Identification Of Factors Research Articles

Childhood cardiometabolic risk factors associated with the perinatal environment of the maternal-paternal-child triad.

Clustering of cardiometabolic risk factors in childhood significantly increases the risk of atherosclerotic cardiovascular disease later in life. Identification of modifiable parental factors that contribute to offspring cardiometabolic health is critical for the prevention of disease. The objective was to identify factors associated with child cardiometabolic risk factors at age 5 years. Triads from a longitudinal cohort were recalled at 5 years (n = 68). Dietary intake, anthropometrics, physical activity and serum-based risk factors were collected. Best subset selection, linear and logistic regressions were used to identify triad variables associated with increased risk of cardiometabolic risk factor clustering at age 5 years. In this cohort, best subset modelling revealed that increased paternal fat mass, serum low-density lipoproteins and triglycerides, maternal dietary added sugar and being female were associated with increased odds of offspring having two or more cardiometabolic risk factors at age 5 years. Dietary and exercise interventions prior to conception targeting paternal adiposity and dyslipidaemia as well as maternal dietary habits could decrease children's cardiometabolic risk in later life.

Exploring the critical factors influencing the severity of maritime accidents via multinomial logit model with adaptive sparse group lasso penalty

Identifying the most influential factors affecting the severity of maritime accidents is crucial for developing effective strategies to reduce accident losses. However, this task is challenging due to the complex interactions between influencing factors and the presence of numerous irrelevant and redundant factors. As a new effort, this paper proposes a multinomial logit model with adaptive sparse group lasso penalty (MLASGL) to identify critical factors influencing the severity of maritime accidents. To fully illustrate the effect of complex interactions on severity, factor importance is initially evaluated using association rule mining and complex networks. Subsequently, adaptive weights are constructed based on the factor importance evaluation, followed by proposing an adaptive sparse group lasso that can impose a greater penalty on the noise factors. Additionally, considering that severity as a decision-making objective is often a multi-categorical variable, the multinomial logit is utilized to portray the relationship between the influencing factors and severity. Simultaneously, the negative log-likelihood function of the multinomial logit model is incorporated into the proposed adaptive sparse group lasso to eliminate irrelevant and redundant factors, thereby realizing the identification of critical factors. Finally, the feasibility and superiority of the proposed method are demonstrated by analyzing a real maritime accident dataset.

C-repeat binding factor (CBF) identification and expression pattern to abiotic stress response in Casuarina equisetifolia and overexpression of CeCBF4 increase stress tolerance in Arabidopsis

Casuarina equisetifolia stands out as a highly valuable tree species crucial for industries and ecological restoration projects in tropical and subtropical regions, owing to its exceptional salt resistance. However, its growth is hampered in cold and drought-prone areas. Understanding the genetic basis for abiotic stress tolerance is imperative for enhancing stress-resistant breeding efforts of C. equisetifolia. However, the CBF genes are renowned for their pivotal roles in cold response and broad resilience to other adverse environments, such as drought, and high salinity. In this study, five CeCBFs were identified from the genome of C. equisetifolia. CeCBF1 and CeCBF3 belong to Clade I group, which diverged early from DREBIII members, while CeCBF2, CeCBF4, and CeCBF5 are classified into Clade II, a group innovated from Clade I. These genes lack introns in their sequences. The proteins encoded by CeCBFs feature classic AP2 domains and CBF signature sequences, localize in the nucleus and exhibit transactivation activity. Additionally, stress-related, abscisic acid, and jasmonic acid responsive elements are present on the CeCBFs promoters. Expression analysis revealed that CeCBFs were prodominantly induced by cold, drought, and salinity treatments, except for CeCBF1, which showed repression specifically under low temperature. Moreover, CeCBF1, CeCBF4, and CeCBF5 were inhibited by abscisic acid, while CeCBF1 showed reduced transcript levels in response to methyl jasmonate treatment. Furthermore, overexpression of CeCBF4 enhanced tolerance to low temperature, depriving of water, and salt by up-regulating stress-responsive genes expression and promoting proline accumulation, albeit with a trade-off in growth and productivity. Hence, CeCBFs emerge as potential regulators contributing significantly to stress tolerance mechanisms in C. equisetifolia.

Whole exome sequencing identifies risk variants associated with intracranial epidermoid cyst deterioration: A case report

BACKGROUND Intracranial epidermoid cyst (IEC) transformation to malignant squamous cell carcinoma (SCC) is extremely rare, and its etiology is yet unknown. Currently, SCC is treated by performing surgery, followed by a combination of radiotherapy and chemotherapy. It is crucial to identify efficient and trustworthy therapeutic targets for SCC to improve its diagnosis, prognosis, and treatment. CASE SUMMARY In this study, we report the case of a 47-year-old female patient with SCC, which progressed from IEC in the left internal capsule region. The patient was sought treatment at our hospital for severe diplopic vision, accompanied with speech disorder and memory loss. Based on the clinical and postoperative pathology, this patient was finally diagnosed with SCC. To identify disease-causing variants, whole exome sequencing (WES) was performed on the proband. WES revealed two pathogenic missense mutations on Gap junction protein beta 2 (GJB2) (c.257C>T) and Toll-like receptor 2 (TLR2) (c.1039A>G), respectively. CONCLUSION This study provided the first clinical evidence for demonstrating the role of GJB2 and TLR2 in IEC development and treatment. We further confirmed WES as a robust and reliable technique for underlying rare and complex disease-related genetic factor identification.

Review on assessing climate-change-induced risks to run-of-river hydropower infrastructure in Nepal

Abstract. Nepal annually invests millions of dollars in hydropower development, with a substantial portion of these funds allocated to civil infrastructure. Climate change, which impacts geological and hydrological conditions, poses a threat to civil components throughout hydropower project construction and operation. This causes budget overruns, project delays, and adverse consequences for society and the environment, ultimately resulting in multimillion-dollar losses. The identification of risk factors and their underlying causes, stemming from the impacts of climate change, constitutes a fundamental aspect of this study. This critical analysis primarily draws upon extensive literature reviews to pinpoint these factors (risk factors arising from climate change), emphasizing their economic and human impacts. This paper highlights the risks to run-of-river hydropower infrastructures in Nepal. The findings of the study can be used to develop and implement adaptation strategies to mitigate the risks posed by climate change to Nepal's vital hydropower sector.

When Hope Fades: Considering Self-Esteem, Depression, Social Support, Loneliness in The Context of Suicide Prevention

Individuals engaging in suicidal ideation or making suicide attempts are a substantial demographic group to investigate preventive mental health due to inherent high risks associated with potential outcomes of suicidal behaviors for public health. Factors increasing the likelihood of suicide might include self-esteem, depression, social support, loneliness, or certain demographic profiles, and the purpose of this study is to synthesize these variables to advocate for effective strategies to intervene in cases of suicide. Specifically, this commentary aims to identify suicidal coping mechanisms and psychological resilience factors among suicidal individuals through the enhancement of self-esteem, intervention of depressive symptoms, and promotion of connectedness. Through discussing the determinants that might play a role in the onset of suicidal thoughts and suicide attempts, this paper has important implications for suicide prevention strategies and the identification of psychological resilience factors that can predict suicidal thoughts and suicide attempts in individuals.

Identification of risk factors for necrotizing enterocolitis in twins: a case-control matching analysis of over ten-years' experience.

The identification of risk factors is crucial for the clinical prevention and diagnosis of necrotizing enterocolitis (NEC). Monochorionic twins (MCT), due to the high genetic homogeneity, provided a valuable model for investigating the risk factors of various diseases. This study aimed to explore the risk factors for NEC using MCT. A retrospective review was conducted on the medical records of monochorionic twins (MCT) treated at Guangzhou Women and Children's Medical Center from January 2012 to March 2023. We compared perinatal condition, feeding and preceding condition between MCT pairs with NEC (NEC MCT) and without NEC(No NEC MCT).Logistic regression analysis was utilized to identify independent risk factors. In 85 pairs of monochorionic twins (MCT), NEC occurred in one twin in 78.8% of cases, whereas both twins were affected in 21.2% of cases. In the final cohort of 60 pairs of MCT, several parameters were found to differ significantly between NEC MCT group and No NEC MCT group. Compared to No NEC MCT group, the incidence of umbilical cord abnormalities was significantly higher in the NEC MCT group (25% vs. 8.3%, P = 0.014). Meanwhile, NEC MCT group showed higher prevalence of SGA infants (48.3% vs. 21.7%, P = 0.002) and sFGR (38.3% vs. 6.7%, P = 0.000). Furthermore, TTTs (13.3% vs. 3.3%, P = 0.027) and septicemia (25% vs. 5%, P = 0.002) were more common in NEC MCT group. In a multivariable logistic regression model, sFGR (OR 6.81,95%CI 2.1-21.9, p = 0.001) was eventually output as an independent risk factor. Non-genetic factors play a predominant role in the pathogenesis of NEC. Umbilical cord abnormalities, SGA, sFGR, TTTs and septicemia significantly increase the risk of NEC. sFGR is an independent risk factor of NEC.

Sport, Choice and Social Class: Reading Indian Female Sports Life Writings

Sports form a continuous part of any culture, created and sustained for entertainment, pleasure, competition and bonding; founded on certain standards, interests, requirements, and resources of the sports community. Yet, the classification of some sports as ‘elite’ goes unrecognised simply because it appears to be natural and moreover it is always ‘how things are’. Traditional theories of class indicate that economic differentiation is the reason for various choices in the society. On the other hand Bourdieu has suggested that economic capital is not the only element influencing one’s choice and there are other multiple non-economic criteria too. Taking into account Bourdieu’s class concepts we seek to identify the non-economic factors that have led sportspersons in India to their choice of sport. Narrative analysis is performed for autobiographies of two female sportspersons, Saina Nehwal and Mary Kom, to highlight the different parameters that have influenced their choice of sport. The identification of such non-economic factors like a person’s mental strength, level of angst, resilience, emotional and financial well-being, and others, provide insight into the stratifications that impact sports culture in India.

Insights into fetomaternal outcomes in pre-eclampsia: A tertiary care center descriptive study

Preeclampsia and eclampsia remain significant challenges in both maternal and perinatal health worldwide, with a pronounced impact in regions such as India, where access to comprehensive maternal care can be limited. The objective of this study was to examine the outcomes for both mothers and babies, along with the complications linked to severe cases of preeclampsia and eclampsia, within a tertiary healthcare facility situated in South India. : Sixty-five pregnant women diagnosed with severe preeclampsia or eclampsia were enrolled in this descriptive observational study conducted at a tertiary care teaching hospital, Chennai, spanning from March 2023 to December 2023. Inclusion criteria comprised women with singleton pregnancies exhibiting severe preeclampsia (defined by blood pressure ≥160/110 mmHg and 1+ or more albuminuria) or eclampsia. Exclusion criteria included chronic hypertension, multiple pregnancies, chronic renal disease, connective tissue disorder, neurological complications, and refusal of consent. Data on sociodemographic variables, obstetric characteristics, maternal symptoms, and complications were collected using a structured questionnaire. Maternal and fetal well-being were assessed through biochemical, radiological, and nonstress tests.: The results revealed that 80% of the study population with severe preeclampsia or eclampsia fell within the age group of 21-30 years, with 49.2% aged between 26-30 years. Majority (60%) were primigravida. Common maternal symptoms included headache (60%), oedema (76.9%), with fewer experiencing epigastric pain (3.1%) and vaginal bleeding (15.4%). Complications observed were HELLP syndrome (12.35%), placental abruption (7.7%), and eclampsia (10.8%). Perinatal outcomes included intrauterine fetal death (4.6%), fetal growth retardation (23.1%), low birth weight (30.8%), respiratory distress syndrome (4.6%), and stillbirth (1.5%), with 35.4% being normal births.This study emphasises the substantial impact of severe preeclampsia and eclampsia on the health of both mothers and fetuses, underscoring the importance of thorough antenatal care, prompt identification of risk factors, and timely interventions to minimise negative consequences. There is a clear call for additional research to investigate and implement effective strategies for prevention and management, aiming to decrease the morbidity and mortality rates associated with these hypertensive disorders during pregnancy.

Determination of Factors Affecting Wage Differentiation in EU Countries

This study aims to identify the determinants of wage differentiation in European Union (EU) countries using panel data analysis. The literature review provides an overview of previous studies on wage differentiation, the current situation of wage differentiation in the EU, and the potential determinants and consequences of wage differentiation. The analysis shows that many potential variables influence wages and that direct modeling is problematic. However, the application of factor analysis led to the identification of significant factors, namely the economic strength of a country, the level of digitalization and working conditions, investment, and the unemployment rate. These findings are consistent with the existing literature. The robustness analysis of the results is provided. The conclusion offers recommendations for increasing wages based on the research results.

Outcomes within 100 days of hematopoietic cell transplantation in pediatric patients: insights from an intensive care unit in Colombia

IntroductionHematopoietic cell transplantation (HCT) has become an essential therapeutic modality for pediatric patients with malignant and non-malignant conditions. Despite its effectiveness, many patients experience post-transplant complications often leading into life-threatening conditions requiring specialized care in a Pediatric Intensive Care Unit (PICU). This study aims to describe clinical characteristics associated with mortality in pediatric HCT patients who needed PICU care within 100 days post-transplant in a resource-limited country.MethodsA retrospective cohort study was conducted involving pediatric HCT patients (<18 years old) admitted to our PICU from January 2012 to December 2021. Variables were characterized according to their nature, employing appropriate measures of central tendency and dispersion. The relationship between mortality and patient clinical characteristics was assessed using the Chi-square test or the Mann-Whitney U test, as applicable. A p-value of <0.05 was considered statistically significant. A Kaplan Meier survival curve was performed considering the days from HCT to death during PICU admission and a Cox regression analysis was conducted to analyze the association between PRISM III score and risk of death. Data analysis was executed utilizing the STATA SE v18 statistical software package. Of 316 HCTs, 69 patients required admission to the PICU. Haploidentical transplants from related donors were performed in 72.5% of these patients. The primary cause of PICU admission was infection, accounting for 68.1% (n = 47) of cases. Factors significantly associated with mortality included a PRISM III score > 20 (p < 0.002), mechanical ventilation (p < 0.007), renal replacement therapy (p < 0.002) and vasoactive support (p < 0.001). A total of 27 patients succumbed during their PICU stay. Kaplan Meier curve showed a survival rate of 51.6% at100-days post-transplant. A PRISM III score higher than 20 points was related with mortality (Hazard ratio 5.71 CI 95% 2.09-15.5).DiscussionThis study examines critical factors associated with mortality in pediatric HCT recipients who required admission to our PICU within the first 100 days post-transplant. Our findings indicate that infectious complications, alongside the need for advanced cardiovascular, respiratory, and renal support are strongly correlated with mortality. These results underscore the importance of early risk factor identification and targeted interventions to optimize patient outcomes.

Risk Factors for Invasive Surgical Site Infections Among Adult Single Liver Transplant Recipients at Duke University Hospital in the Period 2015–2020

Background. Invasive primary surgical site infections (IP-SSI) are a severe complication of liver transplant surgery. Identification of risk factors for IP-SSI is critical to IP-SSI prevention. Methods. All adult single liver transplants performed at Duke University Hospital in the period 2015–2020 were reviewed for IP-SSI occurring within 90 d of transplant. Risks for IP-SSI were identified using least absolute shrinkage and selection operator variable selection procedure. A 2-sided P value of <0.05 was considered statistically significant. Results. IP-SSI were identified in 34/470 (7.2%) adult single liver transplants. Repeat transplantation, spilt liver, Roux-en-Y biliary anastomosis, anastomotic leak, and post-transplant renal replacement therapy were positively associated with IP-SSI. IP-SSI were associated with increased length of index transplant hospitalization (24.5 versus 10.0 d, P < 0.01) and 1-y all-cause mortality (14.7% versus 4.1%, P = 0.02). Gram positive bacteria were the main pathogens (51.7%), followed by Gram negative bacteria (24.1%) and Candida (24.1%). Multidrug resistance bacteria increased over time (27.3% in 2015 versus 66.7% in 2020, P = 0.17). Conclusions. In the setting of routine antimicrobial prophylaxis and an overall low rate of IP-SSI, surgical factors were the main determinants of IP-SSI among adult liver transplant recipients. IP-SSI had a negative impact on the length of index transplant hospitalization and 1-y mortality. While the surgical factors associated with an increased risk of IP-SSI are not easily modifiable, their impact may be best contained by close clinical monitoring and tailored antimicrobial therapy.

A new scoring system to predict fatal accidents in General Aviation and to facilitate emergency control centre response.

Numerous accidents occur with General Aviation aircraft every year. To date, pre-emptive prediction of survival or death is impossible. The current study aims to identify significant factors elementary to predict survival after General Aviation (GA) aircraft accidents. The Implementation of a scoring system, including these factors, may facilitate emergency control centre response. Data of flight accidents over a 20-year period (extracted from the German Federal Bureau of Aircraft Accident Investigation [BFU]) was analysed for fixed-wing motorized small aircrafts below 5,700kg MTOW. Factors of interest were analysed using Chi2- and Mann-Whitney-U-Tests. Logistic regression was used to establish a score to calculate the probability of a fatal outcome after an aircraft accident. The BFU lists 1,595 GA aircraft accidents between 2000 and 2019. The factors "third quarter of the year" (p = 0.04), "last quarter of the year" (p = 0.002), "fire" (p < 0.0001), "distance from airport > 10km" (p < 0.0001), "landing" (p < 0.0001) and "cruise" (p < 0.0001), significantly correlated positively or negatively with a fatal outcome. "Take-off", "approach", "month", "day of the week", "persons on board above three", "night-time" and "icing conditions" showed no significant correlation. Using logistic regression "third quarter of the year" and "cruise" were excluded when using the B-STEP method. Including the four significant parameters, the score showed a strong effect with f2 = 0.709. The analysis of GA aircraft accidents in Germany enabled the identification of relevant factors and establishment of a new scoring system for survival prediction after small aircrafts accidents below 5,700kg MTOW. The implementation of the scoring system in emergency control centres in the context of digital development and artificial intelligence can improve emergency response planning and distribution.

Identification of novel transcription factors regulated by H3K27 acetylation in myogenic differentiation of porcine skeletal muscle satellite cells.

H3K27 acetylation (H3K27ac) is crucial in muscle development as it regulates gene expression. Dysregulation of H3K27ac level has been linked to muscle-related diseases such as Duchenne muscular dystrophy, yet the mechanisms through which H3K27ac influences myogenic differentiation are not fully understood. Here, we utilized the SGC-CBP30 drug, a CBP/p300 bromodomain inhibitor, to reduce H3K27ac level and investigated its effect on myogenic differentiation of porcine skeletal muscle satellite cells. The results demonstrated an increased H3K27ac level during normal muscle satellite cell differentiation. We found that the addition of SGC-CBP30 resulted in a reduced level of H3K27ac based on ATAC-seq and CUT&Tag data. Our analysis revealed that a cluster characterized by reduced levels of H3K27ac and increased levels of H3K27me3 was enriched with motifs corresponding to Bach2, MafK, and Fosl2 transcription factors. Furthermore, knockdown of Bach2, MafK, and Fosl2 produced a similar suppression effect on myogenic differentiation. Taken together, our study contributes to a better understanding of how H3K27ac influences myogenic differentiation.

Clinical characteristics and prognosis analysis of pseudomonas aeruginosa bloodstream infection in adults: a retrospective study.

Pseudomonas aeruginosa bloodstream infections (PA BSIs) in adults, especially those complicated by sepsis, are associated with high rates of morbidity and mortality. Early identification of risk factors for both mortality and sepsis-induced coagulopathy (SIC) is critical to optimizing patient management and improving outcomes. We conducted a retrospective analysis of 118 adult patients diagnosed with PA BSIs at the Affiliated Hospital of Xuzhou Medical University from January 2022 to February 2024. Univariate analysis was employed to identify significant clinical factors, followed by multivariate stepwise logistic regression to determine independent predictors of mortality and SIC. Based on these findings, nomogram models were constructed and evaluated using the area under the receiver operating characteristic curve (AUC), Bootstrap resampling, and calibration plots to assess model performance. Empiric sensitive antibiotic therapy (ESAT) (OR = 0.039, P < 0.001), coronary artery disease (CAD) (OR = 10.315, P = 0.010), and invasive mechanical ventilation (OR = 3.926, P = 0.020) emerged as significant predictors of mortality. In contrast, elevated C-reactive protein (CRP) (OR = 1.011, P = 0.003), procalcitonin (PCT) (OR = 1.030, P = 0.005), and lower hemoglobin levels (OR = 0.963, P = 0.004) were independently associated with SIC. The AUC of mortality prediction model is 0.908, while the SIC prediction model yielded an AUC of 0.817. The predictive models developed in this study demonstrate early identification of mortality rates and SIC risk in PA BSI patients, which may have the potential to guide timely therapeutic interventions and improve clinical outcomes in this high-risk population.

Identification of a vital transcription factor of the alanine aminotransferase in the brown planthopper and its upstream regulatory pathways.

The brown planthopper (Nilaparvata lugens) is an important insect pest of rice, and can rapidly adapt to insect-resistant rice varieties. In our previous studies, alanine aminotransferase in N. lugens (NlALT) was found to play an important role in the adaptation of the brown planthopper to resistant rice IR36. Here, we further identified CCAAT/enhancer binding protein (NlC/EBP) as a vital transcription factor of NlALT. Nlp38b in the MAPKs pathway regulated the expression of NlALT by influencing the phosphorylation level of NlC/EBP. In addition, we found that NlGRL101, a G protein-coupled receptor (GPCR), was significantly higher expressed in the N. lugens population adapted to IR36 (P-IR36). After knockdown of NlGRL101 through RNAi in P-IR36 population, lower expressions of Nlp38b and NlC/EBP, along with reduced phosphorylation levels of Nlp38b and NlC/EBP were observed; moreover, NlALT activity and honeydew amount were decreased by 15.68% and 76.08%, respectively. These results indicated that insect-resistant rice IR36 induced expression of NlGRL101, which enhanced expression of NlALT through Nlp38b and NlC/EBP. These findings are helpful for better understanding of insect adaptation to resistant crop varieties.

Prevalence and risk factors of knee osteoarthritis: a cross-sectional survey in Nanjing, China

BackgroundKnee osteoarthritis (KOA) presents a significant public health challenge due to its hazards and increasingly severe trends. Addressing this challenge requires targeted investigation into the prevalence and identification of risk factors for KOA across different regions, especially in populous and vast China. Therefore, a cross-sectional survey was conducted in Nanjing, China, with the aim of investigating the prevalence and risk factors of KOA among individuals aged 50 and above.MethodA total of 1,045 subjects were selected using the stratified random sampling method and diagnosed with KOA based on the diagnostic criteria established by the Chinese Medical Association. Data on 14 potential risk factors were collected through a self-designed questionnaire and standardized on-site tests. The association between KOA and these risk factors was explored using t-tests, Chi-square tests, and logistic regression analysis.ResultsThe prevalence of KOA among the subjects was 23.64%. Multiple logistic regression models indicated that the risk of KOA was significantly higher among women (OR: 5.34, 95% CI: 3.13–9.11), subjects aged 60–69 (OR: 1.83, 95% CI: 1.25–2.69) and over 70 (OR: 2.87, 95% CI: 1.80–4.59), individuals with high school education and above (OR:2.22, 95% CI: 1.37–3.60), those with flatfoot (OR: 1.74, 95% CI: 1.10–2.74), and subjects classified as overweight (OR: 1.91, 95% CI: 1.21–3.04) and obese (OR: 4.63, 95% CI: 2.18–9.85) based on their BMI status. Additionally, the models identified weight (OR: 1.04, 95% CI: 1.01–1.08), 30-s chair stand performance (OR: 0.94, 95% CI: 0.91–0.97), and single-leg stand performance (OR: 0.96, 95% CI: 0.93–0.99) as independent risk factors for KOA.ConclusionThe prevalence of KOA is remarkable in Nanjing city. The risk factors for KOA include women, older age, higher education, flatfoot, increased weight and BMI, as well as poor performance in 30-s chair stand and single-leg stand tests.

Abstract 4114597: Spontaneous coronary artery dissection: Case series and review of associated cardiovascular risks

Background: Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of ACS, myocardial infarction, and sudden death particularly among young women and individuals with few conventional atherosclerotic risk factors. We reveiwed possible risk factors that could predispose to SCAD. Methods: We reviewed 13 consecutive patients presenting with SCAD across three different institutions over a period of 5 yrs and determined risk fatcors associated with this disase entity. Results: 13 patients presented with SCAD represented % 0.5 of the total number of patients who underwent cardiac cathaterizations for chest pain requiring admissions. 11/13 (84%) were female. 5/13 (38%) were Caucasian or Hispanic, and 3/13 (23%) were African-American. Mean age age was 49.3 + years. 8/13 (61%) had associated hyperlipidemia with LDL levels &gt; than 110 mg/dL, 9/13 (64%) had an A1c &lt; 5.6% and only 1/13 (0.07%) had A1c of 6.4%. HTN was present in 6/13 (46%) of patients, and family history of SCD or heart disease were only seen in 2/13 (15%). None of the patients had features suggestive of associated fibromuscular dysplasia or connecive tissue disease. D-dimer was elevated in 5/13 (38%) with average value of 1578 ng/dL. Inflammatory markers were reviewed, only 3 patient has had ESR and CRP ordered, and only 1/3 had a mildly elevated CRP 3.9 mg/dL. Only 1/13 (0.07%) required intervention which was due to further drop in her ejection fraction requiring PCI, with improvement in her symptoms. All patients were treated with dual anti-platelet therapy for 1 year, 1 was discontinued due to persitent chest pain and decision was made to treat with only aspirin. Traditionally, risks for SCAD were thought to be due to non-atheresclerotic factors, however our case series shows that more then 60% of patients had elevated LDL's and 46% with hypertension, implying that traditional atheresclerotic risk factors should not be ignored and may play a crucial role. Autoimmune diseases were not found in any of our patients. Conclusion and implications: In this series patients who had SCAD had conventional risk factors of CAD including HLD and hypertension. The variability of co morbidities makes the identification of specific risk factors very difficult and none of the patients had Fibromuscular dysplasia or any signs of inflammation. Elevated D Dimer was also seen in a majority of patients, and all but one was managed medically with a favorable outcome

Exploring factors influencing pedestrian accident severity: a multi-source study in the city of Berlin

Abstract Background Road safety remains a critical concern in Europe’s transport sector. In urban areas, where 40% of total road fatalities occur, pedestrians are particularly vulnerable, since according to road safety data accidents involving a pedestrian are 2.8 and 15 times more probable to be fatal than in rural areas and motorways respectively. In line with the Vision Zero concept and the European Commission’s directives, many EU members are taking steps to improve road safety. Accordingly, the identification of the key factors behind pedestrian accident occurrence and pedestrian accident severity in urban areas is ever more relevant. Methodology The proposed methodology employs traditional logistic regression models and artificial neural networks, using accident data from Berlin, Germany, sourced from the Berlin Open Data portal. The dataset comprises information on 3,257 accidents involving pedestrians in 2018 or 2019, including details about involved vehicles, accident details, and injury severity information. Additionally, the dataset was augmented with average network speed data from Uber Movement and road network information from Geographic Information System (GIS) applications. Results Formal analysis results indicated several factors as significant to accident severity, such as involvement of bicycle or heavy vehicles, lighting conditions, speed limit and accident type. Additionally, a comparison between modelling approaches shows a clear performance advantage of ANNs over statistical models. Research findings provide insight for various stakeholders working to enhance pedestrian safety in urban areas.

'Can do' versus 'Do do' in nursing home residents: identification of contextual factors discriminating groups with aligned or misaligned physical activity and physical capacity.

Physical activity (PA) is fundamental to nursing home residents' health. Likewise, physical capacity (PC) is essential to carry out activities of daily living. Although PC and PA are associated, misalignment has been reported in specific subgroups. Increased PC is oftentimes not linked to high PA (i.e., Can do - don't do) and vice versa (i.e., Can't do - do do). Therefore, identifying other contextual factors influencing PA in misaligned groups is important. This study aimed to identify contextual factors in nursing home residents with aligned or misaligned PA and PC. In total, 180 nursing home residents (≥ 65 years, 79.4% females) were divided into four quadrants (Q1: Can do - do do; Q2: Can do - don't do; Q3: Can't do - do do; Q4: Can't do - don't do) based on thresholds for PA (≥ or < 2,500 steps/day) and PC (≤ or > 0.5m/s gait speed). Kruskal-Wallis H test and effect sizes (ES) were applied to analyze quadrants' differences regarding PA (steps per day), objective motor capacity, life-space mobility, activities of daily living (ADL), psychosocial well-being, cognition, subjective mobility-related concerns, and spatial orientation. Specific contextual factors differed significantly between the groups. Compared to Q1, Q2 presents a significantly lower life-space mobility (ES: 0.35) and objective motor capacity (ES: 0-36-0.49); Q3 has a lower objective motor capacity (ES: 0.55-1.10); Q4 shows lower independence in ADL (ES: 0.57), life-space mobility (ES: 0.48), subjective mobility-related concerns (ES: 0.38) and objective motor capacity (ES: 0.99-1.08). No significant group differences were found for psychosocial well-being, cognition, and spatial orientation. This study provides new insights into PA behavior of nursing home residents. Key variables linked to PA are objective motor capacity, life-space mobility, ADL, and subjective mobility-related concerns. Surprisingly, some potentially impactful variables such as cognition, orientation, and psychosocial well-being did not differ between the groups. This may suggest that these variables may not represent key targets for interventions aiming to improve PA. This study builds the foundation for further research into the underlying mechanisms behind PA behaviors and supports future efforts to plan specific, targeted interventions for nursing home residents. The trial was prospectively registered at DRKS.de with registration number DRKS00021423 on April 16, 2020.