Validity, reliability, and application of the electronic version of a chronic kidney disease patient awareness questionnaire: a pilot study.

OBJECTIVES: A questionnaire which provides desirable reliability and validity has been previously developed to assess the disease awareness of diagnosed chronic kidney disease (CKD) patients. However, conventional paper questionnaires often have disadvantages, including recall bias. To substantially improve this, we therefore aimed to explore the feasibility of developing a smartphone-based electronic version (e-version) based upon its original paper version and subsequently tested its validity, reliability, and applicability. METHODS: A pilot study was conducted at Guangdong Provincial Hospital of Chinese Medicine in Guangzhou, China, during August 2019. The e-version had identical content to the paper version and was adapted in terms of layout and assisted functions via the Wechat-incorporated Wen-Juan-Xing platform. Eligible patients with diagnosed CKD were invited to participate and were assigned the e-version. Randomly selected respondents received a test-retest of the same e-version 2 weeks after their first completion. In some instances, psychometric properties, including validity and reliability of the e-version, were examined. In others, its clinical application was also tested, which included comparisons among the clinical profiles of patients who had/had not responded to the questionnaire as well as patients with above or below average questionnaire scores. RESULTS: Of the 225 patients screened, 217 were enrolled to participate, with a response rate of 52.5%. Desirable reliability (Cronbachα = 0.962, ICC for total scores = 0.948), while good convergent validity (Cronbachα = 0.962) and low discriminant validity (one extracted component), of the e-version were detected. Performing inter-group comparisons highlighted statistical differences in terms of higher education level (z = -2.436, P = 0.015) and earlier CKD stages (z = -1.978, P = 0.048), with these patients often preferring to respond. No significant differences were detected in the clinical profiles between respondents who obtained an above or below average questionnaire score. CONCLUSION: The e-version is reliable but was not shown to be a valid approach. Audiences with higher education levels and less advanced disease condition may prefer to respond to the e-version. Adaptation of this e-questionnaire, from its original paper version, may not be a direct transition and meticulous modifications may be required during the transition process. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR1900024633).

Measurement of the reflection and loss of the hybrid air-core photonic-bandgap fiber ring resonator.

A fiber ring resonator is the key element in a resonant fiber optic gyroscope (RFOG). Both reflection and loss characteristics can severely decrease the accuracy of the RFOG. This paper first implements optical frequency domain reflectometry (OFDR) to measure the reflection and loss coefficients of the hybrid air-core photonic-bandgap fiber (PBF) ring resonator. Compared with the traditional measurement method of the resonant curve, OFDR can clearly distinguish the two junctions between the air-core PBF and the solid-core fiber. The measured reflection coefficients at the two splicing points are 1.77% and 2.65%, respectively. The excess losses are 2.28 dB and 3.22 dB, respectively. Thus, the measurement of the junctions in the fiber ring resonator is realized.

Resonant fiber optic gyro based on a sinusoidal wave modulation and square wave demodulation technique.

New developments are made in the resonant fiber optic gyro (RFOG), which is an optical sensor for the measurement of rotation rate. The digital signal processing system based on the phase modulation technique is capable of detecting the weak frequency difference induced by the Sagnac effect and suppressing the reciprocal noise in the circuit, which determines the detection sensitivity of the RFOG. A new technique based on the sinusoidal wave modulation and square wave demodulation is implemented, and the demodulation curve of the system is simulated and measured. Compared with the past technique using sinusoidal modulation and demodulation, it increases the slope of the demodulation curve by a factor of 1.56, improves the spectrum efficiency of the modulated signal, and reduces the occupancy of the field-programmable gate array resource. On the basis of this new phase modulation technique, the loop is successfully locked and achieves a short-term bias stability of 1.08°/h, which is improved by a factor of 1.47.

[Role of syndromic surveillance program in the practice of early detection on disease outbreak].

OBJECTIVE: A Dengue outbreak was reported in Dongfen town Jianou county, Fujian province on September 19, 2014. The goal of this project was to explore the role of syndromic surveillance program in the practice of early detection on disease outbreak through the case mentioned above. METHODS: The authors retrospectively collected data related to Outpatient log and Pharmacy drug use in Dongfen township hospital through the electronic information system of the hospital from August to November, 2014. All the abnormal events were recorded, according to related data on fever and drug use. Description of fever, syndromic characteristics, correlation and Linear regression analyses were conducted, using the surveillance data on fever syndrome and drug use from the pharmacy. RESULTS: A total of 1 102 cases with fever and 2 437 fever-related clinic visits were reported which showing an increased number of 19.6, 10.2 times respectively, when compared to the same period of the previous year in which men accounted for 45.3% (499/1 102) and female accounted for 54.7% (603/1 102). Age groups presented an atypical type " M" type. 5 and 10 year olds groups formed the largest proportion, accounted for 11.5% (127/1 102) of the total number os the patients. The correlation coefficient ranged from 0.85 to 0.97 (P<0.05). Data from the syndromic surveillance program showed an " outbreak" was occured in August 23, 2014. CONCLUSIONS: Compared to routine surveillance program, the syndromic surveillance program could detect the appearence of an outbreak, a month or even more earlier. The role of syndromic surveillance program needs to be further explored.

Resonant micro-optic gyro using a short and high-finesse fiber ring resonator.

A novel hybrid integrated scheme is proposed for a high-performance resonant micro-optic gyro (RMOG), which requires a low-loss micro-ring resonator for mass production. A new record for the RMOG is established experimentally with a short fiber ring resonator and an integrated signal detecting and processing circuit. The finesse of the short fiber ring resonator with a length of 60 cm and a diameter of 4.77 cm is as high as 202, and the theoretical sensitivity of the RMOG is better than 0.3°/h assuming the average optical intensity at the photodetector is 1 mW. The 60 cm long spliceless micro-ring resonator is experimentally proved to be sufficient for a tactical-grade RMOG. An angle random walk coefficient of 0.64°/√h and a typical bias stability below 9.6°/h for the integration time of 50 s are successfully demonstrated using an innovative open-loop approach for an operation time of 1600 s.

Effect of Fresnel reflections in a hybrid air-core photonic-bandgap fiber ring-resonator gyro.

A novel hybrid polarization-maintaining (PM) air-core photonic bandgap fiber (PBF) ring resonator is firstly demonstrated by using a conventional solid-core PM fiber optical coupler formed by splicing a section of PM air-core PBF into the resonator. Due to Fresnel reflections exist at the two junctions between the air-core PBF and the solid-core fiber, the forward output signal of this hybrid ring resonator is the normal resonant curve with the superposition of the lightwaves that experienced even numbers of Fresnel reflections and the backward output signal is composed of lightwaves that experienced odd numbers of Fresnel reflections. Rigorous derivations of the forward and backward output signals are given out. The biggest resonant depth and finesse of the hybrid air-core PBF ring resonator predicted are 0.352 and 6.3 respectively by assuming a splice loss of 1.8 dB per junction. These predictions are finally confirmed by testing both the forward and backward output signals of the hybrid ring resonator. With the countermeasures against the influences of the odd numbers of Fresnel reflections, a bias stability of 0.007°/s is successfully demonstrated in a hybrid PM air-core PBF ring-resonator gyro.

Laser frequency noise induced error in resonant fiber optic gyro due to an intermodulation effect.

For the first time, a significant noise source in the resonant fiber optic gyroscope (RFOG) called intermodulation induced error is proposed and deeply analyzed in this paper. The intermodulation error is produced by the laser frequency noise at even multiples of the modulation frequency due to an intermodulation effect, which will seriously limit the random noise performance of the RFOG. Experiments are designed and conducted to verify and measure the intermodulation induced error in the RFOG. The experimental results confirm the existence of intermodulation error, and fit well with the theory. As for the design of the RFOG, light sources with a narrow intrinsic linewidth and a high modulation frequency are preferable to achieve a high rotation-rate sensitivity.

Double closed-loop resonant micro optic gyro using hybrid digital phase modulation.

It is well-known that the closed-loop operation in optical gyros offers wider dynamic range and better linearity. By adding a stair-like digital serrodyne wave to a phase modulator can be used as a frequency shifter. The width of one stair in this stair-like digital serrodyne wave should be set equal to the optical transmission time in the resonator, which is relaxed in the hybrid digital phase modulation (HDPM) scheme. The physical mechanism for this relaxation is firstly indicated in this paper. Detailed theoretical and experimental investigations are presented for the HDPM. Simulation and experimental results show that the width of one stair is not restricted by the optical transmission time, however, it should be optimized according to the rise time of the output of the digital-to-analogue converter. Based on the optimum parameters of the HDPM, a bias stability of 0.05°/s for the integration time of 400 seconds in 1 h has been carried out in an RMOG with a waveguide ring resonator with a length of 7.9 cm and a diameter of 2.5 cm.

[A cohort study on the characteristics of the recurrent epidemics on hand, foot and mouth disease, in Fujian province].

OBJECTIVE: To explore the recurrent epidemiological characteristics of hand, foot and mouth disease (HFMD) among children aged <4 years to provide evidence for HFMD prevention and control. METHODS: Principles on historical cohort study were followed when analyzing data related to HFMD surveillance in Fujian province. All the research objects were restricted to patients aged <4, with HFMD and who were permanent residents in Fujian province. Characteristics of the study objects were extracted as potential factors when the patients first showed symptoms of HFMD. These factors might cause the recurrence of HFMD and were filtered by the logistic stepwise regression with SAS 9.0. RESULTS: A total of 82 949 children were included. Among them, 2 612 had repetitiously suffered from HFMD(occupied 3.15%), including 2 510 who had the histories of suffering twice, 98 suffering three times, 3 suffering four times, and 1 even suffering five times. Comparing with the objects who had the first onset at the age of 3, also with the risk increased to 4.39 (95%CI:3.80-5.07) times, when compared to those who had the first onset at the age below 2. Again, the risk among children whose first onset was at the age of 2 had increased to 2.73 (95% CI: 2.35-3.18) times. According to the current residents areas, the morbidities of patients under 6 years old were below 2% when the symptoms first started, but the risk of the objects whose morbidities were higher than 4% , had increased 2.15(95% CI:1.88-2.45)times. Again, risk of the objects whose morbidities were between 3% and 4% had increased to 2.10 (95%CI:1.85-2.38) times. Among those whose specific morbidities were between 2% and 3% , the risk had increased to 1.65 (95% CI: 1.44-1.89) times. Comparing with the objects who never visited any maternal/child care settings when started the first onset, the risk among the ones who had been to the maternal/child care settings, had increased to 1.64 (95% CI:1.51-1.78) times. Boys had the risk 1.34 (95% CI:1.23-1.46)times increase than girls. The preponderant pathogen causing HFMD recurrence was EV71 (33/60). Recurrence might cause more severe symptoms or signs (8/2 612). Pathogens causing the initial infection and recurrence might both belonged to the same-EV71 (3/6). CONCLUSION: Recurrence of the disease were closely related to the opportunities of contacting the pathogens. Interventions should be imposed on patients in time as soon as the disease initiated, especially at the younger age.

Role of metabolism in the effects of genistein and its phase II conjugates on the growth of human breast cell lines.

Genistein has been investigated for several decades for its potential role in breast cancer prevention. Previous researches have shown that glucuronide and sulfate conjugates are the major species circulating in the blood after genistein ingestion. It was hypothesized that enzymes (UDP-glucuronosyltransferases, sulphotransferases, ß-glucuronidases, and sulphatases) present in breast tissues would catalyze the inter-conversion between the aglycone and the conjugates in situ. Therefore, our aim was to investigate how genistein, genistein-7-glucuronide (G-7-G), genistein-7-sulfate (G-7-S), and 4'-sulfate (G-4'-S) were metabolized in mammary cells and to determine the effects of metabolism on their proliferative actions using cultured breast cell lines. As expected, genistein stimulated the cell growth of breast cancer cells (MCF-7 and T47D) concentration-dependently at lower concentrations but inhibited their growth at higher concentration. It showed low activities in a non-tumorigenic cell line (MCF-10A) due to the absence of ERα. Genistein was extensively metabolized to glucuronides by MCF-7 and to sulfates by T47D, while it was poorly metabolized by MCF-10A. G-7-G displayed weak stimulation activity in breast cancer cells. G-7-G underwent extensive metabolism in T47D and MCF-10A but not in MCF-7. The proliferative effects of G-7-G on MCF-7 and T47D were associated with its hydrolysis to genistein in these cells. In contrast, G-7-S and G-4'-S were not metabolized by these three cells and had no effects on their growth. In conclusion, production of phase II metabolites did not affect the proliferation effect of genistein on MCF-7 and T47D. Deconjugation was correlated to the apparent proliferative effects of G-7-G in breast cancer cells.

Validated HPLC method for the quantitative determination of CoQ(10) in dog plasma and its application to a pharmacokinetic study.

Coenzyme Q(10) (CoQ(10) ) is a naturally occurring compound located in all membranes throughout the cell. A rapid and sensitive HPLC method was developed to determine the concentration of CoQ(10) in dog plasma using a surrogate matrix. Chromatographic separation was carried out on a Diamonsil C(18) column with the UV detector set at 275 nm. Methanol-2-propanol (40:60, v/v) was used as a mobile phase delivered at a flow rate of 1.0 mL/min. Calibrators were prepared using blank plasma-K(2) HPO(4) buffer (50 mm, pH 8.0)-saline (1:3:6, v/v/v) as surrogate matrix. It was shown that the surrogate matrix had similar properties to dog plasma for CoQ(10) in extraction, freeze-thaw and stability. The assay was linear over the concentration range of 0.10-100 µg/mL. The intra- and inter-day precisions were within 13.3% in terms of relative standard deviation (RSD%) and the accuracy was within ±7.5% in terms of relative error. This simple and reproducible HPLC method with less plasma volume (0.4 mL) and adequate sensitivity was successfully applied to pharmacokinetic studies of CoQ(10) in dogs and an investigation of the effect of CoQ(10) formulation on CoQ(10) baseline levels.

[Application of purified recombinant outer membrane lipoprotein LipL32 in detecting antibodies among leptospirosis cases].

OBJECTIVE: To establish recombinant outer membrane lipoprotein LipL32-based antibody detection assays in identifying leptospirosis. METHODS: Recombinant leptospiral outer membrane protein LipL32 was obtained by genetic engineering method. This purified protein was used in the indirect and sandwich ELISA assays to test the antibodies in sera of human beings and rats, and the results were compared with those obtained by microscopy agglutination test (MAT) and imported ELISA kit. RESULTS: When the acute and convalescent phase specimens from 9 leptospiral patients were tested, the detected rates of three ELISAs were similar to the MAT. Among the 45 probable cases which MAT showed positive, 32 (71.11%) samples were positive by r32-I-ELISA, 36 (80.00%) by r32-S-ELISA, while 28.89% (13/45) samples were positive and 55.56% (25/45) were suspicious by D.A.I-ELISA. The specificity of r32-I-ELISA and r32-S-ELISA were 97.10% (67/69) for 69 specimens. 43 healthy specimens were negative by both r32-I-ELISA and r32-S-ELISA, 14 healthy specimens were negative by D.A.I-ELISA. Among 16 non-leptospirosis patients, two specimens were positive by r32-I-ELISA and r32-S-ELISA, D.A.I-ELISA and identified one positive specimen, while 12 specimens were suspicious by D.A.I-ELISA. For 10 syphilis specimens, data obtained through three ELISAs were in consistent with that by MAT. A sandwiched ELISA, using rLipL32 protein as the antigen was developed to detect rat sera. Considering MAT as standard test, the sensitivity and specificity were 86.75% (131/151), 99.19% (122/123) respectively with coincidence rate as 92.34% (253/274). CONCLUSION: The recombinant protein LipL32 had high immunoreactivity and could be used as an antigen for the detection of pathogenic leptospirosis. In summary, the novel sandwiched ELISA with rLipL32 showed similar sensitivity and specificity to that of MAT in the antibody detection of rat leptospirosis. It was suitable for large scales field sero-epidemiological studies.

[A sero-epidemiology study on hepatitis E virus infection in Fujian province].

OBJECTIVE: To understand the sero-prevalence of hepatitis E virus (HEV) infection among different populations and animals in Fujian province. METHODS: One thousand one hundred and fifty-one serum samples were collected from 5 species of animals including swine, dog, cow, sheep and rat. A total of 2209 and 1722 serum samples from the general population and from the exposed population were collected. Anti-HEV IgG was detected by ELISA. The general population was composed of healthy blood donors and the individuals who had attended physical examination including farmers, handlers, veterinarians, cooks who worked with pigs or chickens while the poultry wholesale suppliers made up the exposure population. RESULTS: The infection rates of HEV in animals were different between species (chi2 = 406.25, P < 0.01) with the highest seen in the pig group. With pigs being kept at home, the rates were between 70.00% and 94.12% but the rate was 39.77% for those families that keeping the pigs at farms. The infection rate of HEV was 23.3% in the general population and 33.3% in the exposed populations, respectively. A significantly higher infection rate for anti-HEV was found in the exposed population when comparing with general population. The positive rate of anti-HEV IgG was significantly higher in the exposed population that closely having had contact with chickens than those who had contact with pigs. The increasing trend of HEV infection rate with age had been found but there was no significant difference between males and females in the general population. In the exposed population, the infection rate in males was significantly higher than that in females. CONCLUSION: The infection ratse of HEV in pigs and in the exposure population were much higher, especially for those persons in close contact with chickens or pigs, suggesting that the sub-clinical infection for HEV might exist. These data further supported the hypothesis that HEV might have been an zoonotic disease.