Causative Risk Factors Research Articles

Pediatric Infective Endocarditis: A Literature Review.

Infective endocarditis in children is a rare entity that poses multiple challenges. A history of congenital heart disease is the most common risk factor, although in recent years, other emerging predisposing conditions have gained relevance, such as central venous catheters carriers or children with chronic debilitating conditions; cases in previously healthy children with no medical history are also seen. Diagnosis is complex, although it has improved with the use of multimodal imaging techniques. Antibiotic treatment should be started early, according to causative microorganism and risk factors. Complications are frequent and continue to cause significant morbidity. Most studies have been conducted in adults and have been generalized to the pediatric population, with subsequent limitations. Our manuscript presents a comprehensive review of pediatric infective endocarditis, including recent advances in diagnosis and management.

Modeling Profitability-Influencing Risk Factors for Construction Projects: A System Dynamics Approach

This study addressed the complexity involved in integrating the causative risk factors influencing construction profitability. Most of the existing studies cover the individual effects of profitability influencing factors. Very few focus on the systematic impact without incorporating the complexity and associated dynamics, presenting a gap targeted by the current study. The current study aimed to assess causative interrelations and interdependencies between profitability influencing risk factors (PIRF), through systems thinking (ST) and system dynamics (SD) modeling. The SD approach was used to evaluate the integrated impacts on profitability-influencing risk categories (PIRC) in construction projects. The causative influencing factors affecting construction profitability were identified through a comprehensive literature review. These were ranked using content analysis, and categorized into significant issues. Through 250 structured surveys and 15 expert opinion meetings, the path for quantitative and qualitative evaluations was prepared. Following these investigations, a causal loop diagram (CLD) was established using the ST technique, and the integrated effect was quantified using SD modeling. The study finds the rising cost of material, supply chain process, payment issues, planning and scheduling problems, financial difficulties, and effective control of manpower and equipment resources as the most critical PIRFs. The integrated effects of PIRFs on PIRC were quantified using SD modeling. This study helps field professionals with profitability-influencing factors, diagnosing issues, and integrating impacts regarding decision-making and policy formulation. For researchers, it presents a list of factors that can be investigated in detail, and the holistic interrelationships established.

Alzheimer's Disease-Related Dysbiosis Might Be Triggered by Certain Classes of Antibiotics with Time-Lapse: New Insights into the Pathogenesis?

Several putative factors are identified in the literature as causative agents or risk factors for the development of Alzheimer's disease (AD). The amyloid cascade hypothesis has been the main hypothesis about the pathophysiology of AD for decades, but recent studies raised the possible role of dysbiosis in the development of AD, which prevents memory loss. Finding possible associations between antibiotic consumption patterns and the prevalence of AD in European countries. Antibiotic consumption (European Centre for Disease Prevention and Control, ECDC) for 1997-2007, 2008-2018, and as the whole 1997-2018 period, has been compared to the AD prevalence for 2018 expressed in percentage of the population and statistically analyzed by Pearson calculation. A significant positive correlation has been found between the AD prevalence (2018) and the average quinolone consumption for the years 1997-2007 (r: 0.37, p: 0.044). A similar association was not observed for the entire 22 years (1997-2018) of the average quinolone consumption, and the years 2008-2018, indicating 10-20 years of time-lapse between the antibiotic exposure and the development of AD. The ratio of broad-spectrum and narrow-spectrum antibiotics (B/N) estimated in the ECDC database for the years of 2008-2018 showed a strong positive association with AD prevalence (2018) (r: 0.406, p: 0.026) and a positive correlation tendency for the entire 22 years 1997-2018 (r: 0.344, p: 0.063), but none for the years 1997-2007 (r: 0.256, p: 0.241). Our study indicated the possible sequential role of certain classes of antibiotics in the development of dysbiosis leading to amyloid deposits of AD, which strengthen the possible role of different mediator molecules (short-chain fatty acids, lipopolysaccharides, etc.) produced by the altered microbiome in the development of AD.

An interesting finding: What is the relation between aortic enlargement and COVID-19?

We aim to compare the diameters of ascending aorta in COVID-19 patients and COVID-19-free individuals referred to our pandemic hospital. The medical records and thorax tomographies of patients admitted to the "pandemic central" state hospital with symptoms of COVID-19 were observed between April 2020 and May 2020 in this case-control study. The first group consisted of patients diagnosed with COVID-19, and the second group consisted of patients without the disease. The diameter of the ascending aorta is measured via tomography and compared to each other. The most causative risk factors for aortic enlargements underwent a multivariate regression analysis. Charts of 156 patients (104 COVID-19 positives, 52 COVID-19 negatives) were reviewed. There was a statistical difference (p: .01) between the mean aortic diameter of COVID-19 patients (39mm) and COVID-free patients (32.5mm) even though comorbid factors and patient characteristics were similar in the two groups at the time of hospital admission. The regression analysis result demonstrates that COVID-19 (leading factor), age, and coronary artery disease were the most significant factors associated with increasing aortic dimensions. (p: .001, B: 5.3/, p: .02, B: 3.36/, p: .002, B: 0.13/, R square: 40.2%). This study shows that the mean aortic diameter of COVID-19 patients is larger than non-COVID-19 patients with similar comorbidities referred to a pandemic hospital. COVID-19, age, and coronary artery disease are the most influential factors that affect the aortic diameter, and the COVID-19 was the leading factor.

Environmental Risk Factors for Childhood Acute Lymphoblastic Leukemia: An Umbrella Review.

Simple SummaryLeukemia is the most common type of cancer among children worldwide. The aim of this umbrella review was to provide an evidence-based summary of epidemiological studies on environmental risk factors and the risk of childhood acute lymphoblastic leukemia (ALL), by exposure window. Second aim was to assess the prevalence in the German population which determines the relevance on population level. Only low doses of ionizing radiation in early childhood and maternal exposure to general pesticides during pregnancy showed convincing evidence of an association with childhood ALL. Other risk factors vary in level of association. The results of this umbrella review should be interpreted with caution; as the evidence are mostly from case-control studies, where selection and recall bias are potential concerns.Leukemia is the most common type of cancer among children and adolescents worldwide. The aim of this umbrella review was (1) to provide a synthesis of the environmental risk factors for the onset of childhood acute lymphoblastic leukemia (ALL) by exposure window, (2) evaluate their strength of evidence and magnitude of risk, and as an example (3) estimate the prevalence in the German population, which determines the relevance at the population level. Relevant systematic reviews and pooled analyses were identified and retrieved through PubMed, Web of Science databases and lists of references. Only two risk factors (low doses of ionizing radiation in early childhood and general pesticide exposure during maternal preconception/pregnancy) were convincingly associated with childhood ALL. Other risk factors including extremely low frequency electromagnetic field (ELF-MF), living in proximity to nuclear facilities, petroleum, benzene, solvent, and domestic paint exposure during early childhood, all showed some level of evidence of association. Maternal consumption of coffee (high consumption/>2 cups/day) and cola (high consumption) during pregnancy, paternal smoking during the pregnancy of the index child, maternal intake of fertility treatment, high birth weight (≥4000 g) and caesarean delivery were also found to have some level of evidence of association. Maternal folic acid and vitamins intake, breastfeeding (≥6 months) and day-care attendance, were inversely associated with childhood ALL with some evidence. The results of this umbrella review should be interpreted with caution; as the evidence stems almost exclusively from case-control studies, where selection and recall bias are potential concerns, and whether the empirically observed association reflect causal relationships remains an open question. Hence, improved exposure assessment methods including accurate and reliable measurement, probing questions and better interview techniques are required to establish causative risk factors of childhood leukemia, which is needed for the ultimate goal of primary prevention.

Evaluation of Tooth Wear and its Causative Risk Factors Amongst Patients Attending Dental Hospital of Karachi

OBJECTIVE: Tooth wear is a term defined as the loss of dental hard tissue in a damaged tooth if there is no existing dental caries or trauma. Tooth wear rarely exists alone and is observed clinically and experimentally in combination. Excessive tooth wear leads to hypersensitivity and exposed dentin. Tooth wear can be classified as attrition, erosion, abrasion. The frequency of normal tooth preservation is greater than ever, thus a better prevalence of tooth wear is experiential in the population. Therefore, the objective of the present cross-sectional study was to evaluate tooth wear and its causative risk factors amongst patients attending the Dental Hospital of Karachi. METHODOLOGY: The current study was a cross-sectional study conducted on adult patients recruited from the Out-Patient Department of Oral Diagnosis from May 2018 - December 2018. A consecutive sampling method was used and 250 adult patients aged 18-45 years were included. Tooth wear was assessed by using Smith and Knight Tooth Wear Index (TWI index).Data was entered and analyzed by using SPSS, frequency, percentages were calculated, and a chi-square test was performed to find the association between gender and risk factors. RESULTS: The subject populations of 250 were assessed. Out of which 178 were male (71.2%) and 72 (28.8%) were female with age ranging between 18 to 48 years old. In this study, 92.4% of them were suffering from tooth wear and only 31.2% have extended to the severe stage of the tooth surface loss. CONCLUSION: The present study concluded that there is an association between tooth wear and its risk factors. KEYWORDS: Tooth Wear; Dental Wear; Tooth Wear Indices; Sensitivity and Specificity; Risk Factors.

The Burden of Atrial Fibrillation in Sickle Cell Disease

▪IntroductionLife expectancy amongst individuals with sickle cell disease (SCD) has plateaued, with cardiopulmonary complications now becoming a leading cause of death (Fitzhugh et al. Am. J. Hematology 2010). Indeed, SCD is associated with increased rates of pulmonary hypertension (pHTN) and diastolic dysfunction (Sachdev et al. Blood 2005). In the general population, atrial fibrillation (AF) is associated with an increased mortality in the setting of either pHTN or diastolic dysfunction. Although cardiac structural and biochemical changes likely create an electrophysiological substrate for AF in SCD, the prevalence and risk factors for AF in SCD remain unclear. We determined the prevalence, incidence, and clinical characteristics of AF in a large cohort of patients with SCD.MethodsWe conducted a retrospective, longitudinal cohort study of all adult patients with SCD seen at our large, urban single center from January 2008 to December 2017. SCD patients were identified using a previously described semi-automated system with a subset with direct chart review (Srisuwananukorn et al. Blood Advances 2020). We performed manual review of ~17,000 available electrocardiograms of all enrolled subjects to look for AF. For univariate analyses, the associations of linear and categorical variables with AF were assessed using the Kruskal-Wallis test and Pearson's χ 2 test, respectively. We used Bonferroni correction for categorical variables with greater than two groups. Logistic regression analysis with stepwise addition of variables (p>0.15) was used to evaluate for the effects of previously described AF risk factors, degree of anemia, hydroxyurea use, and genotype on AF development.ResultsOur cohort consisted of 763 adult SCD patients with a median age of 27.95 years, 59.50% female, 72.4% with Hb SS or Sβ 0-thalassemia genotype, and 61.2% were prescribed hydroxyurea. Mean observation time for the cohort was 8.3 ± 6.3 yrs. We identified AF in 30 out of 763 adult SCD individuals with a mean age onset of 51 ± 10 years (median age 52 years). The period prevalence of AF was 3.93% and the incidence density was 3.02 per 1000 patient years observed. Individuals with AF tended to be older at initial (40 vs. 25 years, p<0.0001) and follow-up (53 vs. 35 years, p<0.0001) visits and were observed for a longer period (13.3 vs. 9.5 years, p=0.0014). There was no difference in gender (p=0.7), ethnicity (p=0.5), or SCD genotype (p=0.03) between groups (see Table 1). Those with AF were more likely to carry diagnoses of chronic obstructive pulmonary disease (p=0.0004), hypertension (p<0.0001), chronic kidney disease (p<0.0001), type 2 diabetes (p<0.0001), and any cancer (p=0.04). However, hydroxyurea use was not associated with AF development (p=0.3). SCD patients with AF were more likely to receive diuretics, atrioventricular nodal blocking agents, antihypertensives, antiplatelets, and statin therapies (see Table 1). AF was associated with worse anemia and reduced renal function. Regression analysis identified significant odds ratios (ORs) for age at initial visit (OR 1.06, p=0.03), serum creatinine per 1 mg/dL increase (OR 2.34, p=0.02), hemoglobin level per 1 g/dL increase (OR 0.52, p=0.0009), fetal hemoglobin level per 1% increment (OR 0.81, p=0.008), and total observation time per year follow up (OR 1.26, p=0.0006).ConclusionWe showed that the prevalence and incidence of AF is high in patients with SCD with the median age of onset occurring 1-2 decades earlier than in the general populace (Feinberg et al. JAMA Internal Medicine 1995). AF in patients with SCD is associated with advanced age, worse renal function, a higher degree of anemia, and greater usage of cardio- and nephro-active medications. The high incidence of AF in patients with SCD may contribute to the plateauing of life expectancy and identifying the causative risk factors and the underlying mechanisms may not only improve life expectancy but also the quality of life. Further study is warranted. [Display omitted] DisclosuresSaraf: Novartis: Membership on an entity's Board of Directors or advisory committees, Research Funding; Global Blood Therapeutics: Membership on an entity's Board of Directors or advisory committees, Research Funding; Pfizer: Research Funding.

Impact of educational intervention on knowledge and awareness of TB among secondary school students in The Gambia

Objectives: Health education and awareness campaigns about tuberculosis (TB) can empower adolescents on different aspects of the disease and its management, resulting in early and appropriate care seeking behavior through their advocacy in the community. We assessed the impact of educational intervention on knowledge and awareness about TB among adolescents in the greater Banjul area of The Gambia where approximately 70% of national TB cases are notified. Materials and Methods: A school-based, interventional analytical study, and interactive educational workshop was conducted among grade 12 students of the Methodist Academy Secondary School in Bakau, Banjul The Gambia. The workshop activities included illustrative demonstrations using posters, flipcharts, infographics, and games to convey TB messages in six domains: (1) Basic knowledge; (2) symptoms; (3) risk factors (4) modes of transmission; (5) treatment; and (6) care and support. Structured questionnaires were used to assess changes in the student’s knowledge and awareness about TB in the six domains before and after the workshop. Data were analyzed using proportional percentages, mean (95% CI) and differences standard error (SE) and student paired t-test. Results: Ninety-six students participated in the workshop out of which 92 (96%) students completed both pre- and post-test questionnaires. Sixty-eight percent of the students were females and 58% were from the science stream of the grade 12 students who participated in our workshop. The mean difference and SE between the pre- and post-workshop test scores in the six domains were: basic knowledge: +1.4 (0.2; P &lt; 0.0001); symptoms: +1.5 (0.2; P &lt; 0.0001); risk factors: +3.1 (0.3; P &lt; 0.0001); modes of transmission: +1.2 (0.2; P &lt; 0.0001); treatment: +0.8 (0.1; P &lt; 0.0001); and care and support of TB: +0.5 (0.1; P = 0.0001). Conclusion: This school-based educational interactive workshop significantly improved the knowledge and awareness of the students especially in understanding the causative agent and risk factors of TB disease. We recommend exposure of students to TB educational activities as part of the school curriculum. The knowledge acquired in this workshop is likely to have impact on the wider community and should be assessed in future follow-up studies to determine if it impacts positively on views held within the wider community.

An Outbreak of Guillain-Barre Syndrome with Respiratory Failure in Joypurhat, Bangladesh, 2018

We describe an investigation to identify the causative agent and risk factors for a cluster of Guillain-Barre Syndrome (GBS) reported in northern Bangladesh, November 2018. Medical record review and verbal autopsies were conducted. We actively searched for and interviewed other GBS cases in the hospital to gather demographic and clinical information. Blood samples were collected for serological testing for campylobacter and molecular testing for dengue, Zika, and Chikungunya and stool samples for poliovirus. We identified 13 GBS patients of which eight were males. The case fatality rate was 23%. We found development of respiratory muscle paralysis in 10 patients; three had rapid involvement within 48 hours and eventually died in the acute progressive phase without mechanical ventilation support. Serological tests confirmed the presence of antibodies against Campylobacter jejuni in three of seven patients. All other tests were negative. The high case fatality rate was due to rapid onset of respiratory muscle paralysis. We recommend establishing a surveillance system to timely capture and report GBS patients and to enhance investigation capacity. We also recommend that sufficient quantity of mechanical ventilators be present in peripheral tertiary hospitals.

Potential roles of gastroesophageal reflux in patients with superficial esophageal squamous cell carcinoma without major causative risk factors.

Cigarette smoking, alcohol consumption, and Lugol-voiding lesions (LVLs) are the major causative risk factors of esophageal squamous cell carcinoma (ESCC); however, reports on ESCC cases unrelated to these risk factors are very limited. Here, we investigated the clinicopathological features and etiology of such cases. We retrospectively analyzed 704 consecutive superficial ESCC tumors of 512 patients who were treated with endoscopic submucosal dissection. The enrolled patients were divided into two groups-the very low-risk (VLR)-group and risk (R)-group-based on the presence of the abovementioned risks. Clinical, endoscopic, and pathological characteristics and genetic findings were assessed in both groups. The VLR-group consisted of 21 (4.1%) patients, who were characteristically female. Patients in the VLR-group presented gastroesophageal reflux disease (GERD), hiatal hernia, and non-open-type atrophic gastritis, and were negative for Helicobacter pylori. We found unique endoscopic features-frequently observed in the posterior wall of the middle thoracic esophagus-with a linear shape that closely resembled the erosion-like form of GERD. Additionally, histopathological examination showed that these tumors presented atypical nuclei limited to the basal and parabasal layer, sequential to the surrounding changes that presented pathological chronic inflammation of esophagitis. Evaluation of somatic mutations in cancer-related genes using next-generation sequencing revealed that the positive carcinogenic potential (TP53 mutation) of the tumors was relatively frequent in the VLR-group. Our study suggests that ESCC without major causative factors is related to GERD, with no remarkable oncogenic difference.

ABO Blood Group System and Periodontal Disease Indices: A Cross-Sectional Study in Greek Adults

Introduction: Periodontal disease (PD) development has been associated with the presence of causative microorganisms, host immunity and risk factors, whereas the types of periodontal diseases are characterized by interactions between host and bacteria. Moreover, ABO blood groups are the most investigated erythrocyte antigen system. However, a small number of researches have been focused on the possible associations between ABO blood groups and periodontal diseases. Methods: A cross-sectional, epidemiological study was carried out on 854 individuals, 404 males and 450 females, aged 45 to 77. The study sample was interviewed and underwent an oral and dental clinical examination. The assessment of the possible associations between several indices of PD, such as Probing Pocket Depth (PPD), Clinical Attachment Loss (CAL) and Bleeding on Probing (BOP) as dependent variables and ABO blood groups A, B, AB, and O as independent ones was carried out by using a multiple regression analysis model. Results: Individuals with blood group A [OR= 2.94, 95% CI = 1.27-3.96] and B [OR= 2.66, 95% CI = 1.11-3.87] were significantly associated with the risk of developing deeper periodontal pockets (PPD) and worse values of attachment loss (CAL) [OR= 2.42, 95% CI= 1.37-3.85] and [OR= 2.31,95% CI=1.25-3.68], respectively. However, no significant associations were recorded between ABO blood groups and BOP [OR= 1.04, 95% CI= 0.92-1.18]. Conclusion: A significant association was revealed between A and B blood groups and deeper periodontal pockets and worse attachment loss, whereas no associations were observed between ABO blood groups and bleeding of probing.

Impact of COVID-19 on Noncommunicable Diseases (NCDs)

Since December 2019, a novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), pandemic has affected more than 18.6 million people worldwide. Male gender, older age, obesity, and comorbid noncommunicable diseases (NCDs) like diabetes, hypertension, cardiovascular disease (CVD), chronic respiration illnesses, and cancer have higher risk and fatal outcome of COVID-19. India has a huge burden of NCDs and their associated risk factors which could act in harmony with COVID-19 to produce severe and fatal outcome. Till date the specific treatment options for COVID-19 are elusive and as NCDs are reported as the main causative risk factors for COVID-19 which can worsen the outcome, the focus should be made on continuing and improving the healthcare facilities related to the prevention, management, and control of NCDs. The management of NCDs in the context of SARS-CoV-2 infection are quite challenging. The restrictive measures imposed by governments all over the world such as complete or partial lockdown, travel restrictions, and physical distancing to contain the spread of SARS-CoV-2 infection have affected the people with NCDs by limiting their access to healthcare facilities, physical activity access to healthy food, and even to medicines and essential supplies. These factors increase the risk of developing obesity, diabetes, and CVDs. This article reviews the burden of NCDs in India, the cross-connection between NCDs and COVID-19, disruptions of healthcare services for NCDs, and proposes research priorities during COVID-19 for effective management and control of NCDs.

"A decade with micro-tubular decompression": Peri-operative complications and surgical outcomes in single and multilevel lumbar canal stenosis.

We present tenyears experience with micro-tubular decompression (MTD) performed for single and multilevel lumbar canal stenosis (LCS) assessing the peri-operative complications and mid-term surgical outcome. The aims of this study were to review the incidence of peri-operative complications and classification of complications and define risk factors to prevent it while negotiating the learning curve. A retrospective review of prospectively collected data over a period of tenyears involving 625 patients who underwent single/multilevel lumbar MTD. Peri-operative clinical-radiological parameters, post-operative complications, clinical outcome (VAS and ODI), and satisfactory outcomes in the form of Wang and Bohlmann's criteria were evaluated. The peri-operative complications were divided into five broad categories based on their time of occurrence, severity, and system affected. The comparison between the patients with and without complications was done to evaluate the causative risk factors. The overall incidence of the peri-operative complication was 12.96% over tenyears with higher rate (29.8%) during the initial threeyears of practice and lower rate (8.78%) in the last seven years. The most common peri-operative complications were urinary tract infections (UTI). The risk factors for complications with MTD revealed in statistical analysis were presence of one or more comorbidities, L4-L5 single-level stenosis, bilateral stenosis with ipsilateral and bilateral decompression done through unilateral approach, and multilevel MTD done through single incision for multilevel LCS. More than 95% patients operated with MTD showed excellent to good outcome as per the Wang and Bohlmann's criteria at the final follow-up. This study represents 12.96% overall incidence of peri-operative complications with higher rate (29.8%) during the initial threeyears of practice and lower rate (8.78%) in the last sevenyears with MTD for single/multilevel LCS with. MTD is an effective procedure with substantial clinical benefits in the form of excellent to good clinico-radiological outcomes at twoyear follow-up. However, there is a learning curve associated with the adoption of the technique. The described classification for peri-operative complications is helpful to record, to evaluate, and to understand the aetiology and risk factors based on its duration of occurrence in the peri-operative period.

Frequency of anemia and causative risk factors in patients presenting to tertiary care hospital: A cross sectional study.

Objective: To determine the frequency of anemia and its causative risk factors in patients attending the gynecology outpatient department of Nishtar Medical University and Hospital. Study Design: Cross sectional study. Setting: Gynecology Outpatient Department attendees of Nishtar Medical University and Hospital. Period: 1st September to 31st December 2019. Material &amp; Methods: Total 361 females between 19-49 years of age were enrolled and included those patients who consented to be tested for blood hemoglobin estimation. Their brief history was taken after proper consent according to predesigned proforma to rule out the risk factors. Patients with chronic kidney disease, chronic lung diseases and liver diseases were excluded. Blood test was done by obtaining the blood sample by finger prick method. Hemoglobin analysis was performed by portable Hemocueanalyser. Frequency of anemia, severity of anemia and their stratification was performed against the risk factors like age, educational status, socioeconomic status, status of pregnancy, parity and contraception were obtained to rule the causative factors. Anemia was defined per standard criteria as hemoglobin less than 11gm/dl. Results: Majority of patients 65% were between 19-35 years of age and 34% were 36-49years of age. Frequency of pregnant patients and non-pregnant patients was 63.4% and 36.6%. Frequency of anemia was 56.8%, mean hemoglobin 10.48±1.18 with mild, moderate and severe anemia were 36.8%, 17.2% and 2.8%. Majority of females 82.9%, never went to school and had primary education, 71.70% belong to very poor and poor socioeconomic status, 79.02% were multipara and 81.95% never and infrequently practiced the contraceptive methods. Conclusion: Frequency of anemia is very high in females presenting to tertiary care hospital being more common in younger age group. Frequent pregnancies, poor socioeconomic status and low level of educational attainment were the major determinants of anemia in females.

Uncovering Potential Roles of Differentially Expressed Genes, Upstream Regulators, and Canonical Pathways in Endometriosis Using an In Silico Genomics Approach.

Endometriosis is characterized by ectopic endometrial tissue implantation, mostly within the peritoneum, and affects women in their reproductive age. Studies have been done to clarify its etiology, but the precise molecular mechanisms and pathophysiology remain unclear. We downloaded genome-wide mRNA expression and clinicopathological data of endometriosis patients and controls from NCBI’s Gene Expression Omnibus, after a systematic search of multiple independent studies comprising 156 endometriosis patients and 118 controls to identify causative genes, risk factors, and potential diagnostic/therapeutic biomarkers. Comprehensive gene expression meta-analysis, pathway analysis, and gene ontology analysis was done using a bioinformatics-based approach. We identified 1590 unique differentially expressed genes (129 upregulated and 1461 downregulated) mapped by IPA as biologically relevant. The top upregulated genes were FOS, EGR1, ZFP36, JUNB, APOD, CST1, GPX3, and PER1, and the top downregulated ones were DIO2, CPM, OLFM4, PALLD, BAG5, TOP2A, PKP4, CDC20B, and SNTN. The most perturbed canonical pathways were mitotic roles of Polo-like kinase, role of Checkpoint kinase proteins in cell cycle checkpoint control, and ATM signaling. Protein–protein interaction analysis showed a strong network association among FOS, EGR1, ZFP36, and JUNB. These findings provide a thorough understanding of the molecular mechanism of endometriosis, identified biomarkers, and represent a step towards the future development of novel diagnostic and therapeutic options.

Sleep Disorders in Late-Life Depression

Depression is an important mental health problem in developed societies, and as many as 50%-90% of patients with depression complain of sleep disorders. In the elderly, sleep disorders comorbid depressive disorders are getting worse. Late-life Depression (LLD) is often not detected because the symptoms are less specific than younger age. It even provides an independent risk factor impact on suicide ideas and behaviour. Causative risk factors of sleep disorders in Late-life Depression are biological and non-biological factors that form the basic of pharmacological and non- pharmacological management.

In silico features of ADAMTS13 contributing to plasmatic ADAMTS13 levels in neonates with congenital heart disease

IntroductionRisk factors contributing to heightened thrombosis in pediatric congenital heart disease (CHD) patients are not fully understood. Among the neonatal CHD population, those presenting with single ventricular physiology are at the highest risk for perioperative thrombosis. The von Willebrand factor and ADAMTS13 interactions have emerged as causative risk factors for pediatric stroke and could contribute to heightened thrombosis in CHD neonates. MethodsThis study investigates a cohort of children with single ventricle physiology and undergoing cardiac surgery, during which some patients developed thrombosis. In this cohort, we analyzed the relationship of several molecular features of ADAMTS13 with the plasma and activity levels in patients at risk of thrombosis. Additionally, in light of the natural antithrombotic activity of ADAMTS13, we have sequenced the ADAMTS13 gene for each patient and evaluated the role of genetic variants in determining the plasma ADAMTS13 levels using a series of in silico tools including Hidden Markov Models, EVmutation, and Rosetta. ResultsLower ADAMTS13 levels were found in patients that developed thrombosis. A novel in silico analysis to assess haplotype effect of co-occurring variants identified alterations in relative surface area and solvation energy as important contributors. Our analysis suggested that beneficial or deleterious effect of a variant can be reasonably predicted by comprehensive analysis of in silico assessment and in vitro and/or in vivo data. ConclusionFindings from this study add to our understanding the role of genetic features of ADAMTS13 in patients at high risk of thrombosis related to an imbalanced relation between VWF and ADAMTS13.

Assessment of the effect of external risk factors on the success of an oil and gas construction project

PurposeConstruction projects in the oil and gas sector are greatly affected by external risk factors, especially those related to the economy, politics, security and stability factors. Hence, this research aimed to investigate the fundamental relationship between the external risk factors and their effects on the construction project success using Structural Equation Modeling method and PLS-SEM approach.Design/methodology/approachData collected through a structured survey distributed to projects teams in the oil and gas sectors in Yemeni companies involved in mega construction projects. A hierarchical model for assessing causative external risk factors and their effects on project success was developed and analyzed using Smart PLS 3 software of SEM.FindingsThe findings showed that economic, political, force majeure and security-related risk factors had a strong effect on project success. Besides, the Coefficient of Determination (R-squared value) equals 0.743, represented the proportion of variation in the dependent variable(s), which can be explained by one or more predictor variable. Moreover, the predictive relevance value Q2 is 0.375 above zero, which indicates that the conceptual model can predict the endogenous latent constructs. The calculated Goodness of Fit (GoF) Index of the model was 0.699, which shows that the developed model had substantial explanatory power to represent the relationship between the cause of external risk factors to and the effect on construction project success.Research limitations/implicationsThis research was limited to the oil and gas construction projects in Yemen as case study.Practical implicationsPractically, this study highlights the external risk factors that cause a negative effect on the success of oil and gas construction projects in Yemen. The research model of these factors is the first step in the risk management process to develop strategic responses for risks and explain the relationship between cause and effect on project success.Social implicationsThe model of external risks factors that cause the failure of construction projects helps develop response strategies for these risks, thereby increasing the chances of project success reflected in the oil and gas sector, which is a main tributary of the national economy in developing countries.Originality/valueThere is a need to improve the planning of economic and security performance as well as to mitigate political risk factors effects on project success and other risk factors discussed in this study, which effect on construction project success according to their priorities.

Incidence of prostate cancer in Eritrea: Data from the National Health Laboratory, Orotta Referral Hospital and Sembel Hospital 2011-2018.

IntroductionUp-to-date statistics on prostate cancer incidence and causative risk factors are essential for the primary prevention of this disease. However, the incidence of Prostate cancer (ICD-10 code C61) (PCa), or cancers in general, are poorly documented in Eritrea. This study analyses the data available to produce an estimate of the incidence of PCa in Eritrea.MethodsWe conducted a retrospective study by identifying all incident cases of PCa captured between 2011–2018 in the National Health Laboratory pathology database (Polytech 8.37.C); Urology departments of Orotta Referral Hospital and Sembel Hospital. Crude incidence rates (CIRs), age-adjusted rates per 100,000 person years and associated trends were subsequently calculated. Joinpoint Regression Program, V.4.5.0.1 was employed in these analyses.ResultsA total of 1721 cases were reported, of which 1593 (92.5%) were benign prostatic hypertrophy cases and 128 (7.5%) were PCa cases. The mean (±SD) age of the patients with PCa was 73.49 (± 8.9), confidence interval (CI) (54–98) and the minimum and maximum ages were 54 and 98, respectively. The median age interquartile ranges (IQR) was 73 (13) years. The highest and lowest PCa incidence rates were in 2017 (4.51 per 100 000) and 2014 (2.69 per 100 000), respectively. The age standardised rates (ASIR) (World) over the study period (2011–2018) was 30.26 per 100 000. The annualized ASIR values over the study period was 3.78 per 100 000. The associated average annual percentage change (APC) (CI) over the study period was 5.4 (-1.4–12.7), P-value = 0.100, showing a static trend over the study period.ConclusionThis study suggests that previous reports have under-estimated the incidence of PCa in Eritrea. The study provides ample evidence on the need for research targeted at uncovering the true burden of PCa in Eritrea. Potential solutions will require the establishment of high-quality population-based cancer registries (PBCRs) and long-term commitment to improvements in research, training, screening, diagnosis, and the overall management of PCa in the country.

Structural modelling of internal risk factors for oil and gas construction projects

PurposeProject failure is the result of one or a combination of several causes of risk factors that are very important to identify for effective performance. This study aims to focus on studying the fundamental relationship between internal risk factors and the negative effect on oil and gas project success in Yemen using the partial least square structural equation modelling (PLS-SEM) method.Design/methodology/approachData collection was carried out using a formal questionnaire survey of the oil field sector in Yemen by companies involved in mega-oil and gas construction projects. A hierarchical model for determining causative internal risk factors and their effects was developed and evaluated using SEM method by SmartPLS3 software technology.FindingsThe findings of analyzing model indicate that all categories have a significant effect on project success, while the most significant affected categories in the internal risk factors are project management factors, feasibility study-design and resources-material supply with a path coefficient value of 0.213, 0.197 and 0.186, respectively. Moreover, for the hypotheses test, the positive relationship means that all experimental hypotheses are accepted according to path coefficient value analysis. In addition, the internal risk factors research model shows the ranking of effects on project success starting with project stoppage (loading factor 0.841), cost overruns (loading factor 0.818), time overruns (loading factor 0.726) and project target failure with loading factor 0.539.Research limitations/implicationsThe research was limited to the oil and gas construction projects in Yemen.Practical implicationsInterpreting the relationship between internal risk factors and their impact on the success of construction projects in the oil and gas sector will assist project team and oil companies in developing risk response strategies and developing appropriate plans to mitigate the effects of risks, which is presented in this paper.Originality/valueThe paper explains the relationship between cause and effect of internal risk factors in oil and gas projects in Yemen, and is expected to be a guideline for the oil companies and future academic research in the risk management area.