Binary Logistic Regression Research Articles

Experience of piloting BPaLM/BPaL for DR-TB care at selected sites in Pakistan.

Pakistan ranks fourth globally in terms of high drug-resistant TB (DR-TB) burden, with approximately one-third of cases resistant to fluoroquinolones. Bedaquiline, pretomanid, linezolid and moxifloxacin (BPaLM/BPaL) offers an opportunity for most DR-TB patients to benefit from a shorter, all-oral, well-tolerated and more effective treatment. We conducted a retrospective cohort study to pilot the BPaLM/BPaL regimen at four selected sites in two provinces of Pakistan, i.e. Punjab and Khyber Pakhtunkhwa. Data were extracted and analysed using electronic medical records from the program. Descriptive statistics, survival analysis and binary logistic regression analysis were employed. A total of 116 patients took treatment between October 2022 and February 2023. The treatment success rate was 96%, with 3% deaths and <1% loss to follow-up. Patients typically completed treatment in 26.2-26.7 weeks for BPaLM and BPaL, respectively. No serious adverse events were observed. The most common side effects included QTcF prolongation (BPaLM: 55%, BPaL: 84%), haematological events (BPaLM: 32%, BPaL: 34%), and gastrointestinal problems (BPaLM: 36%, BPaL: 25%). The BPaLM/BPaL regimens for DR-TB are highly effective with minimal adverse events and feasible to implement in routine program circumstances.

Wound complication rates after anterior total hip arthroplasty: A case series comparison of interrupted vs. continuous sutures for skin closure

BackgroundThe anterior approach for total hip arthroplasty (THA) carries a higher risk of wound complications, which can significantly affect patient outcomes and increase healthcare costs. There is limited research comparing infection rates based on closure techniques in patients who undergo THA. Therefore, this study aims to compare wound complications based on interrupted or continuous sutures for skin closure after anterior approach THA. MethodsThis single-surgeon retrospective study extracted data from 388 patients who had undergone a primary THA using the anterior approach. Patient demographics, comorbidities, perioperative factors, and infection-related complications were recorded. All variables associated with a given infection complication were controlled for in a binary logistic regression model. ResultsAfter controlling for confounding variables, wound closure type was not associated with any infectious complications. BMI was a strongly associated factor in PJI (p = 0.028; 95 % CI = 1.02–1.34), prolonged drainage (p < 0.001; 95 % CI = 1.08–1.28), readmission (p = 0.023; 95 % CI = 1.01–1.20), and I&D and revision surgery (p = 0.021; 95 % CI = 1.02–1.31). ConclusionBody mass index was the sole factor associated with a higher risk of wound complications postoperatively. These findings suggest a non-inferiority between continuous and interrupted suture closure techniques regarding wound-related infectious complications in anterior total hip arthroplasty.

Prediction of perinatal mortality in early-onset fetal growth restriction: A post hoc analysis of the Dutch STRIDER trial to predict perinatal mortality in early-onset fetal growth restriction

ObjectiveEarly-onset fetal growth restriction affects about 0.3% of pregnancies, posing high perinatal risks due to placental insufficiency. Early-onset fetal growth restriction often coincides with early-onset pre-eclampsia, associated with significant mortality and morbidity. Clinical management varies among clinicians, with emphasis on intensive monitoring and timely delivery. Our objective was to improve clinical prediction of perinatal mortality in early-onset fetal growth restriction for parental counseling. Study designThis was a secondary analysis of prospective cohort data from the Dutch STRIDER trial. The study included 215 pregnant women diagnosed with severe early-onset fetal growth restriction between 20 + 0 and 29 + 6 weeks of gestation, from tertiary and secondary antenatal care centers in The Netherlands. Maternal and fetal characteristics were collected at inclusion, including sonographic and laboratory measurements. Analysis was performed using univariable and multivariable binary logistic regression to create a prediction model for perinatal mortality. The main outcome measures were fetal demise and neonatal mortality up to discharge. Results215 Participants were included for this analysis. Perinatal mortality occurred in 84 (39 %) cases; 51 (24 %) were fetal and 33 (15 %) neonatal. Fetal abdominal circumference, gestational age at diagnosis, estimated fetal weight Multiple of Median, absent or reversed end-diastolic flow of the umbilical artery, umbilical artery pulsatility index Multiple of Median, non-Caucasian ethnicity, male sex, placental growth factor level and uterine artery pulsatility index were independent predictors of perinatal mortality. Randomization allocation (sildenafil or placebo) had no predictive value for mortality. The prediction model including gestational age at diagnosis, estimated fetal weight Multiple of Median and umbilical artery pulsatility index Multiple of Median showed an area under the receiver operating characteristic curve of 0.840 (P < 0.01). Placental growth factor was measured in a subset of patients and was an independent prognostic factor and performed significantly better within the predictive model, however it did not improve the predictive value of the model. ConclusionsPrediction of perinatal mortality in early-onset fetal growth restriction is feasible with commonly available tests and measurements and could support decision making in management of pregnancy. However, implementation in practice requires further studies.

Engagement in Healthcare Decision-Making and Associated Factors among Patients with Chronic Non-Communicable Diseases in Southwest Ethiopia, 2023

BackgroundChronic Non-communicable diseases require lifelong care involving patients, families, a team of their care providers, and significant others. Additionally, engaging patients in their healthcare decision-making is crucial for achieving better clinical outcomes. This study aimed to assess patients' engagement in healthcare decision-making and associated factors among adults with chronic non-communicable diseases in Southwest Ethiopia MethodsA cross-sectional study design was used among 422 participants at the public hospital of Jimma town. Study participants were consecutively recruited from May 01 to June 01, 2023. A structured Patient Activation Measure was used to measure patient engagement in healthcare decision-making. Descriptive statistics and binary logistic regression analysis describe the association between dependent and independent variables. ResultA total of 422 patients with chronic diseases participated in the study yielding a response rate of 99.3%. Slightly greater than one-third (35.8% (95% CI: 31.19, 40.41)) of participants in The study area had a high engagement in healthcare decision-making. Residence (Odd ratio 0.27; 95% confidence interval 0.137-0.534), educational level(Odd ratio 0.168; 95% confidence interval 0.064-0.443), access to information materials(Odd ratio 0.226; 95% confidence interval 0.112-0.458), duration(Odd ratio 3.864; 95% confidence interval 2.083-7.169), health literacy(Odd ratio 1.192; 95% confidence interval 1.111-1.28), and preference for autonomy(Odd ratio 1.097; 95% confidence interval 1.058-1.136) were factors statistically associated with patient engagement in healthcare decision-making. ConclusionOne-third of study participants reported high engagement in healthcare decision-making. Thus, healthcare providers should pay attention to patients with low educational levels, who do not have access to information materials, low health literacy levels, and their preference for autonomy to engage them in their healthcare decision-making.

War-related trauma and posttraumatic stress disorder in refugees, displaced, and nondisplaced people during armed conflict in Sudan: a cross-sectional study

BackgroundThe ongoing armed conflict in Sudan has caused mass displacement, affecting mental health. This study aimed to assess the prevalence of posttraumatic stress disorder (PTSD) and trauma among refugees, internally displaced, and nondisplaced people, while also examining the link between displacement type, PTSD severity, and associated factors.MethodsThis cross-sectional study used the Posttraumatic Stress Disorder Checklist for DSM-5 to assess PTSD symptoms and the General Health Questionnaire-28 to evaluate depression. Data were collected from 642 participants, targeting general social media groups for those within Sudan and specific groups for refugees outside the country. Sociodemographic and trauma event data were also gathered. Data analysis was conducted using SPSS, applying one-way ANOVA and independent t-tests to compare PTSD and depression. Binary logistic regression identified associations between sociodemographic factors and PTSD symptoms.ResultsAmong the 642 participants, 46.3% were internally displaced people (IDP), 42.1% were refugees, and 11.7% were non-displaced individuals. Clinically significant PTSD symptoms were identified in 36.6% of the participants. Refugees had a significantly greater percentage of traumatic events (M = 4.31, SD = 2.605, p < .01). Depression symptoms were found to be strongly associated with clinically significant PTSD (p < .001). Factors significantly linked to depression symptoms included female gender (p = 0.015), being single (p = 0.048), younger age (p = 0.036), dissatisfaction with living conditions (p < 0.001), and unemployment (p = 0.021). Dissatisfaction with living conditions also significantly influenced the likelihood of developing PTSD (p < .001).ConclusionThe study found that 36.6% of participants experienced PTSD, with refugees having a 1.4 times greater risk of developing PTSD compared to IDP and non-displaced individuals. Traumatic events were moderately correlated with PTSD symptoms, though non-displaced individuals had higher exposure to such events. These findings highlight the need for targeted mental health interventions, particularly for refugees and those affected by traumatic events. Further research using probability sampling is necessary to confirm these results and inform more effective mental health policies and programs for displaced populations.

Comparison of clinically meaningful improvements following center-based and home-based tele rehabilitation in people with COPD.

Response to pulmonary rehabilitation is not equal for all participants, and may vary across health outcomes for any one individual. Alternative modes of pulmonary rehabilitation delivery, e.g. telerehabilitation, may improve program access but could also affect response to rehabilitation. What is the rate of clinical response to home-based telerehabilitation compared to center-based pulmonary rehabilitation? And, are there participant baseline characteristics associated with pulmonary rehabilitation response relative to model of delivery? Secondary analysis of two randomized controlled trials. Participants were categorized as 'responders' or 'non-responders' according to achievement of the minimal important difference (MID) for each outcome of interest at end rehabilitation and after 12-month follow-up (change from baseline). Outcomes of interest were: functional exercise capacity (six-minute walk distance [6MWD], MID 30m); health-related quality of life (chronic respiratory questionnaire [CRQ], MID 2.5, 2, 3.5 and 2 points for the dyspnea, fatigue, emotion and mastery domains, respectively; CRQ total score MID 10 points); and symptoms (modified Medical Research Council [mMRC], MID -1 point). 266 individuals with COPD were included in the analysis. The proportion of responders was not different between center-based pulmonary rehabilitation and home-based telerehabilitation at either end rehabilitation or 12-month follow-up for any outcome (range 39% to 62%). In a binary logistic regression analysis, baseline outcome values, but not participant demographic characteristics, were most commonly associated with responder status. The relative risk of program non-completion in the center-based group was nearly four times greater than for telerehabilitation (PR completion: center-based PR n=79 (58%) versus home-based telerehabilitation n=116 (90%); RR 3.89, 95%CI 2.28 to 6.63). Responder status to pulmonary rehabilitation was not different between center-based and home-based telerehabilitation. The ability to identify patient characteristics that confer greater potential for rehabilitation response, or better suitability for a particular model of rehabilitation, remains a challenge. Take home points: STUDY QUESTION: What is the rate of clinical response to home-based telerehabilitation compared to center-based pulmonary rehabilitation? And, are participant baseline characteristics, program completion or program location associated with rehabilitation response? The proportion of responders to rehabilitation is not different between center-based and home-based telerehabilitation programs; however the risk of program non-completion is 4 times higher for center-based rehabilitation. Responder status to pulmonary rehabilitation was not different between center-based and home-based telerehabilitation, although rehabilitation completion was higher for home-based telerehabilitation. Identifying participant features that confer greater potential for rehabilitation response, or better suitability for a particular model of rehabilitation, remains a challenge.

Diuresis-led volume replacement strategy in extremely low birth weight infants.

In extremely low birth weight infants, fluid overload has been associated with bronchopulmonary dysplasia and death. Excessive weight loss may increase the risk of meconium obstruction and intestinal perforation. As these infants display oliguria followed by polyuria, we embarked on a diuresis-led volume replacement strategy as of January 2020. This single-centre analysis presents data of infants <1000 g birth weight surviving for more than 3 days admitted 2017-2019 (n = 217, daily volume increase) versus 2020-2022 (n = 2022, diuresis-led volume replacement). The second cohort had lower gestational age (median [interquartile range]: 253/7 [243/7-264/7] vs. 263/7 [251/7-282/7] weeks), less antenatal steroids (58% vs. 69%), more indomethacin (66% vs. 47%) and higher initial diuresis (5.6 [4.9-6.8] vs. 4.8 [4.2-5.5] mL/kg/h) but did not differ by relative weight loss at Day 7 of life. Employing binary logistic regression with gestational age, antenatal steroids and indomethacin as covariates, the cohorts did not differ by rates of patent ductus arteriosus, abdominal surgery or severe retinopathy of prematurity, while there were significant declines in sepsis (from 32% to 19%), bronchopulmonary dysplasia (from 26% to 23%) and mortality (from 13% to 7%). Diuresis-led volume replacement appears to be safe and maybe beneficial.

Correlation between acute mountain sickness and body constitution of Tibetan medicine and other factors: a case-control study

ObjectiveThis study aimed to determine the correlation between the incidence of acute mountain sickness (AMS) and the body constitution of Tibetan medicine and other relevant factors to provide a reference for the prediction and prevention of AMS. MethodsA case-control study was conducted to recruit participants who experienced or did not experience AMS after entering a plateau. The data was collected through online questionnaires for convenient sampling. Demographic characteristics, body constitution, and related states or behaviors were investigated before and after entering the plateau. The participants were divided into case and control groups based on the incidence of AMS. The distributions of relevant factors were compared. Binary logistic regression analysis was used to screen for risk and protective factors. ResultsThere were 167 participants who completed the questionnaire. A total of 54 cases were excluded, and 113 participants were included, including 52 in the case group and 61 in the control group. In the case group, 37, 13, and 2 patients had mild, moderate, and severe AMS, respectively. In terms of the Tibetan medicine constitution, the case group had the highest proportion of Bad-rlung (25.0%) and Rlung types (21.2%), whereas the control group had the highest proportion of Bad-rlung (29.5%) and Mkhris-bad types (24.6%). There was no significant difference in the distribution of the constitutional types between the two groups. Insomnia or insufficient sleep within the week prior to entering the plateau and fatigue after arrival were risk factors for AMS, with odds ratios (OR) and 95% confidence intervals (CI) of 5.012 (1.871 to 13.426) and 3.387 (1.393 to 8.236), respectively. A history of short-term plateau travel is a protective factor for AMS (OR: 0.32, 95% CI: 0.129 to 0.792). ConclusionInsomnia or lack of sleep before ascending to a plateau and fatigue after arrival are risk factors for AMS. The Rlung constitution might be related to the incidence of AMS; however, this still needs to be verified in large-sample observational studies. The risk factors identified in this study can provide a reference for the prevention practice and research of AMS.

Similarities between copycat mass shooters and their role models: An empirical analysis with implications for threat assessment and violence prevention

BackgroundAlthough an important subset of mass shooters has admitted copying previous shooters, there has been almost no empirical research on the similarities between mass shooting role models and their copycats. Such analysis is essential for understanding who is most susceptible to the influence of high-profile mass shooters and what behaviors they are likely to copy. MethodsWe first compiled all documented instances we could find globally of public mass shooters and active shooters becoming a role model for a copycat from 1966 to 2022 (n = 205) and calculated how often their risk profiles and behaviors were similar. Next, we ran simulated matches (n = 2000) and used binary logistic regression to test whether copycats were significantly more similar to their role models than to a random shooter. FindingsCompared to a random shooter, copycat attackers were significantly closer to their role models in age and more likely to share the same sex, race, country, incident location type, and offender outcome. Nearly 80% of copycats attacked more than one year after their role model, and the average temporal gap was approximately eight years. Copycats averaged significantly fewer victims killed and wounded than their role models. ConclusionsThe risk that high-profile mass shooters influence copycat attackers persists for many years, with the most susceptible individuals sharing characteristics of the role model shooters themselves. These findings could be used to make media coverage of mass shootings safer and to inform triage and case prioritization for threat assessment and violence prevention.

Perioperative Complications After Pediatric Liver Transplantation-A Retrospective Analysis of 421 Cases.

Due to the low incidence of pediatric liver transplantations, short- and long-term data regarding their outcome, details on early postoperative complications and their risk factors are under-represented in the literature. We retrospectively reviewed 1645 LTx performed at Hannover Medical School between January 2005 and December 2021. Of these, 421 transplantations were performed in 405 pediatric recipients. Univariate and multivariate binary logistic regressions were performed to identify independent risk factors for the onset of selected perioperative complications requiring intervention within the first 30 days following transplantation and their influence on graft and patient survival. Pleural effusions represent the most common postoperative complication observed in 49.4% (n = 208) of cases, followed by vascular complications in 22.6% (n = 95) and biliary complications in 20.0% (n = 84) of cases. Donor age (OR: 1.019; p = 0.010) and recipient age between 3 and 12 years (OR: 1.849; p = 0.008) were identified as independent risk factors for the onset of pleural effusions. Retransplantations within the first year after LTx were necessary in 11.4% of all cases (n = 48). Twenty (4.8%) patients died within the first year after LTx. Pleural effusions requiring postoperative intervention were observed in approximately half of the pediatric recipients. Therefore, the preemptive intraoperative placement of a chest drain under sterile conditions and general anesthesia should be considered. Our data further indicate that a two-stage procedure for biliary reconstruction may be the preferred procedure in patients at risk of early bile duct complications and retransplantation within the first year.

Impact of non-invasive ventilation on microbial colonisation patterns in preterm infants: a single-centre study.

The objective of this study is to assess the relationship between non-invasive ventilation (NIV) and the colonisation of oral and nasal microbiota in preterm infants within the neonatal intensive care unit (NICU). A prospective cohort study. The NICU of Zhejiang University Children's Hospital. Patients include preterm infants with a gestational age of 28-35 weeks, enrolled within the first 24 hours of life. Infants were categorised based on respiratory support: NIV, which included nasal continuous positive airway pressure, nasal intermittent positive pressure ventilation or high-flow nasal cannula; and no respiratory support, defined as room air or low-flow nasal cannula at ≤2 L/min. The primary outcome was the colonisation of oral and nasal microbiota at 5 days post birth, measured by colony-forming units per millilitre (CFU/mL), with colonisation defined as bacterial growth >103 CFU/mL. The study included 100 preterm infants, with 50 in each group. Nasal microbial colonisation was observed in 56% (28/50) of the NIV group, significantly higher than the 28% in the no respiratory support group. No significant differences were found in oral colonisation. Adjusted binary logistic regression showed an association between NIV and increased risk of nasal colonisation (adjusted OR=2.91, 95% CI 1.12 to 7.58, p=0.028). NIV in preterm infants was linked to a higher risk of nasal microbial colonisation. This finding suggests the need for further research and consideration of infection control strategies in the NICU.

Intimate Partner Violence and Associated Factors Among Pregnant Women in the Conflicted Northeast Ethiopia: A Cross-Sectional Study.

Intimate partner violence (IPV), perpetrated by male partners, inflicts physical, sexual, or psychological harm on women. During pregnancy, it becomes a significant public health concern and human rights violation, especially in conflict-affected areas, affecting both mother and fetus negatively. Research in Ethiopia often overlooks nonusers of antenatal services, primarily conducted in health facilities. This study addresses this gap, aiming to provide valuable insights into community dynamics. Hence, this study assessed the prevalence and factors associated with IPV during pregnancy in the conflict-affected district of Northeast Ethiopia. A community-based cross-sectional study surveyed 603 postpartum women in the Argoba district, Amhara region Northeast Ethiopia, from March 26 to April 25, 2023, utilizing a multistage sampling technique. Data collection employed a structured questionnaire, coded, and entered into Epi-data 4.6, then analyzed using SPSS version 26. Descriptive and Binary logistic regression analyses were conducted. Adjusted odds ratios were computed at a 95% confidence interval [CI], with a significance level set at p < 0.05. Model fit and multicollinearity were assessed for validity. The study found an overall prevalence of 45.1% (95% CI: 41.1-49.1) for IPV during pregnancy, with psychological violence being the most prevalent (38.0%), followed by physical (24.7%) and sexual violence (18.6%). Factors significantly associated with IPV included unwanted pregnancy (AOR = 1.94; 95% CI: 1.10-3.47), women's acceptance of violence (AOR = 2.39; 95% CI: 1.64-3.48), having a partner who chews khat (AOR = 1.99; 95% CI: 1.31-3.03), and spouse's engagement in multiple sexual partners (AOR = 1.63; 95% CI: 1.03-2.58). The study's findings indicate a higher prevalence compared to others, with key factors including unwanted pregnancy, acceptance of violence, khat chewing, and multiple sexual partners. Recommendations include comprehensive sex education, awareness campaigns, relationship counseling, community engagement, improved healthcare access, stronger legal frameworks, and empowerment programs.

Association Between Serum Magnesium Levels and Depression in Patients Undergoing Peritoneal Dialysis: A Study Conducted at Handan First Hospital, China.

Depression exhibits notable prevalence among patients affected by chronic kidney disease(CKD) and end-stage renal disease (ESRD). Emerging reports suggest a potential association between magnesium (Mg) levels and depressive symptoms, there has been a surge of interest in exploring Mg supplementation as a complementary measure in depression treatment. In this study our aim is to investigate the correlation between depressive symptoms and serum Mg level in patients undergoing peritoneal dialysis (PD) at Handan First Hospital, China. Additionally, we assessed the diagnostic significance of this relationship and identified pertinent influencing factors. This study comprises a cohort of 140 individuals undergoing PD for a minimum duration of 3 months at the PD center of the Handan First Hospital. The Hamilton Depression Scale (HAMD) served as the assessment tool to evaluate the psychological status of the patients. Serum Mg levels, hemoglobin (Hb), and various demographic and clinical data were collected. Logistic regression and ROC analysis were performed to identify significant predictors of depression. The prevalence of depression was higher in patients with hypomagnesemia (60%) compared to those with normal or elevated Mg levels. Notably, a correlation emerged between abnormal serum Mg levels and the presence of depressive symptoms among individuals undergoing PD. Furthermore, binary logistic regression analysis revealed that serum Mg levels, hemoglobin (Hb) concentration, and unemployment significantly influenced the likelihood of occurrence of depression in patients undergoing PD (P< 0.05). In addition, serum Mg levels demonstrate significant predictive value in anticipating onset of depression, indicating that rectifying low serum Mg levels among patients undergoing PD may serve as a preventive measure against depression. Further research is recommended to explore the therapeutic potential of Mg supplementation in this population.

Immuno-hematological parameters among adult HIV patients before and after initiation of Dolutegravir based antiretroviral therapy, Addis Ababa, Ethiopia.

Immuno-hematological abnormalities are common among HIV infected individuals as well as patients with highly active antiretroviral therapy (HAART). However, the immuno-hematological outcome of Dolutegravir based antiretroviral therapy (ART) usage is not well investigated. To assess hematological and immunological parameters among adult HIV patients before and after initiation of Dolutegravir based ART regimen at St. Peter Specialized Hospital, Addis Ababa, Ethiopia. A cross-sectional study was conducted from May to July 2021 at St. Peter Specialized Hospital among adult HIV patients. A total of 422 HIV patients on Dolutegravir based ART (combination of Dolutegravir/lamivudine/tenofovir disoproxil fumarate (DTG/3TC/TDF)) for a minimum of 3 months were selected using convenient sampling methods. Socio-demographic as well as clinical data of the participants was obtained using pre-tested structured questionnaires and a review of medical records. Hematological parameters such as CBC was obtained using Beckman coulter automated hematology analyzer and immunological parameters such as CD4 count were determined using BD FACS presto. Statistical analysis of the data was done using SPSS version 21. Paired t-test was used to compare dependent variables before and after initiation of the new HAART and binary logistic regression was used to determine predictors of immuno-hematological abnormalities. P-value < 0.05 was considered as statistically significant. Of 422 adult HIV patients, about 273(64.7%) were females. The mean age of study participants was 42.2 years (±10.4SD). The mean white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin (Hb), platelet distribution width (PDW), CD4 count, as well as lymphocyte percentage, neutrophil percentage, and platelet counts (PLT) were increased significantly(P<0.05) after 3 months of the Dolutegravir based therapy. While, red cell distribution width (RDW) and mean cell hemoglobin (MCH) were decreased (P<0.05) after the treatment. Other hematological parameters such as mean cell volume (MCV), hematocrit (HCT), mean cell hemoglobin concentration (MCHC), mean platelet volume (MPV) and platelet distribution width (PDW) showed no significant change. On the other hand, the most common hematological abnormalities identified after the new HAART were anemia (12.1%); followed by Leucopenia (11.3%), neutropenia (6%), and thrombocytopenia (4%). Anemia was associated with female sex (AOR = 7.8, 95% CI: 1.9-32.2, P<0.005) and WHO clinical stage III/IV (AOR = 16, 95% CI: 10.63-66.46, P<0.01). There was a significant change in certain immuno-hematological parameters such as WBC count, RBC count, PLT count, Hb, PDW, CD4 count, lymphocyte and neutrophil percentage after initiation of the Dolutegravir based therapy. Anemia was the most common hematological abnormality. Further studies are required to fully comprehend the outcome of the new treatment regimen on immuno-hematological parameters.

FLOOD PROGNOSIS USING AGGREGATION MACHINE LEARNING STRUCTURE

Frequent and devastating floods in Lagos State pose a significant threat to people and property. Accurate and real-time forecasting of floods is essential to mitigate their impact. This thesis focuses on evaluating different machine-learning structures for flood prediction in Lagos State. The structures assessed include K-Nearest Neighbor (KNN), Support Vector Classifier (SVC), Binary Logistic Regression, and Stacked Generalization (Stacking). The researchers trained and tested these structures using a rainfall dataset. The results demonstrate the better results of the stacked generalization model than the others, achieving an impressive accuracy of 93.3 per cent with a standard deviation(sd) of 0.098. These findings highlight the potential of machine learning models to provide precise and timely flood predictions, empowering the local authorities, especially disaster management ones, to take necessary actions to avoid destruction and preferably save people. Floods pose significant threats to human life, infrastructure, and economic stability. Timely and accurate flood predictions are crucial for effective disaster management. This study proposes an innovative aggregation machine learning structure to enhance flood prognosis accuracy. By integrating multiple machines learning algorithms, including random forests, support vector machines, and artificial neural networks, our framework leverages the strengths of individual models to improve predictive performance. The proposed framework is evaluated using a comprehensive dataset of hydrological and meteorological factors. Results demonstrate significant improvements in flood prediction accuracy, with a reduction in false positives and false negatives. The aggregation structure outperforms individual models, achieving an accuracy of [insert percentage] and a mean absolute error of [insert value]. This research contributes to the development of reliable flood prediction systems, enabling proactive measures to mitigate flood risks and protect vulnerable communities.

A prediction nomogram for mortality in patients following wasp stings: a retrospective study

Numerous studies have shown that wasp stings can lead to serious, sometimes fatal, health outcomes. Predicting deaths associated with wasp stings remains challenging yet is of critical importance. This study was conducted to identify predictors and develop a visual model for predicting mortality following wasp stings. Clinical data from 486 patients were analyzed, dividing them into two groups: survival group (N = 435) and death group (N = 51). Various statistical methods were used to create a prognostic model, including one-way analysis, the least absolute shrinkage and selection operator (LASSO) regression, and binary logistic regression. The model’s accuracy was evaluated through ROC curves, calibration plots, and decision curve analysis (DCA). The study identified four key predictors of mortality: receiving more than 50 stings, having serum lactate dehydrogenase (LDH) levels of ≥ 2200 U/L, activated partial thromboplastin time (APTT) of ≥ 90 s, and the requirement for invasive mechanical ventilation within 24 h. These factors contributed to a model with an area under the ROC curve of 0.980 (95% CI: [0.968–0.992]), indicating high calibration and applicability. The decision curve analysis confirmed the model’s substantial net clinical benefit. Thus, the number of stings, serum LDH, APTT, and the need for early invasive mechanical ventilation are reliable, independent predictors of death among patients experiencing wasp stings. The developed predictive model exhibits high levels of accuracy, sensitivity, consistency, and practical use.

몽골인의 사회계층이 관광 목적지 숙식 및 체험활동 선택에 미치는 영향 : 홉스골 국립공원 지역 관광자를 대상으로 한 이항 로지스틱 회귀분석

Looking at Mongolian tourists to the Khuvsgul National Park area, this study examines the impacts of tourists’ social stratification on their accommodation, dining, and experiential activity choices. The survey was conducted both online and offline at five different accommodations in the Khuvsgul National Park area between January 2024 and March 2024, and 288 valid questionnaires were used for the binary logistic regression analysis. The results showed that tourists’ occupation, average monthly household income, and subjective social class significantly influenced their choice of either luxury (e.g., hotels and resorts) or inexpensive accommodation (e.g., traditional Mongolian ger camps). Specifically, office workers were about 4.24 times more likely to stay in hotels or resorts than unskilled laborers, and the probability of staying at a hotel or resort increased by 1.45 times with each increment in subjective social stratification. In regard to tourists' dining choices (i.e., eating at hotel or resort restaurants vs. bringing their own food or eating at regular restaurants), average monthly household income and subjective social class had significant effects. However, education level influenced neither accommodation nor dining choices. Finally, tourists’ choices of some experiential activities (e.g., Tsaatan experience and Sukhbaatar ship travels) were influenced by their occupation and other control variables such as gender and age. The study findings and their implications were further discussed at the conclusion of this article.

What factors influence women's empowerment in Ethiopia? A multilevel analysis of Ethiopia's demographic and health survey data.

Women's empowerment has been a global priority, as countries can achieve significant growth and economic development by empowering women. Understanding the individual and community-level factors that influence women's empowerment is crucial for policymakers to develop effective policies and to improve women's empowerment. A community-based cross-sectional survey was conducted in 11 administrative regions of Ethiopia. The analysis included a weighted sample of 7,108 married women of reproductive age (15-49 years) from the 2,016 Ethiopian Demographic and Health Survey (EDHS). A multilevel mixed-effect binary logistic regression analysis was used to examine the individual and community-level factors associated with women's empowerment. In the final model, significant variables were identified using a p-value of <0.05 and an adjusted odds ratio (AOR) with a 95% confidence interval (CI). The overall magnitude of women's empowerment was 23.7% (95% CI: 22.7-24.7). Only 30.9% of women reported participating in household decision-making, and 32.5% disagreed with all the reasons justifying wife-beating. At individual-level, factors positively associated with women's empowerment included secondary (AOR: 2.72 (1.77-4.23), and higher (AOR: 3.65 (1.81-7.34) education. However, belonging to the Muslim religion was negatively associated with women's empowerment (AOR: 0.63 (0.47-0.85). At the community level, wealthy communities were positively associated with women's empowerment (AOR: 1.60 (1.05-2.44). Conversely, residing in rural areas (AOR: 0.49 (0.29-0.83), and living in the Afar (AOR: 0.35 (0.17-0.70), Amhara (AOR: 0.45 (0.26-0.79), Oromia (AOR: 0.43 (0.26-0.73), South Nation Nationalities, and Peoples (SNNP) (AOR: 0.42 (0.24-0.75), and Gambella (AOR: 0.36 (0.20-0.66) regional states were negatively associated with women's empowerment. The overall magnitude of women's empowerment in this study was low. Factors that positively influenced empowerment included attending secondary and higher education, as well as residing in communities with higher wealth status. On the other hand, being Muslim, residing in rural areas, and living in the Afar, Amhara, Oromia, SNNPR, Gambella, and Tigray regions were negatively associated with women's empowerment. As a result, the government of Ethiopia needs to design community-based women's empowerment strategies and involve women in income-generation activities that improve their participation in household decision-making to empower them.

PREDICTIVE ROLE OF MATERNAL DEPRESSIVE SYMPTOMS AND PERCEIVED QUALITY OF LIFE ON POSTNATAL MOTHER-INFANT BONDING

This cross-sectional study was focused on the predictive role of maternal depressive symptoms and perceived quality of life on postnatal mother-infant bonding. Research show that impaired postnatal bonding has a negative long-term effect on child’s development. Relevant literature also acknowledges a scientific gap in the understanding of the relationship between maternal mental health and the quality of postnatal mother-infant bonding. Respondents were 162 women in the first 12 months after childbirth, advising with gynecologist in maternity hospitals in the Republic of North Macedonia. Edinburgh postnatal depression scale, subscales of psychological and environmental domain of the WHO Quality of Life Scale-brief, and Postpartum Bonding Questionnaire were applied to measure study variables. Results from hierarchical binary logistic regression showed that psychological domain of quality of life significantly predicted quality of postnatal bonding in the first and second block. However, its effect was suppressed in the third block when depressive symptoms variable was entered. The presence of depressive symptoms and environmental domain of the perceived quality of life significantly predicted postnatal mother-infant bonding. Findings confirmed the significant predictive relationship of maternal depressive symptoms and of environmental domain of mother’s perceived quality of life on the quality of postnatal boding. This gives reason for increased attention on development of mother–infant dyads during the postnatal period and on the importance of social support.

RTS, S malaria vaccination among children aged 24–59 months in the Sunyani Municipality, Ghana; 2023

BackgroundFollowing the successful pilot of RTS,S malaria vaccine, it has been recommended by the WHO for prevention of Plasmodium falciparum malaria in children living in endemic areas. Despite the proven benefits of the malaria vaccine, uptake especially of the fourth dose, remains relatively low. We assessed complete uptake of RTS,S malaria vaccine among children 24–59 months and associated factors in the Sunyani Municipality of Ghana. MethodsA cross-sectional study was conducted among 361 caregivers of children aged 24–59 months in the Sunyani Municipality, who had received at least one dose of RTS,S malaria vaccine. Structured questionnaires were administered to caregivers and relevant vaccination information was extracted from the maternal and child health record books. Binary logistic regression analysis was used to determine factors associated with complete uptake of the vaccine at 95 % confidence interval (CI). ResultsApproximately 45 % (164/361) of the children had completed the RTS,S malaria vaccination schedule. Children aged 48–59 months (AOR:0.26, 95 %CI:0.09–0.76), those with caregivers who believed that children were being used for experiment (AOR:0.29, 95 %CI:0.16–0.54) or doubted the safety of the vaccine (AOR:0.27, 95 %CI:0.14–0.52) were less likely to complete the four doses. On the other hand, children of caregivers who reported vaccine shortages and travelled long distances to access immunization services (AOR:3.15, 95 %CI:1.17–8.47), and those with adequate knowledge on the malaria vaccine (AOR:1.89, 95 %CI:1.08–3.29) were more likely to complete the vaccination schedule. ConclusionLess than half of the children who started RTS,S malaria vaccination completed the full schedule. Age of child, caregiver knowledge and perception of the malaria vaccine, and access to immunization service were associated with complete uptake of the RTS,S malaria vaccine. Strengthening caregiver education and access to immunization services could improve uptake of the subsequent doses and coverage of the fourth dose.