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Flexible rubber with metal-like thermal conductivity achieved via hydrogen bonding engineering

Abstract WE488: A Comparison of English and Spanish AI Chatbot Responses to Online Cardiovascular Questions: Differences in Response Length, Readability, and Guidance

Introduction: Large language models (LLMs) such as ChatGPT (OpenAI) and Gemini (Google) have become a dominant source of information. These tools contain nuanced and personalized information; they are also prone to hallucinations, societal biases, and sycophancy. While studies suggest LLMs are capable of providing high quality health information, less is known how this information varies by language and reading level. Because cardiovascular disease remains a leading cause of morbidity and mortality, and access to understandable health information is critical to promoting health equity, we studied the abilities of these models in providing approachable health information. Methods: Twelve common cardiovascular questions were queried in English and Spanish using two popular sources for patient LLM usage, the ChatGPT (4o) and Google’s AI summaries (Table 1). Response length, sentence length, disclaimers, and clinical guidance elements were recorded and analyzed using descriptive statistics and paired t-tests were performed to assess between-language differences. Readability was assessed using validated tools - Flesch-Kincaid Grade Level for English and Fernández-Huerta index for Spanish. Results: Across 48 responses, ChatGPT produced longer answers than Google in both languages. Mean sentence length was significantly longer in ChatGPT English compared with ChatGPT Spanish. Conversely, Google responses were slightly longer in Spanish. ChatGPT offered further medical guidance in 10 of 12 English and 11 of 12 Spanish responses, whereas Google provided none. Medical disclaimers were present in all Google responses and in approximately half of ChatGPT responses. Readability was above the recommended 6th grade level across languages and platforms. Conclusion: In conclusion, AI response length, readability, and guidance to cardiovascular questions varied by language and platform. AI companies should target health-related outputs to reading levels that are appropriate to users. Our finding of decreased medical disclaimers is consistent with other work in this field. Further research should evaluate the quality of responses in different languages with validated metrics. There are major limitations to our study, most notably that it had a small sample size, and our evaluation did not analyze quality or meaning. Greater attention to readability and linguistic tailoring of AI outputs may enhance equitable access to understandable online health information.

Abstract TU206: Multimorbidity and Obesity-related Associations with Variations in 24-hour Movement Cycles in Adults: The Dallas Heart and Minds 24-Hour Rest-Activity Cycle Study (DHS 24-REACT)

Introduction: Multimorbidity (MM) increases healthcare costs and worsens quality of life. Obesity can further complicate care. The 24-h movement cycle (e.g., physical activity [PA] and sleep) is associated with health, but less is known about how MM and MM with obesity (MMxobesity) is related to differences in cycle composition. Hypotheses: MM and obesity are independently associated with less PA and sleep compared to no chronic disease and MMxobesity would have stronger associations compared to either condition alone. Methods: Data are from 1273 Dallas Heart&Minds participants (age 60.5±10.6 yrs; 59% women; 7% Asian; 45% Black; 13% Hispanic; 33% White) that wore an ActiGraph GT9X Link on the wrist for 24-h for 7 days between 2019-24. GGIR was used to process data using the sleep algorithm and Hildebrand cutpoints. Valid wear was ≤30 h in the wake-sleep window with ≥10 h waking and ≥1 to ≤17 h of sleep. MM included ≥2 conditions of reported: diabetes, hypertension, heart failure, transient ischemic attack, peripheral artery disease, kidney problems, hepatitis, cancer, Major Depressive Disorder, Seasonal Affective Disorder, or schizophrenia. Linear mixed effects models were used to examine differences in daily minutes of sleep, sedentary behavior (SED), light intensity PA (LIPA), and moderate to vigorous intensity PA (MVPA) by MM and obesity status controlling for covariates. An interaction term (MMxobesity) was included to assess whether the effect of MM on 24-h movement cycle components varied by weight status. Results: On average (±SD), participants (28.4% had MM and 30.2% with obesity) spent 7.3±2.1 h in sleep, 13.1±2.5 h in SED, 2.5±1.1 h in LIPA, and 62.0±48.8 min in MVPA per day. For sleep ( Fig. A ), SED ( Fig. B ), LIPA ( Fig. C ) and MVPA ( Fig. D ), MM and obesity were both independently associated, however their combined effects (MMxobesity) did not modify the strength of these associations (all p > .05). Those with MM had had more minutes in SED (β: 30.9, 95% CI: 15.3, 46.4) to the expense of less LIPA (β: -9.1, 95% CI: -17.0, -1.1) and MVPA (β: -12.8, 95% CI: -18.7, -7.0). Those with obesity had more minutes in SED (β: 40.7, 95% CI: 24.1, 57.2) to the expense of less sleep (β: -16.7, 95% CI: -29.9, -3.5), LIPA (β: -14.3, 95% CI: -22.7, -5.8), and MVPA (β: -9.1, 95% CI: -15.3, -2.9). Conclusions: Variations in the 24-h movement cycle across both MM and obesity highlight the importance of targeted interventions to combat inadequate movement profiles.

Correction: Miniaturized flexible skin moisture sensor with optimized coil for enhanced wireless power efficiency

A high-throughput conditioned-media-based screening system identifies inhibitors of aggregation induced by iPSC-secreted amyloid β

Abstract In early drug discovery, in vitro screening is frequently used, but selected candidates often fail in vivo. Induced pluripotent stem cell (iPSC)–based disease models offer improved physiological relevance; however, the high costs of media and differentiation procedures limit large-scale testing. Here, we develop a high-throughput conditioned-media-based screening system—the High-throughput screening technology for Aggregation Inhibitors of Diseased cell-derived Aggregative Proteins (HaiDap) system—to identify inhibitors of aggregation induced by iPSC-secreted amyloid β (Aβ). Using conditioned media derived from differentiated iPSCs of a male Alzheimer’s disease patient, we screen extracts from 22 edible plants. Whereas PBS-based assays showed 40.9% (9/22) apparent selectivity, the HaiDap system demonstrates higher specificity (13.6%; 3/22). All three identified extracts ( O. aristatus , S. aromaticum , and G. yesoense ) significantly delay Aβ aggregation on neuronal surfaces in an iPSC-based assay. These findings suggest that the HaiDap system enables efficient, accurate, and low-cost screening of amyloid aggregation inhibitors.

Abstract TU105: Depression and Physical Rehabilitation in Older Patients with Heart Failure: An Analysis from the REHAB-HF study

Background: In the multicenter, randomized REHAB-HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) trial, older hospitalized patients with decompensated heart failure (HF) who participated in an early, transitional, tailored, progressive, and multidomain physical rehabilitation intervention demonstrated significant improvements in physical function and quality of life (QOL). Prevalence of depression is high in HF, but it is unknown whether older patients with concomitant HF and depression who undergo rehabilitation have similar improvements in outcomes. Objective: We assessed for physical function and QOL differences in intervention outcomes among patients with and without baseline depression. Methods: REHAB-HF included patients > 60 years hospitalized for HF and randomized them to a physical rehabilitation intervention or attention control. Participants were stratified across baseline depression status using the Geriatric Depression Scale (GDS, ≥5). Primary outcomes included physical function measured with the Short Physical Performance Battery (SPPB) score and health-related (HR) QOL measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ) at 3 months. Clinical outcomes included all-cause/HF hospitalizations or mortality at 6 months. Results: Out of 343 participants (mean±SD age 73±8, 52.2% female), 44.6% (n=153) had depression. Those with depression had higher BMI (34.2±8.8 vs. 31.8±8.2, p=0.01), had EF > 45% (61.4% vs. 47.9%, p=0.01) and were frail (54.9% vs. 38.9%, p=0.003). Adherence to rehab intervention did not differ for participants with and without depression. Participants demonstrated improvements in SPPB with the intervention with (Effect Size 1.4; 95% CI 0.5, 2.3; p=0.002) and without (1.5; 0.7, 2.3; p=0.0001) depression. There was a trend toward a larger intervention effect size for HRQOL, with significant improvement among patients with (11.6; 3.9, 19.3; p=0.003) vs. without depression (3.2; -3.6, 10.0, p=0.4) as measured by KCCQ. No differences in clinical outcomes were seen. Conclusions: Older HF patients with and without depression had similar adherence and demonstrated significant improvements in physical function in response to intervention. Those with depression also demonstrated significant improvements in HRQOL. These findings suggest that physical rehabilitation may improve physical function and HRQOL in older patients with comorbid depression during recovery from acute HF decompensation.

Abstract TU142: Global Burden and Trends in Heart Failure due to Pneumoconiosis From 1990 to 2023: A Comprehensive Benchmarking Analysis

Background: Pneumoconiosis, a chronic occupational lung disease resulting from prolonged dust exposure, has emerged as a systemic condition with significant cardiovascular consequences, particularly heart failure (HF). Despite advances in workplace safety, the global burden and long-term trends of HF linked to pneumoconiosis remain underexplored. Methods: Temporal trends in HF attributable to asbestosis, silicosis, coal workers’ pneumoconiosis, and berylliosis were analyzed globally from 1990 to 2023 across 204 countries and territories using GBD 2023 tool. Age-standardized prevalence rates (per 100,000 population) were assessed by region, age, sex, and income group, and temporal changes were quantified using the Average Annual Percent Change (AAPC) derived from log-linear regression models. Results: Between 1990 and 2023, the global prevalence of heart failure attributable to pneumoconiosis showed an overall rising trend, increasing from 1,718 to 8,246 cases for asbestosis (AAPC = 4.98%), 364 to 1,246 for silicosis (AAPC = 4.34%), 649 to 1,042 for coal workers’ pneumoconiosis (AAPC = 1.30%), and 363 to 1,114 for berylliosis (AAPC = 3.01%). Regionally, the highest AAPC was observed for silicosis (7.50%) and asbestosis (7.02%) in Southeast Asia, East Asia, and Oceania, followed by coal workers’ pneumoconiosis (4.13%) in the same region and berylliosis (4.10%) in North Africa and the Middle East. Across income levels, the greatest rise occurred in upper-middle-income countries (AAPC = 6.8%), followed by lower-middle-income countries (AAPC = 4.9%), while high-income regions exhibited a comparatively modest increase (AAPC = 2.7%). Age-specific analysis revealed a modest rise in individuals aged <20 years (AAPC = 0.08%), a notable increase among those aged 20–54 years (AAPC = 2.51%), and a substantial elevation in the ≥55-year group (AAPC = 1.52%). By gender, males showed a higher increase in the age-standardized prevalence rate compared with females (AAPC = 2.78% vs. 1.23%). Conclusion: The global burden of heart failure attributable to pneumoconiosis has risen significantly over the past three decades, with sharpest increases in upper-middle-income and industrializing regions, particularly in Asia. The upward trends across all age and sex groups emphasize the need for reinforced occupational health regulations, early cardiovascular monitoring, and integrated preventive strategies to mitigate the growing cardiopulmonary consequences of pneumoconiosis.

Effects of curved carbon fiber plate bending stiffness on plantar pressure characteristics and performance during speed step in jump rope athletes

Sperm hyperactivation drives a circling-and-wandering swimming behavior

Abstract During migration through the female reproductive tract, sperm undergo physiological changes known as capacitation, including a motility transition termed hyperactivation. Hyperactivation is essential for various aspects of fertilization, particularly effective migration within the tract. However, how hyperactivation facilitates this migration remains elusive. Here, we profiled bull sperm hyperactivation and swimming in Newtonian and complex fluids, using microfluidic surfaces to mimic confinement of the tract. We identified three swim gaits: wandering (persistent random walks), circling, and an intriguing circling-and-wandering mode marked by stochastic transitions between the two. All gaits exhibit diffusive behavior over long time scales, with wandering showing a tenfold higher diffusivity than circling, and the effective diffusivity of circling-and-wandering falling in between. We found that while wandering sperm scatter from convex and concave surfaces, circling sperm become trapped around pillars, highlighting a distinctive feature of each phase. Additionally, stochastic simulations of active transport in porous media showed that as the geometrical complexity of the environment increases, circling-and-wandering outperforms either motility alone in spreading through the media. Our findings suggest that wandering may broaden the search landscape, while circling could help maintain local focus. Therefore, the combined circling-and-wandering swimming behavior might provide a flexible mechanism for modulating motility and facilitating migration in complex environments. Our results may have implications for understanding the physical aspects of sperm migration in the female reproductive tract.

Abstract TU194: An allostatic load domain-specific metabolic profile in young adults - The African-PREDICT study

Introduction: Allostatic load scores (ALS) quantify cumulative physiological burden of sustained stress across neuro-endocrine, metabolic, cardiovascular, and inflammatory domains. The heterogeneity of ALS complicates stress and risk evaluation and comparisons. Urinary metabolomic signatures may provide an innovative alternative to physiological stress characterization and identify early domain-specific changes. We (1) designed a novel, multilayered perceptron neural network (MLP-NN) method to investigate metabolic perturbations associated with domain-specific alterations in low and high sustained stress, as measured by ALS, and (2) described ALS domain-specific metabolomic profiles in young South Africans. Methods: Baseline data from 955 healthy Black and White South Africans (mean age 24±3 years; 48%Black; 50%male), was used. ALS was calculated using the upper quartile population-distributions of dehydroepiandrosterone, adrenocorticotropic hormone, cortisol, interleukin-6 , C-reactive protein, waist circumference, glycated haemoglobin, blood pressure, and the lower quartile population distributions of high-density lipoprotein cholesterol. Urinary amino acids and acylcarnitines (N=32 metabolites) were analyzed via liquid chromatography-tandem mass spectrometry. MLP-NN was used to assess metabolite contribution to the ALS domains while controlling for confounders identifying the top metabolites, per domain, with the highest synaptic weight. Results: High stress (ALS≥4) was observed in 30% of participants. All 32 metabolites significantly differed between high and low ALS groups (all P <0.05). MLP-NN revealed distinct metabolomic patterns for the four AL domains in both ALS groups. In the low ALS group, the MLP-NN identified metabolites, pyroglutamic acid, histidine, methionine, tryptophan, propionylcarnitine, butyrylcarnitine, and isovalerylcarnitine was identified to be significant in the neuro-endocrine, cardiovascular, and metabolic domains (all P <0.05). In the high ALS group, tyrosine, glutamine, pyroglutamic acid, 2-aminoadipic acid, histidine, valine, and arginine were identified to be significant in the neuro-endocrine, metabolic and inflammatory domains (all P <0.05). Conclusion: This MLP-NN-based approach identified unique urinary profiles reflective of higher AL, independent of confounders. This non-invasive approach may serve as a novel alternative for assessing AL, retaining the domain-specificity, yet allowing comparative studies.

Abstract TH856: Program Engagement and Frequency of Hospital Readmission among Participants of Postpartum Remote Blood Pressure Monitoring: Differences by Preferred Language

Introduction: Limited multi-language access in healthcare is a public health concern as language barriers can contribute to lower quality care, miscommunication, and adverse health effects. Language barriers also reduce engagement with digital health technologies, such as remote blood pressure monitoring (RBPM), often developed for English speakers. Hypothesis: There is lower engagement in postpartum RBPM and higher occurrence of postpartum readmission among non-English speakers than English speakers. Methods: In 2020, a large safety-net hospital implemented a postpartum RBPM program for patients with hypertensive disorders of pregnancy, including chronic or gestational hypertension, preeclampsia, and hypertension during delivery hospitalization. Program materials and messaging are available in several languages including Spanish, Haitian Creole, and English. Patients are instructed to take their BP daily up to 6 weeks postpartum using a cell-enabled cuff that automatically uploads readings to a provider-facing portal. Using health records, we abstracted data including race, ethnicity, nativity, and language as well as healthcare utilization through 12 months postpartum. Program engagement was examined by preferred language during the six-week postpartum period using two measures: frequency, defined as the number of days with ≥1 BP reading, and duration, defined as the last day with a recorded reading. We also examined the proportion of patients readmitted to the hospital by preferred language within 12 months postpartum. Results: Between January 2021 and June 2023, 2,200 patients were enrolled in the RBPM program of which 94% (n=2,069) provided ≥2 BP measures. Frequency (days with BP measures) and duration (last day with a BP measure) of program engagement were higher among Spanish (mean: 15.7; 31.7) and Haitian Creole (mean: 17.4; 34.1) speakers compared to English speakers (mean: 13.6; 29.9). Approximately 7% (n=153) of patients were readmitted within 12 months postpartum. Readmission rates were highest among English (8.3%) and Haitian Creole (6.8%) speakers and lowest among Spanish speakers (3.8%), though differences between language groups may be partially explained by variations in race, ethnicity, and nativity. Conclusions: These findings suggest that when digital health programs are designed with intentional language inclusivity, non-English speakers can engage as effectively as English speakers which may translate to reductions in postpartum readmission rates.

Assessing smart city maturity through a multidimensional DP2-based clustering of the IMD smart city index

B–N–B Embedded multiple-resonance polyaromatic enabling efficient narrowband electroluminescence

Abstract WE510: Ultra-Processed Food Intake and Cardiometabolic Outcomes: A Cross-Sectional Analysis in a Multi-Ethnic Asian Population in Singapore

Background: Ultra-processed food (UPF) intake has been linked to adverse cardiometabolic outcomes, but there is limited evidence from Asia, a region with a unique food environment and diverse populations with varying rates of cardiometabolic disease. Objective: To examine the association of UPF intake with prevalent cardiometabolic outcomes in multiple Asian ethnic groups. Methods: Cross-sectional data of 5515 Chinese, 1553 Indian, and 1067 Malay individuals aged 30–84 years from the Health for Life in Singapore Study (2018–2022) were analyzed. UPF intake was defined by applying the Nova classification for food processing to the 163-item Singaporean food frequency questionnaire. The associations of total UPF intake with the prevalence of general obesity (BMI≥27.5kg/m2), abdominal obesity (waist circumference ≥90cm for men, ≥80cm for women), metabolic syndrome (Asian definition), type 2 diabetes, hypertension, and dyslipidemia were examined using multivariable Poisson regression adjusted for sociodemographic and behavioral factors, family cardiometabolic history, total energy intake, and BMI (except for general obesity). Results: The mean intake of total UPF was the highest in Malays (6.1±3.6 servings/day), followed by Chinese (5.3±3.2) and Indians (5.2±3.2). The top food groups contributing to total UPF intake by servings were gravies and sauces, snacks and desserts, refined grain products, and coffee and tea with condensed milk/additives (Figure 1). Cardiometabolic conditions were more prevalent in Indians and Malays compared to the Chinese (Figure 2). Total UPF intake was significantly associated with general obesity (prevalence ratio and 95% CI for 3 servings/day: 1.06, 1.01–1.11) and abdominal obesity post-BMI adjustment (1.04, 1.01–1.08) but not the other assessed outcomes (Figure 2). There was a significant interaction of total UPF intake with ethnicity for obesity (P=0.0001), with the association being more pronounced among Chinese. In leave-one-out analyses of UPF subtypes, the associations with adiposity were attenuated when coffee and tea with condensed milk/additives, gravies and sauces, or sweet beverages were excluded from total UPF. Conclusions: In this multi-ethnic Singaporean population, UPF intake was positively associated with general and abdominal obesity, with ethnic variation in general obesity. The heterogeneity and details of the types of UPFs consumed across ethnic groups require further investigation in prospective analyses.

Abstract TU199: Association Between Physical Activity and All-Cause Mortality Among Middle-Aged and Older Adults With Elevated C-Reactive Protein: NHANES 1999–2006

Background: Evidence suggests participation in aerobic and muscular strengthening physical activity (PA) is associated with a decrease in risk for all-cause mortality. Elevated C-reactive protein (CRP), a marker of low-grade chronic inflammation, is associated with an increased risk for mortality. Few studies have examined whether PA mitigates the increased risk for mortality associated with elevated CRP. Purpose: Examine the association between self-reported PA and all-cause mortality among a representative sample of U.S. adults with elevated CRP. Methods: Data from the 1999-2006 National Health and Nutrition Examination Survey were used. Particpants were adults (40-79 years, mean age 55.6 years, n=2,635) with elevated CRP (3-10 mg/L) who participated in data collection from the Mobile Examination Center. Aerobic PA was categorized as meeting the guidelines (≥500 MET-minutes/week), some activity (>0-<500 MET-minutes/week), and no aerobic PA. Muscular strengthening activity (MSA) was categorized as meeting (≥2 days/week) or not meeting the guidelines (<2 days/week). All-cause mortality was the dependent variable. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) across the categories of aerobic PA and MSA. Results: In the total sample, those meeting the aerobic PA guidelines had a significant reduction in all-cause mortality (HR: 0.75, 95% CI: 0.61-0.92, p=0.007). When stratified by gender, similar findings were revealed found among men (HR: 0.72, 95% CI: 0.54-0.96, p=0.03) and women (HR 0.59, 95% CI 0.43-0.80, p=0.001). No risk reduction was found for MSA participation. Conclusions: Among U.S. adults with elevated CRP, meeting current aerobic PA guidelines significantly reduced the risk for all-cause mortality in both men and women. Future studies should examine effects of domain-specific PA, objectively measured (e.g., accelerometer-derived) PA, and/or more precise measures of MSA and all-cause mortality among those living with chronic systemic inflammation.

A blockchain-integrated multi-scale convolutional network for accurate recognition and secure tracking of high-difficulty movements in aerobics training

Continuous evolution of a halogenase enzyme with improved solubility and activity for sustainable bioproduction

Abstract Halogenation enhances the stability and function of pharmaceuticals, biomaterials, and industrial compounds. However, chemical halogenation of molecules and peptides can lack stereoselectivity and require the use of toxic chemicals. Although enzymatic halogenation can improve selectivity and reduce environmental impact, current halogenases are inefficient and insoluble, leading to low yields that limit their applications. Here, we develop RebH Evo4 , a soluble and highly active tryptophan halogenase, containing 12 mutations that confer 37-fold and 44-fold increases in 7-chloro- and 7-bromotryptophan production respectively, in vivo. To create RebH Evo4 , we devise an aminoacyl-tRNA synthetase-based halogenase biosensor and conduct over 500 hours of phage-assisted continuous evolution (PACE). Use of RebH Evo4 in a bioreactor results in the production of 2.7 g/L of halogenated tryptophan. When coupled with a downstream enzyme, RebH Evo4 allows 36-fold increased yields of halogenated tryptamines compared to the wild-type enzyme. Additionally, RebH Evo4 enables efficient production of genetically encoded antimicrobial halogenated peptides. The efficient, site-specific halogenation enabled by our evolved halogenase will accelerate sustainable biomanufacturing of halogenated drugs.

Abstract TH811: Electronic Patient Portal Recruits for Cardiovascular Trials are Demographically Distinct with Improved Rates of Eligibility and Screening Attendance

Introduction: Participant recruitment challenges are a leading cause of delays and early termination in clinical trials, resulting in substantial financial costs and risk of underpowered, unrepresentative samples. Recruitment through patient messaging on the electronic medical record (EMR) provides a time- and cost-effective option. However, research on the EMR’s effectiveness in enrolling a representative sample is sparse. Hypothesis: Participant demographics, eligibility, and screening attendance will differ between EMR recruitment and traditional recruitment methods in two similar randomized control trials (GoFresh, GoFreshRx). Methods: Trials for a lifestyle intervention used EMR, flyers, and other methods to recruit Black adults (≥18 years) with high blood pressure living in Boston-area food deserts. EMR recruitment included additional medication criteria. Participants completed a telephone pre-screen (PQ) and, if eligible, two in-person screenings (SVa, SVb). Outcomes included participant demographics, pre-screen eligibility (i.e., eligible after PQ), screening attendance (i.e., attending SVa), and post-screen eligibility (i.e., eligible after SVa/SVb). Multivariable logistic regressions modeled outcomes by recruitment source (EMR vs. non-EMR), adjusting for age and hypertension treatment status (participants in GoFreshRx, but not GoFresh, were on treatment). We compared ineligibility reasons between EMR and non-EMR recruits using chi-square tests with Bonferroni-corrected post-hoc pairwise comparisons. Results: People recruited by EMR were more likely to own their home, be married, be a college graduate, be employed full-time, have a household income >$60,000, have private health insurance, and be food secure (all P <0.05; Figure 1 ). In GoFreshRx, EMR recruits had greater odds of pre-screen eligibility (Adjusted Odds Ratio [aOR]: 1.54; 95% CI: 1.04, 2.28) and screening attendance (aOR: 2.28, 95% CI: 1.06, 4.89; Table 1 ). Disqualifying medical conditions, particularly diabetes, accounted for a lower proporton of reasons for ineligibility in EMR than in non-EMR recruited populations ( P <0.001; Table 2 ). Conclusion: EMR recruitment offers opportunities for more targeted recruitment with greater eligibility rates than other recruitment methods. It can successfully recruit underrepresented minoritized populations; however, EMR recruits were of higher socioeconomic status. Thus, combining EMR use with other approaches may be necessary to achieve representative samples.

Abstract TH942: A Human-Centered Design Approach to Develop 'The Health Integrated Nutrition and Kidney Wellness' Intervention with Community, Health System, and Patient Partners

Introduction: Lifestyle interventions are a promising approach to promote health behavior change, yet integrated interventions for multimorbid conditions, such as cardio-kidney-metabolic syndrome, are lacking. Moreover, patient recruitment, engagement and retention are major barriers to impacting behavior change, especially for people living with socioeconomic disadvantages. To overcome these challenges, we aimed to co-design with community, health system and patient partners ‘The Health Integrated Nutrition and Kidney Wellness (THINK-Well)’ intervention for people with cardio-kidney-metabolic syndrome and to describe our human-centered design approach to intervention development. Methods: Using human-centered design methods, we conducted three one-hour virtual meetings with a panel of seven partners representing patients with kidney disease, registered dietitians, grocers, nephrologists, healthcare payers, lifestyle coaches, and a national kidney organization. Meetings used a virtual collaboration board to share observed barriers to recruitment, engagement and retention, propose solutions, and create an intervention blueprint. Results: Based on panelists feedback, the top challenges were poor visibility of recruitment communications and the need for curriculum individualization and incentives to promote engagement and retention. The first meeting generated thirty ideas, which were prioritized by importance and implementation difficulty during the second meeting. The blueprint for THINK-Well intervention was designed to align with the Capability, Opportunity, Motivation-Behavior theory in the third meeting. The intervention included recruitment newsletters and reminder text messages to increase awareness of resources; a mix of biweekly virtual and in-person group meetings to promote socialization and remove travel constraints; retention items such as food boxes and biometric devices to enable and educate about nutrient-rich eating and health monitoring; and goal setting to motivate through individualized counseling. Conclusions: We co-designed THINK-Well intervention in partnership with patients, multi-level health system representatives and community advocates. The human-centered design approach generated practical solutions to recruitment, engagement and retention using the experiential knowledge of panelists. Future steps will test feasibility and implementation of THINK-Well Intervention.

Compact multi-band bandpass filter with independently controlled passbands using CRLH-TZRP