Lancet Reg Health Eur. 2022 Mar 22;15:100344. doi: 10.1016/j.lanepe.2022.100344. eCollection 2022 Apr.
NO ABSTRACT
PMID:35342893 | PMC:PMC8943426 | DOI:10.1016/j.lanepe.2022.100344
Perspect Behav Sci. 2021 May 13;45(1):259-294. doi: 10.1007/s40614-021-00289-9. eCollection 2022 Mar.
ABSTRACT
Multiple quantitative methods for single-case experimental design data have been applied to multiple-baseline, withdrawal, and reversal designs. The advanced data analytic techniques historically applied to single-case design data are primarily applicable to designs that involve clear sequential phases such as repeated measurement during baseline and treatment phases, but these techniques may not be valid for alternating treatment design (ATD) data where two or more treatments are rapidly alternated. Some recently proposed data analytic techniques applicable to ATD are reviewed. For ATDs with random assignment of condition ordering, the Edgington’s randomization test is one type of inferential statistical technique that can complement descriptive data analytic techniques for comparing data paths and for assessing the consistency of effects across blocks in which different conditions are being compared. In addition, several recently developed graphical representations are presented, alongside the commonly used time series line graph. The quantitative and graphical data analytic techniques are illustrated with two previously published data sets. Apart from discussing the potential advantages provided by each of these data analytic techniques, barriers to applying them are reduced by disseminating open access software to quantify or graph data from ATDs.
PMID:35342876 | PMC:PMC8894511 | DOI:10.1007/s40614-021-00289-9
Perspect Behav Sci. 2021 May 24;45(1):53-75. doi: 10.1007/s40614-021-00290-2. eCollection 2022 Mar.
ABSTRACT
Functional analysis (FA) is an integral component of behavioral assessment and treatment given that clinicians design behavioral treatments based on FA results. Unfortunately, the interrater reliability of FA data interpretation by visual analysis can be inconsistent, potentially leading to ineffective treatment implementation. Hall et al. (2020) recently developed automated nonparametric statistical analysis (ANSA) to facilitate the interpretation of FA data and Kranak et al. (2021) subsequently extended and validated ANSA by applying it to unpublished clinical data. The results of both Hall et al. and Kranak et al. support ANSA as an emerging statistical supplement for interpreting FA data. In the present article, we show how ANSA can be applied to interpret FA data collected in clinical settings in multielement and pairwise designs. We provide a detailed overview of the calculations involved, how to use ANSA in practice, and recommendations for its implementation. A free web-based application is available at https://ansa.shinyapps.io/ansa/.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40614-021-00290-2.
PMID:35342875 | PMC:PMC8894515 | DOI:10.1007/s40614-021-00290-2
Perspect Behav Sci. 2021 Sep 1;45(1):13-35. doi: 10.1007/s40614-021-00304-z. eCollection 2022 Mar.
ABSTRACT
This study investigated the power of two-level hierarchical linear modeling (HLM) to explain variability in intervention effectiveness between participants in context of single-case experimental design (SCED) research. HLM is a flexible technique that allows the inclusion of participant characteristics (e.g., age, gender, and disability types) as moderators, and as such supplements visual analysis findings. First, this study empirically investigated the power to estimate intervention and moderator effects using Monte Carlo simulation techniques. The results indicate that larger values for the true effects and the number of participants resulted in a higher power. The more moderators added to the model, the more participants needed to detect the effects with sufficient power (i.e., power ≥.80). When a model includes three moderators, at least 20 participants are required to capture the intervention effect and moderator effects with sufficient power. For that same condition, but only including one moderator, seven participants are sufficient. Specific recommendations for designing a SCED study with sufficient power to estimate intervention and moderator effects were provided. Second, this study introduced a newly developed user-friendly point and click Shiny tool, PowerSCED. This tool assists applied SCED researchers in designing a SCED study that has sufficient power to detect intervention and moderator effects. To end, the use of HLM with the inclusion of moderators was demonstrated using two previously published SCED studies in the journal School Psychology Quarterly.
PMID:35342874 | PMC:PMC8894540 | DOI:10.1007/s40614-021-00304-z
Zhonghua Wei Chang Wai Ke Za Zhi. 2022 Mar 25;25(3):235-241. doi: 10.3760/cma.j.cn441530-20210729-00305.
ABSTRACT
Objective: To summarize short-term postoperative complications of transanal total mesorectal excision (taTME) in the treatment of middle-low rectal cancer. Methods: A descriptive case series of cases was constructed. Clinical data of consecutive 83 patients with mid-low rectal cancer who received taTME treatment from November 2016 to April 2021 at Department of General Surgery of Beijing Friendship Hospital, Capital Medical University were collected. Among 83 patients, 58 (69.9%) were males, with a mean age of (61.4±11.8) years; 42 (50.6%) were low rectal cancer, 41 (49.4%) were middle rectal cancer. Short-term postoperative complication was defined as complication occurring within 30 days after operation. The complication was graded according to the Clavien-Dindo classification. At the same time, the morbidity of short-term postoperative complication in the first 40 patients and that in the last 43 patients were compared to understand the differences before and after passing the taTME learning curve. Results: Two patients (2.5%) were converted to laparotomy ; 78 (94.0%) completed anastomosis.While 5 (6.0%) underwent permanent stoma. The total operation time of transabdominal+ transanal procedure was (246.9±85.0) minutes, and the median intraoperative blood loss was 100 (IQR: 100) ml. Seventy-five cases (75 /78, 96.2%) underwent defunctioning stoma, including 74 cases of diverting ileostomy, 1 case of diverting transverse colostomy and 3 cases without stoma. The morbidity of complication within 30 days after operation was 38.6% (32/83), and the morbidity of complication after discharge was 8.4% (7/83). Minor complications accounted for 31.3% (26/83) and major complications accounted for 7.2% (6/83). No patient died within 30 days after operation. The incidence of anastomotic leakage was 15.4% (12/78). Eight patients (9.6%) were hospitalized again due to complications after discharge. The median postoperative hospital stay was 7 (IQR: 3) days. All the patients with minor (I-II) complications received conservative treatment. One patient with grade C anastomotic leakage was transferred to intensive care unit and received a second operation due to sepsis and multiple organ dysfunction. Two patients with paralytic ileus (Clavien-Dindo IIIa) underwent endoscopic ileus catheter placement. There were 3 patients with Clavien-Dindo III or above respiratory complications, including 1 patient with pleural effusion and ultrasound-guided puncture, 2 patients with respiratory failure who were improved and discharged after anti-infection and symptomatic treatment. One patient underwent emergency ureteral stent implantation due to urinary infection (Clavien-Dindo IIIb). The morbidity of postoperative complication in the first 40 cases was 50.0% (20/40), and that in the latter 43 cases decreased significantly (27.9%, 12/43), whose difference was statistically significant (χ(2)=4.270, P=0.039). Conclusions: The procedure of taTME has an acceptable morbidity of short-term postoperative complication in the treatment of mid-low rectal cancer. The accumulation of surgical experience plays an important role in reducing the morbidity of postoperative complication.
PMID:35340173 | DOI:10.3760/cma.j.cn441530-20210729-00305
Zhongguo Fei Ai Za Zhi. 2022 Mar 20;25(3):167-173. doi: 10.3779/j.issn.1009-3419.2022.101.09.
ABSTRACT
BACKGROUND: The previous study has indicated that lung cancer has a high incidence and mortality in China, and has caused a large economic burden. The purpose of this study was to analyze the incidence and economic burden of lung cancer by analyzing the information on the home page of discharge history of lung cancer patients in Hebei Tumor Hospital, and to provide scientific basis for the prevention and treatment of lung cancer.
METHODS: The information of all of the discharges, new cases, surgical patients, age, gender, length of stay and hospitalization cost of lung cancer patients in Hebei Tumor Hospital from January 2012 to December 2019 were retrieved based on the medical record management system, and the incidence trend, gender and age distribution as well as the economic burden of the disease were statistically described.
RESULTS: The number of new cases of lung cancer increased year by year, from 2,235 cases in 2012 to 5,012 cases in 2019. The number of males always outnumbered females, but the gender ratio decreased year by year, from 2.25 in 2012 to 1.56 in 2019. Among new cases of lung cancer, the proportion of surgical treatment increased year by year, from 28.14% in 2012 to 44.83% in 2019. Except for 2012, the proportion of surgical operations in female patients was higher than that in male patients from 2013 to 2019. The proportion of surgical operations in male and female patients was 23.52% and 28.07% in 2013, and 36.14% and 58.37% in 2019, respectively. The median age at the onset of lung cancer has increased year by year, from 61 years old in 2012 to 63 years old in 2019. The median age of onset in all lung cancer patients was higher in males than in females. The number of new lung cancer patients and surgical patients both showed an increasing trend with the increase of age, and both reached the maximum value in the age group of 60-69 years old. With the increase of age, the number of patients gradually decreased. The median length of hospital stay for all discharged lung cancer patients or surgical patients decreased year by year, from 10 d and 19 d in 2012 to 8 d and 17 d in 2019, respectively, while the median hospitalization cost increased year by year. It increased from 10,611.46 yuan and 38,750.13 yuan in 2012 to 17,187.15 yuan and 84,030.16 yuan in 2019, respectively.
CONCLUSIONS: Lung cancer is still one of the main cancers endangering the health of Chinese residents. The incidence of lung cancer is increasing year by year, and the distribution of gender and age has certain characteristics. In order to reduce the number of cases and the economic burden, effective prevention and control measures should be formulated and medical reform should be strengthened.
PMID:35340159 | DOI:10.3779/j.issn.1009-3419.2022.101.09
HIV Med. 2022 Mar 27. doi: 10.1111/hiv.13306. Online ahead of print.
ABSTRACT
OBJECTIVE: Our objective was to describe and compare the occurrence of neurological outcomes and neurosyphilis in people living with HIV with incident syphilis and no neurological symptoms who underwent early screening for asymptomatic neurosyphilis (ANS) or regular clinical management without a lumbar puncture.
METHODS: This was a retrospective cohort study in a single referral centre of Sao Paulo, Brazil. Patients with incident syphilis diagnosed between January 2000 and August 2016 and meeting the adapted criteria for ANS investigation suggested by Marra et al. (CD4+ T-cell counts ≤350 cells/mm³ and/or venereal disease research laboratory test results ≥1:16) were identified. Those with no neurological symptoms and immediately referred for lumbar puncture were categorized as group 1, and those not referred for cerebrospinal fluid collection were categorized as group 2. We compared the occurrence of neurological symptoms and neurosyphilis diagnoses between the groups using incidence rates and Kaplan-Meier curves.
RESULTS: We included 425 participants with a median follow-up of 6 years. The incidence rate of neurological symptoms was 36.5/1000 person-years in group 1 and 40.6/1000 person-years in group 2 (incidence rate ratio [IRR] 0.90; 95% confidence interval [CI] 0.57-1.39; p = 0.62). The incidence rate of neurosyphilis was 15.0 cases/1000 person-years in group 1 and 6.7 cases/1000 person-years in group 2 (IRR 2.26; 95% CI 0.93-5.68; p = 0.05).
CONCLUSIONS: We found no statistically significant differences between groups in the incidence rates of neurological symptoms and neurosyphilis. Our findings support the current guidelines, which suggest a less invasive approach regarding ANS investigation among people living with HIV with incident syphilis.
PMID:35340123 | DOI:10.1111/hiv.13306
J Cosmet Dermatol. 2022 Mar 27. doi: 10.1111/jocd.14940. Online ahead of print.
ABSTRACT
BACKGROUND: Tumor Necrosis Factor α (TNFα) is a protein that plays a key role in the pathophysiology of chronic inflammatory disorders like psoriasis.
AIMS: The goal of this study was to see if the TNFα gene -238G>A polymorphism was linked to psoriasis susceptibility.
METHODS: This study comprised ninety psoriasis patients and ninety healthy controls. For the TNFa gene -238G>A polymorphism, genomic DNA was extracted and genotyped using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) studies.
RESULTS: Psoriasis patients had higher frequencies of the A allele and the AA genotype than the control group, and psoriasis was linked to the AA genotype (OR = 4.25, 95% CI = 1.37-13.1, p = 0.008) and the A allele (OR = 1.55, 95% CI = 1.01-2.34, p = 0.04). Patients with a family history of psoriasis showed an increase in the frequency of the AA genotype compared to GG and GA genotypes (respectively, 46.7%, 36.7%, and 16.7%, p = 0.003). Furthermore, psoriasis patients with the AA genotype were discovered more commonly among those under 30 years old and male patients than those with the GG and GA genotypes, but the differences were not statistically significant.
CONCLUSION: The TNFa gene -238G>A polymorphism has been related to an increased incidence of psoriasis.
PMID:35340111 | DOI:10.1111/jocd.14940
Pediatr Transplant. 2022 Mar 27:e14258. doi: 10.1111/petr.14258. Online ahead of print.
ABSTRACT
BACKGROUND: Detection of donor-derived cell-free DNA (dd-cfDNA) reliably identifies allograft rejection in pediatric and adult kidney transplant (KT) recipients. Here, we evaluate the utility of dd-cfDNA for monitoring response to treatment among pediatric renal transplant recipients suffering graft rejection.
METHODS: 58 pediatric transplant recipients were enrolled between April 2018 and March 2020 and underwent initial dd-cfDNA testing to monitor for rejection. Allograft biopsy was performed for dd-cfDNA scores >1.0%. Patients with histologically proven rejection formed the study cohort and underwent appropriate treatment. Results of dd-cfDNA, serum creatinine (SCr), biopsy findings, and treatment outcomes were evaluated. Standard statistical analyses were applied.
RESULTS: Nineteen of 58 (31%) patients had dd-cfDNA score >1.0%, of which 18 (94.7%) had biopsy-proven rejection. Median dd-cfDNA value was 1.90% (interquartile range 1.43%-3.23%), and biopsy results showed 11 patients (61.1%) with antibody-mediated rejection (AMR), 2 patients (11.1%) with T-cell mediated rejection (TCMR), and 5 patients (27.7%) with mixed AMR/TCMR. SCr at time of biopsy was 1.28 ± 1.09 mg/dl. Following treatment, dd-cfDNA scores decreased for all types of rejection but still remained >1.0% in both AMR (1.50% [0.90%-3.10%]) and mixed (1.40% [0.95%-4.15%]) groups. Repeat dd-cfDNA values were <1.0% for patients with TCMR (0.20%-0.28%). SCr showed minimal change from pre-treatment levels regardless of rejection subtype.
CONCLUSIONS: Patients with TCMR may be reliably followed by dd-cfDNA; however, it remains unclear whether persistently elevated dd-cfDNA levels in AMR is a reflection of ongoing subclinical rejection or an inherent limitation of the assay’s utility.
PMID:35340104 | DOI:10.1111/petr.14258
Am J Addict. 2022 Mar 27. doi: 10.1111/ajad.13265. Online ahead of print.
ABSTRACT
BACKGROUND AND OBJECTIVES: Congenital syphilis (CS) is increasing in the United States and is associated with intersecting social and structural determinants of health. This study aimed to delineate birthing parent characteristics associated with CS in an adjusted model. METHODS (N = 720): People diagnosed with syphilis during pregnancy from 2017 to 2018 who were interviewed and linked to infants in the California state surveillance system were included (herein, “birthing parents”). Sociodemographic and clinical CS risk factors informed a stepwise multivariable logistic regression model in which the outcome of interest was infants born with CS. CS prevention continuums delineated the proportion of pregnant people with syphilis who completed steps (e.g., prenatal care entry, syphilis testing, treatment) needed to prevent CS; the outcome was delivering an infant without CS. We stratified continuums by homelessness and methamphetamine use to explore differences in CS outcomes.
RESULTS: Of 720 birthing parents, 245 (34%) delivered an infant with CS. Although CS was initially associated with homelessness (odds ratio [OR] = 2.5, 95% confidence interval [CI]: 1.6, 4.0) and methamphetamine use (OR = 2.1, 95% CI: 1.4, 3.1), the addition of prenatal care into a final adjusted model attenuated these associations to not significant. In CS prevention continuums, delivering an infant without CS was less likely for people who reported methamphetamine use (p < .001) and/or homelessness (p < .001). However, when examining only those who received prenatal care, statistical differences for these predictors no longer existed. In the final adjusted model the following were associated with CS: no prenatal care (OR = 16.7, 95% CI: 9.2, 30.3) or late prenatal care (OR = 2.9, 95% CI: 1.9, 4.2); early stage of syphilis (OR = 2.6, 95% CI: 1.8, 3.7); living in Central California (OR = 2.1, 95% CI: 1.1, 4.2).
CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: This is the first analysis to explore birthing parent characteristics associated with delivering an infant with CS in an adjusted model. We demonstrate that prenatal care, when accessed, can result in effective CS prevention among people who are unhoused and/or using methamphetamine equally well compared to counterparts without these risk factors.
PMID:35340101 | DOI:10.1111/ajad.13265