Small Magnitude Effects Research Articles

Acute and chronic effects of stretching on balance – A systematic review with multilevel meta-analysis

Introduction One-third of individuals over the age of 65 fall at least once per year. Lacroix et al. (2017) shows that supervised strength training improves balance and muscle strength, which might beneficially impact the risk of falls. The American Geriatrics Society and the American Academy of Orthopaedic Surgeons recommend resistance training to improve balance (McMurdo, 2002). However, administrative burden such as limited mobility can reduce engagement among older adults for common training routines and call for the development of alternatives, but no review has investigated whether stretching has acute or chronic effects on balance. Purpose Since recent studies pointed out that high volumes of stretch could be used interchangeable with resistance training, but can be safely used without supervision (Warneke et al., 2024), this systematic review with meta-analysis investigate the effects of stretching on balance parameters across the lifespan. Methods PubMed, Web of Science, and Scopus were screened for (randomized) controlled trials (RCTs) on acute and chronic stretching effects, with subgroup analyses for a) stretching types, and b) different balance tasks, e.g., standing as still as possible on a force plate to measure the center of pressure (CoP) with eyes open (EO) and eyes closed, as well as Y-balance and star excursion test were conducted. We assessed risk of bias, while certainty of evidence was assessed in accordance with the GRADE working group guidelines. Statistical calculations were performed with R (version 4.2.3). Effect sizes (ES) were quantified using the packages Robumeta and Meta. Results Out of 18 acute studies, 15 compared acute stretching effects to passive control, while 4 performed comparisons to an active control, resulting in small magnitude effects on CoP/Sway EO (ES: 0.21, p = 0.03). Out of eleven chronic studies, seven had passive control, and 5 an active control group, resulting in moderate balance improvements with ES reaching 0.63, p = 0.04 for CoP/Sway EO. The remaining effects remained unsignificant (p = 0.091 - 1). Discussion While flexibility is commonly performed to enhance flexibility, it can also positively impact balance in some conditions. While our research question was derived via the positive association between strength and balance (Muehlbauer et al., 2015), and the possibility to use high volume stretching to enhance strength (Warneke et al., 2024), neither used included studies stretching durations of sufficient length, nor was strength measured as an outcome. It is noteworthy that most of the included studies did not interpret stretching effects in the light of underlying physiology, but on a more phenomenological basis, making a final conclusion about potential mechanisms complicated. Conclusion Although our results indicated beneficial effects of stretching on balance in some subgroup analyses, underlying mechanisms remain speculative, yet. There is a dearth of high-quality randomized controlled studies, using reasonable stretching times to enhance strength and muscle size via stretch to check whether there is the potential to use stretch-mediated hypertrophy and strength increases as a viable alternative to common resistance training and balance programs when aiming to enhance balance. References Lacroix, A., Hortobágyi, T., Beurskens, R., & Granacher, U. (2017). Effects of supervised vs. unsupervised training programs on balance and muscle strength in older adults: A systematic review and meta-analysis. Sports Medicine, 47(11), 2341–2361. https://doi.org/10.1007/s40279-017-0747-6 McMurdo, M. E. T. (2002). ‘Guideline for the prevention of falls in older persons’: Essential reading. Age and Ageing, 31(1), 13–14. https://doi.org/10.1093/ageing/31.1.13 Muehlbauer, T., Gollhofer, A., & Granacher, U. (2015). Associations between measures of balance and lower-extremity muscle strength/power in healthy individuals across the lifespan: A systematic review and meta-analysis. Sports Medicine, 45(12), 1671–1692. https://doi.org/10.1007/s40279-015-0390-z Warneke, K., Lohmann, L. H., Behm, D. G., Wirth, K., Keiner, M., Schiemann, S., & Wilke, J. (2024). Effects of chronic static stretching on maximal strength and muscle hypertrophy: A systematic review and meta-analysis. Sports Medicine – Open, 10, Article 45. https://doi.org/10.1186/s40798-024-00706-8

The Effects of High-Intensity, Short-Duration and Low-Intensity, Long-Duration Hamstrings Static Stretching on Contralateral Limb Performance.

Increases in contralateral range of motion (ROM) have been shown following acute high-intensity and high-duration static stretching (SS) with no significant change in contralateral force, power, and muscle activation. There are currently no studies comparing the effects of a high-intensity, short-duration (HISD) or low-intensity, long-duration (LILD) SS on contralateral performance. The aim of this study was to examine how HISD and LILD SS of the dominant leg hamstrings influence contralateral limb performance. Sixteen trained participants (eight females, eight males) completed three SS interventions of the dominant leg hamstrings; (1) HISD (6 × 10 s at maximal point of discomfort), (2) LILD (6 × 30 s at initial point of discomfort), and (3) control. Dominant and non-dominant ROM, maximal voluntary isometric contraction (MVIC) forces, muscle activation (electromyography (EMG)), and unilateral CMJ and DJ heights were recorded pre-test and 1 min post-test. There were no significant contralateral ROM or performance changes. Following the HISD condition, the post-test ROM for the stretched leg (110.6 ± 12.6°) exceeded the pre-test (106.0 ± 9.0°) by a small magnitude effect of 4.2% (p = 0.008, d = 0.42). With LILD, the stretched leg post-test (112.2 ± 16.5°) exceeded (2.6%, p = 0.06, d = 0.18) the pre-test ROM (109.3 ± 16.2°) by a non-significant, trivial magnitude. There were large magnitude impairments, evidenced by main effects for testing time for force, instantaneous strength, and associated EMG. A significant ROM interaction (p = 0.02) showed that with LILD, the stretched leg significantly (p = 0.05) exceeded the contralateral leg by 13.4% post-test. The results showing no significant increase in contralateral ROM with either HISD or LILD SS, suggesting the interventions may not have been effective in promoting crossover effects.

A 2-Year Longitudinal Randomized Control Trial of Speed of Processing Cognitive Training in Aging Adults with HIV-Associated Neurocognitive Disorder: Results of the Think Fast Study

Nearly 40% of people with HIV (PWH) experience HIV-associated Neurocognitive Disorder (HAND). In this 3-group efficacy study, 216 PWH 40 + years with HAND or borderline HAND were randomized to either: (1) 10 h of SOP training (n = 70); (2) 20 h of SOP training (n = 73), or (3) 10 h of Internet navigation training (n = 73; contact control group). Participants were administered a measure of SOP [i.e., the Useful Field of View Test (UFOV®)] at baseline, at posttest immediately after training, and at year 1 and year 2 follow up. Intent-to-treat linear mixed-effect models with subject-specific intercept and slope were fitted to estimate between-group mean differences at the follow-up time-points. At the post-intervention time-point, small beneficial SOP training effects were observed for the 10-h group in UFOV® total (d = 0.28, p = 0.002). Effects were of larger magnitude for the 20-h group in these same outcomes [UFOV® total (d = 0.43, p < 0.001)]. These results indicated better benefit with more training. No intervention effect was observed at year 1. At year 2, beneficial effects of small magnitude were observed again in the 10-h group [UFOV® total (d = 0.22, p = 0.253)] with larger small-to-moderate magnitude in the 20-h group [UFOV® total (d = 0.32, p = 0.104)]. This study suggests that SOP training can improve a key indicator of this cognitive performance and that treatment gains are small-to-moderate over a two-year period. Prior literature suggests slower SOP is predictive of impairment in everyday functioning in older PWH; such an approach could potentially improve everyday functioning in PWH.

Examining intergenerational risk factors for conduct problems using polygenic scores in the Norwegian Mother, Father and Child Cohort Study

The aetiology of conduct problems involves a combination of genetic and environmental factors, many of which are inherently linked to parental characteristics given parents’ central role in children’s lives across development. It is important to disentangle to what extent links between parental heritable characteristics and children’s behaviour are due to transmission of genetic risk or due to parental indirect genetic influences via the environment (i.e., genetic nurture). We used 31,290 genotyped mother-father-child trios from the Norwegian Mother, Father and Child Cohort Study (MoBa), testing genetic transmission and genetic nurture effects on conduct problems using 13 polygenic scores (PGS) spanning psychiatric conditions, substance use, education-related factors, and other risk factors. Maternal or self-reports of conduct problems at ages 8 and 14 years were available for up to 15,477 children. We found significant genetic transmission effects on conduct problems for 12 out of 13 PGS at age 8 years (strongest association: PGS for smoking, β = 0.07, 95% confidence interval = [0.05, 0.08]) and for 4 out of 13 PGS at age 14 years (strongest association: PGS for externalising problems, β = 0.08, 95% confidence interval = [0.05, 0.11]). Conversely, we did not find genetic nurture effects for conduct problems using our selection of PGS. Our findings provide evidence for genetic transmission in the association between parental characteristics and child conduct problems. Our results may also indicate that genetic nurture via traits indexed by our polygenic scores is of limited aetiological importance for conduct problems—though effects of small magnitude or effects via parental traits not captured by the included PGS remain a possibility.

Can web-based implementation interventions improve physician early diagnosis of cerebral palsy? Protocol for a 3-arm parallel superiority randomised controlled trial and cost–consequence analysis comparing adaptive and non-adaptive virtual patient instructional designs with control to evaluate effectiveness on physician behaviour, diagnostic skills and patient outcomes

IntroductionCerebral palsy (CP) is the most common childhood physical disability. Accurate diagnosis before 6 months is possible using predictive tools and decision-making skills. Yet diagnosis is typically made at 12–24...

Investigating the asymmetric effects of renewable energy-carbon neutrality nexus: Can technological innovation, trade openness, and transport services deliver the target for Germany?

The present millennium records the most devastating effects of global warming than what was evident in the pre-industrial era. The pervasive effects of global warming have raised concerns about the sustainability of the present and future generations. Hence, researchers are working assiduously towards proffering the most effective method of halting the surging emissions from global, regional, and national angles. This study contributes to the extant literature by providing the first empirical verification of how renewable energy, technological innovations, trade openness, and transport services impact carbon emissions in Germany. The empirical evidence is anchored on annual time series data from 1990 to 2020 estimated using the novel nonlinear ARDL to explore the positive and negative shocks associated with the short and long-run nexus. The wavelet coherence estimator is equally for ascertaining the multiple time scales in the time series and extends the knowledge frontier to the literature. The following findings are eminent from the overall analyses. First, long-run cointegration is supported among the variables of interest Second, only the adverse effects of renewable energy and technology are substantial enough to mitigate carbon emissions. The trade-induced emissions are established with the positive impacts of trade openness on carbon emissions. Transport services contribute significantly to carbon emissions in the long-run and short-run periods. However, mitigating effects of small magnitude are apparent in the long-run due to the perceived transition to green transportation. Policy implications supporting the transition to 100% renewable energy and green transportation are significant steps towards achieving Germany's carbon neutrality target.

Effects of an Exercise Program on Brain Health Outcomes for Children With Overweight or Obesity

Pediatric overweight and obesity are highly prevalent across the world, with implications for poorer cognitive and brain health. Exercise might potentially attenuate these adverse consequences. To investigate the effects of an exercise program on brain health indicators, including intelligence, executive function, academic performance, and brain outcomes, among children with overweight or obesity and to explore potential mediators and moderators of the main effects of exercise. All preexercise and postexercise data for this 20-week randomized clinical trial of 109 children aged 8 to 11 years with overweight or obesity were collected from November 21, 2014, to June 30, 2016, with neuroimaging data processing and analyses conducted between June 1, 2017, and December 20, 2021. All 109 children were included in the intention-to-treat analyses; 90 children (82.6%) completed the postexercise evaluation and attended 70% or more of the recommended exercise sessions and were included in per-protocol analyses. All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions per week in an out-of-school setting. Intelligence, executive function (cognitive flexibility, inhibition, and working memory), and academic performance were assessed with standardized tests, and hippocampal volume was measured with magnetic resonance imaging. The 109 participants included 45 girls (41.3%); participants had a mean (SD) body mass index of 26.8 (3.6) and a mean (SD) age of 10.0 (1.1) years at baseline. In per-protocol analyses, the exercise intervention improved crystallized intelligence, with the exercise group improving from before exercise to after exercise (mean z score, 0.62 [95% CI, 0.44-0.80]) compared with the control group (mean z score, -0.10 [95% CI, -0.28 to 0.09]; difference between groups, 0.72 SDs [95% CI, 0.46-0.97]; P < .001). Total intelligence also improved significantly more in the exercise group (mean z score, 0.69 [95% CI, 0.48-0.89]) than in the control group (mean z score, 0.07 [95% CI, -0.14 to 0.28]; difference between groups, 0.62 SDs [95% CI, 0.31-0.91]; P < .001). Exercise also positively affected a composite score of cognitive flexibility (mean z score: exercise group, 0.25 [95% CI, 0.05-0.44]; control group, -0.17 [95% CI, -0.39 to 0.04]; difference between groups, 0.42 SDs [95% CI, 0.13-0.71]; P = .005). These main effects were consistent in intention-to-treat analyses and after multiple-testing correction. There was a positive, small-magnitude effect of exercise on total academic performance (mean z score: exercise group, 0.31 [95% CI, 0.18-0.44]; control group, 0.10 [95% CI, -0.04 to 0.24]; difference between groups, 0.21 SDs [95% CI, 0.01-0.40]; P = .03), which was partially mediated by cognitive flexibility. Inhibition, working memory, hippocampal volume, and other brain magnetic resonance imaging outcomes studied were not affected by the exercise program. The intervention increased cardiorespiratory fitness performance as indicated by longer treadmill time to exhaustion (mean z score: exercise group, 0.54 [95% CI, 0.27-0.82]; control group, 0.13 [95% CI, -0.16 to 0.41]; difference between groups, 0.42 SDs [95% CI, 0.01-0.82]; P = .04), and these changes in fitness mediated some of the effects (small percentage of mediation [approximately 10%-20%]). The effects of exercise were overall consistent across the moderators tested, except for larger improvements in intelligence among boys compared with girls. In this randomized clinical trial, exercise positively affected intelligence and cognitive flexibility during development among children with overweight or obesity. However, the structural and functional brain changes responsible for these improvements were not identified. ClinicalTrials.gov Identifier: NCT02295072.

Factors Associated with the Magnitude Of acUpuncture treatment effectS (FAMOUS): a meta-epidemiological study of acupuncture randomised controlled trials

ObjectiveTo identify factors and assess to what extent they impact the magnitude of the treatment effect of acupuncture therapies across therapeutic areas.Data sourceMedline, Embase, Cochrane Central Register of Controlled Trials,...

Fall prevention in community-dwelling adults with mild to moderate cognitive impairment: a systematic review and meta-analysis

BackgroundCognitive impairment (CI) increases an individual’s risk of falls due to the role cognition plays in gait control. Older adults with dementia fall 2–3 times more than cognitively healthy older adults and 60–80% of people with dementia fall annually. Practitioners require evidence-based fall prevention best practices to reduce the risk of falls in cognitively impaired adults living in the community.MethodsWe conducted a systematic review and meta-analysis to identify the effectiveness of primary and secondary fall prevention interventions in reducing falls and fear of falling, and improving gait, balance, and functional mobility. We searched 7 databases for fall prevention interventions involving community-dwelling adults ≥50 years with mild to moderate CI. Reviewers screened citations, extracted data, and assessed risk of bias and certainty of evidence (GRADE). We assessed statistical and methodological heterogeneity and performed a meta-analysis of studies including subgroup analysis based on intervention and risk of bias groupings.ResultsFive hundred nine community-dwelling adults (mean age 67.5 to 84.0 years) with mild to moderate CI from 12 randomized or clinical controlled trials (RCTs/CCTs) were included in this review. Eight studies were exercise interventions, 3 were multifactorial, and 1 provided medication treatment. Fall prevention interventions had significant effects of medium magnitude on fear of falling (standardized mean difference (SMD) -0.73 [− 1.10, − 0.36]), balance (SMD 0.66 [0.19, 1.12]), and functional mobility measured as Timed Up and Go test (SMD -0.56 [− 0.94, − 0.17]) and significant effects of small magnitude on gait control (SMD 0.26 [0.08, 0.43]) all with moderate certainty of evidence. The meta-analysis showed no significant effects for falls (number of events or falls incidence). Sub-analysis showed that exercise and low risk of bias studies remained significant for balance and perceived risk of falls.ConclusionThe effect of fall prevention interventions on direct outcomes, such as falls, remains unclear in cognitively impaired individuals. Exercise interventions are effective at improving fall risk factors, however, high quality studies with longer follow-up and adequate sample sizes are needed to determine their effectiveness on falls directly. There remains a gap in terms of effective fall prevention interventions for older adults with CI.

Satisfaction With Oral Anticoagulants Among Patients With Atrial Fibrillation: A Prospective Observational Study

BackgroundSatisfaction with treatment has been identified as an important contributing factor to adherence with oral anticoagulant (OAC) therapy in patients with atrial fibrillation (AF). We aimed to evaluate the satisfaction level of patients with AF regarding OAC use over time, using validated patient-reported outcome instruments, and to identify associated patient characteristics. MethodsParticipants were recruited from specialized AF clinics in Canada. Eligible AF patients who were prescribed OACs were followed for up to 2 years. Participants were interviewed via telephone every 3-4 months using a structured survey. The Treatment Satisfaction Questionnaire for Medication (TSQM II) and the Anti-Clot Treatment Scale (ACTS) were used to measure satisfaction over time. ResultsAmong the 306 participants, satisfaction scores on the TSQM II and ACTS instruments were high. Unadjusted analyses showed significantly greater satisfaction with the burden of therapy with direct OACs (DOACs) compared to that with warfarin (small-magnitude effect) and greater satisfaction with the convenience of rivaroxaban, compared with that of all other OACs (moderate-magnitude effect). After adjustment for all other variables, vitamin K antagonist therapy was associated with greater global satisfaction than was DOAC treatment. Satisfaction with benefit and burden as measured by the ACTS scale, and global satisfaction on the TSQM II scale, tended to increase over time. Patient factors that were somewhat consistently associated with greater satisfaction were female sex and younger age. ConclusionsPatients with AF were highly satisfied with their therapy, with few differences among OAC classes and individual OACs. Individual patients may or may not be more satisfied with DOAC than VKA therapy, and regardless of the OAC prescribed, the may require significant support to maintain therapy adherence.

Anti-Müllerian hormone levels among contraceptive users: evidence from a cross-sectional cohort of 27,125 individuals

Anti-Müllerian hormone has become the clinical biomarker-based standard to assess ovarian reserve. As anti-Müllerian hormone testing becomes more common, more individuals are seeking to interpret the values obtained while using contraceptives. To appropriately counsel women, a better understanding of anti-Müllerian hormone levels in women using different contraceptives is needed. To study the association between different forms of contraceptives and anti-Müllerian levels in women of reproductive age. This is a cross-sectional study including 27,125 US-based women aged 20 to 46 years, accessing reproductive hormone results through Modern Fertility and who provided informed consent to participate in the research. Anti-Müllerian hormone levels were collected through dried blood spot card (95.9%) or venipuncture (4.1%), and previous work has shown high correlation between hormone levels collected by these 2 methods. Multiple linear regressions were run to compare anti-Müllerian hormone levels in women using contraceptives with women not on any contraceptive, controlling for age, age of menarche, body mass index, smoking, sample collection method, cycle day, and self-reported polycystic ovary syndrome diagnosis. We also analyzed whether duration of contraceptive use predicted anti-Müllerian hormone levels in users of the hormonal intrauterine device and combined oral contraceptive pill, given the size of these contraceptive groups. Mean anti-Müllerian hormone levels were statistically significantly lower in women using the combined oral contraceptive pill (23.68% lower; coefficient, 0.76; 95% confidence interval, 0.72-0.81; P<.001), vaginal ring (22.07% lower; coefficient, 0.78; 95% confidence interval, 0.71-0.86; P<.001), hormonal intrauterine device (6.73% lower; coefficient, 0.93; 95% confidence interval, 0.88-0.99; P=.014), implant (23.44% lower; coefficient, 0.77; 95% confidence interval, 0.69-0.85; P<.001), or progestin-only pill (14.80% lower; coefficient, 0.85; 95% confidence interval, 0.76-0.96; P=.007) than women not on any contraceptive when controlling for covariates. Anti-Müllerian hormone levels were not significantly different when comparing women not using any contraceptives to those using the copper intrauterine device (1.57% lower; coefficient, 0.98; 95% confidence interval, 0.92-1.05, P=.600). Associations between contraceptive use and anti-Müllerian hormone levels did not differ based on self-reported polycystic ovary syndrome diagnosis. Duration of hormonal intrauterine device use, but not of combined oral contraceptive pill use, was slightly positively associated with anti-Müllerian hormone levels, although this small magnitude effect is likely not clinically meaningful (coefficient, 1.002; 95% confidence interval, 1.0005-1.003; P=.007). Current hormonal contraceptive use is associated with a lower mean anti-Müllerian hormone level than that of women who are not on contraceptives, with variability in the percent difference across contraceptive methods. These data provide guidance for clinicians on how to interpret anti-Müllerian hormone levels assessed while on contraceptives and may facilitate more patients to continue contraceptive use while being evaluated for their ovarian reserve.

Non-local acute stretching effects on strength performance in healthy young adults.

Static stretching (SS) can impair performance and increase range of motion of a non-exercised or non-stretched muscle, respectively. An underdeveloped research area is the effect of unilateral stretching on non-local force output. The objective of this review was to describe the effects of unilateral SS on contralateral, non-stretched, muscle force and identify gaps in the literature. A systematic literature search following preferred reporting items for systematic review and meta-analyses Protocols guidelines was performed according to prescribed inclusion and exclusion criteria. Weighted means and ranges highlighted the non-local force output response to unilateral stretching. The physiotherapy evidence database scale was used to assess study risk of bias and methodological quality. Unilateral stretching protocols from six studies involved 6.3 ± 2 repetitions of 36.3 ± 7.4s with 19.3 ± 5.7s recovery between stretches. The mean stretch-induced force deficits exhibited small magnitude effect sizes for both the stretched (-6.7 ± 7.1%, d = -0.35: 0.01 to -1.8) and contralateral, non-stretched, muscles (-4.0 ± 4.9%, d = , 0.22: 0.08 to 1.1). Control measures exhibited trivial deficits. The limited literature examining non-local effects of prolonged SS revealed that both the stretched and contralateral, non-stretched, limbs of young adults demonstrate small magnitude force deficits. However, the frequency of studies with these effects were similar with three measures demonstrating deficits, and four measures showing trivial changes. These results highlight the possible global (non-local) effects of prolonged SS. Further research should investigate effects of lower intensity stretching, upper versus lower body stretching, different age groups, incorporate full warm-ups, and identify predominant mechanisms among others.

Relação entre variáveis sociodemográficas e do percurso escolar e a adaptabilidade de carreira de estudantes do ensino secundário

Neste estudo, analisámos a relação entre a adaptabilidade de carreira, expressa nas dimensões Preocupação, Controlo, Confiança e Curiosidade, e um conjunto de variáveis sociodemográficas (sexo, zona de residência, educação parental) e do percurso escolar (média de classificações, retenções, participação em atividades extracurriculares). Testámos ainda a relação entre a participação prévia reportada em atividades de carreira e a realização de atividades ocupacionais, e a adaptabilidade de carreira. Participaram no estudo 201 estudantes do ensino secundário, com idades compreendidas os 16 e os 23 anos (M = 17.56, DP = 0.89). Os instrumentos foram um questionário sociodemográfico e escolar e a versão Portuguesa da Career Adapt-Abilities Scale. Os resultados não mostraram um efeito global das variáveis sociodemográficas na adaptabilidade de carreira, com a exceção de um efeito de pequena magnitude da área de residência (rural) no Controlo; e um efeito de pequena magnitude do sexo (feminino) na Preocupação. Verificou-se uma associação entre o desempenho escolar (moderado na média das classificações; fraco no caso das retenções) e a adaptabilidade de carreira. A participação prévia em atividades de educação e desenvolvimento de carreira, ou a realização de atividades ocupacionais, não se associaram à adaptabilidade de carreira com a presente amostra.

Pruning of small fruit crops can affect habitat suitability for Drosophila suzukii

Insect activity, survival, and development are affected by climatic conditions that elicit effects at multiple scales. Pruning small fruit crop canopies alters the microclimate, which in turn may influence insect pest activity. We investigated the effect of three canopy density treatments (high, medium, low) on Drosophila suzukii (Matsumura) (Diptera: Drosophilidae) fruit infestation in blueberries and caneberries using a two-year, multi-state experiment. We quantified the effect of canopy density on canopy microclimate, fruit quality (total soluble solids, fruit firmness), and yield. To better understand heterogeneity in canopy microclimate, parameters were further separated by canopy location (exterior vs. interior) in Maryland. In both crops, meta-analyses reveal small magnitude effects of the plant canopy on microclimate, whereas analysis of variance did not separate these effects, with mean canopy differences of 0.1–0.7 °C and 0.5–1.3 % relative humidity (RH) between caneberry canopy densities and locations. In caneberry multi-state trials, 0.14 fewer D. suzukii larvae (g fruit)−1 occurred on average in the low canopy density treatment, and 0.2 fewer D. suzukii larvae (g fruit)−1 occurred in exterior raspberries in Maryland compared with the canopy interior. Artificially infested blueberry fruit indicated immature D. suzukii survival within fruit can vary across canopy densities and locations. Although lower total yield was produced in low density canopies, canopy density did not influence berry quality or marketable yield. Microhabitats provide important shelter from extreme environmental conditions; the availability of shelter and ability to locate it affects insect pest populations and distributions. Understanding how crop canopy microclimate affects D. suzukii infestation can inform efforts to develop habitat manipulation tactics and improve the efficiency of fruit production.

The Effect of Caffeine on the Velocity of Half-Squat Exercise during the Menstrual Cycle: A Randomized Controlled Trial.

Recent literature confirms the ergogenic effect of acute caffeine intake to increase muscle strength and power in men. However, the information about the effect of caffeine on muscle performance in women is uncertain and it is unknown whether its ergogenicity is similar during the menstrual cycle. The goal of this investigation was to assess the effect of acute caffeine intake on mean and peak velocity of half-squat exercise during three different phases of the menstrual cycle. Thirteen trained eumenorrheic athletes (age = 31 ± 6 years; body mass = 58.6 ± 7.8 kg) participated in a double-blind, crossover and randomized experimental trial. In the early follicular (EFP), late follicular (LFP) and mid luteal phases (MLP), participants either ingested a placebo (cellulose) or 3 mg/kg/bm of caffeine in an opaque and unidentifiable capsule. In each trial, participants performed a half-squat exercise at maximal velocity with loads equivalent to 20%, 40% 60% and 80% of one repetition maximum (1RM). In each load, mean and peak velocity were measured during the concentric phase of the exercise using a rotatory encoder. In comparison to the placebo, a two-way ANOVA showed that the ingestion of 3 mg/kg/bm of caffeine increased mean velocity at 60% 1RM in EFP (Δ = 1.4 ± 2.7%, p = 0.04; ES: 0.2 ± 0.2) and LFP (Δ = 5.0 ± 10.4%, p = 0.04; ES: 0.3 ± 0.4). No other statistical differences were found for the caffeine-placebo comparison for mean velocity, but caffeine induced an ergogenic effect of small magnitude in all of the menstrual cycle phases. These results suggest that the acute intake of 3 mg/kg/bm of caffeine induces a small effect to increase movement velocity during resistance exercise in eumenorrheic female athletes. The positive effect of caffeine was of similar magnitude in all the three phases of the menstrual cycle.

Educational strategy intervention and remote supervision on the post-discharge management of tuberculosis diagnosed in the hospital: Randomized clinical trial.

One of the most serious problems in TB control is non-adherence to treatment leading to the risk of drug resistance and subsequent treatment failure. To assess the impact of an educational strategy intervention and remote supervision on the post-discharge management of new cases of TB diagnosed in hospital on TB cure rate. Secondarily, to assess the impact of this intervention on default rate. Randomized control trial conducted at a general, tertiary care, university affiliated hospital. New cases of TB diagnosed in hospital were included. The primary outcome was cure rate and secondary outcome was default rate. Analysis was carried out by modified intention to treat. A total of 169 new tuberculosis patients were enrolled. Among them, 80 were assigned to intervention group and 89 to control group. The cure rate was 71.3% in the intervention group and 58.4% in the control group. In the multivariate binary logistic regression model to evaluate the effect of the intervention, controlled by age, sex, current smoking status and directly observed treatment short, intervention was independently associated with cure rate (OR=0.47; 95% CI: 0.24-0.94; P=0.033).There was a significant difference in the default rate between the control and intervention groups (18.0% vs 5.0%, respectively, P=0.039). An educational strategy intervention and remote supervision on the post-discharge management of new cases of TB with in-hospital diagnosis had a positive effect of small magnitude on cure rate. Secondarily, the treatment default rate has been significantly decreased with the intervention.

Eccentric cycling does not improve cycling performance in amateur cyclists.

Eccentric cycling training induces muscle hypertrophy and increases joint power output in non-athletes. Moreover, eccentric cycling can be considered a movement-specific type of strength training for cyclists, but it is hitherto unknown if eccentric cycling training can improve cycling performance in trained cyclists. Twenty-three male amateur cyclists were randomized to an eccentric or a concentric cycling training group. The eccentric cycling was performed at a low cadence (~40 revolution per minute) and the intensity was controlled by perceived effort (12–17 on the Borgs scale) during 2 min intervals (repeated 5–8 times). The cadence and perceived effort of the concentric group matched those of the eccentric group. Additionally, after the eccentric or concentric cycling, both groups performed traditionally aerobic intervals with freely chosen cadence in the same session (4–5 x 4–15 min). The participants trained twice a week for 10 weeks. Maximal oxygen uptake (VO2max), maximal aerobic power output (Wmax), lactate threshold, isokinetic strength, muscle thickness, pedaling characteristics and cycling performance (6- and 30-sec sprints and a 20-min time trial test) were assessed before and after the intervention period. Inferences about the true value of the effects were evaluated using probabilistic magnitude-based inferences. Eccentric cycling induced muscle hypertrophy (2.3 ± 2.5% more than concentric) and augmented eccentric strength (8.8 ± 5.9% more than concentric), but these small magnitude effects seemed not to transfer into improvements in the physiological assessments or cycling performance. On the contrary, the eccentric training appeared to have limiting or detrimental effects on cycling performance, measured as Wmax and a 20-min time trial. In conclusion, eccentric cycling training did not improve cycling performance in amateur cyclists. Further research is required to ascertain whether the present findings reflect an actual lack of efficacy, negative effects or a delayed response to eccentric cycling training.

The Economic Benefits of Marriage and Family Strengthening Programs

Marriage and family strengthening programs have historically had small magnitude effects on changing relationship outcomes. The present study explores the possibility that although these statistical effects are small, they can be shown to represent meaningful financial impacts. Secondary data from 2092 control and 2042 intervention couples who were married with children and participating in the Supporting Healthy Marriage (SHM) project were analyzed. Intervention participants had the opportunity to receive standardized curricula (e.g., PREP) and marital counseling. Similar to meta-analytic findings, conventional analysis of these data found only a modest impact on proximal relationship outcomes (e.g., satisfaction). Offering counseling in conjunction with curricula, although costlier and only demonstrating marginally significant improvements in averting divorce, appears to offer a substantial financial return on investment. The implications of these findings are discussed.

Small-Magnitude Effect Sizes in Epigenetic End Points are Important in Children's Environmental Health Studies: The Children's Environmental Health and Disease Prevention Research Center's Epigenetics Working Group.

Background:Characterization of the epigenome is a primary interest for children’s environmental health researchers studying the environmental influences on human populations, particularly those studying the role of pregnancy and early-life exposures on later-in-life health outcomes.Objectives:Our objective was to consider the state of the science in environmental epigenetics research and to focus on DNA methylation and the collective observations of many studies being conducted within the Children’s Environmental Health and Disease Prevention Research Centers, as they relate to the Developmental Origins of Health and Disease (DOHaD) hypothesis.Methods:We address the current laboratory and statistical tools available for epigenetic analyses, discuss methods for validation and interpretation of findings, particularly when magnitudes of effect are small, question the functional relevance of findings, and discuss the future for environmental epigenetics research.Discussion:A common finding in environmental epigenetic studies is the small-magnitude epigenetic effect sizes that result from such exposures. Although it is reasonable and necessary that we question the relevance of such small effects, we present examples in which small effects persist and have been replicated across populations and across time. We encourage a critical discourse on the interpretation of such small changes and further research on their functional relevance for children’s health.Conclusion:The dynamic nature of the epigenome will require an emphasis on future longitudinal studies in which the epigenome is profiled over time, over changing environmental exposures, and over generations to better understand the multiple ways in which the epigenome may respond to environmental stimuli.Citation:Breton CV, Marsit CJ, Faustman E, Nadeau K, Goodrich JM, Dolinoy DC, Herbstman J, Holland N, LaSalle JM, Schmidt R, Yousefi P, Perera F, Joubert BR, Wiemels J, Taylor M, Yang IV, Chen R, Hew KM, Freeland DM, Miller R, Murphy SK. 2017. Small-magnitude effect sizes in epigenetic end points are important in children’s environmental health studies: the Children’s Environmental Health and Disease Prevention Research Center’s Epigenetics Working Group. Environ Health Perspect 125:–526; http://dx.doi.org/10.1289/EHP595

Steep delay discounting and addictive behavior: a meta-analysis of continuous associations.

To synthesize continuous associations between delayed reward discounting (DRD) and both addiction severity and quantity-frequency (QF); to examine moderators of these relationships; and to investigate publication bias. Meta-analysis of published studies examining continuous associations between DRD and addictive behaviors. Published, peer-reviewed studies on addictive behaviors (alcohol, tobacco, cannabis, stimulants, opiates and gambling) were identified via PubMed, MEDLINE and PsycInfo. Studies were restricted to DRD measures of monetary gains. Random-effects meta-analysis was conducted using Pearson's r as the effect size. Publication bias was evaluated using fail-safe N, Begg-Mazumdar and Egger's tests, meta-regression of publication year and effect size and imputation of missing studies. The primary meta-analysis revealed a small magnitude effect size that was highly significant (r=0.14, P<10-14 ). Significantly larger effect sizes were observed for studies examining severity compared with QF (P=0.01), but not between the type of addictive behavior (P=0.30) or DRD assessment (P=0.90). Indices of publication bias suggested a modest impact of unpublished findings. Delayed reward discounting is associated robustly with continuous measures of addiction severity and quantity-frequency. This relation is generally robust across type of addictive behavior and delayed reward discounting assessment modality.