METHODS: Using data from the pre-registered International Sex Survey [n = 82 243; mean age (Mage) = 32.4 years, standard deviation = 12.5], a study across 42 countries from five continents, we evaluated the psychometric properties (i.e. factor structure, measurement invariance, and reliability) of the PPCS, PPCS-6, and BPS and examined their associations with relevant correlates (e.g. treatment-seeking). We also compared PPU risk among diverse groups (e.g. three genders).
RESULTS: The PPCS, PPCS-6, and BPS demonstrated excellent psychometric properties [for example, comparative fit index = 0.985, Tucker-Lewis Index = 0.981, root mean square error of approximation = 0.060 (90% confidence interval = 0.059-0.060)] in the confirmatory factor analysis, with all PPCS' inter-factor correlations positive and strong (rs = 0.72-0.96). A total of 3.2% of participants were at risk of experiencing PPU (PPU+) based on the PPCS, with significant country- and gender-based differences (e.g. men reported the highest levels of PPU). No sexual orientation-based differences were observed. Only 4-10% of individuals in the PPU+ group had ever sought treatment for PPU, while an additional 21-37% wanted to, but did not do so for specific reasons (e.g. unaffordability).
CONCLUSIONS: This study validated three measures to assess the severity of problematic pornography use across languages, countries, genders, and sexual orientations in 26 languages: the Problematic Pornography Consumption Scale (PPCS, and PPCS-6, respectively), and the Brief Pornography Screen (BPS). The problematic pornography use risk is estimated to be 3.2-16.6% of the population of 42 countries, and varies among different groups (e.g. genders) and based on the measure used.
AIM: To assess the Malay-translated version of the ACDAS, postadaptation into the local context and validation by the content and construct experts.
DESIGN: The English ACDAS was translated into Malay first through forward translation and then through backward translation. The prefinal translated version of the instrument was designed, with the participation of 61 children and 61 parents or legal guardians. Subsequently, a final cross-cultural adaptation of the instrument was then made for another group of participants and evaluated for validity and test-retest reliability among 144 children and 144 parents or legal guardians participating in the self-report feedback process at the Paediatric Dental Clinic, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia. The cross-cultural adaptation of the instrument considered translating to Malaysian national language and adapting to its culture.
RESULTS: The Malay-translated ACDAS consisted of 19 items. The translated version of Malaysian-ACDAS (MY-ACDAS) achieved an acceptable agreement between six expert committee members with an internal consistency (Cronbach's alpha value, αconsistency) of 0.839. The test-retest reliability results of all participants support semantic and conceptual equivalence as an accepted construct validity between the children, parents and DHPs across the multicultural Malaysian population.
CONCLUSION: The MY-ACDAS is a valid and reliable scale for measuring dental anxiety among Malaysian children.
MATERIALS AND METHODS: This was a retrospective study using computed tomography (CT) scans from 3 hospitals. Inclusion criteria were scans with 1-5 nodules of diameter ≥5 mm; exclusion criteria were poor-quality scans or those with nodules measuring <5mm in diameter. In the lesion detection phase, 2,147 nodules from 219 scans were used to develop and train the deep learning 3D-CNN to detect lesions. The 3D-CNN was validated with 235 scans (354 lesions) for sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) analysis. In the path planning phase, Bayesian optimization was used to propose possible needle trajectories for lesion biopsy while avoiding vital structures. Software-proposed needle trajectories were compared with actual biopsy path trajectories from intraprocedural CT scans in 150 patients, with a match defined as an angular deviation of <5° between the 2 trajectories.
RESULTS: The model achieved an overall AUC of 97.4% (95% CI, 96.3%-98.2%) for lesion detection, with mean sensitivity of 93.5% and mean specificity of 93.2%. Among the software-proposed needle trajectories, 85.3% were feasible, with 82% matching actual paths and similar performance between supine and prone/oblique patient orientations (P = .311). The mean angular deviation between matching trajectories was 2.30° (SD ± 1.22); the mean path deviation was 2.94 mm (SD ± 1.60).
CONCLUSIONS: Segmentation, lesion detection, and path planning for CT-guided lung biopsy using an AI-guided software showed promising results. Future integration with automated robotic systems may pave the way toward fully automated biopsy procedures.
METHODS: Using data from the International Sex Survey (N = 82,243; Mage = 32.39; SDage = 12.52; women: n = 46,874; 57 %), we examined the reliability of depression and anxiety symptom scores of the BSI-18, as well as evaluated evidence of construct, invariance, and criterion-related validity in predicting clinically relevant variables across countries, languages, genders, and sexual orientations.
RESULTS: Results corroborated an invariant, two-factor structure across all groups tested, exhibiting excellent reliability estimates for both subscales. The 'caseness' criterion effectively discriminated among those at low and high risk of depression and anxiety, yielding differential effects on the clinical criteria examined.
LIMITATIONS: The predictive validation was not made against a clinical diagnosis, and the full BSI-18 scale was not examined (excluding the somatization sub-dimension), limiting the validation scope of the BSI-18. Finally, the study was conducted online, mainly by advertisements through social media, ultimately skewing our sample towards women, younger, and highly educated populations.
CONCLUSIONS: The results support that the BSI-12 is a valid and reliable assessment tool for assessing depression and anxiety symptoms across countries, languages, genders, and sexual orientations. Further, its caseness criterion can discriminate well between participants at high and low risk of depression and anxiety.
DESIGN: This is a cross-sectional study that used a convenient sampling technique.
STUDY SAMPLE: One hundred and fifty-seven parents of typically developing children aged between 4 months and 7 years participated in the study. Forty-nine completed the Malay PEACH + in a pen-to-paper format (Aim 1). One hundred and eight parents completed PEACH + online (69 completed the Malay version and 39 the English version), and 20 of them completed the questionnaire twice (Aim 2).
RESULTS: The PEACH + in Malay showed high internal consistency and item-total correlation. The normative data revealed that scores for frequency of auditory behaviour increased rapidly with age until about 20 months and reached an asymptote of around 90% by about 40 months of age. A similar trend was observed for ease of listening scores, which asymptoted around 85%.
CONCLUSIONS: The validated Malay PEACH + Rating Scale can be used as a guide to monitor auditory functional performance and listening efforts of Malaysian children in real-world environments.
STUDY DESIGN: The study design is a cross-sectional self-report study conducted across 42 countries.
METHODS: A cross-sectional, self-report study was conducted in 42 countries, with a total of 82,243 participants included in the final data set.
RESULTS: The study provides an overview of suicide ideation rates across 42 countries and confirms the structural validity of the P4 screener. The findings indicated that sexual and gender minority individuals exhibited higher rates of suicidal ideation. The P4 screener showed adequate reliability, convergence, and discriminant validity, and a cutoff score of 1 is recommended to identify individuals at risk of suicidal behavior.
CONCLUSIONS: The study supports the reliability and validity of the P4 suicide screener across 42 diverse countries, highlighting the importance of using a cross-cultural suicide risk assessment to standardize the identification of high-risk individuals and tailoring culturally sensitive suicide prevention strategies.
DESIGN: Descriptive, cross-sectional survey.
METHODS: The research method employed in this study is characterized as a methodological study. Self-reported survey data were collected among community-dwelling older adults with chronic diseases residing in suburban counties in China. Including the following psychometric characteristics, item analysis was performed using the decision value method and Pearson's correlation analysis. Content validity was assessed through expert panel evaluation. The internal consistency of the questionnaire was determined by calculating Cronbach's alpha coefficient and corrected item-total correlation. Additionally, confirmatory factor analysis (CFA) was utilized to assess the construct validity of the ACPRS-C.
RESULTS: A total of 228 older adults participated in this psychometric study from August to October 2023. The item content validity index ranged from 0.80 to 1.00, while the scale content validity index was 0.945. The scale demonstrated excellent internal consistency (Cronbach's alpha = 0.931), and the correlation between items and total score was satisfactory. The structural validity was deemed robust (CFA model fit: chi-square/df = 1.121, comparative fit index = 0.992).
CONCLUSION: The ACPRS-C is a scale with strong psychometric properties to assess the ACP readiness within the context of community-dwelling older adults with chronic diseases residing in suburban counties in China. Its reliability and validity hold considerable significance for both research and clinical practice.
METHODS: A total of 399 women in their second and third trimester of pregnancy were recruited from government maternal and child health clinics in Kuala Lumpur and Putrajaya and completed a self-administered online questionnaire. Content validity was conducted with an expert panel consisting of 4 members. Confirmatory factor analysis (CFA) using maximum likelihood was conducted to determine the construct validity. Internal consistency was determined by Cronbach's alpha coefficient (CAC), while the test-retest reliability was conducted using intraclass correlation coefficient (ICC).
RESULTS: The questionnaire had an appropriate content validity index of 0.91. The CPQ-P consists of 22 items, measuring 5 constructs, including morning chrono-habits, sleeping habits, evening eating, temporal eating, and pregnancy symptoms. The factor model showed good fit with χ2/df = 2.486, GFI = 0.893, CFI = 0.912, and RMSEA = 0.065. The 22 items in CPQ-P showed fair to excellent test-retest reliability (ICC: 0.42 to 0.98). The 5 constructs in CPQ-P were found to have a good to excellent internal consistency (α = 0.612-0.963).
CONCLUSIONS: The CPQ-P is a valid and reliable tool for assessing lifestyle habits during pregnancy. The questionnaire can be used to identify areas where pregnant women may need additional support or intervention to adopt healthy behaviours and reduce the risk of adverse maternal and foetal outcomes.
TRIAL REGISTRATION: NCT05700136 (clinicaltrials.gov). Trial registration date: 26/01/2023.
METHODS: The Menopause Quick 6 (MQ6) questionnaire was translated into the Malay language with an addition of an item, henceforth termed MQ6 (M). Forward and backward translation was performed. Face and content validity were conducted. MQ6 (M) was self-administered to 400 women aged between 40 and 60 attending six primary healthcare clinics in Malaysia. To ascertain the reliability for MQ6 (M), corrected Item-Total Correlation, Squared Multiple Correlation, Cronbach's Alpha if the Item is Deleted, and Kuder-Richardson Reliability Coefficients (KR20). Exploratory factor analysis was done to determine its' construct validity.
RESULTS: The outcome of the validation was satisfactory. By the Lawshe method, the content validity ratios ranged from 0.6 to 1.0 and the content validity index was 0.914. The Internal consistency for MQ6(M) Cronbach's alpha was 0.711 while Kuder-Richardson Reliability Coefficients KR20 was 0.676. Factor loading of all four items is above 0.70, indicating a well-defined structure. Whereas factor loading for three items fell within the range of 0.50-0.69 indicating a practically significant threshold for a new questionnaire.
CONCLUSION: MQ6 (M) has acceptable reliability and construct validity to be considered as a self-administered screening tool in primary care clinics in Malaysia.
METHODS: The WoCKSS was developed with 20 and 31 items for knowledge and stigma domains, respectively, based on an extensive review of COVID-19 literature. Content validation was conducted by four experts using a content validation form to assess the relevancy of each item to the intended construct. Content Validity Index (CVI) was calculated to measure the agreement between the experts on the relevance of each item to the intended construct. Face validation was then conducted by randomly selecting 10 respondents from the manufacturing industry, who rated the clarity and comprehension of each item using a face validation form. The Item Face Validity Index (I-FVI) was calculated to determine the clarity and comprehension of each question, and only items with an I-FVI ≥ 0.83 were retained.
RESULTS: The WoCKSS achieved excellent content validity in both knowledge and stigma domains. Only 19 items from the knowledge domain and 24 items from the stigma domain were retained after CVI analysis. All retained items received a CVI score of 1.00, indicating perfect agreement among the experts. FVI analysis resulted in 17 items for the knowledge domain and 22 items for the stigma domain. The knowledge domain achieved a high level of agreement among respondents, with a mean I-FVI of 0.91 and a S-FVI/UA of 0.89. The stigma domain also showed high agreement, with a mean I-FVI of 0.99 and a S-FVI/UA of 0.86.
CONCLUSION: In conclusion, the WoCKSS demonstrated high content and face validity. However, further testing on a larger sample size is required to establish its construct validity and reliability.
METHODS: Relevant data from multiple data sources which include national oral health and health surveys, national census, extensive systematic literature reviews, as well as discussion with experts, were used to estimate the economic burden of non-surgical periodontal management in specialist clinics in Malaysia in 2020. This estimation was done from the oral healthcare provider's perspective in both public and private sectors using an irreducible Markov model of 3-month cycle length over a time horizon of one year.
RESULTS: In 2020, the national economic burden of non-surgical periodontal treatment during the first year of periodontal management in specialist clinics in Malaysia was MYR 696 million (USD 166 million), ranging from MYR 471 million (USD 112 million) to MYR 922 million (USD 220 million). Of these, a total of MYR 485 million (USD 115 million) and MYR 211 million (USD 50 million) were the direct oral healthcare cost in public and private dental clinics, respectively.
CONCLUSION: The findings of this study demonstrated substantial economic burden of non-surgical periodontal management in specialist clinics in Malaysia. Being a life-long disease, these findings highlight the importance of enforcing primary and secondary preventive measures. On the strength and reliability of this economic evidence, this study provides vital information to inform policy- and decision-making regarding the future direction of managing periodontitis in Malaysia.
METHODS: We obtained information on medication use and cancer diagnosis from National Health and Nutrition Examination Survey participants. After propensity score matching, we conducted survey-weighted multivariate logistic regression and restricted cubic spline analysis to assess the observed correlation between medication use and cancer while adjusting for multiple covariates. We also performed MR analysis to investigate causality based on summary data from genome-wide association studies on medication use and cancers. We performed sensitivity analyses, replication analysis, genetic correlation analysis, and reverse MR analysis to improve the reliability of MR findings.
RESULTS: We found that the use of agents acting on the renin-angiotensin system was associated with reduced risk of prostate cancer (odds ratio (OR) = 0.42; 95% confidence interval (CI) = 0.27-0.63, P