Modern mediation analysis techniques supplement the primary intention-to-treat analysis with the aim to shed light onto the treatment mechanism. We investigate to what extent the anatomic marker vitreomacular adhesion resolution (VMAR) mediates vision benefits, comparing ocriplasmin vs. a sham regimen. A causal mediation analysis is applied to randomized trial data including 218 participants with vitreomacular traction. Logistic regression models are used to estimate the total treatment effect (TTE) on binary outcomes. Outcomes, assessed at month 24, included visual acuity improvement (VA-I): ≥2-line increase in VA; visual function questionnaire improvement (VFQ-I): ≥5-point increase in the 25-item visual function questionnaire composite score (VFQ-25cs); visual function improvement (VF-I): defined as either a VA-I or a clinically meaningful improvement in the VFQ-25cs. Quantity of interest is the breakdown of TTE into an indirect (through VMAR) and direct effect to estimate the extent to which the TTE is transmitted through the mediating variable (VMAR) vs. other pathways. Causal effects are expressed as risk differences. Indirect effects for VFQ-I, VA-I, and VF-I are 5.7%, 11.8%, and 5.2%, respectively, representing the increase in the probability of a vision improvement if VMAR status were changed for each participant to the extent that it is affected by ocriplasmin. The direct effects are 8.3%, 12.1%, and 24.1% respectively, capturing the effect of treatment on the probability of a vision improvement if ocriplasmin left each participant's VMAR status unchanged. The relative treatment effect of ocriplasmin on the functional outcome VA-I is to a large extent the result of its effect on VMAR, while an improvement in the patient-reported outcomes VFQ-I or VF-I was only partially mediated by VMAR.
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http://dx.doi.org/10.3390/jmahp12040022 | DOI Listing |
Environ Res
December 2024
Social Epidemiology and Health Policy, Department of Family Medicine and Population Health, University of Antwerp, Doornstraat 331, BE-2610, Wilrijk, Belgium; Institute for Environment and Sustainable Development (IMDO), Groenenborgerlaan 171, BE-2020, Antwerpen, Belgium; Laboratory of Applied Microbiology and Biotechnology (LAMB), Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, BE-2020, Antwerpen, Belgium.
Introduction: Previous studies on prenatal green space exposure and early respiratory health show inconsistent results. This may reflect stage-specific in utero effects and pollen influence. We examine associations of surrounding greenness and pollen exposure during pregnancy (overall and by trimester) with preschool wheezing, and assess potential mediation by pollen.
View Article and Find Full Text PDFActa Psychol (Amst)
December 2024
School of Chinese Language and Literature, Beijing Foreign Studies University, Beijing 100089, China.
Introduction: The interaction between parents and children is a crucial determinant of adolescents' learning behavior, future orientation, and self-esteem. Moreover, positive relationships between parents and students significantly enhance these factors, promoting better academic and personal development outcomes.
Objective: This study aims to investigate the effects of parent-child contact on learning behavior, with future orientation and self-esteem serving as mediating factors.
BMC Womens Health
December 2024
Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria.
Background: Endometriosis is the most frequent gynecological diseases and accompanied by both physical and psychological symptoms. An increasing number of studies suggested acknowledging endometriosis as a systematic disease due to the multifactorial effects throughout the body. The chronic disease significantly impacts daily life, including romantic relationships.
View Article and Find Full Text PDFAtherosclerosis
December 2024
Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China. Electronic address:
Aims: This study aimed to explore the association between plasma caspase-1 levels and cardiovascular disease (CVD), as well as the potential mediating role of metabolic syndrome (Mets) in the association.
Methods: This study analyzed the UK Biobank Precision Proteomics Project (UKB-PPP), which detected plasma caspase-1 levels in participants. CVD was defined by ICD-9/ICD-10 codes.
Am J Hypertens
December 2024
Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Background: Systolic blood pressure (BP) is a key factor in the outcomes of patients with acute ischemic stroke (AIS) receiving endovascular thrombectomy (EVT). However, the factors that mediate the association between BP and clinical outcome are unclear.
Methods: Consecutive patients with AIS in the anterior circulation underwent continuous blood pressure monitoring for 24 hours.
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