A robust hazard ratio for general modeling of survival-times

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Pablo Martínez-Camblor ◽  
Todd A. MacKenzie ◽  
A. James O’Malley
Keyword(s):  
Cox Regression ◽  
Finite Sample ◽  
Survival Times ◽  
Time To Event ◽  
Real Model ◽  
Hazard Ratios ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship ◽  
Event Variable

Abstract Hazard ratios (HR) associated with the well-known proportional hazard Cox regression models are routinely used for measuring the impact of one factor of interest on a time-to-event outcome. However, if the underlying real model does not fit with the theoretical requirements, the interpretation of those HRs is not clear. We propose a new index, gHR, which generalizes the HR beyond the underlying survival model. We consider the case in which the study factor is a binary variable and we are interested in both the unadjusted and adjusted effect of this factor on a time-to-event variable, potentially, observed in a right-censored scenario. We propose non-parametric estimations for unadjusted gHR and semi-parametric regression-induced techniques for the adjusted case. The behavior of those estimators is studied in both large and finite sample situations. Monte Carlo simulations reveal that both estimators provide good approximations of their respective inferential targets. Data from the Health and Lifestyle Study are used for studying the relationship of the tobacco use and the age of death and illustrate the practical application of the proposed technique. gHR is a promising index which can help facilitate better understanding of the association of one study factor on a time-dependent outcome.

scholarly journals Sexual Effect of Platelet-to-Lymphocyte Ratio in Predicting Cardiovascular Mortality of Peritoneal Dialysis Patients

2022 ◽  
Vol 2022 ◽  
pp. 1-9
Author(s):  
Hui Sheng ◽  
Yagui Qiu ◽  
Xi Xia ◽  
Chunyan Yi ◽  
Jianxiong Lin ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Cox Proportional Hazards ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Relationship Of ◽  
The Relationship ◽  
Cvd Mortality

Background. The study is aimed at exploring the relationship of platelet-to-lymphocyte (PLR), all-cause, and cardiovascular disease (CVD) mortality in peritoneal dialysis (PD) patients based on gender. Methods. A total of 1438 PD patients from January 1,2007 to December 31, 2014 in PD center at The First Affiliated Hospital, Sun Yat-sen University, were included. Patients were followed up until December 31, 2019. The endpoint was all-cause mortality and CVD mortality. Cox proportional hazards regression models were used to evaluate the association of PLR with all-cause and CVD mortality to calculate hazard ratios (HR) and 95% confidence intervals (CI). Results. After a median of 48.9 (interquartile range [IQR]: 23.4-79.3) months of follow-up, 406 (28.2%) patients died based on all-cause death, among which 200 (49.3%) patients died from CVD. In the multivariate Cox regression model, we found that PLR was independently related to an increased risk of CVD mortality only in female PD patients, with HR of 1.003 (95% CI: 1.001-1.006). Interaction test showed that the correlation between PLR level for all-cause and CVD mortality varied with gender ( p = 0.042 and p = 0.012 , respectively). Conclusion. Higher PLR was associated with a higher risk of CVD mortality in female PD patients.

Business: Making Cents of Coding Systems: Billing for Professional Services

2010 ◽  
Vol 20 (1) ◽  
pp. 3-8
Author(s):  
Dee Adams Nikjeh
Keyword(s):  
Professional Services ◽  
Speech Language Pathology ◽  
Coding Systems ◽  
Language Pathology ◽  
Program Funding ◽  
Fee Schedule ◽  
Procedure Codes ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

Abstract Administrators and supervisors face daily challenges over issues such as program funding, service fees, correct coding procedures, and the ever-changing healthcare regulations. Receiving equitable reimbursement for speech-language pathology and audiology services necessitates an understanding of federal coding and reimbursement systems. This tutorial provides information pertaining to two major healthcare coding systems and explains the relationship of these systems to clinical documentation, the Medicare Physician Fee Schedule and equitable reimbursement. An explanation of coding edits and coding modifiers is provided for use in those occasional atypical situations when the standard use of procedural coding may not be appropriate. Also included in this tutorial is a brief discussion of the impact that the Medicare Improvements for Patients and Providers Act of 2008 (HR 6331 Medicare Improvements for Patients and Providers Act [MIPPA], 2008) has had on the valuation of speech-language pathology procedure codes.

scholarly journals The Relationship of CSR Communication on Social Media with Consumer Purchase Intention and Brand Admiration

2021 ◽  
Vol 16 (5) ◽  
pp. 1217-1230
Author(s):  
Shuchi Gupta ◽  
Nishad Nawaz ◽  
Adel Abdulmhsen Alfalah ◽  
Rana Tahir Naveed ◽  
Saqib Muneer ◽  
...  
Keyword(s):  
Social Media ◽  
Purchase Intention ◽  
Structural Equation ◽  
Mediating Effect ◽  
Equation Modeling ◽  
Csr Communication ◽  
Consumer Purchase Intention ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

With the advent of the Internet and other digital technologies, contemporary businesses from all sectors are using social media for communication with consumers to engage them meaningfully with a brand. However, the use of social media for corporate social responsibility (CSR) communication is relatively new to the existing literature. Likewise, the impact of CSR communication through social media (CSR-S) on consumer emotions and behavior is, to date, underexplored. To address this, the present research aims to test the relationship of CSR-S on brand admiration and consumer purchase intention. The study proposes a direct relationship between CSR-S and purchase intention with a mediating effect of brand admiration. The data were collected from the banking consumers of Pakistan through a self-administered questionnaire. The authors distributed 800 questionnaires and received 463 questionnaires useful for data analysis, so the present research study response rate was around 59%. The data were analyzed using the structural equation modeling (SEM) technique in AMOS. The results revealed that CSR-S is positively related to purchase intention (β = 0.233). The results further showed that brand admiration partially mediates this relationship (β = 0.079). The survey respondents confirmed that their bank’s CSR communication helps enhance their purchase likelihood and their feelings of admiration for their bank. These findings will help policymakers at banking institutions better understand the importance of CSR communication on different social media platforms to achieve consumer-related outcomes.

scholarly journals Ethics of Retailers and Consumer Behavior in E-Commerce

2020 ◽  
Vol 11 (1) ◽  
pp. 107-126
Author(s):  
Zhi Yang ◽  
Quang Van Ngo ◽  
Chung Xuan Thi Nguyen
Keyword(s):  
Electronic Commerce ◽  
Communication Technology ◽  
Purchase Intention ◽  
Purchase Decision ◽  
Information Communication ◽  
Significant Relationships ◽  
Online Retailers ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

In the era of the information-communication technology with the development of electronic commerce, consumers can buy almost everything anywhere and at any time. One of the greatest benefits of e-commerce has been the convenience and the vast choices which consumers get online. However, some serious issues exist that impede consumers from transaction online. These issues have attracted the attention of many marketing researchers in recent years. In this research, the authors focus on the impact of consumers' ethics perception of e-retailer on their purchase intention and satisfaction. The authors also try to clarify the roles of trust and commitment in the relationship of ethics on consumers purchase decision and satisfaction because of their importance in e-commerce but also the privation in the research of previous studies. The data collected from a survey of 390 online consumers in Vietnam. Results reveal that there are significant relationships between online retailers' ethics and consumers' purchase intention and satisfaction via the mediation of trust and commitment.

The impact of tinnitus characteristics and associated variables on tinnitus-related handicap

2015 ◽  
Vol 130 (1) ◽  
pp. 25-31 ◽  
Author(s):  
S Degeest ◽  
P Corthals ◽  
I Dhooge ◽  
H Keppler
Keyword(s):  
Additional Insight ◽  
Tinnitus Handicap Inventory ◽  
Hearing Status ◽  
Questionnaire Score ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship ◽  
Sample Case ◽  
Insight Into ◽  
Associated Variables

AbstractObjective:This study aimed to determine the characteristics of tinnitus and tinnitus-related variables and explore their possible relationship with tinnitus-related handicap.Methods:Eighty-one patients with chronic tinnitus were included. The study protocol measured hearing status, tinnitus pitch, loudness, maskability and loudness discomfort levels. All patients filled in the Tinnitus Sample Case History Questionnaire, the Hyperacusis Questionnaire and the Tinnitus Handicap Inventory. The relationship of each variable with the Tinnitus Handicap Inventory score was evaluated by univariate and multivariate analyses.Results:Five univariables were associated with the Tinnitus Handicap Inventory score: loudness discomfort level, subjective tinnitus loudness, tinnitus awareness, noise intolerance and Hyperacusis Questionnaire score. Multiple regression analysis showed that the Hyperacusis Questionnaire score and tinnitus awareness were independently associated with the Tinnitus Handicap Inventory score.Conclusion:Hyperacusis and tinnitus awareness were independently associated with the Tinnitus Handicap Inventory score. Questionnaires on tinnitus and hyperacusis are especially suited to providing additional insight into tinnitus-related handicap and are therefore useful for evaluating tinnitus patients.

scholarly journals Impact of Authoritative and Laissez-Faire Leadership on Thriving at Work: The Moderating Role of Conscientiousness

2021 ◽  
Vol 11 (3) ◽  
pp. 667-685
Author(s):  
Zulfiqar Ahmed Iqbal ◽  
Ghulam Abid ◽  
Muhammad Arshad ◽  
Fouzia Ashfaq ◽  
Muhammad Ahsan Athar ◽  
...  
Keyword(s):  
Leadership Style ◽  
Positive Impact ◽  
Work Relationship ◽  
Laissez Faire ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship ◽  
Moderating Role ◽  
Thriving At Work

This study empirically investigates the less discussed catalytic effect of personality in the relationship of leadership style and employee thriving at work. The growth and sustainability of the organization is linked with the association of leadership style and employee thriving at the worplace. The objectives of this study are to explore the impact of authoritative and laissez-faire leadership styles and the moderating role of the personality trait of conscientiousness on thriving in the workplace. A sample of 312 participants was taken from a leading school system with its branches in Lahore and Islamabad, Pakistan. The participants either worked as managers, teachers in headquarters, or school campuses, respectively. The regression results of the study show that authoritative leadership and conscientiousness have a significantly positive impact on thriving at work. Furthermore, conscientiousness moderates the relationship between laissez-faire style of leadership and thriving at work relationship. The findings of this study have theoretical implications for authoritative and laissez-faire leadership, employee conscientiousness, and managerial applications for the practitioners.

The impact of Traditional Chinese Medicine on mitophagy in disease models

2021 ◽  
Vol 27 ◽  
Author(s):  
Li-Ping Yu ◽  
Ting-Ting Shi ◽  
Yan-Qin Li ◽  
Jian-Kang Mu ◽  
Ya-Qin Yang ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Molecular Mechanisms ◽  
Human Diseases ◽  
Regulatory Mechanisms ◽  
Disease Models ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

: Mitophagy plays an important role in maintaining mitochondrial quality and cell homeostasis through the degradation of damaged, aged, and dysfunctional mitochondria and misfolded proteins. Many human diseases, particularly neurodegenerative diseases, are related to disorders of mitochondrial phagocytosis. Exploring the regulatory mechanisms of mitophagy is of great significance for revealing the molecular mechanisms underlying the related diseases. Herein, we summarize the major mechanisms of mitophagy, the relationship of mitophagy with human diseases, and the role of traditional Chinese medicine (TCM) in mitophagy. These discussions enhance our knowledge of mitophagy and its potential therapeutic targets using TCM.

Understanding Learning Environments, Personality, and Proctoring During Mandatory Remote Delivery

2021 ◽  
Vol 65 (1) ◽  
pp. 767-770
Author(s):  
Nancy J. Stone
Keyword(s):  
Online Learning ◽  
Online Education ◽  
Learning Environments ◽  
Online Survey ◽  
Campus Housing ◽  
Learning Success ◽  
Time Required ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

To evaluate students’ online learning environments, the relationship between personality and online learning success, and students’ perceptions about online proctoring during mandatory remote delivery due to the pandemic, students responded to an online survey. Learning environments generally included houses and rarely included on-campus housing. The specific room type was predominantly the bedroom. Only conscientiousness was related positively to anticipated semester GPA. The positive relationship between anticipated and overall GPA supports the notion that more conscientious students tend to be successful in online learning situations, as online education was rated as slightly ineffective. A majority of students did not see a need for online proctoring due to the inability or time required to search for materials, which would only harm one’s performance. There is a need to research further the impact of the study environment, relationship of the students’ personality to learning success, and consequences of online proctoring during remote learning.

Sequential monitoring of PD-L1 on circulating stromal cells in blood predicts PFS in NSCLC patients undergoing immunotherapy after definitive chemoradiation.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 8534-8534
Author(s):  
Daniel L Adams ◽  
Alexander Augustyn ◽  
Jianzhong He ◽  
Yawei Qiao ◽  
Ting Xu ◽  
...  
Keyword(s):  
Stromal Cells ◽  
Progression Free Survival ◽  
Free Survival ◽  
Hazard Ratios ◽  
Fda Approval ◽  
Inflammatory State ◽  
Nsclc Patients ◽  
Tumor Biopsies ◽  
Relationship Of ◽  
The Relationship

8534 Background: Cancer Associated Macrophage-Like cells (CAMLs) are circulating stromal cells in the blood of patients (pts) with solid tumors that are phagocytic macrophages that may represent the inflammatory state of the tumor microenvironment. Previously, we demonstrated CAMLs ≥50µm after chemo-radiation therapy (CRT) in NSCLC is associated with worse progression free survival (PFS) and overall survival (OS). We also showed that PDL1 expression in CAMLs is dynamic & can change with CRT, difficult to assess with repeat biopsies, but possible with liquid biopsy. For this study we evaluated whether CAML properties can predict response to CRT with/without immunotherapy (IMT) agents in unresectable NSCLC. Methods: A single blind multi-year prospective study was undertaken to test the relationship of PDL1 expression and ≥50µm CAML size to PFS/OS in NSCLC, pre and post CRT with (n = 96) and without (n = 72) anti-PDL1/PD1 IMT. This included atezolizumab (prospective single arm NCT02525757) n = 39, durvalumab n = 52 or pembrolizumab n = 5 both after 2018 FDA approval. We recruited 168 pts with pathologically confirmed unresectable NSCLC prior to CRT. Blood samples 15 mL were taken at baseline (BL), CRT completion (T1), and ̃1 month after CRT (T2) (with n = 96 or without n = 72 IMT). Blood was filtered by CellSieve filtration and CAMLs quantified for size ( < 49 µm or ≥50 µm) and PDL1 expression to evaluate PFS and OS hazard ratios (HRs) by censored univariate and multivariate analysis at 24 months. Results: CAMLs were found in 90% of all samples, average 5.8 CAMLs/15mL. At BL, ≥50µm CAMLs did not predict PFS in CRT/IMT pts (HR 1.6, p = 0.220) nor CRT alone (HR 1.3, p = 0.593). However, after completion of CRT (T1) ≥50µm CAMLs predicted PFS in CRT/IMT pts (HR 2.7, p = 0.003) and CRT alone (HR 2.5, p = 0.015). In primary tumor biopsies, PDL1 expression > 1% did not predict CRT/IMT response (PFS HR 1.8, p = 0.262 & OS HR 2.3, p = 0.158). At BL, high CAML PDL1 did not predict PFS in CRT/IMT pts (HR 1.4, p = 0.427) nor CRT alone (HR 1.1, p = 0.982). Further, at CRT completion (T1), high CAML PDL1 only trended for better PFS in CRT/IMT pts (HR 1.7, p = 0.137), but not CRT alone (HR 1.1, p = 0.972). At T2, however, pts with continuously high CAML PDL1 had significantly better PFS with IMT (HR 3.2, p = 0.002) vs CRT alone (HR 1.4, p = 0.616). While ≥50µm CAMLs at BL did not predict 24 month progression, ≥50 µm CAMLs after CRT (with or without 1 cycle of anti-PDL1 IMT) was 84% accurate at predicting progression. Further subtyping and analysis is ongoing to evaluate OS and PDL1 in the CAML populations. Conclusions: Our data suggests that in unresectable NSCLC, ≥50 µm CAMLs after completion of CRT is prognostic regardless of IMT use. PDL1 expression in CAMLs also appears to predict for response to consolidated IMT after CRT. Additional studies are needed to validate these findings.

H3K27M-mutant Diffuse Midline Gliomas should be Further Molecularly Stratified: An Integrated Analysis of 669 Patients

2021 ◽  
Author(s):  
Huy Gia Vuong ◽  
Hieu Trong Le ◽  
Tam N.M. Ngo ◽  
Kar-Ming Fung ◽  
James D. Battiste ◽  
...  
Keyword(s):  
Cox Regression ◽  
Fatal Outcome ◽  
Extent Of Resection ◽  
Tumor Location ◽  
Genetic Alterations ◽  
Integrated Analysis ◽  
Prognostic Impact ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
The Impact

Abstract Introduction: H3K27M-mutated diffuse midline gliomas (H3-DMGs) are aggressive tumors with a fatal outcome. This study integrating individual patient data (IPD) from published studies aimed to investigate the prognostic impact of different genetic alterations on survival of these patients.Methods: We accessed PubMed and Web of Science to search for relevant articles. Studies were included if they have available data of follow-up and additional molecular investigation of H3-DMGs. For survival analysis, Kaplan-Meier analysis and Cox regression models were utilized, and corresponding hazard ratios (HR) and 95% confidence intervals (CI) were computed to analyze the impact of genetic events on overall survival (OS).Result: We included 30 studies with 669 H3-DMGs. TP53 mutations were the most common second alteration among these neoplasms. In univariate Cox regression model, TP53 mutation was an indicator of shortened survival (HR = 1.446; 95% CI = 1.143-1.829) whereas ACVR1 (HR = 0.712; 95% CI = 0.518-0.976) and FGFR1 mutations (HR = 0.408; 95% CI = 0.208-0.799) conferred prolonged survival. In addition, ATRX loss was also associated with a better OS (HR = 0.620; 95% CI = 0.386-0.996). Adjusted for age, gender, tumor location, and the extent of resection, the presence of TP53 mutations, the absence of ACVR1 or FGFR1 mutations remained significantly poor prognostic factors.Conclusions: We outlined the prognostic importance of additional genetic alterations in H3-DMGs and recommended that these neoplasms should be further molecularly segregated. It could help neuro-oncologists better evaluate the risk stratification of patients and consider pertinent treatments.

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