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).

Refinement and Evaluation of a Chinese and Western Medication Adherence Scale for Patients with Chronic Kidney Disease: Item Response Theory Analyses.

PURPOSE: This study aimed to simplify the version-1 Chinese and Western medication adherence scale for patients with chronic kidney disease (CKD) to a version-2 scale using item response theory (IRT) analyses, and to further evaluate the performance of the version-2 scale. MATERIALS AND METHODS: Firstly, we refined the version-1 scale using IRT analyses to examine the discrimination parameter (a), difficulty parameter (b) and maximum information function peak (Imax). The final scale refinement from version-1 to version-2 scale was also decided upon clinical considerations. Secondly, we analyzed the reliability and validity of version-2 scale using classical test theory (CTT), as well as difficulty, discrimination and Imax of version-1 and version-2 scale using IRT in order to conduct scale evaluation. RESULTS: For scale refinement, the 26-item version-1 scale was reduced to a 15-item version-2 scale after IRT analyses. For scale evaluation using CTT, internal consistency reliability (total Cronbach α = 0.842) and test-rest reliability (r = 0.909) of version-2 scale were desirable. Content validity indicated 3 components of knowledge, belief and behaviors. We found meritorious construct validity with 3 detected components as the same construct of medication knowledge (items 1-9), medication behavior (items 13-15), and medication belief (items 10-12) based upon exploratory factor analysis. The correlation between the version-2 scale and Morisky, Green and Levine scale (MGL scale) was weak (Pearson coefficient = 0.349). For scale evaluation with IRT, the findings showed enhanced discrimination and decreased difficulty of most retained items (items 1, 2, 3, 4, 5, 6, 7, 9, 10, 11, 12, 13, 14, 15), decreased Imax of items 1, 2, 3, 4, 6, 11, 14, as well as increased Imax of items 5, 7, 8, 9, 10, 12, 13, 14, 15 in the version-2 scale than in the version-1 scale. CONCLUSION: The original Chinese and Western medication adherence scale was refined to a 15-item version-2 scale after IRT analyses. The scale evaluation using CTT and IRT showed the version-2 scale had the desirable reliability, validity, discrimination, difficulty, and information providedoverall. Therefore, the version-2 scale is clinically feasible to assess the medication adherence of CKD patients.

Fabrication of 3D Porous Polyvinyl Alcohol/Sodium Alginate/Graphene Oxide Spherical Composites for the Adsorption of Methylene Blue.

In this study, three-dimensional (3D) networked porous polyvinyl alcohol/sodium alginate/graphene oxide (PVA/SA/GO) spherical composites were fabricated by the sol-gel method and employed as adsorbents for the adsorption of methylene blue (MB) in aqueous solution. The obtained samples were characterized by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), thermal property analysis, and nitrogen adsorption/desorption isotherms. Moreover, the adsorption properties for MB were investigated by batch experiments. The pseudo-first-order and pseudo-second-order equations were used to fit the adsorption kinetics data, and the Langmuir and Freundlich isothermal models were used to analyze the adsorption isothermals. The results showed that the spherical composites had 3D porous structures, and GO, PVA and SA were fused and linked together by self-assembly, physical intertwining, hydrogen bonding, and Ca2+ and boric acid crosslinking. The maximum adsorption capacity of the 3D porous PVA/SA/GO spherical composites for MB was 759.3 mg/g. The adsorption kinetics had a better agreement with the pseudo-secondorder equation than the pseudo-first-order equation, and the equilibrium data followed the Freundlich model.

Prognostic Value of Mismatch Repair Genes for Patients With Colorectal Cancer: Meta-Analysis.

DNA mismatch repair was proposed to play a pivotal role in the development and prognosis of colorectal cancer. However, the prognostic value of mismatch repair on colorectal cancer is still unknown. The PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched. The articles about mismatch repair (including hMLH1, hMSH2, hMSH3, hMSH6, hPMSH1, and hPMSH2) deficiency for the prognosis of patients with colorectal cancer were included in the study. The hazard ratio and its 95% confidence interval were used to measure the impact of mismatch repair deficiency on survival time. Twenty-one articles were included. The combined hazard ratio for mismatch repair deficiency on overall survival was 0.59 (95% confidence interval: 0.50-0.69) and that on disease-free survival was 0.57 (95% confidence interval: 0.43-0.75). In subgroup analysis, there were a significant association between overall survival and mismatch repair deficiency in Asian studies (hazard ratio: 0.67; 95% confidence interval: 0.50-0.91) and Western studies (hazard ratio: 0.56; 95% confidence interval: 0.46-0.67). For disease-free survival, the hazard ratios in Asian studies and Western studies were 0.55 (95% confidence interval: 0.38-0.81) and 0.62 (95% confidence interval: 0.50-0.78), respectively. Our meta-analysis indicated that mismatch repair could be used to evaluate the prognosis of patients with colorectal cancer.

Copper leaching from waste printed circuit boards using typical acidic ionic liquids recovery of e-wastes' surplus value.

In this study, using several types of acidic ionic liquids as the leaching reagents, the leaching behaviors of the copper present in waste printed circuit boards (WPCBs) were investigated. The effects of various parameters on the copper leaching rate were studied, such as the particle size of the shredded WPCB, type of ionic liquid used, hydrogen peroxide dosage, solid-to-liquid ratio, leaching temperature, and leaching time. The experimental results showed that the copper leaching rate increases continuously when the powder particle size is increased from 0.071 to 0.500 mm. Moreover, the copper leaching rate also increases with an increase in the leaching temperature. In contrast, the leaching rate first increases and then decreases with increases in the leaching time, hydrogen peroxide dosage, and solid-to-liquid ratio. The optimal conditions that provided a 98.31% copper leaching rate were: particle size >0.500 mm, 8.5 mL 90% (v/v) ionic liquid, 1.5 mL 30% hydrogen peroxide, solid-to-liquid ratio of 1/20, leaching temperature of 80 °C, and leaching time of 2 h.