scholarly journals A foci cohort analysis to monitor successful and persistent foci under Thailand’s Malaria Elimination Strategy

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Prayuth Sudathip ◽  
Suravadee Kitchakarn ◽  
Jui A. Shah ◽  
Donal Bisanzio ◽  
Felicity Young ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Forest Disturbance ◽  
Cohort Analysis ◽  
Information Criteria ◽  
Factors Associated ◽  
Malaria Burden ◽  
Hazards Model ◽  
Autochthonous Transmission

Abstract Background Thailand’s success in reducing malaria burden is built on the efficient “1-3-7” strategy applied to the surveillance system. The strategy is based on rapid case notification within 1 day, case investigation within 3 days, and targeted foci response to reduce the spread of Plasmodium spp. within 7 days. Autochthonous transmission is still occurring in the country, threatening the goal of reaching malaria-free status by 2024. This study aimed to assess the effectiveness of the 1-3-7 strategy and identify factors associated with presence of active foci. Methods Data from the national malaria information system were extracted from fiscal years 2013 to 2019; after data cleaning, the final dataset included 81,012 foci. A Cox’s proportional hazards model was built to investigate factors linked with the probability of becoming an active focus from 2015 to 2019 among foci that changed status from non-active to active focus during the study period. We performed a model selection technique based on the Akaike Information Criteria (AIC). Results The number of yearly active foci decreased from 2227 to 2013 to 700 in 2019 (68.5 %), and the number of autochthonous cases declined from 17,553 to 3,787 (78.4 %). The best Cox’s hazard model showed that foci in which vector control interventions were required were 18 % more likely to become an active focus. Increasing compliance with the 1-3-7 strategy had a protective effect, with a 22 % risk reduction among foci with over 80 % adherence to 1-3-7 timeliness protocols. Other factors associated with likelihood to become or remain an active focus include previous classification as an active focus, presence of Plasmodium falciparum infections, level of forest disturbance, and location in border provinces. Conclusions These results identified factors that favored regression of non-active foci to active foci during the study period. The model and relative risk map align with the national malaria program’s district stratification and shows strong spatial heterogeneity, with high probability to record active foci in border provinces. The results of the study may be useful for honing Thailand’s program to eliminate malaria and for other countries aiming to accelerate malaria elimination.

scholarly journals Longterm Outcomes of 188 Japanese Patients with Eosinophilic Granulomatosis with Polyangiitis

2018 ◽  
Vol 45 (8) ◽  
pp. 1159-1166 ◽  
Author(s):  
Aiko Saku ◽  
Shunsuke Furuta ◽  
Masaki Hiraguri ◽  
Kei Ikeda ◽  
Yoshihisa Kobayashi ◽  
...  
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Disease Onset ◽  
Japanese Patients ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Factors Associated ◽  
Hazards Model ◽  
Eosinophilic Granulomatosis ◽  
Eosinophil Counts

Objective.Patients with eosinophilic granulomatosis with polyangiitis (EGPA) frequently experience relapses, which lead to cumulative organ damage. In this retrospective observational study, we aimed to reveal the risk factors for relapse in EGPA.Methods.A total of 188 Japanese patients with EGPA diagnosed between 1996 and 2015 were identified from medical records in 10 hospitals. The diagnosis was based on the American College of Rheumatology 1990 criteria or Lanham’s criteria. Baseline characteristics, treatments, asthma exacerbation, and relapses were evaluated by retrospective chart review.Results.The median followup period was 56 months. The median age at disease onset was 59.7 years. At the disease onset, 95.2% of the patients had a history of bronchial asthma and 44.7% were positive for antineutrophil cytoplasmic antibodies. The cumulative survival and relapse-free survival rates at 5 years were 89.6% and 64.0%, respectively. Multivariate analysis with 2 models, proportional hazards, and competing risk models, was performed to identify the factors associated with relapse. The proportional hazards model identified azathioprine (AZA) maintenance therapy and high eosinophil counts at onset as independent factors with lower relapse risks, and high immunoglobulin E (IgE) levels at onset as a risk factor for relapse. The competing risk model identified no statistically significant factors.Conclusion.Although potential benefit of AZA maintenance therapy in preventing relapse of EGPA was suggested by the proportional hazards model, there was a discrepancy in the results between the models. Eosinophil counts and IgE levels at onset were also identified as candidates of factors associated with relapse in EGPA.

A Hierarchical Bayes Analysis and Comparison of PH Weibull and PH Exponential Models for One-Shot Device Testing Experiment

2021 ◽  
pp. 2150036
Author(s):  
Reema Sharma ◽  
Richa Srivastava ◽  
Satyanshu K. Upadhyay
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Real Data ◽  
Hierarchical Bayes ◽  
Information Criteria ◽  
Accelerated Life Tests ◽  
Hazards Model ◽  
Bayes Analysis ◽  
Posterior Predictive Loss ◽  
The One

The one-shot devices are highly reliable and, therefore, accelerated life tests are often employed to perform the experiments on such devices. Obviously, in the process, some covariates are introduced. This paper considers the proportional hazards model to observe the effect of covariates on the failure rates under the assumption of two commonly used models, namely the exponential and the Weibull for the lifetimes. The Bayes implementation is proposed using the hybridization of Gibbs and Metropolis algorithms that routinely extend to missing data situations as well. The entertained models are compared using the Bayesian and deviance information criteria and the expected posterior predictive loss criterion. Finally, the results based on two real data examples are given as an illustration.

scholarly journals In utero exposure to the Great Chinese Famine and risk of intracerebral hemorrhage in midlife

Neurology ◽  
2020 ◽  
Vol 94 (19) ◽  
pp. e1996-e2004
Author(s):  
Yun Li ◽  
Yanping Li ◽  
M. Edip Gurol ◽  
Yesong Liu ◽  
Peng Yang ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cohort Analysis ◽  
In Utero ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
In Utero Exposure ◽  
Hazards Model ◽  
Record Review

ObjectiveTo investigate whether in utero exposure to the Great Chinese Famine in 1959 to 1961 was associated with risk of intracerebral hemorrhage (ICH) in adulthood.MethodsIn this cohort analysis, we included 97,399 participants of the Kailuan Study who were free of cardiovascular disease and cancer at baseline (2006). Cases of incident ICH were confirmed by medical record review. We used the Cox proportional hazards model to calculate the hazard ratio (HR) and 95% confidence interval (CI) for ICH according to in utero famine exposure status.ResultsAmong 97,399 participants in the current analyses, 6.3% (n = 6,160) had been prenatally exposed to the Great Chinese Famine. During a median 9.0 years of follow-up (2006–2015), we identified 724 cases of incident ICH. After adjustment for potential confounders, the HR of ICH was 1.99 (95% CI 1.39–2.85) for in utero famine-exposed individuals vs individuals who were not exposed to the famine. When exposure to famine and severity of famine were examined jointly, the adjusted HR was 2.99 (95% CI 1.21–7.39) for in utero exposure to severe famine and 1.94 (95% CI 1.32–2.84) for in utero exposure to less severe famine relative to those without exposure to famine.ConclusionsIndividuals with in utero exposure to famine, especially those exposed to severe famine, were more likely to have ICH in midlife, highlighting the role of nutritional factors in susceptibility to this severe cerebral condition.

scholarly journals Unplanned Reoperation After Trapeziometacarpal Arthroplasty: Rate, Reasons, and Risk Factors

Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. 446-452 ◽  
Author(s):  
Suzanne C. Wilkens ◽  
Zichao Xue ◽  
Jos J. Mellema ◽  
David Ring ◽  
Neal Chen
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Regression ◽  
Persistent Pain ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Cox Regression Analysis ◽  
Factors Associated ◽  
Hazards Model ◽  
Kaplan Meier

Background: Trapeziometacarpal (TMC) arthritis is an expected part of ageing to which most patients adapt well. Patients who do not adapt to TMC arthritis may be offered operative treatment. The factors associated with reoperation after TMC arthroplasty are incompletely understood. The purpose of this study was to determine the rate of, the underlying reasons for, and the factors associated with unplanned reoperation after TMC arthroplasty. Methods: In this retrospective study, we included all adult patients who had TMC arthroplasty for TMC arthritis at 1 of 3 large urban area hospitals between January 2000 and December 2009. Variables were inserted into a multivariable Cox proportional hazards model to determine factors associated with unplanned reoperation, and the Kaplan-Meier curve was used to estimate and describe the probability of unplanned reoperation over time. Results: Among 458 TMC arthroplasties, 19 (4%) had an unplanned reoperation; 16 of 19 (84%) for persistent pain and two-thirds within the first year. The multivariate Cox regression analysis showed that unplanned reoperation was independently associated with younger age, surgeon inexperience, and index procedure type. Conclusions: Surgeons should be aware as well as patients should be informed that as many as 4% are offered or request a second surgery, usually for persistent pain and often within the 1-year window when additional improvement is anticipated.

scholarly journals 442. Sex-Related Differences in Mortality from COVID-19: Survival Analysis of Patients from an Urban Hospital

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S323-S323
Author(s):  
Mamta Sharma ◽  
Susan M Szpunar ◽  
Ashish Bhargava ◽  
Leonard B Johnson ◽  
Louis Saravolatz
Keyword(s):  
Risk Factors ◽  
Survival Analysis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Factors Associated ◽  
Hazards Model ◽  
Cox Proportional Hazards Models ◽  
Failure Assessment

Abstract Background Mortality from COVID-19 is associated with male sex, older age, black race, and comorbidities including obesity. Our study identified risk factors for in-hospital mortality from COVID-19 using survival analysis at an urban center in Detroit, MI. Methods This was a single-center historical cohort study. We reviewed the electronic medical records of patients positive for severe acute respiratory syndrome coronavirus 2 (the COVID-19 virus) on qualitative polymerase-chain-reaction assay, who were admitted between 3/8-6/14/20. We assessed risk factors for mortality using Kaplan-Meier analysis and Cox proportional hazards models. Results We included 565 patients with mean age (standard deviation) 64.4 (16.2) years, 52.0% male (294) and 77.2% (436) black/African American. The overall mean body mass index (BMI) was 32.0 (9.02) kg/m2. At least one comorbidity was present in 95.2% (538) of patients. The overall case-fatality rate was 30.4% (172/565). The unadjusted mortality rate among males was 33.7% compared to 26.9% in females (p=0.08); the median time to death (range) for males was 16.8 (0.3, 33.9) compared to 14.2 (0.32, 47.7) days for females (p=0.04). Univariable survival analysis with Cox proportional hazards models revealed that age (p=< 0.0001), admission from a facility (p=0.002), public insurance (p< 0.0001), respiratory rate ≥ 22 bpm (p=0.02), lymphocytopenia (p=0.07) and serum albumin (p=0.007) were additional risk factors for mortality (Table 1). From multivariable Cox proportional hazards modeling (Table 2), after controlling for age, Charlson score and qSofa, males were 40% more likely to die than females (p=0.03). Table 1. Univariate analysis with Cox proportional hazards model on factors associated with mortality in patients with COVID-19 Abbreviations: HR: Hazard ratio, CI: Confidence interval Table 2. Multivariable analysis with Cox proportional hazards model on factors associated with mortality in patients with COVID-19 Abbreviations: HR: Hazard ratio, CI: Confidence interval, CWIC: Charlson weighted index of comorbidity, qSOFA: Quick sepsis related organ failure assessment Conclusion After controlling for risk factors for mortality including age, comorbidity and sepsis-related organ failure assessment, males continued to have a higher hazard of death. These demographic and clinical factors may help healthcare providers identify risk factors from COVID-19. Disclosures All Authors: No reported disclosures

scholarly journals Understanding the Correlates of Under-five Mortality in Sudan Using Survey Survival Models

2020 ◽  
pp. 55-68
Author(s):  
Dawit Getnet Ayele ◽  
Ali Satty ◽  
Temesgen Zewotir
Keyword(s):  
Public Health ◽  
Child Mortality ◽  
Urban Areas ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Under Five ◽  
Factors Associated ◽  
Hazards Model

Under-five mortality is among the major public health problems in developing countries, the rate of which is an important factor for a country’s development. For this reason, under-five mortality status is an important outcome to measure for children’s health. This study uses the Cox proportional-hazards model to identify risk factors associated with under-five mortality in Sudan. This study uses the 2014 Sudan Multiple Indicator Cluster Survey (MICS) conducted by the Central Bureau of Statistics in collaboration with several national institutions. The survival Cox proportional-hazards model was used to identify factors that affect under-five child mortality in Sudan. The results show that the weight of a child at birth is positively associated with the under-five child mortality rate. Under-five children who have both small and large weights at birth are at a higher risk of dying before reaching five years. Based on demographic factors associated with under-five mortality, our analysis showed that mothers who were married at the time of the survey are most likely to have higher under-five child mortality as compared to formerly married mothers. In addition to this, that mother’s age at the time of the birth is significantly associated with under-five mortality. Based on the result, the lack of important policies targeting the reduction of socioeconomic inequalities between rural and urban areas is the major problem of public health interventions to improve child health and survival in Sudan.

Predictors of falls and fractures in patients (pts) with nonmetastatic castration-resistant prostate cancer (nmCRPC) treated with apalutamide (APA) plus ongoing androgen deprivation therapy (ADT).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5025-5025 ◽  
Author(s):  
YaoYao Guan Pollock ◽  
Matthew Raymond Smith ◽  
Fred Saad ◽  
Simon Chowdhury ◽  
Stephane Oudard ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Older Age ◽  
Free Survival ◽  
Factors Associated ◽  
Hazards Model ◽  
Low Serum

5025 Background: SPARTAN, a phase 3 study of APA vs placebo (PBO) added to ongoing ADT in pts with nmCRPC, demonstrated that APA significantly prolongs metastasis-free survival, time to symptomatic progression, and second progression free survival (Smith et al. NEJM 2018), with no decline in health-related quality of life (Saad et al. Lancet Oncol 2018). SPARTAN pts who received APA, vs PBO, with ongoing ADT had higher rates of falls (15.6% vs 9.0%) and fractures (11.7% vs 6.5%). An analysis was performed to identify clinical characteristics associated with falls and fractures in APA-treated SPARTAN pts. Methods: Of 1207 pts enrolled, 806 were randomized to APA. Univariate Cox proportional hazards model (UVA) assessed the association of 47 baseline clinical characteristics (demographics, comorbidities, and medication use, including bone-sparing agents) with time to fall or time to fracture. Characteristics with p values < 0.10 were included in a multivariate Cox proportional hazards model (MVA) to determine independent factors associated with these outcomes (p < 0.05). Results: Factors associated with time to both fall and fracture on UVA (p < 0.10) included older age, low serum albumin, and poor ECOG performance status (PS). Additional factors associated with time to fall were cerebrovascular accidents/transient ischemic attacks, neuropathy, depression, α-blocker use, and antidepressant use. On MVA, older age, poor ECOG PS, history of neuropathy, and α-blocker use were independently associated with falls; older age and low serum albumin were independently associated with fractures (Table). Conclusions: At initiation of APA added to ongoing ADT, nmCRPC pts with higher risk of falls and fractures can be identified and are candidates for intervention to reduce the risk for these events. Clinical trial information: NCT01946204. [Table: see text]

scholarly journals Factors associated with the incidence of pressure ulcer during hospital stay

2017 ◽  
Vol 51 (0) ◽  
Author(s):  
Fernanda Penido Matozinhos ◽  
Gustavo Velasquez-Melendez ◽  
Sabrina Daros Tiensoli ◽  
Alexandra Dias Moreira ◽  
Flávia Sampaio Latini Gomes
Keyword(s):  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Hypothesis Test ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Factors Associated ◽  
Hazards Model ◽  
Braden Scale

Abstract OBJECTIVE Estimating the incidence rate of pressure ulcers and verifying factors associated with this occurrence in a cohort of hospitalized patients. METHOD This is a cohort study in which the considered outcome was the time until pressure ulcer occurrence. Estimated effect of the variables on the cumulative incidence ratio of the outcome was performed using the Cox proportional hazards model. Variable selection occurred via the Logrank hypothesis test. RESULTS The sample consisted of 442 adults, with 25 incidents of pressure ulcers. Patients with high scores on the Braden scale presented a higher risk of pressure ulcer incidence when compared to those classified into the low score category. CONCLUSION These results reinforce the importance of using the Braden Scale to assist in identifying patients more likely to develop pressure ulcers.

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