Search results for: Logistic ‎regression‎

Authors: Sha Fan, Renuka Mahadevan

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In recent years, the subject of how retirement influences consumption behaviours has garnered attention in economic research. However, a significant gap persists in our understanding of how retirement precisely impacts tourism consumption patterns among the elderly demographic. To address this gap, this research conducts an in-depth exploration into the multifaceted relationship between retirement and elderly tourism consumption.To achieve this, the study employs regression discontinuity design, using three waves of panel data from China covering a span of six years. This approach aims to identify the causality between retirement and tourism consumption. Furthermore, the study scrutinizes the pathways through which retirement's impact on tourism consumption unfolds. It adopts a dual-pronged perspective, examining the roles played by economic status and the availability of leisure time. The economic dimension underscores the financial adjustments that retirees make as they transition into a new phase of life, impacting their propensity to allocate resources towards tourism activities. Meanwhile, considering leisure time recognizes that retirement often heralds an era of newfound freedom, allowing retirees the luxury to engage in leisurely pursuits like tourism.

Keywords: tourism consumption, retirement, the elderly, regression discontinuity design

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Authors: Elnaz Bandeh

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This study aimed to predict marital burnout based on irrational beliefs and sexual dysfunction of couples. The research method was descriptive-correlational, and the statistical population included all couples who consulted to counseling clinics in the fall of 2016. The sample consisted of 200 people who were selected by convenience sampling and answered the Ahwaz Irrational Beliefs Questionnaire, Pines Couple Burnout, and Hudson Marital Satisfaction Questionnaire. The data were analyzed using regression coefficient. The results of regression analysis showed that there was a linear relationship between irrational beliefs and couple burnout and dimensions of helplessness toward change, expectation of approval from others, and emotional irresponsibility were positive and significant predictors of couple burnout. However, after avoiding the problem of power, it was not a significant predictor of marital dissatisfaction. There was also a linear relationship between sexual dysfunction and couple burnout, and sexual dysfunction was a positive and significant predictor of couple burnout. Based on the findings, it can be concluded that irrational beliefs and sexual dysfunction play a role in couple dysfunction.

Keywords: couple burnout, irrational beliefs, sexual dysfunction, marital relationship

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Authors: Mehmet Izzettin Yilmazer, Emin Cadirli

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Zn-7wt.%Al-2.96wt.%Cu eutectic alloy was directionally solidified upwards with different temperature gradients (from 6.70 K/mm to 10.67 K/mm) at a constant growth rate (16.4 Km/s) and also different growth rate (from 8.3 micron/s to 166 micron/s) at a constant temperature gradient (10.67 K/mm) using a Bridgman–type growth apparatus.The values of eutectic spacing were measured from longitudinal and transverse sections of the samples. The dependency of microstructures on the G and V were determined with linear regression analysis and experimental equations were found as λl=8.953xVexp-0.49, λt=5.942xVexp-0.42 and λl=0.008xGexp-1.23, λt=0.024xGexp-0.93. The measurements of microhardness of directionally solidified samples were obtained by using a microhardness test device. The dependence of microhardness HV on temperature gradient and growth rate were analyzed. The dependency of microhardness on the G and V were also determined with linear regression analysis as HVl=110.66xVexp0.02, HVt=111.94xVexp0.02 and HVl=69.66xGexp0.17, HVt=68.86xGexp0.18. The experimental results show that the microhardness of the directionally solidified Zn-Al-Cu alloy increases with increasing the growth rate. The results obtained in this work were compared with the previous similar experimental results.

Keywords: directional solidification, eutectic alloys, microstructure, microhardness

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Authors: Mohamed Mounir Tellache, Hiroyuki Kambara, Yasuharu Koike, Makoto Miyakoshi, Natsue Yoshimura

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This study explores the practicality of using electroencephalographic (EEG) independent components to predict eight-direction finger movements in pseudo-real-time. Six healthy participants with individual-head MRI images performed finger movements in eight directions with two different arm configurations. The analysis was performed in two stages. The first stage consisted of using independent component analysis (ICA) to separate the signals representing brain activity from non-brain activity signals and to obtain the unmixing matrix. The resulting independent components (ICs) were checked, and those reflecting brain-activity were selected. Finally, the time series of the selected ICs were used to predict eight finger-movement directions using Sparse Logistic Regression (SLR). The second stage consisted of using the previously obtained unmixing matrix, the selected ICs, and the model obtained by applying SLR to classify a different EEG dataset. This method was applied to two different settings, namely the single-participant level and the group-level. For the single-participant level, the EEG dataset used in the first stage and the EEG dataset used in the second stage originated from the same participant. For the group-level, the EEG datasets used in the first stage were constructed by temporally concatenating each combination without repetition of the EEG datasets of five participants out of six, whereas the EEG dataset used in the second stage originated from the remaining participants. The average test classification results across datasets (mean ± S.D.) were 38.62 ± 8.36% for the single-participant, which was significantly higher than the chance level (12.50 ± 0.01%), and 27.26 ± 4.39% for the group-level which was also significantly higher than the chance level (12.49% ± 0.01%). The classification accuracy within [–45°, 45°] of the true direction is 70.03 ± 8.14% for single-participant and 62.63 ± 6.07% for group-level which may be promising for some real-life applications. Clustering and contribution analyses further revealed the brain regions involved in finger movement and the temporal aspect of their contribution to the classification. These results showed the possibility of using the ICA-based method in combination with other methods to build a real-time system to control prostheses.

Keywords: brain-computer interface, electroencephalography, finger motion decoding, independent component analysis, pseudo real-time motion decoding

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Authors: Pawthawala Nancy Manish, Syed Alay Hashim

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A hybrid rocket is a rocket engine which uses propellants in two different states of matter- one is in solid and the other either gas or liquid. A hybrid rocket exhibit advantages over both liquid rockets and solid rockets especially in terms of simplicity, stop-start-restart capabilities, safety and cost. This paper deals the design and development of a hybrid rocket having paraffin wax as solid fuel and liquid oxygen as oxidizer. Due to variation of pressure in combustion chamber there is significantly change in mass flow rate, burning rate and uneven regression along the length of the grain. This project describes the working model of a hybrid propellant rocket motor. We have designed a hybrid rocket thrust chamber based on the predetermined combustion chamber pressure and the properties of hybrid propellant. This project is all ready in working condition with normal oxygen injector. Now we have planned to modify the injector design to improve the combustion property. We will use spray type injector for injecting the oxidizer. This idea will increase the performance followed by the regression rate of the solid fuel. By employing mass conservation law, oxygen mass flux, oxidizer/fuel ratio and regression rate the thrust coefficient can be obtained for our current design. CATIA V5 R20 is our design software for the complete setup. This project is fully based on experimental evaluation and the collection of combustion and flow parameters. The thrust chamber is made of stainless steel and the duration of test is around 15-20 seconds (Maximum). These experiments indicates that paraffin based fuel provides the opportunity to satisfy a broad range of mission requirements for the next generation of the hybrid rocket system.

Keywords: burning rate, liquid oxygen, mass flow rate, paraffin wax and sugar

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Authors: Redvan Ghasemlounia, Elham Ansari, Hikmet Kerem Cigizoglu

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Hydrological modeling in arid and semi-arid regions is very important. Iran has many regions with these climate conditions such as Chaharmahal and Bakhtiari province that needs lots of attention with an appropriate management. Forecasting of hydrological parameters and estimation of hydrological events of catchments, provide important information that used for design, management and operation of water resources such as river systems, and dams, widely. Discharge in rivers is one of these parameters. This study presents the application and comparison of some estimation methods such as Feed-Forward Back Propagation Neural Network (FFBPNN), Multi Linear Regression (MLR), Gene Expression Programming (GEP) and Bayesian Network (BN) to predict the daily flow discharge of the Soolegan River, located at Chaharmahal and Bakhtiari province, in Iran. In this study, Soolegan, station was considered. This Station is located in Soolegan River at 51° 14՜ Latitude 31° 38՜ longitude at North Karoon basin. The Soolegan station is 2086 meters higher than sea level. The data used in this study are daily discharge and daily precipitation of Soolegan station. Feed Forward Back Propagation Neural Network(FFBPNN), Multi Linear Regression (MLR), Gene Expression Programming (GEP) and Bayesian Network (BN) models were developed using the same input parameters for Soolegan's daily discharge estimation. The results of estimation models were compared with observed discharge values to evaluate performance of the developed models. Results of all methods were compared and shown in tables and charts.

Keywords: ANN, multi linear regression, Bayesian network, forecasting, discharge, gene expression programming

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Authors: A. A. Agbor, Jean Joel R. Bigna, Serges Clotaire Billong, Mathurin Cyrille Tejiokem, Gabriel L. Ekali, Claudia S. Plottel, Jean Jacques N. Noubiap, Hortence Abessolo, Roselyne Toby, Sinata Koulla-Shiro

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Background: Contributors to fatal outcomes in patients undergoing tuberculosis (TB) treatment in the setting of HIV co-infection are poorly characterized, especially in sub-Saharan Africa. Our study’s aim was to assess factors associated with death in TB/HIV co-infected patients during the first 6 months their TB treatment. Methods: We conducted a tertiary-care hospital-based retrospective cohort study from January 2006 to December 2013 at the Yaoundé Central Hospital, Cameroon. We reviewed medical records to identify hospitalized co-infected TB/HIV patients aged 15 years and older. Death was defined as any death occurring during TB treatment, as per the World Health Organization’s recommendations. Logistic regression analysis identified factors associated with death. Magnitudes of associations were expressed by adjusted odds ratio (aOR) with 95% confidence interval. A p value < 0.05 was considered statistically significant. Results: The 337 patients enrolled had a mean age of 39.3 (+/- 10.3) years and more (54.3%) were women. TB treatment outcomes included: treatment success in 60.8% (n=205), death in 29.4% (n=99), not evaluated in 5.3% (n=18), loss to follow-up in 5.3% (n=14), and failure in 0.3% (n=1) . After exclusion of patients lost to follow-up and not evaluated, death in TB/HIV co-infected patients during TB treatment was associated with: a TB diagnosis made before national implementation of guidelines regarding initiation of antiretroviral therapy (aOR = 2.50 [1.31-4.78]; p = 0.006), the presence of other AIDS-defining infections (aOR = 2.73 [1.27-5.86]; p = 0.010), non-AIDS comorbidities (aOR = 3.35 [1.37-8.21]; p = 0.008), not receiving co-trimoxazole prophylaxis (aOR = 3.61 [1.71-7.63]; p = 0.001), not receiving antiretroviral therapy (aOR = 2.45 [1.18-5.08]; p = 0.016), and CD4 cell counts < 50 cells/mm3 (aOR = 16.43 [1.05-258.04]; p = 0.047). Conclusions: The success rate of anti-tuberculosis treatment among hospitalized TB/HIV co-infected patients in our setting is low. Mortality in the first 6 months of treatment was high and strongly associated with specific clinical factors including states of greater immunosuppression, highlighting the urgent need for targeted interventions, including provision of anti-retroviral therapy and co-trimoxazole prophylaxis in order to enhance patient outcomes.

Keywords: TB/HIV co-infection, death, treatment outcomes, factors

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Authors: Waseem Al Talalwah, Shorok Al Dorazi, Roger Soames

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Persistent sciatic artery is a rare anatomical vascular variation resulting from a lack of regression of the embryonic dorsal axial artery. The axial artery is the main artery supplying the lower limb during development in the first trimester. The current research includes 206 sciatic artery cases in 171 patients between 1864 and 2012. It aims to identify the risk factor of sciatic artery aneurysm in congenital limb anomalies. Sciatic artery aneurysm was diagnosed incidentally in amniotic band syndrome (ABS) existing with no congenital anomaly in 0.7% or with double knee in 0.7%, with the tibia in 0.7% and with hemihypertrophy or soft tissue hypertrophy in 1.4%. Therefore, the current study indicates a relationship the same gene responsible for the congenital limb deformities may be responsible for non-regression of the sciatic artery. Furthermore, pediatricians should refer cases of congenital limb anomalies for vascular evaluation prior to corrective surgical intervention.

Keywords: amniotic band syndrome, congenital limb deformities, double knee, sciatic artery, sciatic artery aneurysm , soft tissue hypertrophy

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Authors: Seher Arslankaya, Bahar Uludağ

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Meeting the needs and demands of customers and pleasing the customers are important requirements for companies in food sectors where the growth of competition is significantly unpredictable. Customer satisfaction is also one of the key concepts which is mainly driven by wide range of customer preference and expectation upon products and services introduced and delivered to them. In order to meet the customer demands, the companies that engage in food sectors are expected to have a well-managed set of Total Quality Management (TQM), which sets out to improve quality of products and services; to reduce costs and to increase customer satisfaction by restructuring traditional management practices. It aims to increase customer satisfaction by meeting (their) customer expectations and requirements. The achievement would be determined with the help of customer satisfaction surveys, which is done to obtain immediate feedback and to provide quick responses. In addition, the surveys would also assist the making of strategic planning which helps to anticipate customer future needs and expectations. Meanwhile, periodic measurement of customer satisfaction would be a must because with the better understanding of customers perceptions from the surveys (done by questioners), the companies would have a clear idea to identify their own strengths and weaknesses that help the companies keep their loyal customers; to stand in comparison toward their competitors and map out their future progress and improvement. In this study, we propose a survey based on customer satisfaction measurement method and its statistical analysis for sales and logistic activities of food firms. Customer satisfaction would be discussed in details. Furthermore, after analysing the data derived from the questionnaire that applied to customers by using the SPSS software, various results obtained from the application would be presented. By also applying ANOVA test, the study would analysis the existence of meaningful differences between customer demographic proportion and their perceptions. The purpose of this study is also to find out requirements which help to remove the effects that decrease customer satisfaction and produce loyal customers in food industry. For this purpose, the customer complaints are collected. Additionally, comments and suggestions are done according to the obtained results of surveys, which would be useful for the making-process of strategic planning in food industry.

Keywords: customer satisfaction measurement and analysis, food industry, SPSS, TQM

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Authors: Mohsen Amiri

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This study aimed at investigating the relationship between familial functioning, child characteristics, demographic variables and parenting stress and mental health among parents of children with mental disabilities. 200 parents (130 mothers and 70 fathers) were studied and they completed the Parenting Stress Index, General Health Questionnaire, Family Assessment Device and demographic questionnaires for parents and children. Data were analyzed using correlation and regression analysis. Regression analysis showed that child characteristics, familial functioning and parents demographic factors could predict 8, 4 and 17 percent of variance in parental stress and 3.6, 16 and 10 percent of variance in mental health, respectively. Familial functioning, child characteristics and parental demographic variables correlated with mental health and parental stress and could predict them.

Keywords: parenting stress, mental health, mentally disabled children, familial functioning, demographic variables

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Authors: Syrus Zimaze, George Nsimbe, Valley Mugwanya, Matiya Lule, Edgar Watson, Patrick Gwayambadde

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Physical inactivity is a growing global epidemic, also recognised as a major public health challenge. Globally, there are alarming rates of children reported with cardiovascular disease and obesity with limited interventions. In Sub Saharan Africa, there is limited information about involvement in physical activity especially among children aged 6 to 18 years. The aim of this study was to explore factors associated with involvement in physical activity among children in Uganda. Methods: We included all parents with children aged 6 to 18 years training with Excel Soccer Academy between January 2017 and June 2018. Physical activity definition was time spent participating in routine soccer training at the academy for more than 30 days. Each child's attendance was recorded, and parents provided demographic and social economic data. Data on predictors of physical activity involvement were collected using a standardized questionnaire. Descriptive statistics and frequency were used. Binary logistic regression was used at the multi variable level adjusting for education, residence, transport means and access to information technology. Results: Overall 356 parents were interviewed; Boys 318 (89.3%) engaged more in physical activity than girls. The median age for children was 13 years (IQR:6-18) and 42 years (IQR:37-49) among parents. The median time spent at the Excel soccer academy was 13.4 months (IQR: 4.6-35.7) Majority of the children attended formal education, p < 0.001). Factors associated with involvement in physical activity included: owning a permanent house compared to a rented house (odds ratio [OR] :2.84: 95% CI: 2.09-3.86, p < 0.0001), owning a car compared to using public transport (OR: 5.64 CI: 4.80-6.63, p < 0.0001), a parent having received formal education compared to non-formal education (OR: 2.93 CI: 2.47-3.46, p < 0.0001) and daily access to information technology (OR:0.40 CI:0.25-0.66, p < 0.001). Parent’s age and gender were not associated to involvement in physical activity. Conclusions: Socioeconomic factors were positively associated with involvement in physical activity with boys participating more than girls in soccer activities. More interventions are required geared towards increasing girl’s participation in physical activity and those targeting children from less privilege homes.

Keywords: physical activity, Sub-Saharan Africa, social economic factors, children

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Authors: Jeeban Amgain

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This paper investigates the impact of the size and composition of government expenditure and tax on GDP per capita growth in 36 Asian economies over the period of 1991-2012. The research employs the technique of panel regression; Fixed Effects and Generalized Method of Moments (GMM) as well as other statistical and descriptive approaches. The finding concludes that the size of government expenditure and tax revenue are generally low in this region. GDP per capita growth is strongly negative in response to Government expenditure, however, no significant relationship can be measured in case of size of taxation although it is positively correlated with economic growth. Panel regression of decomposed fiscal components also shows that the pattern of allocation of expenditure and taxation really matters on growth. Taxes on international trade and property have a significant positive impact on growth. In contrast, a major portion of expenditure, i.e. expenditure on general public services, health and education are found to have significant negative impact on growth, implying that government expenditures are not being productive in the Asian region for some reasons. Comparatively smaller and efficient government size would enhance the growth.

Keywords: government expenditure, tax, GDP per capita growth, composition

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Authors: Estibe Dagne Mekonnen

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In recent years, the prevalence of undernourishment was 30 percent for sub-Saharan Africa, compared with 16 percent for Asia and the Pacific (Ali, 2011). In Ethiopia, almost 40 percent of the total population in the country and 57 percent of Addis Ababa population lives below the international poverty line of US$ 1.25 per day (UNICEF, 2009). This study aims to analyze the determinant of household food secrity in Addis Ababa city administration. Primary data were collected from a survey of 256 households in the selected sub-city, namely Addis Ketema, Arada, and Kolfe Keranio, in the year 2022. Both Purposive and multi-stage cluster random sampling procedures were employed to select study areas and respondents. Descriptive statistics and order logistic regression model were used to test the formulated hypotheses. The result reveals that out of the total sampled households, 25% them were food secured, 13% were mildly food insecure, 26% were moderately food insecure and 36% were severely food insecure. The study indicates that household family size, house ownership, household income, household food source, household asset possession, household awareness on inflation, household access to social protection program, household access to credit and saving and household access to training and supervision on food security have a positive and significant effect on the likelihood of household food security status. However, marital status of household head, employment sector of household head, dependency ratio and household’s nonfood expenditure has a negative and significant influence on household food security status. The study finally suggests that the government in collaboration with financial institutions and NGO should work on sustaining household food security by creating awareness, providing credit, facilitate rural-urban linkage between producer and consumer and work on urban infrastructure improvement. Moreover, the governments also work closely and monitor consumer good suppliers, if possible find a way to subsidize consumable goods to more insecure households and make them to be food secured. Last but not least, keeping this country’s peace will play a crucial role to sustain food security.

Keywords: determinants, household, food security, order logit model, Addis Ababa

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Authors: Arun Dhakal, Geoff Cockfield, Tek Narayan Maraseni

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This paper attempts to fulfil the gap in measuring adoption in agroforestry studies. It explains the derivation of an index of adoption rate in a Nepalese context and examines the factors affecting adoption of agroforestry-based land management practice (AFLMP) in the Dhanusha District of Nepal. Data about the different farm practices and the factors (bio-physical, socio-economic) influencing adoption were collected during focus group discussion and from the randomly selected households using a household survey questionnaire, respectively. A multivariate regression model was used to determine the factors. The factors (variables) found to significantly affect adoption of AFLMP were: farm size, availability of irrigation water, education of household heads, agricultural labour force, frequency of visits by extension workers, expenditure on farm inputs purchase, household’s experience in agroforestry, and distance from home to government forest. The regression model explained about 75% of variation in adoption decision. The model rejected ‘erosion hazard’, ‘flood hazard’ and ‘gender’ as determinants of adoption, which in case of single agroforestry practice were major variables and played positive role. Out of eight variables, farm size played the most powerful role in explaining the variation in adoption, followed by availability of irrigation water and education of household heads. The results of this study suggest that policies to promote the provision of irrigation water, extension services and motivation to obtaining higher education would probably provide the incentive to adopt agroforestry elsewhere in the terai of Nepal.

Keywords: agroforestry, adoption index, determinants of adoption, step-wise linear regression, Nepal

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Authors: Stephanie Yun Yu Law

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Background: This study aims to investigate into communication between trainee doctors and patients, especially how doctor’s reaction to patient’s emotional issues expressed in the consultation affect patient’s satisfaction. Objectives: Thus, there are three aims in this study, 1.) how do trainee doctors react to patients emotional cues in OSCE station? 2.) Any differences in the respond type to emotional cues between first year students and third year students? 3.) Is response type (reducing space) related to OSCE outcome (patient satisfaction and expert rating)? Methods: Fifteen OSCE stations was videotaped, in which 9 were stations with first-year students and 6 were with third-year students. OSCE outcomes were measured by Communication Assessment Tool and Examiners Checklist. Analyses: All patient’s cues/concerns and student’s reaction were coded by Verona Coding Definitions of Emotional Sequence. Descriptive data was gathered from Observer XT and logistic regression (two-level) was carried out to see if occurrence of reducing space response can be predicted by OSCE outcomes. Results: Reducing space responses from all students were slightly less than a half in total responses to patient’s cues. The mean percentage of reducing space behaviours was lower among first year students when compared to third year students. Patient’s satisfaction significantly (p<0.05) and negatively predicted reducing space behaviours. Conclusions: Most of the medical students, to some extent, did not provide adequate responses for patient’s emotional cues. But first year students did provide more space for patients to talk about their emotional issues when compared to third year students. Lastly, patients would feel less satisfied if trainee doctors use more reducing space responses in reaction to patient’s expressed emotional cues/concerns. Practical implications: Firstly, medical training programme can be tailored on teaching students how to detect and respond appropriately to emotional cues in order to improve underperformed student’s communication skills in healthcare setting. Furthermore, trainee doctor’s relationship with patients in clinical practice can also be improved by reacting appropriately to patient’s emotive cues in consultations (such as limit the use of reducing space behaviours).

Keywords: doctors-patients communication, applied clinical psychology, health psychology, healthcare professionals

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Authors: Philip Friedlander, John Rutledge, Jason Suh

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Inhibition of programmed death-1 (PD-1) or its ligand PD-L1 confers therapeutic efficacy in a wide range of solid tumor malignancies. Primary or acquired resistance can develop through activation of immunosuppressive immune cells such as tumor-associated macrophages. The renin angiotensin system (RAS) systemically regulates fluid and sodium hemodynamics, but components are expressed on and regulate the activity of immune cells, particularly of myeloid lineage. We hypothesized that inhibition of RAS would improve the efficacy of PD-1/PD-L-1 treatment. A retrospective analysis was performed through a chart review of patients with solid metastatic malignancies treated with a PD-1/PD-L1 inhibitor between 1/2013 and 6/2019 at Valley Hospital, a community hospital in New Jersey, USA. Efficacy was determined by medical oncologist documentation of clinical benefit in visit notes and by the duration of time on immunotherapy treatment. The primary endpoint was the determination of efficacy differences in patients treated with an inhibitor of RAS ( ace inhibitor, ACEi, or angiotensin blocker, ARB) compared to patients not treated with these inhibitors. To control for broader antihypertensive effects, efficacy as a function of treatment with beta blockers was assessed. 173 patients treated with PD-1/PD-L-1 inhibitors were identified of whom 52 were also treated with an ACEi or ARB. Chi-square testing revealed a statistically significant relationship between being on an ACEi or ARB and efficacy to PD-1/PD-L-1 therapy (p=0.001). No statistically significant relationship was seen between patients taking or not taking beta blocker antihypertensives (p= 0.33). Kaplan-Meier analysis showed statistically significant improvement in the duration of therapy favoring patients concomitantly treated with ACEi or ARB compared to patients not exposed to antihypertensives and to those treated with beta blockers. Logistic regression analysis revealed that age, gender, and cancer type did not have significant effects on the odds of experiencing clinical benefit (p=0.74, p=0.75, and p=0.81, respectively). We conclude that retrospective analysis of the treatment of patients with solid metastatic tumors with anti-PD-1/PD-L1 in a community setting demonstrates greater clinical benefit in the context of concomitant ACEi or ARB inhibition, irrespective of gender or age. This data supports the development of prospective assessment through randomized clinical trials.

Keywords: angiotensin, cancer, immunotherapy, PD-1, efficacy

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Authors: Ali Soroush, Mehdi Mirzaei Alavijeh, Touraj Ahmadi Jouybari, Fazel Zinat-Motlagh, Abbas Aghaei, Mari Ataee

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Diabetes is a disease with long cardiovascular, renal, ophthalmic and neural complications. It is prevalent all around the world including Iran, and its prevalence is increasing. The aim of this study was to determine the factors related to self-care behavior based on health belief model among sample of Iranian diabetic patients. This cross-sectional study was conducted among 301 type 2 diabetic patients in Gachsaran, Iran. Data collection was based on an interview and the data were analyzed by SPSS version 20 using ANOVA, t-tests, Pearson correlation, and linear regression statistical tests at 95% significant level. Linear regression analyses showed the health belief model variables accounted for 29% of the variation in self-care behavior; and perceived severity and perceived self-efficacy are more influential predictors on self-care behavior among diabetic patients.

Keywords: diabetes, patients, self-care behaviors, health belief model

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Authors: Hamed Rashid Sarand, Kemal Selçuk Öğüt

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Speed is one of the fundamental variables of road traffic flow that stands as an important evaluation criterion for traffic analyses in several aspects. In particular, varieties of speed variable, such as average speed, free flow speed, optimum speed (capacity speed), acceleration/deceleration speed and so on, have been explicitly considered in the analysis of not only road safety but also road capacity. In the purpose of realizing 'road speed – maximum speed difference across lanes' and 'road flow rate – maximum speed difference across lanes' relations on freeway traffic, this study presents a case study conducted on a basic freeway segment of O-2 in Istanbul. The traffic data employed in this study have been obtained from 5 remote traffic microwave sensors operated by Istanbul Metropolitan Municipality. The study stretch is located between two successive freeway interchanges: Ümraniye and Kavacık. Daily traffic data of 4 years (2011-2014) summer months, July and August are used. The speed data are analyzed into two main flow areas such as uncongested and congested flows. In this study, the regression analyses were carried out in order to examine the relationship between maximum speed difference across lanes and road speed. These investigations were implemented at uncongested and congested flows, separately. Moreover, the relationship between maximum speed difference across lanes and road flow rate were evaluated by applying regression analyses for both uncongested and congested flows separately. It is concluded that there is the moderate relationship between maximum speed difference across lanes and road speed in 50% cases. Additionally, it is indicated that there is the moderate relationship between maximum speed difference across lanes and road flow rate in 30% cases. The maximum speed difference across lanes decreases as the road flow rate increases.

Keywords: maximum speed difference, regression analysis, remote traffic microwave sensor, speed differentiation, traffic flow

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Authors: Fuchun Li, Hong Xiao

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We propose a new early warning model for predicting financial stress events for a given future time. In this model, we examine whether credit conditions play an important role as a nonlinear propagator of shocks when predicting the likelihood of occurrence of financial stress events for a given future time. This propagation takes the form of a threshold regression in which a regime change occurs if credit conditions cross a critical threshold. Given the new early warning model for financial stress events, we evaluate the performance of this model and currently available alternatives, such as the model from signal extraction approach, and linear regression model. In-sample forecasting results indicate that the three types of models are useful tools for predicting financial stress events while none of them outperforms others across all criteria considered. The out-of-sample forecasting results suggest that the credit-regime switching model performs better than the two others across all criteria and all forecasting horizons considered.

Keywords: cut-off probability, early warning model, financial crisis, financial stress, regime-switching model, forecasting horizons

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Authors: Yusuke Katayama, Tetsuhisa Kitamura, Kosuke Kiyohara, Sumito Hayashida, Taku Iwami, Takashi Kawamura, Takeshi Shimazu

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Background: Recently, the number of ambulance dispatches has been increasing in Japan and it is, therefore, difficult to accept emergency patients to hospitals smoothly and appropriately because of the limited hospital capacity. To facilitate the request for patient transport by ambulances and hospital acceptance, the emergency information system using information technology has been built up and introduced in various communities. However, its effectiveness has not been insufficiently revealed in Japan. In 2013, we developed a smartphone application system that enables the emergency-medical-service (EMS) personnel to share information about on-scene ambulance and hospital situation. The aim of this study was to assess the introduction effect of this application for EMS system in Osaka City, Japan. Methods: This study was a retrospective study with population-based ambulance records of Osaka Municipal Fire Department. This study period was six years from January 1, 2010 to December 31, 2015. In this study, we enrolled emergency patients that on-scene EMS personnel conducted the hospital selection for them. The main endpoint was difficulty in hospital acceptance at the scene. The definition of difficulty in hospital acceptance at the scene was to make >=5 phone calls by EMS personnel at the scene to each hospital until a decision to transport was determined. The definition of the smartphone application group was emergency patients transported in the period of 2013-2015 after the introduction of this application, and we assessed the introduction effect of smartphone application with multivariable logistic regression model. Results: A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 smartphone application group (50.0%) in 2010-2012 and 300,395 non-smartphone application group (50.0%) in 2013-2015. The proportion of the difficulty in hospital acceptance was 14.2% (42,585/300,131) in the smartphone application group and 10.9% (32,819/300,395) in the non-smartphone application group, and the difficulty in hospital acceptance significantly decreased by the introduction of the smartphone application (adjusted odds ration; 0.730, 95% confidence interval; 0.718-0.741, P<0.001). Conclusions: Sharing information between ambulance and hospital by introducing smartphone application at the scene was associated with decreasing the difficulty in hospital acceptance. Our findings may be considerable useful for developing emergency medical information system with using IT in other areas of the world.

Keywords: difficulty in hospital acceptance, emergency medical service, infomation technology, smartphone application

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Authors: Tahir Nawaz Cheema, Dumitru Baleanu, Ali Raza

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In this research work, we design intelligent computing through Bayesian Regularization artificial neural networks (BRANNs) introduced to solve the mathematical modeling of infectious diseases (Covid-19). The dynamical transmission is due to the interaction of people and its mathematical representation based on the system's nonlinear differential equations. The generation of the dataset of the Covid-19 model is exploited by the power of the explicit Runge Kutta method for different countries of the world like India, Pakistan, Italy, and many more. The generated dataset is approximately used for training, testing, and validation processes for every frequent update in Bayesian Regularization backpropagation for numerical behavior of the dynamics of the Covid-19 model. The performance and effectiveness of designed methodology BRANNs are checked through mean squared error, error histograms, numerical solutions, absolute error, and regression analysis.

Keywords: mathematical models, beysian regularization, bayesian-regularization backpropagation networks, regression analysis, numerical computing

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Authors: Ahmad Zulfahmi Mohd Kamaruzaman, Mohd Ismail Ibrahim, Ariffin Marzuki Mokhtar, Maizun Mohd Zain, Saiful Nazri Satiman, Mohd Najib Majdi Yaacob

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Background: Aftermath any patient safety incidents, the involved healthcare providers possibly sustained second victim-related distress (second victim distress and reduced their professional efficacy), with subsequent negative work-related outcomes or vice versa cultivating resilience. This study aimed to investigate the factors affecting negative work-related outcomes and resilience, with the triad of support; colleague, supervisor, and institutional support as the hypothetical mediators. Methods: This was a cross sectional study recruiting a total of 733 healthcare providers from three tertiary care in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for each outcome; negative work-related outcomes and resilience. Then, four multiple mediator models of support triad were analyzed. Results: Second victim distress, professional efficacy, and the support triad contributed significantly for each regression model. In the pathway of professional efficacy on each negative work-related outcomes and resilience, colleague support partially mediated the relationship. As for second victim distress on negative work related outcomes, colleague and supervisor support were the partial mediator, and on resilience; all support triad also produced a similar effect. Conclusion: Second victim distress, professional efficacy, and the support triad influenced the relationship with the negative work-related outcomes and resilience. Support triad as the mediators ameliorated the effect in between and explained the urgency of having good support for recovery post encountering patient safety incidents.

Keywords: second victims, patient safety incidents, hierarchical linear regression, mediation, support

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Authors: Mohammad Noor Hisham Osman, Ahmed Razman Abdul Latiff, Zaidi Mat Daud, Zulkarnain Muhamad Sori

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The problem that Malaysian auditors do not issue going concern opinion (GC opinion) to seriously financially distressed companies is still a pressing issue. Policy makers, particularly the Financial Statement Review Committee (FSRC) of Malaysian Institute of Accountant, have raised this issue as early as in 2009. Similar problem happened in the US, UK, and many developing countries. It is important for auditors to issue GC opinion properly because such opinion is one signal about the viability of a company much needed by stakeholders. There are at least two unanswered questions or research gaps in the literature on determinants of GC opinion. Firstly, is client’s probability of failure associated with GC opinion issuance? Secondly, to what extent influential owners (management, family, and institution) moderate the association between client probability of failure and GC opinion issuance. The objective of this study is, therefore, twofold; (1) To examine the extent of the relationship between the probability of client failure and the issuance of GC opinion and (2) To examine the level of management, family, and institutional ownerships moderate the association between client probability of failure and the issuance of GC opinion. This study is quantitative in nature, and the sources of data are secondary (mainly company’s annual reports). A total of four hypotheses have been developed and tested on data accumulated from annual reports of seriously financially distressed Malaysian public listed companies. Data from 2006 to 2012 on a sample of 644 observations have been analyzed using panel logistic regression. It is found that certainty (rather than probability) of client failure affects the issuance of GC opinion. In addition, it is found that only the level of family ownership does positively moderate the relationship between client probability of failure and GC opinion issuance. This study is a contribution to auditing literature as its findings can enhance our understanding about audit quality; particularly on the variables that are associated with the issuance of GC opinion. The findings of this study shed light on the roles family owners in GC opinion issuance process, and this would open ways for the researcher to suggest measures that can be used to tackle the problem of auditors do not want to issue GC opinion to financially distressed clients. The measures to be suggested can be useful to policy makers in formulating future promulgations.

Keywords: audit quality, auditing, auditor characteristics, going concern opinion, Malaysia

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Authors: Mmamapudi Kubjane, Natacha Berkowitz, Rene Goliath, Naomi S. Levitt, Robert J. Wilkinson, Tolu Oni

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Background: South Africa remains a high tuberculosis (TB) burden country globally and the burden of diabetes – a TB risk factor is growing rapidly. As an infectious disease, TB also induces transient hyperglycaemia. Therefore, screening for diabetes in newly diagnosed tuberculosis patients may result in misclassification of transient hyperglycaemia as diabetes. Objective: The objective of this study was to determine and compare the prevalence of hyperglycaemia (diabetes and impaired glucose regulation (IGR)) in TB patients and to assess the cross-sectional association between TB and hyperglycaemia at enrolment and after three months of follow-up. Methods: Consecutive adult TB and non-TB participants presenting at a TB clinic in Cape Town were enrolled in this cross-sectional study and follow-up between July 2013 and August 2015. Diabetes was defined as self-reported diabetes, fasting plasma glucose (FPG) ≥ 7.0 mmol·L⁻¹ or glycated haemoglobin (HbA1c) ≥ 6.5%. IGR was defined as FPG 5.5– < 7.0 mmol·L⁻¹ or HbA1c 5.7– < 6.5%. TB patients initiated treatment. After three months, all participants were followed up and screened for diabetes again. The association between TB and hyperglycaemia was assessed using logistic regression adjusting for potential confounders including sex, age, income, hypertension, waist circumference, previous prisoner, marital status, work status, HIV status. Results: Diabetes screening was performed in 852 participants (414 TB and 438 non-TB) at enrolment and in 639 (304 TB and 335 non-TB) at three-month follow-up. The prevalence of HIV-1 infection was 69.6% (95% confidence interval (CI), 64.9–73.8 %) among TB patients, and 58.2% (95% CI, 53.5–62.8 %) among the non-TB participants. Glycaemic levels were much higher in TB patients than in the non-TB participants but decreased over time. Among TB patients, the prevalence of IGR was 65.2% (95% CI 60.1 - 69.9) at enrollment and 21.5% (95% CI 17.2-26.5) at follow-up; and was 50% (45.1 - 54.94) and 32% (95% CI 27.9 - 38.0) respectively, among non-TB participants. The prevalence of diabetes in TB patients was 12.5% (95% CI 9.69 – 16.12%) at enrolment and 9.2% (95% CI, 6.43–13.03%) at follow-up; and was 10.04% (95% CI, 7.55–13.24%) and 8.06% (95% CI, 5.58–11.51) respectively, among non-TB participants. The association between TB and IGT was significant at enrolment (adjusted odds ratio (OR) 2.26 (95% CI, 1.55-3.31) but disappeared at follow-up 0.84 (0.53 - 1.36). However, the TB-diabetes association remained positive and significant both at enrolment (2.41 (95% CI, 1.3-4.34)) and follow-up (OR 3.31 (95% CI, 1.5 - 7.25)). Conclusion: Transient hyperglycaemia exists during tuberculosis. This has implications on diabetes screening in TB patients and suggests a need for diabetes confirmation tests during or after TB treatment. Nonetheless, the association between TB and diabetes noted at enrolment persists at 3 months highlighting the importance of diabetes control and prevention for TB control. Further research is required to investigate the impact of hyperglycaemia (transient or otherwise) on TB outcomes to ascertain the clinical significance of hyperglycemia at enrolment.

Keywords: diabetes, impaired glucose regulation, transient hyperglycaemia, tuberculosis

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Authors: Zbigniew Izdebski, Alicja Kozakiewicz, Maciej Białorudzki, Joanna Mazur

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Work is an extremely important part of everyone's life and affects functioning in daily life. Healthcare workers (HCW) are suffering from negative actions in and out of the workplace, such as harassment, abuse, long working hours, mental suffering, exhaustion, and professional burnout. Staff burnout is detrimental not only in terms of individual employees but also to working with patients and to the healthcare institution as a whole. The purpose of this study was to explore the level of professional burnout among HCW working in medical institutions during the COVID-19 pandemic in Poland. The extent to which selected sociodemographic factors and perceived stress increase the risk of professional burnout was assessed. In addition, the frequency of use of professional psychological help and less formal support groups by HCW in relation to the level of professional burnout was presented. The survey was conducted as part of a larger project on the humanization of medicine and clinical communication from February-April 2022. This study used a self-administered online survey (CAWI) technique and PAPI (pen and paper interview) technique. The BAT-12 scale was used to measure burnout, the PSS-4 scale was used to measure stress, and questions formulated by the research team were also used. For the purpose of analysis, the sample was limited to 2196 HCWs who worked on a daily basis with patients during the COVID-19 pandemic. Frequency distributions were analyzed, and multivariate logistic regression was performed. The mean scores (scores) of job burnout as measured by the BAT-12 scale ranged among the professional groups from 2.15(0.69) to 2.30 (0.69) and remained highest for the nurses' group. The groups differed significantly in levels of burnout (chi-sq=17.719; d.f.=8; p<0.023). In the final model, raised stress most likely increased the risk of burnout (OR=3.88; 95%CI <3.13-3.81>; p<0,001). Other significant predictors of burnout included: traumatic work-related experience (OR=1.91, p<0.001), mobbing (OR=1.83, p<0.001), and a higher workload than before the pandemic (OR=1.41, p=0.002). Only 7% of respondents decided to use various forms of psychological support during the pandemic. HCW experiences challenges in dealing with an unpredictable pandemic. Limited preparedness can lead to physical and psychological problems such as high-stress levels, anxiety, fear, helplessness, hopelessness, anger and stigma. The workload can lead to professional burnout, as well as threaten patient safety.

Keywords: burnout, work, healthcare, healthcare worker, stress

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Authors: Suryapeta Harini

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Road surface roughness is one of the essential aspects of the road's functional condition, indicating riding comfort in both the transverse and longitudinal directions. The government of India has made maintaining good surface evenness a prerequisite for all highway projects. Pavement distress data was collected with a Network Survey Vehicle (NSV) on a National Highway. It determines the smoothness and frictional qualities of the pavement surface, which are related to driving safety and ease. Based on the data obtained in the field, a regression equation was created with the IRI value and the visual distresses. The suggested system can use wireless acceleration sensors and GPS to gather vehicle status and location data, as well as calculate the international roughness index (IRI). Potholes, raveling, rut depth, cracked area, and repair work are all affected by pavement roughness, according to the current study. The study was carried out in one location. Data collected through using Bump integrator was used for the validation. The bump integrator (BI) obtained using deflection from the network survey vehicle was correlated with the distress parameter to establish an equation.

Keywords: roughness index, network survey vehicle, regression, correlation

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Authors: Cagdas Agirdas

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Background: The Affordable Care Act (ACA) requires non-grandfathered private insurance plans, starting with plan years on or after September 23rd, 2010, to provide certain preventive care services without any cost sharing in the form of deductibles, copayments or co-insurance. This requirement may affect racial and ethnic disparities in preventive care as it provides the largest copay reduction in preventive care. Objectives: We ask whether the ACA’s free preventive care benefits are associated with a reduction in racial and ethnic disparities in the utilization of four preventive services: cholesterol screenings, colonoscopies, mammograms, and pap smears. Methods: We use a data set of over 6,000 individuals from the 2009, 2010, and 2013 Medical Expenditure Panel Surveys (MEPS). We restrict our data set only to individuals who are old enough to be eligible for each preventive service. Our difference-in-differences logistic regression model classifies privately-insured Hispanics, African Americans, and Asians as the treatment groups and 2013 as the after-policy year. Our control group consists of non-Hispanic whites on Medicaid as this program already covered preventive care services for free or at a low cost before the ACA. Results: After controlling for income, education, marital status, preferred interview language, self-reported health status, employment, having a usual source of care, age and gender, we find that the ACA is associated with increases in the probability of the median, privately-insured Hispanic person to get a colonoscopy by 3.6% and a mammogram by 3.1%, compared to a non-Hispanic white person on Medicaid. Similarly, we find that the median, privately-insured African American person’s probability of receiving these two preventive services improved by 2.3% and 2.4% compared to a non-Hispanic white person on Medicaid. We do not find any significant improvements for any racial or ethnic group for cholesterol screenings or pap smears. Furthermore, our results do not indicate any significant changes for Asians compared to non-Hispanic whites in utilizing the four preventive services. These reductions in racial/ethnic disparities are robust to reconfigurations of time periods, previous diagnosis, and residential status. Conclusions: Early effects of the ACA’s provision of free preventive care are significant for Hispanics and African Americans. Further research is needed for the later years as more individuals became aware of these benefits.

Keywords: preventive care, Affordable Care Act, cost sharing, racial disparities

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Authors: Miguel Cañon, Darwin Mena, Ivan Cabeza

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In this work was compared and evaluated the applicability of statistical methods for the estimation of missing precipitations data in the basin of the river Lenguazaque located in the departments of Cundinamarca and Boyacá, Colombia. The methods used were the method of simple linear regression, distance rate, local averages, mean rates, correlation with nearly stations and multiple regression method. The analysis used to determine the effectiveness of the methods is performed by using three statistical tools, the correlation coefficient (r2), standard error of estimation and the test of agreement of Bland and Altmant. The analysis was performed using real rainfall values removed randomly in each of the seasons and then estimated using the methodologies mentioned to complete the missing data values. So it was determined that the methods with the highest performance and accuracy in the estimation of data according to conditions that were counted are the method of multiple regressions with three nearby stations and a random application scheme supported in the precipitation behavior of related data sets.

Keywords: statistical comparison, precipitation data, river subbasin, Bland and Altmant

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Authors: Raeed Alanazi

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Introduction: Nursing students have a crucial role to play in the inhibition of infectious diseases and, therefore, must be trained in infection control and prevention modules prior to entering clinical settings. Simulations have been found to have a positive impact on infection control skills and the use of standard precautions. Aim: The purpose of this study was to use the four sources of self-efficacy in explaining the level of clinical self-efficacy and adherence to infection control practices in Saudi nursing students during simulation practice. Method: A cross-sectional design with convenience sampling was used. This study was conducted in all Saudi nursing schools, with a total number of 197 students participated in this study. Three scales were used simulation self- efficacy Scale (SSES), the four sources of self-efficacy scale (SSES), and Compliance with Standard Precautions Scale (CSPS). Multiple linear regression was used to test the use of the four sources of self-efficacy (SSES) in explaining level of clinical self-efficacy and adherence to infection control in nursing students. Results: The vicarious experience subscale (p =.044) was statistically significant. The regression model indicated that for every one unit increase in vicarious experience (observation and reflection in simulation), the participants’ adherence to infection control increased by .13 units (β =.22, t = 2.03, p =.044). In addition, the regression model indicated that for every one unit increase in education level, the participants’ adherence to infection control increased by 1.82 units (beta=.34= 3.64, p <.001). Also, the mastery experience subscale (p <.001) and vicarious experience subscale (p = .020) were shared significant associations with clinical self-efficacy. Conclusion: The findings of this research support the idea that simulation-based learning can be a valuable teaching-learning method to help nursing students develop clinical competence, which is essential in providing quality and safe nursing care.

Keywords: simulation-based learning, clinical self-efficacy, infection control, nursing students

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Authors: Müzeyyen Balçikanli, Erdoğan Özbay, Hakan Tacettin Türker, Okan Karahan, Cengiz Duran Atiş

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In this research, effect of curing time (TC), curing temperature (CT), sodium concentration (SC) and silicate modules (SM) on the compressive strength, chloride ion permeability, and water absorption capacity of alkali activated slag (AAS) concretes were investigated. For maximization of compressive strength while for minimization of chloride ion permeability and water absorption capacity of AAS concretes, best possible combination of CT, CTime, SC and SM were determined. An experimental program was conducted by using the central composite design method. Alkali solution-slag ratio was kept constant at 0.53 in all mixture. The effects of the independent parameters were characterized and analyzed by using statistically significant quadratic regression models on the measured properties (dependent parameters). The proposed regression models are valid for AAS concretes with the SC from 0.1% to 7.5%, SM from 0.4 to 3.2, CT from 20 °C to 94 °C and TC from 1.2 hours to 25 hours. The results of test and analysis indicate that the most effective parameter for the compressive strength, chloride ion permeability and water absorption capacity is the sodium concentration.

Keywords: alkali activation, slag, rapid chloride permeability, water absorption capacity

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