Physical examination tests of the shoulder: a systematic review with meta-analysis of individual tests

OBJECTIVE

To compile and critique research on the diagnostic accuracy of individual orthopaedic physical examination tests in a manner that would allow clinicians to judge whether these tests are valuable to their practice.

METHODS

A computer-assisted literature search of MEDLINE, CINAHL, and SPORTDiscus databases (1966 to October 2006) using keywords related to diagnostic accuracy of physical examination tests of the shoulder. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool was used to critique the quality of each paper. Meta-analysis through meta-regression of the diagnostic odds ratio (DOR) was performed on the Neer test for impingement, the Hawkins-Kennedy test for impingement, and the Speed test for superior labral pathology.

RESULTS

Forty-five studies were critiqued with only half demonstrating acceptable high quality and only two having adequate sample size. For impingement, the meta-analysis revealed that the pooled sensitivity and specificity for the Neer test was 79% and 53%, respectively, and for the Hawkins-Kennedy test was 79% and 59%, respectively. For superior labral (SLAP) tears, the summary sensitivity and specificity of the Speed test was 32% and 61%, respectively. Regarding orthopaedic special tests (OSTs) where meta-analysis was not possible either due to lack of sufficient studies or heterogeneity between studies, the list that demonstrates both high sensitivity and high specificity is short: hornblowers's sign and the external rotation lag sign for tears of the rotator cuff, biceps load II for superior labral anterior to posterior (SLAP) lesions, and apprehension, relocation and anterior release for anterior instability. Even these tests have been under-studied or are from lower quality studies or both. No tests for impingement or acromioclavicular (AC) joint pathology demonstrated significant diagnostic accuracy.

CONCLUSION

Based on pooled data, the diagnostic accuracy of the Neer test for impingement, the Hawkins-Kennedy test for impingement and the Speed test for labral pathology is limited. There is a great need for large, prospective, well-designed studies that examine the diagnostic accuracy of the numerous physical examination tests of the shoulder. Currently, almost without exception, there is a lack of clarity with regard to whether common OSTs used in clinical examination are useful in differentially diagnosing pathologies of the shoulder.

A Multifoci Person-Centered Perspective on Workplace Affective Commitment: A Latent Profile/Factor Mixture Analysis

The current study aims to explore the usefulness of a person-centered perspective to the study of workplace affective commitment (WAC). Five distinct profiles of employees were hypothesized based on their levels of WAC directed toward seven foci (organization, workgroup, supervisor, customers, job, work, and career). This study applied latent profile analyses and factor mixture analyses to a sample of 404 Canadian workers. The construct validity of the extracted latent profiles was verified by their associations with multiple predictors (gender, age, tenure, social relationships at work, workplace satisfaction, and organizational justice perceptions) and outcomes (in-role performance, organizational citizenship behaviors, and intent to quit). The analyses confirmed that a model with five latent profiles adequately represented the data: (a) highly committed toward all foci; (b) weakly committed toward all foci; (c) committed to their supervisor and moderately committed to the other foci; and (d) committed to their career and moderately uncommitted to the other foci; (e) committed mostly to their proximal work environment. These latent profiles present theoretically coherent patterns of associations with the predictors and outcomes, which suggests their adequate construct validity.

Measurement invariance of big-five factors over the life span: ESEM tests of gender, age, plasticity, maturity, and la dolce vita effects

This substantive-methodological synergy applies evolving approaches to factor analysis to substantively important developmental issues of how five-factor-approach (FFA) personality measures vary with gender, age, and their interaction. Confirmatory factor analyses (CFAs) conducted at the item level often do not support a priori FFA structures, due in part to the overly restrictive assumptions of CFA models. Here we demonstrate that exploratory structural equation modeling (ESEM), an integration of CFA and exploratory factor analysis, overcomes these problems with the 15-item Big Five Inventory administered as part of the nationally representative British Household Panel Study (N = 14,021; age: 15-99 years, Mage = 47.1). ESEM fitted the data substantially better and resulted in much more differentiated (less correlated) factors than did CFA. Methodologically, we extended ESEM (introducing ESEM-within-CFA models and a hybrid of multiple groups and multiple indicators multiple causes models), evaluating full measurement invariance and latent mean differences over age, gender, and their interaction. Substantively the results showed that women had higher latent scores for all Big Five factors except for Openness and that these gender differences were consistent over the entire life span. Substantial nonlinear age effects led to the rejection of the plaster hypothesis and the maturity principle but did support a newly proposed la dolce vita effect in old age. In later years, individuals become happier (more agreeable and less neurotic), more self-content and self-centered (less extroverted and open), more laid back and satisfied with what they have (less conscientious, open, outgoing and extroverted), and less preoccupied with productivity.

Psychometric properties of the Center for Epidemiologic Studies Depression Scale (CES-D) in French clinical and nonclinical adults

BACKGROUND

Previous research on the Center for Epidemiologic Studies Depression Scale (CES-D) has five main limitations. First, no study provided evidence of the factorial equivalence of this instrument across samples of depressive and community participants. Second, only one study included systematic tests of measurement invariance based on confirmatory factor analyses (CFA), and this study did not consider the higher-order factor structure of depression, although it is the CES-D global scale score that is most often used in the context of epidemiological studies. Third, few studies investigated the screening properties of the CES-D in non-English-language samples and their results were inconsistent. Fourth, although the French version of the CES-D has been used in several previous studies, it has never been systematically validated among community and/or depressed adults. Finally, very few studies have taken into account the ordered-categorical nature of the CES-D answer scale. The purpose of the study reported herein was therefore to examine the construct validity (i.e., factorial, reliability, measurement invariance, latent mean invariance, convergence, and screening properties) of the CES-D in a French sample of depressed patients and community adults.

METHODS

A total sample of 469 participants, comprising 163 clinically depressed patients and 306 community adults, was involved in this study. The factorial validity, and the measurement and latent mean invariance of the CES-D across gender and clinical status, were verified through CFAs based on ordered-categorical items. Correlation and receiver operator characteristic curves were also used to test the convergent validity and screening properties of the CES-D.

RESULTS

The present results: (i) provided support for the factor validity and reliability of a second-order measurement model of depression based on responses to the CES-D items; (ii) revealed the full measurement invariance of the first- and second-order measurement models across gender; (iii) showed the partial strict measurement invariance (four uniquenesses had to be freely estimated, but the factor variance-covariance matrix also proved fully invariant) of the first-order factor model and the complete measurement invariance of the second-order model across patients and community adults; (iv) revealed a lack of latent mean invariance across gender and across clinical and community subsamples (with women and patients reporting higher scores on all subscales and on the full scale); (v) confirmed the convergent validity of the CES-D with measures of depression, self-esteem, anxiety, and hopelessness; and (vi) demonstrated the efficacy of the screening properties of this instrument among clinical and nonclinical adults.

CONCLUSION

This instrument may be useful for assessing depressive symptoms or for the screening of depressive disorders in the context of epidemiological studies targeting French patients and community men and women with a background similar to those from the present study.

Visceral perception in health and functional dyspepsia. Crossover study of gastric distension with placebo and domperidone

The symptoms of functional dyspepsia are still unexplained. To evaluate the possible role of abnormal visceral perception, we studied the symptomatic responses and the pressure variations during progressive gastric distension in 10 female healthy control subjects (mean age 33.6 years) and in 10 female patients with functional dyspepsia (mean age 35.2 years). A rubber balloon was positioned 4 cm below the lower esophageal sphincter (LES) and inflated with progressively larger volumes of air by steps of 50 ml; pressures at the gastric fundus and at the LES were continuously recorded by perfused manometric catheters. Each subject was studied on two separate occasions after randomized double-blind administration of either placebo or 20 mg of domperidone. Symptomatic responses and the manometric data were analyzed at the time of the initial recognition of distension (bloating step) and at the time of reporting pain or up to a maximum of 700 ml of balloon inflation (pain or 700-ml step). On placebo, the volumes of gastric distension were more than two times lower in patients than in control subjects at the bloating step (185 +/- 32 ml vs 470 +/- 40 ml, P = 0.001) and at the pain or 700-ml step (265 +/- 54 ml vs 600 +/- 34 ml, P less than 0.005), while the pressure gradients (pressure at inflation steps minus baseline pressure before beginning inflation) were not statistically different between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Methodological Measurement Fruitfulness of Exploratory Structural Equation Modeling (ESEM): New Approaches to Key Substantive Issues in Motivation and Engagement

The most popular measures of multidimensional constructs typically fail to meet standards of good measurement: goodness of fit, measurement invariance, lack of differential item functioning, and well-differentiated factors that are not so highly correlated as to detract from their discriminant validity. Part of the problem, the authors argue, is undue reliance on overly restrictive independent cluster models of confirmatory factor analysis (ICM-CFA) in which each item loads on one, and only one, factor. Here the authors demonstrate exploratory structural equation modeling (ESEM), an integration of the best aspects of CFA and traditional exploratory factor analyses (EFA). On the basis of responses to the 11-factor Motivation and Engagement Scale ( n = 7,420, Mage = 14.22), we demonstrate that ESEM fits the data much better and results in substantially more differentiated (less correlated) factors than corresponding CFA models. Guided by a 13-model taxonomy of ESEM full-measurement (mean structure) invariance, the authors then demonstrate invariance of factor loadings, item intercepts, item uniquenesses, and factor variancescovariances, across gender and over time. ESEM has broad applicability to other areas of research that cannot be appropriately addressed with either traditional EFA or CFA and should become a standard tool for use in psychometric tests of psychological assessment instruments.

Relations with parents and with peers, temperament, and trajectories of depressed mood during early adolescence

The present study examined (a) whether groups of children can be empirically identified with distinct longitudinal profiles of depressed mood from late childhood through early adolescence, (b) to what extent these different longitudinal depression profiles are predicted by problematic relations with parents, same-sex peers, and other-sex peers, and (c) what role individuals' temperamental characteristics play in this context. Based on a sample of 414 early adolescents (197 girls), four groups were identified with distinct longitudinal profiles of depressed mood between ages 11 and 14: One group with consistently low levels of depressed mood, another with consistently moderate levels of depressed mood, a third group whose depressed mood increased sharply from late childhood through early adolescence, and a fourth group who already showed clinical-range levels of depressed mood during late childhood and whose depressive feelings increased even slightly more thereafter. Subsequent analyses revealed that rejection by same-sex peers was related to the odds of following an increasing trajectory of depressed mood, but only for girls with a highly reactive temperament. A problematic relationship with parents increased the odds of an elevated trajectory of depressed mood regardless of individual temperament. The theoretical and practical implications of these findings are discussed.

Prevalence of overweight and obesity among children and adolescents with intellectual disabilities: a systematic review and meta-analysis

Although there have been numerous studies examining the prevalence of overweight and obesity among children and adolescents with intellectual disabilities, they have not yet been integrated and synthesized through a systematic quantitative review process. The purpose of this systematic review and meta-analysis was to determine: (i) the prevalence of overweight/obesity among children and adolescents with intellectual disabilities; (ii) the sources of heterogeneity in studies reporting the prevalence of overweight/obesity in this population; and (iii) the risk of overweight/obesity in this population compared with their typically developing peers. A systematic literature search was performed and 16 studies, published between 1985 and 2015, met the inclusion criteria. The resulting pooled prevalence estimates for overweight, overweight-obesity and obesity were respectively: (i) 15%, 30%, and 13%, in children; and (ii) 18%, 33%, and 15% in adolescents. Subgroup analyses showed significant variations in the pooled prevalence estimates as a function of geographical region, recruitment setting, additional diagnoses, and norms used to define overweight or obesity. The findings also showed adolescents with intellectual disabilities to be respectively 1.54 and 1.80 times more at risk of overweight-obesity and obesity than typically developing adolescents. Unfortunately, no such comparison is available for children. © 2016 World Obesity.

Microbial polysaccharides with actual potential industrial applications

The microbial polysaccharides reviewed include xanthan gum, scleroglucan, PS-10, PS-21 and PS-53 gums, polysaccharides from Alcaligenes sp., PS-7 gum, gellan gum, curdlan, bacterial alginate, dextran, pullulan, Baker's Yeast Glycan, 6-deoxy-hexose-containing polysaccharides and bacterial cellulose. Factors limiting the commercial potential of certain microbial polysaccharides such as availability, rheological properties, and polyvalency are outlined. The polysaccharides are classified according to their uses as viscosity-increasing agents and as gelling agents. A third category includes polysaccharides with specific applications such as tailor-made dextran and pullulan and polysaccharides used as substrates for the preparation of rare sugars. The difficulties encountered in development of a polysaccharide at the industrial level are pointed out.

The genotype 3-specific hepatitis C virus core protein residue phenylalanine 164 increases steatosis in an in vitro cellular model

BACKGROUND AND AIMS

The prevalence and severity of liver steatosis are higher in patients infected with genotype 3 hepatitis C virus (HCV) than in patients infected with other genotypes. HCV core protein is known to affect lipid metabolism, inducing lipid droplet accumulation both in vitro and in vivo. An in vitro cellular model was used to investigate whether an HCV core protein with residues specific to genotype 3 increased this phenomenon.

METHODS

Sequence comparisons for HCV core protein domain II, which is known to interact with lipid droplets, identified the phenylalanine (F) residue at position 164 as the only residue specific to genotype 3. The area covered by lipid droplets in sections of cells producing a wild-type genotype 1a HCV core protein was compared with that in cells producing a Y164F mutant protein.

RESULTS

Cumulative lipid droplet area was significantly greater in sections of cells producing the Y164F mutant HCV core protein than in cells producing the wild-type protein (p<0.001). The frequency of cell sections containing more than 3 mum(2) of lipid droplets, in particular, was higher for the mutant than for the wild-type protein.

CONCLUSION

The data provide a molecular explanation for HCV genotype 3-specific lipid accumulation. This difference between genotypes may be due to phenylalanine having a higher affinity for lipids than tyrosine (Y). These observations provide useful information for further studies of the mechanisms involved in HCV-induced steatosis.

Exploring sources of construct-relevant multidimensionality in psychiatric measurement: A tutorial and illustration using the Composite Scale of Morningness

This paper illustrates a psychometric approach of broad relevance to psychiatric research instruments. Many instruments include indicators related to more than one source of true-score variance due to the: (1) assessment of conceptually adjacent constructs; (2) the presence of a global construct underlying answers to items designed to assess multiple dimensions. Exploratory structural equation modelling (ESEM) is naturally suited to the investigation of the first source, whereas bifactor models are particularly suited to the investigation of the second source. When both sources are present, bifactor-ESEM becomes the model of choice. To illustrate this framework, we use the responses of 1159 adults [655 female, 504 male, mean age (M_age ) = 41.84] who completed the French Version of the Composite Scale of Morningness (CSM). We investigate the factor structure of the CSM, test the relations between CSM factors and body mass index, and verify the measurement invariance of the model across gender and age groups. Copyright © 2015 John Wiley & Sons, Ltd.

Enzymatic conversion of adenosine to inosine and to N1-methylinosine in transfer RNAs: a review

Inosine (6-deaminated adenosine) is a characteristic modified nucleoside that is found at the first anticodon position (position 34) of several tRNAs of eukaryotic and eubacterial origins, while N1-methylinosine is found exclusively at position 37 (3' adjacent to the anticodon) of eukaryotic tRNA(Ala) and at position 57 (in the middle of the psi loop) of several tRNAs from halophilic and thermophilic archaebacteria. Inosine has also been recently found in double-stranded RNA, mRNA and viral RNAs. As for all other modified nucleosides in RNAs, formation of inosine and inosine derivative in these RNA is catalysed by specific enzymes acting after transcription of the RNA genes. Using recombinant tRNAs and T7-runoff transcripts of several tRNA genes as substrates, we have studied the mechanism and specificity of tRNA-inosine-forming enzymes. The results show that inosine-34 and inosine-37 in tRNAs are both synthesised by a hydrolytic deamination-type reaction, catalysed by distinct tRNA:adenosine deaminases. Recognition of tRNA substrates by the deaminases does not strictly depend on a particular "identity' nucleotide. However, the efficiency of adenosine to inosine conversion depends on the nucleotides composition of the anticodon loop and the proximal stem as well as on 3D-architecture of the tRNA. In eukaryotic tRNA(Ala), N1-methylinosine-37 is formed from inosine-37 by a specific SAM-dependent methylase, while in the case of N1-methylinosine-57 in archaeal tRNAs, methylation of adenosine-57 into N1-methyladenosine-57 occurs before the deamination process. The T psi-branch of fragmented tRNA is the minimalist substrate for the N1-methylinosine-57 forming enzymes. Inosine-34 and N1-methylinosine-37 in human tRNA(Ala) are targets for specific autoantibodies which are present in the serum of patients with inflammatory muscle disease of the PL-12 polymyositis type. Here we discuss the mechanism, specificity and general properties of the recently discovered RNA:adenosine deaminases/editases acting on double-stranded RNA, intron-containing mRNA and viral RNA in relation to those of the deaminases acting on tRNAs.

The impact of total and partial inclusion or exclusion of active and inactive time invariant covariates in growth mixture models

This article evaluates the impact of partial or total covariate inclusion or exclusion on the class enumeration performance of growth mixture models (GMMs). Study 1 examines the effect of including an inactive covariate when the population model is specified without covariates. Study 2 examines the case in which the population model is specified with 2 covariates influencing only the class membership. Study 3 examines a population model including 2 covariates influencing the class membership and the growth factors. In all studies, we contrast the accuracy of various indicators to correctly identify the number of latent classes as a function of different design conditions (sample size, mixing ratio, invariance or noninvariance of the variance-covariance matrix, class separation, and correlations between the covariates in Studies 2 and 3) and covariate specification (exclusion, partial or total inclusion as influencing class membership, partial or total inclusion as influencing class membership, and the growth factors in a class-invariant or class-varying manner). The accuracy of the indicators shows important variation across studies, indicators, design conditions, and specification of the covariates effects. However, the results suggest that the GMM class enumeration process should be conducted without covariates, and should rely mostly on the Bayesian information criterion (BIC) and consistent Akaike information criterion (CAIC) as the most reliable indicators under conditions of high class separation (as indicated by higher entropy), versus the sample size adjusted BIC or CAIC (SBIC, SCAIC) and bootstrapped likelihood ratio test (BLRT) under conditions of low class separation (indicated by lower entropy). (PsycINFO Database Record

Person-Centered Methodologies in the Organizational Sciences

The 2011 Organizational Research Methods Feature Topic on latent class procedures has helped to establish person-centered analyses as a method of choice in the organizational sciences. This establishment has contributed to the generation of substantive-methodological synergies leading to a better understanding of a variety of organizational phenomena and to an improvement in research methodologies. The present Feature Topic aims to provide a user-friendly introduction to these new methodological developments for applied organizational researchers. Organized around a presentation of the typological, prototypical, and methodologically exploratory nature of person-centered analyses, this introductory article introduces seven contributions aiming to: (a) clarify the meaning, advantages, and applications of person-centered analyses; (b) illustrate emerging prototypical and longitudinal cluster analytic approaches; (c) introduce researchers to multilevel person-centered analyses as well as to auxiliary approaches that will drastically increase the scope of application of these methods; and (d) describe the application of these methods for confirmatory purposes.