Search results for: reverse logistic
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1357

Search results for: reverse logistic

1117 Accuracy of Trauma on Scene Triage Screen Tool (Shock Index, Reverse Shock Index Glasgow Coma Scale, and National Early Warning Score) to Predict the Severity of Emergency Department Triage

Authors: Chaiyaporn Yuksen, Tapanawat Chaiwan

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Introduction: Emergency medical service (EMS) care for trauma patients must be provided on-scene assessment and essential treatment and have appropriate transporting to the trauma center. The shock index (SI), reverse shock index Glasgow Coma Scale (rSIG), and National Early Warning Score (NEWS) triage tools are easy to use in a prehospital setting. There is no standardized on-scene triage protocol in prehospital care. The primary objective was to determine the accuracy of SI, rSIG, and NEWS to predict the severity of trauma patients in the emergency department (ED). Methods: This was a retrospective cross-sectional and diagnostic research conducted on trauma patients transported by EMS to the ED of Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand, from January 2015 to September 2022. We included the injured patients receiving prehospital care and transport to the ED of Ramathibodi Hospital by the EMS team from January 2015 to September 2022. We compared the on-scene parameter (SI, rSIG, and NEWS) and ED (Emergency Severity Index) with the area under ROC. Results: 218 patients were traumatic patients transported by EMS to the ED. 161 was ESI level 1-2, and 57 was level 3-5. NEWS was a more accurate triage tool to discriminate the severity of trauma patients than rSIG and SI. The area under the ROC was 0.743 (95%CI 0.70-0.79), 0.649 (95%CI 0.59-0.70), and 0.582 (95%CI 0.52-0.65), respectively (P-value <0.001). The cut point of NEWS to discriminate was 6 points. Conclusions: The NEWs was the most accurate triage tool in prehospital seeing in trauma patients.

Keywords: on-scene triage, trauma patient, ED triage, accuracy, NEWS

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1116 From Sampling to Sustainable Phosphate Recovery from Mine Waste Rock Piles

Authors: Hicham Amar, Mustapha El Ghorfi, Yassine Taha, Abdellatif Elghali, Rachid Hakkou, Mostafa Benzaazoua

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Phosphate mine waste rock (PMWR) generated during ore extraction is continuously increasing, resulting in a significant environmental footprint. The main objectives of this study consist of i) elaboration of the sampling strategy of PMWR piles, ii) a mineralogical and chemical characterization of PMWR piles, and iii) 3D block model creation to evaluate the potential valorization of the existing PMWR. Destructive drilling using reverse circulation from 13 drills was used to collect samples for chemical (X-ray fluorescence analysis) and mineralogical assays. The 3D block model was created based on the data set, including chemical data of the realized drills using Datamine RM software. The optical microscopy observations showed that the sandy phosphate from drills in the PMWR piles is characterized by the abundance of carbonate fluorapatite with the presence of calcite, dolomite, and quartz. The mean grade of composite samples was around 19.5±2.7% for P₂O₅. The mean grade of P₂O₅ exhibited an increasing tendency by depth profile from bottom to top of PMWR piles. 3D block model generated with chemical data confirmed the tendency of the mean grades’ variation and may allow a potential selective extraction according to %P₂O₅. The 3D block model of P₂O₅ grade is an efficient sampling approach that confirmed the variation of P₂O₅ grade. This integrated approach for PMWR management will be a helpful tool for decision-making to recover the residual phosphate, adopting the circular economy and sustainability in the phosphate mining industry.

Keywords: 3D modelling, reverse circulation drilling, circular economy, phosphate mine waste rock, sampling

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1115 Lifestyle Factors Associated With Overweight/obesity Status In Croatian Adolescents: A Population-Based Study

Authors: Lovro Štefan

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The main purpose of the present study was to investigate the associations between the overweight/obesity status and lifestyle factors. In this cross-sectional study, participants were 1950 urban secondary-school students (54.7% of female students) aged 17-18 years old. Dependent variable was body-mass index status derived from self-reported height and weight. The outcome was binarised, where participants with value <25 kg/m2 were collapsed into „normal“, while those ≥25 kg/m2 into „overweight/obesity“ category. Independent variables were gender, type of school, physical activity, sedentary behaviour, self-rated health, self-perceived socioeconomic status and psychological distress. The associations between the dependent and independent variables were analyzed by using multiple logistic regression analysis. In the univariate model, being overweight/obese was significantly associated with being a male student (OR 0.31; 95% CI 0.23 to 0.42), attending a vocational school (OR 1.87; 95% CI 1.42 to 2.48), not meeting the recommendations for moderate-to-vigorous physical activity (OR 0.44; 95% CI 0.22 to 0.88), more time spending in sedentary behaviour (OR 1.53; 95% CI 1.07 to 2.19), poor self-rated health (OR 0.35, 95% CI 0.20 to 0.56) and lower socioeconomic status (OR 0.63; 95% CI 0.48 to 0.84). In the multivariate model, the same associations occured between the dependent and independent variable. In both models, psychological distress was not associated with being overweight/obese. In conclusion, our findings suggest, that lifestyle factors are independently associated with body-mass index

Keywords: body mass index, secondary-school students, Croatia, physical activity, sedentary behaviour, logistic regression

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1114 Trajectories of Depression Anxiety and Stress among Breast Cancer Patients: Assessment at First Year of Diagnosis

Authors: Jyoti Srivastava, Sandhya S. Kaushik, Mallika Tewari, Hari S. Shukla

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Little information is available about the development of psychological well being over time among women who have been undergoing treatment for breast cancer. The aim of this study was to identify the trajectories of depression anxiety and stress among women with early-stage breast cancer. Of the 48 Indian women with newly diagnosed early-stage breast cancer recruited from surgical oncology unit, 39 completed an interview and were assessed for depression anxiety and stress (Depression Anxiety Stress Scale-DASS 21) before their first course of chemotherapy (baseline) and follow up interviews at 3, 6 and 9 months thereafter. Growth mixture modeling was used to identify distinct trajectories of Depression Anxiety and Stress symptoms. Logistic Regression analysis was used to evaluate the characteristics of women in distinct groups. Most women showed mild to moderate level of depression and anxiety (68%) while normal to mild level of stress (71%). But one in 11 women was chronically anxious (9%) and depressed (9%). Young age, having a partner, shorter education and receiving chemotherapy but not radiotherapy might characterize women whose psychological symptoms remain strong nine months after diagnosis. By looking beyond the mean, it was found that several socio-demographic and treatment factors characterized the women whose depression, anxiety and stress level remained severe even nine months after diagnosis. The results suggest that support provided to cancer patients should have a special focus on a relatively small group of patient most in need.

Keywords: psychological well being, growth mixture modeling, logistic regression analysis, socio-demographic factors

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1113 Stock Prediction and Portfolio Optimization Thesis

Authors: Deniz Peksen

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This thesis aims to predict trend movement of closing price of stock and to maximize portfolio by utilizing the predictions. In this context, the study aims to define a stock portfolio strategy from models created by using Logistic Regression, Gradient Boosting and Random Forest. Recently, predicting the trend of stock price has gained a significance role in making buy and sell decisions and generating returns with investment strategies formed by machine learning basis decisions. There are plenty of studies in the literature on the prediction of stock prices in capital markets using machine learning methods but most of them focus on closing prices instead of the direction of price trend. Our study differs from literature in terms of target definition. Ours is a classification problem which is focusing on the market trend in next 20 trading days. To predict trend direction, fourteen years of data were used for training. Following three years were used for validation. Finally, last three years were used for testing. Training data are between 2002-06-18 and 2016-12-30 Validation data are between 2017-01-02 and 2019-12-31 Testing data are between 2020-01-02 and 2022-03-17 We determine Hold Stock Portfolio, Best Stock Portfolio and USD-TRY Exchange rate as benchmarks which we should outperform. We compared our machine learning basis portfolio return on test data with return of Hold Stock Portfolio, Best Stock Portfolio and USD-TRY Exchange rate. We assessed our model performance with the help of roc-auc score and lift charts. We use logistic regression, Gradient Boosting and Random Forest with grid search approach to fine-tune hyper-parameters. As a result of the empirical study, the existence of uptrend and downtrend of five stocks could not be predicted by the models. When we use these predictions to define buy and sell decisions in order to generate model-based-portfolio, model-based-portfolio fails in test dataset. It was found that Model-based buy and sell decisions generated a stock portfolio strategy whose returns can not outperform non-model portfolio strategies on test dataset. We found that any effort for predicting the trend which is formulated on stock price is a challenge. We found same results as Random Walk Theory claims which says that stock price or price changes are unpredictable. Our model iterations failed on test dataset. Although, we built up several good models on validation dataset, we failed on test dataset. We implemented Random Forest, Gradient Boosting and Logistic Regression. We discovered that complex models did not provide advantage or additional performance while comparing them with Logistic Regression. More complexity did not lead us to reach better performance. Using a complex model is not an answer to figure out the stock-related prediction problem. Our approach was to predict the trend instead of the price. This approach converted our problem into classification. However, this label approach does not lead us to solve the stock prediction problem and deny or refute the accuracy of the Random Walk Theory for the stock price.

Keywords: stock prediction, portfolio optimization, data science, machine learning

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1112 Machine Learning Approach for Stress Detection Using Wireless Physical Activity Tracker

Authors: B. Padmaja, V. V. Rama Prasad, K. V. N. Sunitha, E. Krishna Rao Patro

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Stress is a psychological condition that reduces the quality of sleep and affects every facet of life. Constant exposure to stress is detrimental not only for mind but also body. Nevertheless, to cope with stress, one should first identify it. This paper provides an effective method for the cognitive stress level detection by using data provided from a physical activity tracker device Fitbit. This device gathers people’s daily activities of food, weight, sleep, heart rate, and physical activities. In this paper, four major stressors like physical activities, sleep patterns, working hours and change in heart rate are used to assess the stress levels of individuals. The main motive of this system is to use machine learning approach in stress detection with the help of Smartphone sensor technology. Individually, the effect of each stressor is evaluated using logistic regression and then combined model is built and assessed using variants of ordinal logistic regression models like logit, probit and complementary log-log. Then the quality of each model is evaluated using Akaike Information Criterion (AIC) and probit is assessed as the more suitable model for our dataset. This system is experimented and evaluated in a real time environment by taking data from adults working in IT and other sectors in India. The novelty of this work lies in the fact that stress detection system should be less invasive as possible for the users.

Keywords: physical activity tracker, sleep pattern, working hours, heart rate, smartphone sensor

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1111 Unlocking the Future of Grocery Shopping: Graph Neural Network-Based Cold Start Item Recommendations with Reverse Next Item Period Recommendation (RNPR)

Authors: Tesfaye Fenta Boka, Niu Zhendong

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Recommender systems play a crucial role in connecting individuals with the items they require, as is particularly evident in the rapid growth of online grocery shopping platforms. These systems predominantly rely on user-centered recommendations, where items are suggested based on individual preferences, garnering considerable attention and adoption. However, our focus lies on the item-centered recommendation task within the grocery shopping context. In the reverse next item period recommendation (RNPR) task, we are presented with a specific item and challenged to identify potential users who are likely to consume it in the upcoming period. Despite the ever-expanding inventory of products on online grocery platforms, the cold start item problem persists, posing a substantial hurdle in delivering personalized and accurate recommendations for new or niche grocery items. To address this challenge, we propose a Graph Neural Network (GNN)-based approach. By capitalizing on the inherent relationships among grocery items and leveraging users' historical interactions, our model aims to provide reliable and context-aware recommendations for cold-start items. This integration of GNN technology holds the promise of enhancing recommendation accuracy and catering to users' individual preferences. This research contributes to the advancement of personalized recommendations in the online grocery shopping domain. By harnessing the potential of GNNs and exploring item-centered recommendation strategies, we aim to improve the overall shopping experience and satisfaction of users on these platforms.

Keywords: recommender systems, cold start item recommendations, online grocery shopping platforms, graph neural networks

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1110 Organic Farming Profitability: Evidence from South Korea

Authors: Saem Lee, Thanh Nguyen, Hio-Jung Shin, Thomas Koellner

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Land-use management has an influence on the provision of ecosystem service in dynamic, agricultural landscapes. Agricultural land use is important for maintaining the productivity and sustainability of agricultural ecosystems. However, in Korea, intensive farming activities in this highland agricultural zone, the upper stream of Soyang has led to contaminated soil caused by over-use pesticides and fertilizers. This has led to decrease in water and soil quality, which has consequences for ecosystem services and human wellbeing. Conventional farming has still high percentage in this area and there is no special measure to prevent low water quality caused by farming activities. Therefore, the adoption of environmentally friendly farming has been considered one of the alternatives that lead to improved water quality and increase in biomass production. Concurrently, farm households with environmentally friendly farming have occupied still low rates. Therefore, our research involved a farm household survey spanning conventional farming, the farm in transition and organic farming in Soyang watershed. Another purpose of our research was to compare economic advantage of the farmers adopting environmentally friendly farming and non-adaptors and to investigate the different factors by logistic regression analysis with socio-economic and benefit-cost ratio variables. The results found that farmers with environmentally friendly farming tended to be younger than conventional farming and farmer in transition. They are similar in terms of gender which was predominately male. Farmers with environmentally friendly farming were more educated and had less farming experience than conventional farming and farmer in transition. Based on the benefit-cost analysis, total costs that farm in transition farmers spent for one year are about two times as much as the sum of costs in environmentally friendly farming. The benefit of organic farmers was assessed with 2,800 KRW per household per year. In logistic regression, the factors having statistical significance are subsidy and district, residence period and benefit-cost ratio. And district and residence period have the negative impact on the practice of environmentally friendly farming techniques. The results of our research make a valuable contribution to provide important information to describe Korean policy-making for agricultural and water management and to consider potential approaches to policy that would substantiate ways beneficial for sustainable resource management.

Keywords: organic farming, logistic regression, profitability, agricultural land-use

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1109 A Wearable Device to Overcome Post–Stroke Learned Non-Use; The Rehabilitation Gaming System for wearables: Methodology, Design and Usability

Authors: Javier De La Torre Costa, Belen Rubio Ballester, Martina Maier, Paul F. M. J. Verschure

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After a stroke, a great number of patients experience persistent motor impairments such as hemiparesis or weakness in one entire side of the body. As a result, the lack of use of the paretic limb might be one of the main contributors to functional loss after clinical discharge. We aim to reverse this cycle by promoting the use of the paretic limb during activities of daily living (ADLs). To do so, we describe the key components of a system that is composed of a wearable bracelet (i.e., a smartwatch) and a mobile phone, designed to bring a set of neurorehabilitation principles that promote acquisition, retention and generalization of skills to the home of the patient. A fundamental question is whether the loss in motor function derived from learned–non–use may emerge as a consequence of decision–making processes for motor optimization. Our system is based on well-established rehabilitation strategies that aim to reverse this behaviour by increasing the reward associated with action execution as well as implicitly reducing the expected cost associated with the use of the paretic limb, following the notion of the reinforcement–induced movement therapy (RIMT). Here we validate an accelerometer–based measure of arm use, and its capacity to discriminate different activities that require increasing movement of the arm. We also show how the system can act as a personalized assistant by providing specific goals and adjusting them depending on the performance of the patients. The usability and acceptance of the device as a rehabilitation tool is tested using a battery of self–reported and objective measurements obtained from acute/subacute patients and healthy controls. We believe that an extension of these technologies will allow for the deployment of unsupervised rehabilitation paradigms during and beyond the hospitalization time.

Keywords: stroke, wearables, learned non use, hemiparesis, ADLs

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1108 Farmers’ Access to Agricultural Extension Services Delivery Systems: Evidence from a Field Study in India

Authors: Ankit Nagar, Dinesh Kumar Nauriyal, Sukhpal Singh

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This paper examines the key determinants of farmers’ access to agricultural extension services, sources of agricultural extension services preferred and accessed by the farmers. An ordered logistic regression model was used to analyse the data of the 360 sample households based on a primary survey conducted in western Uttar Pradesh, India. The study finds that farmers' decision to engage in the agricultural extension programme is significantly influenced by factors such as education level, gender, farming experience, social group, group membership, farm size, credit access, awareness about the extension scheme, farmers' perception, and distance from extension sources. The most intriguing finding of this study is that the progressive farmers, which have long been regarded as a major source of knowledge diffusion, are the most distrusted sources of information as they are suspected of withholding vital information from potential beneficiaries. The positive relationship between farm size and ‘Access’ underlines that the extension services should revisit their strategies for targeting more marginal and small farmers constituting over 85 percent of the agricultural households by incorporating their priorities in their outreach programs. The study suggests that marginal and small farmers' productive potential could still be greatly augmented by the appropriate technology, advisory services, guidance, and improved market access. Also, the perception of poor quality of the public extension services can be corrected by initiatives aimed at building up extension workers' capacity.

Keywords: agriculture, access, extension services, ordered logistic regression

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1107 Local Interpretable Model-agnostic Explanations (LIME) Approach to Email Spam Detection

Authors: Rohini Hariharan, Yazhini R., Blessy Maria Mathew

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The task of detecting email spam is a very important one in the era of digital technology that needs effective ways of curbing unwanted messages. This paper presents an approach aimed at making email spam categorization algorithms transparent, reliable and more trustworthy by incorporating Local Interpretable Model-agnostic Explanations (LIME). Our technique assists in providing interpretable explanations for specific classifications of emails to help users understand the decision-making process by the model. In this study, we developed a complete pipeline that incorporates LIME into the spam classification framework and allows creating simplified, interpretable models tailored to individual emails. LIME identifies influential terms, pointing out key elements that drive classification results, thus reducing opacity inherent in conventional machine learning models. Additionally, we suggest a visualization scheme for displaying keywords that will improve understanding of categorization decisions by users. We test our method on a diverse email dataset and compare its performance with various baseline models, such as Gaussian Naive Bayes, Multinomial Naive Bayes, Bernoulli Naive Bayes, Support Vector Classifier, K-Nearest Neighbors, Decision Tree, and Logistic Regression. Our testing results show that our model surpasses all other models, achieving an accuracy of 96.59% and a precision of 99.12%.

Keywords: text classification, LIME (local interpretable model-agnostic explanations), stemming, tokenization, logistic regression.

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1106 Effect of Genuine Missing Data Imputation on Prediction of Urinary Incontinence

Authors: Suzan Arslanturk, Mohammad-Reza Siadat, Theophilus Ogunyemi, Ananias Diokno

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Missing data is a common challenge in statistical analyses of most clinical survey datasets. A variety of methods have been developed to enable analysis of survey data to deal with missing values. Imputation is the most commonly used among the above methods. However, in order to minimize the bias introduced due to imputation, one must choose the right imputation technique and apply it to the correct type of missing data. In this paper, we have identified different types of missing values: missing data due to skip pattern (SPMD), undetermined missing data (UMD), and genuine missing data (GMD) and applied rough set imputation on only the GMD portion of the missing data. We have used rough set imputation to evaluate the effect of such imputation on prediction by generating several simulation datasets based on an existing epidemiological dataset (MESA). To measure how well each dataset lends itself to the prediction model (logistic regression), we have used p-values from the Wald test. To evaluate the accuracy of the prediction, we have considered the width of 95% confidence interval for the probability of incontinence. Both imputed and non-imputed simulation datasets were fit to the prediction model, and they both turned out to be significant (p-value < 0.05). However, the Wald score shows a better fit for the imputed compared to non-imputed datasets (28.7 vs. 23.4). The average confidence interval width was decreased by 10.4% when the imputed dataset was used, meaning higher precision. The results show that using the rough set method for missing data imputation on GMD data improve the predictive capability of the logistic regression. Further studies are required to generalize this conclusion to other clinical survey datasets.

Keywords: rough set, imputation, clinical survey data simulation, genuine missing data, predictive index

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1105 Establishment of a Nomogram Prediction Model for Postpartum Hemorrhage during Vaginal Delivery

Authors: Yinglisong, Jingge Chen, Jingxuan Chen, Yan Wang, Hui Huang, Jing Zhnag, Qianqian Zhang, Zhenzhen Zhang, Ji Zhang

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Purpose: The study aims to establish a nomogram prediction model for postpartum hemorrhage (PPH) in vaginal delivery. Patients and Methods: Clinical data were retrospectively collected from vaginal delivery patients admitted to a hospital in Zhengzhou, China, from June 1, 2022 - October 31, 2022. Univariate and multivariate logistic regression were used to filter out independent risk factors. A nomogram model was established for PPH in vaginal delivery based on the risk factors coefficient. Bootstrapping was used for internal validation. To assess discrimination and calibration, receiver operator characteristics (ROC) and calibration curves were generated in the derivation and validation groups. Results: A total of 1340 cases of vaginal delivery were enrolled, with 81 (6.04%) having PPH. Logistic regression indicated that history of uterine surgery, induction of labor, duration of first labor, neonatal weight, WBC value (during the first stage of labor), and cervical lacerations were all independent risk factors of hemorrhage (P <0.05). The area-under-curve (AUC) of ROC curves of the derivation group and the validation group were 0.817 and 0.821, respectively, indicating good discrimination. Two calibration curves showed that nomogram prediction and practical results were highly consistent (P = 0.105, P = 0.113). Conclusion: The developed individualized risk prediction nomogram model can assist midwives in recognizing and diagnosing high-risk groups of PPH and initiating early warning to reduce PPH incidence.

Keywords: vaginal delivery, postpartum hemorrhage, risk factor, nomogram

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1104 Unveiling Comorbidities in Irritable Bowel Syndrome: A UK BioBank Study utilizing Supervised Machine Learning

Authors: Uswah Ahmad Khan, Muhammad Moazam Fraz, Humayoon Shafique Satti, Qasim Aziz

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Approximately 10-14% of the global population experiences a functional disorder known as irritable bowel syndrome (IBS). The disorder is defined by persistent abdominal pain and an irregular bowel pattern. IBS significantly impairs work productivity and disrupts patients' daily lives and activities. Although IBS is widespread, there is still an incomplete understanding of its underlying pathophysiology. This study aims to help characterize the phenotype of IBS patients by differentiating the comorbidities found in IBS patients from those in non-IBS patients using machine learning algorithms. In this study, we extracted samples coding for IBS from the UK BioBank cohort and randomly selected patients without a code for IBS to create a total sample size of 18,000. We selected the codes for comorbidities of these cases from 2 years before and after their IBS diagnosis and compared them to the comorbidities in the non-IBS cohort. Machine learning models, including Decision Trees, Gradient Boosting, Support Vector Machine (SVM), AdaBoost, Logistic Regression, and XGBoost, were employed to assess their accuracy in predicting IBS. The most accurate model was then chosen to identify the features associated with IBS. In our case, we used XGBoost feature importance as a feature selection method. We applied different models to the top 10% of features, which numbered 50. Gradient Boosting, Logistic Regression and XGBoost algorithms yielded a diagnosis of IBS with an optimal accuracy of 71.08%, 71.427%, and 71.53%, respectively. Among the comorbidities most closely associated with IBS included gut diseases (Haemorrhoids, diverticular diseases), atopic conditions(asthma), and psychiatric comorbidities (depressive episodes or disorder, anxiety). This finding emphasizes the need for a comprehensive approach when evaluating the phenotype of IBS, suggesting the possibility of identifying new subsets of IBS rather than relying solely on the conventional classification based on stool type. Additionally, our study demonstrates the potential of machine learning algorithms in predicting the development of IBS based on comorbidities, which may enhance diagnosis and facilitate better management of modifiable risk factors for IBS. Further research is necessary to confirm our findings and establish cause and effect. Alternative feature selection methods and even larger and more diverse datasets may lead to more accurate classification models. Despite these limitations, our findings highlight the effectiveness of Logistic Regression and XGBoost in predicting IBS diagnosis.

Keywords: comorbidities, disease association, irritable bowel syndrome (IBS), predictive analytics

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1103 Exploring the Factors Affecting the Presence of Farmers’ Markets in Rural British Columbia

Authors: Amirmohsen Behjat, Aleck Ostry, Christina Miewald, Bernie Pauly

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Farmers’ Markets have become one of the important healthy food suppliers in both rural communities and urban settings. Farmers’ markets are evolving and their number has rapidly increased in the past decade. Despite this drastic increase, the distribution of the farmers’ markets is not even across different areas. The main goal of this study is to explore the socioeconomic, geographic, and demographic variables which affect the establishment of farmers’ market in rural communities in British Columbia (BC). Thus, the data on available farmers’ markets in rural areas were collected from BC Association of Farmers’ Markets and spatially joined to BC map at Dissemination Area (DA) level using ArcGIS software to link the farmers’ market to the respective communities that they serve. Then, in order to investigate this issue and understand which rural communities farmer’ markets tend to operate, a binary logistic regression analysis was performed with the availability of farmer’ markets at DA-level as dependent variable and Deprivation Index (DI), Metro Influence Zone (MIZ) and population as independent variables. The results indicated that DI and MIZ variables are not statistically significant whereas the population is the only which had a significant contribution in predicting the availability of farmers’ markets in rural BC. Moreover, this study found that farmers’ markets usually do not operate in rural food deserts where other healthy food providers such as supermarkets and grocery stores are non-existent. In conclusion, the presence of farmers markets is not associated with socioeconomic and geographic characteristics of rural communities in BC, but farmers’ markets tend to operate in more populated rural communities in BC.

Keywords: farmers’ markets, socioeconomic and demographic variables, metro influence zone, logistic regression, ArcGIS

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1102 Investigating the Impacts on Cyclist Casualty Severity at Roundabouts: A UK Case Study

Authors: Nurten Akgun, Dilum Dissanayake, Neil Thorpe, Margaret C. Bell

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Cycling has gained a great attention with comparable speeds, low cost, health benefits and reducing the impact on the environment. The main challenge associated with cycling is the provision of safety for the people choosing to cycle as their main means of transport. From the road safety point of view, cyclists are considered as vulnerable road users because they are at higher risk of serious casualty in the urban network but more specifically at roundabouts. This research addresses the development of an enhanced mathematical model by including a broad spectrum of casualty related variables. These variables were geometric design measures (approach number of lanes and entry path radius), speed limit, meteorological condition variables (light, weather, road surface) and socio-demographic characteristics (age and gender), as well as contributory factors. Contributory factors included driver’s behavior related variables such as failed to look properly, sudden braking, a vehicle passing too close to a cyclist, junction overshot, failed to judge other person’s path, restart moving off at the junction, poor turn or manoeuvre and disobeyed give-way. Tyne and Wear in the UK were selected as a case study area. The cyclist casualty data was obtained from UK STATS19 National dataset. The reference categories for the regression model were set to slight and serious cyclist casualties. Therefore, binary logistic regression was applied. Binary logistic regression analysis showed that approach number of lanes was statistically significant at the 95% level of confidence. A higher number of approach lanes increased the probability of severity of cyclist casualty occurrence. In addition, sudden braking statistically significantly increased the cyclist casualty severity at the 95% level of confidence. The result concluded that cyclist casualty severity was highly related to approach a number of lanes and sudden braking. Further research should be carried out an in-depth analysis to explore connectivity of sudden braking and approach number of lanes in order to investigate the driver’s behavior at approach locations. The output of this research will inform investment in measure to improve the safety of cyclists at roundabouts.

Keywords: binary logistic regression, casualty severity, cyclist safety, roundabout

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1101 Reversible Information Hitting in Encrypted JPEG Bitstream by LSB Based on Inherent Algorithm

Authors: Vaibhav Barve

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Reversible information hiding has drawn a lot of interest as of late. Being reversible, we can restore unique computerized data totally. It is a plan where mystery data is put away in digital media like image, video, audio to maintain a strategic distance from unapproved access and security reason. By and large JPEG bit stream is utilized to store this key data, first JPEG bit stream is encrypted into all around sorted out structure and then this secret information or key data is implanted into this encrypted region by marginally changing the JPEG bit stream. Valuable pixels suitable for information implanting are computed and as indicated by this key subtle elements are implanted. In our proposed framework we are utilizing RC4 algorithm for encrypting JPEG bit stream. Encryption key is acknowledged by framework user which, likewise, will be used at the time of decryption. We are executing enhanced least significant bit supplanting steganography by utilizing genetic algorithm. At first, the quantity of bits that must be installed in a guaranteed coefficient is versatile. By utilizing proper parameters, we can get high capacity while ensuring high security. We are utilizing logistic map for shuffling of bits and utilization GA (Genetic Algorithm) to find right parameters for the logistic map. Information embedding key is utilized at the time of information embedding. By utilizing precise picture encryption and information embedding key, the beneficiary can, without much of a stretch, concentrate the incorporated secure data and totally recoup the first picture and also the original secret information. At the point when the embedding key is truant, the first picture can be recouped pretty nearly with sufficient quality without getting the embedding key of interest.

Keywords: data embedding, decryption, encryption, reversible data hiding, steganography

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1100 Agroforestry Systems and Practices and Its Adoption in Kilombero Cluster of Sagcot, Tanzania

Authors: Lazaro E. Nnko, Japhet J. Kashaigili, Gerald C. Monela, Pantaleo K. T. Munishi

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Agroforestry systems and practices are perceived to improve livelihood and sustainable management of natural resources. However, their adoption in various regions differs with the biophysical conditions and societal characteristics. This study was conducted in Kilombero District to investigate the factors influencing the adoption of different agroforestry systems and practices in agro-ecosystems and farming systems. A household survey, key informant interviews, and focus group discussion was used for data collection in three villages. Descriptive statistics and multinomial logistic regression in SPSS were applied for analysis. Results show that Igima and Ngajengwa villages had home garden practices dominated, as revealed by 63.3% and 66.7%, respectively, while Mbingu village had mixed intercropping practice with 56.67%. Agrosilvopasture systems were dominant in Igima and Ngajengwa villages with 56.7% and 66.7%, respectively, while in Mbingu village, the dominant system was agrosilviculture with 66.7%. The results from multinomial logistic regression show that different explanatory variable was statistical significance as predictors of the adoption of agroforestry systems and practices. Residence type and sex were the most dominant factor influencing the adoption of agroforestry systems. Duration of stay in the village, availability of extension education, residence, and sex were the dominant factor influencing the adoption of agroforestry practices. The most important and statistically significant factors among these were residence type and sex. The study concludes that agroforestry will be more successful if the local priorities, which include social-economic need characteristics of the society, will be considered in designing systems and practices. The socio-economic need of the community should be addressed in the process of expanding the adoption of agroforestry systems and practices.

Keywords: agroforestry adoption, agroforestry systems, agroforestry practices, agroforestry, Kilombero

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1099 Basics of Gamma Ray Burst and Its Afterglow

Authors: Swapnil Kumar Singh

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Gamma-ray bursts (GRB's), short and intense pulses of low-energy γ rays, have fascinated astronomers and astrophysicists since their unexpected discovery in the late sixties. GRB'sare accompanied by long-lasting afterglows, and they are associated with core-collapse supernovae. The detection of delayed emission in X-ray, optical, and radio wavelength, or "afterglow," following a γ-ray burst can be described as the emission of a relativistic shell decelerating upon collision with the interstellar medium. While it is fair to say that there is strong diversity amongst the afterglow population, probably reflecting diversity in the energy, luminosity, shock efficiency, baryon loading, progenitor properties, circumstellar medium, and more, the afterglows of GRBs do appear more similar than the bursts themselves, and it is possible to identify common features within afterglows that lead to some canonical expectations. After an initial flash of gamma rays, a longer-lived "afterglow" is usually emitted at longer wavelengths (X-ray, ultraviolet, optical, infrared, microwave, and radio). It is a slowly fading emission at longer wavelengths created by collisions between the burst ejecta and interstellar gas. In X-ray wavelengths, the GRB afterglow fades quickly at first, then transitions to a less-steep drop-off (it does other stuff after that, but we'll ignore that for now). During these early phases, the X-ray afterglow has a spectrum that looks like a power law: flux F∝ E^β, where E is energy and beta is some number called the spectral index. This kind of spectrum is characteristic of synchrotron emission, which is produced when charged particles spiral around magnetic field lines at close to the speed of light. In addition to the outgoing forward shock that ploughs into the interstellar medium, there is also a so-called reverse shock, which propagates backward through the ejecta. In many ways," reverse" shock can be misleading; this shock is still moving outward from the restframe of the star at relativistic velocity but is ploughing backward through the ejecta in their frame and is slowing the expansion. This reverse shock can be dynamically important, as it can carry comparable energy to the forward shock. The early phases of the GRB afterglow still provide a good description even if the GRB is highly collimated since the individual emitting regions of the outflow are not in causal contact at large angles and so behave as though they are expanding isotropically. The majority of afterglows, at times typically observed, fall in the slow cooling regime, and the cooling break lies between the optical and the X-ray. Numerous observations support this broad picture for afterglows in the spectral energy distribution of the afterglow of the very bright GRB. The bluer light (optical and X-ray) appears to follow a typical synchrotron forward shock expectation (note that the apparent features in the X-ray and optical spectrum are due to the presence of dust within the host galaxy). We need more research in GRB and Particle Physics in order to unfold the mysteries of afterglow.

Keywords: GRB, synchrotron, X-ray, isotropic energy

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1098 Cigarette Smoking and Alcohol Use among Mauritian Adolescents: Analysis of 2017 WHO Global School-Based Student Health Survey

Authors: Iyanujesu Adereti, Tajudeen Basiru, Ayodamola Olanipekun

Abstract:

Background: Substance abuse among adolescents is of public health concern globally. Despite being the most abused by adolescents, there are limited studies on the prevalence of alcohol use and cigarette smoking among adolescents in Mauritius. Objectives: To determine the prevalence of cigarette smoking, alcohol use and associated correlates among school-going adolescents in Mauritius. Methodology: Data obtained from 2017 WHO Global School-based Student Health Survey (GSHS) survey of 3,012 school-going adolescents in Mauritius was analyzed using STATA. Descriptive statistics were used to obtain prevalence. Bivariate and multivariate logistic regression analysis was used to evaluate predictors of cigarette smoking and alcohol use. Results: Prevalence of alcohol consumption and cigarette smoking were 26.0% and 17.1%, respectively. Smoking and alcohol use was more prevalent among males, younger adolescents, and those in higher school grades (p-value <.000). In multivariable logistic regression, male gender was associated with a higher risk of cigarette smoking (adjusted Odds Ratio (aOR) [95%Confidence Interval (CI)]= 1.51[1.06-2.14]) but lower risk of alcohol use (aOR[95%CI]= 0.69[0.53-0.90]) while older age (mid and late adolescence) and parental smoking were found to be associated with increased risk of alcohol use (aOR[95%CI]= 1.94[1.34-2.99] and 1.36[1.05-1.78] respectively). Marijuana use, truancy, being in a fight and suicide ideation were associated with increased odds of alcohol use (aOR[95%CI]= 3.82[3.39-6.09]; 2.15[1.62-2.87]; 1.83[1.34-2.49] and 1.93[1.38-2.69] respectively) and cigarette smoking (aOR[95%CI]= 17.28[10.4 - 28.51]; 1.73[1.21-2. 49]; 1.67[1.14-2.45] and 2.17[1.43-3.28] respectively) while involvement in sexual activity was associated with reduced risk of alcohol use (aOR[95%CI]= 0.50[0.37-0.68]) and cigarette smoking (aOR[95%CI]= 0.47[0.33-0.69]). Parental support and parental monitoring were uniquely associated with lower risk of cigarette smoking (aOR[95%CI]= 0.69[0.47-0.99] and 0.62[0.43-0.91] respectively). Conclusion: The high prevalence of alcohol use and cigarette smoking in this study shows the need for the government of Mauritius to enhance policies that will help address this issue putting into accounts the various risk and protective factors.

Keywords: adolescent health, alcohol use, cigarette smoking, global school-based student health survey

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1097 Simulating the Dynamics of E-waste Production from Mobile Phone: Model Development and Case Study of Rwanda

Authors: Rutebuka Evariste, Zhang Lixiao

Abstract:

Mobile phone sales and stocks showed an exponential growth in the past years globally and the number of mobile phones produced each year was surpassing one billion in 2007, this soaring growth of related e-waste deserves sufficient attentions paid to it regionally and globally as long as 40% of its total weight is made from metallic which 12 elements are identified to be highly hazardous and 12 are less harmful. Different research and methods have been used to estimate the obsolete mobile phones but none has developed a dynamic model and handle the discrepancy resulting from improper approach and error in the input data. The study aim was to develop a comprehensive dynamic system model for simulating the dynamism of e-waste production from mobile phone regardless the country or region and prevail over the previous errors. The logistic model method combined with STELLA program has been used to carry out this study. Then the simulation for Rwanda has been conducted and compared with others countries’ results as model testing and validation. Rwanda is about 1.5 million obsoletes mobile phone with 125 tons of waste in 2014 with e-waste production peak in 2017. It is expected to be 4.17 million obsoletes with 351.97 tons by 2020 along with environmental impact intensity of 21times to 2005. Thus, it is concluded through the model testing and validation that the present dynamic model is competent and able deal with mobile phone e-waste production the fact that it has responded to the previous studies questions from Czech Republic, Iran, and China.

Keywords: carrying capacity, dematerialization, logistic model, mobile phone, obsolescence, similarity, Stella, system dynamics

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1096 Relationship and Associated Factors of Breastfeeding Self-efficacy among Postpartum Couples in Malawi: A Cross-sectional Study

Authors: Roselyn Chipojola, Shu-yu Kuo

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Background: Breastfeeding self-efficacy in both mothers and fathers play a crucial role in improving exclusive breastfeeding rates. However, less is known on the relationship and predictors of paternal and maternal breastfeeding self-efficacy. This study aimed to examine the relationship and associated factors of breastfeeding self-efficacy (BSE) among mothers and fathers in Malawi. Methods: A cross-sectional study was conducted on 180 pairs of postpartum mothers and fathers at a tertiary maternity facility in central Malawi. BSE was measured using the Breastfeeding Self-Efficacy Scale Short-Form. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale. A structured questionnaire was used to collect demographic and health variables. Data were analyzed using multivariable logistic regression and multinomial logistic regression. Results: A higher score of self-efficacy was found in mothers (mean=55.7, Standard Deviation (SD) =6.5) compared to fathers (mean=50.2, SD=11.9). A significant association between paternal and maternal breastfeeding self-efficacy was found (r= 0. 32). Age, employment status, mode of birth was significantly related to maternal and paternal BSE, respectively. Older age and caesarean section delivery were significant factors of combined BSE scores in couples. A higher BSE score in either the mother or her partner predicted higher exclusive breastfeeding rates. BSE scores were lower when couples’ depressive symptoms were high. Conclusion: BSE are highly correlated between Malawian mothers and fathers, with a relatively higher score in maternal BSE. Importantly, a high BSE in couples predicted higher odds of exclusive breastfeeding, which highlights the need to include both mothers and fathers in future breastfeeding promotion strategies.

Keywords: paternal, maternal, exclusive breastfeeding, breastfeeding self‑efficacy, malawi

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1095 Public Administrators, Code of Conduct and the Nigerian Society

Authors: Mahmud Adam, Inuwa Abdu Ibrahim

Abstract:

The issue of ethics and values of public office holders in Nigerian has been and still is a matter of great mystery. Their behaviours in the discharge of their official responsibility remain unsatisfactory. The paper looks at the code of conduct and the societal values with which the Nigerian Administrators function today. Secondary sources of data were used. In conclusion, a change in attitude, reorientation, harsh and enforceable laws is required to reverse the trend.

Keywords: society, administrators, code of conduct, Nigeria

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1094 An Analysis of Human Resource Management Policies for Constructing Employer Brands in the Logistics Sector

Authors: Müberra Yüksel, Ömer Faruk Görçün

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The purpose of the present study is to investigate the role of strategic human resource management (SHRM) in constructing "employer branding" in logistics. Prior research does not focus on internal stakeholders, that is, employees. Despite the fact that logistic sector has become customer-oriented, the focus is solely on service quality as the unique aspect of logistic companies for competitive advantage. With an increasing interest lately in internal marketing of the employer brand, the emphasis is on the value that human capital brings to the firm which cannot be imitated. `Employer branding` has been the application of branding and relationship marketing principles for competitive advantage in SHRM. Employer branding is an organizing framework for human resource managers since it represents an organization’s efforts to promote, both within and outside, a coherent view of what makes the firm different and desirable as an employer, i.e., the distinct “employer brand personality” and "employee value propositions" (EVP) offered. The presumption of employer branding enhanced by internal marketing is to make customer-conscious employees to handle services better by being aligned with business mission and goals. Starting from internal customers and analyzing the gaps of EVP by using analytical hierarchy process methodology (AHP) and inquiring whether these brand values are communicated and conceived well may be the initial steps in our proposal for employer branding in logistics sector. This empirical study aims to fill this research gap within the context of an emergent market- Turkey, which is located at a hub of transportation and logistics.

Keywords: Strategic Human Resource Management (SHRM), employer branding, Employee Value Propositions (EVP), Analytical Hierarchy Process (AHP), logistics

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1093 Expression Level of Dehydration-Responsive Element Binding/DREB Gene of Some Local Corn Cultivars from Kisar Island-Maluku Indonesia Using Quantitative Real-Time PCR

Authors: Hermalina Sinay, Estri L. Arumingtyas

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The research objective was to determine the expression level of dehydration responsive element binding/DREB gene of local corn cultivars from Kisar Island Maluku. The study design was a randomized block design with single factor consist of six local corn cultivars obtained from farmers in Kisar Island and one reference varieties wich has been released by the government as a drought-tolerant varieties and obtained from Cereal Crops Research Institute (ICERI) Maros South Sulawesi. Leaf samples were taken is the second leaf after the flag leaf at the 65 days after planting. Isolation of total RNA from leaf samples was carried out according to the protocols of the R & A-BlueTM Total RNA Extraction Kit and was used as a template for cDNA synthesis. The making of cDNA from total RNA was carried out according to the protocol of One-Step Reverse Transcriptase PCR Premix Kit. Real Time-PCR was performed on cDNA from reverse transcription followed the procedures of Real MODTM Green Real-Time PCR Master Mix Kit. Data obtained from the real time-PCR results were analyzed using relative quantification method based on the critical point / Cycle Threshold (CP / CT). The results of gene expression analysis of DREB gene showed that the expression level of the gene was highest obtained at Deep Yellow local corn cultivar, and the lowest one was obtained at the Rubby Brown Cob cultivar. It can be concluded that the expression level of DREB gene of Deep Yellow local corn cultivar was highest than other local corn cultivars and Srikandi variety as a reference variety.

Keywords: expression, level, DREB gene, local corn cultivars, Kisar Island, Maluku

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1092 Association between Severe Acidemia before Endotracheal Intubation and the Lower First Attempt Intubation Success Rate

Authors: Keiko Naito, Y. Nakashima, S. Yamauchi, Y. Kunitani, Y. Ishigami, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

Abstract:

Background: A presence of severe acidemia, defined as pH < 7.2, is common during endotracheal intubation for critically ill patients in the emergency department (ED). Severe acidemia is widely recognized as a predisposing factor for intubation failure. However, it is unclear that acidemic condition itself actually makes endotracheal intubation more difficult. We aimed to evaluate if a presence of severe acidemia before intubation is associated with the lower first attempt intubation success rate in the ED. Methods: This is a retrospective observational cohort study in the ED of an urban hospital in Japan. The collected data included patient demographics, such as age, sex, and body mass index, presence of one or more factors of modified LEMON criteria for predicting difficult intubation, reasons for intubation, blood gas levels, airway equipment, intubation by emergency physician or not, and the use of the rapid sequence intubation technique. Those with any of the following were excluded from the analysis: (1) no blood gas drawn before intubation, (2) cardiopulmonary arrest, and (3) under 18 years of age. The primary outcome was the first attempt intubation success rates between a severe acidemic patients (SA) group and a non-severe acidemic patients (NA) group. Logistic regression analysis was used to test the first attempt success rates for intubations between those two groups. Results: Over 5 years, a total of 486 intubations were performed; 105 in the SA group and 381 in the NA group. The univariate analysis showed that the first attempt intubation success rate was lower in the SA group than in the NA group (71.4% vs 83.5%, p < 0.01). The multivariate logistic regression analysis identified that severe acidemia was significantly associated with the first attempt intubation failure (OR 1.9, 95% CI 1.03-3.68, p = 0.04). Conclusions: A presence of severe acidemia before endotracheal intubation lowers the first attempt intubation success rate in the ED.

Keywords: acidemia, airway management, endotracheal intubation, first-attempt intubation success rate

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1091 Customer Churn Prediction by Using Four Machine Learning Algorithms Integrating Features Selection and Normalization in the Telecom Sector

Authors: Alanoud Moraya Aldalan, Abdulaziz Almaleh

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A crucial component of maintaining a customer-oriented business as in the telecom industry is understanding the reasons and factors that lead to customer churn. Competition between telecom companies has greatly increased in recent years. It has become more important to understand customers’ needs in this strong market of telecom industries, especially for those who are looking to turn over their service providers. So, predictive churn is now a mandatory requirement for retaining those customers. Machine learning can be utilized to accomplish this. Churn Prediction has become a very important topic in terms of machine learning classification in the telecommunications industry. Understanding the factors of customer churn and how they behave is very important to building an effective churn prediction model. This paper aims to predict churn and identify factors of customers’ churn based on their past service usage history. Aiming at this objective, the study makes use of feature selection, normalization, and feature engineering. Then, this study compared the performance of four different machine learning algorithms on the Orange dataset: Logistic Regression, Random Forest, Decision Tree, and Gradient Boosting. Evaluation of the performance was conducted by using the F1 score and ROC-AUC. Comparing the results of this study with existing models has proven to produce better results. The results showed the Gradients Boosting with feature selection technique outperformed in this study by achieving a 99% F1-score and 99% AUC, and all other experiments achieved good results as well.

Keywords: machine learning, gradient boosting, logistic regression, churn, random forest, decision tree, ROC, AUC, F1-score

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1090 An Efficient Machine Learning Model to Detect Metastatic Cancer in Pathology Scans Using Principal Component Analysis Algorithm, Genetic Algorithm, and Classification Algorithms

Authors: Bliss Singhal

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Machine learning (ML) is a branch of Artificial Intelligence (AI) where computers analyze data and find patterns in the data. The study focuses on the detection of metastatic cancer using ML. Metastatic cancer is the stage where cancer has spread to other parts of the body and is the cause of approximately 90% of cancer-related deaths. Normally, pathologists spend hours each day to manually classifying whether tumors are benign or malignant. This tedious task contributes to mislabeling metastasis being over 60% of the time and emphasizes the importance of being aware of human error and other inefficiencies. ML is a good candidate to improve the correct identification of metastatic cancer, saving thousands of lives and can also improve the speed and efficiency of the process, thereby taking fewer resources and time. So far, the deep learning methodology of AI has been used in research to detect cancer. This study is a novel approach to determining the potential of using preprocessing algorithms combined with classification algorithms in detecting metastatic cancer. The study used two preprocessing algorithms: principal component analysis (PCA) and the genetic algorithm, to reduce the dimensionality of the dataset and then used three classification algorithms: logistic regression, decision tree classifier, and k-nearest neighbors to detect metastatic cancer in the pathology scans. The highest accuracy of 71.14% was produced by the ML pipeline comprising of PCA, the genetic algorithm, and the k-nearest neighbor algorithm, suggesting that preprocessing and classification algorithms have great potential for detecting metastatic cancer.

Keywords: breast cancer, principal component analysis, genetic algorithm, k-nearest neighbors, decision tree classifier, logistic regression

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1089 Admission C-Reactive Protein Serum Levels and In-Hospital Mortality in the Elderly Admitted to the Acute Geriatrics Department

Authors: Anjelika Kremer, Irina Nachimov, Dan Justo

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Background: C-reactive protein (CRP) serum levels are commonly measured in hospitalized patients. Elevated admission CRP serum levels and in-hospital mortality has been seldom studied in the general population of elderly patients admitted to the acute Geriatrics department. Methods: A retrospective cross-sectional study was conducted at a tertiary medical center. Included were all elderly patients (age 65 years or more) admitted to a single acute Geriatrics department from the emergency room between April 2014 and January 2015. CRP serum levels were measured routinely in all patients upon the first 24 hours of admission. A logistic regression analysis was used to study if admission CRP serum levels were associated with in-hospital mortality independent of age, gender, functional status, and co-morbidities. Results: Overall, 498 elderly patients were included in the analysis: 306 (61.4%) female patients and 192 (38.6%) male patients. The mean age was 84.8±7.0 years (median: 85 years; IQR: 80-90 years). The mean admission CRP serum levels was 43.2±67.1 mg/l (median: 13.1 mg/l; IQR: 2.8-51.7 mg/l). Overall, 33 (6.6%) elderly patients died during the hospitalization. A logistic regression analysis showed that in-hospital mortality was independently associated with history of stroke (p < 0.0001), heart failure (p < 0.0001), and admission CRP serum levels (p < 0.0001) – and to a lesser extent with age (p = 0.042), collagen vascular disease (p=0.011), and recent venous thromboembolism (p=0.037). Receiver operating characteristic (ROC) curve showed that admission CRP serum levels predict in-hospital mortality fairly with an area under the curve (AUC) of 0.694 (p < 0.0001). Cut-off value with maximal sensitivity and specificity was 19.7 mg/L. Conclusions: Admission CRP serum levels may be used to predict in-hospital mortality in the general population of elderly patients admitted to the acute Geriatrics department.

Keywords: c-reactive protein, elderly, mortality, prediction

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1088 Association Between Advanced Parental Age and Implantation Failure: A Prospective Cohort Study in Anhui, China

Authors: Jiaqian Yin, Ruoling Chen, David Churchill, Huijuan Zou, Peipei Guo, Chunmei Liang, Xiaoqing Peng, Zhikang Zhang, Weiju Zhou, Yunxia Cao

Abstract:

Purpose: This study aimed to explore the interaction of male and female age on implantation failure from in vitro fertilisation (IVF)/ intracytoplasmic sperm injection (ICSI) treatments in couples following their first cycles using the Anhui Maternal-Child Health Study (AMCHS). Methods: The AMCHS recruited 2042 infertile couples who were physically fit for in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatment at the Reproductive Centre of the First Affiliated Hospital of Anhui Medical University between May 2017 to April 2021. This prospective cohort study analysed the data from 1910 cohort couples for the current paper data analysis. The multivariate logistic regression model was used to identify the effect of male and female age on implantation failure after controlling for confounding factors. Male age and female age were examined as continuous and categorical (male age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40; female age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40) predictors. Results: Logistic regression indicated that advanced maternal age was associated with increased implantation failure (P<0.001). There was evidence of an interaction between maternal age (30-<35 and ≥ 35) and paternal age (≥35) on implantation failure. (p<0.05). Only when the male was ≥35 years of increased maternal age was associated with the risk of implantation failure. Conclusion: In conclusion, there was an additive effect on implantation failure with advanced parental age. The impact of advanced maternal age was only seen in the older paternal age group. The delay of childbearing in both men and women will be a serious public issue that may contribute to a higher risk of implantation failure in patients needing assisted reproductive technology (ART).

Keywords: parental age, infertility, cohort study, IVF

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