Related Risk Factors Research Articles

Cone Density Distribution and Related Factors in Patients Receiving Hydroxychloroquine Treatment.

Hydroxychloroquine is an effective treatment for rheumatic diseases; however, retinal damage is a possible side effect. We aimed to identify the retinal area and related risk factors associated with cone density reduction caused by hydroxychloroquine. We recorded the retinal images of patients with rheumatic diseases taking hydroxychloroquine (n = 44) and compared them with images of healthy controls (n = 107). Cone density was obtained in vertical and horizontal axes. Regions of decreased cone density and associations between age, rheumatic disease type, dosage for ideal body weight, and cone density were evaluated. Cone densities were significantly lower in hydroxychloroquine-treated patients than in sex- and age-matched controls in the vertical axis (P < 0.001), with no significant difference in the horizontal axis (P = 0.120); in healthy elderly than in healthy young people in the horizontal axis (P < 0.001), with no significant difference in the vertical axis (P = 0.100); in hydroxychloroquine-treated elderly than in hydroxychloroquine-treated young patients in both axes (both P < 0.05); among patients with different rheumatic disease types, with no significant difference in the vertical axis (P = 0.294). The daily dose was negatively correlated with cone density in the vertical axis and inferior quadrant. Hydroxychloroquine reduces retinal cone cell density in the vertical axis. Cone density loss in the horizontal axis increases with age; further, hydroxychloroquine dosage is negatively correlated with cone density in the vertical axis and inferior quadrant. Early screening of hydroxychloroquine-related retinal injury should consider changes in cone density in the vertical axis.

Cardiovascular risk factors in military personnel of the brazilian airforce at Alcântara (MA)

Objective: To investigate the frequency of cardiovascular risk factors in military personnel of the Brazilian Air Force in Alcântara, Brazil. Methods: A retrospective cross-sectional study was conducted with clinical records of 240 active military personnel from the Medical and Statistical Archives Service and nutritional assessment from the Nutrition Subsection Sector. The modifiable (diabetes mellitus - DM, systemic arterial hypertension - SAH, generalized obesity, abdominal obesity, hypercholesterolemia, hypertriglyceridemia, sedentarism, smoking, and alcoholism) and non-modifiable (gender and age) cardiovascular risk factors, anthropometric data, and cardiovascular diseases (CVD) were extracted. Descriptive statistics and chi-square test was applied (a=5%). Results: The sample was predominantly male (55.8%) and with a mean age of 33 (±8.4) years. The most prevalent risk factors were overweight (43.8%), abdominal obesity (42.9%), generalized obesity (21.3%), alcoholism (34.6%), and sedentary lifestyle (31.3%). Regarding the distribution of cardiovascular risk factors in relation to gender, a significant association was found with SAH, sedentarism, abdominal obesity and nutritional status (p=0.004, p=0.027, p=0.040 and p=0.018, respectively). For the sample studied, 2.7% had CVD. Conclusions: The predominant cardiovascular risk factors were overweight, abdominal obesity, generalized obesity, alcoholism and sedentary lifestyle. In men, hypertension and overweight were predominant, and in women, sedentarism and abdominal obesity.

Thromboembolism risk in patients diagnosed with EGFR- and ALK-mutant lung adenocarcinoma

In this study, we investigated the incidence of venous thromboembolism (VTE), related risk factors for VTE, and the effect of VTE on overall survival in patients with non-small-cell lung cancer harboring epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) gene mutations. The study included patients older than 18 years of age who were diagnosed with histologically proven locally advanced or advanced-stage adenocarcinoma and were followed in our center between January 2014 and December 2019. These patients were divided into two groups: one comprising mutation-positive individuals and the other mutation-negative individuals. We examined factors influencing the occurrence of VTE, assessed the incidence of VTE, and compared the differences in overall survival. Univariate Cox regression analysis revealed that the independent predictors of VTE were the number of metastases (Hazard ratio [HR]: 3.784; 95% confidence interval [CI]: 2.198 &amp;ndash; 6.515; P &lt; 0.001) and the presence of EGFR exon 21 mutations (HR: 2.386; 95% CI: 1.276 &amp;ndash; 4.462; P = 0.006). However, in multivariate analysis, only the number of comorbidities was associated with an increased risk for VTE (HR: 3.462; 95% CI: 1.977 &amp;ndash; 6.060; P &lt; 0.001). It is essential to consider the risk of VTE development in patients with EGFR exon 21 mutation-positive lung adenocarcinoma. Physicians should be vigilant in terms of screening, prophylaxis, and follow-up for underlying VTE in these patients.

Denture use and risk for cardiometabolic disease: observational and Mendelian randomization analyses.

Denture use may potentially increase the risk of cardiometabolic diseases (CMDs), but the casual relevance and strength of the associations are currently unknown. A total of 495 938 participants from the UK Biobank were included in the observational analyses. Linkage disequilibrium score (LDSC) regression and Mendelian randomization analyses were employed to estimate genetic correlation and the associations between the genetic liability for denture use with coronary artery disease, myocardial infarction, heart failure (HF), any stroke (AS), ischaemic stroke, haemorrhagic stroke, type 2 diabetes (T2D), and related clinical risk factors. In observational analysis, denture use was associated with 14-25% higher risks of various CMDs. The LDSC analysis found that denture use showed a positive genetic correlation with CMDs (rg 0.21-0.38). Genetic liability for denture use was associated with an elevated risk of HF [odds ratio: 1.49 (1.20-1.83)] and T2D [1.11 (1.01-1.24)]. By integrating genetic summary data of denture use with the sum of decayed, missing, and filled tooth surfaces (DMFS), a clinical measure of dental caries obtained from an independent source, genetically determined denture use/DMFS was also associated with an elevated risk of AS [1.21 (1.04-1.40)]. Furthermore, genetically predicted denture use/DMFS was significantly associated with established cardiometabolic risk factors, including HDL cholesterol, triglycerides, waist circumference, waist-to-hip ratio, and height. Our study supported potential causal associations between the genetic liability for denture use and risks for HF, AS, T2D, and related clinical risk factors. These findings may inform prevention and intervention strategies targeting dental diseases and CMDs.

Prediction model of cervical lymph node metastasis based on clinicopathological characteristics of papillary thyroid carcinoma: a dual-center retrospective study.

The overall prevalence of papillary thyroid carcinoma (PTC) patients is expanding along with an ongoing increase in thyroid cancer incidence. Patients with PTC who have lymph node metastases have a poor prognosis and a high death rate. There is an urgent need for indicators that can predict lymph node metastasis (LNM) before surgery as current imaging techniques, such as ultrasonography, do not have sufficient sensitivity to detect LNM. To predict independent risk factors for Central lymph node metastasis (CLNM) or Lateral lymph node metastasis (LLNM), we therefore developed two nomograms based on CLNM and LLNM, separately. In two centers, the Second Affiliated Hospital of Nanchang University and Yichun People's Hospital, we retrospectively analyzed clinicopathological characteristics of PTC patients. We utilized multivariate analysis to screen for variables that might be suspiciously related to CLNM or LLNM. Furthermore, we developed nomograms to graphically depict the independent risk valuables connected to lymph node metastasis in PTC patients. Ultimately, 6068 PTC patients in all were included in the research. Six factors, including age<45, male, mETE, TSH>1.418, tumor size>4cm, and location (multicentric and lobe), were observed to be related to CLNM. Age<45, male, mETE (minimal extrathyroidal extension), multifocality, TSH≥2.910, CLNM positive, and tumor size>4cm were regarded as related risk factors for LLNM. The two nomograms developed subsequently proved to have good predictive power with 0.706 and 0.818 and demonstrated good clinical guidance functionality with clinical decision curves and impact curves. Based on the successful establishment of this dual-institution-based visual nomogram model, we found that some clinical features are highly correlated with cervical lymph node metastasis, including CLNM and LLNM, which will better help clinicians make individualized clinical decisions for more effectively rationalizing managing PTC patients.

Intra-operative drug level monitoring of pre-operative antibiotic for surgical prophylaxis inthe patients of elective spinal surgery.

Single dose prophylaxis is good enough for general surgery with low risk patients. However, the evidence for the effectiveness of single dose anti-microbial prophylaxis (AMP) is not conclusive in high risk patients andspinal surgeries requiring instrumentation or the use of implants in particular. No studies have explored the various concentration of ceftriaxone in plasma and tissue as well during an ongoing spinal surgery. Therefore, the objective of study was to correlate the serum and tissue concentrations of ceftriaxone with the SSI and identify patients with increased risk of SSI. It was an open label prospective study in 50 consecutive patients who underwent elective spine surgery under prophylactic cover of ceftriaxone. Serum and tissue concentration were estimated by high pressure liquid chromatography during the ongoing surgery. Subjects were observed for any post-operative complications including SSI. Serum (p=0.002) and tissue (p=0.012) concentrations of ceftriaxone at the closure of spinal surgery were associated with SSI. Duration of the surgery (p=0.04) and use of implants (p=0.02) were also important surgery related risk factors. Serum and tissue concentrations of ceftriaxone atthe closure and duration of surgery and instrumentation or use of implants in the spinal surgery are good predictors of SSI.

The role of miR1 and miR133a in new-onset atrial fibrillation after acute myocardial infarction

BackgroundThe development of new-onset atrial fibrillation (NOAF) after acute myocardial infarction (AMI) is a clinical complication that requires a better understanding of the causative risk factors. This study aimed to explore the risk factors and the expression and function of miR-1 and miR-133a in new atrial fibrillation after AMI.MethodsWe collected clinical data from 172 patients with AMI treated with emergency percutaneous coronary intervention (PCI) between October 2021 and October 2022. Independent predictors of NOAF were determined using binary logistic univariate and multivariate regression analyses. The predictive value of NOAF was assessed using the area under the receiver operating characteristic (ROC) curve for related risk factors. In total, 172 venous blood samples were collected preoperatively and on the first day postoperatively; the expression levels of miR-1 and miR-133a were determined using the polymerase chain reaction. The clinical significance of miR-1 and miR-133a expression levels was determined by Spearman correlation analysis.ResultsThe Glasgow prognostic score, left atrial diameter, and infarct area were significant independent risk factors for NOAF after AMI. We observed that the expression levels of miR-1 and miR-133a were significantly higher in the NOAF group than in the non-NOAF group. On postoperative day 1, strong associations were found between miR-133a expression levels and the neutrophil ratio and between miR-1 expression levels and an increased left atrial diameter.ConclusionsOur findings indicate that the mechanism of NOAF after AMI may include an inflammatory response associated with an increased miR-1-related mechanism. Conversely, miR-133a could play a protective role in this clinical condition.

The Prevalence and Risk Factors of Low Back Pain Among Office Workers in Saudi Arabia.

Background and objective Lowback pain (LBP) is a significant and prevalent musculoskeletal disorder associated with the workplace that impacts individuals, families, communities, healthcare systems, and companies. Although LBP prevalence and risk factors have been studied in various professional categories in Saudi Arabia, there is no data on the prevalence of LBP among office workers and related risk factors. This study aimed to determine the prevalence of LBP among office workers in Saudi Arabia and identify major risk factors. Methodology This cross-sectional study was conducted among office workers in Saudi Arabia of both genders aged over 18 years living in five geographical regions: Central, Western, Southern, Eastern, or Northern. A self-administered questionnaire was distributed among office workers using an online survey. The questionnaire comprised sociodemographic characteristics, the prevalence of work-related LBP, and work-related characteristics. Results Among 604 office workers, 51.7% were malesand 43.5% were aged between 18 and 30 years old. The prevalence of work-related LBP in this study was 59.9%. Independent risk factors for LBP include being overweight or obese, sleep disturbance, previous history of back trauma, increasing years of working in the office, changes made to workstation/work habits to reduce the risk of LBP, and frequent work stress. Protective risk factors for LBP include regular physical exercise and satisfaction with the current job. Conclusions LBP was widely prevalent among office workers in Saudi Arabia. Office workers with elevated body mass index (BMI) who had a previous history of back trauma and had sleep disturbance or work stress in the past month were at significant risk for LBP. Occupational health and safety programs are vital for building ergonomically safe working conditions, and regular physical exercise promotion could alleviate the risk of LBP at work.

Evaluation of malnutrition and screening tools in hospitalized children

Detecting malnutrition and its related risk factors are crucial, in hospitalized children. Anthropometric z scores are used to assess malnutrition. Screening tools also aim to detect the presence of malnutrition and the developing risk of malnutrition in hospitalized children to determine who may benefit from nutritional support. Therefore, the aims of the study are to detect malnutrition and its related demographic and clinical risk factors in hospitalized children and determining the sensitivity of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) and Pediatric Yorkhill Malnutrition Score (PYMS) screening tools. A total of 130 hospitalized children aged between 0 and 18 years were included in to study. A survey including demographic and clinical characteristics, STAMP and PYMS were applied to parents of the children. Patients were classified into nutritional risk groups through screening tools. Anthropometric measurements (body weight, length/height, and middle upper arm circumference (MUAC) of the children were taken. Body mass index-for-age and height-for-age z scores were calculated to assess acute and chronic malnutrition prevalence. MUAC-for-age z scores were calculated as well. To detect independent risk factors for acute and chronic malnutrition multivariable logistic regression models were constructed. A total of 14.6% of hospitalized children had acute malnutrition, 21.5% of children had chronic malnutrition and 27.7% of them had low MUAC standard deviation score (SDS) (less than-2). The independent risk factors for acute malnutrition were younger maternal age at birth and long length of stay (p<0.05). The independent risk factors for chronic malnutrition were being female, younger maternal age at birth, longer illness duration and having urological or allergy and immunological diseases (p<0.05). However, MUAC for age SDS groups were not related to any demographic and clinical factors, in children of all ages (p>0.05). Regarding the screening tools, PYMS displayed 100% sensitivity against acute malnutrition. While PYMS displayed better sensitivity to identify acute malnutrition than STAMP, STAMP was more sensitive than PYMS to detect chronic malnutrition and low MUAC SDS. Low MUAC for age SDS was not related to any demographic and clinical factors, in hospitalized children of all ages, unlike acute and chronic malnutrition, in this study. Pediatric screening tools mainly PYMS did not have high sensitivity to detect chronic malnutrition and low MUAC SDS, in hospitalized children. Therefore, the tools have to be used along with z scores of anthropometric parameters.

Circadian Urinary Excretion of Water, and Not Salt, Is Affected by the White Coat Effect.

Hypertension is an important morbidity factor. The prognostic consequences of the white-coat effect have been studied extensively. The repercussion on the circadian rhythm of urinary water and salt excretion in the same subgroup remain, conversely, among the open topics. Postulating an impaired diurnal sodium and volume excretion we decided to investigate both, in subjects with or without a white-coat effect, in the general population. A sample of 1023 subjects, has been considered. We collected 24-h urine samples, divided in day and night, and we measured the blood pressure with an Ambulatory Blood Pressure Monitoring (ABPM). ABPM values were then compared with physician collected in-office values to assign subjects to the group with or without the white-coat effect. Concerning the circadian pattern of urinary sodium excretion, we found no significant differences between the groups. There was instead in the white-coat effect group a higher night/day ratio of urinary water excretion. The white-coat effect, has been considered a potential hypertension precursor, and its consequent handling could be prospectively relevant in hypertension prevention. The absence of repercussions on the urinary circadian sodium excretion pattern and on the potentially related risk factors in subjects with a white coat effect is reassuring. The clinical significance of the impact on the night/day ratio of water excretion needs to be further investigated.

Prevalence and Knowledge of Respiratory Symptoms Among the General Public in the Southern Area of Najran, Saudi Arabia: A Cross-Sectional Health Survey Study.

To investigate the knowledge, prevalence of chronic respiratory disorders, and utilization of their medications among the adults at Najran region, Saudi Arabia. An online cross-sectional survey was carried out in Najran region, Saudi Arabia. A self-administered questionnaire was distributed among a random sample of the general population, aged 18 or above between March and December 2022. The survey instrument included questions regarding history and exposure, physician diagnosed-disorders, respiratory symptoms, allergy, use of medications and possible risk-related factors. This research had a total of 712 individuals. Nearly one-third of the participants in the survey (n = 218; 30.6%) said that they or a member of their family suffer from respiratory ailments. The majority of research participants (n = 167; 76.8%) identified asthma as their primary respiratory condition. A total of 32.0% of participants (n = 70) reported dealing with dust or chemicals such as paints, fertilizers, and cleaning products on a daily basis at work or at home. Around 62.0% of the participants (n = 134) said that exposure to gases, fragrances, and other such substances negatively impacts their health. Almost 78.0% (n = 169) of them indicated that summer weather affects their health, whereas 63.0% (n = 138) reported that winter cold affects their health. Participants aged 41-50 years were 38.0% less likely to have CRDs compared to others (p < 0.05). This study is among the first few studies that explored the knowledge, prevalence of chronic respiratory disorders, and utilization of their medications among the adults at Najran region, Saudi Arabia. In the southern area of Najran, respiratory symptoms are frequent among the inhabitants of Saudi Arabia. More research is required to discover avoidable risk factors and create countermeasures for them. It is recommended that healthcare personnel increase their efforts to educate their patients about respiratory illness prevention methods.

Related risk factors of periodontal health in Chinese adolescents

Related risk factors of periodontal health in Chinese adolescents

Prevalence and risk factors of stroke in high-altitude areas: a systematic review and meta-analysis

ObjectiveThe primary objective of this study is to investigate the prevalence and risk factors of stroke in high-altitude areas through a comprehensive systematic review and meta-analysis.DesignThis study adopts a systematic...

Prevalence of major infectious diseases in backyard chickens from rural markets in Morocco.

Raising backyard chickens is a common practice in Morocco, mainly in rural or periurban areas. Constraints due to devastating avian diseases have been recognized as a major limiting factor in backyard poultry production. Consequently, these flocks could potentially be implicated as reservoirs for poultry diseases. However, there is a considerable lack of information on disease prevalence in this production system, and the risk represented by these small flocks remains under debate. This study aimed to estimate the seroprevalence and identify related risk factors of a range of bacterial and viral pathogens of outstanding importance for the economy and public health in backyard poultry in Morocco. A total of 712 sera samples and 258 cloacal swabs were collected from 712 backyard chickens from 15 rural markets in the Khemisset and Skhirat-Temara provinces. None of the sampled chickens received any vaccination. Sera samples were screened for antibodies against Newcastle disease virus (NDV) and low pathogenic avian influenza H9N2 subtype (LPAI H9N2) using a hemagglutination-inhibition test, against bursal infectious disease virus (IBDV) and infectious bronchitis virus (IBV) using enzyme-linked immunosorbent assay, and against Mycoplasma gallisepticum (MG) and Mycoplasma synoviae (MS) using a rapid serum agglutination test. Swab samples were compiled into 86 pools and submitted for molecular detection using real-time reverse-transcription-polymerase chain reaction (RT-PCR). The seroprevalences in backyard chickens for NDV, LPAI H9N2, IBDV, IBV, MG, and MS were 52.1% (371/712), 63.5% (452/712), 84.7% (603/712), 82.2% (585/712), 58% (413/712), and 74.8% (533/712), respectively. Based on the RT-PCR results, 2.3% (2/86), 62.8% (54/86), 2.3% (2/86), 63.9% (55/86), 40.7% (35/86), and 29.1% (25/86) of the pools were positive for NDV, H9N2 LPAI, IBDV, IBV, MG, and MS, respectively. Multiple coinfections (H9N2-IBV-MG), (H9N2-IBV-MS), or (IBV-MG-MS) were observed in 15.1%, 8.5%, and 8.5% of the tested samples, respectively. The results show that backyard chicken flocks and rural markets have the potential to serve as reservoirs or amplifiers for poultry pathogens and could pose a risk to the commercial poultry sector. This highlights the need for a comprehensive and adapted vaccination plan for backyard chickens, and extension of efforts to increase flock owners' awareness of avian diseases and incite the implementation of biosecurity measures at the farm level.

Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plus

BackgroundNumerous studies over the past four decades have revealed that breast cancer screening (BCS) significantly reduces breast cancer (BC) mortality. However, in BRICS-plus countries, the association between BCS and BC case fatality and disability are unknown. This study examines the association of different BCS approaches with age-standardized mortality, case-fatality, and disability-adjusted life years (DALYs) rates, as well as with other biological and sociodemographic risk variables, across BRICS-plus from a national and economic perspective.MethodsIn this ecological study applying mixed-effect multilevel regression models, a country-specific dataset was analyzed by combining data from the Global Burden of Disease study 2019 on female age-standardized BC mortality, incidence, and DALYs rates with information on national/regional BCS availability (against no such program or only a pilot program) and BCS type (only self-breast examination (SBE) and/or clinical breast examination (CBE) [SBE/CBE] versus SBE/CBE with mammographic screening availability [MM and/or SBE/CBE] versus SBE/CBE/mammographic with digital mammography and/or ultrasound (US) [DMM/US and/or previous tests] in BRICS-plus countries.ResultsCompared to self/clinical breast examinations (SBE/CBE) across BRICS-plus, more complex BCS program availability was the most significant predictor of decreased mortality [MM and/or SBE/CBE: − 2.64, p < 0.001; DMM/US and/or previous tests: − 1.40, p < 0.001]. In the BRICS-plus, CVD presence, high BMI, second-hand smoke, and active smoking all contributed to an increase in BC mortality and DALY rate. High-income and middle-income regions in BRICS-plus had significantly lower age-standardized BC mortality, case-fatality, and DALYs rates than low-income regions when nationwide BC screening programs were implemented.ConclusionsThe availability of mammography (digital or traditional) and BCS is associated with breast cancer burden in BRICS-plus countries, with regional variations. In light of high-quality evidence from previous causal studies, these findings further support the preventive role of mammography screening for BCS at the national level. Intervening on BCS related risk factors may further reduce the disease burden associated with BC.

Neonatal outcomes and related risk factors of 30 cases with aplastic anemia in pregnancy: A retrospective study

ObjectiveTo analyze the neonatal outcomes of pregnancies complicated by aplastic anemia (AA) and to investigate the underlying risk factors. MethodsA single-center retrospective study was performed. Thirty singleton gravidas with AA (AA group) and another thirty singleton gravidas (control group) without immune or blood system disorders who gave birth around the same time were selected. Neonatal outcomes were compared between the two groups. Meanwhile, multivariable analyses were utilized to investigate the association between underlying risk factors and adverse neonatal events. ResultsNo neonatal deaths occurred. Compared to the control group, the offspring of women with AA had a smaller gestational age (36 ± 1.9 vs. 39.1 ± 0.9 weeks; P < 0.001) and birth weight (2683.7 ± 479.9 vs. 3324.3 ± 394.1 g; P < 0.001). Newborns of women with AA had a higher risk of premature delivery (53.3 % vs. 3.3 %; P < 0.001), low birth weight (23.3 % vs. 0 %; P < 0.001) and NICU admission (53.3 % vs. 16.7 %; P = 0.003). Multivariate analysis showed neutropenia, anemia and thrombocytopenia as risk factors for premature delivery and admission to NICU. Anemia was independently associated with low birth weight (OR 0.94, 95 % CI 0.9–0.98, P = 0.01). ConclusionsNeonatal complications such as premature delivery, low birth weight and NICU admission are more common in pregnant women with AA. Newborn babies' s hematopoietic system did not appear to have been affected. Maintaining a certain level of neutrophils, hemoglobin, and platelets in the mother can improve newborn outcomes.

The use of pediatric fall risk assessment tool in gastrointestinal endoscopic procedures: A prospective study

Background and Aims: The aim of this study is to evaluate the fall risk with Humpty Dumpty Fall Scale and determine related risk factors in pediatric patients undergoing gastrointestinal endoscopy. Materials and Methods: A prospective descriptive study was conducted in a large tertiary pediatric hospital. Patients' demographics, type of endoscopy, duration of endoscopic procedures, type of procedural sedation, doses of administered drugs during anesthesia, and post-procedure Humpty Dumpty Fall Scale scores were collected. Post-hoc and logistic regression analyses were performed to identify within-group differences and independent predictors of patient outcomes. Results: One hundred ninety-two pediatric patients (54.2% female) with a mean (standard deviation) age of 11.16 (5.32) years were admitted for a diagnostic gastrointestinal endoscopy. During procedures, the most commonly administered sedatives were midazolam (98.9%), propofol (96.9%), fentanyl (63.0%), and ketamine (34.9%). According to the Humpty Dumpty Fall Scale, 148 (77.1%) patients had a high risk for falls. No falls after endoscopic procedures was observed in the patients. When the predictive factors determining being at high-risk for falls were examined, the simultaneous application of esophagogastroduodenoscopy and colonoscopy under the same procedural sedation increases the risk of being high-risk 5.2 times compared to the performing esophagogastroduodenoscopy alone (p = 0.047). Conclusion: To the best of our knowledge, this is the first study evaluating the use of Humpty Dumpty Fall Scale to predict falls in pediatric patients undergoing gastrointestinal endoscopy with procedural sedation. Although 77.1% of the patients were found to be at high risk for falls, there was no fall event after the endoscopic procedures due to precautionary measures. Our results indicate that pediatric patients undergoing gastrointestinal endoscopy with sedation are at increased risk of falling and preventive measures should be taken.

Assessment of users' adoption behaviour for stock market investment through online applications

Investing in stocks has become increasingly accessible, with beginners able to start an account via a brokerage's website or mobile app with very little money. Online trading through applications allows you to trade independently without a broker's interference. This not only lowers the overall cost of trading but also makes it hassle-free, increasing the value of the business significantly. Using an online trading account gives an investor more control. This paper examined the user's perspective on stock market investment through online applications. The impact of users' awareness, benefits & choice of investment, reliability, safety, risk-related factors, financial literacy, technical aspect, and dependency was analyzed on users' adoption behaviour. An empirical survey with a valid sample of 424 respondents from India was collected from the respondent and analyzed using descriptive analysis, correlation analysis, reliability analysis, analysis of variance, and regression analysis. Results indicated that users' awareness, benefits & choice of investment, reliability, safety, risk-related factors, financial literacy, technical aspect, and dependency significantly influence the users' adoption behaviour in using stock trading applications. The findings will assist potential investors in comprehending the factors influencing the adoption of such apps and aiding the organizations engaged in operating or creating such applications in understanding user behaviour, which will significantly add value to the society at large.

Investigation of risk factors for the diagnosis of heart disease

Introduction: Limited studies have investigated the association between diagnosis of heart disease and its relating risk factors and haven’t met with robust results. We hypothesized that all or part of the risk factors are correlated with the heart disease. Method: This dataset published in 1998 was obtained from UCI Machine Learning Repository and was collected at University of Irvine. The dataset has 303 instances with 76 attributes, but all published experiments refer to using a subset of 14 of them. Our study focuses on 11 parameters specifically, including body health conditions, historic medical records, and habits. Logistic regression analyses were conducted to assess the relative risks of heart disease. Results: Both chest pain type (p &lt; 0.01) and ST depression (p &lt; 0.05) are positively correlated with the incidence of heart disease. Maximum heart rate, on the other hand, are negatively correlated with the diagnosis of heart disease. Conclusion: Our study suggested that chest pain type, ST depression and maximum heart rate are saliant contributors to indicate the occurrence of heart disease. The findings from our study have implications for the heart disease and call for future studies to explore the underlying prevention strategies of this findings.

Geographic social vulnerability is associated with the alpha diversity of the human microbiome.

The human microbiome ecosystems living within the human body are exposed to exogenous foreign substances from the various environments that humans live within. Therefore, dynamics between microbes and human hosts can be influenced by environmental changes, which potentially impact microbiome composition and diversity. Geographic area, as a microbiome-relevant environmental factor, has been well reported. Human geography, however, is often linked to socioeconomic status, racial and ethnic population enclaves, and disparities in area disadvantage. Potential mechanisms linking the microbiome to factors tied to area disadvantage include household crowding, use of public transportation, and lack of exposure to biodiverse natural environments. Through an analysis of data from the Human Microbiome Project including healthy adults who reported residential area information at the time of microbiome sampling (n = 201), we found a significant relationship between the social vulnerability index (SVI), as a measure of area disadvantage, and multiple alpha diversity measures across oral, airways, and urogenital sites when controlling for age, gender, and body mass index. With regard to race/ethnicity, we found significant mediation by SVI score to explain racial/ethnic differences in urogenital microbiome diversity in females. Our results highlight the importance of considering environmental variables such as area social vulnerability as a variable of interest in microbiome studies within healthy individuals and suggest a potential role to explain urogenital race/ethnicity differences. Future studies including a diverse, representative community-based population, more precise residential location, and inclusion of related risk factors such as dietary intake, are needed to further understand the implications of these results. IMPORTANCE As a risk factor for conditions related to the microbiome, understanding the role of SVI on microbiome diversity may assist in identifying public health implications for microbiome research. Here we found, using a sub-sample of the Human Microbiome Project phase 1 cohort, that SVI was linked to microbiome diversity across body sites and that SVI may influence race/ethnicity-based differences in diversity. Our findings, build on the current knowledge regarding the role of human geography in microbiome research, suggest that measures of geographic social vulnerability be considered as additional contextual factors when exploring microbiome alpha diversity.