Scanner-specific optimisation of automated lesion segmentation in MS.

BACKGROUND & OBJECTIVE: Automatic lesion segmentation techniques on MRI scans of people with multiple sclerosis (pwMS) could support lesion detection and segmentation in trials and clinical practice. However, knowledge on their reliability across scanners is limited, hampering clinical implementation. The aim of this study was to investigate the within-scanner repeatability and between-scanner reproducibility of lesion segmentation tools in pwMS across three different scanners and examine their accuracy compared to manual segmentations with and without optimization. METHODS: 30 pwMS underwent a scan and rescan on three MRI scanners. GE Discovery MR750 (3.0 T), Siemens Sola (1.5 T) and Siemens Vida (3.0 T)). 3D-FLuid Attenuated Inversion Recovery (3D-FLAIR) and 3D T1-weighted scans were acquired on each scanner. Lesion segmentation involved preprocessing and automatic segmentation using the Lesion Segmentation Toolbox (LST) and nicMSlesions (nicMS) as well as manual segmentation. Both automated segmentation techniques were used with default settings, and with settings optimized to match manual segmentations for each scanner specifically and combined for the three scanners. LST settings were optimized by adjusting the threshold to improve the Dice similarity coefficient (DSC) for each scanner separately and a combined threshold for all scanners. For nicMS the last layers were retrained, once with the multi-scanner data to represent a combined optimization and once separately for each scanner for scanner specific optimization. Volumes and counts were extracted. DSC was calculated for accuracy, and reliability was assessed using intra-class correlation coefficients (ICC). Differences in DSC between software was tested with a repeated measures ANOVA and when appropriate post-hoc paired t-tests using Bonferroni correction. RESULTS: Scanner-specific optimization significantly improved DSC for LST compared to default and combined settings, except for the GE scanner. NicMS showed significantly higher DSC for both the scanner-specific and combined optimization than default. Within-scanner repeatability was excellent (ICC>0.9) for volume and counts. Between-scanner ICC for volume between Vida and Sola was higher (0.94-0.99) than between GE MR750 and Vida or Sola (0.18-0.93), with improved ICCs for nicMS scanner-specific (0.87-0.93) compared to others (0.18-0.79). This was not present for Sola vs. Vida where all ICCs were excellent (>0.94). CONCLUSION: Scanner-specific optimization strategies proved effective in mitigating inter-scanner variability, addressing the issue of insufficient reproducibility and accuracy found with default settings.

Improving agreement in assessing subtrochanteric fracture healing among orthopedic surgeons using the Radiographic Union Score for Hip (RUSH).

BACKGROUND: Prompt identification of fracture healing is crucial for medical decision-making and clinical research. This study aims to assess the effectiveness of the Radiographic Union Score for Hip (RUSH) in subtrochanteric fractures and determine the optimal scoring threshold for fracture healing. METHODS: We obtained 94 sets of X-ray films from the postoperative follow-up of 35 patients who underwent intramedullary nail fixation for subtrochanteric fractures. Six orthopedic trauma surgeons evaluated the imaging data and determined fracture healing based on subjective judgment. They then scored the X-ray images using the RUSH form. After four weeks, the same observers re-evaluated 47 randomly selected sets of radiographs. Subsequently, the observers and study designer conducted a consensus meeting where they agreed on whether the fractures had healed. We used Fleiss kappa to evaluate agreement among observers based on subjective impressions, and the intraclass correlation coefficient assessed RUSH score consistency. Regression analysis examined the relationship between scores and fracture healing consensus using a receiver operator characteristic (ROC) curve. RESULTS: Based on overall impressions, the agreement level among orthopedic trauma surgeons for determining the healing status of subtrochanteric fractures was moderate (Kappa = 0.564, 95% CI: 0.511-0.616). However, utilizing the RUSH scoring system can improve the consistency to a substantial level of agreement (ICC = 0.748, 95% CI: 0.663-0.817). Regarding intraobserver reliability, there were significant differences among orthopedic trauma surgeons in judging fracture healing based on overall impressions. However, using the RUSH scoring form, the attending group achieved better intraobserver consistency than the resident group. Regression analysis and ROC curve analysis revealed a strong correlation between the RUSH total score, cortical bone score, cancellous bone score, and consensus on fracture healing. The AUC values are 0.769 (95% CI: 0.670-0.868), 0.779 (95% CI: 0.681-0.876), and 0.771 (95% CI: 0.674-0.867), respectively. CONCLUSIONS: Our study highlights the effectiveness of the RUSH scoring system in enhancing interobserver agreement and intraobserver consistency when evaluating subtrochanteric fracture healing in orthopedic trauma surgeons. We propose setting 21 points as the threshold for the simplified RUSH scoring system to determine fracture healing. This system includes only eight items related to cortical bone, with a total score of 24 points.

The STarT Back Screening Tool: The Nepali Translation, Cross-Cultural Adaptation and Measurement Properties in Adults With Non-Specific Low Back Pain.

INTRODUCTION/OBJECTIVE: The STarT Back Screening Tool (SBST) stratifies low back pain (LBP) patients based on their risk of chronicity to guide treatment accordingly. The absence of its validated Nepali version limits stratified LBP care in Nepal. The study aimed to translate and cross-culturally adapt the SBST into Nepali and evaluate its measurement properties in adults with LBP. METHODS: The measurement properties of the Nepali SBST were evaluated in 102 Nepali adults with non-specific LBP. We assessed content validity, internal consistency, test-retest reliability, construct and discriminant validity. Item redundancy was evaluated using Cronbach's alpha (α > 0.90), test-retest reliability using Intraclass Correlation Coefficient (ICC2,1) and Cohen's kappa using established cutoffs score for categorising patients into risk groups, construct validity using hypothesis testing (if a minimum of 75% of the hypotheses were supported), and discriminant validity using Area Under the Curve (AUC) with the reference scales administered at baseline. RESULTS: Cronbach's alpha scores were 0.72 for the overall scale and 0.66 for the psychosocial subscale. Test-retest reliability values were good to excellent with ICC2,1 of 0.94 (95% CI: 0.87-0.97) for the overall scale and 0.87 (95% CI: 0.73-0.94) for the psychosocial subscale and Kappa values of 0.68 (95% CI: 0.43-0.93) for the overall scale and 0.79 (95% CI: 0.52-1.00) for psychosocial subscale. Construct validity was confirmed as 100% of a priori hypotheses were met. Acceptable discriminative validity was observed with reference scales with AUCs (0.75-0.80). CONCLUSIONS: Nepali SBST demonstrates the reliability and validity of screening for chronicity risk in Nepali adults with LBP. Future studies should evaluate its responsiveness, predictive abilities, and effectiveness in stratifying LBP patients in the Nepalese context.

The Persian version of the fear of pain questionnaire mong Iranian post-surgery patients: a translation and psychometrics.

INTRODUCTION: The Fear of Pain Questionnaire (FOPQ) is a self-report tool designed to measure an individual's fear of pain (FOP). While the Persian version of the FOPQ (FOPQ-P) has been developed, its validity and reliability have not yet been assessed in the Iranian context. This study aims to evaluate the psychometric properties of the FOPQ-P among Iranian patients after surgery. METHODS: A methodological study was conducted in 2023 involving 400 post-surgery patients selected with a convenience sampling. The FOPQ was translated into Persian, and its psychometric properties were analyzed using network analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), as well as assessments of convergent and discriminant validity. Internal consistency was measured using Cronbach's alpha, McDonald's Omega, average inter-item correlation coefficient, Composite Reliability, and Maximal Reliability. RESULTS: The EFA results with Promax and Kaiser Normalization rotation identified two factors that explained 54.32% of the variance, comprising seven items. The CFA confirmed the model's validity. Both convergent and discriminant validity were established. The reliability analyses showed that Cronbach's alpha, McDonald's omega, composite reliability, and MaxR for all constructs were above 0.7. Additionally, the average inter-item correlation coefficient was greater than 0.5, indicating strong internal consistency and construct reliability. CONCLUSION: The findings suggest that the FOPQ-P possesses a valid structure and was acceptable reliability in patients cultural context of Iran post-surgery, making it a suitable instrument for measuring fear of pain in this population.

Cultural adaptation and psychometric evaluation of the Persian version of the motivation for nursing student scale (MNSS).

BACKGROUND: Motivation is a critical factor in the success of nursing students, as it significantly influences their ability to acquire the necessary knowledge and skills for the nursing profession. Insufficient motivation can result in a lack of engagement with learning activities, thereby impeding the development of essential competencies. AIM: This study aimed to translate the Motivation for Nursing Student Scale (MNSS) into Persian and evaluate its psychometric properties within the context of nursing students in Iran. METHOD: This methodological cross-sectional study involved a sample of 542 nursing students selected through convenience sampling. The MNSS was translated into Persian following the guidelines recommended by the World Health Organization. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of internal consistency were conducted to evaluate the validity and reliability of the instrument. RESULTS: The EFA and CFA validated the structure of the instrument, identifying four factors and 20 items, which explained 58.68% of the total variance. The CFA results indicated a well-fitting model with the following indices: CFI = 0.91, GFI = 0.93, IFI = 0.946, TLI = 0.92, RMSEA = 0.061, and SRMR = 0.049. The Cronbach's alpha coefficient and Intraclass Correlation Coefficient (ICC) for the scale were 0.882 and 0.802, respectively. CONCLUSION: The Persian version of the MNSS demonstrates satisfactory reliability and validity, making it a dependable instrument for measuring the academic motivation of nursing students. This tool can be effectively used to assess the motivation of nursing students in Iran.

[Reference ranges and test-retest reliability of subject visual horizontal from different head-tilt angles in young healthy adults].

Objective:To establish the normal values of subjective visual horizontal（SVH） under different head tilt angles, analyze the test-retest reliability, and provide a normal value reference for the refined diagnosis and functional assessment of SVH in clinical vestibular disorders. Methods:Thirty-one healthy young people were selected to wear visual reality glasses to test SVH data in five different head tilt angles: upright head position 0°, head tilted 45°to the left（L45°ï¼‰, head tilted 45° to the right（R45°ï¼‰, head tilted 90° to the left（L90°ï¼‰, and head tilted 90° to the right（R90°ï¼‰, and were re-tested 2 weeks later. Results:①The normal values of SVH at 0°, L45°, R45°, L90°, and R90°were 0.30±1.32, 5.94±5.54, -11.44±5.32, -0.87±8.63, -2.70±8.02, respectively. ②The 95% confidence intervals of SVH at 0°, L45°, R45°, L90°, and R90° were: （-2.34,2.94）,（-5.14,17.02）,（-22.08,-0.80）,（-18.13,16.39）,（-18.74，13.34）, respectively. The ratio of asymmetry in the absolute value of bilateral 45° deviation was 26.4% and the ratio of asymmetry in the absolute value of bilateral 90° deviation was 1.3%. ③The intra-class correlation coefficient（ICC） for 0°, L45°, R45°, L90° and R90° was 0.625, 0.641, 0.564, 0.769, 0.656, respectively. Conclusion:SVH has good test-retest reliability and high clinical test stability and stability. The data on normal values of SVH at different head tilt angles established in this study can provide clinical references for the refined diagnosis and functional assessment of vestibular system disorders.

Comprehensive needs assessment tool for informal cancer caregivers (CNAT-ICs): Instrument development and cross-sectional validation study.

Background: Growing cancer incidence and its subsequent burden is a worldwide concern. Needs assessment for caregivers has recently received growing attention, as it identifies specific unmet needs. The remaining tools have been established within the healthcare context of Western countries and have been studied only in some Asian populations; it seems appropriate to develop needs assessment tools that apply to a wider ethnic and socio-cultural context. Objective: This study planned to adapt and examine the psychometric properties of the CNAT-C for the Sri Lankan informal caregivers for wider applicability. Design: An instrument development and cross-sectional validation study was conducted. Setting: Apeksha Hospital Maharagama, Sri Lanka (National Cancer Institute). Participants: A sample of 226 informal caregivers (ICs) providing palliative care for patients with advanced cancer was selected. Methods: A CNAT-C (41 items; seven factors) was incorporated and used after a cross-cultural adaptation following WHO guidelines after the permission and pilot test. ICs completed the socio-demographic and clinical details along with the validated Centre for Epidemiological Studies-Depression (CES-D), and the World Health Organization-Quality of Life-Brief (WHOQOL-BREF). Internal consistency and test-retest were used to check the reliability. Convergent and divergent validity of the Sinhala version of CNAT (S-CNAT) was confirmed using the CES-D scale and WHOQOL-BREF. Construct validity was evaluated using the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results: Most of the participants were female (60 %) and married (72 %), and the mean age was 41.78 (SD+14.54). Face and content validity were established during the cross-cultural adaptation. Cronbach's alpha was 0.903 for the overall S-CNAT and the test-retest reliability was 0.965. The S-CNAT was associated positively with the CES-D while negatively with the WHOQOL-BREF. Both EFA and CFA discovered a structure contained seven factors (35 items); domain named as healthcare staff/nurses' support and information, physical/practical needs, medical officers' support, psychological needs, social/family support, spiritual/religious support, and hospital facilities/service. Conclusions: The Sinhala version of CNAT is shown to have adequate validity and reliability in assessing the comprehensive and multidimensional/unmet needs of informal caregivers of patients with advanced cancer (S-CNAT-ICs). It would be a helpful tool to determine the unmet needs of ICs and guide future interventions to meet those needs and enhance or maintain the quality of life for patients and their informal caregivers.

Quantitative reliability assessment of brain MRI volumetric measurements in type II GM1 gangliosidosis patients.

Purpose: GM1-gangliosidosis (GM1) leads to extensive neurodegenerative changes and atrophy that precludes the use of automated MRI segmentation techniques for generating brain volumetrics. We developed a standardized segmentation protocol for brain MRIs of patients with type II GM1 and then assessed the inter- and intra-rater reliability of this methodology. The volumetric data may be used as a biomarker of disease burden and progression, and standardized methodology may support research into the natural history of the disease which is currently lacking in the literature. Approach: Twenty-five brain MRIs were included in this study from 22 type II GM1 patients of which 8 were late-infantile subtype and 14 were juvenile subtype. The following structures were segmented by two rating teams on a slice-by-slice basis: whole brain, ventricles, cerebellum, lentiform nucleus, thalamus, corpus callosum, and caudate nucleus. The inter- and intra-rater reliability of the segmentation method was assessed with an intraclass correlation coefficient as well as Sorensen-Dice and Jaccard coefficients. Results: Based on the Sorensen-Dice and Jaccard coefficients, the inter- and intra-rater reliability of the segmentation method was significantly better for the juvenile patients compared to late-infantile (p < 0.01). In addition, the agreement between the two rater teams and within themselves can be considered good with all p-values < 0.05. Conclusions: The standardized segmentation approach described here has good inter- and intra-rater reliability and may provide greater accuracy and reproducibility for neuromorphological studies in this group of patients and help to further expand our understanding of the natural history of this disease.

Intra- and inter-rater reliability of goniometric finger range of motion using a written protocol.

Introduction: Goniometric finger range of motion (ROM) is the most common outcome measure used for functional evaluation of finger joints, but its reliability is not well-evaluated. This study aimed to investigate intra- and inter-rater reliability of goniometric finger ROM using a written protocol for active, passive, and composite movements in healthy adults. Methods: The design was a single-center, cross-sectional, reliability study. Participants were 20 healthy adults (mean ± standard deviation, 36.4 ± 10.9 years). ROM for active, passive, and composite movements of the fingers was assessed by three occupational therapists with at least 5 years clinical experience in the field of physical disabilities. To standardize the measurement method used, we developed a written protocol, stabilized the wrist position, and trained the evaluators. Intraclass correlation coefficient (ICC) values were used for the reliability analysis. ICC (1,1) was used for intra-rater reliability. ICC (2,1) was used for inter-rater reliability. Hand-shaped heatmaps were used to summarize the reliability data. Results: Most of the results (88.7%) showed moderate to good intra-rater reliability (ICC ≥ 0.50), while inter-rater reliability showed less (69.0%). Both intra- and inter-rater reliability showed no trends between dominant and non-dominant hands, type of movement, finger, or joint. Conclusions: Intra-rater reliability was relatively high and using a written protocol was beneficial. Inter-rater reliability tended to be lower, and differences in the physical structure of both raters and participants may have affected inter-rater reliability values.

Effects of the kinematic variable, time delay and data length on test-retest reliability of the maximal Lyapunov exponent of human walking.

The maximal Lyapunov exponent (MLE) has been used to quantify the dynamic stability of human locomotion. The method for estimating MLE requires selecting a proper time series of kinematic variables and reconstructing phase space using proper time delay. The data length also affects the reliability of the measured MLE. However, there has been no criterion for the choice of the time series, time delay or data length. Here, we quantified the effect of these factors on the test-retest reliability of MLE estimations. We recruited 15 young and healthy adults and let them walk on a treadmill three times. We calculated MLE employing various lengths of time series of 18 frequently used kinematic variables and two typical choices of time delay: fixed delay and delay selected by average mutual information algorithm. Then, we measured the intraclass correlation coefficient (ICC) of the measured MLE under each condition. Our results show that the choice of time delay does not affect reliability. Five among the 18 kinematic variables enabled excellent reliability with ICC above 0.9 within 450 strides and also enabled ICC above 0.75 even with 60 or less strides. These findings can contribute to establishing the criteria for measuring the dynamic stability of human walking.

Personality testing of large language models: limited temporal stability, but highlighted prosociality.

As large language models (LLMs) continue to gain popularity due to their human-like traits and the intimacy they offer to users, their societal impact inevitably expands. This leads to the rising necessity for comprehensive studies to fully understand LLMs and reveal their potential opportunities, drawbacks and overall societal impact. With that in mind, this research conducted an extensive investigation into seven LLMs, aiming to assess the temporal stability and inter-rater agreement on their responses on personality instruments in two time points. In addition, LLMs' personality profile was analysed and compared with human normative data. The findings revealed varying levels of inter-rater agreement in the LLMs' responses over a short time, with some LLMs showing higher agreement (e.g. Llama3 and GPT-4o) compared with others (e.g. GPT-4 and Gemini). Furthermore, agreement depended on used instruments as well as on domain or trait. This implies the variable robustness in LLMs' ability to reliably simulate stable personality characteristics. In the case of scales which showed at least fair agreement, LLMs displayed mostly a socially desirable profile in both agentic and communal domains, as well as a prosocial personality profile reflected in higher agreeableness and conscientiousness and lower Machiavellianism. Exhibiting temporal stability and coherent responses on personality traits is crucial for AI systems due to their societal impact and AI safety concerns.

Design of a Temporally Augmented Text Messaging Bot to Improve Adolescents' Physical Activity and Engagement: Proof-of-Concept Study.

BACKGROUND: Digital interventions hold promise for improving physical activity in adolescents. However, a lack of empirical decision points (eg, timing of intervention prompts) is an evidence gap in the optimization of digital physical activity interventions. OBJECTIVE: The study examined the feasibility and acceptability, as well as the technical and functional reliability, of and participant engagement with a digital intervention that aligned its decision points to occur during times when adolescents typically exercise. This study also explored the impact of the intervention on adolescents' moderate to vigorous physical activity (MVPA) levels. Consistent with the Obesity-Related Behavioral Interventions Trials (ORBIT) model, the primary goal of the study was to identify opportunities to refine the intervention for preparation for future trials. METHODS: Ten adolescents completed a 7-day baseline monitoring period and Temporally Augmented Goal Setting (TAGS), a 20-day digital physical activity intervention that included a midday self-monitoring message that occurred when adolescents typically start to exercise (3 PM). Participants wore an accelerometer to measure their MVPA during the intervention. Participants completed questionnaires about the acceptability of the platform. Rates of recruitment and attrition (feasibility), user and technological errors (reliability), and engagement (average number of text message responses to the midday self-monitoring message) were calculated. The investigation team performed multilevel models to explore the effect of TAGS on MVPA levels from preintervention to intervention. In addition, as exploratory analyses, participants were matched to adolescents who previously completed a similar intervention, Network Underwritten Dynamic Goals Engine (NUDGE), without the midday self-monitoring message, to explore differences in MVPA between interventions. RESULTS: The TAGS intervention was mostly feasible, acceptable, and technically and functionally reliable. Adolescents showed adequate levels of engagement. Preintervention to intervention changes in MVPA were small (approximately a 2-minute change). Exploratory analyses revealed no greater benefit of TAGS on MVPA compared with NUDGE. CONCLUSIONS: TAGS shows promise for future trials with additional refinements given its feasibility, acceptability, technical and functional reliability, participants' rates of engagement, and the relative MVPA improvements. Opportunities to strengthen TAGS include reducing the burden of wearing devices and incorporating of other strategies at the 3 PM decision point. Further optimization of TAGS will inform the design of a Just-in-Time Adaptive Intervention for adolescent physical activity and prepare the intervention for more rigorous testing.

Transparency improves the accuracy of automation use, but automation confidence information does not.

Increased automation transparency can improve the accuracy of automation use but can lead to increased bias towards agreeing with advice. Information about the automation's confidence in its advice may also increase the predictability of automation errors. We examined the effects of providing automation transparency, automation confidence information, and their potential interacting effect on the accuracy of automation use and other outcomes. An uninhabited vehicle (UV) management task was completed where participants selected the optimal UV to complete missions. Low or high automation transparency was provided, and participants agreed/disagreed with automated advice on each mission. We manipulated between participants whether automated advice was accompanied by confidence information. This information indicated on each trial whether automation was "somewhat" or "highly" confident in its advice. Higher transparency improved the accuracy of automation use, led to faster decisions, lower perceived workload, and increased trust and perceived usability. Providing participant automation confidence information, as compared with not, did not have an overall impact on any outcome variable and did not interact with transparency. Despite no benefit, participants who were provided confidence information did use it. For trials where lower compared to higher confidence information was presented, hit rates decreased, correct rejection rates increased, decision times slowed, and perceived workload increased, all suggestive of decreased reliance on automated advice. Such trial-by-trial shifts in automation use bias and other outcomes were not moderated by transparency. These findings can potentially inform the design of automated decision-support systems that are more understandable by humans in order to optimise human-automation interaction.

The quality and reliability of short videos about thyroid nodules on BiliBili and TikTok: Cross-sectional study.

Background: The detection rate of thyroid nodules has witnessed a significant surge in recent years, triggering heightened public apprehension. Short video platforms such as TikTok and BiliBili have showed tremendous potential in the dissemination of health information. There is a plethora of videos about thyroid nodules on TikTok and BiliBili, but the quality and reliability of videos concerning thyroid nodules remains unknown. Methods: On December 3rd, 2023, the top 100 short videos related to thyroid nodules on BiliBili and TikTok were collected through a comprehensive search in Chinese. After extracting the basic information, the quality and reliability of each video was assessed by using the global quality score (GQS) and DISCERN score. Further, Spearman correlation analyses were applied to examine the correlation among video variables, GQS and DISCERN score. Results: Compared to BiliBili, TikTok exhibits greater popularity, as evidenced by higher counts of likes (P = 0.021), comments (P = 0.008) and shares (P = 0.017). The median (interquartile range) scores of GQS and DISCERN score were 3 (2-3) on TikTok while 2 (2-3) on BiliBili. Both reviewers exhibited good consistency in GQS and DISCERN score. Moreover, it was observed that the videos shared by thyroid specialists demonstrated higher scores both in GQS (P = 0.014) and DISCERN score (P = 0.022) than others on TikTok. Spearman correlation analysis revealed no significant correlation between video variables and the scores of GQS and DISCERN score. Conclusions: The quality and reliability of thyroid nodules videos on BiliBili and TikTok were unsatisfactory. Notably, videos shared by thyroid specialists are more likely to exhibit superior quality and reliability. People should exercise caution when perusing short videos.

Vocal Fatigue Index (VFI): Cross-Cultural Adaptation, Validation, and Cut-off Values of the Arabic Version.

OBJECTIVE: This study aims to validate, cross-culturally, and linguistically adapt the Vocal Fatigue Index (VFI) into Arabic. STUDY DESIGN: Cross-sectional study. METHODS: The VFI was translated into Arabic, reverse translated, and content validated. To assess its psychometric properties, 398 patients with voice disorders (199 males, 199 females, mean age=46.2 ± 15.0years) and 121 vocally healthy controls (57 males, 64 females, mean age=42.1 ± 6.9years) completed the VFI-Arabic. We calculated internal consistency and test-retest reliability using Cronbach's alpha and intraclass correlation (ICC) coefficients. Independent sample t tests determined mean factor score differences between groups, while receiver operator characteristic curves analyzed sensitivity, specificity, and cut-off scores for the three factors. RESULTS: The overall Cronbach's alpha was 0.95, across all factors combined, it was 0.68; and for factors 1, 2, and 3, it was 0.95, 0.91, and 0.91, respectively. Test-retest reliability for the subscales was excellent (ICC: 0.97, 0.91, 0.82 for factors 1, 2, and 3). Mean subscale scores were significantly higher in the voice-disordered group than in controls. The area under the curve for factors 1, 2, and 3 was 0.824, 0.759, and 0.646, respectively. Best cut-off scores were ≥14.5 (69.8% sensitivity, 83.1% specificity) for factor 1, ≥3.5 (66.3% sensitivity, 74.4% specificity) for factor 2, and ≥5.5 (60.1% sensitivity, 64.5% specificity) for factor 3. CONCLUSION: The VFI-Arabic is a valid and reliable tool for identifying and quantifying vocal fatigue symptoms in Arabic speakers.

Development and validation of the RQLQ: a Raynaud's disease-specific measure of health-related quality of life.

INTRODUCTION/OBJECTIVES: The aim of this study was to develop and validate the Raynaud Specific Quality of Life Questionnaire (RQLQ) for assessing health-related quality (HRQOL) of life in patients with Raynaud's disease (RD). METHOD: The questionnaire was developed and validated in three stages. Initially, semi-structured interviews with 28 RD patients identified domains of everyday life affected by RD, leading to the creation of the initial RQLQ. In the first quantitative stage, 101 patients completed the RQLQ, and exploratory factor analysis assessed dimensionality and factor structure. After removing poorly performing items, the final RQLQ was tested with 102 patients. This stage also evaluated convergent, divergent, and discriminant validity, as well as internal reliability. RESULTS: From the interviews, 135 items were generated, with factor analysis refining the measure to 29 items across five subscales, showing good internal consistency. The RQLQ demonstrated significant correlations with self-rated quality of life and physical and mental health outcomes, confirming convergent and divergent validity. It also showed discriminant validity for different levels of disease activity. CONCLUSIONS: The RQLQ is the first specific HRQOL measure for RD patients, proving to be a psychometrically sound, reliable, and valid tool for clinical research and practice. Key Points • The Raynaud Specific Quality of Life Questionnaire (RQLQ) is an important scale that evaluates the quality of life of patients with Raynaud's disease. • The questionnaire showed good validity and reliability a capturing disease-specific quality of life. • This tool may aid in clinical research and practice.

Psychometric evaluation of the study interest questionnaire-short form among Chinese nursing students based on classical test theory and item response theory.

BACKGROUND: There is currently no dedicated measurement for assessing nursing students' study interest in China. Considering the good reliability, validity, and widespread applicability of the Study Interest Questionnaire-Short Form (SIQ-SF), the objective of this study was to validate its usage among Chinese nursing students. METHODS: The translation and cross-cultural adaptation rigorously followed the modified Brislin model. A cross-sectional survey was conducted using the Chinese version of the SIQ-SF and convenience sampling was employed to select nursing students. The Psychometric evaluation of the Chinese version of the SIQ-SF was conducted based on Classical Test Theory and Item Response Theory. RESULTS: A total of 1158 participants were included in the analysis. The item-level content validity index (CVI) ranged from 0.9 to 1.0, and the scale-level CVI was 0.98. In the Exploratory factor analysis, three factors with eigenvalues above 1 were identified, accounting for 62.554% of the cumulative variance. In the confirmatory factor analysis, the CMIN\DF was 5.639, the GFI was 0.953, the CFI was 0.902, and the IFI was 0.904. The Cronbach's α coefficient of the Chinese version of the SIQ-SF was 0.70. Thirty-one participants were invited to sign the scale after two weeks. The intraclass correlation coefficient was 0.784, and that of items ranged from 0.70 to 0.819. The infit MnSQ values ranged between 0.76 and 1.51, and the outfit MnSQ values ranged between 0.72 and 1.76. The point-measure correlation value ranged between 0.30 and 0.68. The item difficulty measures ranged from - 0.66 to 1.44 logit and the individual learning interest estimations ranged from - 4.22 to 4.97 logit. DIF contrast ranged from 0.00 to 0.33 logits, with all p values greater than 0.05. CONCLUSIONS: The Chinese version of the SIQ-SF demonstrated acceptable reliability and validity among Chinese nursing students and could be used to assess nursing students' study interest in China. With the aid of this scale, teachers can gain a better understanding of nursing students' study interests, thereby maximizing their learning effects through appropriate content and methods.

Empathy unmasked: the compassion quotient of dental students.

BACKGROUND: Despite an empathic doctor patient relationship being of utmost importance to improve health care outcomes, this aspect is scarcely explored in dental students of Pakistan. This primary objective of the present study was to assess the reliability and validity of the Jefferson Scale of Empathy- Health Professions Student (JSE- HPS) version in a sample of Pakistani dental students. The study also compared the differences in empathy levels of dental students studying in different academic years. METHODS: This comparative cross-sectional study was conducted on a sample of 304 students from first to final year from selected 02 private and 02 public dental colleges of Karachi, Pakistan from December 2021- January 2022. The self-administered Jefferson Scale of Empathy- Health Professions Student (JSE-HPS) version was used for data collection. This questionnaire includes 20 items that can be answered on a 7-point Likert scale. After attendance sheets were obtained, random student names were marked, and questionnaire distributed by hand to these students. All forms were collected right after to maximize response rate. RESULTS: A total of 304 forms with complete data were returned, a response rate of 86.9%. Females (97.79 ± 15 94) were more empathetic than males (94.16 ± 12.13) (p = 0.001). Students of third-year were the most empathetic (p = 0.000). Internal consistency of questionnaire was acceptable (Cronbach's α- 0.77). Factor analysis revealed factor related to belief that patient's perspectives improve health outcome had 14 items with factor coefficient > 0.4 contributing to largest proportion of variance (23.15%). CONCLUSIONS: Our study shows JSE- HPS to have acceptable internal consistency. Structural validity of the scale evaluated by confirmatory factor analysis reported results that were in concordance to those suggested by developers of this scale. In our study population, like other studies, females were more empathic than males. Third-year dental students were more empathetic than students of other undergraduate years.

Accuracy of pelvic bone segmentation for 3d printing: a study of segmentation accuracy based on anatomic landmarks to evaluate the influence of the observer.

BACKGROUND: 3D printing has a wide range of applications and has brought significant change to many medical fields. However, ensuring quality assurance (QA) is essential for patient safety and requires a QA program that encompasses the entire production process. This process begins with imaging and continues on with segmentation, which is the conversion of Digital Imaging and Communications in Medicine (DICOM) data into virtual 3D-models. Since segmentation is highly influenced by manual intervention the influence of the users background on segmentation accuracy should be thoroughly investigated. METHODS: Seventeen computed tomography (CT) scans of the pelvis with physiological bony structures were identified, anonymized, exported as DICOM data sets, and pelvic bones were segmented by four observers with different backgrounds. Landmarks were measured on DICOM images and in the segmentations. Intraclass correlation coefficients (ICCs) were calculated to assess inter-observer agreement, and the trueness of the segmentation results was analyzed by comparing the DICOM landmark measurements with the measurements of the segmentation results. The correlation between segmentation trueness and segmentation time was analyzed. RESULTS: The lower limits of the 95% confidence intervals of the ICCs for the seven landmarks analyzed ranged from 0.511 to 0.986. The distance between the iliac crests showed the highest agreement between observers, while the distance between the ischial tuberosities showed the lowest. The distance between the upper edge of the symphysis and the promontory showed the lowest deviation between DICOM measurements and segmentation measurements (mean deviations < 1 mm), while the intertuberous distance showed the highest deviation (mean deviations 14.5-18.2 mm). CONCLUSIONS: Investigators with diverse backgrounds in segmentation and varying experience with slice images achieved pelvic bone segmentations with landmark measurements of mostly high agreement in a setup with high realism. In contrast, high variability was observed in the segmentation of the coccyx. In general, interobserver agreement was high, but due to measurement inaccuracies, landmark-based approaches cannot conclusively show that segmentation accuracy is within a clinically tolerable range of 2 mm for the pelvis. If the segmentation is performed by a very inexperienced user, the result should be reviewed critically by the clinician in charge.

Quantitative analysis of construction risks in shallowly buried biased tunnel portal section.

To address the prominent problem of collapse instability in shallow buried soft ground tunnels, a non-invasive stochastic finite element method was introduced. Taking Fujian Puyan Wenbishan tunnel as the background project, ABAQUS finite element software was used to analyze the tunnel excavation mechanics and parameter sensitivity. And developed the software interface program based on Python to output explicit limit state equation for the key mechanical indexes of the tunnel, so as to evaluate the tunnel reliability under different excavation methods, quantitatively. Study results show a significant improvement in efficiency and accuracy when calculating the probability of failure in tunnel excavation by the non-invasive stochastic finite element method. The maximum displacement monitoring points for the Wenbishan tunnel portal section were all vault settlement, with displacements of 33.6 mm, 30.2 mm, and 25.3 mm, respectively, using the annular retained core soil method, single sidewall guide pit and double sidewall guide pit method, with probabilities of failure of 36.11%, 28.03%, and 20.02%. It is found that the reliability of the tunnel is mainly determined by the geotechnical weight, elastic modulus and cohesion of the weak sandy soil layer, which can provide ideas for this type of engineering researches.