Search

Background: Behavioral interventions targeting weight loss may be affected by socio-environmental factors that influence physical activity (PA) and cardiometabolic outcomes. Purpose: To evaluate the relation of neighborhood walkability on PA levels and glucose control in a sample of adults participating in a weight loss study. Methods: Secondary analysis of a prospective observational study providing a 12-month behavioral weight loss intervention to examine lapses after intentional weight loss. Neighborhood walkability was assessed via Walk Score (0-100), PA via waist-worn ActiGraph GT3X, and blood glucose via phlebotomy. Study variables included car-dependent and walkable neighborhoods (Walk Score < vs. ≥50), prediabetes (fasting blood glucose from 100-126mg/dL) and recommended PA (moderate-to-vigorous PA [MVPA] >22 minutes/day; steps ≥7500/day). Standard descriptive and group comparative statistics were employed. Regression results are reported as adjusted odds ratios (OR) with 95% confidence intervals (CI). Results: The sample (N=112) was mostly female (90.2%), white (90.2%), well educated (75.9% with ≥4 years of college) and on average 51.5±9.8 years of age. At baseline, no differences existed between persons from car-dependent vs. walkable neighborhoods across all metrics. At 12 months, PA and glucose control were improved for the entire sample, with no differences across walkability categories. Neighborhood walkability did not predict attainment of recommended MVPA (OR=1.16, 95% CI: 0.97-1.39) or steps (OR=1.08, 95% CI: 0.90-1.30) at 12 months. However, those from walkable neighborhoods had 17% lower odds of having prediabetes compared to those from car-dependent neighborhoods (OR=0.83, 95% CI: 0.72-0.97). Conclusion: Our findings corroborate previous studies showing an inverse relation between neighborhood walkability and prediabetes. The key drivers of this association warrant further investigation in a study with a larger, more diverse sample. Disclosure J. K. Kariuki: None. J. Cheng: None. L. E. Burke: None. Z. Bizhanova: None. B. Rockette-wagner: None. B. B. Gibbs: None. S. M. Sereika: None. C. Kline: None. K. Erickson: None. D. Mendez: None. I. Pulantara: None. Funding National Heart, Lung, and Blood Institute (HL107370S to J.K.K.)

Background: Obesity is a major risk factor for CVD. Standard behavioral treatment (SBT) typically requires face-to-face sessions, is expensive, has limited evidence for sustained weight loss, and critically, is not available to many with obesity. Using innovative mobile technology to provide real-time tailored feedback (FB) to the self-monitoring (SM) of diet, physical activity, and weight can improve lifestyle and weight management habits. It can be accessible to those without access to SBT, or to those not wishing to participate in a structured, in-person program. We report short-term, 6-month weight findings from the SMARTER Trial. Methods: SMARTER tests the efficacy of adding automated FB to smartphone SM compared to SM alone on weight loss. We randomized 502 adults with overweight/obesity to either 1) SM alone (n=251) or 2) SM+FB (n=251). The SM+FB group received up to 3 FB pop-up messages/day on their smartphone which were tailored to data in SM entries and delivered at random times during waking hours. Participants used a smartphone app to self-report diet, a Fitbit Charge 2 to monitor physical activity, and a digital Bluetooth scale for weight tracking. At baseline, all had a 90-min one-on-one session with a dietitian on behavioral changes to target weight loss. Percent weight loss from baseline to 6 months and the percentage of participants having at least a 5% weight loss at 6 months were compared between treatment groups using an intention to treat (ITT) approach with either parametric or non-parametric group comparisons. Missing assessment weights at 6 months were imputed using participants’ weight tracking data. Results: Groups had similar demographic characteristics and anthropometric measures at baseline (all p≥.05). The sample was mostly female (79.5%,399/502) and white (84.3%, 423/502) with mean BMI of 33.10 ± 3.93 kg/m 2 . There was no difference between groups in having weight data available at 6 months (SM: 84.9%, 213/251), SM+FB: 83.7%, 210/251); p=.713). Based on ITT analyses, there was no significant difference between the two groups in mean percent weight loss from baseline to 6 months (SM: Mean= -3.24% [SD=5.27], SM+FB: Mean= -3.16% [SD=5.50]; p=.860). Similar results were obtained using non-parametric methods, further supporting no difference in percent weight loss between the groups (SM: Median= -2.25% [IQR=5.53], SM+FB: Median= -2.45% [IQR=6.88]; p=.962). Overall, 30.1%,151/502) achieved at least 5% weight loss at 6 months, with similar percentages between treatment groups (SM: 28.3%,71/251, SM+FB: 31.9%, 80/251); p=.381). Conclusions: These findings demonstrate excellent 6-month assessment completion rates. We did not support our hypothesis that participants in the SM+FB group would show greater weight loss at 6 months than those in the SM group. It is possible that weight loss outcomes may differ between groups in the second half of the 12-month intervention.

Background: Social cognitive theory (SCT) postulates that observing similar others succeed (vicarious experience) can improve self-efficacy and motivate action. The utility of vicarious experience has been demonstrated in controlled laboratory and clinical settings, but its operationalization and applicability for promoting physical activity (PA) in community settings remains unknown. Characterizing vicarious experiences and other neighborhood factors that are associated with improved PA in the community could help enhance exercise self-efficacy and PA. This secondary analysis examines neighborhood factors that predict leisure-time PA during exam 5 of the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: The sample included MESA subjects who participated in exam 5 (N= 4,716). Leisure-time PA was assessed using the MESA Typical Week PA Survey. Neighborhood behaviors and characteristics, including vicarious experiences (operationalized as observing others “exercise” or “walk”), perceived safety, crime, and walkability, were self-reported. Group comparative analyses were used to evaluate differences in categorical and continuous variables. The relationships between neighborhood characteristics and optimal leisure-time PA (≥10 MET-hrs/wk) were assessed using logistic regression adjusting for age, gender, race, income, body mass index (BMI), and depression, and including interactions between race, BMI and age. Adjusted odds ratios with 95% confidence intervals (CI) are reported. Results: Participants with complete data on variables of interest (n=4,417) were elderly (age 69.8 ± 9.4 yrs), predominantly female (53%), and diverse (40% white, 12% Chinese, 26% black, 22% Hispanic). Participants who saw people exercise in their neighborhood were 44% (OR 1.44, 95% CI; 1.22 - 1.69) more likely to engage in optimal leisure-time PA compared to those who did not. Observing other people walk in the neighborhood did not impact leisure-time PA (OR 0.84, 95% CI; 0.68 - 1.04). Older age, female gender, obesity, minority status, and high-risk for depression were associated with lower odds of engaging in optimal leisure-time PA controlling for vicarious experience. Race had significant interactions with BMI and age. Other neighborhood characteristics including perceived safety, crime, and walkability did not influence the association between seeing similar others engage in PA and their own engagement in PA. Conclusions: Developing PA programs that expose community-dwelling adults to their peers who engage in PA could improve exercise self-efficacy and adherence to PA guidelines.

Objective The objective of this study was to quantify the features of stereotypy in epileptic seizures and compare it with that of stereotypy in psychogenic nonepileptic seizure-like events (PNES) confirmed by video-electroencephalography (VEEG) monitoring. Methods Video-electroencephalography monitoring records of 20 patients with temporal lobe seizures (TLS) and 20 with PNES were retrospectively reviewed (n = 138 seizures, 48 TLS and 90 PNES). We analyzed the semiology of 59 behaviors of interest for their presence, duration, sequence, and continuity using quantified measures that were entered into statistical analysis. Results We identified discontinuity as the parameter that was clearly distinct between PNES and epileptic TLS events: there were significantly more frequent pauses of behavior (i.e., “on–off” pattern) in PNES compared with TLS (P = 0.012). The frequency of pauses during an event was diagnostic of PNES events. For instance, the presence of 2 “pauses” during an episode determines a 69% probability of the seizure being nonepileptic. Moreover, PNES events had significantly greater duration (143 s) than TLS events (68 s) (excluding outliers, P = 0.002) and greater duration variability from one event to another in the same subject (P = 0.005). Significance Our work provides the first quantified measure of behavioral semiology during epileptic and nonepileptic seizures and offers novel behavioral measures to differentiate them from each other.

Background Self-monitoring food intake and physical activity (PA) is positively related to weight loss and the addition of feedback (FB) messages has been shown to reinforce behavior change. Moreover, the more immediate the delivery of reinforcing FB messages, the more likely they will promote the desired behaviors. Purpose Describe design and rationale of SMARTER, a National Institute of Heart, Lung, and Blood (NHLBI)-sponsored randomized, controlled trial, which compares the differential efficacy of two weight loss treatments among 530 adults, ages 18 and older. Methods Single-site, 2-group design trial with subjects randomized 1:1 to either: 1) self-monitoring (SM), where participants self-monitor diet, PA, and weight using a commercial smartphone application (app); or 2) SM + FB, where participants self-monitor and receive real-time, tailored feedback (FB) as pop-up messages up to 3 times/day for 12 months. Daily FB messages address diet and PA behaviors and a weekly FB message addresses self-weighing. We hypothesize that subjects assigned to SM + FB will show greater weight loss at 6 and 12 months and greater sustained engagement in the program than the SM group, measured by adherence to the study's lifestyle and SM protocol. We will explore temporal relationships of the frequency, timing, and type of FB delivered and subsequent lifestyle behaviors through examination of serially collected real-time SM (diet, PA, weight) data over 12 months. Conclusions If efficacious, this fully scalable intervention could be efficiently translated and disseminated to reach large numbers of individuals through commercial apps at lower cost than existing in-person weight loss programs.

Background: The nutritional support after hematopoietic stem cell transplantation (HSCT) has not been well established due to the scarcity of clinical trials. To conduct international clinical trials in Asia, we performed the questionnaire survey to investigate the current standard of nutritional support after HSCT. Method: We sent the questionnaire to the physicians nominated by the Asia Pacific Blood and Marrow Transplantation (APBMT) members of each country/ region. Result: We received 15 responses from 7 different countries/regions. The target calorie amount is 1.0 - 1.3 × basal energy expenditure (BEE) in 11 institutes when partial parenteral nutrition is used. When total parenteral nutrition (TPN) is used, the target calorie amount is 1.0 - 1.3 × BEE in 9 institutes and 1.3 - 1.5 × BEE in 4 institutes. Lipid emulsion is routinely used in 12 institutes. Multivitamins and trace elements are routinely added to TPN used in most institutes. It is still uncommon to use the immunonutrition. Blood glucose levels are routinely monitored in all institutes, but the target range varies (

Title: Comprehensive Characterization of SOX4 Protein Complexes in Prostate Cancer Cells. Authors: Yu Heng Lai, Junmin Peng, Jessica Cheng, and Carlos S. Moreno Abstract: SOX4 is a developmental transcription factor in vertebrates that is required for differentiation and proliferation in multiple tissues. SOX4 is overexpressed in many human malignancies, but the precise role of SOX4 in cancer progression is still not well understood. Although it is known that SOX4 directly interacts with p53 and β-catenin, many of SOX4's protein binding partners remain unknown. Thus, the identification of additional SOX4 binding partners is essential for elucidating the mechanism of SOX4-mediated effects in cancer progression. We have adapted a one-step affinity purification method that allows rapid purification of via intracellular biotinylation of the amino-terminus of SOX4. We have transiently expressed SOX4 protein in LNCaP prostate cancer cells and purified SOX4 complexes with streptavidin-linked paramagnetic beads in order to perform large scale of proteomics analysis. We have identified several proteins that interact with SOX4 in vivo by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Details of these SOX4 protein-protein binding partners will be discussed. These proteomic data provide insights into the role of SOX4 in key pathways in cell proliferation, development, and cancer progression. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3912.