Protocol of the COSMIN study: COnsensus-based Standards for the selection of health Measurement INstruments

BACKGROUND: Choosing an adequate measurement instrument depends on the proposed use of the instrument, the concept to be measured, the measurement properties (e.g. internal consistency, reproducibility, content and construct validity, responsiveness, and interpretability), the requirements, the burden for subjects, and costs of the available instruments. As far as measurement properties are concerned, there are no sufficiently specific standards for the evaluation of measurement properties of instruments to measure health status, and also no explicit criteria for what constitutes good measurement properties. In this paper we describe the protocol for the COSMIN study, the objective of which is to develop a checklist that contains COnsensus-based Standards for the selection of health Measurement INstruments, including explicit criteria for satisfying these standards. We will focus on evaluative health related patient-reported outcomes (HR-PROs), i.e. patient-reported health measurement instruments used in a longitudinal design as an outcome measure, excluding health care related PROs, such as satisfaction with care or adherence. The COSMIN standards will be made available in the form of an easily applicable checklist. METHOD: An international Delphi study will be performed to reach consensus on which and how measurement properties should be assessed, and on criteria for good measurement properties. Two sources of input will be used for the Delphi study: (1) a systematic review of properties, standards and criteria of measurement properties found in systematic reviews of measurement instruments, and (2) an additional literature search of methodological articles presenting a comprehensive checklist of standards and criteria. The Delphi study will consist of four (written) Delphi rounds, with approximately 30 expert panel members with different backgrounds in clinical medicine, biostatistics, psychology, and epidemiology. The final checklist will subsequently be field-tested by assessing the inter-rater reproducibility of the checklist. DISCUSSION: Since the study will mainly be anonymous, problems that are commonly encountered in face-to-face group meetings, such as the dominance of certain persons in the communication process, will be avoided. By performing a Delphi study and involving many experts, the likelihood that the checklist will have sufficient credibility to be accepted and implemented will increase

Analysis of the Diversity of Megachilidae Bees on the Northern Subplateau of the Iberian Peninsula

In the western Mediterranean, 772 species of bees in the family Megachilidae have been reported. Special emphasis has been placed on the Iberian Peninsula, where to date 218 species are known. However, few intensive studies providing information about communities of Megachilidae have been carried out. Two earlier works cite 70 species; almost one third of those known on the Peninsula. With an aim of gaining insight into the structure of the communities of Megachilidae and the factors influencing them, an analysis was made of the alpha and beta diversity of different localities in the northern subplateau. Malaise traps (black and white) were used, and 559 specimens belonging to 55 species were identified of which most exhibited a nest-holder-type nesting habit. Abundance and richness were higher for white traps, although a considerable degree of complementarity was observed with the black traps. In the study zone, diversity can be considered medium-high with a phylogenetic diversity corresponding to stable populations. Regarding the composition of the Megachilidae communities, the influence of the landscape structure, of the microhabitat, and of the colour of the trap used to collect the specimens was detected. The following are recommended: (1) the use of both black and white traps, since they show high complementarity and offer different information about community structure, (2) homogenization of the samples in comparisons among communities, owing to the influence of the color of the trap, which masks the importance of ecological factors in community structuring, and (3) the collection of samples from at least two years previous, in view of the elevated “replacement” of species observed with species richness estimators

Characterisation of a 3-hydroxypropionic acid-inducible system from Pseudomonas putida for orthogonal gene expression control in Escherichia coli and Cupriavidus necator

3-hydroxypropionic acid (3-HP) is an important platform chemical used as a precursor for production of added-value compounds such as acrylic acid. Metabolically engineered yeast, Escherichia coli, cyanobacteria and other microorganisms have been developed for the biosynthesis of 3-HP. Attempts to overproduce this compound in recombinant Pseudomonas denitrificans revealed that 3-HP is consumed by this microorganism using the catabolic enzymes encoded by genes hpdH, hbdH and mmsA. 3-HP-inducible systems controlling the expression of these genes have been predicted in proteobacteria and actinobacteria. In this study, we identify and characterise 3-HP-inducible promoters and their corresponding LysR-type transcriptional regulators from Pseudomonas putida KT2440. A newly-developed modular reporter system proved possible to demonstrate that PpMmsR/PmmsA and PpHpdR/PhpdH are orthogonal and highly inducible by 3-HP in E. coli (12.3- and 23.3-fold, respectively) and Cupriavidus necator (51.5- and 516.6-fold, respectively). Bioinformatics and mutagenesis analyses revealed a conserved 40-nucleotide sequence in the hpdH promoter, which plays a key role in HpdR-mediated transcription activation. We investigate the kinetics and dynamics of the PpHpdR/PhpdH switchable system in response to 3-HP and show that it is also induced by both enantiomers of 3-hydroxybutyrate. These findings pave the way for use of the 3-HP-inducible system in synthetic biology and biotechnology applications

Pollination and biological control research: are we neglecting two billion smallholders

Food insecurity is a major world problem, with ca. 870 million people in the world being chronically undernourished. Most of these people live in tropical, developing regions and rely on smallholder farming for food security. Solving the problem of food insecurity is thought to depend, in part, on managing ecosystem services, such as the pollination of crops and the biological control of crop pests, to enhance or maintain food production. Our knowledge regarding regulating ecosystem services in smallholder-farmed (or dualistic) landscapes is limited and whilst pollination has been the focus of considerable research, the provision of natural enemy services, important for every crop worldwide, has been relatively neglected. In order to assess whether ecosystem-service research adequately represents smallholder-farmed landscapes, whilst also considering climatic region and national economic status, we examined the constituent studies of recent quantitative reviews relevant to biological control and pollination. No regulating ecosystem service meta-analysis, to our knowledge, has focussed on smallholder agriculture despite its importance to billions of peoples’ local food security. We found that whilst smallholdings contributed 16% of global farmland area and 83% of the global agricultural population (estimated using FAO’s World Census of Agriculture 2000) only 22 of 190 studies (12%), overall, came from smallholder-farmed landscapes. These smallholder studies mostly concerned coffee production (16 studies). Individual reviews of biological control were significantly and strongly biased towards data from large-scale farming in temperate regions. In contrast pollination reviews included more smallholder studies and were more balanced for climate regions. The high diversity of smallholder-farmed landscapes implies that more research will be needed to understand them compared to large-scale landscapes but we found far more research from the latter. We highlight that these skews in research effort have implications for sustainable intensification and the food security of billions in the developing world. In particular we urge for balance in future ecosystem-services research and synthesis by greater consideration of a diverse range of smallholder-farmed landscapes in Africa and continental Asia

Factor structure of the Shoulder Pain and Disability Index in patients with adhesive capsulitis

<p>Abstract</p> <p>Background</p> <p>The Shoulder Pain and Disability Index (SPADI) is a self-administered questionnaire that aims to measure pain and disability associated with shoulder disease. It consists of a pain section and a disability section with 13 items being responded to on visual analogue scales. Few researchers have investigated SPADI validity in specified diagnostic groups, although the selection of an evaluative instrument should be based on evidence of validity in the target patient group. The aim of the present study was to investigate factor structure of the SPADI in a study population of patients with adhesive capsulitis.</p> <p>Methods</p> <p>The questionnaire was administered to 191 patients with adhesive capsulitis. Descriptive statistics for items and a comparison of scores for the two subscales were produced. Internal consistency was analyzed by use of the Cronbach alpha and a principal components analysis with varimax rotation was conducted. Study design was cross-sectional.</p> <p>Results</p> <p>Two factors were extracted, but the factor structure failed to support the original division of items into separate pain and disability sections.</p> <p>Conclusion</p> <p>We found minimal evidence to justify the use of separate subscales for pain and disability. It is our impression that the SPADI should be viewed as essentially unidimensional in patients with adhesive capsulitis.</p

Optimal foraging and fitness in Columbian ground squirrels

Optimal diets were determined for each of 109 individual Columbian ground squirrels ( Spermophilus columbianus ) at two sites in northwestern Montana. Body mass, daily activity time, and vegetation consumption rates for individuals were measured in the field, along with the average water content of vegetation at each ground squirrel colony. I also measured stomach and caecal capacity and turnover rate of plant food through the digestive tract for individuals in the laboratory to construct regressions of digestive capacity as a function of individual body mass. Finally, I obtained literature estimates of average daily energy requirements as a function of body mass and digestible energy content of vegetation. These data were used to construct a linear programming diet model for each individual. The model for each individual was used to predict the proportion of two food types (monocots and dicots) that maximized daily energy intake, given time and digestive constraints on foraging. Individuals were classified as “optimal” or “deviating”, depending on whether their observed diet was significantly different from their predicted optimal diet. I determined the consequences of selecting an optimal diet for energy intake and fitness. As expected, daily energy intake calculated for deviators (based on their observed diet proportion) was less than that for optimal foragers. Deviating foragers do not appear to compensate for their lower calculated energy intake through other factors such as body size or physiological efficiency of processing food. Growth rate, yearly survivorship, and litter size increase with calculated energy intake, and optimal foragers have six times the reproductive success of deviators by age three. Optimal foraging behavior, therefore, appears to confer a considerable fitness advantage.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47783/1/442_2004_Article_BF00318534.pd

All-arthroscopic versus mini-open repair of small or moderate-sized rotator cuff tears: A protocol for a randomized trial [NCT00128076]

BACKGROUND: Rotator cuff tears are the most common source of shoulder pain and disability. Only poor quality studies have compared mini-open to arthroscopic repair, leaving surgeons with inadequate evidence to support optimal, minimally-invasive repair. METHODS/DESIGN: This randomized, multi-centre, national trial will determine whether an arthroscopic or mini-open repair provides better quality of life for patients with small or moderate-sized rotator cuff tears. A national consensus meeting of investigators in the Joint Orthopaedic Initiative for National Trials of the Shoulder (JOINTS Canada) identified this question as the top priority for shoulder surgeons across Canada. The primary outcome measure is a valid quality-of-life scale (Western Ontario Rotator Cuff (WORC)) that addresses 5 domains of health affected by rotator cuff disease. Secondary outcomes will assess rotator cuff functionality (ROM, strength, Constant score), secondary dimensions of health (general health status (SF-12) and work limitations), and repair integrity (MRI). Outcomes are measured at baseline, at 6 weeks, 3, 6, 12, and 24 months post-operatively by blinded research assistants and musculoskeletal radiologists. Patients (n = 250) with small or medium-sized cuff tears identified by clinical examination and MRI who meet eligibility criteria will be recruited. This sample size will provide 80% power to statistically detect a clinically important difference of 20% in WORC scores between procedures after controlling for baseline WORC score (α = 0.05). A central methods centre will manage randomization, data management, and monitoring under supervision of experienced epidemiologists. Surgeons will participate in either conventional or expertise-based designs according to defined criteria to avoid biases from differential surgeon expertise. Mini-open or all-arthroscopic repair procedures will be performed according to a standardized protocol. Central Adjudication (of cases), Trial Oversight and Safety Committees will monitor trial conduct. We will use an analysis of covariance (ANCOVA), where the baseline WORC score is used as a covariate, to compare the quality of life (WORC score) at 2 years post-operatively. As a secondary analysis, we will conduct the same statistical test but will include age and tear size as covariates with the baseline score. Enrollment will require 2 years and follow-up an additional 2 years. The trial will commence when funding is in place. DISCUSSION: These results will have immediate impact on the practice behaviors of practicing surgeons and surgical trainees at JOINTS centres across Canada. JOINTS Canada is actively engaged in knowledge exchange and will publish and present findings internationally to facilitate wider application. This trial will establish definitive evidence on this question at an international level

Treatment of myofascial trigger points in common shoulder disorders by physical therapy: A randomized controlled trial [ISRCTN75722066]

Contains fulltext : 52454.pdf (publisher's version ) (Open Access

Friends and Foes from an Ant Brain's Point of View – Neuronal Correlates of Colony Odors in a Social Insect

Background: Successful cooperation depends on reliable identification of friends and foes. Social insects discriminate colony members (nestmates/friends) from foreign workers (non-nestmates/foes) by colony-specific, multi-component colony odors. Traditionally, complex processing in the brain has been regarded as crucial for colony recognition. Odor information is represented as spatial patterns of activity and processed in the primary olfactory neuropile, the antennal lobe (AL) of insects, which is analogous to the vertebrate olfactory bulb. Correlative evidence indicates that the spatial activity patterns reflect odor-quality, i.e., how an odor is perceived. For colony odors, alternatively, a sensory filter in the peripheral nervous system was suggested, causing specific anosmia to nestmate colony odors. Here, we investigate neuronal correlates of colony odors in the brain of a social insect to directly test whether they are anosmic to nestmate colony odors and whether spatial activity patterns in the AL can predict how odor qualities like ‘‘friend’’ and ‘‘foe’’ are attributed to colony odors. Methodology/Principal Findings: Using ant dummies that mimic natural conditions, we presented colony odors and investigated their neuronal representation in the ant Camponotus floridanus. Nestmate and non-nestmate colony odors elicited neuronal activity: In the periphery, we recorded sensory responses of olfactory receptor neurons (electroantennography), and in the brain, we measured colony odor specific spatial activity patterns in the AL (calcium imaging). Surprisingly, upon repeated stimulation with the same colony odor, spatial activity patterns were variable, and as variable as activity patterns elicited by different colony odors. Conclusions: Ants are not anosmic to nestmate colony odors. However, spatial activity patterns in the AL alone do not provide sufficient information for colony odor discrimination and this finding challenges the current notion of how odor quality is coded. Our result illustrates the enormous challenge for the nervous system to classify multi-component odors and indicates that other neuronal parameters, e.g., precise timing of neuronal activity, are likely necessary for attribution of odor quality to multi-component odors