Study Design: Clinical measurement, longitudinal; multicenter prospective cohort study. Objectives: To examine the validity, reliability, and responsiveness of the Patient-Specific Functional Scale (PSFS) in patients with musculoskeletal upper extremity problems being treated in physical therapy. Background: The clinimetric properties of the PSFS have not been established nor compared with region-specific outcome measures in patients with upper extremity problems. Methods: Patients completed the PSFS, Upper Extremity Functional Index (UEFI), and numeric pain rating scale (NPRS) at baseline and follow-up, and were categorized as improved, stable, or worsened, using the global rating of change. Construct validity was assessed by comparing the change scores of the stable and improved groups, using independent-samples t tests. Reliability was evaluated using intraclass correlation coefficient (ICC_2,1) with 95% confidence intervals. Bland-Altman plots determined limits of agreement. Responsiveness and minimal important difference (MID) were determined with receiver operator characteristic (ROC) curves. Results: One hundred eighty patients met the inclusion criteria. Construct validity was supported for the PSFS and the UEFI (P<.001). Reliability was moderate to good for the PSFS (ICC_2,1 = 0.713) and UEFI (ICC_2,1 = 0.848). Reported estimates of reliability may be lower than true values because the group of “stable” patients from this cohort had, on average, a small positive change. Bland-Altman plots indicated good agreement. The area under the ROC curve (AUC) was significantly different from the null value of 0.5 for the PSFS (0.887) and the UEFI (0.877), indicating good accuracy in distinguishing improved patients from stable patients. MID was 1.2 for the PSFS (scale, 0–10) and 8.5 for the UEFI (scale, 0–80). Conclusion: The PSFS is a valid, reliable, and responsive outcome measure for patients with upper extremity problems. J Orthop Sports Phys Ther 2012;42(2):56–65. doi:10.2519/jospt.2012.3953

The utility of wild-type outer membrane vesicle (wtOMV) vaccines against serogroup B (MenB) meningococcal disease has been explored since the 1970s. Public health interventions in Cuba, Norway and New Zealand have demonstrated that these protein-based vaccines can prevent MenB disease. Data from large clinical studies and retrospective statistical analyses in New Zealand give effectiveness estimates of at least 70%. A consistent pattern of moderately reactogenic and safe vaccines has been seen with the use of approximately 60 million doses of three different wtOMV vaccine formulations. The key limitation of conventional wtOMV vaccines is their lack of broad protective activity against the large diversity of MenB strains circulating globally. The public health intervention in New Zealand (between 2004–2008) when MeNZB was used to control a clonal MenB epidemic, provided a number of new insights regarding international and public-private collaboration, vaccine safety surveillance, vaccine effectiveness esti...

Seismic shear waves emitted by earthquakes can be modeled as plane (transverse) waves. When entering an anisotropic medium, they can be split into two orthogonal components moving at different speeds. This splitting occurs along an axis, the fast polarization, that is determined by geologic conditions. We present here a comprehensive analysis of the Silver and Chan (1991) method, used to obtain shear wave splitting parameters, comprising theoretical derivations and statistical tests of the assumptions used to construct the standard errors. We find discrepancies in the derivations of equations in their article, with the most important being a mistake in how the standard errors are calculated. Our simulations suggest that the degrees of freedom are being overestimated by this method, and consequently, the standard errors are too small. Using a set of S waveforms from very similar shallow earthquakes on Reunion Island, we perform a statistical analysis on the noise of these replicates and find that the assumption of Gaussian noise does not hold. Further, the properties of background noise differ substantially from the noise obtained from the shear wave splitting analysis. However, we find that the estimated standard errors for the fast polarization are comparable to the spread in the fast polarization parameters between events. Delay time errors appear to be comparable to delay time estimates once cycle skipping is accounted for. Future work using synthetic seismograms with simulated noise should be conducted to confirm this is the case for earthquakes in general.