bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P375: Using a Recalibrated Cardiovascular Disease Risk Score is Not Adequate to Predict Risk of Recurrence Within 3 Years in Australian Survivors of Stroke
Authors: Ung David , Gerraty Richard P , Frayne Judith , Olaiya Muideen T , Kim Joosup , Srikanth Velandai K , Phan Thanh , Cadilhac Dominique A , Nelson Mark R , Bladin Christopher F , Thrift Amanda G
Published: March 2019

Background:
Prognostic performances of models predicting risk of recurrent events of cardiovascular disease (CVD) are not adequate for use in clinical settings. We aimed to determine whether adapting the Framingham Risk Score (FRS) to an Australian population could effectively predict recurrent cardiovascular outcomes.

Methods:
Patients comprised survivors of stroke/TIA who participated in the Shared Team Approach between Nurses and Doctors For Improved Risk factor Management (STAND FIRM) trial (n = 563). We used standardised anthropometric, biochemical and blood pressure data, collected at baseline, to evaluate risk factors for stroke/TIA. Cox proportional hazards regression models were used to determine the risk of recurrence of CVD-related events and deaths within 3 years after stroke/TIA; adjudicated by two independent stroke specialists. Regression estimates were then used to recalibrate the coefficients used by the FRS, and performance of the model assessed.

Results:
In women, the recalibrated FRS model had poor discrimination (C-statistic = 0.634) and appeared to better predict CVD recurrence (AUC = 0.664) than the original FRS model (AUC = 0.598). However in men, the recalibrated FRS model had poor discrimination (C-statistic = 0.604) and prediction of CVD recurrence (AUC = 0.632) similar to the original FRS model (AUC = 0.606).

Conclusion:
The original FRS and recalibrated FRS models appeared to perform poorly in Australian men and women with stroke. The identification of relevant risk factors, easily measured in a clinical setting, may help clinicians better monitor the risks of their patients and enhance secondary prevention strategies.
Abstract P376: Clinical Use of a Proteomic Cardiovascular Risk Score for Assessing How Personal Risk Assessment Positively Drives Patient Attitudes and Behavior Change
Authors: Trujillo jr Nelson P , Wall Kirsten , Alexander Leigh , Housholder Sandy , Zach Jordan , Gill Rosalyn , williams Stephen
Published: March 2019

Background:
The ACC has outlined a strategic goal where innovation and knowledge optimize cardiovascular care and outcomes. We tested whether sharing with patients a personal 7-protein cardiovascular risk score might motivate them to better adhere to cardiovascular risk reduction measures.

Methods:
The 7-protein risk score (SOMAscan® CVD Secondary Risk Panel, SomaLogic) provides % risk by year for experiencing a cardiovascular event up to 5 years. Patients with stable coronary heart disease received a baseline lifestyle and behavior survey, chart abstraction, and blood draw for the 7-protein risk score. Results were shared with the patient by their physician. One month after receiving the panel results, patients were surveyed on the overall impact of the panel on health, lifestyle, and medication changes.

Results:
Among the 138 patients, 23.9% had ≥ 20% predicted risk of a cardiovascular event in 5 years. Higher risk patients reported higher rates of desirable lifestyle changes, including healthier diet (Figure 1). Lower risk patients stated they would maintain their lifestyle to remain healthy.

Conclusions:
Patients presented with their personal 7-protein cardiovascular risk score were motivated to improve their lifestyle and adherence to medications. The additional motivation from the test results, if sustained long-term, may translate into improved outcomes in patients with coronary heart disease.
Abstract P378: A Novel Risk Prediction Score for Incident Heart Failure Among Patients With Diabetes
Authors: Segar Matthew W , Patel Kershaw V , Berry Jarett D , Pandey Ambarish
Published: March 2019

Introduction:
Diabetes is a well-established risk factor for heart failure (HF). However, risk prediction models for incident HF in patients with diabetes are lacking. Accordingly, we aim to develop a novel risk-prediction model for HF in a diabetes cohort using a hybrid machine learning method for variable selection and CoxPH approach for risk prediction.

Methods:
We used data from the ACCORD trial that included patients with prevalent diabetes at baseline and had adjudicated HF events on follow up. The data was divided in to 80/20% training and testing (n = 6,896/1,725, respectively) and 152 baseline variables were included. A random survival forest (RSF) of 1000 trees was constructed to identify the top 20 predictors. Finally, a 5-year incident HF risk score was developed using the 9 variables selected by backward CoxPH regression.

Results:
The study included 8,621 participants (Mean age: 63 y, 62% male) without prevalent HF. The RSF model for incident HF with top 20 predictors derived from the training cohort had superior discrimination than the CoxPH model in the testing cohort (
C
-index 0.80 vs. 0.78; P < 0.001). The top 9 variables identified included age, waist circumference, BP, serum creatinine, HDL, prior MI, prior CABG, and EKG QTC duration and T-axis. The weighted risk score based on the nine clinical variables was used to create a composite HF risk score ranging from -6 to 36. A 1-unit increment in the risk score was associated with a 27% higher risk of HF at 5 years. A graded increment in the 5-year HF incidence was noted across quintiles of the HF risk score ranging from 1.2% in the lowest to 9.8% in the highest quintile (Figure). The HF risk score demonstrated good discrimination with an overall
C
-index of 75.2.

Conclusions:
In conclusion, an RSF model in a clinical diabetes cohort outperformed conventional CoxPH in the identification of important risk factors of incident HF. Additionally, the diabetes-HF prediction model using common clinical variables demonstrated good discrimination and risk stratification in the overall cohort.
Abstract P380: Validity and Reliability of Pulse Wave Velocity Measurement in a Seated Posture
Authors: Kowalsky Robert J , Stoner Lee , Perdomo Sophy , Taormina John Michael , Jones Melissa , Credeur Daniel , Barone Gibbs Bethany
Published: March 2019

Introduction:
Accumulating evidence suggests that prolonged sitting may have adverse effects on vascular health. Pulse wave velocity (PWV) is a simple measurement of vascular stiffness that would be advantageous to measure in a seated posture. However, the reliability and validity of PWV measured in a seated posture are unknown.

Objective:
To assess day-to-day reliability and validity of seated peripheral PWV.

Methods:
This randomized cross-over study (N=20, 50% male, mean (SD) age = 25.9 (7.7)) consisted of two experimental visits, conducted a maximum of 14 days apart. Outcome measures were carotid-radial PWV (crPWV), carotid-ankle PWV (caPWV), and carotid-femoral PWV (cfPWV; supine position only) by tonometry using the Complior Analyse System. Measurements were completed in both a supine and seated posture (counterbalanced), preceded by a 10-minute rest, and following a 12-hr abstention from food, caffeine, nicotine, alcohol, and exercise. Intra-class correlations (ICCs) assessed day-to-day reliability with ≥0.75 as the criterion for good reliability. Validity was determined by comparing (Pearson’s correlation) peripheral PWV measures in the seated compared to supine posture as well as to central PWV measures (supine cfPWV).

Results:
ICCs for crPWV were 0.64 (supine) and 0.77 (seated) and for caPWV were 0.36 (supine) and 0.76 (seated). Supine vs. seated peripheral PWV measures were highly correlated for crPWV but not correlated for caPWV (
Figure
). Comparison of supine cfPWV to seated peripheral PWV were r=0.483 (
p
=0.031) for crPWV and r=0.386 (
p
=0.103) for caPWV.

Conclusion:
While measures of seated crPWV and caPWV were both reliable and small-to-moderately correlated with related vascular measures, only seated crPWV was valid compared to the standard supine measure. Future studies evaluating the impact of prolonged sitting and breaking up prolonged sitting could consider measuring crPWV in a seated posture.
Abstract P383: Smoking Cessation and Weight Change in Relation to Cardiovascular Disease Incidence and Mortality Among Patients With Diabetes Mellitus
Authors: Liu Gang , Hu Yang , Zong Geng , Hu Frank B , Manson JoAnn E , Rexrode Kathryn M , Rimm Eric B , Sun Qi
Published: March 2019

Introduction:
Some studies suggested that smoking cessation could result in short-term weight gain, deterioration in glycemic control, and worsening of some diabetic symptoms. It is unclear whether weight gain following smoking cessation might mitigate the health benefits among adults with diabetes.

Hypothesis:
Smoking cessation is associated with a lower risk of cardiovascular disease (CVD) incidence and mortality among individuals with diabetes, and weight gain following smoking cessation does not modify the association.

Methods:
This prospective analysis included 9,780 men and women with type 2 diabetes from the Nurses’ Health Study (1984-2014) and Health Professionals Follow-Up Study (1988-2014). Information on newly diagnosed diseases, medical history, dietary and lifestyle factors, including smoking status and weight change, was updated every two years through validated questionnaires.

Results:
During 154,825 person-years of follow-up, there were 2,590 incident CVD cases and 3,326 deaths among participants with diabetes. Compared with those who continued to smoke, quitters had a lower risk of CVD incidence, regardless of weight change after quitting. The multivariate-adjusted hazard ratios (95% confidence intervals) for CVD were 0.66 (0.54-0.81) among recent quitters (≤6 years since smoking cessation) without weight gain, 0.69 (0.47-0.99) among recent quitters with weight gain of 0.1 to 5.0 kg, 0.57 (0.37-0.87) among recent quitters with weight gain of more than 5.0 kg, 0.71 (0.60-0.83) among longer-term quitters (>6 years since smoking cessation), and 0.51 (0.45-0.59) among never-smokers. Similar results were observed for CVD, cancer, and all-cause mortality, although the associations did not reach statistical significance among recent quitters with weight gain.

Conclusions:
Smoking cessation was associated with a lower risk of CVD incidence among men and women with diabetes, even among those who gained weight after quitting. A health benefit of smoking cessation on mortality was also observed.
Abstract P394: Health Literacy Within a Diverse Community-Based Cohort: The Multi-Ethnic Study of Atherosclerosis
Authors: Anderson Madison , Stein Merkin Sharon , Everson Rose Susan A. , Widome Rachel , Seeman Teresa , Rodriguez Carlos , Lutsey Pamela L.
Published: March 2019

Introduction:
In 2018 the American Heart Association released a Scientific Statement on the importance of health literacy to cardiovascular disease (CVD) primary and secondary prevention. Health literacy has been defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” However, most studies exploring the prevalence of health literacy have been conducted in populations that were demographically relatively homogeneous.

Hypothesis:
Using cross-sectional data from the race-ethnically diverse, sex-balanced and community-based Multi-Ethnic Study of Atherosclerosis (MESA), we tested the hypotheses that low health literacy was associated with older age, lower income and less acculturation.

Methods:
Four standard questions assessing health literacy were asked during annual phone follow up encounters which took place from August 2016 through August 2018. The questions assessed: 1) ability to read materials received from a doctor, 2) problems learning about health conditions, 3) confidence in filling out medical forms, and 4) understanding of medical statistics. Consistent with prior literature, responses to the 4 questions were combined into a composite score, and then a dichotomous variable was created to classify health literacy as low or adequate. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated, adjusted for age, sex, and race/ethnicity. Race/ethnicity-stratified associations were also explored.

Results:
Our sample consisted of 3,638 adults ages 53-94 years (median, 69), including 1,513 White, 445 Chinese, 936 Black, and 734 Hispanic participants. A total of 15.4% had low health literacy, which was more common among elderly [PR (95% CI) for ≥70 years vs. <70 years: 2.24 (1.92, 2.61)], female [1.23 (1.07, 1.42)] and lower income [3.56 (2.82, 4.49)] participants, respectively. A higher prevalence of low health literacy was observed among participants who were Chinese, [PR (95% CI): 5.22 (4.15, 6.55)] Hispanic [4.94 (3.97, 6.14)], and Black [1.35 (1.01, 1.79)], relative to white participants. Acculturation factors such as non-US place of birth, fewer generations in the United States, and language other than English spoken in the home were all also associated with lower health literacy. When stratified by race/ethnicity, patterns of health literacy with age, sex, income and acculturation were similar to findings from the full study population.

Conclusions:
Within a diverse population low health literacy was more common among individuals who were older, female, had lower income, and were less acculturated. Since patients with low health literacy may need additional support to optimize their cardiovascular health, our results illustrate possible priority populations for health education intervention.
Abstract P402: Association Between Post-stroke Disability and 5-year Hip-fracture Risk: the Women’s Health Initiative
Authors: Northuis Carin , Crandall Carolyn J , Margolis Karen L , Diem Susan J , Ensrud Kristine E , Wactawski-Wende Jean , Lakshminarayan Kamakshi
Published: March 2019

Background:
Hip fractures are a significant post-stroke complication. While studies have shown an increased incidence of hip fractures post-stroke, the relationship between stroke-related disability and hip fracture rates are not well characterized. Herein, we examine factors associated with hip fracture risk after stroke using the Women’s Health Initiative (WHI) data.

Methods:
The WHI is a prospective study of 161,808 postmenopausal women aged 50-79 years. In the WHI, stroke cases were initially self-reported and then confirmed by a neurologist adjudication using medical records and a manual. Hip fracture cases were self-reported and then radiologically confirmed by physician adjudication. We included stroke survivors from the observational and clinical trial arms who had a Glasgow Outcome Score (GOS) of 1-3 (good recovery, moderately disabled, severely disabled) and survived at least one week after stroke (n=4,640). Survival free from any radiologically-confirmed hip fracture post-stroke was estimated and compared by GOS status. Secondary analysis examined the post-stroke hip fracture risk while accounting for the competing risk of death.

Results:
There were 124 hip fractures. Average age of stroke was 74.6 ± 7.2 years. Mean follow-up time was 3.1±1.8 years. Hip fractures by GOS status represented 2.4% (45/1872), 2.5% (34/1366), and 3.5% (45/1278) among good recovery, moderately disabled, and severely disabled. In the competing risk model, 23.3% (1079/4640) of the participants died before the end of follow-up or the occurrence of a hip fracture. Severely disabled (HR: 2.1 (95% CI: 1.3, 3.2), p=0.001) status, but not moderately disabled (HR: 1.1 (95% CI: 0.7, 1.7) p=0.8), was significantly associated with an increase in risk of hip fracture compared to good recovery status. This association was attenuated and not significant for moderately disabled (HR: 1.1 (95%CI: 0.7, 1.7), p=0.8) and severely disabled (HR 1.5 (95%CI: 1.0, 2.3), p=0.06) status when accounting for mortality after stroke. High Hip Fracture Risk Assessment Tool (FRAX) risk (without bone density information), being Caucasian, and increasing age were associated with an increased post stroke hip fracture risk. When accounting for mortality after stroke, higher FRAX-predicted hip fracture risk and race/ethnicity remained significant. The association between age and hip fracture was attenuated and not significant after accounting for post-stroke mortality.

Conclusion:
Among stroke survivors, severely disabled status and FRAX-predicted hip fracture risk were associated with a higher risk of subsequent radiologically confirmed hip fracture, but only the FRAX-predicted hip fracture risk association remained significant when considering the competing risk of mortality after stroke. Interventions to reduce fracture risk after stroke should be evaluated in clinical trials.
Abstract P404: Sex-specific Associations of Plasma Endothelin-1 With Incidence of Stroke in African Americans: the Jackson Heart Study
Authors: Fan Hao , ArdeshirRouhaniFard Shirin , Gao Xiang , Musani Solomon , Fox Ervin , Curtis Lesley , Correa Adolfo , O’Brien Emily , Bidulescu Aurelian
Published: March 2019

Background:
Endothelin-1 (ET-1) is a vasoconstrictive peptide with cerebral action, also associated with the degree of atherosclerosis. Previous research found that estrogen has inhibitory effect on ET-1 level, which points to putative differences of ET-1 by sex. As stroke is the fifth leading cause of death in the U.S., killing approximately 133,000 people per year, more among African Americans (AA), we aimed to identify the sex differences of the association between ET-1 and incident stroke among AA.

Methods:
Our AA study participants (N= 4995), with ages 21-90 years and no prevalent stroke, were enrolled in the Jackson Heart Study in Jackson, Mississippi. Stroke events were ascertained through 2011 by reviewing medical records for hospitalizations of JHS participants. Plasma ET levels were measured at the baseline study visit (2000-2004) and expressed in picograms/ml by QuantiGlo Human Endothelin-1 Immunoassay (R&D Systems Inc). Hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated using Cox proportional hazard regression models. Several interactions were assessed such as by sex, smoking and hypertension.

Results:
Baseline plasma ET-1 level (mean=1.35, median= 1.30) was significantly lower in women (mean =1.32) than in men (mean =1.40; P-value <0.0001). Sex was not an effect modifier of the association between ET-1 and time to stroke event (p for interaction =0.18). After adjusted for age, ET-1 was associated with reduced risk of stroke [HR (95% CI) for all gender: 0.61 (0.40, 0.94), P
trend
=0.015, among men: 0.32 (0.14, 0.72), P
trend
=0.003, but not among women: 0.96 (0.54, 1.68), P
trend
=0.68, for highest vs. lowest quartile, respectively]. After additional adjustment for hypertension and smoking status, the association was still significant among men [0.35 (0.15, 0.79), P
trend
=0.007, for highest vs. lowest quartile, respectively], but not among women. No statistically significant associations were found among both men and women after additional adjustment for BMI, cigarette smoking, anti-hypercholesterolemic medication status, diabetes and hypertension status, cholesterol levels and homocysteine. No interactions by smoking or hypertension were detected.

Conclusion:
Our study indicates a non-statistical significant lower risk of stroke with higher levels of endothelin-1, with variation by sex. Our findings warrant confirmation in other epidemiologic studies.
Abstract P406: Trajectories of Engagement in Leisure-time Physical Activity and Risk of Incident Ischemic Stroke: the Atherosclerosis Risk in Communities Study
Authors: Cowan Logan , Tarasenko Yelena , Evenson Kelly , Palta Priya , Lakshminarayan Kamakshi
Published: March 2019

Introduction:
Engagement in leisure-time physical activity (PA) levels recommended by the American Heart Association (AHA) is inversely associated with ischemic stroke risk. PA level can fluctuate over time but the association between PA fluctuations and ischemic stroke risk is unknown. The extent that ischemic stroke risk could be attenuated by increasing PA among those who are inactive could inform stroke prevention.

Hypothesis:
We hypothesize that participants who remained active or increased their PA levels will have lower ischemic stroke risk relative to those who were persistently inactive.

Methods:
We included 12,611participants of the Atherosclerosis Risk in Communities (ARIC) cohort study ages 45-64 at visit 1 (1987-1989) who did not have a history of stroke at visit 3 (1993-1995). Leisure-time PA was assessed using the modified Baecke questionnaire at visits 1 and 3 and categorized according to the AHA guidelines for PA (ideal, intermediate, or poor). All adjudicated definite and probable incident ischemic strokes between visit 3 and end of year 2013 were included. Cox-proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for ischemic stroke by cross-categories of PA at visits 1 and 3 using those with poor PA at both visits as the referent group. We adjusted for age, sex, race/center, smoking status, and alcohol intake at visit 3.

Results:
During a median of 18.6 years of follow-up, 777 incident ischemic stroke events occurred. Compared with those with poor PA at visits 1 and 3, participants with ideal PA at both visits had the lowest ischemic stroke risk (HR=0.64, 0.51, 0.80). Those whose PA increased from poor to ideal also had significantly lower ischemic stroke risk (HR = 0.70, 0.53, 0.94).

Conclusion:
Sustained ideal PA was associated with the lowest ischemic stroke risk. Increasing PA between visit 1 and visit 3 was also associated with significantly lower ischemic stroke risk. Increasing PA may be an important component of stroke prevention.
Abstract P407: Stroke Dispatch, Provider Impression and Critical Pre-Hospital Time Intervals: NEMSIS, 2016
Authors: Odom Erika , Abbas Amena , Nwaise Isaac
Published: March 2019

Introduction:
Stroke management guidelines have established several recommendations to ensure a proper response by Emergency Medical Services (EMS), including EMS arrival at the scene in ≤8 minutes (response time, RT), and an on-scene time (OST) of ≤15 minutes. Understanding factors associated with achieving these time intervals may help to focus EMS interventions.

Hypothesis:
We assessed the hypothesis that RT and OST for suspected patients with a dispatch of stroke are more likely to fall within guideline recommendations than those with a dispatch for non-stroke related events.

Methods:
Using the 2016 National Emergency Medical Services Information System (NEMSIS), a database of patient care reports resulting from 911 calls, we extracted cases with a primary or secondary provider impression of stroke, their EMS arrival to the scene (RT) ≤8 minutes and OST of ≤15 minutes. The sample included persons aged ≥18 years with non-missing sociodemographic data on sex, race/ethnicity, rurality and dispatch calls of events. The percentages of 911 cases, stroke events, and time intervals of interest were calculated. Chi-square tests was used to assess associations.

Results:
There were 153,730 events (1.4% of all 911 transports) with a primary or secondary provider impression of stroke. Within these events, 69.5% had a RT ≤8 minutes, and 49.2% had an OST ≤15 minutes: differences varied within all sociodemographic groups. A significant difference was found between those dispatched as stroke and those dispatched as other, with a greater proportion of dispatched strokes having both a RT ≤8 minutes (70.2% vs 68.8%) and OST ≤15 minutes (53.0% vs 45.6%).

Conclusion:
In conclusion, we found a significantly higher proportion of patients dispatched as stroke falling within the critical time intervals of response time and on-scene time. Future EMS stroke education should place more focus on dispatcher knowledge of stroke signs and symptoms, as an integral pre-hospital partner in improving the stroke system of care.
Abstract P411: Does Age at Natural Menopause Influence Changes in Left Ventricular Structure and Function During the Menopausal Transition? The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: Appiah Duke , Nwabuo2 Chike C , Ebong Imo , Vasconcellos Henrique D , Wellons Melissa F , Lewis Cora E , Lima Joao A , Schreiner Pamela J
Published: March 2019

Introduction:
The association between menopause and incident cardiovascular disease (CVD) is controversial. Cardiac structure and function are important predictors of future CVD events, however, evidence for the long-term association of age at natural menopause (NM) with cardiac remodeling as women transition through menopause is lacking. We assessed the hypothesis that age at NM will be positively associated with changes in echocardiographic parameters of left ventricular (LV) structure and function.

Methods:
We studied 771 premenopausal women (37% black) from the Coronary Artery Risk Development in Young Adults (CARDIA) Study with echocardiographic data in 1990-1991 (mean age: 32 years) who later reached NM by 2015-2016 and had additional echocardiogram.

Results:
Mean age at NM was 50 years and the average time from menopause to the last echocardiogram was 7 years. In cross-sectional analyses, no associations were found between age at NM and premenopausal baseline parameters of LV structure and function (Table1). However, a one-year decrement in age at NM was significantly associated with higher postmenopausal levels of LV mass (LVM), LVM indexed to body surface area, LV mass-to-volume ratio, and relative wall thickness. In longitudinal analyses, higher age at NM was inversely associated with pre-to-postmenopausal changes in LV structure parameters. Controlling for baseline echocardiographic parameters, demographics, smoking, systolic blood pressure, BMI, physical activity, reproductive factors, total cholesterol and pre- to postmenopausal changes in systolic blood pressure, BMI and total cholesterol as well as hormone therapy attenuated the association of age at NM with these LV structure parameters.

Conclusion:
In this study, premenopausal CVD risk factors explained the association of age at NM with changes in LV structure parameters during the menopausal transition. These data suggest that premenopausal CVD risk factors rather than age at NM may predispose women to elevated future CVD risk.
Abstract P416: Objectively Measured Snoring is Not Associated With Maladaptive Arterial Remodeling in Overweight and Obese Adults
Authors: Taylor Christy , Kline Christopher , Duan Chunzhe , Barinas-Mitchell Emma
Published: March 2019

Introduction:
We previously reported that snoring severity was related to carotid arterial remodeling as characterized by wider inter-adventitial diameter (IAD) and greater intima-media thickness (IMT) in overweight and obese adults without obstructive sleep apnea (OSA). Considered to be an adaptive mechanism to maintain circumferential wall and shear stress homeostasis and a natural process in the setting of aging, early arterial remodeling is associated with cardiovascular morbidity and mortality. Elevations in arterial circumferential wall tension (CWT) and stress (CWS) in the setting of this compensatory arterial remodeling is considered maladaptive. We aimed to examine the association between snoring severity and CWT and CWS in adults with or without OSA.

Methods:
Cross-sectional analyses were conducted using 24-month follow up data from the Slow Adverse Vascular Effects lifestyle intervention study. The original population consisted of 349 overweight/obese (BMI 25-40 kg/m
2
) adults aged 20-45 years old without hypertension or diabetes. The snoring index (SI) and oxygen desaturation index (ODI) were measured by the ResMed ApneaLink device among 122 participants. Snoring/OSA was categorized into three groups: OSA (ODI≥5; n=41), heavy snoring (ODI<5, ≥median SI; n=40), and low snoring (ODI<5, below-median SI; n=41). B-mode carotid ultrasound was used to measure end-diastole mean common carotid artery (CCA) IMT and lumen diameter (LD). Mean CWT (kPa*mm) and CWS (kPa) were calculated using Laplace’s law: CWT=MAP*(LD/2) and CWS= CWT/IMT; CCA wall to lumen ratio (WLR) = IMT/ LD. We used multiple linear regression to assess the association between snoring/OSA categories and CWT, CWS, and WLR adjusting for intervention group, age, sex, race, pulse pressure, BMI, non-HDL cholesterol, and fasting glucose, .

Results:
Participants were, on average, 40.1 ± 5.9 years old with a BMI of 31.6 ± 4.4 kg/m
2
; 76.2% were women and 82% were white. Most CVD risk factors differed across snoring/OSA categories, including age, BMI, lipids, and fasting glucose, with risk factors worse in the OSA and heavy snoring groups compared to the low snoring group (all p <0.05). In unadjusted analyses, CWT was higher in both heavy snoring (32.71 ± 4.74) and OSA (33.74 ± 5.09) groups compared to the low snoring group (29.94 ± 4.51; all p<0.01). Differences were also noted in WLR between the low snoring and OSA groups (0.11 ± 0.01 vs. 0.12 ± 0.02; p<0.05). Between-group differences in CWT were attenuated (p=0.09) and eliminated in WLR after multivariable adjustment. Differences in CWS across snoring/OSA categories were not observed.

Conclusion:
Our findings suggest that, in overweight and obese young to middle-aged adults without hypertension or diabetes, objectively measured snoring may not be associated with maladaptive arterial remodeling after accounting for traditional CVD risk factors.
Abstract P419: Migraine and Arterial Stiffness in the Brazilian Longitudinal Study of Adult Health ELSA-Brasil
Authors: Baena Cristina P , Appelbaum Patricia , Andrade Lotufo Paulo , Santos Itamar S , Goulart Alessandra C , Benseñor Isabela M
Published: March 2019

Introduction:
Migraine with aura has been associated with cardiovascular events however the mechanisms are unclear. Arterial stiffness is a validated predictor of cardiovascular events and could play a role in that association.

Hypothesis:
We tested the hypothesis that migraine is associated with arterial stiffness in a well-defined middle-aged population.

Methods:
In a cross-sectional analysis of a well-defined population with complete and validated information about migraine and aura according to International Headache Society criteria, the arterial stiffness measured by carotid-to-femural pulse wave velocity was tested with multiple linear regression models comparing migraine without aura (MO) and migraine with aura (MA) to the reference group no migraine (NM) . Subsequent adjustments were made for age, sex, education, physical activity, alcohol use, diabetes, smoking, use of anti-hypertensive medication, waist circumference, LDL-cholesterol and triglycerides levels to test the independence of the association between migraine status and arterial stiffness.

Results:
We studied 4649 participants, 2521 women (25.7% MO and 15% MA)and 2128 men (11% MO and 4.3% MA). NM, MO and MA presented mean age 52.3 ±9.2 , 49.2 ± 7.7 and 47.9 ±7.1 years respectively (P<0.001 for trend); mean systolic blood pressure 120.96 (±16.5), 117.35(±14.9) and 115 (±15.2) mmHg respectively (p<0.001 for trend); mean fasting glucose 112.5 (± 29.37), 108.9(±30.7) and 103.12 (±24.6) mg/dl respectively (p<0.001 for trend). Hypertension and diabetes were less prevalent in MA compared to NM (25,5% vs 33 % ) and (17.4% vs 21.3%) (p<0.001 for both) and arterial stiffness was not significantly different across groups 9.22(±1.8), 9.28(±1.9) and 9.26(±2) m/s, respectively (p=0.746 for trend). Fully adjusted models yielded non-significant linear coefficients β (CI95%) 0.43 (-0.105;0.191)m/s when MA was compared with NM.

Conclusion:
In a large population of middle-aged with validated aura information, migraine status was not associated with arterial stiffness measured by carotid-to-femural pulse wave velocity.
Abstract P421: Cardiovascular Death Trends in Minnesota From 2000-2017
Authors: Gerber Yariv , Weston Susan , Manemann Sheila , Bielinski Suzette , Chamberlain Alanna , Killian Jill , Dugani Chandrasagar , Roger Veronique L
Published: March 2019

Background:
The decline in cardiovascular disease (CVD) mortality in the United States noted since the mid 1970s has recently leveled off. This has generated concern and a need for further analyses to understand geographic variation, cause-specific deaths, location of death, and age-specific trends.

Methods:
Death certificate data obtained from the Minnesota Department of Health were used for analysis. The American Heart Association (AHA) classification was applied to the underlying cause of death to generate the following CVD categories: coronary heart disease (CHD), non-CHD diseases of the heart, and non-cardiac circulatory diseases. Temporal trends in death rates were explored by negative binomial regression, which enables estimates of age- and sex-adjusted average annual percentage changes (AAPCs). Differences in AAPCs between 2000-2009 and 2010-2017 were tested overall and across demographic, CVD, and location of death categories.

Results:
CVD mortality rates, which were declining in 2000-2009, have leveled off in 2010-2017 (Table). These trends were observed across all subgroups. After adjusting for sex, the age group that drove the decline in rates from 2000-2009 was the 65-84 year old group, which experienced no change in rates from 2010-2017. Across CVD categories, after adjusting for age and sex, the decline in rates from 2000-2009 was largely attributable to steep reductions in CHD and non-cardiac circulatory diseases, with lesser reduction in non-CHD diseases of the heart. In 2010-2017, CHD and non-cardiac circulatory diseases rates showed no change, whereas the rate of non-CHD diseases of the heart increased. The rates for in- and out-of-hospital deaths improved in 2000-2009 with no further improvement observed in 2010-2017.

Conclusions:
CVD mortality rates are no longer declining in Minnesota, paralleling national trends. These trends are particularly concerning for non-CHD diseases of the heart.
Abstract P426: Association Between Neighborhood Characteristics, Personal Resilience, and Arterial Stiffness Among Blacks: Results From the Morehouse-Emory Cardiovascular (MECA) Center for Health Equity
Authors: Kim Jeong Hwan , Topel Matthew L , Lewis Tené T , Baltrus Peter , Liu Chang , Ko Yi-An , Mujahid Mahasin , Vaccarino Viola , Sims Mario , Mubasher Mohamed , Khan Ahsan , Ejaz Kiran , Searles Charles , Dunbar Sandra B , Pemu Priscilla , Taylor Herman , Quyyumi Arshed A
Published: March 2019

Introduction:
Arterial stiffness is associated with cardiovascular (CV) risk factors and adverse cardiovascular events. While inter-racial differences in arterial stiffness have been reported, factors contributing to intra-racial differences within Blacks are less known. We examined whether neighborhood characteristics and personal resilience factors were associated with arterial stiffness among Blacks.

Hypothesis:
More desirable neighborhood characteristics and greater personal resilience are associated with reduced arterial stiffness.

Methods:
We examined 385 Black adults (age 53 ± 10, 40% male) without known CV disease living in Atlanta, GA. Arterial stiffness was measured as augmentation index (AIX) and pulse wave velocity (PWV) using applanation tonometry (Sphygmocor Inc). Perceived residential neighborhood characteristics in 7 domains: aesthetic quality, walking environment, safety, food access, social cohesion, activity with neighbors, and violence were determined. Personal resilience was also assessed using standard questionnaires on experience of discrimination, environmental mastery, purpose in life, optimism, resilient coping, and depressive symptoms. Multiple linear regression models were used to examine the differences of arterial stiffness between the highest and the lowest tertiles of neighborhood characteristics and personal resilience factors after adjustment for age, gender, systolic blood pressure, body mass index, household income, education, marital status, and employment status.

Results:
Higher composite scores of neighborhood characteristics were associated with lower AIX (β=-3.42, 95% CI [-6.42 to -0.41], P=0.026; highest vs lowest tertiles). Specifically, higher scores of safety (β=-4.26, 95% CI [-7.34 to -1.17], P=0.007) and social cohesion (β=-4.62 [-7.64 to -1.61], P=0.003) were associated with lower AIX (highest vs lowest tertiles for both). For factors of personal resilience, higher scores in purpose in life (β=-4.89 [-7.88 to -1.90], P=0.001) and resilient coping (β=-3.26 [-6.36 to -0.15], P=0.040) were significantly associated with lower AIX (highest vs lowest tertiles for both). There were no significant associations between PWV and scores of neighborhood characteristics or personal resilience factors.

Conclusion:
In a study examining the impact of neighborhood and markers of resilience on arterial stiffness in an exclusively Black cohort, we found that better neighborhood characteristics and personal resilience factors were associated with lower pulse wave reflections (AIX).
A synopsis of Thyrsacanthus (Acanthaceae) in Argentina and Paraguay, with notes on generic delimitation, a new combination, and lectotypifications
Authors: EZCURRA CECILIA , CÔRTES LUIZA A. , DANIEL THOMAS F.
Published: March 2019

A taxonomic synopsis of the members of the re-circumscibed Thyrsacanthus from Argentina and Paraguay is presented. Two species are recognized for the region, T. boliviensis and T. sulcatus. The latter is a new combination here proposed, based on Jacobinia sulcata (until now treated in Carlowrightia), that is corroborated by morphological data and geographic distribution as well as molecular phylogenetic information. Thyrsacanthus sulcatus is clearly distinguished from T. boliviensis by its small, white, lilac or pale blue, presumably psychophilous flowers with a narrow tube, instead of the large and red ornithophilous flowers with a tube that widens to the throat, which is typical of other species of Thyrsacanthus. Differences between the re-circumscribed Thyrsacanthus and other genera of the Tetramerium lineage to which it belongs are discussed, and references to additional genera of Acanthaceae that present similar wide diversification in floral morphology are noted. The synopsis includes a key, full synonymies, descriptions, illustrations, distributions, and lists of representative specimens. Lectotypifications are provided for the following names: Anisacanthus malmei, Dianthera sulcata, Jacobinia caducifolia, Schaueria caduciflora, and Siphonoglossa gentianifolia.
Catalogue of Recent and fossil taxa of the family Architectonicidae Gray, 1850 (Mollusca: Gastropoda)
Authors: BIELER RÜDIGER , PETIT RICHARD E.
Published: March 2019

The marine gastropod family Architectonicidae (= Solariidae), commonly known as sundials, comprises about 140 worldwide extant species classified in 11 genera. More than ten times as many names are used in the literature for both Recent and fossil taxa, the latter dating from the Mesozoic (Paleozoic taxa were misinterpreted). Herein we catalog more than 1550 names that have appeared in print at the family-group (10), genus-group (137), and species-group levels (1408). Of the last, nearly 1100 are found to be nomenclatorially available or potentially available. An Appendix is included in which nomenclatural changes are made and/or commented upon. It is demonstrated that Solarium maculatum Link, 1807 was validly introduced and, as Architectonica maculata (Link, 1807), becomes the valid name for the species usually cited as A. picta (Philippi, 1849). The invalid introduction of Heliacus messanensis Bertolaso & Palazzi, 2000 is discussed. The emended spelling of the specific name in the binomen Solatisonax alleryi (G. Seguenza, 1876) is shown to be correctly accepted. Philippia lepida Bayer, 1942, Torinia gyrus depressiusculaBayer, 1848, Solarium subconcolor von Martens, 1880, Solarium conulus Weinkauff, 1868 and Solarium submoniliferum d’Orbigny, 1852 were proposed as replacement names for multiple preoccupied names and/or misidentifications. These are here restricted to avoid possible confusion. The history and current status of the similarly spelled and inconsistently used nomina Fluxiella and Fluxinella (as placed in Architectonicidae and/or Seguenziidae) are discussed.
Description of a new species, records of five previously unrecorded species, and rediscovery of a lost species in the genus Ancylis Hübner (Lepidoptera: Tortricidae) from China
Authors: BYUN BONG-KYU , YAN SHANCHUN
Published: March 2019

We describe and illustrate Ancylis youmiae, sp. nov., from Heilongjiang (Laoyeling), China, and report five other species of Ancylis from China for the first time: A. melanostigma Kuznetsov, 1970, A. partitana (Christoph, 1881), A. repandana Kennel, 1901, A. uncella ([Denis & Schiffermüller], 1775), and A. upupana (Treitschke, 1835). Ancylis mandarinana (Walsingham, 1900), which has not been documented from China since its original description, is rediscovered. For all species we provide redescriptions, illustrations, and information on geographic distribution and host plants.
Description and biological notes of the first species of Xenos (Strepsiptera: Stylopidae) parasitic in Polistes carnifex F. (Hymenoptera: Vespidae) in Mexico
Authors: KATHIRITHAMBY JEYARANEY , HUGHES DAVID P.
Published: March 2019

A description and biological notes on the first species of Xenos (X. hamiltoni) (Strepsiptera: Stylopidae) parasitic in Polistes carnifex F. from Mexico is given. A list of Strepsiptera and their hosts from Mexico is provided.
Macrobiotus rigidus sp. nov., new species of eutardigrade from New Zealand
Authors: PILATO GIOVANNI , LISI OSCAR
Published: March 2019

Macrobiotus rigidus sp. nov. is a new species of eutardigrade from New Zealand very similar to M. coronatus de Barros, 1942. It is characterized by having a smooth cuticle, lacking eye spots, having three macroplacoids and a microplacoid, and eggs with conical processes (with reticular sculpture and an evident ring of basal digitations) and egg shell with dots that seem to continue the basal digitations.
A new acuariid species (Spirurida, Acuariidae) and other nematodes from Hydromys (Muridae, Hydromyinae) from Papua, Indonesia and Papua New Guinea
Authors: SMALES LESLEY R.
Published: March 2019

From a survey of the intestinal helminths of 8 common water rats, Hydromys chrysogaster, and 1 Shaw Mayer’s water rat, Hydromys shawmayeri, from Papua New Guinea and 1 H. chrysogaster from Papua Indonesia, an acanthocephalan, Porrorchis hydromuris, a cestode Hymenolepis diminuta, a notocotylid and a psilostomid trematode and the nematodes Heterakis fieldingi, Subulura sp., Toxocara mackerrasae, Trichuris sp., Uncinaria hydromyos were found, all being new records for Hydromys in the Island of New Guinea. Tikusnema intersedis sp. nov. (Acuariidae), differing from its congenors in the number of teeth on the leaves of the pseudolabia and the length and morphology of the left spicule, was described from H. chrysogaster. Similar life styles and diets provide a common link between the rodents hosts of Tikusnema spp. The commonalities between the helminth communities of H. chrysogaster in northern Australia and New Guinea support the hypothesis that H. chrysogaster originated in New Guinea and subsequently migrated south.
The fossil mite family Archaeorchestidae (Acari, Oribatida) II: redescription of Plategeocranus sulcatus and family-group relationships
Authors: SIDORCHUK EKATERINA A. , NORTON ROY A.
Published: March 2019

The oribatid mite family Archaeorchestidae was proposed based on a single specimen of Archaeorchestes minguezae Arillo & Subías, 2000, from Lower Cretaceous amber (Spain). In a previous paper we redescribed Strieremaeus illibatus Sellnick, 1918, from Eocene Baltic and Rovno amber, and considered Strieremaeus a senior synonym of Archaeorchestes. Herein, we transfer a second genus, Plategeocranus, to Archaeorchestidae. This is based on a redescription of the type species, P. sulcatus (Karsch, 1884), using non-type specimens (44 adults and 2 immatures from Baltic and Rovno ambers). Among these are eight Baltic amber specimens identified by Max Sellnick and currently housed in two museums in Kaliningrad: from the Museum of the World Ocean we designate specimen #39 as neotype and specimens 22, 30, 33, 35 and 37 as paraneotypes; from the Kaliningrad Museum of Amber we designate specimens 197-22 and 197-54 as paraneotypes. The contention of Arillo and Subías that Archaeorchestidae is a member of Zetorchestoidea (Eremaeoidea auct.), and is the extinct sister-family of Zetorchestidae, is supported with additional characters that relate to leg setation and the morphology of immatures. The possible inclusion of another Cretaceous fossil mite, Rasnitsynella punctulata Krivolutsky, in Archaeorchestidae or Zetorchestoidea was rejected, leaving it in Plateremaeidae pending the direct investigation of specimens. New diagnoses are presented for Plategeocranus, Archaeorchestidae, and Zetorchestoidea.
The type series of Pseudopaludicola ternetzi Miranda-Ribeiro, 1937 (Anura, Leiuperidae) with designation of a lectotype
Authors: CARAMASCHI ULISSES , POMBAL JR. JOSÉ P.
Published: March 2019

The genus Pseudopaludicola was erected by Miranda-Ribeiro (1926) to accomodate one species, P. falcipes (Hensel, 1867). Posteriorly, he added a second species to the genus, P. ternetzi, based on an undefined number of specimens, but surely involving males and females (Miranda-Ribeiro 1937). After a relatively detailed description and figures of a male and a female specimen, he particularly standed out one female specimen as coming from “Goyaz (Dr. Ternetz). Passa-Tres”. Paulo Miranda-Ribeiro (1955), in his survey on the types of the species described by his father, cited P. ternetzi, but he did not define a type specimen for the species. Notwithstanding, Frost (2011) referred to purportedly “Syntypes: MNRJ (2 specimens); MNRJ 488, considered holotype by Miranda-Ribeiro, 1955”, but this latter is actually the holotype of Barycholos ternetzi (Miranda-Ribeiro, 1937) (see Caramaschi & Pombal 2001). The type locality was cited by Frost (2011) only as “Goyaz [= Goiás]”, following P. Miranda-Ribeiro (1955), but adding that it was “restricted to ‘Passa Três, Goiás’ by Bokermann (1966). Actually, Bokermann (1966)”, besides incorrectly having synonymized the species with Pseudopaludicola ameghini (Cope, 1887) (see Lobo 1994), just referred, as type locality for the species, without comments, the only locality cited by Miranda-Ribeiro (1937) for one specimen examined by him. Given that for ongoing taxonomic revisions it is important to precisely identify all name-bearing type specimens in this genus, we examined the type series of P. ternetzi. Herein we designate a lectotype and list the paralectotypes for the species, thereby restricting and defining its type locality.
The Polydectinae Dana, 1851, of the Philippines, with description of a new genus for Lybia hatagumoana Sakai, 1961 (Crustacea: Decapoda: Brachyura: Xanthidae)
Authors: MENDOZA JOSE CHRISTOPHER E. , NG PETER K. L.
Published: March 2019

The xanthid subfamily Polydectinae Dana, 1851, is recorded for the first time in the Philippines, being represented by four species: Polydectus cupulifer (Latreille, in Milbert, 1812), Lybia tessellata (Latreille, in Milbert, 1812), L. leptochelis (Zehntner, 1894), and L. hatagumoana Sakai, 1961. The taxonomy of L. hatagumoana is discussed at length, and a new genus, Tunebia gen. nov., established for it and the allied L. tutelina Tan & Ng, 1994, from New Caledonia. The new genus is diagnosed and compared with other polydectine genera.