Multiple Races Research Articles

Racial Differences in Utilization of Hematopoietic Cell Transplantation for Lymphoma in the United States

<h3>Introduction</h3> Racial disparities have been documented in hematopoietic cell transplantation (HCT), a complex and expensive therapeutic modality for hematologic malignancies. Prior work suggests that racial minorities in the US have lower rates of utilization of HCT compared to White patients. However, the available literature on racial disparities in HCT is limited, particularly with regard to lymphoma patients. <h3>Objectives</h3> The objective of this study was to determine if racial differences exist in utilization of HCT for lymphoma by comparing transplant activity to disease incidence rates between 2013-2016. <h3>Methods</h3> This was a retrospective cohort study using publicly available data from the Center for International Blood and Marrow Transplant Research; Surveillance, Epidemiology, End Results program; and US Census Bureau. All patients in the US who underwent HCT for Hodgkin lymphoma (HL) and Non-Hodgkin lymphoma (NHL) between 2013-2016 were included. Patients with unknown race or multiple races were excluded. We assessed transplant utilization by calculating the transplant utilization rate (TUR) for each disease, separately. Rates were operationalized as the number of transplants performed per 100 new cases of the disease diagnosed in the US during the same time period. <h3>Results</h3> There were a total of 18,569 transplants for HL and NHL included. Table 1 shows patient characteristics by transplant type. During the same time period, age-adjusted incidence rates [95% confidence interval (CI)] for HL for Whites, Blacks, Asians/Pacific Islanders (API), and American Indians/Alaska Natives (AI) were 2.65 (2.59-2.71), 2.61 (2.46-2.77), 1.24 (1.14-1.36), and 1.00 (0.73-1.34) cases/100,000 persons at risk, respectively. Incidence rates were higher for NHL for the same racial groups at 20.22 (20.05-20.38), 14.44 (14.06-14.82), 13.53 (13.16-13.90), and 8.75 (7.82-9.75), respectively. Transplant and incidence data were consistent from 2013-2016. There were no significant differences in TURs for HL between racial groups. However, Whites with NHL had a higher TUR than Blacks [7.02 (95% CI 6.90-7.13) vs 4.75 (95% CI 4.49-5.02), p < 0.001], which was due to differences in utilization of autologous rather than allogeneic HCT [5.77 (95% CI 5.67-5.88) vs. 3.56 (95% CI 3.33-3.79), p < 0.001 for autologous HCT and 1.24 (95% CI 1.20-1.29) vs. 1.19 (95% CI 1.06-1.33), p = 0.488 for allogeneic HCT]. Figure 1 shows the utilization data for both HL and NHL. The impact of this difference in utilization of autologous HCT was an estimated loss of 143 transplants per year for Black patients. <h3>Conclusion</h3> Autologous HCT for NHL is underutilized for Black patients compared to White patients in the US. Additional research is needed to understand the reasons for this difference.

New-Onset Diabetes, Longitudinal Trends in Metabolic Markers, and Risk of Pancreatic Cancer in a Heterogeneous Population

Observational studies of predominantly white populations have found new-onset diabetes to be associated with increased risk of pancreatic cancer. We sought to determine whether this relationship applies to other races or ethnicities and to identify metabolic profiles associated with increased risk of pancreatic cancer. We conducted a population-based cohort study of Asian, black, Hispanic and white patients from Kaiser Permanente Southern California from 2006 through 2016 (n = 1,499,627). Patients with diabetes were identified based on glucose and hemoglobin A1c (HbA1c) measurements. We used Cox regression to assess the relationship between diabetes status and duration and pancreatic cancer. For patients with recent diagnoses of diabetes (1 year or less) we compared longitudinal changes in glucose, HbA1c, and weight, from time of diabetes diagnosis through 3years prior to the diagnosis, in patients with vs without pancreatic cancer. We identified 2,002 incident cases of pancreatic cancer from nearly 7.5 million person-years of follow-up. Compared to patients without diabetes, individuals who received a recent diagnosis of diabetes had an almost 7-fold increase in risk of pancreatic cancer (relative risk, 6.91; 95% CI, 5.76-8.30). Among patients with a recent diagnosis of diabetes, those who developed pancreatic cancer had more rapid increases in levels of glucose (Δslope: cases, 37.47 mg/dL vs non-cases, 27.68 mg/dL) and HbA1c (Δslope: cases, 1.39% vs non-cases, 0.86%) in the month preceding the diagnosis of diabetes, and subtle weight loss in the prior years (slope: cases -0.18 kg/interval vs non-cases 0.33 kg/interval). These longitudinal changes in markers of metabolism were stronger for specific race and ethnic groups. In a study of a large ethnically diverse population, we found risk of pancreatic cancer to be increased among patients with a diagnosis of diabetes in the past year among different races and ethnicities. Weight loss and rapid development of poor glycemic control were associated with increased risk of pancreatic cancer in multiple races.

Similarities and Differences in Left Ventricular Size and Function among Races and Nationalities: Results of the World Alliance Societies of Echocardiography Normal Values Study

The World Alliance Societies of Echocardiography (WASE) Normal Values Study evaluates individuals from multiple countries and races with the aim of describing normative values that could be applied to the global community worldwide and to determine differences and similarities among people from different countries and races. The present report focuses specifically on two-dimensional (2D) left ventricular (LV) dimensions, volumes, and systolic function. The WASE Normal Values Study is a multicenter international, observational, prospective, cross-sectional study of healthy adult individuals. Participants recruited in each country were evenly distributed among six predetermined subgroups according to age and gender. Comprehensive 2D transthoracic echocardiograms were acquired and analyzed following strict protocols based on recent American Society of Echocardiography and European Association of Cardiovascular Imaging guidelines. Analysis was performed at the WASE 2D core laboratory and included 2D LV dimensions, LV volumes, and LV ejection fraction (LVEF) by the biplane Simpson method and global longitudinal strain (GLS). Two thousand eight subjects were enrolled in 15 countries. The median age was 45years (interquartile range, 32-65years), 42.8% were white, 41.8% were Asian, and 9.7% were black. LV dimensions and volumes were larger in male subjects, while LVEF and GLS were higher in female subjects. Global WASE normal ranges for LV dimensions were smaller than those in the guidelines, but the upper limits of normal for LV volumes and the lower limits of normal for LVEF were higher in the WASE study. Significant intercountry variation was identified for all LV parameters reflecting LV size (dimensions, mass, and volumes) even after indexing to body surface area, with LV end-diastolic and end-systolic volumes having the highest variation. The largest volumes were noted in Australia, while the smallest were measured in India for both genders. This finding suggests that in addition to gender and body surface area, specific country should be considered when evaluating LV volumes. Intercountry variation for LVEF and GLS was smaller but still statistically significant (P<.05 for all). LV dimensions and volumes are larger in men, while LVEF and GLS are higher in women. Current guideline-recommended normal ranges for LV volumes and LVEF should be adjusted. Intercountry variability is significant for LV volumes, and therefore nationality should be considered for defining ranges of normality.

2800. Pragmatic Assessment of Influenza Vaccine Effectiveness in the DoD (PAIVED): Influenza-Like-Illness Rates in Year 1

BackgroundInfluenza-like illnesses (ILI) are common in military populations due to close living and working conditions, physical exertion, and exposure to novel viruses. The PAIVED trial aims to compare the effectiveness of 3 FDA approved influenza vaccines in active-duty military, retiree, and dependent populations, and will also provide information about the burden, impact, and severity of ILI.MethodsParticipants were enrolled in the 2018–2019 influenza season at 5 geographically diverse military facilities. Active duty, non-recruit military personnel, retirees, and dependents were randomized to receive influenza vaccine (egg-based, recombinant, or cell-culture derived) and then completed weekly electronic surveys throughout the influenza season. If a participant reported ILI symptoms during surveillance, 2 in-person visits with study personnel were scheduled for confirmed ILI. Nasal swabs and blood samples were collected for diagnostic and immunologic testing.ResultsAmong the 852 non-recruit participants enrolled in PAIVED, 25% were active military, 36% retired military, and 39% dependents. Almost half (48%) were female, and 72% were white, 15% African American, 6% Asian, 4% multiple races, and 3% unknown or other race. 788 participants (92%) responded to at least one surveillance questionnaire. Participants reported 407 ILIs (Figure 1), of which 160 met the study case definition. Between 12 and 28% of the participants experienced an ILI during the surveillance period, and 12 people experienced 2 ILIs. Most sites reported a median 2–3 days of fever/feverishness or chills and 3–4 days of reduced activity associated with an ILI episode. No viruses were detected in 58% of nasal swabs, 1 virus in 40%, and 2 viruses in 1% of swabs (Figure 2 for pathogen data).ConclusionDuring the period under study, ILIs were common with 1 in 6 participants experiencing a confirmed ILI, many of which were 6–8 days in duration. ILIs resulted in reduced activity, although few individuals reported missing work or school, a situation that could result in greater likelihood of transmission to others. Planned analyses will provide additional information about the pathogens responsible for these illnesses and help guide effective prevention policies in these populations. Disclosures All authors: No reported disclosures.

Rank–size law, financial inequality indices and gain concentrations by cyclist teams. The case of a multiple stage bicycle race, like Tour de France

This note examines financial distributions to competing teams at the end of the most famous multiple stage professional (male) bicyclist race, ”TOUR DE FRANCE”. A rank–size law (RSL) is calculated for the team financial gains. The RSL is found to be hyperbolic with a surprisingly simple decay exponent ≈−1. Yet, the financial gain distributions unexpectedly do not obey Pareto principle of factor sparsity. Next, several (8) inequality indices are considered : the Entropy, the Hirschman–Herfindahl, Theil, Pietra–Hoover, Gini, Rosenbluth indices, the Coefficient of Variation and the Concentration Index are calculated for outlining «diversity measures». The connection between such indices and their «concentration aspects» meanings are presented as support of the RSL findings. The results emphasize that the sum of skills and team strategies are effectively contributing to the financial gains distributions. From theoretical and practical points of view, the findings suggest that one should investigate other ”long multiple stage races” and rewarding rules. Indeed, money prize rules coupling to stage difficulty might influence and maybe enhance (or deteriorate) purely sportive aspects in group competitions.Due to the delay in the peer review process, the 2019 results can be examined. They are discussed in an Appendix ; the value of the exponent (−1.2) is pointed out to mainly originating from the so called «king effect»; the tail of the RSL rather looks like an exponential.

Identification of a polymorphism within the Rosa multiflora muRdr1A gene linked to resistance to multiple races of Diplocarpon rosae W. in tetraploid garden roses (Rosa × hybrida).

A QTL for resistance to several races of black spot co-located with the known Rrd1 locus in Rosa. A polymorphism in muRdr1A linked to black spot resistance was identified and molecular markers were designed. Black spot, caused by Diplocarpon rosae, is one of the most serious foliar diseases of landscape roses that reduces the marketability and weakens the plants against winter survival. Genetic resistance to black spot (BS) exists and race-specific resistance is a good target to implement marker-assisted selection. High-density single nucleotide polymorphism-based genetic maps were created for the female parent of a tetraploid cross between 'CA60' and 'Singing in the Rain' using genotyping-by-sequencing following a two-way pseudo-testcross strategy. The female linkage map was generated based on 227 individuals and included 31 linkage groups, 1055 markers, with a length of 1980cM. Race-specific resistance to four D. rosae races (5, 7, 10, 14) was evaluated using a detached leaf assay. BS resistance was also evaluated under natural infection in the field. Resistance to races 5, 10 and 14 of D. rosae and field resistance co-located on chromosome 1. A unique sequence of 32bp in exon 4 of the muRdr1A gene was identified in 'CA60' that co-segregates with D. rosae resistance. Two diagnostic markers, a presence/absence marker and an INDEL marker, specific to this sequence were designed and validated in the mapping population and a backcross population derived from 'CA60.' Resistance to D. rosae race 7 mapped to a different location on chromosome 1.

Alternate-Day Low Energy Availability During Spring Classics in Professional Cyclists.

To assess energy and carbohydrate (CHO) availability and changes in blood hormones in 6 professional male cyclists over multiple single-day races. The authors collected weighed-food records, power-meter data, and morning body mass measurements across 8 d. CHO intakes were compared with contemporary guidelines. Energy availability (EA) was calculated as energy intake minus exercise energy expenditure, relative to fat-free mass (FFM). Skinfold thickness and blood metabolic and reproductive hormones were measured prestudy and poststudy. Statistical significance was defined as P ≤ .05. Body mass (P = .11) or skinfold thickness (P = .75) did not change across time, despite alternate-day low EA (14 [9] vs 57 [10]kcal·kg-1 FFM·d-1, race vs rest days, respectively; P < .001). Cyclists with extremely low EA on race days (<10kcal·kg-1 FFM·d-1; n = 2) experienced a trend toward decreased testosterone (-14%) and insulin-like growth factor 1 (-25%), despite being high EA (>46kcal·kg-1 FFM·d-1) on days between. CHO intakes were significantly higher on race versus rest days (10.7 [1.3] vs 6.4 [0.8]g·kg-1·d-1, respectively; P < .001). The cyclists reached contemporary prerace fueling targets (3.4 [0.7]g·kg-1·3h-1 CHO; P = .24), while the execution of CHO guidelines during race (51 [9]g·h-1; P = .048) and within acute (1.6 [0.5]g·kg-1·3h-1; P = .002) and prolonged (7.4 [1.0]g·kg-1·24h-1; P = .002) postrace recovery was poor. The authors are the first to report the day-by-day periodization of energy and CHO in a small sample of professional cyclists. They also examined the logistics of conducting a field study under stressful conditions in which major cooperation from the subjects and team management is needed. Their commentary around these challenges and possible solutions is a major novelty of the article.

Development of molecular markers associated with resistance to Meloidogyne incognita by performing quantitative trait locus analysis and genome-wide association study in sweetpotato.

The southern root-knot nematode, Meloidogyne incognita, is a pest that decreases yield and the quality of sweetpotato [Ipomoea batatas (L.) Lam.]. There is a demand to produce resistant cultivars and develop DNA markers to select this trait. However, sweetpotato is hexaploid, highly heterozygous, and has an enormous genome (∼3 Gb), which makes genetic linkage analysis difficult. In this study, a high-density linkage map was constructed based on retrotransposon insertion polymorphism, simple sequence repeat, and single nucleotide polymorphism markers. The markers were developed using F1 progeny between J-Red, which exhibits resistance to multiple races of M. incognita, and Choshu, which is susceptible to multiple races of such pest. Quantitative trait locus (QTL) analysis and a genome-wide association study detected highly effective QTLs for resistance against three races, namely, SP1, SP4, and SP6-1, in the Ib01-6 J-Red linkage group. A polymerase chain reaction marker that can identify genotypes based on single nucleotide polymorphisms located in this QTL region can discriminate resistance from susceptibility in the F1 progeny at a rate of 70%. Thus, this marker could be helpful in selecting sweetpotato cultivars that are resistant to multiple races of M. incognita.

Characterization of Ethiopian Wheat Germplasm for Resistance to Four Puccinia graminis f. sp. tritici Races Facilitated by Single-Race Nurseries.

In Ethiopia, breeding rust resistant wheat cultivars is a priority for wheat production. A stem rust epidemic during 2013 to 2014 on previously resistant cultivar Digalu highlighted the need to determine the effectiveness of wheat lines to multiple races of Puccinia graminis f. sp. tritici in Ethiopia. During 2014 and 2015, we evaluated a total of 97 bread wheat and 14 durum wheat genotypes against four P. graminis f. sp. tritici races at the seedling stage and in single-race field nurseries. Resistance genes were postulated using molecular marker assays. Bread wheat lines were resistant to race JRCQC, the race most virulent to durum wheat. Lines with stem rust resistance gene Sr24 possessed the most effective resistance to the four races. Only three lines with adult plant resistance possessed resistance effective to the four races comparable with cultivars with Sr24. Although responses of the wheat lines across races were positively correlated, wheat lines were identified that possessed adult plant resistance to race TTKSK but were relatively susceptible to race TKTTF. This study demonstrated the importance of testing wheat lines for response to multiple races of the stem rust pathogen to determine if lines possessed non-race-specific resistance.

Management of Adverse Events in Cancer Patients Treated With PD-1/PD-L1 Blockade: Focus on Asian Populations.

The interaction between programmed cell death protein 1 (PD-1) and its ligand programmed death-ligand 1 (PD-L1) induces exhaustions of cytotoxic lymphocytes in the tumor microenvironment, which facilitates tumor immune evasion. PD-1/PD-L1 blockade therapy, which prevents the receptors and ligands from binding to each other, disrupts the T-cell exhaustion signaling, thereby increasing antitumor immunity. Inspiringly, it has revolutionized the treatment of many different types of cancers including non-small-cell lung carcinoma, melanoma, lymphoma, and so on. However, with the intention of generating an antitumor immune response, PD-1/PD-L1 blockade may also lead to a spectrum of side effects. The profile of adverse events (AEs) of PD-1/PD-L1 blockade is not exactly the same with other immune checkpoint blockades, such as blockade of cytotoxic T-lymphocyte-associated protein 4. Although cutaneous, gastrointestinal, and pulmonary systems are common victims, AEs of PD-1/PD-L1 blockade might occur in any other organ system of the human body. These toxicities can be life-threatening if not managed promptly, and proper treatment intervention is imperative for optimal control and prevention of severe damage. Currently, clinical practice for the management of AEs in PD-1/PD-L1 blockade remains sporadic and variable. The majority of initial clinical trials were carried out in Caucasians. The trials of multiple races usually included a small portion of Asian participants, and results were calculated and interpreted for the entire included subjects without any race-specific conclusions. Therefore, the information on PD-1/PD-L1 blockade in Asians is far from systematic or comprehensive. Recently, as the results of clinical trials of anti-PD-1/PD-L1 agents in Asian populations have been gradually released, we summarized current evidence with a specific focus on the Asian population, hoping to outline strategies and offer guidance on the management of AEs in cancer patients treated with PD-1/PD-L1 blockade in the Asian world.

THE DEVELOPMENT OF A MULTI-ETHNIC AND MULTI-RELIGIOUS SOCIETY IN MALAYSIA

Malaysia has its own uniqueness with its population consists of multiple races and religions. The presence of this multi-ethnic and multi-religious society is caused by various factors that related to human life such as jobs security, national policy and so on. This article will attempt to examine the factors of the Malaysia’s demographic changes and development which will cover three phases i.e. the Pre-colonial period, the Colonial period and Postcolonial period. It also discusses the historical facts of a multi-ethnic and a multi-religious society in Malaysia. In order to examine the subject matter, library research has been conducted to seek the data needed. Numerous historical literature related to this study have been reviewed. This study shows that the development of multi-ethnic and multi-religious society in Malaysia was caused by several factors such as migration and colonization. These factors triggered demographic changes in Malaysia’s population which can still be noticed as one of the unique features of the state until today. © 2019, Academy of Islamic Studies, Dept of Islamic History and Civilization, University of Malaya. All rights reserved.

Unique Hair Properties that Emerge from Combinations of Multiple Races

The fusion of ethnicity in human populations is becoming increasingly common, so the conventional definition of ethnicity is going to become deficient. The aim of this study was to investigate the hair properties which emerge from combinations of multiple races. Hair fibers collected from mixed-race subjects were investigated and classifications of hair shape as well as measurements of thickness, ellipticity and surface damage were carried out. The results show that hair shapes varied widely: straight hair and very curly hair often existed together on the heads of individuals with mixed ethnicity. Curly hair tended to be thicker than loose wavy hair. As for damage to the hair surface, the hairs of mixed-race subjects showed a very unique property in that they were much more severely damaged near the root (the proximal end) than the hairs of monoracial subjects. The hair shape (curly or loose wavy) was not related to the level of damage. The severe damage near the proximal end is thought to be caused by entanglement, due to the presence of various curl phases. This study reports the unique characteristics of hairs of subjects with mixed ethnicity, which have never been noted in the previous studies on subjects with a monoracial background.

Development and Validation of the First Multi-Racial Prognostic Nomogram for Patients with Bone Metastatic Prostate Cancer Worldwide

Background: The independent prognostic factors for survival of patients with bone metastatic prostate cancer (PCa) remain controversial; Besides, a nomogram for application to multiple ethnicities has yet to be established. We aimed to build a generic nomogram to predict the prognosis of bone metastatic PCa. Methods: The independent prognostic factors for survival were identified, and the nomogram was further developed in a retrospective study of 1,556 patients with bone metastatic PCa registered in the Surveillance, Epidemiology and End Results (SEER) database. The discriminative ability of the nomogram was assessed by C-index (concordance index) and ROC (receiver operating characteristic) curve analysis, whereas its predictive accuracy was measured by calibration curve assessment. Furthermore, the model was externally validated using the data of 711 patients enrolled in the same database at different times. Results: Age ≥70 years, Gleason score ≥8, stage T4, stage N1, liver metastases, and Asian/Pacific ethnicity were identified as independent prognostic factors. The C-index of the nomogram for predicting cancer-specific survival (CSS) was 0.68 (95% confidence interval [CI]: 0.65-0.70), with areas under the receiver operating characteristic (ROC) curve (AUCs) for one, three, and five years of 0.70, 0.70, and 0.76, respectively. In the validation cohort, the C-index was 0.66 (95% CI: 0.62 to 0.69), with AUCs for one, three, and five years of 0.67, 0.66 and 0.71, respectively. The calibration curve presented a strong agreement between the nomogram-predicted and actual one-, three-, and five-year CSSs in both the primary and external validation cohorts. Conclusion: We established and validated the first nomogram applied to multiple races for predicting the one-, three-, and five-year CSSs of patients with bone metastatic PCa, which will further facilitate individualized clinical decision-making and will be useful for patient counseling. Funding: This study is supported by the Key Science and Technology Program of Shaanxi Province, PR China (grant number: 2016SF-162) and the Development Funds of Shaanxi Science and Technology Agency of China (grant number:2018SF/091). Declaration of Interest: There are no conflicts of interest. Ethical Approval: The present study conformed to the 1964 Helsinki Declaration and its later amendments and was performed under the ethical standards of the institutional and national research committees.

Whole-genome re-sequencing reveals the impact of the interaction of copy number variants of the rhg1 and Rhg4 genes on broad-based resistance to soybean cyst nematode.

SummarySoybean cyst nematode (SCN) is the most devastating plant‐parasitic nematode. Most commercial soybean varieties with SCN resistance are derived from PI88788. Resistance derived from PI88788 is breaking down due to narrow genetic background and SCN population shift. PI88788 requires mainly the rhg1‐b locus, while ‘Peking’ requires rhg1‐a and Rhg4 for SCN resistance. In the present study, whole genome re‐sequencing of 106 soybean lines was used to define the Rhg haplotypes and investigate their responses to the SCN HG‐Types. The analysis showed a comprehensive profile of SNPs and copy number variations (CNV) at these loci. CNV of rhg1 (GmSNAP18) only contributed towards resistance in lines derived from PI88788 and ‘Cloud’. At least 5.6 copies of the PI88788‐type rhg1 were required to confer SCN resistance, regardless of the Rhg4 (GmSHMT08) haplotype. However, when the GmSNAP18 copies dropped below 5.6, a ‘Peking’‐type GmSHMT08 haplotype was required to ensure SCN resistance. This points to a novel mechanism of epistasis between GmSNAP18 and GmSHMT08 involving minimum requirements for copy number. The presence of more Rhg4 copies confers resistance to multiple SCN races. Moreover, transcript abundance of the GmSHMT08 in root tissue correlates with more copies of the Rhg4 locus, reinforcing SCN resistance. Finally, haplotype analysis of the GmSHMT08 and GmSNAP18 promoters inferred additional levels of the resistance mechanism. This is the first report revealing the genetic basis of broad‐based resistance to SCN and providing new insight into epistasis, haplotype‐compatibility, CNV, promoter variation and its impact on broad‐based disease resistance in plants.

Exploring factors associated with health disparities in asthma and poorly controlled asthma among school-aged children in the U.S.

Objective: Certain populations suffer disproportionately from asthma and asthma morbidity. The objective was to provide a national descriptive profile of asthma control and treatment patterns among school-aged children (SAC: aged 6–17) in the U.S. Methods: This was a cross-sectional analysis using the nationally representative 2007–2014 Medical Expenditure Panel Survey. Among SAC with asthma, indicators of poor control included: exacerbation/asthma attack; >3 canisters short-acting beta agonist (SABA)/3 months; and asthma-specific Emergency Department or inpatient visits (ED/IP). Results: Non-Hispanic black, non-Hispanic multiple races, Puerto Rican, obese, Medicaid, poor, ≥2 non-asthma chronic comorbidities (CC), and family average CC ≥ 2 were associated with higher odds of having asthma. The following had significantly higher odds ratios (OR) of excessive SABA use compared to non-Hispanic whites [OR; CI; p < 0.05]: Puerto Rican (3.8; 2.1–6.9), Mexican (3.6; 2.0–6.4), Central/South American (3.0; 1.2–7.7), Hispanic-other (3.1; 1.1–9.0), non-Hispanic black (2.5; 1.6–3.9), and non-Hispanic Asian (4.0; 1.7–9.2). SABA OR were also significant for Spanish spoken at home (2.5; 1.6–3.8), obese (2.1; 1.3–3.3), Medicaid (2.9; 2.0–4.1), no medical insurance (2.1; 1.1–4.1), no prescription insurance (2.5; 1.8–3.5), poor (2.8; 1.7–4.7), CC ≥ 2 (2.1; 1.6–2.8), parent-without high-school degree (2.5; 1.8–3.6), parent-SF-12 Physical Component Scale <50 (1.6; 1.2–2.1) and Mental Component Scale <50 (1.5; 1.1–2.0). Significant differences also existed across subgroups for ED/IP visits. Conclusions: There are disparities in asthma control and prevalence among certain populations in the U.S. These results provide national data on disparities in several indicators of poor asthma control beyond the standard race/ethnicity groupings.

Horse-Racing Fraud in Victorian Fiction

Horse-Racing Fraud in Victorian Fiction Nancy Henry (bio) In his account of English horse racing, A Mirror of the Turf (1892), Louis Henry Curzon writes: There is no other business, perhaps, which offers so many opportunities for successful fraud as horse-racing, and that for the best of reasons: the chicanery that is prevalent does not render those who practice it amendable to the criminal law, turf crimes being without the pale of legal action. (271)1 Curzon reflects that frauds in the late nineteenth century are more subtle and less violent than in the past, when a horse might be “ ‘nobbled’ or ‘got at’ by some person hired for the purpose, or it might be lamed by the farrier, or perhaps poisoned by a stable attendant” (272). In contrast, the “coups” of his own time are planned over months or years, as when bookmakers purchase horses in order to manipulate their odds across multiple races. Such scams may be impossible to detect, much less punish. He concludes that “turf frauds of many kinds, but especially those kinds which entail no penal consequences, are plentiful enough even at the present time” (300).2 Victorian and contemporary historians have established the changing nature of racing fraud, which became more businesslike as the sport became more commercialized.3 Victorian horse-racing fiction represents a distinctive subculture at the intersection of athletic competition and local and global economies of betting. J. Jeffrey Franklin analyzes gambling as “part of the Victorian discourse of money, [treated] as one among the other channels through which capital was circulated in nineteenth-century Britain” (34–35). I argue further that a focus on horse racing, and on fraud in particular, in Victorian fiction contributes not only to the histories of racing and gambling but also to the history of finance and financial fiction. Writers of fiction were particularly drawn to those earlier forms of fraud mentioned by Curzon, such as poisoning and laming, which could only be carried out by someone intimate enough with the horse to get close and do harm. Such acts of sabotage were motivated by vengeance—usually against the owners of the horse. The elements of class conflict and personal vendetta played into the overall themes of Victorian fiction. The problem of how to identify the perpetrator was consistent with that of other financially themed novels. Swindlers such as Charles Dickens’s Merdle in Little Dorrit (1855–57) [End Page 235] or Anthony Trollope’s Dobbs Broughton (also a horse player) in The Last Chronicle of Barset (1866–67) or Augustus Melmotte in The Way We Live Now (1875) disguise their scams through false identities and elaborate schemes. In contrast, tampering with a horse to sabotage a race, on which great sums of money might be wagered, depends on the simple fact that horses cannot testify. Fiction has the capacity to examine the psychology of the saboteur as well as the experience of the horse. In this respect, examining frauds that involve tampering with the equine athlete opens up the study of financial fiction to the realm of animal studies.4 That Curzon sought a variety of terms—fraud, chicanery, and crime—to describe cheating in racing suggests the difficulty of definitions. The term fraud is expansive, encompassing many possible scenarios of dishonest behaviour. Chicanery seems quaint, and crime is inaccurate where the law is not involved. Within sports generally, Graham Brooks, Azeem Aleem, and Mark Button see fraud as a subset of corruption and offer a useful definition: fraud “is based on deception with the intention of securing some advantage—immediate or in the future—and depriving a third party such as individual(s), a small group of people or organisation of honest services or benefits at the expense of other individuals and organisations” (18). I keep this definition in mind while employing the term fraud in cases where a saboteur intends to deprive an owner of a sound horse, and, consequently, to defraud of their money the people who bet on that horse. Furthermore, such fraud may symbolically target an entire class of wealthy horse owners; crucially, it also physically harms the animal, which may or may not recover. With...

Acute Post-Exercise Recovery Strategies in Cycling: A Review

Cycling events often include multiple races a day or racing over consecutive days. Congested competition schedules and increased training load have led to the implementation of recovery strategies; with the goal of alleviating post-exercise fatigue and enhancing subsequent performance. This review aims to review the efficacy of recovery strategies used following different cycling events. Compression garments have been shown to improve subsequent 30s – 30min mean cycling power and 5-min max cycling power, while cold water immersion may improve 5-15s sprint cycling power output, 1-15min time trial (TT) total work performed and mean power output in hot and humid conditions. Cold water immersion was also more beneficial than active recovery at improving total work performed. Contrast water therapy could increase 15s – 15min TT work performed and sprint mean and peak power output. Similarly, active recovery has been shown to improve power measures and time to completion. Conversely, hot water immersion appears to be detrimental to sprint power output and TT power output over consecutive days. Thermoneutral water immersion appears beneficial for improving average cycling speed and time to completion during a 20-km TT, where humidification therapy and sports massage are beneficial at improving sprint and middle duration time trial performance. A combination of recovery strategies appear more beneficial than stand-alone strategies and various combinations should be explored further.

Evidence of Own‐Race Bias in Heisman Trophy Voting*

ObjectiveIn this article, I test for evidence of own‐race bias in voting for the Heisman Trophy.MethodsTo study own‐race bias in Heisman Trophy voting, I use individual vote data from Heisman voters from 2002 to 2012 and an ordered probit model with controls for player and team performance that flexibly allows votes be affected by a player's race and racial match between player and voter.ResultsEstimates show nonblack voters are more likely to vote for nonblack players in absolute terms and compared with black voters assuming homogeneous voter preferences. Allowing preferences to vary by race, results show nonblack voters continue to be more likely to vote for nonblack players in absolute terms and are strongly suggestive of a larger relative bias in favor of nonblack players by nonblack voters as compared with black voters.ConclusionThere is a racial component to Heisman Trophy voting and bias is large enough to affect official aggregate results. Racial bias may have affected the award's winner in multiple Heisman races between 2002 and 2012.

Identification of a Novel Semi-Dominant Spotted-Leaf Mutant with Enhanced Resistance to Xanthomonas oryzae pv. oryzae in Rice.

Many spotted-leaf mutants show enhanced disease resistance to multiple pathogen attacks; however, the mechanisms are largely unknown. Here, we reported a novel semi-dominant spotted-leaf mutant 24 (spl24) obtained from an ethyl methane sulfonate (EMS)-induced IR64 mutant bank. spl24 developed tiny brown lesions on the leaf tip and spread down gradually to the leaf base as well as the sheath at the early heading stage. The performances of major agronomic traits such as the plant height, panicle length, number of panicles/plant, and 1000-grain weight were significantly altered in spl24 when compared to the wild-type IR64. Furthermore, spl24 exhibited a premature senescing phenotype with degeneration of nuclear acids, significantly reduced soluble protein content, increased level of malonaldehyde (MDA), and lowered activities of reactive oxygen species (ROS) scavenging enzymes. Disease evaluation indicated that spl24 showed enhanced resistance to multiple races of Xanthomonas oryzae pv. oryzae, the causal pathogen of bacterial leaf blight in rice, with elevated expression of pathogenesis-related genes, salicylic acid (SA) signaling pathway-associated genes revealed by real-time quantitative PCR and high-throughput RNA sequencing analysis. Genetic analysis and gene mapping indicated that the lesion mimic phenotype was controlled by a novel semi-dominant nuclear gene. The mutation, tentatively termed as OsSPL24, was in a 110 kb region flanked by markers Indel-33 and Indel-12 in chromosome 11. Together, our data suggest that spl24 is a novel lesion mimic mutant with enhanced innate immunity and would facilitate the isolation and functional characterization of the target gene.

1107. The MAAGE Study: Health Care Utilization for the Treatment of Medically Attended Acute Gastroenteritis

BackgroundAcute gastroenteritis (AGE) exacts a substantial disease burden across the age spectrum, although healthcare utilization for AGE is not well characterized. Through active surveillance of medically attended acute gastroenteritis (MAAGE) encounters within a large, integrated healthcare delivery system, we analyzed demographic patterns of healthcare utilization among AGE patients.MethodsFrom April 1, 2014 to September 30, 2016, we collected information on all MAAGE encounters in Kaiser Permanente Northwest (KPNW) patients through daily abstraction from electronic health records using ICD-9/-10 codes. For each patient, a MAAGE episode was defined as all MAAGE encounters <30 days apart.ResultsThere were 109,493 MAAGE encounters among 39,451 patients. Patients were 60.4% female and 39.6% male; 10.3% were <5 years old, 9.7% were 5–17, 31.1% were 18–44, 25.4% were 45–64, and 23.5% were ≥65. Among those with known race, 87.2% were white; 4.1% were Asian, 3.6% were black, and 5.1% were other or multiple races. Prevalence of any chronic comorbid condition was 52.9%.Of 52,107 MAAGE episodes, 81.0% first presented as outpatients; this was most common in those aged <5 (92.1%) and decreased with age to 75.0% in those ≥65. First presenting remotely (email or telephone) ranged from 4.0% in those aged <5 to 19.3% in those ≥65; 52.7% of episodes first presenting remotely had no subsequent visits. Few episodes first presented to an emergency department (3.8% in <5 year olds to 6.6% in 18–44 year olds) or inpatient setting (0.1% in <5 year olds to 1.7% in ≥65 year olds).Most MAAGE episodes comprised of one encounter (median: 1.0, mean: 2.1). The number of encounters per episode was lowest in those <5 years old (median: 1.0, mean: 1.5) and highest in those ≥65 (median: 2.0, mean: 2.5). Most deaths within 30 days from the start of an episode (131/161) were in those ≥65; there were none in those <5, 1 in those 5–17, 5 in those 18–44, and 24 in those 45–64.ConclusionWe found that the number of encounters per MAAGE episode increased with age and that outpatient and remote encounters are important settings for the initial clinical management of MAAGE in all ages. These data can help to better quantify the economic burden of AGE and guide appropriate delivery of healthcare services.Disclosures All authors: No reported disclosures.