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Modulation of quantum geometry and its coupling to pseudo-electric field by dynamic strain

Abstract 20: A Pro-Inflammatory Diet Potentiates Genetic Risk for Coronary Artery Disease: A Longitudinal Analysis of the Framingham Offspring Study

Introduction: Diet and genetics are key determinants of coronary artery disease (CAD). A pro-inflammatory diet, quantified by the Dietary Inflammatory Index (DII), and inherited susceptibility, quantified by a polygenic risk score (PRS), are independent risk factors for CAD. However, their interactive effect on long-term CAD risk is not well established. Hypothesis: We assessed the hypothesis that a pro-inflammatory diet is associated with a higher risk of incident CAD, and that this association is potentiated by an individual's genetic susceptibility, as measured by a CAD-PRS. Methods: We studied 2,856 participants from the Framingham Offspring Study free of prevalent cardiovascular disease at baseline (1991-1995). A validated food-frequency questionnaire was used to calculate DII scores. A genome-wide PRS for CAD was constructed. Participants were followed for incident CAD (myocardial infarction, coronary insufficiency, or CAD death). We used multivariable Cox proportional hazards models to assess the independent and joint associations of DII and PRS tertiles with CAD risk, adjusting for established risk factors. A multiplicative interaction term was tested. Results: Over a median follow-up of 22 years, 467 incident CAD events occurred. In fully adjusted models, both the highest DII tertile (HR: 1.45; 95% CI: 1.15-1.83) and the highest PRS tertile (HR: 1.70; 95% CI: 1.35-2.14) were independently associated with increased CAD risk compared to their respective lowest tertiles. A significant statistical interaction was observed between DII and PRS (p−interaction=0.015). The effect of DII was most pronounced among those with high genetic risk. Compared to individuals with low DII and low PRS, those with high DII and high PRS had a nearly threefold increased risk of incident CAD (HR: 2.84; 95% CI: 1.82-4.43). Conclusions: In conclusion, a pro-inflammatory diet is associated with an increased risk of incident CAD, particularly among individuals with a high genetic predisposition. These findings suggest that adopting an anti-inflammatory diet may be a particularly effective strategy for mitigating CAD risk in genetically susceptible individuals, supporting a role for precision nutrition in cardiovascular prevention.

Abstract WE478: Association of the AHA’s PREVENT-HF score with Incident Heart Failure Subtypes in the REGARDS study.

Background: The American Heart Association’s Predicting Risk of cardiovascular disease EVENTs equations Heart Failure (PREVENT-HF) score estimates the risk of heart failure (HF), based on demographic and cardiovascular risk factors. Knowing if PREVENT-HF predicts the two major subtypes of HF, with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF), could inform HF prevention strategies. Objective: To estimate the association between PREVENT-HF score and incident HFpEF and HFrEF hospitalization, separately. Methods: The PREVENT-HF score was calculated for the 23,043 participants, aged 45-79 years and without HF at baseline, in the nationwide Reason for Geographic and Racial Differences in Stroke (REGARDS) study. HF hospitalizations were adjudicated prospectively. The association between HFpEF and HFrEF and PREVENT-HF score was evaluated using the Cox regression in the overall sample, adjusted for the region of residence. Pre-specified subgroup analyses were performed by sex, race, annual household income, atrial fibrillation and albuminuria. Results: Over median follow up of 13.8 years, there were 478 incident hospitalizations for HFpEF (EF > 50%) and 609 - for HFrEF (EF<50%). The mean PREVENT-HF score at baseline was 7.2 (SD 5.9). Sixty two percent of the participants were in the “low risk” category (PREVENT-HF score < 7.5), 12% - in the “intermediate” category (score =7.5-9.9) and 26% - in the “high risk” category (score > 10). For HFpEF, compared to participants in the “low-risk” category, the HR for participants in the “intermediate” and “high risk” PREVENT-HF score categories were 3.56, 95%CI [2.27-4.66] and 5.93 [4.91-7.30], respectively (Figure 1A). For HFrEF, compared to participants in the “low-risk” category, the HR for participants in the “intermediate” and “high risk” PREVENT-HF score categories were 2.80, 95%CI [2.21-3.55] and 4.61 [3.86-7.51], respectively (Figure 1B). PREVENT-HF score was associated with incident HF hospitalization regardless of HF subtype within all subgroups investigated, except for individuals with atrial fibrillation, where this association was less pronounced. Conclusion: Higher PREVENT-HF scores were associated similarly with both incident HFpEF and HFrEF hospitalizations. Prevention strategies, utilizing PREVENT-HF score, may prevent both HF subtypes.

Study on the influence of time-varying characteristics of mud cake on the safe density window of drilling fluid

KIF11 prevents retinal endothelial ferroptosis in familial exudative vitreoretinopathy by inhibiting phosphorylation-driven PRDX1 phase separation

Abstract Familial exudative vitreoretinopathy is a hereditary disorder predominantly affecting infants and young children, often leading to severe vision loss. Approximately 40% of patients carry mutations in Norrin/β-catenin pathway genes. Nevertheless, the downstream pathogenic mechanisms remain unclear. Here, by using bulk RNA sequencing and single-cell RNA sequencing analyses, we identify KIF11 as a key downstream effector in retinal endothelial cells. Lentivirus-mediated KIF11 overexpression partially restores vascular defects in endothelial cell-specific Ctnnb1 knockout mice. Functional and multi-omics studies reveal that β-catenin/KIF11 deficiency induces autophagy-accompanied ferroptosis. Mechanistically, KIF11 binds PRDX1, and the disrupted β-catenin/KIF11 axis releases the competitive restraint of KIF11 on Src-mediated PRDX1 phosphorylation, triggering subsequent liquid-liquid phase separation. Treatment with the ferroptosis inhibitor ferrostatin-1 or lentiviral overexpression of non-phosphorylatable PRDX1 partially rescues vascular defects in familial exudative vitreoretinopathy-associated mice. Overall, we elucidate a β-catenin/KIF11/PRDX1 axis-dependent ferroptosis mechanism in familial exudative vitreoretinopathy, highlighting ferroptosis-targeting and antioxidant strategies as potential therapies.

Abstract TH806: Outreach Strategy Impacts Trial Enrollment, Cost, Efficiency, and Diversity: Results from the GoFresh Trials

Introduction: Approximately one-third of randomized controlled trials struggle to meet their recruitment goals. New recruitment strategies have emerged with the advent of online platforms, but their efficiency and cost-effectiveness vary by population. There is a critical need for more evidence on the effectiveness of diverse recruitment modalities, particularly for enrolling Black participants in clinical trials. Objective: To identify differences in participant diversity, recruitment efficiency, and cost-effectiveness by recruitment modality for enrolling eligible trial participants. Methods: The GoFresh trials tested whether DASH-patterned groceries might lower blood pressure (BP) in Black adults with elevated BP, residing in Boston-area food deserts. The trials employed various recruitment modalities and collectively screened over 5,000 adults. Recruitment data was collected during the screening phases of both trials. Odds ratios for recruiting participants with certain characteristics by recruitment modality were assessed using logistic regression, with word-of-mouth as the reference. Modality performance for randomization rates per 100 prescreened was evaluated with two-sample proportion tests. Results: In this study of 356 participants, the top five recruitment modalities successfully enrolling participants were transit, mailing, tabling, online, and word-of-mouth (WoM) ( Table 1 ). Compared to WoM, mail (OR 2.77, 95% CI: 1.40–5.47) and tabling (OR 4.59, 95% CI: 1.37–15.34) modalities were more likely to recruit participants ≥65 years ( Figure 1 ). Compared to WoM, mail (OR 2.14, 95% CI: 1.16-3.97) and online (OR 2.74, 95% CI: 1.03-7.27) modalities were more likely to recruit female participants. Recruitment modalities did not differ significantly from WoM for recruiting college-educated, low-income, or obese participants. Mail had a significantly higher randomization rate than transit (difference in proportions: 4.5%, p<0.001) and online (difference in proportions 3.2%, p=0.03) modalities ( Table 2 ). Cost per screening and per randomization varied by recruitment modality. Conclusion: Mail, tabling, and online recruitment modalities were optimal for recruiting older female adults. Overall, recruitment strategies differed in efficiency and cost. Tailoring recruitment by modality can enhance enrollment success, resource use, and representation in clinical trials.

Abstract TU137: Concordance of prenatal tobacco smoking, vaping, and cannabis use between electronic health records and self-administered research surveys

Background: Prenatal vaping and cannabis use are steadily increasing, with unknown epidemiological consequences. Unfortunately, the measurement of stigmatized health behaviors such as prenatal tobacco smoking, vaping, and cannabis use can be difficult. In the absence of biochemical testing, self-report via self-administered validated surveys may offer the best available estimates. Data from electronic health records (EHR) are a pragmatic alternative assessment method to research surveys, but the accuracy of EHR-reported prenatal vaping and cannabis use is unknown. Methods: The Mountain Mama&Baby Study is a prospective pregnancy cohort seeking to establish the epidemiology and health outcomes associated with prenatal vaping and cannabis use in central Appalachia. Participants were recruited by nurse navigators from six West Virginia University Medicine obstetric clinics between January-June 2025 at their first prenatal encounter in their first trimester (N=417, 44% enrollment). Upon enrollment, participants completed self-administered surveys adapted from national validated instruments querying their first-trimester tobacco smoking, vaping, and cannabis use. EHR data on substance use reported during the initial prenatal visit were also abstracted. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using survey data as the criterion standard. Results: Among the 374 participants who completed all relevant surveys, self-reported substance use was consistently lower in the EHR than in the survey responses: 5.6% vs 6.1% for tobacco smoking, 11.7% vs. 13.3% for vaping, and 4.8% vs 9.4% for cannabis use. When identifying current smokers, the EHR had a sensitivity of 0.74, a specificity of 0.99, a PPV of 0.81, and an NPV of 0.98. When identifying current vapers, the EHR had a sensitivity of 0.76, a specificity of 0.98, a PPV of 0.86, and an NPV of 0.96. When identifying current cannabis users, the EHR had a sensitivity of 0.40, a specificity of 0.99, a PPV of 0.78, and an NPV of 0.94. Conclusion: During the first trimester of pregnancy, the EHR was moderately concordant with self-administered surveys for tobacco smoking and vaping but had lower fidelity for cannabis use. Future research should compare EHR and survey-measured prenatal tobacco smoking, vaping, and cannabis use to biochemical assessments.

Understanding tens of thousands of pockmarks and domes using machine learning (Gulf of Lions, NW Mediterranean Sea)

Direct conversion of enzymatic hydrolysis lignin to jet fuel via relay catalysis

Abstract TU209: Cardiovascular Fitness Testing at a Large Public Event: Minnesota State Fair

Introduction: Change in heart rate in one minute following maximum exercise, or heart rate recovery (HRR), is a strong predictor of cardiovascular (CV) health and mortality. HRR assessment is appealing as it does not require expensive equipment or a clinic setting to be measured. The objective of this study was to assess CV fitness at a large public event using HRR and to evaluate the association of demographic characteristics, CV risk factors, and health behaviors with HRR. Methods: We conducted this study at the 2025 Minnesota State Fair, enrolling healthy, asymptomatic adults. Heart rate was obtained using a chest band monitor during 2 minutes of vigorous exercise and 1 minute of recovery. Demographic and CV health history were obtained via a post-test survey, including self-reported CV risk factors, exercise, and sleep. Participants were grouped by tertiles of increasing HRR and an age adjusted fitness score (poor, fair, good, excellent) was assigned. Results: A total of 263 participants were enrolled; 62 were excluded, 21 for technical failure related to the chest band or app, and 41 for inability to reach adequate heart rate for HRR calculation. Of the 201 participants with HRR data, mean age (SD) was 43.6 (17.5) years, 60% were female, 75% White, and 16% Asian. CVD risk factors were common including hypertension (18%) and high cholesterol (25%). When divided into tertiles, those with the highest (best) HRR tended to be younger, spend more time exercising, have a college or master’s degree, and were never smokers (Figure). In regression models, there was no significant association with demographic or CV risk factors and “excellent” HRR. Self-reported 7-9 hours of sleep compared to <7 hours was associated with excellent HRR (OR 2.45, 1.45-4.16) in the unadjusted model, but when adjusted for demographics and CV risk factors the association was no longer significant (OR 1.47, 0.77-2.84). Higher self-reported physical activity was significantly associated with excellent HRR in the adjusted model – tertile 2 vs 1 (OR 2.56, 1.19-5.52) and tertile 3 vs 3 (OR 4.13, 2.01-8.50). Conclusions: Measuring HRR and corresponding heart fitness grade in a brief exercise test may be a useful screening tool for CV health in otherwise healthy adults. Longitudinal studies are needed to determine the association of CV fitness measured by this method and CV outcomes.

Abstract TH879: Baseline Metabolomic Profile Predicts 5-Year Multimorbidity Trajectories and Incident Disease Risk in a Community-Dwelling Japanese Cohort

Background: The accumulation of multiple chronic diseases (multimorbidity) is a major public health challenge. However, the patterns of disease accumulation over time and their underlying biological drivers remain poorly understood. We aimed to identify distinct multimorbidity trajectories and their associated baseline metabolomic signatures. Methods: We conducted a prospective analysis of 7,441 community-dwelling Japanese adults aged ≥40 years, free of cardiovascular disease and cancer at baseline. Using claims data from 2015 to 2021, we calculated the monthly cumulative Charlson Comorbidity Index (CCI) for each participant. We applied k-means clustering to 5-year CCI data to identify distinct multimorbidity trajectories. Baseline plasma metabolomic profiles were analyzed using ordinal logistic regression to identify metabolites associated with trajectory progression. Subsequently, we used adjusted Cox proportional hazards models to assess the association between these progression-associated metabolites and the risk of future incident diseases over a 5-year follow-up. Results: We identified 3 distinct multimorbidity trajectories among 7,256 participants with complete follow-up: Stable Low (n=6,367), Gradual Increase (n=620), and Rapid Increase (n=269). The Rapid Increase group was characterized by older age and higher baseline CCI. Ordinal logistic regression identified 38 baseline metabolites significantly associated with a higher odds of being in a more progressive trajectory (FDR < 0.05). These metabolites were primarily involved in urea cycle/arginine metabolism and fatty acid metabolism. In disease-specific analyses, several progression-associated metabolites predicted incident disease. For instance, higher baseline levels of Phenylalanine, a top predictor of trajectory progression, were associated with an increased risk of both incident congestive heart failure (HR: 1.30; 95% CI: 1.11-1.52) and chronic pulmonary disease (HR: 1.26; 95% CI: 1.09-1.45). Conversely, higher levels of the medium-chain fatty acid Hexanoate were associated with a reduced risk of congestive heart failure (HR: 0.76; 95% CI: 0.67–0.87). Conclusion: Distinct data-driven multimorbidity trajectories exist and can be predicted by a baseline metabolomic signature. This signature is also linked to the future risk of specific cardiometabolic diseases, suggesting a potential role for metabolomics in the early risk stratification and prevention of multimorbidity.

Bond strength and interfacial stability of a universal adhesive to alendronate-treated dentin

Abstract The enzymatic degradation of the hybrid layer by endogenous matrix metalloproteinases (MMPs) represents the major cause of resin–dentin bond strength deterioration. The current study assessed the influence of dentin pre-bonding treatment with alendronate, an MMP inhibitor, on the efficacy of a universal adhesive.Ninety-six extracted molars were randomly allocated into four groups ( n  = 24) based on dentin surface treatment: no treatment (control), 2 wt% chlorhexidine, 0.03 wt% alendronate, and 0.3 wt% alendronate. Each group was further classified into two sub-divisions ( n  = 12) according to the adhesive application mode: etch-and-rinse (ER) and self-etch (SE). On flat dentin surfaces, the treatment solution was applied, followed by application of universal adhesive (All Bond UNIVERSAL, BISCO) and composite buildup. Eighty teeth were used for the assessment of microtensile bond strength (µTBS), failure mode, and nanoleakage, while the remaining sixteen teeth were examined using scanning electron microscopy (SEM) to assess the bonded interface. All tests were conducted at 2 time intervals; after 24 h and after aging for 5000 thermocycles. Statistical analysis of the µTBS data was performed using three-way ANOVA followed by Tukey’s post hoc test. The 0.3 wt% alendronate-treated ER group exhibited the highest µTBS values under both immediate and aged conditions (p value < 0.05). Using SE adhesive mode, the same treatment showed relatively higher µTBS values; however, the variations among SE groups were not significant. Failure mode analysis revealed that immediate alendronate-treated ER groups predominantly exhibited cohesive failures, whereas the ER control group presented a higher frequency of mixed failures. Following thermocycling, alendronate-treated ER groups showed a shift toward mixed failure mode. Nanoleakage analysis indicated greater silver uptake in the ER groups compared to SE groups, particularly after aging. Micromorphological surface analysis by SEM showed that the 0.3 wt% alendronate-treated ER group exhibited the most pronounced resin penetration. It has been concluded that dentin treatment with alendronate specifically 0.3 wt%, before bonding, appeared to enhance bond strength, particularly with etch-and-rinse mode. The results of failure mode analysis, nanoleakage evaluation and micromorphological interface observations confirmed these findings.

A single-atom potential confinement strategy for stabilizing rhodium nanocatalysts in methane oxidation

Abstract TH920: Plant-based Diet Quality and Cardiometabolic Biomarkers in Pregnant U.S. Women

Introduction: Evidence suggests that high quality plant-based diets are associated with favorable cardiometabolic outcomes. However, there is no consensus on the optimal measure to assess the quality of plant-based diet. Furthermore, little is known about how plant-based diet quality relates to cardiometabolic health in pregnant women. Hypothesis: We assessed the hypothesis that plant-based diet quality is associated with cardiometabolic biomarkers in pregnant women, with “healthy” plant foods linked to more favorable biomarker profiles. Methods: Data from pregnant women who participated in seven cycles (2005 to 2020 pre-pandemic) of the cross-sectional National Health and Nutrition Examination Survey (NHANES) were used to calculate six independent plant-based diet quality indices. Multivariable log-linear regression models were used to assess associations between these indices and cardiometabolic biomarkers, adjusting for age, race/ethnicity, education, and ratio of family income to poverty. Results: Dietary and cardiometabolic biomarker data were available for 580 pregnant women. Higher plant-based diet quality index values, independent of the index used, were positively associated with high-density lipoprotein cholesterol (HDL-C) concentrations, and negatively associated with triglyceride (TG)/HDL-C ratios. Additionally, those indices that accounted for plant foods quality were also associated with lower fasting insulin and TG concentrations, and homeostatic model assessment for insulin resistance (HOMA-IR). Conclusions: In this NHANES cohort of pregnant women, higher values of all plant-based diet indices were associated with more favorable biomarkers of cardiometabolic health. Those plant-based diet indices that emphasized the quality of plant foods rather than penalizing the inclusion of animal foods were more strongly associated with cardiometabolic health biomarkers.

Abstract TH882: Pigmentation-Related Disparities in Smartwatch Photoplethysmography for Atrial Fibrillation Detection: A Scoping Review

Background: Photoplethysmography (PPG) is widely used in smartwatches for detecting atrial fibrillation (AF), the most common cardiac arrhythmia. However, technical limitations related to melanin absorption, inadequate skin tone measures like the Fitzpatrick scale, and underrepresentation of persons with darker skin tones in validation studies are concerns that may compromise device accuracy and exacerbate health disparities. This scoping review aimed to systematically map the extent to which the literature acknowledges and addresses these pigmentation-related limitations. Methods: Following the Joanna Briggs Institute methodology, we conducted a scoping review of 6 databases: MEDLINE, EMBASE, Cochrane, Web of Science, Scopus, and ClinicalTrials.gov. Eligibility included English-language articles on PPG and cardiovascular disease published between January 1, 2015 to May 1, 2024 in adult populations and included grey literature (e.g., abstracts and reviews). Data were extracted to assess whether articles mentioned the identified limitations or reported results stratified by skin tone or race/ethnicity. Results: Of the 4,981 articles screened, 635 met inclusion criteria. Of those, 68 (10.6%) addressed technical limitations, 4 (0.6%) addressed skin tone measures, and 40 (6.2%) addressed underrepresentation. Of the 130 (20.4%) clinical studies that evaluated PPG-based AF detection, 11 (8.4%) addressed technical limitations, none addressed skin tone measures, and 11 (8.4%) addressed underrepresentation. Only two clinical studies reported stratified results. In a large-scale trial (n=455,699), the diagnostic yield for confirmed AF following an irregular rhythm detection was 2.2% (4/180) for Black non-Hispanic participants vs. 7.7% (293/3,812) for White non-Hispanic participants; however, formal statistical analysis and diagnostic accuracy were not reported. In a validation study, (n=111), the Black/African American subgroup was found to have a lower interval-level sensitivity (67.5%) compared to the White subgroup (97.2%). Conclusion: Pigmentation-related disparities and technical challenges of PPG due to skin tone are well-known yet seldom addressed as evidenced by our scoping review. Studies reporting stratified results further demonstrate the need for additional research. Future research should address the accuracy of PPG in darker skin tones, the accuracy of skin tone measures, and adequate recruitment of underrepresented populations.

A length-biased Sujit distribution framework: properties, simulation-based inference, and application to clinical remission data

SNX-mediated biogenesis of a plant-unique vesicle derived from the multivesicular body

Abstract TH888: Do Midlife Diet and Physical Activity Build Cognitive Reserve for Later Life? Results from the Framingham Heart Study

Background: Physical activity (PA) and healthy dietary patterns are associated with reduced risk of cognitive decline and dementia. However, it remains unclear whether these lifestyle factors, assessed in midlife, confer greater resilience to late-life neurodegeneration on cognitive function (i.e., cognitive reserve). Methods: We included 581 Framingham Heart Study Offspring cohort participants who completed food frequency questionnaires (FFQ) and PA questionnaires between ages 40-59 years and at least one neuropsychological (NP) assessment and brain MRI between ages 65-75 years. Dietary Approaches to Stop Hypertension (DASH) scores were based on FFQs. PA was based on the physical activity index (PAI) score. We used previously derived factor scores for memory (MEM) and executive functioning (EF) from the NP exams. MRI measures included hippocampal volume (HCV) and total brain volume (TBV). We used linear regression models to examine the two-way interaction between DASH quartiles or PAI tertiles and each outcome. Post-estimation marginal effects of the associations for each DASH group or PAI group were also obtained. Results: Participants were on average 54 years old at baseline; 53% were female ( Table 1) . Relationships between brain and cognitive measures with diet and PA did not show consistent effects. For example, HCV was positively associated with MEM performance only among those in the second ( β : 0.23; 95% CI: 0.11, 0.34) and fourth ( β : 0.14; 95% CI: 0.02, 0.26) quartiles of DASH scores ( Table 2 ). Greater TBV was significantly associated with better MEM performance only among those in the fourth quartile of DASH diet scores ( β : 0.003; 95% CI: 0.0005, 0.01). Similar positive associations were observed for HCV with EF among individuals in the second quartile of DASH diet scores. HCV was positively associated with MEM performance among those in the first ( β : 0.14; 95% CI: 0.03, 0.25) and third ( β : 0.14; 95% CI: 0.03, 0.26) tertiles of PAI scores ( Table 3 ). TBV was associated with EF only in individuals in the second tertile of PAI. No significant interactions were observed between DASH or PA and brain volume on performance in MEM and EF. Conclusion: DASH diet or PA in midlife does not appear to confer resilience to neurodegeneration in MEM or EF at an average age of 69 years. Continued follow-up of these participants as they enter a period of greater risk for dementia may reveal effects of midlife diet and PA on cognitive resilience in later life.

Abstract TU228: Lipid Optimization among Veterans with Familial Hypercholesterolemia: The VALOR-QI Program

Background: Despite the availability of effective lipid-lowering therapies, only about one-third of Veterans at risk for ASCVD achieve optimal LDL-cholesterol (LDL-C) levels. Patients with familial hypercholesterolemia (FH, LDL-C >=190 mg/dL) carry a disproportionately high burden of ASCVD. We sought to determine the impact of the VALOR-QI programon lipid optimization program among veterans with FH after 24 months of engagement. Methods: VALOR-QI was implemented across 50 VA sites from December 2022 to December 2025. Clinical Champions, Health Care Coaches, and AHA QI Consultants worked with participating providers to address site-level barriers. Veterans were considered engaged if they had ASCVD documented in ≥2 outpatient visits, ≥1 inpatient visit, or ≥1 procedure, and a qualifying appointment with a participating provider. Baseline LDL-C was defined as the closest value within 365 days of the first visit. FH was defined as ≥1 LDL-C ≥190 mg/dL. The primary outcome was the percentage of veterans achieving LDL-C< 70 mg/dL. Secondary outcomes included mean LDL-C change, lipid-lowering therapy (LLT) use, and LLT adherence, measured using the proportion of days covered (PDC ≥0.8). Results: Among 157,977 veterans with ASCVD, 1,171 had baseline LDL-C ≥190 mg/dL and were included in the current analyses; mean age, 65±11 years; 85% male; 63% White; and 68% urban. Between baseline and 24 months, 15% of veterans achieved LDL- C <70 mg/dL; mean LDL-C decreased by 86 mg/dL (from 216±34 to 130±64); LLT adherence rose from 23% to 57%; and LLT use increased from 74% to 89%. Conclusion: VALOR-QI demonstrates that addressing site-specific barriers with scalable, low-cost interventions can significantly improve lipid management in Veterans with ASCVD and FH.

Optimizing urban development through identification of urban fringe areas and construction of ecological security pattern