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Zhang, Fanchang, Jingyang Yang, Chuanhui Li, Dong Li, and Yang Gao. "Direct inversion for reservoir parameters from prestack seismic data." Journal of Geophysics and Engineering 17, no. 6 (October 24, 2020): 993–1004. http://dx.doi.org/10.1093/jge/gxaa058.
Повний текст джерелаАнотація:
Abstract Reliably estimating reservoir parameters is the final target in reservoir characterisation. Conventionally, estimating reservoir characters from seismic inversion is implemented by indirect approaches. The indirect estimation of reservoir parameters from inverted elastic parameters, however, will produce large bias due to the propagation of errors in the procedure of inversion. Therefore, directly obtaining reservoir parameters from prestack seismic data through a rock-physical model and prestack amplitude variation with offset (AVO) inversion is proposed. A generalised AVO equation in terms of oil-porosity (OP), sand indicator (SI) and density is derived by combining a physical rock model and the Aki–Richards equation in a whole system. This makes it possible to perform direct inversion for reservoir parameters. Next, under Bayesian theorem, we develop a robust prestack inversion approach based on the new AVO equation. Tests on synthetic seismic gathers show that it can dramatically reduce the prediction error of reservoir parameters. Furthermore, field data application illustrates that reliable reservoir parameters can be directly obtained from prestack inversion.
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Curtin, François. "Meta-analysis combining parallel and crossover trials using generalised estimating equation method." Research Synthesis Methods 8, no. 3 (June 5, 2017): 312–20. http://dx.doi.org/10.1002/jrsm.1242.
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Purnomo, Jerry Dwi Trijoyo, Chih-Rung Chen, and Guan-Hua Huang. "A Modified Model-Selection Criteria in a Generalised Estimating Equation for Latent Class Regression Models." MATEMATIKA 35, no. 2 (July 31, 2019): 201–11. http://dx.doi.org/10.11113/matematika.v35.n2.1175.
Повний текст джерелаАнотація:
In recent years, generalised estimating equations (GEEs) have played an important role in many fields of research, such as biomedicine. In this paper, we use GEEs for latent class regression (LCR) with covariate effects on underlying and measured variables. However, there are only a few model-selection criteria in GEEs. The widely known Akaike information criterion (AIC) cannot be used directly, since AIC is a full likelihood-based model, whereas GEEs are nonlikelihood based. Hence, we propose a modification to AIC in GEEs for (LCR) models, where the likelihood is replaced by quasi-likelihood, and a proper adjustment is made by giving a penalty term. The data of the modified hospital elder life program (mHELP) project are used to illustrate our method.
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SPEYBROECK, N., F. BOELAERT, D. RENARD, T. BURZYKOWSKI, K. MINTIENS, G. MOLENBERGHS, and D. L. BERKVENS. "Design-based analysis of surveys: a bovine herpesvirus 1 case study." Epidemiology and Infection 131, no. 2 (October 2003): 991–1002. http://dx.doi.org/10.1017/s095026880300102x.
Повний текст джерелаАнотація:
This paper critically assesses the design implications for the analysis of surveys of infections. It indicates the danger of not accounting for the study design in the statistical investigation of risk factors. A stratified design often implies an increased precision while clustering of infection results in a decreased precision. Through pseudo-likelihood estimation and linearisation of the variance estimator, the design effects can be taken into account in the analysis. The intra-cluster-correlation can be investigated through a logistic random effect model and a generalised estimating equation (GEE), allowing the investigation of the extent of spread of infections in a herd (cluster). The advantage of using adaptive Gaussian quadrature in a logistic random effect model is discussed. Applicable software is briefly reviewed. The methods are illustrated with data from a bovine herpesvirus 1 (BHV-1) serosurvey of Belgian cattle.
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Hurst, Yumi, and Haruhisa Fukuda. "Effects of changes in eating speed on obesity in patients with diabetes: a secondary analysis of longitudinal health check-up data." BMJ Open 8, no. 1 (January 2018): e019589. http://dx.doi.org/10.1136/bmjopen-2017-019589.
Повний текст джерелаАнотація:
ObjectiveFew studies have examined the causal relationships between lifestyle habits and obesity. With a focus on eating speed in patients with type 2 diabetes, this study aimed to analyse the effects of changes in lifestyle habits on changes in obesity using panel data.MethodsPatient-level panel data from 2008 to 2013 were generated using commercially available insurance claims data and health check-up data. The study subjects comprised Japanese men and women (n=59 717) enrolled in health insurance societies who had been diagnosed with type 2 diabetes during the study period. Body mass index (BMI) was measured, and obesity was defined as a BMI of 25 or more. Information on lifestyle habits were obtained from the subjects’ responses to questions asked during health check-ups. The main exposure of interest was eating speed (‘fast’, ‘normal’ and ‘slow’). Other lifestyle habits included eating dinner within 2 hours of sleeping, after-dinner snacking, skipping breakfast, alcohol consumption frequency, sleep adequacy and tobacco consumption. A generalised estimating equation model was used to examine the effects of these habits on obesity. In addition, fixed-effects models were used to assess these effects on BMI and waist circumference.ResultsThe generalised estimating equation model showed that eating slower inhibited the development of obesity. The ORs for slow (0.58) and normal-speed eaters (0.71) indicated that these groups were less likely to be obese than fast eaters (P<0.001). Similarly, the fixed-effects models showed that eating slower reduced BMI and waist circumference. Relative to fast eaters, the coefficients of the BMI model for slow and normal-speed eaters were −0.11 and −0.07, respectively (P<0.001).DiscussionChanges in eating speed can affect changes in obesity, BMI and waist circumference. Interventions aimed at reducing eating speed may be effective in preventing obesity and lowering the associated health risks.
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Gibb, Sheree J., David M. Fergusson, and L. John Horwood. "Relationship duration and mental health outcomes: findings from a 30-year longitudinal study." British Journal of Psychiatry 198, no. 1 (January 2011): 24–30. http://dx.doi.org/10.1192/bjp.bp.110.083550.
Повний текст джерелаАнотація:
BackgroundMarriage is known to be associated with improved mental health, but little research has examined whether the duration of a cohabiting relationship is associated with mental health.AimsTo examine the associations between relationship duration and mental health problems in a birth cohort of 30-year-olds.MethodAssociations between relationship duration and mental health were examined using a generalised estimating equation approach. Associations were adjusted for covariates, including prior mental health problems.ResultsLonger relationship duration was significantly associated with lower rates of depression, suicidal behaviour and substance abuse/dependence, even after adjustment for covariates. In most cases the associations did not vary with gender. Legal relationship status (legally or de facto married) was not significantly related to mental health once due allowance was made for relationship duration.ConclusionsIncreasing relationship duration, but not legal relationship status, has a protective effect on mental health for men and women.
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Campa, Francesco, Catarina N. Matias, Tatiana Moro, Giuseppe Cerullo, Andrea Casolo, Filipe J. Teixeira, and Antonio Paoli. "Methods over Materials: The Need for Sport-Specific Equations to Accurately Predict Fat Mass Using Bioimpedance Analysis or Anthropometry." Nutrients 15, no. 2 (January 5, 2023): 278. http://dx.doi.org/10.3390/nu15020278.
Повний текст джерелаАнотація:
Bioelectrical impedance analysis (BIA) and anthropometry are considered alternatives to well-established reference techniques for assessing body composition. In team sports, the percentage of fat mass (FM%) is one of the most informative parameters, and a wide range of predictive equations allow for its estimation through both BIA and anthropometry. Although it is not clear which of these two techniques is more accurate for estimating FM%, the choice of the predictive equation could be a determining factor. The present study aimed to examine the validity of BIA and anthropometry in estimating FM% with different predictive equations, using dual X-ray absorptiometry (DXA) as a reference, in a group of futsal players. A total of 67 high-level male futsal players (age 23.7 ± 5.4 years) underwent BIA, anthropometric measurements, and DXA scanning. Four generalized, four athletic, and two sport-specific predictive equations were used for estimating FM% from raw bioelectric and anthropometric parameters. DXA-derived FM% was used as a reference. BIA-based generalized equations overestimated FM% (ranging from 1.13 to 2.69%, p < 0.05), whereas anthropometry-based generalized equations underestimated FM% in the futsal players (ranging from −1.72 to −2.04%, p < 0.05). Compared to DXA, no mean bias (p > 0.05) was observed using the athletic and sport-specific equations. Sport-specific equations allowed for more accurate and precise FM% estimations than did athletic predictive equations, with no trend (ranging from r = −0.217 to 0.235, p > 0.05). Regardless of the instrument, the choice of the equation determines the validity in FM% prediction. In conclusion, BIA and anthropometry can be used interchangeably, allowing for valid FM% estimations, provided that athletic and sport-specific equations are applied.
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Chih, An-Hsuan, Yang-Ching Chen, Yu-Kang Tu, Kuo-Chin Huang, Tai-Yuan Chiu, and Yungling Leo Lee. "Mediating pathways from central obesity to childhood asthma: a population-based longitudinal study." European Respiratory Journal 48, no. 3 (May 12, 2016): 748–57. http://dx.doi.org/10.1183/13993003.00226-2016.
Повний текст джерелаАнотація:
The mediating pathways linking obesity and asthma are largely unknown. We aimed to investigate the mediating pathways and to search for the most prominent pathological mechanism between central obesity and childhood asthma.In the Taiwan Children Health Study, we collected data on an open cohort of children aged 9–13 years. Children's respiratory outcomes, atopic conditions, obesity measures and pulmonary function were surveyed annually between 2010 and 2012. Exhaled nitric oxide fraction concentrations were recorded in 2012. Generalised estimating equations and general linear models were used to examine the associations between central obesity, possible mediators and asthma. Structural equation models were applied to investigate the pathways that mediate the link between central obesity and asthma.Central obesity (waist-to-hip ratio) most accurately predicted childhood asthma. In the active asthma model, the percentage of mediation was 28.6% for pulmonary function, 18.1% for atopy and 5.7% for airway inflammation. The percentage of mediation for pulmonary function was 40.2% in the lifetime wheeze model. Pulmonary function was responsible for the greatest percentage of mediation among the three mediators in both models.Decline in pulmonary function is the most important pathway in central obesity related asthma. Pulmonary function screening should be applied to obese children for asthma risk prediction.
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Dragioti, Elena, Björn Gerdle, and Britt Larsson. "Longitudinal Associations between Anatomical Regions of Pain and Work Conditions: A Study from The SwePain Cohort." International Journal of Environmental Research and Public Health 16, no. 12 (June 19, 2019): 2167. http://dx.doi.org/10.3390/ijerph16122167.
Повний текст джерелаАнотація:
We investigated the time-based associations between workload (physical and mechanical), psychosocial work stressors (demands, control, and support), and the number of anatomical regions with pain (ARP). This population-based study with a two-year follow-up included 11,386 responders (5125 men, 6261 women; mean age: 48.8 years; SD: 18.5) living in south-eastern Sweden. Predictive associations were assessed through generalised linear models, and changes over time were examined using a generalised estimating equation. The results of both models were reported as parameter estimates (B) with 95% confidence interval (CIs). Mean changes in the number of ARP, workload, and psychosocial work stressors were stable over time. High mechanical workload and job demands were likely associated with the number of ARP at the two-year follow-up. In the reverse prospective model, we found that the number of ARP was also associated with high physical and mechanical workload and low job control and support. In the two time-based models of changes, we found a reciprocal association between number of ARP and mechanical workload. Our results add epidemiological evidence to the associations between work conditions and the extent of pain on the body. Components of work conditions, including job demands and mechanical strain, must be considered when organisations and health policy makers plan and employ ergonomic evaluations to minimise workplace hazards in the general population.
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Lukas, M. A. "Assessing regularised solutions." Journal of the Australian Mathematical Society. Series B. Applied Mathematics 30, no. 1 (July 1988): 24–42. http://dx.doi.org/10.1017/s0334270000006019.
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AbstractConsider the prototype ill-posed problem of a first kind integral equation ℛ with discrete noisy data di, = f(xi) + εi, i = 1, …, n. Let u0 be the true solution and unα a regularised solution with regularisation parameter α. Under certain assumptions, it is known that if α → 0 but not too quickly as n → ∞, then unα converges to u0. We examine the dependence of the optimal sequence of α and resulting optimal convergence rate on the smoothness of f or u0, the kernel K, the order of regularisation m and the error norm used. Some important implications are made, including the fact that m must be sufficiently high relative to the smoothness of u0 in order to ensure optimal convergence. An optimal filtering criterion is used to determine the order where is the maximum smoothness of u0. Two practical methods for estimating the optimal α, the unbiased risk estimate and generalised cross validation, are also discussed.
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Tsai, Miao-Yu, Chia-Ni Sun, and Chao-Chun Lin. "Concordance correlation coefficients estimated by modified variance components and generalized estimating equations for longitudinal overdispersed Poisson data." Statistical Methods in Medical Research 31, no. 2 (December 20, 2021): 267–86. http://dx.doi.org/10.1177/09622802211065156.
Повний текст джерелаАнотація:
For longitudinal overdispersed Poisson data sets, estimators of the intra-, inter-, and total concordance correlation coefficient through variance components have been proposed. However, biased estimators of quadratic forms are used in concordance correlation coefficient estimation. In addition, the generalized estimating equations approach has been used in estimating agreement for longitudinal normal data and not for longitudinal overdispersed Poisson data. Therefore, this paper proposes a modified variance component approach to develop the unbiased estimators of the concordance correlation coefficient for longitudinal overdispersed Poisson data. Further, the indices of intra-, inter-, and total agreement through generalized estimating equations are also developed considering the correlation structure of longitudinal count repeated measurements. Simulation studies are conducted to compare the performance of the modified variance component and generalized estimating equation approaches for longitudinal Poisson and overdispersed Poisson data sets. An application of corticospinal diffusion tensor tractography study is used for illustration. In conclusion, the modified variance component approach performs outstandingly well with small mean square errors and nominal 95% coverage rates. The generalized estimating equation approach provides in model assumption flexibility of correlation structures for repeated measurements to produce satisfactory concordance correlation coefficient estimation results.
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Meagher, David, Dimitrios Adamis, Paula Trzepacz, and Maeve Leonard. "Features of subsyndromal and persistent delirium." British Journal of Psychiatry 200, no. 1 (January 2012): 37–44. http://dx.doi.org/10.1192/bjp.bp.111.095273.
Повний текст джерелаАнотація:
BackgroundLongitudinal studies of delirium phenomenology are lacking.AimsWe studied features that characterise subsyndromal delirium and persistent delirium over time.MethodTwice-weekly evaluations of 100 adults with DSM-IV delirium using the Delirium Rating Scale – Revised-98 (DRS-R98) and Cognitive Test for Delirium (CTD). The generalised estimating equation method identified symptom patterns distinguishing full syndromal from subsyndromal delirium and resolving from persistent delirium.ResultsParticipants (mean age 70.2 years (s.d. = 10.5)) underwent 323 assessments (range 2–9). Full syndromal delirium was significantly more severe than subsyndromal delirium for DRS-R98 thought process abnormalities, delusions, hallucinations, agitation, retardation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance, orientation and memory. Persistent full syndromal delirium had greater disturbance of DRS-R98 thought process abnormalities, delusions, agitation, orientation, attention, and short- and long-term memory items, and CTD attention, vigilance and orientation.ConclusionsFull syndromal delirium differs from subsyndromal delirium over time by greater severity of many cognitive and non-cognitive symptoms. Persistent delirium involves increasing prominence of recognised core diagnostic features and cognitive impairment.
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Luijk, Maartje P. C. M., Agnes M. M. Sonnenschein-van der Voort, Viara R. Mileva-Seitz, Pauline W. Jansen, Frank C. Verhulst, Albert Hofman, Vincent W. V. Jaddoe, et al. "Is parent–child bed-sharing a risk for wheezing and asthma in early childhood?" European Respiratory Journal 45, no. 3 (December 10, 2014): 661–69. http://dx.doi.org/10.1183/09031936.00041714.
Повний текст джерелаАнотація:
Household crowding can place young children at risk for respiratory infections which subsequently provoke asthma symptoms. However, crowding might also protect against asthma, in accordance with the hygiene hypothesis. We tested if parent–infant bed-sharing, an important dimension of household crowding, increases or decreases the risk for asthma.In a population-based prospective cohort (N = 6160) we assessed bed-sharing at 2 and 24 months; wheezing between 1 and 6 years of age; and asthma at 6 years of age. Generalised estimating equation models were used to assess repeated measures of wheezing and asthma.We found no association between bed-sharing in early infancy and wheezing or diagnosis of asthma. By contrast, we found a positive association between bed-sharing in toddlerhood and both wheezing (OR 1.42, 95% CI 1.15–1.74) and asthma (OR 1.57, 95% CI 1.03–2.38). Wheezing was not associated with bed-sharing when using cross-lagged modelling.This study suggests that bed-sharing in toddlerhood is associated with an increased risk of asthma at later ages, and not vice versa. Further studies are needed to explore the underlying causal mechanisms.
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Huang, Su-Fei, Wan-Ling Zheng, Jung-Yu Liao, Chiu-Mieh Huang, Tsung-Yi Lin, and Jong-Long Guo. "The effectiveness of a theory-based drama intervention in preventing illegal drug use among students aged 14–15 years in Taiwan." Health Education Journal 77, no. 4 (April 13, 2018): 470–81. http://dx.doi.org/10.1177/0017896918768647.
Повний текст джерелаАнотація:
Objective: Age of initiation of drug use is closely associated with the risk of developing drug dependence or abuse. Effective programmes are needed to prevent adolescents from using drugs at an early age. The aim of this intervention programme was to prevent adolescents from using illegal drugs by using drama in education (DIE) to convey a universal prevention strategy. Method: We recruited 65 children aged 14–15 years from two junior high schools and assigned them to experimental ( n = 34) and comparison ( n = 31) groups. The experimental group attended six 45-minute sessions of a DIE preventive programme. The comparison group received traditional didactic teaching. We used a generalised estimating equation (GEE) to analyse the data. Results: GEE analysis revealed that the experimental group showed significant improvements in attitude, subjective norms, perceived behavioural control and drug-free intentions compared with counterparts in the comparison group. Student feedback indicated that DIE method can contribute to the prevention of illegal drug use. Conclusion: Applying DIE method to a theory-based drug prevention programme offers a promising way of increasing the intention to not use illegal drugs among students aged 14–15 years.
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Tischer, Christina, Mireia Gascon, Ana Fernández-Somoano, Adonina Tardón, Aitana Lertxundi Materola, Jesus Ibarluzea, Amparo Ferrero, et al. "Urban green and grey space in relation to respiratory health in children." European Respiratory Journal 49, no. 6 (June 2017): 1502112. http://dx.doi.org/10.1183/13993003.02112-2015.
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We assessed the effect of three different indices of urban built environment on allergic and respiratory conditions.This study involved 2472 children participating in the ongoing INMA birth cohort located in two bio-geographic regions (Euro-Siberian and Mediterranean) in Spain. Residential surrounding built environment was characterised as 1) residential surrounding greenness based on satellite-derived normalised difference vegetation index (NDVI), 2) residential proximity to green spaces and 3) residential surrounding greyness based on urban land use patterns. Information on wheezing, bronchitis, asthma and allergic rhinitis up to age 4 years was obtained from parent-completed questionnaires. Logistic regression and generalised estimating equation modelling were performed.Among children from the Euro-Siberian region, higher residential surrounding greenness and higher proximity to green spaces were negatively associated with wheezing. In the Mediterranean region, higher residential proximity to green spaces was associated with a reduced risk for bronchitis. A higher amount of residential surrounding greyness was found to increase the risk for bronchitis in this region.Associations between indices of urban residential greenness and greyness with respiratory diseases differ by region. The pathways underlying these associations require further exploration.
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Zhou, Zi, Jian Fu, Y. Alicia Hong, Ping Wang, and Ya Fang. "Association between exercise and the risk of dementia: results from a nationwide longitudinal study in China." BMJ Open 7, no. 12 (December 2017): e017497. http://dx.doi.org/10.1136/bmjopen-2017-017497.
Повний текст джерелаАнотація:
ObjectiveThis study was conducted to examine the causal association between exercise and the risk of dementia among older Chinese adults.DesignLongitudinal population-based study with a follow-up duration of 9 years.SettingData for the Chinese Longitudinal Healthy Longevity Survey waves occurring from 2002 to 2011–2012 were extracted from the survey database.ParticipantsIn total, 7501 dementia-free subjects who were older than 65 years were included at baseline. Dementia was defined as a self-reported or proxy-reported physician’s diagnosis of the disease.Outcome measures and methodsRegular exercise and potential confounding variables were obtained via a self-report questionnaire. We generated longitudinal logistic regression models based on time-lagged generalised estimating equation to examine the causal association between exercise and dementia risk.ResultsOf the 7501 older Chinese people included in this study, 338 developed dementia during the 9-year follow-up period after excluding those who were lost to follow-up or deceased. People who regularly exercised had lower odds of developing dementia (OR=0.53, 95% CI 0.33 to 0.85) than those who did not exercise regularly.ConclusionRegular exercise was associated with decreased risk of dementia. Policy-makers should develop effective public health programmes and build exercise-friendly environments for the general public.
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de Vicente, Javier, and Fortunato Crespo. "A new wildland fire danger index for a Mediterranean region and some validation aspects." International Journal of Wildland Fire 21, no. 8 (2012): 1030. http://dx.doi.org/10.1071/wf11046.
Повний текст джерелаАнотація:
Wildland fires are the main cause of tree mortality in Mediterranean Europe and a major threat to Spanish forests. This paper focuses on the design and validation of a new wildland fire index especially adapted to a Mediterranean Spanish region. The index considers ignition and spread danger components. Indicators of natural and human ignition agents, historical occurrence, fuel conditions and fire spread make up the hierarchical structure of the index. Multi-criteria methods were used to incorporate experts’ opinion in the process of weighting the indicators and to carry out the aggregation of components into the final index, which is used to map the probability of daily fire occurrence on a 0.5-km grid. Generalised estimating equation models, which account for possible correlated responses, were used to validate the index, accommodating its values onto a larger scale because historical records of daily fire occurrence, which constitute the dependent variable, are referred to cells on a 10-km grid. Validation results showed good index performance, good fit of the logistic model and acceptable discrimination power. Therefore, the index will improve the ability of fire prevention services in daily allocation of resources.
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Gizaw, Zemichael, Alemayehu Worku Yalew, Bikes Destaw Bitew, Jiyoung Lee, and Michael Bisesi. "Effects of local handwashing agents on microbial contamination of hands in the rural settings of northwest Ethiopia: protocol for a two-arm, clustered-randomised controlled trial." BMJ Open 11, no. 8 (August 2021): e046828. http://dx.doi.org/10.1136/bmjopen-2020-046828.
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IntroductionHands play a part in the transmission of infections. Handwashing with soap sufficiently reduces the level of hand contamination and the spread of infections. As soap is not usually available due to cost, ash is often used as a zero-cost alternative to soap in the rural settings of developing countries. However, there is limited evidence on the effectiveness of ash to reduce microbial contamination of hands. This study is, therefore, designed to assess the effect of ash on microbial contamination of hands in the rural settings of northwest Ethiopia.Methods and analysisA two-arm clustered-randomised controlled trial will be employed. A total of 11 clusters per arm will be selected using simple random sampling technique. A total of 220 mothers or caregivers of under-5 children will be included in each arm. After providing health education on effective handwashing process, we will ask study subjects to do the usual activities. We will then take swab samples from the dominant hand before washing. After swabbing, participants will be asked to wash their hands with water only and with ash by following effective handwashing procedures. We will again take swab samples from the dominant hand after washing and drying. Finally, we will compare each intervention arm against the control. A generalised estimating equation (GEE) with robust SE estimation will be used to account the cluster nature of data.Ethics and disseminationResults will be published in peer-reviewed journal and presented at international conferences. The protocol is approved by the Institutional Review Board of the University of Gondar, Ethiopia.Trial registration numberPan African Clinical Trial Registry; PACTR202011855730652.
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Rana, Rohit, Prerna Gaur, Vijyant Agarwal, and Harish Parthasarathy. "Tremor Estimation and Removal in Robot-Assisted Surgery Using Lie Groups and EKF." Robotica 37, no. 11 (April 15, 2019): 1904–21. http://dx.doi.org/10.1017/s0263574719000341.
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SummaryThis paper aims at estimating the tremor torque using extended Kalman filter (EKF) applied to a two-link 3-DOF robot with nonlinear dynamics modelled using Lie-group and Lie-algebra theory. Later, it is generalised to d number of links with (d + 1) -DOF. The configuration of each link at any time is described by its rotation relative to the preceding link. Using this formulation, an elegant formula for the kinetic energy of the (d + 1) -DOF system is obtained as a quadratic form in the angular velocities with coefficients being highly nonlinear trigonometric functions of the angles. Properties of the Lie algebra generators and the Lie adjoint map are used to arrive at this expression. Further, the gravitational potential energy and the torque potential energy are expressed as nonlinear trigonometrical functions of the angles using properties of the SO(3) group. The input torque comprises a nonrandom intentional torque component and a highly nonlinear tremor torque component. The tremor torque is modelled as a stochastic differential equation (sde) satisfying Ornstein–Uhlenbeck (OU) process with diffusion and damping coefficients. Further, the tremor is treated as the disturbance. The Euler–Lagrange equations for the angles are derived. These form a system of sdes, and the EKF is used to get a more accurate disturbance estimate than that provided by the usual disturbance observer. The EKF is based on noisy angle measurements and yields as a bonus the angle and angular velocity estimates on a real-time basis. The parameters in the OU process model of the tremor torque, and parameters of the Fourier components of the intentional torque have also been estimated.
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Kirchberger, Inge, Barbara Maleckar, Christine Meisinger, Jakob Linseisen, Max Schmauss, and Jessica Baumgärtner. "Long-term outcomes in patients with severe depression after in-hospital treatment – study protocol of the depression long-term Augsburg (DELTA) study." BMJ Open 9, no. 12 (December 2019): e032507. http://dx.doi.org/10.1136/bmjopen-2019-032507.
Повний текст джерелаАнотація:
IntroductionDepressive disorders are very common diseases entailing a great burden on affected people. However, comprehensive information on long-term disease course in patients with severe depression is lacking so far. The objectives of the DELTA study are to examine long-term outcomes and their predicting factors, to assess clinical response of antidepressant pharmacotherapy by applying therapeutic drug monitoring, to identify predictors of therapeutic non-response, to describe the long-term healthcare utilisation and to investigate the role of biomarkers in disease course.Methods and analysisA cohort study including all adult hospitalised cases (age range 18 to 75 years) of severe major depression who are admitted to the Bezirkskrankenhaus Augsburg is established. It is planned to include 300 patients. During the hospital stay, information is gathered through personal interview, self-administered questionnaires, cognitive tests and chart review. Furthermore, biomaterials are collected. After hospital discharge, patients are repeatedly re-examined over time (3, 6, 12, 24 and 36 months) to collect information about mortality, relapse, depression severity, health-related quality of life (HRQOL), perceived stigma, cognitive functions, diet, physical activity, treatment and healthcare utilisation. Follow-up blood samples are collected to determine therapeutic drug levels. The primary study aim is to investigate long-term therapeutic response, survival, relapse, HRQOL and cognitive functions. Survival time and time to relapse or re-hospitalisation will be analysed using Cox regression models. Changes of HRQOL, depressive symptoms and cognitive functions over time will be examined using generalised linear regression models for repeated measures or mixed models. Correlates of the disease course will be modelled using suitable generalised linear, mixed, estimating equation and growth curve models.Ethics and disseminationThe study protocol was approved by the Ethics Committee of the Ludwig-Maximilians-Universität München (date of approval: 23 October 2017, reference number: 17–625). Study results will be presented at scientific conferences and published in peer-reviewed scientific journals.
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Tesfaw, Lijalem Melie, Demeke Lakew Workie, and Zelalem G. Dessie. "Discrepancies of recurrent birth intervals using longitudinal data analysis in Ethiopia: interim EDHS 2019." BMJ Open 12, no. 11 (November 2022): e066739. http://dx.doi.org/10.1136/bmjopen-2022-066739.
Повний текст джерелаАнотація:
ObjectiveThis study aimed to determine whether the birth interval changes differently over time among women in Ethiopia and whether the change depends on women, children and household characteristics measured at the last visit.MethodsLongitudinal study design was implemented based on the data obtained from the 2019 Ethiopia Mini Demographic and Health Survey consisting of a total of 3630 mothers. Generalised estimating equation and generalised linear mixed model were employed to estimate the effect of the determinants given the correlation between birth intervals within a mother is under consideration.ResultsThe majority of women were Muslims (48.1%) and come from rural areas (82.2%). About 77.2% of women at first birth were below 20 years old. A significant correlation (p value<0.0001) between the first and second birth intervals of mothers was observed. The estimated birth interval of women from the poorest household was 0.877 (e−0.1317) times the estimated birth intervals of women from the richest household. This indicates richest households were likely to have higher birth intervals as compared with the poorest households (95% CI e−0.1754=0.839 to e−0.088=0.916).ConclusionThe birth intervals of over one-fifth of mothers were 1 year, less than the birth interval recommended by the WHO standard. It was also perceived that successive birth intervals are correlated. Mothers who have delivered female children had lower birth intervals than mothers who have delivered male children. As compared with the birth intervals of mothers from a household with higher economic status, the birth intervals of mothers from a household with lower economic status had lower birth intervals. In this study, significant effects of religion, contraceptive use, region, mothers’ current age, education level and mothers’ current marital status on birth intervals were also noted.
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Cunningham, John A., Christian S. Hendershot, Frances Kay-Lambkin, Clayton Neighbors, Kathleen M. Griffiths, Kylie Bennett, Anthony Bennett, Alexandra Godinho, and Christina Schell. "Does providing a brief internet intervention for hazardous alcohol use to people seeking online help for depression reduce both alcohol use and depression symptoms among participants with these co-occurring disorders? Study protocol for a randomised controlled trial." BMJ Open 8, no. 7 (July 2018): e022412. http://dx.doi.org/10.1136/bmjopen-2018-022412.
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IntroductionHazardous alcohol consumption is common among people experiencing depression, often acting to exacerbate depressive symptoms. While many people with these co-occurring disorders do not seek face-to-face treatment, they do seek help online. There are effective internet interventions that target hazardous alcohol consumption or depression separately but none that combine these online interventions without the involvement of a therapist. In order to realise the potential of internet interventions, we need to develop an evidence base supporting the efficacy of internet interventions for co-occurring depression and hazardous alcohol use without any therapist involvement. This study aims to evaluate the effects on drinking, and on depressive symptoms, of combining an internet intervention targeting hazardous alcohol consumption with one for depression.Methods and analysisA double blinded, parallel group randomised controlled trial will be used. Participants with current depression who also drink in a hazardous fashion (n=986) will be recruited for a study to ‘help improve an online intervention for depression’. Participants will be randomised either to receive an established online intervention for depression (MoodGYM) or to receive MoodGYM plus a brief internet intervention for hazardous alcohol consumption (Check Your Drinking; CYD). Participants will be contacted 3 and 6 months after receiving the interventions to assess changes in drinking and depression symptoms. It is predicted that participants receiving the CYD intervention in addition to MoodGYM will report greater postintervention reductions in alcohol consumption and depressive symptoms compared with those who received MoodGYM only. Hypothesised mediation and moderation effects will also be investigated. Using an intention-to-treat basis for the analyses, the hypotheses will be tested using a generalised linear hypothesis framework, and longitudinal analyses will use either generalised linear mixed modelling or generalised estimating equation approach where appropriate.Ethics and disseminationThis research comprises the crucial first steps in developing lower-cost and efficacious internet interventions for people suffering from depression who also drink in a hazardous fashion—promoting the widespread availability of care for those in need. This study has been approved by the standing ethics review committee of the Centre for Addiction and Mental Health, and findings will be disseminated in the form of at least one peer-reviewed article and presentations at conferences.Trial registration numberNCT03421080; Pre-results.
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Lin, Yu-Fang, Megan F. Liu, Mu-Hsing Ho, Yen-Kuang Lin, Yu-Ling Hsiao, Ming-Hsu Wang, Chia-Chi Chang, and Jed Montayre. "A Pilot Study of Interactive-Video Games in People with Mild Cognitive Impairment." International Journal of Environmental Research and Public Health 19, no. 6 (March 16, 2022): 3536. http://dx.doi.org/10.3390/ijerph19063536.
Повний текст джерелаАнотація:
Early preventive strategies for improving cognitive function are crucial for people with mild cognitive impairment (MCI). Cognitive training exercises may improve cognitive functioning. However, there was limited evidence from training programs that combined cognitive-specific and physical activities, particularly in using interactive video games as interventions. This study aimed to evaluate the feasibility and effects of the interactive-video games on cognitive function, physical function, mood status and quality of life in community-dwelling people with MCI. A quasi-experimental study was undertaken. Participants in the intervention group received 60 min group-based training program once per week for 12 weeks. A generalised estimating equation (GEE) was used to examine the main effect, interactions and changes in outcomes over time. Sixteen participants completed the trial with eight in the intervention group and eight in the comparison group. The tolerable acceptance rate, perfect attendance rate, high satisfaction with the training content, and no injuries or falls demonstrated the feasibility of this program. The scores of cognitive function increased in both groups and the interaction between time and groups were significant over 12 weeks of training (p < 0.05). As the result, we determined that interactive-video games can be a safe, feasible, enjoyable intervention and user-friendly among people with MCI in community settings.
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Akhter, Nasima, Ross Stewart Fairbairn, Mark Pearce, Jon Warren, Adetayo Kasim, and Clare Bambra. "Local Inequalities in Health Behaviours: Longitudinal Findings from the Stockton-On-Tees Cohort Study." International Journal of Environmental Research and Public Health 18, no. 21 (October 20, 2021): 11018. http://dx.doi.org/10.3390/ijerph182111018.
Повний текст джерелаАнотація:
This paper provides a longitudinal examination of local inequalities in health behaviours during a period of austerity, exploring the role of ‘place’ in explaining these inequalities. Data from the Stockton-on-Tees prospective cohort study of 836 individuals were analysed and followed over 18 months (37% follow-up). Generalised estimating equation models estimated the deprivation gap in health behaviours (smoking status, alcohol use, fruit and vegetable consumption and physical activity practices) between the 20% most- and least-deprived neighborhoods (LSOAs), explored any temporal changes during austerity, and examined the underpinning role of compositional and contextual determinants. All health behaviours, except for frequent physical activity, varied significantly by deprivation (p ≤ 0.001). Smoking was lower in the least-deprived areas (OR 0.21, CI 0.14 to 0.30), while alcohol use (OR 2.75, CI 1.98 to 3.82) and fruit and vegetable consumption (OR 2.55, CI 1.80 to 3.62) were higher in the least-deprived areas. The inequalities were relatively stable throughout the study period. Material factors (such as employment, education and housing tenure) were the most-important and environmental factors the least-important explanatory factors. This study suggests that material factors are the most important ‘place’ determinants of health behaviours. Health promotion activities should better reflect these drivers.
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Iqbal, Najam, Muhammad Saqib Manzoor, and Muhammad Ishaq Bhatti. "Asymmetry and Leverage with News Impact Curve Perspective in Australian Stock Returns’ Volatility during COVID-19." Journal of Risk and Financial Management 14, no. 7 (July 8, 2021): 314. http://dx.doi.org/10.3390/jrfm14070314.
Повний текст джерелаАнотація:
This paper studies the effect of COVID-19 on the volatility of Australian stock returns and the effect of negative and positive news (shocks) by investigating the asymmetric nature of the shocks and leverage impact on volatility. We employ a generalised autoregressive conditional heteroskedasticity (GARCH) model and extend the analysis using the exponential GARCH (EGARCH) model to capture asymmetry and allegedly leverage. We proxy the news related to the negative effect of COVID-19 on the Australian health system and its economy as bad news, and on the other hand, measures taken by government economic stimulus packages through their monetary and fiscal policies as good news. The S&P ASX200 (ASX-200) index is used as a proxy to the Australian stock market, and we use value-weighted returns of the stocks listed on ASX-200 for the period 27 January 2020 to 29 December 2020. The empirical results suggest the EGARCH model fits better in capturing asymmetry and leverage than the GARCH model in estimating the volatility of the Australian stock returns. However, another interesting finding is that the EGARCH model with volatility equation without news demonstrates a larger (smaller) leverage effect of the negative (positive) shocks on the conditional volatility compared to its variant with the news.
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Chen, Yi, Hui Liu, Zhicong Ye, Hao Zhang, Bifeng Jiang, and Yang Zhang. "Social Justice in Urban–Rural Flood Exposure: A Case Study of Nanjing, China." Land 11, no. 9 (September 16, 2022): 1588. http://dx.doi.org/10.3390/land11091588.
Повний текст джерелаАнотація:
The environmental justice research on urban–rural exposure to flooding is underdeveloped and few empirical studies have been conducted in China. This study addresses this gap by exploring the probabilities of exposure to floods (10-, 20-, and 50-year) and examining the relationship between vulnerable groups and flooding in Nanjing, an important central city on the Yangtze River. Statistical analysis is based on multivariable generalised estimating equation (GEE) models that describe sociodemographic disparities at the census-tract level. The results revealed that (1) highly educated people in the urban centre are more likely to live in areas with high flood risk because of the abundance of education resources, and employment opportunities are concentrated in the urban centre. (2) Natives in suburban areas are more likely to live in flood-prone areas due to their favourable ecological environments near rivers and lakes. (3) Women in rural areas are more likely to live in high-flood-risk zones because most of the men are migrant workers. These findings highlight the urgent need to develop mitigation strategies to reduce flood exposure, especially in districts with high proportions of socially disadvantaged people. The linkages between rural and urban areas need to be strengthened in order to reduce flood exposure.
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González-López, Julio J., Gema Rebolleda, Marina Leal, Noelia Oblanca, Francisco J. Muñoz-Negrete, Lucienne Costa-Frossard, and José C. Álvarez-Cermeño. "Comparative Diagnostic Accuracy of Ganglion Cell-Inner Plexiform and Retinal Nerve Fiber Layer Thickness Measures by Cirrus and Spectralis Optical Coherence Tomography in Relapsing-Remitting Multiple Sclerosis." BioMed Research International 2014 (2014): 1–10. http://dx.doi.org/10.1155/2014/128517.
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Objective. To estimate sensitivity and specificity of several optical coherence tomography (OCT) measurements for detecting retinal thickness changes in patients with relapsing-remitting multiple sclerosis (RRMS), such as macular ganglion cell-inner plexiform layer (GCIPL) thickness measured with Cirrus (OCT) and peripapillary retinal nerve fiber layer (pRNFL) thickness measured with Cirrus and Spectralis OCT.Methods. Seventy patients (140 eyes) with RRMS and seventy matched healthy subjects underwent pRNFL and GCIPL thickness analysis using Cirrus OCT and pRNFL using Spectralis OCT. A prospective, cross-sectional evaluation of sensitivities and specificities was performed using latent class analysis due to the absence of a gold standard.Results. GCIPL measures had higher sensitivity and specificity than temporal pRNFL measures obtained with both OCT devices. Average GCIPL thickness was significantly more sensitive than temporal pRNFL by Cirrus (96.34% versus 58.41%) and minimum GCIPL thickness was significantly more sensitive than temporal pRNFL by Spectralis (96.41% versus 69.69%). Generalised estimating equation analysis revealed that age (P=0.030), optic neuritis antecedent (P=0.001), and disease duration (P=0.002) were significantly associated with abnormal results in average GCIPL thickness.Conclusion. Average and minimum GCIPL measurements had significantly better sensitivity to detect retinal thickness changes in RRMS than temporal pRNFL thickness measured by Cirrus and Spectralis OCT, respectively.
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Jackson, Caroline, Gerrie-Cor Herber-Gast, and Wendy Brown. "Joint Effects of Physical Activity and BMI on Risk of Hypertension in Women: A Longitudinal Study." Journal of Obesity 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/271532.
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Introduction. There is debate as to whether physical activity counteracts the adverse effect of weight on health outcomes. We investigated how physical activity modifies the effect of body mass index (BMI) on hypertension risk.Methods. BMI, physical activity, and hypertension were measured at baseline and at three-year interval for 14 years (from 1996 to 2010), in 10,339 participants in the Australian Longitudinal Study on Women’s Health. Generalised estimating equation models for binary repeated measures were performed to determine the individual and joint effects of BMI and physical activity on incident hypertension.Results. At baseline (mean age47.6±1.5 SD), 57% were healthy weight, 28% overweight, and 14% obese. Increasing BMI and decreasing physical activity were associated with increased risk of hypertension. Physical activity attenuated the positive association between weight and risk of hypertension, especially for obese women. Compared to healthy weight high active women, risk of hypertension in obese high active women was 3.4 times greater (OR 3.43, 95% CI 2.68, 4.39) and in obese inactive women 4.9 times greater (OR 4.91, 95% CI 3.92, 6.13).Conclusions. Both physical activity and maintenance of a healthy body weight are associated with lower risk of hypertension. Physical activity reduced but did not remove the effect of obesity on hypertension risk.
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Chaiton, Michael, Joanna E. Cohen, Sue J. Bondy, Peter Selby, K. Stephen Brown, Roberta Ferrence, and John M. Garcia. "Perceived Addiction as a Predictor of Smoking Cessation Among Occasional Smokers." Journal of Smoking Cessation 12, no. 3 (January 21, 2016): 165–72. http://dx.doi.org/10.1017/jsc.2015.19.
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Introduction: Common short screening measures of dependence that use number of cigarettes per day may not be appropriate for use in populations of occasional smokers.Aims: In this study, we investigate whether perceived addiction (PA) predicts quit attempts and successful cessation among occasional smokers.Methods: Current occasional smokers (18+) in the Ontario Tobacco Survey (OTS) longitudinal cohort study followed up every six months for up to three years. Respondents rated their self-perceived level of addiction (very vs. somewhat or not very addicted). Generalised Estimating Equation models and proportional hazard models were used to test the predictive ability of PA.Results/Findings: Occasional smokers with very high PA had a higher likelihood of reporting a quit attempt (RR: 2.49; 95% CI: 1.88, 3.30) after adjusting for demographics. Given an incident quit attempt, occasional smokers who reported being very addicted were 2.93 times more likely to relapse (95%: 2.01, 4.28). The effect of PA was independent of other predictors of smoking behaviour.Conclusions: For some, occasional smokers, smoking cessation is a difficult process that may require significant support. Asking occasional smokers about PA is an effective way to predict likely success in quitting smokers that may be easily assessed in population based, as well as in community and clinical, settings.
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Van den Broucke, Evelyne Van den, Lore Thijs, Stefanie Desmet, Lotte Vander Vander Elst, Matthias Gijsen, Marnix Mylemans, Otto Van de Van de Gaer, Willy E. Peetermans, Charlotte Quintens, and Isabel Spriet. "Clinical Efficacy of Temocillin Standard Dosing in Patients Treated with Outpatient Antimicrobial Therapy." Pharmaceutics 14, no. 11 (October 25, 2022): 2289. http://dx.doi.org/10.3390/pharmaceutics14112289.
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In 2020, EUCAST introduced breakpoints for temocillin. Based on these guidelines, reporting of temocillin susceptibility of Enterobacterales in the context of complicated urinary tract infections (cUTI) implicates the use of a high dose of temocillin (2 g q8h) constantly. We aimed to evaluate the clinical outcome of patients treated with the standard dose (4 g/day) of temocillin in outpatient parenteral antimicrobial therapy (tOPAT). Demographics, clinical and treatment parameters, and late clinical cure (at day 30 after tOPAT completion) were recorded. Univariate generalised estimating equation analyses, with clinical cure as outcome variable, were performed to evaluate covariate associations. Fifty-seven tOPAT episodes in 50 patients were included with a median antimicrobial treatment duration of 21 (range 10–228) days, and cUTI was the main indication (87.7%). Late clinical cure was achieved in 85.7% of the tOPAT episodes. Non-disseminated infections and minimal inhibitory concentrations (MIC) values ≤ 8 mg/L were associated with good late clinical outcome. In conclusion, a standard temocillin dose (4 g/day) results in good clinical outcomes in the treatment of cUTIs in tOPAT patients. Therefore, our centre concluded that the use of standard temocillin dosing should be continued instead of the high dose for cUTI in non-critically ill patients infected with Enterobacterales with an MIC ≤ 4 mg/L.
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Lo, Andrew W. "Maximum Likelihood Estimation of Generalized Itô Processes with Discretely Sampled Data." Econometric Theory 4, no. 2 (August 1988): 231–47. http://dx.doi.org/10.1017/s0266466600012044.
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This paper considers the parametric estimation problem for continuous-time stochastic processes described by first-order nonlinear stochastic differential equations of the generalized Itô type (containing both jump and diffusion components). We derive a particular functional partial differential equation which characterizes the exact likelihood function of a discretely sampled Itô process. In addition, we show by a simple counterexample that the common approach of estimating parameters of an Itô process by applying maximum likelihood to a discretization of the stochastic differential equation does not yield consistent estimators.
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Westgate, Philip M. "A readily available improvement over method of moments for intra-cluster correlation estimation in the context of cluster randomized trials and fitting a GEE–type marginal model for binary outcomes." Clinical Trials 16, no. 1 (October 8, 2018): 41–51. http://dx.doi.org/10.1177/1740774518803635.
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Background/aims Cluster randomized trials are popular in health-related research due to the need or desire to randomize clusters of subjects to different trial arms as opposed to randomizing each subject individually. As outcomes from subjects within the same cluster tend to be more alike than outcomes from subjects within other clusters, an exchangeable correlation arises that is measured via the intra-cluster correlation coefficient. Intra-cluster correlation coefficient estimation is especially important due to the increasing awareness of the need to publish such values from studies in order to help guide the design of future cluster randomized trials. Therefore, numerous methods have been proposed to accurately estimate the intra-cluster correlation coefficient, with much attention given to binary outcomes. As marginal models are often of interest, we focus on intra-cluster correlation coefficient estimation in the context of fitting such a model with binary outcomes using generalized estimating equations. Traditionally, intra-cluster correlation coefficient estimation with generalized estimating equations has been based on the method of moments, although such estimators can be negatively biased. Furthermore, alternative estimators that work well, such as the analysis of variance estimator, are not as readily applicable in the context of practical data analyses with generalized estimating equations. Therefore, in this article we assess, in terms of bias, the readily available residual pseudo-likelihood approach to intra-cluster correlation coefficient estimation with the GLIMMIX procedure of SAS (SAS Institute, Cary, NC). Furthermore, we study a possible corresponding approach to confidence interval construction for the intra-cluster correlation coefficient. Methods We utilize a simulation study and application example to assess bias in intra-cluster correlation coefficient estimates obtained from GLIMMIX using residual pseudo-likelihood. This estimator is contrasted with method of moments and analysis of variance estimators which are standards of comparison. The approach to confidence interval construction is assessed by examining coverage probabilities. Results Overall, the residual pseudo-likelihood estimator performs very well. It has considerably less bias than moment estimators, which are its competitor for general generalized estimating equation–based analyses, and therefore, it is a major improvement in practice. Furthermore, it works almost as well as analysis of variance estimators when they are applicable. Confidence intervals have near-nominal coverage when the intra-cluster correlation coefficient estimate has negligible bias. Conclusion Our results show that the residual pseudo-likelihood estimator is a good option for intra-cluster correlation coefficient estimation when conducting a generalized estimating equation–based analysis of binary outcome data arising from cluster randomized trials. The estimator is practical in that it is simply a result from fitting a marginal model with GLIMMIX, and a confidence interval can be easily obtained. An additional advantage is that, unlike most other options for performing generalized estimating equation–based analyses, GLIMMIX provides analysts the option to utilize small-sample adjustments that ensure valid inference.
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Chen, Chen, Chen, Lee, Chang, and Huang. "Effect of an Oral Health Programme on Oral Health, Oral Intake, and Nutrition in Patients with Stroke and Dysphagia in Taiwan: A Randomised Controlled Trial." International Journal of Environmental Research and Public Health 16, no. 12 (June 24, 2019): 2228. http://dx.doi.org/10.3390/ijerph16122228.
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No previous studies have evaluated an oral health programme, before swallowing therapy, in patients with stroke and dysphagia in Taiwan. This randomised controlled trial evaluated the effect of an oral health programme (i.e., sputum assessment, Bass method-based tooth brushing, and tooth coating with fluoride toothpaste) before swallowing therapy. Sixty-six patients with stroke (23 female, 43 male) in our rehabilitation ward, who underwent nasogastric tube insertion, were assigned randomly to an oral care group (n = 33) and a control group (n = 33). Demographic data, oral health assessment, Functional Oral Intake Scale (FOIS) scores, Mini-Nutritional Assessment-Short Form (MNA-SF) scores, and nasogastric tube removal rates were compared between groups. We evaluated outcomes using generalised estimating equation analysis. Three weeks post-implementation, the oral care group had significant oral health improvements relative to the control group (95% CI =−2.69 to −1.25, Wald χ2 = 29.02, p < 0.001). There was no difference in the FOIS (95% CI = −0.16 to 0.89, Wald χ2 = 1.86, p > 0.05), MNA-SF (95% CI = −0.35 to 0.53, Wald χ2 =−0.17, p > 0.05), and nasogastric tube removal (p > 0.05) between groups. The oral care group had a higher, but non-significant FOIS score (3.94 vs 3.52) (p > 0.05). Routine oral health programmes implemented during stroke rehabilitation in patients with dysphagia may promote oral health and maintain oral intake.
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Hao, Yongchen, Jing Liu, Sidney C. Smith, Yong Huo, Gregg C. Fonarow, Junbo Ge, Jun Liu, et al. "Rationale and design of the improving Care for Cardiovascular Disease in China (CCC) project: a national registry to improve management of atrial fibrillation." BMJ Open 8, no. 7 (July 2018): e020968. http://dx.doi.org/10.1136/bmjopen-2017-020968.
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IntroductionInadequate management of patients with atrial fibrillation (AF) has been reported in China for anticoagulation therapy and treatment for concomitant diseases. An effective quality improvement programme has been lacking to promote the use of evidence-based treatments and improve outcome in patients with AF.Methods and analysisThe Improving Care for Cardiovascular Disease in China-AF programme is a collaboration of the American Heart Association and the Chinese Society of Cardiology. This programme is designed to promote adherence to AF guideline recommendations and outcomes for inpatients with AF. Launched in February 2015, 150 hospitals are recruited by geographic-economic regions across 30 provinces in China. Each month, 10–20 inpatients with AF are enrolled in each hospital. A web-based data collection platform is used to collect clinical information for patients with AF, including patients’ demographics, admission information, medical history, in-hospital care and outcomes, and discharge medications for managing AF. The quality improvement initiative includes monthly benchmarked reports on hospital quality, training sessions, regular webinars and recognitions of hospital quality achievement. Primary analyses will include adherence to performance measures and guidelines. To address intrahospital correlation, generalised estimating equation models will be applied. As of March 2017, 28 801 AF inpatients have been enrolled.Ethics and disseminationThis study protocol was approved by the Ethics Committee of Beijing Anzhen Hospital, Capital Medical University. Results will be published in peer-reviewed medical journals.Trial registration numberNCT02309398.
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Langholz, Petja Lyn, Tom Wilsgaard, Inger Njølstad, Rolf Jorde, and Laila Arnesdatter Hopstock. "Trends in known and undiagnosed diabetes, HbA1c levels, cardiometabolic risk factors and diabetes treatment target achievement in repeated cross-sectional surveys: the population-based Tromsø Study 1994–2016." BMJ Open 11, no. 3 (March 2021): e041846. http://dx.doi.org/10.1136/bmjopen-2020-041846.
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ObjectivesThe aim of this study was to investigate time trends in known and undiagnosed diabetes, glycated haemoglobin (HbA1c) levels and other cardiometabolic risk factors in the general population as well as treatment target achievement among those with diabetes.Design and settingRepeated cross-sectional surveys in the population-based Tromsø Study.MethodsWe used age-adjusted generalised estimating equation models to study trends in self-reported and undiagnosed (HbA1c ≥6.5%) diabetes, cardiometabolic risk factors and the metabolic syndrome in 27 281 women and men aged 40–84 years examined in up to four surveys of the Tromsø Study between 1994 and 2016. Further, we analysed trends in diabetes treatment target achievement.ResultsDuring 1994–2016, diabetes prevalence increased in women (2.3% to 4.6%) and men (2.4% to 5.8%) and in all age groups, while the proportion of undiagnosed diabetes in women (32% to 17%) and men (37% to 24%) decreased. Blood pressure and total cholesterol decreased, while waist circumference increased in participants with and without diabetes, leading to a relatively stable prevalence of the metabolic syndrome throughout the study period. There was a marginal increase in HbA1c levels among participants without diabetes. Only half of those with diabetes achieved the treatment target of HbA1c ≤7.0%.ConclusionIn the last two decades, diabetes prevalence increased, while the proportion of undiagnosed diabetes declined. The prevalence of the metabolic syndrome remained stable throughout, driven by opposing trends with an increase in obesity and a decrease in other cardiometabolic risk factors. HbA1c treatment target achievement did not improve.
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Wang, Mei, Michael Paterson, Lehana Thabane, Deborah Siegal, Lawrence Mbuagbaw, Laura Targownik, and Anne Holbrook. "Association of direct oral anticoagulant-proton pump inhibitor cotherapy with adverse outcomes: protocol for a population-based cohort study." BMJ Open 12, no. 6 (June 2022): e057991. http://dx.doi.org/10.1136/bmjopen-2021-057991.
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IntroductionProton pump inhibitors (PPIs) are widely used for primary and secondary prevention of upper gastrointestinal bleeding. However, there remains controversy about the overall net clinical benefit of PPIs (omeprazole, rabeprazole, pantoprazole, lansoprazole) when coprescribed with direct oral anticoagulants (DOACs; dabigatran, rivaroxaban, apixaban, edoxaban). Our objective is to explore the risk of clinically relevant events, including bleeding, thromboembolic events and death, in patients prescribed DOACs while taking PPIs versus no PPI.Methods and analysisThe protocol describes a retrospective cohort study of all Ontario residents aged 66 years or older with atrial fibrillation and at least one pharmacy dispensation for a DOAC identified using linked administrative healthcare databases covering 2009–2020. Ontario drug benefit dispensation records will be used to ascertain PPI exposure during DOAC therapy. The primary outcome is a composite of clinically relevant bleeding, thrombotic events or all-cause death. A minimum of 520 patients in total with at least one of the components of the composite outcome are needed. Poisson regression with a generalised estimating equation model will be used to calculate the adjusted incidence rate difference, incidence rate ratios 95% CI, adjusting for propensity for PPI use using inverse probability of treatment weights.Ethics and disseminationThis research is exempt from REB review under section 45 of Ontario’s Personal Health Information Protection Act. We will report our findings in a peer-reviewed biomedical journal and present them at conferences. The study will provide useful evidence to optimise the coprescription of DOACs and PPIs in practice.
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Lee, Meng-Rui, Hung-Ling Huang, Shu-Wen Lin, Meng-Hsuan Cheng, Ya-Ting Lin, So-Yi Chang, Bo-Shiun Yan, et al. "Isoniazid Concentration and NAT2 Genotype Predict Risk of Systemic Drug Reactions during 3HP for LTBI." Journal of Clinical Medicine 8, no. 6 (June 6, 2019): 812. http://dx.doi.org/10.3390/jcm8060812.
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Weekly rifapentine and isoniazid therapy (known as 3HP) for latent tuberculosis infection (LTBI) is increasingly used, but systemic drug reactions (SDR) remain a major concern. Methods: We prospectively recruited two LTBI cohorts who received the 3HP regimen. In the single-nucleotide polymorphism (SNP) cohort, we collected clinical information of SDRs and examined the NAT2, CYP2E1, and AADAC SNPs. In the pharmacokinetic (PK) cohort, we measured plasma drug and metabolite levels at 6 and 24 h after 3HP administration. The generalised estimating equation model was used to identify the factors associated with SDRs. Candidate SNPs predicting SDRs were validated in the PK cohort. A total of 177 participants were recruited into the SNP cohort and 129 into the PK cohort, with 14 (8%) and 13 (10%) in these two cohorts developing SDRs, respectively. In the SNP cohort, NAT2 rs1041983 (TT vs. CC+CT, odds ratio [OR] [95% CI]: 7.00 [2.03–24.1]) and CYP2E1 rs2070673 (AA vs. TT+TA, OR [95% CI]: 3.50 [1.02–12.0]) were associated with SDR development. In the PK cohort, isoniazid level 24 h after 3HP administration (OR [95% CI]: 1.61 [1.15–2.25]) was associated with SDRs. Additionally, the association between the NAT2 SNP and SDRs was validated in the PK cohort (rs1041983 TT vs. CC+CT, OR [95% CI]: 4.43 [1.30–15.1]). Conclusions: Isoniazid played a role in the development of 3HP-related SDRs. This could provide insight for further design of a more optimal regimen for latent TB infection.
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Rajmil, Luis, David Taylor-Robinson, Geir Gunnlaugsson, Anders Hjern, and Nick Spencer. "Trends in social determinants of child health and perinatal outcomes in European countries 2005–2015 by level of austerity imposed by governments: a repeat cross-sectional analysis of routinely available data." BMJ Open 8, no. 10 (October 2018): e022932. http://dx.doi.org/10.1136/bmjopen-2018-022932.
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ObjectiveTo assess whether the level of austerity implemented by national governments was associated with adverse trends in perinatal outcomes and the social determinants of children’s health (SDCH) in rich countriesDesignLongitudinal ecological study of country-level time trends in perinatal outcomes and SDCH and from 2005 to 2015.Setting and participants16 European countries using available data from the International Monetary Fund, the Organisation for Economic Co-operation and Development and Eurostat.Main outcome measuresTrends in perinatal outcomes (low birth weight (LBW); infant mortality) and the SDCH: child poverty rates; severe material deprivation in families with primary education; preschool investment in three time periods: 2005–2007, 2008–2010 and 2012–2015. Outcomes were compared according to the cyclically adjusted primary balance (CAPB, differences between 2013 and 2009) as a measure of austerity, stratified in tertiles. Generalised estimating equation models of repeated measures were used to assess time trend differences in three periods.ResultsCountries with higher levels of austerity had worse outcomes, mainly at the last study period. Material deprivation increased during the period 2012–2015 in those countries with higher CAPB (interaction CAPB-period 2012–2015, B: 5.62: p<0.001), as did LBW (interaction CAPB-period 2012–2015, B: 0.25; p=0.004).ConclusionsCountries that implemented more severe austerity measures have experienced increasing LBW, and for families with primary education also increasing material deprivation, worsening the negative impact of economic crisis. Reversing austerity policies that impact children is likely to improve child health outcomes.
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Clockaerts, S., G. J. V. M. Van Osch, Y. M. Bastiaansen-Jenniskens, J. A. N. Verhaar, F. Van Glabbeek, J. B. Van Meurs, H. J. M. Kerkhof, A. Hofman, B. H. Ch Stricker, and S. M. Bierma-Zeinstra. "Statin use is associated with reduced incidence and progression of knee osteoarthritis in the Rotterdam study." Annals of the Rheumatic Diseases 71, no. 5 (October 11, 2011): 642–47. http://dx.doi.org/10.1136/annrheumdis-2011-200092.
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BackgroundOsteoarthritis is the most frequent chronic joint disease causing pain and disability. Besides biomechanical mechanisms, the pathogenesis of osteoarthritis may involve inflammation, vascular alterations and dysregulation of lipid metabolism. As statins are able to modulate many of these processes, this study examines whether statin use is associated with a decreased incidence and/or progression of osteoarthritis.MethodsParticipants in a prospective population-based cohort study aged 55 years and older (n=2921) were included. x-Rays of the knee/hip were obtained at baseline and after on average 6.5 years, and scored using the Kellgren and Lawrence score for osteoarthritis. Any increase in score was defined as overall progression (incidence and progression). Data on covariables were collected at baseline. Information on statin use during follow-up was obtained from computerised pharmacy databases. The overall progression of osteoarthritis was compared between users and non-users of statins. Using a multivariate logistic regression model with generalised estimating equation, OR and 95% CI were calculated after adjusting for confounding variables.ResultsOverall progression of knee and hip osteoarthritis occurred in 6.9% and 4.7% of cases, respectively. The adjusted OR for overall progression of knee osteoarthritis in statin users was 0.43 (95% CI 0.25 to 0.77, p=0.01). The use of statins was not associated with overall progression of hip osteoarthritis.ConclusionsStatin use is associated with more than a 50% reduction in overall progression of osteoarthritis of the knee, but not of the hip.
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Aanerud, Marianne, Anne-Elie Carsin, Jordi Sunyer, Julia Dratva, Thorarinn Gislason, Deborah Jarvis, Roberto deMarco, et al. "Interaction between asthma and smoking increases the risk of adult airway obstruction." European Respiratory Journal 45, no. 3 (November 27, 2014): 635–43. http://dx.doi.org/10.1183/09031936.00055514.
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The aim of the present study was to analyse the interaction between asthma and smoking in the risk of adult airway obstruction, accounting for atopy.In the European Community Respiratory Health Survey, 15 668 persons aged 20–56 years underwent spirometry in 1991–1993 and 9 years later (n=8916). Risk of airway obstruction and lung function decline associated with smoking and early-onset (<10 years of age) and late-onset (>10 years of age) asthma were analysed with generalised estimating equation models and random-effect linear models, adjusting for covariates. Interaction of asthma with smoking was expressed as relative excess risk due to interaction (RERI).A 20-fold increase in adult airway obstruction was found among those with early-onset asthma independently of smoking status (never-smokers: OR 21.0, 95% CI 12.7–35; current smokers: OR 23.7, 95% CI 13.9–40.6). Late-onset asthma was associated with airway obstruction, with a stronger association among current smokers (OR 25.6, 95% CI 15.6–41.9) than among never-smokers (OR 11.2, 95% CI 6.8–18.6) (RERI 12.02, 95% CI 1.96–22.07). Stratifying by atopy, the association between smoking and asthma was most pronounced among nonatopics.Early- and late-onset asthma were associated with 10–20-fold increased risk of adult airway obstruction. Smoking increased the risk of adult airway obstruction in subjects with asthma onset after age 10 years. Investigation of measures potentially preventive of chronic obstructive pulmonary disease development following asthma is urgently needed.
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Richter, A., J. Listing, M. Schneider, T. Klopsch, A. Kapelle, J. Kaufmann, A. Zink, and A. Strangfeld. "Impact of treatment with biologic DMARDs on the risk of sepsis or mortality after serious infection in patients with rheumatoid arthritis." Annals of the Rheumatic Diseases 75, no. 9 (November 13, 2015): 1667–73. http://dx.doi.org/10.1136/annrheumdis-2015-207838.
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ObjectiveThis observational cohort study investigated the impact of biological (b) disease-modifying antirheumatic drugs (DMARDs) on the outcomes of serious infections (SIs) in patients with rheumatoid arthritis.MethodsWe investigated outcomes of SIs observed in 947 patients enrolled in the German biologics register RABBIT(Rheumatoid arthritis: observation of biologic therapy). Outcomes were (1) recovery without complication, (2) sepsis following SI (≤30 days), and (3) death after SI without known sepsis (≤90 days). We applied a multinomial generalised estimating equation model for longitudinal data to evaluate the risks of sepsis and death simultaneously.ResultsSepsis within 30 days after SI was reported in 135 out of 947 patients, 85 of these had a fatal outcome. Fifty-three patients died within 90 days after SI without known sepsis. The adjusted risk of developing sepsis increased with age and was higher in patients with chronic renal disease. Compared with conventional synthetic (cs)DMARDs, the risk was significantly lower when patients were exposed to bDMARDs at the time of SI (OR: 0.56, 95% CI 0.38 to 0.81). Risk factors of fatal SI were higher age, use of glucocorticoids at higher doses and heart failure. Patients treated with bDMARDs and those with better physical function had a significantly lower mortality risk.ConclusionsThese results suggest a beneficial effect of bDMARDs on the risk of sepsis after SI and the risk of a fatal outcome. Successful immunosuppression may prevent an unregulated host response to SI, that is, the escalation to sepsis. Further investigation is needed to validate these results.
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Wong, Janet Yuen Ha, Maggie Mee Kie Chan, Vivien Wai Yin Tsang, Michelle Tsz Ha Pang, Claudia Kor Yee Chan, Pui Hing Chau, and Agnes Tiwari. "Rubric-based debriefing to enhance nursing students’ critical thinking via simulation." BMJ Simulation and Technology Enhanced Learning 7, no. 1 (April 29, 2020): 11–16. http://dx.doi.org/10.1136/bmjstel-2019-000523.
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IntroductionDebriefing plays a vital role in effective simulation-based learning by providing feedback to students to foster their development of critical thinking in the learning.ObjectivesWe evaluated the effects of rubric-based debriefing on students’ critical thinking, level of confidence in performing tasks and communication.MethodThis is a quasi-experimental study. Final year nursing undergraduates (n=204) of a local university participated in the study. In the intervention group, students performed two 20 min simulation sessions individually with simulated patients followed by a 15 min individual rubric-based debriefing between the two sessions and had a 5 min of that at the end. In the control group, students performed the same simulation sessions followed by a 20 min individual rubric-based debriefing at the end. The primary outcome was comparing the critical thinking of students between two groups, which was assessed by The Northeastern Illinois University Critical Thinking Rubric. The qualitative data were collected by an open-ended question.ResultsBased on generalised estimating equation models, the intervention effect over time was found to be statistically significant (β=2.06, 95% CI 1.04 to 3.08) in enhancing students’ critical thinking. No statistically significant differences were reported in the self-perceived confidence levels between the intervention group and control group. Qualitative data reflected positive feedback from students on simulation activities.ConclusionsThis is the first study to provide evidence that a rubric-based debriefing enhances students’ critical thinking in simulation learning.
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van Nie-Visser, Noémi C., Judith Meijers, Jos Schols, Christa Lohrmann, Sabine Bartholomeyczik, Marieke Spreeuwenberg, and Ruud Halfens. "Which characteristics of nursing home residents influence differences in malnutrition prevalence? An international comparison of The Netherlands, Germany and Austria." British Journal of Nutrition 111, no. 6 (November 18, 2013): 1129–36. http://dx.doi.org/10.1017/s0007114513003541.
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Prevalence rates of malnutrition vary considerably internationally, partly due to differences in measurement methodology and instruments. In the present study, the same measurement methodology and instruments were used in The Netherlands, Germany and Austria. The aim of the present study was to investigate whether resident characteristics influence possible differences in malnutrition prevalence between countries. The study followed a cross-sectional, multi-centre design that measured malnutrition in nursing home residents from The Netherlands, Germany and Austria. Resident data were gathered using a standardised questionnaire. Malnutrition was operationalised using BMI, unintentional weight loss and nutritional intake. Data were analysed using an association model. The prevalence rates of malnutrition in The Netherlands, Germany and Austria were 18·3, 20·1 and 22·5 %, respectively. The multivariate generalised estimating equation (GEE) logistic regression analysis showed that sex, age, care dependency, the mean number of diseases and some specific diseases were influencing factors for whether the resident was malnourished or not. The OR of malnutrition in the three countries declined after including the influencing factors resulting from the multivariate GEE analysis. The present study reveals that differences in the prevalence rates of malnutrition in nursing homes in The Netherlands, Germany and Austria are influenced by different resident characteristics. Since other country-related factors could also play an important role in influencing differences in the prevalence rates of malnutrition between the countries (structural and process factors of malnutrition care policy). We recommend the investigation of these factors in future studies.
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KIM, WOORIM, YOUNG CHOI, TAE-HOON LEE, SUK-YONG JANG, KYU-TAE HAN, and EUN-CHEOL PARK. "Job displacement and social safety net on depressive symptoms in individuals aged 45 years or above: findings from the Korean Longitudinal Study of Aging." Ageing and Society 38, no. 6 (January 31, 2017): 1199–222. http://dx.doi.org/10.1017/s0144686x16001471.
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ABSTRACTThis study aimed to investigate the relationship between the unemployment experience and depressive symptoms among mid-aged (ages 45–59) and elderly (ages 60 or above) persons and to examine further the effects of unemployment insurance, industrial accident compensation insurance (IACI) and national pension on the stated relationship. Data were used from the Korean Longitudinal Study of Aging (KLoSA) between 2006 and 2012. A total of 1,536 individuals employed at the 2006 baseline were followed. The association between employment status change during 2006 to 2008, 2008 to 2010 or 2010 to 2012 and depressive symptoms in years 2008, 2010 or 2012 were analysed using a generalised estimating equation model. Depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale (CES-D 10) scale. The results showed that the ‘employed to unemployed’ group had statistically significant increases in depression scores in the mid-aged (β = 0.4884,p= 0.0038) and elderly (β = 0.8275,p⩽ 0.0001) categories, compared to the ‘employed to employed’ group. Findings were maintained in groups without a social safety net. Contrastingly, the ‘employed to unemployed’ groups with unemployment insurance and IACI did not show statistically significant increases in depression scores. The ‘employed to unemployed’ category of individuals enrolled in the national pension system exhibited a lower increase of depression. Therefore, an enhanced focus on the mental health of unemployed individuals is required, in addition to the provision of a reliable social safety net.
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Zhang, Tingting, Elaine Kingwell, Feng Zhu, John Petkau, Lorne F. Kastrukoff, Ruth Ann Marrie, Helen Tremlett, and Charity Evans. "Effect of adherence to the first-generation injectable immunomodulatory drugs on disability accumulation in multiple sclerosis: a longitudinal cohort study." BMJ Open 7, no. 9 (September 2017): e018612. http://dx.doi.org/10.1136/bmjopen-2017-018612.
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ObjectiveTo examine the association between optimal adherence to the first-generation injectable immunomodulatory drugs (IMDs) for multiple sclerosis (MS) and subsequent disability accumulation.MethodsWe accessed prospectively collected linked clinical and administrative health data from British Columbia, Canada. Subjects with MS treated with a first-generation injectable IMD at an MS clinic (1996–2004) were followed until their last clinic visit before 2009. Adherence was estimated using the proportion of days covered (PDC). The primary outcome was disability accumulation, defined as an increase in the Expanded Disability Status Scale (EDSS) score as recorded during each year of follow-up. Generalised estimating equation models, adjusted for baseline sex, age, EDSS and time between scores, were used to measure associations between optimal adherence (≥80% PDC) during the first year of treatment and subsequent disability accumulation. The relationship between early IMD adherence and the secondary outcome, time to sustained EDSS 6, was examined using Cox proportional hazards regression.ResultsAmong 801 subjects, 598 (74.7%) had optimal adherence over the first year of IMD treatment and 487 (39.0%) demonstrated one or more instances of disability accumulation. Early optimal adherence was not associated with disability accumulation (adjusted OR 0.94; 95% CI 0.78 to 1.15), nor with time to sustained EDSS 6 (adjusted HR 0.91; 95% CI 0.57 to 1.44).ConclusionAlmost three-quarters of subjects with MS had optimal early adherence to their first-line injectable IMD. There was no evidence that this was associated with disability accumulation in the following years.
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Lu, M., M. Pontecorvo, A. Siderowf, AD Joshi, MD Devous, MA Mintun, and A. Montoya. "Prognostic value of 8F-Florbetapir scan: a 36-month follow up analysis using ADNI data." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 42, S1 (May 2015): S30. http://dx.doi.org/10.1017/cjn.2015.143.
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Background: The Alzheimer’s Disease Neuroimaging Initiative (ADNI) provides an opportunity to investigate the relationship between β-Amyloid neuropathology and patients’ long-term cognitive function change. We examined baseline 18F-florbetapir PET amyloid imaging status and 36-months’ change from baseline in cognitive performance in subjects with mild cognitive impairment (MCI). Method: The study included all ADNI subjects who underwent PET-imaging with 18F-florbetapir and had a clinical diagnosis of MCI at the visit closest to florbetapir imaging. β-Amyloid deposition was measured by florbetapir standard uptake value ratio (SUVR), and dichotomized as Aβ+(SUVR>1.1) or Aβ–(SUVR≤1.1). Cognitive scores, including ADAS11, MMSE and CDR sum of boxes (CDR-SB), were evaluated for up to 36 months. Results: Of 478 MCI-subjects who had at least one florbetapir scan, 153 had a cognitive evaluation at 36-month follow-up. Of those, 79 were Aβ– and 74 Aβ+. At 36-months, the Aβ+ vs. Aβ– group scores changed from baseline (LS means 4.03 vs. 0.26 for ADAS11; -2.61 vs.-0.40 for MMSE; 1.53 vs. -0.11 for CDR-SB [p< 0.0001 all comparisons]). Generalised estimating equation analysis on clinically significant cognitive change showed a marginal Odds Ratio=2.18 (95% CI: 1.47–3.21) for Aβ+ vs. Aβ– groups. Conclusion: MCI subjects with higher β-Amyloid deposition had greater deterioration in cognitive function over 36 months while subjects with no β-Amyloid accumulation tended to be stable.
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Bliekendaal, Sander, Maarten Moen, Young Fokker, Janine H. Stubbe, Jos Twisk, and Evert Verhagen. "Incidence and risk factors of medial tibial stress syndrome: a prospective study in Physical Education Teacher Education students." BMJ Open Sport & Exercise Medicine 4, no. 1 (October 2018): e000421. http://dx.doi.org/10.1136/bmjsem-2018-000421.
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ObjectiveMedial tibial stress syndrome (MTSS) is a common lower extremity overuse injury often causing long-term reduction of sports participation. This study aimed to investigate the incidence and risk factors of MTSS in first-year Dutch Physical Education Teacher Education (PETE) students.MethodsThis prospective study consisted of physical measures at baseline (height, weight, fat percentage, 3000 m run test, navicular drop test, hip internal and external range of motion, hip adduction and adduction strength, single leg squat and shin palpation), an intake questionnaire at baseline (age, sport participation, presence of MTSS, MTSS history, insole use and use of supportive shoes) and an MTSS registration procedure during the academic year of 2016–2017 (10 months) using a validated questionnaire. In total 221 first-year PETE students were included, of whom 170 (77%) were male and 51 (23%) female. The evaluation of risk factors was conducted with univariable and multivariable logistic generalised estimating equation analyses.ResultsIn total 55 (25%) subjects, 35 (21%) men and 20 (39%) women, developed MTSS during the follow-up period. The associated risk factors were female sex (OR=3.14, 95% CI 1.39 to 7.11), above-average age (OR=0.31, 95% CI 0.13 to 0.76), above-average body mass index (OR=2.29, 95% CI 1.02 to 5.16) and history of MTSS (OR=5.03, 95% CI 1.90 to 13.30).ConclusionThe incidence of MTSS is high in PETE students. Several risk factors were identified. These results demonstrate the need for prevention and may provide direction to preventive intervention design.
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Cai, Zongwu, Yu Ren, and Linman Sun. "PRICING KERNEL ESTIMATION: A LOCAL ESTIMATING EQUATION APPROACH." Econometric Theory 31, no. 3 (October 27, 2014): 560–80. http://dx.doi.org/10.1017/s0266466614000589.
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This paper investigates a general semiparametric stochastic discount factor formulation that avoids functional form misspecification. A new semiparametric estimation procedure is proposed which combines orthogonality conditions and local linear fitting to give a semiparametric generalized estimating equation approach. Asymptotic properties of the estimators are established and we explore the empirical usefulness of the proposed approach to value-weighted stock returns.
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Vens, M., and A. Ziegler. "Generalized Estimating Equations." Methods of Information in Medicine 49, no. 05 (2010): 421–25. http://dx.doi.org/10.3414/me10-01-0026.
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Summary Background: Generalized estimating equations (GEE) are an extension of generalized linear models (GLM) in that they allow adjusting for correlations between observations. A major strength of GEE is that they do not require the correct specification of the multivariate distribution but only of the mean structure. Objectives: Several concerns have been raised about the validity of GEE when applied to dichotomous dependent variables. In this contribution, we summarize the theoretical findings concerning efficiency and validity of GEE. Methods: We introduce the GEE in a formal way, summarize general findings on the choice of the working correlation matrix, and show the existence of a dilemma for the optimal choice of the working correlation matrix for dichotomous dependent variables. Results: Biological and statistical arguments for choosing a specific working correlation matrix are given. Three approaches are described for overcoming the range restriction of the correlation coefficient. Conclusions: The three approaches described in this article for overcoming the range restrictions for dichotomous dependent variables in GEE models provide a simple and practical way for use in applications.
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Chao, Edward C. "Generalized Estimating Equations." Technometrics 45, no. 4 (November 2003): 363–64. http://dx.doi.org/10.1198/tech.2003.s165.
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