Non-significant Effect Size Research Articles

Characterization of preclinical models to investigate spinal cord stimulation for neuropathic pain: a systematic review and meta-analysis.

Despite advancements in preclinical and clinical spinal cord stimulation (SCS) research, the mechanisms of SCS action remain unclear. This may result from challenges in translatability of findings between species. Our systematic review (PROSPERO: CRD42023457443) aimed to comprehensively characterize the important translational components of preclinical SCS models, including stimulating elements and stimulation specifications. Databases (Embase, PubMed, Web of Science, and WikiStim) were searched on October 5, 2023, identifying 78 studies meeting the search criteria. We conducted a post hoc meta-analysis, including subgroup analyses and meta-regression, to assess SCS efficacy on mechanical hypersensitivity in rats subjected to neuropathic pain. Although monopolar electrodes were predominantly used as stimulating elements until 2013, quadripolar paddle and cylindrical leads gained recent popularity. Most research was conducted using 50 Hz and 200 µs stimulation. Motor threshold (MT) estimation was the predominant strategy to determine SCS intensity, which was set to 71.9% of MT on average. Our analysis revealed a large effect size for SCS (Hedge g = 1.13, 95% CI: [0.93, 1.32]) with similar magnitudes of effect between conventional (≤100 Hz) and nonconventional SCS paradigms while sham SCS had nonsignificant effect size. In addition, different stimulation intensity, frequency, and electrode design did not affect effect size. The risk of bias was assessed using Systematic Review Centre for Laboratory animal Experimentation criteria and was unclear, and only the frequency subgroup analysis showed publication bias. In summary, our review characterizes the critical components of preclinical SCS models and provides recommendations to improve reproducibility and translatability, thereby advancing the scientific foundation for SCS research.

Transparency, trustworthiness and usefulness in pre-eclampsia randomised controlled trials in the last three decades.

Over the last decades, there has been a rising number of randomised controlled trials (RCTs) on pre-eclampsia. We investigated pre-eclampsia RCTs between 1987 and 2021 and reported on trustworthiness, risk of biases, p-values, transparency, and usefulness. We searched PubMed for RCTs containing "pre-eclampsia" or "hypertensive disorders of pregnancy" in the title between 1987 and 2021. We created a transparency, trustworthiness and usefulness checklist, and recorded the characteristics of p-value reporting, RCT characteristics including registration, journal of publication, and outcomes. We found 202 RCTs, with the median number of authors increasing from four in 1987 to 12 in 2021. Trial registration increased nearly seven-fold from 17/93 between 1987-2010 to 79/109 RCTs registered between 2011-2021. Between 2010-2021, 338 p-values were published in the abstract with a rise in non-significant p-values (significant vs non-significant: 214/338, 63% vs 124/338, 37%). The number of effect sizes published increased by 58% from 659 in 1987-2010 to 1,038 in 2011-2021. The median of combined transparency and usefulness scores of RCTs improved from 6 to 9 out of 13, between 1987-1991 and 2017-2021. From the trustworthiness checklist, trials performed worst at adequate registration (43/202, 21%). Risk of reporting, performance, and detection biases were detected in most RCTs (166/202, 82%, 131/202, 65% and 141/202, 70% respectively). The reporting of non-significant p-values and effect sizes increased after mandatory trial registration in 2010, along with the transparency and trustworthiness of most trials. RCTs need to be more transparent, trustworthy, and useful to increase the value of research.

Assessment of Polycyclic Aromatic Hydrocarbon Exposure in Trainee Firefighters Using PAH CALUX Bioassay.

This work investigated the application of a reporter gene bioassay in assessing polycyclic aromatic hydrocarbon (PAH) exposure in trainee firefighters. In the PAH CALUX bioassay, the PAH-induced activation of the aryl hydrocarbon receptor in a reporter cell line is recorded by increased luminescence. A repeated measurement study was performed, collecting urine and skin wipe samples at two baseline sessions (spring and autumn) and after three firefighting sessions: one with wood fuel, one with gas fuel, and one without fire. The bioassay response was expressed as benzo[a]pyrene equivalents, which was compared to levels of 16 EPA criteria PAHs in skin wipe samples and 8 hydroxylated PAHs (OH-PAHs) in urine samples quantified by chromatography-tandem mass spectrometry techniques. Benzo[a]pyrene equivalents and PAH levels in skin wipes indicated larger exposure to PAHs during the wood session compared to the other sessions. The urine bioassay showed non-significant effect sizes after all sessions, whereas the chemical analysis showed increased OH-PAH levels after the gas session. The non-significant changes observed for the session without fire suggest a negligible exposure from contaminated gear. In conclusion, the bioassay response for skin wipes shows that trainee firefighters were exposed to higher levels of potentially toxic PAHs during the wood fire training session.

A novel digital twin strategy to enable the translation of evidence from randomized control trials to new populations

Abstract Background Randomized clinical trials (RCTs) are essential to guide medical practice; however, their generalizability to a given population is often uncertain. Between the SPRINT and ACCORD trials, only SPRINT found a significant reduction in major cardiovascular events (MACE) with intensive blood pressure control, but ACCORD did not, without clear evidence of whether this reflected differences in enrolled patients. Purpose To use a novel RCT digital twin-based approach to demonstrate the translation of an RCT to a different population, leveraging the differences in populations and treatment effects in SPRINT and ACCORD. Methods We developed a statistically informed Generative Adversarial Network (GAN) model that leverages relationships between covariates and outcomes using Directed Acyclic Graphs (DAGs). This model can generate a digital twin of an RCT (RCT-Twin) conditioned on covariate distributions from a second patient population while maintaining these relationships (Fig A). Using this, we generated the (i) RCT-Twin of SPRINT, which was conditioned on the 10 most disparate covariates drawn from ACCORD, and (ii) an RCT-Twin of ACCORD conditioned on SPRINT. To demonstrate treatment effect estimates of each RCT conditioned on the other RCT’s patient population, we evaluated the cardiovascular event-free survival of 10 iterations of these cross-trained RCT-Twins against the original trials. Results Using 9361 SPRINT participants and conditioning on 4733 ACCORD participants, we generated 10 ACCORD-conditioned SPRINT-Twin datasets. We confirmed that the RCT-Twins were consistently balanced between treatment and controls across all measured covariates (mean absolute standardized mean difference (MASMD) 0.019, SD 0.018), as expected for real RCTs. We also confirmed that covariates of the ACCORD-conditioned SPRINT-Twins were closer to ACCORD than SPRINT (MASMD 0.0082 vs 0.46, SD 0.016 vs 0.20), suggestive of successful conditioning. Most importantly, across iterations, ACCORD-conditioned SPRINT-Twin datasets reproduced the overall non-significant effect size seen in ACCORD (5-year MACE hazard ratio (95% confidence interval) of 0.88 (0.73-1.06) in ACCORD vs median 0.87 (0.68-1.13) in the ACCORD-conditioned SPRINT-Twins, Fig B), while the SPRINT-conditioned ACCORD-Twin datasets reproduced the significant effect size seen in SPRINT (0.75 (0.64-0.89) vs median 0.79 (0.72-0.86) in the SPRINT-conditioned ACCORD-Twins, Fig C). Conclusions Our novel conditioned digital twin approach simulates RCT-derived effects in different patient populations by translating these effects to the covariate distributions of the patients. This key methodological advance may enable the direct translation of RCT-derived effects into disparate patient populations and may enable causal inference in real-world settings.

A Meta-Analysis of the Relations Between Achievement Goals and Internalizing Problems

This systematic meta-analytic review investigated the relations between achievement goals and internalizing symptoms and disorders, namely, anxiety and depression. The number of samples for each focal relationship ranged from 3 to 36. The results indicated significant effect sizes for the relations between mastery-approach goals and anxiety (r = − .10) and depression (r = − .18), as well as performance-avoidance goals and anxiety (r = .25) and depression (r = .16). A significant effect size was also found for the relation between performance-approach goals and anxiety (r = .15), and a non-significant effect size was observed for the relation between performance-approach goals and depression (r = .05). Mastery-avoidance goals were not significantly related to either anxiety (r = .08) or depression (r = − .13). Several moderators representing the conceptualization of achievement goals (e.g., theoretical model), sample characteristics (e.g., education level), and methodology- and publication-based characteristics (e.g., year of publication) were significant, and suggested avenues for future research. These findings herein have implications for intervention programs that could focus on reducing the links between achievement goals and internalizing problems.

A Novel Digital Twin Strategy to Examine the Implications of Randomized Clinical Trials for Real-World Populations.

Randomized clinical trials (RCTs) are essential to guide medical practice; however, their generalizability to a given population is often uncertain. We developed a statistically informed Generative Adversarial Network (GAN) model, RCT-Twin-GAN, that leverages relationships between covariates and outcomes and generates a digital twin of an RCT (RCT-Twin) conditioned on covariate distributions from a second patient population. We used RCT-Twin-GAN to reproduce treatment effect outcomes of the Systolic Blood Pressure Intervention Trial (SPRINT) and the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Blood Pressure Trial, which tested the same intervention but found different treatment effects. To demonstrate treatment effect estimates of each RCT conditioned on the other RCT's patient population, we evaluated the cardiovascular event-free survival of SPRINT digital twins conditioned on the ACCORD cohort and vice versa (ACCORD twins conditioned on SPRINT). The conditioned digital twins were balanced across intervention and control arms (mean absolute standardized mean difference (MASMD) of covariates between treatment arms 0.019 (SD 0.018), and the conditioned covariates of the SPRINT-Twin on ACCORD were more similar to ACCORD than SPRINT (MASMD 0.0082 SD 0.016 vs. 0.46 SD 0.20). Notably, across iterations, SPRINT conditioned ACCORD-Twin datasets reproduced the overall non-significant effect size seen in ACCORD (5-year cardiovascular outcome hazard ratio (95% confidence interval) of 0.88 (0.73-1.06) in ACCORD vs. median 0.87 (0.68-1.13) in the SPRINT conditioned ACCORD-Twin), while the ACCORD conditioned SPRINT-Twins reproduced the significant effect size seen in SPRINT (0.75 (0.64-0.89) vs. median 0.79 (0.72-0.86)) in the ACCORD conditioned SPRINT-Twin). Finally, we demonstrate the translation of this approach to real-world populations by conditioning the trials on an electronic health record population. Therefore, RCT-Twin-GAN simulates the direct translation of RCT-derived treatment effects across various patient populations.

Role of cardiac magnetic resonance in stratifying arrhythmogenic risk in mitral valve prolapse patients: a systematic review and meta-analysis.

To perform a systematic review and meta-analysis of studies investigating the diagnostic value of cardiac magnetic resonance (CMR) features for arrhythmic risk stratification in mitral valve prolapse (MVP) patients. EMBASE, PubMed/MEDLINE, and CENTRAL were searched for studies reporting MVP patients who underwent CMR with assessment of: left ventricular (LV) size and function, mitral regurgitation (MR), prolapse distance, mitral annular disjunction (MAD), curling, late gadolinium enhancement (LGE), and T1 mapping, and reported the association with arrhythmia. The primary endpoint was complex ventricular arrhythmias (co-VAs)as defined by any non-sustained ventricular tachycardia, sustained ventricular tachycardia, ventricular fibrillation, or aborted sudden cardiac death. Meta-analysis was performed when at least three studies investigated a CMR feature. PROSPERO registration number: CRD42023374185. The meta-analysis included 11 studies with 1278 patients. MR severity, leaflet length/thickness, curling, MAD distance, and mapping techniques were not meta-analyzed as reported in < 3 studies. LV end-diastolic volume index, LV ejection fraction, and prolapse distance showed small non-significant effect sizes. LGE showed a strong and significant association with co-VA with a LogORs of 2.12 (95% confidence interval (CI): [1.00, 3.23]), for MAD the log odds-ratio was 0.95 (95% CI: [0.30, 1.60]). The predictive accuracy of LGE was substantial, with a hierarchical summary ROC AUC of 0.83 (95% CI: [0.69, 0.91]) and sensitivity and specificity rates of 0.70 (95% CI: [0.41, 0.89]) and 0.80 (95% CI: [0.67, 0.89]), respectively. Our study highlights the role of LGE as the key CMR feature for arrhythmia risk stratification in MVP patients. MAD might complement arrhythmic risk stratification. LGE is a key factor for arrhythmogenic risk in MVP patients, with additional contribution from MAD. Combining MRI findings with clinical characteristics is critical for evaluating and accurately stratifying arrhythmogenic risk in MVP patients. MVP affects 2-3% of the population, with some facing increased risk for arrhythmia. LGE can assess arrhythmia risk, and MAD may further stratify patients. CMR is critical for MVP arrhythmia risk stratification, making it essential in a comprehensive evaluation.

Effectiveness of empathy portfolios in developing professional identity formation in medical students: a randomized controlled trial

BackgroundMedical education requires innovative strategies to enhance empathic skills and the formation of professional identities among students. However, evidence-based teaching of empathy and professional identity formation is inadequately represented, particularly in medical curricula. This study investigated the effectiveness of empathy portfolios in developing Professional Identity Formation (PIF) among medical students and the correlation between empathy and PIF. The objectives of this study were to determine the effectiveness of empathy portfolios for teaching and nurturing PIF in medical students and to investigate the correlation between empathy and PIF.MethodsA randomized controlled trial was conducted at Peshawar Medical College, Pakistan. The protocol adhered to CONSORT guidelines. A total of 120 students participated in the study. Empathy and PIF were assessed using two validated questionnaires JSPE-S and PIQ before randomization. The participants were randomized in a stratified fashion into the experimental (n = 60) and control (n = 60) groups. The Participants in the intervention group attended a training workshop on portfolio use. Students maintained their portfolios and wrote reflections on incidents that evoked empathy. Independent t-tests were performed to determine whether the control and experimental groups differed in terms of mean empathy and PIF scores, and Pearson’s correlation analyses were used to investigate the relationships between pre- and post-empathy, and pre-post-PIF.ResultsThe mean post-test scores on the Empathy and PIF showed a statistically insignificant difference of 0.75 +-17.6 for empathy and 0.45 ± 8.36 for PIF. The intervention had little influence on empathy and PIF scores, as evidenced by nonsignificant effect sizes of 0.32 and 0.36 for empathy and PIF respectively.A strong positive correlation was found between Pre-Empathy and the PIF-Total score (0.519), and between Post- empathy and the PIF-Total score (0.395) (p < 0.001).ConclusionsEmpathy had a positive linear correlation with PIF; however, the use of empathy portfolios as a three-week single-point intervention was ineffective at nurturing PIF.

The Efficacy and Durability of Mindfulness-Based Cognitive Therapy in the Treatment of Anxiety and Depressive Disorders: A Systematic Review and Meta-analysis

Background: There is a dearth of meta-analytical studies measuring the durability of mindfulness-based cognitive therapy (MBCT) in the treatment of anxiety and depressive disorders. Therefore, the present study was conducted to evaluate both the effectiveness and durability of MBCT in the treatment of depression and anxiety disorders. Methods: We systematically searched six databases from June 11, 2023 to September 16, 2023 for randomized control trials (RCTs) of adults diagnosed with anxiety or depressive disorders as per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision or the Tenth Revision of the International Classification of Diseases and Related Health Problems diagnostic criteria; the treatment group received the complete form of MBCT, whereas the control group received other interventions or treatment as usual; the treatment outcome focused on symptoms of depression or anxiety. Two independent reviewers included studies, assessed quality, and extracted data. The Cochrane Risk-of-Bias 2.0 tool was applied to appraise the methodological quality of the included studies. R 4.2.1 software and the “metafor” package were used to estimate the effect sizes based on mean and standard deviation of anxiety and depressive disorders at baseline and postintervention, and at postintervention and follow-up periods for both the treatment and control groups. Result: A total of 1,470 studies were reviewed, and 21 RCTs met the inclusion criteria. The meta-analysis showed an overall standardized mean difference of −0.4806 [CI: −0.7185; −0.2428] and −0.3817 [CI: −0.5407; −0.2228] for reducing anxiety and depression symptoms, respectively indicating the effectiveness of MBCT. Comparison between postintervention and follow-up or follow-up measurement showed a small and nonsignificant effect size for depression (0.0130 [CI: −0.2109; 0.2369]) and anxiety (0.0198 [CI: −0.0660; 0.1057]), suggesting that recovered symptoms in the treatment group were maintained until the follow-up evaluation. Conclusion: MBCT produces long-term treatment effects in the management of both depressive and anxiety disorders. Protocol preregistration: The current meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and got registered with PROSPERO (CRD42023465494).

Paradox of life after work: A systematic review and meta-analysis on retirement anxiety and life satisfaction.

Retirement is a pivotal life transition that often changes routines, identity, and objectives. With increasing life expectancies and evolving societal norms, examining the interplay between retirement anxiety and life satisfaction is vital. This study delves into this relationship, recognising the complexities of retirement. A systematic review and meta-analysis followed PRISMA guidelines. Research from 2003 to 2023 was sourced from databases like CINAHL, PubMed/Medline, PsycINFO, ERIC, and Google Scholar, focusing on diverse methodologies and outcomes related to retirement registered in Prospero database (CRD42023427949). The quality assessment used an eight-criterion risk of bias scale, and analyses included qualitative and quantitative approaches, such as random-effects meta-analysis and moderator analyses. After reviewing 19 studies with varied geographical and demographic scopes, a mixed relationship between retirement and life satisfaction emerged: 32% of studies reported a positive relationship, 47% were negative, and 21% found no significant correlation. Meta-analysis indicated high heterogeneity and non-significant mean effect size, suggesting no consistent impact of retirement on life satisfaction. Moderator analyses highlighted the influence of measurement tools on outcomes. The findings reveal a complex interplay between retirement anxiety and life satisfaction, stressing the need for holistic retirement policies that encompass mental health, social integration, and adaptability, focusing on cultural sensitivity. Challenges include potential biases in data sources, methodological diversity, the scarcity of longitudinal studies, and difficulties in addressing recent societal shifts, like the COVID-19 pandemic. Variability in measurement tools and possible publication bias may have also influenced results. This study contributes to understanding retirement, emphasising the relationship between retirement anxiety and life satisfaction. It advocates for ongoing, detailed, culturally informed research to grasp retirement's multifaceted aspects fully.

Multicomponent Physical Program: Effects on Physical Fitness of Older Women of Different Age Groups

ABSTRACT Purpose: Experimental studies investigating the outcomes of physical exercise among age-stratified groups of older women are still incipient. This study aimed to investigate the effects of a ten-month multicomponent physical program on the physical fitness of older women in three age-stratified groups (60–69 years, 70–79 years, and ≥80 years). Method: Participants (n = 141) were divided into three age groups: GR1 60–69 years (n = 45; 65.2 ± 2.3 years); GR2 70–79 years (n = 67; 72.9 ± 2.9 years), GR3 ≥80 years (n = 29; 83.5 ± 4.5 years). The participants performed the multicomponent physical program and were evaluated before and after the intervention with Senior Fitness Test. Data were analyzed using generalized estimating equations, Bonferroni test (p ≤.05) and effect size (Cohen’s d). Results: For the group factor, there were significant differences in lower limb strength (p = .003), upper limb strength (p < .001), upper limb flexibility (p < .001), balance/agility (p < .001), and cardiorespiratory fitness (p < .001). For the time factor, significant differences were observed in lower limb strength (GR2, p = .014, small effect size), upper limb strength (GR1, p = .003; GR2, p < .001; GR3, p = .017; small effect sizes), lower limb flexibility (GR1, p = .025, non-significant effect size), cardiorespiratory fitness (GR1, p < .001, medium effect size; GR2, p = .002; small effect size). Conclusion: Physical fitness improved with training, but effects differed between age groups. Positive effects were observed for GR1 and GR2, whereas GR3 showed maintenance of physical fitness. Aging interferes more strongly in women aged 80 years and older and it is necessary for specific training programs for this age group.

IMMERSIVE VIRTUAL REALITY INTERVENTIONS FOR OLDER ADULTS: A SERIES OF META-ANALYSES

Abstract Many older adults desire to age in place, a term used to describe living independently versus transitioning to a residential care facility. Virtual reality (VR) has the potential to positively impact the functioning of older adults as an assessment or intervention to help compensate for lost or declining functions. VR captures a wide variety of technologies ranging from non-immersive to fully immersive, designed to give the user a feeling of presence. To date, VR interventions have been used with older adults including improving health outcomes, improving functional abilities, and for neuropsychological purposes. A handful of meta-analyses (M-As) attempt to summarize the overall effectiveness of VR interventions with older adults, but many contain methodological issues and cover the gamut of VR technology. The present M-A fills a gap in the literature by assessing the literature on immersive VR interventions for older adults. Sixteen articles met inclusion for meta-analysis, and 41 effect sizes (ES) were calculated. ES were grouped by category, neuropsychological, health/mental health, functional, and eight meta-analyses were performed with one exploratory analysis. Results revealed small, significant ES for VR interventions on measures of global cognition, simple attention tasks, executive functioning tasks, anxiety ratings, and pain ratings. Nonsignificant ES were found for stress ratings, gait speed, depression ratings, and TUG task (exploratory M-A). Continuing to develop affordable, safe interventions to assist with aging in place is important as the number of older adults continues to increase. Immersive VR is a promising avenue to continue exploring to better assist the aging population.

BIOMARKERS IN CNS-ORIGINATING EXTRACELLULAR VESICLES: A DIAGNOSTIC META-ANALYSIS FOR PARKINSONIAN DISORDERS

Abstract Parkinsonian disorders, including Parkinson’s disease (PD), multiple system atrophy (MSA), dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP), and corticobasal syndrome (CBS), present overlapping early symptoms, complicating accurate diagnosis. Predicting the conversion of prodromal conditions like REM behavior disorder (RBD) to PD, MSA, or DLB is also complex. Extracellular vesicles (EVs), small structures released by cells, carry cell-state-specific biomarkers that can cross the blood-brain barrier, providing a window into the brain’s biochemistry. Blood-isolated CNS-originating EVs have become a popular diagnostic tool. Yet, challenges remain in replicating and validating these findings. We conducted a PRISMA-guided systematic review and meta-analysis of 15 studies involving 1,455 persons with PD, 206 with MSA, 21 with DLB, 172 with PSP, 152 with CBS, 189 with RBD, and 1,045 healthy controls (HCs). Diagnostic accuracy for distinguishing persons with PD from HCs was moderate but showed high heterogeneity and significant publication bias. This indicates that studies with non-significant or lower effect sizes were less likely to be published. Differentiating persons with PD from those with PSP or CBS is limited due to the small number of involved studies. Our analyses suggest that biomarkers from CNS-originating EVs may not reliably differentiate persons with MSA or RBD from HCs due to variable accuracy and high heterogeneity. Our findings highlight the moderate diagnostic accuracy of EV biomarkers in differentiating Parkinsonian disorders, emphasizing substantial heterogeneity and significant publication bias. The need for larger, more standardized, and unbiased studies is underscored to validate the utility of EV biomarkers as diagnostic tools.

Screen Time and Autism Spectrum Disorder

Contemporary studies raise concerns regarding the implications of excessive screen time on the development of autism spectrum disorder (ASD). However, the existing literature consists of mixed and unquantified findings. To conduct a systematic review and meta-analyis of the association between screen time and ASD. A search was conducted in the PubMed, PsycNET, and ProQuest Dissertation & Theses Global databases for studies published up to May 1, 2023. The search was conducted independently by 2 authors. Included studies comprised empirical, peer-reviewed articles or dissertations published in English with statistics from which relevant effect sizes could be calculated. Discrepancies were resolved by consensus. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Two authors independently coded all titles and abstracts, reviewed full-text articles against the inclusion and exclusion criteria, and resolved all discrepancies by consensus. Effect sizes were transformed into log odds ratios (ORs) and analyzed using a random-effects meta-analysis and mixed-effects meta-regression. Study quality was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Publication bias was tested via the Egger z test for funnel plot asymmetry. Data analysis was performed in June 2023. The 2 main variables of interest in this study were screen time and ASD. Screen time was defined as hours of screen use per day or per week, and ASD was defined as an ASD clinical diagnosis (yes or no) or ASD symptoms. The meta-regression considered screen type (ie, general use of screens, television, video games, computers, smartphones, and social media), age group (children vs adults or heterogenous age groups), and type of ASD measure (clinical diagnosis vs ASD symptoms). Of the 4682 records identified, 46 studies with a total of 562 131 participants met the inclusion criteria. The studies were observational (5 were longitudinal and 41 were cross-sectional) and included 66 relevant effect sizes. The meta-analysis resulted in a positive summary effect size (log OR, 0.54 [95% CI, 0.34 to 0.74]). A trim-and-fill correction for a significant publication bias (Egger z = 2.15; P = .03) resulted in a substantially decreased and nonsignificant effect size (log OR, 0.22 [95% CI, -0.004 to 0.44]). The meta-regression results suggested that the positive summary effect size was only significant in studies targeting general screen use (β [SE] = 0.73 [0.34]; t58 = 2.10; P = .03). This effect size was most dominant in studies of children (log OR, 0.98 [95% CI, 0.66 to 1.29]). Interestingly, a negative summary effect size was observed in studies investigating associations between social media and ASD (log OR, -1.24 [95% CI, -1.51 to -0.96]). The findings of this systematic review and meta-analysis suggest that the proclaimed association between screen use and ASD is not sufficiently supported in the existing literature. Although excessive screen use may pose developmental risks, the mixed findings, the small effect sizes (especially when considering the observed publication bias), and the correlational nature of the available research require further scientific investigation. These findings also do not rule out the complementary hypothesis that children with ASD may prioritize screen activities to avoid social challenges.

Life is precious: A quasi-experimental study of a community-based program to prevent suicide among Latina adolescents in New York City.

Rising rates of suicidal thoughts and behaviors (STBs) among U.S. Latina adolescents urgently need attention. Life is Precious (LIP) is a culturally responsive, community-based, afterschool-model program offering wellness-support services to supplement outpatient mental health treatment for Latina adolescents experiencing STB's. This 12-month quasi-experimental pilot study explored LIP's impact on clinical outcomes. Latina adolescents newly enrolled in LIP and receiving outpatient treatment (n = 31) and those newly starting outpatient treatment only (n = 12; Usual Care) were assessed for Suicidal Ideation (Suicidal Ideation Questionnaire; SIQ) and depressive symptoms (Patient Health Questionnaire-9). We estimated differences in mean scores using longitudinal linear mixed models and adjusted risk ratios (ARRs) of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements using exact logistic models. The direction of the estimated impact of LIP was positive [differences (95% CIs): -15.5 (-34.16, 3.15) for SIQ; -1.16 (-4.39, 2.07) for PHQ-9], with small-to-moderate nonsignificant effect sizes (0.19-0.34). LIP participants saw two to three times higher prevalence than controls of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements; ARRs (95% CIs) were 1.91 (0.61, 3.45), 3.04 (0.43, 11.33), and 1.97 (0.44, 5.07), respectively. Suicidal behaviors also decreased in LIP. The effects of LIP were in positive directions across clinical outcomes, warranting further research on its effectiveness in decreasing STBs.

Anxiety and Depression in Gifted Individuals: A Systematic and Meta-Analytic Review

This article reviews the experimental research on the level of anxiety or depression in gifted individuals. Twenty-seven studies compared gifted and typically developing individuals for the anxiety level and 15 studies for the depression level comparison. This current meta-analysis was performed on the anxiety and depression levels distinctly. We found a non-significant negative effect size for both anxiety, g = −0.14, k = 27, and depression, g = −0.14, k = 15. These values should be taken cautiously given that a high heterogeneity was also found, which remained largely unexplained by the moderators tested. Only age and type of anxiety assessment emerged as significant moderators for the anxiety domain. The observed effect size for depression was not significantly affected by the subgroups analyzed.

Applying precision methods to treatment selection for moderate/severe depression in person-centered experiential therapy or cognitive behavioral therapy

Objective To develop two prediction algorithms recommending person-centered experiential therapy (PCET) or cognitive–behavioral therapy (CBT) for patients with depression: (1) a full data model using multiple trial-based and routine variables, and (2) a routine data model using only variables available in the English NHS Talking Therapies program. Method Data was used from the PRaCTICED trial comparing PCET vs. CBT for 255 patients meeting a diagnosis of moderate or severe depression. Separate full and routine data models were derived and the latter tested in an external data sample. Results The full data model provided the better prediction, yielding a significant difference in outcome between patients receiving their optimal vs. non-optimal treatment at 6- (Cohen’s d = .65 [.40, .91]) and 12 months (d = .85 [.59, 1.10]) post-randomization. The routine data model performed similarly in the training and test samples with non-significant effect sizes, d = .19 [−.05, .44] and d = .21 [−.00, .43], respectively. For patients with the strongest treatment matching (d ≥ 0.3), the resulting effect size was significant, d = .38 [.11, 64]. Conclusion A treatment selection algorithm might be used to recommend PCET or CBT. Although the overall effects were small, targeted matching yielded somewhat larger effects.

Cognitive behavioral therapy for lifestyle changes in patients with obesity and type 2 diabetes: a systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to examine the contribution of cognitive behavioral therapy (CBT) to the implementation of lifestyle changes, considering health-related and behavioral outcomes. A systematic literature review was performed using multiple databases (PsycInfo, PubMed and MEDLINE). The inclusion criteria comprised randomised controlled trials of CBT for lifestyle changes in patients with obesity and/or type 2 diabetes. The quality of study reporting was assessed with the revised Cochrane Collaboration’s risk of bias tool. A meta-analysis was conducted on studies with appropriate outcomes. Nine randomised controlled trials, with a total sample size of 902 participants, met the inclusion criteria. The meta-analysis has shown a medium, significant effect size of CBT interventions for weight loss and weight maintenance, and a low, non-significant effect size of CBT interventions for reducing glycated hemoglobin (HbA1c) levels. A separate, combined, meta-analysis for all nine calculated effect sizes has yielded a medium and significant overall effect size for the model. Our review of the studies about the effectiveness of CBT in implementing lifestyle changes has, in comparison to usual control groups, proven the efficacy of CBT interventions in implementing lifestyle changes, especially for weight loss and weight maintenance.

Do bystanders always see more than the players? Exploring Solomon's paradox through meta-analysis.

Solomon's paradox is a widespread phenomenon regarding how we think, which asserts that people reason more wisely about other people's social problems than they do about their own. This means that we are more likely to make rational decisions when decision-making on the behalf of others than for ourselves, which has practical implications in the field of interpersonal conflicts and social dilemmas. However, it remains unclear whether Solomon's paradox exists across cultures, and the magnitude of its effect size. A meta-analysis was conducted, examining six studies and 20 effect sizes, to gain more insight into this phenomenon, considering the influencing effects of culture, measurement instrument, conflict type, and some other moderating factors. The results showed that Solomon's paradox does exist in interpersonal conflict (d = 0.317; 95% CI = 0.828-0.852). Moderator analysis revealed that measurement instrument and subjects had an impact on the effect of Solomon's paradox and there was a non-significant effect size of culture and conflict type. Future research should explore the diverse forms of Solomon's paradox across more diverse cultural contexts (e.g., various countries) to better understand the phenomenon and help people cope with life's problems more wisely.

THE EFFECT OF DEBT TO EQUITY RATIO, RETURN ON ASSETS AND COMPANY SIZE ON BOND RATINGS OF NON-FINANCIAL COMPANIES RATED BY PT PEFINFO.

One form of funding by the company is by issuing bonds. This study aims to examine the effect of debt to equity ratio, return on assets and firm size on bond ratings of non-financial companies ranked by PT Pefindo during the 2015-2019 period. The type of data used is secondary data from each non-financial sector company obtained from the official website of the Indonesia Stock Exchange and the website of PT Pefindo. The sampling technique was carried out by purposive sampling. The sample used in this study is a total of 11 companies. The data analysis technique used is logistic regression analysis test. The results showed that the debt to equity ratio had a significant negative effect, return on assets had a nonsignificant negative effect and firm size had an insignificant positive effect on bond ratings. The results of the coefficient of determination show a value of 0.206, which means that the variables of debt to equity ratio, return on assets and firm size are able to explain the bond rating variable of 20.6%.