Application of Survival Tree Model in Determining Affecting Factors in Breastfeeding Duration

Background and Purpose: Survival tree model is a nonparametric method which can be used to identify the affecting factors from a specific time to the onset of an event. In this method, the categories are selected according to the most important factors. The purpose of this study was to determine the factors affecting the duration of breastfeeding in mothers and introduce the homogeneous subgroups using a survival tree model. Materials and Methods: It was a historical cohort study analyzing the survival data of mothers with healthy single childbirths referring to the rural and urban health centers of Agh-Ghala County since 2011 until 2014. Data analyses and groupings of breastfeeding survival were performed using survival tree model with conditional inference algorithm in R Software. A separation criterion (SEP) confirmed the relevance of the model. Results: Survival tree model results revealed that the type of consumed milk with the complementary nutrition, ethnicity and the time interval between current childbirth and the previous delivery were the most important factors affecting the duration of breastfeeding. The SEP's criterion was 2.082. Thus, due to the significant difference between the subgroups and the value of more than 1 for SEP criterion, the efficiency of the model was confirmed. Conclusion: Survival tree model could be introduced as a suitable and powerful method for ranking the duration of breastfeeding rate which presents four homogeneous subgroups for analysis in addition to identifying the predictive variables.

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Factors affecting academic failure in medical students in Iran

Research and Development in Medical Education ◽

10.34172/rdme.2021.014 ◽

2021 ◽

Vol 10 (1) ◽

pp. 14-14

Author(s):

Zohreh Tajabadi ◽

Matineh Sadat Miri ◽

Soliman Ahmadi ◽

Matineh Pourrahimi ◽

Mojtaba Abdi ◽

...

Keyword(s):

Student Satisfaction ◽

Academic Failure ◽

Educational Status ◽

Cross Sectional Study ◽

Academic Probation ◽

Affecting Factors ◽

Cross Sectional ◽

Significance Level ◽

Factors Affecting ◽

Significant Difference

Background: Students are considered part of the capital of each country. Several factors can affect their educational status and, as a result, contribute to their academic failure. The current study seeks to investigate the relationship between students’ academic failure and the affecting factors with the Iranian Educational Ranking of Universities. Methods: This is a descriptive cross-sectional study. The required sample size was calculated using Cochran’s formula. A researcher-made questionnaire with 5 parts was used to collect data. Kruskal Wallis and Spearman’s analysis of variance was used for analysis. The significance level was considered as 0.05. Results: A total of 1215 people participated; 13.7% of students had had an academic failure and 2.0% of them were on academic probation. There was a correlation between university RAD rank and academic failure (r = -0.098 and P = 0.0001) as well as student satisfaction (r = 0.264 – P = 0.0001). There was a significant difference between an academic drop and academic grade in three ranks of university (Pv= 0.0001), and, interestingly, having moved from Rank 1 to 3, having academic grade increases, and having academic failure decreases. Conclusion: According to the findings of this study, the higher ranked the college campus is on the RAD scale, the higher the academic failure rate. For annual assessment of universities, it is proposed that assessment of academic failure and grades be used as a benchmark.

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Relationship between regional food and hypertension in the East of Turkey

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20192289 ◽

2019 ◽

Vol 6 (6) ◽

pp. 2306

Author(s):

Cihan Önen ◽

Gülsen Güneş

Keyword(s):

Target Population ◽

Behavioral Risk ◽

Time Interval ◽

City Center ◽

Significant Relation ◽

Cross Sectional ◽

Factors Affecting ◽

Regional Food ◽

The People ◽

Significant Difference

Background: It is important to focus on behavioral risk factors, such as harmful habits, unhealthy diet, for hypertension. In the study the aim is to examine the hypertension frequency of adults in Bitlis city center, factors affecting this and other related factors.Methods: The target population of the cross-sectional research consists of people aged 30 and higher in Bitlis city center. Face to face interviews were performed with people incorporated to the sample between February 15th and April 15th 2015 time interval in order to collect data from the field.Results: Hypertension frequency was found to be 35.5%. 59.3% of the people with hypertension are aware of the situation. The blood pressure of 26.3% of the people who are aware of their situation is under control. Significant difference was determined between hypertension and consumption frequency of regional foods such as fried fish, local cheese, fish Basma and Kurut. In logistic regression analysis significant relation was determined between hypertension and old age, women, obesity≥30 and Kurut frequent consumption.Conclusions: In the research the hypertension frequency was found to be 35.5%. Significant relation was detected between hypertension and frequent consumption of Kurut which is a regional food.

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Factors affecting academic failure in medical students in Iran

Research and Development in Medical Education ◽

10.34172/rdme.2021.013 ◽

2021 ◽

Vol 10 (1) ◽

pp. 13-13

Author(s):

Zohreh Tajabadi ◽

Matineh Sadat Miri ◽

Soliman Ahmadi ◽

Matineh Pourrahimi ◽

Mojtaba Abdi ◽

...

Keyword(s):

Student Satisfaction ◽

Academic Failure ◽

Educational Status ◽

Cross Sectional Study ◽

Academic Probation ◽

Affecting Factors ◽

Cross Sectional ◽

Significance Level ◽

Factors Affecting ◽

Significant Difference

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THE STUDY ON SITUATON OF EXCLUSIVE BREAST FEEDING FOR THE FIRST 6 MONTHS IN HOI AN

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.3.6 ◽

2016 ◽

pp. 36-42

Author(s):

Thi Ngoc Anh Nguyen ◽

Hoang Lan Nguyen

Keyword(s):

Breast Milk ◽

Breast Feeding ◽

Exclusive Breastfeeding ◽

Multivariable Logistic Regression Model ◽

Factors Affecting ◽

Exclusive Breast Feeding ◽

Key Words Breast ◽

Breastfeeding Rate ◽

Knowledge And Attitude ◽

Structured Questionnaire

Background: Breast milk is the most valuable source of food for infants, no food is comparable. However in many countries around the world including Vietnam, the breastfeeding prevalence has been declining. A report of the Ministry of Health showed that only 19.6% of infants in Vietnam were exclusively breastfed for the first 6 months. The study was conducted in Hoi An with the aim at describing the situation of exclusive breastfeeding for the first 6 months of the mothers in Hoi An city, Quang Nam province and; identifying some factors affecting exclusive breast feeding for the first 6 months in the study area. Methods: A crosssectional descriptive study was conducted in Hoi An city in December 2014. 516 mothers of infants aged from 6 to 12 months were directly interviewed on the basis of a structured questionnaire. Information about general characteristics of mothers and their infants, their knowledge and attitude of breastfeeding and the feeding types of their baby for the first 6 months was collected. Multivariable logistic regression model was used to identify factors affecting exclusive breastfeeding for the first 6 months. Results: The exclusive breastfeeding prevalence for the first 6 months is 22.3%. Knowledge in breastfeeding and attitude toward exclusive breastfeeding for the first 6 months are factors that significantly related to exclusive breastfeeding prevalence for the first 6 months (OR = 3.3; p=0.001 and OR=10.4; p<0.001, respectively). Conclusion: The exclusive breastfeeding rate for the first 6 months in Hoi An city is low. The promoting antenatal education in exclusive breastfeeding is necessary solution to improve exclusive breastfeeding rate for the first 6 months. Key words: breast milk, exclusive breastfeeding, Hoi An

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Factors affecting progression to permanent atrial fibrillation in an unselected population of patients with non-permanent form of atrial fibrillation

European Heart Journal ◽

10.1093/ehjci/ehaa946.0481 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

V.L Malavasi ◽

E Fantecchi ◽

V Tordoni ◽

L Melara ◽

A Barbieri ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cox Regression ◽

Area Under The Curve ◽

Roc Curves ◽

Factors Affecting ◽

Cox Proportional Hazard ◽

Significant Difference ◽

History Of ◽

Unselected Population ◽

Cox Proportional Hazard Regression

Abstract Background Natural history of atrial fibrillation (AF) shows a progression of arrhythmia from non-permanent to permanent AF. Permanent AF was found associated with a worse prognosis than non-permanent one. Aim To assess the factors associated with progression to permanent AF in an unselected population of AF patients with non-permanent AF. Methods In this prospective study we enrolled in- as well as out-patients with non-permanent AF and age ≥18 years, with at least one episode of ECG-documented AF within 1 year. The patients were followed-up at 1 month and every 6 months thereafter. Results Out of 523 patients, 314 (60%) were in non-permanent AF (80 [25.5%] paroxysmal AF, 165 [52.5%] persistent AF, 69 [2%] first diagnosed AF), mostly male (188, 59.9%), median age 71 years (IQ range 62–77), median CHA2DS2VASc 3 (1–4), median HATCH score 1 (1–2). After a median follow-up of 701 (IQ range 437–902) days, 66 patients (21%) showed permanent AF. CHA2DS2VASc and HATCH scores were incrementally associated to progression to permanent AF (CHA2DS2VASc χ2 p=0.001; HATCH χ2 p=0.017; p for trend CHA2DS2VASc <0.001, HATCH p=0.001). At multivariable Cox proportional hazard regression the following variables were significantly associated with AF progression: age (hazard ratio [HR] 1.041; 95% CI: 1.004–1.079; p=0.028), at least moderate left atrial (LA) enlargement (>42 ml/m2) (HR 2.092; 95% CI: 1.132–3.866; p=0.018), antiarrhythmics drugs after the enrollment (HR 0.087; 95% CI: 0.011–0.662; p=0.018), EHRA score >2 (HR 0.351; 95% CI: 0.158–0.779; p=0.010) and Valvular HD (HR 2.161; 95% CI: 1.057–4.420; p=0.035). Adding LA dilation to HATCH score (HATCH-LA) and assigning 2 points based on multivariable Cox regression, HATCH-LA was statistically better in ROC curves in prediction of AF progression vs HATCH score (area under the curve 0.695 vs 0.636; DeLong p=0.0225). Survival-free curves on freedom from permanent AF using as discriminator HATCH-LA score ≤2 vs >2 led to a statistically significant difference (χ2=16.080 p<0.001), but the same was not found for HATCH score (χ2 =3.099; p=0.078). Conclusions In patients without permanent AF, progression of AF was independentely related to age, LA dilation, AF symptoms severity, antiarrhythmic drugs and Valvular HD. HATCH score predicted AF progression and adding to it LA dilation (at least moderate) improved patients stratification for the risk of evolution to permanent AF. Funding Acknowledgement Type of funding source: None

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Financing Growth through Remittances and Foreign Direct Investment: Evidences from Balkan Countries

Journal of Risk and Financial Management ◽

10.3390/jrfm14030117 ◽

2021 ◽

Vol 14 (3) ◽

pp. 117

Author(s):

Esmeralda Jushi ◽

Eglantina Hysa ◽

Arjona Cela ◽

Mirela Panait ◽

Marian Catalin Voica

Keyword(s):

Developing Economies ◽

Central Banks ◽

Sustainable Growth ◽

Time Interval ◽

Foreign Direct Investments ◽

Factors Affecting ◽

Balkan Countries ◽

To Come ◽

Sustainable Economic Growth ◽

The Impact

The ultimate goal of central banks, worldwide, is to promote the foundations for sustainable economic growth. In the case of developing economies, in particular, such objective requires time, huge efforts, attention, and plenty of resources in order to be accomplished to the fullest degree. This paper thoroughly investigates key factors affecting Balkan countries’ economic development (as measured by gross domestic product (GDP) growth), focusing especially on the impact of remittances. The analysis was done over an 18-year time interval (2000–2017) and builds on 144 observations. The data figures were retrieved from the World Bank database while two dummies were created to test the impact of the last financial crisis (2008–2012). Econometric tools were employed to carry out a broad analysis on the interdependencies that exist and, in particular, to determine the role of remittance income on growth. The vector auto regressive model was estimated using EViews software, and was used to come up with relevant insights. Empirical findings suggest the following: population growth, remittances, and labor force participation are insignificant factors for sustainable growth. On the other hand, previous levels of GDP, trade, and foreign direct investments (FDIs) appear to be relevant for the predictor. This research provides up-to-date conclusions, which can be considered during the decision-making process of central banks, as well as by government policymakers.

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Operational experience of the Dutch helicopter emergency medical services (HEMS) during the initial phase of the COVID-19 pandemic: jeopardy on the prehospital care system?

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-020-01569-w ◽

2021 ◽

Author(s):

Quinten G. H. Rikken ◽

Sarah Mikdad ◽

Mathijs T. Carvalho Mota ◽

Marcel A. De Leeuw ◽

Patrick Schober ◽

...

Keyword(s):

The Netherlands ◽

Initial Phase ◽

Prehospital Care ◽

Operational Experience ◽

Level Of Evidence ◽

Historical Cohort ◽

Significant Difference ◽

One Year ◽

Retrospective Comparative Study ◽

Global And Local

Abstract Purpose The SARS-CoV-2 virus has disrupted global and local medical supply chains. To combat the spread of the virus and prevent an uncontrolled outbreak with limited resources, national lockdown protocols have taken effect in the Netherlands since March 13th, 2020. The aim of this study was to describe the incidence, type and characteristics of HEMS and HEMS-ambulance ‘Lifeliner 1’ dispatches during the initial phase of the COVID-19 pandemic compared to the same period one year prior. Methods A retrospective review of all HEMS and HEMS-ambulance ‘Lifeliner 1’ dispatches was performed from the start of Dutch nationwide lockdown orders from March 13th until May 13th, 2020 and the corresponding period one year prior. Dispatch-, operational-, patient-, injury-, and on-site treatment characteristics were extracted for analysis. In addition, the rate of COVID-19 positively tested HEMS personnel and the time physicians were unable to take call was described. Results During the initial phase of the COVID-19 pandemic, the HEMS and HEMS-ambulance was requested in 528 cases. One year prior, a total of 620 requests were received. The HEMS (helicopter and ambulance) was cancelled after deployment in 56.4% of the COVID-19 cohort and 50.7% of the historical cohort (P = 0.05). Incident location type did not differ between the two cohorts, specifically, there was no significant difference in the number of injuries that occurred at home in pandemic versus non-pandemic circumstances. Besides a decrease in the number of falls, the distribution of mechanisms of injury remained similar during the COVID-19 study period. There was no difference in self-inflicted injuries observed. Prehospital interventions remained similar during the COVID-19 pandemic compared to one year prior. Specifically, prehospital intubation did not differ between the two cohorts. The rate of COVID-19 positively tested HEMS personnel was 23.1%. Physicians who tested positive were unable to take call for a mean of 25 days (range 8–53). Conclusion A decrease in the number of deployments and increase in the number of cancelled missions was observed during the COVID-19 study period. No major differences in operational- and injury characteristics were found for HEMS and HEMS-ambulance dispatches between the initial phase of the COVID-19 pandemic in the Netherlands and the same period one year prior. These findings highlight the importance of continued operability of the HEMS, even during pandemic circumstances. Level of evidence III, retrospective comparative study.

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Impact of pretreatment anemia on upfront abiraterone acetate therapy for metastatic hormone-sensitive prostate cancer: a multicenter retrospective study

BMC Cancer ◽

10.1186/s12885-021-08206-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Teppei Okamoto ◽

Daisuke Noro ◽

Shingo Hatakeyama ◽

Shintaro Narita ◽

Koji Mitsuzuka ◽

...

Keyword(s):

Prostate Cancer ◽

Prognostic Factor ◽

Abiraterone Acetate ◽

Tumor Burden ◽

Hazard Ratio ◽

Historical Cohort ◽

High Tumor Burden ◽

Significant Difference ◽

Hormone Sensitive ◽

The Impact

Abstract Background Anemia has been a known prognostic factor in metastatic hormone-sensitive prostate cancer (mHSPC). We therefore examined the effect of anemia on the efficacy of upfront abiraterone acetate (ABI) in patients with mHSPC. Methods We retrospectively evaluated 66 mHSPC patients with high tumor burden who received upfront ABI between 2018 and 2020 (upfront ABI group). We divided these patients into two groups: the anemia-ABI group (hemoglobin < 13.0 g/dL, n = 20) and the non-anemia-ABI group (n = 46). The primary objective was to examine the impact of anemia on the progression-free survival (PFS; clinical progression or PC death before development of castration resistant PC) of patients in the upfront ABI group. Secondary objectives included an evaluation of the prognostic significance of upfront ABI and a comparison with a historical cohort (131 mHSPC patients with high tumor burden who received androgen deprivation therapy (ADT/complete androgen blockade [CAB] group) between 2014 and 2019). Results We found that the anemia-ABI group had a significantly shorter PFS than the non-anemia-ABI group. A multivariate Cox regression analysis showed that anemia was an independent prognostic factor of PFS in the upfront ABI group (hazard ratio, 4.66; P = 0.014). Patients in the non-anemia-ABI group were determined to have a significantly longer PFS than those in the non-anemia-ADT/CAB group (n = 68) (P < 0.001). However, no significant difference was observed in the PFS between patients in the anemia-ABI and the anemia-ADT/CAB groups (n = 63). Multivariate analyses showed that upfront ABI could significantly prolong the PFS of patients without anemia (hazard ratio, 0.17; P < 0.001), whereas ABI did not prolong the PFS of patients with anemia. Conclusion Pretreatment anemia was a prognostic factor among mHSPC patients who received upfront ABI. Although the upfront ABI significantly improved the PFS of mHSPC patients without anemia, its efficacy in patients with anemia might be limited.

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Computer-Assisted System in Stress Radiography for Anterior Cruciate Ligament Injury with Correspondent Evaluation of Relevant Diagnostic Factors

Diagnostics ◽

10.3390/diagnostics11030419 ◽

2021 ◽

Vol 11 (3) ◽

pp. 419

Author(s):

Chien-Kuo Wang ◽

Liang-Ching Lin ◽

Yung-Nien Sun ◽

Cheng-Shih Lai ◽

Chia-Hui Chen ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Cruciate Ligament ◽

Anterior Tibial Translation ◽

Computer Assisted ◽

Time Interval ◽

Stress Radiography ◽

Factors Affecting ◽

Anterior Tibial ◽

Anterior Cruciate ◽

Tibial Translation

We sought to design a computer-assisted system measuring the anterior tibial translation in stress radiography, evaluate its diagnostic performance for an anterior cruciate ligament (ACL) tear, and assess factors affecting the diagnostic accuracy. Retrospective research for patients with both knee stress radiography and magnetic resonance imaging (MRI) at our institution was performed. A complete ACL rupture was confirmed on an MRI. The anterior tibial translations with four different methods were measured in 249 patients by the designed algorithm. The diagnostic accuracy of each method in patients with all successful measurements was evaluated. Univariate logistic regression analysis for factors affecting diagnostic accuracy of method four was performed. In the inclusive 249 patients, 177 patients (129 with completely torn ACLs) were available for analysis. Mean anterior tibial translations were significantly increased in the patients with a completely torn ACL by all four methods, with diagnostic accuracies ranging from 66.7% to 75.1%. The diagnostic accuracy of method four was negatively associated with the time interval between stress radiography and MRI as well as force-joint distance on stress view, and not significantly associated with age, gender, flexion angle, intercondylar distance, and force-joint angle. A computer-assisted system measuring the anterior tibial translation in stress radiography showed acceptable diagnostic performance of complete ACL injury. A shorter time interval between stress radiography and MRI as well as shorter force-joint distance were associated with higher diagnostic accuracy.

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Comparative Evaluation of Orthostatic Hypotension in Patients with Diabetic Nephropathy

Kidney & Blood Pressure Research ◽

10.1159/000517316 ◽

2021 ◽

pp. 1-7

Author(s):

Gamze Aytaş ◽

Rümeyza Kazancıoğlu ◽

Ömer C. Elçioğlu ◽

Meltem Gürsu ◽

A. Serra Artan ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Orthostatic Hypotension ◽

Electronic Device ◽

Channel Blockers ◽

Factors Affecting ◽

Clinical Criteria ◽

Measure Blood Pressure ◽

Significant Difference ◽

Male Patients ◽

Very High

Introduction: Orthostatic hypotension (OH) affects 5–20% of the population. Our study investigates the presence of OH in diabetic nephropathy (DNP) patients and the factors affecting OH in comparison with nondiabetic chronic kidney disease (NDCKD) patients. Method: Patients presented to the nephrology clinic, and those who consented were included in the study. DNP was defined by kidney biopsy and/or clinical criteria. NDCKD patients of the same sex, age, and eGFR were matched to DNP patients. Demographic parameters and medications were obtained from the records. OH was determined by Mayo clinic criteria. The same researcher used an electronic device to measure blood pressure (BP). All samples were taken and analyzed the same day for biochemical and hematologic parameters and albuminuria. Results: 112 (51 F, 61 M, mean age: 62.56 ± 9.35 years) DNP and 94 (40 F, 54 M, mean age: 62.23 ± 10.08 years) NDCKD patients were included. There was no significant difference between DNP and NDCKD groups in terms of OH prevalence (70.5 vs. 61.7%, p = 0.181). Male patients had significantly higher OH prevalence than female patients (74.7 vs. 60.0%, p = 0.026). There was no significant difference in change in systolic BP between the groups (24.00 [10.00–32.00] mm Hg vs. 24.00 [13.75–30.25] mm Hg, p = 0.797), but the change in diastolic BP was significantly higher in the DNP group (8.00 [2.00–13.00] mm Hg vs. 6.00 [2.00–9.00] mm Hg, p = 0.025). In the DNP group, patients with OH had significantly higher uric acid levels than those without OH (7.18 ± 1.55 vs. 6.36 ± 1.65 mg/dL, p = 0.017). And, 73.7% of patients on calcium channel blockers developed OH (p = 0.015), and OH developed in 80.6% of 36 patients on alpha-blockers (p = 0.049). Conclusion: OH prevalence is very high in CKD, and etiology of CKD does not have a statistically significant effect on the frequency of OH, despite a difference that could be meaningful clinically. Therefore, patients with CKD are checked for OH, with or without concurrent diabetes mellitus. Evaluation of postural BP changes should be a part of nephrology practice.

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