基于Bayes时空模型分析HIV/AIDS晚发现的时空分布特征及其影响因素

【目的】旨在分析兰州市HIV/AIDS晚发现的时空聚集性特征及相关影响因素,明确兰州市HIV/AIDS晚发现高风险地区和时间趋势,为兰州市因地制宜地制定HIV/AIDS防治策略措施提供参考依据。【方法】选择兰州市2011-2018年间新报告的成年HIV/AIDS病例作为研究对象,研究中所需的数据资料来自兰州市疾病预防控制中心和兰州市统计年鉴。采用Bayes时空模型分析HIV/AIDS晚发现相对风险(RR)的时空分布特征及其影响因素。【结果】2011-2018年间兰州市新报告的HIV/AIDS病例共计1984例,其中HIV/AIDS晚发现者有982例(49.5%),平均年龄为39.67岁,男性占90.9%。老年人和女性HIV/AIDS病例中晚发现的比例更高;城关区(51.1%)、安宁区(50.3%)和榆中县(51.9%)具有高于平均水平的HIV/AIDS晚发现比例;2011-2018年间兰州市总体的晚发现比例呈波动上升趋势。Bayes时空模型分析结果显示,兰州市HIV/AIDS晚发现风险在2011-2015年间波动变化,而在2015年后迅速上升,其RR(95%CI)从1.01(0.84,1.23)上升到1.11(0.77,1.97);红古区和三个县的晚发现风险变化趋势与兰州市的总体变化趋势相似,而城关区和七里河区的晚发现风险呈下降趋势;晚发现相对风险大于1的区县包括:永登县(RR=1.07,95%CI:0.55,1.96)、西固区(RR=1.04,95%CI:0.67,1.49)、城关区(RR=2.41,95%CI:0.85,6.16)和七里河区(RR=2.03,95%CI:1.10,3.27)。冷热点分析结果显示城关区和七里河区为热点区。影响因素分析结果显示,随着人均GDP(RR=0.65,95%CI:0.35,0.90)和HIV/AIDS病例中的男性比例(RR=0.53,95%CI:0.19,0.92)的增高,HIV/AIDS晚发现的相对风险越低;而人口密度(RR=1.35,95%CI:1.01,1.81)越大,晚发现风险越高。【结论】兰州市的HIV/AIDS晚发现风险呈上升趋势,并且存在明显的地区差异特征;人均GDP、HIV/AIDS中男性比例和人口密度是HIV/AIDS晚发现的影响因素。因此,对于晚发现风险高和存在相关风险因素的区县,应重视并制定有针对性的HIV筛查和防治服务,降低HIV/AIDS晚发现比例和风险。

HIV/AIDS患者肠内营养治疗喂养不耐受发生风险预测模型的构建与验证

目的调查HIV/AIDS患者肠内营养治疗喂养不耐受的影响因素,建立列线图预测模型并进行验证。方法回顾性分析2015年1月1日至2021年9月30日南宁市第四人民医院收治的HIV/AIDS住院患者临床资料,通过二分类Logistic回归模型,探索HIV/AIDS患者肠内营养治疗喂养不耐受的危险因素,构建列线图预测模型并验证评价。结果共纳入174例HIV/AIDS患者,其中76例HIV/AIDS患者发生早期肠内营养喂养不耐受(43.68%)。多因素分析显示,平均动脉压≤80 mmHg[OR=2.822,95%CI(1.267,6.287)]、急性生理学与慢性健康状况评分Ⅱ>15分[OR=5.625,95%CI(1.435,22.048)]、机械通气应用[OR=5.459,95%CI(2.046,14.564)]、高效抗反转录病毒治疗[OR=2.428,95%CI(1.118,5.275)]、肌松剂应用[OR=3.833,95%CI(1.758,8.357)]、CD4^(+)T细胞计数≤200个·μL^(-1)[OR=3.785,95%CI(1.126,12.724)]、抗生素使用数量>2种[OR=2.365,95%CI(1.039,5.384)]是HIV/AIDS患者肠内营养治疗发生喂养不耐受的影响因素。列线图预测模型AUC值为0.849[95%CI(0.794,0.905)],最大约登指数为0.555时,最佳临界值为0.331,灵敏度为88.16%,特异度为67.35%;校准曲线、决策曲线评价模型具有较好的一致性及获益性。结论本研究构建的HIV/AIDS患者肠内营养治疗喂养不耐受风险预测模型可为医护人员快速识别HIV/AIDS患者喂养不耐受发生风险、及时采取预防性护理措施提供参考依据。

Analysis of the Role of Problem-Based Independent Learning Model in Teaching Cerebral Ischemic Stroke First Aid in Emergency Medicine

Objective:To analyze the effect of using a problem-based(PBL)independent learning model in teaching cerebral ischemic stroke(CIS)first aid in emergency medicine.Methods:90 interns in the emergency department of our hospital from May 2022 to May 2023 were selected for the study.They were divided into Group A(45,conventional teaching method)and Group B(45 cases,PBL independent learning model)by randomized numerical table method to compare the effects of the two groups.Results:The teaching effect indicators and student satisfaction scores in Group B were higher than those in Group A(P<0.05).Conclusion:The use of the PBL independent learning model in the teaching of CIS first aid can significantly improve the teaching effect and student satisfaction.

Stability Analysis of a Delayed HIV/AIDS Epidemic Model with Treatment and Vertical Transmission

A delayed HIV/AIDS epidemic model with treatment and vertical transmission is investigated. The model allows some infected individuals to move from the symptomatic phase to the asymptomatic phase;next generation of infected individuals may be infected and it will take them some time to get maturity and infect others. Mathematical analysis shows that the global dynamics of the spread of the HIV/AIDS are completely determined by the basic reproduction number R0 for our model. If R0 R0 > 1.

基于贝叶斯Cox风险比例回归的兰州市HIV感染者/AIDS患者死亡影响因素分析

[目的]了解兰州市HIV/AIDS报告病例相关特征的构成情况,分析艾滋病相关死亡的影响因素。[方法]通过收集兰州市2011-2019年HIV/AIDS报告病例信息,采用生存分析方法,构建贝叶斯Cox风险比例回归模型分析影响死亡的相关因素。[结果]本研究共选取2312例HIV/AIDS患者,其中艾滋病相关死亡45例。多因素回归结果显示,患者年龄越大,死亡风险越高;确诊时为AIDS患者的死亡风险是HIV感染者的13.91倍;与未接受CD4检测的患者相比,接受CD4检测的患者的死亡风险降低;进行抗病毒治疗者的死亡风险是未进行抗病毒治疗者的0.22倍。[结论]确诊时年龄、病程阶段、是否接受抗病毒治疗是兰州市HIV/AIDS患者艾滋病相关死亡的影响因素,因此要加强艾滋病相关人群健康教育,提倡早发现、早诊断、早治疗,扩大艾滋病检测与治疗的覆盖面,延长艾滋病患者的生存时间。

中国城乡居民消费结构升级与影响因素研究——基于LA/AIDS拓展模型的实证分析

本文选取1995-2014年省际年度面板数据,对中国城乡居民消费结构特征展开剖析,通过增加人口构成、收支水平、消费惯性等影响因子,对LA/AIDS模型进行拓展,从消费份额角度实证分析了城乡居民消费结构变动的原因,有效克服了"加总谬误"。研究发现:1人口构成对城乡居民衣着、家庭设备及用品、医疗保健的消费占比具有极大促进作用;2收入水平对提高城乡居民食品和家庭设备消费支出占比提升显著。3城镇居民消费结构对消费惯性的依赖程度远远高于农村。为城乡产业布局调整和有关经济政策制定提供了理论依据。

基于LA-AIDS模型的中国居民能源消费回弹效应研究

基于1993-2013年中国居民消费的时间序列数据,构建居民能源需求的LA-AIDS计量回归模型与能源效率仿真模型,实证分析了中国城镇和农村居民能源消费的回弹效应;根据Slutsky方程进一步分解出城镇与农村居民能源消费直接与间接回弹效应。结果表明：中国居民能源消费存在明显的回弹效应,且城镇居民能源消费的回弹效应显著高于农村居民;城镇居民能源消费的回弹效应呈逐年下降趋势,农村居民能源消费的回弹效应呈逐年上升趋势,2013年之后表现为＂回火效应＂;居民能源消费回弹效应的直接效应高于间接效应,即替代效应高于收入效应,说明中国居民能源消费的回弹效应主要是由于能源效率提高后居民增加了对能源的直接消费所导致的。

城镇居民恩格尔系数降速趋缓成因研究——基于LES-LA/AIDS两阶段模型的实证

恩格尔定律表明随着居民生活水平的提高,恩格尔系数会逐渐下降,然而近年来,我国城镇居民恩格尔系数降速放缓,从理论上与食物收入弹性缺乏相矛盾。文章从在恩格尔系数中扮演重要角色的食品消费中居民行为特征变动中分析恩格尔系数变动的原因,在考虑城镇化背景、政府干预程度及地区差异的基础上,建立两阶段LES-LA/AIDS需求系统模型,对我国城镇居民七大类消费需求和八种食品项目的消费需求进行分析。主要研究结论是,城镇居民消费结构正在从生存型向享受、发展型转变;城镇化对居民食品消费结构产生显著影响;不同地区之间食品消费结构具有各自的明显特点;消费结构的变动及其所对应的较大支出弹性是造成恩格尔系数变动趋缓的主要原因。最终提出相关对策建议。

牧民消费行为差异分析——基于LA/AIDS模型

本文以内蒙古地区的牧民为例,通过构建修正的近似理想的LA/AIDS模型,对该地区牧民消费行为进行了实证分析。结果表明,当收入增加时,牧民的消费意愿更倾向于交通、通讯工具的更新、家庭设备和医疗保健用品以及服务的提高。牧民消费水平较高但不尽合理,牧民对各种消费品的需求变动更容易受到自价格的影响,交叉价格变动的影响则较小。

基于LA-AIDS模型的宁夏农村居民消费结构研究

运用2000—2019年宁夏农村居民8类商品消费支出及消费价格指数构建LA—AIDS模型,采用ITSUR估计法对宁夏农村居民消费结构进行实证分析。结果显示:宁夏农村居民随着收入增加,生存型消费支出比例逐步下降,发展享受型消费中的交通通信、文教娱乐和医疗保健的消费富有收入弹性,具有巨大增长潜力,但文教娱乐和其他商品及服务方面的消费占比增长较慢。因此,建议通过合理增加农村地区公共服务资源投入、加速重塑农村居民新型消费习惯和有效促进农村居民收入来源多元化等优化其消费结构。

收入增长对城乡居民消费差异化的影响分析——基于拓展LA/AIDS模型

将我国城乡居民收入增长因素引入到LA/AIDS模型中,实证检验了消费结构受收入增长影响的显著性水平,并进一步对比消费支出弹性系数和收入增长差异,考察居民收入增长对其消费结构影响的内在作用机制并探索如何采取相应措施控制城乡居民收入增长差距来缩小消费的差距。结果表明:首先,我国各地区城乡居民在消费结构和消费形式上趋于一致;其次,加快农村居民收入增长、控制城乡居民收入差距有助于降低衣着、居住、生活用品、医疗保健和其他类商品的消费差距,而保持农村居民收入增长、缩小城乡居民收入差距有助于降低食品、交通通信、教育文化娱乐的消费差距;最后,收入增长对城乡居民消费差异化的影响具有区域性的特点。

人口老龄化对城乡居民消费结构的影响研究——基于LA-AIDS拓展模型视角

通过扩展LA-AIDS模型,引入人口特征变量即年龄、性别差异、受教育程度和城乡收入差距等影响因素,分析人口老龄化对城乡居民消费结构的影响,根据中国2003—2017年省际面板数据进行实证研究,研究发现人口老龄化对农村居民消费结构具有显著的影响。根据老年化系数,将全国分为深度老龄化、中度老龄化和轻度老龄化三个区域,在不同的老龄化区域,人口老龄化对居民消费结构影响效果不同。

The Changing Trends of HIV/AIDS in An Ethnic Minority Region of China: Modeling the Epidemic in Liangshan Prefecture, Sichuan Province

Objective This study was to investigate the HIV current situation in Liangshan prefecture, in order to predict prevalence and transmission trends. Methods Region-specific population, behavior, serosurveillence, and policy/program data （from 1995 to 2020） were gathered from various local and national organizations and applied to the Asian Epidemic Model （AEM） and used to derive estimates of future HIV prevalence, epidemic trends, and outcomes of intervention strategies. Results The AEM projections for 2020 included increased number of people living with HIV （PLHIV; to 136 617）, increased HIV prevalence （2.51%）, and 8037 deaths from acquired immunodeficiency syndrome （AIDS） in this region. However, the overall HIV incidence rate （per 10 000） was projected to decline from 27 in 2015 to 22 in 2020, largely due to a predicted decrease in HIV infection rate （per 10 000） from 658 in 2013 to 621 in 2020 among intravenous drug users. In contrast, the cases of HIV infection per i0 000 was projected to increase from 420 in 2010 to 503 in 2020 among men who have sex with men, and from 8 in 2010 to 15 in 2020 among the general population. The predominant risk factor for HIV transmission over the next decade in Liangshan was casual sex. Community-based outreach strategies to reduce injected drug use and casual sex, and to promote condom use, were predicted as effective interventions to decrease HIV transmission. Conclusion Implementation of a comprehensive public health program, with targeting to the region-specific at-risk populations, will help to mitigate HIV/AIDS spread in Liangshan.

How to Effectively Detect and Manage People Living with HIV/AIDS in China:Establishment of a Community-based Model

This study explored a novel systemic community-based model for detecting and manag-ing people living with HIV/AIDS (PLWHA). Both quantitative and qualitative research methods were used in this study. A quantitative questionnaire investigation was conducted in a sample of 1192 subjects which were randomly selected from two areas with high HIV prevalence, Xiangfan City and Shiyan City of Hubei Province, China. Twenty-two medical and health service staffs were inter-viewed by semi-structured questionnaire focusing on awareness, status, problems, and suggestions about community-based Voluntary Counseling and Testing and Provider Initiated Testing and Coun-seling (VCT/PITC). And they were organized to discuss about the aforementioned issues in Xiangfan City and Shiyan City, respectively. Our results showed that the accessibility and availability of the general VCT/PITC were bad. About 28.3% had known and only 4.9% had made use of VCT/PITC. Developing community-based VCT/PITC had some special advantages that can overcome some ex-isting problems to remedy the aforementioned defects. We are led to conclude that, to maximize the availability and uptake rate of the VCT/PITC, we plan to detect PLWHA by developing the commu-nity-based VCT/PITC through 4 paths. Then we establish the community HIV health care center con-stituted of 8 sectors to provide an overall management. Thus, we can effectively detect and manage the PLWHA with a new systemic community-based model.

HIV/AIDS患者出现肝损伤的预测模型初步建立和验证

目的调查HIV/AIDS患者出现肝损伤发生情况,建立其预测模型并进行验证。方法选择2021年1~12月四川绵阳四○四医院接诊的290例新确诊HIV/AIDS患者,以7∶3分为模型组203例与验证组87例。收集可能影响HIV/AIDS患者肝损伤的因素,根据有无出现肝损伤将患者分为2组,比较2组患者性别、年龄、BMI等各因素,采用LASSO回归筛选变量后行多因素Logistic回归筛选出独立性影响因素,根据Logistic回归结果构建列线图模型。结果肝损伤组与无肝损伤组患者饮酒史、CD4^(+)T淋巴细胞水平、抗真菌药物使用情况、合并结核感染、使用其他类型抗反转录病毒药物、磺胺类药物使用情况、糖尿病、心血管病、营养状况差异均具有统计学意义(P<0.05)。LASSO回归模型筛选出7个潜在影响因素:饮酒史、CD4^(+)T淋巴细胞水平、抗真菌药物使用情况、合并结核感染、糖尿病、心血管病、营养状况。多因素Logistic回归分析显示:饮酒史、CD4^(+)T淋巴细胞水平、抗真菌药物使用情况、合并结核感染、糖尿病、心血管病、营养状况是HIV/AIDS患者肝损伤的独立影响因素(P<0.05)。基于上述影响因素构建HIV/AIDS患者肝损伤风险预测的列线图模型,模型组列线图模型预测HIV/AIDS患者肝损伤的受试者操作曲线下面积(area under the subject curve,AUC)为0.969(95%CI:0.904,0.988);验证组AUC为0.971(95%CI:0.905,0.992)。Bootstrap法重复抽样1000次,并以验证组进行验证,校准曲线结果显示:模型组与验证组预测曲线与标准曲线基本拟合;H-L拟合优度检验结果显示,该列线图模型预测HIV/AIDS患者肝损伤的概率与实际概率比较,差异无统计学意义(χ^(2)=2.088,P=0.148)。模型组决策曲线分析结果显示:当该列线图模型预测HIV/AIDS患者肝损伤的概率阈值为0.15~0.95时,患者的净受益率>0;验证组决策曲线分析结果显示:当该列线图模型预测HIV/AIDS患者肝损伤的概率阈值为0.10~0.95时,患者的净受益率>0。结论饮酒史、CD4^(+)T淋巴细胞水平、抗真菌药物使用情况、合并结核感染、糖尿病、心血管病、营养状况是HIV/AIDS患者肝损伤的独立影响因素,基于上述因素构建的列线图模型用于HIV/AIDS肝损伤风险预测具有较高的准确度。

Sailfish Optimization with Deep Learning Based Oral Cancer Classification Model

Recently,computer aided diagnosis(CAD)model becomes an effective tool for decision making in healthcare sector.The advances in computer vision and artificial intelligence(AI)techniques have resulted in the effective design of CAD models,which enables to detection of the existence of diseases using various imaging modalities.Oral cancer(OC)has commonly occurred in head and neck globally.Earlier identification of OC enables to improve survival rate and reduce mortality rate.Therefore,the design of CAD model for OC detection and classification becomes essential.Therefore,this study introduces a novel Computer Aided Diagnosis for OC using Sailfish Optimization with Fusion based Classification(CADOC-SFOFC)model.The proposed CADOC-SFOFC model determines the existence of OC on the medical images.To accomplish this,a fusion based feature extraction process is carried out by the use of VGGNet-16 and Residual Network(ResNet)model.Besides,feature vectors are fused and passed into the extreme learning machine(ELM)model for classification process.Moreover,SFO algorithm is utilized for effective parameter selection of the ELM model,consequently resulting in enhanced performance.The experimental analysis of the CADOC-SFOFC model was tested on Kaggle dataset and the results reported the betterment of the CADOC-SFOFC model over the compared methods with maximum accuracy of 98.11%.Therefore,the CADOC-SFOFC model has maximum potential as an inexpensive and non-invasive tool which supports screening process and enhances the detection efficiency.

DYNAMIC FOR A STOCHASTIC MULTI-GROUP AIDS MODEL WITH SATURATED INCIDENCE RATE

In this paper,a stochastic multi-group AIDS model with saturated incidence rate is studied.We prove that the system is persistent in the mean under some parametric restrictions.We also obtain the sufficient condition for the existence of the ergodic stationary distribution of the system by constructing a suitable Lyapunov function.Our results indicate that the existence of ergodic stationary distribution does not rely on the interior equilibrium of the corresponding deterministic system,which greatly improves upon previous results.

Effects of AIDS-related disability on workforce participation and earned income in Botswana: A quasi-experimental evaluation

Background: Botswana is regarded as a leader of progressive HIV/AIDS policy, as the first country in sub-Saharan Africa to establish a free, national antiretroviral therapy program. In light of such programmatic successes, it is important to evaluate the potentially changing relationship of HIV/AIDS to the wellbeing of individuals, households, and institutions in the country. Methods: We evaluate the effects of HIV-related illness on absenteeism and earnings several years after the start of the national treatment program among a random sample of adults in Botswana using survey data from 3999 individuals aged 15 to 49, using quasi-experimental methods. We compare absenteeism between individuals with and without HIV-related illness, using a propensity score matching approach. We then estimate the effect of HIV-related illness on earnings using a Heckman selection model to account for selection into the workforce. We stratify our analyses by sex. Results: Men and women with HIV-related illness were absent by about 5.2 and 3.3 additional days, respectively, in the month prior to the survey compared to matched controls, and earned approximately 38% and 43% less, respectively, in the month prior to the survey compared to those without HIV-related illness. Conclusions: HIV-related illness appears to increase absenteeism in this sample and dramatically reduce earnings. The findings suggest a need for policies that confer greater financial security to individuals with HIV/AIDS in Botswana.

Exploring the Impact of Factors Affecting the Lifespan of HIVs/AIDS Patient’s Survival: An Investigation Using Advanced Statistical Techniques

This study investigates the impact of various factors on the lifespan and diagnostic time of HIV/AIDS patients using advanced statistical techniques. The Power Chris-Jerry (PCJ) distribution is applied to model CD4 counts of patients, and the goodness-of-fit test confirms a strong fit with a p-value of 0.6196. The PCJ distribution is found to be the best fit based on information criteria (AIC and BIC) with the smallest negative log-likelihood, AIC, and BIC values. The study uses datasets from St. Luke hospital Uyo, Nigeria, containing HIV/AIDS diagnosis date, age, CD4 count, gender, and opportunistic infection dates. Multiple linear regression is employed to analyze the relationship between these variables and HIV/AIDS diagnostic time. The results indicate that age, CD4 count, and opportunistic infection significantly impact the diagnostic time, while gender shows a nonsignificant relationship. The F-test confirms the model's overall significance, indicating the factors are good predictors of HIV/AIDS diagnostic time. The R-squared value of approximately 72% suggests that administering antiretroviral therapy (ART) can improve diagnostic time by suppressing the virus and protecting the immune system. Cox proportional hazard modeling is used to examine the effects of predictor variables on patient survival time. Age and CD4 count are not significant factors in the hazard of HIV/AIDS diagnostic time, while opportunistic infection is a significant predictor with a decreasing effect on the hazard rate. Gender shows a strong but nonsignificant relationship with decreased risk of death. To address the violation of the assumption of proportional hazard, the study employs an assumption-free alternative, Aalen’s model. In the Aalen model, all predictor variables except age and gender are statistically significant in relation to HIV/AIDS diagnostic time. The findings provide valuable insights into the factors influencing diagnostic time and survival of HIV/AIDS patients, which can inform interventions aimed at reducing transmission and improving early diagnosis and treatment. The Power Chris-Jerry distribution proves to be a suitable fit for modeling CD4 counts, while multiple linear regression and survival analysis techniques provide insights into the relationships between predictor variables and diagnostic time. These results contribute to the understanding of HIV/AIDS patient outcomes and can guide public health interventions to enhance early detection, treatment, and care.