Rational Design of FeCo-S/Ni2P/NF Heterojunction as a Robust Electrocatalyst for Water Splitting.

The rational design of nonnoble-metal-based catalysts with high electroactivity and long-term stability, featuring controllable active sites, remains a significant challenge for achieving effective water electrolysis. Herein, a heterogeneous catalyst with a FeCo-S and Ni2P heterostructure (denoted FeCo-S/Ni2P/NF) grown on nickel foam (NF) was synthesized by a solvothermal method and low-temperature phosphorization. The FeCo-S/Ni2P/NF catalyst shows excellent electrocatalytic performance and stability in alkaline solution. The FeCo-S/Ni2P/NF catalyst demonstrates low overpotentials (η) for both the hydrogen evolution reaction (HER) (49 mV@10 mA cm-2) and the oxygen evolution reaction (OER) (279 mV@100 mA cm-2). Assembling the FeCo-S/Ni2P/NF catalyst as both cathode and anode in an electrolytic cell for overall water splitting (OWS) needs an ultralow cell voltage of 1.57 V to attain a current density (CD) of 300 mA cm-2. Furthermore, it demonstrates excellent durability, significantly outperforming the commercial Pt/C∥IrO2 system. The results of experiments indicate that the heterostructure and synergistic effect of FeCo-S and Ni2P can significantly enhance conductivity, facilitate mass/ion transport and gas evolution, and expose more active sites, thereby improving the catalytic activity of the electrocatalyst for the OWS. This study provides a rational approach for the development of commercially promising dual-functional electrocatalysts.

Bidirectional Enhancement of Nitrogen Removal by Indigenous Synergetic Microalgal-Bacterial Consortia in Harsh Low-C/N Wastewater.

Conventional microalgal-bacterial consortia have limited capacity to treat low-C/N wastewater due to carbon limitation and single nitrogen (N) removal mode. In this work, indigenous synergetic microalgal-bacterial consortia with high N removal performance and bidirectional interaction were successful in treating rare earth tailing wastewaters with low-C/N. Ammonia removal reached 0.89 mg N L-1 h-1, 1.84-fold more efficient than a common microalgal-bacterial system. Metagenomics-based metabolic reconstruction revealed bidirectional microalgal-bacterial interactions. The presence of microalgae increased the abundance of bacterial N-related genes by 1.5- to 57-fold. Similarly, the presence of bacteria increased the abundance of microalgal N assimilation by 2.5- to 15.8-fold. Furthermore, nine bacterial species were isolated, and the bidirectional promotion of N removal by the microalgal-bacterial system was verified. The mechanism of microalgal N assimilation enhanced by indole-3-acetic acid was revealed. In addition, the bidirectional mode of the system ensured the scavenging of toxic byproducts from nitrate metabolism to maintain the stability of the system. Collectively, the bidirectional enhancement system of synergetic microalgae-bacteria was established as an effective N removal strategy to broaden the stable application of this system for the effective treatment of low C/N ratio wastewater.

Rational Design of NiCo-borate/GO Heterojunction as a High-Performance Supercapacitor Electrode.

The bottleneck in the preparation of supercapacitors is how to develop high-energy and high-power-density devices by using appropriate materials. Herein, a novel NixCo3-x-B/GO heterostructure material was synthesized through a simple ultrasonic and precipitation method. The prepared NixCo3-x-B/GO heterostructure exhibits significant improvements in supercapacitor performance than NixCo3-x-B. The presence of GO effectively suppresses the excessive growth and accumulation of NixCo3-x-B; therefore, Ni2.7Co0.3-B/GO exhibits the best performance as an electrode material for supercapacitors: a high specific capacitance (Cm, 1789.72 F g-1@1 A g-1) and excellent rate performance. The asymmetric supercapacitor (ASC) device of Ni2.7Co0.3-B/GO//AC exhibits a Cm of 76.6 F g-1@1 A g-1, a large voltage window of 1.6 V, and a high energy density (ED) of 98.0 Wh kg-1. Furthermore, a flexible, all-solid-state supercapacitor assembled with Ni2.7Co0.3-B/GO as both the positive and negative electrodes demonstrates a Cm of 46.9 F g-1@1 A g-1. Even after multiple folding and bending at various angles, the device maintains excellent performance, showcasing remarkable stability. With a power density (PD) of 479.7 W kg-1, the device achieves a high ED of 60.0 Wh kg-1. This work provides valuable insights into the synergistic effects in electrochemical processes based on heterostructure materials.

Hollow Spherical Heterostructured FeCo-P Catalysts Derived from MOF-74 for Efficient Overall Water Splitting.

The design of catalysts with tunable active sites in heterogeneous interface structures is crucial for addressing challenges in the water-splitting process. Herein, a hollow spherical heterostructure FeCo-P is successfully prepared by hydrothermal and phosphorization methods. This hollow structure, along with the heterogeneous interface between Co2 P and FeP, not only facilitates the exposure of more active sites, but also increases the contact area between the catalyst and the electrolyte, as well as shortens the distance for mass/electron transfer. This enhancement promotes electron transfer to facilitate water decomposition. FeCo-P exhibits excellent hydrogen evolution (HER) and oxygen evolution (OER) performance when reaching @ 10 mA cm-2 in 1 mol L-1  KOH, with overpotentials of 131/240 mV for HER/OER. Furthermore, when FeCo-P is used as both the cathode and anode for overall water splitting (OWS), it only requires low voltages of 1.49, 1.55, and 1.57 V to achieve CDs of 10, 100, and 300 mA cm-2 , respectively. Density functional theory calculations indicate that constructing a Co2 P and FeP heterogeneous interface with good lattice matching can facilitate electron redistribution, thereby enhancing the electrocatalytic performance of OWS. This work opens up new possibilities for the rational design of efficient water electrolysis catalysts derived from MOFs.

Heterostructured MoO3 Anchored Defect-Rich NiFe-LDH/NF as a Robust Self-Supporting Electrocatalyst for Overall Water Splitting.

The rational design of inexpensive metal electrocatalysts with exciting catalytic activity for overall water splitting (OWS) remains a significant challenge. Heterostructures of NiFe layered double hydroxides (NiFe-LDHs) with abundant oxygen defects and tunable electronic properties have garnered considerable attention. Here, a self-supporting heterostructured catalyst (named MoO3/NiFe-NF) is synthesized via a hydrothermal method to grow NiFe-LDH with oxygen vacancies (OV) in situ on inexpensive nickel foam (NF). Subsequently, MoO3 is anchored and grown on the surface of NiFe-LDH by electrodeposition. The obtained catalysts achieved outstanding oxygen/hydrogen evolution reaction (OER/HER, 212 mV/85 mV@10 mA cm-2) performance in 1 m KOH. Additionally, when MoO3/NiFe-NF is utilized as the cathode and anode in OWS, a current density of 10 mA cm-2 can be obtained as an ultralow battery voltage of 1.43 V, a significantly lower value compared to the commercial electrolyzer incorporating Pt/C and IrO2 electrode materials. Finally, density functional theory (DFT) calculations and advanced spectroscopy technology are conducted to reveal the effects of heterojunctions and OV on the internal electronic structure of the electrical catalysts. Mainly, the present study provides a novel tactic for the rational design of remarkable, low-cost NiFe-LDH electrocatalysts with heterostructures for OWS.

Construction of a transition-metal sulfide heterojunction photocatalyst driven by a built-in electric field for efficient hydrogen evolution under visible light.

Photocatalytic H2 evolution is of prime importance in the energy crisis and in lessening environmental pollution. Adopting a single semiconductor as a photocatalyst remains a formidable challenge. However, the construction of an S-scheme heterojunction is a promising method for efficient water splitting. In this work, CdS nanoparticles were loaded onto NiS nanosheets to form CdS/NiS nanocomposites using hollow Ni(OH)2 as a precursor. The differences in the Fermi energy levels between the two components of CdS and NiS resulted in the formation of a built-in electric field in the nanocomposite. Density functional theory (DFT) calculations reveal that the S-scheme charge transfer driven by the built-in electric field can accelerate the effective separation of photogenerated carriers, which is conducive to efficient photocatalytic hydrogen evolution. The hydrogen evolution rate of the optimized photocatalyst is 39.68 mmol·g-1 h-1, which is 6.69 times that of CdS under visible light. This work provides a novel strategy to construct effective photocatalysts to relieve the environmental and energy crisis.

Enhanced Visible-Light-Induced Photocatalytic Activity in M(III)Salophen-Decorated TiO2 Nanoparticles for Heterogeneous Degradation of Organic Dyes.

In this work, the construction of two heterojunction photocatalysts by coordinative anchoring of M(salophen)Cl complexes (M = Fe(III) and Mn(III)) to rutile TiO2 through a silica-aminopyridine linker (SAPy) promotes the visible-light-assisted photodegradation of organic dyes. The degradation efficiency of both cationic rhodamine B (RhB) and anionic methyl orange (MO) dyes by Fe- and Mn-TiO2-based catalysts in the presence of H2O2 under sunlight and low-wattage visible bulbs (12-18 W) is investigated. Anionic MO is more degradable than cationic RhB, and the Mn catalyst shows more activity than its Fe counterpart. Action spectra demonstrate the maximum apparent quantum efficiency (AQY) at 400-450 nm, confirming the visible-light-driven photocatalytic reaction. The enhanced photocatalytic activity might be attributed to the improved charge transfer in the heterojunction photocatalysts evidenced by photoluminescence (PL) and electrochemical impedance spectroscopy (EIS) analyses. A radical pathway for the photodegradation of dyes is postulated based on scavenging experiments and spectral data. This work provides new opportunities for constructing highly efficient catalysts for wastewater treatment.

Construction of ZIF-67-On-UiO-66 Catalysts as a Platform for Efficient Overall Water Splitting.

A well-organized construction of hybrid metal-organic frameworks (MOFs) with exquisite structures is vital due to their potential applications. Herein, a novel hybrid nanostructure of UiO-66-on-ZIF-67, denoted as MZU-CoxZry (x and y represent the mass ratios of ZIF-67 and UiO-66, respectively), was successfully prepared by a simple method and showed a highly efficient and stable bifunctionality of both oxygen evolution reaction (OER) and hydrogen evolution reaction (HER) in an alkaline medium. The MZU-Co2.5Zr1 shows remarkable OER performance with a low overpotential of 252 mV and an overpotential of 172 mV @ 10 mA/cm2 for HER in 1 mol/L KOH. With MZU-Co2.5Zr1 as the cathode and anode, the integrated water decomposition device has achieved low total potentials of 1.56 V @ 10 mA/cm2 and 1.59 V @ 30 mA/cm2, exhibiting its excellent performance of overall water splitting. Based on the experimental results, the mechanism of the superior electrocatalytic performance of MZU-CoxZry was discussed. This work supplies guidance for the rational design of non-precious composites for energy conversion.

Distribution of bacteriologically positive and bacteriologically negative pulmonary tuberculosis in Northwest China: spatiotemporal analysis.

Pulmonary tuberculosis (PTB) is a major health issue in Northwest China. Most previous studies on the spatiotemporal patterns of PTB considered all PTB cases as a whole; they did not distinguish notified bacteriologically positive PTB (BP-PTB) and notified bacteriologically negative PTB (BN-PTB). Thus, the spatiotemporal characteristics of notified BP-PTB and BN-PTB are still unclear. A retrospective county-level spatial epidemiological study (2011-2018) was conducted in Shaanxi, Northwest China. In total, 44,894 BP-PTB cases were notified, with an average annual incidence rate of 14.80 per 100,000 persons between 2011 and 2018. Global Moran's I values for notified BP-PTB ranged from 0.19 to 0.49 (P < 0.001). Anselin's local Moran's I analysis showed that the high-high (HH) cluster for notified BP-PTB incidence was mainly located in the southernmost region. The primary spatiotemporal cluster for notified BP-PTB (LLR = 612.52, RR = 1.77, P < 0.001) occurred in the central region of the Guanzhong Plain in 2011. In total, 116,447 BN-PTB cases were notified, with an average annual incidence rate of 38.38 per 100,000 persons between 2011 and 2018. Global Moran's I values for notified BN-PTB ranged from 0.39 to 0.69 (P < 0.001). The HH clusters of notified BN-PTB were mainly located in the north between 2011 and 2014 and in the south after 2015. The primary spatiotemporal cluster for notified BN-PTB (LLR = 1084.59, RR = 1.85, P < 0.001) occurred in the mountainous areas of the southernmost region from 2014 to 2017. Spatiotemporal clustering of BP-PTB and BN-PTB was detected in the poverty-stricken mountainous areas of Shaanxi, Northwest China. Our study provides evidence for intensifying PTB control activities in these geographical clusters.

Amorphous Yolk-Shelled ZIF-67@Co3(PO4)2 as Nonprecious Bifunctional Catalysts for Boosting Overall Water Splitting.

It is challenging to generate inexpensive and noble metal-free catalysts for efficient overall water splitting (OWS). To achieve this goal, suitable tuning of the structure and composition of electrocatalytic materials is a promising approach that has attracted much attention in recent years. Herein, novel hybrid amorphous ZIF-67@Co3(PO4)2 electrocatalysts with yolk-shell structures were prepared using a reflux method. It is demonstrated that yolk-shelled ZIF-67@Co3(PO4)2 is not only an active catalyst for the hydrogen evolution reaction (HER) but also an efficient catalyst for the oxygen evolution reaction (OER). The optimized composite electrode showed superior performance with low overpotentials of 73 and 334 mV @ 10 mA·cm-2 toward HER and OER, respectively, and a low potential of 1.62 V @ 10 mA·cm-2 and 1.66 V @ 30 mA·cm-2 in a practical OWS test under alkaline conditions. N-O bonds were formed to connect the two components of ZIF-67 and Co3(PO4)2 in the composite ZIF-67@Co3(PO4)2, which indicates that the two components are synergistic but not isolated, and this synergistic effect may be one of the important reasons to boost the oxygen and hydrogen evolution performances of the hybrid. Based on experimental data, the high electrocatalytic performance was inferred to be related to the unique structure of ZIF-67, tuning the ability of Co3(PO4)2 and synergism between ZIF-67 and Co3(PO4)2. The preparation strategy reported herein can be extended for the rational design and synthesis of cheap, active, and long-lasting bifunctional electrocatalysts for OWS and other renewable energy devices.

Simultaneous decontamination of arsenite and antimonite using an electrochemical CNT filter functionalized with nanoscale goethite.

The co-presence of arsenic (As) and antimony (Sb) in water bodies has been commonly reported. The toxicity of As and Sb varies with different speciation. Herein, we designed a dual-functional electrochemical filter toward "one-step" detoxification and sequestration of highly toxic As(III) and Sb(III). The key to this technology is a functional anodic filter consists of nanoscale goethite and carbon nanotubes (CNT). Results showed that 97.9% As(III) and 91.9% Sb(III) transformation and 86.4% Astotal and 70.1% Sbtotal removal efficiency can be obtained over 2 h continuous filtration under optimized conditions. The Astotal removal kinetics and efficiency enhanced with flow rate and applied voltage (e.g., the Astotal removal efficiency increased from 62.9% at 0 V to 86.4% at 2.5 V). This enhancement in kinetics and efficiency can be explained by the synergistic effects of the flow-through design, plentiful exposed sorption sites, electrochemical reactivity, and nanoscale goethite. Moreover, the proposed technology works effectively across a wide pH range. Only negligible inhibition was observed in the presence of nitrate, chloride, and carbonate. Exhausted hybrid filters can be effectively regenerated by using chemical wash with NaOH solution. This study not only revealed the different adsorption behaviors of As(III) and Sb(III) on the hybrid filters, but also provided new insights into rational design of continuous-flow filters toward simultaneous decontamination of As(III) and Sb(III).

Sea urchin-like FeOOH functionalized electrochemical CNT filter for one-step arsenite decontamination.

Advanced nanotechnologies for efficient arsenic decontamination remain largely underdeveloped. The most abundant inorganic arsenic species are neutrally-charged arsenate, As(III), and negatively-charged arsenite, As(V). Compared with As(V), As(III) is 60 times more toxic and more difficult to remove due to high mobility. Herein, an electrochemical filtration system was rationally designed for one-step As(III) decontamination. The key to this technology is a functional electroactive carbon nanotube (CNT) filter functionalized with sea urchin-like FeOOH. With the assistance of electric field, CNT-FeOOH anodic filter can in situ transform As(III) to less toxic As(V) while passing through. Then, as-produced As(V) could be effectively sequestrated by FeOOH. The sufficient exposed sorption sites, flow-through design, and filter's electrochemical reactivity synergistically guaranteed a rapid arsenic removal kinetic. The underlying working mechanism was unveiled based on systematic experimental investigations and theoretical calculations. The system efficacy can be adapted across a wide pH range and environmental matrixes. Exhausted CNT-FeOOH filters could be effectively regenerated by chemical washing with diluted NaOH solution. Outcomes of the present study are dedicated to provide a straightforward and effective strategy by integrating electrochemistry, nanotechnology, and membrane separation for the removal of arsenic and other similar heavy metals from water bodies.

Efficient antimony removal by self-assembled core-shell nanocomposite of Co3O4@rGO and the analysis of its adsorption mechanism.

Co3O4@rGO were facilely prepared by template free self-assemble in this study. The morphology of Co3O4@rGO was actiniaria-like core-shell structural nanocomposites. The formation mechanism of Co3O4@rGO core-shell nanocomposite was discussed according to its significant time-dependent morphology evolution course. To evaluate the application potential of Co3O4@rGO, its adsorption performance toward highly toxic antimony ions were studied. The Co3O4@rGO nanocomposite exhibit high anti-interference ability and high adsorption ability. The maximum adsorption capacities towards Sb(III) and Sb(V) are 151.04 and 165.51 mg/g, respectively. River water samples containing antimony violating the limit were used to evaluate the practical application of Co3O4@rGO, and high performance was achieved. The EU and China limits for antimony in drinking water can be met by using mesoporous Co3O4@rGO treating the actual river water samples with original antimony concentration lower than 50 µg/L. Adsorption isotherm, adsorption kinetics, pH and co-existing ions effects were also studied in details. The results indicate that mesoporous Co3O4@rGO is an excellent adsorbent for antimony removal. Mesoporous Co3O4@rGO nanocomposite is a potential candidate for antimony removal from waste water.

Optimization of Boron Doped TiO2 as an Efficient Visible Light-Driven Photocatalyst for Organic Dye Degradation With High Reusability.

No visible light activity is the bottle neck for wide application of TiO2, and Boron doping is one of the effective way to broaden the adsorption edge of TiO2. In this study, several Boron doped TiO2 materials were prepared via a facile co-precipitation and calcination process. The B doping amounts were optimized by the degradation of rhodamine B (Rh B) under visible light irradiation, which indicated that when the mass fraction of boron is 6% (denoted as 6B-TiO2), the boron doped TiO2 materials exhibited the highest activity. In order to investigate the enhanced mechanism, the difference between B-doped TiO2 and bare TiO2 including visible light harvesting abilities, separation efficiencies of photo-generated electron-hole pairs, photo-induced electrons generation abilities, photo-induced charges transferring speed were studied and compared in details. h+ and · O 2 - were determined to be the two main responsible active species in the photocatalytic oxidation process. Besides the high degradation efficiency, 6B-TiO2 also exhibited high reusability in the photocatalysis, which could be reused at least 5 cycles with almost no active reduction. The results indicate that 6B-TiO2 has high photocatalytic degradation ability toward organic dye of rhodamine B under visible light irradiation, which is a highly potential photocatalyst to cope with organic pollution.

The effectiveness of virtual reality-based technology on anatomy teaching: a meta-analysis of randomized controlled studies.

BACKGROUND: Virtual reality (VR) is an innovation that permits the individual to discover and operate within three-dimensional (3D) environment to gain practical understanding. This research aimed to examine the general efficiency of VR for teaching medical anatomy. METHODS: We executed a meta-analysis of randomized controlled studies of the performance of VR anatomy education. We browsed five databases from the year 1990 to 2019. Ultimately, 15 randomized controlled trials with a teaching outcome measure analysis were included. Two authors separately chose studies, extracted information, and examined the risk of bias. The primary outcomes were examination scores of the students. Secondary outcomes were the degrees of satisfaction of the students. Random-effects models were used for the pooled evaluations of scores and satisfaction degrees. Standardized mean difference (SMD) was applied to assess the systematic results. The heterogeneity was determined by I2 statistics, and then was investigated by meta-regression and subgroup analyses. RESULTS: In this review, we screened and included fifteen randomized controlled researches (816 students). The pooled analysis of primary outcomes showed that VR improves test scores moderately compared with other approaches (standardized mean difference [SMD] = 0.53; 95% Confidence Interval [CI] 0.09-0.97, p < 0.05; I2 = 87.8%). The high homogeneity indicated that the studies were different from each other. Therefore, we carried out meta-regression as well as subgroup analyses using seven variables (year, country, learners, course, intervention, comparator, and duration). We found that VR improves post-intervention test score of anatomy compared with other types of teaching methods. CONCLUSIONS: The finding confirms that VR may act as an efficient way to improve the learners' level of anatomy knowledge. Future research should assess other factors like degree of satisfaction, cost-effectiveness, and adverse reactions when evaluating the teaching effectiveness of VR in anatomy.

Developing and Validating an Adjustment Scale: The Adaptation Status Assessment of Drug-Resistant Tuberculosis Patients.

PURPOSE: Drug-resistant tuberculosis (DR-TB) remains a major global public health issue. For DR-TB patients, effective adaptation is crucial to prevent disease progression, improve health outcomes and decrease mortality. To date, there is no appropriate tool for evaluating the adaptation status of DR-TB patients. In this work, we aim to develop an adjustment scale for DR-TB patients (AS-DRTBP) and to evaluate its psychometric properties. PATIENTS AND METHODS: The development of the AS-DRTBP was based on the theory of the Roy adaptation model (RAM). The scale was designed through a literature review, in-depth individual interviews, a Delphi survey, and pilot testing. In total, 433 patients with DR-TB were recruited to validate the instrument. The split-half reliability coefficient, Cronbach's alpha coefficient, and test-retest reliability coefficient were calculated to assess the reliability of the instrument. Content validity, construct validity and concurrent validity tests were applied to calculate the validity of the instrument. RESULTS: The final AS-DRTBP consisted of four dimensions and 26 items. The Cronbach's alpha coefficient, split-half reliability coefficient and test-retest reliability coefficient were 0.893, 0.954, and 0.853, respectively. The content validity index was 0.92. Four factors that explained 64.605% of the total variance were also further determined by confirmatory factor analysis (CFA). The CFA results showed that the fitting effect of the model was appropriate (CMIN/DF = 1.681, GFI = 0.832, AGFI = 0.799, RMSEA = 0.055, SRMR = 0.0684). The AS-DRTBP and adjustment scale had correlation in the total score, and the correlation coefficient was 0.355 (p<0.05). CONCLUSION: The findings of this study demonstrate that the AS-DRTBP is a reliable and valid instrument for measuring the adaptation status of patients with DR-TB, allowing health providers to comprehend the adaptive level of DR-TB patients and thus laying the foundation for interventions to help these patients achieve a physiologically, psychologically and socially optimal outcome.

Synthesis of (ZrO2-Al2O3)/GO nanocomposite by sonochemical method and the mechanism analysis of its high defluoridation.

A nanocomposite of (ZrO2-Al2O3)/GO was successfully synthesized by a simple sonochemical method in this study. A special 3D network was formed in (ZrO2-Al2O3)/GO, which produced a large surface area and good distribution of metal oxide nanoparticles. The as-synthesized (ZrO2-Al2O3)/GO exhibits a maximum fluoride adsorption capacity of 62.2 mg/g, and an adsorption ability of 13.80 mg/g when the F- equilibrium concentration is 1 mg/L, both of which are higher than most previously reported defluoridation adsorbents, indicating that it is among the top adsorbents. Large amounts of drinking water contaminated by F- can be treated by (ZrO2-Al2O3)/GO to meet the WHO limit, indicating the high potential for practical application of the adsorbent. Based on the experimental analysis, the origin of the high defluoridation performance and the adsorption mechanism were discussed in detail. Due to the simple preparation, easy operation and high performance, the adsorbent and the related sonochemical method are considered to be significant for developing highly effective adsorbents.

Development And Preliminary Evaluation Of Psychometric Properties Of A Tuberculosis Self-Efficacy Scale (TBSES).

PURPOSE: No instrument exists for measuring TB patients' self-efficacy which is vital for choosing and insisting in benefit TB-management behaviors. Our study aimed to develop and test a new tuberculosis self-efficacy scale (TBSES). PATIENTS AND METHODS: The TBSES was designed through literature review, individual interviews, Delphi surveys, and pilot testing. After that, 460 TB patients were recruited to validate TBSES. Exploratory and confirmatory factor analysis and correlation analysis were used to evaluate the scale reliability and validity. The cut-off point for TBSES was identified using receiver operating characteristic (ROC) analysis. RESULTS: The final TBSES includes 21 items scored on a 5-point Likert scale, and these items are loaded in four distinct factors that explain 67.322% of the variance, both exploratory and confirmatory factor analysis proved that the scale had good construct validity. The scale had adequate internal consistency, split-half reliability, test-retest reliability, as well as demonstrated content, concurrent validity. The ROC analysis results showed the cut-off point was 86.5. CONCLUSION: This 21-item TBSES demonstrated favorable psychometric properties. It provides an instrument for not only measuring specific self-efficacy in TB, but also identifying patients with low self-efficacy and determining the specific area toward designing interventions for enhance self-efficacy.

Chinese health literacy scale for tuberculosis patients: a study on development and psychometric testing.

BACKGROUND: The role of health literacy on tuberculosis patients has not been evaluated in China, in part because few special health literacy measurements exist. METHODS: A three-step design process was used: (1) Scale construction: Based on the model of revised Bloom's taxonomy, the item-pool was drafted from a literature review, focus group discussion, and in-depth interviews. In addition, a Delphi survey was used in order to select items for inclusion in the scales; (2) Pilot study: Acceptability and clarity were tested with 60 tuberculosis patients; and (3) Psychometric testing: Validity analysis includes content validity, construct validity, and discriminative validity. The Cronbach's alpha coefficient, split-half reliability, and test-retest method were used to assess reliability. Finally, a receiver operating characteristic analysis was conducted to generate a cut-off point. RESULTS: The final scale had 29 items with four domains. The item level Content Validity Index ranged from 0.70 to 1.0, and the scale level Content Validity Index was 0.95. The mean score among the lowest 27% group was significantly lower than that those of the highest 27% group (p < 0.01), which supports adequate discriminant validity. Explanatory factor analysis produced a clear four-factor construct, explaining 47.254% of the total variance. Factor 1 and Factor 2 were consistent with read and memorize TB-related words; Factor 3 was associated with understand the meaning of the health education leaflets and examine if TB patients can apply the correct approach to correct context; Factor 4 was related to the ability of TB patient to calculate and identify what unspecified assumptions are included in known conditions. The confirmatory factory analysis results confirmed that a four-factor model was an acceptable fit to the data, with a goodness-of-fit index = 0.930, adjusted goodness of fit index = 0.970, root mean square error of approximation = 0.069, and χ2/df = 2.153. The scale had good internal consistency and test-retest reliability. Additionally, the receiver operating characteristic analysis indicated that the cut-off point for the instrument was set at 45 and 35. CONCLUSIONS: The Chinese Health Literacy scale for Tuberculosis has good reliability and validity, and it could be used for measuring the health literacy of Chinese patients with tuberculosis.

Key genes and pathways in measles and their interaction with environmental chemicals.

The aim of the present study was to explore key genes that may have a role in the pathology of measles virus infection and to clarify the interaction networks between environmental factors and differentially expressed genes (DEGs). After screening the database of the Gene Expression Omnibus of the National Center for Biotechnology Information, the dataset GSE5808 was downloaded and analyzed. A global normalization method was performed to minimize data inconsistencies and heterogeneity. DEGs during different stages of measles virus infection were explored using R software (v3.4.0). Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of the DEGs were performed using Cytoscape 3.4.0 software. A protein-protein interaction (PPI) network of the DEGs was obtained from the STRING database v9.05. A total of 43 DEGs were obtained from four analyzed sample groups, including 10 highly expressed genes and 33 genes with decreased expression. The most enriched pathways based on KEGG analysis were fatty acid elongation, cytokine-cytokine receptor interaction and RNA degradation. The genes mentioned in the PPI network were mainly associated with protein binding and chemokine activity. A total of 219 chemicals were identified that may, jointly or on their own, interact with the 6 DEGs between the control group and patients with measles (at hospital entry), including benzo(a)pyrene (BaP) and tetrachlorodibenzodioxin (TCDD). In conclusion, the present study revealed that chemokines and environmental chemicals, e.g. BaP and TCDD, may affect the development of measles.