张家口市大气颗粒物PM2.5、PM10浓度与慢性阻塞性肺疾病住院人次的关系研究

目的:研究张家口市大气颗粒物对慢性阻塞性肺疾病(COPD)的影响,并分析大气颗粒物对不同特征人群的影响。方法:从张家口市医保办公室获取张家口市2013年1月1日-2015年12月31日两家三甲医院COPD患者的住院病历资料,从中国环境监测总站网站获取大气污染物的监测数据,从张家口市气象局获取气象资料。建立广义相加模型(GAM),在控制长期趋势、星期几效应和温湿度影响后,应用条件Logitic回归方法评估PM_(2.5)、PM_(10)对COPD住院人次的影响。根据患者不同特征(性别、年龄、季节)进行分层分析,评估颗粒物污染的高危人群。结果:研究纳入两家三甲医院,共1984例住院COPD患者,其中男性患者1258例(63.4%)、女性患者726例(36.6%),≥75岁患者678例(34.2%),60~75岁患者936例(47.2%)、芨60岁患者370例(18.6%)。2013-2015年PM_(2.5)、PM_(10)年均浓度分别为[(36.54±20.34)μg/m~3、(84.37±52.54)μg/m~3],[(34.50±27.08)μg/m~3、(78.43±69.78)μg/m~3],[(32.04±21.35)μg/m~3、(75.46±50.02)μg/m~3],两者在移动平均滞后3d时,对COPD的影响最大,即PM_(2.5)每增加10μg/m~3,COPD住院人次增加1.90%(95%CI:1.002-1.033,P0.05),PM_(10)每增加10μg/m~3,COPD住院人次增加2.10%(95%CI:1.005-1.045,P0.05)。分层分析结果显示:PM_(2.5)、PM_(10)每升高10μg/m~3,女性COPD患者住院人次增加1.09%、1.14%,差异具有统计学意义(P0.05);≥75岁患者,COPD住院人次增加1.03%、0.99%,差异具有统计学意义(P0.05);而年龄芨60岁、60~75岁、男性以及季节分层分析中,PM_(2.5)、PM_(10)浓度与COPD住院人次无统计学意义(P0.05)。结论:颗粒物污染会增加COPD住院率,≥75岁的老年患者及女性患者更敏感。     

A Regression Modeling Approach for Describing Patterns of HIV Genetic Variation

We introduce a novel approach for describing patterns of HIV genetic variation using regression modeling techniques. Parameters are defined for describing genetic variation within and between viral populations by generalizing Simpson's index of diversity. Regression models are specified for these variation parameters and the generalized estimating equation framework is used for estimating both the regression parameters and their corresponding variances. Conditions are described under which the usual asymptotic approximations to the distribution of the estimators are met. This approach provides a formal statistical framework for testing hypotheses regarding the changing patterns of HIV genetic variation over time within an infected patient. The application of these methods for testing biologically relevant hypotheses concerning HIV genetic variation is demonstrated in an example using sequence data from a subset of patients from the Multicenter AIDS Cohort Study.     

Uniqueness of limit cycles in models for microparasitic and macroparasitic diseases

 The aim of this paper is to prove the uniqueness of isolated periodic solutions (i.e. limit cycles) in two simple models for microparasitic and macroparasitic diseases. Both models are described by systems of planar autonomous ordinary differential equations. After transformation of these systems to generalized Liénard systems, we will apply a modified theorem of Zhang and Dulac’s criterion to prove the uniqueness of limit cycles. Received 27 February; received in revised form 19 May 1997     

Dietary exposure to an environmental toxin triggers neurofibrillary tangles and amyloid deposits in the brain

Neurofibrillary tangles (NFT) and β-amyloid plaques are the neurological hallmarks of both Alzheimer''s disease and an unusual paralytic illness suffered by Chamorro villagers on the Pacific island of Guam. Many Chamorros with the disease suffer dementia, and in some villages one-quarter of the adults perished from the disease. Like Alzheimer''s, the causal factors of Guamanian amyotrophic lateral sclerosis/parkinsonism dementia complex (ALS/PDC) are poorly understood. In replicated experiments, we found that chronic dietary exposure to a cyanobacterial toxin present in the traditional Chamorro diet, β-N-methylamino-l-alanine (BMAA), triggers the formation of both NFT and β-amyloid deposits similar in structure and density to those found in brain tissues of Chamorros who died with ALS/PDC. Vervets (Chlorocebus sabaeus) fed for 140 days with BMAA-dosed fruit developed NFT and sparse β-amyloid deposits in the brain. Co-administration of the dietary amino acid l-serine with l-BMAA significantly reduced the density of NFT. These findings indicate that while chronic exposure to the environmental toxin BMAA can trigger neurodegeneration in vulnerable individuals, increasing the amount of l-serine in the diet can reduce the risk.     

Model checking for ROC regression analysis

Summary .   The receiver operating characteristic (ROC) curve is a prominent tool for characterizing the accuracy of a continuous diagnostic test. To account for factors that might influence the test accuracy, various ROC regression methods have been proposed. However, as in any regression analysis, when the assumed models do not fit the data well, these methods may render invalid and misleading results. To date, practical model-checking techniques suitable for validating existing ROC regression models are not yet available. In this article, we develop cumulative residual-based procedures to graphically and numerically assess the goodness of fit for some commonly used ROC regression models, and show how specific components of these models can be examined within this framework. We derive asymptotic null distributions for the residual processes and discuss resampling procedures to approximate these distributions in practice. We illustrate our methods with a dataset from the cystic fibrosis registry.     

Bayesian semiparametric proportional odds models

Methodology for implementing the proportional odds regression model for survival data assuming a mixture of finite Polya trees (MPT) prior on baseline survival is presented. Extensions to frailties and generalized odds rates are discussed. Although all manner of censoring and truncation can be accommodated, we discuss model implementation, regression diagnostics, and model comparison for right-censored data. An advantage of the MPT model is the relative ease with which predictive densities, survival, and hazard curves are generated. Much discussion is devoted to practical implementation of the proposed models, and a novel MCMC algorithm based on an approximating parametric normal model is developed. A modest simulation study comparing the small sample behavior of the MPT model to a rank-based estimator and a real data example is presented.     

Generating Correlated Binary Variables with Complete Specification of the Joint Distribution

Most statistical methods for the analysis of correlated binary data are based on asymptotic theory. Therefore it is important to generate correlated binary data efficiently for Monte Carlo simulation studies to investigate the finite sample performance of these methods. This article provides a simple method for generating correlated binary data with a given joint distribution. The key idea is to consider k‐variate binary data as a multinomial distribution with 2^k possible outcomes.     

The Effect of Sample Design in the Discriminant Analysis for Two Groups

This paper shows the effect of sample design on the Discriminant Analysis for two groups by means of a simulation study involving stratified design. Four criteria of discrimination are used and compared. Also, the equivalency between the Multiple Linear Regression using the Generalized Estimating Equations and the Discriminant Analysis for two normal populations from a Complex Design is proved. The results are applied to an epidemiological problem.     

One‐Sided Test to Assess Correlation in Linear Logistic Models using Estimating Equations

A score‐type test is proposed for testing the hypothesis of independent binary random variables against positive correlation in linear logistic models with sparse data and cluster specific covariates. The test is developed for univariate and multivariate one‐sided alternatives. The main advantage of using score test is that it requires estimation of the model only under the null hypothesis, that in this case corresponds to the binomial maximum likelihood fit. The score‐type test is developed from a class of estimating equations with block‐diagonal structure in which the coefficients of the linear logistic model are estimated simultaneously with the correlation. The simplicity of the score test is illustrated in two particular examples.     

Linear Contrasts in Experimental Design with Non‐Identical Error Distributions

Estimation of linear contrasts in experimental design, and testing their assumed values, is considered when the error distributions from block to block are not necessarily identical. The normal‐theory solutions are shown to have low efficiencies as compared to the solutions presented here.