Type I multivariate zero-inflated COM-Poisson regression model.

In this paper, we present the Type I multivariate zero-inflated Conway-Maxwell-Poisson distribution, whose development is based on the extension of the Type I multivariate zero-inflated Poisson distribution. We developed important properties of the distribution and present a regression model. The AIC and BIC criteria are used to select the best fitted model. Two real data sets have been used to illustrate the proposed model. Moreover, we conclude by stating that the Type I multivariate zero-inflated Conway-Maxwell-Poisson distribution produces a better fitted model for multivariate count data with excess of zeros.

A New Regression Model for the Analysis of Overdispersed and Zero-Modified Count Data.

Count datasets are traditionally analyzed using the ordinary Poisson distribution. However, said model has its applicability limited, as it can be somewhat restrictive to handling specific data structures. In this case, the need arises for obtaining alternative models that accommodate, for example, overdispersion and zero modification (inflation/deflation at the frequency of zeros). In practical terms, these are the most prevalent structures ruling the nature of discrete phenomena nowadays. Hence, this paper's primary goal was to jointly address these issues by deriving a fixed-effects regression model based on the hurdle version of the Poisson-Sujatha distribution. In this framework, the zero modification is incorporated by considering that a binary probability model determines which outcomes are zero-valued, and a zero-truncated process is responsible for generating positive observations. Posterior inferences for the model parameters were obtained from a fully Bayesian approach based on the g-prior method. Intensive Monte Carlo simulation studies were performed to assess the Bayesian estimators' empirical properties, and the obtained results have been discussed. The proposed model was considered for analyzing a real dataset, and its competitiveness regarding some well-established fixed-effects models for count data was evaluated. A sensitivity analysis to detect observations that may impact parameter estimates was performed based on standard divergence measures. The Bayesian p-value and the randomized quantile residuals were considered for the task of model validation.

Improvement in fetal pulmonary hypertension and maturity after reversal of ductal constriction: prospective cohort study.

OBJECTIVES: To test the hypotheses that estimated mean pulmonary arterial pressure (MPAP) decreases and pulmonary vascular maturation, assessed by the ratio of pulmonary arterial flow acceleration time to ejection time (AT/ET ratio), increases after reversal of fetal ductus arteriosus constriction by reducing maternal intake of the causal agent (prostaglandin inhibitors, such as polyphenol-rich foods or non-steroidal anti-inflammatory drugs), and that these effects are independent of gestational age, which are inferences not yet demonstrated in the clinical setting. METHODS: This was a prospective cohort study comparing Doppler echocardiographic ductal flow dynamics, MPAP and pulmonary arterial flow AT/ET ratio in third-trimester fetuses (≥ 28 weeks' gestation) with ductus arteriosus constriction, at the time of diagnosis and after 2 weeks of reduced maternal intake of prostaglandin inhibitors either by suspending the use of pharmacological agents with potential for prostaglandin inhibition or by restricting the consumption of polyphenol-rich foods. MPAP was estimated using the Dabestani equation (MPAP = 90 - (0.62 × AT)), and pulmonary vascular maturity was assessed using the AT/ET ratio, according to reported validation studies. Student's t-test was used for comparison of variables at diagnosis with those after reversal of ductal constriction. Change in MPAP and pulmonary AT/ET ratio between the two assessments was compared with the expected change in the same gestational period in normal fetuses based on reference curves of MPAP and pulmonary AT/ET ratio constructed in normal fetuses from healthy pregnant women at 19-37 weeks' gestation, encompassing the same gestational age range as the study group (28-37 weeks). RESULTS: Seventy pregnancies with fetal ductus arteriosus constriction were included in the study. After 2 weeks of reduced maternal intake of prostaglandin inhibitors, normalization of mean systolic (change from 1.86 ± 0.34 m/s at diagnosis to 1.38 ± 0.41 m/s; P < 0.001) and diastolic (change from 0.41 ± 0.11 m/s to 0.21 ± 0.065 m/s; P < 0.001) ductal velocities and of mean pulsatility index (change from 1.99 ± 0.20 to 2.55 ± 0.42; P < 0.001) was demonstrated. MPAP decreased between the assessments (change from 66.7 ± 6.90 mmHg at diagnosis to 54.5 ± 6.70 mmHg after 2 weeks; P < 0.001) and mean pulmonary AT/ET ratio increased (change from 0.20 ± 0.06 to 0.33 ± 0.07; P < 0.001). Change in MPAP between diagnosis and after 2 weeks of reduced maternal intake of prostaglandin inhibitors was -12.2 ± 0.30 mmHg, which was 5.3-times higher than that in 305 normal fetuses over 2 weeks during the same gestational period (-2.3 ± 0.19 mmHg) (P < 0.001), and change in pulmonary AT/ET ratio between the two assessments was 0.13 ± 0.08, which was 8.7-times higher than that in normal fetuses in the same gestational period (0.015 ± 0.08) (P < 0.001). CONCLUSIONS: Resolution of fetal ductal constriction is followed by a fall in MPAP and by an increase in pulmonary vascular maturity, to a significantly greater degree than is observed in normal fetuses in the same gestational-age period. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

A new mixed-effects regression model for the analysis of zero-modified hierarchical count data.

Count data sets are traditionally analyzed using the ordinary Poisson distribution. However, such a model has its applicability limited as it can be somewhat restrictive to handle specific data structures. In this case, it arises the need for obtaining alternative models that accommodate, for example, (a) zero-modification (inflation or deflation at the frequency of zeros), (b) overdispersion, and (c) individual heterogeneity arising from clustering or repeated (correlated) measurements made on the same subject. Cases (a)-(b) and (b)-(c) are often treated together in the statistical literature with several practical applications, but models supporting all at once are less common. Hence, this paper's primary goal was to jointly address these issues by deriving a mixed-effects regression model based on the hurdle version of the Poisson-Lindley distribution. In this framework, the zero-modification is incorporated by assuming that a binary probability model determines which outcomes are zero-valued, and a zero-truncated process is responsible for generating positive observations. Approximate posterior inferences for the model parameters were obtained from a fully Bayesian approach based on the Adaptive Metropolis algorithm. Intensive Monte Carlo simulation studies were performed to assess the empirical properties of the Bayesian estimators. The proposed model was considered for the analysis of a real data set, and its competitiveness regarding some well-established mixed-effects models for count data was evaluated. A sensitivity analysis to detect observations that may impact parameter estimates was performed based on standard divergence measures. The Bayesian p -value and the randomized quantile residuals were considered for model diagnostics.

Two-year Experience of the "Organ Donation Week" of the Federal University of Health Sciences of Porto Alegre, Brazil.

BACKGROUND: Today, Brazil is the second country of the world in number of transplants. Nonetheless, waiting lists are getting longer. This lack of organs occurs mostly because of people's reduced knowledge about the donation process. With the aim of changing this scenario, in 2013 and 2014, "Organ Donation Week" events were held at the Federal University of Health Sciences of Porto Alegre. METHODS: During the 2 years, documentaries followed by a cycle of debates with experts in this area were exhibited. In 2013, a "flash-mob" took place, with the purpose of performing a "transplant waiting list" around the perimeter of Santa Casa's Hospital Complex. In 2014, a morning full of educational activities was planned for the pediatric patients from the Santo Antônio Children's Hospital and their relatives. RESULTS: It is estimated that approximately 1774 people were directly reached by the projects. Among these people, we can include medical students, healthcare professionals, university staff, transplanted patients, and their families. We believe that education and consciousness are central points in the donation and transplant process. Through this project, we could inform people about it, solving their doubts and myths and stimulating this kind of conversation among the family circle, making the moment when the family must make the decision much easier. CONCLUSIONS: Education and public awareness are essential for enhancing the number of organ donations. Therefore, events such as "Organ Donation Week" should be encouraged among medical schools.

Implementing Activities Developed by the Organ Transplantation Academic Society of the Hospital Dom Vicente Scherer: A Pilot Study.

BACKGROUND: The number of academic societies has been growing significantly in Brazilian universities, offering an extra opportunity for the development of educational activities and research. Because organ donation and transplantation is an area still insufficiently approached during the graduation of health professionals, we evaluated how academic societies might be a valuable tool. METHODS: Participants of the course promoted by the Organ Transplantation Academic Society of the Hospital Dom Vicente Scherer were evaluated through the use of a questionnaire and cognitive tests with 16 multiple-choice questions about topics approached during the course, before and after the lectures. Topics approached consisted of a general introduction about transplantation in Brazil, brain death, organ allocation and removal, post-transplant follow-up, and clinical cases. RESULTS: Of the 45 participants, 30 answered the tests at both times. The subjects were students of medicine, nursing, and phonoaudiology; 93.3% were organ donors, 84.6% said their families knew about this decision, and 65% had relatives who were organ donors. The mean score of correct answers was 7.63 of 16 before the activities and 12.54 after activities, demonstrating a 64.4% improvement. CONCLUSIONS: The improvement in performance suggests that academic societies are a useful resource for educational purposes and for students to get a deeper insight about organ donation and transplantation.

Zero-modified Poisson model: Bayesian approach, influence diagnostics, and an application to a Brazilian leptospirosis notification data.

In this paper, a Bayesian method for inference is developed for the zero-modified Poisson (ZMP) regression model. This model is very flexible for analyzing count data without requiring any information about inflation or deflation of zeros in the sample. A general class of prior densities based on an information matrix is considered for the model parameters. A sensitivity study to detect influential cases that can change the results is performed based on the Kullback-Leibler divergence. Simulation studies are presented in order to illustrate the performance of the developed methodology. Two real datasets on leptospirosis notification in Bahia State (Brazil) are analyzed using the proposed methodology for the ZMP model.

Pyocolpos in a Pinscher bitch: a case report

Diseases related to the urogenital system in both males and females, are common in clinical routine of smallanimal and represents important causes of morbidity and mortality in dogs and cats. Pyocolpos is a cysticdilatation of the vagina due to the accumulation of pus resulting from the genital tract obstruction. The maincause of obstruction is imperforate hymen, transverse vaginal membrane, or vaginal atresia.We present a caseof a three-year-old female Pinscher with a history of constipation for four days, even after administration oflaxatives and enema, and estrus for ten days without a report of cover. Physical examinations were performed,which revealed increased abdominal size. Ultrasound confirmed the presence of large amounts of vaginal fluid.Exploratory laparotomy was performed, which confirmed the diagnosis of pyocolpos. Although pyocolposis a rare congenital malformation in female domestic animals, this report of its existence underscores theimportance of more accurate clinical research when increased abdominal size is noted by veterinarians.

Celiac artery with a pulmonary branch in dog: a rare variation

Hepatic, lienal and left gastric arteries are the "classical branches" of the celiac artery in dogs. This report describes a rare case in which the celiac artery emitted a branch to the caudal lobe of the right lung in an adult male mongred dog. The celiac artery and its proximal branches were dissected in situ, and measured with a digital pachymeter.This vascular variation was not previously known in the canine species. The knowledge about the presence of the celiac artery variations in dogs will contribute to a better understanding of the anatomical alterations that can occur in the vascularization of the abdominal region in dogs. The report is also important for angiographic, surgical and clinical procedures that involve this region.

Richards growth model and viability indicators for populations subject to interventions.

In this work we study the problem of modeling identification of a population employing a discrete dynamic model based on the Richards growth model. The population is subjected to interventions due to consumption, such as hunting or farming animals. The model identification allows us to estimate the probability or the average time for a population number to reach a certain level. The parameter inference for these models are obtained with the use of the likelihood profile technique as developed in this paper. The identification method here developed can be applied to evaluate the productivity of animal husbandry or to evaluate the risk of extinction of autochthon populations. It is applied to data of the Brazilian beef cattle herd population, and the the population number to reach a certain goal level is investigated.

Richards growth model and viability indicators for populations subject to interventions

In this work we study the problem of modeling identification of a population employing a discrete dynamic model based on the Richards growth model. The population is subjected to interventions due to consumption, such as hunting or farming animals. The model identification allows us to estimate the probability or the average time for a population number to reach a certain level. The parameter inference for these models are obtained with the use of the likelihood profile technique as developed in this paper. The identification method here developed can be applied to evaluate the productivity of animal husbandry or to evaluate the risk of extinction of autochthon populations. It is applied to data of the Brazilian beef cattle herd population, and the the population number to reach a certain goal level is investigated.

Neste trabalho estudamos o problema de identificação do modelo de uma população utilizando um modelo dinâmico discreto baseado no modelo de crescimento de Richards. A população é submetida a intervenções devido ao consumo, como no caso de caça ou na criação de animais. A identificação do modelo permite-nos estimar a probabilidade ou o tempo médio de ocorrência para que se atinja um certo número populacional. A inferência paramétrica dos modelos é obtida através da técnica de perfil de máxima verossimilhança como desenvolvida neste trabalho. O método de identificação desenvolvido pode ser aplicado para avaliar a produtividade de criação animal ou o risco de extinção de uma população autóctone. Ele foi aplicado aos dados da população global de gado de corte bovino brasileiro, e é utilizado na investigação de a população atingir um certo número desejado de cabeças.