Multidimensional Risk Factors Research Articles

Risk and protective factors of suicidal tendencies among freshmen in China revealed by a hierarchical regression model.

This study aimed to identify risk and protective factors for suicidal tendencies among college students by exploring current mental health, personal experiences, family environment, and school adaptation. A total of 11,504 freshmen in China were recruited. Suicidal tendencies were assessed using the Adolescents Suicidal Tendencies Scale (ASTS), while explored risk and protective factors included mental health assessed by the Symptom Checklist-90 (SCL-90), campus adaptation using the College Student School Adaptation Scale, and Personal Situation Survey. Single-factor Logistic regression analysis, correlation analysis, and hierarchical regression analysis were used to analyze the risk and protective factors affecting suicidal tendencies. The results showed that in terms of personal experience, self-injury behavior (OR = 3.522, 95% CI [3.256, 3.811]), sexual assault experience (OR = 2.603, 95% CI [2.374, 2.855]) and lack of friendship relationship (OR = 2.249, 95% CI [2.076, 2.436]) were the most significant risk factors. Regarding family environment, parenting style (OR = 2.455, 95% CI [2.272, 2.652]), parent-child relationship (OR = 2.255, 95% CI [2.092, 2.429]) and violent conflict (OR = 2.164, 95% CI [2.015, 2.324]) were the most prominent risk factors. For protective factors, life satisfaction (OR = 0.330, 95% CI [0.304, 0.359]) and rest quality (OR = 0.415, 95% CI [0.386, 0.447]) were the most significant protective factors. In addition, Symptom Checklist-90 was positively correlated with suicidal tendencies (r = 0.541, 95% CI [0.522, 0.560], p < 0.001), while school adaptation was negatively correlated with suicidal tendencies (r = - 0.590, 95% CI [- 0.579, - 0.601], p < 0.001). After considering demographic variables, psychological symptoms, school adaptation and other risk and protective factors, the hierarchical regression model could explain 48.9% of the variance of suicidal tendencies. The study emphasizes a range of multidimensional risk and protective factors for suicidal tendencies. This enhanced understanding is crucial in aiding the design of future intervention studies targeted at improving the mental health of college students.

Multidimensional risk factor analysis of acute low back pain progressing to chronicity: a longitudinal cohort study protocol.

Approximately 40% of patients with acute low back pain (LBP) develop chronic low back pain, which significantly increases the risk of poor prognosis. To reduce the risk of acute LBP becoming chronic, effective preventive strategies are needed. Early identification of risk factors for the development of chronic LBP can help clinicians choose appropriate treatment options and improve patient outcomes. However, previous screening tools have not considered medical imaging findings. The aim of this study is to identify factors that can predict the risk of acute LBP becoming chronic based on clinical information, pain and disability assessment, and MRI imaging findings. This protocol describes the methodology and plan for investigating multidimensional risk factors for acute LBP becoming chronic, in order to better understand the development of acute LBP and prevent chronic LBP. This is a prospective multicenter study. We plan to recruit 1,000 adult patients with acute low back pain from four centers. In order to select four representative centers, we find the larger hospitals from different regions in Yunnan Province. The study will use a longitudinal cohort design. Patients will undergo baseline assessments upon admission and will be followed up for 5 years to collect the time of chronicity and associated risk factors. Upon admission, patients will be collected detailed demographic information, subjective and objective pain scores, disability scale, and lumbar spine MRI scanning. In addition, patient's medical history, lifestyle, psychological factors will be collected. Patients will be followed up at 3 months, 6 months, 1 year, 2 years and up for 5 years after admission to collect the time of chronicity and associated factors. Multivariate analysis will be used to explore the multidimensional risk factors affecting the chronicity of acute LBP patients (such as age, gender, BMI, degree of intervertebral disc degeneration, etc.), and survival analysis will be performed to explore the impact of each factor on the time of chronicity. The study has been approved by the institutional research ethics committee of each study center (main center number: 2022-L-305). Results will be disseminated through scientific conferences and peer-reviewed publications, as well as meetings with stakeholders.

Development of a predictive risk stratification tool to identify the population over age 45 at risk for new-onset stroke within 7 years.

With the acceleration of the aging process of society, stroke has become a major health problem in the middle-aged and elderly population. A number of new stroke risk factors have been recently found. It is necessary to develop a predictive risk stratification tool using multidimensional risk factors to identify people at high risk for stroke. The study included 5,844 people (age ≥ 45 years) who participated in the China Health and Retirement Longitudinal Study in 2011 and its follow-up up to 2018. The population samples were divided into training set and validation set according to 1:1. A LASSO Cox screening was performed to identify the predictors of new-onset stroke. A nomogram was developed, and the population was stratified according to the score calculated through the X-tile program. Internal and external verifications of the nomogram were performed by ROC and calibration curves, and the Kaplan-Meier method was applied to identify the performance of the risk stratification system. The LASSO Cox regression screened out 13 candidate predictors from 50 risk factors. Finally, nine predictors, including low physical performance and the triglyceride-glucose index, were included in the nomogram. The nomogram's overall performance was good in both internal and external validations (AUCs at 3-, 5-, and 7-year periods were 0.71, 0.71, and 0.71 in the training set and 0.67, 0.65, and 0.66 in the validation set, respectively). The nomogram was proven to excellently discriminate between the low-, moderate-, and high-risk groups, with a prevalence of 7-year new-onset stroke of 3.36, 8.32, and 20.13%, respectively (P < 0.001). This research developed a clinical predictive risk stratification tool that can effectively identify the different risks of new-onset stroke in 7 years in the middle-aged and elderly Chinese population.

The role of booster vaccination in decreasing COVID-19 age-adjusted case fatality rate: Evidence from 32 countries.

The global COVID-19 pandemic is still ongoing, and cross-country and cross-period variation in COVID-19 age-adjusted case fatality rates (CFRs) has not been clarified. Here, we aimed to identify the country-specific effects of booster vaccination and other features that may affect heterogeneity in age-adjusted CFRs with a worldwide scope, and to predict the benefit of increasing booster vaccination rate on future CFR. Cross-temporal and cross-country variations in CFR were identified in 32 countries using the latest available database, with multi-feature (vaccination coverage, demographic characteristics, disease burden, behavioral risks, environmental risks, health services and trust) using Extreme Gradient Boosting (XGBoost) algorithm and SHapley Additive exPlanations (SHAP). After that, country-specific risk features that affect age-adjusted CFRs were identified. The benefit of booster on age-adjusted CFR was simulated by increasing booster vaccination by 1-30% in each country. Overall COVID-19 age-adjusted CFRs across 32 countries ranged from 110 deaths per 100,000 cases to 5,112 deaths per 100,000 cases from February 4, 2020 to Jan 31, 2022, which were divided into countries with age-adjusted CFRs higher than the crude CFRs and countries with age-adjusted CFRs lower than the crude CFRs (n = 9 and n = 23) when compared with the crude CFR. The effect of booster vaccination on age-adjusted CFRs becomes more important from Alpha to Omicron period (importance scores: 0.03-0.23). The Omicron period model showed that the key risk factors for countries with higher age-adjusted CFR than crude CFR are low GDP per capita and low booster vaccination rates, while the key risk factors for countries with higher age-adjusted CFR than crude CFR were high dietary risks and low physical activity. Increasing booster vaccination rates by 7% would reduce CFRs in all countries with age-adjusted CFRs higher than the crude CFRs. Booster vaccination still plays an important role in reducing age-adjusted CFRs, while there are multidimensional concurrent risk factors and precise joint intervention strategies and preparations based on country-specific risks are also essential.

Identifying roadway departure crash patterns on rural two-lane highways under different lighting conditions: Association knowledge using data mining approach

Introduction: More than half of all fatalities on U.S. highways occur due to roadway departure (RwD) each year. Previous research has explored various risk factors that contribute to RwD crashes, however, a comprehensive investigation considering the effect of lighting conditions has been insufficiently addressed. Data: Using the Louisiana Department of Transportation and Development crash database, fatal and injury RwD crashes occurring on rural two-lane (R2L) highways between 2008-2017 were analyzed based on daylight and dark (with and without streetlight). Method: This research employed a safe system approach to explore meaningful complex interactions among multidimensional crash risk factors. To accomplish this, an unsupervised data mining algorithm association rules mining (ARM) was utilized. Results and conclusions: Based on the generated rules, the findings reveal several interesting crash patterns in the daylight, dark-with-streetlight, and dark-no-streetlight, emphasizing the importance of investigating RwD crash patterns depending on the lighting conditions. In daylight condition, fatal RwD crashes are associated with cloudy weather conditions, distracted drivers, standing water on the roadway, no seat belt use, and construction zones. In dark lighting condition (with and without streetlight), the majority of the RwD crashes are associated with alcohol/drug involvement, young drivers (15–24 years), driver condition (e.g., inattentive, distracted, illness/fatigued/asleep), and colliding with animal(s). Practical Applications: The findings also reveal how certain driver behavior patterns are connected to RwD crashes, such as a strong association between alcohol/drug intoxication and no seat belt usage in the dark-no-streetlight condition. Based on the identified crash patterns and behavioral characteristics under different lighting conditions, the findings could aid researchers and safety specialists in developing the most effective RwD crash mitigation strategies.

A New Method for Environmental Risk Assessment of Pollutants Based on Multi-Dimensional Risk Factors.

Pollutant discharge causing the deterioration of the watershed environment has seriously threatened human health and ecosystem function. The importance of improving the risk warning system is becoming more and more prominent. Traditional chemical risk assessment methods focused on toxicity and the exposure of pollutants without considering the impact of persistent pollutants in different environmental media. In this study, a new approach was proposed to reflect multi-dimensional evaluation with a synthetic risk factor (SRF) of pollutants. The integrating parameters of SRF include toxicity endpoint values, environmental exposure level, persistent properties, and compartment features. Selected pesticides, perfluorinated compounds, organophosphate esters and endocrine disruptors were analyzed by the proposed and traditional methods. The results showed a higher risk outcome using SRF analysis for PFOS, imazalil, testosterone, androstenedione and bisphenol A, which were different from those obtained by the traditional method, which were consistent with existing risk management. The study demonstrated that the SRF method improved the risk assessment of various pollutants in different environmental media in a more robust fashion, and also provided a more accurate decision basis for ecological environment protection.

Application of the RDoC Framework to Predict Alcohol Use and Suicidal Thoughts and Behaviors among Early Adolescents in the Adolescent Brain and Cognitive Development (ABCD) Study.

Alcohol use confers risk for suicidal thoughts and behaviors (ideation, attempt) in early adolescents. The Research Domain Criteria provides a framework for examination of multidimensional and modifiable risk factors. We examined distinct latent profiles based on patterns of positive valence (reward responsivity) and cognitive systems (neurocognition) from the ABCD Study (age 9–10, N = 10,414) at baseline enrollment. Longitudinal associations were determined between baseline positive valence and cognitive profiles and group classification (alcohol use, suicidal thoughts and behaviors, or their co-occurrence) two-years after initial assessment (ages 11–12). Three unique profiles of positive valence, cognition, alcohol use, and suicidal thoughts and behaviors were identified. Two baseline profiles predicted alcohol use and suicidal thoughts and behaviors, two-years after initial assessment. Low positive valence with high cognition (but low impulsivity) predicted alcohol use (OR = 1.414, p < 0.001), while high positive valence with low cognition (but high impulsivity) predicted suicidal thoughts and behaviors (OR = 1.25, p = 0.038), compared to average positive valence and cognition. Unique profiles of positive valence and cognitive systems among 9–12-year-olds may be predictive of alcohol use and suicidal thoughts and behaviors over a two-year period. Findings underscore the potential for trajectory research on positive valence and cognitive profiles to enhance prevention for early-adolescents.

Risk factors for habitual snoring among children aged 2-14years in Chengdu, Sichuan.

Habitual snoring (HS) is a prominent symptom of sleep-disordered breathing; thus, it isalso important to consider the associated, multidimensional risk factors for HS in children. This study was aimed to identify risk factors for HS in children. A cross-sectional survey was performed in Chengdu. Children aged 2-14years from four districts were randomly chosen to participate. Questionnaires were voluntarily completed by the children's guardians. The survey included 926 boys and 622 girls, who were an average of 6.4 ± 3.0years old. The sample included 463 habitual snorers (30.4%), 683 occasional snorers (44.8%), and 402 nonsnorers (26.4%). HS was found in 51.8% of children under 7years old and 26.6% of children aged 7years old or older. The prevalence of pregnancy complications was significantly lower in mothers who bore children with HS (p = .006). Among the HS group, 86.6% had an immediate family member who snores. Breastfeeding duration among the HS group was significantly less than among the occasional snoring and nonsnoring groups. History of symptoms of allergic rhinitis, rhinosinusitis, tonsillitis, and pneumonia/bronchitis in the past 6months was associated with HS. Likewise, maternal smoking during pregnancy, maternal exposure to secondhand smoke during pregnancy, and child exposure to secondhand smoke were also associated with HS. The prevalence of HS was higher in children under 7years old. Having a mother with more education, a family history of snoring, a shorter period of breastfeeding, upper respiratory tract inflammation, and passive smoking are important risk factors for HS. Pregnancy complications may be associated with lower prevalence of snoring in childhood.

General Risk on Trust, Satisfaction, and Recommendation Intention for Halal Food`

The purpose of this empirical research is to determine the effect of multidimensional general risk factors on halal consumer confidence, satisfaction, and intention to recommend halal food. This study also calculates the average comparison of trust, satisfaction, and recommendation intentions across demographic variables of halal customers. Our results from structural analysis reveal that general risks have a significant and positive effect on trust, satisfaction, and intention to recommend halal food. Also, the results of the mean difference test show that satisfaction and intention to recommend halal food differ significantly between male and female customers and trust varies significantly among halal customers with different educational backgrounds and marital status. This study adds a valuable contribution to the current literature on halal food consumption by undertaking a series of symmetrical analytical approaches to assess the desired responses from halal food customers.

Prevalence and associated factors of malnutrition in patients with Parkinson's disease using CONUT and GNRI

ObjectiveParkinson's disease (PD) is a common neurodegenerative disease, but its nutritional problems have not received enough attention. This study aims to identify the prevalence and associated factors of malnutrition in PD patients using two simple nutritional tools. MethodsWe conducted a large-scale cross-sectional study with 1478 PD patients and equal healthy controls (HC). The controlling nutritional status score (CONUT) and geriatric nutritional risk index (GNRI) were used for malnutrition stratification. ResultsBy CONUT or GNRI, the prevalence of malnutrition in PD patients was higher than that in HC (40.7% vs. 25.3% and 11.1% vs. 2.1%, respectively). The binary logistic regression model showed that malnutrition in PD was associated with male sex (OR = 0.600, P < 0.001), older age (OR = 1.015, P = 0.003), lower body mass index (BMI) (OR = 0.942, P < 0.001), higher levodopa equivalent daily doses (LEDD) (OR = 1.001, P < 0.001), worse motor symptoms (OR = 1.012, P = 0.004), more serious perceptual problems/hallucinations (OR = 1.067, P = 0.019) by CONUT. In comparison, older age (OR = 1.045, P < 0.001), lower blood lymphocyte count (OR = 0.607, P = 0.006), lower serum total cholesterol levels (OR = 0.991, P < 0.001), dyskinesia (OR = 2.231, P = 0.002), worse motor symptoms (OR = 1.016, P = 0.015), more severe depression (OR = 1.028, P = 0.008) and perceptual problems/hallucinations (OR = 1.061, P = 0.033) were associated with malnutrition in PD by GNRI. ConclusionsOur study indicated that malnutrition is more prevalent in PD patients than HC. Multidimensional risk factors for malnutrition in PD should be taken seriously.

Multidimensional Risk Factors of Age-Related Hearing Loss Among Malaysian Community-Dwelling Older Adults.

PurposeThis study evaluates the prevalence of and the multidimensional risk factors associated with age-related hearing loss (ARHL) among community-dwelling older adults in Malaysia.Patients and MethodsA total of 253 participants aged 60 years and above participated in this cross-sectional study. The participants were subjected to pure tone audiometric assessment. The hearing threshold was calculated for the better ear and classified into pure-tone average (PTA) for the octave frequencies from 0.5 to 4 kHz and high-frequency pure-tone average (HFA) for the octave from 2 to 8kHz. Then, the risk factors associated with PTA hearing loss (HL) and HFAHL were identified by using multivariate logistic regression analysis.ResultsThe prevalence of ARHL based on PTA and HFA among the community-dwelling older adults was 75.5% and 83.0%, respectively. Following multifactorial adjustments, being older (OR: 1.239; 95% CI: 1.062–1.445), having higher waist circumference (OR: 1.158; 95% CI: 1.015–1.322), lower intake of niacin (OR: 0.909; 95% CI: 0.831–0.988) and potassium (OR: 0.998; 95% CI: 0.996–1.000), and scoring lower in RAVLT T5 (OR: 0.905; 95% CI: 0.838–0.978) were identified as the risk factors of PTAHL. Meanwhile, being older (OR: 1.117; 95% CI: 1.003–1.244), higher intake of carbohydrate (OR: 1.018; 95% CI: 1.006–1.030), lower intake of potassium (OR: 0.998; 95% CI: 0.997–0.999), and lower scores on the RAVLT T5 (OR: 0.922; 95% CI: 0.874–0.973) were associated with increased risk of having HFAHL.ConclusionIncreasing age, having higher waist circumference, lower intake of niacin and potassium, higher intake of carbohydrates and having lower RAVLT T5 score were associated with increased risk of ARHL. Modifying these risk factors may be beneficial in preventive and management strategies of ARHL among older persons.

Risk and Protective Factors for Personality Disorders: An Umbrella Review of Published Meta-Analyses of Case-Control and Cohort Studies.

The putative risk/protective factors for several personality disorders remain unclear. The vast majority of published studies has assessed personality characteristics/traits rather than disorders. Thus, the current umbrella review of meta-analyses (MAs) aims to systematically assess risk or protective factors associated with personality disorders. We searched PubMed–MEDLINE/PsycInfo databases, up to August 31, 2020. Quality of MAs was assessed with AMSTAR-2, while the credibility of evidence for each association was assessed through standard quantitative criteria. Out of 571 initial references, five meta-analyses met inclusion criteria, encompassing 56 associations of 26 potential environmental factors for antisocial, dependent, borderline personality disorder, with a median of five studies per association, and median 214 cases per association. Overall, 35 (62.5%) of the associations were nominally significant. Six associations met class II (i.e., highly suggestive) evidence for borderline personality disorder, with large effect sizes involving childhood emotional abuse (OR = 28.15, 95% CI 14.76–53.68), childhood emotional neglect (OR = 22.86, 95% CI 11.55–45.22), childhood any adversities (OR = 14.32, 95% CI 10.80–18.98), childhood physical abuse (OR = 9.30, 95% CI 6.57–13.17), childhood sexual abuse (OR = 7.95, 95% CI 6.21–10.17), and childhood physical neglect (OR = 5.73, 95% CI 3.21–10.21), plus 16 further associations supported by class IV evidence. No risk factor for antisocial or dependent personality disorder was supported by class I, II, and III, but six and seven met class IV evidence, respectively. Quality of included meta-analyses was rated as moderate in two, critically low in three. The large effect sizes found for a broad range of childhood adversities suggest that prevention of personality disorders should target childhood-related risk factors. However, larger cohort studies assessing multidimensional risk factors are needed in the field.

EXPLORING GANG RISK FACTORS AMONG URBAN NIGERIAN YOUTHS

The proliferation of urban youth gangs is often attributed to criminogenic factors of economic, family, and community contexts. Among urban Nigerian youths, the sharp increase in youth gangs has been exacerbated by a broken socio-cultural value system arising from a sustained economic dislocation, aping of foreign cultures, as well as a predatory political elite that uses gang members as foot soldiers in the violent struggle for political power by rival political groups. This study examines the etiology, trend, and dynamism of gang culture in Nigeria. Employing a qualitative approach, the study used data from semi-structured interviews with gang members in Ibadan and Lagos, two of the large southwestern cities in Nigeria. Findings revealed that the interplay of multi-dimensional risk factors has contributed to the rapid growth of urban gang culture in Nigeria with the consequent effect on the increase in crime rates

Development and Validation of a Risk Prediction Model for Mortality Using Nomogram Among the Chinese Older Adults

Background: Rapid population ageing is a worldwide trend, highlighting an urgent need to have a reliable prediction tool for estimating a general older adult mortality risk. Previous predictive models have limited by the cause mortality, clinical indexes, participants as young as 50 years old, and western countries. We aimed to develop and validate a all-cause mortality prediction model based on multidimensional risk factors in Chinese older adults. Methods: In three prospective cohorts, we used the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (mean age 88.08, n=37074) as the derivation cohort and the Healthy Ageing and Biomarkers Cohort Study (HABCS) (mean age 86.74, n=2552) and the China Health and Retirement Longitudinal Study (CHARLS) (mean age 72.48, n=4794) as validation cohorts. 42 risk factors were filtered by Lasso regression. The predictive factors of final models were decided by both improved net reclassification improvement (NRI) and public health significance. Cox proportional hazards models were established the mortality risk prediction equations. Model fit was evaluated by discrimination C-statistic. We conducted the 10x10 cross-validation technique to evaluate the internal consistency of the discrimination and calibration performance. Calibration plots were shown the results by comparing the predicted probabilities with the observed probabilities. The prediction ability of the equation was illustrated by using Nomogram. Findings: During 20-year follow-up, 28158 older adults (76%) died, leading to a total of 101429 person-years of observation in the CLHLS. The final model for all-cause mortality included age, sex, cognitive status, ADL status, current spouse status, past smoke status, frequency of doing housework, frequency of reading and watching TV, and frequency of doing garden work. The C statistic of derivation Cohort was 0.728 (96%CI, 0.724,0.732), and external validation were 0.761 (96%CI, 0.749,0.773) in HABCS and 0.713 (96%CI, 0.697,0.729) in CHARS. Interpretation: This study provides an objective, validated, and acceptable predictive factors to predict mortality risk in Chinese older adults. Our finding suggest that these predictive factors could be useful for policy, epidemiological and clinical applications. Funding Information: This work was supported by the fund of “San-ming” Project of Medicine in Shenzhen (NO.SZSM201812088) for data collection and analysis. Declaration of Interests: None. Ethics Approval Statement: The Protection of Human Subjects for the CLHLS, HACBS and CHARLS were approved by the biomedical ethics committee of Peking university. The written informed consent was provided by survey respondents before investigation.

Chronic Primary Pain of the Spine: an Integrative Perspective Part 1

The aim of this study is to conduct a narrative review of the literature emphasizing current models of non-specific low back and neck pain with an emphasis on chronic and disabling pain. We include its risk factors, etiology, pathophysiology, and differential diagnosis. Emphasis is also placed on variables of chronification and the persistence of this type of pain. Our secondary aim was to provide foundational knowledge before advancing the discussion to a proposal of evidence-based management strategies for patients suffering from chronic primary spine pain in a subsequent follow-up article. A review of the English medical literature was performed using search terms “chronic low back pain” OR “chronic neck pain” AND “primary,” “differential diagnosis,” “pathophysiology,” “functional imaging” and “risk factors.” Additional searches were made using Google Scholar and PubMed search engines through January 17, 2020. A total of 112 articles were used. Acute and chronic spine pain differ significantly in risk factors, pathophysiology, prevalence, and differential diagnosis. Chronic spinal pain is multifactorial in nature, and that proposed causes of chronicity and pain-related disability span the entire spectrum of the biopsychosocial domain. Chronic low back and neck pain poses a significant global threat of disabling and burdensome quality of life. Because pain is a complex multifactorial integrative experience, the scientific literature reports an abundance of multidimensional risk factors associated with the persistence of pain beyond normal healing times. Understanding the nature of chronic primary spinal pain will provide clinicians with necessary and valuable insights for patient care along the complex and variable spectrum of the biopsychosocial approach.

Risk factors associated with curiosity about alcohol use in the ABCD cohort.

Curiosity and intent to use alcohol in pre-adolescence is a risk factor for later experimentation and use, yet we know little of how curiosity about use develops. Here, we examine factors that may influence curiosity about alcohol use, as it may be an important predictor of later drinking behavior. Cross-sectional data on youth ages 10-11 from the ongoing Adolescent Brain Cognitive Development℠ (ABCD) Study Year 1 follow-up were used (n=2,334; NDA 2.0.1). All participants were substance-naïve at time of assessment. Group factor analysis identified latent factors across common indicators of risk for early substance use (i.e., psychopathology and trait characteristics; substance use attitudes/behaviors; neurocognition; family and environment). Logistic mixed-effect models tested associations between latent factors of risk for early substance use and curiosity about alcohol use, controlling for demographics and study site. Two multidimensional factors were significantly inversely and positively associated with greater curiosity about alcohol use, respectively: 1) low internalizing and externalizing symptomatology coupled with low impulsivity, perceived neighborhood safety, negative parental history of alcohol use problems, and fewer adverse life experiences and family conflict; and 2) low perceived risk of alcohol use coupled with lack of peer disapproval of use. When assessing all risk factors in an overall regression, lack of perceived harm from trying alcohol once or twice was associated with greater likelihood of alcohol curiosity. Taken together, perceptions that alcohol use causes little harm and having peers with similar beliefs is related to curiosity about alcohol use among substance-naïve 10-11-year-olds. General mental health and environmental risk factors similarly increase the odds of curiosity for alcohol. Identification of multidimensional risk factors for early alcohol use may point to novel prevention and early intervention targets. Future longitudinal investigations in the ABCD cohort will determine the extent to which these factors and curiosity predict alcohol use among youth.

More than the sum of their parts: A dyad-centered approach to understanding adolescent sexual behavior.

Research has documented multiple levels of influences on adolescent sexual behavior, but has generally focused less on the relational nature of this behavior. Studies with dyadic data have provided important findings on relationship process, including the role of gender in different-sex dyads. However, both of these bodies of literature typically utilize a variable-centered approach, which examines average influences of particular variables on sexual behavior. This study expands upon this research by presenting a dyad-centered approach to adolescent sexual behavior that can identify types of couples based on patterns of multidimensional risk and protective factors. I demonstrate the dyad-centered approach using data from different-sex dyads in the National Longitudinal Study of Adolescent to Adult Health to uncover profiles marked by individual, parent, peer, and religion predictors for both male and female partners. Analyses uncovered five classes of dyadic influences, four of which were marked by relative similarity between partners and one marked by lesser approval of sex for women compared to men. Dyads marked by both partners intending to have sex and being in a context that is more approving of sex were more likely to engage in sexual intercourse. Findings demonstrate the heterogeneity of influences and intentions to have sex among adolescent couples, and identify profiles of dyads who are more likely to engage in sexual intercourse. This approach can explicate dyadic processes involved in sexual behavior and the types of couples that exist in a population, leading to more tailored and efficacious interventions.

Artificial neural networks to compare the contribution of basic clinical factors, ESC SCORE, and multidimensional risk factors for cardiovascular event prediction performance: an observational study

Abstract Background/Introduction Despite the recent increase in the availability of different data sources that can be used for prediction models for cardiovascular disease (CVD), it remains unclear to what extent such data could contribute to improving performance of the models in data-driven cardiovascular research. Purpose To compare the contribution of different data types in basic clinical factors, the European Society of Cardiology Systematic Coronary Risk Evaluation (ESC SCORE), and multidimensional risk factors for CVD prediction performance of artificial neural networks (ANN) using the relevant input features derived from a large-scale medical claims database. Methods We abstracted data through the National Health Insurance Sharing Service and collected information on 258,896 middle-aged individuals free of CVD at baseline (2009–2010) who were followed up for incident CVD until 2013. Multidimensional risk factors identifiable from the database were chosen from a systematic review of published articles. Input features in ANN were classified as follows: basic clinical factors (age, sex, and body mass index), ESC SCORE (age, sex, total cholesterol, systolic blood pressure, and cigarette smoking), and multidimensional risk factors (sociodemographic, lifestyle behavior, underlying medical conditions, dental health, medication use, etc). The data were partitioned into the training and test sets with 7:3 ratio and the performance of each ANN model was evaluated with area under the curve (AUC). Results The ANN model with multidimensional risk factors had higher prediction performance (AUC: 0.692) compared to the models with basic clinical factors (AUC: 0.671) and ESC SCORE (AUC: 0.684). Within the multidimensional risk factors, atrial fibrillation, family history, chronic kidney disease, retinal vein occlusion, dental caries, antipsychotics, and corticosteroid use were some of the strong predictors. However, adding multidimensional risk factors only showed marginal improvement (increase in 1.17% of AUC) compared with the ESC SCORE model. Conclusions Adding multidimensional risk factors as input features in the ANN only showed marginal improvement in the CVD prediction performance. When assessing cardiovascular risk from the large-scale healthcare data, variables included in the ESC SCORE should primarily be considered in the model. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Kyuwoong Kim received a scholarship from the BK21-plus education program provided by the National Research Foundation of the Republic of Korea. This work is a part of Kyuwoong Kim's PhD dissertation.

Prevalence of Physical Frailty and Its Multidimensional Risk Factors in Korean Community-Dwelling Older Adults: Findings from Korean Frailty and Aging Cohort Study.

Frailty is defined as a state of increased vulnerability to stressors, and it predicts disability and mortality in the older population. This study aimed to investigate the standardized prevalence and multidimensional risk factors associated with frailty among Korean community-dwelling older adults. We analyzed the baseline data of 2907 adults aged 70–84 years (mean age 75.8 ± 3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and prefrailty was 7.9% (95% confidence interval (CI) 6.8–8.9%) and 47.0% (95% CI, 45.1–48.8%), respectively. The following 14 risk factors were significantly associated with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive symptoms, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer Timed Up and Go, and low Short Physical Performance Battery score (p < 0.05). Physiconutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.

Benefit allocation model of distributed photovoltaic power generation vehicle shed and energy storage charging pile based on integrated weighting-Shapley method

In this study, to develop a benefit-allocation model, in-depth analysis of a distributed photovoltaic-power-generation carport and energy-storage charging-pile project was performed; the model was developed using Shapley integrated-empowerment benefit-distribution method. First, through literature survey and expert interview to identify the risk factors at various stages of the project, a dynamic risk-factor indicator system is developed. Second, to obtain a more meaningful risk-calculation result, the subjective and objective weights are combined, the weights of the risk factors at each stage are determined by the expert scoring method and entropy weight method, and the interest distribution model based on multi-dimensional risk factors is established. Finally, an example is used to verify the rationality of the method for the benefit distribution of the charging-pile project. The results of the example indicate that the limitations of the Shapley method can be reasonably avoided, and the applicability of the model for the benefit distribution of the charging-pile project is verified.