bluuebunny/crossref_metadata_2025 huggingface dataset:
TREAFET: Temperature-Aware Real-Time Task Scheduling for FinFET based Multicores
Authors: Chakraborty Shounak , Sharma Yanshul , Moulik Sanjay
Published: May 2024

The recent shift in the VLSI industry from conventional MOSFET to FinFET for designing contemporary chip-multiprocessor (CMP) has noticeably improved hardware platforms’ computing capabilities, but at the cost of several thermal issues. Unlike the conventional MOSFET, FinFET devices experience a significant increase in circuit speed at a higher temperature, called temperature effect inversion (TEI), but higher temperature can also curtail the circuit lifetime due to self-heating effects (SHEs). These fundamental thermal properties of FinFET introduced a new challenge for scheduling time-critical tasks on FinFET-based multicores that how to exploit TEI towards improving performance while combating SHEs. In this work,TREAFET, a temperature-aware real-time scheduler, attempts to exploit the TEI feature of FinFET-based multicores in a time-critical computing paradigm. At first, the overall progress of individual tasks is monitored, tasks are allocated to the cores, and finally, a schedule is prepared. By considering the thermal profiles of the individual tasks and the current thermal status of the cores, hot tasks are assigned to the cold cores and vice-versa. Finally, the performance and temperature are balanced on-the-fly by incorporating a prudential voltage scaling towards exploiting TEI while guaranteeing the deadline and thermal safety. Moreover,TREAFETstimulates the average runtime frequency by employing an opportunistic energy-adaptive voltage spiking mechanism, in which energy saving during memory stalls at the cores is traded off during the time slice having the spiked voltage. Simulation results claimTREAFETmaintains a safe and stable thermal status (peak temperature below 80 °C) and improves frequency up to 17% over the assigned value, which ensures legitimate time-critical performance for a variety of workloads while surpassing a state-of-the-art technique. The stimulated frequency inTREAFETalso finishes the tasks early, thus providing opportunities to save energy by power gating the cores, and achieves a 24% energy delay product (EDP) gain on average.
TEFLON: Thermally Efficient Dataflow-aware 3D NoC for Accelerating CNN Inferencing on Manycore PIM Architectures
Authors: Narang Gaurav , Ogbogu Chukwufumnanya , Doppa Janardhan Rao , Pande Partha Pratim
Published: May 2024

Resistive random-access memory (ReRAM)-based processing-in-memory (PIM) architectures are used extensively to accelerate inferencing/training with convolutional neural networks (CNNs). Three-dimensional (3D) integration is an enabling technology to integrate many PIM cores on a single chip. In this work, we propose the design of a
t
hermally
e
fficient data
flo
w-aware monolithic 3D (M3D)
N
oC architecture referred to as
TEFLON
to accelerate CNN inferencing without creating any thermal bottlenecks.
TEFLON
reduces the Energy-Delay-Product (EDP) by 42%, 46%, and 45% on an average compared to a conventional 3D mesh NoC for systems with 36-, 64-, and 100-PIM cores, respectively.
TEFLON
reduces the peak chip temperature by 25
K
and improves the inference accuracy by up to 11% compared to sole performance-optimized SFC-based counterpart for inferencing with diverse deep CNN models using CIFAR-10/100 datasets on a 3D system with 100-PIM cores.
Prostate Cancer Detection from MRI Using Efficient Feature Extraction with Transfer Learning
Authors: Islam Rafiqul , Imran Al , Rabbi Md. Fazle
Published: May 2024

Prostate cancer is a common cancer with significant implications for global health. Prompt and precise identification is crucial for efficient treatment strategizing and enhanced patient results. This research study investigates the utilization of machine learning techniques to diagnose prostate cancer. It emphasizes utilizing deep learning models, namely VGG16, VGG19, ResNet50, and ResNet50V2, to extract relevant features. The random forest approach then uses these features for classification. The study begins by doing a thorough comparison examination of the deep learning architectures outlined above to evaluate their effectiveness in extracting significant characteristics from prostate cancer imaging data. Key metrics such as sensitivity, specificity, and accuracy are used to assess the models’ efficacy. With an accuracy of 99.64%, ResNet50 outperformed other tested models when it came to identifying important features in images of prostate cancer. Furthermore, the analysis of understanding factors aims to offer valuable insights into the decision-making process, thereby addressing a critical problem for clinical practice acceptance. The random forest classifier, a powerful ensemble learning method renowned for its adaptability and ability to handle intricate datasets, then uses the collected characteristics as input. The random forest model seeks to identify patterns in the feature space and produce precise predictions on the presence or absence of prostate cancer. In addition, the study tackles the restricted availability of datasets by utilizing transfer learning methods to refine the deep learning models using a small amount of annotated prostate cancer data. The objective of this method is to improve the ability of the models to generalize across different patient populations and clinical situations. This study’s results are useful because they show how well VGG16, VGG19, ResNet50, and ResNet50V2 work for extracting features in the field of diagnosing prostate cancer, when used with random forest’s classification abilities. The results of this work provide a basis for creating reliable and easily understandable machine learning-based diagnostic tools for detecting prostate cancer. This will enhance the possibility of an early and precise diagnosis in clinical settings such as index terms deep learning, machine learning, prostate cancer, cancer identification, and cancer classification.
Oxygen Vacancy‐Rich NiCo2O4 on Carbon Framework with Controlled Pore Architectures as Efficient Bifunctional Electrocatalysts for Zn‐Air Batteries
Authors: Kim Min , Hong Jeong Hoo , Kim Ki Beom , Koo Hye Young , Kang Yun Chan
Published: May 2024

Transition metal oxides are considered alternative electrocatalysts for ZAB owing to their multiple oxidation states. However, they have limitations such as low electrical conductivity and the deficiency of reactive sites. In this study, to overcome these shortcomings and improve electrocatalytic activity, oxygen vacancies and porous architectures were introduced through a partial reduction process and a porous carbon framework. Open porous carbon microspheres with uniformly loaded NiCo2O4 nanosheets and oxygen vacancies (V‐NCO/OPC) displayed enhanced electrocatalytic performance with a low Tafel slope (68 mV dec-1) in the oxygen reduction reaction (ORR) and a low overpotential (402 mV) at 10 mA cm–2 in the oxygen evolution reaction (OER). The combined effect of the oxygen vacancies and porous architecture can offer sufficient active sites, modify the electronic structure of the metal oxide surface, and facilitate mass transport, enhancing the electrocatalytic properties of V‐NCO/OPC. Furthermore, when applied for ZAB, V‐NCO/OPC demonstrated better electrochemical performance including discharge power density (154.9 mW cm-2) at the current density of 175.9 mA cm-2, low voltage gap (0.85 V) at the initial cycle, and long‐term (250 h) cycle stability at the current density of 10 mA cm−2 than those of noble‐metal electrocatalysts.
Seguridad y espacios públicos: Boric tiene razón
Authors: Díaz Carlos
Published: May 2024

La lucha contra el crimen es uno de los principales desafíos que enfrenta La Moneda y, como en otros ámbitos de la política pública, requiere de un enfoque integral. En este contexto, las declaraciones recientes del Presidente Gabriel Boric sobre la importancia de recuperar los espacios públicos como parte fundamental de la estrategia para combatir el crimen merecen una reflexión detenida. (seguir leyendo...)
Anastrozole Dose Escalation for Optimal Estrogen Suppression in Postmenopausal Early-Stage Breast Cancer: A Prospective Trial
Authors: Haddad Tufia C. , Suman Vera J. , Giridhar Karthik V. , Sideras Kostandinos , Northfelt Donald W. , Ernst Brenda J. , O’Sullivan Ciara C. , Singh Ravinder J. , Desta Zeruesenay , Peethambaram Prema P. , Hobday Timothy J. , Chumsri Saranya , Leon-Ferre Roberto A. , Ruddy Kathryn J. , Yadav Siddhartha , Taraba Jodi L. , Goodnature Barbara , Goetz Matthew P. , Wang Liewei , Ingle James N.
Published: May 2024

Purpose:

We previously reported that postmenopausal women with estrogen receptor-α–positive breast cancer receiving adjuvant anastrozole 1 mg/day (ANA1) with estrone (E1) ≥1.3 pg/mL and estradiol (E2) ≥0.5 pg/mL [inadequate estrogen suppression (IES)] had a threefold increased risk of a breast cancer event. The objective of this study was to determine if increasing anastrozole to 10 mg/day (ANA10) could result in adequate estrogen suppression (AES: E1 <1.3 pg/mL and/or E2 <0.5 pg/mL) among those with IES on ANA1.

Patients and Methods:

Postmenopausal women with estrogen receptor-α–positive breast cancer planning to receive adjuvant ANA1 were eligible. E1 and E2 were assessed pre- and post-8 to 10 weeks of ANA1. Those with IES were switched to 8- to 10-week cycles of ANA10 followed by letrozole 2.5 mg/day. E1 and E2 were assessed after each cycle. Anastrozole concentrations were measured post-ANA1 and post-ANA10. Primary analyses included patients who documented taking at least 80% of the planned treatment (adherent cohort).

Results:

In total, 132 (84.6%) of 156 eligible patients were ANA1 adherent. IES occurred in 40 (30.3%) adherent patients. Twenty-five (78.1%) of 32 patients who began ANA10 were adherent, and AES was achieved in 19 (76.0%; 90% confidence interval, 58.1%–89.0%) patients. Anastrozole concentrations post-ANA1 and post-ANA10 did not differ by estrogen suppression status among adherent patients. AES was maintained/attained in 21 (91.3%) of 23 letrozole-adherent patients.

Conclusions:

Approximately 30% of ANA1-adherent patients had IES. Among those who switched to ANA10 and were adherent, 76% had AES. Further studies are required to validate emerging data that ANA1 results in IES for some patients and to determine the clinical benefit of switching to ANA10 or an alternative aromatase inhibitor.
Table S5 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Tumor volume and other MRI features: Pearson r coefficient and p values are indicated for each variable. Tumor volume is associated with midline shift.
Table S3 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Tumor FKBP51-expression does not affect the counts of the indicated peripheral blood TAM phenotypes nor does it influence CD4 and CD8 T lymphocytes’ counts. Pearson r coefficient and p values are indicated for each variable.
Supplementary Figure S8 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Comparison of flow cytometry data of TME (upper) and PB (lower) between primary tumors (black columns) and recurrences (red columns). Only a difference (*) in HLA-DR and CD206 TME-TAMs (higher in primary tumors than recurrences) was registered. No difference in PB-TAMs counts was relieved.
Supplementary Figure S5 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Cytokine levels in the sera from the two patients’ groups. Beyond the nominal p-values, the adjusted p-values by FDR method are also calculated and reported.
Supplementary Figure S2 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Values of MFI of HLA-DR expression in TME-TAMs.
Supplementary Figure S12 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Ependymal enhancement (EE) and Immunophenotype of TME and peripheral blood. Graphical representation of flow cytometry data of TME (graphs on the left) and peripheral blood (graphs on the right) from primary tumors (upper) and recurrences (lower). No EE, black histograms; EE, red histograms. P values are calculated using Mann Whitney test. The number of primary tumors with EE was <3.
FIGURE 4 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Immunologic markers as indicators of imaging profiles. A, Linear regression of MFI values of HLA-DR TME-TAMs and the counts of CD163/FKBP51s PB-TAMs versus CCI (upper images). T2 FLAIR and (lower images) T1 with gadolinium on the sagittal plane, passing through the CC. No alteration of the CC signal in the left images. The right images show the infiltration of the anterior trunk of the CC (arrows). B, Linear regression of tumor HLA-DR expression and ADC. Representative ADC maps of left hemispheric GBMs. The signal of the solid tumor component appears hyperintense in a GBM of the frontoparietal lobe in the left hemisphere (right, high ADC value), low intense signal in a GBM of the temporal lobe of the right hemisphere (left, low ADC value). C, Correlation of TV versus HLA-DR brightness of TME-TAMs or versus counts of PD-L1 TME-TAMs. Axial T1w images after gadolinium show on the left a GBM with a small focal area of enhancement in the left frontal lobe (small TV). In contrast, the image on the right shows a GBM with an extensive enhancement area in the right frontal lobe (large TV). D, Correlation of NS with tumor PD-L1 expression and counts of PD-L1/FKBP51s PB-TAMs. T1w axial images after gadolinium: (left) frontal GBM in the right hemisphere shows vivid enhancement, which spares only small necrotic areas (NS: 1); (right), GBM in the frontoparietal lobe of the left hemisphere shows predominantly peripheral gadolinium enhancement with a large central necrotic component (NS: 3).
FIGURE 1 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

GBM TME analysis clusters two groups that differ in TAM composition. A, The subjects were divided into two groups using the Ward hierarchical clustering method based on the variable parameters measured in the TME (top heat map). The data from PB (bottom heat map) were not used for clustering, they followed the separation of TME data. Age, gender, HLA-DR tumor, FKBP51s tumor, PD-L1 tumor, and % of total infiltrating CD14 are reported as annotations of the heat map. B, Values of TME immunophenotype measured for each cluster are reported as box plots. C, Values of PB immunophenotype are reported as box plots. The P values of statistical difference tests are shown. *, P < 0.05; **, P < 0.01; ***, P < 0.001; ****, P < 0.0001.
Skin Transillumination Improves Peripheral Vein Cannulation by Residents in Neonates: A Randomized Controlled Trial
Authors: Hinterstein Samantha , Ehrhardt Harald , Zimmer Klaus-Peter , Windhorst Anita Cornelia , Kappesser Judith , Hermann Christiane , Schuler Rahel , Waitz Markus
Published: May 2024

Introduction: Establishing peripheral vein access is challenging for pediatric residents and a painful procedure for neonates. We assessed the efficacy of a red light-emitting diode transilluminator during peripheral vein catheter insertion performed by pediatric residents. Methods: Patients were stratified by current weight (≤1,500 g, >1,500 g) and randomized to the transillumination or the control group. The first three attempts were performed by pediatric residents, followed by three attempts by a neonatologist. The primary outcome was success at first attempt. Secondary comparisons included time to successful insertion and overall success rates of residents and neonatologists. Results: A total of 559 procedures were analyzed. The success rate at resident’s first attempt was 44/93 (47%) with transillumination versus 44/90 (49%) without transillumination (p = 0.88) in the strata ≤1,500 g and 103/188 (55%) with transillumination versus 64/188 (34%) without transillumination in the strata >1,500 g (p < 0.001). The overall success rate for residents was 86% in the transillumination versus 73% in the control group in the strata >1,500 g (p = 0.003) but not different in the strata ≤1,500 g (78/93 [84%] vs. 72/90 [80%], p = 0.57). There was no effect when the experience level of residents exceeded 6 months. Neonatologists’ overall success rate and time to successful cannulation did not differ significantly in both weight strata. Conclusion: Transillumination improves the first-attempt success rate of peripheral vein cannulation performed by pediatric residents in neonates >1,500 g, while no benefit was found in infants ≤1,500 g.
Factors Considered by Experienced Urologists when Selecting Alpha-Blockers for Patients with Lower Urinary Tract Symptoms or Benign Prostatic Hyperplasia according to Age
Authors: Lee Hyomyoung , Lee Jung Hoon , Choo Min Soo , Cho Min Chul , Son Hwancheol , Jeong Hyeon , Yoo Sangjun
Published: May 2024

Introduction: The objectives of the study were to examine the opinions of urology specialists on whether there are actual differences in efficacy among α1-blockers and to identify the factors that should be considered when prescribing these medications according to age. Methods: We surveyed 50 South Korean urology specialists with over 3 years of clinical experience in secondary or tertiary hospitals in July-August 2021. The survey covered urologists' demographics, awareness of α1-blocker prescription differences, and key factors in α1-blocker selection based on LUTS severity and patient age. Results: Overall, 82% of the respondents believed that there were differences in the efficacy of α1-blockers in actual practice according to age. Over 90% of the respondents agreed on the need for head-to-head comparison studies to compare the effects of different α1-blockers. Regardless of the severity of LUTS, urologists prioritize cardiovascular side effects when prescribing α1-blockers to patients aged ≥70 years. Further, 19% of the urologists prioritized ejaculatory side effects for mild-to-moderate LUTS and 9% for severe LUTS (p < 0.001). Conclusions: This study shows that head-to-head studies comparing the efficacy of different α1-blockers are highly valuable for the real-world clinical application of α1-blockers. Notably, urologists prioritize cardiovascular and ejaculatory side effects in older and younger patients while prescribing α1-blockers, respectively.
Abstract 03: Cardiovascular Disease Risk Factor Control Following Release From Carceral Facilities
Authors: Aminawung Jenerius A , Puglisi Lisa , Roy Brita , Horton Nadine , Elumn Johanna , Lin Hsiuju , Bibbins-Domingo Kirsten , Krumholz Harlan M , Wang Emily
Published: May 2024

Background:
Incarceration is a social determinant of cardiovascular disease (CVD) but is rarely addressed in clinical settings or cardiovascular prevention efforts. People who have been incarcerated are more likely to develop CVD at younger ages and have worse cardiovascular outcomes compared with the general population, even after controlling for traditional risk factors. The objective of this study is to identify incarceration-specific factors that are associated with uncontrolled CVD risk factors and identify potential targets for prevention specific to this population.

Methods:
Using data from Justice-Involved Individuals Cardiovascular Disease Epidemiology (JUSTICE), a prospective cohort study of individuals released from incarceration with CVD risk factors, we examine the association between incarceration-specific and psychosocial factors and CVD risk factor control, including systolic blood pressure (SBP≥140 mmHg, diastolic blood pressure (DBP)≥90, body mass index (BMI)≥40, glycosylated hemoglobin (HbA1c) ≥8%, and low-density lipoprotein cholesterol (LDL-c) ≥160). Incarceration-specific factors include the conditions of confinement (jail vs. prison, time spent in solitary confinement), the carceral health care delivery system (co-payment, medication self-management, discharge planning), and collateral sanctions following release (barriers to housing, food, employment due to criminal record). Psychosocial factors included perceived discrimination and stress, self-efficacy, and lifetime adversity.

Results:
The mean age of participants (N=417) was 45.2 ±SD 10.7 years and disproportionately men (92%), racially minoritized groups (80%), and poor (66% without an income). Over half (53%) had at least one uncontrolled CVD risk factor. Having been incarcerated in a jail, as compared with prison, was associated with an increased odds of having an uncontrolled CVD risk factor, even after adjusting for age, race and ethnicity, gender, perceived stress, depression symptoms, and life adversity score (AOR 1.79, 95% CI 1.08-2.94). People held in jail, as compared with prison, had higher rates of smoking, uncontrolled hypertension, fewer opportunities to manage one’s own medications while incarcerated, or receive medications prior to release.

Discussion:
Release from jail is associated with worse CVD risk factor control and requires tailored intervention focused on smoking cessation, hypertension control, and improved discharge planning. These data are especially informative as states design and implement the Centers of Medicare & Medicaid Services new Medicaid Reentry Section 1115 Demonstration Opportunity, which allow Medicaid programs for the first time in history to cover services prior to release from correctional facilities that address chronic health conditions like cardiovascular disease and its risk factors.
Abstract 11: Biological Age as a Predictor of Arterial Stiffness in Midlife Women
Authors: Spikes Telisa , Thorpe Roland J , Alonso Alvaro , Pelkmans Jordan , Dunbar Sandra B , Mehta Puja , Pemu Priscilla , Taylor Herman A , Quyyumi Arshed A
Published: May 2024

Introduction:
Black women develop hypertension (HTN) earlier in life and experience higher cardiovascular disease (CVD) morbidity and mortality rates at younger ages compared to White women. Growing evidence suggests this may be due to Black women experiencing premature physiological deterioration and accelerated biological aging, true global state of an aging organism. Yet, the relationship between biological aging and arterial stiffness, a precursory marker of subclinical CVD, in Black women has not been studied. We investigated the association between biological age (BA) and arterial stiffness in Black and White women.

Hypothesis:
BA will be associated with arterial stiffness and this association will be modified by race.

Methods:
In 219 women (n=140 White, n=79 Black) enrolled in the Morehouse-Emory Center for Health Equity and Predictive Health Institute cohorts (age range 25-49), arterial stiffness was assessed using carotid-femoral pulse wave velocity (CFPWV), measured by applanation tonometry (SphygmoCor®). BA was estimated using the Klemera-Doubal method from 10-select clinical biomarkers (BUN, Creatinine, Total Cholesterol, Alkaline Phosphatase, MCV, RDW, Albumin, Lymphocytes, WBC, CRP) and chronological age. Overall and race-specific associations between BA and arterial stiffness adjusting for demographics (race, education, income, marital status), lifestyle (alcohol, smoking), clinical (body mass index, HTN, diabetes history, SBP), and mental health factors (depressive symptoms) were estimated using multiple linear regression.

Results:
Mean chronological and BA age was 40 (SD=6.1) and 43 (SD=7.2) years, respectively. Black women had a BA that was 3.4 (SD=5.7) years older than their chronological age, while the difference was 1.3 (SD=4.8) years older for White women. Thus, Black women’s BA was 2.1 (95%CI: -3.5, -0.6) years older than White women. Mean (SD) CFPWV was 7.3 (1.1) in Black women and 6.3 (0.8) in White women. Overall, BA was associated with higher (worse) CFPWV in the minimal (β=0.06 m/s per year, 95%CI: 0.03, 0.08) and fully adjusted models (β=0.04 m/s, 95%CI: 0.01, 0.08). There was no significant interaction between race and BA in the association with arterial stiffness.

Conclusions:
Black women had older BA and worse CFPWV than White women. BA may partially account for the higher arterial stiffness in Black women.
Abstract 29: Effects of a Novel Structural Variant in Hemoglobin on Racial Differences in Hemoglobin A1c
Authors: Wallace Amelia S , Jun Goo , Boerwinkle Eric , Rooney Mary R , Arking Dan E , Coresh Joe , Selvin Elizabeth
Published: May 2024

Background:
Studies have found higher hemoglobin A1c (HbA1c) at similar levels of glucose for adults who self-identify as Black vs. White, but the mechanism for this difference is poorly understood. Genetic variants that are more common in persons of African descent that affect hemoglobin (Hb) or red cell turnover may explain some of this difference. A recently discovered deletion in a non-coding region of the
HBA2
gene is common in persons of African descent and may contribute to differences in Hb and HbA1c.

Methods:
We evaluated 5178 participants (mean age 56 years, 18% Black, 55% female) who attended Visit 2 (1990-1992) of the Atherosclerosis Risk in Communities Study without diagnosed diabetes and BMI <30 kg/m
2
. We compared the distributions of Hb and HbA1c in Black and White participants by the number of deletions in the
HBA2
region (zero, one, or two). We used linear regression to evaluate the extent to which this genetic variant explained glucose-independent Black-White differences in HbA1c and Hb.

Results:
Deletions in the
HBA2
region were common in Black participants (30% one, 4% two) but rare in White participants (1%: one, 0%: two). Mean Hb was lower in Black participants with one (-0.38 g/dL, p<0.001) and two deletions (-0.76 g/dL, p=0.002) and HbA1c was higher (one: +0.11%, p<0.001; two deletions: +0.13%, p=0.11) (
Figure
). Results were similar in White participants with one deletion (N=38), but non-significant. In a regression model adjusted for age, sex, fasting glucose, and BMI, the differences in HbA1c and Hb comparing Blacks vs White adults were +0.2% and -0.6 g/dL, respectively. Additional adjustment for
HBA2
deletions explained 16% of the difference in HbA1c and 19% of the difference in Hb.

Conclusions:
A variation in the non-coding region of the HBA2 gene common in those with African ancestry results in significantly lower Hb and significantly higher HbA1c, partially explaining the small observed racial differences in HbA1c. Other undiscovered variants could more fully explain observed racial differences in HbA1c.
Abstract 42: Metabolite Risk Scores of Lifestyle Measures Improve Incident Hypertension Prediction
Authors: Sofer Tamar , Zhang Yu , Faquih Tariq , Zhang Ying , Wang Heming , Qi Qibin , Boerwinkle Eric , Kaplan Robert , Isasi Carmen R , Yu Bing
Published: May 2024

Introduction:
Metabolites capture the metabolic environment associated with exposures.

Objective:
To develop and assess the usefulness of metabolite risk scores (MRSs) as biomarkers representing exposure measures.

Methods:
We used two separate sets of individuals sampled from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Both sets of individuals had metabolite data measures on the Metabolon HD4 platform. We applied the least absolute selection and shrinkage operator (LASSO) to develop MRSs for current smoking, physical activity, Mediterranean diet, and anxiety in set 1 (n=2,178), cross-sectionally, and evaluated them for replication in set 2 individuals (n=4,002). We defined hypertension as SBP140, DBP90, or hypertension medication use, and estimated MRS associations with incident hypertension longitudinally (6 years after the baseline exam, on average) in set 2 individuals free of hypertension at baseline (426 cases and 1,556 controls). The association models were adjusted for age, sex, and BMI. We compared the estimated association with those of self-reported phenotypes.

Results:
All MRSs were developed in set 1 individuals have replicated associations in set 2 individuals. The figure provides the estimated association of MRSs for diet, smoking, physical activity, and anxiety with incident hypertension and compares them to the associations of self-reported Mediterranean diet, anxiety measured using the Spielberger trait anxiety scale, pack-years of smoking, and self-reported physical activity in MET-min/day. All associations are per 1 SD increase in the exposure measure. The figure shows that the MRS associations are often stronger than those of the self-reported measure.

Conclusions:
MRSs have the potential to serve as accurate biomarkers of self-reported exposures.
Abstract 44: Soluble CD14 and Risk of Incident Cognitive Impairment: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Authors: Ogunlana Emmanuel , Wilkinson Katherine , Sawyer Russell P. , Raffield Laura M , Plante Timothy B , Cushman Mary , Olson Nels C
Published: May 2024

Introduction:
Black adults in the U.S. experience a greater burden of systemic inflammation and cognitive impairment and dementia compared with White adults. Increasing evidence suggests peripheral inflammation is a risk factor for cognitive decline, however few longitudinal studies have investigated these relationships. CD14 is a pattern recognition receptor expressed by monocytes and macrophages that promotes inflammation. Concentrations of the soluble form of CD14 (sCD14) vary by race, and higher sCD14 was associated with incident coronary heart disease (CHD) and stroke in Black but not White participants in the REGARDS cohort study. We hypothesized higher sCD14 would also be more strongly associated with incident cognitive impairment (ICI) in Black compared to White adults.

Methods:
We performed a nested case-control study of ICI in the REGARDS study, a biracial cohort of 30,239 American adults ≥45 years old. Cases were 495 participants without cognitive impairment or stroke at baseline who developed ICI during a median 3.5 years of follow-up based on abnormal scores on ≥2 of 3 cognitive tests. 587 controls were selected from a cohort random sample and free of cognitive impairment or stroke at baseline. Logistic regression models estimated odds ratios (OR) of ICI by concentration of sCD14 measured from stored baseline serum samples. We tested for a sCD14-by-race interaction a priori.

Results:
The sCD14-by-race interaction term was statistically significant in each model (p-interaction <0.05). In analyses stratified by race, adjusting for demographic factors (age, sex, and region), a 1-SD increment sCD14 was associated with a 40% higher odds of ICI among Black adults (OR: 1.40; 95% CI: 1.07, 1.95) with no association among White adults (OR: 1.08; 95% CI: 0.90, 1.28). In models adjusted for cognitive and vascular risk factors (income, education, systolic blood pressure, hypertension medication use, dyslipidemia, BMI, history of heart disease, atrial fibrillation, diabetes, smoking, and alcohol use), the relationship was attenuated in Black participants (OR: 1.33; 95% CI: 0.96, 1.84) and remained null among White participants (OR: 0.99; 95% CI: 0.81, 1.22). Comparing those with sCD14 concentration >90th percentile to below, adjusted for risk factors, Black participants had a 2.47 (95% CI: 1.08, 5.67) higher odds of ICI with no association in White participants (OR: 0.91; 95% CI: 0.46, 1.80).

Discussion:
Higher sCD14 was associated with ICI risk in Black but not White adults, similar to prior observations for stroke. Results suggest that sCD14-associated inflammatory responses may be a risk factor for ICI among Black adults.
Abstract 45: Elevated Long-Term Triglyceride-Glucose Index Variability From Childhood is Linked to Poorer Midlife Cognitive Function: The Bogalusa Heart Study
Authors: Kang Soo Jung , De Anda-Duran Ileana , Fernandez Camilo , JIN XUANYI , Carmichael Owen , Bazzano Lydia A
Published: May 2024

Background:
Insulin resistance has been linked to a higher risk of cardiovascular events and cognitive impairment in older adults. Recently, an elevated triglyceride-glucose (TyG) index, a noninvasive marker of insulin resistance, has been linked to a greater risk of cardiovascular disease. Whether long-term TyG index variability from childhood to midlife impacts midlife cognitive function (CF) is unclear.

Hypothesis:
We hypothesized that elevated TyG index variability from childhood to midlife is associated with poorer midlife CF.

Aim:
We aimed to identify the impact of elevated TyG index variability from childhood to midlife on midlife CF.

Methods:
We studied 1,100 midlife Bogalusa Heart Study participants (age at enrollment: mean 9.5 years +/- standard deviation(SD) 3.5 years; age at midlife: 48.1 +/- 5.2 years; 60.3% women(663 of 1100), 34% Black(374 of 1100)) with ≥ 3 lipid and glucose measurements across follow-up. Participants with Type 2 diabetes mellitus were excluded. TyG index levels were calculated as ln [(serum fasting triglyceride in mg/dL x serum fasting glucose in mg/dL)/2]. TyG index measures of each individual were fitted into random-effects models stratified by race and sex, and individual growth curves were obtained. Visit-to visit TyG index variability from childhood to midlife was calculated by the deviation from age-predicted values (DEV) and residual SD (RSD) from these models. Midlife CF was measured from 10 neuropsychological (NP) tests, which were categorized into 3 distinct NP profiles (optimal, average, and mixed-low) using cluster analysis. Associations between TyG index variability and NP profiles were analyzed using multinomial logistic regression models, adjusting for education status and the mean of TyG index levels from childhood to midlife. DEV and RSD were standardized to z-scores according to race and sex before regression analysis. Interactions according to race and sex were performed.

Results:
Every 1 SD increase in DEV increased the odds of having a mixed-low CF by 48.9% (95% CI 1.201, 1.847) and an average CF by 22.9% (95% CI 1.046, 1.443) compared to optimal CF, after adjusting for education status and mean TyG levels. Every 1 SD increase in RSD increased the odds of having a mixed-low CF by 51% (95% CI 1.217, 1.873) and an average CF by 25.4% (95% CI 1.068, 1.472) compared to optimal CF, adjusting for education status and mean TyG levels. Neither race nor sex modified the effects of DEV nor RSD on CF.

Conclusions:
Greater long-term TyG index variability was linked with poorer midlife CF. Further studies are needed to elucidate the brain effects of higher long-term variability in insulin resistance from childhood to midlife.
Abstract 61: Differential Associations of Cardiovascular Health Factors With Vascular Health in Adults Free of Cardiovascular Disease
Authors: Jha Mawra , Dong Zhiyong , Ruda Maria , Prescott Brenton , Larson Martin , Nayor Matthew G , Xanthakis Vanessa , Benjamin Emelia J , Vasan Ramachandran , Vasan Ramachandran , Mitchell Gary F , Tsao Connie W
Published: May 2024

Background:
There is limited understanding of the association of the AHA's Life's Essential 8 (LE8), reflecting cardiovascular health (CVH) behaviors and factors, with vascular stiffness and hemodynamics in adults without cardiovascular diseases (CVD).

Methods:
In 2330 Framingham Heart Study Offspring participants (Exam 7, 1998-2002) with applanation tonometry and LE8 data (diet, physical activity, smoking, sleep health, BMI, lipids, glucose, blood pressure), we calculated CVH scores per AHA guidelines. In multivariable linear regression analyses adjusting for CV risk factors, we analyzed LE8 as a predictor of vascular health, assessed by carotid femoral pulse wave velocity (PWV) and central pulse pressure (CPP). We examined for effect modification by age (dichotomized at median) and sex in the associations between LE8 and arterial stiffness. We set p=0.05 and p=0.10 as thresholds for significance in primary and secondary analyses, respectively. Mediation analysis was utilized to discern the indirect effects of PWV and CPP on the relationship between LE8 and both all-cause and CVD mortality.

Results:
In our sample (60±9 years; 57% women; LE8 = 69±12), higher LE8 indicating better CVH, was associated with lower PWV and CPP (Table). Age and sex interactions were noted for PWV (p=0.01 and 0.07, respectively). Higher LE8 was associated with lower PWV in adults ≥59 years and women but not in <59 years or men (Table). With low CVH category as referent, intermediate CVH category had no significant association with PWV and high CVH category had lower PWV. CPP was lower in the intermediate and high CVH categories compared to low CVH category (Table). PWV mediated 19% and CPP 10% of the association between LE8 and CVD mortality and 17% and 15%, respectively, for all-cause mortality.

Conclusion:
In our community cohort, we observed age and sex differences in the relationship between CVH and vascular health. Mediation analyses revealed indirect effects on mortality, warranting further study.

Table
Abstract 62: Association of Cardiovascular Health Trajectories Through Young Adulthood With Later-Life Incident Cardiovascular Disease and Mortality: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: Guo James W , Ning Hongyan , Allen Norrina B , Perak Amanda M , Walker James M , Gabriel Kelley P , Lloyd-Jones Donald M
Published: May 2024

Introduction:
Associations of mid-life cardiovascular health (CVH) and incident cardiovascular disease (CVD) are well-studied. Less is known about patterns of young adulthood (YA) CVH, including its changes, and associations with later-life CVD outcomes.

Methods:
CVH was defined by Life’s Essential 8 (LE8) score. First, we used latent class modeling (SAS Proc Traj) to determine trajectories of continuous CVH scores (0-100) for CARDIA participants with ≥3 CVH measurements in YA (from year [Y]0, mean age 25, to Y20, mean age 45). Second, we examined direction and magnitude of change in CVH status (low, moderate, or high) between 2 CVH measurements (at Y0 and Y20), comparing participants with increased, decreased, or stable CVH status. Outcomes included incident CVD (MI, heart failure, stroke, CVD death) after Y20. Cox proportional hazards regression was used to estimate HRs for associations of YA CVH patterns with incident CVD.

Results:
There were 4,257 participants in YA (44% female, 48% Black) included. In the trajectory analysis, we identified four distinct CVH trajectory groups (
Figure 1A
): compared to the Persistently-High CVH group, the Moderate-Low-Declining and Moderate-Declining CVH trajectory groups had substantially higher hazards for incident CVD (
Figure 1B
). In the CVH status change analysis (N=2,884;
Figure 1B
), compared to Stable High CVH in YA, Stable Low CVH had a 19-fold higher risk for incident CVD, and both increasing and decreasing CVH status in YA had greater risk for incident CVD as well.

Conclusions:
Trajectories of declining moderate and low CVH in YA had substantially higher risk for later-life incident CVD events. Those with decreasing CVH and those who started with lower CVH and improved it through YA, were also at higher risk. These data suggest that early life CVH and maintaining high CVH through YA are both important for prevention of later-life CVD.
Abstract 63: Change in Cardiovascular Health and Risk of Multimorbidity in Two Community-Based Studies
Authors: Prugger Christof , Perier Marie-Cecile , Sabia Severine , Fayosse Aurore , Van Sloten Thomas , Jouven Xavier , Pentti Jaana , Kivimäki Mika , Empana Jean-Philippe
Published: May 2024

Introduction:
Better cardiovascular health is associated with lower risk of various chronic diseases, but its association with multimorbidity is poorly understood. We aimed to examine whether cardiovascular health and its change are associated with multimorbidity risk.

Methods:
The primary analysis was conducted in the Whitehall II study (UK), a prospective cohort study established in 1985-1988, with clinical examinations in 1991-1993 and 1997-1999, and morbidity follow-up until 2019. The validation analysis was conducted in a cohort of Finnish public employees (Finnish Public Sector study, Finland). Exposures were the level of and change in cardiovascular health, assessed by the American Heart Association Life’s Simple 7 (LS7, ideal levels of smoking, physical activity, healthy diet, body mass index, blood pressure, fasting blood glucose, and total cholesterol) and Life’s Essential 8 (LE8, additionally considering sleep duration) at baseline and re-assessment. Primary outcome was incident multimorbidity defined as the presence of two or more of 12 chronic diseases during follow-up (coronary heart disease, stroke, heart failure, chronic obstructive pulmonary disease, chronic kidney disease, liver disease, depression, dementia, other mental disorders, Parkinson’s disease, arthritis/rheumatoid arthritis, and cancer). We estimated hazard ratios and 95% confidence intervals (CI) using Cox’s proportional hazard models with age as time scale, adjusting for sex, education, occupation, marital status, and ethnicity.

Results:
In the primary analysis among 9715 participants, mean age was 44.8 (standard deviation 6.0) years and 67.6% participants were men at baseline. During the median follow-up of 31.4 (interquartile range 26.8-32.3) years, 2751 participants developed multimorbidity. The hazard of multimorbidity decreased by 21% (adjusted hazard ratio (adj HR) 0.79, 95% CI 0.76-0.82) per one ideal LS 7 metric increment and by 23% per 10 points higher LS8 score (adj HR 0.77, 95% CI 0.74-0.79) at baseline, respectively. The hazard of multimorbidity decreased by 8% (adj HR 0.92, 95% CI 0.88-0.96) per ideal LS7 metric increment over 5 years (from baseline to 1991-1993) and by 14% (adj HR 0.86, 95% CI 0.80-0.93) per ten points increase in LE8 score over 10 years (from baseline to 1997-1999) respectively. These findings were replicated in the validation analysis among 75377 participants, both in terms of the baseline level and 4-year change in cardiovascular health.

Conclusions:
Better cardiovascular health and its improvement were associated with lower multimorbidity risk in two community-based cohorts.
Abstract 65: Association Between Life’s Essential 8 and Incident Cardiovascular Disease in Women With a History of Adverse Pregnancy Outcomes
Authors: Qian Frank , Chen Haozhang , Pan An , Liu Gang
Published: May 2024

Background:
Women with a history of adverse pregnancy outcomes (APOs) are at increased risk of developing cardiovascular disease (CVD). Whether maintaining higher cardiovascular health is associated with a lower risk of CVD in this population is not known.

Aims:
To evaluate the association between Life’s Essential 8 (LE8) and incident CVD in women with a history of APOs.

Methods:
We included 2,263 participants with a prior diagnosis of APOs (including hypertensive disorders of pregnancy, gestational diabetes, placental abruption, small for gestational age, or preterm birth) and 107,260 parous participants without a history of APOs from the UK Biobank, all of whom were free of CVD at baseline. LE8 was calculated at baseline (range 0-100). Multivariable-adjusted Cox models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) between LE8 score and incident total and subtypes of CVD. We also examined the interaction between LE8 score and incident CVD among individuals with and without a history of APOs.

Results:
Over a mean 13.5 years of follow-up, 197 incident CVD events were documented in women with a history of APOs. Compared to women in the bottom tertile of LE8 score (<67), those in the top tertile (>76) had a lower incidence of total CVD, HR (95% CI) of 0.43 (0.29, 0.65), CHD [0.31 (0.17, 0.56)] and AF [0.46 (0.23, 0.91)]. We observed a significant interaction between history of APOs, LE8 score, and incident CVD (
Table 1
). Women with a history of APO who maintained high LE8 score were at similar risk as those without APO with a high LE8 score, 0.95 (0.63-1.43), whereas there was an excess risk observed for those with an intermediate (HR with vs. without APO: 1.73 vs 1.25) and low LE8 scores (HR with vs. without APO: 2.48 vs 1.81).

Conclusion:
Among women with a history of APOs, better cardiovascular health as assessed using the LE8 score was associated with a significantly lower incidence of incident CVD. Additionally, women with a history of APOs who maintained high LE8 scores had similar risk of CVD as women without a history of APOs.