Related Potential Risk Factors Research Articles

Sex/gender differences in injury risk, types of injuries, and potential risk factors of adult recreational mountain-bikers in Tyrol

Introduction & Purpose In Austria, 99% of fatally injured (Pocecco et al., 2022) and 81% of accidented mountain-bikers (Woyke et al., 2024) are males. However, these evident sex/gender differences in prevalence do not allow any conclusions to be drawn either about the risk of injury or about potential risk factors between the sex/genders. Thus, the present study aimed to investigate possible sex/gender-specific differences in injury risk, types of injuries, and related potential risk factors in adult recreational mountain-bikers in Tyrol, Austria. Methods This retrospective survey was conducted in the surroundings of Innsbruck (Austria) in 2017-2019, involving randomly selected adult recreational mountain-bikers. A standardized questionnaire was used to collect data on injuries ever experienced during mountain-biking (MTB), including circumstances (e.g., skill level and risk-taking behaviour according to Ruedl et al. (2010), riding alone or in a group) related to the most severe injury. Proportions were compared by χ2 tests. Results In total, 1,439 mountain-bikers (37.8 ± 14.3 years, 33.4% females) were interviewed, 486 (33.8%) of them suffering one or more injuries requiring medical attention. Men showed a higher injury risk compared to women (37.2% vs. 26.9%, p < 0.001) and injured males reported a higher number of injuries during MTB compared to their female counterpart (2.4 ± 2.4 vs. 1.7 ± 1.4, p < 0.001). In general, concerning the most severe injury ever suffered during MTB, the most frequent injury types were fractures (28.4%), followed by open wounds (15.9%), contusions (14.5%), abrasions (12.0%), and ligament/muscle injuries (10.4%), showing sex/gender differences (p = 0.010). In particular, fractures were the most frequent injury type among male (32.7%), open wounds among female (20.3%) mountain-bikers. Moreover, men reported higher MTB skills (p < 0.001) and higher risk-taking behaviour (72.8% vs. 50.5%, p < 0.001) at the time of the worst accident compared to women. Additionally, males were more likely to be biking alone on the day of the accident compared to females (30.1% vs. 15.0%, p = 0.007), who tended to ride in groups. Discussion Comparably to alpine skiing and snowboarding (Ruedl et al., 2010), men were found to exhibit a higher skill level and engage in riskier behaviour more frequently than women. In alpine skiing and snowboarding, these two factors are associated with higher speeds (Ruedl et al., 2010), which could be therefore also the reason for the higher injury risk and frequency of fractures among the surveyed male mountain-bikers. In the present study, fractures were the most common self-reported injury type with 28%, which seems comparable to 24% of fractures in the study by Woyke et al. (2024). Conversely, biking in a group, which was more common among women, apparently did not lead to a higher risk of injury due to possible peer pressure. Conclusion Results of this study found sex/gender differences in injury risk, types of injury, and related potential risk factors in recreational adult mountain-bikers which should be considered in future preventive measures. In particular, relevant information campaigns should address especially males. Moreover, future research comparing injured and non-injured recreational mountain-bikers should be conducted to confirm or reject the hypothesized risk factors. References Pocecco, E., Wafa, H., Burtscher, J., Paal, P., Plattner, P., Posch, M., & Ruedl, G. (2022). Mortality in recreational mountain-biking in the Austrian Alps: A retrospective study over 16 years. International Journal of Environmental Research and Public Health, 19(19), Article 11965. https://doi.org/10.3390/ijerph191911965 Ruedl, G., Pocecco, E., Sommersacher, R., Gatterer, H., Kopp, M., Nachbauer, W., & Burtscher, M. (2010). Factors associated with self-reported risk-taking behaviour on ski slopes. British Journal of Sports Medicine, 44(3), 204-206. https://doi.org/10.1136/bjsm.2009.066779 Woyke, S., Hütter, A., Rugg, C., Tröger, W., Wallner, B., Ströhle, M., & Paal, P. (2024). Sex differences in mountain bike accidents in Austria from 2006 to 2018: A retrospective analysis. High Altitude Medicine & Biology, 25(1), 89-93. https://doi.org/10.1089/ham.2023.0086

Incidence, risk factors, and outcome of asymptomatic central nervous system involvement in adult patients with acute myeloid leukemia.

Examination of central nervous system (CNS) involvement is not routine diagnostic practice in adult patients with acute myeloid leukemia (AML). Therefore, many asymptomatic patients with CNS involvement might go undetected. The effect of CNS involvement on the AML disease course is not well defined, with conflicting results regarding clinical outcome. This study aimed to determine the incidence of asymptomatic CNS involvement in AML estimated by multiparametric flow cytometry of cerebrospinal fluid (MFC-CSF) at diagnosis, the related potential risk factors, and prognosis. In total, 645 patients with de novo AML were screened; 183 (28.4%) of them fulfilled institutional practice for MFC-CSF analysis based on presence of CNS symptoms and/or clinical features. CNS symptoms and signs were observed in 8/183 (4.4%) patients, but most patients (175/183, 95.6%) were asymptomatic. In the asymptomatic group, 73/175 (41.7%) patients had positive or suspicious cerebrospinal fluid (CSF) findings categorized as CNS positive (CNSpos) and 102/175 (58.3%) had normal CNS findings categorized as CNS negative (CNSneg). The presence of leukemic blasts was confirmed in 81/183 (44.3%) patients; the total incidence of CNS involvement in the whole AML group was 12.6% (81/645). Compared with asymptomatic patients with CNSneg, those with CNSpos had a significantly higher frequency of lymphadenopathy, white blood cell count ≥30×109/L, presence of the monocytic phenotype, and a high percentage of bone marrow (BM) blasts. The multivariate logistic regression model identified monocytic phenotype (p=0.047) and high percentage of BM blasts (p=0.042) as predictors for CNSpos. CNSpos did not affect overall survival in patients with AML. There was a higher incidence of CNS involvement in asymptomatic adult patients with de novo AML, emphasizing possible undervalued rates of CNS disease at diagnosis. Prospective studies should determine whether diagnostic lumbar puncture for MFC-CSF analysis and CNS prophylaxis could contribute to better selection and prognosis in this patient population.

Seroprevalence and risk factors associated with bovine herpesvirus 1 (BHV-1) infection in dairy cattle in southern and central Ethiopia.

Bovine herpesvirus 1 (BHV-1) is an important pathogen of cattle with a worldwide distribution. It occurs as a subclinical, mild or severe disease. The clinical signs may vary widely with respiratory, genital, ocular and encephalomyelitis form. This cross-sectional study was carried out between May 2019 and March 2020 with the aim to estimate the seroprevalence of bovine herpesvirus 1 (BHV-1) and to identify related potential risk factors in dairy cattle in central and southern Ethiopia. A total of 954 serum samples were obtained from randomly selected dairy cattle in 98 herds. The samples were collected from animals over 6 months old and tested using a BHV-1 antibody blocking enzyme linked immunosorbent assay (b-ELISA). The study showed that the animal- and herd-level seroprevalence of BHV-1 was 30.0% (95% CI: 21.7, 39.9) and 75.5% (95% CI: 65.9, 83.1), respectively. Multiple logistic regression model demonstrated that adult animals (>2.5 years) (OR=2.4, 95% CI: 1.1, 5.5) had higher seroprevalence of BHV-1 compared to their counterparts (p<0.05). Cattle in farms using artificial insemination (AI), and both AI and bulls had a 3.9 (95% CI: 1.2, 13.3) and 5.1 (95% CI: 1.8, 14.8) odds of being seropositive, respectively, compared to farms using bulls only. Arrangement of animals in a tail-to-tail fashion appeared to be protective against BHV-1 infection (p<0.05). However, source of the animal was not associated with BHV-1 serostatus (p>0.05). The animal- and herd-level prevalence recorded in our study confirms that BHV-1 infection is widespread and remains endemic in dairy cattle of central and southern Ethiopia.

Predictors of in-hospital mortality in older patients undergoing distal femur fracture surgery: A case-control study.

Geriatric fractures including distal femur and hip fractures are associated with high mortality rates. Currently, prognostic factors for in-hospital postoperative mortality are not identified. We aimed to evaluate overall in-hospital mortality and related potential risk factors in elderly patients who underwent distal femur fracture surgery. A retrospective cohort study of patients older than 60 years, who underwent distal femur fracture surgery between January 01, 2003, and December 31, 2021, was conducted. A case-control study was conducted to compare two age-matched groups of elderly patients of equivalent ages at a 1:4 ratio. The in-hospital mortality rate was calculated and potential confounders were compared between groups. A total of 170 patients were enrolled; five died during hospital stay after undergoing surgery, yielding a 2.94% in-hospital mortality rate. Twenty patients who did not die were included in the control group. Patients' demographics were similar. The case-control comparison showed that the time from injury to surgery, preoperative hemoglobin level, estimated glomerular filtration rate (eGFR), and white blood cell count were significant factors correlated with in-hospital mortality. The overall in-hospital mortality rate was 2.94%. Significant risk factors for in-hospital mortality included a longer time from injury to surgery, lower preoperative hemoglobin level and eGFR, and higher preoperative white blood cell count. In conclusion, preoperative comprehensive geriatric assessment, including cognitive, nutritional, and frailty status, should also be considered in the elderly fracture care model.

Obsessive-compulsive symptoms among the general population during the first COVID-19 epidemic wave in Italy

This study investigated obsessive-compulsive symptoms (OCS) in the Italian general population during the initial stage of the pandemic and the impact of COVID-19 related potential risk factors. A web-based survey was spread throughout the internet between March 27th and April 9th, 2020. Twenty thousand two hundred forty-one individuals completed the questionnaire, 80.6% women. The Dimensional Obsessive-Compulsive Scale (DOCS) was included to assess the severity of the obsessive-compulsive symptom domains. Further, selected outcomes were depression, anxiety, insomnia, perceived stress, and COVID-19 related stressful life events. A panel of logistic or linear regression analyses was conducted to explore the impact of COVID-19 related risk factors, socio-demographic variables, and mental health outcomes on OCS. A total of 7879 subjects (38,9%) reported clinically relevant OCS. Specifically, more than half of the sample (52%) reported clinically relevant symptoms in the Contamination domain, 32.5% in the Responsibility domain, 29.9% in the Unacceptable thoughts domain, and 28.6 in the Symmetry/Ordering domain. Being a woman was associated with OCS, except for Symmetry/Ordering symptoms. A lower education level and younger age were associated with OCS. Moreover, depression, anxiety, perceived stress symptoms, insomnia, and different COVID-19 related stressful events were associated with OCS. We found high rates of OCS, particularly in the contamination domain, in the Italian general population exposed to the first COVID-19 epidemic wave and COVID-19 related risk factors. These findings suggest the need to investigate further the trajectories of OCS in the general population along with the long-term socio-economic impact of the pandemic.

Mental Health Outcomes Among Healthcare Workers and the General Population During the COVID-19 in Italy.

IntroductionDuring the COVID-19 pandemic, healthcare workers in Italy have been exposed to an unprecedented pressure and traumatic events. However, no direct comparison with the general population is available so far. The aim of this study is to detail mental health outcomes in healthcare workers compared to the general population.Methods24050 respondents completed an on-line questionnaire during the contagion peak, 21342 general population, 1295 second-line healthcare workers, and 1411 front-line healthcare workers. Depressive, anxious, post-traumatic symptoms and insomnia were assessed. Specific COVID-19 related potential risk factors were also considered in healthcare workers.ResultsDepressive symptoms were more frequent in the general population (28.12%) and front-line healthcare workers (28.35%) compared to the second-line healthcare workers (19.98%) groups. Anxiety symptoms showed a prevalence of 21.25% in the general population, 18.05% for second-line healthcare workers, and 20.55% for front-line healthcare workers. Insomnia showed a prevalence of 7.82, 6.58, and 9.92% for the general population, second-line healthcare workers, and front-line healthcare workers, respectively. Compared to the general population, front-line healthcare workers had higher odds of endorsing total trauma-related symptoms. Both second-line healthcare workers and front-line healthcare workers had higher odds of endorsing core post-traumatic symptoms compared to the general population, while second-line healthcare workers had lower odds of endorsing negative affect and dissociative symptoms. Higher total traumatic symptom score was associated with being a front-line healthcare worker, having a colleague infected, hospitalized, or deceased, being a nurse, female gender, and younger age.ConclusionThis study suggests a significant psychological impact of the COVID-19 pandemic on the Italian general population and healthcare workers. Front-line healthcare workers represent a specific at-risk population for post-traumatic symptoms. These findings underline the importance of monitoring and intervention strategies.

Stress, Anxiety, and Depression Symptoms in a Population Sample in The Initial Stage of The Coronavirus (COVID-19) Pandemic Outbreak

Context: Changes in everyday life have been rapid and drastic, with the virus surge outbreaks, the death rate escalating, and stringent steps to control the disease spread increasing across regions of the world. While significant attention has been paid to efforts to diagnose people with the coronavirus infection, recognizing the mental health needs of people affected by this pandemic has been ignored relatively. The psychological impact of the Coronavirus Disease 2019 (COVID-19) outbreak and lockdown measures on the Egyptian population are unknown.&#x0D; Aim: This study assesses levels of stress, anxiety, and depression symptoms in a population sample in the initial stage of the coronavirus pandemic (COVID-19) outbreak and explores its related potential risk factors.&#x0D; Methods: A cross-sectional design used to conduct the study on a convenience sample of 1010 subjects residing at Benha City, Qalyubiyah Governorate, Egypt. The tool utilized in this study consists of two parts: Self-administered questionnaire, which was designed to assess people's socio-demographic and family data, and Depression, Anxiety, and Stress Scale (DASS) that measure the symptoms of the emotional state of depression, anxiety, and stress.&#x0D; Results: The result reveals a mean of total stress scale as 15.44±3.62, mean of total anxiety scale as 13.56±3.74, and mean of total depression scale as 12.41±3.86. There was a high statistically significant positive correlation between anxiety, stress, and depression at p-value &lt;0.01.&#x0D; Conclusion: This study concluded that more than two-thirds of the studied population suffered from a moderate level of stress, less than two-thirds of the studied population suffered from moderate anxiety, while around one-tenth of them were normal, and more than one-third of the studied population suffered from a moderate level of depression, while one-fifth of them were normal. The current result revealed that age (year), marital status, having children, educational level, income, and occupation were predictors of stress, anxiety, and depression. The study suggested the need for additional research on predictive factors affecting people's stress in the era of COVID-19 outbreak and carried out psychological intervention activities through various mediums to help people become more resilient during the COVID-19 epidemic.

Prevalence and related potential risk factors of Toxoplasma gondii infection among slaughterhouse workers and animals in Makkah

Toxoplasma gondii is a protozoan parasite that causes a parasitic disease known as toxoplasmosis. The disease transmits from animals to humans via the eating raw or insufficient cook meat or by contact with raw meat. The main aim of the present study was to define the prevalence and the associated risk factors of the disease in workers and animals in slaughterhouses in Makkah. The study was based on a cross-sectional study in humans and animals including, sheep, goats, cattle, and camels. Data were collected using a short questionnaire. Approximately 108 blood samples were collected from workers included the butchers and the workers and 160 blood samples of the slaughterhouse animals. Serum samples were kept in -80o C till examined by using ELISA IgM and IgG tests. The data analyzed by using SPSS version 25. The result showed that the prevalence in workers was 0.9% and 25% using IgM and IgG, respectively. In animals, all the results were negative using ELISA IgM and IgG tests. The result showed that there was a correlation between chronic infection and contact with a cat (p&lt;0.015). The study focussed on the T. gondii in slaughterhouse workers which found that both acute and chronic toxoplasmosis. The results also showed no infection was registered in different species of animals in both slaughterhouses.

Prevalence and Risk Factors Associated with Self-Rated Morbidities Among South Asian Migrant Gas Station Workers in Kuwait.

Gas station workers (GSWs) are at elevated risk of morbidities associated with exposure to petrochemical substances. This cross-sectional study assessed the prevalence and examined demographics and occupation-related risk factors associated with self-rated ill-health among GSWs in Kuwait. Structured questionnaire was used to record self-rated ill-health from 460 selected GSWs of South-Asian origin. Prevalence of self-rated ill-health conditions was computed. Random-intercept multivariable logistic regression model was used to identify the demographics and/or work-place related potential risk factors associated with one or more morbidities. Prevalent morbidities were eye(s) complaint (45.2%), asthma/shortness of breath (7.6%), frequent sneezing and allergic rhinitis (44.3%), recurrent headache (48.3%), dizziness (9.8%), tremors (42%), and eczema/skin complaint (44.1%). Furthermore, GSWs were significantly more likely to report one or more ill-health conditions (vs. none), if they were overweight/obese (aOR 1.8; 95% CI 1.1-2.9), married (aOR 2.6; 95% CI 1.5-4.5) or on current job for more than one year (aOR 6.4; 95% CI 2.9-15.4). In conclusion, GSWs suffer from ailments of multiple organ systems and need education and facilitation for self-protection.

Vertigo and dizziness in adolescents: Risk factors and their population attributable risk.

ObjectivesTo assess potential risk factors for vertigo and dizziness in adolescents and to evaluate their variability by different vertigo types. The role of possible risk factors for vertigo and dizziness in adolescents and their population relevance needs to be addressed in order to design preventive strategies.Study designThe study population consisted of 1482 school-children between the age of 12 and 19 years, who were instructed to fill out a questionnaire on different vertigo types and related potential risk factors. The questionnaire specifically asked for any vertigo, spinning vertigo, swaying vertigo, orthostatic dizziness, and unspecified dizziness. Further a wide range of potential risk factors were addressed including gender, stress, muscular pain in the neck and shoulder region, sleep duration, migraine, coffee and alcohol consumption, physical activity and smoking.ResultsGender, stress, muscular pain in the neck and shoulder region, sleep duration and migraine were identified as independent risk factors following mutual adjustment: The relative risk was 1.17 [1.10–1.25] for female sex, 1.07 [1.02–1.13] for stress, 1.24 [1.17–1.32] for muscular pain, and 1.09 [1.03–1.14] for migraine. The population attributable risk explained by these risk factors was 26%, with muscular pain, stress, and migraine accounting for 11%, 4%, and 3% respectively.ConclusionSeveral established risk factors in adults were also identified in adolescents. Risk factors amenable to prevention accounted for 17% of the total population risk. Therefore, interventions targeting these risk factors may be warranted.

Anesthetic Considerations in Patients Undergoing Bariatric Surgery: A Review Article.

ContextThis article discusses the anesthetic considerations in patients undergoing bariatric surgery in the preoperative, intraoperative, and postoperative phases of surgery.Evidence AcquisitionThis review includes studies involving obese patients undergoing bariatric surgery. Searches have been conducted in PubMed, MEDLINE, EMBASE, Google Scholar, Scopus, and Cochrane Database of Systematic Review using the terms obese, obesity, bariatric, anesthesia, perioperative, preoperative, perioperative, postoperative, and their combinations.ResultsObesity is a major worldwide health problem associated with many comorbidities. Bariatric surgery has been proposed as the best alternative treatment for extreme obese patients when all other therapeutic options have failed.ConclusionsAnesthetists must completely assess the patients before the surgery to identify anesthesia- related potential risk factors and prepare for management during the surgery.

Serum Vitamin D Deficiency and Risk of Schizophrenia : A Case Control Study

Background: Schizophrenia is a mental illness with symptoms like delusions and hallucinations. A recent study concluded that individuals with vitamin D deficiency are twice more likely to have schizophrenia than optimum level vitamin D people. Objective: To measure schizophrenic patients` serum vitamin D concentration and compare it to healthy controls(non schizophrenics), and to investigate the relationship between serum schizophrenia and related potential risk factors. Subjects and Methods: Twenty patients with schizophrenia were recruited and compared to 20 controls with no major psychopathology using age and sex matched case control study. The SCID-1(semi-structured interview for making major DSM-IV Axis 1 diagnoses), was administered and the blood samples were withdrawn after patient consent on the same day. Results: Schizophrenic patients showed a significantly lower mean vitamin D level (14.8±4.5 IU) compared to control group (19.6±3.3 IU) (P<0.001). Higher vitamin D level participants were nearly 80% less likely to have schizophrenia compared to low level ones. Being older and female were 80%and 40% less likely to have schizophrenia respectively. Individuals with large body mass index were 1.2 times more likely to have schizophrenia compared to normal body weight. Smokers were 10% less likely to be schizophrenic compared to non-smoker participants. Conclusions: Patients with schizophrenia showed lower serum vitamin D level compared to healthy controls. Further studies are needed to explore the role of vitamin D in the pathogenesis of schizophrenia.

Theory of mind and social functioning in patients with temporal lobe epilepsy

This study aimed to explore the effects of theory of mind (ToM) and related potential risk factors, including cognitive functions, psychiatric status, and seizure-related clinical variables, on social functioning in patients with temporal lobe epilepsy (TLE). Sixty-seven patients with intractable TLE who were potential candidates for epilepsy surgery and 30 matched controls were included. All participants completed four tasks measuring different levels of ToM (False Belief, Faux Pas Recognition, Implication Stories, and Visual Cartoon), the Symptom Checklist-90-Revised (SCL-90-R), the Social and Occupational Functioning Scale for Epilepsy (SOFSE), and neuropsychological tests. The patients exhibited impairments in both basic and advanced ToM. Multiple regression analyses revealed the following: (1) the SOFSE total score was significantly predicted by the Faux Pas Recognition (FPR), Global Severity Index (GSI) score of the SCL-90-R, and Full-Scale intelligence quotient (IQ) of the Wechsler Adult Intelligence Scale (WAIS), which accounted for 38%, 11%, and 8% of the variance, respectively; and (2) the FPR was a significant predictor of all SOFSE subscales, whereas the GSI score contributed substantially to the Interpersonal Relationships, Communication, and Occupation subscales of the SOFSE. Advanced ToM, measured by impaired faux pas recognition, is a relatively strong predictor of poor social functioning in surgical candidates for intractable TLE. Identifying ToM impairment may help plan nonpharmacologic treatment for improving social functions in patients with intractable TLE.

Incidence of and related risk factors on preterm delivery among HIV-infected pregnant women in China

To measure the incidence rates of preterm delivery in HIV-infected pregnant women and to explore related potential risk factors. Data from 'Information System of Prevention of Mother-to-child Transmission of HIV Management in China, 2013' was used in the study. Information regarding demographic characteristics, pregnancy, HIV relevant situations and pregnancy outcomes related to these HIV-infected pregnant women, were extracted and analyzed. Incidence of preterm delivery was calculated with related potential risk factors explored. 3 913 HIV-infected pregnant women were involved in this study, including 336 of them having undergone preterm deliveries (8.6%). Results from univariate and multivariate analyses showed that preterm delivery was associated with factors as: maternal age, ethnicity, education, being migrant, pregnancy hypertension, multiple pregnancy and times of antenatal care visits (P < 0.05) of the pregnant women. Compared with those who contracted the HIV infection through drug injection, the ones who were infected through other routes suffered fewer preterm deliveries (adjusted OR = 0.562, 95% CI: 0.360-0.879). Pregnant women who received antiretroviral therapy either between 14 to 27 gestational weeks or during the period of less than 14, were more likely to experience preterm delivery, comparison to those who did not receive the therapy during pregnancy. The adjusted ORs were 1.712 (95% CI: 1.196-2.451) and 1.862 (95% CI: 1.261-2.749), respectively. Preterm delivery was a common adverse outcome during pregnancy among HIV-infected women in China. Other than traditionally known risk factors, routes of transmission and the use of antiretroviral therapy might also be associated with the increased risks for preterm delivery.

Menstrual cycle characteristics and risk of coronary heart disease and type 2 diabetes

In a prospective cohort study, we observed that women with a history of irregular cycles have a 28% increased coronary heart disease risk and tended to have a higher type 2 diabetes risk as compared with women who had a regular cycle length of 27 to 29 days. This association could not be explained by metabolic risk factors or altered hormone levels.