Texas Population Research Articles

Perinatal Hypoxic-Ischemic Encephalopathy Among a Large Public Hospital Population.

This cohort study evaluates an increase in perinatal hypoxic-ischemic encephalopathy among a large public hospital population in Texas.

Long live the cat: Ocelot population viability in a planned reintroduced population in Texas, USA

AbstractReintroductions are often needed to recover carnivore populations and restore ecological processes. Felids are common subjects of reintroduction efforts, but published population models informing felid reintroduction plans are uncommon, and poor planning has sometimes caused issues in felid reintroduction programs. In the United States, ocelots (Leopardus pardalis pardalis) are classified as endangered, and recovery requires population expansion into historic habitat. A multi‐organization effort is underway to establish a new ocelot population in Texas by releasing ocelots into an area of 478 km2 of suitable habitat in ocelots' historic but now unoccupied range. In this study, we used population viability analyses to compare different ocelot reintroduction strategies for the identified reintroduction area. Based on a potential ocelot breeding program's limitations, we modeled reintroduction using a founding population of no more than six ocelots and no more than four ocelots released per year for no more than 15 subsequent years. Within these limitations, we assessed projected population abundances and extinction risks after 30 years for 20 different reintroduction strategies. We found that long‐term releases are necessary to establish a viable population; under conservative model assumptions, releasing six ocelots in the initial year and then releasing four individuals annually for an additional 10–15 years is necessary for attaining a projected population greater than 36.62 ocelots (baseline) with <6% extinction risk. We also found that ocelot population abundance is about equally sensitive to post‐release mortality and inbreeding depression. This highlights the importance of not only supporting reintroduced ocelots' survival but also managing for high genetic diversity in the reintroduction program. Further, we found that realistic but more liberal assumptions on the carrying capacity of the reintroduction area and the age of first reproduction for ocelots increase projected population abundances (53.95 individuals and 61.26 individuals, respectively), and thus reintroduction success. The model's sensitivity to carrying capacity suggests that long‐term habitat protection and expansion are among the most important management actions to support ocelot reintroduction. Our study establishes the first population viability model for an ocelot reintroduction plan anywhere across the species' wide geographic range, and it reinforces several key considerations for wildlife reintroduction efforts worldwide.

Population genomics of a specialized insect, Tetraopes texanus (Coleoptera: Cerambycidae), across a fragmented grassland system

AbstractSpecialist insects are especially susceptible to loss of genetic diversity in the face of habitat destruction and fragmentation. Implementing effective conservation practices for specialist insects will benefit from knowledge of population structure and genetic diversity. Because insects are hyper-diverse, characterizing the population structure of all species within the insect community is untenable, even if focused within a particular habitat type. Thus, concentrating on a single species specialized to a particular habitat type is needed to infer general trends. Here, we investigate the range-wide population genetics of Tetraopes texanus Horn 1878 (Coleoptera: Cerambycidae), which provides a useful model of grassland insects due to its’ habitat specificity and unique biology. Tetraopes texanus occurs primarily in Texas and Oklahoma, into Northern Mexico, and possibly into eastern New Mexico but also occurs in Black Belt prairies of Mississippi and Alabama. Mitochondrial and nuclear DNA (RAD-seq) analysis identified two distinct population clusters of T. texanus corresponding to the Texas and Oklahoma population and the Mississippi and Alabama population. Demographic models indicate ongoing, though incomplete, isolation of the two populations, with estimated dates of divergence in the mid-Pleistocene, coinciding with the end of a glacial period and a shift in glacial interval. These results can inform conservation of grassland adapted insects and offers insight to the biogeography of the Gulf Coastal Plain.

Population isolation in the Plains spadefoot toad: causes and conservation implications.

Range disjunctions appear to be common in nature, although they may be caused by various factors. They may simply be an artefact of inadequate sampling. If real, they may be the result of colonization events or habitat change. With natural habitats showing increasing fragmentation because of human activity, understanding the cause of a disjunction can have important conservation implications. We investigate the geographical range of the Plains spadefoot toad, Spea bombifrons, a widely distributed species in the midwestern and southwestern United States, with a putative disjunct population in southern Texas. We combine GIS mapping, species distribution modeling, and population genetic analysis to investigate this putative disjunction. We establish that this southern Texas population is truly geographically disjunct and genetically distinct. Further, using climate projections we show that this unique population is at high risk of local extinction.

HEMATOLOGY AND BIOCHEMICAL REFERENCE INTERVALS FOR FREE-RANGING PRONGHORN (ANTILOCAPRA AMERICANA) IN WEST TEXAS.

Pronghorn (Antilocapra americana) are considered a keystone species of North American grasslands and an important economic source for many landowners in Texas. Pronghorn restoration projects routinely capture and translocate individuals from surplus populations to restoration areas. The objective of this study was to generate normal hematological and biochemical reference intervals (RI) for free-ranging pronghorn populations in Texas as a health monitoring tool for pronghorn restoration efforts. Blood samples were collected by jugular venipuncture and divided among an EDTA tube, serum separator tube, and a single blood smear on site. Complete blood counts and biochemical profiles were completed at the Texas Veterinary Medical Diagnostic Laboratory. In total, 417 individuals (41 males, 376 females) were included in the analysis. RI were determined by robust methods (R Studio) and mixed models' analysis of variance (SPSS 28) to examine differences in blood parameters due to fever, sex, age (adult versus yearling [<1 yr of age]), cell abnormalities, and pathogen exposure reported by the testing laboratory. Sex, age, and pathogen exposure affected mean blood values, but did not warrant development of separate RI by class. Bluetongue virus was identified in 46.8% (195/417) of pronghorns and epizootic hemorrhagic disease in 89.4% (194/217) of pronghorns; 84.8% (184/217) of the pronghorns tested positive for both diseases. This information provides baseline hematology and biochemical parameters to assess the health of free-ranging pronghorn and guide wildlife managers in decision-making for future translocations and restoration objectives.

Translocations, rising populations, and phylogeographic consequences: genomic implications for conservation of introduced Aoudad (Ammotragus lervia) in the southwestern United States

Abstract Over the last century, Texas has been inundated with exotic ungulates, with as many as 67 species represented by captive and free-ranging populations. One of the most successful species to have established free-ranging populations is the Aoudad (Ammotragus lervia). Herein, we expand on previous genetic studies in Aoudad by including new genomic profiles based on double-digest restriction site-associated DNA sequencing methods with the intent of better understanding the effects of &amp;gt;70 years of human-mediated translocations, population expansion, and gene flow among populations. Using a range of 4,338 to 5,529 single-nucleotide polymorphisms obtained from 73 individuals that potentially represented A. l. blainei, A. l. lervia, and A. l. sahariensis, we measured genetic patterns of diversity and connectivity between source populations from California and New Mexico and resultant aoudad populations in Texas. Principal component analyses identified phylogeographically structured populations across Texas. Further, we identified a signature of isolation by distance among Texas populations. To assess geographic regions that facilitated or blocked gene flow between populations, we used estimation of effective migration surfaces, which indicated 3 barriers to movement between populations as well as connectivity among populations in close proximity. Comparison of mtDNA haplogroups and nuclear genotypes among the 3 examined subspecies were discordant, indicating that the current subspecific taxonomic classification needs refinement. Given the vulnerable status of Aoudad in their native range of northern Africa and the exponential population growth and potential competition with native ungulates in Texas, we propose that efforts to manage non-native Aoudad should strive to maintain and preserve unique genetic units while minimizing competition and other detriments to native species in Texas. Conservation efforts are especially important given the vulnerable status of Aoudad within their native range of northern Africa.

A unique model: Partnership between community oncology and pharma for clinical trial enrichment.

1535 Background: Clinical trials are the foundation of oncologic drug development. Historically, only 23% of oncology trials are conducted in the community despite &gt;70% of patients being treated this setting, leading to a disconnect between the therapy being tested and target population. Also, patients are hesitant to enroll in trials- in 2020, only 49% were willing, down from 85% in 2019. One way to improve this is participation by community oncologists, allowing patients to stay close to home. Targeted therapies are increasingly being approved by the FDA, with 89 small molecule drugs approved by 2020. Given the above landscape, Precision Health Informatics (PHI) collaborated with Mirati Therapeutics to pilot a clinical trial enrichment program focused on increasing enrollment of patients in the community related to efficacy and outcomes of adagrasib (KRAS G12C inhibitor) for NSCLC and CRC. Methods: This pilot was launched in 2021, with a prescreening study (DetECT) to find eligible patients with KRASG12C mutations. The pilot was then expanded across Mirati ‘Krystal’ studies in 2022 and to “1719” studies in 2023. These studies were available to all investigators throughout Texas Oncology (TxO) via STAR model (clinical trial access to all TxO investigators/sites through a regulated but rapid approval process). Eligible patients were identified from PHI’s proprietary molecular data warehouse (that stores molecular results for &gt;400,000 patients treated at TxO). A data analyst identified patients with KRAS G12C mutation from the warehouse, and then cross-referenced patient-centric data in EMR to assess eligibility. The treating physician was then alerted of their patient’s eligibility. Patient demographic information was also collected from the EMR. Results: This collaboration resulted in accrual of 118 patients, engagement of 40 different PIs, across 8 different trials. 6 studies remain open across the practice. 21 patients were enrolled on Krystal-001, 7 on Krystal-007, 10 on Krystal-010 and 56 on DetECT. Enrollment was inclusive of patients from urban areas of DFW as well as rural populations in NE Texas, South and West Texas. In DetECT, TxO provided 84% of the total US enrollment, with a diverse population – 54% white, 23% Hispanic, 12% black, 9% Asian. Texas Oncology is the 2nd highest screening and enrolling site on Krystal studies. Conclusions: This pilot successfully demonstrates that community oncology can lead the way in clinical trial enrollment, even in early phase targeted therapy studies. Community physicians can be engaged so patients can benefit from research participation close to home. This model shows that a diverse population was accrued and may serve as a blueprint to help Pharma satisfy the diversity requirements for clinical trials. PHI, with its molecular database, may partner with Pharma to identify targetable mutations and drive rapid trial enrollment for targeted therapies.

Examining the risk factors for trastuzumab-related cardiotoxicity in a predominantly Hispanic South Texas population: A descriptive study.

e24000 Background: Trastuzumab, a monoclonal antibody targeting human epidermal growth factor receptor 2 (HER2), stands as first line treatment for HER2 positive breast cancer. Despite its efficacy, trastuzumab’s association with cardiotoxicity requires monitoring via serial transthoracic echocardiograms (TTEs). We aimed to evaluate the risk factors for trastuzumab related cardiotoxicity in a South Texas population that is uniquely a majority-minority Hispanic population. Methods: A retrospective chart review study was conducted of all female patients with HER2-positive breast cancer who received trastuzumab treatment from 2015-2021. A total of 180 patients were identified. Patients without baseline TTE or a baseline left ventricle ejection fraction (LVEF) less than 53% were excluded. The final sample size included 132 patients. Cardiotoxicity was defined as a decrease in LVEF of more than 10% during the 1-year study period. Results: The mean age at the time of diagnosis in the study population was 54.2 years. The average BMI of the study participants was 30.89. The incidence of cardiotoxicity in this study population was 6%. Among those who developed cardiotoxicity, 50% had hypertension, 25% had hyperlipidemia, 12.5% had type 2 diabetes mellitus, and 12.5% had previous coronary artery bypass surgery (CABG). In terms of cancer treatment, 12.5% of patients had a history of radiation, 25% had a history of anthracycline therapy, and 12.5% had their trastuzumab treatment ended prematurely. Of the cardiotoxicity population, 37.5% patients were former smokers and 25% were former alcohol users. Hispanic/Latino patients composed 58% of the study population and represented 50% of patients who experienced cardiotoxicity. Conclusions: The incidence of trastuzumab-related cardiotoxicity in this Hispanic/Latino majority-minority population was 6%, lower than the 9% observed in a predominantly white population in our previous study. However, further studies are needed to determine the factors contributing to this reduced cardiotoxicity rate in this population.

Genetic Variability Among U.S.-Sentinel Cotton Plot Cotton Leafroll Dwarf Virus and Globally Available Reference Isolates Based on ORF0 Diversity.

The aphid-transmitted polerovirus, cotton leafroll dwarf virus (CLRDV), first characterized from symptomatic cotton plants in South America, has been identified in commercial cotton plantings in the United States. Here, the CLRDV intraspecific diversity was investigated by comparative sequence analysis of the most divergent CLRDV coding region, ORF0/P0. Bayesian analysis of ORF0 sequences for U.S. and reference populations resolved three well-supported sister clades comprising one U.S. and two South American lineages. Principal component analysis (PCA) identified seven statistically supported intraspecific populations. The Bayesian phylogeny and PCA dendrogram-inferred relationships were congruent. Population analysis of ORF0 sequences indicated most lineages have evolved under negative selection, albeit certain sites/isolates evolved under positive selection. Both U.S. and South American isolates exhibited extensive ORF0 diversity. At least two U.S. invasion foci were associated with their founder populations in Alabama-Georgia and eastern Texas. The Alabama-Georgia founder is implicated as the source of recent widespread expansion and establishment of secondary disease foci throughout the southeastern-central United States. Based on the geographically restricted distribution, spread of another extant Texas population appeared impeded by a population bottleneck. Extant CLRDV isolates represent several putative introductions potentially associated with catastrophic weather events dispersing viruliferous cotton aphids of unknown origin(s).

The Effect of Limb Salvage Efforts in Different Age Groups: Relationships Between Major and Minor Amputations

“Limb salvage” efforts, such as performing minor amputations before infections spread proximally from the foot to decrease major lower extremity amputation, are an important part of healthcare today. It is unclear whether these efforts are preventing the number of major amputations and improving patients’ quality of life and the cost-effectiveness of the U.S. healthcare system. Rates of non-traumatic lower extremity amputation (NLEA) among patients with diabetes decreased in the early 2000s but rebounded in the 2010s. We analyzed the proportion of major amputations and differences in amputation rates between age groups in Texas. Patient data was extracted from the Texas Hospital Discharge Data Public Use Data File. Population estimates were obtained from the Texas Population Estimates Program from 2011 to 2015 and from intercensal estimates provided by the U.S. Census Bureau from 2006 to 2010. Raw numbers of minor, major, and all NLEA surgeries and the ratio of major amputations to total amputations per year were reported for each age group. Poisson regression and Joinpoint analyses were performed to capture these changes in trends. Rates of amputations increased, with significant decreasing relative prevalence of major amputations. Patients aged 45 to 64 with diabetes are likely driving these increases. Rates of lower extremity amputation in patients with diabetes increased from 2009 to 2015. This holds for all and minor amputations. In contrast, the ratio of major to all amputations decreased from 2010. Utilization of major and minor amputation differs between age groups, remaining stable in the youngest subjects, with minor amputation rates increasing in those aged 45 to 64.

Annual bluegrass cross resistance to prodiamine and pronamide in the southern United States

Abstract Annual bluegrass is one of the most problematic weeds in the turfgrass industry, exhibiting both cross-resistance and multiple-herbicide resistance. Prodiamine, pronamide, and indaziflam are commonly used preemergence herbicides for the control of this species on golf courses in the southern United States. There have been increasing anecdotal reports of annual bluegrass populations escaping control with these herbicides, but resistance has yet to be confirmed. To evaluate the response of annual bluegrass to three herbicides, populations were collected from golf courses, athletic fields, and landscape areas in Texas and Florida, and a dose-response assay was conducted on populations that were suspected to be resistant to and known to be susceptible to prodiamine, pronamide, and indaziflam. The suspected-resistant populations showed survival to prodiamine at 32 times the recommended field rate (both populations from Florida and Texas) of 736 g ai ha−1, and to pronamide at 32 times (the Florida populations) or 16 times (the Texas populations) the recommended field rate of 1,156 g ha−1. In contrast, the known susceptible populations attained 100% mortality at rates as low as 46 and 578 g ha−1, respectively, from applications of prodiamine and pronamide. For indaziflam, the suspected-resistant populations showed reduced sensitivity up to the recommended field rate of 55 g ha−1, but they were controlled when treated with a rate twice that of the field rate. Overall, annual bluegrass populations with resistance to prodiamine and pronamide, and reduced sensitivity to indaziflam (at the recommended field rate) were confirmed from golf courses in Florida and Texas. In the presence of herbicide-resistant annual bluegrass populations, especially to commonly used herbicides such as prodiamine and pronamide, turfgrass managers should adopt integrated management strategies and frequently rotate herbicide sites of action, rather than relying solely on microtubule-assembly inhibitors or cellulose biosynthesis inhibitors, to control this species.

Assessing fall armyworm (Spodoptera frugiperda) allochronic behavior as a predictor of local strain composition in United States populations.

The fall armyworm, Spodoptera frugiperda (J.E. Smith), is comprised of two genetically distinct strains that are morphologically identical yet exhibit differences in their behavior and physiology (C-strain and R-strain). Evidence of ongoing genetic differentiation between strains highlights the importance of considering strain identity in research and management of fall armyworm populations, but the logistical and technical burden of genotyping limits strain-specific applications. Controlled experiments with laboratory colonies have shown that the strains engage in allochronic ("allo" - different, "chronic" - time) mating behavior, with C-strain mating early in the evening (0-5 hours after sunset) and R-strain mating late in the evening (5-10 hours after sunset). Using temporal field collections and genotype data, we show that strain-specific variation in allochronic male mating behavior occurs across Texas and Florida fall armyworm populations, both of which act as primary source populations for annual migrations of this pest into the continental United States. Time of capture in pheromone traps was significantly different between strains in both Texas and Florida, with the R-strain males consistently being collected in the traps late in the night. The C-strain males were generally captured earlier in the night than their R-strain counterparts, though there was notable variation in the timing between nights and across locations. Allochronic behavior in field populations is consistent with previous laboratory studies reporting differences in the timing of mating between the strains, however increased variability in behavior within and across native populations was observed. Although allochronic behavior in local populations may partially contribute to reproductive isolation between the strains, the behavior is not consistent enough to serve as a complete reproductive barrier. Furthermore, the observed variability in behavior both within and between independent sampling events, especially in the C-strain, poses a challenge to the development of models that utilize time of capture as a predictive phenotype for monitoring strain identity in local populations.

Abstract B032: Outcomes of patients with acute promyelocytic leukemia treated at John Peter Smith Hospital

Abstract Background: Acute Promyelocytic Leukemia (APL) is a subtype of Acute Myeloid Leukemia (AML), accounting for about 10% of all AML cases. Historically, APL was considered to be the subtype of AML with the worst prognosis because most newly diagnosed patients died within a few weeks, and only 35% to 45% of patients achieved long-term survival. The discovery and application of all trans retinoic acid (ATRA) improved complete remission (CR) rate and overall survival (OS) to 70%. Combination of ATRA, a vitamin A derivative, and arsenic trioxide (ATO) as induction therapy for APL resulted in 90-95% CR and &amp;gt;90% 5-year OS. Even though CR and OS has improved, early death (5%-10%) remains the most challenging issue for the disease, especially in resource poor settings. Since APL is rare, oncologists in community may not be fully equipped to treat early complications. John Peter Smith hospital (JPS) is a safety-net hospital serving the needs of underserved population in north Texas. We report outcomes of patients with APL treated at JPS. Methods: Data was obtained from the JPS Oncology Registry. Patients were diagnosed with APL from 1/1/2017 to 12/31/2020 with partial or complete treatment at JPS. We collected non-identifiable patient demographics, diagnosis and initial treatment and complication details. Remission documentation by disappearance of the chromosome abnormality, time from diagnosis to date of death (if applicable) or last activity in medical chart (any phone call with patient, office visit) before 6/12/2023 were obtained. Time to CR and any use of consolidation or maintenance treatment was also collected. Results: 8 APL patients were included- 3 were high-risk patients and 5 were low-risk. Half were male. Age ranged from 22 to 64 years. 5 were under the age of 40 years, 2 were in their 40s and 1 was in 60s at diagnosis. Hispanic:4, Black:3, Asian:1. Induction treatment included ATRA+ATO in 6 patients, while 2 high risk patients received ATRA plus anthracycline-based chemotherapy. Bone marrow morphology post induction was negative in all patients indicating CR (median time to CR was 41.5 days). During induction, treatment complications occurred in all patients including bleeding (75%), clotting (63%), neutropenic fever (50%). Differentiation syndrome (50%) and DIC (50%). All patients underwent ATRA+ATO consolidation treatment for 8-10 months. No patients relapsed. All patients were alive at the time of last medical chart entry (6/12/2023) without active cancer. Conclusions: All patients were in CR post induction treatment. 4 had minimal residual disease post induction. All patients received consolidation with ATRA+ATO, eventually there was no disease detected at molecular level. No patients relapsed. All patients were alive with no active disease at their last follow-up. Excellent outcomes in APL are possible at safety-net setting but will need diligent care to prevent, predict and treat early complications; this may require communication with academic leukemia specialists when transfer to leukemia treatment centers is not possible. Citation Format: Kavya Athipatla, Kari Teigen, Kalyani Narra. Outcomes of patients with acute promyelocytic leukemia treated at John Peter Smith Hospital [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B032.

An innovative model using Promotores or Community Health Workers for home based dementia care

AbstractBackgroundHealth disparities and issues with trust building and relationship building are prominent in Hispanic and underserved populations in south Texas. Community health workers can play a bridging role with underserved communities and may be essential in improving the quality and value of health care. The Texas Health and Human Services Commission certifies the training Community Health Workers under the label of “promotores”.MethodCommunity health workers were integrated into the primary health care team to serve as a bridge between patient/caregiver dyads and the health care team.ResultCommunity health workers (CHWs) connected patients to social determinants of health resources such as transportation, food pantries and/or social benefits, Medicaid services, and home care provider services. Caregiver education and resources for respite care, caregiver support in person and virtually. Additionally, CHW’s provided education on dementia care resources, caregiver support, recruiting and engaging Hispanic underserve participants in research. Our team was able to increase home visits by 229% to homebound patients throughout several underserved zip codes in Bexar County. This is a success as our team was able to increase health care access to persons with dementia that are homebound that may have not been seen by a healthcare provider until they required emergency care. In fact, we saw roughly 11% decrease of inpatient admissions between 2021 and 2022.ConclusionTrust and familiarity allows the promotores to easily communicate interventions with cultural sensitivity and experiential knowledge of community values, leading to foster rapport with patients and families. The rapport and trust developed with the patients also helped to engage, and recruit Hispanic and underserved participants for research in dementia.

Abstract B033: Patterns of testing and survival for EGFR mutation and ALK abnormalities in advanced lung cancer at John Peter Smith Hospital

Abstract Background: There is paucity of literature regarding outcomes of patients treated for non-small cell lung cancer (NSCLC) at safety-net hospitals (Muslim et al., 2022). John Peter Smith (JPS) hospital is a safety-net hospital serving the needs of underserved population in north Texas. We evaluated testing patterns, prevalence of Epidermal Growth Factor Receptor (EGFR) mutations and Anaplastic Lymphoma Kinase (ALK) fusions in advanced NSCLC at JPS, and outcome measures of 1-, 3- and 5-year overall survival (OS) as compared to patients without these alterations. Methods: We used data from the JPS Oncology Registry and abstracted information from medical records. Eligible patients were diagnosed with stages IIIB-IV NSCLC and treated at JPS from 1/1/2017 to 12/31/2021. Patients were grouped into EGFR+, ALK+, both EGFR- and ALK-, test not ordered/completed (NT). A Kaplan Meier curve was used to assess the difference in post diagnosis survival time across testing status. The log rank test was then performed to assess if the survival distributions were significantly different. To further assess the impact of EGFR and ALK results on patient death three cox proportional hazard models were generated assessing 1-, 3- and 5-year OS. To establish a full model all items collected underwent univariate pre-filtering. All available items were analyzed via a univariate model and items with a p-value of 0.2 or lower were analyzed in our multivariate model using SAS 9.4. Results: 220 patients were included for analysis, 183 (83%) were stage IV. 57% were males. Racial/ethnic distribution included 45% Non-Hispanic Whites (NHW), 32% Blacks, 13% Hispanic Whites (HW) and 10% Asians. 71% were tested for EGFR, ALK, or both. 21 patients (13.7%) were found to have EGFR mutations and 7 patients (4.9%) had ALK fusions. For EGFR, tissue (T) was tested in 134 and blood (B) in 44, both T and B in 23 with concordance in 20. For ALK, T was done in 129, B in 44, 23 had both, with concordance in 21. Testing was inconclusive in 3 (T) for EGFR and 5 (3 T and 2 B) for ALK. Lung was the most common site tested for EGFR with 90 patients followed by liver (8), lymph node (8), and bone (8). Females accounted for 67% of EGFR+ and 57% for ALK+. Asians accounted for 43% of EGFR+ and 28% of ALK+. Median OS in days for study population: 155, EGFR+: 845, ALK+: 1333, both-:162, NT: 105. At 3 years, EGFR+ (HR: 0.427; 95% CI: 0.222, 0.822; p-value: 0.0109) and ALK+ (HR: 0.191; 95% CI: 0.046, 0.795; p-value: 0.0229) showed a significant reduction in the hazard of death compared to both-. NT patients had 1.679 times higher hazard of death when compared to both- (HR: 1.679; 95% CI: 1.206, 2.338; p-value: 0.0021). Similar pattern was seen for EGFR+ for 1 and 5 year OS and for ALK+ at 5 year OS. Conclusions: Prevalence of EGFR and ALK alterations at JPS is similar to nationally reported statistics. Tissue testing is the gold standard for identifying these alterations. 29% of the patients were not tested. Median survival of EGFR+ or ALK+ patients is significantly longer than other cohorts. Citation Format: Vivek Athipatla, James Blackwell, Anna Diaz, Bassam Ghabach, Kalyani Narra. Patterns of testing and survival for EGFR mutation and ALK abnormalities in advanced lung cancer at John Peter Smith Hospital [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B033.

Abstract PR010: Cutaneous melanoma treatment outcomes in Texas: A study of the Texas Cancer Registry/Medicare linked database and an analysis of disparities

Abstract Background: Given that Hispanics make up a large portion of the United States, further research has been necessary to analyze the effects of treatment methods on all-cause and skin cancer mortality in Hispanic populations. While Caucasians have the highest incidence of melanoma, Hispanics make up the second most common group in the United States and in Texas. Incidence of melanoma is increasing, including in the Hispanic population. Importantly, mortality from melanoma is higher in the Hispanic than in the Caucasian population. Methods: We conducted an analysis of patients with cutaneous melanoma in the Texas Cancer Registry Medicare database to assess treatment modalities used and outcomes among demographic groups from 2007 to 2018. A bivariate analysis using Chi-square, Fisher’s exact test, and Student’s T-Test was done to compare patient, clinical, cancer and treatment characteristics between Hispanic and Non-Hispanic White (NHW). A Cox Proportional Hazard regression analysis was performed to assess treatment effect on outcome, with race-ethnicity as an effector modifier. Models were adjusted for patient age, sex, cancer stage, primary care provider, and comorbidity. Results: A higher percentage of Hispanic patients (7.6%) presented with a metastatic tumor stage diagnosis and cancer-related mortality (22.11%) compared to NHW patients (p &amp;lt;0 .0001). In both the Hispanic and NHW cohorts, post-diagnosis radiation (Hispanic 95% CI 0.984 – 2.634, NHW 95% CI 2.082-2.648) and post-diagnosis chemotherapy (Hispanic 95% CI 1.085-3.321, NHW 95% CI 1.664-2.489) are each associated with an increased risk in cancer-related mortality. Similar results are seen with post-diagnosis radiation (Hispanic 95% CI 1.121-2.40, NHW 95% CI 1.644-1.971) and chemotherapy (Hispanic 95% CI 0.900-2.368, NHW 95% CI 1.356-1.869) when considering all-cause mortality in both populations. However, post-diagnosis surgery (95% CI 0.571-0.678) and post-diagnosis immunotherapy (95% CI 0.032-1.565) had the opposite effect in cancer-related mortality for NHW. Cancer-related mortality for post-diagnosis surgery in the Hispanic cohort had a similar trend (95% CI 0.395-0.856), yet the effect of post-diagnosis immunotherapy was dismissed due to small sample size. Conclusion: Our results propose differences in all-cause and cancer-only related mortality with separate treatment modalities, particularly with chemotherapy and radiation therapy; this retrospective cohort study validated that health disparities exist in the Hispanic Medicare population of Texas with cutaneous melanoma. Citation Format: Hannah R. Riva, Fabiola Ramirez, Lorena Fernandez, Yae Kye, David Lopez, Biai Digbeu, Jessica Chacon. Cutaneous melanoma treatment outcomes in Texas: A study of the Texas Cancer Registry/Medicare linked database and an analysis of disparities [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr PR010.

Plasma Neurofilament Light and Markers of Sensorimotor Function in a Predominantly Hispanic Population of Older Adults in San Antonio, Texas

AbstractBackgroundSensorimotor and blood‐based biomarkers are promising dementia biomarkers with high accessibility and limited invasiveness. Although sensorimotor changes appear with aging, more severe changes may precede cognitive decline, dementia, and other neurological diseases. Additionally, blood‐based neurofilament light (NfL), a broad marker of neuroaxonal injury, is commonly elevated in many types of neurological disease. Prior studies have suggested that increased blood levels of NfL in conjunction with sensorimotor decline may allow for earlier neurological disease diagnosis and/or prediction of disease severity, but little is known about the correlation of these markers in the general population. We examined the association between NfL and sensorimotor markers in a predominantly Hispanic population in San Antonio, Texas.MethodOur sample included older adults from our San Antonio MarkVCID and South Texas Alzheimer’s Disease Research Center (ADRC) cohorts (n = 152, mean age 71.2±7.63, 60.4% women, 79.5% Hispanic) with available plasma NfL, olfaction (B‐SIT age‐adjusted percentile), grip strength, and touch (monofilament) data (Table 1). NfL concentrations were log‐transformed to achieve a normal distribution. We used linear or logistic regression models, as appropriate, to assess the association between NfL and sensorimotor outcomes, adjusting for age, sex, race, ethnicity, and cognitive diagnosis.ResultHigher plasma NfL was significantly associated with decreased olfaction score percentiles (Beta [95% Confidence Interval], β = ‐8.79; [95% CI ‐16.89; ‐0.12], p = 0.05), grip strength in either hand (left: β = ‐3.62; [95% CI ‐5.51; ‐1.74], p = 0.0002; right: β = ‐2.99; [95% CI ‐5.01; ‐1.03], p = 0.003), and impaired touch perception (Odds Ratio [95% CI], OR = 2.56; [95% CI 1.01; 6.48]; p = 0.05), independent of the potential confounders listed above.ConclusionThese results highlight the association of plasma NfL with several markers of sensorimotor function, which may reflect central and peripheral neuroaxonal injury. Additional studies are needed in larger community samples to confirm these findings and explore the potential of NfL as a marker of functional decline in longitudinal studies. We plan to continue collecting these markers, as well as gait and balance, longitudinally to gain a better understanding of the link between neurodegeneration, sensorimotor markers, and neurological disease trajectory in our unique South Texas population.

The Landscape of Primary Gastric Leiomyosarcoma in Texas Population: Analysis of Texas Cancer Registry Data.

Introduction Primary gastric leiomyosarcoma is an extremely rare disease. There have been no previous studies regarding gastric leiomyosarcoma in the Texas population. Methods Anonymous data of gastric leiomyosarcoma from the Texas Cancer Registry (TCR) was used. Information collected included the primary tumor site, age at diagnosis, gender, race/ethnicity, diagnosis and treatments, tumor size, lymph node and metastasis status, grade and stage, body weight and height, public health regions and payer, metropolitan status, neighborhood poverty level, smoking status, survival interval, and cause of death for statistical analysis. Result Thirty-three cases from 2003-2019 were selected. Primary gastric leiomyosarcoma was more commonly diagnosed in patients over 50 years of age, females, and individuals of white race. The diagnosis was primarily based on histology, and the disease was typically treated with surgery and chemotherapy. At the time of diagnosis, 45.5% of patients were in the late stage, and 48.5% of patients died from gastric leiomyosarcoma with a mean survival interval of 15.3 months. BMI scores showed a positive correlation with survival intervals. Surveillance, Epidemiology and End Results (SEER) tumor staging was associated with the prognosis of gastric leiomyosarcoma. Conclusion There were multiple disparities among patients with primary gastric leiomyosarcoma in the Texas population. The SEER summary stage was associated with the prognosis of gastric leiomyosarcoma.

Abstract 18447: Comparative Seasonal Variation in Outcomes Among Patients Hospitalized for Heart Failure in Cold- and Warm-Climate States

Background: Despite emerging evidence that extreme heat and air pollution exposure are linked to adverse cardiovascular disease outcomes, paradoxical seasonal trends in heart failure hospitalizations and deaths have been observed, with peaks occurring in winter months. This study aimed to explore how seasonal variations in heart failure admissions differ among individuals hospitalized in cold-climate and warm-climate states. Methods: Population-level, state-wide data were used to explore outcomes among all individuals hospitalized for heart failure in Texas (1999-2016) and New York (1994-2007). Seasonal variation was assessed using time of discharge (January-March, April-June, July-September, October-December). Multivariable logistic and linear regression were used to explore the relationship between time of discharge and the primary outcomes of interest: mortality and length of stay (LOS). Analyses were adjusted for age, sex, race, ethnicity, and comorbidities (hypertension, hyperlipidemia, diabetes, CAD, arrhythmias, anemia, COPD, tobacco use). Results: Among individuals hospitalized for heart failure in both Texas and New York, mortality and LOS were significantly increased during winter months compared to spring, summer, and early fall (Table). While similar seasonal trends were observed across states, the observed effect sizes were smaller in the Texas population. Conclusions: Among patients hospitalized for heart failure in Texas and New York, there is an increase in mortality and LOS during winter months. However, the differences in effect sizes after controlling for traditional risk factors suggests that other variables (i.e., temperature fluctuations) may affect these seasonal trends and warrants further exploration.

EXPLORING A PLANT-DIVERSITY HYPOTHESIS TO EXPLAIN HELMINTH PREVALENCE IN NORTHERN BOBWHITE (COLINUS VIRGINIANUS) IN TEXAS, USA.

Helminths, in particular eyeworms (Oxyspirura petrowi) and cecal worms (Aulonocephalus pennula), may be a factor influencing northern bobwhite (Colinus virginianus) populations in Texas. Previous research has shown a discrepancy in helminth infections between the Rolling Plains and Rio Grande Plains of Texas, US, potentially caused by differences in intermediate host distribution and abundance. We explored an alternative hypothesis centered on plant diversity, given that many plants possess phytochemicals with anthelmintic properties. We predicted that plant diversity would be greater and bobwhite diet more diverse in the Rio Grande Plains than the Rolling Plains, which in turn would potentially expose bobwhites to more plants with anthelmintic properties and therefore result in lower parasite prevalence and intensity. We conducted a literature review of plant diversity, anthelmintic plants, and bobwhite diet in Texas to explore this hypothesis. We also quantified the relationship between helminth prevalence in bobwhites and latitude. We documented trends for higher plant species richness, greater number of anthelmintic plants, and more diverse bobwhite diet in the Rio Grande Plains compared to the Rolling Plains. In addition, we documented a trend for increasing helminth prevalence with latitude for eyeworms but not cecal worms. Our study provides circumstantial evidence supporting the plant-diversity hypothesis and warrants experimental testing.