Previous Validation Studies Research Articles

Validation of the Khorana score for predicting venous thromboembolism in 40 218 patients with cancer initiating chemotherapy

AbstractThe Khorana score is recommended for guiding primary venous thromboembolism (VTE) prophylaxis in cancer patients, but its clinical utility overall and across cancer types remains debatable. Also, some previous validation studies have ignored the competing risk of death, hereby potentially overestimating VTE risk. We identified ambulatory cancer patients initiating chemotherapy without other indications for anticoagulation using Danish health registries and estimated 6-month cumulative incidence of VTE stratified by Khorana levels. Analyses were conducted with and without considering death as a competing risk using the Kaplan-Meier method vs the cumulative incidence function. Analyses were performed overall and stratified by cancer types. Of 40 218 patients, 35.4% were categorized by Khorana as low risk (score 0), 53.6% as intermediate risk (score 1 to 2), and 10.9% as high risk (score ≥3). Considering competing risk of death, the corresponding 6-month risks of VTE were 1.5% (95% confidence interval [CI], 1.3-1.7), 2.8% (95% CI, 2.6-3.1), and 4.1% (95% CI, 3.5-4.7), respectively. Among patients recommended anticoagulation by guidelines (Khorana score ≥2), the 6-month risk was 3.6% (95% CI, 3.3-3.9). Kaplan-Meier analysis overestimated incidence up to 23% compared with competing risk analyses. Using the guideline-recommended threshold of ≥2, the Khorana score did not risk-stratify patients with hepatobiliary or pancreatic cancer, lung cancer, and gynecologic cancer. In conclusion, the Khorana score was able to stratify ambulatory cancer patients according to the risk of VTE, but not for all cancer types. Absolute risks varied by methodology but were lower than in key randomized trials. Thus, although certain limitations with outcome identification using administrative registries apply, the absolute benefit of implementing routine primary thromboprophylaxis in an unselected cancer population may be smaller than seen in randomized trials.

Effects of aerosol particle size on the measurement of airborne PM2.5 with a low-cost particulate matter sensor (LCPMS) in a laboratory chamber.

Previous validation studies found a good linear correlation between the low-cost particulate matter sensors (LCPMS) and other research grade particulate matter (PM) monitors. This study aimed to determine if different particle size bins of PM would affect the linear relationship and agreement between the Dylos DC1700 (LCPMS) particle count measurements (converted to PM2.5 mass concentrations) and the Grimm 11R (research grade instrument) mass concentration measurements. Three size groups of PM2.5 (mass median aerodynamic diameters (MMAD): < 1µm, 1-2µm, and > 2µm) were generated inside a laboratory chamber, controlled for temperature and relative humidity, by dispersing sodium chloride crystals through a nebulizer. A linear regression comparing 1-min average PM2.5 particle counts from the Dylos DC1700 (Dylos) to the Grimm 11R (Grimm) mass concentrations was estimated by particle size group. The slope for the linear regression was found to increase as MMAD increased (< 1µm, 0.75 (R2 = 0.95); 1-2µm, 0.90 (R2 = 0.93); and > 2µm, 1.03 (R2 = 0.94). The linear slopes were used to convert Dylos counts to mass concentration, and the agreement between converted Dylos mass and Grimm mass was estimated. The absolute relative error between converted Dylos mass and the Grimm mass was smaller in the < 1µm group (16%) and 1-2µm group (16%) compared to the > 2µm group (32%). Therefore, the bias between converted Dylos mass and Grimm mass varied by size group. Future studies examining particle size bins over a wider range of coarse particles (> 2.5µm) would provide useful information for accurately converting LCPMS counts to mass concentration.

Real-Time Finger Force Estimation Robust to a Perturbation of Electrode Placement for Prosthetic Hand Control.

In the use of real-time myoelectric controlled prostheses, the low accuracy of the user's intention estimation for simultaneous and proportional control (SPC) and the vulnerability to electrode shifts make application to real-world scenarios difficult. To overcome this barrier, we propose a method to estimate muscle unit activation in real time through neurophysiological modeling of the forearm. We also propose a high-performance finger force intention estimation model that is robust to perturbation of electrode placement based on estimated muscle unit activation. We compared the proposed model with previous studies for quantitative validation of finger force intention estimation and electrode shift compensation performance. Compared to other regression-based models in the on/offline test, our model achieved a significantly high intention estimation performance (p < 0.001). In addition, it attained high performance in electrode shift compensation, and at this time, the amount of data required and the number of models utilized were small. In conclusion, the model proposed in this study was verified to be robust to electrode shift and has high finger force intention estimation accuracy.

A Global Evaluation of IMERG Precipitation Occurrence Using SMAP Detected Soil Moisture Change

Abstract A globally consistent ground validation method for remotely sensed precipitation products is crucial for building confidence in these products. This study develops a new methodology to validate the IMERG precipitation products through the use of SMAP soil moisture changes as a proxy for precipitation occurrence. Using a standard 2 × 2 contingency table method, preliminary results provide confidence in SMAP’s ability to be utilized as a validation tool for IMERG as results are comparable to previous validation studies. However, the method allows for an overestimate of false alarm frequency due to light precipitation events that can evaporate before the subsequent SMAP overpass and changes in overpass-to-overpass SMAP soil moisture that are within the range of SMAP uncertainty. To counter these issues, a 3 × 3 contingency table is used to reduce noise and extract more signal from the detection method. Through the use of this novel approach, the validation method produces a global mean POD of 0.64 and global mean FAR of 0.40, the first global-scale ground validation skill scores for the IMERG products. Advancing the method to validate precipitation quantity and the development of a real-time validation for the IMERG Early product are the crucial next developments. Significance Statement We wanted to see if there was a method in which remotely sensed precipitation observations could be validated at a near-global scale for land areas. Scientific literature is filled with studies that validate various precipitation datasets over local-to-regional scales, with very few extending beyond that domain. This study provides a robust first attempt at validating a global precipitation product at a global scale using changes in remotely sensed soil moisture as an independent proxy for precipitation presence/absence. While the method demonstrates that there is skill in using soil moisture as a tool to validate precipitation at the global scale, we find that there are still instances of a systemic bias for arid climate regimes. This method lays the groundwork for future studies to provide a comprehensive global validation in a globally consistent manner.

A satellite-measured view of aerosol component content and optical property in a haze-polluted case over North China Plain

The Directional Polarimetric Camera (DPC) is the first Chinese satellite-borne multi-angle polarimetric sensor onboard the GaoFen-5 (GF-5) satellite, which was launched on May 9th 2018. In this paper, we present the spatiotemporal variability of satellite-measured aerosol components (such as, black carbon, brown carbon, iron oxides contained in mineral dust etc.) over North China Plain (36–41°N, 113–123°E) for a heavily haze-polluted case, to demonstrate the first successful retrievals of aerosol component content and optical property directly from the DPC/GF-5 instrument measurements. We also reveal the relationship between absorbing/scattering component mass ratio and aerosol absorption based on the multi-angle polarimetric satellite measurements, which presents comparable agreement with previous laboratory studies and field studies for an indirect validation of aerosol component retrievals. In addition, the feasibility, stability and uncertainty of the aerosol optical property and component content retrievals from DPC multi-angle polarimetric observations were evaluated and assessed by sensitivity tests. The distributions of DPC/GF-5 aerosol optical depth (AOD) are in line with satellite-observed MODIS (Moderate-resolution Imaging Spectroradiometer) AOD and ground-based CARSNET (China Aerosol Remote Sensing Network) AOD products. Therefore, the multi-angle polarimetric satellite measurements show an encouraging potential for the comprehensive inversion of aerosol optical, microphysical and chemical properties. The results and further applications of this component algorithm in the future are helpful to reduce the uncertainty of climate change assessment by providing the measurements of aerosol component, in particular for black carbon, brown carbon, and iron oxides contained in dust, with large and extensive spatiotemporal scale.

Measuring Fear of Failure

Abstract. Fear of failure (FF) is a multidimensional construct encompassing anticipated negative consequences deriving from potential failures in evaluative achievement contexts, such as education or sports. The Performance Failure Appraisal Inventory (PFAI; Conroy et al., 2002 ) assesses five threat appraisals associated with FF and has been validated in various cultures, languages, and contexts. To date, there is no instrument measuring FF in an academic context in German. Thus, this study examined the psychometric properties of a German version of the PFAI in a sample of N = 326 university students. Confirmatory factor analyses supported a correlated five-factor structure that has already been established in previous validation studies as well as a bifactor structure. All dimensions demonstrated satisfactory internal consistencies and construct validity. Within the scope of this study, the German version of the PFAI was found to be a psychometrically sound measure to assess FF in an academic context amongst university students.

External validation of a prostate biopsy simulator.

Simulation-based training has proven to be a promising option allowing for initial and continuous training while limiting the impact of the learning curve on the patient. The Biopsym simulator was developed as a complete teaching environment for the prostate biopsy procedure. This paper presents the results of an external validation of this simulator, involving urology residents recruited during a regional teaching seminar. Residents from 4 academic urology departments of the French Auvergne Rhône-Alpes region, who did not take part in the previous simulator validation studies, were enrolled. After a short presentation and standardized initiation session, residents carried out a simulated systematic 12-core biopsy procedure and were asked to fill in a questionnaire collecting their expectations and evaluation of the Biopsym simulator. The number of biopsies reaching each targeted sector, the total score provided by the simulator and the duration of the procedure were recorded. Twenty-three residents were recruited. The overall added value (/100) for learning was rated at a median of 100 (interquartile range 83-100), overall realism of the biopsy procedure at 80 (65-89). The median percentage of biopsies reaching the targeted sector was 66.7% (62-75). The median score provided by the simulator was 50% (37-60). For both, the difference between residents with or without prior biopsy experience was not statistically significant. The median duration of the simulated biopsy procedure was 4:58 (minutes: seconds) (3:49-6:00). Resident with prior experience required less time to complete the biopsy procedure 3:53 (3:39-4:56) vs. 5:10 (4:59-7:10), P=0.01. This external validation study confirms a high acceptance of the simulator by the target audience. To our knowledge, the Biopsym simulator is the only prostate biopsy simulator that demonstrated such validity as evaluated by clinicians, outside the center involved in its early development. 3.

ChemSkin Reference Chemical Database for the Development of an In Vitro Skin Irritation Test.

Since the animal test ban on cosmetics in the EU in 2013, alternative in vitro safety tests have been actively researched to replace in vivo animal tests. For the development and evaluation of a new test method, reference chemicals with quality in vivo data are essential to assess the predictive capacity and applicability domain. Here, we compiled a reference chemical database (ChemSkin DB) for the development and evaluation of new in vitro skin irritation tests. The first candidates were selected from 317 chemicals (source data n = 1567) searched from the literature from the last 20 years, including previous validation study reports, ECETOC, and published papers. Chemicals showing inconsistent classification or those that were commercially unavailable, difficult or dangerous to handle, prohibitively expensive, or without quality in vivo or in vitro data were removed, leaving a total of 100 chemicals. Supporting references, in vivo Draize scores, UN GHS/EU CLP classifications and commercial sources were compiled. Test results produced by the approved methods of OECD Test No. 439 were included and compared using the classification table, scatter plot, and Pearson correlation analysis to identify the false predictions and differences between in vitro skin irritation tests. These results may provide an insight into the future development of new in vitro skin irritation tests.

Impact of Inherited Bleeding Disorders on Maternal Bleeding and Other Pregnancy Outcomes: A Population-Based Cohort Study

▪Introduction: Increasing rate of postpartum hemorrhage (PPH) has been observed between 2003 and 2010 in Canada. Given that bleeding disorders contribute to the risk of PPH, it is important to identify the current trend in PPH in the last decade and assess the impact of inherited bleeding disorders on maternal bleeding and other pregnancy outcomes.Methods: This is a retrospective population-based cohort study using the Alberta Pregnancy Birth Cohort. The creation of this cohort using multiple linked administrative databases has been previously described. Number of deliveries per year in Alberta, Canada was determined by Vital Statistics birth registry from 2010 to 2018 and was linked with Discharge Abstract Database (DAD) to identify cases of PPH and other pregnancy outcomes. PPH was defined as a blood loss of ≥500 ml following vaginal delivery or ≥1000 ml following Caesarean section, or as a diagnosis noted by a health care provider. All diagnoses and procedures were identified by International Classification of Diseases (ICD)-10 codes and Canadian Classification of Interventions (CCI) codes, respectively. Previous validation study of diagnostic code for PPH in DAD showed high sensitivity and specificity. Inherited bleeding disorders including von Willebrand disease, hemophilia carriers, platelet function disorder, and hereditary deficiencies of other coagulation factors were identified by presence of at least two ICD codes. All analyses were restricted to hospitalized deliveries with live births. Temporal trend of PPH rate was assessed by Mann-Kendall test. Univariate logistic regression analyses were used to compute odds of pregnancy outcomes among women with inherited bleeding disorders compared with those without at their index pregnancies during the study period.Results: Between 2010 to 2018, 311,657 women had a total of 452,846 pregnancies with live births. The mean age of the study cohort was 29 years. Most (90%) of them reached term pregnancies. The total number of PPH was 47,602 (10.5 per 100 deliveries). The rate of PPH did not have any significant change from 10.3 in 2010 (95% confidence interval [CI] 10.0-10.6) to 10.8 (95% CI 10.6 -11.1) in 2018 (P for trend =0.28) [Figure 1]. Among 311,657 women, 345 (0.1%) had a diagnosis of inherited bleeding disorders [Table 1]. Women with bleeding disorders were more likely to experience PPH (odds ratio [OR] 1.4; 95% CI 1.1-1.9), antepartum hemorrhage (OR 4.3; 95% CI 2.9-6.4) and had a 3-fold increased risk of undergoing hysterectomy (OR 3.1; 95% CI 1.8-5.2). The bleeding cohort had 3.8 (95% CI: 2.4-6.0) times greater risk of being transfused with blood products. We observed a trend towards higher odds of caesarean delivery in women with bleeding disorders compared with those without (OR 1.2, 95% CI 0.9-1.5), albeit not statistically significant. However, there was no significant difference in prolonged labor, obstetric hematoma, low birth weight baby and induced labour.Conclusion: Despite a rise in the rate of PPH between 2003-2010, we observed no significant change in the rate of PPH in Alberta between 2010-2018. Women with inherited bleeding disorders are at an increased risk of bleeding events during pregnancy and childbirth. Further investigation into quality of care among this patient population is ongoing to identify areas for improvement. [Display omitted] DisclosuresWu: BMS-Pfizer: Honoraria, Research Funding; Leo Pharma: Honoraria; Pfizer: Honoraria; Servier: Honoraria; Bayer: Research Funding; Daiichi-Sankyo: Research Funding. Sun: Pfizer: Consultancy; Novo Nordisk: Consultancy; Bayer: Consultancy; Octapharma: Consultancy, Research Funding; Shire: Consultancy.

Validation of the HFA-PEFF and the H2FPEF scores for the diagnosis of heart failure with preserved ejection fraction in Japanese patients:a report from the Japanese multicentre registry

Abstract Background The standard diagnosis of heart failure (HF) with preserved ejection fraction (HFpEF) is based on the following: 1) symptoms of HF, 2) preserved left ventricular (LV) ejection fraction (LVEF, &amp;gt;50%), and 3) presence of LV diastolic dysfunction confirmed by echocardiography or cardiac catheterisation. However, there are limits to the diagnostic accuracy of individual parameters, and what cut-off values should be applied and how they should be combined remain unclear. Diagnostic algorithms for HFpEF such as the HFA-PEFF algorithm and the H2FPEF score have been proposed; however, previous validation studies were conducted in stable chronic HF and did not include an invasive haemodynamic assessment. Thus, the diagnostic accuracy for HFpEF lacked robustness. Moreover, information on their applicability in the Asian population is limited. Purpose The aim of this study was to investigate these scores' diagnostic validity for HFpEF in Japanese patients recently hospitalised due to acute decompensated HF. Methods We examined patients with HFpEF recently hospitalised with acute decompensated HF whose HFA-PEFF and H2FPEF scores could be calculated at discharge from a nationwide HFpEF-specific multicentre registry (HFpEF group) and control patients who underwent echocardiography to investigate the cause of dyspnoea in our hospital (Non-HFpEF group). We calculated the HFA-PEFF and the H2FPEF scores among the studied population. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were computed to compare the diagnostic accuracy of these scores. Results The studied population included 372 consecutive patients (194 HFpEF group and 178 Non-HFpEF group; HFpEF prevalence, 52%). The HFA-PEFF score classified 155 (42%) of all patients into the high likelihood category (5–6 points) and only 19 (5%) into the low likelihood category (0–1 point). A high HFA-PEFF score could diagnose HFpEF with a high specificity of 84% and a positive predictive value (PPV) of 82%, and a low HFA-PEFF score could rule out HFpEF with a high sensitivity of 99% and a negative predictive value (NPV) of 89%. The H2FPEF score classified 86 (23%) of all patients into the high likelihood category (6–9 points) and 84 (23%) into the low likelihood category (0–1 point). HFpEF could be diagnosed with a high H2FPEF score (specificity, 97%; PPV, 94%) or ruled out with a low H2FPEF score (sensitivity, 97%; NPV, 93%). The diagnostic accuracy for the HFA-PEFF and H2FPEF scores was 0.82 (95% confidence interval [CI] 0.78–0.86) and 0.89 (95% CI 0.86–0.93), respectively, by the AUC of the ROC curve (P=0.004) (Figure 1A). In the HFA-PEFF sub-scores, the functional score showed little diagnostic value, while the morphological and biomarker scores showed moderate diagnostic value (Figure 1B). Conclusions The H2FPEF score may be more useful than the HFA-PEFF score in diagnosing HFpEF in Japanese patients. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS KAKENHI) Figure 1

Valuation of Lost Productivity in Caregivers: A Validation Study.

ObjectiveThis study aimed to: (a) adapt the previously validated Valuation of Lost Productivity (VOLP) questionnaire for people with health problems, to a caregiver version to measure productivity losses associated with caregiving responsibilities, and (b) evaluate measurement feasibility and validity of an online version of the caregiver VOLP questionnaire.MethodsA mixed methods design was utilized. Qualitative methods, such as reviewing existing questionnaires that measured caregiver work productivity losses and performing one-on-one interviews with caregivers, were used for VOLP adaptation and online conversion. Quantitative methods were used to evaluate feasibility and validity of the online VOLP. The Work Productivity and Activity Impairment (WPAI) questionnaire for caregivers was included to compare its absenteeism and presenteeism outcomes and their correlations with VOLP outcomes.ResultsWhen adapting the VOLP for caregivers, our qualitative analysis showed the importance of adding three major components: caregiving time, work productivity loss related to volunteer activities and caregivers’ lost job opportunities. A total of 383 caregivers who completed online survey were included in our final quantitative analysis. We found small Spearman rank correlations between VOLP and WPAI, observing a larger correlation between their absenteeism [r = 0.49 (95% confidence interval: 0.37–0.60)] than their presenteeism [r = 0.36 (0.24–0.47)]. Correlations between VOLP outcomes and total caregiving hours were larger for absenteeism [r = 0.38 (0.27–0.47)] than presenteeism [r = 0.22 (0.10–0.34)]. Correlations between WPAI outcomes and total caregiving hours were smaller for absenteeism [r = 0.27 (0.15–0.38)] than presenteeism [r = 0.35 (0.23–0.46)].ConclusionThe study provides evidence of the feasibility and preliminary validity evidence of the adapted VOLP caregiver questionnaire in measuring productivity losses due to caregiving responsibilities, when compared with the results for WPAI and the results from the previous patient-VOLP validation study.

Investigating the Psychometric Properties of the Arabic Version of the Family Adaptability and Cohesion Evaluation Scale IV (FACES IV) in Saudi Arabia

The Family Adaptability and Cohesion Evaluation Scale IV (FACES IV) has been widely used to assess family functioning and to implement family therapeutic interventions. Cross-cultural adaptation is needed given the high sensitivity of family norms with culture. This study investigates the psychometric properties of the FACES IV in the context of Saudi culture. The sample consisted of 369 participants (270 females and 99 males) aged between 13 and 70. The results of the confirmatory factor analysis supported the FACES IV model, after some adjustments. The findings indicated that FACES IV was a reliable and valid measure that can be used in the context of Saudi Arabia. The study showed some particularities with the rigid and enmeshed dimensions and concurred with previous validation studies in suggesting that these dimensions must be investigated further with respect to different cultures.

Performance of the H2FPEF and the HFA-PEFF scores for the diagnosis of heart failure with preserved ejection fraction in Japanese patients: A report from the Japanese multicenter registry

BackgroundDiagnosing heart failure with preserved ejection fraction (HFpEF) is challenging. Although the H2FPEF score and HFA-PEFF algorithm have been proposed for diagnosing HFpEF, previous validation studies were conducted in stable chronic heart failure (HF). Moreover, information on their applicability in the Asian population is limited. We sought to investigate these scores' diagnostic performance for HFpEF in Japanese patients recently hospitalized due to acute decompensated HF. MethodsWe examined patients with HFpEF recently hospitalized with acute decompensated HF from a nationwide HFpEF-specific multicenter registry (HFpEF group) and control patients who underwent echocardiography to investigate the cause of dyspnea in our hospital (Non-HFpEF group). ResultsThe studied population included 372 patients (194 HFpEF group and 178 Non-HFpEF group; HFpEF prevalence, 52%). A high H2FPEF score (6–9 points) could diagnose HFpEF with a high specificity of 97% and a positive predictive value (PPV) of 94%, and a low H2FPEF score (0–1 point) could rule out HFpEF with a high sensitivity of 97% and a negative predictive value (NPV) of 93%. HFpEF could be diagnosed with a high HFA-PEFF score (5–6 points) (specificity, 84%; PPV, 82%) or ruled out with a low HFA-PEFF score (0–1 point) (sensitivity, 99%; NPV, 89%). The H2FPEF score was significantly superior to the HFA-PEFF score in diagnostic accuracy (area under the curve: 0.89 vs. 0.82, respectively, p = 0.004). ConclusionsThe H2FPEF and the HFA-PEFF scores had acceptable diagnostic accuracy in diagnosing HFpEF in Japanese patients.

Three Versions of the Perceived Stress Scale: Psychometric Evaluation in a Nationally Representative Sample of Chinese Adults during the COVID-19 Pandemic.

(1) Background: The COVID-19 outbreak has created pressure in people’s daily lives, further threatening public health. Thus, it is important to assess people’s perception of stress during COVID-19 for both research and practical purposes. The Perceived Stress Scale (PSS) is one of the most widely used instruments to measure perceived stress; however, previous validation studies focused on specific populations, possibly limiting the generalization of results. (2) Methods: This study tested the psychometric properties of three versions of the Chinese Perceived Stress Scale (CPSS-14, CPSS-10, and CPSS-4) in the Chinese general population during the COVID-19 pandemic. A commercial online survey was employed to construct a nationally representative sample of 1133 adults in Mainland China (548 males and 585 females) during a one-week period. (3) Results: The two-factor (positivity and negativity) solution for the three versions of the CPSS showed a good fit with the data. The CPSS-14 and CPSS-10 had very good reliability and the CPSS-4 showed acceptable reliability, supporting the concurrent validity of the CPSS. (4) Conclusions: All three versions of the CPSS appear to be appropriate for use in research with samples of adults in the Chinese general population under the COVID-19 crisis. The CPSS-10 and CPSS-14 both have strong psychometric properties, but the CPSS-10 would have more utility because it is shorter than the CPSS-14. However, the CPSS-4 is an acceptable alternative when administration time is limited.

The comprehensive inventory of thriving: a systematic review of published validation studies and a replication study

In this study we sought to collect evidence regarding the validity of the Comprehensive Inventory of Thriving (CIT), systematically reviewing studies that tested its psychometric properties (Study 1) and trying to replicate validity evidence collected across previous validation studies (Study 2). We found five studies that tested the validity of CIT scores through the collection of different kinds of evidence (score structure validity, convergent validity, discriminant validity, criterion-related validity, incremental validity, internal consistency, test-retest reliability). Results were often inconsistent across studies (especially for the score structure validity evidence). Using a sample of 483 Italian participants (63.0% female; aged 18–71 years), we replicated the tests performed in the previous validation studies. Findings suggest that the best fitting model is the one that (1) adds the overarching latent construct of thriving, which can be measured using the total scale score; and (2) merges the Skills and Flow factors in just one factor, named “Skills for Flow”. At the same time, the different kinds of validity evidence collected both in previous validation studies and in the current replication study indicate high overlap among thriving sub-dimensions and poor validity evidence. We concluded that the CIT in its present form is not an adequate instrument to assess thriving, thus mono-dimensional scales (e.g. Brief Inventory of Thriving) should be currently preferred. Suggestions to develop a multi-dimensional scale measuring thriving (both using a theory-driven approach or a data-drive approach) are discussed.

Differential influence of Clinical Disease Activity Index components based on disease state in rheumatoid arthritis patients: real-world results from the Ontario Best Practices Research Initiative.

The Clinical Disease Activity Index (CDAI) is routinely used in clinical care when treating-to-target RA patients. Previous validation studies have looked at CDAI's overall performance; this analysis aimed at evaluating its properties by disease state and identifying drivers of variance. RA patients enrolled in the OBRI registry, with available follow-up of ≥6 months were included. Construct validity of CDAI was assessed with principal component analysis; internal consistency with Cronbach's alpha (α); correlational validity with Spearman's rho (ρ); agreement in disease state classification with the kappa statistic. Stratification by disease states was performed. CDAI correlation with DAS28 was strong when CDAI>10 (ρ=0.79), moderate when CDAI≤10 (ρ=0.56) or 2.8<CDAI≤10 (ρ=0.44), and very weak when CDAI≤2.8 (ρ=0.02). Classification agreement of low disease activity (LDA)/remission between CDAI (≤10) and DAS28 (≤3.2) or HAQ-DI (≤2) was fair-to-moderate, while poor-to-fair for remission. For CDAI>10, CDAI was able to be reduced to a single component with patient global assessment (PtGA) having the lowest loading. When CDAI≤10, two distinct components were identified: (1) PtGA and physician global assessment; (2) SJC28 and TJC28. Moderate levels (α=0.71) of internal consistency were observed when CDAI>10 but low when CDAI≤10 (α=0.23), 2.8<CDAI≤10 (α=-0.42) or CDAI≤2.8 (α=-0.35). PtGA showed lowest correlation with remaining CDAI components. CDAI and DAS28 correlated well in moderate/high disease activity and poorly in LDA/remission. PtGA correlated weakly with other CDAI components and had a stronger influence on CDAI in LDA/remission. Thus, careful interpretation of PtGA is necessary when making treatment decisions, particularly in patients in CDAI LDA who are non-remitters.

Validity of Student Worksheet Inquiry Based Learning Model with Scientific Approach Integrated Creative Thinking Skills for Grade XI Physics Learning on 21st Century

One of the success factors of learning is the use of learning resources in the form of worksheets that are able to guide students in investigating and solving problems. Choosing a model and approach that is integrated with the ability to think creatively is also another factor that also supports the success of learning. Based on the analysis of student needs and characteristics, as well as the limitations of previous validation studies, an inquiry-based learning model with scientific approach integrated creative thinking skills can be a problem solution. The purpose of this study was to produce worksheets based on an inquiry-based learning model with scientific approach integrated creative thinking skills in the valid category. The research method used is descriptive statistics. The instrument used was a validation sheet that was filled in by the experts. The validity of the worksheets is obtained from the feasibility of the content, presentation, language and graphics components. The average validation of the LKS for the four components was 0.83 by development experts. Therefore, a worksheet based on an inquiry-based learning model with scientific approach integrated creative thinking skills is produced, the ability to think creatively in the valid category.

The Application of the Adult Self-Report and the Adult Behavior Checklist Form to Chinese Adults: Syndrome Structure, Inter-Informant Agreement, and Cultural Comparison.

Given the global public health burden of mental illness, there is a critical need for culturally validated psychopathology assessment tools that perform well in diverse societies. This study examines the psychometric properties of the Adult Self-Report (ASR) and Adult Behavioral Checklist (ABCL) from the Achenbach System of Empirically Based Assessments in adults in China. Chinese adults (N = 1276) and their spouses completed the ASR and ABCL, respectively. We conducted confirmatory factor analysis on 99 ASR items and 93 ABCL items. Estimators of model fit confirmed that both measures demonstrated excellent fit (e.g., root mean square error of approximation = 0.016 and 0.018, respectively). Syndrome loadings on both measures were satisfactory but generally higher on the ASR. Neither gender nor education had significant effects, but there were informant x gender effects on most problem scales. Cross-informant agreement correlations between the ASR and ABCL were medium to large. Findings from this novel sample of Chinese adults are consistent with previous validation studies supporting the dimensionality, syndrome structure, gender differences, and inter-informant agreement of the ASR and ABCL. Our findings contribute to the cross-cultural understanding of mental health assessment and offer a psychometrically sound approach to measuring adult psychopathology in Chinese populations.

Commercial beef farms excelling in terminal and maternal genetic merit generate more gross profit.

Validation of beef total merit breeding indexes for improving performance and profitability has previously been undertaken at the individual animal level; however, no herd-level validation of beef genetic merit and profit has been previously investigated. The objective of the present study was to quantify the relationship between herd profitability and both herd-average terminal and maternal genetic merit across 1,311 commercial Irish beef herds. Herd-level physical and financial performance data were available from a financial benchmarking tool used by Irish farmers and their extension advisors. Animal genetic merit data originated from the Irish Cattle Breeding Federation who undertake the national beef and dairy genetic evaluations. Herd-average genetic merit variables included the terminal index of young animals, the maternal index of dams, and the terminal index of service sires. The herds represented three production systems: 1) cow-calf to beef, 2) cow-calf to weanling/yearling, and 3) weanling/yearling to beef. Associations between herd financial performance metrics and herd average genetic merit variables were quantified using a series of linear mixed models with year, production system, herd size, stocking rate, concentrate input, and the two-way interactions between production system and herd size, stocking rate, and concentrate input included as nuisance factors. Herd nested within the county of Ireland (n = 26) was included as a repeated effect. Herds with young cattle excelling in terminal index enjoyed greater gross and net profit per hectare (ha), per livestock unit (LU), and per kg net live-weight output. The change in gross profit per LU per unit change in the terminal index of young animals was €1.41 (SE = 0.23), while the respective regression coefficient for net profit per LU was €1.37 (SE = 0.30); the standard deviation of the terminal index is €37. Herd-average dam maternal index and sire terminal index were both independently positively associated with gross profit per ha and gross profit per LU. Each one unit increase in dam maternal index (standard deviation of €38) was associated with a €1.40 (SE = 0.48) and €0.76 (SE = 0.29) greater gross profit per ha and per LU, respectively. Results from the present study at the herd-level concur with previous validation studies at the individual animal level thus instilling further confidence among stakeholders as to the expected improvement in herd profitability with improving genetic merit.

Do Strengths Converge into Virtues? An Item-, Virtue-, and Scale-Level Analysis of the Italian Values in Action Inventory of Strengths-120

The Values in Action Inventory of Strengths (VIA-IS) is a widely-used measure for character. Its factorial structure is still debated, however, and previous validation studies usually failed to examine the unidimensionality of the single character strengths. In addition, no studies to date have examined its Italian version. We validated the structure of the Italian short form of the VIA-IS in a sample of 16722 participants. Using confirmatory factor analysis and treating items as ordinal variables, we followed three simple, but too often neglected, steps: we studied the unidimensionality of the single strengths first, then their convergence into second-order virtues, and then fitted a hierarchical model that includes items, strengths and virtues, as originally proposed by Peterson and Seligman. All strengths except “love of learning” were unidimensional, and both the virtues and the final hierarchical models showed acceptable fit indices, unlike three models derived from an exploratory factor analysis. The same findings emerged for a smaller sample of 1035 participants. Finally, both character strengths and virtues showed positive relations with general mental health and negative relations with psychological distress. These results are discussed considering previous studies on the factorial structure of the VIA-IS.