Survey Dataset Research Articles

Inequalities in global residential cooling energy use to 2050

Intersecting socio-demographic transformations and warming climates portend increasing worldwide heat exposures and health sequelae. Cooling adaptation via air conditioning (AC) is effective, but energy-intensive and constrained by household-level differences in income and adaptive capacity. Using statistical models trained on a large multi-country household survey dataset (n = 673,215), we project AC adoption and energy use to mid-century at fine spatial resolution worldwide. Globally, the share of households with residential AC could grow from 27% to 41% (range of scenarios assessed: 33-48%), implying up to a doubling of residential cooling electricity consumption, from 1220 to 1940 (scenarios range: 1590-2377) terawatt-hours yr.−1, emitting between 590 and 1,365 million tons of carbon dioxide equivalent (MtCO2e). AC access and utilization will remain highly unequal within and across countries and income groups, with significant regressive impacts. Up to 4 billion people may lack air-conditioning in 2050. Our global gridded projections facilitate incorporation of AC’s vulnerability, health, and decarbonization effects into integrated assessments of climate change.

Hospitals and Superutilization

A small percentage of patients consume most of the health services in the US. These cases of superutilization affect hospitals, but little is known about what it is, the impact on hospitals, or how hospitals can identify potential cases of superutilization. We conducted exploratory research using the Medical Expenditure Panel Survey (MEPS) datasets for 2019 to examine superutilization as it relates to hospitals. Using total charges for health services to identify superutilization, we found a surprising amount of superutilization was not related to hospital care. When superutilization did occur in hospitals, there was reduced reimbursement for care in superutilization as measured by the reimbursement relative to charges. Demographic variables had limited utility in predicting superutilization. Our demographic analysis suggested that there are potential cases of superutilization that are not accessing hospital care. Our analyses suggest that given the amount of care that cases of superutilization require, the decreased reimbursement for the high levels of care and the untapped potential of superutilization, hospitals should consider developing capabilities to manage these challenging cases.

Institution and land transfer contract stability: Evidence from Jiangxi, Jiangsu and Liaoning provinces in rural China

Stable transfer contracts are essential for the development of the land market. This analysis investigates the impacts of different institutions and their interactive effects on the stability of land transfer contracts in rural China. Based on a survey dataset of 833 farmers from three provinces, we demonstrate that tenure institutions have a significantly positive effect and that informal social relationships have a significantly negative effect. Additionally, rules that are relevant to village self-governance strengthen the effect of formal tenure institutions and weaken the effect of social relationships. This finding indicates that complementary and substitute interactive effects exist between these two groups of institutions.

Vitamin C and suicidal ideation: A cross-sectional and Mendelian randomization study

BackgroundStudies have shown that a history of suicide attempts is associated with low levels of antioxidant vitamins. However, the specific relationship between vitamin C and suicidal ideation remains poorly understood. The purpose of this study is to investigate the effect of vitamin C on the development of suicidal ideation and to explore further the causal relationship using Mendelian randomization (MR). MethodsUsing the 2005–2018 National Health and Nutrition Examination Survey (NHANES) dataset, a comprehensive, cross-sectional, stratified survey of 28,623 participants aged 20 years and older was conducted. Suicidal ideation was assessed using item 9 of the Patient Health Questionnaire-9 (PHQ-9) item. The relationship between vitamin C and suicidal ideation was revealed by weighted multiple linear regression, smooth curve fitting, hierarchical analysis, and interaction test. To determine causality, MR was performed on vitamin C and suicidal ideation. ResultsIn cross-sectional studies, all models showed a negative association between vitamin C and suicidal ideation, with a 37 % reduction in the risk of suicidal ideation for each unit increase in vitamin C in the highest quartile in the fully adjusted model. The results of the subgroup analysis showed that the association between vitamin C and suicidal ideation was stable across gender, age, education, smoking status, and marital status. In the MR study, our bivariate model showed no significant causal relationship between vitamin C and the development of suicidal ideation. ConclusionsDietary vitamin C intake was negatively associated with the development of suicidal ideation. However, genetic evidence does not support causation of these associations.

Novel applications of linked administrative data – adding longitudinal capability and additional variables to a nationally representative survey of an indigenous population.

Can linked administrative data be used to transform New Zealand's only sample survey on indigenous wellbeing into a longitudinal study? This project extends the usefulness of an important survey dataset by linkage to admin data, effectively adding longitudinal capability within a linked administrative data source. This created robust statistical processes to transform an official statistics survey into a nationally representative cohort study. NZ's Integrated Data Infrastructure (IDI) is a research database of administrative and survey datasets containing a range of variables linkable at the individual level. Te Kupenga is a large nationally representative post-censal survey of NZ's indigenous population (Māori) and is the only official survey with Māori culturally-informed variables. However, it is under-utilised in research. The Te Kupenga survey was used as a foundational cohort linking to outcomes and determinants in different datasets at different time periods. Outcomes included hospitalisations and COVID-19 vaccinations, while determinants included individual, household and geographic variables. Linking a representative survey to admin data created issues of loss to follow-up and missing data, so the original sample is not maintained after linkage. Loss to follow-up and missingness differed depending on variable selection and time periods. So, new universally applicable weights were not possible. However, we created a robust, generally applicable process for re-weighting survey data to account for missingness and loss to follow-up in admin data. This project demonstrates the approach for turning a sample survey into a longitudinal cohort using admin data and creates methods that can be used for other official statistics surveys.

Linkage error and ethnicity information source affect estimates of ethnic disparities in non-communicable disease rates

Objective and ApproachThis study examined the impact of two sources of bias on differences in ethnic disparities in non-communicable disease rates in New Zealand (NZ). Data were sourced from Stats NZ’s Integrated Data Infrastructure (IDI), a collection of deidentified whole-population administrative (eg, health, justice, housing) and survey datasets (eg, NZ Census) linked at the individual level using probabilistic linkage procedures. Linking several datasets reduces the size of the population available for study because not all individuals can be linked. In addition, there are several sources of ethnicity information that may disagree with each other. We will illustrate the impact of population loss due to linkage and ethnicity data source on Māori-European gaps in lung cancer and cardiovascular disease. ResultsOur results showed that the choice of ethnicity information source and the population used had an impact on the size of ethnic disparities in lung cancer and cardiovascular disease. For lung cancer the age standardised rate ratio for Māori:European ranged from 2.88 to 3.21, and for CVD 1.70 to 1.87. Population loss and ethnicity data source each had independent effects on the size of ethnic differences. ConclusionsDifferent combinations of population and ethnicity information source produced different estimates of ethnic gaps in lung cancer and CVD prevalence. Population and source of ethnicity data both had independent effects on the size of ethnic differences. ImplicationsComparisons of ethnic differences in disease prevalence between studies, or over time, may be misleading if they do not use the same population and ethnicity data source.

Impact of temperatures on grassland transfer strategy: Evidence from the Qinghai-Tibet plateau in China

The increasing severity and complexity climate change present significant challenges to agricultural and social activities. This study investigates the effects of extreme temperatures on grassland transfer strategies, utilizing micro-level survey datasets obtained from pastoral areas of the Qinghai-Tibet Plateau in China, which are then matched with weather data. Employing the piecewise linear method and the temperature bins approach, the results reveal that extreme high temperature weather has a positive and significant effect on grassland transfer decisions. Specifically, each additional day of high-temperature weather throughout the year increases the overall probability of grassland transfer by 0.52%. Additionally, the analysis reveals a U-shaped relationship between temperature and grassland transfer-in decision, with the turning point occurring in the of 5–8 °C range. Furthermore, the findings indicate that grassland transfer decisions are predominantly influenced by moderating effects of factors such as the grassland quality and non-pastoral income. Moreover, herder households characterized by high income levels and younger demographics exhibit a notable capability in rapidly applying adaptive strategies to cope with temperature variations. Projections for future climate change scenarios indicate that extreme temperatures will significantly negatively impact grassland transfer-out, while positively influencing transfer-in.

Prediction of delayed breastfeeding initiation among mothers having children less than 2 months of age in East Africa: application of machine learning algorithms.

Delayed breastfeeding initiation is a significant public health concern, and reducing the proportion of delayed breastfeeding initiation in East Africa is a key strategy for lowering the Child Mortality rate. However, there is limited evidence on this public health issue assessed using advanced models. Therefore, this study aimed to assess prediction of delayed initiation of breastfeeding initiation and associated factors among women with less than 2 months of a child in East Africa using the machine learning approach. A community-based, cross-sectional study was conducted using the most recent Demographic and Health Survey (DHS) dataset covering the years 2011 to 2021. Using statistical software (Python version 3.11), nine supervised machine learning algorithms were applied to a weighted sample of 31,640 women and assessed using performance measures. To pinpoint significant factors and predict delayed breastfeeding initiation in East Africa, this study also employed the most widely used outlines of Yufeng Guo's steps of supervised machine learning. The pooled prevalence of delayed breastfeeding initiation in East Africa was 31.33% with 95% CI (24.16-38.49). Delayed breastfeeding initiation was highest in Comoros and low in Burundi. Among the nine machine learning algorithms, the random forest model was fitted for this study. The association rule mining result revealed that home delivery, delivered by cesarean section, poor wealth status, poor access to media outlets, women aged between 35 and 49 years, and women who had distance problems accessing health facilities were associated with delayed breastfeeding initiation in East Africa. The prevalence of delayed breastfeeding initiation was high. The findings highlight the multifaceted nature of breastfeeding practices and the need to consider socioeconomic, healthcare, and demographic variables when addressing breastfeeding initiation timelines in the region. Policymakers and stakeholders pay attention to the significant factors and we recommend targeted interventions to improve healthcare accessibility, enhance media outreach, and support women of lower socioeconomic status. These measures can encourage timely breastfeeding initiation and address the identified factors contributing to delays across the region.

Intimate partner violence and childhood health outcomes in 37 sub-Saharan African countries: an analysis of demographic health survey data from 2011 to 2022

Understanding the contribution of intimate partner violence (IPV) to childhood health outcomes (eg, morbidity and mortality) is crucial for improving child survival in sub-Saharan Africa. This comprehensive study aimed to explore the associations between maternal exposure to physical, sexual, or emotional violence and adverse childhood health outcomes in sub-Saharan Africa. We analysed Demographic Health Survey datasets from 37 sub-Saharan African countries from 2011 to 2022. A generalised linear mixed model was used to examine the associations between maternal physical violence, sexual violence, or emotional violence, and early childhood health outcomes (eg, acute respiratory infection, diarrhoea, undernutrition, and child mortality). A random effects meta-analysis was used to calculate pooled odds ratios (ORs) for adverse childhood health outcomes. The odds of undernutrition and mortality were 55% and 58% higher among children younger than 5 years born to mothers who were exposed to physical and sexual violence, respectively. 238 060 children younger than 5 years were included. Children whose mothers experienced physical violence (adjusted OR 1·33, 95% CI 1·29-1·42), sexual violence (1·47, 1·34-1·62), emotional violence (1·39, 1·32-1·47), or a combination of emotional and sexual violence (1·64, 1·20-2·22), or a combination of all the three forms of violence (1·88, 1·62-2·18) were associated with an increased odds of developing diarrhoeal disease. Similarly, children whose mothers experienced physical violence (1·43, 1·28-1·59), sexual violence (1·47, 1·34-1·62), emotional violence (1·39, 1·32-1·47), or a combination of emotional and sexual violence (1·48, 1·16-1·89), or a combination of all three forms of violence (1·66, 1·47-1·88) were positively associated with symptoms of acute respiratory infection. We found a strong link between maternal exposure to IPV and health outcomes for children younger than 5 years in sub-Saharan Africa, with minor variations across countries. To address childhood morbidity and mortality attributed to IPV, interventions need to be tailored for specific countries. Burkina Faso, Burundi, Chad, Comoros, Gabon, Liberia, Nigeria, Sierra Leone, South Africa, and Uganda should be priority nations. None.

Characteristics of the structure and hydrocarbon prospectivity of the deeply buried strata in the eastern Precaspian basin

The article examines the geological structure and oil and gas prospects of the pre-salt complex in the eastern Precaspian Basin (PB). Based on the synthesis and comprehensive analysis of geological exploration (GE) results and the analysis of geological-geochemical criteria for hydrocarbon potential, the oil and gas geological zoning has been updated, and effective directions for GE have been identified. The justification of a new hydrocarbon resources base within the eastern PB margin can be ensured by further investigating of the deeply buried Devonian-Middle Carboniferous horizons in the known petroleum plays, as well as within the less explored Sakmar-Kokpektinsky segment of the Ural fold-and-thrust belt. Within the productive KT-I and KT-II formations, there is an unrealized hydrocarbon potential at depths of 5-6 km. Using the example of the Bozoba West area, the oil and gas prospects of the Visean-Bashkirian and Lower Permian strata are examined, highlighting the significance of faults as elements of the hydrocarbon system. The applied set of 3D seismic survey data and deep drilling allowed for the interpretation of deep seismic sections, up to depths of 7.0-7.5 km. The Middle-Upper Devonian strata are considered prospective but have not been extensively explored by deep drilling. To establish a new hydrocarbon resource base within the eastern Precaspian Basin margin, it is recommended to conduct advanced regional seismic surveys and parametric exploration drilling.

The Impact of Environmental Factors on Mental Health and Well-being in Urban Areas of China

Background: Over the years, a lot of work has been done within the context of Chinese industry, promoting industrialized urban areas. As a result, the environment of the associated industrialized urban regions has been polluted mainly due to the promotion of emissions. This might also impact the associated individuals' overall mental health and wellbeing. As a result, the current study has focused on the impact of environmental factors on mental health and wellbeing of the individuals within the context of industrialized urban areas in China. Methods: For this purpose, the "China Labor-force Dynamic Survey (CLDS) dataset" of 2020 was considered. A regression model was used to determine the impact of work environment, subjective perception and built environment on the mental health of the associated citizens. In this regard, the industrial employees were also taken into account. Results: The results obtained from this research show significant association within the context of mental health and industrial employees, however, significant association was observed within the context of residents (p < 0.05). Conclusion: In conclusion the environmental factors essentially play an essential role in influencing the mental wellbeing of the individuals, emphasizing the integration of greener environment to attain significant outcomes.

Early neonatal mortality in Ethiopia from 2000 to 2019: an analysis of trends and a multivariate decomposition analysis of Ethiopian demographic and health survey

BackgroundEarly neonatal deaths, occurring within the first six days of life, remain a critical public health challenge. Understanding the trends and factors associated with this issue is crucial for designing effective interventions and achieving global health goals. This study aims to examine the trends in early neonatal mortality in Ethiopia and identify the key factors associated with changes in early neonatal mortality over time.MethodsThis study utilized five consecutive Ethiopian Demographic and Health Survey datasets from 2000 to 2019. To investigate the trends and identify factors influencing changes in early neonatal mortality over time, conducted a trend analysis and a logit-based multivariate decomposition analysis. Data management and analyses were performed using STATA version 17/MP software. All analyses were weighted to account for sampling probabilities and non-response. Statistical significance was determined at a two-sided p-value threshold of less than 0.05.ResultThe analysis included a total of 12,260 weighted women from the 2000 survey and 5,527 weighted women from the 2019 survey. Over the study period, there was an overall downward trend in early neonatal mortality, decreasing from 34 deaths per 1000 live births in 2000 to 27 deaths per 1000 live births in 2019. The annual rate of reduction was estimated to be 1.03%. Approximately 45% of the observed decline in early neonatal mortality rate can be attributed to changes in population characteristics or endowments (E) during the study period. Factors such as the mother’s age, maternal education, marital status, preceding birth interval, types of pregnancy, and the sex of the child significantly contributed to the compositional change in the early neonatal mortality rate.ConclusionOver the past two decades, Ethiopia has seen a modest decline in early neonatal mortality, but this progress falls short of the Sustainable Development Goal (SDGs) targets. To achieve the SDGs, the Ministry of Health and its partners should intensify efforts to reduce early neonatal mortality. Strategies like preventing early/late pregnancies, promoting appropriate marriage timing, and prioritizing education could help further reduce early neonatal deaths. Further research is also needed to explore the factors driving this issue.

Differences in modifiable cancer risk behaviors by nativity (US-born v. Non-US-born) and length of time in the US.

Previous studies have identified racial-ethnic disparities in modifiable risk factors for cancers. However, the impact of US nativity on these risks is understudied. Hence, we assessed the association between US nativity and length of time in the US on modifiable cancer risk factors. Utilizing the 2010 and 2015 National Health Interview Survey datasets, we analyzed 8,861 US-born and non-US-born adults. Key variables included age, sex, race-ethnicity, education, income, diet, body mass index, physical activity, alcohol consumption, and smoking. Statistical methods included descriptive statistics and regression. Most respondents were US-born (n = 7,370), followed by long-term (≥15 years, n = 928), and recent (<15 years, n = 563) immigrants. Moderate-to-vigorous physical activity was higher among US-born individuals (342.45 minutes/week), compared to recent (249.74 minutes/week) and long-term immigrants (255.19 minutes/week). Recent immigrants consumed more fruits (1.37 cups/day) and long-term immigrants more vegetables (1.78 cups/day) than US-born individuals. Multivariate analyses found recent immigrants had lower odds of consuming alcohol (AOR: 0.33, 95% CI: 0.21-0.50) and smoking (AOR: 0.30, 95% CI: 0.19-0.46), and higher odds of meeting fruit consumption guidelines (AOR: 2.80, 95% CI: 1.76-4.45) compared to US-born individuals. Long-term immigrants had lower odds of alcohol consumption (AOR: 0.56, 95% CI: 0.37-0.84) and smoking (AOR: 0.42, 95% CI: 0.30-0.59), and higher odds for meeting fruit (AOR: 1.87, 95% CI: 1.22-2.86) and fiber (AOR: 2.03, 95% CI: 1.02-4.05) consumption guidelines. Our findings illustrate the importance of considering the impact nativity and length of US residency has on health. Our findings underscore the need for culturally tailored public health strategies.

Overnutrition and associated factors among women of reproductive age in Sub-Saharan Africa: A hierarchical analysis of 2019–2023 standard demographic and health survey data

ObjectivesOvernutrition, a leading cause of global mortality, has seen a significant rise in low- and middle-income countries, including sub-Saharan Africa. Despite emerging evidence linking overnutrition to non-communicable diseases, limited action has been taken to address this issue. While undernutrition studies have received more attention, research on overnutrition and women's health remains scarce in sub-Saharan Africa. Our study aims to assess the prevalence and associated factors of overnutrition among reproductive women in this region MethodsWe conducted a secondary analysis of 2019–2023 Demographic and Health Survey datasets in sub-Saharan Africa. Our study included a weighted sample of 65,161 women aged 15–49 y. Using a multilevel mixed-effects logistic regression model, we identified factors associated with overnutrition. The adjusted odds ratio, along with a 95% confidence interval and a significance level of p < 0.05, determined the statistical significance of the explanatory variables. ResultsThe pooled prevalence of overnutrition among women of reproductive age in sub-Saharan Africa was 34.79% (95% CI: 34.42–35.16). Specifically, the prevalence of overweight and obesity was 21.81% and 12.99%, respectively. Women's educational status, age, media use, household wealth, urbanization, community poverty, and country income level were significantly associated with higher odds of overnutrition. ConclusionsThe prevalence of overnutrition among women of reproductive age in sub-Saharan Africa is relatively high. Key factors associated with this issue include women's educational status, age, media utilization, household wealth, place of residence, community poverty level, and national income status. These multilevel determinants highlight the need for a comprehensive, evidence-based approach to address overnutrition in this population. Effective strategies should target individual behaviors while considering broader social, economic, and environmental contexts. Integrating overnutrition prevention into maternal and reproductive health services, as well as strengthening social protection measures, are recommended steps to tackle this growing challenge in sub-Saharan Africa.

Radio U-Net: a convolutional neural network to detect diffuse radio sources in galaxy clusters and beyond

ABSTRACT The forthcoming generation of radio telescope arrays promises significant advancements in sensitivity and resolution, enabling the identification and characterization of many new faint and diffuse radio sources. Conventional manual cataloguing methodologies are anticipated to be insufficient to exploit the capabilities of new radio surveys. Radio interferometric images of diffuse sources present a challenge for image segmentation tasks due to noise, artifacts, and embedded radio sources. In response to these challenges, we introduce Radio U-Net, a fully convolutional neural network based on the U-Net architecture. Radio U-Net is designed to detect faint and extended sources in radio surveys, such as radio haloes, relics, and cosmic web filaments. Radio U-Net was trained on synthetic radio observations built upon cosmological simulations and then tested on a sample of galaxy clusters, where the detection of cluster diffuse radio sources relied on customized data reduction and visual inspection of Low-Frequency Array Two metre Sky Survey (LoTSS) data. The 83 per cent of clusters exhibiting diffuse radio emission were accurately identified, and the segmentation successfully recovered the morphology of the sources even in low-quality images. In a test sample comprising 246 galaxy clusters, we achieved a 73 per cent accuracy rate in distinguishing between clusters with and without diffuse radio emission. Our results establish the applicability of Radio U-Net to extensive radio survey data sets, probing its efficiency on cutting-edge high-performance computing systems. This approach represents an advancement in optimizing the exploitation of forthcoming large radio surveys for scientific exploration.

Association between Life's essential 8 and stress urinary incontinence in women from the National Health and nutrition examination survey 2005-2018: A cross-sectional study.

Stress urinary incontinence (SUI) may be associated with cardiovascular disease. Life's Essential 8 (LE8), a recently updated measure of cardiovascular health (CVH), has been investigated for its association with SUI in women. The study adopted a cross-sectional design with national scope, incorporating 9332 women aged 20 and above, selected from the National Health and Nutrition Examination Survey dataset from 2005 to 2018. The LE8 metric, which varies from 0 to 100, was evaluated based on the criteria set by the American Heart Association. SUI was determined based on self-report. To evaluate these correlations, we employed models with multivariable logistic variables and a restricted cubic spline. In the cross-sectional study, a total of 9332 participants were included (weighted average age, 52.23 years), and 4274 had SUI (weighted percentage, 48.64%). Considering potential confounders, it was found that higher LE8 scores were associated with lower odds of SUI (odds ratio [OR] for each 10-point increase was 0.83; 95% confidence interval [CI], 0.80-0.87). Compared to participants with lower LE8 scores, those with higher LE8 scores had a 57% lower probability of developing SUI. There was a statistically significant association between LE8 score and SUI among participants who were middle-aged, non-Hispanic white, had higher levels of education and income, and were living with a partner. According to this study, there was an association between increase in Life's Essential 8 and reduction in SUI risk. Therefore, promoting optimal CVH may associate with reducing SUI in women.

The effect of prenatal exposure to Ramadan on human capital: evidence from Turkey

This study aims to analyze the effect of prenatal exposure to certain nutritional disruptions in utero on human capital formation. In order to resolve the endogeneity driven by maternal dietary deficiencies, we use the Islamic holy month of Ramadan, during which observers abstain from eating and drinking entirely from sunrise to sunset, as a natural experiment to assess the effects of fetal malnourishment on educational and labor market outcomes. We compare schooling and employment measures of individuals who are prenatally exposed to Ramadan with those who are not using the 2016 round of the Turkish Family Structure Survey dataset. Our results indicate that men who are exposed to Ramadan in utero in the first or third trimester complete 0.53 fewer years of schooling and are less likely to obtain middle school, high school, and college degrees. These effects are stronger when Ramadan coincides with summer.

Targeting SDG7: Identifying heterogeneous energy dilemmas for socially disadvantaged groups in India using machine learning

To achieve Sustainable Development Goal (SDG) 7, prioritizing the socially disadvantaged segments of the population is imperative, given their inherent susceptibility to heightened risks of energy exclusion. However, a comprehensive understanding of the diverse energy challenges faced by households with socio-economic disparities remains elusive. This article thus addresses this gap by examining three widely acknowledged categories of marginalized households in India: racial inferiority, income poverty, and gender inequality. It notably pioneers the quantification of an umbrella pattern of energy deprivation within the SDG7 framework, encompassing energy unaffordability, energy unreliability, energy inaccessibility, and energy inequality. To do so, leveraging the latest household survey dataset and employing least squares estimates, we preliminarily capture that these three disadvantaged groups encounter significant energy barriers in the pursuit of SDG7 achievement. Given respectively selected models based on Least Absolute Shrinkage and Selection Operator (LASSO) approach, the gradient boosting model (GBM), another state-of-the-art machine learning technique, is subsequently adopted to verify feature significance and rank its importance in determining diverse energy deprivation faced by each group. The results reveal that the disadvantaged caste groups and those experiencing greater gender inequality encounter the greatest impediments to their right to reliable energy access. In comparison, energy unaffordability poses a paramount challenge for low-income households. These findings enable policymakers to design straightforward interventions that address a spectrum of socio-economic disparities, thereby fostering an just energy transition grounded in data-driven evidence.

Power constraints and firm-level total factor productivity in developing countries

This paper analyzes the effects of power outages and constraints on manufacturing firms’ revenue-based total factor productivity in developing countries. The empirical analysis is based on the World Bank Enterprise Surveys dataset for 84 countries for the period 2006–2019. The paper starts by showing statistically that firms facing power outages differ and operate in very different environments compared to firms not facing power outages, underlining a potential nonrandom issue relating to the treatment variable. A matching-based approach is designed to contain this type of bias. It shows that power outages reduce firm-level revenue-based total factor productivity, with average productivity 11% lower for exposed firms compared to unexposed firms. Our results, robust to several tests, reveal some heterogeneity, particularly with regard to the level of development, country income group, and geographical location. In addition to the effects on productivity, the analyses highlight that power outages reduce business expansion, captured by sales growth, and employment. Moreover, we show that this effect is mitigated for firms with R&D activities and those equipped with backup power generators. Finally, transmission channel tests indicate that the negative effect of power outages on productivity is mainly driven by capacity utilization reduction and higher sales losses.

Non-linear association of triglyceride-glucose index with cardiovascular and all-cause mortality in T2DM patients with diabetic kidney disease: NHANES 2001–2018 retrospective cohort study

BackgroundThe triglyceride glucose (TyG) index is a cutting-edge and highly effective marker of insulin resistance, a crucial factor in the development and exacerbation of diabetic kidney disease (DKD). To date, there has been limited research on how the triglyceride-glucose (TyG) index affects the outlook for patients suffering from DKD.MethodsIn this multicenter retrospective cohort study, the analysis recruited 2,203 DKD patients from the National Health and Nutrition Examination Survey (NHANES) dataset, which covers the US from 2001 to 2018. The research applied a Cox proportional hazards model with multiple variables to investigate the association of the TyG index with mortality outcomes. Restricted cubic splines (RCS) and methods for analyzing threshold effects were employed to identify possible non-linear relationships.ResultsOver nearly 19 years of follow-up, this study captured data on 753 all-cause and 231 cardiovascular disease-specific fatalities. Sophisticated statistical methods, including RCS and smoothing curve adjustments via penalized splines, helped identify distinctive patterns: The baseline TyG index was observed to have a U-shaped pattern related to overall mortality and an L-shape with cardiovascular diseases(CVD) mortality among individuals with DKD. Notably, TyG index below 9.15 for overall mortality and 9.27 for CVD mortality were linked to reduced death rates (HR = 0.65, 95% CI = 0.52–0.82 for all-cause; HR = 0.58, 95% CI = 0.43–0.83 for CVD). On the other hand, TyG index exceeding these benchmarks (greater than 9.15 for all-cause and 9.27 for CVD) correlated with increased all-cause mortality risks (HR = 1.21, 95% CI = 1.02–1.43) and showed a non-significant change in CVD mortality risks (HR = 1.07, 95% CI = 0.83–1.38).ConclusionsThis study emphasizes the non-linear linkage involving the TyG index and death rates due to CVD and other factors in patients with DKD, demonstrating its effectiveness in estimating potential adverse events within this demographic.