A New Lifetime Distribution and Its Power Transformation

New one-parameter and two-parameter distributions are introduced in this paper. The failure rate of the one-parameter distribution is unimodal (upside-down bathtub), while the failure rate of the two-parameter distribution can be decreasing, increasing, unimodal, increasing-decreasing-increasing, or decreasing-increasing-decreasing, depending on the values of its two parameters. The two-parameter distribution is derived from the one-parameter distribution by using a power transformation. We discuss some properties of these two distributions, such as the behavior of the failure rate function, the probability density function, the moments, skewness, and kurtosis, and limiting distributions of order statistics. Maximum likelihood estimation for the two-parameter model using complete samples is investigated. Different algorithms for generating random samples from the two new models are given. Applications to real data are discussed and compared with the fit attained by some one- and two-parameter distributions. Finally, a simulation study is carried out to investigate the mean square error of the maximum likelihood estimators, the coverage probability, and the width of the confidence intervals of the unknown parameters

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Reliability equivalence with a basic series/parallel system

Abstract This paper extends the concept of reliability equivalence from simple series and parallel systems to some complex systems. The reliability equivalence factors of a complex system are obtained. We consider a radar system in an aircraft, which consists of three independent and non-identical components. Both survival function and mean time to failure are used as references of reliability equivalence. The case of independent and identical components is studied as a special case. Theoretical comparisons among the used methods of improving the system reliability are introduced. Numerical examples are presented to interpret how one can utilize the obtained result

A new class of bivariate distributions and its mixture

A new class of bivariate distributions is presented in this paper. The procedure used in this paper is based on a latent random variable with exponential distribution. The model introduced here is of Marshall–Olkin type. A mixture of the proposed bivariate distributions is also discussed. The results obtained here generalize those of the bivariate exponential distribution present in the literature

A new class of bivariate distributions and its mixture

A new class of bivariate distributions is presented in this paper. The procedure used in this paper is based on a latent random variable with exponential distribution. The model introduced here is of Marshall-Olkin type. A mixture of the proposed bivariate distributions is also discussed. The results obtained here generalize those of the bivariate exponential distribution present in the literature.Generalized exponential distribution Bivariate exponential distribution Moments Mixtures

Stress-strength reliability under partially accelerated life testing using Weibull model

The reliability of a system is the probability that its strength exceeds its stress. This reliability is called as the stress-strength reliability. The inferences of the stress-strength reliability R=P(X>Y), when: (1) the strength (X) and stress (Y) are independent random variables follow one-parameter exponential distributions; and (2) the strength variable is subjected to the step-stress partially accelerated life test (SSPALT) are discussed recently. Exponential distribution has limitation to describe the strength and stress due to its constant failure rate. In this paper, we consider the estimate of R, when: (1) X and Y are independent random variables that follow two-parameter Weibull distributions; and (2) the strength variable X is subjected to the SSPALT. The maximum likelihood estimator of R and its asymptotic distribution are not obtained analytically and therefore the asymptotic confidence interval of R is discussed. A real data set is analyzed using the proposed model for illustrative and comparison purposes. Based on the numerical results, we would conclude that the exponential distribution is rejected to fit the strength and stress, at any significant level that is greater than or equal to 2.58%, against the Weibull model

Statistical inference of reliability distributions based on progressively hybrid censoring data

This paper studies the statistical inferences of the unknown parameters of some reliability models using progressively hybrid censoring of type-I and type-II. We apply the maximum likelihood and Bayesian approaches to perform the statistical inferences of the parameters when the data follow Weibull, power Lindley, and Sarhan–Tadj–Hamilton distributions. Bayes method is implemented under the squared error loss function when the parameters are independent and follow gamma prior distributions with known hyperparameters. The maximum likelihood estimates cannot be obtained in an analytic form. Therefore we use the R function “optim” to find those estimates. Also, the joint posterior distribution of the unknown parameters cannot be obtained in closed form. Therefore, we will use the Markov Chain Monte Carlo method to approximate the Bayesian analysis. We constructed the highest posterior density intervals of the model parameters. We analyzed three real data sets for illustration and comparison purposes. We found out that Sarhan–Tadj–Hamilton distribution fits those three real data sets better than Weibull and Power Lindley distribution using both complete and progressively hybrid censored samples. We used expected experimentation time to discuss the optimal test plans. Simulation studies are performed to investigate the proposed methods. Based on the simulation results, we could conclude that Bayesian method does not provide better estimations than the maximum likelihood method