Factors affecting blood sugar changes in diabetic patients using a three-level model in analysis of longitudinal data.

Background: Diabetes, a currently threatening disease, has severe consequences for individuals' health conditions. The present study aimed to investigate the factors affecting the changes in the longitudinal outcome of blood sugar using a three-level analysis with the presence of missing data in diabetic patients. Methods: A total of 526 diabetic patients were followed longitudinally selected from the annual data collected from the rural population monitored by Tonekabon health centers in the North of Iran during 2018-2019 from the Iranian Integrated Health System (SIB) database. In analyzing this longitudinal data, the three-level model (level 1: observation (time), level 2: subject, level 3: health center) was carried out with multiple imputations of possible missing values in longitudinal data. Results: Results of fitting the three-level model indicated that every unit of change in the body mass index (BMI) significantly increased the fasting blood sugar by an average of 0.5 mg/dl (p=0.024). The impact of level 1 (observations) was insignificant in the three-level model. Still, the random effect of level 3 (healthcare centers) showed a highly significant measure for health centers (14.62, p<0.001). Conclusion: The BMI reduction, the healthcare centers' socioeconomic status, and the health services provided have potential effects in controlling diabetes.

Parental involvement and student creativity: a three-level meta-analysis.

Introduction: The Ecological Systems Model of Creativity Development (ESMCD) proposes that parental involvement positively impacts student creativity. However, prior empirical studies present mixed results, including positive, negative, and no correlations between these variables. Methods: To synthesize these inconsistent primary studies, the current study conducted a systematic meta-analysis synthesizing 30 primary studies involving 37 independent samples with 70 effect sizes and a total N = 20,906 participants. Results: The results demonstrated: (1) an overall significant small, positive correlation (r = 0.101) between parental involvement and student creativity; (2) significant small, positive correlations between specific involvement types (autonomy support r = 0.144; behavioral control r = 0.133; content support r = 0.131) and creativity, alongside a significant small, negative correlation between psychological control and creativity (r = -0.117); (3) no statistically significant moderating effects of student grade level, parental gender, region, or publication type. Discussion: This systematic meta-analytic review consolidates empirical evidence indicating that parental involvement positively predicts students' creativity, while highlighting the detrimental impact of psychological control on creative outcomes. Further research elucidating the mechanisms underlying these relations is critical for informing parenting approaches and education policies seeking to foster creativity development among students.

A Multi-Center Study on the Implementation and Challenges of Nursing Three-Level Ward Rounds in Tertiary Hospitals in Shanxi Province.

Background: The "Key Points of the Core System of Medical Quality and Safety" (hereinafter referred to as the "Key Points") was promulgated by the National Health Commission of China in 2018, requiring that nursing ward rounds should be carried out with reference to the three-level ward round system; In 2020 and 2022 editions of the "Evaluation Standards for Tertiary Hospitals", which were implemented in China, required that nursing ward rounds should be carried out with reference to the "Key Points". Additionally, the Action Plan for Comprehensively Improving Medical Quality (2023-2025) also mentions the need to improve the quality of three-level ward rounds. However, there are no detailed guidelines regarding implementing "Nursing Three-level Ward Rounds". Purpose: This study aimed to investigate the current situation of nursing three-level ward rounds in tertiary hospitals after the promulgation of the "Key Points of the Core System of Medical Quality and Safety" to provide insights and guidelines regarding relevant standards, so as to better implement of the requirements of "nursing ward rounds" in the "Evaluation Standards for Tertiary Hospitals" and "improving the quality of three-level ward rounds" in the "Action Plan". Methods: A multi-center study was conducted in February 2024, including all tertiary public hospitals in the Shanxi Province, China. A questionnaire survey using the self-designed "Questionnaire on the Implementation of Nursing Three-level Ward Rounds" was carried out. The questionnaire included the basic information of the hospital and the implementation of the three-level (namely I, II, and III) rounds (including "five aspects": ward round personnel, object, content, frequency, and record), which is expressed by quantity and composition ratio. Next is the text analysis method. First, the "five aspects" of the hospital that filled in the questionnaire survey with "nursing three-level ward rounds have been carried out" were assessed. Second, the five aspects of each hospital were assessed for consistency with the "Nursing Three-level Ward Rounds System" (hereinafter referred to as the "System") of their respective hospitals.Third, the consistency of the "System" of the hospital with the "Key Points" was assessed. The results of the analysis of the former are expressed in terms of quantity and composition ratio; the results of the latter two were analyzed using Fisher's exact test method to compare any differences. Results: Notably, 14 of the 67 tertiary public hospitals (20.9%) carried out nursing three-level ward rounds. There were 4-10 situations in the five aspects of I, II, and III ward rounds filled in by the hospitals. The five aspects of the I, II, III ward rounds in 14 hospitals were significantly comparable with the "System", which, in turn, was comparable with the "Key Points" (P < 0.05). Conclusion: Not all tertiary public hospitals in the Shanxi Province have not all carried out nursing three-level ward rounds. Furthermore, the five aspects of the hospitals that carried out nursing three-level ward rounds were not entirely consistent in terms of ward round personnel, object, content, frequency, and record. The filling in of the nursing three-level ward rounds carried out by the hospitals is inconsistent with the respective "System"; the "System" of the hospital is not in line with the "Key Points". Impact on Nursing Work: Nursing administrators should be aware of the newly issued norms and requirements in their workplace, and revise the relevant systems in accordance with the norms and requirements in a timely manner. Additionally, the revision of the system should cover the core requirements of the norms and be practicable. The system should be supervised to ensure that 100% of the implementation is in accordance with the system.

Cognitive expertise in esport experts: a three-level model meta-analysis.

Objectives: The cognitive expertise of experts has been an intriguing theme; there has been rapid growth in cognitive research related to esports. Given the close association between esports activities and cognition, esports holds promise in offering new perspectives for understanding cognitive expertise. This meta-analysis aims at quantitatively delineating the cognitive disparities between esports experts and amateurs. Methods: The expert group comprised professional video game players and high-ranking players (top 1%), while amateurs were assigned to the control group. Research studies published between January 2000 and December 2023 were systematically searched in databases. A three-level model with cluster-robust variance estimation was used to calculate the overall effect size. The moderating variables included professional level, cognitive abilities, dependent variable type, game genre, gender and age. Results: A total of 15 studies containing 142 effect sizes and 1085 participants were included in this meta-analysis. The results indicated that, compared to amateurs, video game experts demonstrated superior cognitive abilities with a small effect size (Hedges' g = 0.373, 95% CI [0.055-0.691], p = .012). The differences between experts and amateur players mainly manifest in spatial cognition and attention. Sensitivity analysis, risk of bias, and publication bias results indicated the reliability of these findings. Conclusions: This meta-analysis confirms that esports experts possess superior cognitive abilities compared to amateurs, particularly in aspects of spatial cognition and attention. These can provide an effective reference for future selection and training in esports.

The association between social support and prosocial behavior: A three-level meta-analysis.

Numerous studies have examined the relationship between social support and prosocial behavior and have concluded that social support is an important factor in generating prosocial behavior. However, different studies have produced different conclusions, and the moderating effect on the relationship is not entirely clear. The current study uses a three-level meta-analysis method to clarify the relationship between social support and prosocial behavior, and explores the moderating variables that affect the relationship between the two variables. Through a systematic literature search, a total of 92 studies, 418 effect sizes, and 74,378 participants were obtained. The main effects test found a significant positive correlation between social support and prosocial behavior. Tests of the moderating effects indicated that the relationship between social support and prosocial behavior was moderated by year of publication, source of social support, measurement of social support and measurement of prosocial behavior. In summary, social support plays an important role in prosocial behavior, and exploring their relationship is beneficial to families, schools and society in guiding individuals' prosocial behavior.

Effects of game-based digital interventions for mental disorders: A meta-analysis.

With increasing research attention on game-based digital interventions for mental disorders, a number of studies have been conducted to explore the effectiveness of digital game-based interventions on mental disorders. However, findings from previous research were inconsistent. Thus, we conducted a comprehensive meta-analytic review of the effectiveness of game-based digital interventions for mental disorders. By searching the articles in databases, we identified 53 studies in which 2433 participants were involved, and 282 effect sizes were extracted. Among the 53 studies, 14 employed within-group (pre/post) designs, and the remaining 39 utilized controlled trial designs. Using a three-level random-effects meta-analytic model, a medium effect size of game-based digital interventions (g = 0.47, 95 % CI: 0.33, 0.61) was revealed in the controlled trial designs and a close-to-medium effect size (g = 0.45, 95 % CI: 0.32, 0.58) was found in the within-group (pre/post) designs, indicating close-to-medium-sized efficacy of game-based digital interventions for mental disorders. Moderator analyses showed that age in the controlled trial designs had contributed to the heterogeneity in previous studies, suggesting that interventions might be more effective for the elderly. However, given that only a limited number of studies were focused on the elderly, more studies with older participants should be conducted in the future to provide more robust evidence and explore the mechanisms of how digital gaming interventions can be more effective in improving mental disorders symptoms.

Anterior Cervical Discectomy and Fusion with Zero-Profile Anchored Spacer Versus Plate and Cage for 3-Level Contiguous Cervical Degenerative Disease: A Systematic Review and Meta-Analysis.

OBJECTIVE: To compare the safety, clinical outcomes, and radiological results of anterior cervical discectomy and fusion (ACDF) with zero-profile anchored spacer (ZPAS) versus plate and cage (PC) for 3-level contiguous cervical degenerative disease. METHODS: The study was registered at PROSPERO (CRD42024512706). The Web of Science core collection, PubMed, and Embase were searched up to February 12, 2024. Review Manager 5.3 was used. The relative risk (RR) and 95% confidence interval were evaluated for dichotomous data. Continuous data were assessed using the mean difference and 95% confidence interval. RESULTS: Nine studies comparing ACDF with ZPAS versus PC for 3-level contiguous cervical degenerative disease were included. The intraoperative blood loss and operation time in ZPAS were significantly less than those in PC. The subsidence rate, loss of cervical alignment, fusion segmental height, and intervertebral disc height were significantly greater in ZPAS than in PC. The cervical alignment and dysphagia rate within 6 months were significantly lower in ZPAS than in PC. The ASD of ZPAS was significantly lower than that of PC according to the sensitivity analysis when 1 study was excluded. No significant differences were identified in the other aspects. CONCLUSIONS: Both ACDF with ZPAS and PC were safe and effective procedures. PC was associated with increased surgical trauma. The ZPAS could better decrease the incidence of ASD and dysphagia. ZPAS was also accompanied by high subsidence rate and poor cervical alignment.

Biomechanical Effects on the Prostheses and Vertebrae of Three-Level Hybrid Surgery: A Finite Element Study.

PURPOSE: Three-level hybrid surgery (HS) consisting of cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) has been partly used for the treatment of multi-level cervical degenerative disc disease (CDDD). The complications related to the implants and the collapse of the surgical vertebral bodies had been reported in multi-level anterior cervical spine surgery. Thus, this study aimed to explore the biomechanical effects on the prostheses and vertebrae in three-level HS. METHODS: A FE model of cervical spine (C0-T1) was constructed. Five surgical models were developed. They were FAF model (ACDF-CDA-ACDF), AFA model (CDA-ACDF-CDA), FFF model (three-level ACDF), SF model (single-level ACDF), and SA model (single-level CDA). A 75-N follower load and 1.0-N·m moment was applied to produce flexion, extension, lateral bending, and axial rotation. RESULTS: Compared with the intact model, the range of motion (ROM) of total cervical spine in FAF model decreased by 34.54%, 54.48%, 31.76%, and 27.14%, respectively, in flexion, extension, lateral bending, and axial rotation, which were lower than those in FFF model and higher than those in AFA model. The ROMs of CDA segments in FAF and AFA models were similar to the intact model and SA model. Compared with the intact model, the ROMs at C3/4 segment in FFF model increased from 5.71% to 7.85%, and increased from 5.31% to 6.81% at C7/T1 segment, following by FAF model, then the FAF model. The maximum interface pressures of the Prestige-LP in FAF model were similar to SA model, however the corresponding values were increased in AFA model. The maximum interface pressures of the Zero-P were increased in FAF and AFA model compared with those in SF and FFF models. The stress was mainly distributed on the screws. In AFA model, the maximum pressures of the ball and trough articulation in superior and inferior Prestige-LP were all increased compared with those in SA and FAF model. In FFF model, the maximum pressures of the vertebrae were higher than those in other models. The stress was mainly distributed on the anterior area of the vertebral bodies. CONCLUSIONS: HS seemed to be more suitable than ACDF for the surgical treatment of three-level CDDD in consideration of the biomechanical effects, especially for the two-level CDA and one-level ACDF construct. But a more appropriate CDA prosthesis should be explored in the future.

The association between trait mindfulness and sleep problems: A three-level meta-analysis.

Trait mindfulness has shown potential in relieving the symptoms related to sleep problems, but the relationship between trait mindfulness and sleep problems varies across studies. To explore this association and obtain reliable estimates, a three-level meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach. A comprehensive literature search identified 86 studies involving 87 independent samples and 35,521 participants. A total of 441 effect sizes were analyzed. The study indicated a negative association between trait mindfulness and sleep problems. Furthermore, the meta-analysis revealed significant moderating effects of study design, mindfulness facets, and measurement for trait mindfulness on this relationship. This study suggests that trait mindfulness is closely related to the alleviation of sleep problems. Furthermore, trait mindfulness is vital important in strengthening prevention and intervention measures targeting individuals' sleep problems.

High-performance finite-time adaptive control strategy for three-level T-type converters.

Three-level T-type converters are necessary interfaces for distributed energy resources to interact with the public grid. Naturally, designing a control strategy, featuring superior dynamics and strong robustness, is a promising solution to guarantee the efficient operation of converters. This article presents an improved finite-time control (IFTC) strategy for three-level T-type converters to enhance the dynamic performance and anti-disturbance capacity. The IFTC strategy integrates a dual-loop structure to regulate the dc-link voltage and grid currents. Specifically, the voltage regulation loop employs a finite-time adaptive controller that can counteract load disturbances without relying on current sensors. In the current tracking loop, finite-time controllers combined with a command filter are constructed to obtain fast and accurate current tracking. In this loop, the command filter is utilized to avoid calculating the derivative of current references. Theoretical analysis and experimental results demonstrate the IFTC strategy's effectiveness.

Baseline trait mindfulness moderates the efficacy of mindfulness interventions and active controls: A meta-analysis of 177 randomised controlled trials.

Previous evidence suggests that benefits of mindfulness-based interventions (MBIs) may depend on individuals' baseline trait mindfulness (BTM) levels. This meta-analysis investigated moderating effects of BTM on changes in mental health outcomes and trait mindfulness in randomised controlled trials (RCTs) of MBIs. A total of 177 primary studies (total N = 13,486), comparing the treatment effects of MBIs against active, treatment-as-usual (TAU) and waitlist control groups, were synthesised via three-level meta-analysis. Lower BTM was associated with larger changes in mental health outcomes (B = -0.14, 95% CI [-0.21, -0.06], p < .001) and trait mindfulness (B = -0.09 [-0.16, -0.02], p = .009) in MBIs and active controls combined. These associations were significantly larger than from those in TAU and waitlist controls. Moderating effects were less tangible for changes in trait mindfulness in MBIs and active controls individually and less tangible in various sensitivity analyses which, however, were confounded by client type across the RCTs. Individuals low in BTM may, by a small effect size, benefit more from MBIs and active control interventions. BTM may thus affect the evaluation of treatment efficacy. MBIs and active interventions could be offered specifically to persons low in BTM.

Effects of chronic physical exercise on executive functions and episodic memory in clinical and healthy older adult populations: a systematic review and meta-analysis protocol.

BACKGROUND: Executive functions (EFs) and episodic memory are fundamental components of cognition that deteriorate with age and are crucial for independent living. While numerous reviews have explored the effect of exercise on these components in old age, these reviews screened and analyzed selected older adult populations, or specific exercise modes, thus providing only limited answers to the fundamental question on the effect of exercise on cognition in old age. This article describes the protocol for a systematic review and multilevel meta-analytic study aiming at evaluating the effectiveness of different types of chronic exercise in improving and/or maintaining EFs and long-term episodic memory in older adults. METHODS AND ANALYSIS: The study protocol was written in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Several databases will be searched. Randomized controlled trials (RCTs) conducted in older adults aged ≥ 60 years providing any kind of planned, structured, and repetitive exercise interventions, and EFs and/or episodic memory measures as outcomes, published in English in peer-reviewed journals and doctoral dissertations will be included. Two independent reviewers will screen the selected articles, while a third reviewer will resolve possible conflicts. The Cochrane risk-of-bias tool will be used to assess the quality of the studies. Finally, data will be extracted from the selected articles, and the formal method of combining individual data from the selected studies will be applied using a random effect multilevel meta-analysis. The data analysis will be conducted with the metafor package in R. DISCUSSION AND CONCLUSION: This review will synthesize the existing evidence and pinpoint gaps existing in the literature on the effects of exercise on EFs and episodic memory in healthy and unhealthy older adults. Findings from this meta-analysis will help to design effective exercise interventions for older adults to improve and/or maintain EFs and episodic memory. Its results will be useful for many researchers and professionals working with older adults and their families. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022367111.

Cost and environmental analysis and optimization of a new and green three-level waste heat recovery-based cogeneration cycle: A comparative study.

Effective and maximum utilization of waste heat from industrial processes and fossil plants can improve thermodynamic performance and declined the environmental impacts of waste heat discharge to the atmosphere. Here, the multi-aspect assessment and optimization of a novel cogeneration power and cooling load cycle (CPCC) is developed. The considered cogeneration process is designed under a three-level waste heat recovery process consisting of an ORC (organic Rankine cycle) unit and an ejection-based refrigeration process. Thermodynamic performance, cost feasibility and environmental assessments of the suggested process have been comprehensively evaluated and discussed. A two-objective optimization is developed to minimize the total cost and maximize the exergy efficiency. Moreover, the comprehensive CPCC behavior is compared with a reference system (a single-level recovery/ORC process and a compression-based refrigeration process). The performance of the considered CPCC is also examined under various environmentally compatible refrigerants. The environmental analysis is based on two indicators (i.e., life cycle-climate performance and total equivalent-warming impacts). Due to the multi-level recovery of waste heat, the environmental impacts of emitting waste heat into the environment are significantly reduced. The outcomes revealed that the R1234/yf is considered as the most suitable refrigerant that can causes to optimum achievements for both systems. The exergetic performance is improved by about 10.3% compared to that reference system, while the exergy destruction and total annual cost of the CPCC, respectively, are reduced by approximately 7.4% and 21.6% compared to the reference cycle. It was also found that about 11,640 tons of carbon dioxide can be reduced by using the ejector in the refrigeration process.

Clinical Evidence, Triangulation of Perspectives and Contextualization. Part 1: The Beginning of Carla's Treatment.

We propose to critically evaluate and strengthen the level of clinical evidence in psychoanalysis, using a strategy of triangulating clinical phenomena from different perspectives and increasing contextual knowledge. Insufficient discussion of alternative hypotheses and limited contextual information are two Achilles heels of psychoanalytic case presentations. We examine the concept and quality standards of clinical evidence in psychoanalysis and related disciplines, with particular attention to the contribution of the three-level model (3-LM). We analyze the case of a patient treated with transference-focused psychotherapy (TFP), making explicit the theoretical-clinical agreements and disagreements of the authors. We discuss the strengths and limitations of triangulation and contextualization, concluding that they make clinical work and psychoanalytic writing more reliable, transparent, auditable, and replicable.

[Features of medical care provision in the profile «Maxillofacial surgery¼ in the Southern Federal District of the Russian Federation]. / Osobennosti okazaniya meditsinskoi pomoshchi po profilyu «chelyustno-litsevaya khirurgiya¼ v Yuzhnom federal'nom okruge Rossiiskoi Federatsii.

OBJECTIVE: To study the actual state of the organization of medical care for patients with the profile of «maxillofacial surgery¼ in the Southern Federal District of the Russian Federation in order to develop proposals for its optimization within the framework of a three-level system of medical care. MATERIAL AND METHODS: We analyzed accounting and reporting materials characterizing the organization of medical care in the field of «Oral and maxillofacial surgery¼ to the population in the Southern Federal District of the Russian Federation. RESULTS: The population of the Southern Federal District of the Russian Federation is currently provided with accessible round-the-clock medical care in the field of maxillofacial surgery. The forces and means at the disposal of the district government allow this to be implemented. However, the article describes a number of obstacles to the provision of high-quality medical care in the field of maxillofacial surgery and suggests ways to eliminate them. CONCLUSION: Preparation of an Order defining the functioning of a three-level system of medical care for adults and children with maxillofacial pathology in the Southern Federal District of the Russian Federation, as well as more effective use of telemedicine consultations will significantly improve the availability and quality of medical care.

The effect of dance on mental health and quality of life of people with Parkinson's disease: A systematic review and three-level meta-analysis.

OBJECTIVES: Parkinson's disease (PD) is a neurodegenerative disease that affects millions of individuals worldwide. Dance has emerged as a comprehensive intervention for enhancing well-being in this population. This meta-analysis aimed to assess the effectiveness of dance on mental health and quality of life among individuals with PD. METHODS: Three databases were searched in December 2022. Research papers comparing the effects of dance with a non-dance control on the quality of life or mental health of individuals with PD were included. Two authors independently screened the studies, extracted data, and assessed methodological quality of eligible studies. To address the interdependence of effect sizes within studies, the three-level meta-analysis approach was employed to analyze the data. RESULTS: Thirteen trials involving a total of 496 participants were included, with 11 being subjected to statistical analysis. The results indicated that dance had a positive impact on mental health (g = 0.43, 95 % CI = [0.11, 0.75]) and quality of life (g = 0.46, 95 % CI = [-0.04, 0.95]) when compared to passive control groups. Moderator analyses revealed that non-partnered dance and dance interventions with lower total dosages were particularly beneficial for mental health. CONCLUSION: Dance interventions are an effective lifestyle activity for enhancing mental health and quality of life in individuals with PD. A theoretical framework is proposed to explain the impact of dance on well-being from neurological, social, physical, and psychological perspectives.

Carbon-Related Quantum Emitter in Hexagonal Boron Nitride with Homogeneous Energy and 3-Fold Polarization.

Most hexagonal boron nitride (hBN) single-photon emitters (SPEs) studied to date suffer from variable emission energy and unpredictable polarization, two crucial obstacles to their application in quantum technologies. Here, we report an SPE in hBN with an energy of 2.2444 ± 0.0013 eV created via carbon implantation that exhibits a small inhomogeneity of the emission energy. Polarization-resolved measurements reveal aligned absorption and emission dipole orientations with a 3-fold distribution, which follows the crystal symmetry. Photoluminescence excitation (PLE) spectroscopy results show the predictability of polarization is associated with a reproducible PLE band, in contrast with the non-reproducible bands found in previous hBN SPE species. Photon correlation measurements are consistent with a three-level model with weak coupling to a shelving state. Our ab initio excited-state calculations shed light on the atomic origin of this SPE defect, which consists of a pair of substitutional carbon atoms located at boron and nitrogen sites separated by a hexagonal unit cell.

The Association Between Emotion Recognition and Internalizing Problems in Children and Adolescents: A Three-Level Meta-Analysis.

Numerous studies have explored the link between how well youth recognize emotions and their internalizing problems, but a consensus remains elusive. This study used a three-level meta-analysis model to quantitatively synthesize the findings of existing studies to assess the relationship. A moderation analysis was also conducted to explore the sources of research heterogeneity. Through a systematic literature search, a total of 42 studies with 201 effect sizes were retrieved for the current meta-analysis, and 7579 participants were included. Emotion recognition was negatively correlated with internalizing problems. Children and adolescents with weaker emotion recognition skills were more likely to have internalizing problems. In addition, this meta-analysis found that publication year had a significant moderating effect. The correlation between emotion recognition and internalizing problems decreased over time. The degree of internalizing problems was also found to be a significant moderator. The correlation between emotion recognition and internalizing disorders was higher than the correlation between emotion recognition and internalizing symptoms. Deficits in emotion recognition might be relevant for the development and/or maintenance of internalizing problems in children and adolescents. The overall effect was small and future research should explore the clinical relevance of the association.

Fingerprinting and characterization of the polysaccharides from Polygonatum odoratum and the in vitro fermented effects on Lactobacillus johnsonii.

Polygonatum odoratum (Yu-Zhu) can be utilized to treat the digestive and respiratory illness. Previous studies have revealed that the underlying therapeutic mechanism of P. odoratum polysaccharides (POPs) is associated with remodeling the gut microbiota. However, POPs in terms of the chemical composition and fermentation activities have been understudied. Here we developed the three-level fingerprinting approaches to characterize the structures of POPs and probed into the beneficial effects on promoting the growth and fermentation of Lactobacillus johnsonii. POPs were prepared by water decoction followed by alcohol sedimentation, while trifluoroacetic acid under different conditions to prepare the hydrolyzed oligosaccharides and monosaccharides. POPs exhibited three main molecular distribution of 601-620 kDa, 4.12-6.09 kDa, and 3.57-6.02 kDa. Hydrolyzed oligosaccharides with degree of polymerization (DP) 2-13 got primarily characterized by analyzing the rich fragmentation information obtained by hydrophilic interaction chromatography/ion mobility-quadrupole time-of-flight mass spectrometry (HILIC/IM-QTOF-MS). Amongst them, the DP5 oligosaccharide was characterized as 1,6,6-kestopentaose. The molecular ratio of Fru: Ara: Glc: Gal: Xyl was 87.72: 0.30: 11.56: 0.19: 0.23. In vitro fermentation demonstrated that 4.5 mg/mL of POPs could significantly promote the growth of L. johnsonii. Co-cultivated with 4.5 mg/mL of POPs, L. johnsonii exhibited stronger antimicrobial activity against Klebsiella pneumoniae. The concentrations of short-chain fatty acids in the POPs-lactobacilli fermented products, including acetic acid, isobutyric acid, and isovaleric acid, were increased. Conclusively, POPs represent the promising prebiotic candidate to facilitate lactobacilli, which is associated with exerting the health benefits.

Bayesian pattern-mixture models for dropout and intermittently missing data in longitudinal data analysis.

Valid inference can be drawn from a random-effects model for repeated measures that are incomplete if whether the data are missing or not, known as missingness, is independent of the missing data. Data that are missing completely at random or missing at random are two data types for which missingness is ignorable. Given ignorable missingness, statistical inference can proceed without addressing the source of the missing data in the model. If the missingness is not ignorable, however, recommendations are to fit multiple models that represent different plausible explanations of the missing data. A popular choice in methods for evaluating nonignorable missingness is a random-effects pattern-mixture model that extends a random-effects model to include one or more between-subjects variables that represent fixed patterns of missing data. Generally straightforward to implement, a fixed pattern-mixture model is one among several options for assessing nonignorable missingness, and when it is used as the sole model to address nonignorable missingness, understanding the impact of missingness is greatly limited. This paper considers alternatives to a fixed pattern-mixture model for nonignorable missingness that are generally straightforward to fit and encourage researchers to give greater attention to the possible impact of nonignorable missingness in longitudinal data analysis. Patterns of both monotonic and non-monotonic (intermittently) missing data are addressed. Empirical longitudinal psychiatric data are used to illustrate the models. A small Monte Carlo data simulation study is presented to help illustrate the utility of such methods.