Browse Articles

Risk assessment for cardiovascular adverse drug events in the ICU: Case study on COVID-19 patients

The COVID-19 outbreak quickly became a pandemic. In Brazil, more than seven million cases were recorded in 2020. Most patients affected by the disease were admitted to intensive care units (ICU), requiring qualitative polypharmacy, increasing the risk of serious adverse drug reactions (ADE), especially cardiovascular. This study aimed to identify cardiovascular ADE in the ICU of a reference hospital for the treatment of COVID-19 in Brasília, Brazil. The Tisdale score was determined by analyzing 141 medical records of patients with COVID-19 admitted in 2020. Furthermore, the MedUTI software was used to simulate hypothetical drug substitutions to reduce cardiovascular risk. The result showed that after simulating the hypothetical intervention of prescriptions, a 53% decrease in high-risk patients was observed (from 96.0% to 43.0%). In this optimized prescription condition, 56% of them began to show a Tisdale score of medium or low risk. In addition, a decrease from 67 to 51 of medications with serious cardiovascular ADE was noted, i.e., QT interval prolongation (from 37 to 30), Torsades de Pointes (from 21 to 15), and SS (from 9 to 6). The COVID-19 medical emergency has highlighted the need for rapid medication management in ICU patients. Thus, the use of technologies to support healthcare professionals’ work can be decisive for patient survival, especially in ICU overcrowding scenarios.

Abstract TH973: Longitudinal Associations of Blood Pressure and Arterial Stiffness in Youth with Type 1 and Type 2 Diabetes: The SEARCH for Diabetes in Youth Study

Introduction: Increasing arterial stiffness and blood pressure (BP) are thought to contribute to cardiovascular disease risk in youth-onset type 1 (T1D) and type 2 (T2D) diabetes. Prior work in generally healthy youth found that arterial stiffness preceded changes in BP. Whether this temporal relationship exists in a youth-onset diabetes population, who have higher arterial stiffness and BP compared to healthy controls, is unknown. Further, which arterial stiffening mechanisms are most involved (load-dependent stiffening due to elevated BP or structural stiffening due to arterial wall thickening and remodeling) is unknown. Hypothesis: Our objective is to investigate the longitudinal bidirectional relationships between arterial stiffness (measured by carotid-femoral pulse wave velocity [PWV CF ]), and BP in youth-onset T1D or T2D. Additionally, we will use a recently-published modeling strategy to uncouple structural stiffness (PWV Structural ) and load-bearing stiffness (PWV Load ) components from measured PWV CF . We hypothesize that baseline PWV measures will predict future BP, as in generally healthy youth. Methods: Participants from the SEARCH for Diabetes in Youth Study (T1D, n=566; T2D, n=93; baseline age, 18.0 ± 4.6 years) had clinical, BP, and PWV CF assessed at two timepoints (mean follow-up time: 4.5 ± 1.1 years). Using a modeling approach which incorporates arterial mechanics, PWV CF , and BP, we calculated the PWV Structural and PWV Load components. We constructed separate multivariable linear regression models to quantify associations of (A) baseline PWV measures with follow-up BP, and (B) baseline BP with follow-up PWV. Results: In fully-adjusted models ( Image 1 ), a 1-SD higher baseline PWV Load was associated with a 4.03 (95%CI: 2.68-5.37) mmHg higher SBP at follow-up, but baseline PWV CF (ß: 1.15, 95%CI: -0.28-2.57) and PWV Structural (ß: 0.45, 95%CI: -0.95-1.85) were not associated. In the reverse analysis ( Image 2 ), a 10 mmHg higher SBP at baseline was associated with 0.08 (95%CI: 0.02-0.13) SD higher PWV CF , 0.32 (95%CI: 0.24-0.41) SD higher PWV Load , and 0.05 (95%CI: -0.01-0.11) SD higher PWV Structural . Bidirectional associations were largely consistent for DBP. Conclusions: In adolescents and young adults with youth-onset diabetes, BP may temporally precede changes in arterial stiffness, with load-dependent stiffening playing a larger role. This suggests BP control as a primary target for reducing arterial stiffness and CVD risk in youth-onset diabetes.

Abstract WE447: Rising Burden of Endocarditis in OECD Nations: Demographic Shifts and Epidemiological Insights from 1990-2021

Background: Endocarditis is associated with substantial morbidity and mortality, particularly in high-income settings. In OECD countries, its burden is exacerbated by aging populations, a higher prevalence of comorbidities, and the widespread use of invasive medical procedures, underscoring the need for targeted surveillance and robust health system responses. Methods: We estimated prevalence, incidence, mortality, and DALYs in 38 OECD countries from 1990-2021 using the global burden of disease study 2021 framework, which integrates standardized case definitions with data from national vital registration systems, hospital records, and epidemiological models. Age-standardized rates were calculated to ensure comparability over time and across countries. Temporal trends were evaluated using annual percentage change (APC) derived from log-linear regression models. All estimates are presented with 95% uncertainty intervals (UIs) and were stratified by sex, age group, and country to capture demographic and regional variations. Results: In 2021, OECD countries accounted for 30.51% of global new cases, 48.79% of global deaths, and 31.64% of total DALYs due to endocarditis. Between 1990 and 2021, the total prevalence increased from 50,244 (95% UI: 43,265–57,640) to 188,436 (159,128–218,790), deaths from 14,108 (12,824–15,039) to 37,985 (32,514–41,026), and DALYs from 319,658 (300,744–338,520) to 657,112 (599,608–692,976). The most significant increase in ASIR was observed in Switzerland (APC: +2.58%), followed by Chile (+2.40%), Netherlands (+2.24%), and Luxembourg (+1.98%). ASMR increased most in the United Kingdom (+4.89%), Netherlands (+4.70%), and Iceland (+4.29%), while the United States showed a slight decline (–0.11%). Age-wise, incidence rates rose by 117% in individuals aged 55+, 26% in those aged 20–54, and declined by 3% in individuals under 20 years. Similarly, mortality rates increased by 60% in the 55+ group, 34% in the 20–54 age group, and decreased by 47% in those under 20 years. Conclusion: From 1990 to 2021, the burden of endocarditis in OECD countries rose sharply, driven by a growing impact among adults aged 55 and older. While several countries, including the UK and Netherlands, experienced steep rises in incidence and mortality, the USA showed a modest decline. These findings highlight the need for targeted prevention and improved clinical strategies to address the rising burden in aging populations.

Abstract WE469: Comparing Trends in Acute Myocardial Infarction Related Mortality Among Type 2 Diabetic versus Type 1 Diabetic Adults in United States: Data from CDC WONDER 1999-2020

Objective: Diabetes mellitus (DM) continues to be a major contributor to acute myocardial infarction (AMI)-related mortality. Both Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM) are associated with AMI; however, mortality data on the regional and demographic disparities among patients with concomitant AMI and T1DM remain understudied. Methods: We utilized publicly available, deidentified data from the Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) database. Using the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), we identified diabetic patients with AMI (codes I21.0-I21.1, I21.3-I21.4, I21.9, I22.0-I22.1, I22.8-I22.9). T2DM was defined using codes E11.0–E11.9, and T1DM using codes E10.0–E10.9. Age-adjusted mortality rates (AAMRs), standardized per 100,000 population, were stratified by year, sex, ethnicity, urbanization, geographic region, and state. Analyses were conducted using Joinpoint Regression Software version 5.0.2. Results: Between 1999 and 2020, a total of 203,068 AMI-related deaths occurred among individuals with diabetes. Of these, 169,973 were in patients with T2DM and 33,095 in those with T1DM, with overall AAMRs substantially higher in T2DM (4.5) than in T1DM (0.4). Mortality was consistently greater among males (T2DM: 5.0; T1DM: 1.0) when compared to females (T2DM: 3.4; T1DM: 0.7). Among T2DM patients, the AAMR was highest in Hispanics (5.9), while in T1DM, it was greatest in non-Hispanics (0.9). Across both cohorts, non-metropolitan areas demonstrated higher mortality (T2DM: 5.9; T1DM: 1.3). T2DM-related mortality peaked in the Western region (AAMR: 5.3), whereas T1DM-related mortality was highest in the Midwest region (AAMR: 1.1). West Virginia showed the highest T2DM mortality (AAMR: 7.9), followed by Iowa, California, Ohio, and Tennessee. For T1DM, Rhode Island reported the highest mortality (AAMR: 1.8), with Tennessee, West Virginia, Arkansas, and North Dakota also ranking in the 90th percentile. Conclusion: AMI imposes a substantial mortality burden among individuals with DM, especially those with T2DM. Marked disparities by sex, ethnicity, region, and urbanization emphasize the need for targeted preventive and healthcare strategies to reduce inequities.

ATP13A2 restrains macrophage NLRP3 inflammasome activation to repress neurodegeneration via modulating mitochondrial homeostasis

Neuro-immune crosstalk is increasingly recognized in Parkinson’s disease (PD), and ATP13A2 is well known for its neuroprotective role. However, it remains unclear whether ATP13A2 mutations carried by PD patients contribute to immune dysfunction that exacerbates disease progression. Here, we systematically demonstrate that many ATP13A2 mutations result in a loss-of-expression phenotype. ATP13A2 is highly expressed in macrophages. Myeloid ATP13A2 deficiency causes uncontrolled NLRP3 inflammasome activation driven by lysosomal alkalization and subsequent disrupted mitochondrial homeostasis, rendering mice susceptible to a PD-like phenotype. PD-linked ATP13A2 loss-of-expression mutants fail to restore the ATP13A2 levels required to suppress NLRP3 hyperactivation in ATP13A2-depleted human THP-1 monocytes. Macrophages from a PD patient carrying the ATP13A2 loss-of-expression L927P mutation exhibit excessive NLRP3 activation due to lysosomal-mitochondrial dysfunction. Our findings provide insight into PD pathogenesis, emphasizing genetic factor-driven dysregulated macrophage NLRP3 activation, particularly in ATP13A2 loss-of-expression mutation cases.

Design considerations for technology-assisted fall-resisting skills training trials in older adults: A pilot and feasibility study

Training fall-resisting skills can prevent falls in older adults. These fall-resisting skills include proactive gait adaptability, gait robustness, and reactive gait recovery, which allow people to effectively avoid, resist, and recover from balance threats, respectively. This pilot study guided the design of an RCT of fall-resisting skills training by investigating key design factors, such as the design of a placebo-control group, obstacle difficulty settings, exploring evaluation methods for gait robustness, testing the effect of task unpredictability on anxiety, and the general feasibility. Eleven healthy older adults performed non-task-specific “placebo” balance tasks and assessment and training tasks for each fall-resisting skill. Placebo tasks included static weight-shifting exercises and dual-task walking. For the fall-resisting skill tasks, participants walked on a treadmill under different conditions. For proactive gait adaptability, participants avoided projected obstacles varying in size, approach speed, and available response time. Gait robustness was assessed using perturbations of increasing magnitude, where the margin of stability following each perturbation was compared with participants’ perceived balance loss and researchers’ observations. For reactive gait recovery, perturbations with increasing unpredictability were applied, after which participants reported their anxiety scores. Weight-shifting tasks were perceived as balance training by most participants, indicating their potential as placebo tasks. Obstacle avoidance difficulty increased most with fast approach speed and large obstacle sizes. A margin of stability-based threshold did not consistently align with perceived balance loss or observer judgement. Anxiety did not increase with more unpredictable perturbation tasks when introduced gradually. Fall-resisting skill tasks generally were feasible for older adults.

Abstract TH953: The Roles of Major Life Stressors in The Development of Cardiovascular Disease: Findings from the Jackson Heart Study

Background: Major life stressors, defined as dramatic and severely taxing situations, may have traumatic and cumulative impacts on cardiovascular disease (CVD). Black adults experience a high burden of CVD and elevated exposure of psychosocial stressors. This study aims to investigate the associations between major life stressors and three CVD subtypes, coronary heart disease (CHD), stroke and heart failure (HF) over 15 years of follow-up in the Jackson Heart Study (JHS), a cohort of Black adults. Methods: Major life events (MLEs) were assessed at the first annual follow up call after exam 1 (2000-2004). JHS participants were asked about the occurrence of 11 different major life stressors in the past 12 months, such as death of someone close, violence, and divorce. CVD events were monitored from MLE assessment through 2016, except HF, which was monitored from 2005. Participants with missing MLEs and a history of CVD before or at the first year were excluded. Missing covariates were imputed using Multiple Imputation by Chained Equation. Cox proportional hazard model estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) of incident CVD events. Models were adjusted for demographics, socioeconomic status, CVD risk factors and baseline perceived stress. Informative censoring was addressed using inverse probability of censoring weights. Results: Among the 4,424 included Black participants (age 53.7 ± 12.7 years; 65% female), 71% reported at least one MLE. During a median follow-up of 12 years, 210 CHD events, 146 stroke events and 282 HF events occurred. We found serious illness or injury (HR: 1.51, 95% CI: 1.04, 2.19) and unwilling retirement (HR: 2.25, 95% CI: 1.24, 4.09) were associated with a higher hazard of CHD, but not stroke or HF ( Figure 1 ). We didn’t find statistically significant associations of composite MLEs (≥1 vs. 0) in the overall samples ( Figure 2 ). Sex-stratified analyses ( Figure 2&3 ) suggest MLEs (≥ 1 vs. 0) were associated with CHD among males (HR: 1.81, 95% CI: 1.06, 3.08) but not females, and the effect modification of sex was not statistically significant (p-value=0.19). Modelling MLEs continuously, we found a significant dose-response relationship between MLEs and CHD among males (HR: 1.21, 95% CI: 1.02, 1.42). Conclusion: Some major life stressors were associated with higher hazards of CHD among Black adults. The associations of MLEs with CHD appeared stronger among males than females.

Abstract TU181: Integrating Pathogenic Variants to Assess Familial Hypercholesterolemia Prevalence, Underdiagnosis, and Undertreatment in the <i>All of Us</i> Research Program

Introduction: Familial hypercholesterolemia (FH) is a genetic condition that, if untreated, results in premature atherosclerotic cardiovascular disease due to lifelong exposure to elevated low-density lipoprotein cholesterol (LDL-C) levels. While the prevalence of FH has been estimated to be as high as 1 in 188 in the general population, &lt;10% of affected individuals are diagnosed. We sought to achieve a better understanding of the prevalence of FH-related genetic variants and rates of underdiagnosis and undertreatment in the U.S. Hypothesis: We hypothesized that genetic screening using updated pathogenic/likely pathogenic (P/LP) variant classifications would reveal higher rates of FH prevalence in our cohort compared to previous studies, and substantial rates of underdiagnosis and undertreatment. Methods: We conducted a cross-sectional study using data from the NIH All of Us Research Program. Prevalences of P/LP variants in LDLR , ApoB , and PCSK9 were evaluated according to ClinVar classifications. Underdiagnosis and undertreatment were examined using electronic health record data with ICD diagnosis codes and LDL-C measurements. Results: Of the 414,830 study participants with genomic data available, 3,466 (1 in 120) had at least one P/LP variant in LDLR , PCSK9 , or ApoB . Gene-specific P/LP variant prevalence was highest in non-Hispanic Black participants for LDLR (0.62%), non-Hispanic Asian participants for PCSK9 (0.28%), and both non-Hispanic Asian (0.38%) and non-Hispanic White (0.35%) participants for ApoB . Non-Hispanic Asian participants had the highest prevalence of having any P/LP variant (1 in 86) while Hispanic participants had the lowest (1 in 147). Among participants with a P/LP variant and LDL-C measurements available (n=1,371), &lt;5% had an FH diagnosis in their EHR. Among participants taking a cholesterol-lowering medication (n=816), 57.5% of participants with a P/LP variant in LDLR , 26.5% in PCSK9 , and 45.7% in ApoB still had LDL-C levels exceeding the recommended target of &lt;100 mg/dl. Conclusion: Our results reveal a higher rate of FH prevalence than previously estimated in the U.S. Prevalence of having a P/LP variant differed between racial/ethnic groups. Among participants with P/LP variants, there was a significant rate of underdiagnosis and undertreatment. In conclusion, our study suggests that genetic screening can improve the diagnosis and treatment of individuals with FH, with the goal of preventing atherosclerotic cardiovascular disease.

Abstract WE529: Multiple Markers of Autonomic Dysfunction are Related to an Increased Risk of Cancer Mortality in Healthy Adults

Introduction: Dysfunction of the autonomic nervous system—which regulates involuntary physiological functions throughout the body such as heart rate—increases the risk of cardiovascular disease (CVD) and CVD-related mortality. The health implications of autonomic dysfunction may also extend beyond CVD, including to cancer outcomes, although these associations are less well-understood. Methods: We studied a prospective cohort of healthy adults in the Cooper Center Longitudinal Study who completed a preventive medicine exam, which included assessment of heart rate and blood pressure before, during, and after a maximal treadmill test. We examined the associations between multiple established markers of autonomic dysfunction—resting heart rate, heart rate recovery at 1-, 2- and 5-minutes, heart rate reserve, and systolic blood pressure [SBP] response to exercise—with all-site and site-specific cancer mortality (lung, prostate, pancreas, colorectal) ascertained through the National Death Index. Gompertz mortality models were used to estimate the associations between each marker of autonomic dysfunction and cancer mortality, adjusted for demographic and health-related variables. Analyses were sex-stratified when a significant sex interaction was present. Results: Among 75,222 participants (26.8% women), 3853 cancer deaths (644 among women) were identified during a median follow-up of 21.9 years. Each marker of autonomic dysfunction was related to higher cancer mortality risk, including: higher resting heart among men (hazard ratio [HR] per 10 beats per minute [bpm]: 1.04; 95% CI: 1.01, 1.08), though not women; slower heart rate recovery among men and women combined (e.g., at 5-minutes, HR per 10 bpm slower recovery: 1.06; 95% CI: 1.03, 1.09); lower heart rate reserve among men and women combined (HR per 10% lower reserve: 1.05; 95% CI: 1.02, 1.07); and higher SBP response among men (HR per 10 mmHg: 1.02; 95% CI: 1.00, 1.04) and women (HR per 10 mmHg: 1.06; 95% CI: 1.01, 1.10). Slower heart rate recovery, lower heart rate reserve, and higher SBP response were similarly associated with increased lung cancer mortality (687 deaths). No other site-specific associations were statistically significant. Conclusions: Multiple non-invasive markers of autonomic function routinely obtained during exercise testing were related to the risk of cancer mortality in healthy adults. Autonomic dysfunction may represent an early marker linking cardiovascular health with cancer risk.

TON1 and FASS are required to recruit myosin VIII, a cell division guidance factor

Because plant cells cannot migrate, their position is fixed with respect to their neighbors. Thus, placement of the new cell plate is critical for determining cell shape, cell identity, and tissue patterning. Here, we show that TONNEAU1 (TON1), a protein essential for preprophase band formation, plays a role in phragmoplast guidance even in cells that do not have a microtubule-based preprophase band. TON1 is part of a complex that contains TONNEAU2/FASS, PROTEIN PHOSPHATASE 2A (PP2A), and the TON1 RECRUITING MOTIF (TRM) proteins, known as the TON1-TRM-PP2A (TTP) complex. We found that TON1 localizes specifically to the plasma membrane along the branch-adjacent wall in a branching cell in Physcomitrium patens juvenile tissue. Knocking out FASS does not affect TON1 localization, suggesting that TON1 recruitment to the plasma membrane is independent of FASS. A novel point mutation in TON1 disrupts dimerization and localization to the plasma membrane. In mutants lacking TTP function, myosin VIII localization is altered, resulting in phragmoplast guidance defects. Our data suggest a model whereby myosin VIII guides the phragmoplast in a TTP-dependent manner to the branch-adjacent wall facilitating efficient insertion at that site.

Healthcare access and barriers in Jordan: Insights from a Nationwide Survey

Background Healthcare access disparities are a significant public health concern, particularly in low- and middle-income countries like Jordan. Despite advancements in healthcare infrastructure, barriers such as financial constraints, cultural norms, and logistical challenges persist, exacerbated by the influx of refugees. This study evaluates the influence of demographic, socioeconomic, and health-related factors on healthcare access and utilization in Jordan, aiming to identify specific barriers and disparities. Methods A nationwide survey was conducted in April 2024 using Facebook for recruitment, with 908 eligible participants aged 18–65 completing the survey. Data on healthcare access, barriers, and demographic variables were collected using a validated questionnaire. Statistical analyses included chi-squared tests and Kruskal-Wallis tests to assess differences in healthcare access across subgroups. Results Marital status significantly influenced healthcare access, with never-married individuals reporting better access to immediate and specialist care compared to married participants. Employment status revealed disparities, as students had better access to immediate and specialist care, while retired individuals had better access to routine check-ups. Self-reported health status was strongly associated with healthcare access, as individuals reporting excellent health experienced fewer delays and demonstrated higher trust in providers. Barriers to healthcare access included financial constraints, time limitations, and fear of diagnosis, while surgical access challenges centered on cost and waiting times. Conclusions Significant disparities in healthcare access exist in Jordan, driven by demographic and socioeconomic factors. Addressing these challenges requires policy reforms, digital health integration, and enhanced public-private partnerships to improve equity and reduce barriers.

Abstract TH822: Characteristics of Glucagon-like Peptide-1 Receptor Agonist Initiators and Temporal Trends in Prescriptions by Diabetes Status; MarketScan 2016-2023

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were originally approved for diabetes treatment (liraglutide in January 2010, semaglutide in December 2017, and tirzepatide in May 2022). Recently GLP-1 RAs have also been approved to manage obesity (liraglutide in December 2014, semaglutide in June 2021 and tirzepatide in September 2023). We seek to describe characteristics of recent GLP-1 RA users (2016-2023) and document temporal trends in GLP-1 RA prescription use, stratified by diabetes status. Methods: We used MarketScan administrative claims databases (2016-2023) to construct a cohort of enrollees prescribed GLP-1 RAs via outpatient pharmaceutical claims. Diabetes and comorbid conditions included in the Charlson Comorbidity Index (CCI) were defined using inpatient and outpatient ICD-10-CM codes. Demographic information was measured from enrolment data at time of first GLP-1 RA prescription. We focused on GLP-1 RA initiators, analyzing only the first prescribed drug. Results: We included 1,063,761 new GLP-1 RA users who were prescribed liraglutide (N=293,745), semaglutide (N=661,598), or tirzepatide (N=108,418) between January 1, 2016 and December 31, 2023. There were 591,139 (56%) enrollees with prevalent diabetes. Enrollees without any indication of diabetes were younger on average (mean±SD: 47±12) compared to those with a diabetes diagnosis (mean±SD: 54±11) and more likely to be female (76% vs. 55%, respectively). Mean CCI Score was lower among those without diabetes compared to those with diabetes (0.45 vs. 2.61). Since 2021, semaglutide has overtaken liraglutide as the most prescribed GLP-1 RA (Figure 1), regardless of diabetes status. Tirzepatide prescriptions have increased rapidly since their introduction in 2022. Discussion: GLP-1 RA initiators without diabetes are more likely to be female and younger than those with diabetes. Semaglutide and tirzepatide use has increased dramatically since their approval for chronic weight management whereas the share of liraglutide prescriptions has plummeted. As these newer drugs gain popularity, contemporary data will be needed to track the evolving landscape of GLP-1 RA initiation patterns.

Abstract TH914: Food insecurity is related to lower nutrient intake in college students: Findings from the FRESH Study

Background: Food insecurity affects up to 40% of U.S. college students and may negatively impact nutrient intake critical for cardiovascular and metabolic health (CVMH). Hypothesis: Food insecurity (which includes both low and very low food security) is associated with lower nutrient intake among 2 nd -year college students. Methods: The Food, Rest, Exercise, and Student Health (FRESH) study is a 2-year longitudinal observational study of 349 second-year students (with no major health issues) at the University of California, Santa Cruz. Baseline data include last-30-day food security status, measured height and weight, and three 24-hour dietary recalls (using ASA-24) assessing macro- and micro-nutrient intake. Statistical Analysis: Multivariable linear regression models estimated relationships between food security status and average daily nutrient intake of kcals, carbohydrates (g), fats (g), protein (g), fiber (g), Fe (g), Mg (g), C (g), and D(g). Adjusted models controlled for sex, BMI, race and ethnicity. Results: Participants averaged 19.5±2.8 years old, were 69% female, and 20% reported food insecurity. In unadjusted models, food insecurity was related to lower daily average intakes of kcals (β= -.14, p=0.01), protein (β= -.17, p=0.003), carbohydrates (β= -.13, p=0.02), total fat (β= -.12, p=0.04), polyunsaturated fat (β= -.14, p&lt;0.05), fiber (β= -.16, p=0.004), Mg (β= -.16, p=0.01), vitamin C (β= -.13, p=0.03), and iron (β= -.14, p=0.01). Adjusted models showed that food insecurity was related to lower intakes of protein (β= -.11, p=0.04), fiber (β= -.14, p=0.01), Mg (β= -.12, p=0.03), and vitamin C (β= -.12, p=0.03). There was a trend in relationship with lower intake of polyunsaturated fats (β= -.10, p=0.07). Conclusion: Food insecurity was related to lower intake of protein, fiber, Mg and vitamin C among FRESH participants. Findings suggest that food insecurity may contribute to poor nutrient intake among college students, potentially impacting CVMH via mechanisms involving oxidative stress, body repair function, and weight management. Federal food assistance could benefit students who experience food insecurity.

Abstract TH970: Physical Activity Levels and Cardiovascular Health Profiles among First-year Medical Students: A Cross-Sectional study

Background: Cardiovascular disease (CVD) is the leading cause of death globally, and risk factors often manifest during adolescence and young adulthood. Medical students undergo significant lifestyle changes that can elevate their cardiometabolic risk. Therefore, we conducted an evaluation to determine the associations between physical activity (PA), cardiovascular health profile among first-year medical students. Methods: We performed a cross-sectional study at a Colombian medical school (2019–2020). PA was evaluated with the International Physical Activity Questionnaire, cardiovascular health with the AHA’s Life’s Simple 7 (LS7), and CVD risk through Waist-to-Height Ratio (WHtR). Predictors of intermediate LS7 and high WHtR-based CVD risk were identified using robust Poisson regression models. Results: We included 188 participants (61.2% female; median age 18 years). Most achieved ideal LS7 scores (79.6%), yet 43.3% of those with complete WHtR data (n=178) were categorized as high CVD risk. Intermediate or poor L7S outcomes were especially frequent for diet (94.6%), PA (50.0%), cholesterol (38.8%), and blood pressure (35.9%). Male students reported greater moderate PA and energy expenditure. In multivariable models, higher WHtR (PR 1.78, 95% CI 1.39–2.27) and resting heart rate (PR 1.36, 95% CI 1.01–1.83) predicted intermediate LS7. Protective factors included vigorous PA (PR 0.56, 95% CI 0.33–0.96), moderate PA (PR 0.78, 95% CI 0.65–0.94), and avoiding sugar-sweetened beverages (PR 0.38, 95% CI 0.19–0.74). Current smoking more than doubled the prevalence of high WHtR-CVD risk (PR 2.18, 95% CI 1.22–3.91), whereas vigorous PA reduced it (PR 0.75, 95% CI 0.56–0.99). Conclusions: This study shows that cardiovascular vulnerability is already detectable in young medical students. The findings support WHtR as a practical screening marker and emphasize the importance of incorporating structured physical activity and lifestyle education into medical curricula to strengthen long-term cardiovascular health and counseling.

AI-enhanced techno-economic and environmental optimization for nearly zero-energy building retrofitting: a case study of university campus

Predicting the performance of a graphene-based patch antenna using a machine learning model for terahertz applications

Assessing the role of magician patter on deception in the Three-Card Monte

Visual perception of longitudinal waves: theory and observations

Abstract We introduce the study of the visual perception of longitudinal travelling wave motion, which as a physical phenomenon forms the basis of acoustics and some forms of seismic transmission. A theoretical analysis of physical longitudinal wave motion reveals that it exhibits profound nonlinearities that have been almost entirely neglected by the physics community. We simulated longitudinal motion in visual form with a random-dot field in which each dot particle oscillates sinusoidally about a fixed position at the same frequency but with a phase advance proportional to its distance from the origin. The resultant longitudinal density wave is essentially sinusoidal at very low oscillation amplitudes, becoming progressively distorted as oscillation amplitude increases. Perceptually, the motion splits into a combination of forward motion of the crests and backward for the troughs, rather than a uniform travelling wave. When the maximum velocity of each dot particle equals that of the propagation, the density function approximates a narrow spike, which splits into a double spike at even greater amplitudes. Adding a single (‘rigid’) velocity component can eliminate either the forward or backward percept. Remarkably, the speed needed for perceptual cancellation scales with oscillation amplitude, but nonlinearly so for the forward crest motion. Longitudinal waves evoked no motion aftereffect at any amplitude unless the contrast of the forward crest motion was reduced, revealing a motion aftereffect from the now-dominant retrograde trough motion. These unexpected results underline the emergent, or higher-order, nature of the perception of longitudinal travelling wave motion.

Correction: Soil phosphorus availability as affected by root exudates of cover crop species

A hybrid pipeline for carotid artery segmentation using YOLOv11n and contour models

Abstract Carotid artery segmentation is critical for determining the degree of vascular disease, and for recommending treatment options. Early detection of carotid atherosclerosis is critical for preventing stroke. Stroke-related brain damage can cause deficits in speech or vision, and large strokes can be fatal. However, automatic segmentation of the carotid artery lumen remains difficult due to the low quality of US images, and the existence of stenosis, jugular veins, and abnormalities in carotid images. This article presents a hybrid pipeline for segmenting both carotid transverse and longitudinal lumens without any user interaction. This hybrid pipeline starts with automatically localizing the carotid artery lumen in the transverse and longitudinal sections via YOLOv11n. Then, a multistage preprocessing framework was applied to the transverse section before its lumen was segmented by the active contour. For the longitudinal section, an automated padded mask was generated to guarantee reliable initialization for Chan-Vese level-set evolution. A paired t test validated the relevance of the proposed modules ( p  &lt; 0.0001). The proposed multiphase segmentation pipeline achieved a Dice index and accuracy of 94.9% and 97.7%, respectively, for the longitudinal section and 90.8% and 99.6%, respectively, for the transverse section. A comprehensive ablation analysis has shown that numerical stability depends on the YOLOv11n localization phase. The system attained near real-time inference for the carotid transverse section (&lt; 1 s) despite being evaluated on low-end hardware, demonstrating its computational efficiency and promise for clinical integration.