Random Effects Regression Models Research Articles

Does the education level of the CEO and CFO affect the profitability of real estate and construction companies? Evidence from Vietnam

This article aims to determine the level and trend of the impact of the educational level of CEOs and CFOs on the profitability of real estate and construction companies in Vietnam. Because Vietnam is an emerging economy, insights into the profitability of this market will be lessons learned for other economies with similar characteristics. This quantitative study is based on secondary data collected from audited financial statements, annual reports of 123 Vietnamese real estate and construction companies, and macroeconomic data. Pool OLS, Fixed effect and Random effect regression models and the Hausman test are used to find the appropriate model. The study uses GLS regression to overcome heteroscedasticity and autocorrelation and uses the generalized method of moments (GMM) to overcome endogeneity. We find that the profitability of listed construction and real estate companies with highly educated CEOs is no higher than that of other companies. Furthermore, companies whose CFOs have master's or doctorate degrees are less likely to be profitable. Other findings confirm the heterogeneous effects of operating efficiency, economic growth rate, and financial leverage on different profitability measures. The study also proves that company age, firm size, net working capital, liquidity ratio and inflation rate do not affect profitability.

Obstetric Interventions Among Native and Migrant Women: The (Over)use of Episiotomy in Portugal.

Objective: Episiotomy, defined as the incision of the perineum to enlarge the vaginal opening during childbirth, is one of the most commonly performed surgical interventions in the world. We aimed to determine if migrant status is associated with episiotomy, and if individual characteristics mediate this association. Methods: We analyzed data from the Bambino study, a national, prospective cohort of migrant and native women giving birth at a public hospital in mainland Portugal between 2017 and 2019. We included all women with vaginal delivery. The association between migrant status and episiotomy was assessed using multivariable multilevel random-effect logistic regression models. We used path analysis to quantify the direct, indirect and total effects of migrant status on episiotomy. Results: Among 3,583 women with spontaneous delivery, migrant parturients had decreased odds of episiotomy, especially those born in Africa, compared to native Portuguese women. Conversely, with instrumental delivery, migrant women had higher odds of episiotomy. Disparities in episiotomy were largely explained by maternity units' factors, and little by maternal and fetal characteristics. Conclusion: Our results suggest non-medically justified differential episiotomy use during childbirth and highlight the importance of developing evidence-based recommendations for episiotomy use in a country with a high frequency of medical interventions during delivery.

Working capital management strategies and financial performance: A cause-and-effect analysis

This study attempts to validate whether the working capital management strategies can be considered as the causes of good or bad financial performance of an organization, particularly in Indian cement industry. Whether the decisions of finance managers of Indian cement companies concerning the components of working capital such as account receivables, inventory, accounts paybles, cash holding etc. affect the firm’s performance individually and in total, a sample of 31 Indian cement companies listed on the Bombay Stock Exchange are being selected and their financial statements are analyzed for a period of 11-years (2010-2020). The findings of Pearson’s correlation coefficient and random effect regression model analysis show that there exists a negative relationship between financial performance measured in terms of return on assets (ROA) and inventory turnover period (ITP) as well as accounts payable period (APP). In contrast, a firm’s performance is not significantly affected by the accounts receivable period (ARP) and cash conversion cycle (CCC). Similarly, it has been observed that liquidity ratios such as current ratio (CR) and quick ratio (QR) have a significant positive association with ROA. Moreover, the size of the firms and leverage are inversely related to ROA but the age of the firms is not significantly affecting their financial performances.

Investigating the nexus between energy, socio-economic factors and environmental pollution: A geo-spatial multi regression approach

The Yellow River Basin (YRB) and Yangtze River Basin (YZRB) stand as pivotal regions in China, holding paramount importance in both economic development and environmental security. However, the rapid pace of climate change and extensive human activities have dramatically reshaped these areas, leading to substantial alterations in natural landscapes and urban ecosystems. To ensure sustainable socio-economic growth, a profound understanding of the intricate interplay between socioeconomic factors and the emission of fine particulate matter (FPM) is imperative, along with an exploration of the underlying mechanisms governing these relationships. n this comprehensive study, we conducted spatial autocorrelation and spatial panel regression analyses, leveraging panel data encompassing the years from 2002 to 2021, derived from provincial-level administrative units within the YZRB and YRB. By adopting a holistic approach that considers comprehensive features and spatial effects, our research contributes substantively to the existing literature concerning the YZRB and YRB areas. Our analysis unveiled a notable decline in pollutant emissions over the course of the study period, yet it became evident that socioeconomic and energy-related factors continued to exert significant influence on FPM levels. Furthermore, we identified pronounced positive spatial autocorrelations in FPM emissions, suggesting a need for regionally tailored environmental management strategies. Employing various statistical tests, we rigorously examined the spatial autocorrelation patterns among the regions. Results from our random effect regression model and Geographically Weighted Regression (GWR) approach underscored the significant impact of socioeconomic and natural factors on FPM concentrations. Importantly, the magnitudes of these impacts exhibited variations contingent upon the specific river basin type. Within the YZRB, our findings emphasize the relevance of urbanization metrics, such as urban population, urban green space, Gross Domestic Product (GDP), and economic spending, which displayed positive and statistically significant relationships with FPM concentrations. Conversely, in the YRB, the utilization of energy resources and natural assets emerged as pivotal determinants.

Human Papillomavirus-Attributable Head and Neck Cancers in India-A Systematic Review and Meta-Analysis.

Head and neck cancer accounts for about one third of the global burden in India. Mucosal high-risk human papillomavirus (HPV) has been hypothesized as a contributory risk factor for head and neck cancer (HNC) but its prevalence in Indian patients is not well established. Therefore, this systematic review and meta-analysis aimed to estimate the prevalence of HPV in HNC in India and their attributable fraction by considering the biomarkers of carcinogenesis, p16, and HPV E6/E7 mRNA. A systematic literature search was done in Medline via PubMed, Embase, Scopus, ScienceDirect, ProQuest, and Cochrane to identify studies on HPV and HNC in the Indian population, published between January 1990 and October 2022. Fifty-four eligible studies were identified and relevant clinical information was collected. Meta-analysis was conducted to estimate the pooled prevalence of HPV DNA, p16INK4a, and E6/E7 mRNA percent positivity by random-effect logistic regression model using Metapreg, STATA 18. Thirty-four high-quality studies were taken for meta-analysis. The pooled prevalence of HPV in HNC was 20% (95% CI, 12 to 32) with a high level of heterogeneity (I2 = 90.79%). The proportion of HPV in oropharyngeal cancer (OPC; 22% [95% CI, 13 to 34]) and laryngeal cancer (LC; 29% [95% CI, 17 to 46]) was higher than in oral cancer (OC; 16% [95% CI, 8 to 30]). The HPV-attributable fraction of OPC, considering the E6/E7 mRNA and p16 positivity, was 12.54% and 9.68%, respectively, almost similar to LC (11.6% and 9.57%), while it was much lower in OC (3.36% and 4%). The HPV-attributable fraction is considerably lower for OC, suggesting a negligible causative role of HPV in OC. A significant proportion of OPC and LC are attributed to HPV; however, their exact causative role is unclear because of the presence of other known risk factors.

Gross regional product in Ukraine: two-dimensional analysis of regularities and territorial features

Purpose. Carrying out an analysis of panel data on individual indicators of the development of the regions of Ukraine in general and their aggregates, distinguished by territorial location and profitability in order to establish the main regularities and specific features of changes in their gross regional product. Methodology. On the basis of a sample of statistical indicators of the socio-economic development of the regions of Ukraine for the period from the beginning of the Russian-Ukrainian war (2014) to the full-scale invasion, the authors created panel series of data with the separation of regional groups according to territorial and income criteria. For each group panel series of data, random effects regression models were built in order to determine the presence of regularities and specific features of regional development in different groups. Findings. An analysis of scientific developments and practical results in the issue of determining the key factors of the formation of the gross regional product was carried out. Given the uncertainty in views on the key factors of regional development, an attempt was made to determine them using a two-dimensional analysis of panel data. For this purpose, a sample of statistical information on the main indicators of socio-economic development of each of the regions of Ukraine was formed and their grouping was carried out according to two criteria: territorial location and profitability according to the indicator of the gross regional product per capita. In general, five groups of oblasts were formed based on territorial characteristics and four groups of oblasts based on income characteristics, and a panel regression model was constructed for each of these groups, including the total set of regional panel data. The received specifications of the models made it possible to form a list of key regularities in the formation of the gross regional product in Ukraine, as well as to determine specific factors of influence on the resulting indicator for each of the groups of oblasts. Originality. On the basis of the given approach to the panel analysis of factors of regional development and, in particular, the formation of the gross regional product, based on a combination of statistical methods for grouping (clustering) regions according to various criteria and panel regression models, the hypothesis regarding the presence of common regularities of regional development in certain groups of oblasts of Ukraine was confirmed. The key factors and specific features of changes in the indicator of the gross regional product in Ukraine in general and in individual regional clusters are determined. Practical value. The possibility of practical use of the obtained results as key risk factors in the process of forming plans for the economic development of individual oblasts in the long term, as well as the application of the proposed approach to the study on key factors of the formation of other indicators of regional development.

ASSESSMENT OF THE CONNECTION BETWEEN THE BANK'S CAPITALIZATION LEVEL AND THE COUNTRY'S MACROECONOMIC STABILITY

A well-capitalized banking system is crucial for maintaining macroeconomic stability, preventing financial crises, and bolstering the economy's resilience to shocks. Governments often strive to ensure adequate bank capitalization to foster stable economic growth. This article aims to assess the relationship between bank capitalization and macroeconomic stability in 34 European countries from 2010 to 2021, based on World Bank statistics.The study utilizes the principal components method to identify relevant indicators of bank capitalization and macroeconomic stability, canonical analysis and regression analyses to detail the interconnections between these blocks. The canonical analysis confirms a link between bank capitalization and macroeconomic stability indicators with a coefficient of determination of 0.617 signifying that 61.8% of the variance in macroeconomic stability is explained by fluctuations in bank capitalization.The article presents one fixed-effect and two random-effect regression models detailing the directions and strength of influence of independent variables (NPL, ROA, ROE - indicators of the bank capitalization level) on dependent variables (INFLATION, UNEMPL, GINI - indicators of macroeconomic stability). The Wald criteria and a p-value less than 0.05 indicated that the models with random effects (UNEMPL, GINI) were statistically significant.The results reveal that a 1% increase in non-performing loans correlates with a 0.25% rise in the unemployment rate, and a 1% increase in return on assets leads to a 0.08% increase in the unemployment rate. Additionally, a 1% increase in non-performing loans raises the Gini index by 0.05%, while a 1% increase in return on equity decreases the Gini index by 0.03%. Notably, the impact of return on assets on the unemployment rate and the Gini coefficient is not statistically significant (p-value greater than 0.05).These results can inform the forecasting of national indicators, the development of tools to ensure sufficient bank capitalization, and the formulation of effective macroeconomic policies, taking into account fluctuations in banks' capitalization levels as key financial intermediaries.

Does practice make perfect? The impact of hospital and surgeon volume on complications after intra-abdominal procedures

BackgroundThere is increasing interest in the regionalization of surgical procedures. However, evidence on the volume-outcome relationship for emergency intra-abdominal surgery is not well-synthesized. This systematic review and meta-analysis summarize evidence regarding the impact of hospital and surgeon volume on complications. MethodsWe identified cohort studies assessing the impact of hospital/surgeon volume on postoperative complications after emergency intra-abdominal procedures, with data collected after the year 2000 through a literature search without language restriction in the PubMed, Web of Science, and Cochrane databases. A weighted overall complication rate was calculated, and a random effect regression model was used for a summary odds ratio. A sensitivity analysis with the removal of studies contributing to heterogeneity was performed (PROSPERO: CRD42022358879). ResultsThe search yielded 2,153 articles, of which 9 cohort studies were included and determined to be good quality according to the Newcastle Ottawa Scale. These studies reported outcomes for the following procedures: cholecystectomy, colectomy, appendectomy, small bowel resection, peptic ulcer repair, adhesiolysis, laparotomy, and hernia repair. Eight studies (2,358,093 patients) with available data were included in the meta-analysis. Low hospital volume was not significantly associated with higher complications. In the sensitivity analysis, low hospital volume was significantly associated with higher complications when appropriate heterogeneity was achieved. Low surgeon volume was associated with higher complications, and these findings remained consistent in the sensitivity analysis. ConclusionWe found that hospital and surgeon volume was significantly associated with higher complications in patients undergoing emergency intra-abdominal surgery when appropriate heterogeneity was achieved.

A global analysis of bank profitability factors

We analyze the factors that explain banks’ profitability globally and by region. With increasing globalization, knowing the different aspects of bank profitability is essential for countries’ financial stability and economic growth. This study used a sample of 2,091 commercial banks operating in 110 countries grouped into major world regions. With random effect regression models, the global results show that the internal factors that explain the bank´s profitability are listed entities, impaired loans, efficiency, gross interest margin, and capitalization. For its part, the most significant external factors are related to the position of the countries in the ranking by assets, inflation, unemployment, interest rates, and economic growth. From a regional perspective, the results allow us to deduce with high robustness the existence of variable sets that determine bank profitability in each region and that regional models outperform global models in most cases.

Dynamic short-term crash analysis and prediction at toll plazas for proactive safety management

Toll plazas are commonly recognized as bottlenecks on toll roads, where vehicles are prone to crashes. However, there has been a lack of research analyzing and predicting dynamic short-term crash risk specifically at toll plazas. This study utilizes traffic, geometric, and weather data to analyze and predict dynamic short-term collision occurrence probability at mainline toll plazas. A random-effects logit regression model is employed to identify crash precursors and assess their impacts on the probability of crash occurrence at toll plazas. Meanwhile, a Long Short-Term Memory Convolutional Neural Network (LSTM-CNN) network is applied for crash prediction. The results of random-effects logit regression model indicate that the flow standard deviation of downstream, upstream occupancy, speed difference and occupancy difference between upstream and downstream positively influence the probability of crash occurrence. Conversely, an increase in the proportion of ETC lanes negatively impacts the probability of crash occurrence. Additionally, there appears a higher likelihood of crashes occurring during summer at toll plaza area. Furthermore, to address the issue of data imbalance, Synthetic Minority Oversampling Techniques (SMOTE) and class weight methods were employed. Stacked Sparse AutoEncoder-Long Short-Term Memory (SSAE-LSTM) and CatBoost were developed and their performance was compared with the proposed model. The results demonstrated that the LSTM-CNN model outperformed the other models in terms of the Area Under the Curve (AUC) values and the true positive rate. The findings of this study can assist engineers in selecting suitable traffic control strategies to improve traffic safety in toll plaza areas. Moreover, the developed collision prediction model can be incorporated into a real-time safety management system to proactively prevent traffic crash.

EFFECT OF ENVIRONMENTAL ACCOUNTING ON FINANCIAL PERFORMANCE OF QUOTED DEPOSIT MONEY BANKS IN NIGERIA

This study investigates the impact of environmental accounting on the financial performance of quoted deposit money banks in Nigeria. The sample consisted of 14 banks, which were selected using census sampling techniques. A random effect regression model was used to test the hypotheses after conducting diagnostic tests. The results indicate that environmental conservative cost disclosure has a significant positive effect on return on assets, while environmental compliance cost disclosure has an insignificant positive effect on return on assets. Additionally, community development cost disclosure has an insignificant negative effect on return on assets. The study suggests that deposit money banks in Nigeria should prioritize environmental conservative cost disclosure in their financial reporting and continue to comply with environmental regulations by disclosing their environmental compliance costs to improve their financial performance. In summary, the lack of clarity on environmental accounting practices can lead to information gaps for responsible financiers and investors. The study recommends specific actions for Nigerian banks to enhance their sustainability reporting and ultimately improve their financial performance.

Effect of Capital Structure on Shareholder Value: Evidence from Panel ARDL Approach

This study examines the effect of capital structure on the shareholders’ value in Indian pharmaceutical industry collecting data over a period from 2001 to 2020. Further, the study also investigates the long-run and short-run relationship between capital structure and shareholder value. This study employs pooled, fixed, random effect regression models and panel autoregressive distributed lag analysis. The shareholder value of Indian firms is measured by earnings per share (EPS) and market value added (MVA) while the debt-equity ratio, interest coverage ratio, and total liabilities to total assets are the proxy variables for capital structure. The study reveals that capital structure influences shareholder value significantly. The findings also explored the existence of a long-run relationship between capital structure and shareholder value.

The Impact of Dividend Policy on Stock Prices: Evidence from Nepalese Banking Sector

The study examined the impact of dividend policy on market price of share in banking sector of Nepal. Out of 27 commercial banks, 10 banks have been selected under convenience sampling with ten years data for the period 2068/69 to 2077/78 were taken for the analysis. Panel data regression models (random effect model) has been utilized to analyze the data as the Hausman test suggest the random effect model is the most appropriate for describing the relationship among the given variables. The result indicates that earning per share, dividend per share, price-earnings ratio and retained earnings have a positive relationship on stock prices of commercial banks. The study concluded that dividend payments lead to a rise in the market price of a stock. Hence, it can be inferred from the outcome of the random effect regression model that it is consistent with the applicable methods related to dividend policy, indicating that there is a noteworthy impact of dividend policy on the stock price of companies. The findings of this study will contribute to the existing literature on dividend policy and market price of share, especially in the context of Nepal. The study will also provide important implications for investors, policymakers, and companies in making decisions regarding dividend rules and its impact on the stock prices.

Neuropsychiatric Adverse Effects of Synthetic Glucocorticoids: A Systematic Review and Meta-Analysis.

Synthetic glucocorticoids are widely used to treat patients with a broad range of diseases. While efficacious, glucocorticoids can be accompanied by neuropsychiatric adverse effects. This systematic review and meta-analysis assesses and quantifies the proportion of different neuropsychiatric adverse effects in patients using synthetic glucocorticoids. Six electronic databases were searched to identify potentially relevant studies. Randomized controlled trials, cohort studies, and cross-sectional studies assessing psychiatric side effects of glucocorticoids measured with validated questionnaires were eligible. Risk of bias was assessed with RoB 2, ROBINS-I, and AXIS appraisal tool. For proportions of neuropsychiatric outcomes, we pooled proportions, and when possible, differences in questionnaire scores between glucocorticoid users and nonusers were expressed as standardized mean differences (SMD). Data were pooled in a random-effects logistic regression model. We included 49 studies with heterogeneity in study populations, type, dose, and duration of glucocorticoids. For glucocorticoid users, meta-analysis showed a proportion of 22% for depression (95% CI, 14%-33%), 11% for mania (2%-46%), 8% for anxiety (2%-25%), 16% for delirium (6%-36%), and 52% for behavioral changes (42%-61%). Questionnaire scores for depression (SMD of 0.80 [95% CI 0.35-1.26]), and mania (0.78 [0.14-1.42]) were higher than in controls, indicating more depressive and manic symptoms following glucocorticoid use. The heterogeneity of glucocorticoid use is reflected in the available studies. Despite this heterogeneity, the proportion of neuropsychiatric adverse effects in glucocorticoid users is high. The most substantial associations with glucocorticoid use were found for depression and mania. Upon starting glucocorticoid treatment, awareness of possible psychiatric side effects is essential. More structured studies on incidence and potential pathways of neuropsychiatric side effects of prescribed glucocorticoids are clearly needed.

Evaluating the Impact of Maternal Exposure to Ozone on Twin Fetal Growth in China.

Unlike singletons, twins require attention not only to the birth weight of the fetuses but also to discordance (i.e., the differences between weights) because twin growth discordance is a significant factor contributing to perinatal mortality and morbidity in twin pregnancies. However, the impact of maternal air pollution exposure on twin growth discordance has rarely been investigated. We examined the association of long-term ozone exposure during preconception and pregnancy with the birth weight of twins and twin growth discordance among 35,795 twins from the National Free Preconception Health Examination Project between January 2010 and December 2019. Linear mixed-effect models and random-effect logistic regression models were used to examine the associations of ozone exposure with the birth weight-related outcomes (i.e., birth weight of twins and within-pair birth weight difference) and risk of twin growth discordance, respectively, after adjustment for demographic characteristics and lifestyle. We found that an interquartile range (IQR) increase (15 μg/m3) in ozone exposure during the entire pregnancy was associated with a reduction (-28.96g, 95% confidence interval [CI]: -46.37, -11.56) in the total birth weight of twins, and ozone had a more pronounced impact on the birth weight of the smaller fetuses (-18.28 g, 95% CI: -27.22, -9.34) compared to the larger fetuses (-9.88 g, 95% CI: -18.84, -0.92) in twin pregnancies. An IQR increase in ozone exposure during the entire pregnancy was associated with a significant increase (8.41 g, 95% CI: 4.13, 12.69) in the within-pair birth weight difference; the odds ratio (OR) of twin growth discordance related to ozone exposure increased by 9% (OR = 1.09, 95% CI: 1.01, 1.18). However, no consistently significant associations were observed for ozone exposure during prepregnancy. Male-male twin pairs and those who were born prematurely appeared to be more susceptible to ozone exposure than their counterparts. Long-term ozone exposure during pregnancy was associated with twin growth discordance, and our findings provide reference data for future studies.

The Clinical Picture of Castleman Disease: A Systemic Review and Meta-Analysis of Almost 2000 Patients

Background: Castleman disease (CD) encompasses a spectrum of rare disorders with characteristic histopathological features, including unicentric (UCD), idiopathic multicentric (iMCD) and cases that are associated with the human herpesvirus 8 (HHV8+ MCD). As treatment options for each type of CD vary, it is important to be able to distinguish their clinical presentation from their subtypes and determine the correct diagnosis. To our knowledge, there are no major review articles summarising the clinical features of different CD subtypes. The aim of this study was to describe and compare the clinical presentation of different CD subtypes reported in the literature. Methods: We performed a systematic review of publications reporting ≥5 cases of CD between 1995 and 2021, following the PRISMA guidelines. Publications were cross-checked by study location, data collection period and investigators to identify duplicated patients. Where a patient may have been included in >1 study, the publication with the fewest patients or least symptom data was excluded. For each subtype of CD within each study, we extracted data on demographics, clinical symptoms and laboratory parameters as stated in the international consensus diagnostic criteria for iMCD. We estimated the mean percentage of patients meeting each diagnostic criterion for each CD subtype using meta-analyses conducted with random-effects logistic regression models. Results: We analysed 32 studies with 1998 patients from 16 countries, including 559 UCD, 1023 iMCD and 416 HHV8+ MCD cases. There was a predominance of males not only in HHV8+ MCD (88.5% males) but also in iMCD (59.1% males). Patients with UCD tended to be younger than patients with iMCD and HHV8+ MCD. Most patients with iMCD (91.8%) and UCD (84.7%) were of Asian ethnicity. Only 58 patients (6.4%) with iMCD were White. In contrast, almost all patients with HHV8+ MCD (93.7%) were White or Black/African American. Many symptoms and laboratory abnormalities occurred at similar rates in patients with iMCD and HHV8+ MCD (Table 1). There were no significant differences in laboratory findings between patients with iMCD and HHV8+ MCD. However, compared with patients with HHV8+ MCD, patients with iMCD had significantly lower rates of constitutional symptoms (46.6% vs 98.6%, p=0.038) and splenomegaly (48.2% vs 89.2%, p=0.031). In contrast, renal dysfunction seemed to appear more commonly in iMCD (36.9% vs 17.4%, not statistically significant). Patients with UCD had significantly lower rates of laboratory abnormalities vs those with iMCD and HHV8+ MCD (p<0.05 for all parameters listed in Table 1). Except for cutaneous findings, patients with UCD had significantly lower rates of symptoms than patients with either iMCD or HHV8+ MCD (p<0.05 for all non-cutaneous parameters in Table 1). However, elevated C-reactive protein (CRP), anaemia and hypergammaglobulinaemia occurred in almost 20% of patients with UCD and pulmonary findings were observed in 15.3% of cases. We identified five additional publications including 88 paediatric patients with UCD. Paediatric patients with UCD had more signs of systemic inflammation than adult UCD patients. Elevated CRP was reported in 45.1% (95% CI 20.9-71.8, n=50) of paediatric UCD patients (vs 19.7% of adults [95% CI 11.2-30.9]). Constitutional symptoms were reported in 44.4% (95% CI 21.5-69.2, n=18) of patients - significantly higher than the rate reported in adult patients with UCD (4.5%, 95% CI 1.6-12.3; p=0.0005). Conclusions: This systematic review complements the diagnosis and management guidelines for iMCD and UCD and provides a detailed description of the clinical presentation of HHV8+ MCD. We found several distinct differences between iMCD and HHV8+ MCD, probably reflecting the heterogeneity of the underlying pathomechanisms and/or different comorbidity burdens of these CD subtypes. We confirmed that systemic symptoms may be present in up to 20% of patients with UCD. Whether these cases represent a distinct entity and whether intermediate CD cases require systemic therapy beyond surgery remains to be elucidated.

Intrapartum trends of NT-proBNP and hs-cTnT in patients with severe features of preeclampsia

BackgroundPreeclampsia with severe features (SPE) is a multisystem syndrome associated with long-term cardiovascular morbidity. Serum concentrations of N-terminal B-type natriuretic peptide (NT-proBNP) and high sensitivity cardiac troponin-T (hs-cTnT) are sensitive markers of cardiac stretch and ischemia, respectively. ObjectiveOur aim was to examine NT-proBNP and hs-cTnT in patients with SPE during labor. We hypothesized that patients with severe preeclampsia would have increased serum concentrations of these analytes as compared with normotensive laboring patients.Study Design.This was a prospective cohort study of intrapartum patients with SPE and normotensive controls. Patients were recruited at the time of SPE diagnosis or admission to the labor unit, and those with medical conditions that could predispose to baseline cardiac dysfunction were excluded. Serum from venous blood was collected for NT-proBNP and hs-cTnT measurement at three time points: 0–2 h, 4 h, and 12 h after admission. A mixed random effects regression model was used to compare analyte levels at each time point and to compare trends over time. The primary outcome was NT-proBNP concentration at each collection time point in patients with severe preeclampsia as compared to normotensive controls. Power analysis yielded a goal sample of 25 patients with a 12 h and at least 1 other sample in each arm. Two-tailed P values less than 0.05 were considered statistically significant. P value adjustment for multiple comparisons was performed. ResultsOf 78 patients analyzed, 36 had severe preeclampsia and 42 were normotensive controls with 25 in each cohort having a 12 h and at least 1 other sample. The NT-proBNP trend was significantly different in the two cohorts (P < 0.001). After adjustment for multiple comparisons, the mean serum concentration of NT-proBNP was elevated in the severe preeclampsia group at 0–2 and 4 h, but not at 12 h. After similar adjustment, detectable serum concentrations of hs-cTnT were more frequent in patients with severe preeclampsia at all three timepoints. ConclusionIntrapartum serum concentrations of NT-proBNP were elevated nearly twofold in patients with SPE when compared with normotensive controls, with the most pronounced differences found during early labor. Detectable but low serum concentrations of hs-cTnT were more common in women with severe preeclampsia as compared with normotensive controls. These findings suggest cardiac dysfunction with SPE may be present at the time of admission and contribute to features of maternal cardiovascular morbidity and mortality.

Impact of health risk factors on healthcare resource utilization, work-related outcomes and health-related quality of life of Australians: a population-based longitudinal data analysis.

Health risk factors, including smoking, excessive alcohol consumption, overweight, obesity, and insufficient physical activity, are major contributors to many poor health conditions. This study aimed to assess the impact of health risk factors on healthcare resource utilization, work-related outcomes and health-related quality of life (HRQoL) in Australia. We used two waves of the nationally representative Household, Income, and Labor Dynamics in Australia (HILDA) Survey from 2013 and 2017 for the analysis. Healthcare resource utilization included outpatient visits, hospitalisations, and prescribed medication use. Work-related outcomes were assessed through employment status and sick leave. HRQoL was assessed using the SF-6D scores. Generalized estimating equation (GEE) with logit or log link function and random-effects regression models were used to analyse the longitudinal data on the relationship between health risk factors and the outcomes. The models were adjusted for age, sex, marital status, education background, employment status, equilibrium household income, residential area, country of birth, indigenous status, and socio-economic status. After adjusting for all other health risk factors covariates, physical inactivity had the greatest impact on healthcare resource utilization, work-related outcomes, and HRQoL. Physical inactivity increased the likelihood of outpatient visits (AOR = 1.60, 95% CI = 1.45, 1.76 p < 0.001), hospitalization (AOR = 1.83, 95% CI = 1.66-2.01, p < 0.001), and the probability of taking sick leave (AOR = 1.31, 95% CI = 1.21-1.41, p < 0.001), and decreased the odds of having an above population median HRQoL (AOR = 0.48, 95% CI = 0.45-0.51, p < 0.001) after adjusting for all other health risk factors and covariates. Obesity had the greatest impact on medication use (AOR = 2.02, 95% CI = 1.97-2.29, p < 0.001) after adjusting for all other health risk factors and covariates. Our study contributed to the growing body of literature on the relative impact of health risk factors for healthcare resource utilization, work-related outcomes and HRQoL. Our results suggested that public health interventions aim at improving these risk factors, particularly physical inactivity and obesity, can offer substantial benefits, not only for healthcare resource utilization but also for productivity.

For narrower income inequality: traditional finance or microfinance?

ABSTRACT This paper uses the theory of information imperfections to examine the relationship between income inequality and financial development in a dual financial system comprising traditional finance and microfinance. It uses panel data for 97 developing countries over a period characterized by declining income inequality from 2000 to 2017. Traditional finance is measured through domestic credit relative to GDP and the IMF Financial Development Index. Microfinance is measured through the size of microfinance gross loan portfolio relative to GDP and the number of active microfinance borrowers to the total population. Controlling for various measures of macroeconomic and socioeconomic variables and using different econometric specifications including a random-effects linear regression model with endogenous sample selection, the results show that microfinance consistently predicts a lower income inequality measured by the Gini coefficient, while traditional finance shows no impact. The findings of this paper draw clear policy implications regarding the role of microfinance as a tool for income equality in developing countries.

Impact of Foreign Enterprises’ Capital Inflow on Urbanization Factors: Evidence from Northeastern Cities of China

This study investigates the impact of foreign capital inflow and the number of contracted foreign direct investment projects on urbanization. The study focused on the less-explored provinces of Liaoning, Jilin, and Heilongjiang, covering the period from 2007 to 2021. The definition of urbanization was expanded to include three elements: the urbanized labor force, emission and pollution levels, and the productivity of services in the economy. Most importantly, an urbanization index was generated to estimate the total effect of foreign capital investment on sustainable green urbanization. The analysis employs both random and fixed effects regression models, complemented by robustness checks using the generalized least squares (GLS) method. The findings indicate that while foreign capital investments contribute positively to labor urbanization and service productivity, they have a notably adverse impact on environmental quality in the examined cities. Moreover, our findings confirm an overall inverse relationship between foreign capital investment and the urbanization index: the negative impact is primarily driven by inadequate procedures for emissions control in the northeastern Chinese cities. In conclusion, this research provides insights and strategic recommendations for promoting sustainable green urbanization.