Non-modifiable Risk Factors Research Articles

RISK DETERMINANTS THAT ESCALATE CARDIO VASCULAR DISORDERS

Notwithstanding credible advances in cardiovascular health progress contributed byscientific studies during the preceding few decades, cardiovascular disease (CVD) relics a largenumber of deaths in developing as well as developed countries. Out of total of 161 articles screened.87 articles were excluded based on the preliminary scrutiny of abstract and titles and the study wasrestricted to remaining 74 articles to capture the most relevant literature. The risk factors of cardiovascular diseases have been recognized as modifiable and non-modifiable risk factors. Modifiablecardio- vascular risk factors involve tobacco usage, hypertension, elevated blood glucose,dyslipidemia, overweight, environmental tobacco smoke (ETS), unhealthy diet, alcohol intake, lack ofphysical activity. The non modifiable cardio vascular risks are age, sex, family history and raciallocale. A public awareness of risk factors contributing cardio vascular disorders is imperative forhealth of individuals and suggested to investigate time and again during life. Risk factors identified inthis research are sufficient markers of changes in heart health during aging process. In future, riskfactors of cardio vascular diseases should be included in secondary classes’ syllabi for the earlyawareness and prevention of cardiovascular diseases in new generation. Public awareness should beenhanced through print and electronic media. Annual, work place surveys are required to be conductedfor early identification of cardio vascular disorders in workers of government and privateinstitutions/sectors, an effort that should be done on the part of employers to retain healthy and highquality employees.

Insights into Prevention of Health Complications in Small for Gestational Age (SGA) Births in Relation to Maternal Characteristics: A Narrative Review.

Small for gestational age (SGA) births are a significant clinical and public health issue. The objective of this review was to summarize maternal biological and socio-demographic factors and preventive strategies used to reduce the risk of SGA births. A literature search encompassing data from the last 15 years was conducted using electronic databases MEDLINE/PubMed, Google Scholar and Scopus to review risk factors and preventive strategies for SGA. Current evidence shows that primiparity, previous stillbirths, maternal age ≤24 and ≥35 years, single motherhood, low socio-economic status, smoking and cannabis use during pregnancy confer a significant risk of SGA births. Studies on alcohol consumption during pregnancy and SGA birth weight are inconclusive. Beneficial and preventive factors include the "Mediterranean diet" and dietary intake of vegetables. Periconceptional folic acid supplementation, maternal 25-hydroxyvitamin D, zinc and iron levels are partly associated with birth weight. No significant associations between COVID-19 vaccinations and birthweight are reported. A midwifery-led model based on early and extensive prenatal care reduces the risk of SGA births in women with low socio-economic status. Major preventive measures relate to the awareness of modifiable and non-modifiable risk factors of SGA, leading to changes in parents' lifestyles. These data support that education, monitoring during pregnancy, and implementing preventive strategies are as important as biological determinants in risk reduction of SGA births.

Epidemiology and modifiable risk factors for atrial fibrillation.

The global prevalence of atrial fibrillation (AF) has increased substantially over the past three decades and is currently approximately 60 million cases. Incident AF and its clinical consequences are largely the result of risk factors that can be modified by lifestyle changes. In this Review, we provide evidence that the lifetime risk of AF is modified not only by sex and race but also through the clinical risk factor and comorbidity burden of individual patients. We begin by summarizing the epidemiology of AF, focusing on non-modifiable and modifiable risk factors, as well as targets and strategies for theprimary prevention of AF. Furthermore, we evaluate the role of modifiable risk factors in the secondary prevention of AF as well as the potential effects of risk factor interventions on the frequency and severity of subsequent AF episodes. We end the Review by proposing strategies that require evaluation as well as global policy changes that are needed for the prevention of incident AF and the management of recurrent episodes in patients already affected by AF.

Association of Non-Modifiable Risk Factors with Coronary Artery Disease (CAD) in a Tertiary Care Hospital in Peshawar, Pakistan

Introduction: Coronary Artery Diseases (CAD) have been estimated to be the leading cause of mortalities in developing countries in the year 2010. It is evident from previous studies that healthy life style choices can help in the reduction of CAD risk factors. They are either modifiable risk factors including hypertension, hypercholesterolemia, smoking, diabetes mellitus, obesity, and psychological stress or non-modifiable risk factors such as age, gender, family history and ethnicity. Non modifiable risk factors, however, are not studied in detail regarding their association with CAD. Objective: The objective of this study was to assess non-modifiable risk factors associated with CAD in patients and to devise strategies to deal with these risk factors to reduce the incidence of CAD among local population. Methodology: Retrospective observational study was conducted at Peshawar Institute of Cardiology (PIC). Data was extracted from Electronic Medical Records (EMR) of 98 patients including non-modifiable risk factors associated with CAD i.e., gender, age and family history. Results: The analysis performed indicated that in patients with CAD, non-modifiable risk factors such as age and gender play a significant role (p

Effect of modifiable and non-modifiable risk factors on hypertension among diabetics: An observational study

Background: This study was increased prevalence of hypertension among diabetics. Aim and Objectives: The aims of this study were to assess the influence of various modifiable and non-modifiable risk factors on hypertension among diabetics. Materials and Methods: Five hundred and one (n = 501) known diabetics in the age group of 40–70 of both the gender were included in the study. Various non-modifiable risk factors such as age, gender, and duration of diabetes mellitus were recorded in a standard pro forma. Various modifiable risk factors such as smoking and alcohol consumption were reordered in a standard pro forma. The glycosylated hemoglobin value and lipid profile were collected from the laboratory reports. The blood pressure value was recorded using mercury sphygmomanometer with both palpatory and auscultatory methods. All the values were statistically analyzed using t-test and Chi-square by SPSS 20 software. Results: Study shows that the prevalence of hypertension among diabetics was 53.89%. The study shows that among the non-modifiable risk factors duration of diabetes was higher among the diabetics with hypertension (P = 0.001**). The study shows that among the modifiable risk factors smoking and alcohol consumption were significantly associated with development of hypertension among diabetics (P = 0.00**). The study shows that high-density lipoprotein (P = 0.011*) value were significantly higher, whereas total cholesterol (P = 0.001*) values were significantly lower among diabetics with hypertension. Conclusion: Increase in duration of diabetes, smoking, and alcohol consumption influences the development of hypertension among diabetics.

Prevalence of hypertension and associated risk factors in urban slums: A community based cross sectional study in India.

Hypertension is a global public health issue. Being a silent killer, very rarely symptoms are seen in the early stages till a severe medical crisis (heart attack, stroke, or chronic kidney disease) occurs. A community-based cross-sectional study was conducted to estimate the prevalence of hypertension in urban slums and to evaluate the association of hypertension with various modifiable and nonmodifiable risk factors. Data were collected by house-to-house visits in the slums. Pro forma created in the Magpi app was used to collect demographic characteristics and record anthropometric findings. SPSS version 25 was used for statistical analysis. Of the 534 participants, 71.91% were female. The prevalence of hypertension was found to be 15.36%. The risk of hypertension increased with age >50 years, female gender, and habits such as tobacco and alcohol. Awareness programs to reduce modifiable risk factors such as smoking and alcohol, promoting healthy lifestyles, as well as early diagnosis and treatment, will benefit the community.

Epidemiology and impact of non-communicable diseases

Non communicable diseases are the leading cause of death and disability whole over the world. The main non communicable diseases include cardiovascular disease, Cancer, Diabetes and Chronic respiratory diseases. To prevent and control the non-communicable diseases it very essential to know the epidemiology of the disease. To address any health problem it is very essential to know the size of population. Epidemiology helps to find out the frequency, distribution and determinants of diseases. Non communicable diseases kills around 41 million people each year which is equal to 74% of total death worldwide. The determinants of these disease include cultural, political environmental and socioeconomic factors, modifiable and non-modifiable risk factors and metabolic risk factors. Impact of non-communicable disease include the macroeconomic impact and microeconomic impact. Disease burden estimation based on epidemiological consideration will help the health authorities for proper policy planning and programme management.

Assessing Community Awareness of Ischemic Heart Disease Risk Factors in Nangarhar: A Comprehensive Study

‌Background: Ischemic heart disease (IHD) is the impairment of the heart due to reduced blood flow to the heart. Usually, the reduced flow is the result of coronary artery disease, a condition in which the coronary artery is narrowed. The risk factors for IHD are classified into modifiable risk factors (age, sex, ethnicity, family history) and non-modifiable risk factors (hypertension, hyperlipidemia, diabetes mellitus, obesity, smoking, poor diet, sedentary lifestyle). The study aimed to evaluate the awareness of adults about IHD-related risk factors and to recognize demographic variables correlated with this knowledge level. Materials and Methods: This descriptive cross-sectional study was conducted among a convenience sample of 114 adults taking part in a health awareness fair held in a shopping mall in Nangarhar, in January 2023. A modified version of the IHD Facts questionnaire was used to estimate awareness of IHD risk factors. The number of correct responses for each item, which ranged from 0 to 21, has been integrated up in order to calculate the score. A mean score of less than 70% indicated insufficient awareness. To determine correlated demographic variables and demonstrate the participants' knowledge level, descriptive and multivariate logistic regression analyses were carried out. Findings: The study had a response rate of 87.7%, with 114 subjects participating in total. Of the participants, 69 individuals (60.5%) showed a mean IHD awareness score that was insufficient. It was found that there was a significant correlation between body mass index (odds ratio = 0.739; p = 0.023), marital status (OR = 0.057; p = 0.036), and education level (OR = 9.243; p = 0.006) and awareness of IHD risk factors. Conclusion: The Nangarhar study population showed a low level of awareness regarding IHD risk factors. It appears that the participants' inability to engage in prevention is a result of their limited awareness. These results underline how important it is for Nangarhar to carry out educational initiatives to raise public awareness of IHD risk factors and prevention.

Breast cancer: Epidemiology, risk factors and screening.

Breast cancer is a global health concern with a significant impact on the well-being of women. Worldwide, the past several decades have witnessed changes in the incidence and mortality of breast cancer. Additionally, epidemiological data reveal distinct geographic and demographic disparities globally. A range of modifiable and non-modifiable risk factors are established as being associated with an increased risk of developing breast cancer. This review discusses genetic, hormonal, behavioral, environmental, and breast-related risk factors. Screening plays a critical role in the effective management of breast cancer. Various screening modalities, including mammography, ultrasound, magnetic resonance imaging (MRI), and physical examination, have different applications, and a combination of these modalities is applied in practice. Current screening recommendations are based on factors including age and risk, with a significant emphasis on minimizing potential harms to achieve an optimal benefits-to-harms ratio. This review provides a comprehensive insight into the epidemiology, risk factors, and screening of breast cancer. Understanding these elements is crucial for improving breast cancer management and reducing its burden on affected individuals and healthcare systems.

Clinical Profile And Risk Factors Of Stroke: A Comparative Analytical Study Between Young And Old Onset

Background: With ever-increasing incidence, young-onset stroke is responsible for significant psychosocial and economic burden, primarily due to post-stroke disability in the productive population. Objective: The aim of our study is to assess the profile and risk factors in young-onset stroke compared to those in older patients. Methods: This was a retrospective cross-sectional study. We included all patients with acute stroke, or transient ischemic attack (TIA) treated at Siloam Lippo Village Hospital between October 2021 and February 2022. An independent t-test was conducted for continuous variables with normal distribution and a Mann-Whitney U test for ordinal or continuous variables with non-normal distribution. Pearson's chi-square test was performed for categorical variables. Results: 153 patients with acute stroke and TIA were included. On univariate analysis comparing young and old-onset strokes, significant differences were found in diagnosis (p=0.039), Bamford classification (p=0.022), NIHSS (p=0.014), history of smoking (p=0.012), previous stroke (p=0.045), history of coronary artery disease (p=0.026), and routine antiplatelet use (p=0.018). Conclusion: We found a predominance of hemorrhagic stroke and TIA in the young-onset group, with more common involvement of the anterior circulation. Older onset was associated with a higher NIHSS score. Modifiable risk factors are more common in young-onset stroke, while non-modifiable risk factors are more common in the older population. However, hypertension remains an equally important risk factor in both groups. Our study provides an overview of the profile and risk factors for young-onset stroke. The information obtained can be useful as educational material for the community to prevent young-onset stroke.

A cross- sectional, questionnaire-based study to assess the Knowledge and practice on life style modification among hospitalized cardiac patients

Background: Cardiovascular diseases are mostly preventable cardiac diseases which manifest due to practice of unhealthy lifestyle. These days many people are deliberately engaged in find ways to preserve and improve their health by acquiring favourable lifestyle practices. Cardiovascular disease (CVD) is caused by non-modifiable and modifiable risk factors such as smoking, alcohol, obesity, hypertension, and diabetes mellitus. In India there are 60 million cases of cardiovascular diseases are estimated and it is expected to rise to 200 million in next decade. It is imperative to understand that the expected cases can be prevented only through modifying unhealthy lifestyle and practices. Objective: We aimed to assess the knowledge and practice on lifestyle modifications of cardiovascular diseases and also to determine the correlation between knowledge and practices related to lifestyle modifications among hospitalized cardiac patients in a tertiary care hospital of northern India. Methods: This is a, questionnaire based and descriptive study. Respondents who fulfilled the inclusion criteria 60 samples were selected using purposive sampling technique. A structured validated questionnaire was used to assess the knowledge and practice for data collection. After obtaining due approval from institutional ethical committee. Results: Mean knowledge and practice score of the study participants was 12.5±1.4 and 6.6±0.7, respectively. Among the total participants (n=60), 25 (41.7%) had good knowledge, 31(51.7%) had average knowledge and 4(6.6%) had poor knowledge regarding lifestyle and behavioural modifications. In practice score, 13(21.7%) had good practice, 46 (76.7%) had average practice and 1(1.6%) had poor practice. Socio-demographic variables like dietary patterns, education, occupation and body mass index significantly impacted the knowledge of patients regarding CVD prevention. Karl-Pearson coefficient proved that there was a perfect correlation between knowledge score and practices regarding lifestyle modifications among cardiac patients with ‘r’ score of 1. Conclusion: Practice of lifestyle modification regarding cardiovascular diseases are largely determined by Knowledge. Patient with adequate knowledge practices good lifestyle practices. So A definite positive linear relationship exists between knowledge and good CVD prevention practices. Further interventional studies assessing various approaches to promote awareness regarding lifestyle modifications are required in cardiac patients. (Abstract published in Global Journal of Medicine and Medical Sciences 2020, ISSN: 2449-1888, Volume 8/Issue 9/03).

Prevalence of Type 2 Diabetes Mellitus in the General Population of Saudi Arabia, 2000-2020: A Systematic Review and Meta-Analysis of Observational Studies.

The prevalence of type 2 diabetes mellitus (T2DM) has increased worldwide, including in Saudi Arabia. To systematically review the available literature and assess the pooled prevalence of T2DM in Saudi Arabia between 2000 and 2020. Observational studies that reported quantitative estimates of the prevalence of T2DM as their main outcome, included the general population of Saudi Arabia, and were published between 2000-2020 and in English were retrieved using three electronic databases (namely, CINAHL, Medline via PubMed, and Web of Science). Retrieved studies were screened, and relevant data were extracted. The Joanna Briggs Institute Critical Appraisal guideline was used to assess the methodological quality of included studies. A random-effects model was used to estimate the prevalence of T2DM. Twenty-three studies were included in the systematic review, of which 19 were included in the meta-analysis (total pooled population: 258,283). The overall pooled prevalence of T2DM in Saudi Arabia was 16.4% (95% CI: 11.6-17.5). However, there was heterogeneity in the results of the studies [I2 = 99.31%, P < 0.0001] and the summary values varied from 3.18% (95% CI: 1.46-5.95) to 94.34% (95% CI: 89.53-97.38). Although the prevalence of T2DM by age varied across studies, in most studies, it was higher among the older age groups. In addition, the prevalence of diabetes widely varied across the different geographical regions of Saudi Arabia. This is the first meta-analysis that determined the pooled prevalence of T2DM in Saudi Arabia, and it revealed a high prevalence over the past two decades. However, owing to data collection inconsistencies in the identified studies, neither the modifiable (such as obesity, educational status, emotional support, etc.) nor the non-modifiable (such as gender and age) risk factors of T2DM could be determined, thereby indicating the need for a nationally collective effort in determining these factors.

Diarrhea as a Disease of Poverty Among Under-Five Children in Sub-Saharan Africa: A Cross-Sectional Study.

The objective of this study was to assess the prevalence of diarrhea among under-five children in low-middle-income countries and identify the sociodemographic factors associated with it. Data of 36 countries in sub-Saharan Africa from demographic and Health Surveys (2006-2018) comprising 251 341 mother-child (singleton) dyads were analyzed to estimate the prevalence and various modifiable and non-modifiable risk factors of diarrhea. Occurrence of diarrhea during the last 2 weeks was the outcome variable which was measured by mothers' observation of the condition. The overall prevalence of having diarrhea during last 2 weeks was 18.44% (19.12% among boys and 17.75% among girls). Boys had higher percentage of having diarrhea than girls in all countries except in Libya. The risk ratios of having diarrhea decreased progressively with higher wealth quintiles; the risks of were respectively 7% [RR = 0.93, 95% CI = 0.91; 0.97], 11% [RR = 0.89, 95% CI = 0.86; 0.92] and 18% [RR = 0.82, 95% CI = 0.78; 0.85] lower for households in the middle, richer and richest households. Rural residency was associated with lower risks [RR = 0.95, 95% CI = 0.93; 0.98] and not having access to improved water [RR = 1.05, 95% CI = 1.03; 1.08] and toilet facilities [RR = 0.04, 95% CI = 1.01; 1.07] were associated with higher risks of diarrhea. Regarding children's characteristics, higher age groups, birth order were associated with higher risks and female sex with lower risks. Children with mothers in the higher age groups and with above secondary level education had lower risks, and primary education had higher risks of diarrhea. Meta-analysis of 36 countries revealed a significantly negative association between wealth quintile and diarrhea (Odds ratio = 0.72, 95% CI = 0.69; 0.74). Findings indicate the presence of a significant wealth gradient in the burden of diarrheal diseases among under-five children in sub-Saharan Africa, and underscores the need for paying special attention to the marginalized communities when designing intervention programs.

Prenatal Maternal Risk Factors Contributing to Atopic Dermatitis: A Systematic Review and Meta-Analysis of Cohort Studies.

The gestational risk factors predispose to the manifestation of early childhood atopic dermatitis (AD). We evaluated the association between modifiable and non-modifiable gestational and prenatal risk factors that affect the AD prevalence in children. We performed the systematic review and meta-analysis of cohort studies (n=27) in PubMed and EMBASE (2000~2021). A meta-analysis was performed using random-effects models to estimate pooled odds ratios (OR) or hazard ratio (HR). We performed a systematic review according to Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines and summarized cohort studies investigating gestational and prenatal risk factor those predispose to AD in off spring. Leading modifiable and non-modifiable were identified through ORs. Meta-analysis using the random effect model was also conducted to provide an overall estimate for several significant factors. Among the non-modifiable risk factors gestational diabetes (7.2, 95% confidence interval [CI]: 1.4~34.5), maternal history of allergy (2.14, 95% CI: 1.54~2.97) and prenatal history of eczema (2.46, 95% CI: 1.0~5.8) were found as major determining risk factors in early manifestation of AD in children. Further, maternal exposure to industrial products (1.89, 95% CI: 1.10~3.16), exposure to antibiotics during pregnancy (3.59, 95% CI: 1.19~10.85) and passive smoking during pregnancy (2.60, 95% CI: 1.11~6.1) are leading causes of early AD manifestation. Conclusively, both genetic and environmental factors play a pivotal role in early manifestation of AD. The better managing the environmental factors during gestational phase to the least can help curtail the prevalence of AD in children.

S-07-7: ANGIOTENSIN, VASCULAR AGING AND HYPERTENSION

Aging is a major non-modifiable risk factor underlying hypertension and associated cardiovascular disease. With aging, the vasculature undergoes structural, functional and mechanical alterations characterized by endothelial dysfunction, media thickening, reduced distensibility, and arterial stiffening. Many of these processes are associated with activation of the renin angiotensin aldosterone system (RAAS), which is characteristically associated with the pathophysiology of hypertension. In particular Ang II, through the AT1 receptor, and aldosterone through the mineralocorticoid receptor, activate pro-inflammatory and pro-fibrotic signaling pathways that lead to vascular fibrosis, extracellular matrix (ECM) deposition, arterial remodelling, perivascular inflammation and hyperreactivity. These processes are also associated with aging and are amplified by hypertension. Molecular mechanisms underlying these events include increased expression and activation of matrix metalloproteinases, activation of transforming growth factor1/SMAD signalling, upregulation of galectin-3, activation of aging signaling pathways, eg p66Shc, c-Src, and oxidative stress. Fundamental to these processes is phenotypic switching of vascular smooth muscle cells from a contractile to de-differentiated state. This involves epigenetic changes and alterations in the vascular proteome. Complex interplay between the “aging process” and prohypertensive factors, including Ang II and aldosterone, result in accelerated vascular remodelling and fibrosis and increased arterial stiffness, which is typically observed in hypertension. Because the vascular phenotype in a young hypertensive individual resembles that of an elderly otherwise healthy individual, the notion of “early” or “premature” vascular aging is frequently used to describe hypertension-associated vascular disease. This presentation discusses the vascular phenotype in aging and hypertension and the role of the RAAS. In addition novel molecular mechanisms, focusing on oxidative stress and the vascular proteome will be highlighted.

The Impact of Pregnancy on Diabetic Retinopathy: A Single-Site Study of Clinical Risk Factors

Introduction: This study aimed to provide information on modifiable and non-modifiable risk factors for the progression and development of diabetic retinopathy (DR) and diabetic macular edema (DME). This retrospective chart review case-control study was designed to provide perspective on clinical variables. Methods: Single-center study analysis was completed with chart review, identifying 50 patients (100 eyes) ultimately included in the final analysis. Included patients were women with type 1 or 2 diabetes that entered prenatal care and had a delivery from January 2010 to December 2022. The primary outcome measure was clinical variables between progression and no progression groups. Data were analyzed via χ2 analysis and independent samples t test when appropriate. Significantly different variables were further analyzed by binary logistic regression. Results: The DR progression group had significantly higher prepregnancy HbA1c levels (9.9) when compared to the no progression group (8.5, p value 0.028). DR progression group also had higher rates (51.9%) of full-term births. The DME progression group had significantly higher rates of type 2 diabetics (100%) compared to the no progression group (30.9%, p value 0.029). Hypertension treatment before (81.8%; p value 0.008) pregnancy was also more common in the DME progression group. Intravitreal injections were more common in patients with visual acuity deterioration (26.7%, p value 0.046). The average number of fetal complications was significantly higher in the visual acuity non-worsening group (1.1) compared to the progression group (0.5, p value 0.04). These variables were not statistically significant after entry into multivariate analysis. Discussion: Severity and treatment of retinopathy before pregnancy, type of diabetes, and blood pressure control are all significant factors affecting the progression and development of severe ocular complications in pregnancy.

Effects of non-modifiable risk factors of Alzheimer’s disease on intracortical myelin content

BackgroundNon-modifiable risk factors of Alzheimer’s disease (AD) have lifelong effects on cortical integrity that could be mitigated if identified at early stages. However, it remains unknown whether cortical microstructure is affected in older individuals with non-modifiable AD risk factors and whether altered cortical tissue integrity produces abnormalities in brain functional networks in this AD-risk population.MethodsUsing relative T1w/T2w (rT1w/T2w) ratio maps, we have compared tissue integrity of normal-appearing cortical GM between controls and cognitively normal older adults with either APOE4 (N = 50), with a first-degree family history (FH) of AD (N = 52), or with the co-occurrence of both AD risk factors (APOE4+FH) (N = 35). Additionally, individuals with only one risk factor (APOE4 or FH) were combined into one group (N = 102) and compared with controls. The same number of controls matched in age, sex, and years of education was employed for each of these comparisons. Group differences in resting state functional connectivity (rs-FC) patterns were also investigated, using as FC seeds those cortical regions showing significant changes in rT1w/T2w ratios.ResultsOverall, individuals with non-modifiable AD risk factors exhibited significant variations in rT1w/T2w ratios compared to controls, being APOE4 and APOE4+FH at opposite ends of a continuum. The co-occurrence of APOE4 and FH was further accompanied by altered patterns of rs-FC.ConclusionsThese findings may have practical implications for early detection of cortical abnormalities in older populations with APOE4 and/or FH of AD and open new avenues to monitor changes in cortical tissue integrity associated with non-modifiable AD risk factors.

The relationship of E-selectin singlenucleotide polymorphisms with breast cancer in Iraqi Arab women.

Breast cancer (BC) is a significant threat to female health, with both modifiable andnon-modifiable risk factors. It is essential to monitor patients regularly and to raise population awareness. Increasing research also suggests that E-selectin (SELE) may increase tumor angiogenesis and the development of cancer. This study investigated SELE single-nucleotide polymorphisms (SNPs) in the following positions: rs5367T/C, rs5368C/T, rs5362T/G,and rs5362T/C. Using polymerase chain reaction, significant differences in allele and genotype frequencies were found between BC patients and controls. Position rs5368 was associated with an increased risk of BC for the CT and TT genotypes, with odds ratios (ORs) of16.3 and 6.90 (Fisher probability = 0.0001, p = 0.005). Women with the T allele had a 19.3-fold higher incidence of BC, while allele C may be a protective allele against BC (OR, 0.05).Heterozygous genotypes at rs5367, rs5362, and rs5362 were significantly more common inBC patients, with ORs of 5.70, 4.50, and 3.80, respectively. These SNPs may be associatedwith the risk of BC, because the frequency of mutant alleles was significantly higher in patients (OR: 4.26, 3.83, and 4.30, respectively) than in controls (OR: 0.23, 0.30, and 0.20, respectively). These SNPs may be considered a common genotype in the Iraqi population,with the wild-type allele having a protective fraction and the mutant allele having an environmental fraction. The results also revealed a 2-fold increase in gene expression in BCpatients compared to controls, with a significant effect (p = 0.017). This study's findingsconfirm the importance of SELE polymorphisms in cancer risk prediction.

Machine Learning in Hypertension Detection: A Study on World Hypertension Day Data

Many modifiable and non-modifiable risk factors have been associated with hypertension. However, current screening programs are still failing in identifying individuals at higher risk of hypertension. Given the major impact of high blood pressure on cardiovascular events and mortality, there is an urgent need to find new strategies to improve hypertension detection. We aimed to explore whether a machine learning (ML) algorithm can help identifying individuals predictors of hypertension. We analysed the data set generated by the questionnaires administered during the World Hypertension Day from 2015 to 2019. A total of 20206 individuals have been included for analysis. We tested five ML algorithms, exploiting different balancing techniques. Moreover, we computed the performance of the medical protocol currently adopted in the screening programs. Results show that a gain of sensitivity reflects in a loss of specificity, bringing to a scenario where there is not an algorithm and a configuration which properly outperforms against the others. However, Random Forest provides interesting performances (0.818 sensitivity – 0.629 specificity) compared with medical protocols (0.906 sensitivity – 0.230 specificity). Detection of hypertension at a population level still remains challenging and a machine learning approach could help in making screening programs more precise and cost effective, when based on accurate data collection. More studies are needed to identify new features to be acquired and to further improve the performances of ML models.

Breast cancer risk factors in Iranian women: a systematic review and meta-analysis of matched case–control studies

BackgroundIdentifying breast cancer risk factors is a critical component of preventative strategies for this disease. This study aims to identify modifiable and non-modifiable risk factors of breast cancer in Iranian women.MethodsWe used international databases (PubMed/Medline, Scopus, Web of Knowledge, and Embase) and national databases (SID, Magiran, and ISC) to retrieve relevant studies until November 13, 2022. The odds ratio (OR) with a 95% confidence interval using the random-effect model was used to estimate the pooled effect. The publication bias was assessed by the Egger and Begg test. A sensitivity analysis was conducted to evaluate the effect of each included study on the final measurement.ResultsOf the 30,351 retrieved articles, 24 matched case–control records were included with 12,460 participants (5675 newly diagnosed cases of breast cancer and 6785 control). This meta-analysis showed that of the known modifiable risk factors for breast cancer, obesity (vs normal weight) had the highest risk (OR = 2.17, 95% CI 1.47 to 3.21; I2 = 85.7) followed by age at marriage (25–29 vs < 18 years old) (OR = 2.00, 95% CI 1.53 to 2.61; I2 = 0), second-hand smoking (OR = 1.86, 95% CI 1.58 to 2.19; I2 = 0), smoking (OR = 1.83, 95% CI 1.41 to 2.38; I2 = 18.9), abortion history (OR = 1.44, 95% CI 1.02 to 2.05; I2 = 66.3), oral contraceptive use (OR = 1.35, 95% CI 1.11 to 1.63; I2 = 74.1), age at marriage (18–24 vs < 18 years old) (OR: 1.22, 95% CI 1.02 to 1.47; I2 = 0). Of non-modifiable risk factors, history of radiation exposure (OR = 3.48, 95% CI 2.17 to 5.59; I2 = 0), family history of breast cancer (OR = 2.47, 95% CI 1.83 to 3.33; I2 = 73), and age at menarche (12–13 vs ≥ 14 years old) (OR = 1.67, 95% CI 1.31–2.13; I2 = 25.4) significantly increased the risk of breast cancer.ConclusionsSince most risk factors related to breast cancer incidence are modifiable, promoting healthy lifestyles can play an influential role in preventing breast cancer. In women with younger menarche age, a family history of breast cancer, or a history of radiation exposure, screening at short intervals is recommended.