Factor Reliability Research Articles

Estimating Prestressed Concrete Bridge Reliability and Rating Factors Using Bayesian Networks with an Application to a Bridge Made Continuous for Live Load

Estimating Prestressed Concrete Bridge Reliability and Rating Factors Using Bayesian Networks with an Application to a Bridge Made Continuous for Live Load

Analysis of risk factors for the development of major adverse cardiovascular and cerebrovascular events in patients after aortic valve replacement with myocardial revascularization

Background. Acquired aortic valve disease and coronary heart disease often occur together, and almost two thirds of patients with aortic valve stenosis have severe coronary heart disease. Given the presence of both pathologies, this cohort of patients requires an individual diagnostic and therapeutic approach. The aim of the study was to analyze risk factors for the development of major adverse cardiovascular and cerebrovascular events (MACCE) in patients after aortic valve replacement with myocardial revascularization. Materials and methods. For this study, a selection of disease histories of adult patients (over 18 years old) who underwent surgical aortic valve replacement (SAVR) together with myocardial revascularization at the State Institution “Heart Institute of the Ministry of Health of Ukraine” from 2018 to 2022 was carried out. Results. We selected 130 case histories of patients who underwent SAVR together with myocardial revascularization: the first group (n = 51) — a combination of SAVR and percutaneous coronary interventions; the second group (n = 79) — a combination of SAVR and coronary artery bypass grafting. The analysis of intraoperative data showed that the duration of cardiopulmonary bypass and aortic cross-clamping in patients of the first group was significantly lower, by 1.5 times (p = 0.0001) and 1.4 times (p = 0.0001), compared to the second group. There was no significant difference between the study groups regarding the frequency of MACCE (p = 0.589). Reliable risk factors for the development of MAССE in the early postoperative period were the evaluation of the operative risk according to the EuroSCORE II scale (odds ratio (OR) 2.13, confidence interval (CI) 1.54–4.48, p = 0.012), the history of myocardial infarction (OR 1.43, CI 1.13–2.45, p = 0.002) and right coronary artery damage (OR 1.79, CI 1.44–3.78, p = 0.021). Conclusions. Patients who underwent percutaneous coronary interventions before SAVR were characterized by a shorter duration of cardiopulmonary bypass and aortic cross-clamping, however, no significant difference in major early postoperative complications was observed between the study groups. In particular, there were no significant differences regarding the frequency of MACCE in the early postoperative period.

Applying the Theory of Planned Behavior to Understand Ecotourism Behavior: The Role of Human–Land Coordination and Self-Mastery

Ecotourism, which promotes environmental conservation and brings social and economic benefits through conscious and harmonious interactions between humans and nature, has become a principal tool for achieving these objectives. Sustainable tourism can only be supported with tourists realizing the elements of attraction toward ecotourism. This study analyzes the roots of ecotourism behavior using the Theory of Planned Behavior (TPB), specifically determining the roles of ecotourism tendency, attitude, human–land coordination stress, and sense of self-control in influencing tourists’ intention and behavior toward ecotourism. This study used a cross-sectional design, requiring 847 participants to complete a standardized questionnaire assessing their behavior toward ecotourism, attitudes, and perceptions. Reliability testing, descriptive statistics, regression analysis, and factor analysis were used to analyze the datasets to discover major factors relating to ecotourism intention behavior. A consequent outcome is that ecotourism attitude and self-determination are the significant drivers of ecotourism desire, while behavioral norms only impact ecotourism attitude and selflessness. The study concluded that the subjective perception of tourists and their behavior control ability are the ones that affect their ecotourism behavior more than other factors. The findings suggest that enhancing tourists’ ecotourism attitude, sense of self-control, and awareness of human–place coordination can significantly promote ecotourism behaviors. These results highlight the importance of comprehensive regional ecotourism analysis, robust environmental education, and promoting normative behaviors to foster sustainable tourism practices. To validate these findings, further research should focus on longitudinal studies and clinical trials to standardize integrated ecotourism strategies and explore the underlying mechanisms influencing ecotourism behavior.

Digital media ecosystem: a dimensional analysis according to the criteria of specialists

Digital marketing plays an important role in achieving organizations' strategies. This article aims to identify the elements and resources capable of configuring a digital media system that increases the effectiveness of commercial strategies. The present study was a non-experimental cross-sectional study. The empirical method used was data collection with an instrument structured by 5-option Likert scales. The survey was applied to 273 specialists. The statistical procedure used to measure the quality of the model was reliability analysis and factor analysis. The elements most recommended by experts in each digital channel were defined. It is concluded that a digital media ecosystem is formed by social networks, paid advertising, mobile marketing, organic positioning, social media, email marketing, and websites.

Prognostic role of lymph node regression in patients with esophageal cancer undergoing neoadjuvant therapy.

To clarify the prognostic value of lymph node regression (LNR) status including the lymph node regression grade (LNRG) and N downstaging in patients with esophageal cancer receiving neoadjuvant therapy based on available evidence. Several databases were searched up to 25 March 2024. The main outcomes included overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS). Hazard ratios (HRs) and 95% confidence intervals (CIs) were combined. Subgroup analyses based on the neoadjuvant therapy and pathological type were also conducted. In total, 14 retrospective studies with 3,212 participants were included. Nine and five studies explored the relationship between LNRG and N downstaging and survival, respectively. Pooled results indicated that complete LNR predicted significantly improved OS (HR = 0.47, 95% CI: 0.41-0.55, P < 0.001) and DFS (HR = 0.42, 95% CI: 0.32-0.55, P < 0.001) and subgroup analysis based on neoadjuvant therapy and pathological type manifested similar results. Besides, N downstaging was also significantly related to improved OS (HR = 0.40, 95% CI: 0.21-0.77, P = 0.006) and CSS (HR = 0.27, 95% CI: 0.12-0.60, P < 0.001). LNR could serve as a novel and reliable prognostic factor in patients with esophageal cancer receiving neoadjuvant therapy and complete LNR and N downstaging predict better survival.

Prognosis of hepatocellular carcinoma using the albumin to alkaline phosphatase ratio, literature review, and meta-analysis

Background: Data about the impact of albumin-to-alkaline phosphatase ratio (AAPR) on prognosis in hepatocellular cancer (HCC) patients are inconclusive and conflicting. Methods: The authors systematically searched literatures from seven databases (PubMed, Medline, Web of Science, Cochrane Library, Embase, Google Scholar, and CINAHL), updated to September 2023. Hazard ratios (HRs) and 95% CIs were pooled and synthesized using Comprehensive Meta-Analysis version 3 in order to assess the overall impact of AAPR on patient’s prognosis. Results: In total, 8 studies involving 13 cohorts with 3774 cases were included. Pooled results from both univariate and multivariate analyses revealed that higher AAPR was an independent prognostic factor for overall survival (HR=0.429, 95% CI: 0.361–0.509, P=0.001; HR=0.476, 95% CI: 0.421–0.538, P=0.001; respectively). Similarly, pooled multivariate results showed that higher AAPR was associated with better disease-free survival (HR=0.558, 95% CI: 0.452–0.688, P=0.001). Moreover, pooled results from both univariate and multivariate analyses revealed that higher AAPR was an independent prognostic factor for recurrence-free survival (HR=0.540, 95% CI: 0.420–0.694, P=0.001; HR=0.647, 95% CI: 0.494–0.848, P=0.002; respectively). Subgroups analysis showed that elevated AAPR still significantly correlated with better overall survival across the confounding factors. Moreover, sensitivity analysis suggested the robustness of these findings and no publication bias was detected. Conclusions: In summary, higher AAPR could be considered as a reliable prognostic factor in patients with HCC, which could be used as a routine inspection of HCC patients to individualized prognosis prediction and clinical decision making.

Systematic exploration of the molecular characteristics of CD8+ T cells to predict the response to immunotherapy and the prognosis of patients with colon adenocarcinoma

BackgroundRecently, immunotherapy has been recognized as an innovative treatment with great potential for patients with colon adenocarcinoma (COAD). Although the relationships between immune cells and immune substances are intricate and still unclear, some immune cells and substances could be considered prognostic factors for predicting therapeutic efficacy. To understand the genomic signatures of COAD related to CD8+ T cells that could predict the prognosis of patients receiving immunotherapy and to discover new therapeutic targets, we conducted this study. MethodsData were gathered from the TCGA and GEO databases to assess the molecular features of CD8+ T cells. We developed a CD8+ T-cell score (CD8S) to quantify the population of CD8+ T cells in each COAD patient. A thorough analysis of multilevel data was conducted to evaluate overall survival (OS), biological functions, immunological profiles, drug sensitivity, and responses to immunotherapy between the two groups defined by CD8S. Additionally, a series of in vitro experiments were executed to validate the reliability of the signatures associated with CD8+ T cells. ResultsCD8S has been shown to be a reliable prognostic factor for COAD according to different patient and subgroup analyses. Through in vitro experiments, we suggested that TSPYL2 may act as an oncogene in COAD. Through functional analysis, a high expression of genes linked to the cell cycle, cytoskeleton, cell adhesion, and various cancer-related pathways was observed in the high CD8S group, which aids in tumor invasion. Moreover, immune analysis reflected immunosuppression in patients with high CD8S. Patients in the low CD8S group were more sensitive to chemotherapy, targeted drugs, and immunotherapy due to higher genetic variants. ConclusionTo better understand the biological characteristics and prognostic significance of CD8+ T cells in immunotherapy for COAD, we thoroughly examined the molecular properties of CD8+ T cells in COAD and developed a CD8+ T-cell model.

Prognostic Significance of Albumin-Globulin Ratio in Urachal Carcinoma

Introduction: Although albumin-globulin ratio (AGR) has been used in the prognostic assessment of multiple solid malignancies, so far no research has confirmed the prognostic significance of AGR as a biomarker for urachal carcinoma. We analyzed the relationship between AGR and prognosis in urachal carcinoma, aiming to identify a promising prognostic biomarker for urachal carcinoma. Methods: We reviewed the clinical data of 25 patients diagnosed with urachal carcinoma in the Xiangya Hospital, Central South University, from January 2008 to October 2021. The best cut-off value of preoperative AGR was determined according to the receiver operator characteristic curve. The Kaplan-Meier curve was used to analyze the effect of preoperative AGR on the overall survival (OS) and relapse-free survival (RFS) of patients. Cox proportional hazards model was used to analyze prognostic factors including preoperative AGR. Results: The best cut-off value of preoperative AGR in urachal carcinoma patients is 1.45. Low preoperative AGR is significantly associated with worse OS and RFS. Univariate analysis and multivariate analysis indicated that low preoperative AGR is an independent and reliable factor to predict poor prognosis, OS, and RFS in urachal carcinoma patients. Conclusion: Urachal carcinoma patients with low preoperative AGR have worse prognosis, and preoperative AGR is a valuable prognostic indicator for urachal carcinoma research.

Ergonomic Risk Factors and Musculoskeletal System Problems In Healthcare Professionals Working In Central Sterilization Unit

This study was conducted to determine ergonomic risk factors and musculoskeletal system problems in healthcare professionals working in the central sterilization unit. The study is of descriptive cross-sectional type. The sample of the study consisted of 87 health professionals working in the central sterilization unit of seven hospitals of a private health group in Istanbul. Data were collected by face-to-face interview method using the sociodemographic characteristics form, the validated and reliable Ergonomic Risk Factors and Musculoskeletal Disorders Scale (ERKISO) and the Cornell Musculoskeletal Disorder Scale (T-CMDQ) between February and September 2020. Factor analysis, descriptive statistics, Mann Whitney U test, Kruskal-Wallis H test, post-Hoc analysis test and correlation test were used in the evaluation of the data. The level of significance was accepted as p

The Possible Role of Progesterone Receptors in Prostate Cancer Incidences in the Iraqi Population.

Prostate cancer (PCa) is one of the leading diseases causing mortality. It comes in the third rank of common cancer types. It is considered extremely a complicated cancer type since it occurs in highly steroid-responsive and dependent tissues. Many factors are considered to play an important role in the disease progression of PCa, with some functioning at the molecular level. After applying the exclusion criteria, 200 patients who underwent proctectomy were included in this study. Following receiving patient consent, blood samples were withdrawn from patients, DNA was extracted, and precise polymerase chain reaction (PCR) amplification was conducted using specifically designed primers. The resulting amplicons were sequenced and analyzed. The progesterone receptor B (PGRB) DNA from patients showed four distinctive single-nucleotide polymorphisms (SNPs) at sites 11:101128812, 11:101128924, 11:101128949, and 11:101128986, which altered the amino acid sequences to Y>N, A>D, T>I, and C>R, respectively, compared to control. These SNPs resided in sensitive sites that either affected the control elements or promoted alterations in the protein configuration. This DNA change diminished the PGR gene function and promoted an imbalance in the encoded PGR protein structure and expression. Many factors may play a role in PCa manifestation, with steroids and progesterone initially noted as factors. Many studies have dealt with the hormonal effect on PCa; however, few have ultimately determined the molecular impact on disease progression. The presence of pathogenic SNPs in the enhancing region of the gene may impact the expression level of PGR. High or low expression levels may negatively affect gene function, which can be considered a reliable factor in prostate tumorigenesis.

Cross-Cultural Adaptation and Pilot Psychometric Validation of the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire-Sexual Health (EORTC QLQ-SH22) Scale, Moroccan Arabic Version.

The Sexual Health Scale (QLQ-SH22) is the only cancer-specific measure of sexual health. It has never been translated into Arabic. In order to envisage effective healthcare strategies that improve sexual quality of life, the validation of the Moroccan version of this scale is a crucial step in exploring the influence of cancer and its treatment on patients in the Moroccan context. In this regard, this study aimed to validate a Moroccan Arabic version among patients with cancer. A total of 280 Moroccan patients with cancer participated in this study from August 2022 to April 2023. The translation and cross-cultural adaptation of the QLQ-SH22 was performed following the EORTC guidelines. Psychometric validation was explored using the reliability of internal consistency, test-retest reliability, and confirmatory factor analyses (CFA). The analysis revealed a greater internal consistency for both sexual satisfaction (α = 0.83) and sexual pain (α = 0.86). The intraclass correlation coefficient indicated an excellent level of test-retest reliability (from 0.925 to 0.993). The CFA demonstrated high-performing model fit indices (χ2/df = 1.17, SRMR = 0.05, RMSEA = 0.035, GFI = 0.94, CFI = 0.99, TLI = 0.99, IFI = 0.99, NFI = 0.94). The concurrent validity between the QLQ-C30 and QLQ-SH22 confirmed a strong correlation between the fatigue scales in both questionnaires (r = 0.69). This version showed good discrimination between known groups. The QLQ-SH22 Moroccan Arabic version has demonstrated a high level of reliability and validity, and therefore it is now ready for use.

Assessment of Risk Factors and Prognostic Predictors for Endo-Perio Lesions in Indian Cohorts: An Observational Study.

Endodontic and periodontal tissues exhibit a significant interrelationship, whereby pathologies affecting one tissue can precipitate the involvement of the other. The primary objective of this study was to assess the risk factors associated with endo-perio lesions (EPLs). The secondary objective was to assess the prognostic predictors for such lesions and the prevalence rate of EPLs involving both pulpal and periodontal tissues in Indian cohorts. A prospective observational study was conducted on 2170 teeth with EPLs in Indian adults aged > 18 years. A detailed history of smoking, tobacco chewing, and the development of EPLs was obtained from all patients. Detailed periodontal and endodontic examinations were conducted by two calibrated examiners. Intraoral periapical radiographs (IOPAs) were obtained to diagnose EPLs. The chi-square test of association was used to analyze the association between independent and dependent variables, and the strength of association was presented by Pearsoncontingency coefficient (r). Logistic regression analysis was performed to identify reliable factors for diagnosing EPLs. A statistical significance threshold of 0.05 was established. The prevalence of EPLs involving pulpal and periodontal tissues was 29.49%. Type 1 lesions (EPLs involving only pulpal tissue) were most commonly seen at 41-45 years of age, type 2 lesions (EPLs involving primary pulpal and secondary periodontal tissue), and type 3 lesions (EPLs involving only periodontal tissue) at 26-30 years of age, and type 4 lesions (EPLs involving primary periodontal and secondary pulpal tissue) at 31-35 years of age. The pulp was found to be non-vital in all cases of type 3 lesions, and faulty restoration or improper root canal treatment (RCT) was the main risk factor for such lesions. Occupational trauma was found to be the most common risk factor for type 3 and type 4 lesions. Smoking, age, tooth type, occlusal trauma, faulty restorations and RCT, presence of caries, periapical pathology, periodontitis, bone loss, and pulp vitality were significantly associated with EPLs. Pulp vitality and bone loss were two prognostic predictors of EPLs.

New Insights into Contradictory Changes in Brain-Derived Neurotrophic Factor (BDNF) in Rodent Models of Posttraumatic Stress Disorder (PTSD).

Post-traumatic stress disorder (PTSD) is a neuropsychiatric disorder that may develop after experiencing traumatic events. Preclinical studies use various methods to induce PTSD-like models such as fear-conditioning, single-prolonged stress (SPS), restraint stress, and social defeat. Brain-derived neurotrophic factor (BDNF) is a crucial neurotrophin in mood regulation. Evidence shows BDNF changes in different neuropsychiatric disorders particularly PTSD. This review examined BDNF alterations in preclinical rodent models of PTSD where we demonstrated a wide range of paradoxical changes in BDNF. We found that the fear-conditioning model produced the most inconsistent alterations in BDNF, and suggest that conclusions drawn from these changes be approached with caution. We suggest that BDNF maladaptive changes in social defeat and restraint stress models may be related to the duration of stress, while the SPS model appears to have more consistent results. Ultimately, we propose that evaluating BDNF alterations in the process of treating PTSD symptoms may not be a reliable factor.

A Study on the Leisure Sports Participation Behavior of the Elderly through Comparative Analyses by Age: Focusing on Leisure Participation Constraints and Price Sensitivity.

Worldwide, interest in healthy living has been increasing as people's lifespans have lengthened, owing to interest in health and the development of the medical industry. The need for research on healthy lifestyles aided by sports activities for older adults is greater than before. This study aimed to compare and analyze constraints on participation in leisure sports and participation price sensitivity based on age groups in a super-aging society. From 22 May to 10 July 2024, in three community and sports centers, Korean adults over the age of 20 who regularly participated in leisure sports voluntarily responded to a questionnaire. Based on a quantitative research design using a survey with a convenience sampling technique, 305 collected survey responses were analyzed for validity, reliability, and exploratory factor analysis through SPSS 28. Additionally, one-way multivariate analysis of variance and the price sensitivity meter technique allowed us to analyze the differences in leisure participation constraints and price sensitivity among the groups. No statistically significant group differences were found in the health and social factors of leisure sports participation constraints. However, statistically significant differences were found for the cost and time factors. Finally, the price sensitivity meter technique found differences in price sensitivity in participating in leisure sports among the three age groups. This scientific analysis, aiming to expand older adults' participation in leisure sports, provides objective data for the future.

Is Technology Uniquely Placed to Solve Our Problems? An Examination Into Technosolutionism, What It Entails and What It Predicts

Technology plays an important role in business and society. This has resulted in the belief that technology is in a unique position to solve organizational and societal problems. However, technology is not regarded as equally impactful by all. To explore these differences, we designed a technosolutionism scale to measure the extent to which individuals deem technological solutions to be better-suited to address organizational and societal problems. In Studies 1a and 1b, exploratory and confirmatory analyses indicated two reliable factors: (1) near-term and (2) long-term focused technosolutionism. Study 2 confirmed the scale’s convergent and discriminant validity. Next, we tested the predictive validity of the technosolutionism scale. We argue that a propensity to consider intelligent technologies as being able to provide solutions should also predict preferences in areas where technological solutions are being considered in response to organizational issues. Studies 3 and 4 demonstrate that the technosolutionism scale relates to preferences for a robot over a human in job replacement decisions and preferences for artificial intelligence managers over human managers in managerial decision-making tasks, respectively. This is an important finding as current research indicates that people are generally against being replaced or being managed by intelligent technologies, whereas our findings indicate that this preference flips when it comes to those with a higher propensity for technosolutionism. Our technosolutionism scale can be used to gauge the extent to which individuals believe that technology is uniquely placed to solve problems, such that they opt for intelligent technological solutions over and above other (human) solutions.

Machine-learning techniques for enhancing electricity theft detection considering transformer reliability and supply interruptions

Machine-learning techniques are extensively used in fraud detection and have a huge potential application in electricity theft detection. Electricity theft occurs when consumers manipulate their electricity consumption to be recorded as lower than the actual, resulting in reduced revenue for the electricity supplier. This study explores the application of advanced machine-learning techniques to detect electricity theft, focusing on the impact on supply of electricity to electricity usage pattern. We used a dataset that contains supply interruptions influenced by transformer reliability to construct a robust detection model. This model integrates data analytic techniques from decision trees, support vector machines, k-nearest neighbors, and logistic regression classifiers. After selecting the optimal classifier, we used aggregated parameters to improve theft-detection accuracy. A comprehensive sensitivity analysis was used to evaluate the effects of variations in transformer reliability factors on interruption, interruption costs, electricity revenue, and theft-detection performance. Our findings indicate that using optimal aggregated parameters significantly enhances detection accuracy 10.709 percent, 11.435 percent, 4.909 percent, and 2.097 percent from original parameters depend on the number of aggregation in 2-hour, 4-hour, 6-hour, and 12-hour, respectively. The lower transformer reliability leads to increased loss with percentage 66.87 percent, 46.98 percent, 17.22 percent and reduced theft-detection efficiency by 27.32 percent, 19.23 percent, 6.20 percent. depend on reliability factor20 percent, 50 percent, and 80 percent, respectively.

Optimizing and Exploring Untapped Micro-Hydro Hybrid Systems: a Multi-Objective Approach for Crystal Lake as a Large-Scale Energy Storage Solution

Increasing electricity demand and concerns about climate change and fossil fuel consumption have highlighted the importance of renewable energy resources and storage systems. This paper proposes a method for exploring untapped pumped hydro storage potentials to accommodate intermittent renewable energy generation profiles. Hourly measured data from 2022 in Benzie County, Michigan, United States, were gathered for system sizing and a thorough, realistic analysis. By employing the multi-objective grey wolf optimization algorithm, we formulated optimal sizing and energy-management strategies for three different scenarios. Unlike similar studies, the 3rd with triple objective functions (OFs) scenario aims to maximize both reliability and ecological OFs while minimizing the cost OF. It has shown promising results with multiple solutions, considering economic, environmental, and reliability factors. A case study conducted in Crystal Lake, Michigan, revealed that although Crystal Lake would function only as a micro-hydro power facility, it is a promising and huge storage unit with a substantial storage capacity of around 14.9734GWh. The system investigated is significant in the USA due to its rapid deployment capabilities, minimal construction requirements, and ease of integration with the distribution grid. The fuzzy logic method was employed to identify the best non-dominant solution among the other solutions. These outcomes include a notably low levelized cost of energy at 0.046147$/kWh, a robust index of reliability of 99.705%, and a significant reduction in CO2 emissions amounting to 7.9142×103 tons/year, when considering the triple OFs. The paper’s methodology provides valuable insights for regions aiming to utilize renewable energy from untapped storage sources.

Community design of the Brooklyn Health Equity Index

Abstract Health equity drives quality care. Few reliable metrics that capture patients’ perceptions of health equity exist. We report on the development of a patient-centered metric for health systems change in central Brooklyn, which stands out as an outlier in New York City with a disproportionate burden of poverty, disease, and death. A community-engaged, sequential, mixed-methods research design was used. Qualitative interviews were conducted with 80 community and health care stakeholders across central Brooklyn. Candidate items were derived from qualitative themes and examined for face, interpretive validity, and language. Interitem reliability and confirmatory factor analysis was assessed using data collected via text and automated discharge calls among 368 patients from a local hospital. Qualitative data analysis informed the content of 11 draft questions covering 3 broad domains: trust-building, provider appreciation of social determinants of health, and experiences of discrimination. Psychometric testing resulted in a Cronbach's alpha of 0.774 and led to deletion of 1 item, resulting in a 10-item Brooklyn Health Equity Index (BKHI). The 10-item BKHI is a novel, brief, and reliable measure that captures patients’ perceptions of inequities and offers a real-time measure for health systems and payors to monitor progress toward advancing health equity.

A Systematic Review of the Key Predictors of Progression and Mortality of Rheumatoid Arthritis-Associated Interstitial Lung Disease.

Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is an important extra-articular manifestation of rheumatoid arthritis (RA). Identifying patients at risk of progression and death is crucial for improving RA-ILD management and outcomes. This paper explores current evidence on prognostic factors in RA-ILD. We conducted a systematic literature review to examine the impact of clinical, radiological, and histological factors on lung function decline and the survival of RA-ILD patients. We searched electronic databases, including Medline and EMBASE, from inception to date. The incidence and prognosis of predictors were qualitatively analyzed, and univariate results were combined when feasible. Following the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)" guidelines, our systematic literature review involved a five-step algorithm. Out of 2217 records, 48 studies were eligible. These studies reported various prognostic factors, including demographic variables, clinical risk factors, serum markers, and preexisting treatments. Lung function declined over time in 1225 subjects, with significant variability in smoking history and radiological/pathological UIP patterns. Severe lung fibrosis and abnormal pulmonary function tests (PFTs) were key univariate prognostic indicators, while age at initial presentation, RA disease activity, predicted DLCO percentage, and UIP pattern were the most reliable multivariate risk factors for ILD progression. Age, male gender, disease duration, RA activity, acute phase reactants, and specific serum biomarkers (Krebs vin den Lungen 6, surfactant protein D, and interleukin 6) were significantly associated with all-cause mortality. RA-ILD is a severe complication of RA characterized by significant prognostic variability. Key prognostic factors include extensive fibrosis observed on imaging, a marked decline in lung function, high RA disease activity, and specific biomarkers. These factors can guide treatment strategies and improve patient outcomes.

Genetic evidence for lifestyle and cardiometabolic factors on the risk of aortic aneurysms: A comprehensive Mendelian randomization study

Background and aimsAortic aneurysm (AAs) is a chronic and severe aortic disease, which is extremely life-threatening due to its delayed diagnosis and a high risk of rupture. In current studies, the association between lifestyle and metabolic factors remains controversial given the complexity of pathogenesis and progression in AAs. Consequently, more reliable and robust evidence should be provided. MethodsGenome-wide association studies summary statistics were obtained for 25 factors (6 lifestyle factors and 19 cardiometabolic factors) and AAs. Univariable Mendelian randomization (UVMR) and multivariable MR (MVMR) were used to estimate the causal effect of these factors on AAs. Meanwhile, mediation analysis was applied to assess the mediated effect of lifestyle on the association of cardiometabolic factors with AAs. ResultsSeveral factors were associated with AA risk, among which triglyceride (TG) (OR = 1.32, 95 % CI = [1.18–1.47], p < 0.001) and high-density lipoprotein cholesterol (HDL-C) (OR = 0.70, 95 % CI = [0.61–0.82], p < 0.001) remain consistently associated with AA risk, with an idependent effect on AAs after adjusting for body mass index (BMI). In addition, TG mediated 15.6 % of BMI effects and 3.7 % of smoking effects on AAs, and HDL-C mediated 5.3 % of the effects of cigarette smoking on AAs. ConclusionsTG and HDL-C may be the most reliable factors in the risk of AAs. More scientific management of lifestyle and regular monitoring for cardiometabolic traits may serve as a new and effective direction for the prevention and control of the occurrence of AAs.