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Abstract P1079: Association Between Blood Sugar Counseling at Dental Visits and Diabetes Status: Findings from the 2011-2020 National Health and Nutrition Examination Survey

Almost 10 million adults across the United States are unaware that they have diabetes. Despite the strong link between diabetes and adverse oral health outcomes, blood sugar screening is not routine procedure in dental offices. To examine the association between receiving blood glucose counseling from dentist. Cross-sectional data from the 2011-2020 National Health and Nutrition Examination Survey assessed the relationship between blood sugar screening advice by dentists, and diabetes status. The primary exposure was defined as whether individuals were advised by their dentist to check their blood sugar, assessed with the survey question: “In the past 12 months, did a dentist, hygienist, or other dental professional have a direct conversation with you about the dental health benefits of checking your blood sugar?” The outcome variable was categorized into four levels of diabetes status: no diabetes, prediabetes, undiagnosed diabetes, and diagnosed diabetes. We fitted weighted multinomial logistic regression models; first conducting an overall analysis, then performing race-specific analyses to examine how the association between dental blood sugar counseling and diabetes status varied across four racial/ethnic groups. The sample included 14,057 U.S. adults, mean age 53 (±16) years; 52% were female. With prediabetes as the reference group, those with no diabetes had a lower relative risk of receiving blood glucose counseling from dentists (RRR:0.49, 95% CI:0.27, 0.89), while those with diagnosed diabetes were more likely to receive this counseling (RRR:13.71, 95% CI:7.51, 25.03). Race-specific analyses showed variations in this association. For diagnosed diabetes, non-Hispanic White adults showed the strongest association (RRR:13.71, 95% CI:7.51, 25.03), followed by non-Hispanic Asian adults (RRR:10.28, 95% CI: 3.63, 29.08), Hispanic adults (RRR:4.50, 95% CI:2.69, 7.51), and non-Hispanic Black adults (RRR:3.09, 95% CI:1.89, 5.06). Notably, among non-Hispanic Asian adults, undiagnosed diabetes was also strongly associated with counseling (RRR:7.06, 95% CI:1.97, 25.26). Receiving blood glucose counseling during dental visits showed strong associations with diagnosed diabetes, suggesting dentists’ potential to contribute significantly to diabetes management. The varying strengths of this association across racial and ethnic groups may be opportunities for targeted interventions, such as integrating blood sugar screening and counseling into routine dental care.

Unlocking the therapeutic potential of unexplored phytocompounds as hepatoprotective agents through integration of network pharmacology and in-silico analysis

Abstract P2123: Feasibility and acceptability of <i>Boost Your Balance</i> : A digital Intervention to improve balance confidence and reduce fall risk in older women

Introduction: Fear of falling affects nearly 50% of older women, leading to activity restriction and an increased risk of developing cardiovascular disease. Balance training is the most effective intervention to improve balance confidence and reduce falls, lowering fall rates by 23%. However, most older adults, particularly women, do not engage in routine training. Digital interventions can improve the accessibility, scalability, and cost-effectiveness of balance training, but evidence supporting home-based, remotely-guided interventions to reduce fall risk in community-dwelling older adults is limited. This pilot study examined the feasibility and acceptability of Boost Your Balance , an 8-week multi-component, remotely-guided, digital balance intervention in older women. Methods: We enrolled 69 older women (mean age 81) of varying self-reported physical function and physical activity levels, who were part of the intervention arm of the Women’s Health Initiative Strong and Healthy ( WHISH ) trial. We sent participants an email containing a balance education, movement training, and balance exercise video. We then sent the balance exercise video 3 times per week for 8 weeks. Pre-determined benchmarks for feasibility and acceptability included program satisfaction, adverse event rates, recruitment and retention rates, and the ability to perform and upload videos of functional performance tests. We conducted semi-structured interviews to explore participants’ experiences and barriers to participation. Results: We achieved many of our pre-established benchmarks, with qualitative data offering valuable insights for improvement. Most participants rated the program as "extremely" helpful, showing high satisfaction with the intervention. The majority appreciated the ease of access to the intervention components, highlighting their helpfulness in improving balance. Additionally, 100% of participants indicated they would recommend the program to a friend. Barriers to participation included factors like travel, acute illness, and lack of time. Very few participants found any aspect of the program unhelpful. Suggestions for improvement included requests for more specific exercise instructions and additional exercises to maintain balance gains. Conclusions: Results of this study support the feasibility and acceptability of the Boost Your Balance intervention and highlight its potential for broader implementation as a scalable solution for fall prevention in older women.

Abstract P3092: Improvements in Hemoglobin A1c among Diabetic and Prediabetic Participants of a Mobile Health Cardiovascular Program

Background: Cardiovascular disease (CVD) is the leading cause of death globally, and diabetes is a significant independent risk factor. Mobile health (mHealth) technology can enable effective self-management of CVD risk factors. This study evaluates the impact of an mHealth cardiovascular risk self-management program designed to promote behavioral and lifestyle changes on hemoglobin A1c (HbA1c) among participants with diabetes or prediabetes. Methods: We analyzed real-world data from participants of the mHealth program between January 2020 and April 2024. Participants were included in the analysis if they had an A1c of &gt; 5.7% or a previous diagnosis of diabetes, as well as at least two A1c values available from linked electronic health records. Change in A1c was evaluated from baseline (measured up to 6 months before program enrollment) to follow-up. Participants were stratified according to their baseline A1c values (well-controlled: &lt;7%; fairly-controlled: 7% to 9%; poorly-controlled: &gt;9%) to separately evaluate the effects of program membership on A1c outcomes among individuals with different levels of diabetes severity. Results: A total of 4,358 participants (mean age 56.2±11.2 years, 56.8% female, mean baseline A1c 6.8±1.4%) were included (Table 1). The mean follow-up period was 312.4 days. Pre- and post-enrollment A1c values are graphed in Figure 1. Participants with poorly-controlled baseline A1c (&gt;9%, n =352) showed a significant reduction of 2.1% (from 10.1±1.4% to 8.0±1.9%; t (351) = -18.0, p &lt; 0.001, d = -0.96). Those with fairly-controlled baseline A1c (7–9%, n =1,073) experienced a modest decrease of 0.2% (from 7.5±0.56% to 7.3±1.11%; t (1,072) = -7.2, p &lt; 0.001, d = -0.22). Participants with well-controlled baseline A1c (&lt;7%, n =2,933) remained well-controlled, with a clinically insignificant increase of 0.1% (from 6.0% to 6.1%; t (2,932) = 4.8, p &lt; 0.001, d = 0.09). Conclusion: Participants of an mHealth cardiovascular risk self-management program with poorly-controlled baseline A1c (&gt;9%) decreased A1c significantly, while those with well-controlled baseline A1c (&lt;7%) maintained A1c in this range. These findings highlight the potential of mHealth technology to support control of diabetes in the context of managing CVD risk.

Enhancing fetal ultrasound image quality and anatomical plane recognition in low-resource settings using super-resolution models

Abstract P2168: Descriptive Relationships between Respondent Characteristics, Opioid-related Mortality, and Cardiometabolic Disease Mortality in the National Longitudinal Study of Adolescent to Adult Health (Add Health)

Background: Although high opioid-related mortality rates among young-to-middle-aged adults have complicated the interpretation of cardiometabolic disease trends, a US population-based assessment of overlap among risk factors for opioid-related and cardiometabolic disease mortality could clarify the trends. Methods: We described associations of opioid-related and cardiometabolic disease mortality with respondent characteristics at Wave I in the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative longitudinal cohort of 20,745 US middle to high school students aged 12-19 in 1994-1995. Respondents with missing sampling weights or birthdates were excluded. We identified cardiometabolic disease and opioid-related deaths (definite; probable; suspect) through 12/31/22 using International Classification of Disease (ICD-10) codes (I00-I99 or E00-E88; doi.org/10.17615/zbe9-rh36). We computed cumulative mortality incidence weighted to the source population using life tables. We estimated the relative risk (95% CI) between mortality and baseline demographic, geographic, and behavioral measures (smoking; problem drinking; illegal drug use; substance use among friends; availability of cigarettes, alcohol, and illegal drugs in the home) using contingency tables. Results: We identified 658 deaths among 18,891 respondents (median age: 43) over 513,368 person-years of follow-up. Cumulative incidence for overall, opioid-related, and cardiometabolic disease mortality was 3.77%, 0.80%, and 0.63%. The relative risk of opioid-related death was higher among respondents at age&lt;median, 1.25 (0.73-2.13); men, 2.18 (1.29-3.71); non-Hispanic (nH) whites, 2.52 (1.52-4.16); in the Northeast versus other regions, 1.58 (0.94-2.68); and rural versus urban/suburban areas, 1.50 (0.86-2.61) while the relative risk of cardiometabolic disease death was higher among respondents at age&gt;median, 1.58 (0.95-2.62); men, 1.87 (1.10-3.18); nH blacks, 2.01 (1.15-3.51); in the South versus other regions, 1.67 (1.01-2.76); and rural versus urban/suburban areas, 1.47 (0.84-2.59). All behavioral measures were associated with opioid-related mortality and a subset were associated with cardiometabolic disease mortality. Conclusion: Opioid-related and cardiometabolic disease mortality share several demographic, geographic, and behavioral risk factors, suggesting that opioid-related mortality may be influencing cardiometabolic disease trends in the US population.

Abstract MP67: Late-Life Physical Activity and Change in Cognitive Function and Risk of Dementia: The Atherosclerosis Risk in Communities Neurocognitive (ARIC-NCS) Study

Introduction: Physical activity (PA) has been identified as a modifiable factor inversely associated with cognitive decline and dementia risk. However, most longitudinal studies to date have short follow-up and report inconsistent results on the benefit of PA to support brain health among older adults. In this study, we hypothesized that higher levels of PA measured in late life would be associated with slower rates of global and domain-specific cognitive decline and a lower risk of dementia over ~10 years in late life. Methods: Dementia-free participants (n=5,982; mean age: 76 years; 42% male, 23% Black) who completed the interviewer-administered Modified Baecke PA Questionnaire at ARIC visit 5 (2011-2013) were included. Using the PA component of the American Heart Association’s Life’s Simple 7, participants’ PA levels were categorized as ideal, intermediate, or poor. Cognitive tests were administered at ARIC visits 5 (2011-13), 6 (2016-17), 7 (2018-19), 8 (2020), and 9 (2021-22), and were used to calculate factor scores for global cognitive function and the domains of memory, language, and executive function. Linear mixed models estimated the association of PA with change in cognitive function. Dementia cases were defined by adjudicated review, telephone interviews, informant interviews, hospitalization records, and death certificates. Dementia risk was estimated using Cox proportional hazards regression models. All models adjusted for age, sex, race-center, education, APOE-ε4 allele, smoking, hypertension, body mass index, and diabetes. Results: Participants with ideal or intermediate PA, compared to poor PA, had slower rates of decline in global cognition, but no significant differences in rates of decline across individual cognitive domains. Over a median follow-up of 7.8 years, participants with ideal (adjusted hazard ratio [HR] = 0.62, 95% CI: 0.60, 0.67) or intermediate (adjusted HR = 0.87, 95% CI: 0.80, 0.91) PA had a reduced risk of dementia compared to participants with poor PA. Conclusions: Higher PA levels in late life demonstrated a protective association with long-term global cognitive decline and incident dementia. Although further research with more frequent and objective measures of PA is needed to determine the duration, frequency, and intensity of PA recommended to promote brain health in older adults, our findings suggest that promoting PA among aging populations offers a non-invasive and accessible approach to support brain health.

The effects of photosynthetic rate on respiration in light, starch/sucrose partitioning, and other metabolic fluxes within photosynthesis

Abstract P3032: Low Intrinsic Capacity and Cardiometabolic Multimorbidity Are Jointly Associated with a Higher All-cause Mortality Risk Among Chinese Older Adults

Introduction: Intrinsic capacity (IC), encompassing all physical and mental capacities of an individual, is key to healthy aging. Despite increasing emphasis on person-centered care for older adults with cardiometabolic multimorbidity (CMM), the joint effect of IC and CMM on mortality risk is poorly understood. Methods: We included participants aged 65 years and older recruited from five waves of the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2014, with follow-up to 2018. IC was assessed across five domains: cognition, locomotor, sensory function, psychological well-being, and vitality. IC scores were calculated as a percentage of the maximum possible (100) and dichotomized by the median. CMM was defined as the presence of two or more diseases among hypertension, diabetes, stroke or CVD, or heart disease at baseline. We used Cox proportional hazards models to examine the individual and joint effects of IC and CMM on all-cause mortality risk. All models were adjusted for demographics, lifestyles, and Activities of Daily Living. Results: Among 21,097 participants (mean age 84.9 years, 56.0% female), 11,753 deaths were recorded over a median follow-up duration of 3.7 (IQR: 1.6–7.5) years. We found either having CMM (Hazard Ratio = 1.13, 95% CI: 1.04–1.21) or low IC (HR = 1.35, 95% CI: 1.29–1.41) was significantly associated with a higher mortality risk, respectively. In the joint analysis ( P -interaction = 0.026), compared to those with high IC and no CMM, participants with low IC combined with having CMM exhibited the highest mortality risk (HR = 1.40, 95% CI: 1.27–1.55). Conclusions: Low IC and having CMM were jointly associated with a higher all-cause mortality risk among older Chinese adults.

Abstract P1012: Higher Cardiorespiratory Fitness in Midlife is Associated with Postponement of Morbidity and Longer Life

Introduction: Delaying the onset of disease so that morbidity is compressed into a shorter period before death can improve quality of life and lower healthcare costs. Cardiorespiratory fitness (CRF) is one of the strongest known predictors of health, but its association with morbidity compression is unclear. Methods: We examined whether higher CRF in midlife is associated with morbidity compression and life extension (i.e., living a longer, healthier life) among older adults. The sample included 26,237 Cooper Center Longitudinal Study participants (n=19,569 men; n=6,668 women) who had CRF estimated via maximal treadmill test at a mean age of 48.5 (SD: 9.7) years and were later enrolled in Medicare. Participants were healthy through age 66.5 years. Morbidity was defined as incidence of any of the following 11 chronic conditions identified from the Chronic Condition Warehouse: heart failure, ischemic heart disease, stroke, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, dementia, or colorectal, lung, breast, or prostate cancer. Illness-death models were used to estimate the likelihood of transitioning between states of health, morbidity, and death by relative CRF, categorized as low (quintile 1), moderate (quintiles 2-3), or high (quintiles 4-5) based on age- and sex-specific distributions. Sex-stratified models adjusted for year of birth, age, smoking, BMI, fasting glucose, cholesterol, and blood pressure. Model parameters were used to estimate Aalen-Johansen state probabilities, and simulated Markov chains were used to calculate expected occupancy times in each state up to age 100. Results: Among men, high (vs. low) CRF was associated with postponement of morbidity (HR: 0.78, 95% CI: 0.72, 0.84) and death after morbidity (HR: 0.61, 95% CI: 0.54, 0.69). Among women, high (vs. low) CRF was similarly associated with postponement of morbidity (HR: 0.83, 95% CI: 0.73, 0.94) but not death after morbidity (HR: 0.85, 95% CI: 0.67, 1.09). On average, participants with high (vs. low) CRF developed morbidity 1.0 (women) – 1.1 (men) years later and had longer life expectancies (women: age 89.5 vs. 88.1; men: age 87.0 vs. 84.6) ( Figure ). Conclusions: High CRF at midlife was associated with a roughly 1-year extension of healthy life and a 1.4-2.4-year extension of total life expectancy. Interventions that improve CRF through lifestyle behaviors may contribute to meeting AHA’s 2030 Impact Goal of increasing healthy life expectancy by two years.

Characterization and machine learning analysis of hybrid alumina-copper oxide nanoparticles in therminol 55 for medium temperature heat transfer fluid

Abstract Efficient heat dissipation is crucial for various industrial and technological applications, ensuring system reliability and performance. Advanced thermal management systems rely on materials with superior thermal conductivity and stability for effective heat transfer. This study investigates the thermal conductivity, viscosity, and stability of hybrid Al2O3-CuO nanoparticles dispersed in Therminol 55, a medium-temperature heat transfer fluid. The nanofluid formulations were prepared with CuO-Al2O3 mass ratios of 10:90, 20:80, and 30:70 and tested at nanoparticle concentrations ranging from 0.1 wt% to 1.0 wt%. Experimental results indicate that the hybrid nanofluids exhibit enhanced thermal conductivity, with a maximum improvement of 32.82% at 1.0 wt% concentration, compared to the base fluid. However, viscosity increases with nanoparticle loading, requiring careful optimization for practical applications. To further analyze and predict thermal conductivity, a Type-2 Fuzzy Neural Network (T2FNN) was employed, demonstrating a correlation coefficient of 96.892%, ensuring high predictive accuracy. The integration of machine learning enables efficient modeling of complex thermal behavior, reducing experimental costs and facilitating optimization. These findings provide insights into the potential application of hybrid nanofluids in solar thermal systems, heat exchangers, and industrial cooling applications.

Correction for Qin et al., A signaling molecule from intratumor bacteria promotes trastuzumab resistance in breast cancer cells

Abstract P3131: Epic Cosmos Can be Used to Model the Population Impact of Lowering Low-Density Lipoprotein-Cholesterol Goals in Secondary Prevention of Atherosclerotic Cardiovascular Disease

Introduction: Traditionally, access to HIPAA-compliant nationally representative data has been difficult. Cosmos by Epic aims to simplify access to big data for epidemiological research. We used Cosmos to evaluate the population impact of upcoming revised cholesterol guidelines. The upcoming guidelines might lower the LDL-C goal to 55 mg/dL from the current 70 mg/dL goal set by the 2018 ACC/AHA cholesterol guidelines. Hypothesis: We hypothesized that a democratized business analytic tool like Cosmos can be leveraged to estimate the population-level impact of guideline and policy changes. Methods: Cosmos was queried using the patient data model to identify adult patients (≥ 18 years) with clinical ASCVD, defined using a combination of ICD-10 codes and SNOMED CT custom groupers. Patients were included if they had at least 1 LDL-C value recorded between September 2022 and September 2024, and only the most recent value was used in our analysis. The population was sliced using the Lab Component à LDL and Medication filters to assess LDL-C levels and lipid lowering therapy (LLT) utilization. Results: We identified 6,657,563 patients with clinical ASCVD (mean age 69, 53.8% male, 81.7% White). Most of the patients (60.0%) had LDL-C above 70 mg/dL, 19.4% had an LDL-C between 55-70 mg/dL, and 20.8% had an LDL-C below 55 mg/dL ( Figure ). Among the 1,290,111 patients with an LDL-C between 55-70 mg/dL, 79.8% were on statin monotherapy, 47.3% were on a high intensity or maximally tolerated statin, 11.3% were receiving non-statin LLT, and 8.9% had no record of any LLT ( Table ). Conclusions: Our analysis highlights the potential of Epic Cosmos as a powerful tool for answering epidemiological questions using real-world data. In this cohort of 6.7 million patients with ASCVD, about 1.3 million (19.4%) individuals with an LDL-C between 55-70 mg/dL would be considered to have uncontrolled cholesterol if the LDL-C target is lowered to &lt;55 mg/dL in the future ACC/AHA cholesterol guidelines. Less than half of these patients were on high-intensity or maximally tolerated statins, about 1 in 10 were on non-statin LLTs, and around 9% were not receiving any LLT at all. This presents a substantial opportunity for treatment escalation or initiation to help these individuals achieve lower LDL-C targets.

Abstract P1061: Parental Feeding Practices and Cardiovascular Health in Children and Adolescents: the Young Hearts Study

Background: Feeding practices, such as using food as a reward or for emotional regulation, may impact the ability of children to develop healthy emotional coping strategies increasing the risk of weight gain. However, the association between feeding practices and behavioral cardiovascular health (bCVH) in children and adolescents is poorly understood. Methods: We utilized data from the Young Hearts study, an ongoing cohort of children and adolescents that aims to study CVH. Parents completed surveys on CVH behaviors and a modified version of the Comprehensive Feeding Practices Questionnaire. We included all children ages 0-17 with complete baseline surveys. Feeding practice scores were calculated by summing parent-reported behaviors (0-5). We calculated a composite bCVH score by averaging scores on the four behavioral components of the American Heart Association Life’s Essential 8 (diet, physical activity, nicotine exposure, and sleep) and self-reported body mass index (all ranging from 0=poorest to 100=most ideal). We used linear regression to assess the association between feeding practices and bCVH adjusting for age, sex, race, ethnicity, and household income. Results: Of 6,892 included children, 47.6% were female and 46% were non-Hispanic White, with an average age of 8.7 [SD 5.5] years. In adjusted models, each 1-unit higher score for food as reward and food for emotional regulation feeding practices, respectively, were associated with -2.23 (95% CI = -2.61,-1.86) and -2.81 (-3.20, -2.41) point lower bCVH scores. Among individual CVH metrics, food as reward was most strongly associated with diet (-4.90; -5.65, -4.15), whereas food for emotional regulation was most strongly associated with physical activity (-4.98; -5.90, -4.06). Conclusion: Select feeding practices are inversely associated with multiple CVH behaviors, not just diet quality, among children and adolescents. Promoting positive emotional coping strategies in place of food may improve CVH in children and adolescents.

Sex-specific attenuation of constant light-induced memory impairment and Clock gene expression in brain in hepatic Npas2 knockout mice

Abstract NPAS2 (Neuronal PAS Domain Protein 2) is a component of the core circadian clock and the coordinated activity between central brain and peripheral liver clock proteins postulated to be instrumental for linking behaviour and metabolism. We investigated a conditional liver-specific knockout mouse model (Npas2-/- or cKO) to explore its function in activity, circadian rhythms and cognition (novel object recognition-NOR). Circadian rhythms showed no genotype differences. Constant-light reduced NOR in floxxed controls but remarkably not in Npas2-/- mice, particularly females. Consistent with entrainment of systemic and central circadian biology, N pas2-/- mice showed altered expression of circadian gene Clock in frontal cortex. Sex differences independent of genotype were found in expression of circadian genes Clock, Bmal1 and Reverb-b in brain. Sex differences in Clock were absent in N pas2-/- mice. Females showed greater period length and phase response to constant light independently of genotype. The data suggest that a role for peripheral NPAS2 in constant light-induced memory impairment in females, and potential mediation by altered cortical circadian Clock gene expression, merit further investigation. These findings have implications for the interaction between peripheral and central circadian clocks, circadian sex differences and the deleterious effects of constant light on cognition.

Preprint sites bioRxiv and medRxiv launch new era of independence

Abstract P3100: Associations of maternal salt intake with low birth weight and small for gestational age in a large cohort

Background: Excessive salt intake has been strongly associated with multiple health conditions, while evidence linking salt consumption during pregnancy and birth outcomes remains limited. Methods: We included 4,267 mother-child pairs from a prospective cohort study which has been followed since 2017 in Shanghai, China. Salt consumption was estimated based on cooking salt and soy sauce from household condiment weighing measurements over a week, and then categorized into &lt;5.0 (reference), 5.0-10.0, and ≥10.0 g/day. Salt density was calculated as the amount of salt divided by total energy intake from food frequency questionnaires. Outcomes related to birth weight were defined according to standard clinical cutoffs, including low birth weight (LBW), macrosomia, small for gestational age (SGA), and large for gestational age (LGA). Results: Multivariable-adjusted odds ratios (ORs) of LBW were 1.72 (95% CI 1.01-2.91) for 5.0-10.0 g/day salt intake, and 2.06 (95% CI 1.02-4.13) for ≥10.0 g/day, compared to those of &lt;5.0 g/day ( P -trend=0.04). For SGA, ORs were 1.46 (95% CI 1.09-1.97) for 5.0-10.0 g/day and 1.69 (95% CI 1.16-2.47; P -trend=0.006) for ≥10.0 g/day. Similarly, OR comparing extreme tertile (high vs. low) of salt density was (1.91; 95% CI 1.08-3.36; P -trend=0.01) for LBW and (1.63; 95% CI 1.18-2.25; P -trend&lt;0.001) for SGA. No significant associations were observed for salt intake in relation to macrosomia or LGA. These findings remain stable in all sensitivity and subgroup analyses. Conclusions: In this study, habitual salt intake above 5 g/day was associated with increased risks of LBW and SGA, which warrants confirmation by interventional studies.

Abstract P2122: Occupational Physical Activity and Mortality Risk: Evidence from a Nationally Representative U.S. Sample (NHANES 1999-2006)

Background: Leisure-time physical activity (LTPA) is associated with health benefits, but emerging evidence suggests occupational physical activity (OPA) may have paradoxically negative health associations. Limited U.S. data hinders understanding of this phenomenon in the American workforce. This study examined associations between OPA and mortality in a representative U.S. sample. Methods: Data from 8,041 working adults (baseline age 41.4±0.2, 55.9% female, 80.5% non-Hispanic White) in the 1999-2006 National Health and Nutrition Examination Survey, linked to 2019 National Death Index, were analyzed. Participants worked ≥35 hours/week and had complete data on all included variables. Self-reported jobs were classified into standard occupational classifications and categorized as low, intermediate, or high OPA. Cox proportional hazards models estimated hazard ratios (HR) for all-cause and cardiovascular disease (CVD) mortality across OPA categories, adjusting for age, sex, race-ethnicity, education, smoking status, alcohol consumption, body mass index, self-reported CVD, and LTPA. Effect modification by sex, race-ethnicity, smoking, and LTPA was examined. Results: In fully adjusted models, intermediate OPA was associated with higher all-cause mortality (HR 1.24, 95% CI 1.00-1.53) compared to low OPA. For CVD mortality, both intermediate (HR 1.79, 95% CI 1.16-2.75) and high OPA (HR 1.71, 95% CI 1.00-2.92) showed increased risk compared to low OPA. Associations varied by subgroups: females with high OPA had higher all-cause mortality risk (HR 1.59, 95% CI 1.05-2.41) compared to low OPA. Among never smokers, high OPA was associated with increased CVD mortality (HR 3.44, 95% CI 1.26-9.37). Surprisingly, among those meeting LTPA guidelines, high OPA was associated with the highest CVD mortality risk (HR 6.21, 95% CI 2.10-18.39). Conclusion: This analysis supports the OPA health paradox in a U.S. population, with higher OPA levels associated with increased mortality risk, particularly from CVD. Associations varied across subgroups, highlighting the complexity of the OPA-health relationship and potential implications for health disparities. The unexpected finding of heightened risk among those meeting LTPA guidelines warrants further investigation. Results underscore the need for targeted interventions and workplace policies to mitigate health risks for workers in high-OPA occupations, especially among vulnerable populations.

Development of convergent adaptations reveal highly conserved early ontogenetic skull shape in fishes with amphibious vision

Reply to Ye: Parallel progress in funder practices and expansion of academic incentives to support engaged research