Factor analysis for survival time prediction with informative censoring and diverse covariates

Fulfilling the promise of precision medicine requires accurately and precisely classifying disease states. For cancer, this includes prediction of survival time from a surfeit of covariates. Such data presents an opportunity for improved prediction, but also a challenge due to high dimensionality. Furthermore, disease populations can be heterogeneous. Integrative modeling is sensible, as the underlying hypothesis is that joint analysis of multiple covariates provides greater explanatory power than separate analyses. We propose an integrative latent variable model that combines factor analysis for various data types and an exponential proportional hazards (EPH) model for continuous survival time with informative censoring. The factor and EPH models are connected through low-dimensional latent variables that can be interpreted and visualized to identify subpopulations. We use this model to predict survival time. We demonstrate this model's utility in simulation and on four Cancer Genome Atlas datasets: diffuse lower-grade glioma, glioblastoma multiforme, lung adenocarcinoma, and lung squamous cell carcinoma. These datasets have small sample sizes, high-dimensional diverse covariates, and high censorship rates. We compare the predictions from our model to three alternative models. Our model outperforms in simulation and is competitive on real datasets. Furthermore, the low-dimensional visualization for diffuse lower-grade glioma displays known subpopulations.     

Well-Being,Self-Efficacy and Independence in older adults: A Randomized Trial of Occupational Therapy

ObjectiveThe main objective of the research was to analyze whether there were differences in the effects of individual and group occupational therapy (OT) treatment on psychological well-being, self-efficacy and personal independence.MethodA randomized clinical trial (N = 70; age = 85 years, SD = 4) comparing individual versus group occupational therapy treatment for 6 months was conducted. The evaluation was performed with the Barthel Index (Personal Independence), the Ryff Wellness Index (Well-being), the Global Self-Efficacy Scale (Self-efficacy) and the Geriatric Depression Scale (Affective state Scale).ResultsResults showed a decrease in individual treatment scores in the variables autonomy, environmental mastery, personal growth and purpose in life, reflecting worse self-acceptance and negative well-being as well as a lower ability to maintain stable relationships. By contrast, group treatment users maintained more stable social relationships and exhibited a greater ability to resist social pressure, to develop their potential skills and to define their goals in life. There were statistically significant differences in overall self-efficacy (p < 0.001), emotional well-being (p < 0.001) and personal independence (p = 0.013), with better scores in group versus individual treatment.ConclusionsGroup occupational therapy interventions in older adults could be the treatment of choice in people with depressed state, improving their emotional well-being, sense of self-efficacy and level of personal independence in basic activities of daily living.     

Occupational Hazards to the Joint Replacement Surgeon: How Can Technology Help Prevent Injury?

Occupational hazards pose varying threats to the joint replacement surgeon. Musculoskeletal pain due to the repetitive nature of performing joint arthroplasty is felt daily by most surgeons. The purpose of this paper is to offer a basic introduction and demonstrate the many ways technology utilized during total joint arthroplasty can help mitigate common occupational hazards for the arthroplasty surgeon. This paper guides readers through the evolution and drivers behind technology in joint arthroplasty, describes several technologies currently available, and discusses how certain aspects of this technology may work to improve surgeon and patient outcomes. We review how advanced technologies in arthroplasty may reduce physical and mental demand, improve reproducibility, and decrease complications. The decision to utilize advanced technology in joint arthroplasty is ultimately made on an individual level after careful consideration of available literature.     

新型冠状病毒肺炎合并急性脑梗死一例

新型冠状病毒肺炎(COVID-19)为2019新型冠状病毒所致,其起病隐匿,潜伏期较长,具有高度传染性的特点。新型冠状病毒除了可累及呼吸系统,还可累及其他系统,如心脏、肾脏、消化道,并且可合并多个系统疾病,如急性脑血管病等,如果在接诊患者时不引起高度重视、做好防护,极易造成医护人员的感染。文中总结1例起病隐匿的COVID-19患者合并脑梗死症状,在行静脉溶栓治疗后造成1名医务人员感染的临床体会,探讨其临床特点、治疗经过并对其防控环节进行分析,以帮助疫情防控中首诊医生注意识别、减少漏诊、科学排查以减少职业感染。     

Augmented Reality Farm MAPPER Development: Lessons Learned from an App Designed to Improve Rural Emergency Response

Fire departments have right-of-entry to most commercial industrial sites and preemptively map them to identify the onsite resources and hazards they need to promptly and safely respond to an emergency event. This is not the case for private farms. Emergency responders are blind to resources and hazards prior to arrival and must spend critical minutes locating them during an emergency response at a farm location. The original 2013 Farm Mapping to Assist, Protect and Prepare Emergency Responders (Farm MAPPER) project was undertaken to develop a method to give emergency responders an up-to-date view of on-farm hazard information to safely and efficiently conduct emergency response activities on private agricultural operations. In 2017, an augmented reality version of Farm MAPPER was developed to combine the technological advantages of geographic information system-based data points with a heads-up display and graphical overlay of superimposed hazard imagery and informative icons. The development and testing of this iOS- and Android-ready prototype uncovered lessons learned applicable to other mobile-based apps targeting farmers, ranchers, and rural populations faced with limited or inconsistent mobile internet connectivity.     

Increased frequency of chromosomal aberrations and sister chromatid exchanges in peripheral lymphocytes of radiology technicians chronically exposed to low levels of ionizing radiations

Chromosome aberrations (CAs) and sister chromatid exchanges (SCEs) frequencies were estimated in peripheral lymphocytes from 21 radiology technicians, and from 21 non-exposed control subjects. We exclusively considered individuals who neither smoke nor consume drugs or alcohol for a period of at least two years prior to the analysis. Significant differences were found between exposed and controls in terms of SCEs and CAs frequencies.Technicians showed a significant higher number of high-frequency individuals (HFIs) with respect to the control group. Nevertheless, the mean frequency of SCEs observed among technician HFIs did not significantly differ with respect to that observed among control HFIs. Vice versa, the non-HFIs belonging to technicians group showed a statistically higher difference in the SCEs/NSM value with respect to the non-HFIs belonging to control group. Since the differences in the SCEs frequencies between the two groups are due to non-HFIs, our results seem to indicate a general genotoxic effect of the IR, not affected by HFIs.Among technicians, the level of chromosome damage correlated neither with years of radiation exposure nor with the age of the subjects. Vice versa, in the control group, a positive correlation was found between the number of SCEs and age. In both samples the gender status did not influence the frequencies of CAs and SCEs.Our results suggest that chronic long-term exposure to low doses of ionizing radiation could increase the CAs and SCEs frequencies. This study reinforces the relevance of the biomonitoring of hospital workers chronically exposed to ionizing radiation.     

布鲁杆菌病职业人群高危行为习惯调查及健康教育效果评价

目的 调查辽西地区布鲁杆菌病(简称布病)职业人群的高危行为习惯,评估健康教育干预效果.方法 采取分层随机整群抽样的方法,2008-2010年对辽西地区与牛羊等牲畜有密切接触的职业人群高危行为习惯进行现况调查,从中抽取凌海市职业人群作为干预组,实施为期3个月的布病高危行为习惯健康教育,其余职业人群作为对照组.在健康教育基线期和终末期问卷调查干预组和对照组布病高危行为习惯情况.结果 基线期共调查916名观察对象,其中干预组499人,对照组417人.布病高危行为习惯(接触流产牲畜时防护、病畜及时扑杀、病畜深埋处理、不贩卖加工病畜、不吃病死畜肉、不喝生奶、不吃未熟乳肉制品、对饲养牲畜进行免疫)正确率干预组分别为70.9%(354/499)、64.3%(321/499)、53.8%(268/499)、92.2%(460/499)、82.2%(410/499)、87.5%(437/499)、93.6%(467/499)、56.2%(280/499),对照组分别为68.8%(287/417)、59.2%(247/417)、54.7%(228/417)、89.2%(372/417)、85.6%(360/417)、88.5%(369/417)、94.0%(392/417)、55.9%(233/417),组间比较差异无统计学意义(P均＞0.05).终末期共调查908名观察对象,其中干预组499人,对照组409人;干预组上述8种布病高危行为习惯正确率分别为85.4%(426/499)、79.0%(394/499)、69.9%(349/499)、96.4%(481/499)、94.3%(471/499)、94.9%(474/499)、94.0%(469/499)、99.4%(496/499),对照组分别为66.8%(273/409)、57.3%(234/409)、50.1%(205/409)、85.3%(349/409)、88.8%(363/409)、89.5%(366/409)、90.1%(369/409)、57.2%(234/409),组间比较差异有统计学意义(x2值分别为43.991、49.833、37.111、35.032、9.537、9.826、4.485、253.808,P均＜0.05).干预组在基线期除不吃未熟乳肉制品外,其他7种布病高危行为习惯正确率与终末期比较,差异有统计学意义(x2值分别为30.426、26.284、27.854、7.364、36.027、17.238、9270.286,P均＜0.05).结论 健康教育干预可以显著地提高布病职业人群高危行为习惯正确率,值得进行交流和推广.

Abstract：

Objective To find out demography characteristic and risk behaviors of occupation groups and to evaluate the effect of health education. Methods A baseline survey was conducted among occupation groups in the western part of Liaoning province by stratified random cluster sampling. Health education started to intervene in occupation groups in Linghai city of Liaoning province. An investigation of brucellosis related behaviors was carried out before and after a health education among occupation groups. Other occupational groups were as the control group. The research on high-risk behaviors of occupation groups was in the following eight aspects: protection taken when contact with abortion livestock, timely slaughter and burying deeply of sick animals, not selling sick animals do not eat dead meat, nor drink raw milk, do not eat raw meat, and immunity of livestock. Results Before the intervention, a total of 916 objects, of which intervention group 499 and control group 417 were investigated. The high-risk behaviors of brucellosis were not significantly different between the two groups[70.9% (354/499), 64.3%(321/499 ), 53.8% (268/499), 92.2% (460/499), 82.2% (410/499 ), 87.5% (437/499), 93.6% (467/499), 56.2%(280/499) in intervention group, 68.8% (287/417), 59.2% (247/417 ), 54.7% (228/417), 89.2% (372/417 ), 85.6%(360/417) ,885%(369/417),94.0%(392/417),55.9%(233/417) in control group, all P ＞ 0.05]. After the intervention,a total of 908 survey objects, of which intervention group 499 and control group 409, were investigated. The above eight aspects of high-risk behaviors in the intervention group were 85.4% (426/499),79.0% (394/499),69.9%(349/499),96.4%(481/499),943%(471/499),94.9%(474/499),94.0%(469/499), 99.4%(496/499), respectively; in the control 66.8% (273/409),57.3% (234/409),50.1% (205/409),85.3% (349/409),88.8% (363/409),89.5%(366/409) ,90.1% (369/409), and 57.2% (234/409), respectively. Between the two groups, the difference was statistically significant (x2 = 43.991,49.833,37.111,35.032,9.537,9.826,4.485,253.808, all P ＜ 0.05 ). The above seven aspects of high-risk behaviors except do not eat raw dairy at the beginning of intervention were compared with those of after the intervention, the differences were statistically significant (x2 = 30.426,26.284,27.854,7.364,36.027,17.238,9270.286, all P ＜ 0.05). Conclusions Health education intervention can significantly improve the behavior change rate of occupational groups at high risk of brucellosis, and the education intervention is worthwhile to communicate and promote.