Comparing Attained Weight and Weight Velocity During the First 6 Months in Predicting Child Undernutrition And Mortality

Background The first 6 months of life are critical for subsequent risk of undernutrition and mortality. The predictive abilities of attained weight at the end of each month and monthly weight velocity for undernutrition and mortality need to be compared. Objective This study aimed to examine the predictive abilities of different weight metrics during the first 6 months of life in predicting undernutrition and mortality. Methods This study used a cohort of infants in Tanzania. Weight and length were measured monthly from birth to 18 months of age. Three weight metrics during the first 6 months of life were considered as predictors, including attained weight-for-age z-score (WAZ) at the end of each month, monthly change in WAZ, and monthly weight velocity z-score (WVZ). Logistic models were used with undernutrition (at 6 or 12 months) and mortality (over the first 18 months) as outcomes. Area under the curve (AUC) values were compared across metrics. Results For predicting wasting at 6 months, WVZ (AUC = 0.80) had a greater predictive ability than attained WAZ (AUC = 0.76) and change in WAZ (AUC = 0.71) during the second month of life. After 2 months, attained WAZ (AUC: 0.81 to 0.89) had greater predictive abilities than WVZ (AUC: 0.71 to 0.77) and change in WAZ (AUC: 0.65 to 0.67). For predicting stunting at 6 months, attained WAZ (AUC: 0.75 to 0.79) had consistently greater predictive abilities than WVZ (AUC: 0.56 to 0.66) and change in WAZ (AUC: 0.50 to 0.57). The weight metrics had similar abilities in predicting mortality, with the AUC rarely reaching above 0.65. Conclusions Attained weight at the end of each month had greater abilities than monthly weight velocity in the same month in predicting undernutrition. Attained weight remains a useful indicator for identifying infants at greater risk of undernutrition.

Botulinum toxin type A wear-off phenomenon in chronic migraine patients: how long does the maximum efficiency last?

ABSTRACT Background: Botulinum toxin Type A (BoNTA) is a successful treatment for chronic migraine prophylaxis. Objective: We aimed to evaluate the monthly change of effectiveness of BoNTA treatment. Methods: A total of 80 patients (70 females and 10 males) with chronic migraine were included. In our study protocol, we applied to 155 U across 31 fixed-sites and if the patient had pain, 40 U dose injections were applied across 8 specific head/neck muscle areas. Headache days and analgesic intake were noted before the BoNTA injection and during the interviews at the first, second, and third months after the BoNTA injection. Results: The mean age was 37.59 ± 7.60 and 87.5% of the patients were female. The mean number of headache days/month before BoNTA was 18.95±2.69, decreasing to 10.55±3.15 days/month in the first month (p<0.001), 9.31±2.43 days/month in the second month (p<0.001), and increased to 11.97±3.27 days/month in the third month (p<0.001). The mean analgesic intake before BoNTA was 11.48±4.68 tablets/month, while it decreased to 6.53±2.72 tablets/month in the first month (p<0.001) and 5.40±2.46 tablets/month in the second month (p<0.001). In the third month, it was 5.85±2.59 tablets/month (p<0.001). There was a significant increase in pain medication use from the second to the third month (p<0.001). Conclusion: In our study, there was a significant reduction in analgesic intake and headache days in the first and second months after BoNTA injection, and an increase was observed in the third month.

The evolutionary characteristics of the network attention of the five tourism performing arts products on the time scale

Network attention is the intuitive expression of tourism demand and behavior habits on the Internet, with the help of Baidu Index platform to obtain the online attention of the five major tourism performing arts products from 2015 to 2019, and use quantitative methods to analyze their annual, monthly and weekly changes. The results are as follows, from the perspective of interannual change, the network attention of “Ancient Love of Song City” and “Amazing Xiangxi” shows an upward trend, while the rest of the impression series products show negative growth; from the perspective of monthly change, the network attention of “Impression Liu Sanjie", “Ancient Love of Song City” and “Impression West Lake” has seasonal characteristics; the overall change trend is mainly affected by the National Day holiday and summer vacation, the curve trend of “Impression Lijiang” and “Amazing Xiangxi” is relatively stable; from the weekly change, the weekly change of tourism performing arts products is very small.

Economic-State Variation in Uncertainty-Yield Dynamics

We show there is a much stronger negative, dynamic relation between changes in economic uncertainty and Treasury yields over weaker economic times since at least 1990. We document this economic-state variation in uncertainty-yield dynamics for weekly and monthly change horizons, for nominal yields and real-yield proxies, for multiple economic-state identification methods, and for different economic uncertainty metrics. We present additional findings that suggest short-term fluctuations in precautionary-savings and consumption-smoothing forces are more impactful on interest rate dynamics during weaker economic times, especially relying on surveys of expected economic growth and inflation. (JEL G11, G12) Received February 8, 2019; editorial decision August 24, 2020 by Editor Nikolai Roussanov. Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.

Customer Churn Prediction Based on HMM in Telecommunication Industry

The rapid development of technology and increasing numbers of customers have saturated the communication market. Communication operators must give focused attention to the problem of customer churn. Analyzing the customer’s communication behavior and building a prediction model of customer churn can provide the advance evidence for communication operators to minimize churn. This paper describes how to design a HMM to predict customer churn based on communication data. First, we oversample churners to increase the number of positive samples and establish the relative balance of positive and negative samples. Second, the continuous numerical attributes that affect communication customer churn are relatively discretized and their monthly values are converted into monthly change tendencies. Next, we select the communication features by calculating the information gains and information gain rates of all communication attributes. We then construct and optimize a prediction model of customer churn based on HMM. Finally, we test and evaluate the model by using a Spark cluster and the communication data set of Taizhou Branch of China Telecom. Experimental evaluation provides proof that our prediction model is exceptionally reliable.

Follow-Up of Bone Mineral Density Changes in de novo Kidney Transplant Recipients Treated with Two Doses of the Receptor Activator of Nuclear Factor κB Ligand Inhibitor Denosumab

Background: Studies in women with post-menopausal osteoporosis have shown that discontinuation of treatment with denosumab leads to an increased risk of vertebral fractures because of rebound bone turnover and rapid loss of bone mineral density (BMD). Methods: In a post hoc analysis of the Prolia for Osteoporosis of Transplant Operated Patient study, we analyzed the effect of denosumab withdrawal on BMD changes. Twenty-five de novo kidney transplant recipients (KTR) who were treated for 1 year with 2 six-monthly doses of denosumab on top of standard treatment (daily calcium and vitamin D) were compared to a control group of 29 KTR who received standard treatment alone. BMD changes were analyzed by repeated dual-energy X-ray absorptiometry shortly after transplantation (baseline), after 6 and 12 months (active treatment phase) and after 2–6.5 years (follow-up phase). Results: The average BMD at the lumbar spine declined markedly after discontinuation of treatment with denosumab but increased again thereafter. Thus, the average monthly change in lumbar spine BMD from month 12 onward was only 0.1 ± 2.8‰ in the denosumab group but 1.5 ± 1.9‰ in the control group (p = 0.021). The average monthly change in lumbar spine BMD from baseline to follow-up was similar in the control and denosumab group (1.1 ± 1.2‰ vs. 1.5 ± 2.4‰, p = 0.788). Similar results were seen at the total hip. Conclusions: In de novo KTR treated with 2 doses of denosumab, we detect a marked decrease in lumbar spine and hip BMD when denosumab is discontinued. Denosumab treatment should therefore not be discontinued without considering an alternative antiresorptive treatment.

Monthly Levels and Criteria Considerations of Nutrient, pH, Alkalinity, and Ionic Variables in Runoff Containment Basins in Ornamental Plant Nurseries

Triplicate water samples were collected monthly from nine waterways [eight runoff containment basins (RCBs) and one stream] on four commercial ornamental plant nurseries from February to July, and from one RCB and nursery from April to October. Four RCBs, one per nursery, were actively used as an irrigation water source. Analysis was done for 18 water quality variables, including ammonium–nitrogen (NH4+–N), nitrate–nitrogen (NO3−–N), ortho phosphate–phosphorus (PO4–P), total-phosphorus (T-P), potassium (K), calcium (Ca), magnesium (Mg), sulfur (S), aluminum (Al), boron (B), copper (Cu), iron (Fe), manganese (Mn), zinc (Zn), pH, total alkalinity (T-Alk), electrical conductivity (EC), and sodium (Na). The degree and rate of monthly change varied considerably between RCBs. Macronutrients generally increased at most nurseries in 1–2 months after fertilizer application particularly in three RCBs (MD21, VA11, and VA12), with levels of N- and P forms exceeding preferred criteria for irrigation water by June and July in VA11 and VA12. Micronutrients fluctuated less but did vary per RCB with the most monthly change occurring in MD21. Even though pH fluctuated, pH tended to remain alkaline or neutral to acidic respective of the RCB during the entire sample period. T-Alk tended to increase over the summer. EC primarily fluctuated in RCBs with high macronutrient levels. Although levels of N- and P forms were mostly suitable by irrigation water criteria, they were frequently above U.S. Environmental Protection Agency (USEPA) nutrient criteria for promoting healthy water environments of lakes and reservoirs, and are discussed.

Abstract 136: The Relationship of Changing Hospital Readmission Rates and Mortality Rates After Hospitalization for Heart Failure, Acute Myocardial Infarction, and Pneumonia

Background: It is unknown if financial pressures to reduce hospital readmission rates following passage of the Affordable Care Act (ACA) have had the unintended effect of increasing mortality rates after hospitalization. We therefore examined correlations between paired changes in hospital 30-day readmission rates and 30-day mortality rates among Medicare fee-for-service beneficiaries hospitalized with heart failure (HF), acute myocardial infarction (AMI), or pneumonia from 2008 to 2014. Methods: We used linear regression to calculate monthly changes in hospitals’ 30-day risk-adjusted readmission rates (RARRs) and 30-day risk-adjusted mortality rates (RAMRs) after discharge for HF, AMI, and pneumonia from 2008 to 2014. Adjustment was made for patient age, sex, comorbidities, hospital length of stay, and season. We then examined the correlation of hospitals’ paired monthly changes in 30-day RARRs and monthly changes in 30-day RAMRs after discharge. Results: From 2008 to 2014, we identified 2,962,554, 1,229,939, and 2,544,530 hospitalizations for HF, AMI, and pneumonia at 5,016, 4,772, and 5,057 hospitals, respectively. Hospital 30-day RARRs declined for all three conditions from 2008 to 2014; the monthly change in RARRs was -0.053 (95% CI -0.055, -0.051) for HF, -0.044 (95% CI -0.047, -0.041) for AMI, and -0.033 (95% CI -0.035, -0.031) for pneumonia. In contrast, the monthly change in hospital 30-day RAMRs after discharge varied by admitting condition and was 0.008 (95% CI 0.007, 0.010) for HF, -0.003 (95% CI -0.006, -0.001) for AMI, and 0.001 (95% CI -0.001, 0.003) for pneumonia. The correlation between monthly changes in hospitals’ 30-day RARRs and 30-day RAMRs after discharge was 0.060 for HF (p<0.001), 0.059 for AMI (p=0.003), and 0.106 for pneumonia (p<0.001). Representative data showing the poor correlation in hospitals’ paired monthly changes in 30-day RARRs and 30-day RAMRs for AMI is shown in the Figure. Conclusion: Changes in hospital readmission rates for HF, AMI, and pneumonia were poorly correlated with changes in mortality rates after hospitalization between 2008 and 2014. These findings suggest that financial incentives to improve hospitals’ readmission performance have not increased mortality after hospitalization.