Assessment of parent-child interaction by practitioners is of great importance but hindered by a lack of instruments that withstand the constraints daily practice places on usage. Visuals may offer an alternative format. Visualizations were tested on reliability, accuracy, and feasibility in observational assessment of parent-child interaction, as alternatives for textual rating scales.

In Study 1, 95 students rated parent-child interactions with a video or text anchor scale, and in Study 2, 217 professionals rated the same interactions with a decision tree including visual components or a text anchor scale.

Students using the video anchor scale were less reliable and accurate, slower, and had a less positive user experience than students using the text anchor scale. Professionals using the decision tree did not differ in reliability and were comparable in user experience with professionals using the text anchor scale. Rater accuracy showed similar dependency on quality of parental behavior for both scales: ratings were less accurate when the quality of the parent-child interaction was low, and more accurate when the quality was high. However, professionals were less accurate and slower in using the decision tree than the text anchor scale.

With a first iteration of a decision tree performing the same to or only slightly worse, efforts to further develop decision trees might be worthwhile.

These nonintuitive findings underscore the value of experimental testing in assessment design in daily practice.

Divergent thinking and executive function are critical components of cognitive performance, necessitating reliable assessment tools to guide clinical decision-making and research on cognitive deficits. This study aimed to evaluate the interrater reliability of the modified Tinkertoy test (m-TTT), a neuropsychological tool designed to assess these functions, particularly in individuals with schizophrenia.

The interrater reliability of the m-TTT was assessed in a sample of 40 Japanese participants, including 20 individuals with schizophrenia (12 males, eight females; mean age = 42.4 [standard deviation, 12.6] years) and 20 healthy controls (12 males, eight females; mean age = 40.0 [standard deviation, 9.6] years). Performances were independently scored by two occupational therapists using a standardized framework. Relative reliability was evaluated using intraclass correlation coefficients (ICCs), and absolute reliability was examined using Bland-Altman analysis.

In the schizophrenia group, ICC values indicated high interrater reliability for complexity (0.979), creation process (0.881), and total (0.969) scores. Similarly, in the control group, ICC values were high for complexity (0.969), creation process (0.790), and total (0.934) scores. Bland-Altman analysis demonstrated no fixed or proportional bias; however, greater variability was observed at higher creation process scores in the control group.

The results confirm the high interrater reliability of the m-TTT, supporting its utility as a robust tool for assessing cognitive deficits and guiding rehabilitation strategies in psychiatric contexts. However, the study's generalizability is limited by its Japanese-only sample, necessitating further validation across diverse populations and cultural settings.

This is the first study to investigate the agreement between children's self-reports and parents' proxy reports on the quality of life (QoL) of children with medical complexity in the Chinese context. We further examined if there were differences in the concordance between children's self-reports and parents' proxy reports.

A cross-sectional study of 113 parent-child dyads was conducted on parents and their children aged 10-18 years with a diagnosis of medical complexity. The intra-class correlation coefficients between the scores of children and parents were excellent in total PedsQL and physical functioning, good in school functioning, and fair in social functioning and emotional functioning.

Children rated themselves better than their parents for emotional, social, school, and physical functioning. Discordance between the emotional and social components was observed from parent-reported and child-reported. There are some discrepancies in interpretation on pediatric QoL between children with medical complexity and their parents.

The study suggested both parents and children's voices should be taken into account during health assessments and health-decision making to ensure tailor-made and appropriate nursing care is provided to the CMC.

The Criança Feliz (Happy Child) parenting program is a home visiting intervention serving over a million low-income Brazilian families. The current study assessed its longitudinal associations with maternal and child speech and gestures in a subsample (n = 145) from the program's impact evaluation research. We performed a between-participants pragmatic randomized trial. Mothers (79.7% Black) and children (17-25 months of age; 50.3% female) were randomly assigned to control (n = 73) and intervention (n = 72) groups. One year later, mother-child pairs were recorded playing at home, and the videos were transcribed and analyzed for speech (quantity, vocabulary diversity, sentence complexity, and number of questions) and gestures (quantity). Intention-to-treat analysis revealed that the intervention was associated with the mother's vocabulary diversity (d = .35) regardless of schooling level. No direct or indirect (via maternal speech) associations were observed with the child's speech or gestures. This preliminary evidence suggests that participation in the Criança Feliz program is related to mothers' vocabulary diversity but not to children's speech or gesture measures. The program could focus on maternal gestures, questions, and book reading (complexity feature). Future research evaluating the impact of the program on language outcomes should include pretesting and child follow-up assessments.

Identifying Parkinson's disease (PD) during its initial phases presents considerable hurdles for clinicians.

To examine the feasibility and efficacy of a machine learning model based on quantitative multiparametric magnetic resonance imaging (MRI) features in identifying early-stage PD.

We recruited 33 participants, including 19 with early-stage PD, 14 with advanced-stage PD and 20 healthy control subjects. Each participant underwent both quantitative susceptibility mapping (QSM) and diffusion kurtosis imaging (DKI). We utilized combined QSM and DKI features to establish a support vector machine (SVM) model to identify early-stage PD.

When comparing early-stage PD with healthy controls, the SVM model exhibited moderate performance, achieving a training set accuracy of 0.78 and an area under the receiver operating characteristic curve (AUC) of 0.90, and the accuracy of 0.77 (AUC = 0.87) in the test set. When comparing advanced-stage PD with healthy controls, the SVM model exhibited equally high accuracy in both training (0.97, AUC = 0.97) and test (0.94, AUC = 0.94) sets. In discriminating between early-stage PD and advanced-stage PD, the SVM model achieved an accuracy of 0.80 (AUC = 0.81) in the training set and an accuracy of 0.71 (AUC = 0.72) in the test set. The mean kurtosis feature of DKI in the substantia nigra, played a significant role in classification.

These findings suggest that early PD is associated with specific MRI features reflecting magnetic susceptibility and microstructural changes. The SVM model combining quantitative QSM and DKI features holds promise for improving early PD diagnosis.

Alterations in glenohumeral internal rotation (GIR), glenohumeral external rotation (GER), and total range of motion (TROM) have been linked with increased injury risk. GER capacity has been measured routinely with the forearm in neutral rotation (GERN), but a recent study reported GERN was greater than GER with the forearm in pronation (GERP) in Minor League pitchers. This work has not yet been replicated or extended to other groups.

GERP would be significantly less than GERN in Independent League baseball pitchers, and there would be no difference in GERP or GERN measurements between this new group and the previous group of Minor League pitchers.

Cross-sectional study.

Level 3.

Goniometric measurements were recorded for bilateral GIR, GERN, and GERP, and resulting TROM for 37 Independent League baseball pitchers. These data were compared with the previous study. All motions were compared individually between groups, between throwing and nonthrowing arm, and both within and between techniques (forearm neutral or pronated).

GERP was significantly less than GERN for both arms within each group tested (P < 0.01). Independent League pitchers had greater between arm differences for GIR (-16.9° vs -6.9°), GERN (+15.1° vs -0.6°), and GERP (+13.1° vs -5.9°) compared with Minor League pitchers. TROM for the Independent League pitchers was not statistically different for either measurement technique, while TROM for the throwing arm of the Minor League pitchers was statistically reduced with varying effect sizes (d = 0.35-0.99) compared with the nonthrowing arm (P < 0.01).

This study confirmed earlier findings that the pronated forearm resulted in decreased GER capacity, illustrating the adaptive response to throwing and the need to evaluate for this variable.

GERP should be evaluated in all groups of pitchers, but there may be variations within tested groups.

Maternal insensitivity to children's emotional distress (e.g., expressions of sadness or fearfulness) is one mechanism through which maternal alcohol dependence may increase children's risk for psychopathology. Although emotion dysregulation is consistently associated with psychopathology, it remains unclear how or why alcohol dependence's effects on caregiving responses to children's distress may impact children's emotion regulation over time, particularly in ways that may engender risks for psychopathology. This study examined longitudinal associations between lifetime maternal alcohol dependence symptoms, mothers' insensitivity to children's emotional distress cues, and children's emotional reactivity among 201 mother-child dyads (Mchild age = 2.14 years; 56% Black; 11% Latino). Structural equation modeling analyses revealed a significant mediational pathway such that maternal alcohol dependence predicted increases in mothers' insensitivity to children's emotional distress across a one-year period (β = .16, p = .013), which subsequently predicted decreases in children's emotional reactivity one year later (β = -.29, p = .009). Results suggest that mothers with alcohol dependence symptoms may struggle to sensitively respond to children's emotional distress, which may prompt children to suppress or hide their emotions as an adaptive, protective strategy. The potential developmental benefits and consequences of early, protective expressive suppression strategies are discussed via developmental psychopathology frameworks.

The Thematic Apperception Test (TAT) is the second most commonly used performance-based task. However, traditional TAT administration is time-consuming and raises accessibility issues. Research exploring administration modifications has found that within a lab setting, having participants type their own narratives leads to richer responses than when participants narrate the stories out loud to an examiner. The current study extends prior research by investigating the impact of card presentation (hard copy versus computer screen) and setting (in the lab versus online) on narrative quality. A four-card TAT protocol was administered to 134 college students in three separate conditions: in lab with hard copies of cards, in lab with images on the computer, and online in which participants could take the TAT wherever they wished. In all conditions, participants typed their narratives. The narratives were scored using the Social Cognition and Object Relations Scale- Global Rating Method (SCORS-G). MANOVA procedures showed that SCORS-G ratings were not affected by card presentation or setting and add to prior work to suggest that the TAT can be administered online without a diminution in the quality of SCORS-G ratings at least with some populations.

This study explored the salient characteristics of transactions within parent-child engagement and investigated relationships between transactional characteristics and future identification of autism. The main aims of the study were to (1) examine if parents/children and their initial behaviors impact the length of transaction; (2) determine miscue differences among parents and children; and (3) determine if transactional characteristics are predictive of autism at preschool age.The study sample was drawn from extant data of a parent-mediated intervention for young children showing early sings of autism. Thirty parent-child dyad videos were randomly selected and coded for transactions. Statistical analyses were applied to examine the study aims and to perform post-hoc analyses.The length of transaction increased when children initiated with a look cue. Parents displayed a higher proportion of miscues and greater variance in their miscue behavior than their children. Neither the length of transaction nor the proportion of child miscues at 1-year of age predicted an autism diagnosis at preschool age. Post-hoc analyses revealed that girls with high variance of transaction length at 1-year of age, had a lower likelihood of showing autism traits at preschool age. Sustained transactions were more likely when children initiated engagement by looking. Early transactional characteristics were associated with later autism identification among girls, namely longer median transaction length with lower variance of transaction length. This transaction profile is believed to represent high fixation on topics with less ability to explore varied topics.

Digital anthropometry is a useful tool for surgeons and patients in breast reconstruction surgery (BRS). Owing to advancements in smartphone technology, these devices can be used for three-dimensional (3D) surface imaging. In this prospective study, anthropometric measurements of the breast were performed using a smartphone and compared with measurements obtained using an established 3D surface imaging system.

In this study, 40 patients who underwent BRS were included. 3D-surface models (SMs) were obtained using the Vectra H2 stereophotogrammetry camera (Canfield Scientific, USA) and an iPhone 15 (Apple Inc., USA) in combination with the 3D Scanner App (Laan Consulting Corp., USA). Fourteen measurements were performed on all 3D SMs. Subsequently, smartphone-based measurements were compared to Vectra-based measurements. Statistical methods used were the paired t-test, paired Wilcoxon-signed ranks test, Bland-Altman analyses, and calculation of the intraclass correlation coefficient (ICC).

All measurements demonstrated excellent agreement between those obtained using the smartphone and Vectra H2 (ICC between.963 and.998). No statistical differences were found for 11 of the 14 anthropometric measurements. The Bland-Altman analyses yielded promising results, demonstrating 95% limits of agreement within a range of less than ±2 mm between the 2 methods.

The proposed method for smartphone-based anthropometry of the breast showed moderate accuracy for clinical use. However, the approach used to create and evaluate the 3D SMs is considered laborious. Therefore, further refinement of the method may be necessary to enable the implementation of smartphone-based surface imaging in plastic surgery.

DRKS00034221.

The aim of this study was to evaluate the impact of a prototype grid with a 29:1 ratio (r29) and a 15:1 (r15) grid on the image quality (IQ) and radiation dose in abdominal angiography.

Six typical abdominal angiographic image scenarios were created in 4 pigs. Polymethylmethacrylate and aluminum plates were used to add 10 cm of patient equivalent thickness to simulate different body types. Fluoroscopic images were acquired with a source-to-image receptor distance of 120 cm. Tantalum- and iron-specific acquisition protocols at different IQ levels were acquired. IQ of radiation dose equivalent image pairs, created with the r29 and r15 grids, respectively, was quantitatively evaluated using contrast-to-noise ratio (CNR) measurements. Differences in radiation dose were estimated using the dose-weighted CNR. Two blinded readers compared IQ of these images using a Likert scale. In a second step, the readers selected pairs of the r29 and r15 images with subjectively equivalent IQ. Radiation doses were then compared.

Compared with the r15 grid, the r29 grid images achieved similar CNR at an average of 26% (±12%) lower radiation dose at a mean patient equivalent thickness of 26 cm and 36 cm. Both readers noted a significant increase in IQ ( P < 0.001) for dose equivalent images, whereas the interobserver agreement was 0.59. For the selected IQ equivalent images, a radiation dose reduction of 38% (±17%; P < 0.001, interobserver agreement 0.92) was noted when using the r29 grid.

The use of an r29 grid at a large source-to-image receptor distance can significantly improve the IQ compared with the r15 grid at the same radiation dose in abdominal angiography or can reduce radiation dose while preserving IQ.

Motivational interviewing (MI) is frequently used to facilitate behavior change. The use of change talk during motivational interviews can predict subsequent behavior change. However, no studies have compared the information obtained from traditional face-to-face motivational interviews and computer-mediated motivational interviews or resulted in the same amount of behavior change.

This study aimed to investigate if face-to-face motivational-type interviews (MTIs) and computer-mediated MTIs elicit the same amount of "change talk" and behavior change when young adults discuss their ambivalence about using marijuana.

A total of 150 users, including frequent marijuana users, occasional marijuana users, and non-marijuana users, participated in the study. All participants reported being at least moderately ambivalent about their current level of marijuana use. Participants were randomly assigned to complete a brief MTI using either the standard face-to-face format or a computer-mediated format. Amrhein's manual for assessing the presence of "change talk" and "sustain talk" was used to code the language produced by respondents in each interview format. A reduction in marijuana use was assessed at a 2-month follow-up.

The word count was significantly higher in face-to-face MTIs compared with computer-mediated MTIs (P<.001). After controlling for verbosity, face-to-face MTIs, and computer-mediated MTIs did not differ statistically in the overall amount of change talk (P=.47) and sustain talk (P=.05). Face-to-face MTIs elicited significantly more reasons for reducing future marijuana use (ie, change talk; P=.02) and readiness toward not using marijuana (ie, change talk; P=.009), even after controlling for verbosity. However, these differences were not statistically significant after using a conservative Bonferroni correction (P<.004). After controlling for marijuana use at Time 1, the relationship between the strength of commitment language at Time 1 and marijuana use at Time 2 was not statistically significant (semipartial correlation r=0.03, P=.57). The association between Time 1 change talk and Time 2 marijuana use depended on the type of motivational interview that participants experienced: face-to-face MTI versus computer-mediated MTI (B=0.45, P=.01). A negative binomial regression with a log link function was used to probe this relationship after controlling for 2 covariates: gender and Time 1 (baseline assessment) marijuana use. Among participants in the face-to-face MTI condition, Time 2 (follow-up) marijuana use decreased as the strength of Time 1 change talk increased, although this finding was not significant (B=-0.21, P=.08). However, among participants in the computer-mediated MTI condition, Time 2 marijuana use was not significantly related to the strength of Time 1 change talk (B=0.13, P=.16).

Computer-mediated MTIs and face-to-face MTIs elicit both change talk and sustain talk, which suggests that motivational interviews could potentially be adapted for delivery via text-based computer platforms. However, further research is needed to enhance the predictive validity of the type of language obtained via computer-delivered MI.

ClinicalTrials.gov NCT06945471; https://clinicaltrials.gov/study/NCT06945471.

This study aimed to examine the voice quality and voice-related quality of life of children choir singers, an understudied population despite the demanding vocal requirements and limited vocal education.

Forty-five choir-singing children (mean age: 13 years, range: 8.11-17.01 years) participated in this cross-sectional study. A multidimensional assessment, including instrumental voice measurements, auditory-perceptual evaluations of the speaking (using GRBASI) and singing (using Consensus Auditory-Perceptual Evaluation of Voice) voice, and participant-reported outcome measures (PROMs), was conducted at Europa Cantat Junior Ghent 2023, a festival for children and youth choirs. Primary outcomes included Dysphonia Severity Index (DSI), Acoustic Voice Quality Index (AVQI), fundamental frequency (fo), Grade, and PROMs. The PROMs contained a self-reported questionnaire gathering voice-related data, the KIDSCREEN-10 assessing general health-related quality of life (HRQoL), and the Children's Voice Handicap Index-10 (CVHI-10).

Instrumental analysis revealed a mean DSI of +6.4 (range: +0.9 to +9.7), indicating excellent vocal capabilities. In terms of acoustic voice quality, the mean AVQI of 3.1 (range: 1.7-5.0) suggested mild dysphonia. Auditory-perceptual evaluations revealed a mean Grade score of 0.69 (standard deviation [SD]: 0.56) for the speaking voice and 10.67 (SD: 10.22) for the singing voice, corresponding with a mildly deviant voice quality. Global assessment of the singing voice yielded a mean score of 74.33/100, with 100 representing an outstanding voice. PROMs revealed that most participants reported an average (84.4%) to high (6.7%) HRQoL. However, the mean CVHI-10 score of 3.4 (range: 0-15) reflected some self-perceived voice difficulties. Furthermore, 51.1% reported frequent voice complaints after vocal performances.

While choir singing appeared to support excellent vocal capabilities and strong singing abilities, the analyses of the acoustic voice quality and the auditory-perceptual evaluation of both the speaking and singing voice indicated mild dysphonia. Despite their generally good health, half of the children reported vocal complaints after performances. This underscores the importance of further investigating children's understanding of their vocal apparatus, their vocal habits, and the potential impact of singing on their voices.

Executive functions (EFs) predict positive life outcomes and educational attainment. Consequently, it is imperative that our measures of EF constructs are both reliable and valid, with advantages for research tools that offer efficiency and remote capabilities.

The objective of this study was to evaluate reliability and validity evidence for a mobile, adaptive measure of EFs called Adaptive Cognitive Evaluation-Explorer (ACE-X).

We collected data from 2 cohorts of participants: a test-retest sample (N=246, age: mean 35.75, SD 11.74 y) to assess consistency of ACE-X task performance over repeated administrations and a validation sample involving child or adolescent (5436/6052, 89.82%; age: mean 12.78, SD 1.60 years) and adult participants (484/6052, 8%; age: mean 38.11, SD 14.96 years) to examine consistency of metrics, internal structures, and invariance of ACE-X task performance. A subset of participants (132/6052, 2.18%; age: mean 37.04, SD 13.23 years) also completed a similar set of cognitive tasks using the Inquisit platform to assess the concurrent validity of ACE-X.

Intraclass correlation coefficients revealed most ACE-X tasks were moderately to very reliable across repeated assessments (intraclass correlation coefficient=0.45-0.79; P<.001). Moreover, in comparisons of internal structures of ACE-X task performance, model fit indices suggested that a network model based on partial correlations was the best fit to the data (χ228=40.13; P=.06; comparative fit index=0.99; root mean square error of approximation=0.03, 90% CI 0.00-0.05; Bayesian information criterion=5075.87; Akaike information criterion=4917.71) and that network edge weights are invariant across both younger and older adult participants. A Spinglass community detection algorithm suggested ACE-X task performance can be described by 3 communities (selected in 85% of replications): set reconfiguration, attentional control, and interference resolution. On the other hand, Pearson correlation coefficients indicated mixed results for the concurrent validity comparisons between ACE-X and Inquisit (r=-.05-.62, P<.001-.76).

These findings suggest that ACE-X is a reliable and valid research tool for understanding EFs and their relations to outcome measures.

Introduction: obesity is a condition that increases the risk of presenting other non-communicable diseases, reducing life expectancy and quality of life in individuals. Its development involves a complex interaction of several factors, the main ones being inadequate food intake and lack of physical activity. Objective: to design and validate a tool to identify eating habits, physical activity and emotional state in adolescents. Methods: an observational study was carried out in 2 instances design and validation, using the Delphi method, taking as a basis for its design the 7 stages proposed by Sampieri. The design, based on the systematic review of the literature, was proposed by the coordinating group. Validation was carried out in 2 phases: the first by means of the criteria of judges, with the participation of 17 experts who evaluated the wording and relevance of each item, and the second by means of statistical analysis estimating the Aiken V coefficient, binomial tests, Cronbach's Alpha and McDonald's Omega. It was applied to a sample of 673 adolescents from the southern area of the state of Tamaulipas, Mexico. Results: an instrument composed of 46 items in 3 dimensions was obtained. In the validation, binomial tests were estimated, showing a significance of 0.000, which indicates that the questions are correlated. Likewise, the Aiken V coefficient was estimated for all the items, which presented a value > 0.7, establishing adequate content validity for each one of them. Finally, the reliability tests estimated by means of Cronbach's Alpha and McDonald's Omega obtained an overall value of 0.777, which indicates that the instrument is reproducible and consistent. Conclusions: the tool generated presented validity and reliability indicating that it is suitable for its application in the assessment of risk in healthy habits of adolescents (diet and physical activity) and of alteration in their emotional state.

In response to exercise, protein kinases and signaling networks are engaged to blunt homeostatic threats generated by acute contraction-induced increases in skeletal muscle energy and oxygen demand, as well as serving roles in the adaptive response to chronic exercise training to blunt future disruptions to homeostasis. High-intensity interval training (HIIT) is a time-efficient exercise modality that induces superior or similar health-promoting skeletal muscle and whole-body adaptations compared with prolonged, moderate-intensity continuous training (MICT). However, the skeletal muscle signaling pathways underlying HIIT's exercise intensity-specific adaptive responses are unknown.

We mapped human muscle kinases, substrates, and signaling pathways activated/deactivated by an acute bout of HIIT versus work-matched MICT.

In a randomized crossover trial design (Australian New Zealand Clinical Trials Registry number ACTRN12619000819123; prospectively registered 6 June 2019), ten healthy male participants (age 25.4 ± 3.2 years; BMI 23.5 ± 1.6 kg/m2;V ˙ O 2 max 37.9 ± 5.2 ml/kg/min, mean values ± SD) completed a single bout of HIIT and MICT cycling separated by ≥ 10 days and matched for total work (67.9 ± 10.2 kJ) and duration (10 min). Mass spectrometry-based phosphoproteomic analysis of muscle biopsy samples collected before, during (5 min), and immediately following (10 min) each exercise bout, to map acute temporal signaling responses to HIIT and MICT, identified and quantified 14,931 total phosphopeptides, corresponding to 8509 phosphorylation sites.

Bioinformatic analyses uncovered exercise intensity-specific signaling networks, including > 1000 differentially phosphorylated sites (± 1.5-fold change; adjusted P < 0.05; ≥ 3 participants) after 5 min and 10 min HIIT and/or MICT relative to rest. After 5 and 10 min, 92 and 348 sites were differentially phosphorylated by HIIT, respectively, versus MICT. Plasma lactate concentrations throughout HIIT were higher than MICT (P < 0.05), and correlation analyses identified > 3000 phosphosites significantly correlated with lactate (q < 0.05) including top functional phosphosites underlying metabolic regulation.

Collectively, this first global map of the work-matched HIIT versus MICT signaling networks has revealed rapid exercise intensity-specific regulation of kinases, substrates, and pathways in human skeletal muscle that may contribute to HIIT's skeletal muscle adaptations and health-promoting effects.  Preprint: The preprint version of this work is available on medRxiv, https://doi.org/10:1101/2024.07.11.24310302 .

To assess the inter-rater reliability of the Gothenburg direct observation tool-person-centred care in assessing healthcare professionals' competency in delivering person-centred care (PCC).

Observational, fully-crossed inter-rater reliability study.

The study was conducted between October and December 2022 at the participants' homes or offices.

Six health professionals individually rated 10 video-recorded, simulated consultations against the 53-item, 15-domain tool covering four major areas: PCC activities, clinician manner, clinician skills and PCC goals. Cronbach's α was used to assess internal consistency. Intraclass correlations (ICC) and 95% CI were computed for the domains.

Two domains (planning and documentation and documentation) were excluded from analyses due to insufficient evaluable data. Cronbach's α was acceptable (>0.70) for all evaluated domains. ICC values were high (ICC ≥0.75) for 11 of the 13 domains; however, CIs were generally wide and the lower bounds fell within the good range (ICC=0.60-0.74) for six domains and fair agreement (ICC=0.40-0.59) for the remaining six. The ICC for the domain patient perspective was non-informative due to its wide CIs (ICC=0.74 (0.39-0.92)).

ICC estimates for most domains were comparable to or exceeded those reported for similar direct observation tools for assessing PCC, suggesting that they may reliably be used in, for example, education and quality improvement applications. Reliability for the domains planning and documentation and documentation needs to be assessed in studies sampling more documentation behaviours. Reliability for the patient perspective domain may owe to methodological issues and should be reassessed in larger, better-designed studies.

Ketamine is known for its rapid antidepressant effect, but its impact on affective information processing (including attentional bias [AB], a putative cognitive mechanism of depression) remains largely unexplored. We leveraged a novel measurement of AB and sought to 1) establish adequate test-retest reliability and validity among participants with depression prior to ketamine treatment and 2) harness a single dose of ketamine to assess mechanistic shifts in AB and their relationship to antidepressant efficacy.

A novel dual probe video task was used to index AB toward sad film clips. In study 1, treatment-seeking adults with moderate-to-severe depression (N = 40) completed the task at baseline, 1-week retest, and 1-month retest; a subset of participants (n = 15) also performed the task at 24 hours postketamine infusion (0.5 mg/kg over 40 minutes). In study 2, participants (N = 43) completed the task pre- and 24 hours postketamine.

Indices from the novel AB task were stable prior to ketamine, demonstrating good 1-week and 1-month test-retest reliability. Participants in both studies exhibited a robust reduction in AB from pre- to 24 hours postketamine infusion. In study 1, cross-sectional correlations were observed between AB and clinician-rated depressive symptoms at each pretreatment assessment. In study 2, changes in AB were correlated with improved symptoms from pre- to postinfusion.

Results provide evidence for the validity of a novel, psychometrically robust measure of AB among individuals with depression. Findings indicate that ketamine reliably and rapidly reduces AB, offering insight into a replicable, potential cognitive mechanism involved in its antidepressant action.

Patients with posterolateral rotational instability (PLRI) of the elbow exhibit a higher degree of joint incongruence on magnetic resonance imaging (MRI) than patients without PLRI. However, the influence of joint hypermobility and position of the elbow in healthy participants is yet unknown.

To analyze the influence of general hypermobility and elbow joint position on joint congruence in healthy participants via MRI.

Case-control study; Level of evidence, 4.

Twenty participants with Beighton score <5 (normal group) and 20 with Beighton score ≥5 (hypermobile group) who had healthy elbows underwent bilateral MRI in full extension and supination, full extension and pronation, and 30° of flexion in both supination and pronation. Sagittal radiocapitellar joint incongruence and ulnohumeral joint incongruence (in sagittal, coronal, and axial planes) were measured according to a standardized protocol.

Radiocapitellar congruence increased in pronation (P < .001) but did not change between flexion and extension (P > .05). Coronal ulnohumeral congruence increased significantly from extension and supination to pronation (P = .010) and to combined flexion and pronation (P = .011). Sagittal and axial ulnohumeral joint congruence did not change significantly between different elbow joint positions (P > .05). Significant differences between the normal and hypermobile groups were observed in 3 of the 4 evaluated joint positions. Overall, the hypermobile group showed an increased joint incongruence except in extension and pronation (P > .05).

In MRI examination of healthy elbows, joint congruence increased significantly from supination to pronation. In combined extension and pronation, the elbow joint was equally congruent in the normal and hypermobile groups. When MRI scans in supination or combined flexion and pronation are evaluated, increased joint incongruence in hypermobile individuals is physiological and should not be confused with PLRI.

Obsessive-compulsive disorder (OCD) is recognized globally as a serious mental health concern among children and adolescents. Accurate early diagnosis and intervention are crucial for effective management and improving patient outcomes. The primary objective of this study was to evaluate the diagnostic validity of the Child Behavior Checklist-Obsessive Compulsive Scale (CBCL-OCS) in Chinese children and adolescents, ensuring its cultural adaptability. The secondary objective was to explore the clinical characteristics of OCD, including prevalence, symptom severity, and comorbidities.

A cross-sectional epidemiological survey was conducted among 8,595 middle school students in Liaoning Province, China. The CBCL-OCS was employed as the primary screening tool. The optimal cutoff value for OCD screening was determined through receiver operating characteristic (ROC) curve analysis.

The study found an OCD prevalence of 1.710%, which was consistent with the global estimation. ROC analysis determined a cutoff score of 2.5 for CBCL-OCS, with a sensitivity of 0.789 and a specificity of 0.899. Furthermore, adolescents exhibited significantly higher CBCL-OCS scores compared to younger children, suggesting an increase in OCD severity with age. Significant associations were also found between OCD symptoms and comorbid emotional disorders, behavioral problems, and anxiety symptoms.

This study confirms the utility of CBCL-OCS as an effective early screening tool for OCD in Chinese middle school students, highlighting its sensitivity and specificity, and cultural adaptability. Results contributed valuable insights to the epidemiology of OCD among children and adolescents, underscoring the need for targeted interventions during critical developmental periods, especially in adolescence.

To investigate the equivalence of the 12-item speech, spatial, and quality of hearing (SSQ12) scale administered in either the interview or online version to adults with and without hearing loss.

One hundred fifty-two listeners (99 females) aged 18-81 years (M = 46.0, SD = 15.3) participated in this study. Eighty-two individuals were in the normal hearing group and 70 were in the hearing-impaired group. Participants completed the SSQ12 questionnaire twice: 1) interview and 2) online format. The presentation order was randomized (interview or online first); after three to four weeks, the participants completed the questionnaire in another format.

SSQ12 scores differed significantly between formats (p < 0.001), but the mean difference was minimal (0.3 points). The internal consistency was high for both formats (Cronbach's alpha >0.9). Intraclass correlation (ICC) values showed excellent agreement for the speech (ICC = 0.88) and spatial (ICC = 0.84) subscales and good agreement for the Qualities (ICC = 0.66). The area under the receiver operating characteristic curve (AUC) was 0.863, indicating good diagnostic accuracy.

The administration method affects SSQ12 scores, but the difference is not clinically significant. Therefore, both methods can be interchangeable, allowing clinicians to choose the most appropriate format based on patient needs. Additionally, the SSQ12 effectively distinguishes between normal and hearing-impaired listeners.

Valid, reliable measures of psychosocial constructs are needed in oral health research. This study quantitatively evaluated the psychometric properties of nine new Oral Health Behavior Social Support (OHBSS) scales, which measured support for three oral health behaviors (brushing, flossing, dental care), queried for each of three sources (family, health providers, others/friends).

Young Mexican-origin adults in the southwestern United States-Mexico border region completed an online survey, in English or Spanish (N = 502). Survey items included: OHBSS scales, general social support scales, oral health behaviors, self-rated oral health status, dental anxiety, acculturation and socio-demographics. Subsample 1 participants also completed a dental exam (N = 41). Subsample 2 participants also completed a repeat OHBSS survey two-to-six weeks later (N = 56). Psychometric properties were tabulated, overall and by language preference (English or Spanish). Convergent and divergent validity were evaluated via correlations between the dental-specific OHBSS social support scales, scores from three validated general social support scales, and scales expected to be largely unrelated (acculturation, dental anxiety). Correlations examined predictive validity between the OHBSS scales and oral health behaviors, and self-reported and clinical outcomes. Test-retest reliability was assessed via intraclass correlation coefficients in Subsample 2.

Of 502 participants, 60% preferred speaking English, 37% were single, and 21% were male. OHBSS scores indicated that health providers then family provided the most support for all three oral health behaviors, while others/friends did not provide much support. Spanish speakers tended to have higher OHBSS scores than English speakers. Correlations followed expected patterns and supported convergent and divergent validity, in the full sample and across languages. OHBSS scales exhibited many significant weak-moderate positive correlations (r = 0.10-0.38) with general social support scales. Few (11/108) significant correlations (< -0.16) were observed between OHBSS scales, acculturation, and dental anxiety. OHBSS scales exhibited some significant weak-moderate positive correlations with oral health-promoting behaviors. OHBSS scales were not associated with clinical outcomes. OHBSS scales exhibited good test-retest reliability overall and in Spanish.

Psychometric properties for the OHBSS scales were acceptable in both English and Spanish versions. The scales are valid and reliable tools for assessing social support for oral health-promoting behaviors from family, health providers, and others/friends.

Not applicable.

This study analyses the feasibility and effectiveness of BabyMICARE, a manualised intervention programme aimed at improving the interactions between caregivers and infants and toddlers with Down syndrome. The programme's goal is to enhance caregivers' sensitivity and reduce directivity during early interactions, particularly during play and daily routines. A pre-test and post-test design was used with 40 dyads of infants with Down syndrome and their caregivers, who were divided into a control group (n = 20) and an intervention group (n = 20), based on baseline scores in key interaction subscales. Sessions were conducted over 10 weeks by trained psychologists. Parent-infant interaction was assessed using the MACI coding system, which measures aspects such as sensitive responsiveness, directivity and the level of reciprocity between the parent and the child. The programme showed high feasibility, with a 100% attendance rate but some rescheduling. Caregivers evaluated it positively. The intervention group demonstrated significant improvements in five of eight MACI scales, particularly in sensitive responsiveness and nondirectiveness, while no changes were observed in the control group. The results suggest that BabyMICARE is a feasible and effective intervention for promoting more responsive, less directive interactions, which may be crucial in fostering children's development.

Intensive Care Unit (ICU) nurses experience many difficulties and challenges in caring for delirium patients. Identifying and measuring these difficulties experienced by nurses is critical for implementing precise interventions. We currently lack a standard tool for assessing the level of difficulty faced by ICU nurses in caring for delirium patients that fits the nursing context in China. This study aimed to translate the Difficulty Scale for Nurses who Care for Patients with Delirium in the Intensive Care Unit (DSNCPD-ICU) into Chinese (C-DSNCPD-ICU) and psychometrically validate the translated scale.

The English version of DSNCPD-ICU consisted of a main scale with eight factors and an additional scale of one factor. It was translated in strict accordance with Brislin's translation model to yield the Chinese versions. Using a convenience sampling method, 477 ICU nurses from ten general hospitals were recruited for online survey, which collected sociodemographic information, scores on C-DSNCPD-ICU and the Strain of Care for Delirium Index. Subsequent psychometric attributes of the C-DSNCPD-ICU were also tested by the validity and reliability.

There were 437 valid responses. The content validity index was calculated as 0.96. Cronbach's alpha for the total scale and each factor were 0.919 and 0.705-0.878, respectively. Exploratory factor analysis verified an eight-factor scale and an additional scale structure with cumulative variance contributions of the factors of 63.78% and 57.62%, respectively. Confirmatory factor analysis showed that all data-model fits were acceptable.

The C-DSNCPD-ICU validated in this study showed satisfactory psychometric properties. This will help Chinese nurse managers to accurately assess the degree of difficulty and identify the causes of precise barriers in caring for patients with delirium. Using the scale, nurse managers can determine what kind of measures should be taken, including formulating effective and tailored educational programs and providing more resources to support nurses.

Treatment-induced peripheral neuropathy is one of the most complex toxicities to diagnose and manage in cancer patients. The severity and course of neuropathy across various cancer treatments are widely assessed using the Treatment-Induced Neuropathy Assessment Scale (TNAS). However, the psychometric properties and longitudinal measurement invariance of TNAS have not been evaluated in non-Western samples. The purpose of this study was to evaluate psychometric properties and longitudinal measurement invariance of the TNAS in Chinese cancer patients. A quantitative survey with a longitudinal design was used in this study. A total of 361 patients were included and data were collected at three-time points. Confirmatory factor analysis (CFA), convergent validity, longitudinal measurement invariance, criterion validity, and internal consistency reliability were evaluated. In this study, CFA supported the 2-factor structure of the original TNAS construct at three time points. The composite reliability (CR) and the average variance extracted (AVE) indicated that the TNAS had good convergent validity. Furthermore, TNAS exhibited strong measurement invariance over time with good reliability across different time points. The correlation between TNAS and EORTC QLQ-CIPN20 showed good criterion validity. Moreover, the TNAS and sub-scales had high internal consistency at three time points. Thus, TNAS is a reliable and valid instrument with adequate psychometric properties and temporal stability for measuring treatment-induced peripheral neuropathy and tracking changes in neuropathy symptoms.

This study aimed to evaluate the reliability and validity of an adapted English questionnaire in Chinese medical schools, assessing its cross-cultural applicability in China.

A survey was conducted among clinical medical interns from four medical schools in China, collecting 216 valid responses. The questionnaire, based on the latest version of CLEQ, consisted of four dimensions and 18 items. It was translated into Chinese through a six-step forward and backward translation process. Data were analyzed using IBM SPSS Statistics 26 and IBM SPSS AMOS 28 Graphics.

The findings demonstrate that the translated questionnaire is suitable for Chinese clinical medical interns. Except for the "Learning Motivation" dimension with a reliability coefficient of 0.760, all other dimensions scored between 0.8 and 1, indicating strong internal consistency and reliability. Correlation coefficients exceeded 0.5, confirming good test-retest reliability. Model fit indices indicated good compatibility (CMIN/DF = 1.749, RMSEA = 0.057, and IFI, TLI, CFI > 0.9). Validity testing showed that all dimensions, except "Learning Motivation," had AVE values above 0.5 and CR values above 0.7,indicating good convergent validity and composite reliability. The discriminant validity of all dimensions was confirmed, as standardized correlation coefficients between each pair remained below the square root of their respective average variance extracted (AVE) values.

The four-factor CLEQ questionnaire shows good validity and reliability among Chinese clinical interns.

Not applicable.

Endurance-specific activities in diverse terrains, including alpine regions, necessitate the transportation of supplementary equipment, thereby necessitating an adaptation of the load intensity. To ascertain the impact of these loads on acute endurance performance and load intensity, it was essential to conduct tests with additional loads to predict the individual reaction to carrying additional loads on performance. The formulas derived in this study facilitate the prediction of exercise adaptation when carrying additional loads.

This study aimed to develop and validate a formula-based prediction of performance adaptation when carrying additional loads to guide load intensities and training instructions.

The 105 participants, 54 male and 51 female, had a mean age of 23.7 years, a mean height of 174.0 cm, a mean weight of 71.7 kg, and an aerobic capacity of 48.6 mL/kg/min-1. Two treadmill ramp tests were conducted in a laboratory setting, with and without additional loads, to assess the adaptation of cardiopulmonary parameters. Both tests were conducted at 4 km/h and an incline of 1%, with the speed increasing by 1 km/h each minute until the subject reported feeling exhausted. The statistical analysis was conducted via stepwise linear regression. The formulas were validated with an independent t-test on an additional dataset, and the equivalence was determined with a two-sided test (TOST).

Based on these tests, regressions were calculated for speed (p < 0.001) and heart rate (p < 0.001) with additional loads, and formulas were derived to predict the adaptations of heart rate and speed to additional loads. The results revealed that the backpack weight, sex, and individual parameters without load were the most accurate predictors of performance with additional load carriage (p < 0.001). The validation of the formulas, using a sample of N = 64, was statistically equivalent.

The formulas can predict the adaptation of running speeds and heart rates at the ventilatory thresholds with different additional loads. This is useful for controlling optimal load intensities in endurance performance with additional loads, to prevent overstraining. This is particularly relevant in mountain sports or military marches, where optimizing loads and mitigating falls due to overstraining is crucial.

The aim of this study was to determine the validity and reliability of the 10-meter walk test modified by adding 5 and 17 cm obstacles (10MWT-O) in community-dwelling older adults and to examine its ability to differentiate between older and younger adults. The study included 65 older adults and 55 younger adults. 10MWT-O (obstacle height: 0, 5, 17 cm) was performed on two different days (day 1 and day 2). All participants were assessed by the same assessor on days 1 and 2. Berg Balance Scale (BBS), Time Up and Go (TUG) test, Mini Mental State Test, and Functional Reach Test (FRT) assessments were performed on day 1. 10MWT-O speed for all obstacle heights showed moderate to good correlations with FRT distance (r = 0.474-0.539, P < 0.001), TUG Test time (r = -0.722 to -0.671, P < 0.001), and BBS score (r = 0.619-0.660, P < 0.001). Test-retest reliability (intraclass correlation coefficient = 0.924-0.960) was found to be within the excellent range for 10MWT-O speed across all obstacle heights. For obstacle heights of 0, 5, and 17 cm, the minimum detectable change for 10MWT-O speed was 0.16, 0.19, and 0.20 m/s, and the optimal cutoff values for differentiating older from young adults were 1.12, 0.98, and 0.85 m/s, respectively. The 10MWT-O is a reliable and valid clinical measure for assessing walking ability and adaptability in older adults. ClinicalTrials.gov identifier: NCT06307769.

As the use of guided digitally-delivered cognitive-behavioral therapy (GdCBT) grows, pragmatic analytic tools are needed to evaluate coaches' implementation fidelity.

We evaluated how natural language processing (NLP) and machine learning (ML) methods might automate the monitoring of coaches' implementation fidelity to GdCBT delivered as part of a randomized controlled trial.

Coaches served as guides to 6-month GdCBT with 3,381 assigned users with or at risk for anxiety, depression, or eating disorders. CBT-trained and supervised human coders used a rubric to rate the implementation fidelity of 13,529 coach-to-user messages. NLP methods abstracted data from text-based coach-to-user messages, and 11 ML models predicting coach implementation fidelity were evaluated.

Inter-rater agreement by human coders was excellent (intra-class correlation coefficient = .980-.992). Coaches achieved behavioral targets at the start of the GdCBT and maintained strong fidelity throughout most subsequent messages. Coaches also avoided prohibited actions (e.g. reinforcing users' avoidance). Sentiment analyses generally indicated a higher frequency of coach-delivered positive than negative sentiment words and predicted coach implementation fidelity with acceptable performance metrics (e.g. area under the receiver operating characteristic curve [AUC] = 74.48%). The final best-performing ML algorithms that included a more comprehensive set of NLP features performed well (e.g. AUC = 76.06%).

NLP and ML tools could help clinical supervisors automate monitoring of coaches' implementation fidelity to GdCBT. These tools could maximize allocation of scarce resources by reducing the personnel time needed to measure fidelity, potentially freeing up more time for high-quality clinical care.

In pediatric patients, celiac disease (CD) may influence the health-related quality of life (HRQoL).

The study aimed to assess HRQoL and further characterise the clinical factors associated with reduced HRQoL, in a large multicenter pediatric cohort with CD.

The disease-specific questionnaire CD Dutch Questionnaire (CDDUX) and the generic questionnaire Paediatric Quality of Life Inventory (PedsQL) were used to assess the HRQoL. Clinical and sociodemographic characteristics were analyzed, univariate and multivariate analysis were conducted.

Eleven different Italian pediatric centers and 871 families were involved. Mean age at interview was 12.9 ± 2.9 years. The mean total CDDUX score of CD patients was 47.1 ± 18.8, revealing a neutral HRQoL (47.1 ± 18.8), and a good to very good HRQoL according to the PedsQL (81.4 ± 12.6), parents indicated lower scores (p = 0.03) with both questionnaires (CDDUX 45.1 ± 18.6 and PedsQL 79.9 ± 14.5). Patients with lower HRQoL were mainly female, living in Northern Italy, with lower parent's education level and non-biopsy diagnosis of CD. In multivariate analysis, the main predictor of lower CDDUX score was non-biopsy diagnosis.

The HRQoL in a large cohort of Italian children is reported as neutral-good. This indicates a high level of adaptive behaviors in response to the daily challenges of CD. Parents tend to underestimate their children's HRQoL. Specific clinical factors, including non-biopsy diagnosis, may be associated to lower HRQoL.

Team leadership is a critical skill in trauma resuscitation teams, linked to better teamwork and improved patient care. There are numerous published team leadership assessments, though data regarding the performance of these measures in patient care settings (vs. simulation-based settings) remain limited. There remains a need for a valid, reliable, and efficient measure of resuscitation team leadership in the clinical setting to support medical education and research efforts.

We constructed a 12-item behaviorally anchored rating scale (BARS) to measure trauma team leadership. Multiple raters then used the BARS to measure team leadership in 360 recorded trauma resuscitations across 60 participants. In addition to examining inter-rater reliability, we examined the construct validity of the BARS assessment through both correlational and latent modeling techniques to compare the ratings collected with the BARS to those collected using a previously studied checklist-based assessment using a multitrait-multimethod (MTMM) approach. Lastly, we examined the criterion validity of the BARS measure by examining its relationship with previously obtained patient care scores.

BARS items demonstrated high inter-rater reliability when scores were computed using observations averaged over multiple raters (mean item intraclass correlations ICC1k 0.90, item range 0.85-0.98). The correlation between the aggregate ratings from the team leadership BARS and checklist measure demonstrated a strong positive correlation (r = 0.75), and the MTMM analyses indicated consistent evidence for both convergent (mean monotrait-heteromethod r = 0.50) and discriminant (mean heterotrait-heteromethod r = 0.27) validity. Hierarchical Bayesian regression analyses revealed that aggregate BARS scores were predictive of patient care scores (β = 7.06, 95% HDI 3.76-10.43).

The team leadership BARS and a previously studied checklist-based team leadership measure produced convergent assessments of team leadership behavior in the present data. Furthermore, higher overall ratings on the BARS correlated with better patient care delivery at the team level.

Thyroid tissue is sensitive to the effects of endocrine disrupting substances, and this represents a significant health concern. Histopathological analysis of tissue sections of the rat thyroid gland remains the gold standard for the evaluation for agrochemical effects on the thyroid. However, there is a high degree of variability in the appearance of the rat thyroid gland, and toxicologic pathologists often struggle to decide on and consistently apply a threshold for recording low-grade thyroid follicular hypertrophy. This research project developed a deep learning image analysis solution that provides a quantitative score based on the morphological measurements of individual follicles that can be integrated into the standard pathology workflow. To achieve this, a U-Net convolutional deep learning neural network was used that not just identifies the various tissue components but also delineates individual follicles. Further steps to process the raw individual follicle data were developed using empirical models optimized to produce thyroid activity scores that were shown to be superior to the mean epithelial area approach when compared with pathologists' scores. These scores can be used for pathologist decision support using appropriate statistical methods to assess the presence or absence of low-grade thyroid hypertrophy at the group level.

The joint position reproduction (JPR) approach is commonly used to assess joint position sense (JPS), but its psychometric properties in children remain unexplored. This study aimed to assess the reliability and precision of a multi-joint JPR protocol for assessing lower-limb JPS in typically developing (TD) children. Ankle, knee, and hip JPS were assessed in TD children (aged 5-12 years), on two different days, by a single rater using a standardized JPR protocol. The mean and best error (joint reproduction error, °) between the target and reproduction angle were calculated from three-dimensional kinematics for each joint across three trials. Total, joint, and limb JRE scores were provided. For JPR reliability, the intraclass correlation coefficient (ICC, 2.1) was reported. For JPR precision, the standard error of measurement (SEM) and smallest detectable difference (SDD) were calculated. Across 270 JPR trials (15 children, 8.6 ± 1.2 years, 8 boys), the mean and best JRE were 3.7° and 2.5°, respectively. The ICC ranged from poor to fair (0.01-0.44) for mean JRE, and fair to very good (0.46-0.77) for best JRE. The SEM ranged from 0.8° to 1.8°. The SDD was less than 5°, ranging from 2.3° to 4.5°. Evaluating ankle, knee, and hip JPS in children using passive JPR is more reliable and precise when using the best JRE. This study highlights the need for a multi-joint JPR approach and provide joint- and limb-specific SEM and SDD values.

To evaluate previously reported quantitative (tumor thickness 11 mm and depth of invasion [DOI] 7.5 mm) and qualitative (styloglossus/hyoglossus muscle invasion [SHMI]) magnetic resonance imaging (MRI) parameters for predicting occult neck node metastasis in clinical N0 oral tongue squamous cell carcinoma.

This single-center retrospective study included 76 patients. MRI images were independently reviewed by two radiologists for tumor thickness, DOI, and SHMI. Statistical analysis assessed the predictive capability of these parameters for 2-year potential lymph node metastasis.

Among the 76 cases, 30.2% developed 2-year potential lymph node metastasis. For tumor thickness ≥ 11 mm, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 0.46, 0.68, 0.37, 0.75, and 0.61, respectively. DOI ≥ 7.5 mm exhibited a sensitivity, specificity, PPV, NPV, and accuracy of 0.73, 0.59, 0.42, 0.84, and 0.63, respectively. SHMI demonstrated a sensitivity, specificity, PPV, NPV, and accuracy of 0.87, 0.51, 0.46, 0.89, and 0.63, respectively.

DOI ≥ 7.5 mm and SHMI demonstrated comparable diagnostic accuracy in predicting neck metastasis, surpassing tumor thickness of > 11 mm. These findings underscore their potential utility in guiding decisions concerning elective neck dissection.

To describe a new method for the tomographic measurement of canine tibial torsion, evaluate its repeatability and reproducibility, measure the torsion in 40 canine tibiae using both the new and traditional methods, and compare the results.

Retrospective case series.

Tomographic study of the tibiae (n = 40) of client-owned dogs with medial patellar luxation (MPL).

A new method for measuring tibial torsion was described. Four evaluators measured the tibial torsion of 40 canine tibiae with MPL using this new method, with one evaluator repeating these measurements three times. Intraclass correlation coefficients (ICCs) were calculated to assess both intraobserver and interobserver variability for this new method. The same four evaluators also measured the torsion of the same 40 tibiae using the traditional method, and the ICC was calculated to evaluate its interobserver variability. Finally, the results from the new and traditional methods were compared.

The intraobserver and interobserver ICCs for the new method were .99 and .83, respectively, indicating high agreement, excellent repeatability, and reproducibility. The interobserver ICC for the traditional method was .52, indicating moderate agreement. The new method thus demonstrated greater agreement among observers regarding tibial torsion values than the traditional method.

The new tomographic method was repeatable and reproducible for the measurement of tibial torsion in dogs with MPL.

This report describes a new method for the tomographic measurement of canine tibial torsion, which can be used in preoperative planning for dogs with MPL.

Measuring fidelity is critical in program evaluations to assess how implementation influences outcomes. Implementer fidelity is comprised of adherence to the treatment content and competence of treatment delivery. Cognitive behavioral therapy for insomnia (CBT-I) is well-established and empirically supported with variants such as brief CBTi (bCBTi) showing promise in reducing both insomnia and depression. The impact of therapist fidelity on treatment outcomes is unknown in part because reliable measures have not been available. We developed measures of therapist fidelity for bCBT-i and assessed the impact of fidelity in the context of a pilot study with veterans in primary care.

Audio recordings from 23 participants (78 % male) were coded. Therapist adherence measures were created for each session along with a single measure of therapist competence. Inter-rater reliability was established and predictive validity was determined. For total adherence, inter-rater reliability was excellent across sessions (ICC =.73 -.80). The competence measure showed good reliability across all sessions (ICC =.57) and was internally consistent (Cronbach's alpha =.75). There was only 10 % of shared variance between adherence and competence. All of the fidelity measures demonstrated associations with outcomes in the predicted direction; therapist adherence was significantly associated with decreased depression.

The concept of positive occupations that enhance physical, mental, and social well-being is a novel idea that integrates positive psychology and occupational therapy. Valid and reliable scales are required to assess positive occupations for well-being in mental health settings. In this regard, the Assessment of Positive Occupation-15 (APO-15) is unique, as it evaluates positive occupations that promote health and well-being. This study aimed to investigate the validity and reliability of and determine the cutoff value of the Turkish version of the APO-15 in individuals with serious mental illness (SMI). The study was conducted with 106 individuals with SMI. The structural validity of the scale items was determined using confirmatory factor analysis, while the reliability of the scale was analyzed with Cronbach's alpha (α) and McDonald's omega (ω) coefficients. The comparative fit index (0.964) and the Tucker-Lewis index (0.955) demonstrated a good fit. Cronbach's alpha coefficients were .826, .814, .707, and .674, and the total scale score was 0.924. McDonald's ω coefficients for the four scale dimensions were 0.832, 0.818, 0.716, and 0.727. The cutoff point of 49.50 for the APO-15 for point sensitivity (0.727) and specificity (0.766) yielded good results. The Turkish version of the APO-15 is an effective and reliable tool for assessing well-being in mental health settings.

In pediatric urology, urodynamic studies are considered the most reliable method for assessing the function of the lower urinary tract. These evaluations play a particularly important role in guiding treatment decisions for neurogenic bladder conditions.

The aim of this study is to assess the impact of artifacts on the interobserver and intraobserver agreement in the interpretation of pediatric urodynamic traces.

Two pediatric urology experts, each with a broad spectrum of clinical expertise, conducted a thorough retrospective analysis of the urodynamic tracings. This evaluation was independently performed by the specialists on two separate occasions, with a three-month interval between sessions. The patients were categorized into three groups based on the quality of their recordings: Group 1: No artifacts (n = 30), Group 2: 1-5 artifacts (n = 30), Group 3: More than 5 artifacts (n = 30).

A total of 90 patients were included in our study, with each group comprising 30 participants. Observer 1's initial and fourth-month measurements by groups, a statistically significant difference was found between the initial MDP measurement values of the cases according to the groups (p = 0.012). High interobserver agreement was observed for EBC, CBC, MDP, and Q max variables across all groups (p < 0.001 for each comparison). In intra-observer agreement for qualitative assessments (compliance, detrusor function, character of overactivity, and DSD), Observer 2 demonstrated lower agreement in groups 2 and 3. Group 3, which had urodynamics with a lot of artifacts, was the group with the lowest agreement values.

Few studies in the literature assess the intra- and interobserver agreement of urodynamic studies, with reported variations. Venhola et al. and Zimmern et al. found inconsistent interpretations among observers. Quantitative assessments showed higher reliability than qualitative ones. Our study aligns with these findings, indicating variability due to artifacts and differing interpretations of detrusor overactivity.

Artifacts significantly impact interobserver and intraobserver agreement in pediatric urodynamic studies. While quantitative parameters showed higher agreement, particularly in recordings with fewer artifacts, the presence of numerous artifacts in Group 3 led to decreased consistency in evaluations.

Retrospective observational study.

ObjectiveThis review aimed to analyze the size and morphology of the Sella Turcica (ST) in 2-dimensional cephalometric radiographs of individuals with non-syndromic cleft lip and or palate (CLP/CP) compared with non-cleft individuals.MethodsA comprehensive search of multiple electronic databases was conducted without language and date restrictions until October 12, 2024. Studies were included that assessed ST dimensions in lateral cephalograms and compared the patients with non-syndromic CLP or CP and non-cleft individuals. The studies' quality assessment was assessed using the JBI case-control guidelines and the Anatomical Quality Assurance checklist. Quantitative analysis was performed using the random-effects meta-analysis model. The GRADE approach was employed to evaluate the certainty of evidence.ResultsOut of 1087 studies, 10 met the inclusion criteria, and 6 were included in the quantitative analysis. Of all, 7 studies were rated moderate, 2 low, and 1 high quality. Unilateral CLP (UCLP) cohort showed statistically significant smaller dimensions for length (MD = -1.22; 95% CI: -2.21, -0.24), depth (MD = -0.65; 95% CI: -1.41, -0.11), and area (MD = -4.75; 95% CI: -7.22, -2.28) and the odds of ST bridging were more than twice compared to non-cleft control. No significant differences were observed in ST dimensions in bilateral CLP versus non-Cleft and UCLP.ConclusionThe evidence of differences in ST dimensions between non-cleft individuals and patients with UCLP is weak, owing to a greater risk of bias resulting from inadequate reporting of design variability, participant demographics, and measurement methods. Future studies with better methodology and larger sample sizes are needed.

Goal Attainment Scaling (GAS) is a method for writing person-centred approach evaluation scales that can be used as an outcome measure in clinical or research settings in rehabilitation. To be used in a research setting, it requires a high methodological quality approach. The aim of this study was to explore the feasibility and reliability of the GAS quality rating system, to ensure that GAS scales used as outcome measures are valid and reliable. Secondary objectives were: (1) to compare goal attainment scores' reliability according to how many GAS levels are described in the scale; and (2) to explore if GAS scorings are influenced by who scores goal attainment. The GAS scales analysed here were set collaboratively by 57 cognitively impaired adults clients and their occupational therapist. Goals had to be achieved within an inpatient one-month stay, during which clients participated in an intervention aimed at improving planning skills in daily life. The GAS quality rating system proved to be feasible and reliable. Regarding GAS scores, interrater reliability was higher when only three of the five GAS levels were described, i.e., "three milestone GAS" (0.74-0.92), than when all five levels were described (0.5-0.88), especially when scored by the clients (0.5 -0.88).

The 8-item Passion Scale (PS-8) is a unidimensional instrument used in dual versus single passion research. The PS-8 was validated in Icelandic, Persian, and Turkish student samples. In this study, we translated the PS-8 and validated it with physically active and inactive adults from Hungary. We also evaluated measurement invariance (across gender, physical activity, exercise frequency, and age groups) of the Hungarian version of the Passion scale (PS-8-HU). Data were collected online between fall 2023 and winter 2024, including a test and retest phase. The sample comprised 729 Hungarian physically active and inactive adults (68% females, 32% males; ages 18-78 years), of whom 196 participated in the retest. We used confirmatory factor analysis (CFA), item analysis, correlations, t-test and ANOVA in checking the scale's validity and reliability, and we used a multigroup CFA to test the measurement invariance. The results supperted a univariate structure of the PS-8-HU. The instrument was invariant for gender (at the strict level), exercise frequency (metric), physical activity (metric), and age (scalar). The internal reliability of the PS-8-HU was .93 and test-retest reliability was .77. The PS-8-HU also exhibited good concurrent and construct validities, high homogeneity, and adequate discriminant validity.