bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 056: Alcohol Increases Risk Of Cardiovascular Disease At All Levels Of Intake
Authors: Biddinger Kiran J , Emdin Connor , Haas Mary E , Wang Minxian , Hindy George , Ellinor Patrick T , Kathiresan Sekar , Khera Amit V , Aragam Krishna
Published: May 2021

Genetic analyses have suggested a causal association between alcohol intake and cardiovascular diseases, questioning the purported cardioprotective effects of modest intake. Though traditional approaches to genetic epidemiology are limited in ability to assess association shapes, we hypothesized that any alcohol may increase risk of cardiovascular disease. In 371,463 participants from the UK Biobank, we first examined for confounding in epidemiological associations between alcohol intake and cardiovascular diseases. Next, using traditional and non-linear genetic approaches (Mendelian randomization), we assessed for causal links of alcohol consumption with several cardiovascular diseases and evaluated the shapes of all causal associations identified. Study participants consumed 9.2 (SD, 10.6) standard drinks per week on average; 121,708 (32.8%) and 27,667 (7.5%) subjects had hypertension and CAD, respectively. Modest consumers of alcohol demonstrated healthier lifestyles - such as lower BMI and greater physical activity - than abstainers, and adjustment for lifestyle factors attenuated the observed benefits of light alcohol intake. Traditional and non-linear Mendelian randomization demonstrated consistently risk-increasing and quadratic associations between alcohol consumption and both clinical and subclinical cardiovascular disease, with exponential increases in risk across levels of drinking; relative to abstainers, consumption of 7, 14, 21, and 28 drinks per week conferred 1.2, 1.7, 3.4, and 8.9-fold odds of hypertension and 1.2, 2.3, 6.2, and 25.9-fold odds of CAD, respectively (both models p<0.001). In conclusion, coincident, favorable lifestyle factors may mediate the observational benefits of modest alcohol intake. All amounts of alcohol intake increase cardiovascular risk, but marked absolute and relative risk differences exist across levels of intake, which should inform public health recommendations around habitual alcohol consumption.
Abstract 057: Beyond Convenience: Video Visits Can Increase The Efficiency Of Preventive Care Delivery
Authors: Kalwani Neil M , Wang Katherine M , Deb Jahnavi , Gold Thomas , Maddukuri Akhil , Savage Emily , Scheinker David , Dash Rajesh , Rodriguez Fatima
Published: May 2021

Introduction:
In response to the COVID-19 pandemic, medical practices have expanded utilization of telehealth. Little is known about the operational impacts of transitioning from in-person to video visits in specialty clinics. In 2018, the Stanford South Asian Translational Heart Initiative (SSATHI), a preventive cardiology clinic focused on high-risk South Asian adults, introduced CardioClick, a program replacing in-person follow-up visits with video visits.

Hypothesis:
We hypothesized that implementation of video visits increased the efficiency of clinic operations.

Methods:
We extracted visit-level data from the EHR for 134 patients enrolled in CardioClick with video follow-up visits from June 14, 2018 to April 21, 2020 and a cohort of 276 patients enrolled in the in-person SSATHI prevention program with follow-up visits from September 11, 2014 to March 6, 2020.

Results:
Patients in CardioClick and the in-person cohort were similar in terms of age (mean 45 years), gender balance (23 vs 21% female), and cardiometabolic risk profiles. There were 181 video and 637 in-person follow-up visits. Video visits were shorter than in-person visits, both in terms of total clinic time [median 22 min (IQR 16, 29) vs 67 min (48, 100)] and provider time required [median 22 min (IQR 16, 29) vs 30 min (12, 58)]. Video visits were more likely to end on time (71 vs 11%, p<0.001). The median video visit ended on time while the median in-person visit ended 32 min late (13, 70) (see Figure). Providers were also more likely to complete video visit documentation the same day (56 vs 42%, p=0.001).

Conclusions:
In a preventive cardiology clinic, video follow-up visits required less clinic and provider time than in-person visits, were more likely to end on time, and were associated with increased same-day provider documentation completion. In conclusion, video visits offer benefits beyond their convenience and may increase the operational efficiency of specialty care practices focused on disease prevention, improving value in care delivery.
Abstract 069: Sporadic Step Accumulation And All-cause Mortality In The Women’S Health Study: Do All Steps Count?
Authors: Moore Christopher C , Evenson Kelly R , Shiroma Eric J , Howard Annie G , Cuthbertson Carmen C , Buring Julie E , Lee I-Min
Published: May 2021

Background:
With the popularity of step counting and feasibility of accumulating physical activity (PA) through sporadic spurts (e.g., taking the stairs), the 2018 PA Guidelines Committee called for research to inform step-based PA recommendations by quantifying relationships between patterns of stepping and health.

Purpose:
To examine the relationship between daily steps accumulated outside of “bouts” (sporadic steps/d) and all-cause mortality, before and after accounting for bouted steps/d.

Methods:
From 2011-2015, 16,732 women (mean 72 [standard deviation 6] years) wore a hip-worn accelerometer for 7 days to assess steps and met wear time criteria. Stepping bouts were defined as ≥10 consecutive minutes at ≥40 steps/min (purposeful stepping or faster), allowing for ≤20% of time and ≤5 mins at <40 steps/min. Total steps/d were partitioned into steps accrued outside of bouts (sporadic steps/d; SS) and in bouts (bouted steps/d; BS). We estimated hazard ratios (HRs) for mortality through Dec 31, 2019 using Cox proportional hazard models fitted to SS in quartiles and using restricted cubic splines. Analyses were adjusted for covariates and repeated with further adjustment for BS, categorized as 0, 1-2000, and >2000 steps/d in bouts.

Results:
Adjusted HRs (95% confidence intervals) in increasing quartiles of SS were 1.00 (reference); 0.63 (0.52, 0.76); 0.60 (0.49, 0.74); 0.54 (0.42, 0.70). In spline analyses, initial increases in SS corresponded to the greatest mortality reductions (Figure 1), with HRs of 0.69 (0.64, 0.76) per additional 1000 SS below 3200. After further adjusting for BS, initial 1000 steps/d increases in SS were association with HRs of 0.72 (0.66, 0.78). In increasing categories of BS, HRs adjusted for SS were 1.00 (reference); 0.91 (0.76, 1.09); 0.69 (0.56, 0.84).

Conclusion:
Daily step counts were inversely associated with mortality, regardless of how they were accumulated. These results can help inform step-based target PA volumes that communicate the benefits of increasing everyday walking behaviors.
Abstract P003: Effectiveness And Safety Of Direct Oral Anticoagulants Compared With Warfarin In Patients With Atrial Fibrillation Across Body Mass Index Categories
Authors: Tanaka Yoshihiro , Khan Sadiya , Kaplan Rachel , Greenland Philip , Passman Rod S , Martin Karlyn
Published: May 2021

Background:
Although direct oral anticoagulants (DOACs) are preferred for most patients needing anticoagulation for atrial fibrillation (AF), uncertainty remains in the effectiveness and safety of DOACs compared with warfarin in patients with obesity. Available data from large real-word cohorts are lacking.

Purpose:
To examine the effectiveness and safety of DOACs compared with warfarin in patients with obesity and AF.

Methods:
We conducted a retrospective cohort study at an integrated, multi-site healthcare system. We included patients with AF prescribed either a DOAC or warfarin with ≥ one year of follow-up between 2010-2017. The primary effectiveness outcome was ischemic stroke or systemic embolism (S/SE) and the primary safety outcome was incident intracranial hemorrhage (ICH). Using logistic regression, we calculated propensity scores (PS) of prescription for DOAC in each body mass index (BMI) category (<25 kg/m2, 25.0-29.9 kg/m2, 30.0 to 34.9 kg/m2, and BMI≥35.0 kg/m2) using the following covariates: age, sex, race, ethnicity, BMI, systolic blood pressure, and CHA
2
DS
2
-VASc score. We used inverse probability weighting (IPW) based on the PS and IPW-weighted hazard ratios with 95% confidence intervals were calculated by Cox proportional hazard model.

Results:
Of a total of 17,905 patients included, mean (standard deviation [SD]) age was 70 ± 12 years and mean (SD) BMI was 29.9 ± 6.7 kg/m
2
; nearly half received a prescription for DOAC (42.7%) and 57.3% for warfarin. During median follow-up of 3.8 years (interquartile range: 2.2-6.0), a total of 159 stroke and 376 intracranial hemorrhage events were observed. Patients on DOACs had a similar or lower HRs for both S/SE and ICH events compared with warfarin across each BMI category (Figure).

Conclusion:
In this retrospective study, DOACs were as safe and effective compared with warfarin across BMI categories in patients with AF.
Abstract P048: A Model Of Chronic Insufficient Sleep Increases Markers Of Insulin Resistance In Postmenopausal But Not Premenopausal Women
Authors: Zuraikat Faris M , Scaccia Samantha , Campbell Ayanna , Cheng Bin , St-Onge Marie-Pierre
Published: May 2021

Introduction:
Insufficient sleep is widely prevalent among US adults and is a risk factor for type 2 diabetes (T2D). Experimental studies show adverse effects of acute, severe short sleep on insulin sensitivity, but it is unclear whether these reflect risks associated with milder short sleep routinely observed in the general population. To date, no study has evaluated the impact of prolonged mild sleep curtailment on markers of insulin resistance in women or whether these effects differ by menopausal status, known to impact insulin sensitivity.

Hypothesis:
Glucose and insulin levels, as well as a measure of insulin resistance (HOMA-IR), will increase during 6 wk of sleep restriction (SR) relative to adequate sleep (AS). Adverse effects of prolonged short sleep will be exacerbated in postmenopausal women.

Methods:
Thirty-four women (age: 38±14 y; BMI: 25.6±3.6 kg/m2; n=10 postmenopausal) with adequate habitual total sleep time (TST) (453±33 min) took part in a randomized crossover study with two 6-wk phases: AS and SR. In AS, participants were asked to maintain stable nightly bed and wake times determined from 2 wk of screening with wrist actigraphy and sleep logs. In SR, bedtime was delayed to reduce TST by approximately 1.5 h/night. Sleep was measured continuously using actigraphy and verified weekly for compliance. At wk 0, 3, 4, and 6 fasting blood samples were collected. Outcomes included glucose and insulin levels as well as HOMA-IR scores, calculated from those values. Linear-mixed models tested interactions of sleep condition with week on outcome measures in the full sample and by menopausal status.

Results:
Sleep condition impacted the change in TST from baseline (P<0.0001), which was reduced in SR and unchanged in AS (-79±6 vs -4±6min). In the full sample, there was no sleep condition by week interactions for glucose (P=0.67), insulin (P=0.14), or HOMA-IR (P=0.16). Similar results were observed in premenopausal women (all P>0.50). However, in postmenopausal women, there was a significant effect of sleep condition on change in insulin (P=0.046) and HOMA-IR (P=0.039) over the 6 wk. In SR, insulin (slope: 0.26±0.28 μU/mL) and HOMA-IR (slope: 0.07±0.08) increased, while AS resulted in reductions in these outcomes (insulin slope: -0.56±0.29 μU/mL; HOMA-IR slope: -0.16±0.08).

Conclusions:
We provide the first evidence that chronic short sleep, even if mild, adversely affects insulin sensitivity in postmenopausal women. In contrast, maintenance of AS may improve glycemic regulation. Interestingly, prolonged short sleep did not impact markers of insulin resistance in premenopausal women; further investigation into these life-stage related differences, including underlying mechanisms, is warranted. Results suggest that, in postmenopausal women, a group at heightened risk of poor sleep and T2D, achieving adequate sleep may be an effective strategy to improve cardiometabolic health.
Abstract P058: Risk Of Heart Failure In Type 2 Diabetes Has Decreased Over Time - A Danish Nationwide Cohort Study
Authors: Schwartz Brian , Ramachandran Vasan S , Torp-Pedersen Christian , Schou Morten , Lyass Asya , Gislason Gunnar , Kober Lars , Andersson Charlotte
Published: May 2021

Introduction:
Although type 2 diabetes (T2DM) is one of the strongest risk factors for heart failure (HF), there is limited data on contemporary lifetime risk estimates in this segment. Incident HF appears to be decreasing in the general population, but little is known how the risk has changed over time in patients with T2DM. The increasing prevalence and rapidly evolving management of T2DM has furthered interest in the epidemiological relationship between HF and T2DM. We therefore sought to investigate the lifetime risk of HF in people with T2DM and how the long term risk of HF has changed over time in patients with T2DM.

Hypothesis:
We assessed the hypothesis that there would be a statistically significant reduction in the ten- year risk of HF among patients with T2DM over time in all age groups except the youngest (<50 years old), mimicking trends in the general population and that men would have a higher cumulative risk than women.

Methods:
We employed the Danish nationwide databases which included information on all Danish citizens’ hospitalizations, outpatient visits, and medication use since 1978 (diagnoses) and 1995 (medications). Using this data, we calculated the cumulative incidence of HF among patients with T2DM who were free from HF at age 30, 40, 50, 60, and 70 years, respectively. We censored people at time of emigration or at Dec 31, 2017 and we used Aalen-Johnsen estimators to adjust for the competing risk of death.

Results:
A total of 473,685 patients (47% women) had a diagnosis of T2DM between Jan 1, 1995 and Dec 31, 2017. Of those who were free from HF before T2DM onset, 21,030 were diagnosed before the age of 30; 33,786 before age 40; 55,537 before 50 years of age; 85,108 before age 60; and 98,631 before age 70. During follow-up, 48,026 (10%) were diagnosed with HF and 133,561 were censored for death. The cumulative life-time risk of developing HF among people with diabetes at age 50 was 24% (95% CI 21-27%) in females and 27% (25-29%) in men, p for difference <0.0001. Among patients aged 50 years, the 10-year risk of HF decreased from 12.2% (1995-2005) to 9.6% (2005- 2015), p<0.0001. Similar 10-year risks decreased for those free from HF at age 60 year (from 19.0% in 1995-2005 to 13.3% in 2005-2015, p<0.0001) and 70 years old (from 22.2% to 17.1% between 1995-2005 and 2005-2015, p<0.0001).

Conclusion:
The lifetime risk of HF among patients with T2DM exceeds 1 in 4 for both men and women. There was, however, a decrease in ten-year cumulative incidence of HF over time among patients with T2DM in all age groups.
Abstract P078: Gender And Racial Disparities In Aspirin Use For Primary Prevention: Temporal Trends From The National Health And Nutrition Examination Surveys, 2011-2018
Authors: Dasa Osama , Jun Inyoung , Sajdeya Ruba , Taha Mohamad B , Sajdeya Omar , Pearson Thomas A
Published: May 2021

Introduction:
Cardiovascular disease (CVD) disproportionately affects racial minorities in the US. Aspirin is recommended for primary prevention in persons at high CVD risk. Prior evidence revealed racial and gender disparities in aspirin use for primary prevention.

Objectives:
To describe recent trends in aspirin use for primary prevention by race and gender to identify factors associated with differences in aspirin use.

Methods:
Data from the National Health and Nutrition Examination Surveys, 2011-2018, were analyzed. Participants aged 40-79 years, without prior history of CVD were included. Logistic regression was used to assess the association of aspirin use with comorbidities and sociodemographic factors.

Results:
Among 11212 participants, 47.0% were men; the mean (SD) age was 55.8 (9.79) years; 33.1% were non-Hispanic Whites (W), 23.7% non-Hispanic Blacks (B), and 13.1% Hispanics (H). Aspirin use was more prevalent among W (37.8%) compared to B (26.5%) and H (11.5%) (
P
-value <0.001). Trends in aspirin use varied by race and gender over the eight-year follow-up period (Figure 1). Generally, aspirin use was significantly lower in women than men. There was a downward trend in aspirin use in H and B women; H men and women had the lowest prevalence of use across the follow-up duration. Aspirin use was significantly higher at older age, with higher BMI, more comorbidities, non-smokers, and having insurance. Compared to W, H (but not B) had a persistently lower likelihood of aspirin use over time in the unadjusted logistic regression model. After adjustment, race (but not gender) was no longer significantly associated with aspirin use.

Conclusions:
Aspirin use for primary prevention remains prevalent among W compared to others and among men compared to women. However, after adjusting for several covariates, the effects of race were removed but the gender differences remained. The persistent gender gap in aspirin use for primary prevention requires further explanation, and for those at high risk, intervention.
Abstract P096: Association Of Accurately Measured Office, Self-measured Home, And Ambulatory Blood Pressure And Their Variability With Intracranial Arterial Stenosis
Authors: Hisamatsu Takashi , Ohkubo Takayoshi , Fujiyoshi Akira , Torii Sayuki , Segawa Hiroyoshi , Kondo Keiko , Kadota Aya , Takashima Naoyuki , Shitara Satoshi , Arima Hisatomi , Nakagawa Yoshihisa , Watanabe Yoshiyuki , Shiino Akihiko , Nozaki Kazuhiko , Ueshima Hirotsugu , Miura Katsuyuki
Published: May 2021

Background:
Few studies have compared accurately measured office, self-measured home, and ambulatory blood pressure (BP) for asymptomatic intracranial artery stenosis (ICAS). Relationship of day-by-day or short-term variability in BP to asymptomatic ICAS remains unclear.

Objectives:
To examine the association of office, home (mean value and day-by-day variability), and ambulatory BP indices (24-hour/daytime/nighttime mean values, short-term variability, nocturnal decline, and morning pressor surge) with asymptomatic ICAS.

Methods:
Data on office and 7-day home BP and magnetic resonance angiography to assess ICAS were obtained in 677 men (mean age, 70.0 years) from a population-based cohort. Among them, 468 underwent 24-hour ambulatory BP monitoring. Mild- or severe-ICAS was defined as 1-49% or ≥50% stenosis, respectively, and any-ICAS as either mild or severe-ICAS.

Results:
We observed mild- and severe-ICAS in 153 (22.6%) and 36 (5.3%) participants, respectively. In multivariable Poisson regression with robust error variance, higher systolic BP at office, home, or ambulatory BP monitoring was associated with the presence of any- or severe-ICAS. The associations with ICAS were comparable between office, home, and ambulatory systolic BP (all heterogeneity Ps >0.1). Independent of mean systolic BP, greater nocturnal decline or morning pressor surge in systolic BP was associated with higher burden of any- or severe-ICAS.

Conclusion:
The magnitude of association of BP accurately measured at office for asymptomatic ICAS was comparable with that of BP at home or ambulatory BP monitoring. Circadian BP variation based on ambulatory BP monitoring may be considered when assessing ICAS in apparently healthy individuals.
Abstract P098: Effects Of Occupational Radiation Exposure On The Prevalence Of Hypertension And Its Complications
Authors: Thirumal Rithika , Vanchiere Catherine , Bhandari Ruchi , Jiwani Sania , Horswell Ronald , Chu San , Chamaria Surbhi , Katikaneni Pavan , Boerma Marjan , Bailey Steven R , Dominic Paari
Published: May 2021

Background:
Advancement of fluoroscopy-assisted procedures in the field of medicine has led to an increase in the frequency of their use among cardiologists, radiologists and surgeons. The personal health risk involved with radiation exposure is of concern and has come under the limelight in recent times. In addition to other consequences, radiation has been linked to cardiovascular disease, but its significance is not well established.

Methods:
Self-reported demographic, social, occupational, and medical data was collected from board-certified cardiologists via an electronic survey. Bivariate and multivariable logistic regression analyses were performed.

Results:
1478 responses were collected from board-certified cardiologists; 85.4% were males, 79% were Caucasian and 66.1% were ≤65 yrs of age. 35.6% of respondents were interventional cardiologists and 16.4% were electrophysiologists. Of those who performed procedures, 92.2% wore lead apparel during all times of radiation exposure. Exposure hours, stratified by less or more than 20,000, correlated positively with the presence of hypertension, and remained significant when adjusted for common risk factors such as age, sex, race, DM, OSA, and alcohol/tobacco use (OR 1.63 CI 1.16 to 2.29, p = 0.005).

Conclusion:
This study captures self-reported data of just over 4% of cardiologists in the US, and demonstrates a positive correlation between hypertension and procedural radiation exposure hours even post-adjustment for traditional risk factors. As the use of fluoroscopy-assisted procedures continues to grow, further research is necessary to inform operators of the personal health risks of radiation exposure and drive progress in protective attire and risk mitigation strategies.
Abstract P162: Comorbid Asthma And Allergies Are Common In Children With Congenital Heart Disease And Related To Decreased Physical Functioning
Authors: Medford Rochelle , Drews-Botsch Carolyn , Kramer Michael , Oster Matthew , Williams Bryan , Knight Jessica
Published: May 2021

Background:
Congenital heart defects (CHD) are the most common birth defect and asthma and allergies are common conditions in childhood. The co-occurrence of these is not well understood but may be increased due to similar risk factors or immune dysregulation related to early life inflammation. This study aimed to compare the prevalence of asthma and allergies between children with CHD and their unaffected siblings and assess their impact on physical functioning in children with CHD.

Methods:
Parent-reported data was collected on allergy medications and asthma diagnosis, physical functioning (PedsQL physical health), and characteristics in children (age 12-17) with surgically treated CHD and an unaffected sibling (age 11-18). The McNemar test compared the comorbidities between siblings. Among children with CHD, logistic and linear regression were used to estimate the association of each comorbidity with child characteristics and physical functioning respectively. Models included CHD severity, SES, age, BMI, and sex.

Results:
Among 218 sibling pairs, the children with CHD had a higher, but not statistically significant, prevalence of asthma and allergies (Figure 1). In all 497 children with CHD, single ventricle CHD had a 2.5 times greater odds of allergies compared with non-critical (95%CI=1.0,6.0) with no difference in asthma. Asthma was associated with decreased physical functioning (8.7 point decrease vs no asthma, 95%CI=-14.5,-2.9).

Conclusions:
Children with CHD and their siblings had similar levels of allergies and asthma. However, as symptoms of these conditions may overlap, studies should further investigate a possible link with CHD, especially given the lower physical health in patients with CHD and asthma.
Abstract P169: Association Between Years Of Residency In The Usa Of Hispanic Immigrant Women And Small For Gestational Age
Authors: De Anda-Duran Ileana
Published: May 2021

Maternal and fetal factors have been associated with small for gestational age (SGA) and cardiometabolic disease in adulthood. Acculturation in US Latino population has been correlated with negative effects on health, including during perinatal period. We hypothesized that acculturated Hispanic pregnant women have higher risk of SGA.

Methods:
Retrospective study from PeriBank participants born in Latin America. Length of stay (LOS) as proxy for acculturation. SGA defined as birth weight for gestational age <10
th
.

Results:
We included 13,613 women with 15,376 deliveries. Women with LOS >6y showed higher gestational diabetes rates. (Table1) After adjustment, risk of SGA was lower for LOS 4-6y vs. 0-3y; risk was also lower for LOS >6y vs. 0-3y. (Table2) Women with LOS 4-6y had a 1.12kg/m
2
[95% CI 0.84 - 1.39; p-value <0.001] and >6y 3.06kg/m
2
[95% CI 2.78 - 3.32; p<0.001] higher BMI compared to LOS of 0-3 after adjustment.

Conclusions:
Highly acculturated Hispanic women born outside the US, do not have higher risk for having SGA offspring. Likely masked by higher pre-pregnancy BMI and gestational diabetes, alternative pathways for adverse perinatal outcomes.
Abstract P202: Early To Midlife Smoking Trajectories And Cognitive Function In Middle Aged Us Adults: The Coronary Artery Risk Development In Young Adults Study
Authors: Bahorik Amber , Sidney Stephen , Kramer-Feldman Jonathan , Jacobs David R , Mathew Amanda , Reis Jared , Yaffe Kristine
Published: May 2021

Introduction:
Smoking starts in early adulthood and persists throughout the lifecourse, but the association between these trajectories and midlife cognition remains unclear. We assessed the hypothesis that individuals with a heavy smoking trajectory from early adulthood to midlife would be more likely to demonstrate poor cognition at midlife.

Methods:
We studied 3364 participants (mean age: 50.1±3.6, 56% female, 46% black) from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Smoking trajectories were derived in latent class analysis among 1638 ever smokers based on smoking measures every 2-5 years from baseline (age 18-30, 1985-86) through Year 25 (2010-11). We estimated poor cognition using cognitive domain scores ≥1SD below the mean from tests of processing speed (Digit Symbol Substitution Test), executive function (Stroop) and memory (Rey Auditory Verbal Learning Test) at Year 25. Using adjusted logistic regression models, we examined the odds associated with poor midlife cognition and smoking trajectories (reference never smokers, n=1726) from early adulthood to midlife.

Results:
Five smoking trajectories emerged over 25-years: quitters (20%, 20/100), and minimal stable (40%, 40/100), moderate stable (20%, 20/100), heavy stable (15%, 15/100) and heavy declining smokers (5%, 5/100). As shown in the Figure, heavy stable smokers demonstrated poor cognition on all 3 domains compared to never smokers. Compared to never smokers, both heavy declining and moderate stable smokers exhibited slower processing speed, and heavy declining smokers additionally demonstrated poor executive function. For minimal stable smokers and quitters, no association was observed.

Conclusions:
In conclusion, we observed a dose-dependent association between early to midlife smoking and cognitive health risk at midlife. Our results underscore the cognitive health risk of moderate and heavy smoking trajectories in early and midlife periods and highlight the potential benefits of quitting, even in midlife.
Abstract P203: Determinants Of Perceived Factors Discouraging Electronic Nicotine Delivery Systems (ENDS) Use Among Youth
Authors: Hart Joy L , Payne Thomas J , Groom Allison , Walker Kandi L , Robertson Rose M , Kesh Anshula , Landry Robyn L , Giachello Aida L , Vu Thanh-Huyen T
Published: May 2021

Introduction:
Despite cardiovascular and other health risks, youth use of electronic nicotine delivery systems (ENDS) has reached an epidemic level. Studies have examined factors associated with ENDS use, but little is known about factors discouraging youth ENDS use. We examined youth sociodemographic and tobacco/ENDS use determinants of perceived factors discouraging ENDS use.

Methods:
Data from a nationwide online survey of youth were weighted to be representative of the overall U.S. population in terms of age, sex, race, ethnicity, and region. Participants selected up to 3 reasons that would discourage their use of ENDS.

Results:
Of 3000 participants, 55.7% were female, 20.1% Hispanic, and 13.7% non-Hispanic Black; 7.3% current ENDS only, 6.2% current cigarette/other products only, 10.8% current dual/poly, 32.1% any past product, and 43.7% never used. Health risk akin to smoking was the most often selected factor discouraging ENDS use (50.4%), followed by harmful chemicals (47.1%), device dangers (26.0%), parent disapproval (24.4%), high nicotine level (23.3%), leads to smoking (21.0%), increased expense (17.9%), doctor/nurse discouraging (17.8%), friend criticizing (11.7%), and other (7.7%) (Fig 1A). Multivariable logistic regression models revealed that perceptions significantly varied by age, sex, race/ethnicity, parental education, and particularly tobacco/ENDS use status. For example, the odds of selecting health risk as discouraging were 34% lower in boys v. girls, 38% lower for current ENDS only users v. never users, and 33% higher in those with higher parental education (Fig 1B).

Conclusions:
For youth, perceived health risk was most important in discouraging ENDS use. Factors discouraging ENDS use were associated with participant sociodemographic and tobacco/ENDS use status. The findings have relevance for developing communication and education strategies to prevent or reduce ENDS use--thus reducing CVD/health burden--and suggest tailoring such messaging may be key to maximizing impact.
Abstract P224: Does Cognitive Function And C-reactive Protein Produce A Combined Effect On All-cause Mortality Risk? An Analysis Of Older Adults In The 1999-2002 NHANES
Authors: Zipperer Madeline B , Churilla James R , Richardson Michael R
Published: May 2021

Introduction:
There is limited evidence examining the combined effects of cognitive function and C-reactive protein (CRP) on mortality risk using a large nationally representative sample of U.S. adults.

Hypothesis:
We assessed the hypothesis that cognitive function and CRP produce a combined effect in predicting all-cause mortality risk.

Objective:
Examine the combined effects of cognitive function and CRP in predicting all-cause mortality in a large nationally representative sample of U.S. adults.

Methods:
The study sample (n=2,111) included older adults (≥ 60 years of age) who participated in the 1999-2002 National Health and Nutrition Examination Survey. A four-level variable was created based on CRP concentration and cognitive function (high cognitive function and low to average CRP; high cognitive function and high CRP; low cognitive function and low to average CRP; low cognitive function and high CRP).

Results:
Compared to a referent group with low to average CRP and high cognitive function, analysis revealed a statistically significant increase in risk of all-cause mortality in adults with high CRP and low cognitive function (Hazards Ratio [HR] 1.97; 95% Confidence Interval [CI], 1.52-2.55, p<0.0001) and in adults with low to average CRP and low cognitive function (HR 1.76; 95% CI, 1.44-2.15, p<0.0001). Similar relationships were not revealed in adults with high cognitive function, regardless of CRP concentration.

Conclusions:
In a large nationally representative sample of older U.S. adults, low cognitive function was associated with increased all-cause mortality risk independent of CRP concentration.
Contrasting species diversification of Eutarsopolipus (Acariformes: Podapolipidae) on Castelnaudia and Notonomus (Coleoptera: Carabidae)
Authors: SEEMAN OWEN D.
Published: May 2021

Eutarsopolipus (Acari: Podapolipidae) is a large genus of mites parasitic in the subelytral space of carabid beetles. Herein, I explore the species radiations of Eutarsopolipus on the pterostichine genera Castelnaudia and Notonomus found in the rainforests of eastern Australia. Castelnaudia has an extraordinary radiation of podapolipid mite species, with most beetle species carrying multiple species of mites unique to each host. In contrast, each Notonomus species had just one species of Eutarsopolipus (with the exception of a single male mite of another species), and in four of the five host species examined, the single mite species could not be distinguished from each other. The host beetles and their new mite species are: Castelnaudia cordata with E. hebronae sp. nov., E. osculum sp. nov. and E. umbonatus sp. nov.; Castelnaudia eungella with E. savatus sp. nov.; Castelnaudia marginifera with E. labiatus sp. nov.; Castelnaudia mixta with E. mixtus sp. nov.; Castelnaudia porphyriaca with E. basiatus sp. nov., E. despoticus sp. nov. and E. teuceri sp. nov.; Castelnaudia septemcostata with E. nahmani sp. nov. and E. raveni sp. nov.; Castelnaudia setosiceps with E. hadros sp. nov.; Notonomus aurifer, N. dimorphicus, N. flos and N. spurgeoni with E. janus sp. nov.; and Notonomus transitus with E. biuncatus sp. nov.  All the described species from Castelnaudia were from the ochoai species group, and the species on Notonomus were from the leytei species group. Ten additional undescribed species were also found on these hosts, all in numbers insufficient for description: nine from Castelnaudia (ochoai and pterostichi species groups) and one from Notonomus (undetermined species group). Synhospitality was common on Castelnaudia, with four species of Eutarsopolipus on C. cordata, C. eungella, C. porphyriaca and three on C. septemcostata. Co-infestation was also common, with one-third of infested beetles hosting two or more species of Eutarsopolipus. I speculate that the greater longevity and slower speciation rates of Castelnaudia have permitted more successful host-switching and speciation of its parasites.
Design and Performance Analysis of Application Specific Integrated Circuit for Internet of Things Applications
Authors: Pogra Vivek , Singh Amandeep , Vishvakarma Santosh Kumar , Raj Balwinder
Published: May 2021

This paper proposes a novel design of application specific integrated circuit (ASIC) which is capable of connecting sensor network and other electronic systems to the internet. The transfer of data between different networks and electronic systems is controlled by internet of things
(IoT) platform with the help of instruction sent to ASIC. ASIC will act as serial peripheral interface (SPI) master to all connected networks and data will be transferred serially between them. The different ASIC modules are SPI module, control module, memory module and data/instruction decoder
with additional modules built-in self-test (BIST) and direct memory access (DMA). The proposed ASIC will consume less power as compared to conventional microcontroller/microprocessor due to SPI feature along with DMA on ASIC for IoT applications. It is described in very high speed integrated
circuit hardware description language (VHDL) at register transfer level (RTL) and simulation is done on the Vivado 2016.2.
Weakly Nonlinear Double-Diffusive Oscillatory Magneto-Convection Under Gravity Modulation
Authors: Kiran Palle , Manjula S. H.
Published: May 2021

An imposed time-periodic gravity field effect on double-diffusive magneto-convection for oscillatory mode has been investigated. The gravity field consisting of steady and periodic modes. A layer is confined with an electrically conducting fluid with Boussines q approximation and heated
from below cooled from above. While using the perturbation technique we study nonlinear double-diffusive convection just above the critical state of the onset convection. The growth rate of the disturbances is confined with a critical Rayleigh number to investigate oscillatory convection.
Analysis of finite- amplitude convection has been derived through the complex Ginzburg-Landau equation (CGLE). The convective heat and mass transfer obtained through CGLE at third-order under solvability conditions. This convective amplitude is required to estimate heat and mass transfer in
terms of the Nusselt and Sherwood numbers. It is found that increasing the frequency of modulation causes diminishing heat and mass transfer. The effect of Prandtl number Pr, magnetic Prandtl number Pm, and amplitude δ enhances heat/mass transfer. It is found that an oscillatory mode
of convection enhances the heat and mass transfer than the stationary mode. Further, streamlines, isotherms, and isohalines have their usual nature on double-diffusive magnetoconvection.
Controls on Wintertime Nonbrightband Rain Rate and Frequency in California’s Northern Coast Ranges
Authors: Cann Matthew D. , White Allen B.
Published: May 2021

Non-brightband (NBB) rain is a shallow, orographic precipitation that does not produce a radar brightband as a result of melting ice crystals. However, NBB rain is not the same as warm rain, which excludes ice from being involved in the microphysical growth of precipitation. Despite this difference, NBB rain is often treated as warm rain in the literature, and past studies have mostly ignored the role of ice. Here, we use two wet-seasons (2015-16 and 2016-17) at four precipitation observing sites in the Northern Coast Ranges of California to show the role of echo top height and ice in determining NBB rain intensity. It was found that NBB rain was only absent of brightbands 32-46% of the time depending on location of the site. Additionally, all NBB rain rates that exceeded 10 mm hr−1 exhibited observable brightbands during the hour period. We also define Growth Efficiency (GE) as the ability of shallow rain clouds to produce raindrops larger than drizzle size (D > 0.5 mm). High-GE rain drop size distributions were composed of fewer small drops and more large drops than low-GE rain, which was mostly drizzle. High-GE rain occurred with echo top heights above the freezing level where rapid growth of precipitation was observed by radar. Echo tops that only extended 1 km or less above the freezing level suggested hydrometeor growth from mixed-phase processes, indicating that ice may be present in coastal precipitation at warmer temperatures than previously considered.
Blending Noah, SMOS and In-Situ Soil Moisture Using Multiple Weighting and Sampling Schemes
Authors: Zhang Ning , Quiring Steven M. , Ford Trent W.
Published: May 2021

Soil moisture can be obtained from in-situ measurements, satellite observations, and model simulations. This study evaluates the importance of in-situ observations in soil moisture blending, and compares different weighting and sampling methods for combining model, satellite, and in-situ soil moisture data to generate an accurate and spatially-continuous soil moisture product at 4-km resolution. Four different datasets are used: Antecedent Precipitation Index (API), KAPI, which incorporates in-situ soil moisture observations with the API using regression kriging, SMOS L3 soil moisture, and model-simulated soil moisture from the Noah model as part of the North American Land Data Assimilation System (NLDAS). Triple collocation, least square weighting, and equal weighting are used to generate blended soil moisture products. An enumerated weighting scheme is designed to investigate the impact of different weighting schemes. The sensitivity of the blended soil moisture products to sampling schemes, station density and data formats (absolute, anomalies and percentiles) are also investigated. The results reveal KAPI outperforms API. This indicates that incorporating in-situ soil moisture improves the accuracy of the blended soil moisture products. There are no statistically significant (p>0.05) differences between blended soil moisture using triple collocation and equal weighting approaches, and both methods provide sub-optimal weighting. Optimal weighting is achieved by assigning larger weights to KAPI and smaller weights to SMOS. Using multiple sources of soil moisture is helpful for reducing uncertainty and improving accuracy, especially when the sampling density is low, or the sampling stations are less representative. These results are consistent regardless of how soil moisture is represented (absolute, anomalies or percentiles).
The Australian industrial system in the era of COVID-19
Authors: O’Neil Michele
Published: May 2021

COVID-19 caused sudden and serious damage to the Australian economy. The effects have been spread unevenly, and highlighted the shortcomings of over-reliance on insecure forms of work. The lack of any form of paid leave for casual and other insecure workers undermined the public health response, and was emblematic of the broader consequences of insecurity. Despite its limitations, Australia’s industrial relations system responded to the challenges of the pandemic in a way that less regulated and ‘decentralised’ systems would not have been able to. This article argues that the union movement was critical to Australia’s successful response, and that the award system proved to be an adaptable mechanism to deliver change at a national level while ensuring that the representative voice of workers was heard, and basic industrial protections were not jettisoned. Industry bargaining would have also been a beneficial tool to deal with economy-wide issues of this kind. The article urges that the lessons of the pandemic be learned as we move to a recovery phase and that we ensure there are more secure jobs, better bargaining rights and improvements to basic protections to ensure that workers’ rights are not eroded.
Confirmatory Factor Analysis, Internal Consistency, Gender Differential Item Functioning and Discriminant Validity of the Fear of COVID-5 Scale Amidst Emerging Adult University Students in Mexico
Authors: Campo-Arias Adalberto , Tirado-Otálvaro Andrés Felipe , Álvarez-Solorza Isabel , Cassiani-Miranda Carlos Arturo
Published: May 2021

The study aimed to perform confirmatory factor analysis, internal consistency, gender differential item functioning, and discriminant validity of the Fear of COVID-5 Scale in emerging adult students of a university in Mexico. Confirmatory factor analysis, internal consistency (Cronbach's alpha and McDonald's omega), and gender differential item functioning were estimated (Kendall tau b correlation). The Fear of COVID-5 Scale showed a one-dimension structure (RMSEA = 0.07, CFI = 0.98, TLI = 0.96, and SRMR = 0.02), with high internal consistency (Cronbach's alpha of 0.78 and McDonald's omega of 0.81), non-gender differential item functioning (Kendall tau b between 0.07 and 0.10), and significant discriminant validity (Higher scores for fear of COVID-19 were observed in high clinical anxiety levels). In conclusion, the Fear of COVID-5 Scale presents a clear one-dimension structure similar to a previous study.
Disease burden of liver cancer attributable to specific etiologies in China from 1990 to 2019: An age-period-cohort analysis
Authors: Yu Songxia , Wang Haowen , Hu Tingyang , Yu Chengbo , Liu Hanbo , Chen Xudong , Jiang Jingsong , Deng Min
Published: May 2021

Temporal trends of total liver cancer have been well reported in China, especially the trends caused by hepatitis B (HBV); however, the trends of liver cancer attributable to specific etiologies have rarely been reported in China. Thus, this study aims to describe the temporal trends in the incidence, mortality and DALYs of total and etiology-specific liver cancer in China from 1990 to 2019. We extracted the incidence, mortality and disability-adjusted life years (DALYs) of total and etiology-specific liver cancer in China from 1990 to 2019 from global disease burden (GBD) 2019. We plotted the trends in the age-standardized rates for incidence, mortality, and DALYs using locally weighted regression (LOESS)-smoothed data from 1990 to 2019. The age-standardized rate for the incidence of liver cancer was analyzed with an age-period-cohort method. The age-standardized rates for incidence, death, and DALYs decreased by −58.8%, −63.8%, and −65.6%, respectively, between 1990 and 2019. The age-standardized rates of incidence, mortality, and DALYs of total liver cancer showed similar temporal patterns, presenting an overall decline, with the average annual percentage change (AAPC) ranging from −3.3% to −3.8%. People in the period before 2007 had a higher risk, and people after 2007 had a lower risk. The cohort risk ratios (RRs) showed decreasing patterns, with the most rapid decline observed in the 1910 to 1960 cohorts. Our study generally revealed favorable decreasing trends for total and etiology-specific liver cancer in China from 1990 to 2019. Despite the overall decline in liver cancer due to heavy alcohol use and obesity from 1990 to 2019, there have been apparent upward trends since 2006. Planned population-wide interventions targeting heavy alcohol use and obesity may mitigate the increasing trends in liver cancer attributable to alcohol use and NASH.
The Relationship Between First-Year Learning Communities and Academic Performance in Introductory Psychology and Sociology
Authors: Ma-Kellams Christine , Kwon Roy
Published: May 2021

Objective:

How do learning communities influence academic performance in Introductory Psychology?

Method:

The present research examines the relationship between participation in first-year students learning communities and academic performance across a variety of course requirements (midterms, finals, papers, and class participation) in introductory psychology and, for comparison, sociology courses.

Results:

Students who took Introductory Psychology as part of a first-year-student learning community outperformed their peers (who took the same course without a learning community) on the first exam of the semester and were less likely to miss assignments but otherwise showed no significant differences on the other course assignments; introductory sociology students part of these communities showed even greater differences in performance that lasted through the end of the semester.

Conclusion:

First-year students learning communities offers significant albeit limited benefits for student performance in introductory courses in the social sciences.

Teaching Implications:

Short of institutional efforts to enact programming for first-year learning communities, introductory psychology instructors can attempt to simulate the experience of such communities by promoting a sense of belonging via extra-curricular service or discipline-related activities.
Passive noise control in buildings: An engineering case study of ducted systems
Authors: Ibarra-Zarate David I , Navas-Reascos Gustavo , Padilla-Ortiz AL
Published: May 2021

The most common noise sources in buildings are related to Heating, Ventilating and Air Conditioning (HVAC) systems, plumbing systems, electrical systems and exterior sources. Passive Noise Control (PNC) techniques in buildings have been implemented in several ways. The aim of this work is to analyses the use of silencer to attenuate the noise in the ducts that are part of the ventilation systems in buildings, internal combustion systems, fans, gas conduction systems, boilers, etc. The main objective of a silencer is to reduce the transmission of noise, disturbing as little as possible the circulation of gas or liquid. In the first instance, the silencers are classified as reactive and dissipative, depending on whether the attenuation of the noise is produced by reflective or dissipative mechanisms, respectively. In a reactive silencer, the losses occur essentially due to the reflections of the sound waves in impedance discontinuities, such as widening or narrowing of the tube. In dissipative silencers, the flow is in contact with a large surface of absorbent material. The attenuation of the noise is then produced by visco-thermal losses in the porous material. In this work, a practical issue will be addressed with a noise reduction of 19 dBA in 60 Hz.

Practical application

Noise is a current issue in residential areas that could lead to health problems for people. The origin of these noises within buildings is very diverse, one of them is produced by ducts. Appling the PNC technique in modern building construction would be a good prevention practice. For this reason, in this project a PNC system was carried out in the ducts of a residential building, which could be used as a praiseworthy solution, avoiding problems for the inhabitants of these spaces.