bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P421: Smoking Timing, Healthy Diet, and Risk of Incident CKD Among Smokers: A Cohort Study in UK Biobank
Authors: Tang Rui , Hu Ying , Zhou Jian , Wang Xuan , Li Xiang , Heianza Yoriko , Qi Lu
Published: May 2024

Introduction:
While smoking is a recognized risk factor for chronic kidney disease (CKD), the relationship between the smoking timing and CKD remains largely unstudied.

Hypothesis:
We assessed the hypothesis that there is an association between the smoking timing and the risk of CKD.

Method:
A total of 32,776 participants with complete data on the time from waking to the first cigarette and free of prevalent CKD from UK Biobank were included in this prospective study. The Cox proportional hazard model was used to investigate the associations between smoking timing and risk of CKD. The potential interactions of smoking timing with risk factors in relation to CKD risk were assessed on both multiplicative and additive scales.

Results:
During a median follow-up of 12 years, 940 incident CKD cases were reported. Shorter time from waking to the first cigarette was significantly associated with a higher risk of incident CKD (
P
-trend=0.012). The adjusted hazard ratio (HR) associated with smoking timing was 1.28 (95% CI: 0.92-1.80) for 61-120 minutes, 1.48 (95% CI: 1.11-1.96) for 30-60 minutes, 1.36 (95% CI: 1.01-1.88) for 5-15 minutes, and 1.70 (95% CI: 1.22-2.37) for <5 minutes, respectively. Those who smoke within 5 minutes of waking had a 70% increased risk of CKD incident compared to those who delayed for over 120 minutes. Furthermore, there was a significant positive additive interaction between the timing of smoking and a healthy diet score (
P
for additive interaction=0.01).

Conclusion:
Our findings indicate a significant association between the shorter time from waking to the first cigarette and a higher CKD risk; and the associations are exacerbated in the presence of an unhealthy diet.
Abstract P426: County-Level Structural Racism and Diabetes Prevalence Among White and Black US Adults
Authors: Ramos Barrera Krystal , Krumholz Sarah , T. Dean Lorraine , Nguyên Charlie H , Dougherty Geoff B , Gross Alden L , Judd Suzanne , Hines Anika L , Plante Timothy B
Published: May 2024

Background:
Diabetes Mellitus affects 12.7% non-Hispanic Black adults as opposed to 7% non-Hispanic White Adults. We hypothesized that higher structural racism (SR) is associated with greater diabetes prevalence among Black and White adults.

Methods:
The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study recruited 30,239 US Black and White adults from 48 contiguous US states in 2003-2007. We linked a novel county-level structural racism (CSR) metric reflecting domains of housing dissimilarity, school dissimilarity, high school graduation, incarceration, poverty, primary care access, and ambulatory care access. CSR was determined linked to REGARDS participants’ county location at time of recruitment. Diabetes was defined as fasting blood glucose ≥126 mg/dL or random blood glucose ≥200 mg/dL or use of diabetes medications. We excluded those missing CSR score and diabetes status. Poisson regression estimated relative risk (RR) of prevalent diabetes by higher (more adverse) CSR.

Results:
Among the 28,329 included participants (mean [SD] age 65 years, [9.43], 55% female participants, 42% Black participants). There was a greater proportion of Black adults in areas with higher CSR. As is shown in
Table 1
, higher CSR was associated with higher RR of prevalent diabetes overall. However, higher CSR was associated with lower RR in race stratified models.

Conclusions:
Adverse levels of CSR were associated with lower diabetes prevalence in Black adults. It is unclear if this observation reflects operationalization of CSR, omitted variable bias, survival bias, or a true structural racism-diabetes association.

Table 1 - Relative risk (RR) of Diabetes Prevalence age and sex adjusted per 1-point higher CSR*
Abstract P435: Trends and Disparities in Glycemic Control Among Youth and Adults With Type 1 Diabetes in the US Health System: 2008-2022
Authors: Xu Yunwen , Fang Michael , Ballew Shoshana , Coresh Joe , Selvin Elizabeth , Shin Jung-Im
Published: May 2024

Introduction:
Glycemic control is crucial for type 1 diabetes (T1D) management, yet contemporary data in the US are scarce. This study aims to investigate trends in glycemic control among US youth and adults with T1D from 2008 through 2022.

Hypothesis:
Glycemic control has improved over time.

Methods:
We used a well-validated algorithm to identify patients with T1D using de-identified electronic health record data from the Optum Labs Data Warehouse. We characterized trends in hemoglobin A1c (HbA1c) <7% from 2008-2010 to 2020-2022, overall and by age, sex, and race/ethnicity.

Results:
We included 128,821 patients with T1D (17% youth under age 18 years, mean age 38 years, 48% female, 78% non-Hispanic White). Among youth, mean HbA1c decreased from 8.9% in 2008-2010 to 8.5% in 2020-2022 (
P<.001
), and the percentage with HbA1c <7% increased from 8% to 16% (
P<.001
). The percentage with HbA1c <7% did not differ by age or sex, and it was notably higher in Non-Hispanic White youth than racial/ethnic minority youth in 2020-2022 (
Figure A-D
). Among adults, mean HbA1c decreased from 8.2% in 2008-2010 to 8.1% in 2020-2022 (
P<.001
). Trend in percentage with HbA1c <7% among adults increased significantly from 20% in 2008-2010 to 26% in 2020-2022 (
P<.001
). Adults who were older and White were more likely to have HbA1c <7% compared to younger and Black or Hispanic adults in all years (
Figure E-F
).

Conclusion:
There have been marginal improvements in glycemic control among patients with T1D over the last 15 years. Overall, percentage with HbA1c<7% remains low, particularly among youth and racial/ethnic minority patients. There is an urgent need to expand access to care and diabetes technology to enhance management in the population.
Abstract P445: Associations of Homeownership and Overcrowding Conditions With Cardiovascular Health Among Diverse U.S. Children and Adults
Authors: Aguayo Liliana , Fields Nicole
Published: May 2024

Background:
We hypothesized that children and adults living in rented and overcrowded houses have lower cardiovascular health (CVH), as measured by Life Essential 8 (LE8), a powerful predictor of CVD. We evaluated if this association varied by race/ethnicity.

Methods:
This cross-sectional study used pooled data from the National Health and Nutrition Examination Survey 2013-2018 (NHANES). LE8 scores (range 0-100) were estimated following age-specific criteria with all metrics available for each age group. Overcrowding was defined as two or more persons per room, per Census Bureau’s criteria. Multivariable linear regressions estimated the association of overcrowding and homeownership (v. rental status) with CVH, for children (aged 2-19) and adults separately. Racial/ethnic differences were examined using interaction terms. Weighted models adjusted for the complex survey design and the following covariates: age, sex, race/ethnicity, insurance status, country of birth, and self or parental education and marital status.

Results:
Homeownership was associated with a 1-point higher CVH among children (
p
=0.02), except for Black children, who had higher CVH when they lived in rented homes (86.51 for renters vs. 85.46 for homeowners). Among adults, homeownership was associated with 2.4 points higher CVH (p=0.008). An interaction showed that for Black and Latinx adults, homeownership was associated with lower CVH than renters (MD=-3.30,
p=
0.004 for Black and -2.91,
p
= 0.006 for Latinx). Overcrowding was not associated with child CVH (
p
=0.57). Among adults, and interaction showed that living in overcrowded houses was associated with lower CVH for Black (MD= -2.47, p=0.006) and Latinx adults (MD= -3.53,
p
<0.001).

Conclusions:
Overcrowded housing and homeownership are associated with CVH in children and adults, but relationships vary by race/ethnicity. Findings underscore the need to better understand how housing conditions influence CVH disparities and advocate for affordable housing for all.
Abstract P449: Closing the Gender Gap in Bystander Cardiopulmonary Resuscitation: Unveiling Disparities and Pathways to Equal Lifesaving
Authors: Frederick Jynx
Published: May 2024

Introduction:
Gender disparities in CPR persist, with women receiving CPR less frequently than men during out-of-hospital cardiac arrests. This abstract emphasizes the importance of addressing this disparity through awareness campaigns and offers innovative strategies for prevention, including gender-sensitive CPR training methods and a community program example from New Orleans.

Methods:
A comprehensive literature review was conducted to identify studies on gender disparities in bystander CPR. Factors contributing to these disparities were analyzed, including hesitations related to physical contact, challenges in recognizing cardiac arrest in women, and societal biases. Survival data were assessed to highlight the lifesaving potential of gender-equal CPR.

Results:
Research revealed that gender disparities in CPR provision are common, influenced by factors such as reluctance to perform chest compressions on women, difficulties in identifying cardiac arrest in female patients, and the perpetuation of gender stereotypes. These factors result in significantly different survival rates, with women facing a higher risk of worse outcomes.

Discussion:
Addressing gender disparities in bystander CPR provision requires a multifaceted approach, including community-based CPR training programs that emphasize gender sensitivity. These programs should feature anatomically correct CPR training dolls with breast attachments to ensure trainees are prepared to perform CPR on anyone. It is crucial that CPR course instruction also incorporate information on gender disparities to raise awareness among trainees. Public awareness campaigns should work to dispel myths and biases related to gender and CPR, promoting more equitable lifesaving practices. An exemplary program from New Orleans demonstrates the impact of community-based initiatives. In this effort, community members were trained in CPR using gender-inclusive materials, including CPR dolls with breast attachments. The training included statistical information on gender disparities, bias assessments, survivor testimonials, and discussions aimed at dispelling myths about providing CPR to women. This program successfully empowered the community with the knowledge and skills to overcome gender biases in CPR, promoting gender-equitable lifesaving measures.

Conclusion:
Preventing gender disparities in bystander CPR provision to women is essential to enhance survival rates for female cardiac arrest victims. Using public platforms to advocate for these initiatives and emphasizing the need for collaborative efforts to eliminate gender bias in lifesaving practices and CPR training is crucial. By illuminating the issue, proposing innovative solutions, and sharing successful community programs, a standard can be cultivated where every individual, regardless of gender, receives timely and effective CPR.
Abstract P456: Expanding a Pipeline to Address San Joaquin Valley Health Inequity and Social Justice
Authors: Siddiqui Maha
Published: May 2024

Introduction:
San Joaquin Valley (SJV) is the most medically underserved California region. For the last 50 years, SJV continues to face health inequity with not enough physicians for growing communities. With a diverse community of low income and minority groups, the lack of physicians do not represent the workforce of SJV. Many of the talented high school and community college students who aspire to be physicians from SJV leave to bigger cities rather than coming back to enrich their vulnerable communities.

Objectives:
I created and expanded no cost pipeline medical programs (summer programs and online class) for SJV high school students and community college students to increase diversity in the medical profession, encourage underrepresented in medicine (URM) students to pursue medicine and come back to SJV to practice medicine in an effort to lower the patient provider gap.

Methods:
I trained and provided mentorship to medically ambitious low-income high school and community college students in the programs to instill a passion in them to come back after their medical education to practice medicine and lower health equity in SJV. Through the program, students learned about SJV health disparities and applied precision medicine to their own health inequity projects in SJV.

Findings:

-About 76% (106 of 140) of program participants identified as URM

-About 63% (88 of 140) of program participants were first generation

-About 83% (103 of 140) of program participants feel that the pipeline program has helped them solidify their passion in medicine

-About 66% (92 of 140) of program participants aspire to practice medicine in SJV

-About 100% (140 of 140) of program participants feel the program gave them guidance in health disparities, precision medicine, and applying design thinking concepts as a future leader in medicine

Direct Outcomes:

-Students were able to understanding community concerns beyond science and with a health justice perspective

-Served as agents of change by directly communicating with physicians and understanding the need for more URM physicians

-Students received mentorship and confidence to rise as URM first generation college students and pursue STEM majors

-Youth learned the value of service to disadvantaged communities
Abstract P462: A Novel Framework for the Extraction and Modeling of Meal-Related Glucose Excursions Detected via Continuous Glucose Monitoring (CGM)
Authors: Sartini Joseph , Fang Michael , Rooney Mary R , Selvin Elizabeth , Zeger Scott
Published: May 2024

Introduction:
Understanding factors that influence glycemic response to meals can inform strategies for diabetes management. Continuous glucose monitoring (CGM) facilitates analyzing glycemic regulation, but concurrent meal timing, required to study meal-induced excursions, is rarely collected.

Objective:
We develop a framework for extracting meal-related glucose excursions from CGM time series, modeling the excursions using interpretable features, and estimating feature variability explained by patient characteristics and instance-specific patterns.

Methods:
We used CGM data (Abbott Freestyle Pro) from N = 175 clinical trial participants with type 2 diabetes not using insulin (HYPNOS Trial: mean age 60; 49% female; 36% Black adults). To find excursions, we marked local maxima points in the CGM time series. We discarded points with glucose increases <50 mg/dL in a symmetric window around the point. Remaining point-windows became excursions (
Fig. 1A)
. We summarized excursions using relevant features: baseline, height, and shape quantified by splines (
Fig. 1B
).We then assumed each feature could be modelled as the sum of patient-specific effects, both measured as covariates and unmeasured, and instance-specific effects (
Fig. 1C
). Covariates included demographic, biometric, and lifestyle characteristics. Using linear mixed-effects models, we estimated the effects and corresponding variance explained for each feature.

Results:
For baseline glucose, measured covariate effects notably explain 61.2% of variability. For both height and shape, the summed patient-specific effects explain negligible variation, 17.8% and 10% respectively (
Fig. 1D
).

Conclusion:
Using our novel framework, we found that instance-specific information explains most variability in glucose excursions. As diet and adjacent physical activity are the instance-specific features primarily impacting glucose metabolism, it follows that healthy lifestyle choices impact postprandial glucose patterns more than inherent traits.
Abstract P466: A Culturally Tailored mHealth Lifestyle Intervention Improves Diet and Physical Activity Self-Regulation Among African Americans
Authors: Lalika Mathias , Jenkins Sarah , Hayes Sharonne N , Jones Clarence , Burke Lora E , Cooper Lisa A , Patten Christi A , Brewer LaPrincess C
Published: May 2024

Background:
Physical inactivity and poor adherence to healthy eating guidelines impact cardiovascular health (CVH) outcomes in African American (AAs). Our randomized controlled trial (RCT) testing the FAITH! App, an mHealth lifestyle intervention, showed efficacy in promoting ideal CVH, particularly diet and physical activity (PA) among AAs, warranting exploration of underlying factors. Psychosocial factors (e.g., self-regulation, self-efficacy, social support) are key to healthy behavior adoption.

Hypothesis:
The intervention group would have greater improvements in diet and PA-related psychosocial factors than the control group after using the FAITH! App.

Methods:
A 2-arm cluster RCT was conducted among AAs from 16 churches in Minnesota comparing the FAITH! App intervention to a delayed intervention control group. The FAITH! App included culturally relevant, CVH-focused education modules, diet/PA self-monitoring and a sharing board. The outcomes were change in diet and PA self-regulation and self-efficacy (primary) and social support and barriers (secondary) at 6 months post-intervention. The intervention effect was assessed using linear regression.

Results:
Sixty-eight participants were included (71% female; mean age [SD]: 54.7 [12.6] years) (
Table 1
). The intervention group showed a significantly greater increase in diet self-regulation [planning/tracking nutrition] (+0.66, p<.03) and PA self-regulation [step count strategies] (+0.47, p=.003) than the control group. Within groups, the intervention group demonstrated significant improvements across diet and PA self-regulation measures, while the control group showed an improvement only in fruit/vegetable and grain intake. No effect was observed in self-efficacy, social support, or barriers.

Conclusions:
Our culturally tailored mHealth lifestyle intervention was associated with notable increases in diet and PA self-regulation, suggesting a potential mechanism by which the FAITH! App improves healthy eating and PA among AAs.
Abstract P474: Association Between Dietary Patterns and Incident Hypertension in Regards (REasons for Geographic And Regional Differences in Stroke) Participants
Authors: Morton Kara F , Plante Timothy B , Bittner Vera A , Williams Kim A , Clarkson Stephen , Nanavati Hely , Judd Suzanne E
Published: May 2024

Background:
The lifetime hypertension prevalence in the US is >70%. Dietary patterns may partially explain this overall risk. We sought to explore the association between dietary intake and risk of incident hypertension.

Methods:
REGARDS participants without hypertension at Visit 1 (2003-2007) were included, excluding those missing dietary data or Visit 2 follow-up (2013-2016). The exposure of interest was quartile of adherence to 5 dietary patterns previously determined among REGARDS participants using food frequency questionnaires and factor analysis: Convenience, Plant-Based, Sweets, Southern, and Alcohol/Salad (descriptions in Table 1). The outcome of interest was incident hypertension, defined as a blood pressure of ≥130/80 mmHg or the use of antihypertensive medication at follow up. Modified Poisson regression estimated risk ratios (RR), adjusting for demographics, socioeconomic factors, health behaviors, and medical conditions.

Results:
Of the 3,423 (mean [SD] age 61.6 [± 8.4] years, 58.5% women, 17.9% Black race), 42% (1,438) developed hypertension at median follow-up of 9 years. In unadjusted models, there was no clear association between Convenience, Plant-Based, or Sweets dietary patterns and incident hypertension (Table 1). High adherence to a Southern pattern was associated with incident hypertension. This association remained when adjusting for demographics, but not when adjusting for socioeconomic variables, health behaviors, and comorbid conditions. High adherence to the Alcohol/Salad dietary pattern also had no clear association with incident hypertension risk in the unadjusted model. However, in the fully adjusted model, there was greater risk of incident hypertension with greater adherence to the Alcohol/Salad pattern.

Conclusions:
Certain dietary patterns in REGARDS were associated with greater risk of incident hypertension. Future analyses to examine which food groups may be driving differential associations may help develop dietary strategies to reduce hypertension.
Abstract P476: Changes in Olive Oil Consumption and Weight Changes in US Men and Women
Authors: Pacheco Lorena S , Guasch-Ferre Marta , Tessier Anne-Julie J , Willett Walter C , Sun Qi , Salas-Salvado Jordi , Martinez-Gonzalez Miguel A , Stampfer Meir J , Hu Frank B
Published: May 2024

Background:
Olive oil intake is inversely associated with the risk of chronic diseases and mortality. However, it is unclear whether there is an association between olive oil intake and weight changes; because it is an energy-dense food concerns have been raised that high intake may contribute to weight gain. Therefore, we aimed to determine the associations between long-term changes in olive oil consumption and changes in weight.

Methods:
We examined data from 116,243 women and men from the Nurses’ Health Study (NHS, 1990-2010), NHSII (1991-2015), and Health Professional Follow-up Study (HPFS, 1990-2014), who were free from chronic diseases at baseline. We applied multivariable linear regression models with robust variance estimators to assess the association of changes in olive oil intake within each 4-year interval with concurrent weight changes. Results across the three cohorts were pooled using inverse-variance weights.

Results:
At baseline, mean ± SD age was 54.8 ± 6.6 years in the NHS, 45.3 ± 8.0 years in the NHS2, and 53.9 ± 7.2 years in the HPFS. Mean body mass index was 25 kg/m2 at baseline across the three cohorts. The mean weight gain over each 4-year follow-up cycle was highest in the NHS2 (1.8; 95%CI -6.8 to 11.3 kg), followed by the NHS (1.0; 95%CI -6.8 to 9.1 kg), and lastly the HPFS (0.6; 95%CI -5.4 to 6.8 kg). Pooling across the cohorts after adjustment for sociodemographic, lifestyle, and set of dietary factors (fruits, vegetables, red and processed meat, sugar sweetened beverages, coffee, refined grains), each ½ Tablespoon (7 grams) serving per day increment in olive oil was associated with a slightly lower 4-year weight gain of -0.06 kg (95%CI -0.08 to -0.04 kg; p<0.0001). This inverse association was observed in the three cohorts, with a greater magnitude of association in the NHS2 (-0.08; 95%CI -0.10 to -0.05 kg; p<0.0001), followed by the HPFS (-0.07; 95%CI -0.12 to -0.02 kg; p=0.003) and lastly the NHS (-0.05; 95%CI -0.07 to -0.01 kg; p=0.02). Results were attenuated after adjustment for the Alternative Healthy Eating index (pooled -0.03; 95%CI -0.05 to -0.02; p=0.0003).

Conclusions:
Long-term habitual increase in olive oil consumption was not associated with increased weight gain in middle-aged and older adults.
Abstract P482: Associations Between Determinates of Food Choice and Healthy Eating Index-2015 in Adults: An NHANES 2017 - 2018 Analysis
Authors: Tate Kayla E , Petersen Kristina
Published: May 2024

Introduction:
Previous work in nationally representative US samples has focused on associations between single determinants of food choice and diet quality assessed by the Health Eating Index-2015 (HEI-2015). Limited research has examined the relationship between multiple domains of food choice and diet quality. A greater understanding of the association between individual-level determinants of food choice and diet quality may inform the development of interventions to improve diet quality.

Aim:
The aim was to examine the association between potentially modifiable factors known to affect individual-level food choice and HEI-2015.

Methods:
This cross-sectional analysis included adult participants in NHANES 2017 - 2018. Determinates of individual-level food choice were based on a previously proposed framework. Variables assessed in NHANES were mapped to the following four domains: 1) food-external factors (use of nutrition labels, hours worked weekly, typical work schedule); 2) personal-state factors (health status, consumption of food away from home); 3) cognitive factors (perceived diet quality, knowledge of MyPlate); 4) society-related features (monthly grocery expenditures, food security status, income to poverty ratio). Univariate regression assessed the relationship between food choice determinates and HEI-2015 score. Statistically significant variables were entered into multivariate regression models predicting HEI-2015 score. Significant variables from the final model were used in multivariate regression models predicting adequacy and moderation component sub scores of HEI-2015. All models were adjusted for non-modifiable determinates of food choice, including age, sex, race, BMI, education, and relationship status. All analyses were survey weighted.

Results:
The weighted mean HEI-2015 score for the sample (N=1467) was 51.69 points (95% CI 49.55, 53.84; weighted n=95.6 million). In the final model, perceived diet quality, food away from home, and use of nutrition labels were significant predictors of HEI-2015 (R
2
adj
=0.25, p<0.001). Those with excellent/very good perceived diet quality had a 4.88-pt higher HEI-2015 score than those with fair/poor perceived diet quality (p<0.001). Consuming food away from home ≥5 times per week resulted in a 5.92-pt lower HEI-2015 score than 0 times per week (p=0.02). Always/most of the time using nutrition labels was associated with a 7.85-pt higher HEI-2015 score compared to rarely/never using labels (p<0.001). Variables accounted for a higher proportion of variance in adequacy score (R
2
adj
=0.10, p<.001) than moderation score (R
2
adj
=0.24, p<.001).

Conclusion:
Food-external, personal-state, cognitive, and socio-cultural factors are associated with diet quality. Future research should consider multiple individual-level food-choice determinates when developing interventions to improve diet quality.
Abstract P502: Lifestyle Modification for Secondary Prevention of Atrial Fibrillation: A Pilot Study
Authors: Ashburner Jeffrey M , Carmichael Taylor , Bhattacharya Romit , Bapat Aneesh , Natarajan Pradeep , Atlas Steven , Singer Daniel E , Thorndike Anne N
Published: May 2024

Background:
Addressing modifiable cardiovascular risk factors through lifestyle interventions may be effective for secondary atrial fibrillation (AF) prevention.

Aims:
To assess feasibility, acceptability, and preliminary effectiveness of an exercise and nutrition-based cardiac rehabilitation-like program for patients with symptomatic AF.

Methods:
We enrolled overweight (body mass index [BMI] ≥ 28 kg/m
2
) adults aged ≥ 30 years with symptomatic AF in a 12-week cardiac lifestyle group program, which included 6 virtual and 6 in-person visits. All visits included discussion and education about nutrition, exercise, and behavior modification. In-person visits included supervised aerobic exercise and strength training. Patients were evaluated to assess health history, diet, and baseline cardiac risk factors. Outcomes at baseline and 12 weeks included feasibility of participation, change in weight and BMI, acceptability, and changes in survey-based AF burden and symptoms, and AF-related quality of life (QOL).

Results:
From 84 invitees, 11 (13.1%) were enrolled (mean age 64; baseline BMI 38 kg/m
2
; 45% female); 9 (82%) completed the program. Patients attended an average of 9.7 (81%) visits (Range: 6-11). Mean weight loss was 9.1 pounds (Range: 0-16) and mean BMI decrease was 1.4 kg/m
2
(Range: 0-2.6). Nine of 11 patients completed baseline and follow-up surveys
(Table)
. Patients found the program helpful overall: all reported making diet and exercise changes during the program; 8 (89%) were confident in continuing dietary changes and 7 (77%) were confident in continuing exercise changes after the program. Patients reported decreased AF burden and symptoms, and increased QOL at the conclusion of the program
(Table)
.

Conclusions:
Participation in a cardiac rehab-like program was feasible and acceptable for overweight patients with symptomatic AF. Results suggest preliminary effectiveness of the program for reducing AF burden and symptoms and increasing quality of life.
Abstract P508: Comparisons of Cardiovascular Health in US Adults by Chronic Disease Status: National Health and Nutrition Examination Survey (NHANES), 2013-2018
Authors: Guo James W , Ning Hongyan , Lloyd-Jones Donald M
Published: May 2024

Introduction:
Cardiovascular health (CVH) assessment is typically applied to younger, healthy individuals in the setting of primordial prevention, but the concept may have important benefits for those with chronic diseases of aging (CDAs) at increased risk for incident cardiovascular disease (CVD). No studies have assessed CVH in adults with CDAs vs. healthy adults without CDAs using the new Life’s Essential 8 (LE8) metrics.

Methods:
We used NHANES data from 2013-2018 to identify presence of 15 CDAs by participant self-report of diagnosis. We included adults ages 20 to 79. CVH was defined by AHA’s LE8 metrics. Overall mean LE8 (range 0-100, higher = better CVH) and individual LE8 metric scores were calculated according to disease status for all participants and stratified by self-identified sex and race/ethnicity.

Results:
There were 12,296 adults, with mean age 46 years; 51% self-identified as female, 65% as White, 16% Hispanic, 11% Black, 5% Asian, 4% multiracial. Significantly, and often substantially, lower CVH scores were noted for adults with CDA (12 of 15 CDAs) vs. healthy adults, including all subtypes of CVD and lung diseases, liver disease, arthritis, cognitive decline, and depression. Greatest mean LE8 differences were detected for COPD, emphysema, and congestive heart failure. For example, mean overall LE8 score was 14.0 points lower in those with vs. without COPD (51.0 vs. 65.0, P<0.0001) with smoking and physical activity having the largest absolute differences in individual metric scores (36.4 and 23.6, respectively). There were no significant differences in LE8 scores for participants with vs. without cancer, HIV, or osteoporosis. Males and Black adults consistently had lower LE8 scores.

Conclusions:
CVH is significantly poorer in adults with many of the CDAs compared to healthy adults. These data establish the utility of the LE8 CVH score to identify groups for targeted optimization of CVH to enhance primary and secondary prevention efforts for CVD and potentially for other concomitant CDAs.
Abstract P510: Trends in Statin Therapy for Primary Prevention Among Older Veterans, 2003-2020
Authors: Mahbub Hasan M , Wellman Helen , Cho Kelly , Gagnon David , Gaziano Michael , Djousse Luc , Orkaby Ariela , Qazi Saadia
Published: May 2024

Introduction:
The burden and risk of atherosclerotic cardiovascular disease (ASCVD) in US Veterans is higher than the general population, yet rates of use of medications for primary prevention, specifically statins, are not well described. Since the early 2000s, trial data have proven the efficacy of statins for primary prevention, further encouraged by updated guidelines (notably 2001, 2013, 2018). Therefore, we sought to examine the proportion of older veterans free of ASCVD and trends of statin use for primary prevention within this cohort from 2003 to 2020.

Methods:
Study participants comprised all US Veterans ≥65 years, free of ASCVD, and with at least one visit in the Veteran’s Health Administration (VHA) in the year prior. Statin users had at least two or more prescriptions of any statin in each one-year period studied. VA prescription data were linked to Medicare/Medicaid to ensure complete capture of statin use. Descriptive statistics and crude proportions were calculated by year of study entry.

Results:
From 2003-2020, there were 5.1 million Veterans aged 65 and older who received regular care in VHA. The overall proportion of veterans free of ASCVD in that period was 60% (N=3,159,705). Statin prescriptions for primary prevention have increased from 39% in 2003 to 52% in 2020, remaining steady after 2007. For example, in 2011, 51% were prescribed statins, mean age 73±7, 87% white, 98% male, 82% hypertension, 37% diabetes, 94% hyperlipidemia; while in 2017, 53% were prescribed statins (age 72± 7, 80% white, 97% male, 73% hypertension, 31% diabetes, 74% hyperlipidemia), received statin therapy for primary prevention (Figure).

Conclusion:
A substantial proportion of Veterans ≥65 years were at risk for ASCVD. While statin prescriptions for primary prevention have increased from 2003-2020, over the past 15 years, they have remained at around 50%. These findings indicate a focus on primary prevention among older Veterans is needed.
Abstract P511: Trajectories of Modifiable Risk Factors, Cardiac Function and Incident Heart Failure in the Atherosclerosis Risk in Communities (ARIC) Cohort
Authors: Nguyen Ngoc Quynh H , Li Ruosha , Chang Patricia , Shah Amil M , Yu Bing
Published: May 2024

Introduction:
Modifiable risk factors are known to associate with incident heart failure (HF), however, their longitudinal impacts have not been fully understood. Independent trajectory clusters of risk factors can help provide insights to the development of HF.

Hypothesis:
We hypothesize that unfavorable trajectory clusters are associated with increasing risk of HF.

Methods:
Clinical risk factors, including body mass index (BMI), systolic blood pressure (SBP), low-density lipoprotein (LDL), heart rate, total cholesterol (TCH), and high-density lipoprotein (HDL) were measured in Atherosclerosis Risk in Communities (ARIC) study at 5 consecutive visits (1987-2013). Trajectories were built for each clinical risk factor in participants with at least 3 time points using group-based trajectory modeling approach. Controlling for clinical risk factors, trajectory groups and their associations with post visit 5 incident HF were assessed via Cox proportional regression. Sex stratified analyses were conducted to assess effect modification.

Results:
Among 4,548 participants (mean age 75, 18.1% Blacks), 390 developed HF after visit 5 (median follow = 8.4 years). Five distinct clusters were identified for SBP, LDL, TCH, heart rate, and three clusters for BMI and HDL. Compared to the lowest cluster, normal-fast rising SBP cluster (HR = 1.7, 95% CI 1.2, 2.5), severely obese BMI cluster (HR = 1.9, 95%CI 1.4, 2.6), and normal-fast rising heart rate cluster (HR = 1.7, 95%CI 1.1, 2.5) had higher risk of developing HF. Interestingly, suboptimal-stable LDL cluster (HR = 0.6, 95%CI 0.4, 0.8) was associated with lower risk of HF compared to the optimal-stable LDL cluster. When stratified by sex (female =59.1%, male = 40.9%), the identified trajectories shared similar patterns with the parent trajectories. The effects on HF were consistent between sex groups; however, most significant associations were diminished in males.

Conclusion:
We identified distinct trajectories that capture long-term effects of risk factors. Unfavorable clusters significantly associated with increased risk of HF, except LDL, suggesting further investigation on lipids control for HF prevention.
Abstract P514: Association Between Glycemic Disorder and Acute Coronary Syndrome Among Patients With Stable Coronary Artery Disease: A Propensity Score Matching Analysis
Authors: Sheng Chen , Bao Liwen
Published: May 2024

Background:
Type 2 diabetes mellitus is known as a major risk factor of acute coronary syndrome (ACS) as previous studies reported. However, the association between prediabetes and ACS is not fully investigated among patients with stable coronary artery disease (CAD). Furthermore, no study has examined whether there’s effect modification by sex, age and BMI in the association between glycemic disorder and ACS. Our study aimed to evaluate the role of glycemic disorder in ACS occurrence among patients CAD.

Methods:
In this cross-sectional study based on electronic medical records (EMR), participants with CAD after elective coronary artery angiography (CAG) during 2016-2020 were enrolled. Diagnosis of prediabetes was based on patients’ HbA1c level ranging from 5.7% to 6.4% or fasting plasma glucose (FPG) level between 5.6 - 6.9 mmol/L. The diabetes diagnosis was defined as HbA1c ≥6.5% or fasting plasma glucose (FPG) ≥7.0 mmol/L. Multivariable logistic regression models were built to evaluate the association between prediabetes, diabetes and ACS, adjusting for age, body mass index (BMI), hypertension, low density lipoprotein, triglyceride level, statin and anti-platelet medication use. Subjects with prediabetes were matched 1:1 to healthy controls using propensity score matching to test the robustness of the result. In the subgroup analysis, we examined the heterogeneity of age, sex and BMI in the association between glycemic disorders and ACS.

Results:
Among 1525 participants, 1158 were male and 367 were female. Compared to participants with no diabetes, those with prediabetic were not significantly associated ACS, after adjusting for potential confounders. The result persisted after 1:1 propensity score matching. There was effect modification by sex in the association between glycemic disorders and ACS (P
glycemic disorder*sex
= 0.012). Female participants with diabetes, compared to those without diabetes, were positively associated with ACS (OR 2.00, 95% CI 1.00 - 3.98). The association between glycemic disorders and ACS remained stable among those with severe coronary stenosis.

Conclusions:
Our finding suggested that the association between prediabetes and ACS did not differ from those with normal glycemic status and CAD. The association remained consistent among those with severe coronary stenosis. Besides, sex modifies the association, and female participants with diabetes should be paid attention to their higher risk of ACS.
Abstract P522: Racial Differences in Sleep Health in Middle-Aged Adults
Authors: Knutson Kristen L , Alexandria Shaina J , Reid Kathryn , Abbott Sabra , Chapagai Swaty , Cai Xuan , Chirinos Diana , Thomas S. Justin , Lewis Cora E , Schreiner Pamela B , Carnethon Mercedes R
Published: May 2024

Introduction:
Sleep health is comprised of many dimensions, including duration, quality and sleep disorders. Prior work found that Black adults have worse sleep health than White adults, but the underlying reasons are unknown. Our goal was to examine possible determinants of racial disparities in sleep health. We hypothesized that sleep health would be worse in Black participants, and this would be partly explained by clinical, psychosocial and lifestyle risk factors.

Methods:
We used cross-sectional data from the sleep ancillary study to the Coronary Artery Risk Development in Young Adults (CARDIA) study. Several objective sleep measures were collected, including 7 days of wrist actigraphy and a home sleep test (Nox T3s). Sleep disordered breathing was classified by oxygen desaturation index (ODI)>=10 or apnea-hypopnea index (AHI) >=15. We used a series of regression models to calculate the percent reduction in the coefficient estimate for race in models for each sleep health metric after adjusting for clinical factors, psychosocial factors or lifestyle factors.

Results:
There were 565 Black and 741 White adults in this analysis (mean (SD) age 61 (3.6) years). Black adults had significantly worse sleep health based on all measures, including shorter sleep duration, lower sleep percentage, greater sleep fragmentation and higher prevalence of sleep disordered breathing compared to White adults. Clinical factors, psychosocial factors and lifestyle factors all explained a proportion of the racial differences in sleep fragmentation and sleep percentage and explained away the racial differences in sleep disordered breathing (Table).

Conclusions:
Racial disparities in sleep health may be partly explained by clinical factors, such as blood pressure and BMI, psychosocial factors, such as education and depression, and lifestyle factors, such as smoking, alcohol intake, and physical activity. These findings provide several potential intervention targets to improve sleep health, particularly in Black adults.
Abstract P525: Polygenic Risk Scores for Morning Chronotype and Longer Sleep Duration Are Associated With Weight and Glycemic Outcomes in the Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Barragan Rocio , Wallace Danielle , Cheng Bin , Sofer Tamar , ORTEGA CAROLINA , Guo Xiuqing , Rotter Jerome I , Shea Steven , Redline Susan , Corella Dolores , St-Onge Marie-Pierre
Published: May 2024

Introduction:
Circadian rhythms regulate key physiological processes, including sleep-wake. Alterations in the circadian rhythm have been associated with greater risk of metabolic diseases. Genome-wide association studies (GWAS) have revealed genes variants associated with sleep phenotypes.

Hypothesis:
Polygenic risk scores (PRS) for significant SNPs reported in GWAS of chronotype (C), sleep duration (SD), and short sleep (SS, <7/h) are associated with metabolic parameters.

Methods:
We carried out a longitudinal analysis in 6,814 adults (aged 45-84 y at baseline) from the Multi-Ethnic Study of Atherosclerosis (MESA). Glucose, insulin, insulin resistance (HOMA-IR), body mass index (BMI) and waist circumference (WC) were assessed at baseline (2000-2002) and 16-18 y follow-up (Exam 6, N=3,303). DNA was extracted from whole blood, and genotyping data were obtained by the Affymetrix 6.0 SNP array. PRS for the following phenotypes were constructed as weight sum of genoma-wide significant alleles: 1) chronotype [PRS-C]; 2) continuous SD [PRS-SD]; and 3) SS duration [PRS-SS]. Multivariable linear regression models adjusted by sociodemographic, obesity, smoking, Mediterranean diet, physical activity and antidiabetic drugs were performed to assess associations between PRS and study outcomes (fasting glucose and insulin, HOMA-IR, hemoglobin A1c, BMI, and WC) cross-sectionally and longitudinally.

Results:
At baseline, none of the PRS were associated with glucose, insulin or HOMA-IR (p>0.05). A significant positive association was detected for PRS-C with BMI and WC: greater genetically determined morningness was associated with lower BMI (β=-20.0±3.0; p<0.001) and smaller WC (β=-44.1±8.0; p<0.001). Similar results were observed with PRS-SD (BMI: β=-0.1±0.0; p=0.005; WC: β=-0.3±0.1; p=0.008) and PRS-SS (BMI: β=9.3±2.8; p<0.001; WC: β=19.8±7.4; p=0.007). In longitudinal analyses, we observed prospective associations between PRS-C with BMI (β=-43.5±12.2; p<0.001), WC (β=-116.0.1±29.1; p<0.001), and glucose (β=-204.7±90.0; p=0.024). PRS-SS was longitudinally associated with HOMA-IR (β=214.1±88.0; p=0.017) and a trend was observed for hemoglobin A1c (β=-6.6±3.4; p=0.053), but not with anthropometrics parameters. No associations were noted for PRS-SD with obesity and glycemic outcomes in longitudinal analyses.

Conclusion:
In the MESA population, PRS for chronotype, sleep duration, and short sleep are associated with anthropometric but not with glycemic measures in cross-sectional analyses. However, PRS for chronotype and short sleep was associated with anthropometric and glycemic parameters in longitudinal analyses, suggesting the importance of genetic predisposition for morningness and adequate sleep duration for metabolic health.
Phylogeny of Australian Acerentomidae species (Protura: Acerentomidae), with a key to identification
Authors: SHRUBOVYCH JULIA , D’HAESE CYRILLE
Published: May 2024

The materials of three Acerentomidae species from Australia and Tasmania were studied. Additional morphological characters, such as chaetotaxy of head and notal segments, shape of body setae and porotaxy, are provided based on new materials of Australentulus westraliensis from Australia and Tasmanentulus tasmanicus from Tasmania. A new species, Amphientulus markstivensi, is described from Tasmania. The steps of reduction of morphological characters along the presumed phylogenetic line Acerentulus – Australentulus – Tasmanentulus – Amphientulus are discussed. The apical tuft of setae on the labial palps is reduced in Australentulus, Tasmanentulus and Amphientulus. In Tasmanentulus and Amphientulus there is also a reduction of setal number to two setae on abdominal legs. Phylogenetic relationships within Australian Acerentomidae genera are discussed. An identification key to Australian Acerentomidae species is provided.
Design and Performance Analysis of Photovoltaic Power Generation Light Emitting Diode Device
Authors: Fang Xiaomin , Li Xiaolu
Published: May 2024

This research focuses on an independent photovoltaic power generation system with supercapacitor energy storage as the study subject. The model is simplified, and the photovoltaic power generation light emitting diode (LED) device is designed based on the given parameters. This system
selects a Boost-type step-up converter for the supercapacitor charging circuit, capable of achieving Maximum Power Point Tracking (MPPT). The supercapacitor discharge circuit employs an LM2596 series regulator to power the rated load LED (12 V, 1 W), providing good linear regulation capability.
In designing other hardware components of the device, the characteristics of a photoresistor are utilized to implement an automatic load switch circuit. An efficient single-chip integrated circuit LM2575 series is used as a regulator to convert the voltage across the supercapacitor terminals
to +15 V and +5 V. Considering the need to collect the output voltage of the photovoltaic cell array and the voltage across the supercapacitor terminals, a resistor divider method is used to sample these two voltages. The sampling circuit includes a resistor divider circuit and a linear optocoupler
isolation circuit. An HNC-25LTS series Hall current sensor is used for current sampling to measure AC, DC, and pulse signals under electrical isolation conditions. The supercapacitor, solar photovoltaic panel, control unit, and the main circuit for supercapacitor charging and discharging have
been assembled in the experiment. Connecting the charging and discharging circuit with the photovoltaic panel and LED, the system provides power to the LED during the night. Under varying light intensity and temperature conditions, the photovoltaic output voltage waveform, PWM waveform, and
Boost circuit output voltage waveform remain stable when reaching the MPPT point. The output power with added MPPT control at different times is compared. The results indicate that the designed system has effectively achieved the functionality of MPPT for solar energy.
Violent Crime and the Long Shadow of Immigration Enforcement
Authors: Ambrosius Christian
Published: May 2024

This research highlights a neglected paradox of migration policies: whereas narratives on migrants as a security threat in their countries of destination find little support in empirical studies, forcing migrants to return may increase violence and crime back home. Using migrants’ exposure to deportation threats at destination as an exogenous source of identification, this paper traces the long shadow of immigration enforcement on violent crime in Mexico, recipient of more than 3.5 million deportees from the US over the period 2000–2015. Enforced return is associated with more homicides and a stronger presence of cartels in migrants’ municipalities of origin, as well as a higher sense of insecurity among the population and a higher probability of being assaulted. Identifying these local effects of enforced return are a first step towards unpacking the various direct and indirect channels through which immigration enforcement generates unintended negative outcomes in migrants’ communities of origin.