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1.
IEEE Trans Inf Forensics Secur ; 19: 5751-5766, 2024.
Article in English | MEDLINE | ID: mdl-38993695

ABSTRACT

Conducting secure computations to protect against malicious adversaries is an emerging field of research. Current models designed for malicious security typically necessitate the involvement of two or more servers in an honest-majority setting. Among privacy-preserving data mining techniques, significant attention has been focused on the classification problem. Logistic regression emerges as a well-established classification model, renowned for its impressive performance. We introduce a novel matrix encryption method to build a maliciously secure logistic model. Our scheme involves only a single semi-honest server and is resilient to malicious data providers that may deviate arbitrarily from the scheme. The d -transformation ensures that our scheme achieves indistinguishability (i.e., no adversary can determine, in polynomial time, which of the plaintexts corresponds to a given ciphertext in a chosen-plaintext attack). Malicious activities of data providers can be detected in the verification stage. A lossy compression method is implemented to minimize communication costs while preserving negligible degradation in accuracy. Experiments illustrate that our scheme is highly efficient to analyze large-scale datasets and achieves accuracy similar to non-private models. The proposed scheme outperforms other maliciously secure frameworks in terms of computation and communication costs.

2.
Sci Rep ; 14(1): 17005, 2024 Jul 23.
Article in English | MEDLINE | ID: mdl-39043792

ABSTRACT

Despite the amplified vector-control measures, sporadic-epidemic outbreaks of dengue incidence occurred in Delhi, intermittently. This study aimed to identify the major individual, household, and community level predictors of dengue cases in the hot-spots of Delhi. Primary survey data was collected from the selected sample of 347 households, at the South- West district of Delhi. This survey has interviewed the head of the household to collect the information of dengue incidences within last one year and household information related to socio-economic, demographic, environmental factors, such as housing pattern, density, water storage containers, drainage and garbage collection site and method, mosquito protection measures and awareness. Among 347 households, 54 households had reported dengue cases, and 69 individuals had reported dengue cases in last one year. Garbage and water collection site and methods, drainage and household type, household monthly income, indoor bamboo plants, construction site (within 500 m), presence of tertiary care hospital, were the significant predictors of dengue incidences in Delhi. In conclusion, strategic control measures and intense social interventions such as household and community awareness, promotion of healthy practices should be promoted to control the dengue incidences.


Subject(s)
Dengue , Dengue/epidemiology , India/epidemiology , Humans , Incidence , Female , Male , Socioeconomic Factors , Family Characteristics , Adult , Risk Factors , Disease Outbreaks
3.
Stat Med ; 2024 Jul 22.
Article in English | MEDLINE | ID: mdl-39039022

ABSTRACT

Preeclampsia is a pregnancy-associated condition posing risks of both fetal and maternal mortality and morbidity that can only resolve following delivery and removal of the placenta. Because in its typical form preeclampsia can arise before delivery, but not after, these two events exemplify the time-to-event setting of "semi-competing risks" in which a non-terminal event of interest is subject to the occurrence of a terminal event of interest. The semi-competing risks framework presents a valuable opportunity to simultaneously address two clinically meaningful risk modeling tasks: (i) characterizing risk of developing preeclampsia, and (ii) characterizing time to delivery after onset of preeclampsia. However, some people with preeclampsia deliver immediately upon diagnosis, while others are admitted and monitored for an extended period before giving birth, resulting in two distinct trajectories following the non-terminal event, which we call "clinically immediate" and "non-immediate" terminal events. Though such phenomena arise in many clinical contexts, to-date there have not been methods developed to acknowledge the complex dependencies between such outcomes, nor leverage these phenomena to gain new insight into individualized risk. We address this gap by proposing a novel augmented frailty-based illness-death model with a binary submodel to distinguish risk of immediate terminal event following the non-terminal event. The model admits direct dependence of the terminal event on the non-terminal event through flexible regression specification, as well as indirect dependence via a shared frailty term linking each submodel. We develop an efficient Bayesian sampler for estimation and corresponding model fit metrics, and derive formulae for dynamic risk prediction. In an extended example using pregnancy outcome data from an electronic health record, we demonstrate the proposed model's direct applicability to address a broad range of clinical questions.

4.
Front Cell Infect Microbiol ; 14: 1382720, 2024.
Article in English | MEDLINE | ID: mdl-39040601

ABSTRACT

Background: The global COVID-19 pandemic has resulted in over seven million deaths, and IFI can further complicate the clinical course of COVID-19. Coinfection of COVID-19 and IFI (secondary IFI) pose significant threats not only to healthcare systems but also to patient lives. After the control measures for COVID-19 were lifted in China, we observed a substantial number of ICU patients developing COVID-19-associated IFI. This creates an urgent need for predictive assessment of COVID-19 patients in the ICU environment for early detection of suspected fungal infection cases. Methods: This study is a single-center, retrospective research endeavor. We conducted a case-control study on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients. The cases consisted of patients who developed any secondary IFI during their ICU stay at Jilin University China-Japan Union Hospital in Changchun, Jilin Province, China, from December 1st, 2022, to August 31st, 2023. The control group consisted of SARS-CoV-2 positive patients without secondary IFI. Descriptive and comparative analyses were performed, and a logistic regression prediction model for secondary IFI in COVID-19 patients was established. Additionally, we observed an increased incidence of COVID-19-associated pulmonary aspergillosis (CAPA) during this pandemic. Therefore, we conducted a univariate subgroup analysis on top of IFI, using non-CAPA patients as the control subgroup. Results: From multivariate analysis, the prediction model identified 6 factors that are significantly associated with IFI, including the use of broad-spectrum antibiotics for more than 2 weeks (aOR=4.14, 95% CI 2.03-8.67), fever (aOR=2.3, 95%CI 1.16-4.55), elevated log IL-6 levels (aOR=1.22, 95% CI 1.04-1.43) and prone position ventilation (aOR=2.38, 95%CI 1.15-4.97) as independent risk factors for COVID-19 secondary IFI. High BMI (BMI ≥ 28 kg/m2) (aOR=0.85, 95% CI 0.75-0.94) and the use of COVID-19 immunoglobulin (aOR=0.45, 95% CI 0.2-0.97) were identified as independent protective factors against COVID-19 secondary IFI. The Receiver Operating Curve (ROC) area under the curve (AUC) of this model was 0.81, indicating good classification. Conclusion: We recommend paying special attention for the occurrence of secondary IFI in COVID-19 patients with low BMI (BMI < 28 kg/m2), elevated log IL-6 levels and fever. Additionally, during the treatment of COVID-19 patients, we emphasize the importance of minimizing the duration of broad-spectrum antibiotic use and highlight the potential of immunoglobulin application in reducing the incidence of IFI.


Subject(s)
COVID-19 , Intensive Care Units , Invasive Fungal Infections , SARS-CoV-2 , Humans , COVID-19/complications , Female , Male , Middle Aged , Retrospective Studies , SARS-CoV-2/isolation & purification , Invasive Fungal Infections/epidemiology , China/epidemiology , Case-Control Studies , Aged , Coinfection/epidemiology , Adult , Risk Factors
5.
Public Health Pract (Oxf) ; 7: 100501, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38826638

ABSTRACT

Aim: Perinatal mortality can be used as a reference to assess health status in a country. In Indonesia, none of previous studies specifically discuss the incidence of prenatal mortality by region. The objective of this study was to analyze perinatal mortality difference by region of Indonesia. Study design: This study used a cross-sectional approach. Method: The sample in this study was 13,310 women of childbearing age obtained from the Indonesian Demographic Health Survey (IDHS) 2017. The perinatal mortality rate was calculated using data on stillbirths with a gestational duration of seven months or more and early neonatal deaths. Perinatal mortality was analyzed by region using a binary logistic regression statistical test to examine the relationship between perinatal mortality and its factors (socio-demographic factors, individual disease control factors, and maternal factors). Results: This study shows that the proportion of perinatal mortality in Indonesia is 1.5 % of total births. The highest proportion of perinatal mortality (2.5 %) was in the Papua region, while the lowest proportion (1.3 %) was in the Java region. The results of this study indicated that women in the Maluku Islands had a 1.82 times higher chance of perinatal mortality compared to the Java-Bali region. The causative variable associated with perinatal mortality in the Java-Bali and Papua regions was employment status. The causative variables associated with perinatal mortality in Kalimantan were the quality of antenatal care and delivery assistance. The causative variable associated with perinatal mortality in Nusa Tenggara and Papua was the location of delivery. The causative variable associated with perinatal mortality in Kalimantan, Maluku, and Papua was the mother's age. The causative variable associated with perinatal mortality in the Java-Bali region was parity. The causative variable associated with perinatal mortality in Sumatra was the type of delivery. Conclusion: This study show that there were disparities in the incidence of perinatal mortality between regions in Indonesia. The government needs to re-adjust the existing strategies to improve health status and focus on community empowerment for women to prevent perinatal mortality.

6.
Commun Stat Theory Methods ; 53(11): 3940-3957, 2024.
Article in English | MEDLINE | ID: mdl-38835746

ABSTRACT

The problem of constructing locally D-optimal designs for two-variable logistic model with no interaction has been studied in many literature. In Kabera, Haines, and Ndlovu (2015), the model is restricted to have positive slopes and negative intercept for the assumptions that the probability of response increases with doses for both drugs and that the probability of response is less than 0.5 at zero dose level of both drugs. The design space mainly discussed is the set [0, ∞) × [0, ∞), while the finite rectangular design space is presented only in scenarios where the results for the unlimited design space are still appropriate. In this paper, we intend to loose these restrictions and discuss the rectangular design spaces for the model where the D-optimal designs can not be obtained. The result can be extended to the models where drugs have negative or opposite effects, or the models with positive intercept, by using translation and reflection in the first quadrant.

7.
Sci Rep ; 14(1): 14406, 2024 Jun 22.
Article in English | MEDLINE | ID: mdl-38909118

ABSTRACT

This research investigates the application of the ordered ranked set sampling (ORSSA) procedure in constant-stress partially accelerated life-testing (CSPALTE). The study adopts the assumption that the lifespan of a specific item under operational stress follows a half-logistic probability distribution. Through Bayesian estimation methods, it concentrates on estimating the parameters, utilizing both asymmetric loss function and symmetric loss function. Estimations are conducted using ORSSAs and simple random samples, incorporating hybrid censoring of type-I. Real-world data sets are utilized to offer practical context and validate the theoretical discoveries, providing concrete insights into the research findings. Furthermore, a rigorous simulation study, supported by precise numerical calculations, is meticulously conducted to gauge the Bayesian estimation performance across the two distinct sampling methodologies. This research ultimately sheds light on the efficacy of Bayesian estimation techniques under varying sampling strategies, contributing to the broader understanding of reliability analysis in CSPALTE scenarios.

8.
Brief Bioinform ; 25(4)2024 May 23.
Article in English | MEDLINE | ID: mdl-38888457

ABSTRACT

Large sample datasets have been regarded as the primary basis for innovative discoveries and the solution to missing heritability in genome-wide association studies. However, their computational complexity cannot consider all comprehensive effects and all polygenic backgrounds, which reduces the effectiveness of large datasets. To address these challenges, we included all effects and polygenic backgrounds in a mixed logistic model for binary traits and compressed four variance components into two. The compressed model combined three computational algorithms to develop an innovative method, called FastBiCmrMLM, for large data analysis. These algorithms were tailored to sample size, computational speed, and reduced memory requirements. To mine additional genes, linkage disequilibrium markers were replaced by bin-based haplotypes, which are analyzed by FastBiCmrMLM, named FastBiCmrMLM-Hap. Simulation studies highlighted the superiority of FastBiCmrMLM over GMMAT, SAIGE and fastGWA-GLMM in identifying dominant, small α (allele substitution effect), and rare variants. In the UK Biobank-scale dataset, we demonstrated that FastBiCmrMLM could detect variants as small as 0.03% and with α ≈ 0. In re-analyses of seven diseases in the WTCCC datasets, 29 candidate genes, with both functional and TWAS evidence, around 36 variants identified only by the new methods, strongly validated the new methods. These methods offer a new way to decipher the genetic architecture of binary traits and address the challenges outlined above.


Subject(s)
Algorithms , Genome-Wide Association Study , Genome-Wide Association Study/methods , Humans , Logistic Models , Case-Control Studies , Linkage Disequilibrium , Polymorphism, Single Nucleotide , Genomics/methods , Computer Simulation , Haplotypes , Models, Genetic
9.
Front Oncol ; 14: 1360404, 2024.
Article in English | MEDLINE | ID: mdl-38903708

ABSTRACT

Background: This study analyzed the risk factors associated with positive surgical margins (PSM) and five-year survival after prostate cancer resection to construct a positive margin prediction model. Methods: We retrospectively analyzed the clinical data of 148 patients treated with prostatectomy. The patients were divided into PSM group and Negative surgical margins (NSM) group. Several parameters were compared between the groups. All patients were followed up for 60 months. The risk factors for PSM and five-year survival were evaluated by univariate analysis, followed by multifactorial dichotomous logistic regression analysis. Finally, ROC curves were plotted for the risk factors to establish a predictive model for PSM after prostate cancer resection. Results: (1) Serum PSA, percentage of positive puncture stitches, clinical stage, surgical approach, Gleason score on puncture biopsy, and perineural invasion were significantly associated with the risk of PSM (P < 0.05). Serum PSA, perineural invasion, Gleason score on puncture biopsy, and percentage of positive puncture stitches were independent risk factors for PSM. (2) Total prostate-specific antigen (tPSA) by puncture, nutritional status, lymph node metastasis, bone metastasis, and seminal vesicle invasion may be risk factors for five-year survival. Lymph node metastasis and nutritional status were the main risk factors for the five-year survival of patients with prostate cancer. (3) After plotting the ROC curve, the area under the curve (AUC) [AUC: 0.776, 95%, confidence interval (CI): 0.725 to 0.854] was found to be a valid predictor of PSM; the AUC [AUC: 0.664, 95%, confidence interval (CI): 0.576 to 0.753] was also a valid predictor of five-year survival (P < 0.05). (4) The scoring system had a standard error of 0.02 and a cut-off value of 6. It predicted PSM after prostate cancer resection with moderate efficacy. Conclusions: Serum PSA, perineural invasion, puncture biopsy Gleason score, and percentage of positive puncture stitches were independent risk factors for positive surgical margins (PSM). Also, lymph node metastasis and nutritional status were the main risk factors for the five-year survival of patients with prostate cancer. Overall, the prediction efficacy of this scoring system concerning the risk of PSM after prostate cancer resection was moderate.

10.
Ann Nucl Med ; 2024 Jun 13.
Article in English | MEDLINE | ID: mdl-38869809

ABSTRACT

OBJECTIVE: We aimed to establish a practical diagnostic index for Lewy body diseases (LBD), such as Parkinson's disease and dementia, with Lewy bodies in outpatient settings and criteria for exempting patients from late imaging. METHODS: We acquired early and late 123I-metaiodobenzylguanidine (MIBG) images from 108 consecutive patients with suspected LBD and standardized heart-to-mediastinum (H/M) ratios for collimator conditions. Exclusions included young-onset Parkinson's disease (age < 50 years) and genetic transthyretin-type amyloidosis. We developed logistic models incorporating H/M ratios with or without age (n = 92). The sympathetic MIBG index for LBD (SMILe index), categorized LBD likelihood from 0 (lowest) to 1 (highest). Diagnostic accuracy was assessed as the area under the receiver operating characteristic (ROC) curve (AUC). The characteristics of the new index were compared with H/M ratios. The need for late imaging was explored using the SMILe index. RESULTS: Early or late SMILe indexes using a single H/M ratio variable discriminated LBD from non-LBD. The AUC values for early and late SMILe indexes were 0.880 and 0.894 (p < 0.0001 for both), identical to those for early and late H/M ratios. The sensitivity and the specificity of early SMILe indexes with a 0.5 threshold were 76% and 90%, achieving accuracy of accuracy 86%. Similarly, the late SMILe index demonstrated a sensitivity of 76% and specificity of 87%, with an accuracy of 84%. Early SMILe indexes < 0.3 or > 0.7 (representing 84% patients) indicated a diagnosis without a late MIBG study. CONCLUSION: The 123I-MIBG-derived SMILe indexes provide likelihood of LBD, and those with a 50% threshold demonstrated optimal diagnostic accuracy for LBD. The index values of either < 0.3 or > 0.7 accurately selected patients who do not need late imaging.

11.
Heliyon ; 10(9): e30791, 2024 May 15.
Article in English | MEDLINE | ID: mdl-38765160

ABSTRACT

To investigate the dynamic changes in dry matter accumulation in maize after anthesis, we established a logistic model to describe grain filling characteristics (GFC), and analyzed differences between spring and summer maize, and the influence of meteorological factors. The results showed that the logistic model accurately simulated the dynamic changes in grain growth. For spring maize, the fitted hundred-grain weight at maturity was closely related to the average grain filling rate until maturity, days of the active grain filling period, time of the maximum grain filling rate, and duration of the rapid increase in grain weight. For summer maize, it was closely related to the time of the maximum grain filling rate, days of active grain filling period, duration of gradual grain weight, and the rapidly increasing period. The filling characteristics of spring and summer maize differed because of the different meteorological conditions and biological characteristics. The grain filling duration of spring maize was longer than that of summer maize. The maximum grain filling rate of spring maize occurred later than that of summer maize. Temperature and precipitation were the main meteorological factors affecting the hundred-grain weight of spring maize, whereas temperature was the main factor affecting summer maize. The response of spring maize GFC to meteorological factors was more complex than that of summer maize. These results are important for the development of appropriate strategies for improving maize productivity in China.

12.
World J Surg Oncol ; 22(1): 145, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38822338

ABSTRACT

BACKGROUND: The detection of renal cell carcinoma (RCC) has been rising due to the enhanced utilization of cross-sectional imaging and incidentally discovered lesions with adverse pathology demonstrate potential for metastasis. The purpose of our study was to determine the clinical and multiparametric dynamic contrast-enhanced magnetic resonance imaging (CEMRI) associated independent predictors of adverse pathology for cT1/2 RCC and develop the predictive model. METHODS: We recruited 105 cT1/2 RCC patients between 2018 and 2022, all of whom underwent preoperative CEMRI and had complete clinicopathological data. Adverse pathology was defined as RCC patients with nuclear grade III-IV; pT3a upstage; type II papillary RCC, collecting duct or renal medullary carcinoma, unclassified RCC; sarcomatoid/rhabdoid features. The qualitative and quantitative CEMRI parameters were independently reviewed by two radiologists. Univariate and multivariate binary logistic regression analyses were utilized to determine the independent predictors of adverse pathology for cT1/2 RCC and construct the predictive model. The receiver operating characteristic (ROC) curve, confusion matrix, calibration plot, and decision curve analysis (DCA) were conducted to compare the diagnostic performance of different predictive models. The individual risk scores and linear predicted probabilities were calculated for risk stratification, and the Kaplan-Meier curve and log-rank tests were used for survival analysis. RESULTS: Overall, 45 patients were pathologically confirmed as RCC with adverse pathology. Clinical characteristics, including gender, and CEMRI parameters, including RENAL score, tumor margin irregularity, necrosis, and tumor apparent diffusion coefficient (ADC) value were identified as independent predictors of adverse pathology for cT1/2 RCC. The clinical-CEMRI predictive model yielded an area under the curve (AUC) of the ROC curve of 0.907, which outperformed the clinical model or CEMRI signature model alone. Good calibration, better clinical usefulness, excellent risk stratification ability of adverse pathology and prognosis were also achieved for the clinical-CEMRI predictive model. CONCLUSIONS: The proposed clinical-CEMRI predictive model offers the potential for preoperative prediction of adverse pathology for cT1/2 RCC. With the ability to forecast adverse pathology, the predictive model could significantly benefit patients and clinicians alike by providing enhanced guidance for treatment planning and decision-making.


Subject(s)
Carcinoma, Renal Cell , Contrast Media , Kidney Neoplasms , Humans , Carcinoma, Renal Cell/diagnostic imaging , Carcinoma, Renal Cell/pathology , Carcinoma, Renal Cell/surgery , Female , Male , Kidney Neoplasms/pathology , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/surgery , Middle Aged , Contrast Media/administration & dosage , Aged , Retrospective Studies , Prognosis , Multiparametric Magnetic Resonance Imaging/methods , Follow-Up Studies , Neoplasm Staging , ROC Curve , Adult , Magnetic Resonance Imaging/methods
13.
Front Public Health ; 12: 1385118, 2024.
Article in English | MEDLINE | ID: mdl-38784576

ABSTRACT

Background: This study aimed to explore the risk factors for failed treatment of carbapenem-resistant Acinetobacter baumannii ventilator-associated pneumonia (CRAB-VAP) with tigecycline and to establish a predictive model to predict the incidence of failed treatment and the prognosis of CRAB-VAP. Methods: A total of 189 CRAB-VAP patients were included in the safety analysis set from two Grade 3 A national-level hospitals between 1 January 2022 and 31 December 2022. The risk factors for failed treatment with CRAB-VAP were identified using univariate analysis, multivariate logistic analysis, and an independent nomogram to show the results. Results: Of the 189 patients, 106 (56.1%) patients were in the successful treatment group, and 83 (43.9%) patients were in the failed treatment group. The multivariate logistic model analysis showed that age (OR = 1.04, 95% CI: 1.02, 1.07, p = 0.001), yes. of hypoproteinemia (OR = 2.43, 95% CI: 1.20, 4.90, p = 0.013), the daily dose of 200 mg (OR = 2.31, 95% CI: 1.07, 5.00, p = 0.034), yes. of medication within 14 days prior to surgical intervention (OR = 2.98, 95% CI: 1.19, 7.44, p = 0.019), and no. of microbial clearance (OR = 0.31, 95% CI: 0.14, 0.70, p = 0.005) were risk factors for the failure of tigecycline treatment. Receiver operating characteristic (ROC) analysis showed that the AUC area of the prediction model was 0.745 (0.675-0.815), and the decision curve analysis (DCA) showed that the model was effective in clinical practice. Conclusion: Age, hypoproteinemia, daily dose, medication within 14 days prior to surgical intervention, and microbial clearance are all significant risk factors for failed treatment with CRAB-VAP, with the nomogram model indicating that high age was the most important factor. Because the failure rate of CRAB-VAP treatment with tigecycline was high, this prediction model can help doctors correct or avoid risk factors during clinical treatment.


Subject(s)
Acinetobacter Infections , Acinetobacter baumannii , Anti-Bacterial Agents , Carbapenems , Pneumonia, Ventilator-Associated , Tigecycline , Treatment Failure , Humans , Acinetobacter baumannii/drug effects , Risk Factors , Male , Female , Middle Aged , Carbapenems/therapeutic use , Pneumonia, Ventilator-Associated/drug therapy , Pneumonia, Ventilator-Associated/microbiology , Anti-Bacterial Agents/therapeutic use , Aged , Logistic Models , Acinetobacter Infections/drug therapy , Tigecycline/therapeutic use , Adult , Retrospective Studies , China , Drug Resistance, Bacterial
14.
Epigenomes ; 8(2)2024 May 11.
Article in English | MEDLINE | ID: mdl-38804368

ABSTRACT

We consider the newly developed multinomial mixed-link models for a high-risk intestinal metaplasia (IM) study with DNA methylation data. Different from the traditional multinomial logistic models commonly used for categorical responses, the mixed-link models allow us to select the most appropriate link function for each category. We show that the selected multinomial mixed-link model (Model 1) using the total number of stem cell divisions (TNSC) based on DNA methylation data outperforms the traditional logistic models in terms of cross-entropy loss from ten-fold cross-validations with significant p-values 8.12×10-4 and 6.94×10-5. Based on our selected model, the significance of TNSC's effect in predicting the risk of IM is justified with a p-value less than 10-6. We also select the most appropriate mixed-link models (Models 2 and 3) when an additional covariate, the status of gastric atrophy, is available. When the status is negative, mild, or moderate, we recommend Model 2; otherwise, we prefer Model 3. Both Models 2 and 3 can predict the risk of IM significantly better than Model 1, which justifies that the status of gastric atrophy is informative in predicting the risk of IM.

15.
Lifetime Data Anal ; 30(3): 667-679, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38642215

ABSTRACT

Doubly censored failure time data occur in many areas and for the situation, the failure time of interest usually represents the elapsed time between two related events such as an infection and the resulting disease onset. Although many methods have been proposed for regression analysis of such data, most of them are conditional on the occurrence time of the initial event and ignore the relationship between the two events or the ancillary information contained in the initial event. Corresponding to this, a new sieve maximum likelihood approach is proposed that makes use of the ancillary information, and in the method, the logistic model and Cox proportional hazards model are employed to model the initial event and the failure time of interest, respectively. A simulation study is conducted and suggests that the proposed method works well in practice and is more efficient than the existing methods as expected. The approach is applied to an AIDS study that motivated this investigation.


Subject(s)
Computer Simulation , Proportional Hazards Models , Humans , Likelihood Functions , Regression Analysis , Logistic Models , Acquired Immunodeficiency Syndrome/drug therapy , Survival Analysis
16.
Int Wound J ; 21(4): e14845, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38584355

ABSTRACT

Wound complications after surgery for ankle fractures can lead to catastrophic consequences. The purpose of this study was to evaluate the risk factors of postoperative wound complications in patients with ankle fracture and to determine their effects on prognosis. 200 patients with ankle fracture treated in our hospital from October 2021 to December 2023 were analysed retrospectively. The total incidence of postoperative wound complications was 19% (38/200). Type of complications: wound edge necrosis 15 cases (39.47%), dehiscence (reopening of wound) 13 cases (34.21%), delayed healing (>30 days) 10 cases (26.32%); Univariate analysis showed that patients' age, body mass index (BMI), current smoking, alcoholism, diabetes mellitus, injury mechanism, open fracture, wound classification, higher American Society of Anesthesiologists (ASA) score and operation time were all associated with postoperative wound complications. Multivariate Logistic regression model shows: age ≥60 years old OR3.671 (1.875-5.937), BMI OR1.198 (1.143-1.324), current smoking OR2.727 (1.251-5.602), alcoholism OR1.143 (1.034-1.267), complicated with diabetes OR2.763 (1.236-4.852), injury mechanism (high vs. low and medium energy) OR2.437 (1.238-4.786), open fracture OR1.943 (1.8262.139), wound classification (II vs. I) OR4.423 (1.73511.674), ASA score (III-IV vs. I-II) OR1.307 (1.113-2.194) was an independent risk factor for postoperative wound complications in patients with ankle fracture. Further, ROC curves showed that these nine independent influences had high accuracy and validity in predicting postoperative wound complications in patients with ankle fractures. In conclusion, independent risk factors for postoperative complications of ankle fracture were age >60 years, BMI, injury mechanism, open fracture, wound classification (II vs. I), ASA score, current smoking, and alcoholism. The wound classification (II vs. I) has the highest diagnostic value.


Subject(s)
Alcoholism , Ankle Fractures , Diabetes Mellitus , Fractures, Open , Humans , Middle Aged , Ankle Fractures/surgery , Ankle Fractures/complications , Retrospective Studies , Alcoholism/complications , Fracture Fixation, Internal/adverse effects , Risk Factors , Postoperative Complications/epidemiology , Postoperative Complications/etiology
17.
Ecol Evol ; 14(4): e11059, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38571795

ABSTRACT

The R package popharvest was designed to help assess the sustainability of offtake in birds when only limited demographic information is available. In this article, we describe some basics of harvest theory and then discuss several considerations when using the different approaches in popharvest to assess whether observed harvests are unsustainable. Throughout, we emphasize the importance of distinguishing between the scientific and policy aspects of managing offtake. The principal product of popharvest is a sustainable harvest index (SHI), which can indicate whether the harvest is unsustainable but not the converse. SHI is estimated based on a simple, scalar model of logistic population growth, whose parameters may be estimated using limited knowledge of demography. Uncertainty in demography leads to a distribution of SHI values and it is the purview of the decision-maker to determine what amounts to an acceptable risk when failing to reject the null hypothesis of sustainability. The attitude toward risk, in turn, will likely depend on the decision-maker's objective(s) in managing offtake. The management objective as specified in popharvest is a social construct, informed by biology, but ultimately it is an expression of social values that usually vary among stakeholders. We therefore suggest that any standardization of criteria for management objectives in popharvest will necessarily be subjective and, thus, hard to defend in diverse decision-making situations. Because of its ease of use, diverse functionalities, and a minimal requirement of demographic information, we expect the use of popharvest to become widespread. Nonetheless, we suggest that while popharvest provides a useful platform for rapid assessments of sustainability, it cannot substitute for sufficient expertise and experience in harvest theory and management.

18.
Acta Paediatr ; 113(6): 1426-1434, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38429950

ABSTRACT

AIM: To identify predictive variables and construct a predictive model along with a decision algorithm to identify nephrourological malformations (NUM) in children with febrile urinary tract infections (fUTI), enhancing the efficiency of imaging diagnostics. METHODS: We performed a retrospective study of patients aged <16 years with fUTI at the Emergency Department with subsequent microbiological confirmation between 2014 and 2020. The follow-up period was at least 2 years. Patients were categorised into two groups: 'NUM' with previously known nephrourological anomalies or those diagnosed during the follow-up and 'Non-NUM' group. RESULTS: Out of 836 eligible patients, 26.8% had underlying NUMs. The study identified six key risk factors: recurrent UTIs, non-Escherichia coli infection, moderate acute kidney injury, procalcitonin levels >2 µg/L, age <3 months at the first UTI and fUTIs beyond 24 months. These risk factors were used to develop a predictive model with an 80.7% accuracy rate and elaborate a NUM-score classifying patients into low, moderate and high-risk groups, with a 10%, 35% and 93% prevalence of NUM. We propose an algorithm for approaching imaging tests following a fUTI. CONCLUSION: Our predictive score may help physicians decide about imaging tests. However, prospective validation of the model will be necessary before its application in daily clinical practice.


Subject(s)
Urinary Tract Infections , Humans , Urinary Tract Infections/diagnosis , Urinary Tract Infections/diagnostic imaging , Retrospective Studies , Female , Infant , Male , Child, Preschool , Child , Adolescent , Algorithms , Risk Factors
19.
Front Psychol ; 15: 1308397, 2024.
Article in English | MEDLINE | ID: mdl-38434947

ABSTRACT

Objectives: To explore prevalence of depression and its influencing factors in middle-aged and elderly patients with chronic diseases. Method: Data were extracted from the 2018 China Health and Retirement Tracking Survey (CHARLS) for 6,704 middle-aged and elderly patients ≥45 years with chronic diseases. The influencing variables were selected based on LASSO-logistic regression model, and a nomogram was further drawn to visualize regression results. Results: Comorbidity between chronic diseases and depression symptoms were detected in 3058 individuals (45.6%). Female, rural, lower education, poor, insomnia, multiple chronic disease, and functional impairment were associated with a higher proportion of depression. Meanwhile, family interaction, intergenerational financial support, social activity intensity, and satisfaction with life can protect against depression. Conclusion: Depressive symptoms are common in Chinese older adults with chronic diseases. They need regular assessment and intervention, especially those with multiple diseases, female, rural, alone, impaired, poor sleep, or poor economy. These high-risk elders also need family, medical, and social support and care.

20.
Rev Argent Microbiol ; 56(2): 134-139, 2024.
Article in English | MEDLINE | ID: mdl-38472028

ABSTRACT

A bioassay containing Kluyveromyces marxianus in microtiter plates was used to determine the inhibitory action of 28 antibiotics (aminoglycosides, beta-lactams, macrolides, quinolones, tetracyclines and sulfonamides) against this yeast in whey. For this purpose, the dose-response curve for each antibiotic was constructed using 16 replicates of 12 different concentrations of the antibiotic. The plates were incubated at 40°C until the negative samples exhibited their indicator (5-7h). Subsequently, the absorbances of the yeast cells in each plate were measured by the turbidimetric method (λ=600nm) and the logistic regression model was applied. The concentrations causing 10% (IC10) and 50% (IC50) of growth inhibition of the yeast were calculated. The results allowed to conclude that whey contaminated with cephalosporins, quinolones and tetracyclines at levels close to the Maximum Residue Limits inhibits the growth of K. marxianus. Therefore, previous inactivation treatments should be implemented in order to re-use this contaminated whey by fermentation with K. marxianus.


Subject(s)
Anti-Bacterial Agents , Kluyveromyces , Whey , Kluyveromyces/drug effects , Anti-Bacterial Agents/pharmacology , Microbial Sensitivity Tests , Dose-Response Relationship, Drug
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