Propensity Score Matching Model Research Articles

Racial Disparities in Nasopharyngeal Carcinoma Characteristics and Survival

Objective: To investigate and compare the distribution of histological subtypes, stage at presentation, and survival outcomes among Chinese American, Non-Hispanic White, and African American patients with nasopharyngeal carcinoma (NPC). Materials and methods: We identified Chinese American, Non-Hispanic White, and African American patients with NPC who were diagnosed between 2010 and 2017. Statistical analyses were conducted using the chi-square test, propensity score matching, Kaplan-Meier analysis, and multivariate Cox proportional hazards models. Results: A total of 1646 eligible patients with NPC were included. Non-Hispanic White accounted for 1049 (63.7%), African Americans for 265 (16.1%), and Chinese Americans for 332 (20.2%), and their median age at diagnosis was 59, 55, and 53 years, respectively ( P < .001). Chinese Americans most frequently harbored undifferentiated non-keratinizing squamous cell carcinoma subtype (n = 134, 40.4%) than Non-Hispanic White (n = 164, 15.6%) or African American patients (n = 44, 16.7%) ( P < .001). Histological subtype distribution was similar between Non-Hispanic White and African American patients ( P = .338). African American patients had the highest rate of stage III to IV disease (n = 206, 77.7%) compared to Non-Hispanic White (n = 704, 67.1%) and Chinese American patients (n = 210, 63.2%) ( P = .009). No significant difference in stage distribution was observed between Chinese American and Non-Hispanic White patients ( P = .494). Non-Hispanic White patients [hazard ratio (HR) 1.344, 95% confidence interval (CI) 1.007-1.479, P = .045] and African American patients (HR 2.314, 95% CI 1.405-3.813, P < .001) had significantly worse overall survival compared to Chinese American patients. However, race was not associated with NPC-specific survival in the multivariate analysis. Similar results were found after propensity score matching. Conclusions: Race influences the distribution of histological subtypes, stage at presentation, and survival outcomes in NPC.

Peer effects affect the adaptation behaviour of rural residents to geohazards in China: a new policy pathway

ABSTRACT Disaster prevention and mitigation (DPM) is one of the responses to extreme climate change impacts and depends on the adoption of risk adaptation behaviour by rural residents. While residents exhibit a high willingness to adapt, they also show low behaviour with reference to DPM. While adaptation behaviour of individuals has been studied extensively, the mutual impact of adaptation behaviour among residents has so far been neglected in the literature. Evaluating this interaction could serve as an important foundation for refining disaster reduction policies. Drawing on social cognitive theory, we propose a novel theoretical framework to analyze peer effects on individual decision-making in DPM. Using data gathered from 536 respondents in Sichuan Province, China, this paper adopts the Bayes Markov chain Monte Carlo estimation method to perform a regression of the spatial probit model. Further, the propensity score matching model was used to explore peer effects on the transformation between residents’ willingness to actual behaviour. Results indicate significant and robust peer effects on DPM behaviour among residents. A heterogeneity test indicated that peer effects are predominantly observed among residents with low and medium social status perception and not in those with high social status perception. Peer effects have a significant and positive influence on the transformation from residents’ willingness to their behaviour. Residents are not completely independent in their decision-making, and complex social mechanisms dictate rational and irrational choices of behaviour. Therefore, it is necessary to fully consider positive peer effects on residents in the formulation of policies. Key policy insights Focusing on the adaptation behaviours and peer effects of rural residents is conducive to improving the public's acceptance of disaster reduction policies. It is difficult for homogenization policies to accurately meet the needs of rural residents in China, and the response to geohazard events requires diversified local policies. Through peer effect, the government can create a kind of environmental soft pressure and promote the transformation of residents’ willingness into behaviour. Due to peer effects, the government can utilize the leading role of a small number of target groups to reduce the cost of implementing disaster reduction policies.

Does Central Bank Transparency Matter for Inflation: Role of Inflation Targeting

This paper examines the relationship between central bank transparency and inflation for six inflation targeting (IT) and ten non-inflation targeting (non-IT) Asian economies. The propensity score matching and panel regression model are employed in the study. The empirical analysis shows that IT enhances central bank transparency. Further, we find that central bank transparency in IT significantly lowers inflation, suggesting that countries promoting greater monetary policy transparency can have a better advantage of experiencing low inflation. Our findings have policy implications for central banks in developing economies that are grappling with low transparency.

Can socialised agricultural services balance equity and efficiency? Analysis from the perspective of government-market relationships

ABSTRACT Socialized agricultural services (SASs) are becoming increasingly popular in developing countries to address future farming challenges. In China, there is an ongoing debate in the academic community regarding the equity and efficiency issues arising from whether SASs have a ‘smallholder crowding out’ effect. By using data from the 2018 China Labour Force Dynamics Survey, we first investigate the equity problem of SASs using a Logit model and then analyse the efficiency problem of SASs using the propensity score matching model. Specifically, we examine whether smallholder farmers have equal access to SASs when different entities provide services and whether SASs can effectively increase farmer cultivation returns. We find that smallholder farmers have equal access to SASs and that SASs can significantly improve farmer returns on grain production, meaning SASs can balance efficiency and equity. Furthermore, SASs can enhance the efficiency of land resource allocation by accelerating land transfer, leading to increased returns. These findings indicate that China should accelerate the construction of SAS system, improve relevant rules for the SAS market, and support smallholder farmers in adopting SASs.

Comparative effectiveness and safety of direct oral anticoagulants and warfarin in atrial fibrillation patients with dementia.

Developing an effective stroke prevention strategy is crucial for elderly atrial fibrillation (AF) patients with dementia. This is due to the limited and inconsistent evidence available on this topic. In this nationwide, population-based cohort study, we aim to compare the effectiveness and safety of direct oral anticoagulants (DOACs) and warfarin in AF patients with dementia. We identified AF patients with dementia, aged 50 years or older, from Taiwan's National Health Insurance Research Database between 2010 and 2019. The primary outcome was a composite of hospitalizations due to ischemic stroke, acute myocardial infarction, intracranial hemorrhage, or major bleeding, as well as all-cause mortality. We used 1:1 propensity score matching and Cox proportional hazard models to adjust for confounding factors when comparing outcomes between warfarin and DOAC (apixaban, dabigatran, edoxaban, or rivaroxaban) users or warfarin and each individual DOAC. There were 2952 patients in the DOAC-warfarin matched cohort. The apixaban-, dabigatran-, edoxaban-, and rivaroxaban-warfarin matched cohorts had 2346, 2554, 1684, and 2938 patients, respectively. The DOAC group, when compared to warfarin, was associated with a lower risk of both the composite outcome (hazard ratio (HR), 0.81; 95% confidence interval (CI) 0.69-0.95) and ischemic stroke (HR 0.65; 95% CI 0.48-0.87). Apixaban (HR 0.79; 95% CI 0.66-0.94), dabigatran (HR 0.64; 95% CI 0.53-0.77), and rivaroxaban (HR 0.82; 95% CI 0.70-0.97) were also associated with a lower risk of the composite outcome. Compared to warfarin, DOACs, whether as a group or apixaban, dabigatran, or rivaroxaban individually, were associated with a reduced risk of the composite outcome in elderly patients with concurrent AF and dementia.

Graft choice to decrease the revision rate of anterior cruciate ligament reconstruction: a nationwide retrospective cohort study

There are many graft choices for anterior cruciate ligament (ACL) reconstruction, including autografts and allografts. The choice of graft has been identified as a significant factor affecting the outcome of ACL reconstruction. This study aimed to determine whether allograft or autograft is better for avoiding revisional ACL reconstruction. The National Health Insurance Service-Health screening database analyzed 146,122 patients who underwent ACL reconstruction surgery from Jan. 1, 2002, to Dec. 31, 2021. The study was conducted in two groups, autograft or allograft, and the rates of revision ACL reconstruction between the two groups were compared. Propensity score matching and multivariable Cox Proportional Hazard model analysis were used. The significant predictors for complications (p < 0.05) were as follows. The total of patients with ACL reconstruction was 146,122. Allograft was used in 121,148 patients, and autograft was used in 24,974 patients. 9.2% of the allograft group and 8.7% of the autograft group underwent revision ACL reconstruction. (P < .0001) 70.0% & 63.6% of patients underwent revision surgery within 1 year in the allograft & autograft groups, respectively. In summary, using autograft in primary ACL reconstruction is helpful in lowering the rate of revision surgery.

Serum trace elements show association with thyroperoxidase autoantibodies in Thyroid Imaging Reporting and Data System (TI-RADS) 4 nodules

Thyroid nodule (TN) has been becoming a great concern worldwide due to its high incidence. Although some studies have reported associations between trace elements exposure and the risk of TNs, the linkage was not inconclusive. The present study aimed to identify the association of selected serum trace elements (Ca, Mg, V, Fe, Co, Cu, Zn, Se, Mn and Mo) with TNs among general adults. A cross-sectional study was conducted in January 2021 in Chengdu, China. 1282 subjects completed the questionnaire and gave at least one human biological material after an overnight fast, venous blood, and urine, including 377 TN participants defined through ultrasound. Various trace elements in serum specimens were determined by inductively coupled plasma mass spectrometry. Thyroid functions were tested by chemiluminescent microparticle immunoassay (CMIA). The associations between trace elements levels and the risk of TNs were examined by restricted cubic splines (RCS) regression and bayesian kernel machine regression (BKMR) models. TNs were more common in females (P < 0.001) and in the elderly (P < 0.001) and that they were also frequently associated with fertility, marital status, annual household income, drinking, anxiety, vitamin supplement, tea consumption, hypertension and hyperlipidemia. After adjusting for confounders by a propensity score matching model, the association between trace elements concentrations and TNs risk was found to be statistically insignificant in the RCS (P for nonlinear > 0.05) and BKMR models. FT3 or T4 (total or free) increased significantly with increasing total trace elements mixture levels. In TI-RADS-4 TN subjects, TPO-Ab level increased significantly with increasing total trace elements mixture levels in the high-dose range. Ca, Zn, Mo at their 75th percentile showed positive individual effects on TPO-Ab, which was examined to be interactive. The detection of trace elements for TNs in general adults may be of no significance, but once individuals classified as TI-RADS-4 TNs are detected with abnormal TPO-Ab, Ca, Zn and Mo level are recommended to measure. The substantive association on it still needs to be continuously explored in the future.

Waterpipe smoking is associated with presence and severity of coronary artery disease: a propensity score-matched study

BackgroundThe prevalence of waterpipe smoking (WPS) has been increasing worldwide. This trend is alarming as WPS can negatively impact cardiovascular health. In the present study, we explored the association between WPS and the presence and severity of CAD.MethodsThis study was a retrospective analysis of patients who underwent diagnostic coronary angiography at Tehran Heart Center between April 2021 and May 2022. Patients with a previous history of percutaneous coronary intervention and coronary surgery were excluded. Waterpipe smokers were matched with non-smokers based on age, gender, and cigarette smoking using a 1:4 propensity score matching model. Stenosis ≥ 50% in any coronary artery was considered a CAD diagnosis. Gensini score was also calculated to measure the severity of the CAD.ResultsWe reviewed the medical records of 8699 patients, including 380 waterpipe smokers. After matching, 1520 non-smokers with similar propensity scores to the waterpipe smokers were selected. Waterpipe smokers were more likely to have CAD than non-smokers (OR: 1.29; 95% CI: 1.04–1.60, P = 0.021). In addition, WPS increased the natural logarithm of the Gensini score by 1.24 (95% CI: 1.04–1.48, P = 0.014) in patients with atherosclerotic coronary disease.ConclusionWPS may increase the risk of CAD independent of age, gender, and cigarette smoking. In addition, among patients with any degree of atherosclerosis in coronary arteries (GS > 0), WPS may lead to higher average GS, suggesting more severe atherosclerosis.Graphical

Sustainable potato farming in Shandong Province, China: a comprehensive analysis of organic fertilizer applications

IntroductionThe potato holds the distinction of being the world’s largest non-cereal food crop and ensuring its sustainable production is imperative for global food security. Notably, China leads in both the planting area and output of potatoes globally, cementing its crucial role in the nation’s agricultural economy. A scientific assessment of the effectiveness of organic fertilizers on potato cultivation can significantly contribute to the promotion of sustainable agriculture.MethodsThis study utilizes a Propensity Score Matching (PSM) model and introduces a novel cost-efficiency approach to analyze and evaluate the production efficiency and economic impact of organic fertilizer application among 546 potato growers in Shandong.ResultsThe research findings reveal the following: Firstly, compared to the control group without organic fertilizer application, it is evident that the use of organic fertilizers enhances production technology efficiency, labor productivity, land productivity, and net profit per unit by 3.6%, 1588.47 kg/person, 16346.77 kg/ha, and 16135.32 yuan/ha, respectively. Secondly, an examination of cost efficiency among growers with different production scales indicates that those with a planting scale of 0.667-1.333 hectares demonstrate relatively high production efficiency across multiple factors. Additionally, there is an observable inverted U-shaped trend in the relationship between planting scale and production efficiency. Thirdly, the continuous application of organic fertilizers proves advantageous in mitigating inefficiencies in investment techniques, leading to cost savings and efficiency improvements in potato cultivation.DiscussionConsequently, it is recommended that the government and relevant departments enhance technical support, elevate professional training programs, and optimize the allocation of input factors. These measures aim to encourage farmers to adopt organic fertilizers, thereby promoting sustainable agricultural practices.

Axillary lymph node removal in de novo metastatic breast cancer.

Several prospective studies have found that local surgical resection did not improve the survival of patients with de novo metastatic breast cancer (dnMBC). However, a significant portion of dnMBC patients still undergo local surgery, and the role of axillary lymph node dissection (ALND) in dnMBC patients remains unclear. This study aimed to investigate the effect of ALND in patients with dnMBC. We included patients diagnosed with dnMBC between 2010 and 2020 using the data from the Surveillance, Epidemiology, and End Results program. The Chi-square test, binomial logistic regression, propensity score matching (PSM), Kaplan-Meier method, and multivariate Cox proportional models were employed for statistical analysis. A total of 6,838 patients were identified, with 5,562 (81.3%) in the ALND group and 1,276 (18.7%) in the non-ALND group. Being diagnosed in later years emerged as an independent predictive factor related to the receipt of ALND (P=0.003). Before PSM, the 5-year breast cancer-specific survival (BCSS) was 51.1% and 38.2% in those with and without ALND, respectively (P<0.001). The 5-year overall survival (OS) was 45.9% and 32.3% in those with and without ALND, respectively (P<0.001). ALND was identified as an independent prognostic factor related to better BCSS (P<0.001) and OS (P<0.001) compared to the non-ALND group. Similar findings were observed after PSM. The outcomes were significantly better in the ALND group than in the non-ALND group in most subgroups. However, the number of removed lymph nodes did not show a significant association with BCSS (P=0.27) and OS (P=0.29). Our study suggests that ALND is associated with improved survival outcomes in dnMBC patients. These findings advocate for a re-evaluation of the role of surgical interventions in dnMBC, emphasizing the need for personalized treatment strategies that consider the potential benefits of ALND.

Determinants of adoption of urban agriculture (UA) as climate-smart agriculture (CSA) practices and its impact on food security: evidence from Wolaita Sodo city, South Ethiopia

BackgroundClimate change is one of humanity's biggest problems. CSA offers a once-in-a-lifetime chance to adapt to global climate change and reduce greenhouse gas emissions. UA can improve food security by providing affordable, nutritious alternatives to commercially produced food, especially for economically disadvantaged people. This study examined the factors influencing the adoption of UA as CSA practices, as well as their effects on food security in Wolaita Sodo City, South Ethiopia.MethodsData was collected from primary and secondary sources, both qualitative and quantitative form. A structured and semi-structured questionnaire was used to gather data from 384 randomly chosen urban households through surveys/interviews, focus group conversations, and observation. The percentage and mean differences between UA adopters and non-adopters were calculated using the chi-square test and t-test. A propensity score matching (PSM) model assessed UA's impact on food security. A binary logistic regression model was used to determine factors influencing adoption of UA as CSA practice in the study area.ResultsThe descriptive analysis showed that 53.53% of respondents used UA. Statistics showed the existence of a significant mean differences between adopters and non-adopters in employment level, UA attitudes, and household size. Logit model computations showed that family size, home ownership, the household head's occupation, perceptions of UA, market demand, and access to training and support influenced UA adoption as a climate-smart farming practice.ConclusionsAs per the study's findings, there could be a correlation between specific factors and the adoption of UA as CSA in the studied area. The PSM study confirmed that UA deployment significantly improves food security. UA adoption increased food security by 0.685-fold. The report recommends that municipal education offices, UA offices, and cooperative offices create an integrated functional adult education programme for urbanites. Since UA is vital to fighting food insecurity, it suggests increasing support for cooperative entities.

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.

Acetate-containing bicarbonate dialysate increases all-cause mortality more than acetate-free bicarbonate dialysate containing citrate in hemodialysis patients

BackgroundNo studies have compared mortality between acetate-containing bicarbonate dialysate (ABD) and acetate-free bicarbonate dialysate containing citrate (AFD) in hemodialysis (HD) or online hemodiafiltration (OHDF). We therefore compared mortality between ABD and AFD in each modality.MethodsThis retrospective observational study included 738 patients who were receiving super high-flux (SHF) or SHF albumin-leaking HD (n = 310: ABD 235 and AFD 75) or OHDF (n = 428: ABD 321 and AFD 107) at our institution between 1 April and 1 July 2017. Three-year all-cause mortality was compared between ABD and AFD in the HD or OHDF groups using a propensity score matching model. Kaplan–Meier survival curves were compared using the log-rank test, and then Cox regression analysis with adjustments was performed for some covariates that remained significant.ResultsAfter propensity score matching, mortality on ABD was not significantly different from that on AFD in the HD group [n = 75; hazard ratio (HR) 2.271, 95% confidence interval (CI) 0.863–5.981, P = 0.087] or in the OHDF group (n = 107; HR 1.944, 95% CI 0.585–6.458, P = 0.269) without adjustments. However, with adjustments using some covariates, mortality was significantly higher on ABD than on AFD (adjusted HR 4.501, 95% CI 1.434–14.125, P = 0.010) in the HD group, but not in the OHDF group.ConclusionsThese findings suggest that ABD worsens mortality more than AFD in patients on SHF and SHF albumin-leaking HD.Trial registration: UMIN Clinical Trials Registry, UMIN000053090. Prospectively registered 13 December 2023, https://center6.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000060581.

Effect of Online Clinic on Follow-Up Compliance and Survival Outcomes in Nasopharyngeal Carcinoma: Real-World Cohort Study from Endemic Area.

Nasopharyngeal carcinoma (NPC) requires regular follow-up to detect recurrence as early as possible. However, many patients are unable to regularly follow up due to the inconvenience of the conventional approach. Therefore, this study was designed to investigate the impact of the online clinic on follow-up compliance and prognosis in NPC patients. Patients who were first diagnosed with NPC between April 2019 and November 2019 were enrolled. Good follow-up compliance was defined as having at least one follow-up visit every 6 months within 2 years after treatment completion. Sensitivity analyses were performed using a propensity score matching model. A total of 539 (42%) patients used online follow-up while 731 (58%) used traditional follow-up. The median age of patients in the online cohort was lower than that in the traditional cohort (44 vs. 47, p < 0.001). Compared with the traditional cohort, the online cohort had significantly better follow-up compliance (57.3% vs. 17.1%, p < 0.001) and a higher 2-year PFS rate (98.1% vs. 94.4%, p = 0.003). Survival analysis showed that online follow-up was an independent factor for better survival prognosis (HR 0.39, 95%CI 0.20-0.74, p = 0.004). Sensitivity analysis further confirmed these results. Our study found that the online clinic increased follow-up compliance and improved prognosis in NPC patients.

Immediate application of frozen-thawed embryo transfer cycle in month following COVID-19 recovery does not impair ongoing pregnancy outcome.

To investigate whether immediate frozen-thawed embryo transfer (FET) in the next month following coronavirus disease 2019 (COVID-19) recovery affects ongoing pregnancy outcome. This was a retrospective cohort study carried out at a university-affiliated reproductive medicine center. The study group (post-COVID-19 group) comprised women who were affected by COVID-19 in December 2022 and immediately underwent FET in January 2023 after recovery, with transferred embryos not exposed to the infection. The control group comprised women treated during the pre-COVID-19 period (January 2019). Multivariable logistic regression analysis and a propensity score matching (PSM) approach were used to control for potential confounders and selection bias. A total of 200 women were included in the post-COVID-19 group and 641 women were enrolled in the control group. The rate of ongoing pregnancy was comparable between the study cohorts in both the unadjusted and confounder-adjusted logistic regression models. Other reproductive outcomes, including the odds of a positive pregnancy test, implantation, clinical pregnancy and early pregnancy loss, were similar between the comparison groups. PSM models further confirmed the lack of significant differences in pregnancy outcome between the post-COVID-19 group and the control group. Among patients affected by COVID-19 for whom the transferred embryos were generated prior to infection, an immediate FET cycle in the next month after recovery does not seem to compromise ongoing pregnancy outcome. Thus, women who have frozen embryos from preinfection cycles should be counseled and encouraged to undergo FET as soon as possible after COVID-19 recovery. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Application of Machine Learning Algorithms to Analyze the Clinical Characteristics of NIHL Caused by Impulse Noise and Steady Noise.

Occupational hearing loss of workers exposed to impulse noise and workers exposed to steady noise for a long time may have different clinical characteristics. As of May 2019, all 92 servicemen working in a weapon experimental field exposed to impulse noise for over 1 year were collected as the impulse noise group. As of Dec 2019, all 78 servicemen working in an engine working experimental field exposed to steady noise for over 1 year were collected as the steady noise group. The propensity score matching (PSM) model was used to eliminate the imbalance of age and working time between the two groups of subjects. After propensity score matching, 51 subjects in each group were finally included in the study. The machine learning model is constructed according to pure tone auditory threshold, and the performance of the machine learning model is evaluated by accuracy, sensitivity, specificity, and AUC. Subjects in the impulse noise group and the steady noise group had significant hearing loss at high frequencies. The hearing of the steady noise group was worse than that of the impulse noise group at speech frequency especially at the frequency of 1 kHz. Among machine learning models, XGBoost has the best prediction and classification performance. The pure tone auditory threshold of subjects in both groups decreased and at high frequency. The hearing of the steady noise group at 1 kHz was significantly worse than that of the impulse noise group. XGBoost is the best model to predict the classification of our two groups. Our research can guide the prevention of damage caused by different types of noises.

Neonatal phototherapy and risk of epilepsy—A Danish population based study

To evaluate the risk of epilepsy in children who received neonatal phototherapy. A cohort of live singletons born at a Danish hospital (2002–2016) with a gestational age ≥ 35 weeks. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of epilepsy in children treated with neonatal phototherapy compared to children not treated with neonatal phototherapy in the general population, and in a subpopulation of children who had serum bilirubin measurement. Adjusted HRs (aHR) were computed using multivariable and propensity score matching models to take maternal and neonatal factors into consideration. Children were followed from day 29 after birth to diagnosis of epilepsy, death, emigration, or December 31, 2016. Among 65,365 children, 958 (1.5%) received neonatal phototherapy. Seven children (incidence rates (IRs): 10.8 /10,000 person-years) who received neonatal phototherapy and 354 children (IR: 7.7) who did not receive neonatal phototherapy were diagnosed with epilepsy. Neonatal phototherapy was not associated with an increased risk of epilepsy using the multivariable (aHR 0.95, 95% CI: 0.43–2.09) and propensity score matched (aHR 0.94, 95% CI: 0.39–2.28) models. In the subpopulation of 9,378 children with bilirubin measurement, 928 (9.9%) received neonatal phototherapy. In the analysis of the subpopulation in which bilirubin level and age at the time of bilirubin measurement were further taking into consideration, neonatal phototherapy was not associated with an increased risk of epilepsy using the multivariable (aHR 1.26, 95% CI: 0.54–2.97) and propensity score matched (aHR 1.24, 95% CI: 0.47–3.25) models,Conclusions: Neonatal phototherapy was not associated with an increased risk of epilepsy after taking maternal and neonatal factors into consideration.What is known:• A few studies have suggested that neonatal phototherapy for hyperbilirubinemia may increase the risk of childhood epilepsy.• Whether the observed associations contribute to hyperbilirubinemia, phototherapy, or underlying factors requires further investigation.What is new:• This study revealed no increased risk of epilepsy in children treated with neonatal phototherapy compared to children not treated with phototherapy after taking maternal and neonatal factors into consideration.• After further taking bilirubin level and age at the time of bilirubin measurement into consideration, neonatal phototherapy was not associated with an increased risk of epilepsy.

P-134 Fatty acid supplementation during warming improves pregnancy outcomes after frozen blastocyst transfers: a propensity score-matched study

Abstract Study question Does warming with fatty acids (FAs) affect the viability of human blastocysts and pregnancy outcomes after a single vitrified-warmed blastocyst transfer (SVBT)? Summary answer FA-supplemented warming solutions promoted the blastocyst outgrowth by decreasing the degeneration of trophoblast cells and improved pregnancy outcomes after SVBTs. What is known already Vitrification is considered a well-established technique and has been used worldwide. However, previous studies demonstrated the detrimental effects of vitrification on pre-implantation development and term pregnancy in oocytes and embryos. Vitrification reduces the intracellular lipid content and decreases the competence for pre-implantation development. The FA supplementation into the warming solution restores the lipid content in the ooplasm and improves developmental competence by promoting the β-oxidation pathway in mice. Although, in humans, the FA-supplemented warming solutions reportedly improved pregnancy outcomes after vitrified-warmed cleavage-stage embryo transfers, the effectiveness of these solutions on blastocyst warming remain unclear. Study design, size, duration The experimental study included 401 discarded blastocysts. The blastocysts were warmed using the FA-supplemented (FA group) or non-supplemented (control group) solutions. The blastocyst adhesion, outgrowth area, and incidence of outgrowth degeneration were assessed. The retrospective cohort study included 4,426 treatment cycles from 4,426 women who underwent SVBTs between January 2023 and August 2023 (January–May 2023, control group; June–August 2023, FA group). Pregnancy outcomes were compared statistically between the groups. Participants/materials, setting, methods The implantation competence was experimentally examined using an outgrowth model. The blastocysts were placed on fibronectin-coated dishes and cultured for 96 hours. The embryos were designated as degenerated when the outgrowth area decreased by &amp;gt; 10%, compared with the maximum area. For the clinical study, multiple covariates that affected the outcomes were used for propensity score matching. The patients in the FA group were matched with controls using a propensity score in a 1:1 ratio. Main results and the role of chance The adhesion rate after the outgrowth culture was comparable between the control and FA groups. However, the outgrowth was larger in the FA group than in the control group. The multivariate linear regression analysis also demonstrated similar results. Furthermore, the incidence of outgrowth degeneration was significantly decreased in the FA group. Furthermore, the subgroup analyses revealed that FA-supplemented warming solutions were effective in blastocysts donated from young patients, day 5 blastocysts, and morphologically good blastocysts. For the retrospective cohort study, the implantation, clinical pregnancy, and ongoing pregnancy rates were significantly higher in the FA group than in the control group. The multivariate logistic regression analysis also demonstrated that warming with FA-supplemented solutions significantly increased the probability of ongoing pregnancies. However, the rates of early pregnancy loss and miscarriage in the first trimester were comparable between the groups. The subgroup analyses demonstrated a similar trend to in vitro experiments; the FA-supplemented solutions were more effective in good prognosis cases (young patients, day 4/5 blastocysts, and morphologically good blastocysts) than in poor prognosis cases (advanced age patients, day 6/7 blastocysts, and morphologically poor blastocysts). Limitations, reasons for caution This was a single-centre, retrospective study, necessitating further multicentre studies to ascertain the generalizability of these findings to other clinics with different protocols and/or patient demographics. Despite using propensity score matching and multivariate models to adjust for the confounders, we cannot adjust for all possible confounders. Wider implications of the findings FA-supplemented warming solutions improved pregnancy outcomes after SVBTs, particularly in patients with a good prognosis. These warming solutions could contribute to maximizing clinical outcomes, shortening treatment periods, and reducing patient burden. Trial registration number not applicable

Transcatheter Versus Surgical Aortic Valve Replacement in Recipients of Solid Organ Transplants and Liver Cirrhosis: A Propensity-Matched Analysis of National Readmission Data

Transcatheter aortic valve replacement (TAVR) continues to grow in the United States. There are limited data on recipients of solid organ transplant (SOT) and patients with liver cirrhosis who undergo aortic valve replacement (AVR). Our study aims to evaluate outcomes in these populations. Using the national readmission database (2016 to 2020), we identified recipients of SOT and patients with liver cirrhosis without previous liver transplants who were admitted for severe aortic stenosis and underwent either TAVR or surgical AVR (SAVR). We used multivariable regression for adjusted analysis and the propensity score matching model, implementing complete Mahalanobis distance matching within the Propensity Score Caliper (0.2) to match TAVR and SAVR cohorts for outcomes. Of 3,394 hospitalizations for AVR in recipients of SOT, 2,181 underwent TAVR, and 1,213 underwent SAVR. On propensity-matched analysis, SAVR was associated with more adverse events than was TAVR, including in-hospital mortality (5.2% vs 1.1%, adjusted odds ratio [aOR] 4.49, p <0.001), acute kidney injury (43.7% vs 10.2%, p <0.001), cardiogenic shock (9.0% vs 1.6%, p <0.001), sudden cardiac arrest (15.9 vs 6.0%, p <0.001), major adverse cardiac and cerebrovascular events (28% vs 10.4%, p <0.001), and net adverse events (72.8 vs 37.6%, p <0.001). A greater median length of stay (10 vs 2 days, p <0.001) and adjusted cost ($80,842 vs $57,014, p <0.001) were also observed. The readmission rates were the same for both cohorts after a 6-month follow-up. Similarly, in 14,763 hospitalizations for AVR in liver cirrhosis, 7,109 patients underwent TAVR, and 7,654 underwent SAVR. In propensity-matched cohorts (n = 2,341), SAVR was found to be associated with greater adverse events, including in-hospital mortality (19.8% vs 10%), stroke (6.7% vs 2%), acute kidney injury (67.7% vs 30.3%), cardiogenic shock (41.9% vs 19.9%), sudden cardiac arrest (31.8% vs 13.2%, aOR 2.89), major adverse cardiac and cerebrovascular events (66.2% vs 35.7%), and net adverse events (86% vs 59.5%) (p <0.001). A greater median length of stay (16 vs 3 days) and cost ($500,218 vs $263,383) were also observed (p <0.001). However, the rate of readmissions at 30-day (9% vs 11.1%) and 180-day intervals (33.4% vs 39.8%) was lower for the SAVR cohort (p <0.05). In recipients of SOT and patients with liver cirrhosis, SAVR is associated with greater short-term mortality, adverse events, and healthcare burden than is TAVR. TAVR is a relatively safer alternative to SAVR in these patient populations, although further studies are warranted to compare the long-term outcomes.

Targeted Poverty Alleviation and Entrepreneurship Among The Poor

ABSTRACT We examine the effect of China’s Targeted Poverty Alleviation (TPA) on the entrepreneurship of poor households and the effect of entrepreneurship on their economic conditions, using data from the China Household Finance Survey conducted between 2013 and 2019 and employing a joint Difference-in-Differences with propensity score matching (PSM-DID) model. TPA significantly increased the probability of poor households’ entrepreneurship, with mechanism analysis indicating that TPA can promote entrepreneurship by providing microcredit to the poor. However, entrepreneurship did not improve their economic conditions and subjective well-being or achieve the ultimate goal of anti-poverty. Thus, entrepreneurship’s role in anti-poverty should be reconsidered.