Search Results (1,216)

Background: Non-small-cell lung cancer (NSCLC) is driven by distinct oncogenic alterations with important therapeutic and prognostic implications. Noninvasive biomarkers that predict molecular status in surgically resectable disease may aid in their management. We investigated the association of preoperative primary-tumor SUVmax on PET/CT, smoking history, and corrected serum calcium levels with driver oncogenic alterations and PD-L1 expression in surgically resected NSCLC. Methods: We retrospectively studied 170 patients with surgically resected NSCLC at a single tertiary center. Resected tumors were assessed for EGFR, KRAS, and BRAF mutations, ALK and ROS1 rearrangements, and PD-L1 expression. Associations between molecular status, PD-L1 expression, and clinicometabolic parameters were evaluated using univariate analyses and multivariable regression models. Results: A driver alteration was detected in 51.2% of tumors, and 30% of evaluable cases showed high PD-L1 expression (≥50%). Corrected serum calcium was positively correlated with SUVmax and emerged as the strongest independent predictor retained in the final linear regression model, with pack-years also contributing independently. Most molecular subgroups did not show significant differences in SUVmax. EGFR-mutated tumors showed a trend toward a lower SUVmax compared with EGFR wild-type tumors, although this did not reach statistical significance. Smoking history was not significantly associated with PD-L1 expression, and pack-years did not differ significantly across the molecular groups examined. Conclusions: In this cohort of surgically resected NSCLC, preoperative corrected serum calcium and smoking exposure were more closely associated with tumor metabolic activity than with specific molecular alterations. These findings suggest that simple clinical and biochemical parameters may provide complementary information, although their utility for discriminating individual molecular subgroups appears limited. Full article

Background: Chronic limb-threatening ischemia (CLTI) is associated with high morbidity and substantial healthcare utilization. Length of hospital stay (LOS) after lower limb revascularization is influenced by procedural complexity, but patient physiological reserve may also play a role. We evaluated whether CT-derived lean psoas muscle area (LPMA) is independently associated with LOS in patients undergoing revascularization for CLTI. Methods: We retrospectively analyzed 234 consecutive patients treated with endovascular, hybrid, or open revascularization for CLTI (Rutherford 4–5) between 2018 and 2021. Sarcopenia markers were derived from preoperative CT at the L3 level, including psoas muscle area (PMA), muscle density (PMD), and LPMA. Multivariable linear regression models with log-transformed LOS were used to estimate relative effects on hospitalization duration. Results: Median age was 68 years and 65.4% were male; 76.5% of admissions were urgent. Median LOS was 6 days (IQR 4–9). Procedure type was the strongest determinant of LOS: hybrid (β = 0.69, p < 0.001) and open surgery (β = 0.73, p < 0.001) were associated with approximately 99% and 108% longer LOS compared with endovascular treatment. Higher LPMA was independently associated with shorter LOS (β = −0.00049, p = 0.004). Smoking (β = −0.21, p = 0.003) and history of myocardial infarction (β = −0.19, p = 0.030) were associated with shorter LOS, whereas dialysis showed a non-significant trend toward longer hospitalization (β = 0.36, p = 0.056). Conclusions: In patients undergoing lower limb revascularization for CLTI, CT-derived LPMA demonstrated a modest but independent association with hospital stay duration after adjustment for procedural and clinical factors. Given the exploratory nature of this study, these hypothesis-generating findings support further evaluation of imaging-based muscle assessment as an adjunct marker of physiological reserve in this high-risk population. Full article

Background: Atherosclerosis is a degenerative-proliferative disease that leads to lesions primarily in the tunica intima and media of the arteries. Atherosclerotic plaques undergo progressive calcification, and the hydroxyapatite deposited within them absorbs X-rays. The coronary artery calcification score (CAC-score) can be assessed using computed tomography. Intima–media thickness (IMT) and endothelial function, evaluated by flow-mediated dilatation (FMD) of the brachial artery, can be measured using ultrasound. This study aimed to assess the relationship between CAC-score, atherosclerosis risk factors, IMT, and FMD in women, with particular emphasis on the comparison of IMT measurement sites. Methods: The study included 124 women divided into three groups based on CAC-score. The following parameters were evaluated: risk factors for coronary artery disease (CAD), FMD, and IMT. CAD risk factors included age, BMI, smoking status, hypertension, diabetes, and lipid disorders, which were obtained from medical history. Results: A significant positive correlation was observed between CAC-score and IMT of the common carotid artery in women. IMT measured at the carotid bifurcation showed the strongest correlation with CAC-score. No correlation was found between CAC-score and endothelial dysfunction assessed by FMD. Conclusions: IMT, particularly when measured at the carotid bifurcation, was associated with CAC-score in women without diagnosed CAD, whereas no association was observed between FMD and CAC-score in this population. Full article

Background: Hypertension is one of the most common noncommunicable diseases. Objectives: This research assessed the magnitude of hypertension among young adults, identified its key determinants, and explored potential strategies adopted for prevention. Methods: A cross-sectional design was employed, including 1606 participants aged 18 years and older, recruited through convenience sampling from universities and community settings. Data were collected using a content-validated questionnaire covering sociodemographic information, personal and family medical history, and lifestyle habits. Results: Of the participants, 993 (61.8%) reported hypertension, nearly double previous national estimates. Male gender, age ≥ 30 years, and family history were significant risk factors, along with smoking, alcohol use, sedentary lifestyle, and unhealthy diet, while physical activity and dietary modification were protective. Despite high prevalence, only 22.1% had controlled blood pressure and 17.8% adhered to medication, with 51.5% relying on herbal remedies. Conclusions: These findings highlight the urgent need for early screening, youth-focused awareness, and culturally tailored interventions to reduce hypertension and prevent long-term cardiovascular complications. Hypertension among young adults in the UAE is a major public health concern, requiring integrated strategies combining education, lifestyle modification, and medical management to improve outcomes. Full article

Background/Objectives: Chronic obstructive pulmonary disease (COPD) often coexists with heart failure (HF) and can complicate the interpretation of symptoms, biomarker profiles, and clinical deterioration. Its prognostic significance at the time of sodium-glucose cotransporter 2 inhibitor (SGLT2i) initiation remains incompletely defined. We therefore evaluated whether baseline COPD was associated with a greater biomarker burden and worse 12-month outcomes in a real-world HF cohort at the time of SGLT2i initiation. Methods: This prospective single-centre observational cohort included patients with HF enrolled in a tertiary registry between May 2022 and November 2024 in whom SGLT2i therapy was initiated. HF was diagnosed according to contemporary European Society of Cardiology (ESC) criteria on the basis of compatible symptoms and/or signs, objective structural or functional cardiac abnormalities on echocardiography, and elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP). COPD status was defined by a documented pre-existing diagnosis at baseline. The primary endpoint was the 12-month time-to-first composite of all-cause death or unplanned hospitalization for acute decompensated HF. Results: Among 996 patients, 122 (12.2%) had COPD. Compared with patients without COPD, those with COPD more often had a smoking history, a higher comorbidity burden, a worse New York Heart Association (NYHA) class, higher baseline N-terminal pro-B-type natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) levels, and a lower estimated glomerular filtration rate (eGFR), whereas baseline HF pharmacotherapy was broadly similar. NT-proBNP remained higher at 6 and 12 months, whereas CRP remained higher at 6 months but not at 12 months. In multivariable Cox analysis adjusting for age, sex, major comorbidities, left ventricular ejection fraction (LVEF), renal function, high-density lipoprotein cholesterol (HDL-C), glycated haemoglobin (HbA1c), CRP, and log NT-proBNP, COPD remained independently associated with the primary endpoint (hazard ratio [HR] 2.610, 95% confidence interval [CI] 1.707–3.991; p < 0.001) and all-cause death (HR 2.097, 95% CI 1.246–3.532; p = 0.005). Conclusions: Among patients with HF starting SGLT2i therapy, baseline COPD identified a higher-risk cardiopulmonary phenotype characterized by a greater comorbidity burden, higher inflammatory and natriuretic biomarker levels, and worse 1-year outcomes. These observational findings support closer integrated cardiology–pulmonology follow-up. Full article

Background/Objectives: The etiology behind sex differences in the prevalence of abdominal aortic aneurysm (AAA) can only partly be explained by environmental factors such as smoking. Genetic factors are also likely to be part of the explanation since family history is common. We hypothesized that genetic factors on AAA prevalence might be different between the sexes. Methods: This study is designed as a case–control study with 83 female AAA patients, 101 female controls, 97 male AAA patients, and 196 male controls. Single nucleotide polymorphism (SNP) analysis was performed comparing 13 different SNPs. The selection of SNPs was based on previous SNP association studies, estrogen receptors, and SNPs important to inflammation and lipid metabolism, as these processes are modulated by estrogen. Results: A multivariable logistic regression resulted in significant differences in SNP association with AAA development between men and women in two SNPs (rs2010963 and rs8113877). Significant differences were found between cases and controls, using univariate analysis, in four SNPs: rs8113877 among women, and in rs6511720, rs2010963 and rs4988300 among men. No SNPs were significantly different compared to controls in both men and women. SNP rs8113877 is located in the promotor of the MMP-9 gene. Levels of circulating MMP-9 were measured in a subgroup of the study participants: an association between MMP-9 and AAA was found, and the association between rs8113877 and MMP-9 was sex-dependent. Conclusions: Genetic variability associated with AAA differs between men and women; these differences should be accounted for in future research. Full article

Background: Long-term survivors (LTS) after gynecological cancer may be cured but still face physical and psychological challenges. This multicenter study aimed to assess the long-term side effects, the received follow-up care, and the personal perspectives of survivors. Methods: Between 2019 and 2025, LTS from four European countries within the ENGOT (European Network of Gynecological Oncological Trial Groups) and GCIG (Gynecologic Cancer InterGroup) networks were recruited. Long-term survival was defined as surviving at least five years after the first diagnosis. LTS completed a questionnaire with 81 questions (patient’s characteristics, oncological history, current health status, lifestyle factors). Analyses were mainly descriptive. Results: A total of 677 LTS were enrolled, with a median age of 64.0 years (range: 26–92) and a median survival time of 7 years (range: 5–38). A total of 46.6% were diagnosed with cervical cancer, 32.9% with endometrial cancer, 4.4% with ovarian cancer, and 16.1% with other types of gynecological cancer. Moreover, 36.9% still suffer from physical and psychological symptoms, most frequently being lymphedema (36.2%), hot flashes (22.4%), difficulties with concentration (21.1%), fatigue (20.9%), vaginal dryness (20.1%), and urinary incontinence (18.9%). Median overall health status was ranked (scale 1–5; 1 = very good, 5 = very poor) as 2, while 13.5% rated their health as poor/very poor. Current symptoms were associated with poorer health status (p < 0.001) and a history of recurrent disease (p = 0.001). In addition, 13.6% reported not receiving follow-up care. CA-125 was determined in 80.8% of ovarian LTS, as well as in 30.7% of cervical and 28.9% of endometrial LTS. Pap smear follow-up was reported by 50.5% of endometrial LTS. A total of 33.7% did not exercise at all or exercised less than an hour per week, 13.4% smoke tobacco, and 51.2% drink alcohol more often than once a month. Conclusions: Our findings highlight the need for patient-centered follow-up care, addressing both long-term side effects and education on lifestyle and prevention. Follow-up procedures that do not follow guidelines should be avoided. Full article

The interplay between the environmental exposome and the cancer genome remains a critical gap in precision oncology. While somatic mutational signatures—genomic fossils imprinted by exposures such as ultraviolet radiation; tobacco smoke; and industrial pollutants—are well characterised for their etiological significance; their functional impact on therapeutic efficacy remains largely unexplored. We hypothesised that these environmental genomic scars induce distinct pharmacogenomic vulnerabilities and resistance mechanisms that vary by geographical exposure patterns. This study employs two complementary analytical frameworks. First, a linear regression-based pharmacogenomic screen across four datasets (GDSC1, GDSC2, CTRP, CCLE; 1001 cell lines, 31 cancer types) identified 608 statistically significant (p < 0.01) mutational signature–drug interactions, revealing that UV-associated signature SBS7a is associated with broad-spectrum therapeutic resistance, including to BRAF inhibitors (PLX-4720, p < 10⁻⁴), while pollution-driven oxidative stress (SBS18) is associated with sensitivity to p38 MAPK inhibition (VX-702, r = −0.45, p < 10⁻⁹). Second, an XGBoost predictive model trained exclusively on 33,679 GDSC2 records using a 1265-feature matrix integrating 40 SBS signatures, drug chemistry descriptors, proteomic features, and two satellite-derived environmental variables (NASA PM_2.5 and UV)—achieved R² = 0.7973 on a 20% holdout set (grouped cross-validation R² = 0.7296). SHAP analysis revealed that satellite-derived PM_2.5 (Zone_PM25) ranked 7th of 1265 features, exceeding all 40 individual SBS mutational signatures. Synthesising these findings with satellite-derived atmospheric data, we constructed an exploratory spatially interpolated risk surface spanning 122 nations, generating the hypothesis that uniform drug efficacy assumptions may not apply globally. These findings suggest that a patient’s environmental exposure history may constitute a measurable pharmacogenomic variable. This exploratory framework warrants validation in independent datasets and with individual-level geographic data before clinical application. Full article

Background: Diabetes mellitus (DM) is an emerging public health challenge in Africa, driven by rapid urbanisation, changing lifestyles and socio-economic transitions. As the global prevalence rises, evidence on the burden and determinants of DM across African countries remains fragmented and inconsistent. Objective: We aimed to synthesize evidence from existing systematic reviews and meta-analyses on the prevalence and determinants of diabetes mellitus across African populations, thereby informing targeted interventions and policy actions. Methods: This umbrella review followed the PRISMA guidelines and included systematic reviews and meta-analyses of studies, published up to December 2024, that reported on DM prevalence and/or risk factors for DM in adults across four African countries. The literature was retrieved from PubMed, Scopus, Web of Science and African Journals Online (AJOL). Quality assessment was conducted using the AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews, version 2) tool, and only moderate- to high-quality reviews were retained. Random-effects models were used to estimate the pooled prevalence and odds ratios (ORs), while heterogeneity, publication bias and sensitivity analyses were also conducted. Findings: Seven reviews were included, covering four countries: Ethiopia, South Africa, Nigeria and Ghana. The pooled prevalence of diabetes mellitus was 9.0% (95% CI: 6.0–12.0%), with significant heterogeneity (I² = 99.8%). Among the determinants, only family history of DM (OR:5.11, 95% CI: 2.96–8.85), hypertension (OR: 2.52; 95% CI: 1.65–3.83), obesity (OR: 3.04; 95% CI: 1.92–4.82), physical inactivity (OR: 3.32; 95% CI: 1.99–5.54), smoking (OR: 2.59; 95% CI: 1.23–5.47), unhealthy diet (OR: 4.77; 95% CI: 1.73–13.18) and urban residence (OR: 5.81; 95%CI: 4.41–7.65), showed a statistically significant association. Sensitivity analysis confirmed the robustness of pooled prevalence, and no significant publication bias was detected. Conclusions: Diabetes mellitus prevalence in Africa is rising and approaching the global averages. The heterogeneity in risk factors underscores the need for localised, context-specific strategies. Full article

Peripheral artery disease (PAD) is found in 10.9% of patients with ischaemic stroke (IS). This cross-sectional study was performed to investigate the prevalence of PAD and its risk factors among acute IS patients in Singapore. Patients admitted for IS were recruited. Data was collected on sex, age, body mass index (BMI), history of hypertension, diabetes mellitus (DM), hypercholesterolaemia, cigarette smoking, prior stroke (PS) and ischaemic heart disease (IHD). IS was classified as a lacunar infarct (LI) or non-lacunar infarct (NLI) based on neuroimaging. Carotid intima–medial thickening (IMT) and carotid plaques (CP) were determined by ultrasonography. The ankle–brachial Index (ABI) was calculated in both lower limbs; PAD was diagnosed if the ABI was ≤0.9 in any limb. The estimated sample size was 150 subjects. In total, 150 subjects were recruited; the mean age was 62.7 ± 10.2 years, 44.7% were female, and the mean BMI was 24.1 ± 4.1. A total of 63.3% reported hypertension, 42.7% DM, 30.0% hypercholesterolaemia, 38.0% smoking, 18.7% PS, and 6.0% IHD. A total of 30.7% had IMT, 77.3% had CP, and 8.0% had carotid stenosis ≥50%. LI occurred in 64.7%. PAD was diagnosed in 22.0% (95% CI 16.1–29.3). On univariate analysis, based on vascular risk factors alone, PAD was associated with age (p = 0.03), hypercholesterolaemia (p = 0.03), and IHD (p = 0.004). On logistic regression, PAD was only associated with IHD (aOR 6.42, 95% CI 1.25–32.84; p = 0.03). When IMT and CP were added to the model, the association with IHD remained (aOR 5.45, 95% CI 1.03–28.71; p = 0.045). When the results of neuroimaging were added, the association was only with NLI (aOR 2.78, 95% CI 1.09–7.14; p = 0.03). This study found a high prevalence of PAD among Asian patients with IS. It was associated with a non-lacunar infarction. Full article

Background: Chronic obstructive pulmonary disease (COPD) and cardiovascular diseases (CVDs) are closely linked through shared inflammatory and metabolic pathways. Metabolic syndrome (MetS), shared by both conditions, may represent a key mechanistic link between systemic inflammation, cardiovascular disease, and COPD outcomes. Objective: To assess the prevalence and clinical correlates of MetS and examine whether increasing MetS burden is linked to more severe symptoms and a higher comorbidity load in patients with COPD. Methods: We analyzed cross-sectional data from a multicenter COPD registry. MetS was defined by the presence of at least three components: obesity, hypertension, hyperglycemia, or dyslipidemia based on clinical and medication data. Associations between MetS burden and COPD characteristics were evaluated using multivariable models adjusted for age, sex, smoking history, exacerbation status, lung function, inhaled therapy, and study center. Results: Among 5030 patients, MetS was present in 10.4% and was more frequent in women (11.9% vs. 9.6%, p = 0.01). Patients with MetS had greater symptom burden, and more frequent signs of cyanosis, cor pulmonale, and heart failure. MetS was most common in Global Initiative for Chronic Obstructive Lung Disease stage II–III and associated with higher forced expiratory volume in one second but lower forced vital capacity, with similar exacerbation rates between the groups. Cardiovascular, sleep, renal, and connective tissue comorbidities were more prevalent in patients with MetS. A dose–response relationship was observed, with each additional metabolic syndrome component independently associated with increased odds of respiratory symptoms and cardiometabolic comorbidities (all p < 0.01). Conclusions: Our findings suggest that metabolic syndrome is present in approximately 10% of patients with COPD and is associated with greater symptom burden and a higher prevalence of cardiovascular, renal, and sleep-related comorbidities. The observed stepwise relationship supports the presence of a clinically relevant cardiometabolic profile in COPD. However, given the cross-sectional registry-based design, causal inferences cannot be made, and prospective studies are needed to confirm these associations and evaluate targeted interventions. Full article

Aims: The purpose of this study was to clarify the prevalence of diabetic foot lesions and their association with lower-limb amputations and/or foot ulcers. Materials and Methods: In this cross-sectional study, 968 patients with diabetes were surveyed. Diabetic foot lesions were defined according to the broad national criteria, which encompass both mild abnormalities and more advanced conditions. Based on this definition, foot lesions were assessed using a questionnaire comprising the following 10 items: a history of lower-limb amputations, a history of treatment of foot lesions, numbness/loss of sensation/pain, skin discolorations, skin symptoms, nail abnormalities, foot ulcers/gangrene, foot deformities, foot infection, and intermittent claudication. Logistic regression analysis was used to examine risk factors for foot lesions. Area under the curve (AUC) of the number of foot lesions for lower-limb amputations or foot ulcers/gangrene was calculated using the receiver operating characteristic curve (ROC) analysis. Results: Approximately two-thirds of the patients had at least one type of diabetic foot lesion. Logistic regression analysis revealed that women, past or current smoking, a history of cardiovascular disease, and nephropathy were associated with the risk of diabetic foot lesions. According to the ROC analysis, the optimal cut-off point of number of diabetic foot lesions was three for identifying patients with a history of lower-limb amputation and/or the presence of foot ulcers or gangrene (AUC 0.80 (95% CI, 0.70–0.91), p < 0.01). Conclusions: Diabetic foot lesions are common in patients with diabetes and the prevalence of diabetic foot lesions was higher in patients with a history of lower-limb amputations and/or the presence of foot ulcers or gangrene. Early detection and care of diabetic foot lesions are necessary to prevent lower-limb amputations and foot ulcers. Full article

Background/Objectives: Early mobilization following open-heart surgery is a key component of postoperative recovery, yet psychological barriers such as kinesiophobia (fear of movement) may limit patient participation. This study examined the association between kinesiophobia and mobilization level in patients after open-heart surgery and explored sociodemographic and clinical correlates of both variables. Methods: A cross-sectional descriptive design was used. The sample comprised 96 adult cardiac surgery patients recruited consecutively from cardiovascular surgery ICUs at two centers in Istanbul—a public training and research hospital and a foundation-affiliated university hospital—between December 2024 and April 2025. Data were collected via a Personal Information Form, the Tampa Scale of Kinesiophobia (TSK), and the Intensive Care Units Mobility Scale (IMS). Analyses (SPSS 25.0) included Mann–Whitney U and Kruskal–Wallis H tests, Pearson correlation with 95% confidence intervals (CIs) calculated via Fisher’s z-transformation, Bonferroni correction for k = 12 subgroup comparisons within each outcome, and a multivariable linear regression adjusted for sex, age, smoking, and history of surgery. Results: Of the 96 patients enrolled, 76.0% were male, with a mean age of 58.30 ± 6.50 years (SD) and a mean body mass index of 27.53 ± 5.84 kg/m². The mean TSK total score was 46.81 ± 6.51 and the mean IMS score was 5.48 ± 0.73. Kinesiophobia and mobilization showed a small inverse association that reached statistical significance (r = −0.104; 95% CI: −0.298 to 0.099; r² = 0.011; p = 0.041), accounting for approximately 1% of the variance in mobilization. After multivariable adjustment, kinesiophobia was no longer a significant predictor (β = −0.092; p = 0.360), whereas smoking (β = −0.279; p = 0.008) and female sex (β = 0.215; p = 0.039) emerged as the strongest independent correlates. Mobilization level differed by gender and smoking, and kinesiophobia level differed by marital status, history of surgery, and family history of heart disease at the uncorrected level; however, none of these subgroup differences remained significant after Bonferroni correction. Conclusions: Higher kinesiophobia scores were associated with lower mobilization levels following open-heart surgery, but the effect size was small and the association did not persist after adjustment for clinical confounders. The cross-sectional design precludes causal inference. Kinesiophobia may be considered as one of several psychosocial factors potentially relevant to postoperative mobilization rather than as a primary determinant. Full article

Humanities research depends on linking claims to precise evidence, such as juan, pages, passages, or time-stamped media segments. While large language models can assist with extraction and synthesis, their outputs remain difficult to use in scholarly work unless provenance, citation, and verification are explicitly controlled. This paper proposes an evidence-centric knowledge management system for humanities research. The system models sources as stable EvidenceUnits, extracts entities, relations, and events under schema constraints, and admits generated knowledge only after structural validation, evidence-pointer checking, and claim-level verification. Ambiguous or conflicting cases are routed to human review and retained in an audit trail. The main evaluation is a controlled document-modality study on an annotated subset of the Shiji. The system achieves micro-F1 scores of 0.84 for named entity recognition, 0.78 for relation extraction, and 0.82 for event trigger detection. Governance-layer analysis shows that evidence-pointer resolvability rises from 42.3% to 94.2%, while mis-citation and overreach fall to 4.1% and 5.3%. A minimal oral history audio smoke test further demonstrates that timestamped Audio EvidenceUnits can pass through the same governance workflow; though, it is not a full multimodal benchmark. Full article

Background/Objectives: Disc herniation, also termed herniated nucleus pulposus (HNP), is a common spinal disorder affecting approximately 10% of the global population, associated with pain, neurological complications, and diminished quality of life. Despite its global burden, regional variations in public awareness and sociodemographic determinants remain inadequately characterized, particularly in Middle Eastern populations. This study aimed to assess the prevalence, public awareness, and sociodemographic determinants of HNP among adults in Saudi Arabia at a nationwide level. Methods: An analytical cross-sectional study was conducted from December 2024 to July 2025. Using a convenience sampling approach via social media platforms, an online questionnaire was distributed nationwide across Saudi Arabia. Data from 1112 participants were analyzed using descriptive statistics and multiple logistic regression. The questionnaire comprised two sections: sociodemographic characteristics and knowledge and awareness of HNP. Results: The prevalence of disc herniation was 8.9%, consistent with global estimates. Overall awareness was relatively high at 67.6%, though knowledge of specific risk factors varied considerably. Most participants recognized obesity (88.0%), poor sitting posture (85.8%), history of lower back trauma (86.2%), and work requiring physical effort (88.8%) as risk factors, while fewer acknowledged smoking (46.4%), diabetes (51.2%), sleeping on a soft bed (36.9%), and increased height (35.9%). Multiple logistic regression, adjusted for all sociodemographic, lifestyle, and health-related covariates, identified significant independent predictors of HNP including marital status (married OR = 2.90), current smoking (OR = 2.91), hyperlipidemia (OR = 1.86), family history (OR = 8.95), and prior knowledge of the condition (OR = 2.28). Knowledge of HNP was significantly associated with university education (OR = 1.70), higher income levels (OR = 2.23 for ≥15,000 SAR; OR = 2.07 for 5000–9999 SAR), and family history (OR = 4.70), while those in low and medium workload jobs demonstrated lower knowledge. Conclusions: Although overall public awareness of HNP is relatively high in Saudi Arabia, substantial gaps persist in knowledge of modifiable risk factors, particularly smoking and diabetes mellitus. Targeted smoking cessation campaigns, diabetes awareness programs, and ergonomic education initiatives delivered through primary healthcare centers, workplaces, and schools are recommended. Full article