Defending a victimized peer is a socially risky behavior that may require high peer status and may depend on how popular or disliked bullies are in the classroom (i.e., within-classroom correlations ...between bullying and status). Past research has investigated defending as a unidimensional construct, though it can involve confronting the bully (bully-oriented defending) or supporting the victim (victim-oriented defending). This study used multilevel modeling to examine the effects of individual peer status, gender, and bullying as well as two indicators of classroom norms—the bullying-popularity norm and the bullying-rejection norm—on both types of defending. Our sample included 1,460 Dutch adolescents (50% girls; M
age 11 years) from 59 classrooms in 50 schools. Likability and popularity were positively associated with both types of defending. Being female and lower in bullying was associated with victim-oriented defending, whereas being male and higher in bullying was associated with bully-oriented defending. In classrooms where bullies were more rejected, both types of defending were more prevalent, and the positive associations of likability and popularity with victim-oriented defending were stronger. The positive effect of the bullying-rejection norm on victim-oriented defending was stronger for girls. Moreover, the effect of popularity on bully-oriented defending was stronger in classrooms where bullies were less popular.
•Analyzing nonverbal behaviors with a multilevel hidden Markov model (HMM) uncovered latent interpersonal interaction dynamics.•The multilevelHMM predicted patient depression improvement in ...psychotherapy.•Improvement is characterized by patient hyperfocus when listening to their therapist.
Previous human ethology studies have demonstrated that the interpersonal interactions displayed in therapy by both patients and therapists influences a patient's depression improvement. Pairing novel statistical techniques such as the hidden Markov model (HMM), interpersonal interaction dynamics can be uncovered by partitioning time into empirically-derived nonverbal behavioral states. This approach allows for better patient-therapist behavioral dynamics distinctions in predicting depression improvement and, subsequently, for the processes behind depression improvement.
For the 39 participating patients, the first 15 min of the first or second therapy session was recorded on video to examine the interpersonal interaction behaviors of patients and therapists. The video recordings were encoded for vocalization, looking and leg movement behavior events at a 1 s frequency. A Bayesian multivariate multilevel HMM was fitted on the behavioral event data.
It is demonstrated that patients that show improvement in the depression score are characterized by interpersonal interaction dynamics of hyperfocus when listening to their therapist in psychotherapy when compared to non-improving patients. The data supports evidence for the emergence of differences in interpersonal interaction dynamics through changed durations of the patient hyper focused listening states, but not through changed state-switching dynamics over time.
Due to our relatively small sample size we could not fit multilevel HMMs composed of more than three hidden states.
We suggest that applying HMMs will aid human ethological behavior studies in uncovering interpersonal interaction dynamics that occur in therapy and be able to use these dynamics to predict patient depression symptom improvement.
Functional genetic analyses in mice rely on efficient and in-depth characterization of the behavioral spectrum. Automated home-cage observation can provide a systematic and efficient screening method ...to detect unexplored, novel behavioral phenotypes. Here, we analyzed high-throughput automated home-cage data using existing and novel concepts, to detect a plethora of genetic differences in spontaneous behavior in a panel of commonly used inbred strains (129S1/SvImJ, A/J, C3H/HeJ, C57BL/6J, BALB/cJ, DBA/2J, NOD/LtJ, FVB/NJ, WSB/EiJ, PWK/PhJ and CAST/EiJ). Continuous video-tracking observations of sheltering behavior and locomotor activity were segmented into distinguishable behavioral elements, and studied at different time scales, yielding a set of 115 behavioral parameters of which 105 showed highly significant strain differences. This set of 115 parameters was highly dimensional; principal component analysis identified 26 orthogonal components with eigenvalues above one. Especially novel parameters of sheltering behavior and parameters describing aspects of motion of the mouse in the home-cage showed high genetic effect sizes. Multi-day habituation curves and patterns of behavior surrounding dark/light phase transitions showed striking strain differences, albeit with lower genetic effect sizes. This spontaneous home-cage behavior study demonstrates high dimensionality, with a strong genetic contribution to specific sets of behavioral measures. Importantly, spontaneous home-cage behavior analysis detects genetic effects that cannot be studied in conventional behavioral tests, showing that the inclusion of a few days of undisturbed, labor extensive home-cage assessment may greatly aid gene function analyses and drug target discovery.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Soluble suppression of tumorigenicity-2 (sST2) predicts mortality in patients with heart failure. The predictive value of sST2 in patients with a left ventricular assist device remains unknown. ...Therefore, we studied the relationship between sST2 and outcome after left ventricular assist device implantation.
sST2 levels of patients with a left ventricular assist device implanted between January 2015 and December 2022 were included in this observational study. The median follow-up was 25 months, during which 1573 postoperative sST2 levels were measured in 199 patients, with a median of 29 ng/mL. Survival of patients with normal and elevated preoperative levels was compared using Kaplan-Meier analysis, which did not differ significantly (
=0.22) between both groups. The relationship between postoperative sST2, survival, and right heart failure was evaluated using a joint model, which showed a significant relationship between the absolute sST2 level and mortality, with a hazard ratio (HR) of 1.20 (95% CI, 1.10-1.130;
<0.01) and an HR of 1.22 (95% CI, 1.07-1.39;
=0.01) for right heart failure, both per 10-unit sST2 increase. The sST2 instantaneous change was not predictive for survival or right heart failure (
=0.99 and
=0.94, respectively). Multivariate joint model analysis showed a significant relationship between sST2 with mortality adjusted for NT-proBNP (N-terminal pro-B-type natriuretic peptide), with an HR of 1.19 (95% CI, 1.00-1.42;
=0.05), whereas the HR of right heart failure was not significant (1.22 95% CI, 0.94-1.59;
=0.14), both per 10-unit sST2 increase.
Time-dependent postoperative sST2 predicts all-cause mortality after left ventricular assist device implantation after adjustment for NT-proBNP. Future research is warranted into possible target interventions and the optimal monitoring frequency.
Genetic and environmental factors interact throughout life and give rise to individual differences, i.e., individuality. The diversifying effect of environmental factors is counteracted by genetic ...mechanisms to yield persistence of specific features (robustness). Here, we compared robustness between cohorts of isogenic mice of eight different commonly used strains by analyzing to what extent environmental variation contributed to individuality in each of the eight genotypes, using a previously published dataset. Behavior was assessed in the home-cage, providing control over environmental factors, to reveal within-strain variability in numerous spontaneous behaviors. Indeed, despite standardization and in line with previous studies, substantial variability among mice of the same inbred strain was observed. Strikingly, across a multidimensional set of 115 behavioral parameters, several strains consistently ranked high in within-strain variability (DBA/2J, 129S1/Sv A/J and NOD/LtJ), whereas other strains ranked low (C57BL/6J and BALB/c). Strain rankings of within-strain variability in behavior were confirmed in an independent, previously published behavioral dataset using conventional behavioral tests administered to different mice from the same breeding colonies. Together, these show that genetically inbred mouse strains consistently differ in phenotypic robustness against environmental variation, suggesting that genetic factors contribute to variation in robustness.
Aims
Since the withdrawal of HeartWare (HVAD) from the global market, there is an ongoing discussion if and which patients require prophylactically exchange for a HeartMate 3 (HM3). Therefore, it is ...important to study outcome differences between HVAD and HM3 patients. Because centres differ in patient selection and standard of care, we performed a propensity score (PS)‐based study including centres that implanted both devices and aimed to identify which HVAD patients are at highest risk.
Methods and results
We performed an international multi‐centre study (n = 1021) including centres that implanted HVAD and HM3. PS‐matching was performed using clinical variables and the implanting centre. Survival and complications were compared. As a sensitivity analysis, PS‐adjusted Cox regression was performed. Landmark analysis with conditional survival >2 years was conducted to evaluate long‐term survival differences. To identify which HVAD patients may benefit from a HM3 upgrade, Cox regression using pre‐operative variables and their interaction with device type was performed. Survival was significantly better for HM3 patients (P < 0.01) in 458 matched patients, with a median follow‐up of 23 months. Within the matched cohort, HM3 patients had a median age of 58 years, and 83% were male, 80% of the HVAD patients were male, with a median age of 59 years. PS‐adjusted Cox regression confirmed a significantly better survival for HM3 patients when compared with HVAD, with a HR of 1.46 (95% confidence interval 1.14–1.85, P < 0.01). Pump thrombosis (P < 0.01) and ischaemic stroke (P < 0.01) occurred less in HM3 patients. No difference was found for haemorrhagic stroke, right heart failure, driveline infection, and major bleeding. Landmark‐analysis confirmed a significant difference in conditional survival >2 years after implantation (P = 0.03). None of the pre‐operative variable interactions in the Cox regression were significant.
Conclusions
HM3 patients have a significantly better survival and a lower incidence of ischaemic strokes and pump thrombosis than HVAD patients. This survival difference persisted after 2 years of implantation. Additional research using post‐operative variables is warranted to identify which HVAD patients need an upgrade to HM3 or expedited transplantation.
Aims
Left ventricular assist device therapy has become the cornerstone in the treatment of end‐stage heart failure and is increasingly used as destination therapy next to bridge to transplant or ...recovery. HeartMate 3 (HM3) and HeartWare (HVAD) are centrifugal continuous flow devices implanted intrapericardially and most commonly used worldwide. No randomized controlled trials have been performed yet. Analysis based on large registries may be considered as the best alternative but has the disadvantage of different standard of care between centres and missing data. Bias is introduced, because the decision which device to use was not random, even more so because many centres use only one type of left ventricular assist device. Therefore, we performed a propensity score (PS)‐based analysis of long‐term clinical outcome of patients that received HM3 or HVAD in a single centre.
Methods and results
Between December 2010 and December 2019, 100 patients received HVAD and 81 patients HM3 as primary implantation at the University Medical Centre Utrecht. We performed PS matching with an extensive set of covariates, resulting in 112 matched patients with a median follow‐up of 28 months. After PS matching, survival was not significantly different (P = 0.21) but was better for HM3. The cumulative incidences for haemorrhagic stroke (P = 0.01) and pump thrombosis (P = 0.02) were significantly higher for HVAD patients. The cumulative incidences for major bleeding, ischaemic stroke, right heart failure, and driveline infection were not different between the groups. We found no interaction between the surgeon who performed the implantation and survival (P = 0.59, P = 0.78, and P = 0.89). Sensitivity analysis was performed, by PS matching without patients on preoperative temporary support resulting in 74 matched patients. This also resulted in a non‐significant difference in survival (P = 0.07). The PS‐adjusted Cox regression showed a worse but non‐significant (P = 0.10) survival for HVAD patients with hazard ratio 1.71 (95% confidence interval 0.91–3.24).
Conclusions
Survival was not significantly different between both groups after PS matching, but was better for HM3, with a significantly lower incidence of haemorrhagic stroke and pump thrombosis for HM3. These results need to be interpreted carefully, because matching may have introduced greater imbalance on unmeasured covariates. A multicentre approach of carefully selected centres is recommended to enlarge the number of matched patients.
In neuroscience, experimental designs in which multiple observations are collected from a single research object (for example, multiple neurons from one animal) are common: 53% of 314 reviewed papers ...from five renowned journals included this type of data. These so-called 'nested designs' yield data that cannot be considered to be independent, and so violate the independency assumption of conventional statistical methods such as the t test. Ignoring this dependency results in a probability of incorrectly concluding that an effect is statistically significant that is far higher (up to 80%) than the nominal α level (usually set at 5%). We discuss the factors affecting the type I error rate and the statistical power in nested data, methods that accommodate dependency between observations and ways to determine the optimal study design when data are nested. Notably, optimization of experimental designs nearly always concerns collection of more truly independent observations, rather than more observations from one research object.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The multilevel hidden Markov model (MHMM) is a promising method to investigate intense longitudinal data obtained within the social and behavioral sciences. The MHMM quantifies information on the ...latent dynamics of behavior over time. In addition, heterogeneity between individuals is accommodated with the inclusion of individual-specific random effects, facilitating the study of individual differences in dynamics. However, the performance of the MHMM has not been sufficiently explored. We performed an extensive simulation to assess the effect of the number of dependent variables (1-8), number of individuals (5-90), and number of observations per individual (100-1600) on the estimation performance of a Bayesian MHMM with categorical data including various levels of state distinctiveness and separation. We found that using multivariate data generally alleviates the sample size needed and improves the stability of the results. Moreover, including variables only consisting of random noise was generally not detrimental to model performance. Regarding the estimation of group-level parameters, the number of individuals and observations largely compensate for each other. However, only the former drives the estimation of between-individual variability. We conclude with guidelines on the sample size necessary based on the level of state distinctiveness and separation and study objectives of the researcher.
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