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This meta-analysis aims to evaluate and compare the effectiveness of the COG and SIOP treatment protocols for Wilms tumor in terms of overall survival (OS) and event-free survival (EFS). By synthesizing data from eligible studies, this research examines survival outcomes and explores potential differences between the two protocols. Indirect comparisons were performed using meta-regression and Student’s t-tests due to the lack of direct head-to-head studies. The findings of this meta-analysis intend to contribute to a better understanding of the relative effectiveness of these protocols, providing evidence-based insights to guide clinical decision-making and policy development in pediatric oncology.

This meta-analysis reports dental implant survival, and the incidence rate of osteoradionecrosis in irradiated head and neck cancer patients.

The aim of this project is to examine the combined effect of moderate- to vigorous-intensity physical activity (MVPA) and light-intensity physical activity (LPA) on mortality, and whether the effect of increasing LPA differs based on the amount of MVPA.

[To the extent possible, the authors have followed ROSES (RepOrting standards for Systematic Evidence Syntheses) recommendations in creating this protocol (https://www.roses-reporting.com/systematic-review-protocols). Because attaining the goals of this study does not require a full systematic review, we are conducting a review of a subset of all studies on the topic.] Survival rates are often sex-specific in birds. However, it's unclear to what degree scientific studies analyze sexes separately, which can lead to under or over-reporting. We seek out to determine the frequency the literature analyzes survival rates of sexes separately. We hypothesize that sex-specific survival rates are under-reported; that is, the frequency studies aggregate sexes will be higher than the frequency of that survival rates are sex-specific in birds. We also test hypotheses of why these patterns happen, such as older studies, studies on monochromatic birds, and studies led by male authors are more likely to aggregate sexes. We performed a Boolean-style topic word (title, abstract, keywords) search of survival studies (e.g. (woodpecker OR passeri* OR *recapture) AND surviv*) on 1,044 bird types in UCLA’s Web of Science composite database. We used the R package litsearchr to find possible additional search terms. The final search yielded 3,775 results. We uploaded the results to Sysrev for manual screening. Duplicate reviewers (with an experienced reviewer to resolve conflicts if necessary) are assigned to each study to screen and collect data on the studies, and we intend to screen approximately one-third of all the studies. A study is included if it estimates survival rates of wild birds of any species in any geography. Reviewers then classify studies into categories of how sex is treated in survival analysis, and collect data on study species, sample size, and inferred gender of first and last authors. We will conduct an accumulation analysis to determine the sample size at which results become stable. Results will be summarized and visualized in relation to each hypothesis.

The five-year survival rate for patients with advanced non-small cell lung cancer is not favorable. In Taiwan, many patients opt for a combination of traditional Chinese and Western medicine in hopes of enhancing treatment efficacy and prolonging survival. Therefore, we conducted an meta-analysis to provide evidence for clinical physician.

Investigation of the correlation of positive peritoneal washing cytology with the survival outcomes of patients undergoing interval debulking surgery after neoadjuvant chemotherapy for ovarian cancer

Introduction: The main objective of this research is to apply joint modelling technique to assess the relationship between cd4 cell count and survival of ART patients in Gweru, Zimbabwe. The Cox proportional hazards model is mainly used in modelling survival data when the true values of the time-varying covariates are observed. However, most of these measurements are observed with error and to circumvent this problem, measurements are taken longitudinally to reduce the bias caused using such observed measurements in the Cox proportional hazards models. Methods: We conducted secondary data analysis on the Gweru district ART cohort data for the period 2006 to 2010. The association between CD4 cell count and survival time of the patient was determined using a joint longitudinal-survival model. The factors that affected cd4 cell changes were determined using mixed linear regression model and factors associated with survival of ART patients was determined using a Cox proportional hazard model. Shared parameters were used to determine the association between cd4 cell count and survival of the ART patient. Results: A statistically significant direct effect of gender on survival was observed -0.003 (95% CI: -001, -0.002). Also, a highly negative significant association was observed -9.48 (95% CI: -11.7, -7.23), indicating that female patients with high levels of lncd4 had reduced hazard of death compared to male patients. Place of residents of the ART patient had a significant direct effect on survival -0.66 (95% CI: -0.01, 0.003). There is also a highly negative significant association -10.0 (95% CI: -12.4, -7.67), indicating that patients in urban areas and with high lncd4 cell counts had a reduced hazard of death compared to patients in rural areas. Age had a direct effect on survival as the hazard of death increases as we move from one age group to another. A highly negative significant association was observed -9.4 (95% CI: -11.6, -7.17) indicating that the hazard of death for patients with high lncd4 decreases as we move down the age groups.

This article is from Journal of Cardiothoracic Surgery , volume 7 . Abstract Background: We studied potential risk factors for postoperative atrial fibrillation (POAF) in a large cohort of patients who underwent open-heart surgery, evaluating short- and long-term outcome, and we developed a risk-assessment model of POAF. Methods: A retrospective study of 744 patients without prior history of AF who underwent CABG (n = 513), OPCAB (n = 207), and/or AVR (n = 156) at Landspitali Hospital in 2002–2006. Logistic regression analysis was used to study risk factors for POAF, comparing patients with and without POAF. Results: The rate of POAF was 44%, and was higher following AVR (74%) than after CABG (44%) or OPCAB (35%). In general, patients with POAF were significantly older, were more often female, were less likely to be smokers, had a lower EF, and had a higher EuroSCORE. The use of antiarrythmics was similar in the groups but patients who experienced POAF were less likely to be taking statins. POAF patients also had longer hospital stay, higher rates of complications, and operative mortality (5% vs. 0.7%). In multivariate analysis, AVR (OR 4.4), a preoperative history of cardiac failure (OR 1.8), higher EuroSCORE (OR 1.1), and advanced age (OR 1.1) were independent prognostic factors for POAF. Overall five-year survival was 83% and 93% for patients with and without POAF (p

This article is from Journal of Epidemiology and Community Health , volume 65 . Abstract Background: Reducing geographical inequalities in cancer survival in England was a key aim of the Calman–Hine Report (1995) and the NHS Cancer Plan (2000). This study assesses whether geographical inequalities changed following these policy developments by analysing the trend in 1-year relative survival in the 28 cancer networks of England. Methods: Population-based age-standardised relative survival at 1 year is estimated for 1.4 million patients diagnosed with cancer of the oesophagus, stomach, colon, lung, breast (women) or cervix in England during 1991–2006 and followed up to 2007. Regional and deprivation-specific life tables are built to adjust survival estimates for differences in background mortality. Analysis is divided into three calendar periods: 1991–5, 1996–2000 and 2001–6. Funnel plots are used to assess geographical variation in survival over time. Results: One-year relative survival improved for all cancers except cervical cancer. There was a wide geographical variation in survival with generally lower estimates in northern England. This north–south divide became less marked over time, although the overall number of cancer networks that were lower outliers compared with the England value remained stable. Breast cancer was the only cancer for which there was a marked reduction in geographical inequality in survival over time. Conclusion: Policy changes over the past two decades coincided with improved relative survival, without an increase in geographical variation. The north–south divide in relative survival became less pronounced over time but geographical inequalities persist. The reduction in geographical inequality in breast cancer survival may be followed by a similar trend for other cancers, provided government recommendations are implemented similarly.

This article is from PLoS ONE , volume 9 . Abstract Background: MiRNAs are important regulators of different biological processes, including tumorigenesis. MiR-210 is a potential prognostic factor for survival in patients with cancer according to previous clinical researches. We conducted a systematic review and meta-analysis to summarize the significance of increased miR-210 expression in the prognosis of indicated cancers. Methodology/Principal Findings: The present systematic review and meta-analysis of 16 researches included 1809 patients with 7 different types of cancers from 7 countries, and aimed to explore the association between miR-210 expression and the survival of cancer patients. Over-expression of miR-210 may predict poor overall survival (OS, HR = 1.33, 95% CI: 0.85–2.09, P = 0.210), but the effect was not significant. While the predictive effect on disease-free survival (DFS, HR = 1.89, 95% CI: 1.30–2.74, P = 0.001), progression-free survival (PFS, HR = 1.20, 95% CI: 1.05–1.38, P = 0.007) and relapse-free survival(RFS, HR = 4.42, 95% CI: 2.14–9.15, P = 0.000) for patients with breast cancer, primary head and neck squamous cell carcinoma (HNSCC), renal cancer, soft-tissue sarcoma, pediatric osteosarcoma, bladder cancer or glioblastoma was certain. Subgroup analysis showed the limited predictive effect of over-expressed miR-210 on breast cancer OS (HR = 1.63, 95% CI: 0.47–5.67, P = 0.443), breast cancer DFS (HR = 2.03, 95% CI: 0.90–4.57, P = 0.088), sarcoma OS (HR = 1.24, 95% CI: 0.20–7.89, P = 0.818) and renal cancer OS (HR = 1.16, 95% CI: 0.27–4.94, P = 0.842). Conclusions/Significance: This systematic review and meta-analysis suggests that miR-210 has a predictive effect on survival of patients with studied cancer types as indexed by disease-free survival, progression-free survival and relapse-free survival. While the predictive effect on overall survival, breast cancer overall survival, breast cancer disease-free survival, sarcoma overall survival and renal cancer overall survival was not statistically significant.

This article is from BMJ Open , volume 4 . Abstract Objectives: For characterisation of mineral bone disease in chronic kidney disease (CKD), laboratory surrogates have been suggested. This observational should investigate the association of total and skeletal alkaline phosphatase (AP) with mortality of patients undergoing maintenance renal replacement therapy. Setting: Three renal outpatient centers in eastern-central Germany (secondary and tertiary care). Participants: Complete survival and laboratory datasets were available in 407 of 493 patients. Age and gender distribution was equivalent to a general population with end-stage CKD (CKD5D). Patients were included between 2008 and 2010 if at least 2 weeks of maintenance treatment were documented. Primary outcome measures: Mortality was estimated by setting the end of dialysis date as event date. Events other than death (change to another centre, life-sustaining renal function or transplantation) were censored. Results: The OR to die within follow-up for patients in the higher of two total AP strata was 2.70 (95% CI 1.76 to 4.15). In univariate Kaplan-Meier analysis, total AP had a strong association with all-cause mortality (LogRank=24.1, p

This article is from OncoTargets and therapy , volume 7 . Abstract Purpose: Subclones bearing the epidermal growth factor receptor (EGFR) T790M mutation concomitant with deletional mutation in exon 19 (Del19) or a point mutation in exon 21 (L858R) have been reported in non-small cell lung cancer patients before any EGFR tyrosine-kinase inhibitor (TKI) treatment. The effect of pretreatment T790M mutation on the survival of patients with both mutations treated with EGFR TKI is still being debated. Methods: A meta-analysis was undertaken to pool eligible trials to better elucidate whether pretreatment T790M mutation predicts a poorer outcome of EGFR TKI treatment. Hazard ratios and their 95% confidence intervals for progression-free survival (PFS) were extracted and used under the random-effects model. Results: A total of 246 patients with activating EGFR mutation such as Del19 or L858R participated in four selected trials from 350 articles. The overall incidence of patients with pretreatment T790M mutation was 43.10% (106/246), ranging from 34.88% to 80.00% in the individual trials. The combined hazard ratio for PFS in all four eligible studies was 2.602 (95% confidence interval 1.011–6.695; P=0.047), indicating a shorter PFS in patients who had the T790M mutation before receiving EGFR TKI treatment. Heterogeneity testing indicated significant heterogeneity but the absence of publication bias. Conclusion: The meta-analysis reported here found that pretreatment T790M mutation had a negative impact on the PFS of non-small cell lung cancer patients with a Del19 or L858R EGFR mutation who received EGFR TKI treatment.

When it comes to clinical survival trials, regulatory restrictions usually require the application of methods that solely utilize baseline covariates and the intention-to-treat principle. Thereby a lot of potentially useful information is lost, as collection of time-to-event data often goes hand in hand with collection of information on biomarkers and other internal time-dependent covariates. However, there are tools to incorporate information from repeated measurements in a useful manner that can help to shed more light on the underlying treatment mechanisms. We consider dynamic path analysis, a model for mediation analysis in the presence of a time-to-event outcome and time-dependent covariates to investigate direct and indirect effects in a study of different lipid lowering treatments in patients with previous myocardial infarctions. Further, we address the question whether survival in itself may produce associations between the treatment and the mediator in dynamic path analysis and give an argument that, due to linearity of the assumed additive hazard model, this is not the case. We further elaborate on our view that, when studying mediation, we are actually dealing with underlying processes rather than single variables measured only once during the study period. This becomes apparent in results from various models applied to the study of lipid lowering treatments as well as our additionally conducted simulation study, where we clearly observe, that discarding information on repeated measurements can lead to potentially erroneous conclusions.

The electronic health record (EHR) provides an unprecedented opportunity to build actionable tools to support physicians at the point of care. In this paper, we investigate survival analysis in the context of EHR data. We introduce deep survival analysis, a hierarchical generative approach to survival analysis. It departs from previous approaches in two primary ways: (1) all observations, including covariates, are modeled jointly conditioned on a rich latent structure; and (2) the observations are aligned by their failure time, rather than by an arbitrary time zero as in traditional survival analysis. Further, it (3) scalably handles heterogeneous (continuous and discrete) data types that occur in the EHR. We validate deep survival analysis model by stratifying patients according to risk of developing coronary heart disease (CHD). Specifically, we study a dataset of 313,000 patients corresponding to 5.5 million months of observations. When compared to the clinically validated Framingham CHD risk score, deep survival analysis is significantly superior in stratifying patients according to their risk.

The electronic health record (EHR) provides an unprecedented opportunity to build actionable tools to support physicians at the point of care. In this paper, we investigate survival analysis in the context of EHR data. We introduce deep survival analysis, a hierarchical generative approach to survival analysis. It departs from previous approaches in two primary ways: (1) all observations, including covariates, are modeled jointly conditioned on a rich latent structure; and (2) the observations are aligned by their failure time, rather than by an arbitrary time zero as in traditional survival analysis. Further, it (3) scalably handles heterogeneous (continuous and discrete) data types that occur in the EHR. We validate deep survival analysis model by stratifying patients according to risk of developing coronary heart disease (CHD). Specifically, we study a dataset of 313,000 patients corresponding to 5.5 million months of observations. When compared to the clinically validated Framingham CHD risk score, deep survival analysis is significantly superior in stratifying patients according to their risk.

This article is from Iranian Journal of Cancer Prevention , volume 7 . Abstract Background: The aim of this study is to evaluate the association between different treatments and survival time of breast cancer patients using either standard Cox model or stratified Cox model. Methods: The study was conducted on 15830 women diagnosed with breast cancer in British Columbia, Canada. They were divided into eight groups according to patients’ ages and stage of disease Either Cox’s PH model or stratified Cox model was fitted to each group according to the PH assumption and tested using Schoenfeld residuals. Results: The data show that in the group of patients under age 50 years old and over age 50 with stage I cancer, the highest hazard was related to radiotherapy (HR= 3.15, CI: 1.85-5.35) and chemotherapy (HR= 3, CI: 2.29- 3.93) respectively. For both groups of patients with stage II cancer, the highest risk was related to radiotherapy (HR=3.02, CI: 2.26-4.03) (HR=2.16, CI:1.85-2.52). For both groups of patients with stage III cancer, the highest risk was for surgery (HR=0.49, CI: 0.33-0.73), (HR=0.45, CI: 0.36-0.57). For patients of age 50 years or less with stage IV cancer, none of the treatments were statistically significant. In group of patients over age 50 years old with stage IV cancer, the highest hazard was related to surgery (HR=0.64, CI: 0.53-0.78). Conclusion: The results of this study show that for patients with stage I and II breast cancer, radiotherapy and chemotherapy had the highest hazard; for patients with stage III and IV breast cancer, the highest hazard was associated with treatment surgery.

This article is from Annals of Dermatology , volume 26 . Abstract Background: In cutaneous malignant melanoma (MM) with clinically uninvolved regional lymph nodes, sentinel lymph node (SLN) status is the most powerful indicator of both overall survival (OS) and disease-free survival (DFS). However, no studies on the long-term survival and clinical follow-up of Korean patients with acral lentiginous MM (ALM) undergoing SLN biopsy (SLNB) have been published. Objective: The purpose of this study was to investigate the clinical prognosis and long-term survival of Korean patients with ALM according to SLN status. Methods: Thirty-four ALM patients undergoing SLNB were included in this study. We evaluated clinical and histopathological follow-up data such as the stage of disease, treatment, recurrence, and metastasis, and analyzed OS and DFS according to SLN status. Results: The median follow-up time was 60.5 months (range 3~127 months). Positive SLNs were noted in 14 patients (41.2%). Patients with negative SLNs had better OS and DFS than those with positive SLNs (p

The aim of this systematic review and meta-analysis is to refine the threshold for early migration and late aseptic loosening of uncemented tibial components of total knee replacements.

This study establishes desirable characteristics of handguns for use during evasion and survival attempts of aircrew members downed in hostile territory. Based on a quantitative analysis of data from World War II evasion reports of U.S. Army Air Force personnel, the investigation revealed that the primary value of a handgun is affording a psychological sense of security. The weapon can also be used for self-defense, killing small game for food, signaling, and coercion. Recommendations are that effective handguns and ammunition should: be light enough for the aircrew members to carry for long periods of time; be securely attached to the evadee so that they will not be lost during bailout or some other activity where recovery would not be possible; be capable of rapid employment; be very accurate; be capable of disabling an opponent with the first shot; be silent so when employed they will not attract the attention of enemy forces or hostile civilians; be capable of killing small game without destroying the meat. Further, training should also include firing at small moving targets to increase the aircrew member's accuracy.

This study establishes desirable characteristics of handguns for use during evasion and survival attempts of aircrew members downed in hostile territory. Based on a quantitative analysis of data from World War II evasion reports of U.S. Army Air Force personnel, the investigation revealed that the primary value of a handgun is affording a psychological sense of security. The weapon can also be used for self-defense, killing small game for food, signaling, and coercion. Recommendations are that effective handguns and ammunition should: be light enough for the aircrew members to carry for long periods of time; be securely attached to the evadee so that they will not be lost during bailout or some other activity where recovery would not be possible; be capable of rapid employment; be very accurate; be capable of disabling an opponent with the first shot; be silent so when employed they will not attract the attention of enemy forces or hostile civilians; be capable of killing small game without destroying the meat. Further, training should also include firing at small moving targets to increase the aircrew member's accuracy.

Research has demonstrated that high rates of student mobility are associated with a range of negative academic outcomes, both for students who leave their schools and those who remain behind. The current study focused on mobility among those enrolled in charter schools in the state of Indiana. A multilevel Cox Proportional Hazards survival analysis model was used to identify significant predictors of student mobility within and from a state charter school system, using factors at both the student and school levels. Results indicated that initial student achievement upon first entering a charter school, student ethnicity, participation in a Title I funded program, and average years of teacher experience at the school were all associated with the decision to leave the charter. Specifically, students with higher initial achievement scores, those eligible for Title 1 services, and non-Caucasian students were more likely to leave charter schools prematurely. In addition, schools with a more experienced faculty had lower early departure rates than did those with less experienced teachers. (Contains 3 tables.)

This article is from Frontiers in Cellular and Infection Microbiology , volume 4 . Abstract Shiga toxin-producing E. coli O157:H7 and non-O157 have been implicated in many foodborne illnesses caused by the consumption of contaminated fresh produce. However, data on their persistence in soils are limited due to the complexity in datasets generated from different environmental variables and bacterial taxa. There is a continuing need to distinguish the various environmental variables and different bacterial groups to understand the relationships among these factors and the pathogen survival. Using an approach called Topological Data Analysis (TDA); we reconstructed the relationship structure of E. coli O157 and non-O157 survival in 32 soils (16 organic and 16 conventionally managed soils) from California (CA) and Arizona (AZ) with a multi-resolution output. In our study, we took a community approach based on total soil microbiome to study community level survival and examining the network of the community as a whole and the relationship between its topology and biological processes. TDA produces a geometric representation of complex data sets. Network analysis showed that Shiga toxin negative strain E. coli O157:H7 4554 survived significantly longer in comparison to E. coli O157:H7 EDL 933, while the survival time of E. coli O157:NM was comparable to that of E. coli O157:H7 EDL 933 in all of the tested soils. Two non-O157 strains, E. coli O26:H11 and E. coli O103:H2 survived much longer than E. coli O91:H21 and the three strains of E. coli O157. We show that there are complex interactions between E. coli strain survival, microbial community structures, and soil parameters.

This article is from Journal of Otolaryngology - Head & Neck Surgery , volume 42 . Abstract Objectives: To evaluate any disparity in clinical versus pathological TNM staging in oral cavity squamous cell carcinoma (OCSCC) patients and any impact of this on survival. Design: Demographic, survival, staging, and pathologic data on all patients undergoing surgical treatment for OCSCC in Alberta between 1998 and 2006 was collected. Clinical and pathological TNM staging data were compared. Patients were stratified as pathologically downstaged, upstaged or unchanged. Setting: Tertiary care centers in Alberta, Canada. Main outcome measures: Survival differences between groups were analyzed using Kaplan-Meier and Cox regression models. Results: Patients with clinically early stage tumors were pathologically upstaged in 21.9% of cases and unchanged in 78.1% of cases. Patients with clinically advanced stage tumors were pathologically downstaged in 7.9% of cases and unchanged in 92.1% of cases. Univariate and multivariate estimates of disease-specific survival showed no statistically significant differences in survival when patients were either upstaged or downstaged. Conclusions: Some disparity exists in clinical versus pathological staging in OCSCC, however, this does not have any significant impact on disease specific survival.

This article is from Scientific Reports , volume 4 . Abstract To evaluate treatment outcomes in children with acute lymphoblastic leukemia (ALL) over the past 3 decades, we assessed the survival of children with ALL in the Surveillance, Epidemiology, and End Results (SEER) database. Among 12,096 patients from 18 SEER sites diagnosed from 1981 to 2010, survival rates improved each decade from 74.8% to 84.5% to 88.6% at 5 years and from 69.3% to 80.9% to 85.5% at 10 years (P < 0.0001). For ages 10–14 years, 10-year survival increased by more than 20 percentage points to 75.3%, but for infants, it remained low at 54.7%. Improvements in survival rates were observed in both sexes, but survival rates were higher in girls than in boys. For ages 0–14 years during the 2001–2010 period, the 10-year relative survival rates were 87.8% in girls and 83.6% in boys (P < 0.01). Survival rates in child with ALL are expected to further improve with continuous advance in therapies such as targeted therapy and personalized therapy.

We use recurrent-events survival analysis techniques and methods to analyze the duration of Olympic records. The Kaplan-Meier estimator is used to perform preliminary tests and recurrent event survivor function estimators proposed by Wang & Chang (1999) and Pena et al. (2001) are used to estimate survival curves. Extensions of the Cox Proportional Hazards model are employed as well as a discrete-time logistic model for repeated events to estimate models and quantify parameter significance. The logistic model was the best fit to the data according to the Akaike Information Criterion (AIC). We discuss, in detail, covariate significance for this model and make predictions of how many records will be set at the 2012 Olympic Games in London. Keywords: survival analysis, recurrent events, Kaplan-Meier estimator, Cox proportional hazards model, Olympics.

This thesis is an application of logistic regression and survival analysis techniques to the study of current estimated potential (CEP), manpower performance, and attrition behavior in the Singapore military. The manpower data includes both active (30%) and reserve personnel (70%) who entered service as early as the late fifties to as recent as the year 1992. The covariates under consideration are education level, academic or overseas military training award, current rank, length of service, rank seniority, age, salary grade, previous year's annual performance grade and CEP estimates. The study identifies the covariates that explain the CEP and annual performance for the binary and polytomous models of the officers who were still on active duty as of 31 Dec 1992. It also examines the trend of attrition behavior of officers using data from both the active and reserve personnel. The results of the study show that (1) higher education level does not necessary result in better performance grade although it seems to give an indication of higher CEP, (2) The higher the rank of an officer, the more likely it is for him to have a poorer performance grade than when he was in the previous rank, (3) Education level is a significant covariate of the survival functions, and (4) Engineering officers generally has a higher attrition rate than the other service support officers.

This thesis is an application of logistic regression and survival analysis techniques to the study of current estimated potential (CEP), manpower performance, and attrition behavior in the Singapore military. The manpower data includes both active (30%) and reserve personnel (70%) who entered service as early as the late fifties to as recent as the year 1992. The covariates under consideration are education level, academic or overseas military training award, current rank, length of service, rank seniority, age, salary grade, previous year's annual performance grade and CEP estimates. The study identifies the covariates that explain the CEP and annual performance for the binary and polytomous models of the officers who were still on active duty as of 31 Dec 1992. It also examines the trend of attrition behavior of officers using data from both the active and reserve personnel. The results of the study show that (1) higher education level does not necessary result in better performance grade although it seems to give an indication of higher CEP, (2) The higher the rank of an officer, the more likely it is for him to have a poorer performance grade than when he was in the previous rank, (3) Education level is a significant covariate of the survival functions, and (4) Engineering officers generally has a higher attrition rate than the other service support officers.

This article is from BMC Gastroenterology , volume 14 . Abstract Background: This study investigated the survival benefits of sorafenib vs. radiotherapy (RT) in patients with unresectable hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT) in the main trunk or the first branch. Methods: Ninety-seven patients were retrospectively reviewed. Forty patients were enrolled by the Kanagawa Liver Study Group and received sorafenib, and 57 consecutive patients received RT in our hospital. Overall survival was compared between the two groups with PVTT by propensity score (PS) analysis. Factors associated with survival were evaluated by multivariate analysis. Results: The median treatment period with sorafenib was 45 days, while the median total radiation dose was 50 Gy. The Child-Pugh class and the level of invasion into hepatic large vessels were significantly more advanced in the RT group than in the sorafenib group. Median survival did not differ significantly between the sorafenib group (4.3 months) and the RT group (5.9 months; P = 0.115). After PS matching (n = 28 per group), better survival was noted in the RT group than in the sorafenib group (median survival, 10.9 vs. 4.8 months; P = 0.025). A Cox model showed that des-γ-carboxy prothrombin

This article is from Acta Orthopaedica , volume 83 . Abstract Background and purpose: The association between excessive early migration of acetabular cups and late aseptic revision has been scantily reported. We therefore performed 2 parallel systematic reviews and meta-analyses to determine the association between early migration of acetabular cups and late aseptic revision. Methods: One review covered early migration data from radiostereometric analysis (RSA) studies, while the other focused on revision rates for aseptic loosening from long-term survival studies. Thresholds for acceptable and unacceptable migration were classified according the Swedish Hip Arthroplasty Register and the Australian National Joint Replacement Registry: < 5% revision at 10 years. Results: Following an elaborate literature search, 26 studies (involving 700 cups) were included in the RSA review and 49 studies (involving 38,013 cups) were included in the survival review. For every mm increase in 2-year proximal migration, there was a 10% increase in revision rate, which remained after correction for age, sex, diagnosis, hospital type, continent, and study quality. Consequently, proximal migration of up to 0.2 mm was considered acceptable and proximal migration of 1.0 mm or more was considered unacceptable. Cups with proximal migration of between 0.2 and 1.0 mm were considered to be at risk of having revision rates higher than 5% at 10 years. Interpretation: There was a clinically relevant association between early migration of acetabular cups and late revision due to loosening. The proposed migration thresholds can be implemented in a phased evidence-based introduction, since they allow early detection of high-risk cups while exposing a small number of patients.

This article is from BMJ Open , volume 3 . Abstract Objectives: Tumour recurrence of glioblastoma multiforme (GBM) after initial treatment with surgical resection, radiotherapy and chemotherapy is an inevitable phenomenon. This retrospective cohort study compared the efficacy of interstitial high dose rate brachytherapy (HDR-BRT), re-resection and sole dose dense temozolomide chemotherapy (ddTMZ) in the treatment of recurrent glioblastoma after initial surgery and radiochemotherapy. Design: Retropective cohort study. Setting: Primary level of care with two participating centres. The geographical location was central Germany. Participants: From January 2005 to December 2010, a total of 111 patients developed recurrent GBM after initial surgery and radiotherapy with concomitant temozolomide. The inclusion criteria were as follows: (1) histology-proven diagnosis of primary GBM (WHO grade 4), (2) primary treatment with resection and radiochemotherapy, and (3) tumour recurrence/progression. Interventions: This study compared retrospectively the efficacy of interstitial HDR-BRT, re-resection and ddTMZ alone in the treatment of recurrent glioblastoma. Primary and secondary outcome measures: Median survival, progression free survival and complication rate. Results: Median survival after salvage therapy of the recurrence was 37, 30 and 26 weeks, respectively. The HDR-BRT group did significantly better than both the reoperation (p

This article is from BMJ Open , volume 3 . Abstract Objectives: Tumour recurrence of glioblastoma multiforme (GBM) after initial treatment with surgical resection, radiotherapy and chemotherapy is an inevitable phenomenon. This retrospective cohort study compared the efficacy of interstitial high dose rate brachytherapy (HDR-BRT), re-resection and sole dose dense temozolomide chemotherapy (ddTMZ) in the treatment of recurrent glioblastoma after initial surgery and radiochemotherapy. Design: Retropective cohort study. Setting: Primary level of care with two participating centres. The geographical location was central Germany. Participants: From January 2005 to December 2010, a total of 111 patients developed recurrent GBM after initial surgery and radiotherapy with concomitant temozolomide. The inclusion criteria were as follows: (1) histology-proven diagnosis of primary GBM (WHO grade 4), (2) primary treatment with resection and radiochemotherapy, and (3) tumour recurrence/progression. Interventions: This study compared retrospectively the efficacy of interstitial HDR-BRT, re-resection and ddTMZ alone in the treatment of recurrent glioblastoma. Primary and secondary outcome measures: Median survival, progression free survival and complication rate. Results: Median survival after salvage therapy of the recurrence was 37, 30 and 26 weeks, respectively. The HDR-BRT group did significantly better than both the reoperation (p

This article is from BMJ Open , volume 3 . Abstract Objectives: Tumour recurrence of glioblastoma multiforme (GBM) after initial treatment with surgical resection, radiotherapy and chemotherapy is an inevitable phenomenon. This retrospective cohort study compared the efficacy of interstitial high dose rate brachytherapy (HDR-BRT), re-resection and sole dose dense temozolomide chemotherapy (ddTMZ) in the treatment of recurrent glioblastoma after initial surgery and radiochemotherapy. Design: Retropective cohort study. Setting: Primary level of care with two participating centres. The geographical location was central Germany. Participants: From January 2005 to December 2010, a total of 111 patients developed recurrent GBM after initial surgery and radiotherapy with concomitant temozolomide. The inclusion criteria were as follows: (1) histology-proven diagnosis of primary GBM (WHO grade 4), (2) primary treatment with resection and radiochemotherapy, and (3) tumour recurrence/progression. Interventions: This study compared retrospectively the efficacy of interstitial HDR-BRT, re-resection and ddTMZ alone in the treatment of recurrent glioblastoma. Primary and secondary outcome measures: Median survival, progression free survival and complication rate. Results: Median survival after salvage therapy of the recurrence was 37, 30 and 26 weeks, respectively. The HDR-BRT group did significantly better than both the reoperation (p

This article is from Jornal Brasileiro de Pneumologia : Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia , volume 39 . Abstract OBJECTIVE:: To describe demographic characteristics, surgical results, postoperative complications, and overall survival rates in surgically treated patients with lung metastases. METHODS:: This was a retrospective analysis of 119 patients who underwent a total of 154 lung metastasis resections between 1997 and 2011. RESULTS:: Among the 119 patients, 68 (57.1%) were male and 108 (90.8%) were White. The median age was 52 years (range, 15-75 years). In this sample, 63 patients (52.9%) presented with comorbidities, the most common being systemic arterial hypertension (69.8%) and diabetes (19.0%). Primary colorectal tumors (47.9%) and musculoskeletal tumors (21.8%) were the main sites of origin of the metastases. Approximately 24% of the patients underwent more than one resection of the lesions, and 71% had adjuvant treatment prior to metastasectomy. The rate of lung metastasis recurrence was 19.3%, and the median disease-free interval was 23 months. The main surgical access used was thoracotomy (78%), and the most common approach was wedge resection with segmentectomy (51%). The rate of postoperative complications was 22%, and perioperative mortality was 1.9%. The overall survival rates at 12, 36, 60, and 120 months were 96%, 77%, 56%, and 39%, respectively. A Cox analysis confirmed that complications within the first 30 postoperative days were associated with poor prognosis (hazard ratio = 1.81; 95% CI: 1.09-3.06; p = 0.02). CONCLUSIONS:: Surgical treatment of lung metastases is safe and effective, with good overall survival, especially in patients with fewer metastases.

This article is from BMC Public Health , volume 13 . Abstract Background: Volunteering has been advocated by the United Nations, and American and European governments as a way to engage people in their local communities and improve social capital, with the potential for public health benefits such as improving wellbeing and decreasing health inequalities. Furthermore, the US Corporation for National and Community Service Strategic Plan for 2011–2015 focused on increasing the impact of national service on community needs, supporting volunteers’ wellbeing, and prioritising recruitment and engagement of underrepresented populations. The aims of this review were to examine the effect of formal volunteering on volunteers’ physical and mental health and survival, and to explore the influence of volunteering type and intensity on health outcomes. Methods: Experimental and cohort studies comparing the physical and mental health outcomes and mortality of a volunteering group to a non-volunteering group were identified from twelve electronic databases (Cochrane Library, Medline, Embase, PsychINFO, CINAHL, ERIC, HMIC, SSCI, ASSIA, Social Care Online, Social Policy and Practice) and citation tracking in January 2013. No language, country or date restrictions were applied. Data synthesis was based on vote counting and random effects meta-analysis of mortality risk ratios. Results: Forty papers were selected: five randomised controlled trials (RCTs, seven papers); four non-RCTs; and 17 cohort studies (29 papers). Cohort studies showed volunteering had favourable effects on depression, life satisfaction, wellbeing but not on physical health. These findings were not confirmed by experimental studies. Meta-analysis of five cohort studies found volunteers to be at lower risk of mortality (risk ratio: 0.78; 95% CI: 0.66, 0.90). There was insufficient evidence to demonstrate a consistent influence of volunteering type or intensity on outcomes. Conclusion: Observational evidence suggested that volunteering may benefit mental health and survival although the causal mechanisms remain unclear. Consequently, there was limited robustly designed research to guide the development of volunteering as a public health promotion intervention. Future studies should explicitly map intervention design to clear health outcomes as well as use pragmatic RCT methodology to test effects.

This article is from PLoS ONE , volume 8 . Abstract Background: Adjuvant chemotherapy (AC) in Stage II Colon Cancer (CC) is still under debate. Choice should be based on patients and disease characteristics. According to guidelines AC should be considered in high-risk T3N0 patients. No data are available for better option in low-risk patients. The aim of the study is to retrospectively evaluate relapse-free survival (RFS) and disease-free survival (DFS) according to treatment received in T3N0 CC. Methods: RFS and DFS are evaluated with Kaplan-Meier method. Multivariate Cox proportional hazard model was developed using stepwise regression, enter limit and remove limit were p = 0.10 and p = 0.15, respectively. Results: 834 patients with T3N0 CC were recruited. Median age was 69 (29–93), M/F 463/371, 335 low-risk patients (40.2%), 387 high-risk (46.4%), 112 unknown (13.4%); 127 (15.2%) patients showed symptoms at diagnosis. Median sampled lymph nodes were 15 (1–76); 353 (42.3%) patients were treated with AC. Median follow up was 5 years (range 3–24). The 5-years RFS was 78.4% and the 5-years DFS was 76.7%. At multivariate analysis symptoms, lymph nodes, and adjuvant chemotherapy were prognostic factors for RFS. AC is prognostic factor for all endpoints.In low-risk group 5-years RFS was 87.3% in treated patients and 74.7% in non-treated patients (p 0.03); in high-risk group was respectively 82.7% and 71.4% (p 0.005). Conclusions: Data confirmed the role of known prognostic factors and suggest the relevance of adjuvant chemotherapy also in low-risk stage II T3N0 CC patients. However, the highest risk in low-risk subgroup should be identified to be submitted to AC.

This article is from Radiation Oncology (London, England) , volume 9 . Abstract Background: The aim of this retrospective study was to evaluate the stability of spinal metastases in gynecologic cancer patients (pts) on the basis of a validated scoring system after radiotherapy (RT), to define prognostic factors for stability and to calculate survival. Methods: Fourty-four women with gynecologic malignancies and spinal bone metastases were treated at our department between January 2000 and January 2012. Out of those 34 were assessed regarding stability using the Taneichi score before, 3 and 6 months after RT. Additionally prognostic factors for stability, overall survival, and bone survival (time between first day of RT of bone metastases and death from any cause) were calculated. Results: Before RT 47% of pts were unstable and 6 months after RT 85% of pts were stable. Karnofsky performance status (KPS) >70% (p = 0.037) and no chemotherapy (ChT) (p = 0.046) prior to RT were significantly predictive for response. 5-year overall survival was 69% and 1-year bone survival was 73%. Conclusions: RT is capable of improving stability of osteolytic spinal metastases from gynecologic cancer by facilitating re-ossification in survivors. KPS may be a predictor for response. Pts who received ChT prior to RT may require additional bone supportive treatment to overcome bone remodeling imbalance. Survival in women with bone metastases from gynecologic cancer remains poor.

本研讨会包括以下内容： - 了解经常用于比较肿瘤学干预措施的分区生存分析模型。 - 探索生存曲线，以及分析和结果的解释。考虑状态成员的不同表述，包括使用危险函数和其他生存函数 - 了解队列的累积价值（成本/效用）。 完整的视频教程，请登录 科学软件网 www.sciencesoftware.com.cn 观看。

本研讨会包括以下内容： - 了解经常用于比较肿瘤学干预措施的分区生存分析模型。 - 探索生存曲线，以及分析和结果的解释。考虑状态成员的不同表述，包括使用危险函数和其他生存函数 - 了解队列的累积价值（成本/效用）。 完整的视频教程，请登录 科学软件网 www.sciencesoftware.com.cn 观看。

Cricketing knowledge tells us batting is more difficult early in a player's innings but becomes easier as a player familiarizes themselves with the conditions. In this paper, we develop a Bayesian survival analysis method to predict the Test Match batting abilities for international cricketers. The model is applied in two stages, firstly to individual players, allowing us to quantify players' initial and equilibrium batting abilities, and the rate of transition between the two. This is followed by implementing the model using a hierarchical structure, providing us with more general inference concerning a selected group of opening batsmen from New Zealand. The results indicate most players begin their innings playing with between only a quarter and half of their potential batting ability. Using the hierarchical structure we are able to make predictions for the batting abilities of the next opening batsman to debut for New Zealand. Additionally, we compare and identify players who excel in the role of opening the batting, which has practical implications in terms of batting order and team selection policy.

We introduce a semi-parametric Bayesian model for survival analysis. The model is centred on a parametric baseline hazard, and uses a Gaussian process to model variations away from it nonparametrically, as well as dependence on covariates. As opposed to many other methods in survival analysis, our framework does not impose unnecessary constraints in the hazard rate or in the survival function. Furthermore, our model handles left, right and interval censoring mechanisms common in survival analysis. We propose a MCMC algorithm to perform inference and an approximation scheme based on random Fourier features to make computations faster. We report experimental results on synthetic and real data, showing that our model performs better than competing models such as Cox proportional hazards, ANOVA-DDP and random survival forests.

Many researchers have investigated first hitting times as models for survival data. First hitting times arise naturally in many types of stochastic processes, ranging from Wiener processes to Markov chains. In a survival context, the state of the underlying process represents the strength of an item or the health of an individual. The item fails or the individual experiences a clinical endpoint when the process reaches an adverse threshold state for the first time. The time scale can be calendar time or some other operational measure of degradation or disease progression. In many applications, the process is latent (i.e., unobservable). Threshold regression refers to first-hitting-time models with regression structures that accommodate covariate data. The parameters of the process, threshold state and time scale may depend on the covariates. This paper reviews aspects of this topic and discusses fruitful avenues for future research.

Question-&-Answer (QA) websites have emerged as efficient platforms for knowledge sharing and problem solving. In particular, the Stack Exchange platform includes some of the most popular QA communities to date, such as Stack Overflow. Initial metrics used to assess the performance of these communities include summative statistics like the percentage of resolved questions or the average time to receive and validate correct answers. However, more advanced methods for longitudinal data analysis can provide further insights on the QA process, by enabling identification of key predictive factors and systematic comparison of performance across different QA communities. In this paper, we apply survival analysis to a selection of communities from the Stack Exchange platform. We illustrate the advantages of using the proposed methodology to characterize and evaluate the performance of QA communities, and then point to some implications for the design and management of QA platforms.

This study contains the data used to establish the desirable characteristics of handguns for use during evasion and survival attempts of aircrew members downed in hostile territory. The research design and procedures are also presented.

The human malaria parasite P. falciparum exhibits extensive strain- dependent chromosomal polymorphisms that have been implicated in the generation of antigenic variability in this organism. These polymorphisms can result in large deletions in chromosomes as determined by pulsed-field gradient gel electrophoresis. We have investigated the molecular basis for extensive deletions in chromosomes 1, 2 and 8 in multiple geographic isolates of this parasite that result in the loss of expression of well-characterized parasite antigens. The structure of these polymorphic chromosomes reveal that a mechanism of chromosome breakage and healing by the addition of telomeric repeats most plausibly accounts for these karyotypes. Furthermore, the orientation of these gene fragments on their truncated chromosomes reveal that the healed chromosome originally associated with centromeric elements is motitically stable and maintained. These studies indicate a specificity to the process by which chromosomal polymorphisms are generated.

This thesis is an application of logistic regression and survival analysis techniques to the study of current estimated potential (CEP), manpower performance, and attrition behavior in the Singapore military. The manpower data includes both active (30%) and reserve personnel (70%) who entered service as early as the late fifties to as recent as the year 1992. The covariates under consideration are education level, academic or overseas military training award, current rank, length of service, rank seniority, age, salary grade, previous year's annual performance grade and CEP estimates. The study identifies the covariates that explain the CEP and annual performance for the binary and polytomous models of the officers who were still on active duty as of 31 Dec 1992. It also examines the trend of attrition behavior of officers using data from both the active and reserve personnel. The results of the study show that (1) higher education level does not necessary result in better performance grade although it seems to give an indication of higher CEP, (2) The higher the rank of an officer, the more likely it is for him to have a poorer performance grade than when he was in the previous rank, (3) Education level is a significant covariate of the survival functions, and (4) Engineering officers generally has a higher attrition rate than the other service support officers. Logistic regression, Manpower performance, Current estimated potential, Survival analysis, Military attrition

This study applied newly-developed methods of survival analysis with repeated events to a longitudinal data set in order to illustrate stopout hazards for college students. Survival analysis incorporates cases of students returning to college and not yet returning to college in a single analysis. This study applied a multiple-spell survival analysis to stopout data on a cohort of first-time entering freshmen in fall 1983 at University of Texas at El Paso for 20 terms through Spring, 1993. Spells were defined as "enrolled" or "not enrolled." Data collection ended either when the student received a first baccalaureate degree or in spring, 1993. Results found that students' greatest risk of leaving was after the second term of enrollment. Hazard again peaked after the fourth term, then leveled off after the sixth term. Students who left were more likely to return after only one or two terms out. Once they had been gone for six terms, the odds of returning were virtually nil. Return enrollment and stopout spells share basically the same shape as initial spells. Hispanic students were 1.7 times more likely than White non-Hispanic students to return to the institution after a stopout period. (Contains 20 references.) (JB)

By using a competing risks model, survival analysis methods can be extended to predict which of several mutually exclusive outcomes students will choose based on predictor variables, thereby ascertaining if the profile of risk differs across groups. The paper begins with a brief introduction to logistic regression and some of the basic concepts of survival analysis necessary to understand the competing risks survival analysis method. A data set is used to illustrate conducting the competing risks survival analysis, and results of that analysis for each competing risk and predictor variable are presented and interpreted. The procedure for conducting a competing risks survival analysis is similar to that of conducting a survival analysis with only one outcome. Data are prepared and coded in a like manner, and survival and hazard functions are interpreted by the same guidelines. However, in a competing risks survival analysis, the hazard probabilities for each competing outcome are recombined to create a complete profile of each risk for each time period in question. Data from the Dallas (Texas) public schools for 7,748 students (ninth graders in 1990-91) with no more than one of the defined competing risks (school leaving or completion) illustrate the analysis approach. Appendixes contain a Statistical Analysis System program for the analysis, withdrawal and dropout reasons for the student cohort, and a discussion of the transformation of data from person-data to person-period-data. (Contains 2 figures, 12 tables, and 33 references.) (SLD)

This article is from Trials , volume 14 . Abstract None

This article is from Clinical Ophthalmology (Auckland, N.Z.) , volume 8 . Abstract Purpose: To evaluate the outcome of corneal allotransplantation in combined penetrating keratoplasty and vitreoretinal surgery using a temporary keratoprosthesis, and to determine the factors affecting corneal allograft survival. Methods: We reviewed the medical charts of eleven patients who had undergone combined corneal allotransplantation and pars plana vitrectomy using an Eckardt temporary keratoprosthesis, for the treatment of corneal opacification and vitreoretinal disease. The survival rates of the corneal grafts were assessed, and patient demographics, the diagnosis of corneal and retinal disease, the preoperative ocular characteristics, and surgical methods were compared between the group with graft survival and that with graft failure. Results: The causes of corneal opacification were corneal laceration (four eyes), infectious keratitis (four eyes), atopic keratitis (one eye), rejected corneal graft (one eye), and uveitis-related bullous keratopathy (one eye). The preoperative diagnoses included endophthalmitis (six eyes), posterior uveitis (one eye), vitreous opacity or hemorrhage (two eyes), and rhegmatogenous retinal detachment (two eyes). The survival rate of the corneal allografts was 27.3% (3/11 eyes). The mean survival time was 391 days during the mean follow-up period of 687 days. The retinal surgery was successful in 81.8% (9/11 eyes) of cases. The presence of active inflammation in the cornea at the time of surgery was significantly correlated with graft rejection (P=0.004). Other factors, including age, the presence of glaucoma, type of corneal and retinal disease, or type of retinal surgery, such as silicone oil injection and gas tamponade, had no significant correlation with graft rejection. Conclusion: Combined corneal allotransplantation and pars plana vitrectomy using a temporary keratoprosthesis allowed for successful surgical intervention in vitreoretinal disease. However, only 27.3% of corneal allografts survived, depending on the presence of active inflammation in the cornea.

This article is from BMC Cancer , volume 14 . Abstract Background: To compare survival of patients with non-small cell lung cancer (NSCLC) who underwent surgical resection and lymph node sampling based on guidelines proposed by the American College of Surgeons Oncology Group (ACOSOG), National Comprehensive Cancer Network (NCCN), the OSI Pharmaceutical RADIANT trial, and the International Association for the Study of Lung Cancer (IASLC). Methods: Medical records of patients with NSCLC who underwent surgical resection from 2001 to 2008 at our hospital were reviewed. Staging was according to the 7th edition of the AJCC TNM classification of lung cancer. Patients who received surgical resection following the IASLC, ACOSOG, RADIANT or NCCN resection criteria were identified. Results: A total of 2,711 patients (1803 males, 908 females; mean age, 59.6 ± 9.6 years) were included. Multivariate Cox proportional hazards regression analysis indicated that increasing age, adenosquamous histology, and TNM stage II or III were associated with decreased overall survival (OS). Univariate analysis and log-rank test showed that surgical resection following the guidelines proposed by the IASLC, NCCN, ACOSOG, or RADIANT trial was associated with higher cumulative OS rates (relative to resection not following the guidelines). Multivariate analysis revealed that there was a significant improvement in OS only when IASLC resection guidelines (complete resection) were followed (hazard ratio = 0.84, 95% confidence interval 0.716 to 0.985, P = 0.032). Conclusions: Surgical resection following the criteria proposed by IASLC, NCCN, ACOSOG, or the RADIANT trial was associated with a higher cumulative OS rate. However, significant improvement in OS only occurred when IASLC resection guidelines were followed.