Mechanical ventilation is a common procedure of life support in intensive care. Patient-ventilator asynchronies (PVAs) occur when the timing of the ventilator cycle is not simultaneous with the timing of the patient respiratory cycle. The association between severity markers and the events death or alive discharge has been acknowledged before, however, little is known about the addition of PVAs data to the analyses. We used an index of asynchronies (AI) to measure PVAs and the SOFA (sequential organ failure assessment) score to assess overall severity. To investigate the added value of including the AI, we propose a Bayesian joint model of bivariate longitudinal and competing risks data. The longitudinal process includes a mixed effects model for the SOFA score and a mixed effects beta regression model for the AI. The survival process is defined in terms of a cause-specific hazards model for the competing risks death or alive discharge. Our model indicates that the SOFA score is strongly related to vital status. PVAs are positively associated with alive discharge but there is not enough evidence that PVAs provide a more accurate indication of death prognosis than the SOFA score alone.
This article presents the results of an experiment in which we investigated how prior algebra knowledge and personality can influence the permanence time from the confusion state to frustration/boredom state in a computer learning environment. Our experimental results indicate that people with a neurotic personality and a low level of algebra knowledge can deal with confusion for less time and can easily feel frustrated/bored when there is no intervention. Our analysis also suggest that people with an extroversion personality and a low level of algebra knowledge are able to control confusion for longer, leading to later interventions. These findings support that it is possible to detect emotions in a less invasive way and without the need of physiological sensors or complex algorithms. Furthermore, obtained median times can be incorporated into computational regulation models (e.g. adaptive interfaces) to regulate students' emotion during the teaching-learning process.
Semi-competing risks refer to the setting where primary scientific interest lies in estimation and inference with respect to a non-terminal event, the occurrence of which is subject to a terminal event. In this paper, we present the R package SemiCompRisks that provides functions to perform the analysis of independent/clustered semi-competing risks data under the illness-death multi-state model. The package allows the user to choose the specification for model components from a range of options giving users substantial flexibility, including: accelerated failure time or proportional hazards regression models; parametric or non-parametric specifications for baseline survival functions; parametric or non-parametric specifications for random effects distributions when the data are cluster-correlated; and, a Markov or semi-Markov specification for terminal event following non-terminal event. While estimation is mainly performed within the Bayesian paradigm, the package also provides the maximum likelihood estimation for select parametric models. The package also includes functions for univariate survival analysis as complementary analysis tools.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.