Application of Heterogeneity of Treatment-Effects Methods: Exploratory Analyses of a Trial of Exercise-Based Interventions for Knee Osteoarthritis

Objective: To evaluate heterogeneity of treatment effects in a trial of exercise-based interventions for knee osteoarthritis (OA). Methods: Participants (n = 350) were randomized to standard physical therapy (PT; n = 140), internet-based exercise training (IBET; n = 142), or wait list (WL; n = 68) control. We applied qualitative interaction trees (QUINT), a sequential partitioning method, and generalized unbiased interaction detection and estimation (GUIDE), a regression tree approach, to identify subgroups with greater improvements in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score over 4 months. Predictors included 24 demographic, clinical, and psychosocial characteristics. We conducted internal validation to estimate optimism (bias) in the range of mean outcome differences among arms. Results: Both QUINT and GUIDE indicated that for participants with lower body mass index (BMI), IBET was better than PT (improvements of WOMAC ranged from 6.3 to 9.1 points lower), and for those with higher BMI and a longer duration of knee OA, PT was better than IBET (WOMAC improvement was 6.3 points). In GUIDE analyses comparing PT or IBET to WL, participants not employed had improvements in WOMAC ranging from 1.8 to 6.8 points lower with PT or IBT versus WL. From internal validation, there were large corrections to the mean outcome differences among arms; however, after correction, some differences remained in the clinically meaningful range. Conclusion: Results suggest there may be subgroups who experience greater improvement in symptoms from PT or IBET, and this finding could guide referrals and future trials. However, uncertainty persists for specific treatment-effects size estimates and how they apply beyond this study sample

The health care and life sciences community profile for dataset descriptions

Access to consistent, high-quality metadata is critical to finding, understanding, and reusing scientific data. However, while there are many relevant vocabularies for the annotation of a dataset, none sufficiently captures all the necessary metadata. This prevents uniform indexing and querying of dataset repositories. Towards providing a practical guide for producing a high quality description of biomedical datasets, the W3C Semantic Web for Health Care and the Life Sciences Interest Group (HCLSIG) identified Resource Description Framework (RDF) vocabularies that could be used to specify common metadata elements and their value sets. The resulting guideline covers elements of description, identification, attribution, versioning, provenance, and content summarization. This guideline reuses existing vocabularies, and is intended to meet key functional requirements including indexing, discovery, exchange, query, and retrieval of datasets, thereby enabling the publication of FAIR data. The resulting metadata profile is generic and could be used by other domains with an interest in providing machine readable descriptions of versioned datasets

Responses of erectile tissue from impotent men to pharmacological agents

Erectile tissue was removed from the corpora cavernosa of 25 impotent men undergoing surgery for insertion of penile prostheses. Strips, set up in an organ bath, were contracted by the alpha-adrenergic agonist phenylephrine. There was no significant difference between tissue taken from men with diabetes, alcoholism, Peyronie's disease or men with no obvious condition causing the impotence. The sensitivity of tissues from hypertensive patients was significantly reduced but this was probably due to drugs being taken for hypertension. Precontracted tissues could be relaxed by acetylcholine or isoprenaline. The responses, however, were inconsistent, so that no difference between the different groups of patients was apparent

Does Risk for Bipolar Disorder Heighten the Disconnect between Objective and Subjective Appraisals of Cognition?

Deficits in cognitive functioning have been associated with bipolar disorder during episodes of depression and mania, as well as during periods of symptomatic remission. Separate evidence suggests that patients may lack awareness of these deficits and may even be overly confident with self-appraisals. The extent to which these separately or together represent prodromes of the disorder versus a consequence of the disorder remains unclear. The present study sought to test whether risk for bipolar disorder in a younger, college-aged cohort of individuals would be associated with lower performance in cognitive ability yet higher self-appraisal of cognitive functioning. METHOD: Participants (N=128) completed an objective measure of working memory, a self-report measure of everyday cognitive deficits, and a measure associated with risk for bipolar disorder. RESULTS: Contrary to expectation, risk for bipolar disorder did not significantly predict poorer working memory. However, a person\u27s risk for bipolar disorder was associated with higher self-appraisal of cognitive functioning relative to those with lower risk despite there being no indication of a difference in ability on the working memory task. LIMITATIONS: Participant recruitment relied on an analog sample; moreover, assessment of cognitive functioning was limited to working memory. CONCLUSIONS: Results add to a growing body of evidence indicating that overconfidence may be part of the cognitive profile of individuals at risk for bipolar disorder

Measurements of plastic localization by heaviside-digital image correlation

International audienceIn polycrystalline metallic materials, quantitative and statistical assessment of the plasticity in relation to the microstructure is necessary to understand the deformation processes during mechanical loading. Plastic deformation often localizes into physical slip bands at the sub-grain scale. Detrimental microstructural configurations that result in the formation and evolution of slip bands during loading require advanced strain mapping techniques for the identification of these atomically sharp discontinuities. A new discontinuity-tolerant DIC method, Heaviside-DIC, has been developed to account for discontinuities in the displacement field. Displacement fields have been measured at the scale of the physical slip bands over large areas in nickel-based superalloys by high resolution scanning electron microscopy digital image correlation (SEM DIC). However, conventional DIC methods cannot quantitatively measure plastic localization in the presence of discontinuous kinematic fields such as those produced by slip bands. The Heaviside-DIC technique can autonomously detect discontinuities, providing information about their location, inclination, and identify slip systems (in combination with orientation mapping). Using Heaviside-DIC, discontinuities are physically evaluated as sharp shear-localization events, allowing for the quantitative measure of strain amplitude nearby the discontinuities. Measurements using the new Heaviside-DIC technique are compared to conventional DIC methods for identical materials and imaging conditions