Predictors of stroke-associated pneumonia and the predictive value of neutrophil percentage-to-albumin ratio.

BACKGROUND: Early recognition of stroke-associated pneumonia (SAP) is critical to reducing morbidity and mortality associated with SAP. This study investigated the predictors of SAP, and the predictive value of the neutrophil percentage-to-albumin ratio (NPAR) for SAP. METHODS: This retrospective cohort study was conducted among stroke patients admitted to Jordan University Hospital from January 2015 to May 2021. Multivariable logistic regression was used to identify independent predictors for SAP. The predictive performance was assessed using C-statistics, described as the area under the receiver-operating characteristic curve (AUC, ROC) with a 95% confidence interval. RESULTS: Four hundred and six patients were included in the analysis, and the prevalence of SAP was 19.7%. Multivariable logistic analysis showed that males (Adjusted Odds Ratio (AOR): 5.74; 95% Confidence Interval (95%CI): 2.04-1 6.1)], dysphagia (AOR: 5.29; 95% CI: 1.80-15.5), hemiparesis (AOR: 3.27; 95% CI: 1.13-9.47), lower GCS score (AOR: 0.73; 95% CI: 0.58-0.91), higher levels of neutrophil-lymphocyte ratio (NLR) (AOR: 1.15; 95% CI: 1.07-1.24), monocyte-lymphocyte ratio (MLR) (AOR: 1.49; 95% CI: 1.13-1.96), and neutrophil percentage to albumin ratio (NPAR) (AOR: 1.53; 95% CI: 1.33-1.76) were independent predictors of SAP. The NPAR demonstrated a significantly higher AUC than both the NLR (0.939 versus 0.865, Z = 3.169, p = 0.002) and MLR (0.939 versus 0.842, Z = 3.940, p < 0.001). The AUCs of the NLR and MLR were comparable (0.865 versus 0.842, Z = 1.274, p = 0.203). CONCLUSION: Male gender, dysphagia and hemiparesis were the strongest predictors of SAP, and NPAR has an excellent performance in predicting SAP which was better than high NLR and MLR.

Students' Perspectives of the Economic, Financial, and Psychological Effects of Online Learning and Its Gender Association: A Cross-Sectional Study in Jordanian Universities.

INTRODUCTION: Jordan declared a quarantine in March 2020 and shut down all educational institutions in response to the COVID-19 outbreak. E-learning was a novel way to continue the educational process in the wake of the pandemic. The study evaluates online learning (OL), aiming to examine the economic, financial, and psychological effects of OL on students, as well as their concentration, university instructors' efficiency, and satisfaction with OL. This research also explores the gender association of OL effects in Jordanian universities. METHODS: This is a cross-sectional study. A self-filled questionnaire was generated using an online form and distributed to students at public and private universities through social media. The questionnaire utilized a five-point Likert scale to assess various aspects related to OL. The main evaluation involved a Chi-square test and posthoc test to examine gender-based differences in the factors associated with OL. The reliability of the questionnaire was assessed using a Kaiser-Meyer-Olkin (KMO) value of 0.721 and a Cronbach's Alpha of 0.7. RESULTS: A total of 720 responses were collected and analyzed. The results revealed a significant gender association with the economic/financial (P=0.001) and psychological (P=0.002) effects of OL. It was observed that 65.3% of students reported feeling depressed due to online learning. Moreover, a significant correlation was found between students' concentration and university instructors' efficiency (P=0.00). Interestingly, only 14.72% of students believed university instructors were 100% efficient in teaching theoretical and practical subjects. Additionally, 55% of the students expressed their desire for university instructors to record lectures for ease of access. CONCLUSION: The study concludes that OL's poor economic/financial effects disproportionately affect female students. On the other hand, male students were more likely to strongly disagree with the poor psychological effects of OL. Moreover, female students were more inclined to strongly disagree with the notion that OL has no psychological effect. Lastly, significant findings indicate that both students and university instructors share equal responsibility for the success of OL in Jordanian universities.