Deep Q-networks with web-based survey data for simulating lung cancer intervention prediction and assessment in the elderly: a quantitative study

Background Lung cancer screening and intervention might be important to help detect lung cancer early and reduce the mortality, but little was known about lung cancer intervention strategy associated with intervention effect for preventing lung cancer. We employed Deep Q-Networks (DQN) to respond to this gap. The aim was to quantitatively predict lung cancer optimal intervention strategy and assess intervention effect in aged 65 years and older (the elderly). Methods We screened lung cancer high risk with web-based survey data and conducted simulative intervention. DQN models were developed to predict optimal intervention strategies to prevent lung cancer in elderly men and elderly women separately. We assessed the intervention effects to evaluate the optimal intervention strategy. Results Proposed DQN models quantitatively predicted and assessed lung cancer intervention. DQN models performed well in five stratified groups (elderly men, elderly women, men, women and the whole population). Stopping smoking and extending quitting smoking time were optimal intervention strategies in elderly men. Extending quitting time and reducing smoked cigarettes number were optimal intervention strategies in elderly women. In elderly men and women, the maximal reductions of lung cancer incidence were 31.81% and 24.62% separately. Lung cancer incidence trend was deduced from the year of 1984 to 2050, which predicted that the difference of lung cancer incidence between elderly men and women might be significantly decreased after thirty years quitting time. Conclusions We quantitatively predicted optimal intervention strategy and assessed lung cancer intervention effect in the elderly through DQN models. Those might improve intervention effects and reasonably prevent lung cancer.

An Empirical Validation of the Regression Point Displacement Design Using Within-Study Comparison Logic: Emerging Possibilities and Cautions

Background The regression point displacement (RPD) design is a quasi-experiment (QE) that aims to control many threats to internal validity. Though it has existed for several decades, RPD has only recently begun to answer applied research questions in lieu of stronger QEs. Objectives Our primary objective was to implement within-study comparison (WSC) logic to create RPD replicates and to determine conditions under which RPD might provide estimates comparable to those found in validating experiments. Research Design We utilize three randomized controlled trials (two cluster-level, one individual-level), artificially decomposing or creating cluster structures, to create multiple RPDs. We compare results in each RPD treatment group to a fixed set of control groups to gauge the congruence of these repeated RPD realizations with results found in these three RCTs. Results RPD’s performance was uneven. Using multiple criteria, we found that RPDs successfully predicted the direction of the RCT’s intervention effect but inconsistently fell within the .10 SD threshold. A scant 13% of RPD results were statistically significant at either the .05 or .01 alpha-level. RPD results were within the 95% confidence interval of RCTs around half the time, and false negative rates were substantially higher than false positive rates. Conclusions RPD consistently underestimates treatment effects in validating RCTs. We analyze reasons for this insensitivity and offer practical suggestions to improve the chances RPD will correctly identify favorable results. We note that the synthetic, “decomposition of cluster RCTs,” WSC design represents a prototype for evaluating other QEs.

A Bayesian Network Meta-analysis of the Effect of Acute Exercise on Executive Function in Middle-aged and Senior People

Review question / Objective: Objective: To compare the intervention effect of multiple acute movement formulas on the executive function in middle-aged and senior people and to provide references for the discussion of the plans for precise movements. P: middle-aged and senior people elderly people; I: acute exercise; C: reading or sitting; O: Executive Function; S: RCT/crossover. Information sources: Randomized searches were carried out in Chinese databases such as CNKI, Wanfang Database, VTTMS, SinoMed and foreign databases such as PubMed, EMBASE, Cochrane Library, Web of Science. The retrieval period is from the beginning of each database to August 2021, supplemented with manual searches for gray literature and references traced back to previous systematic reviews.

The Expenses Needed for the Effect of Restricted Group Sandplay on Interpersonal Sensitivity in College Students

This study aims to investigate the intervention effect of group sandplay on the interpersonal sensitivity of college students and analyze the relationship between the theme and interactive behavior characteristics and the intervention effect of group sandplay especially during the period of COVID-19. Sixty college students were randomly assigned to the experimental group (group sandplay) or the control group (neutral task interventions). The results showed that the interpersonal sensitivity level of the experimental group was significantly lower than that of the control group. For the experimental group, the variation in the interpersonal sensitivity level was significantly negatively correlated with the change in warm, supportive behavior during group sandplay interaction. These findings suggest that group sandplay is effective in improving the interpersonal sensitivity level of college students, and this effect can be positively predicted by warm and supportive interaction behaviors in group sandplay.

Analysis of Nursing Effect of Children with Henoch-Schonlein Purpura Based on the PDCA Nursing Model

By applying the PDCA model to the care of children with Henoch-Schonlein purpura, the nursing process can be divided into four stages: planning, execution, inspection, and treatment. According to the age characteristics and disease progression of pediatric patients, a complete nursing plan is formulated to efficiently implement the nursing content and improve the nursing effect. This paper studies the application of the PDCA nursing model in the nursing of children with Henoch-Schonlein purpura and statistically analyzes the disappearance of skin rash, joint pain relief, disappearance of urine protein, disappearance of gastrointestinal symptoms, etc. Finally, this paper combines the experiment to evaluate the intervention effect of this nursing model and provides reference for the follow-up care of children with Henoch-Schonlein purpura. From the results of experimental research, it can be known that PDCA nursing can improve the comfort of children with Henoch-Schonlein purpura, shorten the time for symptom disappearance, and speed up the recovery process.

The Effect of the Baduanjin Exercise on the Covid-19-Related Anxiety, Psychological Well-being and Lower Back Pain of College Students During the Pandemic

Background Baduanjin exercise is recognized as having a beneficial effect on both physical and mental health. However, studies lacked consideration of its potential advantageous outcomes during the coronavirus pandemic. This study aimed to examine the effect of Baduanjin exercise on the COVID-19-related anxiety, psychological well-being, and the lower back pain of college students during the coronavirus pandemic in China. Methods Participants consisted of 387 people, ranging in age from 20 to 30 years (M = 23.55; SD = 3.13), and were randomly divided into two groups: 195 participated in the 12-week Baduanjin exercise program, and 192 learned health knowledge during this time. Subsequently, the two groups were analyzed and compared in terms of an intervention effect on the COVID-19-related anxiety, psychological well-being, and lower back pain. Results The intervention effect on the Baduanjin exercise group was remarkably better than that of the control group (p < 0.05). With the intervention of the Baduanjin exercise, the COVID-19-related anxiety score decreased from 5.22±0.45 to 5.07±0.27. The total psychological well-being score increased from 70.11±8.65 to 84.12±7.38, and the prevalence of low back pain decreased from 22.45±1.67 to 18.35±1.05 among college students. Conclusion During the pandemic, the Baduanjin exercise contributes to the reduction of the perceived anxiety related to the COVID-19, decreases the prevalence of the lower back pain, and improves the psychological well-being of college students.

Effect of computerised, knowledge-based, clinical decision support systems on patient-reported and clinical outcomes of patients with chronic disease managed in primary care settings: a systematic review

ObjectivesChronic diseases are the leading cause of disability globally. Most chronic disease management occurs in primary care with outcomes varying across primary care providers. Computerised clinical decision support systems (CDSS) have been shown to positively affect clinician behaviour by improving adherence to clinical guidelines. This study provides a summary of the available evidence on the effect of CDSS embedded in electronic health records on patient-reported and clinical outcomes of adult patients with chronic disease managed in primary care.Design and eligibility criteriaSystematic review, including randomised controlled trials (RCTs), cluster RCTs, quasi-RCTs, interrupted time series and controlled before-and-after studies, assessing the effect of CDSS (vs usual care) on patient-reported or clinical outcomes of adult patients with selected common chronic diseases (asthma, chronic obstructive pulmonary disease, heart failure, myocardial ischaemia, hypertension, diabetes mellitus, hyperlipidaemia, arthritis and osteoporosis) managed in primary care.Data sourcesMedline, Embase, CENTRAL, Scopus, Health Management Information Consortium and trial register clinicaltrials.gov were searched from inception to 24 June 2020.Data extraction and synthesisScreening, data extraction and quality assessment were performed by two reviewers independently. The Cochrane risk of bias tool was used for quality appraisal.ResultsFrom 5430 articles, 8 studies met the inclusion criteria. Studies were heterogeneous in population characteristics, intervention components and outcome measurements and focused on diabetes, asthma, hyperlipidaemia and hypertension. Most outcomes were clinical with one study reporting on patient-reported outcomes. Quality of the evidence was impacted by methodological biases of studies.ConclusionsThere is inconclusive evidence in support of CDSS. A firm inference on the intervention effect was not possible due to methodological biases and study heterogeneity. Further research is needed to provide evidence on the intervention effect and the interplay between healthcare setting features, CDSS characteristics and implementation processes.PROSPERO registration numberCRD42020218184.