Common Risk Factors Research Articles

Improving adolescents’ dietary behavior through teacher-delivered cancer prevention education: a school-based cluster randomized intervention trial in urban Rajasthan

BackgroundDietary practices are one of the most common modifiable risk factors for cancers. Foods rich in dietary fibers are considered protective, meanwhile fast & junk foods are risk for common cancers. Adolescence period is marked by habit formation and is thus suited for delivering behavioral intervention. Schools offer an optimal setting for planning and executing these interventions to a large number of adolescents.ObjectiveTo assess the effectiveness of a teacher-delivered cancer-prevention education in changing dietary behaviors of school going adolescents.MethodsA cluster randomized trial was conducted in government secondary and senior secondary schools with schools as clusters. A minimum required sample of 1032 students was estimated from 16 schools with 1:1 allocation in intervention and non-intervention groups. Dietary behaviors were recorded as dichotomous variable. The determinants were recorded as per theory of planned behavior framework using Likert-scale. Two teachers from each intervention school were trained to deliver cancer prevention education with focus on role of dietary behavior. Pre-post training assessment of teachers’ knowledge towards common cancers was done using a self-administered questionnaire. Gender adjusted difference-in-difference analysis was done to assess intervention effect on both healthy and unhealthy behaviors.ResultsIn selected schools all students from classes 8 to 10 were approached and a total of 1224 students were enrolled, of whom 1096 completed the study. The study recorded significant improvement in scores of students from intervention group compared to non-intervention group for their attitude, subjective norms, perceived behavioral control and intention towards consuming healthy and avoiding unhealthy foods. The intervention was effective in significantly improving the proportion of students limiting fried/fast/packed food & sugar sweetened beverages (OR:1.51, 95%CI:1.08,2.12,p:0.017), and consuming fruits & vegetables daily (OR:1.55, 95%CI:1.08,2.22, p:0.017) while adjusting effect of gender.ConclusionClassroom-based cancer prevention education delivered through teachers during regular working hours is effective in improving dietary behaviors and its determinants among adolescent students. Thus, we recommend integrating a section focusing on the role of diet in cancer prevention and other lifestyle diseases in the existing school curriculum.Trial RegistrationThe trial was registered under Clinical Trial Registry-India with registration number CTRI/2018/12/016586, dated-10/12/2018.

Incidence and prevalence of chronic pulmonary aspergillosis in patients with post-tuberculosis lung abnormality: Results from a community survey in North India.

Post-tuberculosis lung abnormality (PTLA) is the most common risk factor for developing chronic pulmonary aspergillosis (CPA). However, the prevalence and incidence of CPA in PTLA patients in India remain unknown. We aimed to ascertain the incidence and prevalence of CPA in subjects with PTLA. We identified a cohort of pulmonary tuberculosis who completed anti-tuberculosis therapy (ATT) before November 2019 from the records of the 12 tuberculosis treatment centers attached to the national program. We recorded the clinical and demographic details. We performed computed tomography (CT) of the chest and estimated serum A. fumigatus-specific IgG. We categorised subjects as PTLA with or without CPA using a composite of clinical, radiological, and microbiological features. We resurveyed the subjects at 6 months (or earlier) for the presence of new symptoms. We calculated the prevalence and the incidence rate (per 100-person years) of CPA. We included 117 subjects with PTLA, with a median of 3 years after ATT completion. Eleven subjects had CPA in the initial survey, and one additional case developed CPA during the second survey. The prevalence of CPA in PTLA subjects was 10.3% (12/117). The total observation period was 286.7 person-years. The median (interquartile range) time to develop CPA after ATT completion was 12.5 (5-36.7) months. We found the CPA incidence rate (95% confidence interval) of 4.2 (1.8-6.5) per 100-person years. Chronic pulmonary aspergillosis complicates 10% of PTLA subjects after successful outcomes with ATT. Four new CPA cases may develop per 100-persons years of observation after ATT completion. We suggest screening patients with PTLA who develop new symptoms for CPA.

Cerebral white matter hyperintensities indicate severity and progression of coronary artery calcification

Cerebral white matter hyperintensities (WMH) have been associated with subclinical atherosclerosis including coronary artery calcification (CAC). However, previous studies on this association are limited by only cross-sectional analysis. We aimed to explore the relationship between WMH and CAC in elderly individuals both cross-sectionally and longitudinally. The study population consisted of elderly stroke- and dementia-free participants from the community-based Austrian Stroke Prevention Family Study (ASPFS). WMH volume and CAC levels (via Agatston score) were analyzed at baseline and after a 6-year follow-up period. Of 324 study participants (median age: 68 years), 115 underwent follow-up. Baseline WMH volume (median: 4.1 cm3) positively correlated with baseline CAC levels in multivariable analysis correcting for common vascular risk factors (p = 0.010). While baseline CAC levels were not predictive for WMH progression (p = 0.447), baseline WMH volume was associated CAC progression (median Agatston score progression: 27) in multivariable analysis (ß = 66.3 ± 22.3 [per cm3], p = 0.004). Ten of 11 participants (91%) with severe WMH (Fazekas Scale: 3) at baseline showed significant CAC progression > 100 during follow-up. In this community-based cohort of elderly individuals, WMH were associated with CAC and predictive of its progression over a 6-year follow-up. Screening for coronary artery disease might be considered in people with more severe WMH.

Evaluation of predictors of third-generation cephalosporin non-susceptibility and factors affecting recurrence or death in bacteremia caused by Citrobacter freundii complex, Enterobacter cloacae complex, and Klebsiella aerogenes

Factors involved in the susceptibility of third-generation cephalosporins (3GCs) to bacteremia caused by Citrobacter freundii complex, Enterobacter cloacae complex, and Klebsiella aerogenes were investigated based on a case-case-control design. Antimicrobial therapy administered 30 days prior to bacteremia and hospitalization within 90 days were common risk factors for the 3GC susceptible and 3GC non-susceptible groups, while hospitalization from an institution or another hospital was a specific risk factor for the 3GC non-susceptible group. We also attempted to examine the factors affecting the clinical outcome of bacteremia. Hospitalization more than 14 days before the onset of bacteremia was an independent factor indicating poor clinical outcome. In contrast, the implementation of source control was an independent predictor of successful treatment. Although a longer hospital stay before the onset of bacteremia was associated with worse clinical outcomes, implementation of source control may have contributed to improved treatment outcomes for bacteremia.

Identifying the Risk Factors of Allergic Rhinitis Based on Zhihu Comment Data Using a Topic-Enhanced Word-Embedding Model: Mixed Method Study and Cluster Analysis.

Allergic rhinitis (AR) is a chronic disease, and several risk factors predispose individuals to the condition in their daily lives, including exposure to allergens and inhalation irritants. Analyzing the potential risk factors that can trigger AR can provide reference material for individuals to use to reduce its occurrence in their daily lives. Nowadays, social media is a part of daily life, with an increasing number of people using at least 1 platform regularly. Social media enables users to share experiences among large groups of people who share the same interests and experience the same afflictions. Notably, these channels promote the ability to share health information. This study aims to construct an intelligent method (TopicS-ClusterREV) for identifying the risk factors of AR based on these social media comments. The main questions were as follows: How many comments contained AR risk factor information? How many categories can these risk factors be summarized into? How do these risk factors trigger AR? This study crawled all the data from May 2012 to May 2022 under the topic of allergic rhinitis on Zhihu, obtaining a total of 9628 posts and 33,747 comments. We improved the Skip-gram model to train topic-enhanced word vector representations (TopicS) and then vectorized annotated text items for training the risk factor classifier. Furthermore, cluster analysis enabled a closer look into the opinions expressed in the category, namely gaining insight into how risk factors trigger AR. Our classifier identified more comments containing risk factors than the other classification models, with an accuracy rate of 96.1% and a recall rate of 96.3%. In general, we clustered texts containing risk factors into 28 categories, with season, region, and mites being the most common risk factors. We gained insight into the risk factors expressed in each category; for example, seasonal changes and increased temperature differences between day and night can disrupt the body's immune system and lead to the development of allergies. Our approach can handle the amount of data and extract risk factors effectively. Moreover, the summary of risk factors can serve as a reference for individuals to reduce AR in their daily lives. The experimental data also provide a potential pathway that triggers AR. This finding can guide the development of management plans and interventions for AR.

Persistence of vitamin D deficiency among Italian patients with acute myocardial infarction

Background and aimsVitamin D deficiency is a common cardiovascular risk factor associated with the development of atherosclerosis. We evaluated changes in 25(OH)D concentrations in 1510 patients with acute myocardial infarction (AMI) over a long observation period, including the COVID-19 pandemic. Methods and resultsPatients were separated into four groups according to the year of enrolment, group 1 (2009–2010), group 2 (2014–2016), group 3 (2017–2019), and group 4 (2020–2022). The median 25(OH)D concentration in the overall cohort was 17.15 (10.3–24.7) ng/mL. The median plasma concentrations of 25(OH)D for groups 1, 2, 3, and 4 were 14.45 (7.73–22.58) ng/mL, 17.3 ng/mL (10.33–24.2), 18.95 (11.6–26.73) ng/mL and 19.05 (12.5–27.3) ng/mL, respectively. Although 25(OH)D levels increased over the years, the prevalence of vitamin D deficiency remained high in each group (68.4%, 61.4%, 53.8%, and 52% respectively). Hypovitaminosis D was predicted by the season influence (OR:2.03, p < 0.0001), higher body mass index (OR:1.25; p = 0.001), diabetes mellitus (OR:1.54; p = 0.001), smoking (OR:1.47; p = 0.001), older age (OR:1.07; p = 0.008), higher triglycerides levels (OR:1.02; p = 0.01), and female gender (OR:1.3; p = 0.038). After multivariable adjustment, vitamin D ≤ 20 ng/mL was an independent predictor of mortality. ConclusionVitamin D deficiency is highly prevalent and persistent in patients with AMI despite a trend towards increasing 25(OH)D concentrations over the years. The frequent lockdowns did not reduce the levels of 25(OH)D in the fourth group. Low levels of 25(OH)D are an independent predictor of mortality.

Task Sharing and Task Shifting (TSTS) in the Management of Africans with Hypertension: A Call For Action-Possibilities and Its Challenges.

Hypertension is a leading cause of mortality globally and one of the most common risk factors for cardiovascular disease. Diagnosis, awareness, and optimal treatment rates are suboptimal, especially in low- and middle-income countries, with attendant high health consequences and grave socioeconomic impact. There is an enormous gap between disease burden and physician-patient ratios that needs to be bridged. Task sharing and task shifting (TSTS) provide a viable temporary solution. However, sociocultural, demographic, and economic factors influence the effective uptake of such interventions. This review discusses the dynamics of TSTS in the African context looking at challenges, feasibility, and approach to adopt it in the management of hypertension in Africa.

Clinical Course and Visual Outcomes of Papilledema in Pediatric Cerebral Venous Sinus Thrombosis

Cerebral venous sinus thrombosis (CVST) is a rare but life-threatening event with significant neurologic and visual morbidity. In this study, we report on the natural history and visual outcomes of papilledema in children with CVST. Retrospective case series. Patients with CVST evaluated by the Department of Ophthalmology between 2000 and 2023 were included. Records were reviewed for presence and course of papilledema, treatment, and final visual outcomes following papilledema resolution. The study included 35 patients with a mean age of 9 ± 5 years and 40% were female. The most common risk factors for CVST were infection (69%), dehydration (26%), and hypercoagulability (23%). 31 patients (89%) had papilledema. Of these patients, 9 (29%) had progression of papilledema despite treatment, 17 patients (55%) did not have progression, and 5 patients (16%) lacked follow-up records. Initial Frisén grade among all cases was 2 ± 1, and cases with progression reached a grade of 4 ± 1 between 10 and 32 days following initial identification. Most patients (97%) were treated with anticoagulation and 100% required acetazolamide and/or lumbar puncture. Among 26 patients with follow-up, papilledema resolved in 107 ± 128 days. Fifty-four percent of patients had permanent ophthalmic sequelae. An initial Frisén grade ≥3 (odds ratio 7.54, 95% confidence interval 6.53-8.70, P< .001) was significantly associated with eventual optic atrophy. Children with CVST are at high risk for ophthalmologic sequelae. Papilledema can progress despite appropriate therapy. Our results highlight the importance of ophthalmologic follow-up during treatment course to prevent irreversible vision loss.

Lifestyle modification and risk factor control in the prevention and treatment of atrial fibrillation

Atrial fibrillation (AF) is the most prevalent arrhythmia and is related with significant morbidity, mortality and costs. In spite of relevant advances in the prevention of embolic events and rhythm control, little has been done to reduce its prevalence, progression and impact, since it increases with ageing as well as with common risk factors such as alcohol intake, tobacco use and stress as well as with arterial hypertension, diabetes mellitus, heart failure, sleep apnea, kidney failure, chronic pulmonary obstructive disease, ischemic heart disease and stroke, among other important comorbidities. Fortunately, new evidence suggests that lifestyle modifications and adequate risk factors and comorbidities control could be effective in primary and secondary AF prevention, especially in its paroxysmal presentations. This is why a multidisciplinary approach integrating lifestyle modifications, risk factors and comorbidities control, is necessary in conjunction with rhythm or rate control and anticoagulation. Unfortunately, that holistic approach strategy is not considered, is scarcely studied or is subtilized in general clinical practice. The present statement's objectives are to: 1) review the relationship between habits, risk factors and illnesses with AF, 2) review the individual and common physiopathology mechanisms of each one of those conditions that may lead to AF, 3) review the effect of control of habits, risk factors and co-morbidities on the control and impact of AF, and 4) supply guidelines and recommendations to start multidisciplinary and integrative AF treatment.

Comparison between Different Mechanization Systems: Economic Sustainability of Harvesting Poplar Plantations in Italy

After a period of significant development, poplar cultivation in Italy has been in rapid decline since the 1980s. Because of its marked ductility, poplar is valuable for both wood furniture and energy production. Production could be increased through mechanization, because innovative machinery and equipment can reduce the exposure of forest workers to common risk factors, ensure greater and better productivity, increase the efficiency of operations, and reduce costs. There are various systems for the mechanization of poplar production (from traditional to advanced and pushed mechanization). We describe the range of possibilities (in terms of both the techniques adopted and the machines used) for planting, harvesting, and chopping poplar. Based on our analysis of operating costs, we conclude that mechanized poplar production could reduce the average cost per ton of wood chips (EUR/t) by 23% and the average gross cost per hectare of wood chips produced (EUR/ha) by 37%.

Early childhood appetitive traits and eating disorder symptoms in adolescence: a 10-year longitudinal follow-up study in the Netherlands and the UK

Obesity and eating disorders commonly co-occur and might share common risk factors. Appetite avidity is an established neurobehavioural risk factor for obesity from early life, but the role of appetite in eating disorder susceptibility is unclear. We aimed to examine longitudinal associations between appetitive traits in early childhood and eating disorder symptoms in adolescence. In this longitudinal cohort study, we used data from Generation R (based in Rotterdam, the Netherlands) and Gemini (based in England and Wales). Appetitive traits at age 4-5 years were measured using the parent-reported Child Eating Behaviour Questionnaire. At age 12-14 years, adolescents self-reported on overeating eating disorder symptoms (binge eating symptoms, uncontrolled eating, and emotional eating) and restrictive eating disorder symptoms (compensatory behaviours and restrained eating). Missing data on covariates were imputed using Multivariate Imputation via Chained Equations. Ordinal and binary logistic regressions were performed in each cohort separately and adjusted for confounders. Pooled results were obtained by meta-analyses. Sensitivity analyses were performed on complete cases using inverse probability weighting. The final study sample included 2801 participants from Generation R and 869 participants from Gemini. Pooled findings after meta-analyses showed that higher food responsiveness in early childhood increased the odds of binge eating symptoms (odds ratio [OR]pooled 1·47, 95% CI 1·26-1·72), uncontrolled eating (1·33, 1·21-1·46), emotional eating (1·26, 1·13-1·41), restrained eating (1·16, 1·06-1·27), and compensatory behaviours (1·18, 1·08-1·30) in adolescence. Greater emotional overeating in early childhood increased the odds of compensatory behaviours (1·18, 1·06-1·33). By contrast, greater satiety responsiveness in early childhood decreased the odds of compensatory behaviours in adolescence (0·89, 0·81-0·99) and uncontrolled eating (0·86, 0·78-0·95) in adolescence. Slower eating in early childhood decreased the odds of compensatory behaviours (0·91, 0·84-0·99) and restrained eating (0·90, 0·83-0·98) in adolescence. No other associations were observed. In this study, higher food responsiveness in early childhood was associated with a higher likelihood of self-reported eating disorder symptoms in adolescence, whereas greater satiety sensitivity and slower eating were associated with a lower likelihood of some eating disorder symptoms. Appetitive traits in children might be early neurobehavioural risk factors for, or markers of, subsequent eating disorder symptoms. MQ Mental Health Research, Rosetrees Trust, ZonMw.

Mind the gap in kidney care: translating what we know into what we do

Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. The time is now to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions worldwide are diagnosed, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because in the early stages it is often silent. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from patient to clinician to health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay.

Assessment of sensitivity of acoustic reflex decay test in diagnosis of patulous eustachian tube

Abstract Background It has long been believed that the patulous eustachian tube is a unique but uncommon condition, with an estimated incidence ranging from 0.3 to 6.6% in the general population. Hearing one’s own voice and breathing, or autophony and aerophony, are the most common symptoms of PET, along with frequent auditory fullness. Aim This study is to establish a standardized protocol for the audiological evaluation of patulous Eustachian tube using acoustic reflex decay test during different breathing tasks. Methods Between January 2022 and December 2022, the ENT department at Suez Canal University Hospitals undertook an observational case-control study. Fifty-two adult patients who present to the Suez Canal University ENT department with complaints of autophony, auditory fullness, or aerophony are diagnosed with patulous eustachian tube dysfunction through endoscopic examination of the tympanic membrane’s synchronized movement with respiration. Results The incidence rate of PET among adults was approximately 3 patients/1000 patients/year. The age of the whole studied group ranged from 20 to 60 years with mean ± SD of 37.4 ± 12.6 years. They included 23 males (44.2%) and 29 females (55.8%). The most common symptom among the studied group was aural fullness (46%), while the least common symptom was aerophony (12%); the most common risk factor among the studied patients was allergy (46.2%), while the least common was radiotherapy (3.9%); 66.7% of the patients with GERD were males, while 66.7% of the patients who lost weight were females; 58.3% of the patients with allergies were females, and also 60% of the patients with thin built were females. In the case group, there is a significant higher change of middle ear compliance in ipsilateral nostril breathing than the mouth breathing and nasal breathing. The sensitivity of the acoustic reflex decay test to diagnose PET with reference to the gold standard test is 88.5% (23/26*100), the specificity is 100% (26/26*100), and the positive predictive value is 100% (23/23*100). Conclusion The sensitivity of the acoustic reflex decay test to diagnose PET with reference to the gold standard test is high, and the specificity is very high with very good diagnostic accuracy.

Interaction between Sovereign Quanto Credit Default Swap Spreads and Currency Options

This study analyzes the term structures of sovereign quanto credit default swap (CDS) spreads and currency options, which are driven by anticipated currency depreciation risk following sovereign credit default (Twin Ds). We develop consistent pricing models for these instruments using a jump-diffusion stochastic volatility model, which allows us to decompose the term structure into the risk components. We find a common risk factor between the intensity process of sovereign credit risk and the stochastic volatility of the exchange rate, and the depreciation risk mainly captures the dependence structure between these markets during periods of high market stress in the Eurozone countries. Depreciation risk is an important component of sovereign quanto CDS spreads and is evident in the negative slope of the volatility smile in the currency option market.

Oleic and linoleic acids promote chondrocyte apoptosis by inhibiting autophagy via downregulation of SIRT1/FOXO1 signaling

Osteoarthritis (OA) is a complex joint disease that currently has no cure. OA involves metabolic disorders in chondrocytes and an imbalance between autophagy and apoptosis. As a common risk factor for OA, obesity induces changes in the fatty acid composition of synovial fluid, thereby disturbing chondrocyte homeostasis. However, whether unsaturated fatty acids affect the development of OA by regulating chondrocyte autophagy remains unclear. This study aimed to determine the effects of oleic and linoleic acids on chondrocyte autophagy and related mechanisms. Based on the mass spectrometry results, the levels of multiple unsaturated fatty acids, including oleic and linoleic acids, in the synovial fluid of patients with OA and obesity were significantly higher than those in patients with OA only. Moreover, we found that FOXO1 and SIRT1 were downregulated after oleic and linoleic acids treatment of chondrocytes, which inhibited chondrocyte autophagy. Importantly, the upregulation of SIRT1 and FOXO1 expression not only increased the level of autophagy but also improved the expression of chondrocyte extracellular matrix proteins. Furthermore, upregulated SIRT1 and FOXO1 expression alleviated the destruction of the articular cartilage in an OA rat model. Our results suggest that SIRT1/FOXO1 signaling can alleviate oleic acid- and linoleic acid-induced cartilage degradation both in vitro and in vivo and that the SIRT1/FOXO1 pathway may serve as an effective treatment target for inhibiting OA progression.

Prevalence, risk factors and prognostic value of atrial fibrillation detected after stroke after haemorrhagic versus ischaemic stroke

Background and objectivesPrior evidence suggests that atrial fibrillation detected after stroke (AFDAS) is distinct from known atrial fibrillation (KAF), with particular clinical characteristics and impacts on outcomes in ischaemic stroke....

Central nervous system metastases in breast cancer patients with germline BRCA pathogenic variants compared to non-carriers: a matched-pair analysis

BackgroundBreast cancer is a common cause for central nervous system (CNS) metastasis, resulting in a significant reduction in overall survival. Germline pathogenic variants (PVs) in BRCA1/2 are the most common genetic risk factor for breast cancer, associated with poor prognostic factors. This study sought to explore the patterns and outcome of CNS metastases in breast cancer patients with germline PVs in BRCA1/2 genes.MethodsA retrospective cohort of 75 breast cancer patients with known BRCA1/2 mutation status, who were diagnosed with CNS metastases in 2006–2021. Histopathology, characteristics of CNS disease, treatments, and survival were compared between BRCA1/2 carriers (n = 25) and non-carriers (n = 50), using propensity score matching (1:2 ratio) to control for the possible influence of tumor receptor status (ER, PR, HER2) and patient age. Pearson chi-square or Fisher exact test and Kaplan-Meier survival curves with log-rank test were used for statistical analyses.ResultsPatients with PVs in BRCA1/2 had more high-grade tumors (88% vs. 68%, P = 0.060), were younger at CNS disease diagnosis (median 46.69 vs. 55.02 years, P = 0.003) and had better ECOG performance status (ECOG PS 0 in 20% vs. 2%, P = 0.033), but without significant differences in systemic or CNS-directed treatment approaches. BRCA1/2 mutation was associated with a higher rate of temporal lobe involvement (52% vs. 26%, P = 0.026) and leptomeningeal spread (40% vs. 20%, P = 0.020). Survival after diagnosis of CNS disease was shorter (median 8.03 vs. 28.36 months, P < 0.0001), with no significant differences in time to development of CNS metastases or overall-survival.ConclusionPatients with CNS metastatic breast cancer and PVs in BRCA1/2 showed a higher rate of leptomeningeal and temporal lobe involvement, and a shorter survival with CNS disease. To the best of our knowledge, this is the first study suggesting an exclusive impact of germline BRCA1/2 mutations in CNS metastatic breast cancer.

Prevalence of anemia in pregnant women attending out-patient clinic: A cross-sectional study

Anemia is a very common condition in pregnancy. It represents one of the most common risk factors for maternal as well as fetal complications. Its early identification, treatment and prevention is necessary to avoid these complications.The objective of this study was to evaluate prevalence of anemia in pregnant women attending outpatient department.In this single center retrospective clinic-based study carried pregnant women attending for their regular ante-natal checkup were included. Demographic details, hemoglobin level and prior obstetric related history was noted. Prevalence of anemia was estimated based on the hemoglobin level. The severity of anemia was categorized as mild (Hb level 10 g/dL to 10.9 g/dL), moderate (Hb level 7 g/dL to 9.99 g/dL), severe (Hb level &amp;#60;7 g/dL).Corelates of anemia were examined based on the demographic parameters. The study included 199 pregnant females with mean (SD) age was 29.6 (4.1) years. Mean (SD) hemoglobin of the study population was 10.6 (1.4) gm. A total of 174 (87.44%) females were house-makers and 165 (82.9%) were from the urban area. Anemia was observed in 76 (38.2%) pregnant females. Mild, moderate and severe anemia was observed in 32 (42.11%), 43 (56.58%) and 1 (1.3%) female respectively. Out of 76 pregnant females with anemia, 66 (86.8%) were housemakers. No significant difference was observed in the mean age (p=0.34) and body weight (p=0.69) of pregnant females with or without anemia. There was no significant difference in the anemia prevalence in rural versus urban pregnant females (p=0.33).Prevalence of anemia in pregnant women was 38.2%. Moderate anemia was more common than mild and severe anemia. There was no significant difference in the mean age or residence of pregnant females with anemia versus without anemia.

Perinatal outcomes of COVID-19 affected pregnant women in a tertiary care center of eastern India

Pregnancy is an immune-compromised state and pregnancy affected with COVID-19 infection is at a higher risk of adverse perinatal results. Data on feto-maternal outcomes in pregnancies infected with COVID-19 is sparse, which makes it difficult to draw conclusions on vertical transmission.To study the perinatal outcomes of covid-19 affected pregnant women.A prospective observational study was conducted over eighteen months, on 320 COVID-19 positive antenatal patients. Clinical manifestations of pregnancies with COVID-19, demographic profile, pregnancy outcomes were recorded. Important laboratory parameters were assessed along with COVID-19 inflammatory markers like serum ferritin,D-Dimer, CRP etc. Neonatal outcomes assessed included APGAR score, fetal deaths, birth weight, NICU admissions. Neonatal infections were screened by testing for SARS-CoV-2 positivity in neonatal throat swab samples.61.5% of patients complained of pain abdomen, followed by bleeding PV in 1.9%. 52.19% of the patients were asymptomatic for COVID-19 symptoms, followed by fever in 34.69%. Most common risk factor associated was hypothyroidism. Anemia was found in 22%, coagulation parameters were elevated in 30% and COVID-19 inflammatory markers were raised in more than 90% cases. Maternal and neonatal ICU admission rates were 4.69% and 30.34% respectively. Neonatal infection rate was 3.1%.COVID-19 was mainly seen in primigravida, without affecting the birth weight of babies. Coagulation profile and renal parameters were deranged in 30 percent of the patients, without any life any threatening complications. COVID-19 specific inflammatory markers showed derangement in more than 90% cases, although majority of them were asymptomatic. The rate of COVID-19 positivity among newborns was 3.1%.

Socioeconomic disparities and regional environment are associated with cervical lymph node metastases in children and adolescents with differentiated thyroid cancer: developing a web-based predictive model.

To establish an online predictive model for the prediction of cervical lymph node metastasis (CLNM) in children and adolescents with differentiated thyroid cancer (caDTC). And analyze the impact between socioeconomic disparities, regional environment and CLNM. We retrospectively analyzed clinicopathological and sociodemographic data of caDTC from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2019. Risk factors for CLNM in caDTC were analyzed using univariate and multivariate logistic regression (LR). And use the extreme gradient boosting (XGBoost) algorithm and other commonly used ML algorithms to build CLNM prediction models. Model performance assessment and visualization were performed using the area under the receiver operating characteristic (AUROC) curve and SHapley Additive exPlanations (SHAP). In addition to common risk factors, our study found that median household income and living regional were strongly associated with CLNM. Whether in the training set or the validation set, among the ML models constructed based on these variables, the XGBoost model has the best predictive performance. After 10-fold cross-validation, the prediction performance of the model can reach the best, and its best AUROC value is 0.766 (95%CI: 0.745-0.786) in the training set, 0.736 (95%CI: 0.670-0.802) in the validation set, and 0.733 (95%CI: 0.683-0.783) in the test set. Based on this XGBoost model combined with SHAP method, we constructed a web-base predictive system. The online prediction model based on the XGBoost algorithm can dynamically estimate the risk probability of CLNM in caDTC, so as to provide patients with personalized treatment advice.