Search results for: multivariate analysis
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 26970

Search results for: multivariate analysis

26610 The Impact of Deprivation on the Prevalence of Common Mental Health Disorders in Clinical Commissioning Groups across England: A Retrospective, Cross-Sectional Study

Authors: Mohammed-Hareef Asunramu, Sana Hashemi, Raja Ohri, Luc Worthington, Nadia Zaman, Junkai Zhu

Abstract:

Background: The 2012 Health and Social Care Act committed to a ‘parity of esteem between mental and physical health services. Although this investment, aimed to both increase the quality of services and ensure the retention of mental health staff, questions remained regarding its ability to prevent mental health problems. One possible solution is a focus on the social determinants of health which have been shown to impact mental health. Aim: To examine the relationship between the index of multiple deprivations (IMD) and the prevalence of common mental health disorders (CMD) for CCGs in NHS England between 2019 and 2020. Design and setting: Cross-sectional analysis of 189 CCGs in NHS England. Methods: A multivariate linear regression model was utilized with CMD as outcome variable and IMD, age and ethnicity as explanatory variables. Datasets were obtained from Public Health England and the latest UK Census. Results: CCG IMD was found to have a significantly positive relationship with CMD. For every 1-point increase in IMD, CMD increases by 0.25%. Ethnicity had a significantly positive relationship with CMD. For every 1% increase in the population that identifies as BME, there is a 0.03% increase in CMD. Age had a significantly negative relationship with CMD. For every 1% increase in the population aged 60+, there is a 0.11% decrease in CMD. Conclusion: This study demonstrates that addressing mental health issues may require a multi-pronged approach. Beyond budget increases, it is essential to prioritize health equity, with careful considerations towards ethnic minorities and different age brackets.

Keywords: deprivation, health inequality, mental health, social determinants

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26609 Action Research through Drama in Education on Adolescents’ Career Self-Efficacy and Decision-Making Skills Development

Authors: Christina Zourna, Ioanna Papavassiliou-Alexiou

Abstract:

The purpose of this multi-phased action research PhD study in Greece was to investigate if and how Drama in Education (DiE) – used as an innovative group counselling method – may have positive effects on secondary education students’career self-efficacy and career decision-making skills development. Using both quantitative and qualitative research tools, high quality data were gathered at various stages of the research and were analysed through multivariate methods and open-source computer aided data analysis software such as R Studio, QualCoder, and SPSS packages. After a five-month-long educational intervention based on DiE method, it was found that 9th, 10th, and 11th gradersameliorated their self-efficacy and learned the process of making an informed career decision – through targeted information gathering about themselves and possible study paths – thus, developing career problem-solving and career management skills. Gender differences were non statistically important, while differences in grades showed a minor influence on some of the measured factorssuch as general career indecisiveness and self-evaluation. Students in the 11th grade scored significantly higher than younger students in the career self-efficacy scale and have stronger faith in their abilities e.g., choosing general over vocational school and major study orientation. The study has shown that DiE can be effective in group career guidance, especially concerning the pillars of self-awareness, self-efficacy, and career decision-making processes.

Keywords: career decision-making skills, career self-efficacy, CDDQ scale, CDMSE-SF scale, drama in education method

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26608 Specific Biomarker Level and Function Outcome Changes in Treatment of Patients with Frozen Shoulder Using Dextrose Prolotherapy Injection

Authors: Nuralam Sam, Irawan Yusuf, Irfan Idris, Endi Adnan

Abstract:

The most case in the shoulder in the the adult is the frozen shoulder. It make an uncomfortable sensation which disturbance daily activity. The studies of frozen shoulder are still limited. This study used a true experimental pre and post test design with a group design. The participant underwent dextrose prolotherapy injection in the rotator cuff, intraarticular glenohumeral joint, long head tendon biceps, and acromioclavicular joint injections with 15% dextrose, respectively, at week 2, week 4, and week 6. Participants were followed for 12 weeks. The specific biomarker MMP and TIMP, ROM, DASH score were measured at baseline, at week 6, and week 12. The data were analyzed by multivariate analysis (repeated measurement ANOVA, Paired T-Test, and Wilcoxon) to determine the effect of the intervention. The result showed a significant decrease in The Disability of the Arm, Shoulder, and Hand (DASH) score in prolo injection patients in each measurement week (p < 0.05). While the measurement of Range of Motion (ROM), each direction of shoulder motion showed a significant difference in average each week, from week 0 to week 6 (p <0.05).Dextrose prolotherapy injection results give a significant improvement in functional outcome of the shoulder joint, and ROMand did not show significant results in assessing the specific biomarker, MMP-1, and TIMP-1 in tissue repair. This study suggestion an alternative to the use of injection prolotherapy in Frozen shoulder patients, which has fewer side effects and better effectiveness than the use of corticosteroid injections.

Keywords: frozen shoulder, ROM, DASH score, prolotherapy, MMP-1, TIMP-1

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26607 Prevalence of Near Visual Impairment and Associated Factors among School Teachers in Gondar City, North West Ethiopia, 2022

Authors: Bersufekad Wubie

Abstract:

Introduction: Near visual impairment is presenting near visual acuity of the eye worse than N6 at a 40 cm distance. Teachers' regular duties, such as reading books, writing on the blackboard, and recognizing students' faces, need good near vision. If a teacher has near-visual impairment, the work output is unsatisfactory. Objective: The study was aimed to assess the prevalence and associated factors near vision impairment among school teachers at Gondar city Northwest Ethiopia, August 2022. Methods: To select 567 teachers in Gondar city schools, an institutional-based cross-sectional study design with a multistage sampling technique were used. The study was conducted in selected schools from May 1 to May 30, 2022. Trained data collectors used well-structured Amharic and English language questionnaires and ophthalmic instruments for examination. The collected data were checked for completeness and entered into Epi data version 4.6, then exported to SPSS version 26 for further analysis. A binary and multivariate logistic regression model was fitted. And associated factors of the outcome variable. Result: The prevalence of near visual impairment was 64.6%, with a confidence interval of 60.3%–68.4%. Near visual impairment was significantly associated with age >= 35 years (AOR: 4.90 at 95% CI: 3.15, 7.65), having prolonged years of teaching experience (AOR: 3.29 at 95% CI: 1.70, 4.62), having a history of ocular surgery (AOR: 1.96 at 95% CI: 1.10, 4.62), smokers (AOR: 2.21 at 95% CI: 1.22, 4.07), history of ocular trauma (AOR : 1.80 at 95%CI:1.11,3.18 and uncorrected refractive error (AOR:2.01 at 95%CI:1.13,4.03). Conclusion and recommendations: This study showed the prevalence of near vision impairment among school teachers was high, and it is not a problem of the presbyopia age group alone; it also happens at a young age. So teachers' ocular health should be well accommodated in the school's eye health.

Keywords: Gondar, near visual impairment, school, teachers

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26606 Association of Sociodemographic Factors and Loneliness of Adolescents in China

Authors: Zihan Geng, Yifan Hou

Abstract:

Background: Loneliness is the feeling of being isolated, which is becoming increasingly common among adolescents. A cross-sectional study was performed to determine the association between loneliness and different demographics. Methods: To identify the presence of loneliness, the UCLA Loneliness Scale (Version 3) was employed. The "Questionnaire Star" in Chinese version, as the online survey on the official website, was used to distribute the self-rating questionnaires to the students in Beijing from Grade 7 to Grade 12. The questionnaire includes sociodemographic items and the UCLA Loneliness Scale. Results: Almost all of the participants exhibited “caseness” for loneliness, as defined by UCLA. Out of 266 questionnaires, 2.6% (7 in 266) students fulfilled the presence criteria for a low degree of loneliness. 29.7% (79 in 266) of adolescents met the criteria for a moderate degree of loneliness. Moreover, 62.8% (167 in 266) and 4.9% (13 in 266) of students fulfilled the presence criteria for a moderately high and high degree of loneliness, respectively. In the Pearson χ2 test, there were significant associations between loneliness and some demographic factors, including grade (P<0.001), the number of adults in the family (P=0.001), the evaluation of appearance (P=0.034), the evaluation of self-satisfaction (P<0.001), the love in family (P<0.001), academic performance (P=0.001) and emotional support from friends (P<0.001). In the multivariate logistic analysis, the number of adults (2 vs.≤1, OR=0.319, P=0.015), time spent on social media (≥4h vs. ≤1h, OR=4.862, P=0.029), emotional support of friends (more satisfied vs. dissatisfied, OR=0.363, P=0.027) were associated with loneliness. Conclusions: Our results suggest the relationship between loneliness and some sociodemographic factors, which raise the possibility to reduce the loneliness among adolescents. Therefore, the companionship of family, the encouragement from friends and regulating the time spent on social media may decrease the loneliness in adolescents.

Keywords: loneliness, adolescents, demographic factors, UCLA loneliness scale

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26605 Coping Strategies Used by Pregnant Women in India to Overcome the Psychological Impact of COVID-19

Authors: Harini Atturu, Divyani Byagari, Bindhu Rani Thumkunta, Sahitya Bammidi, Manasa Badveli

Abstract:

Introduction: Biological, psychological and social domains influence the outcomes of pregnancy. The COVID19 pandemic had a significant effect on the psychological and social domains of pregnant women all over the world. Everyone has inherent coping mechanisms which ultimately determine the actual impact of such external stimulus on outcomes of pregnancy. This study aims to understand the coping strategies used by pregnant women to overcome the psychological impact of the first wave of the COVID 19 pandemic. Methods: Institutional ethics permission was sought. All pregnant women attending antenatal clinics in the institution during September 2020 were included in the study. Brief-COPE, a self-rated questionnaire, was provided to understand the coping strategies used by them. The Questionnaire consists of 28 questions that fall into 14 themes. These 14 themes were mapped into four domains consisting of Approaching coping (APC) styles, Avoidant Coping (AVC) styles, Humor and Religion. The results were analyzed using univariate and multivariate analysis. Factor analysis was performed to identify themes that are most frequently used. Results: 162 pregnant women were included in the study. The majority of the women were aged between 18 and 30 (90.1%). 60.9% of the respondents were having their first pregnancy and were in the 2nd trimester (59.6%). The majority of them were living in the city (74%), belonged to the middle class (77.6%) and were not working (70.1%). 56 respondents (34.6%) reported that they had contact with suspected or Covid positive patients. Many were worried that their pregnancy might be complicated (43%), their baby may contract COVID (45%) and their family members could get COVID during the hospital visits for antenatal check-ups. 33.6% of women admitted missing their regular antenatal check-ups because of the above concerns. All respondents used various coping strategies to overcome the psychological impact of COVID 19. Out of the 4 coping strategies, participants scored high on Religion with a mean of 5.471.45 followed by Approaching Coping (APC) styles (5.131.25), Humor (4.592.07) and Avoidant Coping (AVC) styles (4.130.88). Religion as a coping strategy scored high for all respondents irrespective of age, parity, trimester, social and employment status. Exploratory Factor analysis revealed two cluster groups that explained 68% of the variance, with Component 1 contributing to 58.9% and component 2 contributing 9.13% of the variance. Humor, Acceptance, Planning, and Religion were the top 4 factors that showed strong loadings. Conclusion: Most of the pregnant women were worried about the negative impact of COVID 19 on the outcomes of their pregnancy. Religion and Approaching coping styles seem to be the predominant coping strategies used by them. Interventionists and policymakers should consider these factors while providing support to such women.

Keywords: coping strategies, pregnancy, COVID-19, brief-COPE

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26604 The Role of the Method of Conception in Description of Intensity and Type of Motivation for Parenthood

Authors: Mila Radovanovic, Jovana Jestrovic, Ivana Mihic

Abstract:

Deciding whether to have a child is a complex psychological process, and the child's birth is an everlasting change in the life of the family. Researchers from all over the world have been recognized the importance of the motivation for parenthood in latter family life, but there is no very clear picture of factors which make the difference in this motivation. One of these factors can be the method of conception and results of the earlier studies are different- some showed the differences, but the others did not. The aim of this study was to determine the type and intensity of motivation for parenting among women in Serbia and to examine whether there are differences in motivation depend on the method of conception. The total sample consisted of 94 women- 57 pregnant women who conceive naturally and the same number of women in the process of in vitro fertilization, who still haven’t known the final result of the process- are they pregnant or no. The Child Study Inventory, which estimates four types of motivation for parenthood- altruistic, instrumental, narcissistic and fatalistic-was used for this purpose. Multivariate analysis of variance was used to answer the main question of the study. The results indicate that there is no statistically significant difference between the two groups of women, while the most common is the altruistic motivation that emphasizes the psychological value of the child, and sees the motivation for parenting as a desire to give love to the child. The results are encouraging because altruistic motivation is intrinsic one and the protective factor for latter family relations and care about child and sensitivity of parents. Altruistic motivation is showed like a good predictor in developing stable emotional relationship between mother and her baby but also is correlated with the higher satisfaction with marriage.

Keywords: development of parental role, in vitro fertilization, motivation for parenthood, pregnancy

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26603 An Optimal Bayesian Maintenance Policy for a Partially Observable System Subject to Two Failure Modes

Authors: Akram Khaleghei Ghosheh Balagh, Viliam Makis, Leila Jafari

Abstract:

In this paper, we present a new maintenance model for a partially observable system subject to two failure modes, namely a catastrophic failure and a failure due to the system degradation. The system is subject to condition monitoring and the degradation process is described by a hidden Markov model. A cost-optimal Bayesian control policy is developed for maintaining the system. The control problem is formulated in the semi-Markov decision process framework. An effective computational algorithm is developed and illustrated by a numerical example.

Keywords: partially observable system, hidden Markov model, competing risks, multivariate Bayesian control

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26602 Determinants of Teenage Pregnancy: The Case of School Adolescents of Arba Minch Town, Southern Ethiopia

Authors: Aleme Mekuria, Samuel Mathewos

Abstract:

Background: Teenage pregnancy has long been a worldwide social, economic and educational concern for the developed, developing and underdeveloped countries. Studies on adolescent sexuality and pregnancy are very limited in our country. Therefore, this study aims at assessing the prevalence of teenage pregnancy and its determinants among school adolescents of Arba Minch town. Methods: Institution- based, cross-sectional study was conducted from 20-30 March 2014. Systematic sampling technique was used to select a total of 578 students from four schools of the town. Data were collected by trained data collectors using a pre-tested, self-administered structured questionnaire. The analysis was made using the software SPSS version 20.0 statistical packages. Multivariate logistic regression was used to identify the predictors of teenage pregnancy. Results: The prevalence of teenage pregnancy among school adolescents of Arba Minch town was 7.7%. Being grade11(AOR=4.6;95%CI:1.4,9.3) and grade12 student (AOR=5.8;95% CI:1.3,14.4), not knowing the correct time to take emergency contraceptives(AOR=3.3;95%CI:1.4,7.4), substance use(AOR=3.1;95%CI:1.1,8.8), living with either of biological parents (AOR=3.3;95%CI:1.1,8.7) and poor parent-daughter interaction (AOR=3.1;95%CI:1.1,8.7) were found to be significant predictors of teenage pregnancy. Conclusion: This study revealed a high level of teenage pregnancy among school adolescents of Arba Minch town. A significant number of adolescent female school students were at risk of facing the challenges of teenage pregnancy in the study area. School-based reproductive health education and strong parent-daughter relationships should be strengthened.

Keywords: adolescent, Arba minch, risk factors, school, southern Ethiopia, teenage pregnancy

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26601 Effects of Wind Load on the Tank Structures with Various Shapes and Aspect Ratios

Authors: Doo Byong Bae, Jae Jun Yoo, Il Gyu Park, Choi Seowon, Oh Chang Kook

Abstract:

There are several wind load provisions to evaluate the wind response on tank structures such as API, Euro-code, etc. the assessment of wind action applying these provisions is made by performing the finite element analysis using both linear bifurcation analysis and geometrically nonlinear analysis. By comparing the pressure patterns obtained from the analysis with the results of wind tunnel test, most appropriate wind load criteria will be recommended.

Keywords: wind load, finite element analysis, linear bifurcation analysis, geometrically nonlinear analysis

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26600 Development and Validation of First Derivative Method and Artificial Neural Network for Simultaneous Spectrophotometric Determination of Two Closely Related Antioxidant Nutraceuticals in Their Binary Mixture”

Authors: Mohamed Korany, Azza Gazy, Essam Khamis, Marwa Adel, Miranda Fawzy

Abstract:

Background: Two new, simple and specific methods; First, a Zero-crossing first-derivative technique and second, a chemometric-assisted spectrophotometric artificial neural network (ANN) were developed and validated in accordance with ICH guidelines. Both methods were used for the simultaneous estimation of the two closely related antioxidant nutraceuticals ; Coenzyme Q10 (Q) ; also known as Ubidecarenone or Ubiquinone-10, and Vitamin E (E); alpha-tocopherol acetate, in their pharmaceutical binary mixture. Results: For first method: By applying the first derivative, both Q and E were alternatively determined; each at the zero-crossing of the other. The D1 amplitudes of Q and E, at 285 nm and 235 nm respectively, were recorded and correlated to their concentrations. The calibration curve is linear over the concentration range of 10-60 and 5.6-70 μg mL-1 for Q and E, respectively. For second method: ANN (as a multivariate calibration method) was developed and applied for the simultaneous determination of both analytes. A training set (or a concentration set) of 90 different synthetic mixtures containing Q and E, in wide concentration ranges between 0-100 µg/mL and 0-556 µg/mL respectively, were prepared in ethanol. The absorption spectra of the training sets were recorded in the spectral region of 230–300 nm. A Gradient Descend Back Propagation ANN chemometric calibration was computed by relating the concentration sets (x-block) to their corresponding absorption data (y-block). Another set of 45 synthetic mixtures of the two drugs, in defined range, was used to validate the proposed network. Neither chemical separation, preparation stage nor mathematical graphical treatment were required. Conclusions: The proposed methods were successfully applied for the assay of Q and E in laboratory prepared mixtures and combined pharmaceutical tablet with excellent recoveries. The ANN method was superior over the derivative technique as the former determined both drugs in the non-linear experimental conditions. It also offers rapidity, high accuracy, effort and money saving. Moreover, no need for an analyst for its application. Although the ANN technique needed a large training set, it is the method of choice in the routine analysis of Q and E tablet. No interference was observed from common pharmaceutical additives. The results of the two methods were compared together

Keywords: coenzyme Q10, vitamin E, chemometry, quantitative analysis, first derivative spectrophotometry, artificial neural network

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26599 Prognostic Implication of Nras Gene Mutations in Egyptian Adult Acute Myeloid Leukemia

Authors: Doaa M. Elghannam, Nashwa Khayrat Abousamra, Doaa A. Shahin, Enas F. Goda, Hanan Azzam, Emad Azmy, Manal Salah El-Din

Abstract:

Background: The pathogenesis of acute myeloid leukemia (AML) involves the cooperation of mutations promoting proliferation/survival and those impairing differentiation. Point mutations of the NRAS gene are the most frequent somatic mutations causing aberrant signal-transduction in acute myeloid leukemia (AML). Aim: The present work was conducted to study the frequency and prognostic significance of NRAS gene mutations (NRASmut) in de novo Egyptian adult AML. Material and methods: Bone marrow specimens from 150 patients with de novo acute myeloid leukemia and controls were analyzed by genomic PCR-SSCP at codons 12, 13 (exon 1), and 61 (exon 2) for NRAS mutations. Results: NRAS gene mutations was found in 19/150 (12.7%) AML cases, represented more frequently in the FAB subtype M4eo (P = 0.028), and at codon 12, 13 (14of 19; 73.7%). Patients with NRASmut had a significant lower peripheral marrow blasts (P = 0.004, P=0.03) and non significant improved clinical outcome than patients without the mutation. Complete remission rate was (63.2% vs 56.5%; p=0.46), resistant disease (15.8% vs 23.6%; p=0.51), three years overall survival (44% vs 42%; P = 0.85) and disease free survival (42.1% vs 38.9%, P = 0.74). Multivariate analysis showed that age was the strongest unfavorable factor for overall survival (relative risk [RR], 1.9; P = .002), followed by cytogenetics (P = .004). FAB types, NRAS mutation, and leukocytosis were less important. Conclusions: NRAS gene mutation frequency and spectrum differ between biologically distinct subtypes of AML but do not significantly influence prognosis and clinical outcome.

Keywords: NRAS Gene, egyptian adult, acute myeloid leukemia, cytogenetics

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26598 The Association of Excessive Work Stress with Job Satisfaction and Turnover Intention in Operating Room Nurses: A Cross-Sectional Study in a Metropolitan Teaching Hospital in Southern Taiwan

Authors: Chia Yu Chen, Shu Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Shu Jiuan Chen, Yen Ling Liu

Abstract:

Aim: It remains undetermined that whether increased work stress may affect the job satisfaction and career loyalty among nursing staffs in the operating room. The long-term goal of this study is to lengthen the professional life of operating room nurses by attenuating the work stress and enhancing their contentment in work. Method: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in the southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses. Chi-square test was used to analyze the categorical data and Pearson correlation was used to analyze the association between two numerical datasets (SPSS version 20.0). Results: The response rate was 80% (80/100) and a total of 73 (73%) completed forms were eventually proceeded for analysis. The average scores for work stress and job satisfaction of the operating room nurses were 145.96±32.91 and 47.38±6.07, respectively. The correlation coefficients of work stress versus job satisfaction and organizational identity were (r=-0.338, p=0.003 and r=-0.354, p=0.002), respectively. There were more nurses who took rotating shift quitted works from the operating room than those who took only dayshift (2=5.176, p<0.05). Nurses who reported of having lower job satisfaction were associated with significantly higher turnover intention (t=3.714, p< 0.01). Following multivariate regression analysis, rotating shift and low job satisfaction were identified as the two independent predictors of intention to quit from working in the operating room. Conclusion: Our study clearly demonstrates that increased work stress significantly attenuates job satisfaction and organizational identity. Rotating shift is associated with higher work stress, lower job satisfaction, and higher turnover intention, which is consistent with the previous surveys carried out in the department of medical technology. Therefore, improvement of working quality in the operating rooms is essential to increase the retain intention of the well-trained nursing staffs. Further investigation into types of work shifts and other strategies of attenuating stress in workplace is currently undertaken in order to improve the job satisfaction and to decrease turnover intention in the operating room.

Keywords: rotating shift, work stress, job satisfaction, turnover intention

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26597 Corporate Governance and Audit Report Lag: The Case of Tunisian Listed Companies

Authors: Lajmi Azhaar, Yab Mdallelah

Abstract:

This study examines the Tunisian market in which recent events, notably financial scandals, provide an appropriate framework for studying the impact of corporate governance on the audit report lag. Moreover, very little research has been done to examine this relationship in this context. The objective of this work is, therefore, to understand the factors influencing audit report lag, drawing primarily on agency theory (Jensen and Meckling, 1976), which shows that the characteristics of the board of directors have an impact on the report lag (independence, diligence, and size). In addition, the characteristics of the committee also have an impact on the audit report lag (size, independence, diligence, and expertise). Therefore, our research provides empirical evidence on the impact of governance mechanisms attributes on audit report lag. Using a sample of forty-seven (47) Tunisian companies listed on the Tunis Stock Exchange (BVMT) during the period from 2014 to 2019, and basing on the GMM method of the dynamic panel, multivariate analysis shows that most corporate governance attributes have a significant effect on audit report lag. Specifically, the audit committee diligence and the audit committee expertise have a significant and positive effect on audit report lag. But the diligence of the board has a significant and negative effect on audit report lag. However, this study finds no evidence that the audit committee independence, the size, independence, and diligence of the director’s board are associated with the audit report lag. In addition, the results of this study also show that there is a significant effect of some control variables. Finally, we are contributing to this study by using the GMM method of the dynamic panel. We are also using an emerging context that is very poorly developed and exploited by previous studies.

Keywords: governance mechanisms, audit committee, board of directors, audit report lag

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26596 Understanding the Issue of Reproductive Matters among Urban Women: A Study of Four Cities in India from National Family Health Survey-4

Authors: Priyanka Dixit

Abstract:

Reproductive health problem is an important public health issue in most of the developing countries like India. It is a common problem in India for women in the reproductive age group to suffer from reproductive illnesses and not seek care. Existing literatures tell us very little about the several dimensions of reproductive morbidity. In addition the general perception says, metros have better medical infrastructure, so its residents should lead a healthier life. However some of the studies reveal a very different picture. Therefore, the present study is conducted with the specific objectives to find out the prevalence of reproductive health problem and treatment seeking behavior of currently married women in four metro cities in India namely; Mumbai, Delhi, Chennai and Kolkata. In addition, this paper also examines the effect of socio-economic and demographic factors on self-reported reproductive health problems. Bi-variate and multivariate regression have been applied to achieve the proposed objectives. Study is based on National Family Health Survey 2015-16 data. The analysis shows that the prevalence of any reproductive health problem among women is the highest in Mumbai followed by Delhi, Chennai, and Kolkata. A bulk of women in all four metro cities has reported abdominal pain, itching and burning sensation as the major problems while urinating. However, in spite of the high prevalence of reproductive health problems, a huge proportion of such women in all these cities do not seek any advice or treatment for these problems. This study also investigates determinants that affect the prevalence of reproductive health problem to policy makers plan for proper interventions for improving women’s reproductive health.

Keywords: reproductive health, India, national family health survey-4, city

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26595 Quantification of Lawsone and Adulterants in Commercial Henna Products

Authors: Ruchi B. Semwal, Deepak K. Semwal, Thobile A. N. Nkosi, Alvaro M. Viljoen

Abstract:

The use of Lawsonia inermis L. (Lythraeae), commonly known as henna, has many medicinal benefits and is used as a remedy for the treatment of diarrhoea, cancer, inflammation, headache, jaundice and skin diseases in folk medicine. Although widely used for hair dyeing and temporary tattooing, henna body art has popularized over the last 15 years and changed from being a traditional bridal and festival adornment to an exotic fashion accessory. The naphthoquinone, lawsone, is one of the main constituents of the plant and responsible for its dyeing property. Henna leaves typically contain 1.8–1.9% lawsone, which is used as a marker compound for the quality control of henna products. Adulteration of henna with various toxic chemicals such as p-phenylenediamine, p-methylaminophenol, p-aminobenzene and p-toluenodiamine to produce a variety of colours, is very common and has resulted in serious health problems, including allergic reactions. This study aims to assess the quality of henna products collected from different parts of the world by determining the lawsone content, as well as the concentrations of any adulterants present. Ultra high performance liquid chromatography-mass spectrometry (UPLC-MS) was used to determine the lawsone concentrations in 172 henna products. Separation of the chemical constituents was achieved on an Acquity UPLC BEH C18 column using gradient elution (0.1% formic acid and acetonitrile). The results from UPLC-MS revealed that of 172 henna products, 11 contained 1.0-1.8% lawsone, 110 contained 0.1-0.9% lawsone, whereas 51 samples did not contain detectable levels of lawsone. High performance thin layer chromatography was investigated as a cheaper, more rapid technique for the quality control of henna in relation to the lawsone content. The samples were applied using an automatic TLC Sampler 4 (CAMAG) to pre-coated silica plates, which were subsequently developed with acetic acid, acetone and toluene (0.5: 1.0: 8.5 v/v). A Reprostar 3 digital system allowed the images to be captured. The results obtained corresponded to those from UPLC-MS analysis. Vibrational spectroscopy analysis (MIR or NIR) of the powdered henna, followed by chemometric modelling of the data, indicates that this technique shows promise as an alternative quality control method. Principal component analysis (PCA) was used to investigate the data by observing clustering and identifying outliers. Partial least squares (PLS) multivariate calibration models were constructed for the quantification of lawsone. In conclusion, only a few of the samples analysed contain lawsone in high concentrations, indicating that they are of poor quality. Currently, the presence of adulterants that may have been added to enhance the dyeing properties of the products, is being investigated.

Keywords: Lawsonia inermis, paraphenylenediamine, temporary tattooing, lawsone

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26594 Is Swaziland on Track with the 2015 Millennium Development Goals?

Authors: A. Sathiya Susuman

Abstract:

Background: The importance of maternal and child healthcare services cannot be stressed enough. These services are very important for the health and health outcomes of the mother and that of the child and in ensuring that both maternal and child deaths are prevented. The objective of the study is to inspire good quality maternal and child health care services in Swaziland. Specifically, is Swaziland on track with the 2015 Millennium Development Goals? Methods: The study used secondary data from the Swaziland Demographic and Health Survey 2006-07. This is an explorative and descriptive study which used pre-selected variables to study factors influencing the use of maternal and child healthcare services in Swaziland. Different types of examinations, such as univariate, bivariate, and multivariate statistical analysis were adopted. Results: The study findings showed a high use rate of antenatal care (97.3%) and delivery care (74.0%), and a low rate of postnatal care use (20.5%). The uptake childhood immunization is also high in the country, averaging more than 80.0%. Moreover, certain factors which were found to be influencing the use of maternal healthcare and childhood immunization include: woman’s age, parity, media exposure, maternal education, wealth status, and residence. The findings also revealed that these factors affect the use of maternal and child health differently. Conclusion: It is important to study factors related to maternal and child health uptake to inform relevant stakeholders about possible areas of improvement. Programs to educate families about the importance of maternal and child healthcare services should be implemented. Swaziland needs to work hard on child survival and maternal health care services, no doubt it is on track with the MDG 4 & 5.

Keywords: maternal healthcare, antenatal care, delivery care, postnatal care, child health, immunization, socio-economic and demographic factors

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26593 Spatio-Temporal Variation of Gaseous Pollutants and the Contribution of Particulate Matters in Chao Phraya River Basin, Thailand

Authors: Samart Porncharoen, Nisa Pakvilai

Abstract:

The elevated levels of air pollutants in regional atmospheric environments is a significant problem that affects human health in Thailand, particularly in the Chao Phraya River Basin. Of concern are issues surrounding ambient air pollution such as particulate matter, gaseous pollutants and more specifically concerning air pollution along the river. Therefore, the spatio-temporal study of air pollution in this real environment can gain more accurate air quality data for making formalized environmental policy in river basins. In order to inform such a policy, a study was conducted over a period of January –December, 2015 to continually collect measurements of various pollutants in both urban and regional locations in the Chao Phraya River Basin. This study investigated the air pollutants in many diverse environments along the Chao Phraya River Basin, Thailand in 2015. Multivariate Analysis Techniques such as Principle Component Analysis (PCA) and Path analysis were utilised to classify air pollution in the surveyed location. Measurements were collected in both urban and rural areas to see if significant differences existed between the two locations in terms of air pollution levels. The meteorological parameters of various particulates were collected continually from a Thai pollution control department monitoring station over a period of January –December, 2015. Of interest to this study were the readings of SO2, CO, NOx, O3, and PM10. Results showed a daily arithmetic mean concentration of SO2, CO, NOx, O3, PM10 reading at 3±1 ppb, 0.5± 0.5 ppm, 30±21 ppb, 19±16 ppb, and 40±20 ug/m3 in urban locations (Bangkok). During the same time period, the readings for the same measurements in rural areas, Ayutthaya (were 1±0.5 ppb, 0.1± 0.05 ppm, 25±17 ppb, 30±21 ppb, and 35±10 ug/m3respectively. This show that Bangkok were located in highly polluted environments that are dominated source emitted from vehicles. Further, results were analysed to ascertain if significant seasonal variation existed in the measurements. It was found that levels of both gaseous pollutants and particle matter in dry season were higher than the wet season. More broadly, the results show that levels of pollutants were measured highest in locations along the Chao Phraya. River Basin known to have a large number of vehicles and biomass burning. This correlation suggests that the principle pollutants were from these anthropogenic sources. This study contributes to the body of knowledge surrounding ambient air pollution such as particulate matter, gaseous pollutants and more specifically concerning air pollution along the Chao Phraya River Basin. Further, this study is one of the first to utilise continuous mobile monitoring along a river in order to gain accurate measurements during a data collection period. Overall, the results of this study can be used for making formalized environmental policy in river basins in order to reduce the physical effects on human health.

Keywords: air pollution, Chao Phraya river basin, meteorology, seasonal variation, principal component analysis

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26592 Potential Risk Factors Associated with Sole Hemorrhages Causing Lameness in Egyptian Water Buffaloes and Native Breed Cows

Authors: Waleed El-Said Abou El-Amaiem

Abstract:

Sole hemorrhages are considered as a main cause for sub clinical laminitis. In this study we aimed at discussing the most prominent risk factors associated with sole hemorrhages causing lameness in Egyptian water buffaloes and native breed cows. The final multivariate logistic regression model showed, a significant association between sub acute ruminal acidosis (P< 0.05), limb affected (P< 0.05) and weight (P< 0.05) and sole hemorrhages causing lameness in Egyptian water buffaloes and native breed cows. According to our knowledge, this is the first paper to discuss the risk factors associated with sole hemorrhages causing lameness in Egyptian water buffaloes and native breed cows.

Keywords: lameness, buffalo, sole hemorrhages, breed cows

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26591 Effectiveness of Group Therapy Based on Acceptance and Commitment on Self-Criticism and Coping Mechanism in People with Addiction

Authors: Mohamad Reza Khodabakhsh

Abstract:

Drug use and addiction are major biological, psychological, and social problems. In drug abuse treatment, it is important to pay attention to personality problems and coping methods of patients. Today, the third-wave treatments in psychotherapy emphasize people's awareness and acceptance of feelings and emotions, cognitions, and behaviors instead of challenging cognitions. For this reason, this research was conducted with the aim of investigating the effectiveness of group therapy based on acceptance and commitment to self-criticism and coping strategies of people with drug use disorder. This research was a quasi-experimental type of research (pre-test-post-test design with an unequal control group), and the statistical population of this research included all men with drug use disorder in Mashhad, 174 of whom among the 75 people eligible for this research, 30 of them were selected by available sampling method and randomly assigned to two experimental and control groups. In this research, Gilbert's self-criticism scale was used to measure self-criticism, and Andler and Barker's coping strategies questionnaire was used to measure coping strategies. Therapeutic intervention (treatment based on acceptance and commitment) was performed on the experimental group for eight sessions of 90 minutes, and then post-tests were taken from both groups, and multivariate analysis of covariance (MANCOVA) was used to analyze the data. The results showed that treatment based on acceptance and commitment significantly reduced self-criticism and improved coping strategies used by patients with drug use disorder (p>0.01). Therefore, treatment based on acceptance and commitment has been effective in reducing self-criticism and improving the coping strategies of patients with drug use disorder due to teaching clients to accept thoughts and conditions.

Keywords: treatment based on acceptance and commitment, self-criticism, coping strategies, addiction

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26590 Density-based Denoising of Point Cloud

Authors: Faisal Zaman, Ya Ping Wong, Boon Yian Ng

Abstract:

Point cloud source data for surface reconstruction is usually contaminated with noise and outliers. To overcome this, we present a novel approach using modified kernel density estimation (KDE) technique with bilateral filtering to remove noisy points and outliers. First we present a method for estimating optimal bandwidth of multivariate KDE using particle swarm optimization technique which ensures the robust performance of density estimation. Then we use mean-shift algorithm to find the local maxima of the density estimation which gives the centroid of the clusters. Then we compute the distance of a certain point from the centroid. Points belong to outliers then removed by automatic thresholding scheme which yields an accurate and economical point surface. The experimental results show that our approach comparably robust and efficient.

Keywords: point preprocessing, outlier removal, surface reconstruction, kernel density estimation

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26589 Statistical Models and Time Series Forecasting on Crime Data in Nepal

Authors: Dila Ram Bhandari

Abstract:

Throughout the 20th century, new governments were created where identities such as ethnic, religious, linguistic, caste, communal, tribal, and others played a part in the development of constitutions and the legal system of victim and criminal justice. Acute issues with extremism, poverty, environmental degradation, cybercrimes, human rights violations, crime against, and victimization of both individuals and groups have recently plagued South Asian nations. Everyday massive number of crimes are steadfast, these frequent crimes have made the lives of common citizens restless. Crimes are one of the major threats to society and also for civilization. Crime is a bone of contention that can create a societal disturbance. The old-style crime solving practices are unable to live up to the requirement of existing crime situations. Crime analysis is one of the most important activities of the majority of intelligent and law enforcement organizations all over the world. The South Asia region lacks such a regional coordination mechanism, unlike central Asia of Asia Pacific regions, to facilitate criminal intelligence sharing and operational coordination related to organized crime, including illicit drug trafficking and money laundering. There have been numerous conversations in recent years about using data mining technology to combat crime and terrorism. The Data Detective program from Sentient as a software company, uses data mining techniques to support the police (Sentient, 2017). The goals of this internship are to test out several predictive model solutions and choose the most effective and promising one. First, extensive literature reviews on data mining, crime analysis, and crime data mining were conducted. Sentient offered a 7-year archive of crime statistics that were daily aggregated to produce a univariate dataset. Moreover, a daily incidence type aggregation was performed to produce a multivariate dataset. Each solution's forecast period lasted seven days. Statistical models and neural network models were the two main groups into which the experiments were split. For the crime data, neural networks fared better than statistical models. This study gives a general review of the applied statistics and neural network models. A detailed image of each model's performance on the available data and generalizability is provided by a comparative analysis of all the models on a comparable dataset. Obviously, the studies demonstrated that, in comparison to other models, Gated Recurrent Units (GRU) produced greater prediction. The crime records of 2005-2019 which was collected from Nepal Police headquarter and analysed by R programming. In conclusion, gated recurrent unit implementation could give benefit to police in predicting crime. Hence, time series analysis using GRU could be a prospective additional feature in Data Detective.

Keywords: time series analysis, forecasting, ARIMA, machine learning

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26588 An Overview of New Era in Food Science and Technology

Authors: Raana Babadi Fathipour

Abstract:

Strict prerequisites of logical diaries united ought to demonstrate the exploratory information is (in)significant from the statistical point of view and has driven a soak increment within the utilization and advancement of the factual program. It is essential that the utilization of numerical and measurable strategies, counting chemometrics and many other factual methods/algorithms in nourishment science and innovation has expanded steeply within the final 20 a long time. Computational apparatuses accessible can be utilized not as it were to run factual investigations such as univariate and bivariate tests as well as multivariate calibration and improvement of complex models but also to run reenactments of distinctive scenarios considering a set of inputs or essentially making expectations for particular information sets or conditions. Conducting a fast look within the most legitimate logical databases (Pubmed, ScienceDirect, Scopus), it is conceivable to watch that measurable strategies have picked up a colossal space in numerous regions.

Keywords: food science, food technology, food safety, computational tools

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26587 Reliable Method for Estimating Rating Curves in the Natural Rivers

Authors: Arash Ahmadi, Amirreza Kavousizadeh, Sanaz Heidarzadeh

Abstract:

Stage-discharge curve is one of the conventional methods for continuous river flow measurement. In this paper, an innovative approach is proposed for predicting the stage-discharge relationship using the application of isovel contours. Using the proposed method, it is possible to estimate the stage-discharge curve in the whole section with only using discharge information from just one arbitrary water level. For this purpose, multivariate relationships are used to determine the mean velocity in a cross-section. The unknown exponents of the proposed relationship have been obtained by using the second version of the Strength Pareto Evolutionary Algorithm (SPEA2), and the appropriate equation was selected by applying the TOPSIS (Technique for Order Preferences by Similarity to an Ideal Solution) approach. Results showed a close agreement between the estimated and observed data in the different cross-sections.

Keywords: rating curves, SPEA2, natural rivers, bed roughness distribution

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26586 Combining the Dynamic Conditional Correlation and Range-GARCH Models to Improve Covariance Forecasts

Authors: Piotr Fiszeder, Marcin Fałdziński, Peter Molnár

Abstract:

The dynamic conditional correlation model of Engle (2002) is one of the most popular multivariate volatility models. However, this model is based solely on closing prices. It has been documented in the literature that the high and low price of the day can be used in an efficient volatility estimation. We, therefore, suggest a model which incorporates high and low prices into the dynamic conditional correlation framework. Empirical evaluation of this model is conducted on three datasets: currencies, stocks, and commodity exchange-traded funds. The utilisation of realized variances and covariances as proxies for true variances and covariances allows us to reach a strong conclusion that our model outperforms not only the standard dynamic conditional correlation model but also a competing range-based dynamic conditional correlation model.

Keywords: volatility, DCC model, high and low prices, range-based models, covariance forecasting

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26585 The Role of Environmental Analysis in Managing Knowledge in Small and Medium Sized Enterprises

Authors: Liu Yao, B. T. Wan Maseri, Wan Mohd, B. T. Nurul Izzah, Mohd Shah, Wei Wei

Abstract:

Effectively managing knowledge has become a vital weapon for businesses to survive or to succeed in the increasingly competitive market. But do they perform environmental analysis when managing knowledge? If yes, how is the level and significance? This paper established a conceptual framework covering the basic knowledge management activities (KMA) to examine their contribution towards organizational performance (OP). Environmental analysis (EA) was then investigated from both internal and external aspects, to identify its effects on that contribution. Data was collected from 400 Chinese SMEs by questionnaires. Cronbach's α and factor analysis were conducted. Regression results show that the external analysis presents higher level than internal analysis. However, the internal analysis mediates the effects of external analysis on the KMA-OP relation and plays more significant role in the relation comparing with the external analysis. Thus, firms shall improve environmental analysis especially the internal analysis to enhance their KM practices.

Keywords: knowledge management, environmental analysis, performance, mediating, small sized enterprises, medium sized enterprises

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26584 The Incidence of Obesity among Adult Women in Pekanbaru City, Indonesia, Related to High Fat Consumption, Stress Level, and Physical Activity

Authors: Yudia Mailani Putri, Martalena Purba, B. J. Istiti Kandarina

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Background: Obesity has been recognized as a global health problem. Individuals classified as overweight and obese are increasing at an alarming rate. This condition is associated with psychological and physiological problems. as a person reaches adulthood, somatic growth ceases. At this stage, the human body has developed fully, to a stable state. As the capital of Riau Province in Indonesia, Pekanbaru is dominated by Malay ethnic population habitually consuming cholesterol-rich fatty foods as a daily menu, a trigger to the onset of obesity resulting in high prevalence of degenerative diseases. Research objectives: The aim of this study is elaborating the relationship between high-fat consumption pattern, stress level, physical activity and the incidence of obesity in adult women in Pekanbaru city. Research Methods: Among the combined research methods applied in this study, the first stage is quantitative observational, analytical cross-sectional research design with adult women aged 20-40 living in Pekanbaru city. The sample consists of 200 women with BMI≥25. Sample data is processed with univariate, bivariate (correlation and simple linear regression) and multivariate (multiple linear regression) analysis. The second phase is qualitative descriptive study purposive sampling by in-depth interviews. six participants withdrew from the study. Results: According to the results of the bivariate analysis, there are relationships between the incidence of obesity and the pattern of high fat foods consumption (energy intake (p≤0.000; r = 0.536), protein intake (p≤0.000; r=0.307), fat intake (p≤0.000; r=0.416), carbohydrate intake (p≤0.000; r=0.430), frequency of fatty food consumption (p≤0.000; r=0.506) and frequency of viscera foods consumption (p≤0.000; r=0.535). There is a relationship between physical activity and incidence of obesity (p≤0.000; r=-0.631). However, there is no relationship between the level of stress (p=0.741; r=0.019-) and the incidence of obesity. Physical activity is a predominant factor in the incidence of obesity in adult women in Pekanbaru city. Conclusion: There are relationships between high-fat food consumption pattern, physical activity and the incidence of obesity in Pekanbaru city whereas physical activity is a predominant factor in the occurrence of obesity, supported by the unchangeable pattern of high-fat foods consumption.

Keywords: obesity, adult, high in fat, stress, physical activity, consumption pattern

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26583 Tip60’s Novel RNA-Binding Function Modulates Alternative Splicing of Pre-mRNA Targets Implicated in Alzheimer’s Disease

Authors: Felice Elefant, Akanksha Bhatnaghar, Keegan Krick, Elizabeth Heller

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Context: The severity of Alzheimer’s Disease (AD) progression involves an interplay of genetics, age, and environmental factors orchestrated by histone acetyltransferase (HAT) mediated neuroepigenetic mechanisms. While disruption of Tip60 HAT action in neural gene control is implicated in AD, alternative mechanisms underlying Tip60 function remain unexplored. Altered RNA splicing has recently been highlighted as a widespread hallmark in the AD transcriptome that is implicated in the disease. Research Aim: The aim of this study was to identify a novel RNA binding/splicing function for Tip60 in human hippocampus and impaired in brains from AD fly models and AD patients. Methodology/Analysis: The authors used RNA immunoprecipitation using RNA isolated from 200 pooled wild type Drosophila brains for each of the 3 biological replicates. To identify Tip60’s RNA targets, they performed genome sequencing (DNB-SequencingTM technology, BGI genomics) on 3 replicates for Input RNA and RNA IPs by Tip60. Findings: The authors' transcriptomic analysis of RNA bound to Tip60 by Tip60-RNA immunoprecipitation (RIP) revealed Tip60 RNA targets enriched for critical neuronal processes implicated in AD. Remarkably, 79% of Tip60’s RNA targets overlap with its chromatin gene targets, supporting a model by which Tip60 orchestrates bi-level transcriptional regulation at both the chromatin and RNA level, a function unprecedented for any HAT to date. Since RNA splicing occurs co-transcriptionally and splicing defects are implicated in AD, the authors investigated whether Tip60-RNA targeting modulates splicing decisions and if this function is altered in AD. Replicate multivariate analysis of transcript splicing (rMATS) analysis of RNA-Seq data sets from wild-type and AD fly brains revealed a multitude of mammalian-like AS defects. Strikingly, over half of these altered RNAs were bonafide Tip60-RNA targets enriched for in the AD-gene curated database, with some AS alterations prevented against by increasing Tip60 in fly brain. Importantly, human orthologs of several Tip60-modulated spliced genes in Drosophila are well characterized aberrantly spliced genes in human AD brains, implicating disruption of Tip60’s splicing function in AD pathogenesis. Theoretical Importance: The authors' findings support a novel RNA interaction and splicing regulatory function for Tip60 that may underlie AS impairments that hallmark AD etiology. Data Collection: The authors collected data from RNA immunoprecipitation experiments using RNA isolated from 200 pooled wild type Drosophila brains for each of the 3 biological replicates. They also performed genome sequencing (DNBSequencingTM technology, BGI genomics) on 3 replicates for Input RNA and RNA IPs by Tip60. Questions: The question addressed by this study was whether Tip60 has a novel RNA binding/splicing function in human hippocampus and whether this function is impaired in brains from AD fly models and AD patients. Conclusions: The authors' findings support a novel RNA interaction and splicing regulatory function for Tip60 that may underlie AS impairments that hallmark AD etiology.

Keywords: Alzheimer's disease, cognition, aging, neuroepigenetics

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26582 Optimal Approach for Siewert Type Ⅱ Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Metanalysis

Authors: Maatouk Mohamed, Nouira Mariem

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

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26581 Assessment of Incidence and Predictors of Mortality Among HIV Positive Children on Art in Public Hospitals of Harer Town Who Were Enrolled From 2011 to 2021

Authors: Getahun Nigusie Demise

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Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: The aim of this study is to assess the incidence and predictors of mortality among HIV positive children on antiretroviral therapy (ART) in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, treatment, Ethiopia

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