Mixed-Effects Parametric Proportional Hazard Model with Generalized Log-Logistic Baseline Distribution

Clustered survival data are widely observed in a variety of setting. Most survival models incorporate clustering and grouping of data accounting for between-cluster variability that creates correlation in order to prevent underestimate of the standard errors of the parameter estimators but do not include random effects. In this study, we developed a mixed-effect parametric proportional hazard (MEPPH) model with a generalized log-logistic distribution baseline. The parameters of the model were estimated by the application of the maximum likelihood estimation technique with an iterative optimization procedure (quasi-Newton Raphson). The developed MEPPH model’s performance was evaluated using Monte Carlo simulation. The Leukemia dataset with right-censored data was used to demonstrate the model’s applicability. The results revealed that all covariates, except age in PH models, were significant in all considered distributions. Age and Townsend score were significant when the GLL distribution was used in MEPPH, while sex, age and Townsend score were significant in MEPPH model when other distributions were used. Based on information criteria values, the Generalized Log-Logistic Mixed-Effects Parametric Proportional Hazard model (GLL-MEPPH) outperformed other models.

Survival Analysis Using Cox Proportional Hazards Regression for Pile Bridge Piles Under Wet Service Conditions

This paper studies the deterioration of bridge substructures utilizing the Long-Term Bridge Performance(LTBP)Program InfoBridge^(TM)and develops a survival model using Cox proportional hazards regression.The survival anal­ysis is based on the National Bridge Inventory(NBI)dataset.The study calculates the survival rate of reinforced and prestressed concrete piles on bridges under marine conditions over a 29-year span(from 1992 to 2020).The state of Maryland is the primary focus of this study,with data from three neighboring regions,the District of Columbia,Vir­ginia,and Delaware to expand the sample size.The data obtained from the National Bridge Inventory are condensed and filtered to acquire the most relevant information for model development.The Cox proportional hazards regres­sion is applied to the condensed NBI data with six parameters:Age,ADT,ADTT,number of spans,span length,and structural length.Two survival models are generated for the bridge substructures:Reinforced and prestressed concrete piles in Maryland and reinforced and prestressed concrete piles in wet service conditions in the District of Columbia,Maryland,Delaware,and Virginia.Results from the Cox proportional hazards regression are used to construct Markov chains to demonstrate the sequence of the deterioration of bridge substructures.The Markov chains can be used as a tool to assist in the prediction and decision-making for repair,rehabilitation,and replacement of bridge piles.Based on the numerical model,the Pile Assessment Matrix Program(PAM)is developed to facilitate the assessment and main­tenance of current bridge structures.The program integrates the NBI database with the inspection and research reports from various states’department of transportation,to serve as a tool for condition state simulation based on mainte­nance or rehabilitation strategies.

Reliability estimation and remaining useful lifetime prediction for bearing based on proportional hazard model

As the central component of rotating machine,the performance reliability assessment and remaining useful lifetime prediction of bearing are of crucial importance in condition-based maintenance to reduce the maintenance cost and improve the reliability.A prognostic algorithm to assess the reliability and forecast the remaining useful lifetime(RUL) of bearings was proposed,consisting of three phases.Online vibration and temperature signals of bearings in normal state were measured during the manufacturing process and the most useful time-dependent features of vibration signals were extracted based on correlation analysis(feature selection step).Time series analysis based on neural network,as an identification model,was used to predict the features of bearing vibration signals at any horizons(feature prediction step).Furthermore,according to the features,degradation factor was defined.The proportional hazard model was generated to estimate the survival function and forecast the RUL of the bearing(RUL prediction step).The positive results show that the plausibility and effectiveness of the proposed approach can facilitate bearing reliability estimation and RUL prediction.

Comparison of Cox proportional hazards model,Cox proportional hazards with time-varying coefficients model,and lognormal accelerated failure time model:Application in time to event analysis of melioidosis patients

Objective:To compare the prognostic factors of mortality among melioidosis patients between lognormal accelerated failure time(AFT),Cox proportional hazards(PH),and Cox PH with time-varying coefficient(TVC)models.Methods:A retrospective study was conducted from 2014 to 2019 among 453 patients who were admitted to Hospital Sultanah Bahiyah,Kedah and Hospital Tuanku Fauziah,Perlis in Northern Malaysia due to confirmed-cultured melioidosis.The prognostic factors of mortality from melioidosis were obtained from AFT survival analysis,and Cox’s models and the findings were compared by using the goodness of fit methods.The analyses were done by using Stata SE version 14.0.Results:A total of 242 patients(53.4%)survived.In this study,the median survival time of melioidosis patients was 30.0 days(95%CI 0.0-60.9).Six significant prognostic factors were identified in the Cox PH model and Cox PH-TVC model.In AFT survival analysis,a total of seven significant prognostic factors were identified.The results were found to be only a slight difference between the identified prognostic factors among the models.AFT survival showed better results compared to Cox's models,with the lowest Akaike information criteria and best fitted Cox-snell residuals.Conclusions:AFT survival analysis provides more reliable results and can be used as an alternative statistical analysis for determining the prognostic factors of mortality in melioidosis patients in certain situations.

Cox Proportional Hazard Model for Survival Time of Neonatal Mortality in Neonatal Intensive Care Unit of Hospitals in River Nile State-Sudan

Cox Proportional Hazard model is a popular statistical technique for exploring the relationship between the survival time of neonates and several explanatory variables. It provides an estimate of the study variables’ effect on survival after adjustment for other explanatory variables, and allows us to estimate the hazard (or risk) of death of newborn in NICU of hospitals in River Nile State-Sudan for the period (2018-2020). Study Data represented (neonate gender, mode of delivery, birth type, neonate weight, resident type, gestational age, and survival time). Kaplan-Meier method is used to estimate survival and hazard function for survival times of newborns that have not completed their first month. Of 700 neonates in the study area, 25% of them died during 2018-2020. Variables of interest that had a significant effect on neonatal death by Cox Proportional Hazard Model analysis were neonate weight, resident type, and gestational age. In Cox Proportional Hazard Model analysis all the variables of interest had an effect on neonatal death, but the variables with a significant effect included, weight of neonate, resident type and gestational age.

SICA for Cox's Proportional Hazards Model with a Diverging Number of Parameters

The smooth integration of counting and absolute deviation （SICA） penalized variable selection procedure for high-dimensional linear regression models is proposed by Lv and Fan （2009）. In this article, we extend their idea to Cox＇s proportional hazards （PH） model by using a penalized log partial likelihood with the SICA penalty. The number of the regression coefficients is allowed to grow with the sample size. Based on an approximation to the inverse of the Hessian matrix, the proposed method can be easily carried out with the smoothing quasi-Newton （SQN） algorithm. Under appropriate sparsity conditions, we show that the resulting estimator of the regression coefficients possesses the oracle property. We perform an extensive simulation study to compare our approach with other methods and illustrate it on a well known PBC data for predicting survival from risk factors.

Measurement Error in Proportional Hazards Models for Survival Data with Long-term Survivors

This work studies a proportional hazards model for survival data with ＂long-term survivors＂, in which covariates are subject to linear measurement error. It is well known that the naive estimators from both partial and full likelihood methods are inconsistent under this measurement error model. For measurement error models, methods of unbiased estimating function and corrected likelihood have been proposed in the literature. In this paper, we apply the corrected partial and full likelihood approaches to estimate the model and obtain statistical inference from survival data with long-term survivors. The asymptotic properties of the estimators are established. Simulation results illustrate that the proposed approaches provide useful tools for the models considered.

Optimal Generalized Case-Cohort Analysis with Cox's Proportional Hazards Model

Generalized case-cohort design has been proved to be a cost-effective way to enhance the efficiency of large epidemiological cohort. In this article, we propose an inference procedure for estimating the unknown parameters in Cox＇s proportional hazards model in generalized case-cohort design and establish an optimal sample size allocation to achieve the maximum power at a given budget. The finite sample performance of the proposed method is evaluated through simulation studies. The proposed method is applied to a real data set from the National Wilm＇s Tumor Study Group.

The Proportional Hazards Model for Multiple Type Recurrent Gap Times

Recurrent events data and gap times between recurrent events are frequently encountered in many clinical and observational studies,and often more than one type of recurrent events is of interest.In this paper,we consider a proportional hazards model for multiple type recurrent gap times data to assess the effect of covaxiates on the censored event processes of interest.An estimating equation approach is used to obtain the estimators of regression coefficients and baseline cumulative hazard functions.We examine asymptotic properties of the proposed estimators.Finite sample properties of these estimators are demonstrated by simulations.

Maximum Likelihood Estimator for the Proportional Hazards Model with Incomplete Information

Right randomly censored data with incomplete infor-mation are frequently met in practice.Although much study about right randomly censored data has been seen in the proportional hazards model,relatively little is known about the inference of regression parameters for right randomly censored data with in-complete information in such model.In particular,theoretical properties of the maximum likelihood estimator of the regression parameters have not been proven yet in that model.In this paper,we show the consistency and asymptotic normality of the maxi-mum likelihood estimator of unknown regression parameters.

Accelerated proportional degradation hazards-odds model in accelerated degradation test

An accelerated proportional degradation hazards-odds model is proposed. It is a non-parametric model and thus has path- free and distribution-free properties, avoiding the errors caused by faulty assumptions of degradation paths or distribution of degra- dation measurements. It is established based on a link function which combines the degradation cumulative hazard rate function and the degradation odds function through a transformation pa- rameter, and this makes the accelerated proportional degradation hazards model and the accelerated proportional degradation odds model special cases of it. Hypothesis tests are discussed, and the proposed model is applicable when some model assumptions are satisfied. This model is utilized to estimate the reliability of minia- ture bulbs under low stress levels based on the degradation data obtained under high stress levels to validate the effectiveness of this model.

Cumulative effects of excess high-normal alanine aminotransferase levels in relation to new-onset metabolic dysfunction-associated fatty liver disease in China

BACKGROUND Within the normal range,elevated alanine aminotransferase(ALT)levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the associations between repeated high-normal ALT measurements and the risk of new-onset MAFLD prospectively.METHODS A cohort of 3553 participants followed for four consecutive health examinations over 4 years was selected.The incidence rate,cumulative times,and equally and unequally weighted cumulative effects of excess high-normal ALT levels(ehALT)were measured.Cox proportional hazards regression was used to analyse the association between the cumulative effects of ehALT and the risk of new-onset MAFLD.RESULTS A total of 83.13%of participants with MAFLD had normal ALT levels.The incidence rate of MAFLD showed a linear increasing trend in the cumulative ehALT group.Compared with those in the low-normal ALT group,the multivariate adjusted hazard ratios of the equally and unequally weighted cumulative effects of ehALT were 1.651[95%confidence interval(CI):1.199-2.273]and 1.535(95%CI:1.119-2.106)in the third quartile and 1.616(95%CI:1.162-2.246)and 1.580(95%CI:1.155-2.162)in the fourth quartile,respectively.CONCLUSION Most participants with MAFLD had normal ALT levels.Long-term high-normal ALT levels were associated with a cumulative increased risk of new-onset MAFLD.

Influence of donor age on liver transplantation outcomes: A multivariate analysis and comparative study

BACKGROUND The growing disparity between the rising demand for liver transplantation(LT)and the limited availability of donor organs has prompted a greater reliance on older liver grafts.Traditionally,utilizing livers from elderly donors has been associated with outcomes inferior to those achieved with grafts from younger donors.By accounting for additional risk factors,we hypothesize that the utili-zation of older liver grafts has a relatively minor impact on both patient survival and graft viability.AIM To evaluate the impact of donor age on LT outcomes using multivariate analysis and comparing young and elderly donor groups.METHODS In the period from April 2013 to December 2018,656 adult liver transplants were performed at the University Hospital Merkur.Several multivariate Cox propor-tional hazards models were developed to independently assess the significance of donor age.Donor age was treated as a continuous variable.The approach involved univariate and multivariate analysis,including variable selection and assessment of interactions and transformations.Additionally,to exemplify the similarity of using young and old donor liver grafts,the group of 87 recipients of elderly donor liver grafts(≥75 years)was compared to a group of 124 recipients of young liver grafts(≤45 years)from the dataset.Survival rates of the two groups were estimated using the Kaplan-Meier method and the log-rank test was used to test the differences between groups.RESULTS Using multivariate Cox analysis,we found no statistical significance in the role of donor age within the constructed models.Even when retained during the entire model development,the donor age's impact on survival remained insignificant and transformations and interactions yielded no substantial effects on survival.Consistent insigni-ficance and low coefficient values suggest that donor age does not impact patient survival in our dataset.Notably,there was no statistical evidence that the five developed models did not adhere to the proportional hazards assumption.When comparing donor age groups,transplantation using elderly grafts showed similar early graft function,similar graft(P=0.92),and patient survival rates(P=0.86),and no significant difference in the incidence of postoperative complications.CONCLUSION Our center's experience indicates that donor age does not play a significant role in patient survival,with elderly livers performing comparably to younger grafts when accounting for other risk factors.

HAZARD REGRESSION WITH PENALIZED SPLINE:THE SMOOTHING PARAMETER CHOICE AND ASYMPTOTICS

In this article, we use penalized spline to estimate the hazard function from a set of censored failure time data. A new approach to estimate the amount of smoothing is provided. Under regularity conditions we establish the consistency and the asymptotic normality of the penalized likelihood estimators. Numerical studies and an example are conducted to evaluate the performances of the new procedure.

Fibrinogen-to-albumin ratio predicts overall survival of hepatocellular carcinoma

BACKGROUND Fibrinogen-to-albumin ratio(FAR)has been found to be of prognostic significance for several types of malignant tumors.However,less is known about the association between FAR and survival outcomes in hepatocellular carcinoma(HCC)patients.AIM To explore the association between FAR and prognosis and survival in patients with HCC.METHODS A total of 366 histologically confirmed HCC patients diagnosed between 2013 and 2018 in a provincial cancer hospital in southwestern China were retrospectively selected.Relevant data were extracted from the hospital information system.The optimal cutoff for baseline serum FAR measured upon disease diagnosis was established using the receiver operating characteristic(ROC)curve.Univariate and multivariate Cox proportional hazards models were used to determine the crude and adjusted associations between FAR and the overall survival(OS)of the HCC patients while controlling for various covariates.The restricted cubic spline(RCS)was applied to estimate the dose-response trend in the FAR-OS association.RESULTS The optimal cutoff value for baseline FAR determined by the ROC was 0.081.Multivariate Cox proportional hazards model revealed that a lower baseline serum FAR level was associated with an adjusted hazard ratio of 2.43(95%confidence interval:1.87–3.15)in the OS of HCC patients,with identifiable dose-response trend in the RCS.Subgroup analysis showed that this FAR-OS association was more prominent in HCC patients with a lower baseline serum aspartate aminotransferase or carbohydrate antigen 125 level.CONCLUSION Serum FAR is a prominent prognostic indicator for HCC.Intervention measures aimed at reducing FAR might result in survival benefit for HCC patients.

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.

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.

Health evaluation method for degrading systems subject to dependent competing risks

This paper proposes a health evaluation method for degrading systems subject to competing risks of dependent soft and hard failures. To characterize the time-varying degradation rate, the degradation process is determined by a non-stationary Gamma process and the soft failure is encountered when it exceeds a predefined critical level. For the hard failure, a Cox’s proportional hazard model is applied to describe the hazard rate of the time to system failure. The dependent relationship is modeled by incorporating the degradation process as a time-varying covariate into the Cox’s proportional hazard model. To facilitate the health characteristics evaluation, a discretization technique is applied both to the degradation process and the monitoring time.All health characteristics can be obtained in the explicit form using the transition probability matrix, which is computationally attractive for practical applications. Finally, a numerical analysis is carried out to show the effectiveness and the performance of the proposed health evaluation method.

Prediction Approach to Life on Wing for Civil Aeroengine

To reduce engine maintenance cost and support safe operation, a prediction method of engine life on wing was proposed. This method is a kind of regression model which is a function of the condition monitoring and failure data. Key causes of engine removals were analyzed, and the life limit due to performance deterioration was predicted by proportional hazards model. Then the scheduled removal causes were considered as constraints of engine life to predicte the finai life on wing. Application of the proposed prediction method to the case of CF6-80C2A5 engine fleet in an airline proved its effectiveness.

Prediction models for development of hepatocellular carcinoma in chronic hepatitis B patients

Chronic hepatitis B(CHB)-related hepatocellular carcinoma(HCC)is a major health problem in Asian-Pacific regions.Antiviral therapy reduces,but does not completely prevent,HCC development.Thus,there is a need for accurate risk prediction to assist prognostication and decisions on the need for antiviral therapy and HCC surveillance.A few risk scores have been developed to predict the occurrence of HCC in CHB patients.Initially,the scores were derived from untreated CHB patients.With the development and extensive clinical application of nucleos(t)ide analog(s)(NA),the number of risk scores based on treated CHB patients has increased gradually.The components included in risk scores may be categorized into host factors and hepatitis B virus factors.Hepatitis activities,hepatitis B virus factors,and even liver fibrosis or cirrhosis are relatively controlled by antiviral therapy.Therefore,variables that are more dynamic during antiviral therapy have since been included in risk scores.However,host factors are more difficult to modify.Most existing scores derived from Asian populations have been confirmed to be accurate in predicting HCC development in CHB patients from Asia,while these scores have not offered excellent predictability in Caucasian patients.These findings support that more relevant variables should be considered to provide individualized predictions that are easily applied to CHB patients of different ethnicities.CHB patients should receive different intensities of HCC surveillance according to their risk category.