Construct validity of the Eating Assessment Tool (EAT-10)

Abstract

Purpose: We aimed to evaluate the construct validity of the Eating Assessment Tool (EAT-10) by determining its dimensionality, rating scale integrity, item-person match, precision and relationship with the degree of airway invasion and functional oral intake.

Methods: We conducted a retrospective analysis of patients’ EAT-10 scores. We used the Rasch rating scale model. We investigated correlations between the EAT-10 and scores on the Penetration-Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS).

Results: The median score of the EAT-10 from 127 patients was 16 of 40 (range 0–40). Confirmatory factor analysis supported unidimensionality. The 5-point rating scale categories met published criteria. Two items misfit the Rasch model and two other items displayed differential item functioning. Rasch person reliability was 0.79. Our patient cohort was divided into three person-strata. Correlations between the EAT-10 and the PAS and FOIS were weak to moderate in strength (respectively: r?=?0.26, p?=?0.0036; r?=??0.27, p?=?0.0027).

Conclusions: Our analyses identified deficits in the construct validity of the EAT-10 suggestive of a need to improve the EAT-10 to support its frequent use in clinical practice and research.

• Implications for Rehabilitation

• Swallowing disorders are associated with severe complications, such as pneumonia and malnutrition, and impose both social and psychological burdens on patients.

• The Eating Assessment Tool is a self-report instrument developed to estimate initial dysphagia severity and monitor change in patient-reported dysphagia symptoms as a response to treatment.

• This study shows that the Eating Assessment Tool has deficits in its construct validity and a need to improve the instrument to support its frequent use in clinical practice and research.

     

Medizinstudierendenauswahl in Deutschland

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Das Bundesverfassungsgericht überprüft aktuell, ob das Vergabeverfahren der Medizinstudienplätze mit dem...     

Subcritical crack growth behavior and life data analysis of two types of dental Y-TZP ceramics

Objectives

The aim of this study was to evaluate the mechanical properties and the subcritical crack growth behavior of a presintered dental Y-TZP (Kavo Everest ZS) and a hot isostatic pressed Y-TZP (Kavo Everest ZH) and to perform life data analysis.

Methods

For each material 150 bending bars were produced. The initial fracture strength was determined in a four-point bending test. The subcritical crack growth parameters n and A were determined in a dynamic fatigue method at four decreasing loading rates from 110 MPa/s to 0.11 MPa/s in distilled water at 38 °C. For each loading rate Weibull statistics were performed and the Weibull moduli m and characteristic strengths σ₀ were calculated. Using these data, strength-fracture probability-life time (SPT) predictions were derived for 1 day, 1 year, 5 years and 10 years, based on a static crack growth mechanism.

Results

The “hipped” Y-TZP ceramic exhibited a higher initial strength (σ_c = 1618.18), characteristic strength (σ₀ = 837.15) and fracture toughness (K_IC = 4.52 MPa/m^1/2) than the pre-sintered ceramic (σ_c = 1431, σ₀ = 745.46 and K_IC = 3.17 MPa/m^1/2, respectively). Fatigue parameters, n and A, were 28.5 and 7.97 × 10⁻²⁴ for Everest ZH and 30.15 and 5.47 × 10⁻²⁰ for Everest ZS. The predicted fracture stress at 5% failure probability for a lifetime of 10 years was 259.34 MPa for Everest ZH and 263.2 MPa for Everest ZS.

Conclusions

Although the “hipped” Y-TZP showed favorable initial mechanical properties, no significant difference could be found in the susceptibility of both ceramics to subcritical crack growth and their long-term strength.     

Ultrasound point shear wave elastography of the pancreas: comparison of patients with type 1 diabetes and healthy volunteers – results from a pilot study

Background

The aims of this study were to establish shear wave elastography of the pancreas by comparing measurements in patients with type 1 diabetes (T1D) and healthy volunteers and to consider whether this method could contribute to the screening or prevention of T1D.

Methods

This pilot study included 15 patients with T1D (10 men, 5 women) and 15 healthy volunteers (10 men, 5 women) as controls. Measurements were performed with a Siemens Acuson S3000 (Siemens Healthcare, Erlangen, Germany) using a 6C1 convex transducer and the Virtual Touch? tissue quantification (VTQ) method.

Results

The mean shear wave velocity of the head of the pancreas was 1.0?±?0.2?m/s (median: 1.1?m/s) for the study group and likewise 1.0?±?0.2?m/s (median: 0.9?m/s) for the control group. Velocities of 1.2?±?0.2?m/s (median: 1.2?m/s) were measured in the body of the pancreas in both groups. There was a significant difference between the values obtained in the tail of the pancreas: patients 1.1?±?0.1?m/s (median: 1.0?m/s) versus controls 0.9?±?0.1?m/s (median: 0.8?m/s) (p?=?0.0474). The mean value in the whole pancreas of the study group was not significantly above that of the control group: 1.1?±?0.1?m/s (median: 1.0?m/s) versus 1.0?±?0.1?m/s (median: 1.0?m/s) (p?=?0.2453).

Conclusions

Sonoelastography of the pancreas revealed no overall difference between patients with T1D and healthy volunteers. Patients with T1D showed higher values only in the tail segment. Future studies need to determine whether specific regional differences can be found in a larger study population.

     

Brain structural correlates of upward social mobility in ethnic minority individuals

Purpose

Perigenual anterior cingulate cortex (pACC) is a neural convergence site for social stress-related risk factors for mental health, including ethnic minority status. Current social status, a strong predictor of mental and somatic health, has been related to gray matter volume in this region, but the effects of social mobility over the lifespan are unknown and may differ in minorities. Recent studies suggest a diminished health return of upward social mobility for ethnic minority individuals, potentially due to sustained stress-associated experiences and subsequent activation of the neural stress response system.

Methods

To address this issue, we studied an ethnic minority sample with strong upward social mobility. In a cross-sectional design, we examined 64 young adult native German and 76 ethnic minority individuals with comparable sociodemographic attributes using whole-brain structural magnetic resonance imaging.

Results

Results showed a significant group-dependent interaction between perceived upward social mobility and pACC gray matter volume, with a significant negative association in the ethnic minority individuals. Post-hoc analysis showed a significant mediation of the relationship between perceived upward social mobility and pACC volume by perceived chronic stress, a variable that was significantly correlated with perceived discrimination in our ethnic minority group.

Conclusion

Our findings extend prior work by pointing to a biological signature of the “allostatic costs” of socioeconomic attainment in socially disadvantaged upwardly mobile individuals in a key neural node implicated in the regulation of stress and negative affect.

     

The JAK2/STAT3 signaling pathway is required for growth of CD44⁺CD24⁻ stem cell-like breast cancer cells in human tumors

Intratumor heterogeneity is a major clinical problem because tumor cell subtypes display variable sensitivity to therapeutics and may play different roles in progression. We previously characterized 2 cell populations in human breast tumors with distinct properties: CD44+CD24- cells that have stem cell-like characteristics, and CD44-CD24+ cells that resemble more differentiated breast cancer cells. Here we identified 15 genes required for cell growth or proliferation in CD44+CD24- human breast cancer cells in a large-scale loss-of-function screen and found that inhibition of several of these (IL6, PTGIS, HAS1, CXCL3, and PFKFB3) reduced Stat3 activation. We found that the IL-6/JAK2/Stat3 pathway was preferentially active in CD44+CD24- breast cancer cells compared with other tumor cell types, and inhibition of JAK2 decreased their number and blocked growth of xenografts. Our results highlight the differences between distinct breast cancer cell types and identify targets such as JAK2 and Stat3 that may lead to more specific and effective breast cancer therapies.