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The Journal of Clinical Psychiatry Sep 2020In randomized controlled trials (RCTs), endpoint scores, or change scores representing the difference between endpoint and baseline, are values of interest. These values...
In randomized controlled trials (RCTs), endpoint scores, or change scores representing the difference between endpoint and baseline, are values of interest. These values are compared between experimental and control groups, yielding a mean difference between the experimental and control groups for each outcome that is compared. When the mean difference values for a specified outcome, obtained from different RCTs, are all in the same unit (such as when they were all obtained using the same rating instrument), they can be pooled in meta-analysis to yield a summary estimate that is also known as a mean difference (MD). Because pooling of the mean difference from individual RCTs is done after weighting the values for precision, this pooled MD is also known as the weighted mean difference (WMD). Sometimes, different studies use different rating instruments to measure the same outcome; that is, the units of measurement for the outcome of interest are different across studies. In such cases, the mean differences from the different RCTs cannot be pooled. However, these mean differences can be divided by their respective standard deviations (SDs) to yield a statistic known as the standardized mean difference (SMD). The SD that is used as the divisor is usually either the pooled SD or the SD of the control group; in the former instance, the SMD is known as Cohen's d, and in the latter instance, as Glass' delta. SMDs of 0.2, 0.5, and 0.8 are considered small, medium, and large, respectively. SMDs can be pooled in meta-analysis because the unit is uniform across studies. This article presents and explains the different terms and concepts with the help of simple examples.
Topics: Data Interpretation, Statistical; Humans; Meta-Analysis as Topic; Statistics as Topic
PubMed: 32965803
DOI: 10.4088/JCP.20f13681 -
BMC Musculoskeletal Disorders Feb 2022Patellofemoral pain syndrome (PFPS) is defined as pain around the patella while performing activities such as squats, running, and climbing steps. One of the inherent... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Patellofemoral pain syndrome (PFPS) is defined as pain around the patella while performing activities such as squats, running, and climbing steps. One of the inherent risk factors for PFPS is an excessively pronated foot posture. The aim of this study was to investigate the effect of foot intervention, talonavicular joint mobilization (TJM) and foot core strengthening (FCS), on PFPS.
METHODS
Forty-eight patients with PFPS (mean age, 21.96 ± 2.34 years; BMI, 22.77 ± 2.95 kg/m) were enrolled in the study. Participants were randomly assigned in a 1:1:1 ratio to three groups, and received 12 sessions of TJM, FCS, and blended intervention at university laboratory for 4 weeks. The primary outcomes were pain while the secondary outcomes were lower extremity function, valgus knee, foot posture, and muscle activity ratio measured at baseline, after 12 sessions, and at the 4-week follow-up.
RESULTS
The two-way repeated-measures ANOVA revealed significant interactions in all groups (p < 0.05). TJM reduced pain more than the FCS at post-test (mean difference, - 0.938; 95% Confidence interval [CI], - 1.664 to - 0.211; p < 0.05), and blended intervention improved lower extremity function (mean difference, 6.250; 95% CI, 1.265 to 11.235; p < 0.05) and valgus knee (mean difference, - 11.019; 95% CI, - 17.007 to - 5.031; p < 0.05) more than the TJM at 4 weeks follow-up. TJM was more effective in post-test (mean difference, - 1.250; 95% CI, - 2.195 to - 0.305; p < 0.05), and TJM (mean difference, - 1.563; 95% CI, - 2.640 to - 0.485; p < 0.05) and blended intervention (mean difference, - 1.500; 95% CI, - 2.578 to - 0.422; p < 0.05) were more effective in foot posture than the FCS in 4 weeks follow-up. Blended intervention displayed greater improvement in muscle activity than the TJM (mean difference, 0.284; 95% CI, 0.069 to 0.500; p < 0.05) and the FCS (mean difference, 0.265; 95% CI, 0.050 to 0.481; p < 0.05) at 4 weeks follow-up.
CONCLUSIONS
Our study is a novel approach to the potential impact of foot interventions on patellofemoral pain. Foot intervention including TJM and FCS is effective for pain control and function improvement in individuals with PFPS.
TRIAL REGISTRATION
KCT0003176 , 16/08/2018 (retrospectively registered).
Topics: Adult; Humans; Knee; Knee Joint; Lower Extremity; Patellofemoral Pain Syndrome; Single-Blind Method; Young Adult
PubMed: 35168620
DOI: 10.1186/s12891-022-05099-x -
JAMA Pediatrics Jul 2019Training parents to implement strategies to support child language development is crucial to support long-term outcomes, given that as many as 2 of 5 children younger... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Training parents to implement strategies to support child language development is crucial to support long-term outcomes, given that as many as 2 of 5 children younger than 5 years have difficulty learning language.
OBJECTIVE
To examine the association between parent training and language and communication outcomes in young children.
DATA SOURCES
Searches of ERIC, Academic Search Complete, PsycINFO, and PsycARTICLES were conducted on August 11, 2014; August 18, 2016; January 23, 2018; and October 30, 2018.
STUDY SELECTION
Studies included in this review and meta-analysis were randomized or nonrandomized clinical trials that evaluated a language intervention that included parent training with children with a mean age of less than 6 years. Studies were excluded if the parent was not the primary implementer of the intervention, the study included fewer than 10 participants, or the study did not report outcomes related to language or communication.
DATA EXTRACTION AND SYNTHESIS
Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were applied to a total of 31 778 articles identified for screening, with the full text of 723 articles reviewed and 76 total studies ultimately included.
MAIN OUTCOMES AND MEASURES
Main outcomes included language and communication skills in children with primary or secondary language impairment and children at risk for language impairment.
RESULTS
This meta-analysis included 59 randomized clinical trials and 17 nonrandomized clinical trials including 5848 total participants (36.4 female [20.8%]; mean [SD] age, 3.5 [3.9] years). The intervention approach in 63 studies was a naturalistic teaching approach, and 16 studies used a primarily dialogic reading approach. There was a significant moderate association between parent training and child communication, engagement, and language outcomes (mean [SE] Hedges g, -0.33 [0.06]; P < .001). The association between parent training and parent use of language support strategies was large (mean [SE] Hedges g, 0.55 [0.11], P < .001). Children with developmental language disorder had the largest social communication outcomes (mean [SE] Hedges g, 0.37 [0.17]); large and significant associations were observed for receptive (mean [SE] Hedges g, 0.92 [0.30]) and expressive language (mean [SE] Hedges g, 0.83 [0.20]). Children at risk for language impairments had moderate effect sizes across receptive language (mean [SE] Hedges g, 0.28 [0.15]) and engagement outcomes (mean [SE] Hedges g, 0.36 [0.17]).
CONCLUSIONS AND RELEVANCE
The findings suggest that training parents to implement language and communication intervention techniques is associated with improved outcomes for children and increased parent use of support strategies. These findings may have direct implications on intervention and prevention.
Topics: Child; Child Language; Communication; Humans; Language Development Disorders; Parents
PubMed: 31107508
DOI: 10.1001/jamapediatrics.2019.1197 -
Computer Methods and Programs in... Sep 2021Eyestrain has been increasingly severe in our lives and works as the progress of computers and smartphones. Evaluating eyestrain helps to prevent and relieve eyestrain....
BACKGROUND AND OBJECTIVE
Eyestrain has been increasingly severe in our lives and works as the progress of computers and smartphones. Evaluating eyestrain helps to prevent and relieve eyestrain. Our study aimed to evaluate eyestrain by analyzing vertical electrooculogram (VEOG).
METHODS
21 young subjects were asked to watch a video on the computer for a totally 120 minutes each, during which the VEOG signal was acquired using only three electrodes, and the questionnaire was answered every 30 minutes. The VEOG signal was divided into four 30-minute phases, from which VEOG signal power probability (VEOGSPP) features and blink features were extracted. The blink features include the changes of blink number (BN), group blinks number (GBN) and ratio (GBR), mean blink amplitude (Mean_BA) and duration (Mean_BD), mean blink duration at 50% (Mean_BD50), mean closing duration (Mean_CD) and opening duration (Mean_OD), mean opening duration at early 50% (Mean_ODE50) and late 50% (Mean_ODL50), mean blink maximum rising slope (Mean_BMRS) and falling slope (Mean_BMFS).
RESULTS
The results showed that the VEOGSPP in the high-frequency band (0.8-6.3Hz), BN, GBN, and GBR significantly increased while the VEOGSPP in the low-frequency band (0.1-0.4Hz), Mean_BA, Mean_OD, and Mean_ODL50 significantly decreased with eyestrain (P<0.05).
CONCLUSIONS
In conclusion, eyestrain induced by watching videos for a long time could be well evaluated by analyzing the VEOG signal.
Topics: Asthenopia; Blinking; Computers; Electrooculography; Humans; Smartphone
PubMed: 34102561
DOI: 10.1016/j.cmpb.2021.106171 -
Systematic Biology Jan 2020We describe the use of the Fréchet mean and variance in the Billera-Holmes-Vogtmann (BHV) treespace to summarize and explore the diversity of a set of phylogenetic...
We describe the use of the Fréchet mean and variance in the Billera-Holmes-Vogtmann (BHV) treespace to summarize and explore the diversity of a set of phylogenetic trees. We show that the Fréchet mean is comparable to other summary methods, and, despite its stickiness property, is more likely to be binary than the majority-rule consensus tree. We show that the Fréchet variance is faster and more precise than commonly used variance measures. The Fréchet mean and variance are more theoretically justified, and more robust, than previous estimates of this type and can be estimated reasonably efficiently, providing a foundation for building more advanced statistical methods and leading to applications such as mean hypothesis testing and outlier detection.
Topics: Classification; Phylogeny
PubMed: 31165169
DOI: 10.1093/sysbio/syz041 -
Scandinavian Journal of Surgery : SJS :... Sep 2021Impact of appearance of congenital hand anomalies has not previously been reported. The purpose of this study was to describe the common perception about how different...
BACKGROUND AND OBJECTIVE
Impact of appearance of congenital hand anomalies has not previously been reported. The purpose of this study was to describe the common perception about how different congenitally malformed hands look.
METHODS
We developed a questionnaire in a game format to evaluate the appearance of different hands. Altogether 1450 (954 females) 4- to 84-year-old residents (296 children) of two European and one Asian (n = 102) country were asked to rate the appearance of different looking hands on a five-point pictorial Likert-type scale. Standardized photographs of the dorsal aspect of 17 different congenitally malformed non-operated hands and a normal hand were presented to respondents. Significance of age, gender, nationality, and profession of the respondents was assessed.
RESULTS
The respondents' ranking order of the hands was nearly consistent. The normal hand (mean = 4.43, standard deviation = 0.85, Md = 5) and clinodactyly (mean = 4.37, standard deviation = 0.86, Md = 5) were perceived to have the best appearance. Symbrachydactyly (mean = 1.42, standard deviation = 0.68, Md = 1) and radial club hand (mean = 1.40, standard deviation = 0.68, Md = 1) received the lowest scores. Adults rated the appearance of hands higher than children regarding 14 hands, females higher than men regarding 15 hands, and Europeans higher than Asians in 4 hands (p < 0.05, respectively). Europeans rated four-finger hand (mean = 3.21, standard deviation = 1.18, Md = 3) better looking than six-finger hand (mean = 2.92, standard deviation = 1.18, Md = 3, p < 0.005), whereas Asians gave higher scores to six-finger hand (mean = 2.66, standard deviation = 1.26, Md = 3) compared to four-finger hand (mean = 2.51, standard deviation = 1.14, Md = 2). Medical doctors and nurses gave higher scores compared to the other profession groups, school children, and high school students in five hands (p < 0.05).
CONCLUSIONS
A normal hand is perceived distinctly better looking than most congenitally different hands. Different malformations' appearance was ranked very coherently in the same order despite of participants' age, gender, nationality, or profession. Asians seem to prefer an additional digit to a four-finger hand.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Female; Hand; Hand Deformities, Congenital; Humans; Male; Middle Aged; Surveys and Questionnaires; Young Adult
PubMed: 32106765
DOI: 10.1177/1457496920903987 -
Cancers Apr 2023Studies have suggested the chemopreventive effects of anthocyanins on breast cancer carcinogenesis. This systematic review and meta-analysis aimed to evaluate the effect... (Review)
Review
Anthocyanins Reduce Cell Invasion and Migration through Akt/mTOR Downregulation and Apoptosis Activation in Triple-Negative Breast Cancer Cells: A Systematic Review and Meta-Analysis.
BACKGROUND
Studies have suggested the chemopreventive effects of anthocyanins on breast cancer carcinogenesis. This systematic review and meta-analysis aimed to evaluate the effect of anthocyanins on triple-negative breast cancer cells (TNBC) cultured in vitro.
METHODS
We searched for all relevant studies that evaluated the mechanisms of migration, invasion, Akt/mTOR and MAPK pathways, and apoptosis, using PubMed and Scopus. Means and standard deviation were used, and a randomized effects model was applied, with a confidence interval of 95%. Statistical heterogeneity between studies was assessed using the Chi2 test and I2 statistics. All analyses were performed using RevMan software (version 5.4).
RESULTS
Eleven studies were included in the systematic review and ten in the meta-analysis, where the roles of anthocyanin-enriched extract or cyanidin-3-O-glucoside (C-3-O-G) on MDA-MB-231 and MDA-MB-453 cells were investigated.
DISCUSSION
There was a significant reduction in invasion (mean difference: -98.64; 95% CI: -153.98, -43.3; ˂ 0.00001) and migration (mean difference: -90.13; 95% CI: -130.57, -49.68; ˂ 0.00001) in TNBC cells after anthocyanins treatment. Anthocyanins also downregulated Akt (mean difference: -0.63; 95% CI: -0.70, -0.57; ˂ 0.00001) and mTOR (mean difference: -0.93; 95% CI: -1.58, -0.29; = 0.005), while JNK (mean difference: -0.06; 95% CI: -1.21, 1.09; = 0.92) and p38 (mean difference: 0.05; 95% CI: -1.32, 1.41; = 0.95) were not modulated. There was also an increase in cleaved caspase-3 (mean difference: 1.13; 95% CI: 0.11, 2.16; = 0.03), cleaved caspase-8 (mean difference: 1.64; 95% CI: 0.05, 3.22; = 0.04), and cleaved PARP (mean difference: 0.93; 95% CI: 0.54, 1.32). Although the difference between control and anthocyanin groups was not significant regarding apoptosis rate (mean difference: 3.63; 95% CI: -2.88, 10.14; = 0.27), the analysis between subgroups showed that anthocyanins are more favorable in inducing overall apoptosis ( ˂ 0.00001).
CONCLUSION
The results show that anthocyanins hold promise in fighting against TNBC, but their effects should not be generalized. In addition, further primary studies should be conducted so that more accurate conclusions can be drawn.
PubMed: 37190229
DOI: 10.3390/cancers15082300 -
Statistics in Medicine Jan 2024Accurate assessment of the mean-variance relation can benefit subsequent analysis in biomedical research. However, in most biomedical data, both the true mean and the...
Accurate assessment of the mean-variance relation can benefit subsequent analysis in biomedical research. However, in most biomedical data, both the true mean and the true variance are unavailable. Instead, raw data are typically used to allow forming sample mean and sample variance in practice. In addition, different experimental conditions sometimes cause a slightly different mean-variance relation from the majority of the data in the same data set. To address these issues, we propose a semiparametric estimator, where we treat the uncertainty in the sample mean as a measurement error problem, the uncertainty in the sample variance as model error, and use a mixture model to account for different mean-variance relations. Asymptotic normality of the proposed method is established and its finite sample properties are demonstrated by simulation studies. The data application shows that the proposed method produces sensible results compared with methods either ignoring the uncertainty in the sample means or ignoring the potential different mean-variance relations.
Topics: Humans; Models, Statistical; Computer Simulation; Uncertainty
PubMed: 37994214
DOI: 10.1002/sim.9970 -
Progress in Neuro-psychopharmacology &... Apr 2021Data regarding the ability of antidepressants to enter fetal, newborn and infant fluids have become gradually available, but mechanisms of antidepressant transfer remain... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Data regarding the ability of antidepressants to enter fetal, newborn and infant fluids have become gradually available, but mechanisms of antidepressant transfer remain poorly understood. Here we calculated penetration ratios in an array of matrices from combined samples of pregnant/breastfeeding women taking antidepressants.
METHOD
We performed a systematic literature search of PubMed and EMBASE to identify studies with concentrations of antidepressants from maternal blood, amniotic fluid, umbilical cord blood and/or breast milk. Penetration ratios were calculated by dividing the concentrations in amniotic fluid, umbilical cord plasma or breast milk by the maternal plasma concentration. When data from multiple studies were available, we calculated combined penetration ratios, weighting the study mean by study size.
RESULTS
Eighty-five eligible studies were identified. For amniotic fluid, the highest penetration ratios were estimated for venlafaxine (mean 2.77, range 0.43-4.70 for the active moiety) and citalopram (mean 2.03, range 0.35-6.97), while the lowest ratios were for fluvoxamine (mean 0.10) and fluoxetine (mean 0.11, range 0.02-0.20 for the active moiety). For umbilical cord plasma, nortriptyline had the highest ratio (mean 2.97, range 0.25-26.43) followed by bupropion (mean 1.14, range 0.3-5.08). For breast milk, the highest ratios were observed for venlafaxine (mean 2.59, range 0.85-4.85), mianserin (mean 2.22, range 0.80-3.64) and escitalopram (mean 2.19, range 1.68-3.00).
CONCLUSION
We observed considerable variability across antidepressants regarding their ability to enter fetal, newborn and infant fluids. Measuring antidepressant concentrations in a maternal blood sample can provide a reliable estimate of fetal/infant exposure, although further evidence for concentration-dependent effects is required.
Topics: Amniotic Fluid; Antidepressive Agents; Breast Feeding; Female; Fetal Blood; Humans; Infant; Milk, Human; Pregnancy; Pregnancy Complications
PubMed: 33358964
DOI: 10.1016/j.pnpbp.2020.110228