Аbstrасt Introduction This study aims to investigate in‐hоsрitаl mоrtаlity in severe асute resрirаtоry syndrоme соrоnаvirus 2 раtients strаtified by serum ferritin levels. Methods Patients were stratified based on ferritin levels (ferritin levels ≤ 1000 or >1000). Results Approximately 89% (118) of the patients with ferritin levels > 1000 had pneumonia, and 51% (67) had hypertension. Fever (97, 73.5%) and shortness of breath (80, 61%) were two major symptoms among the patients in this group. Logistic regression analysis indicated that ferritin level (odds ratio [OR] = 0.36, 95% confidence interval [CI] = 0.21–0.62; p < .001), male sex (OR = 2.63, 95% CI = 1.43–5.06; p = .003), hypertension (OR = 4.16, 95% CI = 2.42–7.36; p < .001) and pneumonia (OR = 8.48, 95% CI = 3.02–35.45; p < .001) had significance in predicting in‐hospital mortality. Additionally, the Cox proportional hazards analysis and Kaplan–Meier survival probability plot showed a higher mortality rate among patients with ferritin levels > 1000. Conclusion In this study, higher levels of serum ferritin were found to be an independent predictor of in‐hоsрitаl mоrtаlity.
In environmental research, missing data are often a challenge for statistical modeling. This paper addressed some advanced techniques to deal with missing values in a data set measuring air quality using a multiple imputation (MI) approach. MCAR, MAR, and NMAR missing data techniques are applied to the data set. Five missing data levels are considered: 5%, 10%, 20%, 30%, and 40%. The imputation method used in this paper is an iterative imputation method, missForest, which is related to the random forest approach. Air quality data sets were gathered from five monitoring stations in Kuwait, aggregated to a daily basis. Logarithm transformation was carried out for all pollutant data, in order to normalize their distributions and to minimize skewness. We found high levels of missing values for NO2 (18.4%), CO (18.5%), PM10 (57.4%), SO2 (19.0%), and O3 (18.2%) data. Climatological data (i.e., air temperature, relative humidity, wind direction, and wind speed) were used as control variables for better estimation. The results show that the MAR technique had the lowest RMSE and MAE. We conclude that MI using the missForest approach has a high level of accuracy in estimating missing values. MissForest had the lowest imputation error (RMSE and MAE) among the other imputation methods and, thus, can be considered to be appropriate for analyzing air quality data.
Rheumatoid arthritis (RA) is a chronic autoimmune of an unknown etiology. Air pollution has been proposed as one of the possible risk factors associated with disease activity, although has not been extensively studied. In this study, we measured the relationship between exposure to air pollutants and RA activity. Data on RA patients were extracted from the Kuwait Registry for Rheumatic Diseases (KRRD). Disease activity was measured using disease activity score with 28 examined joints (DAS-28) and the Clinical Disease Activity Index (CDAI) during their hospital visits from 2013 to 2017. Air pollution was assessed using air pollution components (PM 10 , NO 2 , SO 2 , O 3 , and CO). Air pollution data were obtained from Kuwait Environmental Public Authority (K-EPA) from six different air quality-monitoring stations during the same period. Multiple imputations by the chained equations (MICE) algorithm were applied to estimate missing air pollution data. Patients data were linked with air pollution data according to date and patient governorate address. Descriptive statistics, correlation analysis, and linear regression techniques were employed using STATA software. In total, 1651 RA patients with 9875 follow-up visits were studied. We detected an increased risk of RA using DAS-28 in participants exposed to SO 2 and NO 2 with β = 0 . 003 (95% CI: 0.0004–0.005, p < 0 . 01 ) and β = 0 . 003 (95% CI: 0.002–0.005, p < 0 . 01 ), respectively, but not to PM 10 , O 3 , and CO concentrations. Conclusively, we observed a strong association between air pollution with RA disease activity. This study suggests air pollution as a risk factor for RA and recommends further measures to be taken by the authorities to control this health problem.
Background: Currently there remains controversy in the surgical management of rhegmatogenous retinal detachment (RRD) due to giant retinal tears (GRTs), a potentially blinding condition. To clarify which surgical technique is better depending on the origin and magnitude of the giant tear this study aimed to analyze the anatomical and functional outcomes. To analyze trans- and postoperative surgical complications, we used long-term final postoperative structural, optical coherence tomography (OCT) and correlated the results with the final postoperative best-corrected visual acuity (BCVA) in three different groups of eyes.Methods: Seventy-six consecutive eyes of 66 patients from three participant institutions were recruited and classified according to the degree of GRT-associated RRD extension as follows: group 1, 42 eyes with GRT-associated RRD extension < 180°; group 2, 23 eyes with GRT-associated RRD extension = 180°–270°; and group 3, 11 eyes with GRT-associated RRD extension > 270°. Structural and functional outcomes were compared across groups.Results: Of the 76 eyes analyzed, 63 were phakic, and 13 were pseudophakic. The mean age of the patients was 43.0 ±13.0 years (range, 19–76 years); 36 females, and 40 males. The mean preoperative time for GRT surgery was 1.8 weeks, the mean preoperative and postoperative BCVA was 1.87 logMAR and 0.35 logMAR, respectively (p<0.05), and the mean postoperative follow-up was 28.1 months. Five patients (6.57%) had bilateral GRT-associated RRD, 61 patients (80.26%) had a monocular condition, and 21 eyes (27.63%) had a BCVA ≥20/40. Proliferative vitreoretinopathy resulted in multiple surgeries in 31.57% of the eyes. Postoperative OCT yielded abnormal retinal thickness in all groups, ellipsoid band disruptions, and external limiting line discontinuities in all groups, predominantly in macula-off GRTs requiring multiple surgeries. Conclusions: Multiple structural alterations in spectral-domain OCT biomarkers were observed. Eyes that developed secondary epiretinal membrane (ERM) proliferation showed significantly improved BCVA after proliferation, and the internal limiting membrane was removed. This study presents the severe consequences of macular structure and function. The structural findings correlated with the BCVA allow us to conclude severe consequences of the macular structure and that, despite a fully reattached retina without ERM proliferation, GRTs-associated RRD has a guarded functional prognosis.
This study examines the public relations functions of eight Kuwaiti banks listed in the Kuwait Stock Exchange Market (KSEM) that post on their Instagram accounts. It also uses market-size, organization, and individual level predictors to model Instagram postings. A content analysis of 1,502 posts revealed the banks use Instagram for promotion, information dissemination, community building, and interactive engagement, in that order of prominence. The findings suggest banks operate at the confluence of visual communication through Instagram and integration of religious symbolism to serve a public relations function predicated on image and influence. In doing so, the banks tap into the wellspring of social media use by target publics by navigating a balance between obedience to Allah and meeting bank business objectives. The resulting tension between sacred and secular highlights Arab cultural values and suggests Instagram fosters individualism, which challenges Arab emphasis on collectivism and fractures the notion online platforms can effectively build meaningful relationships that characterize Arab culture. The study posits Instagram is more effective in an Arab context at image building than relationship building, threading the importance of visual communication through social media across Arab culture and global public relations practices.
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