Association Test Research Articles

A protocol for a feasibility study of Cognitive Bias Modification training (IVY) countering fatigue in people with breast cancer

BackgroundCancer-related fatigue (CRF) is the most prevalent, distressing, and quality of life disturbing symptom during and after cancer treatment for many cancer types including breast cancer. The experience and burden of this symptom can induce a cognitive bias towards fatigue or a fatigue-related self-image, which can further increase the fatigue symptoms and related behaviour. For this, a Cognitive Bias Modification (CBM) eHealth app (IVY) has been developed. The app aims to counter the fatigue-related self-image and to modify it towards vitality, which might translate to less experienced fatigue and more experienced vitality. This study aims to evaluate the feasibility of the IVY CBM training and the research design of a wait-list control trial. If feasibility is judged sufficient, the effectiveness of the CBM app will also be analyzed on (1) underlying mechanisms (cognitive fatigue bias), (2) symptom fatigue (self-reported fatigue and vitality), and (3) related behaviours (avoidance and all-or-nothing behaviour).MethodsThis feasibility study addresses individuals being treated for breast cancer receiving (neo)adjuvant treatment or metastatic care. The number of target participants is 120 (60 (neo)adjuvant, and 60 metastatic) patients. Both groups will be randomized with 30 people in the IVY treatment group and 30 people in the delayed treatment control group. All participants will receive the training via the IVY app, in which participants categorize words related to vitality with words related to ‘I’ and words related to fatigue with words related to ‘other’. If feasibility is judged sufficient, the effects of the training will be explored on 3 levels: (1) self-identity bias, which will be measured with a short computer task based on the Implicit Association Test (IAT), (2) avoidance and all-or-nothing behaviour, and (3) fatigue and vitality levels, which will all be measured with questionnaires.DiscussionThis study aims to evaluate the feasibility of a larger-scale multi-centre Randomized Controlled Trial (RCT) to investigate a novel eHealth application and, if possible, to give indications on the effectiveness of this intervention to counter fatigue in individuals with breast cancer. Using the IVY CBM app requires very little effort, both in time and cognitive load, which could be especially beneficial for fatigue symptoms.Trial registrationRegistered at the Open Science Framework (OSF; https://osf.io/e85g7/) on October 20, 2023.

Comparative efficacy of inhaled nitric oxide therapy (Tianox device) in mild cognitive impairment

Chronic cerebrovascular diseases (CVD) and neurodegenerative diseases (NDD) are the most common causes of cognitive impairment (CI). The development of dementia is preceded by mild CI (MCI) over several years.Objective: to investigat the effect of inhaled nitric oxide therapy on cognitive function (CF) in patients with MCI due to CVD and NDD.Material and methods. The study included 94 patients (25 men and 69 women aged 50 to 76 years, mean age 65.3±8.9 years) with MCI due to CVD and/or NDD of the brain. The patients were randomized into two groups: the main group (therapy) and the control group. The control group comprised 22 patients with MCI (5 men and 17 women aged 50 to 76 years, mean age 62.3±8.5 years) who received standard therapy (antihypertensive, antithrombotic and other agents). The main group comprised 72 patients (20 men and 52 women aged 50 to 76 years, mean age 66.2±8.0 years) who additionally inhaled a nitric oxide-enriched air mixture for 30 minutes daily using the Tianox device. Each patient had from 7 to 10 inhalation sessions (the first trial session lasted 20 minutes, the following sessions 30 minutes). Neuropsychological tests, emotional state and sleep quality were examined at the beginning and 3 and 6 months after the end of treatment. Results. In the main group, after 3 and 6 months, a significant (p<0.05) improvement in CF was found according the Montreal Cognitive Assessment (MoCA-test), Frontal Assessment Battery, the Digit Forward and Backward Span Test, the Digit Symbol Substitution Test, the Munsterberg Test, the Literal Association Test and the 12-word Delayed Free Recall Test. A significant (p<0.05) decrease in anxiety and depression according to the Hospital Anxiety and Depression Scale, the Beck Depression Inventory and the Spielberger Anxiety Scale as well as an improvement in sleep quality according to the Insomnia Severity Index were also observed. The therapy was well tolerated, and no serious adverse events occurred. No significant improvement in CF, emotional state or sleep was observed in the control group.Conclusion. Brief therapy (7–10 sessions) with inhaled nitric oxide improves the CF and emotional state of patients with MCI on a background of CVD and NDD. Further studies on inhaled nitric oxide therapy in patients with MCI in a multicenter randomized trial with sham treatment are needed.

The effect of racial and ethnic attitudes on Hispanic identity in the United States

AbstractI study the determinants of choosing to identify as Hispanic among individuals who are eligible—those whose parents, grandparents, or themselves were born in a Spanish‐speaking country. Using a multiple proxy regression approach, I construct a bias measure based on the Implicit Association Test (IAT) and the American National Election Studies (ANES). I find that individuals with Hispanic ancestry are significantly less likely to self‐identify as Hispanic if they reside in states with high levels of bias. A one standard deviation increase in bias reduces self‐reported Hispanic identity by 4 percentage points among all Hispanics. These effects are more pronounced among second‐generation immigrants with both parents born in a Spanish‐speaking country compared to children of inter‐ethnic parents. These findings have implications for interpreting research on ethnic gaps in economic outcomes and for accurately counting the population.

The benefits of elaborative encoding over retrieval practice for associative learning.

The practice of retrieval has been shown to be highly beneficial for memory retention, but it has seldom been compared with learning strategies other than repeated study. Here, we compared the benefits of retrieval practice (without feedback) with the benefits of two elaborative encoding tasks for word pair learning. Specifically, after studying series of randomly combined word pairs, participants performed an interactive-imagery (Experiments 1-2) or sentence-generation task (Experiments 3-5), retrieval practice, and a letter-counting or a rereading task. In Experiments 1-4, the word pairs were shown after a 24-h interval for testing in its original form or with the second word replaced by the second word from another pair, and participants performed recognition (old/new) followed by associative memory tests (intact/rearranged). In Experiment 5, memory was tested in a final cued-recall task administered shortly after initial learning. The interactive-imagery task was as beneficial as retrieval practice for recognition, but consistently more beneficial than retrieval for performance at the associative task. Sentence generation, on the other hand, produced greater performances than retrieval practice in recognition, associative memory, and cued-recall tests. These findings reveal that simple elaborative encoding tasks, such as imagining scenes or generating sentences, can be more beneficial for memory retention than retrieval practice without feedback.

Implicit Ideologies: Do Right-Wing Authoritarianism and Social Dominance Orientation Predict Implicit Attitudes?

Many social and political attitudes, beliefs, and behaviours can be predicted by Right-Wing Authoritarianism (RWA; a preference for authority and tradition) and Social Dominance Orientation (SDO; a preference for social hierarchies and inequality). These two constructs have predominantly been studied in the context of self-reported (explicit) attitudes, so the usefulness of RWA and SDO to predict individuals’ implicit attitudes remains relatively unclear and understudied. The current research is a Registered Report that uses a large dataset collected as part of Project Implicit to test the predictive power of RWA and SDO for implicit and explicit attitudes toward topics relating to authority, tradition and hierarchies (i.e., concepts most relevant to RWA and SDO). The findings of the current study suggest that RWA and SDO are in fact predictive of some implicit attitudes that are in line with the RWA and SDO ideologies, as well as most corresponding explicit attitudes.

What is at the heart of Macao tourism? Residents’ perspective in implicit and explicit associations with Macao destination images

ABSTRACT Macao's image has been purposefully crafted to reflect tourism diversification strategies, but if not grounded in reality, these efforts will only lead to image confusion. This study uses residents as destination experts and taps into their implicit associations using the Implicit Association Test (IAT) to assess the strength of their associations with various aspects of Macao's image projected to tourists. Based on the Associative Network Theory of Memory (ANT), casino hotels and events emerged as the most automatized, while shopping and art were the least rooted associations at an implicit level. By further comparing residents’ implicit associations with their explicit reflections, a deeply rooted resentment of casino image was discovered, raising concerns for residents’ willingness to support this prominent local industry and the reliability of the image projected to tourists. Practical implications for policymakers are discussed.

Increased Wound Prevalence in those Exposed to Xylazine and Fentanyl Compared to Those Exposed to Fentanyl: An Observational Study.

The aim of this study is to determine the difference, if any, in prevalence of wounds in individuals who were exposed to xylazine and fentanyl compared to individuals who were exposed to fentanyl and not xylazine. A large inpatient substance use disorder specialty hospital provided medical records over an 8-month period from July 2023 to February 2024. Individuals were admitted to an American Society of Addiction Medicine 3.7 level of care where a urine drug screen and skin assessment was conducted on admission. If the urine screen noted a presence of fentanyl, the sample was then tested for xylazine exposure. Patients were considered positive for wounds on admission to treatment if any wound was noted during the skin assessment during the admission process. A total of 282 medical records were identified. A chi square test of association was completed and revealed a statistically significant association between xylazine exposure and wounds (P = 0.002, odds ratio = 2.420, 95% confidence interval = 1.376-4.254). This study provides early support for the previously theorized connection between xylazine exposure and wounds.

How does unconscious processing promote creative problem-solving? An examination using priming methods

This study investigated the effect of unconscious processing on creative problem solving (CPS) by combining a revised priming paradigm that manipulated the content of unconscious processing together with remote association tests (RAT). In the real world, most CPS is facilitated by unconscious information processing after a problem is represented. However, most previous studies have focused on priming subthreshold stimuli before the problem presentation, with few exploring unconscious priming after the problem is presented, even though different prime timings might involve distinct processing mechanisms. Therefore, Experiment 1 compared the unconscious priming effects of presenting the prime prior to the target (Before-T) versus during target solving (During-T). The RAT difficulty and type of priming material were also manipulated. The results of Experiment 1 revealed a significant difference in the priming effects of prime timing with the During-T group benefiting more from subliminal stimuli than the Before-T group. Experiment 2 further strengthened the justifications for the hypotheses regarding the influence of word versus picture priming in the during-T condition. Overall, this study found a clear dissociable contribution of unconscious processing to CPS, and the facilitation effect was optimised by prime timing, the prime material, and RAT difficulty.

Cis-eQTL analysis reveals genes involved in biological processes of the immune system in Nelore cattle

The combination of transcriptional profiling and genotype data analyses enables the identification of genetic variants that may affect gene expression (eQTL – expression quantitative trait loci). This study aimed to identify cis-eQTL in Nellore cattle muscle tissue and determine their biological processes related to the immune system and involved eGenes. Genotypic data (SNP-Chip) and gene expression data (RNA-Seq) from a commercial population of 80 Nellore animals were evaluated. For the cis-eQTL identification, association tests were conducted for all variants near the gene (cis variants), followed by permutation tests to correct for multiple comparisons. Our analyses revealed 828 top cis-eQTL related to 1,062 genes of which most of these variants were in intronic and intergenic regions. The eQTLs rs109525554, rs109589165, rs110192253, rs133127698, rs137742430, rs41803313, rs43366333, and rs43711242 were associated with susceptibility and resistance to infections in cattle. Additionally, interferon family eGenes, such as IFNT3, IFN-TAU, IFNK, FYN, and IFNW1, and endothelial leukocyte migration, such as PRKCG and CXCL10 were found. These eGene families were linked to biological processes of innate and adaptive immune responses and associated with somatic cell scores in cattle, respectively. Our results may have implications for selecting desirable resistance traits in animals bred for production and highlight the importance of studying genetic variants involved in quantitative traits to improve our understanding of genetic mechanisms underlying gene expression regulation of adaptive traits in cattle.

A contemporary analysis of the Australian clinical and genetic landscape of spinal muscular atrophy: a registry based study

New paradigms of diagnosis and treatment have changed the neurodegenerative trajectory for individuals with spinal muscular atrophy (SMA). Registries are a critical tool to provide real-world data on treatment patterns, their effects and health care provision within this evolving paradigm of care. This study aimed to evaluate the phenotypic and genotypic landscape, treatment patterns and health impact of SMA in Australia through the national registry. This cross-sectional study investigated demographic, clinical and genetic information, sequelae of weakness, treatment patterns and patient-reported outcomes amongst individuals with SMA enrolled in the Australian Neuromuscular Disease Registry (ANMDR) from 1st January 2020 to 30th April 2023. Descriptive statistics were used for analysis and Chi-Squared or Fisher's exact tests for associations. 195 individuals with SMA enrolled into the ANMDR. 5/195 (2.6%) were deceased by censor date. Of (n=190) individuals living with SMA, 104/190 (54.7%) were children. Minimum Australian prevalence was 0.73/100,000. SMN2 copies were inversely associated with phenotype in those with homozygous SMN1 deletions (p<0.0001)). Treatment was utilised in 154/190 (81%) of the population, with 65/137 (47.6%) of individuals perceiving improvements with therapeutic intervention on Patient/Parent Global Impression of Improvement scale (p<0.0001). Engagement with multidisciplinary care practitioners was significantly higher among children with SMA than adults (93% versus 12%, p<0.0001). Despite diagnostic and therapeutic advances, mortality and the multi-systemic health impact of SMA continue to be experienced within the Australian population. Healthcare provision must align with patient-centred outcomes, adapting to meeting their changing but ongoing care requirements. The study identified the considerable unmet need for multidisciplinary care, not only for adults with SMA but also for the emerging cohort of treated children, emphasising the imperative for comprehensive healthcare provision to address their evolving needs. No funding was received for this study.

Development of a digital Creative Figural Design Test (CFDT): An approach to integrating divergent and convergent processes

Traditional design fluency tests assess an individual's fluency in figural thinking. This fluency is considered a component of executive function, but is also an indicator of divergent thinking in creative thinking tests. However, few studies have examined the creative potential in design fluency tests. In addition, traditional tests are typically administered using pen and paper, making scoring relatively cumbersome and time-consuming; and, other indicators of divergent thinking (such as flexibility and originality) can be developed in traditional tests. Therefore, this study aims to develop a digital Creative Figural Design Test (CFDT) and use digital scoring methods to explore the creative processes and potential within design fluency tests. In phase one, the CFDT was developed, establishing norms for design fluency, design flexibility, and design originality based on 428 participants’ responses to 200 correct designs. Design flexibility was classified into nine categories through the feature detection rules. For design originality, participants’ responses to the 200 correct designs were scored based on frequency. In phase two, digital scoring of the CFDT was established, allowing for instant calculation of three indicators and comparison with norms. 143 participants were invited to finish the CFDT and validity tests (including divergent thinking test and remote associates test). Reliability analysis showed an acceptable test-retest reliability for three indicators. Validity analysis indicated that the design fluency was positively correlated with the two creative tests, while design flexibility and design originality were only correlated with divergent thinking. We have developed a new open-source tool that further understands the relationship between executive function and creativity.

GATA: Test–retest reliability of measurement outcomes

Social researchers have long sought to overcome the vulnerability of the self-report method to a variety of effects based on respondents’ inability or unwillingness to answer correctly. One obvious strategy for solving this problem is to try to extract information in such a way that the respondent’s attitude towards the object under study can be assessed by his or her actions “indirectly” related to that object, without relying on the respondent’s “direct” answers as to what he or she thinks that attitude is. One of the many tools that claim to be able to probe the respondent’s consciousness in this way is the Graphical Associative Test of Attitudes (GATA). This paper presents a summary of the test-retest reliability of GATA. 18 repeat tests two (12 tests) and four (6 tests) weeks after the initial meas¬urement showed that GATA can potentially produce reliable results. At the same time, this ability is not completely stable, it depends on the subject being assessed and the time between the tests being compared. While the reliability of GATA over a two-week period is often satisfactory (Spearman ρ &amp;gt; 0.700 in 4 out of 12 tests) and comparable to that of the self-report method, over a four-week period, only one out of six GATA evaluations maintains such a high level of reliability. Possible dimensions of future research aimed at improving the reliability of GATA output are discussed in the paper.

A novel phenotype imputation method with copula model

BackgroundJointly analyzing multiple phenotype/traits may increase power in genetic association studies by aggregating weak genetic effects. The chance that at least one phenotype is missing increases exponentially as the number of phenotype increases especially for a real dataset. It is a common practice to discard individuals with missing phenotype or phenotype with a large proportion of missing values. Such a discarding method may lead to a loss of power or even an insufficient sample size for analysis. To our knowledge, many existing phenotype imputing methods are built on multivariate normal assumptions for analysis. Violation of these assumptions may lead to inflated type I errors or even loss of power in some cases. To overcome these limitations, we propose a novel phenotype imputation method based on a new Gaussian copula model with three different loss functions to address the issue of missing phenotype.ResultsIn a variety of simulations and a real genetic association study for lung function, we show that our method outperforms existing methods and can also increase the power of the association test when compared to other comparable phenotype imputation methods. The proposed method is implemented in an R package available at https://github.com/jane-zizhen-zhao/CopulaPhenoImpute1.0ConclusionsWe propose a novel phenotype imputation method with a new Gaussian copula model based on three loss functions. Results of the simulation studies and real data analyses illustrate that the proposed method outperforms comparable methods.

Exploring potential causal genetic variants and genes for endometrial cancer: Open Targets Genetics, Mendelian randomization, and multi-tissue transcriptome-wide association analysis.

Endometrial cancer (EC) is the most common gynecological malignancy in developed countries, with incidence rates continuing to rise globally. However, the precise mechanisms underlying EC pathogenesis remain largely unexplored. This study aims to prioritize genes associated with EC by leveraging multi-omics data through various bioinformatic methods. We utilized the Open Targets Genetics (OTG) database to pinpoint potential causal variants and target genes for EC. To explore the pleiotropic effects of gene expression on EC, we applied the Summary-based Mendelian Randomization (SMR) using summary data from a genome-wide association study (GWAS) on EC and expression quantitative trait loci (eQTL) data from the Consortium for the Architecture of Gene Expression (CAGE). We also conducted a cross-tissue transcriptome-wide association study (TWAS) employing sparse canonical correlation analysis (sCCA). Results from the sCCA TWAS and single-tissue TWAS for 22 tissues were combined using the aggregated Cauchy association test (sCCA + ACAT) to identify genes with cis-regulated expression levels linked to EC. The OTG database recognized 15 genomic loci showing independent association with EC. Gene prioritization highlighted nine genes with relatively high locus-to-gene (L2G) scores (≥0.5), the majority of which aligned with those identified using the closest gene. Colocalization analysis identified 11 additional genes at these loci. Our SMR analysis revealed two genes, EVI2A and SRP14, exhibiting a significant pleiotropic association with EC. Cross-tissue TWAS identified 31 genes whose expression was significantly associated with EC after correction for multiple testing, with four genes (EIF2AK4, EVI2A, EVI2B, and NF1) also confirmed by gene colocalization in the OTG analysis. We confirmed the involvement of EVI2A in the pathogenesis of EC and identified several other genes that may contribute to EC development. These findings offer new insights into the genetic mechanisms underlying EC and may inform future research and therapeutic strategies.

The role of predominant polarity on cognitive dysfunctions in patients with bipolar disorder

BackgroundCognitive impairment is frequently observed in bipolar disorder (BD). Previous findings indicated that predominant polarity could have an effect on cognitive deficits. This study aimed to examine the association between predominant polarity and cognitive impairments in BD.Materials and methodsEuthymic BD patients with manic (MPP, n = 31), depressive (DPP, n = 25), undetermined predominant polarity (UPP, n = 28), and healthy controls (HC, n = 27) participated in the study. A battery of neurocognitive and social cognitive tests was implemented. Neurocognitive domains were identified via principal component analysis.ResultsThe MPP group performed worse in the Controlled Oral Word Association Test (COWAT), Reading the Mind in the Eyes Test (RMET), and Hinting Test (HT) compared to the DPP group and reasoning/problem-solving skills compared to the UPP group. Both MPP and UPP groups showed impairments in processing speed compared to HC. Among patient groups, there was no significant difference in working memory, attention, processing speed, verbal, and visual domain scores. The MPP group had poorer scores compared to controls in most of the social cognitive and neurocognitive domains in the study, while the overall cognitive impairment in the DPP group was relatively milder.ConclusionsAlthough our sample size was relatively small, the MPP group yielded more severe cognitive impairment in verbal fluency and social cognition tests compared to DPP. Patients with MPP are particularly vulnerable to cognitive impairment, making them a priority for cognitive enhancement interventions. Future studies should focus on the outcomes of cognitive and pharmacological interventions in these polarity subgroups.

The genetic origins of species boundaries at subtropical and temperate ecoregions in the North American racers (Coluber constrictor).

Phylogeographically structured lineages are a common outcome of range-wide population genetic studies. In the southeastern United States, disconnection between populations found at the intersection of the southeastern coastal plains of peninsular Florida and the southeastern plains of the adjacent continent is readily apparent among many plants and animals. However, the timing and maintenance of species boundaries between these distinctly different subtropical and temperate regions remains unknown for all organisms studied there. Using genome-scale data, we examine the timing of origins, gene flow, and the movement of genes under selection in unique ecoregions within the North American racers (Coluber constrictor). Isolation-migration models along with tests of genome-wide selection, locus-environment associations, and spatial and genomic clines demonstrate that two unrecognized species are present and are in contact at the boundary of these two ecoregions. We show that selection at several loci associated with unique environments have maintained species boundaries despite constant levels of gene flow between these lineages over thousands of generations. This research provides a new avenue of research to examine speciation processes in poorly studied biodiversity hotspots.

The Reliability of the gender Implicit Association Test (gIAT) for Explaining Female−Male Differences in High-Ability Careers

The Reliability of the gender Implicit Association Test (gIAT) for Explaining Female−Male Differences in High-Ability Careers

Exploration of the Impact of Language Proficiency on Vocabulary Association Patterns in English Language Education

This paper explores the lexical association patterns of English as a second language and their relationship with language proficiency. Through the vocabulary association test, the study analyzes the differences in vocabulary association between learners with different language levels. The participants were 100 non-native English-speaking undergraduate students from a top 200 university, such as the University of Nottingham, and a university outside the top 200, such as the University of Aberdeen; the two groups of learners differed in their vocabulary size and learning style. It was found that the two groups of learners differed significantly in vocabulary size, language background, and learning experience. In addition, the study raises three core questions: first, learners’ lexical association patterns, second, differences in association among learners with different language proficiency levels, and third, other variables that affect vocabulary association ability. The limitations of the study are that reaction time was not measured and the influence of native language background on word association was not fully considered; future research should further explore these aspects.

Rare germline variants in cancer-relevant genes are associated with breast cancer risk in young women with high-risk family history.

It is incompletely understood why some women develop breast cancer 15-20years earlier than the majority of women. We hypothesize that women with early-onset breast cancer and high-risk family history without germline pathogenic variants in cancer-predisposing genes (CPGs, n = 83) have a higher load of germline high functional impact variants (gHFI) in cancer hallmark genes (n = 1508) compared to healthy controls. Germline whole exome sequencing data were analyzed from 5818 breast cancer cases from UKBiobank and from 94 young women with breast cancer without CPG pathogenic variants from the Yale Cancer Prevention Clinic, and compared to 149 controls from Yale GENERATIONS project and 56,917 controls from UKBiobank. Rare gHFI variants were compared between cases and controls using the burden test and the optimal unified SNP-set Kernel Association Test (SKAT-O). We assessed germline versus somatic origins of pathway level alterations in the TCGA and Yale data. In UKBiobank, higher gHFI variant load was seen in CPGs in cancer cases regardless of family history (p < 8.78 × 10-8), and in hallmark genes in cases with family history vs controls (p = 0.0093). Similarly, numerically higher rare gHFI burden was seen in hallmark genes in the Yale cohort vs controls, but this difference was not statistically significant. Pathway level alterations were dominated by somatic events. These results suggest that rare germline variants in cancer biology-related genes partly mediate the contribution of family history to cancer risk in individuals without germline alterations in high penetrance CPGs.

A Mixed Effect Similarity Matrix Regression Model (SMRmix) for Integrating Multiple Microbiome Datasets at Community Level.

Recent studies have highlighted the importance of human microbiota in our health and diseases. However, in many areas of research, individual microbiome studies often offer inconsistent results due to the limited sample sizes and the heterogeneity in study populations and experimental procedures. This inconsistency underscores the necessity for integrative analysis of multiple microbiome datasets. Despite the critical need, statistical methods that incorporate multiple microbiome datasets and account for the study heterogeneity are not available in the literature. In this paper, we develop a mixed effect similarity matrix regression (SMRmix) approach for identifying community level microbiome shifts between outcomes. SMRmix has a close connection with the microbiome kernel association test, one of the most popular approaches for such a task but is only applicable when we have a single study. SMRmix enables researchers to consolidate findings from diverse microbiome studies. Via extensive simulations, we show that SMRmix has well-controlled type I error and higher power than some potential competitors. We applied the SMRmix to two real-world datasets. The first, from the HIV-reanalysis consortium, integrated data from 17 studies on gut dysbiosis in HIV. Our analysis confirmed consistent associations between the gut microbiome and HIV infection as well as MSM (men who have sex with men) status, demonstrating greater power than competing methods. The second dataset involved 11 studies on the gut microbiome in colorectal cancer; analysis with SMRmix confirmed significant dysbiosis in affected individuals compared to healthy controls. The development of SMRmix enables the integration of multiple studies and effectively managing study heterogeneity, and provides a powerful tool for uncovering consistent associations between diseases and community-level microbiome data.