bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on Substation Monitoring and Fault Diagnosis Based on Distributed Computing and Artificial Neural Network
Authors: Yang Fujun , Li Xiaohang
Published: March 2023

In the Energy Conversion for Next-Generation Smart Cities, intelligent substation plays an important role in the power conversion. As an important guarantee for the stable operation of intelligent substation, the research on fault diagnosis technology is particularly important. In this paper, the acoustic characteristic diagnosis of substation equipment (take transformers for example) is researched and the application of “Voice Recognition + artificial neural network (ANN)” technology in substation fault diagnosis is analyzed. At the same time, the continuous online monitoring of the intelligent substation equipment will produce a large amount of monitoring data, which needs to be analyzed timely and effectively to understand the operating status of the equipment accurately. Because of this, this paper adopts distributed computing by establishing a real-time distributed computing platform, using open source technology to store the online monitoring of sound data into the computing platform for data processing to achieve the purpose of automatic fault detection and analysis. The results show that distributed computing can realize the intelligent analysis, storage, and visualization of equipment data in the substation, which provides data support for fault diagnosis. Besides, the fitting accuracy rates of ANN model are 95.123% for training process and the fitting accuracy rates of ANN model are 99.353% for training process and the overall fitting accuracy rates of ANN model are 95.478% and the error between the predicted value and the actual value of the 5 sound signals is within 5% in the fault diagnosis process. Consequently, the ANN model can accurately identify each fault sound of substation and achieve the purpose of fault diagnosis.
Developing Entrepreneurial Skillsets Amongst Rural Women in Uganda
Authors: Gavigan Sylvia , Cooney Thomas M. , Ciprikis Klavs
Published: March 2023

Purpose: Rural women in Africa have less entrepreneurship opportunities than men. This is mainly due to societal expectations of women, but it may also be caused by a lack of entrepreneurial knowledge and skills due to their work in agriculture-related activities. Therefore, the purpose of this study is to examine the impact of entrepreneurship training on entrepreneurial skillsets of rural women working in Uganda and how such training influences their entrepreneurial activity. Design/methodology/approach: The primary data set for this study comes from surveys of rural women working in agriculture who participated in a specific entrepreneurship training programme in Uganda. A panel data set is gathered from surveying 298 women before and after the training programme. A random effects regression method is utilised to estimate the impact of entrepreneurship training and other sociodemographic characteristics on entrepreneurial skillsets. Findings: The key finding of this study is that entrepreneurship training increases entrepreneurial skillsets by 25% and that further training and educational opportunities may improve social standing and living standards of rural women working in agriculture. Originality: This study offers distinctive insights into female entrepreneurship in Africa as it quantitatively examines the impact of entrepreneurship training on entrepreneurial skillsets of rural women in Uganda. The findings of this study may inform policymakers of the benefits of appropriate training programmes to improve the living standards, social standing, and economic outcomes for rural women in Africa.
A COMPREHENSIVE REVIEW ON COMBATING THE ELEVATED-TEMPERATURE SURFACE DEGRADATION BY MCrAlX COATINGS
Authors: PRASHAR GAURAV , VASUDEV HITESH
Published: March 2023

Surface degradation (oxidation/corrosion/erosion) at elevated temperature is encountered commonly in engineering industries like gas turbines and thermal power plants. MCrAlX coatings which came into the picture in 1960s were used widely for surface protection in the elevated-temperature section of the gas turbine engines and in boilers to combat oxidation/corrosion/erosion. Among them, MCrAlY ([Formula: see text], Co or [Formula: see text]) were developed to be used as the overlay coatings and bond coat (BC), which offer a combination of multiple features such as oxidation, corrosion and ductility. MCrAlY coatings form a second layer of aluminum oxide beneath the chromium oxide layer at elevated temperatures which minimizes the oxidation/corrosion/erosive wear rates. But the desire to increase combustion efficiencies of power plants and gas turbine engines along with lower CO2 emissions poses a significant challenge for coating design. As the temperature surpasses 900∘C, NiCrAlY coating degrades quickly due to nonregeneration of chromia or alumina. The research and development (R&D) efforts are focusing continuously on improving the existing MCrAlX coatings or developing new sustainable MCrAlX coatings with improved oxidation performance. In this review, the roles of the alloying elements, microstructures, post-deposition treatment techniques and different deposition processes in the elevated-temperature oxidation/corrosion performance of MCrAlX-based alloys have been explored in detail.
The Twin Paradox Put to Rest
Authors: Alencar Geová
Published: March 2023

In this letter, we give a simple and analytical solution to the twin paradox. It relies just on Lorentz transformations and does not involve accelerated frames or any kind of signals exchanged between the twins. We expect that as a result we can put a dead end to this century-old problem.
An Investigation on the Aerodynamics of Flight of a Hand Helicopter
Authors: Lim Jed Li Xin , Ricardo Bernard
Published: March 2023

A simple hand helicopter can be made by attaching rotor blades to one end of a vertical stick. The helicopter moves upwards when the stick is spun above a threshold angular velocity and released — a mechanism of common toys found in toy shops. This study uses computational fluid dynamics to predict the airflow around a hand helicopter from which the lift and drag acting on the hand helicopter’s blades can be obtained. Newton’s Second Law is then applied to find the hand helicopter’s equations of motion. These are solved to predict the helicopter’s trajectory and maximum height. The angle of attack, length of blades and thickness of blades are varied and their effects on the lift coefficient, drag coefficient, lift-off and maximum height are investigated. The findings offer insight into the parameters which will allow a hand helicopter to achieve its optimal maximum height. The conditions required for the hand helicopter to fly stably are also investigated and explained using the Tennis Racket Theorem.
Molecular Epidemiology and Phylogenetic Analysis of Peste des Petits Ruminants Virus Circulating in Sheep in Bangladesh
Authors: Rahman Mohammad Mojibur , Islam Md. Saiful , Sabuj Abdullah Al Momen , Hossain Md. Golzar , Islam Md. Alimul , Alam Jahangir , Ershaduzzaman Md. , Saha Sukumar
Published: March 2023

Peste des petits ruminants (PPR) is a viral disease of small ruminants that is highly contagious, severe, reportable, and economically important. The present study was conducted to detect the PPR virus (PPRV) circulating in sheep in Bangladesh to determine its association with epidemiological risk factors and the degree of relationship between the F and H genes of the PPRV of sheep with those of other sheep and goat isolates. A cross-sectional study was conducted in five selected districts of Bangladesh to collect data on locations, ecological zones, breeds, age, sex, sources, time period, and farming systems using a structured questionnaire accompanied by face-to-face interviews. During sampling, 250 nasal swab samples were collected from live sheep with the typical clinical signs of PPR. Thereafter, a reverse-transcriptase polymerase chain reaction (RT-PCR) assay was employed to detect PPRV using the F and H genes. Risk factors were determined using bivariable and multivariable logistic regression analyses. Phylogenetic analysis of the detected PPRV was performed using MEGA software after sequencing both F and H genes. Using RT-PCR, 35.6% (89/250, 95% CI: 29.6%–41.6%) of the samples were found to be positive for PPRV. Locations, breeds, sources, and feeding systems were identified as potential molecular epidemiological risk factors for PPRV infection in a multivariate logistic regression model. Nucleotide sequencing and phylogenetic analysis showed that the PPRV strain was genetically related to the lineage IV virus isolates. For the F gene, the sequence divergence of our gene and other selected genes ranged from 0.01% to 0.018% within lineage IV, and the similarity ranged from 98.2% to 99.0%. In the case of the H gene, similar results were also observed in divergence, ranging from 0.017% to 0.083% among lineage IV and others, and similarity varied from 91.7% to 98.3%. To the best of our knowledge, this is the first study in Bangladesh conducted to determine the RT-PCR-based molecular epidemiology of PPRV in sheep. This study highlights the importance of establishing successful interventions for managing PPRV infections in small ruminants in Bangladesh.
A Comprehensive Review on Extraction, Structure, Detection, Bioactivity, and Metabolism of Flavonoids from Sea Buckthorn (Hippophae rhamnoides L.)
Authors: He Nengxin , Wang Qinyuan , Huang Huilian , Chen Jie , Wu Guang , Zhu Meining , Shao Feng , Yan Zhihong , Sang Zhipei , Cao Lan , Wei Rongrui , Ma Qinge
Published: March 2023

Sea buckthorn (Hippophae rhamnoides L.) is an important plant with homology of medicine and food. It has rich nutritional and medicinal properties. It is used as a traditional Chinese medicine with therapeutic functions of invigorating spleen, relieving cough, eliminating food, eliminating phlegm, dispersing blood stasis, and promoting blood circulation. This review comprehensively summarized flavonoids from sea buckthorn (Hippophae rhamnoides L.), including extraction methods (solvent extraction, ultrasound-assisted extraction, microwave-assisted extraction, enzyme-assisted extraction, and collaborative extraction), two structure types (18 flavone aglycones and 81 flavone glycosides), detection methods (UV, HPLC, and NMR), bioactivities (antiviral, anti-inflammatory, hepatoprotective, weight-reducing, and hypoglycemic activities), and physiological metabolisms (most of flavonoids are converted into small molecule monophenolic acids through intestinal microbial catabolism). It will supply an important theoretical basis and valuable reference for researching and exploiting sea buckthorn (Hippophae rhamnoides L.) in the future. Practical Applications. Sea buckthorn (Hippophae rhamnoides L.) is an edible and medical plant with many functional properties. A comprehensive review on extraction, structure, detection, bioactivity, and metabolism of flavonoids from sea buckthorn (Hippophae rhamnoides L.) was made in this paper. This review will provide an important foundation for further studies of sea buckthorn (Hippophae rhamnoides L.) focusing on its development and utilization.
Received Signal Strength‐Based Localization for Vehicle Distance Estimation in Vehicular Ad Hoc Networks (VANETs)
Authors: Ahmad Waqas , Husnain Ghassan , Ahmed Sheeraz , Aadil Farhan , Lim Sangsoon
Published: March 2023

Vehicular ad hoc networks (VANETs) are an eminent area of intelligent transportation systems (ITS) which includes vehicle tracking, positioning, and emergency warnings. For protective applications, vehicle localization in the urban area is a significant problem. Global Positioning Systems (GPS) are one of the many solutions that have been offered, although they do not offer accuracy. To locate a target vehicle accurately, a unique approach called received signal strength‐ (RSS‐) based localization scheme has been proposed. By detecting signals within its range, it establishes communication through roadside units (RSUs) and determines the typical RSS. Following the discovery of the RSS, the RSS‐based localization algorithm helped in determining the precise position of the vehicle. The high signal‐to‐noise ratio of the proposed algorithm, which is derived from neighbouring RSUs, is its key component. The vehicle’s Cramer Rao lower bound (CRLB) is examined after its position is discovered. Various experimentations considering dynamic vehicles ranging from 2 to 100, localization error, ranging error, and throughput have been conducted which demonstrates that the proposed algorithm (RSS) has better results (87%, 80%, and 120) than other well‐established least squares (LS) and weighted least squares methods (WLS).
Development of Fragility Curves for Reinforced-Concrete Building with Masonry Infilled Wall under Tsunami
Authors: Waenpracha Suthiwat , Foytong Piyawat , Suppasri Anawat , Tirapat Supakorn , Thanasisathit Nuttawut , Maneekul Pongnathee , Ornthammarath Teraphan
Published: March 2023

A tsunami is a natural disaster that destroys structures and kills many lives in many countries in the world. A risk assessment of the building under a tsunami loading is thus essential to evaluate the damage and minimize potential loss. A crucial tool in risk assessment is the fragility curve. Most building fragility curves for tsunami force were developed using survey building damaged data. This research proposed a method for developing fragility curves under tsunami loading based on the analytical building model data. In the development, the generic building was a one-story reinforced-concrete building with masonry-infilled walls constructed from the structural index, popularly built as residential buildings along the west coast of southern Thailand. Three damage levels were investigated: damage in masonry infill walls, damage in primary structures, and collapses. The masonry infill wall was modeled using multisprings to represent the load-bearing behavior due to tsunami with a hydrodynamic pattern. The fragility curves were developed using the maximum likelihood method and considering the uncertainty due to masonry infill wall type, tsunami flow direction, and tsunami flow velocity. The developed fragility curve agrees well with the empirical tsunami fragility curve of a one-story reinforced-concrete building damage data in Thailand from the 2004 Tsunami. The developed fragility functions could be adopted for assessing tsunami risk assessment and disaster mitigation for similar structures against different tsunami scenarios in the future.
Age as a Determinant of the Effectiveness of Intravaginal Sponges Impregnated with Progestin and Equine Chorionic Gonadotropin for Multiple Births Induction of Awassi Ewes
Authors: Daham Abbas , Jaber Ali , Al-Saaidi Jabbar
Published: March 2023

The present study was conducted to evaluate the role of age in the effectiveness of intravaginal progestin‐impregnated sponges (IPIS) along with equine chorionic gonadotropin (eCG) on the multiple birth rates of Awassi ewes. One hundred mature ewes (live weight was 35–40 kg and age 2–5 years) were allocated to three groups according to their ages (n = 29, 2‐3 years;n = 34, 3‐4 years; and n = 37, 4‐5 years). All ewes were impregnated with IPIS, injected with 20 mg cronolone, for 14 days, and eCG (400 IU, i.m.) at sponges withdrawal. All treated ewes came to estrus (100%); the highest twining rate was recorded in ewes aged 2‐3 years, while the highest triple rate were found in those aged 3‐4 years. A negative correlation coefficient was recorded between the age of treated ewes and the multiple births. In conclusion, the best age of Awassi ewes for estrus synchronization programs and multiple birth outcomes using IPIS along with eCG is 2–4 years.
Managing Nutrition Impact Symptoms in Cancer Cachexia: A Case Series and Mini Review
Authors: Khorasanchi Adam , Nemani Srinidhi , Pandey Sudeep , Del Fabbro Egidio
Published: March 2023

Malnutrition is common in cancer patients and can occur throughout a patient’s disease course. The contributors to the clinical syndrome of cancer cachexia are often multifactorial, and produced by the cancer and associated pro-inflammatory response. Since cancer cachexia is a multifactorial syndrome, a multimodal therapeutic approach is ideal. A key component of therapy is identifying and managing symptom barriers to adequate oral intake, known as nutritional impact symptoms [NIS]. NIS are associated with reduced intake and weight loss in patients with advanced cancer, and aggregate NIS are a predictor of survival in patients with Head and Neck Cancer and in patients undergoing surgery for esophageal cancer. Currently, there are no guidelines regarding the specific management of NIS in oncology patients. Experience from specialist centers suggest relatively simple assessments and inexpensive interventions are available for the diagnosis and treatment of NIS. We present three patient cases from a cachexia clinic, where NIS management decreased symptom burden and improved clinical outcomes such as weight and physical performance.
Impact of Angiopoietin-2 on Kidney Diseases
Authors: Li Mei , Popovic Zoran , Chu Chang , Reichetzeder Christoph , Pommer Wolfgang , Krämer Bernhard K. , Hocher Berthold
Published: March 2023

Background: Angiopoietins (Ang) are essential angiogenic factors involved in angiogenesis, vascular maturation, and inflammation. The most studied angiopoietins, angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2), behave antagonistically to each other in vivo to sustain vascular endothelium homeostasis. While Ang-1 typically acts as the endothelium-protective mediator, its context-dependent antagonist Ang-2 can promote endothelium permeability and vascular destabilization, hence contributing to a poor outcome in vascular diseases via endothelial injury, vascular dysfunction, and microinflammation. The pathogenesis of kidney diseases is associated with endothelial dysfunction and chronic inflammation in renal diseases. Summary: Several preclinical studies report overexpression of Ang-2 in renal tissues of certain kidney disease models; additionally, clinical studies show increased levels of circulating Ang-2 in the course of chronic kidney disease, implying that Ang-2 may serve as a useful biomarker in these patients. However, the exact mechanisms of Ang-2 action in renal diseases remain unclear. Key Messages: We summarized the recent findings on Ang-2 in kidney diseases, including preclinical studies and clinical studies, aiming to provide a systematic understanding of the role of Ang-2 in these diseases.
Methods of Corneal Vertex Centration and Evaluation of Effective Optical Zone in Small Incision Lenticule Extraction
Authors: Liang Chen , Yan Hong
Published: March 2023

Inappropriate small incision lenticule extraction (SMILE) centration methods can affect the decentration of the effective optical zone (EOZ) after operation, which can subsequently lead to the decline of postoperative visual quality. We aimed to provide an overview of corneal vertex (CV) centration methods and an evaluation of the size and decentration of the EOZ in SMILE. We described the CV centration methods for patients with myopia, myopic astigmatism, hyperopia, and large kappa angle. The measurement methods of the EOZ were evaluated from the aspects of corneal morphology and corneal refractive power. Additionally, we summarized the advantages and disadvantages of measuring decentration based on topographic mapping and intraoperative video-captured images. Finally, we discussed the relationship between the EOZ and visual quality. Based on our review, clinicians should consider the following when choosing CV centration methods and evaluating EOZ postoperatively. First, the tear film mark center or topographic map comparison method is preferred for the correction of myopia, low myopic astigmatism, hyperopia, and large kappa angle (>0.2 mm). Triple marking centration is recommended for high myopic astigmatism (−3.5 diopters). Second, the total corneal power better reflects the change in refractive power than the topographic method. The measurement of the area rather than the diameter of the total corneal refractive power is more suitable for the evaluation of noncircular EOZs after high myopia astigmatism (<−2.0 diopters). Third, for the evaluation of decentration, the tangential curvature difference map method is preferred as it is not influenced by offset pupils. Finally, a large EOZ after SMILE may improve patient tolerance to decentration.
The Role of Follicular Regulatory T Cells/Follicular Helper T Cells in Primary Immune Thrombocytopenia
Authors: Sun Mingling , Wang Xiujuan , Wang Lei , Wang Xinyou , Fan Wenxia , Liu Ying , Li Qinzhi , Zhang Ning , Guo Xinhong
Published: March 2023

Introduction: Immune thrombocytopenia (ITP) is an autoimmune disease characterized by thrombocytopenia. Herein, we sought to identify potential immune-related therapeutic targets in ITP. Methods: The differentially expressed genes (DEGs) between ITP patients and controls in GSE43177 and PRJNA299534 were analyzed. The intersections of the two DEG groups were screened as common genes, and enrichment analysis was performed. Additionally, differential analysis of immune cell levels between ITP and controls was performed. Changes in the proportions of T follicular helper (Tfh) and follicular regulatory T (Tfr) cells in peripheral blood samples from ITP patients, ITP patients responding to therapy, and healthy controls were identified. The expression changes in B-cell lymphoma (Bcl)-6 and interleukin (IL)-21 were further evaluated. Results: A total of 76 common genes were identified, and enrichment analysis found that these genes were mainly associated with neutrophil-mediated immunity, the MAPK signaling pathway, and the FOXO signaling pathway. Furthermore, we found different levels of Tfh cells in patients with ITP and controls. The level of Tfh cells in the peripheral blood is significantly increased in ITP patients and declines after responding to therapy. The Tfr/Tfh ratio was reduced in ITP patients and increased after responding to therapy. IL-21 and Bcl-6 were more highly expressed in ITP patients than in controls. Conclusion: We identified abnormally expressed genes in ITP related to immune-related biological functions. We further identified the changes in Tfh and Tfr cells during ITP treatment. This provides a rationale for immunotherapy in ITP patients.
Abstract 03: Partnering in Negating Statistics for Black Women: A Women's Community Wellness Initiative
Authors: Nolan Timiya S , Ogonuwe Stephanie , Zhao Songzhu , Williams Amaris , Addison Sarah , Metlock Faith , Zhang Jing , Joseph Joshua J
Published: March 2023

Background:
Black Americans have the highest rate of mortality from chronic diseases (e.g., cardiovascular disease, cancer, and diabetes) among all non-indigenous races and ethnicities. Higher attainment of ideal cardiovascular health (CVH), as indicated by AHA’s Life’s Simple 7 (LS7; glucose, cholesterol, blood pressure, body mass index, diet, physical activity, smoking), and Life’s Essential 8 metrics (LE8: LS7 + sleep duration) is associated with a lower risk of mortality from chronic disease among all races and ethnicities. About 70% of health outcomes are influenced by social determinants of health (SDoH) and lifestyle behaviors. Unfortunately, Black American women are more likely to be negatively impacted by SDoH and less likely to engage in healthy lifestyle behaviors than their White counterparts. The Partnering in Negating Statistics (P.I.N.S.) for Black Women Initiative began in 2021 to educate, provide access to resources, and partner in science toward promoting health and wellness among Black women. Herein described is the commencement of the P.I.N.S. Initiative through community-based wellness events and community-dwelling Black women’s attainment of LS7 and LE8.

Methods:
The P.I.N.S. Initiative capitalized on engagement of academic-community-government partnerships to plan and implement community-based wellness events for Black women. Large signature events boasted opportunities to participate in education, screenings (e.g., mammograms, pap smears, and LS7/LE8 screening), and research. In addition to capture of screening data, event feasibility was assessed via a program evaluation at signature events in August 2021 and 2022. Descriptive statistics (quantitative data) and thematic content analysis (qualitative data) were performed.

Results:
Community-based wellness events boasted high feasibility in the areas of demand and acceptability. Five hundred Black women attended the events, completing a total of 30 mammograms, 24 pap smears, and 418 biometric screenings. Of women with complete LS7 (N = 123) and LE8 (N = 63) data, the median [interquartile range] LS7 and LE8 scores were 8 [7-10] on a 0-14 scale and 63 [54, 73] on a 0-100 scale. From evaluations (N = 111), attendees (20-74 years old) were well educated (66% with a college degree) and mostly un-partnered (57%). Largely, women heard about our event through family, friends, and community partners. Women were very to extremely satisfied with wellness content (82%) and the program overall (85%). Respondents found value in community engagement and reported the need for an annual event.

Conclusion:
The P.I.N.S. Initiative is a feasible avenue to engage Black women with largely intermediate cardiovascular health in wellness-focused services. This initiative provides a modifiable framework for further research toward identifying interventions to promote ideal CVH and equitable cardiovascular outcomes.
Abstract 05: Length of Time in the United States and Cardiometabolic Outcomes Among Foreign and US-Born Black Adults
Authors: Anikpo Ifedioranma , Dodds Leah , Mesa Robert A , Tremblay Julien , Vilchez Lilliana , Elfassy Tali
Published: March 2023

Introduction:
Among immigrant populations in the United States (US), proxy measures of acculturation such as length of time (LOT) in the US are associated with poor cardiometabolic health. Nevertheless, limited evidence exists among Black immigrants, and the role of nativity has not been fully explored. We aimed to evaluate the association between LOT in the US and cardiometabolic outcomes among US Black adults.

Methods:
The National Health Interview Survey (NHIS) is an annual representative survey of non-institutionalized US civilians. We combined data from 2016 - 2018 and included all Black adults (N = 10,034). LOT was defined as the number of years participants were reported to have lived in the US. Outcomes of interest were obesity, hypertension, diabetes, and high cholesterol, each defined based on self-report of ever being diagnosed by a medical doctor. We used logistic regression models to determine whether LOT in the US was associated with cardiometabolic health factors overall and by nativity subgroups - US-born non-Hispanic, Hispanic, African-born, and Caribbean/Central American (CA)-born groups. Models were adjusted for age, sex, race, education, marital status, health insurance status, and family income-to-poverty ratio. All analyses accounted for the NHIS complex survey design.

Results:
Our study population was 81% US-born non-Hispanic, 5% Hispanic (both foreign- and US-born), 6% African-born, and 6% Caribbean/CA-born groups. Among Black adults overall, compared with those born in the US, the odds of obesity were 70% lower (OR: 0.30, 95%CI: 0.22 - 0.41) for the foreign-born individuals with <15 years in the US, and 44% lower (OR: 0.56, 95%CI: 0.46 - 0.70) for those with ≥15 years. In addition, compared with those born in the US, the odds of hypertension were lower by 67% (OR: 0.33, 95%CI: 0.23 - 0.47) for the foreign-born individuals with <15 years, and by 46% (OR: 0.54, 95%CI: 0.43 - 0.68) for those with ≥15 years in the US. In subgroup analyses, Caribbean/CA-born individuals with <15 years in the US had 68% lower odds of obesity (OR: 0.32, 95%CI 0.13 - 0.76) and 66% lower odds of hypertension (OR: 0.36, 95%CI 0.15 - 0.86) compared to those with ≥15 years, but no significant effect was observed among African-born or Hispanic black adults.

Conclusion:
Among US black adults, shorter LOT in the US was associated with more favorable cardiometabolic health with differential associations by nativity. This heterogeneity suggests a need to examine the implications of acculturation in the context of the specific population of interest.
Abstract 14: Infant Gut Microbiome is Associated With Child Blood Pressure at Age 3 and 6 Years: Findings From a Danish Birth Cohort
Authors: Liu Tiange , Stokholm Jakob , Zhao Ni , Mueller Noel T
Published: March 2023

Background:
Experimental germ-free mice studies indicate that the gut microbiome affects blood pressure (BP). To our knowledge, no epidemiologic studies have investigated whether childhood BP, which portends future cardiovascular disease risk, is influenced by the infant gut microbiome—a microbiome that is less confounded by lifestyle. Understanding the link between gut microbiome and BP will shed light on gut microbiome as a modifiable way to improve child cardiovascular health.

Objectives:
To examine prospective associations of the gut microbiome at 1 month and 1 year with systolic BP (SBP) at 3 and 6 years, and to examine if the associations differed by breastfeeding duration over infancy.

Methods:
We used data from children followed up from birth to six years of age in the Copenhagen Prospective Studies on Asthma in Childhood 2010 cohort in Denmark. We measured infant gut microbiome at 1mo and 1y by 16S rRNA sequencing (V4 region). Research staff measured child BP in triplicate using standardized protocols during scheduled study visits at 3y and 6y. We analyzed microbiome features at each time point during infancy in relation to SBP at 3y and 6y, separately. We focused on Shannon index as a measure of microbiome alpha diversity, and differential abundance of microbial taxa. We assessed effect measure modification by breastfeeding duration at time of microbiome measurement. We adjusted models for maternal diet score during pregnancy, preeclampsia, gestational age, birth weight, and breastfeeding duration (when it was not a modifier).

Results:
Of 526 children included in the analysis, 49% were female and 78% were born vaginally. A 1-unit increment in Shannon index at 1mo was associated with -0.35 mmHg (-1.61, 0.91) lower SBP at 3y and -1.21 (-2.20, -0.23) lower SBP at 6y. Lower abundance of
Bacteroides
and higher abundance of
Staphylococcus
at 1mo was associated with higher SBP at 3y only (both
FDR-P
<0.05); no microbial taxa at 1mo were significantly associated with SBP at 6y. As for microbiome at 1y, associations differed by breastfeeding duration (
P-interaction
< 0.10). In children who were breastfed beyond 1y, a 1-unit increment in Shannon index at 1y was associated with -2.94 mmHg (-5.59, -0.28) and -1.02 mmHg (-3.24, 1.19) lower SBP at 3y (n=56) and 6y (n=72), respectively. In contrast, in children who were breastfed shorter than 1y, 1-unit increment in Shannon index was associated with 0.55 (-0.75, 1.85) and 1.26 (0.28, 2.24) higher SBP at 3y (n=298) and 6y (n=382), respectively. After multivariable adjustment, no microbial taxa at 1y were significantly associated with SBP at 3y or 6y.

Conclusions:
Higher gut microbiome Shannon diversity and higher
Bacteroides
and lower
Staphylococcus
at 1 month was prospectively associated with higher child BP at 3 and 6 years of age. Microbiome Shannon diversity at 1 year was also associated with child BP, however, associations depended on breastfeeding.
Abstract 16: Maternal Coronary Heart Disease and Mortality Within 5 Years of Delivery Among Women With Hypertensive Disorders of Pregnancy and/or Diabetes
Authors: Ash Emily , Wilson Dulaney A , Lackland Daniel T , Mateus Julio , Turan Tanya N , Hunt Kelly J , Malek Angela M
Published: March 2023

Introduction:
Pre-pregnancy hypertension (HTN), hypertensive disorders of pregnancy (HDP), and diabetes are linked to increased risk of post-pregnancy coronary heart disease (CHD) and all-cause mortality, but the cumulative impact of pre-pregnancy HTN, HDP, and diabetes has yet to be fully investigated. We aimed to examine associations between HDP and diabetes with CHD and mortality ≤5 years of delivery stratified by race/ethnicity.

Methods:
This retrospective cohort study included women aged 12-49 with ≥1 singleton, live birth in South Carolina (2004-2016). After exclusions, 431,839 women remained: non-Hispanic White [NHW; 58.8%], non-Hispanic Black [NHB; 31.7%], and Hispanic [9.5%]. Birth certificates defined pre-pregnancy HTN, HDP (preeclampsia, eclampsia, gestational hypertension), and diabetes (pre-pregnancy, gestational); hospitalization/ED visit data also defined pre-pregnancy HTN and HDP. Hospitalization/ED visit data and death certificates defined incident CHD and all-cause mortality. Cox proportional hazard models adjusted for covariates assessed associations by condition and race/ethnicity.

Results:
Incident CHD risk was increased ≤5 years of delivery for women with diabetes (HR=1.79, CI: 1.40-2.29), HDP (HR=2.91, CI: 1.98-2.65), diabetes and HDP (HR=3.95 CI:3.09-5.05), pre-pregnancy HTN and HDP (HR=3.94, CI: 3.11-5.00), and all three conditions (HR=5.78, CI: 4.41-8.06) compared to none. All-cause mortality risk was increased for HDP (HR=1.31, CI: 1.08-1.58), diabetes and HDP (HR=1.93, CI: 1.30-2.87), pre-pregnancy HTN and HDP (HR=2.20, CI: 1.54-3.15), and all three conditions (HR=2.88, CI: 1.61-5.16), but not with diabetes. The table shows overall and race/ethnic-specific event rates and model results.

Discussion:
Women with HDP (regardless of pre-pregnancy HTN) and/or diabetes experienced higher incident CHD and all-cause mortality risk ≤5 years of delivery. Event rates were highest for women with two or three conditions, with all event rates higher for NHB than NHW women.
Abstract 22: The Effects of Randomized Cocoa Extract and Multivitamins on the Gut Microbiome: A Pilot Study in COSMOS
Authors: Dong Yanbin , Li Jun , Zhu Haidong , Chen Li , Lee Kyu H , Manson Joann E , Sesso Howard D
Published: March 2023

Background:
The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a recently completed randomized, double-blind, placebo-controlled, 2x2 factorial trial of a multivitamin and cocoa extract supplement (containing 500 mg/d flavanols) in 21,442 older adults. In view of favorable effects of multivitamins on cognition and promising signals for cardiovascular risk reduction with cocoa extract, we conducted a pilot study to explore whether these interventions affected gut microbial composition and function.

Methods:
We conducted deep shotgun metagenomic sequencing in 30 COSMOS participants using fecal samples collected at baseline and year 2. We performed taxonomic profiling using MetaPhlAn2 and functional profiling using HUMAnN2. After proper quality filtering, we analyzed effects of both interventions on 2-year changes in microbial features, adjusting for age, sex, and body mass index.

Results:
Cocoa extract supplementation significantly altered the overall gut microbial taxonomic compositions from baseline to year 2, and explained 5.5% of the variance in the 2-year changes in relative abundance of all microbial species (
P
=0.008). We further found that randomized cocoa extract supplementation altered the relative abundance of a few microbial species, including those previously linked to anti-inflammatory and cardiometabolic benefits (e.g.,
Akkermansia muciniphila
, nominal
P
<0.05), and several microbial super pathways (including pyrimidine ribonucleotides
de novo
biosynthesis, FDR=0.03, and 28 other pathways with nominal
P
<0.05). Randomized multivitamin use did not significantly affect 2-year changes in alpha or beta diversity, but altered the abundance a few putative bacterial species and functional pathways (nominal
P
<0.05).

Summary:
Our pilot study suggests that cocoa extract and multivitamin supplementation in COSMOS may alter the gut microbiome and influence pathways relevant to health, emphasizing the need for larger studies that allow for more detailed investigations.
Abstract 33: Using the AHA's Life Essential 8 Criteria to Assess Sleep Duration and Its Association With Social Determinants of Health in U.S. Children
Authors: Song Minkyoung , Dieckmann Nathan F , Musil Carol M , Hayman Laura L
Published: March 2023

Introduction:
In 2010, the American Heart Association (AHA) began using 7 indicators to measure cardiovascular health, known collectively as Life’s Simple 7. In June 2022, the AHA added an 8
th
indicator: sleep duration. Although earlier studies have examined whether/how the indicators in Life’s Simple 7 might be impacted by social determinants of health (SDoH), few epidemiological studies have examined how SDoH influence the 8
th
indicator in U.S. children.

Purpose:
We used the AHA Life Essential 8 scoring criteria to assess sleep duration among U.S. children and whether certain SDoH were associated with sleep duration.

Methods:
We utilized data from the 2019-2020 National Survey of Children’s Health. For all children, we calculated the score for sleep duration (range 0 [lowest] to 100 [highest]). Based on the AHA scoring algorithm and the distribution of sleep duration, participants were divided into three mutually exclusive subgroups: (1) those who met age-appropriate
optimal
sleep duration; (2) those who had 1-<2 hour below or ≥ 1 hour above optimal sleep duration; and (3) those who had ≥ 2 hours below optimal sleep duration. Multinomial logistic regressions were used to assess the association of sleep duration with 4 SDoH factors (adverse childhood experiences [ACEs], received preventive care during past 12 months, food insufficiency, and living in unsafe neighborhoods). We controlled for child’s sex, age, race/ethnicity, and household poverty level.

Results:
Among children aged 6 to 17 years (n=49,821), the mean sleep duration score was 77.1 (95% CI 76.4 to 77.7) and 65.5% of the children had age-appropriate optimal sleep scores. Three SDoH factors were associated with higher likelihood of suboptimal sleep duration. Adjusting for covariates, for each point increase in number of ACEs the likelihood of having suboptimal sleep duration was increased (relative risk ratios [RR]:1.05 [95% CI 1.02 to 1.09]; 1.21 [95% CI 1.15 to 1.27]). The likelihood of having suboptimal sleep duration was also increased for those who reported food insufficiency at home (RR:1.19 [95% CI 1.06 to 1.33]; 1.67 [95% CI 1.40 to 1.98]) as well as for those who reported living in an unsafe neighborhood (RR: 1.34 [95% CI 1.04 to 1.71]; 1.63 [95% CI 1.19 to 2.23]).

Conclusions:
Our findings show that using the AHA’s Life Essential 8 scoring criteria, one third of U.S. children do not meet optimal sleep duration standards. These findings highlight the need for greater attention to social and systemic influences on children's sleep health. It is critical for healthcare providers to recognize that suboptimal sleep duration is a risk factor for poor cardiovascular health, and that certain SDoH are associated with suboptimal sleep duration.
Abstract 36: Life’s Essential 8 and Life Expectancy Among Adults in the United States
Authors: Ma Hao , Wang Xuan , Xue Qiaochu , Li Xiang , Liang Zhaoxia , Heianza Yoriko , Franco Oscar , Qi Lu
Published: March 2023

Background:
Cardiovascular disease (CVD) may be the main reason for stagnant growth in life expectancy in the US since 2010. The American Heart Association (AHA) recently released updated algorithm for evaluating cardiovascular health (CVH)--life’s essential 8 (LE8) score.

Hypothesis:
We aimed to quantify the associations of CVH levels, estimated by the LE8 score, with life expectancy in a nationally representative sample of US adults.

Methods:
We included 23003 adults who participated in the National Health and Nutrition Examination Survey (NHANES) 2005-2018 and whose mortality was identified through linkage to the National Death Index through December 31, 2019. Life table method was used to estimate life expectancy by levels of the CVH. The cause-specific decomposition of the life expectancy differences was evaluated by the Arriaga’s method.

Results:
During a median of 7.8 years of follow-up, 1359 total deaths occurred (772 in men and 587 in women). The estimated life expectancy at age 50 was 25.5 years (95% CI, 23.8-27.2), 31.2 years (95% CI, 30.4-31.9) and 33.1 years (95% CI, 29.8-36.2) in men with poor, intermediate and ideal CVH, respectively. The corresponding estimated life expectancy at age 50 in women was 29.5 years (95% CI, 27.8-31.1), 34.2 years (95% CI, 33.5-34.9) and 38.4 years (95% CI, 35.4-41.0), respectively. Equivalently, men and women with ideal CVH had an average 7.5 (95% CI, 3.5-11.5) and 8.9 (95% CI, 5.2-12.5) more years of life expectancy at age 50, respectively, compared with their counterparts with poor CVH. In men, on average, 41.8 % of the gained life expectancy at age 50 from adhering to ideal CVH was attributable to reduced CVD death. The corresponding percentage was 44.1 % in women. Similarly significant associations of CVH with life expectancy were observed in Non-Hispanic Whites and Non-Hispanic Blacks but not in Mexican Americans.

Conclusions:
Adhering to an ideal CVH, defined as the LE8 score, is related to a considerably increased life expectancy in the US adults.
Abstract 37: Proteomic Signatures of Obesity-Related Heart Failure in the Atherosclerosis Risk in Communities (ARIC) Study
Authors: Ozkan Bige , Chen Jingsha , Echouffo Tcheugui Justin B , Schlosser Pascal , North Kari E , Matsushita Kuni , Ballantyne Christie M , Yu Bing , Shah Amil M , Selvin Elizabeth , Coresh Josef , Ndumele Chiadi E
Published: March 2023

Background:
Obesity is a strong risk factor for cardiovascular disease. The excess heart failure (HF) risk associated with obesity is uniquely unexplained by traditional risk mediators. We sought to identify proteomic signatures that reflect mechanistic pathways associated with obesity-related HF.

Methods:
We quantified 4955 plasma proteins in stored plasma samples of ARIC Visit 2 (1990-1992) participants without HF using an aptamer-based platform (SOMAScan v4.0). We used Cox regression to identify the proteins associated with incident HF, stratified by obesity (BMI≥30 kg/m
2
). We used Bonferroni-corrected p-values to assess statistical significance in 2/3 discovery and 1/3 validation subsets. We assessed the biological pathways overexpressed by these proteins using a canonical pathway analysis.

Results:
We included 9940 participants (28% with obesity, mean age 57 years, 55% female, 22% Black adults). Over a median 21-year follow-up, 2,345 HF events (886 in obesity) occurred. In the discovery subset with obesity, we identified 110 proteins associated with incident HF after demographic adjustment, 19 proteins (7 specific to obesity, Figure B) had robust HF associations after additional adjustment for lifestyle and cardiometabolic risk factors (p<10
-5
) (Figure A). Of 19 proteins, 12 were also linked to prevalent obesity status. Angiopoietin-2 was associated with higher risk of HF and higher odds of obesity. Conversely, ephrin type-A receptor 4 and seizure 6-like protein were linked to lower HF risk and lower odds of obesity. Lipid and bile acid metabolism (inhibited), cytokine signaling and wound healing pathways (activated) were overexpressed by HF-associated proteins in those with obesity.

Conclusion:
We identified established and novel proteins associated with HF risk in obesity. Many proteins linked to incident HF in obesity are also strongly associated with prevalent obesity. Formal mediation analysis can help elucidate the potential role of these proteins in the development of obesity-related HF.
Abstract 39: Association of Cardiovascular Health With Time Lived Free of Coronary Artery Calcium
Authors: Shah Nilay S , Huang Xiaoning , Cameron Natalie , Petito Lucia , Allen Norrina B , Carnethon Mercedes R , Greenland Philip , Lloyd-Jones Donald , Khan Sadiya S
Published: March 2023

Introduction:
Zero coronary artery calcium (CAC) is associated with lower risk of cardiovascular disease. More time lived without CAC may delay coronary artery disease morbidity, but prediction of when CAC will first develop is not well understood. To inform cardiovascular prevention, we evaluated how cardiovascular health (CVH) relates to time lived without CAC.

Methods:
In Multi-Ethnic Study of Atherosclerosis (MESA) participants with zero CAC at baseline followed up to 10 years, we used Kaplan-Meier curves to estimate restricted mean survival time since study entry lived with zero CAC, by baseline CVH per Life’s Simple 7 metrics categorized as high (score 12-14), moderate (8-11), and low (0-7), and stratified by sex and age (45-64, 65-84 years).

Results:
Among 3416 participants without CAC at baseline (63% female, mean age 58 [SD 9] years, mean CVH score 8.8 [2.1]), mean years lived with zero CAC was 4.9 (SD 3.5) years. Women with high CVH lived on average 6.6 (95% CI 6.4-6.8) years with zero CAC, with moderate CVH 6.2 (6.1-6.3) years with zero CAC, and with low CVH 5.6 (5.3-5.8) years with zero CAC. Men with high CVH lived on average 6.4 (5.9-6.9) years with zero CAC, with moderate CVH 6.1 (5.9-6.3) years with zero CAC, and with low CVH 5.5 (5.1-5.9) years with zero CAC (Figure A). Among participants aged 45-64 years, those with high CVH lived on average 7.4 (7.1-7.6) years with zero CAC, with moderate CVH 6.8 (6.6-6.9) years with zero CAC, and with low CVH 5.9 (5.7-6.2) years with zero CAC. Among participants aged 65-84 years, those with high CVH lived on average 5.1 (4.5-5.7) years with zero CAC, with moderate CVH 5.2 (5.0-5.4) years with zero CAC, and with low CVH 4.9 (4.6-5.2) years with zero CAC (Figure B).

Conclusions:
High CVH was associated with longer time lived with zero CAC in women and men. Adults aged 45-64 years with high or intermediate CVH at baseline had longer time lived with zero CAC compared with those with low CVH. Older adults had no difference in time lived with zero CAC based on CVH. Maintaining CVH in midlife may delay onset of CAC.
Abstract 42: Artificial Intelligence Electrocardiogram to Detect Coronary Calcification and to Predict Atherosclerotic Cardiovascular Events in the Community
Authors: Medina-Inojosa Jose R , Medina-Inojosa Betsy J , Attia Zachi , Shelly Michal , Baez Suarez Abraham , Friedman Paul , Carter Rickey , Lopez-Jimenez Francisco
Published: March 2023

Background:
We developed a deep learning algorithm that detects coronary artery calcium (CAC) score using 12-lead electrocardiograms (CAC- ECG). We tested the hypothesis that the output from the CAC-ECG algorithm would be associated with incident atherosclerotic cardiovascular disease (ASCVD) events and that the CAC- ECG would refine the AHA/ACC Pooled Cohort Equation’s (PCE) predictive capabilities.

Methods:
A community-based cohort of consecutive patients seeking primary care in Olmsted County, MN, between 1998-2000 with passive follow-up via record linkage. Inclusion was identical to the PCE. The original CAC-ECG was developed in 43,210 subjects yielding an AUC of 0.83. Herein, we used the CAC-ECG output to predict a high CAC (≥ 300). Primary outcome was ASCVD defined as fatal and non-fatal myocardial infarction and ischemic stroke, secondary outcome was Major Adverse Cardiovascular Events (MACE) further including PCI, CABG, and mortality. Events were validated in duplicate. Cox proportional hazard models adjusted for variables included in the PCE and were stratified to evaluate the effect of the CAC-ECG on PCE-predicted risk. Follow-up was truncated at 10 years for PCE analyses.

Results:
We included 24,793 subjects, mean ± SD age 53.9 ± 12.1, 52% women, 95% white. After 16.7±3.7 yrs follow-up, 2,366 (9.5%) had ASCVD and 3,401 (13.7%) had MACE. Risk of ASCVD and MACE increased with CAC-ECG probability quintiles, independent of risk factors,
p
for trend <0.001 (
Fig. A-B
). The CAC-ECG enhanced the predicted capabilities of the PCE across all ASCVD risk groups (
Fig. C
). Net reclassification improved 13.7% with comparable C-statistic from 0.77 vs. 0.78 for PCE and CAC-ECG.

Conclusions:
CAC-ECG was associated with ASCVD and MACE and improved PCE predicted risk. The CAC-ECG algorithm could identify individuals at risk in primary prevention; Unlike the PCE, the CAC-ECG can be applied without chart review or performing a computer tomography and may be reliably used retrospectively in cohorts with digitally stored ECGs.