Feasibility of Using a Commercial Fitness Tracker as an Adjunct to Family-Based Weight Management Treatment: Pilot Randomized Trial.

BACKGROUND: Fitness trackers can engage users through automated self-monitoring of physical activity. Studies evaluating the utility of fitness trackers are limited among adolescents, who are often difficult to engage in weight management treatment and are heavy technology users. OBJECTIVE: We conducted a pilot randomized trial to describe the impact of providing adolescents and caregivers with fitness trackers as an adjunct to treatment in a tertiary care weight management clinic on adolescent fitness tracker satisfaction, fitness tracker utilization patterns, and physical activity levels. METHODS: Adolescents were randomized to 1 of 2 groups (adolescent or dyad) at their initial weight management clinic visit. Adolescents received a fitness tracker and counseling around activity data in addition to standard treatment. A caregiver of adolescents in the dyad group also received a fitness tracker. Satisfaction with the fitness tracker, fitness tracker utilization patterns, and physical activity patterns were evaluated over 3 months. RESULTS: A total of 88 adolescents were enrolled, with 69% (61/88) being female, 36% (32/88) black, 23% (20/88) Hispanic, and 63% (55/88) with severe obesity. Most adolescents reported that the fitness tracker was helping them meet their healthy lifestyle goals (69%) and be more motivated to achieve a healthy weight (66%). Despite this, 68% discontinued use of the fitness tracker by the end of the study. There were no significant differences between the adolescent and the dyad group in outcomes, but adolescents in the dyad group were 12.2 times more likely to discontinue using their fitness tracker if their caregiver also discontinued use of their fitness tracker (95% CI 2.4-61.6). Compared with adolescents who discontinued use of the fitness tracker during the study, adolescents who continued to use the fitness tracker recorded a higher number of daily steps in months 2 and 3 of the study (mean 5760 vs 4148 in month 2, P=.005, and mean 5942 vs 3487 in month 3, P=.002). CONCLUSIONS: Despite high levels of satisfaction with the fitness trackers, fitness tracker discontinuation rates were high, especially among adolescents whose caregivers also discontinued use of their fitness tracker. More studies are needed to determine how to sustain the use of fitness trackers among adolescents with obesity and engage caregivers in adolescent weight management interventions

LC/MS-Based Quantitative Proteomic Analysis of Paraffin-Embedded Archival Melanomas Reveals Potential Proteomic Biomarkers Associated with Metastasis

BACKGROUND: Melanoma metastasis status is highly associated with the overall survival of patients; yet, little is known about proteomic changes during melanoma tumor progression. To better understand the changes in protein expression involved in melanoma progression and metastasis, and to identify potential biomarkers, we conducted a global quantitative proteomic analysis on archival metastatic and primary melanomas. METHODOLOGY AND FINDINGS: A total of 16 metastatic and 8 primary cutaneous melanomas were assessed. Proteins were extracted from laser captured microdissected formalin fixed paraffin-embedded archival tissues by liquefying tissue cells. These preparations were analyzed by a LC/MS-based label-free protein quantification method. More than 1500 proteins were identified in the tissue lysates with a peptide ID confidence level of >75%. This approach identified 120 significant changes in protein levels. These proteins were identified from multiple peptides with high confidence identification and were expressed at significantly different levels in metastases as compared with primary melanomas (q-Value<0.05). CONCLUSIONS AND SIGNIFICANCE: The differentially expressed proteins were classified by biological process or mapped into biological system networks, and several proteins were implicated by these analyses as cancer- or metastasis-related. These proteins represent potential biomarkers for tumor progression. The study successfully identified proteins that are differentially expressed in formalin fixed paraffin-embedded specimens of metastatic and primary melanoma

0524 Polysomnographic Characteristics of Adolescent Patients with Class III Obesity and Severe OSA (AHI ≥30)

Abstract Introduction Adolescents with obesity are at increased risk for obstructive sleep apnea (OSA). Polysomnographic characteristics of pediatric patients with severe OSA (defined as AHI ≥30 events/hour) have not been frequently described. This study aims to describe clinical characteristics and polysomnographic data from a cohort of adolescents with both severe (class III, BMI ≥40 kg/m2) obesity and severe OSA. Methods This IRB-approved, retrospective review examines clinical and polysomnographic data from pediatric patients (ages 8-18) at Nemours Children’s Hospital, Wilmington, Delaware, who had initial baseline diagnostic polysomnogram performed from December 2012-September 2021. Subgroup analysis and descriptive statistics were performed in patients with severe OSA (AHI ≥30 events/hour). Results 259 (mean age 15.2 years, range 8 – 18 years, 64.4% female, 40.2% white, 46.7% black, mean BMI 50.3 kg/m2) pediatric patients with severe obesity completed initial baseline diagnostic polysomnogram in the study period. Of these patients, 41/259 (15.8%) met criteria for severe OSA (mean age mean age 15.4 years, range 12 – 18 years, 43.9% female, 46.3% white, 43.9% black, mean BMI 53.7 kg/m2). Of these studies, the mean total AHI was 65.2 (range 31.4-159.4) events/hr, obstructive apnea index (OAI) of 11.4 (range 0 – 69.4) events/hr and hypopnea index of 47.8 (range 12.9 – 108.8) events/hour. Mean SpO2 nadir was 78.9 (range 52 – 98)% with peak ETCO2 of 53.2 (range 39 – 69) mmHg. 12/41 (29.2%) of patients met polysomnographic criteria for hypoventilation (EtCO2 &amp;gt;50 mmHg for &amp;gt;25% of TST). Sleep architecture was notable for decreased mean sleep efficiency at 62.8% and elevated arousal index (mean 62.4 arousals/hour). Conclusion Adolescents with both severe OSA and obesity demonstrated a high frequency of hypopneas compared to apneic events and disrupted sleep architecture with high arousal index and decreased sleep efficiency. Interestingly, even among those with severe OSA, ventilation was acceptable in a majority of the patients. Further analysis will be completed to correlate patient clinical characteristics, including co-morbidities and lung function measurements, to help identify which patients with severe obesity are at risk for the most severe OSA. Support (If Any) None </jats:sec

Aberrant Fatty Acid-Binding Protein-7 Gene Expression in Cutaneous Malignant Melanoma

Fatty acid-binding protein-7 (FABP7) has been shown to be expressed in cutaneous melanoma; however, its role in tumor progression is unclear. Expression of FABP7 was assessed during melanoma progression through assessment of various clinicopathology stages of primary tumor progression and metastasis. FABP7 mRNA was highly expressed in 60 of 87 (69%) primary melanomas, compared with significant (P<0.0001) reduction in 13 of 68 (19%) metastatic melanomas. Analysis of 37 paired primary and metastatic melanomas by immunohistochemistry with anti-FABP7 Ab showed 73 and 27% positivity, respectively (P<0.001). FABP7 detection of metastatic tissues was inversely correlated with relapse-free (P<0.0001) and overall (P<0.0001) survival. To examine FABP7 expression loss in advanced melanomas, loss of heterozygosity (LOH) was assessed using microsatellite markers encompassing the FABP7 gene. LOH was identified in 10 of 20 (50%) metastatic melanomas at 6q22.31, compared with 0 of 14 primary melanomas (P=0.0017). FABP7 as a surrogate biomarker for circulating tumor cells (CTCs) in the blood was assessed by quantitative real-time (qRT)–PCR from melanoma patients’ blood (n=134). Assessment of patients’ blood showed that FABP7(+) CTC decreased with disease progression. FABP7 may function as a tumor progression gene and can be used as a potential diagnostic biomarker of early-stage melanoma systemic spreading in blood

B7-H3 Associated with Tumor Progression and Epigenetic Regulatory Activity in Cutaneous Melanoma

B7-H3, a cell surface transmembrane glycoprotein, was assessed for its functional and prognostic role in cutaneous melanoma progression. B7-H3 expression in melanoma cells was shown to be related to specific downstream signal transduction events as well as associated with functional epigenetic activity. B7-H3 expression and prognostic utility were shown by reverse transcription and real-time PCR and immunohistochemistry analysis on individual melanoma specimens and then verified in clinically annotated melanoma stage III and stage IV metastasis tissue microarrays in a double-blind study. B7-H3 messenger RNA expression was shown to be significantly increased with stage of melanoma (P<0.0001) and significantly associated with melanoma-specific survival in both stage III (P<0.0001) and stage IV (P<0.012) melanoma patients. B7-H3 expression was related to migration and invasion; overexpression of B7-H3 increased migration and invasion, whereas knockdown of B7-H3 reduced cell migration and invasion. MiR-29c expression was shown to inversely regulate B7-H3 expression. Furthermore, we demonstrated that melanoma B7-H3 expression was correlated to phosphorylated signal transducer and activator of transcription-3 activity level in melanoma tissues and cell lines. These studies demonstrate that B7-H3 is a significant factor in melanoma progression and events of metastasis