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1.
J Environ Manage ; 369: 122317, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39217903

RESUMEN

The growing use of information and communication technologies (ICT) has the potential to increase productivity and improve energy efficiency. However, digital technologies also consume energy, resulting in a complex relationship between digitalization and energy demand and an uncertain net effect. To steer digital transformation towards sustainability, it is crucial to understand the conditions under which digital technologies increase or decrease firm-level energy consumption. This study examines the drivers of this relationship, focusing on German manufacturing firms and leveraging comprehensive administrative panel data from 2009 to 2017, analyzed using the Generalized Random Forest algorithm. Our results reveal that the relationship between digitalization and energy use at the firm level is heterogeneous. However, we find that digitalization more frequently increases energy use, mainly driven by a rise in electricity consumption. This increase is lower in energy-intensive industries and higher in markets with low competition. Smaller firms in structurally weak regions show higher energy consumption growth than larger firms in economically stronger regions. Our study contributes to the literature by using a non-parametric method to identify specific firm-level and external characteristics that influence the impact of digital technologies on energy demand, highlighting the need for carefully designed digitalization policies to achieve climate goals.


Asunto(s)
Electricidad , Alemania , Tecnología Digital , Industrias
2.
Biom J ; 65(8): e2200229, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37357560

RESUMEN

The reference interval is the most widely used medical decision-making, constituting a central tool in determining whether an individual is healthy or not. When the results of several continuous diagnostic tests are available for the same patient, their clinical interpretation is more reliable if a multivariate reference region (MVR) is available rather than multiple univariate reference intervals. MVRs, defined as regions containing 95% of the results of healthy subjects, extend the concept of the reference interval to the multivariate setting. However, they are rarely used in clinical practice owing to difficulties associated with their interpretability and the restrictions inherent to the assumption of a Gaussian distribution. Further statistical research is thus needed to make MVRs more applicable and easier for physicians to interpret. Since the joint distribution of diagnostic test results may well change with patient characteristics independent of disease status, MVRs adjusted for covariates are desirable. The present work introduces a novel formulation for MVRs based on multivariate conditional transformation models (MCTMs). Additionally, we take into account the estimation uncertainty of such MVRs by means of tolerance regions. These conditional MVRs imply no parametric restriction on the response, and potentially nonlinear continuous covariate effects can be estimated. MCTMs allow the estimation of the effects of covariates on the joint distribution of multivariate response variables and on these variables' marginal distributions, via the use of most likely transformation estimation. Our contributions proved reliable when tested with simulated data and for a real data application with two glycemic markers.


Asunto(s)
Toma de Decisiones Clínicas , Humanos , Distribución Normal , Incertidumbre
3.
Comput Stat ; 38(2): 647-674, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37223721

RESUMEN

Topic models are a useful and popular method to find latent topics of documents. However, the short and sparse texts in social media micro-blogs such as Twitter are challenging for the most commonly used Latent Dirichlet Allocation (LDA) topic model. We compare the performance of the standard LDA topic model with the Gibbs Sampler Dirichlet Multinomial Model (GSDMM) and the Gamma Poisson Mixture Model (GPM), which are specifically designed for sparse data. To compare the performance of the three models, we propose the simulation of pseudo-documents as a novel evaluation method. In a case study with short and sparse text, the models are evaluated on tweets filtered by keywords relating to the Covid-19 pandemic. We find that standard coherence scores that are often used for the evaluation of topic models perform poorly as an evaluation metric. The results of our simulation-based approach suggest that the GSDMM and GPM topic models may generate better topics than the standard LDA model.

4.
BMC Med Res Methodol ; 22(1): 187, 2022 07 11.
Artículo en Inglés | MEDLINE | ID: mdl-35818026

RESUMEN

BACKGROUND: Due to contradictory results in current research, whether age at menopause is increasing or decreasing in Western countries remains an open question, yet worth studying as later ages at menopause are likely to be related to an increased risk of breast cancer. Using data from breast cancer screening programs to study the temporal trend of age at menopause is difficult since especially younger women in the same generational cohort have often not yet reached menopause. Deleting these younger women in a breast cancer risk analyses may bias the results. The aim of this study is therefore to recover missing menopause ages as a covariate by comparing methods for handling missing data. Additionally, the study makes a contribution to understanding the evolution of age at menopause for several generations born in Portugal between 1920 and 1970. METHODS: Data from a breast cancer screening program in Portugal including 278,282 women aged 45-69 and collected between 1990 and 2010 are used to compare two approaches of imputing age at menopause: (i) a multiple imputation methodology based on a truncated distribution but ignoring the mechanism of missingness; (ii) a copula-based multiple imputation method that simultaneously handles the age at menopause and the missing mechanism. The linear predictors considered in both cases have a semiparametric additive structure accommodating linear and non-linear effects defined via splines or Markov random fields smoothers in the case of spatial variables. RESULTS: Both imputation methods unveiled an increasing trend of age at menopause when viewed as a function of the birth year for the youngest generation. This trend is hidden if we model only women with an observed age at menopause. CONCLUSION: When studying age at menopause, missing ages must be recovered with an adequate procedure for incomplete data. Imputing these missing ages avoids excluding the younger generation cohort of the screening program in breast cancer risk analyses and hence reduces the bias stemming from this exclusion. In addition, imputing the not yet observed ages of menopause for mostly younger women is also crucial when studying the time trend of age at menopause otherwise the analysis will be biased.


Asunto(s)
Neoplasias de la Mama , Menopausia , Sesgo , Neoplasias de la Mama/epidemiología , Estudios de Cohortes , Femenino , Humanos , Medición de Riesgo
5.
Biom J ; 63(5): 1028-1051, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33734453

RESUMEN

Expectile regression, in contrast to classical linear regression, allows for heteroscedasticity and omits a parametric specification of the underlying distribution. This model class can be seen as a quantile-like generalization of least squares regression. Similarly as in quantile regression, the whole distribution can be modeled with expectiles, while still offering the same flexibility in the use of semiparametric predictors as modern mean regression. However, even with no parametric assumption for the distribution of the response in expectile regression, the model is still constructed with a linear relationship between the fitted value and the predictor. If the true underlying relationship is nonlinear then severe biases can be observed in the parameter estimates as well as in quantities derived from them such as model predictions. We observed this problem during the analysis of the distribution of a self-reported hearing score with limited range. Classical expectile regression should in theory adhere to these constraints, however, we observed predictions that exceeded the maximum score. We propose to include a response function between the fitted value and the predictor similarly as in generalized linear models. However, including a fixed response function would imply an assumption on the shape of the underlying distribution function. Such assumptions would be counterintuitive in expectile regression. Therefore, we propose to estimate the response function jointly with the covariate effects. We design the response function as a monotonically increasing P-spline, which may also contain constraints on the target set. This results in valid estimates for a self-reported listening effort score through nonlinear estimates of the response function. We observed strong associations with the speech reception threshold.


Asunto(s)
Modelos Lineales , Sesgo , Humanos
6.
Stat Med ; 38(3): 413-436, 2019 02 10.
Artículo en Inglés | MEDLINE | ID: mdl-30334275

RESUMEN

Bivariate copula regression allows for the flexible combination of two arbitrary, continuous marginal distributions with regression effects being placed on potentially all parameters of the resulting bivariate joint response distribution. Motivated by the risk factors for adverse birth outcomes, many of which are dichotomous, we consider mixed binary-continuous responses that extend the bivariate continuous framework to the situation where one response variable is discrete (more precisely, binary) whereas the other response remains continuous. Utilizing the latent continuous representation of binary regression models, we implement a penalized likelihood-based approach for the resulting class of copula regression models and employ it in the context of modeling gestational age and the presence/absence of low birth weight. The analysis demonstrates the advantage of the flexible specification of regression impacts including nonlinear effects of continuous covariates and spatial effects. Our results imply that racial and spatial inequalities in the risk factors for infant mortality are even greater than previously suggested.


Asunto(s)
Recien Nacido Prematuro , Modelos Estadísticos , Resultado del Embarazo/epidemiología , Análisis de Regresión , Femenino , Edad Gestacional , Humanos , Lactante , Mortalidad Infantil , Recién Nacido de Bajo Peso , Recién Nacido , Funciones de Verosimilitud , Embarazo
7.
Health Econ ; 27(7): 1074-1088, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29676015

RESUMEN

We reconsider the relationship between income and health taking a distributional perspective rather than one centered on conditional expectation. Using structured additive distributional regression, we find that the association between income and health is larger than generally estimated because aspects of the conditional health distribution that go beyond the expectation imply worse outcomes for those with lower incomes. Looking at German data from the Socio-Economic Panel, we find that the risk of bad health is roughly halved when doubling the net equivalent income from 15,000 to 30,000€. This is more than tenfold of the magnitude of change found when considering expected health measures. A distributional perspective thus highlights another dimension of the income-health relation-that the poor are in particular faced with greater health risk at the lower end of the health distribution. We therefore argue that when studying health outcomes, a distributional approach that considers stochastic variation among observationally equivalent individuals is warranted.


Asunto(s)
Economía Médica , Estado de Salud , Disparidades en Atención de Salud , Renta/estadística & datos numéricos , Modelos Estadísticos , Alemania , Humanos , Factores Socioeconómicos
9.
Biom J ; 59(6): 1232-1246, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28660685

RESUMEN

Studies addressing breast cancer risk factors have been looking at trends relative to age at menarche and menopause. These studies point to a downward trend of age at menarche and an upward trend for age at menopause, meaning an increase of a woman's reproductive lifespan cycle. In addition to studying the effect of the year of birth on the expectation of age at menarche and a woman's reproductive lifespan, it is important to understand how a woman's cohort affects the correlation between these two variables. Since the behavior of age at menarche and menopause may vary with the geographic location of a woman's residence, the spatial effect of the municipality where a woman resides needs to be considered. Thus, a Bayesian multivariate structured additive distributional regression model is proposed in order to analyze how a woman's municipality and year of birth affects a woman's age of menarche, her lifespan cycle, and the correlation of the two. The data consists of 212,517 postmenopausal women, born between 1920 and 1965, who attended the breast cancer screening program in the central region of Portugal.


Asunto(s)
Envejecimiento/fisiología , Biometría/métodos , Menarquia/fisiología , Modelos Estadísticos , Reproducción , Adolescente , Adulto , Teorema de Bayes , Niño , Preescolar , Femenino , Humanos , Persona de Mediana Edad , Análisis de Regresión , Adulto Joven
10.
Biom J ; 59(6): 1104-1121, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28321912

RESUMEN

Joint models for longitudinal and time-to-event data have gained a lot of attention in the last few years as they are a helpful technique clinical studies where longitudinal outcomes are recorded alongside event times. Those two processes are often linked and the two outcomes should thus be modeled jointly in order to prevent the potential bias introduced by independent modeling. Commonly, joint models are estimated in likelihood-based expectation maximization or Bayesian approaches using frameworks where variable selection is problematic and that do not immediately work for high-dimensional data. In this paper, we propose a boosting algorithm tackling these challenges by being able to simultaneously estimate predictors for joint models and automatically select the most influential variables even in high-dimensional data situations. We analyze the performance of the new algorithm in a simulation study and apply it to the Danish cystic fibrosis registry that collects longitudinal lung function data on patients with cystic fibrosis together with data regarding the onset of pulmonary infections. This is the first approach to combine state-of-the art algorithms from the field of machine-learning with the model class of joint models, providing a fully data-driven mechanism to select variables and predictor effects in a unified framework of boosting joint models.


Asunto(s)
Biometría/métodos , Modelos Estadísticos , Teorema de Bayes , Fibrosis Quística/epidemiología , Humanos , Funciones de Verosimilitud , Estudios Longitudinales , Aprendizaje Automático , Sistema de Registros , Factores de Tiempo
11.
J Environ Manage ; 187: 154-165, 2017 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-27894047

RESUMEN

Wildfires are one of the main environmental problems facing societies today, and in the case of Galicia (north-west Spain), they are the main cause of forest destruction. This paper used binary structured additive regression (STAR) for modelling the occurrence of wildfires in Galicia. Binary STAR models are a recent contribution to the classical logistic regression and binary generalized additive models. Their main advantage lies in their flexibility for modelling non-linear effects, while simultaneously incorporating spatial and temporal variables directly, thereby making it possible to reveal possible relationships among the variables considered. The results showed that the occurrence of wildfires depends on many covariates which display variable behaviour across space and time, and which largely determine the likelihood of ignition of a fire. The joint possibility of working on spatial scales with a resolution of 1 × 1 km cells and mapping predictions in a colour range makes STAR models a useful tool for plotting and predicting wildfire occurrence. Lastly, it will facilitate the development of fire behaviour models, which can be invaluable when it comes to drawing up fire-prevention and firefighting plans.


Asunto(s)
Incendios , Modelos Teóricos , Desastres , Incendios/prevención & control , Humanos , Modelos Logísticos , Cadenas de Markov , Probabilidad , España , Análisis Espacio-Temporal
12.
Stat Med ; 35(25): 4637-4659, 2016 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-27334132

RESUMEN

Multi-state models generalize survival or duration time analysis to the estimation of transition-specific hazard rate functions for multiple transitions. When each of the transition-specific risk functions is parametrized with several distinct covariate effect coefficients, this leads to a model of potentially high dimension. To decrease the parameter space dimensionality and to work out a clear image of the underlying multi-state model structure, one can either aim at setting some coefficients to zero or to make coefficients for the same covariate but two different transitions equal. The first issue can be approached by penalizing the absolute values of the covariate coefficients as in lasso regularization. If, instead, absolute differences between coefficients of the same covariate on different transitions are penalized, this leads to sparse competing risk relations within a multi-state model, that is, equality of covariate effect coefficients. In this paper, a new estimation approach providing sparse multi-state modelling by the aforementioned principles is established, based on the estimation of multi-state models and a simultaneous penalization of the L1 -norm of covariate coefficients and their differences in a structured way. The new multi-state modelling approach is illustrated on peritoneal dialysis study data and implemented in the R package penMSM. Copyright © 2016 John Wiley & Sons, Ltd.


Asunto(s)
Modelos de Riesgos Proporcionales , Algoritmos , Humanos , Riesgo
13.
BMC Infect Dis ; 16: 122, 2016 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-26979964

RESUMEN

BACKGROUND: Cirrhosis and severe sepsis are factors associated with increased mortality in intensive care unit (ICU), but chronic hepatitis C (CHC) has been less studied in ICU. The aim of this study was to analyze the impact of CHC on the mortality of cirrhotic patients admitted to ICU according to severe sepsis and decompensated cirrhosis. METHODS: We carried out a retrospective study based on CHC-cirrhotic patients (CHC-group) admitted to ICU (n = 1138) and recorded in the Spanish Minimum Basic Data Set (2005-2010). A control-group (randomly selected cirrhotic patients without HIV, HBV, or HCV infections) was also included (n = 4127). The primary outcome variable was ICU mortality. The cumulative mortality rate on days 7, 30, and 90 in patients admitted to the ICUs was calculated by dividing the number of deaths by the number of patients admitted to the ICU. The adjusted hazard ratio (aHR) for death in the ICU was estimated through a semi-parametric Bayesian model of competing risk. RESULTS: The CHC-group had a higher cumulative incidence of severe sepsis than the control-group in compensated cirrhosis (37.4 vs. 31.1%; p = 0.024), but no differences between the CHC-group and the control-group in decompensated cirrhosis were found. Moreover, a higher cumulative incidence of severe sepsis was associated with decompensated cirrhosis compared to compensated cirrhosis in the control-group (40.1 vs. 31.1%; p < 0.001) whereas this was not observed in the CHC group (38.1 vs. 37.4%; p = 0.872). The CHC-group had higher cumulative mortality than the control-group by days 7 (47 vs. 41.3%; p < 0.001), 30 (78.5 vs. 73.5%; p < 0.001), and 90 (96.3 vs. 95.9%; p < 0.001). In a competitive risk model, the CHC-group had a higher risk of dying if the ICU course was complicated by severe sepsis (adjusted hazard ratio (aHR) = 1.19; p = 0.003), but no significant values in patients with absence of severe sepsis were found (aHR = 1.09; p= 0.068). When patients were stratified by cirrhosis stage and severe sepsis, CHC patients with compensated cirrhosis had the higher risk of death if they had severe sepsis (aHR = 1.35; p = 0.002). Moreover, the survival was low in patients with decompensated cirrhosis and severe sepsis but we did not find significant differences between CHC-group and control-group. CONCLUSIONS: CHC was associated with an increased risk of death in cirrhotic patients admitted to ICUs, particularly in patients with compensated cirrhosis and severe sepsis.


Asunto(s)
Hepatitis C Crónica/mortalidad , Cirrosis Hepática/complicaciones , Sepsis/complicaciones , Adolescente , Adulto , Femenino , Hepatitis C Crónica/complicaciones , Hospitalización , Humanos , Incidencia , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , España/epidemiología , Adulto Joven
14.
Biom J ; 58(1): 222-39, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26289495

RESUMEN

We discuss the semiparametric modeling of mark-recapture-recovery data where the temporal and/or individual variation of model parameters is explained via covariates. Typically, in such analyses a fixed (or mixed) effects parametric model is specified for the relationship between the model parameters and the covariates of interest. In this paper, we discuss the modeling of the relationship via the use of penalized splines, to allow for considerably more flexible functional forms. Corresponding models can be fitted via numerical maximum penalized likelihood estimation, employing cross-validation to choose the smoothing parameters in a data-driven way. Our contribution builds on and extends the existing literature, providing a unified inferential framework for semiparametric mark-recapture-recovery models for open populations, where the interest typically lies in the estimation of survival probabilities. The approach is applied to two real datasets, corresponding to gray herons (Ardea cinerea), where we model the survival probability as a function of environmental condition (a time-varying global covariate), and Soay sheep (Ovis aries), where we model the survival probability as a function of individual weight (a time-varying individual-specific covariate). The proposed semiparametric approach is compared to a standard parametric (logistic) regression and new interesting underlying dynamics are observed in both cases.


Asunto(s)
Modelos Estadísticos , Estadísticas no Paramétricas , Adulto , Animales , Preescolar , Humanos , Lactante , Funciones de Verosimilitud , Análisis Multivariante , Dinámica Poblacional , Oveja Doméstica , Análisis de Supervivencia , Incertidumbre
15.
Lifetime Data Anal ; 22(2): 241-62, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25990764

RESUMEN

One important goal in multi-state modelling is to explore information about conditional transition-type-specific hazard rate functions by estimating influencing effects of explanatory variables. This may be performed using single transition-type-specific models if these covariate effects are assumed to be different across transition-types. To investigate whether this assumption holds or whether one of the effects is equal across several transition-types (cross-transition-type effect), a combined model has to be applied, for instance with the use of a stratified partial likelihood formulation. Here, prior knowledge about the underlying covariate effect mechanisms is often sparse, especially about ineffectivenesses of transition-type-specific or cross-transition-type effects. As a consequence, data-driven variable selection is an important task: a large number of estimable effects has to be taken into account if joint modelling of all transition-types is performed. A related but subsequent task is model choice: is an effect satisfactory estimated assuming linearity, or is the true underlying nature strongly deviating from linearity? This article introduces component-wise Functional Gradient Descent Boosting (short boosting) for multi-state models, an approach performing unsupervised variable selection and model choice simultaneously within a single estimation run. We demonstrate that features and advantages in the application of boosting introduced and illustrated in classical regression scenarios remain present in the transfer to multi-state models. As a consequence, boosting provides an effective means to answer questions about ineffectiveness and non-linearity of single transition-type-specific or cross-transition-type effects.


Asunto(s)
Modelos Estadísticos , Algoritmos , Trasplante de Médula Ósea/estadística & datos numéricos , Simulación por Computador , Cuidados Críticos/estadística & datos numéricos , Interpretación Estadística de Datos , Humanos , Funciones de Verosimilitud , Modelos Lineales , Dinámicas no Lineales , Modelos de Riesgos Proporcionales , Respiración Artificial/estadística & datos numéricos , Programas Informáticos
16.
Biometrics ; 71(2): 520-8, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25586063

RESUMEN

Hidden Markov models (HMMs) are flexible time series models in which the distribution of the observations depends on unobserved serially correlated states. The state-dependent distributions in HMMs are usually taken from some class of parametrically specified distributions. The choice of this class can be difficult, and an unfortunate choice can have serious consequences for example on state estimates, and more generally on the resulting model complexity and interpretation. We demonstrate these practical issues in a real data application concerned with vertical speeds of a diving beaked whale, where we demonstrate that parametric approaches can easily lead to overly complex state processes, impeding meaningful biological inference. In contrast, for the dive data, HMMs with nonparametrically estimated state-dependent distributions are much more parsimonious in terms of the number of states and easier to interpret, while fitting the data equally well. Our nonparametric estimation approach is based on the idea of representing the densities of the state-dependent distributions as linear combinations of a large number of standardized B-spline basis functions, imposing a penalty term on non-smoothness in order to maintain a good balance between goodness-of-fit and smoothness.


Asunto(s)
Cadenas de Markov , Estadísticas no Paramétricas , Animales , Biometría , Simulación por Computador , Buceo/fisiología , Femenino , Funciones de Verosimilitud , Modelos Estadísticos , Procesos Estocásticos , Ballenas/fisiología
17.
Stat Med ; 34(2): 232-48, 2015 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-25319931

RESUMEN

In a dose-finding study with an active control, several doses of a new drug are compared with an established drug (the so-called active control). One goal of such studies is to characterize the dose-response relationship and to find the smallest target dose concentration d(*), which leads to the same efficacy as the active control. For this purpose, the intersection point of the mean dose-response function with the expected efficacy of the active control has to be estimated. The focus of this paper is a cubic spline-based method for deriving an estimator of the target dose without assuming a specific dose-response function. Furthermore, the construction of a spline-based bootstrap CI is described. Estimator and CI are compared with other flexible and parametric methods such as linear spline interpolation as well as maximum likelihood regression in simulation studies motivated by a real clinical trial. Also, design considerations for the cubic spline approach with focus on bias minimization are presented. Although the spline-based point estimator can be biased, designs can be chosen to minimize and reasonably limit the maximum absolute bias. Furthermore, the coverage probability of the cubic spline approach is satisfactory, especially for bias minimal designs.


Asunto(s)
Ensayos Clínicos Fase II como Asunto/métodos , Relación Dosis-Respuesta a Droga , Proyectos de Investigación , Sesgo , Simulación por Computador , Intervalos de Confianza , Determinación de Punto Final/métodos , Humanos , Funciones de Verosimilitud , Modelos Logísticos , Análisis de Regresión
18.
Int J Health Geogr ; 14: 35, 2015 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-26694651

RESUMEN

BACKGROUND: Built environment studies provide broad evidence that urban characteristics influence physical activity (PA). However, findings are still difficult to compare, due to inconsistent measures assessing urban point characteristics and varying definitions of spatial scale. Both were found to influence the strength of the association between the built environment and PA. METHODS: We simultaneously evaluated the effect of kernel approaches and network-distances to investigate the association between urban characteristics and physical activity depending on spatial scale and intensity measure. We assessed urban measures of point characteristics such as intersections, public transit stations, and public open spaces in ego-centered network-dependent neighborhoods based on geographical data of one German study region of the IDEFICS study. We calculated point intensities using the simple intensity and kernel approaches based on fixed bandwidths, cross-validated bandwidths including isotropic and anisotropic kernel functions and considering adaptive bandwidths that adjust for residential density. We distinguished six network-distances from 500 m up to 2 km to calculate each intensity measure. A log-gamma regression model was used to investigate the effect of each urban measure on moderate-to-vigorous physical activity (MVPA) of 400 2- to 9.9-year old children who participated in the IDEFICS study. Models were stratified by sex and age groups, i.e. pre-school children (2 to <6 years) and school children (6-9.9 years), and were adjusted for age, body mass index (BMI), education and safety concerns of parents, season and valid weartime of accelerometers. RESULTS: Association between intensity measures and MVPA strongly differed by network-distance, with stronger effects found for larger network-distances. Simple intensity revealed smaller effect estimates and smaller goodness-of-fit compared to kernel approaches. Smallest variation in effect estimates over network-distances was found for kernel intensity measures based on isotropic and anisotropic cross-validated bandwidth selection. CONCLUSION: We found a strong variation in the association between the built environment and PA of children based on the choice of intensity measure and network-distance. Kernel intensity measures provided stable results over various scales and improved the assessment compared to the simple intensity measure. Considering different spatial scales and kernel intensity methods might reduce methodological limitations in assessing opportunities for PA in the built environment.


Asunto(s)
Planificación Ambiental , Actividad Motora , Características de la Residencia , Seguridad , Población Urbana , Acelerometría/instrumentación , Acelerometría/métodos , Índice de Masa Corporal , Niño , Preescolar , Femenino , Alemania , Humanos , Análisis de los Mínimos Cuadrados , Masculino , Monitoreo Fisiológico/instrumentación , Monitoreo Fisiológico/métodos , Densidad de Población , Análisis de Regresión , Análisis Espacial , Caminata/estadística & datos numéricos
19.
Urol Int ; 95(4): 422-8, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26159232

RESUMEN

INTRODUCTION: Existing nomograms predicting lymph node involvement (LNI) in prostate cancer (PCa) are based on conventional lymphadenectomy. The aim of the study was to develop the first nomogram for predicting LNI in PCa patients undergoing sentinel guided pelvic lymph node dissection (sPLND). MATERIALS AND METHODS: Analysis was performed on 1,296 patients with PCa who underwent radioisotope guided sPLND and retropubic radical prostatectomy (2005-2010). Median prostate specific antigen (PSA): 7.4 ng/ml (IQR 5.3-11.5 ng/ml). Clinical T-categories: T1: 54.8%, T2: 42.4%, T3: 2.8%. Biopsy Gleason sums: ≤ 6: 55.1%, 7: 39.5%, ≥ 8: 5.4%. Multivariate logistic regression models tested the association between all of the above predictors and LNI. Regression-based coefficients were used to develop a nomogram for predicting LNI. Accuracy was quantified using the area under the curve (AUC). RESULTS: The median number of LNs removed was 10 (IQR 7-13). Overall, 17.8% of patients (n = 231) had LNI. The nomogram had a high predictive accuracy (AUC of 82%). All the variables were statistically significant multivariate predictors of LNI (p = 0.001). Univariate predictive accuracy for PSA, Gleason sum and clinical stage was 69, 75 and 69%, respectively. CONCLUSIONS: The sentinel nomogram can predict LNI at a sPLND very accurately and, for the first time, aid clinicians and patients in making important decisions on the indication of a sPLND. The high rate of LN+ patients underscores the sensitivity of sPLND.


Asunto(s)
Escisión del Ganglio Linfático/métodos , Nomogramas , Neoplasias de la Próstata/cirugía , Biopsia del Ganglio Linfático Centinela/métodos , Cirugía Asistida por Computador/métodos , Tecnecio/administración & dosificación , Anciano , Estudios de Seguimiento , Humanos , Inyecciones , Ganglios Linfáticos/patología , Metástasis Linfática , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Pelvis , Valor Predictivo de las Pruebas , Prostatectomía , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/secundario , Recto , Estudios Retrospectivos , Resultado del Tratamiento
20.
Hum Hered ; 76(2): 64-75, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24434848

RESUMEN

Biological pathways provide rich information and biological context on the genetic causes of complex diseases. The logistic kernel machine test integrates prior knowledge on pathways in order to analyze data from genome-wide association studies (GWAS). In this study, the kernel converts the genomic information of 2 individuals into a quantitative value reflecting their genetic similarity. With the selection of the kernel, one implicitly chooses a genetic effect model. Like many other pathway methods, none of the available kernels accounts for the topological structure of the pathway or gene-gene interaction types. However, evidence indicates that connectivity and neighborhood of genes are crucial in the context of GWAS, because genes associated with a disease often interact. Thus, we propose a novel kernel that incorporates the topology of pathways and information on interactions. Using simulation studies, we demonstrate that the proposed method maintains the type I error correctly and can be more effective in the identification of pathways associated with a disease than non-network-based methods. We apply our approach to genome-wide association case-control data on lung cancer and rheumatoid arthritis. We identify some promising new pathways associated with these diseases, which may improve our current understanding of the genetic mechanisms.


Asunto(s)
Algoritmos , Epistasis Genética/genética , Redes Reguladoras de Genes/genética , Estudio de Asociación del Genoma Completo/métodos , Redes y Vías Metabólicas/genética , Modelos Genéticos , Transducción de Señal/genética , Artritis Reumatoide/genética , Simulación por Computador , Humanos , Modelos Lineales , Neoplasias Pulmonares/genética , Factores de Riesgo
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