Predicting Community Survival in Early Psychosis and Schizophrenia Populations after Receiving Intensive Case Management

2000 ◽  
Vol 34 (1) ◽  
pp. 122-128 ◽  
Author(s):  
Neil Joseph Preston
Keyword(s):  
Case Management ◽  
Cox Regression ◽  
Antisocial Behaviour ◽  
Chronic Schizophrenia ◽  
Early Psychosis ◽  
Role Functioning ◽  
Forward Selection ◽  
Community Based ◽  
Cox Regression Analysis ◽  
Living Skills

Objective: The study was undertaken to assess whether social and living skills functioning predicted community survival between subjects with chronic schizophrenia and early episode psychosis after receiving assertive community-based case management. Method: Forty-two chronic schizophrenia patients and 49 early psychosis subjects were measured on hospitalisation for up to 3 years after receiving equivalent community-based assertive case management. A Kaplan–Meier survival analysis was performed to compare community survival between the two groups. A Cox-regression analysis was used to investigate whether sex, age, social and occupational functioning measured by the social and occupational functional assessment score (SOFAS), living skills measured by the life skills profile score (LSP), and overall role functioning measured by the role functioning scale (RFS) predicted community survival. Subscales of the LSP were also analysed in a subsequent Cox-regression using the forward selection method. Results: Differences in rate of community survival were not statistically significant (using the log-rank Chi-squared test) between subjects with early psychosis and chronic schizophrenia; however, half of the early psychosis subjects survived past the 12-month period while only a third of the chronic schizophrenia subjects did so within the same time period. The life skill profile was a significant predictor of community survival with low scores on the subscale of non-turbulence (i.e. antisocial behaviour) contributing to poorer community survival. Conclusion: The amount of antisocial behaviour displayed while receiving assertive community-based case management may be an important predictor of community survival among subjects with early psychosis and chronic schizophrenia. Treatment of such behaviour may improve community survival among these populations.

Abstract P254: Daytime Napping is Associated With Incident Stroke in Community

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Xuting Jin ◽  
Bin Yan ◽  
Ruohan Li ◽  
Ya Gao ◽  
Jingjing Zhang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cox Regression ◽  
Life Quality ◽  
Health Study ◽  
Sleep Habits ◽  
Community Based ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
Registration Number ◽  
The Relationship

Introduction: There are conflicting reports regarding whether daytime napping is a risk factor for cardiovascular events. The purpose of this study was to investigate the relationship between daytime napping and incident stroke within a community-based cohort study. Hypothesis: We assessed the hypothesis that the duration and the frequency of daytime napping may be associated with incident stroke. Methods: Participants without previous stroke were enrolled in the present prospective study from the Sleep Heart Health Study (registration number, NCT00005275). Daytime napping were assessed with a self-reported Sleep Habits Questionnaire. Duration of daytime napping was divided into the following categories: no naps, 0-30 min, 31-60 min, or >60 min. Frequency of naps were categorised as: no naps, 1-2 times/week, 3-4 times/week, 5-6 times/week, or daily. After combining nap duration and frequency, participants were further divided into groups with regular long naps (≥5 times per week and >30 min), regular short naps (≥5 times per week and ≤30 min), irregular naps or no naps. Subsequently, participants were followed up until the first stroke occurred between the date of the completed questionnaire and the final censoring date. Cox regression analysis was used to estimate the relationship between daytime napping and incident stroke. Results: The present study enrolled 4757 participants, of which 220 participants (4.6%) experienced incident stroke during an average follow-up of 10.6 years. There was a higher rate of stroke among participants taking longer and more frequent naps than others. Multivariate Cox regression analysis indicated that, when compared with participants with no naps, those with a nap duration of ≥60 min or of 31-60 min had a higher risk of stroke (HR, 2.182; 95% CI, 1.443-3.301; HR, 1.594; 95% CI, 1.003-2.531, respectively). Moreover, there was an increased risk of stroke among participants taking daily daytime naps (HR, 1.563; 95% CI, 1.059-2.307) or napping 5-6 times per week (HR, 1.548; 95% CI, 1.026-2.335) than those with no naps. And after combining nap duration and frequency, regular long naps and regular short naps were also associated with higher risk of incident stroke (HR, 1.903; 95% CI, 1.182-3.065; HR, 1.451; 95% CI, 1.010-2.084, respectively). Conclusions: In conclusion, daytime napping of long duration and high frequency may increase the risk of incident stroke in community. Modification of sleep habits may improve the life quality among those elderly community-based population.

scholarly journals Hyperuricemia and Impaired Renal Function: A Prospective Cohort Study

2020 ◽  
pp. 1-9
Author(s):  
Noppawit Aiumtrakul ◽  
Puvanant Wiputhanuphongs ◽  
Ouppatham Supasyndh ◽  
Bancha Satirapoj
Keyword(s):  
Renal Function ◽  
Uric Acid ◽  
Regression Analysis ◽  
Cohort Study ◽  
Serum Uric Acid ◽  
Prospective Cohort ◽  
Impaired Renal Function ◽  
Cox Regression ◽  
Community Based ◽  
Cox Regression Analysis

<b><i>Background:</i></b> Related studies have demonstrated a relationship of elevated serum uric levels with a decline in kidney function. However, limited evidence exists in a Southeast Asian community-based population. <b><i>Objective:</i></b> The study aimed to examine the relationship between serum uric acid levels and impaired renal function. <b><i>Methods:</i></b> A prospective cohort study was conducted in the Thai army health checkup population between July 1, 2006 and December 31, 2012. Inclusion criteria included age older than 20 years and baseline estimated glomerular filtration rate (eGFR) over 60 mL/min/1.73 m<sup>2</sup>. Cox regression analysis was used to evaluate the association between incidence of impaired renal function and baseline serum uric acid quartiles. Impaired renal function was defined as eGFR &#x3c;60 mL/min/1.73 m<sup>2</sup> over 3 months. <b><i>Results:</i></b> A total of 9,534 participants (7,474 men and 2,060 women) were enrolled. Cox regression analysis revealed a significant association of serum uric acid level with impaired renal function in the whole population as the unadjusted hazard ratio (HR) (95% CI) of impaired renal function in second, third, and fourth quartiles were 2.1 (1.39, 3.17), 2.39 (1.6, 3.59), and 3.94 (2.71, 5.74), respectively, when compared with serum uric acid in the first quartile, respectively. After adjusting in 2 models, the HR still significantly persisted with similar magnitudes in all quartiles. Higher incidences of impaired renal function were observed among males than among females in all quartiles. Kaplan-Meier curve showed better renal survival rate in the lower quartile groups. Linear regression analysis showed that eGFR negatively correlated with serum uric acid (<i>r</i> = −0.213, <i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> Our study suggests that an independent association exists of serum uric acid levels with the incidence of impaired renal function and renal progression in the Southeast Asian community-based population.

Protective effect of metformin in lung cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22063-e22063
Author(s):  
B. Gagnon ◽  
M. Roseman ◽  
G. Kasymjanova ◽  
N. MacDonald ◽  
H. Kreisman ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Cox Regression ◽  
Human Cell Lines ◽  
Community Based ◽  
Cox Regression Analysis ◽  
Lung Cancer Patients ◽  
The Past ◽  
Jewish General Hospital

e22063 Background: Over the past decade, dozens of studies have shown that metformin not only decreases mortality in diabetics, it also significantly reduces CRP and reduces the risks of cancer in rodent and human cell lines. We report on the survival of lung cancer patients concomitantly exposed to metformin in our community-based program. Methods: 850 patients undergoing treatment from a prospectively collected pulmonary oncology database of the SMBD-Jewish General Hospital over an 8-year period were analyzed. Pilot observational study of survival was performed using Cox regression model. The factors that were included in the model were age, gender, stage, histology and metformin use. Results: 850 patients (F: M=375:475; mean age of 66) were diagnosed since 2000 and followed in pulmonary oncology outpatient clinic for NSCLC. 523 (62%) of those patients were diagnosed with adenocarcinoma; 488 (57%) were stage IIIB with pleural effusion/IV. 79(9%) patients were receiving treatment with metformin for their comorbid type 2 diabetes. The Cox regression analysis demonstrated that age, gender, stage and use of metformin were significant prognostic factors for survival. The use of metformin is associated with a 37% (HR 1.37; CI 1.01–1.84) (p=0.039) increase in survival. Conclusions: Thus, the result obtained from our model suggests that use of metformin may be associated with better survival of lung cancer patients. As this is a pilot study, we will consider alternative explanations. No significant financial relationships to disclose.

Cetuximab (CTX) in first-line treatment of elderly patients with metastatic colorectal cancer (mCRC), KRAS wild type: French multicentre prospective community-based registry and results.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 760-760
Author(s):  
Laurent Mineur ◽  
Eric François ◽  
Jean Marc Phelip ◽  
Rosine Guimbaud ◽  
Carine Plassot ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Rank Test ◽  
Wild Type ◽  
Community Based ◽  
Cox Models ◽  
Cox Regression Analysis ◽  
Effective Age

760 Background: Pts included in clinical trials represent the unusual population in mCRC. This study aims to provide oncologist with a better understanding of the potential benefit of CT with CTX in older patients with mCRC KRAS wild type and evaluate prognostic variables on the PFS including the age. Methods: Premium cancer study is a French multicentre prospective community-based registry. 493 pts enrolled and 487 included between September 2009 to March 2012 from 94 French centers and physicians. Pts had to provide written informed consent and protocol submitted to regulatory authorities. Predefined efficacy endpoints was PFS. CTX was administrated at 250 mg/m2 weekly (n=100; 20.3%) or 500 mg/m2 every 2 weeks (n=380;77,2%), other n=13; 2.5%) CT regimen choice was at physician’s discretion.. The main analysis is PFS as well as analysis of prognostic factors of this PFS (29 items including age (< 65 years n=229; 65-74 years n= 165.; ≥75years n=93). Univariate analysis was performed for each covariate, PFS was estimated by Kaplan-Meier curves and compared by log-rank test. univariable Cox regression analysis was used to assess the association between each variable and outcome. Multivariable stepwise Cox models were then fitted for final variable selection of prognostic factors on PFS. Results: Univariate significant prognostic factors for PFS are OMS (0-1 vs 2-3), Tobacco, Site of tumor (right vs other), Number of metastatic organ (1 vs 2-3), Resecability of metastatic disease defined before CT (definitively non resectable metastases vs possible resectable), Surgery of mCRC, folliculitis or xerosis or paronychia grade 0-1 vs 2-4. Age was unidentified as a prognostic factor in univariate analysis. Four factors were independently associated with a better PFS: xerosis [hazard ratio (HR0,651); 95% confidence interval (CI) 0,494-0,857], (WHO PS) 0–1 (HR0,519 ; 95% CI 0,371–0,726) and folliculitis (HR 0,711; 95% CI0,558–0,956) metastases surgery 0,287(CI 0,205-0,403). Conclusions: CTX in combination with standard CT is effective, age is not identified as a prognostic factor for the PFS. Both groups of pts based on age benefit from CTX.

Methylomic classifiers of anal cancer outcomes: An NRG Oncology / RTOG 98-11 tissue study.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 588-588
Author(s):  
Erin M. Siegel ◽  
Steven A. Eschrich ◽  
Anders E. Berglund ◽  
Abidemi O. Ajidahun ◽  
Anthony Martin Magliocco ◽  
...  
Keyword(s):  
Clinical Features ◽  
Anal Cancer ◽  
Cox Regression ◽  
Cpg Island ◽  
Statistical Significance ◽  
Methylation Status ◽  
Principal Component ◽  
Cox Proportional Hazards ◽  
Forward Selection ◽  
Cox Regression Analysis

588 Background: Genome-wide epigenetic events appear to play a role in the development and behavior of HPV+ cancers. The value of adjuvant therapy following chemoradiation for localized anal cancer (AC) remains unclear. Molecular prognostication to identify patients (pts) who may be at higher risk for recurrence would be valuable. The goal was to define methylomic profiles predictive of disease-free (DFS) and overall (OS) survival in pts with AC. Methods: Genomic DNA was extracted, processed and methylation status at ~450,000 CpG loci examined (Illumina HumanMethylation450 Array). A multistep bioinformatics methodology was applied to develop a prognostic methylomic classifier for OS and DFS: (1) feature selection for methylated regions (β-value interquartile range ≥ 0.2, ≥ 2 adjacent significant probes within a CpG Island and p < 0.05 by univariate Cox proportional hazards) (2) selected features were entered into a supervised principal component analysis (PCA) and 3 components (PC1, PC2, PC3) were derived (3) classifier was built using forward selection multivariate regression models [PC1, PC2, PC3 alone and in combination with clinical features (size: > T2 vs. ≤ T2, nodal status: N0 vs N+)] using a 10-fold cross-validation (4) final model prediction risk score was generated, dichotomized and evaluated for prognostic values in Cox regression analysis. Results: 121 AC specimens from RTOG 98-11 were examined. The methylomic-only classifier model trended towards statistical significance (log-rank p = 0.05; HR = 1.96; 95% CI 0.99-3.88) in DFS (PC1, PC3 selected). In the combined model with clinical features, the final classifier included T status and epigenetic features (PC1, PC3) and was strongly predictive for DFS (p < 0.0001, HR = 4.45; 2.02-9.76). Final OS classifier models [methylomic-only (p = 0.28 HR = 1.55; 0.70-3.44) or combined (p = 0.013 HR = 2.88; 1.20-6.89)] were not as accurate. Conclusions: Methylomic and clinical features synergize to predict DFS in AC. Multivariate modeling reveal independent contributions from clinical and methylomic variables. Epigenomic profiling may contribute to identification of high-risk pts who may benefit from adjuvant strategies. Support: U10CA180822, U10CA180868, U24CA196067

scholarly journals Five-Year Outcome of Aflibercept Monotherapy for Exudative Age-Related Macular Degeneration with Good Baseline Visual Acuity

2021 ◽  
Vol 10 (5) ◽  
pp. 1098
Author(s):  
Wataru Kikushima ◽  
Yoichi Sakurada ◽  
Atsushi Sugiyama ◽  
Seigo Yoneyama ◽  
Mio Matsubara ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Cox Regression ◽  
Median Number ◽  
Age Related Macular Degeneration ◽  
Forward Selection ◽  
Cox Regression Analysis ◽  
Exudative Amd ◽  
Protective Allele ◽  
Age Related

We investigated the long-term visual and anatomical outcomes of aflibercept monotherapy for exudative age-related macular degeneration (AMD) with good baseline best-corrected visual acuity (BCVA). A medical chart review was performed for 40 consecutive patients with baseline decimal BCVA ≥ 0.6 secondary to exudative AMD. Three monthly injections were administrated, and thereafter additional injection was performed if needed over 5 years. In total, 13 eyes with neovascular AMD (nAMD) and 27 eyes with polypoidal choroidal vasculopathy (PCV) were enrolled. In both groups, the mean BCVA significantly improved at the 12-month visit (p < 0.05). However, the significant improvement in BCVA disappeared at the 24-month visit, and the final mean BCVA was equivalent to that at baseline (p = 0.17 in the nAMD group and p = 0.15 in the PCV group). The median number of injections required after the loading dose was 15.0 during the 5-year follow-up (nAMD:15.0 vs. PCV:15). During the study period, 37 (92.5%) eyes required retreatment(s). Cox regression analysis demonstrated that the protective allele of ARMS2 A69S was associated with a retreatment-free period from the initial injection (p = 0.041, repeated forward selection method). As-needed aflibercept monotherapy is a preferable treatment option for exudative AMD with good initial visual acuity regardless of nAMD or PCV during the 5-year study period.

scholarly journals Glucose Intolerance and Cancer Risk: A Community-Based Prospective Cohort Study in Shanghai, China

2021 ◽  
Vol 11 ◽  
Author(s):  
Juzhong Ke ◽  
Tao Lin ◽  
Xiaolin Liu ◽  
Kang Wu ◽  
Xiaonan Ruan ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Glucose Intolerance ◽  
Cox Regression ◽  
Baseline Survey ◽  
Cluster Sampling ◽  
Oral Glucose ◽  
Community Based ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
Risk Of Cancer

BackgroundCancer becomes the leading cause of premature death in China. Primary objective of this study was to determine the major risk factors especially glucose intolerance for cancer prophylaxis.MethodsA cluster sampling method was applied to enroll 10,657 community-based adults aged 15-92 years in Shanghai, China in 2013. A structured questionnaire and physical examination were applied in baseline survey. Prediabetes was diagnosed using 75-g oral glucose tolerance test. After excluding 1433 subjects including 224 diagnosed with cancer before and 1 year after baseline survey, the remaining 9,224 subjects were followed-up to December 31, 2020.ResultsA total of 502 new cancer cases were diagnosed. The cancer incidence was 10.29, 9.20, and 5.95/1,000 person-years in diabetes patients, those with prediabetes, and healthy participants, respectively (p&lt;0.001). The multivariate Cox regression analysis indicated that age, prediabetes and diabetes, were associated with an increased risk of cancer in those &lt;65 years, the hazard ratios (95% confidence interval) for prediabetes and diabetes were, 1.49(1.09-2.02) and 1.51(1.12-2.02), respectively. Glucose intolerance (prediabetes and diabetes) were associated with increased risks of stomach cancer, colorectal cancer, and kidney cancer in those &lt;65 years. Anti-diabetic medications reduced the risk of cancer caused by diabetes. The multivariate Cox analysis showed that age, male, &lt;9 years of education, and current smoking were associated with increased risks of cancer in those ≥65 years independently.ConclusionsGlucose intolerance is the prominent cancer risk factor in adults &lt;65 years. Lifestyle intervention and medications to treat glucose intolerance help prevent cancer in this population.

scholarly journals Eosinophil as a Protective Cell inS. aureusVentilator-Associated Pneumonia

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Ana Rodriguez-Fernandez ◽  
David Andaluz-Ojeda ◽  
Raquel Almansa ◽  
Mar Justel ◽  
Jose Maria Eiros ◽  
...  
Keyword(s):  
Cox Regression ◽  
Wald Test ◽  
Forward Selection ◽  
Cox Regression Analysis ◽  
Icu Admission ◽  
Cell Counts ◽  
Severe Infections ◽  
Leukocyte Counts ◽  
Predicting Outcome ◽  
Eosinophil Counts

Cell counts of leukocytes subpopulations are demonstrating to have an important value in predicting outcome in severe infections. We evaluated here the render of leukogram counts to predict outcome in patients with ventilator-associated pneumonia (VAP) caused byStaphylococcus aureus. Data from patients admitted to the ICU of Hospital Clínico Universitario de Valladolid from 2006 to 2011 with diagnosis of VAP caused byS. aureuswere retrospectively collected for the study (n=44). Leukocyte counts were collected at ICU admission and also at VAP diagnosis. Our results showed that nonsurvivors had significant lower eosinophil counts at VAP diagnosis. Multivariate Cox regression analysis performed by the Wald test for forward selection showed that eosinophil increments from ICU admission to VAP diagnosis and total eosinophil counts at VAP diagnosis were protective factors against mortality in the first 28 days following diagnosis: (HR [CI 95%],P): (0.996 [0.993–0.999], 0.010); (0.370 [0.180–0.750], 0.006). Patients with eosinophil counts <30 cells/mm3at diagnosis died earlier. Eosinophil counts identified survivors: (AUROC [CI 95%],P): (0.701 [0.519–0.882], 0.042). Eosinophil behaves as a protective cell in patients with VAP caused byS. aureus.

scholarly journals Early constipation predicts faster dementia onset in Parkinson’s disease

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
M. Camacho ◽  
A. D. Macleod ◽  
J. Maple-Grødem ◽  
J. R. Evans ◽  
D. P. Breen ◽  
...  
Keyword(s):  
Cox Regression ◽  
Postural Instability ◽  
Community Based ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Universal Feature ◽  
Constipation Severity ◽  
Prognostic Implications ◽  
Dementia Onset ◽  
Categorical Scale

AbstractConstipation is a common but not a universal feature in early PD, suggesting that gut involvement is heterogeneous and may be part of a distinct PD subtype with prognostic implications. We analysed data from the Parkinson’s Incidence Cohorts Collaboration, composed of incident community-based cohorts of PD patients assessed longitudinally over 8 years. Constipation was assessed with the MDS-UPDRS constipation item or a comparable categorical scale. Primary PD outcomes of interest were dementia, postural instability and death. PD patients were stratified according to constipation severity at diagnosis: none (n = 313, 67.3%), minor (n = 97, 20.9%) and major (n = 55, 11.8%). Clinical progression to all three outcomes was more rapid in those with more severe constipation at baseline (Kaplan–Meier survival analysis). Cox regression analysis, adjusting for relevant confounders, confirmed a significant relationship between constipation severity and progression to dementia, but not postural instability or death. Early constipation may predict an accelerated progression of neurodegenerative pathology.

Sign in / Sign up

Export Citation Format

Share Document