OBJECTIVES

This study aimed to evaluate the psychometric properties of the Tagalog version of the PsAQoL to assess its reliability and consistency.

METHODS

This is a prospective validation study involving 47 patients with PsA from June to August 2023. The
psychometric properties tested were internal consistency (Cronbach’s alpha coefficients), test-retest reliability, convergent validity (Spearman’s rank correlation), and known group validity (Mann-Whitney U Test or Kruskal- Wallis One-Way Analysis of Variance).

RESULTS

The PsAQoL on both week 0 and week 2 had Cronbach’s alpha coefficients of 0.926 indicating high
internal consistency. Test-retest reliability was 0.929, which demonstrates excellent reliability and low level of random measurement error. The PsAQoL scores highly correlated with the Health Assessment Questionnaire-Disability Index (r=0.754, pCONCLUSION

The Tagalog version of the PsAQoL demonstrates excellent psychometric properties and is recommended for monitoring of Tagalog-speaking patients with psoriatic arthritis in healthcare settings.

Human ; Male ; Female ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Analysis Of Variance ; Aptitude ; Health ; Index ; Patients ; Psychometrics ; Reproducibility Of Results ; Statistics, Nonparametric ; Validation Study

OBJECTIVES

This study explored the interplay of three Filipino cultural values—hiya (modesty/self-restraint), pakikisama (conflict-avoidance dimension of social harmony), and pakikipag-ugnayan (professional engagement, characterized by vigor, dedication, and absorption)—among Generation Z nurses in Quezon City. Specifically, it assessed their levels, examined interrelationships through correlation and path analysis, and developed a framework to illustrate their influence on nursing practice. In the Filipino context, hiya encompasses both positive dimensions, such as conscientiousness, moral accountability, and social responsibility, and constraining dimensions, including excessive self-restraint, fear of criticism, and inhibition. Pakikisama, while fostering harmony, may discourage assertiveness and limit open communication. Pakikipag-ugnayan, conceptualized here as engagement, reflects dedication, vigor, and absorption, which are vital for performance, patient safety, and workforce retention.

METHODS

A descriptive–correlational design was utilized to assess the relationships among hiya, pakikisama, and pakikipag-ugnayan. Data were gathered through a structured, self-administered questionnaire comprising validated scales for each construct, distributed in online formats to accommodate participants’ availability and work schedules. The purposive sample consisted of 115 Filipino Generation Z nurses engaged in direct patient care in various healthcare facilities in Quezon City. Data analysis involved descriptive statistics to summarize variable scores, Spearman’s rho to examine bivariate correlations, and path analysis to determine the direct and indirect effects among the variables. The results of the path analysis were used to develop a proposed framework illustrating the interplay of these cultural values in nursing practice.

RESULTS

Path analysis revealed distinct patterns in the interplay of hiya, pakikisama, and pakikipag-ugnayan among Generation Z nurses in Quezon City. Very high hiya scores (mean = 5.32) reflected both moral accountability and restraint-oriented tendencies. Despite these positive indicators, hiya showed a negative correlation with pakikipag-ugnayan, suggesting that its inhibiting side—marked by fear of criticism and avoidance of mistakes—may overshadow its constructive moral aspects. In contrast, the path analysis identified a moderate positive direct effect between hiya and pakikipag-ugnayan (β = 0.400, pCONCLUSION

Among Generation Z nurses, hiya demonstrates a dual role: while its ethical and conscientious aspects can strengthen pakikipag-ugnayan, its inhibiting side may suppress pakikipag-ugnayan. Pakikisama, operationalized as conflict avoidance and withholding dissent, emerged as a barrier to pakikipag-ugnayan by discouraging open communication. These findings informed the development of the Hiya–Pakikisama– Pakikipag-ugnayan Cultural Dynamics Framework, which illustrates how cultural values can simultaneously enable and constrain professional engagement. The framework has potential applications in nursing education and organizational practice, particularly in designing reflective learning, mentorship, and communication strategies that balance cultural sensitivity with assertiveness. Further validation across generations and healthcare settings is recommended to refine its applicability.

Human ; Weights And Measures ; Sensitivity And Specificity ; Retention (psychology) ; Education, Nursing ; Social Responsibility ; Appointments And Schedules ; Conflict (psychology)

BACKGROUND: Keloid, a fibroproliferative skin disorder, requires accurate scar assessment. Comprehensive evaluation using a standardized instrument from both patient and observer perspectives is essential to capture its multidimensional impact. This study aimed to translate, culturally adapt, and validate the generic patient and observer scar assessment scale (POSAS) 3.0 into Indonesian for keloid assessment. METHODS: A cross-sectional design was adopted following the translation and cultural adaptation guidelines. The instrument was translated into Indonesian by certified translators and administered to 68 keloid patients and 62 dermatologists especially recruited from Pekanbaru and the surrounding areas. Content validity was assessed using the scale-level content validity index average (S-CVI/Ave), construct validity through exploratory factor analysis (EFA), internal consistency with Cronbach’s alpha, test-retest reliability using the intraclass correlation coefficient (ICC), and external validity by correlating the observer scar assessment scale (OSAS) with the modified Vancouver scar scale (mVSS). RESULTS : The Indonesian version of the generic POSAS 3.0 demonstrated strong psychometric properties. The S-CVI/Ave was 0.97. The EFA revealed 3 factors for the patient scar assessment scale and two for the OSAS, explaining 71.25% and 73.1% of the variance, respectively. Cronbach’s alpha was 0.79–0.90 and ICC was ≥0.83. External validity was confirmed by a strong correlation with the mVSS (Spearman’s rho = 0.82, p<0.001). CONCLUSIONS The Indonesian adaptation of the POSAS 3.0 is a valid and reliable tool for comprehensive keloid scar assessment. Future research should explore the responsiveness to therapeutic interventions.
Indonesia ; keloid ; psychometrics ; reproducibility of results ; validation study

Breast cancer (BC) is the most frequently diagnosed malignancy worldwide and a leading cause of death in women. Machine learning (ML) enables data-driven risk stratification and outcome prediction, potentially improving screening, treatment choices, and overall care. This scoping review cataloged ML models used to predict BC risk and post-treatment outcomes. A PubMed search using MeSH terms (“breast neoplasms,” “breast cancer,” “machine learning,” and “predictive value of tests”) retrieved 44 records, with 9 added by manual searching; 24 studies were included. We excluded 29 reports limited to imaging/radiomics or biomolecular/omics, plus other ineligible items. Model usage among included studies: 13 random forest (RF); 13 support vector machine; 7 decision tree; 5 k-nearest neighbors; 4 deep learning; 3 naïve Bayes; 2 artificial neural networks. Average RF accuracy surpassed 90% in most reports, indicating RF is both common and consistently strong for predictive modeling, supporting targeted clinical translation.
breast neoplasm ; machine learning ; predictive value of tests

OBJECTIVES: To explore the synthesis of high-quality CT (sCT) from cone-beam CT (CBCT) using PE-CycleGAN for adaptive radiotherapy (ART) for nasopharyngeal carcinoma. METHODS: A perception-enhanced CycleGAN model "PE-CycleGAN" was proposed, introducing dual-contrast discriminator loss, multi-perceptual generator loss, and improved U-Net structure. CBCT and CT data from 80 nasopharyngeal carcinoma patients were used as the training set, with 7 cases as the test set. By quantifying the mean absolute error (MAE), peak signal-to-noise ratio (PSNR), structural similarity index (SSIM), as well as the dose gamma pass rate and the relative dose deviations of the target area and organs at risk (OAR) between sCT and reference CT, the image quality and dose calculation accuracy of sCT were evaluated. RESULTS: The MAE of sCT generated by PE-CycleGAN compared to the reference CT was (56.89±13.84) HU, approximately 30% lower than CBCT's (81.06±15.86) HU (P<0.001). PE-CycleGAN's PSNR and SSIM were 26.69±2.41dB and 0.92±0.02 respectively, significantly higher than CBCT's 21.54±2.37dB and 0.86±0.05 (P<0.001), indicating substantial improvements in image quality and structural similarity. In gamma analysis, under the 2 mm/2% criterion, PE-CycleGAN's sCT achieved a pass rate of (90.13±3.75)%, significantly higher than CBCT's (81.65±3.92)% (P<0.001) and CycleGAN's (87.69±3.50)% (P<0.05). Under the 3 mm/3% criterion, PE-CycleGAN's sCT pass rate of (90.13±3.75)% was also significantly superior to CBCT's (86.92±3.51)% (P<0.001) and CycleGAN's (94.58±2.23)% (P<0.01). The mean relative dose deviation of the target area and OAR between sCT and planned CT was within ±3% for all regions, except for the Lens Dmax (Gy), which had a deviation of 3.38% (P=0.09). The mean relative dose deviations for PTVnx HI, PTVnd HI, PTVnd CI, PTV1 HI, PRV_SC, PRV_BS, Parotid, Larynx, Oral, Mandible, and PRV_ON were all less than ±1% (P>0.05). CONCLUSIONS PE-CycleGAN demonstrates the ability to rapidly synthesize high-quality sCT from CBCT, offering a promising approach for CBCT-guided adaptive radiotherapy in nasopharyngeal carcinoma.
Humans ; Cone-Beam Computed Tomography/methods* ; Nasopharyngeal Neoplasms/diagnostic imaging* ; Nasopharyngeal Carcinoma/radiotherapy* ; Radiotherapy Planning, Computer-Assisted/methods* ; Radiotherapy Dosage ; Signal-To-Noise Ratio ; Radiotherapy, Intensity-Modulated

OBJECTIVES: We propose a segmented backprojection tensor degradation feature encoding (SBP-MAC) model for motion artifact correction in dental cone beam computed tomography (CBCT) to improve the quality of the reconstructed images. METHODS: The proposed motion artifact correction model consists of a generator and a degradation encoder. The segmented limited-angle reconstructed sub-images are stacked into the tensors and used as the model input. A degradation encoder is used to extract spatially varying motion information in the tensor, and the generator's skip connection features are adaptively modulated to guide the model for correcting artifacts caused by different motion waveforms. The artifact consistency loss function was designed to simplify the learning task of the generator. RESULTS: The proposed model could effectively remove motion artifacts and improve the quality of the reconstructed images. For simulated data, the proposed model increased the peak signal-to-noise ratio by 8.28%, increased the structural similarity index measurement by 2.29%, and decreased the root mean square error by 23.84%. For real clinical data, the proposed model achieved the highest expert score of 4.4221 (against a 5-point scale), which was significantly higher than those of all the other comparison methods. CONCLUSIONS The SBP-MAC model can effectively extract spatially varying motion information in the tensors and achieve adaptive artifact correction from the tensor domain to the image domain to improve the quality of reconstructed dental CBCT images.
Cone-Beam Computed Tomography/methods* ; Artifacts ; Humans ; Motion ; Image Processing, Computer-Assisted/methods* ; Signal-To-Noise Ratio ; Algorithms

OBJECTIVES: We propose a myocardial infarction (MI) detection and localization model for improving the diagnostic accuracy for MI to provide assistance to clinical decision-making. METHODS: The proposed model was constructed based on multi-scale field residual blocks fusion modified channel attention (MSF-RB-MCA). The model utilizes lead II electrocardiogram (ECG) signals to detect and localize MI, and extracts different levels of feature information through the multi-scale field residual block. A modified channel attention for automatic adjustment of the feature weights was introduced to enhance the model's ability to focus on the MI region, thereby improving the accuracy of MI detection and localization. RESULTS: A 5-fold cross-validation test of the model was performed using the publicly available Physikalisch-Technische Bundesanstalt (PTB) dataset. For MI detection, the model achieved an accuracy of 99.96% on the test set with a specificity of 99.84% and a sensitivity of 99.99%. For MI localization, the accuracy, specificity and sensitivity were 99.81%, 99.98% and 99.65%, respectively. The performances of the model for MI detection and localization were superior to those of other comparison models. CONCLUSIONS The proposed MSF-RB-MCA model shows excellent performance in AI detection and localization based on lead II ECG signals, demonstrating its great potential for application in wearable devices.
Myocardial Infarction/diagnosis* ; Humans ; Electrocardiography/methods* ; Signal Processing, Computer-Assisted ; Algorithms ; Sensitivity and Specificity

OBJECTIVES: To revise and evaluate the psychometric properties of the Chinese version of the Wong and Law's Emotional Intelligence Scale (WLEIS). METHODS: The 11 items of the original WLEIS were modified to form the WLEIS-CR, with the Generalized Anxiety Disorder Scale (GAD-7), 9-item Patient Health Questionnaire (PHQ-9), and Flourishing Scale (FS) as the validity criteria. A total of 1546 adult participants were evaluated using all these scales, and a retest was conducted among 192 college students to assess the item discrimination, reliability, validity and measurement invariance of the modified WLEIS-CR. RESULTS: All the 16 items of the modified WLEIS-CR demonstrated good discriminative power (r=0.570 -0.764, P<0.001). The structural equation model from a confirmatory factor analysis showed excellent fit indices (χ²/df=4.610, GFI=0.965, PGFI=0.674, RMR=0.028, NFI=0.975, CFI=0.980, RMSEA=0.048). The criterion-related validity of the modified WLEIS-CR with FS, GAD-7, and PHQ-9 was 0.674, -0.347, and -0.368, respectively (P<0.001). The internal consistency (Cronbach's α) was 0.913 for the total scale and ranged from 0.867 to 0.916 for the subscales. The split-half reliability was 0.956 for the total scale and 0.865-0.924 for the subscales. Test-retest reliability was 0.701 for the total scale and 0.610-0.684 for the subscales. Normative interpretation criteria were established: 7.6% of participants had "low", 19.3% had "below average", 22.3% had "moderate", 34.3% had "above average", and 16.5% had "very high" emotional intelligence. The scale demonstrated a good measurement invariance across gender, identity, and age groups. CONCLUSIONS The modified WLEIS-CR has good reliability, validity and measurement invariance, and is suitable for evaluating emotional intelligence of Chinese adults to assess their emotional health.
Humans ; Psychometrics ; Emotional Intelligence ; Young Adult ; Adult ; Male ; Female ; Surveys and Questionnaires ; Reproducibility of Results ; Adolescent

OBJECTIVES: To investigate the impact of incorrect specification of the working correlation structure matrix on estimated sample size in a 2×2 crossover design based on the generalized estimating equation (GEE). METHODS: Based on Monte Carlo simulation, the influence of incorrect specification of the work-related structure matrix on the sample size estimation under different conditions was evaluated after controlling the total sample size n, the proportion of subjects assigned to AB sequence (s=1) θ, the correlation coefficient ρ, and the placebo effect OR. Bias and mean square error (MSE) were used to assess the difference between the sample size estimates and the theoretical values. RESULTS: When the correctly specified working correlation structure matrix is independent, the sample size estimation effect of correctly specifying the working correlation structure matrix is better than that of incorrect specification. But when the correctly specified working correlation structure matrix is equal and the correlation coefficient is closer to 0, with other factors being smaller (n≤50, θ≤0.5, OR=2 in this article), there is a situation where the bias of the sample size estimation value for the correctly specified working correlation structure matrix is greater than the bias for the incorrectly specified working correlation structure matrix. CONCLUSIONS Under most conditions, incorrectly specifying the working correlation structure matrix can cause the estimated sample size to deviate significantly from the theoretical value, but under certain conditions, the impact of incorrectly specifying the working correlation structure matrix can be small on the estimated sample size.
Sample Size ; Monte Carlo Method ; Humans ; Cross-Over Studies ; Computer Simulation ; Research Design ; Bias

Depression is increasingly prevalent among adolescents and can profoundly impact their lives. However, the early detection of depression is often hindered by the time-consuming diagnostic process and the absence of objective biomarkers. In this study, we propose a novel approach for depression detection based on an affective brain-computer interface (aBCI) and the resting-state electroencephalogram (EEG). By fusing EEG features associated with both emotional and resting states, our method captures comprehensive depression-related information. The final depression detection model, derived through decision fusion with multiple independent models, further enhances detection efficacy. Our experiments involved 40 adolescents with depression and 40 matched controls. The proposed model achieved an accuracy of 86.54% on cross-validation and 88.20% on the independent test set, demonstrating the efficiency of multimodal fusion. In addition, further analysis revealed distinct brain activity patterns between the two groups across different modalities. These findings hold promise for new directions in depression detection and intervention.
Humans ; Male ; Female ; Adolescent ; Case-Control Studies ; Depression/diagnosis* ; Early Diagnosis ; Rest ; Electroencephalography/methods* ; Brain-Computer Interfaces ; Models, Psychological ; Reproducibility of Results ; Affect/physiology* ; Photic Stimulation/methods* ; Video Recording ; Brain/physiopathology*