Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-04-03 Cooperative journals: 《中国全科医学》
Abstract： Background Acute ischemic stroke （AIS） is the second leading cause of death worldwide after coronary heart disease. Acute kidney injury （AKI） is one serious complication after AIS，and homocysteine （Hcy） may be an important factor associated with AKI and accelerated deterioration of renal function. However，there are few studies on the relationship between Hcy and AKI，especially in patients with AIS. Objective To investigate the relationship between plasma Hcy level and AKI in patients with AIS，and to provide new ideas for the prevention and treatment of AKI. Methods Baseline clinical data of 1 202 patients with AIS who were admitted to Department of Neurology，the Second Hospital of Tianjin Medical University were collected from the electronic medical record systemfrom January 2018 to April 2021. Patients were divided into normal Hcy（Hcy ≤ 15 μmol/L， n=618），mild hyperhomocysteinemia （HHcy）（15 μmol/L30 μmol/L， n=125）groups according to the Expert Consensus on the Diagnosis，Treatment，and Prevention of Hyperhomocysteinemia. Patients were divided into AKI group and non-AKI group by the values of ambulatorily monitored renal function and urine volume within seven days after admission recommended in the KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases. Multivariate Logistic regression was used to explore the effects of Hcy on post-AIS AKI as a continuous variable and a categorical variable，respectively. Subgroup analysis was used to investigate the relationship between Hcy and AKI in subgroups. The nonlinear relation between Hcy and AKI was explored by restricted cubic spline regression. Results One hundred and fifty patients （12.48%） developed AKI in all subjects. Multivariate Logistic regression showed that after adjustment for potential confounders， the risk of AKI increased by 1.035 times〔 OR=1.035，95%CI（1.019，1.052）， P<0.05〕 for every 1 μmol/L increase in Hcy. With reference to normal Hcy，mild and moderate-to-severe HHcy has been associated with a 1.770-fold〔 OR=1.770，95%CI（1.150，2.724）， P<0.05〕and 2.927-fold 〔 OR=2.927，95%CI（1.671，5.126）， P<0.05〕 increased risk of AKI，separately. Subgroup analysis found that the risk of AKI after AIS increased with the increase of Hcy level （used as a continuous variable）in females，those aged ≥ 75 years，those with hypertension，diabetes or moderate to severe stroke at admission，and those whose stroke type was large-artery atherosclerosis （LAA），small artery occlusion （SAO） or cardio embolism （CE）（ P<0.05）. When Hcy was analyzed as a categorical variable，mild HHcy was associated with a higher risk of AKI compared with normal Hcy in the male population，those aged<75 years，those with hypertension，diabetes，a history of stroke or mild stroke at admission，and those without coronary heart disease（ P<0.05）. And moderate-to-severe HHcy was associated with a higher risk of AKI compared with normal Hcy in the female population，those with hypertension，diabetes，or moderate or moderate-to-severe stroke at admission，and those whose stroke type was LAA，SAO or CE regardless of age，coronary heart disease and history of stroke（ P<0.05）. Restricted cubic regression manifested that there was a nonlinear correlation between Hcy and the risk of AKI，and the curve was convex（ P=0.026）. The risk of AKI after AIS increased rapidly with the increase of Hcy when admission Hcy was less than 17 mmol/L，but increased slowly with the increase of Hcy when admission Hcy was greater than or equal to 17 mmol/L.Conclusion Elevated Hcy is a risk factor for AKI whether as a continuous variable or a categorical variable in AIS patients. So monitoring the level of Hcy is conducive to early identification and prevention of AKI，which is helpful to improve the prognosis in AIS patients.
Subjects: Psychology >> Developmental Psychology submitted time 2023-03-28 Cooperative journals: 《心理科学进展》
Abstract： The change point analysis (CPA), as one of the most widely used methods for statistical process control, is introduced to psychological and educational measurement for detection of aberrant response patterns in recent years. CPA outperforms the traditional method as follows: In addition to detecting aberrant response patterns, it can also pinpoint the locations of change points, contributing to efficient cleansing of response data. The method is employed to determine whether there is a point so that the complete sequence can be divided into two parts with different statistical properties, where person-fit statistics (PFS) is needed for quantifying the difference between two sub-sequences. Future researchers should pay more attention to multiple change points detection, making full use of other effective information like response time data, developing non-parametric indices as well as reforming the exiting person-fit statistics for polytomous and multidimensional tests, so as to enhance its applicability and power.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-09 Cooperative journals: 《中国全科医学》
Abstract：
Background Acute ischemic stroke (AIS) is the second leading cause of death worldwide after coronary heart disease. Acute kidney injury (AKI) is one of the serious complications, and homocysteine (Hcy) may be an important factor leading to AKI and accelerating deterioration of renal function. However, there are few studies on the relationship between Hcy and AKI, especially in patients with AIS. Objective To investigate the relationship between plasma homocysteine (Hcy) level and acute kidney injury (AKI) in patients with acute ischemic stroke (AIS), and to provide new ideas for the prevention and treatment of AKI. Methods 1202 patients with AIS admitted to the Department of Neurology, the Second Hospital of Tianjin Medical University were selected from January 2018 to April 2021. Patients were divided into normal Hcy, mild hyperhomocysteinemia (HHcy) and moderate-severe HHcy group according to plasma Hcy levels. Multi-factor logistic regression was used to explore the effects of Hcy on post-AIS AKI as a continuous variable and a classified variable respectively. Subgroup analysis was used to investigate the relationship between Hcy and AKI in subgroups. The nonlinear relation between Hcy and AKI was explored by restricted cubic spline regression. Results 150 patients (12.48%) developed AKI in all subjects. Multi-factor logistic regression showed that after adjustment for potential confounding variables, the risk of AKI increased by 1.035 times (95%CI: 1.019-1.052) for every 1μmol/L increase in Hcy. With reference to normal Hcy patients, mild and moderate-severe HHcy has been associated with a 1.770-fold (95%CI: 1.150~2.724) and 2.927-fold (95%CI: 1.671-5.126) increased risk of AKI, separately. Subgroup analysis demonstrated that no matter as a categorical variable or a continuous variable, Hcy had a more significant effect on AKI in patients with a history of hypertension, diabetes or stroke than those without underlying diseases. Restricted cubic regression manifested that there was a nonlinear correlation between Hcy and the risk of AKI, and the curve was convex. Conclusions Hcy is a risk factor for AKI whether as a continuous variable or a categorical variable in AIS patients. Monitoring the level of Hcy is conducive to early identification and prevention of AKI, and improve the prognosis in AIS patients.
Subjects: Psychology >> Psychological Measurement submitted time 2020-05-12
Abstract：变点分析法(change point analysis, CPA)近些年才引入心理与教育测量学，相较于传统方法，CPA不仅可以侦查异常作答被试，还能自动精确地定位变点位置，高效清洗作答数据。其原理在于：判断作答序列中是否存在可将该序列划分为具有不同统计学属性两部分的点(即变点)，并且需使用被试拟合统计量(person-fit statistic, PFS)来量化两个子序列之间的差异。未来可将单变点分析拓展至多变点，结合反应时等信息，构建非参数化指标以及将现有指标拓展至多级计分或多维测验，以提高CPA的适用广度及效力。
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