Significant Effect Size Research Articles

The Impact of Socioeconomic Factors on Medical School Acceptance Rates.

Purpose: Seventy-five percent of medical students in the United States hail from families in the top 2 income quintiles as defined by the U.S. Census Bureau, while 5% of medical students represent the bottom quintile. 1 Analyses to identify potential barriers contributing to this staggering socioeconomic disparity among our future medical workforce are sparse. Characterization of the exacerbating factors and potential bottlenecks along the premedical pipeline can help inform crucial steps toward initiatives to increase representation of medical school matriculants from all socioeconomic backgrounds. This study examined U.S. medical school acceptance rates across familial income and parental education levels and identified applicant factors predictive of medical school acceptance. Approach/Methods: The American Medical College Application Service (AMCAS) collects the highest level of parental education and childhood family income for every applicant. De-identified AMCAS data were obtained for all medical school applicants from 2014 to 2019 and included the following applicant characteristics: science and nonscience GPA, Medical College Admission Test (MCAT) 2015 score, age, parental education, family income, race/ethnicity, and the number of medical school acceptances obtained. Descriptive statistical analyses assessed acceptance rates, MCAT averages, and GPA averages, stratified by applicant’s family income and parents’ education. Low income was defined as reporting a childhood family income <$75,000, and first-generation status was defined as having no parent with a bachelor’s degree. Multivariate regression analysis modeled the effects of MCAT, GPA, race/ethnicity, first-generation status, and low-income status on acceptance to at least 1 MD program. Results/Outcomes: AMCAS data from 312,898 applicants were analyzed. Of the total, 34.3% (107,396/312,898) were low-income and 19.3% (60,328/312,898) were first- generation applicants. The overall acceptance rate over the study period was 42.3%. Low-income applicants and first-generation applicants’ acceptance rates were 36.0% (38,674/107,396) and 32.7% (19,701/60,328), respectively. On univariate analysis, acceptance was negatively associated with both family income (OR: 0.602; P < .001; CI: 0.592, 0.612) and parental education (OR: 0.581; P < .001; CI: 0.570, 0.592). On multivariate analysis, among those with MCAT2015 scores (n = 142,961), medical school acceptance was most affected by average science GPA (OR: 6.63; P < .001; CI: 6.345, 6.918), underrepresented in medicine (UIM) identity (OR: 5.119; P < .001; CI: 4.923, 5.323), and MCAT score (OR: 1.186; P < .001; CI: 1.184, 1.189). Low-income status (OR: 0.968; P < .05; CI: 0.938, 0.999) was negatively associated with acceptance; however, first-generation status (OR: 0.994; P = .758) was not significantly associated with acceptance. Discussion: These results reveal that first-generation and low-income medical school applicants have a markedly lower rate of acceptance than the general applicant population. Furthermore, both first-generation and low-income status are significantly negatively associated with medical school acceptance. This effect is mediated by UIM identity and GPA and MCAT metrics. Notably, UIM identity status had a significant effect size in predicting medical school acceptance, which is potentially reflective of beneficial race-conscious admissions practices. Furthermore, the miniscule effect size of first-generation college status and low-income status serves as evidence that disadvantaged backgrounds are not widely considered among admission practices as recommended by the Liaison Committee on Medical Education (LCME) Standard on Diversity. 2 Additionally, one study’s analysis of group differences in scores on the latest version of the MCAT revealed disparities in scores and use of preparatory materials depending on an applicant attending a school with more or fewer resources. 3 Therefore, first-generation college and low-income applicants’ relatively poorer acceptance rates may be mitigated by early academic support and access to cost-prohibitive MCAT preparatory materials. Significance: First-generation college and low-income applicants experience lower medical school acceptance rates, but high grades and test scores mediate the effect, in combination with UIM status. These applicant populations require increased support and mentorship to achieve proportional representation among medical students.

Depicting socioeconomic disadvantage and social gradient in quality of life in Limassol, Cyprus

Abstract Background The lack of validated and accepted area-level indices of socioeconomic disadvantage at national or regional level in Cyprus poses a barrier to “spatial thinking” among Public Health policy-makers and researchers. Methods A composite index of socioeconomic disadvantage was constructed by exploring the factor structure of 28 commonly used census indicators at city quarter (N = 38, median population 3894, IQR 2570-6169) and postcode level (N = 124, median 1320, IQR 798-2014). Predictive validity was explored in mixed random-effect regression models in term of associations with SF-36 health-related quality of life among a stratified random sample aged 45-64 (N = 450, 45 neighbourhoods). Results There was wide variability across communities in all indicators, for instance, 0.4%-25.9% unemployment, 41.1%-90.7% at most secondary level education, 3.6%-95.9% residences built prior to 1980. Two factors were identified: “socioeconomic disadvantage” (SED), with the same set of 11-12 indicators at the two levels of geographical aggregation, and “built environment”, reflecting proximity to the city centre, with nevertheless no meaningful associations with the outcome of interest. The SED index captured a stepwise decrease in physical (-1.39 95%CI -2.06, -0.72) and mental health (-1.26 95% -1.98, -0.54) scores across quartiles of postcodes with increasing disadvantage, of similar clinically significant effect size by gender. Associations attenuated slightly but remained significant after adjusting for person-based indicators of social position, with some weak evidence of cross-level interactions for physical, but not mental, health. Conclusions The composite index, tapping on educational, economic, material, occupational and social disadvantage, allowed the exploration of socioeconomic disadvantage patterning at a small-area level in the city of Limassol and documented the social gradient in health-related quality of life among a late working-life sample of residents. Key messages First-time depiction of the geographical patterning of socioeconomic disadvantage across the small geographical level of postcodes in the city of Limassol, Cyprus. Social gradient in physical and mental health in men and women across the continuum of socioeconomic disadvantage over and above person-based indicators of social position.

Designing Dual Compartment HIV Prevention Products: Women's Sensory Perceptions and Experiences of Suppositories for Rectal and Vaginal Use.

Dual compartment suppositories are being developed to prevent HIV and other sexually transmitted infections. Such products, for use in the rectum, the vagina, or both, could have a significant public health impact by decreasing global incidence of these diseases. In this study, 16 women each used two rheologically distinct suppositories in their vagina and rectum. User Sensory Perception and Experience (USPE) scales assessed sensory experiences during sexual activity to understand whether, and how, women perceive formulation properties in the vagina and rectum. Qualitative data from individual in-depth interviews captured women's descriptions and comparisons of the experiences. Significant differences and large Cohen's d effect sizes between vaginal and rectal experiences of suppository-A were found for three scales: Application (APP): Product Awareness, SEX: Initial Penetration; and SEX: Effortful. Qualitative data provided user experience details that credibly align with these score differences. Near significant differences and large effect sizes were found for two additional scales: SEX: Perceived Wetness with suppository-A and SEX: Messiness with suppository-B. In addition, other scale scores showed medium-to-large effect sizes that correspond to hypothesized sensations associated with biophysical properties of the suppositories. Statistical significance combined with large effect sizes and qualitative data accurately represent the hypothesized perceptibility of suppository properties and identifies performance characteristics relevant to acceptability and adherence; together these data provide discernment of factors that can guide the development of dual compartment products. The Clinical Trial Registration number: NCT02744261.

Effectiveness of technology-based psychosocial interventions for child, adolescents and young adults undergoing cancer treatment: A meta-analysis of randomised controlled trials.

Cancer can have various psychosocial effects on children and young adults. Technology-based psychosocial interventions are increasingly popular in paediatric oncology for psychosocial health. The objective of this study is to investigate the effectiveness of technology-based psychosocial interventions applied to children, adolescent and young adults undergoing cancer treatment. Eight electronic databases including PubMed, Cochrane Library (including Cochrane Central Register of Controlled Trials [CENTRAL]), CINAHL Plus with Full Text, PsycINFO, MEDLINE, ProQuest, Science Direct and Scopus were searched to identify eligible randomised controlled trials from 1 January 2010 up to 9 April 2021. Search results were limited to 'children, adolescent and young adults' 6-24 years undergoing cancer treatment. Randomised controlled studies in which technology-based psychosocial interventions were applied were examined. Of 4,927 articles, 12 articles met the inclusion criteria. Hedges' g effect size was computed for each study. Effect sizes and moderator variables were tested using random-effects models. This study is registered with PROSPERO, number CRD42020177787. The outcomes were anger, anxiety, coping, depression, distress, quality of life and resilience. Compared with standard care, technology-based psychosocial interventions had a large effect and significantly on anger (g = -1.327, 95% CI: [-2.43, 0.22], anxiety (g = -0.89, 95%CI: [-1.34, -0.18], and depression (g = -1.05, 95% CI: [-1.65,-0.46]. Also, it was found that the duration of interventions had a significant moderator and effect size of the distress and resilience outcomes increased as the duration increased. This meta-analysis demonstrated that technology-based psychosocial interventions served as an effective intervention as it appears to have implications reducing anger, anxiety and depression in paediatric oncology. Nevertheless, randomised controlled studies with larger samples still needed to establish evidence-based psycho-oncological interventions for paediatric oncology. Future research should develop interventions more graduated by duration.

The comparison of health literacy between health science and non-health science members-A cross sectional study of multifaceted public health affair

Background/ObjectivesHealth literacy is a global concern and is varied across the general population. It is the means to enhance public access to health information and services. The objective of this study was to compare the health literacy among health science and non-health science members and to identify the barriers to health literacy. MethodsA cross-sectional study was conducted among the faculty of health sciences and health sciences teaching institutes. A total of 230 samples were included using stratified proportionate sampling. The Health Literacy Questionnaire (HLQ) and the tool on perceived barriers to health literacy were used to collect the data. ResultsThe health literacy among health sciences people was better compared to the non-health sciences people (p < 0.05) in all the domains. The Cohen's d effect size showed that the difference was statistically significant (Effect size between >0.2 and < 0.8). The top four barriers for health literacy identified were: Home remedies are preferred to medicines for minor ailments, failure to meet doctors due to the job timings, inability to take care of self-due to busy working hours, and priority for the health of family members than one's own health. ConclusionHealth literacy is an important factor that helps every individual to make health-care decisions and enhances one's ability to get the right information. Evaluating the barriers to health literacy gives us the specific areas of concern. The relevant measures must be implemented to improve the knowledge and health literacy, which can lead to better health outcomes.

Agricultural Leadership Development Program Participant Personality and Demographic Characteristics: An Empirical Analysis

Although personality has been widely studied within the academic literature, there has been little research into the relationship between personality and leadership development programs, particularly within an agricultural context for adult learners. The purpose of this research was to investigate the nature of relationships among ten aspects of the Big Five personality factors and demographic characteristics including: gender, age, organizational level, educational attainment, and geographic region within a sample of adult agricultural leadership development program participants. Results of the study indicate that there are differences between demographic groups relative to specific aspects of personality. Among the ten aspects analyzed, the most statistically significant differences between groups were observed between age groups, while the fewest statistically significant differences were observed in the educational attainment and geographic region groups. Effect sizes were also calculated with gender having the largest observed effect sizes and age having the largest number of statistically significant effect sizes.

Effects of Beetroot Juice Supplementation on Cognitive Function, Aerobic and Anaerobic Performances of Trained Male Taekwondo Athletes: A Pilot Study.

Studies have shown that nitrate (NO3−)-rich beetroot juice (BJ) supplementation improves endurance and high-intensity intermittent exercise. The dose–response effects on taekwondo following BJ supplementation are yet to be determined. This study aimed to investigate two acute doses of 400 mg of NO3− (BJ-400) and 800 mg of NO3− (BJ-800) on taekwondo-specific performance and cognitive function tests compared with a placebo (PL) and control (CON) conditions. Eight trained male taekwondo athletes (age: 20 ± 4 years, height: 180 ± 2 cm, body mass: 64.8 ± 4.0 kg) completed four experimental trials using a randomized, double-blind placebo-controlled design: BJ-400, BJ-800, PL, and CON. Participants consumed two doses of BJ-400 and BJ-800 or nitrate-depleted PL at 2.5 h prior to performing the Multiple Frequency Speed of Kick Test (FSKT). Countermovement jump (CMJ) was performed before the (FSKT) and PSTT, whereas cognitive function was assessed (via the Stroop test) before and after supplementation and 10 min following PSTT. Blood lactate was collected before the CMJ tests immediately and 3 min after the FSKT and PSST; rating of perceived exertion (RPE) was recorded during and after both specific taekwondo tests. No significant differences (p > 0.05), with moderate and large effect sizes, between conditions were observed for PSTT and FSKT performances. In addition, blood lactate, RPE, heart rate, and CMJ height were not significantly different among conditions (p > 0.05). However, after the PSTT test, cognitive function was higher in BJ-400 compared to other treatments (p < 0.05). It was concluded that acute intake of 400 and 800 mg of NO3− rich BJ reported a moderate to large effect size in anaerobic and aerobic; however, no statistical differences were found in taekwondo-specific performance.

Understanding the Characteristics of High-Cost Healthcare Users in a Persistent Concussion Clinic for Youth

<h3>Research Objectives</h3> To investigate the predictors of those with high healthcare costs in a Pediatric Persistent Concussion Clinic. <h3>Design</h3> Cohort study. <h3>Setting</h3> A specialty outpatient clinic in a children's rehabilitation hospital in Toronto, Canada. These services included occupational therapy, physical therapy, social work, and/or neuropsychology. <h3>Participants</h3> A referred sample of 461 youth that had been experiencing post-concussion symptoms for at least 4 weeks. Youth were between 3 to 18 years. 47.4% were male and 53.6% were female. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Total direct healthcare costs from the Persistent Concussion Clinic. Clients whose total direct healthcare costs were above the 80th percentile ($1655.48) were classified as high-cost users. <h3>Results</h3> Four logistic regressions were conducted and compared to each other using likelihood ratio tests. Each model contained variables from the previous model along with an additional group of variables. Variable selection was determined based on previous conceptual frameworks for predicting high-cost users of healthcare systems. Model 1: Demographic Characteristics (age, sex). Model 2: Medical History (psychiatric history, number of previous concussions, history of therapy). Model 3: Symptom Severity (number of symptoms, symptom duration). Model 4: Service Utilization (number of services used, being prescribed new medication). Model 4 revealed clinically significant effect sizes (i.e., OR > 2). Being prescribed new medication, b = 1.13, p < .001, OR = 3.096 (95% CI: 1.634, 6.027) and the number of services utilized, b = 1.55, p < .001, OR = 4.731 (95% CI: 3.368, 7.011) were found to be significant predictors. A likelihood ratio test shows that this model performs significantly better than the logistic regression without service utilization variables, χ2(2) = 154.2, p < .001. <h3>Conclusions</h3> Service utilization is a significant predictor of high-cost users. Future research should incorporate this information into a prediction algorithm, whereby early service utilization patterns may inform us as to who will have higher healthcare costs. <h3>Author(s) Disclosures</h3> The authors have no conflicts of interest to declare.

Individually tailored Internet-delivered cognitive-behavioral therapy for survivors of intimate partner violence: A randomized controlled pilot trial

Intimate partner violence (IPV) is a serious public health concern worldwide and defined as behavior performed by spouses or other intimate partners that causes physical, sexual, or psychological harm. Internet-delivered cognitive-behavioral therapy (ICBT) may be particularly useful for survivors of IPV for several reasons, including barriers pertaining to limited community recourses and treatment availability, safety concerns, and issues of stigma, guilt and shame, which may prevent members of this population from seeking help via face-to-face interactions. However, Internet interventions are lacking. The primary aim of the present randomized controlled pilot trial was to explore the feasibility of ICBT as guided self-help individually tailored to the predominant symptomatology of PTSD or depression in survivors of IPV. A second aim was to conduct a preliminary evaluation exploring the short- and long-term effects of the treatment in comparison to a waitlist control condition. Results showed that the treatment was feasible. Attrition rate was low (9.4%), and participants were satisfied with treatment. However, treatment adherence was moderate in terms of completed modules (62.5%). Results of the preliminary evaluation of treatment effects showed large and statistically significant between-group effect sizes (Cohen's d = 0.86–1.08) on some measures of PTSD and depression at post assessment, favoring the treatment condition. However, there were no effects on other measures. At follow-up assessment, when the control condition had received delayed treatment, there were large and statistically significant within-group effect sizes (d = 0.96–1.48) on measures of PTSD, depression and anxiety, and small effects (d = 0.48) on a measure of quality of life. The results of the present pilot study are promising and warrant further research on ICBT for this population.

Effects of Exercise Intervention on Health-Related Quality of Life in Patients with Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis of Controlled Trials.

Exercise and physical activity have been deemed as potentially beneficial for patients with systemic lupus erythematosus (SLE). This study aimed to evaluate the effects of exercise interventions on health-related quality of life in patients with SLE using a systematic review and meta-analysis. Randomized and non-randomized controlled trials published up to July 2021 were examined using the PubMed and Embase databases. Of the 1158 articles retrieved, nine were included for systematic review. Five of them were randomized controlled trials and these were assessed using meta-analysis. Hedges’ g effect size was 0.47; 95% (confidence interval 0.21–0.73; p < 0.001) for the physical health and function aspect of health-related quality of life. None of the other seven domains of the SF-36 showed a significant effect size. However, the latter finding was limited by the small number of available trials. In conclusion, this systematic review and meta-analysis supported that exercise intervention compared to usual care might be able to improve the physical functioning domain of health-related quality of life in patients with SLE. Future high-quality randomized controlled trials that incorporate disease-specific health-related quality of life measures are needed to elucidate the role of exercise on health-related quality of life in patients with SLE.

Comparison and Reliability of Hippocampal Subfield Segmentations Within FreeSurfer Utilizing T1- and T2-Weighted Multispectral MRI Data.

The accurate segmentation of in vivo magnetic resonance imaging (MRI) data is a crucial prerequisite for the reliable assessment of disease progression, patient stratification or the establishment of putative imaging biomarkers. This is especially important for the hippocampal formation, a brain area involved in memory formation and often affected by neurodegenerative or psychiatric diseases. FreeSurfer, a widely used automated segmentation software, offers hippocampal subfield delineation with multiple input options. While a single T1-weighted (T1) sequence is regularly used by most studies, it is also possible and advised to use a high-resolution T2-weighted (T2H) sequence or multispectral information. In this investigation it was determined whether there are differences in volume estimations depending on the input images and which combination of these deliver the most reliable results in each hippocampal subfield. 41 healthy participants (age = 25.2 years ± 4.2 SD) underwent two structural MRIs at three Tesla (time between scans: 23 days ± 11 SD) using three different structural MRI sequences, to test five different input configurations (T1, T2, T2H, T1 and T2, and T1 and T2H). We compared the different processing pipelines in a cross-sectional manner and assessed reliability using test-retest variability (%TRV) and the dice coefficient. Our analyses showed pronounced significant differences and large effect sizes between the processing pipelines in several subfields, such as the molecular layer (head), CA1 (head), hippocampal fissure, CA3 (head and body), fimbria and CA4 (head). The longitudinal analysis revealed that T1 and multispectral analysis (T1 and T2H) showed overall higher reliability across all subfields than T2H alone. However, the specific subfields had a substantial influence on the performance of segmentation results, regardless of the processing pipeline. Although T1 showed good test-retest metrics, results must be interpreted with caution, as a standard T1 sequence relies heavily on prior information of the atlas and does not take the actual fine structures of the hippocampus into account. For the most accurate segmentation, we advise the use of multispectral information by using a combination of T1 and high-resolution T2-weighted sequences or a T2 high-resolution sequence alone.

Evidence for generalizability of edaravone efficacy using a novel machine learning risk-based subgroup analysis tool

Introduction: The edaravone development program for amyotrophic lateral sclerosis (ALS) included trials MCI186-16 (Study 16) and MCI186-19 (Study 19). A cohort enrichment strategy was based on a Study 16 post hoc analysis and applied to Study 19 to elucidate a treatment effect in that study. To determine whether the Study 19 results could be generalized to a broader ALS population, we used a machine learning (ML) model to create a novel risk-based subgroup analysis tool. Methods: A validated ML model was used to rank order all Study 16 participants by predicted time to 50% expected vital capacity. Subjects were stratified into nearest-neighbor risk-based subgroups that were systematically expanded to include the entire Study 16 population. For each subgroup, a statistical analysis generated heat maps that revealed statistically significant effect sizes. Results: A broad region of the Study 16 heat map with significant effect sizes was identified, including up to 70% of the trial population. Incorporating participants identified in the cohort enrichment strategy yielded a broad group comprising 76% of the original participants with a statistically significant treatment effect. This broad group spanned the full range of the functional score progression observed in Study 16. Conclusions: This analysis, applying predictions derived using an ML model to a novel methodology for subgroup identification, ascertained a statistically significant edaravone treatment effect in a cohort of participants with broader disease characteristics than the Study 19 inclusion criteria. This novel methodology may assist clinical interpretation of study results and potentially inform efficient future clinical trial design strategies.

Investigating the Impact of a Mathematics Enhancement Programme on Jamaican Students’ Attainment

Underperformance in mathematics has been an issue that plagues the education system in Jamaica. Studies in first world countries have shown that enrichment programs, including Mathematics Enhancement Programmes (MEPs,) have been positively impacting attainment in mathematics. This quasi-experimental research design study investigated the impact of an MEP on Jamaican students’ attainment in mathematics. A sample of seven grade one classes from two primary schools in representative areas in Jamaica were selected for the intervention group. The treatment involved teaching the Jamaican grade one mathematics standards using the MEP resources for nine months. A statistically significant improvement and large effect size of the intervention was found, indicating that the MEP had a substantial impact on students’ achievement and attitudes towards mathematics. This study has implications for designing enrichment programs geared at addressing mathematics underperformance in Jamaica and in similar countries.

The association between maternal sensitivity/availability and attachment in children with autism Spectrum disorder: A systematic review and Meta-analysis.

The association between maternal sensitivity and attachment security has long been established among normative samples. However, less is known about how this association operates among children with Autism Spectrum Disorder (ASD). This meta-analytic review is the first to address the association between maternal sensitivity/availability and attachment security in a population of children with ASD (aged 1 to 7 years) and to explore if this association is moderated by child chronological age, mental age, ASD-related symptoms severity. The objective was also to assess the role of methodological moderators, including the informant of the attachment measure, country and publication year. A systematic search was performed on relevant databases. Seven studies were retained. Meta-analytic results showed a significant medium effect size between maternal sensitivity/availability and attachment security in children with ASD (r = .47; 95% CI: 0.32–.60; p < .001), which is a stronger association than in the general population (r = .24). Moderation analyses did not show any significant effect of child chronological age and publication year on effect sizes. The categorical moderators (e.g., informant, country) could not be tested due to the limited number of studies. More research is needed to better understand the way mothers adapt to their children with autism and identify the nuances regarding how maternal sensitivity/availability relates to child attachment in the context of ASD.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12144-021-02227-z.

Efficacy of locally delivered statins as an adjunct to scaling and root planning in the treatment of periodontitis: a systematic review and meta-analysis.

The aim of this systematic review is to assess the efficacy of locally delivered statins used in adjunct to scaling and root planing (SRP), compared with SRP alone. An electronic and hand search was carried out up to April 2020. Only randomized controlled trials (RCTs) were included. Clinical attachment level gain (CALgain) and probing depth reduction (PDred), modified sulcular bleeding index reduction (mSBIred), and intrabony defect reduction (IBDred) were the investigated outcomes. Meta-analysis was performed, and the power of the meta-analytic findings was determined by trial sequential analysis (TSA). Studies were also sub-grouped based on the type of statin used. Statistical heterogeneity and publication bias were assessed. Twenty RCTs were included (1212 patients, 1289 defects). An overall statistically significant effect size in favor of statins for CALgain and PDred was found. As opposed to atorvastatin and rosuvastatin, simvastatin did not reach statistical significance for these outcomes, as shown by the sub-group analysis. Within the limits of the available studies, the local administration of statins (in particular, atorvastatin and rosuvastatin) in adjunct to SRP may result in additional significant improvement in terms of CALgain and PDred compared with SRP alone. The high heterogeneity of data and the high risk of bias found, however, impose caution. No approved preparations, moreover, exist, and further well-designed RCTs from independent research centers are needed to confirm the beneficial effects of the different statins and their mutual differences in the non-surgical periodontal treatment.

Performance Differences Between Greco-Roman and Freestyle Wrestlers: A Systematic Review and Meta-Analysis.

Ulupınar, S, Özbay, S, Gençoğlu, C, and İnce, İ. Performance differences between Greco-Roman and freestyle wrestlers: a systematic review and meta-analysis. J Strength Cond Res 35(11): 3270-3279, 2021-This systematic review and meta-analysis aims to summarize evidence on performance differences between Greco-Roman (GR) and freestyle (Fr) wrestlers. Eleven studies met the inclusion criteria (91 individual data and a total of 752 wrestlers). The analysis of handgrip strength comprised 9 outcomes from 5 studies with no significant difference between GR and Fr wrestlers. The analysis of isometric (back or leg) strength comprised 15 outcomes from 6 studies with a significant effect favoring GR wrestlers. The analysis of muscle power comprised 15 outcomes from 5 studies with a significant effect favoring GR wrestlers. The analysis of strength endurance comprised 4 outcomes from 3 studies with no significant difference between GR and Fr wrestlers. The analysis of anaerobic capacity and power comprised 6 outcomes from 3 studies with no significant difference between GR and Fr wrestlers. The analysis of speed comprised 19 outcomes from 7 studies with a significant effect favoring GR wrestlers. The analysis of flexibility comprised 20 outcomes from 6 studies with a significant effect favoring Fr wrestlers. This study indicated that GR wrestlers had greater isometric strength, muscle power, and speed performance, but Fr wrestlers had greater flexibility. Given the significant effect sizes favoring GR wrestlers, it is possible that they focused on training strategies to improve physical strength-power performance. However, considering the significant effect size favoring Fr wrestlers, it is possible that they focused on training strategies to improve flexibility because Fr wrestling techniques require a larger range of motion during both attack and defense.

Near and far transfer: Is music special?

Far transfer rarely occurs, and a recent meta-analysis suggests that music is no exception. The overall effect of musical training on cognition was claimed to be null when considering studies with active control groups or implemented randomization procedures (Sala & Gobet, Memory & Cognition, 48: 1429-1441, 2020). Using the authors' data file and program ( https://osf.io/rquye ), we did not confirm the effect of randomization, and we demonstrated that their conclusion is based in part on the failure to differentiate near and far transfer, with near transfer effect sizes being selectively excluded for the musical training group studies, but not for the active control group studies. Reanalyzing their data file resulted in a significant effect size (g = .234), and also provided new evidence that far-transfer effects of musical training can challenge near-transfer effects of linguistic training. Music is a recreational activity that may be special in allowing for small but statistically significant far-transfer effects.

A-72 Neuropsychological Functioning in Primary Dystonia: A Multi-Domain Meta-Analysis

Abstract Objective Primary dystonia is conventionally seen as a motor disorder, though growing literature indicates cognitive dysfunction among persons with primary dystonia (PWD). Here, we completed a meta-analysis comparing cognition on clinical measures between PWD and normal controls. Method We searched PubMed, Embase, Cochrane Library, Scopus, and PsycINFO using a uniform search-strategy to locate original research comparing cognition between PWD and control samples. All analyses were modeled under random-effects. We used Hedge’s g as a bias-corrected estimate of effect size. Between-study heterogeneity was assessed using Cochran’s Q and I2. Results The initial search strategy yielded 866 results. Twenty studies were analyzed (PWD n = 739, control n = 865; 254 effect sizes extracted). Meta-analysis showed a significant combined effect size of primary dystonia across all studies (g = −0.55, p &amp;lt; 0.001), with low heterogeneity (Q = 23.60, p = 0.21, I2 = 19.49). Trim-and-fill procedure estimated 6 studies missing due to publication bias (adjusted g = −0.47, Q = 44.58). Within-domain effects of primary dystonia were: Motor/Non-Motor Speed = −0.76, Global Cognition/Orientation = −0.65, Language = −0.62, Executive Functioning = −0.50, Learning/Memory = −0.46, Visuospatial/Construction = −0.44, and Simple/Complex Attention = −0.36. Heterogeneity was generally low within domains. Effects were comparable between Speed tasks with (g = −0.85) and without (g = −0.80) a motor component. Meta-regressions indicated age, education, gender, and disease duration were not related to effect sizes. Conclusions PWD consistently demonstrated lower performances on neuropsychological tests compared to controls. Effect sizes were generally moderate in strength, with smallest effects in Simple/Complex Attention, and largest in Motor/Non-Motor Speed. Within the Speed domain, results suggested cognitive slowing beyond effects from motor symptoms. This quantitative summary indicates that PWD experience difficulties in multiple aspects of cognition, as detected by neuropsychological tests.

A-53 The Relationship between Age and TMT-A Performance in Patients with Heart Failure

Abstract Objective A previous meta-analysis utilized the Trail Making Test A (TMT-A) to measure the impact of heart failure (HF) on attention. A near medium effect size with moderate heterogeneity was observed, the HF group performed worse than healthy controls (HC). This study explores if the age of the HF group moderates differences in the performance of individuals with HF versus HC on TMT-A. Data Selection Two researchers searched eight databases, extracted data, and calculated effect sizes as part of a larger study. Inclusion criteria were: (a) adults with HF (New York Heart Association severity II or higher), (b) comparison to a HC group, (c) standardized neuropsychological/cognitive testing, and (d) adequate data to calculate effect sizes. Exclusion criteria were: (a) participants had other types of major organ failure, (b) the article was not in English, or (c) there was a risk of sample overlap with another included study. A total of six articles were included in this sub-study (Total HF n = 602 and HC n = 342). The unrestricted maximum likelihood computational model was used for the meta-regression. Data Synthesis Studies included in the meta-regression evidenced a statistically significant medium effect size estimate with moderate heterogeneity (k = 6, g = 0.636, p &amp;lt; 0.001, I2 = 56.85%). The meta-regression was statistically significant (slope = −0.0515, p = 0.0016, Qmodel = 9.86, df = 1, p = 0.0016). Conclusions Individuals with HF performed worse on the TMT-A than HC. Age accounted for a significant proportion of the observed heterogeneity in the meta-regression. Future research should examine the relationship of age on cognition in individuals with HF.

Effects of Pitch Size and Goalkeeper Participation on Physical Load Measures during Small-Sided Games in Sub-Elite Professional Soccer Players

This study sought to examine the variations of internal and external load measures in soccer players when performing different types of 4 vs. 4 small-sided games (SSGs). Ten U-23 professional and sub-elite soccer players, eight outfield players (age: 20.1 ± 1.5 years old; height: 1.83 ± 0.04 m; total body mass: 76.1 ± 3.6 kg) and two goalkeepers (GK) (age: 20.5 ± 2.1 years old; height: 1.91 ± 0.04 m; total body mass: 77.0 ± 1.4 kg) participated in the study. Five SSGs were performed with 3 min duration and 3 min rest interval. SSG1, SSG2 and SSG4 aimed for ball possession play, while in SSG3 and SSG5, two GK were added, defending regular-size goals. The pitch size changed from SSG1 (16 × 24 m) to SSG2 and SSG3 (both 20 × 30 m) and SSG4 and SSG5 (both 24 × 36 m). All players were monitored using WIMU Pro device during the tasks. Anova One-Way and the post hoc Tukey honestly significant difference were used for analysis of statistically significant differences (p &lt; 0.05) and effect sizes were determined by calculating partial eta-squared. The framework was associated with relevant but steady state internal load fatigue and induce a considerable external load stimulus. GK participation in SSGs should be carefully considered as it seems to have a greater impact on physical load measures when compared to the pitch size manipulation.