bluuebunny/crossref_metadata_2025 huggingface dataset:
Gut Microbiome: Profound Implications for Diet and Disease
Authors: Hills Jr. Ronald D. , Pontefract Benjamin A. , Mishcon Hillary R. , Black Cody A. , Sutton Steven C. , Theberge Cory R.
Published: April 2022

The gut microbiome plays an important role in human health and influences the development of chronic diseases ranging from metabolic disease to gastrointestinal disorders and colorectal cancer. Of increasing prevalence in Western societies, these conditions carry a high burden of care. Dietary patterns and environmental factors have a profound effect on shaping gut microbiota in real time. Diverse populations of intestinal bacteria mediate their beneficial effects through the fermentation of dietary fiber to produce short-chain fatty acids, endogenous signals with important roles in lipid homeostasis and reducing inflammation. Recent progress shows that an individual’s starting microbial profile is a key determinant in predicting their response to intervention with live probiotics. The gut microbiota is complex and challenging to characterize. Enterotypes have been proposed using metrics such as alpha species diversity, the ratio of Firmicutes to Bacteroidetes phyla, and the relative abundance of beneficial genera (e.g., Bifidobacterium, Akkermansia) versus facultative anaerobes (E. coli), pro-inflammatory Ruminococcus, or nonbacterial microbes. Microbiota composition and relative populations of bacterial species are linked to physiolog­ic health along different axes. We review the role of diet quality, carbohydrate intake, fermentable FODMAPs, and prebiotic fiber in maintaining healthy gut flora. The implications are discussed for various conditions including obesity, diabetes, irritable bowel syndrome, inflammatory bowel disease, depression, and cardiovascular disease.
Surgical Therapy in Patients with Colorectal Liver Metastases
Authors: Keck Jan , Gaedcke Jochen , Ghadimi Michael , Lorf Thomas
Published: April 2022

Background: Liver metastases (LM) occur in about 50% of patients with colorectal cancer. Besides the multimodal treatment of the primary tumor, the only way to cure patients with colorectal LM (CRLM) is complete resection. Different surgical procedures for this purpose are available depending on location, size, and number of LM. Additional concepts for patients with primary unresectable LM exist, ranging from Chemotherapy to induction of liver hypertrophy and even liver transplantation. This review intends to provide an overview of the surgical approach. Summary: Surgical options in the treatment of CRLM are defined and limited by their intraparenchymal location and their proximity to major vessels and intrahepatic bile ducts. Lesions located in the periphery can be excised in a parenchymal sparing fashion with a small tumor-surrounding resection margin of healthy liver parenchyma. If this is not possible, anatomical resections based on segmental boundaries are performed. In these cases, a sufficient functional volume of liver parenchyma after resection (future liver remnant volume [FLRV]) has to be preserved. This FLRV depends on various factors such as bodyweight and possible preexisting liver damage, such as cirrhosis, fibrosis, or chemotherapy-induced liver impairment. Liver hypertrophy via partial occlusion of the portal venous system is a standard procedure for patients with primary unresectable LM to increase FLRV. Furthermore, discussion of liver transplantation in cases of unresectable LM is gaining importance again. A combination of surgery and adjuvant and/or neoadjuvant chemotherapy may be indicated in individual cases, but general evidence-based recommendations cannot be given without further studies. Key Messages: Surgical removal of all metastases represents the only option of a potentially curative treatment of UICC stage IV colorectal carcinoma with liver involvement. An interdisciplinary approach consisting of chemotherapeutical downsizing and hypertrophy of the FLRV offers potential curative treatment for patients with initially unresectable metastases. For all others, liver transplantation is seeing a revival showing promising results in overall survival compared to chemotherapy alone.
Potential of Thymus and Activation-Regulated Chemokine (TARC) as a Prognostic Biomarker of Food Protein-Induced Enterocolitis Syndrome (FPIES) Caused by Egg Yolk
Authors: Makita Eishi , Sugawara Daisuke , Kuroda Sae , Itabashi Kae , Hirakubo Yuka , Nonaka Kazuhito , Ichihashi Ko
Published: April 2022

Background: Several recent studies have reported egg yolk-associated food protein-induced enterocolitis syndrome (FPIES) in Japan. We previously reported the usefulness of post-emetic thymus and activation-regulated chemokine (TARC) levels for the diagnosis and evaluation of symptom severity in FPIES caused by solid foods including egg yolk. However, there are no studies on the usefulness of TARC as a prognostic biomarker. Objective: The aim of the study was to evaluate the post-emetic TARC levels, clinical symptoms, and post-index event results of the egg yolk oral food challenge test (OFC), and retrospectively investigate predictive factors of the subsequent OFC result. Method: This retrospective study included 12 patients with egg yolk FPIES. The following long-term management protocol for egg yolk FPIES was mandatory for study inclusion: Patients visited the emergency department, met the diagnostic criteria of FPIES, and underwent an egg yolk OFC 6–12 months after complete elimination of egg yolk. If the result of the OFC was positive, the patient underwent the OFC every year until it was negative. We analyzed a total of 20 episodes (12 department visits and eight positive OFCs). The blood test data, including post-emetic TARC level and symptom severity, were compared between the next-OFC-positive group and the next-OFC-negative group. In addition, tolerance development over follow-up was analyzed. Results: The median (range) ages of the next-OFC-positive and negative groups were 11 (6–33) and 10 (7–21) months, respectively. The median (range) serum TARC (pg/mL) level was 5,208 (2,009–8,147) in the next-OFC-positive group, which was significantly higher (p = 0.004) than that in the next-OFC-negative group, which was 1,803 (905–3,754). There were no significant differences in other hematological results. The next-OFC-positive group had greater severity compared to the next-OFC-negative group (p = 0.026). The remission rate was approximately 30% at 24 months and 80% at 36 months. Conclusion: Post-emetic TARC levels may predict the short-term prognosis of egg yolk FPIES after approximately 1 year and could be useful for the management of egg yolk FPIES.
Diálogos impertinentes: arte e censura no modernismo brasileiro
Authors: Costa Maria Cristina Castilho , Sousa Junior Walter de
Published: April 2022

A primeira ideia que esse livro traz é que é a arte que se configura como o principal traço de nossa humanidade, de uma evolução que nos diferenciou dos demais primatas e transformou-nos em seres que, como disse Michel Foucault, são feitos de linguagem e expressão. Em segundo lugar, discute-se a ideia expressa por Sigmund Freud quando afirma que, na história da humanidade, estabeleceu-se a luta entre a força reprodutora da natureza e a expressão transgressora da arte, um embate sem tréguas cuja finalidade consistiu sempre em saber o que prevalece – a repetição ou a inovação, a liberdade ou a ordem, Eros ou Tanatos. Em terceiro lugar, este livro trata do Brasil, como um país que passou por séculos de colonialismo – essa condição que, assim como a censura, é repressora da liberdade, da criatividade, do desenvolvimento e da emancipação. Os autores esperam que, com essas ideias, esta obra possa reafirmar a importância da arte para a formação cultural de um povo, assim como mostrar que a censura é uma força contra a emancipação, a renovação e a transformação.
Axé, é o que é
Authors: Santos Ana Clara Sousa Damásio dos
Published: April 2022

“Axé, é o que é” é um ensaio visual que busca apresentar mundos imaginados, vividos, sentidos, chorados e experimentados através do desenho. Esse último, se apresenta como um espaço de diálogo com seres materiais, imateriais, com o que escapa aos olhos, as cores e algumas racionalidades.
A cigana e a Universidade
Authors: Scorsolini-Comin Fabio
Published: April 2022

Com o objetivo de problematizar o modo como os saberes podem ser transmitidos pela oralidade, pelo corpo e pela experiência, dentro e fora dos espaços rituais, este artigo parte do caso de uma médium de umbanda do interior de São Paulo. Com 53 anos, atua como vendedora autônoma em espaços como os de uma Universidade pública, sendo conhecida como “Cigana”. Depois do trânsito por alguns terreiros em busca de conhecimentos sobre suas experiências espirituais desde a adolescência, passa a se desenvolver mediunicamente no terreiro em que este caso foi observado. Neste espaço vivencia através do corpo diversas orientações, ocupando inicialmente a posição de cambona (ajudante) e dialogando com os saberes transmitidos pela comunidade, sobretudo pelo pai de santo. A partir dos endereçamentos do caso, discute-se, analogamente, de que modo a transmissão de conhecimentos orais e de profunda sustentação no e pelo corpo são eminentemente apartadas da formação oferecida na Universidade.
Salmo 4: poesia hebraico-bíblica e religiosidade
Authors: Leite Eliathan Carvalho
Published: April 2022

A poesia hebraico-bíblica é repleta de elementos litúrgicos e doxológicos que refletem a religiosidade dos adoradores. O presente trabalho busca explorar os temas e sentidos registrados no Salmo 4, tomando como base o “Método de Análise Total” e a “Intertextualidade sincrônica”, desenvolvidos a partir de Weiss (1984) e Bakhtin (2006), e trabalhados por Buber (1994) e Kristeva (1969), respectivamente. Preliminarmente, uma sintética revisão bibliográfica é feita para apresentar a percepção geral que se tem do Salmo. A seguir, a análise baseia-se em três seções: análise dos aspectos poético-literários presentes no texto, análise macroestrutural e síntese dialógica. Em suma, nota-se que o Salmo estabelece um diálogo entre três figuras cósmicas. As estrofes são delimitadas a partir do uso flexionado de tais pessoas do discurso e elementos de diversos contextos – jurídico, pactual, etc. – são evocados mediante uso de vocabulário específico, estabelecendo uma expressão de religiosidade comum ao livro de Salmos.
Os terreiros de Jarê de Lençóis - BA
Authors: Zanardi Paula Pflüger
Published: April 2022

Ensaio fotográfico realizado no contexto do projeto “Memória das Cantigas do Jarê”, site elaborado entre janeiro e abril de 2021. As fotografias apresentam as principais lideranças religiosas do Jarê de Lençóis e seus Pejis.
Revelando a performance ritual nos Goeku: narrativas fotográficas, fotografias narradas
Authors: Elias Alexsânder Nakaóka
Published: April 2022

Este artigo pretende revelar as nuances das cerimônias póstumas realizadas pela escola budista japonesa Honmon Butsuryu-shu (HBS), a primeira a se estabelecer no Brasil, no ano de 1908. O referido ritual de passagem, denominado “Goeku” (“Culto Póstumo” ou “Culto aos Antepassados”), é constituído por performances realizadas pelos sacerdotes/sacerdotisas e adeptos (fiéis), que abarcam um amplo espectro de relações entre humanos e não-humanos, além de um conjunto de elementos simbólicos composto por objetos sagrados, gestos, orações, posturas e instrumentos musicais. Portanto, pretendo elucidar tais cerimônias a partir das interlocuções estabelecidas junto com a HBS, que resultaram na confecção de cadernos de campo e em ricas narrativas orais. Além da verbalidade (oral e escrita), o intuito será o de dar a ver tais cerimônias por meio de fotografias, pelo fato das imagens destacarem-se pela capacidade de captar e expor, por uma via mais sensorial, as complexas formas de expressão presentes nos rituais.
Abstract 001: Association Between Acculturation Level And Cardiovascular Risk Factor Prevalence Among Asian American Subgroups
Authors: Li Yuemeng , Zhu Alicia , Le Austin , Singh Jaiveer , Dan Shozen , Palaniappan Latha , Srinivasan Malathi , Elfassy Tali , Valero Elizondo Javier , Yang Eugene
Published: April 2022

Introduction:
Limited disaggregated Asian subgroup data exist on the association between cardiovascular (CV) risk factors and acculturation level.

Hypothesis:
The association between acculturation levels and CV risk factors will differ by Asian subgroups.

Methods:
We used the National Health Interview Survey, a nationally representative US survey, years 2014-18. Acculturation was defined using the sum of: (a) years in the US (b) citizenship (c) English proficiency. An acculturation index was created and categorized as low, moderate, or high (scores of 0-1, 2 and ≥ 3, respectively). Self-reported risk factors included high cholesterol, obesity, tobacco use, physical activity level, diabetes and hypertension. Age-adjusted, weighted proportions were used to compare the prevalence of CV risk factors between Asian subgroups using Rao-Scott Chi Square.

Results:
Study sample consisted of 10,891 adults, representing 7.5 million US adults ≥ 18 years (46 % male; mean age 48.3 [SD 15.7]). The distribution by race/ethnicity was Asian Indian 15.1%, Chinese 12.9%, Filipino 10.2%, other Asian 18.2%, and NHW 43.7%. We found a positive association between prevalence of high cholesterol and acculturation level among all Asian subgroups, with increases of 50 to 90% when comparing low vs high acculturation (
Table
). Filipinos had a higher prevalence of obesity and tobacco use associated with higher acculturation level (p< 0.05), but this was not observed among other Asian subgroups. In contrast, physical activity levels were higher among Asian subgroups with higher acculturation levels. No differences were seen for prevalence of hypertension or diabetes based on acculturation level.

Conclusion:
This study demonstrates that acculturation level was associated with higher prevalence of CV risk factors with significant variability among Asian subgroups. It highlights the need for more studies to better understand these differences based on acculturation level and can help inform targeted, culturally specific interventions.
Abstract 010: Longitudinal Impact Of Glucose Homeostasis On Cardiac Structure And Function: Results From The Echocardiographic Study Of Latinos- 2 (echo-sol-2)
Authors: Chavez Patricia , April-Sanders Ayana K , Lee Un Jung , Cai Jianwen , Ponce Sonia , Allison Matthew A , Talavera Gregory A , Kansal Mayank M , Daviglus Martha L , Ostfeld Robert , Schneiderman Neil , Sotres-Alvarez Daniela , Corsino Leonor , Rodriguez Carlos
Published: April 2022

Introduction:
We assessed whether a longitudinal association between change in glucose homeostasis and change in cardiac structure and function was present.

Methods:
Data from ECHO-SOL baseline and visit 2 exams were used including 1643 Hispanic/Latino participants aged 45-74 years with serial echocardiograms obtained on average 4.3 (2.8-6.7) years apart. Glucose hoemostasis was evaluated through fasting plasma glucose levels (FGP), 2 hour oral glucose tolerance test (OGTT) and hemoglobin A1C (A1C) . Glucose homeostasis was categorized as: normal glucose tolerance (NGT) (FPG<100 mg/dL, 2hr OGTT <140 mg/dL, or A1C <5.7%), prediabetes (PDM) (FPG 100–125 mg/dL, or 2h OGTT 140–199 mg/dL, or A1C 5.7–6.4%); among those with self-report of diabetes or currently taking diabetes medicine: controlled diabetes (CDM) (A1C<7), and uncontrolled diabetes (UDM) (A1C>7). Linear regression models were used to examine associations between change in glucose homeostasis [worsening (NGT to PDM, NGT to DM, PDM to DM, CDM to UDM) vs unchanged] with changes in left ventricular mass (LVM), relative wall thickness (RWT), ejection fraction (EF), global longitudinal strain (GLS) and E’ velocity. All analyses were weighted to account for the complex survey design.

Results:
At baseline (mean age 56.4 years ±0.35; 45.4% male), glucose regulation was as follows: NGT (29.1%), PDM (51.8%), CDM (9.2%) and UDM (9.9%). At visit 2, glucose downregulation was as follows: NGT to PDM (55.9%), NGT to DM (13.4%), PDM to DM (27.4%), CDM to UCDM (33.5%). Among those with worsening glucose homeostasis the average age was 55.2 ±0.50 years, 45.7% were male, FPG was 99.4±0.90mg/dL . Change from NGT to PDM compared to remaining at NGT was associated with increase LVM (b=4.0 ±0.9, p<0.001), worsening in GLS (b=0.6 ±0.1, p<0.001) and decrease in E’ velocity (b=-1.1 ±0.1, p<0.001). Neither change from NGT to DM nor from PDM to DM was associated with significant changes in cardiac structure and function. Change from CDM to UDM was associated with increase in RWT (b=0.1 ±0.0, p<0.05), compared to those with unchanged CDM. Worsening glucose homeostasis from any group was not associated with changes in EF.

Conclusions:
Early stages of worsening glucose homeostasis were associated with cardiac structural and functional changes. Identification of those at risk of developing prediabetes may provide opportunities to prevent future cardiac dysfunction.
Abstract 039: Association Of A Cumulative Exposure To Sleep Disordered Breathing From Childhood Through Young Adulthood With Carotid Intima-media Thickness
Authors: Fernandez-Mendoza Julio , Gao Zhaohui , Vachhani Baadal , Brandt Kristen , Shah Kreesha , Liao Jason , He Fan , Calhoun Susan , Vgontzas Alexandros N , Liao Duanping , Bixler Edward O
Published: April 2022

Introduction:
Commensurate with studies in middle-aged adults, we have previously shown that a cumulative exposure to sleep disordered breathing (SDB) since childhood is associated, independent of obesity, with endothelial dysfunction in young adulthood. There is a lack of population-based studies that have examined the association of SDB with atherosclerosis using such a developmental approach.

Hypothesis:
Exposure to SDB since childhood is associated with long-term increased carotid intima-media thickness (CIMT) in young adulthood.

Methods:
We tested this hypothesis in a subsample of the Penn State Child Cohort, a population-based study of 700 children (median age 9y), of whom 421 were followed-up 7.4 years later during adolescence (median age 16y), and 204 have been followed-up 15.4 years later during young adulthood (median age 24y). Subjects (53% female, 23% racial/ethnic minority) underwent in-lab polysomnography to ascertain the apnea/hypopnea index (AHI) at all three time points, and ultrasound to assess CIMT in young adulthood. Based on the AHI truncated at ≥5 events/hour of sleep to include subjects already on positive airway pressure therapy, we averaged the exposure to AHI over the three time points (cAHI). The study outcome was total CIMT from right and left carotids as a continuous measure. Stepwise linear regression models first adjusted for sex, age, race/ethnicity, and length of follow-up and, thereafter, for body mass index (BMI). To test the robustness of the analysis, we applied the same linear models with the square root of CIMT (sqrt-CIMT) as the outcome.

Results:
The mean cAHI was 1.16 (standard deviation=0.99) ranging from 0 to 5 and the mean CIMT was 0.51 (0.07) ranging from 0.37 to 0.79. Although cAHI was positively associated with higher CIMT in young adulthood (β = 0.015; 95% CI = 0.005, 0.025; p = 0.003), the association was significantly diminished after further adjusting for BMI (β = 0.004; 95% CI = -0.004, 0.014; p = 0.424). The results were similar when using sqrt-CIMT (β = 0.010; 95% CI = 0.004, 0.017; p = 0.002 before BMI adjustment; β = 0.003; 95% CI = -0.004, 0.010; p = 0.415 after BMI adjustment).

Conclusions:
In contrast to endothelial dysfunction, the preliminary data of this ongoing longitudinal study indicates that obesity plays a key role in the association between SDB and atherosclerosis in young adulthood.
Abstract 052: Social Determinants Of Health And Uncontrolled Blood Pressure In A National Cohort Of Black And White US Adults
Authors: Akinyelure Oluwasegun P , Jaeger Byron C , Oparil Suzanne , Carson April P , Safford Monika , Howard George , Muntner Paul , Hardy Shakia T
Published: April 2022

Background:
Hypertension and uncontrolled blood pressure (BP) are the largest contributors to racial disparities in life expectancy. Determining the contribution of social determinants of health (SDOH) to racial differences in uncontrolled BP could help identify ways to achieve the American Heart Association’s 2030 impact goal of equitably improving healthy life expectancy.

Methods:
We analyzed data from 7,497 Black and 7,306 White US adults taking antihypertensive medication from the REasons for Geographic and Racial Differences in Stroke study to determine the association between SDOH and uncontrolled BP. SDOH were defined using the Healthy People 2030 domains of education, economic stability, social context, neighborhood environment and healthcare access. Uncontrolled BP was defined as systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg.

Results:
Among participants taking antihypertensive medication (mean age 66.3 years, 50.7% Black, 57.1% female), 68.0% of Black and 59.0% of White participants had uncontrolled BP. After multivariable adjustment, uncontrolled BP (prevalence ratio; 95% CI) was more common among those with less than a high school education (1.06; 1.02 – 1.09), annual household income <$20,000 (1.12; 1.06 – 1.18) and $20,000 to <$35,000 (1.09; 1.04 – 1.15) versus ≥$75,000; without health insurance (1.08; 1.03 – 1.14) and residing in a disadvantaged neighborhood (1.04; 1.01 – 1.07), a zip code with high poverty (1.03; 1.00 – 1.07) or a health professional shortage area (1.07; 1.05 – 1.10). For each SDOH, the proportion of participants with uncontrolled BP was higher among Black compared with White adults. After multivariable adjustment, having a higher number of adverse SDOH was associated with a higher prevalence of uncontrolled BP among both Black and White adults (Table).

Conclusion:
SDOH were associated with uncontrolled BP among both Black and White adults taking antihypertensive medication.
Abstract 061: Social Determinants Of Health And Ambulatory Outcomes Among Covid-19 Positive Patients: Differences By Race/ethnicity
Authors: Alvarez Luisa , April-Sanders Ayana K , Lee Un Jung , Golestaneh Ladan , Bellin Eran , Rodriguez Carlos
Published: April 2022

Background:
COVID-19 has shined a bright light upon the existing socioeconomic and health disparities in the United States. The objective of this study was to assess whether there are racial/ethnic differences in the association between social determinants of health (SDOH) with hospitalization and mortality among COVID+ patients.

Methods:
We identified a cohort of 505,992 patients receiving ambulatory care at Bronx Montefiore Health System (BMHS) between 1/1/18 and 1/1/20 to evaluate SDOH factors associated with hospitalization (n=2,934) and death (n=748) in a COVID time-period (3/1/20-8/15/20). SDOH indicators were collected from US county-level data from the American Community Survey (ACS), and included percent poverty, education, without insurance, using public transportation, and average household size. Socioeconomic status (SES) index scores were calculated based on the Diez Roux method and reported as standard deviations from New York State mean, with lower scores indicating worse neighborhood-level SES. Ambulatory outcomes included hospitalization and in-hospital mortality (model responses: 1=yes, 0=no). Multivariable logistic regression models were adjusted for age, sex, and comorbidities.

Results:
Overall, the cohort was comprised of Hispanic (38%), Black (27%), White (6.4%), and Other (26%) racial/ethnic groups with a mean age of 38.5 years (SD=24.6), and 60% female. Of the 1,755 (3.5%) patients who were COVID+ and hospitalized, 24.5% died. The average SES index was -2.39, with best SES among White patients (-1.05) and worst among Hispanic patients (- 3.57). Average % use of public transportation was common among Black (59.5±11.2), Hispanic (62.4±11.6), and Other (60.1±12.8) patients, with lower use among Whites (48.2±15.7). Average household size ranged from 2.6±0.4 persons among Whites to 2.8±0.4 among other racial/ethnic groups. SDOH factors were associated with both hospitalization and mortality among COVID+ patients and varied by race/ethnicity. Among White COVID+ patients, greater use of public transportation was associated with higher odds of hospitalization (OR=1.02, 95% CI: 1.01, 1.04). Greater average household size was associated with lower odds of mortality among Hispanic (OR=0.49, 95% CI: 0.28-0.86) and Other (0.46, 95% CI: 0.23-0.99) COVID+ hospitalized patients but with increased odds of mortality among White COVID+ hospitalized patients (OR=4.30, 95% CI: 1.19-15.56).

Conclusions:
In-hospital mortality was extremely high during the peak of the COVID period in Bronx, NY. SDOH contributed to hospitalization and mortality among COVID+ patients. Larger average household size may be paradoxically protective against mortality among Hispanics and Others, which did not translate to Whites.
Abstract 078: Mid- To Long- Term Follow-up Care Insufficiencies From A Cross-sectional School- Based Cholesterol Screening Program
Authors: Kohler Rachel A , Poffenberger Paige , lilly Christa , Pyles Lee A
Published: April 2022

Introduction:
The CARDIAC project surveyed cardiometabolic risk and risk for familial hypercholesterolemia (FH) through a school-based program, demonstrating the importance of universal blood cholesterol screening in children. At most, 10% of FH is diagnosed in the United States.

Hypothesis:
We hypothesize a disconnect between identification of risk factors and the follow-up care received by those children and young adults.

Methods:
Between 1998 and 2016, 60,404 5th grade children had their LDL-C levels assessed through venipuncture lipid panels. Of the 638 children who had an LDL-C ≥ 160mg/dl, indicative of probable FH, 395 were identified through EPIC EHR, phone calls, and mail surveys. WVU IRB approved verbal consent by participants. Information on their current status was obtained including medical care for their cholesterol, lipid-lowering medications (LLM), other medications, and family history of cardiac-related events.

Results:
Out of the 395 children identified, 174 were male and 221 were female. We had follow-up lipid panels for 58. Eight participants on a LLM had a follow-up LDL-C that was 57.5 +/- 50.1 mg/dl lower than the 5th grade level. Fifty subjects not on a LLM had an LDL-C that was 27.2 +//- 48.0 mg/dl lower than baseline. No follow-up LDL-C data was available on 33 participants who received a LLM. While only 41 children had ever taken a LLM, 56 participants were taking oral contraceptive, and 63 a psychotropic medicine. Only 1 participant was enrolled in the FH Registry. No subject was found with major adverse coronary event.

Conclusion:
Follow-up after screening demonstrated improved lipid levels in several subjects without known medication. Many subjects were receiving oral contraceptive agents and psychotropic medicines associated with dyslipidemia, usually without follow-up lipid panels. Roughly one-third of participants had unknown mid-term course. Epic EHR for WVU Health System found 393 subjects. The inability to document ongoing medical care in addition to demonstrated lack of care received by those who had an LDL greater than 160mg/dl shows that there is insufficient follow-up care for young people with probable FH. In conclusion, the data points to areas to improve, including better education for patients with this cardiometabolic risk factor. Education of health care professionals, telemedicine, patient-driven advocacy groups, EHRs that cover large catchments, and patient communication portals promise to better focus ongoing care for persons with abnormal lipid profiles.
Abstract MP18: A Multi-ethnic Polygenic Risk Score Is Associated With Hypertension Prevalence And Progression Throughout Adulthood
Authors: Sofer Tamar , Kurniansyah Nuzulul , Goodman Matthew , Bis Joshua , Guo Xiuqing , Haessler Jeffrey , Gao Yan , Smith Jennifer A , Feofanova Elena , Lloyd-jones Don M , Loos Ruth , Kaplan Robert , Levy Daniel ,   The NHLBI Trans-Omics in Precision Medicine (TOPMed) Consortium
Published: April 2022

Background:
We used summary statistics from previously-published GWAS of systolic and diastolic BP and of hypertension (HTN) to construct Polygenic Risk Scores (PRS) to predict hypertension across diverse populations.

Methods:
We used 10,314 participants of diverse ancestry from BioMe to train trait-specific PRS. We implemented a novel approach to select one of multiple potential PRS based on the same GWAS, by optimizing the coefficient of variation across estimated PRS effect sizes in independent subsets of the training dataset. We combined the 3 selected trait-specific PRS as their unweighted sum, called “PRSsum”. We evaluated PRS associations in an independent dataset of 39,035 individuals from eight cohort studies, to select the final, multi-ethnic, HTN-PRS. We estimated its association with prevalent and incident hypertension 4-6 years later. We studied hypertension development within HTN-PRS strata in a longitudinal, six-visit, longitudinal dataset of 3,087 self-identified Black and White participants from the CARDIA study. Finally, we evaluated the HTN-PRS association with clinical outcomes in 40,201 individuals from the MGB Biobank.

Results:
Compared to other race/ethnic backgrounds, African-Americans had higher average values of the HTN-PRS. The HTN-PRS was associated with prevalent hypertension (OR=1.76, 95% CI [1.70, 1.83], per one standard deviation (SD) of the PRS) across all participants, and in each race/ethnic background, with heterogeneity by background (p-value=1.87x10
-4
). The lowest estimated effect size was in African Americans (OR=1.49, 95% CI [1.36, 1.61]). The HTN-PRS was associated with new onset hypertension among individuals with normal (respectively, elevated) BP at baseline: OR=1.54, 95% CI [1.43, 1.66] (OR=1.39, 95% CI [1.23, 1.55]). Association was further observed in age-stratified analysis. In CARDIA, Black participants with high HTN-PRS percentiles developed hypertension earlier than White participants with high HTN-PRS percentiles. The HTN-PRS was significantly associated with increased risk of coronary artery disease (OR=1.11), ischemic stroke (OR=1.12), type 2 diabetes (OR=1.16), and chronic kidney disease (OR=1.12), in the MGB Biobank.

Conclusions:
The multi-ethnic HTN-PRS is associated with both prevalent and incident hypertension at 4-6 years of follow up across adulthood and is associated with clinical outcomes.
Abstract MP19: Characteristics And Patterns Of Retention In Hypertension Care In Primary Care Settings: Findings From The Hypertension Treatment In Nigeria Program
Authors: Ye Jiancheng , Orji Ikechukwu , Baldridge Abigail S , Ojo Tunde , Shedul Grace , Ugwuneji Eugenia , Egenti Nonye , Omitiran Kasarachi , Okoli Rosemary , Eze Helen , Nwankwo Ada , Hirschhorn Lisa , Chopra Aashima , Ale Boni , Shedul Gabriel , Tripathi Priya , Kandula Namratha , Huffman Mark D , Ojji Dike
Published: April 2022

Introduction:
More than 1.2 billion adults have hypertension globally, which contributes to more than 19 million deaths due to cardiovascular diseases each year. High retention in clinical care is essential for long-term management of hypertension, but 1-year retention rates are <50% in many resource-limited settings.

Objective:
To describe retention rates and associated factors among patients with hypertension in primary health care centers in the Federal Capital Territory of Nigeria.

Methods:
Data were collected by trained study staff from adults ≥18 years at 60 public, primary healthcare centers between January 2020 and July 2021 as part of the Hypertension Treatment in Nigeria Program. The 3-month rolling average 37-day retention rate in hypertension care was calculated by dividing the number of patients that had a second visits within 37 days of their first visit by the total number of registered hypertensive patients over multiple consecutive 3-month periods. Regression models were created to evaluate associations between patient-, site-, area council-level factors, treatment and control status, and 37-day retention rate.

Results:
In total 10,686 patients (68.2% female, mean [SD] age = 48.8 [12.7] years) were included. Over the study period, the 3-month rolling average 37-day retention rate was 41% (95% CI: 37% – 46%,
Figure 1
) with wide variability. The retention rate was higher among patients who were older (adjusted OR (aOR) [95% CI]: 1.01 per year [1.007, 1.014]), female (aOR [95% CI]: 1.11 [1.002, 1.22]), higher BMI (aOR [95% CI]: 1.01 [1.002, 1.02]), Kuje area council (aOR [95% CI]: 2.29 [1.28, 4.09]), being treated at the first visit (aOR [95% CI]: 1.20 [1.08, 1.33]), and being controlled at the second visit (aOR [95% CI]: 1.33 [1.20, 1.47]).

Conclusions:
Retention in hypertension care is suboptimal in primary health care centers in Nigeria, although variability was seen. Modifiable factors associated with retention were identified and may be targets for multilevel, contextualized implementation strategies.
Abstract MP22: Myosteatosis Is Associated With Worse Cognition In African Caribbean Women
Authors: Acevedo-Fontanez Adrianna , Cvejkus Ryan , zmuda joseph , Wheeler Victor , Rosano Caterina , Miljkovic Iva , Kuipers Allison L
Published: April 2022

Introduction:
Skeletal muscle adipose tissue infiltration (i.e. myosteatosis) increases with aging, and is recognized as a major risk factor for cardio-metabolic diseases. While it is known that visceral adiposity is related to dementia and cognitive decline, the relationship between myosteatosis and cognition is not well understood. Such studies are particularly needed among African ancestry women, who have greater myosteatosis and higher burden of Alzheimer’s Disease and Related Dementias compared with White women.

Aim:
The objective of this study was to assess if, among African Caribbean middle-aged and older women (aged 40-79), myosteatosis is associated with cognitive function.

Methods:
Data were collected on women (n=481) from the Tobago Health Study. Cognition was assessed by the Digit Symbol Substitution Test (DSST), a test of information processing speed; DSST is a fast, reliable and sensitive test that predicts onset of dementia. DSST was administered to participants by trained interviewers; scores ranged from 0 to 81 (lower score indicating cognitive decline). Peripheral Quantitative Computed Tomography (Stratec XCT-2000) was used to measure calf skeletal muscle density (MD), which was used as a proxy measure for the myosteatosis (lower MD reflects more adiposity). Linear regression was used to assess the association of muscle density with cognition and was adjusted for age, education, muscle area, waist circumference, alcohol intake, smoking, walking hours, diabetes and hypertension. Results for the primary predictor of interest (MD) were standardized with effects shown per standard deviation (SD).

Results:
Mean (SD) DSST scores were 38.8 (13.2). Overall, participants were aged 55.2 years and had a BMI of 30.7 kg/m
2
. Mean (SD) MD was 71.7((5.3) (mg/cm
3
). As expected, in unadjusted analyses, the strongest predictors of lower DSST scores in these women were older age and lower education, higher waist circumference, diabetes and hypertension. After full adjustment, we found that a one SD increase in MD was associated with a 1.48 increase in DSST score (p-value=0.015).

Conclusions:
Our findings suggest that in African Caribbean women, greater myosteatosis is associated with slower information processing speed, an early indicator of future dementia risk. Future studies using expanded battery of cognitive tests and longitudinal follow-up are warranted to further advance our understanding of the novel role of myosteatosis in dementia risk among African ancestry women.
Abstract MP23: Does Predictors Of Overweight/obesity Among Women Vary Based On The Residential Setting? A Multilevel Analysis Of Repeated Cross-sectional Data In Nigeria
Authors: Were Jason M , Kyeremeh Emmanuel , Annor Bridget O , Campbell M. K , Stranges Saverio
Published: April 2022

Background:
Overweight/obesity is increasingly becoming a major public health problem in Nigeria despite the persistence of underweight burden. A major contributor of this is the urban sprawl experienced in the country with approximately half of the Nigerian population living in urban areas. Evidence suggests that similar socio-demographic factors could have different influences on an individual’s nutrition status by virtue of their residential setting. Yet, little is known about this phenomenon in the Nigerian context.

Objectives:
This study aimed to explore the following objectives: 1) to determine whether the anticipated increase in overweight/obesity prevalence is subsequently paralleled by substantial decrease in undernutrition in the last decade; and 2) to examine both the individual and household predictors’ overweight/obesity among women of reproductive age in rural and urban Nigeria.

Methods:
We used data acquired from the 2008, 2013 and 2018 Nigeria Demographic and Health Surveys (DHS). Our outcome was defined using standard Body Mass Index (BMI) categories calculated from height and weight measurements of the study participants. The national and stratified (urban/rural) prevalence estimates of underweight (BMI <18.5 Kg/m
2
), overweight (BMI 25 - 29.9 Kg/m
2
), and obese (BMI ≥ 30 Kg/m
2
) were computed for each survey. Afterwards, the underweight subjects were excluded from the study. Two-level (individual and household) logistic regression models were applied to examine the influence of individual and household characteristics on women’s overweight/obese status.

Results:
Findings show a steady increase in both the prevalence of overweight and obesity from 16.1% and 6.1% in 2008 to 18.2% and 10.0% in 2018, respectively, while underweight prevalence was averagely 12% across each survey. Regardless of the residential setting, age, marital status, education, occupation, household wealth and survey year were consistently associated with increased risk of overweight/obesity, whereas breastfeeding showed a protective association with overweight/obesity. Having multiple children and living in female-headed homes were unique risk factors for overweight/obesity among urban women while ethnicity, media exposure and state of residence were unique risk factors for overweight/obesity among rural women.

Conclusion:
Public health interventions aimed at lowering the risk of overweight/obesity should embrace the differences in risk factors that exists between rural and urban dwellers.
Abstract MP26: Replacing Sedentary Behavior Time With Various Daily-life Physical Activities And Structured Exercises, Recommended Physical Activity, And Incident Coronary Heart Disease
Authors: Li Xiang , Ma Hao , Zhou Tao , Qi Lu
Published: April 2022

Introduction:
While excessive sedentary behavior time has been associated with cardiovascular diseases, it is largely unknown to what extend substituting sedentary behaviors with various physical activities may offset the risk of coronary heart disease (CHD).

Hypothesis:
We hypothesize that reallocating time from sedentary behavior to various daily-life physical activities and structured exercises might be associated with lower risk of CHD. We particularly examined such reallocations according to whether or not the participants meet the recommended physical activity level.

Method:
A total of 468,960 UK Biobank participants free of CHD were included. Sedentary behavior time was quantified by summing up the time spent on television watching, computer use (not at work), and driving. Physical activities were categorized as daily-life activities (walking for pleasure, light DIY, and heavy DIY) and structured exercise (strenuous sports and other exercises). We used iso-temporal substitution model to estimate the effect of replacing sedentary behavior with each type of physical activity for the same amount of time.

Results:
During a median follow-up of 11 years, 7,982 incident CHD cases were documented. Sedentary behavior time was significantly associated with a higher risk of CHD, independent of physical activity. In comparison of the extreme categories (≥6 vs. <2 h/d), the HR for CHD was 1.31 (95% CI: 1.18-1.46). Replacing 30 minutes of sedentary behavior per day with an equal time of various physical activities was significantly associated with a 3%-12% risk reduction of CHD. Replacing 1 hour of sedentary behaviors with different types of physical activities was associated with a 6%-23% risk reduction of CHD. Sedentary behavior-to-strenuous sports reallocations showed the largest reduction in CHD risk when replacing sedentary behavior. Moreover, reallocations of sedentary behavior to various physical activities showed particularly greater benefits among those who did not meet the physical activity recommendations.

Conclusion:
Our study indicates that replacing sedentary behavior time with various daily-life activities or structured exercise was associated with significant reductions in CHD risk.
Abstract MP27: Associations Of Accelerometer-measured Physical Activity And Sedentary Behavior With Incident Ischemic Stroke: The Women’s Health Study (WHS)
Authors: Peter Kennedy M , Evenson Kelly R , Cuthbertson Carmen , Howard Annie Green G , Lee I-min M
Published: April 2022

Introduction:
Higher self-reported physical activity and lower sedentary behavior (SB) are associated with lower incidence of ischemic stroke (IS). Objective measurement by accelerometer allows for novel, in-depth examination of these relationships with IS.

Objective:
Assess the association of accelerometer-measured physical activity and SB with IS.

Methods:
We included 16,031 women adherent with accelerometer wear (≥ 10 hours/day for 4 days) from the WHS cohort (2011-2015) with no prior cardiovascular disease [age 71.4 (SD 5.6) years, BMI 26.2 (SD 5.0), and 67% hypertensive]. ActiGraph GT3X+ accelerometers measured total volume of physical activity (average vector magnitude [VM]/min), mins spent in light-high (LHPA) and moderate-to-vigorous (MVPA) intensity physical activity, and SB. We categorized all metrics as quartiles and residualized to account for accelerometer wear time. We produced adjusted hazard ratios (HR) and 95% confidence intervals (CI) that independently relate physical activity and SB with IS using Cox proportional hazards models. Sensitivity analyses excluded events in the first year and those with poor self rated health to assess reverse causality.

Results:
Over a mean of 7.1 (SD 1.6) years of follow-up, 181 IS were observed (30 in first year). Greater total volume of physical activity and more minutes spent in MPVA were associated with lower hazards of ischemic stroke (quartile 4 vs. ref: VM/min HR=0.51, 95% CI: 0.32, 0.82, MVPA HR=0.42, 95% CI: 0.26, 0.67). Minutes spent in LHPA were not associated with IS. Less time spent in SB was associated with lower hazards of IS, but was not statistically significant (Table). Results were robust when adjusted for clinical covariates. Exclusions for reverse causality did not alter inferences made and decreased precision.

Conclusion:
Greater total volume of physical activity and more minutes spent in MVPA were associated with lower occurrence of IS in this cohort. Less time spent in SB appeared to be protective against IS, but requires further investigation.
Abstract MP44: Adolescent Team Sports Participation, Adiposity, And Inflammation Among Young Adult Child Maltreatment Survivors
Authors: Cammack Alison L , Suglia Shakira F
Published: April 2022

Background:
A body of literature shows that child maltreatment (CM) is associated with subsequent adiposity and inflammation, but few studies examine factors that buffer against these outcomes among survivors of CM. Child and adolescent team sports participation has been associated with positive mental and physical health outcomes, including decreased risk of obesity. However, it is unclear if these benefits extend to longer-term cardiometabolic outcomes in maltreated individuals, given that CM survivors often have impaired stress coping and may use obesogenic behaviors as a coping mechanism. The goal of this study was to assess, within a nationally representative sample of CM survivors, if sports team participation during adolescence is associated with decreased adiposity and inflammation in young adulthood.

Methods:
The analytic sample consisted of individuals who retrospectively self-reported CM (sexual, emotional, and physical abuse and neglect) in the National Longitudinal Study of Adolescent to Adult Health (N=3,298). We examined associations between intended team sports participation in grades 7-12 and BMI (kg/m2), waist circumference (cm), log transformed high-sensitivity C-reactive protein (hsCRP; mg/L), obesity (>30 kg/m2), high waist circumference (>88.9 cm for women, >101.6 cm for men), and elevated hsCRP (>3 mg/L) at ages 24-32 using linear regression and predictive margins. Models adjusted for age, sex, race/ethnicity, childhood household education, if raised by both biological parents, school type and size, subclinical infectious disease symptoms (hsCRP only), and BMI during adolescence. All analyses incorporated complex sample weighting.

Results:
57% (1883/3298) of the sample reported plans to participate in sports teams during the school year as adolescents. The mean young adult BMI, waist circumference, and hsCRP values were 29.35 kg/m2 (SD=0.21), 98.64 cm (SD=0.50), and 4.73 mg/L (SD=0.17), respectively. In the overall sample, adolescent sports participation was inversely associated with waist circumference (B=-1.73,95% CI:-0.13, -2.13), log hsCPR (B=-0.25,95% CI:-0.13,-4.01), and elevated hsCRP (PR= 0.82,95% CI:0.74,0.92). When examining specific sports, the protective impact was especially pronounced among women who participated in track (BMI B=-2.37, 95% CI,-1.62,-3.13; waist circumference B=-5.11,95% CI:-3.14,-7.08; log hsCRP B=-.52,95% CI:-0.30,-0.74).

Conclusions:
There is evidence that team sports participation is associated with decreased adiposity and inflammation in men and women with histories of CM. Although intervention studies are needed to establish a causal relationship, these findings suggest that team sports participation during adolescence may help promote cardiometabolic health in survivors of CM.