2018PosterDay

Imagecredit:ATaleofDespair:IncomeInequalityandMortalityfromDrugs,Alcohol,andSuicideintheUnitedStates.Chun-TungKuo,IchiroKawachi

eareverypleasedtowelcomeyoutothe2018HarvardChanPosterDay.ThiseventprovidesavaluableopportunityformembersoftheSchooltoengagein

interdisciplinaryinteracGon,toshareresearchresultsandtogeneratenewideas.Thisbookletisacomprehensivedossieroftheabstractsthataccompanyeachposterbeingpresentedtoday.Pleaseuseitasaguide.ItoutlinesalloftheresearchthathasbeensubmiIedinordertomakeyourvisittoPosterDayeasiertonavigate.ThankyouforyourparGcipaGoninthe2018HarvardChanPosterDay.Wehopethatyouenjoythisspecialevent.Sincerely,HarvardChanPosterDayOrganizingCommiIee

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PresentaGonListPosterNumber

Presenter Title

1 BoyaAbudu TheRoleofHealthInsuranceintheDiagnosisofEarlyversusLate-StageMelanomainNon-ElderlyAdults

2 VictorBarrera AccessibleandScalableBioinformaGcsfortheHarvardCommunity

3 JacobBeckerman EnvironmentalandEconomicCostsandOpportuniGesofShelf-StableDairyandSoyMilkinSchoolMeals

4 ChrisGneBohne SeasonalWork,InterruptedCare:AQualitaGveStudyofMaternalandChildHealthGapsofSeasonalBrickKilnWorkersinBihar,India

5 KarelBrinda LineagecallingcanidenGfyanGbioGcresistantcloneswithinminutes

6 ClaireCadeau DietaryandsupplementalvitaminCandriskofbreastcancer:EvidencefromtheNurses’HealthStudy

7 BrendhaCação TheroleofPhotobiomodulaGoninhypoxiaandLPSinducedexosomeformaGonandcellularuptakeinlungepithelialcells

8 SeungmanCha Cause-specificperformanceinchildmortalityreducGonduringtheMillenniumDevelopmentGoalsera:acountrylevelanalysis

9 SeungmanCha

Cost-benefitanalysisofsource-basedwaterimprovementthroughboreholedrillingorrehabilitaGon:anempiricalstudybasedonaclusterrandomizedcontrolledtrialinVoltaRegion,Ghana

10 AdeelChaudhry SIMDADiseaseSurveillanceSystem:CaseStudyandUsabilityEvaluaGon

11 MyDzungChu Leveragingreal-GmedatatoidenGfydeterminantsofindoorPM2.5exposuredispariGesatthecommunity-level

12 FernandaEstevan MVBandexosomesmodulaGonbyhypoxiaandototoxicdrugs

13 RogerFigueroaAutonomousmoGvaGon,sugar-sweetenedbeverageconsumpGon,andhealthybeverageintakeinUSfamilies:Differencesbetweenmother-adolescentandfather-adolescentdyads

14 AaronFisher ModelClassReliance:VariableImportanceMeasuresforanyMachineLearningModelClass,fromthe“Rashomon”PerspecGve

15 KaitlinHagan Bodysizethroughoutthelifecourseandriskofvenousthromboembolism

PresentaGonListPosterNumber

Presenter Title

16 Wan-TingHsu Preadmissionuseofaspirinorclopidogrelonsepsisoutcome:apopulaGon-basedcohortstudy

17 Chong-ChiChiuComparisonofoutcomeandcostbetweentheopen,laparoscopic,androboGcsurgicaltreatmentsforcoloncancer:apropensityscore-matchedanalysisusingnaGonwidehospitalrecorddatabase

18 Yu-TienHsu TimingofFamilyAdversityduringAdolescenceandImpactonAlcoholandTobaccoIniGaGon:ALongitudinalStudy

19 Wang-TingHsu Cost-effecGvenessAnalysisofHigh-sensiGveTroponinTVersusConvenGonalTroponinITesGngforAcuteMyocardialInfarcGon

20 Wang-TingHsu Effectofrenin-angiotensin-aldosteronesysteminhibitorsonshort-termmortalityajersepsis:apopulaGon-basedcohortstudy

21 PragaGJaiswal BuildingacaseforintegratedcommunityhealthprogramsinKenya

22 Z.BegumKalyoncu AssessingdietaryacculturaGonamongfirstgeneraGonimmigrants:Ascopingreview

23 RockliKimContribuGonofSocioeconomicFactorstoExplainingVariaGoninBodyMassIndex:AnAnalysisof1,212,758Womenfrom58Low-andMiddle-IncomeCountries

24 JungyeonKim IsScale-UpofHepaGGsCScreeningandTreatmentwithDirect-acGngAnGviralsWorthIt?EconomicAnalysisofHepaGGsCinSouthKorea

25 KaislaKomulainen SocioeconomicposiGonandintergeneraGonalassociaGonsofidealhealthbehaviors

26 NithinKondapuram Psycho-SocialPredictorsofSuicideamongFarmersinIndia

27 MikaKunieda PeersupportforcorrectknowledgeonvaccinaGoninNiamey,Niger:amulGlevellogisGcalregressionanalysis

28 Chun-TungKuo ATaleofDespair:IncomeInequalityandMortalityfromDrugs,Alcohol,andSuicideintheUnitedStates

29 OmolaraUwemedimoDistribuGonanddeterminantsofpneumoniadiagnosisusingIntegratedManagementofChildhoodIllnessguidelines:anaGonallyrepresentaGvestudyinMalawi

30 WenyuanLi WeatherandRiskofMigraineHeadacheOnsetAmongMigraineurs

PresentaGonListPosterNumber

Presenter Title

31 Ming-ChiehLi WaistcircumferenceinrelaGontooutcomesofinferGlitytreatmentwithassistedreproducGvetechnologies

32 GangLiu MeatCookingMethodsandRiskofHypertension

33 GuilhermeMagnavita Interimanalysisofanon-inferiorityRCTcomparingS+KetaminetoRacemicKetamineforrefractorydepression

34 PamelaMarGnez NegaGvefrequency-dependentselecGonmodelsinepidemiology

35 AmandaMcClainChildhoodfoodinsufficiencyandadulthoodcardiometabolichealthcondiGonsamongapopulaGon-basedsampleofelderlyadultsinPuertoRico

36 SusannaMitro Childhoodabuse,inGmatepartnerviolence,andplacentalabrupGonamongPeruvianwomen

37 SeranneMoGlal Painismorelikelytobemoderate-severe,race-baseddifferencesinreceivingopioidanalgesicspersist.

38 DanielMyran AssociaGonBetweenNeighborhoodMarginalizaGonandAlcoholAvailabilityinOntario,Canada

39 FeibyNassan MarijuanasmokinginrelaGontosemenquality,spermDNAintegrityandreproducGvehormonesamongmenfromaferGlitycenter

40 KaterinaNozhenko SocioeconomicstatusindicatorsanduseofendocrinedisrupGngchemical-associatedpersonalcareproductsinpregnantwomen

41 ScoIOlesen ThedistribuGonofanGbioGcuseanditseffectonanGbioGcresistance

42 AdamOsborne InvesGgaGngtheRoleofMitochondrialDNARepairinCellularSensiGvitytoDNADamagingAgents

43 Hae-RyungPark IdenGficaGonofnovelERstresssuppressorsusingagenome-wideCRISPRscreenandimplicaGoninearlybraindevelopment

44 CorIPieICellularHeterogeneitywithRespecttoDNARepairCapacity:DevelopmentandApplicaGonofaFluorescence-BasedPlapormforDetecGngRepairDeficientSubpopulaGons

45 RamyaPinnamaneni MaternalKnowledge,Aqtude,PracGcesduringchildhooddiarrhea(India)

PresentaGonListPosterNumber

Presenter Title

46 MaryPiper OpGmizingNGS-baseddataanalysistraining

47 SaranyaRamakrishnan ABusinessCaseforImprovingPaGentExperienceinPediatricRadiologyUsingDesign-Thinking

48 CailinJoyce AcGvatedTGFbsignalinginearlyhematopoieGcprogenitorspromotesbonemarrowfailureinShwachman-DiamondSyndrome

49 SujataSaunik Economic,publichealthanddiseaseanalysisofinsurancebasedhealthschemesinMaharashtra,India.

50 RumaniSingh Smallmoleculeinhibitors(BH3mimeGcs)ofpro-survivalBCL-2familyproteins,aspotenGaltherapeuGcsfortherapyresistantglioblastomas

51 ConanSo ExaminingtheAssociaGonBetweenFuncGonintheAcuteCareSeqngandHospitalOutcomes

52 RockyStroudNeuropsychiatricGeneGcsofAfricanPopulaGons-PsychosisStudy:ExpandingKnowledgeofGeneGcandEnvironmentalRiskFactorsforSchizophreniaandBipolarDisorderinAfrica

53 SanjanaSundaresan Genome-WideAssociaGonStudyofNeuroblastomainChildrenofAfrican-AmericanDescent

54 AndrewSynn CigareIeSmokeExposureandRadiographicPulmonaryVascularMorphologyintheFraminghamHeartStudy

55 MarthaTamez Changesindiet,lifestylebehaviors,andbodyweightovertwoyearsinMexicanwomen

56 LukeTillman Mntoxicityandeffectsonpolarizedhepatocytes

57 SnehToprani MeasuringDNArepaircapacityinhumanbloodcellssubtypesusingFluorescenceMulGplexHostCellReacGvaGon(FM-HCR)assays

58 GurolTuncman Leveragingmetaboliccontroltopreventasthma

59 KelseyVercammen FoodInsecurityandPredicted10-YearCardiovascularDiseaseRiskAmongAdultsintheUnitedStates

60 JenniferYlandEvaluaGonoftheIntrafollicularFluidInflammatoryNetworkinPaGentswithUnilateralEndometriomaanditsRelaGonshipwithIVFOutcomes:AmulGplexproteomicanalysis

PosterAbstracts1.TheRoleofHealthInsuranceintheDiagnosisofEarlyversusLate-Stage

MelanomainNon-ElderlyAdultsBoyaAbudu,AlanGeller,MPH

Objec3ve: Health insurance plays a criGcal role in the access and quality of health care formelanomapaGents in theUnited States. This studyexamined theassociaGonbetweenhealth insurance status anddiagnosisofearlyversuslate-stagemelanomainnon-elderlyadults.Methods:DatawascollectedfromtheNaGonalCancerDatabasebetween2004to2015onnewcasesofmelanomaforpaGents26to64yearsofage.AlogisGcregressionmodelusingStata/MP15.0wasusedtotestforcorrespondencebetweenhealthinsurancestatus(uninsured,private,Medicaid,andunknown)andmelanomastage.Results:Usingprivatehealthinsurancestatusasthereference(OR=1.00)intheassociaGonbetweenlate-stage (III, IV) versusearly-stage (0, I, II)melanomadiagnosis, crude logisGc regressiondemonstrated thefollowing:uninsuredOR=2.84(95%CI2.71-2.99),MedicaidOR=3.82(95%CIof3.65-4.01),andunknowninsuranceOR=1.30(95%CI1.21-1.41).AllresultswerestaGsGcallysignificant(p-value<0.001).Conclusion:Medicaidwasassociatedwiththehighestriskforlate-stagemelanomafollowedbyuninsuredstatus.UnknownandprivateinsurancewereprotecGveagainstlate-stagediagnosiscomparedtoMedicaidanduninsuredstatus.Significance:Thisstudysupportstheroleofhealthcarereforminimprovinghealthinsurancebenefitsandscreening pracGces to improve early detecGon of melanoma and to reduce dispariGes in late-stagemelanomadiagnosis.

2.AccessibleandScalableBioinformaGcsfortheHarvardCommunityVictorBarrera

Objec3ve:RapidtechnologicaldevelopmenthasenabledHarvardresearcherstogeneratelargedatasetsthat require complex analyses. This presents a challenge: experGse may not be available withinexperimental labs, making it difficult to ensure accurate and reproducible results. The objecGve of theHarvard Chan BioinformaGcs Core (HBC) is to provide best pracGce bioinformaGcs support to theseresearchersinascalableandcollaboraGvefashion.Methodsandconduct:Employingateamof11bioinformaGcianswithdiversebiologicaldomainexperGseandskillsets,theHBCtriestosupportcommonbioinformaGcsissues.Todoso,theHBCiniGatedanopensource,communitydevelopedsetofworkflowscalledbcbio,whosedevelopment issteeredbyconGnualre-assessmentofnewmethodsandbioinformaGcsneedsatHarvard.Inthisprocess,theHBCfollowsbestpracGcesandusesdocumentedtoolswhereverpossible.Outcomes: Through its bcbio infrastructure, the HBC can support the majority of next generaGonsequencingrelatedresearchrequests,withworkflowsinplacefortheanalysisofbulkRNA-seq,singlecellRNA-seq, small RNA-seq, variant sequencing, bisulfite sequencing, and ChIP-seq, as well as funcGonalanalysisbygenesetenrichment.TheHBChassupportedhundredsofgrantsandanalysesofallsizes,fromsmallexpressionstudies to studies involving thousandsofwholegenomes.Manyof theseconsultshaveresultedinhighprofilepublicaGons.

PosterAbstracts3.EnvironmentalandEconomicCostsandOpportuniGesofShelf-StableDairy

andSoyMilkinSchoolMealsJacobP.Beckerman,StacyA.Blondin,ScoGRichardson,EricRimm

Objec3ves:ToesGmateeconomicandenvironmentalimpactsofreducingmilkwastefromtheBreakfastintheClassroom(BIC)SchoolBreakfastProgrambyreplacingconvenGonalmilkwithshelf-stabledairyorsoymilk.Methods and Materials: To esGmate the net greenhouse gas emissions (GHGE, kg CO2e) of replacingconvenGonal milk with shelf-stable dairy or soy milk, we adapted exisGng life cycle assessments andEnvironmentalProtecGonAgencyWasteReducGonModelesGmatestoBICparameters.WeesGmatednetcostusingUSschoolmealpurchasingdata.Results:ReplacingconvenGonaldairymilkwithshelf-stabledairyorsoymilkwouldreducemilk-associatedGHGE28.6% (0.12kgCO2e)or82.2% (0.34kgCO2e)per studentpermeal, respecGvely.NaGonally, thisequatestodriving220millionor633millionfewermilesannually,respecGvely.Thischangewouldincreasemilkcosts1.9%($0.005)or59.4%($0.163)perstudentpermeal,respecGvely.Conclusions: Replacing convenGonal milk with shelf-stable dairy and/or soy milk would substanGallyreduce waste and concomitant GHGE in BIC with low net costs, while providing nutriGous opGons forchildren.Workontheacceptabilityof theseopGons iswarrantedtoopGmize thenutriGonalvalue,cost,andsustainabilityofBIC.ImpactandSignificance:Underthe2016NaGonalEnvironmentalPolicyAct,theUnitedStatesDepartmentofAgricultureshouldconsidershelf-stablemilkstoenhanceschoolmealsustainability.

4.SeasonalWork,InterruptedCare:AQualitaGveStudyofMaternalandChildHealthGapsofSeasonalBrickKilnWorkersinBihar,India

ChrisKneBohne

Objec3ves: Asmany as 50millionwomen and children could be residing as seasonalmigrant brick kilnworkers(SMBKWs)inIndia.ThisprojectexploresthechallengesSMBKWsfaceinidenGfying,accessing,andreceivingmaternalandchildhealth(MCH)services.Methods: The research took place in four blocks in Patna District, Bihar. In-depth interviews (IDIs) andfocusgroupdiscussions(FGDs)wereconductedusingsemi-structuredguideswithapurposivesampleofwomen,men, brick kilnmanagers, and healthworkers. ParGcipants were asked about experiences andpercepGonsoffactorsaffecGngbarrierstocareforMCHservices.AcontentanalyGcalapproachwasusedthroughwhichthemesweredevelopedandelaboratedonwithillustraGvequotes.Results: 48 IDIs and 2 FGDs were conducted. System level barriers to MCH care arising from theexploitaGvenatureofthebrickkilnindustry,theabsolutepowerthemanagerholds,thesocialsegregaGonworkers experience from the local populaGon, sGgma and discriminaGon by health workers, and thedelivery mechanisms of government schemes which systemaGcally exclude seasonal migrants wereidenGfied.Conclusions:ThereisaneedforsystemaGcinvestmentsinknowledgeanddataaroundseasonalmigrants.ExisGng programs should bemigrant-sensiGve in order to ensure conGnuity of care as peoplemigrate.Impact:SMBKWsaresystemaGcallyexcludedfromsocialservices,asexisGngpolicieshavefailedtoprovideprotecGon.

PosterAbstracts5.LineagecallingcanidenGfyanGbioGcresistantcloneswithinminutes

KarelBrinda,LaurenA.Cowley,AlannaCallendrello,ThemoulaCharalampous,JusKnO’Grady,MichaelBaym,WilliamP.Hanage

TheproblemofanGbioGcresistanceposesmulGplechallengestohealthcaresystems.CliniciansmustmakerapiddecisionsonappropriatetreatmentintheabsenceofdataonwhetherthepaGentissufferingdiseasedue to a drug resistant organism. There is hence great interest in developing more rapid diagnosGcs,deployable at the point of care and in resource poor seqngs, with a parGcular focus on the use ofgenomics.TradiGonalmethodsfordetecGngresistance,basedonculGvaGon,typicallyrequireseveraldays.However,modernsequencingtechnologiesenabledtodetectresistancefromsequencingreadsobtaineddirectly from a paGent metagenomic sample. For instance, assembly- and alignment-based approacheshave recently been shown to detect resistance ofM.tuberculosis within the same day. In this talk, wepresent methods to match a sample against a database of known genomes, from isolates for whichresistance has already been determined, and predict resistance based on the anGbiograms of the bestmatches.WedemonstrateusingtheexampleofpneumococcusandfiveanGbioGcs(penicillin,cejriaxone,trimethoprim, erythromycin, and tetracycline) that we can idenGfy known resistant clones, and theirserotype,onastandardlaptopwithinminutes.OursoluGonissuitableforapplicaGonseveninresource-poorcountries,makingitnotonlyusefulfordiagnosinginfecGons,butalsoenhancingsurveillance.

6.DietaryandsupplementalvitaminCandriskofbreastcancer:EvidencefromtheNurses’HealthStudy

ClaireCadeau(Ph.D.),WalterWilleG(M.D.,Dr.P.H.),HeatherEliassen(Sc.D.)

Objec3ve:ToprospecGvelystudytheassociaGonbetweentotal,dietaryandsupplementalvitaminCintakeandbreastcancerrisk.MethodsandMaterials:Between1980and2012,7,619invasivebreastcancersoccurredin88,042womenfromtheNurses’HealthStudy(NHS).DataonvitaminCintakehavebeencollectedevery2-4yearsthroughavalidated foodfrequencyquesGonnaireandspecificquesGonsondietarysupplementuse.MulGvariateHazardRaGos(HRs)and95%confidenceintervals(CIs)forincidentinvasivebreastcancerwereesGmatedwithCoxmodels.Results: During follow-up, 67% of parGcipants ever used supplements containing vitamin C, includingmulGvitamins.CumulaGvetotal(HRforquinGle5vs.1:1.02,95%CI:0.94,1.11),dietary(HRforquinGle5vs.1:1.00,95%CI:0.92,1.08)orsupplemental(HRforquinGle5vs.1:1.02,95%CI:0.92,1.13)vitaminCintakewasnot associatedwithbreast cancer risk. Complementary analyseswereperformedbut resultsremainednull.Conclusion:WedidnotobserveanyassociaGonbetweenvitaminCintakeandbreastcancerrisk.Impact and Significance: Previous studies suggested that high supplemental vitamin C intake could beassociatedwithanincreasedriskofbreastcancerbutothersdidnot.Ourstudy,whichisthefirstcohortstudy with regularly updated quanGtaGve data on vitamin C intake, does not support this associaGon.Acknowledgments:NCI(CA050385andCA186107),FondaGonARCandPhilippeFoundaGon.

PosterAbstracts7.TheroleofPhotobiomodulaGoninhypoxiaandLPSinducedexosome

formaGonandcellularuptakeinlungepithelialcellsBrendhaCação,DevinM.Jones,ElisaGhelfi,YohannGrondin,MagdaBortoni-Rodriguez,JamesCarroll,

AdamBartos,Rick.A.RogersandRosalindaSepulvedaObjec3ves: PhotobiomodulaGon (PBM) could be a possible treatment that bypasses the physiologicallimitaGonofthepulmonarycompartmentandsuppresseshypoxicstress-inducedexosomeformaGon.OurgoalistoinvesGgatetheeffectofPBMonexosomeformaGonandcellularuptakeduringLPSandhypoxicstress.MethodsandMaterials:ExosomewererecoveredfromA549humanlungcarcinomacellstreatedwithacombinaGon of LPS, hypoxia, and 810 nm near-infrared LEDs. Exosomes were collected byultracentrifugaGon,labeledwithfluorescentdyeCFDASEandincubatedatequalconcentraGonswithnaïveA549cells(3hours).Results:ExosomeuptakebynaïvecellsincreasedsignificantlywhendonorcellswereexposedtoLPSandhypoxia (+85% p<0.01). Uptake was reduced when naïve were treated with PBM (-11% p<0.05).Conclusions:Exosomeuptake by naïve cells varieswith the stress condiGon experienced by donor cellssuggesGngadifferentbiochemicalsignature.ThatuptakeisalteredbyPBM.Impact and significance: Exosomes parGcipate in cell-to-cell communicaGon by delivering proteins andRNAto targetcells.Althoughthemessagecarriedbyexosomedetermines theresponseof therecipientcells, ourdata suggest that the strengthof thatmessage canbedeterminedat thedonor cell.AbeIerunderstandingofexosomeuptakecouldleadtonewtherapeuGcapplicaGonsforthelung.

8.Cause-specificperformanceinchildmortalityreducGonduringtheMillenniumDevelopmentGoalsera:acountrylevelanalysis

SeungmanCha,PatrickBanda,PaulMansiangi,JinYan

Objec3ves:Cause-specificchangeinchildmortalityhasbeenanalyzedatglobalorregionallevel.Weaimto explore the annual changes in cause-specific mortality at country level to understand what causescontributedmosttochildmortalityreducGonin2000-2015.Methods andMaterials:Wederived the average annual changes in cause-specificmortality rates usingpublisheddataonchildmortalityin2000-2015forthe75developingcountries,where95%maternalandchilddeathsoccurred.Results:Chinaistheonlycountrysuccessfullyreducedneonatalmortalityineverycause.In20among45sub-SaharanAfricancountries,malaria-specificchildmortality reducGonwasthemaincontributorof theprogress.Inotherregions,pneumoniawasthemaincontributorofchildmortalityreducGon,rangingfrom46.6%ofcontribuGontoall-causechildmortalityreducGoninPakistanto26.8%inCambodia.InLesotho,South Africa, and Zimbabwe, AIDS-specific child mortality reducGon contributed 60%-95% of overallprogress.Conclusions: In many Countdown countries, successful performance in single disease masked theunsuccessful progress in other disease, and the success in all-cause child mortality reducGonmisrepresentedthepoorperformanceincause-specificmortalityreducGons.Impact and Significance: The findings provide global communitywith evidence for formulaGng country-specificstrategytoacceleratechildmortalityreducGon.

PosterAbstracts9.Cost-benefitanalysisofsource-basedwaterimprovementthrough

boreholedrillingorrehabilitaGon:anempiricalstudybasedonaclusterrandomizedcontrolledtrialinVoltaRegion,Ghana

SeungmanCha,InseoCho,SharonKim,YoungjooLee,YoungwhanKim,SoonyoungChoi,PatrickAsuming,JinYan

Objec3ves: We aim to esGmate the cost-benefit of source-based water improvement intervenGons inresourcepoorseqngsandhard-to-reachareas.MethodsandMaterials:PredicteddiarrhealreducGonsofthepopulaGonwerecalculatedonthebasisoftheempiricalfindingsfromaclusterrandomizedcontrolledtrial.ThefullinvestmentandtheesGmaGonofannualrunningcostswereusedforcalculaGngtheintervenGoncosts.Directeconomicbenefitsofavoidingchilddiarrhealdisease,indirecteconomicbenefitsrelatedtohealthimprovement,andnon-healthbenefitsrelated to water improvement were esGmated. A one-way and mulG-way sensiGvity analyses wereperformedtodeterminetherobustnessofthefindings.Results:Ourstudyshowsthat thereturnonaUS$1 investmentwasUS$8.1 forboreholedrillingandUS$12.3 for borehole rehabilitaGon. Time savings were the main contributor, covering 68% of benefitsfollowed by economic benefits of averted child deaths contribuGng to 14%. The results of sensiGvityanalyses suggest that improving water source is yielding high returns at all Gmes and boreholerehabilitaGonoutweighsboreholedrilling.Conclusions:Thecost-benefitraGoofboreholerehabilitaGonisremarkablecomparedwithothertargetedhealthintervenGonssuchasmicronutrientforGficaGonordewormingtreatmentforchildren.ImpactandSignificance:ThestudyprovidesevidenceformakinginformeddecisionofresourceallocaGonandpriorityseqngs.

10.SIMDADiseaseSurveillanceSystem:CaseStudyandUsabilityEvaluaGonAdeelChaudhry,GezielSousaPhD,AntonioNetoMDPhD,MarciaCastroPhD

‘Sistema de monitoramento diario de agravos’ (SIMDA), which translates as ‘daily disease monitoringsystem’ in English, is an innovaGve disease surveillance system in the municipality of Fortaleza, Ceara,Brazil that georeferences and public reports noGfiable disease cases. PanAmericanHealthOrganizaGon(PAHO)andtheNaGonalBrazilianMinistryofHealthare interested inscaling this informaGonsystemtothenaGonaldengueprogramandreplicaGngtheprograminothermunicipaliGes.Tothisextent,in2017,PAHOhighlightedSIMDAasaglobalmodelforbestpracGces.WhilepreviouspublicaGonshaveanalyzedSIMDAgenerateddata,nopriorpublicaGonshaveassessedtheeffecGvenessorusabilityoftheinformaGonsystem.Consequently,primaryobjecGvesofthiscasestudyandusabilityevaluaGonaretodocumentthehistoricalcontextandstrategicdevelopmentofSIMDA,measuretheusabilityofthesystem,andevaluatethe effecGveness of the informaGon system for scaling purposes. To measure the relaGve usability ofSIMDA in comparison to other disease surveillance systems, system users voluntarily completed twowidely-used informaGon system usability quesGonnaires, the system usability scale (SUS) and theusefulness, saGsfacGon, and ease of use (USE) quesGonnaire. Survey results, as well as stakeholderinterviews, idenGfiedkey successes, limiGng factors,and futureprospects for scalingand replicaGng thisdiseasesurveillancesystem.

PosterAbstracts11.Leveragingreal-GmedatatoidenGfydeterminantsofindoorPM2.5

exposuredispariGesatthecommunity-levelMyDzungT.Chu,SaraGillooly,JoseVallarino,LacyReyna,GaryAdamkiewicz

PM2.5 is a keydeterminantof indoor air quality and cardiorespiratoryhealth.Aspartof theCenter forResearchonEnvironmental& Social Stressors inHousingacross the LifeCourse,we invesGgated indoorPM2.5sourceswithinsmallspaGalandtemporalscales.For72householdsinChelsea,MA,wecollectedin-home and outdoor PM2.5, housing, & acGvity data across 1week for 2 seasons using real-Gme sensorplaporm, visual assessments, and surveys. We assessed predictors of indoor PM2.5 by season usingmulGvariable linearmixed-effectmodels.HouseholdsweremostlyHispanic (49%), renters (54%),& low-income(<$50K)(54%).Meanlevelswere10.3µg/m3(SD:60.2)forsummer&9.6µg/m3(30.2)forwinter.Acrossseasons,significantpredictors(p<0.05)wereGmeofday(β=1.16-2.18)&outdoorPM2.5(β≥1.43).Also significantwere use of gas stoves (vs. electric) (β=2.05) & having visitors who smoked (β=4.55) insummer, and weekend cooking (β≥3.23), residenGal smoking (β=2.72), & weekday status (β=1.07) inwinter.Riskfactorsvariedsocio-demographically:rentersweremorelikelytosmoke(8.5x),homeownersmoreojenhadgasstoves(1.3x)&low-incomehouseholdscookedlonger(≥60min.:1.72x).Ourfindingsunderscorevalueofreal-GmedatatoidenGfyGme-varyingpredictorsofindoorPM2.5.Seasonaleffectsarelikely driven by factors related to air exchange. The socioeconomic paIerning of risk factors implicatestargetsforreducingexposureandhealthdispariGes.

12.MVBandexosomesmodulaGonbyhypoxiaandototoxicdrugsFernandaEstevan,ElisaGhelfi,BrendhaCacao,DevinJones,AdamBartos,MagdaBordoni,Yohann

Grondin,RosalindaSepulveda,RickRogers

Background:Hearinglosscanbeinducedbyototoxicdrugsandhypoxia.Westudyhowpericytesfromthecapillary network in the lateral wall of the inner ear respond to stress induced by the ototoxic drugsgentamicin(GTM)andcisplaGn(CIS),andhypoxia.HypoxiccondiGonshavebeenknowntoassociatewithloudnoiseevents.CellsreleaseexosomesinphysiologicalandpathologicalcondiGons.ExosomesaresmallvesiclesthatcanactinintercellularcommunicaGonandalsosheddamagedproteins.StudiessuggestthatexosomesoriginatefrommulGvesicularbodies(MVB)insidethecytoplasm.Inthisstudy,welookatMVBmarkers to beIer understand how themechanisms of exosome formaGon and release aremodified bypathologicalcondiGons.Methods: Lysate was obtained from pericytes exposed to the stressors GTM, CIS, and hypoxia. Thefollowing markers from MVB were tested with Immunobloqng: Alix, TSG101, CHMP1, and HIF1α.Exosomeswereobtainedandmeasuredfrompericytessupernatant.Results:TheexpressionofAlix,CHMP1decrease inhypoxia.CIS increases theexpressionofTSG101andCHMP1 in normoxia and doubles it in hypoxia. GTM decreases the expression of HIF1 in hypoxia.Conclusions:InhypoxiccondiGons,proteinexpressionofMVBmarkersdecreased,suggesGngadecreaseinexosomesformaGonandproducGon.CisplaGn,alone,andincombinaGonwithhypoxia, increasesproteinexpressionofmarkersforMVB.

PosterAbstracts13.AutonomousmoGvaGon,sugar-sweetenedbeverageconsumpGon,and

healthybeverageintakeinUSfamilies:Differencesbetweenmother-adolescentandfather-adolescentdyads

RogerFigueroa,BegümZ.Kalyoncu,JaclynA.Saltzman,KirstenK.DavisonObjec3ve:ToassessinterdependenteffectsofautonomousmoGvaGontolimitsugar-sweetenedbeverage(SSB)consumpGon inrelaGontoSSBandhealthybeverage(HB) intake inmother-adolescentandfather-adolescentdyads.Methods: An Actor-Partner Interdependence Modeling (APIM) approach was used to construct andanalyzetwoAPIMsformother-adolescent(n=1225)andfather-adolescentdyads(n=424).Thefirstmodelassessed actor effects and partner effects of autonomous moGvaGon on SSB consumpGon in mother-adolescent and father-adolescent dyads. The second model assessed actor and partner effects ofautonomousmoGvaGononHBintake.Results:Inthefirstmodel,actoreffectsweresignificantforadolescents,butnotfortheirparents.Partnereffectsweresignificantformother-adolescent,butnotfather-adolescentdyads.Inthesecondmodel,actoreffectswere significant for adolescents and parents in all dyadic combinaGons. Adolescent autonomousmoGvaGon had a significant partner effect on HB intake for mothers and fathers, but only maternalautonomousmoGvaGonhadasignificanteffectonadolescentHBintake.Conclusions:WefoundsignificantinterdependenteffectsofautonomousmoGvaGoninrelaGontoSSBandHB intake in mother-adolescent and father-adolescent dyads for 11 out of 16 pathways modeled.Significance: Our study expands on current research by taking a dyadic systems approach to addressfamily-levelpublichealthproblems.

14.ModelClassReliance:VariableImportanceMeasuresforanyMachine

LearningModelClass,fromthe“Rashomon”PerspecGveAaronFisher,CynthiaRudin,FrancescaDominici

Objec3ves:FormalizetoolsfromtheVariableimportance(VI)literatureinordertoask:(1)doesaspecificpredicGonmodelrelyonagivensetofvariablesinordertopredictwell,and(2)howmuch,orhowliIle,couldanotherpredicGonmodelrelyonthesevariableswhilesGllperformingwell?Methods: The building block of our proposed approach, Model Reliance (MR), compares a predicGonmodel’sexpectedlosswiththatmodel’sexpectedlossonapairofobservaGonsinwhichthevalueofthecovariateofinteresthasbeenswitched.ExpandingonMR,weproposeModelClassReliance(MCR)astheupperandlowerboundsonthedegreetowhichanywell-performingpredicGonmodelwithinaclassmayrelyonavariableofinterest,orsetofvariablesofinterest.WegiveprobabilisGcboundsforMRandMCR,whichcanbegeneralizedtocreatefinite-sampleconfidenceregionsforthebest-performingmodelsfromany class.We also illustrate connecGons betweenMR, condiGonal causal effects, and linear regressioncoefficients.WeproposeabinarysearchproceduretocomputeesGmatesofMCR.WethenapplyMR&MCR in a public dataset of Broward County criminal records to study the reliance of (hypotheGcal)recidivismpredicGonmodelsonsexandrace.Conclusions&Significance:Oftherecidivismmodelsintheclassweconsidered,nowellperformingmodelhadahighexplicitrelianceonsexorrace,althoughimplicitrelaGonshipsviacriminalhistoryarepossible.

PosterAbstracts15.Bodysizethroughoutthelifecourseandriskofvenous

thromboembolismKaitlinA.Hagan,LauraB.Harrington,JihyeKim,SaraLindstrom,CarlosA.Camargo,FrancineGrodstein,

ChristopherKabrhelObjec3ves: Adult body mass index (BMI) is strongly associated with venous thromboembolism (VTE),howeverwhetherearlier-lifeadiposityorothermeasuresofadultbodysizeareassociatedwithVTEriskremainsunknown.MethodsandMaterials:WeevaluatedassociaGonsofchildhoodsomatotype,BMIinearlyadulthood,andmeasuresofadultbodysizewithincidentVTEamong200,959parGcipantsfromtheNurses’HealthStudies(NHS/NHSII)andtheHealthProfessionalsFollow-UpStudy(HPFS)withoutapriorVTE.CoxproporGonalhazardsmodelswereusedcalculatemulGvariable-adjustedhazardraGos(HR)ofVTE.Results:AdultBMIandwaistcircumferencewerestronglyassociatedwithVTE inall threecohorts.BodysizeinchildhoodandyoungadulthoodwerenotsignificantlyassociatedwithVTErisk,ajeraccounGngforadult BMI. Increasing weight gain was significantly associated with VTE ajer adjusGng for current BMIamongwomen(NHS:1.36[95%CI:1.12,1.65],NHSII:1.48[95%CI:1.17,1.87])butnotmen(HPFS:1.20[95%CI:0.97,1.50],Ptrend=0.38)Conclusions:AdultBMIandwaistcircumferencewereposiGvelyassociatedwithincidentVTErisk.EarlylifebodysizewasnotsignificantlyassociatedwithVTEriskajeraccounGngforadultBMI.ImpactandSignificance:Theseresults indicatethatBMIandadiposityare likelymore importantacutelythatcumulaGvelyoverGmeintheeGologyofVTE.Clinically,encouragingweightlossinadultscouldalsohelpreduceVTErisk.

16.Preadmissionuseofaspirinorclopidogrelonsepsisoutcome:a

populaGon-basedcohortstudyWan-TingHsu,LorenzoPorta,Tzu-ChunHsu,Chien-ChangLee

Objec3ves:WeaimedtoexaminetheeffectofthepreadmissionanGplatelettreatmentonsepsisoutcome.MethodsandMaterials:WeconductedapopulaGon-basedcohortstudyontheNaGonalHealthInsuranceResearch Database of Taiwan. The associaGon between anGplatelet drugs use and 90-day mortality ofsepsis paGents was determined by Cox proporGonal hazard models, adjusGng for either individualcovariatesorapropensityscore.RestrictedmeansurvivalGme(RMST)analysiswasperformedasawayofsensiGvityanalysis.Results: Of 52,982 paGents with sepsis, 12,776 were assigned to pre-hospital uses of aspirin, 1,125 toclopidogrel,and39,081didnotreceiveanyanGplateletdrugs.Prehospitaluseofaspirinwithin90daysofsepsis was associated with a decreased risk of mortality (PS-adjusted HR: 0.89, 95%CI: 0.84-0.93).Prehospitaluseofclopidogrel,however,wasnotfoundbeneficial(PS-adjustedHR:1.06,95%CI:0.94-1.20).RMSTanalysisconfirmedthebeneficialeffectofaspirinwhichincreasedmeansurvivalGmeby1.31days(95%CI:0.42-2.19),whencomparedtononuse.Conclusion:Our study confirms thatprehospitaluseof aspirin reducesmortality inpaGentswith sepsis,whiletheuseofclopidogreldoesnot.ImpactandSignificance:Tothebestofourknowledge,thecurrentstudyisbyfarthelargestonetostudytheeffectofanGplatelettreatmentonsepsisoutcome.

PosterAbstracts17.Comparisonofoutcomeandcostbetweentheopen,laparoscopic,androboGcsurgicaltreatmentsforcoloncancer:apropensityscore-matched

analysisusingnaGonwidehospitalrecorddatabaseChong-ChiChiu,JamesJChoi,Tzu-ChunHsu,BrandonGalm,Wan-TingHsu,Meng-tseGabrielLee,Chia-Na

Chang,Chien-ChangLee

Objec3ves:WeaimedtocomparethethreesurgicalmodaliGesforcoloncancertreatment.Methods and Materials: We conducted a populaGon-based cohort study using the US NaGonwideInpaGent Sample database. PaGents with a primary diagnosis of colon cancer who underwent roboGc,laparoscopic, or open surgeries between2008 and2012were eligible for enrollment.We compared in-hospitalmortality, complicaGons, length of hospital stay, and cost for paGents undergoing oneof thesethreeproceduresusingamulGvariateadjustedlogisGcregressionanalysisandpropensityscorematching.Results:Ofthe386,505paGentsundergoingsurgicaltreatmentforcoloncancerduringthestudyperiod.Compared to those undergoing laparoscopic surgery, paGents undergoing open surgery had a highermortality rate (OR 2.39, 95% CI 2.04-2.80), more general medical complicaGons (OR 1.60, 95% CI1.50-1.72),alongerlengthofhospitalstay(6.38vs.4.47days),andhighertotalcost($15,541vs.$13,686)in the propensity score matched cohort. Mortality rate, general medical complicaGons, and length ofhospitalstaywereequivalentinthelaparoscopicandroboGcsurgerygroups,butmediancostwaslowerinthelaparoscopicgroup($14,102vs.$16,600USD).Conclusions: Robot-assisted surgery had comparable outcomes but higher cost as compared tolaparoscopicsurgery.Impact and Significance: Our study included a large naGon-wide sample was a large and staGsGcallypowerfulcohortstudy.

18.TimingofFamilyAdversityduringAdolescenceandImpactonAlcoholandTobaccoIniGaGon:ALongitudinalStudy

Yu-TienHsu,MD,MPH,IchiroKawachi,MD,PhD

Background: We examined the impact of Gme-varying exposure to family adversity, including parentalconflict,parentalabsencefromhome,divorce,andparentaldeath,ontheGmingofdrinkingandsmokinginiGaGonamongTaiwaneseyouthbetweenages14and22years.Method:Weuseddatafromalongitudinalpanelstudybetween2001and2009.ThepopulaGonwasdrawnfromnorthernTaiwanandincluded2,689seventh-gradersand2,757ninth-graders.Weselectedsixwaves,at which the students were aged 14, 15, 16, 18, 20, and 22 years. At each wave we inquired aboutexposuretofamilyadversityandrecentiniGaGonofsubstanceuse.Results:SmokinganddrinkinginiGaGonincreasedwithage.ExposuretoparentalconflictanddivorceandparentaldeathincreasedtheriskofdrinkingandsmokinginiGaGon.TheoddsraGos(OR)forsmokinganddrinkinginiGaGonamongyouthexperiencingparentalconflictswere1.33(95%CI:1.10–1.73)forsmokingand 2.00 (95%CI: 1.26–3.20) for drinking. TheOR for parental deathwere 2.96 (95%CI: 1.69–5.18) forsmoking,and8.07(95%CI:1.79–36.49)fordrinking.Conclusion:ExperiencingfamilyadversityisassociatedwithahigherriskoftobaccoandalcoholiniGaGonamongyouth.TheassociaGonbecomesmorepronouncedatage18(thelegalagefordrinkinginsmoking),andlastsunGlearlyadulthood.Implica3on: The study offers insight into idenGfying a populaGon with a high need for substance useprevenGonandintervenGon.

PosterAbstracts19.Cost-effecGvenessAnalysisofHigh-sensiGveTroponinTVersusConvenGonalTroponinITesGngforAcuteMyocardialInfarcGon

Wan-TingHsu,BrandonGalm,Chien-ChangLee

Objec3ves: A clinical decision model was designed to evaluate the cost-effecGveness of 0-hour/1-houralgorithm of high-sensiGvity cardiac troponin T (hs-TnT) assays compared to the convenGonal diagnosispathwayamongadultpaGentswithsymptomssuggesGveofacutemyocardialinfarcGon.Methods and Materials: EffecGveness or efficacy data were abstracted from the a Japan-TaiwanesevalidaGonstudy,healthcareprocessandhumanresourcesdatawereextractedfromtheelectronicmedicalrecord database of a terGary hospital in Taiwan, and cost data were derived from the NaGonal HealthInsurance Research Database of Taiwan from 2011 to 2013. The clinical outcomes were measured byquality-adjustedlifeyear.Results:ComparedtoconvenGonaldiagnosGcpathway,the0-hour/1-houraccelerateddiagnosisalgorithmresultedinfewerovernightemergencydepartmentstays(60.3%vs.24.1%),andfewercardiologyreferrals(32.4%vs.20.9%).Usinghs-cTnTiscost-savingwithbeIeroutcomes.Conclusions: The 0-hour/1-hour algorithm based on hs-TnT assays is cost effecGve in in emergencydepartmentsinAsia.Impact and Significance: A 0-hour/1-hour algorithm of hs-cTnT has been validated in Japan-TaiwanprospecGve cohort study, but cost-effecGveness analysis remains controversial. Our study is the firsteconomic evaluaGon of 0-hour/1-hour algorithm of hs-cTnT to aid decisionmakers in Asian healthcareseqng.20.Effectofrenin-angiotensin-aldosteronesysteminhibitorsonshort-term

mortalityajersepsis:apopulaGon-basedcohortstudyWan-TingHsu,BrandonGalm,GregorySchrank,Wan-ChienLee,Chien-ChangLee

Objec3ves: Antagonists of the renin-angiotensin-aldosterone system (RAAS), including angiotensinconverGngenzymeinhibitors(ACEI)andangiotensinIIreceptorblockers(ARB),maypreventorganfailureandreducemortality.TodeterminewhetherspecificRAASinhibitorsareassociatedwithreducedmortalityinpaGentswithsepsis.MethodsandMaterials:TheNaGonalHealthInsuranceResearchdatabasewasusedtoconductacohortstudyusingaCoxproporGonalhazardsregressionmodel.TodirectlycompareACEIusers,ARBusers,andnonusers,athree-waypropensityscore(PS)matchingapproachwasalsoconducted.Results: A total of 52,727 paGents were hospitalized with sepsis between 2001 and 2011. In the PS-matchedanalysis,priorACEIusewasassociatedwithdecreased90-daymortality(HR,0.85;95%CI,.78–.93)comparedtonon-users.PriorARBusewasassociatedwithdecreased90-daymortality(HR,0.87;95%CI,.82–.93).Conclusions:ComparedtothosewhowerenottakingRAASinhibitors,theshorttermmortalityajersepsiswas substanGally lower among thosewhowere already established on RAAS inhibitor treatment whensepsisoccurred.Impact and Significance: Use of a large populaGon-based sepsis cohort allowed us to perform severalrigorousanalyses,includingthree-wayPSmatching,anacGvecomparatoranalysis,andsubgroupanalyses.OurstudycouldbeabreakthroughfindingtoprovethebenefitsofpreadmissionuseofRAASinhibitorsinpaGentswithsepsis.

PosterAbstracts

21.BuildingacaseforintegratedcommunityhealthprogramsinKenyaPragaKJaiswal

Policymakersacross theglobehaverealized thatbuildingstrongprimaryhealthcaresystem iscrucial toachievingUniversal Health Coverage. Community health represents a key component of strong primaryhealthcare systems.Thepresentworkaims todevelopan investmentcaseof integratedapproaches tocommunity health and idenGfy barriers and facilitators to developing a sustainable community healthsysteminadecentralizedgovernancestructureusingKenyaasacasestudy.KenyaunderwentdevoluGonin 2010 and adoptedCommunityHealth Strategyunderwhichper every 5000people therewill beoneCommunityHealthDevelopmentUnit that acts afirstpointof care for the community. Fijeen in-depthqualitaGveinterviewswereconductedwithstakeholdersfromKenya’sMinistryofHealth,UNICEF,USAIDand selectedNGOs. The level of integraGonof these twoNGOswithin thehealth system funcGonswasanalyzedusingtheframeworkdesignedbyAtunetal.ThestudyfoundthatajerdevoluGonhappeneditisincumbentuponthecountygovernmentstoimplementtheintegratedcommunityhealthprogramsintheircounGes,alotofwhichdependsonthepoliGcalwilloftheleadership.Evenintheintegratedprograms,thedonorsconGnuetofundtheirareaofinterests.TheinferencefromtheIDIscertainlyvalidatesthebenefitsof having an integrated community health programbut challenges arounduncertain sGpend, highworkconGnuestopersist.

22.AssessingdietaryacculturaGonamongfirstgeneraGonimmigrants:Ascopingreview

Z.BegumKalyoncu,PhDc,MSAmandaMcClain,PhD,MSKirstenK.Davison,PhD,MS

DietaryacculturaGon is theprocessof immigrantsadopGng thedietof ahost country, and is related toimmigranthealthoutcomes.AssessmentofdietaryacculturaGonhasbeeninconsistent.OurobjecGvewastoconductascopingreviewtoexaminetoolsandsummarizefindingsofdietaryacculturaGonassessmentamong various immigrant groups. A scoping reviewwas conductedwith three databases (Medline, CABand CINAHL). Two invesGgators reviewed these and narrowed to 37 studies (11 quanGtaGve and 25qualitaGve) assessing (quanGtaGvely) or understanding (qualitaGvely) dietary acculturaGon of first-generaGon immigrant adults. Dietary acculturaGon assessment tools in the quanGtaGve studies differedacross immigrant groups for the same host countries. Over half of the tools were not validated. Usingdifferent tools for each immigrant group created heterogeneity in pooled assessment of health effects.QualitaGvestudiesemployedavarietyofqualitaGvemethods (e.g. interviews, focusgroups,parGcipantobservaGon,etc.),primarilywithwomen.ThisisthefirstscopingreviewtoinvesGgatetheassessmentofdietary acculturaGon. Results suggest that a common assessment tool for each host country mayharmonize research, though tools should also capture immigrant group-specific dietary experiences.Assessmenttoolsshouldnotonlyassessfoodandbeverageintake,butalsothelargersocial,cultural,andenvironmentalcontextofeaGng.

PosterAbstracts23.ContribuGonofSocioeconomicFactorstoExplainingVariaGoninBodyMassIndex:AnAnalysisof1,212,758Womenfrom58Low-andMiddle-

IncomeCountriesRockliKim,IchiroKawachi,BrentA.Coull,SVSubramanian

Objec3ves: ToesGmate theextent towhichbasic socioeconomic factors contribute tovariaGon inbodymassindex(BMI)acrossdifferentpopulaGons.MethodsandMaterials:Thelatestcross-secGonalDemographicandHealthSurveys(2005-2016)from58low- and middle-income countries were pooled for 15-49 year old women with complete data onanthropometricmeasures.EsGmatesfrommulGlevelvariancecomponentmodelsforBMIwerecomparedbefore and ajer adjusGng for age and socioeconomic factors (place of residence, educaGon, householdwealth,andmaritalstatus).Results:Of1,212,758womennestedwithin64,764communiGesand58countries,wefoundthatmajorityof variaGon in BMI was aIributed to between-individual differences (80%) and the remaining wasbetween-populaGon differences (14% for countries and 6% for communiGes). Socioeconomic factorsexplained a large proporGon of between-populaGon variance in BMI (15% for countries and 47% forcommuniGes), but less than 2% of inter-individual variance. In country-specific models, we foundsubstanGal variaGon in themagnitude of between-individual differences (86%-99%) and the proporGonexplainedbysocioeconomicfactors(1%-5%).Conclusions:We consistently founddisproporGonately largeunexplainedbetween-individual variance inBMI.ImpactandSignificance: InferenGalquesGonstargeGngwithin-andbetween-populaGonsareimportantlyinter-relatedandshouldbeconsideredsimultaneously.

24.IsScale-UpofHepaGGsCScreeningandTreatmentwithDirect-acGng

AnGviralsWorthIt?EconomicAnalysisofHepaGGsCinSouthKoreaJungyeonKim,MarkusHaacker,SalmaanKeshavjee,RifatAtun

ThispaperaimstoanalyzetheeffectsofpolicyintervenGonsonthestateandconsequencesofhepaGGsCepidemicinKorea,toassessthecostsofalternaGvepolicies,andtosupportacost-effecGvenessanalysisonpolicy choices with respect to the coverage of screening and treatment in Korea. We constructed acompartmentalageandsexstructuredmodelofprogressionhepaGGsCandanalyzedtheeconomicimpactofexpansionofscreeningandDAAstreatmentandthecost-effecGvenessofdifferentpolicyintervenGonsregardingthisexpansion.TheexpansionofaccesstoDAAstreatmenthighlyimprovedthefutureepidemicofhepaGGsCby reducing theprevalenceof chronichepaGGsCand themortality related tohepaGGsC.Status-quo,screening fromag60,screening fromage40andscreening fromage20werecost-effecGve.Thebiggest returntothetreatmentofhepaGGsCatearlystageoccurred in latersavings in thecostsofcareespeciallyincirrhosistreatment.Theongoingstatus-quopolicywithexpansionofDAAstreatmentandthenaGonalregularscreeningprogramappearstobehighlycost-effecGve incontrollingtheepidemicbyreducingprevalenceof chronic infecGons from0.3percent of the adults populaGon to a projected0.05percentby2030.OurstudyconfirmstheimportanceofrapidexpansionofthetreatmentwithDAAsandnaGonalregularscreeningprogramsforthehepaGGsCeliminaGon.

PosterAbstracts25.SocioeconomicposiGonandintergeneraGonalassociaGonsofidealhealth

behaviorsKaislaKomulainen,MurrayMiGleman,MarkusJokela,TomiLaiKnen,KatjaPahkala,MarkusJuonala,Olli

Raitakari,LauraPulkki-Råback

Objec3ves:PromoGngidealhealthbehaviorsisanobjecGveoftheAmericanHeartAssociaGon(AHA)2020goals.WeassessedthehypothesisthatidealhealthbehaviorstransmitfromparentstotheiroffspringandthathighersocioeconomicposiGon(SEP)promotesthetransmissionofidealbehaviors.MethodsandMaterials:DatawerefromtheCardiovascularRiskinYoungFinnsStudy.Weincluded1856parGcipantswhohaduptothreerepeatedmeasurementsofSEP(educaGon,incomeandoccupaGon)andsmoking status, BMI, physical acGvity and diet. Parental SEP and health behaviors were collected fromparents at baseline. We categorized health behaviors as ideal vs non-ideal using the AHA definiGons.IntergeneraGonal associaGons were examined in mulGvariable-adjusted mulGlevel regression models.Results: Overall, each addiGonal parental ideal behavior was associated with 28% higher odds for oneaddiGonal ideal behavior among offspring (OR=1.28, 95% CI, 1.17,1.39). Furthermore, ORs for theseintergeneraGonal associaGons were greater among offspring whose parents had higher educaGonalaIainment(p=0.009)orwhothemselveshadhighereducaGonalaIainment(p=0.02).SimilartrendswereseenwithparentalincomeandoffspringoccupaGon.Conclusions: These data suggest that higher SEP in parents or their offspring may enhance theintergeneraGonalconGnuumofidealhealthbehaviors.Impactandsignificance:Policiesenhancingsocialmobilitymayimprovehealthbehaviors.

26.Psycho-SocialPredictorsofSuicideamongFarmersinIndiaNithinKondapuram,KSChetanKumar,VHMChaitra,KanchanaRamachandran,NithyanandaS

Introduc3on:Farmers’suicideinIndiaisacauseofconcernandgovernmentfigures,thoughconservaGve,predictanimpendingepidemic.Around16,000farmerscommitsuicideeveryyearespeciallyduetofamilyissues. Our study reflects upon the paIern and psychosocial predictors of suicide among farmers.Methods: We conducted a Secondary data analysis of NCRB 2015 and 2016 data. Along withSociodemographic factors,financial status,violenceonpartners, substanceuse, typeofwork, the familysetupandotherdetailswereassessedandmulGvariablelogisGcregressionmodelswereusedtoexaminetherelaGonshipbetweenpsychosocialfactorsinaddiGontoabovefactorsandoutcomes.Results:Majorityare inagricultural laborers intheagegroupof20-39with lowliteracyandgotmarriedrecently (1-2 years) There is highalcohol and tobaccouseamong themandweremore violent towardspartners1-2monthsbeforecommiqngsuicide.Thelowmoodwashighlyprevalent2-3monthsbeforethedeath.Wifebeingpregnant,staying inanuclearsetup,havingagirlchildbelowtheageof5yearswereprotecGvefactorsagainstsuicide.WivesofallfarmerswereincontactwithASHAworkers,ANMsandVROsviaPanchayat.Conclusion: Most of the factors are avoidable and can easily be brought under surveillance throughexisGngongroundresourceslikeASHAworkers,ANMs,VROs.IfthesefactorsareidenGfiedearlythroughexisGngresources,wecanpreventamajorityoftheseSuicides.

PosterAbstracts27.PeersupportforcorrectknowledgeonvaccinaGoninNiamey,Niger:a

mulGlevellogisGcalregressionanalysisMikaK.Kunieda

Background and Objec3ves: VaccinaGon has contributed in reducing child mortality worldwide. LiIle,however,isknownaboutcommunitylevelinfluenceonthemother’sdecisiontogetherchildcompletelyvaccinated.ThisstudywasconductedtoidenGfyfactorsassociatedwiththemother’sdecisiontovaccinateherchildandknowinghowmanyGmesshemusttakeherchild(underoneyearold)tothehealthcenterforvaccinaGon.Methods:Across-secGonalmulG-stagecluster samplingvaccinaGoncoverageandhouseholdvaccinaGonbehaviorquesGonnairesurveywasconductedinOctober2016,followingtheWHOclustersurveymethod.Thestudyoutcomewasthemother’scorrectknowledgeofhowmanyGmesachild(underoneyearold)mustbetakentothehealthcenterforvaccinaGon.Results: The mulGlevel logisGc regression found a staGsGcally significant associaGon between havingcorrect knowledge and having discussed vaccinaGonwith friends (AOR 2.07, 95% CI 1.00-4.26, p=0.05).Conclusions: Discussion with peers and their support had an influence on a mother having correctknowledgeofvaccinaGon.ImpactandSignificance:Socialnetworks influenceparentaldecision-makingandbehaviors inrelaGontochild vaccinaGon. The policy implicaGon is how best uGlize psychosocialmechanisms,which convert anindividual’sinformaGonandknowledge,tohealthliteracyandcommunity-leveldiseaseprevenGonacGons,whenimplemenGngpoliciesandprograms.28.ATaleofDespair:IncomeInequalityandMortalityfromDrugs,Alcohol,

andSuicideintheUnitedStatesChun-TungKuo,IchiroKawachi

Background:Risingmortalityamongmiddle-agedwhiteAmericanshascaused lifeexpectancy todeclinefor2consecuGveyears.CaseandDeatonhavenotedthispaIernisdrivenby“deathsofdespair”–deathsfromdrugoverdose,alcoholabuse,andsuicide.Objec3ves:WesoughttoexaminetherelaGonshipbetweenUSstateincomeinequalityanddeathsfromdrugs,alcohol,andsuicideamongnon-HispanicsWhitesaged25to64years.Methods:Dataonage-adjustedmortalityrates(1999-2016)wereobtainedfromCDCWONDERDeathFiles.TheGiniindexin1990andincomeandeducaGondatain2000wasfromtheUScensus.UsingamulGlevelmodelof3140counGesnestedwithin50states,weexaminedthecontextualeffectofstate-levelincomeinequalityonthedeathsofdespair.Results:AjeradjusGngforincomeandeducaGonlevel,eachunitincreaseintheGiniindexwasassociatedwith1.60excessdeathratesfordrugs,alcohol,andsuicideper100,000(95%CI=0.10,3.11)amongnon-HispanicWhitesbutnotforotherrace/ethnicgroup.HigherGiniwasrelatedtohigherdeathsfromdrugs,alcohol,andsuicideregardlessofthecounGes’incomelevel.Conclusions: Income inequality is related to higher drug, alcohol-related and suicide mortality amongworking-agednon-HispanicsWhites.ImpactandSignificance:BeyondafocusontheaddicGontreatmentandthesupplyofdrugs,responsestotheepidemicmustaddresstheinequalityofsocialandeconomiccondiGonsthatdrivethesedeaths.

PosterAbstracts29.DistribuGonanddeterminantsofpneumoniadiagnosisusingIntegratedManagementofChildhoodIllnessguidelines:anaGonallyrepresentaGve

studyinMalawiOmolaraT.Uwemedimo,ToddP.Lewis,ElsieA.Essien,GraceJ.Chan,HumphreysNsona,MargaretE.Kruk,

HannahH.Leslie

Objec3ve:SubopGmalclinicalevaluaGonofpneumoniaresults inmissedordelayeddiagnosisandexcessmorbidityandmortality.WeaimedtoesGmatethesensiGvityofpneumoniadiagnosisandinvesGgateitsdeterminantsamongchildreninMalawi.Methods:Weused data from the 2013-2014 Service ProvisionAssessment, a facility censuswith directobservaGon of care and re-examinaGon by trained observers. We calculated sensiGvity of pneumoniadiagnosisandusedlog-binomialregressiontoassessfactorsassociatedwithsensiGvity.Results:Clinicianscompleted30%(SD13%)ofIMCIguidelinesonaverageperencounter.573childrenmetIMCIcriteriaforpneumonia;118(21%)werecorrectlydiagnosed.AdvancedpracGcecliniciansweremorelikelythanotherproviderstodiagnosepneumoniacorrectly(ARR1.91,95%CI1.14,3.19).Clinicalqualitywasstronglyassociatedwithcorrectdiagnosis:sensiGvitywas23%forprovidersatthe75thpercenGleforguidelineadherencecomparedto14%atthe25thpercenGle.TrainingorsupervisionwerenotassociatedwithsensiGvity.Conclusions: DiagnosGc accuracy of pneumonia for Malawian children is poor. BeIer sensiGvity isassociated with provider type and IMCI adherence. ExisGng intervenGons are insufficient to improvesensiGvity.Significance: Most pneumonia cases are missed despite widespread disseminaGon of guidelines.AlternaGvequalityimprovementopGonsarerequiredifMalawiistomakestridesinchildsurvival.

30.WeatherandRiskofMigraineHeadacheOnsetAmongMigraineursWenyuanLi,SuzanneBerKsch,ElizabethMostofsky,CatherineBueGner,MichaelRueschman,MurrayA.

MiGleman

Objec3ves:Migraineisacommonrecurrentneurologicdisorder.AlthoughmigraineursojenaIributetheheadacheonsettoweathercondiGons,fewstudieshaveusedobjecGvelyrecordedmeteorologicaldatatoquanGfytheassociaGon.Methods:ThisisaprospecGvecohortstudyamong101adultsintheBostonareawithepisodicmigraine.For6weeks,parGcipantsworeacGgraphsandcompleteddailyquesGonnairestorecordmigraineheadacheonset,duraGon,andother lifestylefactors.Dailyaveragetemperature,relaGvehumidity,andbarometricpressure were from Logan Airport Weather StaGon. We conducted a nested case-crossover analysismatchedondayofweek.Bydesign,eachparGcipantwascomparedtothemselvesonheadachedaysandreferentdays.WeusedacondiGonallogisGcregressionmodelandadjustedforseason.Results:AninterquarGlerangelowerdailyaveragetemperature(10°F)andhigherrelaGvehumidity(27%)onthedayofmigraineheadachewereassociatedwith4%(95%CI0.94,1.15)and11%(95%CI0.98,1.25)higher odds of migraine headache onset compared to other days. The associaGon for temperatureappeared stronger in the cold season (October-March), while the associaGon for relaGve humidityappeared stronger in thewarm season (April-September). Barometric pressurewas not associatedwithmigraineheadacheonset.Conclusions: Lower temperature but higher relaGve humidity were associated with higher incidence ofmigraineheadache.

PosterAbstracts31.WaistcircumferenceinrelaGontooutcomesofinferGlitytreatmentwith

assistedreproducGvetechnologiesMing-ChiehLi,MarielArvizu,Yu-HanChiu,LidiaMinguez-Alarcon,JenniferFord,PaigeL.Williams,JohnC.

Petrozza,RussHauser,JorgeE.Chavarro

Objec3ves: To examine the relaGon between waist circumference (WC) and outcome of inferGlitytreatmentwithassistedreproducGvetechnologies(ART).Methods and Materials: We followed 258 women who underwent 371 ART (in vitro ferGlizaGon orintracytoplasmic sperm injecGon) cycles for inferGlity treatment at theMassachuseIs General Hospitalbetween 2010 and 2017. The women were divided into terGles of WC (<77.5, 77.5-87, >87 cm) atenrollment.WeusedgeneralizedlinearmixedmodelswithrandominterceptstomodeltheprobabilityoflivebirthaccounGngformulGpletreatmentcycleswhilealsoadjusGngforpotenGalconfoundersincludingbodymassindex(BMI).Results:MeanWCandBMIwere84cmand24.2kg/m2.WCwasinverselyrelatedtotheprobabilityoflivebirth.ThemulGvariableadjustedprobabilityof livebirth(95%CI) forwomen in increasingterGlesofWCwere 44% (34-55%), 31% (22-42%) and 30% (21-41%) (p, trend=0.04). When BMI and WC weresimultaneously considered, women with BMI≥25 and WC≥77.5, had the lowest live birth rate (28%(20-39%)), while women with BMI<25 andWC<77.5 had the highest (42% (32-54%)). The results weresimilarusingdifferentWCcut-offvalues.Conclusions: WC is inversely related to the probability of live birth among women undergoing ARTindependentlyofBMI.ImpactandSignificance:JointlyconsideringBMIandWCcouldidenGfywomenmostlikelytobenefitfromlifestyleintervenGonsaimedatimprovingtreatmentoutcomes.

32.MeatCookingMethodsandRiskofHypertensionGangLiu,GengZong,KanaWu,FrankB.Hu,WalterC.WilleG,DavidEisenberg,JohnForman,QiSun

Objec3ves:Toexaminecookingmethodsformeats(redmeats,chicken,orfish)inrelaGontohypertensionriskamongmenandwomenwhoconsumedmeatregularly(≥2servings/week).Methods: Study populaGon consisted of 32,925 women from the Nurses’ Health Study (NHS), 53,852women from the NHS II, and 17,104 men from the HPFS, who were free of hypertension, diabetes,cardiovasculardisease,andcanceratbaseline.Results:Wedocumented37,123incidenthypertensioncasesduring1.06millionperson-yearsoffollowup.Ajer mulGvariate adjustments including total consumpGon of red meats, chicken, and fish, a higherfrequency of open-flame and/or high-temperature cooking and a preference for highermeat donenesslevel were both independently associated with an increased hypertension risk.When comparing open-flameand/orhigh-temperaturecooking>15Gmes/monthwith<4Gmes/month, thepooledhazard raGo(HR) and 95% confidence interval (CI) of hypertension was 1.17 (1.12, 1.21; P<0.001). The associaGonspersistedwhendatawereanalyzedbyredmeatsandwhitemeats.TheseassociaGonswereaIenuatedbutremainedsignificantwhenfurtheradjusGngforbaselinebodymassindex.Conclusions:Ourresultssuggestthat,independentoftheamountofmeatconsumpGon,open-flameand/orhigh-temperaturecookingandhighdonenesslevelforbothredmeatsandwhitemeatsareassociatedwithamodestlyincreasedriskofhypertension.

PosterAbstracts33.Interimanalysisofanon-inferiorityRCTcomparingS+Ketamineto

RacemicKetamineforrefractorydepressionGuilhermeMagnavita,FelipeArgolo,LucasQuaranKni

Objec3ves:toassessefficacy,safetyandcondiGonalpowerofanon-inferiorityrandomizedcontrolledtrialcomparingS+ketamineagainstracemicketamineforrefractorydepression.Methods: this is a scheduled interim analysis at 50% enrolment. Efficacy was analysed for the binaryoutcomeofresponseontheMADRSscalebycalculaGngaonesided99.9%CIoftheriskdifference.Safetywasassessedbyanalysingmeansof theCADSSscale.CondiGonalpowerwascalculated throughanovelapproach by summing the probabiliGes of all possible scenarios which could reject the null hypothesisusingexactbinomials.AnRfuncGonforcalculaGngcondiGonalpowerinNItrialsaccordingtothismethodwas also developed, togetherwith another funcGon to calculate increments in sample size for adapGvedesigns.Results:therewere13(54%)responsesintheintervenGonand10(47%)inthecontrol.Alowerboundof39.96%was found for the 99.9%CI of themain outcome (NImargin of 20%).Mean differences on theCADSSacrossbothgroupswere-0.66(95%CI-11.5–10.25).CondiGonalpowerwas81.3%(assumingtrueresponserisksof70%forbothgroups)and90.5%(assumingthetrueresponseriskstobeasobservedsofar).Conclusions:S+KetamineseemstohaveanacceptableprofileofsideeffectsandefficacyascomparedtoRKetamine.Impact: a free and simple to use funcGon is developed in R for exact binomial condiGonal powercalculaGonsinNItrials.

34.NegaGvefrequency-dependentselecGonmodelsinepidemiologyPamelaMarKnezandMarcLipsitch

Manypathogensarehighlydiverse,beingdifficulttoeradicate.WelookedatdifferentnegaGvefrequency-dependent selecGonmodels proposed to explain this diversity. Our goal is to review thesemodels andunderstandhowtheirassumpGonsdiffer,howthesedifferencesdrivetheirconclusions,andwhataretheimplicaGonsfordiseasecontrol.

PosterAbstracts35.Childhoodfoodinsufficiencyandadulthoodcardiometabolichealth

condiGonsamongapopulaGon-basedsampleofelderlyadultsinPuertoRicoAmandaC.McClain&JosiemerMaGei

Objec3ve:Childhoodfoodinsufficiency(CFI)isrelatedtopoorchildhealth.Lessisknownaboutlong-termhealtheffects.WeaimedtotesttheassociaGonofCFIwithcardiometabolichealthcondiGons(CHC) inasampleofelderlyadults.Methods: We analyzed cross-secGonal data from the Puerto Rican Elderly: Health CondiGons Project(n=2,712), a longitudinal, populaGon-based sample of elderly adults (>60 y) in Puerto Rico. CFI wasreportedatwave2,andCHCsatwave1or2 (hypertension,diabetes,andcardiovasculardisease (heartaIack,heartdisease,andstroke)).Obesitywasassessedatwave2.MulGvariate-adjustedcomplexsurveylogisGc regression models tested overall and sex-straGfied associaGons of CFI and each CHC, and totalnumberofCHCs.Results: 31.8% reported CFI. 71.0% had hypertension, 33.0% had diabetes, 34.3% had cardiovasculardisease,29.5%hadobesity,and55.2%had≥2CHCs. Inadjustedmodels,CFIwasassociatedwithhigheroddsofhypertension(OddsRaGo(95%ConfidenceIntervals):1.4(1.0,2.0))and2CHCs(1.6(1.0,2.7))vs0.In sex-straGfied models, CFI was associated with CHCs only in men: hypertension (1.6 (1.0, 2.6)),cardiovasculardisease(1.7(1.1,2.6)),2CHCs(2.1(1.1,4.0)),and≥3CHCs(2.2(1.2,4.3))Conclusions:CFImayincreasetheoddsofhypertensionor≥2CHCinPuertoRicanadults,butmenmaybemoresensiGve.Impact/Significance: CreaGng strategies to prevent and reduce CFI may be a way to prevent eventualCHCs.

36.Childhoodabuse,inGmatepartnerviolence,andplacentalabrupGonamongPeruvianwomen

SusannaD.Mitro,SixtoE.Sanchez,HenryPalomino,BizuGelaye,MichelleA.Williams

Objec3ves: Experiencing childhood abuse (CA) or inGmate partner violence (IPV) is linked to adversepregnancy outcomes. We examined whether CA history and IPV in the current pregnancy areindependentlyandjointlyassociatedwithplacentalabrupGon(PA).Methods andMaterials:We recruited 662 PA cases and 665 full-term controls in Lima, Peru.We usedmulGvariatelogisGcregressiontocalculateoddsraGos,adjusGngforage,educaGon,andparity.Results: About 42%of cases and controls reportedCA; 50%of cases and49%of controls reported IPV.HistoryofanyCAwasnotassociatedwithPA,buthistoryofsevereCA(>1CAevent;25%ofwomen)wasassociatedwith38%increasedoddsofPA(aOR=1.38;95%CI:1.07-1.80)adjusGngforIPV.Therewasasmallbut nonsignificant associaGon between severe IPV (20% of women) and odds of PA (aOR=1.22; 95%CI:0.92-1.62), adjusGng for CA.Womenwho experienced severe CA and severe IPV had 2.06-fold (95%CI:1.25-3.40)higheroddsofPAthanwomenwhoexperiencednoorrareabuse.ThejointeffectofCAandIPVwas posiGve but nonsignificant on the mulGplicaGve (aOR=1.48; 95%CI: 0.79-2.79) and addiGve scale(RERI=0.70;95%CI:-0.39-1.78).Conclusions:We found joint and independent effects of CA and IPV on odds of PA, and evidence for adose-responserelaGonshipbetweenviolenceandPAodds.ImpactandSignificance:PublichealtheffortstopreventexposuretoviolenceormiGgateitseffectsmayimprovematernaloutcomes.

PosterAbstracts37.Painismorelikelytobemoderate-severe,race-baseddifferencesin

receivingopioidanalgesicspersist.SeranneMoKlal,ShravanthiSeshasayee

Background:AnexacerbatedconsequenceofAmerica’sdecades-longopioidepidemic, race-basedbiasesin opioid prescripGons ojen arise from emergency physicians being forced tomake decisions based oncues, ojen subconsciously. This study hypothesizes that if there is no incenGve to exhibit drug seekingbehavior,suchasincriGcalcare,theremustbenodifferenceinhowthesedrugsareprescribedtopaGentsofdifferentraces.Methods: We compared race-based odds of receiving IV opioids in the ICU using bivariate andmulGvariable logisGc regressionmodels, ajer adjusGng for demographic and clinical covariates, amongover45,000admissionsrecordedintheMIMIC-IIIdatabasebetween2002and2011.Results:BivariatelogisGcregressionmodelsbetweenraceandIVopioidprescripGon,foundthatHispanicsandWhitesappearedtobeequallylikely(OR=1.07(0.94;1.22))toreceiveanIVopioidprescripGon,butBlacks(OR=0.74)andOtherraces(OR=0.90(0.84;0.96))werelesslikelytodoso.AjeradjusGngformeanself-reportedpain score, age, sex, insurance,andOASIS (OxfordSeverityof Illness score), adjustedoddsraGosforBlacksandOtherracestoreceiveanIVopioidprescripGonwere0.74(0.68,0.80)and0.90(0.84,0.96),respecGvely,bothstaGsGcallysignificant.Conclusion:Ourfindingsindicatethateveninaseqngwherepainismorelikelytobemoderate-severe,race-baseddifferencesinreceivingopioidanalgesicspersist.

38.AssociaGonBetweenNeighborhoodMarginalizaGonandAlcoholAvailabilityinOntario,CanadaDanielMyran,JarvisChen,VaughanRees

Whilepreviousworkhas found that low-incomeneighborhoodshavehighernumbersofalcoholoutlets,the associaGon betweenmore nuancedmeasures of availability and socialmarginalizaGon are lesswellcharacterized.We analyzed these associaGons, and the impact of a 2015 government policy liberalizingalcohol sales, in data from Ontario. Methods We matched a list of all alcohol outlets and hours ofoperaGon to their corresponding census neighborhood including the four domains of the OntarioMarginalizaGonIndex(OMI).WefitpoissonregressionmodelsfortheassociaGonbetweenthenumberofoutletswithin 1 kmof neighborhoods andOMI scores; and linear regressionmodels for the associaGonbetweenOMIscoresandoutlethoursofoperaGon.ResultsWefoundsignificantincreasesinboththethenumber of alcohol outlets 1km from a neighbrohood and the totalweekly hours of operaGon for eachquinGle increase inmarginalizaGon. Themean number of outlets within 1 km of urban neighborhoodsincreased significantly between 2014 and 2017. Conclusion We demonstrated significant associaGonsbetweenneighborhoodmarginalizaGonandalcoholavailability.Recentchangestoalcoholsales,withthegoal to “enhance the customer experience” have disproporGonately increased access in urbanmarginalizedneighborhoods. ImpactPolicyseekingtodecreasealcoholrelatedharmsshouldplace limitsonthenumberandhoursofoperaGonforalcoholoutletsinmarginalizedneighborhoods.

PosterAbstracts39.MarijuanasmokinginrelaGontosemenquality,spermDNAintegrityand

reproducGvehormonesamongmenfromaferGlitycenterFeibyL.Nassan,MarielArvizu,LidiaMinguez-Alarcon,PaigeWilliams,JillAGaman,johnPetrozza,Russ

Hauser,JorgeChavarro

Objec3ve: Examine theassociaGonsofmarijuana smokingwith semenparameters, spermDNA integrityandserumreproducGvehormones.Methods: Of 1,011 enrolled men from a ferGlity clinic (2000-2017), 662 provided informaGon aboutmarijuana smoking and ≥1 semen sample (total of 1,143). A subgroupof 317men also provided serumsamples. We used linear mixed effect models to evaluate these associaGons, while adjusGng forconfounders.Results:MenwereprimarilyCaucasian(88%)andhadameanageof36years.44%ofthemenwerepastand 11%were currentmarijuana smokers. Past and currentmarijuana smokers had significantly higherspermconcentraGonthanmenwhohadneversmokedmarijuana.ThemulGvariableadjustedmean(95%confidenceinterval)spermconcentraGon(millions/ml)was45.4(38.6,53.3)fornever,63.5(56.1,72.0)forpast,and59.5(47.3,74.8)forcurrentmarijuanasmokers.AsimilarpaIernwasobservedfortotalspermcount.Thesefindingsdidnotchangeajerco-adjustmentforcocaineuse.Conclusions:ThesefindingsarenotconsistentwithadeleteriousroleofmarijuanasmokingontesGcularfuncGon. Whether these findings are reflecGve of the previously described role of cannabinoids inspermatogenesisorareaspuriousassociaGonsrequiresfurtherwork.Impactandsignificance:ThisquesGonisofahighimportanceformenseekinginferGlitytreatmentgivenincreasinglegalizaGonofmarijuanaworldwide.

40.SocioeconomicstatusindicatorsanduseofendocrinedisrupGngchemical-associatedpersonalcareproductsinpregnantwomen

KaterinaNozhenko,AndreaBellavia,DavidCantonwine,MarissaGrenon,ThomasMcElrath,TamarraJames-Todd

Objec3ves:Personalcareproducts(PCP)areanimportantsourceofendocrinedisrupGngchemical(EDC)exposure.However,liIleisknownaboutwhetherEDC-associatedPCPusediffersbysocioeconomicstatus(SES),parGcularlyinvulnerablegroups,suchaspregnantwomen.WeinvesGgatedSESdifferencesinEDC-associatedPCPuseamongwomeninapregnancycohort.Methods:508womenfromtheLIFECODESstudy(Boston,MA)completedaself-reportedquesGonnaireinthe1stand/or2ndtrimester.Womenreporteduseof13PCPswithin48hoursofeachvisitandawarenessofproduct fragrance (yes,no, Idon’tknow).MaternaleducaGonand insurancestatus (publicv.private)wereusedas indicatorsofSES.Weevaluated trimester-specific frequenciesandpercentagesofPCPusestraGfiedbySES.Results:WomenwithlowSESreportedhigherbarsoapandperfumeuse.WomenwithhighSESreportedhighershampoo,liquidsoap,andcosmeGcsuse.SignificantdecreaseswereonlyobservedforoverallPCPuseamongwomenwithlowereducaGon(10%decreaseinusefrom1stto2ndtrimester;95%CI:1-17%).ParGcipantswith lower SESwere less likely to be aware of product fragrance informaGon (45% v. 37%;p<0.001).Conclusion:PaIernsofPCPuseandfragrance-freeawarenessdifferedbySES,suggesGngthatPCPusemaycontributetoSESdispariGesinEDCexposure.Impact & Significance: PCP use could be an important risk factor of SES dispariGes in EDC-associatedadversepregnancyoutcomes.

PosterAbstracts41.ThedistribuGonofanGbioGcuseanditseffectonanGbioGcresistance

ScoGOlesen,MichaelBarneG,DerekMacFadden,JohnBrownstein,SoniaHernández-Díaz,MarcLipsitch,YonatanGrad

AnGbioGcuse is theprimarydriverofanGbioGc resistance.However, the sameamountofanGbioGcusecanbedistributedindifferentwaysthroughoutapopulaGon,andtheeffectofthedistribuGonofuseonanGbioGcresistancehasnotbeenexplored.Hereweaimedtotestthehypothesisthatrepeated,intenseuse of anGbioGcs has a greater effect on populaGon-wide anGbioGc resistance than broadly-distributed,low-intensity use. First, we characterized the distribuGon of outpaGent anGbioGc use across US states,finding that anGbioGc use is uneven, with 10% of people taking 57% of anGbioGcs, and that repeated,intenseuseofanGbioGcsmakesupaminorityofanGbioGcuse.Second,wecomparedtotalanGbioGcusewith resistance for 70 pathogen-anGbioGc combinaGons across states, creaGng a landscape of theecological evidence for use-resistance relaGonships in the US. Finally, having parGGoned total use intoextensiveandintensivemargins,wefoundnoecologicalevidencethatintenseusehasagreatereffectonresistance than extensive use, either per prescripGon fill or in aggregate. These results suggest thatreducing anGbioGc use among top users will not have a disproporGonate effect on populaGon-wideanGbioGc resistance and that reducing total use and selecGon intensity will require reducing broadly-distributed,low-intensityuse.42.InvesGgaGngtheRoleofMitochondrialDNARepairinCellularSensiGvity

toDNADamagingAgentsAdamE.Osborne,HongjianHe,BingXu,ZacharyNagel

Mitochondria produce the energy necessary for cellular funcGon and contain their own geneGc code.Damage to this genome has been associatedwith a host of toxins and diseases.Many open quesGonsremainabouttherolethatmitochondrialDNAdamageandrepairplayinthedevelopmentandtreatmentofdiseases.WhilemuchisknownaboutnucleargeneGcmaintenance,liIleisknownaboutmitochondrialmaintenance.Effortstostudymechanismsofmitochondrialgenomic integrityhavebeenhamperedbyalackofassaysforsystemaGccharacterizaGonofmitochondrialDNArepair.Thegoalofthisresearch istodevelopsuchrepairassaystobeIerunderstandtheroleofmitochondriainsuscepGbilitytoDNAdamagingagents. ExisGng assays from theNagel lab use plasmids encoding fluorescent proteins as an output fornuclearDNA repair capacity.Wearenowdevelopinganalogous assays to interrogateDNA repair in themitochondria.Asaproofofprinciple,plasmidsexpressingGFPhavebeentransformedintomitochondriausingexvivoand invivomethods.Cellswere imaged forfluorescenceasverificaGonofplasmiduptake.SuchassayswillallowforrapidcharacterizaGonofrepairpathwaysthatoperateinthemitochondriawhileexpanding the understanding of their role in determining cellular sensiGvity to DNA damaging agents.Future work will focus on mitochondrial DNA repairs role in the development of cancer as well as apotenGalmetricfordeterminingtreatmentforpaGents.

PosterAbstracts43.IdenGficaGonofnovelERstresssuppressorsusingagenome-wideCRISPR

screenandimplicaGoninearlybraindevelopmentHae-RyungPark,RonaldA.Panganiban,MayaShumyatcher,RyanSun,BlancaE.Himes,DavidC.ChrisKani,

andQuanLu

Objec3ves:IdenGficaGonofnovelsuppressorsofERstressresponse.Methods andMaterials:We conducted a genome-wide lenGviral CRISPR-Cas9 screen to idenGfy geneswhoseinacGvaGonincreasesERstress.Results: We idenGfied novel suppressors of As-induced ER stress including microRNA(miR)-124. WeshowedthatmiR-124directlytargetsIRE1pathway,onebranchofUPRsignalingviadirectbindingtothe3’UTRofERN1(geneforIRE1).WefurtherdemonstratedthatmiR-124overexpressionreducesAs-inducedERstress/UPRsignaling.InaddiGon,astreatmentinhibitedcellproliferaGoninhumanneuralstemcellsorSH-SY5Y cells with concomitant acGvaGon of ER stress/UPR signaling. Furthermore, miR-124overexpression reducedAs-inducedgrowth inhibiGon in SH-SY5Y cells.We further showed thatmiR-124polymorphismsignificantlyassociateswithneurologicaloutcomesinchildren,andpotenGallyinteractwithasexposure.Conclusions:MiR-124downregulates the IRE1branchof theER stresspathwaybydirectly targeGng theIRE1gene.MiR-124polymorphismisassociatedwithneurocogniGveoutcomesinchildren.ImpactandSignificance:ResultsfromourstudyimplicateAs-inducedERstress/UPRsignalingasacrucialmechanism for the detrimental effects of As on neural stem cell funcGon and neurodevelopment, andidenGfymiR-124asapotenGal target forpreventaGveand therapeuGc intervenGonsagainstdetrimentaleffectsofAsexposureinchildren.

44.CellularHeterogeneitywithRespecttoDNARepairCapacity:DevelopmentandApplicaGonofaFluorescence-BasedPlapormforDetecGng

RepairDeficientSubpopulaGonsPieG,C.,Toprani,S.,Osborne,A.,Oki,T.,Scadden,D.,&Nagel,Z

Objec3ves: Measure andmodel DNA repair capaciGes in mulGple DNA repair pathways in normal andcancerousGssuestopredictcancersuscepGbilityinhumanpopulaGons,andpredictchemo-sensiGvitywithsinglecellresoluGon.Materials/Methods: Simultaneous transfecGon of mulGple DNA repair specific lesion-containingfluorescent plasmids, which are used to measure cell-to-cell variaGon in DNA repair capacity. Flow-cytometricanalysisandlivecelldynamicimagingoffluorescentreporterexpression.NormalandleukemiccellsareidenGfiedusingfluorescentanGbodyconjugatesthatrecognizecell-typespecificanGgens.Results:FM-HCRisarobustmethodologyformeasuringDNArepairinhumanleukemiccellsandmulGpleprimarymouse Gssues.We observe differences in DNA repair capacity comparing leukemic cells versusnormalmonocytes,andcomparingleukemiccellsfromdifferentindividuals.Conclusions: FM-HCR is a reproducible and reliable tool for measuring DNA repair capacity in mousemodelsandhumancasesofleukemia,andiscapableofidenGfyingrarecellpopulaGonswithalteredDNArepaircapacity.Impact/Significance: Differences in DNA repair signatures in normal cells may provide key informaGonneededtodeveloppersonalizedcancerprevenGonstrategies,anddifferencesinDNArepairsignaturesinleukemic cells may enable personalized treatment strategies by idenGfying sensiGve/targetable cellpopulaGons.

PosterAbstracts45.MaternalKnowledge,Aqtude,PracGcesduringchildhooddiarrhea(India)

RamyaPinnamaneni,DhulikaDhingra,AashimaDabas,TanuAnand

MostofthediarrhealdeathsinchildhoodarepreventablewithappropriatehygienicmeasuresandGmelyiniGaGonof rehydraGon therapy. There is limiteddataonmaternal knowledgeaboutdiarrhealpracGcesformIndia.AcrosssecGonalsurveywasconductedon280motherswithchildrenaged2-59monthswithacutewaterydiarrhea.59(21%)motherswereilliterate.96(34.3%)motherspretreatedwatertomakeitpotable.Themeanknowledgescoreforhand-washing,diarrheaprevenGonandcomplicaGonsofdiarrheawere 0.87±0.25, 0.24±0.36 and 0.37±0.29 respecGvely; significantly higher in educated mothers thanilliterate (P<0.05). The KAP scores didn’t differ between those with first episode or repeat episode ofdiarrhea.30.7%mothersdidn’tadministerrehydraGontherapyathome.Only50.4%and55.2%mothersknewcorrectmethodofORSpreparaGonandadministraGonrespecGvely.45.4%motherspracGcedfoodrestricGonduringdiarrheaandonly14.3%co-administeredzinc.The lackofcorrectmaternalknowledgeandpracGcesinchildhooddiarrheahighlightstheneedofpaGentcounselingandeducaGoninORTcornersinIndia.

46.OpGmizingNGS-baseddataanalysistrainingMaryPiper,RadhikaKhetani,MeetaMistry,JohnHutchinson,ShannanHoSui

Objec3ves: The Harvard Chan BioinformaGcs Core provides consulGng and to the Harvard community.Three years ago, we iniGated a new training program designed to empower researchers not only tounderstandnextgeneraGonsequencing(NGS),butalsotoperformanalysisoftheirowndata.Ourgoalhasbeentodeveloplocalexpertsinthecommunity,withinlabsanddepartments,whocanhelpaddresstheboIleneckinhighthroughputdataanalysis.Methods&Conduct:OurtrainingcurriculumhasbeenguidedbyclasssurveyresultsandobservedtrendsfromongoingconsulGngrequeststomeettheneedsofourcommunity.Theprogramhasprogressedfromteaching NGS overview workshops using Galaxy to working on the command line in introductoryworkshopsforLinux,R,andNGSanalyses.InaddiGontotheseshorterworkshops,werunanin-depthNGSanalysiscoursespanning6-weeksandcoveringmulGpleNGSmethods.Overthelastthreeyearswehavemodifiednotonlycontent,butalsomethodsfororganizingthecourses.Webasedthesechangesontrialanderror,surveyfeedback,classroomobservaGonsandcollaboraGons.Impact:ThesechangeshaveresultedinhigheraIendance,loweraIriGon,greaterworkshopsaGsfacGon,andeasiertroubleshooGnginclass.Wepresentourmethodstotargetappropriateaudiences,techniquesfor improvedmaterialdesign toaid in retenGonand facilitaGonofhands-on tutorials,andstrategies forbeIerevaluaGonandgeneraGonoffeedback.

PosterAbstracts47.ABusinessCaseforImprovingPaGentExperienceinPediatricRadiology

UsingDesign-ThinkingSaranyaRamakrishnan

Pediatric imagingpresentsuniquechallenges forproviders.The tradiGonal imagingexperience isanxietyprovoking for children: they ojen dissolve into tears, have claustrophobic reacGons, feel stressed, andmoveduringimaging.DuetothiscliniciansojenhavetousesedaGononchildrenandperformaddiGonalscans,leadingtomoreextendedvisits,potenGalbacklogs,andotherrisks.GEHealthcarerecognizedthattherehadtobeabeIerapproachtosolvingthispain-point,anddesignedamore‘‘child-friendly’’imagingroom - theGEadventure series. Theadventure series, reduces thenumberof sedaGons, increases scanvolume, improves paGent experience, reduced backlog and decreased moGon arGfacts. My projectinvolveddevelopingabusinesscasetoconvinceseniormanagement inhospitalstoadopttheadventureseries.48.AcGvatedTGFbsignalinginearlyhematopoieGcprogenitorspromotes

bonemarrowfailureinShwachman-DiamondSyndromeCailinE.Joyce*,AssiehSaadatpour*,MelisaRuiz-GuKerrez,OzgeVargelBolukbasi,LanJiang,DollyD.

Thomas,SarahYoung,IngaHofmann,ColinA.Sieff,KasianiC.Myers,TowiaA.Libermann,ChadNusbaum,Guo-ChengYuan,AkikoShimamura,CarlD.Novina

*Jointfirstauthors

Objec3ves: Shwachman-Diamond Syndrome (SDS) is a rare and clinically heterogeneous bone marrowfailure syndrome caused bymutaGons in the SBDS gene. The only curaGve treatment for bonemarrowfailure inSDSpaGents ishematopoieGcstemcell transplant,butoutcomesare limitedbythe inabilitytopredictwhich paGentswill develop complicaGons that outweigh significant transplant risks. There is anurgentneedforraGonaltherapiestosupplantordelaytransplant.Methods:ThedevelopmentofraGonaltherapiesrequiresadeeperunderstandingofthecelltype-specificresponses to SBDS mutaGons. To address this, we used single-cell RNA sequencing to profile rare andheterogeneous hematopoieGc stem and progenitor cells from SDS paGents’ bone marrow. We thendevelopedandappliedacomputaGonalpipelineallowingus to idenGfycell typesandpathwaysthatareaffectedbythedisease.Results: Our computaGonal analysis revealed selecGve dysregulaGon of TGFb target genes in SDShematopoieGcstemcellsandmulGpotentprogenitors,butnot in lineagecommiIedprogenitors.Follow-upexperimentsperformedonprimarypaGentcellsandbloodplasmaconfirmedhyperacGvaGonofTGFbsignalingasamechanismofbonemarrowfailureinSDS.Conclusions and Impact: These data establish the TGFb pathway as a novel biomarker and therapeuGctargetinSDS,andtranslateinsightsfromsingle-cellbiologyintoapotenGaltherapy.

PosterAbstracts49.Economic,publichealthanddiseaseanalysisofinsurancebasedhealth

schemesinMaharashtra,India.SujataSaunik

Objec3ves: To study the impact of the insurance based health care model rolled out by the stategovernmentin2012toseeiftheintendedobjecGveshavebeenmet,whatdoestheclaimdatasayaboutthediseaseprofileof thebeneficiaries,whether it issustainable inthe longtermand if there isneedtoimproveandreformasthelargestinsurancebasedhealthcarescheme,AyushmanBharatrollsoutinIndia.Methods and Materials: Claim data from 2012-2018 has been studied, for the first Gme using SPSS.Results:TheuGlizaGonoftheschemeisgoingupeachyearandsoisthecost,thelowestwealthquinGlegroups uGlizaGon not even 1 percent of the total beneficiaries, top three procedures performed are –cardiac, oncology- both radiaGon andmedical and nephrology, age group seeking care is largest 35-65yearsandmorementhanwomenarecomingfortreatmenttonetworkhospitals,moreruralbeneficiariesthanurbanandrelaGvelyhighincidenceofbypassingofnear-byfaciliGesseen.Conclusions: The unmet need of the supply side problem is beingmet through this scheme. However,awareness in the most vulnerable and poor beneficiaries is rather low and growing burden of non-communicablediseaseshastobeaddressedthroughbeIerawarenessandprevenGvemeasureswhilealsobuildingcapacityandaccountabilityofthepublichealthsector.Impact and Significance: The study can help reform the present scheme and give insights for the newproposedscheme.

50.Smallmoleculeinhibitors(BH3mimeGcs)ofpro-survivalBCL-2familyproteins,aspotenGaltherapeuGcsfortherapyresistantglioblastomas

RumaniSingh,CameronFraser,KristopherSarosiek

Glioblastomas are themost lethal type of primary brain tumorswith amedian survival of less than 12months. This is in part due to their profound resistance to radiaGon and chemotherapeuGc treatments.Amongst glioma cancer cells, a subpopulaGon of cells that express the neural stem cell marker CD133(Prominin-1) have reportedly shown greater tumorigenic potenGal and resistance to therapies and arereferredtoas“cancerstemcells.”WehypothesizedthatCD133+glioblastomastemcellsmayresistanG-cancer therapy by suppressing the apoptosis pathway, which may potenGally be reversed to improvetherapyoutcomes.Usingflowcytometry-basedBH3profiling,wefirstidenGfiedthepercentageofCD133+cellsinGBMs.ThemeasurementofoverallapoptoGcprimingshowedthatCD133+cellsweresignificantlylessprimed for apoptosis thanCD133- cells andexhibited resistance to radiaGonand chemotherapeuGcagents. To target CD133+ and CD133- cells, the smallmolecule inhibitors of pro-survival proteins BCL-2(ABT-199), BCL-xl (A133) andMCL-1 (S663845)were used alone and in combinaGonwith radiaGon andtemozolomide drug in glioma cell lines. InteresGngly, we observed A133 (BCL-xl inhibitor) and S63845(MCl-1inhibitor)aloneandincombinaGonwithradiaGonandtemozolomidepotentlyinducedapoptosisinbothsub-populaGons.Wearefurtherestablishingin-vivogliomamousemodelstotesttheefficacyofthesedrugstoimproveoutcomesforpaGentswithCNStumors.

PosterAbstracts51.ExaminingtheAssociaGonBetweenFuncGonintheAcuteCareSeqng

andHospitalOutcomesConanSoBSc,DanielELageMDMSc,ChloeSSlocumMDMPH,RossDZafonteDO,JeffreyCSchneiderMD

Objec3ve:ThereisgrowingresearchthatsuggeststhatearlymobilityimproveshealthcareuGlizaGon.ThepurposeofthisstudywastoreviewtheliteratureexaminingtheassociaGonbetweenphysicalfuncGonintheacuteseqngandvarioushospitaloutcomes.MethodandMaterials:AliteraturereviewoftheMEDLINEdatabaseusingPubMedwasperformed.Searchterms includedacute funcGonaloutcomesand frailtyoutcomes.Studieswere included if theyexaminedhow funcGonal metrics collected at acute care hospitalizaGon impacted hospital outcomes. CohortcharacterisGcsandmeasuresofassociaGonswereextractedfromthestudies.Results: 30 eligible studies were idenGfied. Higher funcGon during acute care was associated withstaGsGcally significant lower odds of hospital readmission, discharge to skilled nursing faciliGes andinpaGent rehabilitaGon faciliGes, shorter hospital stays, decreased mortality, and greater funcGonalrecoverywhencomparedtopaGentswithlowerfuncGon,whenadjustedforageandsex.Conclusions:Although this reviewwas limitedby theheterogeneityof funcGonalmeasuresandhospitaloutcomes,thereisagrowingbodyofevidencethatfuncGonalmetricsassessedinacutecarearesignificantpredictorsofabroadarrayofhospitaloutcomes.Impact and Significance: Future research would benefit frommore widespread collecGon of funcGonaldataandconsensusoffuncGonalmetricsforuseinacutecarehospitals.

52.NeuropsychiatricGeneGcsofAfricanPopulaGons-PsychosisStudy:ExpandingKnowledgeofGeneGcandEnvironmentalRiskFactorsfor

SchizophreniaandBipolarDisorderinAfricaStroudR,StevensonA,AtwoliL,DickensA,GroblerG,KariukiSM,NewtonCR,SteinDJ,TeferraS,ZingelaZ

&KoenenKC

Objec3ves:Recentadvances inpsychiatricgeneGcshave idenGfiedover100geneGc lociassociatedwithschizophrenia that are now being used to inform translaGonal research. However large-scale geneGcstudies to date have primarily used genomes with European ancestry. Harvard Chan and the BroadInsGtute are therefore undertaking to expand neuropsychiatric geneGcs research in Africa with theobjecGveofimprovingtheexisGngscienceandaddressingissuesofequity.Methods andMaterials:Over thenext four years, theNeuropsychiatricGeneGcsofAfricanPopulaGons(NeuroGAP) – Psychosis study aims to collect DNA and phenotypic data frommore than 17,000 cases(subjectswith schizophrenia and bipolar disorder) and an equal number of controls in Ethiopia, Kenya,SouthAfrica,andUganda.Results: As of this submission, NeuroGAP–Psychosis has recruited 234 parGcipants (by country: 154 inUganda,76inKenya,and4inSouthAfrica).AveragescoresfortheK10baIeryhavebeen15.15outof50and14.86outof20forthefirstUBACCtrial.Conclusion:IfweignorediversifyinggeneGcsamples,advancesingeneGcswillbelimitedwiththeensuingriskthattherapeuGcinnovaGonsleaveoutlargesegmentsoftheglobalpopulaGon.Impact and Significance: This novel study will generate a large-scale dataset that combines deepphenotypingandgeneGcdata.Thisstudyalsoaimstobuildin-countrylaboratorycapacityandbuildlocal,Africanbiorepositories.

PosterAbstracts53.Genome-WideAssociaGonStudyofNeuroblastomainChildrenofAfrican-

AmericanDescentSanjanaSundaresan,ZalmanVaksman,SharonJ.Diskin,JohnM.Maris,MarcellaDevoto

Aim: To combine and perform a meta-analysis on two independent, African-American datasets, andidenGfyuniqueneuroblastomariskloci.Methods: We genotyped and imputed SNPs located throughout the genome and tested them forassociaGontoneuroblastomainchildrenofAfrican-Americandescentthroughameta-analysis.Atotalof432 cases of neuroblastoma and 2386 ethnicallymatched, healthy controlswere involved in this study.Results:SNPsintheBARD1geneshowedreplicaGonofassociaGonintheAfrican-AmericanpopulaGonwithrs7587476idenGfiedasthe leadSNPinthat locus.LimitedassociaGonwasobservedintheCASC15genelocusonchromosome6.AnewassociaGonemergedfromthemeta-analysis inthePTPRGgenelocusonchromosome3.Conclusions:ReplicaGonoftheassociaGonofcommonSNPsattheBARD1locus,verifythattheyconferriskofneuroblastomatoAfrican-Americans.However,otherSNPsinregionsimplicatedinneuroblastomariskinchildrenofEuropeandescent,conferredminuteornoriskofoccurrenceofneuroblastoma.IncreaseinstaGsGcalpowermayproveotherwise,sofurtherresearchinthisdomainmustbeperformed.Impact: The newly idenGfied SNPs in the PTPRG gene on chromosome 3, provide direcGon for futureendeavors. GWAS on the naGve African populaGon may provide insight into the occurrence andmanifestaGon of neuroblastoma, and the validity of the SNPs idenGfied, paving the way to idenGfyingrelevantlociinAfrican-Americans.

54.CigareIeSmokeExposureandRadiographicPulmonaryVascularMorphologyintheFraminghamHeartStudy

AndrewSynn,GeorgeWashko,GeorgeO’Connor,MurrayMiGleman,MaryRice

Objec3ves:NarrowingandobliteraGonofperipheralpulmonaryvessels(knownas“pruning”)isacommonpathologicfeatureofsmoking-relatedemphysema.WhileitisgenerallyfeltthatcigareIesmokecausesaprogressionfromendothelialdysfuncGon/vasoconstricGon,tovesseldamage,andfinallytoovertvascularpruning, the radiographic vascular effects of smoke exposure in generally healthy adults are uncertain.Materials:2,400parGcipantsof theFraminghamHeartStudyunderwentchestCTscans from2008-2011with assessment of total intrapulmonary blood volume (TBV), small vessel (area <5mm2) volume (BV5),andBV5/TBV raGo (BV5%). Linear regressionmodelswere used to invesGgate the relaGonship betweensmoking and radiographic vascular parameters, adjusGng for age, sex, height, weight, occupaGon,educaGon,andincome.Results:MeanvaluesforBV5andTBVwere56±12and143±31mL,respecGvely,andBV5%was39.3±4.1%.In fully-adjusted models, ever-smoking status and higher pack-years of exposure were associated withincreased TBV and BV5 values. Ever-smoking status and second-hand exposure were associated withincreasedBV5%.Conclusions: In a generally healthy cohort, cigareIe smoke exposure was associated with increasedpulmonarybloodvolumesandperipheralbloodraGo.ThisfindingcontrastswiththetradiGonalparadigmof cigareIe smoke and progressive vascular pruning, and suggests a different paIern of vascularremodelingduetocigareIeexposure.

PosterAbstracts55.Changesindiet,lifestylebehaviors,andbodyweightovertwoyearsin

MexicanwomenMarthaTamez,JosiemerMaGei,AdrianaMonge,RuyLópez-Ridaura,MarKnLajous

Objec3ve:Toevaluate2-ychangesindiet/lifestyleandweightinMexicanwomen.Methods:InaprospecGvecohortofMexicanwomen(n=12,154),weobtaineddataondietaryintakeusingan FFQ. Weight, physical acGvity, smoking, alcohol use, and TV watching were self-reported on aquesGonnaire.Weexcludedwomenwhowerepregnant,with chronicdiseases,with implausibleenergyintake or missing diet, lifestyle, or weight data. We calculated the change in weight and diet/lifestylebehaviorsbysubtracGng the informaGonobtained in2008 fromthat in2006.Weused linear regressionmodels adjusted for age, state, menopausal status, contracepGve use, and all diet/lifestyle behaviors,simultaneously.Results: Increasing one serving/wk of individual food groupswere posiGvely associatedwith 2-yweightgainforintakeofMexicandishes(0.13kg),sodas(0.04kg),corn/potatoes(0.05kg),corntorGllas(0.03kg),redmeats(0.02kg), refined grains(0.01kg), and sweets/desserts(0.01kg).We observed an inverse associaGonfor intake of fruits(-0.004kg), vegetables(-0.01kg), whole grains(-0.02), and diet sodas(-0.11kg). Lifestylefactors were also associated with weight gain, including smoking (starters=-0.24 kg, quiIers=0.18 kg),physicalacGvity(-0.004kgpermin/wk),andTVwatching(0.05kgperh/d).Allp<0.05.Conclusion:Changesinspecificdietary/lifestylebehaviorswereassociatedwithmodestchangesinweight.Theseresultsmaybeusefulfortargetedweightmanagementmessages.

56.Mntoxicityandeffectsonpolarizedhepatocytes

LukeTillman,MarianneWessling-Resnick,KhristyThompson

Objec3ves:MntoxicitystemsfromnutriGonal,occupaGonal,andgeneGcfactors.ExcessMniseliminatedbyhepatobiliaryclearance.Wepostulatevectorialmembranetraffickingis involvedandtheGolgiCa/MntransporterSPCA1hasbeenimplicatedindetoxificaGon.OurgoalwastocharacterizeMneffectsonGolgitraffickinginpolarizedhepatocytes.Methods:WIF-B hepatocyteswere grown tomaximal polarity and exposed toMn for 4h. ViabilitywasassessedusingTox-1MTTassay.ChangesintheGolgiresidentproteinsTGN38andGM130weremeasuredbybloqngandimmunofluorescencemicroscopy.Results: Cell viability declinedwith exposure to increasingMn, but an adapGve responsewas observedabove 25uM suggesGng dose-dependent detoxificaGon. During exposure, the trans-Golgimarker TGN38was degraded in a dose-dependent manner while the cis-Golgi marker GM130 was maintained. ThelysosomalinhibitorbafilomycinA1blockedMn-inducedTGN38degradaGonandincreasedassociaGonwithlateendosomalM6PR.Conclusions:MnexposureinducesTGN38degradaGoninadose-dependentmanner.Co-localizaGonwithM6PRindicatesTGN38issortedforlysosomaldegradaGon.WeconcludethatTGN38membranetraffickingbetweenendosomes/plasmamembraneandthetrans-GolginetworkisdisruptedandpossiblycontributestoMndetoxificaGon.Impact/significance:OurstudiescharacterizeeffectsofMnexposureonhepatocytesandsupporta roleforGolgimembranetraffickinginMndetoxificaGon.

PosterAbstracts57.MeasuringDNArepaircapacityinhumanbloodcellssubtypesusing

FluorescenceMulGplexHostCellReacGvaGon(FM-HCR)assaysSnehMToprani,CorGPieG,AdamOsborne,TurnerPecen,YuxiangHeandZacharyDNagel

Thehumanimmunesystemcomprisesofvariousbloodcellsubsets(T/Blymphocytes,monocytes,NKcells)whichoriginate fromdifferent developmental lineages andperform separatebiological funcGons. ThesecellsareexposedtomyriadsDNAdamagingagentsleadingtoDNAlesionswhicharerepairedbyatleast6majorDNArepairpathways.DeficiencyinDNArepairpathwaycapacity(DRC)isassociatedwithincreasedcancer risk in humans. Due to technological limitaGons, measuring DRC in live cell for all 6 pathwayssimultaneouslywasnot feasiblewhich isaccomplishedbyourrecentlydevelopedfluorescencemulGplexhost cell reacGvaGon (FM-HCR) assays. So, the objecGve of this studywas to analyze DRC of blood cellsubtypesinmulGpleDNArepairpathwayusingFM-HCRassay.Forthat,peripheralbloodmononuclearcellswere isolatedfromhumanbloodsamplesandsubtypeswereseparated.ThecellsweretransfectedwithFM-HCRreporterplasmidsandanalyzedusingflowcytometry.SignificantdifferencesinDRCamongthecelltypes were observed in several DNA repair pathways. These findings have important implicaGons forstudiesthatinvolvemeasuringDRCinmixedcellpopulaGon.Ourstudywillalsorefineourunderstandingof the molecular basis for immune cell depleGon following exposure to DNA damaging agents, whichdetermines theoutcomeof cancer treatments, and couldbeamechanismunderpinning inter-individualdifferenceinsuscepGbilitytoDNAdamagingagentexposure.

58.LeveragingmetaboliccontroltopreventasthmaGurolTuncman,CemGorgun,EricVaillancourt,GökhanS.Hotamışlıgil

Asthma is a common non-communicable disorder characterized by airway inflammaGon and airflowobstrucGon. While there are over 300 million people worldwide who are affected with asthma, thepathophysiology is notwell understood, limiGng the prevenGon and treatment of this chronic immuno-metabolicdisease.InaddiGontoclassicmodelsdrivenbyenvironmentaltriggersandgeneGcsuscepGbility,obesityhasnowemergedasamajorriskfactorforasthma,suggesGngthatthesetwochronicdiseasesmaysharecommonmechanismsthatareyettobeidenGfied.Inthepastfewdecades,ithasbecomeclearthattheacGonoffaIyacidbindingproteinaP2/FABP4significantlycontributestoimmuno-metabolicdiseasesassociatedwithobesity,bothinexperimentalmodelsandinhumans.InteresGngly,wehavedetectedthepresenceofaP2/FABP4inthebronchialepitheliumspecificallyinresponsetoTH2cytokinesandduringthecourseofanallergen-inducedmodelofasthmainmice.HereweshowthatgeneGcablaGonofaP2(aP2-/-)inmice results in dramaGc protecGon against allergen-induced changes in the airways and significantlyimproved lung funcGon. These unexpected findings illustrate a mechanisGc link between metabolicalteraGonsandairwaydiseasewhichmayexplaintheincreasedriskofasthmainobesity.

PosterAbstracts59.FoodInsecurityandPredicted10-YearCardiovascularDiseaseRiskAmong

AdultsintheUnitedStatesKelseyVercammen,AlyssaMoran,EricRimm

Objec3ves: To examine the associaGon between food insecurity and cardiovascular disease (CVD) risk.Methods:13,518adults(aged20-64years)and7340olderadults(aged40-79years)wereassessedusingthe2007-2014NHANES.MulGplelinearregressionswereconductedtoexamineassociaGonsbetweenfoodinsecurity,individualCVDriskfactorsandmeasuresofadiposityamongadults.LogisGcregressionwasusedtoexaminetheassociaGonbetweenfoodinsecurityandtheoddsof≥20%10-yearPooledCohortEquaGonCVDriskamongolderadults.Results:Comparedtowomenwith full foodsecurity,adultswithmarginal foodsecurityhadsignificantlyhigher systolic blood pressure (ß=0.94, SE= 0.43), women with marginal food security had significantlylowerHDL cholesterol (ß=-1.56, SE=0.73), andmenwith low food security had significantly higher totalcholesterol (ß=6.93, SE=2.89). Compared to women with full food security, women withmarginal foodsecurityhada1.03kg/m2(SE=0.31)higherBMI,thosewithlowfoodsecurityhada1.65kg/m2(SE=0.42)higherBMIandthosewithverylowfoodsecurityhada1.30kg/m2(SE=0.42)higherBMI.Olderadultswithvery lowfoodsecurityhad2.4-foldgreateroddsof10-yearCVDrisk≥20%comparedtothosewithhighfoodsecurity.Conclusions:Adultswithfoodinsecurityaheightened10-yearriskofCVD.AddressingfoodsecuritymaybeanimportantwaytoimprovetheCVDhealthoutcomesofAmericans.

60.EvaluaGonoftheIntrafollicularFluidInflammatoryNetworkinPaGentswithUnilateralEndometriomaanditsRelaGonshipwithIVFOutcomes:A

mulGplexproteomicanalysisJenniferYland,BA;LuizFernandoPinaCarvalho,MDPhD;MichaelBeste,PhD;MauricioSAbrão,MDPhD;LindaGriffith,PhD;AmeliaBailey,MD;CatherineRacowsky,PhD;CassandraThomas;StaceyA.Missmer,

ScD

Objec3ves: To assess the relaGonship between inferGlity and the intrafollicular inflammatory milieu inendometriosis.Materials and Methods: ProspecGve cohort study of 36 women presenGng for oocyte retrieval at auniversity-based inferGlity clinic. Inflammatory markers were measured in follicular fluid samples fromeach ovary, using a 27-plex immunoassay panel. We compared intrafollicular cytokine levels and IVFoutcomes betweenwomenwith unilateral endometrioma andwomenwithout endometriosis, by ovarydiseasestatus.Results: RespecGvely, MCP-1 and IL-8 levels were 3.0 and 2.7 Gmes higher in samples obtained fromaffected ovaries compared to control ovaries, on average. The affected ovaries of women withendometriosisyieldedfeweroocytescomparedtoboththeunaffectedovariesandtheovariesofwomeninthecontrolgroups.ThisrelaGonshipremainedsignificantevenajeradjusGngforage,bodymassindex,andinflammatoryfactors.Conclusions:Our results suggest that the inflammatorymilieuofovarianendometriosis ismorestronglylocalizedthansystemic.TheseresultsalsosuggestthattherelaGonshipbetweenendometriosisandearlyIVFoutcomescannotbefullyexplainedbyincreasedinflammaGon.ImpactandSignificance: Ithasbeenhypothesizedthatendometriosismaycause inferGlity through localinflammatoryagents,butourfindingssuggestthatthereareothermediatorsofthisrelaGonship.

he HSPH Poster DayOrganizing CommiIeewould like to thank theindividualswhomadethiseventasuccess.Firstandforemost,Poster

DaywouldnothavebeenpossiblewithoutthehardworkofthededicatedOrganizingCommiIeevolunteers:u  ThecommiIeechair:

NachiketVaze

u  RepresentaGvesfromtheHSPHPostdoctoralAssociaGon: LucasHenneman LucyLi ScoIOlesen LuciaPeGto ChrisGanSuharlim

u  RepresentaGvefromtheHSPHStudentAssociaGon:

BryanBuckley

u  TheOfficeofFacultyAffairs: ChrisGnaBurkot

We would also like to thank all of the students, postdocs, and researchassociates who parGcipated as well as the judges for adjudicaGng thecompeGGon. Without their commitment, this event would not havepossible.Finally, we would like to extend a special thanks to Dean MeredithRosenthal for supporGng the Poster Day and who generously agreed tospeakatthePosterDayRecepGonandpresenttheawards.Weappreciatealloftheeffortsthatwentintoplanningandorganizingthisevent, and we look forward to the same enthusiasm at the next HSPHPosterDay.

T

Imagecredit:MeasuringDNArepaircapacityinhumanbloodcellssubtypesusingFluorescenceMulKplexHostCellReacKvaKon(FM-HCR)assays.SnehM.Topranietal.

2018PosterDay|May3rd,2018