical predictions is about 10%. The relative error rapidly decreases as the initial distance increases.

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Abstract This study aimed to investigate the activities of novel 20(R)-3,20-dihydroxy-19-norpregn-1,3,5(10)-trienes (kuz7 and kuz8b) of natural 13ß- and epimeric 13α-series against triple-negative MDA-MB-231 breast cancer cells. High antiproliferative activity of synthesized compounds kuz8b and kuz7 against MDA-MB-231 triple-negative cancer cells was revealed. The steroid kuz7 of natural 13ß-configuration was more active against MDA-MB-231 cells than the 13α-steroid kuz8b. Cell cycle analysis revealed common patterns for the action of both tested compounds. The number of cells in the subG1 phase increased in a dose-dependent manner, indicating induction of apoptosis, which was also verified by PARP cleavage. In contrast, the number of cells in the G0/G1 phase decreases with increasing compound concentration. Steroid kuz7 at micromolar concentrations reduced the expression of GLUT1, a glucose transporter. High efficacy of the combination of kuz7 with biguanide metformin was shown, and synergistic effects on MDA-MB-231 cell growth and expression of the anti-apoptotic protein Bcl-2 were revealed. According to the obtained results, including the high activity of kuz7 against triple-negative cancer cells, the detected induction of apoptosis, and the decrease in GLUT1 expression, 13ß-steroid kuz7 is of interest for further preclinical studies both alone and in combination with the metabolic drug metformin

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Objective: To determine whether infertility diagnoses differ between Black ethnic subgroups. Design: Retrospective review. Setting: an urban safety-net hospital. Patients: Women seeking infertility care between 2005 and 2015. Interventions: Charts of women with infertility and polycystic ovary syndrome (International Classification of Diseases, Ninth Revision diagnoses) were reviewed to confirm diagnoses. Data were stratified by race and subsequently by ethnicity to evaluate the differences in infertility diagnoses between Black American, Black Haitian, and Black African women. White American women were used as the comparison group. Main Outcome Measures: Infertility diagnoses between Black ethnic subgroups and White women. Results: A total of 358 women met the inclusion criteria, including 99 Black American, 110 Black Haitian, 61 Black African, and 88 White American women. Anovulation/polycystic ovary syndrome was the most common diagnosis in each ethnic group, accounting for 40% of infertility among White American, 57% among Black American, 25% among Black Haitian, and 21% among Black African women. There were no significant differences in the individual infertility diagnoses between Black and White women. Between ethnic subgroups, multivariate analysis showed significantly higher odds of infertility because of anovulation/polycystic ovary syndrome in Black American women compared with Black African women (odds ratio [OR], 4.9; 95% confidence interval [CI], 1.4-17.0). Compared with Black African women, higher odds of tubal factor infertility were observed in Black American (OR, 4.7; 95% CI, 1.16-18.7) and Black Haitian women (OR, 4.0; 95% CI, 1.1-14.0). Conclusions: Infertility diagnoses were not homogeneous across Black ethnic groups. Studies examining infertility should specify the ethnic subgroups within a race because this may affect results.