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We administered an anonymous survey to assess knowledge, attitudes, and prevention practices related to the Zika virus among pregnant women residing in Texas. Multivariate logistic regression models controlling for age, race/ethnicity, education, and number of years in the United States assessed differences between women born in outbreak areas (N = 390) versus those born in the United States (N = 249). Results demonstrated that most women wanted more information on the Zika virus and desired to obtain it from their physician. The majority did not know that the Zika virus could be spread through sex with an asymptomatic partner or how often those infected were symptomatic. Few women took precautions to avoid mosquito bites. Only 40% reported frequently using repellent; 21% stated that cost was problematic and almost half were concerned about use during pregnancy. Three-fourths stated they would agree to vaccination, if available. Compared with U.S.-born women, those born in outbreak areas were more likely to have already discussed the Zika virus with their doctor (adjusted odds ratio [aOR] = 1.86, 95% confidence interval [CI] = 1.27, 2.71) and identify microcephaly as the most common birth defect (aOR = 2.59, 95% CI = 1.78, 3.76). Moreover, women born in outbreak areas were less likely to desire to keep it a secret if they became infected (aOR = 0.47, 95% CI = 0.31, 0.71). This study found that, regardless of birthplace, pregnant women need more education on the Zika virus disease and assurance regarding the safety of using repellent during pregnancy. They also need financial assistance for repellent, especially if living in states where transmission by mosquitos has been reported.

We surveyed third-year medical students to assess whether personal vaccination status was associated with willingness to recommend the human papillomavirus vaccine to patients. A total of 231 students completed an anonymous survey evaluating their knowledge, attitudes, and personal vaccine history. Of 122 female students, 81 (66.4%) reported initiating the vaccine, as did 16 of 109 males (14.7%). Females and students ≤ 25 years old were more likely to be vaccinated. Knowledge did not vary by vaccination status, but anticipated behaviors did. Vaccinated students reported greater willingness to vaccinate adolescents before 15 – 16 years of age (92.1% vs. 78.6%, p=0.008) and discuss vaccination at any type of medical visit (100% vs. 89.7%, p

Melanoma is an aggressive skin cancer developing from melanocytes, frequently resulting in metastatic disease. Melanoma cells utilise amoeboid migration as mode of local invasion. Amoeboid invasion is characterized by rounded cell morphology and high actomyosin contractility driven by the RhoA signalling pathway. Migrastatic drugs targeting actin polymerization and contractility to inhibit invasion and metastasis are therefore a promising treatment option. To predict amoeboid invasion and metastatic potential, there is a need for biomarkers functionally linked to contractility pathways. The glycoprotein podoplanin drives actomyosin contractility in lymphoid fibroblasts, and is overexpressed in several cancer types. Here, we show that podoplanin enhances amoeboid invasion in melanoma. Expression of podoplanin in murine melanoma models drives rounded cell morphology, increasing motility and invasion in vivo. Podoplanin expression is upregulated in a subset of dedifferentiated human melanoma, and in vitro is sufficient to suppress melanogenesis and upregulate melanoma-associated markers Mitf and Pou3f2 . Together, our data indicates that podoplanin is both a potential biomarker for dedifferentiated invasive melanoma and a promising migrastatic therapeutic target.

CD20-targeting antibodies are the current standard of care for patients with mature B-cell malignancies. However, many patients relapse or develop therapy resistance, which emphasizes the urgent need for new therapies. Here, we provide an overview of the biology of the CD20 protein and the mechanisms of action of CD20 antibodies currently used in the clinic. In addition, we discuss different mechanisms underlying therapy resistance, and recent advances made in the development of novel antibody-based therapeutics to improve clinical outcome of patients with mature B-cell malignancies.

Many medical students are not comfortable recommending the human papillomavirus (HPV) vaccine because they do not feel prepared to discuss it with their patients. A prior study demonstrated that this is particularly a problem among unvaccinated students. Our purpose was to determine if medical student attitudes and comfort with counseling could be improved by attending a single lecture delivered by an expert on the topic. To assess the effects of the educational program, we conducted pre- and posttests on medical students before and after a single lecture on HPV vaccination. Changes in items related to attitude and comfort were examined. Student characteristics associated with changes in scores were also examined and compared. A total of 256 medical students participated in the pre- and posttests. Before the lecture, students demonstrated low knowledge of HPV vaccination and did not feel comfortable counseling parents of younger patients. However, students

T cells are central to the adaptive immune response, playing a role in both the direct and indirect killing of pathogens and transformed cells. The activation of T cells is the result of a complex signaling cascade, initiated at the T cell receptor (TCR), and ending with the induction of proliferation. CD45, a member of the protein tyrosine phosphatase family, is one of the most abundant membrane proteins on T cells and functions by regulating activation directly downstream of the TCR. As a result of alternative splicing, CD45 can be expressed in multiple isoforms, naive T cells express the CD45RA isoform, while activated T cells gain expression of CD45RO, which has been proposed to increase signaling. Though the importance of CD45 in TCR signaling, proliferation and cytokine production is well established, little is known about the regulation of CD45 activity. We discovered that the immune-specific tetraspanin CD53 directly affects the stability and function of CD45RO in T cells.We have identified CD53 as a T cell co-stimulatory molecule in primary human and murine cells. Furthermore, we have shown that the absence of CD53 leads to an altered CD45 isoform expression as a result of decreased CD45RO stability on the cell surface. This instability was accompanied by increased mobility as measured by FRAP.Together, this indicates that CD53 functions as a stabilizer of CD45RO, and therefore as a positive regulator of TCR signaling at the T cell surface. Our data provides novel insight into the role of tetraspanins in the regulation of immune signaling and may provide a new avenue for the regulation of T cell signaling.

Synchronized oscillations are a ubiquitous feature of neuronal circuits and can modulate online information transfer and plasticity between brain areas. The disruption of these oscillatory processes is associated with the symptoms of several brain disorders. While conventional therapeutic high-frequency deep brain stimulation can perturb neuronal oscillations, manipulating the timing of oscillatory activity between areas more precisely could provide a more efficient and effective method of modulating these activities. Here we describe a prototype circuit for synchronizing the clocks between an active implantable and an external sensing and stimulation system that could be used to achieve this goal. Our specific focus is on synchronizing the systems for paired-associative stimulation. The ability to repetitively drive two brain regions with a fixed latency has specific implications for neural plasticity. Furthermore, the general concept can be applied for many potential applications involving distributed neural interfaces.

Dental professionals are encouraged by the American Dental Association (ADA) to recommend the HPV vaccine to eligible patients. To better understand their comfort level in following this recommendation, we conducted a mixed methods study of dentists and dental hygienists. A total of 173 providers were surveyed and 8 interviewed. The majority felt they had an important role in preventing HPV-related OPC and that they should educate their patients and encourage HPV vaccination. However, most providers had low knowledge about HPV and expressed a need to obtain more information on the topic. In particular, they desired information about the HPV vaccine, its connection to cancer and where to refer patients for vaccination. They also wanted access to visual aids to help them bring up the topic. This study demonstrates the need to develop and disseminate educational programs for dental providers so they can assist with efforts to raise HPV vaccination rates.

Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination and influenza vaccination are recommended during pregnancy primarily to prevent influenza and pertussis in mothers and their infants. This study examines associations between prenatal Tdap vaccination and influenza vaccination of mothers and hepatitis B vaccination of their infants. A retrospective cohort study was conducted using data from electronic medical records from 15,468 deliveries to 14,925 mothers occurring April 2, 2014-December 3, 2016 at a university hospital in Texas. Hepatitis B vaccine receipt in the first 3 days of life was dichotomized. Margins post-estimation commands in Stata SE 15.1 were used to obtain predicted probabilities and risk differences after estimating odds ratios in logistic regression with robust variance estimates. Adjusted models included maternal age, race/ethnicity, Medicaid use, year of delivery, parity, and gravidity. Infants of mothers who received prenatal influenza vaccination in the 2014–2015 and 2015–2016 influenza seasons were more likely than those of mothers who did not to receive a hepatitis B vaccine in their first 3 days of life (adjusted risk difference (RD) 2.8%, 95% confidence interval (CI) 1.5–4.1% and RD 2.2%, 95% CI 0.9–3.5%, respectively). Hepatitis B vaccination was also higher among infants of Tdap-eligible mothers who received prenatal Tdap vaccination during pregnancy compared to those of mothers who did not (adjusted RD 9.1%, 95% CI 7.6–10.5%). Overall, prenatal vaccination was significantly associated with uptake of infant hepatitis B vaccine.

6041 Background: The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) has been reported to be increasing among both middle-aged and elderly adults in the United States. This study was to assess racial and regional differences in the incidence of OPSCC among adults in the US. Methods: We included 271,037 adult patients ≥ 20 years old diagnosed with potentially HPV-related OPSCC from the US Cancer Statistics 2001–2017 database which essentially covered the entire US population. Incidence of OPSCC was age- adjusted to the US standard population. Annual percentage change (APC) in the incidence was assessed across races/ethnicities and regions of residence. Results: Among these adults with potentially HPV-related OPSCC from 2001-2017, 5.3% were Hispanics, 83.0% were non-Hispanic Whites, and 9.2% were non-Hispanic Blacks, and 79.1% were male. Incidence of OPSCC increased from 3.9 per 100,000 in 2001 to 4.0 per 100,000 in 2017 (APC 0.43, 95% confidence interval (CI) 0.01, 0.85) in Hispanics, increased from 5.3 per 100,000 in 2001 to 8.6 per 100,000 in 2017 (APC 2.97, 95% confidence interval (CI) 2.71, 3.24) in non-Hispanic Whites, and decreased from 6.3 per 100,000 in 2001 to 5.1 per 100,000 in 2017 (APC -1.27, 95% confidence interval (CI) -1.56, -0.99) in non-Hispanic Blacks. The incidence increased from 5.8 per 100,000 in 2001 to 7.8 per 100,000 in 2017 (APC 1.94, 95% confidence interval (CI) 1.67, 2.21) in the South, increased from 5.0 per 100,000 in 2001 to 7.1 per 100,000 in 2017 (APC 2.13, 95% confidence interval (CI) 1.92, 2.34) in the Northeast, increased from 4.9 per 100,000 in 2001 to 6.3 per 100,000 in 2017 (APC 1.85, 95% confidence interval (CI) 1.53, 2.17) in the West, and increased from 4.9 per 100,000 in 2001 to 7.7 per 100,000 in 2017 (APC 2.79, 95% confidence interval (CI) -2.52, 3.07) in the Midwest. The incidence decreased from 0.9 per 100,000 in 2001 to 0.8 per 100,000 in 2017 (APC -0.81, 95% confidence interval (CI) -1.41, -0.20) among adults 20-44 years old, increased from 9.0 per 100,000 in 2001 to 12.7 per 100,000 in 2017 (APC 2.01, 95% confidence interval (CI) 1.66, 2.36) among adults 45-64 years old, and increased from 10.9 per 100,000 in 2001 to 16.7 per 100,000 in 2017 (APC 2.96, 95% confidence interval (CI) 2.75, 3.16) among adults 65+ years old. Conclusions: OPSCC incidence increased across racial/ethnic groups, regions, and age groups from 2001 to 2017, except that the incidence decreased among non-Hispanic Blacks and young people. Underlying causes for the decreasing trend in the incidence of OPSCC among certain groups need further investigation.

5578 Background: Endometrial cancer at this time is predominantly being looked at as a disease of postmenopausal population. Increased obesity has been identified as an important risk factor for endometrial cancer. An overall increase incidence of endometrial hyperplasia and endometrial carcinoma in obese premenopausal women has been reported. A close examination of the relationship between trends in endometrial cancer incidence and obesity prevalence in young women will provide important information for prevention and early screening of the disease and its precursors. This study was to assess current trends in endometrial cancer incidence in women ages 20-29 and 30-39 years in relationship to obesity in the US. Methods: We used data on US adult women 20-39 years old from the National Program for Cancer Registries and Surveillance, Epidemiology, and End Results Incidence–U.S. Cancer Statistics 2001–2017 database. This database covered essentially all young female population between 2001 and 2017 in the US (Puerto Rico not included). Incidence was age adjusted to the 2020 U.S. standard population. We also examined the trends in obesity prevalence among females 18-34 years old using data from the National Health and Nutrition Examination Survey (NHANES) III and NHANES 1999-2014. Results: There were 24,446 cases of endometrial cancer among young adult women aged 20-39 years during 2001-2017. Endometrial cancer incidence increased from 0.6 per 100,000 in 2001 to 1.2 per 100,000 in 2017 (APC 3.6, 95% CI 2.9-4.4) among young women 20-29 years old, and increased from 4.6 per 100,000 in 2001 to 7.5 per 100,000 in 2017 (APC 3.0, 95% CI 2.7-3.3) among women 30-39 years old. Obesity prevalence also increased significantly from 1988-2014 among females 18-34 years old. Incidence of endometrial cancer and obesity prevalence were both higher in Hispanics than in other racial/ethnic groups. Conclusions: The significant increasing incidence in endometrial cancer among young adult women is in accordance with the concurrent increasing prevalence in obesity in young girls and women in the US. This indicates that endometrial cancer screening might need to be considered at much earlier age among patients with abnormal bleeding and certain ethnic populations.

Between 2009 and 2012, the proportion of young women in the United States completing the human papillomavirus (HPV) vaccine doubled. To understand how quickly this increased uptake is affecting women in the United States, we evaluated the prevalence of vaccine-type (VT) HPV strains among young women in national data sets from 2009-2010 and 2011-2012. Among 18-26-year-old women, the prevalence of VT HPV decreased markedly over a short interval, from 15.4% in 2009-2010 to 8.5% in 2011-2012 (prevalence ratio, 0.51; 95% confidence interval, .28-.92), and the prevalence of high-risk VT HPV decreased from 13.1% to 6.5% (0.46; .25-.86). Reductions in HPV-related diseases will probably follow.

Race/ethnicity has been shown to modify the effects between obesity and cancer screening among women. The purpose of this article is to update the literature with recent data to examine how the association between different characteristics, including body mass index (BMI), and cancer screening compliance varies by race/ethnicity in a national sample of women.Three cycles of the Health Information National Trends Survey (HINTS) were combined for this cross-sectional study. Weighted descriptive statistics were evaluated using chi-square tests. Multivariable logistic regression evaluated associations between women with underweight or normal (25), overweight (25-29.9), and obese (30) BMIs and cancer screening concordant with guidelines (Papanicolaou [Pap] testing ≤3 years, ages 21+ years; mammography ≤2 years, ages 40+ years) in analyses stratified by race/ethnicity. We also assessed variance between racial/ethnic groups in how age, income, and insurance status were associated with cancer screening compliance.This study included 4992 women who were evaluated for Pap testing and 3773 for mammography. In analyses stratified by race/ethnicity, whites with a higher household income were more likely to report having a Pap test (adjusted prevalence ratio [aPR] 2.16, 95% confidence interval [95% CI] 1.38-3.40) and a mammogram (aPR 1.63, 95% CI 1.04-2.55) compared to lower income white women. Black women with BMIs between 25 and 30 were less likely to receive a Pap test (aPR 0.38, 95% CI 0.19-0.76) than black women with BMIs25, while no association was observed among the other groups. Insurance was associated with increased likelihood of Pap testing among white and black women. Insurance coverage was positively associated with mammography only among white and Hispanic women.We found variations in adherence to cancer screening guidelines by age, insurance coverage, and income between racial/ethnic groups. Little evidence was observed for variations in screening by BMI.

Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination is recommended for all women during each pregnancy to prevent pertussis in young infants. However, data on the safety of this protective measure are limited and conflicting. To assess maternal and infant outcomes associated with administration of this vaccine during pregnancy, we reviewed medical records of 1,759 women who delivered a singleton infant at a southeast Texas public hospital between November 1, 2012 and June 30, 2014. After excluding women who had inadequate prenatal care or who delivered at

Background: Ovarian cancer is the fifth most common cause of cancer death among US women. Assessing racial/ethnic differences in ovarian cancer incidence and mortality will provide important information regarding improving efforts of prevention, early detection, and treatment in population groups that need to be targeted. Methods: We included adult women diagnosed with ovarian cancer ≥ ages 20 from the National Program for Cancer Registries and Surveillance, Epidemiology, and End Results Incidence Incidence–-U.S. Cancer Statistics 2001–2016 database. Incidence of ovarian cancer was age- adjusted to the U.S. standard population. Joinpoint analyses were used to assess incidence trend and calculate annual percentage change (APC). Hazard ratios (HRs) and 95% CIs were estimated from the Cox proportional hazard models for comparing differences in 5-year survival probability across races/ethnicities, after controlling for age at diagnosis and county of residence. Results: Among adult women ≥ 20 years old, ovarian cancer incidence decreased among Hispanics, non-Hispanic Whites, and non-Hispanic Blacks, from 9.4 per 100,000 in 2001 to 6.9 per 100,000 in 2016 (APC -1.8, 95% confidence interval (CI) -2.2 - -1.5) in Hispanics, from 11.0 per 100,000 in 2001 to 7.6 per 100,000 in 2016 (APC -2.1, 95% CI -2.3 - -1.9) in non-Hispanic Whites, and from 8.0 per 100,000 in 2001 to 6.6 per 100,000 in 2016 (APC -1.3, 95% CI -1.6 - -1.0) in non-Hispanic Blacks. No joinpoints were found among those racial/ethnic groups. Among ovarian cancer patients, observed 5-year ovarian-cancer-specific survival was 51.6% (95% CI 50.4%-52.8%) in Hispanics, 44.7% (95% CI 44.2%-45.1%) in non-Hispanic Whites, and 37.4% (95% CI 36.1%-38.8%) in non-Hispanic Blacks (HR for dying from ovarian cancer, Whites vs. Blacks 0.68, 95% CI 0.66-0.71; Hispanics vs. Blacks 0.73, 95% CI 0.69-0.76). Similar patterns were also observed for 5-year overall survival and 5-year relative survival among adult ovarian patients. Conclusions: Ovarian cancer incidence decreased across all three racial/ethnic groups from 2001 to 2016. Although Non-Hispanic Blacks had the lowest ovarian cancer incidence, they had the lowest survival rate. More efforts are needed to focus on this underserved population to target early detection and treatment of ovarian cancer. Citation Format: Fangjian Guo, Abbey B. Berenson, Yong-Fang Kuo. Racial/ethnic differences in ovarian cancer incidence and mortality among adult women in the United States, 2001-2016 [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D087.