Kauilaon膩lani Tengan is inspired to encourage greater participation from Native Hawaiian, Pacific Islander and Filipino communities in diabetes clinical trials to ensure research better reflects the populations most affected by the disease.

Leave your assumptions and biases at the door and engage these communities with aloha.
—Kauilaon膩lani Tengan

He is translating that goal into practice through applied research. A master of science student in epidemiology at the University of Hawaiʻi at 惭腻苍辞补 , Tengan was part of a study team at The Queen鈥檚 Health Systems (QHS) whose findings were published in in the study Exploring Diabetes Clinical Trial Participation: A Diverse Group Interview Study.

“I have a family history of cardiometabolic diseases and I remember visiting extended family who had to fly from Moloka驶i just to receive quality care here on Oʻahu,” he said. “This [experience] instilled in me a desire to learn more about health issues so prevalent in our islands and contribute to innovative solutions.”

Research findings and lessons learned

While at QHS, Tengan split his time between health equity research and clinical data management, utilizing electronic medical records to address research questions. He helped conduct interviews with 56 hospitalized patients to explore what motivates—or prevents—patients from joining diabetes clinical trials.

Although 84% expressed willingness to participate, most had never been asked. Barriers included mistrust, concerns about medication risks, and lack of understanding, while many Native Hawaiian and Pacific Islander participants cited family and community benefit as key motivators.

“Engaging face-to-face with people in a clinical setting humanized health data for me,” Tengan said. “It reminded me that these are people, not statistics. I realized that my work has a lasting impact, so it is my responsibility to do things in a pono manner.”

Tengan hopes to carry these lessons forward. “Leave your assumptions and biases at the door and engage these communities with aloha,” he said. “It is vital that we do work in an ethically and culturally nuanced way because there are real world impacts in the data that we publish.”

The study was part of an Food and Drug Administration-funded project at The Queen驶s Medical Center, in collaboration with the 东精影业 惭腻苍辞补 , and clinical partners. also found that Native Hawaiian and Pacific Islander participants are consistently underrepresented in U.S. clinical trials.

“Kauilaon膩lani鈥檚 perspectives and real-life application from quantitative analyses are so important to building collective public health,” said Tetine Sentell, public health professor and study co-author.

While life expectancy across the U.S. declined significantly during the COVID-19 pandemic, a new study led by researchers at the University of Hawaiʻi and the found that Hawaiʻi experienced a smaller decline compared to national trends.

Yan Yan Wu, Michael Phillips and Kathryn L. Braun from the 东精影业 惭氓苍辞补 , along with Lance Ching and Claire Prieto from the , found that life expectancy in Hawaiʻi declined by 1.4 years, from 82.1 in 2019 to 80.7 in 2021. Nationwide, the decline over the same period was 2.4 years, from 78.8 to 76.4. Their findings were published in the .

“The smaller magnitude and delayed timing of Hawaiʻi’s decline may reflect the state’s geographic isolation and early implementation of public health interventions,” said Wu, the study’s lead author. “In 2022, life expectancy partially rebounded by 0.5 years in Hawaiʻi and by 0.9 years nationally, with Hawaiʻi remaining about four years higher than the U.S. average throughout the pandemic.”

“Hawaiʻi ranks among the top U.S. states for COVID-19 vaccination coverage. By May 2023, data reported by the U.S. Centers for Disease Control and Prevention (CDC) showed that more than 90% of residents received at least one dose and more than 80% were considered fully vaccinated with the primary COVID-19 vaccine series,” said Ching, epidemiologist with the DOH Chronic Disease Prevention & Health Promotion Division. “These high vaccination levels—reached over the course of the pandemic—helped delay the peak of COVID-19 mortality in Hawaiʻi by approximately six months compared to the national average and contributed to the state’s distinction of having the lowest age-adjusted COVID-19 death rate in the country.”

Key Findings

• Life expectancy in Hawaiʻi remained stable from 2018 to 2020 (82.3, 82.1, and 82.0 years, respectively).
• A decline occurred in 2021 to 80.7 years, followed by a partial rebound to 81.2 years in 2022.
• Among males, life expectancy fell from 79.2 years in 2018 to 77.5 years in 2021, then rose to 78.2 years in 2022.
• Among females, life expectancy fell from 85.4 years in 2018 to 84.0 years in 2021, rebounding to 84.4 years in 2022.
• The gap between female and male life expectancy widened to 6.5 years in 2021 before narrowing to 6.2 years in 2022—the same as in 2019.
• Despite these fluctuations, Hawaiʻi‘s overall decline in life expectancy remained less severe than the U.S. average throughout the pandemic.

Policy Implications

The researchers note that Hawaiʻi‘s better outcomes underscore the effectiveness of early public health interventions, strong community engagement, and high vaccine uptake. They recommend that future policies build on these strengths by investing in rapid-response infrastructure and maintaining high vaccination coverage to better protect vulnerable communities during future disease outbreaks.

The at the University of Hawaiʻi (ARL at 东精影业) is known for its research in renewable energy, coastal defense for sea-level rise, cybersecurity and more but it has also been active in supporting the community, especially in times of crisis.

Maui wildfires

ARL at 东精影业 worked with the Maui tech community to distribute Starlink terminals to Lahaina as part of the wildfire recovery effort. Approximately 500 Starlink terminals were distributed over two days, reestablishing communications for emergency personnel and those affected by the wildfires. The team also developed an app to organize information about missing community members and coordinated financial and supply donations for the Lahaina community, acting as “boots on the ground” to support recovery on Maui.

“Our work is community-driven. We help meet the needs of many of the emerging problems 贬补飞补颈ʻ颈鈥檚 communities are facing,” said Margo Edwards, director of ARL at 东精影业. “ARL at 东精影业 is at the forefront of technological innovation for disaster response, which will be crucial for Hawaiʻi as climate change continues to impact our state.”

COVID-19 pandemic

ARL at 东精影业 partnered with the Hawaiʻi Pandemic Applied Modeling Work Group to create a forecast tool that allowed epidemiologists to visualize the future state of the COVID-19 pandemic. The tool helped Hawaiʻi鈥檚 medical professionals prepare for hospital capacity and overflow.

“Several online tools exist that incorporate the SEIR [model for infectious disease dynamics] model, however, what we did was take those tools and customize it for Hawaiʻi to support 贬补飞补颈ʻ颈鈥攁辫辫濒测颈苍驳 the lessons from around the world and also factoring in 贬补飞补颈ʻ颈鈥檚 unique circumstances,” said Baseem Missaghi, an application developer at ARL at 东精影业 who helped work on the forecasting tool. “It also allowed us to develop a strong relationship with other groups in Hawaiʻi that had a shared passion for helping the community.”

With the 东精影业 Mānoa College of Engineering, ARL at 东精影业 assisted Hawaiʻi physicians to develop a technique for ventilating up to four patients using a single ventilator with a “multi-split ventilator system.” ARL at 东精影业 also partnered with the 东精影业 Mānoa School of Nursing to develop and deploy an app to count how masks were being worn in Hawaiʻi.

“ARL at 东精影业 has the ability to quickly build services, tools and apps,” said Missaghi. “Our work with the Department of Education on a check-in app and the 东精影业 Mānoa School of Nursing on the facemask tracking app allowed ARL at 东精影业 to help and serve the Hawaiʻi community.”

ARL at 东精影业 is the fifth U.S. Navy-sponsored University-Affiliated Research Center, bringing in a total of $139 million since it was established in 2008.

Heart disease, stroke and diabetes are three of the leading causes of death in Hawaiʻi. Many people do not know that they have a chronic condition, even those with regular healthcare.

To improve patient health and possibly prevent deaths from chronic conditions, a team of state partners and researchers with the University of Hawaiʻi at 惭腻苍辞补 collaborated to improve the assessment of undiagnosed conditions in patients through new algorithms and analysis that could help hundreds of people in the state.

Our work highlights the potential of a relatively simple health information technology intervention
—Catherine Pirkle

Among the important findings: 53% of adults receiving regular care at six primary clinics in The Queen鈥檚 Health System (QHS) had diagnosed hypertension and only 3% of adults exhibited high blood pressure readings without a formal diagnosis, showcasing the clinics’ effectiveness in diagnosing hypertension cases. Additionally, Medicaid beneficiaries with clinical evidence of hypertension were less likely to receive a diagnosis compared to those covered by other insurance types. Also, the COVID-19 pandemic led to underdiagnosis of hypertension.

Supported by two Centers for Disease Control and Prevention grants, the initiative was a collaboration with the Hawaiʻi State Department of Health (DOH), The Queen鈥檚 Clinically Integrated Physician Network (QCIPN) and The QHS. The initiative was a part of national efforts to increase detection of chronic conditions and improve patient quality of care.

“This research is an excellent example of collaboration between academic, governmental and healthcare partners committed to improving the population鈥檚 health. Our work highlights the potential of a relatively simple health information technology intervention,” said Catherine M. Pirkle, associate professor and corresponding author.

Algorithms developed to assess undiagnosed hypertension

DOH developed automated algorithms, which were then implemented by The QHS in the electronic data warehouse of six primary care clinics. 东精影业 faculty and students conducted evaluations, assessing the effectiveness of the algorithms in identifying potentially undiagnosed conditions, while also exploring factors placing individuals at higher risk of not getting an appropriate diagnosis for hypertension.

“Understanding these factors can help to inform new clinical workflows to improve hypertension diagnosis, an important step to reducing the prevalence of hypertension in Hawaiʻi,” said lead-author and epidemiology PhD student, Mika D. Thompson.

Results of the hypertension algorithm evaluation, presented at the American Public Health Association annual conference and published in the , revealed that 53% of adults at QCIPN clinics had diagnosed hypertension, which is higher than the 26% of adults who reported having hypertension in a .

Other co-authors of the study include Blythe Nett, Yanyan Wu, Tetine L. Sentell, Meghan D. McGurk, Lance K. Ching, Hermina Taylor and Tiffany Lemmen.

Back pain is a common problem that impacts more than 619 million people globally and remains the of disability worldwide. In the next three decades, that number is expected to jump to 840 million people.

“I don鈥檛 think this fact is widely known, and it became worse during the pandemic with people staying home and not having access to appropriate care,” said Eric Hurwitz, professor and director of the (OPHS) at the at the University of Hawaiʻi at 惭腻苍辞补. Hurwitz is an epidemiologist who has studied back pain for 30 years.

In addition to known risks for back pain, including smoking, obesity and occupational ergonomic factors, a co-authored by Hurwitz found an association to depression. Those with back pain were more likely to report symptoms consistent with depression at subsequent follow-up, and those with depression were more likely to report subsequent back pain. The study surveyed more than 2,000 adults in the U.S. over a nine-year period.

“Similar to back and neck pain, depression is also a leading cause of disability worldwide,” noted Hurwitz.

In involving Hurwitz and colleagues, researchers used data from the U.S. National Health Interview Survey and found that cardiovascular conditions, hypertension, diabetes as well as poor mental health were associated with higher odds of spinal pain. The study also found links between spinal pain and cognitive impairment.

“The next steps in this research will be to figure out why these associations exist, if they have common causes that we can intervene on, and the effectiveness of these interventions,” said Hurwitz. “We need more studies that can help us better understand the causal relationships (if any) between these conditions.”

Chiropractic care, epidemiology

Hurwitz has led numerous studies on the effectiveness of spinal manipulation and other therapies for treating back pain and other conditions often seen by chiropractors throughout his career. In his research, he looks at what populations tend to be at higher or lower risk, what are the risk and protective factors, and what are the best ways to manage it.

His interest in back pain therapy stems from his time in chiropractic school where he earned his doctor of chiropractic from Los Angeles College of Chiropractic. He took the advice of his teachers to pursue epidemiology and earned his master鈥檚 and PhD from UCLA. Hurwitz joined the faculty at 东精影业 惭腻苍辞补 in 2006 where he has served as graduate chair of the in OPHS since 2010.

Keeping back pain away

So how does one deal with common back issues? Hurwitz advises, “Try to keep moving, find exercises or physical activities that you enjoy doing so you鈥檒l keep at it. The important thing is to stay active and maintain a healthy weight so your back isn鈥檛 unduly strained. It not only helps physically, but for your mental well-being too, and being sedentary increases the risk for all of these musculoskeletal and non-musculoskeletal ailments.”

Hurwitz suggests walking, swimming and bicycling, as well as activities that aim to improve mobility and range of motion like stretching exercises, yoga and Tai Chi.

“Most back pain isn鈥檛 serious but if it鈥檚 persistent, and it keeps you from moving or sleeping, or goes down the leg, then it鈥檚 time to seek advice from a health care provider,” he said.

Big picture in public health

Hurwitz believes public health plays an important role in addressing back pain issues, and improving coordination efforts on multiple levels is needed.

“Interventions that motivate people in pain (either mentally or physically or both) to move more might have wide-ranging benefits,” Hurwitz said. “But what can we do not just individually, but as a community, society, organizationally, legislatively to promote health and well-being for all of us?”

He added, “We might have the motivation but societal or other constraints may get in the way, such as lack of safe spaces to exercise, the inability to afford gym membership and time constraints due to working multiple jobs.”

—by Arlene Abiang

Sometimes we have had a class where the subject material seems a bit tough to interpret. And sometimes a teaching assistant who has been in our place helps make the connections we could not initially see.

University of Hawaiʻi at 惭腻苍辞补 graduate students who have studied any life sciences field as an undergraduate or graduate student are invited to apply to become a teaching assistant (TA) in the .

According to School of Life Sciences Associate Director of Instruction Stephanie Kraft-Terry, the school is looking for approximately 64 TAs to assist in teaching undergraduate labs in the areas of biology, botany, marine biology, microbiology and molecular cell biology.

“We hire TAs with background in both undergraduate and graduate studies in the life sciences and encourage anyone with that background who is interested in providing excellent instruction to undergraduate students, regardless of their graduate program, to apply,” Kraft-Terry said.

The application review deadline is April 29. Applications will continue to be accepted but priority will be given to those students who submit an application by April 29. Visit the for more information and to apply.

Creating an impact for students

Breena Gaskov is working as a life sciences TA, while finishing up her first year as a student in the program. Gaskov holds an undergraduate degree in biology with a focus in microbiology.

“Being a TA for the School of Life Sciences allows me to make that impact on students who are looking for their passion in science, and guide them along the way,” Gaskov said. “For me, becoming a School of Life Sciences TA was a no brainer. I now get to come full circle and teach others in the same way that made me fall in love with science!”

Along with receiving a nine-month salary and tuition waiver, Gaskov said one of the major benefits is to be able to personalize your instruction to your skill set.

“I purposely teach in the same way that worked best for me when I was in my students鈥� place,” Gaskov said. “I have the ability to make even difficult subjects fun, for both me and the students! The biggest one though, for me, is the ability to see the impact being made on students. I have had multiple students walk into class and tell me ‘I was having a bad day today and this class made it better,’ and ‘I actually look forward to coming to this lab.’ I always leave the lab feeling full of happiness, every single time.”

Gaining self-confidence

Chris Nakano became a life sciences TA after hearing about the position from fellow peers in his classes. He earned his graduate degree in in fall 2021.

“Aside from the tuition exemption and stipends, the office staff, lab coordinators and principal investigators are incredibly supportive in both the sense of helping you excel as a budding educator and understanding of your busy schedule as a student,” Nakano said. “It鈥檚 a great introduction to scientific pedagogy, and you鈥檒l nurture the self-confidence to troubleshoot the basic lab techniques prevalent in any scientific laboratory. You鈥檒l also be surrounded by experts in the field that are generous in experience and wisdom, who are incredibly eager to share their counsel.”

Nakano recommends interested applicants to apply early, have enthusiasm and be committed.

This work is an example of 东精影业 惭腻苍辞补鈥檚 goals of (PDF) and (PDF), two of four goals identified in the (PDF), updated in December 2020.

—By Marc Arakaki

Nutritional epidemiologists Rachel Novotny of the Department of Human Nutrition, Food and Animal Sciences, and Carol Boushey, of the , are two of only 20 nationally recognized scientists on the U.S. Department of Agriculture (USDA) independent advisory committee which published the .

• Related 东精影业 News story: 东精影业 epidemiologists to help develop U.S. dietary guidelines, February 26, 2019

The report is an in-depth review of the latest available science on specific nutrition topics. The report鈥檚 findings will help to shape the 2020–2025 Dietary Guidelines for Americans, which will provide hundreds of millions of Americans鈥攁nd nutritionists around the world鈥攚ith recommendations on what to eat and drink to promote health 鈥痑nd prevent chronic disease. An ongoing began on July 15, 2020, and will remain open until August 13, 2020, 11:59 p.m., Eastern time.

“The Dietary Guidelines translate current science into food and beverage intake guidance for the U.S. population, which is used as the basis for key federal food-assistance programs such as the School Breakfast and Lunch Program and the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps),” explained Novotny.

“I chaired the Dietary Patterns Sub-Committee, which reviewed the relationship between dietary patterns and all-cause mortality for the first time,” said Boushey, who is also a registered dietitian. “The results, informed by data from Hawaiʻi and around the world, show a reduced risk of all-cause mortality when food patterns are primarily comprised of vegetables, fruits, legumes, nuts, whole grains, unsaturated vegetable oils, fish and lean meat or poultry.”

Novotny added, “What鈥檚 interesting is that the 2020–2025 Dietary Guidelines are the first to include the whole life span, including 0–2 years of age, and to focus on patterns of food and beverage intake.”

The guidelines, co-developed by USDA and the U.S. Department of Health and Human Services (HHS), are the cornerstone of U.S. nutrition programs and policies, so the work of the advisory committee has far-reaching implications for years to come. The goal is to release the Dietary Guidelines by the end of 2020.

The committee鈥檚 work was informed by more than 62,000 public comments, a marker of USDA and HHS鈥檚 commitment to public involvement in the dietary guidelines process. In addition to co-developing the guidelines, USDA鈥檚 Food and Nutrition Service administers 15 nutrition-assistance programs to ensure children and low-income individuals and families have nutritious food to eat.

As the number of COVID-19 cases surge in cities like New York, some in Hawaiʻi fear an exponential rise in the Aloha State is imminent. There is a statewide stay-at-home order in effect and practicing social distancing remains crucial to stem the spread. But 鈥�Alan Katz鈥�, an professor at the , said 鈥媌ecause a majority of Hawaiʻiʻs communities are rural, it could help lessen the chance of a major outbreak.

“We only have one urban center in Honolulu and the rest of the islands are rural including any spot on Oʻahu that鈥檚 outside of Honolulu, that鈥檚 considered rural. So that鈥檚 good. People are less densely populated,” Katz explained. The 东精影业 Mānoa epidemiologist said it gives the state some leeway in minimizing the spread of the highly infectious virus.

Because the incubation period for COVID-19 is up to 14 days, Katz said Hawaiʻi will inevitably see more cases during the statewide lockdown but is hopeful it won鈥檛 be a steep increase. In order to avoid a major outbreak, he urges everyone to take health guidelines seriously.

“The most important thing you can do is maintain social distancing. Stay 6 feet away from each other. That鈥檚 going to really dramatically mitigate person to person spread of this. If you鈥檙e not essential, if you鈥檙e supposed to be at home try to stay at home. Don鈥檛 aggregate in groups,” Katz said.

According to researchers, 鈥婥OVID-19 is much more contagious than the seasonal flu.

—By Moanikeʻala Nabarro

Health crisis restrictions such as social distancing, which government and top health officials are implementing across the nation, stem from data gathered by epidemiologists. Those experts across the globe are analyzing stats from hospitals in countries slammed by COVID-19 to formulate how to control the virus鈥� spread.

Thomas Lee, an assistant professor of at the , explained the trends epidemiologists are now looking at.

It鈥檚 going to be important as the virus spreads, and it鈥檚 going to spread to rural communities as well, how well we can screen all of our citizens. Not just the ones living in the current hotspots.
—Lee

“Because China is five to six weeks ahead of where everyone else鈥檚 response is, (epidemiologists) are now able to utilize that and shift some focus on looking at what caused it,” said Lee.

He said epidemiologists are looking at population trends and COVID-19鈥檚 infection rate to develop an aggressive approach toward containing it. Lee explains one of the findings experts arrived at regarding testing.

“It鈥檚 going to be important as the virus spreads, and it鈥檚 going to spread to rural communities as well, how well we can screen all of our citizens. Not just the ones living in the current hotspots,” Lee said.

Like thousands of 东精影业 faculty, Lee is transitioning all of his courses online for the remainder of the semester. He plans to focus epidemiology lectures on COVID-19 studies that continue to surface as the outbreak grips the globe.

When researchers work together with community members to conduct studies to address health disparities, both groups reap the benefits, says a new paper led by faculty in the Myron B. Thompson School of Social Work at the campus.

The in a recent issue of the .

Katherine Yang, a recent from the 东精影业 and a current in , and colleagues conducted detailed interviews with 12 leading local experts. The goal is to learn about their experiences in using a community-based participatory research (CBPR) approach to improve health outcomes and promote health equity.

“In CBPR, researchers take the time to get to know their communities by being present and listening to their concerns and priorities,” Yang said. “Our analysis showed that CBPR can serve as a bridge between academic researchers and the communities that they study.”

A true partnership

CBPR projects involve community members not as research “subjects,” but as active participants and co-leaders in all research phases. Community members work closely with researchers to conduct the study from beginning to end.

Research that uses a CBPR approach starts with an issue that is important to the community, values reciprocal learning and benefits and promotes social action.

For example, in one project, researchers who were developing a substance abuse prevention program worked with ōpio (teenagers) in a rural Hawaiian community. The teens took pictures of things that represented Native Hawaiian values to them, and then worked with the researchers to use the photos in designing a public health intervention to prevent substance use.

“Community members feel engaged when they know their voices matter and that research is relevant to their experiences, concerns and priorities,” said Jane J. Chung-Do, an associate professor with 东精影业 public health and co-author of the paper. “We wanted to better understand what makes these projects successful and what we can work on to advance CBPR in Hawaiʻi.”

For the .

—By Theresa Kreif

The rocky and semi-arid terrain of northeastern Brazil, dotted with small cities and rural communities, represents a formidable barrier not only to travel, but to conducting quality health research. Now, researchers at the are partnering with Brazilian epidemiologists to reach out to college students in Brazil seeking to improve health programs in this hard-to-reach and economically disadvantaged region.

The students are being taught to administer health surveys, interview study participants, collect epidemiological data in the field and write research articles for publication in peer-reviewed journals, according to a .

“These students want to learn how to conduct epidemiological research so that they can improve the health programs of their community and we want to support them in doing this,” said Catherine Pirkle, 东精影业 Mānoa assistant professor.

In one project, training modules conveyed how to properly collect data on body measurements and take samples for laboratory analyses in pregnant women. In another, students were taught how to recruit pregnant women for a study and provided tips on how to conduct systematic interviews to address women’s health and factors that might contribute to the high rate of teen pregnancy in the region.

“We chose to focus on adolescent pregnancy because doing research on this topic requires a solid understanding of the social, economic and psychological motivations of community members—and all of these ideas are at the core of what we do as public health researchers,” said Pirkle.

Associate Professor Tetine Sentell added that exposing the students to international training was an important objective. Four students from northeastern Brazil visited 东精影业 Mānoa to learn how to draft scientific manuscripts for submission to public health journals. So far, three have been published.

“These students are interested in graduate school and academic careers, so we wanted to support their academic development,” said Sentell. “We’re hoping to help them build a thriving research community and to provide new opportunities to support health in this region.”

—By Theresa Kreif

The nutritional health of all Americans is guided by a federal , which now includes University of Hawaiʻi at 惭腻苍辞补 nutritional epidemiologists Rachel Novotny of the and Carol Boushey of the .

“We will be considering the diversity of the United States population,” noted Novotny. “Our goal will be to synthesize current nutrition science that will guide policy to provide food and nutrition for our diverse population.”

“I am so honored to have the opportunity to participate in recommendations to positively influence the health of Americans,” said Boushey, who is also a registered dietician. “The appointment also recognizes the value of the research we do at the 东精影业 Cancer Center, and 东精影业 as being important for people across the United States. Our work investigating diet quality and the relationships of diet quality to health and disease will allow our research to reach a broader audience.”

Novotny and Boushey will be joined by 18 other nationally recognized scientists on the independent advisory committee. They will review scientific evidence on specific nutrition and health-related topics.

Their recommendations along with public and agency comments will help inform U.S. Department of Agriculture and U.S. Department of Health and Human Services development of the cornerstone of federal nutrition programs and policies through the .

When the first patient came in complaining of joint pain, rash and conjunctivitis, or “red eyes,” W. Thane Hancock wasn鈥檛 sure what was causing the condition. He scribbled down “viral exanthem” as the diagnosis. (Exanthem is the medical term for rash.)

When another patient came in that same morning with identical symptoms, Hancock thought to himself, “that鈥檚 weird.” After lunch, a third patient presented with similar symptoms, he suspected something was going on. That鈥檚 when Hancock began to piece together what would become the world鈥檚 first reported outbreak of Zika virus infections.

It was 2007, and Hancock, who graduated in 2003 from the University of Hawaiʻi at 惭腻苍辞补 (JABSOM), was only nine months into his job as a family doctor on the island of Yap, part of the Federated States of Micronesia. At the time he was the only U.S. trained physician working on the small Micronesian island.

Hancock, schooled in the “Problem-Based Learning” (PBL) curriculum at JABSOM, was accustomed to thinking broadly. When confronting a medical mystery, PBL students are taught not to rule out anything too early, but to list all possibilities, then plug away at eliminating possible causes one by one.

“The PBL process that encourages curiosity and a determination to find out what it is served me very well in Yap,” said Hancock, who grew up on Hawaiʻi Island. “The curriculum at JABSOM emphasizes life-long learning,” said Hancock, and that is how he approaches every case.

For more on the story, .

—By Tina Shelton

Japanese Americans have a greater predisposition to accumulate fat inside the abdomen (visceral fat) and liver (liver fat), compared to other races/ethnicities, according to a study.

“This new discovery is important because excess visceral fat and liver fat found in Japanese Americans pose a much greater risk of metabolic disorders than fat stored in other body areas,” said , 东精影业 Cancer Center epidemiologist and the study鈥檚 lead author. “These metabolic disorders, if left untreated, may lead to heart disease, diabetes and more than a dozen types of common cancers.”

Researchers for the study published in collected data from almost 2,000 participants in the Multiethnic Cohort Study (Hawaiʻi and Los Angeles residents, 60–77 years old; of African, European (white), Japanese, Latino, or Native Hawaiian ancestry) from 2013 to 2016. The study is the most ethnically diverse study conducted to date measuring body fat distribution accurately with whole-body composition imaging and abdominal MRI.

Distribution of fat as visceral, and liver fat varied significantly with ethnicity鈥攖hey were highest in Japanese Americans, lowest in African Americans, and intermediate in the other ethnic groups. For the same amount of total body fat and compared with African Americans, visceral fat area was 45 percent and 73 percent greater in Japanese American men and women, respectively, and liver fat was 61 percent and 122 percent greater in Japanese American men and women.

“Our goal is to develop blood markers of visceral and liver fat in order to identify high-risk individuals for prevention of metabolic diseases,” said , 东精影业 Cancer Center epidemiologist and study鈥檚 principal investigator. “We are also testing dietary and lifestyle changes that would specifically reduce visceral fat and liver fat. Physicians in Hawaiʻi and elsewhere should be aware that race/ethnicity is an important risk factor for metabolic diseases and obesity-related cancers.”

—By Nana Ohkawa

A long term healthy, high-quality diet can reduce the risk of cardiometabolic conditions such as heart disease, diabetes or stroke according to a new University of Hawaiʻi Cancer Center .

A high-quality diet includes a diet high in vegetables, fruits, whole grains, and legumes, with lean, low-fat protein sources plus, fat-free or low-fat dairy foods and oils, such as olive oil. An important component of a high-quality diet is limiting sodium (salt) intake, and empty calories from sugar and saturated and trans fat.

“The burden of chronic diseases related to obesity, such as diabetes and breast cancer, is high among many ethnic groups in Hawaiʻi. Therefore, it is important to study how diet may improve excess body weight and fatty liver. This may allow the development of better prevention strategies,” said , first author and researcher.

The participants completed food frequency questionnaires from 1993 to 1996 and clinic visits in 2013 to 2016 and underwent whole-body and abdominal scans. Four science-based diet quality scores predicted lower visceral fat, excess body fat within the abdomen and the liver, and fatty liver. Of the 2,000 participants of the Multiethnic Cohort, more than half live in Hawaiʻi and Los Angeles.

Individuals with the highest diet quality scores were 35 to 59 percent less likely to have high visceral fat and were also 22 to 43 percent less likely to have fatty liver than those with the lowest scores.

“In recent years, the importance of body fat distribution has emerged. Visceral fat appears to be a stronger risk factor for chronic diseases than body fat located directly under the skin. The proportion of visceral fat appears to differ by ethnicity with higher levels among individuals of Japanese and other Asian ancestries than Whites,” said Maskarinec. “The new findings suggest that body fat distribution beyond excess body weight is a critical feature to consider when advising individuals about the health effects of their regular diets.”

For more information please visit the .

researchers discovered a novel therapeutic target and treatment strategy for acute myeloid leukemia (AML), a cancer of the blood and bone marrow that normally requires prompt and aggressive treatment.

“New therapeutic targets and drugs are urgently needed to improve AML patient outcomes,” said , researcher in the 东精影业 Cancer Center’s Cancer . “We found an increased use of fructose in AML patients. This unique metabolic feature predicts poor treatment outcomes in patients. Our study provides strong evidence that blocking fructose utilization using a small molecule drug shows dramatic therapeutic benefit for AML treatment.”

The conventional regimen for AML treatment is limited. Only about 25 to 30 percent of patients survive for 5 years or more after they are diagnosed.

This discovery can have a profound impact on cancer treatment outcomes, not just for AML patients, but possibly for many other patients with different types of cancers,” said Randall Holcombe, 东精影业 Cancer Center director. “Metabolomics is a unique program at the center, for which Dr. Jia is an international leader.”

The findings published in highlight the unique ability of AML cells to switch their energy supply from glucose to fructose, when glucose is in short supply. Fructose is the second most abundant blood sugar in the body and is used as a glucose alternative by AML cells in order for the cells to retain energy. After the switch, cancer cells begin to multiply faster.

The study found a treatment potential by stopping the glucose transporter (GLUT5). This method restricts the AML energy supplies and effectively stops cancer growth. By targeting the GLUT5, researchers can effectively slow the growth of the cancer cells leading to a new promising treatment for AML patients.

“Our normal cells hardly rely on fructose for growth. This makes the fructose transport in cancer cells an attractive drug target,” said Jia. “We are in the process of developing a GLUT5 inhibitor, thus cutting the cancer cells’ energy source and eventually killing them. The new GLUT5 inhibitor can potentially be used alone, or in addition to the current chemotherapy drugs to enhance anti-cancer effects,” said Jia.

Leukemia in Hawaiʻi

Leukemia is one of the top ten most common cancers among women in Hawaiʻi and the top ten causes of cancer deaths in both men and women. From 2004 to 2013, the incidence of leukemia significantly increased in Hawaiʻi men and women.

For full Cancer Cell publication visit: .

—By Nana Ohkawa

researchers discovered new genetic markers associated with a fast rate of nicotine metabolism, which potentially leads smokers to smoke more, thereby, increasing their risk for lung cancer.

Loïc Le Marchand, a professor and leading epidemiologist in the 东精影业 Cancer Center’s Epidemiology Program, and his colleagues, identified differences in the CYP2A6 (cytochrome P450, family 2, subfamily A, polypeptide 6) gene that are associated with a high rate of nicotine metabolism. Smokers who have these CYP2A6 markers may smoke more cigarettes and/or inhale a greater amount of nicotine per cigarette than smokers who metabolize nicotine less rapidly, in order to maintain stable levels of nicotine in the blood.

“Smokers adjust the way they smoke to satisfy their craving for nicotine. Nicotine is the highly addictive component in cigarettes that makes people want to smoke. Smokers with the genetic markers we discovered, smoke more extensively in order to keep their nicotine levels high and achieve the desired effects of nicotine in the brain,” said Le Marchand.

“This new finding could identify smokers who are at greater risk for lung cancer. The knowledge of these markers will help doctors and public health leaders improve strategies for cancer prevention, a major focus of research at the 东精影业 Cancer Center. In addition, application of this research may improve the survival and quality of life of lung cancer patients, since continued use of tobacco products after diagnosis is known to correlate with poor outcomes,” said Randall F. Holcombe, incoming director of the 东精影业 Cancer Center.

Smoking exposes individuals to tobacco-derived carcinogens. The increased exposure that occurs in individuals with the specific genetic markers leads to an increased risk for lung cancer, according to the study.

The multiethnic cohort study

Le Marchand’s findings published in used data from the 东精影业 Cancer Center’s multiethnic cohort study and an international consortium of lung cancer genetic studies. Smokers are about 25 times more likely to develop lung cancer in their lifetime compared to non-smokers (). Smokers identified as being at high risk for the disease could be offered regular screenings by low-dose CT scans.

Le Marchand collaborated with University of Minnesota and University of Southern California researchers to evaluate nicotine metabolism among 2,239 smokers participating in the multiethnic cohort study.

“We were able to translate differences in lung cancer risk that we first observed among Hawaiʻi’s ethnic groups into information that has implications for the occurrence and prevention of a common and very deadly cancer.”

Lung cancer in Hawaiʻi

Lung cancer remains the leading cause of cancer-related deaths in Hawaiʻi, with 776 new cases and 526 deaths every year. The five-year survival rate for lung cancer remains very low at 18 percent (Hawaiʻi Tumor Registry).

—By Nana Ohkawa

The 2016 Regents’ Medal for Excellence in Research was awarded to Brian W. Bowen, Loïc Le Marchand and Kristin Pauker.

The research medal is awarded by the University of Hawaiʻi in recognition of scholarly contributions that expand the boundaries of knowledge and enrich the lives of students and the community.

Regents’ medal honorees

Brian W. Bowen

Research professor, 东精影业 Mānoa, School of Ocean and Earth Science and Technology’s

has made outstanding contributions to the conservation of marine species such as sea turtles, shrimp, sturgeon and white sharks. Since joining the Hawaiʻi Institute of Marine Biology in 2003, he has trained 23 graduate students and sits on the committees of another 14 graduate students. He has published approximately 200 peer-reviewed publications, garnering more than 13,000 citations. This sought-after speaker has given 16 guest lectures in the past three years and, over his career, has presented 90-plus times. His competitive grants represent more than $6 million of extramural funding. This American Association for the Advancement of Science Fellow earned the Kobe Award for lifetime achievement in aquatic biology.

Loïc Le Marchand

Professor, 东精影业 Mānoa, University of Hawaiʻi Cancer Center’

has contributed significantly to the field of cancer epidemiology and was one of the first epidemiologists to study the role of genes and the environment on cancer incidence. His work has been nationally and internationally recognized. He was a member of the 2015 International Agency for Research in Cancer committee that reviewed evidence for processed meat as a carcinogen, and was recognized on the 2015 Thomson Reuters’ World’s Most Influential Scientific Minds and Highly Cited Researchers list. Extremely successful at obtaining grant support, he brings in several millions of dollars to the university annually. He always strives to build a research environment that fosters the training of new scientists.

Kristin Pauker

Assistant professor, 东精影业 Mānoa, College of Social Sciences’

is described by a nominator as a young scholar whose thoughtful and careful research has contributed to developmental science with an impressive scope and breadth. She is making significant contributions to developmental and social psychology in the areas of intergroup attitudes, racial bias, interracial anxiety and essentialist beliefs. Using cutting-edge methodology, her research particularly focuses on the timely and important topic of racial prejudice. Since joining 东精影业 Mānoa in fall 2011, Pauker has published 12 peer-reviewed journal articles and a book chapter, with four manuscripts currently under review and a number under preparation. She has also been successful in obtaining federal funding to support her scholarly works.