Based on a panel of 30 provinces and a timeframe from January 2009 to December 2013, we estimate the association between monthly human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) incidence and the relevant Internet search query volumes in Baidu, the most widely used search engine among the Chinese. The pooled mean group (PMG) model show that the Baidu search index (BSI) positively predicts the increase in HIV/AIDS incidence, with a 1% increase in BSI associated with a 2.1% increase in HIV/AIDS incidence on average. This study proposes a promising method to estimate and forecast the incidence of HIV/AIDS, a type of infectious disease that is culturally sensitive and highly unevenly distributed in China; the method can be taken as a complement to a traditional HIV/AIDS surveillance system.

Lower rates of intravenous (IV) thrombolysis use after stroke in Black and Hispanic individuals have been described in the US. [1][2][3][4][5][6] However, it is unclear whether the disparities gap in thrombolysis use is changing or remaining the same. We investigated the temporal trend in racial and ethnic differences in stroke IV thrombolysis use between 2009 and 2018 in a representative sample of US adults.Methods | Adult hospital discharges with a primary diagnosis of ischemic stroke were identified from the 2009-2018 National Inpatient Sample (NIS), an all-payer administrative database containing data on a 20% sample of deidentified discharges from nonfederal US hospitals (eMethods, eTable 1, and eTable 2 in the Supplement), usingICD-9-CM and ICD-10-CM codes. Elective admissions and cases transferred in from another hospital were excluded because interhospital transfers could result in potentially duplicate records for the same patient. Observations with missing data on variables of interest were excluded. The primary exposure was self-reported patient race and ethnicity, provided by the data source and categorized as Asian/Pacific Islander, Black, Hispanic, Native American, White, and other. The outcome was IV thrombolysis. This study was deemed exempt by the Johns Hopkins University School of Medicine institutional review board.All analyses accounted for the stratified cluster design of the NIS by using the TRENDWT variable and the svy command group in Stata. Crude proportions and percentages of IV thrombolysis use by race and ethnicity and year were calculated. Multivariable logistic regression models stratified data by year and compared IV thrombolysis use in individuals categorized as White with those in all of the other racial and Supplemental contentTable. Baseline Characteristics of the Study Population Stratified by Year (N = 752 369) a

Background and Purpose: Intravenous thrombolysis (IVT) after ischemic stroke is underutilized in racially/ethnically minoritized groups. We aimed to determine the regional and geographic variability in racial/ethnic IVT disparities in the United States. Methods: Acute ischemic stroke admissions between 2012 and 2018 were identified in the National Inpatient Sample. Multivariable logistic regression was used to test the association between IVT and race/ethnicity, stratified by geographic region and controlling for demographic, clinical, and hospital characteristics. Results: Of the 545 509 included cases, 47 031 (8.6%) received IVT. Racially/ethnically minoritized groups had significantly lower adjusted odds of IVT compared with White people in the South Atlantic region (odds ratio [OR], 0.86 [95% CI, 0.82–0.91]), the East North Central region (OR, 0.91 [95% CI, 0.85–0.97]) and the Pacific region (OR, 0.90 [95% CI, 0.85–0.96]). In the South Atlantic region, IVT use in racial/ethnic minority groups was below the national average of all racial/ethnic minority patients ( P =0.002). Compared with White patients, Black patients had lower odds of IVT in the Middle Atlantic region (OR, 0.84 [95% CI, 0.78–0.91]), the South Atlantic region (OR, 0.78 [95% CI, 0.74–0.82]), and the East North Central region (OR, 0.86 [95% CI, 0.79–0.93]). In the South Atlantic region, this difference was below the national average for Black people ( P <0.001). Hispanic patients had significantly lower use of IVT only in the Pacific region (OR, 0.92 [95% CI, 0.85–0.99]), while Asian/Pacific Islander patients had lower odds of IVT in the Mountain (OR, 0.76 [95% CI, 0.59–0.98]) and Pacific region (OR, 0.89 [95% CI, 0.82–0.97]). Conclusions: Racial/ethnic disparities in IVT use in the United States vary by region. Geographic hotspots of lower IVT use in racially/ethnically minoritized groups are the South Atlantic region, driven predominantly by lower use of IVT in Black patients, and the East North Central and Pacific regions.