High Level Of Risk Research Articles

The disparities in health risks of multiple pollutants through soil and dietary exposure in a rural-urban area based on accessibility method.

Rapid urbanization has resulted in disparities in environmental conditions for different communities in suburban area. This study presents a comprehensive investigation into the occurrence of pollutants in the soil and dietary food, and associated health risks in an urban-rural transitional area. The levels of potential toxic pollutants, notably metals, organophosphate esters (OPEs), and agrochemicals in surface soil and dietary food were evaluated. Higher levels of metals and OPEs were found in soils of industrial area, and agricultural soils had an elevated level of agrochemicals. The highest health risk was found for Chromium (Cr) which exceeded 1, indicating a high probability of adverse non-cancer effect to local residents. The levels of contaminants in food showed higher variability in community market and farmers' market than in supermarket, while higher levels of OPEs were found in food from supermarkets. The accessibility to fresh food mainly determined the differences in health risks of different communities. For dietary exposure, residents of industrial areas have higher levels of risk than other neighborhoods, mainly due to the possibility of exposure of foodstuffs with higher metal contents. In terms of market type, community markets mainly contributed to the comprehensive health risk through dietary exposure, especially for industrial and agricultural communities. The findings of this study provided further understanding of the spatial distribution of various contaminants as well as their health risks for different communities, which could guide the monitoring and management of potential toxic pollutants to safeguard public health in rural-urban transitional regions.

Prévention du risque thromboembolique de la fibrillation atriale dans le service de cardiologie d'Abidjan

IntroductionAtrial fibrillation is the most common cardiac rhythm disorder whose incidence with age and which is responsible for high morbidity and mortality. ObjectiveEvaluate the thromboembolic risk of patients with atrial fibrillation and analyze the quality of the oral anticoagulation therapy at the Abidjan cardiology institute. MethodsThis was a multicenter, retrospective and prospective cross-sectional study, with descriptive and analytical aims in 332 patients followed for atrial fibrillation diagnosed on the electrocardiogram. ResultsAverage age of 61 years (standard deviation = 16), with a female predominance with a sex ratio (M/F) of 0.93. The circumstances of discovery of atrial fibrillation were mainly palpitations (58.1%). Hypertension (57.8%). was the most frequently encountered comorbidity Underlying heart diseases were dominated by dilated cardiomyopathy (26.8%) and hypertensive heart disease (18.1%). The average CHA2DS2-VASc score was = 3.1 (standard deviation = 1.5) revealing a high level of thromboembolic risk (CHA2DS2-VASc score ≥2) in 76% of cases. The mean HAS-BLED score was =1.9 (SD =1.2).VKA were the main antithrombotic therapy prescribed in our patients and appeared of poor quality with a TTR <65% in the great majority of patients (93,75%) ConclusionAtrial fibrillation is a condition responsible for the occurrence of thromboembolic complications when antithrombotic management is not correct. In this instance good oral anticoagulation is the best treatment to instaure. VKA are the most prescribed OAC in our context.The evaluation of the quality of anticoagulation by vitamin K antagonist is essential by one of its most used indices is the time spent in the therapeutic zone (TTR).

Factors associated with a high level of suicide risk among patients with late-life depression: a cross-sectional study from a tertiary psychiatric hospital in Guangzhou China.

As global aging accelerates, depression among the elderly becomes more common. Research had revealed that patients with late-life depression (LLD) face a higher risk of suicide compared to their counterparts in other age groups, with the pathways to suicide being multifaceted. Thus, investigating the various factors linked to the elevated risk of suicide in patients with LLD is critical. To investigate the factors associated with a high level of suicide risk among patients with LLD. A total of 108 patients with LLD were recruited for this study. From October 2022 to November 2023, a cross-sectional study was conducted on patients with LLD from the Affiliated Brain Hospital of Guangzhou Medical University. Suicide risk was evaluated using the Chinese version of the Nurses' Global Assessment of Suicide Risk Scale (NGASR). Potential influencing factors were included and analyzed through multivariate linear regression to identify the factors associated with a high level of suicide risk among patients with LLD. The mean NGASR score among patients with LLD was 7.30 ± 4.34 (range: 0 ~ 19). Multiple linear regression analyses revealed that depression-anxiety of the Brief Psychiatric Rating Scale (BPRS) (β = 0.31, 95% CI = 0.13, 0.45, p<0.001), activation of the BPRS (β=-0.29, 95% CI=-1.22, -0.35, p<0.001), normal cognitive function of the Mini-Mental State Examination (MMSE) (β = 0.21, 95% CI = 0.50, 3.48, p<0.05), involuntary admission (β = 0.20, 95% CI = 0.44, 3.43, p<0.05), and objective support of the Social Support Rating Scale (SSRS) (β = 0.21, 95% CI = 0.08, 0.66, p<0.05) were statistically associated with a high level of suicide risk in patients with LLD. This study found that LLD patients with severe depression-anxiety, low activation, normal cognitive function, involuntary admission, and strong objective support exhibited a high level of suicide risk. These patients should receive intensified monitoring and comprehensive measures should be implemented to prevent the occurrence of suicidal behaviors during hospitalization.

Abstract 4138019: eQTL Analysis of the PAH Biomarker CCN2 Identifies a Novel SNP that Associates with Survival

Background: We recently determined that cellular communication network factor 2 (CCN2) (also known as IGFBP8) levels associate with metrics of severity, and survival, in pulmonary arterial hypertension (PAH). While genetic variants that modify CCN2 gene expression have been described, the variants across the genome that associate with CCN2 protein levels in human circulation remain unknown. Research Question: We sought to identify genetic variants associated with circulating levels of CCN2 and to determine those variants’ relationship with clinical severity and survival. Methods: Serum CCN2 was measured by ELISA in subjects from a national sample repository, the PAH Biobank. A genome wide association study (GWAS) for CCN2 (natural log transformed) was performed in White idiopathic PAH (IPAH) PAH Biobank participants (n = 768) using Illumina OMNI5 genotypes in plink after standard quality control. Subsequent exploration of the SNP of interest was conducted in a separate dataset of 687 White PAH participants (n=360 IPAH, n=313 APAH) linked to genetic and clinical data, including REVEAL 2.0 risk score assessment (divided into low, medium, and high-risk levels) and outcomes (the STRIDE (Sitaxsentan To Relieve Impaired Exercise) trials cohort). Results: In the PAH Biobank, using GWAS, we found CCN2 levels were significantly associated with rs9493157 (p = 2.8 x10 -12 ) ( Figure A ). rs9493157 is reported in the Genotype-Tissue Expression (GTEx) portal to be an eQTL for CCN2 expression in the left ventricle. In the STRIDE cohort, the hazard ratio (HR) for death was 1.33 (99% CI 1.03 to 1.72) for participants with one or more T alleles (p=0.027; ( Figure B )). On multivariate analysis, the HR for death was 1.28 (95% CI 0.99 to 1.66; p=0.060). Among subjects with the highest REVEAL2.0 risk, those with a T allele had worse survival than those no T allele, with best survival among those with low a REVEAL2.0 score and no T allele. Conclusions: In White PAH subjects, rs9493157 associates with human levels of serum CCN2, a known biomarker for PAH. While additional studies are warranted, the T allele associates with worse survival and may enhance the prognostic value of the REVEAL2.0 risk score.

Application of Capillary Barrier Systems for Slope Stabilization Under Extreme Rainfall: A Case Study of National Highway 10, India

Global warming has led to an increase in extreme rainfall events, which often result in landslides, posing significant threats to infrastructure and human life. This study evaluated the effectiveness of the Capillary Barrier System (CBS) in enhancing slope stability along a vulnerable section of India’s National Highway 10 (NH10) during maximum daily rainfall. The GEOtop model was employed to conduct water balance simulations and obtain the pore–water pressure (PWP), which was then used to calculate the Factor of Safety (FoS). Results showed that CBS effectively delayed the rise in PWP, leading to lower peak values and smaller areas of very high and high risk levels. Spatial distribution mapping further confirmed that CBS minimized very high risk zones. At three historical landslide points, CBS slopes generally maintained FoS values above 1, demonstrating enhanced stability and improved resilience to extreme rainfall. These findings highlight the potential of CBS as a viable strategy for slope reinforcement in regions susceptible to heavy rainfall.

Role and Impact of Safety Leadership Culture in Promoting Safety Practices in Construction Sector of Pakistan

The construction industry offers employment to about one hundred eighty million people worldwide. The construction sector has grown and evolved to meet the demands of urbanization and industrialization, which are the foundation of the modern economy. Construction is still seen as a risky and difficult industry, with the most hazardous and vulnerable work environment, even with the industry's notable improvements. Pakistan's construction industry is known for its high level of risk, which makes strict safety procedures necessary to protect the health and safety of its workforce. This research seeks to understand the impact of safety leadership on safety practices and identify key factors influencing safety culture. In order to provide comprehensive insights, the research uses a mixed-methods approach that combines quantitative surveys and qualitative interviews. The validity and reliability of the results are ensured by thorough experimentations of the statistical methods such as reliability test, relative importance index (RII), and descriptive analysis tests. In order to effectively promote safety practices, management commitment, employee involvement, safety training, and good communication are essential. An in-depth examination of the relationship between management commitment and safety performance reveals how effective leadership and proactive participation improve safety results. The results shows that safety leadership is crucial to encourage safety procedures in Pakistan's construction sector by 68.81%, success factor for safety management by 65.42%, safety management practices by 64.32%, safety performance by 63.35%, barriers to effective safety management 62.47% and safety culture by 61.46%. Strengthening frameworks for regulations, promoting a safety-first culture, investing more in safety equipment, improving worker safety training, improving monitoring and evaluation mechanisms, fostering communication and collaboration, and addressing cultural barriers are just a few of the recommendations.

Use of self-organizing maps for the classification of cardiometabolic risk and physical fitness in adolescents

This study aimed to automatically classify physical fitness and cardiometabolic risk in a Chilean adolescent using self-organizing maps. This cross-sectional study analysed a nationally representative database from the Physical Education Quality Measurement System (n = 7197). Physical fitness and cardiometabolic risk variables were derived from anthropometric indicators. Self-Organizing maps (SOM) were employed to identify participant profiles based on an unsupervised predictive model. After implementing and training the SOM, a detailed analysis of the generated maps was conducted to interpret the revealed relationships and clusters. The analysis resulted in three classification groups, categorizing the sample into low, moderate, and high-risk levels. Students with better physical fitness exhibited lower cardiometabolic risk levels and a lower body mass index. SOM, through an unsupervised model, is a reliable tool for classifying cardiometabolic risk and physical fitness in adolescents.

Age Stratification and Prognostic Factor Analysis in Pediatric Differentiated Thyroid Cancer.

Differentiated thyroid cancer (DTC) is rare in the pediatric population. It remains unclear whether younger children are at greater risk of more aggressive disease. We aimed to identify prognostic factors for aggressive pediatric DTC and to define an appropriate age stratification. This retrospective cohort study included all patients aged 18 years or less who were treated for DTC between 1985 and 2021 in a tertiary medical center and were followed up for a minimum of 1.5 years after treatment. Seventy-eight patients were included, all diagnosed with papillary thyroid carcinoma: 30 (38.5%) low-risk, 21 (26.9%) intermediate-risk, and 27 (34.6%) high-risk according to the American Thyroid Association (ATA) risk stratification. The mean duration of follow-up was 11.8 ± 7.8 years. No evidence of disease was documented in 52 patients (66.7%) at 1-year post-treatment and 64 patients (82.1%) at the end of follow-up. On analysis by age, evidence of disease at 1-year post-treatment was found in 66.7% of children younger than 11 years, compared to 25.4% of older children (p = 0.002). There was no significant difference by age in evidence of disease at the last follow-up (p = 0.453). Patients aged <11 years at diagnosis were associated with more aggressive disease features on histopathologic examination, metastatic disease, and high ATA risk level. Patients aged <8 years were associated with more frequent bilateral disease and extrathyroidal extension. Pediatric DTC patients who are younger than 11 years at diagnosis have more aggressive disease features and a lower early remission rate than older patients. Nevertheless, their long-term outcome is satisfactory. 4-retrospective cohort study Laryngoscope, 134:4818-4825, 2024.

Exploring the traits and possible ecological risks of heavy metals in biochars derived from rice husk and sugar beet pulp.

This research investigated the properties and potential environmental hazards associated with biochars derived from rice husk (RH) and sugar beet pulp (SBP), both of which are rich in heavy metals (HMs). The results indicated that the concentration of various HM fractions is significantly affected by the type of feedstock and the pyrolysis temperature. Specifically, the total concentrations of HMs in biochars produced at 600°C were found to be 10-140% higher than those in the original biomasses, a phenomenon attributed to the precipitation of HMs. Cd was a notable exception, exhibiting a reduction of 3-7% in the resultant biochars when compared to biomass, likely attributable to its volatilization. The results also revealed that the F1 + F2 fraction of HMs were largely transformed into F3 + F4 fraction during combustion, indicating that pyrolysis may reduce the ecotoxicity of HMs present in contaminated biomass. However, the process did not effectively diminish the F1 and F2 fractions of Cr and Cd. Elevated pyrolysis temperature significantly enhanced the reduction of HMs phytoavailability. Specifically, the phytoavailability of HMs in biochars produced at 600°C exhibited a decrease ranging from 10 to 92% when compared to the original biomass. Conversely, an unexpected rise in the phytoavailable fractions of Cr and Cd was noted in both RH and SBP biochars as the pyrolytic temperature increased, which correspondingly raised the potential ecological risk index (PERI). All materials analyzed exhibited a very high risk level, with PERI values exceeding 800, primarily due to the significant toxicity of Cd. Excluding Cd from consideration, the biomasses and their resultant biochars displayed PERI values ranging from 7 to 13. It is important to acknowledge that pyrolysis may not effectively diminish the environmental toxicity associated with HMs present in contaminated biomass, thereby limiting its safe application.

Spatial pattern, source apportionment, and source-oriented health risk quantifying of heavy metals in farmland soils of southern China.

The contamination of heavy metal has permeated many parts of China, especially in densely populated and industrialized southern China. This study focused on the degree of pollution in farmland soil heavy metals (HMs), and its spatial distribution characteristics and source apportionment. Meanwhile, we conducted an evaluation of the health risks attributed to soil HMs and analyzed the factors that impact them. We found that the distribution of five heavy metals is mainly concentrated in the east-central and southern parts of the study area. Specifically, Cd and Hg have high levels of pollution and present potential ecological risks. The pollution sources of five HMs were analyzed utilizing positive matrix factorization. The results revealed that the contribution of different sources keeps the following order: natural source (42.42%), agricultural activities (29.93%), industrial pollution source (20.49%), and atmospheric deposition pollution (7.16%). The non-carcinogenic risks to residents were acceptable, whereas the carcinogenic risks were relatively high. Children and the elderly are more vulnerable to the negative effects of Cr, As. Using structural equation modeling, we found soil property is a vital factor affecting soil contamination, with the soil organic matter and cation exchange capacity having a relatively greater impact on heavy metals pollution. Our study provides some data reference and guidance for soil ecological protection and restoration.

Analisis Tingkat Risiko Penyebab Rel Patah pada Jalur Kereta Api Wilayah Divre IV Tanjung Karang

The increase in the volume of passengers and goods in rail transportation in Indonesia has an impact on the condition of railway infrastructure, especially railway infrastructure. The main focus of this condition is the risk of rail damage, especially broken rails. So a holistic assessment approach is needed to identify the root causes and formulate appropriate treatment and improvement strategies. The aim of the research is to identify the factors causing the rail to break and analyze the causes. This research uses a risk level value analysis method by multiplying the results of probability and impact, thus producing a risk value. Risk variables such as extreme rain events, expansion in the alignment area, and mud pumping are high level risks. This is followed by medium, low and very low risks, according to the classification of each risk variable analyzed. Therefore, the priority scale for handling broken rail repairs is grouped based on the risk level value starting from the highest risk to the lowest risk. The conclusion is that risk variables such as extreme rain produce a risk value of IDR 296,881,200 with a probability value of 0.99% and an impact of IDR 29,988,000,000, expansion in the straight area produces a risk value of IDR 376,992,000 with a probability value of 1.10% and impact IDR 34,272,000,000, and mud pumping produces a risk value of IDR 394,128,000 with a probability value of 1.15% and impact IDR 34,272,000,000, these three risk variables are classified as high risk.

Environmental risks of plastic losses from landfills: A comparative study of divisional cities in Bangladesh

In Bangladesh, where nearly 95% of landfills are unsanitary or open dumps, these sites are significant contributors to environmental plastic pollution, making it a critical issue for the country. This study presents a framework to quantify the risk index of plastic losses from landfills across the eight major divisional cities of Bangladesh. The assessment focuses on three key components: hazard, exposure, and vulnerability. The hazard index is derived from local weather and climate data, exposure is evaluated based on the proximity of water bodies and urban areas, and vulnerability is measured using population, landfill, and waste production data. The study employs a Data Envelopment Analysis (DEA) approach to quantify and compare the levels of exposure, vulnerability, and overall risk among the cities. The results reveal that Sylhet is located in a severe hazard zone, Dhaka faces severe exposure and vulnerability, and Chittagong experiences very high levels of exposure and vulnerability. Overall, Dhaka is categorized as severe in risk, while Chittagong and Sylhet are classified as very high risk, with other cities at comparatively safer risk levels. Cities identified with severe to high-risk levels must urgently address plastic losses. This city-wise assessment provides valuable insights for urban planners and policymakers, enabling them to identify and prioritize cities in urgent need of interventions to mitigate environmental plastic losses, and to focus on the reduction, substitution, and management of plastics.

Risk Factors for Developing Occupational Back Pain in Electronics Industry Workers: A Cross-Sectional Study

Back pain is an occupation-related problem among workforces. This cross-sectional study aimed to identify the prevalence of back pain and the risk factors of occupational back pain among workers in the electronics industry. In total, 354 electronics workers in Thailand participated in the study. Data were collected using the Musculoskeletal Disorders Severity and Frequency Questionnaire, the Job Content Questionnaire, and ergonomics risk assessment via the Rapid Upper Limb Assessment (RULA). Risk factors of back pain were identified by multiple logistic regression analysis, providing adjusted odds ratios (ORadj) and 95% confidence intervals (95% CI). The study found that most workers were operators (92.09%) and had repetitive work (83.62%). A high ergonomics risk was observed in workers who stood during work (68.49%) and operated machines (71.70%). The 1-month prevalence of developing back pain was 20.62% and the significant factors correlated with back pain were low levels of job control and decision-making (ORadj = 2.26; 95% CI [1.26 ,4.05]), lack of exercise (ORadj = 8.30; 95% CI [1.35, 24.28]), repetitive work (ORadj = 2.94; 95% CI [1.19, 7.29]), and high ergonomic risk level (ORadj = 2.81; 95% CI [1.16, 5.07]). These findings suggest that measures should be implemented by empowering electronics workers to make decisions and control their jobs, as well as promoting health through muscle-stretching exercise, to support back pain prevention.

Multi-hazard risk assessment analysis in La Palma: an approach for risk mitigation

BackgroundLa Palma, like many regions of the world, may be affected by various hazards, with different levels of susceptibility, which have a greater or lesser impact on society. In this context, a multi-risk approached model capable of estimating the total risk faced by the territory is required, considering the different hazards to which it is exposed (floods, earthquakes, volcanic eruptions and landslides) and the different conditions of vulnerability of both the population and the exposed assets.MethodsThe methodology employed in this study has been referred to as "multilayer single hazard", which consists of the aggregation or superposition of hazards located in the same space. As usual, the identification of the individual hazard of each one of them was carried out using heterogeneous methods, which is why an index is proposed to homogenize the hazards and make them comparable with each other. On the other hand, the model also integrates a prototype to evaluate vulnerability from a multiple perspective (vulnerability by hazard) and shows the aggregated information in maps at a medium representation scale (definition of 250 m).ResultsThe risk integration results show that 5% of the island is at high risk levels. Simultaneously, the south of the island is presented as the area that shows the highest risk by combining a high hazard, especially related to volcanic hazards, and a high exposure, as it is home to a significant volume of population.ConclusionsThe proposed methodology is also interesting because it can be replicated in other areas of study.

A new framework for assessing and dealing with heat risk from an urban resilience perspective

Cities are exposed to increasing environmental threats, having undergone extensive land development and rapid urbanization. Clarifying the effects of urban resilience to risk can provide effective guidance for mitigating heat risk. To our knowledge; however, quantifying these effects from an urban resilience perspective has not been considered in previous studies. Here, we proposed the adaptation-resistance-response heat-related urban resilience assessment system. The system is integrated with the minimum cumulative resistance model to construct a novel heat risk assessment framework. A case study in Shenzhen, China, showed that resilience to heat had a high degree of spatial heterogeneity. More than half of the study area was at a moderate or high level of risk. Our study provided new insights into the differences in heat risk between urban and rural areas. The heat-risk gap between urban and rural areas was lower than that indicated by surface temperatures, due to the diffusion and attenuation of high temperatures. In addition, we discussed the application of resilience to risk governance and emphasize five governance models for risk zoning. The proposed framework facilitated a better understanding of the effect of resilience on risk mitigation, and our results can be used to guide urban planning and risk management.

Application of Earned Value Analysis Method and Earned Schedule Method to Time and Cost Control In Bank X Building Project

Construction projects are activities that must be completed within limited time and resources. This research aims to identify risky activities and make control efforts to reduce the level of hazard risk in the installation of steel box girder on the bridge. This research used a mixed methods approach, combining quantitative and qualitative methods. Data were collected through surveys and interviews with 60 respondents from 35 bridge projects. The results showed that there were 29 variables of work accident risk factors, including 3 variables with moderate risk levels, 24 variables with high risk levels, and 2 variables with extreme risk levels. The highest risk factors were mobilization that caused congestion and crane overturning during girder lifting that caused operators to fall. To reduce the risk level, efforts are made to ensure all work is done correctly, conduct regular safety inspections, and ensure an effective communication system in the installation of steel box girders on the bridge. The findings can serve as a basis for policy makers to develop better OHS regulations and guidelines, as well as provide valuable information for the development of more effective safety training programs for workers in the construction sector.

Optimal condition-based maintenance policy considering nested conditional value-at-risk and operational availability: A case study on semiconductor manufacturing equipment

To address concerns regarding economic risks and reliability issues in existing maintenance practices, this study introduces a novel condition-based maintenance model that considers failure risks in terms of both cost and availability. Utilizing a Markov decision process, this model determines inspection intervals and maintenance policies aimed at minimizing the nested conditional Value-at-Risk of cumulative costs while satisfying operational availability constraints. By applying this model to the plasma etching process, we demonstrate its effectiveness compared with existing maintenance models. Additionally, we found that higher risk levels do not necessarily lead to stricter maintenance policies, whereas achieving better operational availability incurs additional costs. These findings highlight the importance of balancing cost and availability risks when determining an optimal maintenance policy.

Preventing cardiovascular disease in at-risk patients: Results of a pilot behavioural health programme in general practice

Background The ‘High-Risk Prevention Programme’ (HRPP) involved a six-week health behaviour change programme based in general practices and aimed to address cardiovascular disease (CVD) risk in disadvantaged Irish communities. Objectives This pilot study aimed to establish the HRPP’s likely effectiveness and acceptability to inform the development of a future definitive trial. Methods The HRPP was conducted at six general practices in disadvantaged areas in the Ireland East region. Patients with high CVD risk were recruited by participating practices and were allocated to either a General Practice Nurse (GPN) or Health Promotion Professional (HPP) led programme focusing on positive health behavioural change. Baseline and 12-month follow-up data were collected to capture the HRPP’s likely effectiveness in promoting health outcomes and health behavioural change. Results The HRPP programme was completed by 270 patients. Out of these 270 patients, 245 (90.74%) completed baseline assessments, and 176 (65.19%) completed follow-up assessments at 12 months. Baseline data indicated a high level of CVD risk among patients and follow-up demonstrated positive change in several areas, especially weight (−1.95 kg, p < 0.001), BMI (−0.72, p < 0.001), exercise during the last week ( p <0.001), and consumption of healthy fats in the HPP group (+60%, p < 0.001). Conclusion The HRPP was a much-needed pilot intervention, and positive results were seen in both GPN and HPP arms, especially with regards to weight loss, exercise, and dietary improvements. Future definitive trials of the HRPP are likely to be effective and acceptable in terms of combatting these issues among high-risk patients.

Association between dietary fiber intake and chronic kidney disease in adults with and without hypertension in the United States: a cross-sectional study of NHANES 2009–2020

While previous research has highlighted the potential advantages of increasing dietary fiber intake (DFI) for managing hypertension and chronic kidney disease (CKD), there is a gap in large-scale empirical studies examining the relationship between DFI and CKD among hypertensive and nonhypertensive cohorts independently. This study involved 22,871 participants sourced from the NHANES database spanning 2009 to 2020, who were divided into hypertensive (n = 9,861) and nonhypertensive (n = 13,010) groups. The analysis revealed a significant inverse correlation between DFI and CKD prevalence across the sample after adjusting for various covariates (OR = 0.98, 95% CI: 0.97–0.99, p = 0.001). Within the subset of hypertensive individuals, this inverse association mirrors the findings of the overall sample, indicating that a higher DFI was associated with a reduced occurrence of CKD (OR = 0.97, 95% CI: 0.96–0.99, p < 0.001). However, this correlation was not detected in the nonhypertensive group (OR = 0.99, 95% CI: 0.98–1.01, p = 0.285). The RCS analysis further confirmed a pronounced nonlinear inverse relationship between DFI and CKD prevalence in both the entire cohort and the hypertensive group but not in the nonhypertensive group. Further scrutiny of the hypertensive group revealed that individuals with a higher DFI had 33% lower odds of CKD progression for the moderate risk level and 36% lower odds for the high to very high risk level. Subgroup analyses confirmed the consistency of these relationships across various demographics. In summary, this investigation revealed a significant inverse relationship between DFI and CKD prevalence in US adults with hypertension, a relationship not observed in nonhypertensive individuals.

Unaccompanied homelessness among high school students across ten states: prevalence and risk in multiple domains

ABSTRACT Unaccompanied homelessness during adolescence is a risk factor for varied poor outcomes, yet enumeration efforts struggle to provide feasible results and few analyses consider how risk might differ for this group. We consider data from the 2019 Youth Risk Behavior Survey from 10 states that asked about unaccompanied homelessness and sleeping arrangement. Students who experienced any form of homelessness were at higher risk for poor outcomes and other risk experiences. Few students reported both unaccompanied homelessness and usually sleeping in a homeless situation. Youth experiencing unaccompanied homelessness had higher risk for alcohol problems and lower risk for severe drug use and poor grades compared to students who experienced other forms of homelessness; otherwise they had similar levels of risk for poor outcomes. Results are consistent with the view that students who experience unaccompanied homeless are a distinguishable subpopulation of students who experience homelessness and are at high levels of risk of poor outcomes.