Differences In Effect Sizes Research Articles

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.

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.

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.

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.

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.

Circulating metabolites associate with the QT interval in individuals without prevalent cardiovascular disease

Abstract Background Patients with metabolic syndrome have a higher prevalence of heart-rate corrected QT (QTc) interval prolongation. Despite this the effect of circulating metabolites on the QTc is largely unknown and limited to small studies. Purpose To test for association of circulating metabolites with the QTc interval in the UK Biobank study. Methods Participants were identified from the UK Biobank with same day plasma metabolite profiling and electrocardiograms. All 249 metabolites measured underwent quality control and log transformation to account for rightward skew and zero values. 149 metabolites with inter-correlations &amp;gt;0.7 were excluded. Participants taking QTc-prolonging medication or with a history of ischaemic heart disease or heart failure up to 6 months after the visit, were excluded. Participants were allocated to a training group (N=21,610) or an independent test group (N=5,304), if samples were obtained at recruitment or at a second visit, respectively. In the training group, each metabolite was tested separately for association with the QTc in linear regression analyses, adjusted for clinical covariates (age, sex, fasting time, body mass index (BMI), systolic blood pressure (SBP), smoking status, diabetes, lipid-lowering drug use and dietary factors). Significant metabolites (P&amp;lt;5x10-4) underwent validation in the test group. Sex-stratified analyses were also performed. In the training group, variables in two models underwent regularisation by LASSO regression (10-fold cross-validation) to reduce multicollinearity and downweigh less important variables; 1) clinical variables, 2) clinical variables and validated metabolites. Coefficients were used for QTc prediction in the test group. Significance between the models was evaluated by fisher’s transformation of R-squared statistics. Results In the per metabolite multivariate analysis, 56 metabolites were associated with the QTc interval. 19 metabolites validated in the test group. For 14 of these, absolute effect sizes were &amp;gt;5ms when comparing individuals in the top decile of the metabolite distribution verses the bottom (Figure 1), including the ketone body 3-hydroxybutyrate (9ms), and omega-6 fatty acid to total fatty acid ratio (7.2ms). For associations in males and females separately, significant effect size differences (P&amp;lt;0.05) were observed for 9 metabolites (Figure 2). In the training group, the combined LASSO model selected 17 (of 19) metabolites along with age, sex, SBP and BMI. In the test group, this model R-squared was 0.115 compared with 0.081 for clinical covariates alone, representing a significant 41.9% increase in QTc variation explained (P=0.002). Conclusions This study demonstrates clinically relevant metabolite associations with the QTc in individuals without cardiovascular disease and explain a significant proportion of QTc variation. Further investigation is warranted to test for direct effects on cardiac electrophysiology and proarrhythmic potential.Validated metabolitesSignificant sex differences

Altered neural activities during emotion regulation in depression: a meta-analysis.

Deficient neural activities during emotion regulation have been reported in depression. We sought to conduct a meta-analysis to provide a comprehensive description of these neural alterations during use of emotion regulation strategies among patients with depression, including major depressive disorder (MDD) and bipolar disorder (BD). We identified neuroimaging studies of abnormal neural activities during emotion regulation in depression. We extracted the peak coordinates and effect sizes of differences in brain activity between patients and healthy controls. Using seed-based d mapping, we conducted voxel-wise meta-analyses of the neural activation pattern differences between the 2 groups across conditions involving emotion regulation and those where emotion regulation was not needed. We included 33 studies reporting 34 data sets, including 23 involving MDD (571 people with MDD and 578 matched controls) and 11 involving BD (358 people with BD and 369 matched controls). Overall, compared with controls, patients with depression showed hyperactivity in the insula and postcentral gyrus, and hypoactivity in the prefrontal part of the inferior, middle, and superior frontal gyrus, the middle temporal gyrus, and the supplementary motor area. In subgroup analyses, data from patients with MDD and studies focused on decreasing negative emotions or using the emotional strategy of reappraisal reported specific hypoactivity in the middle cerebellar peduncles. Given limited studies involving patients with BD, we were unable to detect the common and distinct abnormalities in neural activation between MDD and BD. We did not conduct any meta-regression analyses because of limited information. In this meta-analysis, we identified hyperactivity in brain regions associated with emotional experience and hypoactivity in brain regions associated with cognitive control during emotion regulation among patients with depression, relative to healthy controls. These findings could help indicate a target for future interventions aimed at increasing emotion regulation capacity for patients with depression.

A Meta-Analytic Evaluation: Investigating Evidence for the Validity of the Cognitive Abilities Test

Cognitive Abilities Test (CogAT) is one of the most frequently used gifted identification tools. In this meta-analytic study, we investigated empirical evidence of the validity of CogAT, in relation to different types of instruments. After reviewing 1,480 studies, a total of 24 with 33 effect sizes were included in the meta-analysis. According to our findings, the average effect size of r was found to be .63 with a 95% confidence interval [.57, .69]. Based on the heterogeneity test, significant variation due to the systematic between-study differences exists among the included correlations. Egger’s test for funnel plot asymmetry also indicates that no obvious publication bias exists in our study pool, which indicates there might not be a serious threat to alter the obtained results with publication bias. The moderator analysis revealed Lohman’s authorship and publication type influenced the effect size differences among studies. CogAT’s overall correlation with other identification tools (.63) might suggest using at least one more identification tool besides CogAT.

The Use of Language Sample Analysis to Differentiate Developmental Language Disorder From Typical Language in Bilingual Children: A Systematic Review and Meta-Analysis.

Language sample analysis (LSA) is a commonly recommended method of assessment for bilingual children. This systematic review and meta-analysis provides a comprehensive overview of the literature on the use of LSA to differentiate between developmental language disorder (DLD) and typical language (TL) in bilingual children. We conducted a search of several large electronic databases along with forward and backward searches and applied abstract and full-text screening procedures to identify all relevant studies. We then estimated standardized mean differences, representing the ability of LSA to differentiate between DLD and TL, using multilevel model and subgroup and moderator analyses to identify characteristics of LSA that may be associated with differences in effect size magnitude. We conducted assessments of publication bias and risk of bias by examining quality indicators for each study. The search yielded 35 articles that met the inclusion criteria. Participants ranged in age from 2;0 (years;months) to 11;9, with over 40 languages represented. Across studies, the pooled standardized mean difference indicated that children with DLD performed 0.78 SD lower on LSA measures than those with TL. Measures of morphosyntactic accuracy exhibited the largest pooled effect size. Elicitation method, language of task, and age were not associated with differences in effect size. Results of this study provide evidence of the clinical utility of LSA in differentiating between DLD and TL in bilingual children. Further research is needed to examine classification accuracy as well as task characteristics that may improve its diagnostic utility.

Prevalence of psychotic-like experiences and their association with depression symptoms among patients entering adolescent psychiatric care

Background Psychotic-like experiences (PLEs) are common in clinical adolescent samples and form a continuum based on their frequency and intensity. PLEs can have harmful effects on both behaviour and affect. Methods Prevalence and subjective distress due to PLEs were assessed with the Prodromal Questionnaire-Brief (PQ-B) and depressive symptoms with the Beck Depression Inventory (BDI-21A) among adolescents (N = 399; 71.7% female, mean age 14.9 years, range 13–18) entering specialized adolescent psychiatric services. Various PQ-B Distress scale cut-off points were tested for their ability to detect high and low BDI scores using the superiority index, the effect size for mean difference, and spline regressions. Results The mean number of endorsed PLEs assessed with the PQ-B was 3.27 (SD 3.64; males: M 1.75; SD 2.78; females: M 3.89; SD 3.78), while mean PQ-B Distress scores were 20.33 (SD 18.03; males: M 11.84; SD 13.90; females: M 23.74; SD 18.40). The most common PLE within both genders were experiences of paranoia and suspiciousness, with a prevalence of 59.9%. BDI scores and PQ-B distress scores were strongly associated (r = 0.534, p<.001). Superiority indices, effect sizes, and spline regressions indicated that a low PQ-B Distress cut-off of 2 or 3 was most informative both when using BDI as a continuous variable and when dichotomized as mild depression (≥10) or major depressive disorder (≥16). Conclusion PLEs are common among adolescent entering psychiatric care. Even a relatively small amount of distress due to PLEs indicates clinical levels of depressive symptoms.

Effectiveness of osteopathic craniosacral techniques: a meta-analysis.

Craniosacral osteopathic manipulative medicine-also known as craniosacral therapy (CST)-is a widely taught and used component of osteopathic medicine. This paper seeks to systematically review and conduct a meta-analysis of randomized controlled trials assessing the clinical effectiveness of CST compared to standard care, sham treatment, or no treatment in adults and children. A search of Embase, PubMed, and Scopus was conducted on 10/29/2023 and updated on 5/8/2024. There was no restriction placed on the date of publication. A Google Scholar search was conducted to capture grey literature. Backward citation searching was also implemented. All randomized controlled trials employing CST for any clinical outcome were included. Studies not available in English as well as studies that did not report adequate data were excluded. Multiple reviewers were used to assess for inclusions, disagreements were settled by consensus. PRISMA guidelines were followed in the reporting of this meta-analysis. Cochrane's Risk of Bias 2 tool was used to assess for risk of bias. All data were extracted by multiple independent observers. Effect sizes were calculated using a Hedge's G value (standardized mean difference) and aggregated using random effects models. The GRADE system was used to assess quality of evidence. The primary study outcome was the effectiveness of CST for selected outcomes as applied to non-healthy adults or children and measured by standardized mean difference effect size. Twenty-four RCTs were included in the final meta-analysis with a total of 1,613 participants. When subgroup analyses were performed by primary outcome only, no significant effects were found. When secondary outcomes were included in subgroup analyses, results showed that only Neonate health, structure (g = 0.66, 95% CI [0.30; 1.02], Prediction Interval [-0.73; 2.05]) and Pain, chronic somatic (g = 0.34, 95% CI [0.18; 0.50], Prediction Interval [-0.41; 1.09]) show reliable, statistically significant effect. However, these should not be interpreted as positive results as wide prediction intervals, high bias, and statistical limitations temper the real-world implications of this finding. CST demonstrated no significant effects in this meta-analysis, indicating a lack of usefulness in patient care for any of the studied indications.Pre-registration available at https://doi.org/10.17605/OSF.IO/54K6G. https://osf.io/57t4w.

Comparison of the Patient Health Questionnaire-9 and Quick Inventory of Depressive Symptomatology-Self Report in assessing the antidepressant effects of Transcranial Magnetic Stimulation: Sensitivity to change

BackgroundThe PHQ-9 and QIDS-SR are widely used assessment tools but have not been compared in sensitivity to the antidepressant effects of TMS. MethodsThe PHQ-9 and QIDS-SR were administered to 578 patients with MDD treated at a large TMS practice in Southern California. At baseline patients scored ≥ 10 on both instruments and received ≥ 36 TMS sessions (Mn=38.9, SD=5.3). Response was defined on each scale as ≥ 50 % reduction in scores and remission as a post-TMS score ≤ 5. ResultsBaseline symptom severity was greater on the PHQ-9 (Mn=19.1, SD=4.2) than QIDS-SR (Mn=18.2, SD=3.7), P < 0.0001. Both the change in scores from baseline to post-TMS [PHQ-9 (Mn=10.1, SD=6.8); QIDS-SR (Mn=8.4, SD=5.9), P < 0.0001] and percent change [PHQ-9 (Mn=52.1 %, SD=33.5); QIDS-SR (Mn=45.4 %, SD=30.2), P < 0.0001] were greater for the PHQ-9 than the QIDS. The remission rate was 10 % greater with the PHQ-9 than QIDS-SR (37.5 % vs. 27.9 %), P < 0.0001, while the nonresponse rate was greater on the QIDS-SR (49.7 % vs. 42.9 %), P < 0.0001. Effect sizes for differences in effectiveness among 3 TMS protocols were greater for the PHQ-9 than QIDS-SR. The PHQ-9 also showed greater internal consistency and higher loadings on a single depression severity factor. LimitationsThese are real world data, and the order of scale administration was unconstrained. ConclusionsThe PHQ-9 and QIDS-SR were highly correlated at baseline and following TMS. Nonetheless, the PHQ-9 was more sensitive to symptom change and appeared to assess more consistently a single dimension of depression severity.

Effects of Aerobic Exercise on Vascular Wall Thickness: A Meta-Analysis of Pre-Clinical Trials on Rat Model.

Exercise instigates adaptations in structural as well as functional organisation of the body at tissue and organ levels. However, the effect of exercise on vascular wall morphology is still under investigation. The objective of the review is to provide a meta-analysis of data from the previously published research to provide compiled analysis to determine the effect of exercise on the thickness of large-sized vessel walls. This meta-analysis was executed at the Ziauddin College of Rehabilitation Sciences with an extensive literature search using databases and search engines such as Pubmed, CINAHL, Web of Science, Scopus, and Google Scholar between September 2022 and January 2023. Studies were appraised according to an estimate of mean difference and pooled effect size was calculated using a random effect model. The risk of bias was also calculated using SYRCLE's risk of bias tool and CAMARADES. Overall, five eligible pre-clinical trials using rat models with pertinent data to determine the effect of exercise on vessel wall thickness were included in the meta-analysis. The results showed that aerobic exercise significantly reduced the vessel wall thickness (SMD -0.854 5%; CI: -1.365 to -0.344; p <0.001). Moreover, no significant publication bias was found through funnel plot and statistical test (Egger's p = 0.276; Begg's p = 0.624). However, an extensive review of the literature currently available on the topic has shown mixed findings that are consistent with the study and vice versa. Therefore, it indicated the need for sub-group analysis with different types of exercises for more peculiar clinical approaches. Key Words: Morphometry, Animal studies meta-analysis, Media thickness, Physical activity, Vascular morphology.

Heterogeneous genetic architectures of prostate cancer susceptibility in sub-Saharan Africa.

Men of African descent have the highest prostate cancer incidence and mortality rates, yet the genetic basis of prostate cancer in African men has been understudied. We used genomic data from 3,963 cases and 3,509 controls from Ghana, Nigeria, Senegal, South Africa and Uganda to infer ancestry-specific genetic architectures and fine-map disease associations. Fifteen independent associations at 8q24.21, 6q22.1 and 11q13.3 reached genome-wide significance, including four new associations. Intriguingly, multiple lead associations are private alleles, a pattern arising from recent mutations and the out-of-Africa bottleneck. These African-specific alleles contribute to haplotypes with odds ratios above 2.4. We found that the genetic architecture of prostate cancer differs across Africa, with effect size differences contributing more to this heterogeneity than allele frequency differences. Population genetic analyses reveal that African prostate cancer associations are largely governed by neutral evolution. Collectively, our findings emphasize the utility of conducting genetic studies that use diverse populations.

How to estimate causal effects associated with family planning? An introduction to Prince BART, a new approach to effect estimation based on principal stratification and Bayesian non-parametric models

There is interest in learning about the causal effect of family planning (FP) on empowerment-related outcomes. Experimental data related to this question are available from trials in which FP programs increase access to FP. However, estimating the effect of interest is challenging because FP and empowerment-related variables are likely to be confounded. We propose a new approach, Prince BART, to estimate the causal effect of FP on other outcomes of interest, among women affected by a FP program. Prince BART combines principal stratification, to account for differences in FP behavior based on exposure to a FP program, with Bayesian Additive Regression Trees (BART), to non-parametrically model stratum membership and relationships between variables. Prince Bart allows for estimation of effect heterogeneity. We use Prince BART to assess the causal effect of modern contraceptive use on employment in six cities in Nigeria, based on quasi-experimental data from a FP program trial during the first half of the 2010s. In the sample, we find a positive overall effect of contraceptive use on employment and substantial differences in effect sizes across subgroups defined by baseline covariates such as marital status, work at baseline, and wealth or education. The modeling approach and results can be used to inform future analyses seeking to understand the causal relationship between family planning use and other outcomes, e.g., related to empowerment.

Comparison of automated and manual intracellular particle tracking using quantitative phase imaging

Transport within cells is commonly studied using particle tracking methods. However, these typically require either labeling or identification of specific organelles that can be identified and tracked from label-free imaging modalities, limiting application of this approach. Quantitative phase imaging (QPI) provides dynamic data on the redistribution of mass within live cells, potentially enabling broader application of particle tracking methods. In previous work, we developed quantitative phase velocimetry (QPV) to automatically track the motion of subcellular control volumes from QPI data. However, the relationship of QPV to traditional particle tracking methods has not been established. Here, we directly compare QPV to manual particle tracking across multiple drug treatment conditions. We find that QPV effective diffusivity is correlated with diffusivity measured from manual particle tracking. The differences between QPV and manual tracking are explained by the difference in effective size of particles tracked by QPV. Overall, these data indicate that automated tracking of the motion of cellular mass from QPI data can effectively be used to characterize effective diffusivity within living cells.

A - 131 Patterns of Functional Decline in Alzheimer Biomarker-Positive Vs. Negative Cognitive Impairment

Abstract Objective To contrast longitudinal patterns of functional decline between groups of cognitively impaired individuals with or without biomarker support for Alzheimer’s disease (ad). Method We requested data from the National Alzheimer’s Coordinating Center on individuals who underwent serial evaluation with the Functional Activities Questionnaire (FAQ) and those for whom cerebrospinal fluid biomarkers for ad were available. By cross-referencing the two datasets, we identified 570 subjects, 71 of whom were biomarker positive and 499 biomarker negative. Item-level FAQ item-level scores were then entered as predictor variables into lagged mixed-effects regression models with a single FAQ item as the dependent variable in each model (one model for each of the ten FAQ items). Coefficients for statistically significant predictors of follow-up FAQ items were plotted as arcs on a directed graph, with one vertex for each of the ten FAQ items. We repeated this process for biomarker positive and negative individuals and created a map depicting effect size differences, i.e., biomarker positive minus biomarker-negative regression coefficients (Δ = β + − β-) for statistically significant arcs (α = 0.05). Results Twelve out of 21 arcs that were significant in the biomarker-positive individuals were significant only for this group. The largest effect size difference was STOVE → STOVE (Δ = 0.233). Twenty of 29 arcs that were significant in the biomarker-negative individuals were significant only for this group. The largest effect size difference was GAMES → GAMES (Δ = −0.168). Conclusion ad biomarker status modulated the patterns of longitudinal functional change in this sample.

Enhancing Imaging Anatomy Competency: Integrating Digital Imaging and Communications in Medicine (DICOM) Viewers Into the Anatomy Lab Experience.

Radiologic interpretation is a skill necessary for all physicians to provide quality care for their patients. However, some medical students are not exposed to Digital Imaging and Communications in Medicine (DICOM) imaging manipulation until their third year during clinical rotations. The objective of this study is to evaluate how medical students exposed to DICOM manipulation perform on identifying anatomical structures compared to students who were not exposed. This was a cross-sectional cohort study with 19 medical student participants organized into a test and control group. The test group consisted of first-year students who had been exposed to a new imaging anatomy curriculum (n = 9). The control group consisted of second-year students who had not had this experience (n = 10). The outcomes measured included quiz performance, self-reported confidence levels, and eye-tracking data. Students in the test group performed better on the quiz compared to students in the control group (p = 0.03). Confidence between the test and control groups was not significantly different (p = 0.16), though a moderate to large effect size difference was noted (Hedges' g = 0.75). Saccade peak velocity and fixation duration between the groups were not significantly different (p = 0.29, p = 0.77), though a moderate effect size improvement was noted in saccade peak velocity for the test group (Hedges' g = 0.49). The results from this study suggest that the early introduction of DICOM imaging into a medical school curriculum does impact students' performance when asked to identify anatomical structures on a standardized quiz.