Métodos probabilísticos e estatísticos na gestão de fogos florestais

Tese de doutoramento, Estatística e Investigação Operacional (Probabilidades e Estatística), Universidade de Lisboa, Faculdade de Ciências, 2014

Weekend versus weekday admission and mortality after acute pulmonary embolism.

BACKGROUND: Optimal management of acute pulmonary embolism (PE) requires medical expertise, diagnostic testing, and therapies that may not be available consistently throughout the entire week. We sought to assess whether associations exist between weekday or weekend admission and mortality and length of hospital stay for patients hospitalized with PE. METHODS AND RESULTS: We evaluated patients discharged with a primary diagnosis of PE from 186 acute care hospitals in Pennsylvania (January 2000 to November 2002). We used random-effect logistic models to study the association between weekend admission and 30-day mortality and used discrete survival models to study the association between weekend admission and time to hospital discharge, adjusting for hospital (region, size, and teaching status) and patient factors (race, insurance, severity of illness, and use of thrombolytic therapy). Among 15 531 patient discharges with PE, 3286 patients (21.2%) had been admitted on a weekend. Patients admitted on weekends had a higher unadjusted 30-day mortality rate (11.1% versus 8.8%) than patients admitted on weekdays, with no difference in length of stay. Patients admitted on weekends had significantly greater adjusted odds of dying (odds ratio 1.17, 95% confidence interval 1.03 to 1.34) than patients admitted on weekdays. The higher mortality among patients hospitalized on weekends was driven by the increased mortality rate among the most severely ill patients. CONCLUSIONS: Patients with PE who are admitted on weekends have a significantly higher short-term mortality than patients admitted on weekdays. Quality-improvement efforts should aim to ensure a consistent approach to the management of PE 7 days a week.

Ecologia demogràfica de la perca americana (Micropterus salmoides) a l'Estany de Banyoles

L'Estany de Banyoles, sistema peculiar tant des del punt de vista de la seva formació geològica com de les seves característiques limnològiques, conté actualment una comunitat de peixos profundament modificada respecte de la comunitat original. La perca americana (Micropterus salmoides), introduïda a finals dels anys seixanta del segle XX, és avui una de les espècies dominants en aquesta comunitat, i ocupa sobretot l'hàbitat litoral de l'Estany. Es tracta d'una espècie molt ben estudiada a Nord Amèrica des de diverses disciplines de la biologia i des de fa diverses dècades, cosa que ha comportat que actualment es disposi d'un gran volum d'informació sobre ella. Amb tot, fora del seu continent d'origen ha rebut poca atenció, malgrat l'amplia expansió que ha experimentat arreu del món. En aquesta tesi doctoral s'han abordat, amb un enfocament descriptiu, aspectes fins ara desconeguts per a l'espècie a l'Estany de Banyoles, a la península ibèrica i fins i tot a Europa. Concretament, se n'ha analitzat la condició, el creixement i la demografia, així com les seves variacions temporals. Amb aquesta finalitat, s'ha dissenyat un mostreig composat de deu campanyes de pesca intensives més alguns petits mostrejos addicionals intercalats, mostreig que s'ha allargat des del juliol del 1997 i fins el novembre del 1999. La captura dels exemplars s'ha realitzat mitjançant una tècnica de pesca elèctrica amb una embarcació posada a punt expressament per a aquest estudi, la qual s'ha mostrat considerablement eficient malgrat les dificultats que ofereix el medi. S'ha realitzat un mostreig de marcatge-recaptura basat en la mutilació d'aletes i, en alguns casos, en el marcatge amb pintura acrílica. Només en la darrera campanya (novembre del 1999) s'ha sacrificat una part important de les captures a fi de retirar-ne els otòlits per a la determinació de l'edat. Pel que fa a l'anàlisi de les dades, s'ha aplicat un ampli ventall de mètodes i models per a cada un dels aspectes estudiats, a fi de contrastar-ne els resultats i validar-ne la seva fiabilitat. En el cas de la condició, s'han aplicat mètodes d'anàlisi de la covariància (ANCOVA) i altres mètodes anàlegs, així com, paral·lelament, regressions i anàlisis derivades a partir de la relació longitud-pes. En l'estudi del creixement, s'han realitzat ajustaments de diversos models mitjançant regressions sobre dades de mida a l'edat i sobre dades d'increments de mida observats per interval de temps. També s'han aplicat anàlisis de freqüències de longitud, i, finalment, s'han aplicat mètodes de retrocàlcul a partir dels increments anuals del radi observats en els otòlits. Finalment, en el cas de l'estudi de la demografia, s'han aplicat models de marcatge-recaptura per a l'estimació de la grandària poblacional i de la supervivència, i, a més, s'han ajustat diversos models continus de supervivència sobre aquestes estimacions prèvies. També s'han estimat les capturabilitats associades a la nova tècnica de captura. Per una altra banda, s'ha implementat i realitzat un mostreig sobre la població de pescadors esportius de l'Estany encarat a determinar, bàsicament, la pressió de pesca a què es veu sotmesa l'espècie. Els resultats mostren sobretot una alta estabilitat interanual en tots els aspectes estudiats, que s'explica per l'estabilitat ambiental que, al seu torn, és característica d'aquest ecosistema lacustre. Això reverteix en una longevitat màxima observada que iguala la màxima descrita a la literatura per a l'espècie. Alhora, també s'han descrit fortes oscil·lacions estacionals tant en la condició, com en el creixement, com també en la supervivència, les quals, però, presenten certes diferències en la seva temporalitat, cosa que indica una certa diferenciació en els factors que les regulen.

Contributions of Weather and Predation to Reduced Breeding Success in a Threatened Northern Loggerhead Shrike Population

Populations on the periphery of a species' range may experience more severe environmental conditions relative to populations closer to the core of the range. As a consequence, peripheral populations may have lower reproductive success or survival, which may affect their persistence. In this study, we examined the influence of environmental conditions on breeding biology and nest survival in a threatened population of Loggerhead Shrikes (Lanius ludovicianus) at the northern limit of the range in southeastern Alberta, Canada, and compared our estimates with those from shrike populations elsewhere in the range. Over the 2-year study in 1992–1993, clutch sizes averaged 6.4 eggs, and most nests were initiated between mid-May and mid-June. Rate of renesting following initial nest failure was 19%, and there were no known cases of double-brooding. Compared with southern populations, rate of renesting was lower and clutch sizes tended to be larger, whereas the length of the nestling and hatchling periods appeared to be similar. Most nest failures were directly associated with nest predators, but weather had a greater direct effect in 1993. Nest survival models indicated higher daily nest survival during warmer temperatures and lower precipitation, which may include direct effects of weather on nestlings as well as indirect effects on predator behavior or food abundance. Daily nest survival varied over the nesting cycle in a curvilinear pattern, with a slight increase through laying, approximately constant survival through incubation, and a decline through the nestling period. Partial brood loss during the nestling stage was high, particularly in 1993, when conditions were cool and wet. Overall, the lower likelihood of renesting, lower nest survival, and higher partial brood loss appeared to depress reproductive output in this population relative to those elsewhere in the range, and may have increased susceptibility to population declines.

Methods for Equivalence and Noninferiority Testing

Classical hypothesis testing focuses on testing whether treatments have differential effects on outcome. However, sometimes clinicians may be more interested in determining whether treatments are equivalent or whether one has noninferior outcomes. We review the hypotheses for these noninferiority and equivalence research questions, consider power and sample size issues, and discuss how to perform such a test for both binary and survival outcomes. The methods are illustrated on 2 recent studies in hematopoietic cell transplantation.

Pro-oxidative synergic bactericidal effect of NO: kinetics and inhibition by nitroxides

NO plays diverse roles in physiological and pathological processes, occasionally resulting in opposing effects, particularly in cells subjected to oxidative stress. NO mostly protects eukaryotes against oxidative injury, but was demonstrated to kill prokaryotes synergistically with H2O2. This could be a promising therapeutic avenue. However, recent conflicting findings were reported describing dramatic protective activity of NO. The previous studies of NO effects on prokaryotes applied a transient oxidative stress while arbitrarily checking the residual bacterial viability after 30 or 60min and ignoring the process kinetics. If NO-induced synergy and the oxidative stress are time-dependent, the elucidation of the cell killing kinetics is essential, particularly for survival curves exhibiting a "shoulder" sometimes reflecting sublethal damage as in the linear-quadratic survival models. We studied the kinetics of NO synergic effects on H2O2-induced killing of microbial pathogens. A synergic pro-oxidative activity toward gram-negative and gram-positive cells is demonstrated even at sub-μM/min flux of NO. For certain strains, the synergic effect progressively increased with the duration of cell exposure, and the linear-quadratic survival model best fit the observed survival data. In contrast to the failure of SOD to affect the bactericidal process, nitroxide SOD mimics abrogated the pro-oxidative synergy of NO/H2O2. These cell-permeative antioxidants, which hardly react with diamagnetic species and react neither with NO nor with H2O2, can detoxify redox-active transition metals and catalytically remove intracellular superoxide and nitrogen-derived reactive species such as (•)NO2 or peroxynitrite. The possible mechanism underlying the bactericidal NO synergy under oxidative stress and the potential therapeutic gain are discussed.

Testes de hipóteses em modelos de sobrevivência com Fração de cura

Survival models deals with the modeling of time to event data. However in some situations part of the population may be no longer subject to the event. Models that take this fact into account are called cure rate models. There are few studies about hypothesis tests in cure rate models. Recently a new test statistic, the gradient statistic, has been proposed. It shares the same asymptotic properties with the classic large sample tests, the likelihood ratio, score and Wald tests. Some simulation studies have been carried out to explore the behavior of the gradient statistic in fi nite samples and compare it with the classic statistics in diff erent models. The main objective of this work is to study and compare the performance of gradient test and likelihood ratio test in cure rate models. We first describe the models and present the main asymptotic properties of the tests. We perform a simulation study based on the promotion time model with Weibull distribution to assess the performance of the tests in finite samples. An application is presented to illustrate the studied concepts

Algumas distribuições de probalidade para idosos grupados e censurados

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Modelos bayesianos para análise de características reprodutivas de fêmeas Nelore

Pós-graduação em Genética e Melhoramento Animal - FCAV

A Bayesian analysis of the Conway-Maxwell-Poisson cure rate model

The purpose of this paper is to develop a Bayesian analysis for the right-censored survival data when immune or cured individuals may be present in the population from which the data is taken. In our approach the number of competing causes of the event of interest follows the Conway-Maxwell-Poisson distribution which generalizes the Poisson distribution. Markov chain Monte Carlo (MCMC) methods are used to develop a Bayesian procedure for the proposed model. Also, some discussions on the model selection and an illustration with a real data set are considered.

The polysurvival model with long-term survivors

Long-term survival models have historically been considered for analyzing time-to-event data with long-term survivors fraction. However, situations in which a fraction (1 - p) of systems is subject to failure from independent competing causes of failure, while the remaining proportion p is cured or has not presented the event of interest during the time period of the study, have not been fully considered in the literature. In order to accommodate such situations, we present in this paper a new long-term survival model. Maximum likelihood estimation procedure is discussed as well as interval estimation and hypothesis tests. A real dataset illustrates the methodology.

A Bayesian destructive weighted Poisson cure rate model and an application to a cutaneous melanoma data

In this article, we propose a new Bayesian flexible cure rate survival model, which generalises the stochastic model of Klebanov et al. [Klebanov LB, Rachev ST and Yakovlev AY. A stochastic-model of radiation carcinogenesis - latent time distributions and their properties. Math Biosci 1993; 113: 51-75], and has much in common with the destructive model formulated by Rodrigues et al. [Rodrigues J, de Castro M, Balakrishnan N and Cancho VG. Destructive weighted Poisson cure rate models. Technical Report, Universidade Federal de Sao Carlos, Sao Carlos-SP. Brazil, 2009 (accepted in Lifetime Data Analysis)]. In our approach, the accumulated number of lesions or altered cells follows a compound weighted Poisson distribution. This model is more flexible than the promotion time cure model in terms of dispersion. Moreover, it possesses an interesting and realistic interpretation of the biological mechanism of the occurrence of the event of interest as it includes a destructive process of tumour cells after an initial treatment or the capacity of an individual exposed to irradiation to repair altered cells that results in cancer induction. In other words, what is recorded is only the damaged portion of the original number of altered cells not eliminated by the treatment or repaired by the repair system of an individual. Markov Chain Monte Carlo (MCMC) methods are then used to develop Bayesian inference for the proposed model. Also, some discussions on the model selection and an illustration with a cutaneous melanoma data set analysed by Rodrigues et al. [Rodrigues J, de Castro M, Balakrishnan N and Cancho VG. Destructive weighted Poisson cure rate models. Technical Report, Universidade Federal de Sao Carlos, Sao Carlos-SP. Brazil, 2009 (accepted in Lifetime Data Analysis)] are presented.

Mortality from road traffic accidents in Switzerland: longitudinal and spatial analyses

Road traffic accidents (RTA) are an important cause of premature death. We examined socio-demographic and geographical determinants of RTA mortality in Switzerland by linking 2000 census data to RTA mortality records 2000-2005 (ICD-10 codes V00-V99). Data from 5.5 million residents aged 18-94 years, 1744 study areas, and 1620 RTA deaths were analyzed, including 978 deaths (60.4%) in motor vehicle occupants, 254 (15.7%) in motorcyclists, 107 (6.6%) in cyclists, and 259 (16.0%) in pedestrians. Weibull survival models and Bayesian methods were used to calculate hazard ratios (HR), and standardized mortality ratios (SMR) across study areas. Adjusted HR comparing women with men ranged from 0.04 (95% CI 0.02-0.07) in motorcyclists to 0.43 (95% CI 0.32-0.56) in pedestrians. There was a u-shaped relationship with age in motor vehicle occupants and motorcyclists. In cyclists and pedestrians, mortality increased after age 55 years. Mortality was higher in individuals with primary education (HR 1.53; 95% CI 1.29-1.81), and higher in single (HR 1.24; 95% CI 1.05-1.46), widowed (HR 1.31; 95% CI 1.05-1.65) and divorced individuals (HR 1.62; 95% CI 1.33-1.97), compared to persons with tertiary education or married persons. The association with education was particularly strong for pedestrians (HR 1.87; 95% CI 1.20-2.91). RTA mortality increased with decreasing population density of study areas for motor vehicle occupants (test for trend p<0.0001) and motorcyclists (p=0.0021) but not for cyclists (p=0.39) or pedestrians (p=0.29). SMR standardized for socio-demographic and geographical variables ranged from 82 to 190. Prevention efforts should aim to reduce inequities across socio-demographic and educational groups, and across geographical areas, with interventions targeted at high-risk groups and areas, and different traffic users, including pedestrians.

Prognosis of patients with HIV-1 infection starting antiretroviral therapy in sub-Saharan Africa: a collaborative analysis of scale-up programmes

Background Prognostic models have been developed for patients infected with HIV-1 who start combination antiretroviral therapy (ART) in high-income countries, but not for patients in sub-Saharan Africa. We developed two prognostic models to estimate the probability of death in patients starting ART in sub-Saharan Africa. Methods We analysed data for adult patients who started ART in four scale-up programmes in Côte d'Ivoire, South Africa, and Malawi from 2004 to 2007. Patients lost to follow-up in the first year were excluded. We used Weibull survival models to construct two prognostic models: one with CD4 cell count, clinical stage, bodyweight, age, and sex (CD4 count model); and one that replaced CD4 cell count with total lymphocyte count and severity of anaemia (total lymphocyte and haemoglobin model), because CD4 cell count is not routinely measured in many African ART programmes. Death from all causes in the first year of ART was the primary outcome. Findings 912 (8·2%) of 11 153 patients died in the first year of ART. 822 patients were lost to follow-up and not included in the main analysis; 10 331 patients were analysed. Mortality was strongly associated with high baseline CD4 cell count (≥200 cells per μL vs <25; adjusted hazard ratio 0·21, 95% CI 0·17–0·27), WHO clinical stage (stages III–IV vs I–II; 3·45, 2·43–4·90), bodyweight (≥60 kg vs <45 kg; 0·23, 0·18–0·30), and anaemia status (none vs severe: 0·27, 0·20–0·36). Other independent risk factors for mortality were low total lymphocyte count, advanced age, and male sex. Probability of death at 1 year ranged from 0·9% (95% CI 0·6–1·4) to 52·5% (43·8–61·7) with the CD4 model, and from 0·9% (0·5–1·4) to 59·6% (48·2–71·4) with the total lymphocyte and haemoglobin model. Both models accurately predict early mortality in patients starting ART in sub-Saharan Africa compared with observed data. Interpretation Prognostic models should be used to counsel patients, plan health services, and predict outcomes for patients with HIV-1 infection in sub-Saharan Africa.

Prognosis of HIV-1-infected patients up to 5 years after initiation of HAART: collaborative analysis of prospective studies

OBJECTIVE: To estimate the prognosis over 5 years of HIV-1-infected, treatment-naive patients starting HAART, taking into account the immunological and virological response to therapy. DESIGN: A collaborative analysis of data from 12 cohorts in Europe and North America on 20,379 adults who started HAART between 1995 and 2003. METHODS: Parametric survival models were used to predict the cumulative incidence at 5 years of a new AIDS-defining event or death, and death alone, first from the start of HAART and second from 6 months after the start of HAART. Data were analysed by intention-to-continue-treatment, ignoring treatment changes and interruptions. RESULTS: During 61 798 person-years of follow-up, 1005 patients died and an additional 1303 developed AIDS. A total of 10 046 (49%) patients started HAART either with a CD4 cell count of less than 200 cells/microl or with a diagnosis of AIDS. The 5-year risk of AIDS or death (death alone) from the start of HAART ranged from 5.6 to 77% (1.8-65%), depending on age, CD4 cell count, HIV-1-RNA level, clinical stage, and history of injection drug use. From 6 months the corresponding figures were 4.1-99% for AIDS or death and 1.3-96% for death alone. CONCLUSION: On the basis of data collected routinely in HIV care, prognostic models with high discriminatory power over 5 years were developed for patients starting HAART in industrialized countries. A risk calculator that produces estimates for progression rates at years 1 to 5 after starting HAART is available from www.art-cohort-collaboration.org.