Responsiveness and minimal important change (MIC) are central measurement properties when interpreting scores from health questionnaires. The aim of the study was to evaluate the responsiveness and ...MIC of the Danish version of the shortened version the Disabilities of the Arm, Shoulder and Hand questionnaire (Quick-DASH) in patients with shoulder disorders referred to primary care physiotherapy treatment.
The study included 261 patients who completed questionnaires at baseline and 3 and 6 months follow up. Absolute and relative change scores was analysed using receiver-operating-characteristics (ROC) curve analysis with the Patient Global Impression of Change (PGIC) as external anchor.
At both 3 and 6 months follow up, the Area under the Curve (ROC AUC) exceeded 0.70 and MIC was 9.1 and 13.6 at 3 and 6 months respectively.
The Danish version of the Quick-DASH demonstrated adequate ability to measure changes in disability over 3 and 6 months in patients with shoulder disorders undergoing primary care physiotherapy treatment.
The late Miocene offers the opportunity to assess the sensitivity of the Earth's climate to orbital forcing and to changing boundary conditions, such as ice volume and greenhouse gas concentrations, ...on a warmer-than-modern Earth. Here we investigate the relationships between low- and high-latitude climate variability in an extended succession from the subtropical northwestern Pacific Ocean. Our high-resolution benthic isotope record in combination with paired mixed layer isotope and Mg/Ca-derived temperature data reveal that a long-term cooling trend was synchronous with intensification of the Asian winter monsoon and strengthening of the biological pump from ~7 Ma until ~5.5 Ma. The climate shift occurred at the end of a global δ
C decrease, suggesting that changes in the carbon cycle involving the terrestrial and deep ocean carbon reservoirs were instrumental in driving late Miocene climate cooling. The inception of cooler climate conditions culminated with ephemeral Northern Hemisphere glaciations between 6.0 and 5.5 Ma.
We present high‐resolution (2–3 kyr) benthic foraminiferal stable isotopes in a continuous, well‐preserved sedimentary archive from the West Pacific Ocean (Ocean Drilling Program Site 1146), which ...track climate evolution in unprecedented resolution over the period 12.9 to 8.4 Ma. We developed an astronomically tuned chronology over this interval and integrated our new records with published isotope data from the same location to reconstruct long‐term climate and ocean circulation development between 16.4 and 8.4 Ma. This extended perspective reveals that the long eccentricity (400 kyr) cycle is prominently encoded in the δ13C signal over most of the record, reflecting long‐term fluctuations in the carbon cycle. The δ18O signal closely follows variations in short eccentricity (100 kyr) and obliquity (41 kyr). In particular, the obliquity cycle is prominent from ~14.6 to 14.1 Ma and from ~9.8 to 9.2 Ma, when high‐amplitude variability in obliquity is congruent with low‐amplitude variability in short eccentricity. The δ18O curve is additionally characterized by a series of incremental steps at ~14.6, 13.9, 13.1, 10.6, 9.9, and 9.0 Ma, which we attribute to progressive deep water cooling and/or glaciation episodes following the end of the Miocene climatic optimum. On the basis of δ18O amplitudes, we find that climate variability decreased substantially after ~13 Ma, except for a remarkable warming episode at ~10.8–10.7 Ma at peak insolation during eccentricity maxima (100 and 400 kyr). This transient warming, associated with a massive negative carbon isotope shift, is reminiscent of intense global warming events at eccentricity maxima during the Miocene climatic optimum.
Key Points
Stepwise climate cooling at ~14.6, 13.9, 13.1, 10.6, 9.9, and 9.0 Ma
Transient warming episode at ~10.8 Ma coincident with eccentricity extremes
Miocene astronomically tuned benthic isotope reference curve spanning 8 Myr
To determine and compare estimates of the smallest worthwhile effect (SWE) for physiotherapy in neck, shoulder, and low-back pain patients and to investigate the influence of sociodemographic, ...clinical, and psychological factors on these estimates.
A structured telephone interview was conducted before treatment was commenced in 160 patients referred for primary care physiotherapy. The benefit-harm trade-off method was used to estimate the SWE of physiotherapy for the following outcomes; pain, disability, and time to recovery, compared with the improvement achieved without any treatment (natural course). Regression analyses were used to assess the influence of sociodemographics, clinical variables, and intake scores on pain, disability, and psychological scales.
The median SWE for improvements on pain and disability was 20% (interquartile range 10%–30%), and the SWE for time to recovery was 10 days (interquartile range 7–14 days) over a period of 6 weeks. These estimates did not differ with respect to pain location (neck, shoulder, or back) and were generally unaffected by sociodemographic, clinical, and psychological factors.
People with neck, shoulder, and low-back pain need to see at least 20% of additional improvement on pain and disability compared with natural recovery to consider that the effect of physiotherapy is worthwhile, given its costs, potential side effects, and inconveniences.
Tracing the origin of nutrients is a fundamental goal of food web research but methodological issues associated with current research techniques such as using stable isotope ratios of bulk tissue can ...lead to confounding results. We investigated whether naturally occurring δ(13)C patterns among amino acids (δ(13)CAA) could distinguish between multiple aquatic and terrestrial primary production sources. We found that δ(13)CAA patterns in contrast to bulk δ(13)C values distinguished between carbon derived from algae, seagrass, terrestrial plants, bacteria and fungi. Furthermore, we showed for two aquatic producers that their δ(13)CAA patterns were largely unaffected by different environmental conditions despite substantial shifts in bulk δ(13)C values. The potential of assessing the major carbon sources at the base of the food web was demonstrated for freshwater, pelagic, and estuarine consumers; consumer δ(13)C patterns of essential amino acids largely matched those of the dominant primary producers in each system. Since amino acids make up about half of organismal carbon, source diagnostic isotope fingerprints can be used as a new complementary approach to overcome some of the limitations of variable source bulk isotope values commonly encountered in estuarine areas and other complex environments with mixed aquatic and terrestrial inputs.
A detailed reconstruction of West African monsoon hydrology over the past 155,000 years suggests a close linkage to northern high-latitude climate oscillations. Ba/Ca ratio and oxygen isotope ...composition of planktonic foraminifera in a marine sediment core from the Gulf of Guinea, in the eastern equatorial Atlantic (EEA), reveal centennial-scale variations of riverine freshwater input that are synchronous with northern high-latitude stadials and interstadials of the penultimate interglacial and the last deglaciation. EEA Mg/Ca-based sea surface temperatures (SSTs) were decoupled from northern high-latitude millennial-scale fluctuation and primarily responded to changes in atmospheric greenhouse gases and low-latitude solar insolation. The onset of enhanced monsoon precipitation lags behind the changes in EEA SSTs by up to 7000 years during glacial-interglacial transitions. This study demonstrates that the stadial-interstadial and deglacial climate instability of the northern high latitudes exerts dominant control on the West African monsoon dynamics through an atmospheric linkage.
Many recently published papers have investigated the spatial and temporal manifestation of the 4.2 ka BP climate event at regional and global scales. However, questions with regard to the potential ...drivers of the associated climate change remain open. Here, we investigate the interaction between Atlantic and Mediterranean climate forcing on the south-eastern Iberian Peninsula during the mid- to late Holocene using compound-specific hydrogen isotopes from fossil leaf waxes preserved in marine sediments. Variability of hydrogen isotope values in the study area is primarily related to changes in the precipitation source and indicates three phases of increased Mediterranean sourced precipitation from 5450 to 5350 cal. BP, from 5150 to 4300 cal. BP including a short-term interruption around 4800 cal. BP, and from 3400 to 3000 cal. BP interrupted around 3200 cal. BP. These phases are in good agreement with times of prevailing positive modes of the North Atlantic Oscillation (NAO) and reduced storm activity in the Western Mediterranean suggesting that the NAO was the dominant modulator of relative variability in precipitation sources. However, as previously suggested other modes such as the Western Mediterranean Oscillation (WeMO) may have altered this overall relationship. In this regard, a decrease in Mediterranean moisture source coincident with a rapid reduction in warm season precipitation during the 4.2 ka BP event at the south-eastern Iberian Peninsula might have been related to negative WeMO conditions.
•A new method for profiling salmon using multivariate analyses of amino acids (AA) δ13C was developed.•Characteristic δ13CAA profiles of distinct groups are referred to as δ13CAA fingerprints.•The ...fingerprints can discriminate between wild and organic salmon with high fidelity.•The fingerprints are well suited for detecting novel ingredients such as macroalgae and insects.•δ13C profiles of essential and non-essential AA differ in their source diagnostic abilities.
The rapid expansion of the aquaculture industry with carnivorous fish such as salmon has been accompanied by an equally rapid development in alternative feed ingredients. This has outpaced the ability of prevailing authentication method to trace the diet and origins of salmon products at the retail end. To close this gap, we developed a new profiling tool based on amino acid δ13C fingerprints. With this tool, we discriminated with high-accuracy among wild-caught, organically, and conventionally farmed salmon groups, as well as salmon fed alternative diets such as insects and macroalgae. Substitution of fishmeal with macroalgae was detected at 5% difference level. The δ13C fingerprints of essential amino acids appear particularly well suited for tracing protein sources, and the non-essentials for tracing lipid origins (terrestrial vs. aquatic). In an industry constantly developing new feed proteins and functional additives, our method is a promising tool for tracing salmon and other seafood products.
One of the most enigmatic features of Cenozoic long-term climate evolution is the long-lasting positive carbon-isotope excursion or “Monterey Excursion”, which started during a period of global ...warmth after 16.9 Ma and ended at ∼
13.5 Ma, approximately 400 kyr after major expansion of the Antarctic ice-sheet. We present high-resolution (1–9 kyr) astronomically-tuned climate proxy records in two complete sedimentary successions from the northwestern and southeastern Pacific (ODP Sites 1146 and 1237), which shed new light on the middle Miocene carbon-isotope excursion and associated climatic transition over the interval 17.1–12.7 Ma. We recognize three distinct climate phases with different imprints of orbital variations into the climatic signals (1146 and 1237
δ
18O,
δ
13C; 1237 XRF Fe, fraction >
63 μm): (1) climate optimum prior to 14.7 Ma characterized by minimum ice volume and prominent 100 and 400 kyr variability, (2) long-term cooling from 14.7 to 13.9 Ma, principally driven by obliquity and culminating with rapid cryosphere expansion and global cooling at the onset of the last and most pronounced
δ
13C increase, (3) “Icehouse” mode after 13.9 Ma with distinct 100 kyr variability and improved ventilation of the deep Pacific. The “Monterey” carbon-isotope excursion (16.9–13.5 Ma) consists overall of nine 400 kyr cycles, which show high coherence with the long eccentricity period. Superposed on these low-frequency oscillations are high-frequency variations (100 kyr), which closely track the amplitude modulation of the short eccentricity period. In contrast to
δ
13C, the
δ
18O signal additionally shows significant power in the 41 kyr band, and the 1.2 Myr amplitude modulation of the obliquity cycle is clearly imprinted in the 1146
δ
18O signal. Our results suggest that eccentricity was a prime pacemaker of middle Miocene climate evolution through the modulation of long-term carbon budgets and that obliquity-paced changes in high-latitude seasonality favored the transition into the “Icehouse” climate.
PDF
