Agreement between methods of measurement with multiple observations per individual

Limits of agreement provide a straightforward and intuitive approach to agreement between different methods for measuring the same quantity. When pairs of observations using the two methods are independent, i.e., on different subjects, the calculations are very simple and straightforward. Some authors collect repeated data, either as repeated pairs of measurements on the same subject, whose true value of the measured quantity may be changing, or more than one measurement by one or both methods of an unchanging underlying quantity. In this paper we describe methods for analysing such clustered observations, both when the underlying quantity is assumed to be changing and when it is not

Changing Behavior Using Self-Determination Theory

Self-determination theory is a generalized theory of behavior that focuses on motivation quality and psychological need satisfaction as preeminent behavioral determinants. The theory distinguishes between autonomous and controlled forms of motivation. Autonomous motivation reflects willingly engaging in behaviors for self-endorsed reasons, whereas controlled motivation reflects engaging in behavior for externally or internally pressured or controlled reasons. Satisfaction of the needs for autonomy, competence, and relatedness is necessary for optimal functioning and well-being, and influences the form of motivation, autonomous or controlled, experienced by individuals when acting. Autonomous motivation is consistently related to sustained behavior change and adaptive outcomes. Interventions to promote autonomous motivation have targeted psychological need support provided by social agents (e.g., leaders, managers, teachers, health professionals), particularly autonomy need support. Interventions using need-supportive techniques have demonstrated efficacy in promoting autonomous motivation, behavior change, and adaptive outcomes. Research has identified behaviors displayed, and language used, by social agents, or communicated by other means, that support autonomous motivation. Autonomy-support training programs have been developed to train social agents to promote autonomous motivation and behavior change. Future research needs to examine the unique and interactive effects of specific autonomy-support techniques, provide further evidence for long-term efficacy, and examine “dose” effects and long-term efficacy.Peer reviewe

Subjective knowledge, perceived risk, and information search when purchasing a franchise: A comparative exploration from Australia

Franchising has long been a method by which organizations seek to expand and facilitate local market development. However, franchising as a growth strategy can often be hampered by lack of suitable franchisees. To mitigate this shortage, some franchisors have engaged in recruiting franchisees internally from the ranks of their employees in addition to the traditional approach of recruiting franchisees externally. Predominantly franchisees are individuals rather than corporations and thus purchasing a franchise should most commonly be characterized as a consumer acquisition. To explore the relationship between subjective knowledge, perceived risk, and information search behaviors when purchasing a franchise qualitative interviews were conducted with franchisees from the restaurant industry. Half of these respondents were externally recruited having never worked for the franchisor and half were internally recruited having previously been employees of the franchisor. The external recruits expressed a strong desire to own their own business and engaged in extensive decision-making processes with significant information search when purchasing their franchises. Contrastingly, the internal recruits expressed a strong desire to be their own boss and engaged in limited, bordering on habitual decision-making processes with negligible information search when acquiring their franchises. The results reveal that differences in subjective knowledge and perceived risk appear to significantly impact the extent of information search between these two groups. A model of the relationship between subjective knowledge, perceived risk and information search in the purchasing of a franchise is developed that reconciles these findings. The findings also have practical implications for franchisors’ franchisee recruiting efforts which are integral to their capacity to develop local markets

A subset of methylated CpG sites differentiate psoriatic from normal skin.

Psoriasis is a chronic inflammatory immune-mediated disorder affecting the skin and other organs including joints. Over 1,300 transcripts are altered in psoriatic involved skin compared with normal skin. However, to our knowledge, global epigenetic profiling of psoriatic skin is previously unreported. Here, we describe a genome-wide study of altered CpG methylation in psoriatic skin. We determined the methylation levels at 27,578 CpG sites in skin samples from individuals with psoriasis (12 involved, 8 uninvolved) and 10 unaffected individuals. CpG methylation of involved skin differed from normal skin at 1,108 sites. Twelve mapped to the epidermal differentiation complex, upstream or within genes that are highly upregulated in psoriasis. Hierarchical clustering of 50 of the top differentially methylated (DM) sites separated psoriatic from normal skin samples with uninvolved skin exhibiting intermediate methylation. CpG sites where methylation was correlated with gene expression are reported. Sites with inverse correlations between methylation and nearby gene expression include those of KYNU, OAS2, S100A12, and SERPINB3, whose strong transcriptional upregulation is an important discriminator of psoriasis. Pyrosequencing of bisulfite-treated DNA from skin biopsies at three DM loci confirmed earlier findings and revealed reversion of methylation levels toward the non-psoriatic state after 1 month of anti-TNF-α therapy

Seasonal and interannual variations in ice melange and its impact on terminus stability, Jakobshavn Isbræ, Greenland

We used satellite-derived surface temperatures and time-lapse photography to infer temporal variations in the proglacial ice melange at Jakobshavn Isbræ, a large and rapidly retreating outlet glacier in Greenland.We used satellite-derived surface temperatures and time-lapse photography to infer temporal variations in the proglacial ice melange at Jakobshavn Isbræ, a large and rapidly retreating outlet glacier in Greenland. Freezing of the melange-covered fjord surface during winter is indicated by a decrease in fjord surface temperatures and is associated with (1) a decrease in ice melange mobility and (2) a drastic reduction in iceberg production. Vigorous calving resumes in spring, typically abruptly, following the steady up-fjord retreat of the sea-ice/ice-melange margin. An analysis of pixel displacement from time-lapse imagery demonstrates that melange motion increases prior to calving and subsequently decreases following several events. We find that secular changes in ice melange extent, character and persistence can influence iceberg calving, and therefore glacier dynamics over daily-to-monthly timescales, which, if sustained, will influence the mass balance of an ice sheet.This research was supported by funds from the Gordon and Betty Moore Foundation (GBMF2627), NASA (NNX08AN74G), the US National Science Foundation (ANT0944193 and ANS0909552) and the New Hampshire Space Grant Consortium (NNX10AL97H). We thank CH2M HILL Polar Services and Air Greenland for logistics support, and PASSCAL (Program for the Array Seismic Studies of theContinental Lithosphere) for the use of seismic instrumentation. Ian Joughin derived TerraSAR-X velocities and terminus positions from images provided by the German (DLR) space agency under NASA grant NNX08AL98A. We acknowledgethe use of Rapid Response imagery from the Land Atmosphere Near-real time Capability for EOS (LANCE) system operated by the NASA/GSFC/Earth Science Data and Information System (ESDIS) with funding provided by NASA HQ. Glacier surface elevations were provided by CReSIS, and bed elevations by CReSIS and Mathieu Morlighem. The manuscript was significantly improved by comments from Tim Bartholomaus and an anonymous reviewer.Ye

The Response of Antarctic Sea Ice Algae to Changes in pH and CO2

Ocean acidification substantially alters ocean carbon chemistry and hence pH but the effects on sea ice formation and the CO2 concentration in the enclosed brine channels are unknown. Microbial communities inhabiting sea ice ecosystems currently contribute 10–50% of the annual primary production of polar seas, supporting overwintering zooplankton species, especially Antarctic krill, and seeding spring phytoplankton blooms. Ocean acidification is occurring in all surface waters but the strongest effects will be experienced in polar ecosystems with significant effects on all trophic levels. Brine algae collected from McMurdo Sound (Antarctica) sea ice was incubated in situ under various carbonate chemistry conditions. The carbon chemistry was manipulated with acid, bicarbonate and bases to produce a pCO2 and pH range from 238 to 6066 matm and 7.19 to 8.66, respectively. Elevated pCO2 positively affected the growth rate of the brine algal community, dominated by the unique ice dinoflagellate, Polarella glacialis. Growth rates were significantly reduced when pH dropped below 7.6. However, when the pH was held constant and the pCO2 increased, growth rates of the brine algae increased by more than 20% and showed no decline at pCO2 values more than five times current ambient levels. We suggest that projected increases in seawater pCO2, associated with OA, will not adversely impact brine algal communities

Primary total knee arthroplasty in a patient with a chronic extensor mechanism deficiency

AbstractA 44-year-old female presented with a chief complaint of left knee pain and dysfunction. The patient had a complex surgical history including patellar fracture repair, subsequent patellar ligament repair, and ultimately allograft reconstruction which was complicated by septic arthritis requiring graft resection. On presentation to our clinic, she was noted to have significant degenerative disease in addition to chronic extensor mechanism deficiency. She underwent primary total knee arthroplasty with concomitant tibial tubercle osteotomy and advancement. The patient has had an excellent result postoperatively including return of full range of motion without residual extensor lag

A gyroscope-based system for intraoperative measurement of tibia coronal plane alignment in total knee arthroplasty

Coronal plane alignment in total knee arthroplasty (TKA) is an important predictor of clinical outcomes including patient satisfaction and device longevity. Radiography and computer assisted navigation are the two primary technologies currently available to surgeons for intraoperative assessment of alignment; however, neither is particularly well-suited for use in this increasingly high volume procedure. Herein we propose a novel gyroscope-based instrument for intraoperative validation of tibia coronal plane alignment, and provide initial analytical and experimental performance assessments. The gyroscope-based alignment estimate is derived from simplified joint geometry and verified experimentally using a custom tibial trial insert containing a consumer-grade inertial measurement unit (IMU). Average accuracy of the gyroscope-based tibia coronal angle estimate was found to be within ±1° in mechanical leg jig and cadaver testing. These results indicate that the proposed gyroscope-based method shows promise for low cost, accurate intraoperative validation of limb alignment in TKA patients. Integrating IMU technology into the TKA surgical workflow via low-cost instrumentation will enable surgeons to easily validate implant alignment in real time, thereby reducing cost, operating room time, and future revision burden