EPIC Study Research Articles

The Heroic Epic of Manas and Mukhtar Auezov’s Role in Its Popularization

heroic epic of Manas and the publication of its parts in the twentieth century. The purpose of the article is to determine the place of the famous monograph “The Kyrgyz heroic epic of Manas” by M. O. Auezov in a series of works on epic studies. Objectives of the article: to describe M. O. Auezov’s research dedicated to the Kyrgyz epic of Manas from the standpoint of defining the functions of manaschi (storyteller, poet, shaman) and the preserved pre-Islamic cult of ancestors among the Kyrgyz; to substantiate M. O. Auezov in the aspect of Kyrgyz studies and Manas studies. The relevance of the work consists in summarizing the contribution of M. O. Auezov to Kyrgyz and Manas Studies in connection with new trends in education in the Republic of Kyrgyzstan, caused by the adoption of the Law “On the Manas Epic” in 2011. The scientific novelty of the work lies in a new approach to understanding the works by M. O. Auezov in the aspect of theory of mentality, that is practically not involved in literary practice. M. O. Auezov introduced into scientific circulation the terms associated with the performers of the epic, yrchi and zhomokchi. He was the first to describe the history of Kyrgyz manaschi ‒ storytellers: from a contemporary of Manas Keldibek to Sagymbay Orozbаkov, a contemporary of M. O. Auezov. Manas himself chooses those who will perform the epic dedicated to him. The text of the epic keeps the spirit of the people, i. e. the heroic epic of Manas contains the spiritual basis of Kyrgyz culture, its mentality. M. O. Auezov summarized the data on manaschi and outlined their main functions: a storyteller, a poet, a shaman. The scientist pointed to the pre-Islamic cult of ancestors that has come down to us among the Kyrgyz people. Keywords: the epic of Manas, manaschi, pre-Islamic Turkic spiritual culture, works by M. O. Auezov, mentality, myth, cult of ancestors, the Kyrgyz language picture of the world

Greenhouse gases emissions from the diet and risk of death and chronic diseases in the EPIC-Spain cohort.

Evidence from the scientific literature shows a significant variation in greenhouse gas (GHG) emissions from the diet, according to the type of food consumed. We aim to analyze the relationship between the daily dietary GHG emissions according to red meat, fruit and vegetables consumption and their relationship with risk of total mortality, and incident risk of chronic diseases. We examined data on the EPIC-Spain prospective study, with a sample of 40621 participants. Dietary GHG emission values were calculated for 57 food items of the EPIC study using mean emission data from a systematic review of 369 published studies. Dietary GHG emissions (kgCO2eq/day), per 2000kcal, were 4.7 times higher in those with high red-meat consumption (>140g/day) than those with low consumption (<70g/day). The average dietary GHG emissions were similar in males and females, but it was significantly higher in youngest people and in those individuals with lower educational level, as well as for northern EPIC centers of Spain. We found a significant association with the risk of mortality comparing the third vs. the first tertile of dietary GHG emissions [hazard ratio (HR) 1.095; 95% confidence interval (CI) 1.007-1.19; trend test 0.037]. Risk of coronary heart disease (HR 1.26; 95% CI 1.08-1.48; trend test 0.003) and risk of type 2 diabetes (HR 1.24; 95% CI 1.11-1.38; trend test 0.002) showed significant association as well. Decreasing red-meat consumption would lead to reduce GHG emissions from diet and would reduce risk of mortality, coronary heart disease and type 2 diabetes.

Antibody Responses to Helicobacter pylori and Risk of Developing Colorectal Cancer in a European Cohort.

While Helicobacter pylori (H. pylori) is the major cause of gastric cancer, it has also been suggested to be involved in colorectal cancer development. However, prospective studies addressing H. pylori and colorectal cancer are sparse and inconclusive. We assessed the association of antibody responses to H. pylori proteins with colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. We applied H. pylori multiplex serology to measure antibody responses to 13 H. pylori proteins in prediagnostic serum samples from 485 colorectal cancer cases and 485 matched controls nested within the EPIC study. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable conditional logistic regression to estimate the association of H. pylori overall and protein-specific seropositivity with odds of developing colorectal cancer. Fifty-one percent of colorectal cancer cases were H. pylori seropositive compared with 44% of controls, resulting in an OR of 1.36 (95% CI, 1.00-1.85). Among the 13 individual H. pylori proteins, the association was driven mostly by seropositivity to Helicobacter cysteine-rich protein C (HcpC; OR: 1.66; 95% CI, 1.19-2.30) and Vacuolating cytotoxin A (VacA) (OR: 1.34; 95% CI, 0.99-1.82), the latter being nonstatistically significant only in the fully adjusted model. In this prospective multicenter European study, antibody responses to H. pylori proteins, specifically HcpC and VacA, were associated with an increased risk of developing colorectal cancer. Biological mechanisms for a potential causal role of H. pylori in colorectal carcinogenesis need to be elucidated, and subsequently whether H. pylori eradication may decrease colorectal cancer incidence.

Methodological approaches to compile and validate a food composition database for methyl-group carriers in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

A standardised methodology was used to compile and validate a methyl-group carrier database (MGDB) including folate, choline, betaine and methionine, for use in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Compilation was performed by following structured guidelines to match the EPIC dietary intake data to food items from four food composition databases, according to their assigned priority of use. To assess relative validity, calculated dietary folate intakes were compared between the MGDB and the EPIC nutrient database (ENDB), used as the reference database. Folate intakes based on the MGDB and those generated using the ENDB showed good agreement (weighted κ=0.63) and were strongly correlated (r=0.81). This MGDB can be used for investigating potential associations between methyl-group carrier intakes and risk or prognosis of cancer and other diseases in the EPIC study population.

The Last of the Long Takes: Feminism, Sexual Harassment, and the Action of Change

The surging activism of #MeToo has expanded discussion of the revival of feminism and the role of digital activism, and raised questions about potential for lasting change. This is approached by comparing the featured politics of naming in two eras of feminism: the naming of alleged harassers in #MeToo which originated with the claims against Harvey Weinstein by Hollywood identities in 2017; and the naming of sexual harassment as a workplace issue by feminist activists in the 1970s. Anita Hill’s testimony to the US Senate against Clarence Thomas in 1991 is a bridging episode between the eras to which Lauren Berlant responded with her theory of Diva Citizenship and her argument that change depends on the action of the body politic in response to the Diva Citizen. I argue that the historical naming of sexual harassment was a crucial first stage in any lasting change.

Drug use, sexual risk, and structural vulnerability among female sex workers in two urban centers of the Dominican Republic: The EPIC study

BackgroundEvidence in different countries suggest an association between sex work and drug use. In the Dominican Republic an estimated 60,000–100,000 women work in the sex industry. However, little is known about their drug use behaviors. ObjectiveTo characterize the burden of drug use and examine correlates of these behaviors among female sex workers in the Dominican Republic. MethodsData for this analysis comes from a cross-sectional study among key populations at risk for HIV. A community sample of female sex workers (N = 389) was recruited using passive and active recruitment strategies. Participants completed a behavioral survey between 2015 and 2016. Logistic regression models were constructed to examine predictors of drug use. ResultsProtective factors against marijuana and crack or cocaine use included being heterosexual, having a higher level of education, regular employment, and fewer male sexual partners. Increased odds of crack or cocaine use were associated with incarceration, having slept in a place not meant for human habitation in the last six months, and having ever lived in a batey (a community around a sugar mill where workers and their families live). Participants that used marijuana were generally younger, while those that used crack or cocaine were older. ConclusionsOur findings highlight characteristics of the social and economic environment that require further research to optimize prevention and care strategies for this population. Public health interventions are needed that address drug use, sexual risk-taking, and helping female sex workers and their families achieve a healthy life.

Healthy lifestyle and the risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition study.

Limited evidence exists on the role of modifiable lifestyle factors on the risk of lymphoma. In this work, the associations between adherence to healthy lifestyles and risks of Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) were evaluated in a large-scale European prospective cohort. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), 2,999 incident lymphoma cases (132 HL and 2,746 NHL) were diagnosed among 453,808 participants after 15 years (median) of follow-up. The healthy lifestyle index (HLI) score combined information on smoking, alcohol intake, diet, physical activity and BMI, with large values of HLI expressing adherence to healthy behavior. Cox proportional hazards models were used to estimate lymphoma hazard ratios (HR) and 95% confidence interval (CI). Sensitivity analyses were conducted by excluding, in turn, each lifestyle factor from the HLI score. The HLI was inversely associated with HL, with HR for a 1-standard deviation (SD) increment in the score equal to 0.78 (95% CI: 0.66, 0.94). Sensitivity analyses showed that the association was mainly driven by smoking and marginally by diet. NHL risk was not associated with the HLI, with HRs for a 1-SD increment equal to 0.99 (0.95, 1.03), with no evidence for heterogeneity in the association across NHL subtypes. In the EPIC study, adherence to healthy lifestyles was not associated with overall lymphoma or NHL risk, while an inverse association was observed for HL, although this was largely attributable to smoking. These findings suggest a limited role of lifestyle factors in the etiology of lymphoma subtypes.

Temporal changes in clinical and radiographic variables in dogs with preclinical myxomatous mitral valve disease: The EPIC study.

BackgroundThe Evaluation of pimobendan in dogs with cardiomegaly caused by preclinical myxomatous mitral valve disease (EPIC) study monitored dogs with myxomatous mitral valve disease (MMVD) as they developed congestive heart failure (CHF).ObjectivesTo describe the changes in clinical and radiographic variables occurring as dogs with MMVD and cardiomegaly develop CHF, compared to similar dogs that do not develop CHF.AnimalsOne hundred and thirty‐five, and 73 dogs that did or did not develop CHF, respectively.Materials and methodsThe following variables were evaluated in 2 groups of dogs (dogs that did or did not develop CHF): Heart rate (HR), clinic respiratory rate (RR), home‐measured resting respiratory rate (RRR), rectal temperature (RT), body weight (BW), and vertebral heart sum (VHS). Absolute value and rate of change of each variable were calculated for each day a dog was in study. Daily means were calculated and plotted against time. The onset of CHF or last visit before leaving the study were set as reference time points.ResultsThe most extreme values and rate of change occurred in variables immediately before onset of CHF. Vertebral heart sum increased earliest. Heart rate, RR, and RRR also increased. Rectal temperature and BW decreased. Increases in RR and RRR were most extreme and occurred immediately before CHF.Conclusions and Clinical ImportanceDogs with MMVD and cardiomegaly experience increases in HR, RR, RRR, and VHS, and decreases in BW and RT as they develop CHF. The variables with highest absolute change and rate of change were RR and RRR. These findings reinforce the value of RR and RRR as indicators of impending or incipient CHF.

SITUATION MOTIVES IN EUROPEAN AND CENTRAL ASIAN EPICS

The article reveals the comparative study of situation motives in European and Central Asian epics. It provides the detailed information about similar motives, in which an extraordinary and adventurous life styles of epic heroes, their courage and undergoing a risky occasions. KEY WORDS: epic characters, situation motives, magical birth, comparative study of epics, European and Central Asian epics, adventurous life, courage and proud.

Nutrient-wide association study of 92 foods and nutrients and breast cancer risk

BackgroundSeveral dietary factors have been reported to be associated with risk of breast cancer, but to date, unequivocal evidence only exists for alcohol consumption. We sought to systematically assess the association between intake of 92 foods and nutrients and breast cancer risk using a nutrient-wide association study.MethodsUsing data from 272,098 women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, we assessed dietary intake of 92 foods and nutrients estimated by dietary questionnaires. Cox regression was used to quantify the association between each food/nutrient and risk of breast cancer. A false discovery rate (FDR) of 0.05 was used to select the set of foods and nutrients to be replicated in the independent Netherlands Cohort Study (NLCS).ResultsSix foods and nutrients were identified as associated with risk of breast cancer in the EPIC study (10,979 cases). Higher intake of alcohol overall was associated with a higher risk of breast cancer (hazard ratio (HR) for a 1 SD increment in intake = 1.05, 95% CI 1.03–1.07), as was beer/cider intake and wine intake (HRs per 1 SD increment = 1.05, 95% CI 1.03–1.06 and 1.04, 95% CI 1.02–1.06, respectively), whereas higher intakes of fibre, apple/pear, and carbohydrates were associated with a lower risk of breast cancer (HRs per 1 SD increment = 0.96, 95% CI 0.94–0.98; 0.96, 95% CI 0.94–0.99; and 0.96, 95% CI 0.95–0.98, respectively). When evaluated in the NLCS (2368 cases), estimates for each of these foods and nutrients were similar in magnitude and direction, with the exception of beer/cider intake, which was not associated with risk in the NLCS.ConclusionsOur findings confirm a positive association of alcohol consumption and suggest an inverse association of dietary fibre and possibly fruit intake with breast cancer risk.

Sacred Tree as an Archaic Motif in Kyrgyz Epic

This article is investigating archaic motif of the saint tree in the Kyrgyz epic through a comparison of world folklore materials. This research aims to show an artistic image of archaic motifs in the Kyrgyz epic in mythological and poetic contexts. Objectives of the study were to determine formation and development of epic, the role of archaic motifs by using the comparative-typological methods in the folklore study. Research results are useful for the folklore studies in the philological aspect, particularly in the epic studies. The relevance of the chosen topic is associated with the study of ancient poems and folk works from the modern point of view, and the concept of human values through the prism of folklore heritage.

Nutrient-wide association study of 92 foods and nutrients and breast cancer risk

AbstractSeveral dietary factors have been extensively investigated for associations with risk of breast cancer, but to date unequivocal evidence only exists for alcohol consumption. We sought to systematically evaluate the association between 92 dietary factors and breast cancer risk using a nutrient-wide association study approach. Using data from 272,098 women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, we assessed dietary intake of 92 foods and nutrients estimated by dietary questionnaires. Cox regression with age as the time scale and adjustment for potential confounders, was used to quantify the association between each food or nutrient and risk of breast cancer. A false discovery rate (FDR) of 0.05 was used to select the set of foods and nutrients to evaluate in the independent replication cohort, the Netherlands Cohort Study (NLCS). During a median follow-up time of 15 years, 10,979 incident invasive breast cancers were identified in the women from the EPIC study. Six foods and nutrients were associated with risk of breast cancer when controlling the FDR at 0.05. Higher intake of alcohol overall was associated with a higher risk of breast cancer (hazard ratio (HR) for a 1 SD increment in intake = 1.05, 95% confidence interval (CI) 1.03–1.07), as was beer/cider intake and wine intake (HRs per 1 SD increment = 1.05, 95% CI 1.03–1.06 and 1.04, 95% CI 1.02–1.06, respectively), whereas higher intakes of fibre, apple/pear, and carbohydrates were associated with a lower risk of breast cancer (HRs per 1 SD increment = 0.96, 95% CI 0.94–0.98; 0.96, 95% CI 0.94–0.99; and 0.96, 95% CI 0.95–0.98, respectively). When evaluated in the NLCS (2368 invasive breast cancer cases), estimates for each of these foods and nutrients were similar in magnitude and direction, with the exception of beer/cider intake, which was not associated with risk of breast cancer in the NLCS. Our findings confirm the well-established increased risk of breast cancer associated with alcohol consumption, and suggest that higher intake of dietary fibre, and possibly fruit and carbohydrates, might be associated with reduced breast cancer risk.

Shteyngart's Super Sad True(th): The Äppärät, a "Work[ing] of Art" in an Internet Age of Digital Reproduction

"Shteyngart's Super Sad True(th): The Äppärät, a 'Work[ing] of Art' in an Internet Age of Digital Reproduction" examines Gary Shteyngart's neo-Orwellian interrogation of how race/ethnicity (Jewish American, Korean American, and other minority identities), gender, sexuality, class, immigration, and the surveillance technology of the American present provide the context in which the democracy collapses. Shteyngart's novel is an epic study, influenced by the collapse of the Soviet Union, of how the equivalent of iPhone technology enables the demise of the state. Part love story, part comic satire, part sci-fi dystopia, Shteyngart's Super Sad True also deploys a critique of neo-liberal consumerist culture and shows the decay of the critical thought requisite for a healthy republic. In short, Shteyngart's novel offers surveillance and society, digital reproduction and propaganda (an update of Benjamin) as the theme for our new era of post-literacy. This essay highlights, in particular, the central role Shteyngart's äppärät plays throughout the novel. This multifaceted trope is the key to discerning Shteyngart's logic, and the hidden ironies of Super Sad True Love Story.

ВКЛАД Е. М. МЕЛЕТИНСКОГО В КАВКАЗСКОЕ ЭПОСОВЕДЕНИЕ: К 100-ЛЕТИЮ СО ДНЯ РОЖДЕНИЯ УЧЕНОГО

The article analyses the contribution of Meletinsky to Caucasian epic studies. The role of Caucasian epic traditions in the study of the problem of the origins and the early forms of the epos is considered. A significant number of the comparative-typological studies of Meletinsky are based on the materials of mythoepic cultures of Caucasus mountain people. The scholar singled out the Caucasian epics, along with some other traditions, as the special early stage in the history of the epic. Meletinsky was one of the pioneers in the fundamental studies of the Caucasian Nart epics. Based on the analysis of materials available to him at that time, Meletinsky comes to the fundamental conclusions on the genre nature, national versions, images, subjects and motifs of the Nart epic. The scholar considered Sataney and Sasrykua to be the earliest characters in the epic, whose images clearly reflected the features of a cultural hero, especially in the close Abkhaz and Adyg versions. Furthermore, according to Meletinsky, the Transcaucasian legends about the chained heroes – Abkhaz Abryskil, Armenian Mger and Georgian Amiran – represent a kind of interweaving of mythological epic and heroic tales, in which the motives of cultural exploits are largely supplanted by episodes of the heroic struggle with Giants. In the studies of Meletinsky, the epic traditions of the people of the North Caucasus and Transcaucasia are subjected to the deepest analysis at a very high level of comparative studies.

The associations of major foods and fibre with risk of ischaemic and haemorrhagic stroke: results from the prospective EPIC study.

AbstractIntroductionThe evidence of associations between individual foods and dietary fibre with subtypes of stroke (ischaemic and haemorrhagic) is not conclusive. We aimed to investigate this in a large prospective cohort.Materials and methodsWe analysed data on 418,329 men and women from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Consumption of various animal-sourced foods (red and processed meat, poultry, fish, dairy, egg), plant-sourced foods (fruit and vegetables, legumes, nuts and seeds) and dietary fibre was assessed using validated country-specific questionnaires, calibrated with 24-hour recalls. Using multivariable Cox regressions adjusted for energy intake and socio-demographic, lifestyle and physiological confounders, we estimated hazard ratios of fatal and non-fatal ischaemic, haemorrhagic and total (i.e. ischaemic, haemorrhagic and unspecified) stroke associated with calibrated increment differences in consumption of each food or dietary fibre.ResultsOver an average of 12.7 years of follow-up, we observed 4281 cases of ischaemic stroke, 1430 cases of haemorrhagic stroke, and 7378 cases of total stroke. For ischaemic stroke, lower risks were observed with higher consumption of fruit and vegetables (hazard ratio (HR); 95% confidence interval (CI) for per 200g/d of calibrated intake, 0.87; 0.82–0.93) and dietary fibre (per 10g/d, HR 0.77; 95% CI 0.69–0.86) (p-trend &lt; 0.001 for both); more modest inverse associations were also observed for milk (per 200g/d, HR 0.95; 95% CI 0.91–0.99, p-trend = 0.02), yogurt (per 100g/d, HR 0.91; 95% CI 0.85–0.97, p-trend = 0.004) and cheese (per 30g/d, HR 0.88; 95% CI 0.81–0.97, p-trend = 0.008), while a modest positive association was observed with higher red meat consumption (per 50g/d, HR 1.14; 95% CI 1.02–1.27, p-trend = 0.02). For haemorrhagic stroke, higher risk was associated with higher egg consumption (per 20g/d, HR 1.25; 95% CI 1.09–1.43, p-trend = 0.002). For total stroke, associations were consistent with those of both subtypes; we observed inverse associations for fruit and vegetables (HR 0.89, 95% CI 0.85–0.93), dietary fibre (HR 0.80, 95% CI 0.74–0.86), yogurt (HR 0.91, 95% CI 0.87–0.96), cheese (HR 0.88, 95% CI 0.82–0.94), and positive associations for red and processed meat (HR 1.18, 95% CI 1.05–1.33) and egg (HR 1.07, 95% CI 1.01–1.14).DiscussionTo conclude, risk of ischaemic stroke was inversely associated with consumption of fruit and vegetables, dietary fibre and dairy foods, and positively associated with red meat, while risk of haemorrhagic stroke was positively associated with egg consumption. Causality of the associations cannot be determined in this observational study.

Chokan Valikhanov and Oral Theory of Word Art

The article is devoted to the memory of Ch. Ch. Valikhanov and topical problems of oral theory-the object of modern intercultural communication. It raises questions about the style and genre of oral utterance, oral and stylistic techniques and the art of speech, which are necessary for students of genre theory and the art of journalism. The main purpose of the article is to identify the relevance of the sci-entist’s ideas in the light of the oral theory of Parry-Lord-the leading American researchers, which comes from the nature of not only genre forms of Kazakh folklore, but also functionally related stylistics and art of speech. The methodological value of both the research and the works of the scientist is revealed in the analysis of oral genre forms of folklore, stylistics and art of speech and taking into account the main method of Ch. Ch. Valikhanov, his view “from within the tradition itself”. This methodology takes into account the comparative studies and comparative-historical and typological, and the systemic methods and method of analysis. The main conclusion of the article is that the first Kazakh folklorist, Ch. Ch. Va-likhanov is at the origins of journalism, acts as a master of the essay. His “ Notes...», “Notes...”,” Essays... &nbsp; “ require a closer reading: he foresaw many directions of modern oral theory and world folklore. These visionary ideas were based on his clear awareness of the unique value of centuries-old Steppe knowl-edge, an important part of which was the great oral epic and folklore of the Turks of the North Caucasus, Southern Siberia, Central and Central Asia. unified in its development, the integral steppe tradition of the art of speech first appeared in his works in all its genre and species diversity. such a holistic historical and ethnographic approach to the analysis of folklore and the art of speech of the turkic peoples has practical and methodological significance for both oral theory and world epic studies. Кey words: genre, parry-lord oral theory, tradition, formula style, word art, steppe knowledge, genre form.

The image of a Horse in Yakut and Khakass Heroic Epic: Based on Yakut Olonkho and Khakass Alyptyh Nymah

The article is devoted to a comparative analysis of the image of the epic horse in the texts of two related Turkic epics. The material for the research in a comparative aspect was the texts of the Yakut epic “The Girl-Warrior of Dzhyrybyna Dzhyrylyatta with a milk-white horse” by P. P. Yadrikhinsky – Bedjeele and “Son of the Horse Dyyray Warrior” by I. I. Burnasheva – Tong Suorun; Khakass epic “Altyn-Aryg” by S. P. Kadyshev and “Ai-Khuuchin” by P. V. Kurbizhekov. The choice of these texts is due to the fact that their academic publications are equipped with a good reference apparatus, as well as the presence of facing Russian translation and relatively equal volume of texts. The relevance of the study is determined by the increasing interest in the comparative study of Turkic epics. The subject of this study is the image of an epic horse from the texts of the Yakut olonkho and Khakass alyptyh nymah. The purpose of this article is to identify the commonality and differences in the images of the epic horse in the epics of related Turkic peoples. In order to achieve this objective, сontrastive-сomparative and comparative-historical methods were used to identify the general and specific in the Turkic epics and a descriptive method that allows us to more deeply characterize the image of the epic horse taking into account the worldview and mentality of these peoples. The analysis showed that the horse is present in all the main events of the life of the epic bogatyr accompanying him in all significant events. A commonplace in the image of a horse for the Yakut and Khakass heroic epics is a beautiful description of a horse, loyalty and power of a horse, as well as its ability to speak in human language. A wide variety of horse’s colors in epics indicates good knowledge of Turkic peoples in horse breeding. The image of the horse, which had a major impact, refers to the archetypal symbols of the culture of the Turkic people.

Eclipsing Binaries in the Open Cluster Ruprecht 147. II. Epic 219568666

Abstract We report our spectroscopic monitoring of the detached, grazing, and slightly eccentric 12 day double-lined eclipsing binary EPIC 219568666 in the old nearby open cluster Ruprecht 147. This is the second eclipsing system to be analyzed in this cluster, following our earlier study of EPIC 219394517. Our analysis of the radial velocities combined with the light curve from the K2 mission yields absolute masses and radii for EPIC 219568666 of M 1 = 1.121 ± 0.013 M ☉ and R 1 = 1.1779 ± 0.0070 R ☉ for the F8 primary and M 2 = 0.7334 ± 0.0050 M ☉ and R 2 = 0.640 ± 0.017 R ☉ for the faint secondary. Comparison with current stellar evolution models calculated for the known metallicity of the cluster points to a primary star that is oversized, as is often seen in active M dwarfs, but this seems rather unlikely for a star of its mass and with a low level of activity. Instead, we suspect a subtle bias in the radius ratio inferred from the photometry, despite our best efforts to avoid it, which may be related to the presence of spots on one or both stars. The radius sum for the binary, which bypasses this possible problem, indicates an age of 2.76 ± 0.61 Gyr, which is in good agreement with a similar estimate from the binary in our earlier study.

Abstract 320: Statewide Implementation of the Prehospital Traumatic Brain Injury Guidelines in Children: The EPIC4Kids Study

Introduction: The EPIC Study implemented the national EMS TBI Guidelines in a massive, statewide initiative (&gt;11,000 providers trained, 133 agencies). While implementation was not associated with improved survival to discharge in moderate or critically-severe TBI in the primary (all-age) study, the adjusted odds of survival doubled in severe TBI and tripled in severe, intubated TBI. We now report the preplanned pediatric subgroup analysis (“EPIC4Kids”-NIH R01NS071049). Methods: Multisystem, intention-to-treat study using a before/after controlled design in patients with moderate to critically severe TBI. Interventions: Prevention/treatment of hypoxia, hypotension, and hyperventilation by EMS providers. Inclusion: Age&lt;18; CDC Barell Matrix Type 1; 1/07-6/15. Severity subgroups [Head Region Severity Score (IDC-based AIS equivalent)]: Moderate=1-2; Severe=3-4; Critical=5-6. The pre-implementation (P1) and post-implementation (P3) cohorts were compared using logistic regression (Firth’s approach when comparisons had small event numbers), adjusting for risk factors/confounders. Results: Included were 2801 cases [P1=2041 (72.9%), P3=760 (27.1%); median age 11 (IQR 2, 15); 62.9% male]. The all-severity P3 vs P1 cohort analysis yielded adjusted odds (aOR) of 1.16 (95%CI 0.697, 1.92, p=0.57) for survival. In severe TBI (P1=1405, P3=605; 80% of P3 cases), but not moderate or critical TBI, adjusted survival was significantly improved after implementation (Figure; p=0.049). Improvement in survival for those with severe, intubated TBI (P1=174, P3=44) approached significance (Fig; p=0.11). Conclusion: In the first controlled study of its kind, implementation of the EMS TBI guidelines was independently associated with a dramatic increase in adjusted survival among children with severe TBI. The aOR for survival was even larger than that of the overall (all-age) EPIC Study and supports widespread implementation of the guidelines in children.

Abstract 386: Prehospital Capnography in Non-Intubated Traumatic Brain Injury Patients: Association Between End-Tidal CO2 and Level of Consciousness

Background: The EMS traumatic brain injury (TBI) guidelines encourage limiting prehospital intubation (ETI) to patients with profoundly depressed level of consciousness (LOC) and who cannot protect their airway or adequately ventilate without ETI. Thus, EMS providers may manage many TBI patients without intubating even when they have significant alterations in LOC. Monitoring End-Tidal CO2 by placing sensors in the nares (NC-CO2) of non-intubated patients may give providers valuable information about ventilatory status and trends. Study Objective: To evaluate the association between LOC and NC-CO2 in non-intubated TBI patients. Methods: Non-intubated cases from 6 EMS agencies reporting continuous monitor data (Philips MRx™) in the EPIC Study (NIH 1R01NS071049) were evaluated (4/13-3/17). Glasgow Coma Scale (GCS) was available from the EMS record in call cases. Comparisons in patient-level mean, median, lowest and highest NC-CO2 levels were made across GCS categories using clinically meaningful thresholds: &lt;15, &lt;12, &lt;9, and 3. Statistics: Wilcoxon rank-sum test. Results: Included were 106 cases [median age: 47 (range: 9-91), 66% male]. The Table shows the NC-CO2 patterns and comparisons across the GCS categories. In no case was there a significant difference in NC-CO2 between the better vs. worse mental status cohort. Conclusion: We believe this is the first evaluation of the association between NC-CO2 and mental status in TBI. Patients that had significant (and even profound) decreases in LOC, but whom paramedics chose not to intubate, had remarkably similar NC-CO2 patterns compared to those with normal or near-normal mental status. This may support the overall approach of limiting ETI to those with airway/ventilatory compromise or impending hypoxia as there was no evidence of increasing NC-CO2, indicative of hypercapnia, in the non-intubated patients even when they had very depressed LOC.