Comparison of estimation and prediction methods for a zero-inflated geometric INAR(1) process with random coefficients.

This study explores zero-inflated count time series models used to analyze data sets with characteristics such as overdispersion, excess zeros, and autocorrelation. Specifically, we investigate the ZIGINAR RC ( 1 ) process, a first-order stationary integer-valued autoregressive model with random coefficients and a zero-inflated geometric marginal distribution. Our focus is on examining various estimation and prediction techniques for this model. We employ estimation methods, including Whittle, Taper Spectral Whittle, Maximum Empirical Likelihood, and Sieve Bootstrap estimators for parameter estimation. Additionally, we propose forecasting approaches, such as median, Bayesian, and Sieve Bootstrap methods, to predict future values of the series. We assess the performance of these methods through simulation studies and real-world data analysis, finding that all methods perform well, providing 95% highest predicted probability intervals that encompass the observed data. While Bayesian and Bootstrap methods require more time for execution, their superior predictive accuracy justifies their use in forecasting.

Which G-Tube to Use in Pullers: Assessment of Pull Pressures on Skin Models to Determine Optimal Catheter Choice in Patients with Recurrent Pulled Gastrostomy Tubes.

INTRODUCTION: Pulled or dislodged gastrostomy catheters represent a common complication associated with percutaneous gastrostomy and are a common cause of recurrent visits in patients with altered mental status. We intended to perform an experiment to compare the pull forces required to dislodge different commonly used gastrostomy catheters. MATERIALS AND METHODS: We used a digital force gauge device to measure the pull forces required to dislodge three types of 20 French gastrostomy catheters in double-layer skin models. These included the Flow 20 Pull Method (Cook Medical, Bloomington, IN, USA), Entuit Gastrostomy BR Balloon Retention feeding tube (Cook Medical, Bloomington, IN, USA), and Ponsky Non-Balloon Replacement Gastrostomy Tube (CR Bard Inc, Salt Lake City, Utah, USA). The catheters were inserted into the skin model using the same technique as would be utilized in a patient. RESULTS: The mean forces measured to dislodge the per-oral Flow 20 Pull Method, Entuit Thrive Balloon Retention, and button-type retention Ponsky replacement catheters were 35.6, 22.8, and 20.6 Newtons, respectively. The pull method per-oral gastrostomy catheter required significantly more pull force to dislodge than both the Ponsky button-type retention catheter and the Entuit balloon retention catheters. There was no significant difference in the pull force required to dislodge the Ponsky replacement catheter and the Entuit balloon retention catheter. CONCLUSIONS: Per-oral image-guided gastrostomy with pull-method button-type retention catheters may be the ideal choice in patients at high risk of tube dislodgment.