Excellent Reliability Research Articles

Reliability of the Wolf Motor Function Test for Parkinson's disease.

Reliability of the Wolf Motor Function Test for Parkinson's disease.

Development and validation of a brief questionnaire for the joint assessment of early maltreatment and early caring experiences.

Development and validation of a brief questionnaire for the joint assessment of early maltreatment and early caring experiences.

Validation of magnetic resonance imaging derived venous oxygen saturation and oxygen consumption measurements during exercise.

Background: Accurate measurement of venous oxygen saturation (SvO2) is fundamental for quantifying oxygen consumption (VO2) and its Fick determinants. This study evaluated the validity of a novel MRI approach using susceptometry-based oximetry (SBO) to non-invasively measure SvO2 during exercise. Methods: First, SvO2 was measured from an antecubital vein in 14 adults (26±5years; 8 males) via portable blood analyzer (iSTAT) at rest and during two 5-min bouts of rhythmic handgrip exercise at 30% of maximum voluntary contraction, with temporally matched SBO measures of SvO2 during an identical in-scanner exercise protocol. Separately, 21 adults (27±6years; 8 males) completed incremental step ergometry exercise with simultaneous pulmonary VO2 measurement (indirect calorimetry) and MRI-derived VO2 from the Fick determinants (MRIFick) including inferior vena cava SvO2 (SBO) and cardiac output (cardiac MRI). Agreement between methods was assessed by interclass correlation coefficients (ICC), linear regression, and Bland-Altman plots. Results: There was good to excellent agreement between iSTAT and SBO SvO2 for arm exercise (ICC: 0.86, 95%CI: 0.71-0.93, p<0.01; mean bias: +5.2%).Test-retest reliability demonstrated excellent agreement for SvO2 measures between trials using iSTAT (ICC: 0.97; 95%CI: 0.93-0.96, p<0.01; mean bias: -2.7%) and SBO (ICC: 0.90, 95%CI: 0.80-0.95, p<0.01; mean bias: -0.3%), VO2 calculated from MRIFick demonstrated excellent agreement with pulmonary VO2 (ICC: 0.98, 95%CI: 0.97-0.99, p<0.01; mean bias: +0.10 L/min). Conclusion: MRI-SBO derived SvO2 measurements demonstrated excellent reliability and strong agreement with both venous measures and respiratory gas analysis, validating this technique across a wide range of SvO2 values during exercise.

The BruxChecker System for Quantitatively Assessing Sleep Bruxism at the Dental Level: Reliability, Reference Values and Methodological Considerations.

There is a need for reliable instruments that can quantitatively assess sleep bruxism at the dental level. This study aimed to determine the test-retest reliability of the occlusal peeled area using the BruxChecker, the methodological aspects that affect this reliability, and the reference values in a population of dental students. Eighty-four dental students participated in this test-retest study (median age, 21.7 years; 74 women). A BruxChecker was worn for 3 consecutive nights and scanned after each night in the plaster model and by transillumination. The relative and absolute peeled areas were measured using the FIJI software, and BruxChecker perforation was determined visually. Reliability was assessed by the intraclass correlation coefficient (ICC) and Cohen's kappa. The absolute and relative peeled areas of the BruxChecker by transillumination after 2 or 3 nights provided the highest ICC values, which ranged from 0.918 to 0.929. BruxChecker perforation was present in 45% of the participants, with a kappa value of 0.777. The respective median peeled areas were 84.3 mm2 and 9.9% for the absolute and relative values after using the BruxChecker for three nights. Ranges for the 10th-90th percentiles were 4.7%-17.0% and 39.4%-143.4 mm2, respectively. The BruxChecker system demonstrates excellent reliability in measuring the occlusal peeled area in the studied population. This study proposes reference values for absolute and relative peeled areas after using the BruxChecker for three nights and scanning by transillumination.

Open Source, Open Science: Development of OpenLESS as the Automated Landing Error Scoring System.

The Open Landing Error Scoring System (OpenLESS) is a novel tool for automating the LESS to assess lower extremity movement quality during a jump-landing task. With the growing use of clinical measures to monitor outcomes and limited time during clinical visits, there is a need for automated systems. OpenLESS is an open-source tool that uses a markerless motion capture system to automate the LESS using 3D kinematics. To describe the development of OpenLESS, examine its validity against expert rater LESS scores in healthy and clinical cohorts, and assess its intersession reliability in an athlete cohort. Cross-Sectional. 92 total adult participants from three distinct cohorts: a healthy university student cohort (12 males, 14 females; age=23.0±3.8 years; height=171.9±8.3 cm; mass=75.4±18.9 kg), a post-anterior cruciate ligament reconstruction (ACLR) cohort (8 males, 19 females; age=21.4±5.7 years, height=173.5±12.5 cm; mass=73.9±13.1 kg; median 33 months post surgery), and a field-based athlete cohort (39 females; age=25.0±4.7 years, height=165.0±7.1cm; mass=63.5±8.6kg). The OpenLESS software interprets movement quality from kinematics captured by markerless motion capture. Validity and reliability were assessed using intraclass correlation coefficients (ICC), standard error of measure (SEM), and minimal detectable change (MDC). OpenLESS agreed well with expert rater LESS scores for healthy (ICC2,k=0.79) and clinically relevant, post-ACLR cohorts (ICC2,k=0.88). The automated OpenLESS system reduced scoring time, processing all 353 trials in under 25 minutes compared to the 35 hours (~6 minutes per trial) required for expert rater scoring. When tested outside laboratory conditions, OpenLESS showed excellent reliability across repeated sessions (ICC2,k>0.89), with a SEM of 0.98 errors and MDC of 2.72 errors. OpenLESS is a promising, efficient tool for automated jump-landing assessment, demonstrating good validity in healthy and post-ACLR populations, and excellent field reliability, addressing the need for objective movement analysis.

Evaluating machine learning-based probabilistic lightning forecasts using the HRRR: A comparison to three forecast baselines

Abstract 4-hr and 1-hr probabilistic forecasts of lightning for the CONUS were generated by post-processing the HRRR with neural networks (NNs). These NN probability forecasts (NNPFs) were produced for HRRR forecasts in 2021–2022 using NNs trained with 00 UTC HRRR forecasts from 2019–2020 paired with ≥ 1 observed CG (CG1) flash as the target variable. CG1-NNPF skill was evaluated against three baselines: smoothed HRRR-based surrogate lightning forecasts, SPC probabilistic thunderstorm outlooks, and calibrated ensemble thunderstorm guidance from the High-Resolution Ensemble Forecast (HREF) system. The hourly-maximum updraft speed (UP) diagnostic was the most skillful HRRR surrogate for predicting CG1, outperforming diagnostics such as hourly-maximum lightning threat and updraft helicity. The UP forecasts were compared to the NNPFs by using the most skillful combination of UP threshold and smoothing length-scale at each forecast hour. The 4-hr and 1-hr CG1-NNPFs exceeded the skill of the UP forecasts in 2021 for nearly all forecast hours, with reduced skill differences overnight compared to the daytime. The NNPFs exhibited excellent reliability, with slight overforecasting of probabilities overnight. The NNPFs were more skillful than NOAA Storm Prediction Center (SPC) Thunderstorm Outlooks in both 2021 and 2022, especially overnight, while during the daytime, the SPC forecasts had similar or slightly greater skill. Finally, the NNPFs outperformed calibrated thunder guidance from the HREF system evaluated across forecasts in 2022. These findings imply that using NNs for thunderstorm prediction can improve upon existing non-machine learning baselines from deterministic and ensemble systems and may improve operational SPC thunderstorm forecasts.

How can MRI descriptors be optimally combined to predict idiopathic intracranial hypertension?

To establish how MRI descriptors on standard MRI sequences can be optimally combined to predict idiopathic intracranial hypertension (IIH). A retrospective single institution cross-sectional study evaluated consecutive IIH patients undergoing MRI between 2002-2015 and a control group. Six established and eight exploratory MRI descriptors were evaluated. Two observers independently analysed MRI descriptors on T1w sagittal and T2w axial sequences whilst blinded to clinical data with consensus obtained. Inter-rater reliability was calculated, and the presence of MRI descriptors was compared between IIH patients and controls (Bonferroni correction, p < 0.004). Forward stepwise logistic regression determined which combination of MRI descriptors best predicted IIH. 54 IIH patients (mean age 31.2, standard deviation 10.2, 3 men) and 54 control subjects (mean age 31.7, standard deviation 7.1, 3 men) were evaluated. There was excellent inter-rater reliability for 13/14 MRI descriptors. There were 4/6 established and 6/8 exploratory MRI descriptors associated with IIH (p < 0.004). The optimal combination of descriptors to predict IIH were vertical tortuosity of the optic nerve, enlarged optic nerve sheath, globe flattening score ≥ 2, Yuh Score ≥ 3, cervical skin folding and cervical fat thickness ≥ 10.5 mm. The model correctly classified 93.5% of cases (sensitivity 94.4%, specificity 92.6%, AUC 0.965). Evaluating a combination of vertical tortuosity of the optic nerve, enlarged optic nerve sheath, globe flattening, Yuh Score, cervical skin folding and cervical fat thickness optimally predicts IIH. New MRI features are validated for the diagnosis of IIH and the optimal combination for diagnosis is established.

The British object and action naming test for intraoperative mapping (BOATIM): A standardised and clinically tested framework for awake brain surgery

BackgroundPicture-naming tasks are widely used for identifying speech-eloquent regions during awake craniotomy. However, language-specific and culturally relevant task stimuli remain scarce. Current practices mostly rely on translated stimuli that do not reflect the everyday language use of the target speakers and might be susceptible to misinterpretations due to linguistic and cultural differences. Additionally, non-standardised homemade tasks are used. Here, we, for the first time, present the development, standardisation, and clinical application of two tests designed specifically for functional mapping in British English.Methods115 object and 86 action stimuli were developed using the British National Corpus (BNC) and controlled for confounding psycholinguistic variables using normative data from native speakers. Optimization of the items for intraoperative use was done by first standardising the tests in healthy volunteers followed by their application during the electrical stimulation of language-eloquent regions in brain tumour patients. In the standardised data, the influence of word- and subject-related factors on performance, and the test-retest reliability was explored.ResultsThe final items achieved above 80% naming agreement. Object naming proved easier compared to action naming, with accuracy positively influenced by word frequency and negatively affected by the age-of-acquisition variable in both tasks. No subject-related effects were found. Excellent test-retest reliability confirmed the consistency of the tests in measuring language abilities. Positive maps obtained during intraoperative functional mapping demonstrated the sensitivity of the tests in detecting speech-eloquent regions.ConclusionThe tests provide a reliable and robust tool containing stimuli that are linguistically and culturally appropriate to British-English speakers.

Greek translation and cross-cultural adaptation of the Oslo Sports Trauma Research Center Questionnaires on overuse injuries and health problems

Purpose This study aimed to cross-culturally adapt the second version of the Oslo Sports Trauma Research Center Questionnaires on Overuse Injuries (OSTRC-O2) and Health Problems (OSTRC-H2) into Greek. Materials and Methods The questionnaires were translated using the back-translation method in accordance with international guidelines. The OSTRC-O2 was administered to 56 female volleyball players, focusing on shoulder injuries, while the OSTRC-H2 was delivered to 52 adolescent and young adult male and female volleyball and soccer players. Validity was assessed through content validity (Content Validity Index – CVI), face validity (using additional questions on comprehensibility, difficulty, relevance, and completeness), and concurrent validity (correlations between the OSTRC-O2 severity score and the numeric pain rating scale [NPRS], as well as between the OSTRC-H2 severity score with days of time loss [DL] and NPRS). Reliability was evaluated using internal consistency (Cronbach's α) and the test-retest method (intraclass correlation coefficient – ICC). The study was conducted for a two-week period and the test-retest was performed with a two-day interval. Results Twenty-three athletes (41%) reported shoulder problems using the OSTRC-O2, while 28 injury events and 5 cases of illness were reported with the OSTRC-H2. Face and content validity were excellent (CVI = 0.925 and 0.975 for OSTRC-O2 and OSTRC-H2). A strong correlation was observed between the OSTRC-O2 severity score and the NPRS (ρ = 0.819, p &lt; 0.001), while the OSTRC-H2 severity score demonstrated significant correlations with both the NPRS (ρ = 0.72, p &lt; 0.001) and days of time loss (ρ = 0.625, p &lt; 0.001). Both questionnaires demonstrated excellent reliability and internal consistency, with the OSTRC-O2 showing an ICC of 0.90 (95% CI: 0.82–0.94) and Cronbach's alpha of 0.84, and the OSTRC-H2 showing an ICC of 0.93 (95% CI: 0.89–0.97) and Cronbach's alpha of 0.93. Conclusions The Greek versions of the OSTRC questionnaires are valid and reliable tools for injury surveillance among Greek volleyball and soccer players.

Use of complementary electrocardiogram-gated cardiac computed tomography in the assessment of aortic valve repairability: a pilot study.

In young patients with type I/II aortic regurgitation, the feasibility of aortic valve repair has been traditionally evaluated with echocardiography. We evaluate electrocardiogram-gated cardiac computed tomography as a complement to transoesophageal echocardiography in the preoperative assessment of aortic repairability. Patients undergoing non-urgent aortic valve repair with or without aortic root replacement from October 2016 to May 2023 who had both imaging tests for the evaluation of aortic valve repairability were included. The measurements obtained with echocardiography and electrocardiogram-gated scan of geometric height, aortic annulus and commissural orientation were compared using the Intraclass Correlation Coefficient for inter-rater reliability. All 24 patients were males, with a median age of 47,5 years (41,9-59,3). Of these, 87,5% presented severe aortic regurgitation; 62,5% had associated aortopathy. 58,3% were in New York Heart Association class I and the remnant 41,7% in class II. The aortic valve was bicuspid in 62,5% of the patients. The Intraclass Correlation Coefficient indicated excellent reliability of electrocardiogram-gated scan for commissural orientation (ICC = 0,98, 95% CI: 0,96 to 0,99) and conjoined cusp geometric height (ICC = 0,91, 95% CI: 0,74 to 0,97) in bicuspid aortic valves, while in tricuspid valves it showed good reliability for left cusp geometric height (ICC = 0,76, 95% CI: 0,19 to 0,93) and annular diameter (ICC = 0,8, 95% CI: 0,33 to 0,95). Electrocardiogram-gated cardiac scan complements echocardiography in aortic repair, showing excellent agreement for morphologic evaluation and commissural orientation. It is particularly reliable for geometric height in bicuspid valves and annular diameter and left cusp geometric height in tricuspid valves.

The Role of Virtual Physical Therapy in the Management of Musculoskeletal Patients: Current Practices and Future Implications.

The rapid evolution of virtual technology and artificial intelligence (AI), combined with physical distancing limitations imparted by the COVID- 19 pandemic, has hastened the shift of healthcare toward digitally enabled practitioners. As physical therapy embraces virtual care, its impact is far-reaching across stakeholders, affecting patients, providers, and payors. This article seeks to explore the role of virtual physical therapy (VPT) in managing patients with musculoskeletal (MSK) conditions and its impact on healthcare and patient outcomes. While research on VPT is growing, high-quality studies remain limited due to challenges in conducting blinded, randomized controlled trials, sponsor bias, and the diversity of digital solutions that complicate comparative studies. Nevertheless, general literature trends show that VPT, particularly when guided by a physical therapist, can yield improvements in pain and function comparable to in-person therapy. VPT demonstrates fair to excellent reliability and validity across key assessment areas, successfully identifying MSK diagnoses and delivering outcomes similar to conventional treatment for pain, function, and quality of life across multiple MSK disorders. Additionally, VPT addresses adherence issues by reducing travel, costs, and exposure risks, while technology enhancements foster patient engagement and communication with therapists. By increasing access and adherence to PT, VPT has the potential to optimize outcomes and curb long-term healthcare costs by preventing progression to more expensive interventions. Virtual care harnesses technology to advance musculoskeletal care by improving access, enhancing patient-provider communication and connection, and optimizing patient engagement and outcomes. VPT moves beyond replication of the in-person experience to an enhanced patient journey. This journey taps into technological advancements to deliver a more integrated experience that engages and supports the patient. VPT offers a sophisticated model of care from the therapist, emphasizing evidence-based practice and critical thinking.

Development of a Computed Tomography Imaging Grading Scale for Pneumolabyrinth.

To develop a reliable prognostic grading scale for pneumolabyrinth detected on CT. Retrospective case series. Tertiary care institution. A total of 39 patients with pneumolabyrinth identified through CT imaging from 2010 to 2019 were included. The main outcome measures involved reviewing clinical outcomes and radiographic features. The extent of pneumolabyrinth was assessed and graded as low, intermediate, or high risk for permanent hearing loss, by expert radiologists. The primary outcome of the study was the association between the extent of pneumolabyrinth, as graded by a novel prognostic scale (low, intermediate, or high risk), and the likelihood of permanent hearing loss. Hearing outcomes and vestibular symptoms were assessed through retrospective chart review, while the grading of pneumolabyrinth extent was based on expert radiologic evaluations of CT imaging. The hypothesis regarding the predictive utility of the grading scale was formulated after data collection. Reliability of the grading scale was measured using Cohen's kappa and Fleiss' kappa. The patient cohort had a median age of 30 years (range = 8-84 years), 33% of whom were female. Trauma, predominantly temporal bone fractures (87.5%), was the most common cause. The grading scale demonstrated excellent intra-rater reliability (Cohen's kappa = .95) and substantial inter-rater reliability (Fleiss' kappa = .729). High risk pneumolabyrinth cases had a higher rate of profound hearing loss (90.9%) compared low or intermediate risk cases (46.2%, P = .0136). Dizziness was not associated with pneumolabyrinth grade, but correlated with involvement of semicircular canals (72.7%) compared to patients with pneumolabyrinth limited to vestibule and/or cochlea (31.3%, P = .008). Presence of pneumolabyrinth isolated to the vestibular labyrinth was significantly associated with dizziness symptoms (P = .047). Our novel grading scale reliably predicted clinical outcomes, providing prognostic utility in hearing status and potential guidance in surgical approach.

A new-type intelligent monitoring anchor system for CFRP strand wires based on CFRP self-sensing

Abstract In order to explore the feasibility of the structural health monitoring on the in-service anchor system for carbon fiber-reinforced polymer (CFRP) strand wires, the relative theoretical analysis and experimental tests were conducted. The piezoresistive model for CFRP strand wires was established by theoretical deduction. The damage model of the anchor system at different load stages of the anchorage zone was established by theoretical derivation. Thereby, the regional distribution monitoring methodology of the anchor system was established based on the above two models. The tensile experiments on the anchor system for the CFRP strand wires were carried out, and the typical mechanical and electrical features were ascertained, including volt–ampere characteristics, resistance–strain relationship, strain sensitivity, and the distribution of shear and tensile stresses along the anchorage zone. The results show the theoretical results are in line with the experimental measurements, with a maximum error of below 15%. This indicates excellent applicability and reliability of self-monitoring on the anchoring systems throughout loading.

Prevention of Violence in an Acute Psychiatric Unit: Spanish Validation of the Brøset Violence Checklist and Assessment of Its Predictive Capacity for Physical Restraint.

The management of violence and restrictive practices in acute mental health units poses a challenge for the design of clinical nursing protocols that combine the safety of professionals and the dignified care of patients. Many of the strategies aimed at reducing seclusion and restraint practices include the use of standardised risk assessment instruments, preferably conducted by the nursing staff. Among them, the Brøset Violence Checklist (BVC) is one of the most widely supported tools. To conduct the Spanish validation of the BVC and to explore its predictive validity for violence and for the use of restraint. Prospective data from 115 patients consecutively admitted to an acute unit of a general university hospital were gathered to validate the instrument. The role of risk factors for violence such as gender, age, substance use or the involuntariness of the admission was analysed, both in relation to the BVC score and to the need for physical restraint in the short and middle term (72 h and 1 week). The Spanish version of the BVC maintains its predictive validity for imminent violence and guarantees excellent inter-rater reliability among mental health nurses. The score in the first shift after admission is significantly associated with increased odds of restraint at 72 h (OR = 7.272), and age with decreased odds (OR = 0.903), with no significant effect of the rest of the variables. The BVC is a reliable tool that seems to capture the risk for violence intrinsic to other factors, such as the involuntariness of admission. Its role in the design of non-restraint policies is discussed. BVC is a useful and freely available instrument. Its Spanish version opens up its use in the fourth most widely spoken language.

Manufacturing enterprise digital platform capabilities: structural dimensions and scale development

ABSTRACT Although the importance of digital platform capabilities in manufacturing enterprises is widely acknowledged in the literature, limited attention has been given to their measurement. This study selected 10 companies as samples from the 50 companies identified as typical cases of digital transformation in the manufacturing industry in 2023 by the Ministry of Industry and Information Technology of China, involving discrete, process-based and project-based manufacturing companies. Using a mixed-methods approach, we explore the structural dimensions and measurement scale of digital platform capabilities in these manufacturing firms. The findings reveal that digital platform capabilities are a multidimensional construct, consisting of four key dimensions: technical architecture capabilities, data integration capabilities, business expansion capabilities, and intelligent application capabilities. A measurement scale for digital platform capabilities in manufacturing enterprises, comprising 15 items, was developed. Additionally, the results of factor analysis indicate that the scale demonstrates excellent reliability and validity, making it an effective tool for assessing the digital platform capabilities of manufacturing enterprises. The research outcomes contribute to advancing the theoretical framework in the field of digital platform capabilities and provide valuable insights for implementing targeted strategies to enhance the effectiveness of digital transformation in manufacturing enterprises.

Business analytics as a driver of organizational performance: Evidence from the pharmaceutical industry

This study investigates the role of business analytics in enhancing organizational performance within the pharmaceutical industry. Business analytics, encompassing data collection, analytical tools, technology, human resources, strategic alignment, performance measurement, and compliance, is crucial for driving informed decision-making and strategic planning. A quantitative approach was employed, surveying 162 professionals across various managerial levels in pharmaceutical companies. A structured questionnaire assessed the impact of business analytics on organizational performance, focusing on financial, operational, market, employee, and sustainability metrics. Data were analyzed using SPSS software, with reliability, descriptive, and regression analyses conducted to evaluate the relationship between business analytics and performance outcomes. The results revealed a high Cronbach's Alpha value (0.980), indicating excellent reliability. Descriptive statistics showed moderate agreement with business analytics practices, while regression analysis demonstrated a strong positive correlation (R = 0.762) between business analytics and organizational performance, explaining 58% of the variance. The findings underscore the critical role of business analytics in improving financial performance, operational efficiency, market share, employee productivity, and sustainability within the pharmaceutical industry. Organizations are encouraged to invest in advanced analytics tools and technologies to drive strategic alignment and enhance overall performance.

Development and Psychometric Testing of the Nurses’ Professional Dignity Scale

Background/Objectives: Human dignity is an inalienable value central to human rights and ethics. Professional dignity is pivotal to fostering self-esteem, job satisfaction, and high-quality care in nursing. Despite its importance, no validated tool currently exists to measure nurses’ professional dignity in English-speaking contexts. This study aimed to develop and psychometrically test the Nurses’ Professional Dignity Scale (NPDS). Methods: The tool’s development was guided by a theoretical model from a meta-synthesis. A consensus meeting with five nurse researchers identified three core dimensions for the NPDS: Respect, Professional Value, and Appreciation. Nineteen items were initially generated and refined through face and content validity assessments (all item-level content validity indices [I-CVIs] ≥ 0.80; scale-level content validity index/Ave [S-CVI/Ave] = 0.92). Psychometric testing was conducted with 227 nurses across clinical settings in the United States using confirmatory factor analysis (CFA) to validate a three-factor model. Results: The CFA confirmed the three-factor model with acceptable fit indices (CFI = 0.938, TLI = 0.923, RMSEA = 0.069), resulting in the retention of 15 items. The scale demonstrated excellent reliability, with composite reliability coefficients of 0.92 for Respect, 0.82 for Professional Value, 0.93 for Appreciation, and 0.91 for the overall scale. Conclusions: The NPDS is a valid and reliable measure of nurses’ professional dignity, aligning with theoretical frameworks. It captures both status-dignity and condition-dignity aspects, encompassing respect, professional competence, and societal appreciation, offering a multidimensional structure for assessing individual domains and overall scores. The NPDS contributes to advancing nursing research and practice by addressing workplace dignity, enhancing job satisfaction, and fostering supportive organizational environments that recognize nurses’ professional worth. Future studies are recommended to validate the scale in diverse populations and explore its stability over time through longitudinal research. This study highlights the importance of preserving nurses’ dignity in improving professional identity, workplace environments, and patient care outcomes.

Development and Validation of a Multidimensional Intravaginal Ring Acceptability Scale Among US Women and Their Male Partners.

Intravaginal rings (IVRs) are marketed or in development for contraception and other indications. We sought to develop and validate the IVR Acceptability Scale (IVR-AS) as a multidimensional, standardized tool for assessing IVR acceptability among end-users in the United States. Scale items reflect specific aspects of IVR acceptability for women and male partners. Response options range from 1 (not-at-all acceptable) to 5 (highly acceptable). We evaluated the IVR-AS within a randomized, crossover clinical trial of three nonmedicated silicone IVRs of differing external diameters (46, 56, 66 mm) in heterosexual couples who used each for ~30 days, then completed a self-administered survey. We conducted exploratory factor analysis and multivariable regression to assess convergent validity. Follow-up in-depth interviews with all participants explored scale salience. Twenty-four couples participated (mean age 27). The final 19-item women's scale (Cronbach's alpha = 0.93) included six subdimensions: ease of use; experience and sensation; effect on sexual desire/engagement, and effect on vaginal sex (all alphas > 0.78). The final eight-item men's scale comprised two subdimensions: effect on sexual desire/engagement and effect on vaginal sex (all alphas > 0.89). For both sexes, higher overall/subdimension scores were consistently associated with favorable assessments of the ring, for example, ease of insertion/removal; adherence (most p < 0.001). The 46/56 mm IVRs had higher overall and subdimension scores than the 66 mm IVR (most p < 0.001). Qualitative reports reinforced the salience of scale subdimensions and item content. The IVR-AS captures multiple dimensions of IVR acceptability among women and their partners. The scales demonstrated excellent reliability and convergent validity. Further validation is warranted in future studies. Clinical Trials.gov: NCT05128136. https://clinicaltrials.gov/study/NCT05128136?intr=non-medicated%20silicone%20ring&rank=2.

Tear Location of Superficial Medial Collateral Ligament Tears: Validation of a Magnetic Resonance Imaging-Based Classification System.

The superficial medial collateral ligament (sMCL) is commonly injured, with treatment varying based on associated injuries, tear grade, and location. However, the prevalence of different tear locations and the predictors of tear types have not been studied. To evaluate the interrater and intrarater reliability for a magnetic resonance imaging (MRI)-based sMCL classification system and assess the incidence of different tear types with its predictors. Cohort study; Level of evidence, 3. A retrospective search in a single institution's MRI database identified patients with acute, complete sMCL tears (≤30 days between injury and MRI) between January 2018 and December 2022. Exclusion criteria included previous ligamentous knee trauma/surgery, >30 days between injury and MRI, and partial sMCL tears. MRI scans were assessed by 3 independent raters using a predefined sMCL tear location system: type I (proximal 25%), type Ib (proximal femoral bony avulsion), type II (midsubstance, 25%-75%), type III (distal 25%), type IIIb (distal tibial bony avulsion), and type IIIs (Stener-like lesion). The intraclass correlation coefficient (ICC) was used to assess interobserver and intraobserver reliability for continuous data, whereas Fleiss and Cohen kappas were used for categorical data. Univariate and multivariate logistic regression assessed predictors of tear location. The study included 239 patients (49% female; mean age, 38 ± 14 years; range, 13-75 years). The MRI-based sMCL classification system showed excellent interobserver reliability (0.960; 95% CI, 0.951-0.969) and excellent intraobserver reliability (evaluator 1: 0.969 (95% CI, 0.960-0.976); evaluator 2: 0.952 (95% CI, 0.915-0.973)). Type I sMCL tears were most common (65.4%), followed by type III (14.6%), type II (14.5%), type Ib (3.4%), and type IIIs (1.7%). Binary logistic regression identified medial meniscal tears (odds ratio [OR] 7.987; P = .034) and younger age (OR 0.916; P = .0001) as predictors for distal sMCL tears and older age as a predictor for proximal tears (OR 1.048; P = .001). This study validates an MRI-based sMCL classification system for locating high-grade sMCL tears with excellent reliability. Proximal tears were the most common (69%) and were significantly more prevalent with increasing age, whereas distal tears were more commonly seen with younger age and midbody medial meniscal tears. These findings may guide individualized treatment strategies and refine diagnostic protocols for patients with acute sMCL tears.

Development and psychometric properties of the Academic Mindfulness Scale for university students

Academic environments require specialized measurement instruments for mindfulness assessment. This study developed and validated the Academic Mindfulness Scale (AMS) to address the gap in context-specific mindfulness measures for university students in Saudi Arabia. Using a quantitative approach with 553 undergraduates (311 males, 242 females, aged 18-26), we developed the AMS through literature review, expert consultation, and pilot testing. Factor analyses revealed a four-factor structure explaining 57.098% of variance: Academic attention in the classroom (33.072%), Academic acceptance without judgment (9.994%), Performing academic tasks with full awareness (7.639%), and Academic presence in the present moment (6.394%). Confirmatory factor analysis supported this structure (χ² = 689.248, CFI = .871, RMSEA = .076). The 20-item scale demonstrated excellent reliability (α = .889, ω = .911) with satisfactory subscale reliability (α = .775–.818) and item-total correlations ranging from .42 to .64 (p &lt; .01). The AMS provides a valid, reliable tool for assessing academic mindfulness among university students, offering educators and researchers a targeted instrument to evaluate mindfulness interventions, identify students needing support, and enhance academic engagement. This scale moves beyond adaptations of general mindfulness measures to provide a nuanced understanding of mindfulness specifically in educational contexts.