Individual Risk Factors Research Articles

Statin Use and Hyperglycemia: Do Statins Cause Diabetes?

Atherosclerotic cardiovascular disease (ASCVD) and diabetes are leading causes of morbidity and mortality in the United States and globally. Statin medications, a cornerstone of ASCVD prevention and treatment strategies, have been demonstrated to cause hyperglycemia and new onset diabetes mellitus (NODM). The purpose of this review is to summarize existing and emerging knowledge around the intersection of statins and these two important clinical problems. Since initial reporting of statin-induced hyperglycemia and NODM, the totality of available data corroborates an association between incident diabetes and statin use. A consensus that high-intensity statin and individuals with obesity or glycemic parameters approximating diabetes thresholds constitute the majority of risk exists. Alterations in insulin signaling, glucose transport and gastrointestinal microbiota are leading hypotheses underlying the mechanisms of statin-induced hyperglycemia. The probability of NODM based on an individual's risk factors and statin specific properties can be anticipated. This risk needs to be contextualized with the risk of ASCVD. In order to effectively adjudicate the risk of NODM, improvement in formulating and ultimately conveying a comprehensive ASCVD risk assessment to patients is necessary.

Inequalities in the geographic access to delivery services in Brazil

BackgroundDespite Brazil’s recent social progress, access to health services is still unequal. This article analyzes the inter-municipal distances traveled by pregnant women to access delivery services, documenting their magnitude and relationship to socioeconomic and risk factors for over a decade in Brazil.MethodsUsing data between 2007 and 2017 from the Brazilian Information System of Live Births and a matrix of inter-municipal distances, we describe the evolution of (i) the share of pregnant women that traveled across municipalities and (ii) the average distance they traveled. Next, we assess which of the previous variables explains the changes in travel distance over time. Finally, we estimate the difference in the average travel distance by individual risk factors and use regression analysis to measure the association between this distance and municipal socioeconomic determinants from the Brazilian census.ResultsWe observe that, on average, (i) the share of women traveling for childbirth increased, reaching 31% in 2017, and (ii) distances got longer, approaching the 60-kilometer mark by 2017. The increase in distance is mainly due to more women traveling. Nevertheless, regional disparities persist, especially between the north/inland and coastal regions. Women with high-risk pregnancies or newborns with risks such as low birth weight tend to travel longer distances. However, those residing in higher-development municipalities tend to travel shorter distances.ConclusionLong distances remain an obstacle to accessing delivery facilities. This matter affects the most vulnerable disproportionately. Policymakers must consider the geographic accessibility of mothers when expanding birth-related services. Additionally, more research is required to understand the decision to travel and the distance effectively traveled as different accessibility facets.

Cardiovascular risk profile with SCORE2 and SCORE2-OP: comparing Portugal, Spain, Italy, and France using the new European predictive models

IntroductionThis study aims to characterize the cardiovascular risk profile in countries with low-to-moderate cardiovascular mortality risk (Italy, Portugal, France, and Spain) using the SCORE2 and SCORE2-OP models. It also examines regional variations and the involvement of healthcare professionals in performing risk assessments.MethodsA retrospective observational study was conducted using data from 24,434 cardiovascular risk assessments performed between December 2022 and July 2023 through a digital application used by physicians. The assessments used the SCORE2 model for individuals aged 40–69 and the SCORE2-OP model for those aged 70 and older. Risk stratification into “low-to-moderate,” “high,” and “very high” categories was analyzed based on individual risk factors such as age, smoking habits, systolic blood pressure, and cholesterol levels.ResultsApproximately 50%–60% of individuals in these countries were classified as having “high” or “very high” cardiovascular risk. The highest proportions were observed in Portugal (62.44%) and Italy (64.05%), while lower proportions were found in Spain (46.65%) and France (52.74%). Regional analysis identified areas with the highest cardiovascular risk, such as Portalegre in Portugal and Apulia in Italy. Key risk factors included older age, smoking, high systolic blood pressure, and high non-HDL cholesterol. General practitioners were the primary healthcare professionals conducting these assessments.DiscussionThe study highlights a significant proportion of individuals with “high” or “very high” cardiovascular risk in countries with low-to-moderate mortality risk. These findings underscore the need for targeted cardiovascular disease prevention strategies and the crucial role of general practitioners in managing cardiovascular risk.

Prevention of medication-related osteonecrosis of the jaw: institutional insights from a retrospective study.

Medication-related osteonecrosis of the jaw (MRONJ) is a serious, debilitating condition of the jaw bones. Dental extraction is the most significant independent risk factor for MRONJ. This interim study aimed to evaluate the demographics, medical data and outcomes of patients at risk for MRONJ who underwent dental extractions in a dedicated MRONJ clinic following a risk reduction protocol at a large public dental clinic in New South Wales Health. A retrospective study analysed demographic and clinical data of patients at risk for MRONJ who underwent dental extractions between March 2020 and April 2024. Data from 329 at-risk patients who underwent 836 dental extractions were included. Most patients were women (75.1%) with a median age of 74 years (IQR 67-80). The primary indication for medications was osteoporosis (85.4%), with Denosumab being the most frequently prescribed (66.9%). Eighteen patients (5.5%) developed MRONJ at 8 weeks of follow-up. Patients categorized as high-risk had a higher incidence of MRONJ (72.2%) compared to the low-risk group (22.2%). This study is the first retrospective audit carried out after implementing preventive protocols in this dedicated MRONJ clinic. The higher incidence of MRONJ in patients classified as 'high risk' underscores the importance of considering individual risk factors in their treatment.

Guidance for creating morally healthy organizations that remediate the experience of moral injury in healthcare: Findings from an international e-Delphi study.

To date, research and policy directives have focused on identifying individual risk factors for moral injury, with less attention to solutions for establishing non-morally injurious cultures and practices. Experts with academic or clinical knowledge of moral injury were recruited to a three-round e-Delphi survey exploring descriptors and characteristics of non-morally injurious organisations. Forty-nine, forty-one and thirty-nine experts responded at each round. Morally 'healthy', 'congruent' and 'centred' were endorsed as descriptors for non-morally injurious organisations. Consensus was also obtained on 111 characteristics and behaviours relating to organisational identity (e.g., just culture), behaviours and practices (e.g., transparency in decision-making), and self-awareness (e.g., monitoring of moral injury in workforce). The findings implicate the need for a strengths-oriented, solution-focused approach to addressing moral injury. The recommendations proposed warrant evaluation and operationalisation within formal guidance.

Association of Vascular Risk With Severe vs Non-Severe Stroke: An Analysis of the INTERSTROKE Study.

Acute stroke is associated with a spectrum of functional deficits. The objective of this analysis was to explore whether the importance of individual risk factors differ by stroke severity, which may be of relevance to public health strategies to reduce disability. INTERSTROKE is an international case-control study of risk factors of first acute stroke (recruitment 2007-August 2015) in 32 countries. Stroke severity was measured using the modified Rankin Scale (mRS) score within 72 hours of admission to hospital. Severe stroke is defined as mRS scores of 4-6 (and non-severe stroke, score of 0-3). We used multinomial logistic regression to estimate comparative odds ratios (ORs; 95% CIs) for severe and non-severe stroke and tested for heterogeneity (pheterogeneity). We also conducted a matched case-case analysis (matched for age, sex, country, and primary stroke subtype) to determine whether the prevalence of risk factors differed significantly between severe and non-severe stroke. A significant difference in the association of a risk factor of severe stroke compared with non-severe stroke was defined as p < 0.05 for both pheterogeneity and pcase-case. Of patients with acute stroke (n = 13,460), 64.0% (n = 8,612) were reported to have mRS scores of 0-3 and 36.0% (n = 4,848) scores of 4-6. The mean age was 61.7 years for patients with non-severe stroke and 62.9 years for patients with severe stroke (p = 0.72). 38.1% (n = 3,278) of patients with non-severe stroke and 44.6% (n = 2,162) of patients with severe stroke were female. Hypertension (OR 3.21; 95% CI 2.97-3.47 for severe stroke, OR 2.87; 95% CI 2.69-3.05 for non-severe stroke; pheterogeneity = 0.03; pcase-case < 0.001), atrial fibrillation (OR 4.70; 95% CI 4.05-5.45 for severe stroke, OR 3.61; 95% CI 3.16-4.13 for non-severe stroke; pheterogeneity = 0.009; pcase-case < 0.001), and smoking (OR 1.87; 95% CI 1.72-2.03 for severe stroke, OR 1.65; 95% CI 1.54-1.77 for non-severe stroke; pheterogeneity = 0.02; pcase-case < 0.001) had a stronger association with severe stroke, compared with non-severe stroke. The waist-to-hip ratio had a stronger association with non-severe stroke compared with severe stroke (pheterogeneity < 0.001; pcase-case < 0.001). Hypertension, atrial fibrillation, and smoking had a stronger magnitude of association with severe stroke (compared with non-severe stroke) while the increased waist-to-hip ratio had a stronger magnitude of association with non-severe stroke.

Trajectories of Violence Exposure and Drug Use Among Justice-Involved Male Adolescents: A Multi-Trajectory Approach

A strong link exists between exposure to violence and drug use, yet their simultaneous development is less understood. This study utilizes multi-trajectory modeling to investigate the dynamic relationship between violence exposure and drug use among justice-involved male adolescents. Using a sample from the Pathways to Desistance study ( n = 1,095), we identify five group trajectories of violence exposure and drug use; “Chronic Low” (39.2%), “Resisters” (17.6%), “Accelerators” (13.9%), “Desisters” (22.2%), and “At-risk” (7.1%). Multinomial logistic regression analysis examines individual, social, and environmental risk factors predicting trajectory group membership. Results highlight the need to address cumulative vulnerabilities shaping outcomes among high-risk adolescents. We conclude by discussing the importance of drug treatment and intervention strategies to foster positive outcomes for justice-involved youth.

Совершенствование организационных и лечебно-профилактических мероприятий, направленных на профилактику избыточной массой тела и ожирения.

Relevance. Obesity is a serious public health problem due to its high prevalence, increasing treatment costs and adverse effects. In this regard, the development of preventive measures aimed at preventing the formation and progression of obesity based on modern information and digital technologies seems to be an urgent and extremely important task. Research objective: development of a system for early diagnosis of overweight and obesity with the identification of predictors of their formation to prevent the progression of the pathological process and effective prevention of its occurrence. Materials and methods. To assess the prevalence of overweight and obesity, an analysis of the data of the reporting forms of federal statistical observation № 30 «Information about the medical organization» and № 12 «Information on the number of diseases registered in patients living in the service area of the medical organization» for the period 2012–2023 was carried out. To assess the economic component, we used the data from reports on the summary of expenses at the expense of budget funds, funds received from the provision of paid services. The study used the following methods: analytical, statistical, comparative analysis and content analysis. Statistical processing of materials was carried out using calculation tables in Excel format. Results. The article presents data on the relevance and prevalence of overweight and obesity in the adult group, including the workingage population. The risks of human health impairment with possible disability and mortality due to overweight and obesity are analyzed. Socioeconomic factors leading to obesity are considered. The economic consequences of this problem, as well as unresolved problems of obesity prevention are noted. Priority areas of comprehensive prevention programs are identified and prognostic models for the development of overweight and obesity are developed, taking into account the identified individual medical and social risk factors. The results of the study will allow personalizing preventive measures aimed at preventing obesity and its complications.

Immediate Versus 5-Year Risk-Guided Initiation of Treatment for Primary Prevention of Cardiovascular Disease for Australians Aged 40 Years: A Health Economic Analysis.

Current Australian cardiovascular disease (CVD) prevention guidelines calculate 5-year CVD risk and recommend treatment when risk crosses specific thresholds. This may leave risk factors untreated for people with a low short-term (i.e. 5 years), but high long-term (i.e. lifetime), risk of CVD. We aimed to evaluate the cost effectiveness of intervention for risk factor control at age 40 years (regardless of calculated risk) compared to intervention for risk factor control at the age recommended by contemporary Australian CVD prevention guidelines (when the 5-year CVD risk reaches 10%) across a range of individual risk factor profiles. We used a causal microsimulation model populated with 108 different risk factor profiles, each replicated 10,000 times. Model data were derived from the UK Biobank study and published sources. The primary causal relationships factored in were those of low-density lipoprotein-cholesterol and systolic blood pressure with CVD (defined as myocardial infarction or stroke). The model simulated the ageing of individuals from 40 to 85 years. We calculated years of life lived, quality-adjusted life-years gained, incremental healthcare costs and the incremental cost-effectiveness ratio when low-density lipoprotein-cholesterol and blood pressure were controlled from age 40 years compared to initiation of treatment as recommended by Australian guidelines. The main side effect in the model was an increased risk of type 2 diabetes mellitus from statin use. The trade-off between reduced CVD and increased type 2 diabetes was summarised via quality-adjust life-years. Incremental cost-effectiveness ratios were compared to the Australian willingness-to-pay threshold of AU$28,000 per quality-adjust life-year gained. We adopted a healthcare perspective (2022 AUD) and discounted results at 3% annually. An earlier intervention meaningfully prevented CVD in all but the lowest risk individuals. Intervention at age 40 years versus age when the 5-year CVD risk reaches 10% led to an increase in quality-adjust life-years for 37/54 female individuals and 44/54 male individuals simulated and an increase in years of life lived (i.e. life expectancy) for 46/54 female individuals and 47/54 male individuals simulated. Earlier intervention was also cost effective in 5/54 female individuals and 17/54 male individuals. Current guidelines may result in certain individuals with a lower 5-year, but higher lifetime, risk of CVD being overlooked for earlier cost-effective interventions to prevent CVD.

Feasibility and effectiveness of cardiac telerehabilitation for older adults with coronary heart disease: A pilot randomized controlled trial.

Cardiac rehabilitation is a beneficial multidisciplinary treatment of exercise promotion, patient education, risk factor management, and psychosocial counseling for people with coronary heart disease (CHD) that is underutilized due to substantial disparities in access, referral, and participation. Empirical studies suggest that cardiac telerehabilitation (CTR) have safety and efficacy comparable to traditional in-person cardiac rehabilitation, however, older adults are under-reported with effectiveness, feasibility, and usability remains unclear. The study randomized 43 older adults (84% males) to the 12-week CTR intervention or standard of care. Guided by Social Cognitive Theory, participants received individualized in-person assessment and e-coaching sessions, followed by CTR usage at home. Data were collected at baseline (T0), six-week (T1), and 12-week (T2). Participants in the CTR intervention group showed significant improvement in daily steps (T1: β=4126.58, p=0.001; T2: β=5285, p=0.01) and health-promoting lifestyle profile (T1: β=23.26, p<0.001; T2: β=12.18, p=0.008) across study endpoints. Twenty participants completed the intervention, with 40% used the website for data-uploading or experiential learning, 90% used the pedometer for tele-monitoring. Improving awareness of rehabilitation and an action focus were considered key facilitators while physical discomforts and difficulties in using the technology were described as the main barriers. The CTR is feasible, safe and effective in improving physical activity and healthy behaviors in older adults with CHD. Considering the variation in individual cardiovascular risk factors, full-scale RCT with a larger sample is needed to determine the effect of CTR on psychological symptoms, body weight and blood pressure, and quality of life.

Persistent spinal pain syndrome : Consideration of psychosocial risk factors

The introduction of the term persistent spinal pain syndrome (PSPS), replacing the term failed back surgery syndrome (FBSS) has significantly changed diagnostic and treatment approaches of PSPS. There are multiple risk factors that may contribute to the development of PSPS. Accurately identifying individual risk factors is, therefore, crucial for patient-centered treatment planning. This article mainly focuses on patient-related psychosocial risk factors. Possibilities of evaluating these risk factors prior to spinal surgery in order to prevent PSPS from developing, as well as treatment options for established PSPS will be discussed.

Influence of postoperative D-dimer evaluation and intraoperative use of intermittent pneumatic vein compression (IPC) on detection and development of perioperative venous thromboembolism in brain tumor surgery

Background ObjectiveVenous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common complication in craniotomy patients and is associated with increased morbidity and mortality. The duration of surgery is a known risk factor. Other factors such as positioning and tumor entity have hardly been investigated or are controversial.In two pilot studies, the determination of plasma D-dimer concentration led to a high detection rate of DVT, while the use of intermittent pneumatic venous compression (IPC) drastically reduced the incidence of VTE. In the present study we investigated the efficacy of the two approaches, either alone or in combination, in a large patient cohort.Methods1759 patients who underwent elective craniotomy between 2009 and 2023 were retrospectively analyzed. The staggered use of D-dimer determination and intraoperative use of IPC resulted in 3 groups: Group 1: no procedure; Group 2: D-dimer evaluation; Group 3: IPC and D-dimer evaluation. If the D-dimer level was ≥ 2 mg/l (Fibrinogen equivalent units; FEU), venous ultrasound was performed. Age, gender, tumor entity, duration and extent of surgery, patient positioning, type of VTE were also recorded and analyzed.ResultsThe introduction of postoperative D-dimer evaluation increased the rate of detection of thrombosis from 1.7% in group 1 to 22.6% in group 2. The addition of IPC reduced the rate of thrombosis to 4.4%. Age, gender and patient positioning did not affect the rate of VTE. We were able to confirm the duration of surgery as an individual risk factor and showed that WHO grade 4 tumors and metastasis have an increased VTE risk.ConclusionsIf D-Dimer levels are not analyzed routinely about 20% of craniotomy patients suffer from a clinically silent thrombosis. Each with the risk of fate PE. Intraoperative use of IPC during craniotomy dramatically reduces the risk of VTE.

Individual, Host-Vector Interactions, and Environmental Risk Factors for Plasmodium knowlesi Malaria Among At-Risk Communities in Peninsular Malaysia: A Case-Control Study.

Background: Highlighting the individual, host-vector interactions, and environmental risk factors for knowlesi malaria were consequential toward more focused and effective prevention and control strategies. This study aims to identify the individual, host-vector interactions, and environmental risk factors for Plasmodium knowlesi malaria among at-risk communities in Peninsular Malaysia. Materials and Methods: A case-control study was conducted involving laboratory-confirmed cases of P. knowlesi malaria, while a locality-matched individual with no history of fever and tested negative for malaria was taken as control. Univariate and multiple logistic regression were applied to evaluate the potential risk factors among respondents using IBM SPSS Statistics for Windows, Version 26.0. Results: Results showed higher cases among males as compared to females (76.1% vs. 23.9%). Multiple logistic regression analysis showed being male is 3.51 higher risk (p < 0.001) to become a case. Respondents whose place of work or study is near the forest edge have 44.0% lower risk (p = 0.030), while those living in the Orang Asli village were 56.0% lower risk as compared to the organized village to become a case (p = 0.035). Conclusion: These findings demonstrated that gender emerges as an independent individual risk factor while residing near a forest edge, in an Orang Asli village, or occupying workers' longhouses situated in hilly areas lowered the environmental risk among respondents. These findings attested that alternative directions must be considered in addressing the known risk factors associated with this type of malaria and the design of prevention and control programs should be tailored to the unique characteristics of each population.

Gender-affirming hormone therapy in the transgender patient: influence on thrombotic risk.

Research regarding the hematologic sequelae of estrogen and testosterone therapy for transgender people is an emerging area. While estrogen therapy has been widely studied in cisgender women, studies in transgender individuals are limited, revealing variable adverse effects influenced by the dose and formulation of estrogen used. Thrombotic risk factors in transgender and gender-diverse individuals are multifactorial, involving both modifiable and nonmodifiable factors. Management of venous thromboembolism (VTE) in individuals receiving gender-affirming estrogen entails standard anticoagulation therapy alongside shared decision-making regarding hormone continuation and risk factor modification. While data and guidance from cisgender women can offer a reference for managing thrombotic risk in transgender individuals on hormone therapy, fully applying these insights can be challenging. The benefits of gender-affirming hormone therapy include significantly reducing the risk of suicide and depression, highlighting the importance of a contemplative approach to the management of hormonal therapy after a VTE event. Although limited, the available data in the literature indicate a low thrombotic risk for transgender individuals undergoing gender-affirming testosterone therapy. However, polycythemia is a common adverse effect necessitating monitoring and, occasionally, adjustments to hormonal therapy. Additionally, iron deficiency may arise due to the physiological effects of testosterone or health care providers' use of phlebotomy, an aspect that remains unstudied in this population. In conclusion, while the set of clinical data is expanding, further research remains vital to refine management strategies and improve hematologic outcomes for transgender individuals undergoing gender-affirming hormone therapy.

Cybervictimization and Online Sexual Harassment: Prevalence, Association, and Predictors

Background: The daily and massive use of the Internet and social media by adolescents has led to increased interest and attention to prevalence rates, risk factors, and potential consequences of different forms of online victimization. This study aims to examine the possible associations between cybervictimization and online sexual harassment among 697 Italian adolescents (Mage = 15.17; SD = 0.68; 42.3% female), understanding the contribution of individual and school risk factors. Methods: A short longitudinal design was used to test a path model where emotional/behavioral problems and school climate predicted cybervictimization and online sexual harassment, controlling for their co-occurrence. Results: The results show similar prevalence among the two phenomena with a consistent reciprocal association (ρs = 0.426**). Regarding predictors, cybervictimization at Wave 5 is predicted by the problematic peer relationships with peers (β = 0.164*, SE = 0.068) and lack of school cohesion (β = −0.189*, SE = 0.086) assessed at Wave 4. In contrast, online sexual harassment at Wave 5 is predicted by the presence of emotional symptoms (β = 0.248***, SE = 0.077) and the absence of social norms (β = −0.254**, SE = 0.085) measured at Wave 4. Conclusion: Online sexual harassment and cybervictimization are related phenomena with a co-occurrence of around 22%; being a victim of cybervictimization is positively associated with being a victim of OSH-P. However, risk factors are different: cybervictimization is more easily explained by social and contextual factors, while online sexual harassment is explained by individual factors.

Risk assessment in geriatric traumatology : Crucial role of anesthesiology

The postoperative outcome of older people is significantly influenced by individual age-related risk factors. Therefore, factors such as frailty, cognitive impairment and functional dependency should be routinely included in the preoperative anesthesiological assessment of older patients. The approach recommended in the catalogue of criteria for geriatric trauma centers of the German Society for Trauma Surgery (DGU®) includes screening to identify geriatric patients, determination of frailty, assessment of cognitive impairment and delirium screening even in the emergency department. In addition, abasic geriatric assessment should be performed at the latest in the early postoperative phase to determine the need for further supportive therapy. Anesthesiologists work closely with geriatricians and trauma surgeons in the geriatric traumatological treatment. The recommendations for action and the nature of interdisciplinary collaboration are defined in standard operating procedures. It would be desirable to develop comparable concepts for the perioperative care of all older people beyond the field of geriatric traumatology.

Social determinants of health and mild cognitive impairment in a diverse community sample.

The associations between community-wide social determinants of health and mild cognitive impairment (MCI) among individuals warrant investigation. Among 2830 dementia-free individuals aged 65+ years in a community-based US study, we examined cross-sectional associations of MCI (Clinical Dementia Rating = 0.5) with the following potential social determinants of health: at the census tract or block group level obtained from public sources: neighborhood disadvantage (Area Deprivation Index, ADI), air pollution with fine particulate matter (PM2.5), greenspace, Walkability Index, ambulatory healthcare availability per square mile, homicide rate; and at the individual participant level, birth/schooling in a southern US state. Unadjusted logistic regression models found higher odds ratios (OR, 95% CI) for MCI with higher ADI (1.01, 1.003-1.02), higher PM2.5 (1.16, 1.07-1.26), higher homicide rate (1.007, 1.001-1.012), lesser greenspace (0.99, 0.90-0.99), and southern schooling (2.06, 1.6-3.54). Adjusting for age, race, sex, and educational level, ADI remained statistically significant (1.04, 1.01-1.06), while PM2.5 and Southern state schooling interacted significantly with race and were more strongly affected in Black participants than in White participants. In this cohort, several community-wide social/environmental factors were associated with MCI. While clinicians should continue to encourage older adults to modify their individual risk factors, policy changes are needed to mitigate social determinants of health in the community.

Relationship Between Sleep Position and Glaucoma Progression

&amp;lt;i&amp;gt;Introduction&amp;lt;/i&amp;gt;: Glaucoma, a leading cause of irreversible blindness worldwide, is strongly influenced by intraocular pressure (IOP), with recent studies suggesting that nocturnal IOP fluctuations and body position during sleep may play a critical role in disease progression. The purpose of the study was to explore the relationship between sleep position and glaucoma progression. &amp;lt;i&amp;gt;Aim of the study&amp;lt;/i&amp;gt;: The aim of the study was to evaluate the relationship between sleep position and glaucoma progression. Methods: This cross-sectional observational study was conducted at the Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, over a 1-year period from mid-2023 to mid-2024. A total of 40 patients were included. Data were collected retrospectively from medical records, focusing on demographic characteristics, sleep position preferences, and intraocular pressure (IOP) measurements. Descriptive statistics, chi-square tests used for data analysis, with statistical significance set at p &amp;lt; 0.05. &amp;lt;i&amp;gt;Result&amp;lt;/i&amp;gt;: Among the patients, 35.00% were aged 60-70 years, with a significant male predominance (87.50%). The most preferred sleep position was the right lateral decubitus position (LDP), chosen by 45.00% of patients, and it was associated with a mean intraocular pressure (IOP) increase of 1.8 mmHg and a 50.00% progression rate of glaucoma. Notably, patients with higher baseline IOP, representing 30.00% of the sample, experienced a mean IOP increase of 2.0 mmHg. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: The study highlights that the right lateral decubitus position is strongly associated with increased intraocular pressure and higher glaucoma progression, emphasizing the need to consider sleep position and individual risk factors in glaucoma management.

Risk coupling analysis of miners’ health-compromising behaviors: A multimethod fusion with practical application

Risk analysis of miners’ health-compromising behaviors is essential for advancing their overall health and well-being. This paper proposed a method for quantifying the risk coupling of miners’ health-compromising behaviors based on the Bayesian network (BN) model, N-K model, and cumulative risk (CR) model. First, the causation of miners’ health-compromising behaviors was analyzed, and the risk factors were systematically classified. Second, the types of risk coupling resulting from physical environmental risk factors, psychosocial environmental risk factors, and individual characteristics risk factors were delineated. Third, the BN model was constructed through a comprehensive risk analysis of miners’ health-compromising behaviors. Leveraging both the N-K model and the CR model, calculations were applied to the questionnaire data to identify the parameters influencing the risk coupling nodes within the developed BN. Finally, the established model undergoes validation through a three-axiom-based method. Subsequently, a sensitivity analysis of risk coupling types was conducted, and the influences of risk factors were quantified using mutual information. Employing the developed model, an uncertainty analysis was performed to explore the effects of failure rates of risk factors on the primary risk coupling types.

The Utility of Pre-Procedural Blood Tests in Neuraxial Blocks: A Retrospective Study in High-Risk Patients.

Background/Objectives: The necessity and clinical utility of routine pre-procedural blood tests (PBTs) before neuraxial blockade remain controversial. This study evaluates the effectiveness of PBTs in identifying clinically significant conditions in an outpatient setting. Methods: This single-center retrospective study involved patients who received neuraxial blockades from January 2020 to August 2023. We extracted medical information and laboratory data from the electronic medical records during the pre-procedural period. Through a multivariate regression analysis, we identified patient factors associated with abnormal laboratory results. Results: Advanced age (OR, 1.021; p = 0.026) and a history of cancer (OR, 2.359; p = 0.016) were significantly associated with elevated CRP levels (>0.30 mg/dL). Severe hyperglycemia (≥200 mg/dL) was found in 24 patients (3.88%), with a history of cancer being a strong predictor (OR, 6.764; p < 0.001). No significant abnormalities were observed in PT or PTT. Reduced eGFR (<60 mL/min/1.73 m2) was detected in 8.62% of patients, despite no prior history of renal dysfunction. A multivariate analysis revealed that advanced age, hypertension, cancer, and coronary artery disease were significant predictors of abnormal PBT results, highlighting the importance of selective testing in high-risk patients. Conclusions: Routine PBTs are not universally required for all patients undergoing neuraxial blockade but can provide crucial information in high-risk populations. A selective testing approach based on individual risk factors is recommended to optimize patient safety and resource utilization. Future studies should aim to establish clear guidelines for targeted PBT use.