Some recent developments in modeling quantile treatment effects

This paper provides a selective review of the recent developments on econometric/statistical modeling in quantile treatment effects under both selection on observables and on unobservables.First,we discuss identification,estimation and inference of quantile treatment effects under the framework of selection on observables.Then,we consider the case where the treatment variable is endogenous or self-selected,for which an instrumental variable method provides a powerful tool to tackle this problem.Finally,some extensions are discussed to the data-rich environments,to the regression discontinuity design,and some other approaches to identify quantile treatment effects are also discussed.In particular,some future research works in this area are addressed.

Pharmacological Treatment of Adult Attention-Deficit/Hyperactivity Disorder(ADHD)in a Longitudinal Observational Study:Estimated Treatment Effect Strengthened by Improved Covariate Balance

An improved method for estimation of causal effects from observational data is demonstrated. Applications in medicine have been few, and the purpose of the present study is to contribute new clinical insight by means of this new and more sophisticated analysis. Long term effect of medication for adult ADHD patients is not resolved. A model with causal parameters to represent effect of medication was formulated, which accounts for time-varying confounding and selection-bias from loss to follow-up. The popular marginal structural model (MSM) for causal inference, of Robins et al., adjusts for time-varying confounding, but suffers from lack of robustness for misspecification in the weights. Recent work by Imai and Ratkovic?[1][2] achieves robustness in the MSM, through improved covariate balance (CBMSM). The CBMSM (freely available software) was compared with a standard fit of a MSM and a naive regression model, to give a robust estimate of the true treatment effect in 250 previously non-medicated adults, treated for one year, in a specialized ADHD outpatient clinic in Norway. Covariate balance was greatly improved, resulting in a stronger treatment effect than without this improvement. In terms of treatment effect per week, early stages seemed to have the strongest influence. An estimated average reduction of 4 units on the symptom scale assessed at 12 weeks, for hypothetical medication in the 9 - 12 weeks period compared to no medication in this period, was found. The treatment effect persisted throughout the whole year, with an estimated average reduction of 0.7 units per week on symptoms assessed at one year, for hypothetical medication in the last 13 weeks of the year, compared to no medication in this period. The present findings support a strong and causal direct and indirect effect of pharmacological treatment of adults with ADHD on improvement in symptoms, and with a stronger treatment effect than has been reported.

Improving Model Specifications When Estimating Treatment Effects across Alternative Medical Interventions

Objective: The purpose of this paper is to critique the list of independent variables commonly used in observational research and test the impact of variables for prior use and treatment history on estimates of treatment effects. Methods: Using data from the California Medicaid program, this study generated a series of OLS estimates of the effect of atypical antipsychotic medications on costs and duration of therapy to illustrate the impact of alternative model specifications on treatment effects. The first sequence of estimates consisted of six model specifications, the last of which included variables reflecting the type of episode defined according to prior treatment history and compliance. The second sequences repeated the specification of the first 6 models but were carried out separately by episode type to examine the heterogeneity of treatment effect. The second sequence of models documented the impact of additional drug history variables. Results: Estimates of the impact of atypical antipsychotic use on total costs and duration on initial drug were statistically significant in the first 6 models. Estimates changed significantly when dummy variables indicating prior use of inpatient service and nursing home care were included in the model specification. Estimated effects changed substantially when prior total cost was included in cost analysis, or when prior treatment duration was included in duration analysis. Significant variation also existed in estimated effects across episode types, and it was particularly pronounced before controlling for prior cost/duration. Conclusion: It is important to add prior measures of the outcome variable to control for unobserved bias in retrospective studies. Also, the accuracy and utility of results to clinicians can be improved significantly if analyses are performed by episode type.

Robust Estimation of Average Treatment Effects with Observational Studies

Estimating treatment effects has always been one of the hot issues in empirical research.It brings great challenges to estimating treatment effects because heterogeneity exists in the distribution of covariates between treated and controlled groups.Propensity score methods have been widely used to adjust for heterogeneity in observational studies.However,the propensity score is usually unknown and needs to be estimated.In this article,we propose a generalized single-index model to estimate the propensity score and use the propensity score residuals to reduce the estimation bias.The finite-sample performance of the proposed method is evaluated through simulation stud-ies.We use the proposed method to evaluate the policy of"Sunshine Running"and find that the physical test scores of college students par-ticipating in the"Sunshine Running"can be improved by 3.72 points.

Evaluation of the Efficacy and Effectiveness of Hysteroscopic Electroresection in the Treatment of Submucosal Uterine Fibroids

Objective:To evaluate the effect of hysteroscopic electroresection in treating submucosal uterine fibroids.Methods:Using the random number table method,70 patients with submucosal uterine fibroids were divided into two groups,35 cases/group.The control group underwent laparoscopic myomectomy,and the observation group underwent hysteroscopic electroresection.Surgical indicators,sex hormone indicators,inflammation indicators,and treatment effects were compared between the two groups.Results:The surgical indicators,sex hormone indicators,and inflammatory indicators three months after operation in the observation group were all more ideal than those of the control group.The total effective rate of the observation group(97.14%)was higher than that of the control group(P<0.05).Conclusion:Hysteroscopic electroresection for the treatment of submucosal uterine fibroids was less invasive,accelerates recovery,and is more effective.

Analysis of the Effectiveness of Modified Non- Traumatic Filling Technology in the Treatment of Pediatric Dental Caries

Objective:To analyze the effectiveness of modified non-traumatic filling technology in the treatment of pediatric dental caries.Methods:Ninety-seven children with dental caries who were treated in our hospital(Panyu Maternal and Child Care Service Center of Guangzhou)from January 2022 to December 2023 were selected and randomly divided into two groups,with 48 cases in the experimental group and 49 in the control group.The experimental group was treated with modified non-traumatic filling techniques,while the control group was treated with conventional filling techniques.Observation indicators such as the total effectiveness of the treatment,incidence of adverse events,treatment compliance,and pain scores were analyzed after the intervention.Result:After intervention,the total effectiveness of the treatment in the experimental group was higher than that in the control group(P<0.05).The incidence of adverse events in the experimental group was lower than that of the control group(P<0.05).The treatment compliance of patients in the experimental group was higher than that in the control group(P<0.05).The pain score of the experimental group was lower than that of the control group(P<0.05).Conclusion:The application of modified non-traumatic filling technology in the treatment of pediatric dental caries showed good therapeutic outcomes.After the intervention,the child’s symptoms were significantly alleviated,the incidence of adverse events such as filling material falling off was reduced,their compliance was improved,and the pain was relieved.This procedure is worth to be promoted for clinical application.

Estimation of Treatment Effects in Nonlinear Models with Unobserved Confounding

Estimation of treatment effects is one of the crucial mainstays in economics and sociology studies.The problem will become more serious and complicated if the treatment variable is endogenous for the presence of unobserved confounding.The estimation and conclusion are likely to be biased and misleading if the endogeny of treatment variable is ignored.In this article,we propose the pseudo maximum likelihood method to estimate treatment effects in nonlinear models.The proposed method allows the unobserved confounding and random error terms to exist in an arbitrary relationship(such as,add or multiply),and the unobserved confounding have different influence directions on treatment variables and outcome variables.The proposed estimator is consistent and asymptotically normally distributed.Simulation studies show that the proposed estimator performs better than the special regression estimator,and the proposed method is stable for various distribution of error terms.Finally,the proposed method is applied to the real data that studies the influence of individuals have health insurance on an individual’s decision to visit a doctor.

Therapeutic effect of Wendan Decoction combined with mosapride on gastroesophageal reflux disease after esophageal cancer surgery

BACKGROUND Gastroesophageal reflux disease(GERD)is a common complication of esophageal cancer surgery that can affect quality of life and increase the risk of esophageal stricture and anastomotic leakage.Wendan Decoction(WDD)is a traditional Chinese herbal formula used to treat various gastrointestinal disorders,such as gastritis,functional dyspepsia,and irritable bowel syndrome.Mosapride,a prokinetic agent,functions as a selective 5-hydroxytryptamine 4 agonist,enhancing gastrointestinal motility.AIM To evaluate the therapeutic effects of WDD combined with mosapride on GERD after esophageal cancer surgery.METHODS Eighty patients with GERD were randomly divided into treatment(receiving WDD combined with mosapride)and control(receiving mosapride alone)groups.The treatment was conducted from January 2021 to January 2023.The primary outcome was improved GERD symptoms as measured using the reflux disease questionnaire(RDQ).The secondary outcomes were improved esophageal motility(measured using esophageal manometry),gastric emptying(measured using gastric scintigraphy),and quality of life[measured via the Short Form-36(SF-36)Health Survey].RESULTS The treatment group showed a notably reduced RDQ score and improved esophageal motility parameters,such as lower esophageal sphincter pressure,peristaltic amplitude,and peristaltic velocity compared to the control group.The treatment group showed significantly higher gastric emptying rates and SF-36 scores(in both physical and mental domains)compared to the control group.No serious adverse effects were observed in either group.CONCLUSION WDD combined with mosapride is an effective and safe therapy for GERD after esophageal cancer surgery.It can improve GERD symptoms,esophageal motility,gastric emptying,and the quality of life of patients.Further studies with larger sample sizes and longer follow-up periods are required to confirm these findings.

Comparison of Covariate Balance Weighting Methods in Estimating Treatment Effects

Different covariate balance weighting methods have been proposed by researchers from different perspectives to estimate the treatment effects.This paper gives a brief review of the covariate balancing propensity score method by Imai and Ratkovic(2014),the stable balance weighting procedure by Zubizarreta(2015),the calibration balance weighting approach by Chan,et al.(2016),and the integrated propensity score technique by Sant’Anna,et al.(2020).Simulations are conducted to illustrate the finite sample performance of both the average treatment effect and quantile treatment effect estimators based on different weighting methods.Simulation results show that in general,the covariate balance weighting methods can outperform the conventional maximum likelihood estimation method while the performance of the four covariate balance weighting methods varies with the data generating processes.Finally,the four covariate balance weighting methods are applied to estimate the treatment effects of the college graduate on personal annual income.

Performance of a water hyacinth(Eichhornia crassipes)system in the treatment of wastewater from a duck farm and the effects of using water hyacinth as duck feed

Nowadays, intensive breeding of poultry and livestock of large scale has made the treatment of its waste and wastewater an urgent environmental issue, which motivated this study. A wetland of 688 mz was constructed on an egg duck farm, and water hyacinth （Eichhornia crassipes） was chosen as an aquatic plant for the wetland and used as food for duck production. The objectives of this study were to test the role of water hyacinth in purifying nutrient-rich wastewater and its effects on the ducks＇ feed intake, egg laying performance and egg quality. This paper shows that the constructed wetland removed as much as 64.44% of chemical oxygen demand （COD）, 21.78% of total nitrogen （TN） and 23.02% of total phosphorus （TP）. Both dissolved oxygen （DO） and the transparency of the wastewater were remarkably improved, with its transparency 2.5 times higher than that of the untreated wastewater. After the ducks were fed with water hyacinth, the average daily feed intake and the egg-laying ratio in the test group were 5.86% and 9.79% higher, respectively, than in the control group; the differences were both significant at the 0.01 probability level. The egg weight in the test group was 2.36% higher than in the control group （P 〈 0.05）, but the feed conversion ratios were almost the same. The eggshell thickness and strength were among the egg qualities significantly increased in ducks fed with water hyacinth. We concluded that a water hyacinth system was effective for purifying wastewater from an intensive duck farm during the water hyacinth growing season, as harvested water hyacinth had an excellent performance as duck feed. We also discussed the limitations of the experiment.

Impact of failure mode and effects analysis-based emergency management on the effectiveness of craniocerebral injury treatment

BACKGROUND Craniocerebral injuries encompass brain injuries,skull fractures,cranial soft tissue injuries,and similar injuries.Recently,the incidence of craniocerebral injuries has increased dramatically due to the increased numbers of traffic accidents and aerial work injuries,threatening the physical and mental health of patients.AIM To investigate the impact of failure modes and effects analysis(FMEA)-based emergency management on craniocerebral injury treatment effectiveness.METHODS Eighty-four patients with craniocerebral injuries,treated at our hospital from November 2019 to March 2021,were selected and assigned,using the random number table method,to study(n=42)and control(n=42)groups.Patients in the control group received conventional management while those in the study group received FMEA theory-based emergency management,based on the control group.Pre-and post-interventions,details regarding the emergency situation;levels of inflammatory stress indicators[Interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)];incidence of complications;prognoses;and satisfaction regarding patient care were evaluated for both groups.RESULTS For the study group,the assessed parameters[pre-hospital emergency response time(9.13±2.37 min),time to receive a consultation(2.39±0.44 min),time needed to report imaging findings(1.15±4.44 min),and test reporting time(32.19±6.23 min)]were shorter than those for the control group(12.78±4.06 min,3.58±0.71 min,33.49±5.51 min,50.41±11.45 min,respectively;P<0.05).Pre-intervention serum levels of IL-6(78.71±27.59 pg/mL),CRP(19.80±6.77 mg/L),and PCT(3.66±1.82 ng/mL)in the study group patients were not significantly different from those in the control group patients(81.31±32.11 pg/mL,21.29±8.02 mg/L,and 3.95±2.11 ng/mL respectively;P>0.05);post-intervention serum indicator levels were lower in both groups than pre-intervention levels.Further,serum levels of IL-6(17.35±5.33 pg/mL),CRP(2.27±0.56 mg/L),and PCT(0.22±0.07 ng/mL)were lower in the study group than in the control group(30.15±12.38 pg/mL,3.13±0.77 mg/L,0.38±0.12 ng/mL,respectively;P<0.05).The complication rate observed in the study group(9.52%)was lower than that in the control group(26.19%,P<0.05).The prognoses for the study group patients were better than those for the control patients(P<0.05).Patient care satisfaction was higher in the study group(95.24%)than in the control group(78.57%,P<0.05).CONCLUSION FMEA-based craniocerebral injury management effectively shortens the time spent on emergency care,reduces inflammatory stress and complication risk levels,and helps improve patient prognoses,while achieving high patient care satisfaction levels.

A new quantile treatment effect model for studying smoking effect on birth weight during Mother's pregnancy

This paper proposes a new quantile regression model to characterize the heterogeneity for distributional effects of maternal smoking during pregnancy on infant birth weight across different the mother's age.By imposing a parametric restriction on the quantile functions of the potential outcome distributions conditional on the mother's age,we estimate the quantile treatment effects of maternal smoking during pregnancy on her baby's birth weight across different age groups of mothers.The results show strongly that the quantile effects of maternal smoking on low infant birth weight are negative and substantially heterogenous across different ages.

Quantile treatment effect estimation with dimension reduction

Quantile treatment effects can be important causal estimands in evaluation of biomedical treatments or interventions for health outcomes such as medical cost and utilisation.We consider their estimation in observational studies with many possible covariates under the assumption that treatment and potential outcomes are independent conditional on all covariates.To obtain valid and efficient treatment effect estimators,we replace the set of all covariates by lower dimensional sets for estimation of the quantiles of potential outcomes.These lower dimensional sets are obtained using sufficient dimension reduction tools and are outcome specific.We justify our choice from efficiency point of view.We prove the asymptotic normality of our estimators and our theory is complemented by some simulation results and an application to data from the University of Wisconsin Health Accountable Care Organization.

Observation on the Curative Effect of Auricular Acupoint Sticking Combined with Acupoint Sticking in the Treatment of Diabetic Constipation

The study was conducted to observe the clinical effect of acupoint and auricular point application on diabetes patients with constipation.Around 104 patients with diabetes and constipation were selected from the Hospital Shaanxi University of Chinese Medicine from February 2021 to February 2022 as the study subjects.They were divided into groups by drawing lots.The experimental group carried out the combined analysis of acupoint and auricular point application based on the treatment methods of the control group.Meanwhile,the control group carried out the traditional treatment,and the evaluation index,including the improvement of constipation and the clinical effective rate data were included in the analysis.This study showed that,the total effective number of patients,times of defecation per week,time of defecation,and interval of defecation in the experimental group were greater,compared to control group(p<0.05).In summary,diabetes patients with constipation,the auricular plaster and acupoint application can effectively improve the constipation symptoms,shorten the defecation time,improve the cure rate of the disease,and ensure the normal defecation cycle in the patients.

The Effect of the Early Application of Tirofiban on Acute Ischemic Stroke (AIS) after Intravenous Thrombolysis with Urokinase

Objective:Discussion and analysis of the effect of the early application of Tirofiban on acute ischemic stroke(AIS)after intravenous thrombolysis with urokinase.Method:The subjects of this study are 40 patients with AIS admitted at the Yibin Fourth People’s Hospital,of which were computer-randomized into a control group(20 cases,with regular urokinase intravenous thrombolysis therapy)and a research group(20 cases,combined with early Tirofiban treatment)from January 2018 to December 2022.The intervention outcomes between these two groups were compared and analyzed.Result:The blood platelet-related parameters before treatment had no statistical difference between the two groups(P>0.05),but the research group was higher than that of the control group after treatment(P<0.05).The Barthel index before treatment in both groups had no statistical difference(P>0.05),but the research group was higher than that of the control group after treatment(P<0.05).Conclusion:Early Tirofiban treatment for patients with AIS after intravenous thrombolysis with urokinase could effectively regulate the blood platelet-related parameters,hence improving treatment benefits and living capacity for patients,with definite clinical benefits.

Interferon beta(IFN-β) treatment exerts potential neuroprotective effects through neurotrophic factors and novel neurotensin/neurotensin high affinity receptor 1 pathway

Multiple sclerosis（MS）is a chronic autoimmune disease of the central nervous system（CNS）characterized by coexisting processes of inflammation,demyelination,axonal neurodegeneration,and gliosis.It is the most common disabling neurological disease in young adulthood.

“Crowbar Effect”技术促进球囊跨过高阻力冠状动脉慢性完全性闭塞病变的有效性和安全性研究

背景经皮冠状动脉介入治疗(PCI)开通冠状动脉慢性完全性闭塞(CTO)失败的原因之一是球囊不能跨过CTO病变。目的评估“Crowbar Effect”技术促进球囊穿过冠状动脉高阻力CTO病变的有效性和安全性,为开通CTO提供一种可选择的新技术和提高CTO开通的成功率。方法选择2010年1月—2019年1月在首都医科大学附属北京安贞医院和北华大学附属医院应用前向技术治疗冠状动脉CTO病变患者648例,其中导丝通过了病变,而球囊不能跨过的高阻力CTO病变84例(12.96%),对其应用“Crowbar Effect”技术促使小球囊通过CTO病变,完成PCI。观察PCI成功率和主要不良心血管事件(MACE)。结果84例CTO病变的J-score评分为(1.63±0.90)分。在第1条导丝成功穿过CTO病变后,由于使用了“Crowbar Effect”技术,小球囊穿透CTO病变的成功率为91.67%(77/84)。仍有7例(8.33%)失败,其中2例因360°严重钙化病变和5例冠状动脉穿孔而失败。84例患者未发生围术期心源性死亡和非致死性心肌梗死。结论“Crowbar Effect”技术是一种有效且安全的技术,可使小型球囊穿过普通球囊不可穿透的CTO病变。应用这种简单的技术开通CTO有很高的成功率和应用价值。

Effect of Treatment Temperature on Iron Nitride Foils Irradiated with Nitrogen Plasma

We investigated the effect of treatment temperature on the magnetic property of iron nitride foils irradiated with nitrogen plasma. The iron nitride foils irradiated with nitrogen plasma were composed of ε-Fe2/3N, γ'-Fe4N and γ nitrogen austenite in α-Fe of the matrix. The saturation magnetization of the iron nitride foils decreased with increasing the surface temperature. The coercive force of the iron nitride foils increased with increasing the surface temperature.