Power and sample size estimation for interim analysis using PASS

Clinical significance of anti-mutated citrullinated vimentin antibodies in rheumatoid arthritis patients

BACKGROUND

Anti-mutated citrullinated vimentin (MCV) antibodies have recently been recommended as a better arthritis diagnostic marker.

OBJECTIVES

To investigate the association between anti-MCV antibodies and the clinical, functional, and radiographic characteristics of rheumatoid arthritis (RA) patients.

METHODS

This case-control study was conducted on 40 RA patients and 40 healthy subjects. All patients were subjected to an assessment of disease using the 28-joint DAS (DAS28) and Clinical Disease Activity Index (CDAI), function by HAQ-DI, physical activity by International Physical Activity Questionnaire (IPAQ), fatigue by Functional Assessment of Chronic Illness Therapy (FACIT), serological tests as well as anti-MCV Abs measurement. A plain X-ray of both hands and wrists was done.

RESULTS

The anti-MCV Abs level was significantly higher in RA patients than in healthy controls (P< 0.001). The anti-MCV Abs had a significant positive correlation with DAS, CDAI, HAQ, RF, Anti-CCP, and CRP (P= 0.006, 0.013, 0.005, < 0.001, < 0.001and 0.041 respectively) and a significant negative correlation with FACIT (p= 0.007). Positive anti-MCV RA patients had significantly higher erosions, JSN, and a total sharp score.

CONCLUSIONS

Anti-MCV Abs may contribute to poor physical activity and more fatigue in RA patients beyond their established role in disease activity and erosion.

Understanding the determinants for predicting citizens’ travel mode change from private cars to public transport in China

Rapid urbanization and motorization have generated increasing social and environmental challenges to the urban transport sector in China, such as traffic congestion, car accidents, air pollution, and global warming. Prioritizing the development of urban public transport system has been adopted as a primary strategy by Chinese government. However, the problems caused by large numbers of private cars are still far from being solved, and the ridership of public transport in China is relatively low. Therefore, the current study proposes a new comprehensive framework by enhancing the norm activation model (NAM) and theory of planned behavior (TPB) with the perceived accessibility to public transport, to better understand the determinants for predicting citizens’ choice of public transport as a sustainable travel mode. An online survey concerning travel mode change was conducted among citizens in Hangzhou, China. Based on 341 valid samples, partial least squares structural equation modeling (PLS-SEM) was employed to verify the proposed framework. The analytical results confirm that awareness of consequences and subjective norms are the two key constructs for connecting the two theories as a whole. Further, the examination of intention-behavior relationship shows that perceived accessibility to public transport could strengthen the relationship between behavioral intention and actual behavior in using public transport. The findings not only contribute to the development of pro-environmental theories, but also have meaningful implications for governments to develop relevant policies to encourage citizens to use public transport as a sustainable travel mode.

Effectiveness and validity of midsagittal tongue cross-sectional area and width measured by ultrasound to predict difficult airways

BACKGROUND

Increased tongue volume measured by ultrasound has been proven to be related to difficult airways. Tongue volume is an indirect parameter and is derived from multiplying the midsagittal tongue cross-sectional area (CSA) by the tongue width. However, few studies have focused on the ability of tongue CSA and tongue width to predict difficult airways. This study aimed to investigate the predictive value of tongue CSA and tongue width for predicting difficult laryngoscopy and difficult intubation.

METHODS

This study included 244 adult patients who underwent general anesthesia and endotracheal intubation. Demographic variables were collected, and clinical airway assessments were performed. A curvilinear low-frequency probe was used for ultrasonography, and midsagittal tongue CSA and tongue width were measured before anesthesia. The laryngoscopic view and the difficulty of intubation was graded or scored after induction of anesthesia.

RESULTS

A total of 230 patients were analyzed. Twenty-eight (12.2%) patients experienced difficult laryngoscopy and twelve (5.2%) patients experienced difficult intubation. Midsagittal tongue CSA evaluated by ultrasonography could help identify patients with difficult laryngoscopy (sensitivity 0.71, specificity 0.60) and patients with difficult intubation (sensitivity 0.50, specificity 0.97). And tongue width could help identify patients with difficult laryngoscopy (sensitivity 0.39, specificity 0.89).

CONCLUSIONS

Ultrasonic measurement of midsagittal tongue CSA may be a valuable predictor of difficult laryngoscopy and difficult intubation. By contrast, tongue width measured by ultrasound may be a weak predictor of difficult laryngoscopy, but its predictive ability was questionable.

Do Personal Norms Predict Citizens’ Acceptance of Green Transport Policies in China

In order to solve the environmental problems caused by the increasing private car use in China, such as transport energy consumption, traffic congestion, and air pollution, many policy measures including car purchase taxes, restrictions on car use in the city center, and incentives to promote electric vehicles have been developed. By taking Hangzhou, a low-carbon metropolitan city in China, as an illustrative example, green transport policies have been proactively implemented in order to turn the metropolitan city into an ecologically livable city. However, citizens’ acceptance of comprehensive green transport policies has seldom been studied and explored, which is actually quite valuable information for implementing and assessing the effectiveness of green transport policies. This study presents a new integrated framework by extending the value belief norm (VBN) theory in order to explore the internal factors for predicting citizens’ acceptance of comprehensive green transport policies and other pro-environmental behaviors in the transport field. A survey on car use reduction was conducted among citizens in Hangzhou and a quantitative analysis was performed using a structural equation model (SEM) method. Results show that personal norms can successfully predict citizens’ acceptance of pull policies for reducing car use, while is less capable of predicting that of push ones. The theoretical implications of different pro-environmental behaviors are explained. This analysis may inspire policy makers to implement appropriate policies to encourage the public to use low-carbon transport in daily life.