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Background: Ecological momentary assessment (EMA) has become a popular method of gathering information about participants as they go about their daily lives. However, participant non-compliance, especially non-random compliance, in EMA is a concern. Better knowledge of the moment-to-moment factors that predict prompt non-response can inform the design of strategies to mitigate it.Method: We used data from a general population young adult (n = 260) EMA study, 'decades-to-minutes' (D2M) and fitted dynamic structural equation models (DSEMs) to explore a range of candidate momentary predictors of missing the next prompt.Results: We found that higher levels of stress, overall negative affect, and the specific negative affective state of 'upset' at a given prompt predicted a greater likelihood of missing the next prompt. However, no other specific affective states, alcohol use, experiencing social provocations nor aggressive behaviour predicted missing the next prompt.Limitations: The primary limitation of the present study was a lack of information on predictors concurrent with missed prompts.Conclusions: Findings point to the potential value of gathering information on momentary negative affect (especially feeling upset) and stress to help inform strategies that intervene to prevent application disengagement at optimal moments and to feed into strategies to mitigate bias due to non-random non-response in EMA studies. [ABSTRACT FROM AUTHOR]

In this paper, two generalized class such as ratio to exponential and the difference type of estimators have been proposed for estimating the finite population mean by utilizing information on higher order moments of an auxiliary variable in the two traditional situations of non-response. The expressions of biases and mean squared errors of the estimators are derived up to first order of approximation. The efficiency comparisons of the proposed methods over other contemporary estimators are carried out on real data sets. A simulation study is also performed to support the present study. The performance of the proposed methods are better than the others existing methods. Results are interpreted and suitable recommendations are made. [ABSTRACT FROM AUTHOR]

Individuals with body dysmorphic disorder (BDD) suffer from distressing or impairing preoccupations with perceived imperfections in their appearance. This often-chronic condition is associated with significant functional impairment and elevated rates of psychiatric comorbidity and morbidity, including depression, substance use disorders, and suicidality. Cognitive behavioral therapy (CBT) for BDD has been shown to be efficacious. However, this intervention is long (up to 24 weeks) relative to many manualized approaches for other related conditions, there is a significant shortage of clinicians trained in CBT for BDD, and some patients drop out of treatment and/or do not respond. Thus, there is great interest in understanding and predicting who is most likely to respond, to better allocate clinical resources. This secondary data analysis of participants enrolled in prior uncontrolled and controlled studies of CBT for BDD explored whether early response to CBT, operationalized as percentage change in symptom severity within the first four weeks and the first 12 weeks of this 24-week treatment, predicts clinical outcomes for patients with BDD (n = 90). The findings indicated that minimal early symptom change was not indicative of eventual non-response. This suggests that patients and clinicians should not be discouraged by limited early improvement but should instead continue with a full course of treatment before reevaluating progress and alternative interventions. Overall, the results support the view that treatment success is more likely if a longer CBT protocol is followed. More work is needed to understand mechanisms of change and thus match optimal interventions to patient characteristics. • Examined early response to CBT for BDD as a potential predictor of outcome. • Minimal early symptom change was not indicative of eventual non-response. • Patients and clinicians should be encouraged to follow a full course of CBT for BDD. [ABSTRACT FROM AUTHOR]

Non-response is unavoidable in any disaggregate-level survey efforts where information is sought from individuals. There is a strong need to understand the contributing factors of non-response behavior in freight surveys as there is very little information on what sort of establishments respond positively to survey inquiries. To meet this research gap, this paper analyzes the non-response behavior in an establishment-based freight survey (EBFS) conducted in Kerala, India. The analysis involves usage of five prominent classifiers: classification trees, random forests, Naïve Bayes classifier, logistic regression and K nearest neighbors. A closer look at the results revealed that the industrial classes handling commodities with high value density (machinery, electronics and electrical equipment, other manufacturing products, textiles) exhibit high non-response probability for freight surveys. This may be explained in terms of the limited logistic information shared by establishments handling high valued products due to less attention given to logistics strategies. Another reason could be that the amount of capital and opportunity costs tied up with these commodities are high, and therefore, their information tend to be more proprietary in nature. The analysis also reveals that the location of establishment plays a modest, yet, noticeable effect on non-response behavior. The establishments from cities located closer to Ports with high per-capita income are less likely to respond to survey requests, possibly due to the higher opportunity cost for time and increased concerns of intrusion into privacy. Finally, the comparison of ROC curves suggests that KNN algorithm is most suitable for modelling non-response behavior. These models are expected to be useful for developing sample weighting schemes and targeted incentive strategies that can improve the state of practice of freight data collection in middle-income countries like India. The study findings are expected to be useful for developing more elaborate and dynamically responsive survey designs for EBFS, in which sample recruitment strategies can be adapted real time during data collection. This study also informs policymakers that the apparent trends in non-response, if not arrested, are likely to weaken the validity of inferences drawn from estimates based on EBFS and undermine, perhaps fatally, the potential of EBFS to guide facility planning and policy interventions. • Study findings demonstrate a critical sampling problem that is often overlooked in freight surveys. • First research to investigate the underlying patterns in EBFS non-response. • Establishments handling high valued commodities are likely to be underrepresented in EBFS samples. • Establishments in cities closer to Ports with high per-capita income show reduced response propensity. • ROC curves suggest that KNN algorithm is most suitable for modelling non-response behavior. [ABSTRACT FROM AUTHOR]

Autoimmune hepatitis (AIH) has been well characterised and codified through the development of diagnostic criteria. These criteria have been adapted and simplified and are widely used in clinical practice. However, there is a need to update and precisely define the criteria for both treatment response and treatment. A systematic review was performed and a modified Delphi consensus process was used to identify and redefine the response criteria in autoimmune hepatitis. The consensus process initiated by the International Autoimmune Hepatitis Group proposes that the term 'complete biochemical response' defined as 'normalization of serum transaminases and IgG below the upper limit of normal' be adopted to include a time point at 6 months after initiation of treatment. An insufficient response by 6 months was a failure to meet the above definition. Non-response was defined as '<50% decrease of serum transaminases within 4 weeks after initiation of treatment'. Remission is defined as liver histology with a Hepatitis Activity Index <4/18. Intolerance to treatment was agreed to stand for 'any adverse event possibly related to treatment leading to potential drug discontinuation'. These definitions provide a simple and reproducible framework to define treatment response and non-response, irrespective of the therapeutic intervention. A consensus on endpoints is urgently required to set a global standard for the reporting of study results and to enable inter-study comparisons. Future prospective database studies are needed to validate these endpoints. Consensus among international experts on response criteria and endpoints in autoimmune hepatitis is lacking. A consensus on endpoints is urgently required to set a global standard for the reporting of study results and to enable the comparison of results between clinical trials. Therefore, the International Autoimmune Hepatitis Group (IAIHG) herein presents a statement on 5 agreed response criteria and endpoints: complete biochemical response, insufficient response, non-response, remission, and intolerance to treatment, which can be used to guide future reporting. [Display omitted] • Consensus among experts on response criteria in autoimmune hepatitis is lacking. • A consensus on endpoints is required to set a standard for reporting study results. • Herein, the IAIHG presents a statement on 5 agreed response criteria and endpoints. [ABSTRACT FROM AUTHOR]

Background: To summarize the current state of knowledge on antipsychotic treatment strategies for the acute phase and treatment resistance in schizophrenia, we conducted a systematic review of guidelines and algorithms.Methods: We conducted a systematic literature search to identify clinical guidelines and algorithms on this topic using MEDLINE and Embase. We extracted information on recommendations for antipsychotic treatment strategies, including those for non-response (i.e., increasing antipsychotic dose and switching to another antipsychotic) and treatment resistance.Results: We identified a total of 17 guidelines/algorithms in various countries that were published after 2011. With respect to antipsychotic dose, most of the guidelines (N = 10/11) agreed starting with a low dose or the lowest licensed/effective dose and then titrating the dose upwards. Regarding antipsychotic treatment strategies for non-response, all of the guidelines (N = 9/9) recommended increasing antipsychotic dose towards the upper end of its approved dose range. Five guidelines suggested for increasing beyond the therapeutic dose range in exceptional cases, while overall 10 guidelines including them were negative about such strategy. The vast majority of guidelines (N = 16/17) recommended switching to another antipsychotic for non-response; however, some guidelines mentioned the lack of evidence for these strategies other than the use of clozapine. All the guidelines (N = 17/17) endorsed initiating clozapine after failure to respond to 2 different antipsychotics. Four guidelines endorsed an early use of clozapine, yet as the third antipsychotic.Conclusion: The currently available guidelines and algorithms recommended increasing antipsychotic dose and switching to another antipsychotic, particularly clozapine for treatment-resistant schizophrenia, during the acute phase of schizophrenia for non-response. [ABSTRACT FROM AUTHOR]

The present note addresses the problem of estimation of population mean in the presence of non response. We have proposed the difference and ratio type estimators in two distinct situations of non response using the dual of an auxiliary variable. Some conventional estimators like mean, ratio, product, power transformation, regression, difference, and some other difference type estimators are the special cases of the proposed estimators apart from being less efficient than proposed estimators in the respective situations.The present work can be considered as the efficient extension of a recent work that is based on the dual use of auxiliary information. The theoretical results are obtained under large sample approximation. A comparative study based on real and simulated data is conducted where the results are quite encouraging, providing the improvement over all the discussed works. [ABSTRACT FROM AUTHOR]

This paper addresses the problem of estimation of the population distribution function in the presence of non response which may be useful for data analysis in socio-economic surveys. We have proposed some enhanced difference and ratio type estimators using the information on two auxiliary variables in two well defined situations of non response. We derive the expressions of bias and mean square error of the proposed estimators to the first order approximation. In the empirical study it has been shown that the proposed estimators perform better than other estimators which are constructed using one auxiliary variable. A simulation study is also carried out in support of this work. [ABSTRACT FROM AUTHOR]

Background: Survival for patients with locally advanced esophageal cancer remains dismal. Non-response to neoadjuvant chemoradiation (nCRT) portends worse survival. We hypothesized that patients undergoing up-front esophagectomy may have better survival than those who do not respond to nCRT.Methods: We identified all patients undergoing esophagectomy with a pathologic stage of II or greater at our institution between 1994 and 2015 and separated them into two groups: those who received nCRT and those undergoing up-front esophagectomy. The neoadjuvant group was further separated into patients downstaged to pathologic stage 0 or I (responders) and patients with either the same or higher pathologic stage after nCRT, or with pathologic stage II disease or greater (non-responders). Overall survival was compared between groups using Kaplan-Meier statistics. Covariate-adjusted Cox modeling was used to estimate hazard ratios (HR) for mortality associated with non-response.Results: Overall, 287 patients met inclusion criteria. Fifty-nine percent of the responders had pathologic complete response (pCR). The majority of non-responders and primary esophagectomy patients had stage II or III disease (94%). Median survival was 58.3 months in responders, 23.9 months in non-responders, and 29.1 months in primary esophagectomy patients (p < 0.01). The HR for mortality associated with non-response was 1.82 compared to response to nCRT (p < 0.01) and 1.09 compared to primary esophagectomy (p = 0.71).Conclusions: In patients with esophageal cancer who do not respond to nCRT, neoadjuvant therapy may represent a toxic and costly treatment modality that does not improve survival and may delay potentially curative resection. Further research is needed to identify potential non-responders with advanced resectable disease and allow individual tailoring of pre-surgical decision-making. [ABSTRACT FROM AUTHOR]

• Follow-up work to a recent JAMA article that received wide media coverage (NYtimes, CNN, etc). • Sensitivity analyses on estimates of fetal alcohol spectrum disorders (FASD) prevalence. • Methodological implications to epidemiological surveys using weights where unobserved 'confounding' (for non-response) might be present. Fetal alcohol spectrum disorders (FASD) are thought to be the leading cause of developmental disabilities worldwide. Accurate estimates of the prevalence of FASD have been lacking. An improved estimate of FASD prevalence in the U.S. was recently reported in a study where multistage methods of active case ascertainment of first-grade children with FASD were utilized in four regions in the U.S. Each method relied on parental consent and therefore had potential non-response bias. We consider weighted approaches, where the weights were formed using the distribution of observed variables in the population from which the samples were drawn. However, there are likely other unobserved variables that affect both non-response and FASD outcome. We describe sensitivity analyses using methodology developed for causal inference. The results show feasible regions of FASD prevalence under certain assumptions, and provide a framework for explaining the non-response bias due to the unobserved variables. [ABSTRACT FROM AUTHOR]

Background Understanding the long-term health effects of employment – a major social determinant – on population health is best understood via longitudinal cohort studies, yet missing data (attrition, item non-response) remain a ubiquitous challenge. Additionally, and unique to the work-family context, is the intermittent participation of parents, particularly mothers, in employment, yielding ‘incomplete’ data. Missing data are patterned by gender and social circumstances, and the extent and nature of resulting biases are unknown. Method This study investigates how estimates of the association between work-family conflict and mental health depend on the use of four different approaches to missing data treatment, each of which allows for progressive inclusion of more cases in the analyses. We used 5 waves of data from 4983 mothers participating in the Longitudinal Study of Australian Children. Results Only 23% had completely observed work-family conflict data across all waves. Participants with and without missing data differed such that complete cases were the most advantaged group. Comparison of the missing data treatments indicate the expected narrowing of confidence intervals when more sample were included. However, impact on the estimated strength of association varied by level of exposure: At the lower levels of work-family conflict, estimates strengthened (were larger); at higher levels they weakened (were smaller). Conclusions Our results suggest that inadequate handling of missing data in extant longitudinal studies of work-family conflict and mental health may have misestimated the adverse effects of work-family conflict, particularly for mothers. Considerable caution should be exercised in interpreting analyses that fail to explore and account for biases arising from missing data. [ABSTRACT FROM AUTHOR]

Introduction Controversy exists around the immunogenicity of the various formulations of botulinum neurotoxin type A (BoNT-A). Methods A systematic review of the literature (1968–2013) was performed, including review of materials from the FDA. Neutralizing antibody rates were calculated for overall BoNT-A and for each commercially available BoNT-A (abobotulinumtoxinA, incobotulinumtoxinA, onabotulinumtoxinA), and were compared by using the Chi-squared test. Two different onabotulinumtoxinA products were identified during the specified time-frame and classed as ‘old’ and ‘new’ versions. Results A total of 31 studies involving 5811 subjects met inclusion criteria and were analyzed. Therapeutic indications included: cervical dystonia, blepharospasm, spasticity, glabellar lines, hyperactive detrusor/sphincter dysfunction. The overall rate of development for neutralizing antibodies to BoNT-A was 2.1%. Individual rates were 1.4% for abobotulinumtoxinA, 0.8 to 1.1% for incobotulinumtoxinA, 7.2% for old onabotulinumtoxinA and 3.6% for new onabotulinumtoxinA. No significant differences were found between abobotulinumtoxinA and incobotulinumtoxinA rates (OR 1.82 [95%CI] [0.96–3.43], p = 0.066; OR 1.30 [0.69–2.46], p = 0.415). Rates of neutralizing antibodies were significantly lower with abobotulinumtoxinA and incobotulinumtoxinA versus either onabotulinumtoxinA formulations. Conclusions The overall neutralizing antibody rate for BoNT-A was low (≤2.1%). The rate of developing neutralizing antibodies was similar between abobotulinumtoxinA and incobotulinumtoxinA, both significantly lower when compared with onabotulinumtoxinA. [ABSTRACT FROM AUTHOR]

Using Programme of International Student Assessment (PISA) data, we show that parental non-response on a survey is negatively and significantly associated with children's test scores after controlling for the usual determinants of educational achievement. A one-standard-deviation increase in the proportion of parental non-responses decreases their children's scores by an average of 7.2 PISA points. Considering the incidence of non-response, we find that children with parents who had at least one missing or invalid item on the questionnaire scored 11.14 PISA points lower on average than children whose parents answered all of the survey questions. We present parents' personality, in particular conscientiousness, as a prominent candidate to explain our results. [ABSTRACT FROM AUTHOR]

• Genuine clozapine non-response must be differentiated from a misperceived clozapine non-response after ruling out drug interactions and employing therapeutic drug monitoring. • Patients with treatment refractory schizophrenia who genuinely fail to respond to an adequate clozapine trial may respond to other antipsychotic medications. • Non-clozapine antipsychotic medications that are more likely to result in a response after failing clozapine are those that are selected based on patients' presenting symptoms and comorbidities. Clozapine is the only approved treatment for Treatment-Refractory Schizophrenia. Here we describe a case series of three hospitalized patients with clozapine nonresponse. One of them responded to clozapine after dose adjustments were made for an interaction between clozapine and ciprofloxacin. The other two cases remained clozapine nonresponders despite optimizing clozapine treatment. However, both these patients responded to other antipsychotic medications (APMs) with better tolerability than observed with clozapine treatment. This case series focuses on diagnosing a genuine from a pseudo-nonresponse to clozapine and to consider other APMs in genuine nonresponse before switching to invasive interventions, such as ECT. [ABSTRACT FROM AUTHOR]

Objective The issue of non-response in dementia epidemiological studies, which may result in the underestimation of the prevalence of dementia, has attracted little attention. We aimed to explore the causes and related factors of non-response in a dementia survey among Chinese veterans. Methods A two-phase, cross-sectional study investigated the prevalence of dementia and mild cognitive impairment in Chinese veterans aged ≥60 years. We collected the socio-demographic data and prior medical history, evaluated the health status of veterans and their caregivers, assessed the cognitive status of veterans, and evaluated the care burden of caregivers by Caregiver Burden Inventory (CBI). Results Of 9676 eligible participants, 525 (5.4%) veterans in phase 1 and 1706 (35.0%) veterans among 4875 veterans in phase 2 did not respond. Illness, hospitalization and death accounted for 63.0% and 75.5% non-response in phases 1 and 2, respectively. Non-participation in social activities, self-perceived poor health status, worsened health changes, self-reported need for life care, and history of hearing loss or glaucoma independently predicted non-response in phase 1 or 2. The heavy care burden, suggested by the higher CBI scores and self-reported health deterioration of the primary caregivers, predicted non-response in phase 1 or 2. Conclusions The negative factors from both the participants and their caregivers independently predicted the non-response in the dementia study in an older population. Preventative strategies from the perspectives of the participants and caregivers should be developed to improve the response rates in both phases in a cross-sectional study. [ABSTRACT FROM AUTHOR]

Background Non-response to an initial antipsychotic trial emerges frequently in the pharmacological management of schizophrenia. Increasing the dose (high-dose treatment, dose escalation) is an often applied strategy in this regard, but there are currently no meta-analytic data available to ascertain the evidence of this treatment option. Methods We systematically searched for all randomized controlled trials (RCTs) that compared a dose increase directly to the continuation of standard-dose medication in patients with initial non-response to a prospective standard-dose pharmacotherapy with the same antipsychotic compound. Primary outcome was mean change in the Positive and Negative Syndrome Scale (PANSS) or Brief Psychiatric Rating Scale (BPRS) total score. Secondary outcomes were positive and negative symptoms, response rates, and attrition rates. Hedges's g and risks ratios were calculated as effect sizes and the influence of the amount of the dose increase was examined by meta-regressions. Results Altogether, five trials with 348 patients investigating dose escalation with quetiapine, ziprasidone, haloperidol, and fluphenazine could be included. We did not find any significant difference for the mean PANSS/BPRS score change between the dose-increase and control group, neither for the pooled antipsychotic group nor for the individual antipsychotic drugs. Moreover, there were no between-group differences in positive and negative symptoms, response rates, and drop-out rates. The meta-regressions indicate no significant influence of the different amounts of dose increments on effect sizes. Conclusions This meta-analysis suggests no evidence for a dose-escalation of the investigated antipsychotic drugs fluphenazine, haloperidol, quetiapine, and ziprasidone in case of initial non-response to standard-dose pharmacotherapy. [ABSTRACT FROM AUTHOR]

A cohort based study has been undertaken to investigate the possible association of genetic polymorphisms in genes functionally related to follicular T helper (TfH) cells with non-responsiveness to hepatitis B virus (HBV) vaccination. A total of 24 single nucleotide polymorphisms (SNPs) in 6 TfH related genes (CXCR5, ICOS, CXCL13, IL-21, BCL6 and CD40L) were investigated in 20 non-responders and 45 responders to HBV vaccination. Genetic association analysis revealed that three SNPs (rs497916, rs3922, rs676925) in CXCR5 and one SNP (rs355687) in CXCL13 were associated with hepatitis B vaccine efficacy. In addition, significantly unbalanced distributions of two haplotypes, defined by three SNPs (rs497916, rs3922, rs676925) within CXCR5, were also seen between non-responders and responders. Furthermore, we demonstrated that the rs3922 “GG” genotype was associated with higher levels of CXCR5 than the “AG” and “AA” genotype in a group of healthy volunteers. A dual luciferase report assay was used to confirm that the “G” allele in rs3922 may lead to higher gene expression than the “A” allele, implicating that rs3922 might be a functional SNP affecting CXCR5 expression. These results indicated that polymorphism associated changes in CXCR5 expression in TfH cells may be associated with non-responsiveness to hepatitis B vaccination. [ABSTRACT FROM AUTHOR]

Highlights: [•] We propose a Bayesian data augmentation scheme for analyzing ERGM with partially observed data. [•] We demonstrate estimation and predictive distributions for three quarters of ties unobserved. [•] We demonstrate analysis when a particularly influential attribute is only partially observed. [Copyright &y& Elsevier]

Abstract: Background: Surveys are a common method of data collection within health service research. An essential aspect of reporting survey research is ensuring that sufficient information is provided to enable readers to determine the validity and representativeness of research findings. Method: This study reports a secondary analysis of survey research published in Radiography and Clinical Radiology between 2001 and 2010. The purpose of the study was to evaluate trends in response rates and establish how non-response bias was being addressed. Results: Analysis of non-response bias was undertaken in 9.4% (n = 9/96) of studies. Where analysis was performed, strong reliance on demographic characteristics to determine sample representativeness was noted (n = 8/9; 88.9%). Conclusion: The findings of this study suggest that non-response bias is not being adequately addressed within published imaging related survey research and more needs to be done to encourage a rigorous approach to the analysis and reporting of survey results. [Copyright &y& Elsevier]

Abstract: Background: Several post-hoc studies have shown that lack of early improvement reduces the chance of later response or remission. This post-hoc analysis evaluates different cut-off points of non-improvement at 4 weeks of escitalopram treatment to predict 8-week non-response and non-remission. Method: This study consisted of MDD patients with an absence of improvement (<30% reduction in baseline score of the HAMD-17) at Week 4 of escitalopram treatment (10mg/day) that continued escitalopram treatment (10–20mg/day) for a further 4-week period (n=251). Predictive, sensitivity and specificity values for the several definitions of non-improvement (≤25%, ≤20% and ≤15% reduction in the HAMD-17 baseline total score) at 4 weeks were calculated. Results: Overall, 70.1% (176/251) of patients did not achieve response at Week 8 and 84.5% (212/251) did not achieve remission. The predictive value for non-response was high (71.4–74.3%) for all cut-off points of non-improvement tested. The respective values for non-remission were placed between 85.0% and 87.2%. Limitations: This was a post-hoc subgroup analysis. The only drug assessed was escitalopram. Conclusions: Our data indicate that an absence of improvement, <30% reduction in the HAMD-17, after 4 weeks of escitalopram treatment should prompt clinicians to consider a change in treatment strategy. Similar findings were previously reported for other antidepressants. [Copyright &y& Elsevier]

Abstract: Background: Preclinical data suggested all-trans retinoic acid (tretinoin) as a potential antiviral agent against chronic hepatitis C infection. Aims: To assess efficacy, safety, and tolerability of tretinoin in combination with peg-interferon and ribavirin in genotype-1 infected patients with prior non-response. Method: We performed an open-label multicentre clinical trial. Patients were randomised to either receive additional tretinoin (45mg/m2/day) for 12 weeks (arm A), or peg-interferon and ribavirin alone (arm B). Primary endpoint was the slope of the third phase of viral decline (Mδ) as determined in an established kinetic model known to correlate with treatment outcome. Secondary endpoints were additional kinetic parameters, viral response rates, safety, and tolerability. Results: 27 patients in arm A and 30 patients in arm B were treated per protocol until week 12. Viral kinetic parameters did not differ. Rates of early virological response (>2log10 drop at week 12) were similar (10/27 versus 11/30 patients). In arm A, patients experienced a higher rate and intensity of adverse events, most commonly skin and mucosal dryness, and headache. Conclusion: Addition of tretinoin was safe and acceptably well tolerated. However, it did not influence viral kinetics and thus cannot be further considered as a treatment option. [Copyright &y& Elsevier]

Abstract: Among the best established treatments for anxiety disorders are cognitive-behavioral interventions and serotonin reuptake inhibitors. Although clinically useful, these therapies are far from universally efficacious; some patients are unable to complete treatment, and many treatment completers fail to achieve clinically significant improvement. A review of meta-analyses on the treatment of anxiety disorders reveals that about a fifth of patients drop out prematurely and a third of treatment completers are classified as non-responders. In this article we examine the predictors of, and potential solutions for, the problems of treatment non-adherence and non-response to cognitive-behavioral and serotonergic treatments of adult anxiety disorders. Despite decades of research, few reliable predictors have been identified, and no predictor has been consistently supported in the literature. However, there is suggestive evidence that risk of premature dropout is associated with low treatment motivation, side effects, and practical barriers to attending sessions. There is also suggestive evidence that poor response is associated with severe pretreatment psychopathology and comorbidity, as well as high expressed emotion in the patient''s family environment. Methods for better estimating treatment prognosis are proposed and possible directions for improving treatment outcome are discussed. [Copyright &y& Elsevier]

Aim of the study: Non-response (NR) to treatment of childhood relapsed acute lymphoblastic leukaemia (ALL) is an end-point of protocol therapy. Subsequent management has not yet been standardised. This study analyses different approaches after NR to aid optimising future strategies. Patients and methods: Ninety-three children with NR to treatment according to ALL relapse-protocols of the Berlin/Frankfurt/Muenster (BFM) Study Group (03/1990–2006/1999) were retrospectively assigned to a curative (C: intensive polychemotherapies, stem cell transplantation (SCT); n =51), palliative (P: 1–2 antineoplastic agents; n =23) or supportive (S: no antineoplastic therapy; n =19) treatment approach. Results: Median survival after diagnosis of NR were 121 (C), 89 (P) and 42 (S) days, respectively (p <0.001). In cohort C, a complete remission (2ndCR) was obtained in 16/51 patients, among these 13 only after SCT, and nine children achieved partial remission. Ten of the 51 patients died from treatment-related complications, 39/51 from disease progression. Today, two patients are still in continuous CR after SCT. Adverse prognostic factors were overrepresented in the non-curative cohorts. Time-point of relapse and treatment after NR were independent predictors of survival duration. Most patients without antineoplastic treatment died at home, the majority of the others in the hospital. Conclusions: Treatment after NR has been heterogeneous and customised. Therapies with curative intent are capable of inducing 2ndCR but associated with high treatment-related morbidity, -mortality and minimal survival. NR patients may, therefore, be ideal candidates for controlled phase I/II trials, thus offering them a chance to benefit from new drugs and promoting drug development for cohorts with better prognosis. [Copyright &y& Elsevier]

Abstract: This paper analyzes the main characteristics of travel behavior by the Arab minority community in Israel and discusses two issues related to household travel surveys: data collection among minorities and under-reporting of mid-day trips. Household travel surveys are generally designed and conducted for the majority population and, therefore, lack a proper accounting of minorities and miss many of their less-frequent trips. An alternative approach to conducting household surveys is presented, with the aim of improving data quality for transportation planning. The survey was designed for and conducted in three Arab towns in Israel. The main improvement of the survey involves better interaction between interviewer and interviewee, which should materialize into a relaxed environment that allows for obtaining detailed, reliable results within a reasonable amount of time. The results of the survey employing the alternative approach were compared to a sub-sample of the same towns taken from a regional survey conducted by the regional planning agency at the same time. The paper presents simple statistics on the main variables for each survey. Significant differences are found in the two data sets, mostly regarding the frequency of less frequent, non-home-based trips. A plausible explanation for these differences relates to the more detailed and improved data collected in the new survey. [ABSTRACT FROM AUTHOR]

Abstract: A sampling strategy for estimating spatially averaged annual element leaching fluxes from forest soils is presented and tested in three Dutch forest monitoring plots. In this method sampling locations and times (days) are selected by probability sampling. Sampling locations were selected by stratified random sampling with five blocks of equal surface area as strata. At each selected day six composite soil solution samples were collected, consisting of five aliquots of equal volume, one per stratum. For most sampling days at some locations no soil solution was collected (non-response), and as a result the average of the six composite sample concentrations (the naïve estimator) is a biased estimator of the plot mean concentration. The plot mean concentration at these days was estimated by ordinary least squares. This estimation method eliminates the bias of the naïve estimator. This estimated concentration was multiplied by the modeled water flux to obtain an estimate of the daily element leaching flux. Sampling times (days) were selected by systematic πps-sampling (sampling with probabilities proportional to size), with precipitation surplus, averaged over the past 30years, as a measure of size. The spatially averaged annual leaching flux was estimated by the ratio-estimator, accounting for the selection probabilities of the days, using the modeled daily water flux as an auxiliary variable. [ABSTRACT FROM AUTHOR]

Abstract: This paper considers the problem of estimating the population mean of the study variate y with two auxiliary variates x and z in the presence of non-response using two-phase (double) sampling procedure. Four classes of combined regression and ratio estimators have been defined in four different situations and their properties are studied under large sample approximation. Comparisons of the suggested classes of estimators with usual unbiased estimator reported by , estimator, estimator and estimator have been made. The results obtained are demonstrated with the help of an empirical study. [Copyright &y& Elsevier]

Abstract: Trial registration: NTR1043 (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1043). Background: Five to ten percent of immunocompetent persons fail to develop a protective immune response to hepatitis B vaccination, and are defined non-responders (NR). We investigated the immune response to intradermal hepatitis B vaccination after pre-treatment of the skin with the TLR7 agonist imiquimod. Methods: Twenty-one non-responders (anti-HBs <10IU/l after at least 6 intramuscular hepatitis B vaccinations) were randomly assigned to the control group (N =11) or the experimental group (N =10). Participants in both groups received 3 intradermal (ID) vaccinations with 5μg HBsAg (0.125mL) at 0, 1 and 6 months. In the experimental group, the dermal site of injection was pre-treated with 250mg imiquimod ointment. Anti-HBs antibodies were determined at 0, 1, 2, 6 and 7 months. Results: In both study groups, 70% of the participants developed a protective immune response (anti-HBs ≥10IU/l), after the 3rd intradermal vaccination. Conclusion: The application of imiquimod on the skin prior to intradermal vaccination did not enhance the humoral response to hepatitis B vaccine. However, irrespective of imiquimod application, 70% of the NR who had not responded to 6 previous intramuscular vaccinations, developed a protective immune response with high affinity antibodies after 3 ID hepatitis B vaccinations with 5μg HBsAg. [Copyright &y& Elsevier]

Abstract: In this paper, bias-adjustment in the jackknife estimator of variance accredited to has been considered. Then the bias-adjusted estimator has been calibrated such that its expected value under the imputing superpopulation model remains the same as the expected value of the mean squared error of the ratio estimator in the presence of non-response. A simulation study has been performed to compare the six different estimators of variance: out of them four estimators belong to and the other two proposed estimators are named as bias-adjusted and bias-adjusted-cum-calibrated estimators. The empirical relative bias and empirical relative efficiency of the two proposed estimators with respect to the four existing estimators accredited to have been investigated through simulations. The bias-adjusted-cum-calibrated estimator has been found to be an efficient estimator in the case of heteroscadastic populations. The present paper considers the situation of simple random and without replacement sampling. The possibility of obtaining a negative estimate of variance by the estimator due to has been pointed out. [Copyright &y& Elsevier]

Abstract: Residual platelet function despite treatment with clopidogrel may predict an unfavourable cardiovascular outcome. The majority of studies have investigated the effects of clopidogrel administration in conjunction with aspirin in patients undergoing percutaneous coronary intervention. The primary objective of the present study was to assess the platelet response to clopidogrel in the absence of aspirin in patients with peripheral arterial occlusive disease (PAOD) and to investigate whether non-responsiveness to clopidogrel is reproducible during long-term follow-up. Fifty-four clinically stable PAOD patients on a maintenance dose of 75mg/d clopidogrel were enrolled in this study. Platelet function was assessed at baseline and after a median follow-up of 18 months using light transmittance aggregometry (LTA) with 2μM ADP as an agonist. HPLC-coupled mass spectrometry was used to detect clopidogrel and clopidogrel carboxylic acid, the main metabolite of clopidogrel. Residual platelet function, as defined by late aggregation values within the reference range (i.e., >43%), was observed in 35.2% of patients at baseline and 17.6% during follow-up. During the observation period, 26.5% had switched from responder to non-responder status or vice versa. Among non-responders, either clopidogrel or its metabolite was detected in 89.5% and 83.3% of patients at baseline and at follow-up, respectively. We conclude that non-responsiveness to clopidogrel as determined by ADP-induced LTA is not stable over time. This phenomenon cannot be attributed to non-compliance alone. [Copyright &y& Elsevier]

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Summary: Background: Participation rates in epidemiologic studies conducted with postal questionnaires have steadily declined since 1970s. This can lead to an increased risk for selection bias. The aim of this study was to examine cause and effect of non-response in a large cross sectional study assessing respiratory health in western Sweden. Methods: The study sample was 29,218. The response rate to the initial postal questionnaire was 33%. The response rates to subsequent postal reminders were 15%, 7% and 7% of eligible participants totalling a participation of 62%. Of those who did not respond to the postal survey, a random sample of 400 subjects were identified and contacted for interview by telephone. Results: Non-responders did not differ significantly in prevalence of airway diseases or symptoms when compared with responders. Male sex, young age and smokers were underestimated among non-responders. No clear trends in prevalence of respiratory symptoms and report of asthma were found with delayed response to the postal survey. The proportion of smokers and men increased with increasing number of reminders. Letters reminding subjects about the study did increase the participation rate but did not alter the risk estimates. Conclusion: We conclude that with a response rate of 62%, our estimate of disease and symptom prevalence was not biased in this Swedish population. However, smoking was underestimated. No general trend for late-responders was seen and therefore we conclude that extrapolation of results to non-responders is not possible in our study. Causes of non-response were mainly due to circumstantial factors. [Copyright &y& Elsevier]

Abstract: Introduction: Large individual variability in clopidogrel responses has been reported. However, mechanisms of the non-responsiveness are unclear. Our aim was to study the extent of platelet inhibition at the receptor level by in vitro receptor antagonists of P2Y12 (AR-C69931MX, cangrelor) and P2Y1 (adenosine 3’,5’diphosphate) in aspirin treated patients with coronary artery disease (CAD) prior to and after in vivo clopidogrel. Materials and Methods: 51 aspirin-treated (100 mg/day) patients participated. Blood was collected before and after administration of clopidogrel at 300 mg loading dose on day one, followed by 75 mg/d for four days. Aggregation in platelet-rich plasma was assessed. Results: In 20% of patients clopidogrel failed to inhibit platelet responses to ADP. These non-responders had also decreased sensitivity to an in vitro P2Y12-receptor antagonist compared with the responders (mean inhibition of aggregation 25 vs. 32%, difference of means 7% (95% CI 2-12%), P<0.02). Moreover, the P2Y12-receptor inhibition by in vivo clopidogrel correlated with the inhibition by in vitro ARMX measured prior to administration of clopidogrel. Neither P2Y1-receptor activity, thrombin generation while on aspirin nor basal platelet activity associated with clopidogrel responses. Conclusions: Concomitant aspirin and clopidogrel treatment failed to suppress platelet activity in 20% of patients. Non-responders to clopidogrel had decreased responses also to another ADP receptor antagonist, which suggests that the impaired response occurs at the level of P2Y12-receptor. [Copyright &y& Elsevier]

Abstract: Over the last twenty years, the consumption of natural gas in Korea has increased dramatically. This increase has mainly resulted from the rise of consumption in the residential sector. The main objective of the study is to estimate households’ demand function for natural gas by applying a sample selection model using data from a survey of households in Seoul. The results show that there exists a selection bias in the sample and that failure to correct for sample selection bias distorts the mean estimate, of the demand for natural gas, downward by 48.1%. In addition, according to the estimation results, the size of the house, the dummy variable for dwelling in an apartment, the dummy variable for having a bed in an inner room, and the household’s income all have positive relationships with the demand for natural gas. On the other hand, the size of the family and the price of gas negatively contribute to the demand for natural gas. [Copyright &y& Elsevier]

In survey sampling an investigator may be unable to get the complete and correct information at the same time. So non-response and measurement error occur simultaneously and consequently may effect the estimator. Considering this problem, a generalized class of estimators is proposed for estimating the finite population mean for sensitive variable in the presence of measurement error and non-response under stratified random sampling. We conducted a study based on real data set at Quaid-i-Azam University, Islamabad. Simulation and real life data sets are used to observe the performances of the estimators. Bias and MSE values are given for the comparison of estimators. [ABSTRACT FROM AUTHOR]

Background/Aims: In severe alcoholic hepatitis (AH), 40% of patients will obtain no benefit from corticosteroids. Improvement in management of non-responders is warranted and only pentoxifylline can be considered an alternative. A two-step strategy was evaluated consisting of early withdrawal of corticosteroids and a switch to pentoxifylline for 28 additional days in non-responders identified using early change in bilirubin level. Methods: One hundred and twenty-one patients with AH were treated prospectively with corticosteroids, and the two-step strategy was proposed to 29 non-responders treated according to a two-step strategy who were compared to 58 matched non-responders treated with corticosteroids only. Results: Clinical and biological features of the two groups were similar. There was no survival improvement at 2 months in patients treated with the two-step strategy compared to controls: 35.5±6.3% vs 31±8.6%. After 21 days, biological evolution was similar for prothrombin time (−0.25s vs +0.2s), bilirubin (0.8mg/dl vs 2.03mg/dl) and creatinine (+0.16mg/dl vs −0.7mg/dl). In multivariate analysis, only age, evolution of bilirubin during the first week, creatinine and DF were associated with 2-month survival. Conclusions: Non-responders to corticosteroids do not obtain any benefit from an early switch to pentoxifylline. Thus, the issue of management of non-responders remains unresolved. [Copyright &y& Elsevier]

Abstract: The non-response to hepatitis B vaccine in health care workers (HCWs) is reported to vary between 5 and 40%. The underlying cellular and molecular events for unresponsiveness to HBV vaccine have not yet been characterized at any great extent. In the current study, we examined the CD150 surface expression levels and its association with polyclonally activated and HBV specific stimulated cellular proliferations in responders and non-responders. CD150 was identified as upregulated expression marker with suppressive regulatory cell function on all activated T cells by gene chip analysis. We found the overall weak cellular proliferation in response to specific and non-specific agents in non-responders. This is significantly associated with enhanced surface expression of CD150 in the non-responders. A strong expression of CD150 with weak cellular proliferation could be used as a predictive marker for non-responsiveness. [Copyright &y& Elsevier]

Abstract: Intensive care unit (ICU)-acquired lower respiratory tract infections include acute tracheobronchitis and hospital-acquired and ventilator-associated pneumonia (VAP). Nosocomial pneumonia is the second most common hospital-acquired infection and the leading cause of death in hospital-acquired infections. The mortality rate in VAP ranges from 24% to 76% in several studies. ICU ventilated patients with VAP have a 2- to 10-fold higher risk of death than patients without it. Early oropharyngeal colonization is pivotal in the etiopathogenesis of VAP. The knowledge of risk factors for VAP is important in developing effective preventive programs. Once the physician decides to treat a suspected episode of ICU-acquired pneumonia, some issues should be kept on mind: first, the adequacy of the initial empiric antibiotic therapy; second, the modification of initial inadequate therapy according to microbiological results; third, the benefit of combination therapy; and finally, the duration of the antimicrobial treatment. Additionally, a protocolized work-up to identify the causes of non-response to treatment is mandatory. All these issues are discussed in depth in this article. [Copyright &y& Elsevier]

PURPOSE: Differences in respondent characteristics may lead to bias in prevalence estimates and bias in associations. Both forms of non-response bias are investigated in a study on psychosocial factors and cancer risk, which is a sub-study of a large-scale monitoring survey in the Netherlands.METHODS: Respondents of a cross-sectional monitoring project (MORGEN; N = 22,769) were also asked to participate in a prospective study on psychosocial factors and cancer risk (HLEQ; N = 12,097). To investigate diverse aspects of non-response in the HLEQ on prevalence estimates and associations are studied, based on information gathered in the MORGEN-project.RESULTS: A response percentage of 45% was obtained in the MORGEN-project. Response rates were found to be lower among men and younger people. The HLEQ showed a response percentage of 56%, and respondents reported higher socioeconomic status, better subjective health and healthier lifestyle behaviors than non-respondents. However, associations between smoking status and either socioeconomic status or subjective health based on respondents only were not statistically different from those based on the entire MORGEN-population.CONCLUSION: Non-response leads to bias in prevalence estimates of current smoking, current alcohol intake, and low physical activity or poor subjective health. However, non-response did not cause bias in the examined associations. [Copyright &y& Elsevier]

The development of the web survey has led to significant strides in questionnaire survey methodology, including its potential to substantially increase sample sizes at minimal costs. Despite its advantages, web surveys typically achieve lower response rates from participants compared to more conventional survey methods. The aim of this review was to evaluate strategies to increase the response rate to web surveys. CINAHL (EBSCO), MEDLINE Complete, the Cochrane database of systematic reviews, the Cochrane central register of controlled trials and Psych Info were searched, from inception to the 24th of June, 2021. The Boolean search phrase (Ti: Web survey* OR online survey* OR internet survey*) AND (Ti: response rate* OR nonresponse* or participation rate*) was used. This was supplemented by a secondary search of the reference lists. To be eligible for inclusion in the review, papers had to evaluate one or more strategies to improve response rates to web surveys. Experimental and quasi experimental studies were included in the review. A total of 159 papers were identified. Following removal of duplicates, and further screening by two independent reviewers, 45 papers met the inclusion and exclusion criteria, and were included in the final review. The use of e-mail pre-notification, email invitation and two reminders were found to increase response rates to web surveys as do the use of a semi-automatic log-in, a simple design and a short survey which takes around 10 min to complete. Incentives, including entry into a prize draw with a cash prize considered to be of value to the participants also increase response rates. Research studies are needed to explore whether the different strategies used by researchers with the intent to improve response rates are acceptable to potential participants and to evaluate the potential synergistic effect of combinations of several strategies identified in this review. Tweetable abstract : Email prenotification, email invitation, 2 reminders, simple 10 min design and lottery incentives improve response rates to web surveys [ABSTRACT FROM AUTHOR]

The left-right dimension plays a crucial role in how political scientists think about politics. Yet we know surprisingly little about the extent to which citizens are able to position themselves on a left-right dimension. By analysing non-response on left-right self-identification question from seven waves of the European Social Survey (N = 295,713), this study demonstrates that citizens' ability to position themselves on the left-right dimension depends on the political system they live in and its history. Citizens in countries with lower levels of elite polarization place themselves on a left-right dimension less often, this difference is partiularly pronounced for citizens with high levels of political interest. Citizens in countries with a recent authoritarian history were unable to place themselves on the left-right dimension more often. These findings show the importance of political socialization for left-right self-identification. [ABSTRACT FROM AUTHOR]

• Definitions of symptom improvement and deterioration in OCD vary highly. • Thus, a comprehensive definition of treatment-refractory OCD is provided. • This contributes to psychotherapists' training and psychoeducation in OCD. Although effective treatments exist, obsessive-compulsive disorder (OCD) is, according to the views of patients and experts, still associated with chronicity, a term with no clear and consistent definition. To improve patient care and to foster research, a clear distinction between the various concepts of chronicity cited in the literature is crucial. The aim was thus to explicate central concepts related to courses and trajectories in OCD based on an explorative, scoping search of the existing literature. Our review revealed a considerable lack in content validity, as the concepts were operationalized inconsistently. Concepts related to symptom improvement were (complete) recovery, partial/full remission and partial/full response. Terms used in relation with symptom stability or worsening were chronic/continuous, intermittent and episodic course, waxing and waning, relapse, recurrence, deterioration and treatment-refractoriness. All concepts are explained and visualized as a result of the review. Further, based on authors' remarks, we present recommendations on how to enhance care for chronic OCD patients, namely training psychotherapists to apply CBT as intended, managing patient beliefs about disease and treatment, and adapting psychotherapy to OCD subtypes. Finally, we then propose a literature-based definition of treatment-refractory OCD. [ABSTRACT FROM AUTHOR]