Between-subjects Analysis Research Articles

Secular Trends in Physical Growth Among Peruvian Children and Adolescents Living at High Altitudes.

We aim (1) to examine secular trends in height, weight, and waist circumference (WC) among Peruvian children and adolescents living in the city of Junín and (2) to compare their growth status with the World Health Organization (WHO) and US Centers for Disease Control and Prevention (CDC) reference data. The sample included 2874 Peruvians (n = 1681 in the 2009 cohort and n = 1193 in the 2019 cohort) aged 6-16 years from the district of Junín (4107 m of altitude). Height, weight, and WC were measured using standardized protocols. Within each sex, a two-way between-subjects analysis of variance-age, and cohort as main factors and age-by-cohort as the interaction-was used to test for differences in height, weight, and WC. STATA 17 software was used in all statistical analyses. Height revealed a positive secular trend among girls, aged 6-11 years, and among boys up to 14 years of age. Similar positive secular trends in weight and WC were found across all age groups in both boys and girls. Compared to North American peers, children in the 2009 cohort were shorter, lighter, and had a smaller WC. For weight and WC, the 2019 cohort overlapped the 50th percentile across all age groups (except for 16-year-old girls). Both boys' and girls' height, weight, and WC showed positive secular trends between 2009 and 2019, with statistically significant differences varying across age groups. Peruvian youth of both sexes were shorter and lighter than their North American peers.

The Impact of a Digital Contraceptive Decision Aid on User Outcomes: Results of an Experimental, Clinical Trial.

Nearly 40% of unplanned pregnancies in the USA are the result of inconsistent or incorrect contraceptive use. Finding ways to increase women's comfort and satisfaction with contraceptive use is therefore critical to public health. One promising pathway for improving patient outcomes is through the use of digital decision aids that assist women and their physicians in choosing a contraceptive option that women are comfortable with. Testing the ability of these aids to improve patient outcomes is therefore a necessary first step toward incorporating this technology into traditional physician appointments. To evaluate the effectiveness of a novel contraceptive decision aid at minimizing decisional conflict and increasing comfort with contraception among adult women. In total, 310 adult women were assigned to use either the Tuune contraceptive decision aid or a control aid modeled after a leading online contraceptive prescriber's patient intake form. Participants then completed self-report measures of decisional conflict, contraceptive expectations, satisfaction, and contraceptive use intentions. Individual between-subjects analysis of variance (ANOVA) models were used to examine these outcomes. Women using the Tuune decision aid (vs. those using the control aid) reported lower decisional conflict, more positive contraceptive expectations, greater satisfaction with the decision aid and recommendation, and more positive contraceptive use intentions. Use of Tuune improved each of the predicted patient outcomes relative to a control decision aid. Online decision aids, particularly when used alongside physician consultations, may be an effective tool for increasing comfort with contraceptive use. NCT05177783, ClinicalTrials.gov, https://clinicaltrials.gov/ct2/show/NCT05177783.

Examining Behavioral Variations in Disadvantaged Adolescents: A Cross-Racial Study of African, Latinx, and Asian American Adolescents

This study explored racial differences in internalizing and externalizing problems among minority adolescents in impoverished urban communities. The study centered on a sample of 211 participants who were engaged in the 2018 Building Resilience Against Violence Engagement (BRAVE) programs. Their internalizing and externalizing problems were assessed using Youth Self-Report (YSR). The results of a one-way between-subjects Analysis of Variance (ANOVA) uncovered substantial racial disparities, with African American adolescents reporting a higher prevalence of externalizing problems compared to Asian adolescents. Additionally, Latinx adolescents exhibited the highest prevalence of delinquency rate at the p < .05 level. These findings underscore the strong connection between racial groups and youth problems, emphasizing the importance of considering racial factors in the context of service provision for minority adolescents.

The potency of audiovisual attractiveness and influencer marketing: The road to customer behavioral engagement

Digital technologies have signified audiovisual (vs. textual) cues for customers on online booking platforms (e.g., Airbnb and hotels). Predicating on the current literature, this study investigates the influencers' audiovisual attractiveness, customer-influencer interaction, and their consequent customer behavioral engagement using three experimental studies. This research involved an analysis using IBM SPSS 28.0, which included independent sample t-test and One-way ANOVA. Additionally, moderation analysis was conducted using the PROCESS macro model 4. In order, Study 1 reveals that influencers' audiovisual attractiveness at high (vs. low) significantly and directly manipulate customer engagement. In Study 2, using Process Model 4, customer-influencer interaction significantly mediates the relationships between influencers' audiovisual attractiveness and customer behavioral engagement. Last, Study 3 incorporates the moderation of influencers' audiovisual expertise between customer-influencer interaction and customer behavioral engagement. The two-way between-subjects analysis anchors that when influencers’ audiovisual expertise is high (vs. low), and customers having good (vs. bad) interactions, it engenders higher effects on customer behavioral engagement. The findings add to the literature on consumer engagement on booking platforms and underscore the potency of audiovisual attractiveness to engage customers. We also acknowledge the shortcomings and provide recommendations for future studies.

Study of the Length of time Window in Emotion Recognition based on EEG Signals

The objective of this research is to present a comparative analysis using various lengths of time windows (TW) during emotion recognition, employing machine learning techniques and the portable wireless sensing device EPOC+. In this study, entropy will be utilized as a feature to evaluate the performance of different classifier models across various TW lengths, based on a dataset of EEG signals extracted from individuals during emotional stimulation. Two types of analyses were conducted: between-subjects and within-subjects. Performance measures such as accuracy, area under the curve, and Cohen's Kappa coefficient were compared among five supervised classifier models: K-Nearest Neighbors (KNN), Support Vector Machine (SVM), Logistic Regression (LR), Random Forest (RF), and Decision Trees (DT). The results indicate that, in both analyses, all five models exhibit higher performance in TW ranging from 2 to 15 seconds, with the 10 seconds TW particularly standing out for between-subjects analysis and the 5-second TW for within-subjects; furthermore, TW exceeding 20 seconds are not recommended. These findings provide valuable guidance for selecting TW in EEG signal analysis when studying emotions.

The impact of progress indicators and information density on users' temporal perception and user experience in mobile pedestrian navigation applications

This study examines progress indicators and information density in mobile pedestrian navigation applications and explores their impact on user duration perception and experience. The study attempted to improve the user's pedestrian navigation experiences through different interface visual design strategies. We conducted a 3 × 2 between-subjects analysis to evaluate the effect of progress indicators (bar, pointer, and countdown) and visual information (less and regular information) in a simulated pedestrian navigation application. Forty-eight subjects participated in a one-on-one manipulation experiment simulating walking a designated route, followed by duration judgments and scale surveys. The results showed that progress indicator types significantly influenced participants' duration perceptions. The duration perception of “less information” increased by nearly 26.3%, and the duration perception of “regular amount of information” decreased by almost 29%. In addition, participants experienced the progress “bar” type as having higher learnability. Finally, participants preferred the “bar” type progress indicator, and the information density did not affect their preferences.

Graphical features of interactive dashboards have little influence on engineering students performing a design task

This study investigates how interactive dashboards influence decision making by exploring how specific dashboard features impact design task performance, efficiency, understanding, and confidence. An experiment was conducted in which undergraduate student participants were given a design activity and randomly assigned to one of five dashboards, each using the same underlying functions but varying in the visualization features employed. These features include different graphical representations of the design decision inputs and performance outputs. Participants were first asked to use their assigned dashboard to design a catapult system that maximizes launch distance while meeting requirements related to height, weight, and cost. Following the design task, they were asked a series of questions about their experiences with the dashboard and their understanding of the catapult model. A between-subjects analysis then evaluated how the dashboard design influenced various outcomes of interest. The results show that students who used the most feature-rich dashboard did not perform objectively better than those with the most feature-sparse dashboard, though their self-reported performance was higher. The performance of female versus male participants was also compared, with no significant differences found. The findings support the notion that dashboards should be designed with minimal features to convey the necessary information, and they also point out the disconnect between objective performance and user-assessed performance with interactive dashboards.

Consumer perceptions of price increase by CSR: Focusing on construal level and consumer attribution

Product price increases caused by Corporate Social Responsibility (CSR) activities can stifle sales. In this study, we investigate consumers’ perceptions of prices raised by CSR and ways to improve negative consumer viewpoints. This study presents consumers’ construal level and internal attribution as key variables. As a result of Study 1 applying 2 (price level) x 2 (construal level) between-subjects analysis, consumers with activated high-level construal perceived product price as a benefit derived from CSR, whereas those with activated low-level construal perceived product price as a cost. As a result of Study 2 examining the influence of intrinsic attribution, the negative effect of product price was mitigated when consumers’ intrinsic attribution was activated. Consumers with intrinsic attribution perceived product price as benefits of CSR regardless of their construal level. The results of this study are expected to provide important guidelines regarding the success of corporate CSR strategies. Finally, we propose the related academic and practical implications.

A cross-sectional investigation of back pain beliefs and fear in physiotherapy and sport undergraduate students.

Although low back pain (LBP) beliefs have been well investigated in mainstream healthcare discipline students, the beliefs within sports-related study students, such as Sport and Exercise Science (SES), Sports Therapy (ST), and Sport Performance and Coaching (SPC) programmes have yet to be explored. This study aims to understand any differences in the beliefs and fear associated with movement in students enrolled in four undergraduate study programmes-physiotherapy (PT), ST, SES, and SPC. 136 undergraduate students completed an online survey. All participants completed the Tampa Scale of Kinesiophobia (TSK) and Back Beliefs Questionnaire (BBQ). Two sets of two-way between-subjects Analysis of Variance (ANOVA) were conducted for each outcome of TSK and BBQ, with the independent variables of the study programme, study year (1st, 2nd, 3rd), and their interaction. There was a significant interaction between study programme and year for TSK (F(6, 124) = 4.90, P < 0.001) and BBQ (F(6, 124) = 8.18, P < 0.001). Post-hoc analysis revealed that both PT and ST students had lower TSK and higher BBQ scores than SES and SPC students particularly in the 3rd year. The beliefs of clinicians and trainers managing LBP are known to transfer to patients, and more negative beliefs have been associated with greater disability. This is the first study to understand the beliefs about back pain in various sports study programmes, which is timely, given that the management of injured athletes typically involves a multidisciplinary team.

Changes in physical performance during British Army Junior Entry, British Army Standard Entry and Royal Air Force Basic Training

IntroductionThe purpose was to quantify physical performance in men and women during British Army Junior Entry (Army-JE), British Army Standard Entry (Army-SE) and Royal Air Force (RAF) basic training (BT).DesignProspective...

A Conversational, Virtual, Avatar-Led Cognitive Behavioral Therapy App Intervention for Improving the Quality of Life and Mental Health of People With Epilepsy: Protocol for a Randomized Controlled Trial.

Epilepsy is a common neurological disorder affecting about 1 in 100 people in the United Kingdom. Many individuals experience a lower quality of life as a result of their epilepsy diagnosis and are more likely to develop mental health problems, such as anxiety and depression. Medical interventions for this client group tend to focus on the treatment of seizures, whereas mental health disorders often remain undiagnosed and untreated. Early identification and treatment of mental health difficulties in people with epilepsy are vital to ensure better outcomes and improvements in quality of life. The aim of this exploratory randomized controlled trial is to evaluate whether an 8-week cognitive behavioral therapy-based intervention delivered through a mobile app-ThinkNinja for Epilepsy-is a clinically effective tool to improve quality of life, mental health, and emotional well-being in a large sample of people with epilepsy and anxiety or comorbid anxiety and depression. The study aims to recruit 184 individuals, 18 to 65 years of age, with a self-reported diagnosis of epilepsy and anxiety or comorbid anxiety and depression. Participants will be randomly assigned to the ThinkNinja for Epilepsy app condition (arm A) or the waiting-list control group (arm B). Participants in arm A will receive access to the ThinkNinja for Epilepsy app first. After 8 weeks, participants in arm B will receive the same full access to the ThinkNinja for Epilepsy app as the participants in arm A. This design will allow an initial between-subjects analysis between the two conditions as well as a within-subject analysis including all participants. The primary outcome is participants' quality of life, measured by the 10-item patient-weighted Quality of Life in Epilepsy questionnaire. The secondary outcomes include measures of anxiety, using the 7-item Generalized Anxiety Disorder assessment; depression, using the 9-item Patient Health Questionnaire; medication adherence, using the Medication Adherence Questionnaire; and impression of change, using the Patient Global Impression of Change questionnaire. Recruitment for this study began in March 2022 and was completed in October 2022. We expect data collection to be finalized by May 2023 and study results to be available within 12 months of the final data collection date. Results of the study will be written up as soon as possible thereafter, with the intention of publishing the outcomes in high-quality peer-reviewed journals. This study aims to determine the clinical efficacy and safety of the ThinkNinja for Epilepsy intervention at improving the quality of life, mental health, and emotional well-being of people with epilepsy. The findings from our study will hopefully contribute to addressing the critical gap in universal provision and accessibility of mental health and emotional well-being support for people with epilepsy. ISRCTN Registry 16270209 (04/03/2022); https://www.isrctn.com/ISRCTN16270209. DERR1-10.2196/40261.

Assessing the contrast sensitivity function in myopic parafovea: A quick contrast sensitivity functions study.

PurposeCompare peripheral contrast sensitivity functions (CSF) between myopes and emmetropes to reveal potential myogenic risks during emmetropization.Materials and methodsThis observational, cross-sectional, non-consecutive case study included data from 19 myopes (23.42 ± 4.03 years old) and 12 emmetropes (22.93 ± 2.91 years old) who underwent central and peripheral quick CSF (qCSF) measurements. Summary CSF metrics including the cut-off spatial frequency (cut-off SF), area under log CSF (AULCSF), low-, intermediate-, and high-spatial-frequency AULCSFs (l-, i-, and h-SF AULCSFs), and log CS at 19 SFs in the fovea and 15 peripheral locations (superior, inferior, temporal, and nasal quadrants at 6, 12, 18, and 24° eccentricities, excluding the physiological scotoma at 18°) were analyzed with 3-way and 4-way between-subjects analysis of variance (ANOVA) (α = 0.05).ResultsThree-way ANOVA showed that myopes had significantly increased AULCSF at 6° (mean difference, 0.08; 95% CI, 0.02–0.13; P = 0.007) and 12° (mean difference, 0.09; 95% CI, 0.03–0.14; P = 0.003). Log CS at all 19 SFs were higher in the myopia group compared to the normal group (mean differencesuperior, 0.02; 95% CI, 0.01–0.20; P = 0.02 and mean differenceinferior, 0.11; 95% CI, 0.02–0.21; P = 0.01) at 12°. The h-SF AULCSF at 6° (mean differenceinferior, 1.27; 95% CI, 0.32–2.22; P = 0.009) and i-SF AULCSF at 12° (mean differencesuperior, 5.31; 95% CI, 4.35–6.27; P < 0.001; mean differenceinferior, 1.14; 95% CI, 0.19–2.10; P = 0.02) were higher in myopia vs. normal group.ConclusionWe found myopia increased contrast sensitivity in superior and inferior visual field locations at 6° parafoveal and 12° perifoveal regions of the retina. The observation of increased contrast sensitivities within the macula visual field in myopia might provide important insights for myopia control during emmetropization.

Lysergic Acid Diethylamide–Assisted Therapy in Patients With Anxiety With and Without a Life-Threatening Illness: A Randomized, Double-Blind, Placebo-Controlled Phase II Study

BackgroundThis study aimed to investigate the efficacy and safety of lysergic acid diethylamide (LSD)–assisted therapy in patients who experienced anxiety with or without association with a life-threatening illness. MethodsThe study is an investigator-initiated 2-center trial that used a double-blind, placebo-controlled, 2-period, random-order, crossover design with 2 sessions with either oral LSD (200 μg) or placebo per period. The primary end point was anxiety symptoms 16 weeks after the last treatment session, assessed by the Spielberger State-Trait Anxiety Inventory–Global score in 42 patients. Further outcome measures included ratings for depression symptoms (Beck Depression Inventory and Hamilton Depression Rating Scale, 21-item version) and ratings for acute subjective drug effects. The outcomes for the first period (between-subjects analysis) are primarily shown due to carryover effects. ResultsLSD treatment resulted in significant reductions of State-Trait Anxiety Inventory–Global scores up to 16 weeks after treatment (least-square mean [standard error] change from baseline difference = −16.2 [5.8], 95% CI, −27.8 to −4.5, d = −1.18, p = .007). Similar effects were observed for ratings of comorbid depression on the Hamilton Depression Rating Scale, 21-item version (−7.0 [1.9], 95% CI, −10.8 to −3.2, d = −1.1, p = .0004) and the Beck Depression Inventory (−6.1 [2.6], 95% CI, −11.4 to −0.9, d = −0.72, p = .02). Positive acute subjective drug effects and mystical-type experiences correlated with the long-term reductions in anxiety symptoms. Transient, mild, acute untoward effects of LSD treatment were reported by 8 patients (19%). One treatment-related serious adverse event (acute transient anxiety) occurred (2%). ConclusionsLSD produced long-lasting and notable reductions in anxiety and comorbid depression symptoms up to 16 weeks.

Early Childhood Teachers’ Inclusion in Their Elementary School’s Social-Emotional Multitiered System of Supports: A Mixed Methods Study

In this mixed methods study, we used a state-wide survey to explore the perceptions of 936 preschool through second-grade teachers about inclusion in their elementary school’s social-emotional multitiered system of supports (MTSS). Overall, early childhood teachers reported feeling included in their school’s social-emotional MTSS. Results of a one-way between-subjects analysis of variance (ANOVA) indicated that preschool teachers working in elementary schools reported general agreement about being included, but not as strongly as kindergarten, first-, and second-grade teachers. Qualitative analyses of teachers’ open-ended responses revealed similar grade-level patterns. When early childhood teachers did not feel included, they described feeling separate from the rest of the school, using a different social-emotional approach, or the school’s social-emotional MTSS approach not being appropriate for their students. Inclusion in school-wide activities and implementation issues, such as consistency across teachers, an efficient behavioral MTSS process, and training opportunities, affected teachers’ feelings of inclusion in the social-emotional MTSS.

Using Structural Equation Modeling in Place of Between-Subjects Analysis of Variance

This article demonstrates how to use structural equation modeling (SEMing) in place of between-subjects analysis of variance (BS-ANOVA). More specifically, this article demonstrates how to closely reproduce the F-values and p-values from ANOVA (for all main and interactions effects) using an SEM model comparison approach (i.e., difference tests between two SEMs that conform to the main and interaction effects of the null and alternative hypotheses of an ANOVA main or interaction effect). Therefore, researchers less familiar with SEM can use this article to test hypotheses common to BS-ANOVA, and potentially use this article as a steppingstone for implementing more complex SEMs (including modern methods for missing data, estimation of latent variables, and relaxation of homogeneity of variance assumptions).

Knowledge, Attitudes, and Beliefs of Pediatric Health Care Workers: Understanding the Response to COVID-19.

IntroductionThis research aims to assess knowledge, attitudes, and beliefs of PHCW regarding COVID-19.MethodData collected using an electronic survey sent to pediatric health care workers.ResultsAge was not likely to influence willingness to care for patients with COVID-19. Males were more likely to be willing to care for patients than female. Nurse practitioners were more likely to be willing to care for patients with COVID-19 than physicians. Availability of proper personal protective equipment, COVID-19 knowledge, and training did not influence willingness to care for COVID-19 patients. Healthcare workers with a higher risk of COVID-19-related sickness, and who received most of their COVID-19 information from social media, were less likely to be willing to care for COVID positive patients. As perception of hospital preparedness increased, reluctance to care for COVID-19 positive patients decreased.DiscussionHospital preparedness and social media exposure play a significant role in willingness to care for patients with COVID-19.

Restless legs syndrome severity in the National RLS Opioid Registry during the COVID-19 pandemic

Objective/backgroundNo research has yet assessed the impact of the coronavirus disease 2019 (COVID-19) pandemic on restless legs syndrome (RLS). We hypothesized that RLS symptom severity would be increased during the COVID-19 pandemic in a sample of patients with diagnosed RLS. Patients/methodsThe National RLS Opioid Registry is a longitudinal observational study of patients using opioid medications for treatment of RLS. Questionnaires assessing RLS symptom severity, medication dosages, sleep disturbance, depression, and anxiety are administered at baseline and at recurring 6-month surveys. Survey responses from the outset of the pandemic in April/May 2020 were compared to responses completed by other participants in January/February 2020 (between-subjects analysis), as well as responses by the same participants at baseline, approximately six months later in September 2020 through February 2021, and approximately one year later in March through June 2021 (within-subjects analyses). ResultsThese analyses provide evidence for higher RLS symptom severity scores at the outset of the COVID-19 pandemic in the US. Symptom severity scores were still elevated on subsequent questionnaires completed over six months into the pandemic but had returned towards baseline by the spring of 2021. Participants with increases in RLS severity were significantly more likely than others to see increases in sleep disturbance, depression, and anxiety. ConclusionsThis is the first study demonstrating increased RLS symptom severity during the earliest stage of the COVID-19 pandemic. These findings warrant similar investigations in other patient populations and suggest that clinicians should attend to RLS symptoms during times of socioeconomic and/or political uncertainty.

Meta-cognitive impairment in processing ingredients: the effects of jargon, list length and aids on young consumers’ evaluations of cosmetic products

PurposeThis study aims to examine the nonidentical impacts of identical panel information that discloses cosmetic ingredients by their English (i.e. low jargon; e.g. vitamin E) versus scientific names (i.e. high jargon; tocopherol instead) presented in short versus crowded panel on young consumers’ confidence in processing ingredients information and product judgements. In the same context, this study also explores the effects of declarative aids provided within the ingredients panel.Design/methodology/approachThis study conducted four experiments by using a 2 (jargon: high, low) × 2 (ingredients list: short, long) between-subjects analysis of variance design.FindingsYoung consumers’ processing-confidence and product evaluations increase (decrease) when the panel is brief (crowded) and presents cosmetic ingredients in low (high) jargon (Experiments 1, 2). However, when it discloses a factual aid [i.e. ingredient functions; e.g. tocopherol (antioxidant)], confidence in processing even the high-jargon information, as well as product judgements, increases irrespective of the panel’s length (Experiment 3). Moreover, a fictitious aid (e.g. dryness-fighting “atomic robots”) stimulates the same effect and bolsters processing confidence and product evaluations irrespective of both jargon and panel’s length (Experiment 4).Originality/valueDespite their heavy use of over-the-counter beauty/cosmetic products, little do we know how young consumers consult and use on-pack ingredients information provided in one format versus the other. To the best of the author’s knowledge, this study is the first experimental work investigating the cosmetics-consuming youth’s reactions to panel format and aids to processing.

Shot Distribution and Accuracy in Senior and Youth International Basketball Games: Changes over the Decade of the 2010s.

This study aimed to investigate the changes in shot distribution and accuracy in senior and under-17 international basketball tournaments in the 2010s. A retrospective cross-sectional design was employed, and a total of 1055 games from 20 world-level tournaments held between 2010 and 2019 were analyzed. The tournaments held in 2010 were played under the old three-point line (6.25 m), and the rest of the tournaments were played under the new three-point line (6.75 m). The numbers of two- and three-point shot attempts in each game were normalized to 100 possessions. Differences in mean values of two- and three-point shot attempts were analyzed by a two-way (category × year) between-subjects analysis of variance (ANOVA). Differences in the success rates of two- and three-point shots were analyzed by Fisher’s exact test. There was no significant category × year interaction for two-point shot attempts. However, there were significant main effects of category and year for two-point shot attempts. The number of two-point shot attempts increased significantly in 2012 and, in 2016, returned to a level not significantly different from that in 2010, independent of categories. There was a significant category × year interaction for three-point shot attempts. The number of three-point shot attempts decreased significantly in 2012 and, by 2016, returned to a level not significantly different from that in 2010 in senior men and under-17 women. There was no significant change in the number of three-point shot attempts in under-17 men. The effect of the extension of the three-point line on shot accuracy was limited. Differences in shot accuracy were prominent between age categories: the accuracy was lower in under-17 games than in senior games for both sexes. Although under-17 men attempted fewer three-point shots than senior men, under-17 women attempted a similar number of or more three-point shots than senior women. These findings can contribute to a better understanding of age and sex differences in recent trends in international basketball.

Clinical Cohort Validation of Sex-Specific Effect of Apolipoprotein E Status on Psychosis in Alzheimer's Disease

<h3>Introduction</h3> Psychosis is one of the most typical and persistent neuropsychiatric manifestations of AD where nearly half of AD patients experiences psychotic symptoms such as hallucinations and/or delusions (Ropacki & Jeste., 2005). Psychotic AD patients tend to have poorer overall health (Bassiony et al., 2000) and experience greater cognitive and functional impairments (Chui et al., 1994; Fischer et al., 2012). These qualities contribute to a reduced quality of life for patients and their caregivers. Researchers from our group found that psychosis risk in neuropathologically-diagnosed AD patients is significantly higher in females who are homozygous positive for <i>APOE</i> ε4 with the presence of Lewy body pathology (Kim et al., 2017). These results point to a sexual dimorphism in AD psychosis where the ε4 allele may play a larger role in influencing psychosis development in females. We hypothesize that AD patients with this high-risk profile (female and homozygous positive for <i>APOE</i> ε4) are more susceptible to psychosis, potentially leading to more severe symptoms as well as earlier disease onset respectively. As such, this exploratory study aims to validate the sex-specific effect of <i>APOE</i> ε4 status (i.e. high-risk profile) on psychosis in a clinical cohort. <h3>Methods</h3> We first obtained all required Research Ethics Board approval from St. Michael's Hospital and the National Alzheimer's Coordinating Centre (NACC). A series of parallel analyses were conducted via SPSS (Version 27.0.0.0). For each analysis, we first conducted a descriptive analysis of our sample including age, sex, cognitive status, psychosis status, and presence of the relevant alleles. Patients with CNS neoplasm, non-AD-induced dementia, and significant psychiatric co-morbidity were excluded as per the inclusion/exclusion criteria for NACC. Participants Selected participants from the NACC database had a presumptive etiological diagnosis of AD from a clinician. They also had available <i>APOE</i> ε4 status and Neuropsychiatric Inventory Questionnaire (NPI-Q) data. Subjects were categorized by high-risk profile. Subjects with either hallucinations or delusions as defined by the NPI-Q were considered psychotic (Figure 1). Procedure & Analyses We investigated the effect of having a high-risk profile (female and homozygous positive for <i>APOE</i> ε4) on age and neuropsychiatric test scores at initial visit, as well as presence and severity of psychotic symptoms (delusions or hallucinations). <h3>Results</h3> To investigate the effect of the high-risk profile on age, we conducted a one-way between-subjects analysis of variance in the high-risk vs. non-high-risk conditions. Subjects with the high-risk profile (M = 70.43, SD = 7.75) were significantly younger than those without the profile (M = 74.69, SD = 9.76) at the time of their initial visit [F(1, 16202) = 139.05, <i>p</i> < .001] (Figure 2). To investigate the effect of the high-risk profile on the presence of delusions and hallucinations, we conducted a binary logistical regression for each psychotic symptom. We found that the high-risk profile significantly predicted the presence of delusions, <i>b</i> = 0.302, df = 1, <i>p</i> = .004. There was no significance for hallucinations. Lastly, to study the effect of the high-risk profile on the severity of delusions and hallucinations, we conducted an ordinal logistical regression for each psychotic symptom. Subjects with the high-risk profile had a predicted increase of 0.388 in the log-odds of being in a more severe category for delusions, <i>p</i> = .041. Similarly, high-risk individuals had a predicted increase of 0.638 in the log-odds of being in a more severe category for hallucinations, <i>p</i> = .046. <h3>Conclusions</h3> From our results, the high-risk profile of being female and homozygous positive for <i>APOE</i> ε4 seems to be associated with an earlier age of initial visit, an increased presence of delusions and more severe psychotic symptoms. In terms of psychosis in AD, our findings are in line with our prior work suggesting <i>APOE</i> ε4 may play a modulatory role in the development of psychosis in female patients with AD, leading to earlier onset of symptoms, increased prevalence of delusions and more severe psychotic symptoms (Kim et al., 2017). Taken together, we believe that this high-risk profile may be a significant step towards understanding the mechanisms that underly AD and psychosis in AD. Future directions include elucidating the sex-specific cellular mechanisms on <i>APOE</i> ε4 status. <h3>Funding</h3> We wish to acknowledge the generosity of the St. Michael's Hospital Foundation and the Heather and Eric Donnelly endowment.