bluuebunny/crossref_metadata_2025 huggingface dataset:
Road‐Type Classification with Deep AutoEncoder
Authors: Molefe Mohale E. , Tapamo Jules R.
Published: March 2023

Machine learning algorithms are among the driving forces towards the success of intelligent road network systems design. Such algorithms allow for the design of systems that provide safe road usage, efficient infrastructure, and traffic flow management. One such application of machine learning in intelligent road networks is classifying different road network types that provide useful traffic information to road users. We propose a deep autoencoder model for representation learning to classify road network types. Each road segment node is represented as a feature vector. Unlike existing graph embedding methods that perform road segment embedding using the neighbouring road segments, the proposed method performs embedding directly on the road segment vectors. The proposed method performs embedding directly on the road segment vectors. Comparison with state‐of‐the‐art graph embedding methods show that the proposed method outperforms graph convolution networks, GraphSAGE‐MEAN, graph attention networks, and graph isomorphism network methods, and it achieves similar performance to GraphSAGE‐MAXPOOL.
Classification of External Vibration Sources through Data-Driven Models Using Hybrid CNNs and LSTMs
Authors: Liang Ruihua , Liu Weifeng , Kaewunruen Sakdirat , Zhang Hougui , Wu Zongzhen
Published: March 2023

Excessive external vibrations could affect the normal functioning and integrity of sensitive buildings such as laboratories and heritage buildings. Usually, these buildings are exposed to multiple external vibration sources simultaneously, so the monitoring and respective evaluation of the vibration from various sources is necessary for the design of targeted vibration mitigation measures. To classify the sources of vibration accurately and efficiently, the advanced hybrid models of the convolutional neural network (CNN) and long short-term memory (LSTM) network were built in this study, and the models are driven by the extensive data of external vibration recorded in Beijing, and the parametric studies reveal that the proposed optimal model can achieve an accuracy of over 97% for the identification of external vibration sources. Finally, a real-world case study is presented, in which external vibration monitoring was carried out in a laboratory and the proposed CNN+LSTM model was used to identify the sources of vibration in the monitoring so that the impact of vibration from each source on the laboratory was analyzed statistically in detail. The results demonstrate the necessity of this study and its feasibility for engineering applications.
Molecular Characterization of Feline Chaphamaparvovirus (Carnivore chaphamaparvovirus 2) Firstly Detected in Dogs from China
Authors: Ji Jun , Cui Hao , Xu Shuqi , Xu Xin , Liu Qiang , Kan Yunchao , Xie Qingmei , Yao Lunguang
Published: March 2023

A new type of parvovirus known as feline chaphamaparvovirus (FeChPV) was discovered in the feces of shelter cats in Canada in 2019, and >50% of cats were reported to be infected with this virus. In this study, two FeChPV-positive samples were identified from the rectal swabs of 285 dogs with diarrhea but none in 50 healthy dogs. Whole genome sequences of these two FeChPV strains (OQ162042 and OQ162043) were amplified and compared with those of the two viruses originally discovered in Canada (IDEXX-1 and VRI849). The whole genome, NS1, and VP1 of the two FeChPV strains shared a high identity of 95.0%–97.8% nucleotide, 96.9%–98.6% amino acid (aa), and 97.2%–98.8% aa with the reported FeChPV strains, respectively. The phylogenetic tree of NS1 and VP1 revealed that two FeChPV strains, namely, CHN20201025 and CHN20201226, were closely clustered with the two FeChPV prototypes detected in Canada in a group. Moreover, CHN20201025 and CHN20201226 were obviously different from Carnivore chaphamaparvovirus 1 and were classified as Carnivore chaphamaparvovirus 2. This is the first study to report the identification of FeChPV in fecal samples from dogs in China, and the genetic analysis of the FeChPV, which was previously detected in Canadian cats, would improve our understanding of its host spectrum.
Forecasting the Effectiveness of COVID-19 Vaccination Using Vector Autoregressive with an Exogenous Variable: On the Cases of COVID-19 in Indonesia
Authors: Sukono Sukono , Ibrahim Riza Andrian , Riaman Riaman , Hertini Elis , Hidayat Yuyun , Saputra Jumadil
Published: March 2023

This study aims to forecast the COVID-19 spread in Indonesia involving vaccination factors using vector autoregressive with exogenous variables (VARX). The COVID-19 spread represented by active, recovered, and death case rate indicators acts as endogenous variables, while the COVID-19 vaccination represented by second-dose vaccination rates acts as exogenous variables. Because the sum of three COVID-19 spread indicators in one day is one, only two indicators with the highest correlation rates are involved in VARX modelling. The other indicator is practically projected by subtracting one from the sum of two indicator projection results. Based on the analysis results, the active and recovered case rates are two indicators chosen in VARX modelling. Using Akaike information criterion, the most suitable VARX model to project the case and recovered case rates are VARX (7, 1). This model is expected to help the Indonesian government project the COVID-19 spread in Indonesia.
Research on the Rate of Penetration Prediction Method Based on Stacking Ensemble Learning
Authors: Ren Yangfeng , Lu Baoping , Zheng Shuangjin , Bai Kai , Cheng Lin , Yan Hao , Wang Gan
Published: March 2023

ROP is an important index to evaluate the efficiency of oil and gas drilling. In order to accurately predict the ROP of an oilfield in Xinjiang working area, a ROP prediction model based on the historical drilling data of this working area was established based on stacking ensemble learning. This model integrates the

K

-nearest neighbor algorithm and support vector machine algorithm by stacking ensemble strategy and uses genetic algorithm to optimize model parameters, forming a new method of ROP prediction suitable for this oilfield. The prediction results show that the accuracy of ROP prediction by this method is up to 92.5%, and the performance is stable, which can provide reference for the optimization of drilling parameters in this oilfield and has specific guiding significance for improving the efficiency of drilling operations.
Attenuation of Strychnine-Induced Epilepsy Employing Amaranthus viridis L. Leaves Extract in Experimental Rats
Authors: Bharadwaj Aashish , Sharma Ashwani , Singh Talever , Pathak Devender , Virmani Tarun , Kumar Girish , Sharma Anjali , Alhalmi Abdulsalam
Published: March 2023

Objective. Epilepsy is one of the most prevalent neurological illnesses defined by periodic seizures with or without loss of consciousness caused by aberrant neural activity. There are many allopathic medications available for the treatment of epilepsy such as phenytoin (PHY), but the side effects are a major concern. Therefore, the present study involved the evaluation of the pharmacological significance of Amaranthus viridis L. extract (EAV) in the management of strychnine (STR)-induced epilepsy. Method. STR (3.5 mg/kg, i.p.) was injected into male rats 30 minutes after the pre-treatment of a standard drug (PHY: 20 mg/kg) and the two doses of EAV (EAV-200 and EAV-400 mg/kg, p.o.) to the respective groups to cause the convulsions. The anti-convulsant effect of EAV-200 and EAV-400 against STR-induced convulsion in rats was investigated in terms of convulsion onset, duration of convulsions, number of convulsions, and convulsion score. Furthermore, the mitochondrial function and integrity in the brain’s prefrontal cortex (PFC) were also estimated. Results. EAV-400 significantly increased the onset of convulsion from61.67±3.051to119.2±2.738and reduced the STR-induced duration of convulsions from144.8±3.582to69.17±3.736, number of convulsions from4.000±0.1592to1.533±0.1542, and convulsion score from5.000±0.3651to2.833±0.3073in rats. EAV-400 significantly attenuated the STR-induced decrease in the mitochondrial function and integrity of the rat PFC. In rats, EAV-400 significantly accelerated the onset of convulsions while decreasing the STR-induced duration, frequency, and score. Conclusion. Based on investigational findings, EAV-400 could be inferred to be a possible anti-epileptic option for the treatment of epilepsy of this plan in preclinical research.
Pubertal and Gonadal Outcomes in 46,XY Individuals with Partial Androgen Insensitivity Syndrome Raised as Girls
Authors: Guaragna-Filho Guilherme , Guerra-Junior Gil , Tadokoro-Cuccaro Rieko , Hughes Ieuan A. , Barros Beatriz A. , Hiort Olaf , Balsamo Antonio , Guran Tulay , Holterhus Paul M. , Hannema Sabine , Poyrazoglu Sukran , Darendeliler Feyza , Bryce Jillian , Ahmed S. Faisal , Quigley Charmian A.
Published: March 2023

Introduction: Although it was common in the 1970s–1990s to assign female gender of rearing to 46,XY infants with limited virilization of varying etiologies, including those with partial androgen insensitivity syndrome (PAIS), long-term data on outcomes for these individuals are sparse. Therefore, our goal was to use the power of an international registry to evaluate clinical features, surgical management, and pubertal data in patients with a molecularly confirmed diagnosis of PAIS who were born before 2008 and were raised as girls. Methods: The current study interrogated the International Disorders of Sex Development Registry for available data on management and pubertal outcomes in individuals with genetically confirmed PAIS who were raised as girls. Results: Among the 11 individuals who fulfilled the key criteria for inclusion, the external masculinization score (EMS) at presentation ranged from 2 to 6 (median 5); 7 girls underwent gonadectomy before the age of 9 years, whereas 4 underwent gonadectomy in the teenage years (≥ age 13). Clitoral enlargement at puberty was reported for 3 girls (27%) who presented initially at the time of puberty with intact gonads. In the 9 individuals (82%) for whom gonadal pathology data were provided, there was no evidence of germ cell tumor at median age of 8.1 years. All girls received estrogen replacement, and 8/11 had attained Tanner stage 4–5 breast development at the last assessment. Conclusion: In general, although it appears that female assignment in PAIS is becoming uncommon, our data provide no evidence to support the practice of prophylactic prepubertal gonadectomy with respect to the risk of a germ cell tumor.
Nutritional Status Assessment in Older Cancer Patients
Authors: Medeiros de Morais Cecília
Published: March 2023

Background & aims: Elderly cancer patients are at particularly high risk for malnutrition because both the disease and the old age threaten their nutritional status. The Global Leadership Initiative on Malnutrition (GLIM) released new universal criteria for diagnosing and grading malnutrition, but the validation of these criteria in elderly cancer population is not well documented. Our objective was to investigate the application of the GLIM criteria in nutrition assessment and survival prediction in elderly cancer patients. Methods: This retrospective cohort analysis was conducted on a primary cohort of 1192 cancer patients aged 65 years or older enrolled from a multi-institutional registry, and a validation cohort of 300 elderly cancer patients treated at the First Affiliated Hospital of Sun Yat-sen University. Patients considered at-risk for malnutrition based on the NRS-2002 were assessed using the GLIM criteria. The association between the nutritional status and patients' overall survival (OS) was then analyzed by the Kaplan-Meier method and a Cox model. A nomogram was also established that included additional independent clinical prognostic variables. To determine the predictive accuracy and discriminatory capacity of the nomogram, the C-index, receiver operating characteristic (ROC) curve and calibration curve were evaluated. Results: The percentage of patients considered “at-risk” for malnutrition was 64.8% and 67.3% for the primary and validation cohorts, respectively. GLIM-defined malnutrition was diagnosed in 48.4% of patients in the primary cohort and 46.0% in the validation cohort. In the primary cohort, patients at risk of malnutrition (NRS-2002 ≥ 3) showed a worse OS than those with a NRS-2002 < 3 (HR 1.34, 1.10-1.64; p = 0.003). Additionally, patients with GLIM-defined severe malnutrition (HR1.71, 1.37-2.14; p < 0.001) or moderate malnutrition (HR1.35, 1.09-1.66; p = 0.006) showed a significantly shorter OS compared to those without malnutrition. The nomogram incorporating the domains of the GLIM with other variables was accurate, especially for predicting the 1- and 2-year overall survival rates. Conclusions: The GLIM criteria can be used in elderly cancer patients not only to assess malnutrition, but also to predict survival outcome. The nomogram developed based on the GLIM domains can provide a more accurate prediction of the prognosis than existing systems.
Evaluation of Retinal Microvascular Features in Patients with Amblyopia Based on Optical Coherence Tomography Angiography: A Systematic Review and Meta-Analysis
Authors: Feng Kangchun , Yu Xuelin , Zhang Jingyue , Yang Zhenghua , Chen Xing , Kang Gangjing
Published: March 2023

Background: The performance of optical coherence tomography angiography (OCTA) in macular microvasculature of patients with amblyopia has been widely studied, but these studies have yielded different and controversial results. Objectives: The aim of this study is to investigate retinal microvascular features in patients with amblyopia undergoing OCTA. Methods: PubMed, Embase, and Web of Science were searched for published articles comparing the retinal microvascular features between individuals with amblyopia and controls until April 2022. The mean difference with a 95% confidence interval was used to assess continuous variables. Results: The analysis included 17 studies. The whole vessel density of the superficial capillary plexus (SCPVD) was lower in amblyopic eyes (AE) than in normal eyes (NE) in 3 × 3 mm2 scans, while the perifoveal vessel density of superficial and deep capillary plexus was lower in 6 × 6 mm2 scans. The whole, parafoveal vessel density of deep capillary plexus (DCPVD) and parafoveal SCPVD were lower in both scans. The comparison between AE and fellow eyes (FE) revealed no statistical difference in all quadrants except the parafoveal and perifoveal SCPVD and the foveal DCPVD. Additionally, SCPVD in all quadrants except the fovea and DCPVD in all quadrants except the parafoveal were higher in FE compared to NE. No significant difference was found in the foveal avascular area between AE and NE, AE and FE, or NE and FE. Conclusions: The retinal vessel density of superficial and deep capillary plexus in AE and FE was lower than in NE, and differences were more likely discovered using 6 × 6 mm2 scans. Consequently, OCTA might be explored as a diagnostic tool to identify and monitor patients with amblyopia.
The Application of the Proposed Sydney System for Reporting Lymph Node Cytopathology: A Five-Year Experience of an Academic Institution in South India
Authors: Shanmugasundaram Sakthisankari , Balasubramanian Nandhini Bala , Sundari Amirthakatesan Abinaya
Published: March 2023

Introduction: Fine needle aspiration biopsy (FNAB) is a routinely used investigation in the evaluation of lymph node pathologies. However, there exists a lack of uniformity in cytopathology reporting owing to the nonavailability of standard guidelines. Recently, a novel system for reporting lymph node cytopathology has been proposed. The present study aimed to analyze the utility of the proposed system in cytopathology reporting in our institution. Materials: FNABs of lymph nodes performed over a period of 5 years were categorized as per the proposed Sydney system. The diagnoses on cytopathology were correlated with histopathologic diagnoses to assess the diagnostic accuracy. The rate of malignancy (ROM) for each category was calculated. Results: A total of 747 lymph node FNABs were included in the study. Histopathology was available in 262 cases. ROM in categories I–V was 26.3%, 7.2%, 76.9%, 82.3%, and 100.0%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of FNAB when considering category L3 to represent benign cytopathology were 84.2%, 97.5%, 97.1%, and 86.2%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of FNAB when considering category L3 to represent malignant cytopathology were 92.56%, 95.08%, 94.9%, and 92.8%, respectively. Conclusion: The study substantiates the usefulness of the proposed Sydney system in lymph node cytopathology in enhancing better communication between clinicians and cytopathologists. The use of ancillary techniques like immunocytochemistry and flow cytometry will aid in arriving at a more precise diagnosis.
The Effect of Combined Phacoemulsification and Endo-Cyclophotocoagulation on Intraocular Pressure Fluctuation Assessed by the Water Drinking Test in Patients with Primary Open Angle Glaucoma
Authors: Mohammad Razali Amirah , Tang Seng Fai , Syed Zakaria Syed Zulkifli , Che-Hamzah Jemaima , Aung Tin , Othman Othmaliza , Md Din Norshamsiah
Published: March 2023

Introduction: The aim of this study was to assess the effect of phacoemulsification and endo-cyclophotocoagulation (phaco-ECP) on intraocular pressure (IOP) fluctuation as assessed by the water drinking test (WDT) in primary open angle glaucoma (POAG). Methods: This was a prospective observational study carried out at a tertiary referral centre. POAG patients on topical antiglaucoma medications and planned for phaco-ECP were recruited. WDT was performed before surgery and 6 weeks postoperatively by drinking 10 mL/kg of water in 5 min followed by serial IOP by Goldmann applanation tonometry measurements at 15, 30, 45, and 60 min. Mean IOP, IOP fluctuation (difference between highest and lowest IOP), IOP reduction, and factors affecting IOP fluctuation were analysed. Results: Twenty eyes from 17 patients were included. Baseline IOP was similar before (14.7 ± 2.7 mm Hg) and after (14.8 ± 3.4 mm Hg, p = 0.90) surgery. There was no difference in mean IOP (17.6 ± 3.4 mm Hg vs. 19.3 ± 4.7 mm Hg pre- and postoperative, respectively, p = 0.26) or peak IOP (19.37 ± 3.74 mm Hg vs. 21.23 ± 5.29 mm Hg, p = 0.25), albeit a significant reduction in IOP-lowering medications (2.2 ± 1.15 vs. 0.35 ± 0.93, p < 0.001) postoperatively. IOP fluctuation was significantly greater (6.4 ± 3.2 mm Hg vs. 4.6 ± 2.1 mm Hg, p = 0.015) with more eyes having significant IOP fluctuation of ≥6 mm Hg (11 eyes [55%] vs. 4 eyes [20%], p < 0.001) postoperatively. Factors that were significantly associated with increased postoperative IOP fluctuations were higher preoperative IOP fluctuation (β = 0.69, 95% CI 0.379–1.582, p = 0.004) and more number of postoperative antiglaucoma medications (β = 0.627, 95% CI 0.614–3.322, p = 0.008). Conclusion: Reducing aqueous production with phaco-ECP does not eliminate IOP fluctuation in POAG patients. The increase in postoperative IOP fluctuation suggests increased outflow resistance after phaco-ECP.
Alterations in Epidermal Biophysical Properties in Autistic Children
Authors: Wang Bin , Li You-Dong , Wang Zi-Yan , Zhao Jia-Qing , Zhang Guo-Qiang , Man Mao-Qiang
Published: March 2023

Autism is a neurodevelopmental disorder. Individuals with autism can exhibit multiple neurological symptoms such as deficit in social communication, restricted interests, and repetitive behaviors. Recent study showed that murine model of autism displays an increased transepidermal water loss (TEWL) and dry skin. But whether epidermal functions are also altered in children with autism is unknown. In the present study, TEWL, stratum corneum hydration, and skin surface pH were compared between children with autism (N = 56) and normal controls (N = 48). Our results showed that children with autism exhibited lower stratum corneum hydration levels, higher TEWL, and elevated skin surface pH in comparison to normal controls (p < 0.0001 for all). These results demonstrate that children with autism exhibit epidermal dysfunction.
Changes in Corticotropin-Releasing Factor Receptor Type 1, Co-Expression with Tyrosine Hydroxylase and Oxytocin Neurons, and Anxiety-Like Behaviors across the Postpartum Period in Mice
Authors: De Guzman Rose M. , Rosinger Zachary J. , Rybka Krystyna A. , Jacobskind Jason S. , Thrasher Christina A. , Caballero Aya L. , Sturm Kassandra L. , Sharif Massoud S. , Abbas Marawan S. , Parra Katherine E. , Zuloaga Kristen L. , Justice Nicholas J. , Zuloaga Damian G.
Published: March 2023

Introduction: Corticotropin-releasing factor and its primary receptor (CRFR1) are critical regulators of behavioral and neuroendocrine stress responses. CRFR1 has also been associated with stress-related behavioral changes in postpartum mice. Our previous studies indicate dynamic changes in CRFR1 levels and coupling of CRFR1 with tyrosine hydroxylase (TH) and oxytocin (OT) neurons in postpartum mice. In this study, we aimed to determine the time course of these changes during the postpartum period. Methods: Using a CRFR1-GFP reporter mouse line, we compared postpartum mice at five time points with nulliparous mice. We performed immunohistochemistry to assess changes in CRFR1 levels and changes in co-expression of TH/CRFR1-GFP and OT/CRFR1-GFP across the postpartum period. Mice were also assessed for behavioral stress responses in the open field test. Results: Relative to nulliparous mice, CRFR1 levels were elevated in the anteroventral periventricular nucleus (AVPV/PeN) but were decreased in the medial preoptic area from postpartum day 1 (P1) through P28. In the paraventricular hypothalamus (PVN), there is a transient decline in CRFR1 mid-postpartum with a nadir at P7. Co-localization of CRFR1 with TH-expressing neurons was also altered with a transient decrease found in the AVPV/PeN at P7 and P14. Co-expression of CRFR1 and OT neurons of the PVN and supraoptic nucleus was dramatically altered with virtually no co-expression found in nulliparous mice, but levels increased shortly after parturition and peaked near P21. A transient decrease in open field center time was found at P7, indicating elevated anxiety-like behavior. Conclusion: This study revealed various changes in CRFR1 across the postpartum period, which may contribute to stress-related behavior changes in postpartum mice.
Abstract 02: Intergenerational Socioeconomic Mobility is Associated With Adulthood All-Cause Mortality in the Hispanic Community Health Study/Study of Latinos
Authors: Whalen Adam M , Filigrana Paola , Perreira Krista M , Gallo Linda C , Kaplan Robert , Suglia Shakira F , Cai Jianwen , Llabre Maria M , Cordero Christina , Penedo Frank J , Lee David J , Daviglus Martha L , Pirzada Amber , Pichardo Margaret , Isasi Carmen R
Published: March 2023

Introduction:
Different patterns of socioeconomic mobility (SEM) across the life course may influence the risk of all-cause mortality in adulthood. Lifetime low socioeconomic status and downward social mobility may be associated with a higher risk of mortality.

Hypothesis:
SEM is associated with mortality, and persons with enduring intergenerational adversity or downward SEM have a higher risk of mortality compared to persons with enduring intergenerational advantage.

Methods:
This study included 13,459 participants, 18-74 years of age, from the Hispanic Community Health Study/Study of Latinos who participated in the baseline visit (2008-2011) and were not missing key covariate information. Socioeconomic position (SEP) was assessed as parental education in childhood (dichotomized at high school), and a 5-facet index of SEP in adulthood across education, income, employment status, longest held occupation type, and homeownership. The adulthood SEP index was dichotomized at the median value of 2 (range: 0-5). Childhood and adulthood SEP were then combined into a single 4-level measure of SEM (enduring advantage, upward mobility, downward mobility, and enduring adversity). Multivariable sampling weight-adjusted Cox proportional hazards regression was performed to estimate the association between SEM and all-cause mortality. Potential confounders included age, gender, Hispanic/Latino ethnic background, US nativity, years spent in the US, and study center, whereas alcohol and tobacco use, depression score, and BMI were considered potential mediators. Presence of mediation was assessed by calculating total and direct effects via modeling, then evaluating percent change from total to direct effects against a 10% guideline.

Results:
During the follow-up period of 2008-2019, 515 deaths were recorded. After adjusting for all potential confounders, a significant association was found between adulthood all-cause mortality and SEM overall (F = 7.62, p < 0.0001). Downward mobility had significantly higher hazard of death compared to enduring advantage (aHR: 1.81, 95% CI: 1.17-2.81), although upward mobility and enduring adversity groups were not significant. The direct effect for downward mobility was reduced after adjustment for potential mediators (aHR: 1.49, 95% CI: 0.96, 2.30).

Conclusions:
Socioeconomic mobility, specifically downward mobility, is associated with all-cause mortality among a diverse cohort of Hispanic/Latino individuals residing in the United States. This association shows evidence of mediation by clinical and behavioral characteristics.
Abstract 07: Cardiovascular Health and Environmental Justice Concerns of Exposure to Fine Particulate Matter: Insights From the Houston Methodist Outpatient Learning Health System Registry
Authors: Nwana Nwabunie , Makram Omar M , Javed Zulqarnain , Parekh Tarang , Al-Kindi Sadeer , Nicolas Charlie , Gullapelli Rakesh , Jones Stephen , Nasir Khurram
Published: March 2023

Air pollution remains a public health concern affecting cardiovascular outcomes. In particular, fine particulate matter measuring ≤ 2.5 μm (PM
2.5
) is associated with cardiovascular disease (CVD). Of important concern is the potential for this impact to fall disproportionately on communities of low-income and color. We assessed whether living in neighborhoods with environmental justice concerns of exposure to PM
2.5
(EJPM
2.5
) is associated with CV risk factor burden and CV health (CVH). Our cross-sectional study used data from approximately 1.07 million patients aged 18+ years in the Houston Methodist Outpatient Disease Learning Health System Registry (2016-2021). Linking to the US Environmental Protection Agency (EPA)-Environmental Justice Screen (EJScreen) Database, each patient was assigned an EJPM
2.5
index, and then categorized into 1 of 5 quintiles according to their geocoded residential census block group. Individuals with missing data (n=27221) were excluded. Logistic regression models were used to examine the association between EJPM
2.5
and CV risk factors and CVH. Poor CVH was defined as study participants with ≥ 3 CV risk factors.We included 1044382 patients (mean age 52.31, female 59%, NHB 14%, and 15% Hispanics). Overall, 18% (n=240286) had poor CV health. In our cohort, 27% (n=287077) of patients were exposed to worst PM
2.5
levels (5
th
quintile). Overall, those with worst environmental justice concerns to PM 2.5 (EJPM
2.5
) were associated with higher odds of HTN, DM, obesity and poor CVH. These associations were attenuated, but remain statistically significant accounting for clinical risk factors, demographics and socioeconomic factors.
Table
. Our findings demonstrate association between EJPM
2.5
and CVD risk factors/CVH. These robust findings support the need to prioritize environmental policies for reducing ambient pollution in communities of color and low-income as this may mitigate the CVD-associated health disparities in these communities
Abstract 08: Prevalence and Patterns of Cardiovascular Multimorbidity in Black and White Adults at Midlife: The Bogalusa Heart Study
Authors: Moukaled Shirine , De Anda-Duran Ileana , Potts Kaitlin , Fernandez Alonso Camilo , Bazzano Lydia A
Published: March 2023

Background:
Multiple chronic conditions, primarily of cardiovascular origins, are a major cause of disability, death, and health care spending. Cardiovascular multimorbidity is also associated with multiplicative risk of morality and substantially lower life expectancy, which may exacerbate health disparities. However, its impact in a rural and low socioeconomic community with a high proportion of minorities is understudied. We aimed to describe multimorbidity prevalence and patterns by race, sex, and socioeconomic status in a middle-aged, community-based cohort.

Methods:
We examined 1,298 Black (35%) and White (65%) individuals (mean age 48.17 ± SD 5.27 years; 59% female) from the Bogalusa Heart Study, a rural, community-based, longitudinal cohort in Bogalusa, Louisiana, between 2013 and 2016. Eight chronic conditions (CCs) selected based on CMS (Centers for Medicare & Medicaid Services) guidance were defined using data from self-reported medical history, medication use, and physiological or laboratory measures. We defined multimorbidity as the coexistence of two or more of these conditions. The prevalence of cardiovascular multimorbidity and the most commonly occurring dyads and triads were assessed by race, sex, and socioeconomic factors using chi-square tests.

Results:
We found that 70% of the 1,298 participants had ≥2 CCs, while 31% had ≥3 CCs. The most prevalent conditions were dyslipidemia (87.9%, n=1,141), hypertension (66.6%, n=864), and diabetes (19.7%, n=255). The prevalence of multimorbidity was higher in Black than in White (76.8%, n=344 vs. 66.5%, n=565; p<0.01) participants and higher in men than in women (73.6%, n=393 vs. 67.5%, n=516; p<0.02). Hypertension and dyslipidemia made up the most prevalent dyad (33.0%, n=413), while hypertension, dyslipidemia, and diabetes made up the most prevalent triad (9.4%, n=116). Multimorbidity prevalence was significantly higher among participants with government issued insurance compared to private insurance (80.7%, n=267 vs. 64%, n=427; p<0.001), and more common among lower income compared to higher income (74.6%, n=390 vs 65.4%, n=397; p<0.01), respectively.

Conclusion:
Cardiovascular multimorbidity is highly prevalent in midlife among participants of the Bogalusa cohort compared to national and even state-wide levels. These findings have critical public health ramifications and support the need to better study multiple CCs in rural, underserved populations to create tailored interventions that are effective among adults in their most productive years of life despite geographic and income barriers.
Abstract 10: Cumulative Ideal Cardiovascular Health During Young Adulthood and Premature Cardiovascular Events in Midlife
Authors: Lee Hokyou , Lee Hyeok-Hee , Kim Eunji , Cho So Mi Jemma , Kim Hyeon Chang
Published: March 2023

Introduction:
Data are lacking on the association between long-term cumulative achievement of ideal cardiovascular health (CVH) during young adulthood and midlife cardiovascular disease (CVD) events. We hypothesized that higher cumulative ideal CVH score during young adulthood is associated with lower risk of CVD events in midlife.

Methods:
We studied 230 959 participants of the Korean National Health Insurance health screening at index age 40 years without prior CVD. All participants underwent ≥3 (median, 7) health examinations, including Y0 at age 30, Y10 at age 40, and ≥1 visit in between. We defined a 10-year cumulative CVH score, calculated as the area under CVH score plotted against age from 30 to 40 years, based on the AHA’s “Life’s Simple 7” metric excluding diet (score 0-12 at each visit; cumulative score 0-120 over 10 years; Figure A). The primary outcome was composite CVD events, including myocardial infarction, stroke, heart failure, and CVD-related death.

Results:
During a median follow-up of 9.6 years after index age 40 years, 2180 CVD events occurred. Participants with higher cumulative CVH score before age 40 years had lower cumulative incidence of CVD events over the next decade (Figure B). After multivariable adjustment, each year lived with 1-point higher CVH score from age 30 to 40 years was associated with 3.5% lower hazard of CVD events after age 40 years (Figure C). Each 1-point higher CVH score maintained for 10 years was associated with 30% lower hazard of CVD events. The associations remained significant even when adjusted for midlife CVH (single-visit CVH score at index age 40 years). When stratified by midlife CVH, higher cumulative CVH score during young adulthood was associated with lower hazard of subsequent CVD events, irrespective of midlife CVH (Figure D).

Conclusions:
Cumulative attainment of ideal CVH during young adulthood, independently of midlife CVH, was associated with lower risk of premature CVD events in midlife, highlighting the importance of maintaining ideal CVH from an earlier age.
Abstract 18: Impact of Preeclampsia on Cardiovascular Risk Factors in Mothers and Newborns
Authors: Taageby Nielsen Sofie , Qvist Thomassen Jesper , Kamstrup Pia R , Nordestgaard Borge G , Sillesen Anne-Sophie , Tybjaerg-Hansen Anne , Bundgaard Henning , Iversen Kasper , Frikke-Schmidt Ruth
Published: March 2023

Introduction:
Preeclampsia is a multifactorial disease and a cause of maternal and neonatal morbidity and mortality. Women with preeclampsia have increased risk of cardiovascular diseases in later life. The impact on the offspring is, however, still uncertain. Lipid traits in newborns are considered to reflect the child’s own production.

Hypothesis:
We assessed the hypothesis that preeclampsia increases risk of future cardiovascular disease in both mother and offspring.

Methods:
For this purpose, we used the Copenhagen General Population Study comprising 59,571 women of which 1,365 had a diagnosis of preeclampsia to investigate the association between preeclampsia and risk of cardiovascular diseases. Further, we used the Copenhagen Baby Heart Study comprising more than 13,000 umbilical cord blood samples and assessed the impact of preeclampsia on atherogenic lipid traits in cord blood.

Results:
Age adjusted hazard ratios for preeclampsia versus no preeclampsia (95% CI) were 1.48 (1.13-1.94) for ischemic heart disease, 1.50 (1.07-2.12) for ischemic cerebrovascular disease, and 1.53 (1.22-1.91) for composite vascular disease. Corresponding multivariable adjusted hazard ratios (95% CI) were 1.31 (1.00-1.72), 1.44 (1.02-2.02), and 1.39 (1.11-1.74). Concentrations of non-HDL cholesterol, total cholesterol, LDL cholesterol, apolipoprotein B, and triglycerides in cord blood increased stepwise from no preeclampsia (n=11,221) to mild/moderate preeclampsia (n=253) to severe preeclampsia (n=104) (p for trends <0.0001 for non-HDL cholesterol, total cholesterol and LDL cholesterol; p for trend=0.0002 for apolipoprotein B; p for trend=0.003 for triglycerides). Multivariable adjusted odds ratios (95% CI) for preeclampsia versus no preeclampsia (reference) for cord blood concentrations above the 80
th
percentile were 2.09 (1.67-2.61) for non-HDL cholesterol, 1.58 (1.25-2.01) for total cholesterol, 1.72 (1.37-2.16) for LDL cholesterol, 1.38 (1.07-1.78) for apolipoprotein B, and 2.64 (2.07-3.35) for triglycerides.

Conclusion:
Women with preeclampsia had increased risk of future cardiovascular disease and lipid traits in umbilical cord blood of their offspring were elevated. This indicates that preeclampsia affects lipid metabolism during fetal life and potentially contributes to an increased risk of future cardiovascular disease in offspring of mothers with preeclampsia.
Abstract 20: Effect of Dietary Sodium Reduction in Chronic Kidney Disease Patients With Albuminuria: Results of a Randomized Trial
Authors: Mills Katherine T , Chen Jing , Nguyen Bernadette , He Hua , Dorans Kirsten S , Uwaifo Gabriel I , Kumbala Damodar , Appel Lawrence J , Whelton Paul K , He Jiang
Published: March 2023

Introduction:
Albuminuria, an early marker of kidney damage, is a risk factor for chronic kidney disease (CKD) progression, cardiovascular disease (CVD), and death. Dietary sodium is a risk factor for elevated blood pressure, CVD, and all cause-mortality. It is particularly important in patients with CKD due to increased salt-sensitivity. It is unclear if dietary sodium reduction is associated with reduced albuminuria.

Hypothesis:
A low sodium diet will reduce albuminuria in patients with CKD.

Methods:
The Sodium Lowering and Urinary Protein Reduction (SUPER) Trial was a randomized, parallel trial testing the effect of a 24-week dietary sodium reduction intervention compared to usual diet on albuminuria in 151 CKD patients with albuminuria. Participants were eligible if they had an estimated glomerular filtration rate (eGFR) of 30-90 mL/min/1.73 m
2
and an albumin-to-creatinine ratio (ACR) of 30-1,500 mg/g. Intervention group participants received a dietician-led behavioral change intervention targeting sodium intake <2,300 mg/day and those in the control group received no dietary intervention. Twenty-four hour urine samples and dietary recalls, blood pressure, weight, and questionnaire data was collected at baseline, 12 weeks and 24 weeks. Mixed effects models were used to examine the intervention effect.

Results:
Study participants were an average of 65.6 years old, 72% African American, and 48% women. Median baseline ACR was 180.3 mg/g in the intervention and 157.4 mg/g in the control group, respectively. Urinary sodium excretion was reduced by 15.5% and 0.0% in the intervention and control groups, respectively. Results for the primary and key secondary outcomes are presented in the Table.

Conclusions:
The dietician-led dietary sodium reduction intervention succeeded in significantly reducing dietary sodium and BP in patients with CKD and albuminuria. However, no significant differences were observed in ACR, albuminuria, or eGFR between treatment groups.
Abstract 24: Association of the Gut Microbiome With Kidney Function and Damage in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Authors: Peters Brandilyn A , Qi Qibin , Usyk Mykhaylo , Daviglus Martha L , Cai Jianwen , Franceschini Nora , Lash James P , Gellman Marc D , Yu Bing , Boerwinkle Eric , Knight Rob , Burk Robert D , Kaplan Robert C
Published: March 2023

Background:
The gut microbiome is altered in chronic kidney disease (CKD), potentially contributing to CKD progression and co-morbidities such as cardiovascular disease, but population-based studies of the gut microbiome across a wide range of kidney function and damage are lacking.

Methods:
In the Hispanic Community Health Study/Study of Latinos, gut microbiome was assessed by shotgun sequencing of stool (n=2,438; 292 with suspected CKD). We examined cross-sectional associations of estimated glomerular filtration rate (eGFR), urinary albumin:creatinine (UAC) ratio, and CKD with gut microbiome features, adjusting for covariates, and also stratified by diabetes status. Kidney trait-related microbiome features were interrogated for correlation with serum metabolites (n=700), and associations of microbiome-related serum metabolites with kidney trait progression were examined in a prospective analysis (n=3,635) (
Figure 1a
).

Results:
Higher eGFR was significantly associated with overall gut microbiome composition, greater abundance of species from
Prevotella
,
Faecalibacterium
,
Roseburia
, and
Eubacterium
, and microbial functions related to synthesis of long-chain fatty acids and carbamoyl-phosphate. Higher UAC ratio and CKD were related to lower gut microbiome diversity and altered overall microbiome composition only in participants without diabetes. Microbiome features related to better kidney health were associated with many serum metabolites (e.g., higher indolepropionate, beta-cryptoxanthin; lower imidazole propionate, deoxycholic acids, p-cresol glucuronide) (
Figure 1b
). Imidazole propionate, deoxycholic acid metabolites, and p-cresol glucuronide were associated with prospective reductions in eGFR and/or increases in the UAC ratio (
Figure 1c
).

Conclusions:
Kidney function is a significant correlate of the gut microbiome, while the relationship of kidney damage with the gut microbiome depends on diabetes status. Gut microbiome metabolites may contribute to CKD progression.
Abstract 25: Long-Term Trends of BMI During Childhood and Adolescence Modify the Association of DNA Methylation Change at TXNIP With Glucose Change During Midlife
Authors: Ma Hao , Wang Xuan , Li Xiang , Heianza Yoriko , Bazzano Lydia A , He Jiang , Chen Wei , Qi Lu
Published: March 2023

Background:
Thioredoxin-interacting protein (TXNIP) is a central master regulator of whole-body glucose homeostasis in humans; and DNA methylation (DNAm) at TXNIP has been identified to be related to diabetes. It remains unknown whether dynamic changes in DNAm at TXNIP are associated with glycemic changes; and whether early-life adiposity changes modify such association.

Hypothesis:
We hypothesized that dynamic changes in DNAm at TXNIP are associated with glycemic changes in midlife, and early-life adiposity changes may modify such association.

Methods:
A total of 594 Bogalusa Heart Study participants who had DNAm measurements at two time points in midlife were included in this study. Of them, 353 participants had at least 4 examinations of BMI during childhood and adolescence (aged 4–19 years). The area under the curve (AUC) was calculated as a measure of long-term burden (total AUC) and trends (incremental AUC) of BMI during childhood and adolescence.

Results:
We found 25.3% of participants showed greater than 5% DNAm change at TXNIP during a mean of 6.2 years follow-up. Increase in DNAm at TXNIP was significantly associated with decrease in FPG independent of cell-type composition and other covariates (
P
<0.001). Moreover, we found the increasing trend of BMI during childhood and adolescence significantly modified the above dynamic association. Each 1% increase in DNAm at TXNIP was associated with 2.90 (0.77) mg/dl decrease in FPG among participants with the highest tertile of incremental AUC of BMI, 0.96 (0.38) mg/dl decrease among those with middle tertile, whereas no significant association was observed among participants with the lowest tertile (
P
-interaction=0.003).

Conclusions:
Our results indicate that changes in DNAm at TXNIP are significantly associated with dynamics in FPG in midlife, and such association is modified by BMI changes during childhood and adolescence.
Abstract 26: Plasma Metabolomic Profile of Adiposity in Childhood: Gen3G Study
Authors: Semnani-Azad Zhila , Perron Patrice , Bouchard Luigi , Hivert Marie-France
Published: March 2023

Objective:
Childhood obesity is associated with long-term adverse outcomes including increased risk of cardiometabolic diseases. The integration of metabolomics in determining metabolites specific to excess adiposity could identify novel markers of adverse adiposity accumulation and insights into the pathogenesis of obesity-related outcomes, but investigations in childhood are limited. Thus, our aim was to identify metabolite networks associated with adiposity in childhood using gold-standard measurements.

Methods:
This study used cross-sectional data from 329 children at mid-childhood (age 5.3 ± 0.3 years) from the Gen3G prospective pre-birth cohort. We quantified 1,038 plasma metabolites including 798 annotated and 240 unannotated molecules. We measured adiposity using the gold-standard dual-energy X-ray absorptiometry (DXA), as well as skinfold, waist circumference and body mass index (BMI). We applied weighted-correlation network analysis to identify networks of highly correlated metabolites. Spearman’s partial correlations were applied to determine the associations of adiposity measures with metabolite networks and individual metabolites, adjusting for age and sex, with false discovery rate correction.

Results:
We identified a network of 23 metabolites (MEmagenta on Figure), primarily comprised of lipids (primary and secondary bile acids metabolism sub-pathways), that showed positive correlations with DXA total and truncal fat (ρ
adjusted
= 0.11 to 0.19), skinfold measures (ρ
adjusted
= 0.09 to 0.26), and BMI and waist circumference (ρ
adjusted
= 0.15 and 0.18, respectively). Within this network, glycol-alpha-muricholate and glycol-beta-muricholate metabolites, bile acid sub-species associated with glucose and lipid metabolism, appeared to be driving the associations. These correlations remained consistent when stratified by sex.

Conclusions:
A unique network of metabolites was associated with adiposity measures at 5 years of age.
Abstract 27: Genetic Risk of Blood Pressure on Antihypertensive Efficacy and Apparent Treatment Resistant Hypertension in Participants of the Genetics of Hypertension Associated Treatments (GenHAT) Study
Authors: Armstrong Nicole D , Srinivasasainagendra Vinodh , Parcha Vibhu , Pampana Akhil , Limdi Nita , Tiwari Hemant K , Arnett Donna K , Arora Pankaj , Irvin Marguerite M
Published: March 2023

Background:
Polygenic risk scores (PRS) have shown promise in complementing existing clinical risk factors and improving early diagnosis of cardiovascular disease. Recently, several studies have developed PRS for blood pressure traits; however, few have examined to what extent these PRS predict antihypertensive (AHT) efficacy.

Hypothesis:
We hypothesize that applying a systolic blood pressure (SBP) PRS developed and trained in multi-ancestral observational studies will predict response to chlorthalidone (CHL), as well as non-response to AHT treatment (apparent treatment resistant hypertension, aTRH), among African Americans (AA).

Methods:
We applied an optimized multi-ancestry PRS generated in a pooled Trans-Omics for Precision Medicine (TOPMed) cohort of >21,000 adults for SBP (PRS
SBP
) to 4,297 AA Genetics of Hypertension Associated Treatment (GenHAT) participants randomized to CHL as part of the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) with genome wide association study data. We then used linear regression to test the association of PRS
SBP
quintiles with CHL response (6 month BP - baseline BP) adjusting for age, sex, genetic ancestry, and baseline SBP. For the analysis of aTRH, cases were defined as individuals (a) treated with 3 different AHT classes, with average BP ≥140/90 mmHg at year 3 follow-up or (b) ≥4 AHT classes regardless of BP (cases, n=286). Treated controls were defined as individuals with BP <140/90 mmHg and on trial drug monotherapy at year 3 (n=2,391). Logistic regression models adjusting for age, sex, and genetic ancestry were used to calculate the odds ratio for aTRH comparing the highest and lowest quintile (Q5 and Q1, respectively).

Results:
The PRS
SBP
was associated with reduced SBP response in Q5 (-5.01 [-6.15, -3.87] mmHg) versus Q1 (-8.24 [-9.39, -7.09] mmHg) and Q2 (-7.25 [-8.39, -6.11] mmHg). In regard to aTRH, Q5 was nominally associated with higher odds of aTRH compared to Q1 (1.48 [1.00, 2.20]).

Conclusions:
We found that a general SBP PRS was associated with BP response in AAs from GenHAT. On average, a greater SBP reduction was found in participants at low genetic risk (Q1 or Q2) compared to the high risk (Q5) taking the same AHT. Similarly, when compared to participants in the bottom 20% of the distribution, those in the top 20% had increased odds of aTRH. Additional work using the PRS
SBP
in other ancestral populations, as well as developing novel AHT class treatment response PRS, is warranted and in progress to determine whether we can identify individuals who would benefit the most from specific AHT classes.