Mitochondrial DNA Copy Number and Incident Heart Failure: The Atherosclerosis Risk in Communities (ARIC) Study

Heart failure (HF) is a leading clinical and public health concern because of its high prevalence and poor prognosis. It is thus critical to identify novel risk factors for developing HF. Mitochondrial DNA copy number (mtDNA-CN), an indirect biomarker of mitochondrial dysfunction, is associated with atherosclerotic cardiovascular disease endpoints, cardiovascular risk factors, all-cause mortality, and sudden cardiac death. The association between mtDNA-CN and the risk of incident HF, however, is unknown. We examined this association in the Atherosclerosis Risk in Communities (ARIC) cohort

Heart Failure Stages among Older Adults in the Community: The Atherosclerosis Risk in Communities Study

Background: Although heart failure (HF) disproportionately affects older adults, little data exist regarding the prevalence of American College of Cardiology/American Heart Association HF stages among older individuals in the community. Additionally, the role of contemporary measures of longitudinal strain and diastolic dysfunction in defining HF stages is unclear. Methods: HF stages were classified in 6118 participants in the Atherosclerosis Risk in Communities study (67-91 years of age) at the fifth study visit as follows: A (asymptomatic with HF risk factors but no cardiac structural or functional abnormalities), B (asymptomatic with structural abnormalities, defined as left ventricular hypertrophy, dilation or dysfunction, or significant valvular disease), C1 (clinical HF without prior hospitalization), and C2 (clinical HF with earlier hospitalization). Results: Using the traditional definitions of HF stages, only 5% of examined participants were free of HF risk factors or structural heart disease (Stage 0), 52% were categorized as Stage A, 30% Stage B, 7% Stage C1, and 6% Stage C2. Worse HF stage was associated with a greater risk of incident HF hospitalization or death at a median follow-up of 608 days. Left ventricular (LV) ejection fraction was preserved in 77% and 65% in Stages C1 and C2, respectively. Incorporation of longitudinal strain and diastolic dysfunction into the Stage B definition reclassified 14% of the sample from Stage A to B and improved the net reclassification index (P=0.028) and integrated discrimination index (P=0.016). Abnormal LV structure, systolic function (based on LV ejection fraction and longitudinal strain), and diastolic function (based on e', E/e', and left atrial volume index) were each independently and additively associated with risk of incident HF hospitalization or death in Stage A and B participants. Conclusions: The majority of older adults in the community are at risk for HF (Stages A or B), appreciably more compared with previous reports in younger community-based samples. LV ejection fraction is robustly preserved in at least two-thirds of older adults with prevalent HF (Stage C), highlighting the burden of HF with preserved LV ejection fraction in the elderly. LV diastolic function and longitudinal strain provide incremental prognostic value beyond conventional measures of LV structure and LV ejection fraction in identifying persons at risk for HF hospitalization or death

Polygenic transcriptome risk scores for COPD and lung function improve cross-ethnic portability of prediction in the NHLBI TOPMed program

While polygenic risk scores (PRSs) enable early identification of genetic risk for chronic obstructive pulmonary disease (COPD), predictive performance is limited when the discovery and target populations are not well matched. Hypothesizing that the biological mechanisms of disease are shared across ancestry groups, we introduce a PrediXcan-derived polygenic transcriptome risk score (PTRS) to improve cross-ethnic portability of risk prediction. We constructed the PTRS using summary statistics from application of PrediXcan on large-scale GWASs of lung function (forced expiratory volume in 1 s [FEV1] and its ratio to forced vital capacity [FEV1/FVC]) in the UK Biobank. We examined prediction performance and cross-ethnic portability of PTRS through smoking-stratified analyses both on 29,381 multi-ethnic participants from TOPMed population/family-based cohorts and on 11,771 multi-ethnic participants from TOPMed COPD-enriched studies. Analyses were carried out for two dichotomous COPD traits (moderate-to-severe and severe COPD) and two quantitative lung function traits (FEV1 and FEV1/FVC). While the proposed PTRS showed weaker associations with disease than PRS for European ancestry, the PTRS showed stronger association with COPD than PRS for African Americans (e.g., odds ratio [OR] = 1.24 [95% confidence interval [CI]: 1.08–1.43] for PTRS versus 1.10 [0.96–1.26] for PRS among heavy smokers with ≥ 40 pack-years of smoking) for moderate-to-severe COPD. Cross-ethnic portability of the PTRS was significantly higher than the PRS (paired t test p < 2.2 × 10−16 with portability gains ranging from 5% to 28%) for both dichotomous COPD traits and across all smoking strata. Our study demonstrates the value of PTRS for improved cross-ethnic portability compared to PRS in predicting COPD risk

Whole genome sequence analysis of pulmonary function and COPD in 19,996 multi-ethnic participants

Chronic obstructive pulmonary disease (COPD), diagnosed by reduced lung function, is a leading cause of morbidity and mortality. We performed whole genome sequence (WGS) analysis of lung function and COPD in a multi-ethnic sample of 11,497 participants from population- and family-based studies, and 8499 individuals from COPD-enriched studies in the NHLBI Trans-Omics for Precision Medicine (TOPMed) Program. We identify at genome-wide significance 10 known GWAS loci and 22 distinct, previously unreported loci, including two common variant signals from stratified analysis of African Americans. Four novel common variants within the regions of PIAS1, RGN (two variants) and FTO show evidence of replication in the UK Biobank (European ancestry n ~ 320,000), while colocalization analyses leveraging multi-omic data from GTEx and TOPMed identify potential molecular mechanisms underlying four of the 22 novel loci. Our study demonstrates the value of performing WGS analyses and multi-omic follow-up in cohorts of diverse ancestry

Physical and chemical properties of the products of in situ vitrification engineering tests 5, 6, and 7

In situ vitrification (ISV) is an in situ thermal treatment process that is being investigated by the Idaho National Engineering Laboratory (INEL) for application to buried waste sites. ISV is a thermal treatment process that converts contaminated soil into a chemically inert and stable glass and crystalline product. The INEL is evaluating whether the treatment process is a viable one for remediating a buried mixed transuranic waste site at the INEL Subsurface Disposal Area (SDA). The SDA is a Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) site. As part of the INEL investigation, a series of tests have been performed that address issues associated with vitrification of buried waste. Two pilot ISV tests and four tests at laboratory scale, formerly called engineering scale, were performed in 1990 to support the INEL investigation. The chemical composition and leaching of the produce glass is described

Product evaluation of in situ vitrification engineering, Test 4

This report is one of several that evaluates the In Situ Vitrification (ISV) Engineering-Scale Test 4 (ES-4). This document describes the chemical and physical composition, microstructure, and leaching characteristics of ES-4 product samples; these data provide insight into the expected performance of a vitrified product in an ISV buried waste application similar to that studied in ES-4

Assessment of gas flammability in transuranic waste container

The Safety Analysis Report for the TRUPACT-II Shipping Package [Transuranic Package Transporter-II (TRUPACT-II) SARP] set limits for gas generation rates, wattage limits, and flammable volatile organic compound (VOC) concentrations in transuranic (TRU) waste containers that would be shipped to the Waste Isolation Pilot Plant (WIPP). Based on existing headspace gas data for drums stored at the Idaho National Engineering Laboratory (INEL) and the Rocky Flats Environmental Technology Site (RFETS), over 30 percent of the contact-handled TRU waste drums contain flammable VOC concentrations greater than the limit. Additional requirements may be imposed for emplacement of waste in the WIPP facility. The conditional no-migration determination (NMD) for the test phase of the facility required that flame tests be performed if significant levels of flammable VOCs were present in TRU waste containers. This paper describes an approach for investigating the potential flammability of TRU waste drums, which would increase the allowable concentrations of flammable VOCS. A flammability assessment methodology is presented that will allow more drums to be shipped to WIPP without treatment or repackaging and reduce the need for flame testing on drums. The approach includes experimental work to determine mixture lower explosive limits (MLEL) for the types of gas mixtures observed in TRU waste, a model for predicting the MLEL for mixtures of VOCS, hydrogen, and methane, and revised screening limits for total flammable VOCs concentrations and concentrations of hydrogen and methane using existing drum headspace gas data and the model predictions

Position for determining gas-phase volatile organic compound concentrations in transuranic waste containers. Revision 2

In the conditional no-migration determination (NMD) for the test phase of the Waste Isolation Pilot Plant (WIPP), the US Environmental Protection Agency (EPA) imposed certain conditions on the US Department of Energy (DOE) regarding gas phase volatile organic compound (VOC) concentrations in the void space of transuranic (TRU) waste containers. Specifically, the EPA required the DOE to ensure that each waste container has no layer of confinement that contains flammable mixtures of gases or mixtures of gases that could become flammable when mixed with air. The EPA also required that sampling of the headspace of waste containers outside inner layers of confinement be representative of the entire void space of the container. The EPA stated that all layers of confinement in a container would have to be sampled until DOE can demonstrate to the EPA that sampling of all layers is either unnecessary or can be safely reduced. A test program was conducted at the Idaho National Engineering and Environmental Laboratory (INEEL) to demonstrate that the gas phase VOC concentration in the void space of each layer of confinement in vented drums can be estimated from measured drum headspace using a theoretical transport model and that sampling of each layer of confinement is unnecessary. This report summarizes the studies performed in the INEEL test program and extends them for the purpose of developing a methodology for determining gas phase VOC concentrations in both vented and unvented TRU waste containers. The methodology specifies conditions under which waste drum headspace gases can be said to be representative of drum gases as a whole and describes a method for predicting drum concentrations in situations where the headspace concentration is not representative. The methodology addresses the approach for determining the drum VOC gas content for two purposes: operational period drum handling and operational period no-migration calculations

Position for determining gas phase volatile organic compound concentrations in transuranic waste containers. Revision 1

In the conditional no-migration determination (NMD) for the test phase of the Waste Isolation Pilot Plant (WIPP), the US Environmental Protection Agency (EPA) imposed certain conditions on the US Department of Energy (DOE) regarding gas phase volatile organic compound (VOC) concentrations in the void space of transuranic (TRU) waste containers. Specifically, the EPA required the DOE to ensure that each waste container has no layer of confinement that contains flammable mixtures of gases or mixtures of gases that could become flammable when mixed with air. The EPA also required that sampling of the headspace of waste containers outside inner layers of confinement be representative of the entire void space of the container. The EPA stated that all layers of confinement in a container would have to be sampled until DOE can demonstrate to the EPA that sampling of all layers is either unnecessary or can be safely reduced. A test program was conducted at the Idaho National Engineering Laboratory (INEL) to demonstrate that the gas phase VOC concentration in the void space of each layer of confinement in vented drums can be estimated from measured drum headspace using a theoretical transport model and that sampling of each layer of confinement is unnecessary. This report summarizes the studies performed in the INEL test program and extends them for the purpose of developing a methodology for determining gas phase VOC concentrations in both vented and unvented TRU waste containers. The methodology specifies conditions under which waste drum headspace gases can be said to be representative of drum gases as a whole and describes a method for predicting drum concentrations in situations where the headspace concentration is not representative. The methodology addresses the approach for determining the drum VOC gas content for two purposes: operational period drum handling and operational period no-migration calculations

The TRUPACT-II Matrix Depleton Program

Contact-handled transuranic (CH-TRU) wastes will be shipped and disposed at the Waste Isolation Pilot Plant (WIPP) repository in the Transuranic Package Transporter-II (TRUPACT-II) shipping package. A primary transportation requirement for the TRUPACT-II is that the concentration of potentially flammable gases (i.e., hydrogen and methane) must not exceed 5 percent by volume in the package or the payload during a 60-day shipping period. Decomposition of waste materials by radiation, or radiolysis, is the predominant mechanism of gas generation during transport. The gas generation potential of a target waste material is characterized by a G-value, which is the number of molecules of gas generated per 100 eV of ionizing radiation absorbed by the target material. To demonstrate compliance with the flammable gas concentration requirement, theoretical worst-case calculations were performed to establish allowable wattage (decay heat) limits for waste containers. The calculations were based on the G-value for the waste material with the highest potential for flammable gas generation. The calculations also made no allowances for decreases of the G-value over time due to matrix depletion phenomena that have been observed by many experimenters. Matrix depletion occurs over time when an alpha-generating source particle alters the target material (by evaporation, reaction, or decomposition) into a material of lower gas generating potential. The net effect of these alterations is represented by the ``effective G-value.`