Vulnerability Index Research Articles

Examining the Relationship Between Social Vulnerability and Animal Shelter Intakes and Outcomes: Patterns and Implications

(1) Background: This study investigates the impact of social vulnerability, as quantified by the Social Vulnerability Index (SVI), on animal shelter intakes and adoptions, and the flow of animals between SVI groups at seven shelters within the United States. Understanding how social vulnerability influences these factors is crucial for developing targeted interventions to improve shelter outcomes and community support programs. (2) Methods: The research analyzed intake and adoption data from multiple animal shelters to assess the relationship between the social vulnerability at intake and adoption locations based on Census Tract obtained from addresses, focusing on comparison across strays, seized animals, and owner surrenders. Effect sizes were calculated to determine the magnitude and practical implications of these relationships. The study also examined the distribution of outcomes and reasons for animal surrender in relation to SVI levels. (3) Results: The analysis found that animals tended to enter shelters from areas of higher vulnerability while being adopted out to homes from all levels of vulnerability. Stray animals and those seized by authorities were more likely to come from high-SVI areas and showed a stronger disparity between intake and adoption SVI levels than owner surrenders. Racial/ethnic minority status and socioeconomic status were the components of the SVI that produced the strongest differences between intake and adoption vulnerability levels. Adoptions, however, were evenly distributed across different SVI levels, suggesting equitable access to adoption services. The study also identified that animals from high-SVI areas were not euthanized at higher rates compared to those from lower-SVI areas. (4) Conclusions: The findings highlight the need for further investigation into the high numbers of stray adult dogs in areas of communities that are most socially vulnerable as well as programs to address the volume of young animals originating from these areas. The equitable distribution of adoptions across SVI levels suggests that shelters are effectively engaging with socioeconomically and racially/ethnically diverse communities. Future research should focus on exploring the dynamics of stray animal intakes and enforcement patterns to enhance community and animal welfare initiatives.

Assessing climate change vulnerability in coastal communities: a composite vulnerability index approach in Kuala Gula, Malaysia

Assessing climate change vulnerability in coastal communities: a composite vulnerability index approach in Kuala Gula, Malaysia

Spatial Patterns of Emergency Dental Care Utilization: Assessing the Influence of Social Vulnerability and Dental Provider Availability

Aim: Our aim was to examine the association between emergency dental care use and dental providers’ availability and ZIP code social vulnerability index. Methods: This cross-sectional observational study mapped variations in emergency dental care and analyzed their association with social vulnerability using generalized spatial two-stage least-squares to address spatial correlation. To perform spatial autoregressive modeling to examine how dental provider capacity and social vulnerability influence emergency care use across neighboring counties, accounting for ZIP Code Tabulation Area (ZCTA) spillover effects, we used secondary data from the Maryland Health Services Cost Review Commission, InfoUSA, and the US Census American Community Survey. We focused on emergency dental care usage in ZIP Code Tabulation Areas, using emergency department visits and inpatient stays per 1000 residents for dental conditions, as the dependent variable. Results: Highly vulnerable ZCTAs saw 5.9× more non-traumatic dental condition (NTDC) ED visits, 5.3× more chronic dental ED visits, 3.3× more NTDC inpatient stays, and 1.3× more chronic dental inpatient stays than less vulnerable areas. For all four measures of emergency dental care use, increased dental provider availability was associated with reductions in use of emergency dental care (ED), while higher social vulnerability was associated with increased use. For example, an increase of one dental provider per 1000 residents was associated with a reduction of 28.2 non-traumatic dental ED visits, while a high social vulnerability index was associated with an increase of 88.6 non-traumatic dental ED visits. Conclusions: There was an association among dental provider availability, social vulnerability, and the use of emergency dental care.

A Spatial Landslide Risk Assessment Based on Hazard, Vulnerability, Exposure, and Adaptive Capacity

Landslides threaten human life, property, and vital infrastructure in most mountainous regions. As climate change intensifies extreme weather patterns, the landslide risk is likely to increase, resulting in challenges for disaster management, sustainability development, and community resilience. This study presents a comprehensive framework for assessing landslide risk, integrating advanced machine learning models with the Iyengar–Sudarshan method. Our case study is Son La province, the Northwest region of Vietnam, with data collected from 1771 historical landslide occurrences and fifteen influencing factors for developing landslide susceptibility maps using advanced ensemble machine learning models. The Iyengar–Sudarshan method was applied to determine the weights for landslide exposure, vulnerability, and adaptive capacity indicators. The resulting landslide risk map shows that the highest-risk districts in Son La province are located in the central and northeastern regions, including Mai Son, Phu Yen, Thuan Chau, Yen Chau, Song Ma, and Bac Yen. These districts experience high landslide hazards, exposure, and vulnerability, often affecting densely populated urban and village areas with vulnerable populations, such as young children, the elderly, and working-age women. In contrast, due to minimal exposure, Quynh Nhai and Muong La districts have lower landslide risks. Despite having high exposure and vulnerability, Son La City is situated in a low-susceptibility zone with high adaptive capacity, resulting in a low landslide risk for this region. The proposed framework provides a reference tool for mitigating risk and enhancing strategic decision making in areas susceptible to landslides while advancing our understanding of landslide dynamics and fostering community resilience and long-term disaster prevention.

Effect of Different MCDM Techniques and Weighting Mechanisms on Women Vulnerability Index

Effect of Different MCDM Techniques and Weighting Mechanisms on Women Vulnerability Index

Climate change and external debt vulnerability: the case of Sub-Saharan Africa

This study examined the influence of climate change vulnerability on the external debt vulnerability of Sub-Saharan Africa, with a focus on the Vulnerable Twenties (V20s), utilizing panel data spanning from 2015 to 2020. The climate readiness, climate vulnerability, and external debt vulnerability indices were derived via principal component analysis (PCA). The results from the system GMM analysis indicate that climate readiness exhibits a negative and significant impact across short- and long-term periods for the overall sample. However, for the V20s, the negative effect of climate readiness shifts to a positive and significant one over both short and long terms, with the long-term effect being more notable. These findings highlight a vicious cycle between debt and climate crises within the V20s. Thus, prioritizing debt relief over climate finance loans, decarbonizing greenhouse gas emissions, redirecting funds for climate goals, improving debt practices, and investing in public services would break nations’ vicious cycle of debt and climate vulnerability.

Effect of Different MCDM Techniques and Weighting Mechanisms on Women Vulnerability Index

Effect of Different MCDM Techniques and Weighting Mechanisms on Women Vulnerability Index

Assessment of socio-economic strategies for managing regional flood risk in an urban coastal catchment

With the cascading flooding events over the past decades, several structural and non-structural measures have been effectively implemented for improved flood management. However, the uneven impacts of the flooding events have highlighted that socio-economic inequality amongst the community needs to be addressed along with hazards to devise long term and sustainable flood management strategies. This study aims to evaluate the impact of socio-economic adaptive scenarios over an urban coastal catchment for reduction in flood risk. Flood risk is estimated utilizing socio-economic aspects (vulnerability) and flood inundation (hazard), for the highly flood-prone coastal city of Mumbai, India. A multivariate approach is used for assessing socio-economic vulnerability, starting with Principal Component Analysis followed by Data Envelopment Analysis, for various socio-economic scenarios, i.e., by reducing percentage of certain feasible socio-economic sensitivity indicators, to identify the key indicators, which contribute to significant change in vulnerability. The flood hazard is assessed through a comprehensive hydrodynamic flood modelling approach to quantify the flood inundation depth and extent. The flood risk is, thereafter, evaluated by combining socio-economic vulnerability and flood hazard using bivariate risk mapping approach. The results indicate that, with the decrease in alteration percentage of certain feasible socio-economic sensitivity indicators, the overall vulnerability and flood risk may be reduced. The areas under very high and high vulnerability classes reduce gradually for all scenarios as the percentage reduction for various indicators is varied from 5 % to 15 %, total illiteracy being the most significant indicator. This study marks the first effort to discern socio-economic vulnerability indicators that have the potential to significantly diminish flood risk, thereby constituting a viable long-term flood risk mitigation strategy. This novel framework is generic and applicable to any flood prone catchments, to devise appropriate long-term flood management measures.

Co‐production of a vulnerability assessment for aquatic and riparian ecosystems in the southwestern United States

AbstractTo address impacts of climate change and other stressors on stream ecosystems, managers must prioritize resources and locations for conservation actions to facilitate effective cross‐boundary solutions. Through a science management partnership, we co‐produced a spatially explicit landscape assessment framework for cold‐water fish habitat and riparian corridors in three large watersheds of the southwestern United States. Using literature review and stakeholder workshops, we developed indicators of vulnerability and built spatial datasets depicting areas of low to high vulnerability based on exposure, sensitivity, and adaptive capacity for each resource. We found that, in general, vulnerability was greater for cold‐water fish habitat than for riparian corridors. The Little Colorado River and San Juan River watersheds had the highest percentages of subwatersheds with high vulnerability of cold‐water fish habitat. Conversely, the Upper Rio Grande watershed had the highest percentage with high vulnerability of riparian corridors. Assessments like ours facilitate the management of water resources at the scale of watersheds or river basins and incorporate physical characteristics, land‐use history, current management practices, and status of imperiled species into actionable management plans.

A triadic model of job retention and turnover dynamics in the hospitality industry

Purpose This study aims to examine key factors influencing hospitality employee turnover in a post-pandemic context, challenging conventional assumptions about the role of demographics and work-related factors in retention decisions. Design/methodology/approach The research adopted a comprehensive framework using the capability approach and geospatial data analysis, integrating social vulnerability indexes with survey responses from 797 hospitality employees. This study analyzed turnover intentions across demographics, job roles and regions, focusing on Florida’s I-4 corridor. Findings Individual conversion factors like age and marital status were the strongest predictors of turnover, with older and married employees less likely to leave their jobs. In contrast, traditional variables like income, education and job type did not significantly influence turnover intentions. The pandemic blurred distinctions between job roles, highlighting personal circumstances, health risks and economic pressures as critical factors. Contrary to expectations, financial assistance did not significantly reduce turnover intentions. In addition, employees’ life circumstances, such as social vulnerability, influence labor relations and turnover more than work-related conditions. Research limitations/implications This study enriches turnover literature by confirming that personal life circumstances, like age and marital status, are pivotal in understanding employee retention. It challenges conventional demographic and work-related predictors and urges future research to explore the interaction between personal and professional factors in the hospitality industry. The study’s agent-based framework deepens the understanding of how various factors shape employee decisions to stay or leave. Practical implications The findings suggest that hospitality employers must develop more localized, employee-centric retention strategies, especially for younger employees. Tailored approaches considering regional and demographic differences, such as providing career development opportunities and flexible work conditions, could foster long-term loyalty. In rural areas, retention efforts should focus on improving job satisfaction and community support, while in urban areas, strategies prioritize career progression and flexibility. Social implications The study’s findings have significant social implications, particularly in reshaping how employee retention strategies are developed in the hospitality industry. By emphasizing life circumstances over traditional work-related factors, the research highlights the importance of supporting employees’ resilience, especially for those facing social vulnerability. Employers may need to create more flexible and inclusive policies that account for personal, economic and health-related challenges. In addition, the findings suggest that financial aid alone is insufficient in reducing turnover, calling for a more holistic approach that integrates emotional and social support to foster a more stable and loyal workforce. Originality/value This study challenges traditional turnover models by shifting focus from work-related factors to life circumstances, particularly the resilience of older and married employees. It integrates three dimensions – personal (sociodemographics), social (support) and environmental (job type, pandemic challenges) – to examine their influence on employee agency. This triadic framework offers insights into how individual, social and contextual factors shape turnover decisions.

Detection of Hepatovirus A (HAV) in wastewater indicates widespread national distribution and association with socioeconomic indicators of vulnerability.

Wastewater-based epidemiology, which seeks to assess disease occurrence in communities through measurements of infectious disease biomarkers in wastewater, may represent a valuable tool for understanding the occurrence of hepatitis A infections in communities. In this study, we measured concentrations of Hepatovirus A (HAV) RNA, in samples from 191 wastewater treatment plants spanning 40 US states and the District of Columbia from September 2023 to June 2024 and compared the measurements with traditional measures of disease occurrence. Nationally, 13.76% of the 21,079 wastewater samples were positive for HAV RNA, and both concentrations and positivity rates were associated with NNDSS hepatitis A case data nationally (Kendall rank correlation coefficient = 0.20, concentrations; and 0.33, positivity rate; both P < 0.05). We further demonstrated that higher rates of wastewater HAV detection were positively associated with socioeconomic indicators of vulnerability including homelessness and drug overdose deaths (both P < 0.0001). Areas with above average levels of homelessness were 48% more likely to have HAV wastewater detections, while areas with above average levels of drug overdose deaths were 14% more likely to have HAV wastewater detections. Using more granular case data, we present a case study in the state of Maine that reinforces these results and suggests a potential lead time for wastewater over clinical case detection and exposure events. The ability to detect HAV RNA in wastewater before clinical cases emerge could allow public health officials to implement targeted interventions like vaccination campaigns.IMPORTANCEDespite the existence of a highly effective vaccine for hepatitis A, outbreaks in vulnerable populations remain common. The disease can be asymptomatic or subclinical, and disproportionately impacts populations with inadequate access to healthcare, leading to a severe underestimation of the occurrence of this viral infection. This study investigates the potential for wastewater measurements of biomarkers of the causative agent of hepatitis A (HAV RNA) to provide insights into disease occurrence. Results highlight the potential for wastewater-based epidemiology to be a complementary tool to traditional surveillance for monitoring and controlling HAV transmission.

A Comparison of Pediatric Prehospital Opioid Encounters and Social Vulnerability

ABSTRACT OBJECTIVES This study explores the relationship between socioeconomic factors and pediatric opioid-related emergencies requiring naloxone administration in the prehospital setting, an escalating public health concern. METHODS A retrospective analysis of the National Emergency Medical Services Information System (NEMSIS) database was conducted, examining data from pediatric opioid-related EMS activations between January 2018 and December 2021. The Social Vulnerability Index (SVI) was used to gauge each incident's socioeconomic context and assess correlations between SVI scores and the likelihood of opioid-related activations and naloxone interventions. RESULTS A total of 7,789 pediatric opiate-related EMS activations were identified. Lower socioeconomic status (SES) areas (higher SVI scores) exhibited a decreased rate of opioid-related activations compared to lower SVI-scored areas but an increased frequency of naloxone administration. The analysis demonstrated that as socioeconomic status (SES) improves, the likelihood of opioid-related activations increases significantly supported by a significant negative linear trend (Estimate = -0.2971, SE = 0.1172, z = -2.54, p = 0.0112. On the other hand, naloxone administration was more frequently required in lower SES areas, suggesting an increased emergency response in these (Estimate = 0.05806, SE = 0.2403, z = 0.24, p = 0.8091). CONCLUSIONS The analysis highlights a statistically significant correlation between the SES of an area and pediatric opioid-related EMS activations, yet an inverse correlation with the likelihood of naloxone administration. These findings demonstrate that in lower socioeconomic areas, the total number of opiate-related EMS activations is lower; however, naloxone was more likely to be deployed during those activations. This underscores the need for further research to understand the disparities in opioid crisis management across different socioeconomic landscapes.

The Association between the Social Vulnerability Index and Adverse Neonatal Outcomes.

Identifying underlying social risk factors for neonatal intensive care unit (NICU) admission is important for designing interventions to reduce adverse outcomes. We aimed to determine whether a patient's exposure to community-level stressors as measured by the social vulnerability index (SVI) is associated with NICU admission. Retrospective cohort study (2014-2018) of patients delivering a liveborn ≥ 22 weeks' gestation at a quaternary care center. Patient addresses were used to assign each individual a composite SVI and theme score. The primary exposure was a composite SVI score categorized into tertiles. The primary outcome was NICU admission. Secondary outcomes included NICU length of stay and neonatal morbidity composite. Multivariable logistic regression was performed to estimate the association between composite SVI and outcomes (low SVI as referent). We secondarily compared mean composite and theme SVI scores; individual components of each theme were also compared. From 2014 to 2018, 13,757 patients were included; 2,837 (21%) had a neonate with NICU admission. Patients with higher SVI were more likely to self-identify as Black race and have medical comorbidities. Living in areas with moderate or high SVI was not associated with NICU admission (moderate SVI adjusted odds ratio [aOR]: 1.13, 95% confidence interval [CI]: 0.96-1.34; high SVI aOR: 1.12, 95% CI: 0.95-1.33). Moderate SVI was associated with increased neonatal morbidity (aOR: 1.18, 95% CI: 1.001-1.38). In an analysis of SVI as a continuous variable, mean SVI scores were significantly higher in individuals who had an infant admitted to the NICU. Those requiring NICU admission lived in areas with lower per capita income and a higher number of mobile homes (p < 0.001). Patients living in areas with moderate or high SVI were not shown to have higher odds of having a neonate admitted to the NICU. Neonatal morbidity was higher in those living in areas with moderate SVI. Increased access to social services may improve neonatal outcomes. · Mean SVI scores are higher in those with a neonate admitted to the NICU.. · There was no observed association between moderate and high SVI scores and NICU admission.. · Moderate SVI is associated with an increased odds of overall neonatal morbidity.. · Greater exposure to low income may be associated with NICU admission..

Regional agricultural drought vulnerability prediction based on interpretable Random Forest.

Drought is one of the leading natural disasters in the world. It severely restricts the normal functioning of societies and economies. The purpose of this paper is to predict the drought vulnerability index in Henan Province so that timely measures can be taken to mitigate the impact of drought and to ensure the continued stability of people's lives and social development. First, the drought vulnerability index of Henan Province for 2010-2022 was calculated based on relevant literature and the regional situation of Henan Province. In addition, the main factors of sensibility and resilience are selected, the prediction indicator system is established, and the grey correlation analysis model is applied to select the top 10 main factors of drought vulnerability. Second, the Random Forest model was trained and simulated, and the drought vulnerability index of Henan Province was predicted for 2023-2025. Finally, the SHapley Additive exPlanations model was used to explain the specific effects of the influences of the Random Forest model. The interpretable Random Forest model not only accurately predicts the drought vulnerability index in Henan Province but also alleviates concerns about the "black box" problem of indirect interpretation of the Random Forest model. The results of the study show that the Average Percentage Error of the drought vulnerability index in Henan Province from 2010 to 2022 simulated by the Random Forest model is as low as 3.0457%, and the simulation accuracy is as high as 96.9643%. Drought vulnerability prediction for Henan Province was also made for the period 2023-2025, showing an increasing trend. Relevant sectors should enhance awareness and early warning of drought, improve resilience, and take effective measures to reduce the socio-economic impact of drought.

Sustainability of Small-Scale Capture Fisheries Based on Coastal Vulnerability in Pangpang Bay, Banyuwangi Regency, Indonesia

Graphical Abstract Highlight Research Climate change impacts on coastal vulnerability. Low coastal vulnerability in Pangpang Bay, Banyuwangi Regency. Sustainability of small-scale capture fisheries based on vulnerability. Sustainable small-scale fisheries management. Abstract Teluk Pangpang is one of the water areas that has considerable capture fisheries potential in Banyuwangi Regency, Indonesia. On the other hand, climate change impacts the vulnerability of coastal areas and coastal communities, especially small-scale fishers. This study aims to analyse the coastal vulnerability of Pangpang Bay and formulate a sustainable development of small-scale capture fisheries in Pangpang Bay. The research method used a descriptive method with a quantitative approach. Data collection techniques used geographic information systems and focus group discussions (FGDs). The data analysis used was Coastal Vulnerability Index (CVI) analysis with spatial approach and Participatory Prospective Analysis (PPA). From the CVI analysis, through the assessment of geomorphological parameters, erosion/accretion, coastal slope, distance of plants from the beach, wave height, and average tide range, the level of coastal vulnerability of Teluk Pangpang is included in the low category. Meanwhile, the PPA analysis resulted in seven variables that most influence the sustainability of small-scale capture fisheries, namely climate change, coastal vulnerability, coral reef area and density, number of small-scale fishers, catches, human resources of small-scale fishers, and management of small-scale fisheries resources. Furthermore, for the formulation of the sustainability scenario of small-scale capture fisheries in Pangpang Bay, is to minimise the impact of climate change and conduct disaster mitigation, improve the human resources of small-scale fishers, and equalise perceptions as outlined in the commitment between all interested parties and small-scale fishing communities.

Intraspecific Variability of Xylem Hydraulic Traits of Calligonum mongolicum Growing in the Desert of Northern Xinjiang, China

Plant hydraulic traits are essential for understanding and predicting plant drought resistance. Investigations into the mechanisms of the xylem anatomical traits of desert shrubs in response to climate can help us to understand plant survival strategies in extreme environments. This study examined the xylem anatomical traits and related functional traits of the branches of seven Calligonum mongolicum populations along a precipitation gradient, to explore their adaptive responses to climatic factors. We found that (1) the vessel diameter (D), vessel diameter contributing to 95% of hydraulic conductivity (D95), hydraulic weighted vessel diameter (Dh), vessel density (VD), percentage of conductive area (CA), thickness-to-span ratio of vessels ((t/b)2), and theoretical hydraulic conductivity (Kth) varied significantly across sites, while the vessel group index (Vg), wood density (WD), and vulnerability index (VI) showed no significant differences. (2) Principal component analysis revealed that efficiency-related traits (Kth, Dh, D95) and safety-related traits (VI, VD, inter-wall thickness of the vessel (t)) were the primary factors driving trait variation. (3) Precipitation during the wettest month (PWM) had the strongest influence, positively correlating with (t/b)2 and negatively with D, D95, Dh, CA, and Kth. (4) Structural equation modeling confirmed PWM as the main driver of Kth, with indirect effects through CA. These findings indicate that C. mongolicum displays high plasticity in xylem traits, enabling adaptation to changing environments, and providing insight into the hydraulic strategies of desert shrubs under climate change.

Investigation of local soil properties of Erzurum province (Eastern Türkiye) by Horizontal/Vertical Spectral ratio method

Erzurum province is a basin developed under the effect of strike-slip faults in the Eastern Anatolia region. Erzurum province is generally influenced by the left strike-slip Erzurum Fault Zone, the left- strike-slip Aşkale fault, and the Başköy-Kandilli reverse fault. It is also located approximately 80 km from the Karlıova joint, which is the intersection of the North Anatolian and East Anatolian Faults. When the earthquakes of the instrumental and historical periods are analyzed, it is seen that many damaging earthquakes of medium to large magnitude have occurred in Erzurum province. Erzurum basin is generally covered with old alluvium at the edges of the plains, while the flat areas in the central parts are covered with new alluvium. Determination of local soil properties in regions with high earthquake hazard plays an important role in reducing earthquake risks. For this purpose, single station microtremor measurements were applied at 25 sites in Palandöken and Yakutiye districts of Erzurum province. The measurements were taken for at least 30 minutes and evaluated according to the Horizontal/Vertical Spectral Ratio method. As a result of the analysis, the dominant period, H/V ratio and vulnerability index (Kg) values of the measurement points were calculated. The period values obtained vary between 0.15 s and 3.7 s, while the H/V ratios vary between 2.2 and 8.5. The Kg value obtained using these parameters is defined as the vulnerability of the soil. It is concluded that high period, high H/V and high Kg values are obtained in areas with recent alluvium and multidisciplinary analyses should be performed in soil investigations in these regions.

Multi-attribute-based procedure for seismic loss scenario in a historical area

AbstractSeismic events have shown to be exceedingly damaging to structures over time, with serious social and economic consequences. As a result, large-scale seismic risk assessments are essential for reducing the potential damage from future earthquakes. Therefore, the proposed study attempts to examine the vulnerability and risk of unreinforced masonry buildings (URM) placed in aggregate conditions in a historical area of the city centre of Lisbon. To this purpose, a comprehensive exposure model was developed combining satellite remote sensing, GIS software, and census data. Subsequently, seismic hazard was evaluated in the area, considering both Peak Ground Acceleration (PGA) and macro-seismic intensity for different return periods (i.e. 2-50-100-475-975-2500-5000 years). Vulnerability was assessed by introducing a novel approach to earthquake risk assessment using Multi-Criteria Decision-Making methodologies. Specifically, the method employs the Analytic Hierarchy Process (AHP) and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) computational methods to evaluate parameter weights and vulnerability index. Damage scenarios, fragility curves and mean damage ratios curves were provided to offer an overview of the vulnerability of the assets exposed to risk. Finally, the expected consequences were evaluated in terms of direct economic losses showing an economic loss of 595 M€ for a 475-years return period, while 1108 M€ for 5000-years. This study significantly enhances seismic analysis for urban areas by introducing a Multi-Criteria Approach. This method simplifies vulnerability assessment, ensuring ease of application and reproducibility. Its insights offer valuable support for disaster risk management decisions, facilitating the implementation of resilience and risk-reduction strategies.

Association of ethanolamine desaturase TMEM189-plasmalogen axis with the stability of atherosclerotic plaque and cardiovascular events after acute coronary syndrome

Abstract Background Patients with acute coronary syndrome (ACS) are still at high risk of recurring major adverse cardiovascular events (MACE). Disorders of lipid metabolism play an important role in the pathogenesis and progression of ACS. However, whether there are lipid components that can play an early warning role on the recurrence of MACE in patients with ACS and its potential mechanism is not yet known. Purpose To explore the changes of lipid profile before recurrent MACE in ACS patients, screen lipid molecules related to recurrent MACE, and explore their effects on pathological changes of atherosclerotic plaque. Methods We selected 44 Chinese ACS patients from the ‘Peking and Rotterdam on Mission to Reduce Coronary Artery Disease’ (PRoMISS) study. Among them, patients with recurrent MACE within 1 year after first onset of ACS were defined as MACE group, and the control group was recruited through 1:1 matching. The lipid profile of patients was analyzed by liquid chromatography-mass spectrometry. The effects of the screened potential lipid biomarkers and their synthesis enzymes were evaluated by real-time PCR, Western blot, IHC staining and ELISA. The enzyme knockout mice and ApoE knockout mice were hybridized and bred to obtain double gene knockout mice to determine whether the enzyme deficiency affects atherosclerotic plaque. Results Lipomic analysis showed that in the MACE group, plasmalogens and their 12 subtypes continued to decrease three months before the MACE recurrence. The most critical ethanolamine desaturase in the synthesis pathway of plasmalogen, transmembrane protein 189 (TMEM189) was also significantly lower in the MACE group than in the control group, and the level of TMEM189 was positively correlated with plasmalogen. Analysis of single-cell RNA sequencing results in human carotid artery plaques shows that TMEM189 is enriched in endothelial cells and smooth muscle cells (VSMC). In VSMC, treatment with oxLDL reduced TMEM189 expression. Overexpression of TMEM189 significantly improved oxLDL induced reduction in collagen synthesis, expression of alpha-smooth muscle actin (alpha-SMA) and smooth muscle protein 22 (SM22). Overexpression of TMEM189 in VSMC, significantly reduced the content of plasmalogens in the cells. After 12 weeks of feeding with high-fat and high-cholesterol diet, it was found that the content of smooth muscle cells and vulnerability index in the aortic plaque in TMEM189 -/-ApoE -/- mice were significantly decreased than in ApoE -/- mice. Conclusions Before the recurrence of MACE in ACS patients, the synthesis pathway of plasmalogen was gradually damaged, and the reduction of plasmalogen was a potential marker for predicting the recurrence of MACE in ACS patients. The deficiency of TMEM189 - plasmalogen axis aggravates atherosclerosis, it can regulate the phenotype transformation of smooth muscle cells, inhibit their collagen synthesis, and thus affect plaque stability.

The paradox of CAC score and plaque vulnerability

Abstract Introduction The effect of coronary artery calcification on plaque vulnerability remains unclear. The coronary artery calcium (CAC) score, quantified using coronary computed tomography, has a strong correlation with total atherosclerotic burden and risk of adverse cardiac events. Nevertheless, different patterns in the distribution of coronary artery calcium have been reported to convey different effects on plaque stability. Some biomechanical models suggest that microcalcifications can intensify stress in the fibrous cap, promoting plaque rupture. On the other hand, large calcium deposits are hypothesized to promote plaque stability, as statin therapy has been shown to promote the calcification of atherosclerotic lesions. The purpose of this study is to investigate the relationship between CAC score and vulnerable plaque using coronary computed tomographic angiography (CCTA) in patients with an acute coronary syndrome (ACS). Methods CCTA was performed in 444 patients; these patients were divided into two groups (those with vulnerable plaque and those without). CAC score of each patient was obtained. We calculated median value of CAC score of both groups and compared them using Two Sample Mann-Whitney U Test. All tests were 2-sided, p values below a threshold of 0.05 were considered to be significant. All statistical analyses were performed using IBM SPSS Statistics 29.0 (SPSS Inc, Chicago, IL). Results Out of 444 patients with an ACS and evaluated with CCTA, vulnerable plaques were found in 57 patients (13%). The median value of CAC score in patients with vulnerable plaques was significantly higher compared with patients without vulnerable plaques (mean CAC score 1065,07 AU (95% Confidence Intervals 526,26-2656,40 AU) vs 444,03 AU (95% CI 120,18-766,88 AU, p &amp;lt; 0.001). Using Mann–Whitney U test, we found a statistically significant difference between CAC score of patients with vulnerable plaques and those that did not have such plaques. Conclusion Although CAC score is a reliable marker of atherosclerosis it is still uncertain whether CAC score is an indicator of plaque vulnerability. In our study, CAC score was higher in patients with vulnerable plaque compared to those without such plaques. A highly statistically significant difference was found between the median value of CAC score between these two groups of patients.Boxplot