bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P162: Cardiovascular Disease And Periodontal Disease In Type 1 Diabetes
Authors: Remmers Lauryn M , Snell-bergeon Janet
Published: April 2022

Type 1 diabetes (T1D) is a condition in which the body’s immune system destroys insulin-producing beta cells, resulting in hyperglycemia. Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in those with T1D. Periodontal disease (PD) is the 6th major complication of T1D. Oral bacteria have been detected in atherosclerotic plaques. Thus, oral bacteria may play a causal role in cardiovascular disease. The aims of this study are to determine how subclinical measures of cardiovascular disease differ by diabetes status and how they are related to the extent of periodontal disease. It is hypothesized that people with T1D will have stiffer vessels with higher pulse wave velocity (PWV), lower brachial artery distensibility (BrachD), and higher carotid intima-media thickness (cIMT) compared to non-diabetic controls. It is also hypothesized that people with T1D will have a higher prevalence of PD compared to non-diabetic controls. Study visits were performed to assess cardiovascular and periodontal outcomes in people with T1D (n=144) and non-diabetic controls (n=147). Univariate analysis was performed using t-test and chi-square to test for significant differences in vascular measures and periodontal status between T1D and controls. Age and sex-adjusted multivariate linear and logistic regression was used to further examine differences in vascular measures and periodontal disease by diabetes status. PWV was significantly higher in people with T1D compared to controls (8.390 +/- 0.111 vs. 7.822 +/- 0.108, p=0.0003). BrachD was significantly lower in people with T1D compared to controls (5.795 +/- 0.095 vs. 6.413 +/- 0.094, p<0.0001). cIMT was significantly higher in people with T1D compared to controls (0.679 +/- 0.009 vs. 0.626 +/- 0.009, p<0.0001). Adults with T1D were significantly more likely to have moderate to severe PD compared to controls (OR = 2.759, 95% CI [1.310-5.811], p=0.0076). Adults with T1D have worse cardiovascular health as measured by stiffer central vessels, more subclinical atherosclerosis, and lower peripheral vessel distensibility. Adults with T1D had almost 3-fold higher risk of moderate to severe PD compared to non-diabetic adults. The relationship between PD and the increased CVD risk in people with T1D warrants further examination.
Abstract P164: Most Non-invasive Diabetes Risk Scores Identify Type 2 Diabetes Due To Insulin Resistance But Not β-cell Failure: The Africans In America Study
Authors: Wentzel Annemarie , Patterson Arielle C , Duhuze Karera M. Grace , Waldman Zoe , Schenk Blayne R , DuBose Christopher W , Sumner Anne E , Horlyck-Romanovsky Margrethe
Published: April 2022

Background:
Five of the most important Type 2 Diabetes (T2D) prediction scores are: Cambridge, Finnish Diabetes Risk Score (FINDRISC), Rotterdam, Kuwaiti and Omani. These scores are based on the premise that Insulin Resistance (IR) is the primary cause of T2D. Yet, data in Africans suggest β-cell-failure without obesity is the most common cause of T2D. It is unknown whether these scores can identify undiagnosed T2D when the cause is β-cell-failure.

Aims:
Our aim was to compare in 514 African-born Blacks (age 38±10 (mean±SD); 68% male; BMI 28±5 kg/m
2
) the ability of Cambridge, FINDRISC, Rotterdam, Kuwait and Omani scores to identify previously undiagnosed T2D due to either IR or β-cell-failure.

Methods:
Diabetes was diagnosed by OGTT. Insulin resistance was defined by the lowest quartile of the Matsuda index (≤2.97). Beta-cell failure was defined as T2D diagnosis in the absence of IR. Body mass index (BMI), waist circumference (WC) and visceral adipose tissue (VAT) was measured. Area under the Receiver Operator Characteristic curve (AROC) estimated sensitivity, specificity, and criteria for AROC were: 0.70-0.79=acceptable; 0.80-0.89=excellent; >0.90=outstanding. Logistic regression determined odds of T2D at the optimal cut-point for each score.

Results:
The prevalence of T2D was 7% (38/514). Of the T2D cases, IR occurred in 61% (23/38) and β-cell failure in 39% (15/38). Age did not differ by group, but the IR group had higher BMI (31±5 vs 27±4 kg/m
2
P
<0.001) and WC (101±10 vs 91±10 cm
P
<0.001). This is supported by the higher VAT in the IR group (161±73 vs 106±62 cm
2
P
<0.001), an important physiological correlate of insulin resistance. All scores showed acceptable to outstanding predictability for T2D due to IR, ranging from Cambridge at AROC=0.75, to the FINDRISC with AROC=0.92. Only weak to moderate predictability for all scores were shown in β-cell-failure (Cambridge at AROC=0.48 to FINDRISC with AROC=0.63). All models predicted significant odds of T2D due to IR, with FINDRISC≥10 OR=6.8 (95%CI, 2.6, 17.8)
P<0
.001; Rotterdam≥7 OR=8.5 (95%CI, 3.1, 23.2)
P<0
.001; Cambridge≥23 OR=11.4 (95%CI, 2.6, 50.0)
P
=0.001) proving most effective. Only the Cambridge score significantly predicted odds of T2D in β-cell-failure (OR=5.7 (95%CI 1.58, 20.54)
P
=0.001).

Conclusions:
All 5 diabetes risk scores effectively predicted undiagnosed T2D in Africans when the etiology was IR, but only the Cambridge score predicted T2D when the cause was β-cell failure. The Cambridge risk score rates overweight status, not just obesity status, which might explain why it was successful in predicting T2D in β-cell failure and the others were not. Existing scores which predict T2D might be modified, to effectively assess T2D risk when β-cell failure is the primary cause.
Abstract P166: The Joint Secular Trends Of Sleep Quality And Diabetes Among The US Adults
Authors: Wang Xuan , Ma Hao , Gupta Shaveta , Heianza Yoriko , Fonseca Vivian A , Qi Lu
Published: April 2022

Introduction:
Despite the extensive efforts in controlling diabetes-related modifiable risk factors, two recent studies showed that the estimated prevalence of diabetes in the U.S. has still increased in the past two decades. The sleep quality has been related to the risk of diabetes.

Hypothesis:
We examined the secular trends of the overall sleep quality, and the joint trends in the prevalence of diabetes by the overall sleep quality among US adults from 2005 to 2018.

Methods:
A total of 17,046 participants aged 20 years or older, from seven cycles of National Health and Nutrition Examination Survey (NHANES) data between 2005 to 2018, were eligible for the study. A healthy sleep score was calculated based on sleep 7-8 hours, no trouble sleeping, no snoring, no nocturia and no excessive daytime sleepiness to represent an overall sleep quality. The trends in estimated prevalence of diabetes were examined in different sleep quality groups.

Results:
From 2005 to 2018, the overall sleep quality significantly declined among US adults (
P
for trend<0.001). Both the estimated age-standardized prevalence of diabetes and changing trend in prevalence of diabetes varied by the overall sleep quality groups. The highest prevalence of diabetes was consistently observed in the low sleep quality group in each cycle, in which a significantly increasing trend was also noted across cycles (
P
for trend=0.004). In contrast, the lowest prevalence of diabetes was consistently observed in the high sleep quality group in each cycle, in which no increasing trend over time was observed (
P
for trend=0.346). Such differential secular trends by sleep quality were more significant among Non-Hispanic Whites than other racial/ethnic minorities.

Conclusions:
The overall sleep quality decreased significantly between 2005-2018 in U.S. adults. The estimated prevalence of diabetes only increased in participants with low or medium overall sleep quality but remained stable in participants with high sleep quality.
Abstract P181: The Genetic Epidemiology Of Longitudinal Blood Pressure Traits From Adolescence To Early Adulthood In Latinos
Authors: Okello Samson , Kim Daaeun , Memili Aylin , Yaser Mohammad , Highland Heather , Graff Mariaelisa , Franceschini Nora , North Kari E
Published: April 2022

Introduction:
Blood pressure (BP) is known to rise during developmental stages from childhood to adulthood, and that those with higher BP trajectories are more likely to develop hypertension and CVD. Yet, there is a paucity of studies that have evaluated trajectories of BP change or the genetic factors involved in the BP changes from childhood to adulthood. Epidemiological and genetic epidemiological studies of longitudinal BP changes through the life-course may enable a better understanding of the pathogenesis of hypertension and may lead to the identification of loci associated with BP trajectories and CVD risk during this critical period.

Methods:
We leverage multiple self-identified Hispanic/Latino populations with longitudinal BP and genomic data across the lifecourse, in particular between adolescence and young adulthood. We present herein preliminary results from the Santiago longitudinal study (SLS) that enrolled infants of Hispanic ancestry and measured BP at late adolescence (average age of 16 years) and early adulthood (average age of 22 years) to identify genetic variants associated with trajectories of BP traits (systolic BP, diastolic BP, mean arterial pressure and pulse pressure). We conducted a complete case analysis excluding participants taking antihypertensive medications and those whose BP measures were statistical outliers. Linear mixed models were used to assess the trajectories of individual BP traits between late adolescence and early adulthood (n = 1236), adjusting for age, sex and BMI. We assessed the relationship between residuals and genetic variants adjusting for two ancestral principal components using SUGEN software.

Results:
Males constituted 51% of the total SLS cohort. Interestingly, with each year increase in age, we observed downward trajectories of both mean systolic BP (-0.3 mmHg, 95% CI (-0.4, -0.2)) and mean diastolic BP (-0.1 mmHg, 95% CI (-0.2, -0.04)) adjusted for BMI and sex. We identified evidence for five known BP loci and two suggestive new signals. Our most significant finding is rs10894989 [beta (SE) = 6.57 (1.26),
p
=1.86x10
-7
, minor allele frequency (EAF = 0.94)] near the
ARHGAP42
gene, an established locus for hypertension. However, this variant is not in linkage disequilibrium with the commonly reported SNP rs604723 (r
2
= 0.04). Ancestry-specific allele frequencies differed with rs604723 more common in East Asians and Europeans and rs10894989 commonest in Africans.

Conclusion:
Our longitudinal analyses of BP from late adolescence to early adulthood replicated BP loci and identified novel suggestive loci associated with BP trajectories supporting a need for further GWAS of longitudinal BP. We are currently conducting a meta-analysis of longitudinal BP trajectories in 3,000 young adults self-identified as Hispanic Latino in the Population Architecture using Genomics and Epidemiology (PAGE) study.
Abstract P182: Large Scale Analyses Of Gene-by-smoking Interaction On Cardiovascular Disease
Authors: Richard Erin , Cao Steven , Salem Rany
Published: April 2022

Introduction:
Cardiovascular disease risk is determined by both genetic susceptibility and lifestyle factors such as smoking. However, gene-by-smoking interactions have been understudied in this context. The objective of this study was to leverage large-scale individual level data to carry out a genome-wide gene-by-smoking interaction analysis on cardiovascular outcomes including coronary heart disease (CHD), stroke and peripheral artery disease (PAD).

Methods:
Our study sample included 401,384 unrelated, European-ancestry participants of the UK Biobank study. CHD, stroke, and PAD outcomes were based on data from baseline questionnaires and linked data from inpatient admissions and death registries. Smoking status (ever vs never) was based on self-report at baseline. Gene-environment interaction analyses were carried out using GEM (https://github.com/large-scale-gxe-methods/GEM), a new, computationally efficient software tool developed for biobank scale data. Using generalized linear models, we carried out a test of the genetic main effect adjusted for smoking status, a formal test for gene-by-smoking interaction, and a joint test of the main genetic and interaction effects. Single nucleotide polymorphisms with a minor allele frequency less than 1% were excluded from analyses.

Results:
The formal interaction test revealed a novel genome-wide significant (GWS) gene-by-smoking signal for PAD within the
IREB2
gene (p=2.0x10
-8
), which has been previously associated with smoking intensity and lung disease. The joint test has been shown to increase power for genetic discovery, which we observed here. The joint test for PAD identified 10 additional loci reaching genome-wide significance (p<5x10
-8
) that were not revealed in the main effect analyses. Several of these loci are in genes linked with measures of body composition in earlier studies (
PNLIP, CDH4, STAT5A,
PRKCE
). We did not detect any GWS gene-by-smoking interactions for CHD or stroke. However, for CHD, two novel loci within the
ARSG
and
SARS1
genes were identified using the joint test but had no GWS main effects. Both genes have been associated with LDL-cholesterol levels in prior genome-wide studies. Although our analyses did not yield any signals that exceeded the GWS threshold for stroke, we did identify 25 and 47 independent loci that reached genome-wide suggestive significance (p<1x10
-5
) for the formal interaction and joint tests, respectively. We are augmenting the current analyses to include additional data from approximately 120,000 trans-ethnic ancestry individuals.

Conclusion:
The analysis of gene-by-smoking interactions can provide novel insights into the genetic architecture and pathophysiology of cardiovascular disease.
Abstract P185: Adverse Cardiovascular Events In Patients With Psoriasis And Psoriatic Arthritis
Authors: Ottensoser Molly , Berger Jeffrey , Garshick Michael S
Published: April 2022

Background:
Patients with psoriasis who have severe enough disease to require biologic therapy have increased risk of cardiovascular (CV) disease and CV comorbidities. Complications of immune modulating therapy can include weight and lipid alterations, potentiation of heart failure, and athero or venoembolic events, which may also be race or gender dependent. Clinical trials of biologic therapy represent an opportunity to capture and study CV related events and important safety signals. The aim of this investigation was to evaluate the public reporting of CV related adverse events in the psoriatic patient population.

Methods:
The prevalence of reporting of demographics, and adverse CV related events was obtained from clinicaltrials.gov from registered clinical trials leading to FDA approval of biologic medications.

Results:
In total, 39 clinical trials of biologic therapy ranging from 2011 through 2020 were included encompassing 27,693 participants. Median age was 46 (IQR; 45 - 48) years and 68% (IQR; 48 - 69) male. Nineteen (49%) of the trials reported race, of which whites constituted 89% (range 67 - 98) of the enrolled population. Randomization of Blacks (median 2.3%, range 0 - 3.9) and Hispanics (median 10.3%, range 0.3 - 17) was low. Thirty-two of 39 (82%) of trials reported acute coronary syndrome as a serious adverse event. Other adverse cardiovascular endpoints were less frequently reported (Figure 1).

Conclusion:
There is significant underreporting of minority populations in clinical trials of biologics in patients with psoriasis. When reported, there is low representation of minority groups. Furthermore, adverse event reporting of CV disease is poor and inconsistent. These data represent a missed opportunity to study important safety signals in this high CV risk patient population across a diverse generalizable population.
Abstract P190: Health Literacy And Cardiovascular Health: The Multi-Ethnic Study Of Atherosclerosis
Authors: Adam Hamdi S , Merkin Sharon S , Anderson Madison , Seeman Teresa , Kershaw Kiarri N , Magnani Jared W , Everson-rose Susan A , Lutsey Pamela L
Published: April 2022

Background:
Limited health literacy (HL) is associated with individual cardiovascular risk factors and poor risk factor control. The association of HL to composite indices of cardiovascular health (CVH) has not been documented.

Hypothesis:
Limited HL is associated with suboptimal achievement of ideal CVH as identified by Life’s Simple 7 (LS7).

Methods:
Included in this analysis are 3766 participants of the Multi-Ethnic Study of Atherosclerosis who completed four HL questionnaire items via follow-up phone calls (2016-2018). Item scores were summed and dichotomized into adequate (≤10) or limited HL (>10). Clinical measures of BMI, total cholesterol, blood pressure, and fasting blood glucose, along with self-reported smoking status, physical activity, and healthy diet were measured at baseline (2000-2002) and categorized by LS7 achievement criteria (poor, inadequate, ideal). LS7 metrics were incorporated into overall CVH (low, medium, high). Poisson regression with robust variance estimation was used to compute prevalence risk ratios and 95% confidence intervals (PRR[95% CI]) of high/medium CVH as well as intermediate/ideal LS7 comparing limited HL to adequate HL.

Results:
Participants were on average(SD) 59.4(9.13) years old at baseline, 46.0% male, and 58.0% non-white. Prevalence of limited HL was 15.0%. Compared to adequate HL, participants with limited HL were less likely to have medium CVH (0.90[0.84-0.97]) and high CVH achievement (0.53[0.39-0.73]) after adjusting for age, sex, race/ethnicity and field center (
Table
). These associations attenuated with further adjustment for education and income, to 0.94[0.88-1.02] for medium and 0.68[0.50-0.94] for high CVH. Of individual LS7 metrics, limited HL was significantly associated with high glucose levels.

Conclusion:
Limited HL was associated with suboptimal overall CVH as well as elevated blood glucose levels independent of education. Clinical trials are needed to assess whether improving health literacy enhances CVH.
Abstract P191: Sex-related Differences In Mortality After 15-years Follow Up Post Coronary Artery Bypass Graft Surgery:a Systematic Review And Meta-analysis
Authors: ALSADAOEE Maryam , Aslam Faisal , Ijaz Hina , Dhar kalyani , AlSadawi Mohammed
Published: April 2022

Background:
Previous data suggest that short and intermediate term outcomes post coronary artery bypass graft (CABG) surgery differ between women and men, but long-term outcomes (>15-years) has been poorly investigated. This meta-analysis sought to elaborate sex-specific differences in mortality post CABG after 15 years of follow up.

Methods:
Systematic search was executed in December, 2020 for studies reporting sex-specific mortality post CABG after 15 years of follow up. The search was not restricted to time, publication status or language.

Results:
A total of 6 studies and 81,691 patients (15,501 women and 66,189 men) were included. Pooled analysis demonstrated that after 15 years of follow up post CABG, women did not have a statistically significant 15-years mortality compared to men [odds ratio (OR) 0.96, 95% confidence interval (CI) 1.60-1.68, p=0.09].

Conclusions:
In out finding, women did not have a statistically significant 15-years mortality post CABG compared to men.
Abstract P197: Heart Failure In A Universally Insured Working Age Population: The Military Community Experience
Authors: Roger Veronique L , Banaag Amanda , Korona-Bailey Jessica , Turner Clesson , Haigney Mark C , Perez Koehlmoos Tracey
Published: April 2022

Background:
Heart disease is the leading cause of death in the United States (US) and deaths due to heart failure (HF) are increasing, while disparities are widening. The military community is pertinent to the study of the epidemiology of HF for several reasons: the 9.6 million individuals receiving care through the Military Health System (MHS) are representative of the working age US population and the MHS is the closest model to universal healthcare in the US. Hence, this environment is conducive to evaluate health disparities as access to care is uncoupled from race, sex, and ethnicity. Further, persons who serve have numerous risk factors (hypertension, smoking, PTSD, anxiety), HF is a leading cause of death among veterans and for those on active duty presents challenges to military readiness.

Methods:
We conducted a cross-sectional study of MHS beneficiaries aged 18 to 64 years to measure the prevalence of HF in 2018-19 overall and by sex, race, and other sociodemographic characteristics. HF was defined by International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes.

Results:
Among 6,375,086 MHS beneficiaries aged 18 to 64 years, 142,201 (2.23%) were diagnosed with HF. Beneficiaries with HF were mainly men (60%), age 50 to 59 (41%), retired from military service (52%), with a Senior Enlisted rank (proxy for lower socio-economic status based on salary) (79%) and serving in the US Army (39%). In logistic regression, male sex, older age, Black race, and lower rank were associated with higher relative odds of HF. After multivariable adjustment, Black race and lower rank were independently associated with large increases in prevalent HF (Table).

Conclusion:
Among MHS beneficiaries of working age, the prevalence of HF is high and substantial disparities exist. The large excess odds of HF among Black beneficiaries and among lower rank individuals underscores the urgent need to understand and address the determinants of these disparities.
Abstract P205: Long-term Changes In Proteomic Levels And The Risk Of Incident Atrial Fibrillation In Older Adults: The Atherosclerosis Risk In Communities (ARIC) Study
Authors: Misialek Jeffrey R , Norby Faye L , Alonso Alvaro , Chen Lin Y , Ballantyne Christie M , Boerwinkle Eric , Coresh Josef , Pankow Jim S , Lutsey Pamela L
Published: April 2022

Background:
Previous studies examining proteomic markers and atrial fibrillation (AF) have used protein measurements at one time point; however, few have studied these protein changes over time. Using data from the Atherosclerosis Risk in Communities (ARIC) study, we examined the association of long-term protein changes with AF in white and Black participants.

Methods:
Of 4877 plasma proteins measured at visits 3 (1993-1995) and 5 (2011-2013) using an aptamer-based proteomic profiling platform, we examined 17 proteins previously associated with AF. Protein changes between visits 3 and 5 were log base 2 transformed, corresponding to the log base 2 of the ratio [log
2
(protein5/protein3)]. AF was ascertained from hospital discharge codes, ECGs, and death certificates. We used Cox proportional hazards to assess the association of protein changes and AF.

Results:
This study included 3552 participants (mean age 75±5 years; 58% female; 17% Black) who had proteomic measures and were free of AF at visit 5. Over a mean follow-up of 6.4±2 years, 486 participants developed AF. After adjustment for clinical factors of AF, medication use, estimated glomerular filtration rate, and protein level at visit 5 (Model 2), changes in natriuretic peptides B and spondin-1 were associated with the risk of AF (HR: 1.57; 95%CI: 1.25-1.98; p-value=0.0001; and HR: 1.82; 95%CI: 1.23-2.70; p-value=0.0027, respectively) after Bonferroni correction. Although changes in NT-proBNP were not associated with AF risk, adjustment for visit 5 NT-proBNP attenuated associations for natriuretic peptides B and spondin-1 to non-significance.

Conclusion:
Examining protein changes over time may provide additional information about mechanistic pathways of AF development.
Abstract P208: The Impact Of Circadian Misalignment On Energy Metabolism And Substrate Oxidation In Adults With Adequate Sleep
Authors: Carabuena Thomas J , Boege Hedda L , Bhatti Mehreen Z , Cheng Bin , St-Onge Marie-Pierre
Published: April 2022

Background:
Circadian misalignment (CM), the mismatch between timing of behaviors and internal body clock, increases cardiometabolic risk, but the mechanisms are not fully understood. Population studies in night shift workers and intervention studies attempting to replicate CM have often been confounded by differences in energy intake, sleep duration and timing, and eating window duration. We aimed to investigate the effects of CM, induced by delaying mealtimes relative to wake time, independent of sleep timing and duration as well as duration of eating window, on energy expenditure (EE) and substrate oxidation. We hypothesized that CM would reduce EE and increase respiratory quotient (RQ) relative to meals closer to wake time (circadian alignment [CA]).

Methods:
We used a 2-phase, randomized, crossover study. Men and women (age 20-49 y) were studied under controlled feeding conditions (CA and CM). Each phase included a 10-h eating window at 0900-1900 h (CA) or 1300-2300 h (CM) with fixed mealtimes. Bedtimes were set at 2400-0800 h. Minute-by-minute EE, RQ, and substrate oxidation were obtained over 23 h in a metabolic chamber on d 3-4 and 14-15. Post-meal EE, RQ, and substrate oxidation were calculated as the average of 2-h, 1-h, and 30 min data collections following breakfast, dinner, and snack, respectively. Data were analyzed using a linear mixed effects model including condition, day, and day-by-condition interaction as main predictor variables, and phase as an adjusting covariate. As an exploratory aim, sex-by-condition interaction was also included in the model.

Results:
Three men and 4 women completed both study phases (age 37.6±8.8 y, BMI 30.8±3.2 kg/m
2
). EE did not differ between CM and CA. Post-meal RQ for breakfast (p=0.06), dinner (p<0.001), and snack (p<0.001) were higher in CM vs CA. Glucose oxidation after dinner (p<0.001) and snack (p<0.01) were higher in CM vs CA. There were sex-by-condition interactions on EE and glucose oxidation after breakfast (both p=0.06) and dinner (p<0.05), and on EE after snack (p<0.01). In general, CA resulted in greater rise in EE and lesser reduction in glucose oxidation following meals in men compared to women.

Conclusion:
Delaying mealtimes by 4 h, independent of sleep duration, timing, or diet composition, shifts nutrient metabolism towards greater carbohydrate and lower fat oxidation. Sex may influence the effect of CM on energy metabolism and should be considered in investigations of cardiometabolic risk associated with shift work and late-night eating.
Abstract P214: Plant-based Diets And Risk Of Hospitalization With Respiratory Infection: Results From The Atherosclerosis Risk In Communities (ARIC) Study
Authors: Kendrick Karla , Kim Hyunju , Casey Rebholz , Selvin Elizabeth , Steffen Lyn , Juraschek Stephen P
Published: April 2022

Introduction:
The benefits of plant-based diets may depend on the type of plant; unhealthy plant foods, such as sugar and refined grains, have detrimental health consequences. Micronutrients in plants decrease inflammation and are essential for proper immune function. Deficiencies in these nutrients can contribute to a pro-inflammatory state and may increase risk of infection.

Methods:
We conducted a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) Study. Participants completed food frequency questionnaires in 1993-1996 (visit 3). We used reported intakes to calculate a plant-based diet index (PDI), healthy plant-based diet index (hPDI), and an unhealthy plant-based diet (uPDI). Active surveillance is conducted for all hospitalizations. We used Cox models to examine the associations of three plant-based diet indices (in quintiles) with risk of pneumonia and influenza, and other infection-related hospitalizations identified by ICD codes.

Results:
In our sample of 11,956 adults there were 2522 hospitalizations with respiratory infections and 4308 hospitalizations with any infection during a median follow-up of ~22 years. The incidence of hospitalization with respiratory infections and any infection was lower among those adults consuming more plant-based foods
(Table)
. Higher hPDI was associated with a lower risk of hospitalization with any infection or respiratory infection. Higher PDI was associated with a lower risk of hospitalization with any infection. Significant associations were not observed with the uPDI.

Conclusions:
Adults who adhere to diets high in any plant foods, as well as healthy plant foods, have a lower risk of hospitalization with infections. Adherence to diets high in healthy plant foods specifically is associated with lower risk of hospitalizations with respiratory infections.
Abstract P215: A Qualitative Exploration Of Barriers And Facilitators To A Cardiac Rehabilitation-based Weight Loss Program For Patients With Atrial Fibrillation And Obesity.
Authors: Williamson Tamara M , Wilton Stephen , Arena Ross , Aggarwal Sandeep , Campbell Tavis , Rouleau Codie
Published: April 2022

Background:
Cardiac rehabilitation (CR) programs are ideal treatment settings for atrial fibrillation (AF) risk factor management, yet few CR curricula include a behavioral weight loss treatment (BWLT) component for patients with comorbid obesity (BMI ≥ 30 kg/m
2
).

Aim:
To identify perceived barriers, facilitators, and preferences regarding CR with added BWLT among patients with AF and obesity using a qualitative descriptive approach.

Methods:
Patients (18+) with paroxysmal or persistent AF and obesity were recruited from a Canadian AF clinic. Patients completed questionnaires assessing socio-demographic variables and participated in semi-structured interviews to elicit their potential barriers, facilitators, and preferences regarding a proposed 12-week CR+BWLT program (i.e., twice-weekly supervised exercise, risk factor management, and weekly group-based cognitive-behavioral weight management support). Interviews were recorded and transcribed. Conventional content analysis was used to derive themes from qualitative data.

Results:
Twenty patients (9 women; 63±12 years; BMI=35.50±6.00 kg/m
2
) participated. Data were categorized to describe patients' barriers, facilitators, and preferences/perspectives (Figure 1). Four overarching themes emerged from the categories: 1) frustration with weight management; 2) AF symptoms are manageable; 3) AF information needs; and 4) desire for program flexibility.

Conclusion & Future Directions:
The proposal to offer BWLT alongside CR was acceptable to patients with AF and obesity, with most reporting few barriers to participating. The results will inform AF-specific adaptations to an established BWLT (e.g., modules on AF pathophysiology and exercise recommendations). The AF-adapted BWLT will be piloted in the target population prior to testing the full intervention package in a randomized controlled trial. The novel combination of CR+BWLT, tailored to an AF population, has potential to improve AF management and outcomes for patients with comorbid obesity.
Abstract P218: Analysis Of YouTube Videos As A Patient-Education Tool For Cardiac Stress Testing
Authors: Janumpally Sanjana , Kamma Sai , Nus Bradley , Wu Kylie , Sledge Trey , Torres Grant , Sammour Yasser
Published: April 2022

Background:
YouTube is the most popular video sharing platform, and it is a common source of information for people interested in learning about medical topics. YouTube videos discussing cardiac stress testing have amassed millions of views, but their educational quality has not been thoroughly assessed. We sought to investigate the quality of cardiac stress testing videos on YouTube.

Methods:
We searched YouTube.com for keywords including “Cardiac Stress Test” and “Exercise Stress Test”. We evaluated 113 videos with at least 15,000 views and excluded 51 videos. The exclusion criteria comprised videos that were unrelated, under 1 minute, not in English, or repeats of a video. The remaining videos were rated by two independent reviewers using the Global Quality Scale (GQS; 4-5 = high quality, 1-3 = low quality), to evaluate usefulness. The view count, modality, upload source and date were used for additional sub-analyses to determine possible associations with the educational quality of videos. Modalities that were analyzed included patient-friendly delivery methods such as patients speaking about their experiences or interviews with patients on their experiences, live patient tests where the patient undergoes cardiac stress testing to educate viewers, or physician-led presentations.

Results:
The average GQS score was 5 in 4 out of 62 videos (4/62; 6.5%), 4 in 14 videos (14/62; 22.5%), and 0-3 in 44 videos (44/62; 71%) with a mean overall GQS score of 3.04 demonstrating moderate-suboptimal educational quality of videos. Days since upload and view ratio were not associated with educational quality of the videos. Physician-uploaded videos (37/62; 60%) had significantly higher GQS scores compared with non-physicians (3.43 vs. 2.46; p<0.01). When grouped by modality, live patient tests (23/62; 37%) had the highest GQS score of 3.33 while physician-led presentations (28/62; 45%) produced GQS score of 3.13. Patient-friendly delivery methods (interviews and patient stories) (11/62; 18%) had the lowest average GQS score of 2.23.

Conclusion:
There is an abundance of content about cardiac stress testing on YouTube videos that often deliver low quality information. Healthcare providers need to be cognizant about possible misinformation their patients may encounter. YouTube can be a useful resource for physicians and patients in the future as shared decision-making aids if higher quality videos are uploaded directly by physicians.
Abstract P227: Adverse Childhood Environment And Cardiovascular Health Score Across The Lifecourse: The Coronary Artery Risk Development In Young Adults (CARDIA) Study
Authors: Ortiz Robin , Kershaw Kiarri , Zhao Songzhu , Kline David , Brock Guy , Jaffee Sara , Golden Sherita H , Carroll Judith , Seeman Teresa , Joseph Joshua J
Published: April 2022

Background:
Childhood adversity has been associated with poor health outcomes including cardiovascular disease (CVD) and mortality across the lifecourse. In contrast, ideal cardiovascular health (CVH) inclusive of seven lifestyle-related target metrics, has demonstrated protection from morbidity and mortality. While the relationship between adversity and CVD is hypothesized to be in part due to poor lifestyle, few studies have directly tested this.

Purpose:
To examine potential associations between childhood risky family environment (RFE) and CVH.

Methods:
The analyses included 1,987 CARDIA participants without CVD at baseline with complete data. The RFE questionnaire assessed adversities including caregiver abuse, affection, low support, substance use, household disorganization, and limited family engagement (score 0-28). CVH score was calculated as low (0-7), moderate (8-9), and high (10-14) based on AHA poor, intermediate, and ideal categories of smoking status, cholesterol, blood pressure, fasting glucose, body mass index, physical activity, and diet. We applied logistic regression for cross-sectional analyses at each year (0, 7, and 20) and logistic regression with random intercepts for longitudinal analyses across time (all years), adjusting for age, sex, income, and alcohol use.

Results:
The study sample was age 25.3 SD(3.5) years and 56% female at baseline. Average RFE score was 10 (IQR [8, 14], min 7, max 27). For every unit higher RFE score, the odds of high CVH decreased by 3% (OR=0.97, p=0.036) at year 0, 2% (OR=0.98, p=0.027) at year 7, and longitudinally over 20 years by 3% (OR=0.97, p=0.004).

Conclusion:
Adverse childhood environment is associated with sustained poor CVH across the lifecourse, suggesting that population health interventions mitigating RFE may improve lifecourse outcomes. Future work should explore if the identification of such environmental exposures may improve modifiable CVD risk factors in adulthood, even when childhood experiences may be long passed.
Association of Bleeding Severity With Mortality in Extended Thromboprophylaxis of Medically Ill Patients in the MAGELLAN and MARINER Trials
Authors: Spyropoulos Alex C. , Raskob Gary E. , Cohen Alexander T. , Ageno Walter , Weitz Jeffrey I. , Spiro Theodore E. , Lu Wentao , Lipardi Concetta , Albers Gregory W. , Elliott C. Gregory , Halperin Jonathan L. , Hiatt William R. , Maynard Gregory , Steg P. Gabriel , Sugarmann Chiara , Barnathan Elliot S.
Published: April 2022

Background:

Extended thromboprophylaxis has not been widely implemented in acutely ill medical patients because of bleeding concerns. The MAGELLAN (Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Medically Ill Patients Comparing Rivaroxaban With Enoxaparin) and MARINER (Medically Ill Patient Assessment of Rivaroxaban Versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk) trials evaluated whether rivaroxaban compared with enoxaparin or placebo could prevent venous thromboembolism without increased bleeding. We hypothesized that patients with major bleeding but not those with nonmajor clinically relevant bleeding would be at an increased risk of all-cause mortality (ACM).

Methods:

We evaluated all bleeding events in patients taking at least 1 dose of study drug and their association with ACM in 4 mutually exclusive groups: (1) no bleeding, or first event was (2) nonmajor clinically relevant bleeding, (3) major bleeding, or (4) trivial bleeding. Using a Cox proportional hazards model adjusted for differences in baseline characteristics associated with ACM, we assessed the risk of ACM after such events.

Results:

Compared with patients with no bleeding, the risk of ACM for patients with nonmajor clinically relevant bleeding was not increased in MARINER (hazard ratio, 0.43;
P
=0.235) but was increased in MAGELLAN (hazard ratio, 1.74;
P
=0.021). Major bleeding was associated with a higher incidence of ACM in both studies, whereas trivial bleeding was not associated with ACM in either study.

Conclusions:

Patients with major bleeding had an increased risk of ACM, whereas nonmajor clinically relevant bleeding was not consistently associated with an increased risk of death. These results inform the risk-benefit calculus of extended thromboprophylaxis in medically ill patients.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: MAGELLAN, NCT00571649. URL:
https://www.clinicaltrials.gov
; Unique identifier: MARINER, NCT02111564.
Disentangling the Pelodiscus axenaria complex, with the description of a new Chinese species and neotype designation for P. axenaria (Zhou, Zhang & Fang, 1991)
Authors: GONG SHIPING , FRITZ UWE , VAMBERGER MELITA , GAO YANGCHUN , FARKAS BALÁZS
Published: April 2022

We describe a new species from the Pelodiscus axenaria complex from Hunan and Jiangxi Provinces, China. Also, the application of the name P. axenaria (Zhou, Zhang & Fang, 1991) is clarified by designating a neotype for this species. Besides its genetic divergence, the new species differs from all other Pelodiscus species, including the two other taxa constituting the complex (P. axenaria, P. huangshanensis), in the following combination of morphological traits: (1) small adult size, <15 cm carapace length; (2) carapace distinctly keeled, more or less strongly tuberculated, usually olive clay-coloured and adorned with greenish black marbling; (3) plastron yellowish white, typically immaculate except for a blurred-edged blotch behind each axilla that does not extend to the entoplastron and some slight black suffusion along its anterior border; (4) underside of the leathery margin of the carapace with varying amounts of dark pigmentation; (5) head olive clay-coloured with numerous black splotches; (6) chin grey brown with pale stipples, throat dark grey, finely spotted with black; (7) neck with a wide yellow lateral band stretching from the tympanum posteriorly, which tends to fade with age; (8) entoplastron boomerang-shaped, the amount of bending of the transverse bar between the two posteriolaterally directed rami >90°.
What enables us to better experience our work as meaningful? The importance of awareness and the social context
Authors: Lysova Evgenia I , Fletcher Luke , El Baroudi Sabrine
Published: April 2022

Why does becoming more aware of yourself and your wider work environment enable you to experience greater meaningful work? Drawing upon mindfulness-to-meaning and interpersonal sensemaking theories, we argue that in a state of awareness individuals are cognitively flexible and are able to interpret relevant interpersonal cues in ways that enable them to experience their work as meaningful. Study 1 is a quantitative diary study over a period of six weeks that tests the state-level relationships between awareness, cognitive flexibility, and meaningful work. We find that awareness is, directly and indirectly, related to three of four dimensions of meaningful work via cognitive flexibility. Study 2 qualitatively explores what individuals cognitively attend to in the social context when they reflect upon the most meaningful work events that occurred each week, over four weeks. Findings reveal that ambivalent work events are experienced as meaningful when individuals attend to interpersonal cues in their work context that convey a sense of worth, care, and/or safety. Overall, our article advances knowledge about meaningful work as a state-level experience that is facilitated by awareness, cognitive flexibility, and cues from the social context. It shows the importance of integrating meaningful work, mindfulness, and interpersonal sensemaking literatures.
The Aborted ICT-CITEC Agreement: Causes of the Failure of Anglo-French Information Technology Cooperation in 1965
Authors: Kuo Laureen
Published: April 2022

This article, using French information technology archives, is the first to describe attempted Anglo-French cooperation in information technology in 1965. This episode is often overlooked when discussing information technology cooperation cases in European countries. Moreover, the article further explores the main causes of the breakdown of negotiations. The breakdown was due to France's reversal of its position, mainly stemming from three factors: a refusal to develop large computer projects, the pall cast by the ELDO and Concorde affairs and the pursuit of an autonomous information technology industry.
Fragmented fiber pollution from common textile materials and structures during laundry
Authors: Palacios-Marín Alma V , Jabbar Abdul , Tausif Muhammad
Published: April 2022

The fiber damage during manufacture, use, and service of textiles leads to fragmented fiber generation. All textiles (natural, regenerated, and synthetic polymer sources) release fiber fragments. Several textile structural parameters have been studied in association with fragmented fiber release; however, there is a paucity of work on the effect of different fiber types and yarn structures on fragmented fiber release. This study elucidates the impact of key fiber types and yarn structures (rudimentary elements of textiles) on fragmented fiber release during laundry. Five different bespoke textile samples from three primary yarn structures (flat filament, textured filament, and staple yarn) from the two most employed fibers (polyethylene terephthalate and cotton) were subjected to repeated simulated washing processes to quantify shed fragmented fiber and length distribution of the collected fragmented fiber. The results show that yarn structure impacts the quantity of fragmented fiber shed and the length distribution profile. The release of fragmented fiber decreases during repeated washing of fabrics from staple and textured filament yarns, except for fabrics from flat filament yarns. The mean fragmented fiber length for all samples increases on repeated laundering. The quantity of fragmented fiber shed per gram of textile, and the length distribution profile of fragmented fiber from the woven fabrics made of the five types of yarns after the first and fifth washing cycles were estimated.
Image Clustering: An Unsupervised Approach to Categorize Visual Data in Social Science Research
Authors: Zhang Han , Peng Yilang
Published: April 2022

Automated image analysis has received increasing attention in social scientific research, yet existing scholarship has mostly covered the application of supervised learning to classify images into predefined categories. This study focuses on the task of unsupervised image clustering, which aims to automatically discover categories from unlabelled image data. We first review the steps to perform image clustering and then focus on one key challenge in this task—finding intermediate representations of images. We present several methods of extracting intermediate image representations, including the bag-of-visual-words model, self-supervised learning, and transfer learning (in particular, feature extraction with pretrained models). We compare these methods using various visual datasets, including images related to protests in China from Weibo, images about climate change on Instagram, and profile images of the Russian Internet Research Agency on Twitter. In addition, we propose a systematic way to interpret and validate clustering solutions. Results show that transfer learning significantly outperforms the other methods. The dataset used in the pretrained model critically determines what categories the algorithms can discover.
Dynamic surface control for formation control of quadrotors with input constraints and disturbances
Authors: Dun Ao , Wang Rui , Lei Fei , Yang Yuning
Published: April 2022

In this paper, a novel formation control scheme is presented by integrating the dynamic surface control for multi-quadrotor subject with model uncertainties and external disturbances. First, according to requirements of formation control, the target trajectories of followers are obtained by the designed virtual quadrotors. Then, the formation control problem is transformed into the trajectory tracking control problem. Second, the saturation function and the auxiliary system are developed to make up for nonlinear terms arising from input saturation. A nonlinear extended state observer (ESO) is proposed to estimate and compensate for model uncertainties and external disturbances, and a dynamic surface controller based on the nonlinear ESO is constructed for the desired formation performance. In addition, the amount of communications between the quadrotors is decreased by the constructed distributed speed estimator. And the uniformly ultimately bounded is proved by using the Lyapunov method. Finally, the numerical example is used to demonstrate that the designed controller is effective.
Atypical Fibroxanthoma Resected without Auricular Deformity in an Elderly Patient: A Case Study
Authors: Sim Jae-Yeop , Lee Dong Hui , Jang Bogun , Suh Michelle J.
Published: April 2022

Atypical fibroxanthoma (AFX) is a dermal spindle-cell cutaneous malignancy, which is a relatively benign type of skin cancer that occurs in the elderly with sun-damaged skin. This is a case study of a rapidly enlarged left auricular mass lesion in an elderly patient who was diagnosed with AFX based on histopathological and immunohistochemical findings, and then treated by complete excision to prevent recurrence or metastasis. There was no recurrence during the 1-year follow-up. For otolaryngologists or plastic surgeons, recognizing the clinical and pathologic characteristics of AFX is important for accurate diagnosis and treatment.