Non‐parametric Bayesian Hazard Regression for Chronic Disease Risk Assessment

Assessing the absolute risk for a future disease event in presently healthy individuals has an important role in the primary prevention of cardiovascular diseases (CVD) and other chronic conditions. In this paper, we study the use of non‐parametric Bayesian hazard regression techniques and posterior predictive inferences in the risk assessment task. We generalize our previously published Bayesian multivariate monotonic regression procedure to a survival analysis setting, combined with a computationally efficient estimation procedure utilizing case–base sampling. To achieve parsimony in the model fit, we allow for multidimensional relationships within specified subsets of risk factors, determined either on a priori basis or as a part of the estimation procedure. We apply the proposed methods for 10‐year CVD risk assessment in a Finnish population. © 2014 Board of the Foundation of the Scandinavian Journal of Statistics     

病情史料发掘与沈从文再认识

沈从文的家族存在着强大的“疯狂”遗传基因,这使得沈从文的感知方式呈现出一定的“异常性”,并对其文学活动、精神流变与生命创建产生了深远的影响。20世纪40年代中期,沈从文文学创作风格发生了较大的转变,出现了诸如《看虹录》《绿魇》《莲花》之类的“悦乐疯狂”之作,并产生了“神”、“生命”等超逻辑的思想命题,与这一时期他病情的加剧有着密切的关系。     

美国七彩山鸡传染性法氏囊病(IBD)的诊断与治疗

四川省绵阳市江油某养殖户饲养的美国七彩山鸡 2d内突然发病死亡1 2 0余只 ,其表现在流行病学、症状、病理变化方面与蛋鸡、肉鸡发生IBD的基本一致 ,经诊断为IBD ,经用抗IBD高免卵黄抗体治疗效果良好。饲养美国七彩山鸡应作好IBD预防接种     

人工干扰下重大传染病扩散演化的仿真研究——以非典为例

重大传染病发生后若应对不当，往往会借助自然系统或社会系统之间相互依存和相互制约的关系迅速扩散演化，产生一系列次生衍生事件。以重大传染病的发生和发展过程为基础构建其扩散模型，利用系统动力学仿真软件比较不同防控情形下系统演化结果，结果表明：（1）通过对疾病接触系数、自由传播期、开始防控时间进行控制可以改变重大传染病的扩散演化；（2）单独限制人口流动虽可降低传染速率但无法抑制重大传染病的扩散，而同时采取限制人口流动和隔离措施的效果优于单独采取隔离措施。     

Introduction: Leading Lesbians Fight Disease and Disability

This thematic issue of the Journal of Lesbian Studies focuses on the ways in which lesbian leaders have dealt with disease and disability. In the articles that follow, eight prominent lesbians describe what it means to cope with serious illness and medical treatment in the context of lesbian identity and community. This introduction provides an overview of some of the themes that arose in the various articles, focusing on lesbian support systems as well as best medical practices.     

冠心病合并2型糖尿病临床表现与冠状动脉造影结果的临床研究

目的探讨冠心病（CHD）合并2型糖尿病（NIDDM）患者的临床表现和冠状动脉病变特点。方法对80例冠心病合并2型糖尿病患者及与之配对的非糖尿病冠心病患者进行临床表现和血管造影资料对照分析。结果冠心病合并2型糖尿病组与配对组比较，有高血压病史者分别占71．5％和45.3％（P〈0．05），有高血脂者分别占68．7％和42．2％（P〈0．05），冠心病合并2型糖尿病组与配对组的3支病变比例分别为35．0％和12．5％（P〈0．05），病变血管比例分别为68．3％和55．8％（P〈0．05），弥漫性病变血管比例分别为15．0％和5．8％（P〈0．05）。两组的冠状动脉狭窄程度差异不明显（P〉0．05）。结论冠心病合并2型糖尿病患者的高血压、高血脂患病率较高，其冠状动脉血管的病变特点有别于无糖尿病的冠心病患者，3支病变比例和弥漫性病变血管比例高，血管受累支数多，在对冠心病合并2型糖尿病患者的诊疗过程中要充分考虑其病变特点。     

The Use of Risk Assessment to Decide the Control Strategy for Bluetongue in Italian Ruminant Populations

The affiliation, assessment and management of risks is a traditional part of veterinary medicine. In the past, veterinary services involved in this type of activity usually assessed risks qualitatively. However, since the 1990s, quantitative methods have become increasingly important. The establishment of the World Trade Organization in 1994, and the promulgation of its Agreement on the Application of Sanitary and Phytosanitary Measures (the "SPS Agreement") led to an increased application of import risk analysis and to significant improvements in the methodology of risk analysis as applied to international trade policy for animals and animal products. However, there was very little development of risk analysis in veterinary fields other than international trade and management of health risks to consumers of animal products and little has been published on its use in the choice and definition of control or prophylaxis strategies for animal diseases. This article describes a quantitative risk assessment, which was undertaken in Italy to help choose an appropriate national response strategy following an incursion of bluetongue, an infectious disease of sheep and goats. The results obtained in this study support the use of risk analysis as a tool to assist in choosing an appropriate animal disease management strategy. The use of risk analysis in the evaluation of disease management strategies also offers advantages in international trade. It makes easier the comparison of different strategies applied in the various countries, and thus facilitates the assessment of equivalence of the guarantees provided by different strategies.     

Forward and Backward Recurrence Times and Length Biased Sampling: Age Specific Models

Consider a chronic disease process which is beginning to be observed at a point in chronological time. The backward recurrence and forward recurrence times are defined for prevalent cases as the time with disease and the time to leave the disease state, respectively, where the reference point is the point in time at which the disease process is being observed. In this setting the incidence of disease affects the recurrence time distributions. In addition, the survival of prevalent cases will tend to be greater than the population with disease due to length biased sampling. A similar problem arises in models for the early detection of disease. In this case the backward recurrence time is how long an individual has had disease before detection and the forward recurrence time is the time gained by early diagnosis, i.e., until the disease becomes clinical by exhibiting signs or symptoms. In these examples the incidence of disease may be age related resulting in a non-stationary process. The resulting recurrence time distributions are derived as well as some generalization of length-biased sampling.     

A Risk Analysis Approach to Prioritizing Epidemics: Ebola Virus Disease in West Africa as a Case Study

The 2014 Ebola virus disease (EVD) outbreak affected several countries worldwide, including six West African countries. It was the largest Ebola epidemic in the history and the first to affect multiple countries simultaneously. Significant national and international delay in response to the epidemic resulted in 28,652 cases and 11,325 deaths. The aim of this study was to develop a risk analysis framework to prioritize rapid response for situations of high risk. Based on findings from the literature, sociodemographic features of the affected countries, and documented epidemic data, a risk scoring framework using 18 criteria was developed. The framework includes measures of socioeconomics, health systems, geographical factors, cultural beliefs, and traditional practices. The three worst affected West African countries (Guinea, Sierra Leone, and Liberia) had the highest risk scores. The scores were much lower in developed countries that experienced Ebola compared to West African countries. A more complex risk analysis framework using 18 measures was compared with a simpler one with 10 measures, and both predicted risk equally well. A simple risk scoring system can incorporate measures of hazard and impact that may otherwise be neglected in prioritizing outbreak response. This framework can be used by public health personnel as a tool to prioritize outbreak investigation and flag outbreaks with potentially catastrophic outcomes for urgent response. Such a tool could mitigate costly delays in epidemic response.     

From waterfall plots to spaghetti plots in early oncology clinical development

Waterfall plots are used to describe changes in tumor size observed in clinical studies. They are frequently used to illustrate the overall drug response in oncology clinical trials because of its simple representation of results. Unfortunately, this visual display suffers a number of limitations including (1) potential misguidance by masking the time dynamics of tumor size, (2) ambiguous labelling of the y‐axis, and (3) low data‐to‐ink ratio. We offer some alternatives to address these shortcomings and recommend moving away from waterfall plots to the benefit of plots showing the individual time profiles of sum of lesion diameters (according to RECIST). The spider plot presents the individual changes in tumor measurements over time relative to baseline tumor burden. Baseline tumor size is a well‐known confounding factor of drug effect which has to be accounted for when analyzing data in early clinical trials. While spider plots are conveniently correct for baseline tumor size, they cannot be presented in isolation. Indeed, percentage change from baseline has suboptimal statistical properties (including skewed distribution) and can be overly optimistic in favor of drug efficacy. We argued that plots of raw data (referred to as spaghetti plots) should always accompany spider plots to provide an equipoised illustration of the drug effect on lesion diameters.