Variation In Effect Sizes Research Articles

Atopic dermatitis: Correlation of distinct risk factors with age of onset in adulthood compared to childhood.

Atopic dermatitis (AD) has long been regarded as a primarily pediatric disease. However, there is growing evidence for a high rate of adult-onset AD. We aimed to characterize factors associated with adult-onset versus childhood-onset AD and controls. We analyzed cross-sectional data of the CK-CARE-ProRaD cohorts Bonn, Augsburg, Davos, Zürich of 736 adult patients stratified by age of AD onset (childhood-onset <18 years: 76.4% (subsets: 0 to 2; ≥2 to 6; ≥7 to 11; ≥12 to 18); adult-onset ≥18 years: 23.6% (subsets: ≥18 to 40; ≥41 to 60; ≥61) and 167 controls (91 atopic, 76 non-atopic)). We identified active smoking to be associated with adult-onset AD versus controls (adjusted Odds Ratio (aOR) = 5.54 [95% Confidence Interval: 1.06-29.01] vs. controlsnon-atopic , aOR = 4.03 [1.20-13.45] vs. controlsatopic ). Conjunctivitis showed a negative association versus controlsatopic (aOR = 0.36 [0.14-0.91]). Food allergy (aOR = 2.93 [1.44-5.96]), maternal food allergy (aOR = 9.43 [1.10-80.95]), palmar hyperlinearity (aOR = 2.11 [1.05-4.25]), and academic background (aOR = 2.14 [1.00-4.54]) increased the odds of childhood-onset AD versus controlsatopic . Shared AD-associated factors were maternal AD (4-34x), increased IgE (2-20x), atopic stigmata (2-3x) with varying effect sizes depending on AD onset and control group. Patients with adult-compared to childhood-onset had doubled odds of allergic rhinitis (aOR = 2.15 [1.12-4.13]), but reduced odds to feature multiple (3-4) atopic comorbidities (aOR = 0.34 [0.14-0.84]). Adult-onset AD, particularly onset ≥61 years, grouped mainly in clusters with low contributions of personal and familial atopy and high frequencies of physical inactivity, childhood-onset AD, particularly infant-onset, mainly in "high-atopic"-clusters. The identified associated factors suggest partly varying endo- and exogeneous mechanisms underlying adult-onset versus childhood-onset AD. Our findings might contribute to better assessment of the individual risk to develop AD throughout life and encourage prevention by non-smoking and physical activity as modifiable lifestyle factors.

Role of urban vegetation in air phytoremediation: differences between scientific research and environmental management perspectives

Air pollutant removal by urban vegetation is perceived to be a key ecosystem service for mitigating air pollution. However, the effectiveness of air phytoremediation in cities requires more synthesis to inform environmental management. A Bayesian meta-analysis approach was used to quantify the effectiveness of the removal of typical air pollutants—particle matter (PM), nitrogen oxide (NOx), sulfur dioxide (SO2) and ozone (O3)—by synthesizing global field measurement studies. The results revealed that urban vegetation can mitigate the growth of air pollutant concentrations, with reduction rates of 16.5~26.7% for PM, 13.9~36.2% for NOx, and 20.5~47.8% for SO2. However, they failed to significantly mitigate ground-level O3, corresponding to an increase of 5.1~25.9%. The variability in effect sizes was mainly influenced by the distance to nearest highway, ambient concentration, relative humidity, and green coverage. A questionnaire survey conducted in Shenzhen city (China) showed that most environmental managers supposed positive impacts of urban vegetation on all four air pollutants, which was at odds with our findings with respect to O3. This study can inform the lessening of discrepancies between scientific research and environmental managers’ perceptions on how to improve air phytoremediation for urban air pollution mitigation in China and elsewhere.

Clinical outcomes of renin angiotensin system inhibitor-based dual antihypertensive regimens in chronic kidney disease: a network meta-analysis

This study comprehensively investigated clinical outcomes associated with renin angiotensin system inhibitor-based dual antihypertensive regimens in non-dialysis chronic kidney disease (CKD) patients. Keyword searches of databases were performed per PRISMA-NMA guidelines. Frequentist network meta-analysis were conducted with 16 head-to-head randomized controlled trials. The effect sizes of dichotomous and continuous variables were estimated with odds ratio (OR) and standard mean differences (SMD), respectively. The protocol is registered in PROSPERO (CRD42022365927). Dual antihypertensive regimens with combination of angiotensin receptor blockers (ARB) and calcium channel blockers (CCB) demonstrated substantially reduced odd of major cardiovascular disease (CVD) events over other regimens including angiotensin converting enzyme inhibitor (ACEI) monotherapy (OR 3.19) and ARB monotherapy (OR 2.64). Most significant reductions in systolic (SBP) and diastolic blood pressure (DBP) were observed with ARB-based CCB dual regimen over ACEI monotherapy (SMD 17.60 SBP and 9.40 for DBP), ACEI-based CCB regimen (SMD 12.90 for SBP and 9.90 for DBP), and ARB monotherapy (SMD 13.20 for SBP and 5.00 for DBP). However, insignificant differences were noticed for the odds of hyperkalemia, end stage renal disease progression, and all-cause mortality. ARB-based CCB regimen has the greatest benefits on BP reduction as well as major CVD risks in non-dialysis CKD patients.

Abstract 5786: Spatial relationships in the tumor microenvironment predict response to immune checkpoint inhibitors in urothelial and head and neck cancer

Abstract Background: Immune checkpoint inhibitors (ICI) can achieve remarkable clinical responses in urothelial cancer (UC). However, it remains unclear which aspects of the tumor microenvironment (TME) determine a patient’s response. The TME is usually characterized by immune cell density, which ignores cells’ spatial relationships relative to each other. Methods: Using multiplex immunofluorescence data (PanCK, CD20, CD68, CD3, CD8, and FoxP3 antibody panel) of 24 pre-ICI UC transurethral resections retrieved from the NABUCCO trial (NCT03387761), we spatially profiled cancer cells, macrophages, B-cells, and distinct T-cell populations. We first quantified the TME immune cell densities at the tumor and stroma tissue compartments. We then quantified the TME spatial relationships with a novel approach based on fitting a Weibull function to the first nearest neighbor (1-NN) distance distribution, allowing us to uniquely summarize spatial relationships with two parameters (Weibull approach). We compared this approach to conventional techniques (G-functions) that rely upon a predefined distance threshold. We performed a simulation study to identify sources of variation in the spatial relationship parameters. Lastly, we associated the TME parameters with ICI (ipilimumab + nivolumab) response. Results: Unlike the Weibull approach, the G-function quantifications manifested a variable effect size and statistical power in association studies because of its distance threshold dependence. We found that variation in density affected the spatial relationship metrics of rare cell types (i.e., B-cells) but not of abundant cell types (i.e., cancer cells). The spatial relationship metrics from the Weibull approach outperformed immune cell density in ICI response prediction. Specifically, immune cell density did not discriminate between ICI response groups (FDR&amp;gt;10%). In contrast, the spatial relationship between either CD8+ T-cells or macrophages to their closest cancer cell did associate with response to ICI (FDR=1%). Furthermore, non-responding tumors were characterized by CD8+ T-cells close to B-cells (FDR=9%). Importantly, we validated the association between proximity and response from CD8+ T-cells to cancer cells (FDR=1%) and from macrophages to cancer cells (FDR=1%) using data from 25 pre-ICI head and neck squamous cell carcinoma tumors from the IMCISION trial (NCT03003637, arm B, ipilimumab + nivolumab). Conclusion: We created a framework to quantify, study, interpret and analyze spatial relationships in the TME and illustrated its superior clinical relevance compared to density metrics for predicting ICI treatment response. Our findings emphasize the importance of spatial relationships in the TME for response and suggest that proximity between either macrophages or CD8+ T-cells to cancer cells are candidate biomarkers for ICI response. Citation Format: Alberto Gil-Jimenez, Nick van Dijk, Yoni Lubeck, Maurits L. van Montfoort, Dennis Peters, Erik Hooijberg, Annegien Broeks, Joris L. Vos, Charlotte L. Zuur, Bas van Rhijn, Daniel J. Vis, Michiel S. van der Heijden, Lodewyk F. Wessels. Spatial relationships in the tumor microenvironment predict response to immune checkpoint inhibitors in urothelial and head and neck cancer. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5786.

국내 대학 문제중심학습(PBL)의 학습 효과에 대한 메타분석

Objectives The purpose of this study is to analyze the learning effects of problem-based learning(PBL) implemented in universities in Korea and to provide implications for the instructional design of PBL in higher education. Methods Researchers collected manuscripts published in academic journals and dissertations related to PBL conducted in Korea from 2010 to September 2022, and finally selected 116 studies following the PICOS approach. We conducted a meta-analysis to analyze the overall effects, the effect sizes for cognitive and affective variables, and the effects of moderating variables using CMA software. Results As a result of analyzing 392 effect sizes from the 116 research results, the overall effect size of PBL was 0.737, indicating an intermediate effect size. The effect sizes for cognitive and affective variables were 0.582 and 0.837 respectively, which indicates affective variables showed significantly higher effect size than cognitive variables. Moderating variables were academic domains, curriculum, learning environment, and program duration. Among the moderating effect of subgroups, the effect size of the academic domains was significantly larger in the order of humanities, social sciences, arts and physical education, natural sciences, and engineering. Regarding the curriculum variable, the effect size was significantly larger in the order of the teaching professional subjects curriculum, the major curriculum, and the liberal arts curriculum. Conclusions Based on the results, it was suggested that further research on the design and delivery of PBL in various learning environments is needed. The results of this study are expected to be used as a basis for effective PBL design in higher education.

Effect size assessment in quasi-experimental studies

Objectives. To estimate effect sizes in quasi-experimental studies.Methods. Methods of the theory of estimation, methods of mathematical statistics.Results. Estimation of the effect size on an ordinal scale, estimation of the effect size on a binary in the case of opposite direction effects in groups, in quasi-experimental studies for the analytical method "differences in differences".Conclusion. The paper considers approaches to assessing absolute and standardized effect sizes in experimental and quasi-experimental studies. A brief review of the estimators of absolute and standardized effect sizes for quantitative and binary study variables is provided. The applied approach is proposed to assess the effect sizes of a binary variable in the case of opposite direction effects in groups within a quasi-experimental studies for the "differences in differences" analytical method. An example of assessment of absolute and standardized effect sizes of quantitative and binary variables in quasi-experimental studies in clinical epidemiology is considered.

A network meta-analysis of the efficacy of hypoxia-inducible factor prolyl-hydroxylase inhibitors in dialysis chronic kidney disease.

Five types of HIF-PHIs have been authorized for anemia treatment in CKD patients in China and Japan. These are enarodustat, roxadustat, daprodustat, vadadustat, and molidustat. How effectively they compare to ESAs about clinical results in CKD-DD patients is uncertain. This study examined the RCT evidence about the benefits and risks of HIF-PHIs and ESAs in dialysis CKD patients. We conducted an extensive investigation and network meta-analysis of RCTs. In these RCTs, patients with CKD-DD received one of five different HIF-PHI or ESAs, a placebo, and no medical intervention. Outcomes included hemoglobin, iron parameters, and adverse events, and there were four weeks of follow-up at least. A frequentist framework for multivariate random effects meta-analyzed the results. The effect sizes of categorical variables were displayed as odds ratios. Mean differences were employed for computing continuous outcomes with common units; otherwise, standardized mean differences were applied. The Cochrane tool evaluated the bias risk in RCTs. 26 RCTs with 14945 patients were qualified for inclusion. Compared to the placebo, HIF-PHIs and ESAs dramatically boosted hemoglobin without affecting serum iron. Roxadustat performed better hemoglobin levels than ESAs (MD 0.32, 95% CI 0.10 to 0.53) and daprodustat (0.46, 0.09 to 0.84). Roxadustat (91.8%) was the top hemoglobin treatment among all medical interventions, as determined by the SUCRA ranking. However, roxadustat caused more thrombosis and hypertension than ESAs (1.61, 1.22 to 2.12) and vadadustat (1.36, 1.01 to 1.82). The lowest rates of hypertension and thrombosis were seen in molidustat (80.7%) and ESAs (88.5%). Compared with a placebo, ESAs and HIF-PHIs all affected TSAT levels. Except for molidustat, the other four HIF-PHIs impact different iron parameters. Regarding ferritin reduction, roxadustat (90.9%) and daprodustat (60.9%) came out on top. Enarodustat (80.9%) and roxadustat (74%) placed best and second in lowering hepcidin levels. The former two medicines for TIBC improvement were vadadustat (98.7%) and enarodustat (80.9%). The most effective treatment for hemoglobin correction is roxadustat. The superior efficacy of reducing hepcidin makes roxadustat and enarodustat appropriate for patients with inflammation. However, the increased risk of hypertension and thrombosis associated with roxadustat should be noted. In patients at risk for hypertension and thrombosis, molidustat and ESAs may be preferable options. When administering roxadustat and daprodustat, clinicians should check ferritin to assess iron storage. Lower TSAT in patients receiving HIF-PHIs and ESAs treatment suggests intravenous iron supplements are needed.

Directed forgetting of emotionally toned items and mental health: a meta-analytic review

ABSTRACT Item- and list-method directed forgetting paradigms have been used to study forgetting of emotionally toned items in clinical and control group populations for several decades. Meta-analysis of item-method studies found that clinical populations retained more remember- than forget-cued items of each valence. These effects were comparable to that shown by control populations for positive and negative items, but less than that shown by controls on neutral items. Encoding deficits may underlie clinical populations’ item-method directed forgetting since those populations retained fewer remember-cued items of each valence compared to control populations. Moderator analysis indicated larger effect size variability for some clinical populations (e.g., anxiety disorders) than other populations (e.g., PTSD, schizophrenia). Meta-analysis of list-method directed forgetting among clinical populations revealed only List 1 forgetting or costs for neutral items; i.e., better memory for to-be-remembered than forgotten List 1 neutral items, but no List 2 enhancements or benefits; i.e., better memory for List 2 items among those told to forget than remember List 1 items, for any item valence. Control populations showed costs and benefits for all item valences. Results from both paradigms are discussed in terms of clinical-control population differences in executive processes. Limitations of the meta-analyses and suggestions for future research are presented.

Genetic Modifiers of Cystic Fibrosis Lung Disease Severity: Whole-Genome Analysis of 7,840 Patients.

Rationale: Lung disease is the major cause of morbidity and mortality in persons with cystic fibrosis (pwCF). Variability in CF lung disease has substantial non-CFTR (CF transmembrane conductance regulator) genetic influence. Identification of genetic modifiers has prognostic and therapeutic importance. Objectives: Identify genetic modifier loci and genes/pathways associated with pulmonary disease severity. Methods: Whole-genome sequencing data on 4,248 unique pwCF with pancreatic insufficiency and lung function measures were combined with imputed genotypes from an additional 3,592 patients with pancreatic insufficiency from the United States, Canada, and France. This report describes association of approximately 15.9 million SNPs using the quantitative Kulich normal residual mortality-adjusted (KNoRMA) lung disease phenotype in 7,840 pwCF using premodulator lung function data. Measurements and Main Results: Testing included common and rare SNPs, transcriptome-wide association, gene-level, and pathway analyses. Pathway analyses identified novel associations with genes that have key roles in organ development, and we hypothesize that these genes may relate to dysanapsis and/or variability in lung repair. Results confirmed and extended previous genome-wide association study findings. These whole-genome sequencing data provide finely mapped genetic information to support mechanistic studies. No novel primary associations with common single variants or rare variants were found. Multilocus effects at chr5p13 (SLC9A3/CEP72) and chr11p13 (EHF/APIP) were identified. Variant effect size estimates at associated loci were consistently ordered across the cohorts, indicating possible age or birth cohort effects. Conclusions: This premodulator genomic, transcriptomic, and pathway association study of 7,840 pwCF will facilitate mechanistic and postmodulator genetic studies and the development of novel therapeutics for CF lung disease.

A Manifesto for More Productive Psychological Games Research

Despite enormous resource investment, researchers lack consensus on seemingly simple questions about how video games affect players. Topics such as violent games and aggression, playtime and wellbeing, and more are characterized by deeply divided opinions and conflicting results even at the meta-analytic level. I argue that much of this disagreement stems from limitations of common methods, including use of problematic self-report measures, overreliance on cross-sectional research, and superficial use of theory, among others. To resolve debates more effectively, I describe seven practices games research should adopt more widely: (1) strengthening the theoretical derivation chain, (2) attending to inter-individual effect size variation, (3) prioritizing longitudinal, within-person studies, (4) justifying measurement decisions, (5) harnessing digital trace data, (6) controlling individual game features, and (7) adopting open research principles. For each practice, I include practical steps and resources for implementing them in one’s own work. While critical of the current state of knowledge, the article is hopeful: with the help of these practices, the next generation of video games research can be the most informative yet.

Reproducibility of infant fNIRS studies: a meta-analytic approach.

Concerns about the reproducibility of experimental findings have recently emerged in many disciplines, from psychology to medicine and neuroscience. As NIRS is a relatively recent brain imaging technique, the question of reproducibility has not yet been systematically addressed. The current study seeks to test the replicability of effects observed in NIRS experiments assessing young infants' rule-learning ability. We conducted meta-analyses and mixed-effects modeling-based inferential statistics to determine whether effect sizes were replicable and comparable in a sample of 23 NIRS studies investigating infants' abilities to process repetition- and diversity-based regularities in linguistic and nonlinguistic auditory and visual sequences. Additionally, we tested whether effect sizes were modulated by different factors such as the age of participants or the laboratory. We obtained NIRS data from 12 published and 11 unpublished studies. The 23 studies involved a total of 487 infants, aged between 0 and 9 months, tested in four different countries (Canada, France, Italy, and USA). Our most important finding is that study and laboratory were never significant moderators of variation in effect sizes, indicating that results replicated reliably across the different studies and labs included in the sample. We observed small-to-moderate effect sizes, similar to effect sizes found with other neuroimaging and behavioral techniques in the developmental literature. In line with existing findings, effect sizes were modulated by the participants' age and differed across the different regularities tested, with repetition-based regularities giving rise to the strongest effects; in particular, the overall magnitude of this effect in the left temporal region was 0.27 when analyzing the entire dataset. Meta-analysis is a useful tool for assessing replicability and cross-study variability. Here, we have shown that infant NIRS studies in the language domain replicate robustly across various NIRS machines, testing sites, and developmental populations.

Trans-generational immune priming is not mediated by the sex of the parent primed: a meta-analysis of invertebrate data.

Traditionally, only vertebrates were thought capable of acquired immune responses, such as the ability to transfer immunological experience vertically to their offspring (known as trans-generational immune priming, TGIP). Increasing evidence challenges this belief and it is now clear that invertebrates also have the ability to exhibit functionally equivalent TGIP. This has led to a surge in papers exploring invertebrate TGIP, with most focusing on the costs, benefits or factors that affect the evolution of this trait. Whilst many studies have found support for the phenomenon, not all studies do, and there is considerable variation in the strength of positive results. To address this, we conducted a meta-analysis to answer the question: what is the overall effect of TGIP in invertebrates? Then, to understand the specific factors that affect its presence and intensity, we conducted a moderator analysis. Our results corroborate that TGIP occurs in invertebrates (demonstrated by a large, positive effect size). The strength of the positive effect was related to if and how offspring were immune challenged (i.e. whether they were challenged with the same or different insult as their parents or not challenged at all). Interestingly, there was no effect of the ecology or life history of the species or the sex of the parent or the offspring primed, and responses were comparable across different immune elicitors. Our publication bias testing suggests that the literature may suffer from some level of positive-result bias. However, even after accounting for potential bias, our effect size remains positive. Publication bias testing can be influenced by diversity in the data set, which was considerable in our data, even after moderator analysis. It is therefore conceivable that differences among studies could be caused by other moderators that were unable to be included in our meta-analysis. Nonetheless, our results suggest that TGIP does occur in invertebrates, whilst providing some potential avenues to examine the factors that account for variation in effect sizes.

Effectiveness of Subtitles in L2 Classrooms: A Meta-Analysis Study

The use of subtitles in language-learning environments has received considerable attention. Nevertheless, conclusive findings have yet to be reached regarding the effectiveness of integrating subtitles into L2 classrooms. This meta-analysis examined the overall effectiveness of subtitles to enhance learners’ L2. A total of 26 experimental studies conducted between 2010 and 2022 were analyzed to examine the performance of L2 classroom learners based on integrating subtitles as a teaching/learning tool, compared to learners who did not use subtitles. A meta-analysis investigated how effect sizes varied depending on L2 skills (listening, speaking, reading, writing, grammar, vocabulary, and pronunciation), institutional level (school, university, and language institute), participants’ native language (L1), language proficiency, and implementation mode. The results indicated that integrating subtitles into L2 classrooms have a medium effect size (d = 0.69), and the effect sizes of different variables affecting the use of subtitles in language learning are reported. Several pedagogical implications are discussed in light of the findings, which can help promote the successful integration of subtitles in L2 classrooms.

Power Analysis for High Dimensional Neuroimaging Studies

This article considers the problem of sample size determination for power analysis of neuroimaging studies involving multiple comparisons. High dimensional neuroimaging data arise naturally in the context of developing biomarkers for patients with neurological disorders. The standard methodology for power analysis cannot be used or extended in such cases because multiple comparisons involving high dimensional data are more complex and require more parametric information, rather than simply providing the effect size that often plays the vital role in a traditional power analysis problem. This article introduces concepts such as varying effect size and discrimination of null and non-null distributions, while exploring the complexity of relevant data. It systematically develops a sample size determination approach that has a simple interpretation and satisfies some desirable intuitive properties (eg, larger effect size requires a smaller sample, larger sample provides better power). Results are illustrated with a real data set. [ Psychiatr Ann . 2023;53(3):137–144.]

Functional Connectivity Mapping for rTMS Target Selection in Depression.

Repetitive transcranial magnetic stimulation (rTMS) protocols increasingly use subgenual anterior cingulate cortex (sgACC) functional connectivity to individualize treatment targets. However, the efficacy of this approach is unclear, with conflicting findings and varying effect sizes across studies. Here, the authors investigated the effect of the stimulation site's functional connectivity with the sgACC (sgACC-StimFC) on treatment outcome to rTMS in 295 patients with major depression. The reliability and accuracy of estimating sgACC functional connectivity were validated with data from individuals who underwent extensive functional MRI testing. Electric field modeling was used to analyze associations between sgACC-StimFC and clinical improvement using standardized assessments and to evaluate sources of heterogeneity. An imputation-based method provided reliable and accurate sgACC functional connectivity estimates. Treatment responses weakly but robustly correlated with sgACC-StimFC (r=-0.16), but only when the stimulated cortex was identified using electric field modeling. Surprisingly, this association was driven by patients with strong global signal fluctuations stemming from a specific periodic respiratory pattern (r=-0.49). Functional connectivity between the sgACC and the stimulated cortex was correlated with individual differences in treatment outcomes, but the association was weaker than those observed in previous studies and was accentuated in a subgroup of patients with distinct, respiration-related signal patterns in their scans. These findings indicate that in a large representative sample of patients with major depressive disorder, individual differences in sgACC-StimFC explained only ∼3% of the variance in outcomes, which may limit the utility of existing sgACC-based targeting protocols. However, these data also provide strong evidence for a true-albeit small-effect and highlight opportunities for incorporating additional functional connectivity measures to generate models of rTMS response with enhanced predictive power.

Effects of goal orientation on online learning: A meta-analysis of differences in Korea and US.

This meta-analysis examines the correlation between goal orientation and related variables in online learning to examine the influence of individual goal orientation on online learning as well as the differences arising from diverse cultural backgrounds. The study analyzed 27 papers from 2000 to 2022, comprising 8 US and 19 Korean studies. The average effect size of goal orientation and related variables, such as learning satisfaction, self-efficacy, and task value, were also analyzed. In addition, moderating effect according to the country and type of goal orientation was examined to evaluate differences arising from cultures. It was found that learning immersion, learning participation, and intention to continue learning, showed a high average effect size with goal orientation, with the other related variables also demonstrating a significant average effect size. There was no moderating effect of the state in the relationship between goal orientation and academic achievement, although a moderating effect existed according to the type of goal orientation. Based on the results of this study, we analyzed the variables that can reinforce learning along with goal orientation in online learning situations. Therefore, our findings will help formulate various educational support directions that can lead students to successfully gain knowledge through online learning, which has been growing expeditiously in the wake of the COVID-19 pandemic.

Improved Genomic Prediction of Staphylococcus epidermidis Isolation Sources with a Novel Polygenic Score.

Staphylococcus epidermidis infections can be challenging to diagnose due to the species frequent contamination of clinical specimens and indolent course of infection. Nevertheless, S. epidermidis is the major cause of late-onset sepsis among premature infants and of intravascular infection in all age groups. Prior work has shown that bacterial virulence factors, antimicrobial resistances, and strains have up to 80% in-sample accuracy to distinguish hospital from community sources, but are unable to distinguish true bacteremia from blood culture contamination. Here, a phylogeny-informed genome-wide association study of 88 isolates was used to estimate effect sizes of particular genomic variants for isolation sources. A "polygenic score" was calculated for each isolate as the summed effect sizes of its repertoire of genomic variants. Predictive models of isolation sources based on polygenic scores were tested with in-samples and out-samples from prior studies of different patient populations. Polygenic scores from accessory genes (AGs) distinguished hospital from community sources with the highest accuracy to date, up to 98% for in-samples and 65% to 91% for various out-samples, whereas scores from single nucleotide polymorphisms (SNPs) had lower accuracy. Scores from AGs and SNPs achieved the highest in-sample accuracy to date, up to 76%, in distinguishing infection from contaminant sources within a hospital. Model training and testing data sets with more similar population structures resulted in more accurate predictions. This study reports the first use of a polygenic score for predicting a complex bacterial phenotype and shows the potential of this approach for enhancing S. epidermidis diagnosis.

Pain phenotyping and investigation of outcomes in physical therapy: An exploratory study in patients with low back pain.

Phenotypes have been proposed as a method of characterizing subgroups based on biopsychosocial factors to identify responders to analgesic treatments. This study aimed to, first, confirm phenotypes in patients with low back pain receiving physical therapy based on an a priori set of factors used to derive subgroups in other pain populations. Second, an exploratory analysis examined if phenotypes differentiated pain and disability outcomes at four weeks of physical therapy. Fifty-five participants completed psychological questionnaires and pressure pain threshold (PPT). Somatization, anxiety, and depression domains of the Symptom-Checklist-90-Revised, and PPT, were entered into a hierarchical agglomerative cluster analysis with Ward's method to identify phenotypes. Repeated measures ANOVAs assessed pain ratings and disability by phenotype at four weeks. Three clusters emerged: 1) high emotional distress and pain sensitivity (n = 10), 2) low emotional distress (n = 34), 3) low pain sensitivity (n = 11). As an exploratory study, clusters did not differentiate pain ratings or disability after four weeks of physical therapy (p's>0.05). However, trends were observed as magnitude of change for pain varied by phenotype. This supports the characterization of homogenous subgroups based on a protocol conducted in the clinical setting with varying effect sizes noted by phenotype for short-term changes in pain. As an exploratory study, future studies should aim to repeat this trial in a larger sample of patients.

Synthesis on the effectiveness of soil translocation for plant community restoration

Abstract Many degraded ecosystems need active restoration to conserve biodiversity and re‐establish ecosystem function, both highlighted targets of the UN Decade on Ecosystem Restoration and the proposed EU Nature restoration law. Soil translocation, where both plant propagules and their associated soil biota are co‐introduced, has increasingly been proposed as a powerful restoration technique for terrestrial ecosystems. However, a synthesis of the effectiveness of this method across ecosystems is lacking. To address how soil translocation affects restoration success, we performed a meta‐analysis synthesizing data from 46 field experiments and their respective reference ecosystems in 17 countries across four continents. In each experiment, vegetation composition was recorded in response to soil translocation treatments and the resultant vegetational changes (diversity and composition) were quantified. We found that soil translocation leads to plant community development further away from the control and more towards the reference plant communities compared with treatments where only plant propagules were introduced. However, the variability of effect sizes among experiments was large, suggesting strong dependence of restoration success on restoration context. We found that restoration success was more likely on loamy soils and when translocation treatments were implemented over larger spatial areas (&gt;180 m2). Furthermore, we found that restoration success either consistently increased or decreased over time depending on the experiment. Not only is this congruent with positive feedbacks between plant and soil communities driving plant community development, but it also suggests that the composition of the translocated plant and soil communities, and initial starting conditions, are critical for long‐term restoration success. Synthesis and applications. Our analysis highlights soil translocation can be a successful restoration method across a broad range of ecosystems. However, its implementation needs to depend on a thorough evaluation of local conditions and the potential added value. Further refinement of soil translocation techniques is needed to increase success rates.

Benefits of the microalgae Spirulina and Schizochytrium in fish nutrition: a meta-analysis

Use of microalgae in fish nutrition can relieve pressure on wild fish stocks, but there is no systematic quantitative evaluation of microalgae benefits. We conducted a metanalysis on the nutritional benefits of Spirulina and Schizochytrium as replacements of fishmeal and fish or plant oil, respectively. We reviewed 50 peer-reviewed studies involving 26 finfish species and 144 control vs microalgae replacement comparisons. Inclusion of Spirulina in the fish diet significantly improved growth compared to controls (SMD = 1.21; 95% CI 0.71–1.70), while inclusion of Schizochytrium maintained the content of omega-3 PUFA of the fish fillet compared to fish fed on fish or plant oils (SMD = 0.62; 95% CI − 0.51–1.76). Benefits were apparent at replacement levels as low as 0.025% in the case of Spirulina and 10% in the case of Schizochytrium oil. Dose-dependent effects were found for Spirulina replacement on growth, but not for Schizochytrium on omega-3 fillet content. Subgroup analysis and meta-regression revealed that ~ 24–27% of variation in effect sizes can be accounted by variation between fish families, the rest likely reflecting variation in experimental conditions. Overall, the evidence indicates that Spirulina and Schizochytrium replacement in aquafeeds can be used to improve fish growth and maintain fillet quality, respectively, but considerable uncertainty exists on the predicted responses. To reduce uncertainty and facilitate the transition towards more sustainable aquafeeds, we recommend that feeding trials using microalgae are conducted under commercially relevant conditions and that greater care is taken to report full results to account for sources of heterogeneity.