Inverse Probability Weighted Regression Adjustment Research Articles

Consider or not consider: the unsolved question on the use of radioactive iodine for differentiated thyroid cancer with low to intermediate risk of recurrence.

Surgery stands as the cornerstone treatment for differentiated thyroid cancer (DTC). After surgery, radioactive iodine (RAI) administration is primarily recommended for high-risk patients and commonly employed to address residual disease or mitigate the risk of recurrence. However, the optimal application of RAI in cases categorized as low to intermediate risk is still uncertain. This study aims to assess the indication of post-surgical RAI treatment specifically in patients diagnosed with DTC falling within the low to intermediate risk category for recurrent disease. retrospective analysis of consecutive patients with DTC falling within the low to intermediate risk category for recurrence and diagnosed between 2009-2015. Patients were categorized into either treated or untreated with RAI. Treatment effect was assessed by the inverse-probability weighted regression adjustment (IPWRA), by balancing the distribution of factors influencing outcome and treatment assignment. after surgery, 328 patients (69.9%) were treated with RAI while 141 (30.1%) were left untreated. Across the entire cohort, 44 individuals (9.4%) displayed biochemical or structural disease after a median time of 17.5 months following diagnosis. Recurrent disease was more prevalent in patients who underwent RAI treatment compared to those untreated (12.5% vs 2.1%, respectively, p < 0.001). Factors independently associated with recurrent disease, identified through multivariate logistic regression analysis, included lymph node metastases (pN1) (OR = 4.07; 95% CI 1.84-8.97), male sex (OR = 2.71; 95% CI 1.31-5.59), tumor size (OR = 1.03; 95% CI 1.00-1.06), and microscopic extrathyroidal extension (OR = 2.36; 95% CI 1.15-4.81). IPWRA analysis revealed that the occurrence of recurrent disease was 9.6% (95% CI = 6.3-12.9) in RAI-treated patients and 15.9% (95% CI = 11.1-20.71) in untreated patients (p = 0.021). As a consequence, if all patients underwent RAI treatment, the estimated risk of recurrence would be reduced by 42% (RR = 0.58; 95% CI = 0.35-0.91, p = 0.018). The greatest benefit was observed in patients with 2 intermediate risk factors. These results suggest that treatment with RAI in low to intermediate DTC can reduce the risk of recurrence in selected patients. However, definitive answers regarding whether to consider RAI therapy for this category of patients can only be attained through prospective clinical trials. Up to date these results recommend a meticulous assessment of tumor characteristics at diagnosis to guide the decision regarding RAI administration.

Impact of the degree of agricultural green production technology adoption on income: evidence from Sichuan citrus growers

Enhancing farmers’ adoption of agricultural green production technology (AGPT) is crucial for the green transformation of the agricultural sector. Obtaining additional income is the primary motivation for farmers to adopt AGPTs. Therefore, clarifying the relationship between AGPTs’ adoption degree and income will facilitate the possibility of farmers’ adoption of AGPTs. Based on research data obtained from 805 citrus farmers in Sichuan Province, this study examines the impact of the degree of AGPT adoption on farmers’ income and its mechanisms using the inverse probability weighted regression adjustment (IPWRA) model. These findings indicate: (1) The greater the degree of adoption of AGPTs by farmers, the more pronounced the impact on income increase. Using 1, 2, and 3 AGTs can increase farmers’ income from citrus sales by 7.1, 10.5, and 19.8 percentage points, respectively. (2) The adoption of AGPTs leads to increased income through higher yields and sales prices, which offset the incurred costs. (3) Market channels and farmers’ operating scales can affect the revenue effect of AGPT adoption. (4) Factors (i.e., education level, physical health status, and cultivation area) can affect farmers’ adoption of AGPTs. This study presents policy recommendations based on the above conclusions, aiming to guide the government in promoting AGPTs and advancing agricultural green transformation.

Does arts and cultural group participation influence subsequent well-being? A longitudinal cross-country comparison of older adults in Japan and England

IntroductionArts engagement is a positive health behaviour that could support the mental and social well-being of ageing populations globally. However, research is predominantly from Western countries, leaving it unclear whether...

Comparing Quality, Costs, and Outcomes of VA and Community Primary Care for Patients with Diabetes.

The Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act expanded access to independent community providers outside the Veterans Health Administration (VA). Little is known how quality, costs, and outcomes of primary care received in the community compare to that of the VA. To compare quality, costs, and outcomes of community and VA-provided primary care for patients with diabetes over a 12-month episode. A cross-sectional study using VA administrative data and community care claims. Adjusted analyses were conducted using inverse probability weighted regression adjustment to balance patient characteristics. Veterans with diabetes receiving primary care in the VA or community. Quality measures included receipt of hemoglobin A1C tests, eye exams, microalbumin urine tests, and flu shots. Outcomes were measured by hospitalizations for an ambulatory care sensitive condition (ACSC). Costs were measured for VA and community outpatient care, inpatient care, and prescription drugs. There were 652,648 VA patients and 3650 community care patients. VA patients were less likely to be White, had shorter mean drive time to VA primary care, and were less likely to be rural than community care patients. In adjusted analyses, community care patients had significantly lower probability of receiving a hemoglobin A1C test, eye exam, microalbumin urine test, and flu shot compared to the VA group. There was no difference in probability of an ACSC hospitalization. Community care patients had higher mean total costs ($1741 [95% CI, $431, $3052]), driven by higher inpatient and prescription drug costs but lower emergency care costs than VA patients. Patients receiving community primary care had worse diabetes quality and higher costs than patients receiving VA primary care. There was no difference in health outcomes. Care provided by an integrated delivery system may have advantages in quality and value.

Promoting sustainable agrifood production under climate change: adaptation, returns, and food security implications

ABSTRACT Climate change is challenging sustainable agrifood production and food security, and encouraging farmers’ climate change adaptation can help promote sustainable agrifood production and ensure food security. This study investigates farmers’ climate change adaptation and its impact on agrifood production. We employ the propensity score matching (PSM) model to address the selection bias issue of climate change adaptation and estimate the survey data collected from 415 rice-producing households in rural China. We also estimate the inverse probability weighted regression adjustment (IPWRA) model for robustness check. The empirical results show that farmers’ decisions on climate change adaptation are influenced by household heads’ age, education level, life satisfaction, temperature perception, and transportation conditions. The treatment effect estimations of the PSM model reveal that climate change adaptation significantly increases land productivity by 41.24–44.29% and labor productivity by 55.06–63.72% in rice production. The IPWRA model estimation largely confirms the robustness of the PSM model estimation. We also find that climate change adaptation significantly increases the net returns of rice production. These findings have significant global implications. By understanding the factors influencing farmers’ decisions to adapt to climate change, policymakers worldwide can design targeted interventions to encourage similar practices in other regions. Promoting farmers’ climate change adaptation to increase farm productivity is crucial for ensuring global food security in the face of ongoing climate challenges.

P-753 Obstetric and neonatal risks in 7,378 singletons following fresh and frozen-thawed embryo transfers in Japan: An analysis utilizing doubly robust estimation

Abstract Study question How do obstetric and neonatal risks differ between frozen-thawed embryo transfer (FET) and fresh embryo transfer (FreshET), as well as other non-assisted-reproductive-technology (non-ART) infertility treatments? Summary answer FET demonstrated a significantly higher incidence of obstetric complications, with a discernable but not statistically significant trend toward increased neonatal anomalies. What is known already Several studies indicate that FET is associated with an increased incidence of obstetric complications, encompassing gestational hypertension, placenta accreta, and gestational diabetes. Additionally, reports suggest that ART may elevate the risk of neonatal anomalies, although discerning whether this risk is more prevalent in FET or FreshET remains uncertain. Study design, size, duration This single-center, retrospective cohort analysis was conducted, encompassing 7,378 singletons delivered between January 2013 and December 2022 following fertility treatment within our institution. Within this cohort, cases conceived through controlled ovarian stimulation, timed intercourse, intrauterine insemination, or routine infertility checkups were categorized as the non-ART group. We compared the obstetric complications and neonatal outcomes between the FET and FreshET groups, using the non-ART group as the control. Participants/materials, setting, methods The evaluated outcomes included placenta accreta, placenta previa, postpartum hemorrhage, gestational hypertension, gestational diabetes, preterm birth, placental abruption, neonatal anomalies, high birth weight (≥4,000 g), and low birth weight (&amp;lt;2,500 g). For the statistical analysis, we employed inverse probability weighted regression adjustment (IPWRA). IPWRA integrates outcome regression with a model for exposure (propensity score), ensuring unbiased estimates even if one of the models is misspecified (a doubly robust property). Main results and the role of chance Among the 7,378 singleton births, 2,643 were in the non-ART group, 4,219 in the FET group, and 516 in the FreshET group. Comparative analysis with the non-ART group revealed that the FET group exhibited a higher risk across various obstetric complications, including placenta accreta (adjusted risk difference [ARD] 3.61%, 95% confidence interval [CI] 2.95 to 4.28), placenta previa (ARD 0.55%, 95% CI 0.14 to 0.96), postpartum hemorrhage (ARD 7.08%, 95% CI 6.03 to 8.13), gestational hypertension (ARD 3.57%, 95% CI 2.47 to 4.68), gestational diabetes (ARD 0.96%, 95% CI 0.17 to 1.75), preterm birth (ARD 2.13%, 95% CI 1.23 to 3.02), and high birth weight (ARD 0.97%, 95% CI 0.42 to 1.52). The analysis of neonatal anomalies initially showed a significant risk difference between the FET and non-ART groups in the crude analysis (crude risk difference 0.74%, 95% CI 0.09 to 1.38), although this significance diminished after adjustment (ARD 0.68%, 95% CI -0.02 to 1.39). The FreshET group did not demonstrate an increased risk of obstetric complications or neonatal anomalies. Limitations, reasons for caution The retrospective design of this study, conducted at a single institution, limits the generalizability of its findings to a broader population. Factors inherent to the specific facility, practices, and patient demographics may introduce variability in outcomes. Moreover, the potential for bias from unmeasured confounders cannot be entirely ruled out. Wider implications of the findings The mitigation of the risk of obstetric complications may be achieved through careful selection for FreshET, as opposed to a predominant inclination towards FET. It is crucial to develop a collaborative framework that enables the seamless exchange of information on maternal and neonatal prognoses between ART and perinatal facilities. Trial registration number not applicable

P-776 School-age outcomes among IVF and ICSI -conceived children: a causal inference analysis using linked population-wide data

Abstract Study question What is the causal effect of method of oocyte insemination; standard in-vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI), on childhood development at school entry? Summary answer The developmental outcomes at school entry for children conceived by ICSI, without severe male factor infertility, are equivalent to those conceived via standard IVF. What is known already Over 12 million children have been conceived globally with the assistance of assisted reproductive technology (ART). Within ART, ICSI continues to increase as the most common mode of oocyte insemination, even when not clearly indicated (i.e. without male factor infertility). Large cohort studies have suggested that ART, and ICSI in particular, may be associated with an increase in congenital abnormalities, autism spectrum disorder, developmental delay and intellectual disability. However, the studies are heterogenous and the evidence conflicting. The association between the ICSI technique itself and long-term childhood development remains unclear. Study design, size, duration Causal inference methods were used to analyse observational data in a way that emulates a target randomised clinical trial. For example, patients where standard IVF was not an option, (e.g., due to severe male factor infertility), were excluded. The state-wide cohort included linked maternal and childhood administrative data from Victoria, Australia. To eliminate potential confounding associated with IVF, comparison was made with children conceived via standard IVF (rather than conception without assistance). Participants/materials, setting, methods The study included singleton infants conceived via ART and born between 2005-2013. The primary exposure was conception via ICSI, with those born following conventional IVF insemination as controls. The outcome examined was the Australian Early Development Census (AEDC), a broad assessment of development and well-being performed in Australian schools, every triennium, at school entry (age 4-6). We combined multiple imputation and inverse probability weighting with regression adjustment to estimate population average causal effects. Main results and the role of chance The final cohort included 4,035 IVF and ICSI conceived children across the two outcome cohorts. Linked records were available for 2,468 ICSI children and 1,567 IVF-conceived controls. Maternal characteristics between the two treatment cohorts were similar for age, parity, education, language background, and number of eggs collected during treatment cycle. The ICSI conceived children were generally from residential areas of lower socio-economic status and conception was more likely to involve donated gametes. The unadjusted rate of the primary outcome; AEDC-defined “developmental vulnerability”, was 10.83% among the IVF group and 10.14% among the ICSI group. Given the use of observational data, there were missing data and inherent differences in the covariate profile between exposure cohorts. Multiple imputation, bootstrapping and doubly robust inverse probability weighted regression adjustment modelling was utilised to allow a causal interpretation of results. There was no evidence of a causal effect of ICSI-conception on the risk of AEDC-defined developmental vulnerability at school entry compared with spontaneously conceived children; adjusted risk difference -0.8% (95% CI -2.7% to 1.1%) and adjusted risk ratio 0.92 (95% CI 0.76 to 1.12). The adjustment variable set was determined a priori via a modified Delphi procedure. Limitations, reasons for caution Children who did not attend school due to severe disability were excluded, leading to potential selection bias. Within our study cohort of 2,468 ICSI children, no increased risk of developmental vulnerability was identified. It is possible that unmeasured confounders could have led to bias in estimating the treatment effects. Wider implications of the findings This study, in contrast to previous evidence, suggests that empiric use of ICSI compared with conventional IVF insemination does not affect early childhood developmental outcomes. These findings provide important reassurance for current and prospective parents, and clinicians alike. Trial registration number not applicable

Relationship between hukou conversion and psychological integration of rural older migrants: the mediating effect of accessibility to health resources

ObjectiveThis study investigates the relationship between hukou conversion and the psychological integration of rural older migrants, exploring the mediating role of accessibility to health resources.MethodsThe 3,963 valid samples of rural older migrants included in the study were sourced from the 2017 China Migrants Dynamic Survey (CMDS). The study established a multiple linear regression model for estimation and utilized inverse probability-weighted regression adjustment (IPWRA) method to correct for the selection bias of hukou conversion.ResultsCompared to older migrants with rural hukou, merit-based (β = 0.384, 95% CI: 0.265 to 0.504), family-based (β = 0.371, 95% CI: 0.178 to 0.565) and policy-based (β = 0.306, 95% CI: 0.124 to 0.487) converters have significantly higher psychological integration. These findings remain robust even after addressing the potential issue of endogenous selection bias using the IPWRA method. Bootstrap mediating effect tests indicate that hukou conversion can indirectly affect psychological integration through the mediator role of health resources accessibility.ConclusionAccessibility of health resources mediates the association between hukou conversion and psychological integration. Policymakers should enhance the implementation of hukou conversion, strengthen the health resource guarantee system, and achieve a deeper psychological integration among rural older migrants.

Endovascular Thrombectomy Versus Intravenous Thrombolysis of Posterior Cerebral Artery Occlusion Stroke.

Posterior cerebral artery occlusion (PCAo) can cause long-term disability, yet randomized controlled trials to guide optimal reperfusion strategy are lacking. We compared the outcomes of PCAo patients treated with endovascular thrombectomy (EVT) with or without intravenous thrombolysis (IVT) to patients treated with IVT alone. From the multicenter retrospective Posterior cerebraL ArTery Occlusion (PLATO) registry, we included patients with isolated PCAo treated with reperfusion therapy within 24 hours of onset between January 2015 and August 2022. The primary outcome was the distribution of the modified Rankin Scale (mRS) at 3 months. Other outcomes comprised 3-month excellent (mRS 0-1) and independent outcome (mRS 0-2), early neurological improvement (ENI), mortality, and symptomatic intracranial hemorrhage (sICH). The treatments were compared using inverse probability weighted regression adjustment. Among 724 patients, 400 received EVT+/-IVT and 324 IVT alone (median age 74 years, 57.7% men). The median National Institutes of Health Stroke Scale score on admission was 7, and the occluded segment was P1 (43.9%), P2 (48.3%), P3-P4 (6.1%), bilateral (1.0%), or fetal posterior cerebral artery (0.7%). Compared to IVT alone, EVT+/-IVT was not associated with improved functional outcome (adjusted common odds ratio [OR] 1.07, 95% confidence interval [CI] 0.79-1.43). EVT increased the odds for ENI (adjusted OR [aOR] 1.49, 95% CI 1.05-2.12), sICH (aOR 2.87, 95% CI 1.23-6.72), and mortality (aOR 1.77, 95% CI 1.07-2.95). Despite higher odds for early improvement, EVT+/-IVT did not affect functional outcome compared to IVT alone after PCAo. This may be driven by the increased risk of sICH and mortality after EVT.

Real-world outcomes in patients with chronic spontaneous urticaria receiving omalizumab: insights from a clinical practice survey

Objective Chronic spontaneous urticaria (CSU) is a debilitating inflammatory skin condition, often impacting quality of life. International guidelines recommend omalizumab, an anti-immunoglobulin E antibody, for second-line treatment. Our objective was to understand patient characteristics associated with prescription of omalizumab, and assess real-world outcomes in patients with CSU treated with omalizumab. Methods We analyzed data from the Adelphi Real World CSU Disease Specific Programme, a cross-sectional survey with retrospective data collection (December 2020–October 2021) from physicians and patients with CSU in the United States. Results Data from allergists (n = 45), dermatologists (n = 51), and primary care physicians (PCPs; n = 20) were included. At the time of data collection, one-third of patients were receiving omalizumab (n = 220) and 67% were eligible for but not receiving omalizumab (n = 455). Using logistic regression, the odds of receiving omalizumab were higher in patients whose entire bodies were affected by hives [odds ratio (OR) = 2.551; 95% confidence interval (CI) 1.502–4.333; p < 0.001] or with deteriorating/unstable prognoses at treatment initiation [OR = 2.219; 95% CI 1.031–4.777; p = 0.042], and lower in patients managed by PCPs [OR = 0.276; 95% CI 0.130–0.584; p < 0.001]. Estimates from an inverse probability weighted regression adjustment model indicated that patients receiving omalizumab had higher treatment satisfaction, improvements in itching, hives, angioedema, insomnia, and anxiety, and lower impact on work productivity, compared with patients not receiving omalizumab. Conclusion Around two-thirds of patients with CSU considered eligible for omalizumab were not receiving the guideline-recommended therapy. Patients receiving omalizumab had better real-world outcomes compared with patients not receiving omalizumab. Ensuring patients receive the most appropriate treatment could benefit patients with CSU.

Ethnic minority underachievement in UK higher education: an analysis of nationally representative data provides little support for the intersectionality thesis

ABSTRACT This study evaluated the intersectionality thesis, which suggests that the interaction of ethnicity, sex, and socioeconomic status significantly affects achievement in UK higher education. The study used a sample of 135,699 students from the Graduate Outcomes survey for the 2018/19 cohort, the last to leave higher education before the COVID-19 pandemic. Conditioning on a rich set of background characteristics, results from a series of regressions indicated that some interactions are statistically significant predictors of obtaining a good degree. However, the estimated size of these interaction effects, as estimated using marginal effects, appeared to be negligible. Robustness checks included consideration of selection on observables using Inverse Probability Weighted Regression Adjustment (IPWRA), which confirmed the main results’ robustness. Overall, the findings suggest that the data do not support the intersectionality thesis and that markers of disadvantage, when combined, do not have an effect on educational outcomes that is over and above that of the single factors in isolation. These results could have implications for recent policies introduced in England to close ethnic achievement gaps in higher education by 2038. However, the findings should be treated with some caution due to the ethnic categories used in the analysis and the potential bias from omitted and unobserved variables that may lead to an underestimation of ethnic penalties.

Agricultural services and rural household welfare: empirical evidence from Ghana

PurposeThis paper aimed to examine the impacts of agricultural services on welfare of rural farmers in Ghana.Design/methodology/approachUsing data from 1431 rural maize farmers, we employ multinomial endogenous switching regression and multivalued inverse probability weighted regression adjustment to assess the impacts.FindingsResults show that 19.8%, 9.7% and 3.42% of farmers adopted solely irrigation, extension and mechanization, respectively. Furthermore, utilizing a range of agricultural services significantly improves maize yields, gross income and per capita food consumption.Research limitations/implicationsThis study recommends strategies that target the adoption of combinations of agricultural services to enhance rural farmers’ welfare in Ghana and other developing countries.Originality/valueWhile agricultural services are claimed to improve agricultural production and peasants’ welfare, their impacts are not studied exhaustively. This paper contributes by providing empirical evidence of the impacts of agricultural services on farmers’ welfare.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-11-2022-0745.

Gender dynamics of the impact of cash transfer on female educational expenditure of informal settlements in Bangladesh

Gender-biased educational investment remains a critical issue for vulnerable households. Despite increased female enrolment in the past decade, motivation to invest on female education remains low. Resource scarcity and low woman empowerment are two major reasons of low educational expenditure on female children of a vulnerable household. As the most vulnerable households in a society, informal settlers (slum households) are supposed to spend less on female children. However, whether there is any gender bias in informally settled households’ spending on education remains a question. Further, Cash Transfer (CT) programs provide resources to vulnerable households for investing on human capital elements like education. This study aims to examine three research questions: whether a informally settled household’s spending on education is gender biased, whether the households in which women receive CT spend more for female education than those in which women do not receive CT, and finally whether the impact of female receipt of CT differs from that of male receipt of CT in terms of female education expenditure. As the assignment of female access to CT is not randomized, the simple comparison between the treated and untreated suffers from selection bias. We employ propensity score matching (PSM) as an identification strategy to address selection bias. Inverse probability weighted regression adjustment (IPWRA) has been applied as a robustness check. The study's policy implications highlight the significance for policymakers in the domains of women's education, empowerment, and the achievement of Sustainable Development Goals.

Climate change adaptation and smallholder farmers welfare: Empirical evidence from the Sahelian Region of West Africa

Global climate change has threatened sustainable agricultural growth over the years, severely affecting food sufficiency and the livelihood of farmers. The Climate-Smart Agricultural Technologies (CSAT), as a form of adaptation, offer pathways for mitigating the negative effect of climate change on crop producers in developing countries. This study uses cross-country (Mali and Niger) cross-sectional data to examine the welfare (proxied by crop sales revenue and income) impact of multiple adoptions of CSAT on smallholder farm households. To control for potential endogeneity that leads to bias estimates, we employ the multinomial endogenous treatment effect (METE) model, complemented with the inverse probability weighted regression adjustment (IPWRA) for the analysis. The result reveals that household (education, location, and assets) and plot (plot size, plot topography, and soil fertility) characteristics, institutional factors (farmer-based organization, access to formal credit, and extension service) and crop disease shock significantly influence different combinations of CSAT adoption. The impact estimates show that adopting joint combinations of CSAT leads to higher crop sales revenue and income among the farmers in most cases. These findings suggest that the adoption of CSAT as a package should be encouraged and disseminated in the West Africa Sahel region. Moreover, some sociodemographic and institutional factors such as education, credit access, farmer-based organizations, and extension services could be strengthened for easy and rapid adoption of CSAT by smallholder farmers, which subsequently improves their economic welfare.

IV Thrombolysis in Basilar Artery Occlusion: Outcomes and Comparison With Endovascular Thrombectomy.

Recanalization is considered a prerequisite for favorable outcome in basilar artery occlusion (BAO). Intravenous thrombolysis (IVT) has been successfully used for eligible patients with BAO well beyond the 4.5-hour time window but has been largely underrepresented in the best medical management arms in recent randomized controlled trials of recanalization therapy in BAO. We aimed to analyze the outcomes of patients with BAO treated with IVT only and to compare IVT with endovascular thrombectomy (EVT). This observational single-center, retrospective cohort study included consecutive patients with BAO treated with IVT and/or EVT up to 48 hours of symptom onset during 1995-2022. The primary outcome was favorable functional outcome (modified Rankin Scale 0-3) at 3 months collected by a stroke physician by phone. In the first part, we described the outcomes and factors associated with functional outcome in the IVT-only cohort during 1995-2022. In the second part, we used doubly robust inverse probability-weighted regression adjustment models to compare functional outcome of patients treated with IVT vs EVT+/-IVT during 2010-2022. In the whole cohort of 376 patients with acute BAO treated with recanalization therapy, 245 (65.2%) received only IVT. In the IVT-only cohort, most patients had moderate-to-severe clinical presentation (median NIH Stroke Scale 18) but no extensive early ischemic changes in the posterior circulation on admission. Half of them had onset-to-treatment time over 6 hours. 46.5% of the IVT-treated patients achieved 3-month favorable functional outcome, whereas mortality was 35.9%. sICH occurred in 11.1%. In a multivariable analysis, younger age, milder symptom severity, and less baseline ischemic changes predicted favorable functional outcome. In the 2010-2022 cohort, when compared with patients treated with EVT+/-IVT (n = 121), the IVT-only cohort (n = 122) had higher odds for favorable functional outcome (IVT 58.2% vs EVT 43.0% (aOR 2.82 [95% CI 1.31-6.05]). IVT alone produced outcomes comparable with those in recent trials of endovascular BAO recanalization. Furthermore, in head-to-head comparison in our cohort, the IVT-only approach was more often associated with favorable outcome than EVT+/-IVT. Thus, it should not be overlooked as the first-line recanalization therapy in acute BAO, even in longer time windows. This study provides Class IV evidence that tPA is as effective as thrombectomy for basilar artery thrombosis.

Gendered health effects of cooking fuel technologies in southern Ghana

The introduction of clean cooking technologies in many developing countries ensures environmental quality and improved well-being through reduction in indoor air pollution. This study examines the adoption of cooking fuel technologies and its effect on health outcomes using panel data from two districts in the Greater Accra region of Ghana. The inverse probability weighting regression adjustment (IPWRA) approach was used to examine the effect of cooking fuel technologies on health outcomes. The empirical results show that factors such as tenancy, kitchen design, assets, gender, education, access to internet and tarred roads influence the adoption of cooking fuel technologies, including clean cooking fuels. The study finds that clean cooking fuels decrease female illness incidence but not male illness incidence, with large improvement for adults. The findings suggest that policies and programs aimed at promoting clean cooking fuel technologies can significantly improve well-being of females in developing countries.

Impact of integrated soil fertility management on maize yield, yield gap and income in northern Ghana

This paper analyzes the impact of integrated soil fertility management (ISFM) on maize yield, yield gap and net income in northern Ghana using an inverse-probability-weighted regression adjustment (IPWRA). In this study, ISFM is restricted to the adoption of crop rotation (CR), inorganic fertilizer (FT), and farmyard manure (MN) either in isolation or in combination. We find a synergy in yield gain (86.52 % increase in yield) and a decrease in yield gap (of 10.22 %) with the adoption of all three technologies as a package (CR+FT+MN). The joint adoption of all three technologies is also associated with a 51.29 % increase in net income from maize production and has a Benefit-Cost Ratio of 3.23.

Does dam-based irrigation affect the sustainability of natural capital ?: A doubly robust analysis

This study assesses the impact of dam-based irrigation on the adoption of management practices for sustaining the natural capital of a region, with a focus on soil and water resources, using survey data from 1020 farmlands in northwestern Tunisia. Because treatment effect estimates are frequently prone to misspecification in either the treatment or outcome models, we use the doubly-robust inverse probability weighted regression adjustment estimator on four soil and water sustaining agricultural practices. As a robustness check, we also apply propensity score matching, with both methods consistently indicating a positive impact of dam irrigation on the adoption of these practices. Overall, these findings emphasize the indirect positive ecological effects of dams on a region's natural capital sustainability.

Combining social protection interventions for better food security: Evidence from female-headed households in Amhara region, Ethiopia.

Ethiopia introduced its flagship poverty-targeted social protection program, the Productive safety net program (PSNP), in 2005 and Community-Based Health Insurance (CBHI) in 2011. Although both programs operate in several districts with some overlaps, evidence is scarce on how these large-scale programs jointly affect the food security of vulnerable groups. This study examines the impacts of a combination of these programs on food security outcomes among female-headed households in a chronically food-insecure and drought-prone district. Cross-sectional data were collected from 365 female-headed households selected through multi-stage sampling technique and analyzed using Inverse-probability-weighted regression adjustment (IPWRA) strategy to assess the effect of the programs on food security. The results show that while 63.6% of sample households are enrolled in CBHI and 48.8% are beneficiaries of PSNP's conditional cash transfer (CCT) component, membership in both social protection programs was 38.9%. The IPWRA analysis finds that inclusion in the CCT combined with CBHI, on average, increased dietary diversity score by 0.918 (95% CI 0.779-1.057) and food consumption score by 0.576 (95% CI 0.464-0.688). It also reduced household food insecurity access scale by 8.658 (95% CI -9.775 - -7.541). In all assessments, a combination of CBHI and CCT always produced results of a larger magnitude than each of CBHI and CCT alone. The findings provide evidence of the potentials of integrating social protection programs to increase food security outcomes among the most vulnerable and marginalized groups in a developing country. In addition, the results have also useful implications to achieve sustainable development goals related to ending hunger and achieving food security among vulnerable groups.

Impact of access to cash remittances on cocoa yield in Southwestern Nigeria

Access to cash remittances has a positive impact on the food security of people living in developing countries. However, little is known about the impact of access to cash remittances concerning cocoa yield. Therefore, the study investigates the impact of access to cash remittances on cocoa yield. A multistage sampling technique was used to select 300 cocoa farming households for the study. The data were analysed using the exponential double hurdle model (Churdle) estimation process, inverse probability weighted regression adjustment (IPWRA), and endogenous switching regression model (ESRM). According to the ATU estimate, the average farmer would produce a yield of 0.824 times more when he/she has access to cash remittances. The conditional treatment effect (ATT), which assesses the impact of access to cash remittances on cocoa yield, was correspondingly approximately 0.828 and statistically significant at 1 %. As a result, the typical farmer who has access to cash remittances would produce a yield that is 0.828 times more than it would be if he/she did not have access to cash remittances. The study found that access to cash remittances has a positive impact on cocoa yield among farmers in rural Nigeria after adjusting for both observable and unobserved factors.