Key Points Question Among patients with cancer and COVID-19, do non-Hispanic Black patients have more severe COVID-19 at presentation and worse COVID-19–related outcomes compared with non-Hispanic White patients, after adjusting for demographic and clinical risk factors? Findings In this cohort study of 3506 patients, Black patients with cancer experienced significantly more severe COVID-19 outcomes compared with White patients with cancer, after adjustment for demographic and clinical risk factors. Meaning These findings suggest that, within the framework of structural racism in the US, having cancer and COVID-19 is associated with worse outcomes among Black patients compared with White patients.

IMPORTANCEThe COVID-19 pandemic has had a distinct spatiotemporal pattern in the United States. Patients with cancer are at higher risk of severe complications from COVID-19, but it is not well known whether COVID-19 outcomes in this patient population were associated with geography. OBJECTIVETo quantify spatiotemporal variation in COVID-19 outcomes among patients with cancer. DESIGN, SETTING, AND PARTICIPANTS This registry-based retrospective cohort study included patients with a historical diagnosis of invasive malignant neoplasm and laboratory-confirmed SARS-CoV-2 infection between March and November 2020. Data were collected from cancer care delivery centers in the United States. EXPOSURES Patient residence was categorized into 9 US census divisions. Cancer center characteristics included academic or community classification, rural-urban continuum code (RUCC), and social vulnerability index. MAIN OUTCOMES AND MEASURES The primary outcome was 30-day all-cause mortality. The secondary composite outcome consisted of receipt of mechanical ventilation, intensive care unit admission, and all-cause death. Multilevel mixed-effects models estimated associations of centerlevel and census division-level exposures with outcomes after adjustment for patient-level risk factors and quantified variation in adjusted outcomes across centers, census divisions, and calendar time. RESULTS Data for 4749 patients (median [IQR] age, 66 [56-76] years; 2439 [51.4%] female individuals, 1079 [22.7%] non-Hispanic Black individuals, and 690 [14.5%] Hispanic individuals) were reported from 83 centers in the Northeast (1564 patients [32.9%]), Midwest (1638 [34.5%]), South (894 [18.8%]), and West (653 [13.8%]). After adjustment for patient characteristics, including month of COVID-19 diagnosis, estimated 30-day mortality rates ranged from 5.2% to 26.6% across centers.Patients from centers located in metropolitan areas with population less than 250 000 (RUCC 3) had lower odds of 30-day mortality compared with patients from centers in metropolitan areas with population at least 1 million (RUCC 1) (adjusted odds ratio [aOR], 0.31; 95% CI, 0.11-0.84). The type of center was not significantly associated with primary or secondary outcomes. There were no statistically significant differences in outcome rates across the 9 census divisions, but adjusted (continued)

Sequence divergence of cis-regulatory elements drives species-specific traits, but how this manifests in the evolution of the neocortex at the molecular and cellular level remains to be elucidated. We investigated the gene regulatory programs in the primary motor cortex of human, macaque, marmoset, and mouse with single-cell multiomics assays, generating gene expression, chromatin accessibility, DNA methylome, and chromosomal conformation profiles from a total of over 180,000 cells. For each modality, we determined species-specific, divergent, and conserved gene expression and epigenetic features at multiple levels. We find that cell type-specific gene expression evolves more rapidly than broadly expressed genes and that epigenetic status at distal candidate cis-regulatory elements (cCREs) evolves faster than promoters. Strikingly, transposable elements (TEs) contribute to nearly 80% of the human-specific cCREs in cortical cells. Through machine learning, we develop sequence-based predictors of cCREs in different species and demonstrate that the genomic regulatory syntax is highly preserved from rodents to primates. Lastly, we show that epigenetic conservation combined with sequence similarity helps uncover functional cis-regulatory elements and enhances our ability to interpret genetic variants contributing to neurological disease and traits.

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A typical predictive analytics workflow will pre-process data in a database, transfer the resulting data to an external statistical tool such as R, create machine learning models in R, and then apply the model on newly arriving data. Today, this workflow is slow and cumbersome. Extracting data from databases, using ODBC connectors, can take hours on multi-gigabyte datasets. Building models on single-threaded R does not scale. Finally, it is nearly impossible to use R or other common tools, to apply models on terabytes of newly arriving data.We solve all the above challenges by integrating HP Vertica with Distributed R, a distributed framework for R. This paper presents the design of a high performance data transfer mechanism, new data-structures in Distributed R to maintain data locality with database table segments, and extensions to Vertica for saving and deploying R models. Our experiments show that data transfers from Vertica are 6× faster than using ODBC connections. Even complex predictive analysis on 100s of gigabytes of database tables can complete in minutes, and is as fast as in-memory systems like Spark running directly on a distributed file system.