Significance of homogeneous operation in light-assisted fixed-bed bioprocess under ammonia stress: Optimization, long-term operation and metagenomic analysis.

Activating microbes with light is a promising strategy for addressing ammonia-stressed anaerobic digestion (AD). However, as a critical in-process parameter, homogenous operation, in light-assisted AD amended by bio-fixed bed has received limited attention. This research endeavors to establish a uniform-illuminated biosystem and assess its practical feasibility through a 90-day semi-continuous operation at pilot scale under solar light illumination. With optimal stirring mode (intermittent stirring for 3 min every 15 min), robust methane yields were achieved across various organic loads, reaching 88.7-94.3% of theoretical yield under high ammonium stress (3500 mg/L). The metagenomic analysis unveiled that uniform illumination triggered synergistic effects in AD, fostering a diversified microbial consortium, enhancing carbohydrate and methane metabolism, and facilitating the formation of an electroactive bio-cluster. This study underscores the significance of homogenous illumination in AD systems for efficient waste-to-energy conversion, highlighting the implementation of solar light as a greener approach for scale-up application.

Quantitative effects of formulation and process parameters on the structure of food emulsions stabilized with an unrefined by-product powder: A statistical approach.

Apple pomace powder is a sustainable food ingredient, but its more complex composition compared to commonly purified ingredients could curb its valorization. This study assesses how physicochemical properties, formulation and process factors influence the physical properties of the emulsion. The two main objectives were to: 1) unravel the structuring and stabilizing mechanisms of such complex systems and 2) account for interactions between various parameters instead of studying them separately. Thirty-one experimental samples were formulated to produce a variety of microstructures with droplet diameters ranging from 28 to 105 µm, textures with viscosity ranging from 135 to 2,490 mPa.s at 50 s-1 and stabilities. Using multicriteria selection of effects revealed that the concentration of the powder and the size of solid particles are the main levers for tailoring the structure-function relationships of the emulsions. Solid particles play a key role in both structuring and stabilizing the emulsions. Process parameters have an impact on the emulsification step by modifying the adsorption rate of solid particles. In conclusion, modelling advanced our understanding of stabilizing mechanisms of the emulsions produced by apple pomace and will enable efficient knowledge transfer for industrial applications.

The Generic Conspiracist Beliefs Scale-5: further psychometric evaluation using a United Kingdom-based sample.

The 5-item Generic Conspiracist Beliefs Scale (GCB-5) is an abridged version of the 15-item GCBS. It was developed as a global measure of the tendency to engage in non-event-based, conspiracy-related ideation. The GCB-5 is appealing to researchers because of its brevity, which facilitates the measurement of belief in conspiracies alongside multiple constructs and/or in situations where resources are limited (time, etc.). Noting that several studies failed to find an adequate unidimensional fit in the parent GCBS measures across different contexts, the present study further assessed the psychometric properties of the GCB-5. This was necessary since the GCB-5 was validated using North American samples. Thus, to ensure that the GCB-5 was satisfactory for use with samples in the United Kingdom (UK), GCBS/GCB-5 items were administered to a large, representative UK-based sample (N = 1,331), alongside a range of validated conspiracy scales. Confirmatory factor analysis found that a one-factor GCB-5 model produced a good model fit. This specified that the GCB-5 was underpinned by a single dimension. Furthermore, the performance of the GCB-5 was equivalent to the longer GCBS. Both instruments produced similar mean item scores and standard deviations and were comparably positively correlated with concurrent measures. Although the GCB-5 internal reliability was lower than the GCBS, it was good. The GCB-5 also demonstrated configural, metric, and scalar invariance (among gender and age subgroups). This indicated that the GCB-5 was interpreted similarly by men and women and different age groups. Overall, results supported the assertion that the GCB-5 is a psychometrically satisfactory global measure of non-event-based, conspiratorial ideation.

Evaluation of cellophane as platform for colorimetric assays on microfluidic analytical devices.

Due to their low cost, simplicity, and pump-free liquid transport properties, colorimetric assays on paper spots and microfluidic paper-based analytical devices (µPADs) are regarded as useful tools for point-of-care testing (POCT). However, for certain types of colorimetric assays, the "non-transparent" and "white" characters of paper can be a disadvantage. In this work, the possibilities of using cellophane as an alternative platform for colorimetric assays have been investigated. Cellophane is a low cost and easy-to-handle transparent film made of regenerated cellulose. Owing to its hydrophilic character, cellophane-based microfluidic channels fabricated through a print-cut-laminate approach enabled pump-free liquid transport into multiple detection areas, similar to µPADs. In addition, the water absorption characteristics of cellophane allowed the stable immobilization of water-soluble colorimetric indicators without any surface modification or additional reagents. The transparency of cellophane provides possibilities for simple background coloring of the substrates, increasing the dynamic signal range for hue-based colorimetric assays, as demonstrated for two model assays targeting H2O2 (46-fold increase) and creatinine (3.6-fold increase). Finally, a turbidity detection-based protein assay was realized on black background cellophane spots. The lowest limits of detection achieved with the cellophane-based devices were calculated as 7 µM for H2O2, 2.7 mg dL-1 for creatinine, and 3.5 mg dL-1 for protein (human serum albumin).

[Follow up analysis of 6 patients with severe trimethyltin chloride poisoning for 4 years].

Objective: Objective to investigate the health changes of patients with severe trimethyltin chloride (TMT) poisoning in four years. Methods: Six patients with severe TMT poisoning treated in the First Affiliated Hospital of Gannan Medical College in August 2016 were numbered 1, 2, 3, 4, 5 and 6 respectively. The patients were followed up 0.5, 2 and 4 years after poisoning and compared and analyzed. The follow-up contents include: symptom degree, score of simple mental intelligence examination scale (MMSE) and modified Rankin Scale (MRS) , cranial magnetic resonance imaging (MRI) , EEG, etc. Results: The symptoms of dizziness, headache, chest tightness, palpitation, nausea and vomiting decreased gradually in 6 patients. The symptoms of speech disorder and memory decline in No.1, 2 and 3 patients gradually increased, and the scores of MMSE and Mrs gradually decreased; Patients No.4, 5 and 6 had improved speech disorder, but their memory decreased, MMSE and Mrs scores were still flat, and mild cognitive impairment. The brain atrophy of No.1, 2 and 3 patients was aggravated, which showed obvious atrophy of hippocampus, temporal lobe, insular lobe and cerebellum and enlargement of ventricle; There was no significant change in brain atrophy in No.4, 5 and 6 patients. Conclusion: The neurotoxic symptoms in the later stage of severe TMT poisoning are still serious, and the neurotoxic time is long.

Development and evaluation of short form of constitution in Chinese medicine questionnaire: a national epidemiological survey data of 21 948 case.

OBJECTIVE: To develop the best short form of constitution in Chinese medicine questionnaire (CCMQ) and evaluate its psychometric properties in Chinese population. METHODS: A total of 21 948 subjects were used to refine the short form. Correlation coefficient, exploratory factor analysis (EFA) and Cronbach's alpha coefficient were used to analyze and select items to form the short form. Separate sample of 205 subjects were collected to further evaluate the short from. EFA, confirmatory factor analysis (CFA), item-scale correlation, discriminant validity, internal consistency reliability and split-half reliability were carried out to evaluate the short form. RESULTS: The short form CCMQ included 26 items. Seven common factors of characteristic root > 1 were extracted to explain 58.488% of the total variation. Result of CFA was consistent with the 9-factors structure. The mean differences of Blood-stasis body constitution and Qi-stagnation body constitution had statistical significance in body mass index differentiation. Cronbach's alpha coefficient of short form CCMQ was 0.863. The split-half reliability of total scale was 0.813, and each scale was 0.568-0.770. The item-scale correlations ranged from 0.620-0.849. CONCLUSION: The short form CCMQ consisted of 26 items with good psychometric properties. The short form should be recommended for the measurement of health of Chinese population in any clinical trial.

Measuring recovery in Arabic countries: Translation of the self-efficacy for personal recovery scale.

AIM: To translate the Self-Efficacy for Personal Recovery Scale (SEPRS) into Arabic and evaluate the psychometric properties of the Arabic version. METHODS: An established translation methodology was employed, involving back-translation, comparison, forward-translation, comparison, and piloting. The pre-final version of the Arabic translated scale was tested for clarity with young people with a primary diagnosis of mental health problem. The final Arabic version and standardized measures of hope and loneliness were administered to 119 young people in two rounds. RESULTS: Internal consistency was adequate (Cronbach's alpha = 0.87 in round 1, 0.91 in round 2). Consistent with the English version, a one-factor solution best fitted the data. The correlation between SEPRS and hope was R = 0.60 (round 1) and R = 0.61 (round 2), indicating convergent validity. The correlation between SEPRS and loneliness was R = -0.52 (round 1) and R = -0.60 (round 2). Correlation between test and retest was R = -0.998 indicated adequate test-retest reliability. Minimal floor and ceiling effects were detected. CONCLUSION: The use of the Arabic SEPRS with Arabic-speaking samples is supported. Further research to investigate divergent validity is warranted.

Efficient approximation of reliabilities for single-step genomic best linear unbiased predictor models with the Algorithm for Proven and Young.

The objectives of this study were to develop an efficient algorithm for calculating prediction error variances (PEVs) for genomic best linear unbiased prediction (GBLUP) models using the Algorithm for Proven and Young (APY), extend it to single-step GBLUP (ssGBLUP), and apply this algorithm for approximating the theoretical reliabilities for single- and multiple-trait models in ssGBLUP. The PEV with APY was calculated by block sparse inversion, efficiently exploiting the sparse structure of the inverse of the genomic relationship matrix with APY. Single-step GBLUP reliabilities were approximated by combining reliabilities with and without genomic information in terms of effective record contributions. Multi-trait reliabilities relied on single-trait results adjusted using the genetic and residual covariance matrices among traits. Tests involved two datasets provided by the American Angus Association. A small dataset (Data1) was used for comparing the approximated reliabilities with the reliabilities obtained by the inversion of the left-hand side of the mixed model equations. A large dataset (Data2) was used for evaluating the computational performance of the algorithm. Analyses with both datasets used single-trait and three-trait models. The number of animals in the pedigree ranged from 167,951 in Data1 to 10,213,401 in Data2, with 50,000 and 20,000 genotyped animals for single-trait and multiple-trait analysis, respectively, in Data1 and 335,325 in Data2. Correlations between estimated and exact reliabilities obtained by inversion ranged from 0.97 to 0.99, whereas the intercept and slope of the regression of the exact on the approximated reliabilities ranged from 0.00 to 0.04 and from 0.93 to 1.05, respectively. For the three-trait model with the largest dataset (Data2), the elapsed time for the reliability estimation was 11 min. The computational complexity of the proposed algorithm increased linearly with the number of genotyped animals and with the number of traits in the model. This algorithm can efficiently approximate the theoretical reliability of genomic estimated breeding values in ssGBLUP with APY for large numbers of genotyped animals at a low cost.

The estimated breeding value (EBV) of an animal measures its genetic merit. For calculating EBVs, pedigree and genomic information are jointly used in a procedure called single-step genomic best linear unbiased prediction (ssGBLUP). Genetic evaluations report each EBV with its reliability, which measures how accurate the breeding value estimation was. Calculating EBV with ssGBLUP for large datasets is computationally expensive; Therefore, the Algorithm for Proven and Young (APY) was developed to reduce its computational cost. However, the procedure for obtaining the reliabilities of EBV is still computationally unfeasible to apply. Thus, this study aimed to develop a new method for approximating reliabilities for ssGBLUP with APY for large datasets. We required this new method to be accurate and with fewer computational requirements than the estimation of breeding values by itself. The method that we develop consists of accumulating pedigree and genomic information in successive steps, allowing for computational efficiency. Using a dataset with more than 300,000 genotypes in a pedigree of 10,000,000 animals provided by the American Angus Association, we showed that our proposed method is accurate and computationally efficient, with a correlation of 0.98 between the approximated and target values running in less than 12 min.

Follow up analysis of 6 patients with severe trimethyltin chloride poisoning for 4 years / 中华劳动卫生职业病杂志

Objective: Objective to investigate the health changes of patients with severe trimethyltin chloride (TMT) poisoning in four years. Methods: Six patients with severe TMT poisoning treated in the First Affiliated Hospital of Gannan Medical College in August 2016 were numbered 1, 2, 3, 4, 5 and 6 respectively. The patients were followed up 0.5, 2 and 4 years after poisoning and compared and analyzed. The follow-up contents include: symptom degree, score of simple mental intelligence examination scale (MMSE) and modified Rankin Scale (MRS) , cranial magnetic resonance imaging (MRI) , EEG, etc. Results: The symptoms of dizziness, headache, chest tightness, palpitation, nausea and vomiting decreased gradually in 6 patients. The symptoms of speech disorder and memory decline in No.1, 2 and 3 patients gradually increased, and the scores of MMSE and Mrs gradually decreased; Patients No.4, 5 and 6 had improved speech disorder, but their memory decreased, MMSE and Mrs scores were still flat, and mild cognitive impairment. The brain atrophy of No.1, 2 and 3 patients was aggravated, which showed obvious atrophy of hippocampus, temporal lobe, insular lobe and cerebellum and enlargement of ventricle; There was no significant change in brain atrophy in No.4, 5 and 6 patients. Conclusion: The neurotoxic symptoms in the later stage of severe TMT poisoning are still serious, and the neurotoxic time is long.

Developing a Scale for the Evaluation of People With Post-prandial Distress Syndrome.

Background: Functional dyspepsia (FD) is one of the most critical health problems worldwide. Although there has been an increased intervention to improve FD symptoms, it is difficult to compare the effect of intervention measures with the existing methods of reporting the outcome, and it is a lack of clinical evaluation tools that can be used to evaluate patients' symptoms and treatment. One way of potentially addressing this way is to offer a patient-reported symptom scoring scales, which can be self-reported by patients to highlight interventions' authenticity and reliability. Nevertheless, there is still a lack of validated patient-reported outcome instruments for post-prandial distress syndrome (PDS). This study aims to establish a symptom scoring scale to evaluate the effectiveness of interventions for PDS. Methods: The study consists of two steps. The first step was to formulate the scale. Through a systematic literature review and group discussion, an item pool and scale framework were formed. Then, through the expert consultation and pre-investigation, the formal version of the scale was formed. The second step is to test the reliability and validity of the scale. The scale is tested in the target population to determine whether the reliability and validity of the scale. Discussion: The improvement in patients' self-reported symptoms had a significant impact on the researchers' evaluation of the intervention's authenticity. Therefore, we develop a symptom scoring scale for reporting studies evaluating the effectiveness of PDS interventions. The scale will be used for a more significant comparison to evaluate PDS interventions' effectiveness. The scale also improves trial reporting, reducing research waste by prioritizing the collection and reporting of critical results for all relevant stakeholders. Clinical Trial Registration: ChiCTR, ChiCTR2100044489. Registered on March 22, 2021.

A Psychometric Analysis of the Brief Self-Control Scale.

The Brief Self-Control Scale (BSCS) is a widely used measure of self-control, a construct associated with beneficial psychological outcomes. Several studies have investigated the psychometric properties of the BSCS but have failed to reach consensus. This has resulted in an unstable and ambiguous understanding of the scale and its psychometric properties. The current study sought resolution by implementing scale evaluation approaches guided by modern psychometric literature. Additionally, our goal was to provide a more comprehensive item analysis via the item response theory (IRT) framework. Results from the current study support both unidimensional and multidimensional factor structures for the 13-item version of the BSCS. The addition of an IRT analysis provided a new perspective on item- and test-level functioning. The goal of a more defensible psychometric grounding for the BSCS is to promote greater consistency, stability, and trust in future results.

Relationship Between Syndrome Elements and Therapy of Ischemic Stroke Based on Scale Hierarchy and Principal Component Analysis / 中国实验方剂学杂志

Objective:To study the distribution of ischemic stroke treatment with data mining technology and evaluate its clinical efficacy. Method:China National Knowledge Infrastructure Database（CNKI），China Science and Technology Reader's Digest Database（VIP），Wanfang Data，Chinese Biomedical Literature Database（Sino Med）were retrieved from January 1978 to December 2018. The clinical observation and study literatures on the treatment of ischemic stroke with the combination of traditional Chinese medicine and Western medicine were retrieved in the four databases. After standardized and hierarchical collection and processing of all syndromes，treatment methods，prescriptions and other information in the literatures，a database of syndrome elements and treatment of ischemic stroke was established. Syndrome factors and treatment methods were analyzed by scale evaluation and hierarchical classification methods. Kendall's tau-b correlation analysis，principal component analysis and other statistical methods were used to describe the correlation and distribution of syndrome factors and treatment methods of ischemic stroke. Result:The results of heterogeneity analysis showed that the included literatures were homogeneous and could be combined with subsequent statistics. A total of 450 syndromes and treatment methods were included in this study，and 1 287 single syndrome elements and 1 562 single treatment methods were obtained after unified and standardized splitting. Besides the corresponding syndrome elements and treatment methods，phlegm-dampness-invigorating Qi（-0.52） and Qi deficiency-invigorating Qi（-0.56） were also highly correlated. The study team represented the importance of syndrome and treatment elements with class Ⅰ，Ⅱ，Ⅲ from high to low. Qi deficiency，blood stasis and fire heat，phlegm，viscera excess were class Ⅰ syndrome elements；Yin deficiency，endogenous wind were class Ⅱ syndrome elements；Yin deficiency and Yang deficiency were class Ⅲ syndrome elements；Removing phlegm dampness，clearing heat，clearing the hollow viscera and extinguishing wind，promoting blood circulation to remove blood stasis，tonifying Qi were class Ⅰ treatment of ischemic stroke，and removing phlegm dampness，clearing heat，clearing the hollow viscera were more likely to appear simultaneously； and extinguishing wind，activating blood circulation and removing blood stasis，and benefiting Qi were more likely to appear simultaneously. Nourishing Yin and regulating Qi were class Ⅱ therapies of ischemic stroke，which were highly correlated and often appear simultaneously. Inducing resuscitation，tonifying Yang and dredging collaterals were class Ⅲ，Ⅳ，Ⅴ therapies. Conclusion:Qi deficiency，blood stasis，phlegm dampness，fire heat and viscera excess were the main syndromes of ischemic stroke，while Qi deficiency and blood stasis，phlegm heat and viscera excess were the main syndromes. Eliminating phlegm and dampness，clearing heat，clearing the hollow viscera，promoting blood circulation and removing blood stasis，extinguishing wind and benefiting Qi were the main therapies for the treatment of ischemic stroke. In clinical treatment for ischemic stroke，the therapies for relieving phlegm and dampness，clearing heat and relieving organs are often used in combination，and the therapies for promoting blood circulation and removing blood stasis were often used in combination with the therapies for invigorating Qi and extinguishing wind for the synergistic effect.

Questionnaire measuring patient participation in health care: Scale development and psychometric evaluation.

BACKGROUND: Patient participation in treatment and care is often encouraged and is desirable because of its proven positive impact on treatment, quality of care and patient safety. AIMS: To develop an instrument to measure patient participation in health care and to investigate the measurement properties of the Patient Participation Questionnaire (PPQ). METHODS: A literature review was conducted to develop a model of patient participation. The PPQ was constructed consisting of 17 items organized into four subscales. Psychometric evaluation of factor structure, convergent construct validity by hypothesis testing and analyses of internal consistency using Cronbach's alpha were performed on data from a hospitalised mixed group of patients with cardiac disease, pulmonary disease and cancer (N=378 patients). RESULTS: Confirmatory factor analysis did not show a clear model fit, which is why an exploratory factor analysis was performed, suggesting a different four subscale structure consisting of a total of 16 items. The four subscales were labelled Shared decision power, Adapted and individualized knowledge, Collaboration and Human approach. There were strong ceiling effects on all items. Analysis of convergent construct validity showed a moderate correlation (0.59) between the PPQ and another instrument measuring patient participation. Internal consistency for the total PPQ score was high: 0.89. CONCLUSION: In a mixed group of patients with cardiac disease, pulmonary disease and cancer, the PPQ showed promising psychometric properties in terms of factor structure, convergent construct validity and internal consistency. The PPQ may be used to shed light on the experience of patient participation and guide quality improvements.

Educational evaluation device of ceará: the (in)visibility of students with disabilities / Dispositif dévaluation de léducation au ceará : l(in)visibilité des étudiants en situation de handicap / Dispositivo de evaluación educativa de ceará: la (in) visibilidad de estudiantes discapacitados / Dispositivo de avaliação educacional do ceará: a (in)visibilidade dos estudantes deficientes

Abstract This article deals with the paradox of school inclusion in the basic education evaluation policy of the state of Ceará, a federative unit that stands out among the state education systems of the country in terms of proficiency indicators in basic education, although there is within its system a normative device that deduces from the evaluation calculation the performance of students with disabilities, generating a state of "internal exclusion" to the school system. Based on the debate about evaluation policies as a mechanism of educational management in the national context and on the observation of studies that point to the exclusionary trend of large-scale evaluation in relation to inclusive education, a law provision is addressed that promotes the exclusion of special education from the results of the evaluations of the Permanent Evaluation System of Ceará Basic Education [Sistema Permanente de Avaliação da Educação Básica do Ceará] (Spaece).

Résumé Cet article traite du paradoxe de l'inclusion scolaire dans la politique d'évaluation de l'éducation de base dans l'état du Ceará, au Brésil. Le système d'éducation de cet état se distingue de ceux des autres états du pays par les indicateurs de compétence qu'on y utilise dans l'enseignement primaire, bien qu'il y ait un dispositif normatif déduisant la performance des élèves handicapés du calcul de l'évaluation, provoquant ainsi un état d'"exclusion interne" du système scolaire. À partir du débat sur les politiques d'évaluation comme mécanisme de gestion de l'éducation au Brésil et de recherches reflétant une tendance à l'exclusion des évaluations à grande échelle allant à l'encontre d'une éducation inclusive, ce travail aborde un dispositif de loi favorisant l'exclusion de l'éducation spécialisée des résultats issus des évaluations du Système d'Évaluation Permanente de l'Éducation de Base du Ceará [Sistema Permanente de Avaliação da Educação Básica do Ceará] (Spaece).

Resumen Este artículo aborda la paradoja de la inclusión escolar en la política de evaluación de la educación básica en el estado de Ceará, una unidad federativa que se destaca entre los sistemas educativos del estado en el país en términos de indicadores de competencia en educación primaria, aunque no exista dentro de su sistema un dispositivo normativo que deduzca del cálculo de la evaluación, el rendimiento de los estudiantes discapacitados, generando un estado de "exclusión interna" al sistema escolar. A partir del debate sobre las políticas de evaluación como mecanismo de gestión educativa en el contexto nacional y la observación de estudios que apuntan a la tendencia excluyente de la evaluación a gran escala en relación con la educación inclusiva, se aborda un dispositivo legal que promueve la exclusión de la educación especial de los resultados procedentes de las evaluaciones del Sistema de Permanente de Evaluación de Educación Básica de Ceará (Spaece).

Resumo Este artigo trata do paradoxo da inclusão escolar na política de avaliação da educação básica do estado do Ceará, unidade federativa que se destaca entre os sistemas estaduais de ensino do país em termos de indicadores de proficiência no ensino fundamental, embora haja no interior de seu sistema um dispositivo normativo que deduz do cálculo da avaliação o desempenho dos estudantes deficientes, gerando um estado de "exclusão interna" ao sistema escolar. A partir do debate acerca das políticas de avaliação como mecanismo de gestão educacional no contexto nacional e da observação de estudos que apontam a tendência excludente da avaliação em larga escala em relação à educação inclusiva, aborda-se um dispositivo de lei que promove a exclusão da educação especial dos resultados provenientes das avaliações do Sistema Permanente de Avaliação da Educação Básica do Ceará (Spaece).

Comparison of Trust Assessment Scales Based on Item Response Theory.

Three widely used interpersonal trust measurement scales [Interpersonal Trust Scale (ITS), Philosophies of Human Nature Scale (RPHNS), Company Trust Scale (CTS)] have seldom been applied in non-Western contexts. Different social environments may lead to variation in the level or structure of trust. Therefore, it is necessary to compare the applicability of these scales to different levels of trust-related traits in Eastern cultures so that researchers can choose appropriate scales for relevant studies. This study attempted to conduct a comparative analysis of the ITS, RPHNS, and CTS. A sample of 725 Chinese college students was analyzed. Total score correlations and latent factor correlations estimated by confirmatory factor analysis (CFA) for a first-order three-factor model were assessed, and then the quality of the item parameters, test reliability and standard errors, and test information were assessed. The results are as follows: (1) the ITS and the RPHNS assessed almost the same trust traits; therefore, only the ITS and the RPHNS are compared in the next sections; (2) the original structure of only the RPHNS is verified; (3) some items on the ITS do not work well, while the RPHNS has higher overall test reliability; and (4) the average item information provided by the RPHNS is higher across all trait levels. In most cases, the RPHNS is the better choice in the Chinese cultural context.

State of the psychometric methods: patient-reported outcome measure development and refinement using item response theory.

BACKGROUND: This paper is part of a series comparing different psychometric approaches to evaluate patient-reported outcome (PRO) measures using the same items and dataset. We provide an overview and example application to demonstrate 1) using item response theory (IRT) to identify poor and well performing items; 2) testing if items perform differently based on demographic characteristics (differential item functioning, DIF); and 3) balancing IRT and content validity considerations to select items for short forms. METHODS: Model fit, local dependence, and DIF were examined for 51 items initially considered for the Patient-Reported Outcomes Measurement Information System® (PROMIS®) Depression item bank. Samejima's graded response model was used to examine how well each item measured severity levels of depression and how well it distinguished between individuals with high and low levels of depression. Two short forms were constructed based on psychometric properties and consensus discussions with instrument developers, including psychometricians and content experts. Calibrations presented here are for didactic purposes and are not intended to replace official PROMIS parameters or to be used for research. RESULTS: Of the 51 depression items, 14 exhibited local dependence, 3 exhibited DIF for gender, and 9 exhibited misfit, and these items were removed from consideration for short forms. Short form 1 prioritized content, and thus items were chosen to meet DSM-V criteria rather than being discarded for lower discrimination parameters. Short form 2 prioritized well performing items, and thus fewer DSM-V criteria were satisfied. Short forms 1-2 performed similarly for model fit statistics, but short form 2 provided greater item precision. CONCLUSIONS: IRT is a family of flexible models providing item- and scale-level information, making it a powerful tool for scale construction and refinement. Strengths of IRT models include placing respondents and items on the same metric, testing DIF across demographic or clinical subgroups, and facilitating creation of targeted short forms. Limitations include large sample sizes to obtain stable item parameters, and necessary familiarity with measurement methods to interpret results. Combining psychometric data with stakeholder input (including people with lived experiences of the health condition and clinicians) is highly recommended for scale development and evaluation.

[Clinical analysis of sequelae of acute trimethyltin oxide poisoning].

Objective: Clinical analysis of sequelae of 16 patients with trimethyltin chloride (TMT) poisoning after 2 years. Methods: Sixteen patients with TMT poisoning from a waste recycling company in Ganzhou City in August 2016 were enrolled. They were investigated by questionnaires and assessed by various scales after two years. 6 cases of severe poisoning were examined by head MRI. The scale includes Hamilton Anxiety Scale (HAMA) , Depression Scale (HAMD) , Simple Mental State Examination Scale (MMSE) , Activity of Daily Living (ADL) , International Cooperative Ataxia Rating Scale (ICARS) . Results: 16 cases of TMT poisoning still have headache, dizziness and other symptoms. Instability of walking in 4 patients with severe poisoning, and the brain MRI manifestations included obvious atrophy of temporal lobe, hippocampus, insula lobe, cerebellum and ventricle enlargement. Two patients were rated as severe mixed anxiety and depression, one as moderate mixed anxiety and depression, and one as mild anxiety. 3 cases were diagnosed as dementia and 1 case as mild cognitive impairment. Two cases were totally dependent on living ability. ICARS scores were 66 points and 63 points respectively. Two cases were mildly dependent on living ability. ICARS scores were 28 points and 6 points respectively. There were 2 cases of mild mixed anxiety and depression in mild and moderate poisoning patients, and 1 case of mild cognitive impairment in each patient. They could live independently. ICARS scores were 0. Conclusion: After 2 years of TMT poisoning, some patients still have general clinical symptoms such as dizziness, headache and so on. There are also mental and intellectual symptoms such as anxiety, depression and cognitive impairment. Some of patients with severe poisoning presented with dementia and cerebellar ataxia, and even lost independent living ability.

Clinical analysis of sequelae of acute trimethyltin oxide poisoning / 中华劳动卫生职业病杂志

Objective@#Clinical analysis of sequelae of 16 patients with trimethyltin chloride (TMT) poisoning after 2 years.@*Methods@#Sixteen patients with TMT poisoning from a waste recycling company in Ganzhou City in August 2016 were enrolled. They were investigated by questionnaires and assessed by various scales after two years. 6 cases of severe poisoning were examined by head MRI. The scale includes Hamilton Anxiety Scale (HAMA) , Depression Scale (HAMD) , Simple Mental State Examination Scale (MMSE) , Activity of Daily Living (ADL) , International Cooperative Ataxia Rating Scale (ICARS) .@*Results@#16 cases of TMT poisoning still have headache, dizziness and other symptoms. Instability of walking in 4 patients with severe poisoning, and the brain MRI manifestations included obvious atrophy of temporal lobe, hippocampus, insula lobe, cerebellum and ventricle enlargement. Two patients were rated as severe mixed anxiety and depression, one as moderate mixed anxiety and depression, and one as mild anxiety. 3 cases were diagnosed as dementia and 1 case as mild cognitive impairment. Two cases were totally dependent on living ability. ICARS scores were 66 points and 63 points respectively. Two cases were mildly dependent on living ability. ICARS scores were 28 points and 6 points respectively. There were 2 cases of mild mixed anxiety and depression in mild and moderate poisoning patients, and 1 case of mild cognitive impairment in each patient. They could live independently. ICARS scores were 0.@*Conclusion@#After 2 years of TMT poisoning, some patients still have general clinical symptoms such as dizziness, headache and so on. There are also mental and intellectual symptoms such as anxiety, depression and cognitive impairment. Some of patients with severe poisoning presented with dementia and cerebellar ataxia, and even lost independent living ability.

Validity of the QUADAS-2 in Assessing Risk of Bias in Alzheimer's Disease Diagnostic Accuracy Studies.

Accurate detection of Alzheimer's disease (AD) is of considerable clinical importance. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) is the current research standard for evaluating the quality of studies that validate diagnostic tests; however, its own construct validity has not yet been evaluated empirically. Our aim was to evaluate how well the proposed QUADAS-2 items and its domains converge to indicate the study quality criteria. This study applies confirmatory factor analysis to determine whether a measurement model would be consistent with meta-analytic data. Cochrane meta-analyses assessing the accuracy of AD diagnostic tests were identified. The seven ordinal QUADAS-2 items, intended to inform study quality based on risk of bias and applicability concerns, were extracted for each of the included studies. The QUADAS-2 pre-specified factor structure (i.e., four domains assessed in terms of risk of bias and applicability concerns) was not testable. An alternative model based on two correlated factors (i.e., risk of bias and applicability concerns) returned a poor fit model. Poor factor loadings were obtained, indicating that we cannot provide evidence that the indicators convergent validity markers in the context of AD diagnostic accuracy metanalyses, where normally the sample size is low (around 60 primary included studies). A Monte Carlo simulation suggested that such a model would require at least 90 primary studies to estimate these parameters with 80% power. The reliability of the QUADAS-2 items to inform a measurement model for study quality remains unconfirmed. Considerations for conceptualizing such a tool are discussed.

A new scale for the evaluation of clinical practice guidelines applicability: development and appraisal.

BACKGROUND: This study aimed to develop the clinical practice guidelines applicability evaluation (CPGAE-V1.0) scale and to evaluate its validity and reliability. METHODS: One hundred fifty assessors were invited to rate two rounds of importance scoring of the applicability indicators by using the 5-point Likert scale. Approved indicators formed the CPGAE-V1.0 scale, consisting of 19 items, arranged into 4 domains. We enrolled eligible clinicians from 8 institutions to evaluate 9 clinical practice guidelines using the CPGAE-V1.0 scale. Content validity, construct validity, internal reliability, intra-rater reliability, and responsiveness were analyzed. RESULTS: A total of 220 clinicians participated, and the response rate was 98.6% (217/220). The CPGAE-V1.0 scale had favorable content validity. The four-factor model produced acceptable fit indices. The scale had an excellent internal consistency and item discrimination. It could identify the degree of applicability of the different dimensions between different guidelines. In all domains, 77.8% (7/9) of CPGs in the minimum-scoring domain were concentrated in the "coordination of support" domain. CONCLUSIONS: The CPGAE-V1.0 scale is a valid and reliable instrument for measuring the applicability of CPG.