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Bayesian analysis of minimal model under the insulin-modified IVGTT

Health 2010年第3期2卷 188-194页

作者： Yi Wang Kent M. Eskridge andrzej T. galecki University of Michigan University of Nebraska-Lincoln

A Bayesian analysis of the minimal model was proposed where both glucose and insulin were analyzed simultaneously under the insulin-modified intravenous glucose tolerance test (IVGTT). The resulting model was implemented with a nonlinear mixed-effects modeling setup using ordinary differential equations (ODEs), which leads to precise estimation of population parameters by separating the inter- and intra-individual variability. The results indicated that the Bayesian method applied to the glucose-insulin minimal model provided a satisfactory solution with accurate parameter estimates which were numerically stable since the Bayesian method did not require approximation by linearization.

关键词： Minimal Model Bayesian Analysis IVGTT Nonlinear Mixed-Effects Modeling ODE

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Predicting Birth-Related Levator Ani Tear Severity in Primiparous Women: Evaluating Maternal Recovery from Labor and Delivery (EMRLD Study)

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Open Journal of Obstetrics and Gynecology 2014年第6期4卷 266-278页

作者： Lisa Kane Low Ruth Zielinski Yebin Tao andrzej.galecki Catherine J. Brandon Janis M. Miller Department of Radiology School of Medicine University of Michigan Ann Arbor Michigan USA School of Nursing University of Michigan Ann Arbor Michigan USA School of Public Health University of Michigan Ann Arbor Michigan USA

Objective: To determine which maternal characteristics or birth events independently predict severity of levator ani muscle (LA) tears at first vaginal birth in a longitudinal/observational investigation in a tertiary care hospital. Sample: Ninety primiparas with at least one at risk for LA tear inclusion factor at vaginal birth: maternal age ≥ 33 years, second stage ≥ 150 minutes, macrosomia, instrumented delivery, and/or anal sphincter laceration were studied. Methods: Magnetic Resonance Imaging (MRI) was obtained early postpartum (mean ± sd 48.9 ± 21.6 days) to identify LA tear. Severity of LA muscle fiber loss was graded on an ordinal scale of: “0” as no loss, “1” as <50% unilateral loss, “2” as ≥50% unilateral or <50% bilateral loss, and “3” as ≥50% bilateral loss. Data were analyzed using proportional odds modeling. Inclusion factors were explored as predictors of LA tear severity and at analysis episiotomy, time spent actively pushing, epidural, and oxytocin were also considered. The main outcome measures of interest included grading of severity of LA muscle fiber loss on an ordinal scale. Results: Respective counts/percentages of women within each 0 thru 3 ordered category of LA tear severity were: “0” = 58(64%), “1” = 9(10%), “2” = 15(17%), and “3” = 8(9%). Estimates and 95% CI for significant demographic or obstetric univariate predictors of LA tear severity level were age, OR 1.093 (CI 1.012 - 1.180), p = 0.023;and time spent in active pushing, OR 1.089 (CI 1.005 - 1.180), p = 0.038. The other factors considered were not significant. There were too few women with forceps deliveries to analyze. Conclusion: In our enriched sample of primiparous women, 26% showed a significant LA tear. Maternal age and time spent actively pushing independently predict LA tear severity.

关键词： Reproductive Physiological Phenomena Birth Injuries Parturition Labor Pelvic Floor Disorders Soft Tissue Injuries of the Pelvis

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