Disease Prevention Study Research Articles

Zebrafish: A Versatile Animal Model in Biomedical Research

Zebrafish (Danio rerio) has emerged as a powerful animal model in biomedical research, offering a unique combination of genetic tractability, rapid development, and conserved gene function with humans. This review highlights the significance of zebrafish in understanding various human diseases, including neurodegenerative disorders, metabolic disorders, cancer, and more. The zebrafish genome, with over 70% similarity to the human genome, allows for the modelling of human diseases with high fidelity. The ease of genetic manipulation, high fecundity, and low maintenance costs make zebrafish an attractive model for large-scale genetic screens and drug discovery. Zebrafish models of neurodegenerative diseases, such as Parkinson's disease, Alzheimer's disease, and Huntington's disease, have been developed, providing insights into disease mechanisms and potential therapeutic targets. Similarly, zebrafish models of metabolic disorders, including diabetes, dyslipidaemia, and atherosclerosis, have been established, enabling the study of disease pathogenesis and prevention strategies.The zebrafish has also been used to model various types of cancer, including leukaemia, melanoma, and pancreatic cancer, facilitating the discovery of novel oncogenes and tumor suppressors. The transparent nature of zebrafish embryos and larvae allows for in vivo imaging of cancer cells, enabling the study of cancer cell behavior and response to therapy. Furthermore, zebrafish has been used to investigate brain-to-organ communication, cell transplantation, and cell-cell interactions, providing insights into the complex interactions between different tissues and organs. The development of novel tools, such as CRISPR/Cas9 genome editing and single-cell RNA sequencing, has further expanded the capabilities of zebrafish research.

Digital Intervention for behaviouR changE and Chronic disease prevenTION (DIRECTION): Study protocol for a randomized controlled trial of a web-based platform integrating nutrition, physical activity, and mindfulness for individuals with obesity

Excess body weight, suboptimal diet, physical inactivity, alcohol consumption, sleep disruption, and elevated stress are modifiable risk factors associated with the development of chronic diseases. Digital behavioural interventions targeting these factors have shown promise in improving health and reducing chronic disease risk. The Digital Intervention for behaviouR changE and Chronic disease prevenTION (DIRECTION) study is a parallel group, two-arm, randomized controlled trial evaluating the effects of adding healthcare professional guidance and peer support via group-based sessions to a web-based wellness platform (experimental group, n = 90) compared to a self-guided use of the platform (active control group, n = 90) among individuals with a body mass index (BMI) of 30 to <35 kg/m2 and aged 40–65 years. Obesity is defined by a high BMI. The web-based wellness platform employed in this study is My Viva Plan (MVP)®, which holistically integrates nutrition, physical activity, and mindfulness programs. Over 16 weeks, the experimental group uses the web-based wellness platform daily and engages in weekly online support group sessions. The active control group exclusively uses the web-based wellness platform daily. Assessments are conducted at baseline and weeks 8 and 16. The primary outcome is between-group difference in weight loss (kg) at week 16, and secondary outcomes are BMI, percent weight change, proportion of participants achieving 5% or more weight loss, dietary intake, physical activity, alcohol consumption, sleep, and stress across the study. A web-based wellness platform may be a scalable approach to promote behavioural changes that positively impact health. This study will inform the development and implementation of interventions using web-based wellness platforms and personalized digital interventions to improve health outcomes and reduce chronic disease risk among individuals with obesity.

Exploring the Relationships between Lifestyle Patterns and Epigenetic Biological Age Measures in Men.

DNA methylation, validated as a surrogate for biological age, is a potential tool for predicting future morbidity and mortality outcomes. This study aims to explore how lifestyle patterns are associated with epigenetic changes in British men. Five biological age clocks were utilised to investigate the relationship between these epigenetic markers and lifestyle-related factors in a prospective study involving 221 participants. Spearman's correlation test, Pearson's correlation test, and univariate linear regression were employed for analysis. The results indicate that higher consumption of saturated fat and total daily calories, and a higher body mass index (BMI) are associated with accelerated biological aging. Conversely, higher vitamin D intake and a higher healthy lifestyle index (HLI) are linked to decelerated biological aging. These findings highlight the potential impact of specific lifestyle-related factors on biological aging and can serve as a reference for applying healthy lifestyle improvements in future disease prevention studies.

Highlights of Cardiovascular Disease Prevention Studies Presented at the 2024 American College of Cardiology Conference.

To summarize selected late-breaking science on cardiovascular (CV) disease prevention presented at the 2024 Scientific Session of the American College of Cardiology (ACC) conference. The LIBerate-HR trial showed the efficacy and safety of lerodalcibep, a subcutaneous injection that prevents binding of Pro-Protein Convertase Subtilisin/Kexin (PCSK) 9 to low-density lipoprotein (LDL)-receptors resulting in LDL-cholesterol (LDL-C) lowering in patients at very high risk or high risk of atherosclerotic CV disease (ASCVD). The AEGIS-II randomized patients with type 1 myocardial infarction (MI) with multivessel coronary artery disease and additional CV risk factors and found no benefit in major adverse CV events (MACE) with CSL112, an apolipoprotein A1 infusion shown to increase cholesterol efflux capacity. The Bridge-TIMI 73a trial showed a significant reduction in triglyceride (TG) levels with olezarsen, an antisense mRNA, in patients with moderate hyperTG with elevated CV risk. The BE ACTIVE trial showed significant improvement in step counts in patients given behavioral and financial incentives. The DRIVE study showed a significant increase in the prescription of either sodium-glucose co-transporter-2 inhibitors or glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes mellitus (T2DM) at elevated CV or renal risk with a remote team-based, non-licensed navigator and clinical pharmacist approach. The TACTiC trial showed increased and sustained use of statin therapy by patient-driven use of a web-based portal that calculated the ASCVD risk score and gave prompts. The VICTORIAN-INITIATE trial showed efficacy and safety in early use of inclisiran in patients with ASCVD who did not reach target LDL-C < 70mg/dL despite maximally tolerated statin therapy. The ARISE-HF trial showed no difference in change of peak oxygen consumptionwith the use of an oral aldose reductase inhibitor, AT-001, in patients with well-controlled T2DM and diabetic cardiomyopathy with high-risk features compared to placebo. The PREVENT trial showed a significant reduction in target vessel failure at 2years in patients with non-flow limiting vulnerable plaques with percutaneous coronary intervention and optimal medical therapy (OMT) compared to OMT alone. The late-breaking clinical science presented at the 2024 Scientific Session of the ACC paves the way for an evidence-based alternative to statin therapy and provides data on several common clinical scenarios encountered in daily practice.

Exercise Physiology: A Review of Established Concepts and Current Questions

Exercise physiology is the science that studies the processes of physical activity and their impact on the body. It usually requires a multidisciplinary approach with a team of experts because of the multiple physiological systems involved. At the cellular level, exercise can trigger a cascade of events that involve metabolic pathways, muscle recruitment and conditioning, neuromuscular adaptations, and optimization of energy production. On a systematic level, this has involved the cardiovascular system, the respiratory system, the musculoskeletal system, the peripheral and central nervous systems, and even the endocrine system to improve adaptation to meet the demands of exercise, improving strength and endurance with the goal of maximizing performance. This field, which began largely with a focus on the kinetics of oxygen consumption and the relationship between aerobic and anaerobic metabolism, has expanded with technological advancements such as wearable devices, advanced imaging techniques, and genomics, which has allowed for a greater appreciation of the physiologic responses of exercise at the level of molecular and cellular interactions. Recently, this science has evolved into the study of overall health promotion and disease prevention to meet individual fitness needs and goals. This philosophy, which is captured by the motto “Exercise is Medicine”, has been adopted as a Global Health Initiative by the World Health Organization (WHO). Despite the advancements in technology and impactful, large-scale studies, a variety of questions, such as how physical activity interacts with aging to affect physical and cognitive function, how inactivity influences acute and chronic disease states, and how we maximize human performance in extreme conditions like microgravity environments, remain. The purpose of this review is to present and discuss established concepts, controversial topics, and unanswered questions within exercise physiology that have allowed this field to become a science that embraces the overall well-being of individuals.

Application and Development Prospect of Metagenomes in the Identification of Intestinal Microorganisms

Intestinal microorganisms are the result of long -term coexistence coordination of microorganisms and hosts in the human body, which plays an important role in maintaining normal physiological functions and regulating human health. With the development of metagenomic sequencing technology, the research on gut microbes has become more in-depth. Researchers have used metagenomic technology to identify the composition of the intestinal flora in patients with diseases and compare it with the composition of the intestinal flora in healthy people to study the pathogenesis of related diseases. At present, there is still a lack of unified standard process for metagenomic technology, and the study of the internal mechanism of intestinal flora affecting diseases has not been in-depth. Future research can integrate multi-omics methods to conduct in-depth research on the dynamic changes of intestinal flora. This paper reviews the current research progress of intestinal flora and mental diseases, metabolic diseases of obesity and cancer after applying metagenomic technology to intestinal microbes, hoping to better identify the important role of intestinal microbes in the study of disease occurrence, treatment and prevention, and provide a reference for related studies.

Abstract 2530: Advancing ICK assay: Real-time, label-free imaging of lymphocyte subsets

Abstract Background: Immune Cell Killing (ICK) Assay is pivotal in immunology and clinical research, uncovering the intricate connections between the immune system and diseases. Traditional ICK assays utilizing antibody staining for endpoint data generation pose challenges in capturing dynamic interactions. Moreover, antibody labeling for data quantification may compromise sensitivity, especially with low-affinity antibodies or a limited number of cells. The anticipation of label-free lymphocyte subset classification and real-time effector/target cell interaction analysis in one field of view is expected to provide more valuable insights than traditional ICK assays. Previous studies achieved 70-80% accuracy in image-based lymphocyte subset classification using digital holographic microscopy, light scattering, etc. but the cells’ condition during the cell sorting or sample preparation process may affect the lymphocyte subset status, resulting in real morphological discrepancies. Our approach focuses on directly sorting human PBMCs to enable label-free, dynamic interaction analysis of natural immune system responses in one field of view. Method: In this study, PBMC samples from 6 individuals were separated using standard-density gradient centrifugation and labeled with antibodies. Data were acquired using the Holotomographic Microscope HT-X1 (Tomocube Inc.). We employed Densenet 121 as the deep learning model architecture, considering the trade-off between memory consumption and performance. The cross-entropy loss function was utilized, and the AdamW optimizer was chosen for model parameter optimization. Input data consisted of 3D refractive index (RI) data for individual cells, each of sized (20, 54, 54). Individual cell labeling was performed using staining information. Results: An overall accuracy of 93.75% in Human PBMC subtype cell classification was achieved. In stage 1, an accuracy of 97.56% was demonstrated in classifying [CD14, CD15, Others]. Among the cells classified as "Others" in stage 2, [CD3, CD19, CD16&amp;CD56] displayed an accuracy of 93.5%. In stage 3, classifying [CD4, CD8] within the CD3 subtype achieved an accuracy of 90.2%. This classification is presumably based on pattern recognition of the chromosomal landscape in holotomography images. Conclusion: Our research has successfully demonstrated the feasibility of real-time label-free lymphocyte subset classification. This approach enabled the classification of effector cells as live cells in ICK assay and the analysis of effector-target cell dynamic interactions. Further training in the classification of more detailed subtype cells and various cell death types will provide additional insights. The advancement of this technology is expected to play a pivotal role in disease prevention, treatment, vaccine development, medical research, and academic studies. Citation Format: Sanggeun Oh, Jaephil Do, Hyun-Seok Min, Dongmin Ryu, Wei sun Park. Advancing ICK assay: Real-time, label-free imaging of lymphocyte subsets [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2530.

Highlights of Cardiovascular Disease Prevention Studies Presented at the 2023 American Heart Association Scientific Sessions.

Focused review highlighting ten select studies presented at the 2023 American Heart Association (AHA) Scientific Sessions. Included studies assessed semaglutide and cardiovascular outcomes in overweight or obese patients without diabetes (SELECT); dapagliflozin in patients with acute myocardial infarction without diabetes (DAPA-MI); effects of dietary sodium on systolic blood pressure in middle-aged individuals (CARDIA-SSBP); long-term blood pressure control after hypertensive pregnancy with physician guided self-management (POP-HT); effect and safety of zilebesiran, an RNA interference therapy, for sustained blood pressure reduction (KARDIA-1); recaticimab add-on therapy in patients with non-familial hypercholesterolemia and mixed hyperlipidemia (REMAIN-2); efficacy and safety of lepodisiran an extended duration short-interfering RNA targeting lipoprotein(a); safety and pharmacodynamic effects of an investigational DNA base editing medicine that inactivates the PCSK9 gene and lowers LDL cholesterol (VERVE-101); automated referral to centralized pharmacy services for evidence-based statin initiation in high-risk patients; and effects of intensive blood pressure lowering in reducing risk of cardiovascular events (ESPRIT). Research presented at the 2023 AHA Scientific Sessions emphasized innovative strategies in cardiovascular disease prevention and management.

Estimation of trajectory of protective efficacy in infectious disease prevention trials using recurrent event times.

In studies of infectious disease prevention, the level of protective efficacy of medicinal products such as vaccines and prophylactic drugs tends to vary over time. Many products require administration of multiple doses at scheduled times, as opposed to one-off or continual intervention. Accurate information on the trajectory of the level of protective efficacy over time facilitates informed clinical recommendations and implementation strategies, for example, with respect to the timing of administration of the doses. Based on concepts from pharmacokinetic and pharmacodynamic modeling, we propose a non-linear function for modeling the trajectory after each dose. The cumulative effect of multiple doses of the products is captured by an additive series of the function. The model has the advantages of parsimony and interpretability, while remaining flexible in capturing features of the trajectories. We incorporate this series into the Andersen-Gill model for analysis of recurrent event time data and compare it with alternative parametric and non-parametric functions. We use data on clinical malaria disease episodes from a trial of four doses of an anti-malarial drug combination for chemoprevention to illustrate, and evaluate the performance of the methods using simulation. The proposed method out-performed the alternatives in the analysis of real data in terms of Akaike and Bayesian Information Criterion. It also accurately captured the features of the protective efficacy trajectory such as the area under curve in simulations. The proposed method has strong potential to enhance the evaluation of disease prevention measures and improve their implementation strategies.

About Community Health Centers in the Main District of Chongqing Municipality Current Situation and Measures of Infectious Disease Prevention and Control Introduction

With the acceleration of urbanization and the increase of population mobility, the public health and safety situation in the main urban area of Chongqing, as a modern metropolis with rapid economic development and dense population, has become increasingly complex and severe. The outbreak and spread of infectious diseases pose a serious threat to the lives and health of community residents and social stability, so it is crucial to strengthen the research on the prevention and control system of infectious diseases in grassroots community health service centers. Grassroots community health service centers in the main urban areas of Chongqing are the foundation and frontier of the entire public health prevention and control system, which is directly related to the health level of community residents and community public health safety. In the current global context of multiple, new, and frequent outbreaks of infectious diseases, it has become imperative to strengthen the construction of the infectious disease prevention and control system of grassroots community health service centers to improve the effectiveness and level of infectious disease prevention and control. This study will focus on the infectious disease prevention and control system of grassroots community health centers in the main urban areas of Chongqing, aiming to deeply analyze its composition structure, functional positioning, operation mechanism, personnel quality and facilities and equipment. Through the study and analysis of the infectious disease prevention and control system, existing problems and bottlenecks will be identified, and feasible and operable optimization suggestions will be made to promote the improvement and enhancement of the infectious disease prevention and control system. The significance of this study is not only to provide scientific basis and practical guidance for the improvement of the infectious disease prevention and control system in the main urban area of Chongqing, but also to provide reference and experience sharing for similar problems in other cities and regions, so as to jointly promote the modernization and standardization of the infectious disease prevention and control system of China's grassroots community health service centers, in order to ensure the health and safety of the community residents.

Highlights of Cardiovascular Disease Prevention Studies Presented at the 2023 European Society of Cardiology Congress.

To summarize selected late-breaking science on cardiovascular (CV) disease prevention presented at the 2023 European Society of Cardiology (ESC) congress. The NATURE-PARADOX was a naturally randomized trial that used genetic data from the UK Biobank registry to create "cumulative exposure to low-density lipoprotein-cholesterol (LDL-C)" biomarker and evaluate its association with major CV events regardless of plasma LDL-C levels or age. Safety and efficacy data of inclisiran, a PCSK9-interfering mRNA (PCSK9i) administered subcutaneously twice annually, were presented. Data on two new PCSK9is were presented, recaticimab, an oral drug, and lerodalcibep, a subcutaneous drug with a slightly different architecture than currently available PSCK9is. A phase 1 trial on muvalaplin, an oral lipoprotein (a) inhibitor, was presented. An atherosclerotic CV disease (ASCVD) risk prediction algorithm for the Asian population using SCORE2 data was presented. Long-term follow-up of patients enrolled in the CLEAR outcomes trial showed sustained and more significant ASCVD risk reduction with bempedoic acid in high-risk patients. The late-breaking clinical science at the 2023 congress of the ESC extends the known safety and efficacy data of a PCSK9i with the introduction of new drugs in this class. Using cumulative exposure to LDL-C rather than a single value will help clinicians tailor the LDL-C reduction strategy to individual risk and is an important step towards personalized medicine.

Undue Burden the Medical School Application Process Places on Low-Income Latinos

Undue Burden the Medical School Application Process Places on Low-Income Latinos

Statins and risk of type 2 diabetes: mechanism and clinical implications.

Statins are widely used to prevent cardiovascular disease events. Cardiovascular diseases and type 2 diabetes are tightly connected since type 2 diabetes is a major risk factor for cardiovascular diseases. Additionally, cardiovascular diseases often precede the development of type 2 diabetes. These two diseases have common genetic and environmental antecedents. Statins are effective in the lowering of cardiovascular disease events. However, they have also important side effects, including an increased risk of type 2 diabetes. The first study reporting an association of statin treatment with the risk of type 2 diabetes was the WOSCOPS trial (West of Scotland Coronary Prevention Study) in 2001. Other primary and secondary cardiovascular disease prevention studies as well as population-based studies have confirmed original findings. The purpose of our review is to examine and summarize the most important findings of these studies as well as to describe the mechanisms how statins increase the risk of type 2 diabetes.

Understanding Barriers and Facilitators to Signing Up for a Mobile-Responsive Registry to Recruit Healthy Volunteers and Members of Underrepresented Communities for Alzheimer’s Disease Prevention Studies

BackgroundAlzheimer’s disease (AD) disproportionately affects Black/African American and Hispanic/Latino adults, yet they are underrepresented in AD studies. Recruitment challenges for these populations limit generalizability of findings.ObjectivesThis study explores barriers and facilitators to signing up for an AD participant recruitment registry website intended to optimize recruitment of these adults. The registry is geared toward recruitment on smartphones and tablets (mobile devices), as research suggests that mobile-first approaches may be more successful within these populations.DesignIn 2020, we conducted four focus groups (n = 39) and an online survey (n = 1010) with Black/African American and Hispanic/Latino adults. The survey also included Whites as a comparison group.SettingFocus groups were in-person at research facilities in New Orleans, Louisiana, and Los Angeles, California. The online survey was distributed by a survey panel company to participants nationwide.ParticipantsBlack/African American (n = 360), Hispanic/ Latino (n = 359), or White (n = 330) individuals, 45–75 years old, who self-reported not having mild cognitive impairment (MCI), dementia, or AD.MeasurementsBarriers and facilitators explored in the focus groups and survey were related to health and AD (e.g., AD-related concerns and past participation/willingness to participate in health or AD studies); current use of mobile devices (e.g., comfort using devices and receptivity to the AD recruitment registry); and participant characteristics and beliefs (e.g., demographics, health literacy level, and trust in government and the scientific community).ResultsThe focus groups and survey revealed similar findings. Participants commonly use mobile devices to go online and perform health-related activities. They were aware of AD, expressed concerns with developing it, and were willing to participate in AD-related studies (motivated by personal connection to AD, altruism, and compensation). When presented with the AD recruitment registry, most provided positive feedback (e.g., easy to use and informative) and shared an interest in joining. Barriers to joining the registry with a mobile device included complex or multistep enrollment processes, beliefs that studies are primarily for those with a specific disease, and confusion about how studies can prevent AD among those low-risk for AD. The focus groups also revealed that Black/African American participants expressed more hesitation than Hispanic/Latinos in joining the registry due to greater distrust in the government and scientific community.ConclusionsRecruiting more Black/African American and Hispanic/Latino participants into AD studies is vitally important. This mixed methods study suggests that adults in these underrepresented groups are motivated to prevent AD and willing to sign up for an AD participant recruitment registry using mobile devices. Most barriers to joining a registry can be addressed through slight modifications to the registry’s design and functionality and by adding content. These findings can help enhance the appeal of joining AD recruitment registries to ultimately enroll more diverse, representative groups of participants and increase the generalizability of AD study findings.

Protocol for a scoping review of health equity frameworks and models applied in empirical studies of chronic disease prevention and control

BackgroundChronic diseases, such as cancers and cardiovascular diseases, present the greatest burden of morbidity and mortality worldwide. This burden disproportionately affects historically marginalized populations. Health equity is rapidly gaining increased attention in public health, health services, and implementation research, though many health inequities persist. Health equity frameworks and models (FM) have been called upon to guide equity-focused chronic disease and implementation research. However, there is no clear synthesis of the health equity FM used in chronic disease research or how these are applied in empirical studies. This scoping review seeks to fill this gap by identifying and characterizing health equity FM applied in empirical studies along the chronic disease prevention and control continuum, describing how these FM are used, and exploring potential applications to the field of implementation science.MethodsWe follow established guidance for conducting scoping reviews, which includes six stages: (1) identify the research question; (2) identify relevant studies; (3) select studies for inclusion; (4) data extraction; (5) collating, summarizing, and reporting the results; and (6) consultation. This protocol presents the iterative, collaborative approach taken to conceptualize this study and develop the search strategy. We describe the criteria for inclusion in this review, methods for conducting two phases of screening (title and abstract, full text), data extraction procedures, and quality assurance approaches taken throughout the project.DiscussionThe findings from this review will inform health-equity focused chronic disease prevention and control research. FM identified through this review will be added to an existing website summarizing dissemination and implementation science frameworks, and we will offer case examples and recommendations for utilizing a health equity FM in empirical studies. Our search strategy and review methodology may serve as an example for scholars seeking to conduct reviews of health equity FM in other health disciplines.Systematic review registrationOpen Science Framework Registration https://doi.org/10.17605/OSF.IO/SFVE6

"ActuaYa": A Preliminary Efficacy Study of a Chronic Disease Prevention and Health Promotion Intervention for Older Hispanic Women.

Chronic diseases (CDs) are increasingly common among the aging population. Some evidence suggests that older Hispanic women ages 50years and older (OHW) are at an increased risk for CDs and poorer outcomes than other groups. This study investigated the preliminary efficacy of ActuaYa, a culturally tailored CD prevention and health promotion intervention for OHW. A prospective, single-group, repeated measures study (n = 50) was conducted in Florida. Clinical measures and surveys were collected at baseline and post-intervention at 3- and 6-month follow-up. Descriptive statistics, paired-sample t-tests, and McNemar tests were used for analysis. At baseline, more than half of the participants had a CD. Post-intervention results showed a significant decrease in participants' MAP, BMI, and A1C, and a significant increase in self-efficacy for exercise and HIV knowledge compared to baseline measures. The results of this study support the preliminary efficacy of ActuaYa in preventing CDs and increasing health promotion among OHW.

Highlights of Cardiovascular Disease Prevention Studies Presented at the 2023 American College of Cardiology Conference.

To summarize selected late-breaking science on cardiovascular (CV) disease prevention presented at the 2023 American College of Cardiology (ACC) conference. The CLEAR outcomes randomized control trial (RCT) compared bempedoic acid to placebo in patients at high-risk of cardiovascular disease (CVD) or prevalent CVD and statin intolerance for CV outcomes. The YELLOW III was a single-arm study that evaluated the effect of Evolocumab on coronary plaque characteristics in patients with stable coronary artery disease (CAD). A cohort evaluated the association between a self-reported low-carbohydrate high-fat (ketogenic) diet and serum lipid levels as compared to a standard diet. The LOADSTAR trial compared CV outcomes with targeted low-density lipoprotein cholesterol (LDL-C) approach vs. high-intensity statin in patients with CAD. The PCDS statin cluster randomized trial compared the effectiveness of an electronic reminder to the clinician on a high-intensity statin use among patients with a history of ASCVD as compared to no reminder. A prospective cohort study compared the extent of coronary atherosclerosis among lifelong endurance athletes and healthy non-athletes. A causal artificial intelligence study combined polygenic risk scores with data from large CV prevention RCTs to guide systolic blood pressure and LDL-C reduction targets to reach average CV risk. The ACCESS trial evaluated the impact of eliminating copayment for low-income older adults in Canada with chronic CV diseases on composite CV outcomes. A pooled analysis of 3 large RCTs evaluated the association between residual inflammatory risk and CV outcomes, as compared to residual elevated cholesterol risk in patients receiving statin therapy. A Phase 2B RCT compared the efficacy of an oral PCSK9i, MK-0616, in reducing LDL-C as compared to a placebo. The late-breaking clinical science presented at the 2023 conference of the ACC paves the way for an evidence-based alternative to statin therapy and provides data on several common clinical scenarios encountered in daily practice.

Attitudes and Viewpoints Toward Prevention Trials in Alzheimer’s Disease

Abstract: Alzheimer’s disease (AD) prevention studies use biomarkers to determine risk in asymptomatic study participants. This involves multifaceted implications. Determinants regarding participation in these trials are therefore of particular relevance. We used semistructured individual interviews to interview uninvolved persons ( n = 10), relatives of Alzheimer’s patients ( n = 10), and patients with mild cognitive impairment ( n = 5) and analyzed the interviews using qualitative content analysis according to Mayring. We discovered various factors to be positive motivations for participation; the most significant inhibiting factor was concern about negative psychological effects. These motivations and concerns should be specifically addressed in the study design of AD prevention trials. The fears and concerns expressed highlight the importance of a good methodological and ethical framework to increase participant acceptance.

System Action Learning: Reorientating Practice for System Change in Preventive Health

It is now widely accepted that many of the problems we face in public health are complex, from chronic disease to COVID-19. To grapple with such complexity, researchers have turned to both complexity science and systems thinking to better understand the problems and their context. Less work, however, has focused on the nature of complex solutions, or intervention design, when tackling complex problems. This paper explores the nature of system intervention design through case illustrations of system action learning from a large systems level chronic disease prevention study in Australia. The research team worked with community partners in the design and implementation of a process of system action learning designed to reflect on existing initiatives and to reorient practice towards responses informed by system level insights and action. We were able to observe and document changes in the mental models and actions of practitioners and in doing so shine a light on what may be possible once we turn our attention to the nature and practice of system interventions.

Development of a Mobile-First Registry to Recruit Healthy Volunteers and Members of Underrepresented Communities for Alzheimer's Disease Prevention Studies.

Web-based participant recruitment registries can be useful tools for accelerating enrollment into studies, but existing Alzheimer's disease (AD)-focused recruitment registries have had limited success enrolling individuals from underrepresented racial and ethnic groups. Designing these registries to meet the needs of individuals from these communities, including designing mobile-first, may facilitate improvement in the enrollment of underrepresented groups. Evaluate the usability of a prototype mobile-first participant recruitment registry for AD prevention studies; assess users' perceptions of and willingness to sign up for the registry. Quantitative usability testing and an online survey; online setting. We recruited 1,358 adults ages 45-75 who self-reported not having a diagnosis of mild cognitive impairment, AD, or other forms of dementia (Study 1: n=589, Study 2: n=769). Black/African American and Hispanic/Latino participants were specifically recruited, including those with lower health literacy. Study 1 measures the prototype's usability through observed task success rates, task completion times, and responses to the System Usability Scale. Study 2 uses an online survey to collect data on perceptions of and willingness to sign up for the mobile-first registry. Study 1 findings show the prototype mobile-first recruitment registry website demonstrates high usability and is equally usable for Black / African American, Hispanic/Latino, and White user groups. Survey results from Study 2 indicate that users from underrepresented communities understand the registry's purpose and content and express willingness to sign up for the registry on a mobile device. Designing mobile-first participant recruitment registries based on feedback from underrepresented communities may result in more sign-ups by individuals from minoritized communities.