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BACKGROUND: Lipid-lowering therapy (LLT) plays a central role in managing atherosclerotic cardiovascular disease (ASCVD) risk, but its underuse is reported in over 40% of the qualified population in the United States. Studies on factors, particularly actionable factors associated with guideline-directed LLT are limited. METHODS: This study evaluated participants from the Multi-Ethnic Study of Atherosclerosis (MESA) on their qualification for LLT at exam 5 (2010-2012) according to the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) guideline on cholesterol management. Participants were categorized as on-LLT or off-LLT at the following exam (2016-2018). Multi-variable relative risk (RR) models were used to analyze between LLT usage and factors prior to 2013, including age, gender, race/ethnicity, education level and medical insurance, income, smoking, body mass index (BMI), diabetes, hypertension, and presence of coronary artery calcium (CAC). RESULTS: Among the 2114 participants qualified for LLT at exam 5 with an average age of 70.7, 1,129 (53.4%) were on LLT while 985 (46.6%) were off LLT at exam 6. Black participants were less likely to be on LLT compared to the reference white participants (RR 0.80, 95% confidence interval CI 0.71-0.90). Higher BMI showed borderline significant association with LLT. Comorbidities of diabetes and hypertension were positively associated with LLT use (RR 1.39 and 1.23, 95% CI 1.27-1.52 and 1.10-1.36, respectively). CAC score > 0 as an indicator of subclinical ASCVD was strongly associated with LLT too, independent of other demographic or comorbidity factors (RR 1.38, 95% CI 1.21-1.56). CONCLUSIONS: This study identifies key factors influencing LLT use among MESA participants. Black participants were less likely to be on LLT, highlighting healthcare disparities. CAC presence was strongly associated with LLT use, suggesting that CAC measurement could be an actionable factor to improve adherence to LLT guidelines.

Slow rebound polyurethane foam (SPUF) has been widely used due to its advantages such as sound insulation, energy absorption, and good tactile sensation. However, SPUF is prone to harden at low temperature, and its application in medical equipment and households requires significant antibacterial properties. In this paper, self-made silicone modified polyethylene glycol (Si-APEG) and graphene oxide supported allicin (Alc@GO) were prepared and used as low-temperature resistant agent and antibacterial agent, respectively. Low-temperature resistant polyurethane foam (LSPUF) and antibacterial LSPUF (ALSPUF) were prepared respectively with water as foaming agent. The morphology of ALSPUF was observed by scanning electron microscope. Properties studied include apparent core density and porosity, mechanical properties including tensile strength, 40% compressive hardness, and rebound resilience, as well as low-temperature resistance. Effects of Si-APEG content on the structures and properties were analyzed and the LSPUF with an SiAPEG content of 10 wt.% showed the best comprehensive performance. Therefore, ALSPUFs with Si-APEG content of 10 wt.% and Alc@GO content of 03 wt.% were prepared. The addition of Alc@GO increased the antibacterial ratio significantly without obvious effect on the structure and mechanical properties of LSPUF. The antibacterial ratio of ALSPUF reached 99.07% at a Alc@GO content of 2.5 wt.% and testing time of 60 min. This work provides an effective and feasible method for the preparation of ALSPUF which can be widely used in medical devices and households. Highlights * Silicone modified polyether is a suitable low-temperature resistant agent for PU foam. * Allicin supported on GO provides good antibacterial property for PU foam. * ALSPUF has better mechanical properties than SPU. KEYWORDS antibacterial properties, graphene oxide supported allicin, low-temperature resistance, silicone modified polyethylene, slow rebound polyurethane foam, 1 | INTRODUCTION Slow rebound polyurethane foam (SPUF), also known as memory foam, undergoes plastic deformation under external pressure and does not recover immediately. (1) SPUF has many excellent properties, [...]

ObjectiveThis study compared small dense low-density lipoprotein cholesterol (sdLDL-C) with apolipoprotein B (apo B), and low-density lipoprotein particles (LDL-P) in predicting CHD risk in generally healthy adults with normal fasting glucose (NFG).MethodsThis study was conducted among participants with NFG in the Multi-Ethnic Study of Atherosclerosis (MESA) prospective cohort with measurements of sdLDL-C, LDL-P, and apo B available at baseline (2000-2002) and follow-up CHD data (through 2015) (N = 3,258). Biomarkers were evaluated as quartiles, and in categories using clinically and 75th percentile-defined cut-points. Discordance/concordance of sdLDL-C relative to other biomarkers was calculated using 75th percentile cut-points and linear regression residuals. Associations between individual biomarkers, sdLDL-C discordance and CHD incidence were evaluated using Cox proportional hazards regression.ResultsThere were 241 incident CHD events in this population through 2015. Higher sdLDL-C, apo B, LDL-P were similarly associated with increased CHD in individuals with NFG. Discordance of sdLDL-C with apo B or LDL-P by 75th percentiles was not significantly associated with CHD. Residuals discordantly higher/lower sdLDL-C relative to apo B (discordant high HR=1.26, 95% CI: 0.89, 1.78; discordant low HR=0.94, 95% CI: 0.68, 1.29) and LDL-P (discordant high HR=1.25, 95% CI: 0.88, 1.75; discordant low HR=0.84, 95% CI:0.60, 1.16), compared to those with concordant measures, had non-statistically significant higher/lower risk of CHD.ConclusionsResults suggest sdLDL-C, apo B and LDL-P are generally comparable for predicting CHD events in normoglycemic individuals. Larger studies are needed to confirm findings and to investigate whether measurement of sdLDL-C may be beneficial to evaluate as an additional risk-enhancing factor.

Objective To summarize the research trends and hotspots of patient reported outcome measurement information system (PROMIS). Methods China National Knowledge Infrastructure (CNKI) and PubMed databases were systematically searched, Bicomb 2.0 software was used for data sorting and cleaning, keywords were extracted, word frequency analysis was performed on high-frequency fields, and co-word matrix was constructed. SPSS 24.0 was used for co-word clustering analysis to summarize and explore research trends and hotspots. Results The hot topic clusters of the PROMIS were patient reported outcome measures, quality of life, symptoms and psychological variables assessment. Conclusion PROMIS has become a hot issue in the field of patient health level and care quality. Future studies tend to use consensus-based health measurement tools to conduct the measurement test of PROMIS, build a systematic clinical interpretation system, and then promote its transformation and application in clinical practice.