BACKGROUND: There are significant geographic inequities in COVID-19 case fatality rates (CFRs), and comprehensive understanding its country-level determinants in a global perspective is necessary. This study aims to quantify the country-specific risk of COVID-19 CFR and propose tailored response strategies, including vaccination strategies, in 156 countries.
METHODS: Cross-temporal and cross-country variations in COVID-19 CFR was identified using extreme gradient boosting (XGBoost) including 35 factors from seven dimensions in 156 countries from 28 January, 2020 to 31 January, 2022. SHapley Additive exPlanations (SHAP) was used to further clarify the clustering of countries by the key factors driving CFR and the effect of concurrent risk factors for each country. Increases in vaccination rates was simulated to illustrate the reduction of CFR in different classes of countries.
RESULTS: Overall COVID-19 CFRs varied across countries from 28 Jan 2020 to 31 Jan 31 2022, ranging from 68 to 6373 per 100,000 population. During the COVID-19 pandemic, the determinants of CFRs first changed from health conditions to universal health coverage, and then to a multifactorial mixed effect dominated by vaccination. In the Omicron period, countries were divided into five classes according to risk determinants. Low vaccination-driven class (70 countries) mainly distributed in sub-Saharan Africa and Latin America, and include the majority of low-income countries (95.7%) with many concurrent risk factors. Aging-driven class (26 countries) mainly distributed in high-income European countries. High disease burden-driven class (32 countries) mainly distributed in Asia and North America. Low GDP-driven class (14 countries) are scattered across continents. Simulating a 5% increase in vaccination rate resulted in CFR reductions of 31.2% and 15.0% for the low vaccination-driven class and the high disease burden-driven class, respectively, with greater CFR reductions for countries with high overall risk (SHAP value > 0.1), but only 3.1% for the ageing-driven class.
CONCLUSIONS: Evidence from this study suggests that geographic inequities in COVID-19 CFR is jointly determined by key and concurrent risks, and achieving a decreasing COVID-19 CFR requires more than increasing vaccination coverage, but rather targeted intervention strategies based on country-specific risks.

To effectively explore the impacts of several key factors on taxi drivers\' traffic violations and provide traffic management departments with scientific decisions to reduce traffic fatalities and injuries.
43,458 electronic enforcement data about taxi drivers\' traffic violations in Nanchang City, Jiangxi Province, China, from July 1, 2020, to June 30, 2021, were utilized to explore the characteristics of traffic violations. A random forest algorithm was used to predict the severity of taxi drivers\' traffic violations and 11 factors affecting traffic violations, including time, road conditions, environment, and taxi companies were analyzed using the Shapley Additionality Explanation (SHAP) framework.
Firstly, the ensemble method Balanced Bagging Classifier (BBC) was applied to balance the dataset. The results showed that the imbalance ratio (IR) of the original imbalanced dataset reduced from 6.61% to 2.60%. Moreover, a prediction model for the severity of taxi drivers\' traffic violations was established by using the Random Forest, and the results showed that accuracy, m_F1, m_G-mean, m_AUC, and m_AP obtained 0.877, 0.849, 0.599, 0.976, and 0.957, respectively. Compared with the algorithms of Decision Tree, XG Boost, Ada Boost, and Neural Network, the performance measures of the prediction model based on Random Forest were the best. Finally, the SHAP framework was used to improve the interpretability of the model and identify important factors affecting taxi drivers\' traffic violations. The results showed that functional districts, location of the violation, and road grade were found to have a high impact on the probability of traffic violations; their mean SHAP values were 0.39, 0.36, and 0.26, respectively.
Findings of this paper may help to discover the relationship between the influencing factors and the severity of traffic violations, and provide a theoretical basis for reducing the traffic violations of taxi drivers and improving the road safety management.

One of the major challenges that confront medical experts during a pandemic is the time required to identify and validate the risk factors of the novel disease and to develop an effective treatment protocol. Traditionally, this process involves numerous clinical trials that may take up to several years, during which strict preventive measures must be in place to control the outbreak and reduce the deaths. Advanced data analytics techniques, however, can be leveraged to guide and speed up this process. In this study, we combine evolutionary search algorithms, deep learning, and advanced model interpretation methods to develop a holistic exploratory-predictive-explanatory machine learning framework that can assist clinical decision-makers in reacting to the challenges of a pandemic in a timely manner. The proposed framework is showcased in studying emergency department (ED) readmissions of COVID-19 patients using ED visits from a real-world electronic health records database. After an exploratory feature selection phase using genetic algorithm, we develop and train a deep artificial neural network to predict early (i.e., 7-day) readmissions (AUC = 0.883). Lastly, a SHAP model is formulated to estimate additive Shapley values (i.e., importance scores) of the features and to interpret the magnitude and direction of their effects. The findings are mostly in line with those reported by lengthy and expensive clinical trial studies.