Multiblock modelling to assess the overall risk factors for a composite outcome

2011 ◽  
Vol 140 (2) ◽  
pp. 337-347 ◽  
Author(s):  
S. BOUGEARD ◽  
C. LUPO ◽  
S. Le BOUQUIN ◽  
C. CHAUVIN ◽  
E. M. QANNARI
Keyword(s):  
Risk Factors ◽  
Redundancy Analysis ◽  
Complex Disease ◽  
Linear Models ◽  
Epidemiological Data ◽  
Health Issues ◽  
Explanatory Variables ◽  
Modelling Framework ◽  
Several Variables ◽  
Veterinary Epidemiology

SUMMARYResearch in epidemiology may be concerned with assessing risk factors for complex health issues described by several variables. Moreover, epidemiological data are usually organized in several blocks of variables, consisting of a block of variables to be explained and a large number of explanatory variables organized in meaningful blocks. Usual statistical procedures such as generalized linear models do not allow the explanation of a multivariate outcome, such as a complex disease described by several variables, with a single model. Moreover, it is not easy to take account of the organization of explanatory variables into blocks. Here we propose an innovative method in the multiblock modelling framework, called multiblock redundancy analysis, which is designed to handle most specificities of complex epidemiological data. Overall indices and graphical displays associated with different interpretation levels are proposed. The interest and relevance of multiblock redundancy analysis is illustrated using a dataset pertaining to veterinary epidemiology.

A Strategy for Analysing Multiple Risk Factors with Application to Cervical Pain Syndrome

1989 ◽  
Vol 28 (01) ◽  
pp. 14-19 ◽  
Author(s):  
J. F. Dartigues ◽  
Ph. Peytour ◽  
E. Puymirat ◽  
P. Henry ◽  
M. Gagnon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Power ◽  
Head Trauma ◽  
Pain Syndrome ◽  
Psychological Status ◽  
Confounding Factors ◽  
Cervical Pain ◽  
Extreme Form ◽  
Explanatory Variables ◽  
Multiple Risk Factors

Abstract:When studying the possible effects of several factors in a given disease, two major problems arise: (1) confounding, and (2) multiplicity of tests. Frequently, in order to cope with the problem of confounding factors, models with multiple explanatory variables are used. However, the correlation structure of the variables may be such that the corresponding tests have low power: in its extreme form this situation is coined by the term “multicollinearity”. As the problem of multiplicity is still relevant in these models, the interpretation of results is, in most cases, very hazardous. We propose a strategy - based on a tree structure of the variables - which provides a guide to the interpretation and controls the risk of erroneously rejecting null hypotheses. The strategy was applied to a study of cervical pain syndrome involving 990 subjects and 17 variables. Age, sex, head trauma, posture at work and psychological status were all found to be important risk factors.

scholarly journals Cerebral venous thrombosis in a patient with Down syndrome and coronavirus disease 2019: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Henry Robayo-Amortegui ◽  
Natalia Valenzuela-Faccini ◽  
Cesar Quecano-Rosas ◽  
Darlyng Zabala-Muñoz ◽  
Michel Perez-Garzon
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Case Report ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Epidemiological Data ◽  
Thromboembolic Disease ◽  
Hispanic Woman ◽  
Case Presentation ◽  
The World

Abstract Background The new coronavirus disease 2019 pandemic has spread throughout most of the world. Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection. Case presentation We report the case of a Hispanic woman with Down syndrome who has coronavirus disease 2019 and presents as a complication extensive cerebral venous thrombosis. Conclusions Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection. In the absence of clinical and epidemiological data, it is important to carry out further investigation of the risk factors and pathophysiological causes related to the development of cerebrovascular thrombotic events in patients with Down syndrome with coronavirus disease 2019 infection.

scholarly journals Attitudes about Testicular Self-Examination among Polish Males

Biology ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 239
Author(s):  
Tomasz Milecki ◽  
Natalia Majchrzak ◽  
Adam Balcerek ◽  
Maciej Rembisz ◽  
Michał Kasperczak ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Practitioner ◽  
Testicular Cancer ◽  
Family Member ◽  
Malignant Tumor ◽  
Epidemiological Data ◽  
Access To Information ◽  
The Mean ◽  
Original Survey ◽  
Self Examination

Introduction: Epidemiological data indicate an increased incidence of testicular cancer (TC), making it the most common malignant tumor in men from aged 15–45. Oncological and urological associations recommend that men with specific TC risk factors should regularly perform a testicular self-exam (TSE). The aim of the study was to discover the attitudes among Polish males regarding TSE and factors (environmental, social, educational) that affect intention to perform TSE. Methods: An original survey containing 21 questions was used to conduct a study among the Polish branch of VW (Volkswagen Poland) employees. Results: A total of 522 fully completed questionnaires were collected. The mean age of the surveyed respondents was 32 years. Information about TC and how to perform TSE was obtained by 34.4% (n = 185) of the men. It was shown that the following factors increase men’s intention to perform TSE: TC in their family member (p < 0.05; HR = 5.9; 95% Cl: 1.5–23.0), GP’s(General Practitioner) recommendations (p < 0.001; HR = 6.8; 95% Cl: 3.2–14.3), concern expressed by their partner (p < 0.001; HR = 3.3; 95% Cl: 2.1–5.3), and social campaigns (p < 0.001; HR = 2.6; 95% Cl: 1.5–4.6). Conclusions: Approximately half of young polish males do not perform TSE. Access to information on TC prevention is limited. Further action is needed to improve men’s awareness of TC and TSE.

scholarly journals The malaria burden of Amerindian groups of three Venezuelan states: a descriptive study based on programmatic data

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Juan C. Gabaldón-Figueira ◽  
Carlos Chaccour ◽  
Jorge Moreno ◽  
Maria Villegas ◽  
Leopoldo Villegas
Keyword(s):  
Risk Factors ◽  
Plasmodium Falciparum ◽  
Malaria Incidence ◽  
Hot Spot ◽  
Public Health Problem ◽  
Epidemiological Data ◽  
Descriptive Study ◽  
Malaria Burden ◽  
Indigenous Groups ◽  
The Impact

Abstract Background Fifty-three percent of all cases of malaria in the Americas in 2019 came from Venezuela, where the epidemic is heavily focused south of the Orinoco river, and where most of the country’s Amerindian groups live. Although the disease is known to represent a significant public health problem among these populations, little epidemiological data exists on the subject. This study aims to provide information on malaria incidence, geospatial clustering, and risk factors associated to Plasmodium falciparum infection among these groups. Methods This is a descriptive study based on the analysis of published and unpublished programmatic data collected by Venezuelan health authorities and non-government organizations between 2014 and 2018. The Annual Parasite Index among indigenous groups (API-i) in municipalities of three states (Amazonas, Bolivar, and Sucre) were calculated and compared using the Kruskal Wallis test, risk factors for Plasmodium falciparum infection were identified via binomial logistic regression and maps were constructed to identify clusters of malaria cases among indigenous patients via Moran’s I and Getis-Ord’s hot spot analysis. Results 116,097 cases of malaria in Amerindian groups were registered during the study period. An increasing trend was observed between 2014 and 2016 but reverted in 2018. Malaria incidence remains higher than in 2014 and hot spots were identified in the three states, although more importantly in the south of Bolivar. Most cases (73.3%) were caused by Plasmodium vivax, but the Hoti, Yanomami, and Eñepa indigenous groups presented higher odds for infection with Plasmodium falciparum. Conclusion Malaria cases among Amerindian populations increased between 2014 and 2018 and seem to have a different geographic distribution than those among the general population. These findings suggest that tailored interventions will be necessary to curb the impact of malaria transmission in these groups.

scholarly journals Assessment of the relationship between estimated cardiovascular risk and structural damage in patients with axial spondyloarthritis

2020 ◽  
Vol 12 ◽  
pp. 1759720X2098283
Author(s):  
María Lourdes Ladehesa-Pineda ◽  
Iván Arias de la Rosa ◽  
Clementina López Medina ◽  
María del Carmen Castro-Villegas ◽  
María del Carmen Ábalos-Aguilera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cluster Analysis ◽  
Structural Damage ◽  
Disease Duration ◽  
Linear Models ◽  
Axial Spondyloarthritis ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Atherosclerotic Plaques ◽  
Cross Sectional

Aims: To evaluate the association of estimated cardiovascular (CV) risk and subclinical atherosclerosis with radiographic structural damage in patients with axial spondyloarthritis (axSpA). Methods: Cross-sectional study including 114 patients axSpA from the SpA registry of Córdoba (CASTRO) and 132 age- and sex-matched healthy controls (HCs). Disease activity and the presence of traditional CV risk factors were recorded. The presence of atherosclerotic plaques and carotid intima media thickness (cIMT) were evaluated through carotid ultrasound and the SCORE index was calculated. Radiographic damage was measured though modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). The association between mSASSS and SCORE was tested using generalized linear models (GLM), and an age-adjusted cluster analysis was performed to identify different phenotypes dependent on the subclinical CV risk. Results: Increased traditional CV risk factors, SCORE, and the presence of carotid plaques were found in axSpA patients compared with HCs. The presence of atherosclerotic plaques and SCORE were associated with radiographic structural damage. The GLM showed that the total mSASSS was associated independently with the SCORE [β coefficient 0.24; 95% confidence interval (CI) 0.10–0.38] adjusted for disease duration, age, tobacco, C-reactive protein, and non-steroidal anti-inflammatory drugs (NSAID) intake. Hard cluster analysis identified two phenotypes of patients. Patients from cluster 1, characterized by the presence of plaques and increased cIMT, had a higher prevalence of CV risk factors and SCORE, and more structural damage than cluster two patients. Conclusion: Radiographic structural damage is associated closely with increased estimated CV risk: higher SCORE levels in axSpA patients were found to be associated independently with mSASSS after adjusting for age, disease duration, CRP, tobacco and NSAID intake.

Life Course Socioeconomic Position, Intergenerational Social Mobility, and Hypertension Incidence in ELSA-Brasil

2021 ◽  
Author(s):  
José Aparecido Soares Lopes ◽  
Luana Giatti ◽  
Rosane Harter Griep ◽  
Antonio Alberto da Silva Lopes ◽  
Sheila Maria Alvim Matos ◽  
...  
Keyword(s):  
Life Course ◽  
Social Mobility ◽  
Socioeconomic Position ◽  
Linear Models ◽  
Sociodemographic Factors ◽  
Incidence Rates ◽  
Explanatory Variables ◽  
Rate Ratios

Abstract Background Life course epidemiology is a powerful framework to unravel the role of socioeconomic position (SEP) disparities in hypertension (HTN). This study investigated whether life course SEP is associated with HTN incidence. Specifically, to test whether cumulative low SEP throughout life and unfavorable intergenerational social mobility increased HTN incidence. METHODS Longitudinal analysis of 8,754 ELSA-Brasil participants without HTN or cardiovascular in visit 1 (2008–2010). The response variable was the incidence of HTN between visits 1 and 2 (2012–2014). The explanatory variables were childhood, youth, and adulthood SEP, cumulative low SEP, and intergenerational social mobility. Associations were estimated by incidence rate ratios (IRRs) obtained by generalized linear models, with Poisson distribution and logarithmic link function, after adjustment for sociodemographic, behavioral, and health factors. RESULTS The incidence of HTN was 43.2/1,000 person-years, being higher in males, elderly (70–74 years), self-declared black, and low SEP individuals. After considering sociodemographic factors, low SEP in childhood, youth, and adulthood remained statistically associated with increased HTN incidence. Individuals in the third (IRR: 1.26; 95% confidence interval (CI): 1.11–1.44) and fourth top quartiles (IRR: 1.29; 95% CI: 1.11–1.49) of cumulative low SEP, vs. first, as well as those with low stable intergenerational trajectory (IRR: 1.29; 95% CI: 1.16–1.43), vs. high stable, also had increased HTN incidence rates. Conclusions Socioeconomic disparities at all phases of the life cycle appear to raise HTN incidence rates, being the individuals with greater accumulation of exposure to low SEP and with more unfavorable intergenerational mobility at greatest risk, even in a short follow-up time.

scholarly journals Neisseria meningitidis carriage and risk factors among teenagers in Suizhou city in China

2020 ◽  
Vol 148 ◽  
Author(s):  
Fei He ◽  
Hong mei Yang ◽  
Guo ming Li ◽  
Bing qing Zhu ◽  
Yating Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Population Density ◽  
Neisseria Meningitidis ◽  
Old Age ◽  
Age Groups ◽  
Significant Risk ◽  
Epidemiological Data ◽  
Significant Risk Factor ◽  
Antibiotic Use ◽  
Carriage Rate

Abstract Teenagers are important carriers of Neisseria meningitidis, which is a leading cause of invasive meningococcal disease. In China, the carriage rate and risk factors among teenagers are unclear. The present study presents a retrospective analysis of epidemiological data for N. meningitidis carriage from 2013 to 2017 in Suizhou city, China. The carriage rates were 3.26%, 2.22%, 3.33%, 3.53% and 9.88% for 2013, 2014, 2015, 2016 and 2017, respectively. From 2014 to 2017, the carriage rate in the 15- to 19-year-old age group (teenagers) was the highest and significantly higher than that in remain age groups. Subsequently, a larger scale survey (December 2017) for carriage rate and relative risk factors (population density, time spent in the classroom, gender and antibiotics use) were investigated on the teenagers (15- to 19-year-old age) at the same school. The carriage rate was still high at 33.48% (223/663) and varied greatly from 6.56% to 52.94% in a different class. Population density of the classroom was found to be a significant risk factor for carriage, and 1.4 persons/m2 is recommended as the maximum classroom density. Further, higher male gender ratio and more time spent in the classroom were also significantly associated with higher carriage. Finally, antibiotic use was associated with a significantly lower carriage rate. All the results imply that attention should be paid to the teenagers and various measures can be taken to reduce the N. meningitidis carriage, to prevent and control the outbreak of IMD.

scholarly journals Independent Behavior of Commensal Flora for Carriage of Fluoroquinolone-Resistant Bacteria in Patients at Admission

2010 ◽  
Vol 54 (12) ◽  
pp. 5193-5200 ◽  
Author(s):  
Victoire de Lastours ◽  
Françoise Chau ◽  
Florence Tubach ◽  
Blandine Pasquet ◽  
Etienne Ruppé ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bacterial Resistance ◽  
Care Facility ◽  
Health Care Facility ◽  
Epidemiological Data ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
E Coli ◽  
Commensal Flora ◽  
Resistant Strains

ABSTRACT The important role of commensal flora as a natural reservoir of bacterial resistance is now well established. However, whether the behavior of each commensal flora is similar to that of other floras in terms of rates of carriage and risk factors for bacterial resistance is unknown. During a 6-month period, we prospectively investigated colonization with fluoroquinolone-resistant bacteria in the three main commensal floras from hospitalized patients at admission, targeting Escherichia coli in the fecal flora, coagulase-negative Staphylococcus (CNS) in the nasal flora, and α-hemolytic streptococci in the pharyngeal flora. Resistant strains were detected on quinolone-containing selective agar. Clinical and epidemiological data were collected. A total of 555 patients were included. Carriage rates of resistance were 8.0% in E. coli, 30.3% in CNS for ciprofloxacin, and 27.2% in streptococci for levofloxacin; 56% of the patients carried resistance in at least one flora but only 0.9% simultaneously in all floras, which is no more than random. Risk factors associated with the carriage of fluoroquinolone-resistant strains differed between fecal E. coli (i.e., colonization by multidrug-resistant bacteria) and nasal CNS (i.e., age, coming from a health care facility, and previous antibiotic treatment with a fluoroquinolone) while no risk factors were identified for pharyngeal streptococci. Despite high rates of colonization with fluoroquinolone-resistant bacteria, each commensal flora behaved independently since simultaneous carriage of resistance in the three distinct floras was uncommon, and risk factors differed. Consequences of environmental selective pressures vary in each commensal flora according to its local specificities (clinical trial NCT00520715 [http://clinicaltrials.gov/ct2/show/NCT00520715 ]).

СОСТОЯНИЕ ПРОБЛЕМЫ НАРКОЛОГИЧЕСКИХ РАССТРОЙСТВ В КУРСКОЙ ОБЛАСТИ И СОПРЕДЕЛЬНЫХ ТЕРРИТОРИЯХ В 2014-2019 ГОДАХ

Innova ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 33-38
Author(s):  
Владимир Игоревич Тимошилов ◽  
◽  
Альберт Генрихович Ластовецкий
Keyword(s):  
Risk Factors ◽  
Drug Addiction ◽  
Epidemiological Data ◽  
Drug Prevention ◽  
Social Risk ◽  
Social Risk Factors ◽  
Social Instability ◽  
Lower Incidence Rate ◽  
Kursk Region ◽  
Active Substances

Period 2014-2019 characterized by a certain increase in social instability in Russia, which led to an increase of social risk factors for drug addiction. In the Kursk region, at the same time, there have been changes in the regulation of anti-drug prevention, a large number of specialists have been trained, and a movement of competent volunteers has developed. In this regard, the epidemiological data for 2014-2019 are of particular interest. For the period from 2005 to 2019 the primary incidence of alcohol use disorders in Russia decreased from 147.4 to 48.3, in the Kursk region – from 106 to 53.5 cases per 100 000 population per year. Of the adjacent regions in 2019, a lower incidence rate than in the Kursk region was noted only in the Belgorod region – 39.4 cases per 100,000 population. Primary incidence of disorders associated with the use of narcotic active substances, during 2014-2019 in Russia as a whole decreased from 15 to 9.8, in the Kursk region – from 11.3 to 4 new cases per 100 000 inhabitants per year. In 2019, the detection rate of primary incidence of drug addiction and substance abuse was significantly higher than in the Kursk region in Bryansk and Lipetsk. Despite favorable trends, it was noted that the coronavirus pandemic and the restrictions introduced to combat it can have a significant impact on the risk factors for drug addiction, which requires the adaptation of preventive programs to new conditions.

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