Early Perihematomal Edema Expansion: Definition, Significance, and Association with Outcomes after Intracerebral Hemorrhage

Objective. To investigate the association between early perihematomal edema (PHE) expansion and functional outcome in patients with intracerebral hemorrhage (ICH). Methods. Patients with ICH who underwent initial computed tomography (CT) scans within 6 hours after the onset of symptoms and follow-up CT scans within 24 ± 12 hours were included. Absolute PHE increase was defined as the absolute increase in PHE volume from baseline to 24 hours. A receiver-operating characteristic (ROC) curve was generated to determine the cutoff value for early PHE expansion, which was operationally defined as an absolute increase in PHE volume of >6 mL. The outcome of interest was 3-month poor outcome defined as modified Rankin scale score of ≥4. A multivariable logistic regression procedure was used to assess the association between early PHE expansion and outcome after ICH. Results. In 233 patients with ICH, 89 (38.2%) patients had poor outcome at 3-month follow-up. Early PHE expansion was observed in 56 of 233 (24.0%) patients. Patients with early PHE expansion were more likely to have poor functional outcome than those without (43.8% vs. 11.8%, p < 0.001 ). After adjusting for age, admission systolic blood pressure, admission Glasgow Coma Scale score, baseline ICH volume and the presence of intraventricular hemorrhage, and time from onset to CT, early PHE expansion was associated with poor outcome (adjusted odds ratio, 4.25; 95% confidence interval, 1.70–10.60; p = 0.002 ). Conclusions. The early PHE expansion was not uncommon in patients with ICH and was correlated with poor outcome following ICH.

Testing the Integrity of the Middle and Later Stone Age Cultural Taxonomic Division in Eastern Africa

The long-standing debate concerning the integrity of the cultural taxonomies employed by archaeologists has recently been revived by renewed theoretical attention and the application of new methodological tools. The analyses presented here test the integrity of the cultural taxonomic division between Middle and Later Stone Age assemblages in eastern Africa using an extensive dataset of archaeological assemblages. Application of a penalized logistic regression procedure embedded within a permutation test allows for evaluation of the existing Middle and Later Stone Age division against numerous alternative divisions of the data. Results suggest that the existing division is valid based on any routinely employed statistical criterion, but that is not the single best division of the data. These results invite questions about what archaeologists seek to achieve via cultural taxonomy and about the analytical methods that should be employed when attempting revise existing nomenclature.

DETERMINANTS OF INCOME SECURITY AMONG PENSIONABLE RETIRED PERSONS IN KENYA

Retirees’ income security constitutes a key concern for nations aiming to secure their ageing populations. Kenya has a growing retirement sector with about 252,000 retired civil servants who are on pension and a significant number of private sector retirees who receive a gratuity at retirement. Though formally retired workers may receive a pension, studies consistently report low pensions uptake and inadequate incomes for those retired as well as an increasing national and societal burden. This paper explores the key determinants of income security among 978retired persons who were receiving dues on their retirement savings. Guided by the life cycle and third age theory, the study investigated whether retirees’ socio-economic attributes, pre-retirement financial status, retirees’ benefit package, retirees’ utilization of retirement savings and investments and pre-retirement preparation correlated with income security. A mixed-method study design was used combining survey and case study approaches. Cluster, purposive and random sampling methods were employed to select retirees under the four categories of retirement schemes in Kenya across 18 selected counties of Kenya. Hypotheses were tested using the Chi square test of significance and comparison of means (t-test) specifically to illustrate the relationship between socio-economic indicators, pre-retirement factors and income security at retirement. Logistic regression procedure was employed to isolate the significant factors that predict income security in retirement. The binary logistic regression analysis confirm that retirees with higher education had 26% higher chances of enjoying income security, those who earned higher pre-retirement salary had 25% higher chances of having a secure income at retirement, those knowledgeable about pensions had 35% higher chances of being income secure while those who had planned for their retirement had 14% higher chances of achieving income security. The study recommends crafting of a robust retirement planning package, financial and health plans for retirees’ income security and sustainable livelihoods.

Factors Underlying Adoption of Rice Power-Threshers in West Sumatera

<p><strong>Abstract</strong></p><p><br />Since the use of threshers in post harvest operation has shown promise of providing higher technical as well as allocative efficiency, this study was focused primarily on how such a device could be adopted and diffused more rapidly in response to the government's emphasis on rice quality improvement. Not only was this study interested in farmer's constraints to adopt such a technology, but it also investigated the role of innovating agents as well as the institutional nature of rural labor relation in the adoption process. The former has been analyzed by fitting logistic regression procedure towards data of 75 farmers in six villages while the latter is presented in the form of comparison between West Sumatera and Java.</p>

Comparing Demographic Characteristics and Adverse Event Rates at Two Dermatologic Surgery Practices

Background: Patient demographics and operative techniques may contribute to adverse events after surgeries. Objective: To identify differences in adverse event rates between different dermatologic surgery centers and potential contributing features affecting these rates. Methods: Data regarding demographics, procedure type, and adverse events were collected at two dermatologic surgery centers. Results: The most common adverse event at both sites was infection: 2.1% at site 1 versus 0.5% at site 2 ( p < .001). Using multivariate logistic regression, procedure type (Mohs surgery), geographic location (being at site 1), older age, and anatomic location of surgery were associated with a higher risk of infection. Conclusion: Adverse event rate appears to correlate with patient demographics, procedure type, and setting of surgery more than use of prophylactic antibiotics. Identification of differences in adverse event rates and potential contributing variables at different practices may allow for identification of opportunities to prevent adverse events.

Risk Factors Associated with the Occurrence of the Second-Litter Syndrome in Sows in Southeastern Mexico

The objective was to estimate the incidence of and to determine the effect of some risk factors on the decrease of litter size at parity 2 of sows in three commercial farms in Yucatan, Mexico. Data on 8,592 farrowing records of 4,296 sows were analyzed using a binomial logistic regression procedure. The model included the fixed effect of farm (1, 2, and 3), year of farrowing (2003–2011), season of farrowing (dry, rainy, and windy), number of pigs born alive at first parity (<9, 9-10, 11-12, and >12 piglets), lactation length (<18, 18–24, and >24 days), and weaning to conception intervals (<4, 4–11, and >11 days). Fifty-five point eight percent of all sows presented a reduced or similar litter size at parity 2. The odds of decrease in the second litter size were 1.56 and 2.01 for farms 2 and 3, respectively. Higher odds were found for sows farrowing during the rainy and dry seasons (1.20 and 1.24, resp.) and for sows with large litters at parity 1 (>12 piglets, odds = 33.2). Sows with weaning to conception intervals <4 days and between 4 and 11 days had higher odds of a decrease in the second litter (1.78 and 2.74 pigs, resp.).

Factors Related to Hydrocephalus after Aneurysmal Subarachnoid Hemorrhage

OBJECTIVE The purpose of this study was to identify factors predictive of shunt-dependent hydrocephalus among patients with aneurysmal subarachnoid hemorrhage. The data can be used to predict which patients in this group have a high probability of requiring permanent cerebrospinal fluid diversion. METHODS Seven hundred eighteen patients with aneurysmal subarachnoid hemorrhage who were treated between 1990 and 1999 were retrospectively studied, to identify factors contributing to shunt-dependent hydrocephalus. With these data, a stepwise logistic regression procedure was used to determine the effect of each variable on the development of hydrocephalus and to create a scoring system. RESULTS Overall, 152 of the 718 patients (21.2%) underwent shunting procedures for treatment of hydrocephalus. Four hundred seventy-nine of the patients (66.7%) were female. Of the factors investigated, the following were associated with shunt-dependent hydrocephalus, as determined with a variety of statistical methods: 1) increasing age (P&lt; 0.001), 2) female sex (P= 0.015), 3) poor admission Hunt and Hess grade (P&lt; 0.001), 4) thick subarachnoid hemorrhage on admission computed tomographic scans (P&lt; 0.001), 5) intraventricular hemorrhage (P&lt; 0.001), 6) radiological hydrocephalus at the time of admission (P&lt; 0.001), 7) distal posterior circulation location of the ruptured aneurysm (P= 0.046), 8) clinical vasospasm (P&lt; 0.001), and 9) endovascular treatment (P= 0.013). The presence of intracerebral hematomas, giant aneurysms, or multiple aneurysms did not influence the development of shunt-dependent hydrocephalus. CONCLUSION The results of this study can help identify patients with a high risk of developing shunt-dependent hydrocephalus. This may help neurosurgeons expedite treatment, may decrease the cost and length of hospital stays, and may result in improved outcomes.