Differential Functioning Research Articles

A person-reported cumulative social risk measure does not show bias by income and education

BackgroundSocial risk such as housing instability, trouble affording medical care and food insecurity are a downstream effect of social determinants of health (SDOHs) and are frequently associated with worse health. SDOHs include experiences of racism, sexism and other discrimination as well as differences in income and education. The collective effects of each social risk a person reports are called cumulative social risk. Cumulative social risk has traditionally been measured through counts or sum scores that treat each social risk as equivalent. We have proposed to use item response theory (IRT) as an alternative measure of person-reported cumulative social risk as IRT accounts for the severity in each risk and allows for more efficient screening with computerized adaptive testing.MethodsWe conducted a differential item functioning (DIF) analysis comparing IRT-based person-reported cumulative social risk scores by income and education in a population-based sample (n = 2122). Six social risk items were analyzed using the two-parameter logistic model and graded response model.ResultsAnalyses showed no DIF on an IRT-based cumulative social risk score by education level for the six items examined. Statistically significant DIF was found on three items by income level but the ultimate effect on the scores was negligible.ConclusionsResults suggest an IRT-based cumulative social risk score is not biased by education and income level and can be used for comparisons between groups. An IRT-based cumulative social risk score will be useful for combining datasets to examine policy factors affecting social risk and for more efficient screening of patients for social risk using computerized adaptive testing.

Bayesian Adaptive Lasso for Detecting Item-Trait Relationship and Differential Item Functioning in Multidimensional Item Response Theory Models.

In multidimensional tests, the identification of latent traits measured by each item is crucial. In addition to item-trait relationship, differential item functioning (DIF) is routinely evaluated to ensure valid comparison among different groups. The two problems are investigated separately in the literature. This paper uses a unified framework for detecting item-trait relationship and DIF in multidimensional item response theory (MIRT) models. By incorporating DIF effects in MIRT models, these problems can be considered as variable selection for latent/observed variables and their interactions. A Bayesian adaptive Lasso procedure is developed for variable selection, in which item-trait relationship and DIF effects can be obtained simultaneously. Simulation studies show the performance of our method for parameter estimation, the recovery of item-trait relationship and the detection of DIF effects. An application is presented using data from the Eysenck Personality Questionnaire.

The Influence of Vision Impairment on the Measurement of Cognition in Older Adults in India: Findings From LASI-DAD.

Prior investigations have not considered whether poor vision biases cognitive testing. However, such research is vital given increasing evidence that vision impairment (VI) may be an important modifiable risk factor for dementia, particularly in low- and middle-income settings where the prevalence of VI is high. This study employed data from 3784 participants in Wave 1 of the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (LASI-DAD) who underwent both visual acuity and cognitive function testing. We used multiple indicators and multiple causes models to assess differential item functioning (DIF; eg, bias) in cognitive testing by objectively measured distance and near VI. Multivariable linear regression was used to model the association between VI and cognitive factor scores before and after DIF adjustment. Analyses were performed for general cognition and separate cognitive domains, corresponding to memory, language/fluency, executive functioning, and visuospatial performance. Models were adjusted for demographic, health, and socioeconomic covariates. Participants in our sample were 60 and older. Most participants with VI were 60-69 years old (59.6%) and 50.8% were female. Individuals experiencing both distance and near VI tended to be older, have lower educational attainment, be married, reside in rural settings, and belong to lower consumption and BMI categories. Both distance and near VI were associated with poorer cognition before and after DIF-adjustment. Differences between DIF-unadjusted and -adjusted scores were small compared to the standard error of measurement, indicating no evidence of meaningful measurement differences by VI. In well-conducted large-scale surveys, bias in cognitive testing due to VI is likely minimal. Findings strengthen previous evidence on the association between VI and dementia by showing that such associations are unlikely to be attributable to vision-related measurement error in the assessment of cognitive functioning.

Localization of EFA6A, an exchange factor for Arf6, in Z-lines and sarcoplasmic reticulum membranes in addition to myofilaments in I-domains of skeletal myofibers of peri-natal mice

Membrane trafficking and actin-remodeling are critical for well-maintained integrity of the cell organization and activity, and they require Arf6 (ADP ribosylation factor 6) activated by GEF (guanine nucleotide exchange factor) including EFA6 (exchange factor for Arf6). In the present immuno-electron microscopic study following previous immunohistochemical study by these authors (Chomphoo et al., 2020) of in situ skeletal myoblasts and myotubes of pre-and perinatal mice, the immunoreactivity for EFA6A was found to be localized at Z-bands and sarcoplasmic reticulum (SR) membranes in I-domains as well as I-domain myofilaments of skeletal myofibers of perinatal mice. Based on the previous finding that EFA6 anchored on the neuronal postsynaptic density via α-actinin which is known to be shared by muscular Z-bands, the present finding suggests that EFA6A is also anchored on Z-bands via α-actinin and involved in the membrane trafficking and actin-remodeling in skeletal myofibers. The localization of EFA6A-immunoreactivity in I-domain SR suggests a differential function in the membrane traffic between the I- and A-domain intracellular membranes in perinatal skeletal myofibers.

Activities-specific balance confidence scale: a Rasch evaluation of the Arabic version in lower-limb prosthetic users

Purpose To evaluate the psychometric properties of the Arabic version of the Activities-Specific Balance Confidence Scale using the 5-option response categories for individuals with lower limb amputation (ABC-5/Ar). Materials and methods This was a methodological study on a convenience sample of individuals with unilateral lower-limb amputation attending outpatient rehabilitation centres in Saudi Arabia and Turkey (N = 155). Rasch analysis (WINSTEPS version 4.6.5) was used to examine the 5-categories rating scale structure, item fit, item difficulty hierarchy, person separation index, unidimensionality, local item dependency, and differential item functioning. Results The ABC-5/Ar 5-response option demonstrated an appropriate model fit. Most items fit the Rasch model, except for item #12 “walk in a crowded mall,” which showed an overfitting value of 0.63. The person separation indices 2.95 (Cronbach’s α = 0.96). Principal component analysis of residuals confirmed the unidimensionality of the scale; however, local dependency was detected between item #14 “Ride in escalator holding rail,” and item #15 “Ride in escalator not holding rail.” Conclusions The findings suggest that the ABC-5/Ar shows promise in assessing balance confidence in Arabic-speaking lower-limb prosthesis users. However, further studies with larger sample sizes and in diverse clinical contexts are needed to confirm its effectiveness in various clinical settings.

Trajectory optimization for aerodynamically controlled missiles by chance-constrained sequential convex programming

The flight environment of aerodynamically controlled missiles is full of complexity and uncertainty. To cope with the uncertainty more effectively and enhance the convergence performance in trajectory optimization problems for aerodynamically controlled missiles simultaneously, the chance-constrained sequential convex programming (CC-SCP) algorithm is proposed in this paper. The uncertainty is regarded as the chance constraint, and a smooth and differential approximation function is designed to transform this chance constraint into the constraint that the convex optimization method can handle. Subsequently, the originally non-convex trajectory optimization problem is reformulated into a series of convex optimization subproblems, in which an initial reference trajectory guess generation strategy is proposed, and a theoretical proof of the exact convex relaxation is given to enhance the algorithm's convergence performance and theoretical value, respectively. Numerical simulations are provided to verify the convergence and effectiveness of the CC-SCP algorithm, and the advantages of using the CC-SCP algorithm to cope with the uncertainty are illustrated. Furthermore, comparative simulation examples show that the proposed algorithm possesses a low conservatism, which means the proposed algorithm can obtain a bigger convergence region and a better solution than other current methods when handling the same chance constraints. Finally, the robustness of the algorithm is discussed.

Cxcl10 and Cxcr3 regulate self-renewal and differentiation of hematopoietic stem cells

BackgroundThe function of hematopoietic stem cells (HSC) is regulated by HSC internal signaling pathways and their microenvironment. Chemokines and chemokine ligands play important roles in the regulation of HSC function. Yet, their functions in HSC are not fully understood.MethodsWe established Cxcr3 and Cxcl10 knockout mouse models (Cxcr3−/− and Cxcl10−/−) to analyze the roles of Cxcr3 or Cxcl10 in regulating HSC function. The cell cycle distribution of LT-HSC was assessed via flow cytometry. Cxcr3−/− and Cxcl10−/− stem/progenitor cells showed reduced self-renewal capacity as measured in serial transplantation assays. To study the effects of Cxcr3 or Cxcl10 deficient bone marrow microenvironment, we transplanted CD45.1 donor cells into Cxcr3−/−or Cxcl10−/− recipient mice (CD45.2) and examined donor-contributed hematopoiesis.ResultsDeficiency of Cxcl10 and its receptor Cxcr3 led to decreased BM cellularity in mice, with a significantly increased proportion of LT-HSC. Cxcl10−/− stem/progenitor cells showed reduced self-renewal capacity in the secondary transplantation assay. Notably, Cxcl10−/− donor-derived cells preferentially differentiated into B lymphocytes, with skewed myeloid differentiation ability. Meanwhile, Cxcr3-deficient HSCs demonstrated a reconstitution disadvantage in secondary transplantation, but the lineage bias was not significant. Interestingly, the absence of Cxcl10 or Cxcr3 in bone marrow microenvironment did not affect HSC function.ConclusionsThe Cxcl10 and Cxcr3 regulate the function of HSC, including self-renewal and differentiation, adding to the understanding of the roles of chemokines in the regulation of HSC function.

Revisiting the English Short Measure for Adult Playfulness (SMAP): An Investigation of Reliability, Validity, and Cross-Cultural Comparisons

Adult playfulness describes the personality of the quick initiation and strong intensity of enjoyable experiences coupled with the frequency of engaging in playful behaviors. In addition to examining the reliability and validity of the Short Measure for Adult Playfulness (SMAP), we compared the psychometric properties of the SMAP across (a) 4- and 7-point answer formats; (b) German and English language versions; and (c) gender. The SMAP and criterion validity measures were distributed across three independent samples from Canada (N total = 1,177) and a German sample (N = 660). Results supported a unidimensional solution with strong factor loadings for all items (>.50 across all samples) and high test-retest reliability (r = .67, BF10>100). In item response theory analyses, high discrimination parameters were found across the latent continuum. Although both the four-point and seven-point Likert scale versions showed robust item properties, the seven-point Likert scale version yielded more precise measurement of higher playfulness (θ > 1.50). No significant differential item functioning was located across gender or language. Finally, results supported external construct validity via associations with broad personality traits, humor, and orientations to happiness. The present investigation provides support for the reliability and validity of the English SMAP for concise adult playfulness measurement.

SIMEX-Based and Analytical Bias Corrections in Stocking–Lord Linking

Stocking–Lord (SL) linking is a popular linking method for group comparisons based on dichotomous item responses. This article proposes a bias correction technique based on the simulation extrapolation (SIMEX) method for SL linking in the 2PL model in the presence of uniform differential item functioning (DIF). The SIMEX-based method is compared to the analytical bias correction methods of SL linking. It turned out in a simulation study that SIMEX-based SL linking performed best, is easy to implement, and can be adapted to other linking methods straightforwardly.

Identification and validation of genes associated with prognosis of cisplatin-resistant ovarian cancer

PurposeTo investigate the role of prognostic genes related to cisplatin resistance in ovarian cancer during disease progression.MethodThe gene expression profile of the NCI-60 cell line was acquired through comprehensive analysis of the GEO database accession GSE116439. We performed a thorough analysis of gene expression differences in samples from seven individuals exposed to cisplatin concentrations of 0 nM compared to seven samples exposed to 15000 nM over a 24-h period. Key genes were initially identified through LASSO regression, followed by their enrichment through differential gene function analysis (GO) and pathway enrichment analysis (KEGG). Subsequently, a prognostic risk model was established for these key genes. The prognostic model's performance was assessed through K-M survival curves and ROC curves. To examine the variance in immune cell infiltration between the high and low-risk groups, CIBERSORTx analysis was employed. Finally, validation of prognostic gene expression in cisplatin-resistant ovarian cancer was carried out using clinical samples, employing RT-qPCR and Western Blot techniques.ResultsA total of 132 differential genes were found between cisplatin resistance and control group, and 8 key prognostic genes were selected by analysis, namely VPS13B, PLGRKT, CDKAL1, TBC1D22A, TAP1, PPP3CA, CUX1 and PPP1R15A. The efficacy of the risk assessment model derived from prognostic biomarkers, as indicated by favorable performance on both Kaplan–Meier survival curves and ROC curves. Significant variations in the abundance of Macrophages M1, T cells CD4 memory resting, T cells follicular helper, and T cells gamma delta were observed between the high and low-risk groups. To further validate our findings, RT-qPCR and Western Blot analyses were employed, confirming differential expression of the identified eight key genes between the two groups.ConclusionVPS13B, TBC1D22A, PPP3CA, CUX1 and PPP1R15A were identified as poor prognostic genes of cisplatin resistance in ovarian cancer, while PLGRKT, CDKAL1 and TAP1 were identified as good prognostic genes. This offers a novel perspective for future advancements in ovarian cancer treatment, suggesting potential avenues for the development of new therapeutic targets.

Is the use of multiple-choice items and a holistically-scored paragraph translation task fair? Examining a large-scale translation subtest

AbstractThis study investigated the test fairness of the translation section of a large-scale English test in China by examining its Differential Test Functioning (DTF) and Differential Item Functioning (DIF) across gender and major. Regarding DTF, the entire translation section exhibits partial strong measurement invariance across female and male test takers, while exhibiting full measurement invariance across test takers in (1) arts & humanities and social sciences (A&HSS) and (2) science, technology, engineering or mathematics (STEM) majors. No major-based DIF was detected in this study. Objective test items tend to favor male test takers, while direct translation test task was more favorable to females. Combining the DIF and DTF results, there may be a cancelation effect in our case. However, the effect size of DIF is either negligible or slight to moderate, indicating minimal impact on the overall fairness of the translation test task. This study further discusses the necessity of exploring the source of DIF and the importance of combining DIF and DTF for test fairness research.

Correlation between renal sonographic measurements and differential renal function obtained from nuclear renography in children with unilateral hydronephrosis

Children with higher grades of hydronephrosis often undergo mercaptoacetyltriglycine nuclear renography scans (MAG3) to assess differential renal function (DRF) and drainage. Although MAG3 helps identify the potential need for pyeloplasty, its use incurs increased costs, radiation exposure, and stress for children and families. Several studies demonstrate pyramidal thickness (PT)≤3mm as a reliable predictive risk factor for pyeloplasty in children with a history of prenatal hydronephrosis. Our hypothesis was that renal sonographic measurements including PT and parenchymal thickness (ParT) correlate with DRF in children with high-grade unilateral hydronephrosis and may be used to better select the need and frequency of MAG3 scans in children at increased risk for diminished relative renal function. The objective of this project was to determine the correlation between sonographic renal measurements and DRF in patients with unilateral hydronephrosis, we assessed: 1) the correlation between PT, ParT, and the ratio of PT/ParT in hydronephrotic kidneys to DRF, 2) the correlation between the ratio of hydronephrotic PT/contralateral non-hydronephrotic PT and DRF, 3) the correlation between the ratio of hydronephrotic ParT/contralateral non-hydronephrotic ParT and DRF, and 4) the correlation between the ratio of (hydronephrotic PT/ParT)/(contralateral non-hydronephrotic PT/ParT) and DRF. We retrospectively reviewed 71 children with grades 3 or 4 unilateral hydronephrosis. Most patients presented with a history of prenatally detected hydronephrosis at median age (IQR) of 112 days (43-274). Measurements of PT and ParT were completed on 98 renal ultrasounds and DRF was collected from corresponding MAG3 scans. Threshold values were identified visually through scatterplots. Spearman's correlation coefficient and Fisher's p-values were calculated. Ratios of PT and ParT in hydronephrotic kidneys to contralateral non-hydronephrotic kidneys were positively correlated with DRF. Ratios of hydronephrotic PT/non-hydronephrotic PT>0.8 and hydronephrotic ParT/non-hydronephrotic ParT >0.7 occurred more frequently in patients with a DRF >40% (p=0.11 and p=0.001, respectively). A PT>3mm and ParT >5mm occurred significantly more frequently in patients with a DRF >40% (p=0.008 and p=0.006, respectively). Renal sonographic measurements including threshold values of PT>3mm, ParT > 5mm, ratio of hydronephrotic PT/contralateral non-hydronephrotic PT (>0.8), and ratio of hydronephrotic ParT/contralateral non-hydronephrotic ParT (>0.7) are good predictors of DRF >40% in unilateral high-grade hydronephrosis. These identified threshold values have potential utility in determining the need for nuclear renal scans in children with high-grade hydronephrosis.

Sex chromosome-encoded protein homologs: current progress and open questions.

The complexity of biological sex differences is markedly evident in human physiology and pathology. Although many of these differences can be ascribed to the expression of sex hormones, another contributor to sex differences lies in the sex chromosomes beyond their role in sex determination. Although largely nonhomologous, the human sex chromosomes express seventeen pairs of homologous genes, referred to as the 'X-Y pairs.' The X chromosome-encoded homologs of these Y-encoded proteins are crucial players in several cellular processes, and their dysregulation frequently results in disease development. Many diseases related to these X-encoded homologs present with sex-biased incidence or severity. By contrast, comparatively little is known about the differential functions of the Y-linked homologs. Here, we summarize and discuss the current understanding of five of these X-Y paired proteins, with recent evidence of differential functions and of having a potential link to sex biases in disease, highlighting how amino acid-level sequence differences may differentiate their functions and contribute to sex biases in human disease.

Risk and protective factors for secondary procedures after endoscopic dilatation of primary obstructive megaureters.

High-pressure balloon dilatation (HPBD) of the ureterovesical junction with double-J stenting is a minimally invasive alternative to ureteral reimplantation or cutaneous ureterostomy for first-line surgical treatment of primary obstructive megaureter (POM). The aim of our study was to identify the risk factors associated with the need for secondary procedures due to HPBD failure. Prospective data were collected from patients who underwent HPBD for POM between 2007 and 2021 at a single institution. The collected data included patient demographics, diagnostic modalities, surgical details, results, and follow-up. Multivariate logistic regression analysis was performed. Fifty-five ureters underwent HPBD for POM in 50 children, with a median age of 6.4months (IQR: 4.5-13.8). Nineteen patients (37.25%) underwent secondary ureteric reimplantation, with a median of 9.8months after primary HBPD (95% CI 6.2-9.9). The median follow-up was 29.4months (IQR: 17.4-71). Independent risk factors for redo-surgery in a multivariate logistic regression model were: progressive ureterohydronephrosis (OR = 7.8; 95% CI 0.77-78.6) and early removal of the double-J stent. A risk reduction of 7% (95% CI 2.2%-11.4%) was observed per extra-day of catheter maintenance. The optimal cut-off point is 55days, ROC curve area: 0.77 (95% CI 0.62-0.92). Gender, distal ureteral diameter, pelvis diameter, dilatation balloon diameter and preoperative differential renal function did not affect the need for reimplantation. The use of a double-J stent for at least 55days seems to avoid the need for a secondary procedure. Therefore, we recommend removing the double-J catheter at least 2months after the HBPD.

Assessing health-related quality of life using the Wound-QoL-17 and the Wound-QoL-14-Results of the cross-sectional European HAQOL study using item response theory.

For assessing health-related quality of life in patients with chronic wounds, the Wound-QoL questionnaire has been developed. Two different versions exist: the Wound-QoL-17 and the Wound-QoL-14. For international and cross-cultural comparisons, it is necessary to demonstrate psychometric properties in an international study. Therefore, the aim of this study was to test both questionnaires in a European sample, using item response theory (IRT). Participants were recruited in eight European countries. Item characteristic curves (ICC), item information curves (IIC) and differential item functioning (DIF) were calculated. In both questionnaires, ICCs for most items were well-ordered and sufficiently distinct. For items, in which adjacent response categories were not sufficiently distinct, response options were merged. IICs showed that items on sleep and on pain, on worries as well as on day-to-day and leisure activities had considerably high informational value. In the Wound-QoL-14, the item on social activities showed DIFs regarding the country and age. The same applied for the Wound-QoL-17, in which also the item on stairs showed DIFs regarding age. Our study showed comparable results across both versions of the Wound-QoL. We established a new scoring method, which could be applied in international research projects. For clinical practice, the original scoring can be maintained.

IL-2 family cytokines IL-9 and IL-21 differentially regulate innate and adaptive type 2 immunity in asthma

BackgroundAsthma is often accompanied by type 2 immunity rich in IL-4, IL-5 and IL-13 cytokines produced by TH2 lymphocytes or type 2 innate lymphoid cells (ILC2s). Interleukin-2 family cytokines play a key role in the differentiation, homeostasis and effector function of innate and adaptive lymphocytes. ObjectiveIL-9 and IL-21 boost the activation and proliferation of TH2 and ILC2s, but the relative importance and potential synergism between these γc cytokines is currently unknown. MethodsUsing newly generated antibodies, we inhibited IL-9 and IL-21 alone or in combination, in various murine models of asthma. In a translational approach using segmental allergen challenge, we recently described elevated IL-9 levels in human allergic asthmatics in comparison to non-asthmatic controls. Here, we also measured IL-21 in both groups. ResultsIL-9 played a central role in controlling innate IL-33 induced lung inflammation by promoting proliferation and activation of ILC2s, in an IL-21 independent manner. Conversely, chronic house dust mite induced airway inflammation, mainly driven by adaptive immunity, was solely dependent on IL-21, that controlled TH2 activation, eosinophilia, total serum IgE and formation of tertiary lymphoid structures. In a model of innate on adaptive immunity driven by papain allergen, a clear synergy was found between both pathways, since combined anti-IL-9 or anti-IL-21 blockade was superior in reducing key asthma features. In human bronchoalveolar lavage (BAL) samples we measured elevated IL-21 protein within the allergic asthmatic group, compared with the allergic control group. We also found increased IL21R transcripts and predicted IL-21 ligand activity in various disease-associated cell subsets. ConclusionIL-9 and IL-21 play important and non-redundant roles in allergic asthma by boosting ILC2s and TH2 cells, revealing a dual IL-9 and IL-21 targeting strategy as a new and testable approach.

Associations between digital health literacy and health system navigating abilities among Norwegian adolescents: validating the HLS19-DIGI scale using Rasch modeling

BackgroundDespite increasing global attention to health literacy and adolescents’ digital health information seeking, no unidimensional instruments measuring digital health literacy (DHL) in adolescents have reportedly been validated using Rasch modeling. Moreover, the evidence of adolescents’ abilities to navigate the health system (NAV-HL) in light of their DHL proficiency is still scarce. Therefore, our study aims to evaluate the psychometric properties of a DHL instrument (HLS19-DIGI scale) in order to investigate DHL in adolescents and young adults aged 16–25 and associations with abilities to navigate the health system.MethodsA population-based cross-sectional survey among 890 Norwegian adolescents was conducted during April–October 2020 using computer-assisted telephone interviewing. Rasch modeling, independent samples t-test, chi-square test, and binary regression models were used to analyze the data.ResultsThe HLS19-DIGI scale was sufficiently unidimensional, whereas no differential item functioning or disordered response categories were observed. However, relatively poor targeting was revealed indicating too many easy items for the target population. Yet, a high proportion (54%) of low DHL proficiency in adolescents was observed, as well as DHL was positively associated with the abilities to navigate the health system.ConclusionsThe HLS19-DIGI scale is considered a sufficiently unidimensional and valid instrument for measuring DHL in adolescents, which may be a useful tool for health authorities, public health workers, and health service providers. While DHL affects adolescents’ abilities to navigate the health system, future research should measure and examine their ability to utilize digital health services, separately.

The Flare-OA-16 questionnaire measuring flare in knee and hip osteoarthritis in the patient perspective: scale reduction and validation using a Rasch model

ObjectivesThe recent Flare-OA questionnaire measuring flare in knee and hip osteoarthritis (OA) (19 items in 5 domains, numerical rating scale) showed good psychometric properties along with classical test theory. This study aimed to determine its scaling properties by Rasch analysis and to present evidence for a refined scalable version. Study Design and SettingThe participants were 398 subjects (mean age 64 years [standard deviation = 8.1], 70.4% women) recruited from Australia, France, and the United States, with clinically and radiologically symptomatic knee or hip OA, who completed an online survey. The sample was split into derivation and validation subsamples, stratified by country and joint. Rasch analysis examined differential item functioning (DIF) for sex, age, country, and joint. A confirmatory factor analysis and an analysis of convergent validity were performed to document the psychometric properties of the short version. ResultsTo fit the Rasch model, we reordered thresholds of answering modalities when necessary. Two items were removed. A local dependency between 2 items was solved by combining items modalities into a super-item. A uniform DIF (expected and nonremoved) was identified for one item that was split by joint, and a nonuniform DIF for one item for age and country (removed). The person-item threshold distribution showed a well-focused scale; the confirmatory factor analysis and the analysis of convergent validity showed good fit indicators for the short version. ConclusionThe Rasch analysis was helpful in guiding the decision to refine the measurement instrument. After analysis, the 16-item Flare-OA self-report questionnaire is available for use in clinical research.

Three-dimensional cultured human umbilical cord mesenchymal stem cells attenuate pulmonary fibrosis by improving the balance of mitochondrial fusion and fission.

Pulmonary fibrosis is a kind of fibrotic interstitial pneumonia with poor prognosis. Aging, environmental pollution, and coronavirus disease 2019 are considered as independent risk factors for pulmonary fibrogenesis. Consequently, the morbidity and mortality striking continues to rise in recent years. However, the clinical therapeutic efficacy is very limited and unsatisfactory. So it is necessary to develop a new effective therapeutic approach for pulmonary fibrosis. Human umbilical cord mesenchymal stem cells (hucMSCs) are considered as a promising treatment for various diseases because of their multiple differentiation and immunomodulatory function. The key bottleneck in the clinical application of hucMSCs therapy is the high-quality and large-scale production. This study used FloTrix miniSpin bioreactor, a three-dimensional (3D) cell culture system, for large-scale expansion of hucMSCs in vitro, and proved 3D cultured hucMSCs inhibited the differentiation of fibroblasts into myofibroblasts and myofibroblasts proliferation and migration, leading to slow down the development of pulmonary fibrosis. Further mechanistic studies clarified that hucMSCs reduced the amount of binding between circELP2 and miR-630, resulting in blocking YAP/TAZ translocation from cytoplasm to nucleus. This condition inhibited mitochondrial fusion and promoted mitochondrial fission, and ultimately improved fusion/fission balance and cellular homeostasis. To sum up, this work clarified the anti-fibrosis and mechanism of hucMSCs cultured from the 3D FloTrix miniSpin bioreactor. We hope to provide new ideas and new methods for the clinical transformation and industrialization of hucMSCs therapy.

Using ECHO program data to develop a brief measure of caregiver support and cognitive stimulation using the home observation for measurement of the environment-infant/toddler (HOME-IT).

Data from three NIH Environmental influences on Child Health Outcomes (ECHO) Program cohorts that collected the HOME-Infant-Toddler (HOME-IT age 0-3 years) version were used to examine the reliability of a brief scale of caregiver support and cognitive stimulation. Participants with HOME-IT data (N = 2518) were included in this analysis. Mean child age at HOME-IT assessment was 1.51 years, 48% of children were female, and 43% of children identified as Black. A four-stage analysis plan was used to evaluate item response theory assumptions, item response theory model fit, monotonicity, scalability, item fit, and differential item functioning. Results indicate the feasibility of developing a reliable 10-item scale (reliability >0.7) with particularly high precision for children with lower levels of cognitive stimulation.