·AIM:To identify various risk factors that may play a significant role in the development of congenital nasolacrimal duct obstruction(CNLDO).·METHODS:This observational case-control study included a case gro...·AIM:To identify various risk factors that may play a significant role in the development of congenital nasolacrimal duct obstruction(CNLDO).·METHODS:This observational case-control study included a case group of 122 children less than two years of age with CNLDO who underwent probing and irrigation treatment at the ophthalmology department of Imam Khomeini Hospital in Ahvaz,Iran,from June 2022 to June2024.A control group of 122 age-matched children without CNLDO was also included for comparison.Data was collected from the children's medical records.·RESULTS:The study found a significant correlation between the occurrence of CNLDO and several maternal factors,such as preeclampsia,the use of levothyroxine,hypothyroidism,having more than three pregnancies(gravidity>3),natural pregnancy,and gestational diabetes mellitus.Additionally,in children,factors,such as oxygen therapy,anemia,reflux,jaundice,and a family history of CNLDO in first-degree relatives were associated with CNLDO,and maternal preeclampsia and hypothyroidism were found to significantly increase the risk of developing CNLDO in children.·CONCLUSION:Given that CNLDO affects both premature and full-term children,the present findings may potentially facilitate the early identification of children and infants at risk of nasolacrimal duct obstruction,thereby preventing the onset of chronic dacryocystitis.展开更多
Urban railways are vital means of public transportation in Korea.More than 30%of metropolitan residents use the railways,and this proportion is expected to increase.To enhance safety,the government has mandated the in...Urban railways are vital means of public transportation in Korea.More than 30%of metropolitan residents use the railways,and this proportion is expected to increase.To enhance safety,the government has mandated the installation of closed-circuit televisions in all carriages by 2024.However,cameras still monitored humans.To address this limitation,we developed a dataset of risk factors and a smart detection system that enables an immediate response to any abnormal behavior and intensive monitoring thereof.We created an innovative learning dataset that takes into account seven unique risk factors specific to Korean railway passengers.Detailed data collection was conducted across the Shinbundang Line of the Incheon Transportation Corporation,and the Ui-Shinseol Line.We observed several behavioral characteristics and assigned unique annotations to them.We also considered carriage congestion.Recognition performance was evaluated by camera placement and number.Then the camera installation plan was optimized.The dataset will find immediate applications in domestic railway operations.The artificial intelligence algorithms will be verified shortly.展开更多
BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double c...BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.展开更多
Flood extremes due to sea level rise and extreme precipitation are expected to increase in frequency and intensity. However, despite the need for accurate climate change risk assessment, significant misconceptions in ...Flood extremes due to sea level rise and extreme precipitation are expected to increase in frequency and intensity. However, despite the need for accurate climate change risk assessment, significant misconceptions in key risk terms, including vulnerability and impact, could lead to risk miscalculations. These misconceptions around risk concepts derive from the lack of risk terms’ standardization and the gaps in an integrated and widely accepted methodology for assessing climate change risks. Risk assessment frameworks should follow the specialties of each element/sector it is applied on and the special features of each climate hazard. Also, risk assessment matrix should not follow specific design settings but it should better follow the needs of each study, so as to optimize the understanding of each risk. Through an extensive literature review, this is the first paper that identifies gaps, inconsistencies and misuses of climate risk concepts and suggests specific systemization and standardization of risk terms definitions. Finally, it develops a climate change risk assessment framework and matrix, focusing on sea level rise and extreme precipitation, which could be widely implemented in risk assessment of all elements at sea level rise and extreme precipitation risk.展开更多
Nitrate contamination of groundwater is a worldwide problem, particularly in agricultural countries. Exposure to high levels of nitrates in groundwater can have adverse effects on the health of residents who use groun...Nitrate contamination of groundwater is a worldwide problem, particularly in agricultural countries. Exposure to high levels of nitrates in groundwater can have adverse effects on the health of residents who use groundwater for drinking. This study aims to assess the health risk associated with the ingestion of nitrates in well water in the town of M’bahiakro. Health risk maps were created on the basis of hazard quotients (HQ) using the US Environmental Protection Agency (USEPA) health risk assessment model. The results indicate that residents of the Koko, Dougouba and Baoulekro neighbourhoods, whatever their age, are potentially exposed to the toxic effects of NO3−during their daily intake of nitrate-contaminated well water, with reference to hazard quotients (HQ) greater than 1. Nitrate concentrations in the groundwater should therefore be controlled in order to prevent their harmful effects on the health of the population and guarantee its use in rice-growing activities in M’Bahiakro.展开更多
Introduction: Considering a disease of postmenopausal women, there is a noted trend of increasing breast cancer cases among premenopausal women. Our study aimed to determine the main risk factors for breast cancer in ...Introduction: Considering a disease of postmenopausal women, there is a noted trend of increasing breast cancer cases among premenopausal women. Our study aimed to determine the main risk factors for breast cancer in women aged 40 and under. Materials and Methods: This was a case-control study with exhaustive sampling of all respondents with histological proof over a 12-month period, matched by age. For all statistical tests, we used a significance threshold of 5%. Additionally provided are the ORs and their 95% confidence intervals, the mean, and standard deviation. Results: We collected 65 cases and 130 controls. The frequency of breast cancer in women aged 40 and under was 35.5%. The mean age was 35.6 ± 4.5 years among cases compared to 32.1 ± 7.9 years among controls. A significantly positive association was detected in both univariate and multivariate analysis between age and breast cancer [(OR) = 10.30;95% CI (1.99 - 53.23)] and [(OR) = 7.53;95% CI (1.82 - 31.23)];family history of breast cancer and breast cancer [(OR) = 9.99;95% CI (1.43 - 69.58)];smoking and breast cancer [OR = 13.11;95% CI (1.05 - 163.30)];sedentary lifestyle and breast cancer [OR = 3.36;95% CI (1.01 - 11.17)];and night work and breast cancer [(OR) = 72.05;95% CI (8.15 - 637.25)]. Conclusion: Earlier systematic screening and regular follow-up should be conducted in young women in our context.展开更多
Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast...Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast cancer, this particular study deals with the distribution, determinants, and frequency of the disease. Breast cancer incidence and death data are critical to determining healthcare priorities. Women’s cancer is the most common, accounting for 25.1 percent of all malignancies. According to this specific report, more than 42,000 women die from breast cancer each year. Hence, it is apparent that it is the second leading cause of death among women, especially in the US. Family history/genetics, reproductive, hormone, benign proliferative breast disease, and mammographic density are the four main risk factors for breast cancer that can be meaningfully categorized. These elements are briefly discussed, and the risk estimators are provided. Numerous screening technologies have found breast cancer;some are linked to an increased risk of breast cancer, such as ultrasound techniques and MRI scanning. Breast cancer is more common in developed countries, while relative mortality is highest in developing countries. Women’s education is recommended for early detection and treatment in all nations. Health policymakers must prioritize plans to control and prevent this malignancy and increase awareness of risk factors and early detection in less developed countries.展开更多
Necrotizing enterocolitis (NEC) in newborns is one of the life-threatening diseases. With the continuous advancement of perinatal medicine and neonatal intensive care technology, NEC has been on the rise year by year....Necrotizing enterocolitis (NEC) in newborns is one of the life-threatening diseases. With the continuous advancement of perinatal medicine and neonatal intensive care technology, NEC has been on the rise year by year. The etiology of NEC is not yet clear, and it may be the result of multiple risk factors working together, such as premature birth, infection, formula feeding, ischemia, hypoxia, dysbiosis of intestinal flora, and immune damage. Additionally, recent reports have documented factors such as immunoglobulin treatment for hemolytic jaundice, blood transfusion therapy, and rapid achievement of adequate feeding. This article comprehensively analyzes the current research progress on high-risk factors of NEC, and provides a reference for future prevention, diagnosis, and treatment directions.展开更多
In reward-based crowdfunding, projects are to disclose the operational risks and mitigation strategies for delivering the physical rewards during the funding phase. However, limited knowledge exists regarding projects...In reward-based crowdfunding, projects are to disclose the operational risks and mitigation strategies for delivering the physical rewards during the funding phase. However, limited knowledge exists regarding projects’ operational risks and mitigation strategies during the funding phase. In contributing to the literature, the study uses data on Kickstarter.com and conducts a content analysis to explore themes and their relationships. The results reveal various operational risks and associated mitigation strategies. Among the identified themes, product-related, contract manufacturers, and supply markets are the most expected risks, while outsourced production and proactive sourcing are the popular mitigation strategies. Also, the finding reveals that proactive sourcing and outsourced production, in-house production and post-campaign sourcing, contract manufacturer risk, and project internal risk are themes forming clusters. The results extend crowdfunding risk disclosure literature and set the tone for future research in crowdfunding operational risk management. Finally, other business implications are drawn for crowdfunding practitioners.展开更多
Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serio...Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serious but common diseases and their association with atherosclerotic cardiovascular risk factors establish a vicious circle culminating in high atherogenicity.Because of that,it is of paramount importance to perform risk stratification of patients with prediabetes to define phenotypes that benefit from various interventions.Furthermore,stress hyperglycemia assessment of hospitalized patients and consensus on the definition of prediabetes is vital.The roles lifestyle and metformin play in prediabetes are well established.However,the role of glucagon-like peptide agonists and metabolic surgery is less clear.Prediabetes is considered an intermediate between normoglycemia and diabetes along the blood glucose continuum.One billion people are expected to suffer from prediabetes by the year 2045.Therefore,realworld randomized controlled trials to assess major adverse cardiac or cerebrovascular event risk reduction and reversal/prevention of type 2 diabetes among patients are needed to determine the proper interventions.展开更多
Early onset of hypertension (HTN) raises the risk of cardiovascular disease (CVD), the leading cause of death in the U.S. For university students who do not follow healthy diets or lifestyles, high blood pressure (BP)...Early onset of hypertension (HTN) raises the risk of cardiovascular disease (CVD), the leading cause of death in the U.S. For university students who do not follow healthy diets or lifestyles, high blood pressure (BP) may be markedly prevalent. Researchers utilized a cross-sectional design to assess HTN prevalence and its risk factors among college students (N = 123). Self-administered surveys comprising four validated questionnaires: the Perceived Stress Scale (PSS), Rapid Eating Assessment for Participants-Shortened (REAPS), Dietary Approaches to Stop Hypertension Quality (DASH-Q), and the U.S. Adult Food Security Survey (FSS) were employed. Additionally, physical measurements were conducted, including height, weight, waist circumference (WC), and BP. Results indicated that 71.6% of students had elevated BP, with 24.4% classified as Stage 1 HTN and 23.6% as Stage 2 HTN. Notably, 60% of students reported low adherence to the DASH diet and a mean REAPS score of 26.3 out of 39. Students experiencing marginal food security had higher systolic blood pressure (SBP) 131.7 ± 16.8 mm Hg compared to those with high food security 123.03 ± 11.7 mm Hg (p = 0.028). Furthermore, REAPS scores showed a negative correlation with diastolic blood pressure (DBP) (β = −0.201, p = 0.03). Significant predictors for SBP included WC (β = 0.40, p β = −0.33, p β = 0.16, p = 0.046). The findings highlight the need for BP screenings and nutrition education programs to improve dietary habits among college students, which may help reduce HTN and its associated long-term risks for CVD.展开更多
One of the most promising vector control strategies for controlling dengue fever is the stable introduction of the obligate intracellular Wolbachia bacteria strain into Aedes aegypti mosquitoes. This method reduces th...One of the most promising vector control strategies for controlling dengue fever is the stable introduction of the obligate intracellular Wolbachia bacteria strain into Aedes aegypti mosquitoes. This method reduces the mosquito’s ability to transmit dengue through reproductive strategies associated with Wolbachia infection, such as parthenogenesis, male elimination or feminization, sex ratio distortions and cytoplasmic incompatibility. Expert knowledge and a risk assessment framework were used to identify the risks associated with the release of Wolbachia-bearing mosquitoes. Then, consultations with individual participants were organized and a Bayesian network (BN) was developed to capture the relationship between the hazards as well as the likelihood of these adverse events occurring. Finally, risk was calculated from the probability and consequence estimates obtained from our Burkina Faso participants, using a questionnaire based on the identified risks. Our “Cause More Harm” study yielded 46.15% negligible risk, 44.23% very low risk and 9.62% low risk. The “socio-cultural change” parameter had the greatest influence, with the perception that the dissemination project would be poorly received by the local population. This parameter alone accounted for 80% of the most significant risks. This explains the fact that hazard RA 49 “negative messages in social media” is ranked as the highest individual risk (although the risk is low) with a calculated risk of 0.261. The risk assessment was designed to integrate the interdependent complexity of hazards likely to affect the dissemination of technology in the environment. It represents an important implementation phase in the success of this innovative research, introducing a new technology to combat the transmission of dengue fever.展开更多
BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD i...BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.展开更多
Arsenic is a toxic element. Chronic exposure to arsenic can pose a variety of health problems including cancers, lung disease, skin lesions, diabetes, gangrene, reproductive disorders, hypertension, and heart disease....Arsenic is a toxic element. Chronic exposure to arsenic can pose a variety of health problems including cancers, lung disease, skin lesions, diabetes, gangrene, reproductive disorders, hypertension, and heart disease. Globally the concern of arsenic is growing day by day. Addressing this concern, the study aimed to assess the arsenic level in raw rice grain and rice cooked with tubewell water and rainwater. The study was conducted at the Sholotaka Union of Gangni Upazila in Meherpur District of Khulna Division, Bangladesh in 2023. For this purpose, seven raw samples including rice grain, rainwater and tubewell water samples and six cooked rice samples were analyzed. Rice and water samples were digested using the USEPA method-3050B in Arsenic Center Jashore, under Asia Arsenic Network, Japan. The arsenic level in the samples was tested using the HG-AAS method using a Shimadzu model AA7000 (Japan) Atomic Absorption Spectrophotometer. The study’s findings revealed that arsenic concentration in rainwater samples consistently displays 0 mg/l indicating the absence of arsenic in this sample. Three (03) tube well water samples and three (03) raw rice grain samples showed a significant variation in arsenic concentration. The mean value of tubewell water samples T1, T2, and T3 was found 0.53 ± 0.003 mg/l, 0.31 ± 0.003 mg/l, and 0.65 ± 0.002 mg/l, respectively. Whereas raw rice grain samples RG1 showed a mean of 0.607 ± 0.007 mg/kg, RG2 at 0.458 ± 0.008 mg/kg, and RG3 at 0.7145 ± 0.001 mg/kg. The study found that rice cooked with tubewell water contained a higher arsenic concentration than rice cooked with rainwater. The most prominent finding of this study was that cooked rice using rainwater had a lower amount of arsenic than the raw rice grain. So, it is clearly said that using rainwater can minimize the amount of arsenic. Furthermore, the study indicates that the health risks associated with arsenic exposure have increased. Estimated daily intake (EDI) values for cooked rice samples ranged from 3.07 to 5.47 μg/kg body weight/day, exceeding safe limits. Target Hazard Quotient (THQ) values varied from 10.2 to 18.2, indicating significant potential for non-carcinogenic health effects. Lifetime Cancer Risk (LCR) values ranged from 0.461% to 0.821% exceeding the U.S. Environmental Protection Agency’s acceptable risk threshold of 0.01%, which reflects a heightened cancer risk. The study suggests that people in the study area should use rainwater instead of tubewell water for their cooking purposes. Furthermore, rainwater harvesting should be prioritized in this area to address arsenic issues.展开更多
Background: Cesarean sections have become increasingly prevalent in both developed and developing nations. Nevertheless, postoperative complications, including surgical site infections (SSIs), remain a substantial con...Background: Cesarean sections have become increasingly prevalent in both developed and developing nations. Nevertheless, postoperative complications, including surgical site infections (SSIs), remain a substantial concern that contributes to heightened morbidity and mortality. This study is designed to evaluate the frequency and key determining factors associated with surgical site infections following cesarean section procedures in a tertiary care hospital in Bangladesh. Materials and Methods: This observational cross-sectional study, conducted at the Gynecology Department of Dhaka Medical College Hospital, involved 100 patients aged 15 - 45 who had cesarean deliveries. Data was collected during hospitalization and post-discharge and analyzed to determine the prevalence and relationship between socio-demographic characteristics and surgical site infection. Results: Among the study participants, 14% developed surgical site infections following cesarean operations. More than half of these patients were under the age of 25, with a mean age of 24.45 ± 4.44 years. Surgical site infections were more prevalent in individuals over 30 years old (P-value Conclusion: Post-cesarean surgical site infections are notably prevalent among the participants in this study. Several risk factors have been identified, including age, body mass index (BMI), socioeconomic status, anemia, preterm delivery, personal hygiene practices, regular menstrual cycles, and adherence to antenatal check-ups. The implementation of an effective awareness program, coupled with updated antibiotic protocols, is crucial for significantly reducing the incidence of these infections.展开更多
This study investigates the prevalence of HIV high-risk behaviors among university students in S City, Sichuan Province. Using a sampling survey method, a total of 3262 valid questionnaires were collected. Data analys...This study investigates the prevalence of HIV high-risk behaviors among university students in S City, Sichuan Province. Using a sampling survey method, a total of 3262 valid questionnaires were collected. Data analysis revealed ten significant issues related to HIV risk behaviors among university students, leading to suggested intervention strategies to address these behaviors.展开更多
Professional and trade skills are required for handling the construction related projects;Construction industries of the present day however lack useful information concerning different practices,patterns and trends i...Professional and trade skills are required for handling the construction related projects;Construction industries of the present day however lack useful information concerning different practices,patterns and trends involved in risk management.Considering this,the present study focuses on the aforementioned variables of risk management by quantitative analysis specifically in the domain of construction industry.This study has used IBM’s SPSS(Statistical Package for Social Sciences)version 25.0 to analyze the results.This study is an initiative to assess the impact of risk management in the construction sector of Jordan.It will assist the construction sector for exploring the limitations with respect to integrate effective risk management.A sense of competition will be developed through a comparison of risk factors of construction projects among the project stakeholders such as contractors should enhance their risk management practices.展开更多
The aging global population is driving an increase in dementia,making the early identification of at-risk individuals crucial.Studies have shown that elderly people often exhibit a slowing gait before dementia diagnos...The aging global population is driving an increase in dementia,making the early identification of at-risk individuals crucial.Studies have shown that elderly people often exhibit a slowing gait before dementia diagnosis,which is linked to cognitive decline and predicts dementia risk.With 30%of those over 65 years of age experiencing falls annually,managing fall risk is essential.Motoric cognitive risk syndrome(MCR),characterized by subjective memory impairment and slow gait,is a pre-dementia condition that can identify high-risk individuals without extensive evaluation.The prevalence of MCR varies globally and is associated with an increased risk of falls,disability,and death.Early screening and intervention for MCR can delay dementia and improve fall regulation,offering a new perspective on elderly health management.This review synthesizes the current understanding of MCR-related falls,evaluates risk assessment methods,and discusses health strategies to provide a theoretical basis for fall prevention in community-dwelling older adults.展开更多
BACKGROUND Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring.Early identification and intervention of antenatal depression ca...BACKGROUND Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring.Early identification and intervention of antenatal depression can help to prevent adverse outcomes.However,there have been few population-based studies focusing on the association of social and obstetric risk factors with antenatal depression in China.AIM To assess the sociodemographic and obstetric factors of antenatal depression and compare the network structure of depressive symptoms across different risk levels based on a large Chinese population.METHODS The cross-sectional survey was conducted in Shenzhen,China from 2020 to 2024.Antenatal depression was assessed using the Chinese version of the Edinburgh Postnatal Depression Scale(EPDS),with a score of≥13 indicating the presence of probable antenatal depression.Theχ2 test and binary logistic regression were used to identify the factors associated with antenatal depression.Network analyses were conducted to investigate the structure of depressive symptoms across groups with different risk levels.RESULTS Among the 44220 pregnant women,the prevalence of probable antenatal depression was 4.4%.An age≤24 years,a lower level of education(≤12 years),low or moderate economic status,having a history of mental disorders,being in the first trimester,being a primipara,unplanned pregnancy,and pregnancy without pre-pregnancy screening were found to be associated with antenatal depression(all P<0.05).Depressive symptom networks across groups with different risk levels revealed robust interconnections between symptoms.EPDS8("sad or miserable")and EPDS4("anxious or worried")showed the highest nodal strength across groups with different risk levels.CONCLUSION This study suggested that the prevalence of antenatal depression was 4.4%.Several social and obstetric factors were identified as risk factors for antenatal depression.EPDS8("sad or miserable")and EPDS4("anxious or worried")are pivotal targets for clinical intervention to alleviate the burden of antenatal depression.Early identification of highrisk groups is crucial for the development and implementation of intervention strategies to improve the overall quality of life for pregnant women.展开更多
BACKGROUND Coronary heart disease(CHD)is a prevalent type 2 diabetes mellitus(T2DM)complication.Further,the risk stratification before angiography may help diagnose T2DM with CHD early.However,few studies have investi...BACKGROUND Coronary heart disease(CHD)is a prevalent type 2 diabetes mellitus(T2DM)complication.Further,the risk stratification before angiography may help diagnose T2DM with CHD early.However,few studies have investigated the coronary imaging characteristics and risk factors of patients with T2DM complicated with CHD.AIM To compare the differences in coronary imaging between patients with T2DM with and without CHD,determine the risk factors of T2DM complicated with CHD,and establish a predictive tool for diagnosing CHD in T2DM.METHODS This study retrospectively analyzed 103 patients with T2DM from January 2022 to May 2024.They are categorized based on CHD occurrence into:(1)The control group,consisting of patients with T2DM without CHD;and(2)The observation group,which includes patients with T2MD with CHD.Age,sex,smoking and drinking history,CHD family history,metformin(MET)treatment pre-admission,body mass index,fasting blood glucose(FBG),triglyceride(TG),total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol(LDL-C),serum creatinine,blood urea nitrogen(BUN),alanine aminotransferase,aspartate aminotransferase,glycosylated hemoglobin(HbA1c),and coronary imaging data of both groups were collected from the medical record system.Logistic risk analysis was conducted to screen risk factors.The prediction model’s prediction efficiency was evaluated with receiver operating characteristic curves.RESULTS The control and observation groups consisted of 48 and 55 cases,respectively.The two groups were statistically different in terms of age(t=2.006,P=0.048),FBG(t=6.038,P=0.000),TG(t=2.015,P=0.047),LDL-C(t=2.017,P=0.046),and BUN(t=2.035,P=0.044).The observation group demonstrated lower proportions of patients receiving MET(χ^(2)=5.073,P=0.024)and higher proportions of patients with HbA1c of>7.0%(χ^(2)=6.980,P=0.008)than the control group.The observation group consisted of 15,17,and 23 cases of moderate stenosis,severe stenosis,and occlusion,respectively,with a greater number of coronary artery occlusion cases than the control group(χ^(2)=6.399,P=0.041).The observation group consisted significantly higher number of diffuse lesion cases at 35 compared with the control group(χ^(2)=15.420,P=0.000).The observation group demonstrated a higher right coronary artery(RCA)stenosis index(t=6.730,P=0.000),circumflex coronary artery(LCX)stenosis index(t=5.738,P=0.000),and total stenosis index(t=7.049,P=0.000)than the control group.FBG[odds ratio(OR)=1.472;95%confidence interval(CI):1.234-1.755;P=0.000]and HbA1c(OR=3.197;95%CI:1.149-8.896;P=0.026)were independent risk factors for T2DM complicated with CHD,whereas MET(OR=0.350;95%CI:0.129-0.952;P=0.040)was considered a protective factor for CHD in T2DM.CONCLUSION Coronary artery occlusion is a prevalent complication in patients with T2DM.Patients with T2MD with CHD demonstrated a higher degree of RCA and LCX stenosis than those with T2DM without CHD.FBG,HbA1c,and MET treatment history are risk factors for T2DM complicated with CHD.展开更多
文摘·AIM:To identify various risk factors that may play a significant role in the development of congenital nasolacrimal duct obstruction(CNLDO).·METHODS:This observational case-control study included a case group of 122 children less than two years of age with CNLDO who underwent probing and irrigation treatment at the ophthalmology department of Imam Khomeini Hospital in Ahvaz,Iran,from June 2022 to June2024.A control group of 122 age-matched children without CNLDO was also included for comparison.Data was collected from the children's medical records.·RESULTS:The study found a significant correlation between the occurrence of CNLDO and several maternal factors,such as preeclampsia,the use of levothyroxine,hypothyroidism,having more than three pregnancies(gravidity>3),natural pregnancy,and gestational diabetes mellitus.Additionally,in children,factors,such as oxygen therapy,anemia,reflux,jaundice,and a family history of CNLDO in first-degree relatives were associated with CNLDO,and maternal preeclampsia and hypothyroidism were found to significantly increase the risk of developing CNLDO in children.·CONCLUSION:Given that CNLDO affects both premature and full-term children,the present findings may potentially facilitate the early identification of children and infants at risk of nasolacrimal duct obstruction,thereby preventing the onset of chronic dacryocystitis.
基金supported by a Korean Agency for Infrastructure Technology Advancement(KAIA)grant funded by the Ministry of Land,Infrastructure and Transport(grant no.RS-2023-00239464).
文摘Urban railways are vital means of public transportation in Korea.More than 30%of metropolitan residents use the railways,and this proportion is expected to increase.To enhance safety,the government has mandated the installation of closed-circuit televisions in all carriages by 2024.However,cameras still monitored humans.To address this limitation,we developed a dataset of risk factors and a smart detection system that enables an immediate response to any abnormal behavior and intensive monitoring thereof.We created an innovative learning dataset that takes into account seven unique risk factors specific to Korean railway passengers.Detailed data collection was conducted across the Shinbundang Line of the Incheon Transportation Corporation,and the Ui-Shinseol Line.We observed several behavioral characteristics and assigned unique annotations to them.We also considered carriage congestion.Recognition performance was evaluated by camera placement and number.Then the camera installation plan was optimized.The dataset will find immediate applications in domestic railway operations.The artificial intelligence algorithms will be verified shortly.
基金Supported by the Health Technology Project of Pudong New District Health Commission,No.PW2020D-12.
文摘BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.
文摘Flood extremes due to sea level rise and extreme precipitation are expected to increase in frequency and intensity. However, despite the need for accurate climate change risk assessment, significant misconceptions in key risk terms, including vulnerability and impact, could lead to risk miscalculations. These misconceptions around risk concepts derive from the lack of risk terms’ standardization and the gaps in an integrated and widely accepted methodology for assessing climate change risks. Risk assessment frameworks should follow the specialties of each element/sector it is applied on and the special features of each climate hazard. Also, risk assessment matrix should not follow specific design settings but it should better follow the needs of each study, so as to optimize the understanding of each risk. Through an extensive literature review, this is the first paper that identifies gaps, inconsistencies and misuses of climate risk concepts and suggests specific systemization and standardization of risk terms definitions. Finally, it develops a climate change risk assessment framework and matrix, focusing on sea level rise and extreme precipitation, which could be widely implemented in risk assessment of all elements at sea level rise and extreme precipitation risk.
文摘Nitrate contamination of groundwater is a worldwide problem, particularly in agricultural countries. Exposure to high levels of nitrates in groundwater can have adverse effects on the health of residents who use groundwater for drinking. This study aims to assess the health risk associated with the ingestion of nitrates in well water in the town of M’bahiakro. Health risk maps were created on the basis of hazard quotients (HQ) using the US Environmental Protection Agency (USEPA) health risk assessment model. The results indicate that residents of the Koko, Dougouba and Baoulekro neighbourhoods, whatever their age, are potentially exposed to the toxic effects of NO3−during their daily intake of nitrate-contaminated well water, with reference to hazard quotients (HQ) greater than 1. Nitrate concentrations in the groundwater should therefore be controlled in order to prevent their harmful effects on the health of the population and guarantee its use in rice-growing activities in M’Bahiakro.
文摘Introduction: Considering a disease of postmenopausal women, there is a noted trend of increasing breast cancer cases among premenopausal women. Our study aimed to determine the main risk factors for breast cancer in women aged 40 and under. Materials and Methods: This was a case-control study with exhaustive sampling of all respondents with histological proof over a 12-month period, matched by age. For all statistical tests, we used a significance threshold of 5%. Additionally provided are the ORs and their 95% confidence intervals, the mean, and standard deviation. Results: We collected 65 cases and 130 controls. The frequency of breast cancer in women aged 40 and under was 35.5%. The mean age was 35.6 ± 4.5 years among cases compared to 32.1 ± 7.9 years among controls. A significantly positive association was detected in both univariate and multivariate analysis between age and breast cancer [(OR) = 10.30;95% CI (1.99 - 53.23)] and [(OR) = 7.53;95% CI (1.82 - 31.23)];family history of breast cancer and breast cancer [(OR) = 9.99;95% CI (1.43 - 69.58)];smoking and breast cancer [OR = 13.11;95% CI (1.05 - 163.30)];sedentary lifestyle and breast cancer [OR = 3.36;95% CI (1.01 - 11.17)];and night work and breast cancer [(OR) = 72.05;95% CI (8.15 - 637.25)]. Conclusion: Earlier systematic screening and regular follow-up should be conducted in young women in our context.
文摘Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast cancer, this particular study deals with the distribution, determinants, and frequency of the disease. Breast cancer incidence and death data are critical to determining healthcare priorities. Women’s cancer is the most common, accounting for 25.1 percent of all malignancies. According to this specific report, more than 42,000 women die from breast cancer each year. Hence, it is apparent that it is the second leading cause of death among women, especially in the US. Family history/genetics, reproductive, hormone, benign proliferative breast disease, and mammographic density are the four main risk factors for breast cancer that can be meaningfully categorized. These elements are briefly discussed, and the risk estimators are provided. Numerous screening technologies have found breast cancer;some are linked to an increased risk of breast cancer, such as ultrasound techniques and MRI scanning. Breast cancer is more common in developed countries, while relative mortality is highest in developing countries. Women’s education is recommended for early detection and treatment in all nations. Health policymakers must prioritize plans to control and prevent this malignancy and increase awareness of risk factors and early detection in less developed countries.
文摘Necrotizing enterocolitis (NEC) in newborns is one of the life-threatening diseases. With the continuous advancement of perinatal medicine and neonatal intensive care technology, NEC has been on the rise year by year. The etiology of NEC is not yet clear, and it may be the result of multiple risk factors working together, such as premature birth, infection, formula feeding, ischemia, hypoxia, dysbiosis of intestinal flora, and immune damage. Additionally, recent reports have documented factors such as immunoglobulin treatment for hemolytic jaundice, blood transfusion therapy, and rapid achievement of adequate feeding. This article comprehensively analyzes the current research progress on high-risk factors of NEC, and provides a reference for future prevention, diagnosis, and treatment directions.
文摘In reward-based crowdfunding, projects are to disclose the operational risks and mitigation strategies for delivering the physical rewards during the funding phase. However, limited knowledge exists regarding projects’ operational risks and mitigation strategies during the funding phase. In contributing to the literature, the study uses data on Kickstarter.com and conducts a content analysis to explore themes and their relationships. The results reveal various operational risks and associated mitigation strategies. Among the identified themes, product-related, contract manufacturers, and supply markets are the most expected risks, while outsourced production and proactive sourcing are the popular mitigation strategies. Also, the finding reveals that proactive sourcing and outsourced production, in-house production and post-campaign sourcing, contract manufacturer risk, and project internal risk are themes forming clusters. The results extend crowdfunding risk disclosure literature and set the tone for future research in crowdfunding operational risk management. Finally, other business implications are drawn for crowdfunding practitioners.
文摘Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serious but common diseases and their association with atherosclerotic cardiovascular risk factors establish a vicious circle culminating in high atherogenicity.Because of that,it is of paramount importance to perform risk stratification of patients with prediabetes to define phenotypes that benefit from various interventions.Furthermore,stress hyperglycemia assessment of hospitalized patients and consensus on the definition of prediabetes is vital.The roles lifestyle and metformin play in prediabetes are well established.However,the role of glucagon-like peptide agonists and metabolic surgery is less clear.Prediabetes is considered an intermediate between normoglycemia and diabetes along the blood glucose continuum.One billion people are expected to suffer from prediabetes by the year 2045.Therefore,realworld randomized controlled trials to assess major adverse cardiac or cerebrovascular event risk reduction and reversal/prevention of type 2 diabetes among patients are needed to determine the proper interventions.
文摘Early onset of hypertension (HTN) raises the risk of cardiovascular disease (CVD), the leading cause of death in the U.S. For university students who do not follow healthy diets or lifestyles, high blood pressure (BP) may be markedly prevalent. Researchers utilized a cross-sectional design to assess HTN prevalence and its risk factors among college students (N = 123). Self-administered surveys comprising four validated questionnaires: the Perceived Stress Scale (PSS), Rapid Eating Assessment for Participants-Shortened (REAPS), Dietary Approaches to Stop Hypertension Quality (DASH-Q), and the U.S. Adult Food Security Survey (FSS) were employed. Additionally, physical measurements were conducted, including height, weight, waist circumference (WC), and BP. Results indicated that 71.6% of students had elevated BP, with 24.4% classified as Stage 1 HTN and 23.6% as Stage 2 HTN. Notably, 60% of students reported low adherence to the DASH diet and a mean REAPS score of 26.3 out of 39. Students experiencing marginal food security had higher systolic blood pressure (SBP) 131.7 ± 16.8 mm Hg compared to those with high food security 123.03 ± 11.7 mm Hg (p = 0.028). Furthermore, REAPS scores showed a negative correlation with diastolic blood pressure (DBP) (β = −0.201, p = 0.03). Significant predictors for SBP included WC (β = 0.40, p β = −0.33, p β = 0.16, p = 0.046). The findings highlight the need for BP screenings and nutrition education programs to improve dietary habits among college students, which may help reduce HTN and its associated long-term risks for CVD.
文摘One of the most promising vector control strategies for controlling dengue fever is the stable introduction of the obligate intracellular Wolbachia bacteria strain into Aedes aegypti mosquitoes. This method reduces the mosquito’s ability to transmit dengue through reproductive strategies associated with Wolbachia infection, such as parthenogenesis, male elimination or feminization, sex ratio distortions and cytoplasmic incompatibility. Expert knowledge and a risk assessment framework were used to identify the risks associated with the release of Wolbachia-bearing mosquitoes. Then, consultations with individual participants were organized and a Bayesian network (BN) was developed to capture the relationship between the hazards as well as the likelihood of these adverse events occurring. Finally, risk was calculated from the probability and consequence estimates obtained from our Burkina Faso participants, using a questionnaire based on the identified risks. Our “Cause More Harm” study yielded 46.15% negligible risk, 44.23% very low risk and 9.62% low risk. The “socio-cultural change” parameter had the greatest influence, with the perception that the dissemination project would be poorly received by the local population. This parameter alone accounted for 80% of the most significant risks. This explains the fact that hazard RA 49 “negative messages in social media” is ranked as the highest individual risk (although the risk is low) with a calculated risk of 0.261. The risk assessment was designed to integrate the interdependent complexity of hazards likely to affect the dissemination of technology in the environment. It represents an important implementation phase in the success of this innovative research, introducing a new technology to combat the transmission of dengue fever.
基金Supported by National Key Research and Development Program of China,No.2022YFC3600903Key Discipline Project under Shanghai's Three-Year Action Plan for Strengthening the Public Health System(2023-2025),No.GWVI-11.1-44.
文摘BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.
文摘Arsenic is a toxic element. Chronic exposure to arsenic can pose a variety of health problems including cancers, lung disease, skin lesions, diabetes, gangrene, reproductive disorders, hypertension, and heart disease. Globally the concern of arsenic is growing day by day. Addressing this concern, the study aimed to assess the arsenic level in raw rice grain and rice cooked with tubewell water and rainwater. The study was conducted at the Sholotaka Union of Gangni Upazila in Meherpur District of Khulna Division, Bangladesh in 2023. For this purpose, seven raw samples including rice grain, rainwater and tubewell water samples and six cooked rice samples were analyzed. Rice and water samples were digested using the USEPA method-3050B in Arsenic Center Jashore, under Asia Arsenic Network, Japan. The arsenic level in the samples was tested using the HG-AAS method using a Shimadzu model AA7000 (Japan) Atomic Absorption Spectrophotometer. The study’s findings revealed that arsenic concentration in rainwater samples consistently displays 0 mg/l indicating the absence of arsenic in this sample. Three (03) tube well water samples and three (03) raw rice grain samples showed a significant variation in arsenic concentration. The mean value of tubewell water samples T1, T2, and T3 was found 0.53 ± 0.003 mg/l, 0.31 ± 0.003 mg/l, and 0.65 ± 0.002 mg/l, respectively. Whereas raw rice grain samples RG1 showed a mean of 0.607 ± 0.007 mg/kg, RG2 at 0.458 ± 0.008 mg/kg, and RG3 at 0.7145 ± 0.001 mg/kg. The study found that rice cooked with tubewell water contained a higher arsenic concentration than rice cooked with rainwater. The most prominent finding of this study was that cooked rice using rainwater had a lower amount of arsenic than the raw rice grain. So, it is clearly said that using rainwater can minimize the amount of arsenic. Furthermore, the study indicates that the health risks associated with arsenic exposure have increased. Estimated daily intake (EDI) values for cooked rice samples ranged from 3.07 to 5.47 μg/kg body weight/day, exceeding safe limits. Target Hazard Quotient (THQ) values varied from 10.2 to 18.2, indicating significant potential for non-carcinogenic health effects. Lifetime Cancer Risk (LCR) values ranged from 0.461% to 0.821% exceeding the U.S. Environmental Protection Agency’s acceptable risk threshold of 0.01%, which reflects a heightened cancer risk. The study suggests that people in the study area should use rainwater instead of tubewell water for their cooking purposes. Furthermore, rainwater harvesting should be prioritized in this area to address arsenic issues.
文摘Background: Cesarean sections have become increasingly prevalent in both developed and developing nations. Nevertheless, postoperative complications, including surgical site infections (SSIs), remain a substantial concern that contributes to heightened morbidity and mortality. This study is designed to evaluate the frequency and key determining factors associated with surgical site infections following cesarean section procedures in a tertiary care hospital in Bangladesh. Materials and Methods: This observational cross-sectional study, conducted at the Gynecology Department of Dhaka Medical College Hospital, involved 100 patients aged 15 - 45 who had cesarean deliveries. Data was collected during hospitalization and post-discharge and analyzed to determine the prevalence and relationship between socio-demographic characteristics and surgical site infection. Results: Among the study participants, 14% developed surgical site infections following cesarean operations. More than half of these patients were under the age of 25, with a mean age of 24.45 ± 4.44 years. Surgical site infections were more prevalent in individuals over 30 years old (P-value Conclusion: Post-cesarean surgical site infections are notably prevalent among the participants in this study. Several risk factors have been identified, including age, body mass index (BMI), socioeconomic status, anemia, preterm delivery, personal hygiene practices, regular menstrual cycles, and adherence to antenatal check-ups. The implementation of an effective awareness program, coupled with updated antibiotic protocols, is crucial for significantly reducing the incidence of these infections.
文摘This study investigates the prevalence of HIV high-risk behaviors among university students in S City, Sichuan Province. Using a sampling survey method, a total of 3262 valid questionnaires were collected. Data analysis revealed ten significant issues related to HIV risk behaviors among university students, leading to suggested intervention strategies to address these behaviors.
文摘Professional and trade skills are required for handling the construction related projects;Construction industries of the present day however lack useful information concerning different practices,patterns and trends involved in risk management.Considering this,the present study focuses on the aforementioned variables of risk management by quantitative analysis specifically in the domain of construction industry.This study has used IBM’s SPSS(Statistical Package for Social Sciences)version 25.0 to analyze the results.This study is an initiative to assess the impact of risk management in the construction sector of Jordan.It will assist the construction sector for exploring the limitations with respect to integrate effective risk management.A sense of competition will be developed through a comparison of risk factors of construction projects among the project stakeholders such as contractors should enhance their risk management practices.
文摘The aging global population is driving an increase in dementia,making the early identification of at-risk individuals crucial.Studies have shown that elderly people often exhibit a slowing gait before dementia diagnosis,which is linked to cognitive decline and predicts dementia risk.With 30%of those over 65 years of age experiencing falls annually,managing fall risk is essential.Motoric cognitive risk syndrome(MCR),characterized by subjective memory impairment and slow gait,is a pre-dementia condition that can identify high-risk individuals without extensive evaluation.The prevalence of MCR varies globally and is associated with an increased risk of falls,disability,and death.Early screening and intervention for MCR can delay dementia and improve fall regulation,offering a new perspective on elderly health management.This review synthesizes the current understanding of MCR-related falls,evaluates risk assessment methods,and discusses health strategies to provide a theoretical basis for fall prevention in community-dwelling older adults.
基金Supported by the Joint Funds of the National Natural Science Foundation of China,No.U23A20434National Natural Science Foundation of China,No.82301738,No.82371535,and No.82171518+1 种基金the National Key Research and Development Program of China,No.2021YFF1201204the Science and Technology Innovation Program of Hunan Province,No.2023RC3083.
文摘BACKGROUND Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring.Early identification and intervention of antenatal depression can help to prevent adverse outcomes.However,there have been few population-based studies focusing on the association of social and obstetric risk factors with antenatal depression in China.AIM To assess the sociodemographic and obstetric factors of antenatal depression and compare the network structure of depressive symptoms across different risk levels based on a large Chinese population.METHODS The cross-sectional survey was conducted in Shenzhen,China from 2020 to 2024.Antenatal depression was assessed using the Chinese version of the Edinburgh Postnatal Depression Scale(EPDS),with a score of≥13 indicating the presence of probable antenatal depression.Theχ2 test and binary logistic regression were used to identify the factors associated with antenatal depression.Network analyses were conducted to investigate the structure of depressive symptoms across groups with different risk levels.RESULTS Among the 44220 pregnant women,the prevalence of probable antenatal depression was 4.4%.An age≤24 years,a lower level of education(≤12 years),low or moderate economic status,having a history of mental disorders,being in the first trimester,being a primipara,unplanned pregnancy,and pregnancy without pre-pregnancy screening were found to be associated with antenatal depression(all P<0.05).Depressive symptom networks across groups with different risk levels revealed robust interconnections between symptoms.EPDS8("sad or miserable")and EPDS4("anxious or worried")showed the highest nodal strength across groups with different risk levels.CONCLUSION This study suggested that the prevalence of antenatal depression was 4.4%.Several social and obstetric factors were identified as risk factors for antenatal depression.EPDS8("sad or miserable")and EPDS4("anxious or worried")are pivotal targets for clinical intervention to alleviate the burden of antenatal depression.Early identification of highrisk groups is crucial for the development and implementation of intervention strategies to improve the overall quality of life for pregnant women.
基金Supported by the Science and Technology Major Project of Changzhou Science and Technology Bureau,No.CE20205047Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01F52Changzhou A Major Scientific Research Project of the Municipal Health Commission,No.ZD202220.
文摘BACKGROUND Coronary heart disease(CHD)is a prevalent type 2 diabetes mellitus(T2DM)complication.Further,the risk stratification before angiography may help diagnose T2DM with CHD early.However,few studies have investigated the coronary imaging characteristics and risk factors of patients with T2DM complicated with CHD.AIM To compare the differences in coronary imaging between patients with T2DM with and without CHD,determine the risk factors of T2DM complicated with CHD,and establish a predictive tool for diagnosing CHD in T2DM.METHODS This study retrospectively analyzed 103 patients with T2DM from January 2022 to May 2024.They are categorized based on CHD occurrence into:(1)The control group,consisting of patients with T2DM without CHD;and(2)The observation group,which includes patients with T2MD with CHD.Age,sex,smoking and drinking history,CHD family history,metformin(MET)treatment pre-admission,body mass index,fasting blood glucose(FBG),triglyceride(TG),total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol(LDL-C),serum creatinine,blood urea nitrogen(BUN),alanine aminotransferase,aspartate aminotransferase,glycosylated hemoglobin(HbA1c),and coronary imaging data of both groups were collected from the medical record system.Logistic risk analysis was conducted to screen risk factors.The prediction model’s prediction efficiency was evaluated with receiver operating characteristic curves.RESULTS The control and observation groups consisted of 48 and 55 cases,respectively.The two groups were statistically different in terms of age(t=2.006,P=0.048),FBG(t=6.038,P=0.000),TG(t=2.015,P=0.047),LDL-C(t=2.017,P=0.046),and BUN(t=2.035,P=0.044).The observation group demonstrated lower proportions of patients receiving MET(χ^(2)=5.073,P=0.024)and higher proportions of patients with HbA1c of>7.0%(χ^(2)=6.980,P=0.008)than the control group.The observation group consisted of 15,17,and 23 cases of moderate stenosis,severe stenosis,and occlusion,respectively,with a greater number of coronary artery occlusion cases than the control group(χ^(2)=6.399,P=0.041).The observation group consisted significantly higher number of diffuse lesion cases at 35 compared with the control group(χ^(2)=15.420,P=0.000).The observation group demonstrated a higher right coronary artery(RCA)stenosis index(t=6.730,P=0.000),circumflex coronary artery(LCX)stenosis index(t=5.738,P=0.000),and total stenosis index(t=7.049,P=0.000)than the control group.FBG[odds ratio(OR)=1.472;95%confidence interval(CI):1.234-1.755;P=0.000]and HbA1c(OR=3.197;95%CI:1.149-8.896;P=0.026)were independent risk factors for T2DM complicated with CHD,whereas MET(OR=0.350;95%CI:0.129-0.952;P=0.040)was considered a protective factor for CHD in T2DM.CONCLUSION Coronary artery occlusion is a prevalent complication in patients with T2DM.Patients with T2MD with CHD demonstrated a higher degree of RCA and LCX stenosis than those with T2DM without CHD.FBG,HbA1c,and MET treatment history are risk factors for T2DM complicated with CHD.
