Development and validation of the health literacy environment scale for Chinese hospitals from patients' perspective.

Introduction: While the research on improving individual health literacy by promoting individual skills and abilities is increasing, less attention has been paid to the complexities of the healthcare environment that may influence patients' ability to access, understand, and apply health information and health services to make health decisions. This study aimed to develop and validate a Health Literacy Environment Scale (HLES) that is suitable for Chinese culture. Methods: This study was conducted in two phases. First, using the Person-Centered Care (PCC) framework as a theoretical framework, initial items were developed by using the existing health literacy environment (HLE) related measurement tools, literature review, qualitative interviews, and the researcher's clinical experience. Second, scale development was based on two rounds of Delphi expert consultation and a pre-test conducted with 20 hospitalized patients. Using 697 hospitalized patients from three sample hospitals, the initial scale was developed after item screening and its reliability and validity were evaluated. Results: The HLES comprised 30 items classified into three dimensions as follows: interpersonal (11 items), clinical (9 items), and structural (10 items) dimensions. The Cronbach's α coefficient of the HLES was 0.960 and the intra-class correlation coefficient was 0.844. The confirmatory factor analysis verified the three-factor model after allowing for the correlation of five pairs of error terms. The goodness-of-fit indices signified a good fit for the model (χ2/df = 2.766, RMSEA = 0.069, RMR = 0.053, CFI = 0.902, IFI = 0.903, TLI = 0.893, GFI = 0.826, PNFI = 0.781, PCFI = 0.823, PGFI = 0.705). The item-content validity index ranged from 0.91 to 1.00, and the scale-content validity index was 0.90. Conclusion: The HLES had good reliability and validity and provides a patient perspective tool for evaluating HLE and a new perspective for improving health literacy in China. That is, healthcare organizations make it easier for patients to access, understand, and use health information and service. Further studies about the validity and reliability of HLE should include other districts and different tiers or types of healthcare organizations.

A CARE-compliant article: A case report and literature review of IgG4-related lung disease.

RATIONALE: IgG4-related lung disease (IgG4-RLD) is an unusual disease, with various clinical manifestations and various chest imaging findings. The patients may have no respiratory symptoms. Therefore, diagnosis is challenging. This can easily cause misdiagnosis and mistreatment. PATIENT CONCERNS: A 71-year-old male presented with chest pain, cough, and shortness of breath. Plain chest computed tomography scans showed multi-locus nodes at the center of the hilum. DIAGNOSIS: Percutaneous lung biopsy was performed, and IgG4-RLD was diagnosed. INTERVENTIONS: Prednisone was orally administered daily. OUTCOMES: The case's symptoms improved. The patient was discharged from the hospital. After 2 months of reexamination, his symptoms were relieved. Reexamination of the chest computed tomography showed that multi-locus nodes of the lung were obviously absorbed compared with those before. LESSONS: IgG4-RLD is a rare respiratory disease. It has atypical clinical manifestations and chest images. We report the first case of IgG4-RLD showing multi-locus nodes centered on the hilar, hypertrophic mucosa; as well as a narrow and even occluded lumen.

FeTe1-xSex monolayer films: towards the realization of high-temperature connate topological superconductivity.

We performed angle-resolved photoemission spectroscopy studies on a series of FeTe1-xSex monolayer films grown on SrTiO3. The superconductivity of the films is robust and rather insensitive to the variations of the band position and effective mass caused by the substitution of Se by Te. However, the band gap between the electron- and hole-like bands at the Brillouin zone center decreases towards band inversion and parity exchange, which drive the system to a nontrivial topological state predicted by theoretical calculations. Our results provide a clear experimental indication that the FeTe1-xSex monolayer materials are high-temperature connate topological superconductors in which band topology and superconductivity are integrated intrinsically.

Relationship between nutritional risk and exercise capacity in severe chronic obstructive pulmonary disease in male patients.

OBJECTIVE: The nutritional status of chronic obstructive pulmonary disease (COPD) patients is associated with their exercise capacity. In the present study, we have explored the relationship between nutritional risk and exercise capacity in severe male COPD patients. METHODS: A total of 58 severe COPD male patients were enrolled in this study. The patients were assigned to no nutritional risk group (n=33) and nutritional risk group (n=25) according to the Nutritional Risk Screening (NRS, 2002) criteria. Blood gas analysis, conventional pulmonary function testing, and cardiopulmonary exercise testing were performed on all the patients. RESULTS: Results showed that the weight and BMI of the patients in the nutritional risk group were significantly lower than in the no nutritional risk group (P<0.05). The pulmonary diffusing capacity for carbon monoxide of the no nutritional risk group was significantly higher than that of the nutritional risk group (P<0.05). Besides, the peak VO2 (peak oxygen uptake), peak O2 pulse (peak oxygen pulse), and peak load of the nutritional risk group were significantly lower than those of the no nutritional risk group (P<0.05) and there were significantly negative correlations between the NRS score and peak VO2, peak O2 pulse, or peak load (r<0, P<0.05). CONCLUSION: The association between exercise capacity and nutritional risk based on NRS 2002 in severe COPD male patients is supported by these results of this study.

[Effects of returning maize straw into field on dynamic change of soil microbial biomass C, N and P under different promoted decay condition].

A 2-year field experiment of wheat-maize rotation was conducted on a cinnamon soil of east Hebei Province to study the effects of returning maize straw into field on the dynamics of soil microbial biomass C, N and P, and their relationships with soil nutrients and enzyme activities. The results showed that under the condition of returning maize straw combined with applying chemical fertilizer to adjust straw C/N, the application of effective microorganisms could increase soil microbial biomass C, N and P in each crop growth period, advance their peak time, and better regulate soil nutrient supply, compared with no application of effective microorganisms. Soil microbial biomass had a significantly positive correlation with soil enzyme activities, but its correlation with soil hydrolysable N and available P was strongly affected by crop growth and fertilization system.