Objectives:
Compare a disease specific questionnaire (American Shoulder and Elbow Surgeons ASES) and a multidimensional global health scale (Patient reported outcome measurement system PROMIS) across ...a variety of shoulder conditions.
Methods:
The ASES (Pain subscore, Function subscore, and total score) and PROMIS Physical Function (PF), Pain Interference (PI), and Depression Computer Adaptive Tests (CATs) were collected on all clinic visits for two high volume shoulder surgeons over a 12-week period between 1/26/16 and 4/20/16. Data included all (n=123) records for new patient visits of patients over 18 years old for shoulder diagnoses of Impingement (M75.41, n=50), Pain (M25.11, n=30), Rotator Cuff Tear (M75.10, M75.12; n=12), Arthropathy (M12.9, n=12), Instability (M75.02, n=6), Adhesive Capsulitis (M75.02, n=4), and miscellaneous (n=9). Excluding diagnoses with small samples (n<10) Two way ANOVA’s (Diagnosis by Outcome Measure Domains) with age and gender as covariates were used to determine if specific diagnoses presented with different initial severity of pain, function, or depression. This was followed by univariate analysis to determine the associations between the disease specific ASES scores and non disease specific PROMIS domains. Correlations of r>0.7 were considered strong correlation, r>0.5 moderate, and <0.5 poor. All analyses were carried out using
SPSS
® version 22 (copyright 2013).
Results:
Two way ANOVA’s demonstrated no significant differences of ASES or PROMIS scores across diagnoses, suggesting similar levels of pain, function and depression across diagnoses. PROMIS PF was moderately associated with ASES Function (r=0.61, p<0.01), and ASES Total (r=0.59, p<0.01). PROMIS PI was strongly correlated to ASES Function (r=-0.71, p<0.01) and ASES Total (r=-0.74, p<0.01) as well as moderately correlated to ASES Pain (r=-0.56, P<0.01). ASES Pain had poor correlation to ASES Function (r=0.45, p<0.01). PROMIS Depression had poor correlation to all ASES domains.
Conclusion:
The non-disease specific PROMIS PF and PI demonstrated the ability to determine disease severity across shoulder diagnosis equal to an accepted disease specific scale (ASES). Furthermore, PROMIS PI had a stronger correlation to ASES Function than either PROMIS PF or the ASES Pain subscore and may more accurately describe the true affect of pain on a patient’s daily life. This data shows the potential for the universally available and emerging PROMIS instrument to track shoulder problems similar to a prior established disease specific instrument.
Low-mass pre-main sequence (PMS) stars are strong and variable X-ray emitters, as has been well established by EINSTEIN and ROSAT observatories. It was originally believed that this emission was of ...thermal nature and primarily originated from coronal activity (magnetically confined loops, in analogy with Solar activity) on contracting young stars. Broadband spectral analysis showed that the emission was not isothermal and that elemental abundances were non-Solar. The resolving power of the Chandra and XMM X-ray gratings spectrometers have provided the first, tantalizing details concerning the physical conditions such as temperatures, densities, and abundances that characterize the X-ray emitting regions of young star. These existing high resolution spectrometers, however, simply do not have the effective area to measure diagnostic lines for a large number of PMS stars over required to answer global questions such as: how does magnetic activity in PMS stars differ from that of main sequence stars, how do they evolve, what determines the population structure and activity in stellar clusters, and how does the activity influence the evolution of protostellar disks. Highly resolved (R>3000) X-ray spectroscopy at orders of magnitude greater efficiency than currently available will provide major advances in answering these questions. This requires the ability to resolve the key diagnostic emission lines with a precision of better than 100 km/s.
Understanding the origins and distribution of matter in the Universe is one of the most important quests in physics and astronomy. Themes range from astro-particle physics to chemical evolution in ...the Galaxy to cosmic nucleosynthesis and chemistry in an anticipation of a full account of matter in the Universe. Studies of chemical evolution in the early Universe will answer questions about when and where the majority of metals were formed, how they spread and why they appar today as they are. The evolution of matter in our Universe cannot be characterized as a simple path of development. In fact the state of matter today tells us that mass and matter is under constant reformation through on-going star formation, nucleosynthesis and mass loss on stellar and galactic scales. X-ray absorption studies have evolved in recent years into powerful means to probe the various phases of interstellar and intergalactic media. Future observatories such as IXO and Gen-X will provide vast new opportunities to study structure and distribution of matter with high resolution X-ray spectra. Specifically the capabilities of the soft energy gratings with a resolution of R=3000 onboard IXO will provide ground breaking determinations of element abundance, ionization structure, and dispersion velocities of the interstellar and intergalactic media of our Galaxy and the Local Group
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