An indirect simulation-optimization model framework with enhanced computational efficiency and risk-based decision-making capability was developed to determine optimal total maximum daily load (TMDL) allocation under uncertainty. To convert the traditional direct simulation-optimization model into our indirect equivalent model framework, we proposed a two-step strategy: (1) application of inter...

Background Despite consistent evidence showing the importance of exclusive breastfeeding (EBF) for six months, it remains a sub-optimal practice in The Gambia. This study aimed at investigating the determinants of EBF knowledge and intention to or practice of EBF. Methods A cross-sectional study was conducted among 334 women receiving care at the Edward Francis Small Teaching Hospital (EFSTH)...

This study aims to investigate the psychological effects of the earthquake. We investigated the psychological conditions of 3,609 students survived from the Marmara Earthquake, which occurred on 17 August 1999. The Beck Depression Inventory (BDI) was employed to assess the levels of depression and other psycho-pathological states. The BDI was classified as mild depression if the score was < or ...

BACKGROUND The Checklist for the Reporting of Updated Guidelines (CheckUp) was recently developed. However, so far, no systematic assessment of the reporting of updated clinical guidelines (CGs) exists. We aimed to examine (1) the completeness of reporting the updating process in CGs and (2) the inter-observer reliability of CheckUp. METHODS We conducted a systematic assessment of the reporti...

OBJECTIVE The purpose of this study was to identify medical and non-medical factors associated to the performance of a trial of labor during the second delivery of women with one previous cesarean section. METHODS This was a nested case control study, with a secondary data analysis from a retrospective population based cohort study. It was primarily performed on a population of women who had ...

BACKGROUND Variation in paediatric inpatient length of stay exists - whether this is driven by differences in patient characteristics or health service delivery is unclear. We will test the hypotheses that higher levels of deprivation are associated with prolonged length of stay and that differences in prolonged length of stay across 2 hospitals will be explained by demographic, clinical and pr...

BACKGROUND Among most minority groups, males seem to report higher levels of exposure and vulnerability to racial discrimination. Although darker skin tone may increase exposure to racial discrimination, it is yet unknown whether skin tone similarly influences perceived discrimination among male and female Caribbean Black youth. OBJECTIVE The current cross-sectional study tests the role of ge...

OBJECTIVES To investigate the relationship of heart rate (HR) and ECG time intervals to body weight (BWT) in healthy horses and ponies. We hypothesized that HR and ECG time intervals are related to BWT. ANIMALS 250 healthy horses of >30 breeds; 5.5 (1-30) y [median (range)]; 479 (46-1018) kg. METHODS Prospective study. Standard base-apex ECGs were recorded while the horses were standing qui...

Trust is a major issue with deploying empirical models in the real world since changes in the underlying system or use of the model in new regions of parameter space can produce (potentially dangerous) incorrect predictions. The trepidation involved with model usage can be mitigated by assembling ensembles of diverse models and using their consensus as a trust metric, since these models will be...