Ordinal Logistic Regression Research Articles

Harm-to-self from gambling: A national study of Australian adults.

Understanding how gambling harm is distributed is essential to inform effective harm reduction measures. This first national Australian study of gambling harm-to-self examined the extent, distribution, risk factors, and health related quality of life (HRQoL) impacts of this harm. ARandom Digit Dialling sample of 15,000 Australian adults was weighted to key population variables. Key measures included the Gambling Harms Scale-10 (GHS-10), PGSI, SF-6D, gambling behaviours, and demographics. Analyses included ordinal logistic regression. Amongst gamblers, 14.7% reported harm on the GHS-10, including 1.9% reporting high-level harm. While high-level harm occurred mainly in the problem gambling group (77.3%), other PGSI groups accounted for most of the more prevalent low (98.5%) and moderate (87.2%) harms reported. Proximal predictors of greater harm were use of online gambling and more frequent gambling on electronic gaming machines (EGMs), race betting sports betting, poker, skin gambling, scratchies, and loot box purchasing. Distal predictors were being younger, male, single, Aboriginal or Torres Strait Islander, and speaking a non-English language at home. At the population level, the greatest aggregate HRQoL impacts were amongst lower-risk gamblers, confirming the results of other studies regarding the 'prevention paradox'. The distribution of harm across gambler risk groups indicates the need for preventive measures, not just interventions for problem gambling. Reducing harm requires modifying product features that amplify their risk, especially for EGMs, race betting and sports betting that are both inherently risky and widely used. Gambling harm exacerbates health disparities for disadvantaged and vulnerable groups, requiring targeted resources and support.

Military Family Perspectives on Enrollment and Engagement in the WIC Program.

One in four U.S. service members endorses food insecurity. The Supplemental Nutrition Program for Women, Infants, and Children (WIC) is an invaluable, underutilized resource that can increase access to nutritious food for families with children under 5 years of age. Our research sought to evaluate military family perceptions and engagement with the WIC program. We conducted a mixed-method study, recruiting from a convenience sample of military families who applied for financial assistance for child care. An 18-question survey and follow-up focus groups assessed participant demographics and experiences with WIC. We utilized descriptive statistics ordinal logistic regression analyses for quantitative data analysis. For qualitative data, descriptive content analysis with constant comparison and inductive and deductive coding of interviews identified emerging themes. This study was approved by the Uniformed Services University of the Health Sciences Institutional Review Board. Among the 399 survey respondents, 25% were currently enrolled in WIC and 39% had been previously enrolled. Service members and their partners learned about WIC from a variety of sources, and there was no significant association between the branch of service or rank and WIC enrollment. There were 40 total participants in 10 completed focus groups. Six themes emerged: (1) Military-specific factors create unique circumstances related to WIC engagement; (2) the WIC program facilitates access to formula supplementation and nutritious foods for military families; (3) lack of program awareness and misinformation are top barriers to WIC engagement in military families; (4) stigma impacts WIC program enrollment and engagement; (5) logistics of enrollment can impact WIC engagement among military families; and (6) the military can support WIC enrollment and engagement through standardization, education, and leadership commitment. Our findings suggest that unique circumstances related to military family life create a profound need for programs addressing food support, such as WIC. Interventions to improve WIC enrollment among military families need to be rooted in broad outreach efforts, not targeted at specific ranks, branches, or ages. Specific recommendations include increasing information dissemination, universally screening military families for WIC, decreasing logistical burdens, and involving military leadership.

Are the shoulder joint function, stability, and mobility tests predictive of handstand execution?

Handstand is a basic element common across gymnastic disciplines and physical education classes that is frequently evaluated for quality in competition or skill acquisition. The correct handstand execution relies on maintaining balance, for which the shoulders seem particularly important. This study explores the relationship between shoulder joint function and the quality of handstand execution in novice college athletes (n = 111; aged 19-23 years). We assessed the shoulder joint function using standardized field tests (Upper Quarter Y Balance Test and Closed Kinetic Chain Upper Extremity Stability Test) and evaluated handstand execution on official rating scale. Ordinal logistic regression models showed no relationship between the quality of handstand execution (E-score) and measures of shoulder joint stability or mobility in our sample (POR = 0.97 [0.91, 1.03] and 1.00 [0.91, 1.09] for E-score). Two major factors may have caused an observed pattern of results. Firstly, the standardized tests assess shoulder joints in different loads and ranges of motion compared to handstands. Secondly, our novice sample was not able to perform the handstand sufficiently well. In our sample of novice college athletes, shoulder function seems not related to handstand execution as other latent factors hindered their performance.

Patient attitudes towards self- or partner-, friend-, or family-administered long-acting injectable antiretroviral therapy: a mixed-methods study across three urban HIV clinics

Abstract Background Long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) offers a novel drug-delivery option for persons with HIV (PWH), but requires administration every 4-or-8-weeks by a medical professional, thus increasing demand for clinical services amid workforce shortages. Methods With the goal of facilitating LAI-antiretroviral therapy (ART) scale-up, we evaluated patient interest in alternative administration approaches via a mixed-methods, serial cross-sectional study across three U.S. urban HIV clinics. From 12/2021-05/2022, we surveyed PWH on appeal of self- or partner/friend/family-administered LAI-CAB/RPV; multivariable ordinal logistic regression explored characteristics associated with appeal. To contextualize survey results, we thematically analyzed semi-structured interview data collected from PWH between 08/2020-07/2021 on attitudes towards out-of-clinic LAI-ART administration. Results Among 370 surveyed PWH (median age 46 years, 26% cis-female, 59% Black, 56% sexual minority, 34% housing instability), self-administering LAI-CAB/RPV appealed to 67%. PWH who were White (aOR 3.30 [95%CI 1.42,7.64]), stably housed (aOR 2.16 [1.30,3.59]) or gay/bisexual (aOR 1.81, [1.14,2.89]) had higher odds of endorsing self-administration as appealing. Slightly fewer PWH (60%) reported partner/friend/family-administration as appealing; adjusted models revealed similar sociodemographic preferences for this outcome. In 72 interviews, PWH noted acceptability of out-of-clinic LAI-ART administration was qualified by convenience, prior injection experience, and potential fear of self-inflicted pain, dependence on others, and/or HIV disclosure. Conclusions In a multisite sample of PWH, self- and to a lesser extent partner/friend/family-administration of LAI-CAB/RPV appealed to the majority, however, appeal was greater for populations less impacted by health disparities. Innovative LAI-ART delivery options could potentially free up in-clinic resources to focus scale-up among marginalized populations.

A simulation study to assess the impact missing values on the performance of different statistical methods for analysis of binary repeated measures data with an additional hierarchical structure

The primary objective of the study was to assess the impact of missing values on the analy- sis of binary repeated measures data with an additional hierarchical structure. One motivat- ing example for the present study was records of high somatic cell counts in milk samples obtained by approximately monthly sampling throughout the lactations of cows in dairy herds. Random effects models with autocorrelated (ρ = 1, 0.9 or 0.5) subject-level ran- dom effects were behind the simulated data. In general, the settings of the simulation were chosen to reflect a real somatic cell count dataset (scc40), except that the within-cow time series length was set to 8-time points for each cow. The estimation procedures consid- ered were: Ordinary Logistic Regression (OLR), Alternating Logistic Regression (ALR), Weighted Generalized Estimating Equations (WGEE), Penalized Quasi Likelihood (PQL), Maximum likelihood via numerical integration (ML) and Bayesian Markov chain Monte Carlo (MCMC). Multiple scenarios of simulated incomplete datasets were considered and include: a scenario corresponded to a combination of missingness patterns present in the scc40 dataset (scc40 scenario) The remaining scenarios involved only drop-outs, and corre- sponded to either moderate or high percentages of values either missing at random (MAR) or not missing at random (NMAR), respectively. In the scc40 scenario, all estimation procedures except OLR performed well and produced estimates with small relative bias (generally less than 5%) for levels of missingness that roughly corresponded to the scc40 data. In MAR missingness scenarios, some biases were found for ALR, WGEE and PQL procedures, whereas the likelihood-based procedures were largely unaffected by the miss- ing values. In NMAR scenarios, all procedures experienced similar and strong biases in the time coefficient; however, fixed effects estimates at the subject and cluster levels were relatively unaffected. Journal of Statistical Research 2023, Vol 57, No.1-2, pp.35-67

Risk factors associated with the severity of pericoronitis of mandibular third molar.

The factors related to pericoronitis severity are unclear, and this study aimed to address this knowledge gap. In total, 113 patients with pericoronitis were included, and their demographic, clinical, and radiographic characteristics were recorded. The Patient-Clinician Pericoronitis Classification was used to score and categorize the severity of pericoronitis. Statistical analysis was conducted to examine the participants' characteristics, validity of the Patient-Clinician Pericoronitis Classification, and risk factors associated with the severity of pericoronitis. The demographic, clinical, and radiographic characteristics of males and females were similar, except for Winter's classification, pain, and intraoral swelling. The constructive validity of the Patient-Clinician Pericoronitis Classification was confirmed with three latent factors, including infection level, patient discomfort, and social interference. Ordinal logistic multivariate regression analysis revealed that upper respiratory tract infection was the sole risk factor associated with pericoronitis severity in males (odds ratio = 4.838). In females, pericoronitis on the right side (odds ratio = 2.486), distal radiolucency (odds ratio = 5.203), and menstruation (odds ratio = 3.416) were significant risk factors. This study demonstrated the constructive validity of the Patient-Clinician Pericoronitis Classification. Among females, pericoronitis in mandibular third molars on the right side with radiolucency in menstruating individuals was more severe. In males, upper respiratory tract infection was the sole risk factor associated with pericoronitis severity. Individuals with risk factors should be aware of severe pericoronitis in the coming future.

Chronic and Latent Viral Infections and Leukocyte Telomere Length across the Lifespan of Female and Male Individuals Living with or without HIV

Background: Chronic/latent viral infections may accelerate immunological aging, particularly among people living with HIV (PLWH). We characterized chronic/latent virus infections across their lifespan and investigated their associations with leukocyte telomere length (LTL). Methods: Participants enrolled in the CARMA cohort study were randomly selected to include n = 15 for each decade of age between 0 and >60 y, for each sex, and each HIV status. Cytomegalovirus (CMV), Epstein–Barr virus (EBV), human herpesvirus 8 (HHV-8), herpes simplex virus 1 (HSV-1), and HSV-2 infection were determined serologically; HIV, hepatitis C (HCV), and hepatitis B (HBV) were self-reported. LTLs were measured using monochrome multiplex qPCR. Associations between the number of viruses, LTL, and sociodemographic factors were assessed using ordinal logistic and linear regression modeling. Results: The study included 187 PLWH (105 female/82 male) and 190 HIV-negative participants (105 female/84 male), ranging in age from 0.7 to 76.1 years. Living with HIV, being older, and being female were associated with harbouring a greater number of chronic/latent non-HIV viruses. Having more infections was in turn bivariately associated with a shorter LTL. In multivariable analyses, older age, living with HIV, and the female sex remained independently associated with having more infections, while having 3–4 viruses (vs. 0–2) was associated with a shorter LTL. Conclusions: Our results suggest that persistent viral infections are more prevalent in PLWH and females, and that these may contribute to immunological aging. Whether this is associated with comorbidities later in life remains an important question.

Urosepsis 30-day mortality, morbidity, and their risk factors: SERPENS study, a prospective, observational multi-center study

PurposeTo provide a descriptive report of mortality and morbidity in the first 30 days of diagnosis of urosepsis. Secondary aim is to identify risk factors of unfavourable outcomes.MethodsProspective observational multicentre cohort study conducted from September 2014 to November 2018 in European hospitals. Adult patients (≥ 18 years) diagnosed with acute urosepsis according to Sepsis-2 criteria with confirmed microbiological infection were included. Outcomes were classified in one of four health states: death, multiple organ failure, single organ failure, and recovery at day 30 from onset of urosepsis. Descriptive statistics and ordinal logistic regression analysis was performed.ResultsThree hundred and fifty four patients were recruited, and 30-day mortality rate was 2.8%, rising to 4.6% for severe sepsis. All patients who died had a SOFA score of ≥ 2 at diagnosis. Upon initial diagnosis, 79% (n = 281) of patients presented with OF. Within 30 days, an additional 5% developed OF, resulting in a total of 84% affected. Charlson score (OR 1.14 CI 1.01–1.28), patients with respiratory failure at baseline (OR 2.35, CI 1.32–4.21), ICU admission within the past 12 months (OR 2.05, CI 1.00–4.19), obstruction causative of urosepsis (OR 1.76, CI 1.02–3.05), urosepsis with multi-drug-resistant(MDR) pathogens (OR 2.01, CI 1.15–3.53), and SOFA baseline score ≥ 2 (OR 2.74, CI 1.49–5.07) are significantly associated with day 30 outcomes (OF and death).ConclusionsImpact of comorbidities and MDR pathogens on outcomes highlights the existence of a distinct group of patients who are prone to mortality and morbidity. These findings underscore the need for the development of pragmatic classifications to better assess the severity of UTIs and guide management strategies.Study registration: Clinicaltrials.gov registration number NCT02380170.

A surge in food insecurity during the COVID-19 pandemic in a cohort in Mexico City.

The COVID-19 pandemic has not only caused tremendous loss of life and health but has also greatly disrupted the world economy. The impact of this disruption has been especially harsh in urban settings of developing countries. We estimated the impact of the pandemic on the occurrence of food insecurity in a cohort of women living in Mexico City, and the socioeconomic characteristics associated with food insecurity severity. We analyzed data longitudinally from 685 women in the Mexico City-based ELEMENT cohort. Food insecurity at the household level was gathered using the Latin American and Caribbean Food Security Scale and measured in-person during 2015 to 2019 before the pandemic and by telephone during 2020-2021, in the midst of the pandemic. Fluctuations in the average of food insecurity as a function of calendar time were modeled using kernel-weighted local polynomial regression. Fixed and random-effects ordinal logistic regression models of food insecurity were fitted, with timing of data collection (pre-pandemic vs. during pandemic) as the main predictor. Food insecurity (at any level) increased from 41.6% during the pre-pandemic period to 53.8% in the pandemic stage. This increase was higher in the combined severe-moderate food insecurity levels: from 1.6% pre-pandemic to 16.8% during the pandemic. The odds of severe food insecurity were 3.4 times higher during the pandemic relative to pre-pandemic levels (p<0.01). Socioeconomic status quintile (Q) was significantly related to food insecurity (Q2 OR = 0.35 p<0.1, Q3 OR = 0.48 p = 0.014, Q4 OR = 0.24 p<0.01, and Q5 OR = 0.17 p<0.01), as well as lack of access to social security (OR = 1.69, p = 0.01), and schooling (OR = 0.37, p<0.01). Food insecurity increased in Mexico City households in the ELEMENT cohort as a result of the COVID-19 pandemic. These results contribute to the body of evidence suggesting that governments should implement well-designed, focalized programs in the context of economic crisis such as the one caused by COVID-19 to prevent families from the expected adverse health and well-being consequences associated to food insecurity, especially for the most vulnerable.

Sex-specific associations between the developmental alterations in the pituitary-thyroid hormone axis and thyroid nodules in Chinese euthyroid adults: a community-based cross−sectional study

BackgroundPrevious studies have revealed the sex-specific features of pituitary–thyroid hormone (TH) actions and the prevalence of thyroid nodules (TNs) in children and adolescents. However, it was unclear in adults. We aimed to investigate the features of pituitary–TH actions in women and men at different ages, and the associations of thyrotropin (TSH), THs, and central sensitivity to THs indices including the thyroid feedback quantile-based index by FT4 (TFQIFT4) and the thyroid feedback quantile-based index by FT3(TFQIFT3) with of TNs in Chinese euthyroid adults.Methods8771 euthyroid adults from the communities in China were involved. Demographic, behavioral, and anthropometric data were gathered through the questionnaires. Ultrasound was performed to evaluate the TNs. TSH and THs levels were measured. The multivariable logistic regression and multivariable ordinal logistic regression were conducted.ResultsTFQIFT3 among both genders, except women aged 43 to 59 years, where it increased slightly. Additionally, there was an age-related decline in TFQIFT4 levels in both women and men at ages &amp;lt; 50 and &amp;lt; 53, respectively, but a marked increase after that. Lower TSH levels were significantly associated with a higher prevalence and lower odds of having fewer TNs using multiple nodules as the base category in both men and women (both P for trend &amp;lt; 0.05). Additionally, lower TFQIFT3 and TFQIFT4 levels were significantly associated with a higher prevalence of TNs in women (both P for trend &amp;lt; 0.05), and lower TFQIFT3 levels were significantly associated with a higher prevalence of TNs in men. Both higher TFQIFT3 and TFQIFT4 levels were significantly associated with higher odds of having fewer TNs using multiple nodules as the base category in women. However, the relationships between TFQIFT4 and the prevalence or number of TNs in men were not found.ConclusionsThe trends of THs, TSH, TFQIFT4, and TFQIFT3 at different ages were sex-dependent. Both TFQIFT4 and TFQIFT3 levels were negatively associated with the prevalence and number of TNs in women. The present results may lead to a better understanding of the sex-specific relationships between the development of the pituitary-TH axis and the formation of TNs.

Impact of deep learning image reconstruction on volumetric accuracy and image quality of pulmonary nodules with different morphologies in low-dose CT

BackgroundThis study systematically compares the impact of innovative deep learning image reconstruction (DLIR, TrueFidelity) to conventionally used iterative reconstruction (IR) on nodule volumetry and subjective image quality (IQ) at highly reduced radiation doses. This is essential in the context of low-dose CT lung cancer screening where accurate volumetry and characterization of pulmonary nodules in repeated CT scanning are indispensable.Materials and methodsA standardized CT dataset was established using an anthropomorphic chest phantom (Lungman, Kyoto Kaguku Inc., Kyoto, Japan) containing a set of 3D-printed lung nodules including six diameters (4 to 9 mm) and three morphology classes (lobular, spiculated, smooth), with an established ground truth. Images were acquired at varying radiation doses (6.04, 3.03, 1.54, 0.77, 0.41 and 0.20 mGy) and reconstructed with combinations of reconstruction kernels (soft and hard kernel) and reconstruction algorithms (ASIR-V and DLIR at low, medium and high strength). Semi-automatic volumetry measurements and subjective image quality scores recorded by five radiologists were analyzed with multiple linear regression and mixed-effect ordinal logistic regression models.ResultsVolumetric errors of nodules imaged with DLIR are up to 50% lower compared to ASIR-V, especially at radiation doses below 1 mGy and when reconstructed with a hard kernel. Also, across all nodule diameters and morphologies, volumetric errors are commonly lower with DLIR. Furthermore, DLIR renders higher subjective IQ, especially at the sub-mGy doses. Radiologists were up to nine times more likely to score the highest IQ-score to these images compared to those reconstructed with ASIR-V. Lung nodules with irregular margins and small diameters also had an increased likelihood (up to five times more likely) to be ascribed the best IQ scores when reconstructed with DLIR.ConclusionWe observed that DLIR performs as good as or even outperforms conventionally used reconstruction algorithms in terms of volumetric accuracy and subjective IQ of nodules in an anthropomorphic chest phantom. As such, DLIR potentially allows to lower the radiation dose to participants of lung cancer screening without compromising accurate measurement and characterization of lung nodules.

Study on Consumers’ Perceived Benefits and Risks of Smart Energy System

This study explores consumer perceptions of smart energy systems, delving into both the perceived benefits and risks associated with their adoption and usage. This study addresses a crucial gap in understanding the consumer side of smart energy system implementation. Through ordinal logistic regression analysis, the study examines the relationship between various independent variables and an ordinal dependent variable represented on a Likert scale. The findings highlight a significant consumer emphasis on 'Safe Energy System Construction' and 'Economic Benefits,' including 'Home Energy Saving' and 'New Profit Creation.' However, the perceived benefits and risks are influenced by these factors and individual propensities, such as sensitivity to environmental destruction and acceptance of new technology. The study uncovers new areas of concern, exceptionally high energy consumption and the 'Uncertainty of Electricity Rates,' which have not been extensively addressed in previous research. The conclusions drawn from this study suggest a need for balanced policy-making that fosters technological advancement while addressing consumer apprehensions about energy consumption, rate volatility, and privacy. This study contributes to the broader discourse on technology acceptance and the sustainable implementation of smart energy solutions by providing a nuanced understanding of consumer perceptions in the evolving landscape of smart energy systems.

Impacts of Streetscape Features on Individual Social Capital: Applying Korea’s Neighborhood Data to Street View Images to Improve Lives of the Socially Vulnerable

Neighborhood social vulnerability is a dimension of vulnerability that influences society’s response to external factors, encompassing various social factors tied to socioeconomic and demographic attributes at the neighborhood level. While previous studies have explored the associations between vulnerable neighborhoods and stressors like environmental hazards, understanding of their impact on residents’ social capital remains limited. Moreover, the role of built environments in mitigating these effects is uncertain. This study investigates the impact of neighborhood social vulnerability, alongside streetscape features, on individual social capital in Seoul, South Korea. Using a stratified random sampling method, we surveyed 1000 Seoul residents, assessing their social capital and demographics. In particular, six questionnaires based on a four-point Likert scale were used to measure the individual level of social capital: two questions for social networks, three questions for social participation, and one question for sense of community. Additionally, we employed a deep learning-based model to analyze Google Street View images for detailed streetscape features. Our analysis, utilizing multiple and ordinal logistic regression models, reveals that walkable environments and neighborhood prosperity, indicated by factors like income, education, and street greenery, are linked to higher social capital. Moreover, less urbanized areas with lower land prices and greater openness to the sky also show positive associations. These findings underscore the potential of improving streetscape features to mitigate the negative impacts of neighborhood vulnerability, particularly in neighborhoods where low-income and less-educated residents are concentrated, offering insights for urban planners and community leaders.

Determinants of depressive and alcohol use disorders among female sex workers in Ethiopia: evidence from a national bio-behavioral survey, 2020

BackgroundFemale sex workers (FSWs) face an elevated risk of developing mental health disorders and alcohol use disorders (AUD), which in turn increase their vulnerability to HIV and other sexually transmitted infections (STIs) and other negative outcomes. To effectively address both of these health issues, it is crucial to understand the shared key determinants underlying these illnesses, which is a substantial knowledge gap in Ethiopia and elsewhere in the world. Therefore, this study aimed to identify the common key determinants of depression and AUD among FSWs in Ethiopia using a bivariate multivariable ordinal logistic model.MethodsWe analyzed cross-sectional biobehavioral data collected in 2020 from 16 cities and major towns in Ethiopia using the respondent-driven sampling (RDS) technique, which involved a total of 6,085 FSWs. FSWs who had lived at the study sites for at least a month before the study period were deemed eligible for recruitment. Major depressive disorder (DD) and AUD were screened using the Patient Health Questionnaire (PHQ9) and alcohol use disorder identification test (AUDIT), respectively. We used descriptive statistics to summarize study population characteristics and bivariate multivariable ordinal logistic regression (BMOLR) to identify common determinants of DD and AUD combined and their nonnormal correlation.ResultsAmong 6085 FSWs screened for DD and AUD, 13.5% and 4.0% have met the criteria for moderate and severe depressive disorder, respectively, and 20.3% and 34.7% have met the AUDIT criteria for harmful or hazardous behavior and alcohol dependence, respectively. FSW with experience of inconsistent condom use, condom failure, violence, mobility, use of any drugs, non-paying partners, abortion, and selling sex for more than five years were associated with an increase in the severity of both disorders. A high average income from selling sex and the number of paying partners reduced the severity of depression and increased the level of alcohol dependence. Being HIV positive and ever having anal sex were associated only with an increase in depression.ConclusionMajor DD and AUD are prevalent among FSWs in Ethiopia. The findings revealed that common key determinants, which exacerbated the severity of both disorders, were also risk factors for HIV and other STIs. Consequently, integrated STI strategies are essential in the screening, referral, and treatment of depression and AUD. Intervention packages should encompass determinants of depression and AUD, including condom utilization, drug use, mobility between towns, abortion, violence, and counseling services. Additionally, strategies to ensure economic security should be incorporated.

Determinants of nutritional status of children aged 6–59 months in the case of Itang special woreda, Gambella, Ethiopia

Nutritional status is one of the most important causes of improper physical and mental development in children. The study attempts to assess the factors affecting the severity status of children aged 6–59 months’ malnutrition based on the weight-for-age anthropometric index (z-score) and examine between-kebeles-level differences in determinants of the nutritional status of children. A community-based, cross-sectional study design was conducted from October 12 to November 12, 2022. A sample of 397 children aged 6–59 months primary data by applying multi–stage clustered sampling technique was used by considering their heterogeneity. The data were entered by SPSS and analyzed by using R version 3.4.0 and STATA 14.2 statistical software package using a multilevel ordinal logistic regression model and inferences were conducted at a 5% significance level. The results show that birth interval ≥ 24 months (OR = 1.431253, 95% CI 1.221337 1.6763421, P-value = 0.008), economic status of households medium (OR = 16.21466, 95% CI 1.221403 1.423929, P-value = 0.000), economic status of households rich (OR = 223.2856, 95% CI 1.34295 2.582325, P-value = 0.000), employment status of the mother unemployed (OR = 0.2291348, 95% CI 0.0529511 0.9966281, P-value = 0.049), No toilet facility (bush field) (OR = 0.3163329, 95% CI 0.1825356 0.5481975, P-value = 0.000), number of household members (OR = 0.9100682, 95% CI 0.8313481 0.9967315, P-value = 0.042), breastfeeding < 12 months (OR = 0.53803, 95% CI 0.322315 0.898135, P-value = 0.018), educational level of father Primary (OR = 4.601687, 95% CI 1.758009 2.22053, P-value = 0.000), educational level of father Secondary above (OR = 99.65229, 95% CI 2.533502 4.788896, P-value = 0.000) and geographical area (kebeles) were found to be important factors that affect a child's nutritional status between 6 and 59 months. 15% of the overall variation is attributable to the Kebeles level, according to two-level multilevel ordinal logistic regressions with estimates of the variation attributable to the Kebeles level equal to 0.569 and an intraclass correlation coefficient of 0.15. Due to the nature of the response variable random intercept model with random coefficients fitted the data adequately in predicting the severity status of children aged 6–59 months’ malnutrition for the multilevel ordinal logistic regression model analysis. So, the researcher recommended that implementing primary health care and nutrition programs that would fit each kebeles’ features in Itang Special Woreda to safeguard children from nutritional deficiency.

Assessment of the Quality of Sinus Elevation with Lateral Window Approach Procedure Videos on YouTube: A Content-quality Analysis.

Although the lateral window approach allows for greater graft material delivery and bone formation, it is more challenging and invasive, prompting keen interest among dentists to master this method. YouTube is increasingly used for medical training; however, concerns regarding the quality of instructional videos exist. This study proposes new criteria for evaluating YouTube videos on maxillary sinus elevation with the aim of establishing standards for assessing instructional content in the field. We sourced 100 maxillary sinus elevation videos from YouTube and, following exclusion criteria, analyzed 65 remaining videos. The video characteristics, content quality, and newly developed criteria were evaluated. Statistical analyses, employing ordinal logistic regression, identified the factors influencing the quality of instructional videos and evaluated the significance of our new criteria. Although video interaction and view rate exhibited positive relations to content quality, they were not significant (P=0.818 and 0.826, respectively). Notably, videos of fair and poor quality showed a significant negative relation (P<0.001). Audio commentary, written commentary, and descriptions of preoperative data displayed positive but statistically insignificant relationships (P=0.088, 0.228, and 0.612, respectively). The comparison of video evaluation results based on the developed criteria with content quality scores revealed significant negative relationships for good, fair, and poor videos (P<0.001, Exp(B)=-4.306, -7.853, -10.722, respectively). Among the various video characteristics, only image quality showed a significant relationship with content quality. Importantly, our newly developed criteria demonstrated a significant relationship with video content quality, providing valuable insights for assessing instructional videos on maxillary sinus elevation and laying the foundation for robust standards.

Country Differences in Older Men's Hearing Difficulty Disadvantage.

Objectives: Hearing difficulty is prevalent in older adulthood and projected to increase via global aging, particularly among men. Currently, there is limited research on how this gender disparity might vary by country. Methods: Using 2018 data (n = 29,480) from the Health and Retirement Study (HRS) international family of studies, we investigate gender disparities in hearing difficulty among respondents ages 55-89 from the United States (n = 12,566), Mexico (n = 10,762), and Korea (n = 6152) with country-specific ordinal logistic regression models that progressively adjust for demographic, social, and health indicators. Results: In the United States, men's hearing difficulty disadvantage was consistently observed. In Mexico, men's hearing difficulty disadvantage was explained by the interactive effect of gender and age group but resurfaced after adjusting for comorbidities. In Korea, there was consistently no gender difference in hearing difficulty. Discussion: Our results highlight the heterogeneity in older men's hearing difficulty disadvantage among a diverse group of aging countries.

Determinants of public-private partnership governance structures: evidence from India

ABSTRACT Public-private partnerships (PPPs) represent a continuum of governance structures characterized by wide variability in private sector risk transfer. Despite the widespread adoption of PPPs, few studies examine the reasons for such heterogeneity. We investigate the factors explaining variability across PPP governance structures and their impact on the extent of private sector risk transfer using ordinal logistic regression on a novel dataset of 2330 Indian PPP projects. We find that the risk transfer is mainly driven by economic and fiscal factors, service-specific transaction costs and project-specific factors, while political factors and institutional quality barely influence it.

Modelling Consumers’ Preferences for Time-Slot Based Home Delivery of Goods Bought Online: An Empirical Study in Christchurch

Due to the remarkable growth in online retail sales in New Zealand, a large number of parcels are needed to be delivered to consumers’ doorsteps. Home deliveries in major New Zealand cities (e.g., Christchurch) typically occur between 9 a.m. and 6 p.m. on weekdays, when many home delivery attempts fail. This leads to adverse effects, such as vehicular traffic in residential areas and greater air pollution per parcel delivered. However, home deliveries outside of typical business hours (i.e., before 9 a.m. and after 5 p.m.) might be worthwhile to help subside the above issues. Therefore, this study investigated consumers’ preferences for receiving home deliveries during various times, such as early morning, morning, afternoon, late afternoon, and evening. The data used in this study were obtained via an online survey of 355 residents of Christchurch city. Non-parametric tests, namely the Friedman test, Wilcoxon signed-rank test, and ordinal logistic regression, were carried out to examine consumer preferences for the above time slots. The results showed that consumers preferred the late afternoon (3 p.m. to 6 p.m.) time slot the most for receiving home deliveries. It appeared that the off-peak delivery option is less likely to draw the desired consumer patronage and is thus less likely to assist in lowering the number of unsuccessful home deliveries, the transportation costs incurred by service providers, traffic congestion, and pollution in urban areas.

177 Modulation of fecal microbiome by phytogenics, a postbiotic, and mix of organic acids with essential oils in weaned pigs subjected to F18 Escherichia coli challenge

Abstract This study evaluated the effects of bioactive feed ingredients on fecal microbiome of weaned pigs subjected to F18 enterotoxigenic Escherichia coli (ETEC) challenge. Two blocks of weaned pigs [n = 72; Yorkshire/Landrace/Duroc; initial body weight (BW) = 6.62 ± 1.37 kg] were balanced by gender and litter and randomly allocated to one of the six treatments with 12 pens/block and 6 pigs/pen. Treatments included: 1) basal diet (NC), 2) NC + 0.1% phytogenic (Fresta Protect, Delacon, Austria; PFP), 3) NC + 0.2% postbiotic (Dia-V Nursery, Diamond V, IA; PB), 4) NC + 0.2% new phytogenic prototype (Delacon, Austria; NPP), 5) NC + 0.2% organic acid and essential oil blend (OA+EO), and 6) NC + 0.1% phytogenic (Fresta Protect) + 0.2% postbiotic (Dia-V Nursery; PFP+PB). The trial lasted 15 d, with a 7-d pre-challenge and 8-d post-challenge periods. Pigs were orally inoculated with 5 x 1010 CFU/mL of F18 ETEC (O147:H2, LT:STb:STa:Stx2:F18) on d 8 and 9 of study after 5-h fasting. Fecal swabs were collected before challenge (d 8) and 3- and 8-d post-challenge (d 10 and 15 of study) and subjected to shotgun metagenomics. Diarrhea score and E. coli shedding (CFU/mL) were monitored daily and analyzed using a multi-level mixed effect ordinal logistic regression with block and pen as random effects. Microbiome data were center-log-ratio transformed and analyzed for diversity, abundance, and interaction networks. At 3-d post-challenge, the OA+EO, PFP+PB and NPP supplemented pigs had reduced (P &amp;lt; 0.001) E. coli shedding compared with NC. Diarrhea score tended to be less (P = 0.054) in PFP+PB fed pigs 5-d post-challenge and was less (P = 0.02) in PFP+PB, OA+EO, and NPP 6-d post-challenge than NC. Alpha-diversity declined (P &amp;lt; 0.01) 3-d post-challenge with most reduction in PFP and OA+EO but recovered 8-d post-challenge except for PFP and OA+EO (P &amp;lt; 0.01). At the baseline and 8-d post-challenge, the largest number of differentially abundant taxa (P &amp;lt; 0.05) were observed in PFP+PB compared with NC. The PFP+PB reduced the abundances of Escherichia.sp000208585 and Campylobacter.P585 which were negatively correlated (P &amp;lt; 0.01) with average daily gain (ADG) and BW, and positively correlated (P &amp;lt; 0.01) with diarrhea score and E. coli shedding. The PFP+PB increased beneficial species including Prevotella.sp900543585, Mitsuokella jalaludinii, and Faecalibacterium prausnitzii with the first two positively correlated (P &amp;lt; 0.01) with ADG and BW, and negatively correlated (P &amp;lt; 0.01) with diarrhea score and E. coli shedding. By d-8 post-challenge, PFP+PB microbial network had the highest degree of negative connections suggestive of a more competitive microbial ecosystem against opportunistic microorganisms compared with NC. In conclusion, co-supplementation of Fresta Protect phytogenic and postbiotic promoted a microbiome with greater beneficial and reduced detrimental bacteria resulting in low diarrhea score post-challenge.