bluuebunny/crossref_metadata_2025 huggingface dataset:
Design and prediction simulation of an active-dispersing mechanism for magnetorheological damper with twin-tube configuration
Authors: Zhu Minghui , Zhang Honghui , Zou Zhiyuan , Chen Shiwei , Zhang Dengyou
Published: May 2024

Sedimentation immunity is one of the key features of magnetorheological (MR) dampers, which means the lifetime-long service without degradation under the sedimentation of MR fluid. In this paper, an active-dispersing mechanism is established with twin-tube configuration toward the sedimentation immunity, by adding a circulation channel powered by rotating blades between the tubes when the MR damper is not in operation. Finite element (FE) method is employed to reveal the re-dispersion process once the MR fluid settled to a specific degree, and the benefits of circulating channel and twin-tube sedimentation-immunity system for the MR fluid are discovered by the simulation. Ultimately, a self-adaptive system could be built to ensure the MR fluid in the damper keeping in a relative uniform and thus the sedimentation immunity is fulfilled.
Enhanced transport phenomena in Casson fluid flow over radiative moving surface: Influence of velocity and thermal slip conditions with mixed convection and chemical reaction
Authors: Mahmood Zafar , ur Rehman Mujeeb , Khan Umar , Ali Bilal , Haque Siddiqui Md Irfanul
Published: May 2024

Researchers are interested in the non-Newtonian fluid flow with mixed convection because of its extensive use in industry and manufacturing. Additionally, thermal radiation in convective heat transfer is critical for thermal transmission regulation. As a result, the authors provide an in-depth study of how mixed convective effects on concentration and temperature impact mass, heat, and non-Newtonian Casson fluid flow. A transverse magnetic field and vertical permeable stretched sheet affect the fluid. Nonlinear thermal radiation, Brownian motion, thermophoresis, velocity slip, and temperature slip are all examined. The governing nonlinear partial differential equations (PDEs) can be changed into especially nonlinear coupled ordinary differential equations (ODEs) with the right similarity transformation. We use the RK-45 technique in Mathematica to solve the system to accommodate different physical attributes. The data are analyzed graphically. This study shows that increasing the free convection parameters [Formula: see text] and [Formula: see text] improves the velocity profile. However, the Casson parameter, magnetic field, velocity slip, and mass suction parameter lower it. Increasing [Formula: see text], and [Formula: see text] parameters lead to a higher temperature profile, whereas [Formula: see text], and [Formula: see text] parameters have the opposite. Increased concentration is shown with [Formula: see text] and [Formula: see text] parameters, whereas [Formula: see text] and [Formula: see text] have the opposite impact. Skin friction increases against [Formula: see text] and [Formula: see text] and reduces for S and M Heat transfer increases for [Formula: see text] and S whereas reduces for [Formula: see text] and [Formula: see text] Mass transfer increases for [Formula: see text] and [Formula: see text] and reduces for [Formula: see text] and [Formula: see text].
From the Editor-in-Chief
Authors: Gorla Daniele
Published: May 2024

Welcome everybody to the second issue of 2024! Spring is usually the time of the year where most of us work to submit (or receive feedback on) papers to the forthcoming summer conferences, where hopefully many SIGLOG members will meet and discuss in person. In the meanwhile, I hope that you will enjoy reading this issue.
Chair's Letter
Authors: Palamidessi Catuscia
Published: May 2024

This year, SIGLOG's flagship conference, the ACM-IEEE Symposium on Logic in Computer Science (LICS), will be held in Tallin, Estonia, during 8--11 July 2024. It will feature invited talks by Martin Escardo and Alexandra Silva, and invited tutorials by Sam Buss and Alex Simpson. Many thanks to Ugo Dal Lago and Javier Exparza (PC chairs), Pawel Sobocinski (Local Organizer), Sam Staton (Publicity and Proceedings chair), Valentin Blot (Proceedings chair) and all the other people who are contributing to make it a top conference. I am sure it will be an exciting and unmissable event, and I hope to see many of you there.
Semantics Column
Authors: Panangaden Prakash
Published: May 2024

It is with great sadness that the SIGLOG community learned of the passing away of Philip J. Scott in December 2023. He was a leader of the community and made major contributions to type theory, polymorphic
λ
-calculus, bounded linear logic, Geometry of Interaction and many other topics. He and Jim Lambek wrote the classic textbook, "Introduction to Higher-order Categorical Logic" which exposed the computer science community to what were then exotic topics for us: type theory and categories, categorical proof theory and toposes.
A Brief Survey on the Categorical Semantics for Geometry of Interaction In Memory of Phil Scott
Authors: Lemay Jean-Simon Pacaud
Published: May 2024

Philip Scott, better known to his friends and colleagues as Phil, was a Professor of Mathematics at the University of Ottawa (Canada). Sadly, Phil passed away
1
after a long battle with cancer - which he bravely fought till the very end - on 18 December 2023 at the age of 76. Phil was born on 27 December 1947 in Leeds (UK). When Phil was still a baby, his family moved to North Carolina (USA), where he spent his childhood. He went on to study mathematics at the University of North Carolina at Chapel Hill (USA), before moving to Canada in the 1970s. Phil did his Ph.D. at the University of Waterloo (Canada), supervised by Denis Higgs, and obtained his doctorate in pure mathematics in 1976. Phil joined the Mathematics Department at the University of Ottawa in 1982, eventually becoming Professor Emeritus, and remained there until his passing.
The Squirrel Prover and its Logic
Authors: Baelde David , Delaune Stéphanie , Jacomme Charlie , Koutsos Adrien , Lallemand Joseph
Published: May 2024

Security protocols are widely used today to secure transactions that take place over public channels like the Internet. Common uses include the secure transfer of sensitive information such as credit card numbers, or user authentication on a system. Because of their presence in many widely used applications (
e.g.
electronic commerce, government-issued ID), developing methods and tools to verify security protocols has become an important research challenge. Such tools help increase our trust in protocols, and hence on the applications that rely on them.
Table S2 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Tumor FKBP51-expression does not affect the composition of TME in CD163 or HLA- DR-TAMs nor does it influence tumor HLA-DR expression. Pearson r coefficient and p values are indicated for each variable.
Supplementary Figure S9 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Callosal infiltration and Immunophenotype of TME and peripheral blood. Graphical representation of flow cytometry data of TME (graphs on the left) and peripheral blood (graphs on the right) from primary tumors (upper) and recurrences (lower). No CCI, black histograms; CCI, red histograms. Significant results (Mann Whitney) are underlined in red.
Supplementary Figure S7 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

(a) Macrophage gating by CD45. (b) Representative flow cytometry histograms of CD163/FKBP51s expression on: M0 (no coculture), top; CD45-gated macrophages in cocultures with adherent GB138 (CC GB138), medium; or with spheroids GB138 (CC GB138 spheroids), bottom; the respective isotype antibodies are also shown on the left. (c) A representative flow cytometry histogram of HLA-DR expression in the same cells. (d) Analysis by qPCR of the mRNA levels of IL-10 and IL-4 in spheroids obtained by GB138 and GB83 cell lines, compared to each differentiated counterpart. (f) A representative gating of CD163/FKBP51s+(R1) and CD163/FKBP51s- (R2) macrophages. G) Flow cytometry histograms of pSTAT6 expression in gated R1 and R2 macrophages.
Supplementary Figure S16 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Vasogenic edema and Immunophenotype of TME and peripheral blood. Graphical representation of flow cytometry data of TME (graphs on the left) and peripheral blood (graphs on the right) from primary tumors. No Vasogenic edema, black histograms; Vasogenic edema, red histograms. P values are calculated using Mann Whitney test.
Supplementary Figure S13 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Tumor volume and Immunophenotype of TME and peripheral blood. Graphical representation (linear regression) of flow cytometry data of TME (graphs on the left) and peripheral blood (graphs on the right). Significant results are underlined in red.
Supplementary Figure S11 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Midline shift and Immunophenotype of TME and peripheral blood. Graphical representation of flow cytometry data of TME (graphs on the left) and peripheral blood (graphs on the right) from primary tumors (upper) and recurrences (lower). No midline shift, black histograms; midline shift, red histograms. P values are calculated using Mann Whitney test and unpaired T test with Welch correction.Significant results are underlined in red.
Supplementary Figure S1 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Flow chart of study population. Thirty-7 patients receiving diagnosis of glioblastoma were consecutively enrolled: 28 had primary tumors and 9 recurrences. Of 37 GB patients, 33 were included in the heatmap analysis, whereas 4 were excluded because of incomplete immunophenotyping of TME and/or peripheral blood, as also detailed in Table S1.
Data from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Abstract
The primary treatment for glioblastoma (GBM) is removing the tumor mass as defined by MRI. However, MRI has limited diagnostic and predictive value. Tumor-associated macrophages (TAM) are abundant in GBM tumor microenvironment (TME) and are found in peripheral blood (PB). FKBP51 expression, with its canonical and spliced isoforms, is constitutive in immune cells and aberrant in GBM. Spliced FKBP51s supports M2 polarization. To find an immunologic signature that combined with MRI could advance in diagnosis, we immunophenotyped the macrophages of TME and PB from 37 patients with GBM using FKBP51s and classical M1-M2 markers. We also determined the tumor levels of FKBP51s, PD-L1, and HLA-DR. Tumors expressing FKBP51s showed an increase in various M2 phenotypes and regulatory T cells in PB, indicating immunosuppression. Tumors expressing FKBP51s also activated STAT3 and were associated with reduced survival. Correlative studies with MRI and tumor/macrophages cocultures allowed to interpret TAMs. Tumor volume correlated with M1 infiltration of TME. Cocultures with spheroids produced M1 polarization, suggesting that M1 macrophages may infiltrate alongside cancer stem cells. Cocultures of adherent cells developed the M2 phenotype CD163/FKBP51s expressing pSTAT6, a transcription factor enabling migration and invasion. In patients with recurrences, increased counts of CD163/FKBP51s monocyte/macrophages in PB correlated with callosal infiltration and were accompanied by a concomitant decrease in TME-infiltrating M1 macrophages. PB PD-L1/FKBP51s connoted necrotic tumors. In conclusion, FKBP51s identifies a GBM subtype that significantly impairs the immune system. Moreover, FKBP51s marks PB macrophages associated with MRI features of glioma malignancy that can aid in patient monitoring.
Significance:
Our research suggests that by combining imaging with analysis of monocyte/macrophage subsets in patients with GBM, we can enhance our understanding of the disease and assist in its treatment. We discovered a similarity in the macrophage composition between the TME and PB, and through association with imaging, we could interpret macrophages. In addition, we identified a predictive biomarker that drew more attention to immune suppression of patients with GBM.
Relief in Gastrointestinal Symptoms with Medical Marijuana Over 1 Year
Authors: Wallingford Matthew P. , Kelly Erin L. , Herens Allison , Hanna Daniel , Hajjar Emily , Worster Brooke
Published: May 2024

Introduction: Subjective improvement in gastrointestinal (GI) symptoms was assessed among patients using medical marijuana (MMJ). Methods: Participants completed surveys at 0 days, 30 days, 6 months, and 12 months with questions about the severity of their GI symptoms on a scale from 1 (mild) to 3 (severe). Results: In each survey, participants reported a significant decrease in GI symptom severity when using MMJ versus when not using MMJ (p < 0.05). The most common self-reported side effects from using MMJ were increased appetite (12–21.4%), fatigue (6–16.7%), anxiety (4–11.9%), cough (4–11.9%), headache (6–7.9%), and dry mouth (4–7.1%). Conclusion: In patients with chronic GI symptoms, MMJ may provide persistent symptom severity improvement. Limited product availability and mild to moderate side effects are factors to consider before trialing MMJ.
Effect of End-Stage Renal Disease Prospective Payment System on Utilization of Peritoneal Dialysis in Patients with Kidney Allograft Failure
Authors: Gardezi Ali I. , Yuan Zhongyu , Aziz Fahad , Parajuli Sandesh , Mandelbrot Didier , Chan Micah R. , Astor Brad C.
Published: May 2024

Introduction: The Center for Medicare and Medicaid Services introduced an End-Stage Renal Disease Prospective Payment System (PPS) in 2011 to increase the utilization of home dialysis modalities, including peritoneal dialysis (PD). Several studies have shown a significant increase in PD utilization after PPS implementation. However, its impact on patients with kidney allograft failure remains unknown. Methods: We conducted an interrupted time series analysis using data from the US Renal Data System (USRDS) that include all adult kidney transplant recipients with allograft failure who started dialysis between 2005 and 2019. We compared the PD utilization in the pre-PPS period (2005–2010) to the fully implemented post-PPS period (2014–2019) for early (within 90 days) and late (91–365 days) PD experience. Results: A total of 27,507 adult recipients with allograft failure started dialysis during the study period. There was no difference in early PD utilization between the pre-PPS and the post-PPS period in either immediate change (0.3% increase; 95% CI: −1.95%, 2.54%; p = 0.79) or rate of change over time (0.28% increase per year; 95% CI: −0.16%, 0.72%; p = 0.18). Subgroup analyses revealed a trend toward higher PD utilization post-PPS in for-profit and large-volume dialysis units. There was a significant increase in PD utilization in the post-PPS period in units with low PD experience in the pre-PPS period. Similar findings were seen for the late PD experience. Conclusion: PPS did not significantly increase the overall utilization of PD in patients initiating dialysis after allograft failure.
Abstract 19: Time-Varying Exposure to Food Retailers and Cardiovascular Disease Incidence and Mortality in the Netherlands: A Nationwide Prospective Cohort Study
Authors: Pinho Maria Gabriela M , Koop Yvonne , Mackenbach Joreintje , Lakerveld Jeroen , Simoes Mariana , Vermeulen Roel , Wagtendonk Alfred , Vaartjes Ilonca , Beulens Joline W
Published: May 2024

Background:
The food environment is suggested as a risk factor of cardiovascular disease (CVD), but current evidence is inconsistent and does not account for changes in the food environment. We aimed to explore if time-varying exposure to the food environment was associated with hospitalisation and mortality due to total and specific types of CVD in The Netherlands. We hypothesized that favourable time-varying trends in food environment exposure would be associated with decreased risk of CVD, stroke, heart failure (HF), and coronary heart disease (CHD) morbidity and mortality among the Dutch general population.

Methods:
A prospective cohort study was performed among all Dutch residents aged 35+ years who did not change residence in 2002-2018 without CVD in 2004, identified through registry data from Statistics Netherlands (n=4,641,435; 51.3% female, 91.2% Dutch). Time-varying Food Environment Healthiness Index (FEHI) scores (range: -5 to 5) and time-varying Kernel density of six specific food retailers (food delivery outlets, fast food outlets, restaurants, local food shops, supermarkets and convenience stores) around the home location were based on bi-annual updates between 2004-2018. Hospitalisation and mortality due to overall CVD, stroke, HF, and CHD occurring between 2004 and 2020 were used as outcomes, based on hospital and death registries. Models were adjusted for age, sex, ethnic origin, household composition, income, marital status and neighbourhood urbanisation level and effect modification by age, sex, urbanization and income was studied.

Results:
Each unit increase in the FEHI, representing a 10% improvement, was associated with a lower hospitalisation and mortality of CVD (hospitalization Hazard Ratio (HR
h
)=0.90, 0.89-0.91, mortality Hazard Ratio (HR
m
)=0.85, 0.82-0.89), CHD (HR
h
=0.88, 0.85-0.91, HR
m
=0.80, 0.75-0.86), stroke (HR
h
=0.89, 0.84-0.93, HR
m
=0.89, 0.82-0.98), and HF (HR
h
=0.90, 0.84-0.96, HR
m
=0.84, 0.76-0.92). Increased density of local food shops, fast food outlets, supermarkets and convenience stores, and decreased density of food delivery outlets and restaurants were associated with a higher risk of CVD, CHD, stroke and HF incidence and mortality, albeit with small effect sizes. Stratified analyses suggest slightly stronger associations in highly urbanized areas, younger adults and those with higher incomes.

Conclusions:
Favourable trends in time-varying food retailer exposure were associated with a risk reduction in CVD hospitalisation and mortality, in particular in urbanized areas and for younger adults and those with higher incomes.
Abstract 28: Social Dimensions of Sleep: An Exploration of Midlife Working-Class Women’s Experiences in Mexico
Authors: Zamora Astrid N , Roberts Elizabeth , Tellez-Rojo Martha , Peterson Karen , Torres Olascoaga Libni , Cantoral Alejandra , Jansen Erica C
Published: May 2024

Sleep, one of Life’s Essential 8, is vital to midlife women’s cardiovascular health (CVH). However, achieving healthy sleep is complex. As a first step, it is important to understand the barriers and facilitators to achieve adequate and high-quality sleep among midlife women in a context-specific manner. To comprehensively address this issue, we employed a mixed-methods approach to provide a nuanced understanding of the ecologies and experiences surrounding sleep health among working-class midlife women from Mexico City. First, we utilized existing epidemiologic data on participants to describe sleep and its correlates in a study population (n=120) of women enrolled in a cohort study via objective and subjective standard sleep measures. Then, we used thematic analysis to analyze in-depth ethnographic interview data (n=30) to characterize self-described barriers and facilitators of sleep. Our findings revealed that a substantial proportion of midlife women experienced poor sleep quality, with 53% reporting short sleep duration and 43% experiencing insomnia-related difficulties over seven days. Epidemiologic data suggested poor sleep outcomes were driven by age, type of work/occupation, food insecurity, mental health issues, and diabetes status. Our ethnographic interviews demonstrated that study participants perceived their familial relationships and responsibilities as the prominent barrier to quality sleep, encompassing challenges such as insufficient sleep due to family obligations and sleep disturbances triggered by family-related stressors. Combining these methodological approaches underscored the strong social dimension of sleep, where good sleep hinged on completing household tasks and attending to family needs. In response to sleep deficits, women frequently turned to caffeine consumption and occasional napping as coping mechanisms and described using sleep facilitators, including remedies like teas or other “natural” products. This study highlights the intricate social drivers of sleep, termed the “Sociality of Sleep,” among Mexican midlife women and may demonstrate how sleep recommendations and hygiene principles are likely inadequate in relation to the complex social dynamics of sleep. These insights provide evidence for considering the social context when tailoring recommendations that promote healthy sleep within this demographic. Furthermore, the combined methodology employed in this research may serve as a model for future sleep health studies.
Abstract MP08: Effects of Arm Position and Support on the Accuracy of Blood Pressure Readings: The Arm Rest and Support (ARMS) Trial
Authors: Liu Hairong , Sabit Ahmed , Zhao Di , Pathiravasan Chathurangi H , Ishigami Junichi , Charleston Jeanne , Miller Edgar R , Matsushita Kuni , Appel Lawrence J , Brady Tammy M
Published: May 2024

Background:
Based on studies using mercury sphygmomanometers, arm support is recommended when measuring blood pressure (BP) to keep the cuff at heart level and prevent flexion of arm muscles. Still, BP is commonly measured without arm support, e.g. with the arm resting on the lap or hanging on the side, and the impact when using automated BP devices is unknown.

Methods:
We conducted a randomized crossover trial of among community dwelling adults in Baltimore, MD. Participants were randomly assigned to sets of triplicate BP measurements with the arm positioned in 3 ways: supported on a desk (desk1 [reference]); hand supported on lap (lap), and arm hanging at side unsupported (side). To account for intrinsic BP variability, all participants underwent a 4th set of BP measurements with the arm supported on a desk (desk2). Between each set of triplicate measurements participants walked for 2 minutes, then rested for 5 minutes prior to BP measurement with a WelchAllyn ProB 2000, using an appropriately sized cuff. We conducted difference-in-difference analysis overall and stratified by baseline systolic BP (SBP≥ vs. < 130mmHg) and age (≥ vs. <60yrs)

Results:
N=134, mean age 56 (SD 17) years, 78% Black race, and 52% female. 48 participants had SBP ≥130mmHg, 53% were ≥60 years. Overall, mean desk1 and desk2 BP was 126/74 each (Δ= -0.12; Table). Lap and side were greater than desk1 (Table) with the difference in differences significantly greater for both conditions [lap: SBP Δ 3.8 mmHg (95% CI:2.5, 5.2)/ DBP Δ 4.1 (95% CI:3.1, 5.0); side: SBP Δ 6.4 (95% CI:5.0, 7.9)/ DBP Δ 4.6 (95% CI:3.6, 5.5)]. The patterns were generally consistent across subgroups by SBP and age.

Conclusion:
Commonly used arm positions, i.e. the arm resting on the lap or hanging on the side, resulted in substantial overestimation of BP reading when using an automated device which may lead to patient misdiagnosis and overestimation of the population prevalence of hypertension. Every effort should be made to optimize arm support, even in resource-limited settings.
Abstract MP16: Degree of Joint Risk Factor Control and Incident Chronic Kidney Disease Among Obese Individuals
Authors: Tang Rui , Kou Minghao , Li Xiang , Wang Xuan , Ma Hao , Heianza Yoriko , Qi Lu
Published: May 2024

Introduction:
Individuals who are obese are at a higher risk for chronic kidney disease (CKD) than the non-obese population.

Hypothesis:
We assessed the hypothesis that controlling joint risk factors might reduce the increased risk of CKD observed in participants with obesity.

Methods:
We included a total of 97,538 participants who were obese at baseline and matched 97,538 normal weight control participants from the UK Biobank in the analysis. The degree of joint risk factor control was assessed based on 6 major CKD risk factors, including blood pressure, hemoglobin A1c, low-density lipoprotein cholesterol, albuminuria, smoking, and physical activity. The Cox proportional hazards models were used to estimate associations between the degree of risk factor control and risk of CKD.

Results:
Among obese participants, joint risk factor control showed an association with a stepwise reduction of incident CKD risk. Each additional risk factor control corresponded to an 11% (HR: 0.89, 95%CI: 0.86-0.91) reduced risk of CKD among obese participants; with the optimal controlling of all six risk factors associated with a 49% (HR: 0.51, 95% CI: 0.43-0.61) decrease in risk of CKD. Furthermore, in obese individuals who jointly controlled all six risk factors, the excess risk of CKD associated with obesity was effectively neutralized compared to normal weight control subjects. Notably, the protective correlations between the degree of joint risk factor control and the incidence of CKD were more pronounced in men compared to women, in individuals with a lower healthy food score versus a higher score, and among diabetes medication users as opposed to nonusers (
P
for interaction=0.017, 0.033, 0.014 respectively).

Conclusion:
The joint risk factor control is associated with an inverse association of CKD risk in an accumulative manner among obese people. Achieving ideal control over risk factors may effectively counterbalance the excessive risk of CKD typically associated with obesity.
Abstract MP22: Age-Varying Implications of Recalibration of Cardiovascular Disease Risk Prediction in a New England-Based Healthcare System
Authors: Cho So Mi J , Rivera Rachel , Koyama Satoshi , Kim Min Seo , Ganesh Shriienidhie , Honigberg Michael C , Bhattacharya Romit , Paruchuri Kaavya , Allen Norrina B , Hornsby Whitney , Natarajan Pradeep
Published: May 2024

Introduction:
Atherosclerotic cardiovascular disease (ASCVD) risk estimation via the 2013 Pooled Cohort Equations (PCE) overestimates risk in population-based cohorts. We evaluated its recalibration performance in a contemporary healthcare cohort.

Methods:
We identified 160,926 patients in the Mass General Brigham healthcare system aged 40-79 years and without prior ASCVD or lipid-lowering medication use between 2010 and 2012. Recalibration was achieved using sex- and race-specific baseline survival and risk factor distributions of the derivation (80%) set. Internal validation compared Kaplan-Meier-adjusted observed and predicted risk based on original versus recalibrated PCE. Changes in sensitivity and specificity were calculated across various treatment thresholds for each age decile.

Results:
Of the 160,926 patients (mean [SD] age: 54.6 [8.6] years; 61.4% female; 82.7% non-Hispanic White), 20,373 (12.7%) underwent ASCVD over 10 years. The original PCE underestimated ASCVD risk (observed vs. predicted incidence rate: 0.13 vs. 0.05) globally and across all sex, race, and risk categories. After recalibration (observed vs. predicted incidence rate: 0.13 vs. 0.18), the prediction closely mirrored the actual ASCVD incidence in low-to-borderline risk but overestimated risk in the high risk. At ≥7.5% treatment threshold, patients aged 40-49 years derived the greatest net relative benefit (sensitivity: +42.9%; specificity: -26.6%) whereas the extent of specificity loss surpassed that of sensitivity gain beyond age 50 years with minimal reclassification by seventh decade in life. Treatment threshold yielding the greatest net benefit was incrementally higher with older age from ≥7.4% in age 40-49 years to ≥24.1% in 60-69 years.

Conclusion:
In healthcare setting, PCE significantly underestimated risk. Recalibration recovered sensitivity at the expense of reduced specificity in age-differential manner, highlighting the need for individualized prediction and clinical decision-making.
Abstract MP34: Association of Biological Age Acceleration With Incident Type 2 Diabetes and Coronary Artery Disease
Authors: Yang Guangrui , Zhong Victor W
Published: May 2024

Introduction:
Biological age (BA), compared to chronological age, offers a more accurate reflection of aging status and prediction of cardiometabolic disease mortality. Genetics play an important role in the pathogenesis of type 2 diabetes (T2D) and coronary artery disease (CAD). However, the associations of BA acceleration with incident T2D and CAD as well as how the interactions between genetic risk and BA acceleration implicate in the development of these two diseases remain unclear.

Hypothesis:
We hypothesized that BA acceleration was significantly associated with incident T2D and CAD. We further hypothesized that there were significant interactions between BA acceleration and genetic risk in relation to risk of T2D and CAD.

Methods:
This prospective cohort study utilized data from the UK Biobank. BA was quantified by KDM-BA and PhenoAge, two composite measures derived from blood chemistry and physical examination data. T2D and CAD were diagnosed using self-reported medical history, medication, and hospital inpatient records. Multivariable Cox proportional hazard models were employed to estimate the associations of BA acceleration with incident T2D and CAD. A polygenic risk score (PRS) for T2D or CAD divided into tertiles was used to assess the interactions between BA acceleration (divided into quartiles) and genetic risk with regards to the development of T2D and CAD. Derived estimates were hazard ratios (HRs) and their 95% confidence intervals (CIs) per one standard deviation increment in each of the two BA measures.

Results:
This study analyzed 271,855 participants without T2D and 267,293 participants without CAD at baseline. Over a median follow-up time of 14.6 and 14.5 years, 9,562 incident T2D events and 18,509 incident CAD events occurred, respectively. Individuals with greater BA acceleration were at increased risk of T2D (HR for KDM-BA: 1.42, [95% CI: 1.39-1.46]; HR for PhenoAge: 1.23, [95% CI: 1.20-1.25]). Similarly, BA acceleration was significantly associated with a higher risk of CAD (HR for KDM-BA: 1.22, [95% CI: 1.20-1.25]; HR for PhenoAge: 1.12, [95% CI: 1.10-1.14]). People with greater genetic risk and BA acceleration had higher risks of T2D and CAD (P for interaction < 0.002). Compared with participants with the lowest level of PRS and BA acceleration, those with the highest level of PRS and BA acceleration had a higher risk of developing T2D (HR for KDM-BA: 7.03, [95% CI: 6.16-8.02]; HR for PhenoAge: 6.39, [95% CI: 5.38-7.58]) and CAD (HR for KDM-BA: 2.83, [95% CI: 2.62-3.06]; HR for PhenoAge: 2.27, [95% CI: 2.09-2.46]).

Conclusions:
BA acceleration was significantly associated higher risks of T2D and CAD, especially among individuals with a high genetic predisposition to T2D and CAD.
Abstract MP56: Screening for Familial Hypercholesterolemia: School Based Programs May Be Best Alternative
Authors: Luckasen Gary J , Jenkins NaNet , Pollack Austin , Hamilton Landon D , Willis Meghan , Lueders Paige
Published: May 2024

Introduction:
Familial Hypercholesterolemia (FH) is an autosomal dominant condition characterized by elevated cholesterol and premature development of cardiovascular (CV) disease affecting 1/200 - 1/500 individuals. Only 10% of the affected population in the United States have been identified and treated compared to 50-70% in Scandinavian countries identified through school-based or universal screening programs.

Hypothesis Statement:
School based programs are the best mechanism for FH screening.

Methods:
The Healthy Hearts and Minds Program (HHM) through UCHealth performs biometric screenings on 5th, 7th, and 10th grade students in Northern Colorado. HHM tested 10,991 5th grade students (9/2017 - 5/2022) and identified 424 students with total cholesterol levels ≥200 mg/dL (range 200-302). A buccal smear test (APOB, LDLR, PCSK9) was performed on 99 individuals with the highest total cholesterol levels to identify genetic status. A binomial logistic regression model was used for analysis.

Results:
Of the 99 students, six tested positive (50% male, 10.3 years, 22.8 BMI) for FH with five (40% male, 11.3 years, 17.3 BMI.) reporting a variant of indeterminate significance. A sigmoidal association between total cholesterol and predicted chance of FH was identified with the inflection point at ~270 mg/dL.

Conclusions:
Comprehensive school based programs are the most effective and equitable means of identifying this genetic based disease and should be supported in a collaborative manner with health care systems, industry and the community. With availability to all students, diversity, equity, and inclusion concerns are addressed and provide at risk populations with personalized health information. The results from this study suggest a school-based screening program can be effective at identifying students most at risk for FH. These results further define the relation between total cholesterol and predicted chance of FH for a school-aged population where 245 mg/dL indicates a 10.3% of testing positive for FH whereas 275 mg/dL has a 54.8% chance. Additionally, the multiplier effect documented through cascade FH testing enhances the benefit of the information to other family members, as the autosomal dominant pattern insures that 50% of members will be at risk. The individual benefit of identifying FH early is the treatability of this condition. Early use of lipid lowering agents can make the CV disease risk equal to the general population. If left untreated, CV disease occurs approximately 10 years earlier which results in increased mortality and disability, along with increased health care costs. Therefore, if elevated cholesterol is present in school children, genetic testing is warranted and treatment considered by age 8-10 years, especially if signs of abnormal vascular plaquing is identified.
Abstract MP67: Estimated Health Impact, Cost, and Cost-Effectiveness of Mandating Sodium Benchmarks in Australia’s Packaged Foods
Authors: Marklund Matti , Trieu Kathy , Aminde Leopold , Cobiac Linda , Coyle Daisy , Huang Liping , Neal Bruce C , Veerman J. Lennert , Wu Jason H
Published: May 2024

Objectives:
To estimate the potential health impact, cost, and cost-effectiveness of Australia mandating either A) the World Health Organization’s (WHO) global sodium benchmarks or B) the currently non-mandatory national sodium reformulation targets.

Methods:
We used a multiple cohort proportional multi-state life table model to simulate the impact of the interventions on the adult (≥ 20 years) population. We estimated sodium intake in the base case (i.e., maintaining current sodium intake) and intervention scenarios, using nationally representative data on dietary intake, sodium levels in packaged foods, and food sales volume. Blood pressure and disease burden data were obtained from the Global Burden of Disease study. The effect of sodium reduction on blood pressure and disease risk was modelled using evidence from meta-analyses of randomized trials and prospective studies. Net costs, including implementation and healthcare costs, were used to calculate the incremental cost per health-adjusted life year (HALY) gained. Outcomes were discounted at 3%.

Results:
Compared to the base case scenario, mandating the WHO benchmarks was projected to be cost saving over the first 25 years (99% probability), with 19K deaths (95% uncertainty interval [UI]: 11-28), 138K incident CVD events (95% UI: 81-200), and 100K new CKD cases (95% UI: 60-150) averted (Figure). The intervention could generate around 76K HALYs (95% UI: 44-110) and save $770 million (95% UI: 118-1,715) in healthcare costs. Mandating the less comprehensive and less stringent national targets could also be cost saving (97% probability), but with only about 1/3 of the health benefits of to the WHO benchmarks (Figure).

Conclusions:
Our findings support mandating sodium thresholds for packaged foods as a cost-effective strategy to prevent death and disease in Australia. Making Australia’s voluntary reformulation targets mandatory may save thousands of lives, but mandating the WHO global benchmarks could generate substantially larger health gains.
Abstract P103: Alterations in Sarcopenia Index Are Associated With Inflammation, Gut and Oral Microbiota Among Heart Failure, Left Ventricular Assist Device and Heart Transplant Patients
Authors: Bohn Bruno , Yuzefpolskaya Melana , Ladanyi Annamaria , Pinsino Alberto , Braghieri Lorenzo , Carey Matthew , Clerkin Kevin , Sayer Gabriel T , Latif Farhana , Takeda Koji , Uriel Nir , Nandakumar Renu , Uhlemann Anne-Catrin , Colombo Paolo C , Demmer Ryan
Published: May 2024

Introduction:
Sarcopenia, characterized by loss of muscle mass and function, is prevalent in heart failure (HF) and associated with poor outcomes. We investigated alterations in sarcopenia index (SI), a surrogate marker of skeletal muscle mass, in HF, left ventricular assist device (LVAD) and heart transplant (HT) and assessed its relationship with inflammation and digestive tract (gut and oral) microbiota.

Hypothesis:
Sarcopenia will be associated with increased inflammation, dysbiotic microbial signatures, higher HF class, and earlier time post-HT or post LVAD.

Methods:
We enrolled 460 HF, LVAD and HT patients. Repeated measures pre and post procedures were obtained in a subset of LVAD and HT patients. Sarcopenia index (serum Creatinine/Cystatin C) and inflammatory biomarkers (C-reactive protein, interleukin-6, tumor necrosis factor-alpha) were measured in 271 and 622 blood samples, respectively. Gut and saliva microbiota were assessed via 16S rRNA sequencing among 335 stool and 341 saliva samples. Multivariable regression models were used to assess the relationship between SI and i) New York Heart Association class; ii) pre- vs. post-LVAD or HT; iii) biomarkers of inflammation and microbial diversity.

Results:
Median (interquartile range) ln-SI was -0.13(-0.32,0.05). Ln-SI decreased across worsening HF class, further declined within the 1-month after LVAD and HT and rebounded over time to the levels of symptomatic HF. Ln-SI demonstrated an inverse correlation with inflammation (r=-0.28, p<0.0001), and a positive correlation with gut (r=0.26, p<0.0001) and oral microbial diversity (r=0.24, p<0.0001). Presence of the gut taxa
Roseburia inulinivorans
was associated with increased SI.

Conclusions:
SI levels decreased in symptomatic HF and remained decreased long-term after LVAD and HT. SI levels covaried with inflammation, gut and oral microbiota in a similar fashion.
Abstract P105: Blood Lipids, Lipoproteins, and Apolipoproteins With Risk of Coronary Heart Disease: A Prospective Study Among Multi-Racial Populations
Authors: Deng Kui , Pan Xiong-Fei , Voehler Markus W , Cai Hui , Cai Qiuyin , Shu Xiao-Ou , Gupta Deepak K , Lipworth Loren , Zheng Wei , Yu Danxia
Published: May 2024

Background:
Blood lipids, such as total cholesterol (TC), LDL-cholesterol (LDL-C), and triglycerides (TG), are well-known risk factors for coronary heart disease (CHD). However, studies that examined the associations of circulating lipids and apolipoproteins carried by different lipoproteins with incident CHD remain limited, particularly among racially diverse populations.

Hypothesis:
Potential novel lipoprotein biomarkers, other than TC, TG, LDL-C, and HDL-C, are associated with incident CHD in diverse populations.

Methods:
We conducted nested case-control studies of CHD among White Americans (542 pairs;
n
=1084), Black Americans (622 pairs;
n
=1244), and Chinese adults (557 pairs;
n
=1114) drawn from the Southern Community Cohort Study and Shanghai Women’s and Men’s Health Studies. We examined the associations of 36 plasma lipids, lipoproteins, and apolipoproteins (measured by Bruker IVDr NMR platform) with incident CHD using conditional logistic regression, adjusted for sociodemographics, lifestyle, family history of CHD, and menopausal status (women only). Race-specific odds ratios (ORs) were pooled using fixed-effect meta-analysis.

Results:
TC, TG, LDL-C, and HDL-C were associated with incident CHD, with pooled ORs being 1.35, 1.31, 1.26, and 0.79 per 1-SD increase. Sixteen lipoprotein biomarkers showed larger effect sizes than those conventional lipids, with pooled ORs per 1-SD ranged from 1.37 to 1.59 and a negative OR of 0.77 (
Figure 1
); all associations were significant within each race. Significant associations were observed across subpopulations defined by sociodemographics, lifestyle, and status of obesity, diabetes, hypertension, and dyslipidemia, including among individuals with normal levels of TC, TG, LDL-C, and HDL-C.

Conclusion:
Our study identified several lipoprotein biomarkers (e.g., ApoB/ApoA1 ratio and LDL-TG) associated with incident CHD among multi-racial populations, suggesting potential clinical utility complementing the current lipid panel.
Abstract P110: Biomarkers of Atrial Fibrillation-Related Pathways and Left Atrial Structure and Function in an Overweight and Obese Population
Authors: Li Linzi , Romaguera Dora , Alonso-Gomez Angel M M , Toledo Estefania A , Alonso Alvaro
Published: May 2024

Background:
Blood biomarkers of atrial fibrillation (AF)-related pathways can characterize the atrial substrate promoting the development of AF. Exploring associations of blood biomarkers with left atrial (LA) structure and function could enhance our understanding of AF etiopathogenesis and inform AF prevention strategies.

Methods:
We studied 532 participants of the PREDIMED-Plus trial, a multicenter randomized trial in overweight and obese adults (55-75 years) with the metabolic syndrome in Spain. The trial objective was to test a lifestyle intervention for primary prevention of cardiovascular disease. At baseline, 3 and 5 years after randomization, these participants underwent transthoracic echocardiography and provided blood for serum biomarker measurements [propeptide of procollagen type I (PICP), high-sensitivity (hs) troponin T (hsTnT), hs C-reactive protein (CRP), 3-nitrotyrosine (3-NT), and N-terminal propeptide of B-type natriuretic peptide (NT-proBNP)]. Outcomes of interest included LA peak systolic longitudinal strain (LA PSLS), LA volume index (LAVi), LA function index (LAFi), and LA stiffness index (LASi). We performed cross-sectional and longitudinal analyses to evaluate relationships between log-transformed biomarkers and echocardiographic measurements using multiple linear regression and mixed models: 1) baseline biomarkers and LA outcomes; 2) baseline biomarkers and change in LA outcomes from baseline through year 5; 3) concomitant changes in biomarkers and LA outcomes from baseline to year 5.

Results:
The participants in this analysis had a mean age of 65 (SD 4.8) years, 40% females, and BMI of 32.2 (SD 3.3) kg/m
2
. At baseline, increased NT-proBNP was associated with worse LAVi (0.78 mL/m
2
, 95% CI 0.04, 1.52), LAFi (-3.61, 95% CI -6.75, -0.46), and LASi (0.02, 95% CI 0.00, 0.04). Higher baseline NT-proBNP was associated with a greater decrease in LA PSLS at year 3 (-0.82%, 95% CI -1.57, -0.06) but not year 5 (-0.01%, 95% CI -0.77, 0.75), and an increase in LASi at years 3 (0.04, 95% CI 0.01, 0.06) and 5 (0.02, 95% CI 0.00, 0.04). Over 5 years, larger elevation in NT-proBNP was associated with more decline in LA PSLS (-0.19%, 95% CI -0.35, -0.02) and more elevation in LAVi (0.28 mL/m
2
, 95% CI 0.10, 0.45) each year. PICP, hsTnT, CRP and 3-NT did not show consistently significant associations with LA outcomes at baseline and through 5 years.

Conclusion:
In an overweight and obese population, higher NT-proBNP was associated with LA volume enlargement and worsening LA function over 5 years. The implications of these findings for prevention and prediction of AF warrant further investigation.