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(1) Background: people who migrate from low-to high-income countries are at an increased risk of weight gain, and excess weight is a risk factor for cardiovascular disease. Few studies have quantified the changes in body mass index (BMI) pre- and post-migration among African immigrants. We assessed changes in BMI pre- and post-migration from Africa to the United States (US) and its associated risk factors. (2) Methods: we performed a cross-sectional analysis of the African Immigrant Health Study, which included African immigrants in the Baltimore-Washington District of the Columbia metropolitan area. BMI category change was the outcome of interest, categorized as healthy BMI change or maintenance, unhealthy BMI maintenance, and unhealthy BMI change. We explored the following potential factors of BMI change: sex, age at migration, percentage of life in the US, perceived stress, and reasons for migration. We performed multinomial logistic regression adjusting for employment, education, income, and marital status. (3) Results: we included 300 participants with a mean (±SD) current age of 47 (±11.4) years, and 56% were female. Overall, 14% of the participants had a healthy BMI change or maintenance, 22% had an unhealthy BMI maintenance, and 64% had an unhealthy BMI change. Each year of age at immigration was associated with a 7% higher relative risk of maintaining an unhealthy BMI (relative risk ratio [RRR]: 1.07; 95% CI 1.01, 1.14), and compared to men, females had two times the relative risk of unhealthy BMI maintenance (RRR: 2.67; 95% CI 1.02, 7.02). Spending 25% or more of life in the US was associated with a 3-fold higher risk of unhealthy BMI change (RRR: 2.78; 95% CI 1.1, 6.97). (4) Conclusions: the age at immigration, the reason for migration, and length of residence in the US could inform health promotion interventions that are targeted at preventing unhealthy weight gain among African immigrants.

OBJECTIVE To determine if neonatal serum biomarkers representing different pathways of injury differ for cases of HIE of unknown cause to gain insight into timing and mechanism of injury. STUDY DESIGN In this cohort of all neonates with HIE admitted to our NICU, newborns with sentinel events were compared to those without during the 1 st 3 days of life. Discard neonatal blood during the 1 st 3 days of life was used for analysis. RESULTS Of 277 babies with HIE treated with whole-body hypothermia, 190 (68.6%) had blood available for biomarker analysis. 71 (37.4%) were born within our system, and 119 (62.6%) were transferred in from outside hospitals. Of these babies, 77 (40.5%) had a sentinel event and 113 (59.6%) had no sentinel event. Although the degree of metabolic acidosis was similar, repeated measures analysis showed that during the initial 3 days of life neonates born with HIE in the absence of sentinel events had 41.4% decreased VEGF (p=0.027) and 62.5% increased IL-10 serum concentrations (p=0.005). CONCLUSION These changes indicate that neonatal HIE in the absence of sentinel events is not related to an unrecognized acute intrapartum event and is possibly related to chronic hypoxia of lower severity or recovery from a remote event.

Background: Cardiovascular disease (CVD) and cancer are the leading causes of mortality among adult women in the United States (US), contributing to over 40% of deaths annually. Although the US Preventive Services Task Force recommends routine age-appropriate breast and cervical cancer screening among adult women, it is unknown if its utilization is influenced by the presence of comorbid conditions like CVD. With recent research suggesting that mammography has the potential to alter the course of both breast cancer and heart disease among women, we investigate the routine use of some of these gynecological cancer screening tools among women with and without CVD. Methods: Using the 2006-2015 Medical Expenditure Panel Survey (MEPS), a nationally representative database, we included women ≥21 years with valid responses to the gynecological cancer screening questions. Diagnosis of CVD, was ascertained by ICD9 codes or by self-report, and included individuals with coronary artery disease, stroke, heart failure, cardiac dysrhythmias and/or peripheral arterial disease. We evaluated participant responses to self-administered questionnaires: [How long since last pap smear test? (women 21-65 yrs)] and [How long since last mammogram? (women 50-75 yrs)]. Routine gynecological cancer screen was defined as pap smear test done within the last 3 years (women 21-29 yrs)/within the last 5 years (women 30-65 yrs) or mammogram done within the last 2 years (women 50-75 yrs). A χ2 test was used to assess the proportional differences in the use of these gynecological screening tools among women with and without CVD. Weighted multivariable logistic regression was used to determine the association between the presence of CVD and routine gynecological cancer screening. Results: The study sample included 104,053 MEPS participants, 14% with a diagnosis of CVD and 86% without a diagnosis of CVD, translating into 14.6 million and 89.9 million US adult women with and without CVD respectively. While 14% of women without CVD did not have routine pap smear test, a higher proportion of women with CVD (21%) reported that they did not undergo routine pap smear screen ( p <0.001 ). There was no difference in the proportion of women with or without CVD who reported routine mammogram screen (22% on each arm, p = 0.33). After adjustments for socio-demographic characteristics and comorbid conditions, US adult women with CVD, were less likely to have routine pap smear test (OR 0.59 [95% CI 0.54-0.65]) and mammogram screen (OR 0.90 [95% CI 0.82-0.99]) compared with those without CVD. Conclusion: Women with CVD were less likely to undergo routine gynecological cancer screening than their peers without CVD. Further studies are needed to understand the reasons for the reported association and devise ways to promote increased utilization of these gynecological cancer screening tools among this high risk, vulnerable population.