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Quantification of the impact of local masking policies may help guide future policy interventions to reduce SARS-COV-2 disease transmission. This study's objective was to identify factors associated with adherence to masking and social distancing guidelines.Faculty from 16 U.S. colleges and universities trained 231 students in systematic direct observation. They assessed correct mask use and distancing in public settings in 126 US cities from September 2020 through August 2021.Of 109,999 individuals observed in 126 US cities, 48% wore masks correctly with highest adherence among females, teens and seniors and lowest among non-Hispanic whites, those in vigorous physical activity, and in larger groups (P.0001). Having a local mask mandate increased the odds of wearing a mask by nearly 3-fold (OR = 2.99, P = .0003) compared to no recommendation. People observed in non-commercial areas were least likely to wear masks. Correct mask use was greatest in December 2020 and remained high until June 2021 (P.0001). Masking policy requirements were not associated with distancing.The strong association between mask mandates and correct mask use suggests that public policy has a powerful influence on individual behavior.Mask mandates should be considered in future pandemics to increase adherence.

In this practice note, we document the progression of the Community Vaccine Collaborative (CVC), on which we first published in 2021. The CVC convened to address deep COVID-19-related disparities affecting the Black, Latine, immigrant/refugee, and lesbian, gay, bisexual, transgender, queer, (questioning), intersex, asexual, and (agender) (LGBTQIA+) communities. The COVID-19 pandemic is rooted in centuries of oppression and marginalization leading to inequities and required dedicated focus to support marginalized communities in times of crisis. The CVC comprises community members, community-based organizations, health care providers, researchers, health systems leaders, and public health practitioners (among others), all of whom are dedicated to promoting COVID-19 vaccine equity. As the pandemic shifts and changes, so too has our group, to remain relevant to community needs and priorities. This article details Year 2 of the CVC, focusing on how we have grown and sustained this unique partnership. We also share results from an evaluation of the CVC, documenting participation in the collaborative space and alignment with CVC core principles. Finally, we discuss next steps and implications for the CVC including our pivot from vaccines to community vitality as we expand and sustain our collaborative efforts to address the ongoing COVID-19 pandemic and intersecting public health crises.

Aim: Compare a pre-co-seasonal with a perennial schedule using an undiluted mixture of a depigmented-polymerized grass/Olea europaea immunotherapy (2,000 DPP/mL) in pediatric patients with rhinitis/rhinoconjunctivitis with or without controlled asthma.Material and Methods: Primary objective was to determine the non-superiority of a perennial compared to a pre-co-seasonal schedule by means of Paediatric/Adolescent Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ/AdolRQLQ). Secondary objectives were Paediatric Asthma/Caregiver´s Quality of Life Questionnaire (PAQLQ/PACQLQ) Asthma Control Test (ACT), Visual Analogue Scale global assessment of allergic disease (VAS), use of resources and immunological response. All variables were compared during the pollen season (April-June) without (2015) and with (2016) immunotherapy.Results: Forty patients were included in the study of which 29 patients were assigned to the perennial and 11 to the pre-co-seasonal schedule. During 2016 pollen season a significant improvement in the PRQLQ/AdolRQLQ, PAQLQ/AdolAQLQ, ACT and VAS score were observed both in perennial and pre-co-seasonal schedule group. No significant differences were seen between treatment schedules for PRQLQ/AdolRQLQ, PAQLQ/AdolAQLQ and ACT scores comparing both pollen seasons. A significant increase in sIgG4 and reduction in the number of rescue medications used and number of patients who needed visit to any specialist was observed in both treatment schedules during 2016 pollen season. No relevant differences were found in the safety profile of any treatment schedule.Discussion: Treatment with undiluted mixture of a depigmented-polymerized Grass/Olea europaea allergen immunotherapy has proven to be effective both using a perennial and a pre-co-seasonal schedule and therefore suitable for polyallergic patients.

Background Food allergy is the most common cause of anaphylaxis. Changes in posture during acute reactions can trigger fatal outcomes, but the impact of allergic reactions on the cardiovascular system in nonfatal reactions remains poorly understood. Objective Our aim was to systematically evaluate changes in cardiovascular function during acute allergic reactions to peanut. Methods Participants underwent double-blind placebo-controlled food challenge to peanut as part of a clinical trial. Changes in hemodynamic parameters (heart rate, stroke volume, blood pressure, and peripheral blood flow) and electrocardiogram findings during food challenges were assessed using noninvasive continuous monitoring. Results A total of 57 adults (median age 24 years [interquartile range = 20-29]), 53% of whom were female, participated; 22 (39%) had anaphylaxis. Acute reactions were associated with significant changes in stroke volume (mean decrease of 4.2% [95% CI = 0.8-7.6; P = .03]), heart rate (mean increase 11.6% [95% CI = 8.4-14.8; P < .0001]), and peripheral blood flow (mean increase 19.7% [95% CI = 10.8-28.6; P < .0001]), irrespective of reaction severity. These changes were reproduced at a subsequent repeat peanut challenge in 26 participants, and could be reversed with administration of intravenous fluids which resulted in faster resolution of abdominal symptoms. Conclusions In this first detailed human study of cardiovascular changes during food-induced allergic reactions, we found evidence for significant fluid redistribution, independent of reaction severity. This provides a sound rationale for optimizing venous return during significant allergic reactions to food. Finally, these data provide a new paradigm for understanding severity in anaphylaxis, in which poor outcomes may occur as a result of a failure in compensatory mechanisms., Graphical abstract

Background: As the number of allergic sensitizations increases the severity of allergic respiratory diseases worsens. Multiple monoallergen immunotherapy can be accompanied by poor treatment adherence and high costs, single multiallergen immunotherapy needs to prove efficacy whilst maintaining a good safety profile. Methods: Observational, retrospective, multicenter study using a 2-pollen single undiluted multiallergen subcutaneous immunotherapy (SCIT) in routine clinical practice in Spain. Patients with rhinoconjunctivitis, with/without controlled asthma, sensitized to grass, olive, Parietaria, Cupressus, plane tree and/or Salsola pollen were included. Primary and secondary clinical efficacy endpoints were quality of life (mini Rhinitis Quality of Life Questionnaire (miniRQLQ)) and visual analogue scale (VAS) respectively. All adverse events were documented. Results: Ten centers included 97 patients, median age 32 years. SCIT treatment included combinations of grass mix with olive, Parietaria, Cupressus, plane tree or Salsola or olive with Parietaria, Cupressus or Salsola. The mean duration of SCIT was 1.8 years with a high treatment adherence (73%). Significant improvement in quality of life, nasal and ocular symptoms, activity limitations and practical problems (p< 0.0001) and other symptoms (p= 0.024) was observed. Most patients did not develop asthma-like symptoms and a significant improvement of all allergic symptom severity was perceived. VAS showed a significant improvement in rhinoconjunctivitis and asthma by patients and physicians. Twenty-nine patients experienced adverse reactions, 25 had local and 6 had systemic reactions. Conclusions: Single undiluted multiallergen SCIT treatment of two different pollens is efficacious and safe in both children and adults, showing that it is a suitable option for the treatment of polyallergic patients.

Objective Food allergy encompasses a range of food hypersensitivities. Different clinical phenotypes for food allergy likely exist in much the same way as endotype discovery is now a major research theme in asthma. We discuss the emerging evidence for different reaction phenotypes (ie, symptoms experienced after allergen exposure in food allergic individuals) and their relevance for clinical practice. Data Sources Published and unpublished literature relating to reaction phenotypes in food allergy. Study Selections Authors assessment of the available data. Results Food anaphylaxis may be pathophysiologically different than anaphylaxis caused by nonfood triggers. Currently, there are no robust, clinically useful predictors of severity in food allergy. It is likely that patient-specific reaction phenotypes exist in food allergy, which may affect the risk of severe anaphylaxis. Allergen immunotherapy may modulate these phenotypes. Conclusion Data are emerging to confirm our clinical experience that many food allergic patients experience stereotypical symptoms after allergen exposure, both in the community and at supervised oral food challenge, in a manner that varies among patients. Integrating data sets from different cohorts and applying unbiased machine-based learning analyses may demonstrate specific food allergy endotypes in a similar way to asthma. Whether this results in improvements in patient management (eg, through facilitating risk stratification or affecting the decision to prescribe an epinephrine autoinjector and, perhaps, the number of devices) remains to be determined, but given our current inability to predict which patients are most at risk of severe food allergic reactions, this will clearly be an important area of research in the future.

This chapter will cover the work of practitioners in the areas of social emotional learning, behavior, and school district administration. This chapter will speak to the importance of breaking down silos and bridging general education and special education supports to create an alignment in practices across a school district while implementing social emotional and trauma-informed support for staff and students. Educators and leaders will gain insight to developing a cohesive model of learning for all students, understanding that social emotional learning is essential for academic mastery to occur. The intent is to guide students in their learning while addressing their own social emotional needs, as well as build capacity in staff to carry out this work.

Diabetes, high blood pressure, and obesity are major risk factors for cardiovascular disease (CVD) . Access to and awareness of health education programming is often low in ethnic/racial minorities and individuals of low socioeconomic status experience a higher prevalence of T2D, hypertension, CVD and stroke. Additionally, underserved, at-risk patients face barriers to accessing traditional in-person diabetes self-management education and support (DSME/S) due to transportation, caregiving, and work conflicts. To address this gap, the ADA’s Know Diabetes by Heart (KDBH) initiative partnered with Project Dulce, an evidence-based culturally and linguistically modified DSME/S program to overlay an innovative digital approach to diabetes support programming and resources in the community. In response to COVID-restrictions, Project Dulce sessions integrating KDBH content were delivered via telehealth group sessions and text messaging to encourage heart healthy self-management behaviors. Pre/post surveys assessed knowledge and self-management, and clinical metrics were evaluated via electronic health records. The KDBH/Project Dulce DSME/S program was delivered to 5 health systems in California: 2 Federally Qualified Health Centers, 2 County health clinics and 1 large community-based health system near the US/Mexico border. Of the N=553 who received KDBH/Project Dulce education, 47% were White, 36% Hispanic, 14% African American, Asian, Native American, Pacific Islander, and 3% other. Of all enrollees, 58% were female, and 15% were /= 66 y/o. Participant feedback indicated acceptance of both the group virtual and texting programs. Findings demonstrate the feasibility of disseminating important heart healthy interventions to diverse ethnic/racial minority groups via a variety of digital and telehealth methods. Disclosure M.Ruiz: n/a. A.L.Fortmann: Consultant; Ascensia Diabetes Care, Employee; Dexcom, Inc. H.Sandoval: None. A.Philis-tsimikas: Advisory Panel; Bayer AG, Novo Nordisk, Research Support; Lilly Diabetes, National Institute of Diabetes and Digestive and Kidney Diseases, Novo Nordisk, Viking Therapeutics. M.Chichmarenko: None. S.R.Bagsic: None. J.Boyer: None. Funding American Diabetes Association/KDBH

Dulce Digital (DD) , a simple low-cost text message program designed to enhance clinical diabetes care with educational, motivational and glucose reminder messages when delivered 2-3 times/day over 6 months has been shown to be highly acceptable in diverse racial/ethnic minorities and low SES communities and results in a mean 1% reduction in HbA1c compared to usual care. During the COVID pandemic, barriers to in-person care, including quarantines, stay-at-home work schedules, childcare, and transportation, make digital messaging a practical means of improving patient health. To maximize reach in the T2DM population, a large Southern California health care provider integrated DD into their DSME/S offering. This study aims to learn the reach, acceptability, and effectiveness of Dulce Digital in a real-world patient care setting to motivate patients with daily self-care behaviors. An existing diabetes registry identified N=1423 patients with T2DM and HbA1c>7.5% in the last 6 months. There was enthusiastic adoption of the DD texting program byprimary care clinic sites with 78 providers across the County. Patient recruitment was conducted via a patient portal message (EPIC My Chart) sent from healthcare providers encouraging participation in the program. Within one week of portal outreach, 116 patients (8.2%) enrolled (mean age = 57.3 y/o +/- 14.4, range 24-92; 50% female; mean HbA1c= 9.9 % +/- 1.5, range 8.1-16.2) . Program workflows include using support staff to monitor blood glucose responses in the texting platform, assess possible reasons for hyper/hypoglycemia, and encourage follow up with a provider as needed. Adoption by patients and providers to date demonstrate a digital texting program is acceptable and desired equally by men and women across a wide range of ages in patients with T2D and elevated HbA1c. Outreach to enroll patients using a patient EMR portal can be successful and can serve as an enhanced approach to support DSME/S. Disclosure M.Ruiz: n/a. A.Philis-tsimikas: Advisory Panel; Bayer AG, Novo Nordisk, Research Support; Lilly Diabetes, National Institute of Diabetes and Digestive and Kidney Diseases, Novo Nordisk, Viking Therapeutics. H.Sandoval: None. A.L.Fortmann: Consultant; Ascensia Diabetes Care, Employee; Dexcom, Inc. M.A.Stechschulte: None. S.R.Bagsic: None. K.Patel: None. K.Mendez: None.

Production of probiotics at industrial scale to be used as food supplements involves diverse kinds of processes such as selection of microorganisms, 2) fermentation, 3) drying, and the use of non-food grade commercial culture mediums that should be washed after obtaining the ideal cell concentration. Then, food grade culture medium for probiotics that do not need to be washed and protect the microorganisms through the gastrointestinal tract, is proposed as a low-cost alternative to grow probiotics to be used for incorporation in food. In this way, an experimental design was carried out to obtain the operative conditions for spray drying food-grade culture medium at industrial scale. The factors evaluated were the inlet and outlet temperature and a specific heat treatment before the drying process. As response variables the physical properties of the food-grade medium in powder and the viability count of the probiotic Limosilactobacillus fermentum K73 were evaluated. The viability of four different known probiotics (Limosilactobacillus fermentum, Lactobacillus delbruekii, Lacticaseibacillus rhamnosus and Enterococcus faecium) was proved which resulted after 10 h in 10.6, 10.2, 10.1, and 11.2 logCFU/ml, respectively. Also, in vitro digestions of the probiotics in this food-grade medium were carried out and compared with digestions of the probiotics in the commercial medium MRS, demonstrating that the proposed medium protect the probiotics of the gastrointestinal conditions, allowing them to arrive at the intestine at 7.3, 6.8, 7.5 and 7 logCFU/mL, for L. fermentum, L. delbruekii, L. rhamnosus and E. faecium, respectively. Finally, the optimal conditions of the spray drying process were used to reproduce the whey food-grade medium at a large-scale spray dryer (dimensions), this to validate the medium performance in the production of powdered probiotics as L. fermentum.

Health care personnel attitudes toward refugee claimant entitlement to health care are influenced by multilevel factors including institutional and societal culture. Although individual attitudes may be modified through training, macro- and meso-issues require system-level interventions. This paper analyzes the role of individual-, institutional-, and city-level factors in shaping attitudes toward refugee claimants’ access to health care among Canadian health care personnel. A total of 4207 health care personnel in 16 institutions located in Montreal and Toronto completed an online survey on attitudes regarding health care access for refugee claimants. We used multilevel logistic regression analysis to identify individual-, institutional-, and city-level predictors of endorsing access to care. Participants who had prior contact with refugee claimants had greater odds of endorsing access to care than those who did not (OR 1.13; 95% CI 1.05, 1.21). Attitudes varied with occupation: social workers had the highest probability of endorsing equal access to health care (.83; 95% CI .77, .89) followed by physicians (.77; 95% CI .71, .82). An estimated 7.97% of the individual variation in endorsement of equal access to health care was attributable to differences between institutions, but this association was no longer statistically significant after adjusting for city residence. Results indicate that the contexts in which health care professionals live and work are important when understanding opinions on access to health care for vulnerable populations. They suggest that institutional interventions promoting a collective mission to care for vulnerable populations may improve access to health care for precarious status migrants.

We herein present a case of unsuspected Strongyloides stercoralis (Ss) hyperinfection diagnosis. No screening due to origin or immunosuppressed condition had been done and treatment was presumably prescribed lately, with subsequent vital risk for the patient.

The severity of allergic reactions to foods can vary markedly. Little is known of variations in reaction severity within or between individuals or the effects of cofactors.We examined the effects of sleep deprivation and exercise and repeat challenges on the severity and patterns of allergic reactions to peanut.In a randomized crossover study, adults with peanut allergy underwent 3 open peanut challenges in random order: with exercise after each dose, with sleep deprivation preceding challenge, and with no intervention. The primary outcome was eliciting dose, reported elsewhere. Reaction severity was a secondary outcome, evaluated using a weighted log-transformed numerical severity score. Analyses estimated the difference in severity between nonintervention challenge and challenges with exercise or sleep deprivation, adjusting for challenge order and using the highest dose tolerated by each individual across all their challenges. Symptom pattern reproducibility was assessed by comparing symptom sequences using pairwise sequence alignment to obtain a percentage match in symptom pattern.Eighty-one participants (mean age 25 y) completed at least 1 postbaseline challenge. Sleep deprivation, but not exercise, significantly increased severity score by 48% (95% CI 12%-84%; P = .009) compared with no intervention. A 38% increase in severity was observed between the first and the last postbaseline challenge (95% CI 1%-75%; P = .044). The average pairwise match of symptoms within individuals was 82.4% and across individuals was 78.3%.A novel severity score demonstrates that sleep deprivation and repeated challenges increase reaction severity. Understanding factors affecting severity is essential for effective risk management. We also show that symptom patterns in repeat peanut challenges are similar within and between individuals.

Currently, the use of simulators is growing widely in part due that there is a huge benefit compared to its cost, a well balanced cost-benefit is provided. On the other hand, the risks of practising or to observe in simulators are low contrary to real environments where in some kind of situations the lives of the people can be at risk. There are several works where the simulation of fires is carried out using any kind of simulators, both indoors and outdoors, in this work a comparison has been made between the A * algorithm and the probabilistic roadmap (PRM) algorithm to generate escape routes. As the A* algorithm is the most common in some artificial intelligence and robotics applications, in addition to being easy to implement, it is common to use it in new works to generate the path planning; this work therefore shows that it is possible to reduce the time of generation of an escape route considerably in some cases using other uncommonly used algorithms. It has been observed that even when PRM using probabilistic method for the generation of escape routes like PRM, the generation time decreases compared to the A* algorithm. The images and graphics shown in this work will give a visual comparison of the execution times of both algorithms in the same situations.

International audience; Background: Bioaccessibility of food allergens may be a key determinant of allergic reactions.Objective: To develop a protocol allowing the detection of the major peanut allergen, Ara h 6, in the bloodstream following ingestion of low amounts of peanut and to compare Ara h 6 bioaccessibility by food matrix. We further assessed for differences in absorption in healthy versus peanut-allergic volunteers.Methods: A blood pretreatment combining acidic shock and thermal treatment was developed. This protocol was then applied to blood samples collected from human volunteers (n = 6, healthy controls; n = 14, peanut-allergic patients) at various time-points following ingestion of increasing levels of peanut incurred in different food matrices (cookies, peanut butter and chocolate dessert). Immunodetection was performed using an in-house immunoassay.Results: An original pretreatment protocol was optimized, resulting in irreversible dissociation of human antibodies-Ara h 6 immune complex, thus rendering Ara h 6 accessible for its immunodetection. Ara h 6 was detected in samples from all volunteers following ingestion of 300-1000 mg peanut protein, although variations in the kinetics of passage were observed between individuals and matrices. Interestingly, in peanut-allergic subjects, Ara h 6 could be detected following ingestion of lower doses and at higher concentrations than in non-allergic volunteers.Conclusions and Clinical Relevance: The kinetics and intensity of Ara h 6 passage in bloodstream depend on both individual and food matrix. Peanut-allergic patients appear to demonstrate higher absorption rate, the clinical significance of which warrants further evaluation.

Continuous Glucose Monitors (CGM) automatically capture interstitial glucose levels every 5 minutes, 24 hours/day, allowing users to view their glucose levels in real-time and make informed decisions about how to manage diet, exercise, and medications. While CGMs are a central component in the glucose management of type 1 diabetes and insulin-dependent type 2 diabetes, less is known about the potential value of CGMs for diabetes prevention. The original Diabetes Prevention Program (DPP) demonstrated that 5-7% weight loss - an outcome reliant upon healthful eating and exercise - was more effective than medication in preventing or delaying the onset of T2D; however, subsequent DPP translations have not consistently achieved the same weight loss outcomes. CGM may represent a way to reinforce and incentivize hard-to-make health behavior changes in real-time that are crucial to the more distal (and often elusive) weight loss outcome. This small (n=7) feasibility pilot examined the preliminary effectiveness and acceptability of integrating CGM in a DPP at Scripps Health, a large, non-profit, private insurance-based health system in San Diego, CA. Following a brief introduction to the CGM and target glucose ranges, DPP participants self-inserted and wore the CGM for 2 weeks. Mean time-in-range (70-140 mg/dL) improved from 70.4% to 76.4%, and time > 140 mg/dL decreased from 29.4% to 23.1% during this period. Individual change in time-in-range ranged from -9.7% to + 38.8% (M ∆ = +6.0%). Participants reported high satisfaction with the CGM, but expressed a desire for more education on blood glucose management. Given these findings, a longer-term, randomized controlled trial is planned to investigate whether a CGM-enhanced DPP leads to greater weight loss than DPP alone. This research will also further our understanding of the potential benefit of improved glycemic control for diabetes prevention even among the subset of cases who do not ultimately achieve the targeted weight loss goal. Disclosure A.L. Fortmann: None. A. Bastian: None. S.R.S. Bagsic: None. I. Loupasi: None. K. Luu: None. A.R. Hottinger: None. K.A. Barry: None. M. Ruiz: None. C. Walker: None. A. Philis-Tsimikas: Advisory Panel; Self; Lilly Diabetes, Medtronic, Novo Nordisk A/S, Sanofi. Employee; Spouse/Partner; Ionis Pharmaceuticals, Inc. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Dexcom, Inc., Lilly Diabetes, Medtronic, Novo Nordisk A/S, Sanofi. Funding Confidence Foundation; Dexcom, Inc.

OBJECTIVE Type 2 diabetes is growing in epidemic proportions and disproportionately affects lower-income, diverse communities. Text messaging may provide one of the most rapid methods to overcome the “digital divide” to improve care. RESEARCH DESIGN AND METHODS A randomized, nonblinded, parallel-groups clinical trial design allocated N = 126 low-income, Hispanic participants with poorly controlled type 2 diabetes to receive the Dulce Digital intervention or usual care (UC). Dulce Digital participants received up to three motivational, educational, and/or call-to-action text messages per day over 6 months. The primary outcome was HbA1c; lipids, blood pressure, and BMI were secondary outcomes. Satisfaction and acceptability were evaluated via focus groups and self-report survey items. RESULTS The majority of patients were middle-aged (mean age 48.43 years, SD 9.80), female (75%), born in Mexico (91%), and uninsured (75%) and reported less than a ninth-grade education level (73%) and mean baseline HbA1c 9.5% (80 mmol/mol), SD 1.3, and fasting plasma glucose 187.17 mg/dL, SD 64.75. A statistically significant time-by-group interaction effect indicated that the Dulce Digital group achieved a significantly greater reduction in HbA1c over time compared with UC (P = 0.03). No statistically significant effects were observed for secondary clinical indicators. The number of blood glucose values texted in by participants was a statistically significant predictor of month 6 HbA1c (P < 0.05). Satisfaction and acceptability ratings for the Dulce Digital intervention were high. CONCLUSIONS Use of a simple, low-cost text messaging program was found to be highly acceptable in this sample of high-risk, Hispanic individuals with type 2 diabetes and resulted in greater improvement in glycemic control compared with UC.

In a lot of sciences is always necessary to determine the performance of new algorithms, profiling is a useful tool during the process of development and testing. Is very helpful to have a huge testing dataset to ensure that the proposed methodology is robust for a wide range of possible scenarios. In most of the public dataset the number of scenarios to probe new algorithms is limited and not standard, because of that, in this work is done a comparative between two ways to create scenarios with the characteristic before mentioned: The recursive and the iterative one.

BACKGROUND: Peanut allergy causes severe and fatal reactions. Current food allergen labelling fails to address these risks adequately against the burden of restricting food choice for allergic individuals because of limited data on thresholds of reactivity and the influence of everyday factors. OBJECTIVE: We estimated peanut threshold doses for a UK peanut-allergic population and examined the effect of sleep deprivation and exercise. METHODS: In a crossover study, following blinded challenge, peanut-allergic participants underwent three open peanut challenges in random order: with exercise following each dose, with sleep deprivation preceding challenge, and with no intervention. Primary outcome was the threshold dose triggering symptoms (mg protein). Primary analysis estimated the difference between non-intervention challenge and each intervention in log threshold (as % change). Dose distributions were modelled deriving eliciting doses in the peanut-allergic population. RESULT: Baseline challenges were performed in 126 subjects, 100 were randomized and 81 (mean age 25y) completed at least one further challenge. The mean (SD) threshold was 214 mg (330mg) for non-intervention challenges and this was reduced by 45% (95% confidence interval 21,61 p=0.001) and 45% (22,62 p=0.001) for exercise and sleep deprivation, respectively. Mean (95% confidence interval) estimated eliciting doses for 1% of the population were 1.5mg (0.8,2.5) during non-intervention challenge (n=81), 0.5mg (0.2,0.8) following sleep and 0.3mg (0.1,0.6) following exercise. CONCLUSION: Exercise and sleep deprivation each significantly reduce the threshold of reactivity in people with peanut allergy, putting them at greater risk of a reaction. Adjusting reference doses using these data will improve allergen risk-management and labelling to optimize protection of peanut-allergic consumers. ClinicalTrials.gov Identifier: NCT01429896

Weight loss can significantly reduce an individual’s risk for T2D. However, it can be challenging to engage participants in the DPP long enough to lose weight. This analysis examines sociodemographic characteristics and health behaviors as predictors of participant engagement and weight loss/gain. Participants were recruited into the DPP through a referral from a provider, family/friend, or other. Classes were conducted through local ambulatory clinics and community settings in San Diego, CA. Baseline self-report surveys were administered prior to program start, and weight was assessed at every session. Participants (N=290) were mostly female (81%) with a mean age of 57 (±14), diverse [51% Hispanic, 9% Asian/Native Hawaiian or Pacific Islander (ANHPI), 4% Other], and reported household incomes Disclosure M. AuYoung: None. K. Luu: None. M. Ruiz: None. C. Walker: None. A. Philis-Tsimikas: Advisory Panel; Self; AstraZeneca, Lilly Diabetes, Novo Nordisk A/S, Sanofi. Employee; Spouse/Partner; Ionis Pharmaceuticals, Inc. Research Support; Self; Dexcom, Inc., Glooko, Inc., National Institute of Diabetes and Digestive and Kidney Diseases. Stock/Shareholder; Spouse/Partner; Ionis Pharmaceuticals, Inc., Novo Nordisk Inc. A.L. Fortmann: None.