Response Effects Due to Bystander Presence in CASI and Paper-and-Pencil Surveys of Drug Use and Alcohol Use

In this study we investigated the influence of bystanders on self-administered interviews asking about the use of alcohol and illicit drugs. Interview participants were adolescents and young adults living in urban and suburban areas of the United States. Participants were assigned randomly to either a computerized or a paper-and-pencil self-administered interview. Results show that the impact of bystanders during the interview varies according to the identity of the bystander, age of the person interviewed, and the mode of interview. When a parent was present during the interview, survey participants were less likely to report the use of alcohol and marijuana. The influence of parents was stronger for adolescents than for young adults. The use of computer-assisted self-administered interviewing, compared to interviews with paper-and-pencil forms, reduced the effects due to the presence of parents during the interview. The presence of siblings during the interview had a small, negative effect on reports of using alcohol or illicit drugs. Among married or cohabiting respondents, the presence of the husband, wife, or live-in partner had no influence on reports of alcohol use or drug use. [Translations are provided in the International Abstracts Section of this issue.]     

精神分裂症患者的认知状况及其P300电位研究

目的 探讨P300电位在评价精神分裂症患者认知功能中的作用。方法 对40例精神分裂症患者和36例健康者分别进行P300电位测定和认知能力筛查试验(CASI),并将两组结果进行比较。结果 精神分裂症患者的P300电位成分中N2、P3潜伏期延长及P3波幅降低,与健康对照组存在显著性差异(P<0.01),CASI测定中9个因子分及总分患病组均低于健康对照组,两组存在显著性差异(P<0.01或P<0.05)。结论 P300电位可作为了解精神分裂症患者的认知状况的重要指标应用于临床。     

Disruptions of brain structural network in end-stage renal disease patients with long-term hemodialysis and normal-appearing brain tissues

ObjectiveEnd-stage renal disease (ESRD) patients on hemodialysis were demonstrated to exhibit silent and invisible white-matter alterations which would likely lead to disruptions of brain structural networks. Therefore, the purpose of this study was to investigate the disruptions of brain structural network in ESRD patients.Materials and methodsThiry-three ESRD patients with normal-appearing brain tissues and 29 age- and gender-matched healthy controls were enrolled in this study and underwent both cognitive ability screening instrument (CASI) assessment and diffusion tensor imaging (DTI) acquisition. Brain structural connectivity network was constructed using probabilistic tractography with automatic anatomical labeling template. Graph-theory analysis was performed to detect the alterations of node-strength, node-degree, node-local efficiency, and node-clustering coefficient in ESRD patients. Correlational analysis was performed to understand the relationship between network measures, CASI score, and dialysis duration.ResultsStructural connectivity, node-strength, node-degree, and node-local efficiency were significantly decreased, whereas node-clustering coefficient was significantly increased in ESRD patients as compared with healthy controls. The disrupted local structural networks were generally associated with common neurological complications of ESRD patients, but the correlational analysis did not reveal significant correlation between network measures, CASI score, and dialysis duration.ConclusionGraph-theory analysis was helpful to investigate disruptions of brain structural network in ESRD patients with normal-appearing brain tissues.     

Impaired memory and executive function associated with decreased medial temporal and prefrontal blood flow in Clinical Dementia Rating 0.5 status: the Osaki‐Tajiri project

Aim: The Clinical Dementia Rating (CDR) is an assessment of dementia severity based on observations of activities of daily living, and a CDR of 0.5 (CDR 0.5) represents questionable dementia. A combination of the Cognitive Abilities Screening Instrument (CASI) and the Trail Making Test (TMT) scores discriminated CDR 0.5 subjects from healthy participants with a high degree of accuracy. We investigated the neurological background of CDR 0.5 subjects by correlating CASI and TMT scores with regional cerebral blood flow (rCBF) as measured by single photon emission computed tomography (SPECT). Methods: From a community‐based cohort, 22 CDR 0.5 participants were recruited. CASI and TMT scores, rCBF measure using [¹²³I]‐N‐isopropyl‐p‐iodoamphetamine and SPECT were obtained. We evaluated the relationships between the CASI domain scores, between TMT scores and rCBF in a regions‐of‐interest‐based analysis, and voxel‐based analysis using Statistical Parametric Mapping 5 software. Results: We found that lower rCBF in the left medial temporal cortex correlated with a decreased CASI domain recent memory score both in the regions‐of‐interest and statistical parametric mapping analysis. In both the regions‐of‐interest and statistical parametric mapping analysis, the rCBF in the left prefrontal cortex correlated with CASI domain remote memory and mental manipulation and concentration. Conclusions: Our results indicate that some CDR 0.5 subjects have functional impairments in the medial temporal lobe as well as in the prefrontal cortex, as reflected in the cognitive decline measured by CASI and TMT.     

躯体形式障碍认知能力筛查实验与P300相关性研究

目的探讨躯体形式障碍患者的认知状况及P300电位在评价其认知功能中的临床价值。方法对32例躯体形式障碍患者和30例健康者分别进行了P300电位测定和认知能力筛查实验，并将两组结果加以比较。结果躯体形式障碍组P300电位成分中N2、P3波潜伏期[分别为（256．8±23．3）ms和（358．3±26．6）ms]较对照组[分别为（231．0±22．5）ms和（325．6±25．8）ms]延长，其N2波幅（5．7±2．6）μV、P3波幅（3．3±1．5）μV较对照组的（9．0±2．1）μV和（5．8±1．8）μV降低，差异有统计学意义（P〈0．01）；躯体形式障碍组筛查量表中9个因子分及总分值均低于对照组，差异有统计学意义（P〈0．05或0．01）；P3波潜伏期及波幅与认知能力筛查量表中9个因子分具有相关性，为P3波潜伏期与各因子分值呈负相关（P〈0．01），波幅则呈正相关（P〈0．01）。结论躯体形式障碍患者存在认知功能损伤；P300电位可作为评价躯体形式障碍患者认知状况的指标应用于临床。     

Audio‐computer‐assisted survey interview and patient navigation to increase chronic viral hepatitis diagnosis and linkage to care in urban health clinics

Intravenous drug use and sexual practices account for 60% of hepatitis C (HCV) and B (HBV) infection. Disclosing these activities can be embarrassing and reduce risk reporting, blood testing and diagnosis. In diagnosed patients, linkage to care remains a challenge. Audio‐computer‐assisted survey interview (Audio‐CASI) was used to guide HCV and HBV infection testing in urban clinics. Risk reporting, blood testing and serology results were compared to historical controls. A patient navigator (PN) followed up blood test results and provided patients with positive serology linkage to care (LTC). Of 1932 patients surveyed, 574 (30%) were at risk for chronic viral hepatitis. A total of 254 (44.3%) patients were tested, 34 (13.5%) had serology warranting treatment evaluation, and 64% required HBV vaccination. Of 16 patients with infection, seven HCV and three HBV patients started treatment following patient LTC. Of 146 HBV‐naïve patients, 70 completed vaccination. About 75% and 49% of HCV antibody and HBV surface antigen‐positive patients were born between 1945 and 1965. Subsequently, automated HCV testing of patients born between 1945 and 1965 was built into our hospital electronic medical records. Average monthly HCV antibody testing increased from 245 (January‐June) to 1187 (July‐October). Patient navigator directed LTC for HCV antibody‐positive patients was 61.6%. In conclusion, audio‐CASI can identify patients at risk for HCV or HBV infection and those in need of HBV vaccination in urban medical clinics. Although blood testing once a patient is identified at risk for infection needs to increase, a PN is useful to provide LTC of newly diagnosed patients.     

Efficacy of compound aluminum sulfate injection as a monotherapeutic regimen in non-muscle invasive bladder cancer patients: a retrospective single-arm cohort study

BackgroundCompound aluminum sulfate injection (CASI) originated from a Chinese traditional medicine, “Kuzhiye”, and has been used in treating non-muscle invasive bladder cancer (NMIBC). Previous studies suggested that CASI was a potential monotherapeutic drug for NMIBC. However, the efficacy and safety of CASI in the treatment of NMIBC, as well as the long-term recurrence after treatment, need to be further evaluated.MethodsA multicenter retrospective single-arm cohort study was conducted. From 2006 to 2009, 101 patients (74 men and 27 women, aged 58.9±11.9 years) with T1 or benign NMIBC were enrolled. Each patient was directly injected with CASI through catheter needle into the root of NMIBC. Vital signs, electrocardiography, blood count, blood biochemistry, and urine analysis were re-examined on day 2 and day 14 after CASI injection, together with a cystoscopic examination 4 weeks after CASI treatment was performed for all patients to assess the clinical activity and safety of CASI. To study long-term efficacy, patients in center 2 were followed up for recurrence with a median follow-up time of 13.8 years.ResultsFor the 101 patients enrolled in this study, demographic characteristics in the 3 centers showed no significant differences. After CASI, 2 patients showed administration site-dependent, but not dose-dependent, increase in their aluminum concentration in 24 hours without obvious abnormality in blood biochemistry. The overall effective rate was 97.03%, including complete tumor necrosis in 94 patients. Treatment-related adverse events occurred in 20 patients (19.80%), including 9 drug-related and 11 cystoscopy-related adverse events (AEs). All AEs were endurable and disappeared within 2 weeks without any treatment. The maximum tolerated single dose of CASI was 21 mL. Among the 43 patients at center 2, 3 patients were excluded because they changed to other treatment regimen. As of April 2022, of the 40 patients enrolled, 22 had no recurrence and 7 relapsed. The follow-up time was 2–16.2 years. The other 11 patients were lost to follow up.ConclusionsCASI may be an effective and safe option for the treatment of NMIBC and is expected to be a potential monotherapy regimen for NMIBC.     

Web-based,mobile-device friendly,self-report survey system incorporating avatars and gaming console techniques

We describe building an avatar-based self-report data collection tool to be used for a specific HIV prevention research project that is evaluating the feasibility and acceptability of this novel approach to collect self-reported data among youth. We discuss the gathering of requirements, the process of building a prototype of the envisioned system, and the lessons learned during the development of the solution. Specific knowledge is shared regarding technical experience with software development technologies and possible avenues for changes that could be considered if such a self-report survey system is used again. Examples of other gaming and avatar technology systems are included to provide further background.