Probable Risk Factors Research Articles

Chronic kidney disease of unknown aetiology in Africa: A review of the literature.

During the last two decades, an epidemic of a severe form of chronic kidney disease (CKD) unrelated to traditional risk factors (diabetes and hypertension) has been recognized in low- to middle-income countries. CKD of unknown aetiology (CKDu) mainly affects young working-age adults, and has become as an important and devastating public health issue. CKDu is a multifactorial disease with associated genetic and environmental risk factors. This review summarizes the current epidemiological evidence on the burden of CKDu and its probable environmental risk factors contributing to CKD in Africa. PubMed/Medline and the African Journals Online databases were searched to identify relevant population-based studies published in the last two decades. In the general population, the burden of CKD attributable to CKDu varied from 19.4% to 79%. Epidemiologic studies have established that environmental factors, including genetics, infectious agents, rural residence, low socioeconomic status, malnutrition, agricultural practise and exposure to agrochemicals, heavy metals, use of traditional herbs, and contaminated water sources or food contribute to the burden of CKD in the region. There is a great need for epidemiological studies exploring the true burden of CKDu and unique geographical distribution, and the role of environmental factors in the development of CKD/CKDu.

Diaphragmatic dysfunction in hemodialysis patients: risk factors and effect of incentive spirometry training

BackgroundDiaphragmatic dysfunction (DD) in hemodialysis patients is a scarcely studied issue. Incentive spirometry (IS) is a commonly prescribed maneuver used to prevent or manage pulmonary complications. The present study aimed to identify the prevalence and risk factors of DD in 100 HD patients. Moreover, we assessed the role of IS in management of DD in those patients.MethodsThe present study followed a hybrid design with two phases. In the first cross-sectional phase, 100 consecutive maintenance HD patients for at least 3 years were evaluated for the presence of DD using ultrasound. In the second interventional phase, patients with DD (n = 43) were randomly assigned to receive IS (n = 22) or standard care (n = 21) for management of DD.ResultsComparison between patients with DD and patients without regarding clinical and laboratory data revealed that the former group had significantly higher frequency of males [29 (67.4%)/14 (32.6%) vs. 26 (45.6%)/31 (54.4%), p = 0.03] with lower BMI [23.8 ± 3.8 vs. 26.3 ± 3.5 kg/m2, p < 0.001] and longer HD duration (82.2 ± 42.1 vs. 64.8 ± 36.9 months, p = 0.031). Moreover, it was noted that DD group had significantly higher frequency of patients with moderate/severe malnutrition (81.4% vs. 45.6%, p = 0.005), lower Hb levels (9.6 ± 1.5 vs. 10.3 ± 1.4 gm/dL, p = 0.011), lower albumin levels (3.4 ± 0.4 vs. 4.1 ± 0.5 gm/dL, p < 0.001) and higher hsCRP levels [median (IQR) 113.6 (90.9–130.4) vs. 91.1 (50.9–105.6) mg/dL, p < 0.001] as compared to patients without DD. While no significant differences were found between patients receiving study interventions at baseline, patients submitted to IS training showed significant improvement of diaphragmatic excursion measurements as compared to the standard care group.ConclusionsIn conclusion, DD is commonly encountered in HD patients. Probable risk factors include longer HD duration and low albumin levels. Use of IS can improve diaphragmatic excursion in affected patients.

Respective roles of social deprivation, health literacy, and clinical factors for COVID-19: a case-control study in hospitalized patients.

To investigate the association between social deprivation and COVID-19 among hospitalized patients in an underprivileged department of the greater Paris area. Individuals hospitalized for COVID-19 between March 1st and October 31, 2020, were included, matched on age and sex, and compared with patients hospitalized for any other reason with negative RT-PCR for SARS-CoV-2, through a case-control study. Clinical, socio-demographic characteristics, health literacy, and social deprivation, assessed by the EPICES score, were collected. Factors associated with COVID-19 in hospitalized patients were assessed using univariate and multivariate logistic regression models. 69 cases and 180 controls were included. Participants were mostly men (N = 148: 59.4%) aged 65 or older (N = 109: 44.1%). Median EPICES score was 43.2 (IQR 29.4-62.9). EPICES score > 30.17 (precariousness threshold) was not significantly associated with COVID-19 in hospitalized patients (adjusted odds ratio (aOR) = 0.46; 95% Confidence Interval (CI) [0.21-1.01]). Advanced age, higher BMI, professional activity, home area of less than 25 m2 per person, and low health literacy, were significantly associated with COVID-19 in hospitalized patients. This study highlights probable risk factors for specific exposition in disadvantaged area: maintenance of professional activity, smaller home area, and low health literacy.

High bleeding risk mainly predicts non-access site bleeding events in the first month after percutaneous coronary intervention

Abstract Background/Introduction The majority of bleeding events after percutaneous coronary intervention (PCI) occur in the first month after PCI. To predict and anticipate on events during hospitalisation and in the first month, the CRUSADE- and ACUITY scores have been developed. In order to enhance the use of bleeding risk stratification, a consortium of PCI centres in the South East of the Netherlands has created and implemented a simple binary variant of the existing models. High bleeding risk (HBR) is defined by one of the following: eGFR&amp;lt; 30; anaemia (Hb &amp;lt; 7mmol/L); a spontaneous bleeding within one year before PCI; a history of intracranial haemorrhage. Purpose We evaluated the predictive value of our risk model and other risk factors for bleeding events in the first month after PCI and discriminated between access site- non-access site bleedings. Methods In an ongoing multicentre prospective PCI registry in the South East of the Netherlands collects baseline and follow-up data of all patients undergoing PCI. We compared access site- and non- access site bleedings between HBR and non HBR using the Kaplan Meier method and Cox regression. Also, we performed multivariate analysis of the separate factors of the model and other probable risk factors. Results We collected baseline and 30 day follow-up data in 3996 patients of which 357 with HBR (9%). Access site bleedings occurred in 3% of patients with HBR vs 2% without (sens. 0.13; spec. 0.98). Patients with HBR showed 5% non-access site bleedings versus 1% in non HBR (sens. 0.21; spec. 0.99). Survival curves and hazard ratios presented in figure 1 show that these differences are significant only for non-access site bleedings (HR: 4.2, 95% CI: 2.47-7.30). The multivariate analysis is presented in table 1. All bleeding events were predicted by age ≥ 60 and peripheral arterial disease. Furthermore, non-access site bleedings were predicted by anaemia and bleeding events in the previous year. Additional risk factors for access site bleedings were female sex and double access site punction. Conclusion The simplified risk model showed to be conservative in the determination of HBR as depicted by the sensitivity and specificity. However, it showed good discriminative value for non-access site bleedings which was driven by anemia and a history of bleedings. Furthermore, these results suggest that age ≥60 and peripheral arterial disease should be taken into consideration. Extra precaution for access site bleedings should also be taken in female patients and in the case of double access site punction.Figure 1Table 1

Polymorphisms in genes of melatonin biosynthesis and signaling support the light-at-night hypothesis for breast cancer

Light-at-night triggers the decline of pineal gland melatonin biosynthesis and secretion and is an IARC-classified probable breast-cancer risk factor. We applied a large-scale molecular epidemiology approach to shed light on the putative role of melatonin in breast cancer. We investigated associations between breast-cancer risk and polymorphisms at genes of melatonin biosynthesis/signaling using a study population of 44,405 women from the Breast Cancer Association Consortium (22,992 cases, 21,413 population-based controls). Genotype data of 97 candidate single nucleotide polymorphisms (SNPs) at 18 defined gene regions were investigated for breast-cancer risk effects. We calculated adjusted odds ratios (ORs) and 95% confidence intervals (CI) by logistic regression for the main-effect analysis as well as stratified analyses by estrogen- and progesterone-receptor (ER, PR) status. SNP-SNP interactions were analyzed via a two-step procedure based on logic regression. The Bayesian false-discovery probability (BFDP) was used for all analyses to account for multiple testing. Noteworthy associations (BFDP < 0.8) included 10 linked SNPs in tryptophan hydroxylase 2 (TPH2) (e.g. rs1386492: OR = 1.07, 95% CI 1.02–1.12), and a SNP in the mitogen-activated protein kinase 8 (MAPK8) (rs10857561: OR = 1.11, 95% CI 1.04–1.18). The SNP-SNP interaction analysis revealed noteworthy interaction terms with TPH2- and MAPK-related SNPs (e.g. rs1386483R ∧ rs1473473D ∧ rs3729931D: OR = 1.20, 95% CI 1.09–1.32). In line with the light-at-night hypothesis that links shift work with elevated breast-cancer risks our results point to SNPs in TPH2 and MAPK-genes that may impact the intricate network of circadian regulation.

The glycemic profile in patients with non-alcoholic steatohepatitis and type 2 diabetes depending on diabetic kidney disease

Background. State of carbohydrate metabolism and severity of insulin resistance in the comorbid course of non-alcoholic steatohepatitis (NASH) and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (DM2) is due to the cascade of possible transformation of NASH into liver cirrhosis. The purpose is to study the interaction of changes in glucose and insulin homeostasis, the degree of insulin resistance and insulin sensitivity, the degree of hemoglobin glycosylation on the clinical course of NASH associated with DM depending on the presence of DKD and its stage. Materials and methods. One hundred and eight patients with NASH and comorbid DM2 were examined. The average age of patients was 58.2 ± 6.1 years. There were 63 women (58.3 %) and 45 men (41.7 %). Depending on the presence of DKD, 4 groups of patients were formed, who were randomized by age, sex, activity of cytolytic syndrome. The comparison group consisted of 30 healthy individuals of the appropriate age and sex. The degree of hepatic steatosis and its nature were determined using SteatoTest, ASH and NASH-Test kits (BioPredictive, France). The stage of liver fibrosis was determined using FibroTest (BioPredictive, France), a set of markers for quantitative biochemical evaluation of fibrosis. Results. In patients with NASH, DM2 and DKD stage I–II, we found a significant decrease in serum albumin by 9.0 % (p &lt; 0.05); glomerular filtration rate (GFR) and urine albumin, on the contrary, increased significantly, by 1.5 times (p &lt; 0.05) compared to those in the control group, which indicates the phenomenon of hyperfiltration and is specific to the initial stage of DKD. When NASH is combined with DM2 and DKD stage III, a significant decrease in serum albumin by 1.2 times (p &lt; 0.05) is reported; GFR and albuminuria were significantly increased, by 1.4 and 11.7 times (p &lt; 0.05), respectively, compared to the control group. In patients with NASH, DM2 and DKD stage IV, we found a significant decrease in serum albumin by 1.4 times (p &lt; 0.05), it was significantly increased by 30.2 times (p &lt; 0.05) compared to the indicator in the control group, and the GFR, on the contrary, was significantly reduced by 1.7 times (p &lt; 0.05), which indicates the progression of DKD. Conclusions. Disorders of glucose homeostasis due to insulin resistance are one of the probable risk factors for the progression of non-alcoholic steatohepatitis and type 2 diabetes mellitus in the presence of stage I–IV diabetic kidney disease.

The Risk Factors of Chronic Pain in Victims of Violence: A Scoping Review.

Violent situations are unfortunately very frequent in women and children all over the world. These experiences have long-term consequences for adult physical and psychological health. One of the most reported is chronic pain, defined in various sub-diagnoses and present in all types of violence. Unfortunately, the etiology of this condition is not clear and neither are the predisposing factors. The aim of this scoping review is to examine the literature trends about the probable risk factors of chronic pain in violence victims. Considering a bio-psycho-social model, it is possible to hypothesize the presence of all these aspects. The results will be discussed in the present article.

Associations between eating speed and food temperature and type 2 diabetes mellitus: a cross-sectional study.

This study aimed to evaluate the relationship between eating speed and food temperature and type 2 diabetes mellitus (T2DM) in the Chinese population. A cross-sectional survey was conducted between December 2020 to March 2022 from the department of Endocrinology at the Shandong Provincial Hospital. All recruited participants were asked to complete structured questionnaires on their eating behaviors at the time of recruitment. Clinical demographic data such as gender, age, height, weight, familial history of T2DM, prevalence of T2DM and various eating behaviors were collected. Univariate and multivariate logistic regression analyses were used to analyze the associations between eating behaviors and T2DM. A total of 1,040 Chinese adults were included in the study, including 344 people with T2DM and 696 people without T2DM. Multivariate logistic regression analysis of the general population showed that gender (OR = 2.255, 95% CI: 1.559-3.260, p < 0.001), age (OR = 1.091, 95% CI: 1.075-1.107, p < 0.001), BMI (OR = 1.238, 95% CI: 1.034-1.483, p = 0.020), familial history of T2DM (OR = 5.709, 95% CI: 3.963-8.224, p < 0.001), consumption of hot food (OR = 4.132, 95% CI: 2.899-5.888, p < 0.001), consumption of snacks (OR = 1.745, 95% CI: 1.222-2.492, p = 0.002), and eating speed (OR = 1.292, 95% CI:1.048-1.591, p = 0.016) were risk factors for T2DM. In addition to traditional risk factors such as gender, age, BMI, familial history of T2DM, eating behaviors associated with Chinese culture, including consumption of hot food, consumption of snacks, and fast eating have shown to be probable risk factors for T2DM.

A Scoping Review of Male infertility Risk factors and Potential Causes

Limited studies have been conducted on the probable causes and risk factors for male infertility, despite evidence of diminishing sperm counts globally and increasing male infertility rates. Because there are few primary treatments for male unproductiveness, knowing the reason and risk characteristics will help identify particular ways to prevent it. Detect gaps of possible risks and reasons affecting on male to enable further specialized innovation and research are summarized in this review article. The review covered research from scholarly/scientific journals that addressed male infertility “its causes and risk factors”. There was no time or place restriction. Particular life style such as (smoking, alcohol intake and medication, the high prevalence of obese men, environmental contamination due to indiscriminate use especially (pesticides and heavy metals), electronic devices and male age are discussed. In addition, the genetics factors, STDs, varicocele, ROS and endocrine disorder and the influence on human spermatogenesis are considered. In our opinion, enhance comprehension “the causes and risk factor” will make it easier to develop primary preventive and to guide therapy for male infertility.

Cat attacks towards people and/or animals, an educational pending task on pet’s owners?

This study aimed to explore the context and the characteristics of domestic cats’ (Felis catus) attacking their owners or other pets and their probable risk factors. A survey was targeted to persons perceiving that their cat attacked to people or/and animals. Only no-stray, healthy cats’ information were included. 48 questions covered general information of the owners, and type of house; age sex, color, and medical record of cats; the context on which the aggression to people or other pet took place; handling habitudes in owner-cat interaction. Chi-square and Fisher test were used to compare the frequency of cat’s characteristics between cats with and without attacks towards people and/or animals. Risk factors analysis was made with WinEpi©. The information of 154 cats was obtained, the 91.5% of owners declared to play with their cats, 63 cats performed attacks to people and/or animals in the past three months. 8 (5.2%) cats perceived by their owners as non-aggressive, in fact performed attacks towards people and/or animals. The most commons wounds reported were scratches and bites (68.2%), largely considered by owners (76.2%) as no needing medical revision. 62% of aggression events were preceded by vocalization and/or body posture changes of cats. A significant higher proportion of cats combining &lt; 2years, and with nonexclusive litter box performed aggressions. Cats of age of &lt; 2 years resulted with 4.7 to 32.2 more probabilities to perform aggression. The absence of other animals also resulted as risk factor. Owner attitudes minimizing cat aggression could imply the maintenance of unwanted behaviors in cats, also accidental aggression during human-animal interaction deserve deeper studies due to possible zoonosis risk to owners.

Characteristics and risk factors for spontaneous and postoperative consecutive exotropia in children with esotropia.

To investigate the risk factors for the development of consecutive exotropia (CXT) by comparing patients with spontaneous or postoperative CXT during follow-up with another group of patients who had no deviation or less than 10 prism dioptre (PD) esotropia. In this retrospective cohort study, 6 patients with spontaneous CXT (group A), 13 patients with postoperative CXT (group B), and 39 patients with no exotropia (group C) were enrolled. Probable risk factors for CXT were evaluated among the groups. Kruskal-Wallis H test was used to determine if any significant differences were present among the groups. Fisher's exact test or Mann-Whitney U test was used for univariate analyses to compare differences between case groups or between case and control groups. The Bonferroni method was used to conduct multiple comparisons. The follow-up period of spontaneous CXT patients was significantly longer than that of postoperative CXT and nonconsecutive exotropia patients (p = 0.035 and p < 0.001, respectively). The interval between alignment and CXT onset in spontaneous CXT patients was slightly longer than that in postoperative CXT patients, but not significantly difference (6.50 vs. 5.00 years, p = 0.072). Vertical deviation was associated with a high risk of postoperative CXT (p = 0.001). Most [38 (97.44%)] nonconsecutive exotropia patients had fusion; conversely, the absence of fusion function (p < 0.001) as well as stereoacuity (p = 0.029) were associated with a high risk of CXT. Vertical deviation and poor binocular function are strongly associated with a high risk of CXT. Children with spontaneous CXT are highly recommended to be followed-up long-term, while they maintain long-term ocular alignment before developing consecutive exotropia from comitant esotropia (CE).

Brain insulin resistance and Alzheimer’s molecular changes induced by Western diet

AbstractBackgroundWestern diet (WD) is a type of nourishment based on ultra‐processed foods, rich in simple sugars and saturated fats. Long‐term consumption of WD may lead to disruption of insulin signaling and development of insulin resistance. It is supposed that insulin resistance is a probable risk factors for Alzheimer’s disease (AD). The aim of this study was to verify this hypothesis in wild type mice by checking the WD effect on initiation and propagation of main neuropathological AD features such as amyloid‐β (Aβ) plaques and neurofibrillary tangles, which start from the entorhinal cortex in the temporal area, and progresses to the hippocampus, resulting in the loss of memory and cognition.MethodMales of wild type C57BL/6J mice were fed WD diet or standard diet (SD; CTR). Mice experimental groups (WD and CTR) were divided into age subgroups 4‐, 8‐, 12‐ and 16‐month‐old. In the first step, the WD‐diet dependent insulin signaling was analyzed, and the levels of the insulin pathway components: p‐IRS‐1(Ser616), p‐Akt(473), p‐GSK‐3β(Ser9) in the entorhinal cortex and hippocampus were assessed. To analyze further whether WD‐derived impairments in insulin signaling may induce neuropathological AD features, p‐Tau(Thr231) and APP/Aβ were analyzed by immunoblotting and immunofluorescence of mouse brain tissue sections from entorhinal cortex and the hippocampus.ResultEntorhinal cortex proved to be more sensitive to WD‐dependent insulin impairments than the hippocampus: immunoblotting analysis of mouse entorhinal cortex brain lysates revealed an increase in p‐IRS‐1(Ser616) levels, indicating the development of insulin resistance under WD diet. Moreover, a change in the localization of p‐Tau(Thr231) in cellular compartments from fibers to nerve cell bodies indicated a progressive tauopathy. In addition, we also observed an age‐dependent decrease in APP protein levels correlating with the appearance of Aβ peptides in the cytoplasm of neurons under the WD diet.ConclusionObtained results suggest that the WD diet, by inducing abnormalities in insulin signaling in the brain, promotes the development of AD, and may be consider as a significant modifiable risk factor for AD, additional to the genetic risk factors.

Determination of efficacy of repeated CXL and probable risk factors in patients with progressive keratoconus.

To evaluate the efficacy of Repeated CXL (Re-CXL) and determine probable risk factors that lead to Re-CXL in patients with progressive keratoconus. In this retrospective study, the medical records of patients who had been re-operated in our center between 2014 to 2020 due to progressive keratoconus were evaluated; seven eyes of seven patients had undergone Re-CXL procedure. Pre- and post-treatment variables were recorded and analyzed using IBM SPSS Statistics software. The mean interval between the 1st and 2nd CXL was 49.71months (range 12-72months). Out of 7 patients for whom Re-CXL was considered necessary, eye rubbing was detected in 6 patients. Six patients were very young with a mean age of 13years at primary CXL and 16.83years at Re-CXL. Visual acuity and astigmatism did not change significantly after the Re-CXL procedure (p-values = 0.18, 0.91, respectively). When measurements of these indices prior to Re-CXL and post Re-CXL were compared, K1 (p-value = 0.01), K2 (p-value = 0.01), Kmean (p-value = 0.01), and Kmax (p-value = 0.008) changed significantly. As to pachymetry (p-value = 0.46), it did not change significantly. Kmax value regressed in all eyes after Re-CXL. Re-CXL procedure was effective in halting the progression of disease. As to the risk factors, eye rubbed-related mechanism like eye rubbing and VKC, lower age, and pre-operative Kmax value > 58 D are the risk factors of Re-CXL procedure.

COVID‐19 pandemic and the determinants of depressive symptoms among senior citizens of India: An empirical investigation

AbstractThe COVID‐19 pandemic inflicted multiple threats to individuals' physical, mental, and financial health conditions. The pandemic‐related restrictive behaviors pose serious consequences for public health and increase the risk of mental illness among individuals, particularly among older citizens. The combination of their pre‐existing illnesses, social isolation, COVID fear, and financial adversity frequently aggravates their condition and leads to depression and mental illness. Thus, the present study investigates the mental health status and the determinants of depressive symptoms among older adults of Bhubaneswar during the COVID pandemic context. The study used the Geriatric Depression Scale (GDS‐15) to measure their depressive symptoms. The social isolation parameter is measured with the De Jong Gierveld Loneliness Scale. Financial self‐efficacy, COVID‐19‐related psychological fear, and comorbidity health status are other determinants considered. A chi‐square test and multinomial logistic regression (MLR) models are adopted to find the probable risk factors that may influence depressive symptoms among older people. The results indicate that comorbidity health conditions, a social isolation mindset, and financial efficacy issues are the significant determinants that drive an older person towards different depression categories. The improvement of these influential factors can lead senior citizens to avoid any health emergency like COVID pandemic. In the event of a public health emergency, such as COVID pandemic, the government could use the study's findings to devise methods for assisting the elderly. Society as a whole should be aware of these findings, which can lead to depressive symptoms, and offer support to the elderly. Future research may concentrate on identifying the causes of depressive symptoms in different age groups or in the presence of specific comorbidity health conditions. Future research may also investigate the factors influencing depressive symptoms in a specific occupation.

Incidence and probable risk factors of post COVID syndrome among COVID-19 patients in urban population of North Kerala: a 6 months cohort study

Background: Post-COVID condition is an important health burden all over world. This study was conducted to determine incidence, symptoms and risk factors of post COVID syndrome. Methods: Cohort study was done on COVID-19 patients of Mukkam Municipality tested from Mukkam Community Health Centre. Baseline data was collected using pre-tested semi-structured questionnaire by direct interview method after obtaining their consent. Subjects were followed up weekly for 6 months to know occurrence of post COVID syndrome, its course and outcome if any. Incidence and relative risk for age, gender, COVID-19 vaccination status, comorbidities and severity of COVID-19 illness were assessed for post COVID syndrome. Chi-square test was used for statistical association between severity of COVID-19 and occurrence of post COVID syndrome. Results: Among 800 persons tested for COVID-19, 28.75% were tested positive. Incidence of post COVID syndrome among study subjects was 42.2%. Relative risk for post COVID was high among participants having age more than 60 years (RR-1.76), females (RR-1.07), with comorbidities like diabetes (RR-1.28), hypertension (RR-1.06) and cardiac illness (RR-1.05), unvaccinated status (RR-1.21) and in severe COVID-19 infection (1.20). There is a significant statistical association between occurrence of post COVID syndrome and degree of severity of COVID-19 disease (p=0.0046). Conclusions: Post-COVID syndrome was found more often in older people who had severe COVID-19 illness, also incidence increases with severe COVID-19 illness.

Radiotherapy-related insufficiency fractures and bone mineral density: what is the connection?

Radiotherapy-related insufficiency fractures (RRIFs) represent a common, burdensome consequence of pelvic radiotherapy. Their underlying mechanisms remain unclear, and data on the effect of osteoporosis are contradictory, with limited studies assessing bone mineral density (BMD) by dual-energy x-ray absorptiometry (DXA). BMD by DXA (Hologic) scan and fracture risk following pelvic RRIF were retrospectively assessed in 39 patients (median age 68 years) at a tertiary cancer centre. Patient characteristics and treatment history are presented narratively; correlations were explored using univariate regression analyses. Additional cancer treatments included chemotherapy (n = 31), surgery (n = 20) and brachytherapy (n = 19). Median interval between initiation of radiotherapy and RRIF was 11 (7.5-20.8) and that between RRIF and DXA 3 was (1-6) months. Three patients had normal BMD, 16 had osteopenia and 16 osteoporosis, following World Health Organization classification. Four patients were <40 years at the time of DXA (all Z-scores > -2). Median 10-year risk for hip and major osteoporotic fracture was 3.1% (1.5-5.7) and 11.5% (7.1-13.8), respectively. Only 33.3% of patients had high fracture risk (hip fracture >4% and/or major osteoporotic >20%), and 31% fell above the intervention threshold per National Osteoporosis Guidelines Group (NOGG) guidance (2017). Higher BMD was predicted by lower pelvic radiotherapy dose (only in L3 and L4), concomitant chemotherapy and higher body mass index. At the time of RRIF, most patients did not have osteoporosis, some had normal BMD and overall had low fracture risk. Whilst low BMD is a probable risk factor, it is unlikely to be the main mechanism underlying RRIFs, and further studies are required to understand the predictive value of BMD.

Distinctive characteristics of prolonged standing low back pain developers’ and the associated risk factors: systematic review and meta-analysis

Pain developers (PDs) are considered a pre-clinical low back pain (LBP) population at risk of clinical LBP development and thus exacting great social and economic costs. Therefore, it is necessary to comprehensively investigate their distinctive characteristics and the risk factors of standing-induced LBP based on which appropriate preventive measures can be planned. Scopus, Web of Science, and PubMed databases as well as Google Scholar and ProQuest were systematically searched from inception through 14 July 2022 using a combination of terms relevant to ‘standing’ and ‘LBP’. Studies with low risk of bias in English and Persian using a methodological quality scoring system were deemed eligible for inclusion if they were laboratory studies using prolonged standing duration greater than 42 min to classify adult PDs and non-pain developers (NPDs) without a history of LBP. PDs were compared with NPDs in demographics, biomechanical, and psychological outcomes. Weighted or standardized mean differences, and Hedge’s g were generated to determine the pooled effect sizes using STATA software version 17. 52 papers and theses involving 1070 participants (528 PDs and 542 NPDs) were eligible for inclusion in the systematic review 33 of which were used in meta-analyses. Significant differences between PDs and NPDs in terms of movement patterns, muscular, postural, psychological, structural, and anthropometric variables were evidenced. The following factors were found to have a statistically significant association with standing-induced LBP: lumbar fidgets (Hedge’s g − 0.72, 95% CI − 1.35 to − 0.08, P = 0.03), lumbar lordosis in participants over 25 years (Hedge’s g 2.75, 95% CI 1.89–3.61, P < 0.001), AHAbd test (WMD 0.7, 95% CI 0.36–1.05, P < 0.001), GMed co-activation (Hedge’s g 4.24, 95% CI 3.18–5.3, P < 0.001), and Pain Catastrophizing Scale (WMD 2.85, 95% CI 0.51–5.19, P = 0.02). Altered motor control displayed in AHAbd test and higher lumbar lordosis in individuals over 25 years seem to be probable risk factors for standing-induced LBP. In order to detect standing-induced LBP risk factors, future researchers should investigate the association of the reported distinctive characteristics to the standing-induced LBP and that whether they are manipulable through various interventions.

Poor muscle health and low preoperative ODI are independent predictors for slower achievement of MCID after minimally invasive decompression

Although some previous studies have analyzed predictors of non-improvement, most of these have focused on demographic and clinical variables and have not accounted for radiological predictors. In addition, while several studies have examined the degree of improvement after decompression, there is less data on the rate of improvement. To identify the risk factors and predictors (both radiological and non-radiological) for slower as well as non-achievement of minimal clinically important difference (MCID) after minimally invasive decompression. Retrospective cohort PATIENT SAMPLE: Patients who underwent minimally invasive decompression for degenerative lumbar spine conditions and had a minimum of 1-year follow-up were included. Patients with preoperative Oswestry Disability Index (ODI) <20 were excluded. MCID achievement in ODI (cut off 12.8). Patients were stratified into two groups (achieved MCID, did not achieve MCID) at two timepoints (early ≤3 months, late ≥6 months). Non-radiological (age, gender, BMI, comorbidities, anxiety, depression, number of levels operated, preoperative ODI, preoperative back pain) and radiological (MRI - Schizas grading for stenosis, dural sac cross-sectional area, Pfirrmann grading for disc degeneration, psoas cross-sectional area and Goutallier grading, facet cyst/effusion; X-ray - spondylolisthesis, lumbar lordosis, spinopelvic parameters) variables were assessed with comparative analysis to identify risk factors and with multiple regression models to identify predictors for slower achievement of MCID (MCID not achieved by ≤3 months) and non-achievement of MCID (MCID not achieved at ≥6 months). 338 patients were included. At ≤3 months, patients who did not achieve MCID had significantly lower preoperative ODI (40.1 vs. 48.1, p<0.001) and worse psoas Goutallier grading (p=0.048). At ≥6 months, patients who did not achieve MCID had significantly lower preoperative ODI (38 vs. 47.5, p<0.001), higher age (68 vs. 63 years, p=0.007), worse average L1-S1 Pfirrmann grading (3.5 vs. 3.2, p=0.035), and higher rate of pre-existing spondylolisthesis at the operated level (p=0.047). When these and other probable risk factors were put into a regression model, low preoperative ODI (p=0.002) and poor Goutallier grading (p=0.042) at the early timepoint and low preoperative ODI (p<0.001) at the late timepoint came out as independent predictors for MCID non-achievement. After minimally invasive decompression, low preoperative ODI and poor muscle health are risk factors and predictors for slower achievement of MCID. For non-achievement of MCID, low preoperative ODI, higher age, greater disc degeneration, and spondylolisthesis are risk factors and low preoperative ODI is the only independent predictor.

A cross sectional study on prevalence of hypertension and associated risk factors among bus drivers of Metropolitan Transport Corporation Limited, Chennai

Background: The job of bus driving is not only risky due to probable accidents and incidents but also risky due to probable health risk factors associated with the nature of bus driving. Sedentary work was done by many professional drivers and they were found to be physically inactive during their leisure time which lead to an increase in risk for obesity and hypertension. Therefore, this study was done with the aim to detect the prevalence of hypertension and its associated risk factors among metropolitan transport corporation bus drivers. Methods: A cross sectional descriptive study was conducted among bus drivers of metropolitan transport corporation Limited, Chennai. The sample size obtained was 422. A multistage sampling method was used. A Validated semi-structured questionnaire containing questions on basic socio demographic particulars, lifestyle factors, past and family history and anthropometric and blood pressure measurement was done and was analyzed using SPSS 21. Results: The prevalence of hypertension was found to be 49.5%. Smoking was found in 23.2% of the respondents, tobacco and betel nut chewing in 14.7% of the respondents and 45.5% were found to consume alcohol. It was found that as age increases the prevalence of hypertension also increases which was statistically significant (p=0.001). Conclusions: This rampant disease can be prevented and managed through lifestyle modifications and medication therapy. The risk factors may be avoided by maintaining a regular physical activity, focussing on dynamic exercise, having medical checkups.

Neuronal Hyperactivation in EEG Data during Cognitive Tasks Is Related to the Apolipoprotein J/Clusterin Genotype in Nondemented Adults.

The clusterin (CLU) rs11136000 CC genotype is a probable risk factor for Alzheimer's disease (AD). CLU, also known as the apolipoprotein J gene, shares certain properties with the apolipoprotein E (APOE) gene with a well-established relationship with AD. This study aimed to determine whether the electrophysiological patterns of brain activation during the letter fluency task (LFT) depend on CLU genotypes in adults without dementia. Previous studies have shown that LFT performance involves activation of the frontal cortex. We examined EEG alpha1 and alpha2 band desynchronization in the frontal regions during the LFT in 94 nondemented individuals stratified by CLU (rs11136000) genotype. Starting at 30 years of age, CLU CC carriers exhibited more pronounced task-related alpha2 desynchronization than CLU CT&TT carriers in the absence of any differences in LFT performance. In CLU CC carriers, alpha2 desynchronization was significantly correlated with age. Increased task-related activation in individuals at genetic risk for AD may reflect greater "effort" to perform the task and/or neuronal hyperexcitability. The results show that the CLU genotype is associated with neuronal hyperactivation in the frontal cortex during cognitive tasks performances in nondemented individuals, suggesting systematic vulnerability of LFT related cognitive networks in people carrying unfavorable CLU alleles.