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Background/Objectives Obesity in pregnancy has been associated with increased childhood cardiometabolic risk and reduced life expectancy. The UK UPBEAT multicentre randomised control trial was a lifestyle intervention of diet and physical activity in pregnant women with obesity. We hypothesised that the 3-year-old children of women with obesity would have heightened cardiovascular risk compared to children of normal BMI women, and that the UPBEAT intervention would mitigate this risk. Subjects/Methods Children were recruited from one UPBEAT trial centre. Cardiovascular measures included blood pressure, echocardiographic assessment of cardiac function and dimensions, carotid intima-media thickness and heart rate variability (HRV) by electrocardiogram. Results Compared to offspring of normal BMI women (n = 51), children of women with obesity from the trial standard care arm (n = 39) had evidence of cardiac remodelling including increased interventricular septum (IVS; mean difference 0.04 cm; 95% CI: 0.018 to 0.067), posterior wall (PW; 0.03 cm; 0.006 to 0.062) and relative wall thicknesses (RWT; 0.03 cm; 0.01 to 0.05) following adjustment. Randomisation of women with obesity to the intervention arm (n = 31) prevented this cardiac remodelling (intervention effect; mean difference IVS −0.03 cm (−0.05 to −0.008); PW −0.03 cm (−0.05 to −0.01); RWT −0.02 cm (−0.04 to −0.005)). Children of women with obesity (standard care arm) compared to women of normal BMI also had elevated minimum heart rate (7 bpm; 1.41 to 13.34) evidence of early diastolic dysfunction (e prime) and increased sympathetic nerve activity index by HRV analysis. Conclusions Maternal obesity was associated with left ventricular concentric remodelling in 3-year-old offspring. Absence of remodelling following the maternal intervention infers in utero origins of cardiac remodelling. Clinical trial registry name and registration number The UPBEAT trial is registered with Current Controlled Trials, ISRCTN89971375.

There are costs and benefits to conforming and resisting gender norms, and this ratio likely changes during the transition to adulthood. In this paper, we explore the development of young men’s masculine norm resistance from adolescence through emerging adulthood. Using thematic analysis on interviews with cisgender young adult men who reported feeling at least somewhat gender atypical ( N = 30, Mage = 23, White = 74%), we found that: (a) men reported more direct and indirect gender norm resistance (GNR) as they aged, (b) as men felt less pressure to conform to gender norms, they reported more ease with expressing indirect GNR, and (c) that direct GNR generally paralleled developing an understanding of critical consciousness of broader social inequities. Our study answers the call to utilize a developmental approach to study men and masculinities, and in so doing, illuminates men’s dynamic navigation of masculine norms during the transition into adulthood.

BackgroundAntibiotic prescribing during childhood, most commonly for respiratory tract infections (RTIs), contributes to antimicrobial resistance, which is a major public health concern.AimTo identify factors associated with amoxicillin prescribing and RTI consultation attendance in young children in primary care.Design and settingCohort study in Bradford spanning pregnancy to age 24 months, collected 2007–2013, linked to electronic primary care and air pollution data.MethodAmoxicillin prescribing and RTI consultation rates/1000 child–years were calculated. Mixed-effects logistic regression models were fitted with general practice (GP) surgery as the random effect.ResultsThe amoxicillin prescribing rate among 2493 children was 710/1000 child–years during year 1 (95% confidence interval [CI] = 677 to 744) and 780/1000 (95% CI = 745 to 816) during year 2. During year 1, odds of amoxicillin prescribing were higher for boys (adjusted odds ratio [aOR] 1.36, 95% CI = 1.14 to 1.61), infants from socioeconomically deprived households (aOR 1.36, 95% CI = 1.00 to 1.86), and infants with a Pakistani ethnic background (with mothers born in the UK [aOR 1.44, 95% CI = 1.06 to 1.94] and outside [aOR 1.42, 95% CI = 1.07 to 1.90]). During year 2, odds of amoxicillin prescribing were higher for infants with a Pakistani ethnic background (with mothers born in the UK [aOR 1.46, 95% CI = 1.10 to 1.94] and outside [aOR 1.56, 95% CI = 1.19 to 2.04]) and those born ConclusionSocioeconomic status and ethnic background were associated with amoxicillin prescribing during childhood. Efforts to reduce RTI spread in household and childcare settings may reduce antibiotic prescribing in primary care.

Racial discrimination remains a mechanism by which ethnic-racial minorities are restricted from power. We examined whether racial discrimination restricts ethnic-racial minority access to high-achieving STEM schools. We conducted an audit correspondence experiment to investigate racial discrimination in guidance counselor responsiveness to 976 emails from fictitious Asian, Black, Latina, and White mothers inquiring about school enrollment. Moderation analyses revealed that guidance counselors restricted access from Asian mothers at schools characterized as rural, lower socioeconomic status, and higher STEM prestige-evidence of gatekeeping points to the restriction of Asian students from advanced STEM opportunities. Results are situated within educational audit experiments to objectively document how racism from multiple facets of the education system intersect to inhibit ethnic-racial minority youth.

BackgroundMaternal obesity may increase offspring risk of cardiovascular disease. We assessed the impact of maternal obesity on cardiac structure and function in newborns as a marker of fetal cardiac growth.MethodsNeonates born to mothers of healthy weight (body mass index (BMI) 20–25 kg/m2, n=56) and to mothers who were obese (BMI ≥30 kg/m2, n=31) underwent 25-minute continuous ECG recording and non-sedated, free-breathing cardiac MRI within 72 hours of birth.ResultsMean (SD) heart rate during sleep was higher in infants born to mothers who were versus were not obese (123 (12.6) vs 114 (9.8) beats/min, p=0.002). Heart rate variability during sleep was lower in infants born to mothers who were versus were not obese (SD of normal-to-normal R-R interval 34.6 (16.8) vs 43.9 (16.5) ms, p=0.05). Similar heart rate changes were seen during wakefulness. Left ventricular end-diastolic volume (2.35 (0.14) vs 2.54 (0.29) mL/kg, p=0.03) and stroke volume (1.50 (0.09) vs 1.60 (0.14), p=0.04) were decreased in infants born to mothers who were versus were not obese. There were no differences in left ventricular end-systolic volume, ejection fraction, output or myocardial mass between the groups.ConclusionMaternal obesity was associated with increased heart rate, decreased heart rate variability and decreased left ventricular volumes in newborns. If persistent, these changes may provide a causal mechanism for the increased cardiovascular risk in adult offspring of mothers with obesity. In turn, modifying antenatal and perinatal maternal health may have the potential to optimise long-term cardiovascular health in offspring.

Introduction 1 in every 7 Canadian men is affected by prostate cancer. Given impressive advances in detection, treatment, and survival rates, there is a considerable focus on survivors’ supportive care needs. Among the top unmet supportive care needs for prostate cancer survivors are concerns related to sexual health and intimacy. Aim To provide a rationale for introducing mindfulness- and acceptance-based approaches into the role of psychosexual interventions aimed at improving sexual satisfaction among prostate cancer survivors (and their partners). Methods A literature review was performed to examine the prevalence of sexual difficulties after prostate cancer treatment and the efficacy of current pharmacologic and psychological treatment approaches. Main Outcome Measure The main outcome measure was focused on sexual satisfaction in prostate cancer survivors. Results Current pharmacologic interventions for sexual difficulties after prostate cancer treatment are not fully meeting the needs of prostate cancer survivors and their partners. Conclusions cannot be drawn from existing psychological interventions because of methodologic inconsistencies. Additionally, the focus on erectile function as a measure of treatment effectiveness is likely to instill a greater sense of hopelessness and loss for prostate cancer survivors, which may exacerbate issues around sexual intimacy and satisfaction. An impressive body of evidence supports the role of mindfulness in improving women’s sexual functioning and there is preliminary evidence suggesting the efficacy of this approach for improving men’s sexual functioning. Conclusion We propose that psychosexual interventions that prioritize mindfulness and acceptance-based frameworks may help men to tune into sensations while challenging the foci on performance and erections, thereby increasing the potential for improvement to sexual satisfaction among prostate cancer survivors. Bossio JA, Miller F, O’Loughlin JI, et al. Sexual Health Recovery for Prostate Cancer Survivors: The Proposed Role of Acceptance and Mindfulness-Based Interventions. Sex Med Rev 2019;7:627–635.

Introduction Qualitative and mixed-methods researchers have described the experience of gender norm resistance in adolescence and identified potential types of resistance including indirect resistance (motivated by a preference for gender-atypicality) and direct resistance (motivated by dislike of gender norms and a desire to change them). Building on this work, we developed the Gender Norm Resistance measure to operationalize indirect and direct gender norm resistance. We explored how gender norm resistance aligns with and differs from other gender self-concepts (e.g., felt pressure to conform to gender norms) and peer relations (e.g., contact with peers) and tested for gender differences. Methods Participants included 484 early adolescents (girls = 234; Mage = 11.44 years, SD = 0.56). Analyses included factor analyses (EFA, CFA) and bivariate correlations to gather validity evidence, and ANOVAs to determine mean level differences. Results Evidence that validated using the proposed measure as intended was found including confirmation of the two types of gender norm resistance (indirect and direct). Mean differences were found across participant gender as well as across types of gender norm resistance. Conclusions The findings highlight the strengths and weaknesses of the Gender Norm Resistance measure, the different ways adolescents experience indirect and direct gender norm resistance, and the limited role of felt pressure in gender norm resistance.

This article presents a large-scale evaluation study of over 3000 9–14-year-old students who participated in an engineering workshop during their school fieldtrips. Student perceptions right before...

Community partnered participatory research (CPPR) emphasizes community engagement, respect, and empowerment as guiding principles to promote mental health equity. This article describes the “Vision” stage of a CPPR-informed model to implement evidence-based practices for de­pression in two African American churches in Harlem, New York. Essential parts of the Vision include engagement of stakeholders and collaborative planning. The engage­ment process increased awareness about the project via a community-focused mental health symposium. The collaborative plan­ning stage resulted in creating a multi-dis­ciplinary Community Coalition for Mental Health, establishing the Coalition’s values, agreeing to change the initial chosen study intervention from Interpersonal Counseling to Mental Health First Aid, and developing a website to disseminate the group’s work. Key lessons learned from our partnered process are: 1) support from the lead pas­tor is crucial; 2) balancing community and academic interests can be challenging; 3) icebreaker activities foster relationships and reinforce CPPR principles; 4) multiple com­munication channels can enhance commu­nity participation; and, 5) should organize data in ways that make them easier to interpret.Ethn Dis. 2018;28(Suppl 2):467- 474; doi:10.18865/ed.28.S2.467

Longitudinal social network analysis (SNA) was used to examine how a social-emotional learning (SEL) intervention may be associated with peer socialization on academic performance. Fifth graders (N = 631; 48 % girls; 9 to 12 years) were recruited from six elementary schools. Intervention classrooms (14) received a relationship building intervention (RBI) and control classrooms (8) received elementary school as usual. At pre- and post-test, students nominated their friends, and teachers completed assessments of students' writing and math performance. The results of longitudinal SNA suggested that the RBI was associated with friend selection and peer influence within the classroom peer network. Friendship choices were significantly more diverse (i.e., less evidence of social segregation as a function of ethnicity and academic ability) in intervention compared to control classrooms, and peer influence on improved writing and math performance was observed in RBI but not control classrooms. The current findings provide initial evidence that SEL interventions may change social processes in a classroom peer network and may break down barriers of social segregation and improve academic performance.

Ethnic minorities, such as Latinx people of Hispanic or Latino origin, and women earn fewer engineering degrees than Caucasians and men. With shifting population dynamics and high demands for a technically qualified workforce, it is important to achieve broad participation in the engineering workforce by all ethnicities and both genders. Previous research has examined the knowledge of and interest in engineering among students in grades five and higher. In contrast, the present study examined elementary school students in grades K–5. The study found that older students in grades 4 and 5 had both greater knowledge of engineering occupational activities and greater interest in engineering than younger students in grades K–3. Moreover, Caucasian students had greater knowledge and interest levels than Latinx students. There were no significant differences between boys and girls, nor any significant interactions among gender, grade level, and ethnicity. A significant positive correlation between knowledge of engineering occupational activities and interest in engineering was also found. The findings suggest that early engineering outreach interventions are important. Such early interventions could potentially contribute to preserving the equivalent interest levels of males and females for engineering as students grow older. Also, ethnic disparities in engineering knowledge and interest could potentially be mitigated through early interventions.

Given the ubiquitous influence of gender in a person's life, a number of theories have been developed to explain gender development. These theories can be generally divided into three families: biological, socialization, and cognitive. According to biological theories, psychological and behavioral gender differences are due to the biological differences between males and females. Within this family of approaches, researchers have focused on historical explanations (such as evolutionary processes) and proximal explanations (such as genes and sex hormones). Socialization theories of gender development view gender differences as a byproduct of the differential treatment girls and boys receive from the people in their lives and the pervasive gender stereotyped messages that children are exposed to in their environment. Cognitive theories of gender development view children as active constructors of knowledge who seek, interpret, and act on information in an effort to match their behavior to their understanding of gender. Keywords: biological determinism; gender; gender development; gender socialization; theory

Background Skin cancer is the most common cancer worldwide. Sun exposure is the most important risk factor for its development. The amount of exposure required to cause skin cancer has not been quantified, and the impact of sun protective practices is unknown. Objectives To develop a brief self-administered questionnaire to estimate past and current sun exposure, sun protective practices, and assess the questionnaire’s reliability and validity. Methods The study had three stages: (1) questionnaire formulation, (2) internal reliability and construct validity testing and questionnaire refinement, (3) test–retest and further internal reliability testing. The final Sun Exposure and Behaviour Inventory (SEBI) is composed of 15 questions assessing three domains; current sun behaviour, current sun exposure and prior sun exposure. Results A total of 251 subjects completed Stage 2 testing and 57 completed Stage 3. Final Cronbach’s α-scores ranged from 0.71 to 0.84 and k-scores demonstrated excellent to fair/good agreement, indicating acceptable internal consistency and test–retest reliability. Construct validity was evidenced by significantly higher prior sun exposure scores and lower current sun behaviour scores in subjects with a history of non-melanoma skin cancer. Limitations Self-reported questionnaires, though efficient and low cost, may be subject to recall error and bias. Further work remains to determine if the SEBI maintains its reliability and validity in different populations. Conclusion The SEBI is a brief self-administered questionnaire, which appears to be reliable and valid. It may provide useful measures of past and present sun exposure and current sun behaviour, which may be useful in studies of skin cancer incidence and risk modification.

Intraventricular hemorrhage (IVH) occurs in up to 25% of very low birth weight (VLBW) preterm neonates. Previous studies found that indomethacin administered in the first 6 h of life reduces the incidence of severe IVH in VLBW neonates and decreases cerebral blood flow, suggesting a decrease in cerebral oxygen delivery. Using near-infrared spectroscopy (NIRS), we monitored cerebral oxygenation before, during and after slow indomethacin infusion in extremely low birth weight (ELBW) neonates to determine whether indomethacin decreases cerebral oxygen saturation and increases cerebral oxygen extraction.Twenty-seven ELBW neonates less than 30 weeks gestational age treated with indomethacin for IVH prophylaxis were monitored for arterial oxygen saturation (SaO(2)) and NIRS-determined regional cerebral oxygen saturation (rSO(2)). At 30 to 60 s intervals, SaO(2), rSO(2) and mean arterial pressure (MAP) were recorded using a VitalSync. Average fractional cerebral oxygen extraction was calculated for the hour before indomethacin infusion, during the infusion and 2 h after infusion.Fractional cerebral oxygen extraction increased from baseline after indomethacin administration from 0.23±0.11 to 0.25±0.10 (P=0.034).Fractional cerebral oxygen extraction increased 9% with indomethacin 0.1 mg kg(-1) given over 1 to 2 h. However, the clinical implications of this small increase in extraction, likely representative of decreased cerebral perfusion, are unknown but may be harmful to the developing brain.

The late 1960s through the 1970s marked an important turning point in the field of gender research, including theory and research in gender development. The establishment of Sex Roles in 1975 as a forum for this research represented an important milestone in the field. In this article, we celebrate the 35th anniversary of Sex Roles and, in particular, its contributions to the field of research on children's and adolescents' gender development. We examine the trends in research on gender development published in Sex Roles since its inception and use this analysis as a vehicle for exploring how the field has grown and evolved over the past few decades. We begin with a brief review of the history of this field of research since 1975. Then, we present a descriptive assessment of articles published on gender development in Sex Roles over time, and link this assessment to general trends that have occurred in the study of gender development over the past 35 years. We conclude with a discussion of future directions for the field of gender development. In particular, we highlight areas in which the journal could play a role in promoting more diversity in topics, methods, and ages employed in gender development research.

Widespread gender segregation, evident throughout elementary school, seems to imply that girls and boys have negative feelings and thoughts about one another, and classic theories of inter-group processes support this idea. However, research has generally overlooked children's feelings and perceptions about gender-related interpersonal interactions. This paper investigates the nature of children's attitudes about same- and other-gender peers, and explores how those attitudes relate to the expectancies and beliefs children hold about same- and other-gender peer interactions. Children (N= 98 fifth graders) completed questionnaires assessing their global liking of own- and other-gender peers (Yee & Brown, 1994), positive and negative attitudes about own- and other-gender peers, and outcome expectancies related to interacting with own- and other-gender peers. Results indicated that rather than being characterized by out-group negativity, children's inter-group gender attitudes are best characterized by an in-group positivity bias. Children's positive and negative affective attitudes were also significantly associated with outcome expectancies. In contrast, global liking of own- and other-gender peers was less predictive of outcome expectancies. Thus, the greater specificity of the affective attitude measures appeared to be a more predictive and potentially fruitful gauge of children's feelings about own- and other-gender peers. Results are discussed in terms of the need for finer grained and more extensive studies of children's gender-related feelings and cognitions about own- and other-gender peers.

The present research examined developmental and gender differences in the relative accessibility of different gender stereotype domains. A 1988 Northeastern US sample of 256 children ages 3 to 10 years old provided open-ended descriptions of girls and boys. Responses were coded by domain to examine differences by grade, gender of participant, and gender of target. Analyses revealed that girls and older children provided a higher proportion of stereotypes, and that appearance stereotypes were particularly prevalent in descriptions of girls and activity/trait stereotypes were more prevalent in descriptions of boys. Results are discussed in terms of implications for research on the stereotype knowledge–behavior link and the need for more attention to the role of appearance stereotypes in the gender stereotype literature.

The present study reports initial efficacy data for a new school-based intervention – the Relationship Building Intervention (RBI) – that includes a series of teacher-facilitated, structured activities designed to promote positive peer relationships and inclusive classroom communities. The RBI was evaluated in fifth-grade classrooms by estimating multilevel model (MLM) analyses of covariance (ANCOVA) comparing 368 fifth-grade students in intervention classrooms with 259 fifth-graders in control classrooms on social behaviors, perceptions of classroom connectedness, and academic performance. Controlling for pretest scores, cohort, and demographic variables, findings revealed that students who participated in the RBI liked school more, felt a greater sense of classroom identification and inclusion, were perceived by teachers to be less aggressive, and performed better academically than students who were in control classrooms. Further, implementation data showed that students and teachers responded positively to the activities. These results suggest that the RBI is a promising approach for improving the social and learning environment in fifth-grade classrooms.

Objective - We examined two potential biomarkers of brain damage in HIE neonates: glial fibrillary acidic protein (GFAP; a marker of gliosis) and ubiquitin C-terminal hydrolase L1 (UCH-L1; a marker of neuronal injury). We hypothesized the biomarkers would be measurable in cord blood of healthy neonates and could serve as a normative reference for brain injury in HIE infants. Further, we hypothesized that serum samples of HIE neonates would have higher levels and would correlate with brain damage on MRI and later developmental outcomes.Study Design - Serum UCH - L1 and GFAP concentrations from HIE neonates(n = 16) were compared with controls(n = 11).Pearson correlation coefficients and a mixed model design examined the relationship between biomarker concentrations of HIE neonates and brain damage(MRI) and developmental outcomes(Bayley - III).Result– Both biomarkers were detected in cord blood from control subjects.UCH - L1 concentrations were higher in HIE neonates(p < 0.001) and associated with cortical injury(p < 0.055) and later motor and cognitive developmental outcomes(p < 0.05).The temporal change in GFAP concentrations from birth to 96 hours of age predicted motor developmental outcomes(p < 0.05) and injury to the basal ganglia and white matter.Conclusion– UCH - L1 concentrations correlated with cortical injury and developmental delays and GFAP concentrations correlated with basal ganglia and white matter injury and motor delay in HIE affected patients.Researchers should continue to explore UCH - L1 and GFAP as promising serum biomarkers of brain damage and predictors of neurodevelopmental outcomes in neonates with HIE.

OBJECTIVE The objective of this report was to evaluate a servo-controlled active hypothermia device used during the transport of neonates with HIE. STUDY DESIGN Retrospective review of all cases of therapeutic hypothermia, both passive and active, using a servo-controlled device in a single regional referral neonatal intensive care unit from 2009-2013 RESULTS: An ambulance (43%), fixed wing aircraft (25%), or helicopter (32%) transported 28 neonates with active hypothermia. The servo-controlled device captured core temperatures in all 28 neonates, resulting in 2,985 minutes of data. All neonates attained a core temperature between 33-34 °C by 33 minutes of the transport. Once the neonates attained a core temperature, the average temperature for the remainder of the transport was 33 ± 0.2 °C. The neonates maintained the core temperature regardless of the type of transport vehicle. CONCLUSION Servo-controlled hypothermia enables rapid attainment of targeted temperatures and maintains the temperature throughout the transport process in both ground and air transport.

This study proposes an alternative tumor staging system for cutaneous squamous cell carcinoma (CSCC) that more precisely defines the small subset of tumors with a high risk of metastasis and death.To identify risk factors for poor outcomes in CSCC and evaluate the 2010 American Joint Committee on Cancer (AJCC) tumor (T) staging system's ability to stratify occurrence of these outcomes.Retrospective cohort study.A single academic hospital.Study participants were identified via a pathology and dermatopathology database search for patients diagnosed as having high-risk CSCC.Two hundred fifty-six primary high-risk CSCCs were included. Outcomes for AJCC tumor stages T2 to T4 were statistically indistinguishable because only 4 cases (2% of the cohort) were AJCC stages T3 or T4, which require bone invasion. Subsequently, the bulk of poor outcomes (83% of nodal metastases, 92% of deaths from CSCC) occurred in AJCC stage T2 cases. An alternative tumor staging system was developed with the aim of better stratifying this stage T2 group. Four risk factors were found to be statistically independent prognostic factors for at least 2 outcomes of interest in multivariate modeling. These factors (poor differentiation, perineural invasion, tumor diameter ≥2 cm, invasion beyond subcutaneous fat) were incorporated in the alternative staging with 0 factors indicating T1, 1 factor indicating T2a; 2 to 3 factors, T2b; and 4 factors or bone invasion, T3. Stages T2a and T2b significantly differed in incidences of all 4 end points. Stage T2b tumors comprised only 19% of the cohort but accounted for 72% of nodal metastases and 83% of deaths from CSCC.The proposed alternative tumor staging system offers improved prognostic discrimination via stratification of stage T2 tumors. Validation in other cohorts is needed. Meanwhile, stage T2b tumors are responsible for most poor outcomes and may be a focus of high-risk CSCC study.

An accruing body of evidence supports associations between self-perceived gender typicality and peer relationship difficulties; however, researchers have yet to evaluate peers' perceptions of problem behaviors to gain insight into the social correlates of gender typicality. A short-term longitudinal study was conducted to evaluate associations between gender atypical problem behavior and subsequent peer relational difficulties for 2,076 fifth graders (M age= 10.27; 53% female). Peer nomination methodology was used to assess participants' classroom peer relationships, problem behaviors, and social-emotional characteristics. Findings showed that youth characterized by gender atypical, compared to gender typical, problem behavior (withdrawn boys/aggressive girls vs. withdrawn girls/aggressive boys, respectively) evidenced higher levels of subsequent peer difficulties; moreover, participation in a mutual friendship was associated with decreased risk for peer relationship maladjustment, particularly among youth characterized by gender atypical problem behavior. Results further revealed that, compared to friendless youth, friended youth earned higher prosocial and peer liking scores and, for withdrawn youth, lower emotional sensitivity scores. The present research contributes to our understanding of the potential short-term consequences of youth's gender atypical problem behavior. Findings underscore the need for supplemental conceptualizations of gender typicality as well as multifaceted interventions designed to promote the acceptance of gender nonnormativity, support the development of adaptive peer relationships, and reduce the occurrence of problem behaviors.

BACKGROUND Physical activity has been associated with a lower risk of cancer, including melanoma, but the effect has not yet been assessed for nonmelanoma skin cancer (NMSC). OBJECTIVE To determine whether the risk of skin cancer differs according to physical activity level in patients at high risk for NMSC. METHODS We conducted a retrospective cohort study in kidney, liver, and pancreatic transplant patients via telephone interview. Physical activity scores were calculated for each patient using a previously validated questionnaire. Sun exposure history and skin type were also recorded. The outcome of interest was a biopsy-proven diagnosis of at least one NMSC. RESULTS Of 142 subjects, 45 (32%) developed NMSC. There was no significant effect of physical activity on the development of NMSC. CONCLUSIONS Physical activity level may not be a major predictor of skin cancer risk in organ transplant patients. Controlled trials and population-based studies are needed to determine whether exercise can decrease the risk of NMSC in the general population. The authors have indicated no significant interest with commercial supporters.

BACKGROUND Perineural invasion (PNI) has been associated with poor prognosis in cutaneous squamous cell carcinoma (CSCC), but it is unclear how different degrees of nerve involvement affect prognosis. OBJECTIVE To determine whether the diameter of nerves invaded by CSCC affects outcomes of recurrence, metastasis, and disease-specific and overall survival. METHODS A retrospective cohort study was conducted of patients with CSCC with PNI. Dermatopathologists blinded to subject outcomes determined the diameter of the largest involved nerve. RESULTS Data were obtainable for 48 patients. Small-caliber nerve invasion (SCNI) of nerves less than 0.1 mm in diameter was associated with significantly lower risks of all outcomes of interest. Disease-specific death was 0% in subjects with SCNI, versus 32% in those with large-caliber nerve invasion (LCNI) (p=.003). Other factors associated with significantly worse survival were recurrent or poorly differentiated tumors or tumor diameter of 2 cm or greater or depth of 1 cm or greater. On multivariate analysis, only tumor diameter and age predicted survival. CONCLUSIONS The individual prognostic significance of factors associated with poor survival remains uncertain. Small-caliber nerve invasion may not adversely affect outcomes. Defining PNI as tumor cells within the nerve sheath and routine recording of diameter of involved nerves, tumor depth, and histologic differentiation on pathology reports will facilitate further study.

Background: Although neonatal platelets have been shown to be hyporesponsive to most agonists in vitro, several groups have reported shorter closure times (CT) in term cord blood samples than in children and adults. It is unknown whether this is also true for preterm neonates, or for neonates of any gestational age (GA) during the 1st week of life, since limited studies have evaluated neonatal blood samples. Objectives: We designed this study to determine the effects of GA and postconceptional age on platelet function using the platelet function analyzer PFA-100®. Methods: We measured CTs in cord blood samples and in neonatal blood samples of varying GAs on days of life 1–2, and ≧7. Results: CTs were determined in 51 cord blood samples, 34 neonatal blood samples obtained on day of life 1–2, 16 neonatal blood samples from preterm neonates ≧7 days old, and 10 adults. We found a significant inverse relationship between ADP CTs and GA in both cord blood and neonatal blood day of life 1–2 samples (p = 0.02 and p = 0.01, respectively). When cord blood samples were compared with neonatal and adult blood, epinephrine and ADP CTs were significantly longer in adult blood as well as in neonatal samples obtained at either of the two time points (p ≤ 0.01 for all). Conclusions: Platelet function in response to ADP appears to improve with advancing GA. The differences between cord blood and neonatal blood CTs indicate that substantial changes in primary hemostasis occur shortly after birth. The reasons underlying these changes are unknown.