Various tests to check the homogeneity of variance assumption have been proposed in the literature, yet there is no consensus as to their robustness when the assumption of normality does not hold. This simulation study evaluated the performance of 14 tests for the homogeneity of variance assumption in one-way ANOVA models in terms of Type I error control and statistical power. Seven factors were manipulated: number of groups, average number of observations per group, pattern of sample sizes in groups, pattern of population variances, maximum variance ratio, population distribution shape, and nominal alpha level for the test of variances. Overall, the Ramsey conditional, O'Brien, Brown-Forsythe, Bootstrap Brown-Forsythe, and Levene with squared deviations tests maintained adequate Type I error control, performing better than the others across all the conditions. The power for each of these five tests was acceptable and the power differences were subtle. Guidelines for selecting a valid test for assessing the tenability of this critical assumption are provided based on average cell size.
HT use is becoming increasingly more popular among young adults in the U.S. Methods should target not only cessation of cigarette smoking but use of all tobacco products.
Background In Vietnam, the importance of vivax malaria relative to falciparum during the past decade has steadily increased to 50%. This, together with the spread of multidrug-resistant Plasmodium falciparum , is a major challenge for malaria elimination. A 2-year prospective cohort study to assess P . vivax morbidity after radical cure treatment and related risk factors was conducted in Central Vietnam. Methods and findings The study was implemented between April 2009 and December 2011 in four neighboring villages in a remote forested area of Quang Nam province. P . vivax -infected patients were treated radically with chloroquine (CQ; 25 mg/kg over 3 days) and primaquine (PQ; 0.5 mg/kg/day for 10 days) and visited monthly (malaria symptoms and blood sampling) for up to 2 years. Time to first vivax recurrence was estimated by Kaplan–Meier survival analysis, and risk factors for first and recurrent infections were identified by Cox regression models. Among the 260 P . vivax patients (61% males [159/260]; age range 3–60) recruited, 240 completed the 10-day treatment, 223 entered the second month of follow-up, and 219 were followed for at least 12 months. Most individuals (76.78%, 171/223) had recurrent vivax infections identified by molecular methods (polymerase chain reaction [PCR]); in about half of them (55.61%, 124/223), infection was detected by microscopy, and 84 individuals (37.67%) had symptomatic recurrences. Median time to first recurrence by PCR was 118 days (IQR 59–208). The estimated probability of remaining free of recurrence by month 24 was 20.40% (95% CI [14.42; 27.13]) by PCR, 42.52% (95% CI [35.41; 49.44]) by microscopy, and 60.69% (95% CI [53.51; 67.11]) for symptomatic recurrences. The main risk factor for recurrence (first or recurrent) was prior P . falciparum infection. The main limitations of this study are the age of the results and the absence of a comparator arm, which does not allow estimating the proportion of vivax relapses among recurrent infections. Conclusion A substantial number of P . vivax recurrences, mainly submicroscopic (SM) and asymptomatic, were observed after high-dose PQ treatment (5.0 mg/kg). Prior P . falciparum infection was an important risk factor for all types of vivax recurrences. Malaria elimination efforts need to address this largely undetected P . vivax transmission by simultaneously tackling the reservoir of P . falciparum and P . vivax infections.
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