Gap times between recurrent events are often of primary interest in medical and observational studies. The additive hazards model, focusing on risk differences rather than risk ratios, has been widely used in practice. However, the marginal additive hazards model does not take the dependence among gap times into account. In this paper, we propose an additive mixed effect model to analyze gap time data, and the proposed model includes a subject-specific random effect to account for the dependence among the gap times. Estimating equation approaches are developed for parameter estimation, and the asymptotic properties of the resulting estimators are established. In addition, some graphical and numerical procedures are presented for model checking. The finite sample behavior of the proposed methods is evaluated through simulation studies, and an application to a data set from a clinic study on chronic granulomatous disease is provided. 相似文献
Scant research exists on the development of mostly heterosexual identity, the largest sexual orientation minority subgroup. We used longitudinal latent class analysis to characterize the patterns of identification with lesbian, gay, bisexual (LGB), or mostly heterosexual identities from ages 12 to 23 in 13,859 youth (57% female) in a U.S. national cohort. Three classes emerged: completely heterosexual (88.2%), mostly heterosexual (9.5%), and LGB (2.4%). LGB class youth generally identified with sexual minority identities by ages 12–17. In contrast, mostly heterosexual class youth identified with sexual minority identities gradually, with steady increases in endorsement starting at the age of 14. Developmental implications of these differential patterns are discussed. 相似文献
Objective: The aim of this study was to analyze the age-related recession trajectory of reproductive health indices in middle-aged and elderly Chinese men.
Methods: A population-based cross-sectional study was conducted in Jiashan County, Zhejiang in 2012. Healthy men between 40 and 80 years of age were considered eligible for the study. Physical examination and the sex hormones were measured. The subjects were assessed based on the 5-item version of the International Index of Erectile Function (IIEF-5) for Erectile Dysfunction (ED), and Aging Males’ Symptoms (AMS) scale for Symptomatic Late-Onset Hypogonadism (SLOH).
Results: TG showed a decrease at age 60 years. Testis volume and TT did not show significant difference among the four age groups; cFT began to decrease at age 50 years and Bio-T decreased faster at age 50 years. SHBG and LH increased faster at age 50 and 70 years, respectively. IIEF5 score decrease faster at age 60 years. AMS scores increased faster at age 70 years. With the increase in age, the symptoms of ED and SLOH became severer.
Conclusion: Different indices on reproductive health of men showed turning points at different ages. At first, androgenic sex hormones decreased faster, and then erectile dysfunction got severer, and the last overall male syndromes declined. 相似文献
The aim of this study was to investigate the manner in which teachers facilitate the pedagogical process within a culturally diverse student population. The study focused on two primary schools in China; one located in a more fully developed city in eastern China (Case A), while the other was in a less developed city in rural western China (Case B). This allowed the researchers to compare and analyse the different instructional practices by means of semi-structured interviews and questionnaires. The findings indicate that: the teachers in Case A demonstrated overall affirmative attitudes towards ethnic minority cultures, as well as towards the students belonging to those cultures. However, the teachers also chose not to mention the specific ethnic identities and cultural differences of the students during the course of their instruction in order to ensure equal treatment for everyone. This leads to a kind of ‘cultural blindness’ in the classroom. In Case B, opinions regarding minority cultures were more varied. Compared with the teachers in Case A, more teachers in Case B found minority cultures to be inferior to the dominant Han culture. Some teachers also, counter intuitively, were of the opinion that the minority cultures were even superior. At the instructional level, school leadership developed courses on local culture and ethnicity for the teaching staff. This was done for a variety of reasons. The strongest evidence to support culturally responsive teaching in Case A does not stem from teaching and learning demands but from the necessity to pursue characteristics that make them distinctive from other schools at the same time, Case B’s practice of culturally responsive teaching was strongly supported by the government and UNICEF. Teachers in both schools indicated that they had integrated their knowledge of ethnic minority groups into the subject matter when it was necessary. 相似文献