Large Effect Sizes Research Articles

Lower levels of TRAF1 in Brodmann's area 24, but not 46, in bipolar disorders are not detectable in major depressive disorders

IntroductionMultiple lines of research implicate inflammation-related pathways in the molecular pathology of mood disorders, with our data suggesting a critical role for aberrant cortical tumour necrosis factor α (TNF)-signaling in the molecular pathology of bipolar disorders (BPD) and major depressive disorders (MDD). MethodsTo extend our understanding of changes in TNF-signaling pathways in mood disorders we used Western blotting to measure levels of tumour necrosis factor receptor associated factor 1 (TRAF1) and transmembrane TNF receptor superfamily member 1B (tmTNFRSF1B) in Brodmann's areas (BA) 24 and 46 from people with BPD and MDD. These proteins are key rate-limiting components within TNF-signaling pathways. ResultsCompared to controls, there were higher levels of TRAF1 of large effect size (η = 0.19, Cohen's d = 0.97) in BA 24, but not BA 46, from people with BPD. Levels of TRAF1 were not altered in MDD and levels of tmTNFRSF1B were not altered in either disorder. LimitationsThe cases studied had been treated with psychotropic drugs prior to death which is an unresolvable study confound. Cohort sizes are relatively small but not untypical of postmortem CNS studies. ConclusionsTo facilitate post-synaptic signaling, TRAF1 is known to associate with tmTNFRSF1B after that receptor takes its activated conformation which occurs predominantly after it binds to transmembrane TNF (tmTNF). Simultaneously, when tmTNFRSF1B binds to tmTNF reverse signaling through tmTNF is activated. Hence our findings in BA 24 argues that bidirectional TNF-signaling may be an important component of the molecular pathology of BPD.

Improvements of complex post-traumatic stress disorder symptoms during a multimodal psychodynamic inpatient rehabilitation treatment – results of an observational single-centre pilot study

ABSTRACT Background: Complex post-traumatic stress disorder (CPTSD) describes chronic disturbances in self-organization (i.e. affect dysregulation; negative self-concept; severe difficulties in relationships) which are frequently observed in survivors of prolonged, repeated or multiple traumatic stressors. So far, evidence of psychodynamic treatment approaches for CPTSD is scarce. Methods: In this single-centre observational pilot study, symptom change during a 6-week psychodynamic inpatient treatment in a multimodal psychosomatic rehabilitation centre was evaluated using repeated measures analyses of variance (ANOVAs). Patients completed questionnaires on PTSD and CPTSD symptoms (ITQ), anxiety, depression and somatization (BSI-18), functional impairment (WHODAS) and epistemic trust, mistrust and credulity (ETMCQ) before (T1) and at the end of treatment (T2). A hierarchical linear regression analysis was calculated to identify factors associated with improved CPTSD symptoms. Results: A total of n = 50 patients with CPTSD were included in the study, of whom n = 40 (80%) completed treatment. Patients reported a significant reduction of CPTSD symptoms during treatment with a large effect size (−3.9 points; p < .001; η 2 = .36), as well as a significant reduction of psychological distress (p < .001; η 2 = .55) and functional impairment (p < .001; η 2 = .59). At the end of treatment, 41.0% of patients no longer fulfilled the diagnostic criteria for CPTSD. Changes in epistemic stance included improved epistemic trust (β = –.34, p = .026) and decreased epistemic credulity (β = .37, p = .017), which together with lower age (β = .43, p = .012) and lower depression levels at baseline (β = .35, p = .054) were significantly associated with baseline adjusted mean change of CPTSD symptoms during therapy and explained 48% of its variance. Discussion: In our study, patients reported a significant reduction of CPTSD symptoms and comorbid symptoms during a multimodal psychodynamic inpatient rehabilitation treatment. Improved epistemic trust may facilitate the establishment of a trusting therapeutic relationship, thus fostering an environment of openness for knowledge transfer (i.e. social learning) and the exploration of diverse viewpoints and perspectives in the therapeutic process.

A Novel Intervention to Reduce Fear of Progression and Trauma Symptoms in Advanced Cancer Using Written Exposure to Worst-Case Scenarios.

Background: Adults with advanced cancer experience profound future uncertainty, reflected in elevated fear of cancer progression (FoP) and cancer-related trauma symptoms. These symptoms are associated with physical symptom burden and poorer quality of life, and few interventions exist to manage them. Objective: To develop and pilot a written exposure-based coping intervention (EASE) focused on worst-case scenarios among adults with advanced cancer reporting elevated cancer-related trauma symptoms or FoP. Design: A single-arm intervention development and pilot trial. Participants: The trial enrolled 29 U.S. adults with stage III or stage IV solid tumor cancer (n = 24) or incurable or higher-risk blood cancer (n = 5) reporting elevated cancer-related trauma symptoms or FoP. Among those screened, 74% were eligible, with an eligible-to-enrolled rate of 85%. Design/Measurements: EASE was delivered over five 1:1 videoconferencing sessions. Feasibility and acceptability were evaluated via attendance, surveys, and exit interviews. Outcomes were assessed at five time points through 3-month (FU1, main assessment of interest) and 4.5-month (FU2) follow-up. Results: Participant and interventionist feedback was used to iteratively refine EASE. Among participants, 86% (25/29) completed all five sessions and FU1; surveys and exit interviews indicated high acceptability. Primary outcomes of cancer-related trauma symptoms and FoP improved significantly from pre to both follow-ups by predominantly large effect sizes. Secondary outcomes of anxiety, depression, hopelessness, fear of death/dying, and fatigue, and most process measures improved significantly by FU1 or FU2. Conclusions: EASE, a novel adaptation of written exposure therapy, is a promising approach to reducing FoP and cancer-related trauma symptoms among adults with advanced cancer that warrants further study.

On the Impact of Lower Recall and Precision in Defect Prediction for Guiding Search-Based Software Testing

Defect predictors, static bug detectors and humans inspecting the code can propose locations in the program that are more likely to be buggy before they are discovered through testing. Automated test generators such as search-based software testing (SBST) techniques can use this information to direct their search for test cases to likely-buggy code, thus speeding up the process of detecting existing bugs in those locations. Often the predictions given by these tools or humans are imprecise, which can misguide the SBST technique and may deteriorate its performance. In this paper, we study the impact of imprecision in defect prediction on the bug detection effectiveness of SBST. Our study finds that the recall of the defect predictor, i.e., the proportion of correctly identified buggy code, has a significant impact on bug detection effectiveness of SBST with a large effect size. More precisely, the SBST technique detects 7.5 fewer bugs on average (out of 420 bugs) for every 5% decrements of the recall. On the other hand, the effect of precision, a measure for false alarms, is not of meaningful practical significance as indicated by a very small effect size. In the context of combining defect prediction and SBST, our recommendation is to increase the recall of defect predictors as a primary objective and precision as a secondary objective. In our experiments, we find that 75% precision is as good as 100% precision. To account for the imprecision of defect predictors, in particular low recall values, SBST techniques should be designed to search for test cases that also cover the predicted non-buggy parts of the program, while prioritising the parts that have been predicted as buggy.

Moving pain management programmes into the digital age: development and evaluation of an online PMP for people with chronic pain.

In response to Coronovirus Disease (COVID-19) health care restrictions, the pain management programme delivered group treatment digitally (OPMP). We aimed to: 1) evaluate pain related outcomes of the OPMP, 2) evaluate patient satisfaction and qualitive feedback of the OPMP and 3) compare OPMP outcomes with the pre-pandemic face to face (F2F) PMP outcomes. Age, gender, pain duration, occupational status, referral information and patient satisfaction data were collected. Pre- and post-treatment pain related outcomes were compared by calculating mean difference, benchmarking with effect size (Cohen's d) and determining clinically significant change (CSC) for OPMP and F2F PMP. Two-hundred and thirty-seven patients provided outcome data, with 60 completing the OPMP and 177 completing the F2F PMP. OPMP patients were 10 years younger than the F2F PMP (44.8 vs 53.3), more were female (6.5:1 vs 2.8:1), more were working (45% vs 27%) and fewer were retired (3% vs 17%). The OPMP showed improvements comparable to the F2F PMP. Large effect size was reported across all outcome domains including objective physical outcomes. Eighty-one percent of OPMP patients were 'extremely likely' to recommend the programme but just over 50% of patients felt F2F would provide greater clinical benefits. The results support that OPMP is effective for carefully selected patients following a multidisciplinary team assessment however more complex cases still require F2F PMP.

Novel Performance Rating Instruments for Gynecological Procedures in Primary Care: A Pilot Study.

Improving training and confirming the acquisition of gynecological procedure skills for family physicians (FPs) is crucial for safe healthcare delivery. The objectives of this study were to (a) develop performance rating instruments for four gynecological procedures, and (b) pilot them to provide preliminary validity evidence using modern validity theory. Sixteen academic FPs and gynecologists participated in a modified Delphi technique to develop procedure-specific checklists (PSCs) for four procedures: intrauterine device insertion, endometrial biopsy, punch biopsy of the vulva, and routine pessary care. We modified a previously validated global rating scale (GRS) for ambulatory settings. Using prerecorded videos, 19 academic FPs piloted instruments to rate one first-year and one second-year family medicine resident's performance. They were blinded to the level of training. We compared the mean scores for PSCs and GRS for each procedure using paired samples t tests and Cohen'sdto estimate effect sizes. Consensus on items for the final PSCs was reached after two Delphi rounds. PSC and GRS scores were numerically higher for the second-year resident than the first-year resident for every procedure, with statistically significant differences for six of eight comparisons (P&lt;.05). All comparisons demonstrated large effect sizes (Cohen'sd&gt;0.8). Both instruments received high scores for ease of use by raters. We developed novel performance rating instruments for four gynecological procedures and provided preliminary validity evidence for their use for formative feedback in a simulation setting. This pilot study suggests that these instruments may facilitate the training and documentation of family medicine trainees' skills in gynecological procedures.

Adolescent Substance Use at the Intersection of Sexual Orientation and Gender Identity.

Substance use in adolescence is associated with multiple negative outcomes. Lesbian, gay, or bisexual or transgender or nonbinary (TNB) youth, and those who question their sexual orientation or gender, are more likely to engage in substance use than straight or cisgender youth. However, the extant literature largely considers sexual orientation and gender identity independently. Accordingly, this study examines the associations between the intersectional identities of sexual orientation and gender and substance use to identify those with the greatest need for prevention interventions. Data were from 36 504 high school students aged 14 to 18 years (mean = 15.7, SD = 1.18) enrolled in the 2019 Healthy Kids Colorado Survey using a statewide stratified random sampling design. Logistic regression models examined the associations between intersectional sexual orientation and gender on marijuana use, prescription drug misuse, and polysubstance use, as well as depression and violence victimization (eg, forced sex, partner violence). Adjusted odds of substance use for sexual and gender minority youth varied by intersectional identity and substance. The largest effect sizes were seen for prescription drug misuse, especially among those questioning their gender and sexual orientation and heterosexuals either questioning their gender or who identified as TNB. Effect sizes for marijuana use and polysubstance use were highest for TNB and heterosexual participants. Depression and violence victimization were significantly associated with each substance use outcome. Interventions to reduce substance use in these populations may benefit from targeted interventions for youth with different intersectional identities, and a focus on violence prevention and depression screening and treatment.

The Impact of Psychological Empowerment on Workforce Agility in Organization X

This study aims to determine the effect of psychological empowerment on labour agility in the State Civil Apparatus at Agency X. This questionnaire is based on the Labour Agility Scale and Psychological Empowerment Scale measures. The results of the regression test showed that psychological empowerment has a significant influence on workplace agility, with a large effect size of 56.2%. In addition, the descriptions of both variables, psychological empowerment and workforce agility, are categorised as moderate. The findings of this study are in line with previous research on the impact of psychological empowerment on employees of public and private sector companies in the manufacturing and services sectors in India.

Spatial attention in mental arithmetic: A literature review and meta-analysis.

We review the evidence for the conceptual association between arithmetic and space and quantify the effect size in meta-analyses. We focus on three effects: (a) the operational momentum effect (OME), which has been defined as participants' tendency to overestimate results of addition problems and underestimate results of subtraction problems; (b) the arithmetic cueing effect, in which arithmetic problems serve as spatial cues in target detection or temporal order judgment tasks; and (c) the associations between arithmetic and space observed with eye- and hand-tracking studies. The OME was consistently found in paradigms that provided the participants with numerical response alternatives. The OME shows a large effect size, driven by an underestimation during subtraction while addition was unbiased. In contrast, paradigms in which participants indicated their estimate by transcoding their final estimate to a spatial reference frame revealed no consistent OME. Arithmetic cueing studies show a reliable small to medium effect size, driven by a rightward bias for addition. Finally, eye- and hand-tracking studies point to replicable associations between arithmetic and eye or hand movements. To account for the complexity of the observed pattern, we introduce the Adaptive Pathways in Mental Arithmetic (APiMA) framework. The model accommodates central notions of numerical and arithmetic processing and helps identifying which pathway a given paradigm operates on. It proposes that the divergence between OME and arithmetic cueing studies comes from the predominant use of non-symbolic versus symbolic stimuli, respectively. Overall, our review and findings clearly support an association between arithmetic and spatial processing.

Delivery of a telehealth supported home exercise program with dietary advice to increase plant-based protein in people with non-alcoholic fatty liver disease: a 12-week pilot feasibility randomised controlled trial

Telehealth overcomes common geographical barriers to community/clinic-based healthcare and lifestyle interventions, (1,2) but whether it is a feasible and safe mode of healthcare service delivery for lifestyle-based interventions in those with non-alcoholic fatty liver disease (NAFLD) remains unknown. This study evaluated the feasibility and safety of a home exercise program with dietary advice to increase plant-based protein delivered and monitored by healthcare professionals via telehealth in adults with NAFLD. Secondary aims were to assess changes in macronutrient intake including protein from plant and animal sources, body weight, physical activity and physical function. This was a 12-week pilot feasibility randomised controlled trial conducted in 28 inactive adults (&gt;45 years) with NAFLD. Participants were randomly allocated to receive: 1) a home-based, muscle strengthening exercise program (3 days/week) delivered and monitored remotely by an exercise physiologist using the TeleHab exercise platform/app (VALD Health) plus support from a nutritionist to increase daily protein intake to ~1.2-1.5 g/kg/day from predominately plant-based sources and behavioural change support delivered via 3-4 weekly text messages (Pro-Ex, n = 14) or 2) usual care (UC, n = 14). Feasibility was assessed via retention (defined as ≤10% attrition), adherence [≥66% to the muscle strengthening program and ≥80% to the recommended daily protein serves [total (≥3-3½), plant (≥2) and animal (≤1-1½) per day (via protein checklist)] and safety (intervention-related adverse events). Secondary outcomes included macronutrient intake (3x24-hour records), weight (self-reported), habitual physical activity (PA) [moderate-to-vigorous (MVPA), minutes/week via the Short International Physical Activity Questionnaire], and physical function [30-second sit-to-stand (STS) performance]. Since this was a pilot feasibility study, mean group differences (6 and 12-weeks) were estimated, with 95% confidence intervals, and standardised effects [Cohen D, effect size (ES)] reported for secondary outcomes. Overall, 25 participants (89%) completed the intervention. In Pro-Ex, mean adherence to the exercise program was 52%, while adherence to the recommended plant, animal and total protein serves/day was 32%, 42% and 14% of participants, respectively. One minor exercise-related adverse event occurred from 241 completed sessions over 12 weeks. Relative to UC, Pro-Ex experienced a mean 2.7 (95%CI: 0.9, 4.4; large ES d = 1.29) increase in 30-sec STS number, 46 minute (95%CI: −153, 245; small ES d = 0.19) increase in MVPA, 1.7kg (95%CI: −3.5, 0.2; moderate ES d = 0.54) decrease in body weight, 35.2g (95%CI: 11.0, 59.3; large ES d = 1.23) increase in protein and 8.3g (95%CI:-20.5, 4.0; moderate ES d=-0.57) reduction in saturated fat. In middle-aged and older adults with NAFLD, a home exercise and plant-based dietary protein intervention delivered via telehealth was safe, but not feasible in terms of achieving the desired level of adherence. Despite this, exploratory analysis indicates this mode of healthcare service delivery could play a role to support weight management and improve physical activity and physical function in adults with NAFLD.

High-fidelity simulation versus case-based discussion for training undergraduate medical students in pediatric emergencies: a quasi-experimental study

ObjectiveTo evaluate the effect of high-fidelity simulation of pediatric emergencies compared to case-based discussion on the development of self-confidence, theoretical knowledge, clinical reasoning, communication, attitude, and leadership in undergraduate medical students. Methods33 medical students were allocated to two teaching methods: high-fidelity simulation (HFS, n = 18) or case-based discussion (CBD, n = 15). Self-confidence and knowledge tests were applied before and after the interventions and the effect of HFS on both outcomes was estimated with mixed-effect models. An Objective Structured Clinical Examination activity was conducted after the interventions, while two independent raters used specific simulation checklists to assess clinical reasoning, communication, attitude, and leadership. The effect of HFS on these outcomes was estimated with linear and logistic regressions. The effect size was estimated with the Hedge's g. ResultsBoth groups had an increase in self-confidence (HFS 59.1 × 93.6, p < 0.001; CDB 50.5 × 88.2, p < 0.001) and knowledge scores over time (HFS 45.1 × 63.2, p = 0.001; CDB 43.5 × 56.7, p-value < 0.01), but no difference was observed between groups (group*time effect in the mixed effect models adjusted for the student ranking) for both tests (p = 0.6565 and p = 0.3331, respectively). The simulation checklist scores of the HFS group were higher than those of the CBD group, with large effect sizes in all domains (Hedges g 1.15 to 2.20). ConclusionHFS performed better than CBD in developing clinical reasoning, communication, attitude, and leadership in undergraduate medical students in pediatric emergency care, but no significant difference was observed in self-confidence and theoretical knowledge.

The Effect of Ear Acupressure on Behavioral Problems in Children with Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial.

Due to the limits on treatment for people with attention-deficit/hyperactivity disorder (ADHD), ear acupressure treatment has been considered. This study examined the effect of ear acupressure on behavioral problems of children with ADHD. This randomized controlled trial was conducted in 70 children with ADHD who were randomized into 2 groups. The intervention group received ear acupressure in treatment points and the control group received massage at neutral points. Behavioral problems were measured 3 times: (1) baseline; week 4; and week 8. The last timepoint was a follow-up, using the Child Behavior Checklist. The intervention group had fewer behavioral problems at all 3 timepoints than the control group (Cohen's ∂ = 1.49; 95% confidence interval at week 4: 20.97, 47.43).The ear acupressure group had a large effect size with respect to reduction of attention problems at week 4 (∂ = 1.88) and week 8 (∂ = 1.48) than the control group. Ear acupressure induced significant reduction of the behavioral problems of children with ADHD. Further research can evaluate the use and continuity of the effectiveness of this treatment as a complementary treatment in addition to the usual treatments for these children.

Associations between food groups and biomarkers of inflammation: Are some foods groups more protective than others?

The consumption of healthy foods such as whole grains, vegetables, fruits, nuts, legumes, dairy, and fish is associated with decreased risk of cardiovascular disease (CVD). CVD is an inflammatory disease caused by atherosclerosis. Inflammation is measured clinically using hsCRP, however hsCRP is not specific to CVD. Novel pro-inflammatory markers, such as platelet-activating factor (PAF) and lipoprotein-associated phospholipase A2 (Lp-PLA2), have garnered attention due to their specific roles in endothelial dysfunction and CVD risk. During the COVID 19 outbreak research highlighted a potential interaction between PAF and Lp-PLA2 and the SARS COVID 19 virus(1-3) and related adenovirus-vector and mRNA vaccines.4 This cross-sectional study investigated the association between PAF, Lp-PLA2, hsCRP, and intake of healthy food groups including fruit, cruciferous and other vegetables, grains, meat and poultry, fish and seafood, nuts and legumes, and dairy in 100 adults (49 ± 13 years, 31% male) with variable CVD risk. Data were collected across four groups during May and July 2021 (Groups 1 and 2 - CVD risk factors) and January and April 2022 (Groups 3 and 4 - no CVD risk factors). Fasting PAF, Lp-PLA2 and hsCRP and usual dietary intake (food frequency questionnaire) were measured. Food intake was converted into serves and classified into food groups. Correlations and multiple regressions were performed. Contrary to expectations, mean PAF was lower for groups 1 and 2 (n = 46, mean PAF 3.31 ± 1.66 ng/mL) compared to groups 3 and 4 (n = 54, mean PAF 19.82 ± 12.95 ng/mL) p &lt; 0.001 with a large effect size (eta squared 0.665). Cruciferous vegetables were associated with lower levels of PAF (β = -.27, CI [−0.41, −0.14], p &lt; .001) with a one serve increase in cruciferous vegetables per day associated with an 24% reduction in PAF. Nuts and legumes were associated with lower levels of hsCRP (β = -.51, CI [−0.81, −0.22], p&lt;.001) with an increase of one serve per day associated with a 40% reduction in hsCRP. There were small inverse associations between cheese and both PAF (β = -.15, CI [−0.27, −0.03], p = .017) and Lp-PLA2 (β = -.26, CI [−0.47, −0.04], p = .024), however these were not significant at the Bonferroni-adjusted P&lt;.005 level. In conclusion, cruciferous vegetables and nut and legume consumption were associated with lower levels of inflammation. The lack of associations between PAF and Lp-PLA2 and other healthy foods may be due to confounding by COVID-19 infection and vaccination programs which prevents any firm conclusion on the relationship between PAF, Lp-PLA2 and food groups. Future research should aim to examine the relationship with these novel markers and healthy food groups in a non-pandemic setting.

Perisylvian and Hippocampal Anomalies in Individuals With Pathogenic GRIN2A Variants.

Pathogenic variants in GRIN2A are associated with a spectrum of epilepsy-aphasia syndromes (EASs). Seizures as well as speech and language disorders occur frequently but vary widely in severity, both between individuals and across the life span. The link between this phenotypic spectrum and brain characteristics is unknown. Specifically, altered brain networks at the root of speech and language deficits remain to be identified. Patients with pathogenic variants in GRIN2A offer an opportunity to interrogate the impact of glutamate receptor dysfunction on brain development. We characterized brain anomalies in individuals with pathogenic GRIN2A variants and EASs, hypothesizing alterations in perisylvian speech-language regions and the striatum. We compared structural MRI data from 10 individuals (3 children and 7 adults, 3 female) with pathogenic GRIN2A variants with data from age-matched controls (N = 51 and N = 203 in a secondary analysis). We examined cortical thickness and volume in 4 a priori hypothesized speech and language regions (inferior frontal, precentral, supramarginal, and superior temporal) and across the whole brain. Subcortical structures (hippocampus, basal ganglia, thalamus) and the corpus callosum were also compared. Individuals with pathogenic GRIN2A variants showed increased thickness and volume in the posterior part of Broca's area (inferior frontal gyrus, pars opercularis). For thickness, the effects were bilateral but more pronounced in the left (large effect size, η2 = 0.37) than the right (η2 = 0.12) hemisphere. Both volume and thickness were also higher in the bilateral superior temporal region while the supramarginal region showed increased thickness only. Whole-brain analyses confirmed left-sided thickness increases in Broca's area, with additional increases in the occipital and superior frontal cortices bilaterally. Hippocampal volume was reduced in the left hemisphere. There were no age-dependent effects or corpus callosum group differences. Anomalies in perisylvian regions, with largest differences in Broca's area, suggest an altered development of classical speech-language networks in GRIN2A-related EAS. Left hippocampal reduction suggests a role for this structure in early speech and language development and is consistent with GRIN2A gene expression in that region. Overall, elucidating the neural correlates of EAS provides insights into the impact of GRIN2A dysfunction, opening avenues for targeted intervention in developmental syndromes with compromised speech-language development.

The short version of the Sexual Distress Scale (SDS-3): Measurement invariance across countries, gender identities, and sexual orientations

BackgroundThe three-item Sexual Distress Scale (SDS-3) has been frequently used to assess distress related to sexuality in public health surveys and research on sexual wellbeing. However, its psychometric properties and measurement invariance across cultural, gender and sexual subgroups have not yet been examined. This multinational study aimed to validate the SDS-3 and test its psychometric properties, including measurement invariance across language, country, gender identity, and sexual orientation groups. MethodsWe used global survey data from 82,243 individuals (Mean age=32.39 years; 40.3 % men, 57.0 % women, 2.8 % non-binary, and 0.6 % other genders) participating in the International Sexual Survey (ISS; https://internationalsexsurvey.org/) across 42 countries and 26 languages. Participants completed the SDS-3, as well as questions regarding sociodemographic characteristics, including gender identity and sexual orientation. ResultsConfirmatory factor analysis (CFA) supported a unidimensional factor structure for the SDS-3, and multi-group CFA (MGCFA) suggested that this factor structure was invariant across countries, languages, gender identities, and sexual orientations. Cronbach's α for the unidimensional score was 0.83 (range between 0.76 and 0.89), and McDonald's ω was 0.84 (range between 0.76 and 0.90). Participants who did not experience sexual problems had significantly lower SDS-3 total scores (M = 2.99; SD=2.54) compared to those who reported sexual problems (M = 5.60; SD=3.00), with a large effect size (Cohen's d = 1.01 [95 % CI=-1.03, -0.98]; p < 0.001). ConclusionThe SDS-3 has a unidimensional factor structure and appears to be valid and reliable for measuring sexual distress among individuals from different countries, gender identities, and sexual orientations.

Implementing a group-based online mental well-being program for women living with and beyond breast cancer - A mixed methods study.

There is a gap in available mental well-being services in Australia for women diagnosed with breast cancer. This pilot mixed-methods uncontrolled study aimed to assess the feasibility of an online mental health and well-being intervention, the Be Well Plan (BWP), which enables participants to create a personalized, flexible well-being strategy. Women diagnosed with stages I-IV breast cancer were recruited into 4 asynchronous groups to participate in the BWP, a 5-week facilitator-led group-based mental health and well-being program. Psychological measures used at baseline and post-intervention included: the Warwick Edinburgh Mental Well-Being Scale, Brief Resilience Scale, Self-compassion Scale, 9-item Patient Health Questionnaire, 7-item General Anxiety Disorder scale, and EORC QLQ-C30. Multivariate analysis of variance and effect sizes were calculated on pre- and post-psychological measures, followed by qualitative content analysis on post-completion interviews with participants. Nineteen women (mean age 45.7, standard deviation=7.74) were included in the study. Large effect sizes were reported for mental well-being, depressive symptoms, and anxiety (partial ω2=0.28, 0.21, and 0.20, respectively). Self-compassion, resilience, and quality of life results were not statistically significant. Qualitative content analysis provided insight into experiences with Program Delivery Experience, Application of the BWP, Mental Health Improvements, Supporter Involvement, Adopted Interventions, and Recruitment. Participants reported benefits in mindfulness, grounding techniques, and physical activities. The BWP has the potential to be an effective intervention to support the mental health and well-being of breast cancer survivors. This study highlights flexible interventions that accommodate the diverse needs of breast cancer survivors to improve mental well-being and alleviate psychological distress.

An improved habitat suitability index for the great crested newt Triturus cristatus

An improved habitat suitability index for the great crested newt Triturus cristatus

PROFICIENCY OF TEACHERS' PERCEPTIONS OF DISTANCE EDUCATION AND TECHNOLOGY USAGE COMPETENCIES: A META-ANALYSIS STUDY

In this meta-analysis study, it was aimed to examine the perceptions of distance education and the effect size of technology usage competencies by using meta-analysis method. In the meta-evaluation carried for this purpose, twenty-eight studies that met the criteria for inclusion in the research were reached. By combining these studies, 11.797 sample groups were studied. In order to reach a general decision in the research, a funnel plot graph was drawn before statistical calculations were made. Statistical calculations were performed in order to make a general impression decision about the publication bias in the funnel plot diagram. When the statistical analysis results and the diagram graph results were combined, it was determined that there was no publication bias in the studies included in the study. Then, a heterogeneity test was performed to determine the model type of the research. According to the results of the heterogeneity test, it was decided that this research should be interpreted according to the type of random effects model. For heterogeneity, publication type, school type, and branches were aimed as moderators. It was observed that the meta-analysis study had a small distribution of perceptions of distance education and technology usage competencies, that the variables of publication type, school type and distribution departments did not have a moderator unit in the calculations done on the moderator, but it was concluded that the effect sizes of the studies published as articles, the studies carried out in secondary education institutions and the studies on mathematics teachers had a relatively larger effect size than the others.

451 Identification of candidate sudden arrhythmic death -causing variants in a spontaneous animal model

OBJECTIVES/GOALS: 1. Identify candidate AN-SAD-causing variants. 2. Estimate the variant effect size of and genotypic relative risk for arrhythmias and AN-SAD. METHODS/STUDY POPULATION: We performed whole genome sequencing (WGS) on 59 Thoroughbred AN-SAD cases and 58 controls. WGS was mapped and variants identified using a modified version of the Genome Analysis Toolkit best practices. Variants will be selected based on case-control analysis using SnpSift and presence in candidate genes. The top 400 candidate AN-SAD-causing variants will be selected based on being common in cases and rare or absent in controls, and uncommon (allele frequency less than 10%) in a catalog of genetic variation for the horse. The 400 variants will be genotyped in our cohort of 1,200 racehorses to determine variant effect size and genotypic relative risk. RESULTS/ANTICIPATED RESULTS: 17,182,003 variants were identified. 230 variants had significantly different allele frequencies (AF) between cases and controls (SnpSift). 723 high and 4,824 moderate impact variants were identified in 1,072 candidate genes. 3,681 variants were present at an AF 10% in the equine variant catalog. Variant effect prediction is ongoing to select the final 400 variants. Cardiac phenotyping (cardiac auscultation and ECG before, during, and after exercise) was performed on 790 racehorses and we will have 1,200 racehorses with cardiac phenotypes and/or AN-SAD. We will genotype the top 400 candidate AN-SAD-causing variants in these 1,200 horses to identify variants of large effect size. DISCUSSION/SIGNIFICANCE: Identification of candidate AN-SAD variants in a spontaneous animal model can facilitate interpretation of candidate variants in humans and horses. This project will provide further support for the racehorse AN-SAD model and will support future work exploring the genetic and environmental risk factors contributing to AN-SAD in this animal model.

Technology-based learning effect on the learning outcomes of Indonesian students: a meta-analysis

The utilization of information technology in education offers learners access to a variety of learning resources that are not restricted. It is expected that this use will enhance the success of the learning process and the attainment of educational goals. The purpose of this study is to examine the impact of information technology-based learning on the academic performance of students in Indonesia. This research adopts a meta-analysis design and utilizes a selection process based on established criteria to gather studies from the Google Scholar and Scopus databases. The study adheres to the PRISMA protocol. There were 51 studies included, comprising 44 academic journals and seven proceedings. The analysis technique applied is a meta-analysis using the random effect size model. The results of this study indicate that the utilization of information technology in education has a significant impact on the learning achievement of Indonesian students. The analysis of 51 studies, including 44 scientific journals and seven proceedings, showed that the effect sizes of the studies varied from -0.80 to 5.85, indicating heterogeneity in the studies analyzed. The effect size model used in this meta-analysis was a random effect size model, with the summary effect value showing a large effect size with a value of 1.285, a p-value&amp;lt;0.001, and a confidence interval ranging from 1.012 to 1.559. Subgroup analysis also revealed a significant difference in the average effect size across different levels of education, including elementary, secondary, and tertiary education. The results of the study showed no evidence of publication bias.