Related Risk Factors Research Articles

Vitamin K1 intake is associated with lower risk for all-cause and cardiovascular disease mortality in community-dwelling older Australian women

Background and aimsAssessing the relationship between vitamin K1 intakes, using region-specific food databases, with both all-cause, and cardiovascular disease (CVD) mortality warrants further investigation to inform future preventative strategies. Consequently, we examined the aforementioned associations in the Perth Longitudinal Study of Ageing Women (PLSAW). Methods and results1436 community-dwelling older Australian women (mean ± SD age 75.2 ± 2.7 years) completed a validated food frequency questionnaire at baseline (1998). Vitamin K1 intake was calculated based on an Australian vitamin K food database, supplemented with published data. All-cause and CVD mortality data was obtained from linked health records. Associations were examined using restricted cubic splines within Cox-proportional hazard models, adjusted for a range of cardiovascular and lifestyle related risk factors. Over 15 years of follow-up, 601 (41.9%) women died, with 236 deaths (16.4%) due to CVD. Compared to women with the lowest vitamin K1 intakes (Quartile 1, median 49.1 μg/day), those with the highest intakes (Quartile 4, median 119.3 μg/day) had lower relative hazards for all-cause mortality (HR 0.66 95%CI 0.51–0.86) and CVD mortality (HR 0.61 95%CI 0.41–0.92). A plateau in the inverse association was observed from vitamin K1 intakes of approximately ≥80 μg/day. ConclusionHigher vitamin K1 intakes were associated with lower risk for both all-cause and CVD mortality in community-dwelling older women, independent of CVD related risk factors. A higher intake of vitamin K1 rich foods, such as leafy green vegetables, may support cardiovascular health.

Victimization in Prison. A Study of Victimization and Prison Climate Dimensions in Belgian Prisons

ABSTRACT Prisoner victimization introduces significant challenges to penal institutions worldwide. Researchers across the globe already provided extensive knowledge on risk factors from community crime theories for prison victimization. Other scholars are focusing on prison climate. The present study contributes to previous works by exploring both the role of community crime theory (individual, prisoner related) risk factors and prison climate dimensions in explaining prisoner victimization in Belgium. Three climate dimensions – relationships, safety and autonomy – were analyzed. Specifically, the study examined a sample of 1,006 prisoners using bivariate and multivariate regression analyses. The multivariate results showed that prison climate dimensions significantly contribute to explaining prisoner victimization, in addition to the other risk factors. These findings suggest that deprivation and strain theories remain relevant for understanding prison violence. Future researchers should study other prison climate dimensions, as well as environmental characteristics that may facilitate victimization. This paper also highlights the importance of investments in prison climate, such as dynamic security through relationships, in addition to hard security.

Cardiometabolic and renal phenotypes and transitions in the United States population

Cardiovascular and renal conditions have both shared and distinct determinants. In this study, we applied unsupervised clustering to multiple rounds of the National Health and Nutrition Examination Survey from 1988 to 2018, and identified 10 cardiometabolic and renal phenotypes. These included a ‘low risk’ phenotype; two groups with average risk factor levels but different heights; one group with low body-mass index and high levels of high-density lipoprotein cholesterol; five phenotypes with high levels of one or two related risk factors (‘high heart rate’, ‘high cholesterol’, ‘high blood pressure’, ‘severe obesity’ and ‘severe hyperglycemia’); and one phenotype with low diastolic blood pressure (DBP) and low estimated glomerular filtration rate (eGFR). Prevalence of the ‘high blood pressure’ and ‘high cholesterol’ phenotypes decreased over time, contrasted by a rise in the ‘severe obesity’ and ‘low DBP, low eGFR’ phenotypes. The cardiometabolic and renal traits of the US population have shifted from phenotypes with high blood pressure and cholesterol toward poor kidney function, hyperglycemia and severe obesity.

Hepatitis B immunization status and risk factors of people aged 1 to 69 in Huangpu District, Shanghai, China.

China has long been with high Hepatitis B Virus(HBV) prevalence in the world. The HBV prevalence of people aged 1-59 decreased to less than 8% in 2006, and by 2020, HBsAg positive rate of children aged <5 decreased to less than <1% which was due to the free three-dose hepatitis B(HepB) immunization for newborns nationwide since 2002. Huangpu district was selected as one of the pilot areas for free Hep B vaccination in newborns since 1986, which formed an early protection in the population from mother-to-child transmission. However, the existed HBV infected people were still needed to be discovered, evaluated whether to receive antiviral therapies and intervened with health education in order to reduce the incidence of viral hepatitis related hepatocellular carcinoma (HCC) and also reach the goal to eliminate public health hazards of viral hepatitis by 2030. To know HepB immunization status among people aged 1 to 69 in Huangpu district of Shanghai, and find out risk factors changes of HBV infection. Cross-sectional study was applied to analyze the HepB immunization status and related risk factors by carrying out survey among 706 participants aged 1 to 69 years old. Blood samples were collected for detection of serological HBV markers including hepatitis B surface antigen(HBsAg), hepatitis B surface antibody(HBsAb) and hepatitis B core antibody(HBcAb). Participants with HBsAg positive were required to complete additional examinations such as alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin, albumin, globulin, liver fibroscan and liver ultrasound. For participants aged 1 to 14, the positive rate of HBsAg, HBsAb and HBcAb was 0.00, 50.00 and 30.46%, respectively. The HBsAb positive rate reached a peak of 90.91% at 2 years old, and then showed a significant downward trend (χ2 = 55.612, p < 0.001). All the participants have completed three-dose Hep B vaccination, however for the second dose, those who vaccinated 30 days later than the appointed time(aged one month) got higher HBcAb prevalence than those who vaccinated on time(χ2 = 5.87, p = 0.015). Two mothers were found HBsAg positive, but there was no significant difference in children's HBcAb positive rates regardless of the mothers' HBsAg results. For participants aged 15 to 69, the positive rate of HBsAg, HBsAb and HBcAb was 4.21, 44.25 and 49.23%, respectively. Multivariate analysis for HBcAb positive among people aged 15 to 69 showed that age(50-69) and HBsAb positive were the risk factors for HBcAb positive(p < 0.05). Higher education was the protective factor for HBcAb positive(p < 0.05). After the screening for HBsAg, 22 participants were tested HBsAg positive and required additional examinations, and a total of 12 completed all the examinations. One participant was recognized as active HBV infection without antivirus treatment. Among the 12 participants, 2 have received antiviral treatment before and 4 had a history of HBV infection in family members. In this study, HBsAg positive rate of those who aged 1 to 14 was 0.00%, which indicated that the HepB immunization has achieved a lot in protecting children from being infected. However, failing to get timely Hep B vaccination could be an influencing factor for HBcAb positive in children. As a result, additional tests for HBV DNA could be done to specify an HBV infection and more attention should be paid to the timeliness of Hep B vaccination in the next step. The HBcAb positive rate of people aged 1 to 69 was relatively higher than that of other provinces. Despite of the limited participants with full examinations, we should still put emphasis on HBV treatment and the possibility of transmission within families.

Assessment of the factors for the adoption of Internet of things (IoT) in the logistics: a PLS-SEM (partial least squares structural equation modeling) approach

PurposeThe purpose of this study is to investigate the influence that technological, environmental and organizational factors have on the rate of Internet of Things (IoT) adoption within the logistics industry. In addition, the moderating effect that the risk factor has on the technological, environmental and organizational factors regarding the implementation of IoT in logistics.Design/methodology/approachFor the purpose of testing the models and hypotheses, a survey was carried out in order to collect the responses from currently employed individuals at various companies working in the field of logistics or IoT. For the purpose of analysis, the authors made use of the partial least squares structure equation model (PLS-SEM) technique.FindingsFindings of this study concluded that technology- and environmental-related factors significantly affect the adoption of IoT in logistics, while risk acts as a moderator for the technological-related factor only in the adoption of IoT in logistics.Research limitations/implicationsThe relevance of the authors' study lies in the growing importance of IoT in logistics and the need for logistics companies to understand the factors that impact the adoption of IoT in their operations. By identifying and analyzing the factors that influence IoT adoption in logistics, the authors' study provides valuable insights that can help logistics companies make informed decisions about whether and how to adopt IoT.Practical implicationsThe research will help organizations make strategies for the successful adoption of IoT and ease the lives of all the stakeholders.Originality/valueIn this research, the authors attempted to find the factors that influence the adoption of IoT in logistics management. The influence of the technological, environmental, organizational and risk-related factors on the adoption of IoT in logistics management was studied. The moderating effect of risk over these factors on the adoption of IoT in logistics was also analyzed. This is original work and has never been done earlier.

The Prevalence of Candida Species among HIV-Positive Women in Aluu, Nigeria: A Call for Awareness

Background: The acquired immune deficiency syndrome (AIDS), which HIV brings on, is a major public health concern. The human immunodeficiency virus (HIV) is still a pandemic. Only 2.1% of HIV cases worldwide are recorded in Nigeria. Usually, under the control of the immune system, Candida infections may be dangerous for immunocompromised people, particularly those living with HIV/AIDS.&#x0D; Aim: At the Mbodo Health Centre in Aluu, Rivers State, Nigeria, this study aimed to assess the prevalence of Candida infections and their relationship to HIV-positive patients.&#x0D; Methods: Fifty HIV-positive women were chosen at random. Self-collected oral and vaginal swabs were used to gather data. To identify Candida species, biochemical testing, culture, and microscopy were used.&#x0D; Results: Eighty percent of the 50 individuals had positive candidiasis tests. Oral and vaginal mono/co-candidiasis were found to be common, with Candida albicans being the most common specie. Based on demographic parameters, statistical analysis did not show a significant difference in the prevalence of oral candidiasis. The frequency of vaginal candidiasis was much greater in those with secondary education and aged 31-40 years. The age group of 31 to 40 years old had a considerably greater co-occurrence rate of oral and vaginal candidiasis. Adult female HIV-positive patients at Mbodo Health Centre have a significant prevalence of candidiasis.&#x0D; Conclusion: The study sheds light on the distribution of Candida species and how demographic variables relate to them. These results highlight the significance of treating candidiasis as a serious health issue in people living with HIV. To improve overall health outcomes for HIV-positive people and reduce related risk factors, further research and treatments may be required.

Prevalence of hypertension, diabetes, obesity, multimorbidity, and related risk factors among adult Gambians: a cross-sectional nationwide study

Prevalence of hypertension, diabetes, obesity, multimorbidity, and related risk factors among adult Gambians: a cross-sectional nationwide study

A large sample-based case-control study of related risk factors of two types of lichenoid vulvar disease (LVD)

PurposeThe purpose of this study is to identify the associated factors of two types of lichenoid vulvar disease (LVD) and to compare the differences in related factors between the different pathological types of lichenoid vulvar disease (LVD). MethodsThe study conducted at the West China second Hospital of Sichuan University included a total of 1770 patients with biopsy-confirmed vulvar lichen simplex chronicus (VLSC)and vulvar lichen sclerosus(VLS), along with 1209 patients with normal vulvovagina as control. Further pathological subtype analysis was carried out on 163 cases of vulvar lichen simplex chronicus and 51 cases of vulvar lichen sclerosus. In addition, Univariate chi-square test and multivariate logistic regression were used to analyze the lichenoid vulvar disease group and vulvovaginal normal control group. ResultsUnivariate analysis revealed that there were statistically significant differences (P < 0.05) in factors between the LVD group and the control group, except for living type, sleep habit, history of drinking, and allergic diseases. There was no significant difference in late sleep, spicy diet, and coffee intake in the factors of life and eating habits and the concomitant disease factors. Furthermore, univariate analysis showed that except for eating seafood, humid living environment, residence, caffeinated drinks, hypertension, and vaginitis, there were statistical differences in the related factors of LVSC. ConclusionThe incidence about lichenoid vulvar disease is influenced by various factors such as dietary habits, living environment, mental stress, concomitant diseases, hormone levels and so on, and there were no significant differences in these factors between VLS and VLSC except for income, work stress, systemic immune diseases, and menopause.

Recurrence Patterns and Risk Factors after Curative Resection for Colorectal Cancer: Insights for Postoperative Surveillance Strategies.

This study aimed to assess recurrence patterns and related risk factors following curative resection of colorectal cancer (CRC). This retrospective observational study was conducted at a tertiary care center, including 2622 patients with stage I-III CRC who underwent curative resection between 2008 and 2018. Hazard rates of recurrence were calculated using a hazard function. The primary outcome was the peak recurrence time after curative resection and secondary outcomes were prognostic factors associated with recurrence. Over a median follow-up period of 53 months, the overall, locoregional and systemic recurrence rates were 8.9%, 0.7%, and 8.5%, respectively. Recurrence rates were significantly higher for rectal cancer (14.9% overall, 4.4% locoregionally, and 12.3% systemically) than for colon cancer (all p < 0.001). The peak recurrence time was 11 months, with variations in hazard rates and curves depending on the tumor location, stage, and risk factors. Patients with AL or CRM involvement exhibited a distinct pattern, with a high hazard rate in the early postoperative period. Understanding these recurrence patterns and risk factors is crucial for establishing effective postoperative surveillance strategies. Our findings suggested that short-interval surveillance should be considered during the first 2 years post-surgery, particularly for high-risk patients who should receive early attention.

Peak Blood Lactate at 24 h after ECMO Can Predict 30-day Mortality in Infants after Complex Cardiac Surgery.

Peak blood lactate at 24 h after extracorporeal membrane oxygenation (ECMO) can predict 30-day mortality in infants after complex cardiac surgery. Twenty-eight infants with ECMO after complex congenital heart disease surgery were selected from March 2019 to March 2022 in our hospital. The infants were divided into survival group (n = 11) and non-survival group (n = 17) according to 30-day survival after discharge from hospital. The risk factors at 30-day mortality after discharge were analyzed by Cox regression analysis. When compared to the non-survival group, there were significant differences in peak blood lactate at 24 h after ECMO, liver dysfunction and multiple organ dysfunction syndrome (MODS) in the survival group (p < 0.05). Cox regression analysis showed that peak blood lactate at 24 h after ECMO (HR = 1.074, 95% CI: 1.005-1.149, p = 0.036) and MODS (HR = 4.120, 95% CI: 1.373-12.362, p = 0.012) were related risk factors affecting the prognosis of infants. The best cutoff value for the peak blood lactate at 24 h after ECMO was 10.2 mmol/L. The area under the curve (AUC) for predicting the 30-day survival rate of the ECMO assisted infants after discharge from hospital was 0.770 (95% CI: 0.592-0.948, p = 0.018), with a sensitivity of 94.1% and specificity of 54.5%. The peak blood lactate at 24 h after ECMO can predict the 30-day mortality after discharge of infants treated with ECMO after complex cardiac surgery. The best cut-off value for peak blood lactate at 24 h after ECMO was 10.2 mmol/L.

Assessment of Kidney Impairment and Related Risk Factors in Pregnant Women Attending the University Center for Public Health and Rango Health Centers in the Southern Province of Rwanda

BackgroundPregnant women are susceptible to kidney function impairment due to physiological and metabolic changes induced by pregnancy. A series of studies suggested an overall progressive increase in glomerular filtration rate approximating 40-50% of the non-pregnant state.ObjectiveTo determine the prevalence of kidney impairment and related risk factors in pregnant women attending the University Center for Public Health and Rango health centers in Rwanda.MethodsAn analytical cross-sectional study that enrolled 139 consecutive pregnant women was conducted. Serum creatinine and qualitative urine protein and glucose determinations were carried out using standard laboratory methods to assess the integrity of kidney function. ResultsThe prevalence of kidney impairment in pregnant women was 20.9% comprising mainly women in the 2nd trimester of pregnancy (60.4%). Among the women with kidney impairment, 2.9% had high blood pressure. Of the overall study participants, 8.6% had glycosuria whilst 5% had proteinuria. The majority had gravida of one. There was a significant association between hypertension, glucosuria, age and gravida with kidney impairment (P = 0.001).ConclusionsFindings show that pregnancy with or without putative risk factors is associated with kidney impairment in apparently healthy women, as shown by the high prevalence of 20.9%. We therefore recommend routine screening of kidney dysfunction during pregnancy.Rwanda J Med Health Sci 2023;6(3):379-388

Multiple Hypointense Vessels are Associated with Cognitive Impairment in Patients with Single Subcortical Infarction.

We aimed to explore the relationship between multiple hypointense vessels and cognitive function in patients with single subcortical infarction (SSI) and the role of SSI with different etiological mechanisms in the above relationship. Multiple hypointense vessels were measured by the number of deep medullary veins (DMVs), DMVs score, and cortical veins (CVs) score. The Montreal Cognitive Assessment (MoCA), the Shape Trail Test (STT), and the Stroop Color and Word Test (SCWT) were assessed to evaluate cognitive function. SSI was dichotomized as branch atheromatous disease (BAD) and cerebral small vessel disease (CSVD)-related SSI by whole-brain vessel-wall magnetic resonance imaging. We included a total of 103 acute SSI patients. After adjustments were made for related risk factors of cognitive function, the SSI patients with higher DMVs score were more likely to have longer STT-B (P = 0.001) and smaller STT-B-1 min (P = 0.014), and the SSI patients with higher CVs score were more likely to have shorter STT-A (P = 0.049). In subgroup analysis, we found that the negative relationship between DMVs scores and cognitive function and the positive relationship between CVs scores and cognitive function were significantly stronger in BAD patients. We provided valuable insights into the associations between DMVs, CVs, and multi-domain cognitive impairment in SSI patients, which underscored the necessity to further study the dynamic alterations of venules and their specific influence on post-stroke cognitive impairment.

Remdesivir-Induced Bradycardia and Mortality in SARS-CoV-2 Infection, Potential Risk Factors Assessment: A Systematic Review and Meta-Analysis.

Background: The efficacy of remdesivir in reducing disease severity among COVID-19-infected patients has been established, but concerns have emerged regarding the potential side effects of bradycardia. The aim of this study was to investigate the association between remdesivir-induced bradycardia and mortality, while also identifying the related risk factors. Materials and methods: The PubMed/Medline, Cochrane Central and ClinicalTrials.gov databases were searched. Randomized controlled trials and prospective or retrospective cohort studies were included (through 14 July 2023). The random-effects model was implemented using Comprehensive Meta-Analysis software version 3.0 to examine the outcomes. Results: A total of 12 prospective or retrospective studies involving 7674 patients were analyzed. The primary outcomes revealed a significant association between remdesivir administration and bradycardia development (Odds ratio = 2.556, 95% CI = 2.049-3.188, p < 0.001). However, no statistically significant increase in the mortality rate was observed among patients with bradycardia during remdesivir treatment (Odds ratio = 0.872, 95% CI = 0.483-1.576, p = 0.651). The secondary outcome demonstrated a significant association between chronic kidney disease (CKD) and remdesivir-induced bradycardia (OR: 1.251, 95% CI: 1.003-1.561, p = 0.047). Moreover, patients with obesity (OR = 1.347, 95% CI = 1.098-1.652, p = 0.004) were more likely to experience remdesivir-induced bradycardia. Conclusions: Although a higher risk of bradycardia occurred during remdesivir treatment, the occurrence of remdesivir-induced bradycardia did not lead to higher mortality. Our study also identified patients with obesity and CKD as high-risk subgroups for experiencing bradycardia during remdesivir treatment.

The correlation between bipolar disorder not otherwise specified progression with patients’ clinical and demographic characteristics

Introduction: Bipolar disorder not otherwise specified is a complex condition characterized by unusual shifts in mood, energy levels, and behavior. Objectives: This study aimed to investigate the relationship between bipolar disorder not otherwise specified progression and patients’ clinical and demographic characteristics. Patients and Methods: Data for this study was obtained from a cross-sectional study conducted between the years 2008-2021. The study investigated 171 patients with bipolar disorder not otherwise specified. The data collection tool was the content of the file registered in the psychiatry department of the hospital, which was based on the physician’s interview with the patient. Data analysis was conducted using statistical tests in SPSS version 26 software. Results: Out of 171 patients, 80 (46.8%) were men with a mean age of 39.5 ± 12.2 years. The results found that the duration of symptoms onset to hospitalization in patients with mania symptoms was related to gender, family history of mental illness, and history of opium abuse. On the other hand, the duration of symptoms onset to hospitalization in patients with major depressive episodes (MDEs) was related to education level, marital status, and family history of mental illness (P&lt;0.05). In the patients with both Mania and MDEs’ symptoms, no statistically significant correlation was found between patients’ characteristics with the duration of symptoms onset to their hospitalization (P&gt;0.05). Conclusion: Identification of related risk factors and early treatment of bipolar disorder not otherwise specified, along with addressing potential comorbidities such as family heredity and opium abuse, can help improve patients’ outcomes and quality of life. Clinicians should consider these factors when assessing these patients to provide appropriate treatment and support.

Modifiable risk factors for dementia in Indonesia: Results from STRiDE project

Background &amp; Objective: Indonesia’s ageing population and increasing number of people living with dementia poses significant challenge to the health system. Better understanding of factors related to dementia prevalence is needed to mitigate risk, improve care, and ultimately reduce the incidence of dementia. In this study, we aimed to describe associations between potential risk factors and dementia in Indonesia. Methods: A cross-sectional study, part of the Strengthening Responses to Dementia in Developing Countries (STRiDE) project, was conducted in two provinces in Indonesia, Jakarta and North Sumatra between September and December 2021. A total of 2,110 older adults and their informants completed questionnaires covering cognitive and functional status, socioeconomic, medical and lifestyle factors. Models for each potential modifiable risk factor were created and then adjusted by age, sex and literacy. Prevalence ratios (PRs) were calculated for each risk factor. Results: In the adjusted models, lower education, lower occupational attainment, unmanaged diabetes, stroke, head trauma within the past 5 years, hearing loss, and chronic obstructive airway disease were all associated with higher prevalence of dementia in Indonesia. Current smoking, historic depression and high blood pressure were associated with higher dementia prevalence, but not statistically significant. Conclusion: Improving socioeconomic status (i.e., education and employment) and reducing health- related risk factors may be viable solutions to reduce the high prevalence rates of dementia in Indonesia. Further longitudinal research is needed to confirm direction of effect and causality.

COVID-19-induced hair shedding and related risk factors: A Saudi perspective.

Many cases of telogen effluvium (TE), acute hair shedding, following coronavirus disease 2019 (COVID-19) were reported during the pandemic. We conducted a cross-sectional study to assess the relationship between COVID-19 and TE in Saudi Arabia. Self-administered online questionnaires were distributed online between March and September 2022 in Saudi Arabia. A multivariate logistic regression model was used to determine risk factors associated with TE post-COVID-19 (significance at P < 0.05). Of the 703 responders, 392 were included in the study. 59.70% (n = 234) recognized hair shedding during or after COVID-19. The time taken to realize hair shedding (3 or 6 months) and the duration varied (3, 6, >6 months). The risk factors significantly related to TE post-COVID-19 were: female sex (P < 0.001, odds ratio [OR] = 2.98), COVID-19 antiviral treatment (P = 0.032, OR = 3.02), and TE history (P = 0.001, OR = 3.78). Healthcare providers and physicians should be aware of the relationship between TE and COVID-19, to easily recognize, treat, and improve their patients' outcomes).

Brain Healthy Soul Food Diet Intervention Among Older African Americans

AbstractBackgroundAlzheimer’s disease (AD) poses a major public health crisis, especially among African Americans who are disproportionally burdened by AD. Emerging evidence suggests that up to half of AD cases are a result of modifiable cardiovascular (CV) or metabolic risk factors related to poor diet such as elevated blood pressure, arterial stiffness, obesity, and diabetes, all of which disproportionately affect African Americans. Given the high prevalence of CV related risk factors in the African American community, prevention strategies are critical for reducing the disproportionate impact of AD among African Americans.MethodWe conducted a single arm 12‐week pilot in 2 waves (n = 20 African Americans) to assess feasibility and acceptability of an adapted brain‐healthy soul food diet intervention (MIND+SOUL) as measured by recruitment rates, retention rates, adherence, and satisfaction. The intervention encompassed skill building cooking classes, health coaching, and weekly groceries. We also evaluated preliminary efficacy of the MIND+SOUL diet intervention on CV risk and nutritional health status as measured by body composition, blood pressure, cholesterol, NHANES diet screening questionnaire, and beta carotene spectrophotometer. Lastly, we assessed change in cognition as assessed by the NIH Toolbox (NIH‐TB domains: memory, language, reading, vocabulary, processing speed, and executive function).ResultA total of 20 African Americans participated in the study with a retention rate of 90%. Most participants perceived the MIND+SOUL diet as feasible to follow (88.9%) and perceived the MIND+SOUL diet as effective in improving their overall health (77.8%). The median acceptability score was 67 out of 100 in which participants suggested modifications to the health coaching design and dissemination. Additionally, participated completed baseline and 12‐week CV, nutritional health status, and cognitive assessments.ConclusionFindings from this study indicate that older African Americans have a high interest in culturally tailored diets. Additionally, findings from this study will inform the development of a full‐scale randomized control trial that will test the efficacy of the MIND+SOUL intervention among older African Americans across a larger geographical area.

Analysis of Related Risk Factors and Prognostic Factors of Gastric Cancer with Liver Metastasis: A SEER and External Validation Based Study.

Gastric cancer (GC) has a poor prognosis, particularly in patients with liver metastasis (LM). This study aims to identify relevant factors associated with the occurrence of LM in GC patients and factors influencing the prognosis of gastric cancer with liver metastasis (GCLM) patients, in addition to developing diagnostic and prognostic nomograms specifically. Overall, 6184 training data were from the Surveillance, Epidemiology, and End Results (SEER) database from 2011 to 2015. 1527 validation data were from our hospital between January 2018 and December 2022. Logistic regression was used to identify the risk factors associated with the occurrence of LM in GC patients, Cox regression was used to confirm the prognostic factors of GCLM patients. Two nomogram models were established to predict the risk and overall survival (OS) of patients with GCLM. The performance of the two models was evaluated using the area under the curve (AUC), concordance index (C-index), and calibration curves. A nomogram included five independent factors from multivariate logistic regression: sex, lymph node removal, chemotherapy, T stage and N stage were constructed to calculate the possibility of LM. Internal and external verifications of AUC were 0.786 and 0.885, respectively. The other nomogram included four independent factors from multivariate Cox regression: surgery at primary site, surgery at other site, chemotherapy, and N stage were constructed to predict OS. C-index for internal and external validations were 0.714 and 0.702, respectively, and the calibration curves demonstrated the robust discriminative ability of the models. Based on the SEER database and validation data, we defined effective nomogram models to predict risk and OS in patients with GCLM. They have important value in clinical decision-making and personalized treatment.

Prevalence of Low Back Pain and Its Related Risk Factors and Disability Following Lumbar Discectomy: A Single-Center Study.

Background Lumbar disc herniation is considered the most common cause of sciatica, which is a contributing factor to disability. Surgical management of lumbar disc herniation in the form of discectomy is superior to conservative management in terms of better recovery and pain relief. However, recurrence, residual back pain, and disability are common expected complications following surgery. Therefore, this study aims to determine the prevalence of low back pain and its related risk factors and disability following discectomy at King Fahad Hospital in the Al-Ahsa region. Methodology A cross-sectional study was conducted at King Fahad Hofuf Hospital in the Al-Ahsa region among patients who were admitted and underwent lumbar spine discectomy in the last six years either due to traumatic or degenerative causes. The study used an anonymous questionnaire consisting of the patient's sociodemographic data, medical and surgical history, spine disease history, and surgical history. The preoperative Glasgow Coma Scale score, neurological status, and American Spinal Cord Impairment Scale score were noted. In addition, immediate postoperative neurological status and minor complications were recorded. Moreover, more than six months postoperatively, the Numeric Analogue Scale and the Oswestry low back pain disability index questionnaire were administered. Results A total of 201 patients were included in the study. The majority of the patients were male (59.7%), with ages ranging from 41 to 60 years (51.7). Most patients underwent one surgery (83.6%) in the form of discectomy alone (90.5%) at L3-L4 (58.7%), for which the intervertebral disc was the most common degenerative indication for surgery. All patients (100%) had low back pain preoperatively, and most patients (50.7%) had no back pain six months postoperatively. Preoperatively, 58.2% had diminished neurological status, while only 29.9% showed a deficit postoperatively. Postoperative low back pain was significantly associated with office-based jobs (p = 0.021, 60.5%) and a high number of surgeries (p = 0.004, 74.1%). The following factors were observed to be risk factors for having lower back pain: six months postoperatively, being unemployed (p = 0.024, odds ratio = 4.38, 338% increased risk), having an office-based job (p = 0.012, odds ratio = 3.98, 298% increased risk), and the underlying cause of the problem being degenerative (p = 0.003, odds ratio = 3.34, 234% increased risk). Low back pain-related severe disability postoperatively was significantly associated with increased age >40 (28-50%; p = 0.045), female gender (p = 0.012, 44.4%), and being unemployed (p = 0.002, 51.4%). The level of disability six months postoperatively was moderate in 40.4% of the patients. Conclusions Lumbar discectomy is a successful procedure for relieving low back pain among patients with degenerative spine disease, with an improvement that involves neurological status. However, residual back pain may still occur in less than half of the patients despite appropriate management, such as being unemployed or office-based employees and having multiple spine surgeries. However, low back pain-related disability is often moderate, with increasing severity seen with increased age, being female, and being unemployed.

Developmental delay and its demographic and social predictors among preschool-age children in Palestine

PurposeThis study was designed to assess the developmental outcomes among preschool-aged children and its associated factors in Palestine. MethodsA cross-sectional, descriptive-correlational design involved a representative sample of preschool-aged children from kindergarten in Ramallah governorate. Data were collected using the Ages and Stages Questionnaire, Arabic version-3. Associations between developmental delay (DD), parent, child and family characteristics were analyzed utilizing SPSS-25 version. ResultsA total of 249 preschoolers participated in the study. The overall rate of children with Global Developmental Delay (GDD) was 23.7%. The most prevalent DD were in gross motor, personal social, and fine motor skills (25.3%, 17.7%, and 16.5%, respectively). Binary logistic regression analysis revealed that the male gender of a child (OR = 2.66, 95% CI [1.37, 5.19]), the mother's part-time work (OR = 6.01, 95% CI [1.68, 21.52]), low family income (OR = 3.67, 95% CI [1.05, 12.73]), and families with three or more children (OR = 1.43, 95% CI [1.15, 1.781]) were statistically significant independent predictors of GDD. ConclusionThe study findings revealed higher rate of DD among preschoolers in Palestine than regional areas, especially in gross motor, fine motor, and personal social skills, which has consequences for both national and global health. According to the results, factors related to the child, the mother and the family are associated with the cumulative risk of preschoolers having DD. ImplicationsIt is a crucial role for pediatric nurses to detect DD early and its related risk factors through screening programs to limit the burden of problems in childhood and later adulthood.