Significant Intraclass Correlation Research Articles

Electronic Health Literacy Scale-Web3.0 for Older Adults with Noncommunicable Diseases: Validation Study.

In the current digital era, eHealth literacy plays an indispensable role in health care and self-management among older adults with noncommunicable diseases (NCDs). Measuring eHealth literacy appropriately and accurately ensures the successful implementation and evaluation of pertinent research and interventions. However, existing eHealth literacy measures focus mainly on individuals' abilities of accessing and comprehending eHealth information (Web1.0), whereas the capabilities for web-based interaction (Web2.0) and using eHealth information (Web3.0) have not been adequately evaluated. This study aimed to examine the reliability, validity, and measurement invariance of the eHealth Literacy Scale-Web3.0 (eHLS-Web3.0) among older adults with NCDs. A total of 642 Chinese older adults with NCDs (mean age 65.78, SD 3.91 years; 55.8% female) were recruited in the baseline assessment, of whom 134 (mean age 65.63, SD 3.99 years; 58.2% female) completed the 1-month follow-up assessment. Baseline measures included the Chinese version of the 24-item 3D eHLS-Web3.0, the Chinese version of the 8-item unidimensional eHealth Literacy Scale (eHEALS), and demographic information. Follow-up measures included the 24-item eHLS-Web3.0 and accelerometer-measured physical activity and sedentary behavior. A series of statistical analyses, for example, Cronbach α, composite reliability coefficient (CR), confirmatory factor analysis (CFA), and multigroup CFA, were performed to examine the internal consistency and test-retest reliabilities, as well as the construct, concurrent, convergent, discriminant, and predictive validities, and the measurement invariance of the eHLS-Web3.0 across gender, education level, and residence. Cronbach α and CR were within acceptable ranges of 0.89-0.94 and 0.90-0.97, respectively, indicating adequate internal consistency of the eHLS-Web3.0 and its subscales. The eHLS-Web3.0 also demonstrated cross-time stability, with baseline and follow-up measures showing a significant intraclass correlation of 0.81-0.91. The construct validity of the 3D structure model of the eHLS-Web3.0 was supported by confirmatory factor analyses. The eHLS-Web3.0 exhibited convergent validity with an average variance extracted value of 0.58 and a CR value of 0.97. Discriminant validity was supported by CFA results for a proposed 4-factor model integrating the 3 eHLS-Web3.0 subscales and eHEALS. The predictive validity of the eHLS-Web3.0 for health behaviors was supported by significant associations of the eHLS-Web3.0 with light physical activity (β=.36, P=.004), moderate to vigorous physical activity (β=.49, P<.001), and sedentary behavior (β=-.26, P=.002). Finally, the measurement invariance of the eHLS-Web3.0 across gender, education level, and residence was supported by the establishment of configural, metric, strong, and strict invariances. The present study provides timely empirical evidence on the reliability, validity, and measurement invariance of the eHLS-Web3.0, suggesting that the 24-item 3D eHLS-Web3.0 is an appropriate and valid tool for measuring eHealth literacy among older adults with NCDs within the Web3.0 sphere.

Comparison of intradermal and serum testing for environmental allergen-specific immunoglobulin E determination in a laboratory colony of cats with naturally acquired atopic syndrome.

Allergen testing is used to select antigens included in the desensitisation vaccine. Intradermal skin test (IDT) is the gold standard in cats, yet allergen-specific immunoglobulin (Ig)E serological testing (ASIS) is often used. Feline data are lacking regarding the agreement between IDT and ASIS results. The first objective of the study was to establish a colony of cats with naturally acquired feline atopic syndrome (FAS). Further objectives were to define their hypersensitivity disorder to detail the allergen tests results, and to assess similarity between the allergen tests. Thirty-five cats with FAS and 10 control cats. Enrolled cats went through a five phase-screening and quarantine process before joining the colony. An elimination diet trial was performed on all FAS cats. ASIS and IDT were consecutively performed on all cats under sedation. Reactions to 34 allergens were compiled for the 45 cats. Global sensitivity and specificity of ASIS were 34.7% and 78.9%, respectively. Only flea (ICC = 0.26, p = 0.040) and Dermatophagoides pteronyssinus (ICC = 0.48, p < 0.001) allergens had a significant intraclass correlation (weak agreement). Two FAS cats had negative tests including one cat with a concomitant food allergy. This study depicts the first reported colony of cats with naturally acquired FAS. This is the first feline study to compare and show the poor agreement between allergen tests with a panel of 34 allergens. This colony also harbours two cats with FAS with negative allergen tests. These may represent the first described cats with an intrinsic form of atopic syndrome.

Can Non-Invasive Spectrophotometric Hemoglobin Replace Laboratory Hemoglobin Concentrations for Preoperative Anemia Screening? A Diagnostic Test Accuracy Study.

Preoperative assessment of hemoglobin concentration in blood is important to diagnose anemia. The primary aim of this prospective diagnostic test accuracy study was to monitor non-invasive spectrophotometric hemoglobin (SpHb, g/dL) concentrations among adults prior to elective surgery and to investigate the correlation and agreement of SpHb with laboratory hemoglobin (Hb, g/dl). A secondary aim was to identify the anemia cut-off values for SpHb based on the World Health Organization (WHO) definitions for anemia. This study included 151 consecutive patients (age ≥ 18 year) presenting for preoperative evaluation prior to scheduled elective general or orthopedic surgery. Results identified the mean ± SD of SpHb at 11.43 ± 2.01 g/dL, which underestimated the mean laboratory Hb (12.64 ± 2.29 g/dL, p < 0.001). A bias mean difference (SpHb-Hb) of -1.21 g/dL, with a SD of 1.76, was reported. This bias (SpHb-Hb) was inversely correlated with the mean Hb concentrations. A positive correlation existed between SpHb and Hb, with a good degree of reliability and a significant Intra Class Correlation (ICC). SpHb diagnosed anemia in 32.3% and 60.3% of males and females, respectively. The SpHb cut-off values to identify anemia were 11.3 and 10.2 g/dL for males and females, respectively, with a sensitivity of 83.3% for males and only 62.9% for females. The specificity for males and females were 81% and 91.3%, respectively. SpHb sensitivity allows for anemia diagnosis among males, but not females. However, the specificity allows SpHb to rule out anemia for both.

Psychometric properties of the controlling coach behaviors scale for Japanese athletes

Two studies examined the validity and reliability of the Japanese version of the Controlling Coach Behaviors Scale (CCBS). The CCBS is a multidimensional self-report measure designed to evaluate sports coaches’ controlling interpersonal style from the perspective of self-determination theory (SDT). It comprises 15 items measuring the controlling use of rewards, negative conditional regard, intimidation, and excessive personal control on a seven-point Likert scale. The study 1 sample comprised 526 university student-athletes (Mage = 19.59 years, SD = ±0.94, 364 females) who completed the Japanese CCBS, which was developed through back-translation. Confirmatory factor analyses provided support for the tenability of the hypothesized factor structure of the Japanese CCBS (CFI=.927; NNFI=.909; RMSEA=.079). Moreover, the results supported the invariance of the scale across sex, sport types, and competitive levels. The subscale internal consistency and discriminant validity scores were all acceptable. Test-retest reliability evidence was obtained in Study 2 (N=108), suggesting a positive and significant intraclass correlation between the pre-test and the post-test CCBS (ICC range: .65–.87). These findings support the Japanese CCBS as a valid and reliable measure for use in research which will enhance our understanding of coaches’ controlling interpersonal styles in sports.

Validity of the Italian adaptation of the Hearing Handicap Inventory for the Elderly (HHIE-It).

The aim of this study was to assess the validity and reliability of the Italian translation of the Hearing Handicap Inventory for the Elderly (HHIE). A sample of 275 adults, aged > 65 years, filled out the Italian version of the HHIE (HHIE-It) together with the MOS 36-Item Short Form Health Survey (SF-36). Seventy-one participants answered the questionnaire a second time after six weeks. The internal consistency, test-retest reliability, construct and criterion validity were evaluated. Cronbach's alpha was 0.94 and suggested a high internal consistency. There was also a significant intraclass correlation coefficient (ICC) between test and retest scores. In addition, Pearson's correlation coefficient between the two scores was high and significant. High and significant correlation coefficients were also found between the HHIE-It score and the pure tone average threshold of the better ear and between the HHIE-It and the subscales Role-emotional, Social Functioning and Vitality of the SF-36. These latter results indicate good construct and criterion validity, respectively. The HHIE-It maintained the reliability and validity of the English version suggesting its utility for both clinical and research purposes.

Controlled manufacturing of black and white flower-like dendritic micropattern tags for product unclonable security identification

Anti-counterfeiting tags with physical unclonable functions (PUFs) are critical for ensuring the security of products. In general, PUFs exhibit unique random physical patterns as a result of a stochastic minutiae that generates a large number of robust tags. In the current study, a novel flower-like dendritic micropattern security tag is created in rapid batch production by a simple one-step spray method and a comprehensive examination of the entire security identification system is conducted, from signage to literacy. A silicate condensation reaction was controlled to tune the morphology, resulting in six-class micropatterns with regular geometry. Additionally, the recognition feature of tags was derived directly from the shape contour and distribution characteristics of the pattern. Thus, the micropatterns have both stochastic minutiae and rule-based aspects. The unpredictability of the micropatterns’ size and position distribution contributes to the tags’ high robustness and the structural regularity has potential utility in error correction schemes. The article also discusses the mechanism involved in the formation and evolution of six-class patterns and conducts a systematic analysis of the mathematical foundation of the uniqueness of micropatterns. The experimental statistics indicate that, by appropriately limiting the deviation of the curing parameters and the image capture position, the production and identification of tags remain controllable and stable. Additionally, the tag identification exhibits significant intraclass correlation and interclass uncorrelation, indicating that they meet the requirements for high robustness of anti-counterfeiting tags. These tags have significant potential for application in security management of customized products, high-value goods and forensic purposes.

Validation of Eating Screen in Hindi: A Step Forward to Combat an Under-researched Menace of Eating Disorders in India

Abstract Background: A culturally appropriate tool to screen and diagnose eating disorders (EDs) is lacking in India. Aim: This study aims to translate, adapt, and validate ED Diagnostic Scale (EDDS) in Hindi. Methodology: Hindi translation of EDDS was done by three psychiatrists, two of whom were familiar with Western culture, their mother tongue being Hindi. The bilingual panel of experts, including three surgeons, one Professor in the English language, and one person with severe obesity (International English Language Testing System score Band 8.5) resolved translation inconsistencies. Back translation to the English language was done by an independent translator. Pretesting/focused-group discussion/cognitive interviewing was done in persons with severe obesity (n = 55). Hindi-version so-developed was administered to students (n = 120) after a week. Test–retest reliability was assessed. The original EDDS, Modified Weight Bias Internalization Scale (WBIS-M), and Fat Phobia Scale-Short Form (FPS-SF) were applied to 175 participants (students [n = 120], patients [n = 55]). The psychometric properties of Hindi-EDDS were investigated. Results: The mean age of students and patients was 18.60 and 43.38 years, respectively. Students and patients’ mean body mass index was 21.77 and 43.21 kg/m2, respectively. Kaiser–Meyer–Olkin and Bartlett’s Test of Sphericity for sample adequacy were 0.859 and χ2 = 3155.775; P = 0.000, respectively. The Spearman–Brown coefficient for Hindi-EDDS was 0.755 and 0.707, respectively. Internal consistency (Cronbach’s alpha and Kuder–Richardson - 20) was α = 0.898. Cross-language concordance had a significant intra-class correlation coefficient (0.725–1.000). WBIS-M and FPS-SF showed a significant correlation with various items of Hindi-EDDS. Conclusion: The Hindi EDDS is a culturally sensitive tool with acceptable psychometric properties.

Inventário de Sistemas e Estilos Parentais: Uma Medida para a Primeira Infância

Abstract The Component Model of Parenting (CMP), from an evolutionary perspective, proposes a phylogenetically evolved repertoire of six systems (body contact, body stimulation, face-to-face exchange, object stimulation, and primary care) and two parenting styles (distal and proximal) by combining some of these systems. We developed the Inventory of Parenting Systems and Styles (ISEP) and applied it to hospitals and schools to analyze its psychometric properties. The parenting measure analysis we propose evolved 70 primary caregivers of young children with a mean age of 22.44 months. ISEP consists of 26 daily situations and assesses the most common parenting practices caregivers adopted in each one of them. Besides, we created a Coding Guide to Parenting Practice. It enabled us to classify each response according to the CMP systems. We found a variance of 84.67% and 95.55% in codification agreement between expert judges and a significant intraclass correlation coefficient for all parenting systems, which discloses validity evidence on the response process of the inventory. Our analyses indicated the occurrence of all parental systems, with a prevalence of narrative envelope and body stimulation. Cluster analysis revealed two clusters, one formed by proximal style and another by distal style, in accordance with the interactions of the system, representing a validity of evidence based on the internal structure of the instrument. ISEP provides reasonable measures for research and professional practice in Psychology. Further research with more extensive and diverse samples is necessary to refine the instrument and, especially its guide.

Validation of pelvic magnetic resonance imaging as the method of choice to determine the distance to the anal margin in rectal cancer

IntroductionDistance from anal verge of rectal tumours and their anatomical relationships contribute to determine the multidisciplinary therapeutic strategy based on the combination of radio-chemotherapy and radical surgery. Our aims are to investigate which is the most accurate method for the preoperative measuring of the distance from the anal verge in rectal tumours and if the pelvic MRI can substitute the classical instrumental methods. MethodsProspective study of diagnostic precision between flexible colonoscopy (FC), preoperative rigid rectosigmoidoscopy (pRR) and pelvic MRI in patients scheduled to radical surgery. Rigid intraoperative rectoscopy (iRR) was considered the reference test. The correlations between the different techniques and their determination coefficient as well as the intraclass correlation coefficient and the degree of agreement between the different tests were analyzed. Results96 patients (65% males), mean age (SD): 68 (14.1) years were included. 72% received neoadjuvant treatment. The mean distance to the anal margin measured by FC = 103.5 mm, was significantly greater than others, which had similar values: pRR = 81.1; MRI = 77.4; iRR = 82.9 mm (P < .001). A significant intraclass correlation was observed and there was high agreement between all pre- and intraoperative measurements except for the performed by FC, which overestimated the results. MRI provided more individualized and accurate information. ConclusionsThere is variability between the measurement methods, being colonoscopy the least reliable. MRI offers objective, comparable, accurate and individualized values that can replace those obtained by pRR for tumours of any location in the rectum.

Reliability Of The Visual Analog Scale For Menstrual Cycle Symptoms And Impact On Perceived Performance

PURPOSE: Fluctuations in estrogen during the menstrual cycle are thought to reduce athletic performance and aerobic capacity, hence, the purpose of this study was to determine the reliability of a menstrual cycle survey that proposes to assess the presence of symptoms and the perceived impact on training within collegiate athletes. METHODS: Seven NCAA-Division I women swimmers (19 ± 1 years, 30.1 ± 4.1 BMI), who trained normally participated in this study during the collegiate swim season. Athletes completed an electronic Visual Analog Scale (VAS) assessing menstrual status, as well as the presence and impact of symptoms twice within 30 minutes. Responses were recorded by marking a point on a 100-point line anchored by “not at all” and “often” in response to the presence of menstrual symptoms or “not at all” and “severely impacted” in response to the impact of menstrual symptoms on their training. Test re-test data were analyzed using two-tailed dependent samples t-tests and Intraclass Correlation coefficients (ICC3,1). RESULTS: A significant Intraclass Correlation was observed without a difference between surveys for the presence of mood swings (ICC:0.913, p = 0.143), loneliness (ICC:0.835, p = 0.395), headaches (ICC:0.835, p = 0.057) backaches (ICC:0.958, p = 0.125) and bloating (ICC:0.878, p = 0.198). A significant Intraclass Correlation was also observed without a difference between surveys in the perceived effect on training for cramps (ICC:0.823 p = 0.383), breast pain (ICC:0.818, p = 0.214), and bloating (ICC:0.817, p = 0.857). A significant difference between surveys was observed for athletes’ feelings of anxiousness (ICC:0.896, p = 0.022) and restlessness (ICC:0.707, p = 0.010); as well as the perceived effect anxiety (ICC:0.934, p = 0.041) and backaches (ICC:0.966, p = 0.009) had on training. CONCLUSION: Initial results from this survey suggest an electronic VAS may be a reliable measurement tool for some symptoms, including the frequency of mood swings, loneliness, backaches, bloating and possibly headaches, as well as the perceived effect cramps, breast pain and bloating have on training. Future research should focus on validating the results of this study against performance measures of participants as well as testing the reliability of participants with prior experience completing an electronic VAS.

Reproducibility and Repeatability of Coronary Computed Tomography Angiography (CCTA) Image Segmentation in Detecting Atherosclerosis: A Radiomics Study.

Atherosclerosis is known as the leading factor in heart disease with the highest mortality rate among the Malaysian population. Usually, the gold standard for diagnosing atherosclerosis is by using the coronary computed tomography angiography (CCTA) technique to look for plaque within the coronary artery. However, qualitative diagnosis for noncalcified atherosclerosis is vulnerable to false-positive diagnoses, as well as inconsistent reporting between observers. In this study, we assess the reproducibility and repeatability of segmenting atherosclerotic lesions manually and semiautomatically in CCTA images to identify the most appropriate CCTA image segmentation method for radiomics analysis to quantitatively extract the atherosclerotic lesion. Thirty (30) CCTA images were taken retrospectively from the radiology image database of Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia. We extract 11,700 radiomics features which include the first-order, second-order and shape features from 180 times of image segmentation. The interest vessels were segmentized manually and semiautomatically using LIFEx (Version 7.0.15, Institut Curie, Orsay, France) software by two independent radiology experts, focusing on three main coronary blood vessels. As a result, manual segmentation with a soft-tissuewindowing setting yielded higher repeatability as compared to semiautomatic segmentation with a significant intraclass correlation coefficient (intra-CC) 0.961 for thefirst-order and shape features; intra-CC of 0.924 for thesecond-order features with p < 0.001. Meanwhile, the semiautomatic segmentation has higher reproducibility as compared to manual segmentation with significant interclass correlation coefficient (inter-CC) of 0.920 (first-order features) and a good interclass correlation coefficient of 0.839 for the second-order features with p < 0.001. The first-order, shape order and second-order features for both manual and semiautomatic segmentation have an excellent percentage of reproducibility and repeatability (intra-CC > 0.9). In conclusion, semi-automated segmentation is recommended for inter-observer study while manual segmentation with soft tissue-windowing can be used for single observer study.

Comparison of echocardiographic and catheter methods in the diagnosis of severe aortic valve stenosis

Purpose. 1. Assess the consistency of echocardiographic measurements with catheterization data in severe aortic stenosis. Assess if inter-method consistency improves after adjusting scores for the pressure recovery factor. To identify factors affecting the consistency of echocardiography and catheterization data. Materials and methods. Prospectively, 70 patients (mean age 72 ± 6 years, 38 females) have been included. All patient underwentcardiac catheterization with single-meter echoscanning of the parameters necessary to assess the severity of aortic valve stenosis before transcatheter aortic valve implantation. Inclusion criteria were isolated aortic stenosis (EOA &lt;1 cm2, Gmax ≥64 mm Hg, Gmean ≥40 mm Hg. Exclusion criteria were LV stroke volume index &lt;35 ml/m 2 and a reduced EF &lt;50%, concomitant nontrivial regurgitation of the aortic and mitral valves. Result. The linear regression method showed a weak correlation between the G max (Doppler) and P mean indices, r = 0.48, p = 0.001. Revealed high values of the average difference between the two methods in comparison with the Blent–Altman (SR 19 ± 17 mm Hg.) and low intraclasscorrelation values (ICC = 0.34). After adjusting the Gmax (Doppler) indices for the pressure recovery factor, the correlation between the methods r = 0.84, p ≤ 0.001, significantly improved. There was a decrease in the mean indices, the difference between the two HR methods was (3.15 ± 12 mm Hg.) with highly significant intraclasscorrelation values (ICC = 0.89). Similarly, a low correlation with high values of the average difference was observed when comparing EOA (Doppler) and EOA (catheterization) r = 0.55, p = 0.01, SR 0.21 ± 0.15 cm 2 , ICC = 0.53. With an improvement in the correlation between the methods after adjustment for the pressure recovery coefficient, r = 0.9, p ≤ 0.001, CP = 0.04 ± 0.08 cm 2 , ICC = 0.92. Comparison of Gmean (Doppler) indices with catheter Pmean has showed a high correlation between the methods, r = 0.7, p ≤ 0.001, there were relatively low indices of the average difference between the two methods of HR = 7.2 ± 22 mm Hg and a significant intraclass correlation (ICC = 0.72). The method of analysis of multiple regression revealed that the diameter of the sinotubular ridge was a significant factor affecting the correlation between echocardiography and catheterization data, OR 1.2 (CI 0.09; 2.9). Conclusions The maximum Doppler gradient (G max ) and the effective orifice area (EOA) have low consistency and weak correlation with catheterization data, in contrast to the average Doppler gradient (G mean ) which have a high consistency with catheterization data. After correcting for pressure recovery factor, there is a significant improvement in the consistency between G max and EOA with catheterization data. The diameter of the sinotobular junction is a significant factor influencing the consistency of echocardiography and catheterization data, which must be taken into account when assessing the severity of aortic stenosis.

Prof K C Dube Poster Award

Aim:To translate, adapt and validate Fat Phobia Scale- Short Form (FPS-SF) in Hindi.Methodology:World Health Organization (WHO) process of cultural adaptation of a tool was adopted. Hindi translation of EDDS was done by three psychiatrists, two of whom were familiar with western culture, their mother tongue being Hindi. The expert team was bilingual, including three surgeons, one Professor in the English language, one morbidly-obese person, and a psychiatrist with the past experience of cultural adaptation of tools, resolved inconsistencies in translations. Back translation to the English language was done by an independent translator. Morbidly-obese patients (n=55) seeking treatment from Metabolic Surgery Clinic at Lok Nayak Hospital, New Delhi were involved in pre-testing/focussed-group-discussion/cognitive-interviewing. Hindi-version so-developed was administered on undergraduate students (n=120) twice, separated by a week. Test-retest reliability was assessed. The Hindi-Fat Phobia Scale-Short Form (FPS-SF), original EDDS, and Modified Weight Bias Internalization Scale (WBIS-M), and were applied on 175 participants [students (n=120), patients (n=55)]. Psychometric properties were analyzed.Results:The mean age and Body-Mass Index (BMI) of students and patients were 18.60 and 43.38 years; and 21.77 and 43.21Kg/m2, respectively. The sample size according to the Kaiser-Meyer-Olkin test and Bartlett’s Test of Sphericity was adequate for exploratory factor analysis (KMO-test=0.708 and χ2=1470.52;p=0.000). Internal consistency, Guttman split-half reliability was λ-2=0.838. Intra-class correlation coefficient 0.799(95%CI=0.753-0.840)(p-value=0.000). Cross-language concordance had significant intra-class correlation coefficient (0.877-0.986)(p-value=0.000).Discussion:Fat phobia has detrimental consequences on physical and mental health. Hence, it is pertinent to measure.Conclusion:The Hindi-FPS-SF has good psychometric properties and may be used for epidemiological purposes in India.

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Background:A culturally appropriate tool to screen and diagnose Eating Disorders (EDs) is lacking in India.Aim:To translate, adapt and validate Eating Disorder Diagnostic Screen (EDDS) in Hindi.Methods:World Health Organization (WHO) process of translation and adaptation of instruments was used. Hindi translation of EDDS was done by three psychiatrists, two of whom were familiar with western culture, their mother tongue being Hindi. The bilingual panel of experts, including three surgeons, one Professor in English language, one morbidly-obese person [with International English Language Testing System (IELTS) score Band 8.5] resolved inconsistencies in translations. Back translation to the English language was done by an independent translator. Pre-testing/focussed-group-discussion/cognitive-interviewing was done in morbidly-obese patients (n=55). Hindi-version so-developed was administered on students (n=120) after a week. Test-retest reliability was assessed. The original EDDS, Modified Weight Bias Internalization Scale (WBIS-M), and Fat Phobia Scale-Short Form (FPS-SF) were applied on 175 participants [students (n=120), patients (n=55)]. Psychometric properties of Hindi-EDDS were investigated.Results:The mean age of students and patients were 18.60 and 43.38 years, respectively. The mean Body-Mass Index (BMI) of students and patients was 21.77 and 43.21Kg/m2, respectively. Kaiser-Meyer-Olkin test and Bartlett’s Test of Sphericity for sample adequacy was 0.859 and χ2=3155.775;p=0.000, respectively. Spearman-Brown coefficient for Hindi-EDDS was 0.755 and 0.707, respectively. Internal consistency (Cronbach’s alpha and Kuder–Richardson 20) was α=0.898. Cross-language concordance had significant intra-class correlation coefficient (0.725-1.000). WBIS-M and FPS-SF showed a significant correlation with various items of Hindi-EDDS.Conclusion:The Hindi-EDDS is culturally-sensitive tool with acceptable psychometric properties.

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Background:The Fat Phobia Scale- Short Form (FPS-SF) is widely used to measure negative attitudes towards obese individuals.Aim:To translate, adapt and validate FPS-SF in Hindi.Methods:World Health Organization (WHO) process of cultural adaptation of a tool was adopted. Hindi translation of EDDS was done by three psychiatrists, two of whom were familiar with western culture, their mother tongue being Hindi. The expert team was bilingual, including three surgeons, one Professor in the English language, one morbidly-obese person, and a psychiatrist with the past experience of cultural adaptation of tools, resolved inconsistencies in translations. Back translation to the English language was done by an independent translator. Morbidly-obese patients (n=55) seeking treatment from Metabolic Surgery Clinic at Lok Nayak Hospital, New Delhi were involved in pre-testing/focused-group-discussion/cognitive-interviewing. Hindi-version so-developed was administered on undergraduate students (n=120) twice, separated by a week. Test-retest reliability was assessed. The Hindi-Fat Phobia Scale-Short Form (FPS-SF), original EDDS, and Modified Weight Bias Internalization Scale (WBIS-M), were applied on 175 participants [students (n=120), patients (n=55)]. Psychometric properties were analyzed.Results:The mean age and Body-Mass Index (BMI) of students and patients were 18.60 and 43.38 years; and 21.77 and 43.21Kg/m2, respectively. The sample size according to the Kaiser-Meyer-Olkin test and Bartlett’s Test of Sphericity was adequate for exploratory factor analysis (KMO-test=0.708 and χ2=1470.52;p=0.000). Internal consistency, Guttman split-half-reliability, λ-2=0.838. Intra-class correlation coefficient 0.799(95%CI=0.753-0.840)(p-value=0.000). Cross-language concordance had significant intra-class correlation coefficient (0.877-0.986)(p-value=0.000).Conclusion:The Hindi-FPS-SF has good psychometric properties and may be used for epidemiological purposes in India.

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Background:The Fat Phobia Scale- Short Form (FPS-SF) is widely used to measure negative attitudes towards obese individuals.Aim:To translate, adapt and validate FPS-SF in Hindi.Methods:World Health Organization (WHO) process of cultural adaptation of a tool was adopted. Hindi translation of EDDS was done by three psychiatrists, two of whom were familiar with western culture, their mother tongue being Hindi. The expert team was bilingual, including three surgeons, one Professor in the English language, one morbidly-obese person, and a psychiatrist with the past experience of cultural adaptation of tools, resolved inconsistencies in translations. Back translation to the English language was done by an independent translator. Morbidly-obese patients (n=55) seeking treatment from Metabolic Surgery Clinic at Lok Nayak Hospital, New Delhi were involved in pre-testing/focused-group-discussion/cognitive-interviewing. Hindi-version so-developed was administered on undergraduate students (n=120) twice, separated by a week. Test-retest reliability was assessed. The Hindi-Fat Phobia Scale-Short Form (FPS-SF), original EDDS, and Modified Weight Bias Internalization Scale (WBIS-M), were applied on 175 participants [students (n=120), patients (n=55)]. Psychometric properties were analyzed.Results:The mean age and Body-Mass Index (BMI) of students and patients were 18.60 and 43.38 years; and 21.77 and 43.21Kg/m2, respectively. The sample size according to the Kaiser-Meyer-Olkin test and Bartlett’s Test of Sphericity was adequate for exploratory factor analysis (KMO-test=0.708 and χ2=1470.52;p=0.000). Internal consistency, Guttman split-half-reliability, λ-2=0.838. Intra-class correlation coefficient 0.799(95%CI=0.753-0.840)(p-value=0.000). Cross-language concordance had significant intra-class correlation coefficient (0.877-0.986)(p-value=0.000).Conclusion:The Hindi-FPS-SF has good psychometric properties and may be used for epidemiological purposes in India.

Prof K C Dube Poster Award

Aim:To translate, adapt and validate Eating Disorder Diagnostic Screen (EDDS) in Hindi.Methodology:World Health Organization (WHO) process of translation and adaptation of instruments was used. Hindi translation of EDDS was done by three psychiatrists, two of whom were familiar with western culture. All of them were literate in English, their mother tongue being Hindi. The bilingual panel of experts, including three surgeons, one Professor in English language, one morbidly-obese person [with International English Language Testing System (IELTS) score Band 8.5, familiar with both western and Indian cultures] together identified and resolved inadequate expressions of translations or discrepancies. Back translation to the English language was done by an independent translator, whose mother tongue was English. Pre-testing, focussed-group-sessions/cognitive-interviewing was done in morbidly-obese patients (n=55). Hindi-version so-developed was administered on students (n=120) after a week. Test-retest reliability was assessed. The original EDDS, Modified Weight Bias Internalization Scale (WBIS-M), and Fat Phobia Scale-Short Form (FPS-SF) were applied on 175 participants [students (n=120), patients (n=55)]. Psychometric properties of Hindi-EDDS were investigated.Results:The mean age of students and patients were 18.60 and 43.38 years, respectively. The mean Body-Mass Index (BMI) of students and patients was 21.77 and 43.21Kg/m2, respectively. Kaiser-Meyer-Olkin test and Bartlett’s Test of Sphericity for sample adequacy was 0.859 and χ2=3155.775; p=0.000, respectively. Spearman-Brown and Guttman Split-Half coefficient for Hindi-EDDS was 0.755 and 0.707, respectively. Internal consistency (Cronbach’s alpha and Kuder–Richardson 20) was α=0.898. Cross-language concordance had significant intra-class correlation coefficient (0.725-1.000). WBIS-M and FPS-SF showed a significant correlation with various items of Hindi-EDDS.Discussion:A culturally appropriate tool to screen and diagnose EDs is lacking in India. The Hindi-version of EDDS is culturally sensitive and has acceptable psychometric properties on the basis of standard tests.Conclusion:Hindi-EDDS may be used to estimate various epidemiological parameters of EDs in India.

Step detection and energy expenditure at different speeds by three accelerometers in a controlled environment

Physical activity (PA) is one of the most efficient ways to prevent obesity and its associated diseases worldwide. In the USA, less than 10% of the adult population were able to meet the PA recommendations when accelerometers were used to assess PA habituation. Accelerometers significantly differ from each other in step recognition and do not reveal raw data. The aim of our study was to compare a novel accelerometer, Sartorio Xelometer, which enables to gather raw data, with existing accelerometers ActiGraph GT3X+ and activPAL in terms of step detection and energy expenditure estimation accuracy. 53 healthy subjects were divided into 2 cohorts (cohort 1 optimization; cohort 2 validation) and wore 3 accelerometers and performed an exercise routine consisting of the following speeds: 1.5, 3, 4.5, 9 and 10.5 km/h (6 km/h for 2nd cohort included). Data from optimization cohort was used to optimize Sartorio step detection algorithm. Actual taken steps were recorded with a video camera and energy expenditure (EE) was measured. To observe the similarity between video and accelerometer step counts, paired samples t test and intraclass correlation were used separately for step counts in different speeds and for total counts as well as EE estimations. In speeds of 1.5, 3, 4.5, 6, 9 and 10.5 km/h mean absolute percentage error (MAPE) % were 8.1, 3.5, 4.3, 4.2, 3.1 and 7.8 for the Xelometer, respectively (after optimization). For ActiGraph GT3X+ the MAPE-% were 96.93 (87.4), 34.69 (23.1), 2.13 (2.3), 1.96 (2.6) and 2.99 (3.8), respectively and for activPAL 6.55 (5.6), 1.59 (0.6), 0.81 (1.1), 10.60 (10.3) and 15.76 (13.8), respectively. Significant intraclass correlations were observed with Xelometer estimates and actual steps in all speeds. Xelometer estimated the EE with a MAPE-% of 30.3, activPAL and ActiGraph GT3X+ with MAPE percentages of 20.5 and 24.3, respectively. The Xelometer is a valid device for assessing step counts at different gait speeds. MAPE is different at different speeds, which is of importance when assessing the PA in obese subjects and elderly. EE estimates of all three devices were found to be inaccurate when compared with indirect calorimetry.

Validación de la resonancia magnética pélvica como método de elección para determinar la distancia al margen anal en el cáncer de recto

IntroductionDistance from anal verge of rectal tumors and their anatomical relationships contribute to determine the multidisciplinary therapeutic strategy based on the combination of radio-chemotherapy and radical surgery. Our aims are to investigate which is the most accurate method for the preoperative measuring of the distance from the anal verge in rectal tumors and if the pelvic MRI can substitute the classical instrumental methods. MethodsProspective study of diagnostic precision between flexible colonoscopy (FC), preoperative rigid rectosigmoidoscopy (pRR) and pelvic MRI in patients scheduled to radical surgery. Rigid intraoperative rectoscopy (iRR) was considered the reference test. The correlations between the different techniques and their determination coefficient as well as the intraclass correlation coefficient and the degree of agreement between the different tests were analyzed. Results96 patients (65% males), mean age (SD): 68 (14.1) years were included. 72% received neoadjuvant treatment. The mean distance to the anal margin measured by FC=103.5mm, was significantly greater than others, which had similar values: pRR=81.1; MRI=77.4; iRR=82.9mm (P<.001). A significant intraclass correlation was observed and there was high agreement between all pre- and intraoperative measurements except for the performed by FC, which overestimated the results. MRI provided more individualized and accurate information. ConclusionsThere is variability between the measurement methods, being colonoscopy the least reliable. MRI offers objective, comparable, accurate and individualized values that can replace those obtained by pRR for tumors of any location in the rectum.

Validity and reliability of 2-min step test in patients with symptomatic peripheral artery disease

Although 2-min step test (2MST) has been useful in general population, no study has investigated its validity in patients with peripheral artery disease (PAD). To analyze the validity and reliability of the 2MST in patients with PAD and claudication symptoms. Twenty-four patients with PAD and claudication symptoms were recruited and performed the 2MST comparing it to the six-minute walk test (6MWT). Test performance, step indicators, and heart rate were measured during the test. Validity was verified using Pearson correlation between the performance of 2MST (number of steps) and 6MWT (distance and number of steps). The reliability was analyzed by the intraclass correlation coefficient and by the limits of agreement of Bland and Altman. A similar performance was observed between the two 2MST (65 ± 10 steps vs. 66 ± 10 steps, p = 0.43) with a significant intraclass coefficient correlation of 0.945. The bias between tests was of 0.79 steps with the limits of agreement between -9.6 and 11.2 steps. The 90% minimum detectable difference was 3.2 steps. The number of steps in 2MST was significantly correlated with the number of steps in 6MWT (r = 0.55, p<0.01). However, the number of steps in 2MST did not correlate with distance in the 6MWT (r = 0.26, p = 0.23). The peak heart rate was lower in 2MST compared to 6MWT (p<0.05). The 2MST present adequate reliability and validity in patients with symptomatic PAD.