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Validation of the snore outcomes survey for patients with sleep-disordered breathing.

OBJECTIVE: To develop and validate a self-reported outcomes measure for patients with sleep-disordered breathing-the Snore Outcomes Survey. DESIGN: Item areas of the SOS were developed by an expert panel. Consecutive patients were enrolled into the study in a prospective manner. Patients received the SOS, the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index, the Medical Outcomes Study 36-Item Short-Form Health Survey, and standard overnight polysomnography at baseline and after 4 months of continuous positive airway pressure therapy. SETTING: A tertiary care, academic otolaryngology and sleep disorders referral center. PATIENTS: One hundred fifty-six adult patients presenting with a chief complaint of snoring or sleep-disordered breathing to the Massachusetts Eye and Ear Infirmary, Boston. MAIN OUTCOME MEASURES: Test-retest reliability, intrasurvey reliability, internal consistency, validity, and standardized response means of the SOS. RESULTS: Overall, reliability of the SOS was excellent (test-retest reliability r = 0.86; P<.001; Cronbach alpha coefficient, 0.85). The SOS index significantly correlated with the Epworth Sleepiness Scale (r = - 0.42; P<.001) and the global Pittsburgh Sleep Quality Index score (r = - 0.38; P<.001), as well as with the number of recorded arterial oxygen saturation levels below 85% (r = - 0.46; P =.02). The SOS index was sensitive to clinical changes after intervention (standardized response mean, 0.57). CONCLUSION: The SOS is a reliable and valid instrument for assessing sleep-related health status for patients with snoring and sleep-disordered breathing and for measuring change in health status following therapy.

Adult↗

Validation of the French version of the Dallas Pain Questionnaire in chronic low back pain patients.

OBJECTIVES: To translate and to validate the metrological properties of the Dallas Pain Questionnaire, an instrument designed to evaluate the impact of low back pain on four aspects of patients' lives: daily activities, work and leisure activities, anxiety/depression and social interest. METHODS: The Dallas Pain Questionnaire, originally in English, was translated into French. The metrological properties of the French version were investigated in a cohort of 59 patients with chronic low back pain due to degenerative disk disease. Duration of the pain was between three and 24 months. Treatment consisted of nonsteroidal antiinflammatory drugs and/or analgesics, local corticosteroid injections and a plaster lumbar corset. Patients were evaluated at baseline, after ten days (under the same treatment), and at completion of the treatment. RESULTS: Results were reproducible for all four areas of the questionnaire (CCI > 0.75). Internal structural validity was satisfactory for the four areas (Cronbach alpha test = 0.89 to 0.91). At baseline, the pain score on a visual analog scale was significantly correlated with the Dallas scores for daily activities, anxiety/depression and social interest (external structural validity). The daily activities, work/leisure and anxiety/depression scores were sensitive to change (P < 0.001, P < 0.001, and P = 0.003, respectively), whereas the social interest score was not (P = 0.11). CONCLUSION: The French version of the Dallas Pain Questionnaire is valid, reproducible, and sensitive to change in chronic low back pain patients.

Activities of Daily Living↗

Validating the Interpersonal Communication Assessment Scale.

Despite the centrality of interpersonal communication in nursing, there are few psychometrically sound instruments to measure the communication competencies of undergraduate and graduate nursing students. This article reports on the development and testing of the Interpersonal Communication Assessment Scale (ICAS), which was designed to assess the communication competencies of students in undergraduate and graduate nursing programs. Retroductive triangulation, using both deductive and inductive methods, and the Model of Relational Competence guided the measure's conceptualization and development. We used responses from 531 (24%) undergraduate and graduate clinical faculty from 246 American Association of Colleges of Nursing member schools for the psychometric testing of the 54-item content-validated and pilot-tested ICAS. Exploratory-factor analysis resulted in a three-factor solution labeled as advocacy, therapeutic use of self, and validation. These factors accounted for 60% of the variance. Items that loaded .60 or higher were retained, resulting in a 23-item scale with a Cronbach's alpha of .96. The ICAS significantly differentiated the communication competencies of beginning and graduating students in both undergraduate and graduate programs. The ICAS was found to have construct validity and internal consistency, underscoring its potential as a formative and summative tool to assess the interpersonal communication competencies of nursing students.

Analysis of Variance↗

A novel approach for quality control of total lung capacity in the clinical pulmonary function laboratory: a study in a veteran population.

OBJECTIVE: Quality control in the clinical pulmonary function laboratory has been well developed for spirometry and diffusing capacity but not for the measurement of TLC. The purpose of the present study was to test two approaches to this problem. First, we compared TLC by body plethysmography (TLCb) with a value predicted from TLC measured by multibreath helium dilution (TLCm). Concordance between the measured and predicted values would imply the validity of the measurements. Second, we measured the test-retest variability of TLCb, TLCm and TLC measured by single breath helium dilution (TLCs) to assess the consistency of the measurements. METHODOLOGY: We performed a prospective study of 815 veterans. RESULTS: The prediction of TLCb from TLCm improved (r2 increased from 0.44 to 0.64) when FEV1/FVC and the difference between TLCm and TLCs were added to the model. The coefficient of variation for test-retest of TLCs, TLCm and TLCb were 8.9, 7.1 and 5.4%, respectively. Of all tests, 5.9% were inconsistent based on pathophysiology or measurement error and attributed mostly to TLCm. CONCLUSIONS: Prediction of TLCb from TLCm was not sufficiently accurate as to be useful for quality control. Comparison of TLCs, TLCm and TLCb may be useful for determining the internal data validity.

Airway Obstruction↗

Developing and testing instruments to measure client outcomes at the Comox Valley Nursing Center.

A Nursing Centre in Canada was initiated to demonstrate nursing practice in a primary health care context, unencumbered by conventional health care agency parameters. As one part of a multimethod evaluation, a 5 instrument client questionnaire was designed. The main instrument was developed by the researchers to measure the impact of the Centre and nurses' work from the perspective of clients. No established instrument could be found that was appropriate for the Centre's diverse client population and nature and variation in outcomes. To guide the development of the new instrument, minimally structured client interviews were conducted with 15 clients. To assess the validity and reliability of other selected instruments for the population, clients were asked to comment on the appropriateness of items. Based on findings, the Nurses' Work and Client Outcomes Questionnaire (NWCOQ) was developed, the Client Satisfaction Questionnaire and demographic questions modified, and a Cantril Self-Anchoring ladder to assess health status was supported for use. An open section was added to invite further description of clients' experiences, in particular, the unexpected, contrary or outstanding. Further pilot work was done and the refined five instrument questionnaire then was used to survey all clients who used the Centre during a seven month period. Findings from the NWCOQ revealed the nature of the nurses' work and the degree change occurred for clients on multiple health dimensions: physical, emotional, managing their situation, and group and community involvement. Clients were highly satisfied with the Centre and experienced many positive outcomes. The quantitative instruments and results were examined in relation to results from other data collection approaches and data sources. The NWCOQ has evidence of content validity and internal consistency reliability. The use of qualitative methods to develop and refine quantitative instruments for assessment of health outcomes for diverse client populations is highly recommended. This strategy is feasible even when outcome measurement timeframes are short.

British Columbia↗

Evaluation of a standardized method for determining soluble silver in workplace air samples.

Several occupational exposure limits and guidelines exist for silver, but the values for each depend on the chemical form of the silver compound in question. In the past, it generally was not possible, without prior knowledge of the work process, to distinguish soluble silver from insoluble silver compounds collected in workplace air samples. Therefore, analytical results were historically reported as total silver. In this study, work was conducted to evaluate a method to differentiate between the quantities of water-soluble silver compounds and total silver collected on filters. The investigation entailed an evaluation of an International Organization for Standardization method to determine soluble silver in airborne particulate matter. The study design incorporated laboratory experiments to evaluate analytical figures of merit, such as selection of appropriate filter media and extraction solution, analytical recovery, and sample stability during storage. Polytetrafluoroethylene (PTFE) filters (2 microm, 37 mm) in opaque cassettes were either spiked with known amounts of silver nitrate or contained a known mass of solid silver nitrate. Results showed that over 90% of the silver was recovered from PTFE filters. Also, field studies were conducted in which workplace air samples were collected in two silver refineries. Some of these samples were analyzed only for soluble silver while others were sequentially extracted and analyzed, first, for soluble silver, then for total silver. The mass fractions of soluble silver, as compared to total silver, were approximately 2% or less. This investigation served to validate an international standard procedure for the determination of soluble silver in workplace air samples.

Air Pollutants, Occupational↗

High-throughput biomonitoring of dioxins and polychlorinated biphenyls at the sub-picogram level in human serum.

We report on the use of a state-of-the-art method for the measurement of selected polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and polychlorinated biphenyls in human serum specimens. The sample preparation procedure is based on manual small size solid-phase extraction (SPE) followed by automated clean-up and fractionation using multi-sorbent liquid chromatography columns. SPE cartridges and all clean-up columns are disposable. Samples are processed in batches of 20 units, including one blank control (BC) sample and one quality control (QC) sample. The analytical measurement is performed using gas chromatography coupled to isotope dilution high-resolution mass spectrometry. The sample throughput corresponds to one series of 20 samples per day, from sample reception to data quality cross-check and reporting, once the procedure has been started and series of samples keep being produced. Four analysts are required to ensure proper performances of the procedure. The entire procedure has been validated under International Organization for Standardization (ISO) 17025 criteria and further tested over more than 1500 unknown samples during various epidemiological studies. The method is further discussed in terms of reproducibility, efficiency and long-term stability regarding the 35 target analytes. Data related to quality control and limit of quantification (LOQ) calculations are also presented and discussed.

Chromatography, Liquid↗

A patient satisfaction survey for haemophilia treatment centres.

The importance of patient satisfaction has continued to grow such that patient satisfaction is now viewed as a vital component of health-care delivery. This is evidenced by the expanding body of research in the area and the use of measures of patient satisfaction as indicators of health-care quality. The value of patient satisfaction is particularly apparent in the setting of chronic disease where medical care utilization is high, compliance with therapy is critical and the patient-provider relationship is often long-term. Although several validated tools exist to quantify general measures of patient satisfaction, there is a recognized need for disease-specific instruments. Not only are there issues that are unique to haemophilia, but many patients receive care via a specialized comprehensive clinic model. The authors were unaware of an instrument that could adequately address patient satisfaction issues specific to haemophilia; thus, they undertook to develop one. The patient satisfaction survey presented here contains fixed-choice, Likert-scale and open-ended questions adapted from previously validated questionnaires. Assessment of face validity and internal consistency indicate that the survey is measuring one underlying construct - patient satisfaction. Information acquired through this survey will provide a quantitative assessment of patient satisfaction within a clinic population of persons with bleeding disorders and could be used to guide decisions regarding provision of health-care services.

Adolescent↗

Reliability and validity of noninvasive imaging of internal carotid artery pseudo-occlusion.

BACKGROUND AND PURPOSE: Our study evaluated noninvasive tests for the diagnosis of atheromatous internal carotid artery (ICA) pseudo-occlusion. METHODS: Twenty patients (17 men, 3 women; mean age +/-SD, 64.3+/-11.6 years) with angiographically proven atheromatous ICA pseudo-occlusion (20 vessels) were prospectively examined with MR angiography (MRA; 2D and 3D time-of-flight techniques), color Doppler-assisted duplex imaging (CDDI) and power-flow imaging (PFI) with and without an intravenous ultrasonic contrast agent. As a control group, 13 patients (13 men; mean+/-SD age, 63.0+/-9.0 years) with angiographically proven ICA occlusion (13 vessels) were studied with the same techniques. For the determination of interobserver agreement (kappa statistics), the findings of each diagnostic technique were read by 2 blinded and independent observers who were not involved in patient recruitment and initial data acquisition. Specificity and sensitivity were calculated for all noninvasive techniques (observer consensus) in comparison to the standard of reference (intra-arterial angiography). RESULTS: Interobserver reliabilities were kappa=0.86 for intra-arterial angiography, kappa=0.90 for unenhanced CDDI, kappa=0. 93 for enhanced CDDI, kappa=0.93 for unenhanced PFI, kappa=1.0 for enhanced PFI, kappa=0.93 for 2D MRA, and kappa=0.77 for 3D MRA, respectively (P<0.0001). Specificities and sensitivities were 0.92 and 0.70 for unenhanced CDDI, 0.92 and 0.83 for enhanced CDDI, 0.92 and 0.95 for unenhanced PFI, 1.0 and 0.94 for enhanced PFI, 1.0 and 0.65 for 2D MRA, and 0.89 and 0.47 for 3D MRA, respectively. CONCLUSIONS: Advanced ultrasonographic techniques, especially PFI (with only 1 false-positive diagnosis of occlusion in the present series), can provide reliable and valid data to differentiate between ICA pseudo-occlusion and complete occlusion. In contrast, time-of-flight MRA at its present state is not capable of predicting minimal residual flow within a nearly occluded ICA.

Aged↗

The hyperkinetic abnormal movements scale: a tool for measuring levodopa-induced abnormal movements in squirrel monkeys.

The Hyperkinetic Abnormal Movements Scale (HAMS) was developed based on extensive observation of normal and abnormal movements in squirrel monkeys. The observations of abnormal movements were performed using animals that had undergone prior lesioning with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) that subsequently developed levodopa-induced abnormal movements. Specific and easily observable changes in behavior were used to delineate the boundaries between each rating level of the scale. The full spectrum of abnormal behavior at each rating level was then characterized for the squirrel monkey. Once the scale was fully developed and finalized, reliability testing revealed strong inter-rater (r = 0.959) and intrarater reliability (r = 0.930 to 0.941). Novice raters were easily taught its use and subsequently could use the scale with strong inter-rater reliability (R = 0.9057). In further studies of levodopa-induced abnormal movements, the HAMS was demonstrated to be highly sensitive, highly specific, and valid, both internally and when compared with an objective measure of abnormal movements. Although the scale was developed in MPTP-lesioned squirrel monkeys treated with levodopa, it might provide a framework for the standardized measurement of hyperkinetic abnormal movements in other primates and other experimental conditions.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗

Turkish version of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration: a preliminary study.

BACKGROUND: The Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration is an established instrument to measure the perceived work relationship between physicians and nurses. The survey addresses areas of autonomy and decision making, interprofessional education and relations, psychosocial care, teamwork, and shared responsibility. The aim of this prelimiary study was to adapt the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration for use in Turkey and test its psychometric properties and utility in clinical and research practice. METHODS: The process of cross-cultural adaptation and validation followed the guidelines provided in the existing literature. First, three bilingual health professionals independently translated the original questionnaire into Turkish and a consensus version was generated. Then, three other translators, blind to the original questionnaire, performed a back translation into English to confirm the accuracy of the translation. This version was then compared with the original English questionnaire. Discrepancies were discussed and solved by a panel of two nurses and two physicians. The field-testing for face validity was done in a group of ten monolingual physicians and nurses. Reliability was assessed with test-retest reliability and construct validity was confirmed with factor analysis. RESULTS: The mean time of questionnaire administration was 3 minutes and 45 seconds. The test-retest reliability was 0.75, and Cronbach's coefficient alpha was 0.71 for the entire sample. The findings of the factor analysis indicated that the Turkish version of Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration was comprised of the following four factors: 'physician-nurse relationships', 'shared education', 'nursing role in patient care', and 'accountability and responsibility of nurses.' CONCLUSION: The overall findings of this study indicate that the Turkish version of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration is a psychometrically sound tool with satisfactory measurement characteristics including construct validity and internal consistency reliability. This instrument may be useful in assessing the effectiveness of educational programs designed to enhance collaboration between physicians and nurses, whether these programs are aimed at residents and graduate nursing students or practicing physicians and nurses.

Adult↗

Age-stratified analysis of I-PSS and QoL values in spanish patients with symptoms potentially related to BPH.

OBJECTIVE: The main goal of the present study was to determine age-related symptom changes using a validated Spanish International Prostate Symptom Score (I-PSS) and quality of life index (QoL) in Spanish patients with symptomatic benign prostatic hyperplasia (BPH). METHODS: A total of 2,875 patients with the clinical diagnosis of symptomatic BPH were evaluated. Data were collected during current medical practice in a national study. Patients were excluded if they had any previous prostate operation or suspicion of prostate cancer. I-PSS was self-administered and compared with the physician's global impression. RESULTS: I-PSS symptoms, both voiding and storage symptoms, increased significantly with age (p<0.0001) as well as QoL (p<0.0017). A change in the I-PSS categories (minor, moderate and severe) was found with age, increasing severe symptomatic patients in the oldest groups. A significant correlation was found between I-PSS and QoL (r = 0.49, p<0.001), being this relationship linear and not significantly influenced by age. CONCLUSIONS: This study confirms reliable results using a validated Spanish I-PSS in a large national representative sample of Spanish patients with BPH symptoms. The age-stratified analysis showed that the natural progression of BPH with age was related to an increased symptomatology and bothersomeness, well reflected by increases in the I-PSS and QoL values. Nevertheless, the effect of symptomatology on quality of life was not strongly influenced by the age of the patient.

Age Factors↗

[Validation of two systems of self-measurement of blood pressure, the OMRON HEM-705 CP and OMRON M1 (HEM 422C2-E) models].

Objective. To validate two monitors on the market for self-measurement of blood pressure (SMBP), an automatic one (OMRON HEM-705 CP) and a semi-automatic one (OMRON M1).Design. Descriptive study of validation of diagnostic tests.Setting. Primary care. San Pablo University Health Centre, Sevilla.Participants. 85 individuals (20 men and 65 women) with a wide range of age and blood pressure (BP), belonging to the population attended at the health centre or to its staff. People with arrhythmia and Korotkoff's V phase close to zero were excluded. Main measurements and results. BP and cardiac frequency (CF) measurements obtained with the SMBP devices to be validated were compared with readings on a mercury sphygmomanometer, used as the standard method. The differences between the SMBP devices and the gold standard were quantified and are presented on the scale proposed by the protocol of the British Hypertension Society (BHS). The mean (SD) of the systolic BP differences (in mm Hg) between the devices evaluated and the standard device was 1.084.73 for the automatic monitor and 1.255.30 for the semi-automatic one. The mean differences of diastolic BP were 0.444.03 for the automatic monitor, and 0.513.90 for the semi-automatic one. The cumulative percentage differences of systolic/ diastolic BP5, 10 and 15 mm Hg were 85.5, 98, 98.8/90.6, 98.4, 100% for the automatic monitor and 82.7, 95.7, 98.8/91, 99.6, 100% for the semi-automatic one. This supposes a Grade A on the BHS procedure, which is maintained on analysis of the results by blood pressure rankings. Conclusion. As both monitors meet the internationally accepted validation criteria, they can be recommended for the monitoring and self-monitoring of BP in patients with hypertension.

Adolescent↗

Use of the female sexual function index in women with vulvar intraepithelial neoplasia.

The present investigation extends the validation of the Female Sexual Function Index (FSFI; Rosen et al., 2000) to include women with vulvar excisions for vulvar intraepithelial neoplasia (VIN). No instrument previously has been validated in this population. We administered the instrument to 43 women (n = 43) with VIN treated with vulvar excision and age-matched healthy controls (n = 43). We found the FSFI to have high reliability and validity in the VIN excision population. Discriminant validity and internal consistency were within acceptable ranges. Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C-30; Agronson et al., 1993) and the FSFI in this population, we found a correlation between a related construct of quality of life and sexual function.

Adult↗

Development of a questionnaire measuring student attitudes to working and living in rural areas.

INTRODUCTION: Student attachments in rural locations have been instigated, in part to foster positive attitudes to rural practice and encourage rural recruitment. Based on medical and allied health literature, it was hypothesised that students' attitudes to rural practice and rural life encompasses the following three dimensions: (1) community and social issues; (2) family and personal issues; and (3) professional issues. However, there are limited studies assessing attitudinal change before and after rural placement and no valid and reliable tools which examine change across all three dimensions. This article reports on the development, reliability and validity of such a tool to fill this gap in the rural health research literature. METHODS: Students who undertook a rural placement in South Australia or a rural placement organised by the Mt Isa Centre for Rural and Remote Health in Queensland, Australia, during 2001 were invited to complete a pre- and post-placement questionnaire (n = 243). The response rate for the pre-placement questionnaire was 74.9% (n = 182) and 50.2% (n = 122) for the post-placement questionnaire. A literature review informed the content of the initial questionnaire, which consisted of a series of statements to which respondents were instructed to indicate how strongly they agreed or disagreed on a Likert scale of one to six. The assessment of validity and reliability of the questionnaire involved three main processes. Content validity was assessed by discussion and rating by academics and students, resulting in 18 questionnaire items. Exploratory factor analysis was used to provide evidence of construct validity. The internal consistency reliability of the questionnaire was assessed using Cronbach's alpha. RESULTS: The Cronbach's alpha coefficient for the post-questionnaire was 0.68, acceptable for newly developed scales. Exploratory factor analysis and varimax rotation was conducted for pre- and post-placement (n = 110) questionnaires. The pre-placement questionnaire did not lend itself to logical interpretation, probably due to the diverse attitudes students may have pre-rural placement. However the factors on the post-placement questionnaire were interpretable. The Scree Plot indicated four factors, explaining 60.82% of the total variance. The factors were rotated using the normalised varimax rotation method. The factors extracted were: (1) friendliness and support in rural areas; (2) isolation and socialisation problems associated with living and working in rural areas; (3) enjoyable aspects of living in a rural area; and (4) opportunities that working in a rural area provides. CONCLUSIONS: Analysis of the Student Attitudes to Rural Practice and Life Questionnaire provides evidence of validity. The study identified four factors associated with student attitudes to living and working in rural areas, which differ from those hypothesised. The main deviation was Factor 2, grouping all the negative aspects of isolation and socialisation in a rural area. The resulting factors provide a more integrated reflection of the rural experience, rather than the rigid categorisation of professional, social and personal issues. Reliability was found to be adequate. The questionnaire is able to measure student attitudes to rural practice and rural life, and may be used to evaluate the impact of rural placement on student attitudes.

Attitude of Health Personnel↗

Children's internal representations, empathy, and fantasy play: a validity study of the SCORS-Q.

The authors investigated relationships among internal representations, empathy, and affective and cognitive processes in fantasy play to test the validity of the Social Cognition and Object Relations Scale Q-Sort (SCORS-Q; D. Westen, 1995) with children. Eighty-six 8-10-year-olds were administered 8 Thematic Apperception Test cards, a standardized play task, and a self-report empathy measure. Teachers rated children's empathy and helpfulness. As predicted, internal representations were related to empathy, helpfulness, and quality of fantasy play. Developmental differences on the SCORS-Q were consistent with object relations theory and with results from the original SCORS. The findings support the value of internal representations as a means of understanding children's interpersonal functioning and contribute to the validity of the SCORS-Q for use with children.

Child↗

Generation and validation of a Myh11Dre-Spp1Cre intersectional mouse model for lineage tracing of disease-associated smooth muscle cell states.

BACKGROUND: Phenotypic modulation of vascular smooth muscle cells (VSMCs) is a hallmark of vascular remodeling and cardiovascular disease. Recent lineage-tracing and single-cell transcriptomic studies have identified secreted phosphoprotein 1 (SPP1) as a prominent marker associated with disease-associated VSMC states, particularly those linked to fibrotic remodeling and vascular calcification. However, the cellular origins and fate of SPP1-associated VSMC populations remain incompletely understood. METHODS AND RESULTS: We generated a novel Spp1-rSTOPr-Cre (Spp1Cre) knock-in mouse line in which Cre recombinase is expressed from the endogenous Spp1 locus following Dre-mediated excision of a rox-flanked transcriptional STOP cassette. Correct targeting of the knock-in allele was validated by internal, 5' junction, 3' junction, and long-range PCR analyses, as well as Sanger sequencing. To establish an intersectional lineage-tracing strategy, Spp1Cre mice were crossed with Myh11DreERT2 and Rosa26-RSR-LSL-tdTomato-LSL-eGFP reporter mice, enabling permanent labeling of VSMC-derived populations following activation of the endogenous Spp1 locus. Under physiological conditions, eGFP-positive cells were detected at low frequency within the vascular wall and were predominantly negative for the contractile markers ACTA2 and MYH11. As a proof-of-principle application, eGFP-positive cells markedly expanded within atherosclerotic lesions induced by AAV-PCSK9D377Y and high-fat diet feeding. These lineage-traced cells remained largely ACTA2- and MYH11-negative, consistent with a modulated phenotype. Notably, only a minority of eGFP-positive cells expressed SPP1 or fibronectin at the time of analysis, demonstrating the utility of permanent lineage tracing for tracking cells with a history of endogenous Spp1 activation during vascular remodeling. CONCLUSION: We report the generation and validation of a novel Myh11Dre-Spp1Cre intersectional mouse model for lineage tracing of VSMC-derived populations that have activated the endogenous Spp1 locus. This genetic resource provides a valuable platform for investigating the origin, fate, and phenotypic evolution of Spp1-associated VSMC populations during vascular remodeling and cardiovascular disease.

Animals↗

Translation, adaptation and validation of the Shoulder Rating Questionnaire (SRQ) into the Dutch language.

OBJECTIVE: To translate and adapt the original English version of the Shoulder Rating Questionnaire (SRQ) into the Dutch language (SRQ-DLV) and evaluate its internal consistency, reliability, validity and responsiveness to clinical changes. DESIGN: Prospective study. SETTING: Outpatient departments of orthopaedics, radiology and physical therapy of an academic and a non-academic hospital. SUBJECTS: One hundred and seven patients treated for unilateral shoulder disorder (adhesive capsulitis 68, calcifying tendinitis 22, impingement syndrome or rotator cuff tear 17). METHODS: The original SRQ was translated and adapted following international guidelines. The SRQ-DLV was used among other measures of body function and structure, activities and societal participation in order to determine reliability, internal consistency, validity and responsiveness. Assessments were done at baseline and three months after treatment, with the SRQ-DLV being re-administered within one week before the baseline measurement and the start of the treatment for testing reliability. RESULTS: Cronbach's alpha for internal consistency was 0.89 for the total questionnaire and 0.81, 0.80, 0.72 and 0.84 for the domains pain, daily activities, sports/recreational activities and work, respectively. Test-retest reliability of the SRQ-DLV and its subscales ranged from 0.63 to 0.86. The summary score of the SRQ-DLV correlated with measures of shoulder function, daily activities and quality of life. Except for the work subscale of the SRQ-DLV, large effect sizes, reflecting its responsiveness to clinical changes after treatment, were found for both the summary and the subscales scores. CONCLUSIONS: Empirical data support that the SRQ-DLV is a reliable, valid and responsive measure to be used in clinical trials including Dutch patients with various shoulder disorders.

Disability Evaluation↗