scholarly journals Six Month Abstinence Heterogeneity in the Best Quit Study

2019 ◽  
Vol 53 (12) ◽  
pp. 1032-1044
Author(s):  
Harold S Javitz ◽  
Terry M Bush ◽  
Jennifer C Lovejoy ◽  
Alula J Torres ◽  
Tallie Wetzel ◽  
...  

Abstract Background Understanding the characteristics of smokers who are successful in quitting may help to increase smoking cessation rates. Purpose To examine heterogeneity in cessation outcome at 6 months following smoking cessation behavioral counseling with or without weight management counseling. Methods 2,540 smokers were recruited from a large quitline provider and then randomized to receive proactive smoking cessation behavioral counseling without or with two versions of weight management counseling. A Classification and Regression Tree (CART) analysis was conducted to identify the individual pretreatment and treatment characteristics of groups of smokers with different quitting success (as measured by point prevalence of self-reported smoking of any amount at 6 months). Results CART analysis identified 10 subgroups ranging from 25.5% to 70.2% abstinent. The splits in the CART tree involved: the total number of counseling and control calls received, whether a smoking cessation pharmacotherapy was used, and baseline measures of cigarettes per day, confidence in quitting, expectation that the study would help the participant quit smoking, the motivation to quit, exercise minutes per week, anxiety, and lack of interest or pleasure in doing things. Costs per quitter ranged from a low of $US270 to a high of $US630. Specific treatment recommendations are made for each group. Conclusions These results indicate the presence of a substantial variation in abstinence following treatment, and that the total extent of contact via counseling calls of any type and baseline characteristics, rather than assigned treatment, were most important to subgroup membership and abstinence. Tailored treatments to subgroups who are at high risk for smoking following a quit attempt could increase successful smoking cessation.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nagihan Bostanci ◽  
Konstantinos Mitsakakis ◽  
Beral Afacan ◽  
Kai Bao ◽  
Benita Johannsen ◽  
...  

AbstractOral health is important not only due to the diseases emerging in the oral cavity but also due to the direct relation to systemic health. Thus, early and accurate characterization of the oral health status is of utmost importance. There are several salivary biomarkers as candidates for gingivitis and periodontitis, which are major oral health threats, affecting the gums. These need to be verified and validated for their potential use as differentiators of health, gingivitis and periodontitis status, before they are translated to chair-side for diagnostics and personalized monitoring. We aimed to measure 10 candidates using high sensitivity ELISAs in a well-controlled cohort of 127 individuals from three groups: periodontitis (60), gingivitis (31) and healthy (36). The statistical approaches included univariate statistical tests, receiver operating characteristic curves (ROC) with the corresponding Area Under the Curve (AUC) and Classification and Regression Tree (CART) analysis. The main outcomes were that the combination of multiple biomarker assays, rather than the use of single ones, can offer a predictive accuracy of > 90% for gingivitis versus health groups; and 100% for periodontitis versus health and periodontitis versus gingivitis groups. Furthermore, ratios of biomarkers MMP-8, MMP-9 and TIMP-1 were also proven to be powerful differentiating values compared to the single biomarkers.


2018 ◽  
Author(s):  
Bettina Hoeppner ◽  
Susanne Hoeppner ◽  
John Kelly

BACKGROUND The population of nondaily smokers is large (ie, 24.3% of adult smokers) and increasing (ie, 27% increase over the past decade). The cancer risk of nondaily smoking is substantial (40%-50% of that seen in daily smokers). Existing treatments are ill-suited for nondaily smoking, because the treatments are based on nicotine dependence, and traditional treatments and treatment modalities (eg, in-person counseling, medication) do not appeal to non-dependent nondaily smokers. OBJECTIVE We sought to develop a smartphone app that acts as a behavioral, in-the-pocket coach and uses positive psychology exercises to enhance quitting success. METHODS Nondaily smokers (n=30) used Version 1 of the “Smiling Instead of Smoking” (SiS) app while undergoing a quit attempt (1 week pre-, 2 weeks post-quit). The app assigned daily positive psychology exercises, provided smoking cessation tools (ie, scheduling quit day, logging personal reasons for quitting, planning for challenging times, enlisting social support), and made information about smoking cessation available (ie, benefits of quitting, strategies for cravings). Participants answered surveys at baseline and 2, 6, and 12 weeks post-quit and participated in structured user feedback sessions 2 weeks after their chosen quit day. RESULTS During the 3 weeks of ‘prescribed’ use, 50% of participants completed every daily positive psychology exercise, and the remaining 50% completed on average 85% of the daily exercises. Use of the user-initiated tools was limited: 20% did not use the “Challenging Times” tool at all; those who did only used it twice (median); 27% used the “Social Support” tool on multiple days. Self-reported smoking abstinence rates were 43.3% (7-day abstinence) 2 weeks post-quit, and 40.0% and 43.3% (30-day abstinence) at 6 and 12 weeks post-quit, respectively. Most participants (90%) felt the app helped them during their quit attempt, especially in terms of staying on track, giving them confidence, and reinforcing the idea that quitting was worthwhile. Usefulness ratings were particularly high for functionality that allowed participants to (re-)schedule their quit day and log their personal reasons for quitting smoking. In line with putative mechanisms underlying smoking cessation, compared to baseline, participants reported a lower urge to smoke (F(1,29)=20.55, P<.001), increased self-efficacy to abstain from smoking, both in response to internal (F[,29]=12.69, P<.01) and external stimuli (F[1,29]=18.95, P<.001), decreased endorsement of the psychoactive benefits (F[1,29]=16.24, P<.001) and pleasure (F[1,29]=5.44, P=.03) of smoking, and lower perceived importance of the pros of smoking (F[1,29]=18.26, P<.001). Qualitative feedback indicated a desire for more variety in the positive psychology exercises, more recommended strategies for dealing with cravings, less wordy but more frequent behavioral counseling check-ins, a reward systems, and the removal of the “social support” tool. CONCLUSIONS A positive psychology approach to support smoking cessation resonated well with nondaily smokers. App usage of these exercises was high over a 3-week period, suggesting that this treatment approach is sustainable during the critical phase of smoking cessation. Abstinence rates were substantially higher than natural quit rates in this population, and thus offer some promise, which will need to be evaluated in a randomized trial.


2021 ◽  
Vol 11 (9) ◽  
pp. 1128
Author(s):  
Jordan P. Harp ◽  
Lisa M. Koehl ◽  
Kathryn L. Van Pelt ◽  
Christy L. Hom ◽  
Eric Doran ◽  
...  

Primary care integration of Down syndrome (DS)-specific dementia screening is strongly advised. The current study employed principal components analysis (PCA) and classification and regression tree (CART) analyses to identify an abbreviated battery for dementia classification. Scale- and subscale-level scores from 141 participants (no dementia n = 68; probable Alzheimer’s disease n = 73), for the Severe Impairment Battery (SIB), Dementia Scale for People with Learning Disabilities (DLD), and Vineland Adaptive Behavior Scales—Second Edition (Vineland-II) were analyzed. Two principle components (PC1, PC2) were identified with the odds of a probable dementia diagnosis increasing 2.54 times per PC1 unit increase and by 3.73 times per PC2 unit increase. CART analysis identified that the DLD sum of cognitive scores (SCS < 35 raw) and Vineland-II community subdomain (<36 raw) scores best classified dementia. No significant difference in the PCA versus CART area under the curve (AUC) was noted (D(65.196) = −0.57683; p = 0.57; PCA AUC = 0.87; CART AUC = 0.91). The PCA sensitivity was 80% and specificity was 70%; CART was 100% and specificity was 81%. These results support an abbreviated dementia screening battery to identify at-risk individuals with DS in primary care settings to guide specialized diagnostic referral.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kaizhou Huang ◽  
Feiyang Ji ◽  
Zhongyang Xie ◽  
Daxian Wu ◽  
Xiaowei Xu ◽  
...  

Abstract Artificial liver support systems (ALSS) are widely used to treat patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). The aims of the present study were to investigate the subgroups of patients with HBV-ACLF who may benefit from ALSS therapy, and the relevant patient-specific factors. 489 ALSS-treated HBV-ACLF patients were enrolled, and served as derivation and validation cohorts for classification and regression tree (CART) analysis. CART analysis identified three factors prognostic of survival: hepatic encephalopathy (HE), prothrombin time (PT), and total bilirubin (TBil) level; and two distinct risk groups: low (28-day mortality 10.2–39.5%) and high risk (63.8–91.1%). The CART model showed that patients lacking HE and with a PT ≤ 27.8 s and a TBil level ≤455 μmol/L experienced less 28-day mortality after ALSS therapy. For HBV-ACLF patients with HE and a PT > 27.8 s, mortality remained high after such therapy. Patients lacking HE with a PT ≤ 27.8 s and TBil level ≤ 455 μmol/L may benefit markedly from ALSS therapy. For HBV-ACLF patients at high risk, unnecessary ALSS therapy should be avoided. The CART model is a novel user-friendly tool for screening HBV-ACLF patient eligibility for ALSS therapy, and will aid clinicians via ACLF risk stratification and therapeutic guidance.


Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 386 ◽  
Author(s):  
Tamara Ius ◽  
Fabrizio Pignotti ◽  
Giuseppe Maria Della Pepa ◽  
Giuseppe La Rocca ◽  
Teresa Somma ◽  
...  

Despite recent discoveries in genetics and molecular fields, glioblastoma (GBM) prognosis still remains unfavorable with less than 10% of patients alive 5 years after diagnosis. Numerous studies have focused on the research of biological biomarkers to stratify GBM patients. We addressed this issue in our study by using clinical/molecular and image data, which is generally available to Neurosurgical Departments in order to create a prognostic score that can be useful to stratify GBM patients undergoing surgical resection. By using the random forest approach [CART analysis (classification and regression tree)] on Survival time data of 465 cases, we developed a new prediction score resulting in 10 groups based on extent of resection (EOR), age, tumor volumetric features, intraoperative protocols and tumor molecular classes. The resulting tree was trimmed according to similarities in the relative hazard ratios amongst groups, giving rise to a 5-group classification tree. These 5 groups were different in terms of overall survival (OS) (p < 0.000). The score performance in predicting death was defined by a Harrell’s c-index of 0.79 (95% confidence interval [0.76–0.81]). The proposed score could be useful in a clinical setting to refine the prognosis of GBM patients after surgery and prior to postoperative treatment.


Archaea ◽  
2008 ◽  
Vol 2 (3) ◽  
pp. 159-167 ◽  
Author(s):  
Betsey Dexter Dyer ◽  
Michael J. Kahn ◽  
Mark D. LeBlanc

Classification and regression tree (CART) analysis was applied to genome-wide tetranucleotide frequencies (genomic signatures) of 195 archaea and bacteria. Although genomic signatures have typically been used to classify evolutionary divergence, in this study, convergent evolution was the focus. Temperature optima for most of the organisms examined could be distinguished by CART analyses of tetranucleotide frequencies. This suggests that pervasive (nonlinear) qualities of genomes may reflect certain environmental conditions (such as temperature) in which those genomes evolved. The predominant use of GAGA and AGGA as the discriminating tetramers in CART models suggests that purine-loading and codon biases of thermophiles may explain some of the results.


Author(s):  
Ummey Shapla ◽  
M. Hasanuzzaman ◽  
Md. Omar Kayess

This experiment was conducted at the Research Farm of the Department of Genetics and Plant Breeding of Hajee Mohammad Danesh Science and Technology University, Dinajpur, Bangladesh to develop biometrical methods based on some morphological traits for characterization of the selected wheat varieties. Among the selected wheat varieties BARI Gom 26 requires comparatively fewer days and BARI Gom 27 requires more days for 50% heading than other varieties. The BARI Gom 28, BARI Gom 29 and BARI Gom 30 are comparatively short (< 90 cm) whereas others are medium-sized (> 90 cm) plants. BARI Gom 27 has narrow flag leaf than others. BARI Gom 28 show short spike length while BARI Gom 22, BARI Gom 26 and BARI Gom 30 show nearly a similar length of the spike. The BARI Gom 25 is large-sized in length and breadth but the grain of BARI GOM 27 is comparatively small sized. BARI Gom 22, BARI Gom 23, BARI Gom 24, BARI Gom 25 and BARI Gom 26 are classified which have <7.5 mm length of the grain. The 1000 grain weight of BARI Gom 24 is more than other wheat varieties and comparatively less in BARI Gom 22 and BARI Gom 27. BARI Gom 24 can be identified with the height of >90 cm, breath of flag leaf is >1.2 cm, spike length is >10 cm and yield per plant is >20.196 g. Based on these variations, a classification and regression tree (CART) has been developed to identify the wheat variety easily and quickly.


2021 ◽  
Author(s):  
Desislava Stevanova

This thesis examines individual and community noise perception of environmental noise in three neighbourhoods in the city of Toronto. The significance of this research is based on a relative absence of literature on how noise sensitivity and annoyance are affected by non-acoustic factors such as the built environment, demographic, and socio-economic factors. Data from a neighbourhood noise survey (n=552) were combined with spatial data on exposures to noise. Bivariate analysis, multivariate regression, and classification and regression tree (CART) analysis were used. The results showed that participants in Downtown and Don Valley have similar noise responses (64% and 67% high annoyance) despite differences in noise exposure (LAeq 24h: 66.8 and 59.3). Estimation of Community Tolerance Levels (CTL) confirmed that participants exposed to lower sound levels have a lower tolerance of noise. Further results showed that a neighbourhood with high socioeconomic status and access to green space, and relatively low night time noise levels were still two times more likely to report high annoyance, compared with neighbourhood with moderate socio-economic status and lower access to green space. The results suggest that environmental context influences expectations and sensitivity to noise.


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