Risk Identification Research Articles (Page 1)

Worldwide less than half of adults with hypertension are diagnosed and treated (only 42%), in addition one in five adults with hypertension (21%) has the condition under control. In the American continent, cardiovascular diseases (CVD) are the leading cause of death and high blood pressure (hypertension) is responsible for 50% of CVD deaths. Only a few countries show a population hypertension control rate of more than 50%. In this experimental study, we trained 15 regression-type machine learning algorithms, including traditional and ensemble methods to assess their effectiveness in estimating arterial pressure using noninvasive photoplethysmographic (PPG) signals extracted from 110 study subjects, to identify the risk of hypertension and its correlation with arteriosclerosis. We analyzed the performance of each algorithm using the metrics MSE, MAE, RMSE, and r2. A 10-fold cross-validation showed that the best algorithms for hypertension risk identification were LR, KNN, SVR, RF, LR Baggin, KNNBagging, SVRBagging, and DTBagging. On the other hand, the best algorithms for arterioclesrosis risk identification were LR, KNN, SVR, RF, LR Bagging, and DTBagging. These results suggest that this research is promising and offers valuable information on the acquisition and processing of PPG signals. However, as this is an experimental study, the effectiveness of our model needs to be validated with a larger database. On the other hand, this model represents a support tool for healthcare specialists in the early detection of cardiovascular health, allowing people to self-manage their health and seek medical attention at an early stage.

Objective Universal screening improves suicide risk detection in individuals presenting to the emergency department (ED) who are not presenting with a psychiatric chief complaint, what we refer to as incidental risk. We sought to better understand characteristics of individuals who present with incidental risk and to evaluate their suicide-related outcomes after the ED visit. Methods Two samples (cross-sectional, longitudinal) from the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) study were used. Combined, the samples allowed for comparison of baseline characteristics and suicide-related outcomes for participants with incidental risk compared to those with negligible risk (any kind of chief complaint and negative suicide risk) and clinically congruent risk (psychiatric chief complaint and positive suicide risk). Univariable and multivariable logistic regression analyses were completed. Results Universal screening differentially improved the identification of suicide risk among non-white individuals, potentially reducing racial disparities in risk detection. Participants presenting with incidental risk were generally more similar to those with congruent risk than they were to those with negligible risk across demographics and clinical characteristics. Those with incidental suicide risk exhibited similar post-visit suicide-related outcomes compared to those with congruent risk, yet they were far less likely to receive clinical assessments and interventions during the ED visit. Conclusions The results of this study highlight an opportunity to broaden evidence-based suicide prevention practices in the ED where logistically possible. EDs may need to consider redesigning their clinical approach to address suicide risk among those who present with medical complaints but screen positive for suicide risk.

In the context of China's increasingly aging population, commercial endowment insurance has become an important support for multi-level endowment security system, but its family participation rate has been low for a long time.Based on the mixed cross-section data of CHFS from 2015 to 2019, this paper adopts two-way fixed effect model to systematically examine the impact of financial literacy represented by attention to financial information on whether households purchase commercial endowment insurance. The empirical results show that attention to financial information significantly improves the probability of household insurance participation, and it is still robust after controlling the characteristics of household head, household economic status and two-way fixed effects. After multiple robustness tests such as shrinking the sample, replacing the fixed effect and changing the estimation model, the conclusions remain unchanged. Heterogeneity results show that the positive effect is more significant in rural and eastern regions, but relatively limited in urban and central and western regions. Risk preference is a significantly positive moderating effect on the insurance participation decision. The mechanism analysis further reveals that attention to financial information promotes households to make insurance participation decisions by improving financial knowledge level and risk identification ability. Therefore, the article suggests building the differentiated financial education system, strengthening the construction of financial infrastructure, and improving the institutional environment to enhance residents' long-term confidence in participation.

In an aging society, solving problems associated with the diagnosis and treatment of dementia-related diseases represents a serious challenge. The aim of the study was to evaluate the possibility of applying molecular biology methods to test polymorphisms recognized in the global literature as potentially useful in assessing the risk of developing dementia in a group of patients with hyperlipidemia. A sample of 203 patients: 109 diagnosed with both dementia and hyperlipidemia, 94 with hyperlipidemia, and 101 individuals as an allele frequency control group—were genotyped. Additional data about cognitive decline and neuropsychological assessment were collected. Among all the studied polymorphisms, the frequency of the ABCA1 rs2230806 polymorphism differed between the analyzed groups. The GG genotype (p = 0.0002, RR = 3.22, CI = 1.63 ÷ 6.37) and the G allele (p = 0.0007, RR = 1.53, CI = 1.19 ÷ 1.97) were more frequent in patients diagnosed with dementia, specifically in those with Alzheimer’s disease. Furthermore, the GG genotype was more common in individuals with a shorter disease duration and lower scores on the Montreal Cognitive Assessment (MoCA) scale, and consequently, with greater cognitive function deficits during early stages of the diagnostic process. ABCA1 rs2230806 genotyping is a potential marker for the early identification of dementia risk in patients with hyperlipidemia, which supports the validity of exploring options for incorporating diagnostics based on molecular biology methods.

Background: Artificial Intelligence (AI) holds significant potential to enhance operational efficiency and quality in healthcare. However, despite substantial investment, its widespread, sustained implementation is limited, necessitating a thorough risk assessment to overcome current adoption barriers. Methods: This scoping review, guided by the Arksey and Malley framework, systematically mapped 13 articles published between 2019 and 2024, sourced from five major databases (including CINAHL, Medline, and PubMed). A rigorous, systematic process involving independent data charting and critical appraisal, using the Critical Appraisal Skills Programme (CASP) tool, was implemented, followed by thematic synthesis to address the research questions. Results: AI demonstrates a significant positive impact on both operational efficiency (e.g., optimised resource allocation, reduced waiting times) and patient outcomes (e.g., improved patient-centred, proactive care, and identification of readmission risks). Major implementation hurdles identified include high costs, critical data security and privacy concerns, the risk of algorithmic bias, and significant staff resistance stemming from limited understanding. Conclusions: Healthcare managers must address key challenges related to cost, bias, and staff acceptance to leverage the potential of AI fully. Strategic investments, the implementation of robust data governance frameworks, and comprehensive staff training are crucial steps for mitigating risks and creating a more efficient, patient-centred, and effective healthcare system.

Physicochemical indicators of surface water quality play a crucial role in influencing biological processes in surface waters. In the context of climate change, changes in river hydrological regimes also affect surface water quality. This study aims to evaluate long - term data on dissolved oxygen (DO), surface water temperature (Tw), acidity (pH) and conductivity (EC) in the undisturbed Varínka stream in the northern part of Slovakia, covering the period from 1972 to 2017. The study focuses on identifying significant changes in physicochemical indicators of surface water quality and analyzing monthly and annual trends. The results reveal significant increasing trends in acidity and conductivity values in the Varínka stream . The next section examines regression relationships between selected indicators and models them. Cross - correlation between individual indicators showed that most do not follow a linear pattern, but some correlation coefficients (between surface water temperature and dissolved oxygen) were significantly different from zero. An autoregressive model was tested to model the selected surface water quality indicators, enabling the identification of risks associated with changing values. This model's predictive ability allows for early identification of potential threats and supports the implementation of cost - effective measures to protect surface water resources. The study concludes that the SARIMA model can effectively simulate changes in surface water temperature, dissolved oxygen, and conductivity, providing valuable information for surface water management and conservation strategies.

Placenta accreta spectrum (PAS) is defined by abnormal placental adherence or invasion into the myometrium or adjacent organs and is a leading cause of massive obstetric hemorrhage. Its global incidence is increasing due to rising cesarean delivery rates, uterine surgeries, and the use of assisted reproductive technologies. This review summarizes the current knowledge regarding PAS, including its pathophysiology, risk factors, diagnostic methods, treatment options, and pregnancy outcomes after conservative management. The underlying pathogenesis is related to defective decidualization at the endometrial-myometrial interface, which is commonly associated with uterine scarring. Prenatal diagnosis relies on a thorough clinical history and imaging tools such as ultrasound and magnetic resonance imaging. Management strategies depend on fertility preservation goals and range from hysterectomy to conservative approaches such as leaving the placenta in situ. Effective management requires early risk identification, prenatal screening, referral to specialized centers, and delivery planning by a multidisciplinary team. Despite recent advances in imaging and surgical techniques, PAS remains the leading cause of maternal mortality and morbidity worldwide. There is a critical need for multicenter studies, standardized risk stratification tools, and long-term follow-up studies to optimize care and improve maternal and reproductive outcomes.

Financial risk identification and accounting analysis method of listed companies based on machine learning

Introduction: The social care workforce must evolve to meet the changing needs of an ageing population, including increasing demand and delivery of homecare. Current training for home care workers is often theory-based, with homecare workers often feeling underconfident and lacking skills in some areas. Although simulation is widely used in healthcare for skill enhancement, it is underutilised in homecare training. This project aimed to explore the use of simulation-based education to upskill homecare workers to identify risks they may encounter in a client’s home. Methods: This study was a pre-post mixed-methods study. Two high-fidelity simulations were undertaken, one for home care workers and another for home care managers. The simulation sessions were conducted in an activity of daily living suite. Both simulations were pre-briefed, recorded and debriefed using the STOP 5 hot debrief model [1]. Pre- and post-questionnaires included demographics, the 10-item General Self-Efficacy Scale, a bespoke measure on confidence with caring and communicating with clients, and the Student Satisfaction and Self-Confidence in Learning questionnaire [2]. Descriptive statistics were undertaken on pre and post surveys, the debrief was transcribed verbatim and analysed using thematic analysis alongside open-text comments from the questionnaires [3]. Results: 12 carers and 8 care managers took part in the simulation sessions. Four themes were developed across the quantitative and qualitative findings. Two themes focused on the use of simulation within home care: “Is Aggie okay?” – Risk Identification and client care, and “We’re in for it here” – Showcasing the challenges and difficulties of care. The other two themes focused on participants’ views on simulation as a training method: “Understanding the proper role of a carer” – Benefits of simulation in training, and “Obviously, we’re in a role play situation” – Challenges in engaging in simulation. Discussion: Simulation helped promote client-centered thinking, critical reflection, and peer discussion. It was seen as a useful complement to theoretical training, especially in preparing new carers. However, challenges such as suspension of disbelief, stress, and organisational barriers impacted engagement. To enhance effectiveness and minimise learner anxiety, the study highlights the importance of realistic scenarios, pre-briefing, and debriefing to ensure psychological safety and skill transfer. Ethics Statement: As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable.

Background: Klinefelter syndrome (KS), the most common sex chromosome aneuploidy in males (47,XXY), is generally associated with hypogonadism, gynecomastia, and infertility. Nevertheless, its association with thrombotic risk remains insufficiently recognized, despite accumulating evidence indicating a predisposition to venous thromboembolism (VTE) comparable to that observed in classical, inherited thrombophilias. Description of Case: We present the case of a 33-year-old South Asian male who exhibited unilateral lower limb swelling and pain persisting for one month. Doppler ultrasonography revealed chronic deep vein thrombosis (DVT) affecting the left common femoral and deep femoral veins. The patient lacked identifiable risk factors for thrombosis, such as recent surgery, trauma, malignancy, or immobilization. Physical examination revealed signs of hypogonadism and gynecomastia. Hormonal assays indicated elevated gonadotropin levels with low serum testosterone levels, while karyotype analysis confirmed a 47,XXY genotype, consistent with KS. Further evaluations, including screening for acquired thrombophilias (antiphospholipid antibodies) and genetic mutations (Factor V Leiden, Prothrombin G20210A, and MTHFR C677T), yielded negative results. The patient was successfully managed with heparin, transitioned to long-term anticoagulation with warfarin, and demonstrated clinical improvement upon follow-up. Discussion: This case highlights the significant yet often overlooked association between KS and thrombotic events. The pathophysiological mechanisms remain unclear but are hypothesized to be multifactorial, involving increased expression of X-linked coagulation factors (e.g., Factor VIII), endothelial dysfunction, and a higher prevalence of comorbidities. Notably, in our case, the absence of conventional or inherited prothrombotic factors underscores KS as a potential primary contributor to the hypercoagulable state. Conclusion: Clinicians are advised to maintain a heightened level of suspicion for KS in male patients who present with unexplained thrombotic events, particularly when these events are accompanied by symptoms indicative of hypogonadism. The early identification and management of thrombotic risk in individuals with KS are crucial to mitigating morbidity. Further research is necessary to elucidate the mechanisms that link KS with thrombophilia, as this may inform screening strategies and therapeutic interventions.

Background: Atherosclerotic cardiovascular disease (ASCVD) most often manifests initially with a myocardial infarction or stroke. While the aetiology of atherosclerosis and benefits of risk factor (lipids and blood pressure) management are well established, less is known about the effectiveness of ASCVD risk assessment and management in the period leading up to such events. Aims: To identify patients with a major coronary or cerebrovascular event at first presentation of ASCVD between 2010-23 and assess identification and management of ASCVD risk in the year preceding the event. Methods: We conducted a retrospective, population-level,observational study using linked anonymised health record data amongst 102,148 patients with a fatal or non-fatal major coronary or cerebrovascular event at first ASCVD diagnosisin Wales (UK). Trends in the documentation of QRISK 10-year risk score, management of LDL-C and blood pressure(BP), and prescription of lipid lowering therapy (LLT) were identified in the year preceding presentation. Results: Documentation of LDL-C in the year prior to presentation increased from 27.8% to 38.5% between 2010-23, of which the proportion with a level of <1.8 mmol/L increased from 4.5% to 9.5% (Figure 1A). Prescription of LLT increased from 26.0% to 33.8% between 2010-23, with an increase in the prescribing of high-intensity statin from 2.0% to 6.7% (Figure 1B). Documentation of BP decreased from 55.2% to 49.8% between 2010-23, and achievement of systolic and diastolic BP <140&90 mmHg increased, thoughonly from 26.5% to 27.4% (Figure 1C). Documentation of QRISK score within 5-years prior to presentation increased from 16.1% to 27.7% between 2014-23, of which 28.1% scored >20% in 2023 (Figure 1D). Among patients with a recorded QRISK of >20%, only 19.1% were prescribed LLTin 2014, increasing to 27.5% in 2023 (Figure 1E). Conclusions: Although management of lipids has improved over time in the primary prevention setting, the effectiveness of control of patient's risk factors remains suboptimal at a population level. The majority of patients suffering MI or stroke as their initial presentation of CVD do not have their BP or lipids tested (or controlled when tested) in the year preceding initial presentation with these acute vascular events.Improvements are required in identification of those at risk and management of modifiable risk factors to meet guideline-recommended standards of care at the population level.

Background: With the continuous deepening of population aging, the trend of core family size, and the intensification of social phenomena such as aging before becoming rich, the long-term care risks of disabled elderly are becoming increasingly prominent. Objectives: This study aims to deeply analyze the connotation, characteristics, and causes of long-term care risks for disabled elderly in China, systematically identify their specific manifestations at different levels, and explore how to construct effective risk warning mechanisms and prevention systems. Methods: This study adopts a literature analysis method to systematically clarify the connotation of risk, analyze the specific manifestations of nursing risks faced by disabled elderly people, and examine the influence of factors such as population, family, and labor force, providing theoretical support for the construction of risk warning mechanisms. Results: Research shows that the long-term care risks faced by disabled elderly people in China are mainly reflected in three aspects: financial, caregiving, and poverty risks, and are influenced by factors such as the aging population structure, the prevalence of nuclear families, labor migration, and the increasing burden of elderly care. Conclusion: The long-term care risks faced by disabled elderly people are a key constraint in the development of China's elderly care security system, requiring coordinated responses from the government, society, and families. Establishing a whole-life-cycle risk early warning mechanism, improving the elderly care security system, and optimizing fertility policies are necessary to address these challenges.

Achieving negative surgical margins is fundamental to curative colorectal cancer (CRC) surgery. Despite advancements in imaging, preoperative identification of margin risk remains limited. Recent developments in artificial intelligence (AI) now enable fusion of radiomics, quantitative imaging analysis and histopathology (“pathomics”) to predict microscopic tumor spread more accurately. Radiomics captures sub-visual textural and spatial features from CT and MRI, while AI-driven histopathology interprets digital slides at cellular resolution. Integrating these modalities yields a multi-scale model that reflects both macroscopic tumor architecture and microscopic invasiveness. Multicentric studies in China and the United States have demonstrated superior performance of radiopathomic models over single-modality approaches for predicting therapeutic response and margin status. As countries such as the United Kingdom and South Korea implement AI-driven precision oncology frameworks, transparent validation remains essential. By enabling more informed surgical planning and tailored resections, multimodal AI fusion could markedly enhance oncologic outcomes in CRC.

Introduction: Gestational diabetes mellitus is increasingly recognized as a risk factor for adverse fetal cardiovascular remodeling. Hyperglycemia during pregnancy may lead to altered fetal myocardial development, particularly affecting septal thickness and myocardial function. However, standardized fetal cardiac markers and the magnitude of these changes remain under-investigated. Hypothesis: We hypothesized that fetuses of mothers with GDM exhibit statistically significant increases in interventricular septal thickness and impaired cardiac function compared to fetuses of normoglycemic mothers during the third trimester. Methods: A prospective cohort study was conducted involving 120 pregnant women diagnosed with GDM and 120 matched normoglycemic controls between 28–34 weeks of gestation. All participants underwent fetal echocardiography using standardized M-mode and Doppler measurements. Parameters assessed included IVST, left ventricular myocardial performance index, and E/A ratio. Maternal HbA1c levels were measured concurrently. Statistical analysis was performed using SPSS with independent t-tests and Pearson correlation coefficients; p-values < 0.05 were considered statistically significant. Results: Fetuses in the GDM group exhibited significantly increased IVST (mean ± SD: 4.83 ± 0.45 mm) compared to controls (3.97 ± 0.51 mm), p < 0.001. The myocardial performance index was also elevated in the GDM group (0.55 ± 0.06) versus controls (0.48 ± 0.05), p < 0.001, indicating impaired global myocardial function. A moderate positive correlation was observed between maternal third-trimester HbA1c and fetal IVST (r = 0.58, p < 0.01), and a negative correlation with E/A ratio (r = –0.41, p < 0.05), suggesting diastolic dysfunction. Conclusion: Third-trimester fetuses of GDM mothers demonstrate statistically significant myocardial hypertrophy and impaired cardiac function. These findings support the use of fetal echocardiography in GDM pregnancies to enable earlier identification of cardiometabolic risk. Glycemic control, as indicated by maternal HbA1c, appears moderately correlated with the severity of fetal cardiac remodeling.

Sanchez, KJ, Baruch, T, Ross, KA, Coburn, JW, Costa, PB, Orr, RM, Dawes, JJ, and Lockie, RG. Coronary artery calcium status, body composition, blood lipids, and fitness among firefighters participating in a health and wellness program. J Strength Cond Res XX(X): 000-000, 2025-Cardiovascular disease (CVD) is prevalent among firefighters. Coronary artery calcium (CAC) can contribute to the identification of CVD risk, but there has been limited analysis in firefighters. This study investigated body composition, blood lipid, and fitness test differences in firefighters with normal (CAC-N) and abnormal (CAC-A) CAC. Relationships between these health and fitness variables and CAC status were also derived. Archival data from 45 male firefighters were examined. Data included age, height, body mass, body mass index, body fat mass, lean body mass, waist-to-hip ratio, blood lipids (triglycerides, low-density lipoproteins, high-density lipoproteins, total cholesterol), grip strength, vertical jump (VJ), plank, push-ups, resting heart rate, systolic and diastolic blood pressure (BP), and estimated maximal aerobic capacity (V̇o2max). Firefighters were screened and grouped as CAC-N (CAC = 0; n = 35) and CAC-A (CAC > 0; n = 10). Independent samples t-tests or Mann-Whitney U-tests determined between-group differences. Pearson's correlations determined relationships between the binary variable of CAC status with the other variables. There were no significant between-group differences in any variable. The CAC-N group had a lower systolic BP than the CAC-A group, with a moderate effect (p = 0.080, d = 0.893). Systolic BP also correlated with CAC status (r = 0.355; p = 0.017). The CAC-N group had 9-14% better VJ and V̇o2max than the CAC-A group, which had small effects (p = 0.050-0.110, d = 0.555-0.584). Body composition, blood lipids, and fitness generally did not differentiate or relate to CAC status. Apparently fit and healthy firefighters may have underlying CVD risk factors such as higher CAC. Health and wellness programs should be multifaceted, including exercise and medical screening.

Introduction: Atrial fibrillation (AF) is the most common arrhythmia in patients with hypertrophic cardiomyopathy (HCM) and associated with significant morbidity and mortality. Early identification of patients high risk of AF is vital for closer monitoring and allowing early treatment to improve outcomes. While a novel risk prediction model (HCM-AF score) identifies HCM patients at risk for new-onset AF, there remains ability to improve sensitivity and specificity for select patients. Left atrium (LA) strain is an emerging noninvasive marker, which reflects LA function and remodeling and may identify individuals at higher risk for AF. Therefore, we aim to investigate if LA reservoir strain by cardiovascular magnetic resonance (CMR) is associated with development of new onset AF in patients with HCM. Methods: In this retrospective, multi-center study, we measured LA strain in HCM patients referred for CMR without prior AF history. LA strain was derived from 2-chamber and 4-chamber view using Medis (Medis Medical Imaging, Leiden, the Netherlands, Version 4.0.62.4). Patients were followed for primary endpoint of new onset AF. Univariable and multivariable cox proportional hazard model were performed. Results: A total of 1020 HCM patients were included (62.7% male, 53.4 ± 16.0 years). During a follow up of 3.3±2.0 years, 124 patients (12.2%) developed new onset AF. Reservoir strain was significantly lower in patients with new onset AF (19.3±8.8 vs 24±9.1, p<0.05). Univariable cox regression showed every 5 unit decrease in reservoir strain is significantly associated with increased risk of AF (HR 1.41 [1.23, 1.59], p<0.001). LA reservoir strain remained significant in multivariable analysis when adjusting for HCM AF score (HR 1.16 [1.01, 1.32], p<0.05), and remained independent after further adjusting for hypertension, left ventricular end-diastolic diameter and late gadolinium enhancement (HR 1.15 [1.01, 1.32], p<0.05) (Table 1). Conclusions: CMR-derived LA reservoir strain is an independent predictor of new onset AF in HCM patients and provides incremental prognostic value beyond tradition risk factors. Incorporating LA strain into risk assessment may guide intensity of arrhythmia surveillance, and aid in early identification and treatment of high-risk patients.

Background: Obstructive sleep apnea (OSA) is increasingly recognized as a risk factor for cardiovascular diseases. However, long-term population-based data evaluating its association with a spectrum of cardiovascular outcomes, particularly conduction system disorders, remain limited. Objective: We investigated the 15-year cardiovascular outcomes in patients with OSA using a large-scale nationwide cohort. Methods: We conducted a retrospective cohort study using the Korean National Health Insurance Service database, including 547,749 patients diagnosed with OSA and 2,282,415 matched controls between 2002 and 2020. Following exclusion criteria and 1:1 propensity score matching, 541,812 individuals were included in each group. The primary outcomes were incidence of atrial fibrillation (AF), premature beats, ventricular arrhythmias, atrioventricular block, sinus node dysfunction, heart failure, ischemic heart disease (IHD), and stroke. Cumulative incidence was assessed using Kaplan–Meier survival curves. Hazard ratios (HR) were estimated using Cox proportional hazards models adjusted for relevant covariates. Results: Over a 15-year follow-up period, the OSA group exhibited significantly higher incidence rates of all cardiovascular outcomes than the control group. In the matched cohort, adjusted HR were elevated for AF (1.82 [1.77–1.87]), premature beats (2.25 [2.17–2.34]), ventricular arrhythmias (1.81 [1.64–1.99]), AV block (1.81 [1.64–1.99]), sinus node dysfunction (2.22 [1.96–2.50]), heart failure (1.43 [1.39–1.48]), IHD (1.54 [1.52–1.56]), and stroke (1.20 [1.18–1.22]) (all p < 0.0001). The incidence of conduction disorders, AV block, and sinus node dysfunction nearly doubled in the OSA group. Conclusion: OSA was independently associated with an increased long-term risk of various cardiovascular outcomes, including arrhythmias, ischemic events, and conduction system disorders. This supports the importance of early identification and longitudinal management of cardiovascular risk in this population.

BackgroundDiabetes mellitus (DM) is a significant global public health concern, with prediabetes serving as a critical stage between normoglycemia and DM. Without intervention, individuals with prediabetes face an increased risk of developing DM, underscoring the need for effective preventive measures. The Hemoglobin Glycation Index (HGI)—which measures the discrepancy between actual and predicted glycated hemoglobin (HbA1c) levels—has shown promise in predicting the onset of both microvascular and macrovascular complications associated with DM. However, its potential role in assessing the risk of developing DM or prediabetes remains to be fully established. This study aims to investigate the predictive capacity of HGI for both DM and prediabetes.MethodThis retrospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), involving participants aged 45 years and older who were assessed in 2011 and followed up in 2015. Univariate and multivariate logistic regression models were employed to analyze the relationship between HGI and the incidence of prediabetes and DM. Dose-response analyses were conducted using restricted cubic splines, and subgroup analyses were performed based on various demographic and health-related factors.ResultsAmong 3,963 participants, 187 individuals (4.72%) developed prediabetes within four years, and 107 individuals (2.70%) developed DM. HGI was independently associated with an increased risk of developing both DM and prediabetes, with adjusted odds ratios of 1.61 (95% confidence interval [CI]: 1.19–2.16, p = 0.001) and 2.03 (95% CI: 1.40–2.94, p < 0.001), respectively. A linear relationship was observed between HGI and both DM and prediabetes. An interaction effect was identified between age and HGI; specifically, the association between higher HGI and incident DM was more pronounced in individuals aged 45 to 60 years. Among this age group, the OR was 3.93 (95% CI: 2.19–7.05, p < 0.001).ConclusionHGI is identified as an independent risk factor for both DM and prediabetes, demonstrating its utility in predicting the likelihood of their development, particularly within the population aged 45 to 60. These findings highlight the potential of HGI as a valuable biomarker for the early identification of DM risk, thereby facilitating the formulation of targeted intervention strategies.Trial registrationNot applicable.

Background: The long-term survival of heart transplantation (HTx) recipients is influenced by a range of cardiovascular, immunological, and procedural factors. Accurately predicting post-HTx outcomes remains a major clinical challenge, especially when relying solely on noninvasive methods. Objective: To test the hypothesis that structural and functional indices derived from multi-parametric cardiac MRI-derived can be used to predict cardiovascular events in HTx recipients. Materials and methods: With the approval of institutional review board (IRB), 170 HTx recipients (106 males, age: 47.8 ± 16 years, Range: 19 – 79 years) were recruited for a comprehensive multi-parametric cardiac MRI scan. MRI images were processed to derive global cardiac function and volumes, and myocardial T2 values and T1 values. Pre- and post-Gadolinium T1 was used to calculate extra-cellular volume (ECV) fraction. Cardiovascular events were defined as a composite of any emergency visit, hospitalization or death due to graft failure or reception, myocardial infarction, HF and other events that cannot rule out a cardiovascular origin of complications. Identification of predictors of adverse outcomes at long-term follow-up was based on a Cox proportional hazards model (CPH). Statistical analysis was performed by using SPSS (version 22.0). Results: MRI images were eligilbe for quantitative analysis. See figure 1. The patients were followed for 6 to 4504 days (Median = 2616 days) after multi-parametric cardiac MRI. In total, 140 cardiovascular events occurred (6 to 3294 days, Median = 627 days). The CPH model fits the data (p &lt; 0.001). After the adjustment of traditional cardiovascular risk factors and demographic data, multiple MRI-derived indices were identified as significant predictors of survival time (time between baseline cardiac MRI and adverse event), including left ventricular (LV) end-diastolic volume (LVEDV) (p &lt; 0.001), LV end-systolic volume (LVESV) (p &lt; 0.001), LV stroke volume (LVSV) (p = 0.005), right ventricular (RV) stroke volume (RVSV) (p &lt; 0.001), RV cardiac output (RVCO) ( p = 0.03), myocardial ECV (p &lt; 0.001) and T2 value (p = 0.008). See figure 2. Conclusions: Multi-parametric indices of cardiac tissue (T2, ECV) and function (LVEDV, LVESV, LVSV, RVSV, RVCO) can independently predict adverse clinical outcomes in HTx recipients at long term follow-up (median &gt; 7 years). MRI may offer new imaging biomarkers for early identification of risks for post-HTx complication.

Background: Elevated triglyceride-glucose (TyG) related indices, such as TyG-body mass index, TyG-waist-to-height ratio, TyG-waist circumference was associated with higher risk of cardiovascular disease (CVD). Body roundness index (BRI) is superior to traditional anthropometric indices in predicting metabolic syndrome. However, the association between the TyG-BRI, as a new metabolic indicator, and CVD incidence and whether its predicting effect of CVD incidence is better than other TyG related indices remains unknown. Method: The datasets analyzed in our study were derived from two nationally representative prospective cohort studies: English Longitudinal Study of Ageing (ELSA) and China Health and Retirement Longitudinal Study (CHARLS). TyG was calculated as ln [TG (mg/dL) × FBG (mg/dL)/2]; The TyG-BRI index is determined by TyG index * BRI index. The participants were classified into four groups (Q1, Q2, Q3, and Q4) by the quartiles of TyG-BRI index. We performed Cox proportional hazards models after adjusting for potential confounders to analyze the association between the TyG-BRI index and CVD incidence. Restricted cubic spline models (RCS) were used to explore the non-linear relationship between TyG-BRI and CVD incidence. Receiver operating characteristic (ROC) curve analysis to evaluate and compare the predictive performance of TyG-BRI and TyG-related indices for CVD assessment Results: A total of 3,256 participants from ELSA (female: 54.0%, age more than 60: 63.7%) and 8,323 participants from CHARLS (female: 53.5%, age more than 60: 41.6%) were included in the analysis. The median follow-up periods were 12 years in the ELSA and 7 years in the CHARLS. After adjusting for potential confounding factors, the highest TyG-BRI group (Q4) had an increased risk of CVD compared with the Q1 group. (ELSA, HR 1.81, 95% CI 1.09–2.98; CHARLS, HR 1.57, 95% CI 1.32–1.87). An inverted U-shaped association was identified between TyG-BRI and CVD during the examination of nonlinear relationships (both P &lt;0.05). TyG - BRI has a higher AUC of 0.557 (95% CI: 0.531 - 0.583) in ELSA and AUC of 0.581 (95% CI: 0.565 - 0.596) in CHARLS than other TyG-related indices in predicting CVD incidence. Conclusions: Elevated TyG-BRI levels was associated with higher risk of incident CVD. TyG-BRI offers a new tool for early risk identification, and TyG-BRI had a better predictive ability than other TyG- related indices in predicting CVD incidence.