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Zhao S, Zhang J, Zhang C, Steinhoff MC, Zhang Y, Zhang B. Effect of maternal vaccination on infant morbidity in Bangladesh. BMC Public Health 2024; 24:1213. [PMID: 38698353 PMCID: PMC11064391 DOI: 10.1186/s12889-024-18486-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/29/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Risk factors of infant mortality in Africa and south Asian countries have been broadly discussed. However, infant morbidity is largely underestimated. We analyzed the data from a randomized vaccine trial in Bangladesh to identify and assess the effect of risk factors on infant morbidity. METHODS Pregnant women were randomly assigned to receive either inactivated influenza vaccine or pneumococcal polysaccharide vaccine and the infants were randomly assigned to receive 7-valent pneumococcal conjugate vaccine or Hib conjugate vaccine at week 6, 10 and 14. The data were collected from August 2004 through December 2005. Each pair of infant and mother were followed for 24 weeks after birth with weekly visits. Generalized estimating equations (GEE) for repeated measurements and Poisson regression models were used to identify the risk factors and evaluate their effect on the longitudinal incidence and total number of episodes of respiratory illness with fever (RIF), diarrhea disease, ear problem and pneumonia. RESULTS A total of 340 pregnant women were randomized with mean age of 25 years. The baseline mother and infant characteristics were similar between two treatment groups. Exclusive breastfeeding and higher paternal education level were common factors associated with lower infant morbidity of RIF (adjusted OR = 0.40 and 0.94 with p < 0.01 and p = 0.02, respectively), diarrhea disease (adjusted OR = 0.39 and 0.95 with p < 0.01 and p = 0.04, respectively), and ear problem (adjusted OR = 0.20 and 0.76 with p < 0.01 and p < 0.01, respectively). Maternal influenza vaccine significantly reduced the incidence of RIF (adjusted OR = 0.54; p < 0.01) but not diarrhea disease or ear problem (p > 0.05). Female infants had lower incidence of diarrhea disease (adjusted OR = 0.67; p = 0.01) and ear problem (adjusted OR = 0.12; p = 0.01). CONCLUSIONS Maternal influenza vaccination, exclusive breastfeeding, female children, and higher paternal education level significantly reduced the infant morbidity within the 24 weeks after birth in Bangladesh.
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Affiliation(s)
- Shiqiao Zhao
- Department of Environmental Health, Harvard University, Boston, MA, USA
| | - Jing Zhang
- Department of Statistics, Miami University, 334B Upham Hall, Oxford, OH, 45056, USA.
| | - Chenxin Zhang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mark C Steinhoff
- Global Health Center, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Yanting Zhang
- Department of Environmental Health, Harvard University, Boston, MA, USA
| | - Bin Zhang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Amini E, Heidarzadeh M, Sohbati S, Behseresht M, Amiresmaili M. Exploring causes of neonatal mortality in south east of Iran: A qualitative study. Int J Health Plann Manage 2024; 39:22-35. [PMID: 37717258 DOI: 10.1002/hpm.3708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 07/25/2023] [Accepted: 09/01/2023] [Indexed: 09/19/2023] Open
Abstract
AIM Neonatal mortality (NM) is a significant global challenge that has a profound impact on families, particularly mothers. To address this challenge, the first step is to identify its underlying causes. Accordingly, this study aimed to explore the phenomenon by consulting with stakeholders, including mothers and experts. STUDY DESIGN This study utilized a qualitative design, conducting in-depth interviews with 16 mothers and 15 healthcare experts to gather information. A conventional content analysis approach was employed to analyze the data. RESULTS NM is influenced by personal, systemic, and socioeconomic factors. Personal factors can be further divided into those related to the neonate and those related to the mother. Systemic factors are primarily related to the healthcare system, while socioeconomic factors include low literacy, low income, lack of access to healthcare, and consanguineous marriage. CONCLUSION NM is influenced by a wide range of factors that require separate and targeted interventions to reduce its incidence. In the short term, priority should be given to preventable factors that can be addressed through simple interventions, such as screening mothers for urinary tract infections, educating mothers, and preparing them for pregnancy with necessary lab tests and supplements. In the long term, preventing premature birth, addressing maternal addiction, family poverty, and shortages in healthcare equipment and personnel must be thoroughly addressed.
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Affiliation(s)
- Elham Amini
- Health in Disaster and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Samira Sohbati
- Department of Obstetrics and Gynecology, Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Behseresht
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammadreza Amiresmaili
- Health in Disaster and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Seidu AA, Ahinkorah BO, Anjorin SS, Tetteh JK, Hagan JE, Zegeye B, Adu-Gyamfi AB, Yaya S. High-risk fertility behaviours among women in sub-Saharan Africa. J Public Health (Oxf) 2023; 45:21-31. [PMID: 34850201 DOI: 10.1093/pubmed/fdab381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/30/2021] [Accepted: 10/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND High-risk fertility behaviours such as too early or advanced age at delivery, shorter birth interval, birth order and a higher number of live births to a woman often lead to adverse maternal and child health outcomes. We assessed high-risk fertility behaviours and their associated factors among women in sub-Saharan Africa (SSA). METHODS Data on 200 716 women pooled from the demographic and health surveys of 27 countries conducted between 2010 and 2020 in SSA were analysed. High-risk fertility behaviour from four indicators, mother aged <18 years at the time of delivery; mother aged >34 years at the time of delivery; mother of a child born after a short birth interval (<24 months) and mother of high parity (>3 children), was derived. Multi-level multi-variable logistic regression analyses were carried out and the results were presented as adjusted odds ratios at 95% confidence interval. RESULTS Women who were in polygamous marriages had higher odds of single and multiple high-risk fertility behaviour compared with their counterparts who were in monogamous marriages. Women with middle or high maternal decision-making power had higher odds of single and multiple high-risk fertility behaviours compared with those with low decision-making power. Single and multiple high-risk fertility behaviours were lower among women with access to family planning, those with at least primary education and those whose partners had at least primary education compared with their counterparts who had no access to family planning, those with no formal education and those whose partners had no formal education. CONCLUSION Family structure, women's decision-making power, access to family planning, women's level of education and partners' level of education were identified as predictors of high-risk fertility behaviours in SSA. These findings are crucial in addressing maternal health and fertility challenges. Policy makers, maternal health and fertility stakeholders in countries with high prevalence of high parity and short birth intervals should organize programs that will help to reduce the prevalence of these high-risk factors, taking into consideration the factors that predispose women to high-risk fertility behaviours.
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Affiliation(s)
- Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, PBM TF0494; Cape Coast, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland QLD 4811, Australia.,Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, NSW2007, Australia
| | - Seun Stephen Anjorin
- Warwick Centre for Global Health, Division of Health Sciences, University of Warwick, CV47AL, Coventry, United Kingdom
| | - Justice Kanor Tetteh
- Department of Population and Health, University of Cape Coast, PBM TF0494; Cape Coast, Ghana
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, PMBTF0494 Cape Coast, Ghana.,Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Postfach 10 01 31, 33501 Bielefeld-Germany
| | - Betregiorgis Zegeye
- HaSET Maternal and Child Health Research Program, Shewarobit Field Office, PMB, Shewarobit, Ethiopia
| | | | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, ON K1N 6N5, Canada.,The George Institute for Global Health, Imperial College London, London, W12OBZ, United Kingdom
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Jamee AR, Sen KK, Bari W. Examining the influence of correlates on different quantile survival times: infant mortality in Bangladesh. BMC Public Health 2022; 22:1980. [PMID: 36307785 PMCID: PMC9617317 DOI: 10.1186/s12889-022-14396-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 10/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several studies have identified factors influencing infant mortality, but, to the best of knowledge, no studies assessed the factors considering unequal effects on different survival times of infant mortality in Bangladesh. In this study, it was examined how a set of covariates behaves on different quantile survival times related with the infant mortality. METHODS Data obtained from Bangladesh multiple indicator cluster survey (BMICS), 2019 have been used for purpose of the study. A total of 9,183 reproductive women were included in the study who gave their most recent live births within two years preceding the survey. Kaplan-Meier product limit approach has been applied to find the survival probabilities for the infant mortality, and the log-rank test has also been used to observe the unadjusted association between infant mortality and selected covariates. To examine the unequal effects of the covariates on different quantile survival time of infant mortality, the Laplace survival regression model has been fitted. The results obtained from this model have also been compared with the results obtained from the classical accelerated failure time (AFT) and Cox proportional hazard (Cox PH) models. RESULTS The infant mortality in Bangladesh is still high which is around 28 per 1000 live births. In all the selected survival regression models, the directions of regression coefficients were similar, but the heterogenous effects of covariates on survival time were observed in quantile survival model. Several correlates such as maternal age, education, gender of index child, previous birth interval, skilled antenatal care provider, immediate breastfeeding etc. were identified as potential factors having higher impact on initial survival times. CONCLUSION Infant mortality was significantly influenced by the factors more in the beginning of the infant's life period than at later stages, suggesting that receiving proper care at an early age will raise the likelihood of survival. Policy-making interventions are required to reduce the infant deaths, and the study findings may assist policy makers to revise the programs so that the sustainable development goal 3.2 can be achieved in Bangladesh.
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Affiliation(s)
| | - Kanchan Kumar Sen
- Department of Statistics, University of Dhaka, Dhaka, 1000 Bangladesh
| | - Wasimul Bari
- Department of Statistics, University of Dhaka, Dhaka, 1000 Bangladesh
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Alam MJ, Islam MM, Maniruzzaman M, Ahmed NAMF, Tawabunnahar M, Rahman MJ, Roy DC, Mydam J. Socioeconomic inequality in the prevalence of low birth weight and its associated determinants in Bangladesh. PLoS One 2022; 17:e0276718. [PMID: 36301890 PMCID: PMC9612499 DOI: 10.1371/journal.pone.0276718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Low birth weight (LBW) is a major risk factor of child mortality and morbidity during infancy (0-3 years) and early childhood (3-8 years) in low and lower-middle-income countries, including Bangladesh. LBW is a vital public health concern in Bangladesh. The objective of the research was to investigate the socioeconomic inequality in the prevalence of LBW among singleton births and identify the significantly associated determinants of singleton LBW in Bangladesh. MATERIALS AND METHODS The data utilized in this research was derived from the latest nationally representative Bangladesh Demographic and Health Survey, 2017-18, and included a total of 2327 respondents. The concentration index (C-index) and concentration curve were used to investigate the socioeconomic inequality in LBW among the singleton newborn babies. Additionally, an adjusted binary logistic regression model was utilized for calculating adjusted odds ratio and p-value (<0.05) to identify the significant determinants of LBW. RESULTS The overall prevalence of LBW among singleton births in Bangladesh was 14.27%. We observed that LBW rates were inequitably distributed across the socioeconomic groups (C-index: -0.096, 95% confidence interval: [-0.175, -0.016], P = 0.029), with a higher concentration of LBW infants among mothers living in the lowest wealth quintile (poorest). Regression analysis revealed that maternal age, region, maternal education level, wealth index, height, age at 1st birth, and the child's aliveness (alive or died) at the time of the survey were significantly associated determinants of LBW in Bangladesh. CONCLUSION In this study, socioeconomic disparity in the prevalence of singleton LBW was evident in Bangladesh. Incidence of LBW might be reduced by improving the socioeconomic status of poor families, paying special attention to mothers who have no education and live in low-income households in the eastern divisions (e.g., Sylhet, Chittagong). Governments, agencies, and non-governmental organizations should address the multifaceted issues and implement preventive programs and policies in Bangladesh to reduce LBW.
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Affiliation(s)
- Md. Jahangir Alam
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
- * E-mail: (MJA); , (JM)
| | - Md. Merajul Islam
- Department of Statistics, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | | | | | - Most. Tawabunnahar
- Department of Statistics, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | | | - Dulal Chandra Roy
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
| | - Janardhan Mydam
- Division of Neonatology, Department of Pediatrics, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, United States of America
- Department of Pediatrics, Rush Medical Center, Chicago, IL, United States of America
- Division of Neonatology, Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
- * E-mail: (MJA); , (JM)
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Suri JS, Agarwal S, Saba L, Chabert GL, Carriero A, Paschè A, Danna P, Mehmedović A, Faa G, Jujaray T, Singh IM, Khanna NN, Laird JR, Sfikakis PP, Agarwal V, Teji JS, R Yadav R, Nagy F, Kincses ZT, Ruzsa Z, Viskovic K, Kalra MK. Multicenter Study on COVID-19 Lung Computed Tomography Segmentation with varying Glass Ground Opacities using Unseen Deep Learning Artificial Intelligence Paradigms: COVLIAS 1.0 Validation. J Med Syst 2022; 46:62. [PMID: 35988110 PMCID: PMC9392994 DOI: 10.1007/s10916-022-01850-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 08/02/2022] [Indexed: 11/09/2022]
Abstract
Variations in COVID-19 lesions such as glass ground opacities (GGO), consolidations, and crazy paving can compromise the ability of solo-deep learning (SDL) or hybrid-deep learning (HDL) artificial intelligence (AI) models in predicting automated COVID-19 lung segmentation in Computed Tomography (CT) from unseen data leading to poor clinical manifestations. As the first study of its kind, “COVLIAS 1.0-Unseen” proves two hypotheses, (i) contrast adjustment is vital for AI, and (ii) HDL is superior to SDL. In a multicenter study, 10,000 CT slices were collected from 72 Italian (ITA) patients with low-GGO, and 80 Croatian (CRO) patients with high-GGO. Hounsfield Units (HU) were automatically adjusted to train the AI models and predict from test data, leading to four combinations—two Unseen sets: (i) train-CRO:test-ITA, (ii) train-ITA:test-CRO, and two Seen sets: (iii) train-CRO:test-CRO, (iv) train-ITA:test-ITA. COVILAS used three SDL models: PSPNet, SegNet, UNet and six HDL models: VGG-PSPNet, VGG-SegNet, VGG-UNet, ResNet-PSPNet, ResNet-SegNet, and ResNet-UNet. Two trained, blinded senior radiologists conducted ground truth annotations. Five types of performance metrics were used to validate COVLIAS 1.0-Unseen which was further benchmarked against MedSeg, an open-source web-based system. After HU adjustment for DS and JI, HDL (Unseen AI) > SDL (Unseen AI) by 4% and 5%, respectively. For CC, HDL (Unseen AI) > SDL (Unseen AI) by 6%. The COVLIAS-MedSeg difference was < 5%, meeting regulatory guidelines.Unseen AI was successfully demonstrated using automated HU adjustment. HDL was found to be superior to SDL.
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Teji JS, Jain S, Gupta SK, Suri JS. NeoAI 1.0: Machine learning-based paradigm for prediction of neonatal and infant risk of death. Comput Biol Med 2022; 147:105639. [DOI: 10.1016/j.compbiomed.2022.105639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 05/01/2022] [Accepted: 05/01/2022] [Indexed: 11/29/2022]
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Agarwal M, Agarwal S, Saba L, Chabert GL, Gupta S, Carriero A, Pasche A, Danna P, Mehmedovic A, Faa G, Shrivastava S, Jain K, Jain H, Jujaray T, Singh IM, Turk M, Chadha PS, Johri AM, Khanna NN, Mavrogeni S, Laird JR, Sobel DW, Miner M, Balestrieri A, Sfikakis PP, Tsoulfas G, Misra DP, Agarwal V, Kitas GD, Teji JS, Al-Maini M, Dhanjil SK, Nicolaides A, Sharma A, Rathore V, Fatemi M, Alizad A, Krishnan PR, Yadav RR, Nagy F, Kincses ZT, Ruzsa Z, Naidu S, Viskovic K, Kalra MK, Suri JS. Eight pruning deep learning models for low storage and high-speed COVID-19 computed tomography lung segmentation and heatmap-based lesion localization: A multicenter study using COVLIAS 2.0. Comput Biol Med 2022; 146:105571. [PMID: 35751196 PMCID: PMC9123805 DOI: 10.1016/j.compbiomed.2022.105571] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/05/2022] [Accepted: 04/26/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND COVLIAS 1.0: an automated lung segmentation was designed for COVID-19 diagnosis. It has issues related to storage space and speed. This study shows that COVLIAS 2.0 uses pruned AI (PAI) networks for improving both storage and speed, wiliest high performance on lung segmentation and lesion localization. METHOD ology: The proposed study uses multicenter ∼9,000 CT slices from two different nations, namely, CroMed from Croatia (80 patients, experimental data), and NovMed from Italy (72 patients, validation data). We hypothesize that by using pruning and evolutionary optimization algorithms, the size of the AI models can be reduced significantly, ensuring optimal performance. Eight different pruning techniques (i) differential evolution (DE), (ii) genetic algorithm (GA), (iii) particle swarm optimization algorithm (PSO), and (iv) whale optimization algorithm (WO) in two deep learning frameworks (i) Fully connected network (FCN) and (ii) SegNet were designed. COVLIAS 2.0 was validated using "Unseen NovMed" and benchmarked against MedSeg. Statistical tests for stability and reliability were also conducted. RESULTS Pruning algorithms (i) FCN-DE, (ii) FCN-GA, (iii) FCN-PSO, and (iv) FCN-WO showed improvement in storage by 92.4%, 95.3%, 98.7%, and 99.8% respectively when compared against solo FCN, and (v) SegNet-DE, (vi) SegNet-GA, (vii) SegNet-PSO, and (viii) SegNet-WO showed improvement by 97.1%, 97.9%, 98.8%, and 99.2% respectively when compared against solo SegNet. AUC > 0.94 (p < 0.0001) on CroMed and > 0.86 (p < 0.0001) on NovMed data set for all eight EA model. PAI <0.25 s per image. DenseNet-121-based Grad-CAM heatmaps showed validation on glass ground opacity lesions. CONCLUSIONS Eight PAI networks that were successfully validated are five times faster, storage efficient, and could be used in clinical settings.
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Affiliation(s)
- Mohit Agarwal
- Department of Computer Science Engineering, Bennett University, India
| | - Sushant Agarwal
- Department of Computer Science Engineering, PSIT, Kanpur, India; Advanced Knowledge Engineering Centre, Global Biomedical Technologies, Inc., Roseville, CA 95661, USA
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Gian Luca Chabert
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Suneet Gupta
- Department of Computer Science Engineering, Bennett University, India
| | - Alessandro Carriero
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Alessio Pasche
- Depart of Radiology, "Maggiore della Carità" Hospital, University of Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
| | - Pietro Danna
- Depart of Radiology, "Maggiore della Carità" Hospital, University of Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
| | | | - Gavino Faa
- Department of Pathology - AOU of Cagliari, Italy
| | - Saurabh Shrivastava
- College of Computing Sciences and IT, Teerthanker Mahaveer University, Moradabad, 244001, India
| | - Kanishka Jain
- College of Computing Sciences and IT, Teerthanker Mahaveer University, Moradabad, 244001, India
| | - Harsh Jain
- College of Computing Sciences and IT, Teerthanker Mahaveer University, Moradabad, 244001, India
| | - Tanay Jujaray
- Dept of Molecular, Cell and Developmental Biology, University of California, Santa Cruz, CA, USA
| | | | - Monika Turk
- The Hanse-Wissenschaftskolleg Institute for Advanced Study, Delmenhorst, Germany
| | | | - Amer M Johri
- Division of Cardiology, Queen's University, Kingston, Ontario, Canada
| | - Narendra N Khanna
- Department of Cardiology, Indraprastha APOLLO Hospitals, New Delhi, India
| | - Sophie Mavrogeni
- Cardiology Clinic, Onassis Cardiac Surgery Center, Athens, Greece
| | - John R Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St Helena, CA, USA
| | - David W Sobel
- Minimally Invasive Urology Institute, Brown University, Providence, RI, USA
| | - Martin Miner
- Men's Health Center, Miriam Hospital Providence, Rhode Island, USA
| | - Antonella Balestrieri
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Petros P Sfikakis
- Rheumatology Unit, National Kapodistrian University of Athens, Greece
| | - George Tsoulfas
- Aristoteleion University of Thessaloniki, Thessaloniki, Greece
| | | | | | - George D Kitas
- Academic Affairs, Dudley Group NHS Foundation Trust, Dudley, UK; Arthritis Research UK Epidemiology Unit, Manchester University, Manchester, UK
| | - Jagjit S Teji
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, USA
| | - Mustafa Al-Maini
- Allergy, Clinical Immunology and Rheumatology Institute, Toronto, Canada
| | | | - Andrew Nicolaides
- Vascular Screening and Diagnostic Centre and Univ. of Nicosia Medical School, Cyprus
| | - Aditya Sharma
- Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA
| | | | - Mostafa Fatemi
- Dept. of Physiology & Biomedical Engg., Mayo Clinic College of Medicine and Science, MN, USA
| | - Azra Alizad
- Dept. of Radiology, Mayo Clinic College of Medicine and Science, MN, USA
| | | | | | - Frence Nagy
- Department of Radiology, University of Szeged, 6725, Hungary
| | | | - Zoltan Ruzsa
- Invasive Cardiology Division, University of Szeged, Budapest, Hungary
| | - Subbaram Naidu
- Electrical Engineering Department, University of Minnesota, Duluth, MN, USA
| | | | - Manudeep K Kalra
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Jasjit S Suri
- College of Computing Sciences and IT, Teerthanker Mahaveer University, Moradabad, 244001, India; Stroke Diagnostic and Monitoring Division, AtheroPoint™, Roseville, CA, USA.
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Deep Learning Paradigm for Cardiovascular Disease/Stroke Risk Stratification in Parkinson’s Disease Affected by COVID-19: A Narrative Review. Diagnostics (Basel) 2022; 12:diagnostics12071543. [PMID: 35885449 PMCID: PMC9324237 DOI: 10.3390/diagnostics12071543] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Motivation: Parkinson’s disease (PD) is one of the most serious, non-curable, and expensive to treat. Recently, machine learning (ML) has shown to be able to predict cardiovascular/stroke risk in PD patients. The presence of COVID-19 causes the ML systems to become severely non-linear and poses challenges in cardiovascular/stroke risk stratification. Further, due to comorbidity, sample size constraints, and poor scientific and clinical validation techniques, there have been no well-explained ML paradigms. Deep neural networks are powerful learning machines that generalize non-linear conditions. This study presents a novel investigation of deep learning (DL) solutions for CVD/stroke risk prediction in PD patients affected by the COVID-19 framework. Method: The PRISMA search strategy was used for the selection of 292 studies closely associated with the effect of PD on CVD risk in the COVID-19 framework. We study the hypothesis that PD in the presence of COVID-19 can cause more harm to the heart and brain than in non-COVID-19 conditions. COVID-19 lung damage severity can be used as a covariate during DL training model designs. We, therefore, propose a DL model for the estimation of, (i) COVID-19 lesions in computed tomography (CT) scans and (ii) combining the covariates of PD, COVID-19 lesions, office and laboratory arterial atherosclerotic image-based biomarkers, and medicine usage for the PD patients for the design of DL point-based models for CVD/stroke risk stratification. Results: We validated the feasibility of CVD/stroke risk stratification in PD patients in the presence of a COVID-19 environment and this was also verified. DL architectures like long short-term memory (LSTM), and recurrent neural network (RNN) were studied for CVD/stroke risk stratification showing powerful designs. Lastly, we examined the artificial intelligence bias and provided recommendations for early detection of CVD/stroke in PD patients in the presence of COVID-19. Conclusion: The DL is a very powerful tool for predicting CVD/stroke risk in PD patients affected by COVID-19.
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Role of Artificial Intelligence in Radiogenomics for Cancers in the Era of Precision Medicine. Cancers (Basel) 2022; 14:cancers14122860. [PMID: 35740526 PMCID: PMC9220825 DOI: 10.3390/cancers14122860] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Recently, radiogenomics has played a significant role and offered a new understanding of cancer’s biology and behavior in response to standard therapy. It also provides a more precise prognosis, investigation, and analysis of the patient’s cancer. Over the years, Artificial Intelligence (AI) has provided a significant strength in radiogenomics. In this paper, we offer computational and oncological prospects of the role of AI in radiogenomics, as well as its offers, achievements, opportunities, and limitations in the current clinical practices. Abstract Radiogenomics, a combination of “Radiomics” and “Genomics,” using Artificial Intelligence (AI) has recently emerged as the state-of-the-art science in precision medicine, especially in oncology care. Radiogenomics syndicates large-scale quantifiable data extracted from radiological medical images enveloped with personalized genomic phenotypes. It fabricates a prediction model through various AI methods to stratify the risk of patients, monitor therapeutic approaches, and assess clinical outcomes. It has recently shown tremendous achievements in prognosis, treatment planning, survival prediction, heterogeneity analysis, reoccurrence, and progression-free survival for human cancer study. Although AI has shown immense performance in oncology care in various clinical aspects, it has several challenges and limitations. The proposed review provides an overview of radiogenomics with the viewpoints on the role of AI in terms of its promises for computational as well as oncological aspects and offers achievements and opportunities in the era of precision medicine. The review also presents various recommendations to diminish these obstacles.
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Khanna NN, Maindarkar M, Saxena A, Ahluwalia P, Paul S, Srivastava SK, Cuadrado-Godia E, Sharma A, Omerzu T, Saba L, Mavrogeni S, Turk M, Laird JR, Kitas GD, Fatemi M, Barqawi AB, Miner M, Singh IM, Johri A, Kalra MM, Agarwal V, Paraskevas KI, Teji JS, Fouda MM, Pareek G, Suri JS. Cardiovascular/Stroke Risk Assessment in Patients with Erectile Dysfunction-A Role of Carotid Wall Arterial Imaging and Plaque Tissue Characterization Using Artificial Intelligence Paradigm: A Narrative Review. Diagnostics (Basel) 2022; 12:1249. [PMID: 35626404 PMCID: PMC9141739 DOI: 10.3390/diagnostics12051249] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/14/2022] [Accepted: 05/15/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The role of erectile dysfunction (ED) has recently shown an association with the risk of stroke and coronary heart disease (CHD) via the atherosclerotic pathway. Cardiovascular disease (CVD)/stroke risk has been widely understood with the help of carotid artery disease (CTAD), a surrogate biomarker for CHD. The proposed study emphasizes artificial intelligence-based frameworks such as machine learning (ML) and deep learning (DL) that can accurately predict the severity of CVD/stroke risk using carotid wall arterial imaging in ED patients. METHODS Using the PRISMA model, 231 of the best studies were selected. The proposed study mainly consists of two components: (i) the pathophysiology of ED and its link with coronary artery disease (COAD) and CHD in the ED framework and (ii) the ultrasonic-image morphological changes in the carotid arterial walls by quantifying the wall parameters and the characterization of the wall tissue by adapting the ML/DL-based methods, both for the prediction of the severity of CVD risk. The proposed study analyzes the hypothesis that ML/DL can lead to an accurate and early diagnosis of the CVD/stroke risk in ED patients. Our finding suggests that the routine ED patient practice can be amended for ML/DL-based CVD/stroke risk assessment using carotid wall arterial imaging leading to fast, reliable, and accurate CVD/stroke risk stratification. SUMMARY We conclude that ML and DL methods are very powerful tools for the characterization of CVD/stroke in patients with varying ED conditions. We anticipate a rapid growth of these tools for early and better CVD/stroke risk management in ED patients.
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Affiliation(s)
- Narendra N. Khanna
- Department of Cardiology, Indraprastha APOLLO Hospitals, New Delhi 110076, India;
| | - Mahesh Maindarkar
- Department of Biomedical Engineering, North Eastern Hill University, Shillong 793022, India; (M.M.); (S.P.)
- Stroke Monitoring and Diagnostic Division, AtheroPoint, Roseville, CA 95661, USA;
| | - Ajit Saxena
- Department of Urology, Indraprastha APOLLO Hospitals, New Delhi 110076, India;
| | - Puneet Ahluwalia
- Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi 110017, India;
| | - Sudip Paul
- Department of Biomedical Engineering, North Eastern Hill University, Shillong 793022, India; (M.M.); (S.P.)
| | - Saurabh K. Srivastava
- College of Computing Sciences and IT, Teerthanker Mahaveer University, Moradabad 244001, India;
| | - Elisa Cuadrado-Godia
- Department of Neurology, Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain;
| | - Aditya Sharma
- Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA 22908, USA;
| | - Tomaz Omerzu
- Department of Neurology, University Medical Centre Maribor, 2000 Maribor, Slovenia; (T.O.); (M.T.)
| | - Luca Saba
- Department of Radiology, University of Cagliari, 09124 Cagliari, Italy;
| | - Sophie Mavrogeni
- Cardiology Clinic, Onassis Cardiac Surgery Centre, 176 74 Athens, Greece;
| | - Monika Turk
- Department of Neurology, University Medical Centre Maribor, 2000 Maribor, Slovenia; (T.O.); (M.T.)
| | - John R. Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St. Helena, CA 94574, USA;
| | - George D. Kitas
- Academic Affairs, Dudley Group NHS Foundation Trust, Dudley DY1 2HQ, UK;
- Arthritis Research UK Epidemiology Unit, Manchester University, Manchester M13 9PL, UK
| | - Mostafa Fatemi
- Department of Physiology & Biomedical Engineering, Mayo Clinic College of Medicine and Science, Rochester, NY 55905, USA;
| | - Al Baha Barqawi
- Division of Urology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Martin Miner
- Men’s Health Centre, Miriam Hospital Providence, Providence, RI 02906, USA;
| | - Inder M. Singh
- Stroke Monitoring and Diagnostic Division, AtheroPoint, Roseville, CA 95661, USA;
| | - Amer Johri
- Department of Medicine, Division of Cardiology, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | | | - Vikas Agarwal
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India;
| | - Kosmas I. Paraskevas
- Department of Vascular Surgery, Central Clinic of Athens, 106 80 Athens, Greece;
| | - Jagjit S. Teji
- Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA;
| | - Mostafa M. Fouda
- Department of Electrical and Computer Engineering, Idaho State University, Pocatello, ID 83209, USA;
| | - Gyan Pareek
- Minimally Invasive Urology Institute, Brown University, Providence, RI 02912, USA;
| | - Jasjit S. Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint, Roseville, CA 95661, USA;
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Busch SLP, Houweling TAJ, Pradhan H, Gope R, Rath S, Kumar A, Nath V, Prost A, Nair N. Socioeconomic inequalities in stillbirth and neonatal mortality rates: evidence on Particularly Vulnerable Tribal Groups in eastern India. Int J Equity Health 2022; 21:61. [PMID: 35524273 PMCID: PMC9074184 DOI: 10.1186/s12939-022-01655-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/28/2022] [Indexed: 12/25/2022] Open
Abstract
Background Tribal peoples are among the most marginalised groups worldwide. Evidence on birth outcomes in these groups is scant. We describe inequalities in Stillbirth Rate (SBR), Neonatal Mortality Rate (NMR), and uptake of maternal and newborn health services between tribal and less disadvantaged groups in eastern India, and examine the contribution of poverty and education to these inequalities. Methods We used data from a demographic surveillance system covering a 1 million population in Jharkhand State (March 2017 – August 2019) to describe SBR, NMR, and service uptake. We used logistic regression analysis combined with Stata’s adjrr-command to estimate absolute and relative inequalities by caste/tribe (comparing Particularly Vulnerable Tribal Groups (PVTG) and other Scheduled Tribes (ST) with the less marginalised Other Backward Class (OBC)/none, using the Indian government classification), and by maternal education and household wealth. Results PVTGs had a higher NMR (59/1000) than OBC/none (31/1000) (rate ratio (RR): 1.92, 95%CI: 1.55–2.38). This was partly explained by wealth and education, but inequalities remained large after adjustment (adjusted RR: 1.59, 95%CI: 1.28–1.98). NMR was also higher among other STs (44/1000), but disparities were smaller (RR: 1.47, 95%CI: 1.23–1.75). There was a systematic gradient in NMR by maternal education and household wealth. SBRs were only higher in poorer groups (RRpoorest vs. least poor:1.56, 95%CI: 1.14–2.13). Uptake of facility-based services was low among PVTGs (e.g. institutional birth: 25% vs. 69% in OBC/none) and among poorer and less educated women. However, 65% of PVTG women with an institutional birth used a maternity vehicle vs. 34% among OBC/none. Visits from frontline workers (Accredited Social Health Activists [ASHAs]) were similar across groups, and ASHA accompaniment of institutional births was similar across caste/tribe groups, and higher among poorer and less educated women. Attendance in participatory women’s groups was similar across caste/tribe groups, and somewhat higher among richer and better educated women. Conclusions PVTGs are highly disadvantaged in terms of birth outcomes. Targeted interventions that reduce geographical barriers to facility-based care and address root causes of high poverty and low education in PVTGs are a priority. For population-level impact, they are to be combined with broader policies to reduce socio-economic mortality inequalities. Community-based interventions reach disadvantaged groups and have potential to reduce the mortality gap. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-022-01655-y.
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Affiliation(s)
- Sophie L P Busch
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
| | - Tanja A J Houweling
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | | | | | | | | | | | - Audrey Prost
- Institute for Global Health, University College London, London, UK
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Suri JS, Paul S, Maindarkar MA, Puvvula A, Saxena S, Saba L, Turk M, Laird JR, Khanna NN, Viskovic K, Singh IM, Kalra M, Krishnan PR, Johri A, Paraskevas KI. Cardiovascular/Stroke Risk Stratification in Parkinson's Disease Patients Using Atherosclerosis Pathway and Artificial Intelligence Paradigm: A Systematic Review. Metabolites 2022; 12:metabo12040312. [PMID: 35448500 PMCID: PMC9033076 DOI: 10.3390/metabo12040312] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 12/20/2022] Open
Abstract
Parkinson’s disease (PD) is a severe, incurable, and costly condition leading to heart failure. The link between PD and cardiovascular disease (CVD) is not available, leading to controversies and poor prognosis. Artificial Intelligence (AI) has already shown promise for CVD/stroke risk stratification. However, due to a lack of sample size, comorbidity, insufficient validation, clinical examination, and a lack of big data configuration, there have been no well-explained bias-free AI investigations to establish the CVD/Stroke risk stratification in the PD framework. The study has two objectives: (i) to establish a solid link between PD and CVD/stroke; and (ii) to use the AI paradigm to examine a well-defined CVD/stroke risk stratification in the PD framework. The PRISMA search strategy selected 223 studies for CVD/stroke risk, of which 54 and 44 studies were related to the link between PD-CVD, and PD-stroke, respectively, 59 studies for joint PD-CVD-Stroke framework, and 66 studies were only for the early PD diagnosis without CVD/stroke link. Sequential biological links were used for establishing the hypothesis. For AI design, PD risk factors as covariates along with CVD/stroke as the gold standard were used for predicting the CVD/stroke risk. The most fundamental cause of CVD/stroke damage due to PD is cardiac autonomic dysfunction due to neurodegeneration that leads to heart failure and its edema, and this validated our hypothesis. Finally, we present the novel AI solutions for CVD/stroke risk prediction in the PD framework. The study also recommends strategies for removing the bias in AI for CVD/stroke risk prediction using the PD framework.
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Affiliation(s)
- Jasjit S. Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA 95661, USA; (A.P.); (I.M.S.)
- Correspondence: ; Tel.: +1-(916)-749-5628
| | - Sudip Paul
- Department of Biomedical Engineering, North Eastern Hill University, Shillong 793022, India; (S.P.); (M.A.M.)
| | - Maheshrao A. Maindarkar
- Department of Biomedical Engineering, North Eastern Hill University, Shillong 793022, India; (S.P.); (M.A.M.)
| | - Anudeep Puvvula
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA 95661, USA; (A.P.); (I.M.S.)
- Annu’s Hospitals for Skin & Diabetes, Gudur 524101, India
| | - Sanjay Saxena
- Department of CSE, International Institute of Information Technology, Bhuneshwar 751003, India;
| | - Luca Saba
- Department of Radiology, University of Cagliari, 09121 Cagliari, Italy;
| | - Monika Turk
- Deparment of Neurology, University Medical Centre Maribor, 1262 Maribor, Slovenia;
| | - John R. Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St. Helena, CA 94574, USA;
| | - Narendra N. Khanna
- Department of Cardiology, Indraprastha APOLLO Hospitals, New Delhi 110001, India;
| | - Klaudija Viskovic
- Department of Radiology and Ultrasound, University Hospital for Infectious Diseases, 10000 Zagreb, Croatia;
| | - Inder M. Singh
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA 95661, USA; (A.P.); (I.M.S.)
| | - Mannudeep Kalra
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA;
| | | | - Amer Johri
- Department of Medicine, Division of Cardiology, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Kosmas I. Paraskevas
- Department of Vascular Surgery, Central Clinic of Athens, 106 80 Athens, Greece;
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Hossain MM, Abdulla F, Banik R, Yeasmin S, Rahman A. Child marriage and its association with morbidity and mortality of under-5 years old children in Bangladesh. PLoS One 2022; 17:e0262927. [PMID: 35139075 PMCID: PMC8827428 DOI: 10.1371/journal.pone.0262927] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/07/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Child marriage is a significant social and health concern in many low- and middle-income countries (LMICs). This harmful practice violates children's rights and continues to be widespread across developing nations like Bangladesh. This study investigated the mortality trend among Bangladeshi children and the impact of child marriage on under-5 children morbidity and mortality in Bangladesh. METHODS AND MATERIALS A sample of 8,321 children under-5 years old was analyzed using bivariate and multivariate statistical techniques collected from the recent 2017-18 BDHS data. Chi-square test and logistic regression (unadjusted and adjusted) were used to determine the influence of covariates on the target variable. RESULTS Results revealed that child mortality was significantly higher among children whose mothers married at an early age than their counterparts. Although the general trend in the prevalence of different childhood mortality in Bangladesh was declining gradually from 1993 to 2018, it was still high in 2018. Also, marriage after 18 years lessens likelihood of diarrhea (adjusted OR = 0.93; 95% CI: 0.76-1.16) and cough (adjusted OR = 0.91; 95% CI: 0.78-1.17) among children. Furthermore, findings reveal that likelihood of different child mortality is higher among early married women. CONCLUSION Immediate intervention through rigorous enforcement of policies and different programs to raise the age at marriage and by lessening socioeconomic disparities can combat the prevalence of high morbidity and mortality of under-5 years old children. Findings from this study will be helpful to accelerate strategies for achieving the Sustainable Development Goals (SDGs) related to child and maternal health by 2030.
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Affiliation(s)
- Md. Moyazzem Hossain
- Department of Statistics, Jahangirnagar University, Savar, Dhaka, Bangladesh
- * E-mail:
| | - Faruq Abdulla
- Department of Applied Health and Nutrition, RTM Al-Kabir Technical University, Sylhet, Bangladesh
| | - Rajon Banik
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | | | - Azizur Rahman
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW, Australia
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Amir-Ud-Din R, Mahmood HZ, Abbas F, Muzammil M, Kumar R, Pongpanich S. Association of breast feeding and birth interval with child mortality in Pakistan: a cross-sectional study using nationally representative Demographic and Health Survey data. BMJ Open 2022; 12:e053196. [PMID: 35017244 PMCID: PMC8753421 DOI: 10.1136/bmjopen-2021-053196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 11/17/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This study analysed the association between breast feeding (BF) and birth interval (BI) (both succeeding and preceding) with neonatal mortality (NM), infant mortality (IM) and under-5 mortality (U5M). DESIGN This cross-sectional study used data from the Pakistan Demographic and Health Survey 2017-2018. SETTINGS All provinces, Islamabad and Federally Administered Tribal Areas were included in the analysis. PARTICIPANTS A total of 12 769 children born to ever-married multiparous women aged 30-49 years who gave live birth within 5 years preceding the interview. Multiple births are not included. DATA ANALYSIS Multivariate logistic regression analysis was used. RESULTS We found that BF was associated with nearly 98% lower risk of NM (OR 0.015; 95% CI: 0.01 to 0.03; p<0.001), 96% lower risk of IM (OR 0.038; 95% CI: 0.02 to 0.06; p<0.001) and 94% lower risk of U5M (OR 0.050; 95% CI: 0.03 to 0.08; p<0.001). Compared with optimal preceding birth interval (PBI) (36+ months), short PBI (<18 months) was associated with around six times higher risk of NM (OR 5.661; 95% CI: 2.78 to 11.53; p<0.001), over five times risk of IM (OR 4.704; 95% CI: 2.70 to 8.19; p<0.001) and over five times risk of U5M (OR 4.745; 95% CI: 2.79 to 8.07; p<0.001). Disaggregating the data by child's gender, place of residence and mother's occupational status showed that being ever breast fed was associated with a smaller risk of NM, IM and U5M in all three disaggregations. However, the risk of smaller PBI <18 months was generally more pronounced in female children (NM and U5M) or when the children lived in rural areas (NM, IM and U5M). PBI <18 months was associated with greater risk of NM and IM, and smaller risk of U5M when mothers did a paid job. CONCLUSION This study's significance lies in the fact that it has found BF and BI to be consistent protective factors against NM, IM and U5M. Given Pakistan's economic constraints, optimal BF and BI are the most cost-effective interventions to reduce child mortality.
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Affiliation(s)
- Rafi Amir-Ud-Din
- Department of Economics, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan
| | - Hafiz Zahid Mahmood
- Department of Economics, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan
| | - Faisal Abbas
- Department of Economics, School of Social Sciences and Humanities (S3H), National University of Sciences and Technology, Islamabad, Pakistan
| | - Muhammad Muzammil
- Department of Economics, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan
| | - Ramesh Kumar
- Department of Public Health, Health Services Academy, Islamabad, Pakistan
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Kabir R, Farag M, Lim HJ, Geda N, Feng C. Socio-demographic and environmental risk factors associated with multiple under-five child loss among mothers in Bangladesh. BMC Pediatr 2021; 21:576. [PMID: 34911492 PMCID: PMC8672494 DOI: 10.1186/s12887-021-03034-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/14/2021] [Indexed: 08/24/2023] Open
Abstract
Background Despite the substantial decline in child mortality globally over the last decade, reducing neonatal and under-five mortality in Bangladesh remains a challenge. Mothers who experienced multiple child losses could have substantial adverse personal and public health consequences. Hence, prevention of child loss would be extremely desirable during women’s reproductive years. The main objective of this study was to determine the risk factors associated with multiple under-five child loss from the same mother in Bangladesh. Methods In this study, a total of 15,877 eligible women who had given birth at least once were identified from the 2014 Bangladesh Demographic and Health Survey. A variety of count regression models were considered for identifying socio-demographic and environmental factors associated with multiple child loss measured as the number of lifetime under-five child mortality (U5M) experienced per woman. Results Of the total sample, approximately one-fifth (18.9%, n = 3003) of mothers experienced at least one child’s death during their reproductive period. The regression analysis results revealed that women in non-Muslim families, with smaller household sizes, with lower education, who were more advanced in their childbearing years, and from an unhygienic environment were at significantly higher risk of experiencing offspring mortality. This study also identified the J-shaped effect of age at first birth on the risk of U5M. Conclusions This study documented that low education, poor socio-economic status, extremely young or old age at first birth, and an unhygienic environment significantly contributed to U5M per mother. Therefore, improving women’s educational attainment and socio-economic status, prompting appropriate timing of pregnancy during reproductive life span, and increasing access to healthy sanitation are recommended as possible interventions for reducing under-five child mortality from a mother. Our findings point to the need for health policy decision-makers to target interventions for socio-economically vulnerable women in Bangladesh.
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Affiliation(s)
- Rasel Kabir
- Collaborative Biostatistics Program, School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Marwa Farag
- School of Public Health, University of Saskatchewan, Saskatoon, Canada.,School of Public Administration and Development Economics (SPADE), Doha Institute for Graduate Studies, Doha, Qatar
| | - Hyun Ja Lim
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Nigatu Geda
- Center for Population Studies, College of Development Studies, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Cindy Feng
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
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Suri JS, Agarwal S, Gupta SK, Puvvula A, Viskovic K, Suri N, Alizad A, El-Baz A, Saba L, Fatemi M, Naidu DS. Systematic Review of Artificial Intelligence in Acute Respiratory Distress Syndrome for COVID-19 Lung Patients: A Biomedical Imaging Perspective. IEEE J Biomed Health Inform 2021; 25:4128-4139. [PMID: 34379599 PMCID: PMC8843049 DOI: 10.1109/jbhi.2021.3103839] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/24/2021] [Accepted: 08/06/2021] [Indexed: 12/15/2022]
Abstract
SARS-CoV-2 has infected over ∼165 million people worldwide causing Acute Respiratory Distress Syndrome (ARDS) and has killed ∼3.4 million people. Artificial Intelligence (AI) has shown to benefit in the biomedical image such as X-ray/Computed Tomography in diagnosis of ARDS, but there are limited AI-based systematic reviews (aiSR). The purpose of this study is to understand the Risk-of-Bias (RoB) in a non-randomized AI trial for handling ARDS using novel AtheroPoint-AI-Bias (AP(ai)Bias). Our hypothesis for acceptance of a study to be in low RoB must have a mean score of 80% in a study. Using the PRISMA model, 42 best AI studies were analyzed to understand the RoB. Using the AP(ai)Bias paradigm, the top 19 studies were then chosen using the raw-cutoff of 1.9. This was obtained using the intersection of the cumulative plot of "mean score vs. study" and score distribution. Finally, these studies were benchmarked against ROBINS-I and PROBAST paradigm. Our observation showed that AP(ai)Bias, ROBINS-I, and PROBAST had only 32%, 16%, and 26% studies, respectively in low-moderate RoB (cutoff>2.5), however none of them met the RoB hypothesis. Further, the aiSR analysis recommends six primary and six secondary recommendations for the non-randomized AI for ARDS. The primary recommendations for improvement in AI-based ARDS design inclusive of (i) comorbidity, (ii) inter-and intra-observer variability studies, (iii) large data size, (iv) clinical validation, (v) granularity of COVID-19 risk, and (vi) cross-modality scientific validation. The AI is an important component for diagnosis of ARDS and the recommendations must be followed to lower the RoB.
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Affiliation(s)
- Jasjit S. Suri
- Stroke Diagnosis and Monitoring DivisionAtheroPoint LLCRosevilleCA95661USA
| | - Sushant Agarwal
- Advanced Knowledge Engineering CentreGBTIRosevilleCA95661USA
- Department of Computer Science EngineeringPranveer Singh Institute of Technology (PSIT)Kanpur209305India
| | - Suneet K. Gupta
- Department of Computer Science EngineeringBennett UniversityNoida524101India
| | - Anudeep Puvvula
- Stroke Diagnosis and Monitoring DivisionAtheroPoint LLCRosevilleCA95661USA
- Annu's Hospitals for Skin and DiabetesNellore524101India
| | | | - Neha Suri
- Mira Loma High SchoolSacramentoCA95821USA
| | - Azra Alizad
- Department of RadiologyMayo Clinic College of Medicine and ScienceRochesterMN55905USA
| | - Ayman El-Baz
- Department of BioengineeringUniversity of LouisvilleLouisvilleKY40292USA
| | - Luca Saba
- Department of RadiologyAzienda Ospedaliero Universitaria (AOU)09124CagliariItaly
| | - Mostafa Fatemi
- Department of Physiology and Biomedical EngineeringMayo Clinic College of Medicine and ScienceRochesterMN55905USA
| | - D. Subbaram Naidu
- Electrical Engineering DepartmentUniversity of MinnesotaDuluthMN55812USA
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Mukosha M, Kaonga P, Kapembwa KM, Musonda P, Vwalika B, Lubeya MK, Jacobs C. Modelling mortality within 28 days among preterm infants at a tertiary hospital in Lusaka, Zambia: a retrospective review of hospital-based records. Pan Afr Med J 2021; 39:69. [PMID: 34422192 PMCID: PMC8363965 DOI: 10.11604/pamj.2021.39.69.27138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/05/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction globally, almost half of all deaths in children under five years of age occur among neonates. We investigated the predictors of mortality within 28 days among preterm infants at a tertiary hospital in Lusaka, Zambia. Methods we reviewed admission records linked to birth, mortality, and hospital discharge from 1st January 2018 to 30th September 2019. Information was retrieved with a follow-up period of 28 days post-delivery to discharge/mortality. We used the Weibull hazards regression to establish the best predictor model for mortality among the neonates. Results a total of 3237 case records of women with a median age of 27 years (IQR, 22-33) were included in the study, of which 971 (30%) delivered term infants and 2267 (70%) preterm infants. The overall median survival time of the infants was 98 hours (IQR, 34-360). Preterm birth was not associated with increased hazards of mortality compared to term birth (p=0.078). Being in the Kangaroo Mother Care compared to Neonatal Intensive Care Unit (NICU), and a unit increase in birth weight were independently associated with reduced hazards of mortality. On the other hand, having hypoxic-ischemic encephalopathy, experiencing difficulty in feeding and vaginal delivery compared to caesarean section independently increased the hazards of mortality. Conclusion having hypoxic-ischemic encephalopathy, vaginal delivery, and experiencing difficulty in feeding increases the risk of mortality among neonates. Interventions to reduce neonatal mortality should be directed on these factors in this setting.
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Affiliation(s)
- Moses Mukosha
- Department of Pharmacy, University of Zambia, Lusaka, Zambia.,School of Public Health, University of Zambia, Lusaka, Zambia
| | - Patrick Kaonga
- School of Public Health, University of Zambia, Lusaka, Zambia
| | | | - Patrick Musonda
- School of Public Health, University of Zambia, Lusaka, Zambia
| | - Bellington Vwalika
- Department of Obstetrics and Gynecology, University of Zambia, Lusaka, Zambia
| | - Mwansa Ketty Lubeya
- Department of Obstetrics and Gynecology, University of Zambia, Lusaka, Zambia.,Young Emerging Scientists Zambia, Lusaka, Zambia
| | - Choolwe Jacobs
- School of Public Health, University of Zambia, Lusaka, Zambia
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Remera E, Chammartin F, Nsanzimana S, Forrest JI, Smith GE, Mugwaneza P, Malamba SS, Semakula M, Condo JU, Ford N, Riedel DJ, Nisingizwe MP, Binagwaho A, Mills EJ, Bucher H. Child mortality associated with maternal HIV status: a retrospective analysis in Rwanda, 2005-2015. BMJ Glob Health 2021; 6:e004398. [PMID: 33975886 PMCID: PMC8118007 DOI: 10.1136/bmjgh-2020-004398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Child mortality remains highest in regions of the world most affected by HIV/AIDS. The aim of this study was to assess child mortality rates in relation to maternal HIV status from 2005 to 2015, the period of rapid HIV treatment scale-up in Rwanda. METHODS We used data from the 2005, 2010 and 2015 Rwanda Demographic Health Surveys to derive under-2 mortality rates by survey year and mother's HIV status and to build a multivariable logistic regression model to establish the association of independent predictors of under-2 mortality stratified by mother's HIV status. RESULTS In total, 12 010 live births were reported by mothers in the study period. Our findings show a higher mortality among children born to mothers with HIV compared with HIV negative mothers in 2005 (216.9 vs 100.7 per 1000 live births) and a significant reduction in mortality for both groups in 2015 (72.0 and 42.4 per 1000 live births, respectively). In the pooled reduced multivariable model, the odds of child mortality was higher among children born to mothers with HIV, (adjusted OR, AOR 2.09; 95% CI 1.57 to 2.78). The odds of child mortality were reduced in 2010 (AOR 0.69; 95% CI 0.59 to 0.81) and 2015 (AOR 0.35; 95% CI 0.28 to 0.44) compared with 2005. Other independent predictors of under-2 mortality included living in smaller families of 1-2 members (AOR 5.25; 95% CI 3.59 to 7.68), being twin (AOR 4.93; 95% CI 3.51 to 6.92) and being offspring from mothers not using contraceptives at the time of the survey (AOR 1.6; 95% CI 1.38 to 1.99). Higher education of mothers (completed primary school: (AOR 0.74; 95% CI 0.64 to 0.87) and secondary or higher education: (AOR 0.53; 95% CI 0.38 to 0.74)) was also associated with reduced child mortality. CONCLUSIONS This study shows an important decline in under-2 child mortality among children born to both mothers with and without HIV in Rwanda over a 10-year span.
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Affiliation(s)
- Eric Remera
- Institute of HIV, Disease Prevention and Control, Rwanda Biomedical Center, Gasabo, City of Kigali, Rwanda
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Basel Institute for Clinical Epidemiology and Biostatistics Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Global Health Equity, Kigali, Rwanda
| | - Frédérique Chammartin
- University of Basel, Basel, Switzerland
- Basel Institute for Clinical Epidemiology and Biostatistics Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Sabin Nsanzimana
- Institute of HIV, Disease Prevention and Control, Rwanda Biomedical Center, Gasabo, City of Kigali, Rwanda
- University of Global Health Equity, Kigali, Rwanda
| | - Jamie Ian Forrest
- The University of British Columbia School of Population and Public Health, Vancouver, British Columbia, Canada
| | | | - Placidie Mugwaneza
- Institute of HIV, Disease Prevention and Control, Rwanda Biomedical Center, Gasabo, City of Kigali, Rwanda
| | | | - Muhammed Semakula
- Institute of HIV, Disease Prevention and Control, Rwanda Biomedical Center, Gasabo, City of Kigali, Rwanda
- Center for Excellence in Data Science, University of Rwanda - Kigali Campus, Kigali, Rwanda
- Centre for Statistics, Hasselt University Faculty of Business Economics, Hasselt, Limburg, Belgium
| | - Jeanine U Condo
- National University of Rwanda School of Public Health, Kigali, Rwanda
- Tulane University, New Orleans, Louisiana, USA
| | - Nathan Ford
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - David J Riedel
- University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Marie Paul Nisingizwe
- The University of British Columbia School of Population and Public Health, Vancouver, British Columbia, Canada
| | | | - Edward J Mills
- Cytel, Vancouver, British Columbia, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Heiner Bucher
- University of Basel, Basel, Switzerland
- Basel Institute for Clinical Epidemiology and Biostatistics Department of Clinical Research, University Hospital Basel, Basel, Switzerland
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Al-Sheyab NA, Khader YS, Shattnawi KK, Alyahya MS, Batieha A. Rate, Risk Factors, and Causes of Neonatal Deaths in Jordan: Analysis of Data From Jordan Stillbirth and Neonatal Surveillance System (JSANDS). Front Public Health 2020; 8:595379. [PMID: 33194998 PMCID: PMC7661434 DOI: 10.3389/fpubh.2020.595379] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/07/2020] [Indexed: 11/16/2022] Open
Abstract
Background: It has been estimated that 27.8 million neonates will die worldwide between 2018 and 2030 if no improvements in neonatal and maternal care take place. The aim of this study was to determine the rate, risk factors, and causes of neonatal mortality in Jordan. Methods: In August 2019, an electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in in three large cities through five hospitals. Data on all births, neonatal mortality and their causes, and other characteristics in the period between August 2019 and January 2020 were exported from the JSANDS and analyzed. Results: A total of 10,328 births [10,226 live births (LB) and 102 stillbirths] were registered in the study period, with a rate of 14.1 deaths per 1,000 LBs; 76% were early neonatal deaths and 24% were late deaths. The odds of deaths in the Ministry of Health hospitals were almost 21 times (OR = 20.8, 95% CI: 2.8, 153.1) higher than that in private hospitals. Low birthweight and pre-term babies were significantly more likely to die during the neonatal period compared to full-term babies. The odds of neonatal mortality were significantly higher among babies born to housewives compared to those who were born to employed women (OR = 2.7; 95% CI: 1.2, 6.0). Main causes of neonatal deaths that occurred pre-discharge were respiratory and cardiovascular disorders (43%) and low birthweight and pre-term (33%). The main maternal conditions that attributed to these deaths were complications of the placenta and cord, complications of pregnancy, and medical and surgical conditions. The main cause of neonatal deaths that occurred post-discharge were low birthweight and pre-term (42%). Conclusions: The rate of neonatal mortality have not decreased since 2012 and the majority of neonatal deaths occurred could have been prevented. Regular antenatal visits, in which any possible diseases or complications of pregnant women or fetal anomalies, need to be fully documented and monitored with appropriate and timely medical intervention to minimize such deaths.
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Affiliation(s)
- Nihaya A. Al-Sheyab
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef S. Khader
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khulood K. Shattnawi
- Department of Maternal and Child Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad S. Alyahya
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Anwar Batieha
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Kousar S, Shabbir A, Shafqat R. Investigation of Socioeconomic Determinants on Child Death in South Asian Countries: A Panel Cointegration Analysis. OMEGA-JOURNAL OF DEATH AND DYING 2020; 84:811-836. [PMID: 32276562 DOI: 10.1177/0030222820915023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This article is aimed to examine the relationship between socioeconomic factors and child mortality in South Asia because the relationship between child mortality and socioeconomic factors cannot be overlooked for better progress. Panel data were obtained from (World Development Indicators) and (Human Development Index) for the period 1990-2017. The data were quantitative. Levin, Lin, and Chu and I'm, Pesaran, and Shin test were used to check the stationarity of data. A cointegration test was applied to check the long-run association. Granger causality test was used to determine the direction of the relationship. Fully modified ordinary least squares and dynamic ordinary least squares techniques were used to examine the long-run and short-run impact of socioeconomic determinants on child mortality. The findings from this study showed the significant impact of education, unemployment, and health expenditure, access to improved water and sanitation facilities, and income inequality on child mortality. Overall results showed that there is a negative association between education and child mortality, access to improved water and access to sanitation facilities and child mortality, and health expenditure and child mortality, but there is a positive association between unemployment and income inequality with child mortality. The rate of child mortality is still very alarming in South Asian countries.
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Affiliation(s)
- Shazia Kousar
- Department of Management Science, The Superior College, Lahore, Pakistan
| | - Aiza Shabbir
- Department of Management Science, The Superior College, Lahore, Pakistan
| | - Rukia Shafqat
- Department of Management Science, The Superior College, Lahore, Pakistan
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Siddiquee T, Halder HR, Islam MA. Exploring the influencing factors for non-utilisation of healthcare facilities during childbirth: a special mixed-method study of Bangladesh and 13 other low- and middle-income countries based on Demographic and Health Survey data. Fam Med Community Health 2020; 7:e000008. [PMID: 32148722 PMCID: PMC7032898 DOI: 10.1136/fmch-2018-000008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective To identify the associated factors affecting the decision regarding institutional delivery for pregnant women in 14 low- and middle-income countries (LMICs). Design A special mixed-method design was used to combine cross-sectional studies for harmonising data from Bangladesh and 13 other countries to obtain extended viewpoints on non-utilisation of institutional healthcare facilities during childbirth. Setting Demographic and Health Survey (DHS) data for 14 LMICs were used for the study. Participants There are several kinds of datasets in the DHS. Among them ‘Individual Women’s Records’ was used as this study is based on all ever-married women. Results In the binary logistic and meta-analysis models for Bangladesh, ORs for birth order were 0.57 and 0.51 and for respondents’ age were 1.50 and 1.07, respectively. In all 14 LMICs, the most significant factors for not using institutional facilities during childbirth were respondents’ age (OR 0.903, 95% CI 0.790 to 1.032) and birth order (OR 0.371, 95% CI 0.327 to 0.421). Conclusion Birth order and respondents’ age were the two most significant factors for non-utilisation of healthcare facilities during childbirth in 14 LMICs.
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Vijay J, Patel KK. Risk factors of infant mortality in Bangladesh. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Classification and prediction of diabetes disease using machine learning paradigm. Health Inf Sci Syst 2020; 8:7. [PMID: 31949894 DOI: 10.1007/s13755-019-0095-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 12/21/2019] [Indexed: 12/19/2022] Open
Abstract
Background and objectives Diabetes is a chronic disease characterized by high blood sugar. It may cause many complicated disease like stroke, kidney failure, heart attack, etc. About 422 million people were affected by diabetes disease in worldwide in 2014. The figure will be reached 642 million in 2040. The main objective of this study is to develop a machine learning (ML)-based system for predicting diabetic patients. Materials and methods Logistic regression (LR) is used to identify the risk factors for diabetes disease based on p value and odds ratio (OR). We have adopted four classifiers like naïve Bayes (NB), decision tree (DT), Adaboost (AB), and random forest (RF) to predict the diabetic patients. Three types of partition protocols (K2, K5, and K10) have also adopted and repeated these protocols into 20 trails. Performances of these classifiers are evaluated using accuracy (ACC) and area under the curve (AUC). Results We have used diabetes dataset, conducted in 2009-2012, derived from the National Health and Nutrition Examination Survey. The dataset consists of 6561 respondents with 657 diabetic and 5904 controls. LR model demonstrates that 7 factors out of 14 as age, education, BMI, systolic BP, diastolic BP, direct cholesterol, and total cholesterol are the risk factors for diabetes. The overall ACC of ML-based system is 90.62%. The combination of LR-based feature selection and RF-based classifier gives 94.25% ACC and 0.95 AUC for K10 protocol. Conclusion The combination of LR and RF-based classifier performs better. This combination will be very helpful for predicting diabetic patients.
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Xue M, Su Y, Li C, Wang S, Yao H. Identification of Potential Type II Diabetes in a Large-Scale Chinese Population Using a Systematic Machine Learning Framework. J Diabetes Res 2020; 2020:6873891. [PMID: 33029536 PMCID: PMC7532405 DOI: 10.1155/2020/6873891] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/01/2020] [Accepted: 09/02/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND An estimated 425 million people globally have diabetes, accounting for 12% of the world's health expenditures, and the number continues to grow, placing a huge burden on the healthcare system, especially in those remote, underserved areas. METHODS A total of 584,168 adult subjects who have participated in the national physical examination were enrolled in this study. The risk factors for type II diabetes mellitus (T2DM) were identified by p values and odds ratio, using logistic regression (LR) based on variables of physical measurement and a questionnaire. Combined with the risk factors selected by LR, we used a decision tree, a random forest, AdaBoost with a decision tree (AdaBoost), and an extreme gradient boosting decision tree (XGBoost) to identify individuals with T2DM, compared the performance of the four machine learning classifiers, and used the best-performing classifier to output the degree of variables' importance scores of T2DM. RESULTS The results indicated that XGBoost had the best performance (accuracy = 0.906, precision = 0.910, recall = 0.902, F-1 = 0.906, and AUC = 0.968). The degree of variables' importance scores in XGBoost showed that BMI was the most significant feature, followed by age, waist circumference, systolic pressure, ethnicity, smoking amount, fatty liver, hypertension, physical activity, drinking status, dietary ratio (meat to vegetables), drink amount, smoking status, and diet habit (oil loving). CONCLUSIONS We proposed a classifier based on LR-XGBoost which used fourteen variables of patients which are easily obtained and noninvasive as predictor variables to identify potential incidents of T2DM. The classifier can accurately screen the risk of diabetes in the early phrase, and the degree of variables' importance scores gives a clue to prevent diabetes occurrence.
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Affiliation(s)
- Mingyue Xue
- Hospital of Traditional Chinese Medicine Affiliated to the Fourth Clinical Medical College of Xinjiang Medical University, Urumqi, China
- College of Public Health, Xinjiang Medical University, Urumqi, China
| | - Yinxia Su
- College of Public Health, Xinjiang Medical University, Urumqi, China
| | - Chen Li
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Shuxia Wang
- Center of Health Management, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, China
| | - Hua Yao
- Center of Health Management, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, China
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