Browsing by Author "Wang, Jie"

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    Esketamine vs. placebo combined with erector spinae plane block vs. intercostal nerve block on quality of recovery following thoracoscopic lung resection: a randomized controlled factorial trial
    (Wolters Kluwer, 2024-08-22) Hu, Jing-hui; Zhong, Zhang-zhen; Shi, Hai-jing; Wang, Jie; Chen, Shaomu; Shan, Xi-sheng; Liu, Hua-yue; Liu, Hong; Meng, Lingzhong; Ji, Fu-hai; Peng, Ke; Anesthesia, School of Medicine
    Background: Multimodal analgesic strategy is pivotal for enhanced recovery after surgery. The objective of this trial was to assess the effect of subanesthetic esketamine vs. placebo combined with erector spinae plane block (ESPB) vs. intercostal nerve block (ICNB) on postoperative recovery following thoracoscopic lung resection. Materials and methods: This randomized, controlled, 2×2 factorial trial was conducted at a university hospital in Suzhou, China. One hundred adult patients undergoing thoracoscopic lung surgery were randomized to one of four groups (esketamine-ESPB, esketamine-ICNB, placebo-ESPB, and placebo-ICNB) to receive i.v. esketamine 0.3 mg/kg or normal saline placebo combined with ESPB or ICNB using 0.375% ropivacaine 20 mL. All patients received flurbiprofen axetil and patient-controlled fentanyl. The primary outcome was quality of recovery (QoR) at 24 h postoperatively, assessed using the QoR-15 scale, with a minimal clinically important difference of 6.0. Results: The median age was 57 years and 52% were female. No significant interaction effect was found between esketamine and regional blocks on QoR (P=0.215). The QoR-15 score at 24 h was 111.5±5.8 in the esketamine group vs. 105.4±4.5 in the placebo group (difference=6.1, 95% CI, 4.0-8.1; P<0.001); 109.7±6.2 in the ESPB group vs. 107.2±5.6 in the ICNB group (difference=2.5, 95% CI, 0.2-4.9; P=0.033; not statistically significant after Bonferroni correction). Additionally, esketamine resulted in higher QoR-15 scores at 48 h (difference=4.6) and hospital discharge (difference=1.6), while ESPB led to a higher QoR-15 score at 48 h (difference=3.0). Conclusions: For patients undergoing thoracoscopic lung resection, subanesthetic esketamine improved QoR after surgery, while ICNB can be used interchangeably with ESPB as a component of multimodal analgesia.
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    Goodness-of-fit inference for the additive hazards regression model with clustered current status data
    (Taylor & Francis, 2022-03-24) Feng, Yanqin; Wang, Jie; Li, Yang; Biostatistics and Health Data Science, School of Medicine
    Clustered current status data are frequently encountered in biomedical research and other areas that require survival analysis. This paper proposes graphical and formal model assessment procedures to evaluate the goodness of fit of the additive hazards model to clustered current status data. The test statistics proposed are based on sums of martingale-based residuals. Relevant asymptotic properties are established, and empirical distributions of the test statistics can be simulated utilizing Gaussian multipliers. Extensive simulation studies confirmed that the proposed test procedures work well for practical scenarios. This proposed method applies when failure times within the same cluster are correlated, and in particular, when cluster sizes can be informative about intra-cluster correlations. The method is applied to analyze clustered current status data from a lung tumorigenicity study.
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    Risk reduction and adventure tourism safety: An extension of the risk perception attitude framework (RPAF)
    (Elsevier, 2019-10-01) Wang, Jie; Liu-Lastres, Bingjie; Ritchie, Brent W.; Pan, Dong-Zi
    Visitor safety is an important topic in adventure tourism but remains underexplored. Using a psychological approach, this study applies and extends Rimal and Real's risk perception attitude framework to include personality traits and emotions to understand adventure tourists' safety behaviours on site. Focusing on tidal-bore watching activities in China, this study consists of two phases: interviews with nine local stakeholders followed by a field survey involving 302 visitors. Cluster analyses were conducted and three visitors' groups were identified that varied in risk perception attitudes and safety behaviours. Mediation analyses were conducted to explore the role played by worry during visitors' decision-making related to safety behaviours. Based on the findings, this study provided managerial insight for developing risk communication strategies to engage visitors in self-protective behavior. This study also provided recommendations on how to improve visitors' safety and to protect their lives in adventure-tourism sites in China.
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    Travellers' self-protections against health risks: An application of the full Protection Motivation Theory
    (Elsevier, 2019-09-01) Wang, Jie; Liu-Lastres, Bingjie; Ritchie, Brent W.; Mills, Deborah J.
    Ensuring travellers' health and well-being is an important issue in tourism management and public health. By applying and testing the Protection Motivation Theory (PMT), this study serves as one of the early attempts in tourism to explore travellers' self-protective behavior against health risks. This study conducted semi-structured interviews and an online survey. Consistent with the PMT, this study found that both threat and coping appraisals can enhance travellers' protection motivations, which in turn affect their actual behaviors. This study also provided interpretation of maladaptive perception in a tourism context and found its negative association with coping appraisal. Implications were provided on how to encourage travellers to protect themselves against health risks.