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At least 847 records · Page 47Linked to original sources
PubMed2005

Distinguishing dengue fever from other infections on the basis of simple clinical and laboratory features: application of logistic regression analysis.

BACKGROUND: Dengue fever is a frequent cause of admission to hospital in South East Asia, however many of the clinical characteristics and abnormalities on laboratory investigations at presentation are found in other common infections. OBJECTIVES: To describe the clinical and laboratory features of dengue fever and other common febrile illnesses in Singapore. STUDY DESIGN: We performed a prospective study of consecutive adult admissions to an infectious diseases hospital. Logistic regression analysis was used to identify symptoms, physical signs and laboratory features that differentiated dengue fever from other febrile illnesses within the first 2 days of admission. RESULTS: Of the 381 patients studied, 148 had serologically confirmed dengue fever. Most of these had uncomplicated dengue fever, and only 9% had dengue haemorrhagic fever. A model based on clinical features alone (including a variety of cutaneous signs, pulse rate and the presence of pharyngeal injection) was able to differentiate dengue fever from other infections with a sensitivity of 74% and specificity of 79%. A model based on clinical features (rash) and laboratory parameters (white cell count, haemoglobin, prothrombin time, creatinine and bilirubin levels), achieved a sensitivity of 84% and specificity of 85%. CONCLUSIONS: A combination of simple clinical and laboratory parameters are potentially able to predict dengue fever with a high level of accuracy in adults presenting to hospital with febrile illnesses in Singapore.

Adult↗
PubMed2005

The logistics of food supply following radioactive fallout.

Discussions at the national level about critical infrastructure and its vulnerability are more common now following the events of September 11. The National Emergency Supply Agency organised a training exercise to test the logistics of food supply following passage of a plume containing radioactive material over a district in Finland. This short paper summarises the problems that had to be faced and suggests a way forward for improving emergency preparedness in this area.

Animals↗
PubMed2005

Predicting the probability of abortion in dairy cows: a hierarchical Bayesian logistic-survival model using sequential pregnancy data.

Although abortion contributes substantially to poor reproductive health of dairy herds, little is known about the predictability of abortion based on age, previous abortion or gravidity (number of previous pregnancies). A poor understanding of effects of maternal factors on abortion risk exists, in part, because of methodological difficulties related to non-independence of multiple pregnancies of the same cow in analysis of fetal survival data. We prospectively examined sequential pregnancies to investigate relationships between fetal survival and putative dam risk factors for 2991 abortions from 24,706 pregnancies of 13,145 cows in nine California dairy herds. Relative risks and predicted probabilities of abortion (PPA) were estimated using a previously described hierarchical Bayesian logistic-survival model generalized to incorporate longitudinal data of multiple pregnancies from a single cow. The PPA increased with increasing dam age at conception, with increasing number of previous abortions, and if the previous pregnancy was aborted >60 days in gestation. The PPA decreased with increasing gravidity and with increasing number of days open. For cows that aborted, the median time to fetal death decreased slightly as gravidity increased. The study considers several methodological issues faced in epidemiologic investigations of fetal health, including multi-modal hazard functions, extensive censoring and non-independence of multiple pregnancies. The model improves our ability to predict bovine abortion and to characterize fetal survival, which have important applications to herd health management.

Abortion, Veterinary↗
PubMed2004

On stochastic logistic population growth models with immigration and multiple births.

This paper develops a stochastic logistic population growth model with immigration and multiple births. The differential equations for the low-order cumulant functions (i.e., mean, variance, and skewness) of the single birth model are reviewed, and the corresponding equations for the multiple birth model are derived. Accurate approximate solutions for the cumulant functions are obtained using moment closure methods for two families of model parameterizations, one for badger and the other for fox population growth. For both model families, the equilibrium size distribution may be approximated well using the Normal approximation, and even more accurately using the saddlepoint approximation. It is shown that in comparison with the corresponding single birth model, the multiple birth mechanism increases the skewness and the variance of the equilibrium distribution, but slightly reduces its mean. Moreover, the type of density-dependent population control is shown to influence the sign of the skewness and the size of the variance.

Animal Migration↗
PubMed1997

The logistics of damage control.

Damage control surgery is labor intensive and consumes extensive materials. The unusual logistic effort surrounding the critically injured patient is an integral part of the challenge of damage control surgery. This article is based on data gleaned from the major series in the literature and on the ongoing experience of the Ben Taub General Hospital with patients undergoing damage control surgery.

Aged↗
PubMed2006

Vaccines to prevent transmission of HIV-1 via breastmilk: scientific and logistical priorities.

Mother-to-child transmission (MTCT) of HIV-1 is the major mode of paediatric infection. The rapidly increasing incidence of MTCT worldwide has resulted in an urgent need for preventive strategies. Antiretroviral regimens can prevent intrapartum HIV transmission; however, these regimens do not prevent HIV transmission through breastfeeding. Furthermore, children who escape MTCT are again at risk of infection when they become sexually active as adolescents. An infant vaccine regimen, begun at birth, would hence be a more attractive strategy and might also provide the basis for lifetime protection. Unique features of MTCT and paediatric HIV disease could be helpful in understanding correlates of immune protection and could facilitate rapid assessment of vaccine efficacy. Thus, there is compelling rationale to develop safe, effective HIV vaccines for use in infants and children. Here, we discuss the scientific and logistical challenges for the development of paediatric HIV vaccines; available vaccines and completed or planned paediatric vaccine trials are also discussed.

AIDS Vaccines↗
PubMed1997

Reducing a spatial database to its effective dimensionality for logistic-regression analysis of incidence of livestock disease.

Large databases with multiple variables, selected because they are available and might provide an insight into establishing causal relationships, are often difficult to analyse and interpret because of multicollinearity. The objective of this study was to reduce the dimensionality of a multivariable spatial database of Zimbabwe, containing many environmental variables that were collected to predict the distribution of outbreaks of theileriosis (the tick-borne infection of cattle caused by Theileria parva and transmitted by the brown ear tick). Principal-component analysis and varimax rotation of the principal components were first used to select a reduced number of variables. The logistic-regression model was evaluated by appropriate goodness-of-fit tests.

Animals↗
PubMed1987

Prediction of traumatic aortic rupture from plain chest film findings using stepwise logistic regression.

We reviewed initial chest radiographs of 21 patients with, and 26 without, aortic rupture, and examined the presence or absence of individual signs previously cited to be associated with aortic rupture. Using stepwise logistic regression, the three most significant signs associated with rupture were loss of aortic contour, tracheal deviation, and mediastinal-to-chest ratio. A formula calculating the probability of aortic rupture (P) using these three variables was derived. Using a low cutoff point, this equation would approach 100% sensitivity in detecting aortic rupture while reducing the number of negative aortographs. The reliability of this equation and the optimal cutoff point must be determined in a prospective study before being used to make clinical decisions.

Aorta↗
PubMed1988

Logistics of medical care in rural Afghanistan.

The logistics of maintaining and supplying underground clinics located in war-torn rural Afghanistan are presented. Medical supplies are transported by pack animals over mountainous terrain, and must be specially packaged for the rigorous journey. Twenty percent of supplies are lost en route due to attacks or accidents. Medical and surgical equipment, some of which had to be specially designed, must be lightweight and durable. The system of monitoring clinic efficacy is also discussed.

Afghanistan↗
PubMed2003

[Analysis of logistical and organizational aspects of a cruise for patients with chronic respiratory insufficiency. The RESpIRA Expedition and the COPD Cruise].

Patients with chronic respiratory insufficiency who are receiving domiciliary oxygen therapy and mechanical ventilation report great difficulty in taking complex trips involving several destinations and prolonged stays away from home. Such patients share a common need for home equipment whose technology is relatively sophisticated, a condition that limits their freedom of movement. We are referring to systems for delivering oxygen therapy and mechanical respirators. Given that such patients have problems traveling by air, we hypothesized that a cruise would be an ideal alternative, given that travel would take place in the hotel itself. A cruise would facilitate the logistics of the journey, given that the equipment would have to be set up at only one setting. Working with these assumptions, we have thus far organized two cruises for chronic respiratory insufficiency patients: the "RESpIRA Expedition" and the "COPD Cruise". Our experience shows that the organizational problems to be coped with are patient recruitment, financing and choice of itinerary. With those aspects clear, organizers must then obtain the authorization of the cruise operator, including the approval of the medical and safety personnel on board. After obtaining permission for the cruise and as soon as the organizers know how many patients will travel, a list of oxygen therapy equipment (respirators and disposable supplies) must be compiled. Finally, equipment suppliers must be found. Afterwards, all that remains is to enjoy the trip. The participation of physicians responsible for domiciliary oxygen therapy and mechanical ventilation programs is essential for making patients feel safe and for assuring solutions for technical and medical problems that might arise.

Adult↗
PubMed2003

Modelling soil series data to facilitate targeted habitat restoration: a polytomous logistic regression approach.

Habitat restoration at a landscape scale is becoming increasingly important in environmental management. In this context, geographical information systems are well suited as they can store and integrate many of the abiotic and biotic criteria used to assess the ecological worth of a site. However, this capacity can be limited by the availability or suitability of spatial data sets. A classic example of the latter case is the National Soil Map of England and Wales, which groups soils of a varied nature into associations. Consequently the national soil map has proved to be a poor predictor of habitat suitability. Using polytomous logistic regression we put forward a method for separating soil associations into their constituent soils within the Chilterns Natural Area. This approach used soil association, aspect, slope and relative height as variables for this analysis. Whilst the model's performance is likely to have been limited by the accuracy of the soil association data set, a predictive accuracy of between 47 and 65% is sufficient to facilitate better targeting of habitat restoration when combined with other abiotic factors such as climate and topography.

Climate↗
PubMed1998

Multivariate logistic analysis of dose-effect relationship and latency of radiomyelopathy after hyperfractionated and conventionally fractionated radiotherapy in animal experiments.

PURPOSE: We examined in rats whether the radiation tolerance of spinal cord is enhanced by using hyperfractionated radiotherapy compared to a conventional schedule. Higher tolerable doses to the spinal cord would allow dose escalation to the tumor and thus possibly lead to higher cure rates, especially in tumors with high cell proliferation. METHODS AND MATERIALS: Cervical spinal cord of 276 healthy rats was irradiated over 6 weeks hyperfractionally with single doses ranging from 0.75-2.5 Gy up to total doses ranging from 45-150 Gy (60 fractions) and conventionally with single doses of 1.5-4.0 Gy up to total doses of 45-120 Gy (30 fractions). The rats were examined neurologically and sacrificed when paralysis of the hind legs occurred. After fixation, spinal cord was removed and examined histologically. Dose-effect relationship and latency from the beginning of radiotherapy to the onset of paralysis were computed and analyzed using a multivariate logistic regression model. RESULTS: The model fitted the observed data excellently. There were highly significant effects both for the dose level and for the treatment regimen. Latency analysis showed earlier and more intense acute side effects after hyperfractionation but radiomyelopathy occurred markedly later. CONCLUSIONS: The sparing effect of hyperfractionation on spinal cord as predicted by radiobiologists could be confirmed in our experiments. Thus, it seems possible to escalate tumor doses using hyperfractionation without enhanced risk to spinal cord but with higher probability of tumor cure.

Animals↗
PubMed2001

Prognosis of acute acoustic trauma: a retrospective study using multiple logistic regression analysis.

OBJECTIVE: The prognosis for acute acoustic trauma (AAT) is difficult to predict. Multiple logistic regression analysis was used in this study to determine which factors were most strongly related to outcome for patients with AAT. METHODS: The study group was comprised of 52 patients (52 ears). Separate analyses were performed on the no change and partial recovery groups, and on the no change and full recovery groups. The following eight factors were examined as explanatory variables, age; number of days before the start of treatment; use of earplugs; drug therapy (adrenocortical hormones, low molecular weight dextrans, and vitamin B12), mean hearing levels at 0.5, 1, and 2 kHz (pure tone average, PTA), and mean hearing levels at 4 and 8 kHz (high tone average, HTA). RESULTS: Factors determined to be most strongly related to outcome were the number of days before the start of treatment, PTA, and HTA. No significant relation to outcome was determined for the five following factors, age; use of earplugs; and drug therapy (adrenocortical hormones, low molecular weight dextrans, and vitamin B12). CONCLUSION: Our results will increase the ability to prognosticate the outcome for AAT.

Acute Disease↗
PubMedDate not supplied

Production logistics of 177Lu for radionuclide therapy.

Owing to its favourable decay characteristics 177Lu [T(1/2)=6.71 d, Ebeta(max)=497 keV] is an attractive radionuclide for various therapeutic applications. Production of 177Lu using [176Lu (n,gamma)177Lu] reaction by thermal neutron bombardment on natural as well as enriched lutetium oxide target is described. In all, approximately 4 TBq/g (108 Ci/g) of 177Lu was obtained using natural Lu target after 7 d irradiation at 3 x 10(13) n/cm2/s thermal neutron flux while it was approximately 110 TBq/g (3000 Ci/g) of 177Lu when 60.6% enriched 176Lu target was used. In both the cases, radionuclidic purity was approximately 100%, only insignificant quantity of 177mLu [T(1/2)=160.5 d, Ebeta(max)=200 keV] could be detected as the radionuclidic impurity. Production logistics using different routes of production is compared. Possible therapeutic applications of 177Lu are discussed and its merits highlighted by comparison with other therapeutic radionuclides.

Bone Neoplasms↗
PubMed1990

International air medical transport. Part I: Methods and logistics.

International air medical transport requires reliable equipment, skilled personnel and precise planning. A report is presented of an experience with 29 international transports. Details concerning equipment, personnel and logistics are presented. Results and problem areas are discussed. This early experience demonstrates the capability for the repatriation of critically ill patients, and the evacuation of patients who require access to a level of care which may be unavailable outside the United States.

Aircraft↗
PubMed2003

[Diagnosis of calvarial lesions. Feature selection by neural network and logistic regression].

OBJECTIVES: To establish the minimun set of features needed in the diagnosis of calvarial lesions using computed tomography (CT) and to assess the accuracy of logistic regression (LR) and artificial neural networks (NN) for their diagnosis. MATERIAL AND METHODS: 167 patients with calvarial lesions as the only known disease were enrolled. The clinical and CT data were used for LR and NN models. Both models were tested with the jacknife method. The final results of each model were compared using the area under ROC curves (A 2 ). RESULTS: The lesions were 73.1 % benign and 26.9% malignant. There was no statistically significant difference between LR and NN in differentiating malignancy. In characterizing the histologic diagnoses, NN was statistically superior to LR. Important NN features needed for malignancy classification were age and edge definition, and for the histologic diagnoses matrix, marginal sclerosis and age. CONCLUSIONS: A minimum four features is needed to diagnose these lesions, not being important patients' symptoms. NNs offer wide possibilities over statistics for the calvarial lesions study besides a superior diagnostic performance.

Adolescent↗
PubMed1990

Estimating psychiatric morbidity by logistic regression: application to post-natal depression in a community sample.

The use of logistic regression to estimate the prevalence of psychiatric morbidity in community samples is illustrated here with data from a study of post-natal depression in 702 primiparous Cambridge mothers. The method is also used to validate the primary screening instrument (in this case the Edinburgh Postnatal Depression Scale--EPDS), and to estimate the effects of cofactors, such as maternal age, previous psychiatric history and social class.

Adult↗
PubMed1993

Influences upon attendance at out-patient facilities--the contribution of linear-logistic modelling.

The research on attendance at out-patient psychiatric facilities has produced conflicting evidence that provides little guidance for the practitioner. It is suggested that inadequate data exploration could explain some of the discrepant findings. Analyses of multi-way tables using linear-logistic models were undertaken to demonstrate patterns of association that cannot be revealed through the use of simple chi-square tests on two-way contingency tables. The variables chosen for these analyses were those that have produced conflicting findings in the literature on children's attendance at child guidance facilities.

Adolescent↗