Reliable Assessment Tool Research Articles

QOL-10. AN ASSESSMENT TOOL FOR MEASURING CAREGIVERS’ DEATH ANXIETY IN PRIMARY BRAIN TUMOR: A CONFIRMATORY FACTOR ANALYSIS

Abstract BACKGROUND Caregivers of patients with primary brain tumor describe significant emotional distress regarding their loved one’s impending trajectory and eventual mortality—a construct known as death anxiety. Our team adapted a pre-existing, validated scale for patients with advanced cancer (the Death and Dying Distress Scale; DADDS) to measure this latent variable in caregivers of patients with primary brain tumors. Our adapted scale (DADDS-CG) demonstrated preliminarily strong internal consistency and construct validity. We now seek to confirm the factor structure, internal consistency, and convergent validity of the DADDS-CG in a second sample of neuro-oncology caregivers in accordance with best practices of measure development. METHODS Caregivers of those with primary brain tumors (N=221) completed an online battery of self-report questionnaires, including the 15-item Death and Dying Distress Scale-Caregiving (DADDS-CG), the Generalized Anxiety Disorder (GAD-7), and the Patient Health Questionnaire (PHQ-9). To verify the two-factor structure of the DADDS-CG, we used confirmatory factor analysis. Cronbach’s alpha measured internal consistency, Pearson correlations assessed convergent validity, and descriptive statistics determined the prevalence of death anxiety. RESULTS Caregivers (Mage=46.2) were primarily White (85.5%) female (72.4%) spouses (75.6%). The two-factor model demonstrated adequate fit (X2/df=4.24; CFI-.89; NFI=.87; RMSEA=.06), suggesting two correlated subscales of death anxiety: Finitude and Dying (r=.80). The DADDS-CG demonstrated strong internal consistency (a=.95) and was moderately correlated with the GAD-7 (r=.73) and PHQ-9 (r=.68), suggesting adequate convergent validity. Mean scores fell within the moderate range (M=40.5, SD=18.7), with 20.8%, 36.2%, and 43.0% of caregivers reporting low, moderate, and severe death anxiety, respectively. CONCLUSION The DADDS-CG is a valid and reliable assessment tool for measuring death anxiety in caregivers of those with primary brain tumors. Given the high prevalence of death anxiety, future investigations are needed to understand caregiver’s death anxiety throughout the disease trajectory and to inform intervention development for neuro-oncology caregivers.

Characterization of Contusive Spinal Cord Injury by Monitoring Motor-Evoked Potential

This study involves longitudinal neuro-electrophysiological analysis using motor-evoked potentials (MEP) and the Basso, Beattie, and Bresnahan behavioral examinations (BBB) to evaluate moderate mid-thoracic contusive spinal cord injury (SCI) in a rat model. Objectives/Background: The objective of the study is to characterize the onset and progression of contusive SCI over an eight-week period using a clinically applicable tool in an in vivo model. The background highlights the importance of a reliable and reproducible injury model and assessment tools for SCI. Methods: The methods section describes the experimental setup, including randomly assigned rats in three groups: Sham, Control, and Injury (undergoing a moderate contusive SCI using the NYU-Impactor). MEP monitoring and BBB examinations are conducted at baseline and weekly for eight weeks post-injury. Results: The results indicate that the relative MEP power spectral decreased to 11% and 22% in the left and right hindlimbs, respectively, during the first week post-SCI. In the second week, a slight spontaneous recovery was observed, reaching 17% in the left and 31% in the right hindlimbs. Over the following four weeks post-SCI, continuing deterioration of MEP signal power was observed with no detectable recovery. Conclusions: SCI attenuates hindlimb MEP power spectral and reduces locomotion, though the changes in MEP and locomotion exhibit distinct temporal patterns. The MEP monitoring provides valuable insights into the functional integrity of motor pathways following SCI and offer a sensitive and reliable assessment. By implementing MEP monitoring, researchers can track the progression of SCI and evaluate the efficacy of therapeutic interventions quantitatively.

Validation of the European French Version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-Vf)

ObjectiveThis study aimed to validate the French adaptation of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-Vf) for assessing voice disorders in France. The CAPE-Vf addresses limitations of the GRBAS by providing a more sensitive, standardized approach to evaluating six vocal parameters (overall severity, roughness, breathiness, strain, pitch, and loudness) on three tasks (sustained vowels, sentence reading, and spontaneous speech). The study focused on investigating the intra- and inter-rater reliability, as well as the convergent and discriminant validity of the CAPE-Vf. MethodsThirty-four dysphonic and seven euphonic native French speakers participated in the study. Thirteen speech-language pathologists from France evaluated the voice samples using both the CAPE-Vf and GRBAS tools at a one-week interval. Intra- and inter-rater reliability were calculated using intraclass correlation coefficients (ICC), while convergent and discriminant validity were measured by correlating CAPE-Vf with GRBAS and Voice Handicap Index (VHI) scores, respectively. ResultsThe CAPE-Vf showed good intra-rater reliability for overall severity (mean ICC: 0.89), strain (ICC: 0.83), and pitch (ICC: 0.88), while roughness, breathiness, and loudness exhibited moderate reliability. Inter-rater reliability was low for most parameters, except overall severity, which demonstrated good reliability (mean ICC: 0.77). Strong correlations were observed between CAPE-Vf and GRBAS Grade (mean r: 0.84), supporting its convergent validity. Moderate correlations were found for roughness, breathiness, and strain. The CAPE-Vf’s correlation with the VHI was moderate (mean r: 0.53), reflecting its discriminant validity. ConclusionThe CAPE-Vf is a valid and reliable tool for perceptual assessment of voice disorders in French-speaking populations, with stronger psychometric properties than the GRBAS, particularly for intra-rater reliability and overall severity. While inter-rater reliability was lower, qualitative feedback suggested that improvements to the protocol, particularly for pitch and loudness ratings, could enhance its clinical applicability. The findings support the CAPE-Vf as a comprehensive tool for standardized clinical voice assessment.

Automatic 3-dimensional quantification of orthodontically induced root resorption in cone-beam computed tomography images based on deep learning

Orthodontically induced root resorption (OIRR) is a common and undesirable consequence of orthodontic treatment. Traditionally, studies employ manual methods to conduct 3-dimensional quantitative analysis of OIRR via cone-beam computed tomography (CBCT), which is often subjective and time-consuming. With advancements in computer technology, deep learning-based approaches have gained traction in medical image processing. This study presents a deep learning-based model for the fully automatic extraction of root volume information and the localization of root resorption from CBCT images. In this cross-sectional, retrospective study, 4534 teeth from 105 patients were used to train and validate an automatic model for OIRR quantification. The protocol encompassed several steps: preprocessing of CBCT images involving automatic tooth segmentation and conversion into point clouds, followed by segmentation of tooth crowns and roots via the Dynamic Graph Convolutional Neural Network. The root volume was subsequently calculated, and OIRR localization was performed. The intraclass correlation coefficient was employed to validate the consistency between the automatic model and manual measurements. The proposed method strongly correlated with manual measurements in terms of root volume and OIRR severity assessment. The intraclass correlation coefficient values for average volume measurements at each tooth position exceeded 0.95 (P<0.001), with the accuracy of different OIRR severity classifications surpassing 0.8. The proposed methodology provides automatic and reliable tools for OIRR assessment, offering potential improvements in orthodontic treatment planning and monitoring.

The one-minute sit-to-stand test is an alternative to the 6-minute walk test in patients with atrial fibrillation: A cross-sectional study and ROC curve analysis

BackgroundThe one-minute sit-to-stand test (1STST) is an easy-to-administer, space and time-saving test for determining functional exercise capacity in cardiac disease. This study aimed to investigate the 1STSt-test-retest reliability and convergent validity and compare its physiological responses to the six-minute walk test (6MWT) in patients with Atrial fibrillation (AF). MethodsForty-five patients with AF were included in this study. Functional exercise capacity was evaluated using the 1STST and 6MWT. For assessing test-retest reliability, the intraclass correlation coefficient and Bland-Altman plots were utilised. Convergent validity was determined by correlation analysis 1 STST and 6MWT, age, European Heart Rhythm Association score, ejection fraction, and quality of life. The cut-off point of 1STST was defined using ROC analysis. ResultsWith an intraclass correlation coefficient value of 0.975 [95 % confidence interval (CI) 0.954–0.986], the 1STST demonstrated excellent-test-retest reliability. Physiological responses after tests were similar in the 1STST and 6MWT (p > 0.05). The number of 1STST repetitions was strongly associated with 6MWT distance (r = 0.809; p < 0.001). A cut-off value of ≤13 repetitions in the number of 1STST repetitions was defined as functional impairment related to an increased risk of clinical events [sensitivity: 100 %, specificity: 84.6 %; AUC:0.94; 95 % CI 0.82 to 0.98; p < 0.001]. ConclusionsThe 1STST is a reliable and valid assessment tool that produced comparable hemodynamic responses to the 6MWT in patients with AF. Considering its feasibility and time efficiency, healthcare professionals can use the 1STST rather than the 6MWT test to measure functional exercise status in a constrained environment for this patient group.

Analysis of multi-disulfide bridges for insulin aspart by stepwise reduction and differentiated alkylation.

Disulfide bridge, an important post-translation modification in protein, plays a key role in stabilizing three-dimensional structure of proteins, maintaining correct folded conformation, and thus regulating the biological activities. Disulfide bridge assignment is essential to understand the essence of life process and to develop protein pharmaceutical. In this study, a novel method termed as stepwise reduction and differentiated alkylation (SRDA) was developed analyzing disulfide connectivity for proteins. As a demonstration, three disulfide bridges in insulin aspart were successfully characterized using this SRDA method combined with LC-HRMSn. Firstly, tris (2-carboxyethyl) phosphine (TCEP) was used to partially reduce disulfide bridges with N-ethylmaleimide (NEM) used to block the generated free thiol. Then, dithiothreitol (DTT) was used to reduce the rest disulfide bonds with iodoacetamide (IAM) used to block the newly generated free thiol. After that, an LC-HRMSn method was established to assign disulfide connectivity for an insulin aspart study material, based on the different mass shifts arising from differentiated alkylation. Moreover, this approach allows for the quantitative analysis of various disulfide bond pairings, which can be applied to studies on the consistency and stability among different batches of samples. The results show that SRDA is a valuable tool for reliable quality control and quality assessment of disulfide-rich proteins such as insulin analogues.

Artificial Neural Network-based Model for Predicting Cardiologists’ Over-apron Dose in CATHLABs

Abstract Aim: The radiation dose that cardiologists receive in the catheterization laboratory is influenced by various factors. Handling high-stress tasks in interventional cardiology departments may cause physicians to overlook the use of dosimeters. Therefore, it is essential to develop a model for predicting cardiologists’ radiation exposure. Materials and Methods: This study developed an artificial neural network (ANN) model to predict the over-apron radiation dose received by cardiologists during catheterization procedures, using dose area product (DAP) values. Leveraging a validated Monte Carlo simulation program, we generated data from simulations with varying spectra (70, 81, and 90 kVp) and tube orientations, resulting in 125 unique scenarios. We then used these data to train a multilayer perceptron neural network with four input features: DAP, energy spectrum, tube angulation, and the resulting cardiologist’s dose. Results: The model demonstrated high predictive accuracy with a correlation coefficient (R-value) of 0.95 and a root mean square error (RMSE) of 3.68 μSv, outperforming a traditional linear regression model, which had an R-value of 0.48 and an RMSE of 18.15 μSv. This significant improvement highlights the effectiveness of advanced techniques such as ANNs in accurately predicting occupational radiation doses. Conclusion: This study underscores the potential of ANN models for accurate radiation dose prediction, enhancing safety protocols, and providing a reliable tool for real-time exposure assessment in clinical settings. Future research should focus on broader validation and integration into real-time monitoring systems.

Validity and reliability of a physical literacy knowledge, attitudes, self-efficacy and behaviors questionnaire for early childhood educators (PLKASB-ECE): An exploratory factor analysis.

Nurturing physical literacy in young children offers a unique opportunity to address global physical inactivity trend. Early childhood education and care (ECEC) environments, with their extensive reach into this age group, and early childhood educators, through their daily interactions with children, are strategically positioned to influence children's physical literacy development. However, enhancing educators' ability to foster physical literacy requires valid and reliable assessment tools to measure holistic physical literacy constructs (i.e., cognitive, affective, behavioral) to assess the impact of physical literacy educational interventions. The purpose of this study was to develop a holistic digital tool to measure physical literacy knowledge, attitudes, self-efficacy, and behaviors of early childhood educators (PLKASB-ECE) for both their professional teaching context as well as the educator's own personal physical literacy behaviours. This study was conducted in two phases. Phase 1 involved item generation and content validation. Phase 2 employed a cross-sectional validation study design to assess the psychometric properties of the PLKASB-ECE tool. Based on a literature review an initial 19-item instrument was developed that subsequently underwent three rounds of expert content validation. Six additional items were added, resulting in a final 25-item self-report measure with a readability score equivalent to an 8th grade reading level (Flesch-Kincaid Grade Level: 8.7). This included 1 global rating item, 2 qualitative response items, 7 knowledge items, and 15 items addressing physical literacy attitudes, self-efficacy and behaviors using a 7-point Likert response scale. The PLKASB-ECE tool was administered to 470 educators in Alberta, Canada between 2019 to 2022. The 15 items were subjected to exploratory factor analysis and resulted in a five-factor scale with one item not loading. The five-factor scale held with the final 14 items with loadings ranging from 0.481 to 0.886, Cronbach's alpha ranging from 0.70 to 0.82, with ordinal omega ranging from 0.72 to 0.82. Usability, as assessed by completion time, was 8.15 minutes. These findings demonstrate good indices of reliability and validity for the PLKASB-ECE tool. This tool will be valuable as a research outcome measure for assessing educational interventions aimed at enhancing educators' understanding, confidence, and strategies for fostering holistic concepts of physical literacy in young children within ECECs.

Chinese Version of the Nonverbal Pain Assessment Tool: Critical Patient Reliability and Validity.

To translate and validate the Nonverbal Pain Assessment Tool. Timely assessment of the pain degree of nonverbal intensive care unit (ICU) patients can provide humanistic care. However, there is a lack of pain assessment tools that can meet the needs of patients who cannot use language in ICUs in China. A cross-sectional survey. We conducted forward-backward translation of the Nonverbal Pain Assessment Tool. A total of 300 critically ill patients in the intensive care unit who could not communicate verbally completed the Chinese version of the Nonverbal Pain Assessment Tool and the Critical Care Pain Observation Tool. Exploratory and confirmatory factor analyses were performed to verify structural validity, and content validity and reliability analyses were also conducted. The Nonverbal Pain Assessment Tool demonstrated high internal consistency (α = 0.901) and interrater reliability (intraclass correlation coefficient = 0.981), with good split-half reliability. Content validity was established through acceptable item-level content validity index and scale-level content validity index scores. Exploratory factor analysis showed a single factor explaining 71.79% of total variance, and confirmatory factor analysis confirmed good model fit. The Spearman rank correlation coefficient was 0.917 between the Nonverbal Pain Assessment Tool and the Critical Care Pain Observation Tool. The Chinese Nonverbal Pain Assessment Tool demonstrated significant differences in scores between different states of consciousness and illness severity, supporting its known-groups validity. The Chinese version of the Nonverbal Pain Assessment Tool is a reliable and valid tool for nonverbal pain assessment in ICU patients in China. The Chinese version of the Nonverbal Pain Assessment Tool can assess the pain of patients who cannot use language in ICU, which provides a new valuable assessment tool for Chinese clinicians and nurses in pain assessment and management. Our study followed the STROBE Checklists. Patients actively cooperated and participated in data collection during the implementation of the study.

Psychometric evaluation of the Chinese version of the Chronic Heart Failure Health-related Quality of Life Questionnaire (CHFQOLQ-20)

The incidence rate of chronic heart failure has increased significantly in China and has a large impact on patients’ lives. The purpose of the study was to validate the Chronic Heart Failure Health-Related Quality of Life Questionnaire (CHFQOLQ-20) cross-culturally and test its reliability and validity in patients with chronic heart failure. This study was conducted by investigating 622 patients with chronic heart failure from August 2023 to January 2024, and the data were tested for validity using SPSS 25.0 and AMOS 23.0. The final psychometric validation of the CHFQOLQ-20 was performed. The Chinese version of the CHFQOLQ-20 had a Cronbach’s α of 0.908, a split-half reliability of 0.870, and a retest reliability of 0.892. An exploratory factor analysis yielded four common factors with a cumulative ANOVA of 59.355%, and the validated factor analysis with one correction resulted in a better-fitting model (χ2/df = 2.020, RMSEA = 0.057, CFI = 0.920, TLI = 0.907). The scale is a reliable assessment tool that can be used in future clinical practice.

Effectiveness of video-based teaching in surgery residents: A randomized control trial

Objective: To determine the effectiveness of video-based teaching in surgery residents by comparing it to the routine operating room traditional teaching. Methodology: The randomized control trial was done at four institutions from September 2022 to March 2023. Interventional group underwent video-based instruction of basic surgical skills whereas the control group was taught through traditional operating room teaching. Pre and post-test mean scores were analyzed on SPSS version 20 through paired t-test. Learning gain was calculated. Supervisors’ perceptions were recorded on survey form regarding direct observations and recorded video evaluations of resident skills on post-test. Results: Out of sixty (n=60), fifty-five newly inducted surgical residents completed the study including both females (n=13) and male residents (n=42). Video intervention Group (27.93±3.72) and control group (23.07±4.62) both showed improvements in their post-test scores as compared to pretest scores of 13.68±3.25 and 13.52±3.60 respectively. Mean score difference improvement was more in video intervention group (13.9±3.8) in comparison to control group (9.5±4.3) provided both groups exhibits improvements in all seven domains of the global rating system (reflected by the p &lt;0.0001). However, learning gain of 65% was observed in intervention group as compared to learning gain (41%) of control group. Evaluators(n=5) observed that recorded video evaluations helped to provide integrated feedback, despite being time (40%) and resource intensive (60%). Conclusion: Video-based teaching has higher learning gain irrespective of the fact that both groups exhibit statistically significant results in all seven domains of the global rating system. Recorded video evaluation was found feasible and reliable tool for formative assessment. doi: https://doi.org/10.12669/pjms.40.10.7856 How to cite this: Niaz K, Mahboob U, Masood D, Maqbool A. Effectiveness of video-based teaching in surgery residents: A randomized control trial. Pak J Med Sci. 2024;40(10):2373-2378. doi: https://doi.org/10.12669/pjms.40.10.7856 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Touch: A Review of the Infant-Caregiver Relationship in the Neonatal Field

Touch is a domain of enormous importance with implications in development, from birth, and across the lifespan. This work aims to review touch implications within infant-caregiver interaction. A non-systematic review of the literature was performed to assess the relevance of touch in the neonatal period, on attachment, and in child development. The review was conducted on PubMed database, in May 2023 using the following keywords: “infant”, “child”, “baby”, “newborn”, “neonatal”, “touch”, “contact”, “tactile”, and “attachment”. In the neonatal period, close skin contact facilitates caregiver sensitivity and responsiveness, promotes parent-infant reciprocity, reduces psychological distress both in caregiver and infants, and regulates the infant’s physiological systems (circadian rhythm, autonomic regulation). Touch also plays a crucial role in attachment by contributing to synchrony and self-regulation abilities, since secure attachment promotes learning of emotional regulation, social skills, and behavioural organization. Early sensory experiences are critical to developmental dimensions such as cognitive, motor, and socio-emotional, and influence physical growth rate. Concluding, in neonatal care services, touch should be systematically addressed in routine appointments. Within the field of infant-caregiver interactions, there is an urgent need to create a reliable tool for tactile assessment, allowing clear interpretations and the development of target interventions.

Development and Validation of a Portable EIT System for Real-Time Respiratory Monitoring.

This work contributes to the improvement of novel medical technologies for the prevention and treatment of diseases. Electrical impedance tomography (EIT) has gained attention as a valuable tool for non-invasive monitoring providing real-time insights. The purpose of this work is to develop and validate a novel portable EIT system with a small form factor for respiratory monitoring. The device uses a 16-electrode architecture with adjacent stimulation and measurement patterns, an integrated circuit current source and a single high-speed ADC operating with multiplexers to stimulate and measure across all electrodes. Tests were conducted on 25 healthy subjects who performed a pulmonary function test with a flowmeter while using the EIT device. The results showed a good performance of the device, which was able to recognize all respirations correctly, and from the EIT signals and images, correlations of 96.7% were obtained for instantaneous respiratory rate and 96.1% for tidal volume prediction. These results validate the preliminary technical feasibility of the EIT system and demonstrates its potential as a reliable tool for non-invasive respiratory assessment. The significance of this work lies in its potential to democratize advanced respiratory monitoring technologies, making them accessible to a wider population, including those in remote or underserved areas.

A dual-channel convolutional neural network with attention mechanism DC_EcaNet-6 for creep life prediction of notched components

Machine learning models offer novel possibilities for creep life prediction of materials and components at elevated temperatures. Present studies primarily focus on material-level creep life prediction, with limited reports on component-level analysis due to the complex stress states around structural discontinuities. Based on this, a dual-channel convolutional neural network with attention mechanism, DC_EcaNet-6, is proposed for creep life prediction of notched components, where the images of Mises stress and stress tri-axiality are employed as the input. The prediction results by the DC_EcaNet-6 model are compared with that by some deep learning models and the simplified method. Creep reliability assessment of notched components using the DC_EcaNet-6 model is conducted. The results indicate that the proposed model provides a more superior creep life prediction accuracy of notched components than other models mentioned. This model provides a potential tool for creep life prediction and reliability assessment of notched components.

Artificial neural network-enhanced mathematical simulation based on Carrera unified formulation for dynamic analysis and structural integrity assessment of advanced nanocomposites reinforced tunnel structures

This article presents the application of the Carrera Unified Formulation (CUF) for dynamic analysis and structural integrity assessment of advanced nanocomposite-reinforced tunnel structures. CUF offers a generalized framework that simplifies the modeling of complex structures, providing an efficient approach to address the dynamic behavior of nanocomposites. Advanced nanocomposites, which enhance mechanical performance and durability, are increasingly used in critical infrastructure such as tunnel systems. Traditional methods often fall short in capturing the intricate interactions within these materials, particularly under dynamic loads. CUF overcomes these challenges by incorporating higher-order theories and multi-scale analysis, allowing for accurate prediction of displacements, stresses, and potential failure modes. To further validate the results, an Artificial Neural Network (ANN) model is trained using simulated data, ensuring robust predictions for various loading conditions. The ANN assists in approximating the dynamic response and integrity of the structure, enabling real-time assessments with minimal computational expense. The combined CUF-ANN approach demonstrates high accuracy and efficiency, making it a reliable tool for the structural integrity assessment of nanocomposite-reinforced tunnels. This study highlights the significant potential of integrating CUF and ANN for the analysis and design of advanced engineering structures subjected to dynamic environmental conditions.

An Open-Source Tool for Composite Power System Reliability Assessment in Julia™

An Open-Source Tool for Composite Power System Reliability Assessment in Julia™

The role of artificial intelligence in coronary CT angiography.

Coronary CT angiography (CCTA) offers an efficient and reliable tool for the non-invasive assessment of suspected coronary artery disease through the analysis of coronary artery plaque and stenosis. However, the detailed manual analysis of CCTA is aburdensome task requiring highly skilled experts. Recent advances in artificial intelligence (AI) have made significant progress toward amore comprehensive automated analysis of CCTA images, offering potential improvements in terms of speed, performance and scalability. This work offers an overview of the recent developments of AI in CCTA. We cover methodological advances for coronary artery tree and whole heart analysis, and provide an overview of AI techniques that have shown to be valuable for the analysis of cardiac anatomy and pathology in CCTA. Finally, we provide ageneral discussion regarding current challenges and limitations, and discuss prospects for future research.

A reliable and valid assessment of upper limb movement quality after stroke: the observational Drinking Task Assessment.

To develop and evaluate the reliability and validity of a new observational Drinking Task Assessment (DTA) designed to assess quality of movement in task performance after stroke. Reliability and validity. The DTA measures movement time and movement quality (smoothness, trunk, shoulder, elbow, and grasp movements) on a 4-level ordinal scale. Thirty participants with chronic stroke were assessed independently by 2 therapists. Intra-class correlation (ICC), standard error of measurement (SEM) and minimal real difference (MRD), weighted kappa, percentage of agreement, and Svensson method were used for reliability assessment. Motion capture-based kinematics and established clinical scales were used to evaluate validity. The absolute SEM and MRD for movement time were 0.4 and 1 s (11%), respectively. The ICC (≥ 0.93) and weighted kappa (0.71-1.0) showed good to excellent agreement for intra- and inter-rater reliability. DTA showed strong correlations with Fugl-Meyer Assessment (0.74), Action Research Arm Test (0.93), and kinematic measures of smoothness (0.93), trunk displacement (0.91), elbow extension (0.73), and shoulder movements (0.56), indicating good construct validity. The new DTA proved to be a reliable and valid tool for assessment of movement quality during task performance after stroke.

Development and validation of the Thai Halitosis Associated Life-Quality Test (T-HALT): an evaluation of psychometric properties.

Halitosis appears to have significant impacts on quality of life, necessitating reliable assessment tools. The Halitosis Associated Life-Quality Test (HALT) has been validated in various populations, but not among Thai people. While HALT provides a valuable foundation, there is a need for a culturally adapted and expanded instrument for the Thai context. Consequently, this study aimed to develop and validate a comprehensive questionnaire for assessing halitosis-related quality of life in Thai populations, incorporating a Thai version of HALT (T-HALT) as a core component. This cross-sectional study involved 200 dental patients at Mahidol University. The original HALT was translated into Thai using forward-backward translation. Cultural adaptation and psychometric properties of T-HALT were evaluated through multiple approaches. Content validity was ensured through expert reviews, while face validity was assessed by patient feedback. Reliability was examined via test-retest and internal consistency measures. Criterion and discriminant validity was evaluated by correlating T-HALT scores with self-perceived halitosis and volatile sulfur compound (VSC) measurements, respectively. VSCs were quantified using the OralChroma™ device, which analyzes breath samples collected directly from patients' mouths. Construct validity was assessed through exploratory (EFA) and confirmatory factor analysis (CFA), providing insights into the questionnaire's underlying structure. T-HALT demonstrated excellent internal consistency (Cronbach's alphas = 0.940-0.943) and test-retest reliability (ICC = 0.886). Criterion validity was supported by a significant correlation between T-HALT scores and self-perceived halitosis (r = 0.503, P < 0.001). Discriminant validity was confirmed by the absence of a significant correlation between T-HALT scores and VSC levels (r = 0.071, P = 0.32). EFA revealed a four-factor structure, which was subsequently confirmed by CFA. However, Items 1 and 7 were excluded due to poor standardized factor loadings. T-HALT demonstrates good reliability and validity for assessing halitosis-related quality of life in Thai populations. It performs well as a unidimensional measure, but its multidimensional application requires modifications. Future research should validate a modified version excluding Items 1 and 7 across diverse Thai populations, potentially enhancing its cultural specificity.

Engineering ergonomic risk assessment of karate choku zuki straight punch

This study utilizes the Rapid Upper Limb Assessment (RULA) technique to evaluate suggested improvements aimed at enhancing the safety and efficacy of the Choku Zuki (Straight Punch), a high-risk karate exercise. The primary objective is to identify and address potential musculoskeletal issues associated with this technique. Given the prevalence of musculoskeletal injuries in sports, particularly in activities with high intensity like karate, the need for reliable ergonomic risk assessment tools such as RULA is paramount. By applying RULA to analyze the ergonomic aspects of the Choku Zuki punch, this study provides crucial insights into potential areas of concern. It identifies specific postures and movements that may predispose practitioners to injury, allowing for the development of targeted interventions to mitigate risks and enhance safety. Furthermore, this research underscores the importance of integrating ergonomic considerations into sports training regimens to optimize performance and minimize injury risks. Beyond its implications for karate training, the study emphasizes the broader significance of ergonomic assessments in sports science and engineering. It showcases how engineering methodologies can be leveraged to improve the safety, efficiency, and overall performance of sporting activities, fostering collaboration between sports scientists, engineers, athletes, coaches, and healthcare professionals to advance sports performance and safety standards.lities.