Browse Articles

Abstract P1159: Aortic Arch Calcification Improves Cardiovascular Event Risk Stratification Among Individuals With a History of Cigarette Smoke Exposure

Cigarette smoking and aortic arch calcification (AAC) are powerful risk factors for incident cardiovascular disease (CVD), but their relationship is yet to be thoroughly investigated. We used data from the Multi-Ethnic Study of Atherosclerosis to examine the development and progression of AAC, and the extent to which AAC can risk stratify for CVD, among individuals with a history of smoking. Our study sample consisted of 2846 men and women in the US aged 53 to 93 years old who were scored for AAC at two exams roughly 5 years apart. We hypothesized that cigarette smoke exposure would be significantly associated with AAC at initial exam, with AAC progression between exams, and that AAC would improve risk prediction accuracy for CVD among smokers. We used linear mixed-effects models to assess AAC development and progression, proportional hazards models to investigate the relationship between AAC and incident CVD among smokers, and the area under the time-dependent receiver-operator characteristic curve (AUC) to characterize model prediction accuracy. All models were adjusted for demographic and cardiovascular risk factors. Relative to participants who never smoked, being a former or current smoker was significantly associated with higher AAC at initial exam (P=0.001), but not AAC progression between exams. Among current or former smokers, a one-unit increase of log-transformed AAC was associated with a 20.6% increased risk of CVD (P<0.001), and a 13.0% increased risk of all-cause mortality (P=0.01). The inclusion of AAC as a risk factor among smokers improved the 8-year AUC for CVD events from 0.731 to 0.778. In conclusion, AAC is a measure of atherosclerotic burden that can improve risk stratification for CVD in smokers.

Abstract MP32: Cardiovascular Risk Factors and Predicted Risks Across Asian American, Native Hawaiian and other Pacific Islander Subgroups: The PANACHE Study

Introduction: Cardiovascular disease (CVD) risk varies substantially across racial and ethnic groups, especially among disaggregated Asian American, Native Hawaiian, and other Pacific Islander (AANHPI) subpopulations. We describe differences in the prevalence of CVD risk factors and predicted CVD risk among a large, diverse population of AANHPI adults living in California and Hawai’i. Methods: We identified 2,653,007 adults within Kaiser Permanente Northern California and Hawaii from 2012-2022 aged ≥30 years with no prior myocardial infarction, stroke, heart failure or atrial fibrillation. CVD risk factors were ascertained using validated diagnosis codes, ambulatory measurements, and dispensed medications in the electronic health record. We calculated the 10-year predicted risk of CVD events using the American Heart Association base PREVENT-CVD equations. Prevalence estimates and means were standardized to the overall age and sex distribution using parametric g-computation. Results: Mean (SD) age was 49 (15) years and ranged from 41 (12) years in South Asian to 55 (16) years in Japanese adults. 53% were women overall, ranging from 48% in Native Hawaiian/Pacific Islander to 64% in Korean adults. Compared to non-Hispanic White adults, all AANHPI subgroups had higher prevalences of diabetes and dyslipidemia and lower prevalence of smoking, the latter except Native Hawaiian/Pacific Islander adults ( Figure ). There were notable differences across AANHPI subgroups in the prevalence of hypertension (12% in Chinese to 30% in Filipino adults), obesity (11% in Vietnamese to 41% in Native Hawaiian/Pacific Islander adults), and diabetes (5% in Chinese to 14% in Native Hawaiian/Pacific Islander adults. Filipino, Native Hawaiian/Pacific Islander, Vietnamese, and other Southeast Asian adults lived in neighborhoods with higher deprivation indices. Based on PREVENT-CVD risk estimates, Filipino, Native Hawaiian/Pacific Islander, South Asian and other Southeast Asian populations had higher standardized 10-year CVD risks. Conclusions: We found considerable variation in traditional CVD risk factors and predicted CVD risk across disaggregated AANHPI subgroups in a contemporary population with no prior CVD. Further research is needed to investigate potential differences in mediating pathways to the development of CVD across AANHPI subgroups. There is also a need to examine non-traditional structural and social factors that may uniquely affect AANHPI populations.

In-depth analysis of FeNi-based nanoparticles for the oxygen evolution reaction

Abstract This study investigates the effect of varying iron-to-nickel ratios on the catalytic performance of Fe-Ni oxide nanoparticles (NPs) for the oxygen evolution reaction (OER). Addressing the issue of high energy wastage due to large overpotentials in OER, we synthesized and characterized different NP catalysts with different Fe: Ni oxide ratios. Transmission Electron Microscopy (TEM), Energy Dispersive X-ray Spectroscopy (EDS), and X-ray Diffraction (XRD) were employed to determine the morphology, elemental and phase composition of the NPs. Furthermore, in-depth profiling with X-ray Photoelectron Spectroscopy (XPS) and Hard X-ray Photoelectron Spectroscopy (HAXPES) revealed that iron predominantly exists as oxide, while nickel exhibits both metallic and oxidic forms depending on the Fe content. XPS indicated an enrichment of iron at the NP surface, whereas HAXPES and EDS data agreed on the bulk stoichiometry. The assessment of the catalytic activity via cyclic voltammetry (CV) showed that the Fe: Ni ratio of 2:3 exhibited superior performance, characterized by lower overpotential and a smaller Tafel slope.

Abstract P2001: Sex Differences in Cardiovascular Health Among Syrian Refugees at Zaatari Camp: A Cross-Sectional Study Using the AHA Life's Essential 8

Background: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality globally. The Syrian refugee crisis has exacerbated CVD risk due to socioeconomic, biological, and environmental factors. This study aims to assess cardiovascular health (CVH) using the American Heart Association's Life's Essential 8 (LE8) metric among Syrian refugees residing in the Zaatari Camp in Jordan. Methods: A cross-sectional study was conducted at the King Salman Humanitarian Aid and Relief Primary Health Center within the Zaatari refugee camp. Participants included adult Syrian refugees evaluated for their CVH through the LE8 metrics: diet, physical activity, nicotine exposure, sleep health, body weight, blood glucose, blood pressure, and lipid levels. Data was collected in January 2024 using point-of-care testing devices and structured questionnaires. Descriptive and chi-square analyses were used. The total CVH score was derived by averaging eight health metrics, resulting in a composite score from 0 to 100. Scores of 80+ indicate high CVH, 50-79 indicate moderate CVH, and <50 indicate low CVH. Results: Syrian refugee (N=218) participants included males (50.6%) with a mean age of 48 years (+13.5). Most had a high school education or below (68.3%) and a high unemployment rate (68.2%). Almost 46% of individuals earned a household income of $51 - $150 monthly. More than 50% had low diet diversity, 61.8% were classified as hypertensive, and 49% were obese. Sex-stratified analysis showed that males had higher scores in BMI (24.7%) and physical activity (70.3%) compared to females (p<0.0001, p=0.034, respectively). Females had higher scores in sleep (55.4%) and nicotine exposure (84.1%) compared to males (p=0.001, p<0.0001, respectively). The total LE8 score for the participants was 60.6 (±15.8). Conclusion: Although the refugees demonstrated a moderate level of CVH, these findings suggest that without intervention, their CVH is likely to worsen due to high rates of hypertension, obesity, and poor dietary habits. Furthermore, implementing health assessment tools in refugee camps can aid clinicians in the early identification and management of CVD risk factors.

Abstract P3035: Assessing the Influence of ApoE Gene Polymorphisms on the Risk of Developing Cardiovascular Disease in Type 2 Diabetes Mellitus patients: A Systematic Review

Background: Apolipoprotein E is an essential component of lipoprotein metabolism and it is modulated by the ApoE gene. This gene has three known polymorphic variants: ε2, ε3 and ε4. Several studies showed that the presence of these polymorphisms may increase the risk of cardiovascular diseases (CVD) like coronary artery disease (CAD), peripheral artery disease (PAD), heart failure (HF), atherosclerosis and stroke, especially in type 2 diabetes mellitus (T2DM) patients. Objective: This systematic review aims to evaluate the impact of ApoE gene polymorphisms on the risk of developing cardiovascular disease (CVD) in T2DM patients. Methods: We performed a comprehensive search in the following databases: PubMed, ScienceDirect, and Google Scholar. All observational studies available in English, that provided full text and published before July 2024 were included. Studies were chosen based on the documentation of ApoE gene polymorphisms and their correlation with cardiovascular diseases in individuals with Type 2 diabetes mellitus (T2DM). A qualitative synthesis of the findings was conducted to summarize the associations observed across the studies. Due to heterogeneity of the population characteristics and outcome measures in the included studies, we were not able to conduct statistical testing. Results: A total of 17 studies involving 9,497 participants were included in this review. Results from 11 studies (6 focusing on CAD, 2 on PAD, 1 on CAD+cerebral infarction, 1 on HF and 1 on diabetic atherosclerosis) concluded that there was an increased frequency of the ε3/4 genotype among T2DM patients with CVD and that the presence of the ε4 allele significantly increased the risk of CVD. Ten studies showed that individuals with ε4-bearing genotypes, particularly ε3/4, had lower levels of plasma high-density lipoprotein cholesterol (HDL-C) and higher levels of plasma low-density lipoprotein cholesterol (LDL-C) and total cholesterol. There were two studies on stroke in T2DM patients which reported that the ε2/ε3 genotype was associated with an increased risk of ischemic stroke. Two studies also showed that the presence of ε2 allele may provide certain protection against CVD. Conclusion: ApoE gene polymorphisms, particularly the ε4 allele, are associated with an increased risk of CVD and altered plasma lipid profiles in T2DM patients. These findings suggest that ApoE gene polymorphisms can be a potential screening tool to assess CVD risk in diabetic patients.

Effect of heating temperature on pore structure of briquette coal using SEM, NMR, N2/CH4 adsorption-desorption analyses

Abstract P2005: Applying a comprehensive cardiometabolic risk prediction model to real-world primary care patient data

Background: Comprehensive risk prediction models utilized at the point of care have potential to improve screening rates, facilitate prevention referrals, and reduce disparities. However, feasibility of deploying comprehensive models in the clinical workflow are largely unknown. Objective: To assess: (1) feasibility of applying a validated risk prediction model – the cardiometabolic disease staging system (CMDS) - that incorporates metabolic, vascular, and social determinants of health (SDoH) factors to electronic health record (EHR) data from primary care patients and (2) cardiometabolic disease risk for 10-year onset of type 2 diabetes (T2D) and major adverse cardiovascular events (MACE). Method: Data to calculate CMDS [clinical: BMI, glucose, blood pressure, HDL, triglycerides, smoking status; SDoH: income, education, insurance status, stress and neighborhood level social vulnerability] among patients without documented T2D or MACE diagnosis [myocardial infarction, stroke, cardiovascular death] were extracted. CMDS was applied using 3 algorithms: (1) clinical and (2) clinical + SDoH for predicting T2D; and (3) clinical for MACE. Feasibility of model application was determined by calculating the percent of patients with a score out of all eligible primary care patients. We estimated mean scores overall by outcome; quartiled scores to determine risk strata; and assessed mean MACE by diabetes risk quartile. Results: A total 10,398 patients [mean age: 63.7 years (SD 10.6), 63% female, 26% non-Hispanic Black] were identified. Full data were available to apply the clinical model to 73% of patients and the CMDS + SDoH to <1% for T2D outcome; 67% for clinical MACE model. Among patients that had a clinical CMDS calculated there was a mean 17.4% risk of developing T2D; and 10.6% of MACE. Quartiles of risk had natural breaks at <6%, 6-10%, 11-20% and >21% for T2D and <5%, 5-8%, 9-14%, >14% for MACE. Missing SDoH data [99.4% income; 95.4% education; 0% insurance; 94.7% stress; 33.5% neighborhood level social vulnerability; 0.6% marital status] was the limiting factor for CMDS + SDoH model application. Mean MACE risk was 11.0% among those at highest risk for T2D. Conclusion: While the clinical CMDS algorithms could be applied to EHR data, findings highlight the lack of available data to apply risk prediction models with SDoH measures. Future work should examine how to incorporate models into primary care workflow, including efforts to systematically screen social risks.

Abstract P2013: Underrepresentation of African Countries in Randomized Controlled Trials: A 2022 Analysis Across Five Leading General Medical Journals

Objective: To evaluate the representation of African countries in randomized controlled trials (RCTs) published in five leading general medical journals in 2022. Methods: This systematic review assessed RCTs involving human subjects published between January 1, 2022, and December 31, 2022, across The New England Journal of Medicine , The Lancet , JAMA , Nature Medicine , and BMJ . Trials included were conducted in diverse settings, encompassing hospitals, research institutions, and community health centers. Geographic locations and participant demographics were extracted for analysis. The primary outcome was the proportion of RCTs conducted solely within African countries. The secondary outcome assessed African representation in multi-continental RCTs. Data were aggregated to determine the percentage of Africa-exclusive RCTs and African representation in multi-continental trials within each journal. Results: Of the 390 RCTs meeting inclusion criteria ( BMJ : 31, JAMA : 73, The Lancet : 97, Nature Medicine : 40, NEJM : 149), only 1.6% were conducted exclusively in Africa, with an additional 6.9% representing multi-continental studies where at least one African location was included. A total of 9 Africa-exclusive RCTs were published in 2022: The Lancet (4.1%), NEJM (2.7%), and Nature Medicine (2.5%). No Africa-exclusive RCTs appeared in BMJ or JAMA . Of multi-continental RCTs, NEJM included 14.8% with African sites, followed by The Lancet (9.3%), Nature Medicine (5.0%), and JAMA (1.4%). The BMJ published no RCTs with African representation. Within Africa, study sites were unevenly distributed. South Africa accounted for 67.5% of African RCTs, Northern Africa (7 countries) contributed 8.2%, Eastern Africa (22 countries) contributed 51.0%, Western Africa (17 countries) contributed 22.4%, Southern Africa (5 countries) contributed 75.5%, and Central Africa (9 countries) accounted for only 2.0% of the African representation. Conclusion: This analysis reveals a significant underrepresentation of African countries in RCTs published in top medical journals in 2022. The findings underscore the critical need for increased African participation in RCTs. Expanding African representation is essential for the generalizability of clinical research and the promotion of equitable health outcomes globally.

Analysis of midsole gait in running shoes with various 3d printed biomimetic structure

Abstract P2036: Deciphering the Burden: Lead Exposure as a Major Contributor to Hypertensive Heart Disease Globally: A Global Analysis from 1990-2021

Introduction: Lead exposure (LE) has been increasingly recognized as a significant risk factor for hypertensive heart disease (HHD), with no safe threshold identified for its adverse health effects. Persistent environmental contamination from sources such as old paint and industrial emissions continues to pose cardiovascular risks. Method: Using Burden of Disease Study 2021 tool, we estimated deaths and disability due to HHD attributable to LE by age, sex, year and location across the 204 countries and territories from 1990-2021. Results are shown in absolute counts and unadjusted rates (per 100,000). Results: From 1990 to 2021, the average annual percentage change (APC) in the absolute death count rose by 1.97%, disability-adjusted life years (DALYs) increased by 1.31%, and years lived with disability (YLDs) by 3%. Regionally, the highest increase in APC for deaths was observed in high-income countries at 3.54%, followed by high-SDI regions and South Asia, both at 2.95%. Regarding age, the highest number of deaths occurred in the 80-84 age group, totaling 216,409 (95% uncertainty interval: 179,011-244,186). The highest DALYs were noted in the 70-74 age group, at 3.3 million (2.8-3.7 million), and YLDs in the same age group were 178,655 (102,947-280,059). From 1990 to 2021, females saw higher total percentage changes (TPC) compared to males: deaths increased by 92% vs. 74%, DALYs by 57% vs. 43%, and YLDs by 170% vs. 134%. Conclusion: Deaths due to HHD attributable to LE accounted for 23.93% of all HHD related deaths globally in 2021. The persistent burden of HHD attributable to LE highlights a critical area for public health intervention. Reducing exposure to lead and mitigating its cardiovascular effects are imperative for global health security.

Abstract P1027: Associations between sleep quality and individual lipid abnormalities in Hong Kong Chinese women: Findings from the MECH-HK study

Background: Many studies on the relationship between sleep quality and dyslipidemia have been conducted, but the findings have been inconsistent. Dyslipidemia refers to the presence of one or more of individual lipid conditions: high total cholesterol (TC) level, high triglycerides (TG) level, high low-density lipoprotein cholesterol (LDL-C) level, and low high-density lipoprotein cholesterol (HDL-C) level. Few studies have investigated the relationships between sleep and individual lipid components in Chinese population. Identifying the specific lipid components associated with sleep might help target prevention and improving precise management of dyslipidemia. Methods: Baseline data (collected between October 2019 - December 2020) of the Migraine Exposures and Cardiovascular Health in Hong Kong Chinese women (MECH-HK) cohort were used for analyses. Sleep quality was measured by the Chinese version of the Pittsburgh Sleep Quality Index (PSQI). It has an overall score and 7 domains. Poor sleep quality was defined as overall score > 5. Blood lipids in terms of TC, TG, LDL-C, and HDL-C were measured by CardioChek PA device, and categorized as normal or abnormal according to the Chinese guidelines for lipid management (2023). Results: A total of 3531 adult women were included. The prevalence of poor sleep quality, abnormal TC, TG, LDL-C, and HDL-C was 64.7%, 12.9%, 21.7%, 4.8%, and 3.4% respectively. The association between sleep quality and dyslipidemia was not significant. As for individual lipid abnormalities, poor sleep quality was only associated with 3.0% greater odds of abnormal LDL-C (95% CI: 0.5~5.5%). Regarding sleep pattern, sleep duration ( OR =1.018, 95% CI : 1.006~1.030) and sleep disturbances ( OR =1.033, 95% CI : 1.012~1.055) were associated with abnormal LDL-C. Sleep duration ( OR =1.021, 95% CI : 1.008~1.034) and sleep disturbances ( OR =1.027, 95% CI : 1.005~1.050) were also associated with abnormal TC, while sleep latency ( OR =1.007, 95% CI = 1.001~1.014) and sleep efficiency ( OR =1.005, 95% CI : 1.001~1.009) were associated with abnormal HDL-C. No significant associations were observed between any of the sleep components and abnormal TG. Conclusion: The association of poor sleep quality with dyslipidemia appeared mainly between sleep and abnormal LDL-C. Different sleep patterns were linked to specific lipid components, suggesting that future research may focus on tailored management strategies based on specific sleep patterns and types of dyslipidemia.

Comparison of machine learning models for rock UCS prediction using measurement while drilling data

Abstract 001: Intergenerational social mobility and cardiovascular health among caregivers and their offspring: results from the Study of Latino Youth (SOL Youth)

Introduction: Socioeconomic position (SEP) is one of the main determinants of cardiovascular health (CVH). Among Hispanic/Latino populations living in the US, economic hardship is a leading stressor and a risk factor for suboptimal CVH. However, little is known about how changes in SEP can influence CVH across generations. Hypothesis: We hypothesized worse CVH for offspring and caregivers with persistent low SEP versus higher intergenerational SEP. Methods: The Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth; 2012-2014) is a cross-sectional study of 1466 Hispanic/Latino youth (aged 8-16 years). Social mobility was assessed using the grandparents' and caregivers' SEP. Grandparents' SEP was defined using the highest level of education attained by grandmother or grandfather: lower (<High school) or higher (≥High school). Caregivers' SEP was defined according to their education and income: lower (education <High school and income <30k) or higher (education ≥High school or income ≥30k). Social mobility was classified as stable low, downward, upward, and stable high groups. CVH was assessed for caregivers and offspring based on Life's Essential 8 (LE-8). We conducted survey linear regression models to investigate the association between social mobility and caregivers' (n=848) and offspring's (n=1217) CVH, adjusting for age, sex, place of birth, Hispanic/Latino background, and field center. Results: Among caregivers, lower total LE-8 scores were observed for stable low [β= -3.91(-7.33; -0.49)] and downward [β= -4.85 (-9.61; -0.09)] groups compared to those in the stable high group. Lower BMI scores were observed in the stable low [β= -7.87 (-15.31; -0.43)] compared to those in the stable high group. Lower diet [β= -8.57(-16.75; -0.38)] and nicotine exposure [β= -22.23 (-34.48; -9.98)] scores were observed in the downward group compared to the stable high group. Among offspring, lower total LE-8 [β= -3.00 (-5.24; -0.75)] and glucose [β= -4.96 (-7.89; -2.04) scores were observed in the stable low compared to the stable high group. Conclusions: Among Hispanic/Latinos, the intergenerational persistence of low SEP was associated with worse CVH in caregivers and their offspring compared to remaining in high SEP. Our findings highlight that disadvantages transferred across generations may help explain how CVH disparities emerge early in life. Future policies focused on structural interventions are needed to address these disparities in CVH.

Abstract P1006: Trajectories of Cardiometabolic Diseases and Cancer: Transition Patterns, Multiomics Signatures, and Prediction Model

Objective Multimorbidity is a growing but understudied global challenge in an aging world. Cardiometabolic disease (CMD) and cancer are the 2 most common chronic diseases, yet their transition patterns remain unclear, and reliable tools for early prediction of disease trajectories across the lifespan are scarce. Methods: This study was conducted on 429,909 UK Biobank participants without baseline CMD and cancer. CMD included type 2 diabetes, coronary disease, heart failure, and stroke. A multistate analysis was used to investigate transition patterns and identify multiomics signatures for transitions from baseline to single morbidity and to multimorbidity. Machine learning prediction models for disease trajectories were constructed using genomics, metabolomics, and proteomics data, and predictive performance was assessed. Results: During a median follow-up of 15 years, 105,855 participants developed morbidity and 15,044 developed multimorbidity of CMD and cancer. Participants with multimorbidity had a 9%-30% higher mortality risk and 2.4-5.3 years of shorter survival time than those healthy or with single morbidity. Development of CMD before cancer presented a poorer prognosis than the reverse order. Distinct and shared multiomics signatures underlying disease trajectories were identified. Top 10 multiomics signatures presented a dose-response characteristic from health to single morbidity and to multimorbidity of CMD and cancer. Proteomics scores showed superior prediction performance than metabolomics and genomics scores. For 10-year outcome prediction, proteomics scores showed varying performance across disease trajectories, with area under receiver-operating characteristic curves ranging from 0.64 for health-to-only cancer trajectory to 0.90 for health-to-CMD-to-death trajectory, significantly better than the base model and traditional clinical model. Conclusions This study revealed disease trajectories of CMD and cancer with varying prognostic implications that were predicted with differing accuracy through multiomics approaches.

Publisher Correction: Efficient and rapid identification of tropical maize inbred lines tolerant to waterlogging stress

Abstract 003: Transgender Adults Experience Earlier and Elevated Cardiovascular-Kidney-Metabolic Multimorbidity Compared to Cisgender Peers

Introduction: Cardiovascular disease (CVD) is a key driver of cardiovascular-kidney-metabolic multimorbidity (CKMM) and mortality. Transgender adults appear to face a higher prevalence of CVD risk factors than cisgender peers, but their elevated risk correlates with CKMM remain unclear. This study examines the association between CKMM and transgender identity. Methods: We used nationally representative data from the 2017-2022 Behavioral Risk Factor Surveillance System, including adults aged ≥18 with gender identity data. The primary outcome was CKMM (yes/no), defined as CVD (coronary heart disease, stroke, or myocardial infarction), chronic kidney disease, and metabolic risk factors (BMI ≥ 25 kg/m2 or diabetes mellitus). Multivariable logistic regression models assessed the odds of CKMM, with transgender status as the main independent variable. Covariates included sociodemographics, behavioral risk factors, BMI, age, and age-gender interaction. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) are reported, accounting for complex survey design. Results: The study included 649,106 transgender adults (median age 33 years, IQR 22-53), consisting of 347,539 transgender men and 301,577 transgender women. About 61% of transgender adults exhibited ≥1 CKMM feature, overweight/obesity being the most common. Transgender adults had a threefold higher likelihood of CKMM compared to cisgender peers (aOR 3.09, 95% CI, 1.73-5.52; p<.001). Elevated CKMM odds in transgender adults were driven by significantly higher rates of myocardial infarction, stroke, coronary heart disease, and chronic kidney disease. Age was the only significant predictor of CKMM in transgender adults, while multiple factors—BMI, health coverage, physical activity, heavy drinking, income, and employment—were significant for cisgender adults. A significant age-transgender status interaction (p<.001) demonstrated that transgender adults had a higher predicted probability of CKMM across the age continuum with risk convergence around 80 years. For example, the predicted probability of CKMM in a 22-year-old transgender adult was equivalent to that of a 66-year-old cisgender adult. Conclusion: CKMM is strongly linked to transgender identity, with transgender adults facing higher risks at substantially younger ages. This underscores the need for improved screening and preventive measures in transgender populations to address early onset of CKMM and reduce premature morbidity and mortality.

Abstract P1131: Comparisons of daily patterns of accelerometry-derived physical activity between interdialytic and dialysis days, by session, among patients on hemodialysis.

Introduction: Patients with end-stage chronic kidney disease (CKD) are less physically active than those without CKD. Those who receive hemodialysis (HD) may be less active, especially on HD days, given that most patients are sited for ~3 hours during HD. Nevertheless, limited evidence exists on quantifying activity differences across HD and interdialytic days. Methods: In a cross-sectional study of patients 18 years and older undergoing HD three times per week in a tertiary hospital in Mexico City without contraindications for physical activity or significant mobility limitations, we measured free-living physical activity using wrist accelerometry. Patients have three interdialytic periods each week and three days. On an HD day, some patients have morning sessions (starting at 7 AM), some mid-day sessions (beginning between 11 AM-12:30 PM), and some have evening sessions (starting between 3:30-4:30 PM). The patients wore a triaxial accelerometer in their non-dominant wrist (only removing it for water activities longer than 30 minutes) for 7 days. Valid days had ≥90% of wear time. We derived total activity counts (TAC), time spent active (minutes), and the active-to-sedentary transition probability (ASTP, a measure of fragmentation; higher ASTP= more fragmented activity). With linear regressions accounting for correlation of repeated measures, we estimated differences in TAC, active time, and ASTP. We plotted minute-level median activity counts separately for interdialytic days and HD days by session for descriptive purposes. Results: In a sample of 27 adults (mean age=39.6, SD=12.5, 41% females), the mean TAC was 2.34 million (SD=0.77 million), time spent active 447 minutes (SD=137.12), and ASTP 25% (SD=7). Compared to interdialytic days, during HD days, patients were less active, and their activity was more fragmented (beta coefficient for TAC= -0.7 million [95% CI -0.9, -0.4], for active time=-103 minutes [-148.5, -58.6] and ASTP= 5% [95% CI 3, 7]). In diurnal plots, we also saw that activity began earlier on HD days and was constantly lower across the day relative to interdialytic days (figure) Conclusion: Patients undergoing HD were significantly less physically active and had more fragmented activity patterns on HD days compared to interdialytic days. Interventions aimed at increasing physical activity and reducing sedentary behavior on HD days may be beneficial for improving overall health and quality of life in this population.

Examining the effects of extremely low-frequency magnetic fields on cognitive functions and functional brain markers in aged mice

Genomic divergence across the tree of life

Nucleotide sequence data are being harnessed to identify species, even in cases in which organisms themselves are neither in hand nor witnessed. But how genome-wide sequence divergence maps to species status is far from clear. While gene sequence divergence is commonly used to delineate bacterial species, its correspondence to established species boundaries has yet to be explored across eukaryotic taxa. Because the processes underlying gene flow differ fundamentally between prokaryotes and eukaryotes, these domains are likely to differ in the relationship between reproductive isolation and genome-wide sequence divergence. In prokaryotes, homologous recombination, the basis of gene flow, depends directly on the degree of genomic sequence divergence, whereas in sexually reproducing eukaryotes, reproductive incompatibility can stem from changes in very few genes. Guided by measures of genome-wide sequence divergence in bacteria, we gauge how genomic criteria correspond to species boundaries in eukaryotes. In recognized species of eukaryotes, levels of gene sequence divergence within species are typically very small, averaging <1% across protein-coding regions in most animals, plants, and fungi. There are even instances in which divergence between sister species is the same or less than that among conspecifics. In contrast, bacterial species, defined as populations exchanging homologous genes, show levels of divergence both within and between species that are considerably higher. Although no single threshold delineates species, eukaryotic populations with >1% genome-wide sequence divergence are likely separate species, whereas prokaryotic populations with 1% divergence are still able to recombine and thus can be considered the same species.

Abstract P2075: Impact of a Minimally Processed Provegetarian Diet on LDL-cholesterol and Cardiovascular Risk Factors in Adults with Heterozygous Familial Hypercholesterolemia: a Randomized Controlled Feeding Trial

Introduction: Heterozygous familial hypercholesterolemia (HeFH) is a severe genetic disorder that accelerates atherosclerosis and leads to premature cardiovascular diseases (CVDs). Minimally processed provegetarian diets are recommended in dietary and clinical guidelines worldwide for their cardioprotective properties. However, the impact of such diet on LDL-cholesterol (LDL-C) and other CVD risk factors has not yet been assessed in fully controlled feeding settings among adults with HeFH. Hypothesis: We tested the hypothesis that a minimally processed provegetarian diet (MPVD) induces clinically significant improvements in plasma LDL-C levels (primary outcome) and other CVD risk factors compared to a standard American diet (SAD) among adults with HeFH. Methods: In this randomized, crossover, controlled feeding trial, 50 adults with genetically confirmed HeFH, free of cholesterol-lowering medication, consumed a MPVD and a SAD for 4 weeks each in a random order under fully controlled feeding conditions. Fasting plasma atherogenic lipid levels and other CVD risk factors were measured at the end of each diet. Results: Relative to the SAD, the MPVD induced a clinically significant reduction in LDL-C (−18.6%, 95% confidence interval (CI) −22.1%, −15.2%; P <0.0001). Stratified analyses revealed no evidence of effect modification due to sex, LDL-receptor genotype, and BMI. However, a greater reduction of LDL-C was observed in older participants ( P diet*age =0.02) and in those with lower lipoprotein(a) levels ( P diet*Lp(a) =0.02). The MPVD also reduced apolipoprotein B (−15.2%, 95%CI −18.3%, −12.0%), non-HDL-C (−18.0%, 95%CI −21.0%, −14.8%), triglycerides (−8.6%, 95%CI −14.4%, −2.2%), and systolic (−2 mm Hg, 95%CI −3.3 mm Hg, 0.0 mm Hg) and diastolic (−2 mm Hg, 95%CI −3.4 mm Hg, −0.5 mm Hg) blood pressure. Overall, the MPVD reduced the 10-year risk of CVD by 1.55% ( P =0.03). Moreover, while the two diets were isocaloric and had the same macronutrient composition, the MPVD improved satiety compared to the SAD, with the effect being more important among men ( P diet*gender =0.03). Conclusion: This study demonstrates that, compared to a standard American diet, a minimally processed provegetarian diet induces clinically significant reductions in LDL-C and other CVD risk factors in adults with HeFH. It paves the way for developing precision nutrition strategies that incorporate gender-specific counseling and underscores the critical role of diet modification in HeFH management.