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Objectives: A new patient-reported outcome (PRO) instrument to measure fatigue symptoms and impacts in relapsing multiple sclerosis (RMS) was developed in a qualitative stage, followed by psychometric validation and migration from paper to an electronic format.Methods: Adult patients with relapsing-remitting multiple sclerosis (RRMS) were interviewed to elicit fatigue-related symptoms and impacts. A draft questionnaire was debriefed in cognitive interviews with further RRMS patients, and revised. Content confirmation interviews were conducted with patients with progressive-relapsing multiple sclerosis (PRMS) and relapsing secondary-progressive multiple sclerosis (RSPMS). Psychometric analyses used data from adult patients with different RMS subtypes and matched non-RMS controls in a multicenter, observational study. After item reduction, the final instrument was migrated to a smartphone (eDiary) and usability was confirmed in interviews with additional adult RMS patients.Results: The qualitative stage included 37 RRMS, 5 PRMS, and 5 RSPMS patients. Saturation of concepts was reached during concept elicitation. Cognitive interviews confirmed that participants understood the instructions, items, and response options of the instrument-named FSIQ-RMS-as intended. Psychometric validation included 164 RMS and 74 control patients. Internal consistency and test-retest reliability were demonstrated. The symptoms domain discriminated along the RMS symptom-severity continuum and between patients and controls. Patients were able to attribute fatigue-related symptoms to RMS. Usability and conceptual equivalence of the eDiary were confirmed (n = 10 participants).Conclusions: With 7 symptom items and 13 impact items (in 3 impacts subdomains: physical, cognitive and emotional, and coping) after item reduction, the FSIQ-RMS is a comprehensive, valid, and reliable measure of fatigue-related symptoms and impacts in RMS patients. [ABSTRACT FROM AUTHOR]

Aim: To validate the paper grip test for assessing plantar flexion strength of the hallux.Methods: Plantar flexor strength for 69 people with diabetic neuropathy was assessed: (a) using the paper grip test while simultaneously a plantar pressure platform quantified the force under the hallux, and (b) using a hand-held dynamometer. Following testing, participants were divided into groups: (1) passed vs. failed paper grip test (2) males vs. females. Statistical analyses determined if differences were evident between the groups and assessed the relationship between the paper grip test and the hand-held dynamometer. The discrimination ability, sensitivity, specificity, and reproducibility of the paper grip test was established.Results: Participants who passed the paper grip test demonstrated greater grip force at the hallux than those who failed, and they also exhibited greater isometric maximum force during the hand-held dynamometry test (p ≤ 0.05). Grip force for males was significantly higher than for females. A moderate positive correlation between the paper grip test and the hand-held dynamometer was evident.Conclusions: In the population examined the paper grip test was found to be a valid clinical tool; it offers a non-invasive, inexpensive, and quick method to assess plantar flexion strength of the hallux. [ABSTRACT FROM AUTHOR]

Background: Accurately identifying patients at an elevated risk of suicide in minimal time is an important mental health issue. Therefore, we developed the Ultra Brief Checklist for Suicidality (UBCS) and reported its psychometric properties.Methods: We studied 544 participants who had completed the UBCS, other self-report measures, and structured clinical interviews by trained interviewers. We explored the psychometric properties of the UBCS's paper-based and online versions by identifying optimal cutoff points, sensitivity, specificity, etc. of all participants.Results: The mean score of the UBCS (paper-pencil version) in the no-suicide-risk group was 0.23 (SD = 0.73), while in the Risk-Positive (RP) and the High-Risk (HR) groups it was 3.54 (SD = 3.22) and 6.31 (SD = 3.97), respectively. Optimal cutoff points for the RP and HR groups were 1 (AUC = 0.914) and 3 (AUC = 0.928), respectively.Limitations: The current findings apply only to adults, not to children or adolescents. The original MINI was used as the assessment instrument's reference standard rather than MINI 7.0.2 of DSM-5. Predictive validity was not addressed as this was not a longitudinal cohort study.Conclusions: The UBCS was rigorously tested and validated. More than half the participants completed the UBCS within a minute. It possesses adequate psychometric properties and can be easily administered with minimal clinician time and effort, via paper or Internet. We believe it can contribute to suicide risk identification and timely interventions. [ABSTRACT FROM AUTHOR]

This is the second of two papers reporting the development of a spiritual care competency framework for pre-registration nurses and midwives as part of a PhD study using an embedded sequential mixed methods eclectic research design. The first paper outlines how 116 competency items were generated from an in-depth review of international literature, and offers a theoretical model to underpin development of the Framework. This paper reports how the Framework was developed. Method/Results: Five focus groups were held with stakeholders in Malta (chaplains/spiritual leaders, undergraduate nursing/midwifery educators, qualified nurses/midwives, parents/carers, patients/clients) to ensure that aspects of spirituality/spiritual care important to them, but not identified in the literature review, were included in the Framework. The resulting 55 competencies in seven domains formed the Delphi Questionnaire which was validated using a two round modified Delphi method involving experts from Malta. The final seven domain 54 item Framework demonstrated good to strong internal consistency, stability and a good fit with a six factor model. The Framework's greatest immediate contribution is in its ability to inform undergraduate nursing/midwifery spiritual care curriculum design and delivery. Further development of the Framework could assist in student selection ensuring that the 'art' of nursing/midwifery has parity with the 'science'. • This is the first pre-registration Spiritual Care Competency Framework for nurses/midwives. • It was developed using a rigorous embedded sequential mixed methods eclectic research design. • The Framework is informing design/delivery of spiritula care education programmes across Europe [ABSTRACT FROM AUTHOR]

We have studied the efficiency of research in the EU by a percentile-based citation approach that analyzes the distribution of country papers among the world papers. Going up in the citation scale, the frequency of papers from efficient countries increases while the frequency from inefficient countries decreases. In the percentile-based approach, this trend, which is uniform at any citation level, is measured by the e p index that equals the P top 1% /P top 10% ratio. By using the e p index we demonstrate that EU research on fast-evolving technological topics is less efficient than the world average and that the EU is far from being able to compete with the most advanced countries. The e p index also shows that the USA is well ahead of the EU in both fast- and slow-evolving technologies, which suggests that the advantage of the USA over the EU in innovation is due to low research efficiency in the EU. In accord with some previous studies, our results show that the European Commission’s ongoing claims about the excellence of EU research are based on a wrong diagnosis. The EU must focus its research policy on the improvement of its inefficient research. Otherwise, the future of Europeans is at risk. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the accuracy of three measurement systems estimating gait speed during a loaded military march over graded terrain. Systems developed by the Swiss and Netherlands Armed Forces and a commercial wrist-based device were evaluated in comparison to a Global Positioning System. The first part of the paper focuses on the development of the Dutch system, where speed is estimated from a chest worn accelerometer and body measurements. For this validation study 36 subjects were walking or running 13 laps of 200 m at different speeds. Results showed that walking and running speed can be estimated with a R2adj of 0.968 and 0.740, respectively. In the second part of this paper, data from 64 soldiers performing a 35 km march were used to evaluate the accuracy of three measurement systems in estimating speed. Data showed that estimating gait speed with a single accelerometer can be accurate for military activity, even without prior individual calibration measurements. However, predictions should be corrected for confounders such as body size and shoe type to be accurate. Both, downhill and uphill walking led to changes in gait characteristics and to an overestimation of speed by up to 10%. Correcting for slope or gradient using altimetry in future algorithms/experiments could improve the estimation of gait speed. [ABSTRACT FROM AUTHOR]

Computerized tests benefit from automated scoring procedures and standardized administration instructions. These methods can reduce the potential for rater error. However, especially in patients with severe mental illnesses, the equivalency of traditional and tablet-based tests cannot be assumed. The Brief Assessment of Cognition in Schizophrenia (BACS) is a pen-and-paper cognitive assessment tool that has been used in hundreds of research studies and clinical trials, and has normative data available for generating age- and gender-corrected standardized scores. A tablet-based version of the BACS called the BAC App has been developed. This study compared performance on the BACS and the BAC App in patients with schizophrenia and healthy controls. Test equivalency was assessed, and the applicability of paper-based normative data was evaluated. Results demonstrated the distributions of standardized composite scores for the tablet-based BAC App and the pen-and-paper BACS were indistinguishable, and the between-methods mean differences were not statistically significant. The discrimination between patients and controls was similarly robust. The between-methods correlations for individual measures in patients were r>0.70 for most subtests. When data from the Token Motor Test was omitted, the between-methods correlation of composite scores was r=0.88 (df=48; p<0.001) in healthy controls and r=0.89 (df=46; p<0.001) in patients, consistent with the test-retest reliability of each measure. Taken together, results indicate that the tablet-based BAC App generates results consistent with the traditional pen-and-paper BACS, and support the notion that the BAC App is appropriate for use in clinical trials and clinical practice. [ABSTRACT FROM AUTHOR]

• Adaptation and validation the scale of Positive Parental Practices for children 0- to 3 years. • Exploratory and Confirmatory Factor Analysis were performed with 950 participants. • This study provides the standardization of the Spanish scale scores in parental competences. • The final version for the Spanish population is composed of 27 items and 7 subscales. • This scale is considered useful for assessing parental competences in parents of young children. This study aims to adapt and validate the scale of Positive Parental Practices of the Caregiver (SP + C), in the version for children from 0 to 3 years. First, the process of cross-cultural adaptation was performed. Subsequently, for the validation of the scale, we analyzed a sample of 950 participants, with children aged between 0 and 3 years. The participants' native language was Spanish or it was the language spoken at home. Exploratory Factor Analysis (EFA) was performed with Sample 1 (n = 483 participants), yielding 7 factors: Daily Involvement, Mentalization, Sensitivity, Promoting Learning, Attention and Organization of Daily Life, Monitoring of Parental Activity, and Parental Self-Care. Confirmatory Factory Analysis (CFA) was performed with Sample 2 (n = 467), which confirmed the factor structure of the scale. Reliability analysis showed that the scale had an adequate internal consistency. To determine criterion validity, bivariate correlations were calculated with other variables that evaluate parental competence, expecting to find significant positive relationships between them. This paper provides the standardization of the Spanish scale scores. In conclusion, the final validated scale is composed of 27 items and 7 subscales, with adequate psychometric properties. It is considered useful for the evaluation of parental competences in parents of young children. [ABSTRACT FROM AUTHOR]

Craniofacial reconstruction recreates a facial outlook from the cranium based on the relationship between the face and the skull to assist identification. But craniofacial structures are very complex, and this relationship is not the same in different craniofacial regions. Several regional methods have recently been proposed, these methods segmented the face and skull into regions, and the relationship of each region is then learned independently, after that, facial regions for a given skull are estimated and finally glued together to generate a face. Most of these regional methods use vertex coordinates to represent the regions, and they define a uniform coordinate system for all of the regions. Consequently, the inconsistence in the positions of regions between different individuals is not eliminated before learning the relationships between the face and skull regions, and this reduces the accuracy of the craniofacial reconstruction. In order to solve this problem, an improved regional method is proposed in this paper involving two types of coordinate adjustments. One is the global coordinate adjustment performed on the skulls and faces with the purpose to eliminate the inconsistence of position and pose of the heads; the other is the local coordinate adjustment performed on the skull and face regions with the purpose to eliminate the inconsistence of position of these regions. After these two coordinate adjustments, partial least squares regression (PLSR) is used to estimate the relationship between the face region and the skull region. In order to obtain a more accurate reconstruction, a new fusion strategy is also proposed in the paper to maintain the reconstructed feature regions when gluing the facial regions together. This is based on the observation that the feature regions usually have less reconstruction errors compared to rest of the face. The results demonstrate that the coordinate adjustments and the new fusion strategy can significantly improve the craniofacial reconstructions. [ABSTRACT FROM AUTHOR]

Background: To validate the reliability and validity of the Chinese version of the THINC-it tool in adults with major depressive disorder (MDD).Methods: Subjects aged 18 to 65 years (n=117) with MDD were evaluated and compared to age- and sex-matched healthy controls (n=124). Subjects completed the THINC-it, four criteria-related objective cognitive subtests, and the paper version of Perceived Deficits Questionnaire for Depression-5-item (PDQ-5-D).Results: There were significant differences in Spotter [Mean difference (MD) Standard errors (SE)=-0.40 (0.17), P=0.018; 95% Confidence intervals (CI) (-0.73 to -0.07)]; Codebreaker [MD (SE)=-0.39 (0.14), P=0.006; 95% CI(-0.67 to -0.11)]; and the overall performance of four objective tests (including variants of IDN, OBK, DSST, and TMT-B) [MD (SE)=-0.30 (0.12), P=0.013; 95% CI (-0.53 to -0.06]) between the two groups. In the HC group, PDQ-5-D retest reliability was good (ICC = 0.841), and the test-retest reliability of the objective cognitive test was relatively low (ICC ranging from 0.123 to 0.545). In the MDD group: Cronbach's α of PDQ-5-D=0.704; all the THINC-it subtests had good concurrent validity (r ranging from 0.343 to 0.835, all P<0.01).Limitation: The test-retest sample size was relatively small, the educational level and IQ of the control and MDD groups were not completely matched.Conclusion: The Chinese version of the THINC-it tool exhibits good reliability and validity in adults with MDD. There is a need to incorporate cognitive assessment of adults with MDD broadly. The THINC-it tool is the first tool validated to assess cognition of MDD in a Chinese population. [ABSTRACT FROM AUTHOR]

Aims: The TTM2-trial is a multi-centre randomised clinical trial where targeted temperature management (TTM) at 33 °C will be compared with normothermia and early treatment of fever (≥37.8 °C) after Out-of-Hospital Cardiac Arrest (OHCA). This paper presents the design and rationale of the TTM2-trial follow-up, where information on secondary and exploratory outcomes will be collected. We also present the explorative outcome analyses which will focus on neurocognitive function and societal participation in OHCA-survivors.Methods: Blinded outcome-assessors will perform follow-up at 30-days after the OHCA with a telephone interview, including the modified Rankin Scale (mRS) and the Glasgow Outcome Scale Extended (GOSE). Face-to-face meetings will be performed at 6 and 24-months, and include reports on outcome from several sources of information: clinician-reported: mRS, GOSE; patient-reported: EuroQol-5 Dimensions-5 Level responses version (EQ-5D-5L), Life satisfaction, Two Simple Questions; observer-reported: Informant Questionnaire on Cognitive Decline in the Elderly-Cardiac Arrest version (IQCODE-CA) and neurocognitive performance measures: Montreal Cognitive Assessment, (MoCA), Symbol Digit Modalities Test (SDMT). Exploratory analyses will be performed with an emphasis on brain injury in the survivors, where the two intervention groups will be compared for potential differences in neuro-cognitive function (MoCA, SDMT) and societal participation (GOSE). Strategies to increase inter-rater reliability and decrease missing data are described.Discussion: The TTM2-trial follow-up is a pragmatic yet detailed pre-planned and standardised assessment of patient's outcome designed to ensure data-quality, decrease missing data and provide optimal conditions to investigate clinically relevant effects of TTM, including OHCA-survivors' neurocognitive function and societal participation. [ABSTRACT FROM AUTHOR]

Objective: To present initial validity data on three web-based computerized versions of the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-COMP).Method: The sample for evaluating the validity of the clinician-administered KSADS-COMP included 511 youths 6-18 years of age who were participants in the Child Mind Institute Healthy Brain Network. The sample for evaluating the parent and youth self-administered versions of the KSADS-COMP included 158 youths 11-17 years of age recruited from three academic institutions.Results: Average administration time for completing the combined parent and youth clinician-administered KSADS-COMP was less time than previously reported for completing the paper-and-pencil K-SADS with only one informant (91.9 ± 50.1 minutes). Average administration times for the youth and parent self-administered KSADS-COMP were 50.9 ± 28.0 minutes and 63.2 ± 38.3 minutes, respectively, and youths and parents rated their experience using the web-based self-administered KSADS-COMP versions very positively. Diagnoses generated with all three KSADS-COMP versions demonstrated good convergent validity against established clinical rating scales and dimensional diagnostic-specific ratings derived from the KSADS-COMP. When parent and youth self-administered KSADS-COMP data were integrated, good to excellent concordance was also achieved between diagnoses derived using the self-administered and clinician-administered KSADS-COMP versions (area under the curve = 0.89-1.00).Conclusion: The three versions of the KSADS-COMP demonstrate promising psychometric properties, while offering efficiency in administration and scoring. The clinician-administered KSADS-COMP shows utility not only for research, but also for implementation in clinical practice, with self-report preinterview ratings that streamline administration. The self-administered KSADS-COMP versions have numerous potential research and clinical applications, including in large-scale epidemiological studies, in schools, in emergency departments, and in telehealth to address the critical shortage of child and adolescent mental health specialists.Clinical Trial Registration Information: Computerized Screening for Comorbidity in Adolescents With Substance or Psychiatric Disorders; https://clinicaltrials.gov/; NCT01866956. [ABSTRACT FROM AUTHOR]

Various self-report measures based on Self-Determination Theory (Deci & Ryan, 1985; Ryan & Deci, 2017) have been developed to assess athletes' perceptions of their coaches' need supportive and thwarting behaviors. We propose that it is also conceptually important to distinguish between coaching behaviors that thwart and those that are indifferent to athletes' psychological needs. This distinction is useful, as we contend that athletes' degree of need frustration, and concomitant negative outcomes, are likely to be more pronounced in a coaching environment that actively thwarts (vs. is indifferent to) athletes' needs. In this three-study paper, we outline the conceptual rationale for, the development of, and initial validity evidence for a tripartite (need supportive, thwarting, and indifferent) measure of interpersonal behaviors of coaches (TMIB-C). In Study 1, we developed 54 candidate items and gathered evidence for their face and content validity with athletes and an expert panel. Competing factor models were tested in Study 2 to determine the best representation of the measure's factor structure. In Study 3, we tested the replication of such models and the nomological network surrounding the identified factors. In Study 2, a 22-item, three-factor structure (supportive, thwarting, and indifferent behaviors) using exploratory structural equation modeling, demonstrated acceptable fit, good standardized factor loadings, factor correlations in the expected directions, and acceptable estimates of internal consistency. This model was replicated in Study 3. Tests of nomological networks showed that as expected, need indifference was a weaker predictor of autonomy and competence need frustration as compared to need thwarting, and the only significant predictor of irrelevant thoughts. Unexpectedly however, need indifference, when compared to need thwarting, was as good a predictor of exhaustion and a better predictor of relatedness frustration. Evidence supports the TMIB-C as a parsimonious and promising measure of athletes' perceptions of coach interpersonal behaviors. Our tripartite conceptualization and measure should be further tested in terms of its predictive utility in order to advance conceptual understanding and intervention efforts targeting interpersonal behaviors in sport, and potentially other life domains. • Interpersonal behaviors were classified as need supportive, thwarting, and indifferent. • A new tripartite measure of coach interpersonal behaviours was developed. • A 22-item three-factor ESEM solution provided the best fit to the data. • Need indifference was operationally distinguished from need support, and need thwarting. • Distinct predictive value of the three interpersonal behaviours is discussed. [ABSTRACT FROM AUTHOR]

For decades various pressure ulcer risk assessment scales (PURAS) have been developed and implemented into nursing practice despite uncertainty whether use of these tools helps to prevent pressure ulcers. According to current methodological standards, randomised controlled trials (RCTs) are required to conclusively determine the clinical efficacy and safety of this risk assessment strategy. In these trials, PURAS-aided risk assessment has to be compared to nurses' clinical judgment alone in terms of its impact on pressure ulcer incidence and adverse outcomes. However, RCTs evaluating diagnostic procedures are prone to specific risks of bias and threats to the statistical power which may challenge their validity and feasibility. This discussion paper critically reflects on the rigour and feasibility of experimental research needed to substantiate the clinical efficacy of PURAS-aided risk assessment. Based on reflections of the methodological literature, a critical appraisal of available trials on this subject and an analysis of a protocol developed for a methodologically robust cluster-RCT, this paper arrives at the following conclusions: First, available trials do not provide reliable estimates of the impact of PURAS-aided risk assessment on pressure ulcer incidence compared to nurses' clinical judgement alone due to serious risks of bias and insufficient sample size. Second, it seems infeasible to assess this impact by means of rigorous experimental studies since sample size would become extremely high if likely threats to validity and power are properly taken into account. Third, means of evidence linkages seem to currently be the most promising approaches for evaluating the clinical efficacy and safety of PURAS-aided risk assessment. With this kind of secondary research, the downstream effect of use of PURAS on pressure ulcer incidence could be modelled by combining best available evidence for single parts of this pathway. However, to yield reliable modelling results, more robust experimental research evaluating specific parts of the pressure ulcer risk assessment-prevention pathway is needed. [ABSTRACT FROM AUTHOR]

Abstract The quality of students' experiences in an education environment directly affect learning outcomes. In an applied profession such as nursing, students undertake work-integrated learning in unpredictable health settings where multiple influences interact. Understanding students' perspectives with a valid instrument is the first step in improving learning environments and maximizing learning outcomes. It is important that language and cultural nuances are accounted for when instruments are translated. This paper reports translation and psychometric properties of the Vietnamese language version (V-CLEI) of the modified English language Clinical Learning Environment Inventory (CLEI) (Newton et al., 2010). The V-CLEI was tested with a convenience sample of 209 Vietnamese nursing students to assess clinical learning experiences in hospitals in central Vietnam. The internal consistency, test-retest reliability, content validity and factor structure of the V-CLEI were examined. Results indicate that the V-CLEI is unlikely to be valid and reliable in the Vietnamese context and revision is required. This study informs research, particularly the different cultural dimensions considered when translating and adapting instruments. Highlights • The modified CLEI was translated into Vietnamese using the back-translation method. • Content validity and psychometric testing results of the V-CLEI were inconsistent. • Further modifications and validation need to be undertaken for use of the V-CLEI. [ABSTRACT FROM AUTHOR]

Ignoring and being ignored by others in favor of a smartphone is a common feature of everyday communication. However, little research has examined this phenomenon known as phubbing and even less research has determined how to measure it. This paper reports the results of six studies designed to develop and validate the Generic Scale of Phubbing (GSP) to assess phubbing behavior, and the Generic Scale of Being Phubbed (GSBP) to assess the experience of being phubbed. After reducing and refining items with the assistance of expert panels, exploratory and confirmatory factor analyses were conducted to further reduce the number of items and finalize the scales. Finally, the psychometric properties of both scales were examined. Data from 1836 respondents from the general public were recruited from six online surveys ( N  = 352, 333, and 224 for the GSP; N  = 358, 341, and 228 for the GSBP). The four-factor 15-item GSP and the three-factor 22-item GSBP were developed and revealed good construct validities, criterion validities, convergent validities, discriminant validities, internal consistency reliabilities, and test-retest reliabilities. [ABSTRACT FROM AUTHOR]

Purpose: Imaging phantoms can be cost prohibitive, therefore a need exists to produce low cost alternatives which are fit for purpose. This paper describes the development and validation of a low cost paediatric pelvis phantom based on the anatomy of a 5-year-old child.Methods: Tissue equivalent materials representing paediatric bone (Plaster of Paris; PoP) and soft tissue (Poly methyl methacrylate; PMMA) were used. PMMA was machined to match the bony anatomy identified from a CT scan of a 5-year-old child and cavities were created for infusing the PoP. Phantom validation comprised physical and visual measures. Physical included CT density comparison between a CT scan of a 5-year old child and the phantom and Signal to Noise Ratio (SNR) comparative analysis of anteroposterior phantom X-ray images against a commercial anthropomorphic phantom. Visual analysis using a psychometric image quality scale (face validity).Results: CT density, the percentage difference between cortical bone, soft tissue and their equivalent tissue substitutes were -4.7 to -4.1% and -23.4%, respectively. For SNR, (mAs response) there was a strong positive correlation between the two phantoms (r > 0.95 for all kVps). For kVp response, there was a strong positive correlation between 1 and 8 mAs (r = 0.85), this then decreased as mAs increased (r = -0.21 at 20 mAs). Psychometric scale results produced a Cronbach's Alpha of almost 0.8.Conclusions: Physical and visual measures suggest our low-cost phantom has suitable anatomical characteristics for X-ray imaging. Our phantom could have utility in dose and image quality optimisation studies. [ABSTRACT FROM AUTHOR]

Obsessive-compulsive disorder (OCD) includes many symptom presentations, which creates unique diagnostic challenges. Fears surrounding one's sexual orientation are common within OCD (also called SO-OCD), but SO-OCD is consistently misdiagnosed by physicians and psychologists. To address this issue, we describe the development of a self-report measure for assessing SO-OCD to help distinguish OCD from distress caused by a sexual orientation identity crisis. The current paper details two studies that established the psychometric properties and clinical utility of this measure. In Study 1, the factor structure, validity, and reliability were examined for the measure's 12 items in a sample of 1,673 university students. The results revealed a two-factor solution for the measure (Factor 1: Transformation Fears; Factor 2: Somatic Checking) and preliminary evidence of validity and reliability. In Study 2, the measure was tested with LGBTQ and heterosexual community samples and clinical samples of individuals with SO-OCD and other types of OCD. The two-factor solution and evidence of validity and reliability were supported in these samples. Cut-off points were established to distinguish between community members and SO-OCD sufferers, as well as between those experiencing SO-OCD and other types of OCD. Limitations and future directions are discussed. [ABSTRACT FROM AUTHOR]

Background: The Youth Anxiety Measure-I for DSM-5 has recently been developed to assess youth's anxiety symptomatology. As social anxiety is one of the most common disorders in adolescence, this scale includes a subscale measuring social anxiety. However, psychometric properties of the YAM-5-I social anxiety subscale (YAM-5-I-SAD) in clinical samples are lacking. This paper aims to bridge the gap.Methods: The sample comprised 24 clinically diagnosed and 24 healthy control Spanish-speaking adolescents aged 14-17 years.Results: Data revealed that the YAM-5- I-SAD yielded excellent sensitivity, which makes it particularly useful as a screening tool to early detect socially anxious adolescents. In addition, the YAM-5-I-SAD evidenced good internal consistency and construct validity.Limitations: Data are limited to the social anxiety subscale.Conclusions: The YAM-5-I-SAD is a sensitive and specific measure to screen for adolescents with social anxiety. [ABSTRACT FROM AUTHOR]

Abstract: Recently, we reported on the axial-shear strain fill-in of the interior of loosely bonded stiff elliptical inclusions in a soft backgroundat non-normal orientations, and the lack of fill-in in firmly bonded inclusions at any orientation. In this paper, we report on the experimental validation of the simulation studies using tissue-mimicking gelatin-based phantoms. We also show a few confirmatory examples of the existence of these phenomena in benign vs. malignant breast lesions in vivo. Phantom experiments showed that axial-shear strain zones caused by firmly bonded elliptical inclusions occurred only outside of the inclusion, as predicted by the simulation. By contrast, the axial-shear strain zones filled in the interior of loosely bonded elliptical inclusions at non-normal orientations. The axial-shear strain elastograms obtained from the in vivo cases appeared to be in general agreement with our experimental results. The results reported in this paper may have important clinical implications. Specifically, axial-shear strain fill-in inside an inclusion may be a unique signature of stiff, loosely bonded, ellipsoidal or elongated inclusions at non-normal orientations. Thus, it may be useful as a marker of benignity of benign breast lesions (e.g., fibroadenomas) that are generally stiff, elongated and loosely bonded to the host tissues. (E-mail: Jonathan.Ophir@uth.tmc.edu) [Copyright &y& Elsevier]

Background: Testosterone is used therapeutically in medical settings. Non-prescribed testosterone use is typically illegal, described as 'enhancement' or 'doping', and considered a problem. However, research has found that some non-prescribed testosterone use may be therapeutic (i.e. self-medication). Little is known about testosterone self-medication. It has been noted among individuals who use image and performance enhancing drugs (IPEDs), but never systematically explored.Approach: This paper describes the findings of a 4-year ethnographic study in online forums and social media groups frequented by people who use IPEDs. It focusses on 31 men who used enhancement doses of testosterone, but who described some of their testosterone use as 'testosterone replacement therapy' (TRT). In particular, it focuses on the 26 (84%) of these individuals who self-medicated TRT. Data was analysed thematically (using NVivo) in order to answer the question: 'how and why is testosterone self-medicated?'. Using Bacchi's (2016) problematization approach to policy analysis, this paper also asks, 'what happens to the 'problem' of non-prescribed testosterone use if such use is therapeutic?'.Findings: Self-medicated TRT was found to be very similar to TRT as practised in medical contexts. Self-medication was often practised because of an inability to access testosterone through health practitioners (who were either reluctant or unable to prescribe). However, some individuals were found to prefer self-medication because of price, ease of access, reliability of supply, and because health practitioners were perceived as lacking expertise regarding testosterone use.Conclusion: By documenting the therapeutic use of testosterone outside of medical settings, this paper calls into question previous conceptualisations of all illicit testosterone use as 'abuse', and the utility of the repair/enhancement dichotomy as a foundation for discussions of drug use. It suggests that in some cases the problem may not be non-prescribed testosterone use per se, but policies that prevent access to medical treatment. [ABSTRACT FROM AUTHOR]

Summary: Sports scientists require a thorough understanding of the energy demands of sports and physical activities so that optimal training strategies and game simulations can be constructed. A range of techniques has been used to both directly assess and estimate the physiological and biochemical changes during competition. A fundamental approach to understanding the contribution of the energy systems in physical activity has involved the use of time–motion studies. A number of tools have been used from simple pen and paper methods, the use of video recordings, to sophisticated electronic tracking devices. Depending on the sport, there may be difficulties in using electronic tracking devices because of concerns of player safety. This paper assesses two methods currently used to measure player movement patterns during competition: (1) global positioning technology (GPS) and (2) a computer-based tracking (CBT) system that relies on a calibrated miniaturised playing field and mechanical movements of the tracker. A range of ways was used to determine the validity and reliability of these methods for tracking Australian footballers for distance covered during games. Comparisons were also made between these methods. The results indicate distances measured using CBT overestimated the actual values (measured with a calibrated trundle wheel) by an average of about 5.8%. The GPS system overestimated the actual values by about 4.8%. Distances measured using CBT in experienced hands were as accurate as the GPS technology. Both systems showed relatively small errors in true distances. [Copyright &y& Elsevier]

We describe an improved method for the measurement of retinol in dried blood spots (DBS) on filter paper. Retinol in human DBS on filter paper was analyzed by normal phase HPLC after a simple extraction method. Retinol associated with its binding protein was eluted from the paper into aqueous solution facilitated by ultrasonic agitation. Retinol associated with retinol binding protein was denatured with acetonitrile, and then retinol was isolated in a single hexane extract and analyzed directly by HPLC. When analyzing DBS, the individual plasma volume of the spots was calculated by measuring the sodium content or by weighing the blood spots. The described method yielded low intra- and interassay variability (<6%), with sufficient sensitivity (detection limit, 0.1 micromol/L) and good recovery (97% spike). Compared with matching plasma samples, DBS retinol consistently decreased 18-23% during the 1st wk of storage. After 1 wk, retinol remained stable in the blood spots at 23 degrees C for >3 mo. In conclusion, the analysis of retinol in DBS by HPLC is comparable to retinol analysis in serum. The variability of the method was reduced by using sodium concentration to estimate sample volume. Collection of DBS for retinol analysis is appropriate under field conditions, where it is difficult to centrifuge or freeze blood samples. [ABSTRACT FROM AUTHOR]

Accurate psychiatric diagnosis is critical for both sound clinical interventions and valid research methodology. Over the years, attempts to improve diagnostic reliability and accuracy led to the development of more explicit operationalized diagnostic criteria, starting with DSM-III, and subsequently fully structured and semistructured diagnostic interviews.1 As diagnostic assessment changed and with advances in technology, the use of computers soon developed in parallel to improve the reliability and validity of psychiatric diagnosis. As far back as 1968, computers were used to help clinicians formulate psychiatric diagnoses, by helping them process clinical information according to diagnostic algorithms.2 Since that time, there has been an exponential rise in the use of technology in clinical research and practice. Indeed, computers have been used both to transition diagnostic interviews from paper-and-pencil format to instruments that are clinician-administered via an electronic platform and to create self-report versions of clinician-administered diagnostic interviews. We will discuss each of these in turn. [ABSTRACT FROM AUTHOR]

The brain connections in the different regions demonstrate the characteristics of brain activities. In addition, in various conditions and with neuropsychological disorders, the brain has special patterns in different regions. This paper presents a model to show and compare the connection patterns in different brain regions of children with autism (53 boys and 36 girls) and control children (61 boys and 33 girls). The model is designed by cellular neural networks and it uses the proper features of electroencephalography. The results show that there are significant differences and abnormalities in the left hemisphere, (p < 0.05) at the electrodes AF3, F3, P7, T7, and O1 in the children with autism compared with the control group. Also, the evaluation of the obtained connections values between brain regions demonstrated that there are more abnormalities in the connectivity of frontal and parietal lobes and the relations of the neighboring regions in children with autism. It is observed that the proposed model is able to distinguish the autistic children from the control subjects with an accuracy rate of 95.1% based on the obtained values of CNN using the SVM method. [ABSTRACT FROM AUTHOR]

Diagnostic information regarding the health status of the corneal endothelium may be obtained by analyzing the size and the shape of the endothelial cells in specular microscopy images. Prior to the analysis, the endothelial cells need to be extracted from the image. Up to today, this has been performed manually or semi-automatically. Several approaches to automatic segmentation of endothelial cells exist; however, none of them is perfect. Therefore this paper proposes to perform cell segmentation using a U-Net-based convolutional neural network. Particularly, the network is trained to discriminate pixels located at the borders between cells. The edge probability map outputted by the network is next binarized and skeletonized in order to obtain one-pixel wide edges. The proposed solution was tested on a dataset consisting of 30 corneal endothelial images presenting cells of different sizes, achieving an AUROC level of 0.92. The resulting DICE is on average equal to 0.86, which is a good result, regarding the thickness of the compared edges. The corresponding mean absolute percentage error of cell number is at the level of 4.5% which confirms the high accuracy of the proposed approach. The resulting cell edges are well aligned to the ground truths and require a limited number of manual corrections. This also results in accurate values of the cell morphometric parameters. The corresponding errors range from 5.2% for endothelial cell density, through 6.2% for cell hexagonality to 11.93% for the coefficient of variation of the cell size. [ABSTRACT FROM AUTHOR]

Lung sounds convey relevant information related to pulmonary disorders, and to evaluate patients with pulmonary conditions, the physician or the doctor uses the traditional auscultation technique. However, this technique suffers from limitations. For example, if the physician is not well trained, this may lead to a wrong diagnosis. Moreover, lung sounds are non-stationary, complicating the tasks of analysis, recognition, and distinction. This is why developing automatic recognition systems can help to deal with these limitations. In this paper, we compare three machine learning approaches for lung sounds classification. The first two approaches are based on the extraction of a set of handcrafted features trained by three different classifiers (support vector machines, k-nearest neighbor, and Gaussian mixture models) while the third approach is based on the design of convolutional neural networks (CNN). In the first approach, we extracted the 12 MFCC coefficients from the audio files then calculated six MFCCs statistics. We also experimented normalization using zero mean and unity variance to enhance accuracy. In the second approach, the local binary pattern (LBP) features are extracted from the visual representation of the audio files (spectrograms). The features are normalized using whitening. The dataset used in this work consists of seven classes (normal, coarse crackle, fine crackle, monophonic wheeze, polyphonic wheeze, squawk, and stridor). We have also experimentally tested dataset augmentation techniques on the spectrograms to enhance the ultimate accuracy of the CNN. The results show that CNN outperformed the handcrafted feature based classifiers. [ABSTRACT FROM AUTHOR]

Three-dimensional (3D) body scanners have the potential to evaluate changes to the human form through different clothing configurations, the use of protective equipment, or the effects of medical interventions. To achieve this, scans of an individual need to be superimposed for each experimental condition. The literature highlights that one of the limiting factors is postural variability. This paper describes a newly developed 'positioning aid' that stabilises the posture during the scanning process and is invisible on scans. The results of a study evaluating the efficacy of the positioning aid showed that it reduces postural variability for all body parts in lateral and longitudinal directions. A reference test with a rigid mannequin indicated that the 'technical' variability due to the scanner hardware and software significantly contributes to the residual variability. Furthermore, the study showed that the newly developed positioning aid overall increased the precision of the software-assisted extraction of body dimensions. [ABSTRACT FROM AUTHOR]

Objective: The Opiate Dosage Adequacy Scale (ODAS) is a clinical tool to individually measure the "adequacy" of opioid doses in patients on maintenance treatment. The aim of this paper is to provide evidence for the validity and reliability of the ODAS in a sample of patients in buprenorphine/naloxone (B/N) maintenance treatment.Method: Cross-sectional study of a convenience sample of B/N-treated patients (n = 316) from four Autonomous Communities in Spain. Participants completed a battery of instruments to assess the following: buprenorphine dose adequacy; heroin dependence severity; psychological adjustment; and patient-desired adjustment of buprenorphine dose.Results: Exploratory Factor Analysis identified four factors from the ODAS that together account for 85.4% of the total variance: "Heroin craving and use"; "Overmedication"; "Objective opiate withdrawal symptoms (OWS)" and 'Subjective OWS'. Compared to patients with an "inadequate" B/N dose (ODAS), patients with "adequate" doses had less heroin use in the last week (0.01 vs. 0.40; t = -2.73; p < 0.01, 95% CI: -0.67, -0.10), less severe heroin dependence (2.20 vs. 5.26, t = -5.14, p < 0.001; 95% CI: -4.23, -1.88), less psychological distress (3.00 vs. 6.31, t = -4.37, p < 0.001; 95% CI: -4.80, -1.81), and greater satisfaction with their doses (42.1% vs. 13.6%, χ2 = 14.44, p < 0.01). Cronbach's alpha coefficient was 0.76 (0.81, 0.92, 0.94, and 0.93, respectively, for the four factor dimensions).Conclusion: These findings support the validity and reliability of the ODAS as a tool to measure and assess buprenorphine dose adequacy in the context of an opioid dependency treatment program. [ABSTRACT FROM AUTHOR]

The Golgi Apparatus (GA) is a key organelle for protein synthesis within the eukaryotic cell. The main task of GA is to modify and sort proteins for transport throughout the cell. Proteins permeate through the GA on the ER (Endoplasmic Reticulum) facing side (cis side) and depart on the other side (trans side). Based on this phenomenon, we get two types of GA proteins, namely, cis-Golgi protein and trans-Golgi protein. Any dysfunction of GA proteins can result in congenital glycosylation disorders and some other forms of difficulties that may lead to neurodegenerative and inherited diseases like diabetes, cancer and cystic fibrosis. So, the exact classification of GA proteins may contribute to drug development which will further help in medication. In this paper, we focus on building a new computational model that not only introduces easy ways to extract features from protein sequences but also optimizes classification of trans-Golgi and cis-Golgi proteins. After feature extraction, we have employed Random Forest (RF) model to rank the features based on the importance score obtained from it. After selecting the top ranked features, we have applied Support Vector Machine (SVM) to classify the sub-Golgi proteins. We have trained regression model as well as classification model and found the former to be superior. The model shows improved performance over all previous methods. As the benchmark dataset is significantly imbalanced, we have applied Synthetic Minority Over-sampling Technique (SMOTE) to the dataset to make it balanced and have conducted experiments on both versions. Our method, namely, identification of sub-Golgi Protein Types (isGPT), achieves accuracy values of 95.4%, 95.9% and 95.3% for 10-fold cross-validation test, jackknife test and independent test respectively. According to different performance metrics, isGPT performs better than state-of-the-art techniques. The source code of isGPT, along with relevant dataset and detailed experimental results, can be found at https://github.com/srautonu/isGPT. [ABSTRACT FROM AUTHOR]

Recent evidence suggests that musculoskeletal disorders (MSDs) may be the result of a fatigue failure process in affected tissues. This paper describes a new low back exposure assessment tool (the Lifting Fatigue Failure Tool [LiFFT]), which estimates a "daily dose" of cumulative loading on the low back using fatigue failure principles. Only three variables are necessary to derive the cumulative load associated with a lifting task: the weight of the load, the maximum horizontal distance from the spine to the load, and the number of repetitions for tasks performed during the workday. The new tool was validated using two existing epidemiological databases: the Lumbar Motion Monitor (LMM) database, and a database from a U.S. automotive manufacturer. The LiFFT cumulative damage metric explained 92% of the deviance in low back disorders (LBDs) in the LMM database and 72-95% of the deviance in low back outcomes in the automotive database (depending on the outcome measure). Thus, LiFFT is practitioner friendly and its cumulative damage metric highly related to low back outcomes. [ABSTRACT FROM AUTHOR]

Fingermark detection is in constant evolution, with new techniques being developed and existing ones being continuously optimised. Recently, researchers have begun to express interest in artificial fingermark secretions to overcome the issues arising from the variability of fingermark composition. Some of these artificial secretions have started to appear on the market in the form of pads that can be used to deposit fingermarks with a known and controlled composition. This study aimed at assessing the reliability of three commercially-available pads by comparing the results to those obtained by real fingermarks, using six detection techniques (1,2-indanedione/zinc, ninhydrin, cyanoacrylate followed by rhodamine 6G staining, gold/zinc vacuum metal deposition, and physical developer) on five substrate types (copy and recycled paper, acetate, glass, and glossy paper). The results showed that the artificial fingermarks deposited with these pads reacted in an unreliable way, notably when treated with complex detection techniques such as Physical Developer. Further, the high concentration of some of the target compounds found in the artificial secretion led to an over performance of some detection techniques, which could mislead the operator to overestimating the efficiency of a given method. The resulting artificial fingermarks are considered too dissimilar to real fingermarks to be used as quality control standards and better simulants need to be found for a more efficient and realistic control of the variability. [ABSTRACT FROM AUTHOR]

Numerous gait event detection (GED) algorithms have been developed using accelerometers as they allow the possibility of long-term gait analysis in everyday life. However, almost all such existing algorithms have been developed and assessed using data collected in controlled indoor experiments with pre-defined paths and walking speeds. On the contrary, human gait is quite dynamic in the real-world, often involving varying gait speeds, changing surfaces and varying surface inclinations. Though portable wearable systems can be used to conduct experiments directly in the real-world, there is a lack of publicly available gait datasets or studies evaluating the performance of existing GED algorithms in various real-world settings. This paper presents a new gait database called MAREA (n=20 healthy subjects) that consists of walking and running in indoor and outdoor environments with accelerometers positioned on waist, wrist and both ankles. The study also evaluates the performance of six state-of-the-art accelerometer-based GED algorithms in different real-world scenarios, using the MAREA gait database. The results reveal that the performance of these algorithms is inconsistent and varies with changing environments and gait speeds. All algorithms demonstrated good performance for the scenario of steady walking in a controlled indoor environment with a combined median F1score of 0.98 for Heel-Strikes and 0.94 for Toe-Offs. However, they exhibited significantly decreased performance when evaluated in other lesser controlled scenarios such as walking and running in an outdoor street, with a combined median F1score of 0.82 for Heel-Strikes and 0.53 for Toe-Offs. Moreover, all GED algorithms displayed better performance for detecting Heel-Strikes as compared to Toe-Offs, when evaluated in different scenarios. [ABSTRACT FROM AUTHOR]

The present study aimed to evaluate the invariance of the factor structure of the Drinking Motives Questionnaire Revised (DMQ-R) between Portuguese and US university students. Following tests of factor model invariance we further evaluated cross-cultural differences in (1) mean levels of the four motives, and (2) the association of the four motives with weekly drinking, peak drinking, and binge drinking among college students from the United States and Portugal. Participants were 983 undergraduate students (67% female) from the US (N=515) and Portugal (N=468). Participants completed a confidential online (US) or paper and pencil (Portugal) survey. Results of a CFA demonstrated that the four-factor model of the DMQ-R was invariant with respect to factor loadings, factor variances, and factor covariances across the two countries. Mean differences in ratings of drinking motives were found, with US students ranking all motives higher than Portuguese students. However, rank order of motives (social>enhancement>coping>conformity) were equivalent across countries. Support for convergent validity was demonstrated by significant associations between drinking motives and alcohol consumption for men and women of both samples. Results support the factorial invariance and convergent validity of the DMQ-R across US and Portuguese college students, making it a trustworthy means of assessing college students' drinking motives, and a useful instrument for clinical and research purposes, both within and across cultures. [ABSTRACT FROM AUTHOR]

Aim: To determine the potential effect of changes to the National Institute for Health and Care Excellence (NICE) guidelines to the use of computed tomography (CT) in the assessment of suspected paediatric cervical spine (c-spine) injury.Material and Methods: A 5 year retrospective study was conducted of c-spine imaging in paediatric (<10 years) patients presenting following blunt trauma at a Level 1 trauma centre in London. All patients under the age of 10 years who underwent any imaging of the c-spine following blunt trauma were included. Clinical data relating to the presenting signs and symptoms were obtained from the retrospective review of electronic records and paper notes. This was then applied to the previous NICE guideline (CG56) and to the new NICE guideline (CG176). Patients with incomplete data were excluded.Results: Two hundred and seventy-eight patients <10 years underwent imaging of the c-spine following blunt trauma. Two hundred and seventy (97.12%) examinations had complete data and were included in further analysis. One hundred and forty-nine (55.19%) met the criteria for a CT of the c-spine under NICE CG56, whereas 252 (93.33%) met the updated NICE CG176 criteria for c-spine CT. Five (1.85%) patients had a c-spine injury and met the criteria under both CG56 and CG176 NICE guidelines.Conclusion: Recent changes to NICE Head Injury Guidelines relating to radiological assessment of paediatric c-spine following blunt trauma are likely to result in an increased usage of CT as the initial radiological investigation over plain radiographs, without an apparent increase in specificity in the present series. [ABSTRACT FROM AUTHOR]

The use of e-learning technology is incontestably recognized as an important and integral part of the educational process. Considerable research studies are carried out in order to apprehend how effective and usable e-learning systems. In this paper, an empirical-based study is conducted to explore how lecturers interact with an e-learning environment based on a predefined task model describing low-level interactions. Client-side log data is collected from university lecturers from the Electrical and Computer Science departments. Subsequently, data analysis is conducted to infer the usability degree from the estimated usage metrics together with further exploratory analysis from user feedback via System Usability Scale. Experimental results reveal that the System Usability Scale score is not a sufficient measure to express the true acceptance and satisfaction level of lecturers for using the e-learning systems. The evaluation must be fulfilled in tandem with analyzing the usage metrics derived from interaction traces in a non-intrusive fashion. The proposed approach is a milestone towards usability evaluation to improve the acceptance and user experience for academic staff and students. [ABSTRACT FROM AUTHOR]

Helmet safety benefits are reduced if the headgear is poorly fitted on the wearer's head. At present, there are no industry standards available to assess objectively how a specific protective helmet fits a particular person. A proper fit is typically defined as a small and uniform distance between the helmet liner and the wearer's head shape, with a broad coverage of the head area. This paper presents a novel method to investigate and compare fitting accuracy of helmets based on 3D anthropometry, reverse engineering techniques and computational analysis. The Helmet Fit Index (HFI) that provides a fit score on a scale from 0 (excessively poor fit) to 100 (perfect fit) was compared with subjective fit assessments of surveyed cyclists. Results in this study showed that quantitative (HFI) and qualitative (participants' feelings) data were related when comparing three commercially available bicycle helmets. Findings also demonstrated that females and Asian people have lower fit scores than males and Caucasians, respectively. The HFI could provide detailed understanding of helmet efficiency regarding fit and could be used during helmet design and development phases. [ABSTRACT FROM AUTHOR]

The aim of this paper was to investigate the clinical feasibility and the accuracy in femoral neck densitometry of the Osteoporosis Score (O.S.), an ultrasound (US) parameter for osteoporosis diagnosis that has been recently introduced for lumbar spine applications. A total of 377 female patients (aged 61-70 y) underwent both a femoral dual X-ray absorptiometry (DXA) and an echographic scan of the proximal femur. Recruited patients were sub-divided into a reference database used for ultrasound spectral model construction and a study population for repeatability assessments and accuracy evaluations. Echographic images and radiofrequency signals were analyzed through a fully automatic algorithm that performed a series of combined spectral and statistical analyses, providing as a final output the O.S. value of the femoral neck. Assuming DXA as a gold standard reference, the accuracy of O.S.-based diagnoses resulted 94.7%, with k = 0.898 (p < 0.0001). Significant correlations were also found between O.S.-estimated bone mineral density and corresponding DXA values, with r(2) up to 0.79 and root mean square error = 5.9-7.4%. The reported accuracy levels, combined with the proven ease of use and very good measurement repeatability, provide the adopted method with a potential for clinical routine application in osteoporosis diagnosis. [ABSTRACT FROM AUTHOR]

Background: The outcomes of psychological therapies for anxiety and depression vary across individuals and symptom domains. Being able to predict treatment response from readily available patient data at presentation has potentially important benefits in aiding decisions about the most suitable interventions for a patient. This paper presents a method of identifying subgroups of patients using latent profile analysis, and comparing response to psychological treatments between these profiles.Methods: All outpatients taken into treatment at two psychological treatment services in London, UK and who provided basic demographic information and standardized symptom measures were included in the analysis (n=16636).Results: Latent Profile Analysis was performed on intake data to identify statistically different groups of patients, which were then examined in longitudinal analyses to determine their capacity to predict treatment outcomes. Comparison between profiles showed considerable variation in recovery (74-15%), deterioration rates (5-20%), and levels of attrition (17-40%). Further variation in outcomes was found within the profiles when different intensities of psychological intervention were delivered.Limitations: Latent profiles were identified using data from two services, so generalisability to other services should be considered. Routinely collected patient data was included, additional patient information may further enhance utility of the profiles.Conclusions: These results suggest that intake data can be used to reliably classify patients into profiles that are predictive of outcome to different intensities of psychological treatment in routine care. Algorithms based on these kinds of data could be used to optimize decision-making and aid the appropriate matching of patients to treatment. [ABSTRACT FROM AUTHOR]

Over the past decade, the use of nanotechnology for fingermark detection has been attracting a lot of attention. A substantial number of nanoparticle types has thus been studied and applied with varying success. However, despite all efforts, few publications present clear supporting evidence of their superiority over standard and commonly used techniques. This paper focuses on a rarely studied type of nanoparticles that regroups all desired properties for effective fingermark detection: silicon oxide. These nanoparticles offer optical and surface properties that can be tuned to provide optimal detection. This study explores their potential as a new method for fingermark detection. Detection conditions, outer functionalisations and optical properties were optimised and a first evaluation of the technique is presented. Dye-doped silicon oxide nanoparticles were assessed against a one-step luminescent cyanoacrylate. Both techniques were compared on natural fingermarks from three donors collected on four different non-porous substrates. On average, the two techniques performed similarly but silicon oxide detected marks with a better homogeneity and was less affected by donor inter-variability. The technique remains to be further optimised and yet silicon oxide nanoparticles already show great promises for effective fingermark detection. [ABSTRACT FROM AUTHOR]

Objective: Feature selection is a technique widely used in data mining. The aim is to select the best subset of features relevant to the problem being considered. In this paper, we consider feature selection for the classification of gene datasets. Gene data is usually composed of just a few dozen objects described by thousands of features. For this kind of data, it is easy to find a model that fits the learning data. However, it is not easy to find one that will simultaneously evaluate new data equally well as learning data. This overfitting issue is well known as regards classification and regression, but it also applies to feature selection.Methods and Materials: We address this problem and investigate its importance in an empirical study of four feature selection methods applied to seven high-dimensional gene datasets. We chose datasets that are well studied in the literature-colon cancer, leukemia and breast cancer. All the datasets are characterized by a significant number of features and the presence of exactly two decision classes. The feature selection methods used are ReliefF, minimum redundancy maximum relevance, support vector machine-recursive feature elimination and relaxed linear separability.Results: Our main result reveals the existence of positive feature selection bias in all 28 experiments (7 datasets and 4 feature selection methods). Bias was calculated as the difference between validation and test accuracies and ranges from 2.6% to as much as 41.67%. The validation accuracy (biased accuracy) was calculated on the same dataset on which the feature selection was performed. The test accuracy was calculated for data that was not used for feature selection (by so called external cross-validation).Conclusions: This work provides evidence that using the same dataset for feature selection and learning is not appropriate. We recommend using cross-validation for feature selection in order to reduce selection bias. [ABSTRACT FROM AUTHOR]

Objective: This paper aims at developing an automated gastroscopic video summarization algorithm to assist clinicians to more effectively go through the abnormal contents of the video.Methods and Materials: To select the most representative frames from the original video sequence, we formulate the problem of gastroscopic video summarization as a dictionary selection issue. Different from the traditional dictionary selection methods, which take into account only the number and reconstruction ability of selected key frames, our model introduces the similar-inhibition constraint to reinforce the diversity of selected key frames. We calculate the attention cost by merging both gaze and content change into a prior cue to help select the frames with more high-level semantic information. Moreover, we adopt an image quality evaluation process to eliminate the interference of the poor quality images and a segmentation process to reduce the computational complexity.Results: For experiments, we build a new gastroscopic video dataset captured from 30 volunteers with more than 400k images and compare our method with the state-of-the-arts using the content consistency, index consistency and content-index consistency with the ground truth. Compared with all competitors, our method obtains the best results in 23 of 30 videos evaluated based on content consistency, 24 of 30 videos evaluated based on index consistency and all videos evaluated based on content-index consistency.Conclusions: For gastroscopic video summarization, we propose an automated annotation method via similar-inhibition dictionary selection. Our model can achieve better performance compared with other state-of-the-art models and supplies more suitable key frames for diagnosis. The developed algorithm can be automatically adapted to various real applications, such as the training of young clinicians, computer-aided diagnosis or medical report generation. [ABSTRACT FROM AUTHOR]

Objective: Health-related websites have developed to be much more than information sites: they are used to exchange experiences and find support as well as information and advice. This paper documents the development of a tool to compare the potential consequences and experiences a person may encounter when using health-related websites.Methods: Questionnaire items were developed following a review of relevant literature and qualitative secondary analysis of interviews relating to experiences of health. Item reduction steps were performed on pilot survey data (n=167). Tests of validity and reliability were subsequently performed (n=170) to determine the psychometric properties of the questionnaire.Results: Two independent item pools entered psychometric testing: (1) Items relating to general views of using the internet in relation to health and, (2) Items relating to the consequences of using a specific health-related website. Identified sub-scales were found to have high construct validity, internal consistency and test-retest reliability.Conclusion: Analyses confirmed good psychometric properties in the eHIQ-Part 1 (11 items) and the eHIQ-Part 2 (26 items).Practice Implications: This tool will facilitate the measurement of the potential consequences of using websites containing different types of material (scientific facts and figures, blogs, experiences, images) across a range of health conditions. [ABSTRACT FROM AUTHOR]

Objective: To compare the Diabetes-39 (D-39) with six multi-attribute utility (MAU) instruments (15D, AQoL-8D, EQ-5D, HUI3, QWB, and SF-6D), and to develop mapping algorithms which could be used to transform the D-39 scores into the MAU scores.Research Design and Methods: Self-reported diabetes sufferers (N=924) and members of the healthy public (N=1760), aged 18 years and over, were recruited from 6 countries (Australia 18%, USA 18%, UK 17%, Canada 16%, Norway 16%, and Germany 15%). Apart from the QWB which was distributed normally, non-parametric rank tests were used to compare subgroup utilities and D-39 scores. Mapping algorithms were estimated using ordinary least squares (OLS) and generalised linear models (GLM).Results: MAU instruments discriminated between diabetes patients and the healthy public; however, utilities varied between instruments. The 15D, SF-6D, AQoL-8D had the strongest correlations with the D-39. Except for the HUI3, there were significant differences by gender. Mapping algorithms based on the OLS estimator consistently gave better goodness-of-fit results. The mean absolute error (MAE) values ranged from 0.061 to 0.147, the root mean square error (RMSE) values 0.083 to 0.198, and the R-square statistics 0.428 and 0.610. Based on MAE and RMSE values the preferred mapping is D-39 into 15D. R-square statistics and the range of predicted utilities indicate the preferred mapping is D-39 into AQoL-8D.Conclusions: Utilities estimated from different MAU instruments differ significantly and the outcome of a study could depend upon the instrument used. The algorithms reported in this paper enable D-39 data to be mapped into utilities predicted from any of six instruments. This provides choice for those conducting cost-utility analyses. [ABSTRACT FROM AUTHOR]

This paper describes the development and validation of an educational information web page designed for family members who have relatives in the Intensive Care Unit (ICU). Family members with relatives in the ICU always encounter a stressful experience. Hence, healthcare providers play a crucial in educating and alleviating the psychological distress experienced by family members with relatives in the ICU. This study was a methodology research design. The educational information material was conducted in three stages: 1. Bibliographic survey; 2. Design and development of educational material; and 3. Validation of those materials by experts in the subject and representatives of the target audience and evaluation. The validation was performed by nine experts and 30 representatives of the target audience. A minimum value of 0.78 was recommended for Content Validation Index while a standard usability score value of 0.68 indicates good app usability. The educational information material achieved acceptable CVI values (0.83) and the usability score of the web material was higher than 0.68. Meanwhile, the experts proposed changes to the educational information, which were accepted and updated for the final edition of the content. The educational information material was validated in terms of content and relevance and should be used by nurses to fulfil the needed information. Based on the knowledge given, healthcare providers can support, provide comfort, assurance and proximity to family members or relatives in the ICU. Future studies with this application are necessary to assess educational information effectiveness to reduce the psychological distress experienced by family members in the ICU. [ABSTRACT FROM AUTHOR]

This paper reports on a cross-language longitudinal study in which we extend previous research on the effects of maternal education on vocabulary growth in Spanish- and English-dominant children at three time points: 16 months, 22 months, and 30 months of age. This study addresses recent conflicting evidence regarding the role of maternal education in children's acquisition of Spanish. Participants were 62 English-dominant children, 47 Spanish-dominant children, and their mothers. Growth curve models were constructed separately for English and Spanish vocabulary. Strong growth rate reliability and effect sizes were evinced for vocabulary across samples. As expected, in English-dominant children, maternal education predicted English vocabulary and growth from 16 to 30 months of age. However, in Spanish-dominant children, there was no significant effect of maternal education on vocabulary or growth, although there was a descriptive advantage for children of college-educated mothers at 30 months of age. In conjunction with prior evidence, we conclude that the effect of maternal education on maternal input and child vocabulary does not generalize readily to children whose first language is Spanish. Our findings contribute to a literature that suggests that focusing on maternal beliefs, input, and the home literacy environment are more fruitful approaches in the study of children learning Spanish in the U.S. Further, the importance of maternal beliefs highlights the need to support parent investment in the quantity and quality of input in the home language. [ABSTRACT FROM AUTHOR]

The Integrated Model of Flow and Clutch States describes two overlapping psychological states that underlie exceptional performance and rewarding exercise experiences. However, research based on this model is currently hampered because no validated measure has yet been developed. Therefore, the aim of this multi-study paper was to develop and provide preliminary validation of the Flow-Clutch Scale in sport and exercise. Using two independent adult samples (n = 280; n = 264), three studies were conducted to develop and establish preliminary validity of the Flow-Clutch Scale. In Study 1, we developed an initial version of the scale and established content validity using an expert panel. In Study 2, we employed exploratory factor analysis to: identify the most appropriate factor structure; examine the scale's internal consistency; test whether the scale differentiated between individuals who experience flow, clutch, or neither state; and examine relationships with the Flow State Scale-2. In Study 3, we aimed to replicate findings of Study 2 with an independent sample, and employed confirmatory factor analysis to confirm the factor structure, internal consistency, and relationships with the Flow State Scale-2. The results provide preliminary validation of the four-factor, 22-item Flow-Clutch Scale. These studies indicate the Flow-Clutch Scale represents a useful scale for researchers interested in examining flow and/or clutch states in sport and exercise. Recommendations are provided for further research to continue testing, and accumulating evidence for, the validity and reliability of the Flow-Clutch Scale. • We aimed to develop and provide preliminary validation of the Flow Clutch Scale. • In Study 1 an expert panel confirmed content validity of an initial version of the scale. • Study 2 refined the measure to 22 items and identified a four-factor structure. • Study 3 confirmed the factor structure in an independent sample. • These studies provide preliminary evidence of the validity of the Flow Clutch Scale. [ABSTRACT FROM AUTHOR]

Objective: For many years, the Histologic/Histochemical Grading System (HHGS) for osteoarthritis monitoring has been used as a histological scoring system for the quality of cartilage. There are, however, some limitations using this grading system. The goal of the investigation presented in this paper was to examine the hypothesized advantage of the recently introduced Osteoarthritis Research Society International (OARSI) Cartilage Histopathology Assessment System (OOCHAS) as compared to the most frequently used HHGS by means of reliability, reproducibility, and variability evaluation as well as the correlation analysis between the two systems in goat knee articular cartilage.Methods: Nine hundred and thirty-six sections of Dutch Milk goat articular knee cartilage were scored using light microscopy. Three observers applied the HHGS for all sections and subsequently, the OOCHAS. The same scoring procedure was repeated after a minimum interval of 1 week. For each system the reliability, reproducibility and variability as well as the correlation between both systems were determined.Results: The reliability of the OOCHAS was higher as compared to the HHGS. Both the HHGS as well the OOCHAS have an excellent intra- and inter-observer reproducibility and variability and a good positive correlation between the scores.Conclusions: Although the HHGS has proven to be an excellent tool for histological scoring of cartilage quality, we recommend the OOCHAS as the premium choice while stressing the importance of further research investigating the correlation of the histological results to macroscopic and biochemical parameters. [ABSTRACT FROM AUTHOR]

Abstract: Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNRe) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (≥0.125 ms) and spatial (∼55 μm) resolution as well as high precision (∼0.05 μm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo. (E-mail: ek2191@columbia.edu) [Copyright &y& Elsevier]

Summary: Sports injury etiological studies explore the relationships between potential injury risk factors and injury outcomes. The ability of such studies to clearly identify intrinsic risk factors for sports injury depends on the accuracy of their measurement. Measurements need to be reproducible over time and repeatable by different observers, as well as within a given individual. The importance of the reliability of pre-participation screening protocols and other clinical assessment tools has been identified in a number of published studies. However, a review of these studies indicates that a variety of statistical techniques have been used to calculate intra- and inter-observer reliability. While the intra-class correlation coefficient (ICC) is the most often cited measure, a range of statistical approaches to estimating ICCs have been used. It is therefore difficult to determine which statistical method is most appropriate in the context of measuring intrinsic risk factors in sports injury research. This paper summarises a statistical method for the concurrent assessment of intra- and inter-observer reliability and presents an argument for why this approach should be adopted by sports injury researchers using screening protocols that collect continuous data. [Copyright &y& Elsevier]