Effect of Prior Anterior Superior Iliac Spine Compression Testing on Second Assessor Findings: Implications for Inter-Examiner Reliability Testing

BACKGROUND: Osteopathic physicians use palpation to diagnose sacroiliac joint somatic dysfunction (SD) -- including the Anterior Superior Iliac Spine (ASIS) Compression Test for dysfunctional side lateralization. (Literature suggests right-sided lateralization in 80% of asymptomatic individuals). Accurate, reliable tests are crucial however to diagnose SD and kappa (κ) analysis is a gold-standard to determine the degree of interexaminer reliability for tests. Few studies have examined the effect the palpatory examination has on subsequent diagnostic findings and therefore on κ-values

Inter-Examiner Reliability of an Anterior Superior Iliac Spine Compression Test used to Lateralize Pelvic Somatic Dysfunction to the Right Side or Not

BACKGROUND: Osteopathic physicians use a number of palpatory structural examinations to diagnose pelvic somatic dysfunction (SD). They may elect to use the Anterior Superior Iliac Spine (ASIS) Compression Test to lateralize the dysfunctional side. Accurate, reliable tests are crucial to neuromusculoskeletal diagnosis and this study employs the kappa (κ) analysis protocol recommended for assessing interexaminer reliability of manual medicine tests (published by the Fédération Internationale de Médecine Manuelle [FIMM]). κ-values ≥0.40 (moderate agreement) are considered to be acceptable for use in the clinical setting

The Use of Objective Data to Improve Interexaminer Reliability

BACKGROUND: In Osteopathic Manipulative Medicine (OMM) and Manual/Musculoskeletal Medicine (MMM), palpatory diagnosis is performed on a regular basis to diagnose somatic dysfunction (SD). This examination requires careful and precise touch coupled with subjective interpretation by individual examiners who may have been trained to evaluate SD through different methods. Interexaminer reliability studies aim to minimize variance by providing quantifiable scientific data to evaluate specific test protocols which can then be taught to practitioners. In a previous PCOM study, two examiners independently diagnosed innominate bone dysfunction lateralized using the ASIS compression test on a large group of subjects. A pressure monitoring system (IsoTOUCH®, Chattanooga TN) has been used in various studies at the PCOM Human Performance & Biomechanics Laboratory (Kuchera, Jean et al 2006 & Kuchera, Vardy et al 2005) to quantify or standardize forces used in palpatory diagnosis or OMM/MMM treatment applications. This study gathered data during the tesing phase of a new and improved model of this system, using the protocol of the previous ASIS interexaminer reliability study. The data collected during standardization of the system was analyzed in the same manner as the previous study to compare the results of interexaminer reliability to results achieved using live data feed for baseline pressure synchronization between examiners

Comparing Inter-Examiner Reliability Levels when Diagnosing Male & Female Innominate Dysfunctions Using a Hemi-Pelvise Compression Lateralization Test and Pelvic Landmark Levels.

BACKGROUND: When diagnosing innominate somatic dysfunctions it may be relevant to recognize that structural, functional, and hormonal differences exist between male and female pelvises. The female pelvis is less massive, ilia are less sloped, and female hormones influence ligamentous tension. Despite these differences, few studies have analyzed gender effects on inter-examiner reliability when using palpatory diagnosis to diagnose innominate dysfunctions. In this study, we hypothesized that interexaminer reliability would be higher in male subjects than in female subjects due cyclic variability of hormonal influence of ligamentous tension in the female pelvis. The kappa (κ) statistic was selected to evaluate inter-examiner reliability as it is designed to eliminate agreement by chance. The agreement scale as proposed by Landis and Koch was used in the evaluation if the κ-value

Monotreme glucagon-like peptide-1 in venom and gut: one gene – two very different functions

This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/The importance of Glucagon like peptide 1 (GLP-1) for metabolic control and insulin release sparked the evolution of genes mimicking GLP-1 action in venomous species (e.g. Exendin-4 in Heloderma suspectum (gila monster)). We discovered that platypus and echidna express a single GLP-1 peptide in both intestine and venom. Specific changes in GLP-1 of monotreme mammals result in resistance to DPP-4 cleavage which is also observed in the GLP-1 like Exendin-4 expressed in Heloderma venom. Remarkably we discovered that monotremes evolved an alternative mechanism to degrade GLP-1. We also show that monotreme GLP-1 stimulates insulin release in cultured rodent islets, but surprisingly shows low receptor affinity and bias toward Erk signaling. We propose that these changes in monotreme GLP-1 are the result of conflicting function of this peptide in metabolic control and venom. This evolutionary path is fundamentally different from the generally accepted idea that conflicting functions in a single gene favour duplication and diversification, as is the case for Exendin-4 in gila monster. This provides novel insight into the remarkably different metabolic control mechanism and venom function in monotremes and an unique example of how different selective pressures act upon a single gene in the absence of gene duplication

Genome-wide association and HLA fine-mapping studies identify risk loci and genetic pathways underlying allergic rhinitis

Allergic rhinitis is the most common clinical presentation of allergy, affecting 400 million people worldwide, with increasing incidence in westernized countries1,2. To elucidate the genetic architecture and understand the underlying disease mechanisms, we carried out a meta-analysis of allergic rhinitis in 59,762 cases and 152,358 controls of European ancestry and identified a total of 41 risk loci for allergic rhinitis, including 20 loci not previously associated with allergic rhinitis, which were confirmed in a replication phase of 60,720 cases and 618,527 controls. Functional annotation implicated genes involved in various immune pathways, and fine mapping of the HLA region suggested amino acid variants important for antigen binding. We further performed genome-wide association study (GWAS) analyses of allergic sensitization against inhalant allergens and nonallergic rhinitis, which suggested shared genetic mechanisms across rhinitis-related traits. Future studies of the identified loci and genes might identify novel targets for treatment and prevention of allergic rhinitis

The Ninth Data Release of the Sloan Digital Sky Survey: First Spectroscopic Data from the SDSS-III Baryon Oscillation Spectroscopic Survey

The Sloan Digital Sky Survey III (SDSS-III) presents the first spectroscopic data from the Baryon Oscillation Spectroscopic Survey (BOSS). This ninth data release (DR9) of the SDSS project includes 535,995 new galaxy spectra (median z=0.52), 102,100 new quasar spectra (median z=2.32), and 90,897 new stellar spectra, along with the data presented in previous data releases. These spectra were obtained with the new BOSS spectrograph and were taken between 2009 December and 2011 July. In addition, the stellar parameters pipeline, which determines radial velocities, surface temperatures, surface gravities, and metallicities of stars, has been updated and refined with improvements in temperature estimates for stars with T_eff<5000 K and in metallicity estimates for stars with [Fe/H]>-0.5. DR9 includes new stellar parameters for all stars presented in DR8, including stars from SDSS-I and II, as well as those observed as part of the SDSS-III Sloan Extension for Galactic Understanding and Exploration-2 (SEGUE-2). The astrometry error introduced in the DR8 imaging catalogs has been corrected in the DR9 data products. The next data release for SDSS-III will be in Summer 2013, which will present the first data from the Apache Point Observatory Galactic Evolution Experiment (APOGEE) along with another year of data from BOSS, followed by the final SDSS-III data release in December 2014.Comment: 9 figures; 2 tables. Submitted to ApJS. DR9 is available at http://www.sdss3.org/dr

A somato-cognitive action network alternates with effector regions in motor cortex

Motor cortex (M1) has been thought to form a continuous somatotopic homunculus extending down the precentral gyrus from foot to face representation

Emergency Department Presentations of Diabetic Ketoacidosis in a Large Cohort of Children

Background. Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of childhood diabetes. However, the influence of demographic factors on presentation are not well-defined. Methods. We included children from 12 centers who were \u3c18 years with DKA (glucose \u3e 300 mg/dL, serum pH \u3c 7.25, or serum bicarbonate \u3c15 mEq/L) enrolled in the Pediatric Emergency Care Applied Research Network (PECARN) Fluid Therapies Under Investigation in DKA (FLUID) Trial. Data were also collected for children who presented to the centers during the enrollment period but were not enrolled due to disease or treatment-related reasons. We compared demographic, clinical, and biochemical findings among children with newly and previously diagnosed diabetes and children in different age groups. Results. Of the 1,679 DKA episodes in 1,553 children, 799 (47.5%) episodes occurred in children with newly diagnosed diabetes and 396 (23.6%) were severe (pH \u3c 7.1). Newly diagnosed children \u3c6 years of age were not more likely to have severe DKA in terms of pH, but had more severe hypocarbia and higher blood urea nitrogen levels, factors previously associated with the risk of cerebral injury. Lower socioeconomic status (SES) (based on family income and maternal education level) were associated with more severe DKA in new onset children, and recurrent DKA in the previously diagnosed children. Conclusions. Greater efforts are needed to identify the children with diabetes early and to prevent recurrent DKA, particularly among children in low-SES groups. Young children with DKA may need more intensive monitoring due to higher risk of cerebral injury