Made available in DSpace on 2016-06-02T20:06:01Z (GMT). No. of bitstreams: 1 1988.pdf: 463519 bytes, checksum: ca45424706e2fdb08c40f42f1f560364 (MD5) Previous issue date: 2008-06-13 / Financiadora de Estudos e Projetos / In survival analysis some studies show a meaningful cure rate after treatment followup, so considering standard survival models can not be appropriate. In this work is extended the long-term survival model proposed by Chen, Ibrahim and Sinha (1999) via generating function of a real sequence introduced by Feller (1967). This new formulation is the uni_cation of the long-term survival models proposed by Rodrigues el al. (2008). Also, as in Rodrigues el al. (2008) it is shown that the long-term survival generating function satis_es the proportional hazard property if only if the number of competing causes related to the occurence of a event of interest follows a Poisson distribution. A real data set is considered to illustrate this approach. / Em análise de sobrevivência, determinados estudos caracterizam-se por apresentar uma fração significativa de sobreviventes, ou seja, pacientes em tratamento que não apresentaram o evento de interesse, mesmo após um longo período de acompanhamento. Assim considerar modelos de sobrevivência usuais, que assumem que a função de sobrevivência converge para zero quando a variável tempo tende a infinito, pode não ser adequado. Nesse trabalho é apresentado uma extensão do modelo proposto por Chen, Ibrahim e Sinha (1999), usando a função geradora de uma sequência de números reais introduzida por Feller (1967). Essa extensão possibilitou o desenvolvimento de uma teoria unificada para os modelos de sobrevivência de longa-duração, Rodrigues et al. (2008). Mostra-se que modelos já existentes na literatura são considerados casos particulares da teoria unificada, por exemplo, o modelo de Berkson & Gage (1952). Também tem-se em Rodrigues et al. (2008), que a função geradora de longa-duração satisfaz a propriedade de risco proporcional se, e somente se, o número de causas competitivas relacionadas a ocorrência do evento de interesse segue uma distribuição de Poisson. Como ilutração utiliza-se um conjunto de dados reais.

Made available in DSpace on 2014-12-17T15:34:49Z (GMT). No. of bitstreams: 1 DeborahGPG_DISSERT.pdf: 1421770 bytes, checksum: da1c0ade32fb8610306243b0cf52f13d (MD5) Previous issue date: 2014-02-20 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Among the traits of economic importance to dairy cattle livestock those related to sexual precocity and longevity of the herd are essential to the success of the activity, because the stayability time of a cow in a herd is determined by their productive and reproductive lives. In Brazil, there are few studies about the reproductive efficiency of Swiss-Brown cows and no study was found using the methodology of survival analysis applied to this breed. Thus, in the first chapter of this study, the age at first calving from Swiss-Brown heifers was analyzed as the time until the event by the nonparametric method of Kaplan-Meier and the gamma shared frailty model, under the survival analysis methodology. Survival and hazard rate curves associated with this event were estimated and identified the influence of covariates on such time. The mean and median times at the first calving were 987.77 and 1,003 days, respectively, and significant covariates by the Log-Rank test, through Kaplan-Meier analysis, were birth season, calving year, sire (cow s father) and calving season. In the analysis by frailty model, the breeding values and the frailties of the sires (fathers) for the calving were predicted modeling the risk function of each cow as a function of the birth season as fixed covariate and sire as random covariate. The frailty followed the gamma distribution. Sires with high and positive breeding values possess high frailties, what means shorter survival time of their daughters to the event, i.e., reduction in the age at first calving of them. The second chapter aimed to evaluate the longevity of dairy cows using the nonparametric Kaplan-Meier and the Cox and Weibull proportional hazards models. It were simulated 10,000 records of the longevity trait from Brown-Swiss cows involving their respective times until the occurrence of five consecutive calvings (event), considered here as typical of a long-lived cow. The covariates considered in the database were age at first calving, herd and sire (cow s father). All covariates had influence on the longevity of cows by Log-Rank and Wilcoxon tests. The mean and median times to the occurrence of the event were 2,436.285 and 2,437 days, respectively. Sires that have higher breeding values also have a greater risk of that their daughters reach the five consecutive calvings until 84 months / Dentre as caracter?sticas de import?ncia econ?mica para a pecu?ria leiteira aquelas relacionadas com a precocidade sexual e a longevidade do rebanho s?o determinantes para o sucesso da atividade, uma vez que o tempo de perman?ncia de uma vaca num rebanho ? determinado por suas vidas produtiva e reprodutiva. No Brasil, existem poucos estudos sobre a efici?ncia reprodutiva de vacas Pardo-Su??as e n?o foi encontrado nenhum estudo abordando o uso da metodologia de an?lise de sobreviv?ncia aplicada a esta ra?a. Assim, no primeiro cap?tulo deste trabalho, a idade ao primeiro parto de novilhas Pardo-Su??as foi analisada como o tempo at? o evento por meio do m?todo n?o-param?trico de Kaplan-Meier e do modelo de fragilidade compartilhado gama, sob a metodologia de an?lise de sobreviv?ncia. Foram estimadas curvas de sobreviv?ncia e de taxa de risco associadas com este evento e verificada a influ?ncia das covari?veis consideradas sobre o tempo. Os tempos m?dio e mediano ao primeiro parto foram 987,77 e 1.003 dias, respectivamente; e as covari?veis significativas pelo teste de Log-Rank, na an?lise por Kaplan-Meier, foram esta??o de nascimento, ano de parto, touro (pai da vaca) e esta??o de parto. Na an?lise pelo modelo de fragilidade, foram preditos os valores gen?ticos e as fragilidades dos touros (pais) para o parto, modelando-se a fun??o de risco de cada vaca em fun??o da covari?vel fixa esta??o de nascimento e da covari?vel aleat?ria touro. A fragilidade seguiu a distribui??o gama. Touros com valores gen?ticos positivos e altos possuem fragilidades altas, o que significa menor tempo de sobreviv?ncia de suas filhas ao evento, ou seja, redu??o na idade ao primeiro parto delas. O segundo cap?tulo teve como objetivo avaliar a longevidade de vacas leiteiras utilizando o estimador n?o-param?trico de Kaplan-Meier e os modelos de riscos proporcionais de Weibull e de Cox. Foram simulados 10.000 registros da caracter?stica longevidade de f?meas Pardo-Su??as denotando seus respectivos tempos at? a ocorr?ncia de cinco partos consecutivos (evento), considerados aqui como t?picos de uma vaca longeva. As covari?veis consideradas no banco de dados foram a idade da vaca ao primeiro parto, o rebanho e o pai da vaca. Todas as covari?veis exerceram influ?ncia sobre a longevidade das vacas de acordo com os testes de Log-Rank e Wilcoxon. Os tempos m?dio e mediano para a ocorr?ncia do evento foram de 2.436,285 e 2.437 dias. Touros com maior valor gen?tico tamb?m possuem um maior risco de que as suas filhas alcancem os cinco partos aos 84 meses

Diversos modelos têm sido propostos na literatura com o objetivo de analisar dados de sobrevivência em que a população sob estudo é assumida ser uma mistura de indivíduos suscetíveis (em risco) e não suscetíveis a um específico evento de interesse. Tais modelos são usualmente denominados modelos com sobreviventes de longa duração ou modelos com fração de cura. Neste trabalho, diversos desses modelos (nos contextos paramétrico e semi-paramétrico) foram considerados para analisar os dados de um ensaio clínico aleatorizado conduzido com o objetivo de comparar três estratégias terapêuticas (cirurgia, angioplastia e medicamentoso) utilizadas no tratamento de pacientes com doença coronariana multiarterial. Em todos os modelos, as funções de ligação logito e complemento log-log foram utilizadas para modelar a proporção de sobreviventes de longa duração (indivíduos não suscetíveis). Quanto à função de sobrevivência dos indivíduos suscetíveis, foram utilizados os modelos de Weibull e de Cox. Covariáveis foram consideradas tanto na proporção de sobreviventes de longa duração quanto na função de sobrevivência dos indivíduos suscetíveis. De modo geral, os modelos considerados se mostraram adequados para analisar os dados do ensaio clínico aleatorizado, indicando a cirurgia como a estratégia terapêutica mais eficiente. Indicaram também, que as covariáveis idade, hipertensão e diabetes mellitus exercem influência na ocorrência do óbito cardíaco, mas não no tempo até a ocorrência deste óbito nos pacientes suscetíveis. / Several models have been proposed in the literature with the aim of analyzing survival data when the population under study is assumed to be a mixture of susceptible (at risk) and not susceptible individuals to a specific event of interest. Such models are usually called long-term survivors models or cure rate models. In this work, several of these models (under both parametric and semi-parametric approaches) were considered to analyze the data from a randomized clinical trial conducted in order to compare three therapeutic strategies (surgery, angioplasty and medicine) used in the treatment of patients with multivessel coronary artery disease. For all models the logit and complementary log-log link functions were used to model the proportion of long-term survivors (not susceptible individuals). In regards to the survival function of the susceptible individuals, the Weibull and Cox models were used. Covariates were considered both in the proportion of longterm survivors and in the survival function of the susceptible individuals. Overall, the models considered were suitable for analyzing the data from the randomized clinical trial indicating surgery as the most effective therapeutic strategy. They also indicated that the covariates age, hypertension and diabetes mellitus exhibit influence on the occurrence of cardiac death, but not on the time to the occurrence of this death in susceptible patients.

Introdução: O câncer de orofaringe representa 10 a 12 % entre todos os tumores malignos do trato aero digestivo superior com incidência crescente nos Estados Unidos e Europa. O Papillomavírus humano (HPV) está associado aos tumores de orofaringe em até 63%, promovendo uma evolução e prognóstico melhor. Objetivo: Descrever a prevalência do HPV em carcinomas de células escamosas de orofaringe tratados por cirurgia. Analisar a associação entre a presença do HPV e as características demográficas, clínicas, patológicas e terapêuticas. Avaliar a importância da presença do HPV na sobrevida livre de doença e sobrevida global. Método: Pesquisamos a presença do Papillomavirus humano, por PCR, no anátomo patológico. A descrição da amostra foi realizada através de média, frequência absoluta e relativa. Foi estimada a prevalência do HPV e seu respectivo intervalo de 95% de confiança. A análise da associação entre a presença de HPV e as características demográficas, clínicas e patológicas, foi feita pelo teste de associação pelo quiquadrado. A análise da sobrevida livre de doença e sobrevida global foi feita pelo estimador produto limite de Kaplan-Meier e modelos de risco proporcionais de Cox. Resultados: Os pacientes apresentavam idade variando de 34 a 78 anos, com uma média de 56,9 anos. Apenas 10 mulheres no estudo, totalizando com 76 homens. A maioria dos pacientes eram brancos (83,7%). Até 6 meses foi o tempo que a maioria dos pacientes apresentaram como início dos sintomas (69,0%). O sintoma mais comum foi a odinofagia (38,4%). A amígadala foi a localização mais frequente (69,8%). Quanto ao estádio clínico, o III e o IV apresentavam a maior frequência (71,4%). Forma realizadas cirurgias amplas como as bucofaringectomias em 76 pacientes (88,4%). O esvaziamento cervical ipsilateral foi realizado em 81 pacientes (94,2%) e no contralateral em apenas 21 (24,4%). A prevalência do HPV foi de 57%, e o tipo mais comum foi o 16, em 83,6%. A única associação estatisticamente significativa entre as variáveis do estudo com o HPV, foi o tabagismo, onde todos os não fumantes apresentavam HPV. As taxas de sobrevida livre de doença foram 73,9%, 65,9 e 57,9% respectivamente para 12, 24 e 60 meses. Houve diferença estatisticamente significativa com piores taxas, para idade menor que 55 anos e margens comprometidas. A presença do HPV não influenciou a sobrevida livre de doença, nem a sobrevida global. As taxas de sobrevida global foram 75,6%, 54,7% e 43,0%, respectivamente aos 12, 24 e 60 meses. Houveram piores taxas para o paciente etilista e com recidiva.Conclusão:A presença do HPV não se mostrou importante, como fator prognóstico, nessa série cirúrgica se o paciente for etilista e ou tabagista / Introduction:Oropharynx cancer is considered to enact approximately 10 to 12% of the cases among all malignant tumors from the upper aero digestive tract showing significant growth in its frequency rate in The United States and Europe. Human papillomavirus (HPV) is associated to oropharynx cancer in up to 63% of the cases, promoting better evolution and prognostic.Objective:Describe the prevalence of the HPV in oropharynx squamous cells carcinoma submitted to surgery. Investigate the association between HPV presence and the demographic, clinical, pathologic and therapeutic features. Estimate the importance of the HPV existence on the diseasefree survival and overall survival. Material andMethods: The existence of Human papillomavirus was studied through the use of PCR. The sample account was conducted through average, absolute and relative frequency. It has been estimated the prevalence of HPV and its corresponding 95% confidence interval. The association analysis between the presence of HPV and the demographic, clinical and pathological features was completed by the Qui-square association test. The disease-free survival timeline and the overall survival were estimated using the product limit estimator Kaplan-Meier and Cox proportional hazards model. Results: The studied patients were aged between 34 and 78, showing an average of 56.9 years of age. There were only 10 women in the study, thus presenting 76 men. Most of the patients were white (83.7%). It has been ascertained that 69.0% of the patients presented the symptoms onset up to the sixth month of the disease. The most common symptom among 38.4% of the cases was odinophagy. In regards to the tumor location 69.8% were found in the amygdala.Clinical stagings III and IV were found to be the ones with greater representation among patients (71.4%). Extensive surgeries such as bucopharyngectomy were performed in 76 patients (88.4%). In order to treat ipsilateral neck 81 patients underwent neck dissection (94.2%). Contralateral neck dissection was applied in 21 patients (24.4%). The prevalence of HPV was of 57%, and the most common type was 16, present in 83.6% of the cases. It was possible to notice smoking as the only statistically significant association, which showed all nonsmoking having HPV. The disease-free survival rates were of 73.9%, 65.9% and 57.9% to 12, 24 and 60 months respectively. The study has shown significant statistical difference with worse rates, to the ones under 55 years of age and presenting compromised margins. HPV presence did not influence the disease-free survival timeline, or the overall survival. The overall survival rates were of 75.6%, 54.7% and 43.0% to 12, 24 and 60 months respectively. Worse rates were found in alcoholic patients as well as in relapse cases. Conclusion: In these surgical series, HPV existence was not identified as an important prognosis factor when considering smokers and/or alcoholic patients

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Indiana University-Purdue University Indianapolis (IUPUI) / Introduction: The prevalence of diabetes mellitus (DM) is rapidly increasing among the aging United States population. This poses a challenge to dental providers since DM and multiple oral conditions have been identified as comorbidities. Hypertension (HTN) is associated with more poorly controlled DM and has been identified as contributing to RCT tooth loss in prior studies. Links have also been established between DM and the survival rate of root canal treated teeth, however, previous research has focused on institutional settings despite the majority of RCT being performed in private dental practices. This study will use data from private dental practices to evaluate the survival rate of RCT teeth in patients with DM and HTN. Materials and Methods: This retrospective study evaluated the survival rate of endodontic treated teeth among patients with DM and HTN using National Dental PBRN Practice data. Electronic dental records from 42 private dental practices in the United States over a period of 15 years with a minimum 2-year follow-up comprising 11,532 root canal treated teeth were analyzed. Kaplan-Meier survival curves were used to demonstrate the effects of HTN and DM on RCT tooth survival and Cox proportional hazards survival analysis was used to evaluate the DM and HTN effects after accounting for age, gender, insurance, year of treatment, tooth type, and crown and filling placement as covariates. Results: Patients with HTN only had significantly lower risk of failure than patients with both HTN and DM (p=0.003). Patients with neither HTN nor DM had significantly lower risk of failure than patients with both HTN and DM (p=0.020). Patients with DM only did not have significantly different risk of failure than patients with both HTN and DM (p=0.223). Patients with DM only did not have significantly different risk of failure than patients with HTN only (p=0.361). Patients with neither HTN nor DM did not have significantly different risk of failure than patients with HTN only (p=0.121) or patients with DM only (p=0.800). Conclusions: Patients with both DM and HTN have an increased chance of root canal treated tooth failure while patients with only DM or only HTN do not. Evaluation of severity of DM may be more important in determining RCT failure and studies utilizing laboratory values should be considered for future research.

This paper presents an approach to model the risks associated with defaults, prepayments, and order returns in the context of unsecured consumer credits, specifically in buy-now-pay-later (BNPL) loans. The paper presents a Bayesian competing risk proportional hazard model to model the time to default, prepayment, and order return in BNPL loans. Model parameters are estimated using Markov chain Monte Carlo (MCMC) sampling techniques and Bayesian inference is developed using a unique dataset containing monthly performance data of fixed-duration interest-bearing consumer loans. / I denna rapport presenteras en metod för att modellera riskerna förknippade med fallissemang, förskottsbetalning, och returnering av order i osäkrade konsumentkrediter, mer specifikt i köp-nu-betala-senare (BNPL) krediter. Rapporten presenterar en Bayesiansk konkurrerande utfall-modell (competing risk) för att estimera tiden till fallissemang, förskottsbetalning och retur av order i BNPL-lån. Modellens parametrar estimeras med hjälp av Markov chain Monte Carlo (MCMC) metoder och Bayesiansk inferens uppnås med hjälp av ett unikt dataset med månatlig kassaflödesdata från räntebärande BNPL-lån.

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Approved for public release, distribution is unlimited / The purpose of this thesis is to firstly analyze the determinants on the survival of United States Marine Corps Officers, and secondly, to develop the methodology to optimize the accessions of prior and non-prior enlisted officers. Using data from the Marine Corps Officer Accession Career file (MCCOAC), the Cox Proportional Hazards Model is used to estimate the effects of officer characteristics on their survival as a commissioned officer in the USMC. A Markov model for career transition is combined with fiscal data to determine the optimum number of prior and non-prior enlisted officers under the constraints of force structure and budget. The findings indicate that prior enlisted officers have a better survival rate than their non-prior enlisted counterparts. Additionally, officers who are married, commissioned through MECEP, graduate in the top third of their TBS class, and are assigned to a combat support MOS have a better survival rate than officers who are unmarried, commissioned through USNA, graduate in the middle third of their TBS class, and are assigned to either combat or combat service support MOS. The findings also indicate that the optimum number of prior enlisted officer accessions may be considerably lower than recent trends and may differ across MOS. Based on the findings; it is recommended that prior enlisted officer accession figures be reviewed. / Major, Australian Army