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Incidence of critical events in the post-anesthesia care unit at a resource-limited setting in Debre Markos, Northwest Ethiopia

Background Surgery and anesthesia can disrupt normal physiological function through surgical stress and residual anesthetic effects, increasing the risk of post-anesthetic complications, known as critical incidents. This study aimed to determine the incidence of critical events in the post-anesthesia care unit at Debre Markos Comprehensive Specialized Hospital, Ethiopia. Methods An institution-based prospective cross-sectional study was conducted from June 1, 2024, to September 30, 2024. The sample size was determined by a single proportion formula using a prevalence of 50% and a 5% margin of error at the 95% confidence interval. The data was analyzed using SPSS version 22 for windows. Analysis was conducted using bivariable and multivariable logistic regression as needed. Result Of the 422 patients, 160 (37.9%) experienced one or more critical events, with a total of 214 complications recorded. The most common critical events that occurred in the PACU were cardiovascular-related events (42%) and respiratory & airway related incidents (20%). BMI, duration of anesthesia, intraoperative complications, patient handover, PACU staff training, and ASA physical status were significantly associated with the occurrence of critical events. The odds of critical events were higher among underweight (AOR = 3.71; 95% CI: 1.27–10.79) and overweight patients (AOR = 3.05; 95% CI: 1.28–7.24). Anesthesia duration of 1–2 hours (AOR = 2.01; 95% CI: 1.06–3.81) and >2 hours (AOR = 4.11; 95% CI: 1.59–10.66) also increased the risk. Patients with intraoperative complications had higher odds of critical events (AOR = 3.52; 95% CI: 1.88–6.58), as did those without proper handover (AOR = 3.92; 95% CI: 2.11–7.25). Increasing ASA class was associated with higher risk ASA II (AOR = 2.59; 95% CI: 1.11–6.07), ASA III (AOR = 2.86; 95% CI: 1.20–6.86), and ASA IV (AOR = 11.75; 95% CI: 2.76–50.03). Additionally, patients cared for by PACU nurses without prior PACU training were more likely to develop complications (AOR = 3.15; 95% CI: 1.73–5.72). Conclusion Approximately 38% of patients experienced ≥1 critical event, mainly cardiovascular and respiratory complications. Patients who had intraoperative complications, ASA 2 to ASA 4 status, under/overweight, and those who received anesthesia for a prolonged duration were relatively at higher risk of developing critical events. There was a long time to stay in the PACU for those patients who experienced critical events.

Abstract WE474: Trends and Disparities in Heart Failure and Atrial Fibrillation-Related Mortality in the United States – A Nationwide Retrospective Analysis

Background: Atrial fibrillation (AF) is a significant contributor to heart failure (HF) exacerbations and associated with significant mortality and morbidity, however limited research has evaluated temporal trends in morality and disparities associated with concurrent AF and HF. Methods: Using the CDC WONDER database, we analyzed mortality trends related to concurrent AF and HF in individuals aged 25 and older in the United States from 1999-2023. Age-adjusted mortality rates (AAMR) per 100,000 individuals were calculated and stratified by year, race, gender, urbanization, geographic region, and place of death. Trends were assessed via annual percentage change (APCs) and average annual percentage changes (AAPC) using the Joinpoint regression software. Statistical significance was defined as p <0.05. Results: Between 1999-2023, there were a total of 1,110,367 deaths related to concurrent HF and AF in the United States. The overall AAMR has steadily increased between 1999-2023 (AAPC: 4.2%) with statistically significant spikes from 1999-2010 (APC 1.99%, CI 1.52-2.47), 2010-2018 (APC 5.72%, CI 4.95-6.50), and 2018-2021 (APC 9.56%, CI 5.10-14.20). Males exhibited higher overall AAMRs compared to females while both groups had a steady rise in mortality rates between 1999-2021(Figure 1). Non-Hispanic (NH) White individuals had the highest AAMRs followed by NH Black, American Indian, Hispanic, and Asian individuals (Figure 2). NH Black individuals exhibited the highest rise in AAMRs from 2018 to 2021 (APC 12.5%, 95% CI 0.122-26.5, P<0.05). The overall mortality was highest in the West (AAMR 20.4) while the Midwest had the highest rise in mortality (AAMR 12.9 in 1999 to 35.15 in 2023) (Figure 3). Most deaths (350,199) occurred in inpatient medical facilities (30%), 309,69 in nursing homes (26.52%), and 296,745 in decedent’s homes (25.4%). AAMRs stratified by urban vs. rural geographic regions were only available from 1999-2020 and were higher in non-metropolitan areas at 20.50 (CI 20.4-20.6) compared with large metropolitan areas at 15.3 (CI 15.3-15.4) (Figure 4). Conclusion: Concurrent HF and AF-related mortality has increased across all demographic groups in the United States in the past two decades with the highest rates observed among men, African American, White, and non-metropolitan populations. Recognizing persistent disparities is essential to informing targeted preventive interventions aimed at reducing the burden of AF and HF affecting millions worldwide.

Abstract TH959: Early Metabolic Imbalance in Lean Young Adults is a Risk Factor for Midlife Obesity

Background: Early metabolic imbalance (EMI) is an overlooked condition characterized by compensatory hyperinsulinemia in the face of normal fasting glucose, triglycerides, hemoglobin A1c, and HDL. Also, EMI is associated with subclinical inflammation, oxidative stress, and hypoxemia/hypoxia (Figure 1). Individuals with EMI do not meet the criteria for prediabetes or metabolic syndrome and elude detection during routine screening for chronic disease risk. Previously, we reported that EMI is a risk factor for prediabetes, type 2 diabetes, metabolic syndrome, and cardiovascular disease (CVD). Hypothesis: EMI in lean young adults is an independent risk factor for midlife obesity. Methods: This was a retrospective cohort analysis of CARDIA: Coronary Artery Risk Development in Young Adults. The parent study began in 1985, enrolling 5,114 young adults ages 18-30, with follow-up visits every 5 years. For this retrospective analysis, the baseline exclusion criteria were fasting hyperglycemia, hypertriglyceridemia, low HDL, BMI>=25 kg/m 2 , elevated waist circumference, pregnancy, diabetes, or CVD; n=2,371. Cox proportional hazards regression models were explored using Stata v19.5. The exposure was EMI, a latent variable generated from fasting insulin, globulin/albumin ratio, hemoglobin&resting pulse rate. The outcome was time to incident obesity: BMI≥30. Results were reported as a Cox hazard ratio (HR) with 95% confidence interval (CI) and p-value. All reported models met the proportional hazards and linearity assumptions. Results: Over the 30-year follow-up, there were 632 cases of incident obesity (26.7%). Cox Model 1 included continuous EMI as the exposure, without adjustment (Table 1). Model 2 adjusted for age, sex, race, fitness, sex-fitness interaction, and education level. Model 3 included EMI categorized by quintiles without adjustment. Model 4 categorized by quintiles and adjusted for the same covariates as Model 2. In all models, EMI was an independent risk factor for incident obesity (HR range: 1.5-2.6). Similar results were obtained in parallel Cox analyses where the observed EMI variables were entered individually, with fasting insulin as the 1° exposure. Conclusions: Compared with the lowest quintile, lean young adults in the fifth quintile of EMI had double the risk for future obesity, even after adjustment. If validated, the results could inform efforts to screen young people for hidden EMI, offering the best opportunity to prevent future obesity.

Underwater cultural heritage and extreme events: Storm impacts under climate change

Extreme weather events cause severe ecological disruptions to the marine environment and socioeconomic impacts, while also endangering the evidences of human history resting underwater. Storms, in particular, generate high-intensity currents that lead to substantial material loss and textural alteration. We present a quantitative risk assessment of underwater cultural heritage exposed to storm events, considering climate change and the vulnerability of historical stone materials. We monitored the amount, rate, and patterns of stone erosion through innovative flume simulations and surface three-dimensional modeling, investigating its changes with time, current velocity, and properties of the materials and suspended sediments. The experimental results were combined with global models of storms and ocean currents under present and future climate, accounting for projected changes in storm intensity and frequency, climate scenarios, geographic settings, and seabed environments. Our findings show that even a single storm may result in irreversible damage to historical surfaces, erasing key morphological and textural features and compromising their legibility—especially in global hotspots such as tropical regions. In a future dominated by high greenhouse gas emissions and increasing extreme events, the vulnerability of archaeological stone could locally rise to more than double present levels. Extreme events and climate change pose major threats to the preservation of underwater cultural heritage and its historical, touristic, educational, and scientific values, requiring the development of long-term adaptation and protection strategies.

Grip strength as a mediator in the relationship between physical activity and osteoporosis in older adults: Evidence from two longitudinal cohort studies

Background Osteoporosis is a skeletal disorder characterized by reduced bone mass and increased fracture risk. With the aging global population, its prevalence is rising, posing a significant public health challenge. Physical activity is considered an effective intervention to reduce osteoporosis risk, but the role of grip strength as a mediator remains underexplored. Methods Data from the English Longitudinal Study of Ageing (ELSA) and the Health and Retirement Study (HRS) were analyzed using generalized linear mixed models (GLMM) and mediation analysis to explore the impact of physical activity on osteoporosis and the role of grip strength. Subgroup analyses accounted for age, gender, and confounding factors. Results The prevalence of osteoporosis was 6.3% in ELSA and 14.1% in HRS. A significant negative correlation was found between physical activity and osteoporosis in both groups (ELSA: OR = 0.234, P  < 0.001; HRS: OR = 0.638, P =  0.028). In those aged ≥65, physical activity had a more pronounced effect (OR = 0.478, P  < 0.001). Women showed greater benefit. Mediation analysis in the ELSA group revealed that grip strength mediated 28.3% of the effect of physical activity on osteoporosis (ACME = −0.007, P < 0.001). Conclusion Physical activity, especially resistance training, reduces osteoporosis incidence by enhancing muscle strength, with grip strength playing a mediating role. These findings highlight the importance of physical activity, particularly in older women, for osteoporosis prevention.

Abstract MPTU09: Gut Microbiome Mediates Diet-Driven Diabetes Risk in American Indians

Background: American Indians experience a markedly high prevalence of type 2 diabetes (T2D). Emerging evidence links the gut microbiome to T2D, yet data in this high-risk population are scarce. Objective: To identify specific gut microbial taxa and functional pathways associated with T2D, and to assess their mediating role in the relationships between diet and T2D among American Indians in the Strong Heart Study (SHS). Methods: We conducted deep shotgun metagenomic sequencing (~40 million reads/sample) on stool samples from 971 American Indian adults (mean age 57 years, 68% women) enrolled in the SHS Phase 7 (2022–2025). Taxonomic and functional profiles were generated using MetaPhlAn4 and HUMAnN3, respectively. Diet was assessed via a culturally tailored food frequency questionnaire. Mixed-effects logistic regression models were used to identify microbial species and functional pathways associated with T2D, adjusting for age, sex, study center, BMI, diet control (yes/no), antibiotic use, and Bristol stool scale (with random effects for family relatedness and sequencing batch). Mediation analyses then quantified microbial contributions to diet–T2D associations. Results: T2D prevalence was 37.4% (n=363). Family clustering (R 2 =10.3%, P=0.001) was the strongest predictors of β-diversity (Bray-Curtis), followed by age (R 2 =1.6%, P=0.001), study center (R 2 =0.78%, P=0.001), sex (R 2 =0.60%, P=0.001), and T2D status (R 2 =0.43%, P=0.003). Furthermore, we identified 9 species (e.g., Escherichia coli, Enterocloster bolteae, Dielma fastidiosa ) and 7 metabolic pathways (e.g., glycolysis, thiamine phosphate formation) significantly associated with T2D (false discovery rate (FDR)<0.05). Individuals with T2D reported significantly lower consumption of several key nutrients, including fiber (odds ratio (OR)=0.98, P=0.006), vitamin A (OR=0.99, P=0.007), vitamin D (OR=0.93, P=0.001), and vitamin B12 (OR=0.97, P=0.03). Critically, several species (e.g., Escherichia coli, Phocaeicola vulgatus ) were found to mediate 7%–20% of the associations between these dietary nutrients and T2D (P<0.05). Conclusion: Gut microbial composition and function are robustly associated with T2D and significantly mediate the effects of diet on T2D in American Indians. These findings highlight the gut microbiome as a novel and viable target for T2D prevention and treatment in this high-risk population.

Abstract TU204: Glucagon-like Peptide-1 Receptor Agonists: Are They Associated With Increased Cardiorespiratory Fitness?

Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1) promote weight loss, improve diabetes, and reduce cardiovascular events in obesity. While physical activity (PA) should be integral to weight loss interventions, the effectiveness of GLP-1, with weight loss in the range of 15-20%, may remove incentives to exercise. Cardiorespiratory fitness (fitness), a marker of habitual PA and health outcomes, may increase with weight loss. GLP-1 effects on PA and fitness are not clear. Thus, in a preventive medicine cohort, the question of whether GLP-1 use is associated with changes in fitness was evaluated. Methods: A cohort of 205 generally healthy men and women reported leisure-time PA and completed treadmill exercise testing to estimate fitness before and during GLP-1 use (+GLP-1), 2009-2024. A similar cohort of 10,903 men and women did not report GLP-1 use (-GLP-1) in the same period. A repeated measures growth model provided estimates of the group difference in fitness changes adjusted for sex, age, time between visits, PA, and weight. Results: Before treatment in +GLP-1, 89% were overweight/obese, 19% were diabetic, and 1% had prior cardiovascular events (versus 64%, 2%, and 1% in -GLP-1). The mean (SD) baseline age was 52.0 (8.5) years in +GLP-1 and 52.3 (9.7) in -GLP-1. In +GLP-1, the mean follow-up was 2.6 years (versus 2.5 in -GLP-1). Mean body mass index decreased 2.1 kg/m2 in +GLP-1 versus no significant change in -GLP-1. Mean glucose also decreased in +GLP-1 (from 108.4 mg/dL to 97.5 mg/dL, p<0.001) but no change in -GLP-1. Mean PA was largely unchanged in both groups (+50 versus +30 MET-minutes/week, p=0.8). Mean unadjusted fitness was stable at 9.1 METs in +GLP-1, p=0.5, and decreased from 11.0 to 10.7 METs in -GLP-1, p<0.001 (group difference in changes p<0.001). Results were similar when adjusted for sex, age, time between visits, and PA changes. However, when also adjusted for weight change, mean fitness fell 0.5 METs in +GLP-1 versus 0.2 METs in -GLP-1, p<0.001. Fitness increased less in +GLP-1 than in -GLP-1 whether weight was lost or gained. Conclusions: Fitness changes in +GLP-1 were largely mediated by weight loss. While GLP-1 use was associated with greater weight loss, fitness outcomes were worse in +GLP-1 than in -GLP-1 with similar weight changes. Healthcare providers should prescribe and monitor PA along with GLP-1 receptor agonists, as tolerated by patient’s overall status, to improve weight loss and fitness.

Seasonal variation in meat quality of Angus steers raised in a Mediterranean forage-fed system: A farm case study

This study monitored the impact of seasonal feeding variability on meat quality traits in forage-fed Angus steers. A total of 38 steers were selected based on their diets during the last three months before slaughter: a hay-based winter diet (WIN), a spring fresh-forage-based diet (SPR), or a summer fresh-forage-based diet (SMM). Meat quality was assessed through fatty acid profiling, antioxidant capacity, myoglobin content, color stability, and lipid oxidation during refrigerated storage. Principal components and linear discriminant analysis were used to uncover, underlying patterns, and classify the observations based on the multivariate profile. Meat fatty acids showed limited variation across seasons, with differences restricted to minor polyunsaturated fatty acids. The n-6/n-3 ratio and other health-related lipid indices remained within recommended values despite the feeding season. Meat from SPR and SMM animals showed higher α - and γ -tocopherol levels and greater myoglobin content compared to WIN meat. Color parameters and lipid oxidation were moderately affected by diet and storage time, with better stability observed in meat from animals receiving fresh forage. Despite the subtle impact on individual quality traits, multivariate discriminant analysis effectively differentiated meat samples based on the feeding season, achieving 89.5% correct classification. The most discriminating variables included fatty acids (17:1 c 9 , 18:1 t 10, 22:0, 22:5 n-6), color attributes (b*), and oxidative markers (TBARS, metmyoglobin %). With the caution due to the nature of the study, these findings suggest that while single quality indicators may not strongly reflect dietary differences, their combination may provide a tool to trace seasonal feeding strategies in grass-fed beef production.

Abstract MPTU13: Inclusion of Incarcerated Individuals and Their Families in Cardiovascular Health Research: Insights from Community-Based Focus Groups

Background: Incarceration is a structural determinant of cardiovascular disease (CVD) risk with profound health consequences for both directly impacted individuals and their families. Yet, these populations are largely excluded from CVD research, raising ethical, methodological, and trust-related issues for research participation. This study aimed to identify community-informed strategies for ethically engaging incarcerated and formerly incarcerated individuals and their families in CVD research, with a focus on consent, data governance, and biological sample collection. Methods: Three community-based focus groups were conducted between December 2024 and May 2025 in New Haven, CT (N=12); Durham, NC (N=14); and San Antonio, TX (N=11). Participants (N=37) were currently, or formerly incarcerated individuals and family members or romantic partners recruited through community partners. Eligibility criteria included experience with incarceration and interest in health research participation. Sessions were audio-recorded, transcribed, and analyzed using a rapid qualitative approach involving collaborative interpretation by academic researchers, our community partner (Justice Leadership USA) and formerly incarcerated partners. Key domains examined included motivators for participation, recruitment approaches, informed consent, data sharing expectations, and biological data collection preferences. Results: Across sites, participants emphasized the importance of embedding lived experience throughout the research process to improve trust, relevance, and accuracy. Recommended strategies included peer-led recruitment rather than reliance on correctional staff, offering choice in incentives (e.g., monetary vs. educational benefits), and presenting consent information in clear, multimodal formats tailored to literacy levels and trauma-informed practices. Concerns about biological data centered on privacy, potential misuse, and preference for in-person collection, while participants supported de-identified data sharing under transparent governance structures with explicit protections through community oversight. Conclusions: Community-driven engagement approaches are essential to designing ethical, trustworthy, and effective CVD research in carceral contexts. Incorporating participant input into recruitment, consent, data governance, and sample collection practices can enhance participation, data integrity, and translational impact for justice-impacted populations.

Abstract TH899: Summary Measure of Social Determinants of Health/Health Equity and Cardiovascular Disease Outcomes among Mississippi Adults

Background: Cardiovascular disease (CVD) is the leading cause of death in Mississippi. Mississippi adults experiencing numerous social determinants of health/health equity (SDOH/HE) risk factors have increased odds of CVD than those experiencing no SDOH/HE risk factors. We examined the association between a summary measure of SDOH/HE and CVD outcomes among Mississippi adults. Methods: Using the SDOH/HE Module data from 3,867 respondents who self-identified as non-Hispanic Black or White in the 2023 Mississippi Behavioral Risk Factor Surveillance System survey, we conducted multivariable logistic regression models to examine the association between a SDOH/HE summary measure and CVD outcomes. Results: Myocardial infarction/heart attack and angina or coronary heart disease (CHD) prevalence was 4.4% and 5.0% respectively, and the likelihood of experiencing 0, 1, 2, 3, or 4 or more SDOH/HE risk factors was 38.6%, 22.9%, 13.7%, 7.9%, and 16.8% respectively. Mississippians experiencing four or more SDOH/HE risk factors had higher odds of heart attack or myocardial infarction (AOR, 4.83, 95% CI, 2.15%–10.88%) and angina or CHD (AOR, 2.51, 95% CI, 1.04%–6.09% ) compared to those experiencing no SDOH/HE risk factors respectively. Conclusions: Our results suggest that Mississippi adults with multiple SDOH/HE risk factors have significantly higher odds of myocardial infarction/heart attack and angina/CHD than those with no SDOH/HE risk factors. These findings highlight the importance of addressing multiple SDOH/HE factors of CVD outcomes. Targeted interventions to reduce CVD burden among Mississippi adults should prioritize improving health-related social needs.

Correction: Utility of a freehand frameless navigation system in computed tomography-assisted ventral bulla osteotomy for otitis media in calves

Abstract MPTH61: Women that Meet the Muscle-strengthening Physical Activity Guideline Are Less Likely to Report Hypertension

Introduction: Approximately 43% of US women have hypertension, which can cause serious health conditions (e.g., stroke, heart attack). Previous research has shown that muscle-strengthening physical activity (e.g., resistance training, weightlifting) improves blood pressure outcomes in the general US population. However, limited research has examined this association among women. Hypothesis: We hypothesized that women meeting the muscle-strengthening activity guideline would be less likely to report hypertension, and that this association would vary by race/ethnicity. Methods: We used cross-sectional data from the 2012-2018 National Health Interview Survey on female participants ≥18 years of age (n=111,801). Hypertension was assessed based on whether participants were told by a doctor that they had hypertension (yes vs no). Muscle-strengthening physical activity was categorized as: 1) meeting the guideline (muscle-strengthening activity ≥ 2 times per week), and 2) not meeting the guideline (muscle-strengthening activity less than twice a week/never/unable). Logistic regression analysis was used to estimate the association between meeting the muscle-strengthening activity guideline and hypertension. Models were adjusted for age, education, race/ethnicity, and health insurance status. We also tested whether the association varied by race/ethnicity and stratified models accordingly. Results: In adjusted models, compared with women that did not meet the muscle-strengthening activity guideline, those that met the guideline were significantly less likely to report having hypertension (Odds Ratio [OR]: 0.66, 95% Confidence Interval [CI]: 0.63-0.69). In models stratified by race/ethnicity, non-Hispanic White women, Hispanic women, and non-Hispanic Black women that met the muscle-strengthening activity guideline were significantly less likely to report having hypertension (OR: 0.63, 95% CI: 0.60-0.67; OR: 0.66, 95% CI: 0.57-0.78; OR: 0.82, 95% CI: 0.72-0.93, respectively). Conclusions: Engaging in the recommended amount of muscle-strengthening physical activity may help reduce the risk of hypertension among women. Findings highlight the ongoing importance of health promotion programs aimed at increasing muscle-strengthening physical activity to help reduce hypertension risk in women.

Abstract TH843: Signatures for Tailored Cardiovascular Communication: A Three-Pathway Classification With Chatbot-Enabled Delivery

Background: One-size-fits-all counseling often underperforms in long-term cardiovascular prevention where sustained activation is required. We developed Signatures, a practical framework that maps individuals to four communication archetypes—Listener, Motivator, Director, with an Expert overlay—to guide message tone, structure, and shared decision-making at the point of care. The framework operationalizes psychographic segmentation into an implementable taxonomy. Methods: Classification uses three complementary pathways: (1) a 20-item self-assessment that summarizes activation and support-need domains; (2) a clinician 10-domain binary grid scored 0–10; and (3) a supervised NLP classifier that ingests de-identified narrative to estimate archetype probabilities. Discordance is resolved by conservative tie-breaking and barrier-domain overrides (health literacy, trust, access, food security). Intervention (Chatbot): We prototyped a rules-plus-NLP chatbot to (a) administer the self-assessment, (b) collect short narratives for NLP pre-labeling, and (c) deliver Signature-specific counseling (e.g., plain-language, one-step plans for Listeners; option sets and SMART weekly goals for Motivators; concise, data-driven progressions for Directors; synthesis and trade-offs for Experts). Example phrase templates were derived from our library of Signature-aligned responses for common health questions. Results: Formative testing established face validity of the three-pathway workflow and usability of chatbot dialogues. The system consistently generated actionable outputs: an assigned archetype, domain-level flags, and a message kit (tone, structure, and SDM cues) that clinicians can use or edit in real time. The chatbot supported weekly goal-setting, reminders, and teach-back prompts aligned to the assigned Signature. Conclusions: A triaged, multi-method classification combined with chatbot delivery is a feasible approach to precision communication in cardiovascular prevention, offering a practical bridge from psychographic theory to routine encounters and remote interactions. Prospective validation will assess concordance among pathways, equity, and effects on engagement, lifestyle habits, condition management and clinical proxies.

Ribonuclease 4 Functions in Nociceptor-Mediated Nerve Homeostasis

Abstract The regulation of nociceptor identity and function is essential, as disruptions can significantly influence pain sensation, yet our understanding of the molecular mechanisms involved remains incomplete. In this study, we identified ribonuclease 4 (RNase4) as selectively expressed in the unmyelinated nociceptor lineage. Analysis of RNase4 -deficient mice and single-cell transcriptomic data revealed a cell-autonomous role for RNase4 in regulating nociceptor function. Moreover, in a neuropathic pain model, RNase4 expression was upregulated in nociceptors during the pain and recovery phases, and its deletion altered mechanical sensation. Additionally, RNase4 exerted non-cell- autonomous effects on the myelin structural organization of adjacent myelinated axons. Together, these findings implicate RNase4 as a dual regulator of nociceptor biology and myelin integrity, revealing a molecular pathway for pain regulation and nerve repair.

Hepatitis E virus exposure and risk factors among ethnic minority populations in Northern Vietnam

Background Hepatitis E virus (HEV) causes sporadic outbreaks worldwide, with zoonotic and waterborne genotypes contributing to infections. In Vietnam, HEV genotypes 3 and 4 circulate among humans and swine, but data from remote, ethnic minority populations remain limited. Methods A cross-sectional study was conducted among 272 ethnic minority students at Thai Nguyen University of Medicine and Pharmacy (TUMP) to determine HEV infection markers and associated risk factors. Anti-HEV IgM and IgG were tested in serum samples using Wantai ELISA kits, and HEV RNA was detected by nested PCR targeting the ORF1 region. Demographic and exposure data were collected via structured questionnaires. Statistical analyses were performed using binary logistic regression. Results One participant (0.37%) tested positive for anti-HEV IgM, and 69 (25%) were positive for anti-HEV IgG, while HEV RNA was undetectable. HEV-IgG seroprevalence increased significantly with age (p = 0.004) but showed no sex-related differences. Consumption of tap or mixed water sources (p = 0.043) and raw or undercooked pork liver (p = 0.018) were significantly associated with HEV-IgG positivity. Multivariate analysis confirmed these factors as independent predictors of prior HEV exposure (adjusted OR = 1.6 and 4.8, respectively). Conclusions A moderate HEV seroprevalence among ethnic minorities indicates substantial prior exposure in northern Vietnam. Strengthening water sanitation, food safety awareness, and routine HEV surveillance is recommended to mitigate infection risk in vulnerable communities.

Abstract MPWE30: Sublingual Microvascular Features and Cognition in Midlife Among Women with a History of Vascular Injury in the Placenta

Objective: Women with preeclampsia (PE) or placental evidence of maternal vascular malperfusion (MVM) have excess risk for cardiovascular and cerebrovascular disease years after delivery, perhaps related to microvascular dysfunction. Methods: Women (n=176; mean age 43.4 y ±6; 34% Black) were enrolled in the Window Brain study, designed to disentangle the cognitive sequelae following PE vs MVM, ~ 15 years after delivery. PE and MVM were abstracted from the medical record. We related sublingual microvasculature features (GlycoCheck) to maternal self-report of cognition complaints (Everyday Cognition, eCog). Linear regression models related microvascular features (per z-score standard deviation (SD) increase) to higher cognitive complaints (eCog), adjusted for race and age, BMI and systolic BP at follow-up. Effect modification by MVM or PE history with microvascular features was evaluated and results stratified when p-interaction <0.1. Results: A total of 52 women had prior PE, 74 had placental evidence of MVM, of whom 36 had +PE/+MVM. Overall, a larger perfused boundary region (PBR; marker of damaged or dysfunctional glycocalyx, the protective surface of the endothelium) was related to more cognitive complaints (+eCog score per SD increase, p=0.048). There was evidence of effect modification by MVM (p-interaction=0.09 for PBR) but not PE (p-interaction=0.66). In MVM-stratified models, among those with evidence of prior placental MVM, each SD increase in PBR and vessel diameter (damaged glycocalyx) was associated with more cognitive complaints. Related, each SD increase in red blood cell filling (healthier perfusion) was linked to fewer complaints (PBR, +0.138 eCog ± 0.05, p=0.015; Vessel diameter +0.118 eCog ±.05, p=0.024; RBC filling, -0.127 eCog± 0.05, p=0.018; TABLE). Microvascular features were unrelated to cognition among those without placental evidence of vascular injury; co-occurrence of PE did not influence estimates. Conclusion: Our results indicate that small vessel damage in the placenta during pregnancy may be a marker of vascular susceptibility to impaired cognition at midlife, perhaps related to microvascular pathology. Interestingly, preeclampsia was not linked to cognition absent evidence of placental vascular injury, raising the possibility that the placenta may offer a more precise assessment of small vessel impairments and cognition.

Abstract TH929: GLP-1 Receptor Agonist Medication Use Persistence in the All of Us Research Program

Introduction: Real-world data reveal long-term persistence with GLP-1 Receptor Agonists (RAs) is low. This study examines GLP-1 RA prescription trends and the association between socioeconomic, demographic, and clinical factors with treatment persistence. Methods: Adults (age 18+) prescribed GLP-1 RAs between January 2010 and October 2023 were identified from the All of Us Research Program (electronic health records). We analyzed yearly distributions of primary condition prior to GLP-1 RA therapy, new user trends, sociodemographic characteristics (age, sex at birth, race, ethnicity, insurance, income, education and body mass index/BMI), and GLP-1 RA persistence at 3, 6, and 12 months. We defined persistence as continuous GLP-1 RA use, allowing a prescription gap of up to 60 days and GLP-1 RA class switching. Persistence rates were stratified by sociodemographic and clinical factors, with statistical analyses performed using chi-squared tests and multivariable logistic regression. Results: Drug prescription preference changed from Liraglutide and Dulaglutide to Semaglutide and Tirzepatide over time. GLP-1 RA use was highest among middle-aged women while spanning broad socioeconomic strata. Persistence rates at 3, 6 and 12 months were 71.0%, 55.6% and 38.0% respectively. Persistence varied across age, sex, ethnicity, insurance type, and condition at GLP-1 initiation (P<0.001). At 12 months, patients aged 18-39 had the lowest persistence (27.3%) with adjusted odds ratios (aOR) significantly different from those in the 40-64 age group (P <0.001). Men were more persistent than women (44.6% vs 34.8%; aOR 1.28 [95% CI: 1.18-1.37]); Medicare patients had the highest persistence while those with private insurance had the lowest (42.0% vs 34.7%; aOR 1.23 [95% CI: 1.11-1.35]); and patients with T2D present at GLP-1 RA initiation showed higher persistence compared to those with obesity but without T2D (46.3% vs 23.3%; aOR: 2.70 [95% CI: 2.50-2.94]). Race and education showed little association with persistence, while income and body mass index no association with persistence. Conclusion: GLP-1 RA persistence declines across all groups over time, with higher discontinuation among younger adults, women, privately insured individuals, and those with obesity but without diabetes. These findings may guide future efforts at improving long-term GLP-1 RA persistence, addressing issues such as side effects, lack of desired effect, and cost.

Genome-centric metagenomics reveals electroactive syntrophs in a conductive particle-dependent consortium from coastal sediments

Abstract Conductive particles are common in coastal sediments, yet their role in shaping methane-producing communities and pathways remains unclear. We applied genome-resolved metagenomics to a sediment-derived consortium serially transferred for a decade and obligately dependent on granular activated carbon (GAC). We discovered a particle-obligate food web composed of electrogenic syntrophic acetate oxidizers (SAO), an electrotrophic methanogen, and necromass recyclers. The primary SAO electrogen, Candidatus Geosyntrophus acetoxidans, represents a new genus and possesses a complete acetate oxidation pathway and extracellular electron-transfer (EET) machinery, including two porin-cytochrome conduits, 43 additional multiheme cytochromes and conductive pili. A secondary SAO, a Lentimicrobium sp. with a giant PCC-cluster, supplies an alternative EET-linked acetate-oxidation route. Electrons from electrogens transfer via GAC to a Methanosarcina equipped with the heptaheme cytochrome MmcA and flagellin for electron uptake. These results provide a genomic blueprint of this particle-obligate environmental consortium and suggest an overlooked acetate-to-methane electron-transfer route in geoconductor-rich anoxic sediments.

Functional iron deficiency and outcomes in patients with kidney disease

Introduction This study assesses the impact of functional iron deficiency (FID) on outcomes, including all-cause mortality, hospitalizations and non-fatal cardiovascular events in patients with non-dialysis chronic kidney disease (CKD) and hemodialysis (HD). Methods In HD, absolute iron deficiency (AID) was defined as ferritin < 200 µg/L and TSAT (transferrin saturation) ≤ 20%, and FID ferritin ≥200 µg/L with TSAT ≤20%. In CKD, AID was ferritin < 100 µg/L and TSAT ≤ 20%, and FID ferritin ≥ 100 µg/L with TSAT ≤ 20%. Prevalent HD patients as of January 2012 and incident patients between January 2012 and December 2014 were included (n = 512) and followed to 31/12/2018 (median 36.5 months). CKD patients who received iron infusions between January 2017 and December 2019 were included (n = 831) and followed until 31/12/2023 (median 38.5 months). Results In the HD cohort, 71% of the FID patients were dead at the end of follow-up (vs No Iron Deficiency, NID: 52%, AID: 48%; p = 0.008). In the CKD cohort, 62% of the FID group died by the end of follow-up (vs AID: 49.5%, NID: 46.2%; p = 0.001). The hazard ratio for FID for all-cause mortality was 1.89 (p < 0.001) in HD and 1.48 (p < 0.001) in CKD. Multivariate analysis found FID was independently associated with all-cause mortality (HD HR:1.50, p = 0.015; CKD HR: 1.46, p = 0.017). Patients with FID on HD were more likely to be hospitalized (median episodes 2.5 FID vs 2 in AID and NID, p = 0.041; FID: 22.5 days vs AID: 10, NID:14 days, p = 0.019). Conclusion FID was associated with all-cause mortality in patients with non-dialysis CKD and HD, and with higher rates of hospitalization and prolonged length of stay in HD.

Abstract WE437: Prevalence and Determinants of Diabetes Mellitus in a Semi-Urban Nigerian Riverine Community: Implications for Intervention in Resource-Limited Settings

Background: Diabetes mellitus is a leading global cause of cardiovascular morbidity and mortality, with a rising burden in low- and middle-income countries. Although its prevalence is increasing in Nigeria, data on the burden and determinants of diabetes in riverine and semi-urban populations of the South-South region remain limited. Objective: To determine the prevalence and predictors of diabetes mellitus in a semi-urban riverine community in southern Nigeria. Methods: A descriptive cross-sectional study was conducted among 1,077 adults in Borokiri, Rivers State, over a two-week period in August 2024. Sociodemographic information, anthropometric indices, and blood glucose levels were collected using standardized procedures. Diabetes mellitus was determined based on fasting blood glucose ≥ 7.0 mmol/L (≥ 126 mg/dL) or a prior diagnosis of diabetes mellitus. Data were analyzed with SPSS version 26. Chi-square tests examined associations between glycemic status and independent variables such as family history of diabetes, age, obesity, and hypertension. Binary logistic regression identified significant predictors of diabetes mellitus. Results: A total of 1,077 adults participated in the study, with a mean age of 43.6 ± 15.4 years; 823 (76.4%) were female. The prevalence of diabetes mellitus was 7.8% (n = 84). Diabetes occurred more frequently in females (8.3%) than males (6.3%) (p = 0.308). 46.0% (496) were classified as obese using BMI, and abdominal obesity was 53.9% (n = 581) by WC and 51.8% (n = 558) by WHR. Diabetes was significantly associated with older age (p < 0.005), family history of diabetes (p < 0.005), hypertension (p < 0.005), and central obesity (p < 0.005). Independent predictors included older age (aOR = 3.59; 95% CI: 1.750–7.370; p < 0.005), family history of diabetes (aOR = 2.94; 95% CI: 1.603–5.395; p < 0.005), central obesity (aOR = 1.93; 95% CI: 1.144–3.255; p = 0.014), and hypertension (aOR = 3.64; 95% CI: 2.103–6.296; p < 0.005). Conclusion: Diabetes mellitus was observed in 7.8% of adults in this community, highlighting the need for culturally appropriate health education, lifestyle modification programs, and improved access to affordable diagnostic and treatment services. Strengthening community-based preventive strategies and integrating routine diabetes screening at the primary-care level are essential to address the growing cardiometabolic disease burden in resource-limited settings.