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BACKGROUND: It is currently unknown if within high-quality dietary intake there exist distinct dietary patterns associated with health benefits that are identifiable with multidimensional dietary pattern analyses. The purpose of this study was to identify specific dietary patterns and groups therein and their associations with all-cause, CVD, and cancer mortality. METHODS: We conducted sex-specific k-means cluster analyses within Healthy Eating Index 2015 (HEI-2015) quintile 5 in 3 US cohorts [NIH-American Association of Retired Persons Diet and Health Study (AARP), the Multiethnic Cohort (MEC), Women's Health Initiative Observational Study (WHI OS)], clusters ranging from n = 1190 to n = 12,007. Characterizations incorporated HEI-2015 overall and component-specific percentage adherence goals, using untruncated and truncated radar graphs and shape analyses. Using cohort- and sex-specific Cox proportional hazards models, associations of quintile 5 clusters with all-cause, cardiovascular disease (CVD), and cancer mortality were evaluated relative to quintile 1. RESULTS: In each cohort sex-specific sample, 3 identified clusters included 16%–62% of participants, providing evidence for variation within high-quality dietary intake. Clusters revealed commonalities in total fruits and whole fruits intakes that exceeded goals and high sodium intake. Dairy and whole grain intakes oftentimes fell below goal. Some clusters were in addition characterized by total vegetables, greens & beans, and seafood & plant protein intakes exceeding goals. All high-quality dietary patterns were associated with a multivariable-adjusted significant 15%–26% lower risk of all-cause death than diet intake in quintile 1 (except for cluster 2 in WHI OS), and with a 16%–25% lower risk of CVD mortality in the AARP and MEC cohorts. Cancer mortality results were inconsistent. CONCLUSIONS: Multiple ways to achieve a high-quality diet were identified and significant associations with lower all-cause and CVD mortality were seen in some cohorts.

Cardiovascular disease (CVD) risk factors were examined among church leaders (n = 2309) who attended Mid-South United Methodist Church annual meetings between 2012 and 2017 using repeated cross-sectional data. There was a significant increase in body mass index (BMI) (b = 0.24, p = 0.001) and significant decreases in blood pressure (systolic: b = − 1.08, p

BACKGROUND Health needs assessments help congregations identify issues of importance to them and the communities they serve. Few tools exist, with little known about the processes needed to develop such tools. OBJECTIVE Develop a congregational health needs assessment tool and implementation protocol with community, health-care, and academic partners. METHODS Meetings began in August 2018 to develop the Mid-South Congregational Health Needs Survey (MSCHS) and implementation protocol. Pilot testing occurred in December 2018 and feedback from 95 churches was used in modifications. RESULTS The MSCHS includes: demographics section, a 36-item health index, and the congregation's top five needs.The implementation protocol includes steps for working with congregation leadership to identify members to complete the survey. CONCLUSIONS Cross-disciplinary partnerships made the creation of the MSCHS and implementation protocol possible. Successes include long-term engagement across partnership sectors, organizational "buy-in," and development of a common language. These lessons can help others wanting to develop successful multi-sector partnerships.

Research on the acceptability of faith-based health promotion programs by Latino communities in the Bible Belt is limited. This study examined the needs, barriers, and facilitators related to such programs in Memphis, TN. Thirty Latino community members and ten faith leaders participated in focus groups and in-depth interviews, respectively. Health needs identified included diet, dental care, and screenings, while barriers included cost, education, lack of prevention-seeking behaviors, and need for Spanish language services. Faith leaders were aware of more health resources than community members. Despite being receptive and acknowledging the need for faith-based programs aimed at prevention and filling healthcare gaps, concerns regarding the influence of religious doctrine on health interventions were expressed by members of both groups. Faith leaders, practitioners, and community members must work together to overcome barriers related to trust and health behavior norms.

Drawing from a social network perspective, we examined the extent to which children with and without disabilities play with each other in preschool inclusive classrooms and identified malleable child characteristics that would support children forming these cross-status play interactions. A total of 200 children with disabilities and 301 children without disabilities participated in this study ( Mage = 52.39 months, SDage = 6.13). Results showed that children with and without disabilities did not differ in the extent to which they formed cross-status play interactions after pragmatic language and self-regulation were taken into account. However, typically developing children were more likely to form same-status play interactions than children with disabilities. Children’s cross-status play interactions were predicted by self-regulation ability, which was fully mediated by their pragmatic language. The impact of pragmatic language on the formation of cross-status play interaction was greater for children with disabilities than their typically developing peers.

Everyday wearables such as smartwatches or smart bands can play a pivotal role in the field of fitness and wellness and hold the prospect to be used for early disease detection and monitoring towards Smart Health (sHealth). One of the challenges is the extraction of reliable biomarkers from data collected using these devices in the real world (Living Labs). In this yearlong field study, we collected the nocturnal instantaneous heart rate from 9 participants using wrist-worn commercial smart bands and extracted heart rate variability features (HRV). In addition, we measured core body temperature using our custom-designed flexible Inkjet-Printed (IJP) temperature sensor and SpO2 with a finger pulse oximeter. The core body temperature along with user-reported symptoms have been used for automated spatiotemporal monitoring of flu symptoms severity in real-time. The extracted HRV feature values are within the 95% confidence interval of normative values and shows an anticipated trend for gender and age. The resulting dataset from this study is a novel addition and may be used for future investigations.Clinical Relevance— The findings of this study shows usability of wearables in detection and monitoring of diseases such as obstructive sleep apnea reducing the prevalence of undiagnosed cases. This framework also has potentials to monitor outbreaks of flu and other diseases with spatiotemporal distribution.

In late 2019 a human coronavirus, now known as SARS-CoV-2, emerged, likely from a zoonotic reservoir. This virus causes COVID-19 disease, has infected millions of people, and has led to hundreds of thousands of deaths across the globe. While the best interventions to control and ultimately stop the pandemic are prophylactic vaccines, antiviral therapeutics are important to limit morbidity and mortality in those already infected. At this time, only one FDA approved anti-SARS-CoV-2 antiviral drug, remdesivir, is available and unfortunately, its efficacy appears to be limited. Thus, the identification of new and efficacious antivirals is of highest importance. In order to facilitate rapid drug discovery, flexible, sensitive, and high-throughput screening methods are required. With respect to drug targets, most attention is focused on either the viral RNA-dependent RNA polymerase or the main viral protease, 3CLpro. 3CLpro is an attractive target for antiviral therapeutics as it is essential for processing newly translated viral proteins, and the viral lifecycle cannot be completed without protease activity. In this work, we present a new assay to identify inhibitors of the SARS-CoV-2 main protease, 3CLpro. Our reporter is based on a GFP-derived protein that only fluoresces after cleavage by 3CLpro. This experimentally optimized reporter assay allows for antiviral drug screening in human cell culture at biosafety level-2 (BSL2) with high-throughput compatible protocols. Using this screening approach in combination with existing drug libraries may lead to the rapid identification of novel antivirals to suppress SARS-CoV-2 replication and spread.IMPORTANCEThe COVID-19 pandemic has already led to more than 400,000 deaths and innumerable changes to daily life worldwide. Along with development of a vaccine, identification of effective antivirals to treat infected patients is of the highest importance. However, rapid drug discovery requires efficient methods to identify novel compounds that can inhibit the virus. In this work, we present a method for identifying inhibitors of the SARS-CoV-2 main protease, 3CLpro. This reporter-based assay allows for antiviral drug screening in human cell culture at biosafety level-2 (BSL2) with high-throughput compatible sample processing and analysis. This assay may help identify novel antivirals to control the COVID-19 pandemic.

Background Colorectal cancer (CRC) is the second leading cause of cancer-related death in the United States, with a 5-y survival rate of ∼65%. Therefore, the identification of modifiable health factors to improve CRC survival is crucial. Objective We investigated the association of 4 prediagnostic a priori diet quality indexes with CRC-specific and all-cause mortality in the Multiethnic Cohort (MEC). Methods The MEC included >215,000 African-American, Native Hawaiian, Japanese-American, Latino, and white adults living in Hawaii and California who completed a validated quantitative food-frequency questionnaire in 1993-1996. CRC cases and deaths were identified through linkages to cancer registries and to state and national vital registries. Sex-specific HRs and 95% CIs were estimated for the Healthy Eating Index (HEI) 2010, the Alternative HEI (AHEI) 2010, the alternate Mediterranean Diet (aMED) score, and the Dietary Approaches to Stop Hypertension (DASH) index with CRC-specific and overall mortality as the primary outcomes. Ethnicity-specific analyses were the secondary outcomes. Results Among 4204 MEC participants diagnosed with invasive CRC through 2010, 1976 all-cause and 1095 CRC-specific deaths were identified. A higher aMED score was associated with lower CRC-specific mortality in women [HR continuous pattern score divided by its respective SD (HR1SD): 0.86; 95% CI: 0.77, 0.96] but not in men (HR1SD: 1.01; 95% CI: 0.92, 1.11). A higher aMED score was also associated with lower all-cause mortality in women (HR1SD: 0.88; 95% CI: 0.81, 0.96) but not in men (HR1SD: 1.00; 95% CI: 0.93, 1.07). The HEI-2010, AHEI-2010, and DASH index were not significantly associated with CRC-specific or with all-cause mortality. The inverse relation for the aMED score was limited to African Americans and to colon (compared with rectal) cancer. Conclusions The aMED score was related to lower mortality only in African-American women (1 of 5 ethnic groups studied). The results should be interpreted with caution due to the small numbers of cases within ethnic groups and the issue of multiple testing.

In spite of the well-known benefits of physical activity, the vast majority of children in North America do not meet current international guidelines for accumulating sufficient health-enhancing physical activity. Indeed, despite considerable attention to this population health crisis, the current prevalence of inactivity, along with its concomitant health consequences, shows little sign of abating. In this paper, we identify acknowledged barriers to wide scale physical activity adoption and maintenance at the population level among children and propose a viable tripartite framework (albeit one that would require political support) that we hope will provide the basis for debate and implementation. We emphasize that each of these considerations, in isolation, would be insufficient to substantively address the problem, but when combined would ensure that all elementary school children (without any medical contraindication) are sufficiently active, rather than the minority of this population.

The Healthy Eating Index-2015 (HEI-2015) was created to assess conformance of dietary intake with the Dietary Guidelines for Americans (DGA) 2015–2020. We assessed the association between the HEI-2015 and mortality from all-cause, cardiovascular disease (CVD), and cancer in the Multiethnic Cohort (MEC). White, African American, Native Hawaiian, Japanese American, and Latino adults (n > 215,000) from Hawaii and California completed a quantitative food-frequency questionnaire at study enrollment. HEI-2015 scores were divided into quintiles for men and women. Radar graphs were used to demonstrate how dietary components contributed to HEI-2015 scores. Mortality was documented over 17–22 years of follow-up. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed using Cox proportional hazards models. High HEI-2015 scores were inversely associated with risk of mortality from all-cause, CVD, and cancer for men and women (p-trend

Excess body weight is a risk factor for colorectal cancer (CRC) and may also adversely affect survival in CRC patients. This study examined the relation of body mass index (BMI), which was self-reported at cohort entry and after 5.7 ± 0.8 years, with CRC-specific and all-cause survival among 4,204 incident cases of invasive CRC in the multiethnic cohort. Cox regression analysis with age as time metric and BMI as time-varying exposure was applied to estimate hazard ratios (HR) and 95 % confidence intervals (CIs) while adjusting for relevant covariates. Over 6.0 ± 4.7 years of follow-up, 1,976 all-cause and 1,095 CRC-specific deaths were recorded. The mean time interval between cohort entry and diagnosis was 7.6 ± 4.7 years. No association with CRC-specific survival was detected in men (HR5units = 0.94; 95 %CI 0.84–1.04) or women (HR5units = 0.98; 95 %CI 0.89–1.08). In men, all-cause survival also showed no relation with BMI (HR5unit = 0.97; 95 %CI 0.90–1.06), whereas it was reduced in women (HR5units = 1.10; 95 %CI 1.03–1.18). Interactions of BMI with ethnicity were only significant for obesity. Obese Latino and overweight Native Hawaiian men as well as overweight African-American women experienced significantly better CRC-specific survival than whites. Overweight Japanese men and African-American women had better all-cause survival and obese Latino women had the lowest all-cause survival (HRobese = 1.74; 95 %CI 1.08–2.80). This analysis detected little evidence for an adverse effect of excess body weight on CRC-specific survival, but all-cause survival was reduced in women. These findings suggest that adiposity may be less important for CRC survival than as an etiologic factor.

Background: Summer camps can serve as a modality for dietary interventions. However, camp-based strategies that improve dietary behaviors of children are unclear. Poor diet disproportionately affects low-income and minority children, making the examination of camp-based dietary interventions an important focus. Purpose: To assess the impact of a camp's culinary skills sessions on perceptions of child involvement in meal preparation and changes in attitudes and self-efficacy related to cooking. Methods: A mixed-methods design with quantitative pre–post assessments and interviews. Results: Parents positively received the program, especially lessons on kitchen safety. Participants and parents highlighted the camp's focus on healthy eating as important. They also noted increases in participants' enjoyment of cooking, willingness to try new foods, and culinary abilities. Quantitative data showed increases in participants' frequency of involvement in home meal preparation and self-efficacy for culinary skills. ...

Using the right messaging strategies, churches can help promote behavior change. Frequencies of disease-specific messages in 21 African-American churches were compared to overall and cancer-specific mortality and morbidity rates as well as church-level variables. Disease messages were found in 1025 of 2166 items. Frequently referenced topics included cancer (n = 316), mental health conditions (n = 253), heart disease (n = 246), and infectious diseases (n = 220). Messages for lung and colorectal cancers appeared at low frequency despite high mortality rates in African-American communities. Season, church size, and denomination showed significant associations with health messages. Next steps include testing messaging strategies aimed at improving the health of churchgoing communities.

The Dietary Patterns Methods Project (DPMP) was initiated in 2012 to strengthen research evidence on dietary indices, dietary patterns, and health for upcoming revisions of the Dietary Guidelines for Americans, given that the lack of consistent methodology has impeded development of consistent and reliable conclusions. DPMP investigators developed research questions and a standardized approach to index-based dietary analysis. This article presents a synthesis of findings across the cohorts. Standardized analyses were conducted in the NIH-AARP Diet and Health Study, the Multiethnic Cohort, and the Women’s Health Initiative Observational Study (WHI-OS). Healthy Eating Index 2010, Alternative Healthy Eating Index 2010 (AHEI-2010), alternate Mediterranean Diet, and Dietary Approaches to Stop Hypertension (DASH) scores were examined across cohorts for correlations between pairs of indices; concordant classifications into index score quintiles; associations with all-cause, cardiovascular disease (CVD), and cancer mortality with the use of Cox proportional hazards models; and dietary intake of foods and nutrients corresponding to index quintiles. Across all cohorts in women and men, there was a high degree of correlation and consistent classifications between index pairs. Higher diet quality (top quintile) was significantly and consistently associated with an 11–28% reduced risk of death due to all causes, CVD, and cancer compared with the lowest quintile, independent of known confounders. This was true for all diet index–mortality associations, with the exception of AHEI-2010 and cancer mortality in WHI-OS women. In all cohorts, survival benefit was greater with a higher-quality diet, and relatively small intake differences distinguished the index quintiles. The reductions in mortality risk started at relatively lower levels of diet quality. Higher scores on each of the indices, signifying higher diet quality, were associated with marked reductions in mortality. Thus, the DPMP findings suggest that all 4 indices capture the essential components of a healthy diet.

Future Smart and Connected Communities (SCC) will utilize distributed sensors and embedded computing to seamlessly generate meaningful data that can assist individuals, communities, and society with interlocking physical, social, behavioral, economic, and infrastructural interaction. SCC will require newer technologies for seamless and unobtrusive sensing and computation in natural settings. This work presents a new technology for health monitoring with low-cost body-worn disposable fully passive electronic sensors, along with a scanner, smartphone app, and web-server for a complete smart sensor system framework. The novel wireless resistive analog passive (WRAP) sensors are printed using an inkjet printing (IJP) technique on paper with silver inks (Novacentrix Ag B40, sheet resistance of 21 mΩ/sq) and incorporate a few discrete surface mounted electronic components (overall thickness of

Introduction: Retention of racial/ethnic minority groups into research trials is neces­sary to fully understand and address health disparities. This study was conducted to identify participants’ characteristics associ­ated with retention of African Americans (AAs) in a randomized controlled trial (RCT) of a behavioral intervention.Methods: Using data from an RCT con­ducted from 2009 to 2012 among AAs, participant-level factors were examined for associations with retention between three measurement points (ie, baseline, 3-month, and 12-month). Chi-square tests and logistic regression analyses were conducted to compare retained participants to those who were not retained in order to identify important predictors of retention.Results: About 57% of participants (n=238) were retained at 12 months. Baseline char­acteristics that showed a statistically signifi­cant association with retention status were age, marital status, body mass index (BMI), intervention group, enrollment of a partner in the study, and perceived stress score (PSS). Multivariable logistic regression that adjusted for age, BMI, and PSS showed the odds of being retained among participants who enrolled with a partner was 2.95 (95% CI: 1.87-4.65) compared with participants who had no study partner enrolled. The odds of being retained among participants who were obese and morbidly obese were .32 and .27 (95% CI: .14-.74 and .11-.69), respectively, compared with participants who had normal weight.Conclusion: Having a partner enrolled in behavioral interventions may improve retention of study participants. Researchers also need to be cognizant of participants’ obesity status and potentially target reten­tion efforts toward these individuals. Ethn Dis. 2017;27(3):265-272; doi:10.18865/ed.27.3.265.

AIMS/HYPOTHESIS: Dietary patterns have been associated with the incidence of type 2 diabetes, but little is known about the impact of ethnicity on this relationship. This study evaluated the association between four a priori dietary quality indexes and risk of type 2 diabetes among white individuals, Japanese-Americans and Native Hawaiians in the Hawaii component of the Multiethnic Cohort. METHODS: After excluding participants with prevalent diabetes and missing values, the analysis included 89,185 participants (11,217 cases of type 2 diabetes). Dietary intake was assessed at baseline with a quantitative food frequency questionnaire designed for use in the relevant ethnic populations. Sex- and ethnicity-specific HRs were calculated for the Healthy Eating Index-2010 (HEI-2010), the Alternative HEI-2010 (AHEI-2010), the Alternate Mediterranean Diet Score (aMED) and the Dietary Approaches to Stop Hypertension (DASH). RESULTS: We observed significant inverse associations between higher DASH index scores and risk of type 2 diabetes in white men and women, as well as in Japanese-American women and Native Hawaiian men, with respective risk reductions of 37%, 31%, 19% and 21% (in the highest compared with the lowest index category). A higher adherence to the AHEI-2010 and aMED diet was related to a 13–28% lower risk of type 2 diabetes in white participants but not in other ethnic groups. No significant associations with risk of type 2 diabetes were observed for the HEI-2010 index. CONCLUSIONS/INTERPRETATION: The small ethnic differences in risk of type 2 diabetes associated with scores of a priori-defined dietary patterns may be due to a different consumption pattern of food components and the fact that the original indexes were not based on diets typical for Asians and Pacific Islanders.

Churches are a trusted resource in African American communities; however, little is known about their presentation of health care information. This study characterized health care information disseminated by 11 African American churches. Content analysis conducted on print media systematically collected over one year used a coding scheme with .77 intercoder reliability. Health care information was identified in 243 items and represented three topics (screening, medical services, health insurance). Screening was the most common topic (n = 156), flyers/handouts most often used (n = 90), and the church the most common source (n = 71). Using chi-square tests, information was assessed over time with health insurance information showing a statistically significant increase (χ² = 6.08, p.05). Study churches provided health care information at varying levels of detail with most coming from church and community publications. Future research should examine additional characteristics of health care information, its presence in other churches and community settings, and how exposure influences behaviors.

Background Chronic inflammation is linked to poor lifestyle behaviors and a variety of chronic diseases that are prevalent among African Americans, especially in the southeastern U.S. Purpose The goal of the study was to test the effect of a community-based diet, physical activity, and stress reduction intervention conducted in 2009–2012 on reducing serum C-reactive protein (CRP) in overweight and obese African-American adults. Methods An RCT intervention was designed jointly by members of African-American churches and academic researchers. In late 2012, regression (i.e., mixed) models were fit that included both intention-to-treat and post hoc analyses conducted to identify important predictors of intervention success. Outcomes were assessed at 3 months and 1 year. Results At baseline, the 159 individuals who were recruited in 13 churches and had evaluable outcome data were, on average, obese (BMI=33.1 [±7.1]) and had a mean CRP level of 3.7 (±3.9) mg/L. Reductions were observed in waist-to-hip ratio at 3 months (2%, p =0.03) and 1 year (5%, p p =0.05), but no change after 1 year. No differences were noted in BMI or interleukin-6. Conclusions In overweight/obese, but otherwise "healthy," African-American church members with very high baseline CRP levels, this intervention produced significant reductions in CRP at 3 and 12 months, and in waist-to-hip ratio, which is an important anthropometric predictor of overall risk of inflammation and downstream health effects. Trial registration This study is registered at www.clinicaltrials.gov NCT01760902.

ObjectiveBased on the hypothesis that high-meat diets may increase breast cancer risk through hormonal pathways, the present analysis compared oestrogens in serum and urine by meat-eating status.DesignIntervention with repeated measures.SettingTwo randomized soya trials (BEAN1 and BEAN2) among premenopausal healthy women.SubjectsBEAN1 participants completed seven unannounced 24 h dietary recalls and donated five blood and urine samples over 2 years. BEAN2 women provided seven recalls and three samples over 13 months. Serum samples were analysed for oestrone (E1) and oestradiol (E2) using RIA. Nine oestrogen metabolites were measured in urine by LC–MS. Semi-vegetarians included women who reported consuming 10 g of fish daily. All other women were classified as non-vegetarians. We applied mixed models to compute least-square means by vegetarian status adjusted for potential confounders.ResultsThe mean age of the 272 participants was 41·9 (sd 4·5) years. Serum E1 (85 v. 100 pg/ml, P = 0·04) and E2 (140 v. 154 pg/ml, P = 0·04) levels were lower in the thirty-seven semi-vegetarians than in the 235 non-vegetarians. The sum of the nine urinary oestrogen metabolites (183 v. 200 pmol/mg creatinine, P = 0·27) and the proportions of individual oestrogens and pathways did not differ by meat-eating status. Restricting the models to the samples collected during the luteal phase strengthened the associations.ConclusionsGiven the limitations of the study, the lower levels of serum oestrogens in semi-vegetarians than non-vegetarians need confirmation in larger populations.

The Alternate Mediterranean diet score is an adaptation of the original Mediterranean diet score. Raw (aMED) and energy-standardized (aMED-e) versions have been used. How the diet scores and their association with health outcomes differ between the two versions is unclear. We examined differences in participants’ total and component scores and compared the association of aMED and aMED-e with all-cause, cardiovascular disease (CVD) and cancer mortality. As part of the Multiethnic Cohort (MEC), 193,527 men and women aged 45–75 y from Hawaii and Los Angeles completed a baseline food frequency questionnaire and were followed for 13–18 years. The association of aMED and aMED-e with mortality was examined using Cox regression, with adjustment for total energy intake. The correlation between aMED and aMED-e total scores was lower among people with higher body mass index. Participants who were older, leaner, more educated and consumed less energy scored higher on aMED-e components compared with aMED, except for the red and processed meat and alcohol components. Men reporting more physical activity scored lower on most aMED-e components compared with aMED, whereas the opposite was observed for the meat component. Higher scores of both aMED and aMED-e were associated with lower risk of all-cause, CVD and cancer mortality. Although individuals may score differently with aMED and aMED-e, both scores show similar reductions in mortality risk for persons scoring high on the index scale. Either version can be used in studies of diet and mortality. Comparisons can be performed across studies using different versions of the score.

Background: Diet is known to influence systemic inflammation, a recognized risk factor for colorectal cancer (CRC). Studies in ethnically diverse populations that examine the association between dietary inflammatory potential and CRC incidence are limited.Objectives: We used the Dietary Inflammatory Index to clarify the relation between the inflammatory potential of diet and CRC incidence across racial/ethnic groups. We hypothesized that proinflammatory diets would be associated with an increased risk of CRC, and that these associations may differ across racial/ethnic groups.Methods: The Multiethnic Cohort (MEC) follows a prospective study design. It includes 190,963 white, African-American, native Hawaiian, Japanese-American, and Latino men and women aged 45-75 y at recruitment and followed over 20 y. Participants completed a food frequency questionnaire from which energy-adjusted Dietary Inflammatory Index (E-DII) scores were computed and categorized into quartiles. CRC incidence was documented through linkage to cancer registry programs. Cox proportional hazards regression was used to estimate HRs and 95% CIs, adjusting for known or expected CRC risk factors.Results: Among all participants, more-proinflammatory diets (highest quartile compared with lowest quartile) were associated with an increased risk of CRC (HR: 1.21; 95% CI: 1.11, 1.32). However, the effect size was larger for men (HR: 1.28; 95% CI: 1.13, 1.45) than for women (HR: 1.16; 95% CI: 1.02, 1.33), although the interaction term for sex was not statistically significant (P-interaction = 0.17). When stratified by race/ethnicity, the association was significantly different between groups for men (P-interaction = 0.01), although not for women (P-interaction = 0.20). Significant associations with HRs ranging from 2.33 to 1.04 were observed in white, Japanese-American, and Latino men, and native Hawaiian women.Conclusions: Overall, more-proinflammatory diets, as identified by the E-DII, were associated with increased CRC risk in MEC participants across racial/ethnic groups. This study adds to the evidence suggesting that diets with high proinflammatory potential may increase CRC risk.

Background Obesity is partially a social phenomenon, with college students particularly vulnerable to changes in social networks and obesity-related behaviors. Currently, little is known about the structure of social networks among college students and their potential influence on diet and physical activity behaviors. The purpose of the study was to examine social influences impacting college students’ diet and physical activity behaviors, including sources of influence, comparisons between sources’ and students’ behaviors, and associations with meeting diet and physical activity recommendations. Methods Data was collected from 40 students attending college in Hawaii. Participants completed diet and physical activity questionnaires and a name generator. Participants rated nominees’ influence on their diet and physical activity behaviors as well as compared nominees' behaviors to their own. Descriptive statistics were used to look at perceptions of influence across network groups. Logistic regression models were used to examine associations between network variables and odds of meeting recommendations. Results A total of 325 nominations were made and included: family (n = 116), college friends (n = 104), high school friends (n = 87), and significant others (n = 18). Nearly half of participants were not from Hawaii. Significant others of non-Hawaii students were perceived to be the most influential (M(SD) = 9(1.07)) and high school friends the least influential (M(SD) = 1.31(.42)) network. Overall, perceived influence was highest for diet compared to physical activity, but varied based on comparisons with nominees’ behaviors. Significant others were most often perceived has having similar (44 %) or worse (39 %) eating behaviors than participants, and those with similar eating behaviors were perceived as most influential (M(SD) = 9.25(1.04)). Few associations were seen between network variables and odds of meeting recommendations. Conclusions Among the groups nominated, high school friends were perceived as least influential, especially among students who moved a long distance for college. Intervention strategies addressing perceived norms and using peer leaders may help promote physical activity among college students, while diet interventions may need to involve significant others in order to be successful. Testing of these types of intervention strategies and continued examination of social networks and their influences on diet and physical activity behaviors are needed.

The Dash of Faith pilot used a community-based participatory research approach to design an experiential dietary intervention based in two African-American churches, one intervention and one comparison. Congregation members identified components that were incorporated into 12 weekly and 4 monthly sessions, with a goal of increasing fruit and vegetable and lowering fat intake. At two months, a marginally significant (p=0.07) increase in fruit and vegetable consumption was observed in the intervention group but was not maintained at study conclusion. We propose that these mixed findings may be attributable, in part, to bias introduced by the participatory nature of the design.

Nearly 35% of men treated for prostate cancer (PrCA) will experience biochemically defined recurrence, noted by a rise in PSA, within 10 years of definitive therapy. Diet, physical activity, and stress reduction may affect tumor promotion and disease progression.A randomized trial of an intensive diet, physical activity, and meditation intervention was conducted in men with rising post-treatment PSA after definitive treatment for PrCA. Intention-to-treat methods were used to compare usual care to the intervention in 47 men with complete data. Signal detection methods were used to identify dietary factors associated with PSA change.The intervention and control groups did not differ statistically on any demographic or disease-related factor. Although the intervention group experienced decreases of 39% in intakes of saturated fatty acid (SFA as percent of total calories) (p0.0001) and 12% in total energy intake (218 kcal/day, p0.05)], no difference in PSA change was observed by intervention status. Signal detection methods indicated that in men increasing their consumption of fruit, 56% experienced no rise in PSA (vs. 29% in men who did not increase their fruit intake). Among men who increased fruit and fiber intakes, PSA increased in 83% of participants who also increased saturated fatty acid intake (vs. 44% in participants who decreased or maintained saturated fatty acid intake).Results are discussed in the context of conventional treatment strategies that were more aggressive when this study was being conducted in the mid-2000s. Positive health changes in a number of lifestyle parameters were observed with the intervention, and both increased fruit and reduced saturated fat intakes were associated with maintaining PSA levels in men with biochemically recurrent disease.

Wilgreen Lake (Madison County, Kentucky) is listed as “nutrient impaired” by the United States Environmental Protection Agency and Commonwealth of Kentucky, and it also experiences high fecal microbe counts that restricts its use. The lake is a typical eutrophic lake, experiencing anoxia and dysoxia in its waters during summer stratification. Human activities in the watershed contribute additional nutrients to the lake that may exacerbate periods of anoxia, so knowing the sources of anthropogenic nutrient inputs to the lake would aid in developing best practices for development of lake shore areas and the watershed. Possible sources include residential fertilizers, cattle waste, and human sewage. High nutrient concentrations within surface waters generally occur only proximal to septic system clusters in the upper reaches of Taylor Fork. Bovine and human fecal microbes enter the lake causing periodic high fecal microbe counts, and are likewise restricted to shallow water areas especially after ra...

Participation in ice-skating sports, particularly figure skating, ice hockey and speed skating, has increased in recent years. Competitive athletes in these sports experience a range of dermatological injuries related to mechanical factors: exposure to cold temperatures, infectious agents and inflammation. Part I of this two part review discussed the mechanical dermatoses affecting ice-skating athletes that result from friction, pressure, and chronic irritation related to athletic equipment and contact with surfaces. Here, in Part II, we review the cold-induced, infectious and inflammatory skin conditions observed in ice-skating athletes. Cold-induced dermatoses experienced by ice-skating athletes result from specific physiological effects of cold exposure on the skin. These conditions include physiological livedo reticularis, chilblains (pernio), Raynaud phenomenon, cold panniculitis, frostnip and frostbite. Frostbite, that is the literal freezing of tissue, occurs with specific symptoms that progress in a stepwise fashion, starting with frostnip. Treatment involves gradual forms of rewarming and the use of friction massages and pain medications as needed. Calcium channel blockers, including nifedipine, are the mainstay of pharmacological therapy for the major nonfreezing cold-induced dermatoses including chilblains and Raynaud phenomenon. Raynaud phenomenon, a vasculopathy involving recurrent vasospasm of the fingers and toes in response to cold, is especially common in figure skaters. Protective clothing and insulation, avoidance of smoking and vasoconstrictive medications, maintaining a dry environment around the skin, cold avoidance when possible as well as certain physical manoeuvres that promote vasodilation are useful preventative measures. Infectious conditions most often seen in ice-skating athletes include tinea pedis, onychomycosis, pitted keratolysis, warts and folliculitis. Awareness, prompt treatment and the use of preventative measures are particularly important in managing such dermatoses that are easily spread from person to person in training facilities. The use of well ventilated footgear and synthetic substances to keep feet dry, as well as wearing sandals in shared facilities and maintaining good personal hygiene are very helpful in preventing transmission. Inflammatory conditions that may be seen in ice-skating athletes include allergic contact dermatitis, palmoplantar eccrine hidradenitis, exercise-induced purpuric eruptions and urticaria. Several materials commonly used in ice hockey and figure skating cause contact dermatitis. Identification of the allergen is essential and patch testing may be required. Exercise-induced purpuric eruptions often occur after exercise, are rarely indicative of a chronic venous disorder or other haematological abnormality and the lesions typically resolve spontaneously. The subtypes of urticaria most commonly seen in athletes are acute forms induced by physical stimuli, such as exercise, temperature, sunlight, water or particular levels of external pressure. Cholinergic urticaria is the most common type of physical urticaria seen in athletes aged 30 years and under. Occasionally, skaters may develop eating disorders and other related behaviours some of which have skin manifestations that are discussed herein. We hope that this comprehensive review will aid sports medicine practitioners, dermatologists and other physicians in the diagnosis and treatment of these dermatoses.

Diet quality based on inflammatory potential, assessed by the Dietary Inflammatory Index (DII&reg, ), has been related to mortality, but studies from racially/ethnically diverse populations are scarce. Using data from the Multiethnic Cohort Study in Hawaii and California, we investigated the association of the DII with all-cause, cardiovascular disease (CVD) and cancer mortality, both overall and by race/ethnicity. The analysis included 150,405 African Americans, Native Hawaiians, Japanese Americans, Latinos, and Whites aged 45&ndash, 75 years, with 47,436 deaths during an average follow-up of 18.2 &plusmn, 4.9 years. In multivariable-adjusted Cox models, the hazard ratios (95% confidence intervals) for the highest vs. lowest quintile of the DII in men and women were 1.15 (1.09&ndash, 1.21) and 1.22 (1.14&ndash, 1.28) for all-cause, 1.13 (1.03&ndash, 1.23) and 1.29 (1.17&ndash, 1.42) for CVD, and 1.10 (1.00&ndash, 1.21) and 1.13 (1.02&ndash, 1.26) for cancer mortality. In men, an increased risk of all-cause mortality with higher DII scores was found in all racial/ethnic groups except for Native Hawaiians (P for heterogeneity &lt, 0.001). Similarly, in women, an increased risk of CVD mortality was found in the four racial/ethnic groups, but not in Native Hawaiians. These findings support the association of a pro-inflammatory diet with a higher risk of mortality and suggest the association may vary by race/ethnicity.

The third of this three-part series on water-related sports dermatoses discusses skin changes seen in athletes who participate in sporting activities on top of or nearby water. While also susceptible to several of the freshwater and saltwater dermatoses discussed in parts one and two of the series, these athletes may present with skin changes unique to their particular sports. This updated and comprehensive review details those near-water dermatologic conditions commonly seen in sailors, rowers, fishermen, surfers, windsurfers, rafters, and water skiers, and will serve as a guide for dermatologists, sports medicine physicians and other medical practitioners in recognition and treatment of these conditions.

The second part of this three-part series on water-related dermatoses will discuss dermatologic conditions seen in athletes exposed to saltwater. The vast majority of the following dermatoses result from contact with organisms that inhabit saltwater, including bacteria, cnidarians, and echinoderms. This review also will include other dermatoses affecting saltwater athletes and should serve as a guide for dermatologists, sports medicine physicians, and other medical practitioners in recognition and treatment of these dermatoses.

Objectives: 1) To examine the frequency of culturally tailored cancer messages present in African-American churches; 2) to examine the prevalence of culturally tailored cancer messages by cancer topic, type of media used, and media source. Method: Between July 2010 and June 2013, health-related print media were collected from 21 African-American churches in South Carolina (n=2,166). Content analysis methodology was used to code items as having culturally tailored messages or not. A review of the literature aided in the creation of a codebook used to determine whether items were “culturally tailored” to the African-American community. The Cohen's kappa for this codebook was 0.74. These data were added to a previous codebook, which provided definitions for media types, media sources, and messages related to disease including cancer (Cohen's kappa=.89). Pearson's chi squared tests were conducted to determine the frequency of culturally tailored messages by cancer topic, type of media, and media source. We focused on the three most prevalent types of media (i.e., flyers, booklets/brochures, and magazines) and media sources (i.e., local health organizations, national health organizations, and church-made items) providing cancer messages in the dataset. Results: Of the 316 cancer messages, 118 (37%) were culturally tailored to African Americans. Cancer messages were significantly more likely to be culturally tailored than other types of disease messages (37% vs 19%, p Conclusion: Over one-third of cancer messages in this dataset were culturally tailored. However, the prevalence of culturally tailored messages differed across cancer sites, types of media publishing cancer messages, and sources of media. Additional research is needed to understand how these differences may impact cancer prevention and control behaviors among African Americans. Citation Format: Shaila Strayhorn, Brook Harmon, Andrew Carter, James Hebert. Prevalence of culturally tailored cancer messages in African-American churches [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B10.

The first of this three-part series on water-related dermatoses involving the athlete will include sports occurring with the majority of time spent in the water. These sports include swimming, diving, scuba, snorkeling and water polo. Numerous authors have described dermatologic conditions commonly seen in swimmers. This series provides an updated and comprehensive review of these water dermatoses. In order to organize the vast number of skin conditions related to water exposure, we divided the skin conditions into groupings of infectious and organism-related dermatoses, irritant and allergic dermatoses and miscellaneous dermatoses. The vast majority of skin conditions involving the water athlete result from chemicals and microbes inhabiting each environment. When considering the effects of swimming on one's skin, it is also useful to differentiate between exposure to freshwater (lakes, ponds and swimming pools) and exposure to saltwater. This review will serve as a guide for dermatologists, sports medicine physicians and other medical practitioners in recognition and treatment of these conditions.

A growing body of literature has identified the association between neutrophilic dermatoses and multifocal, aseptic bone lesions in children, termed chronic recurrent multifocal osteomyelitis (CRMO). Classically, patients present with swelling, pain, and impaired mobility of the affected area, with skin lesions developing concurrently or in the future. Bone biopsy reveals inflammatory changes consistent with infectious osteomyelitis, but cultures and histologic staining invariably fail to identify an infectious source. Patients are refractory to antibiotic therapy, but dramatically respond to systemic steroids and may need to be maintained on low-dose steroids to prevent relapse. Numerous authors have suggested that CRMO and synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome lie along the same clinical spectrum. In fact some believe that CRMO is the pediatric presentation of SAPHO. The two syndromes share numerous characteristics, including osteitis, a unifocal or multifocal presentation, hyperostosis, and pustulosis, which all occur in a generally healthy individual. Our seven patients, five of whom were diagnosed with CRMO, and two of whom were diagnosed with SAPHO syndrome further strengthen the idea that CRMO and SAPHO syndrome do indeed lie along the same clinical spectrum. In addition, we include two rare cases of pediatric Sweet's syndrome with evidence of pathergy.

Comprehensive analysis of land morphology is essential to supporting a wide range envi- ronmental studies. We developed a landforms model that identifies eleven landform units for Puerto Rico based on parameters of land position and slope. The model is capable of extracting operational information in a simple way and is adaptable to different environments and objectives. The implementation of the landforms model for land cover change analysis represents an advanced step towards understanding the expansion of urban areas and forest cover in Puerto Rico between 1977 and 1994. Expansion of urban areas has typically been associated with low and flat topographies. Forest recovery, on the other hand, has been associated with high elevations and steep slopes. Our study revealed that (1) nearly half of new develop- ments occurred outside the plains, (2) almost all new forests occurred in mountain regions (but not on the steepest slopes), and (3) there are transitional and very dynamic landforms (the side slopes) that experience both important land development and forest recovery. Finally, we present additional examples of the land- forms model applications, including vegetation mapping, physiography, and the modeling of vertebrate habitat distributions.

Healthy dietary patterns have been linked positively with health and longevity. However, prospective studies in diverse populations in the United States addressing dietary patterns and mortality are limited.We assessed the ability of the following 4 diet-quality indexes [the Healthy Eating Index-2010 (HEI-2010), the Alternative HEI-2010 (AHEI-2010), the alternate Mediterranean diet score (aMED), and the Dietary Approaches to Stop Hypertension (DASH)] to predict the reduction in risk of mortality from all causes, cardiovascular disease (CVD), and cancer.White, African American, Native Hawaiian, Japanese American, and Latino adults (n = 215,782) from the Multiethnic Cohort completed a quantitative food-frequency questionnaire. Scores for each dietary index were computed and divided into quintiles for men and women. Mortality was documented over 13-18 y of follow-up. HRs and 95% CIs were computed by using adjusted Cox models.High HEI-2010, AHEI-2010, aMED, and DASH scores were all inversely associated with risk of mortality from all causes, CVD, and cancer in both men and women (P-trend0.0001 for all models). For men, the HEI-2010 was consistently associated with a reduction in risk of mortality for all causes (HR: 0.75; 95% CI: 0.71, 0.79), CVD (HR: 0.74; 95% CI: 0.69, 0.81), and cancer (HR: 0.76; 95% CI: 0.70, 0.83) when lowest and highest quintiles were compared. In women, the AHEI and aMED showed large reductions for all-cause mortality (HR: 0.78; 95% CI: 0.74, 0.82), the AHEI showed large reductions for CVD (HR: 0.76; 95% CI: 0.69, 0.83), and the aMED showed large reductions for cancer (HR: 0.84; 95% CI: 0.76, 0. 92).These results, in a US multiethnic population, suggest that consuming a dietary pattern that achieves a high diet-quality index score is associated with lower risk of mortality from all causes, CVD, and cancer in adult men and women.

Despite nutrient adequacy concerns, macrobiotic diets are practiced by many individuals with cancer and other life-threatening illnesses. This study compared the nutrient composition and inflammatory potential of a macrobiotic diet plan with national dietary recommendations and intakes from a nationally representative sample. Nutrient comparisons were made using the 1) macrobiotic diet plan outlined in the Kushi Institute's Way to Health; 2) recommended dietary allowances (RDA); and 3) National Health and Nutrition Examination Survey (NHANES) 2009-2010 data. Comparisons included application of the recently developed dietary inflammatory index (DII). Analyses focused on total calories, macronutrients, 28 micronutrients, and DII scores. Compared to NHANES data, the macrobiotic diet plan had a lower percentage of energy from fat, higher total dietary fiber, and higher amounts of most micronutrients. Nutrients often met or exceeded RDA recommendations, except for vitamin D, vitamin B12, and calcium. Based on DII scores, the macrobiotic diet was more anti-inflammatory compared to NHANES data (average scores of -1.88 and 1.00, respectively). Findings from this analysis of a macrobiotic diet plan indicate the potential for disease prevention and suggest the need for studies of real-world consumption as well as designing, implementing, and testing interventions based on the macrobiotic approach.

Introduction: Acute inflammation, the body's response to infection or physical insult, helps to control infection, heal wounds, and promote tissue regeneration. When normal systems of negative feedback fail to turn off inhibitory signaling, persistent chronic inflammation results. Such chronic inflammation has been shown to be associated with cancers of many anatomic sites and other chronic diseases that are both more prevalent and more virulent among African Americans in the Southeastern United States. Also, chronic inflammation has been associated with poor diet, low levels of physical activity, and high levels of psychosocial stress. Using principles of community-based participatory research (CBPR), this randomized controlled trial (RCT) was designed and administered jointly by members of African-American churches and academic researchers. Its goal was to test the effectiveness of a community-based diet, physical activity and stress reduction intervention in reducing inflammation in overweight and obese African-American adults. Methods: The RCT was conducted in greater Columbia, SC from 2010 to 2014. Churches were randomized to receive the intervention either immediately or with a 12-month delay. The latter served as the study's control arm. Church members were the unit of measurement for all health-related outcomes. Three lay health leaders, who constituted the Church Education Team (CET) and facilitated the study, were selected by the pastor of each church. The first intervention phase consisted of 12 weekly group classes led by a trained community health educator and involving hands-on cooking of mainly vegetable-based meals, sharing of healthy recipes, increasing physical activity, and mindfulness-based stress reduction. The second phase included monthly boosters conducted over an additional 9 months, and was meant to reinforce and expand on topics introduced in the more intensive, 12-week phase. Anthropometric measures were taken along with C-reactive protein (CRP), interleukin (IL)-6 and Monocyte Chemoattractant Protein (MCP)-1. A composite inflammatory score was computed by summing the z-scores for CRP, IL-6 and MCP-1. Linear regression models were fit to test intervention effectiveness and to identify predictors of success. Results: Males in the intervention arm had lower mean adjusted CRP values compared to controls (2.6 vs. 3.7mg/L, p=0.05) at 12-week follow-up (immediately after weekly intervention classes). After 1-year follow-up, a difference of similar magnitude, but not statistically significant, was observed (2.6 vs. 3.9, p=0.17). A nearly statistically significant difference in the composite inflammatory biomarker score also was observed between intervention and control arms among males (-0.38 vs. 0.17, p=0.07). Adjustment for ratings of intervention attendance and sustainability revealed a statistically significant difference in waist-to-hip ratio (WHR) between intervention and control group subjects (0.84 vs. 0.86, p=0.03) at 12-week follow-up among all participants. Conclusion: This RCT showed a significant reduction in CRP among males, but not females; and WHR reductions among all participants at 12-week follow-up. Results also included a large dropout and relatively large differences in factors related to retention and participants' investment in the process. Therefore, alternatives to randomization as a method of treatment allocation may be more appropriate from a public health perspective, especially in communities with large cancer-related health disparities. Citation Format: James R. Hebert, Michael D. Wirth, Brook E. Harmon, Nitin Shivappa, Thomas G. Hurley, Lisa C. Davis, Cheryl A. Armstead, Angela E. Murphy. A church-based diet, physical activity, and stress intervention results in lower waist to hip ratios and reduced chronic inflammation in African-American males. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B50.

The use of faith-based organizations as sites to deliver diet and physical activity interventions is increasing. Methods to assess the messaging environment within churches are limited. Our research aimed to develop and test an objective assessment methodology to characterize health messages, particularly those related to diet and physical activity, within a sample of African American churches. Written messages (bulletins, brochures, magazines) were systematically collected over 1 year and analyzed with a coding scheme that had high interrater reliability (average κ = .77). Within all health messages ( n = 1109), diet and physical activity messages were prevalent (47% and 32%, respectively). Consistent with prior qualitative research, messages related to meals and to providing food to people in need were frequently found (54% and 25% of diet messages, respectively). Contrary to past research, sports and physical activity as praise (e.g., praise dancing) were the most prevalent physical activity messages (36% and 31% of physical activity messages, respectively). Bulletins, flyers, and brochures were the media in which diet and physical activity messages were most frequently found (14%, 33%, and 24%, respectively), and the church was the most frequent source (41%). Only diet and physical activity messages focused on disease prevention were more likely to originate from national health organizations than from the church (26% vs. 16%). Churches varied in the topics, media types, and sources of health messages, an important factor to consider when planning and implementing health promotion research. Future research should determine whether the enhancement of church messaging environments can produce behavioral change.

Given the relation between screening and improved cancer outcomes and the persistence of ethnic disparities in cancer mortality, we explored ethnic differences in colonoscopy, prostate-specific antigen (PSA), and mammography screening in the Multiethnic Cohort Study.Logistic regression was applied to examine the influence of ethnicity as well as demographics, lifestyle factors, comorbidities, family history of cancer, and previous screening history on self-reported screening participation collected in 1999-2002.The analysis included 140,398 participants who identified as white, African American, Native Hawaiian, Japanese American, US born-Latino, or Mexican born-Latino. The screening prevalences overall were mammography: 88% of women, PSA: 45% of men, and colonoscopy: 35% of men and women. All minority groups reported 10-40% lower screening utilization than whites, but Mexican-born Latinos and Native Hawaiian were lowest. Men were nearly twice as likely to have a colonoscopy (OR=1.94, 95% CI=1.89-1.99) as women. A personal screening history, presence of comorbidities, and family history of cancer predicted higher screening utilization across modalities, but to different degrees across ethnic groups.This study confirms previously reported sex differences in colorectal cancer screening and ethnic disparities in screening participation. The findings suggest it may be useful to include personal screening history and family history of cancer into counseling patients about screening participation.

Kasabach-Merritt phenomenon (KMP) is a rare consumptive coagulopathy characterized by profound thrombocytopenia and hypofibrinogenemia occurring in association with the vascular tumors kaposiform hemangioendothelioma (KHE) and tufted angioma (TA). Treatment remains challenging without consensus on the optimal medical management. The authors compiled expert opinions regarding management to establish treatment recommendations. Twenty-seven vascular anomalies centers in the United States and Canada were surveyed using 2 representative cases of KHE/TA with and without KMP. Overall response rate was 92% (25/27) with 88% completion (24/27). Most sites (23/25; 92%) do not have a standard of practice for management. The most frequent initial therapy for KHE+KMP was a combination of systemic corticosteroids and vincristine (VCR) (12/24 centers; 50%) followed by corticosteroids alone (29%). Second-line treatments were VCR (38%), rapamycin (21%), and propranolol (21%). Management of KHE/TA without KMP was variable; initial treatments included systemic corticosteroids (8/24; 33%) alone or with VCR (9/24; 38%), monitoring without medication (33%), VCR (8%), propranolol (8%), aspirin (4%), and rapamycin (4%). This survey highlights certain trends in the management of KMP-associated tumors, without standard protocols and consensus.

Background: Recruitment and retention of minority racial/ethnic groups is necessary to assess and address cancer health disparities in the United States. The objective of this study was to characterize participants’ retention status and identify baseline participant factors associated with retention among an entirely African American (AA) population in a randomized controlled trial (RCT). Methods: Using data from the Healthy Eating and Living in the Spirit (HEALS) program, an RCT conducted from 2009 to 2012 among AAs in South Carolina we examined participant-level factors associated with retention. We used SAS v9.4 to compute chi square tests and fit logistic regressions in order to compare 220 (53.14%) retained to 194 not-retained participants with the goal of identifying important predictors of retention. Among the entire study population, main predictor variable of interest was network distance in miles from home of participants to the clinic venue (i.e. their church) whereas among participants randomized to the intervention arm, a second predictor was percentage of intervention classes attended. Results: Baseline characteristics that were significantly associated with retention status included group assignment, age, body mass index (BMI), distance from home to clinic site(s), and partner enrollment in the study. Participants who lived in locations >5 miles from the clinic sites were more likely to be retained in the study (OR = 1.58; 95% CI: 1.04 - 2.4) compared to participants who lived 60 years) were 3.3 times as likely (95% CI: 1.59 - 6.81) than those aged < 41 years to be retained while individuals randomized to the control group were more likely to be retained (OR = 1.63; 95% CI: 1.06 - 2.50) compared with those randomized to the study group. Those who were obese were less likely to be retained (OR = 0.37; 95% CI: 0.17 - 0.79) compared to those who had normal BMI. Participants who had their partner enrolled in the study were less likely to be retained (OR = 0.59; 95% CI: 0.36-0.95) compared with participants who did not have their partners enrolled. Among individuals randomized to the intervention arm, attending 60% of the classes in the first 3 months of the RCT was strongly predictive of being retained in the study with an odds ratio of 4.31 (95% CI: 2.25 - 8.24) compared with those who did not complete 60% of the classes. Conclusions: Participants who lived further away (>5 miles) and attending 60% or more of the intervention classes was strongly predictive of being retained in the study. Ensuring that there is a run-in period as part of the screening procedure for all participants before randomization will help project managers to identify participants that are likely to be retained in the study and more studies need to be done to know why those who lived farther away were more likely to be retained. Citation Format: Oluwole A. Babatunde, Swann A. Adams, Michael D. Wirth, Jan M. Eberth, Jameson Sofge, Brook Harmon, Lisa Davis, Ruby Drayton, Tom Hurley, Heather M. Brandt, James R. Hebert. Predictors of participants’ retention among African Americans in the Healthy Eating and Living in The Spirit (HEALS) trial. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1764.

1559Background: Low-dose computer tomography (LDCT) screening for individuals at high risk for developing lung cancer has led to earlier detection of suspicious nodules, rapid diagnosis, and a redu...

Purpose: Faith-based interventions are community-based approaches that recognize the central role the church plays in African-American communities. Pastors potentially exert an important influence on health behavior, serving as role models, disseminators of health information, and gatekeepers for health promotion programs, including those aimed at cancer prevention and control. This study explores pastors' perceptions and motivations related to being change agents in their churches and communities. Methods: In-depth interviews were conducted with 30 African-American pastors in 2010-2011 using a semi-structured guide. Pastors were asked about their perspectives on influence in relation to their congregation and community. Questions focused on perceptions of their influence as well as how they have been influenced by their congregations, communities, and other roles (i.e., being bi-vocational, as a family member). Interviews were audio-recorded and transcribed verbatim. Data were analyzed using a combination of theory-guided and grounded theory approaches. Results: Participants ranged in age, gender, and religious denomination. While our question asked about influence in general, many pastors' spoke about the health needs of their community as a motivating force, we have great disparity where sickness and disease is concerned. It is important that we use the church to reach people. Within this context of health, two themes emerged and add to our understanding of pastors as influencers of health behavior change. Organizational change theory recognizes the role leadership plays in the implementation of programs and pastors have been noted as the producers of culture within their churches. In our study, pastors acknowledged this influence and spoke of it as a responsibility. Pastors spoke of acting on this responsibility by promoting programs or outreach efforts to meet the needs and “improve the quality of life” (i.e., spiritual, physical, emotional, and financial) of their congregations and communities. They also spoke of the traits and characteristics a pastor requires to be influential. Some spoke of being a “facilitator” to the ideas and wants of their congregation/community, others spoke of being leaders and the motivating force behind initiatives, and still others used the term pioneer and felt they were most influential in helping create a vision or developing new ways for their congregation/community to address health issues. While discussing their influence, pastors spoke about congregation and community synonymously, with the community considered just a larger congregation. Pastors also felt their ability to be influential was modified by their religious denomination and ethnicity. They spoke of denominations with less structure providing more opportunities for pastors to be influential at a local level. In addition, pastors felt their ability to be influential was sometimes limited due to a lack of resources, which they felt was not as important an issue for White pastors and pastors with more affluent and urban congregations. Conclusion: Our findings provide insight into developing effective faith-based interventions. They add to the current theories on pastors as change agents indicating pastors see themselves as important figures and want to foster a culture of holistic health within their churches and communities. However, collaborations between churches and researchers must acknowledge individual differences in pastors' perspectives on their role as behavior change agents and gatekeepers of African-American communities. To be successful, these efforts must take into account each pastor's strengths as well as their vision for themselves and their role in their congregation and community. Pastors' dedication to holistic, congregation-based health improvement holds great promise for reducing health disparities. Citation Format: Paige Pirkey, Brook E. Harmon, Emma Draluck, Christine E. Blake, James R. Hebert. African American pastors' perspectives on their role in addressing health disparities. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A30.

Kaposiform hemangioendothelioma (KHE) is a rare, potentially life-threatening vascular tumor often associated with a coagulopathy known as Kasabach– Merritt phenomenon (KMP). 1 Optimal therapy for KHE is not known, and despite well-published classification systems, physicians still confuse this entity with other vascular anomalies. In the interest of standardizing clinical practice across specialties and institutions and to establish a basis for the design of comparative effectiveness studies in vascular tumors, we have developed a consensus-derived standard of practice for the treatment of KHE with and without associated KMP. Vascularanomaliesencompassaheterogeneousgroupoftumors and malformations characterized by the presence of abnormal vascular structures. Vascular anomalies most often occurintheskinandsofttissue;however,theycanoccurwithin any organ and present with a wide range of symptoms and complications, depending on the type and location of the lesion(s). As a result of the heterogeneity of clinical presentations, patients have traditionally been referred to both adult and pediatric specialists in dermatology, hematology/oncology,interventionalradiology,surgery,plasticsurgery,ophthalmology, and/or otolaryngology to address a particular clinical problem. This type of “problem-driven” care has resulted in patients being seen by multiple specialists without a cohesive understanding of the natural history or mechanism of disease. The formation of interdisciplinary vascular anomalies centershas advanced our ability todiagnose and classify these conditions; however, standardized treatment protocols and assessment of response criteria do not currently exist. Clinicians rely on case reports, limited retrospective series, and expert opinion when selecting therapeutic interventions for complicated patients. This knowledge gap underscores the importance of gaining consensus in the treatment of these rare, often life-threatening anomalies. Consensus will limit practice variability and will allow comparison of data across institutions and subspecialties and facilitate the development of evidence-based practice standards.

Aquatic sport dermatoses include a variety of skin conditions that occur in athletes who participate in sporting activities in or on the water. Chemicals and microbes inhabiting the aquatic environment are often responsible for the development of these cutaneous conditions. We review common water sports dermatoses and divide them based on activities that occur in saltwater, freshwater and activities outside the water. Some of the water sports represented in the review include swimming, diving, scuba diving, snorkeling and water polo which are mainly based in the water, as well as sailing, rowing, fishing, surfing, whitewater rafting and water-skiing which are based on the water and outside the water. Aquatic sports dermatoses are presented according to their etiology including infectious and organism-related, contact dermatitis and miscellaneous causes. We also describe conditions specifically associated with water sports including sailing, rowing, fishing and surfing. This comprehensive review focuses on the key recognizable clinical features and principles of management of aquatic sports dermatoses. Our aim is to help sports medicine physicians, dermatologists and other health care providers recognize and treat water sport dermatoses in athletes.

Background Congenital erosive and vesicular dermatosis (CEVD) healing with reticulated supple scarring, a condition usually observed in premature neonates, presents at birth with vesicles and erosions. Lesions typically heal within a few months, leaving behind scarring with a distinctive supple and reticulated texture. Objectives We sought to merge existing literature with new cases to further define CEVD. Methods We analyzed 19 previous reports of CEVD and added 9 additional patients; we identified unifying characteristics of this cohort. Results In 28 total cases, notable features included: preterm birth (79%), nail abnormalities (46%), hyperthermia/hypohidrosis (46%), a history of maternal chorioamnionitis (43%), alopecia (43%), neurodevelopmental and ophthalmologic abnormalities (36% each), tongue atrophy (29%), or a combination of these. Patients with CEVD may be prone to postnatal herpetic superinfections. Previously unreported findings included: erosive lichen planus, digital tip gangrene, and hydronephrosis. Limitations The small patient sampling makes it difficult to define diagnostic criteria. As certain findings are associated with prematurity, it is unclear to what extent these features result from CEVD, premature birth, or another intrauterine pathology. Conclusions Although rare, CEVD should be considered in the differential diagnosis of neonatal vesicles/erosions in the context of a negative infectious workup. This review strengthens the spectrum of CEVD features, thus facilitating its recognition by clinicians.