Cancer is the leading cause of death among Asian American, Native Hawaiian, and Pacific Islander (AA NHPI) populations, who are among the most diverse and rapidly growing racial/ethnic groups in the United States. Despite this population’s diverse socioeconomic, cultural, and immigration backgrounds, little is known about the within-group disparities in breast cancer stages at diagnosis. This study aims to identify AA NHPI subgroups at heightened risk for advanced breast cancer by analyzing detailed incidence rates and diagnostic stages across these diverse subgroups. Patient data spanning from 2004 to 2020 were extracted from the National Cancer Database, focusing on individuals newly diagnosed with breast cancer. Individuals were disaggregated into specific AA NHPI subgroups by self-reported country of origin. Ordinal logistic regression, adjusting for clinical and sociodemographic factors, was used to calculate adjusted odds ratios (AORs). Higher adjusted odds ratios signify more advanced stage diagnoses. Of 3,001,173 patients with breast cancer, 99,128 (3.30

5534 Background: Over 20 million Americans identify as Asian American, Native Hawaiian, or Pacific Islander (AANHPI). Despite the diversity of indigenous and immigration histories, lived experiences, and health needs within the AANHPI community, prior research has considered this group as an aggregate. Given known disparities in access to cancer screening, this study assessed on cervical cancer stage at presentation, focusing on disaggregated AANHPI groups. Methods: Data from the National Cancer Database (NCDB) from 2004 to 2020 identified patients with newly diagnosed cervical cancer. Patients were disaggregated into AANHPI groups by indigenous history or historical country of origin. We performed ordinal logistic regression, adjusting for clinical and sociodemographic factors, with higher adjusted odds ratios (aORs) indicating diagnoses at later stages on a local, regional, and metastatic scale. Results: Out of 82,193 patients with cervical cancer, 3,943 (4.80%) identified as AANHPI. Compared to non-Hispanic White (NHW) patients, pooled AANHPI patients were slightly older (median age, NHW: 55 years, AANHPI: 56 years, χ2 P<0.001) and more likely to be uninsured or on Medicaid (NHW: 25.6%, AANHPI: 34.0%, χ2 P<0.001). In aggregate, AANHPI patients presented at lower stages of cancer (NWH: 58.7% diagnosed local/regional, AANHPI: 85.6% at local/regional, χ2 P<0.001). The largest AANHPI subgroups included Chinese (n=802, 20.3% of AANHPI), Filipinos (n=777, 19.7%), Asian Indian/Pakistani (n=554, 14.0%), Vietnamese (n=480, 12.2%), and Korean (n=452, 11.5%) Americans respectively. AANHPI disaggregation revealed that Pacific Islander patients had higher odds of later stage at diagnosis (aOR 1.59, 95% CI 1.24–2.03, p < 0.001) relative to NHW patients. Conversely, Chinese (aOR 0.64, 95% CI 0.56–0.73, p < 0.001) and Vietnamese (aOR 0.77, 95% CI 0.65–0.91, p = 0.003) American patients were less likely to represent at later stage. Compared to the largest AANHPI group (Chinese American), all other subgroups were more likely to present at a higher stage. The largest differences were observed in Thai (aOR 2.84, 95% CI 1.56–5.14, p = 0.001), Pacific Islander (aOR 2.71, 95% CI 2.03–3.63, p < 0.001), Hmong (aOR 2.03, 95% CI 1.30–3.18, p = 0.002), Laotian (aOR 1.96, 95% CI 1.27–3.02, p = 0.002), and Korean (aOR 1.87, 95% CI 1.49–2.34, p < 0.001) American patients. Conclusions: Aggregated evaluation of the AANHPI monolith masks disparities in outcomes for distinct populations at risk for equity gaps. This disaggregation study shows that marginalized groups within the larger AANHPI population – including Hmong and Pacific Islander patients – may face different exposures and larger structural barriers to cancer screening and early-stage diagnosis. A future focus on community based disaggregated research and tailored interventions is necessary to close these gaps.

BACKGROUNDTraumatic brain injury (TBI) induces cognitive deficits driven by neuroinflammation and cerebral edema. The commonly used atypical antipsychotic, quetiapine (QTP), has been recently shown to improve post-TBI outcomes. We hypothesized that QTP would thereby improve animal learning and memory 2 weeks after severe TBI.METHODSCD1 male mice (n = 35) underwent severe TBI (controlled cortical impact, injury, I) or sham craniotomy (S), followed by BID saline (P, placebo) or QTP (10 or 20 mg/kg, IP) for 2 weeks. Animals underwent Morris Water Maze (MWM) exercises to gauge spatial learning and memory. The distance and time required for swimming animals to reach the platform area (Zone 5, Z5) located in quadrant 1 (Zone 1, Z1) was calculated from digital video recordings analyzed using Ethovision software. Animal bodyweights were recorded daily and on Day 14, injured cerebral hemispheres were procured for edema determination (wet-to-dry ratio). Intergroup differences were evaluated with ANOVA/Bonferroni correction (p< 0.05).RESULTSOn Day 14, animal weight loss recovery was lowest in I + P compared to I + QTP20 and I + QTP10 (p≤ 0.01 for either). Cerebral edema was greatest in I + P, and only significantly decreased in I + QTP20 (p< 0.05). Both QTP doses similarly improved spatial learning by significantly reducing latency time and travel distance to target zones (p< 0.05). In probe memory trials, only I + QTP20 and not I + QTP10 significantly favored animal reaching or crossing into target zones (p< 0.05).CONCLUSIONPost-TBI QTP reduces brain edema and improves spatial learning and memory with a potential dose dependence impact benefiting memory up to 14 days. These data suggest an unanticipated QTP benefit following brain injury that should be specifically explored.

BACKGROUND:Early but not late tranexamic acid (TXA) after TBI preserves blood-brain-barrier integrity, but it is unclear if and how dose timing affects cognitive recovery beyond hours postinjury. We hypothesized that early (1 hour post-TBI) but not late (24 hours post-TBI) TXA administration improves cognitive recovery for 14 days.METHODS:CD1 male mice (n = 25) were randomized to severe TBI (injury [I], by controlled cortical impact) or sham craniotomy (S) followed by intravenous saline at 1 hour (placebo [P1]) or 30 mg/kg TXA at 1 hour (TXA1) or 24 hours (TXA24). Daily body weights, Garcia Neurological Test scores, brain/lung water content, and Morris water maze exercises quantifying swimming traffic in the platform quadrant (zone [Z] 1) and platform area (Z5) were recorded for up to 14 days.RESULTS:Among injured groups, I-TXA1 demonstrated fastest weight gain for 14 days and only I-TXA1 showed rapid (day 1) normalization of Garcia Neurological Test ( p = 0.01 vs. I-P1, I-TXA24). In cumulative spatial trials, compared with I-TXA1, I-TXA24 hindered learning (distance to Z5 and % time in Z1, p < 0.05). Compared with I-TXA1, I-TXA24 showed poorer memory with less Z5 time (0.51 vs. 0.16 seconds, p < 0.01) and Z5 crossing frequency. Unexpectedly, TXA in uninjured animals (S-TXA1) displayed faster weight gain but inferior learning and memory.CONCLUSION:Early TXA appears beneficial for cognitive and behavioral outcomes following TBI, although administration 24 hours postinjury consistently impairs cognitive recovery. Tranexamic acid in sham animals may lead to adverse effects on cognition.

1119 Background: Cancer is the leading cause of death for AANHPI populations, who represent one of the most diverse and fastest-growing racial/ethnic groups in the US. Prior research has shown that AANHPI patients in aggregate have a lower risk of breast cancer than Non-Hispanic White (NHW) peers. However, within-group disparities in stage at presentation remain largely unexplored and are important given disparate access to primary care and cancer screening in certain populations. Methods: Data from 2004 to 2020 were extracted from the National Cancer Database (NCDB) for women newly diagnosed with breast cancer. Patients were disaggregated into AANHPI subgroups based on indigenous history or country of origin. Ordinal logistic regression, adjusting for clinical and sociodemographic factors, was used to calculate adjusted odds ratios (AORs), with higher AORs signifying more advanced stage diagnoses, from Stage 0 to IV. Results: Out of 2,563,180 patients with breast cancer, 83,315 (3.25%) identified as AANHPI. Compared to NHW patients, AANHPI patients were younger (median age, NHW: 63 years vs. AANHPI: 58 years, χ2 P<0.001) and more likely to be uninsured or on Medicaid (NHW: 51% vs. AANHPI: 58%, χ2 P<0.001). The largest AANHPI subgroups were Chinese (n=18,708), Filipino (n=18,429), Indian/Pakistani (n=16,424), Korean (n=6,548), and Vietnamese (n=5,345). Stage 3 or 4 disease was more common among NHW than AANHPI patients (11.3% vs 10.7%, χ2 p<0.001). In aggregate, AANHPI patients were less likely to present with later-stage disease (AOR: 0.88, 95% CI 0.87-0.90, p < 0.001). AANHPI disaggregation revealed that Hawaiian (AOR 1.13, 95% CI 1.07–1.21, p < 0.001), Hmong (AOR 1.86, 95% CI 1.34–2.60, p < 0.001), Laotian (AOR 1.46, 95% CI 1.23–1.74, p < 0.001), and Pacific Islander patients (AOR 1.25, 95% CI 1.16–1.34, p < 0.001) were more likely to present at a more advanced stage relative to NHW patients. Relative to Chinese Americans (the largest AANHPI subgroup), all AANHPI patients were significantly more likely to be diagnosed at a later stage of disease. The largest odds were observed in Hmong (AOR = 2.60, 95% CI 1.87–3.62, p < 0.001), Laotian (AOR = 2.00, 95% CI 1.68–2.39, p < 0.001), Pacific Islander (AOR = 1.71, 95% CI 1.59–1.84, p < 0.001), Hawaiian (AOR = 1.54, 95% CI 1.44–1.65, p < 0.001), and Kampuchean (AOR = 1.42, 95% CI 1.20–1.68, p < 0.001) patients. Conclusions: This disaggregation study finds disparities in the stage of breast cancer at presentation across AANHPI groups, with patients of Hawaiian, Hmong, Laotian, and Pacific Islander descent more likely to be diagnosed at advanced stages when treatments are more intense and cure less likely. Research which considers AANHPI patients as a monolith masks poor outcomes from disparate subgroups that could benefit from targeted, culturally tailored interventions that involve community leaders and leverage cultural norms.

BACKGROUND Early but not late tranexamic acid (TXA) after TBI preserves blood-brain-barrier integrity, but it is unclear if and how dose timing affects cognitive recovery beyond hours postinjury. We hypothesized that early (1 hour post-TBI) but not late (24 hours post-TBI) TXA administration improves cognitive recovery for 14 days. METHODS CD1 male mice (n = 25) were randomized to severe TBI (injury [I], by controlled cortical impact) or sham craniotomy (S) followed by intravenous saline at 1 hour (placebo [P1]) or 30 mg/kg TXA at 1 hour (TXA1) or 24 hours (TXA24). Daily body weights, Garcia Neurological Test scores, brain/lung water content, and Morris water maze exercises quantifying swimming traffic in the platform quadrant (zone [Z] 1) and platform area (Z5) were recorded for up to 14 days. RESULTS Among injured groups, I-TXA1 demonstrated fastest weight gain for 14 days and only I-TXA1 showed rapid (day 1) normalization of Garcia Neurological Test ( p = 0.01 vs. I-P1, I-TXA24). In cumulative spatial trials, compared with I-TXA1, I-TXA24 hindered learning (distance to Z5 and % time in Z1, p < 0.05). Compared with I-TXA1, I-TXA24 showed poorer memory with less Z5 time (0.51 vs. 0.16 seconds, p < 0.01) and Z5 crossing frequency. Unexpectedly, TXA in uninjured animals (S-TXA1) displayed faster weight gain but inferior learning and memory. CONCLUSION Early TXA appears beneficial for cognitive and behavioral outcomes following TBI, although administration 24 hours postinjury consistently impairs cognitive recovery. Tranexamic acid in sham animals may lead to adverse effects on cognition.