Estimation Equations Research Articles

Functional Analysis of Thyme Production in Denizli Province

This study aimed to conduct an econometric analysis of thyme production in Denizli province agricultural enterprises. The data used in the research were obtained through face-to-face questionnaires in 82 agricultural enterprises determined according to the Simple Random Sampling Method. Research findings revealed that to obtain an average yield of 95.10 kg per decare, 10.296 seedlings, 8,93 cc pesticides, 52.34 kg of chemical fertilizers, 16.57 liters of diesel, 4.49 hours of machinery, and 17.84 hours of labor were needed. In this study, the relationships between the amount of thyme production and the number of seedlings, chemical fertilizers, pesticides, and the machinery used in the whole production, the amount of diesel, the amount of labor used, and the production area were analyzed with the help of the Cobb-Douglas production function. The coefficient of determination for the estimation equation was 0.89 and was found to be significant at the 1% level. Among the variables included in the estimation equation, the production elasticity coefficients of pesticide use and diesel use were negative, while the production elasticity coefficients of the seedling number, chemical fertilizer amount, labor, and production area variables were found to be positive. The fact that the sum of the production elasticity coefficients of the factors in the estimation equation for the amount of thyme production (∑βi) was 1.12 indicates there is increasing returns to scale. Among the variables in the production function, the variables with marginal efficiency coefficient above 1 were determined as the production area (3.20) and the fertilizer factor (1.33). The research findings revealed that production factors, except fertilizer amount and production area inputs, were not used effectively in thyme production.

The Effect of Myopic Control between the Dual-Focus Contact Lenses and High-Concentration Atropine in an Asian Population.

We aim to investigate the myopic control effect of high-concentration atropine (ATR) and dual-focus contact lenses (DFCLs). A retrospective cohort study was conducted. A total of 182 eyes in 91 individuals who used high-concentration ATR (0.125%) and another 70 eyes in 35 individuals who used DFCLs were enrolled in the ATR and DFCL groups, respectively. The primary outcomes were spherical equivalent refraction (SER) progression and axial length (AXL) elongation. The generalized estimate equation was utilized to yield the adjusted odds ratio (aOR) and 95% confidence interval (CI) of cycloplegic SER progression and AXL elongation between groups. According to the multivariable analysis, the change in cycloplegic SER progression was similar between the DFCL and ATR groups (aOR: 1.305, 95% CI: 0.247-2.515, p = 0.803). The DFCL group demonstrated a numerically higher rate of AXL elongation compared to the ATR group (aOR: 1.530, 95% CI: 0.980-1.894, p = 0.051). In the subgroup analysis, cycloplegic SER progression was insignificant between ATR and DFCL users in different subgroups (all p > 0.05). The DFCL patients with moderate astigmatism and high AXL (both p < 0.001) presented a high risk of AXL elongation. In conclusion, DFCL usage demonstrated similar myopic control of cycloplegic SER and AXL compared to high-concentration ATR, while DFCLs showed lower AXL control, mainly in patients with moderate astigmatism and high AXL.

Height Assessment Using the Length of Humerus of Selected Group of Hausa Ethnic Students in Yusuf Maitama Sule University, Kano State

Height assessment from bones plays a vital role in detecting unidentified bodies and parts of bodies or skeletal remnants, the aim of this study was to estimate the height of individual using the length of humerus of selected group of Hausa ethnic Students in Yusuf Maitama Sule University, Kano State, Nigeria. Two hundred and two (202) subjects were selected from the various faculties of the University, using random sampling method. The age range of the participants was between 18-50 years. Ethical approval was required from the Ethical Committee of the College of Health Science of the institution before the beginning of the research, Informed consents were sought from the participants. Using a stadiometer, standing height of individual was measured to the nearest centimeter (cm) with subject standing barefoot in an anatomical position. The humeral length was measured in between two points:- Distal point-Midpoint of elbow joint and Proximal point- Acromian landmarks, line was measured and documented. Length of humerus obtained was put in regression equation for humerus estimation. From the result obtained indicated that height can be estimated from the humeral length with Coefficient of significance (R=0.628) Coefficient of determinant (R2=0.395). The present study found significant differences between the sex in both humeral length and height of the study population and resolved that the maximum height can be estimated from the length of humerus with effective precision so that may help the archaeological, anthropometric and also forensic investigations.

Second-versus first-born twin: comparison of short- and long-term outcomes.

An ancient description of the competition between twins for first breath is found in the biblical story of Jacob and Esau (Genesis 25:26) when Jacob pulled his older brother's heel in the hope of becoming firstborn but to no avail. In this study, we sought to evaluate the short and long-term outcomes of twin pairs, comparing between the second- and first-born twin. A population-based cohort study, including dichorionic twin deliveries occurring between the years 1991 and 2021 at Soroka University Medical Center. A General estimation equation (GEE) was applied to adjust for confounders. The incidence of offspring's hospitalizations due to various medical conditions was compared. Kaplan-Meier survival analyses compared cumulative morbidity. Cox proportional hazards models were used to control for confounders. 5507 twin deliveries met the inclusion criteria. Second-born twins had higher rates of cesarean deliveries, statistically significant in the GEE multivariable analysis. More first-twin fetuses were experiencing non-reassuring fetal heart rate patterns, although other obstetrical outcomes as well as mortality rates were comparable between groups. Second twins weighed lower than their older sibling (mean difference 33g) and were more frequently SGA and low birthweight (1500-2500g); (p < 0.05). Later during childhood, offspring of twin deliveries experienced notable morbidity due to infectious (23.8-24.1%), respiratory (10.5-10.9%), neurological (7.0-7.8%) and cardiovascular pathologies (1.7-1.9%) during childhood, that was unaffected by birth order. Other than birthweight differences, the birth order of dichorionic twins is not associated with adverse neonatal health indices, nor does it predict excess risk for morbidity during childhood.

Buckling behaviour of steel dome cap design under external pressure

This study aims to numerically investigate the buckling behaviour of externally pressurised dome caps. Following the recommendations of the European Standard EN 1993-1-6, there was good agreement between the Finite Element (FE) model and the experimental results, with an average difference of less than 7 %. Several imperfection approaches, such as (i) single load indentation (SLI) and (ii) axisymmetric outward bulge (AOB), and (iii) eigenmode-affine (EM) were used to analyse the dome cap. The EM proved to be the worst imperfection for the externally pressurised dome cap, yet the SLI is an attractive technique for simulating realistic imperfections. The imperfection tolerance was designed according to EN 1993-1-6, and the SLI was used for the realistic-case imperfection. From parametric study, a plot of the upper and lower bound curves serves as a design recommendation, similar to the NASA SP-8032 guideline. Through a regression analysis, a first-cut estimation equation of the imperfect dome cap buckling load with reliability of R2 = 0.97. A case study of shell buckling design on pressurization damage to an oil storage tank's spherical shell partition and its stress assessment are evaluated. This study provides a practical solution for the evaluation of buckling of steel domes under external pressure.

Divestment of foreign direct investment and domestic investment in developing countries agriculture

Divestment of foreign direct investment has accompanied foreign direct investment. The literature on the interface of foreign direct investment and domestic investment in the agricultural sector is limited. None of these addressed the effect of agricultural foreign divestment on agricultural domestic investment. This paper filled this gap by assessing the direction and extent of the effect of agricultural foreign divestment on agricultural domestic investment in developing countries. The panel data of 50 countries, covering 1995 to 2020 and making up 619 observations, was fitted to fixed and random effects as well as generalised estimation equation estimators. We found agricultural foreign divestment crowded out agricultural domestic investment in developing countries. Economic managers in developing countries must work towards strong macroeconomic indicators, as these have collateral benefits for enhancing agricultural domestic investment.

Association between lifestyle and dietary preference factors and conventional adenomas and serrated polyps.

Both conventional adenoma (AD) and serrated polyp (SP) were known precursor lesions of colorectal cancer (CRC). Modifiable lifestyle factors were significantly associated with CRC risk, but whether these factors were related to the risk of different precursors of CRC needed to be clarified. This study aimed to evaluate the risks of AD and SP caused by lifestyle factors and compare the risk differences between AD and SP. The study population was from the CRC screening cohort in Hangzhou, China. A total of 458,457 eligible individuals volunteered to undergo initial screening including the fecal immunochemical test (FIT) and the CRC risk assessment. Finally, 13,993 participants who had undergone colonoscopy tests and had been diagnosed at designated hospitals were selected in this study. All participants were required to fill out a questionnaire during the initial screening for collecting their information. The generalized estimate equation (GEE) model was used to assess the association between lifestyle factors/dietary preferences and AD/SP. The body mass index (BMI) and smoking were positively associated with the risks of only SP (BMI: OR = 1.50, 95%CI: 1.23-1.84; smoking: OR = 1.29, 95%CI: 1.07-1.55), only AD (BMI: OR = 1.53, 95%CI: 1.28-1.82; OR = 1.24, 95%CI: 1.11-1.39), and synchronous SP and AD (BMI: OR = 1.97, 95%CI: 1.40-2.75; smoking: OR = 1.53, 95%CI: 1.27-1.85). In the case-group comparison, smoking was more strongly associated with the risk of synchronous SP and AD than only AD. Alcohol drinking was positively associated with the risk of AD (OR = 1.28, 95%CI: 1.14-1.44), but no statistically significant difference was observed in risks in the case-group comparison. Furthermore, whole-grain intake was associated with a decreased risk of only AD (OR = 0.78, 95%CI: 0.65-0.93). However, white meat intake was positively associated with risks of only SP when compared with AD cases (OR = 1.60, 95%CI: 1.15-2.23). The current study identified common risk factors such as BMI and smoking as well as different risks of certain factors (e.g., alcohol drinking and whole-grain intake) for SP and AD. However, there were still some factors, especially diet-related factors, that have not been fully elucidated in their association with the two lesions. Further research is needed in future to confirm and develop prevention strategies for different lesions.

Risk indicators for gingival recession in the esthetic zone: A cross-sectional clinical, tomographic, and ultrasonographic study.

To evaluate the risk indicators associated with midfacial gingival recessions (GR) in the natural dentition esthetic regions. Cone-beam computed tomography (CBCT) results of thirty-seven subjects presenting with 268 eligible teeth were included in the cross-sectional study. Clinical measurements included presence/absence of midfacial GR; the depth of the midfacial, mesial, and distal gingival recession; the recession type (RT); keratinized tissue width (KT); and attached gingiva width (AG). Questionnaires were utilized to capture patient-reported esthetics and dental hypersensitivity for each study tooth. Buccal bone dehiscence (cBBD) and buccal bone thickness (cBBT) were measured on the CBCT scans. High-frequency ultrasonography was performed to assess gingival thickness (GT) and buccal bone dehiscence (uBBD). Intraoral optical scanning was obtained to quantify the buccolingual position of each study site (3D profile analysis). Multilevel logistic regression analyses with generalized estimation equations were performed to assess the factors associated with the conditions of interest. The presence of midfacial GR was significantly associated with the history of periodontal treatment for pocket reduction (OR 7.99, p=0.006), KT (OR 0.62, p<0.001), cBBD (OR 2.30, p=0.015), GT 1.5mm from the gingival margin (OR 0.18, p=0.04) and 3D profile 1mm from the gingival margin (OR 1.04, p=0.001). The depth of midfacial GR was significantly correlated to previous history of periodontal treatment (OR 0.96, p=0.001), KT (OR -0.18, p<0.001), presence of bone fenestration (OR 0.24, p=0.044), and cBBD (OR 0.43, p<0.001). The depth of midfacial GR was also the only factor associated with patient-reported esthetics (OR -3.38, p=0.022), while KT (OR 0.77, p=0.018) and AG (OR 0.82, p=0.047) were significantly correlated with patient-reported dental hypersensitivity. Several risk indicators of midfacial and interproximal GR in the esthetic region were identified. The use of imaging technologies allowed for detection of parameters associated with the conditions of interest, and, therefore, their incorporation in future clinical studies is advocated. Ultrasonography could be preferred over CBCT for a noninvasive assessment of periodontal phenotype.

Associations of socioeconomic and lifestyle characteristics, psychological symptoms, multimorbidity, and multisite pain with sciatica – a 15-year longitudinal study

Sciatica is defined as pain radiating from the low back to the leg, usually below the knee. It is a disabling condition that causes a major burden to health care and society. Previous evidence of the multifactorial etiology of sciatica comes mostly from cross-sectional studies. Larger, longitudinal studies with a multidimensional set of variables are needed. To examine how socioeconomic and lifestyle characteristics, psychological symptoms, multimorbidity, and multisite pain are associated with sciatica. A longitudinal study of the Northern Finland Birth Cohort 1966. In total 6,683 working-aged members of the Northern Finland Birth Cohort 1966. Self-reported sciatic pain status over a 15-year study period. We conducted a 15-year longitudinal study from the age of 31 to 46. We used multivariable generalized estimation equations analysis to examine how socioeconomic characteristics (low education, unemployment, and living alone), lifestyle characteristics (overweight, obesity, current smoking, and physical inactivity), psychological symptoms (depression, anxiety), multimorbidity, and multisite pain were associated with sciatica. At the age of 31, 21.1% of the study population reported sciatic pain and at the age of 46, 36.7%. Multisite pain was clearly the strongest factor associated with sciatica (odds ratio [OR] 2.61, 95% confidence interval [CI] 2.34‒2.92). In descending order of effect size, older age, low education, psychological symptoms, multimorbidity, overweight, obesity, physical inactivity and current smoking were positively associated with sciatica. Their ORs varied between 1.17 and 2.18. Living alone was negatively associated with sciatica (OR 0.81, 95% CI 0.72‒0.90). Multisite pain had the strongest association with sciatica. The effect sizes of the other factors were clearly smaller. To our knowledge this is the first study to evaluate the association of multisite pain with sciatica. This finding may have considerable implications for clinical work treating patients with sciatica.

Body size estimation from isolated fossil bones reveals deep time evolutionary trends in North American lizards.

Lizards play vital roles in extant ecosystems. However, their roles in extinct ecosystems are poorly understood because the fossil record of lizards consists mostly of isolated bones. This makes it difficult to document changes in lizard morphology and body size over time, which is essential for studies of lizard paleoecology and evolution. It is also difficult to compare available fossil lizard data with existing sources of extant lizard data because extant studies rarely measure individual bones. Furthermore, no previous study has regressed measurements of individual bones to body length across crown lizard groups, nor tested those regressions on fossil skeletons. An extensive dataset of individual bone measurements from extant lizards across crown taxonomic groups is here employed to develop novel methods for estimating lizard body size from isolated fossil elements. These methods were applied to a comparably large dataset of fossil lizard specimens from the robust Paleogene record (66-23 Ma) of the Western Interior of North America. This study tests the hypothesis that anatomical proportions have been conserved within higher-level crown lizard groups since the Paleogene and can therefore be used to reconstruct snout-vent length (SVL) and mass for fossil specimens referred to the same groups. Individual bones demonstrated strong correlation with SVL in extant as well as fossil lizard specimens (R2 ≥ 0.69). Equations for mass estimation from individual bones were derived from the SVL regressions using published equations for calculating lizard body mass from SVL. The resulting body size estimates from regression equations for the entire fossil dataset revealed that lizards reached greatest maximum body size in the middle Paleogene, with the largest size class dominated by anguid lizards that exceeded 1 meter in SVL and 1.5 kg in body mass. Maximum body size decreased to under 400 mm and below 1.5 kg in the late Paleogene. No association was found between changes in maximum lizard body size and marine isotope proxies of global temperature through the Paleogene. This is the first study to investigate body size evolution across lizard clades over a deep time interval and for a large geographic region. The proposed methods can be used to generate body size regressions and provide estimates of body size for isolated lizard bones referred to any crown group.

Effects of Loading Modes on Fatigue Limit Estimation in Terms of Rotating Bending Fatigue and Rate Process Theory

In this study, the influence of loading modes on the fatigue limit estimation of low-to-medium-carbon steels was modeled in terms of the rate process theory proposed by Guennec et al. The axial loading model established in terms of the rate process theory has been shown to be effective for axial loading fatigue, but its applicability to rotating bending fatigue is uncertain. Therefore, low- and medium-carbon steels were tested for rotating bending fatigue, and the fatigue limits obtained were compared with those estimated by the axial loading model established in terms of the rate process theory. However, since the model could not be applied, we propose a new model in which the material parameters of an estimation equation established in terms of the rate process theory are expressed based on Vickers hardness, which was introduced to improve the usability of the model. It was found that there was a discrepancy between the axial load fatigue limit and the rotating bending fatigue limit due to the effect of the loading mode. To solve this discrepancy, the stress index was introduced into the model. The proposed model provides a method for estimating the frequency-dependent fatigue limits for different loading modes.

Physical activity changes and influencing factors among Chinese pregnant women: a longitudinal study

Objective Participating in physical activity during pregnancy has benefited a lot from maternal and child health. However, there are few longitudinal studies describing activity patterns and related factors during pregnancy. The aim of this study is to investigate longitudinal physical activity changes and the influencing factors of Chinese pregnant women. Methods From January to August 2020, 240 pregnant women were recruited in Hangzhou, China. Physical activity during pregnancy was assessed in the first, second, and third trimesters of pregnancy by using the Pregnancy Physical Activity Questionnaire. Results The daily energy consumption during first, second, and third trimesters was 20.55, 20.76, 17.19 METs-h/d. The results of repeated-measure analysis of variance and pairwise comparison showed that the total daily energy consumption of physical activity in the third trimester was significantly lower than that in the first and second trimesters, with statistical significance (p < 0.001). The generalized estimation equation showed that education level, pre-pregnancy BMI, gravidity, unnaturally conceived and pre-pregnancy exercise habits were the influencing factors of physical activity during pregnancy (p < 0.05). Conclusion Physical activity levels of pregnant women during different trimester were not optimistic. In order to improve physical activity during pregnancy and promote the health status of both mother and the developing baby, more attention should be paid on pregnant women with low education level, high BMI before pregnancy, primipara, unnaturally conceived and no good exercise habits before pregnancy.

Agreement and differences between the equations for estimating muscle and bone mass using the anthropometric method in recreational strength trainees.

The interest in estimating muscle mass (MM) and bone mass (BM) has grown in the sporting arena, and more specifically in recreational strength trainees, leading to the creation of different strategies to assess them. The aims were: 1) to investigate the agreement between different MM and BM formulas, and the muscle-bone index (MBI), and to establish the differences between them, in a healthy young adult population; and 2) to analyze if there are differences between males and females in the comparison of MM, BM and MBI formulas. This study followed a descriptive cross-sectional design. A total of 130 adult active recreational strength trainees were evaluated according to the procedures described by the International Society for the Advancement in Kinanthropometry (ISAK). Estimations were made in kilograms of MM and BM by following the equations by different authors. The results showed significant differences between the values obtained by all the MM and BM formulas in the general sample (p < 0.001), and by the majority of formulas for male and female samples. In the general sample, Lin's coefficient indicated a strong agreement between Kerr, Lee, and Poortmans' MM estimation equations (concordance correlation coefficient (CCC) = 0.96-0.97). However, when stratifying by sex, this agreement persisted only in males (CCC = 0.90-0.94), in contrast with a lack of agreement observed in females (CCC < 0.90). Discrepancies in bone mass agreement were noted both in the general sample (CCC < 0.15) and when stratified by sex (CCC < 0.12). In general, differences were found between the values reported by the MM and BM formulas in recreational strength trainees, without an agreement between them. Sex was shown to significantly influence the differences found. The practical implications are that when comparing an individual with reference tables, other studies, or if analyzing an individual's evolution, the same estimation equation should be used, as they are not interchangeable.

Bed expansion in turbulent bed contactor: Experiments and prediction

In this work, turbulent bed contractor (TBC) hydrodynamics have been studied in terms of bed expansion (Hd/Hst) using a particular approach to predict this important property for the design of such equipment. The study is based on 1604 sets of experimental data on the bed expansion, obtained by varying the operating variables (gas velocity, liquid spray, packing characteristics, static bed height, and free opening of the supporting grid). The prediction of the bed expansion necessitates the estimation of gas and liquid holdups. To achieve this, we employed a variety of correlations derived from existing literature, comprising six equations for gas holdup and twenty equations for liquid holdup estimation. Out of a total of 120 cases, bed expansion was estimated, and the accuracy of the model was evaluated by calculating the mean absolute error in percentage (MAPE), root mean square error (RMSE), correlation coefficient (?XY), and explained variance (VECV). This study identified suitable correlations for gas and liquid holdups, leading to predictions with acceptable errors. Furthermore, statistical analysis was employed in a subsequent phase of the study to determine the most appropriate correlations for predicting bed expansion among those proposed by various authors.

Patient-Centered Positive Factors Influencing Glycemic Control in Adolescents with Type 1 Diabetes Mellitus in China: A Cross-Sectional and Longitudinal Study.

This study aimed to explore the stable longitudinalpatient-centered self-protectivefactors of glycosylated hemoglobin (HbA1c) in adolescents with type 1 diabetesmellitus(T1DM). We used both cross-sectional and longitudinal datasets at the Diabetes Education Center and National Endocrine and Metabolism Centre of a university hospital in China from April 2020 to July 2022. Participants were assessed using the Adolescent Diabetic Behavior Rating Scale (DBRS), Diabetes Strengths and Resilience Measure for Adolescents (DSTAR-Teen). HbA1c and other clinical variables were obtained from the medical record at the same time. 266 adolescents (131 male, age 14.1±3.9 years) completed the cross-sectional assessments and 131 (62 male, age 14.6±3.3 years) participated in a follow-up at a 1-year visit interval. Logistic regression analysis of cross-sectional data of 266 cases showed that there were significant positive effects between pump treatment (β=0.090, OR 2.460, P=0.005), DBRS scores (β=2.593, OR 13.366, P=0.002) and the meeting of standard HbA1c (<7.5%, 58 mmol/mol). Disease duration (β=-0.071, OR 0.932, P=0.033) was negatively correlated with it. The longitudinal multivariate generalized estimation equation model showed that DBRS scores (β=3.165, OR 23.681, P=0.009) and DSTAR-Teen scores (β=0.050, OR 1.051, P=0.012) had a positive influence on the meeting of standard HbA1c over one year time of 131 cases. Self-care and resilience had higher cross-temporal stability in influencing glycemic control over time. To reach a better glycemic control and improve long-term health outcomes, attention should be paid to the detection and enhancement of these patient-centered promoters.

Changes in mild cognitive impairment and sociodemographic disparity among adults aged 55 years and above in 4 provinces of China

To investigate the changes in mild cognitive impairment(MCI) and sociodemographic disparity among adults aged 55 years and above in 4 provinces of China. A total of 4687 adults aged 55 years and above from Community-based Cohort Study on Nervous System Disease who did not have Alzheimer&apos;s disease, participated in both rounds of the survey, and had complete baseline sociodemographic data and two rounds of data on cognitive function were selected. Generalized estimation equations were used to analyse the effect of sociodemographic factors on MCI. The detection rates of MCI in adults aged 55 years and above without Alzheimer&apos;s disease in 4 provinces of China in 2018 and 2020 were 48.56% and 42.56% respectively. MCI occurred in 30.11% of those with normal cognition(NC) at baseline, and 44.24% of those with MCI at baseline reverted to NC. The risk of MCI increased and the likelihood of MCI reversion decreased with increasing age and decreasing per capita monthly household income. In the baseline NC population, the risk of MCI in the junior high school and above group was 35% lower than that in the illiterate group(RR=0.65, 95%CI 0.53-0.80), the risk of MCI was lower in those living in rural areas(RR=0.56, 95%CI 0.49-0.65), and the risk of MCI was 1.17 times(95%CI 1.03-1.32) higher in those with a history of chronic diseases than in those without it. In the baseline MCI population, the likelihood of MCI reversion increased with education, the likelihood of MCI reversion was 1.04 times higher for workers than for non-workers(95%CI 1.00-1.08). The incidence and reversal rates of MCI were high in adults aged ≥55 years in four provinces of China. Advanced age, low education and low income level are risk factors for cognitive dysfunction.

Effect of Maternal Pre-Pregnancy Body Mass Index on Longitudinal Fetal Growth and Mediating Role of Maternal Fasting Plasma Glucose: A Retrospective Cohort Study.

To assess the impact of maternal pre-pregnancy body mass index (BMI) on longitudinal fetal growth, and the potential mediation effect of the maternal fasting plasma glucose in first trimester. In this retrospective cohort study, we collected pre-pregnancy BMI data and ultrasound measurements during pregnancy of 3879 singleton pregnant women who underwent antenatal examinations and delivered at Peking Union Medical College Hospital. Generalized estimation equations, linear regression, and logistic regression were used to examine the association between pre-pregnancy BMI with fetal growth and adverse neonatal outcomes. Mediation analyses were also used to examine the mediating role of maternal fasting plasma glucose (FPG) in first trimester. A per 1 Kg/m² increase in pre-pregnancy BMI was associated with increase fetal body length Z-score (β 0.010, 95% CI 0.001, 0.019) and fetal body weight (β 0.017, 95% CI 0.008, 0.027). In mid pregnancy, pre-pregnancy BMI also correlated with an increase Z-score of fetal abdominal circumference, femur length (FL). Pre-pregnancy BMI was associated with an increased risk of large for gestational age and macrosomia. Mediation analysis indicated that the associations between pre-pregnancy BMI and fetal weight in mid and late pregnancy, and at birth were partially mediated by maternal FPG in first trimester (mediation proportion: 5.0%, 8.3%, 1.6%, respectively). Maternal pre-pregnancy BMI was associated with the longitudinal fetal growth, and the association was partly driven by maternal FPG in first trimester. The study emphasized the importance of identifying and managing mothers with higher pre-pregnancy BMI to prevent fetal overgrowth.

Comorbidities and their association with COVID-19 mortality in Mexico between January 2020 and August 2021.

By August 17, 2021, 4.3 million people had died globally as a result of SARS-CoV-2 infection. While data collection is ongoing, it is abundantly obvious that this is one of the most significant public health crises in modern history. Consequently, global efforts are being made to attain a greater understanding of this disease and to identify risk factors associated with more severe outcomes. The goal of this study is to identify clinical characteristics and risk factors associated with COVID-19 mortality in Mexico. The dataset used in this study was released by Sistema Nacional de Vigilancia Epidemiologica de Enfermedades Respiratorias (SISVER) de la Secretaría de Salud and contains 2.9 million COVID-19 cases. The effects of risk factors on COVID-19 mortality were estimated using multivariable logistic regression models with generalized estimation equation and Kaplan-Meier curves. Case fatality rates, case hospitalization rates are also reported using the Centers for Disease Control and Prevention (CDC) USA death-to-case ratio method. In general, older males with pre-existing conditions had higher odds of death. Age greater than 40, male sex, hypertension, diabetes, and obesity are associated with higher COVID-19 mortality. End-stage renal disease, chronic obstructive pulmonary disease, and immunosuppression are all linked with COVID-19 patient fatalities. Smoking and Asthma are associated with lower COVID-19 mortality which is consistent with findings from the article published in Nature based on National Health Service (NHS) of UK dataset (17 million cases). Intensive care unit (ICU), patient intubation, and pneumonia diagnosis are shown to substantially increase mortality risk for COVID-19 patients.

Counting the costs: a nationwide study on healthcare use following an adalimumab biosimilar switch in &gt;1300 inflammatory arthritis patients

Background: In Denmark, cost savings motivate mandatory biosimilar switches. In 2018, patients switched from originator to biosimilar adalimumab, that is, to GP2017 in Eastern and to SB5 in Western Denmark. However, concerns were raised about additional costs covering, that is, an increased number of outpatient visits due to patient education, treatment monitoring, and patient concerns. Objectives: To investigate whether the switch led to increased total healthcare costs, defined as costs related to in- and outpatient contacts in hospitals and the primary sector and use of prescription medicine (excluding biological treatment). Design: Observational cohort study with geographical cluster pseudo-randomization. Methods: Patients with rheumatoid arthritis, psoriatic arthritis (PsA), and axial spondyloarthritis (AxSpA), who switched were identified in the nationwide DANBIO registry. Total healthcare costs 9 months before and after the switch were captured from the National Patient and Prescription registries. The difference between pre- and post-switch costs was estimated by a generalized estimation equations (GEE) model. Results: Overall, 1316 patients switched to GP2017 ( n = 621) or SB5 ( n = 695). Total healthcare costs were mainly driven by hospital costs. The monthly fluctuations of hospital costs 9 months before and after the switch were largely similar or decreased. In the adjusted analyses (GEE), hospital costs decreased after the switch (by approximately 15%) for GP2017 switchers, especially PsA (estimate = 0.83; 95% CI 0.75–0.92) and AxSpA patients (estimate = 0.85; 0.77–0.93), with no significant changes for SB5 switchers. Conclusion: We found no increase in total healthcare costs in 9 months following a nationwide mandatory adalimumab originator to biosimilar switch. Our findings were strengthened by similar results for GP2017 and SB5.

Prescription audit of renally excreted drugs and vancomycin dosing for older patients with reduced kidney function

Japan has the largest aging population in the world, and kidney function declines with age. Therefore, when administering renally excreted drugs to older patients, the dosage should be adjusted according to the kidney function. This study addresses the appropriate use of renally excreted drugs in older patients in two topics. The first topic is concerned with the author’s experience with cibenzoline overdose, which led the author to conduct a survey of renally excreted drugs and establish an in-hospital prescription checking system for these drugs. The second topic clarifies the usefulness of serum creatinine-based kidney function estimation equations for predicting the area under the concentration-time curve of vancomycin in bedridden older patients. Based on these findings, the importance of pharmaceutical interventions by pharmacists in the pharmacotherapy of older patients with reduced kidney function is discussed