Item-level and Composite-level Interrater Reliability of Functional Movement Screen™ Scores Following Condensed Training in Novice Raters

BACKGROUND The Functional Movement Screen™ (FMS™) is a clinical instrument designed to use movement behaviors to screen individuals for injury risk. Current rater certification programs focus on extensive, individualized training, which may not be appropriate in all screening contexts. PURPOSE The purpose of this research was to examine the effect of a two-hour FMSTM training seminar on measures of reliability between previously untrained scorers. STUDY DESIGN Repeated measures, descriptive cohort study. METHODS Four novice raters completed a two-hour training course administered by an FMS™-certified, licensed physical therapist. The novices and the instructor then scored a group of 16 individuals on the seven FMS™ component tests on two separate occasions. Interrater reliability was assessed for FMS™ component scores using Fleiss’ kappa and Krippendorff’s α. Interrater reliability for the FMS™ composite score was assessed using a two-way ICC for agreement (a priori significance level=0.05). RESULTS Reliability ranged from fair to almost perfect (kappa) for Deep Squat (0.61 Day 1, 0.79 Day 2), Shoulder Mobility (0.90 Day 1, 1.00 Day 2), Active Straight Leg Raise (0.53 Day 1, 0.69 Day 2), and Trunk Stability Push Up (0.48 Day 1, 0.49 Day 2) on both testing occurrences (p CONCLUSIONS Findings suggest that a brief training seminar may be sufficient to ensure acceptable reliability in many, but not all, of the FMS™ component tests and composite score. Levels of Evidence Level 2

Ariel - Volume 7 Number 2

Editors Mark Dembert Frank Chervanek John Lammie Jim Burke Curt Cumming

Integrating Glenohumeral Range of Motion with Dynamic Postural Control for Early Detection of Elbow Injury Risk in Collegiate Baseball Pitchers: A Preliminary Prospective Case Series

Introduction: Medial elbow ulnar collateral ligament (UCL) injuries are common in baseball with increased surgical incidence in pitchers. There is no consensus on which modifiable injury risk metrics or performance screening tools to use to identify at risk collegiate baseball pitchers. Current literature on UCL injury risk has focused on local passive glenohumeral rotational motion with limited forays into more global movement patterns. The aim of this study was to assess possible relationships involving UCL injuries and modifiable local and global motor control performance risk factors. Material and Methods: An observational single cohort case series involving 15 collegiate baseball pitchers aimed to elucidate disparitites in glenohumeral active and passive range of motion alongside an assessment of general movement competency and dynamic motor control performance to identify injury risk for the UCL. Preseaon baseline metrics, including the Functional Movement Screen, Upper and Lower Quarter Y Balance Test, and glenohumaral internal and external rotation active, passive, and total arc range of motion were examined. Results: The two pitchers with UCL injury demonstrated less ability to actively move into their available passive rotational range with decreased lower extremity dynamic postural control, but no difference with general movement competency. The pitcher requiring UCL surgical intervention demonstrated even greater excessive passive range compared to the other injured pitcher and a decreased ability to control base of support during the dynamic single-leg balance performance test. Discussion: Participants with UCL injuries exibited noticable deficiencies in baseline active and passive mobility, suggestive of a potential motor control deficit and a compromised ability to fully access available range of motion. Furthermore, diminished performance on the Lower Quarter Y Balance Test identified potential motor control limitations involving a decreased ability to dynamically maintain a base of support. Conclusions: This is the first study designed to identify motor control issues in the both the local shoulder region and global body movement to identify modifiable risk factors for UCL injuries in baseball pitchers. This study may begin to address the gap in the literature by combining modifiable local shoulder range of motion and global balance metrics to identify pitchers at risk for UCL injuries. It underscores the significance of comparing active and passive range of motion in tandem with dynamic postural control assessments to better evaluate the risk of injuries in baseball pitchers. This case series lays the groundwork for future randomized clinical trials to evaluate the utiliity of combining this information

An Innovative Approach to Decreasing Concussions in Adolescent Female Soccer Athletes: 2370 Board #117 May 29, 9

Concussion is a public health issue, fundamental to health promotion and injury prevention. Concussions are prevalent in adolescent athletic competition, in high-collision and non-collision sports. A history of previous concussion increases risk by a factor of three, female gender increases it 1.5 to 2.5 times, and female middle-school soccer players have 22.9 times increased risk during games. Non-collision concussions (indirect) may be primed by altered movement patterns from previous injuries, disruption of cervical proprioception, or musculoskeletal pain. Assessment of dynamic balance and functional movement allows identification of poor movement patterns or control. PURPOSE: To assess a preventative movement-based warm-up routine designed to re-set aberrant afferent information from various systems (vestibular, somatic, ocular) for a cohort of high school female soccer players with prior concussions. METHODS: A retrospective cohort study of convenience consisting of 17 Virginian high school female soccer athletes ages 15 to 18 during 2013-2014 season. Three players had suffered a concussion within the last 6 to 8 months. Athletes were assessed pre-season using the Lower Quarter Y-balance test (LQ-YBT) and the Functional Movement Screen (FMS). Cohort was instructed in a general warm-up placing emphasis on normalizing movement patterns (identified via the YBT and FMS), vestibular ocular reflex, and ACL-prevention exercises, which was performed during the entire season before practices and games. RESULTS: Sixteen varsity high school female soccer athletes, ages 14 to 18 years, participated. The average FMS composite score was 15±2, with 2 athletes being below the injury risk score of 14, and another 3 scoring right at the cutoff. The difference from side to side for the composite LQ-YBT ranged from 5 - 8cm. A total of 10 athletes had differences, with 6 of the athletes had an anterior difference of ≥4cm, and 6 had a posterior difference of ≥6cm. These levels are predictive of a deficit in dynamic balance. There were no new, or repeat concussions during the soccer season. CONCLUSIONS: The finding of no new or repeat concussions, suggests that the intervention may have helped and may indicate a new injury prevention paradigm

Test-Retest Reliability of Postural Control Assessment on Biodex BioSway™

Background. Recent protocols for posturographic assessment of postural control and balance have included head shake test conditions to challenge the vestibular contributions of postural control in an effort to increase the diagnostic accuracy of identifying individuals with impaired balance. However, evidence is limited regarding the test-retest reliability of such assessment protocols. Purpose. The purpose of this study was twofold: to determine the test-retest reliability of postural control assessment on the Biodex Biosway™, an accessible and field expedient tool for posturographic assessment, and to determine the test-retest reliability of the Head Shake Sensory Interaction and Balance Test (HS-SIB), an adaptation of the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) which adds two head shake conditions to challenge the vestibular contributions to postural control. Study Design. This was a correlational time series cohort study completed in a biomechanics laboratory. Methods. The sample consisted of nineteen healthy adults (10 females, 9 males). Sway Index, Equilibrium Score, and the area of the ellipse enclosing 95% of the anterior-posterior (AP) and medial-lateral (ML) center of gravity (COG) displacement (AREA95) are the 3 summary variables. Standard Error of Measurement (SEM) and Minimum Detectable Change (MDC) are also reported. Results. Test-retest reliability was generally poor with limited exceptions. Moderate to good reliability was observed for the more challenging stance conditions (ICC range 0.58-0.81), including those with head shake. Conclusions. Field-expedient systems, such as the Biodex BioSway™, may offer reliable posturographic testing where gold-standard methods are not available. Clinicians should be aware that less demanding test conditions have limited reliability; however, test-retest reliability of this assessment tool is improved with more challenged stance conditions and the inclusion of a head shake task

Molecular mechanisms of cell death: recommendations of the Nomenclature Committee on Cell Death 2018.

Over the past decade, the Nomenclature Committee on Cell Death (NCCD) has formulated guidelines for the definition and interpretation of cell death from morphological, biochemical, and functional perspectives. Since the field continues to expand and novel mechanisms that orchestrate multiple cell death pathways are unveiled, we propose an updated classification of cell death subroutines focusing on mechanistic and essential (as opposed to correlative and dispensable) aspects of the process. As we provide molecularly oriented definitions of terms including intrinsic apoptosis, extrinsic apoptosis, mitochondrial permeability transition (MPT)-driven necrosis, necroptosis, ferroptosis, pyroptosis, parthanatos, entotic cell death, NETotic cell death, lysosome-dependent cell death, autophagy-dependent cell death, immunogenic cell death, cellular senescence, and mitotic catastrophe, we discuss the utility of neologisms that refer to highly specialized instances of these processes. The mission of the NCCD is to provide a widely accepted nomenclature on cell death in support of the continued development of the field

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Search for heavy resonances decaying to two Higgs bosons in final states containing four b quarks

A search is presented for narrow heavy resonances X decaying into pairs of Higgs bosons (H) in proton-proton collisions collected by the CMS experiment at the LHC at root s = 8 TeV. The data correspond to an integrated luminosity of 19.7 fb(-1). The search considers HH resonances with masses between 1 and 3 TeV, having final states of two b quark pairs. Each Higgs boson is produced with large momentum, and the hadronization products of the pair of b quarks can usually be reconstructed as single large jets. The background from multijet and t (t) over bar events is significantly reduced by applying requirements related to the flavor of the jet, its mass, and its substructure. The signal would be identified as a peak on top of the dijet invariant mass spectrum of the remaining background events. No evidence is observed for such a signal. Upper limits obtained at 95 confidence level for the product of the production cross section and branching fraction sigma(gg -> X) B(X -> HH -> b (b) over barb (b) over bar) range from 10 to 1.5 fb for the mass of X from 1.15 to 2.0 TeV, significantly extending previous searches. For a warped extra dimension theory with amass scale Lambda(R) = 1 TeV, the data exclude radion scalar masses between 1.15 and 1.55 TeV