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Background: The mobile device diffusion has increasingly highlighted the opportunity to collect patient-reported outcomes (PROs) through electronic patient-reported outcomes measurements (ePROMs) during the clinical routine. Despite the ePROMs promises and advantages, the equivalence when a PRO measure is moved from the original paper-and-pencil to the electronic version is still little investigated. This study aims at evaluating equivalence between PROMs and ePROMs self-administration in people with multiple sclerosis (PwMS); in addition, preference of self-administration type was evaluated. Methods: The Manual Ability Measure-36 (MAM-36) and Fatigue Severity Scale (FSS) were selected for the equivalence test. The app ABOUTCOME was developed through a user-centered design approach to administer the questionnaires on tablet. Both paper-and-pencil and electronic versions were randomly self-administered. Intrarater reliability between both versions was evaluated through the intraclass correlation coefficient (ICC, excellent for values ≥ 0.75). Results: Fifty PwMS (35 females) participated to the study (mean age: 54.7±11.0 years, disease course: 27 relapsing-remitting and 23 progressive; mean EDSS: 4.7±1.9; mean disease duration: 13.3±9.5 years). No statistically significant differences were found for the means total scores of MAM-36 (p = 0.61) and FSS (p = 0.78). The ICC value for MAM-36 and FSS was excellent (0.98 and 0.94, respectively). Most of participants preferred the tablet version (84%). Conclusion: The results of the study provide evidence about the equivalence between the paper-and-pencil and electronic versions of PROs administration. In addition, PwMS prefer electronic methods rather than paper because the information can be provided more efficiently and accurately. The results could be easily extended to other MS PROs. [ABSTRACT FROM AUTHOR]

Background and Purpose: Patient-Reported Measured Outcomes (PROMs) are essential to gain a full understanding of a patient's condition, and in spine surgery, these questionnaires are of help when tailoring a surgical strategy. Electronic registries allow for a systematic collection and storage of PROMs, making them readily available for clinical and research purposes. This study aimed to investigate the reliability between the electronic and paper form of ODI (Oswestry Disability Index), SF-36 (Short Form Health Survey 36) and COMI-back (Core Outcome Measures Index for the back) questionnaires. Methods: A prospective analysis was performed of ODI, SF-36 and COMI-back questionnaires collected in paper and electronic format in two patients' groups: Pre-Operatively (PO) or at follow-up (FU). All patients, in both groups, completed the three questionnaires in paper and electronic form. The correlation between both methods was assessed with the Intraclass Correlation Coefficients (ICC). Results: The data from 100 non-consecutive, volunteer patients with a mean age of 55.6 ± 15.0 years were analysed. For all of the three PROMs, the reliability between paper and electronic questionnaires results was excellent (ICC: ODI = 0.96; COMI = 0.98; SF36-MCS = 0.98; SF36-PCS = 0.98. For all p < 0.001). Conclusions: This study proved an excellent reliability between the electronic and paper versions of ODI, SF-36 and COMI-back questionnaires collected using a spine registry. This validation paves the way for stronger widespread use of electronic PROMs. They offer numerous advantages in terms of accessibility, storage, and data analysis compared to paper questionnaires. [ABSTRACT FROM AUTHOR]

Introduction: Administering patient-reported outcome measures (PROMs) by text message may improve response rate in hard-to-reach populations. This study explored cultural acceptability of PROMs and compared measurement equivalence of the EQ-5D-3L administered on paper and by text message in a rural South African setting.Materials and Methods: Participants with upper or lower limb orthopaedic pathology were recruited. The EQ-5D was administered first on paper and then by text message after 24 h and 7 days. Differences in mean scores for paper and text message versions of the EQ-5D were evaluated. Test-retest reliability between text message versions was evaluated using Intraclass Correlation Coefficients (ICCs).Results: 147 participants completed a paper EQ-5D. Response rates were 67% at 24 h and 58% at 7 days. There were no differences in means between paper and text message responses for the EQ-5D Index (p = 0.95) or EQ-5D VAS (p = 0.26). There was acceptable agreement between the paper and 24-h text message EQ-5D Index (0.84; 95% Confidence Interval (CI) 0.78-0.89) and EQ-5D VAS (0.73; 95% CI 0.64-0.82) and acceptable agreement between the 24-h and 7-day text message EQ-Index (0.72; CI 0.62-0.82) and EQ-VAS (0.72; CI 0.62-0.82). Non-responder traits were increasing age, Xhosa as first language and lower educational levels.Conclusions: Text messaging is equivalent to paper-based measurement of EQ-5D in this setting and is thus a viable tool for responders. Non-responders had similar socioeconomic characteristics and attrition rates to traditional modes of administration. The EQ-5D by text message offers potential clinical and research uses in hard-to-reach populations. [ABSTRACT FROM AUTHOR]

Purpose: To assess the equivalence of patient-reported outcome (PRO) survey responses across Web, interactive voice response system (IVRS), and paper modes of administration.Methods: Postoperative colorectal cancer patients with home Web/e-mail and phone were randomly assigned to one of the eight study groups: Groups 1-6 completed the survey via Web, IVRS, and paper, in one of the six possible orders; Groups 7-8 completed the survey twice, either by Web or by IVRS. The 20-item survey, including the MSKCC Bowel Function Instrument (BFI), the LASA Quality of Life (QOL) scale, and the Subjective Significance Questionnaire (SSQ) adapted to bowel function, was completed from home on consecutive days. Mode equivalence was assessed by comparison of mean scores across modes and intraclass correlation coefficients (ICCs) and was compared to the test-retest reliability of Web and IVRS.Results: Of 170 patients, 157 completed at least one survey and were included in analysis. Patients had mean age 56 (SD = 11), 53% were male, 81% white, 53% colon, and 47% rectal cancer; 78% completed all assigned surveys. Mean scores for BFI total score, BFI subscale scores, LASA QOL, and adapted SSQ varied by mode by less than one-third of a score point. ICCs across mode were: BFI total score (Web-paper = 0.96, Web-IVRS = 0.97, paper-IVRS = 0.97); BFI subscales (range = 0.88-0.98); LASA QOL (Web-paper = 0.98, Web-IVRS = 0.78, paper-IVRS = 0.80); and SSQ (Web-paper = 0.92, Web-IVRS = 0.86, paper-IVRS = 0.79).Conclusions: Mode equivalence was demonstrated for the BFI total score, BFI subscales, LASA QOL, and adapted SSQ, supporting the use of multiple modes of PRO data capture in clinical trials. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the precision, accuracy, and reliability of the common measurement methods for collecting comfort and reachability distances. Four measurement methods were applied in the study: real-life measurement, virtual reality (VR) simulation, the media method, and the paper-and-pencil test. Forty participants were recruited, who were required to determine their comfort and reachability distances when approached by, or actively approaching, confederates under the four methods. The relative error magnitude and mean absolute difference were used to evaluate the precision and accuracy of the methods, respectively. Then, intraclass correlation coefficients were applied to evaluate the reliability of the methods. The ANOVA results showed that the confederate's gender, method, and pattern all had significant effects on the comfort and reachability distances. The distance obtained by the paper-and-pencil test was the smallest, while the distance measured by the media method was larger. The real-life measurement had high reliability, but its precision performance was worse than that of both the VR simulation and the active media method. The VR simulation had the best precision and reliability, while the measurement value tended to be overestimated. The media method in the passive pattern showed the worst precision, accuracy, and reliability performance among the four methods. The active media method performed well except for accuracy when collecting distance data. The paper-and-pencil test showed erroneous results regarding the precision and reliability performance. These findings provide scientific reference suggestions for the selection of measuring methods for collecting comfort and reachability distances. [ABSTRACT FROM AUTHOR]

Purpose: The Comprehensive assessment of Acceptance and Commitment Therapy (CompACT) is a 23-item questionnaire measuring psychological flexibility, a quality of life protective factor. An 18-item version was recently produced. We assessed validity and reliability of CompACT, and equivalence of paper and electronic (eCompACT) versions in people with multiple sclerosis (PwMS) in Italy, Germany and Spain. Methods: We used confirmatory factor analysis and assessed CompACT-23 and CompACT-18 measurement invariance between the three language versions. We assessed construct validity (Spearman's correlations) and internal consistency (Cronbach's alpha). Test–retest reliability (intraclass correlation coefficient, ICC) and equivalence of paper and eCompACT (ICC and linear regression model for repeated measures) were assessed in subsamples of PwMS. Results: A total of 725 PwMS completed the study. The three-factor structure of the CompACT-23 showed poor fit (RMSEA 0.07; CFI 0.82; SRMR 0.08), while the fit of the CompACT-18 was good (RMSEA 0.05; CFI 0.93; SRMR 0.05). Configural and partial metric invariance were confirmed, as well as partial scalar invariance (reached when five items were allowed to vary freely). The CompACT-18 showed good internal consistency (all alpha ≥ 0.78); and test–retest reliability (all ICCs ≥ 0.86). Equivalence between paper and eCompACT was excellent (all ICCs ≥ 0.86), with no mode, order, or interaction effects. Conclusion: Results support using the refined CompACT-18 as a three-factor measure of psychological flexibility in PwMS. Paper and eCompACT-18 versions are equivalent. CompACT-18 can be used cross-culturally, but sub-optimal scalar invariance suggests that direct comparison between the three language versions should be interpreted with caution. [ABSTRACT FROM AUTHOR]

In this paper measures of interrater absolute agreement for quantitative measurements based on the standard deviation are proposed. Such indices allow (i) to overcome the limits affecting the intraclass correlation index; (ii) to measure the interrater agreement on single targets. Estimators of the proposed measures are introduced and their sampling properties are investigated for normal and non-normal data. Simulated data are employed to demonstrate the accuracy and practical utility of the new indices for assessing agreement. Finally, an application to assess the consistency of measurements performed by radiologists evaluating tumor size of lung cancer is presented. [ABSTRACT FROM AUTHOR]

In many studies in the social and behavioral sciences, the data have a multilevel structure, with subjects nested within clusters. In the design phase of such a study, the number of clusters to achieve a desired power level has to be calculated. This requires a priori estimates of the effect size and intraclass correlation coefficient. If these estimates are incorrect, the study may be under- or overpowered. This may be overcome by using a group-sequential design, where interim tests are done at various points in time of the study. Based on interim test results, a decision is made to either include additional clusters or to reject the null hypothesis and conclude the study. This contribution introduces Bayesian sequential designs as an alternative to group-sequential designs. This approach compares various hypotheses based on the support in the data for each of them. If neither hypothesis receives a sufficient degree of support, additional clusters are included in the study and the Bayes factor is recalculated. This procedure continues until one of the hypotheses receives sufficient support. This paper explains how the Bayes factor is used as a measure of support for a hypothesis and how a Bayesian sequential design is conducted. A simulation study in the setting of a two-group comparison was conducted to study the effects of the minimum and maximum number of clusters per group and the desired degree of support. It is concluded that Bayesian sequential designs are a flexible alternative to the group sequential design. [ABSTRACT FROM AUTHOR]

Purpose: Autistic camouflaging is a collection of strategies used to hide autistic characteristics. It can have serious consequences on autistic people's mental health and needs to be addressed and measured in clinical practice. The purpose of this study is to evaluate the psychometric properties of the French adaptation of the Camouflaging Autistic Traits Questionnaire. Methods: 1227 participants (744 autistic, 483 non-autistic) answered the French version of the CAT-Q in an online survey or on paper. Confirmatory factor analysis, measurement invariance testing, internal consistency analysis (McDonald's ω), and convergent validity with the DASS-21 depression subscale were conducted. Test-rest reliability was assessed on a sample of 22 autistic volunteers using intraclass correlation coefficient. Results: A good fit was found for the original three-factor structure as well as a good internal consistency, excellent test-retest reliability and highly significant convergent validity. Measurement invariance testing indicates however that the meaning behind items is different for autistic vs. non-autistic people. Conclusion: The French version of the CAT-Q can be used in clinical settings to assess camouflaging behaviors and intent to camouflage. Further research is needed to clarify the camouflage construct and whether reported measurement noninvariance are due to cultural differences or a true difference in what camouflaging might mean for non-autistic people. [ABSTRACT FROM AUTHOR]

Background: The majority of studies that explore changes in musculature following resistance training interventions or examine atrophy due to immobilization or sarcopenia use ultrasound imaging. While most studies assume acceptable to excellent reliability, there seems to be unawareness of the existing absolute measurement errors. As early as 1998, methodological research addressed a collective unawareness of the random measurement error and its practical indications. Referring to available methodological approaches, within this work, we point out the limited value of focusing on relative, correlation-based reliability indices for the interpretability in scientific research but also for clinical application by assessing 1,512 muscle thickness values from more than 400 ultrasound images. To account for intra- and inter-day repeatability, data were collected on two consecutive days within four testing sessions. Commonly-stated reliability values (ICC, CV, SEM and MDC) were calculated, while evidence-based agreement analyses were applied to provide the accompanied systematic and random measurement error. Results: While ICCs in the range of 0.832 to 0.998 are in accordance with the available literature, the mean absolute percentage error ranges from 1.34 to 20.38% and the mean systematic bias from 0.78 to 4.01 mm (all p ≤ 0.013), depending on the measurement time points chosen for data processing. Conclusions: In accordance with prior literature, a more cautious interpretation of relative reliability values should be based on included systematic and random absolute measurement scattering. Lastly, this paper discusses the rationale for including different measurement error statistics when determining the validity of pre-post changes, thus, accounting for the certainty of evidence. Key Points: • While reliability of a testing protocol is most often determined via relative reliability indices such as the intraclass correlation coefficient, further reliability values such as the systematic bias and the random error have been described as valuable for results interpretation. • This study used the most frequently employed procedure to determine muscle hypertrophy (ultrasound) as an example linking relative reliability values to absolute measurement errors under special consideration of appropriate calculation models using three scenarios (best case, worst case, stability). • Overall, 504 ultrasound images were examined showing excellent relative reliability, but the corresponding measurement errors suggest that caution must be exercised when interpreting pre-post settings in cases where the measurement error exceeds the expected changes. [ABSTRACT FROM AUTHOR]

Purpose: The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life-Core Questionnaire (QLQ-C30) is a widely used generic self-report measure of health-related quality of life (HRQOL) for cancer patients. However, no validated voice script for interviewer-led telephone administration was previously available. The aim of this study was to develop a voice script for interviewer administration via telephone. Methods: Following guidelines from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) PRO Mixed Modes Good Research Practices Task Force, a randomised cross-over equivalence study, including cognitive debriefing, was conducted to assess equivalence between paper and telephone administration modes. Assuming an expected intraclass correlation coefficient (ICC) of 0.70 and a minimally acceptable level of 0.50, a sample size of 63 was required. Results: Cognitive interviews with five cancer patients found the voice script to be clear and understandable. Due to a protocol deviation in the first wave of testing, only 26 patients were available for analyses. A second wave of recruitment was conducted, adding 37 patients (n = 63; mean age 55.48; 65.1% female). Total ICCs for mode comparison ranged from 0.72 (nausea and vomiting, 95% CI 0.48–0.86) to 0.90 (global health status/QoL, 95% CI 0.80–0.95; pain, 95% CI 0.79–0.95; constipation, 95% CI 0.80–0.95). For paper first administration, all ICCs were above 0.70, except nausea and vomiting (ICC 0.55; 95% CI 0.24–0.76) and financial difficulties (ICC 0.60; 95% CI 0.31–0.79). For phone first administration, all ICCs were above 0.70. Conclusions: The equivalence testing results support the voice script's validity for administration of the QLQ-C30 via telephone. [ABSTRACT FROM AUTHOR]

Over time, technology has greatly enhanced access to vast amounts of public data in government datasets. At the same time there has been an increase in 'neighbourhood' level research, in which researchers typically select an administrative unit for their analysis. As the demand for data driven insights and decision making continues to rise, researchers face a tradeoff between data suppression (to protect the privacy of citizens) and homogeneity (the similarity of individuals within an area unit for given characteristics). In this paper, we explore the extent that different scales of geography impact data suppression and spatial homogeneity using the intra-class correlation and the D-Statistic. We use age, sex, ethnicity, education and income data from the 2013 New Zealand Census to assess a) the extent to which data are suppressed, and b) the spatial homogeneity of these variables across 5 scales of 'small area' geography available to researchers in NZ. The data used for this paper was accessed via the Integrated Data Infrastructure (IDI), a large data repository of de-identified, linked microdata obtained from government agencies, and nationally representative surveys. The scales used in this study are the 2013 Meshblock, Statistical Area 1, Data Zone, Statistical Area 2 and Area Unit, each of which can be used to analyse patterns at the 'neighbourhood' scale. We found that Data Zones are a suitable choice for undertaking analyses of census data as they represent a'medium' scale geography designed to reduce data suppression while maintaining reasonable levels of population homogeneity. The policy implications for this research relate to zone design and decisions relating to the definition of 'a small cell count' for data dissemination for different users of sociodemographic data. [ABSTRACT FROM AUTHOR]

Velocity-based training (VBT) is a scientifically grounded approach to resistance training that provides trainers with precise and reliable guidance by measuring the velocity of the barbell during exercise. Inertial measurement units (IMUs) possess advantages such as low cost and compact size. However, the use of IMUs to accurately estimate velocities and displacements requires refinement due to potential measurement errors. In this paper, we introduce an innovative IMU-based method for acquiring barbell velocity and displacement and conducting motion counting. This approach combines integration and high-pass filtering, allowing for the accurate acquisition of barbell mean concentric velocity (MV), peak concentric velocity (PV), and displacement for both back squat and bench press exercises. Furthermore, it enables precise motion counting. Five healthy male participants were enlisted for the test. The results demonstrated strong correlations between our method and the linear position transmitter (LPT). For back squat and bench press exercises, the Pearson's product moment correlation coefficient (Pearson's r) for MV was 0.93 and 0.91, the intra-class correlation (ICC) was 0.93 and 0.91, and the coefficient of variation (CV) was 13.29% and 16.22%, respectively. For PV, the Pearson's r was 0.92 and 0.95, the ICC was 0.92 and 0.94, and the CV was 13.46% and 17.34%, respectively. These results further demonstrated the validity and reliability of the method proposed in this paper regarding resistance training guidance. [ABSTRACT FROM AUTHOR]

The lives of caregivers can be deeply impacted by having a child with a developmental disability (DD). To offset those impacts, caregivers may engage in accommodations, or strategies to bolster everyday functioning. The nature and extent of these accommodations can provide insight into how the family is doing and what supports are needed from a family-centered perspective. This paper presents the development and preliminary validation of the Accommodations & Impact Scale for Developmental Disabilities (AISDD). The AISDD is a rating scale that measures day-to-day accommodations and impacts of raising a child with a DD. A sample of 407 caregivers of youth with DDs (Mage = 11.7 years; 63% males) completed the AISDD, along with measures of caregiver strain, daily challenges, child adaptive behavior, and behavior and emotional regulation. The AISDD is a unidimensional, 19-item scale with excellent internal consistency (ordinal alpha =.93) and test–retest (ICC =.95) reliability. Scores were normally distributed and sensitive to age (r = −.19), diagnosis (ASD + ID > ASD > ID), adaptive functioning (r = −.35), and challenging behaviors (r =.57). Finally, the AISDD showed excellent convergent validity with similar measures of accommodations and impacts. These findings support the use of the AISDD as a valid and reliable tool for measuring accommodations among caregivers of individuals with DDs. This measure shows promise in its ability to identify which families may need additional support for their children. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Childbirth remains an important risk factor for the development of pelvic floor disorders, regardless of the mode of delivery. To accurately assess these symptoms, accurate, woman-centric assessments are needed. Online versions of these assessments may be especially useful in the COVID-19 era. Women may potentially answer questions differently in an online format, and this study aimed to validate an online version of the paper-based self-administered Australian Pelvic Floor Questionnaire (APFQ). Methods: The questionnaire was completed antenatally and at 3 months postpartum by 647 and 481 women respectively. Test– validity was assessed in subgroups of 61 and 57 women in each period, using intraclass correlation coefficients and Cohen's kappa. Sensitivity to change was assessed by comparing responses during pregnancy to those at 3 months postpartum. Internal consistency was assessed using Cronbach's alpha. Construct validity was assessed by comparing women with and without subjective bothersomeness. Results: Intraclass correlation coefficients were above 0.9 for all domains and the overall questionnaire. Cohen's kappa for individual questions ranged from 0.71–1.00 across the antenatal and postnatal questionnaires. Cronbach's alpha was acceptable for all domains except the prolapse domain. The APFQ was sensitive to changes occurring between antenatal recruitment and 3 months postpartum. Effect sizes ranged from 0.83–7.99. Conclusions: This online version of the APFQ is valid for assessing pelvic floor disorders in an Irish obstetric population. The APFQ is reproducible and responsive to change occurring with childbirth, and can be used to research longitudinal changes in pelvic floor disorders. As an online tool, this questionnaire may be useful in increasing response rates to clinical research. [ABSTRACT FROM AUTHOR]

Background: Feature reproducibility and model validation are two main challenges of radiomics. This study aims to systematically review radiomic feature reproducibility and predictive model validation strategies in studies dealing with CT and MRI radiomics of bone and soft-tissue sarcomas. The ultimate goal is to promote achieving a consensus on these aspects in radiomic workflows and facilitate clinical transferability. Results: Out of 278 identified papers, forty-nine papers published between 2008 and 2020 were included. They dealt with radiomics of bone (n = 12) or soft-tissue (n = 37) tumors. Eighteen (37%) studies included a feature reproducibility analysis. Inter-/intra-reader segmentation variability was the theme of reproducibility analysis in 16 (33%) investigations, outnumbering the analyses focused on image acquisition or post-processing (n = 2, 4%). The intraclass correlation coefficient was the most commonly used statistical method to assess reproducibility, which ranged from 0.6 and 0.9. At least one machine learning validation technique was used for model development in 25 (51%) papers, and K-fold cross-validation was the most commonly employed. A clinical validation of the model was reported in 19 (39%) papers. It was performed using a separate dataset from the primary institution (i.e., internal validation) in 14 (29%) studies and an independent dataset related to different scanners or from another institution (i.e., independent validation) in 5 (10%) studies. Conclusions: The issues of radiomic feature reproducibility and model validation varied largely among the studies dealing with musculoskeletal sarcomas and should be addressed in future investigations to bring the field of radiomics from a preclinical research area to the clinical stage. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the quality of the cross-cultural adaptations and psychometric properties of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5). Methods: A systematic search was performed in three databases, PubMed, SCOPUS, and Dentistry and Oral Science Source (EBSCO). Studies relating to the cross-cultural adaptation and psychometric properties of SOHO-5 were included. The quality of cross-cultural adaptation was assessed in five aspects including translation, synthesis, back-translation, expert committee review, and pretesting. The Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist was used to assess the psychometric properties in seven domains including responsiveness, internal consistency, reliability, measurement error, and structural, construct, and cross-cultural validity. Results: The search identified 162 papers for screening; from these, 107 articles and 9 systematic reviews were excluded. 21 full papers were retrieved and 6 studies that met the inclusion criteria were included. Out of six, two reported all five aspects of cross-cultural adaptation procedures. Regarding the psychometric properties, none of the studies evaluated all aspects of psychometric properties. Almost all of the studies reported internal consistency (Cronbach's alpha ranging from 0.71 to 0.90), test–retest reliability (Intraclass Correlation Coefficient 0.46–0.98), and construct validity. None reported the cross-cultural validity and responsiveness of the measures. Conclusion: While these studies provided satisfactory results regarding the validity and reliability of SOHO-5, the majority of the included studies did not report all domains of the cross-cultural adaptations and psychometric properties. Overall, the quality of the cross-cultural adaptations and psychometric properties of the included studies is doubtful. Future research should follow the guidelines to assess all aspects of psychometric properties and adaptation procedures in cross-cultural settings. [ABSTRACT FROM AUTHOR]

Our study aims to investigate if the ratios proposed by Insall-Salvati and Caton-Deschamps follow the theory of normal distribution levels in a healthy population. 434 skeletal mature, healthy knees were obtained from a CT-scan-based modelling system (SOMA). Patellae height ratios were measured using the Insall-Salvati ratio and the Caton-Deschamps index. The patella height ratios of the sample population were plotted on a quantile plot and diagnosed as patella alta, baja or normal using the original ratio definitions. The study population patella height values at the 95th, 98th and 5th centiles were identified and compared to those described as alta or baja by Insall-Salvati and Caton-Deschamps. This meant that if the patient had patella alta, this would be defined as a ratio of ≥ 1.2 and hypothesised that this would align at the 98th centile of the study population, whilst if diagnosed as patella baja (≤ 0.74), this should align at the 5th centile of the population. The inter-rater reliability of both ratios was calculated using kappa statistics. Two authors made all calculations and compared them for consistency using the intraclass correlation coefficient. For the Insall-Salvati ratio, the study population's value at the 98th centile was equivalent to what Insall-Salvati describes as alta, a ratio of ≥ 1.2. In the study population, patients are overdiagnosed if using the Insall-Salvati ratio as patella baja ≤ 0.74, as the value at the 5th centile in the study population was 0.59. Using the Caton-Deschamps index, the 95th centile was 1.3, higher than the patella alta ratio determined by Caton as a ratio ≥ 1.2. Using Caton-Deschamps, patients are being underdiagnosed if utilising a patella baja ratio of ≤ 0.6. In our population, the 5th centile was 0.75. The two ratios had a kappa coefficient of 0.01, which indicates poor inter-rater reliability. Depending on the ratio used, caton-Deschamps and Insall-Salvati ratios diagnose patients as alta or baja differently. The current patella height ratios have originated from very small, select population samples. The future of patella height discussion should begin with data representing large populations. Then, we can discuss the upper and lower limits of abnormality. [ABSTRACT FROM AUTHOR]

This paper proposes novel features for automated language and dialect identification that aim to improve discriminative power by ensuring that each element of the feature vector has a normalised contribution to inter-class variance. The method firstly computes inter- and intra-class frequency variance statistics and then distributes the overall spectral variance across spectral regions which are sized to contain near-equal-variance difference. Spectral features are average pooled within regions to obtain variance normalised features (VNFs). The proposed VNFs are low complexity drop-in replacements for MFCC, SDC, PLP or other input features used for speech-related tasks. In this paper, they are evaluated in three types of system, against MFCCs, for two data-constrained language and dialect identification tasks. VNFs demonstrate good results, comfortably outperforming MFCCs at most dimension sizes, and yielding particularly good performance for the most challenging data-constrained 3s utterance length in the LID task. [ABSTRACT FROM AUTHOR]

What Works Clearinghouse (WWC, 2022) recommends a design-comparable effect size (D-CES; i.e., gAB) to gauge an intervention in single-case experimental design (SCED) studies, or to synthesize findings in meta-analysis. So far, no research has examined gAB's performance under non-normal distributions. This study expanded Pustejovsky et al. (2014) to investigate the impact of data distributions, number of cases (m), number of measurements (N), within-case reliability or intra-class correlation (ρ), ratio of variance components (λ), and autocorrelation (ϕ) on gAB in multiple-baseline (MB) design. The performance of gAB was assessed by relative bias (RB), relative bias of variance (RBV), MSE, and coverage rate of 95% CIs (CR). Findings revealed that gAB was unbiased even under non-normal distributions. gAB's variance was generally overestimated, and its 95% CI was over-covered, especially when distributions were normal or nearly normal combined with small m and N. Large imprecision of gAB occurred when m was small and ρ was large. According to the ANOVA results, data distributions contributed to approximately 49% of variance in RB and 25% of variance in both RBV and CR. m and ρ each contributed to 34% of variance in MSE. We recommend gAB for MB studies and meta-analysis with N ≥ 16 and when either (1) data distributions are normal or nearly normal, m = 6, and ρ = 0.6 or 0.8, or (2) data distributions are mildly or moderately non-normal, m ≥ 4, and ρ = 0.2, 0.4, or 0.6. The paper concludes with a discussion of gAB's applicability and design-comparability, and sound reporting practices of ES indices. [ABSTRACT FROM AUTHOR]

Few-shot learning is to learn to discriminate novel classes from a minimal amount of support images. The core of the matter lies in obtaining effective feature representations from limited samples and measuring the similarity between query and support images. In this paper, we approach this problem from two perspectives: effective feature learning and similarity measurement. We observe that the objects being classified are typically the common salient targets within the support class in few-shot classification. Based on this observation, we design a Co-Salient Feature Extraction module which can learn the correlations among the intra-class samples in the support images, thereby making the learned features more representative of the class. Regarding similarity measurement, we comprehensively consider both the global features and local details of the images and propose a Multi-Scale Metric module to implement holistic metric and improve the reliability of image-to-class measurement. We conduct experiments on four benchmark datasets for few-shot image classification, including general object recognition, fine-grained categorization, and cross-domain classification. The experimental results in various few-shot learning scenarios demonstrate that the proposed Intra-class Co-Salient (ICoS) network achieves competitive performance, particularly excelling in fine-grained classification, ICoS outperforms the similarity techniques DN4 by 20.61% in 1-shot and 11.23% in 5-shot on the CUB dataset, demonstrating the validity of co-salient learning. [ABSTRACT FROM AUTHOR]

Introduction: Treatment of proximal humerus fractures remains controversial. Understanding the factors that can affect the long-term functional outcomes can aid with management choices. This primary aim of this paper is to evaluate the association of radiographic parameters with functional outcomes. Methods: Radiographic parameters [Caput-collum-diaphyseal (CCD) angles, Y-scapular angles, and humeral head height (HHH)] were studied. The patients were split into varus and valgus groups based on the CCD angles and retroverted and anteverted groups based on Y-scapular angles. Functional outcome was measured by Oxford Shoulder Score (OSS), Constant Shoulder Score (CSS), and quick Disabilities of Arm, Shoulder and Hand score at 1 year follow-up. Intra- and interrater reliability were measured with the intraclass correlation coefficients (ICCs). Receiver operator curve (ROC) analysis and logistic regression analysis defined the optimal value for abnormalities on radiographic evaluation as an outcome predictor. Results: 111 patients were recruited (mean age 69, 78% female). Median final radiographic assessment was at 7 months. Mean initial/final CCD was 119o /111o (varus, n = 36) and 153o/140o (valgus, n = 75). Mean initial/final Y-scapula angle was 27o/27o (retroversion, n = 101) and 70o/40o (anteversion, n = 9). There was a significant relationship between OSS and final Y-scapular angle in the retroverted group (adj coeff 0.034, p = 0.009) with optimum predictive retroversion angulation of 25o predicting poor functional outcome (OSS < 40), area under the ROC curve of 0.614. Higher initial valgus and retroversion significantly predicted more change in the final angle (adj coeff − 0.349, p = 0.002, adj coeff − 0.527, p < 0.001 respectively). Both intra-rater and inter-rater reliability for the radiographic parameters were excellent (ICC > 0.9). Conclusion: Radiographic parameters whilst having excellent reliability, have a limited ability to predict short-term functional recovery. The extent of retroversion is the most important predictor for functional recovery with 25o a cut-off guide. Fractures with a higher initial valgus and retroversion tend to displace more. [ABSTRACT FROM AUTHOR]

Text-based captcha is commonly used by many commercial websites. Most existing captcha recognition methods rely on deep learning and large-scale labeled data. Recently, few-shot learning has shown its effectiveness in various visual classification tasks in the case of insufficient data. However, the performance of current few-shot learning methods will deteriorate in realistic settings with class-imbalance and cross-domain. In this paper, we have proposed a novel captcha solver based on prototypical networks and model-agnostic meta-learning. Two major improvements, including multi-source domain data augmentation and intra-class variance distance weighting method, are proposed to alleviate the performance degradation problems caused by cross-domain and class imbalance. Our approaches achieve an average character accuracy of more than 90% in 5-shot and 10-shot tasks and an astonishing attack rate of 88% in one-shot tasks. The efficacy of this work may promote the application of few-shot learning in realistic settings. [ABSTRACT FROM AUTHOR]

Intraclass correlation, used for measuring the degree of intrafamily resemblance, arises typically in psychology, education and genetics. In this paper, we extend the popular intraclass correlation model to the framework of hierarchical linear mixed models and consider D-optimal designs for the estimation of the fixed effects as well as the prediction of random effects in such settings. Moreover, characterizations of optimal designs are derived for determining the optimality of designs, and several examples are presented for illustration. [ABSTRACT FROM AUTHOR]

This paper presents a new facial feature extraction method on entropy based fractional fuzzy generalized two-dimensional linear discriminant analysis (EnFFG-2DLDA) where the concept of class uncertainty is incorporated within the generalized two-dimensional linear discriminant analysis. The EnFFG-2DLDA achieves the optimal projection matrix (in both directions) by maximizing the entropy and fuzzy membership value, based on inter-class similarity, while minimizing intra-class discrepancy by integrating weight function. This method ameliorates the shortcomings of 2DLDA method, which fails in case of many real-world situations as it focuses on the global relationship of data, and relies on Gaussian distributed data. Our EnFFG-2DLDA method does not depend on the assumptions that the data distributions and it exploits the intrinsic local structure of the data. Moreover, the FkNN has been incorporated into G-2DLDA algorithm to highlight distinguishable features by redefining the intra- (within) and inter- (between) class scatter matrices along horizontal (row) and vertical (column) directions. The global and per-class mean training vectors are regenerated by combining the fuzzy membership values. The weighting function is associated into inter class scatter matrix, in both direction, to solve contour based problem. Finally, Entropy membership values are specifically used for measuring uncertainty in the special variation in a facial image. Therefore, more significant feature information have been distilled out by combining FkNN, weight function and entropy with the G-2DLDA method, which solves the multi-classification problem. The feasibility of fractional fuzzy G-2DLDA with entropy membership value has been validated over frontal, occluded, and rotationally- angled images with four public standard face databases using RBF neural network. The investigational results demonstrate the substantial accuracy of 99.06% (k = 6) for ORL, 97.81% (k = 10) for UMIST and 66.04 (k = 4) for FERET dataset in terms of average recognition accuracy. [ABSTRACT FROM AUTHOR]

The importance of the global offset, the sum of femoral and acetabular offset, has been underlined in the literature as a key factor for the functional outcome of total hip arthroplasty (THA). However, the acetabular offset is not defined for bi-plane X-rays, a technology providing 3D measurements of the lower limb and commonly used for patients undergoing THA. The aim of this paper is to introduce a measurement method of the 3D acetabular offset with bi-plane X-rays. Our method combines the use of technical and anatomical coordinate systems. The most appropriate definition will be selected based on the best reliability and measurement error. The consequent reliability of the global offset was also assessed. Twenty-eight patients undergoing primary THA were selected retrospectively. Two operators performed three reconstructions for each patients before and after THA. Intraclass correlation (ICC) and smallest detectable change (SDC) were computed for intra-operator, inter-operator and test–retest conditions for all combinations of technical and anatomical coordinate systems. ICCs were good to excellent. One combination was more reliable than others with a moderate mean SDC of 6.3 mm (4.3–8.7 mm) for the acetabular offset and a moderate mean SDC of 6.2 mm (5.6–6.7 mm) for the global offset. This is similar to the reliability and mean SDC of the femoral offset (4.8 mm) approved for clinical use which indicates that this method of acetabular offset measurement is appropriate. This opens a research avenue to better understand the role of the acetabular offset on THA outcomes, which seems overlooked in the literature. [ABSTRACT FROM AUTHOR]

Background: Head circumference (HC) correlates with brain growth and development. However, radiologists typically use their visual impressions to evaluate head dimensions, which is a purely subjective assessment. Objective: The first objective of this paper was to analyze whether it is possible to obtain HC measurements by CT and MRI cross-sectional volumetric imaging using parameters similar to the tape measurement method, which is considered the gold standard. The second objective was to determine the most accurate method for characterizing head size: visual impression or imaging measurement. Materials and methods: Children who underwent HC measurement by tape and with volumetric imaging exams were selected from the Paulo Niemeyer State Brain Institute, Brazil. Two radiologists classified the children's heads using their visual impressions and by direct measurement on imaging. We used anatomical parameters similar to the tape measurement method and appropriate head growth charts and compared the absolute values obtained. Results: The concordance between tape and imaging ranged 52.3–72.7% for visual impression (kappa 0.27–0.55), ≥ 95.5% for CT and ≥ 93.1% for MRI (kappa ≥ 0.92 and ≥ 0.88, respectively). Intraclass correlation coefficients ≥ 0.997 and ≥ 0.996, absolute technical error measurements of 0.20–0.31 cm and 0.24–0.29 cm, and relative technical error measurements of 0.49–0.73% and 0.58–0.70% were evidenced in the intra- and inter-rater evaluations, respectively. The means between the methods were not significantly different (P > 0.05), with high values of Pearson correlation coefficient (≥ 0.99) and Lin concordance correlation coefficient (≥ 0.99). Conclusion: Head circumference values obtained by cross-sectional volumetric imaging are similar to those obtained using the tape measurement method (gold standard), with high repeatability and reproducibility. Head size characterization by visual impression is less accurate than head circumference measurement by imaging and plotting the values obtained on World Health Organization normative charts. [ABSTRACT FROM AUTHOR]

Footprint data have large intra-class variances and small inter-class variances; therefore, the key to the footprint recognition problem is to mine and learn the discriminative local details in the footprint images. In this paper, an algorithm based on a multi-scale confusion and filling mechanism is proposed to address the problem of footprint recognition from the perspective of fine-grained image recognition. Firstly, the pressure footprint image is divided evenly into several sub-regions, and the score of each sub-region is calculated by a joint confidence function. Secondly, using the filling mechanism of the Region Filling Module, the region with the lowest score in the split image is filled with a higher one for data enhancement. Then, the filled image is confused once using the Multi-Scale Region Confusion Module, and the regions with high confidence score are confused again to obtain an image with multi-scale information. Finally, the footprint features of the filled image and the confused image are extracted by the backbone network and optimized by the joint loss function to carry out the task of footprint recognition. Comprehensive experiments show that the proposed algorithm achieves 89.3%, 93.4% and 86.5% on three benchmark dataset including CUB-200-2011, Aircraft and Stanford Dogs. Meanwhile, it obtains 97.8% on the footprint dataset. [ABSTRACT FROM AUTHOR]

This paper examines the mental health of service providers working with Syrian refugees. Using the Professional Quality of Life framework, we hypothesize greater stress/less support from the work, person, client environment is associated with symptoms of STS, depression, and anxiety. We surveyed a sample of 104 service providers throughout Istanbul late 2018. Multivariable logistic regression examined associations between work (organizational support, caseload, supervision), person (perceived social support), client environment (trauma disclosure, percent Syrian refugees) on STS, depression, and anxiety. We found rates of moderate-to-severe STS to be 27.88%; depression 40.38%; and anxiety 29.81%. Our hypothesis was partially supported. Lower organizational support was associated with moderate-to-severe STS (aOR 0.91, 95% CI 0.84, 0.99) while lower social support with anxiety (aOR 0.89, 95% CI 0.81, 0.99). Caseload, supervision, trauma disclosure, percent refugees did not show significant associations. Organizations working with Syrian refugees may benefit from enhancing organizational support and promoting social support for staff. [ABSTRACT FROM AUTHOR]

Intraclass correlation coefficients (ICCs) are frequently employed in health science research, often to assess intrarater and interrater reliability. In many cases, insufficient details are provided about these ICCs and there seem to be misunderstandings about their selection and how they should be interpreted. This paper is intended primarily to provide a clear, accessible description of ICCs, including how they should be selected, interpreted, and reported. Emphasis is given to areas where researchers seem to encounter the greatest conceptual difficulties and to exhibit the greatest misconceptions. Two extended examples are used to support the points being made. Major additional aims of this paper are to raise the awareness of authors, reviewers, and editors concerning the importance of using appropriate ICCs, and to encourage them to ensure that complete and accurate information about ICCs is reported in journal articles. Failure to do so perpetuates a risk that incorrect decisions might be made about matters that are of crucial importance for people's health. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to present the systematic review and meta-analysis of the psychometrical analysis of Facial Disability Index (FDI) studies.Methods: A literature search was conducted in the relevant electronic databases "PubMed, Scopus, Web of Science (WoS), and Cochrane Library." A total of 621 articles were obtained by searching the relevant keywords (PubMed: 384, Cochrane Library: 14, Web of Science: 132, Scopus: 91). A total of 8 papers were included. The four-point classification and rating-based "COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN)" tools were used to evaluate the bias risk and evidence levels.Results: Cronbach's alpha pooling of FDI total score was (ES): 0.803 (95% CI: 0.73-0.86). Heterogeneity for the Facial Disability Index-Physical Function (FDI-PF) and Facial Disability Index-Social Function (FDI-SF) subscore based on intraclass correlation coefficient (ICC) were I2 = 84.2% (ICC: 0.88, 95% CI: 0.81-0.92) and I2 = 73.7% (ICC: 0.87, 95% CI: 0.81-0.90), respectively. Correlational results between Sunnybrook Facial Grading System (SFGS) with FDI-PF and FDI-SF were 0.38 and 0.22, respectively. The correlations of FDI-PF with Short Form-12 Physical Component Summary (SF-12-PCS) and Short Form-12 Mental Health Component Summary (SF-12-MCS) were 0.43 and 0.28, respectively. Correlation results of FDI-SF with SF-12-PCS and SF-12-MCS were 0.23 and 0.57. The relationship results of Facial Clinimetric Evaluation with FDI-PF and FDI-SF were 0.71 and 0.57, respectively.Conclusion: FDI is a psychometrically valuable questionnaire, especially for the internal consistency, reliability, and validity. In clinical practice, the use of FDI would be valuable, in addition to clinician-based grading, to see more of patients' social influences precisely. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this review paper is to summarize the current literature regarding inter- and intra-reader reliability of radiomics on rectal MRI. Methods: Original studies examining treatment response prediction in patients with rectal cancer following neoadjuvant therapy using rectal MRI-based radiomics between January 2010 and December 2021 were identified via a PubMed/Medline search. Studies in which intra- and/or inter-reader reliability had been reported were included in this review. Results: Thirteen studies were selected, with an average number of patients of 145 (range, 20–649). All included studies evaluated T2-weighted imaging (T2WI) and/or diffusion-weighted imaging (DWI) sequences, while 3/13 (23%) also evaluated the contrast-enhanced T1-weighted imaging (T1WI) sequence. Most of the selected studies involved two readers (10/13, 77%), 6/13 (46%) studies used baseline MRI only, 1/13 (8%) study used restaging MRI only, and 6/13 (46%) used both. Segmentation was performed manually in 10/13 (77%) studies, and in a slight majority of studies (7/13, 54%), the entire tumor volume (3D VOI) was segmented, while 4/13 (31%) studies segmented the 2D ROI and 2/13 (15%) segmented both. Intraclass correlation coefficient (ICC) on intra-reader agreement varied from 0.73 to 0.93. ICC to assess inter-reader varied from 0.60 to 0.99. Overall, features obtained from baseline rectal MRI, using 3D VOI and first-order features, had higher agreement. Conclusion: Based on our qualitative assessment of a small number of non-dedicated studies, there seems to be good reliability, particularly among low-order features extracted from the entire tumor volume using baseline MRI; however, direct evidence remains scarce. More targeted research in this area is required to quantitatively verify reliability, and before these novel radiomic techniques can be clinically adopted. [ABSTRACT FROM AUTHOR]

This paper presents the psychometric development of a new observer-report research questionnaire for assessing aspects of an individual's mindfulness that are noticeable to others. Items from five established self-report mindfulness scales were re-worded for observer-report, and 30 were endorsed for potential inclusion by an expert panel (n = 5). Factor analytic and item response theory models were used to test item and scale psychometrics with data (N = 494) in three independent samples. A nine-item, three-factor scale with good fit indices was determined (RMSEA = 0.04, CFI = 0.99, TLI = 0.99). The instrument provides an overall score for observed mindful behaviours and subscale scores for observed attentiveness, awareness and acceptance. Within-subject test–retest reliability was strong (ICC 0.91) and agreement between observed mindful behaviours and self-reported mindfulness was adequate (ICC 0.45). Validity tests showed concordance between the new scale and self-reported mindfulness within the selected nomological network constructs (emotional intelligence, empathy and avoidant behaviours). Responsiveness was indicated but unconfirmed in data from a randomized controlled trial of low-dose mindfulness training. The Observed Mindfulness Measure (OMM) is a quantitative instrument that can provide an additional data source to strengthen self-reported findings in mindfulness research. With some further refinement this new instrument can advance research into whether and how mindfulness training might make a noticeable difference in social and organizational domains. [ABSTRACT FROM AUTHOR]

Purpose: Social service counseling (SSC) is an important instrument to support cancer patients, for example, regarding legal support, or rehabilitation. Several countries have established on-site SSC in routine care. Previous analyses have shown that SSC utilization varies across cancer centers. This analysis investigates patient and center-level predictors that explain variations in SSC utilization between centers. Methods: Logistic multilevel analysis was performed with data from 19,865 prostate cancer patients from 102 prostate cancer centers in Germany and Switzerland. Data was collected within an observational study between July 2016 and June 2020 using survey (online and paper) and tumor documentation. Results: The intraclass correlation coefficient for the null model implies that 51% of variance in SSC utilization is attributable to the center a patient is treated in. Patients aged 80 years and older, with higher education, private insurance, without comorbidities, localized intermediate risk, and undergoing androgen deprivation therapy before study inclusion were less likely to utilize SSC. Undergoing primary radiotherapy, active surveillance, or watchful waiting as compared to prostatectomy was associated with a lower likelihood of SSC utilization. Significant negative predictors at the center level were university hospital, center's location in Switzerland, and a short period of certification. Conclusion: The results show that patient and center characteristics contribute to explaining the variance in SSC utilization in prostate cancer centers to a large extent. The findings may indicate different organizational processes in the countries included and barriers in the sectoral structure of the healthcare system. In-depth analyses of processes within cancer centers may provide further insights into the reasons for variance in SSC utilization. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this study was to use image analysis recordings to measure the carrying angle of elite male tennis players during the forehand stroke, with the hypothesis that elite tennis players overstress their elbow in valgus over the physiological degree in the frontal plane just before ball contact on forehand groundstrokes. Methods: The carrying angle of male tennis players ranked in the top 25 positions in the ATP ranking was measured on selected video frames with the elbow as close as possible to full extension just before the ball‐racket contact in forehands. These frames were extracted from 306 videos professionally recorded for training purposes by a high‐profile video analyst. All measures were conducted by three independent observers. Results: Sixteen frames were finally included. The mean carrying angle was 11.5° ± 4.7°. The intraclass correlation coefficient value was 0.703, showing good reliability of the measurement technique. The measured carrying angle was lower than what has been observed in historical cohorts using comparable measurement methodology, suggesting a possible instant varus accommodation mechanism before hitting the ball. Conclusions: The observed decrease in the carrying angle is a consequence of an increase in elbow flexion position dictated by the transition from a closed to open, semi‐open stances. As the elbow flexes during the preparation phase, it is less constrained by the olecranon and its fossa, increasing the strain on the medial collateral ligament and capsule structures. Moving towards full extension before the ball‐racket contact, the elbow is dynamically stabilised by a contraction of the flexor muscles. These observations could provide a new explanation for medial elbow injuries among elite tennis players and drive specific rehabilitation protocols. Study Design: Descriptive epidemiology study. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]

Background: Presbyopia is a progressive condition that reduces the eye's ability to focus on near objects with increasing age. After a systematic literature review identified no existing presbyopia-specific patient-reported outcome (PRO) instruments meeting regulatory guidance, a new PRO instrument, the Near Vision Presbyopia Task-based Questionnaire (NVPTQ), was developed. Results: To explore the patient experience with presbyopia, concept elicitation interviews were conducted with 20 presbyopic participants. The most frequently reported impacts were difficulty with reading menus/books/newspapers/magazines, reading on a cell phone/caller ID, and reading small print. Based on these results, a task-based PRO instrument (the NVPTQ) was developed instructing participants to complete four near-vision, paper-based reading tasks (book, newspaper, nutrition label, menu) under standardized settings, and subsequently assess their vision-related reading ability and associated satisfaction. The draft NVPTQ was cognitively debriefed with a sample of 20 presbyopes, which demonstrated that most participants interpreted the items as intended and endorsed the relevance of the concepts being assessed. After the qualitative research, the draft instrument was psychometrically tested using data from a Phase 2 study. Based on item-level analyses, all items in the NVPTQ demonstrated expected response option patterns and lacked substantial floor or ceiling effects. The reliability, validity, and responsiveness of the NVPTQ Performance and Satisfaction domain scores were assessed. All domains scores had large Cronbach's coefficient α values and good test–retest statistics, indicating that the scores are internally consistent and produce stable values over time. The pattern of correlations with a concurrent measure of visual functioning (National Eye Institute Visual Function Questionnaire 25) demonstrated that the NVPTQ domain scores were related to an alternative assessment of near-vision activities. The NVPTQ domain scores were able to distinguish between groups that were known to differ on the clinical outcome of uncorrected near visual acuity, supporting the construct validity of these scores. The NVPTQ domain scores showed evidence of responsiveness to change by being able to distinguish between groups defined as improved and not improved based on patient-reported and clinical outcomes. Conclusions: This research has resulted in a content-valid and psychometrically sound instrument designed to evaluate vision-related reading ability and satisfaction with vision-related reading ability. Trial registration: ClinicalTrials.gov NCT02780115. Registered 23 May 2016, https://www.clinicaltrials.gov/ct2/show/NCT02780115?term=NCT02780115&draw=2&rank=1. [ABSTRACT FROM AUTHOR]

The news media shape public opinion, and often, the visual bias they contain is evident for careful human observers. This bias can be inferred from how different media sources portray different subjects or topics. In this paper, we model visual political bias in contemporary media sources at scale, using webly supervised data. We collect a dataset of over one million unique images and associated news articles from left- and right-leaning news sources, and develop a method to predict the image's political leaning. This problem is particularly challenging because of the enormous intra-class visual and semantic diversity of our data. We propose two stages of training to tackle this problem. In the first stage, the model is forced to learn relevant visual concepts that, when joined with document embeddings computed from articles paired with the images, enable the model to predict bias. In the second stage, we remove the requirement of the text domain and train a visual classifier from the features of the former model. We show this two-stage approach that relies on an auxiliary task leveraging text, facilitates learning and outperforms several strong baselines. We present extensive quantitative and qualitative results analyzing our dataset. Our results reveal disparities in how different sides of the political spectrum portray individuals, groups, and topics. [ABSTRACT FROM AUTHOR]

The unique properties of terahertz (THz) spectroscopy show a great potential for security and defense applications such as safe screening of persons and objects. However, a successful implementation of THz screening systems requires a development of reliable and efficient identification algorithms. Dimensionality reduction (DR) methods aim to reduce the dimensionality of the multivariate data and are therefore commonly used as a preprocessing step for classification algorithms and as an analytical tool allowing data visualization. In this paper, we compare the use of unsupervised and supervised DR methods for analysis and classification of THz reflection spectra based on their most widespread linear representatives, namely principal component analysis and linear discriminant analysis, respectively. To this end, both methods were applied to more than 5000 THz reflection spectra acquired from six active materials mixed at three different concentrations with polyethylene and measured at various humidity conditions. While considering scenarios with different levels of complexity, we found that the supervised approach provides better results because it enables efficient grouping despite intra-class variability. Furthermore, we showed that manipulating labels introduced into the supervised DR algorithm allows conditioning the data for a desired classification task such as security screening. Presented classification results show that simple machine learning algorithms are sufficient for highly accurate classification (>98.6%) of THz spectra, which will be suitable for many real-life applications of THz spectroscopy based on material identification. [ABSTRACT FROM AUTHOR]

Introduction: While the Patient-Reported Outcomes Measurement Information System (PROMIS) is mainly designed for computer adaptive testing, its static short forms (SF) are used when a paper-pencil format is preferred or item banks are not yet translated into the target language. This study examined the measurement properties of the German PROMIS-SF for pain intensity (PAIN), pain interference (PI) and physical function (PF) in total hip arthroplasty (THA) patients. Methods: SF were collected before and 12 months post-surgery. Higher scores indicate more PAIN, higher PI and better PF. Oxford Hip Score (OHS) was the main reference measure. Six months post-surgery, a subsample completed the SF twice within 14 days to test reliability. Results: Of 172 eligible patients, 147 consented to participate and received questionnaires; 132 (74 males) returned baseline questionnaires (mean age 65.8 ± 10.2 years) and 116, 12-month questionnaires. Forty-five patients provided test-retest data. Correlations of all SF with OHS were large (│r│ ≥ 0.7; confidence intervals did not include 0.50). Cronbach's alpha values were: PAIN, 0.86; PI, 0.93; PF, 0.91. Intraclass correlation coefficients were: PAIN, 0.77; PI, 0.81; PF, 0.69. Standard errors of measurement were: PAIN, 3.8; PI, 2.8; PF, 3.6. Smallest detectable change thresholds were: PAIN, 8.8; PI, 6.6; PF, 8.4. Follow-up data showed a ceiling effect (best score) for PAIN (66%), PI (76%), and PF (66%). SF change scores showed large correlations with OHS change scores (│r│ > 0.6). Conclusion: Our results provide some evidence of construct validity, and acceptable reliability and responsiveness of PROMIS-SF for pain and function in THA patients. These SF can thus be considered acceptable for use, although patients' improvement in physical function might be underestimated due to the large follow-up PF score ceiling effects. Plain English summary: Measurement qualities of PROMIS instruments are mainly assessed for computer adaptive testing but not for non-adaptive short questionnaires. As these questionnaires are in use, their measurement properties must also be evaluated. Results from computer adaptive testing cannot simply be transferred. We studied the measurement qualities of the German PROMIS short questionnaires for pain intensity, pain interference and physical function in patients undergoing hip replacement. We wanted to see how these questionnaires perform when compared to the Oxford Hip Score, a standard questionnaire commonly used to test hip-related disability in these patients. The three questionnaires can be considered acceptable for use in hip replacement patients, but some limitations do exist. Patient improvement in physical function might be underestimated because many patients reach the highest possible score and further improvements cannot be measured. Also, any small but important improvement in physical function cannot be distinguished from measurement error in individual patients. [ABSTRACT FROM AUTHOR]

Significant changes have been made on audio-based technologies over years in several different fields. Healthcare is no exception. One of such avenues is health screening based on respiratory sounds. In this paper, we developed a tool to detect respiratory sounds that come from respiratory infection carrying patients. Linear Predictive Cepstral Coefficient (LPCC)-based features were used to characterize such audio clips. With Multilayer Perceptron (MLP)-based classifier, in our experiment, we achieved the highest possible accuracy of 99.22% that was tested on a publicly available respiratory sounds dataset (ICBHI17) (Rocha et al. Physiol. Meas. 40(3):035,001 20) of size 6800+ clips. In addition to other popular machine learning classifiers, our results outperformed common works that exist in the literature. [ABSTRACT FROM AUTHOR]

The k-means algorithm is a popular clustering method for image segmentation. However, the main disadvantage of this algorithm is its dependence on the number of initial clusters. In this paper, we present an optimal criterion which can select the best segmentation result with less number of clusters. The optimal criterion overcomes the shortcoming of initialization based on the intra-class and inter-class difference. Eight digital images were employed to verify the segmentation results of the optimal criterion. Simultaneously, we have improved the traditional k-means algorithm to find the initial clustering centers efficiently. Experimental results show that the segmented images selected by the optimal criterion have sufficient stability and robustness. In addition, we verify the consistency of results by two kinds of objective assessment measures. The proposed optimal criterion can successfully display the best segmentation results precisely and efficiently so as to instead of artificial selection. [ABSTRACT FROM AUTHOR]

Despite the expansion of early intervention approaches for young children with ASD, investigators have struggled to identify measures capable of assessing social communication change in response to these interventions. Addressing recent calls for efficient, sensitive, and reliable social communication measures, the current paper outlines the refinement and validation of the Social Communication Checklist (SCC). We discuss two small studies exploring the psychometric properties of the SCC and the SCC-R (revised Social Communication Checklist), including sensitivity to change, inter-rater reliability, and test-retest reliability, in two samples of children with ASD and one sample of typically-developing children. Results indicate this measure is reliable, sensitive to change after a brief social communication intervention, and strongly related to well-established measures of social communicative functioning. [ABSTRACT FROM AUTHOR]

There is a great demand of automatic face recognition in the society. The methods of face recognition are performed satisfactorily in controlled environment. The challenging benchmarks demonstrate that these methods may not adequately work in unconstrained environment. In this paper, we develop a novel framework of face recognition system that outperforms in unconstrained environment. The framework works on features based method that extracts facial landmarks from images. After quality check the patch experts are generated and used to model the appearance of landmarks of interests. The effect of discriminatory features is further enhanced by assigning weights to them that are to be set to the ratio of the interclass variance to the intraclass variance. The result shows that the proposed framework achieves better recognition accuracy in comparison to other known methods on publically available challenging datasets. [ABSTRACT FROM AUTHOR]

Introduction: Ultrasonography has been used to understand the functional and biomechanical aspects of the lumbar multifidus muscle in vivo. To characterize the multifidus echogenicity, the peculiarities of their superficial and deep layers must be considered. Purpose: The present paper aimed to characterize the lumbar multifidus echo intensity (EI), in both superficial and deep layers, in ultrasonography images acquired in longitudinal and transversal orientations. Methods: Evaluator obtained two images in each side of the lumbar of the volunteer, who was lying on prone position. Ultrasonography images were taken with probe in transversal and longitudinal orientations. EI was estimated by means average value of the grayscale distribution histogram, by extracting from region of interest of the superficial and deep layer. All participants returned for a second test day. Two-way MANOVA test was applied to compare EI measurements, considering layers and side factors. The reliability and variability were analyzed by the intraclass correlation coefficient and standard error measurements (SEM), respectively. Two-way MANOVA found significant difference between the layers in the transversal and longitudinal images, but not between the sides. Results: Interdays reliability ranged of reasonable to excellent, and SEM values were lower than 17.08%. The superficial layer of the multifidus muscle showed higher EI values than the deeper one. Conclusions: These analyses can serve as a basis for future studies approaching multifidus of the people with low back pain. [ABSTRACT FROM AUTHOR]

Objectives: This study was to evaluate the diagnostic value of liver extracellular volume (LECV) for the staging of liver fibrosis in a cynomolgus monkey model of nonalcoholic steatohepatitis (NASH).Methods: Forty-eight cynomolgus monkeys were enrolled in this prospective study. There are 17 healthy monkeys and 31 monkeys with NASH. Ten of these monkeys were used for repeatability assessment. The remaining 38 monkeys were used to compare LECV with other indicators including pathology fibrosis score, native T1, and serum chemical indexes by Spearman, Pearson correlation test, and ROC curves. The inter-reader variability was assessed by interclass correlation. The repeatability measurement of LECV was analyzed using Bland-Altman plots and the coefficient of variation. Partial correlation analysis was performed to assess the effects of fat content and inflammation scores on the correlation between LECV/T1 and liver fibrosis score.Results: This study demonstrated a good intra-reader agreement (intraclass correlation = 0.79) of LECV in all monkeys and an excellent repeatability in 10 monkeys (coefficient of variation = 2.01%). The LECV has a strong correlation with the fibrosis score (r = 0.949; p < 0.0001), low-density lipoprotein (r = 0.72; p < 0.0001), and cholesterol (r = 0.70; p < 0.0001). LECV showed high diagnostic efficacy in the diagnosis of liver fibrosis (area under the curve of ROC, 0.945~1; p < 0.001).Conclusions: LECV may serve as a noninvasive valuable biomarker for the quantification and differentiating of the non-severe liver fibrosis (stage ≤ F3). However, circulating serum markers low-density lipoprotein and cholesterol (CHO) may not serve for this purpose.Key Points: • This paper demonstrated the excellent repeatability (intraclass correlation coefficient = 0.79) of LECV in monkey animal model. • LECV-MRI has a strong correlation with histopathological fibrosis score stage (r = 0.949; p < 0.0001) and shows high diagnostic efficacy in the staging of non-severe liver fibrosis (the area under ROC curve ≥ 0.945). • The new fibrosis score maps appeared to provide a better imaging tool for the spatial assessment of liver fibrosis. It may eventually facilitate the diagnosis of liver fibrosis distribution. [ABSTRACT FROM AUTHOR]

Purpose: Despite the wide usage of World Health Organization Disability Assessment Schedule II (WHODAS 2.0) in psychiatry research and clinical practice, there was limited knowledge on its proxy reliability among people with mental disorders. This paper aimed to compare the 12-item WHODAS 2.0 responses of adult patients with mental disorders to their family caregivers. Methods: In this study, 205 pairs of patients with mental disorders and primary family caregivers were consecutively recruited from one inpatient mental health department in a large hospital in China. All participants completed the 12-item version WHODAS 2.0 to assess patients' functioning in the 30 days prior to the hospitalization. Measurement invariance, including configural, metric and scalar invariance, was tested across patient and proxy groups, using multi-group confirmatory factor analysis. Agreement between patients and proxies was examined by paired Wilcoxon tests and intraclass correlation coefficients (ICC). Subgroup analyses for proxy reliability were conducted within strata of proxy kinship and patient psychiatric diagnosis. Results: The 12-item WHODAS 2.0 achieved configural, metric and partial scalar invariance across patient and proxy groups. Unsatisfactory consistency was found for most items (ICC < 0.75, P < 0.05), especially for items on Cognition, Getting along, Life activities, and Participation in society (ICC < 0.4, P < 0.05). Spouses agreed with patients more often than parents (ICC ≥ 0.4, P < 0.05). The paired Wilcoxon tests found that impairment of patients with psychotic disorders tended to be overestimated by proxies while proxies tended to underestimate impairment of patients with mood disorders. Conclusion: Our study reveals inconsistency between self and proxy reports in the 12-item WHODAS 2.0 among adult patients with mental disorders. When proxy reports is needed, spouses are preferred than parents. We should be aware of proxies' impairment overestimation among patients with psychotic disorders and underestimation among patients with mood disorders. [ABSTRACT FROM AUTHOR]

Student past and present performances are analyzed, compared, and reflected upon by teachers, curriculum developers, and educational researchers. For the tasks, methods and techniques of traditional statistics are frequently employed. Recent advances in statistical theory and practice, although not yet covered by widely accessible statistics textbooks, shed additional light on the area and facilitate the improvement of old, and the development of new, curricula that are better aligned with learning goals and outcomes. In the present paper we discuss and illustrate the use of an index of increase that has been designed to quantify, and thus compare, relationships between dependent random variables (e.g., student scores in different study subjects) that rarely follow linear relationships; hence, the use and interpretations of the celebrated Pearson correlation coefficient become problematic. The aforementioned index of increase is the proportion of upward movements among all the movements in the scatterplot arising from paired observations. To appreciate the index from both graphical and mathematical points of view, we have illustrated its performance using a classical and easily accessible educational dataset. We have provided examples of how the index values can aid teachers and educational researchers in determining relationships between student performances in different study subjects, and thus in turn help them in, for example, developing curricula. [ABSTRACT FROM AUTHOR]

In order to capture temporal interactions among processes in manufacturing and assembly processes, an end-to-end unified product quality prediction framework called QTD is proposed in this paper. It consists of three modules: quality embedding model pool, temporal-interactive model, and decoding model. Besides, to handle the information transfer and integration problems in the time direction of parallel processes, a novel bidirectional serial–parallel LSTM (Bi-SP-LSTM) is devised as an instantiated model of temporal-interactive model. Bi-SP-LSTM is an extension of bidirectional long short-term memory. Moreover, an unsupervised task and a loss function named adversarial focal loss have been designed to give the framework the ability to assess heteroscedastic uncertainty in classification task due to intrinsic uncertainty in data. Furthermore, experiments are devised based on a subset of a public dataset from Kaggle competition to demonstrate the validity of the proposed framework. Compared with other latest methods, the proposed framework is verified to be more accurate and robust. Taking Matthews correlation coefficient as an example, the adversarial Bi-SP-LSTM-based QTD framework is superior to the best existing methods with 95% confidence interval in most cases, and its mean MCC is 4.88% higher than the best existing method. The results suggest that the proposed framework has a broad application prospect for quality prediction in manufacturing and assembly processes. [ABSTRACT FROM AUTHOR]

Objective: This paper goal was to validate the Portuguese version (Brazil/Portugal) of the Anger, Anxiety, and Depressive Symptoms item banks of the Pediatric PROMIS® Emotional Distress domain (version 1.0) for the Brazilian and Portuguese pediatric population.Method: The total of 1216 participants answered a self-applied version of the Portuguese Anger, Anxiety, and Depressive Symptoms item banks. Reliability was assessed through internal consistency, test-retest reliability, and total information curve (TIC). Confirmatory Factor Analysis (CFA) with a bifactor model was used to confirm construct validity and IRT assumptions. Item calibration was performed according to Graded Response Model (GRM). Differential Item Functioning (DIF) was analyzed according the participants' age, gender, health condition (healthy versus chronic disease), and language.Results: Internal consistency reliability (Cronbach's alpha coefficient = 0.84) and test-retest reliability (intraclass correlation = 0.93) were accurate. Unidimensionality, Local Independency, and construct validity were verified by CFA (CFI = 0.93; TLI = 0.93; RMSEA = 0.05; χ2 = 3052.4 with DIF = 557 and P value = 0.595). GRM was adjusted, and Emotional Distress had a satisfactory coverage. DIF was not significant.Conclusion: The results obtained indicate the adequacy of the psychometric properties of the Portuguese version (Brazil/Portugal) of the Anger, Anxiety, and Depressive Symptoms item banks of the Pediatric PROMIS® Emotional Distress domain. [ABSTRACT FROM AUTHOR]