• Title/Summary/Keyword: covariate

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Penalized variable selection in mean-variance accelerated failure time models (평균-분산 가속화 실패시간 모형에서 벌점화 변수선택)

  • Kwon, Ji Hoon;Ha, Il Do
    • The Korean Journal of Applied Statistics
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    • v.34 no.3
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    • pp.411-425
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    • 2021
  • Accelerated failure time (AFT) model represents a linear relationship between the log-survival time and covariates. We are interested in the inference of covariate's effect affecting the variation of survival times in the AFT model. Thus, we need to model the variance as well as the mean of survival times. We call the resulting model mean and variance AFT (MV-AFT) model. In this paper, we propose a variable selection procedure of regression parameters of mean and variance in MV-AFT model using penalized likelihood function. For the variable selection, we study four penalty functions, i.e. least absolute shrinkage and selection operator (LASSO), adaptive lasso (ALASSO), smoothly clipped absolute deviation (SCAD) and hierarchical likelihood (HL). With this procedure we can select important covariates and estimate the regression parameters at the same time. The performance of the proposed method is evaluated using simulation studies. The proposed method is illustrated with a clinical example dataset.

Novel nomogram-based integrated gonadotropin therapy individualization in in vitro fertilization/intracytoplasmic sperm injection: A modeling approach

  • Ebid, Abdel Hameed IM;Motaleb, Sara M Abdel;Mostafa, Mahmoud I;Soliman, Mahmoud MA
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.2
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    • pp.163-173
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    • 2021
  • Objective: This study aimed to characterize a validated model for predicting oocyte retrieval in controlled ovarian stimulation (COS) and to construct model-based nomograms for assistance in clinical decision-making regarding the gonadotropin protocol and dose. Methods: This observational, retrospective, cohort study included 636 women with primary unexplained infertility and a normal menstrual cycle who were attempting assisted reproductive therapy for the first time. The enrolled women were split into an index group (n=497) for model building and a validation group (n=139). The primary outcome was absolute oocyte count. The dose-response relationship was tested using modified Poisson, negative binomial, hybrid Poisson-Emax, and linear models. The validation group was similarly analyzed, and its results were compared to that of the index group. Results: The Poisson model with the log-link function demonstrated superior predictive performance and precision (Akaike information criterion, 2,704; λ=8.27; relative standard error (λ)=2.02%). The covariate analysis included women's age (p<0.001), antral follicle count (p<0.001), basal follicle-stimulating hormone level (p<0.001), gonadotropin dose (p=0.042), and protocol type (p=0.002 and p<0.001 for short and antagonist protocols, respectively). The estimates from 500 bootstrap samples were close to those of the original model. The validation group showed model assessment metrics comparable to the index model. Based on the fitted model, a static nomogram was built to improve visualization. In addition, a dynamic electronic tool was created for convenience of use. Conclusion: Based on our validated model, nomograms were constructed to help clinicians individualize the stimulation protocol and gonadotropin doses in COS cycles.

Prediction of Deficiency Pattern in Diabetic Patients Using Multi-frequency Bioimpedance Resistance (다주파수 생체임피던스 저항을 이용한 당뇨병 환자의 허증 변증 예측)

  • Kim, Kahye;Kim, Seul Gee;Cha, Jiyun;Yoo, Ho-Ryong;Kim, Jaeuk U.
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.36 no.3
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    • pp.94-99
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    • 2022
  • The discovery of biomarkers related to pattern identification (PI), the core diagnostic theory of Korean medicine (KM), is one of the methods that can provide objective and reliable evidence by applying PI to clinical practice. In this study, 40 diabetic patients and 41 healthy control subjects recruited from the Korean medicine clinic were examined to determine the human electrical response related to the deficiency pattern, a representative pattern of diabetes. Qi-Blood-Yin-Yang deficiency pattern scores, which are representative deficiency patterns for diabetes mellitus, were obtained through a questionnaire with verified reliability and validity, and the human electrical response was measured non-invasively using a bioimpedance meter. In ANCOVA analysis using gender as a covariate, the 5 kHz frequency resistance and 5-250 kHz frequency reactance were significantly lower in the diabetic group than in non-diabetic control group. In addition, the multiple regression analysis showed a positive correlation (R2=0.11~0.19) between the Yang deficiency pattern score and resistance value for the diabetic group; the correlation was higher at higher frequencies of 50kHz (R2=0.18) and 250kHz (R2=0.19) compared to 5kHz(R2=0.11). In contrast, there was no such significant association in the control group. It implies that bioimpedance resistance measured at finite frequencies may be useful in predicting Yang deficiency, which is closely related to diabetic complications by reflecting the decrease in body water content and metabolism. In the future, large-scale planned clinical studies will be needed to identify biomarkers associated with different types of PI in diabetes.

Association Between Cadmium Exposure and Liver Function in Adults in the United States: A Cross-sectional Study

  • Hong, Dongui;Min, Jin-Young;Min, Kyoung-Bok
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.6
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    • pp.471-480
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    • 2021
  • Objectives: Cadmium is widely used, leading to extensive environmental and occupational exposure. Unlike other organs, for which the harmful and carcinogenic effects of cadmium have been established, the hepatotoxicity of cadmium remains unclear. Some studies detected correlations between cadmium exposure and hepatotoxicity, but others concluded that they were not associated. Thus, we investigated the relationship between cadmium and liver damage in the general population. Methods: In total, 11 838 adult participants from National Health and Nutrition Examination Survey 1999-2015 were included. Urinary cadmium levels and the following liver function parameters were measured: alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), total bilirubin (TB), and alkaline phosphatase (ALP). Linear and logistic regression analyses were performed to assess the associations between urinary cadmium concentrations and each liver function parameter after adjusting for age, sex, race/ethnicity, annual family income, smoking status, alcohol consumption status, physical activity, and body mass index. Results: The covariate-adjusted results of the linear regression analyses showed significant positive relationships between log-transformed urinary cadmium levels and each log-transformed liver function parameter, where beta±standard error of ALT, AST, GGT, TB, and ALP were 0.049±0.008 (p<0.001), 0.030±0.006 (p<0.001), 0.093±0.011 (p<0.001), 0.034±0.009 (p<0.001), and 0.040±0.005 (p<0.001), respectively. Logistic regression also revealed statistically significant results. The odds ratios (95% confidence intervals) of elevated ALT, AST, GGT, TB, and ALP per unit increase in log-transformed urinary cadmium concentration were 1.360 (1.210 to 1.528), 1.307 (1.149 to 1.486), 1.520 (1.357 to 1.704), 1.201 (1.003 to 1.438), and 1.568 (1.277 to 1.926), respectively. Conclusions: Chronic exposure to cadmium showed positive associations with liver damage.

Preventive Measures Against COVID-19 in Small- and Mid-sized Enterprises from an Early Stage of the Epidemic in Daegu and Gyeongsangbuk-do

  • Baek, Kiook;Kim, Seong-Hui;Park, Chulyong;Sakong, Joon
    • Safety and Health at Work
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    • v.13 no.3
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    • pp.294-301
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    • 2022
  • Background: In the early stage of the coronavirus disease 2019 (COVID-19) epidemic, small- and midsized enterprises (SMEs) may be an important transmission consideration. The study aimed to identify the pattern of COVID-19 prevention measures during the outbreaks in Daegu and Gyeongsangbuk-do at the early stage of COVID-19. Moreover, we investigated whether SME size and past experiences affected the preventive measures implemented in the region. Methods: A survey detailing the general characteristics and implementation of 12 preventive activities was conducted in 122 SMEs in Daegu and Gyeongsangbuk-do. The survey was analyzed by size and operation period. Results: The study subjects consisted of 53 (43.4%) workplaces with 1-5 employees, 50 (40.9%) workplaces with 6-30 employees, and 19 (15.6%) workplaces with 31-49 employees. The lowest three items among those surveyed were 'symptomatic workers to stay home for 3-4 days' (17.2%), 'work remotely' (18.9%), and 'video meetings' (20.5%). There were significant differences in the rate of several preventive measures implemented. The larger sized SMEs, the higher the number of implementations (p < 0.01). The operation period had no significant relationship with the implementation of preventive measures. The same pattern was observed in multiple generalized linear regression with covariate adjustment. Conclusion: Preventive measures among SMEs with fewer than 50 employees were identified. Even within SMEs, a gap in preventive measures according to size was confirmed. To prevent the spread of infection and protect workers' right to health, different support for different sized SMEs is necessary.

Evaluation of models for estimation of genetic parameters for post-weaning body measurements and their association with yearling weight in Nellore sheep

  • Satish Kumar Illa;Gangaraju Gollamoori;Sapna Nath
    • Animal Bioscience
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    • v.37 no.3
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    • pp.419-427
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    • 2024
  • Objective: The objective of this study was to obtain (co) variance components and genetic parameter estimates for post-weaning body measurements such as body length (BL), height at withers (HW), and chest girth (HG) recorded at six (SBL, SHW, and SHG), nine (NBL, NHW, and NHG) and twelve (YBL, YHW, and YHG) months of age along with yearling weight (YW) in Nellore sheep maintained at livestock research station, Palamaner, Andhra Pradesh, India and also the association among body measurements with YW was studied. Methods: Data on 2,076 Nellore sheep (descended from 75 sires and 522 dams) recorded between 2007 and 2016 (10 years) were utilized in the study. Lambing year, sex of lamb, season of lambing and parity of dam were included in the model as fixed effects and ewe weight was kept as a covariate. Analyses were conducted with six animal models with different combinations of direct and maternal genetic effects using restricted maximum likelihood procedure. Best model for each trait was determined based on Akaike's information criterion. Results: Moderate estimates of direct heritability were obtained for the studied traits viz., BL (0.02 to 0.24), HW (0.31 to 0.49), and CG (0.08 to 0.35) and their corresponding maternal heritability estimates were in the range of 0.00 to 0.07 (BL), 0.13 to 0.17 (HW), and 0.07 to 0.13 (CG), respectively. Positive direct genetic and phenotypic correlations among the traits and they ranged from 0.07 (YBL-YW) to 0.99 (SBL-SHG, SHG-YW, and NBL-YBL) and 0.01 (SBL-YBL) to 0.99 (NBL-NHG), respectively. Further, the genetic correlations among all the body measurements and YW were positive and ranged from 0.07 (YW and YBL) to 0.99 (YW and SHG). Conclusion: There was a strong association of chest girth at six months with YW. Further, it is indicated that moderate improvement of post-weaning body measurements in Nellore sheep would be possible through selection.

An analysis of the waning effect of COVID-19 vaccinations

  • Bogyeom Lee;Hanbyul Song;Catherine Apio;Kyulhee Han;Jiwon Park;Zhe Liu;Hu Xuwen;Taesung Park
    • Genomics & Informatics
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    • v.21 no.4
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    • pp.50.1-50.9
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    • 2023
  • Vaccine development is one of the key efforts to control the spread of coronavirus disease 2019 (COVID-19). However, it has become apparent that the immunity acquired through vaccination is not permanent, known as the waning effect. Therefore, monitoring the proportion of the population with immunity is essential to improve the forecasting of future waves of the pandemic. Despite this, the impact of the waning effect on forecasting accuracies has not been extensively studied. We proposed a method for the estimation of the effective immunity (EI) rate which represents the waning effect by integrating the second and booster doses of COVID-19 vaccines. The EI rate, with different periods to the onset of the waning effect, was incorporated into three statistical models and two machine learning models. Stringency Index, omicron variant BA.5 rate (BA.5 rate), booster shot rate (BSR), and the EI rate were used as covariates and the best covariate combination was selected using prediction error. Among the prediction results, Generalized Additive Model showed the best improvement (decreasing 86% test error) with the EI rate. Furthermore, we confirmed that South Korea's decision to recommend booster shots after 90 days is reasonable since the waning effect onsets 90 days after the last dose of vaccine which improves the prediction of confirmed cases and deaths. Substituting BSR with EI rate in statistical models not only results in better predictions but also makes it possible to forecast a potential wave and help the local community react proactively to a rapid increase in confirmed cases.

Functional Insufficiency of Mitral and Tricuspid Valves Associated With Atrial Fibrillation: Impact of Postoperative Atrial Fibrillation Recurrence on Surgical Outcomes

  • Kitae Kim;Jin Kim;Sung-Ho Jung;JaeWon Lee;Joon Bum Kim
    • Korean Circulation Journal
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    • v.53 no.8
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    • pp.550-562
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    • 2023
  • Background and Objectives: To identify the factors associated with adverse outcomes following surgery for functional insufficiency of the mitral valve (MV) or tricuspid valve (TV) associated with atrial fibrillation (AF). Methods: We evaluated 100 patients (age, 66.5±10.0 years; 47 males) who consecutively underwent surgery for functional insufficiency of the MV or TV associated with AF between January 2000 and December 2020 at our center. The primary outcome was a composite endpoint of all-cause death, valve reoperation, congestive heart failure (CHF) requiring rehospitalization, and stroke. Results: During follow-up (532 patients-years [PYs]), adverse events included death in 16 (3.0%/yr), MV reoperation in 1 (0.2%/yr), CHF in 14 (2.6%/yr), and stroke in 5 (0.9%/yr) patients, demonstrating a 5-year rate of freedom from the primary endpoint of 69.5%. The rate of postoperative AF was high even in those who underwent AF ablation (n=92), with cumulative rates of 48.1% at 1 year and 60.2% at 5 years. In multivariable analyses, the primary outcome was significantly associated with age (adjusted hazard ratio [aHR], 1.06; 95% confidence interval [CI], 1.02-1.10; p=0.005), chronic kidney disease (aHR, 7.76; 95% CI, 2.28-26.38; p=0.001), left atrial appendage exclusion (aHR, 0.35; 95% CI, 0.16-1.78; p=0.010), and postoperative AF as a time-varying covariate (aHR, 3.33; 95% CI, 1.50-7.40; p=0.003). Conclusion: Among patients undergoing surgery for functional atrioventricular insufficiency associated with AF, a significant proportion showed recurrence of AF over time after concomitant AF ablation, which was significantly associated with poor clinical outcomes.

Investigation of the Correlation between Seoul Neuropsychological Screening Battery Scores and the Gray Matter Volume after Correction of Covariates of the Age, Gender, and Genotypes in Patients with AD and MCI (알츠하이머 치매 및 경도인지기능장애 환자에서 나이, 성별, 유전자형을 고려한 뇌 회백질 부피와 표준신경심리검사와의 상관관계 연구)

  • Lee, Seung-Yeon;Yoon, Soo-Young;Kim, Min-Ji;Rhee, Hak Young;Ryu, Chang-Woo;Jahng, Geon-Ho
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.4
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    • pp.294-307
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    • 2013
  • Purpose : To investigate the correlations between Seoul Neuropsychological Screening Battery (SNSB) scores and the gray matter volumes (GMV) in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) and cognitively normal (CN) elderly subjects with correcting the genotypes. Materials and Methods: Total 75 subjects were enrolled with 25 subjects for each group. The apolipoprotein E (APOE) epsilon genotypes, SNSB scores, and the 3D T1-weighted images were obtained from all subjects. Correlations between SNSB scores and GMV were investigated with the multiple regression method for each subject group using both voxel-based and region-of-interest-based analyses with covariates of age, gender, and the genotype. Results: In the AD group, Rey Complex Figure Test (RCFT) delayed recall scores were positively correlated with GMV. In the MCI group, Seoul Verbal Learning Test (SVLT) scores were positively correlated with GMV. In the CN group, GMV negatively correlated with Boston Naming Test (K-BNT) scores and Mini-Mental State Examimation (K-MMSE) scores, but positively correlated with RCFT scores. Conclusion: When we used covariates of age, gender, and the genotype, we found statistically significant correlations between some SNSB scores and GMV at some brain regions. It may be necessary to further investigate a longitudinal study to understand the correlation.

Estimation of Genetic Parameters for Litter Size and Sex Ratio in Yorkshire and Landrace Pigs (요크셔종과 랜드레이스종의 산자수 및 성비에 대한 유전모수 추정)

  • Lee, Kyung-Soo;Kim, Jong-Bok;Lee, Jeong-Koo
    • Journal of Animal Science and Technology
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    • v.52 no.5
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    • pp.349-356
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    • 2010
  • This study was conducted to estimate heritabilities, repeatabilities and rank correlation coefficients among breeding values for litter size and sex ratio of Yorkshire and Landrace pigs using various single trait animal models. The analyses were carried out the data comprising 26,390 litters of Yorkshire and 26,173 litters of Landrace collected from the year 1998 to 2008 at a private swine breeding farm located in central part of Korea. Five different analytical models were used for genetic parameter estimation. Model 1 was most simple basic model fitted with year-month contemporary group fixed effect, random additive genetic effect and random residual effect. Model 2 was similar to the model 1 but permanent maternal environmental effect added as random effect, and model 3 was similar with the model 2 but linear and quadratic effects of sow age were added as fixed covariate effect. Model 4 was similar as model 2 except that the parity was added as fixed effect and model 5 was similar to model 3 or model 4 but covariate of sow age was nested within parity effect. The results obtained in this study are summarized as follows: The means and standard error of total number of pigs born per litter (TNB) and number of pigs born alive per litter (NBA) were $11.35{\pm}0.02$ and $10.04{\pm}0.02$ for Yorkshire, $10.97{\pm}0.02$ and $9.98{\pm}0.02$ for Landrace, respectively. The sex ratio (percentage of female per litter) was $45.75{\pm}0.11%$ and $45.75{\pm}0.11%$ for Yorkshire and Landrace, respectively. The heritability estimates of TNB (0.243) and NBA (0.192) from model 1 tended to be higher than those from any other models in both breeds. Differences in heritability and repeatability for TNB were not large among models 3, 4 and 5 and same tendency of negligible differences among estimates by models 3, 4 and 5 were observed for NBA, where heritability and repeatability ranged from 0.096 to 0.099 and from 0.188 to 0.193, respectively, in Yorkshire; and ranged from 0.092 to 0.098 and from 0.193 and 0.196, respectively, in Landrace. The heritability estimates for sex ratio were close to zero which was ranged from 0.002 to 0.003 for TNB and from 0.001 to 0.003 for NBA over the models applied. The rank correlation coefficients of breeding values by model 1 with those from other models (model 2, 3, 4 and 5), and breeding values by model 2 with those from other models (model 1, 3, 4 and 5) were highly positive but lower than the coefficients among breeding values by model 3, model 4 and model 5 which were high of 0.99, approximately, for TNB and NBA of both breeds.