Marine debris provide long-distance pathways for spreading invasive corals

Anthropogenic marine debris and invasive species are pervasive in the ocean. However, research on the mechanisms and dynamics controlling their distribution in marine systems (e.g.; by floating debris acting as vectors for invasive species) is limited. Applying a numerical modeling approach, we demonstrate that rafting invasive corals (Tubastraea spp.) can be transported over long distances and reach important tropical receptor regions. In <180 days, buoyant debris can cover distances between 264 and 7170 km moving from the Brazilian semiarid coast to the Amazon coast and reaching eight regions in the Wider Caribbean (mainly the Eastern Caribbean and Greater Antilles). Analyzing 48 simulated scenarios (4 years × 3 depths × 4 months), we demonstrate that in ~86 % of the scenarios the particles are stranded in the Caribbean and in ~71 % they end up in the Amazon coast. Our results showed litter floating trajectories at 0-10 m water depth, transported every year to the Caribbean province. However, in August this transport is frequently blocked by the retroflection of the North Brazil Current adjacent to the Amazon River estuarine plume. Our results indicate routes for fast and long-distance transport of litter-rafting invasive species. We hypothesized a high risk of bioinvasion on important marine ecosystems (e.g., coral reefs) likely becoming increasingly threatened by these invasive species and debris. This highlights the imperative need for an ocean governance shift in prevention, control, and eradication, not only focused on local actions to prevent the spread of invasive species but also a broad international action to decrease and mitigate marine debris pollution globally.

Turbidity buffers coral bleaching under extreme wind and rainfall conditions

Coral reefs in turbid waters have been hypothesized to be a refuge from climate change. These naturally occurring communities were brought into the spotlight because some of their species exhibited record levels of resistance to marine heatwaves (MHWs) by disturbance-tolerant corals. However, long-term monitoring data on the drivers of coral bleaching in these extreme reef habitats are scarce. Here, we describe the population structure and bleaching rates of a widespread and resilient coral (Siderastrea stellata). We examine the links between environmental factors, namely, rainfall, wind speed, turbidity, solar irradiance, sea surface temperature, MHWs, and coral bleaching status under the worst recorded drought cycle in the Tropical South Atlantic (2013-2015). We examined 2880 colonies, most of which (∼93%) fit in the size group of 2-10 cm, with a small number (∼1%) of larger and older colonies (>20 cm). The results indicated the absence of MHWs and normal sea surface temperature variations (between 26.6 °C and 29.3 °C), however, we detected an extreme rainfall deficit (30-40% less annual volume precipitation). In general, a high proportion (44-84%) of bleached colonies was found throughout the months when turbidity decreased. Siderastrea is the only reef-building coral that comprises this seascape with encrusting and low-relief colonies. During drought periods, cloudiness is reduced, turbidity and wind speed are reduced, and solar irradiance increase, driving coral bleaching in turbid reefs. However, episodic rainfall and higher wind speeds increase turbidity and decrease coral bleaching. Our hypothesis is that turbidity decreases during drought periods which increases bleaching risk to corals even without thermal stress. Our results suggest that turbidity may have related to wind and rainfall to provoke the coral bleaching phenomenon.

Temperature, species identity and morphological traits predict carbonate excretion and mineralogy in tropical reef fishes

Anthropogenic pressures are restructuring coral reefs globally. Sound predictions of the expected changes in key reef functions require adequate knowledge of their drivers. Here we investigate the determinants of a poorly-studied yet relevant biogeochemical function sustained by marine bony fishes: the excretion of intestinal carbonates. Compiling carbonate excretion rates and mineralogical composition from 382 individual coral reef fishes (85 species and 35 families), we identify the environmental factors and fish traits that predict them. We find that body mass and relative intestinal length (RIL) are the strongest predictors of carbonate excretion. Larger fishes and those with longer intestines excrete disproportionately less carbonate per unit mass than smaller fishes and those with shorter intestines. The mineralogical composition of excreted carbonates is highly conserved within families, but also controlled by RIL and temperature. These results fundamentally advance our understanding of the role of fishes in inorganic carbon cycling and how this contribution will change as community composition shifts under increasing anthropogenic pressures.

No short-term effect of sinking microplastics on heterotrophy or sediment clearing in the tropical coral Stylophora pistillata

Investigations of encounters between corals and microplastics have, to date, used particle concentrations that are several orders of magnitude above environmentally relevant levels. Here we investigate whether concentrations closer to values reported in tropical coral reefs affect sediment shedding and heterotrophy in reef-building corals. We show that single-pulse microplastic deposition elicits significantly more coral polyp retraction than comparable amounts of calcareous sediments. When deposited separately from sediments, microplastics remain longer on corals than sediments, through stronger adhesion and longer periods of examination by the coral polyps. Contamination of sediments with microplastics does not retard corals' sediment clearing rates. Rather, sediments speed-up microplastic shedding, possibly affecting its electrostatic behaviour. Heterotrophy rates are three times higher than microplastic ingestion rates when corals encounter microzooplankton (Artemia salina cysts) and microplastics separately. Exposed to cysts-microplastic combinations, corals feed preferentially on cysts regardless of microplastic concentration. Chronic-exposure experiments should test whether our conclusions hold true under environmental conditions typical of inshore marginal coral reefs.

The flourishing and vulnerabilities of zoantharians on Southwestern Atlantic reefs

In the Southwestern Atlantic reefs (SWA), some species of massive scleractinians and zoantharians are adapted to turbid waters, periodic desiccation, and sediment resuspension events. Moreover, phase shifts in this region have mostly been characterized by the emergence of algae and, less typically, zoantharians. However, nutrient excess and organic pollution are key drivers of the hard coral habitat degradation and may, thus, favor the emergence of novel zoantharian-dominated habitats. Many zoantharian species, particularly those from the genera Palythoa and Zoanthus, have traits that could help them thrive under conditions detrimental to reef-building corals, including rapid growth, several asexual reproduction strategies, high morphological plasticity, and generalist nutrient acquisition strategies. Thus, in a near future, stress-tolerant zoantharians may thrive in nutrient-enriched subtidal SWA locations under low heat stress, such as, upwelling. Overall, coral-zoantharian phase shifts in the SWA may decrease the species richness of reef communities, ultimately influencing ecosystem functioning and services, such as the provision of nursery habitats, fish biomass production, and coastline protection. However, zoantharians will also be threatened at intertidal zones, which are expected to experience higher heat stress, solar radiation, and sea-level rise. Although zoantharians appear to cope well with some local stressors (e.g., decreasing water quality), they are vulnerable to climate change (e.g., heatwaves), invasive species (Tubastraea spp.), microplastics, diseases, and mostly restricted to a narrow depth range (0-15 m depth) in SWA reefs. This shallow zone is particularly affected by climate change, compressing the three-dimensional habitat and limiting depth refugia in deeper SWA reefs. As mesophotic ecosystems have been hypothesized as short-term refuges to disturbances for some species, the narrow depth limit of zoantharians seems to be a potential factor that might increase their vulnerability to growing climate change pressures in SWA shallow-water reefs. Together, these could lead to both range expansions in some locations and loss of suitable reef habitats in other sites. Additional research is needed to better understand the systemic responses of these novel SWA reefs to the concert of increasing and interactive local and global stressors, and their implications for ecosystem functioning and service provisions.

Local Victory: Assessing Interspecific Competition in Seagrass From a Trait-Based Perspective

Tropical seagrass meadows are formed by an array of seagrass species that share the same space. Species sharing the same plot are competing for resources, namely light and inorganic nutrients, which results in the capacity of some species to preempt space from others. However, the drivers behind seagrass species competition are not completely understood. In this work, we studied the competitive interactions among tropical seagrass species of Unguja Island (Zanzibar, Tanzania) using a trait-based approach. We quantified the abundance of eight seagrass species under different trophic states, and selected nine traits related to light and inorganic nutrient preemption to characterize the functional strategy of the species (leaf maximum length and width, leaves per shoot, leaf mass area, vertical rhizome length, shoots per meter of ramet, rhizome diameter, roots per meter of ramet, and root maximum length). From the seagrass abundance we calculated the probability of space preemption between pairs of seagrass species and for each individual seagrass species under the different trophic states. Species had different probabilities of space preemption, with the climax species Thalassodendron ciliatum, Enhalus acoroides, Thalassia hemprichii, and the opportunistic Cymodocea serrulata having the highest probability of preemption, while the pioneer and opportunistic species Halophila ovalis, Syringodium isoetifolium, Halodule uninervis, and Cymodocea rotundata had the lowest. Traits determining the functional strategy showed that there was a size gradient across species. For two co-occurring seagrass species, probability of preemption was the highest for the larger species, it increased as the size difference between species increased and was unaffected by the trophic state. Competitive interactions among seagrass species were asymmetrical, i.e., negative effects were not reciprocal, and the driver behind space preemption was determined by plant size. Seagrass space preemption is a consequence of resource competition, and the probability of a species to exert preemption can be calculated using a trait-based approach.

Phylogeny, body morphology, and trophic level shape intestinal traits in coral reef fishes

Trait-based approaches are increasingly used to study species assemblages and understand ecosystem functioning. The strength of these approaches lies in the appropriate choice of functional traits that relate to the functions of interest. However, trait-function relationships are often supported by weak empirical evidence.Processes related to digestion and nutrient assimilation are particularly challenging to integrate into trait-based approaches. In fishes, intestinal length is commonly used to describe these functions. Although there is broad consensus concerning the relationship between fish intestinal length and diet, evolutionary and environmental forces have shaped a diversity of intestinal morphologies that is not captured by length alone.Focusing on coral reef fishes, we investigate how evolutionary history and ecology shape intestinal morphology. Using a large dataset encompassing 142 species across 31 families collected in French Polynesia, we test how phylogeny, body morphology, and diet relate to three intestinal morphological traits: intestinal length, diameter, and surface area.We demonstrate that phylogeny, body morphology, and trophic level explain most of the interspecific variability in fish intestinal morphology. Despite the high degree of phylogenetic conservatism, taxonomically unrelated herbivorous fishes exhibit similar intestinal morphology due to adaptive convergent evolution. Furthermore, we show that stomachless, durophagous species have the widest intestines to compensate for the lack of a stomach and allow passage of relatively large undigested food particles.Rather than traditionally applied metrics of intestinal length, intestinal surface area may be the most appropriate trait to characterize intestinal morphology in functional studies.

Abstract PS13-11: Oral paclitaxel and encequidar (oPac+E) in the treatment of metastatic breast cancer (mBC): Management of gastrointestinal adverse events (GI AE). Study KX-ORAX-001

Background: There is a need for more effective and less toxic treatments for patients with mBC. Patients may prefer oral vs IV cytotoxic therapies to avoid frequent hospital visits. In addition, oral therapies allow frequent or metronomic dosing regimens which may alter the toxicity or activity profile of agents vs infrequent IV administration. oPac+E is oral paclitaxel combination with Encequidar, a specific, minimally absorbed, oral p-glycoprotein inhibitor that facilitates the absorption of oral paclitaxel. mBC patients who received oPac+E had significantly greater confirmed tumor response and longer survival with lower rates and severity of neuropathy but increased GI AE compared to IV paclitaxel (IVPac) (Study KX-ORAX-001 presented at SABCS, 2019, Abstract # GS6-01).

Methods: Study KX-ORAX-001 was a phase III, randomized, study in women with mBC for whom treatment with IVPac was recommended. Patients were randomized 2:1 to receive oPac+E or IVPac. Patients continued treatment until discontinuation due to progressive disease or toxicity. oPac 205 mg/m2 was given once daily for 3 days weekly. E 12.9 mg was given 1 hour before each dose of oPac. IVPac 175 mg/m2 was infused over 3 hours every 3 weeks. The primary endpoint was efficacy defined as tumor response confirmed by BICR at two consecutive evaluations. Key secondary endpoints included PFS, OS. Safety was monitored throughout the study.

Results: All IVPac patients received high-dose dexamethasone and antihistamine premedication, which have significant anti-emetic activity and may have received additional anti-emetic agents as needed. The protocol did not allow any prophylaxis for GI AE for oPac+E patients nor were they to receive predose corticosteroids, nor antihistamines.

The protocol was amended after approximately 30% of patients were enrolled to allow prophylactic anti-emetic medications for patients randomized to oPac+E. Patients were also given loperamide to take at home and were instructed to initiate loperamide with the onset of diarrhea. The rates of Grade ≥2, vomiting and diarrhea for patients treated with IVPac, the patients treated with oPac+E prior to after the amendment are summarized in the table below.

Prophylactic anti-emetic therapy and early use of loperamide markedly decreased the incidence of ≥Grade 2 vomiting and diarrhea although there was a greater incidence than IVPac.

The most frequently prescribed anti-emetic agents for oPac+E treated patients were ondansetron (54%), metoclopramide (21%), domperidone (4%) and aprepitant (3%). For patients randomized to IVPac, the most frequently prescribed agents were ondanesteron (59%), granisetron (24%), palenosetron (7%) and aprepitant (2%). Oral administration of the oral NK1 inhibitor aprepitant appeared to be associated with increased incidence of oral paclitaxel systemic toxicity, potentially due to inhibition of metabolism of oPac by cytochrome P450 3A4.

Conclusions: oPac+E was associated with greater efficacy in the treatment of mBC and lower rates and severity of peripheral neuropathy, but increased GI AE compared to IVPac 175mg/m2. GI AE in oPac+E treated patients can be managed by prophylactic use of anti-emetics, primarily 5-HT3 inhibitors and early intervention with the anti-diarrhea agent loperamide. The use of the oral NK1 inhibitor aprepitant in combination with oPac+E is not recommended.(NTC02594371)

IVPacoPac+E Pre-AmendmentoPac+E Post AmendmentGrade 2Grade 3Grade 4Grade 2Grade 3Grade 4Grade 2Grade 3Grade 4Vomiting4%1%0%24%7%0%7%4%0%Diarrhea7%1%0%27%9%0%16%3%0.5%

Citation Format: H S Rugo, G Umanzor, F J Barrios, R H Vasallo, M A Chivalan, S Bejarano, J R Ramirez, L Fein, R D Kowalyszyn, D L Cutler, D Kramer, J Goldfinch, H Wang, T Moore, R MF Kwan. Oral paclitaxel and encequidar (oPac+E) in the treatment of metastatic breast cancer (mBC): Management of gastrointestinal adverse events (GI AE). Study KX-ORAX-001 [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS13-11.

Abstract PS13-06: Lower rates of neuropathy with oral paclitaxel and encequidar (oPac+E) compared to IV paclitaxel (IVPac) in treatment of metastatic breast cancer (mBC): Study KX-ORAX-001

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting toxicity associated with IVPac. Primarily sensory, CIPN is an often irreversible condition primarily affecting the hands and feet associated with pain, numbness, tingling, and sensitivity to cold and has a significant impact on quality of life and treatment tolerance. Risk of CIPN increases with age, dose intensity, cumulative dose, and preexisting conditions including diabetes.

Methods: Study KX-ORAX-001 was a phase III, randomized, international study in women with mBC for whom treatment with IVPac was recommended. Eligible patients were randomized 2:1 to receive oPac+E or IVPac. Patients continued treatment until discontinuation due to progressive disease or toxicity. oPac 205 mg/m2 was given once daily for 3 days weekly. E 12.9 mg was given 1 hour before each dose of oPac. IVPac 175 mg/m2 was infused over 3 hours every 3 weeks. The primary endpoint was efficacy defined as tumor response confirmed by BICR at two consecutive evaluations. Key secondary endpoints included PFS, OS. Safety was monitored throughout the study.

Results: A total of 402 mBC patients were enrolled, 265 randomized to oPac+E and 137 to IVPac (ITT population). 399 patients were treated and comprise the safety population. The confirmed response rate was significantly greater in the oPac+E group vs IVPac (35% vs 23%) for the ITT population. Median overall survival was (27.7 vs 16.7 months, ITT) at the time of the analysis. Long-term follow up for final determination of PFS and OS is ongoing.Incidence of neuropathy-related TEAEs were lower in patients receiving oPac+E vs IVPac: Overall (21% vs 64%; all grades), grade ≥3 (2% vs 15%). Cumulative risk for neuropathy with IVPac was &gt;50% by week 8 and was 83% at week 88. In contrast, the cumulative risk of neuropathy with oPac+E rose slowly and plateaued at 34% at week 88. Treatment discontinuations due to neuropathy occurred only in the IVPac arm (8%). Dose reductions due to neuropathy were reported in 8% of IVPac treated patients and in 2% of oPac+E treated patients. In agreement with the lower rates of peripheral neuropathy in patients treated with oPac+E, there was lower use of medications used for the treatment of neuropathic symptoms. Use of gabapentin or pregabalin was 12% for patients receiving oPac+E vs 40% for IVPac treated patients.

Conclusions: oPac+E was associated with greater efficacy in the treatment of patients with mBC and a lower incidence of neuropathy, slower onset and lesser severity of neuropathic events compared to IVPac 175mg/m2 administered every three weeks. Fewer patients receiving oPac+E required dose reduction due to neuropathy and no patients receiving oPac+E discontinued treatment due to neuropathy. Reduction in neuropathy may improve quality of life and allow longer administration of effective therapy while maintaining dose intensity.

Citation Format: H S Rugo, G Umanzor, F J Barrios, R H Vasallo, M A Chivalan, S Bejarano, J R Ramirez, L Fein, R D Kowalyszyn, D L Cutler, D Kramer, J Goldfinch, H Wang, T Moore, R MF Kwan. Lower rates of neuropathy with oral paclitaxel and encequidar (oPac+E) compared to IV paclitaxel (IVPac) in treatment of metastatic breast cancer (mBC): Study KX-ORAX-001 [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS13-06.

Herbivorous fish rise as a destructive fishing practice falls in an Indonesian marine national park

Securing ecosystem functions is challenging, yet common priority in conservation efforts. While marine parks aim to meet this challenge by regulating fishing through zoning plans, their effectiveness hinges on compliance levels and may respond to changes in fishing practices. Here we use a speciose assemblage of nominally herbivorous reef fish in Karimunjawa National Park (zoned since 1989) to investigate whether areas subject to a restrictive management regime sustained higher biomass over seven years compared to areas where moderate and permissive regulations apply. Using a trait-based approach we characterize the functional space of the entire species pool and ask whether changes in biomass translate into changes in functional structure. We track changes in predator biomass, benthic community structure, and fishing practices that could influence herbivore trajectories. Overall herbivore biomass doubled in 2012 compared to 2006-2009 and remained high in 2013 across all management regimes. We found no evidence that this biomass build-up resulted from predator depletion or increased food availability but suggest it emerged in response to a park-wide cessation of fishing with large drive nets known as muroami. The biomass increase was accompanied by a modest increase in taxonomic richness and a slight decrease in community-scale rarity that did not alter functional redundancy levels. Subtle changes in both functional specialization and identity of assemblages emerged as generalist species with low intrinsic vulnerability to fishing recovered sooner than more vulnerable specialists. While this implies a recovery of mechanisms responsible for the grazing of algal turfs and detritus, restoring other facets of herbivory (e.g., macroalgal consumption) may require more time. An increase in the cost-benefit ratio per journey of muroami fishing facilitated a ban on muroami nets that met minimal resistance. Similar windows of opportunity may emerge elsewhere in which gear-based regulations can supplement zoning plans, especially when compliance is low. This does not advocate for implementing such regulations once a fishery has become unprofitable. Rather, it underlines their importance for breaking the cycle of resource depletion and low compliance to zoning, thus alleviating the resulting threats to food security and ecosystem integrity.

'Desculturización,' urbanization, and nutrition transition among urban Kichwas Indigenous communities residing in the Andes highlands of Ecuador

BACKGROUND

The nutrition transition continues to affect populations throughout the world. The added impact of market integration and urbanization exacerbates the impact of the nutrition transition upon Indigenous populations worldwide.

OBJECTIVES

This study aims to explore the nutritional concerns of the urban Kichwas community residing in the Andes highlands of Ecuador.

STUDY DESIGN

This is a qualitative study.

METHODS

Eight focus groups were conducted with Kichwas men and women in November 2015 in the Imbabura province of the Andes in Ecuador.

DATA ANALYSIS

Applied thematic analysis was used to analyze findings regarding nutrition.

RESULTS

The participants shared concerns regarding increased intake of fast food, poor meal timing, and a shift in the child's food preferences that rejects traditional foods. They attributed these concerns to urbanization resulting from an increase in dual-income households and a loss of cultural identity.

CONCLUSIONS

Synergistic cultural factors are related to nutritional concerns voiced by the urban Kichwas community.

PUBLIC HEALTH IMPLICATIONS

Syndemic theory is a useful interpretive lens regarding nutritional trends within the Kichwas communities as they relate to the increased risk of chronic disease.

Risk and resiliency: the syndemic nature of HIV/AIDS in the indigenous highland communities of Ecuador

OBJECTIVES

This community-based study explores the syndemic nature of HIV/AIDS risk and resilience among Indigenous Kichwa communities in the province of Imbabura, Ecuador. This study elucidates individual and community-level factors that serve to exacerbate HIV/AIDS risk, as they relate to underlying macrolevel, structural forces. Critically, this study also elicited opportunities for community-based opportunities for resiliency from HIV/AIDS.

STUDY DESIGN

Exploratory qualitative study.

METHODS

Guided by syndemic theory, a qualitative study was conducted to explore HIV risk and resilience among Indigenous Kichwa communities in the Northern Andean highlands of Ecuador. Eight focus groups (n = 59) with men and women from two communities were conducted. The data were analyzed using applied thematic analysis techniques.

RESULTS

Identified risk factors for HIV/AIDS centered around the following themes: (1) parents leaving the community for work, (2) alcohol and drug consumption, (3) unprotected sex, and (4) barriers to health care. Identified HIV/AIDS resiliency factors included the preservation of Indigenous culture and family-focused interventions.

CONCLUSIONS

The identified risk factors for HIV/AIDS are interrelated within a complex syndemic relationship. The mutually reinforcing individual-level risk factors of substance abuse and risky sexual behavior coalesce with violence to exacerbate the risk for HIV/AIDS acquisition among Ecuadorian Highland Indigenous communities. Moreover, HIV/AIDS risk prevails in the macrolevel context of disproportionate unemployment among Indigenous peoples and a systematically fragmented healthcare system. It is critical that public health professionals work to revolutionize the systematic discrimination that underpins indigenous health disparities at-large.

Detection of High Oncogenic Risk Human Papilloma Virus With CareHPV Test in Women Attended in Health Units in Copán Honduras

Background and context: Persistent infection with high-risk human papilloma virus (HR-HPV) is identified as the main cause of premalignant and malignant cervical diseases. The identification of HR-HPV by viral DNA has been used in multiple studies to characterize the infection, the careHPV test presented HR-HPV prevalence in Latin American countries of: Costa Rica (16%), Mexico (14.5%), Colombia (14.9%), and Chile (14.0%). Cervical cancer represents a public health problem in Latin America, and in Honduras is the main cause of cancer in women. Half of Honduran women at risk are not systematically screened for cervical cancer. Aim: Identifying women at risk for premalignant lesions with rapid and efficient tests can guarantee timely treatment. Strategy/Tactics: Retrospective, descriptive, cross-sectional study at Copán health units (La Entrada, Florida, Trinidad and San Juan Planes), where the results of the careHPV test were analyzed to determine HR-HPV genotypes, in 540 women between 30 and 65 year from September 2016 to March 2017. Program/Policy process: Positive patients received VIAA, and colposcopy/biopsy according to national cervical cancer screening guideline 2015. Outcomes: 458 negative women for HR-HPV 85% and 82 positive women 15%. The age group with the highest prevalence of HR-HPV was 30-49 years. Of 69 positive women, 64 received visual inspection with acetic acid (93%), 47 resulted with negative VIAA (73%), 2 with positive VIAA suspected invasive cancer, both were referred to colposcopy/biopsy, and 15 women with positive VIAA (24%) referred to cryotherapy. What was learned: The prevalence of infection by HR-HPV in the study group was 15%, similar to that reported in the literature. Standardizing the use of careHPV as a screening test can guarantee the prevention of invasive stages of cervical cancer.

An Organized Approach to Multi-Organ Screening in Rural Honduras

Background: Poverty, poor healthcare infrastructure and geographic location contribute to a total lack of cancer screening for most residents of rural Honduras. Three projects built upon each other to develop, with local leaders, multiorgan screening events that mitigated barriers to screening-based early detection of cancers. Targeted barriers included transportation, cost, community perception and convenience. Aim: To test a novel system of multiorgan screening for feasibility, acceptability and effectiveness. Methods: Leveraging well-known brigade-style medical outreach methods, two large-scale weekend programs for women and one for men over four years in the same rural location screened women for cancers of the cervix, breast, oral cavity, thyroid; and men for cancers of the testes, oral cavity, skin, prostate and colon; and connected participants with follow-up care at a Honduran cancer center. Screening methods ranged from simple throat palpation for thyroid lesions to molecular screening for high risk HPV. Generally, screening began with low-tech methods onsite to triage the participants and identify those at high-risk for cancer who should have more technical follow-up at an equipped clinic. Well-trained Honduran medical students provided screening capacity and community leaders were solely responsible for promoting the screening opportunities. Masking was not possible onsite, but data analysis in the U.S. was anonymized. Results: Participants were accrued to each program's capacity (n=400) in 2013 and 2016 and near capacity in 2017 with high levels of participants completing the screening programs, community engagement with the process, and compliance with referrals for clinical follow-up at a collaborating cancer center located three hours away. Participants identified at the screenings for clinical follow-up included for women: breast 2.7% (2013) and 4.2% (2016), thyroid 1.7% (2016), cervix/positive for high risk HPV 8.2% (2013) and 11.8% (2016); and for men all in 2017: skin 0%, testes 7%, colorectal 1%, oropharynx 1 participant, and prostate 6.7%. The dominant local narrative predicted men would not participate in screening, yet 326 participated and of that group, 239 self-identified as having possible colorectal symptoms based on seeing an advertising flyer with questions about symptoms of constipation, bloody stools, or unintended weight loss. That self-identified subset took the initiative to see the local nurse in advance, obtain a colorectal sample kit, collect three days of stool samples, and bring them to the screening event. Conclusion: With community engagement and attention to planning for organized and rapid throughput, large-scale multiorgan cancer screening may be feasible in low-income rural communities. Funding: The Jornada studies were funded by Norris Cotton Cancer Center at Dartmouth's Geisel School of Medicine and a special grant from Geisel's Munck-Pfefferkorn Fund.

High-Risk HPV Genotypes Identified in Northern Honduras: Evidence for Prevention

Background: Cervical cancer is one of the most prevalent cancers in Honduran women. Lacking national or population-based registries, we rely on hospital registries to establish incidence: San Felipe General Hospital in 2012 diagnosed 38% of 998 women and The League against Cancer Hospital (LCC) in 2016 diagnosed 54.4% of 695 women with cervical cancer CC. According to PAHO's Honduras Profile 2013, screening coverage with Pap was 48.1%. Bruni in 2010 reported a prevalence of high risk HPV (hrHPV) infection for Central America of 13%, identifying genotypes 16, 18, 52, 31 and 58 as most frequent. Information about pathogenesis of hrHPV to induce cervical lesions is based on models of genotypes 16 and 18 only. Aim: Inform evidence of hrHPV genotypes collected in Honduras from an urban and a rural population, generate discussion and subsequent improvement of cervical cancer control strategies in our country. Methods: In 2016, 2 clinical studies funded by Norris Cotton Cancer Center at Dartmouth College and the LCC accrued 913 women: 401 in Locomapa Valley (rural), 111 in La Mosquitia (remote rural), and 401 in a textile factory in San Pedro Sula (urban). Women were consented, to obtain 3 cervical samples, during a cervical cancer screening brigade. One sample for conventional cytology, and 2 for hrHPV by PCR genotyping. One local with our customized PCR device and the second at Dartmouth. An educational component and survey were included. Positive patients identified with hrHPV, pre or invasive cancer were referred to LCC for treatment and follow-up. Results: In Locomapa and the factory (rural and urban sites) 13% of participants were positive for hrHPV. Only 15% had HPV 16. The following common genotypes varied by location: urban factory HPV 59, 12% in rural location HPV 58, 10%; HPV 31, 9%; HPV 39 8%; HPV 35 and 66, 7%; HPV 45 and 51, 6%; HPV 18 and 56, 3%; HPV 33 and 52, 1%. 17% of women had multiple hrHPV coinfection. 7.7% had abnormal Pap tests. In La Mosquitia (remote rural), 24% of women were positive for hrHPV: HPV 52, 29%; HPV 16, 23%; HPV 39, 10%; HPV 68, 6%; HPV 58, 6%; HPV 45, 6%; HPV 51 and HPV 31, 18, 66, 59 and 35, 3% each. 1.8% had abnormal Pap tests; all participants identified with hrHPV were referred for follow-up. The average age was 40.3 years, parity, 3 children, education 6.0 years; and 15% were first-time users of a cervical screening program. Conclusion: Associate the burden of disease, with risk factors, will help us to generate models of prevention and care that are reproducible and effective to reduce morbi-mortality. Brigade-type screening models, with trained providers working at a community location over a single day, can offer improved access for women at risk and facilitate educational activities for health promotion. Introducing tests as hrHPV DNA detection, effectively reduces the volume of women to follow. Strengthening the capacity of primary care with novel screening techniques and ensure diligent follow-up is essential.

Thyroid Cancer Profile: Experience of Liga Contra El Cancer Honduras 2014-2017

Background: In recent years we have observed increase in thyroid carcinoma TC incidence at cancer centers in Honduras. TC is linked to exposure to ionizing radiation. Other risks factors described in literature are obesity, diabetes, nitrites and nitrates in diet and alcohol. DNA rupture, activation of oncogenes, and secretion of inflammatory cytokines are initial events that derive in mutations and malignant transformation. Papillar, follicular and undifferentiated carcinoma are the histologic types. Little is known about TC in the population, and there are no efficient models for prevention and early detection to date. Aim: Describe the clinical and demographic profile of patients diagnosed with TC at La Liga Contra el Cancer Hospital LCC from 2014-2017, with intention to identify patterns that allow approaches to pathogenicity and prevention. Methods: We revised 103 medical records of all TC patients treated at LCC from Jan 2014-December 2017 to obtain information about geographical origin, age, gender, localization of tumor, identifiable risk factor, treatment and outcomes. A digital database was in Microsoft Office Excel and exported to SPSS. Patient information was deidentified before data extraction. Results: 91.3% patients were female. Median age 49.3 ± 15.6 years (95% CI, 46.05-52.2). Patients went from 11/18 departments (political division), 74% gathered in the northern zone of the country. Histology type: papillary 91.3%; follicular 4.9%, anaplasic 1.9%; medullary 1.0%. Papillary TC, 37% of patients were in fifth decade, 22.9% in patients 31-40 yo, 17.3% in patients 41-50 yo, 9.7% were under 30s. Clinical stage at diagnosis: I I (n = 24) 23.6%, II (n = 13), 12.6%. III (n = 18), 17.5%. IV (n = 14), 15.6%; not suitable for staging 5.8%, the rest had no precise information for staging. 12.6% of patients reported family history of cancer (any type), 33% of patients reported comorbidities. Conclusion: Thyroid carcinoma has increased in the last years, from our experience we can identify that women are mostly affected, with papillary type being the most common. Ages affected are between 41-60 years old. One third of patients had comorbidities as hypothyroidism, diabetes and arterial hypertension. 74% reside in the northern zone of Honduras, there is need to elucidate if it is a matter of geographical location of the LCC. No emerging risk factors were identified in this cohort. More research is needed to profile thyroid carcinoma in our region.

Reducing Dermal Exposure to Agrochemical Carcinogens Using a Fluorescent Dye-Based Intervention Among Subsistence Farmers in Rural Honduras

Background: Occupational exposure to agrochemicals, some of which are known or suspected carcinogens, is a major health hazard for subsistence agricultural workers and their families. These impacts are more prevalent in low-and-middle income countries (LMICs) due to weak regulations, lack of awareness of the risks of contamination, general lack of personal protective equipment (PPE), and low literacy about proper agrochemical application techniques. Fluorescent tracer dyes have been described as a means of visualizing and quantifying dermal exposure to agricultural chemicals, and dye techniques adapted for LMICs have been developed previously. These tracer dyes have also been used in educational demonstrations about pesticide safety. However, studies evaluating the efficacy of these educational dye interventions in reducing exposure have been lacking. Aim: To evaluate whether observing one's own chemical contamination after applying agrochemicals changed the amount of occupational dermal exposure during a subsequent chemical application. Methods: We used a multimodal community intervention in a rural village in Honduras that incorporated chemical safety education and use of a fluorescent tracer dye during pesticide application and compared dermal exposure between the intervention group (previous dye experience and safety education) and the control group (safety education only). Results: Mean total visual score (TVS) of the tracer dye, which accounts for both extent and intensity of contamination, was lower among those who had previously experienced the dye intervention (mean TVS=41.3) than among participants who were dye-naïve (mean TVS=78.4), with a difference between means of -37.10 (95% CI [-66.26, -7.95], P = 0.02). Conclusion: That workers who had experienced the dye demonstration once before were significantly less contaminated on average when compared with the dye-naïve group indicates that a multimodal community intervention that utilizes fluorescent dye visualization may be effective in reducing dermal exposure to carcinogenic agrochemicals among subsistence farmers in LMICs.

Ongoing removals of invasive lionfish in Honduras and their effect on native Caribbean prey fishes

The invasion of Indo-Pacific lionfish is one of the most pressing concerns in the context of coral reef conservation throughout the Caribbean. Invasive lionfish threaten Caribbean fish communities by feeding on a wide range of native prey species, some of which have high ecological and economic value. In Roatan (Honduras) a local non-governmental organisation (i.e. Roatan Marine Park) trains residents and tourists in the use of spears to remove invasive lionfish. Here, we assess the effectiveness of local removal efforts in reducing lionfish populations. We ask whether reefs subject to relatively frequent removals support more diverse and abundant native fish assemblages compared to sites were no removals take place. Lionfish biomass, as well as density and diversity of native prey species were quantified on reefs subject to regular and no removal efforts. Reefs subject to regular lionfish removals (two to three removals month⁻¹) with a mean catch per unit effort of 2.76 ± 1.72 lionfish fisher⁻¹ h⁻¹ had 95% lower lionfish biomass compared to non-removal sites. Sites subject to lionfish removals supported 30% higher densities of native prey-sized fishes compared to sites subject to no removal efforts. We found no evidence that species richness and diversity of native fish communities differ between removal and non-removal sites. We conclude that opportunistic voluntary removals are an effective management intervention to reduce lionfish populations locally and might alleviate negative impacts of lionfish predation. We recommend that local management and the diving industry cooperate to cost-effectively extend the spatial scale at which removal regimes are currently sustained.

Recent dynamics and condition of coral reefs in the Colombian Caribbean

Long-term monitoring data provide a basis to recognize changes in coral reef communities and to implement appropriate management strategies. Unfortunately, coral reef dynamics have been poorly documented at any temporal scale in the Southern Caribbean. Through the "National Monitoring System of Coral Reefs in Colombia" (Spanish acronym: SIMAC), we assessed 32 permanent plots at different depth levels in six reefs areas of the Colombian Caribbean from 1998 to 2004. Temporal trends in coral and algal cover were evaluated by repeated measures ANOVA. The model included the effect of depth levels (a fixed effect), monitoring plots (a random effect) as a nested factor within depths, and time (repeated factor). We found high spatial variability in major benthic components. Overall means indicated that algae were the most abundant biotic component in nearly all areas, ranging from 30.3% at Rosario to 53.3% at San Andrés. Live coral cover varied considerably from 10.1% at Santa Marta up to 43.5% at Urabá. Coral and algae cover per se are not always accurate reef indicators and therefore they need supplementary information. Temporal analyses suggested relative stability of coral and algal cover along the study but the causes for the observed trends were rarely identified. A significant decrease (p = 0.042) in coral cover was only identified for some monitoring plots in Tayrona-time x plot (depth level) interaction, and importantly, few coral species explained this trend. Significant increase (p = 0.005) in algal cover was observed over time for most plots in Rosario. Temporal trajectories in algal cover were influenced by depth-significant time x depth interaction-in San Andrés (increase, p = 0.004) and Urabá (decrease, p = 0.027). Algae trends were mainly explained by changes in algal turfs. Monitoring programs must focus on the mechanisms mediating the changes, in particular those concerning coral recovery and reef resilience in the current context of climate change.