Browse Articles

Abstract P3091: Participant Perceptions of Diet-Related Feedback Messages: Insights from the SMARTER Trial Focus Groups

Background: Mobile health (mHealth) interventions may provide a more accessible approach to a broader segment of the population needing weight loss treatment. Little is known about individuals’ perceptions of remotely-delivered diet-related feedback (FB) messages. Methods: The aim of this analysis was to assess perceptions of diet-related FB among participants randomized to the FB intervention (n = 251) of SMARTER, a randomized controlled trial that examined the efficacy of a 12-month remotely-delivered mHealth intervention targeting weight loss. Participants were asked to self-monitor (SM) diet using a commercial app and received FB messages in real-time in response to the SM data at least once daily. We conducted six focus groups (N=23) via Zoom to discuss participants’ perceptions of the FB intervention. Trained experts in qualitative research used a semi-structured focus group guide to facilitate discussion on how study participants interacted with technology and the FB they received. Participants were invited to participate in one of two focus groups based on weight loss at 12 months and average step counts during the 30 days prior to their 12-month assessment. After the final study visit, eligible participants were invited to participate in the focus groups and provided noteworthy comments. The data were analyzed using ATLAS.ti (version 9). Results: Four key themes emerged from the content analysis pertaining to FB and broader study issues: timing of the FB notifications, personalization of FB messages, issues with the SM app, and social aspect of the study design. Participants found FB helpful to engage in SM behaviors and reported a desire for more personalized FB messages related to diet. Some participants voiced a desire to set their own schedule for FB message delivery to ensure FB could be viewed when received. They also identified two challenges: the limited selection of foods in the diet SM app which in turn may have affected their SM and FB messaging and the absence of a social community. Conclusions: Our results suggest that giving participants the flexibility for FB notifications to align with their schedules and phone accessibility may improve receipt of FB and engagement. There is a need to enhance the personalization of FB while maintaining the scalability for a broader population reach. Incorporating contact with a coach to supplement remotely-delivered FB may further improve participant engagement in changing nutrition habits.

Modeling current and future distributions of invasive Asteraceae species in Northeast China

Abstract 012: Pilot Testing of Hypertension Management Support with EHR-Integrated Telemonitoring and Automated Patient Messaging for Patients at High Risk from Hypertension

Introduction: Remote patient monitoring (RPM) of blood pressure (BP) can help support hypertension management. To improve the timely interpretation and action based on home BP values, automated messages providing clinical guidance could be delivered to patients based on the results of their home BP monitoring and used to encourage monitoring when additional information is needed for decision making. We hypothesized that among patients with elevated office BP at increased risk from hypertension due to coexisting cardiovascular disease, renal disease or diabetes mellitus, RPM with automated patient messages delivered through an EHR portal would lead to antihypertensive medication adjustments and improved home BP values. Methods: This was a pilot test of RPM with automated messages to patients sent in response to home BP values. Seven clinicians (5 primary care physicians and two nephrologists) reviewed lists of their patients with qualifying comorbidities whose most recent two office BP were ≥140/90 mm Hg (n = 285). Standardized home BP readings supervised by study staff were taken at baseline and 3 months, with follow up at 9 months planned. Antihypertensive medication changes, number of messages sent, and number read by the patient were assessed from EHR data. Results: Clinicians gave approval for 82% (n = 234) of eligible patients to be contacted, of whom 30% (n=70) enrolled. Of enrollees, 31% were non-Hispanic White and 60% were non-Hispanic Black, 69% were female. Baseline mean (SD) office BP was 143 (16) / 79 (11) mm Hg and their baseline mean home BP was 141 (17) / 83 (14) mm Hg. At the 3-month follow up, mean home BP had declined to 130 (15) / 78 (12) mm Hg; p<0.001/<0.001. After a median follow up of 5 months, patients had received a median (IQR) of 6 (5 to 8) messages, and 75% were read. Blood pressure medication changes were common with 50 (71%) having at least one medication change (36% had antihypertensive therapy increased, 9% decreased, and 27% had both types of changes); median (IQR) number of medication changes was 1 (0-3). Conclusions: Among high-risk patients with uncontrolled office BP who received RPM and automated patient portal messaging, medication adjustments were common and home BP was lower at 3 months. Patient and clinician feedback will be used to inform improvements. Future work should consider whether RPM with automated messaging is an effective solution to maintain and improve BP while not over-burdening the health system.

Abstract P3034: Plasma branched-chain amino acid levels and cardiovascular disease risk factors: a longitudinal analysis of a lifestyle trial

Purpose: Branched-chain amino acid (BCAAs) levels have been associated with a higher risk of cardiovascular diseases (CVD), but studies of CVD risk factors have mainly been cross-sectional. We examined the longitudinal association between changes in BCAA levels and CVD risk factors in a lifestyle trial. Method: We used data on 708 male and female participants, aged 25-78, of the U.S. PREMIER study. Data and biospecimens were from the NHLBI Biologic Specimen and Data Repository Information Coordinating Center. Participants were divided into control, lifestyle intervention, or lifestyle plus DASH diet groups. Biomarkers were measured with NMR spectroscopy. Multiple linear regression models assessed changes in BCAA levels in relation to changes in cardiometabolic risk factors over 6 months. Estimates were expressed per SD change in BCAA levels and adjusted for age, sex, race, marital status, region, and body mass index changes. Results: Increases in BCAA levels were associated with increases in insulin resistance (HOMA-IR) (Beta = 0.22, SE = 0.07, p = 0.005), inflammation (GlycA) (Beta = 0.03 mmol/l, SE = 0.004, p <0.001), Apolipoprotein B (Beta = 0.02 g/l, SE = 0.006, p <0.001), and VLDL-cholesterol levels (Beta = 0.03 mmol/l, SE = 0.007, p <0.001).. Associations for other lipoprotein measures differed for individual BCAAs. Increases in valine were associated with LDL-cholesterol (Beta = 0.07 mmol/l, SE = 0.01, p <0.001), with no significant association for leucine and isoleucine. Isoleucine was inversely associated with HDL-C (Beta = -0.03 mmol/l, SE = 0.01, p <0.001) and Apolipoprotein A (Beta = -0.02 g/l, SE = 0.009, p = 0.004). Also, leucine was inversely associated with HDL-C (Beta = -0.04, SE = 0.01, p <0.001), Apolipoprotein A (Beta = -0.03, SE = 0.009, p <0.001) and triglyceride (Beta = -0.05 (mmol/l), SE = 0.01, p = 0.004) while valine had a direct association with HDL-C (Beta = 0.03, SE = 0.01, p <0.001), Apolipoprotein A (Beta = 0.04, SE 0.009, p <0.001) and triglyceride (Beta = 0.06, SE = 0.01, p = 0.001). BCAA levels were not significantly associated with fasting glucose and blood pressure. Conclusion: Increases in BCAA levels were associated with insulin resistance, inflammation, and unfavorable lipid profiles. These findings support BCAA levels as a target for CVD prevention. Further research is warranted to elucidate possible differences in the effects of individual BCAAs on lipid metabolism.

A cross linguistic study on orthographic influence during auditory word recognition

Abstract Learning to read affects speech perception. For example, the ability of listeners to recognize consistently spelled words faster than inconsistently spelled words is a robust finding called the Orthographic Consistency Effect (OCE). Previous studies located the OCE at the rime level and focused on languages with opaque orthographies. This study investigates whether the OCE also emerges at the phonemic level and is a general phenomenon of languages with alphabetic scripts, including those with transparent writing systems. Thirty French (opaque language) and 30 Spanish (transparent language) listeners participated in an auditory lexical decision task featuring words and pseudowords including either only consistently spelled phonemes or also inconsistently spelled phonemes. Our results revealed an OCE in both French and Spanish which surfaced as longer reaction times in response to inconsistently spelled words and pseudowords. However, when analyzing the data split by language, the OCE was only detectable in French but not in Spanish. Our findings have two theoretical implications. First, they show that auditory lexical processing is impacted by orthographic information that is retrieved at the phonemic level, not just the rime level. Second, they suggest that the OCE may be modulated by a language’s opacity. In conclusion, our study highlights the depth of literacy effects on auditory language processing and calls for further investigations involving highly transparent languages.

Daily briefing: NASA begins mass firings of scientists

Prevalence and Clinical Outcomes of Discordant Lesions Between Fractional Flow Reserve and Nonhyperemic Pressure Ratios in Clinical Practice: The J-PRIDE Registry

BACKGROUND: Limited large-scale, real-world data exist on the prevalence and clinical impact of discordance between fractional flow reserve (FFR) and nonhyperemic pressure ratios (NHPRs). METHODS: The J-PRIDE registry (Clinical Outcomes of Japanese Patients With Coronary Artery Disease Assessed by Resting Indices and Fractional Flow Reserve: A Prospective Multicenter Registry) prospectively enrolled 4304 lesions in 3200 patients from 20 Japanese centers. The lesions were classified into FFR+/NHPR−, FFR−/NHPR+, FFR+/NHPR+, or FFR−/NHPR groups according to cutoff values of 0.89 for NHPRs and 0.80 for FFR. The primary study end point was the cumulative 1-year incidence of target vessel failure (a composite of cardiac death, target vessel–related myocardial infarction, and clinically driven target vessel revascularization) on a lesion basis. RESULTS: An NHPR cutoff value of 0.89, determined using online software, predicted an FFR of 0.80 across various NHPR types. Discordance between FFR and NHPRs was observed in 20% of lesions (FFR+/NHPR−, 11.2%; FFR−/NHPRs+, 8.8%). Revascularization was deferred in 42.9% and 88.4% of the FFR+/NHPR− and FFR−/NHPR+ groups, respectively. In deferred vessels, the FFR+/NHPR− and FFR−/NHPR+ groups showed a higher 1-year incidence of target vessel failure compared with the FFR−/NHPR− group (7.9% versus 5.5% versus 1.7%; for FFR+/NHPR−, adjusted hazard ratio [aHR], 4.89 [95% CI, 2.68–8.91]; P <0.001; for FFR−/NHPR+, aHR, 2.64 [95% CI, 1.49–4.69]; P <0.001). In revascularized vessels, the 1-year target vessel failure rate was numerically higher in the FFR−/NHPR+ group than in the FFR+/NHPR+ group (9.6% versus 3.4%; aHR, 2.27 [95% CI, 0.70–7.34]; P =0.17), although with similar outcomes between the FFR+/NHPR− and FFR+/NHPR+ groups (2.3% versus 3.4%; aHR, 0.96 [95% CI, 0.37–2.38]; P =0.93). The FFR+/NHPR− group benefited from revascularization compared with medical treatment (aHR, 0.26 [95% CI, 0.08–0.86]; P =0.027); the FFR−/NHPR+ group did not (aHR, 2.39 [95% CI, 0.62–9.21]; P =0.20). CONCLUSIONS: Discordance between FFR and NHPRs was noted in 20% of lesions, and discordant deferred lesions resulted in worse outcomes than concordant negative lesions. Although the outcomes after deferring revascularization were comparable between the FFR+/NHPR− and FFR−/NHPR+ lesions, only FFR+/NHPR− lesions showed a benefit from revascularization compared with medical treatment, suggesting that an FFR-guided strategy is superior to an NHPR-guided strategy in discordant lesions. REGISTRATION: URL: https://www.umin.ac.jp ; Unique identifier: UMIN000038403.

Abstract P3070: Baseline Characteristics of Participants Enrolled in the EPIPHANY (Equity in the Prevention and Progression of Hypertension by Addressing Barriers to Nutrition and Physical Activity) Trial

Introduction: Black adults in the rural South have disproportionately higher rates of cardiovascular disease and hypertension compared to White and urban adults, largely due to socioeconomic and environmental barriers to a healthy lifestyle. These inequities highlight the need for targeted hypertension prevention programs. Methods: Through partnerships with churches in the Black Belt region of Alabama, we are conducting a cluster randomized controlled trial to test the effectiveness of community-based education alone vs. education combined with individual plus community-level peer support on the prevention and progression of hypertension. Black adults with elevated blood pressure (BP) or stage 1 hypertension, with no history of cardiovascular or kidney disease, and no history of taking antihypertensive medication were recruited from partnering churches and the community. Results: Recruitment was conducted from August 2022 to September 2024. We enrolled 30 churches from 20 counties in rural Alabama. We screened 1,270 adults, and 371 were enrolled. The most common reasons for exclusion were BP being too low, history of hypertension, and BP being too high. Randomized participants had a mean age of 41 years. Participants randomized to the intervention had a mean systolic BP of 126 mmHg and mean diastolic BP of 79 mmHg; 66% were female; 6% had less than a high school education; 83% had a Mediterranean Eating Pattern for Americans (MEPA) score of 4-11; and the median score for metabolic equivalent of task (MET) minutes per week was 728. At enrollment, 40% of intervention participants had a healthcare visit within the past year; 70% had a usual place to receive healthcare; and 9% had delayed medical care due to cost. Participants randomized to control had a mean systolic BP of 125 mmHg and mean diastolic BP of 78 mmHg; 64% were female; 3% had less than a high school education; 80% had a MEPA score of 4-11; and a median score of 954 MET minutes per week. At enrollment, 47% of control participants had a healthcare visit within the past year; 70% had a usual place to receive healthcare; and 13% had delayed medical care due to cost. Conclusion: The EPIPHANY Trial randomized a rural, Black population of individuals with elevated BP or stage 1 hypertension. Most participants are female, have at least a high school education, have poor to moderate diet, are moderately active, and have regular access to healthcare.

Conservation genetic evaluation of Juniperus communis sensu lato in Slovakia

Albuminuria in Cardiovascular, Kidney, and Metabolic Disorders: A State-of-the-Art Review

Albuminuria—increased urine albumin excretion—is associated with cardiovascular mortality among patients with diabetes, hypertension, chronic kidney disease, or heart failure, as well as among adults with few cardiovascular risk factors. Many authors have hypothesized that albuminuria reflects widespread endothelial dysfunction, but additional work is needed to uncover whether albuminuria is directly pathologic or causative of cardiovascular disease. Urinary albumin-to-creatinine ratio is an attractive, unifying biomarker of cardiovascular, kidney, and metabolic conditions that may be useful for identifying and monitoring disease trajectory. However, albuminuria may develop through unique mechanisms across these distinct clinical phenotypes. This state-of-the-art review discusses the role of albuminuria in cardiovascular, kidney, and metabolic conditions; identifies potential pathways linking albuminuria to adverse outcomes; and provides practical approaches to screening and managing albuminuria for clinical cardiologists. Future research is needed to determine how broadly and how frequently to screen patients for albuminuria, whether it is cost-effective to treat low-grade albuminuria (10–30 mg/g), and how to equitably offer newer antiproteinuric therapies across the spectrum of cardiovascular-kidney-metabolic diseases.

Abstract P2079: The prevalence and LDL cholesterol levels of familial hypercholesterolemia in an African ancestry cohort.

Background: Familial hypercholesterolemia (FH) is an inherited disorder characterized by lifelong elevated low density lipoprotein cholesterol (LDL-C). Recently, a large systematic review estimated the prevalence of FH to be 1 in 311 individuals. This estimate was largely derived from populations of European ancestry among high income nations. There is a lack of data on FH from large regions in the world and few studies exist on individuals of African ancestry. To address this gap, we examined the prevalence and phenotype of FH among over 70,000 individuals of African ancestry. We hypothesized that the prevalence and phenotype of FH is the same between African and European ancestry groups. Methods: All of Us and Geisinger’s MyCode are US-based healthcare cohorts with linked genomic sequence data and electronic health record data on over 450,000 participants. Genetic variants were collected from canonical FH genes: LDLR , APOB , and PCSK9 . Variants meeting criteria provided by the ClinGen Variant Curation Expert Panel FH guidelines were classified as pathogenic/likely pathogenic (P/LP) or variants of unknown significance (VUS). Participants were assigned into one of four ancestry groups (AFR, ASN, EUR and unclassified) using Rye. Results: We identified 211 individuals in the AFR group with a P/LP variant and 203 with a VUS. Among EUR individuals, 1,435 had a P/LP variant and 762 had a VUS. The prevalence of a P/LP variant was significantly lower in the AFR group (1 in 342) compared to the EUR group (1 in 273) (p=0.003); however, the prevalence of VUS variants was significantly higher with 1 in 356 in the AFR group compared to 1 in 515 in the EUR group (p=2.8 x10 -6 ). The AFR group was more likely to have a P/LP variant in LDLR compared to the EUR group. In All of Us, AFR individuals with a P/LP variant had pretreatment LDL-C levels of 223.0 mg/dL, versus 122.8 mg/dL without a variant. In MyCode, levels were 242.7 mg/dL with a variant and 125.6 mg/dL without. Notably, pretreatment LDL-C was significantly higher in AFR individuals with a P/LP variant (35.8 mg/dL, p=0.001) compared to EUR individuals. Conclusions: The prevalence of P/LP FH variants is lower in AFR than in EUR individuals, but the LDL-C phenotype is more severe, likely due to a higher prevalence of LDLR variants. VUS variants are more common in AFR, possibly reflecting a lack of clinical data in genetic databases. These findings highlight the need for more diversity in FH studies.

Evaluation of tractor performance, efficiency and fuel consumption in vineyard activities

Abstract Performance analyses of mechanised vineyard activities require a reliable source of information that allows proper sizing of the tractor fleet according to field requirements and an assessment of the operating costs generated by them. To achieve that, however, a large amount of data regarding the power required by machinery and their field capacity, together with fuel consumption per hour and per hectare, is needed. This research, based on CAN-bus raw data collected from narrow tractors of 75 kW through a farming management information system (FMIS) system and then processed through a Python package called Vineyardutils created by the authors resulted in a dataset that summarises 374 labelled mechanised operations over a total of 717 working hours. The summary of each operation specifies its type, duration, idle time, speed and engine parameters such as temperature, engine speed, and torque; in addition, the dataset also includes the terrain slope, fuel consumption and size of the working area. As a result, the lowest values of fuel consumption per hour and per area have been estimated for activities such as fertilisation (4.95 ± 1.20 l/h, 3.73 ± 1.48 l/ha), whereas the highest values belong to harvest operations (14.70 ± 3.39 l/h, 11.69 ± 4.68 l/ha); regarding field capacity, values range from 0.54 ha/h for leaf removal to 4.46 ha/h for multirow crop protection. Furthermore, correlations have been found regarding environmental temperature and requested power, with evidence for most of the activities. Future developments can include different tractor engine setups and additional field data.

Abstract P1066: Improved Access to Cardiovascular Care Reduces Ischemic Heart Disease Mortality in Rural Ohio

Introduction: Ischemic heart disease (IHD) remains a leading cause of death globally, with its impact disproportionately higher in underserved regions, where access to specialist care is limited. In rural areas like Portage County, Ohio, geographic isolation and lack of local healthcare options have led to delayed treatment and poor outcomes. In 2016, a local catheterization (cath) lab, alongside comprehensive cardiovascular screening and prevention programs, was established to address the issue. Hypothesis: We assessed the hypothesis that the introduction of local specialist cardiovascular services would be associated with a reduction in crude death rates (CDRs) from IHD in Portage. Methods: This retrospective study analyzed CDRs for IHD (reported per 100,000) from the CDC WONDER database (Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research) from 2000 to 2019, stratified by age group. Hospital records provided data on angiograms performed from 2016 to 2022. We utilized linear regression and interrupted time series analysis to evaluate correlation between the intervention and CDR trends. As the study used publicly available secondary data and anonymized hospital records, no ethics approval was required. Results: From 2016 to 2019, over 3000 catheterizations were performed. During this period, a general decline in CDRs was observed across all age groups, especially in the older groups: in the 65-74 age group, rates dropped by 36% (294.2 in 2015 to 188.1 in 2019), while the 75-84 and 85+ age groups saw declines of 21% (817.1 to 648.6) and 28% (3715.6 to 2657.8), respectively. However, statistical significance (p>0.05) was not reached due to limited post-intervention dataset. Conclusion: Early findings suggest that increasing access to specialist cardiovascular services may be associated with reduced IHD mortality in underserved regions like Portage. However, other factors like healthcare improvements, may have also influenced the results, and further analysis with a longer post-intervention period and comparison with control regions are needed to confirm these trends. These early results nonetheless offer insights into the potential of such specialist services to improve health outcomes in rural and underserved regions.

Abstract P2064: Comparing East and South Asian population-specific blood pressure trajectories and their associations with cardiovascular disease risk

Introduction: Cardiovascular disease (CVD) risk differs across Asian subgroups possibly due to differences in hypertension burden. We characterized lifetime blood pressure (BP) trajectories for East and South Asian individuals and compared their age-specific associations with lifetime CVD risk. Methods: Using UK Biobank primary care data, we identified 148,872 individuals with BP measurements since age 18 years. For each sex and self-identified ethnicity, life course BP trajectories were fitted as a function of age. We determined associations of time-averaged young adulthood (age 18-39), middle-age (age 40-64), and later-life (age ≥65) systolic BP (SBP) and diastolic BP (DBP) with incident atherosclerotic CVD risk using sex and antihypertensive-adjusted logistic regression. Results: Of 148,872 UK adults (54% women), 376 (0.3%) identified as East Asian, 3077 (2.1%) as South Asian, 143,575 (96.4%) as White European, and 1844 (1.2%) as African or Black. The predicted SBP/DBP [95% CI] at age 30 years was 108 [103-114] / 68 [65-71] mmHg for East Asian and 114 [110-118] / 72 [71-73] mmHg for South Asian individuals. By age 40, South Asian individuals were projected to reach SBP of 130.0 mmHg, whereas East Asian individuals reached the equivalent SBP by age 49. Among South Asian individuals, each standard deviation increase in young adulthood SBP associated with a higher atherosclerotic CVD risk with an odds ratio (OR) [95% CI] of 1.41 [1.12-1.75] but not among East Asians ( P interaction =0.01). Midlife SBP associated with peripheral artery disease among South Asian individuals (OR [95% CI]: 2.08 [1.51-2.88]), and with ischemic stroke among East Asian individuals (3.84 [1.08-5.07]). Later-life SBP associated with myocardial infarction risk by 1.52 [1.15-1.92]-fold among South Asian and ischemic stroke by 2.50 [1.06-3.80]-fold among East Asian individuals. Conclusions: East and South Asian individuals exhibit distinct BP trajectories that age-differentially associate with incident CVD. Disaggregating Asian subgroups may inform tailored hypertension screening and management.

Neural responses to emotional displays by politicians: differential mu and alpha suppression patterns in response to in-party and out-party leaders

Abstract The high levels of polarization raise concerns about individuals’ decreased ability to empathize and understand the representatives of political out-groups. As such, our political biases may lead us to misunderstand out-group politicians. In the current study, we examine the mu rhythm, a neural oscillation in the sensorimotor cortex related to the processing and understanding of other people’s actions, intentions and emotions. The mu rhythm is particularly responsive towards the emotional expressions of others and sensitive to social biases. Hence, we examine (1) whether the emotions displayed by politicians lead to more mu event-related-desynchronization (mu-ERD), (2) whether it matters which emotion (angry, happy, neutral) is displayed, and (3) whether neural responses differ when emotions are displayed by politicians we support (in-party politician) compared to politicians we do not support (out-party politician). To test this, we recorded electroencephalogram (EEG) responses during a preregistered Go/No Go mimicry experiment (N = 47, Obs = 1104), in which participants are presented with dynamic morphed emotional displays of Dutch politicians (in- and out-party) and non-politicians. We find that politicians emotional displays increase participants’ mu-ERD compared to static neutral displays. Most mu-ERD is found for out-party politicians, especially when angry. In addition, we explored alpha oscillations (related to visual attention), where we find the strongest alpha-ERD for the out-party happy condition. Overall our results suggest that our brain is specifically attuned to process the emotions of out-party politicians.

Abstract P1071: Training in motivational interviewing for pediatricians was associated with a higher uptake of wellness coaching: Results from the KP Wellness Coaching for Families and Kids (WC4K) Program

Objective: To determine the association between motivational interviewing (MI) training for pediatricians and the parental or guardian’s uptake of wellness coaching during the Wellness Coaching for Kids implementation. Methods: Pediatricians from 24 (of 49) randomly assigned pediatric clinics across Southern California were trained in MI to motivate eligible parents and children to engage in health coaching to improve health behaviors. Eligible children were 3 to 8 years at referral, with a body mass index (BMI) ≥85th percentile for age. Two years after the program started, we analyzed the proportion of parents/guardians who engaged in wellness coaching after referral by the MI-training status of pediatricians. Results: Among 233 pediatricians from 24 intervention clinics, 53% (n=123) participated in MI training, and 44% (n=102) referred at least one parent to wellness coaching. Out of 19,888 eligible children with a well-child visit, 10.3% (n=2045) were referred to wellness coaching (=reached). The reach was higher in MI-trained compared to untrained pediatricians (20.4±10.1% and 7.0±10.2%, respectively, p=0.003). Among those referred, 49.9% (n=1021) scheduled a coaching appointment, and 43.3% (n=886) received at least one coaching call (=uptake). The uptake of patients with MI-trained pediatricians was significantly higher (aOR 2.3; 95%CI 1.4, 3.6) than the uptake of patients with untrained pediatricians from intervention practices. Conclusion: Parental uptake of wellness coaching was higher when referred by MI-trained pediatricians suggesting MI can be successful for brief interventions to engage patients to initiate health behaviors and lifestyle change treatment related to childhood obesity in primary care.

Abstract MP27: Timing of Carbohydrate Intake and Cardiovascular Disease: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Introduction: Dietary carbohydrates (CHOs) can substantially impact cardiometabolic risk. Given the circadian rhythm of metabolism, CHO intake timing may also impact CVD risk. Hypothesis: The association of CHO intake with CVD risk varies depending on CHO quality intake timing. Methods: Among 12,401 HCHS/SOL participants free of CVD and cancer at baseline (2008-11), CHO intake timing was assessed by two 24-h dietary recalls: absolute CHO intake at each period (time point), proportion of CHO intake at each period (timing distribution), and CHO intake duration ( Fig A ). We also considered CHO quality by examining high- and low-quality carbohydrate intake (based on food sources, Fig B ), carbohydrate-to-fiber ratio, added-sugar-to-fiber ratio, and glycemic load and index at each period. Associations of CHO intake timing with adjudicated incident CVD (including CHD, stroke, and heart failure) were tested by Cox models adjusted for sociodemographic, lifestyle, dietary, and health covariates. Results: Over a median follow-up of 9.7 y, 217 CVD cases occurred. At midnight, a 5% higher daily calorie intake from total and low-quality CHOs was associated with an HR of 1.18 (95% CI 1.04-1.33) and 1.24 (1.03-1.49) for CVD risk, respectively ( Fig B ). In early morning, HRs comparing consumption to no consumption of total and low-quality CHOs were 1.81 (1.09-3.02) and 1.92 (1.03-3.58) for CVD risk ( Fig C ), and poorer carbohydrate quality indices were associated with higher CVD risk ( Fig D ). A one-hour longer intake interval for total and low-quality CHOs was associated with an HR of 1.12 (1.06-1.18) and 1.10 (1.04-1.15) for CVD risk ( Fig B ). Timing of high-quality carbohydrate intake showed minimal association with CVD risk ( Fig B&C ). Conclusion: Higher CHO intake at midnight and early morning, along with longer CHO intake duration, particularly from low-quality sources, is associated with higher CVD risk in US Hispanic/Latino adults. CHO intake timing might need to be included in future dietary recommendations for CVD prevention.

A method for filling traffic data based on feature-based combination prediction model

Abstract P1142: Small for Gestational Age and Lipid Parameters During the First 14-16 Months of Life

Introduction: A lipid profile with high concentrations of apolipoprotein B-containing lipoproteins - non-HDL cholesterol - is a risk factor for atherosclerotic cardiovascular disease. Accumulation of these lipoproteins is cumulative over the lifespan and high concentrations in childhood are associated with high concentrations later in life. Recently, we described developments of lipid traits from birth to 14-16 months of age, and showed that sex of the child, gestational age, and breastfeeding are influencing factors during this period. It is however unknown whether small for gestational age –a state with an unfavorable metabolic profile – influences lipid traits in early life. Hypothesis: We tested the hypothesis that small for gestational age children have a more atherogenic lipid profile. Methods: For this purpose, we used the Copenhagen Baby Heart Study comprising 13,354 umbilical cord blood samples and parallel venous blood samples from children and parents at birth (n=444), at two months (n=363), and at 14-16 months (n=158). All lipid traits were measured in mmol/L. Results: In cord blood medians (25 th -75 th percentiles) for small, appropriate, and large for gestational age newborns were 0.98 (0.81-1.18), 0.95 (0.77-1.15), and 0.92 (0.72-1.15) for non-HDL cholesterol, 0.22 (0.17-0.31), 0.18 (0.13-0.23), and 0.14 (0.11-0.20) for remnant cholesterol, 0.50 (0.37-0.68), 0.39 (0.29-0.51), and 0.32 (0.25-0.44) for triglycerides, and 0.62 (0.46-0.79), 0.73 (0.58-0.91), and 0.78 (0.62-0.96) for HDL cholesterol (all p-values=0.0001). For total cholesterol and LDL cholesterol no differences were found according to size for gestational age. Girls have higher concentrations of lipid traits compared to boys but differences according to size for gestational age were similar in both sexes. Small for gestational age newborns of mothers with preeclampsia had the highest concentrations of non-HDL cholesterol, remnant cholesterol, and triglycerides. Differences according to size for gestational age were also found in venous blood samples at birth, at two months, and at 14-16 months for remnant cholesterol, triglycerides, and HDL cholesterol. Conclusion: Small for gestational age newborns have higher concentrations of the atherogenic lipoprotein fractions non-HDL cholesterol and remnant cholesterol. These differences between small, appropriate, and large for gestational age observed early in life suggest increased risk of atherosclerotic cardiovascular disease later in life.

Abstract 046: Associations of Long-Chain and Very-Long-Chain Saturated Fatty Acids with Outcomes of Sudden Cardiac Arrest

Background: Sudden cardiac arrest (SCA) due to ventricular fibrillation (VF) is a leading cause of mortality. Circulating fatty acids (FA) are influenced by diet and metabolism and have been linked to sudden cardiac arrest (SCA) risk. Certain long-chain saturated fatty acids (LSFA, defined as those with 14-18 carbons) and very long-chain saturated fatty acids (VLSFA, with 20+ carbons) have been associated with higher and lower risk of SCA, respectively. We hypothesized that higher LSFA and VLSFA levels would be associated with lower and higher likelihood of survival from SCA, respectively. Methods: We examined participants from the Cardiac Arrest Blood Study Repository, a study of SCA cases from Washington between 1988 and 2004. Patients were restricted to those with an initial rhythm of VF and who were greater than or equal to 18 years old. Six FA were studied: 3 LSFA (14:0, 16:0, and 18:0) and 3 VLSFA (20:0, 22:0, and 24:0). Poisson regression, adjusted for demographics and health services, was used to assess the association of SCA resuscitation outcomes with FA levels. A 2-sample Mendelian randomization (MR) using the 3 SNPs identified from the CHARGE consortium was conducted to assess causal association between 20:0 VLSFA levels and surviving SCA. Results: We examined 1351 SCA cases, of whom 700 died in the field, 332 died in the hospital, and 319 survived to hospital discharge. Our predominantly male (80%) cohort had an average age of 67±14 years. In multivariable analyses, higher 14:0 levels were associated with a lower likelihood (risk ratio 0.86, 95% CI: 0.77-0.96, P=0.008) of surviving to hospital discharge. Conversely, higher levels of 20:0, 22:0, and 24:0 were nominally associated with better survival (Figure), with 20:0 remaining significant after accounting for multiple testing (risk ratio 1.18; 95% CI: 1.08-1.29, P<0.001). No FA was associated with likelihood of being admitted to the hospital following SCA. Using MR methodology, we found evidence for a causal association of 20:0. For each standard deviation increase in genetically predicted 20:0 levels there was an 84% (P=0.027) higher likelihood of survival. Conclusions: Lower levels of 14:0 LSFA and higher levels of 20:0 VLSFA are associated with higher SCA survival. MR analysis suggested that there was a causal relationship of higher 20:0 VLSFA levels with better survival following SCA. Future studies are needed to assess whether administration of 20:0 improve SCA survival.