Dominant Risk Factor Research Articles

Associations of back muscle endurance with occupational back muscle activity and spinal loading among subsistence farmers and office workers in Rwanda.

Over the course of the physical activity transition, machines have largely replaced skeletal muscle as the source of work for locomotion and other forms of occupational physical activity in industrial environments. To better characterize this transition and its effect on back muscles and the spine, we tested to what extent typical occupational activities of rural subsistence farmers demand higher magnitudes and increased variability of back muscle activity and spinal loading compared to occupational activities of urban office workers in Rwanda, and whether these differences were associated with back muscle endurance, the dominant risk factor for back pain. Using electromyography, inertial measurement units, and OpenSim musculoskeletal modeling, we measured back muscle activity and spinal loading continuously while participants performed occupational activities for one hour. We measured back muscle endurance using electromyography median frequency analysis. During occupational work, subsistence farmers activate their back muscles and load their spines at 390% higher magnitudes and with 193% greater variability than office workers. Partial correlations accounting for body mass show magnitude and variability response variables are positively associated with back muscle endurance (R = 0.39-0.90 [P < 0.001-0.210] and R = 0.54-0.72 [P = 0.007-0.071], respectively). Body mass is negatively correlated with back muscle endurance (R = -0.60, P = 0.031), suggesting higher back muscle endurance may be also partly attributable to having lower body mass. Because higher back muscle endurance is a major factor that prevents back pain, these results reinforce evidence that under-activating back muscles and under-loading spines at work increases vulnerability to back pain and may be an evolutionary mismatch. As sedentary occupations become more common, there is a need to study the extent to which occupational and leisure time physical activities that increase back muscle endurance helps prevent back pain.

Fractures at various skeletal sites are dependent on different risk factors: the results from 10 years of prospective longitudinal observation in postmenopausal women from the RAC-OST-POL Study.

The aim of the study was to present data on risk factors for fractures in various parts of the skeleton in a cohort of postmenopausal women during a 10-year prospective observation period. It can be hypothesised that fracture risk factors should be different for spine, hip, and peripheral fractures. 640 postmenopausal women at mean baseline age was 65.0 ± 6.9 years were enrolled into the study. The cohort was randomly selected from the population of the entire Racibórz district. Data on the incidence of fractures and falls were updated annually during the 10-year follow-up period. Information on clinical risk factors for fractures was collected at baseline. During the observation period, 190 low-traumatic fractures were recorded in 129 patients. The following number of fractures was observed: hip 15, spine 30, non-hip fractures other than spine 145 (including 81 forearm fractures). The effect of falls was insignificant in the case of spine fractures (chi-square test: 3.64; p = 0.06). For all other skeletal sites, the incidence of fractures was significantly increased by falls, with the greatest effect observed for forearm fractures and non-spine and non-hip fractures (chi-square test for hip, forearm, and all non-spine, non-hip fractures was 6.43, p < 0.05; 42.7, p < 0.0001 and 66.7, p < 0.0001, respectively). To determine the factors having a significant impact on the incidence of fractures during the observation period, logistic regression was used separately in subgroups. The following risk factors were taken into account: age, height, body weight, bone mineral density (BMD) at the femoral neck as expressed by T-score, rheumatoid arthritis, steroid use, falls reported at baseline, and the total number of risk factors. Spine fractures depended only on T-score, odds ratio (OR) = 0.42 (0.23-0.76); hip fractures depended only on age, OR = 1.15 (1.07-1.24); forearm fractures depended only on age T-score, OR = 0.69 (0.51-0.92); and non-hip, non-spine on fall rate, OR = 1.86 (1.20-2.87). Fractures at various skeletal sites recorded in long-term follow-up in postmenopausal women were dependent on various risk factors. Multivariate analysis identified a single, dominant risk factor for each fracture location analysed.

Is decreased psoas volume a risk factor for hip fracture? A comparative study of patients with and without hip fractures using the exact matching technique

IntroductionSarcopenia is linked to increased fall and hip fracture risk. However, studies often overlook comprehensively controlling for age, sex, bone mineral density (BMD), and body mass index (BMI). Our study aimed to determine if sarcopenia, determined by evaluating the psoas muscle volume, is an independent risk factor for hip fractures. We employed a methodological approach that includes the exact matching technique. MethodsIn this cross-sectional comparative study, we compared the data of patients who sustained hip fractures between 2015 and 2021 with those of a control group from a health screening center in a single center. The study included 545 patients with hip fractures and 1292 without fractures. We collected data on demographics, BMD determined using dual-energy X-ray absorptiometry, and abdominal and pelvic computed tomography (APCT) scans for psoas muscle volume analysis. ResultsThe analysis after exact matching of 266 pairs revealed that psoas volume/height2 was the most significant and dominant risk factor among the evaluated indices. Multivariate logistic regression analysis, adjusting for age, sex, BMI, and BMD, identified height or height2-adjusted psoas muscle volume as an independent risk factor for hip fractures (p = 0.042 and p = 0.002, respectively). Age, female sex, lower BMI, and lower BMD were associated with an increased risk of hip fractures. ConclusionDecreased psoas muscle volume adjusted for patient height independently predicts hip fracture risk. Psoas volume assessment via APCT is a practical tool for identifying at-risk individuals, emphasizing the necessity of including sarcopenia in hip fracture risk assessments.

Thrombolysis exacerbates cerebrovascular injury after ischemic stroke via a VEGF-B dependent effect on adipose lipolysis.

Cerebrovascular injuries leading to edema and hemorrhage after ischemic stroke are common. The mechanisms underlying these events and how they are connected to known risk factors for poor outcome, like obesity and diabetes, is relatively unknown. Herein we demonstrate that increased adipose tissue lipolysis is a dominating risk factor for the development of a compromised cerebrovasculature in ischemic stroke. Reducing adipose lipolysis by VEGF-B antagonism improved vascular integrity by reducing ectopic cerebrovascular lipid deposition. Thrombolytic therapy in ischemic stroke using tissue plasminogen activator (tPA) leads to increased risk of hemorrhagic complications, substantially limiting the use of thrombolytic therapy. We provide evidence that thrombolysis with tPA promotes adipose tissue lipolysis, leading to a rise in plasma fatty acids and lipid accumulation in the ischemic cerebrovasculature after stroke. VEGF-B blockade improved the efficacy and safety of thrombolysis suggesting the potential use of anti-VEGF-B therapy to extend the therapeutic window for stroke management.

Determinants of Stunting in Indonesia: Investigating Key Factors Influencing Child Growth

Stunting is a condition of growth failure that occurs in children, especially those under the age of five, caused by chronic poor nutritional intake and recurrent infectious diseases. Stunting is a social problem that has an impact on child development and the achievement of human resource quality. This study employed a cross-sectional design to investigate stunting in children in Tapanuli Tengah Regency, North Sumatra, Indonesia. The sample consisted of 402 children from five districts, chosen for their focus on stunting prevention. Data collection involved mother interviews and measuring children's length/height-for-age indicators. The study examined a variety of family and child characteristics, including age, gender, father's occupation, family income, birth weight, birth length, and disease history. Multiple Logistic Regression is used to analyze the determinant impact of stunting events on children under five. It was found that 23.4% of stunted children in Tapanuli Tengah Regency. The results of the study show that there was a significant influence of birth length and history of illness on the incidence of stunting. History of illness is the dominant risk factor for stunting, with an odds ratio (OR) of 1.8 with a Confidence Interval (CI) value of 1.120-2. 895. This informs that children who have a history of illness are almost 2 times more likely to be stunted than children who do not have a history of the disease. This study highlights the prevalence of stunting in Tapanuli Tengah Regency and its association with birth length and a history of illness. Interventions to combat stunting should target improving birth length and addressing children's history of illness. These findings align with existing literature on stunting in Indonesia and underscore the need for targeted interventions. Stunting remains a critical public health concern in Indonesia, necessitating context-specific efforts in Tapanuli Tengah Regency

Analysis of Influencing Risk Factors of Nonsyndromic Unilateral Cleft Lip in South Sulawesi

Abstract Objective This study is to determine the most dominant risk factors for the potential occurrence of nonsyndromic unilateral cleft lip in South Sulawesi, Indonesia. Materials and Methods This is a retrospective study of several hospitals in South Sulawesi, Indonesia. An analysis was performed on the medical records of patients with nonsyndromic unilateral clefts. In the period from January 2018 to December 2022, risk factors include gender, parental education, family history of cleft lip and palate, maternal history of smoking or exposure to secondhand smoke, and consumption of drugs and alcohol during gestational age. The size of the sample is determined using the cluster sampling technique. Statistics uses chi-square test analysis and logistic regression for nominal variables. It uses SPSS Statistics version 25, with a value of p &lt; 0.05. Results The highest risk factor was found in patients with parents with a history of alcohol consumption during pregnancy and in patients with family history of cleft lip and palate, history of smoking or exposure to cigarette smoke, history of drug consumption, and gender. In comparison, parents' education level does not have a significant influence. Conclusion History of alcohol consumption during pregnancy, family history of cleft lip and palate, history of smoking or exposure to cigarette smoke, history of drug consumption, and gender are considered risk factors for nonsyndromic unilateral cleft lip in South Sulawesi, Indonesia.

Lymphovascular invasion is a dominant risk factor for lymph node metastasis in T2 rectal cancer.

Background and study aims Surgical resection is standard treatment of T2 rectal cancer due to risk of concomitant lymph node metastases (LNM). Local resection could potentially be an alternative to surgical treatment in a subgroup of patients with low risk of LNM. The aim of this study was to identify clinical and histopathological risk factors of LNM in T2 rectal cancer. Patients and methods This was a retrospective registry-based population study on prospectively collected data on all patients with T2 rectal cancer undergoing surgical resection in Sweden between 2009 and 2021. Potential risk factors of LNM, including age, gender, resection margin, lymphovascular invasion (LVI), histologic grade, mucinous cancer, and perineural invasion (PNI) were analyzed using univariate and multivariate logistic regression. Results Of 1607 patients, 343 (21%) with T2 rectal cancer had LNM. LVI (odds ratio [OR] = 4.21, P < 0.001) and age < 60 years (OR = 1.80, P < 0.001) were significant and independent risk factors. However, PNI (OR = 1.50, P = 0.15), mucinous cancer (OR = 1.14, P = 0.60), histologic grade (OR = 1.47, P = 0.07) and non-radical resection margin (OR = 1.64, P = 0.38) were not significant risk factors for LNM in multivariate analyses. The incidence of LNM was 15% in the absence of any risk factor. Conclusions This was a large study on LNM in T2 rectal cancer which showed that LVI is the dominant risk factor. Moreover, low age constituted an independent risk factor, whereas gender, resection margin, PNI, histologic grade, and mucinous cancer were not independent risk factors of LNM. Thus, these findings may provide a useful basis for management of patients after local resection of early rectal cancer.

Risk factors for hypertension in pregnant women in Indonesia: A cross-sectional study

Objective: To determine the risk factors for hypertension in pregnant women, which is a significant cause of maternal and newborn morbidity and mortality in Indonesia. Methods: This was a cross-sectional study used secondary data from the 2018 Indonesian Basic Health Research. Pregnant women aged 15-54 years in the second and third trimesters were eligible. The history of hypertension in pregnant women was the dependent variable. The independent variables consisted of the demographic characteristics of pregnant women including pregnancy age, gestational age, education, occupation, place of residence, and region of residence. This study used multivariate logistic regression to determine the risk factors for hypertension in pregnant women in Indonesia. Results: Among 6479 respondents included in this study, 11 (7.0%) had a history of diabetes mellitus (DM) and hypertension compared to pregnant women who did not have a history of DM (0.1%). The dominant risk factors for hypertension in pregnant women in Indonesia include maternal age above 35 years (OR 3.67, 95% CI 2.54-5.32), third-trimester pregnancy (OR 2.40, 95% CI 1.72-3.35), primigravida (OR 1.78, 95% CI 1.19-2.68), excessive consumption of salty foods (OR 1.44, 95% CI 1.03-2.03), and diabetes mellitus (OR 10.20, 95% CI 3.04-32.23). Conclusions: Great efforts must be made to increase public awareness about the dangers of hypertension in pregnant women through early diagnosis and treatment, education on sodium intake, and appropriate care for pregnant women with DM.

Factors Water Characteristic and Exclusive Breastfeeding as Predicting Diarrhea Under 5 Years

Background: The incidence of death diarrheal disease for children under 5 years are 5 million. The prevalence of diarrhea up to 24.8%. The exclusive breastfeeding for infants up to 6 months will provide immunity to against various diseases such as diarrhea. The proportion of Infants not exclusive breastfeeding up to 65.8%. Factors such as washing hands, consumption of drinking water are factors caused diarrhea in children. The study aims to known at the prediction of the risk of diarrhea and the dominant factors related the incidence of diarrhea in Kebumen District.Methods: The study design used case control. The population is mothers who have toddlers 1-4 years in the working area of Berbah Health Center Services was estimated 3,407 toddlers. The sample of case is a toddler who suffers from diarrhea and the control is a toddler who does not suffer from diarrhea in the surrounding environment. The sample was estimated of 50 cases of diarrhea and 50 control without diarrhea who qualified inclusion and exclusion criteria. The instruments were used questionnaires and medical records of diarrhea. Data were analysis with chi square test and logistic regression with 95% confidence interval.Result: Based on bivariate analysis shown that the exclusive breastfeeding was significant risk of diarrhea incidence OR = 3.22 (1.41-7.35). Based on Handwashing that the handwashing variable has no significant risk of diarrhea incidence OR = 1.792 (0.80-4.01). Based on multivariate analysis that exclusive breastfeeding significant caused diarrhea for children OR = 2.76 (95%CI: 1.18-6.47) whereas hand washing did not significantly cause diarrhea in children OR = 1.15 (95% CI: 0.66-3.64) and drinking water did not significantly affect diarrhea in children OR 2.19 (95% CI: 0.91-5.27).Conclusion: The study concluded that the dominant risk factor significantly for diarrhea in toddlers is exclusive breastfeeding.

The Burden of Chronic Diseases with the Status of Family Medical History Among Older Adults in India.

This study aims to assess and compare the prevalence of chronic diseases by the first-degree Family Medical History (FMH) and also explores the relationship between FMH and selected Non-communicable diseases (NCDs) among older adults in India. The present study collated secondary data from the Longitudinal Ageing Study in India (LASI, 2017-18). The eligible respondents for the analysis of this study were aged 45years and above, where the final study sample consistedof 65,562 older adults across all Indian states and union territories. The LASI dataset collected responses onself-reported diseases: Hypertension, Stroke, Heart disease, Cancer, and Diabetes. These diseases have a high prevalence among the population and are considered in the present study. Along with disease status, respondents' first-degree relatives FMH were used to fulfil the objective. Descriptive statistical analysis and multiple logistic regression techniques were used to accomplish the objectives analysis. This approach was chosen due to the binary nature of our primary dependent variables. The study found that the prevalence of selected NCDs was considerably higher among older adults with FMH than those without FMH. It revealed that NCDs and the status of FMH of parents and siblings were significantly associated. Based on the multivariate-adjusted model, we foundsignificantly higher odds for developing the NCDs when the respondents have FMH among at least one of the first-degree relative. The likelihood among those with FMHof having hypertension (AOR: 2.058), diabetes (AOR: 2.94), heart diseases (AOR: 2.39), stroke (AOR: 1.62) and cancer (AOR: 2.32) was higher compared to no FMH of respective diseases. Similarly, significant associations were observed according to the different stratification of the number offirst-degree relatives FMH. The present study demonstrated that first-degree relatives FMH is indeed a dominant associated risk factor for chronic disease among the older adults of India. This study supports the promotion of a disease history tool for chronic disease prevention and early detection approaches as a valuable measure of NCD risk. Public health practitioners can take several steps to access FMH and incorporate FMH into public health programs for the screening of the risk population.

The impact of diet, physical activity, and sleep habits on obesity risk among female teachers in Lhokseumawe City

Unhealthy living behaviors and the double workload of female teachers have led to lifestyle changes that have an impact on the risk of obesity. This study aimed to determine the influence of diet, physical activity, and sleep habits on the risk of obesity among female teachers in Lhokseumawe City. This cross-sectional design research was conducted in Lhokseumawe City from November 2023 to April 2024 on 289 female teachers using multistage random sampling. Eating patterns were measured using a semi-FFQ questionnaire, physical activity using the International Physical Activity Questionnaire (IPAQ), sleeping patterns using the Pittsburgh Sleep Quality Index (PSQI), and body mass index (BMI) using anthropometric measurements. Bivariate analysis uses the chi-square test and multivariate analysis with multiple logistic regression. The results show, Physical activity (p=0.023, RP=2.295) and fat intake (p=0.007, RP=0.484) influenced the incidence of obesity, whereas carbohydrate intake (p=0.622), energy (0.524), protein (0.225), type of food (0.066), and sleep patterns (0.138) did not affect the incidence of obesity among female teachers in Lhokseumawe City. Conclusion: Physical activity is a dominant risk factor for obesity. The risk of obesity was 2.295 times greater for female teachers who were not physically active.

The influence of patriarchal cultural factors on pregnancy complications (antepartum hemorrhage) at Mitra Medika General Hospital, Bandar Klippa, Indonesia

HIGHLIGHTS 1. Antepartum hemorrhage stands as one of the major contributors to maternal mortality globally. 2. Patriarchal culture is among the societal factors impacting maternal mortality rates.3. Patriarchal cultural factors associated with antepartum hemorrhage are examined to establish effective preventive measures. ABSTRACT Objectives: The objective of this study was to determine the influence of patriarchal culture on the occurrence of antepartum hemorrhage at Mitra Medika General Hospital. Materials and Methods: This study employed an analytical observational design with a case-control approach. The sample for this study included pregnant women in their third trimester and mothers who had given birth within a maximum of 4 months from the time of the study at Mitra Medika General Hospital, Bandar Klippa, Indonesia. There were 90 respondents, comprising 30 case groups and 60 control groups. The sampling method for the case group used quota sampling, while the control group utilized accidental sampling. The research instrument utilized questionnaires and secondary data (antepartum hemorrhage diagnoses). Data analysis employed the chi-square test for bivariate analysis and multiple logistic regression for multivariate analysis, with a significance level of 0.05. Results: There was a significant relationship between decision-making (p=0.030), family support (p=0.003), psychological domestic violence (p=0.024), and sexual domestic violence (p=0.039), no relationship with physical domestic violence (p=0.257) with the occurrence of antepartum hemorrhage. Multivariate analysis revealed that the family support variable was the most dominant risk factor with an Exp (B) value of 8.230 in causing antepartum hemorrhage. Conclusion: The patriarchal cultural factors that significantly affect antepartum hemorrhage at Mitra Medika General Hospital, Bandar Klippa, Indonesia, are decision-making, family support, psychological domestic violence, and sexual domestic violence.

Evaluating the integration of CTCA as part of an accelerated diagnostic pathway for patients presenting to the Emergency Department with acute chest pain: a two-year review

Abstract Introduction Chest pain accounts for 8.8% of all presentations to an Hospital Emergency Department. In line with ESC guidelines (2019), an adapted HEART pathway, utilising CT Coronary Angiogram (CTCA) is delivered by our Emergency Cardiology Advanced Nurse Practitioners (ANP) and Clinical Nurse Specialists (CNS) as part of an ambulatory chest pain pathway. It is our first line diagnostic test for patients with a non-ischaemic 12-lead ECG and normal cardiac biomarkers, with a low-to-intermediate HEART score. Responsibility for the referral of patients onto the pathway is shared with the Cardiology Registrars. This is a collaborative interdisciplinary pathway between Emergency Medicine, Cardiology, and Radiology. Purpose To evaluate the effectiveness and safety of CTCA as part of an Accelerated Diagnostic Pathway (ADP), for evaluation of chest pain of possible cardiac origin in low-to-intermediate risk chest pain patients. Methods We examined the CTCA and safety outcomes of patients presenting between Jan 1st 2022 – Dec 31st 2023 who were risk stratified as low-to-intermediate risk for coronary artery disease, based on Heart score, 12-lead ECG and biomarker testing, using the electronic patient records. Institutional ethics was in place. Results Between January 1st and December 31st 2022, 290 patients were referred for CTCA, with a total of 268 CTCAs completed. The number of patients referred on the ADP increased by 53.4% in 2023 with 445 being referred for CTCA, 416 of which have been completed, with 12 pending completion. 38% of patients were found to have evidence of coronary artery disease (CAD). Coronary artery disease causing at least 50% stenosis was identified in 11% of patients. 4.5% of these patients required revascularisation, 17 of whom underwent Percutaneous Coronary Intervention (PCI) with a further 13 being referred for Coronary Artery Bypass Grafting. A positive family history was the most dominant risk factor associated with significant CAD. An equivalent number of males to females were referred for CTCA, however, men were more than 7 times more likely to have severe disease. (12% vs 88%). All patients referred for CTCA via the chest pain pathway were followed up by the Emergency Cardiology ANP/CNS in a virtual clinic, delivering risk factor modification advice and preventative therapies, when indicated. There was no evidence of any major adverse cardiovascular events within a 30-day period for this patient cohort. Conclusion The integration of CTCA into an adapted HEART pathway has resulted a safe and timely discharge for patients presenting to ED with acute chest pain, of possible cardiac origin. CTCA offers excellent early detection of coronary artery disease in this patient cohort with normal ECGs and cardiac biomarkers, but with a history of chest pain suggestive of CAD.

Health Risk Assessment of Heavy Metal(loid)s in the Overlying Water of Small Wetlands Based on Monte Carlo Simulation.

Heavy metal(loid) (HM) contamination is a significant threat to wetland ecosystem. However, contamination risks of HMs in overlying water of small wetlands, which are easily ignored because of their minor occupancy in an overall area, are nearly unknown. A total of 36 water samples containing six HMs were collected from the urban and rural small wetlands of Urumqi in China, and the contamination levels and probabilistic health risks caused by HMs were assessed using the Nemerow pollution index (NPI) and the health risk assessment model introduced by the US EPA. The results revealed that the average concentration of Hg in the urban and rural small wetlands surpassed the Class II thresholds of the Environmental Quality Standards for Surface Water (GB 3838-2002) by factors of 3.2 and 5.0 times, respectively. The overall contamination levels of HMs in the small wetlands fall into the high contamination level. Results of a health risk assessment indicated that non-carcinogenic health risk of the investigated HMs are found to be lower than the acceptable range for adults, but higher than the acceptable range for children. Meanwhile, As falls into the low carcinogenic risk level, whereas Cd falls into the very low carcinogenic risk level. Overall, HMs in rural small wetlands showed relatively higher contamination levels and probabilistic health risks than that of urban small wetlands. In addition, As was identified as the dominant health risk factor in the overlying water of small wetlands in the study area. Findings of this study provide scientific support needed for the prevention of HM contamination of small wetlands in arid zones.

Risk Factor Analysis of Stunting in Children Aged 6-23 Months in Tanralili District, Maros Regency, Indonesia

Background: The high rate of stunting is still a nutritional problem in children in Indonesia which has an impact on the quality of future generations. The study aims to determine the risk factors for stunting in children aged 6-23 months in Tanralili District, Maros Regency. Methodology: This study used a case control study design. The sampling technique uses the side exhaustive method with a ratio of 1: 1, as many as 260 samples consisting of 130 cases and 130 controls. Stata program version 17 is used for data analysis. Results: Risk factors associated with stunting were maternal age &lt;20 or 35 years (OR=1.953), lower-middle family income (OR=1.947), antenatal care &lt;4 visits (OR=1,820), anemia (OR=2.252), chronic energy deficiency (OR=2.261), low birth weight (OR=2,595), exclusive breastfeeding (OR=2.448), poor home sanitation (OR=2.226;). Working mothers are a protective factor against stunting (OR=0.819). Multivariate analysis shows that exclusive breastfeeding is the dominant risk factor for stunting. Conclusion: Risk factors for stunting come from mother, child, as well as environmental and family economic factors. The need for integrated and multisectoral programs to increase family income, access to proper home sanitation, maternal education on pregnancy and nutrition and exclusive breastfeeding to reduce the incidence of stunting.

Pollution and Health Risk Assessment of Potentially Toxic Elements in Groundwater in the Kǒnqi River Basin (NW China).

Potentially toxic elements (PTEs) pose a significant threat to the groundwater system and human health. Pollution and the potential risks of PTEs in groundwater in the Kǒnqi River Basin (KRB) of the northwest arid zones of China are still unknown. A total of 53 groundwater samples containing eight PTEs (Al, As, Cd, Cu, Mn, Pb, Se, and Zn) were collected from the KRB, and the pollution levels and probabilistic health risks caused by PTEs were assessed based on the Nemerow Index (NI) method and the health risk assessment model. The results revealed that the mean contents of Al, As, and Mn in the groundwater surpassed the Class III threshold of the Standard for Groundwater Quality of China. The overall pollution levels of the investigated PTEs in the groundwater fall into the moderate pollution level. The spatial distributions of contents and pollution levels of different PTEs in the groundwater were different. Health risk assessment indicated that all the investigated PTEs in groundwater in the KRB may pose a probabilistic non-carcinogenic health risk for both adults and children. Moreover, As may pose a non-carcinogenic health risk, whereas the non-carcinogenic health risk posed by the other seven PTEs in groundwater will not have the non-carcinogenic risks. Furthermore, As falls into the low carcinogenic risk level, whereas Cd falls into the very low carcinogenic risk level. Overall, As was confirmed as the dominant pollution factor and health risk factor of groundwater in the KRB. Results of this study provide the scientific basis needed for the prevention and control of PTE pollution in groundwater.

Prevention of Dengue Fever Based on Dominant Risk Factors within Elementary School Environment in Bandung City

Background: Dengue fever is an environment-based disease that is endemic in Bandung City. Bandung City with an average temperature of 25.86°C has a humid and cool climate which is a favorable environment for Aedes aegypti. The average amount of rain per day is 21.3 days per month with an average rainfall of 200.4 mm. These environmental conditions favor the breeding of Aedes aegypti. Objective: The study aimed to obtain the dominant variables in the 3M Plus PSN.Penelitian ini merupakan penelitian kuantitatif dengan desain cross sectional. Method: The population in this study were all elementary school students in Bandung City. Through the Cluster Sampling calculation, 973 minimum samples from 13 elementary schools were obtained. With a minimum sample for each elementary school totaling 76 6th-grade students. Results: The results of the study showed that a Knowledge P-value of 0.023, Attitude P-value 0.036, Perception P-value of 0.000, and motivation P-value of 0.018 were associated with DHF Prevention through 3M Plus PSN. Exposure to information media on dengue prevention through the 3M Plus PSN is not associated with dengue prevention through the 3M Plus PSN. The variable that most influenced the prevention of Dengue Fever through the 3M Plus PSN was perception with a P-value of 0.000 CI of 2.118 (1.639-2.737). Conclusion: Knowledge, perception, attitude, and motivation are related to dengue fever prevention through 3M Plus PSN. Perception is the most dominant factor associated with the prevention of dengue fever through the 3M Plus PSN.

Analysis Of Risk Factors For The Incidence Of Sexually Transmitted Infections Of Gonorrhea In Male Patients At Hitam Putih Clinic In Gorontalo

Gonorrhea is a sexually transmitted infection (STI) that occurs most frequently throughout the world every year and is the second most common infection caused by bacteria. This study aimed to analyze the risk factors including education, employment, marital status, alcohol consumption status, sexual practices history, condom use behavior, and the most dominant risk factors for the incidence of sexually transmitted infections (STIs) of Gonorrhea in male patients at the Hitam Putih Clinic in Gorontalo. The research design employed was an analytical observational approach with a case-control design. The sample in this study comprised 33 male patients with gonorrhea and 66 male control patients with non-gonorrhea, matched based on patients’ age. Data were analyzed using Odds Ratio (OR) with a 95% Confidence Interval (CI) in the Mantel-Haenszel test. If the OR value was &gt; 1 and the p-value was ≤ α (0.05), it meant that the factor increased the risk. Factors include educational background (OR=1.963; p=0.120), employment status (OR=3.077; p=0.01), marital status (OR=2.870; p=0.02), alcohol consumption status (OR=4.080; p =0.03), sexual practices history (OR=21.350; p=0.000), condom use behavior (OR=4.389; p=0.007) were risk factors for gonorrhea, where sexual practices history (OR=35.704; p=0.000) stood out as the most dominant risk factor. Therefore, those variables represented significant risk factors for the occurrence of Gonorrhea among male patients in the Hitam Putih Clinic in Gorontalo. Educational background, employment status, marital status, alcohol consumption status, sexual practices history, and condom use behavior are the risk factors of gonorrhea where the sexual practices history stands out as the most dominant risk factor.

Zika Virus Infection Knowledge and Communication Preferences Among Women of Reproductive Age in Central Brooklyn, New York: A Thematic Analysis.

The 2016 outbreak of Zika virus (ZIKV) infected millions and resulted in thousands of infants born with malformations. Though the clusters of severe birth defects resulting from this outbreak have subsided, ZIKV continues to be a concern throughout much of Latin America and the Caribbean. Travel and sexual intercourse remain the dominant transmission risk factors for women of reproductive age and their partners. This is particularly true for communities in Brooklyn, New York, that comprise large immigrant and foreign-born populations. Practitioners of public health understand little about how women at risk for ZIKV are most likely to receive information about the virus or who they trust most to provide that information. In the context of five focus group discussions, this study explored the knowledge and communication preferences of 20 women of reproductive age in Central Brooklyn. Results derived from a thematic analysis suggest that while most women are familiar with mosquitos as ZIKV vectors, knowledge of sexual transmission is considerably lower. Many respondents believe that only women who are pregnant or trying to become pregnant are at risk, and public health agencies, such as the U.S. Centers for Disease Control and Prevention, remain the most trusted sources of information. These findings can support more effective communication about the risks of ZIKV infection and other vector-borne diseases to women in New York City and similar urban communities.

Causal relationships between circulating metabolites and rheumatoid arthritis: A mendelian randomization study

BackgroundBlood metabolites serve as pivotal indicators in identifying and predicting the course of rheumatoid arthritis (RA). However, empirical substantiation of a direct causal link between these serum biomarkers and the development of RA is still lacking comprehensive support. MethodIn pursuit of a thorough exploration of the causal links between circulating blood metabolites and RA, we deployed a two-sample Mendelian randomization (MR) approach during our initial investigative phase. This method was utilized to examine the potential connections between 249 distinct circulating metabolites and the prevalence of RA. In the validation phase, we conducted replication analyses with a new metabolic dataset consisting of 123 metabolites. Furthermore, we employed the Mendelian randomization based on Bayesian model averaging (MR-BMA) technique to pinpoint key metabolic characteristics that have significant causal implications. ResultsIn our primary analysis, we found that acetate, acetoacetate and pyruvate exhibited a consistent protective causal association with rheumatoid arthritis, while lactate demonstrated a positive correlation with rheumatoid arthritis risk. It is also noteworthy that a substantial subset of traits related to both saturated and unsaturated fatty acids showed causal influences. Subsequent secondary analyses substantiated these observations, revealing that traits associated with the average number of methylene groups in a fatty acid chain exhibited protective effects. Ultimately, our MR-BMA analyses unveiled that the ratio of polyunsaturated fatty acids (PUFAs) to total fatty acids assumes a paramount role in increasing the susceptibility to rheumatoid arthritis. ConclusionsBy employing systemic MR analyses, our study has successfully generated an all-encompassing atlas elucidating the intricate connections between circulating metabolites and the susceptibility to rheumatoid arthritis. Our results indicate the high unsaturation degree is a dominant risk factors correlated with rheumatoid arthritis.