Categories Of Risk Factors Research Articles

DMNet: A Personalized Risk Assessment Framework for Elderly People With Type 2 Diabetes.

Type 2 diabetes is the most common chronic disease for the elderly people. This disease is difficult to be cured and causes continued medical expenses. The early and personalized risk assessment of type 2 diabetes is necessary. So far, various type 2 diabetes risk prediction methods have been proposed. However, these methods have three major issues: 1) not fully considering the importance of personal information and rating information of healthcare system, 2) not adopting the long-term temporal information, and 3) not comprehensively capturing the correlation between the diabetes risk factor categories. To address these issues, the personalized risk assessment framework for elderly people with type 2 diabetes is needed. However, it is very challenging due to two reasons, namely imbalanced label distribution and high-dimensional features. In this paper, we propose diabetes mellitus network framework (DMNet) for type 2 diabetes risk assessment of elderly people. Specifically, we propose tandem long short-term memory to extract the long-term temporal information of different diabetes risk categories. In addition, the tandem mechanism is used to capture the correlation between the diabetes risk factor categories. To balance the label distribution, we adopt the method of synthetic minority over-sampling technique with Tomek links. To form the better feature representations, we utilize entity embedding to solve the problem of high-dimensional features. To evaluate the performance of our proposed method, we conduct the experiments on a real-world dataset called Research on Early Life and Aging Trends and Effects. The experiment results show that DMNet outperforms the baseline methods in terms of six evaluation metrics (i.e., accuracy of 0.94, balanced accuracy of 0.94, precision of 0.95, F1-score of 0.95, recall of 0.95 and AUC of 0.94).

Polygenic Risk of Prediabetes, Undiagnosed Diabetes, and Incident Type 2 Diabetes Stratified by Diabetes Risk Factors.

Early diagnosis of type 2 diabetes is crucial to reduce severe comorbidities and complications. Current screening recommendations for type 2 diabetes include traditional risk factors, primarily body mass index (BMI) and family history, however genetics also plays a key role in type 2 diabetes risk. It is important to understand whether genetic predisposition to type 2 diabetes modifies the effect of these traditional factors on type 2 diabetes risk. This work aimed to investigate whether genetic risk of type 2 diabetes modifies associations between BMI and first-degree family history of diabetes with 1) prevalent prediabetes or undiagnosed diabetes; and 2) incident confirmed type 2 diabetes. We included 431 658 individuals aged 40 to 69 years at baseline of multiethnic ancestry from the UK Biobank. We used a multiethnic polygenic risk score for type 2 diabetes (PRST2D) developed by Genomics PLC. Prediabetes or undiagnosed diabetes was defined as baseline glycated hemoglobin greater than or equal to 42 mmol/mol (6.0%), and incident type 2 diabetes was derived from medical records. At baseline, 43 472 participants had prediabetes or undiagnosed diabetes, and 17 259 developed type 2 diabetes over 15 years follow-up. Dose-response associations were observed for PRST2D with each outcome in each category of BMI or first-degree family history of diabetes. Those in the highest quintile of PRST2D with a normal BMI were at a similar risk as those in the middle quintile who were overweight. Participants who were in the highest quintile of PRST2D and did not have a first-degree family history of diabetes were at a similar risk as those with a family history who were in the middle category of PRST2D. Genetic risk of type 2 diabetes remains strongly associated with risk of prediabetes, undiagnosed diabetes, and future type 2 diabetes within categories of nongenetic risk factors. This could have important implications for identifying individuals at risk of type 2 diabetes for prevention and early diagnosis programs.

Optimal or standard control of systolic and diastolic blood pressure across risk factor categories in patients with chronic coronary syndromes.

Guidelines have lowered blood pressure (BP) targets to <130/80 mmHg. We examined the benefit of intensive control for each BP component, vs. the burden of other modifiable risk factors, in patients with chronic coronary syndromes (CCS). The CLARIFY registry (ISRCTN43070564) enrolled 32 703 patients with CCS, from 2009 to 2010, with a 5-year follow-up. Patients with either BP component below European guideline safety boundaries (120/70 mmHg) were excluded, leaving 19 167 patients (mean age: 63.8 ± 10.1 years, 78% men) in the present analysis. A multivariable-adjusted Cox proportional hazards model showed a gradual increase in cardiovascular risk (cardiovascular death, myocardial infarction, or stroke) when the number of uncontrolled risk factors (active smoking, no physical activity, low-density lipoprotein cholesterol ≥100 mg/dL, and diabetes with glycated haemoglobin ≥7%) increased [adjusted hazard ratio (HR): 1.34; 95% confidence interval (CI): 1.17-1.52, 1.65 (1.40-1.94), and 2.47 (1.90-3.21) for 1, 2, and 3 or 4 uncontrolled risk factors, respectively, vs. 0], without significant interaction with BP. Although uncontrolled systolic (≥140 mmHg) and diastolic (≥90 mmHg) BP were both associated with higher risk than standard BP, standard BP was associated with higher risk than optimal control for only the diastolic component (adjusted HR: 1.08; 95% CI: 0.94-1.25 for systolic BP 130-139 vs. 120-129 mmHg and 1.43; 95% CI: 1.27-1.62 for diastolic BP 80-89 vs. 70-79 mmHg). Our results suggest that the optimal BP target in CCS may be ≤139/79 mmHg and that optimizing the burden of other risk factors should be prioritized over the further reduction of systolic BP.

Development and usage of a health recommendation web tool (HeaRT) designed to inform women of personalized preventive health recommendations

BackgroundImplementation of guidelines for evidence-based screening and disease prevention remains a core challenge in health care. The lack of access to accurate and personalized health recommendations may contribute to sub-optimal performance of medical screening, and ultimately increased risk for communicable and non-communicable disease. Many women do not monitor their cardiovascular disease (CVD) risk or receive regular medical screenings. A health recommendation tool (HeaRT) that provides women with profiled, individually tailored information about recommended tests and screening was designed to improve women's engagement in preventive health. This study characterized utilization of the tool in a real world setting. ObjectiveTo describe the development and usage patterns of HeaRT, a novel health web-tool that provides personalized health recommendations for women. MethodsExtracted web-tool data including user input (age, BMI, smoking status and family history of CVD) and time spent in the results screen were analysed. Engagement was assessed by time spent in each results category, number of clicks and whether the user emailed/printed the recommendations. Usage patterns were analysed using multivariate analyses, logistic regression and cluster analyses. ResultsHeaRT was used 13,749 times in the years between its launch and data extraction three years later. Web-tool analysis found that 68.6 % of users accessed results and approximately 15 % printed or emailed the list of recommendations. Further analysis found that almost all the users entered the nutrition category (78 %), followed by the risk-factor category (69.5 %) and Physical activity category (61.9 %). Three usage patterns were identified by cluster analysis, including a nutrition/physical activity cluster, a risk-factor cluster and an all-categories cluster. Cluster affiliation analysis found BMI and smoking status were not predictors of cluster affiliation, whereas users over the age of 65 were more likely to solely enter the risk-factor tab (P < .001) and users with family history of CVD were more likely to either enter only the risk-factor tab or to enter all tabs (P < .01). ConclusionsHeaRT users looked at health recommendations on a variety of health topics, and 15 % printed or emailed the recommendations. A tailored health recommendation web-tool may empower women to seek preventive-care and health maintenance, and help them interact with health care providers from a position of shared responsibility. This tool and similar programs may enable health care consumers to actively participate in directing their own health maintenance by providing consumers with personalized health recommendations. Additionally, user characteristics may inform future web-tool designers on target population profile and usage patterns.

A predictive model using risk factor categories for hospital-acquired pneumonia in patients with aneurysmal subarachnoid hemorrhage.

To identify risk factors for hospital-acquired pneumonia (HAP) in patients with aneurysmal subarachnoid hemorrhage (aSAH) and establish a predictive model to aid evaluation. The cohorts of 253 aSAH patients were divided into the HAP group (n = 64) and the non-HAP group (n = 189). Univariate and multivariate logistic regression were performed to identify risk factors. A logistic model (Model-Logit) was established based on the independent risk factors. We used risk factor categories to develop a model (Model-Cat). Receiver operating characteristic curves were generated to determine the cutoff values. Areas under the curves (AUCs) were calculated to assess the accuracy of models and single factors. The Delong test was performed to compare the AUCs. The multivariate logistic analysis showed that the age [p = 0.012, odds ratio (OR) = 1.059, confidence interval (CI) = 1.013-1.107], blood glucose (BG; >7.22 mmol/L; p = 0.011, OR = 2.781, CI = 1.263-6.119), red blood distribution width standard deviation (RDW-SD; p = 0.024, OR = 1.118, CI = 1.015-1.231), and Glasgow coma scale (GCS; p < 0.001, OR = 0.710, CI = 0.633-0.798) were independent risk factors. The Model-Logit was as follows: Logit(P) = -5.467 + 0.057 * Age + 1.023 * BG (>7.22 mmol/L, yes = 1, no = 0) + 0.111 * RDW-SD-0.342 * GCS. The AUCs values of the Model-Logit, GCS, age, BG (>7.22 mmol/L), and RDW-SD were 0.865, 0.819, 0.634, 0.698, and 0.625, respectively. For clinical use, the Model-Cat was established. In the Model-Cat, the AUCs for GCS, age, BG, and RDW-SD were 0.850, 0.760, 0.700, 0.641, and 0.564, respectively. The AUCs of the Model-Logit were insignificantly higher than the Model-Cat (Delong test, p = 0.157). The total points from -3 to 4 and 5 to 14 were classified as low- and high-risk levels, respectively. Age, BG (> 7.22 mmol/L), GCS, and RDW-SD were independent risk factors for HAP in aSAH patients. The Model-Cat was convenient for practical evaluation. The aSAH patients with total points from 5 to 14 had a high risk for HAP, suggesting the need for more attention during treatment.

Normative values of renin and aldosterone in clinically stable preterm neonates

BackgroundThere is a paucity of literature on the normative levels of plasma renin concentration (PRC) and serum aldosterone (SA) in premature neonates. This study aims to provide normative data on PRC and SA levels in preterm neonates in the first 2 weeks after birth and explore associations with maternal, perinatal, or postnatal factors.MethodsNeonates born at 26- to 34-week gestation were recruited from two neonatal intensive care units in Canada and Australia. The direct renin assay PRC and SA were analyzed on day 1 and days 14–21 after birth to compare across categorical variables and to produce normative values.ResultsA total of 262 subjects were enrolled from the Canadian (29%) and Australian (71%) sites. The mean gestational age was 30 weeks, with a mean birth weight of 1457 g. The normative values of PRC and SA for neonates born between 26 + 0 and 29 + 6 weeks and 30 + 0 and 34 + 0 weeks of gestation were produced for day 1 and day 14–21 after birth. Both PRC and SA increased from day 1 to day 14–21. The more premature neonates reached a higher PRC on days 14–21 after birth but exhibited lower SA levels on day 1 after birth. When comparing gender, birth weight, and maternal risk factor categories, no statistical differences in PRC or SA were found. A small but significant decrease in PRC, but not SA, was noted for neonates with placental pathology.ConclusionsThis study produced normative values of PRA and SA in clinically stable preterm neonates that can be referenced for use in clinical practice.Graphical A higher resolution version of the Graphical abstract is available as Supplementary information

P092 Risk factors for obstructive sleep apnea: A scoping review of systematic reviews

Abstract Introduction The high prevalence of obstructive sleep apnea (OSA) challenges public health and health care significantly. Summarizing the evidence and identifying research gaps on risk factors for OSA could focus efforts to reduce the disease burden. Methods We performed a scoping review to map the current evidence of OSA-related risk factors. Medline was searched systematically for systematic reviews/meta-analyses including observational and interventional studies, excluding reviews limited to paediatric populations. Results Of 974 abstracts, 49 eligible systematic reviews were retrieved, covering six major categories of risk factors, namely demographic(n=9), lifestyle(n=9), genetic(n=11), comorbidity-related(n=10), environmental(n=2), and other(e.g., protein level, surgery, n=12). Obesity/BMI and increasing age were major risk factors for OSA, however, longitudinal obesity trajectories or weight changes were not explored. Smoking was inconsistently associated with OSA. Alcohol consistently increased OSA severity(n=5). 5-HT2A(5-hydroxy-tryptamine), tumor necrosis factor- α, and angiotensin converting enzyme activity were associated with increased risk of OSA(n=4 for each). Comorbidity-related risk factors were identified including asthma, hypothyroidism, gastroesophageal reflux disease, depression while allergic rhinitis and Parkinson’s disease had null and negative effects, respectively. Menopause, ethnicity, and enlarged adenoids/tonsils are yet to be systematically synthesized. Overall, there was no review analyzing any longitudinal risk factor for OSA in the general population. Discussion Although this review supports the potential benefit of reducing OSA and its severity from weight loss and/or quitting smoking among the general population, there is an absence of data on longitudinal risk factor trajectories, which could help guide and strengthen public health policy.

Prevalence, risk factors, and main characteristics of bruises in cattle: A meta-analysis in the American continent

Bruises threaten the welfare of cattle because they cause pain, suffering, and stress during the pre-slaughter stage. Thus, we used meta-analyses to estimate the prevalence of carcass bruising in cattle from the American continent, determined the characteristics of the bruises, and calculated the odds ratio (OR) of risk factor categories associated with bruising. We searched electronic databases to retrieve primary studies conducted in the American continent, which reported cattle carcass bruising, analyzed the size, location, shape, and age of the bruises, and assessed risk factors for bruising. We included 46 studies from nine countries comprising 928 447 cattle carcasses with an overall prevalence of 59.5 % (95 % CI: 51.9 – 66-9) and 2.9 (range 3.4 – 7.4) bruises per carcass in average. The prevalence doubled from 30.7 % during 1991 – 2000 to 64.2 % during 2011 – 2020. Fresh, small-sized bruises of the lowest severity and located mainly in the hindquarter were highly prevalent (37.5 – 66.4 %). The removed meat due to bruising ranged 0.11 – 1.12 kg/carcass with an accumulated weight of condemned meat between 15.6 – 647 kg. Among intrinsic factors, older cattle, dairy cattle, and female cattle had greater odds of bruising (OR=1.57 – 1.98). For extrinsic factors, the odds for bruising increased 1.4 – 2.2 in cattle sourced from auction markets and exposed to poor handling, suboptimal transportation conditions, and deficient facilities. In cattle from America, bruises are a concern because their prevalence is growing and 60 % of cattle assessed in the studies suffered a bruise. Improving facilities and transportation conditions together with proper training of the personnel during the handling and transportation of the cattle will reduce bruising incidence.

Clinical impact of cardiac magnetic resonance in patients with suspected coronary artery disease associated with chronic kidney disease (AQUAMARINE-CKD study): study protocol for a randomized controlled trial

BackgroundAlthough screening for coronary artery disease (CAD) using computed tomography coronary angiography in patients with stable chest pain has been reported to be beneficial, patients with chronic kidney disease (CKD) might have limited benefit due to complications of contrast agent nephropathy and decreased diagnostic accuracy as a result of coronary artery calcifications. Cardiac magnetic resonance (CMR) has emerged as a novel imaging modality for detecting coronary stenosis and high-risk coronary plaques without contrast media that is not affected by coronary artery calcification. However, the clinical use of this technology has not been robustly evaluated.MethodsAQUAMARINE-CKD is an open parallel-group prospective multicenter randomized controlled trial of 524 patients with CKD at high risk for CAD estimated based on risk factor categories for a Japanese urban population (Suita score) recruited from 6 institutions. Participants will be randomized 1:1 to receive a CMR examination that includes non-contrast T1-weighted imaging and coronary magnetic angiography (CMR group) or standard examinations that include stress myocardial scintigraphy (control group). Randomization will be conducted using a web-based system. The primary outcome is a composite of cardiovascular events at 1 year after study examinations: all-cause death, death from CAD, nonfatal myocardial infarction, nonfatal ischemic stroke, and ischemia-driven unplanned coronary intervention (percutaneous coronary intervention or coronary bypass surgery).DiscussionIf the combination of T1-weighted imaging and coronary magnetic angiography contributes to the risk assessment of CAD in patients with CKD, this study will have major clinical implications for the management of patients with CKD at high risk for CAD.Trial registrationJapan Registry of Clinical Trials (jRCT) 1,052,210,075. Registered on September 10, 2021.

Management of Obesity in Children: A Narrative Review

Background and Objectives: Over the past three decades, the prevalence of overweight and obesity in children and adolescents has increased up to 3 times. Obesity is a multi-systemic medical problem affecting all socioeconomic statuses and increases the risk of other severe comorbidities even in childhood. In 50% of cases, there is a persistence of obesity from childhood into adulthood. This narrative review aimed to define the etiology, risk factors, prevention, and management of obesity in children. Methods: This narrative review was conducted through a literature search on articles in English with the keywords of pediatric obesity, child, overweight, and bariatric surgery in PubMed, Scopus, ISI Web of Sciences, Cochrane, and EMBASE databases from 2001 to 2021 for 4 categories of etiology, risk factors, prevention, and management of obesity in children. Scientific articles, systematic reviews, meta-analyses, consensus, recommendations, and international and national guidelines published on pediatric obesity were considered. Results: In this narrative review, we first assessed relevant articles to define childhood obesity and mention its etiologies. We then discussed the probability of persistent obesity from childhood into adulthood and intergenerational and perinatal transmission risks. We also noticed syndromic obesity, evaluation of childhood obesity, and its complications along with medical/surgical interventions. Conclusions: Metabolic programming in particular periods of life, such as before and during pregnancy, infancy, and at the age of rebound adiposity (5.5 years old), is necessary to prevent childhood obesity. Lifestyle changes, diet modifications, promoting exclusive breastfeeding, and increased activity are the main principles of preventing and managing obesity. It is prudent to rule out syndromic and endocrinologic causes of obesity in suspicious patients along with their management.

P253 Features of Cryptococcosis in human immunodeficiency virus-negative patients, France 1985-2020

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PMObjectivesHIV-negative individuals make up an increasing proportion of cases of cryptococcosis in France, but the features of disease and outcomes in this population have yet to be characterized. We describe the presentations and outcomes according to host factors underlying cryptococcosis in HIV-negative individuals in France.MethodsThe French National Reference Centre for Invasive Mycoses and Antifungals has implemented nationwide surveillance of cryptococcosis since 1985 with the determination of the infecting serotype. We analyzed the characteristics of infection in HIV-negative patients diagnosed up to 2020. We also compared the demographic characteristics, presenting features, treatment regimen, and outcomes according to host factor and infecting serotype in patients diagnosed since 2005.ResultsThe mean age of patients was 56.2 years, 60.8% were male, and 60.1% were born in Europe. Only 26 cases were due to Cryptococcus gattii, all others were caused by C. neoformans. Of the 1051 cases, 349 occurred in patients with malignancy (33.2%, including 268 patients with hematological malignancy, 69% of whom had lymphoid neoplasms), 205 occurred in solid-organ transplant (SOT) recipients (19.5%, including 147 kidney and 27 liver), and 298 occurred in patients with ‘other’ underlying factors (28.4%, including auto-immune disease (n = 86), end-stage liver or kidney disease (n = 47), sarcoidosis (n = 42), chronic pulmonary disease (n = 25), and diabetes mellitus (n = 16). A total of 19% of patients (n = 199) had no apparent underlying risk factor.Among 632 patients diagnosed since 2005, there were significant differences according to the four major categories of risk factors (malignancy, SOT, others, and none) in terms of age, diagnostic methods, proportion of patients with positive cryptococcal antigen (CrAg), antigen titers, disease localization, treatment regimens, and 90-day mortality. In the diagnostic workup, a lumbar puncture and blood culture were performed for 96% and 64.2% of patients, respectively, more frequently for immunocompromised patients than those with no underlying host factor (P = .09 and P <.001, respectively). SOT patients had more frequent central nervous system involvement (P <.001), and positive serum CrAg detection with antigen titers >1:512 (P <.001). Patients with malignancy were significantly older (P = .0001) with more frequent fungemia (P = .007). Isolated lung infections (P = .002) and isolated skin lesions (P <.001) were more frequent in patients with ‘other’ conditions and in those with no underlying factor, respectively. Immunocompromised patients were more likely to receive combination antifungals including flucytosine (66.7%, 45.4%, and 42.7% for SOT, malignancies, and ‘other’ conditions, respectively) compared with patients with no underlying factor (33.3%, P <.001). Overall, all cause 90-day mortality was 27.0% (95% CI: 23, 3-31.0%). Patients with malignancy had the highest 90-day mortality (37.3%, <0.001), compared with SOT recipients (23.7%), those with ‘other' conditions (24.7%), and those without underlying conditions (13.9%). Compared with patients with serotype D infections, those infected with serotype A were significantly younger (P = .004), more likely to be born in Africa (P <.001), to have isolated pulmonary disease (P <.005), and less likely to have isolated skin infections (P <.001).ConclusionHIV-seronegative patients with cryptococcosis are a heterogeneous group of patients encompassing different disease characteristics and outcomes. Management of cryptococcosis in HIV-negative patients should be tailored to underlying host factors, disease localization, and infecting serotype.

Medical, behavioural and social preconception and interconception risk factors among pregnancy planning and recently pregnant Canadian women

ObjectivesThe objective of this study is to describe the clustering of medical, behavioural and social preconception and interconception health risk factors and determine demographic factors associated with these risk clusters...

Predictive Modeling for Suicide-Related Outcomes and Risk Factors among Patients with Pain Conditions: A Systematic Review.

Suicide is a leading cause of death in the US. Patients with pain conditions have higher suicidal risks. In a systematic review searching observational studies from multiple sources (e.g., MEDLINE) from 1 January 2000–12 September 2020, we evaluated existing suicide prediction models’ (SPMs) performance and identified risk factors and their derived data sources among patients with pain conditions. The suicide-related outcomes included suicidal ideation, suicide attempts, suicide deaths, and suicide behaviors. Among the 87 studies included (with 8 SPM studies), 107 suicide risk factors (grouped into 27 categories) were identified. The most frequently occurring risk factor category was depression and their severity (33%). Approximately 20% of the risk factor categories would require identification from data sources beyond structured data (e.g., clinical notes). For 8 SPM studies (only 2 performing validation), the reported prediction metrics/performance varied: C-statistics (n = 3 studies) ranged 0.67–0.84, overall accuracy(n = 5): 0.78–0.96, sensitivity(n = 2): 0.65–0.91, and positive predictive values(n = 3): 0.01–0.43. Using the modified Quality in Prognosis Studies tool to assess the risk of biases, four SPM studies had moderate-to-high risk of biases. This systematic review identified a comprehensive list of risk factors that may improve predicting suicidal risks for patients with pain conditions. Future studies need to examine reasons for performance variations and SPM’s clinical utility.

Cognition and Non-Suicidal Self-Injury: Exploring Relationships with Psychological Functions

Objective Non-suicidal self-injury (NSSI) is strongly associated with difficulties in emotion regulation, but its relationships with maladaptive cognitive processes are less clear. Method The current study examined relationships between self-reported NSSI (presence, number of methods, frequency, recency, duration, functions) and negative cognitive processes (rumination, worry, self-criticism, perceived burdensomeness, thwarted belongingness) among 1,357 undergraduates. Cognition variables were submitted to exploratory factor analysis (EFA), and relationships were examined between the resulting factors and NSSI history (among the full sample) and NSSI severity and functions (among those with a history of NSSI). Results The EFA derived two higher order cognitive factors: repetitive negative thinking (RNT) and negative self-perception (NSP). Both RNT and NSP were significantly higher among participants with than those without a history of NSSI. Among those with NSSI, NSP, but not RNT, was positively related to lifetime NSSI frequency and number of methods, as well as recency (presence in the past 12 months) and total duration (in years) of NSSI engagement. Moreover, RNT and NSP were positively associated with aggregate intrapersonal (but not interpersonal) functions of NSSI. The two cognitive factors demonstrated differential relationships with the individual intrapersonal NSSI functions. Conclusions Higher order categories of cognitive risk factors may have unique relationships with functions and severity of NSSI, with possible implications for more targeted approaches to risk assessment and intervention. Highlights Negative thinking and self-perception were higher in people who engage in NSSI. Negative self-perception was associated with greater NSSI severity. Negative thinking and self-perception had different relations to NSSI functions.

Viscoelastic or Viscoplastic Glucose Theory (VGT #66): Relative Risk Probability of Developing Ovarian and/or Uterine Cancers in Female Patients Using a type 2 Diabetes and Obesity Patient Collected Data over 12+ Years from 1/1/2010 to 4/23/2022 with 5 Gender-Independent Generic Cancer Risk Factors, i.e. Obesity, Diabetes, Lipids, Diet, and Exercise to Validate the Suitability of VGT Tool for Gynecological Cancer

A family member of the author was recently diagnosed with ovarian and uterine cancer which piqued his interest in understanding more about this subject. To date, he has read numerous published articles regarding this topic. Although the majority of these research papers utilize statistical data analysis tools to draw their observed conclusions, they indeed identify certain risk factors related to ovarian and uterine cancers. As a result, he has learned that there are three general categories of risk factors related to these gynecological cancers.

Risk factors for bleeding in people living with hemophilia A and B treated with regular prophylaxis: A systematic review of the literature

BackgroundKnowledge about the risk for bleeding in patients with hemophilia (PWH) would be relevant for patients, stakeholders, and policy makers. ObjectivesTo perform a systematic review of the literature on risk assessment models (RAMs) and risk factors for bleeding in PWH on regular prophylaxis. MethodsWe searched Medline, Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews from inception through August 2019. In duplicate, reviewers screened the articles for inclusion, extracted data, and assessed the risk for bias using the Quality in Prognostic Studies (QUIPS) tool. A qualitative synthesis of the results was not performed due to high heterogeneity in risk factors, outcomes definition and measurement, and statistical analysis of the results. ResultsFrom 1843 search results, 10 studies met the inclusion criteria. No RAM for the risk for bleeding in PWH was found. Most studies included only PWH A or both PWH A and B and were conducted in North America or Europe. Only one study had a low risk for bias in all the domains. Eight categories of risk factors were identified. The risk for bleeding was increased when factor levels were lower and in people with a significant history of bleeding or who engaged in physical activities involving contact. ConclusionsOur findings suggest that plasma factor levels, history of bleeds, and physical activity should be considered for the derivation analysis when building a RAM for bleeding in PWH, and the role of other risk factors, including antithrombotic treatment and obesity, should be explored.

THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY AND HEALTH IN SECONDARY PREVENTION OF CARDIOVASCULAR DISEASE

Introduction Patients with established cardiovascular disease (CVD) have a high risk of subsequent CVD events. Monitoring the risk factors is crucial in order to prevent recurrent CVD events. Aim The aim of this study was to develop a protocol for the risk factors of recurrent CVD based on the ICF (The International Classification of Functioning, Disability, and Health) framework. Material and methods An original ICF assessment sheet, which contains risk factors of recurrent CVD, was developed based on up-to-date data from the literature. The evaluation criteria for each category were determined based on recommendations defined in the ESC (European Society of Cardiology), AHA (American Heart Association), EFSD (European Foundation for the Study of Diabetes) and KDIGO (Clinical Practice Guideline for Glomerulonephritis) guidelines. Results The ICF assessment sheet contains CVD risk factor categories such as comorbidities, measures of liver and renal impairment, disorders of carbohydrate and lipid metabolism, pharmacological treatment and lifestyle-related factors. Conclusions The ICF assessment sheet, which contains multiple risk factors for CVD in one place, can make monitoring these parameters to be easier in a doctor’s office.

Risk Factors of Ischemic Stroke in Young Adults: A Chinese Single-Center Study.

IntroductionThe etiology and risk factor profile of ischemic stroke in young adults are different from those in older patients. However, current etiological classifications are more applicable for the older adults, posing a challenge to the diagnosis of young patients with ischemic stroke. In this study, we applied a modified risk factor categorization previously used in the International Pediatric Stroke Study (IPSS) to describe the risk factor profiles of Chinese young patients with ischemic stroke and explore the sex and age differences in the distribution of risk factors.MethodsThis is a single-center retrospective study. Patients aged 18–50 years with a first-ever ischemic stroke admitted to the Peking Union Medical College Hospital between 2013 and 2020 were consecutively included. The risk factors of patients were collected and divided into 10 categories according to the modified IPSS criteria and the sex and age differences were explored.ResultsA total of 538 patients were enrolled in this study. The median age was 39 years and 62.6% were men. At least one IPSS risk factor category was identified in the 93.3% of all patients. The most common IPSS subtype was atherosclerosis-related risk factors (61.7%), followed by prothrombotic states (27.3%), chronic systemic conditions (24.7%), arteriopathy (16.2%), and cardiac disorders (10.4%). Chronic systemic conditions were more prevalent in patients aged <35 years (34.0 vs. 19.6%, p < 0.05) and women (43.3 vs. 13.6%, p < 0.0001). Atherosclerosis-related risk factors were more dominant in patients aged ≥35 years (72.6 vs. 41.9%, p < 0.0001) and men (77.2 vs. 35.8%, p < 0.0001).ConclusionsThe IPSS classification might be a potential tool to better identify the risk factors of ischemic stroke in young adults.

Genetic clinicians' confidence in BOADICEA comprehensive breast cancer risk estimates and counselees' psychosocial outcomes: A prospective study.

Counseling for familial breast cancer focuses on communicating the gene test result (GENE) to counselees, but risk prediction models have become more complex by including non‐genetic risk factors (NGRF) and polygenic risk scores (PRS). We examined genetic clinicians' confidence in counseling and counselees' psychosocial outcomes, using the BOADICEA risk prediction tool with different categories of risk factors as input. A prospective observational study in Dutch, French and German genetic clinics was performed including 22 clinicians, and 406 of 460 (88.3%) eligible cancer‐unaffected women at high breast cancer risk assessed at pre‐test and 350 (76.1%) at post‐test. We performed multilevel analyses accounting for the clinician, and counselees' characteristics. Overall, risk estimates category by GENE versus GENE+ NGRF, or GENE+NGRF+PRS differed in 11% and 25% of counselees, respectively. In multilevel analyses, clinicians felt less confident in counseling when the full model provided lower breast cancer risks than GENE (i.e., in 8% of cases). Older counselees expressed higher breast cancer risk perception and worries about the hereditary predisposition when the full model provided higher breast cancer risks than GENE only. Genetic clinicians appear confident with breast cancer risk comprehensive models, which seem only to affect perceptions of older counselees.

Family Risk Factors That Jeopardize Child Development: Scoping Review.

The obligation to protect children is defined by law. However, there is fragility in identifying actual or potential situations that jeopardize their development. This review aims to identify the family risk factors that jeopardize child development. A scoping review was conducted following the Joanna Briggs Institute for Evidence-Based Practice framework and the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The research was carried out on the electronic databases PubMed, CINAHL, Nursing & Allied Health Collection: Comprehensive, MEDLINE Complete, and MedicLatina, with a time limit of 2010 to 2021. The search was restricted to documents written in Portuguese, English, and French. A total of 3998 articles were initially identified. After selecting and analysing, 28 risk factors were extracted from 29 articles. Four categories of risk factors were identified—namely, patterns of social and economic interaction, family characteristics, caregiver’s characteristics, and parenting. The results of this review allow the identification of family risk factors that jeopardize child development. This is significant for Child Protective Services workers as they carry out their risk assessments. This assessment is the first step in avoiding an accumulation of harm to at-risk children and allowing the development of interventions for minimising harm’s impact on children’s development.