Matched-pair Design Research Articles

Effects on Hypertension Control of Distributing Essential Medicines at No Charge: A Quasi-Experimental  Study In Rural Communities Of China

Background: Hypertension control is public health priority. Available and affordable medicines are regarded as important strategies for successfully controlling hypertension, but little is known about the causal effects of distributing essential medicines at no charge. Methods: People aged above 35 with new or poorly controlled hypertension were entitled to a hypertension management pilot program in Jiaonan rural areas, Qingdao, China. After community screening, the program referring to hypertension control focused on free (Captopril, Nitrendipine, and Compound Reserpine) and self-paid antihypertensive medicines recommended by physicians, accompanied by a multi-component intervention, including physician education on mediation-taken, and health behaviors promotion. Enrolled patients were classified into three groups: non-medicine users, free-medicine users and charged-medicine users. In this quasi-experimental study, pairwise comparison of blood pressure during followed-up period in the three groups were conducted using a matched pair design with propensity score matching. Individual net effects of specific free medicine regimen were then calculated by uplift modelling. Findings: After propensityscore matching, the control rate of blood pressure was higher for free-medicine users than non-medicine ones, and closer to that for charged-medicine users at the end of follow-up period. Judging from individual net effects, above 40% patients could benefit from these free medicines in the aspects of hypertension control. However, almost 50% had unnecessary or inappropriate medicine use. Interpretation: Overall, provision of free essential medicine, along with corresponding follow-up management, could work to reduce blood pressure to the reference range. Essential medicines, such as Captopril, Nitrendipine, and Compound Reserpine, could be applied as options of free anti-hypertensive medicine in China. Nevertheless, individual treatment effects should be taken into consideration to figure out the optimal medicine-prescribing strategy. Funding: National Natural Science Foundation of China and Key R & D projects of science and Technology Department of Shandong Province. Declaration of Interest: We declare no competing interests. Ethical Approval: This study was approved by the institutional ethics review board in Shandong University (No.20111126). All patients were asked to provide written, informed consent to permit the use of their data.

Effects of physical activity to cardiorespiratory changes

The current study aimed to investigate the effect of errorless learning (ELL) and errorful learning (EFL) on a discrete aiming task (dart-throwing). Thirty university students (male, n = 15; female, n = 15) with age of 22 ± 2.0 years old (M = 21.2; SD = 1.08) without any prior experience in dart-throwing participated in this study. After the pre-experimental evaluation, participants were randomly assigned into two groups (ELL and EFL group) by matched-pair design. There were three phases in the study, which were the acquisition, retention, and transfer phases. Both groups did not receive any instructions regarding the dart-throw. The results of variable error showed that there was a significant reduction in the ELL group over trials seemed to indicate that participants in ELL can utilize the learning to become more consistent in dart-throwing performance compared to the EFL group. The results in retention and transfer phases showed that the ELL group performed with significantly less error than the EFL group. The ELL group practiced with errorless learning performed with increased consistency during the retention phase compared to participants who practiced with errorful learning. The study concluded that implicit learning in errorless learning has been beneficial for the individual to get better dart-throwing performance as it can reduce the errors and lower cognitive demand when performing the task.

Errorless and errorful learning: the effect on the discrete throwing task

The current study aimed to investigate the effect of errorless learning (ELL) and errorful learning (EFL) on a discrete aiming task (dart-throwing). Thirty university students (male, n = 15; female, n = 15) with age of 22 ± 2.0 years old (M = 21.2; SD = 1.08) without any prior experience in dart-throwing participated in this study. After the pre-experimental evaluation, participants were randomly assigned into two groups (ELL and EFL group) by matched-pair design. There were three phases in the study, which were the acquisition, retention, and transfer phases. Both groups did not receive any instructions regarding the dart-throw. The results of variable error showed that there was a significant reduction in the ELL group over trials seemed to indicate that participants in ELL can utilize the learning to become more consistent in dart-throwing performance compared to the EFL group. The results in retention and transfer phases showed that the ELL group performed with significantly less error than the EFL group. The ELL group practiced with errorless learning performed with increased consistency during the retention phase compared to participants who practiced with errorful learning. The study concluded that implicit learning in errorless learning has been beneficial for the individual to get better dart-throwing performance as it can reduce the errors and lower cognitive demand when performing the task.

Complex training: Efektifitas Latihan Dalam Meningkatkan Power Otot Pada Atlet Bola Voli Remaja

Complex training is an exercise method that combines plyometrics with strength training. This exercise is an exercise used to increase muscle power. This study aims to determine the effect of training of complex training methods towards leg muscle power and arm muscle power for adolescent volleyball athletes. The method used in this study is an experiment with a control group pretest - post test design. Subjects in this study are 23 adolescent volleyball athletes (14-17 years old) with 12 males and 11 females, who are divided into two groups of experimental groups (n = 12) and control groups (n = 11) with randomized matched pair design based on the ranking of the vertical jump ability. Instrument used in this study is vertical jump test (leg power) and the medicine ball throw test (arm power). The data analysis technique uses the paired t-test with a significance level of α = 0.05. The results show that training using a complex training method provides a good benefit in improving leg and arm muscle power. Therefore, this method is appropriate for used by adolescent volleyball athletes that have had experience of weight training in improving muscle power towards adolescent volleyball athletes

Adding team-based financial incentives to the Carrot Rewards physical activity app increases daily step count on a population scale: a 24-week matched case control study

BackgroundMobile health applications (mHealth apps) targeting physical inactivity have increased in popularity yet are usually limited by low engagement. This study examined the impact of adding team-based incentives (Step Together Challenges, STCs) to an existing mHealth app (Carrot Rewards) that rewarded individual physical activity achievements.MethodsA 24-week quasi-experimental study (retrospective matched pairs design) was conducted in three Canadian provinces (pre-intervention: weeks 1–12; intervention: weeks 13–24). Participants who used Carrot Rewards and STCs (experimental group) were matched with those who used Carrot Rewards only (controls) on age, gender, province and baseline mean daily step count (±500 steps/d). Carrot Rewards users earned individual-level incentives (worth $0.04 CAD) each day they reached a personalized daily step goal. With a single partner, STC users could earn team incentives ($0.40 CAD) for collaboratively reaching individual daily step goals 10 times in seven days (e.g., Partner A completes four goals and Partner B completes six goals in a week).ResultsThe main analysis included 61,170 users (mean age = 32 yrs.; % female = 64). Controlling for pre-intervention mean daily step count, a significant difference in intervention mean daily step count favoured the experimental group (p < 0.0001; ηp2 = 0.024). The estimated marginal mean group difference was 537 steps per day, or 3759 steps per week (about 40 walking min/wk). Linear regression suggested a dose-response relationship between the number of STCs completed (app engagement) and intervention mean daily step count (adjusted R2 = 0.699) with each new STC corresponding to approximately 200 more steps per day.ConclusionDespite an explosion of physical activity app interest, low engagement leading to small or no effects remains an industry hallmark. In this paper, we found that adding modest team-based incentives to the Carrot Rewards app increased mean daily step count, and importantly, app engagement moderated this effect. Others should consider novel small-teams based approaches to boost engagement and effects.

Sleep Hygiene and Light Exposure Can Improve Performance Following Long-Haul Air Travel.

To assess the efficacy of a combined light exposure and sleep hygiene intervention to improve team-sport performance following eastward long-haul transmeridian travel. Twenty physically trained males underwent testing at 09:00 and 17:00hours local time on 4 consecutive days at home (baseline) and the first 4 days following 21hours of air travel east across 8 time zones. In a randomized, matched-pairs design, participants traveled with (INT; n = 10) or without (CON; n = 10) a light exposure and sleep hygiene intervention. Performance was assessed via countermovement jump, 20-m sprint, T test, and Yo-Yo Intermittent Recovery Level 1 tests, together with perceptual measures of jet lag, fatigue, mood, and motivation. Sleep was measured using wrist activity monitors in conjunction with self-report diaries. Magnitude-based inference and standardized effect-size analysis indicated there was a very likely improvement in the mean change in countermovement jump peak power (effect size 1.10, ±0.55), and likely improvement in 5-m (0.54, ±0.67) and 20-m (0.74, ±0.71) sprint time in INT compared with CON across the 4 days posttravel. Sleep duration was most likely greater in INT both during travel (1.61, ±0.82) and across the 4 nights following travel (1.28, ±0.58) compared with CON. Finally, perceived mood and motivation were likely worse (0.73, ±0.88 and 0.63, ±0.87) across the 4 days posttravel in CON compared with INT. Combined light exposure and sleep hygiene improved speed and power but not intermittent-sprint performance up to 96hours following long-haul transmeridian travel. The reduction of sleep disruption during and following travel is a likely contributor to improved performance.

Improving Public Sector Management at Scale? Experimental Evidence on School Governance India

We present results from a large-scale experimental evaluation of an ambitious attempt to improve management quality in Indian schools (implemented in 1,774 randomly-selected schools). The intervention featured several global “best practices” including comprehensive assessments, detailed school ratings, and customized school improvement plans. It did not, however, change accountability or incentives. We find that the assessments were near-universally completed, and that the ratings were informative, but the intervention had no impact on either school functioning or student outcomes. Yet, the program was perceived to be successful and scaled up to cover over 600,000 schools nationally. We find using a matched-pair design that the scaled-up program continued to be ineffective at improving student learning in the state we study. We also conduct detailed qualitative interviews with frontline officials and find that the main impact of the program on the ground was to increase required reporting and paperwork. Our results illustrate how ostensibly well-designed programs, that appear effective based on administrative measures of compliance, may be ineffective in practice. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

Adverse outcomes after major surgery in children with intellectual disability.

To evaluate outcomes after major surgery in children and adolescents with intellectual disability. We used 2004 to 2013 claims data from Taiwan's National Health Insurance programme to conduct a nested cohort study, which included 220292 surgical patients aged 6 to 17years. A propensity score matching procedure was used to select 2173 children with intellectual disability and 21730 children without intellectual disability for comparison. Logistic regression was used to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of the postoperative complications and 30-day mortality associated with intellectual disability. Children with intellectual disability had a higher risk of postoperative pneumonia (OR 2.16, 95% CI 1.48-3.15; p<0.001), sepsis (OR 1.67, 95% CI 1.28-2.18; p<0.001), and 30-day mortality (OR 2.04, 95% CI 1.05-3.93; p=0.013) compared with children without intellectual disability. Children with intellectual disability also had longer lengths of hospital stay (p<0.001) and higher medical expenditure (p<0.001) when compared with children with no intellectual disability. Children with intellectual disability experienced more complications and higher 30-day mortality after surgery when compared with children without intellectual disability. There is an urgent need to revise the protocols for the perioperative care of this specific population. Surgical patients with intellectual disability are at increased risk of postoperative pneumonia, sepsis, and 30-day mortality. Intellectual disability is associated with higher medical expenditure and increased length of stay in hospital after surgical procedures. The influence of intellectual disability on postoperative outcomes is consistent in both sexes and those aged 10 to 17 years. Low income and a history of fractures significantly impacts postoperative adverse events for patients with intellectual disability.

Maximum isometric tongue force in patients with obstructive sleep apnoea

BackgroundObstructive sleep apnea (OSA) is a sleep disorder with a prevalence of 9–38%. The underlying pathology in OSA is a collapse of the upper airway. Especially in more severely affected patients, this collapse is often located at the level of the tongue base. Therefore, various implantable systems (anchors and ligament techniques) were developed to prevent or overcome this collapse. These systems are exposed to various forces. Different models have been developed to measure these forces and data comparing forces in healthy individuals with OSA patients are rare.PurposePurpose of the study was to evaluate possible differences in tongue forces between healthy individuals and patients with OSA.MethodTo evaluate maximum isometric tongue forces, we conducted a matched pair design study including 20 healthy individuals and 20 patients suffering from OSA. Maximum isometric tongue forces were measured in an anterior/posterior direction with the help of self-designed new device that clamps the tongue.ResultsWe could show that the maximum isometric force does not differ significantly in healthy individuals (10.7 ± 5.2N) from patients with OSA (14.4 ± 6.3N).ConclusionCurrently there are no indications that maximum isometric tongue force does differ in healthy individuals and patients with OSA. Higher, as well as lower, tongue forces in patients with OSA seem not to differ from healthy subjects and therefore may not be needed to consider, in the development of tongue management devices, for OSA patients.

Health system affiliation of physician organizations and quality of care for Medicare beneficiaries who have high needs.

To test the hypothesis that health systems provide better care to patients with high needs by comparing differences in quality between system-affiliated and nonaffiliated physician organizations (POs) and to examine variability in quality across health systems. 2015 Medicare Data on Provider Practice and Specialty linked physicians to POs. Medicare Provider Enrollment, Chain, and Ownership System (PECOS) and IRS Form 990 data identified health system affiliations. Fee-for-service Medicare enrollment and claims data were used to examine quality. This cross-sectional analysis of beneficiaries with high needs, defined as having more than twice the expected spending of an average beneficiary, examined six quality measures: continuity of care, follow-up visits after hospitalizations and emergency department (ED) visits, ED visits, all-cause readmissions, and ambulatory care-sensitive hospitalizations. Using a matched-pair design, we estimated beneficiary-level regression models with PO random effects to compare quality of care in system-affiliated and nonaffiliated POs. We then limited the sample to system-affiliated POs and estimated models with system random effects to examine variability in quality across systems. Among 2323301 beneficiaries with high needs, 52.3% received care from system-affiliated POs. Rates of ED visits were statistically significantly different in system-affiliated POs (117.5 per 100) and nonaffiliated POs (106.8 per 100, P<.0001). Small differences in the other five quality measures were observed across a range of sensitivity analyses. Among systems, substantial variation was observed for rates of continuity of care (90% of systems had rates between 70.8% and 89.4%) and follow-up after ED visits (90% of systems had rates between 56.9% and 73.5%). Small differences in quality of care were observed among beneficiaries with high needs receiving care from system POs and nonsystem POs. Health systems may not confer hypothesized quality advantages to patients with high needs.

Cognitive, behavioral and psychological functioning of children and adults with conservatively managed metopic synostosis

ABSTRACT Children diagnosed with metopic synostosis (MS) commonly experience poor neuropsychological outcomes, with research suggesting that children whose MS is managed conservatively (without surgery) potentially having worse outcomes than their operated peers. However, studies of children whose MS was managed conservatively are scarce. This study therefore examined the cognitive, behavioral, and psychological functioning of children/adults with conservatively managed MS (N = 38) and compares their outcomes to individually matched healthy controls (N = 38) of the same age and sex (matched-pairs design) from the general community. Age-appropriate, validated assessments measuring general cognition, verbal and visuospatial ability, attention and working memory, executive functioning, behavior, depression, anxiety, and satisfaction with appearance were utilized. Group differences were estimated using linear regression for (a) the overall sample and (b) by broad developmental stages: 2&3 yrs; ≥6–≤17. Moderate to large negative effects (g = −0.38 to −1.30) were evident before controlling for socio-economic status (SES), with the MS group performing significantly worse on 8 out of the 10 cognitive domains (general cognition, visuospatial ability, working memory, information processing, executive functioning: semantic & initial letter verbal fluency, switching, inhibition+switching). However, only initial letter verbal fluency (g = −0.99) and switching (g = −1.19) remained significant after adjusting for SES. The MS group displayed more behavioral problems, although this was not significant. Depression, anxiety, and satisfaction with appearance did not differ between the groups. Regular monitoring of cognitive functioning, particularly executive functioning, should be undertaken for those with conservatively managed MS.

Metabolic Cost of Paddling on Different Commercially Available Kayak Ergometers.

To comparethe metabolic cost of paddling on different commercially available kayak ergometers using a standardized kayak incremental exercise protocol. Six male sprint kayak athletes undertook an incremental exercise protocol on 3 different kayak ergometers utilizing a randomized counterbalanced pair-matched design. Mean maximal aerobic power on the WEBA ergometer (265 [14]W) was significantly higher than on the Dansprint (238 [9]W) and KayakPro® (247 [21]W, P < .01, effect size [ES] = 0.80). At the fifth stage, absolute oxygen consumption on the WEBA (3.82 [0.25]L·min-1) was significantly lower (P < 0.05, ES = 0.20) than KayakProand Dansprint (4.10 [0.28] and 4.08 [0.27]L·min-1, respectively). Blood lactate concentration response at the sixth stage was significantly lower for the WEBA (3.5 [0.8]mmol·L-1), compared with KayakProand Dansprint (5.4 [1.2] and 5.6 [1.5] mmol·L-1, P = .012, ES = 0.20). Stroke rate was significantly higher, without any effect of pacing during the submaximal stages for the Dansprint, compared with the WEBA (P < .001, ES = 0.28) and KayakPro(P < .001, ES = 0.38). A pacing effect was present at the maximal stage for all ergometers. This study demonstrated that paddling on different kayak ergometers when controlling power output elicits different metabolic and work outputs. It is recommended that scientists and coaches avoid testing on different ergometers and regularly calibrate these devices. Moreover, when an ergometer has been calibrated against a first principle device, it is necessary to consider calibration of various drag settings, due to their impact on stroke rate. Further research should explore the relationship between drag settings and stroke rate.

Insights on Variance Estimation for Blocked and Matched Pairs Designs

Evaluating blocked randomized experiments from a potential outcomes perspective has two primary branches of work. The first focuses on larger blocks, with multiple treatment and control units in each block. The second focuses on matched pairs, with a single treatment and control unit in each block. These literatures not only provide different estimators for the standard errors of the estimated average impact, but they are also built on different sets of assumptions. Neither literature handles cases with blocks of varying size that contain singleton treatment or control units, a case which can occur in a variety of contexts, such as with different forms of matching or poststratification. In this article, we reconcile the literatures by carefully examining the performance of variance estimators under several different frameworks. We then use these insights to derive novel variance estimators for experiments containing blocks of different sizes.

The Impact of Strategic Change on Corporate Misconduct: A Situation-Specific Governance Approach

Firms undergo major strategic changes to realign their operations according to changing internal and external conditions. In this context, we examine the impact of the magnitude of strategic change on the likelihood of corporate misconduct as a severe negative consequence of firms’ strategic change activities. Building on the fraud triangle, we analyze how the three elements of motivation, opportunity, and rationalization simultaneously increase during times of strategic change. We use a matched-pairs design methodology (with 217 fraud cases identified through security class action lawsuits of listed U.S. organizations) and find a positive relationship between the magnitude of strategic change and the likelihood of corporate misconduct. However, this likelihood decreases with larger board sizes and a higher proportion of external CEOs as outside directors. The moderating effects identified in this study path the way towards situation-specific governance mechanisms that increase the board’s monitoring effectivity during unstable times, such as strategic change. The findings contribute to an enhanced understanding of specific situations in which firms require additional monitoring efforts to prevent increased risks of corporate misconduct.

How do academia and society react to erroneous or deceitful claims? The case of retracted articles’ recognition

Researchers give credit to peer-reviewed, and thus, credible publications through citations. Despite a rigorous reviewing process, certain articles undergo retraction due to disclosure of their ethical or scientific deficiencies. It is, therefore, important to understand how society and academia react to the erroneous or deceitful claims and purge the science of their unreliable results. Applying a matched-pairs research design, this study examined a sample of medicine-related retracted and non-retracted articles matched by their content similarity. The regression analysis revealed similarities in obsolescence trends of the retracted and non-retracted groups. The Generalized Estimating Equations showed that citations are affected by the retraction status, life after retraction, life cycle and the journals’ previous reputation, with the two formers being the strongest in positively predicting the citations. The retracted papers obtain fewer citations either before or after retraction, implying academia’s watchful reaction to the low-quality papers even before official announcement of their fallibility. They exhibit an equal or higher social recognition level regarding Tweets and Blog Mentions, while a lower status regarding Mendeley Readership. This could signify social users’ sensibility regarding scientific quality since they probably publicise the retraction and warn against the retracted items in their tweets or blogs, while avoiding recording them in their Mendeley profiles. Further scrutiny is required to gain insight into the sensibility, if any, about scientific quality. The study’s originality relies on matching the retracted and non-retracted papers with their topics and neutralising variations in their citation potentials. It is also the first study comparing the groups’ social impacts.

Psychological outcomes of MRSA isolation in spinal cord injury rehabilitation.

Study designRetrospective secondary analysis with a quantitative, matched-pairs design. Patients isolated due to methicillin-Resistant Staphylococcus aureus (MRSA) were matched with controls without MRSA infection admitted to a multi-bedded ward, based on: gender, injury level, injury severity (AIS grade), age at the time of injury and year of admission.ObjectivesDetermine the implications of MRSA-related infection isolation on spinal cord injury patients’ anxiety, depression, appraisals of disability, perceived manageability and pain intensity. Hypotheses predicted patients who were isolated due to MRSA during inpatient stay would demonstrate poorer psychological health outcomes at discharge in comparison with non-isolated matched controls.SettingNational Spinal Injuries Centre, England, UK.MethodsSecondary analyses were conducted on pre-existing data based on patients’ first admission for primary rehabilitation. Psychometric scales were used to measure outcome variables. Assessments were repeated at the time of admission and discharge.ResultsNonparametric longitudinal analyses using the nparLD package in R were conducted. Relative treatment effects demonstrated that there were no significant differences between groups across all outcome measures. There was a significant effect of time (admission vs discharge) on perceived manageability and pain intensity, indicating improved outcomes at discharge. There was no difference in the overall length of stay between the isolated and non-isolated groups.ConclusionsIsolation experienced by rehabilitation inpatients with spinal cord injury with MRSA had no effect on a series of psychological outcomes. Engaging with rehabilitation had a positive impact in reducing pain unpleasantness and increasing perceived manageability of spinal cord injury, irrespective of infection isolation.

Relationship between Interleukin-18 (IL-18) level and Mean Platelet Volume (MPV) with ischemic stroke event in Sanglah General Hospital, Bali, Indonesia

Background: Long-term stroke risk factors may lead to inflammation of endothelial vessels characterized by migration of macrophages and T-lymphocytes in blood vessel walls by releasing Interleukin-18 (IL-18) cytokines and causing changes in Mean Platelet Volume (MPV) values. This study aims to determine the relationship between IL-18 and MPV levels with ischemic stroke event in Sanglah General Hospital Denpasar. Methods: A matched-pair case-control study design was conducted in this study. The number of stroke and control samples were 33 people, respectively, and the dependent variable was an ischemic stroke, following MPV and IL-18 as dependent variables. Free T-2 sample test used to compare MPV in each group while the Mann-Whitney test used to compare the interleukin levels of the two groups. Data were analyzed using SPSS version 20 for Windows.Results: The MPV value of ischemic stroke patients was significantly higher (8.5±1.19 fL), whereas the MPV value at control was 0.00±0.44 fL (p&lt;0.05). The levels of IL-18 were statistically significantly higher in stroke patients (450.71±278.82 pg/ml) compared with controls (221.46 ± 127.83 pg/ml) (p&lt;0.05). With the Spearman correlation test, there was a significant moderate negative correlation between MPV value and ischemic stroke (r=-0.357; p=0.003) as well as IL-18 and ischemic stroke (r=-0.492;p=0.000).Conclusion: Our study suggests that there was a significant relationship between MPV and IL-18 value and ischemic stroke event at Sanglah General Hospital, Bali, Indonesia

Lake Zeiļu Clay Application Induced Changes in Human Skin Hydration, Elasticity, Transepidermal Water Loss and PH in Healthy Individuals

Clay has a great biomedical application potential, however there are just a few instrumental studies and the impact of lake clay on the skin has not yet been studied. The DermaLab skin analysis system (Cortex Technology) was used for hydration, elasticity, transepidermal water loss (TEWL) and pH measurements after lake clay facial applications. Research included short-term tests (measurements 20 and 60 min after clay application) and long-term tests (application every 4th day for 3 weeks with measurements 20–24 h post-application). Control measurements and application tests to exclude contact allergy were made beforehand. No volunteer (n = 30) had positive allergic reaction. The matched-pairs design was applied: the right and left parts of forehead were used for the test and control groups. The Wilcoxon signed-rank test (significance level p = 0.001) was applied for statistical analysis. There were statistically significant pH changes demonstrated during the short-term measurements. The long-term measurements provided data that clay significantly improves skin hydration and elasticity.

Association between Epstein-Barr virus infection and gastric cancer: a systematic review and meta-analysis

BackgroundNumerous studies conducted over the past 30 years have pointed to the presence of Epstein–Barr virus (EBV) in gastric cancer samples. This study was aimed to provide a meta-analytic review of the prevalence of EBV in gastric cancer patients, and to clarify the relationship between EBV infection and gastric cancer.MethodsA literature search was performed electronically using online databases for English language publications until July 1, 2019. The pooled EBV prevalence and 95% confidence intervals (CIs) were estimated using a random-effects model. To determine the association between EBV and gastric cancer, pooled odds ratio (OR) and its 95% CI were computed for case-control studies. Two separate analyses were performed on data from case-control studies with matched and non-match pairs designs to calculate the pooled estimates of ORs.ResultsThe pooled prevalence of EBV in 20,361 gastric cancer patients was 8.77% (95% CI: 7.73–9.92%; I2 = 83.2%). There were 20 studies with matched pairs design, including tumor and tumor-adjacent normal tissue pairs from 4116 gastric cancer patients. The pooled ORs were 18.56 (95% CI: 15.68–21.97; I2 = 55.4%) for studies with matched pairs design and 3.31 (95% CI: 0.95–11.54; I2 = 55.0%) for studies with non-matched pairs design. The proportion of EBV-associated gastric cancer among male cases was significantly higher than among female cases (10.83%, vs. 5.72%) (P < 0.0001). However, the pooled OR estimate for EBV-associated gastric cancer was significantly higher among females (21.47; 95% CI: 15.55–29.63; I2 = 0%) than in males (14.07; 95% CI: 10.46–18.93; I2 = 49.0%) (P = 0.06). EBV was more prevalent in the cardia (12.47%) and the body (11.68%) compared to the antrum (6.29%) (P = 0.0002).ConclusionsEBV infection is associated with more than 18 times increase the risk of gastric cancer. Although the prevalence of EBV was higher in male patients than in female patients with gastric cancer, women are more likely than men to develop EBV-associated gastric cancer. Our findings showed that using tumor-adjacent normal tissues as the control group provides more robust and accurate results regarding the relationship between EBV infection and gastric cancer.

A Medication Management Intervention for Patients and Families with SCI and ABI.

The purpose of this study was to develop and test the efficacy of a pre-discharge, medication management intervention to improve perceived knowledge and perceived confidence for post-discharge medication management for rehabilitation patients with spinal cord injuries (SCIs) and families of patients with SCIs or acquired brain injuries (ABIs). We used a quasi-experimental, matched-pair design. Treatment participants (n = 112) completed the intervention with pre- and post-tests assessing perceived knowledge and perceived confidence for post-discharge medication management. Control participants (n = 95) enrolled at 60-days post-discharge. All participants (N = 207) completed measures on perceived knowledge, perceived confidence, and medication management by phone at 60-days post-discharge. The intervention significantly increased treatment participants' perceived knowledge and perceived confidence from pre- to post-test. Sex, injury severity, and income were associated with primary outcomes. Treatment participants used more tools for medication management post-discharge. Our findings suggest that patients and family members may benefit from pre-discharge medication management interventions.