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Background: Assessment of scapular dyskinesis (SD) is of clinical interest, as SD is believed to be related to shoulder pathology. However, no clinical assessment with sufficient reliability to identify SD and provide treatment strategies is available.
Objectives: The purpose of this study was to investigate the reliability of the comprehensive SD classification method.
Design: Cross-sectional reliability study.
Method: Sixty subjects with unilateral shoulder pain were evaluated by two independent physiotherapists with a visual-based palpation method. SD was classified as single abnormal scapular pattern [inferior angle (pattern I), medial border (pattern II), superior border of scapula prominence or abnormal scapulohumeral rhythm (pattern III)], a mixture of the above abnormal scapular patterns, or normal pattern (pattern IV). The assessment of SD was evaluated as subjects performed bilateral arm raising/lowering movements with a weighted load in the scapular plane. Percentage of agreement and kappa coefficients were calculated to determine reliability.
Results: Agreement between the 2 independent physiotherapists was 83% (50/60, 6 subjects as pattern III and 44 subjects as pattern IV) in the raising phase and 68% (41/60, 5 subjects as pattern I, 12 subjects as pattern II, 12 subjects as pattern IV, 12 subjects as mixed patterns I and II) in the lowering phase. The kappa coefficients were 0.49-0.64.
Conclusions: We concluded that the visual-based palpation classification method for SD had moderate to substantial inter-rater reliability. The appearance of different types of SD was more pronounced in the lowering phase than in the raising phase of arm movements.
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http://dx.doi.org/10.1016/j.math.2014.10.017 | DOI Listing |
J Bioeth Inq
September 2025
Swedish National Centre for Priorities in Health, Department of Health, Medicine, and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.
When treatments are deemed not to be cost-effective and face non-reimbursement, policymakers in publicly funded healthcare systems may decide to ration treatments by withholding it from future patients. However, they must also address a critical question: should they also ration treatments by withdrawing it from patients already having access to the treatment, or is there an ethical difference between withdrawing and withholding treatments? To explore this question, we conducted a behavioural experiment (n=1404), examining public support for withdrawing and withholding treatments in reimbursement decisions across eleven different circumstances. Overall, public support for rationing by withdrawing and withholding was low, with no general perceived difference between withdrawing and withholding treatments.
View Article and Find Full Text PDFDrugs Aging
September 2025
Dalla Lana School of Public Health, University of Toronto, V1 06, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
Background And Objectives: Older adults living with dementia are a heterogeneous group, which can make studying optimal medication management challenging. Unsupervised machine learning is a group of computing methods that rely on unlabeled data-that is, where the algorithm itself is discovering patterns without the need for researchers to label the data with a known outcome. These methods may help us to better understand complex prescribing patterns in this population.
View Article and Find Full Text PDFChaos
September 2025
Instituto de Física, Universidade Federal de Alagoas, Maceió, Alagoas 57072-970, Brazil.
Neuronal heterogeneity, characterized by a multitude of spiking neuronal patterns, is a widespread phenomenon throughout the nervous system. In particular, the brain exhibits strong variability among inhibitory neurons. Despite the huge neuronal heterogeneity across brain regions, which in principle could decrease synchronization due to differences in intrinsic neuronal properties, cortical areas coherently oscillate during various cognitive tasks.
View Article and Find Full Text PDFInt J Lang Commun Disord
September 2025
Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.
Background: Research Capacity and Culture (RCC) is important for research engagement. Little is known of what speech and language therapy staff perceives to be the barriers or enablers to this at individual, team and organisational levels.
Aims: To identify the barriers and enablers to RCC among speech and language therapy staff, using behaviour change theory as a framework, and to explore their self-reported level of research engagement.
J Morphol
September 2025
School of Agriculture, Biomedicine and Environment, La Trobe University, Melbourne, Victoria, Australia.
Although the surface micro-ornamentation of the scales within the skin of snakes has been the subject of many previous studies, there has been little work done on the spectacle, a protective (keratinised) goggle separated from the underlying cornea by a sub-spectacular space. The surface ultrastructure of the "Oberhäutchen" of the spectacle is examined in nine species of snakes (five aquatic and four terrestrial) using light and electron microscopy, micro-computed tomography and gel-based profilometry. Significant topographic differences in cell size (increases of between 5.
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