Colorectal Cancer, Socioeconomic Distribution and Behavior: A Comparative Analysis of Urban and Rural Counties in the USA

Background: Colorectal cancer (CRC) ranks second for all cancer related deaths among men and women together and third for either sex when considered separately. Disparities exist in CRC incidence and mortality between rural and urban counties in the USA. This study sought to explore socioeconomic and behavioral factors that may partly explain these observed differences. Methods: Using educational and income levels as measures of socioeconomic status (SES), and average alcohol consumption and smoking frequency as behavioral factors, data from the Behavioral Risk Factor Surveillance System (BRFSS) and the Surveillance, Epidemiology, and End Results (SEER) program for analysis were coupled. Results: Results showed statistically significant inequalities for CRC incidence (t = 2.678, p = 0.010) and mortality (t = 2.567, p = 0.013), as well as socioeconomic (i.e., poverty; t = 5.644, p < 0.001) and behavioral (i.e., smoking; t = 2.885, p = 0.006) factors between selected rural and urban counties. Regression analysis for colorectal cancer incidence and mortality rates at the rural, urban, and national levels yielded relative impacts of smoking frequency, alcohol consumption, and educational level. Conclusions: Health policies aimed at reducing disparities between rural and urban populations in the USA must therefore adequately address SES and behavioral factors. Key words: colorectal cancer, rural health, social determinants of health, health behavio

Racial residential segregation and colorectal cancer mortality in the Mississippi Delta Region

INTRODUCTION: Few studies have examined the effects of racial segregation on colorectal cancer (CRC) outcomes, and none has determined whether rurality moderates the effect of racial segregation on CRC mortality. We examined whether the effect of segregation on CRC mortality varied by rurality in the Mississippi Delta Region, an economically distressed and historically segregated region of the United States. METHODS: We used data from the US Census Bureau and the 1999-2018 Surveillance, Epidemiology, and End Results (SEER) program to estimate mixed linear regression models in which CRC mortality rates among Black and White residents in Delta Region counties (N = 252) were stratified by rurality and regressed on White-Black residential segregation indices and 4 socioeconomic control variables. RESULTS: Among Black residents, CRC mortality rates in urban counties were a function of a squared segregation term (b = 162.78, P = .01), indicating that the relationship between segregation and CRC mortality was U-shaped. Among White residents, main effects of annual household income (b = 29.01, P = .04) and educational attainment (b = 34.58, P = .03) were associated with CRC mortality rates in urban counties, whereas only annual household income (b = 19.44, P = .04) was associated with CRC mortality rates in rural counties. Racial segregation was not associated with CRC mortality rates among White residents. CONCLUSION: Our county-level analysis suggests that health outcomes related to racial segregation vary by racial, contextual, and community factors. Segregated rural Black communities may feature stronger social bonds among residents than urban communities, thus increasing interpersonal support for cancer prevention and control. Future research should explore the effect of individual-level factors on colorectal cancer mortality

Psychological Resilience and Cognitive Function Among Older Military Veterans.

The purpose of this study was to explore the association between psychological resilience and cognitive function in military veterans. We obtained public-use data from the Health and Retirement Study (HRS) for this cross-sectional study of military veterans aged 52 to 101 years (n = 150). We estimated a multivariable linear regression model in which cognitive function served as the dependent variable and psychological resilience served as the independent variable. After controlling for demographics, health conditions, and health behaviors, veterans who had higher psychological resilience scores had better cognitive function (b = 0.22, p = 0.03). Our findings suggest that psychological resilience may be associated with cognitive function among veterans. These findings highlight the importance of assessing psychological resilience in gerontological social work practice

Social Support Mediates the Relationship Between Mental-Physical Multiple Morbidities and Engagement in Aerobic Physical Activity Among Military Service Members and Veterans

Some research shows that physical activity levels are low among veterans, but research gaps exist specifically in regards to promoting physical activity in veterans with multiple morbidities. For the present study, we retrieved data from the 2015 Behavioral Risk Factor Surveillance System. The study sample included 57,842 military service members and veterans. We carried out a mediation analysis to determine the effect of social support on the relationship between multiple morbidities and aerobic physical activity. Social support partially mediated the relationship between the presence of multiple morbidities and aerobic physical activity, a*b= -0.003, [95% CI = -0.007, -0.001]. Programs aimed at facilitating adequate social support among service members and veterans with multiple morbidities may increase their uptake of aerobic physical activity, and thus, decrease concomitant risk for health-related disorders. </p

Military veteran residential location and risk for Lyme disease

Some research has shown that Lyme disease cases among U.S. military veterans have increased since the early 2000s. The purpose of the present study was to determine whether high concentrations of military veterans live in areas where Lyme disease is hyper-endemic. Lyme disease case-report data for 2015 were retrieved at the county-level from the Centers for Disease Control and Prevention. Veteran population density at the county level was determined using data from the U.S. Census. County control variables, such as weather patterns, forestation, and socioeconomic conditions were retrieved from various sources. Multiple linear regression was used to examine associations between variables. After controlling for county-level environmental and social conditions, results showed that military veteran population density was positively associated with Lyme disease incidence rates. Military veterans, due to their choice of geographic residence and recreation, may be a population at risk for developing Lyme disease. </p

Military Veteran Residential Location and Risk for Lyme Disease

Some research has shown that Lyme disease cases among U.S. military veterans have increased since the early 2000s. The purpose of the present study was to determine whether high concentrations of military veterans live in areas where Lyme disease is hyper-endemic. Lyme disease case-report data for 2015 were retrieved at the county-level from the Centers for Disease Control and Prevention. Veteran population density at the county level was determined using data from the U.S. Census. County control variables, such as weather patterns, forestation, and socioeconomic conditions were retrieved from various sources. Multiple linear regression was used to examine associations between variables. After controlling for county-level environmental and social conditions, results showed that military veteran population density was positively associated with Lyme disease incidence rates. Military veterans, due to their choice of geographic residence and recreation, may be a population at risk for developing Lyme disease.Population Healt

Exposure assessment of process-related contaminants in food by biomarker monitoring

Exposure assessment is a fundamental part of the risk assessment paradigm, but can often present a number of challenges and uncertainties. This is especially the case for process contaminants formed during the processing, e.g. heating of food, since they are in part highly reactive and/or volatile, thus making exposure assessment by analysing contents in food unreliable. New approaches are therefore required to accurately assess consumer exposure and thus better inform the risk assessment. Such novel approaches may include the use of biomarkers, physiologically based kinetic (PBK) modelling-facilitated reverse dosimetry, and/or duplicate diet studies. This review focuses on the state of the art with respect to the use of biomarkers of exposure for the process contaminants acrylamide, 3-MCPD esters, glycidyl esters, furan and acrolein. From the overview presented, it becomes clear that the field of assessing human exposure to process-related contaminants in food by biomarker monitoring is promising and strongly developing. The current state of the art as well as the existing data gaps and challenges for the future were defined. They include (1) using PBK modelling and duplicate diet studies to establish, preferably in humans, correlations between external exposure and biomarkers; (2) elucidation of the possible endogenous formation of the process-related contaminants and the resulting biomarker levels; (3) the influence of inter-individual variations and how to include that in the biomarker-based exposure predictions; (4) the correction for confounding factors; (5) the value of the different biomarkers in relation to exposure scenario’s and risk assessment, and (6) the possibilities of novel methodologies. In spite of these challenges it can be concluded that biomarker-based exposure assessment provides a unique opportunity to more accurately assess consumer exposure to process-related contaminants in food and thus to better inform risk assessment

Extensive sequencing of seven human genomes to characterize benchmark reference materials

The Genome in a Bottle Consortium, hosted by the National Institute of Standards and Technology (NIST) is creating reference materials and data for human genome sequencing, as well as methods for genome comparison and benchmarking. Here, we describe a large, diverse set of sequencing data for seven human genomes; five are current or candidate NIST Reference Materials. The pilot genome, NA12878, has been released as NIST RM 8398. We also describe data from two Personal Genome Project trios, one of Ashkenazim Jewish ancestry and one of Chinese ancestry. The data come from 12 technologies: BioNano Genomics, Complete Genomics paired-end and LFR, Ion Proton exome, Oxford Nanopore, Pacific Biosciences, SOLiD, 10X Genomics GemCode WGS, and Illumina exome and WGS paired-end, mate-pair, and synthetic long reads. Cell lines, DNA, and data from these individuals are publicly available. Therefore, we expect these data to be useful for revealing novel information about the human genome and improving sequencing technologies, SNP, indel, and structural variant calling, and de novo assembly

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival