Maintenance of medical equipment plays an important role in ensuring the healthcare quality so that the care can be conducted with minimal risk. Preventive maintenance is performed to maintain the equipment in satisfactory operating condition, while corrective maintenance is made when there is an unpredicted maintenance requirement. This study aims to determine what effect preventive maintenance has on corrective maintenance. A correlation analysis, regression analysis and survival analysis are performed on work-order data from 2000-2021. The results obtained indicate that increasing the number of preventive maintenances made to medical equipment will decrease the number of corrective maintenances required for the medical equipment.

Survival analysis is an effective tool for conservation studies, since it measure the risk of an event that is important for the survival of populations and preservation of biodiversity. In this thesis three different models for survival analysis are used to estimate the age at breeding between two genetically different populations of brown trout. These populations are an evolutionary enigma, since they apparently coexist in direct competition with each other, which according to ecological theory should not happen. Thus it is of interest if differences between them can be identified. The data consists of brown trouts and has been collected over 20 years. The models are the Cox Proportional Hazards model, the Complementary Log-Log Link model and the Log Logistic Accelerated Failure-Time model. The Cox model were estimated in three different ways due to the nonproportional hazards in the estimates of time to breeding, which gave different interpretations of the same model. All of the models agree that the population B breed at younger ages than the population A, which suggests that the two populations have different reproductive strategies.

Introdução: Os múltiplos e interativos efeitos protetores do aleitamento materno exclusivo (AME) na saúde e sobrevivência infantil justificam as recomendações universais para promover sua prática. Poucos são os estudos que avaliam a tendência do padrão do AME entre países. Objetivo: Analisar a mudança temporal do AME em cinco países da América Latina e Caribe (ALC) comparando dados das décadas de 1990 e 2000. Métodos: A dissertação é composta por um manuscrito, que avaliou dados de crianças de 0 a 6 meses incluídas nas amostras das pesquisas Demographic Health Survey conduzidas em Brasil, Colômbia, Haiti, Peru e República Dominicana. Foram estimadas as prevalências do AME e suas taxas anuais de variação ponderada, segundo país e ano de inquérito. A duração do AME foi estimada usando a análise de sobrevida de Kaplan-Meier, considerando a idade atual da criança como o tempo de sobrevida e o AME como variável binária, referente à situação da prática no momento da entrevista. As curvas de sobrevivência foram construídas por país, em cada década, e a comparação entre elas usou o teste log-rank. A mediana do tempo de amamentação foi calculada para cada variável independente e a relação entre essas variáveis e o desmame até os seis meses foi analisada pela técnica de regressão de Cox com modelo múltiplo. Resultados: A prevalência de AME aumentou em quatro dos cinco países estudados, com incremento ao ano mais marcante na Colômbia (11 por cento ) e no Haiti (17 por cento ). A duração mediana apresentou duas tendências de evolução: aumento com equidade na Colômbia e no Haiti, e estagnação com distribuição desigual entre os subgrupos populacionais da última década no Brasil, Peru e República Dominicana. No modelo múltiplo de regressão, variáveis de demografia e do perfil de uso dos serviços de saúde associaram-se à duração do AME. A residência em área rural foi a variável reiteradamente associada, de forma negativa no Brasil (HR=1,68; IC 95 por cento :1,06-2,67) e na Colômbia (HR=1,39; IC 95 por cento :1,03-1,87), enquanto que positivamente no Peru (HR=0,40; IC 95 por cento :0,19-0,83). Conclusão: O balanço da tendência do AME na ALC é positivo, embora não uniforme ao longo das duas décadas analisadas. Os achados sinalizam a necessidade de intervenções para a promoção do AME que levem em consideração a localização geográfica das famílias e a qualidade prestada nos serviços de saúde / Introduction: Multiple and interactive protective effects of exclusive breastfeeding (EBF) in health and child survival justify recommendations for promoting universal practice. There are few studies that assess the tendency of the pattern of EBF between countries. Objective: To analyze the temporal change of the AME in five countries in Latin America and Caribbean (LAC) comparing data from 1990 and 2000 decades. Methods: The dissertation consists of a manuscript, which evaluated data from children aged 0 to 6 months in the samples of the Demographic Health Survey conducted research in Brazil, Colombia, Haiti, Peru and the Dominican Republic. Were estimated the prevalence of exclusive breastfeeding and its weighted annual rates of change, according to country and survey year. The duration of EBF was estimated using survival analysis Kaplan-Meier method, considering the current age of the child as the survival time and EBF as binary variable, concerning the state of practice at the time of the interview. The survival curves were constructed for each country, in every decade, and the comparison between them used the log-rank test. The median duration of breastfeeding was calculated for each independent variable and the relationship between these variables and weaning at six months was analyzed using Cox regression model. Results: The prevalence of EBF increased in four of the five countries studied, increasing the most remarkable years in Colombia (II per cent ) and Haiti (17 per cent ). The median duration of evolution showed two trends: growth with equity in Colombia and Haiti, and stagnation with unequal distribution among the population subgroups of the last decade in Brazil, Peru and the Dominican Republic. In the multiple model of regression variables and the demographic profile of use of health services were associated with duration of EBF. The residence in a rural area was the variable consistently associated negatively in Brazil (HR = 1.68, CI 95 per cent : 1,06-2,67) and Colombia (HR = 1.39, CI 95 per cent : 1,03-1,87), while positively in Peru (HR = 0.40, CI 95 per cent : 0,19-0,83). Conclusion: The balance of the trend of EBF in LAC is positive, though not uniform throughout the two decades analyzed. The findings suggest the need for interventions for the promotion of exclusive breastfeeding taking into account the geographical location of families and provided quality health services

Introdução: Os múltiplos e interativos efeitos protetores do aleitamento materno exclusivo (AME) na saúde e sobrevivência infantil justificam as recomendações universais para promover sua prática. Poucos são os estudos que avaliam a tendência do padrão do AME entre países. Objetivo: Analisar a mudança temporal do AME em cinco países da América Latina e Caribe (ALC) comparando dados das décadas de 1990 e 2000. Métodos: A dissertação é composta por um manuscrito, que avaliou dados de crianças de 0 a 6 meses incluídas nas amostras das pesquisas Demographic Health Survey conduzidas em Brasil, Colômbia, Haiti, Peru e República Dominicana. Foram estimadas as prevalências do AME e suas taxas anuais de variação ponderada, segundo país e ano de inquérito. A duração do AME foi estimada usando a análise de sobrevida de Kaplan-Meier, considerando a idade atual da criança como o tempo de sobrevida e o AME como variável binária, referente à situação da prática no momento da entrevista. As curvas de sobrevivência foram construídas por país, em cada década, e a comparação entre elas usou o teste log-rank. A mediana do tempo de amamentação foi calculada para cada variável independente e a relação entre essas variáveis e o desmame até os seis meses foi analisada pela técnica de regressão de Cox com modelo múltiplo. Resultados: A prevalência de AME aumentou em quatro dos cinco países estudados, com incremento ao ano mais marcante na Colômbia (11 por cento ) e no Haiti (17 por cento ). A duração mediana apresentou duas tendências de evolução: aumento com equidade na Colômbia e no Haiti, e estagnação com distribuição desigual entre os subgrupos populacionais da última década no Brasil, Peru e República Dominicana. No modelo múltiplo de regressão, variáveis de demografia e do perfil de uso dos serviços de saúde associaram-se à duração do AME. A residência em área rural foi a variável reiteradamente associada, de forma negativa no Brasil (HR=1,68; IC 95 por cento :1,06-2,67) e na Colômbia (HR=1,39; IC 95 por cento :1,03-1,87), enquanto que positivamente no Peru (HR=0,40; IC 95 por cento :0,19-0,83). Conclusão: O balanço da tendência do AME na ALC é positivo, embora não uniforme ao longo das duas décadas analisadas. Os achados sinalizam a necessidade de intervenções para a promoção do AME que levem em consideração a localização geográfica das famílias e a qualidade prestada nos serviços de saúde / Introduction: Multiple and interactive protective effects of exclusive breastfeeding (EBF) in health and child survival justify recommendations for promoting universal practice. There are few studies that assess the tendency of the pattern of EBF between countries. Objective: To analyze the temporal change of the AME in five countries in Latin America and Caribbean (LAC) comparing data from 1990 and 2000 decades. Methods: The dissertation consists of a manuscript, which evaluated data from children aged 0 to 6 months in the samples of the Demographic Health Survey conducted research in Brazil, Colombia, Haiti, Peru and the Dominican Republic. Were estimated the prevalence of exclusive breastfeeding and its weighted annual rates of change, according to country and survey year. The duration of EBF was estimated using survival analysis Kaplan-Meier method, considering the current age of the child as the survival time and EBF as binary variable, concerning the state of practice at the time of the interview. The survival curves were constructed for each country, in every decade, and the comparison between them used the log-rank test. The median duration of breastfeeding was calculated for each independent variable and the relationship between these variables and weaning at six months was analyzed using Cox regression model. Results: The prevalence of EBF increased in four of the five countries studied, increasing the most remarkable years in Colombia (II per cent ) and Haiti (17 per cent ). The median duration of evolution showed two trends: growth with equity in Colombia and Haiti, and stagnation with unequal distribution among the population subgroups of the last decade in Brazil, Peru and the Dominican Republic. In the multiple model of regression variables and the demographic profile of use of health services were associated with duration of EBF. The residence in a rural area was the variable consistently associated negatively in Brazil (HR = 1.68, CI 95 per cent : 1,06-2,67) and Colombia (HR = 1.39, CI 95 per cent : 1,03-1,87), while positively in Peru (HR = 0.40, CI 95 per cent : 0,19-0,83). Conclusion: The balance of the trend of EBF in LAC is positive, though not uniform throughout the two decades analyzed. The findings suggest the need for interventions for the promotion of exclusive breastfeeding taking into account the geographical location of families and provided quality health services

Many breast cancer diagnoses and second cancers are associated with BRCA gene mutations. Early detection of cancer is necessary to improve health outcomes, particularly with second cancers. Little is known about the influence of risk factors on time to diagnosis of second primary cancers after diagnosis with BRCA-related breast cancer. The purpose of this cohort study was to examine the risk of diagnosis of second primary cancers among women diagnosed with breast cancer after adjusting for BRCA status, age, and ethnicity. The study was guided by the empirical evidence supporting the mechanism of action in the mutation of BRCA leading to the development of cancer. Composite endpoint was used to define second primary cancer occurrences, and Kaplan-Meier survival curves were used to compare the median time-to-event among comparison groups and BRCA gene mutation status. Cox proportional hazards was used to examine the relationships between age at diagnosis, ethnicity, BRCA gene mutation status, and diagnosis of a second primary cancer. The overall median time to event for diagnosis of second primary cancers was 14 years. The hazard ratios for BRCA2 = 1.47, 95% CI [1.03 - 2.11], White = 1.511, 95% CI [1.18 - 1.94], and American Indian/Hawaiian = 1.424, 95% CI [1.12 -1.81] showing positive significant associations between BRCA2 mutation status and risk of diagnosis of second primary colorectal, endometrial, cervical, kidney, thyroid, and bladder cancers. Data on risk factors for development of second cancers would allow for identification of appropriate and timely screening procedures, determining the best course of action for prevention and treatment, and improving quality of life among breast cancer survivors.

Darbo metu buvo išnagrinėta įvairių faktorių (kovariančių) įtaka reumatoidiniu artritu sergančio 531 ligonio mirtingumui. Buvo taikomas vienas iš regresinių išgyvenamumo modelių – Cox’o modelis. Iš minėtos 531 ligonio imties mirę buvo 32 ligoniai. Iš pradžių buvo tiriama ligonių imtis laiko nuo ligos pradžios aspektu. Šiuo atveju prognozuojantys veiksniai buvo amžius, kada liga buvo diagnozuota (AMZDGN), lytis (LYTKOD), gydymas Metotreksatu (GYD_MTX) ir gydymas Azatriopinu/Imuranu (AZA_IMUR). Vėliau, tiriant ligonių mirtingumą kaip amžiaus funkciją, nustatyti svarbiausi lemiantys veiksniai buvo šie: ligonių lytis (LYTKOD) ir gydymas Azatriopinu/Imuranu (AZA_IMUR). Gauti rezultatai, t.y. ligonių išgyvenamumą lemiančios kovariantės (veiksniai), beveik visiškai sutampa su gydytojų nurodytais. Tai dar kartą patvirtina matematinių statistinių modelių, šiuo atveju nagrinėjamo Cox‘o modelio, taikymo realiame gyvenime, svarbą. Kitai duomenų imčiai, t.y. vėžiu sergančių ligonių duomenų aibei, buvo taikomas Persikertančių mirimų intensyvumų (SCE) modelis, t.y. tikrinama Cox‘o modelio adekvatumo duomenims hipotezė. Hipotezė buvo atmesta, nes minėtiems duomenims Cox‘o modelis negalioja. Pagrindinis darbo rezultatas yra šis: gautas kriterijus Cox‘o modelio adekvatumui tikrinti, naudojant nupjautus iš kairės ir cenzūruotus iš dešinės duomenis, sudarytos programos kriterijui realizuoti. Reumatoidinio artrito ligonių duomenų aibei, t.y. nupjautiems iš kairės ir cenzūruotiems iš dešinės... [toliau žr. visą tekstą] / In this work the Cox proportional hazards model was applied to investigate the influence of various factors (covariates) to mortality of rheumatoid arthritis patients of Vilnius. In the first case, the sample of 531 patients was analysed. Analysing survival of patients of the sample as function of time from the beginnig of the disease, the prognostic factors were LYTKOD (the sex of patients), AMZDGN (patients‘ age, when the rheumatoid arthritis was diagnosed), GYD_MTX (treatment with metotrexat) and AZA_IMUR (treatment with Azatriopin/Imuran). When survival was analysed as function of age then the prognostic factor were LYTKOD (the sex of patients) and AZA_IMUR (treatment with Azatriopin/Imuran). The results are almost identical to those, which doctors suggested. This fact confirms the importance of using mathematical statistical models to solve the problems of the real life. In this case, the importance of using the Cox model. On the other hand, Simple cross-effects (SCE) model was aplied for the sample of canser patients. In the case of this model the hypothesis of Cox model fiting for canser patients‘ data was rejected. The most important result of this work is that the criterion of Cox model fitting to left truncated and right censored data was constructed. Also a program of SAS for the criterion was created. The the hypothesis of Cox model fiting for the rheumatoid arthritis patients wasn‘t rejected, because Cox model fit for these data.

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Denna uppsats har undersökt tid-till-försäljning på Uppsala kommuns bostadsmarknad för lägenheter under året 2021. För att analysera tid-till-försäljning har metoder från överlevnadsanalys använts. Överlevnadsfunktionen och den kumulativa hasardfunktionen har skattats med Kaplan-Meier-skattningen och Nelson-Aalen-skattningen. Därutöver har tre modeller skattats; en Cox proportionell hasardmodell och två 'Accelerated Failure Time'-modeller varav en var en Weibullmodell och en var en Loglogistiskmodell. Resultaten indikerar att tid-till-försäljning har en hög hasard efter två veckor på marknaden varefter en avtagande hasard. Resultaten indikerar att kovariat har en statistisk signifikant effekt på tid-till-försäljning. Grafiska tester indikerar att antagandet om proportionalitet för Cox proportionella hasardmodell och antagandet om den underliggande hasardfunktionen för Weibullmodellen är orimliga. Antagandet om den underliggande hasardfunktionen för loglogistiskamodellen verkar rimlig. Goodness-of-fit indikerar att Weibullmodellen och loglogistiskamodellen var mer välanpassade till datamaterialet än Cox proportionella hasardmodell. / This bachelor's thesis has investigated time-to-sale on the Uppsala municipality property market for apartments during 2021. Analysis has been performed utilising methods from survival analysis. Both the survival function and cumulative hazard function were estimated using the Kaplan-Meier estimate and the Nelson-Aalen estimate respectively. Furthermore, three models were estimated; a Cox Proportional Hazards model as well as two Accelerated Failure Time models of which one was a Weibullmodell and the other was a loglogistic model. The results indicate that time-to-sale has a high hazard after two weeks on the market followed by a decreasing hazard. The results also indicate that covariates have a statistically significant effect on time-to-sale. Graphical tests indicate that the assumption of proportionality for the Cox Proportional Hazards model and the assumption of the underlying hazard function for the Weibullmodell are unreasonable. The assumed hazardfunction of the loglogistic model was found to be reasonable. Goodness of fit indicates that the Weibull model and loglogistic model were a better fit to the data than the Cox proportional Hazardsmodel.

Introduction/Background: Guidelines from the World Health Organization currently recommend targeting a body mass index (BMI) between 18.5 and 24.9 kg/m2 based on the lowest risk of mortality observed in epidemiological studies. However, these recommendations are based on population observations and do not take into account potential inter-individual differences. We hypothesized that genetic and non-genetic differences in adiposity, anthropometric, and metabolic measures result in inter-individual variation in the optimal BMI. Methods: Genetic variants associated with BMI as well as related adiposity, anthropometric, and metabolic phenotypes (e.g. triglyceride (TG)) were combined into polygenic risk scores (PRS), cumulative risk scores derived from the weighted contributions of each variant. 387,692 participants in the UK Biobank were split by quantiles of PRS or clinical biomarkers such as C-reactive protein (CRP), and alanine aminotransferase (ALT). The BMI linked with the lowest risk of all-cause and cause-specific mortality outcomes (“nadir value”) was then compared across quantiles (“Cox meta-regression model”). Our results were replicated using the non-linear mendelian randomization (NLMR) model to assess causality. Results: The nadir value for the BMI–all-cause mortality relationship differed across percentiles of BMI PRS, suggesting inter-individual variation in optimal BMI based on genetics (p = 0.005). There was a difference of 1.90 kg/m2 in predicted optimal BMI between individuals in the top and bottom 5th BMI PRS percentile. Individuals having above and below median TG (p = 1.29×10-4), CRP (p = 7.92 × 10-5), and ALT (p = 2.70 × 10-8) levels differed in nadir for this relationship. There was no difference in the computed nadir between the Cox meta-regression or NLMR models (p = 0.102). Conclusions: The impact of BMI on mortality is heterogenous due to individual genetic and clinical biomarker level differences. Although we cannot confirm that are results are causal, genetics and clinical biomarkers have potential use for making more tailored BMI recommendations for patients. / Thesis / Master of Science (MSc) / The World Health Organization (WHO) recommends targeting a body mass index (BMI) between 18.5 - 24.9 kg/m2 for optimal health. However, this recommendation does not take into account individual differences in genetics or biology. Our project aimed to determine whether the optimal BMI, or the BMI associated with the lowest risk of mortality, varies due to genetic or biological variation. Analyses were conducted across 387,692 individuals. We divided participants into groups according to genetic risk for obesity or clinical biomarker profile. Our results show that the optimal BMI varies according to genetic or biomarker profile. WHO recommendations do not account for this variation, as the optimal BMI can fall under the normal 18.5 - 24.9 kg/m2 or overweight 25.0 – 29.0 kg/m2 WHO BMI categories depending on individual genetic or biomarker profile. Thus, there is potential for using genetic and/or biomarker profiles to make more precise BMI recommendations for patients.