Propensity Score Matching Model Research Articles

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.

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 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 ≥ 35weeks. 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 withan 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

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.

Metabolic effects and cardiovascular disease risks of antiviral treatments in patients with chronic hepatitis B

AbstractDifferent antiviral treatments for chronic hepatitis B (CHB) have been known to have different metabolic effects. This study aimed to reveal whether tenofovir alafenamide (TAF)‐induced dyslipidemia and its associated outcomes are significant. This study utilized 15‐year historical cohort including patients with CHB in Korea and consisted of two parts: the single‐antiviral and switch‐antiviral cohorts. In the single‐antiviral cohort, patients were divided into four groups (entecavir [ETV]‐only, tenofovir disoproxil fumarate [TDF]‐only, TAF‐only, and non‐antiviral). Propensity score matching (PSM) and linear regression model were sequentially applied to compare metabolic profiles and estimated atherosclerotic cardiovascular disease (ASCVD) risks longitudinally. In the switch‐antiviral cohort, pairwise analyses were conducted in patients who switched NAs to TAF or from TAF. In the single‐antiviral cohort, body weight and statin use showed significant differences between groups before PSM, but well‐balanced after PSM. Changes in total cholesterol were significantly different between groups (−2.57 mg/dL/year in the TDF‐only group and +2.88 mg/dL/year in the TAF‐only group; p = 0.002 and p = 0.02, respectively). In the TDF‐only group, HDL cholesterol decreased as well (−0.55 mg/dL/year; p &lt; 0.001). The TAF‐only group had the greatest increase in ASCVD risk, followed by the TDF‐only group and the non‐antiviral group. In the switch‐antiviral cohort, patients who switched from TDF to TAF had a higher total cholesterol after switching (+9.4 mg/dL/year) than before switching (−1.0 mg/dL/year; p = 0.047). Sensitivity analysis on data with an observation period set to a maximum of 3 years for NA treatment showed consistent results on total cholesterol (−2.96 mg/dL/year in the TDF‐only group and +3.09 mg/dL/year in the TAF‐only group; p = 0.001 and p = 0.005, respectively). Another sensitivity analysis conducted on statin‐treated patients revealed no significant change in cholesterol and ASCVD risk. TAF was associated with increased total cholesterol, whereas TDF was associated with decreased total and HDL cholesterol. Both TAF and TDF were associated with increased ASCVD risks, and statin use might mitigate these risks.

Association between Vitamin D Deficiency and Serologic Response to Hepatitis B Virus Vaccination among Heavy Industry Workers.

Hepatitis B virus (HBV) vaccination has decreased the overall incidence of HBV infection; however, approximately 5 to 10% of people are non-responders to the vaccination. This study investigated the factors associated with non-response to HBV vaccination, with an emphasis on vitamin D deficiency (VDD). This retrospective observational study focused on adult workers in a single heavy industry. Individuals with negative initial hepatitis B surface antibody (anti-HBs) levels prior to vaccination and who then received a two- or three-dose series of HBV vaccinations were enrolled. The study endpoint was failure to achieve a seroprotective antibody response, defined as an anti-HBs titer less than 10 mIU/mL. Propensity score matching (PSM) and binary logistic regression models were used to adjust the outcomes for other clinical characteristics. Among 760 workers, 566 (74.5%) exhibited VDD. The non-response rates to HBV vaccination were 13.4% (76/566) and 5.7% (11/194) among workers with and without VDD, respectively (p = 0.005). Even after adjustment using PSM, VDD was still associated with a higher rate of response failure (adjusted odds ratio 2.74; 95% confidence interval 1.40-5.38, p = 0.003). The binary logistic regression model showed that VDD, older age, omission of the third vaccine dose, lower initial anti-HBs titer, and current smoking were associated with response failure. Our study suggests that VDD may impair the serologic response following HBV vaccination. Further research is needed to evaluate the effectiveness of vitamin D supplementation in increasing the response to HBV vaccination.

Outcomes of vascular closure devices for femoral venous hemostasis following catheter ablation of atrial fibrillation.

Access site complications remain common following atrial fibrillation (AF) catheter ablation. Femoral vascular closure devices (VCDs) reduce time to hemostasis compared with manual compression, although large-scale data comparing clinical outcomes between the two approaches are lacking. Two cohorts of patients undergoing AF ablation were identified from 36 healthcare organizations using a global federated research network (TriNetX): those receiving a VCD for femoral hemostasis, and those not receiving a VCD. A 1:1 propensity score matching (PSM) model based on baseline characteristics was used to create two comparable cohorts. The primary outcome was a composite of all-cause mortality, vascular complications, bleeding events, and need for blood transfusion. Outcomes were assessed during early (within 7 days of ablation) and extended follow-up (within 8-30 days of ablation). After PSM, 28 872 patients were included (14 436 in each cohort). The primary composite outcome occurred less frequently in the VCD cohort during early (1.97% vs. 2.60%, odds ratio (OR) 0.76, 95% confidence interval (CI) 0.65-0.88; p < .001) and extended follow-up (1.15% vs. 1.43%, OR 0.80, 95% CI 0.65-0.98; p = .032). This was driven by a lower rate of vascular complications during early follow-up in the VCD cohort (0.83% vs. 1.26%, OR 0.66, 95% CI 0.52-0.83; p < .001), and fewer bleeding events during early (0.90% vs. 1.23%, OR 0.73, 95% CI 0.58-0.92; p = .007) and extended follow-up (0.36% vs. 0.59%, OR 0.61, 95% CI 0.43-0.86; p = .005). Following AF ablation, femoral venous hemostasis with a VCD was associated with reduced complications compared with hemostasis without a VCD.

Multi-Dimensional Healthy Aging Interventions: Evidence from an Age-Friendly Community Program in Italy

AbstractIn this paper, we evaluate a pre-pandemic multi-dimensional healthy aging program promoted by an Italian private Foundation to provide new insights on interventions that address both health and social needs within an age-friendly community framework. Using propensity score matching and linear regression models, with specific controls for individuals’ self-selection into the program, we compare lifestyles, physical health, mental conditions, and healthy life expectancy of subjects enrolled into the program with those of similar, but non-enrolled, subjects. Our main finding is that, to be more effective, healthy aging interventions should target the key dimensions of aging - physical, mental, and social - in a holistic approach. Indeed, we show that the multi-dimensionality of the healthy aging intervention under study - the contemporaneous target of older adults’ physical, mental, and social health - is crucial in improving both quantity and quality of life.

Ceftazidime/avibactam versus polymyxin B in carbapenem-resistant Klebsiella pneumoniae infections: a propensity score-matched multicenter real-world study.

In this retrospective observational multicenter study, we aimed to assess efficacy and mortality between ceftazidime/avibactam (CAZ/AVI) or polymyxin B (PMB)-based regimens for the treatment of Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections, as well as identify potential risk factors. A total of 276 CRKP-infected patients were enrolled in our study. Binary logistic and Cox regression analysis with a propensity score-matched (PSM) model were performed to identify risk factors for efficacy and mortality. The patient cohort was divided into PMB-based regimen group (n = 98, 35.5%) and CAZ/AVI-based regimen group (n = 178, 64.5%). Compared to the PMB group, the CAZ/AVI group exhibited significantly higher rates of clinical efficacy (71.3% vs. 56.1%; p = 0.011), microbiological clearance (74.7% vs. 41.4%; p < 0.001), and a lower incidence of acute kidney injury (AKI) (13.5% vs. 33.7%; p < 0.001). Binary logistic regression revealed that the treatment duration independently influenced both clinical efficacy and microbiological clearance. Vasoactive drugs, sepsis/septic shock, APACHE II score, and treatment duration were identified as risk factors associated with 30-day all-cause mortality. The CAZ/AVI-based regimen was an independent factor for good clinical efficacy, microbiological clearance, and lower AKI incidence. For patients with CRKP infection, the CAZ/AVI-based regimen was superior to the PMB-based regimen.

Short- and medium-term impacts of small-scale vegetable support on food security: evidence from Syria

Small-scale agricultural and horticultural interventions play a critical role in improving nutrition and food security of vulnerable households in peaceful settings. However, scant rigorous evidence exists on the impacts and sustainability of such interventions in conflict settings. In this paper, we address this knowledge gap by analyzing the short- and medium-term impacts of a small-scale vegetable input support program involving asset transfers on food security and diets in war-time Syria. We use longitudinal panel household survey data from a quasi-experimental study collected at three rounds: before, one year, and two years after the horticultural intervention ended. We use propensity score matching and fixed-effect regression models to estimate the average treatment effects on the treated. We find that the vegetable support significantly improves food security by 21% and 19% in the short- and medium-term, respectively. More specifically, we find that the intervention significantly increased the consumption of nutrient-rich food groups such as vegetables, root tubers, fruits, eggs, pulses and nuts, milk, and oil and fats. Moreover, we find that the intervention reduces in the short-term the use of harmful coping strategies by 17%. However, this effect dissipates two years after the end of the intervention. The findings underscore the importance of small-scale vegetable support in addressing food insecurity in protracted conflict settings.

Mortality of elderly patients with acute kidney injury undergoing continuous renal replacement therapy: is age a risk factor?

Whether advanced age is associated with poor outcomes of elderly patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) is controversial. This study aimed to evaluate age effect and predictors for mortality in elderly AKI patients undergoing CRRT. Data of 480 elderly AKI patients who underwent CRRT were retrospectively analyzed. Subjects were stratified into two groups according to age: younger-old (age, 65-74 years; n = 205) and older-old (age, ≥75 years; n = 275). Predictors for 28-day and 90-day mortality and age effects were analyzed using multivariable Cox regression analysis and propensity score matching. Urine output at the start of CRRT (adjusted hazard ratio [aHR], 0.99; 95% confidence interval [CI], 0.99-1.00; p = 0.04), operation (aHR, 0.53; 95% CI, 0.30-0.93; p = 0.03), and use of an intra-aortic balloon pump (aHR, 3.60; 95% CI, 1.18-10.96; p = 0.02) were predictors for 28-day mortality. Ischemic heart disease (aHR, 1.74; 95% CI, 1.02-2.98; p = 0.04) and use of a ventilator (aHR, 0.56; 95% CI, 0.36-0.89; p = 0.01) were predictors for 90-day mortality. The older-old group did not exhibit a higher risk for 28- day or 90-day mortality than the younger-old group in multivariable or propensity score-matched models. Advanced age was not a risk factor for mortality among elderly AKI patients undergoing CRRT, suggesting that advanced age should not be considered for therapeutic decisions in critically ill elderly patients with AKI requiring CRRT.

The impact of adverse pregnancy events in the initial cycle on subsequent pregnancy outcomes.

Evidence is accumulating on the impact of previous adverse pregnancy events on future fertility in natural conceptions. However, there is limited knowledge on whether an ectopic pregnancy (EP) or miscarriage after an initial in vitro fertilization (IVF) cycle affects the subsequent outcomes. To investigate the effect of first IVF outcomes: miscarriage, EP, and no pregnancy, on the second cycle outcomes based on a freeze-all strategy. Retrospective cohort study. University-affiliated IVF center. This study involved 16,479 women who had undergone 2 complete frozen embryo transfers (FET) and were classified into 3 groups based on first FET outcomes. None. Live birth rate (LBR). After correcting for confounders, the LBR after the second FET was similar between women who suffered an EP and those who had no pregnancies in their first FET cycles (adjusted OR (aOR), 1.03; 95% confidence interval (CI), 0.83-1.28). However, women who experienced a miscarriage versus those with no prior pregnancy in the first FET had significantly higher LBR in their second cycles (aOR, 1.33; 95% CI, 1.20-1.48). The LBR after the second FET was comparable between the previous EP and miscarriage groups (aOR, 1.24; 95% CI, 0.98-1.58). Similar results were found in the propensity score matching models, supporting the robustness of the main findings. Women who had a miscarriage in the first FET cycle had a higher chance of achieving live births in the subsequent treatment cycle when compared to those who had no pregnancy in the initial cycle. Furthermore, it was found that an EP resulting from the first treatment cycle did not negatively impact reproductive outcomes in the next FET cycles.

Effects of mobile Internet use on the health of middle-aged and older adults: evidences from China health and retirement longitudinal study

The rapid development of digital technology has radically changed people’s lives. Simultaneously, as the population is rapidly aging, academic research is focusing on the use of Internet technology to improve middle-aged and older people’s health, particularly owing to the popularity of mobile networks, which has further increased the population’s accessibility to the Internet. However, related studies have not yet reached a consensus. Herein, empirical analysis of the influence of mobile Internet use on the subjective health and chronic disease status of individuals in their Middle Ages and above was conducted utilizing ordered logit, propensity score matching (PSM), and ordered probit models with data from the 2020 China Health and Retirement Longitudinal Study. The study aimed to provide a theoretical basis and reference for exploring technological advances to empower the development of a healthy Chinese population and to advance the process of healthy aging. The health of middle-aged and older adults mobile Internet users was greatly improved, according to our findings. Further, the use of mobile Internet by these persons resulted in improvements to both their self-assessed health and the state of their chronic diseases. As per the findings of the heterogeneity analysis, the impact of mobile Internet use was shown to be more pronounced on the well-being of middle-aged persons aged 45–60 years compared to those aged ≥ 60 years. Further, the endogeneity test revealed that the PSM model could better eliminate bias in sample selection. The results suggest that the estimates are more robust after eliminating endogeneity, and that failure to disentangle sample selectivity bias would overestimate not only the facilitating effect of mobile Internet use on the self-assessed health impacts of middle-aged and older adults, but also the ameliorating effect of mobile Internet use on the chronic diseases of middle-aged and older adults. The results of the mechanistic analysis suggest that social engagement is an important mediating mechanism between mobile Internet use and the health of middle-aged and older adults. This implies that mobile Internet use increases opportunities for social participation among middle-aged and older adults, thereby improving their health.

Fairtrade coffee and the path to prosperity: a study of smallholder farmers in Bener Meriah Regency

Abstract This study delves into the causal effect of Fairtrade affiliation on coffee productivity. It employs treatment effect and propensity score matching models, utilizing data gathered from 128 randomly selected smallholder coffee farmers in Bener Meriah Regency. This study significantly expands our understanding of the role Fairtrade affiliation plays in boosting the productivity of smallholder coffee farms, all the while ensuring it has no adverse effects on the environment and its underlying factors. The findings unequivocally demonstrate that Fairtrade affiliation leads to a substantial increase in coffee productivity. Expanding Fairtrade’s reach emerges as a crucial strategy to bolster the positive impact on coffee farmers.