Excellent Reliability Research Articles

Prediction of late proximal endoleak risk after EVAR by pre-operative estimation of endograft/aortic neck apposition surface

The aim of this study was to evaluate a new measurement tool for the pre-operative computed tomography (CT) scan to estimate the endograft apposition surface on the proximal aortic neck of the aneurysm that would predict the risk of late type IA endoleak (EL1A). From databases of four high-volume centres, between 2004 and 2020 all patients who underwent EVAR with the possibility of analysing pre- and post-EVAR scans and who presented late (>2 years) EL1A in follow-up were included retrospectively (EL1A group). A control group of randomly selected EL1A-free patients were included (control group) and follow-up beyond four years. The measurement tool (Endosize®, Therenva) was used to model a virtual cylinder constrained by the centreline whose diameter was determined from the diameter of the implanted endograft. The apposition surface was calculated by determining the areas of the virtual cylinder mesh outside the mesh of the neighbouring portion of the segmented aorta by an intersection calculation of surface normals. This apposition surface and the usual anatomical data of the proximal neck were compared between the groups with univariate and multivariate analyses. Intra- and inter-observer variability in the measurement of apposition surface was analyzed using the intraclass correlation coefficient (ICC) and the method of Bland and Altman. Sixty-six comparable patients were included, 33 in the EL1A group and 33 in the control group. The mean time to EL1A onset was 50.2 ± 24.6 months in the EL1A group and the mean follow-up time was 79.8 ± 26.8 months in the control group. In univariate analysis, only the endograft apposition surface ratio on the proximal neck was significantly lower in the EL1A group compared with the control group (50.3% vs. 75.5%; p <0.0001). There was no significant difference in classic anatomical neck characteristics. There was no difference in proximal endograft oversizing or in the length from the lowest renal artery to the beginning of the covered portion of the endograft. In multivariate analysis, only the apposition surface ratio was independently correlated with the presence of EL1A (p <0.0001). The estimation of the intra- and inter-observer variability, indicates excellent reliability (ICC = 0.992; ICC = 0.956). The method estimating the pre-operative endograft apposition surface on the proximal aortic neck appears to be a reliable measuring in predicting the risk of occurrence of late EL1A after EVAR.

Normative Scores and Test-Retest Reliability of Neck Strength, Endurance, and Proprioception Tests in Children and Adolescents

OBJECTIVE: To determine normative scores, test-retest reliability, and minimal detectable change for the neck flexor endurance test (NFET), craniocervical flexion test (CCFT), and joint position error test (JPET) in children. DESIGN: Cross-sectional. METHODS: Two hundred typically developing children (10-15 years) were recruited. Participants were screened for cervical spine instability using the alar and transverse ligament tests prior to administering the NFET, CCFT, and JPET. Testing was performed twice on the same day, 6 hours apart. RESULTS: For the younger age group, average NFET scores were as follows: females = 9.1 seconds, males = 10.1 seconds. Mean CCFT scores decreased with an increase in pressure (22 millimeters of mercury [mmHg]: females = 6.1 seconds [1], males = 6.8 seconds [1]; 30 mmHg: females = 4.07 seconds [1.1], males = 4.1 seconds [0.9]). For the CCFT, reliability reduced as pressure increased. The JPET had moderate reliability (ICC2, k = 0.4-0.63) with the highest error in right rotation (females = 14.1 cm [5], males = 13.4 cm [4.7]). The NFET had excellent reliability (ICC2, k = 0.96 [0.94-0.97], P&lt;.001). CONCLUSION: The normative scores presented serve as a reference standard for future studies and for systematic screening and head and neck injury prevention. JOSPT Open 2024;2(4):348-353. Epub 20 May 2024. doi:10.2519/josptopen.2024.1135

Evaluation of the clinical application value of artificial intelligence in diagnosing head and neck aneurysms

ObjectiveTo evaluate the performance of a semi-automated artificial intelligence (AI) software program (CerebralDoc® system) in aneurysm detection and morphological measurement.MethodsIn this study, 354 cases of computed tomographic angiography (CTA) were retrospectively collected in our hospital. Among them, 280 cases were diagnosed with aneurysms by either digital subtraction angiography (DSA) and CTA (DSA group, n = 102), or CTA-only (non-DSA group, n = 178). The presence or absence of aneurysms, as well as their location and related morphological features determined by AI were evaluated using DSA and radiologist findings. Besides, post-processing image quality from AI and radiologists were also rated and compared.ResultsIn the DSA group, AI achieved a sensitivity of 88.24% and an accuracy of 81.97%, whereas radiologists achieved a sensitivity of 95.10% and an accuracy of 84.43%, using DSA results as the gold standard. The AI in the non-DSA group achieved 81.46% sensitivity and 76.29% accuracy, as per the radiologists’ findings. The comparison of position consistency results showed better performance under loose criteria than strict criteria. In terms of morphological characteristics, both the DSA and the non-DSA groups agreed well with the diagnostic results for neck width and maximum diameter, demonstrating excellent ICC reliability exceeding 0.80. The AI-generated images exhibited superior quality compared to the standard software for post-processing, while also demonstrating a significantly reduced processing time.ConclusionsThe AI-based aneurysm detection rate demonstrates a commendable performance, while the extracted morphological parameters exhibit a remarkable consistency with those assessed by radiologists, thereby showcasing significant potential for clinical application.

Reliability and construct validity of three self-report questionnaires assessing dual-task difficulties in people with multiple sclerosis: an international study

ObjectiveTo evaluate the reliability and validity of the Dual-Tasking Questionnaire (DTQ), Dual-Task Screening-List (DTSL), and Dual-Task-Impact on Daily-life Activities Questionnaire (DIDA-Q). DesignMulti-center, cross-sectional study SettingPwMS were recruited from seven MS centers across six countries (Belgium, Chile, Italy, Israel, Spain, and Turkey). ParticipantsA total of 356 pwMS (mean age 47.5±11.5, EDSS 3.79±1.83) were enrolled. InterventionsNot applicable Main Outcome MeasuresThe reliability (internal consistency, test-retest, and measurement error) and construct validity (structural and convergent) were assessed. ResultsThe DTQ, DTSL, and DIDA-Q demonstrated excellent test-retest reliability [Intraclass correlation coefficients (95% CI): 0.84 (0.80-0.87) to 0.90 (0.87-0.92)] and internal consistency (Cronbach's α: 0.86 to 0.96). As hypothesized, the three questionnaires showed a strong correlation with each other, moderate-to-strong correlations with other self-report questionnaires (perceived walking difficulties, fatigue, and fear of falling), and low-to-moderate correlations with cognitive information processing speed, manual dexterity, and dual-task walking performance (walking with word list generation task), showing convergent validity. The DIDA-Q exhibited systematically superior properties. These results were also verified in subsets from six different countries. In the structural validity analysis, all questionnaires displayed two main factors, allocated as ‘motor-driven’ and ‘cognitive-driven’ subscales. ConclusionsThe DTQ, DTSL, and DIDA-Q have good-to-excellent measurement properties, with the highest properties observed in DIDA-Q. The use of these self-reported questionnaires can be used in research and clinical practice to assess the impact of dual-task difficulties on the daily life of ambulatory pwMS.

Multifunctional 1–octadecanol/expanded graphite/Fe3O4 composite phase change materials with effective solar–to–thermal and magnetic–to–thermal conversion and storage

Composite phase change materials (CPCMs) with multifunctional thermal conversion and storage abilities have demonstrated exceptional properties for diverse energy storage applications recently; however, these composite materials often encounter limitations of low heat storage capacity and high cost. In this study, novel 1–octadecanol (OD)/expanded graphite (EG)/Fe3O4 CPCMs were facilely prepared and characterized for multifunctional thermal conversion and storage properties. The composites showed excellent thermal energy storage capacities, reaching 185.5 J/g at 80 % OD accompanied by high crystallization fractions of above 95 %. In addition, they exhibited great thermal conductivities, excellent leakage resistance, thermal stability, and reliability. Under simulated solar irradiation, the prepared OD/EG/Fe3O4 CPCMs exhibited a rapid temperature increase from 34 to 70 °C, achieving solar–to–thermal conversion efficiency of 80.2–90.5 %. This behavior can be attributed to its ability to capture and convert photons into thermal energy, facilitated by the synergistic effects of the conjugated double–bond system of EG and localized surface plasmon resonance of Fe3O4 nanoparticles. Furthermore, the prepared OD/EG/Fe3O4 CPCMs exhibited superparamagnetic properties, accelerating their temperatures from 32 °C to 88 °C within 11–23 s when subjected to an alternating magnetic field. This demonstrates magnetic–to–thermal conversion and storage ability. These findings highlight the potential of OD/EG/Fe3O4 CPCMs as promising and cost–effective materials for various practical thermal storage applications.

Test-retest and inter-rater reliability and construct validity of the 2-minute step test in individuals with Parkinson's disease

ObjectiveTo evaluate the test-retest and inter-rater reliability and construct validity of the 2-minute step test (2MST) in individuals with Parkinson's disease (PD). MethodsTwo previously trained examiners applied the 2MST in two moments. Clinical measurements of PD were obtained using the following instruments: Berg Balance Scale (BBS), Unified Parkinson's Disease Rating Scale (UPDRS), modified Hoehn and Yahr Scale (H&Y), gait speed and cadence, 5-time Sit-to-Stand Test (5TSST) and Timed Up and Go (TUG). For reliability, the intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) were calculated. For construct validity, Pearson's and Spearman's correlation coefficient were used. The agreement between the measurement in person and via recorded video was assessed by means of Bland-Altman plots. ResultsThe 2MST showed adequate test-retest reliability (ICC = 0.80, SEM = 10.59, MDC = 29.35) and excellent inter-rater reliability (ICC = 0.93, SEM = 4.49, MDC = 12.46). There was acceptable agreement between assessments made with in person and via video. A correlation magnitude above 0.50 was found between 2MST and gait speed, and a correlation magnitude between 0.30 and 0.50 with BBS, gait cadence, UPDRS and TUG. ConclusionThe 2MST presents adequate test-retest and inter-rater reliability and a valid construct to evaluate the aerobic endurance of individuals with PD.

Adaptation and validation of an inventory for assessing subjective task value beliefs regarding the decision to pursue postgraduate studies

The desire to pursue postgraduate studies is motivated by several interrelated and multifaceted factors ranging from intrinsic to extrinsic. However, little consensus exists in the literature regarding an instrument that assesses an individual’s motivation for pursuing postgraduate education. In this study, we adapted and validated a pre-existing inventory that evaluates the individuals’ motives for pursuing postgraduate studies using the subjective task value beliefs framework. The study, in particular, focused on assessing the factor structure, construct validity, and reliability of the adapted scale. Study participation invitations were sent to a pool of postgraduate students in two higher education institutions, of which 501 students finally responded to the online questionnaire. The exploratory and confirmatory factor analyses were used to analyse the data to address the research objectives. The results revealed a five-factor structure for the adapted scale with excellent construct validity and reliability indicators. The findings of the research add value to the psychometric literature and also provide a useful instrument for use among instructors, researchers, and university administrators in their line of duty.

Validation of the cholinergic urticaria activity score, CholUAS

BackgroundIn cholinergic urticaria (CholU), itchy wheal and flare-type skin reactions are triggered by sweat-inducing activities. The CholU activity score, CholUAS, is used to assess disease activity, but has not yet been validated.The aim of the study was to validate the CholUAS, develop an English version, and provide instructions for scoring. MethodsCognitive debriefing of CholUAS was performed. CholU patients (n =75) used the CholUAS on 7 consecutive days, underwent provocation testing, and completed additional anchor instrument questionnaires including global evaluation tools and established quality of life instruments. A scoring protocol for the calculation of the weekly CholUAS, the CholUAS7, was developed. The CholUAS7 was tested for validity, reliability, and influencing factors. An English version of the CholUAS was developed. ResultsThe final CholUAS contains 3 questions that are used for scoring as well as one global question. The weekly CholUAS, CholUAS7, showed excellent test-retest reliability and good correlations with anchor instruments. Statistical analysis showed no significant influence of age or duration of disease on CholUAS7 results. ConclusionThe validated CholUAS is ready for use in clinical trials and routine clinical practice.

Psychometric evaluation of the wijma delivery expectancy/experience questionnaire for pregnant women in Taiwan

BackgroundFear of childbirth profoundly affects women's ability to cope during pregnancy and influences birth outcomes. In Taiwan, there's a lack of validated tools for assessing childbirth fear. ObjectiveTo evaluate the psychometric properties of the Taiwanese version of the Wijma delivery expectancy/experience questionnaire version A (WDEQ-A) in pregnant women. MethodsWe conducted a cross-sectional study with pregnant women, using the WDEQ-A and a Visual Analogue Scale to assess childbirth fear. We employed the Edinburgh Postpartum Depression Scale, State-Trait Anxiety Inventory, and Mindful Attention Awareness Scale to measure depressive symptoms, anxiety, and mindfulness, respectively. We evaluated internal consistency reliability and construct validity using exploratory factor analysis and Rasch analysis. Pearson correlations measured the association between childbirth fear and psychological variables. The receiver operating characteristic curve was used for determining the sensitivity and specificity indices. ResultsThe WDEQ-A demonstrated excellent reliability (Cronbach's alpha = 0.93) and revealed a three-factor structure, including fear, lack of positive anticipation, and isolation. Rasch analysis supported the dimensionality of each of the three revised factors. The total score significantly correlated with depression (r = 0.56), anxiety (r = 0.19), and mindfulness (r = -0.40) (Ps < 0.001). The optimal cut-off for WDEQ-A was established at 55.5, with a sensitivity of 83 % and a specificity of 65 %. ConclusionsThe Taiwanese version of WDEQ-A proved to be a reliable and valid tool for assessing fear of childbirth in pregnant women, demonstrating excellent psychometric properties. Implication for practiceThese findings can assist midwives in Taiwan in identifying and promptly providing effective strategies for women experiencing a high fear of childbirth.

A Multidisciplinary Assessment of Standard Low Dose Versus Ultra-Low Dose Chest CT Scans For Pectus Excavatum Imaging

AimEvaluation of ultra-low dose chest CT imaging for the assessment of pectus excavatum severity as determined by pediatric radiologists and pediatric surgeons using Haller (HI) and Correction indices (CI). MethodsA single institution, prospective evaluation of patients being evaluated for pectus excavatum were scanned with a standard low-dose chest CT protocol (CARE) followed by a consecutive ultra-low dose CT scan (ULTRA). 3 surgeons and 4 radiologists were instructed to determine HI and CI in each series. The Intraclass Correlation Coefficient (ICC) was used to calculate the agreement level between CARE and ULTRA. Bland-Altman (BA) and scatter plots were also performed to determine bias of each approach. Results32 patients had CARE and ULTRA consecutively. The ICC for HI demonstrated good reliability with a value of 0.89 and excellent reliability for CI with a value of 0.91. The reliability for HI was greater in the surgeon group (0.89) compared to the radiologist group (0.88). The reliability for CI was greater in the radiologist group (0.92) compared to the surgeon group (0.90). The Bland Altman plots for the HI and CI demonstrate no consistent bias for CARE or ULTRA approach when evaluating HI and CI. ConclusionUltra-low dose CT scan imaging compared to standard low-dose CT appears to be a reliable alternative for evaluating PE severity as assessed by HI and CI. This work supports the evaluation and potential development of a standardized CT imaging protocol capable of reducing radiation exposure without sacrificing imaging for PE patients. Level of evidence2

Preoperative Planning for Shoulder Arthroplasty is Feasible with Computed Tomography at Lower-Than-Conventional Radiation Doses

Computed tomography (CT) offers a detailed assessment of the shoulder for preoperative shoulder arthroplasty planning; however, this technique exposes the patient to ionizing radiation. The purpose of this study was to prospectively evaluate the practicality of reducing the CT radiation dose compared to conventional dose levels for manual and preoperative planning software measurements for shoulder arthroplasty. A total of 10 shoulder CT examinations were performed for preoperative planning purposes on a dual x-ray source CT scanner. A specialized dose-split scan technique was utilized to reconstruct CT images corresponding to 100%, 70%, and 30% radiation dose relative to our institution's standard of care imaging protocol. Glenoid version, inclination, and humeral head subluxation were measured manually by three authors and by commercially available software platforms. These measurements were analyzed for agreement between the 100%, 70%, and 30% dose levels for each patient. Tolerances of 5° of glenoid version, 5° of glenoid inclination, and 10% humeral head subluxation were used as equivalent for preoperative planning. Automated measurements of 70% dose images were within 5° of version, 5° of inclination, and 10% subluxation in 95.0% of cases. Manual measurements of 70% RD images were within 5° of version for 90.0% of cases, 5° of inclination in 86.7% of cases, and 10% subluxation in 100% of cases. Automated measurements from the 30% dose images were within 5° of version, 5° of inclination, and 10% subluxation for 100% of cases. Manual measurements from the 30% dose images were within 5° of version for 86.7% of cases, 5° of inclination in 76.7% of cases, and 10% subluxation in 100% of cases. The mean absolute difference in software measurement of glenoid version (p = 0.96), glenoid inclination (p = 0.64), or humeral head subluxation (p = 0.09) or in aggregated manual mean absolute difference of version (p = 0.22), inclination (p = 0.31), or humeral head subluxation (p = 0.56) was not significant. Good to excellent reliability was determined by interclass correlation coefficients among the manual observers and automatic software platforms for measurements at all doses (P<0.001) CONCLUSIONS: The results indicate that both preoperative planning software platforms and human observers produced similar measurements of glenoid version, inclination, and humeral head subluxation from reduced-dose images compared to standard of care doses. By implementing reduced dose techniques in preoperative shoulder CT, the potential risks associated with radiation exposure could be reduced for patients undergoing shoulder arthroplasty.

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

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

Upper-Extremity physical performance tests in older adults: Reference values, reliability and measurement error

BackgroundPhysical performance tests are reliable tools to assess aspects related to strength, power, and mobility. Unfortunately, few studies were performed with older adults. The main goal of this study was to describe reference values for the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) and Upper Quarter Y Balance Test (UQYBT) in older adults and to determine differences based on sex. Reliability and measurement error were also established. MethodsTest-retest design with a sample of 103 older adults. The CKCUEST (number of touches, normalized score, and power) and the UQYBT (reach in the medial, superolateral, and inferolateral direction, total excursion, and the composite score) were performed. The scores on both tests were adjusted using an analysis of covariance model. Reliability was determined using Intraclass Correlation Coefficient and error measurement through Standard Error of Measurement, Smallest Detectable Change, and Bland and Altman Plots. ResultsNormative values were provided. Males presented higher scores than females only in the medial reach of the UQYBT in the dominant limb (p < 0.001). Good reliability was found for the CKCUEST, while good to excellent reliability was found for the UQYBT; with the exception of the superolateral reach in the dominant limb. Absence of systematic error was presented. ConclusionNormative data were provided and differences according to sex were found only in the UQYBT. Results demonstrated good to excellent reliability, except the superolateral reach in the dominant limb. Clinically acceptable absolute reliability values were found.

Development and Validation of a Climate Change Version of the Man-Made Disaster-Related Distress Scale (CC-MMDS)

IntroductionClimate change, considered as a pressing man-made disaster, poses a fundamental threat to global health, with significant psychological consequences. However, measurement instruments assessing these consequences of climate change remain limited. This study aimed to address this gap by developing and validating an adapted version of the Man-Made Disaster-Related Distress Scale (MMDS), specifically designed for the assessment of indirect climate change-related psychological consequences. Materials and MethodsThe items of the MMDS were adapted to climate change. The resulting “Climate Change – Man-Made Disaster-Related Distress Scale” (CC-MMDS), comprising 16 items, was validated in an online-based survey in Germany. Initially, 1070 participants were engaged in the survey. ResultsThe data of n = 715 participants was used for analysis. Exploratory and confirmatory factor analyses revealed a two-factor structure, encompassing “psychological distress” and “change of existing belief systems”, with acceptable to good model fit. The CC-MMDS demonstrated excellent reliability and good validity, with measurement invariance across gender, age, and educational level. DiscussionThis study validated the CC-MMDS, confirming a two-factor structure. The scale demonstrated strong measurement properties, making it a promising standardized instrument for assessing climate change-related distress. ConclusionWith its strong psychometric properties and efficient administration, the CC-MMDS offers valuable insights for research and can aid mental health providers in identifying and supporting individuals impacted by climate change.

Suggestion for customized PROMIS measurements of sleep disturbance and fatigue for patients with ovarian cancer.

239 Background: Ovarian cancer (OC) patients experience a high incidence of sleep disturbance and fatigue, which impacts their health-related quality of life (HRQoL). PROMIS short forms are important tools to assess sleep disturbance and fatigue in OC patients and identify the need for additional intervention. However, these frequently used short forms (SFs) may not capture the diversity and range of issues OC patients experience. Methods: In this mixed-methods study, data were collected from stage III/IV OC patients diagnosed within 3 years with diverse treatment trajectories, race/ethnicity, and locations, including semi-structured interviews with 20 patients and surveys of 200 patients. In addition to their medical history, participants were asked to complete PROMIS Sleep Disturbance SF 8b, and Fatigue SF 8a to evaluate their current symptom burden. Participants were also asked to retrospectively assess their fatigue and sleep during each type of treatment they received with a set of custom sleep and fatigue items from the PROMIS bank. Qualitative data were used to determine the best custom survey items in the PROMIS bank to match the issues raised by patients. Construct validity was evaluated with code prevalence from interview data. Cronbach’s Alpha coefficient was used to assess the scale reliability based on survey testing. Results: Sleep disturbance SF 8b does not capture 3 prominent issues OC patients reported as disrupting their sleep: pain, anxiety, and rumination at bedtime. Related PROMIS items were tested in the survey: trouble getting in a comfortable sleeping position (Sleep 71), stress disturbing sleep (Sleep 78), and trouble stopping thoughts during bedtime (Sleep 69). Significant fatigue issues included forcing oneself to get up and do things (FATIMP47), being frustrated by being too tired to do things they want to do (AN15), feeling like fatigue made them slowed down in their thinking (FATIMP2), feeling less effective at work (FATIMP37), and having to limit social activities because of fatigue (FATIMP18 ) . For custom items, Cronbach’s α ranged from 0.898 to 0.946 for sleep and from 0.939 to 0.985 for fatigue when asked for experience during each treatment type, suggesting a possible increase in robustness of the measures over the SFs. Conclusions: Interviews with OC patients identified significant issues not captured in common PROMIS sleep and fatigue short forms. Testing use of custom PROMIS items better matching the OC patients’ profile with a survey of 200 OC patients showed excellent reliability (α ≥ 0.9). Customizing the menu of PROMIS measures used to assess symptom burden among OC patients may improve identification of sleep disturbance and fatigue issues for this patient population. Further research could help identify the best fitting set of questions for a clinical setting when screening advanced OC patients, as well as other patient groups with long term sleep and fatigue issues.

Validity And Reliability Of The Central Kurdish Version Of The Tinnitus Handicap Questionnaire (THQ-CK)

Background — The goal of this study was to evaluate the reliability and validity of the Central Kurdish version of the Tinnitus Handicap Questionnaire (THQ-CK). Initially, the THQ was translated into the central Kurdish language, resulting in the THQ-CK. Subsequently, a supplementary assessment was conducted to ascertain the reliability and validity of the THQ-CK. Methods — The original version of the THQ was translated into the Kurdish language and then offered to 275 tinnitus patients. The procedures were performed using published guidelines for cross-cultural adaptation of health-related quality of life measures. The Tinnitus Handicap Questionnaire (THQ), the Tinnitus Primary Function Questionnaire (TPFQ), and the Visual Analogue Scale (VAS) for tinnitus loudness and annoyance were offered to participants suffering from tinnitus. In addition, a pure-tone audiogram was obtained. Results — Our study encompassed a total of 275 patients (132 female, 143 male). Their mean age was 47.43±14.32 years. Of them, 43.6% previously worked in a noisy environment. The internal consistency of the THQ total score and its factors (Cronbach’s alpha of total scores: 0.833; factors: 0.949, 0.959, 0.960) suggested excellent reliability. The test-retest correlation coefficient demonstrated excellent reliability (0.9) for the total scores, and factors 1 and 2, but moderate reliability (0.66) for factor 3. The THQ-CK demonstrated good construct validity, as indicated by the strong correlation (r=0.757) between the THQ-CK and TPFQ scores. Conclusion — The evaluation of the validity and reliability of the THQ-CK suggests that it is a reliable instrument for assessing the impact of tinnitus on individuals in the central Kurdish-speaking population. The study contributes valuable information to the field of tinnitus research and opens up avenues for future cross-cultural studies.

Muscle Fat and Volume Differences in People With Hip-Related Pain Compared With Controls: A Machine Learning Approach.

Hip-related pain (HRP) affects young to middle-aged active adults and impacts physical activity, finances and quality of life. HRP includes conditions like femoroacetabular impingement syndrome and labral tears. Lateral hip muscle dysfunction and atrophy in HRP are more pronounced in advanced hip pathology, with limited evidence in younger populations. While MRI use for assessing hip muscle morphology is increasing, with automated deep-learning techniques showing promise, studies assessing their accuracy are limited. Therefore, we aimed to compare hip intramuscular fat infiltrate (MFI) and muscle volume, in individuals with and without HRP as well as assess the reliability and accuracy of automated machine-learning segmentations compared with human-generated segmentation. This cross-sectional study included sub-elite/amateur football players (Australian football and soccer) with a greater than 6-month history of HRP [n = 180, average age 28.32, (standard deviation 5.88) years, 19% female] and a control group of sub-elite/amateur football players without pain [n = 48, 28.89 (6.22) years, 29% female]. Muscle volume and MFI of gluteus maximus, medius, minimis and tensor fascia latae were assessed using MRI. Associations between muscle volume and group were explored using linear regression models, controlling for body mass index, age, sport and sex. A convolutional neural network (CNN) machine-learning approach was compared with human-performed muscle segmentations in a subset of participants (n = 52) using intraclass correlation coefficients and Sorensen-Dice index. When considering adjusted estimates of muscle volume, there were significant differences observed between groups for gluteus medius (adjusted mean difference 23 858 mm3 [95% confidence interval 7563, 40 137]; p = 0.004) and tensor fascia latae (6660 mm3 [2440, 13 075]; p = 0.042). No differences were observed between groups for gluteus maximus (18 265 mm3 [-21 209, 50 782]; p = 0.419) or minimus (3893 mm3 [-2209, 9996]; p = 0.21). The CNN was trained for 30 000 iterations and assessed its accuracy and reliability on an independent testing dataset, achieving high segmentation accuracy (mean Sorenson-Dice index >0.900) and excellent muscle volume and MFI reliability (ICC2,1 > 0.900). The CNN outperformed manual raters, who had slightly lower interrater accuracy (Sorensen-Dice index >0.800) and reliability (ICC2,1 > 0.800). The increased muscle volumes in the symptomatic group compared with controls could be associated with increased myofibrillar size, sarcoplasmic hypertrophy or both. These changes may facilitate greater muscular efficiency for a given load, enabling the athlete to maintain their normal level of function. In addition, the CNNs for muscle segmentation was more efficient and demonstrated excellent reliability in comparison to manual segmentations.

Evaluation of the Effect of Topical Prostaglandin Analog Treatment on Orbital Structures in Open-Angle Glaucoma with Computed Tomography

Background/Objectives: This study aims to evaluate the computed tomography (CT) scans of glaucoma patients using prostaglandin analogs (PGA) in one eye, investigate findings associated with prostaglandin-associated periorbitopathy (PAP), and compare these findings with those of the contralateral eyes. Methods: Patients with open-angle glaucoma who had CT images of the orbital region taken for another reason at least one month after starting PGA treatment in one eye were included in the study. Enophthalmos measurements from thin-slice CT images, along with 3D volume measurements of orbital fat tissue, periorbital muscles, and the optic nerve, were performed. Ophthalmological examination findings and treatment information were collected. The values were compared with those of the contralateral eyes of the same patients not using PGA. Intraclass correlation coefficients (ICCs) were computed to evaluate measurement repeatability. Results: Forty patients were included in the study. Among them, 29 (72.5%) used latanoprost, 9 (22.5%) used bimatoprost, and 2 (5%) used travoprost. The mean enophthalmos values on the treated side (15.5 ± 2.0 mm) were lower than on the untreated side (16.1 ± 1.4 mm), but this difference was not statistically significant (p = 0.07). In 29 patients (72.5%), enophthalmos measurements were smaller on the treated side, with 7 patients (17.5%) showing a difference of 2 mm or more. No significant correlation was found between the duration of PGA use and enophthalmos measurements (p = 0.768 r = −0.048). Additionally, no significant differences were found in orbital fat volume, total extraocular muscle volume, and optic nerve volume (p &gt; 0.05). ICC values demonstrated excellent reliability (ICC &gt; 0.75) for all measurements. Conclusions: We did not find significant differences in enophthalmos measurements, orbital fat volume, total muscle volume, and optic nerve volume between the PGA-treated and untreated eyes.

High‐abundance and low‐cost anodes for sodium‐ion batteries

AbstractNowadays, sodium‐ion batteries are considered the most promising large‐scale energy storage systems (EESs) due to the low cost and wide distribution of sodium sources as well as the similar working principle to lithium‐ion batteries (LIBs). Therefore, screening suitable materials with high abundance, low cost, and excellent reliability and modified with different strategies based on them is the key point for the development of sodium‐ion batteries (SIBs). In addition, the ideal anodes with high abundance, and low cost elements also greatly influence the cost of SIB systems, determining the large‐scale application. Herein, recent advances in carbon, iron, manganese, and phosphorus‐based anodes of various types, such as hard carbon, iron oxides, manganese oxides, and red phosphorus, are highlighted. The various sodium storage mechanisms and structure‐function properties for these four types of materials are summarized and analyzed in detail. Considering the commercial profits that the EESs can bring and their suitability for mass electrode manufacturing, the participation of high‐abundance and low‐cost elements such as Fe, Mn, C, and P is convincing and encouraging.

Structural design and experimental verification of a thin-walled plastic chairs based on the finite element method

This study focuses on the design and preparation of a thin-walled plastic chair, and its mechanical properties were investigated by high load, cyclic load and drop impact. The finite element method (FEM) was employed to accurately evaluate the chair’s safety under these forces. Additionally, the effects of important structural parameters on the loading process in different states were investigated. Furthermore, a solid plastic chair prototype was created for experimental analysis. The findings revealed that increasing the thickness of the key structural parameters enhanced the safety properties of the chair under various load conditions. Optimal results were obtained when both dimensions were set to 5 mm. The deformation errors in FEM, experimental strength analysis, fatigue analysis, and drop impact analysis were measured at 3.7%, 3.6%, and 11.7%, respectively. Similarly, the stress errors were determined to be 5.9%, 5.2%, and 6.5%. These results suggest that the structural design of the chair demonstrates excellent reliability. Studying the crucial structural parameters of a plastic chair can provide valuable insights for the scientific design and safety evaluation of thin-walled furniture.