Meta-analysis: recent developments in quantitative methods for literature reviews

A decade on: Reflecting on the limitations of the first meta-analysis of the Implicit Relational Assessment Procedure's (IRAP) criterion validity in the clinical domain

Hussey (in press) recently conducted a detailed critical reanalysis of Vahey, Nicholson and Barnes-Holmes' (2015) meta-analysis. Its stated purpose was to (a) examine the extent to which Vahey et al.'s (2015) meta-analysis contains errors; and (b) to test how computationally reproducible it is by current standards of best practice. Hussey identified a small number of minor numerical errors, but crucially was unable to exactly replicate the original meta-effect of r‾ = .45. Six different variations of the meta-analysis reported by Vahey et al. were used and obtained meta-effects that deviated from the original by Δr‾ = .01-.02. Hussey also reported corresponding 95% credibility intervals that were all of zero width. These discrepancies prompted the present authors to conduct a detailed audit of the original meta-analysis. This revealed one minor transposing error in addition to three identified by Hussey. Once corrected this resulted in a marginally increased Hunter and Schmidt meta-analytic effect of r‾ = .46 without a credibility interval, and a Hedges-Vevea meta-effect of r‾ = .47 with 95% confidence interval (.40, .54). This correction was too small to have any bearing on Vahey et al.'s supplementary analyses regarding publication bias or statistical power. Vahey et al. contained a much lower proportion of transposing errors than is typical of meta-analyses even still (cf. Kadlec, Sainani, & Nimphius, 2023; Lakens et al., 2016; Lakens et al., 2017). Nonetheless, Hussey highlighted important ambiguities about the theoretical and practical meaning of the meta-effect reported by Vahey et al. We clarify our position on these matters in summary, and in so doing explain why we believe that the wider IRAP literature would undoubtedly benefit from increased adoption of contemporary open science standards.

A Meta-analysis of the relationship between growth mindset and grit

Growth mindset is one of the popular educational constructs with strong empirical ties to students' motivation and persistence in the academic context, which has been empirically linked to students' grit. Although a growing body of research suggests that growth mindset and grit are related in nuanced ways, a comprehensive and detailed portrait of this connection is needed to better understand how growth mindset is linked to grit. In this study, we systematically reviewed empirical research on growth mindset and grit among student population. Sixty-six eligible studies involving a total of 42,112 participants were examined. Using the robust variance estimation, we found that the correlations of growth mindset with grit/its facets were generally medium to strong (ρoverall grit = 0.19; ρinterest = 0.20; and ρeffort = 0.24, respectively). The p-curve analysis results suggested that cumulative studies contained evidential value (p < .001). We also investigated 11 potential moderators using meta-regression (covering study, participant, and measurement characteristics), and no significant moderators were observed in the associations between growth mindset and either facet of effort. A stronger growth mindset-overall grit association was observed in a collectivistic context. We concluded with a discussion of heterogeneity, limitations, and implications of meta-analyses.

Vertical and horizontal space-valence associations: A meta-analysis

Previous research found associations between lower vs. upper space and negative vs. positive stimuli correspondingly (vertical Space-Valence Associations, SVAs) and between the left vs. right side and negative vs. positive stimuli correspondingly (horizontal SVAs). We conducted a comprehensive meta-analysis of SVAs for both dimensions in behavioral studies. We tested the robustness of SVAs and examined factors potentially modulating them: participants' culture, handedness, gender, age, the exact valence domain under study, the experimental task, type of stimuli, publication year, and statistics used. Articles were extracted from Web of Science, PubMed, and ScienceDirect in February 2021. Overall, 91 articles with 199 experiments and 21,951 participants were included in the final analysis. We found robust evidence of SVAs in vertical (r = .440, k = 111 experiments) and horizontal dimensions (r = .310; k = 88 experiments), with little evidence for literature biases. The distribution of effect sizes was highly heterogeneous, even after subgroup analyses, which indicates unidentified factors varying across studies. Experiments on vertical SVAs explicitly asking participants to evaluate valence showed larger effect sizes than experiments where valence remained task-irrelevant. There was a robust effect of handedness on horizontal SVAs: Participants associated positive stimuli with the side of their dominant hand. There was also some evidence of cultural influences on the horizontal SVAs. Overall, our meta-analysis revealed a hierarchy of factors modulating activation of SVAs, which includes both situated and embodied factors. It is, therefore, essential to focus on specific concept categories and contexts rather than consider abstract concepts in general. PUBLIC SIGNIFICANCE STATEMENT: This meta-analysis revealed medium effects of space-valence associations: Upper/right space is associated with positive and lower/right space with negative concepts. On the vertical dimension, this effect is modulated by valence being task-relevant, e.g., directly asking people about valence results in stronger associations. For the horizontal dimension, left-handers robustly showed a reversed effect (i.e., left is good); horizontal space-valence associations might be even stronger in non-Western countries.

Clinical and safety outcomes associated with aristolochic acid exposure: a systematic review and meta-analysis

Current studies have clearly shown that aristolochic acid (AA) exposure can induce a variety of diseases, such as kidney disease, liver cancer, and urinary tract cancer (UTC). However, no studies have systematically analyzed and integrated these results. Therefore, we aimed to elucidate the association between AA exposure and the risk of safety outcomes for AA-related overall disease and different types of disease it causes. We conducted an exhaustive search of PubMed, EMBASE, Web of Science, and the Cochrane Library for relevant material up to April 2024. For AA-related overall disease, AA exposure was significantly associated with an increased incidence of AA-related overall disease (OR: 1.289, 95% CI: 1.183-1.404). For different types of disease, AA exposure was significantly associated with increased incidence of kidney disease (OR: 1.279, 95% CI: 1.029-1.590), UTC (OR: 1.842, 95% CI: 1.376-2.465), and liver cancer (OR: 1.146, 95% CI: 1.040-1.262). No significant association was found between AA exposure and the incidence of brain disease (OR: 1.161, 95% CI: 0.989-1.362). This study systematically analyzed various safety outcomes associated with AA exposure to provide a solid scientific basis for future prevention strategies and clinical management.

Prospective Relationships Among Depression and Perceived Opportunity in Juvenile Offenders

Among juveniles in the justice system, depression and perceived opportunity have implications for long-term adjustment. The prospective associations between these two constructs have not yet been examined in this population. We studied the longitudinal association between depression and perceived opportunity in a sample of recently adjudicated juvenile offenders. Juvenile offenders (n = 1,354) completed measures of depression and perceived opportunity shortly after adjudication and then every 6 months thereafter for 3 years (7 time points total). Relative to White juvenile offenders, lower average levels of perceived opportunity were observed among Black, Hispanic, and juveniles of other races/ethnicities. A random-intercept cross-lagged panel model revealed that greater depression was associated with lower subsequent perceived opportunity (d = -0.22, p < .001). Higher perceived opportunity did not predict subsequent depression (d = -0.07, p = .208). The nonexperimental design prevented inferences about causal links between depression and perceived opportunity. Results should also be replicated in a recently collected dataset. Findings suggested a scar-like effect, such that depression was unidirectionally and negatively associated with lower future perceived opportunity among juveniles. Future research should investigate if treatment for depression improves juvenile offenders' perceived opportunity.

Chatbot-delivered mental health support: Attitudes and utilization in a sample of U.S. college students

Objective

Chatbots' rapid advancements raise the possibility that they can be used to deliver mental health support. However, public utilization of and opinions toward chatbots for mental health support are poorly understood.

Methods

Survey study of 428 U.S. university students who participated in early 2024, just over one year after the release of ChatGPT. Descriptive analyses examined utilization of and attitudes toward both traditional mental health services (i.e. psychotherapy, counseling, or medication) and chatbot-delivered mental health support.

Results

Nearly half (49%) of participants reported having used a chatbot for any purpose, yet only 5% reported seeking mental health support from a chatbot (8% when only considering participants with probable depression or generalized anxiety disorder). Attitudes toward traditional mental health services were broadly positive, and attitudes toward chatbot-delivered support were neutral and significantly less positive (d = 1.18, p < .001). Participants reported lack of need and doubts about helpfulness as barriers to using chatbot-delivered support more frequently than they reported them as barriers to traditional services. Cost, time, and stigma barriers were less frequently reported for chatbot-delivered support than for traditional services. Attitudes were generally consistent as a function of mental health status.

Conclusion

Among U.S. students, utilization of chatbots for mental health support is uncommon. Chatbots are perceived as less likely to be beneficial, yet also less affected by cost, time, and stigma barriers than traditional services. Rigorous outcome research may increase public trust in and utilization of chatbots for mental health support.

Emotion suppression differentially moderates the link between stress and cardiovascular disease risk in Japanese and Americans

Background

Cardiovascular disease (CVD) remains a key cause of mortality worldwide. Prior work has found that the association between stress and cardiovascular outcomes is moderated by emotion regulation (ER) and expressive suppression (i.e., emotion inhibition), which is linked with adverse outcomes (i.e., inflammation) in Western (Americans) but not Eastern (Japanese) populations. Existing cultural differences in biological stress responses and suppression use suggest that these factors may have different implications for CV outcomes.

Objective

We address this gap in the literature by examining if ER differentially moderates the relationship between stress and CVD risk between Japanese and American adults.

Method

Participants were from the Midlife in Japan and Midlife in the United States studies and had complete biomarker and psychological data (Japanese: N = 315, M age = 59.22, 149 females; Americans: N = 524, M age = 51.98, 291 females). Stress was indexed using the perceived stress scale. Trait suppression and reappraisal were indexed using the Emotion Regulation Questionnaire. CVD risk was indexed using a composite score of body mass index, C-reactive protein, interleukin-6, systolic blood pressure, and high-density lipoprotein cholesterol ratio.

Results

Adjusting for age, sex, education, tobacco, alcohol, and prescription medication use, linear regressions revealed robust cultural differences among those with high suppression (r = -0.10 [-0.19, -0.01]). Higher stress was linked with higher CVD risk in Americans regardless of the level of reappraisal or suppression (r's > 0.11, p's < 0.07). In contrast, among Japanese with high suppression, higher stress was associated with lower CVD risk (r = -0.09 [-0.23, 0.05]). Higher stress was associated with greater inflammation among Japanese with lower suppression (r = 0.10 [-0.07, 0.28]).

Conclusions

Consistent with prior work, these findings suggest that adaptive ER moderates the association between stress and CVD risk, and that suppression may not be universally 'maladaptive.' Results emphasize the importance of considering cultural context when assessing the impact of emotion suppression on health, which may help explain differences in CVD outcomes between individuals from Eastern and Western populations.

Transcutaneous Auricular Vagus Nerve Stimulation Does Not Accelerate Fear Extinction: A Randomized, Sham-Controlled Study

Transcutaneous auricular vagus nerve stimulation (taVNS) has been tested as a strategy to facilitate fear extinction learning based on the hypothesis that taVNS increases central noradrenergic activity. Four studies out of six found taVNS to enhance extinction learning especially at the beginning of extinction. Facilitatory effects of taVNS were mainly observed in US expectancy, less in fear-potentiated startle (FPS), and not in the skin conductance response (SCR). Suboptimal stimulation parameters may explain the reported mixed results. Also, variability in selected fear conditioning paradigms and statistical power impedes the comparability between studies. This study sought to further test whether taVNS accelerates fear extinction learning as indexed by US expectancy, FPS, and SCR. Similar to most previous studies, we employed a differential fear conditioning paradigm. The left ear of 79 healthy participants was stimulated with either sham (earlobe) or taVNS (cymba concha) during extinction learning. To maximize the beneficial effects of taVNS, the stimulation of the left cymba concha was administered continuously at the maximum level below the pain threshold. Results of the pre-registered frequentist and exploratory Bayesian analyses indicate that taVNS did not accelerate extinction learning in any of the outcomes. The null results indicate that taVNS with commonly used stimulation parameters does not reliably optimize fear extinction learning. More research is needed to test if the stimulation protocol determines the efficacy of taVNS in optimizing fear extinction learning.

Placenta-derived biomaterials vs. standard care in chronic diabetic foot ulcer healing: A systematic review and meta-analysis

INTRODUCTION

This study explored the effectiveness of current placenta-derived biomaterials therapies in ulcer healing in DFU compared to standard of care (SOC).

METHODS

The systematic review and meta-analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard. The electronic databases of PubMed, EMBASE, and Web of Science (WoS) internet were searched for the outcome rate of complete ulcer healing. The risk of bias assessment was conducted using the tool recommended by the Cochrane Collaboration. Statistical analysis included the individual and combined result of the studies, heterogeneity test, the effect size, sensitivity analysis, and publication bias tests.

RESULTS

Twelve randomized controlled trials (RCTs) with a total of 833 patients were included in this study. This meta-analysis showed a higher rate of complete ulcer healing in groups receiving placenta-derived biomaterials therapies (OR = 6.247 [4.425, 8.819], p < 0.01, I2 = 41 %) compared to control groups.

CONCLUSION

Placenta-derived biomaterials therapies have been shown to be more effective for achieving complete ulcer healing compared to current conventional treatments in DFU.

IMPLICATIONS FOR CLINICAL PRACTICE

The utilization of placenta-derived biomaterials in therapies for wound healing, particularly in chronic DFU, presents promising implications for clinical practice. These biomaterials offer a rich source of growth factors, cytokines, and extracellular matrix components, which can stimulate tissue regeneration and angiogenesis. Incorporating such therapies into clinical practice holds the potential to accelerate wound closure, reduce infection rates, and improve overall healing outcomes in people with diabetic chronic foot ulcers. Furthermore, the availability of these biomaterials can offer clinicians a readily-accessible and cost-effective alternative to traditional wound care approaches, ultimately enhancing patient care and quality of life. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

'I still remember': Increased categoric autobiographical memories in behavioural variant of frontotemporal dementia

Autobiographical memory is diminished in patients with behavioural variant of frontotemporal dementia (bvFTD), and research has focused on the hampered ability of patients to retrieve specific memories. In this study, we implemented a methodology seeking to provide a qualitative analysis of autobiographical specificity. We invited patients with bvFTD and control participants to retrieve autobiographical memories and we distinguished between specific, categoric, extended and semantic autobiographical retrieval. The analysis demonstrated that patients with bvFTD produced more categoric than specific, extended or semantic memories. Thus, despite the decreased ability to retrieve specific memories, an increased ability to produce categoric memories can be observed in patients with bvFTD. These results support a positive view according to which autobiographical retrieval in bvFTD is not solely characterized by over-generality, but also by increased retrieval of categoric memories. Categoric memories, albeit lacking uniqueness, nevertheless, involve retrieval of similar or related events upon which patients may draw knowledge related to their self-image and life story.

Physical activity as a moderator of the association between alcohol consumption and hangovers

Frequently mentioned anecdotally, hangovers are under-investigated within the scientific study of alcohol, as is the role of physical activity (PA) on hangovers. The well-established positive association between PA and AC (AC) suggests that PA may buffer negative physiological consequences of AC, including hangovers. The present study was therefore conducted in order to determine whether PA influences hangovers. Undergraduates (N=1676) from two large universities in the United States who experienced at least one hangover in the past three months and who engaged in at least 30 min of moderate PA per week were recruited to participate. Participants completed online questionnaires about their AC, PA, and frequency and severity of hangover symptoms. Both between- and within-person associations between AC and hangover were examined, factoring in the potential moderating effects of both moderate and vigorous PA. Small effects were observed for correlations between PA and outcomes assessing AC and hangovers (rs ranged from 0.09 to 0.15). Results also revealed that individuals who consumed more alcohol per month experienced hangovers more frequently and had more severe symptoms. These associations were attenuated among individuals who spent more hours engaging in vigorous but not moderate PA. The current study is the first to show PA influences the experience of hangovers, and we posit this may be a mechanism underlying the positive relationship between PA and AC. Our findings advance the growing literature on alcohol use and PA and may contribute to the development of interventions for alcohol-related problems and alcohol use disorders.

Gender nonconformity and common mental health problems: A meta-analysis

We tested the association between gender nonconformity and common mental health outcomes, including generalized anxiety symptoms, depressive symptoms, self-esteem, self-harm attempts, and suicide attempts using an exhaustive meta-analysis. PsycInfo, ProQuest Central, EBSCOhost, and PubMed were searched for eligible articles using either cross-sectional or longitudinal designs on 11th July 2024. A total number of 1975 articles were identified and selected following PRISMA. Twenty-five, 48, 32, seven, and nine studies were included on generalized anxiety symptoms, depressive symptoms, self-esteem, self-harm attempts, and suicide attempts, reaching a total sample size of 142,069, 188,681, 27,488, 47,523, and 25,573, respectively. Meta-analyses were performed using a random-effects model stratified by mental health outcomes. We found that higher levels of gender nonconformity were associated with higher levels of generalized anxiety (r = 0.06) and depressive symptoms (r = 0.11), lower levels of self-esteem (r = 0.18), and increased risk of self-harm (r = 0.17) and suicide attempts (r = 0.14). Gender nonconformity had stronger links to generalized anxiety symptoms, depressive symptoms, and self-esteem in men than in women. Behaviors-based gender nonconformity showed stronger links to depressive symptoms and self-esteem compared to traits-based gender nonconformity. The effect size for the association between gender nonconformity and depressive symptoms was significantly larger in adolescent samples than in childhood samples. There was no significant moderation by sexual orientation. While gender nonconformity is robustly associated with a range of common mental health problems, the magnitude of this association varies depending on the specific mental health outcomes considered and sex. Interventions to mitigate mental health differences and improve overall well-being among individuals who display greater gender nonconformity are needed.

Does music training improve inhibition control in children? A systematic review and meta-analysis

Inhibition control is an essential executive function during children's development, underpinning self-regulation and the acquisition of social and language abilities. This executive function is intensely engaged in music training while learning an instrument, a complex multisensory task requiring monitoring motor performance and auditory stream prioritization. This novel meta-analysis examined music-based training on inhibition control in children. Records from 1980 to 2023 yielded 22 longitudinal studies with controls (N = 1734), including 8 RCTs and 14 others. A random-effects meta-analysis showed that music training improved inhibition control (moderate-to-large effect size) in the RCTs and the superset of twenty-two longitudinal studies (small-to-moderate effect size). Music training plays a privileged role compared to other activities (sports, visual arts, drama) in improving children's executive functioning, with a particular effect on inhibition control. We recommend music training for complementing education and as a clinical tool focusing on inhibition control remediation (e.g., in autism and ADHD).

Meta-analysis: a tool for constructing theories or evaluating interventions or simply proving everyday assumptions?

After a brief consideration of the development of meta-analyses as a joint discussion of results from a research area across development stages 0, 1, 2, it is concluded that the present form 2.0 is unsuitable to serve as a basis for theory building. Further development of this tool into a meta-analysis 3.0 is necessary for this purpose which requires the validity of the independent variables in the primary studies, the reduction of the error variance of the dependent variables, a stability of the effects over the primary studies and a quantitative comparison between observed and predicted effects in the primary studies. In the current meta-analyses 2.0, a concrete single-case approach creates the impression that mainly everyday ideas are investigated, which one would like to generalize to a population of other conditions. Furthermore, the results of the existing meta-analyses are either homogeneous and very small or heterogeneous. Meta-analysis 2.0 searches for the instability of the measurements under a specific topic with methods of induction. The procedure of a meta-analysis 3.0 is described in general and carried out hypothetically and with an empirical example. It searches for the stability of quantitative reconstructions of data over different topics with the method of abduction. The conclusion can be summarized as that meta-analysis 3.0 is indispensable as a tool for theorizing, and theorizing presupposes meta-analysis 3.0. The link between this interdependence is abduction in contrast to induction as a research strategy.

Post-traumatic stress disorder in peacekeepers: a systematic literature review and meta-analysis

Background: In peacekeeping operations, soldiers are often exposed to the same traumatic factors as in conventional war and may also be subject to physical risks and psychological stressors associated with post-traumatic stress disorder (PTSD). According to the Conservation of Resources Theory (COR), PTSD stems from resource depletion and inadequate restoration.Objectives: To discuss and meta-analyse PTSD-related factors among peacekeepers, based on the COR theory, framing them as resources or loss/threat of loss of resources.Methods: A systematic literature search was performed with relevant keywords, 51 articles were reviewed and 21 of them meta-analysed.Results: Factors mentioned in prior reviews, reinforced by ours, include: family/community and military support as resources; single marital status, female gender, serving in infantry, and longer time since deployment as lack of resources. Factors mentioned in prior reviews, confirmed by our meta-analysis, include: education, rank, and problem-focused coping as resources; negative perceptions about deployment, combat/trauma exposure, deployment stressors, and deployment duration as lack of resources. Factors overlooked in prior reviews include: age as a resource; negative life events, and negative social interactions as lack of resources. Comorbidities include: physical health problems, post-deployment impact on functioning, and post-deployment psychopathology (e.g., depression, substance use).Conclusions: Significantly more individual than contextual factors were identified. While some factors inherent to missions (e.g., combat exposure, deployment stressors) cannot be mitigated, others are crucial to prevent peacekeepers' PTSD (e.g., coping strategies, deployment duration, perceptions about deployment, social interactions, support during deployment) and to inform selection and monitoring by the Armed Forces (e.g., pre-, during and post-deployment psychopathology). However, the findings should be interpreted with caution due to limitations (e.g., publication bias, study heterogeneity) that may have affected the generalizability and strength of the recommendations.

Ultrasound Evaluation of Onset Core Muscle Activity in Subjects with Non-Specific Lower Back Pain and Without Lower Back Pain: An Observational Case-Control Study

Lower back pain (LBP) has been the leading cause of disability since 1990. Objectives: The main objective of this observational case-control study was to evaluate, using ultrasound, whether there were differences in the onset and ratio of core muscle contraction between subjects with non-specific chronic lower back pain and healthy subjects. Methods: A total of 60 participants (52% women), split between those with non-specific chronic lower back pain (n = 26) and healthy (n = 34) subjects, were recruited. Initial muscle contraction of the lateral abdominal wall, pelvic floor, lumbar multifidus, and respiratory diaphragm was measured using ultrasound. The abdominal drawing-in maneuver, contralateral arm elevation, the Valsalva maneuver, and voluntary contraction of the pelvic floor in seated and standing positions were performed. The muscle thickness of the lateral abdominal wall and lumbar multifidus and excursion of the pelvic floor and diaphragm at rest and during testing were also analyzed. Results: No differences were found between the groups in the initial contraction. Statistically significant differences were found in the following variables: diaphragm excursion (p = 0.032, r = 0.277) and lumbar multifidus ratio (p = 0.010, r = 0.333) in the standing-abdominal retraction maneuver; pelvic floor excursion (p = 0.012, r = 0.325) in the standing-contralateral arm raise; and transverse abdominis ratio (p = 0.033, r = 0.275) in the sitting-contralateral arm raise. A statistically significant interaction between the groups and body mass index was observed in resting diaphragm excursion (p = 0.018, partial eta squared = 0.096) during sitting-voluntary pelvic floor contraction. Conclusions: It cannot be concluded that there is a specific pattern of core activation in any of the groups. However, statistically significant differences were found in the contraction indexes of the lumbopelvic musculature.

The Long-Term Effect of Early-Life Uncertainty on Mental Health in Adolescence and Adulthood: A Meta-Analysis

Turbulent changes in early life are a hidden source of childhood trauma, increasing potential risks for mental illness. Many studies have identified the link between childhood uncertainty and mental health. However, research on the long-term effect of early-life uncertainty (EU) on mental health has not been systematically synthesized. This meta-analysis aims to provide a quantitative estimate of the association between EU and subsequent mental health outcomes. Eight electronic databases and gray literature were searched. Twenty-eight studies met our inclusion criteria: samples of non-clinical adolescents or adults and clear and valid assessments. Random-effect models were used to calculate the pooled effect sizes of EU on internalizing problems, externalizing problems, and well-being. Meta-regression and subgroup analysis were used to explore potential moderators. Results indicated small to moderate associations involving EU and internalizing problem (r = .28; 95% confidence interval [CI] [0.228, 0.326]) and externalizing problem (r = .16; 95% CI [0.102, 0.220]). EU was not significantly associated with well-being (r = -.41; 95% CI [-0.738, 0.071]). Furthermore, moderator analyses found that composite uncertain experiences in childhood had a stronger negative effect than single experiences. EU was a stronger predictor of mental health problems in adults than in adolescents. Cross-sectional studies would amplify the correlation between EU and mental illness compared to longitudinal studies. In the future, childhood uncertain and unpredictable risks should receive more attention. More research needs to focus on positive psychological indicators and samples from non-Western countries.

Effects of rehabilitation exercise program types on dynamic balance in patients with stroke: a meta-analysis of randomized controlled trials

PURPOSE

The purposes of meta-analysis are to evaluate evidence about the effects of Rehabilitation Exercise Program on the balance of post-stroke patients, evaluated by the Berg Balance Scale (BBS).

METHODS

The search was conducted 'stroke,' 'rehabilitation,' 'dynamic balance,' 'Berg Balance Scale,' 'exercise' and 'randomized controlled trial'using MEDLINE (accessed by PubMed), Web of Science (WoS), ProQuest, and Google Scholar for journal studies published from January 2018 to October 2022. Two independent reviewers performed the article selection, data extraction, and methodological quality assessment. The main outcome was dynamic balance assessed by the Berg Balance scale.

RESULTS

The review included 30 papers and a total of 540 patients. The overall effect size was 0.550, a medium effect size according to the Cohen's standard. It was observed that gender has moderate effect size in male (0.551), female (0.458) and higher in male. Exercise type results showed large effect sizes in balance training (0.966), and aquatic activities (0.830), moderate effect sizes in virtual reality (0.762), moderate effect sizes in physically active (0.581), gait training (0.541), dual-task (0.478), trunk control (0.284), and small effect sizes in resistance training (0.128).

CONCLUSIONS

Exercise programs are effective in improving dynamic balance in stroke patients. Especially, the meta-analysis showed higher Effect Size for balance training and virtual reality than for other programs making this relevant interventions for future head to head superiority studies that compare different balance interventions in stroke.

Which ERP components are effective in measuring cognitive load in multimedia learning? A meta-analysis based on relevant studies

The open and generative nature of multimedia learning environments tends to cause cognitive overload in learners, and cognitive load is difficult for researchers to observe objectively because of its implicit and complex nature. Event-related potentials (ERP), a method of studying potential changes associated with specific events or stimuli by recording the electroencephalogram (EEG), has become an important method of measuring cognitive load in cognitive psychology. Although many studies have relied on ERP output measurements to compare different levels of cognitive load in multimedia learning, the results of the effect of cognitive load on ERP have been inconsistent. In this study, we used a meta-analysis of evidence-based research to quantitatively analyze 17 experimental studies to quantitatively evaluate which ERP component (amplitude) is most sensitive to cognitive load. Forty five effect sizes from 26 studies involving 360 participants were calculated. (1) The results of the studies analyzed in subgroups indicated high level effect sizes for P300 and P200 (2) Analyses of moderating variables for signal acquisition did not find that different methods of signal acquisition had a significant effect on the measurement of cognitive load (3) Analyses of moderating variables for task design found that a task system with feedback was more convenient for the measurement of cognitive load, and that designing for 3 levels of cognitive load was more convenient for the measurement of cognitive load than for 2 levels of cognitive load. (4) Analyses of continuous moderating variables for subject characteristics did not find significant effects of age, gender, or sample size on the results.

A meta-analysis of the relationship between metacognition and academic achievement in mathematics: From preschool to university

Many studies have explored the relationship between metacognition and academic achievement in mathematics, but the results vary. In this study, meta-analysis was used to explore this relationship between metacognition and academic achievement in mathematics and influencing factors. According to the literature search, a total of 147 studies (1986-2024) and 338 independent samples met the inclusion criteria (n = 698,096). The results revealed metacognition was significantly positively correlated with academic achievement in mathematics, r = 0.32, 95 % CI [0.30, 0.34], Z = 28.49. Moreover, the moderating effects of age, domain, and culture were significant (p < 0.01). In conclusion, Metacognition is closely associated with academic achievement in mathematics but also that age, domain, and culture have a considerable impact on their relationship. More specifically, the degree of correlation between metacognition and academic achievement in mathematics was on the rise from preschool to high school, while it was lower in college. Compared with general field metacognition, mathematical metacognition is more closely linked to mathematics academic achievement. Lastly, compared with British and American countries, Chinese metacognition was more closely related to academic achievement in mathematics.

Negative effects of institutionalization on the sense of self in Alzheimer's Disease

In this longitudinal study, we investigated the effects of institutionalization on the sense-of-self in individuals with Alzheimer's Disease (AD). We recruited two groups of participants: one living in care facilities (i.e., institutionalized-group) and another group living in their own home (i.e., non-institutionalized-group). In the two groups, we assessed the "Who-am-I" task on which participants were invited to provide statements beginning with the phrase "I am" that they felt were essential in defining who they are. We assessed this task, in the two groups, at a baseline (approximately one-month before-institutionalization) and at a follow-up (approximately six months after institutionalization). We analyzed whether responses on the "Who-am-I" task reflected physical-, social-, or psychological-self. Unlike at the baseline, fewer statements describing physical-, social-, and psychological-self were observed in the institutionalization than in the non-institutionalized group at the follow up. These findings demonstrate negative effects of institutionalization on the sense of self in AD.

Convergent Neuroimaging and Molecular Signatures in Mild Cognitive Impairment and Alzheimer's Disease: A Data-Driven Meta-Analysis with N = 3,118

The current study aimed to evaluate the susceptibility to regional brain atrophy and its biological mechanism in Alzheimer's disease (AD). We conducted data-driven meta-analyses to combine 3,118 structural magnetic resonance images from three datasets to obtain robust atrophy patterns. Then we introduced a set of radiogenomic analyses to investigate the biological basis of the atrophy patterns in AD. Our results showed that the hippocampus and amygdala exhibit the most severe atrophy, followed by the temporal, frontal, and occipital lobes in mild cognitive impairment (MCI) and AD. The extent of atrophy in MCI was less severe than that in AD. A series of biological processes related to the glutamate signaling pathway, cellular stress response, and synapse structure and function were investigated through gene set enrichment analysis. Our study contributes to understanding the manifestations of atrophy and a deeper understanding of the pathophysiological processes that contribute to atrophy, providing new insight for further clinical research on AD.

Focal seizures induce spatiotemporally organized spiking activity in the human cortex

Epileptic seizures are debilitating because of the clinical symptoms they produce. These symptoms, in turn, may stem directly from disruptions in neural coding. Recent evidence has suggested that the specific temporal order, or sequence, of spiking across a population of cortical neurons may encode information. Here, we investigate how seizures disrupt neuronal spiking sequences in the human brain by recording multi-unit activity from the cerebral cortex in five male participants undergoing monitoring for seizures. We find that pathological discharges during seizures are associated with bursts of spiking activity across a population of cortical neurons. These bursts are organized into highly consistent and stereotyped temporal sequences. As the seizure evolves, spiking sequences diverge from the sequences observed at baseline and become more spatially organized. The direction of this spatial organization matches the direction of the ictal discharges, which spread over the cortex as traveling waves. Our data therefore suggest that seizures can entrain cortical spiking sequences by changing the spatial organization of neuronal firing, providing a possible mechanism by which seizures create symptoms.

Endurance training volume cannot entirely substitute for the lack of intensity

PURPOSE

Very low intensity endurance training (LIT) does not seem to improve maximal oxygen uptake. The purpose of the present study was to investigate if very high volume of LIT could compensate the lack of intensity and is LIT affecting differently low and high intensity performances.

METHODS

Recreationally active untrained participants (n = 35; 21 females) cycled either LIT (mean training time 6.7 ± 0.7 h / week at 63% of maximal heart rate, n = 16) or high intensity training (HIT) (1.6 ± 0.2 h /week, n = 19) for 10 weeks. Two categories of variables were measured: Low (first lactate threshold, fat oxidation at low intensity exercise, post-exercise recovery) and high (aerobic capacity, second lactate threshold, sprinting power, maximal stroke volume) intensity performance.

RESULTS

Only LIT enhanced pooled low intensity performance (LIT: p = 0.01, ES = 0.49, HIT: p = 0.20, ES = 0.20) and HIT pooled high intensity performance (LIT: p = 0.34, ES = 0.05, HIT: p = 0.007, ES = 0.48).

CONCLUSIONS

Overall, very low endurance training intensity cannot fully be compensated by high training volume in adaptations to high intensity performance, but it nevertheless improved low intensity performance. Therefore, the intensity threshold for improving low intensity performance is lower than that for improving high intensity performance. Consequently, evaluating the effectiveness of LIT on endurance performance cannot be solely determined by high intensity performance tests.

Organic farming practices increase weed density and diversity over conventional practices: A meta-analysis

Population growth and climate change challenge our food and farming systems and provide arguments for an increased intensification of agriculture. Organic farming has been seen as a promising option due to its eco-friendly approaches during production. However, weeds are regarded as the major hindrance to effective crop production which varies depending on the type of crop and spacing. Their presence leads to reduced yield, increase in harvest cost and lower the qualities of some produce. Thus, weed management is a key priority for successful crop production. Therefore, we conducted a meta-analysis from published studies to quantify possible differences on weed density, diversity and evenness in organic and conventional farming systems and best intervention for weed management in organic farming system. Data included were obtained from 32 studies where 31 studies with 410 observations were obtained for weed density, 15 studies with 168 observations for diversity, and 5 studies with 104 observations for evenness. Standard deviation of mean was obtained from the studies, log transformed using natural logarithms and the effect size pooled using standardized mean difference (SMD). Publication bias was determined through funnel plot. Results showed that organic farming has significant higher weed density (P < 0.01), diversity (P = 0.01), and evenness (P < 0.05) compared to conventional farming. Despite so, diversified crop rotation has been proved to reduce weed density in organic farming by up to 49 % while maize-bean intercropping decrease densities of Amaranthus ssp, Cyperus ssp and Cammelina ssp compared with monocropping. Use of mulch after one hand weeding was found to control up to 98 % of weeds and use of cover crop between 24 % and 85 % depending on the type of the cover crop. The study results show that organic farming encourages high weed density, diversity and evenness but use of the integrated approaches can help to maintain weed density at a manageable level.

The Role of Virtual Reality in the Management of Football Injuries

Injuries represent a serious concern for football players, with a significant loss in terms of sport participation and long periods of rehabilitation. According to the 2019/20 UEFA Élite Club Injury Report, the average incidence of injuries during training is 2.8 per 1000 h of training, with an average absence from training of 20 days. In addition, injured athletes are 4 to 7 times more likely to relapse than uninjured athletes. High workloads and reduced recovery periods represent two of the most important modifiable risk factors. In this context, prevention and an adequate rehabilitation protocol are vital in managing injuries, reducing their incidence, and improving the return to competition. In recent years, technological development has provided new tools in rehabilitation, and Virtual reality (VR) has shown interesting results in treating neurologic and orthopedic pathologies. Virtual Reality (VR) technology finds application in the sports industry as a tool to examine athletes' technical movements. The primary objective is to detect the biomechanical risk factors associated with anterior cruciate ligament injury. Additionally, VR can be used to train athletes in field-specific techniques and create safe and controlled therapeutic environments for post-injury recovery. Moreover, VR offers a customizable approach to treatment based on individual player data. It can be employed for both prevention and rehabilitation, tailoring the rehabilitation and training protocols according to the athletes' specific needs.

"Do not take that medication": negative prospective memory in Korsakoff's syndrome

BACKGROUND

While prospective memory (i.e., the ability to execute a future plan) has been extensively researched, little is known about negative prospective memory (i.e., the ability to remember not to execute a future plan) in Korsakoff's syndrome (KS). We thus evaluated both prospective memory and negative prospective memory in KS, as well as the relationship between both types of prospective memory and inhibition.

METHODS

Patients with KS and control participants were invited to press a button on the keyboard (i.e., prospective memory) or not to press a button when a cue word (e.g., negative prospective memory) was encountered.

RESULTS

The analysis demonstrated that patients with KS had more prospective memory errors (i.e., forgetting to click the keyboard when the instruction was to do so) than control participants. The analysis also demonstrated that patients with KS had more negative prospective memory errors (i.e., clicking the keyboard when the instruction was not to do so) than control participants. Similar levels of commissions and omissions were observed in patients with KS than in control participants. Interestingly, prospective and negative prospective performances were significantly correlated with performance on an inhibition assessment task.

DISCUSSION

Our study demonstrates that KS is characterized by not only difficulty in remembering to execute a future intention but also by difficulty in remembering not to execute a future intention. A decline in negative prospective memory in KS can be associated with difficulty in inhibiting no longer appropriate previously learned intentions.

The phenomenological experience of autobiographical memory in patients with behavioral-variant frontotemporal dementia

In this study, we offer a comprehensive assessment of the phenomenological experience of patients with behavioral-variant frontotemporal dementia (bvFTD) upon retrieval of autobiographical memory. We invited patients with bvFTD and control participants to retrieve autobiographical memories and rate, for each memory, its phenomenological characteristics. We also analyzed the retrieved memories regarding specificity (i.e., whether the memory described a general or a detailed event). Results demonstrated that, compared to control participants, patients with bvFTD attributed lower levels of reliving, back in time (feeling as if going back in time), remembering, realness, visual imagery, auditory imagery, language, emotion, rehearsal, importance, spatial recall and temporal recall to their memories. Lower autobiographical specificity was also observed in patients with bvFTD compared to control participants. Autobiographical specificity in patients with bvFTD was associated with verbal fluency and verbal episodic memory, but not with phenomenological experience. Although autobiographical memories of patients with bvFTD show low ratings of phenomenological experience, the patients may still enjoy some limited subjective experience during autobiographical retrieval.

Does Sex Matter? High Semantic Autobiographical Retrieval in Women and Men With Alzheimer's Disease

The decline of autobiographical memory in Alzheimer's disease (AD) is mainly characterized by overgenerality. While there is a large body of research on autobiographical overgenerality in AD, this research has mainly assessed retrieval with a dichotomy between specific vs. general retrieval. To go beyond this dichotomy, we assessed several degrees of autobiographical specificity in patients with AD, namely, we assessed specific vs. categoric vs. extended vs. semantic retrieval. We also assessed sex differences regarding these degrees of autobiographical specificity. We invited patients with mild AD and control participants to complete sentences (e. g., "When I think back to/of…") with autobiographical memories. Memories were categorized into specific, categoric, extended, or semantic memories. Results demonstrated more semantic than specific, categoric or extended memories in men and women with AD. In control participants, analysis demonstrated more specific than categoric, extended, and semantic memories in men and women. Also, no significant differences were observed between women and men with AD, or between control women and men, regarding specific, categoric, extended, and semantic memoires. This study offers not only a nuanced analysis of autobiographical specificity in patients with mild AD, but also an original analysis regarding this specificity by sex.

Persuasive Effects of Temporal Framing in Health Messaging: A Meta-Analysis

This meta-analysis investigated the persuasive effects of temporal framing in health messaging. Our analysis included 39 message pairs from 22 studies in 20 articles (N = 4,998) that examined the effects of temporal framing (i.e. present-oriented messages vs. future-oriented messages) on attitudes, intentions, and behaviors in health contexts. We found that present-oriented messages were significantly more persuasive than future-oriented messages in terms of intentions and integrated persuasive outcomes. Effects of temporal framing on attitudes and behaviors were not statistically significant. We tested six moderators of temporal framing effects (gain vs. loss framing, temporal framing operationalization, behavior type, timing of effect assessment, age, CFC levels) but none of them was statistically significant. Implications for future temporal framing research are discussed.

Usefulness of Belimumab in Adult Patients With Systemic Lupus Erythematosus Evaluated Using Single Indexes: A Meta-Analysis and Systematic Review

Background

Belimumab is the first antibody drug approved for systemic lupus erythematosus (SLE), and is a fully human monoclonal antibody that inhibits soluble B lymphocyte stimulator protein. In clinical trials, a composite index was used to assess efficacy of belimumab. However, clinical guidelines on SLE treatment currently use single efficacy indexes.

Objective

The main objective of this study was to perform a meta-analysis to evaluate the efficacy of belimumab utilizing single indexes used in routine clinical practice, rather than the composite efficacy index used in clinical trials during the development phase. As a secondary endpoint, safety was also evaluated.

Methods

Several databases were searched to identify reports published up to December 1, 2021 on randomized controlled trials examining the efficacy of belimumab in adult patients with SLE. From the clinical trial data, efficacy was evaluated using single indexes including the SLE Disease Activity Index (SLEDAI), British Isles Lupus Assessment Group Index, and Physician Global Assessment. Safety was also assessed. Data were synthesized and analyzed using Review Manager 5.4. This study protocol was registered in the UMIN Clinical Trials Registry (Registration number: UMIN000052846).

Results

The search identified 12 reports that met the inclusion criteria. Five reports were included in efficacy evaluation and 9 in safety evaluation. The primary endpoint was SLEDAI. Significantly more belimumab-treated patients achieved a ≥4-point reduction in SLEDAI (relative risk 1.28; 95% confidence interval, 1.16-1.40; P < 0.00001) compared with placebo. Other efficacy endpoints were also improved significantly in the belimumab group. No difference in safety was found between belimumab and placebo.

Conclusions

The present meta-analysis evaluating clinical trial data using various single indexes recommended by clinical guidelines for SLE verifies that addition of belimumab to standard of care is efficacious for moderate-to-severe SLE.

Meta-analysis of studies on the mental state of ukrainian students under martial law

OBJECTIVE

Aim: To develop and test a methodology for conducting a meta-analysis of studies on the mental state of Ukrainian students under martial law to determine and summarise their results..

PATIENTS AND METHODS

Materials and Methods: The developed methodology of meta-analysis involves: determining the criteria for inclusion/exclusion of materials published by Ukrainian researchers in February 2022 - April 2024; search, selection, and assessment of content and quality; selection and interpretation of interdisciplinary analytical and operational meta-analysis tools (the concept of Effect Zize and Standardised Index; Fixed- and Random-Effects Models; chi-square and Q homogeneity test; actor-observer asymmetry effect; standard PHQ-9 GAD-7 methods); assessment of statistical heterogeneity of research results; preparation of a meta-analytical report.

RESULTS

Results: The search resulted in 135 articles on the issue. After the initial processing, 43 studies were selected for further analysis. They were structured and characterised according to the following criteria and features: types of research; time it was conducted; its authors; participants in sociological and experimental studies. The reflection of the dominant mental states (stress, anxiety, fear, depression, oppression, pessimism, confusion, apathy) in empirical, empirical-analytical, and experimental studies has been determined. The results of studies of mental states in the fields of medicine, psychology, etc.,have been characterised. A meta-analysis of studies that reflect the impact of mental states on students' attitudes to the learning process and allow tracking the dynamics of changes in their mental reactions at different stages and phases of martial law in Ukraine and related to evacuation has been carried out.

CONCLUSION

Conclusions: based on the results of the studies that became the subject of the meta-analysis, the general reactions that arose in students as a result of traumatic experience have been identified: stress, anxiety, fear, anger, guilt, shame, helplessness, etc. They had a corresponding impact on the effectiveness of their academic performance.

Resting heart rate variability and emotion regulation difficulties: Comparing Asian Americans and European Americans

Asian Americans and European Americans differ in emotion regulation (ER), particularly regarding strategies utilized to adaptively engage in ER. Resting heart rate variability (HRV), a biomarker of ER ability, is suggested to differ between Asian Americans and European Americans, but evidence for such differences has been inconsistent. Yet, research has not considered how Asian Americans and European Americans might differ in the well-established link between resting HRV and ER difficulties, which might lend a better understanding of such inconsistencies. In 374 college-aged individuals (66 Asian Americans; 311 European Americans; 190 women; mean age = 19.3 years [Min. 18, Max 38]), we examined if ethnicity moderated the link between resting HRV and self-reported ER difficulties. Resting HRV was obtained during a 5-min resting-baseline period, and ER difficulties were assessed using the Difficulties in ER Scale, which contained six facets of ER difficulties. Adjusting for gender and body mass index, moderation analyses showed a stronger association between resting HRV and ER difficulties in Asian Americans compared to European Americans. When examining facets of ER, ethnicity moderated only the link between resting HRV and difficulties in accessing ER strategies when facing negative emotions. At lower levels of HRV, Asian Americans reported greater difficulties in ER relative to European Americans. This effect diminished and trended in the opposite direction among those with higher HRV. In sum, these results provide novel evidence that higher resting HRV might be particularly important for adaptive ER among Asian Americans - a marginalized ethnic group - in the U.S.

Nonface-to-Face Visitation to Restrict Patient Visits for Infection Control: Integrative Review

BACKGROUND

In the COVID-19 pandemic, a visit restriction policy for patients has been implemented in medical institutions worldwide and visits are being made using alternative communication technologies. This shift has also required the use of platforms to prevent negative consequences of these restrictions.

OBJECTIVE

The purpose of this review was to comprehensively explore nonface-to-face visits as an alternative during infection prevention and to synthesize the scientific evidence of their benefits and disadvantages.

METHODS

A comprehensive search was conducted via the PubMed, Embase, CINAHL, Cochrane, and Web of Science electronic databases; unpublished trials in the clinical trials register ClinicalTrials.gov; and Virginia Henderson International Nursing Library up to September 10, 2021. The search query was developed according to the guidelines of the Peer Review of Electronic Search Strategies and included keywords on the topics of telemedicine and visitation restrictions. The inclusion criteria were a nonface-to-face modality using telemedicine with family in a hospital setting, experimental and observational studies, and articles written in English. The exclusion criteria were inaccessible in full text, not related to patient or family involvement, mainly focused on the study protocol, or only discussing the pros and cons of telemedicine.

RESULTS

Overall, patients' families experienced emotional distress due to restrictions on face-to-face visits. Nonface-to-face virtual visits compensating for these restrictions had a positive effect on reducing the risk of infection to the patient and the family. This further encouraged psychological and physical recovery and decreased psychological distress. However, nonface-to-face virtual technology could not replace the existence of actual families, and technical problems with networks and devices are reported as limitations.

CONCLUSIONS

Ensuring the availability of technology and educating on the same in alignment with the characteristics of patients and their families, nonface-to-face virtual visits need to show more potential as an effective patient-centered treatment strategy based on more research and advanced practice.

A Meta-Analysis of Social Skills Interventions for Preschoolers with or at Risk of Early Emotional and Behavioral Problems

Early social-behavioral intervention that emphasizes social skill training is critical to addressing emotional and behavioral problems in early childhood. In this meta-analysis review, we examined all the social skills intervention studies for preschoolers with, or at risk of, emotional and behavioral problems using group designs. This review included 25 studies that met the inclusion criteria. The robust variance estimation method was used to calculate the overall effect size of all the included studies, as this method can count for the pre-existing difference between the experiment and control groups. The included studies yielded an overall effect of 0.54 from the 151 effect sizes that were obtained for the 3484 preschool participants. Curriculum, integration, and treatment fidelity were identified as significant moderators of effects.

Elevated levels of mixed-hand preference in dyslexia: Meta-analyses of 68 studies

Since almost a hundred years, psychologists have investigated the link between hand preference and dyslexia. We present a meta-analysis to determine whether there is indeed an increase in atypical hand preference in dyslexia. We included studies used in two previous meta-analyses (Bishop, 1990; Eglinton & Annett, 1994) as well as studies identified through PubMed MEDLINE, PsycInfo, Google Scholar, and Web of Science up to August 2022. K = 68 studies (n = 4660 individuals with dyslexia; n = 40845 controls) were entered into three random effects meta-analyses using the odds ratio as the effect size (non-right-handers; left-handers; mixed-handers vs. total). Evidence of elevated levels of atypical hand preference in dyslexia emerged that were especially pronounced for mixed-hand preference (OR = 1.57), although this category was underdefined. Differences in (direction or degree) of hand skill or degree of hand preference could not be assessed as no pertinent studies were located. Our findings allow for robust conclusions only for a relationship of mixed-hand preference with dyslexia.

The association between adverse childhood events and cluster C personality disorders: A meta-analysis

INTRODUCTION

Studies suggest that adverse childhood events (ACEs) may contribute to the onset and development of cluster C personality disorders. However, the association between ACEs and these disorders remains unclear in terms of consistency across studies and effect magnitude, as well as generalizability within cluster C. The current meta-analysis aimed to examine the associations between ACEs and cluster C personality disorders based on the available literature.

METHODS

Systematic searches were conducted in PubMed, Scopus, Web of Science and PsychInfo. Forty-eight eligible studies were included in the analyses, and pooled effect sizes were estimated both at the level of cluster C and at the level of each specific disorder. Moderation and meta-regression analyses were also conducted.

RESULTS

ACEs were consistently associated with overall cluster C, as well as each of the specific disorders in this cluster. Sources of heterogeneity included type of instrument used to assess ACEs (questionnaires > interviews) and type of instrument used to assess the personality disorders (clinical interviews > questionnaires, as well as their combination with interview). The associations between ACEs and all cluster C personality disorders decreased with age.

CONCLUSIONS

ACEs are consistently associated with all cluster C personality disorders. Future work could approach the mechanisms underlying this association, preferably using longitudinal designs and considering the potential sources of effect variability identified in the present study.

Associations Between Cognitive Function and ACL Injury-Related Biomechanics: A Systematic Review

CONTEXT

Does lower baseline cognitive function predispose athletes to ACL injury risk, especially when performing unplanned or dual-task movements?

OBJECTIVE

To evaluate the association between cognitive function and biomechanics related to ACL injuries during cognitively challenging sports movements.

DATA SOURCES

PubMed (MEDLINE), Web of Science, Scopus, and SciELO databases were searched; additional hand searching was also conducted.

STUDY SELECTION

The following inclusion criteria had to be met: participants completed (1) a neurocognitive test, (2) a cognitively challenging sport-related task involving lower limbs, and (3) a biomechanical analysis. The following criteria determined exclusion from the review: studies involving participants with (1) recent or current musculoskeletal injuries; (2) recent or current concussion; (3) ACL surgical reconstruction, reviews of the literature, commentary or opinion articles, and case studies.

STUDY DESIGN

Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) statement and registered at the International Prospective Register of Systematic Reviews (PROSPERO).

LEVEL OF EVIDENCE

Level 3.

DATA EXTRACTION

Two of authors independently extracted data and assessed the methodological quality of the articles with the Downs and Black and ROBINS-I checklists, to assess methodological quality and risk of bias, respectively.

RESULTS

Six studies with different methodologies and confounding factors were included in this review. Of these 6 studies, 3 were ranked as high-quality, 3 demonstrated a low risk of bias, 2 a moderate risk, and 1 a severe risk. Five studies found a cognitive-motor relationship, with worse cognitive performance associated with increased injury risk, with 1 study reporting the opposite directionality for 1 variable. One study did not identify any interaction between cognitive function and biomechanical outcomes.

CONCLUSION

Worse cognitive performance is associated with an increased injury risk profile during cognitively challenging movements.

The neutral past: emotional (dys)regulation of autobiographical memory in behavioural variant frontotemporal dementia

BACKGROUND

While affective disturbances are a key symptomatic indicator of behavioural variant frontotemporal dementia (bvFTD), little is known about how patients process the emotional load of their autobiographical (i.e. personal) memories.

METHODS

We assessed the interplay of emotional regulation and autobiographical memory by inviting 18 bvFTD and 20 control participants to remember past personal events. For each memory, participants rated its emotional valence "then" (i.e. when the event has occurred) vs "now" (i.e. when retrieving the event).

RESULTS

Patients with bvFTD described their memories as neutral at both times (p = .85), while control participants rated their memories as more positive during "then" than during "now" (p = .013). Autobiographical retrieval triggered fewer emotional words (p < .001) and less specificity (p < .001) in bvFTD patients compared to control participants.

CONCLUSIONS

The lack of significant differences between the emotional characteristics during "then" than "now" in patients with bvFTD (and the flattening of both) may mirror their hampered ability for emotional generation, which may be associated with difficulties in reframing their past experiences to modify and adapt their meaning. The hampered emotional regulation in bvFTD may also be associated with an avoidance strategy and a passive attitude toward the past.

Montessori education's impact on academic and nonacademic outcomes: A systematic review

Background

Montessori education is the oldest and most widely implemented alternative education in the world, yet its effectiveness has not been clearly established.

Objectives

The primary objective of this review was to examine the effectiveness of Montessori education in improving academic and nonacademic outcomes compared to traditional education. The secondary objectives were to determine the degree to which grade level, Montessori setting (public Montessori vs. private Montessori), random assignment, treatment duration, and length of follow-up measurements moderate the magnitude of Montessori effects.

Search Methods

We searched for relevant studies in 19 academic databases, in a variety of sources known to publish gray literature, in Montessori-related journals, and in the references of studies retrieved through these searches. Our search included studies published during or before February 2020. The initial search was performed in March 2014 with a follow-up search in February 2020.

Selection Criteria

We included articles that compared Montessori education to traditional education, contributed at least one effect size to an academic or nonacademic outcome, provided sufficient data to compute an effect size and its variance, and showed sufficient evidence of baseline equivalency-through random assignment or statistical adjustment-of Montessori and traditional education groups.

Data Collection and Analysis

To synthesize the data, we used a cluster-robust variance estimation procedure, which takes into account statistical dependencies in the data. Otherwise, we used standard methodological procedures as specified in the Campbell Collaboration reporting and conduct standards.

Main Results

Initial searches yielded 2012 articles, of which 173 were considered in detail to determine whether they met inclusion/exclusion criteria. Of these, 141 were excluded and 32 were included. These 32 studies yielded 204 effect sizes (113 academic and 91 nonacademic) across 132,249 data points. In the 32 studies that met minimum standards for inclusion, including evidence of baseline equivalence, there was evidence that Montessori education outperformed traditional education on a wide variety of academic and nonacademic outcomes. For academic outcomes, Hedges' g effect sizes, where positive values favor Montessori, ranged from 0.26 for general academic ability (with high quality evidence) to 0.06 for social studies. The quality of evidence for language (g = 0.17) and mathematics (g = 0.22) was also high. The effect size for a composite of all academic outcomes was 0.24. Science was the only academic outcome that was deemed to have low quality of evidence according to the GRADE approach. Effect sizes for nonacademic outcomes ranged from 0.41 for students' inner experience of school to 0.23 for social skills. Both of these outcomes were deemed as having low quality of evidence. Executive function (g = 0.36) and creativity (g = 0.26) had moderate quality of evidence. The effect size for a composite of all nonacademic outcomes was 0.33. Moderator analyses of the composite academic and nonacademic outcomes showed that Montessori education resulted in larger effect sizes for randomized studies compared to nonrandomized studies, for preschool and elementary settings compared to middle school or high school settings, and for private Montessori compared to public Montessori. Moderator analyses for treatment duration and duration from intervention to follow-up data collection were inconclusive. There was some evidence for a lack of small sample-size studies in favor of traditional education, which could be an indicator of publication bias. However, a sensitivity analysis indicated that the findings in favor of Montessori education were nonetheless robust.

Authors' Conclusions

Montessori education has a meaningful and positive impact on child outcomes, both academic and nonacademic, relative to outcomes seen when using traditional educational methods.

Comparison of analog and digital patient decision aids for the treatment of depression: a scoping review

Introduction

Patient decision aids (PDAs) are important tools to empower patients and integrate their preferences and values in the decision-making process. Even though patients with mental health problems have a strong interest in being more involved in decision making about their treatment, research has mainly focused on PDAs for somatic conditions. In this scoping review, we focus on patients suffering from depression and the role of PDAs for this patient group. The review offers an overview of digital and analog PDAs, their advantages and disadvantages as well as recommendations for further research and development.

Methods

A systematic search of the existing literature guided by the Cochrane Handbook for Systematic Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - extension for scoping reviews (PRISMA-ScR) was conducted. Three electronic literature databases with the appropriate thematic focus were searched (PubMed, PsycInfo, and Web of Science). The search strategy used controlled and natural language to search for the key concepts decision aids and depression. The articles were selected in a two-step process guided by predefined inclusion and exclusion criteria. We narratively synthetized information extracted from 40 research articles.

Results

We included 40 articles in our review. Our review revealed that there is more focus on digital PDAs in research than in clinical practice. Digitalization can enhance the benefits of PDAs by developing tools that are more efficient, interactive, and personalized. The main disadvantages of both types of PDAs for the treatment of depression are related to time, dissemination, and capacity building for the health care providers. Digital PDAs need to be regularly updated, effective strategies for their dissemination and acceptance need to be identified, and clinicians need sufficient training on how to use digital PDAs. There is more research needed to study which forms of PDAs are most appropriate for various patient groups (e.g., older adults, or patients with comorbidities), and to identify the most effective ways of PDAs' integration in the clinical workflow. The findings from our review could be well aligned with the International Patient Decision Aids Standards.

Discussion

More research is needed regarding effective strategies for the implementation of digital PDAs into the clinical workflow, ethical issues raised by the digital format, and opportunities of tailoring PDAs for diverse patient groups.

Memory in Social Interactions: The Effects of Introspection on Destination Memory in Traumatic Brain Injury

Destination memory, which is the ability to remember to whom one has sent information, is intimately associated with social cognition. We assessed whether processing attributes of destinations would improve destination memory in patients with traumatic brain injury (TBI). In this cross-sectional study, we tested the destination memory of 24 patients with TBI and 25 control participants in two conditions. On the first one (control condition), we invited participants to tell proverbs to celebrities' faces in order to decide, on a subsequent recognition test, whether they previously told that proverb to that celebrity or not. On the second condition (experimental introspection condition), the same procedures were repeated. However, after telling the proverbs, we invited participants to introspect about what the destination might believe about the proverbs (e.g., "What do you think that the celebrities would think about the proverbs?"). Group comparisons demonstrated better destination memory after the introspection than when no introspection was implemented in control participants, but there were no significant differences between the two conditions in patients with TBI. However, analyses of individual profiles demonstrated that more than half (n = 13) of the patients with TBI demonstrated better destination memory after introspection. While these results demonstrate a beneficial effect of introspection on destination memory for some cases of patients with TBI, more research is needed to reveal how introspection may influence patients' memory in social interactions.

Brief imaginal exposure exercises for social anxiety disorder: A randomized controlled trial of a self-help momentary intervention app

INTRODUCTION

Emerging technological interventions for psychological disorders are being developed continually. Offering imaginal exposure exercises as a self-help intervention presents the opportunity to acquire foundational skills to address social anxiety. The current study evaluates the feasibility and effectiveness of a novel smartphone application for social interaction anxiety.

METHODS

Participants (n = 82) were adults meeting criteria for social anxiety disorder. They were randomly assigned to imaginal exposure (IE; n = 39) or self-monitoring (n = 43) delivered multiple times daily via a smartphone application for a one-week trial. It was expected that participants using the IE exercises would demonstrate significantly greater declines in social anxiety in addition to increases in self-efficacy and that compliance would serve as a predictor of outcome. Mixed-effects models were utilized.

RESULTS

Participants using IE (vs. self-monitoring) evidenced significantly greater reductions in social anxiety from pre- to post-treatment and at 1-month follow-up. Similarly, IE (vs. self-monitoring) led to significantly greater increases in self-efficacy from pre- to post-treatment and 1-month follow-up. Further, more completed IE exercises predicted significantly greater changes in social anxiety and self-efficacy at subsequent timepoints compared with self-monitoring.

CONCLUSIONS

Findings suggest that a brief IE self-help intervention was effective in targeting social interaction anxiety.

Serial dependence in visual perception: A meta-analysis and review

Positive sequential dependencies are phenomena in which actions, perception, decisions, and memory of features or objects are systematically biased toward visual experiences from the recent past. Among many labels, serial dependencies have been referred to as priming, sequential dependencies, sequential effects, or serial effects. Despite extensive research on the topic, the field still lacks an operational definition of what counts as serial dependence. In this meta-analysis, we review the vast literature on serial dependence and quantitatively assess its key diagnostic characteristics across several different domains of visual perception. The meta-analyses fully characterize serial dependence in orientation, face, and numerosity perception. They show that serial dependence is defined by four main kinds of tuning: serial dependence decays with time (temporal-tuning), it depends on relative spatial location (spatial-tuning), it occurs only between similar features and objects (feature-tuning), and it is modulated by attention (attentional-tuning). We also review studies of serial dependence that report single observer data, highlighting the importance of individual differences in serial dependence. Finally, we discuss a range of outstanding questions and novel research avenues that are prompted by the meta-analyses. Together, the meta-analyses provide a full characterization of serial dependence as an operationally defined family of visual phenomena, and they outline several of the key diagnostic criteria for serial dependence that should serve as guideposts for future research.

How different is the remediation effect of biochar for cadmium contaminated soil in various cropping systems? A global meta-analysis

Cadmium (Cd) poses great threats to human health as a major contaminant in agricultural soil. Biochar shows great potential in the remediation of agricultural soil. However, it remains unclear whether the remediation effect of biochar on Cd pollution is affected by various cropping systems. Here, this study used 2007 paired observations from 227 peer-reviewed articles and employed hierarchical meta-analysis to investigate the response of three types of cropping systems to the remediation of Cd pollution by using biochar. As a result, biochar application significantly reduced the Cd content in soil, plant roots and edible parts of various cropping systems. The decrease in Cd level ranged from 24.9% to 45.0%. The feedstock, application rate, and pH of biochar as well as soil pH and cation exchange capacity were dominant factors for Cd remediation effect of biochar, and their relative importance all exceeded 37.4%. Lignocellulosic and herbal biochar were found to be suitable for all cropping systems, while the effects of manure, wood and biomass biochar were limited in cereal cropping systems. Furthermore, biochar exhibited a more long-lasting remediation effect on paddy soils than on dryland. This study provides new insights into the sustainable agricultural management of typical cropping systems.

Estimating measurement equivalence of the 12-item General Health Questionnaire across ethnic groups in the UK

BACKGROUND

This study investigates the extent to which the GHQ-12 exhibits configural, metric and scalar invariance across six ethnic groups in Britain and Northern Ireland, using the UK Household Longitudinal Study (N = 35 410).

METHODS

A confirmatory factor analysis was carried out on a white British group in order to establish an adequate measurement model. Secondly, a multi-group confirmatory factor analysis was conducted in order to assess measurement invariance. A sensitivity analysis comparing summated and latent means across groups was carried out. Finally, revised estimates of scale reliability were derived using two different methods.

RESULTS

A one-factor model including correlated error terms on the negatively phrased items showed superior fit in all ethnic groups. Tests for equal factor loadings and intercepts also showed adequate fit demonstrating metric and scalar invariance. Latent and summated scale estimates of mean group differences were similar for all groups. Scale reliability using McDonald's ω is lower than when using the more conventional Cronbach's α. Reliability across groups is reasonably consistent.

CONCLUSIONS

We find that the GHQ-12 does not display obvious bias in regard to ethnic groups in the UK and that valid comparisons across these groups can be made for the purposes of population research. Caution is needed when using as a screening tool for individuals.

The association between eating disorders and mental health: an umbrella review

OBJECTIVE

There have been an increasing number of systematic reviews indicating the association between eating disorders (ED), including its risk factors, with mental health problems such as depression, suicide and anxiety. The objective of this study was to conduct an umbrella review of these reviews and provide a top-level synthesis of the current evidence in this area.

METHOD

A systematic search was performed using four databases (MEDLINE Complete, APA PyscInfo, CINAHL Complete and EMBASE). The inclusion criteria were systematic reviews (with or without meta-analysis), published in the English language between January 2015 and November 2022. The quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal tools for use of JBI Systematic reviews.

RESULTS

A total of 6,537 reviews were identified, of which 18 reviews met the inclusion criteria, including 10 reviews with meta-analysis. The average quality assessment score for the included reviews was moderate. Six reviews investigated the association between ED and three specific mental health problems: (a) depression and anxiety, (b) obsessive-compulsive symptoms and (c) social anxiety. A further 3 reviews focused on the relationship between ED and attention deficit hyperactivity disorder (ADHD) while 2 reviews focused on ED and suicidal-related outcomes. The remaining 7 reviews explored the association between ED and bipolar disorders, personality disorders, and non-suicidal self-injury. Depression, social anxiety and ADHD are likely to have a stronger strength of association with ED relative to other mental health problems.

DISCUSSION

Mental health problems such as depression, social anxiety and ADHD were found to be more prevalent among people suffering from eating disorders. Further research is necessary to understand the mechanism and health impacts of potential comorbidities of ED.

Intolerance of uncertainty and emotion regulation: A meta-analytic and systematic review

Intolerance of uncertainty, a transdiagnostic factor manifested across emotional disorders, has been associated with difficulties in regulating emotions. This meta-analysis addresses the lack of synthesis of this relationship. PsycInfo, PubMed, Scopus, and ProQuest were systematically searched for relevant articles published up to and during November 2022. We combined 161 effect sizes from 91 studies (N = 30,239), separating the analysis into maladaptive and adaptive emotion regulation strategies and their association with intolerance of uncertainty. We found a moderate positive relationship between maladaptive, and a moderate inverse relationship between adaptive emotion regulation and intolerance of uncertainty. Analysing the magnitude of relationships revealed that cognitive avoidance and mindfulness were the maladaptive and adaptive strategies respectively which had the largest effect sizes and thus strongest relationships with intolerance of uncertainty. Combining all strategies, cognitive avoidance remained the largest effect size, while expressive suppression had the smallest effect size and was non-significant in its relationship. Further analyses testing study sample, design, and age as moderators found no significant moderator for the relationships between intolerance of uncertainty and emotion regulation strategies. These findings have implications for future intolerance of uncertainty interventions, with emotion regulation as a potential target of change.

Disentangling the Relationships Between the Clinical Symptoms of Schizophrenia Spectrum Disorders and Theory of Mind: A Meta-analysis

BACKGROUND AND HYPOTHESIS

Previous studies have suggested links between clinical symptoms and theory of mind (ToM) impairments in schizophrenia spectrum disorders (SSD), but it remains unclear whether some symptoms are more strongly linked to ToM than others.

STUDY DESIGN

A meta-analysis (Prospero; CRD42021259723) was conducted to quantify and compare the strength of the associations between ToM and the clinical symptoms of SSD (Positive, Negative, Cognitive/Disorganization, Depression/Anxiety, Excitability/Hostility). Studies (N = 130, 137 samples) including people with SSD and reporting a correlation between clinical symptoms and ToM were retrieved from Pubmed, PsycNet, Embase, Cochrane Library, Science Direct, Proquest, WorldCat, and Open Gray. Correlations for each dimension and each symptom were entered into a random-effect model using a Fisher's r-to-z transformation and were compared using focused-tests. Publication bias was assessed with the Rosenthal failsafe and by inspecting the funnel plot and the standardized residual histogram.

STUDY RESULTS

The Cognitive/Disorganization (Zr = 0.28) and Negative (Zr = 0.24) dimensions revealed a small to moderate association with ToM, which was significantly stronger than the other dimensions. Within the Cognitive/Disorganization dimension, Difficulty in abstract thinking (Zr = 0.36) and Conceptual disorganization (Zr = 0.39) showed the strongest associations with ToM. The association with the Positive dimension (Zr = 0.16) was small and significantly stronger than the relationship with Depression/Anxiety (Zr = 0.09). Stronger associations were observed between ToM and clinical symptoms in younger patients, those with an earlier age at onset of illness and for tasks assessing a combination of different mental states.

CONCLUSIONS

The relationships between Cognitive/Disorganization, Negative symptoms, and ToM should be considered in treating individuals with SSD.

Effectiveness of Drama-Based Intervention in Improving Mental Health and Well-Being: A Systematic Review and Meta-Analysis during the COVID-19 Pandemic and Post-Pandemic Period

As a creative form of psychotherapy, drama appears to assist individuals in the COVID-19 pandemic and post-pandemic period in altering crisis conditions and challenging negative perspectives. Drama-based intervention is presented as an option for addressing mental health issues in clinical and general populations by utilising various multidisciplinary sources, such as psychodrama and role playing. In this study, a systematic review and meta-analysis were employed to assess the impact of drama on mental health and well-being during the COVID-19 pandemic and post-pandemic. Four electronic databases (PubMed, Cochrane, Web of Science, and ScienceDirect) were extensively searched from December 2019 to October 2022. Quality assessment and Risk of Bias tool of the Cochrane Collaboration were performed. Using a random effect model, standardised mean difference (SMD) values and 95% confidence intervals (CI) were calculated. In the final analysis, 25 studies involving 797 participants were included. The study revealed that drama-based interventions have the potential to improve mental health (e.g., trauma-related disorders) and well-being (e.g., psychological well-being), which could position drama as an adjunctive method of mental health care. This original review offered the newer, more comprehensive recommendations for drama-based intervention based on evidence.