Differences In Effect Sizes Research Articles

Pilates exercise in pregnancy: a systematic review and meta-analysis.

Pilates is widely acknowledged as an effective exercise for enhancing physical, psychological, and motor functions. However, there remains ongoing debate regarding the effects of Pilates on pregnancy outcomes. Thus, the objective of this systematic review was to evaluate and critically analyze the existing scientific evidence regarding the effects of Pilates on pregnant women. A thorough search was performed across 7 databases, focusing on articles published up to June 2024. The quality of evidence was assessed using the Cochrane RoB Tool, and STATA 17.0 software was utilized to perform tests for heterogeneity, publication bias, and sensitivity analysis. (1) A total of 11 studies were included in this review, comprising 538 participants. Among these, 3 studies exhibited a low risk of bias, while 8 studies presented an unclear risk of bias. (2) The meta-analysis results indicated that Pilates exercise resulted in non-significant changes in the Body Mass Index (BMI) of pregnant women (SMD 0.02; 95% CI, -0.27 to 0.31; P = 0.887), the body weight of pregnant women (SMD 0.25; 95% CI, -0.52 to 1.02; P = 0.519), the mode of delivery (RR 1.41; 95% CI, 0.95 to 2.09; P = 0.093), and the Low-density lipoprotein (LDL) levels of pregnant women (SMD - 1.182; 95% CI, -2.443 to 0.079; P = 0.066). However, Pilates exercise during pregnancy was associated with significant improvements in APGAR scores at 1min (SMD 0.41; 95% CI, 0.08 to 0.74; P = 0.015), a reduction in the duration of labor (SMD - 0.557; 95% CI, -0.915 to -0.198; P = 0.002), and a decrease in the Visual Analogue Score (VAS) score (SMD - 0.76; 95% CI, -1.45 to -0.07; P = 0.032). (3) Sensitivity analysis revealed no significant differences in effect size before and after the removal of any individual study, indicating that the meta-analysis results were stable. This systematic review and meta-analysis demonstrate that Pilates during pregnancy positively influences the shortening of labor duration, improves the newborn's immediate physiological status, and alleviates labor pain. The study was registered on the International Prospective Registry of Systematic Reviews--PROSPERO database (CRD42023393309) on January 30, 2023.

Cross-National Validation of the WHO-5 Well-Being Index Within Adolescent Populations: Findings From 43 Countries.

The five-item World Health Organization Well-Being Index (WHO-5) is among the most frequently used brief standard measures to assess hedonic well-being. Numerous studies have investigated different facets of its psychometric properties in adult populations. However, whether these results apply to adolescents is uncertain, and only few psychometric studies employed adolescent populations. Thus, the current study aimed to conduct an in-depth psychometric item response theory analysis of the WHO-5 among adolescents from 43 countries using the Health Behaviour in School-aged Children (HBSC) 2022 data set and investigated its (a) dimensionality and measurement structure, (b) test information values and marginal reliability, (c) cross-country measurement invariance and differential item/test functioning, and (d) convergent validity with other measures related to mental health and well-being across countries. The WHO-5 showed a unidimensional measurement structure and overall high test information values and marginal reliability. Furthermore, although a large proportion of parameters were flagged as non-invariant, differential test functioning of the WHO-5 was only modest. Moreover, the WHO-5 mainly showed a concurring nomological network with the other measures related to mental health and well-being across countries, although with some differences in effect sizes. The WHO-5 Well-Being Index is a psychometrically sound measure that has shown promise for cross-cultural research among adolescents in the included European, Central Asia, and North American countries. The translated versions of the WHO-5 are available at https://osf.io/pbexq.

The Evidence for Office-Based Carpal Tunnel and The Use of UltraSound: A Systematic Review and Meta-Analysis

Introduction Carpal Tunnel Syndrome (CTS) is a common condition characterized by compression of the median nerve at the wrist, leading to neuropathy and associated symptoms that can significantly impair hand function and quality of life. Recent interest has focused on the use of ultrasound-guided carpal tunnel release (CTR-US) as a treatment modality, given its potential to facilitate faster recovery, minimize complications, and enhance patient satisfaction. This systematic review aims to evaluate the efficacy and safety of in-office CTR-US in managing CTS in comparison to interventions performed without ultrasound. Methods A systematic review and meta-analysis were conducted in SPSS v29 using PRISMA 2020 guidelines. Five databases (PubMed, Embase, Scopus, Cochrane, and Web of Science) were searched yielding a total of 713 articles and 5 after the exclusion criteria was applied. The review included clinical trials regarding office based carpal tunnel release (CTR) surgeries with and without ultrasound guidance. Outcome measures included the QuickDASH at 2 weeks and 1 year. Results QuickDASH improved with CTR in both groups at 2 weeks and a year. There was a large effect size difference, 4.42, at 2 weeks and at 1 year, 2.15, between CTR-US and CTR without US, indicating clinical significance. However, the results were not statistically significant, p>0.05. Conclusion The findings show that carpal tunnel release is effective at improving QuickDash scores at 2 weeks and 4 years post treatment. Though more research is required, CTR-US may provide superior clinical outcomes when compared to CTR without US.

Bayesian p-curve mixture models as a tool to dissociate effect size and effect prevalence

Much research in the behavioral sciences aims to characterize the “typical” person. A statistically significant group-averaged effect size is often interpreted as evidence that the typical person shows an effect, but that is only true under certain distributional assumptions for which explicit evidence is rarely presented. Mean effect size varies with both within-participant effect size and population prevalence (proportion of population showing effect). Few studies consider how prevalence affects mean effect size estimates and existing estimators of prevalence are, conversely, confounded by uncertainty about effect size. We introduce a widely applicable Bayesian method, the p-curve mixture model, that jointly estimates prevalence and effect size by probabilistically clustering participant-level data based on their likelihood under a null distribution. Our approach, for which we provide a software tool, outperforms existing prevalence estimation methods when effect size is uncertain and is sensitive to differences in prevalence or effect size across groups or conditions.

Distinct genetic risk loci between biopsy-proven renal and non-renal lupus: a 10-year longitudinal cohort.

Systemic lupus erythematosus (SLE) is a heterogeneous disease which manifests as different subphenotypes. Distinct subphenotypes, such as lupus nephritis (LN), have been associated with increased genetic risk, but prior studies have been limited by cross-sectional and imprecisely subphenotyped cohorts. This study investigated the genetic basis for LN using a longitudinal cohort of distinctly subphenotyped patients. SLE patients with biopsy-proven LN or never developed LN (NLN) were recruited from 8 tertiary referral centres. All patients had longitudinal clinical data for at least 10-years, or died during the study period. NLN patients had no renal involvement for at least 10-years. Subjects were genotyped and polygenic risk scores (PRS) were calculated using 230 SLE-associated SNPs. Genome-wide association analyses were also conducted for LN-vs-control, NLN-vs-control, and LN-vs-NLN comparisons, along with heterogeneity tests to assess differences in effect size. Among 1462 patients, 824 (56%) and 638 (43%) had LN and NLN, respectively. PRS was significantly higher in the LN cohort. Genome-wide significant variants were identified in HLA, TNFAIP3, BLK, and STAT4 loci specifically for LN patients, while STAT4 also remained significant for NLN patients. Direct LN-vs-NLN associations showed no statistically significant variants but heterogeneity tests revealed other genetic loci, including ELF1, OX40, DUSP22, and TPCN2. Different subphenotypes of SLE are predisposed by distinct genetic risk loci, which can only be identified in clearly subphenotyped cohorts with sufficient longitudinal data. We identified unique genetic risk loci enriched among patients with biopsy-proven LN, and postulate that individual subphenotypes may have varying genetic predisposition.

Medication reviews in hospitalised patients for reduced hospital readmission and mortality. Systematic review, meta-analysis and meta-regression of RCTs.

Efforts to reduce preventable medication-related harm through medication reviews have increased, but interventions often yield null-results regarding clinical outcomes. We conducted a systematic literature search in four data bases and summarised the available evidence from randomised controlled trials (RCTs) comparing medication reviews and usual care in hospitalised patients regarding hospital readmissions and all-cause mortality by random-effects meta-analyses. Effect size differences by methodological study differences were of special interest. The meta-analysis of all 24 trials on hospital readmissions, including 12,539 participants, showed a statistically significant 8% decrease in hospital readmissions (risk ratio (RR) [95% confidence interval]: (0.92 [0.88-0.97], p=0.002). The number of patient contacts was the most prominent effect modifier in meta-regression (p=0.003) and the effect of medication reviews was approximately twice as strong (15%) in 11 trials with 2 or more patient contacts (0.85 [0.78-0.92], p<0.001). No statistically significant reduction in all-cause mortality was observed in a meta-analysis of all 22 trials with data for this outcome (0.95 [0.86-1.04], p=0.24), including 12,350 participants. The method of mortality assessment was identified as an effect modifier by meta-regression (p=0.01). A meta-analysis of 10 trials with complete mortality ascertainment via registries or primary care data showed a significantly 19% reduced mortality (0.81 [0.70-0.94], p<0.01)). In conclusion, medication reviews reduce the risk of hospital readmission and might also reduce all-cause mortality. Comprehensive mortality assessment was essential for successful trials. Clinical guidelines should recommend medication reviews with multiple patient contacts, involving pharmacists, either for repeated medication reviews or to improve adherence.

How strong is the relationship between caregiver speech and language development? A meta-analysis.

A growing body of research has found that talking to young children is positively associated with language outcomes. However, there is tremendous heterogeneity in the design of these studies, which could potentially affect the strength and reliability of this association. The present meta-analysis, comprising 4760 participants across 71 studies, goes beyond prior research by including: 1) more recent studies, 2) non-English-speaking populations, 3) more fine-grained categorization of measures of input, 4) additional moderators, and 5) a multilevel model design allowing us to consider multiple effect sizes per study. We find a moderate association between input and outcomes (R2=0.04-0.07) across four input measures, with some evidence of publication bias. We find no differences in effect size across any of the input measures. Child age and study duration moderated some effects of input. Our findings suggest that language input-outcome associations remain robust but modest across a multitude of contexts and measures.

Association of current Schistosoma mansoni, Schistosoma japonicum, and Schistosoma mekongi infection status and intensity with periportal fibrosis: a systematic review and meta-analysis.

Periportal fibrosis is a severe morbidity caused by both current and past exposure to intestinal schistosomes. We aimed to assess the association between current infection status and intensity of Schistosoma mansoni, Schistosoma japonicum, or Schistosoma mekongi with periportal fibrosis. In this systematic review and meta-analysis, we searched the Cochrane Central Register of Controlled Trials, Embase, Global Health, Global Index Medicus, and MEDLINE from database inception to June 18, 2024. We applied methodological filters to limit our search to randomised controlled trials or observational studies, including before-and-after study designs. Animal studies were excluded, and no date or language limits were applied. We excluded reviews, editorials, personal opinions, and case reports. Self-reported infection status was an ineligible exposure. Two reviewers independently screened abstracts and full-text reports for eligibility. A third reviewer was consulted in cases of disagreement. The outcome of periportal fibrosis was recorded as reported by study authors to investigate variation in liver fibrosis definitions. For the key exposure of current infection, data were extracted for Schistosoma species, diagnostics, and author-provided infection status and intensity definitions. A meta-analysis was conducted for current schistosome infection status and intensity against author-defined current periportal fibrosis. Pooled effect sizes were derived using inverse-variance weighted random effects. Subgroup analyses included study characteristics and quality. The modified National Institute of Health risk of bias tool was used for assessing study quality. The protocol adhered to PRISMA reporting standards and was prospectively registered on PROSPERO, CRD42022333919. Our electronic search retrieved 2853 records, of which 1036 were duplicates. Nine records were identified in bibliographies of eligible full-text reports. We screened 1826 titles and abstracts to find 282 articles that met our inclusion criteria for full-text review. 41 studies were eligible for systematic review, 33 studies were eligible for infection status meta-analysis, and seven studies were eligible for infection intensity meta-analysis. Periportal fibrosis was heterogeneously defined with the Niamey ultrasound protocol most used. When findings were pooled, current schistosome infection status was associated with a higher likelihood of periportal fibrosis compared with no current infection (odds ratio [OR] 2·65, 95% CI 1·79-3·92; p<0·0001). Heterogeneity was high (I2=95·81%). In sub-Saharan Africa, before the widespread introduction of mass drug administration in 2003 there was a significant association between current infection status and periportal fibrosis (OR 5·38, 95% CI 2·03-14·25) but this association was no longer present after 2003 (1·19, 0·82-1·74). No association of current infection status was observed with periportal fibrosis in studies that used the Niamey protocol (1·57, 95% CI 0·95-2·59). Associations depended on moderate to high risk of bias studies. No significant differences in pooled effect sizes were observed between infection intensity categories and periportal fibrosis. WHO guidelines use current schistosome infection intensity as a proxy for schistosomiasis-related morbidity. Our findings support that current infection status is only tenuously associated with periportal fibrosis. Guidelines are needed to better monitor schistosomiasis-related morbidities. Nuffield Department of Population Health Pump Priming Fund, Wellcome Trust Institutional Strategic Support Fund, John Fell Fund, Robertson Foundation, and UK Research and Innovation Engineering and Physical Sciences Research Council.

Comprehensive Mendelian Randomization Analysis of Smoking and Its Effects on Venous Thromboembolism.

An increasing number of Mendelian randomization (MR) studies have evaluated the causal link between smoking and venous thromboembolism (VTE). However, previous studies often rely on single genetic variants related to smoking quantity and exhibit various other shortcomings, making them prone to pleiotropy and potentially leading to imprecise causal estimates. Thus, the deeper causal mechanisms remain largely unexplored. This MR study reassessed the causal relationship between smoking and VTE, including its subtypes-deep vein thrombosis (DVT) and pulmonary embolism (PE). Data on VTE were sourced from the FinnGen consortium with nonoverlapping sample sizes. The smoking phenotypes analyzed included smoking initiation, lifetime smoking, the number of cigarettes smoked per day by both current and former smokers (CigDay), and total pack-years of smoking in adulthood. The primary analytical method was inverse-variance-weighted (IVW), supplemented by multiple verification methods to ensure robust results. Statistical rigor was ensured through LDtrait pruning and Steiger filtering for reverse causation, with comprehensive sensitivity analyses including RadialMR confirming the findings' robustness. After Bonferroni correction, this study demonstrates significant causal evidence linking lifetime smoking with the incidence of VTE (odds ratio [OR]IVW = 1.50, 95% confidence interval [CI] 1.21-1.85, p = 1.75 × 10-4) and PE (ORIVW = 1.69, 95% CI 1.25-2.28, p = 6.55 × 10-4), and suggestive evidence with DVT, consistent in direction with previous studies but showing considerable differences in effect sizes and significance. Additionally, CigDay (past and current) increases the risks of VTE and DVT, while no causal link was found between smoking initiation and VTE or its subtypes (p < 0.05), both directly contradicting previous conclusions. Furthermore, our study is the first to suggest a causal link between pack-years and an increased risk of VTE. This MR study employed rigorous statistical pruning of its instrumental variables, using the most comprehensive smoking phenotype to date. It successfully mitigated biases such as winner's curse, yielding causal effect results distinct from previous studies.

Approximation to the optimal allocation for response adaptive designs.

We investigate the optimal allocation design for response adaptive clinical trials, under the average reward criterion. The treatment randomization process is formatted as a Markov decision process and the Bayesian method is used to summarize the information on treatment effects. A span-contraction operator is introduced and the average reward generated by the policy identified by the operator is shown to converge to the optimal value. We propose an algorithm to approximate the optimal treatment allocation using the Thompson sampling and the contraction operator. For the scenario of two treatments with binary responses and a sample size of 200 patients, simulation results demonstrate efficient learning features of the proposed method. It allocates a high proportion of patients to the better treatment while retaining a good statistical power and having a small probability for a trial going in the undesired direction. When the difference in success probability to detect is 0.2, the probability for a trial going in the unfavorable direction is < 1.5%, which decreases further to < 0.9% when the difference to detect is 0.3. For normally distribution responses, with a sample size of 100 patients, the proposed method assigns 13% more patients to the better treatment than the traditional complete randomization in detecting an effect size of difference 0.8, with a good statistical power and a < 0.7% probability for the trial to go in the undesired direction.

A Questionnaire-Based Analysis of the Impact of the COVID-19 Pandemic on the Psychological Health of Key Stakeholders Within an Elite Sports Organization.

To examine the impact of the COVID-19 pandemic on the psychological health of key stakeholders within an elite UK sports organization. The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) was sent electronically to 500 employees, and 8 face-to-face interviews were conducted at an elite-level professional football club. English Premier League (EPL) Football Club. Office/stadium staff, coaching/backroom staff, players from the male U23, women's and men's senior teams. Stakeholder groups that were invited to participate in the study: office/stadium staff, coaching/backroom staff, players from the U23, women's and men's senior teams, and variables of age and gender. WEMWBS scores across the office/stadium staff, coaching/backroom staff, and player cohort. Of 122 responses (24% response rate) and 8 face-face interviews, the average WEMWBS score was 51.2 (SD ±8.4) and 14% of the cohort presented with scores suggestive of a higher risk of depression. The main findings were moderate effect size differences in WEMWBS scores with the players scoring higher than both the office/stadium staff (P = 0.01) and the coaching/backroom staff (P = 0.01). Office/stadium staff experienced greater compromising mental health effects from the COVID-19 pandemic, as compared with the coaching/backroom staff and players, respectively, suggesting that elite sports organizations should also consider providing mental health education and signposting strategies for this area of the workforce.

The Effects of Motivational Interviews About Activities of Daily Living on Physical Adjustment and Quality of Life in Elderly Total Knee Arthroplasty Patients: A Randomised-Controlled Trial.

In old age, knee osteoarthritis is a common disease that reduces mobility. Total knee arthroplasty (TKA) is, in fact, a very important surgery to treat severe knee osteoarthritis. This study aimed to analyse the effect of motivational interviewing (MI) on physical adjustment and quality of life among old patients after TKA. Self-assessment forms were applied before and after the intervention using the functional assessment form and SF-36 Quality of Life Questionnaire in both groups: the intervention group who received MI targeted at daily living activities and the control group who received usual care within a randomised controlled trial that included 70 participants. The results we obtained showed significantly higher functional capacity scores and QOLs among those who underwent MI than those who did not have this additional support, while showing strong adjusted mean differences between two interventions that indicate this effect size difference. There was a notable increase in SF-36 scores from 51.14 to 85.77 which was much higher than the control's rise from 45.97 to 59.46. Therefore, these findings suggest that many elderly people can greatly improve their health status after TKA with MI as it offers an opportunity for effective recovery during the post-operative period, especially among older adults. Therefore, it can be used as an efficient method included in standard routines after operations so that results are improved and patients' satisfaction levels also increased simultaneously too.

Inappropriate grouping of various kinematic alignment techniques and inconsistent reporting of adverse events invalidate comparison across studies: An umbrella review of meta-analyses.

This umbrella review aimed to identify, synthesise and critically appraise the findings of meta-analyses that compare adverse events-rates of complications, reoperations and revisions-following total knee arthroplasty (TKA) using unrestricted kinematic alignment versus mechanical alignment. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria, two authors independently screened articles based on inclusion and exclusion criteria, and assessed the methodological quality based on the 16 domains of A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2). Effect sizes of difference in rates of complications were tabulated for each meta-analysis. Studies included in the meta-analyses were assessed to determine if they were on true unrestricted kinematic alignment. A secondary meta-analysis was performed, excluding studies on restricted kinematic alignment techniques, to calculate pooled estimates of adverse events (odds ratio [OR] with its 95% confidence interval [CI]) in a common effects framework with inverse-variance weighting. Of 78 potential records, 13 meta-analyses were eligible for data extraction, which pooled data from 15 clinical studies (10 on unrestricted kinematic alignment, four on restricted kinematic alignment and one on inverse kinematic alignment). None of the meta-analyses fulfilled all seven critical AMSTAR-2 domains. Meta-analyses categorised adverse events differently and used different measures for the effect sizes but revealed no differences between kinematic versus mechanical alignment. Exclusion of studies on restricted kinematic alignment techniques reduced total sample sizes for kinematic alignment from 658 to 318 and for mechanical alignment from 811 to 403. Secondary meta-analyses exclusively on unrestricted kinematic alignment revealed no difference in complications without reoperation, reoperation without implant removal or reoperation with implant removal following kinematic versus mechanical alignment. Meta-analyses do not distinguish between various kinematic alignment techniques, and adverse events are compared using different metrics. Surgeons, researchers and editors should refrain from pooling data on various kinematic alignment techniques, and orthopaedic societies should promote standards for reporting adverse events and effect sizes to facilitate comparisons across future studies. Level III.

Modest sex differences in the test of basic auditory capabilities (TBAC).

The Test of Basic Auditory Capabilities (TBAC) consists of 19 discrimination and identification tasks selected to study individual differences in audition. In one TBAC study, performance was measured for 340 normal-hearing subjects, but no investigation into possible sex differences was undertaken. That dataset now has been re-analyzed by sex. An effect size for sex difference was calculated for each subtest, and a resampling technique was used to estimate an implied significance for each of those effect sizes. Because almost all the differences observed were small, only the basic outcomes are described here, with more detail provided in Supplementary material. Peripheral physiological measures such as otoacoustic emissions exhibit larger auditory sex differences than do auditory behavioral measures, revealing that those peripheral physiological differences do not propagate simply up the auditory chain.

Four weeks standard vs. one week accelerated intermittent Theta Burst Stimulation for the treatment of depression – A retrospective analysis

IntroductionIntermittent Theta Burst Stimulation (iTBS), a specific form of repetitive transcranial magnetic stimulation (rTMS) is increasingly used for treating affective disorders. Accelerated iTBS protocols (aiTBS) with shorter treatment duration may lead to equal but faster response rates compared to standard protocols. MethodsHere, we retrospectively analyzed the records of 66 rTMS in- and out-patients with major depressive disorder in a tertiary care hospital between April 2023 and September 2023. All patients received left prefrontal iTBS with 1200 pulses, either one session/workday over 4 weeks (n = 34) or left prefrontal aiTBS on five sessions/workday for one week (n = 32). Depressive symptoms were assessed with the 21-item Hamilton Depression Rating Scale (HAMD-21) and the Major Depression Inventory (MDI) before and at the end of the respective treatment. ResultsWith both treatments, iTBS and aiTBS, the severity of depression improved significantly according to HAMD-21 and MDI. Response rates for iTBS were 38 % (HAMD-21) and 35 % (MDI), for aiTBS 19 % (HAMD-21) and 16 % (MDI), respectively. Remission rates showed a similar pattern. Effect sizes for group differences were small to medium. No serious adverse events occurred in any group. Tolerability was lower in aiTBS. Overall satisfaction was low for aiTBS on a qualitative and subjective level. ConclusionaiTBS with 1200 pulses and five daily sessions lead to amelioration of symptoms within one week. But benefit, satisfaction, tolerability was slightly lower in contrast to four weeks of iTBS. For everyday clinical practice, aiTBS protocols can be considered after weighing up the logistical disadvantages, such as possible longer waiting time for new patients that want to start a therapy with TMS. Future studies should explore the optimal dosage regime (number of sessions per day, number of pulses per session) for fast and effective symptom reduction.

Polygenic prediction for underrepresented populations through transfer learning by utilizing genetic similarity shared with European populations.

Because current genome-wide association studies are primarily conducted in individuals of European ancestry and information disparities exist among different populations, the polygenic score derived from Europeans thus exhibits poor transferability. Borrowing the idea of transfer learning, which enables the utilization of knowledge acquired from auxiliary samples to enhance learning capability in target samples, we propose transPGS, a novel polygenic score method, for genetic prediction in underrepresented populations by leveraging genetic similarity shared between the European and non-European populations while explaining the trans-ethnic difference in linkage disequilibrium (LD) and effect sizes. We demonstrate the usefulness and robustness of transPGS in elevated prediction accuracy via individual-level and summary-level simulations and apply it to seven continuous phenotypes and three diseases in the African, Chinese, and East Asian populations of the UK Biobank and Genetic Epidemiology Research Study on Adult Health and Aging cohorts. We further reveal that distinct LD and minor allele frequency patterns across ancestral groups are responsible for the dissatisfactory portability of PGS.

Long-term outcomes of additional surgery versus surveillance-only clinical decision for early colorectal cancer patients after non-curative endoscopic resection: a meta-analysis

ObjectivesThe clinical decision-making regarding post hoc management of early colorectal cancer (CRC) patients who have undergone non-curative endoscopic resection (ER) remains a subject of debate. This systematic review and meta-analysis aims to compare the clinical outcomes between patients undergoing additional surgery and those receiving surveillance only.MethodsA comprehensive literature search was conducted across three major medical databases: PubMed, Embase, and the Cochrane Library. STATA software was utilized for pooling analysis. The methodological quality of the included studies was assessed using the Newcastle–Ottawa Quality Scale.ResultsA total of 15 eligible studies encompassing 3,508 early CRC patients were included in this meta-analysis (additional surgery group: 1,974 cases; surveillance-only group: 1,533 cases). All included studies demonstrated good methodological quality, with Newcastle–Ottawa scores no less than 6. The results of the meta-analysis indicated that compared to the surveillance-only group, patients in the additional surgery group exhibited significantly improved overall survival (OR = 2.95, 95% CI: 2.05–4.24, P < 0.05), enhanced recurrence-free survival (OR = 2.53, 95% CI = 1.38–4.62, P < 0.05), a reduced recurrence rate (OR = 1.96, 95% CI = 1.22–3.13, P < 0.05), and a lower local recurrence rate (OR = 2.35, 95% CI = 1.12–4.95, P < 0.05). No significant sources of heterogeneity were identified among the studies analyzed; publication bias was also deemed acceptable across these investigations. Furthermore, we performed subgroup analyses based on inclusion criteria and age stratification which revealed notable differences in effect sizes between groups (JSCCR subgroup: OR = 2.09; 95% CI = 1.32–3.30 versus Non-JSCCR subgroup: OR = 1 .54; 95% CI = 0.89 -2.65, indicating negative results). Pooling analysis showed no significant difference between subgroups when stratified by age using a cutoff value of 65 years old.ConclusionsCompared to patients who underwent surveillance only, those receiving additional surgical treatment demonstrated superior outcomes in terms of overall survival, recurrence-free survival, recurrence rates, and control of local recurrences. This suggests that such an approach may represent a more optimal clinical decision for early-stage colorectal cancer (CRC) patients who have received non-curative endoscopic resection (ER). Furthermore, this study indicates that the inclusion criteria significantly influence the reported outcomes. Notably, age did not affect the recurrence rate. Overall, this is the first meta-analysis aimed at exploring and clarifying this ongoing controversy.

MRI-free processing of tau PET images for early detection

Abstract Tau positron emission tomography (PET) imaging in Alzheimer’s Disease (AD) is becoming increasingly common to assess in vivo tau burden. MR images are often acquired to assist with processing of PET data, including for region-of-interest definitions in native space and for normalization to template space. However, in the real-world setting, corresponding MRIs may not be available and PET processing may require MRI-free pipelines. This is particularly important and challenging as the field moves towards early detection among clinically unimpaired (CU) individuals where changes in tau PET signal are expected to be subtle. We used two independent [18F]Flortaucipir tau PET datasets to evaluate whether MRI-free PET processing can detect subtle tau PET uptake differences in Amyloid+ (A+) CU individuals (preclinical AD) versus A-. Standardized Uptake Value Ratios (SUVRs) from MRI-free compared to MRI-based methods were evaluated using linear regression and linear mixed-effects regression models. Effect size differences between A+/- CU groups in MRI-free processed cross-sectional and longitudinal tau PET SUVRs were compared to differences quantified through MRI-based processing. Regional MRI-free SUVRs were highly correlated with MRI-based SUVRs within CU individuals (average ICC = 0.90 for ADNI CU and 0.81 for A4 CU). MRI-free and MRI-based pipelines resulted in similar estimates of cross-sectional and longitudinal differences between A- and A+ CU, even in early focal regions within the medial temporal lobe.

Agreement of PROMIS Preference (PROPr) scores generated from the PROMIS-29 + 2 and the PROMIS-16.

Preference-based summary scores are used to quantify values, differences, and changes in health-related quality of life (HRQoL) that can be used for cost-effectiveness analyses. The PROMIS-Preference (PROPr) measure is a preference-based summary score comprised of 7 PROMIS domains. The PROMIS-16 is a new PROMIS profile instrument. We evaluated the measurement properties of PROPr generated from the widely used PROMIS-29 + 2 compared with the PROMIS-16. We performed a secondary analysis of data from an online survey of the general US population, with a longitudinal subsample who reported back pain. The survey included both the PROMIS-16 and the PROMIS-29 + 2 profiles. PROPr scores were calculated from each profile and compared by the distribution of scores, overall mean scores, product-moment correlations with pain measure scores (Oswestry Disability Index, Roland-Morris Disability Questionnaire, Pain Intensity, Interference with Enjoyment of Life, Interference with General Activity Scale, and Graded Chronic Pain Scale), and difference in mean scores in subgroups with 13 chronic health conditions (Cohen's d). Of the 4,115 participants in the baseline survey, 1,533 with any reported back pain were invited for the 6-month follow-up survey and 1,256 completed it. At baseline, the overall mean (SD) PROPr score was 0.532 (0.240) from PROMIS-16 and 0.535 (0.250) from PROMIS 29 + 2. At both time points, the correlations of PROPr scores with physical and mental health summary scores from the PROMIS-29 and 4 pain scales were within 0.01 between profiles. Using subgroups with chronic health conditions and comparing between profiles, Cohen's d estimates of the difference in effect size were small (< 0.2). PROPr scores from the 16-item PROMIS profile measure are similar to PROPr scores from the longer PROMIS-29 + 2.

The spectrum effect: Convergence of clinical and neuropsychological characteristics in adults referred for autism assessment

Clinical and neuropsychological profiles of adults referred for autism assessment are not thoroughly understood, and information derived from studies comparing autistic adults to neurotypical controls might not be accurate to infer on individuals in a real-world, clinical setting. 263 adults (aged 18–65 years, 70 % males) referred to our clinic with a suspected diagnosis of autism were clinically explored and administered neuropsychological investigations. The suspected diagnosis was either confirmed or rejected. We conducted multivariate and post-hoc univariate analyses of covariance (MANCOVA; ANCOVA), controlling for possible confounders, to evaluate differences between autistic and non-autistic participants and further associations. Effect sizes (partial η²) were calculated for significant results. There were no significant differences in age means and sex ratios. Both groups showed high Autism Questionnaire (AQ) scores, high schizoid, avoidant, and obsessive-compulsive scores, and mild depressive symptoms, without significant difference between groups. The effect sizes of differences ranged from negligible to small for measures of nonsocial cognition, but were large for a measure of social cognition, the emotion recognition 40 (ER40). Autistic and non-autistic participants present converging features across multiple measures. In this diagnostic setting, psychiatric and neuropsychological measures are helpful in identifying individual difficulties and strengths. However, most of them, including the AQ, are poor indicators of autism. Our results mostly aligned with previous research and showed that information derived from comparisons to neurotypical controls cannot be directly transferred to a real-world setting. Detected impairments in emotion recognition were fairly specific to autism, expanding on previous findings.