Translation Guidelines Research Articles

Translation, cross-cultural adaptation and validation of the Persian version of the physical workload questionnaire (PWQ)

BackgroundMusculoskeletal disorders in manual workers are often linked to physical workload factors such as heavy lifting, repetitive movements, and awkward postures. These factors can negatively impact health and work efficiency. Simple tools like questionnaires are essential for studying physical workload. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Physical Workload Questionnaire for Persian-speaking populations (PWQ-Pr).MethodsThe study involved 255 participants and followed standard guidelines for translation and cultural adaptation. Various psychometric properties were assessed, including face validity through interviews, construct validity via hypothesis testing and factor analysis, content validity using the Content Validity Index (CVI), convergent validity through Pearson’s correlation with the Spine Functional Index (SFI), internal consistency using Cronbach’s alpha, and test-retest reliability assessed through the intra-class correlation coefficient (ICC) and standard measurement error over a 10-day period.ResultsGood internal consistency (α = 0.89) and high test-retest reliability (ICC = 0.90, 95% confidence interval: 0.81–0.94) were obtained. Convergent validity was indicated by a correlation of r = 0.41 (P < 0.001) with the SFI questionnaire. Content Validity (CVI = 0.93) was approved. Factor analysis identified two distinct factors within the PWQ-Pr, explaining 52.07% of the variance. Hypothesis testing indicated significant differences in physical workload across job types and among individuals with and without spinal musculoskeletal disorders (MSDs), with eight hypotheses confirmed out of twelve tested.ConclusionsThe Persian version of the Physical Workload Questionnaire (PWQ-Pr) is a reliable and valid tool for assessing physical workload among Persian-speaking individuals. It is effective in evaluating workload across various job tasks.

Nanoemulsion: A Promising Nanotechnology Tool to Achieve the Unmet Oral Bioavailability Enhancement Needs

Background: Low oral permeability and low aqueous solubility are considered significant obstacles in achieving systemic therapeutic concentration to show optimum pharmacological response. Pharmaceutical scientists endeavored to overcome the above-stated problem after utilizing various approaches like salt formation, pro-drugs, co-solvency, complexation, solubilization, pH adjustment, sold dispersion, hydrotrophy, and nanotechnology-based techniques. Objective: Among these approaches, nanotechnology-based drug carrier systems have been investigated to address the challenges of the drugs exhibiting poor oral absorption. Essentially, these systems have the potential to overcome the limitations associated with the oral route of drug administration. Among various nano-technological tools, nanoemulsion plays an important role in the bioavailability enhancement of biopharmaceutical classification system Class II, and Class IV drugs, in general and, Class III, in particular. Method: A nanoemulsion is a colloidal system with a size in nanometers, an increased fraction of the dispersed phase, and intensified transparency. Either water is dispersed in oil (w/o type) or oil is dispersed in water (o/w type), and it has a longer shelf life. Results: Nanoemulsion is being utilized as an important drug carrier for bioavailability enhancement; however, it poses some challenges, such as clinical translation, large-scale manufacturing, and regulatory guidelines. Conclusion: The current review aims to compile and discuss the problems faced in the delivery of drugs exhibiting poor oral absorption, challenges faced in oral drug delivery, oral absorption enhancement techniques, mechanism of oral uptake using nanoemulsion, various modifications of nanoemulsion, clinical status, large-scale manufacturing, regulatory status, and new prospects in the future.

Lyell’s Views of Translation in the Perspective of Thick Translation—Cat Country as an Example

As China’s first science fiction novel, Lao She’s satirical novel Cat Country has been welcomed by readers as soon as it was released in its first English translation. The success of this novel’s foreign translation cannot be separated from the translator William Lyell’s “thick translation”. By describing the explicit and implicit thick translation methods of Lyell’s translation of Cat Country, analyzing the translator’s thick translation skills under the characterization of thick translation, the principle of truth-seeking in translating culture, and the translation guideline of serving the readers of the translated language, the article reveals the basic rationale of the successful translation of Lyell’s translation, which will serve as a reference for the foreign translation of Chinese literature, and better serve the translation practice and theoretical construction.

Ferroptosis: A novel cell death modality as a synergistic therapeutic strategy with photodynamic therapy.

Although there has been significant progress in current comprehensive anticancer treatments centered on surgery, postoperative recurrence and tumor metastasis still significantly affect both prognosis and quality of life of the patient. Hence, the development of precisely targeted tumor therapies and exploration of immunotherapy represent additional strategies for tumor treatment. Photodynamic therapy (PDT) is a relatively safe treatment modality that not only induces multiple modes of tumor cell death but also mediates the secondary immunological responses against tumor resistance and metastasis. Ferroptosis, an iron-dependent type of programmed cell death characterized by accumulation of reactive oxygen species and lipid peroxidation products to lethal levels, has emerged as an attractive target trigger for tumor therapies. Recent research has revealed a close association between PDT and ferroptosis, suggesting that combining ferroptosis inducers with PDT could strengthen their synergistic anti-tumor efficiency. Here in this review, we discuss the rationale for combining PDT with ferroptosis inducers and highlight the progress of single-molecule photosensitizers to induce ferroptosis, as well as the applications of photosensitizers combined with other therapeutic drugs for collaborative therapy. Furthermore, given the current research dilemma, we propose potential therapeutic strategies to advance the combined usage of PDT and ferroptosis inducers, providing the basis and guidelines for prospective clinical translation and research directionality with regard to PDT.

Validity and Reliability of the Korean Version of Supportive Care Needs Survey-Short Form 34 for Patients with Cancer: A Methodological Study.

The Supportive Care Needs Survey-Short Form 34 (SCNS-SF34) measures the perceived care needs of patients with cancer. This study aimed to evaluate the reliability and validity of the Korean version of the SCNS-SF34 (i.e., the SCNS-SF34-K). The SCNS-SF34 was translated into Korean following a World Health Organization translation guideline. We recruited 208 patients with cancer via an online survey in 2022. The data were analyzed using SPSS 27.0 and Amos 23.0, and the construct validity, known-group validity, and internal consistency were tested. The SCNS-SF34-K validated the final five-factor model via confirmatory factor analysis. The SCNS-SF34-K's subscales demonstrated discriminant and convergent validity. In addition, known-group validity was confirmed using the Eastern Cooperative Oncology Group Performance Status Scale (t = - 7.12), Patient Health Questionnaire-9 (t = - 7.61), and Distress Thermometer (t = - 9.22). McDonald's Omega coefficient for the total scale was .96, and each sub-domain ranged from .88 to .95. This research provides initial findings on the validity and reliability of the SCNS-SF34-K, a tool for measuring the supportive care needs of Korean cancer patients. The SCNS-SF34-K demonstrates potential for evaluating various aspects of patient needs and may be valuable for both clinical oncology practice and research in Korea.

The nursing shared decision making attitude scale: A translation and psychometric evaluation study

BackgroundNurses have an increasingly important role in the ‘shared decision-making’ process. Knowledge about attitudes can facilitate the implementation process of the different roles of nurses in shared decision-making. However, no specific instrument is available in Dutch to assess Dutch nurses' attitudes towards shared decision-making. AimThis study aims to translate the Nursing Shared Decision Attitude scale into Dutch and evaluate its psychometric properties. DesignPsychometric evaluation study. SettingsA general hospital in the Netherlands. ParticipantsA random sample of 128 nurses. MethodsThe translation was performed using translation and cross-cultural guidelines. Experts assessed content validity. In a cross-sectional study, 128 nurses completed the Dutch Nursing Shared Decision Attitude scale. The factor structure of the Dutch Nursing Shared Decision Attitude scale was determined by principal components analysis. Internal consistency and standard error of measurement (SEM) were assessed. A first and simple hypothesis for construct validity was tested. ResultsExperts rated content validity as adequate. The principal components analysis revealed a 2-factor structure as most suitable (Empathic communication and Mastery learning) consistent with the original Nursing Shared Decision Attitude scale. The explained variance was 55 %. The internal consistency was 0.84 and 0.78 for the subscales and the SEM was 1,65. The mean score on the Dutch Nursing Shared Decision Attitude scale was 46,4 (CI: 42.77–49.23). A first and simple hypothesis that more experience in shared decision-making would lead to higher shared decision-making scores on the Dutch Nursing Shared Decision Attitude scale, could not be confirmed. Conclusion and innovationThis study fills in a gap concerning available instruments to assess attitudes towards SDM among nurses since there is no instrument available for the Dutch population.The results of this study are a first and somewhat promising step towards further developing the reliability and validity of the Dutch Nursing Shared Decision Attitude scale as a measure of hospital nurses' attitudes towards shared decision-making. Such measurement information is relevant to researchers and nurses involved in the implementation of shared decision-making in nursing practice.

GUIDELINES FOR THE PROCESS OF CROSS-CULTURAL ADAPTATION AND TRANSLATION OF THERAPEUTIC MODULES

Background: Language is a very important aspect for the adaptation and translation process. For many people, their native language is not just a means of communication but a vessel of cultural identity and emotional expression. When individuals are experiencing the difficulties of life, they should have the chance to address them using a language that truly connects with their personal experiences. Adapting and translating therapeutic modules to align with cross-cultural settings is important to ensure effectiveness and practicality among different populations. The objective of this article is to provide the guidelines for the process of cross-cultural adaptation and translation-back-translation of the therapeutic modules, and also provide the guidelines to test the reliability and validity of the translated version of therapeutic modules. Method. The Back-to-Back translation model (10) was used in this study for the guidelines of adaptation and translation of therapeutic modules. Following the instructions in this document made the process of adaptation and translation simpler. Results. Results showed that the (10) is a significant model and provided a systematic and comprehensive way for adaptation and translation of therapeutic module with make little changes in reaction to feedback and cultural awareness. Conclusion. At the end, it emphasised how important it is to conduct an extensive study to determine the effectiveness and cultural compatibility of the updated modules. However, these principles ultimately enhance effective and inclusive health care, providing health professionals with a foundation for adapting and translating therapeutic processes to diverse cultural conditions.

Validation analysis of Polish version of Neuropathic Pain Questionnaire - Short Form (NPQ-SF-PL) and assessment of quality of life in patients with chronic neuropathic pain.

The aims of this study were to translate and culturally adapt the Polish version (PL) of the Neuropathic Pain Questionnaire-Short Form (NPQ-SF), as well as to compare this questionnaire to other diagnostic tools in terms of reliability and psychometric validity. Neuropathic pain (NP) affects up to 10% of the general population. Despite a large number of studies, almost 50% of patients have a poor therapeutic outcome. Diagnostic tools are intended to distinguish between NP and non-NP (NoP) and to guide the examiner to perform further diagnostics in accordance with the guidelines. A total of 140 patients with chronic pain (ChP), 90 with NP and 50 with NoP, were enrolled into this study. NPQ-SF-PL has been developed following the guidelines for translation and cultural adaptation. Reliability of the translated version was examined using internal consistency, predictive validity, and intraclass correlation coefficient (ICC). In the study, women predominated over men, and the average age was 53.22. Cronbach's α value for the entire scale was 0.76 and ICC for test-retest reliability was 0.631. Receiver-operating characteristic curve analysis gave a sensitivity of 90.0% and a specificity of 88.0%. Area under the curve was 0.94. NPQ-SF-PL was moderately associated with self-completed Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and weakly associated with the Numerical Rating Scale (NRS). The NP group obtained statistically significantly lower scores than the NoP group in all domains of the 36-Item Short Form Health Survey (SF-36), thus indicating worse health status. Patients aged over 41 years presented a worse quality of life compared to younger ones. Also, more than half of the patients with NP of both genders experienced symptoms of mild or more severe depression. NPQ-SF-PL is a valid screening tool for assessing NP in Polish chronic pain patients. The obtained results showed very good psychometric properties and adequate internal consistency. The repeatability of the questionnaire indicated moderate reliability. Clinical implications/future directions. We believe this study will provide physicians with a new instrument for the evaluation of NP for clinical and research purposes.

Translation and cross-cultural adaptation of the self evaluation of breathing questionnaire (SEBQ) into Danish

ABSTRACT Background and Purpose Dysfunctional breathing (DB) with or without an underlying medical condition is associated with impaired quality of life. DB-related symptoms can be measured with the 25-item Self Evaluation of Breathing Questionnaire (SEBQ). However, the SEBQ is not available in Danish.The aim of the present study was to translate and cross-culturally adapt the SEBQ into Danish and to assess the face validity of the Danish version of the questionnaire in individuals with DB-related symptoms. Materials and Methods The SEBQ was translated and cross-culturally adapted into Danish using an internationally acknowledged six-step forward-backward translation guideline in an interactive process with an expert committee of clinicians, translators, methodologists and the SEBQ developer. Face validity was explored through semi-structured interviews with 24 adult individuals with DB-related symptoms (age 20–70 years, female n = 14). Results The SEBQ was successfully translated and cross-culturally adapted into Danish. Three major modifications were made following the translation process and participant interviews. First, an introductory paragraph, including a recall period of the previous seven days, was added. Second, the administration of the questionnaire was changed from a paper to an electronic version. Finally, adaptations regarding semantic equivalence, especially concerning being ‘breathless’ and ‘short of breath’, were performed. The participants expressed that the final version of the SEBQ embraced their DB-related symptoms, was understandable, and easy to complete. Conclusion The SEBQ is the first available Danish questionnaire to measure DB-related symptoms, following an internationally acknowledged cross-cultural adaptation and face validity evaluation approach. This promising validation should be followed by an assessment of measurement properties in individuals with DB-related symptoms to investigate the adequacy of the SEBQ in a Danish context.

Cross-cultural adaptation and validation to Spanish of the PANELVIEW instrument to evaluate the health guidelines development process

ObjectivesThe PANELVIEW questionnaire identifies the strengths and weaknesses of the process and methods used for developing health guidelines from the guideline development group's perspective. To expand its use, PANELVIEW ideally should be available in different languages. We aimed to cross-culturally adapt PANELVIEW into Spanish and assess its acceptability, validity, and reliability. Study Design and SettingTo translate and culturally adapt PANELVIEW to Spanish, we followed International Society for Pharmacoeconomics and Outcomes Research's Translation and Cultural Adaptation Good Practice Principles guidelines. The process consisted of 1) forward and back translation, 2) input from an expert panel, and 3) cognitive debriefing interviews. We assessed the content validity with experts in guideline development who rated instrument items for relevance to determine the item content validity index and scale content validity index (I-CVI and S-CVI). We tested the reliability with health guidelines panels from Spanish-speaking countries and measured internal consistency (Cronbach's alpha). We examined acceptability through the number of missing responses for each item. ResultsThe content comparison between the back-translation and the original version showed that most items (24/34) were conceptually equivalent but with grammatical differences. Through the cognitive interviews, we identified six items with wording issues, ten with clarity issues, and two with applicability issues. I-CVI ranged from 0.77 to 1.00, with two items needing revision. S-CVI was 0.92, showing excellent content validity. The PANELVIEW Spanish version demonstrated very good reliability (Cronbach's alpha coefficient of 0.96). Panel members responded to all items, showing good acceptability. ConclusionThe PANELVIEW Spanish version was conceptually equivalent to the original version and provided satisfactory evidence of acceptability, validity and reliability.

Translation and Comprehensive Validation of the Hebrew Survey on Patient Safety Culture (HSOPS 2.0).

The study aim was to create an updated valid translation into Hebrew of the AHRQ's survey on patient safety culture for hospitals, version 2.0. It also suggested a supplementary section about workers' safety. Comparable and valid measurement tools are important for national and international benchmarking of patient safety culture in hospitals. The process was carried out by a designated committee according to AHRQ translation guidelines. Methodology included several translation cycles, 6 semistructured cognitive interviews with health workers, and a web-based pilot survey at 6 general hospitals. Main analyses included an exploratory factor analysis, a comparison of the differences in results between versions 1 and 2 of the survey to the differences reported by AHRQ, and content analysis of open-ended questions. A total of 483 returned questionnaires met the inclusion criterion of at least 70% completion of the questionnaire. The demographic distributions suggested this sample to be satisfactory representative. Cronbach's alpha for the translated questionnaire was 0.95, meaning a high internal consistency between the survey items. An exploratory factor analysis revealed 8 underlying factors, and a secondary analysis further divided the first factor into 2 components. The factors structure generally resembled HSOPS 2.0 composite measures. Analyses of the new section about health workers' safety showed high involvement and possible common themes. The study demonstrated good psychometric properties-high reliability and validity of the new translated version of the questionnaire. This paper may serve other countries who wish to translate and adapt the safety culture survey to different languages.

TRANSLATION AND VALIDATION OF URDU VERSION OF BRIEF DISSOCIATIVE EXPERIENCE SCALE FOR SUBSTANCE USE DISORDER IN PAKISTAN

Objective Dissociation is a ubiquitous construct in psychology and is of high clinical relevance. The objective of this study was to translate and validate the Brief Dissociative Experience Scale (DES-B) in the Urdu language for individuals with substance use disorder (SUD). DesignThis was a cross sectional study. Place and Duration of StudyThe study was conducted with a sample of 200 individuals with SUD aged 18 and above from drug rehabilitation centres across Pakistan between July to November 2023. MethodsThis study utilized a rigorous procedure of Mapi guidelines for translation and validation of DES-B. The validation of DES-B was determined through confirmatory factor analysis. ResultsThe data was analyzed using SPSS and AMOS software and factor structure, internal consistency, composite reliability, and convergent validity of the scale were determined. Of the 200 participants, 79.0% were male. The mean age of the participants was 30.61 years (SD = 8.87) with a range between 18 to 65. The findings indicated a good model fit for a one-factor structure with 8 items (χ²/df = 2.61, p &lt; 0.00, RMSEA = 0.089, CFI = 0.908, GFI = 0.944). Moreover, the composite reliability (CR = .77), convergent validity (AVE = .31), and internal consistency (α =.76) showed favorable results. Overall, the Urdu version of DES-B demonstrated acceptable results in terms of the construct’s validity and reliability. ConclusionThe Urdu version of DES-B can be used as a reliable and valid tool to assess dissociative experiences in individuals with SUD suitable for research and clinical settings.

Translation, cross-cultural adaptation and validation of psychometric properties of foot function index in Urdu-speaking population with ankle and foot disorders

BackgroundFoot and ankle problems are frequently prevalent, especially among the elderly, ranging from 70 to 80%. In primary care, foot, and ankle complaints stand out as one of the most frequent reasons for orthopedic consultations. Patient-reported outcome measures are significant in the assessment burden of any condition on the effects of intervention as well as research. The Foot Function Index (FFI) is a region-specific tool that was identified as one of the most commonly used evaluation tools for foot complaints. This study aimed to translate, cross-cultural adapt, and test the psychometric properties of FFI in the Urdu language.MethodologyThe FFI was translated into Urdu language (FFI-U) following Beaton et al. translation guidelines. The data were collected from 230 Urdu-speaking participants with different foot and ankle pathologies. Data collection started after the written informed consent from the participants. All participants completed the FFI-U, Visual Analogue Scale (VAS), SF-36, and the Foot and Ankle Outcome Score (FAOS) at baseline while only 30 participants completed ULFI-U after one week for test-retest reliability. The psychometric properties involved reliability and validity testing. Reliability was assessed where internal consistency was measured using Cronbach’s alpha and test-retest reliability through the intra-class correlation coefficient (ICC). FFI-U was tested for face validity and construct validity (convergent and discriminant). Psychometric criteria were examined against priori hypotheses, and alpha level (p-value < 0.05) was considered statistically significant.ResultsFFI-U demonstrated good reliability with internal consistency (α = 0.86) and test-retest reliability with intra-class correlation coefficient = 0.845 (0.78–0.89). A moderate correlation was found using Pearson correlation between FFI-U total score and physical components of SF-36, VAS (pain, disability), and FAOS (γ= -0.65, 0.72, 0.71, -0.68) respectively, indicating convergent validity however, a weak correlation was found with mental components of SF-36 (γ=-0.25) demonstrating discriminant validity. Face validity was assessed at the pre-final testing stage by interviewing patients. There were no floor and ceiling effects found for FFI-U.ConclusionThe FFI-U has been found reliable, valid, and feasible tool to be used as a patient-reported outcome measure to assess functional levels with different foot and ankle disorders in Urdu speaking population.

Neuropsychological application of the International Test Commission Guidelines for Translation and Adapting of Tests.

The number of test translations and adaptations has risen exponentially over the last two decades, and these processes are now becoming a common practice. The International Test Commission (ITC) Guidelines for Translating and Adapting Tests (Second Edition, 2017) offer principles and practices to ensure the quality of translated and adapted tests. However, they are not specific to the cognitive processes examined with clinical neuropsychological measures. The aim of this publication is to provide a specialized set of recommendations for guiding neuropsychological test translation and adaptation procedures. The International Neuropsychological Society's Cultural Neuropsychology Special Interest Group established a working group tasked with extending the ITC guidelines to offer specialized recommendations for translating/adapting neuropsychological tests. The neuropsychological application of the ITC guidelines was formulated by authors representing over ten nations, drawing upon literature concerning neuropsychological test translation, adaptation, and development, as well as their own expertise and consulting colleagues experienced in this field. A summary of neuropsychological-specific commentary regarding the ITC test translation and adaptation guidelines is presented. Additionally, examples of applying these recommendations across a broad range of criteria are provided to aid test developers in attaining valid and reliable outcomes. Establishing specific neuropsychological test translation and adaptation guidelines is critical to ensure that such processes produce reliable and valid psychometric measures. Given the rapid global growth experienced in neuropsychology over the last two decades, the recommendations may assist researchers and practitioners in carrying out such endeavors.

Assessing health-related quality of life in patients with interstitial lung diseases

BackgroundThe R-Scale-PF was proposed to evaluate the health-related quality of life (HRQoL) in patients with idiopathic pulmonary fibrosis (IPF). We generated a German version of the R-Scale-PF (GR-Scale), representing the first translation of the questionnaire into another language and assessed HRQoL longitudinally in various interstitial lung diseases (ILDs) using the R-Scale-PF scoring system at a specialized ILD centre.MethodsWe have translated the questionnaire in accordance with the WHO translation guidelines and applied it to 80 ILD patients of our department, with follow-ups after 3–6 months, assessing its internal consistency, floor and ceiling effects, concurrent validity, known-groups validity, and its responsiveness to changes over time.ResultsAt baseline, all 80 patients completed the GR-Scale. In 70 patients (87.5%), follow-up data could be obtained after 4.43 ± 1.2 months. The GR-Scale demonstrated acceptable internal consistency (Cronbach’s α 0.749) and slight floor effects. Concurrent validity analysis showed weak but significant correlations with forced vital capacity (FVC; r=-0.282 p = 0.011) and diffusion capacity for carbon monoxide (DLco; r=-0.254 p = 0.025). In the follow-up analysis, moderate correlations were found with FVC (r=-0.41 p < 0.001) and DLco (r=-0.445 p < 0.001). No significant difference in the total score was found between patients with IPF (n = 10) and with non-IPF ILDs (n = 70). The GR-Scale successfully discriminated between groups of varying disease severity based on lung function parameters and the need for long-term oxygen therapy (LTOT). Furthermore, it was able to distinguish between patients showing improvement, stability or decline of lung function parameters.ConclusionOur prospective observational pilot study suggests that the GR-Scales is a simple and quick tool to measure HRQoL in patients with ILDs, thus providing an important additional information for the clinical assessment of ILD patients.Trial registrationOur study was retrospectively registered in the German Clinical Trial Register (DRKS) on 02.11.2022 (DRKS-ID: DRKS00030599).

Translation and Validation of the Korean Version of the Global Interprofessional Therapeutic Communication Scale: A Study of the Psychometric Properties among Korean Nurses

Purpose: This study aimed to validate the Korean version of the Global Interprofessional Therapeutic Communication Scale (K-GITCS), with the ultimate goal of improving therapeutic communication and patient engagement among Korean nurses.Methods: The study rigorously adhered to the original authors’ translation guidelines. A sample of 300 registered nurses from a tertiary hospital in South Korea participated in this research. Confirmatory factor analysis was conducted to verify the tool’s validity, and Cronbach’s ⍺ coefficients were calculated to evaluate the internal consistency of the K-GITCS.Results: The instrument’s reliability was substantiated by an adequate comparative fit index (0.984) and a high Cronbach’s ⍺ coefficient (0.94). The empirical results supported the three-factor structure of the K-GITCS, which comprised trust and rapport building, power sharing, and empathy.Conclusion: The study confirms that the K-GITCS is a valid, reliable, and culturally sensitive instrument for assessing therapeutic communication skills among nurses in Korea. It also highlights the importance of culturally tailored therapeutic communication training, particularly for promoting empathy in patient care. The study emphasizes the potential of the K-GITCS to significantly enhance nurses’ therapeutic communication practices, thereby improving the quality and safety of patient care. It is recommended to apply this tool among nursing students, academic institutions, and interprofessional healthcare providers to facilitate structured educational interventions that will improve therapeutic communication.

Translation and Validation of the Brazilian Version of the European Obesity Academy Questionnaire on Patients' Motivations for Seeking Metabolic and Bariatric Surgery.

Understanding patients' motives for undergoing metabolic and bariatric surgery (MBS) is key to managing postoperative expectations. We aimed to translate and validate the 14-item European Obesity Academy Questionnaire on Expectations about Surgical Treatment (EOAQ-EST) to Brazilian Portuguese for research and clinical use. This study included a total of 198 candidates for MBS at a reference academic hospital in Brazil from January 2021 to February 2022. We followed Beaton and Bombardier's guidelines for translation and cultural adaptation, including translation, back-translation, comparative analysis, expert review, pilot testing, and the creation of the final version of the questionnaire. Reliability was tested with McDonald's omega, and internal validity was assessed using confirmatory factor analysis (CFA). The final version was applied to 161 patients, 85% female, with a mean age of 46.4 ± 10.3years and a mean BMI of 48.3 ± 8.2kg/m2. Validity was supported by a bifactorial model (95% CI 0.044-0.104, p = 0.08), excluding one item (improved fertility) due to a floor effect. The reliability analysis showed that the 13 remaining items were internally consistent, with a McDonald's ω of 0.625. The Brazilian-Portuguese version of EOAQ-EST proved to be user-friendly, consistent, and reliable. This questionnaire may assist multidisciplinary teams in effectively addressing patients' expectations concerning metabolic and bariatric surgery (MBS) outcomes.

Translation guidelines and style guides for quality assurance in institutional legal translation : Focusing on Korean translation of divisional units in international agreements.

Translation guidelines and style guides for quality assurance in institutional legal translation : Focusing on Korean translation of divisional units in international agreements.

The Myanmar Version of the Oswestry Disability Questionnaire: A Cross-Cultural Adaptation, Reliability and Validity Study in the Low Back Pain Population

Objective: To translate and cross-culturally adapt the Myanmar version of the Oswestry Disability Questionnaire (M-ODQ), and examine its reliability and validity in the low back pain (LBP) population. Material and Methods: The M-ODQ was cross-culturally adapted in accordance with the ISPOR guidelines for translation. Prefinal testing was done on 20 individuals with LBP, with minor changes. The test-retest reliability, internal consistency, concurrent and construct validity, plus ceiling and floor effects of the M-ODQ were conducted on 101 individuals with LBP, via calculating the intraclass correlation coefficient ICC(2,1), Cronbach’s alpha, and Spearman’s rank correlation coefficient by correlating with the Myanmar version of the Roland-Morris Disability Questionnaire (M-RMDQ), visual analogue scale (VAS), back performance scale (BPS), and the Stark quality of life (QoL) questionnaire. The level of significance was set at p-value&lt;0.05 for all statistical analyses.Results: The test-retest reliability and internal consistency of the M-ODQ showed an ICC(2,1) of 0.91 and a Cronbach’s alpha of 0.703, thus indicating that the M-ODQ had an acceptable level of reliability. A moderate correlation between the M-ODQ and M-RMDQ (rho=0.56); and fair correlation with the VAS (rho=0.253), BPS (rho=0.336), and the physical component of the Stark QoL questionnaire (rho= -0.274) were found. Weak or no correlation was demonstrated with the mental component of the Stark QoL questionnaire (rho= -0.204). No ceiling or floor effects of the M-ODQ occurred in this study. Conclusion: The M-ODQ is a reliable and valid outcome measure for assessing disability among LBP patients in the Myanmar population.

A systematic review and BMD modeling approach to develop an AOP for humidifier disinfectant-induced pulmonary fibrosis and cell death

Dosimetry modeling and point of departure (POD) estimation using in vitro data are essential for mechanism-based hazard identification and risk assessment. This study aimed to develop a putative adverse outcome pathway (AOP) for humidifier disinfectant (HD) substances used in South Korea through a systematic review and benchmark dose (BMD) modeling. We collected in vitro toxicological studies on HD substances, including polyhexamethylene guanidine hydrochloride (PHMG-HCl), PHMG phosphate (PHMG-p), a mixture of 5-chloro-2-methyl-4-isothiazolin-3-one and 2-methyl-4-isothiazolin-3-one (CMIT/MIT), CMIT, and MIT from scientific databases. A total of 193 sets of dose-response data were extracted from 34 articles reporting in vitro experimental results of HD toxicity. The risk of bias (RoB) in each study was assessed following the office of health assessment and translation (OHAT) guideline. The BMD of each HD substance at different toxicity endpoints was estimated using the US Environmental Protection Agency (EPA) BMD software (BMDS). Interspecies- or interorgan differences or most critical effects in the toxicity of the HD substances were analyzed using a 95% lower confidence limit of the BMD (BMDL). We found a critical molecular event and cells susceptible to each HD substance and constructed an AOP of PHMG-p- or CMIT/MIT-induced damage. Notably, PHMG-p induced ATP depletion at the lowest in vitro concentration, endoplasmic reticulum (ER) stress, epithelial-to-mesenchymal transition (EMT), inflammation, leading to fibrosis. CMIT/MIT enhanced mitochondrial reactive oxygen species (ROS) production, oxidative stress, mitochondrial dysfunction, resulting in cell death. Our approach will increase the current understanding of the effects of HD substances on human health and contribute to evidence-based risk assessment of these compounds.