Fundamento y generalidades de la construcción de modelos estadísticos multinivel en el ámbito de la investigación en salud

Este trabajo tiene como objetivo presentar una mirada global de la aplicabilidad de los modelos de análisis multinivel en el ámbito de la investigación sanitaria. Ofrece información sobre los fundamentos teóricos, metodológicos y estadísticos y, además, menciona los pasos básicos para la construcción de estos modelos, y da ejemplos de su uso, según la estructura jerárquica de los datos. Cabe resaltar que, antes de utilizar estos modelos, se requiere contar con un soporte teórico sobre la necesidad de uso y una valoración estadística que dé cuenta del porcentaje de varianza explicada por el efecto de agrupación de las observaciones. Los requisitos para llevar a cabo este tipo de análisis dependen de condiciones especiales como el tipo de variables, la cantidad de unidades por nivel o el tipo de estructura jerárquica. Se concluye que los modelos de análisis multinivel son una herramienta útil para lograr la integración de información, dadas la complejidad de las relaciones y las interacciones que determinan la mayoría de las condiciones de salud, incluida la pérdida de independencia entre las unidades de observación.

This topic review aims to present a global vision of multilevel analysis models' applicability to health research, explaining its theoretical, methodological, and statistical foundations. We describe the basic steps to build these models and examples of their application according to the data hierarchical structure. It ir worth noticing that before using these models, researchers must have a rationale for needing them, and a statistical evaluation accounting for the variance percentage explained by the observations grouping effect. The requirements to conduct this type of analysis depends on special conditions such as the type of variables, the number of units per level, or the type of hierarchical structure. We conclude that multilevel analysis models are a useful tool to integrate information, considering the complexity of the relationships and interactions involved in most health conditions, including the loss of independence between observation units.

Aseguramiento y control de la calidad de los datos en un estudio de cohorte en Colombia

Introducción: La calidad de los datos facilita garantizar la fiabilidad de los estudios observacionales. Objetivo: Describir el aseguramiento y el control de calidad para mantener la fiabilidad y la validez del dato en un estudio de cohorte. Métodos: Presentar el manejo de datos implementado dentro de un seguimiento de enfermos renales crónicos cuya exposición fue un programa de protección renal comparado con el tratamiento convencional y su asociación con desenlaces clínicos. Se evaluó el cambio en la frecuencia de errores después de implementar el plan y la reproducibilidad del ingreso de registros a las bases de datos. Resultados: Se documentó una disminución progresiva en los errores cometidos en la captación de datos. El valor de Kappa entre los recolectores de la información para las variables clínicas más importantes fue 0,960 para la depuración de creatinina 150 mg/dL; 0,730 para la alteración del sedimento urinario; 0,956 para la asignación de estadio al ingreso. Los coeficientes de correlación intraclase para la identificación de las cifras de presión arterial sistólica fue 0,996; para la de presión arterial diastólica 0,993 y para los niveles de creatinina sérica al diagnóstico 0,995. Discusión: La calidad de los datos comienza con el reconocimiento de los retos y dificultades que implica su responsable captación, de ahí el aporte de la estandarización de los procesos y el personal que los lleve a cabo en forma idónea. Estudios evidencian que muchos procesos de mejora surgen en el desarrollo de la investigación sin protocolos preestablecidos. Conclusión: La reducción en la proporción y el tipo de error durante el proceso de captación de datos se debe a su identificación temprana y la corrección de instructivos, del instrumento de control de diligenciamiento y de la capacitación continua del personal. El análisis mostró una buena concordancia interevaluador.

Introduction: Data quality makes it easier to ensure that observational studies are reliable. Objective: To describe assurance and quality control to maintain data reliability and validity in a cohort study. Methodology: We present the data management strategies implemented in a study that followed patients of chronic kidney disease who were in a renal protection program and compared them with those undergoing conventional treatment to observe its association with clinical outcomes. We assessed the changes in error frequency after implementing the plan along with the reproducibility of the strategies for entering records into the databases. Results: We documented a progressive decrease of data collection errors. The Kappa values among data collectors for the most important variables were: 0.960 for creatinine clearance 150 mg/dl; 0.730 for urinary sediment alteration and 0.956 for stage allocation upon admission. The intraclass correlation coefficient for the identification of systolic blood pressure was 0.996; for diastolic blood pressure, the coefficient was 0.993 and for serum creatinine levels at diagnosis, the value was 0.995. Discussion: Data quality begins with the recognition of the challenges and difficulties involved in responsible data collection, hence the contribution of standardized processes and personnel to carry them out in a suitable manner. Studies show that many improvement processes arise in the development of research without pre-established protocols. Conclusion: The reduction in error ratio and type during the data collection process are the result of the early identification of erroneously entered or missing data, the correction of the guidelines for completing forms as well as of the instruments for detecting errors and continuous training of the staff. The analysis showed good inter-rater reliability.

Viés Atencional na Esquizofrenia: uma Revisão Crítica da Literatura / Attentional Bias in Schizophrenia: a Critical Review of Literature

O viés atencional, compreendido como a tendência de processar informações de acordo com a valência emocional ou significado, pode contribuir para a vulnerabilidade a transtornos psiquiátricos. Este estudo apresenta uma revisão da literatura sobre pesquisas empíricas que investigaram associações entre viés atencional e esquizofrenia. A busca foi realizada nas bases de dados PsycInfo, Web of Science, MedLine e Scopus. Um total de 641 estudos foi identificado. Após a aplicação dos critérios de elegibilidade, 16 artigos foram incluídos na amostra final, com a inclusão de um artigo a partir das referências dos estudos da amostra. Foram observados a utilização de tarefas e estímulos diversos, que apresentaram resultados variados, indicando, por um lado, a presença de viés atencional, e, por outro, interferência equivalente de estímulos emocionais em pacientes e pessoas saudáveis. São necessários mais estudos que, além de investigarem a associação entre viés atencional e esquizofrenia, permitam o controle de variáveis confundidoras.

Attentional bias, understood as the tendency to process information according to emotional valence or meaning, can contribute to vulnerability to psychiatric disorders. This study presents a review of empirical research literature that investigated the associations between attentional bias and schizophrenia. The search was conducted in the PsycInfo, Web of Science, MedLine, and Scopus databases. A total of 641 studies were identified. After applying eligibility criteria, 16 articles were included in the final sample, including one article retrieved from the references of the sample studies. Various tasks and stimuli were observed, yielding diverse results, indicating, on the one hand, the presence of attentional bias, and on the other hand, equivalent interference from emotional stimuli in patients and healthy individuals. Further studies are needed that, in addition to investigating the association between attentional bias and schizophrenia, allow for the control of confounding variables.

Comparison of methods for controlling acquiescence bias in balanced and unbalanced scales / Comparação de métodos para o controle do viés da aquiescência em escalas balanceadas e desbalanceadas / Comparación de métodos para controlar el sesgo de aquiescencia en escalas balanceadas y no balanceadas

Controlling acquiescence bias typically involves the application of positive and negative keyed items. However, little is known about the effect of balancing positive and negative items on bias control. The aim of this study was to compare three Confirmatory Factor Analysis models (without control, MIMIC, and Random Intercept) to recover the factor structure of unbalanced and balanced instruments, using simulated and real data (from an instrument that assesses Personality). By controlling for acquiescence, the results indicated that the performance of balanced scales was better than that of unbalanced scales, as well as in the absence of control for response bias, when considering balanced and unbalanced scales. Thus, this research suggests the possibility of controlling acquiescence through balanced instruments associated with the use of statistical methods in modeling.(AU)

O controle do viés de aquiescência normalmente envolve a aplicação de itens positivos e negativos. Contudo, pouco se sabe sobre o efeito do balanceamento entre itens positivos e negativos sobre o controle do viés. O objetivo deste estudo foi comparar três modelos de Análise Fatorial Confirmatória (sem controle, MIMIC e Intercepto Randômico) para recuperar a estrutura fatorial de instrumentos desbalanceados e balanceados, a partir de dados simulados e reais (procedentes de um instrumento que avalia Personalidade). Mediante o controle da aquiescência, os resultados indicaram que a performance de escalas balanceadas foi melhor do que de escalas desbalanceadas, bem como na ausência de controle desse viés de resposta, ao considerar as escalas balanceadas e desbalanceadas. Dessa maneira, esta pesquisa aponta para a possibilidade de controle de aquiescência por meio de instrumentos balanceados associada ao uso dos métodos estatísticos na modelagem.(AU)

El control del sesgo de aquiescencia involucra la aplicación de ítems positivos y negativos. Sin embargo, el efecto del equilibrio entre ítems positivos y negativos en el control del sesgo sigue siendo una pregunta abierta. En este sentido, el objetivo de este estudio fue comparar tres modelos de Análisis Factorial Confirmatorio (sin control, MIMIC e Intercepto Aleatorio) para recuperar la estructura factorial de instrumentos balanceados y desbalanceados, a partir de datos simulados y reales (a partir de un instrumento que evalúa personalidad). El control de este sesgo de respuesta indicó que el desempeño de escalas balanceadas fue mejor que el de escalas desbalanceadas, así como en la ausencia del control de la aquiescencia, al considerar escalas balanceadas y desbalanceadas. Por lo tanto, esta investigación sugiere la posibilidad de controlar este sesgo de respuesta por medio de instrumentos balanceados asociados con el uso de métodos estadísticos modelado.(AU)

Interferencia generada por la lipemia en la medición de constituyentes bioquímicos

Introducción. La turbidez por lipemia en las muestras para diagnóstico es una de las principales causas de la aparición de sesgos clínicamente significativos en la medición de magnitudes bioquímicas. Objetivo. Valorar la interferencia por lipemia en la medición de 25 constituyentes bioquímicos en dos analizadores con tecnología de química seca (Vitros 7600®) y química liquida (Atellica® Solution). Métodos. Estudio pre-experimental con pre y posprueba. Se añadieron cantidades crecientes de una emulsión lipídica de nutrición parenteral a siete alícuotas de una mezcla de sueros y se determinó por duplicado la influencia del interferente en 25 constituyentes. Se calculó el porcentaje relativo de desviación de la concentración del constituyente por influencia de la turbidez con respecto a una muestra sin interferente. Se establecieron límites de tolerancia para la interferencia utilizando tres criterios: del distribuidor de reactivos, del error sistemático deseable y del error máximo admisible. Resultados. Los constituyentes que presentaron los mayores sesgos para el analizador de química liquida fueron: fósforo (-84,72%), ALT (+81,25%) y AST (-75,76%), mientras que para la plataforma de química seca los constituyentes: ALT (-79,41%), CK (-28,92%) y lipasa (+24,85%). Se detectó interferencia significativa en diferente número de los constituyentes de acuerdo con el criterio de límite tolerable utilizado. Conclusiones. Los distintos resultados encontrados según la metodología y el analizador utilizado, además de la falta de replicabilidad de los ensayos para la valoración de interferencia por lipemia, origina la necesidad de armonizar los procesos e instaurar límites idénticos de interferencia tolerables entre los laboratorios y proveedores de insumos.

Introduction. Turbidity due to lipemia in diagnostic samples is one of the main causes of the appearance of clinically significant biases in the measurement of biochemical magnitudes. Objective. To assess the interference by lipemia in the measurement of 25 biochemical constituents in two analyzers with dry chemistry technology (Vitros 7600®) and liquid chemistry (Atellica® Solution). Methods. Pre-experimental study with pre and post test. Increasing amounts of a parenteral nutrition lipid emulsion were added to seven aliquots of pooled sera and the influence of the interferent on 25 constituents was determined in duplicate. The relative percentage deviation of the concentration of the constituent due to the influence of turbidity with respect to a sample without interference, was calculated. Tolerance limits for interference were established using three criteria: reagent distributor, desirable systematic error, and maximum permissible error. Results. The constituents that presented the greatest biases for the liquid chemistry analyzer were: Phosphorus (-84.72%), ALT (+81.25%) and AST (-75.76%), while for the dry chemistry platform the constituents, ALT (-79.41%), CK (-28.92%) and lipase (+24.85%). Significant interference was detected in a different number of constituents according to the tolerable limit criteria used. Conclusions. The different results found according to the methodology and the analyzer used, in addition to the lack of replicability of the tests for the evaluation of interference by lipemia, originates the need to harmonize the processes and establish identical limits of tolerable interference between the laboratories and suppliers of inputs.

Risk of bias in dentistry-related randomized controlled trials in spanish language journals

Objectives: To assess the risk of bias (RoB) of randomized controlled trials (RCTs) published in dental journals in the Spanish language. Methods: A systematic retrospective survey was conducted of all RCTs published from 1980 to 2019 in dentistry Spanish and Latin American journals. We extracted data and performed RoB assessments using the Cochrane Risk of Bias tool. Results: 292 RCTs published in 51 journals were included. The best-rated domains were incomplete outcome data, selective reporting, and other biases. The domains assessed with higher proportions of an unclear or high risk of bias were sequence generation, allocation concealment, and blinding of outcome assessment. There is a low proportion of RCTs published in Spanish language journals. However, the number has been increasing over the years, and the low risk of bias assessment rates across domains show an increasing trend. Conclusions: A low percentage of Spanish-language dental journals issue RCTs. Our assessment of these RCTs' RoB suggests higher difficulties in the design and conduction phase than in the posterior reporting stage.

Using the cell phone while standing or walking affects balance and mobility in people with Parkinson's disease / O uso do celular em pé ou durante a caminhada afeta o equilíbrio e a mobilidade de pessoas com doença de Parkinson

Abstract Background Cell phones are part of peoples' lives. The literature indicates risks when cell phones are used during a secondary motor task. Studies addressing this topic in people with Parkinson's disease are still scarce. Objective To investigate the impact of daily dual tasks with cell phone on balance and mobility in people with Parkinson's disease, compared to healthy control peers. Methods Participants with Parkinson's disease and controls underwent three motor tasks: (1) Standing and walking without using a cell phone; (2) Standing and walking while talking on the phone; and (3) Standing and walking while texting messages on the phone. Assessments involved balance and mobility tests. Statistical analysis was performed with multivariate analysis of variance, comparing main effect for group (Parkinson's disease × control), task (using × not using cell phone) and interactions (group × task). Significance was set at 5%. Effect sizes are reported. Results Participants with Parkinson's disease showed worse balance (p = 0.001, effect size of 0.471) and mobility (p = 0.001, effect size of 0.472) than control peers. The use of cell phone while performing a secondary motor task affected both groups (p = 0.005, effect size of 0.673 for balance and p = 0.001, effect size of 0.549 for mobility). The dual task impact, however, was higher in the Parkinson's disease group (p = 0.009, effect size of 0.407 for mobility). Conclusion Daily dual tasks with cell phones increase imbalance and mobility risks in Parkinson's disease. People should be careful when using their cell phone while standing or walking.

Resumo Antecedentes Aparelhos celulares fazem parte da vida das pessoas. A literatura aponta riscos quando o uso do celular está associado a uma tarefa motora. Estudos abordando esse tema na doença de Parkinson são escassos. Objetivo Investigar o impacto de tarefas-duplas com o celular sobre equilíbrio e mobilidade de pessoas com doença de Parkinson, na comparação com controles saudáveis. Métodos Participantes com e sem doença de Parkinson foram submetidos a três tarefas: (1) Ficar em pé e caminhar sem o celular; (2) Ficar em pé e caminhar enquanto conversa ao celular; e (3) Ficar em pé e caminhar enquanto digita mensagens. As avaliações envolveram testes de equilíbrio e mobilidade. Os procedimentos estatísticos envolveram testes de análise múltipla de variâncias, com análise de efeito principal para os fatores grupo (doença de Parkinson x controle), tarefa (com celular × sem celular) e interação (grupo × tarefa). Significância foi estipulada em 5%. Tamanhos de efeito foram reportados. Resultados Participantes com doença de Parkinson apresentaram pior equilíbrio (p = 0,001; tamanho do efeito: 0,471) e mobilidade (p = 0,001; tamanho do efeito: 0,472) que controles. O uso do celular afetou ambos os grupos (p = 0,005, tamanho do efeito de 0,673 para equilíbrio e p = 0,001, tamanho do efeito de 0,549 para mobilidade). O impacto da tarefa-dupla, contudo, foi maior no grupo Parkinson (p = 0,009; tamanho do efeito de 0,407 para mobilidade). Conclusão Tarefas simultâneas com o celular causam desequilíbrio e problemas de mobilidade na doença de Parkinson. As pessoas devem ter cuidado ao utilizar celulares durante atividades em pé e ao caminhar.

Reporting of conflict of interests, source of funding, and ethics committee approval in randomized trials of three clinical specialties published in Spanish language

Background: Confidence in the results reported by randomized clinical trials (RCTs) depends mainly on the internal validity of the trial and its conduct, but also on other aspects related to health research such as the complete reporting of conflicts of interest (COI), funding sources and approval by ethics committees. Bias in the study results may arise from any one of these elements. Prior studies have explored the reporting of these items in the medical literature, but there are no reports on RCTs published in Spanish and Latin American journals. This study aimed to evaluate the reporting of COIs, funding sources, and approval by ethics committees of RCTs published in Spanish and Latin American journals in dentistry, geriatrics and neurology. Methods: We did a systematic retrospective survey of all RCTs published from 1990 to 2018 in dentistry, neurology, and geriatrics journals published in Spain and Latin America and included in the BADERI database (Iberoamerican journals and trials database by its initials in Spanish). We completed with hand searching. We included RCTs with a recoverable full text published between 1990 and 2018. We extracted data on sources of funding, COI statements, and ethics reviews. The extraction of these items in the RCTs included was done independently by two pairs of reviewers and in parallel for each article, with a third independent reviewer resolving discrepancies. We analysed compliance for each item. Results: We identified RCTs in 69 journals from Spain and Latin American countries. Dentistry accounted for 75% (n = 52) of the journals, neurology 20.6% (n = 14), and geriatrics 4.4% (n = 3). Of the total number of RCTs included in this study (n = 392), only 102 (26%) reported the presence or absence of a COI, 103 (26%) studies reported funding, and 43 (36%) included the ethics committee approval. Conclusions: RCTs published in the Spanish language in dentistry, neurology, and geriatrics had poor compliance with the reporting of a COI, source of funding, and ethics committee approval. Future research should evaluate the accuracy and completeness of COI statements and their relationship to the funding source and direction of the results.

Tamanho do efeito em estudos observacionais na área de Saúde Bucal Coletiva: importância, cálculo e interpretação / Size effect in observational studies in Public Oral Health: importance, calculation and interpretation

Resumo O objetivo deste estudo foi analisar a literatura científica da área de saúde bucal coletiva quanto ao cálculo, apresentação e discussão do tamanho do efeito em estudos observacionais. A literatura cientifica na área (2015 a 2019) foi analisada quanto: a) informações gerais (periódico e diretrizes aos autores, número de variáveis e desfechos), b) objetivo e coerência com o cálculo amostral apresentado; c) tamanho do efeito (apresentação, medida utilizada e coerência com a discussão dos dados e conclusão). Foram analisados 123 artigos, de 66 periódicos. A maioria dos artigos avaliados apresenta um único desfecho (74%) e não menciona a realização de cálculo amostral (69,9%). Dentre os que realizaram, para 70,3% havia coerência entre o cálculo amostral utilizado e o objetivo. Apenas 3,3% dos artigos mencionam o termo tamanho do efeito e 24,4% não o consideram na discussão dos resultados, apesar de terem calculado. A regressão logística foi a metodologia estatística mais utilizada (98,4%) e o Odds Ratio a medida de tamanho do efeito mais utilizada (94,3%), embora não tenha sido citada e discutida como uma medida de tamanho do efeito na maioria dos estudos (96,7%). Os pesquisadores, em sua maioria, restringiram a discussão dos resultados apenas à significância estatística encontrada nas associações testadas.

Abstract The objective of this study was to analyze the scientific literature in public oral health regarding calculation, presentation, and discussion of the effect size in observational studies. The scientific literature (2015 to 2019) was analyzed regarding: a) general information (journal and guidelines to authors, number of variables and outcomes), b) objective and consistency with sample calculation presentation; c) effect size (presentation, measure used and consistency with data discussion and conclusion). A total of 123 articles from 66 journals were analyzed. Most articles analyzed presented a single outcome (74%) and did not mention sample size calculation (69.9%). Among those who did, 70.3% showed consistency between sample calculation used and the objective. Only 3.3% of articles mentioned the term effect size and 24.4% did not consider that in the discussion of results, despite showing effect size calculation. Logistic regression was the most commonly used statistical methodology (98.4%) and Odds Ratio was the most commonly used effect size measure (94.3%), although it was not cited and discussed as an effect size measure in most studies (96.7%). It could be concluded that most researchers restrict the discussion of their results only to the statistical significance found in associations under study.

The mediating effect of attentional bias of negative information between fatalism and death anxiety in lung neoplasms patients / 中国实用护理杂志

Objective:To explore the mediating effect of attentional bias of negative information between fatalism and death anxiety in lung neoplasms patients.Methods:This study was a cross-sectional study. It was convenient to select 312 lung neoplasms patients treated in the Department of Oncology, First Affiliated Hospital and Second Affiliated Hospital of Air Force Military Medical University the Chinese People′s Liberation Army, from April 2021 to April 2022 as the research subjects. Questionnaires were conducted with Fatalism Scale, Attention to Negative Information Scale, and Templer′s Death Anxiety Scale. Structural equation model were constructed based on self-regulatory executive function models.Results:The total score of fatalism, attentional bias of negative information, and death anxiety of 312 lung neoplasms patients were (61.68 ± 11.92) points, (39.57 ± 5.19) points, and (61.23 ± 9.30) points, respectively. Attentional bias of negative information was significantly positively correlated with fatalism ( r = 0.594, P<0.01). Death anxiety was significantly positively correlated with fatalism and attentional bias of negative information ( r = 0.494, 0.558, both P<0.01). Attentional bias of negative information played a partial mediating role between fatalism and death anxiety, and the mediating effect accounted for 37.7% of the total effect. The value of each fitness index of the mediation effect model was within the acceptable range. Conclusions:Attentional bias of negative information is an intermediary variable between fatalism and death anxiety of lung neoplasms patients. Nursing staff should pay attention to the level of attentional bias of negative information of lung neoplasms patients and carry out targeted nursing interventions from the emotional processing process to reduce the level of death anxiety in patients with lung neoplasms.

The influencing factors of functional somatic discomfort in clinical nurses / 中华劳动卫生职业病杂志

Objective: To investigate the functional somatic discomfort status, and to analyze the effect of job stress, hostile attribution bias and ego depletion on functional somatic discomfort in clinical nurses. Methods: In May 2019, 10 cities in Henan Province and Fujian Province were randomly selected as sampling cities. Using the stratified cluster sampling method, nurses of clinical nursing posts in 22 third class hospitals and 23 second class hospitals were selected as the research objects. The general information, job stress, hostile attribution bias, ego depletion and functional somatic discomfort of clinical nurses were investigated by self-designed general information questionnaire, Perceived Stress Scale, Social Information Processing-attribution Bias Questionnaire, Self-regulatory Fatigue Scale, Patient Health Questionnaire-15. 1200 clinical nurses included, and a total of 1159 valid questionnaires were collected, the effective rate of questionnaire collection was 96.6%. The t test was used to compare the difference of the functional somatic discomfort scores of clinical nurses with different demographic characteristicst. The influence of job stress, hostile attribution bias and ego depletion on functional somatic discomfort of clinical nurses were analyzed with Bootstrap. Results: The functional somatic discomfort score of clinical nurses was (8.95±4.38), of which 859 (74.12%) had functional somatic discomfort symptom. The functional somatic discomfort score of clinical nurses aged 36-50 years old was higher than that of 19-35 years old, the functional somatic discomfort score of clinical nurses with service age ≥5 years was higher than that of <5 years, the functional somatic discomfort score of non-permanent clinical nurses was higher than that of permanent clinical nurses, the functional somatic discomfort score of clinical nurses in tertiary hospitals was higher than that of secondary hospitals, the functional somatic discomfort score of clinical nurses in surgical departments were higher than those in non-surgical departments, and the differences were statistically significant (P<0.05). Job stress affected functional somatic discomfort through the single mediating role of hostile attribution bias, the single mediating role of ego depletion, and the chain mediating role of hostile attribution bias and ego depletion (β=0.17, 95%CI: 0.10-0.20; β=0.16, 95%CI: 0.10-0.20; β=0.07, 95%CI: 0.03-0.10; P<0.05) . Conclusion: The functional somatic discomfort symptoms of clinical nurses are significant and varied among different age, working age, employment form, hospital grade and department groups. They are affected by work stress directly and through the separate mediating effect of hostile attribution bias and ego depletion, and the chain mediating effect of hostile attribution bias and ego depletion.

8. Introduction of Consideration for Students at University of Tsukuba / 医学教育

The University of Tsukuba aims to be a university where all members, not only LGBT but also everyone with diverse personalities, can share their abilities. The Bureau of Human Empowerment plays a central role in student support in line with the Basic Principles and Guidelines on LGBT+ Inclusion at the University of Tsukuba (2020 revision). Students' gender information is accessible only to those who need it, such as teachers in charge. Faculty and staff are encouraged to handle information carefully. While basic knowledge of LGBT and others is necessary, it is also important to consider all students based on the premise that there are those with diverse personalities who are not LGBT, rather than treating LGBT and other students specially. We shared our opinions with faculty and the faculty development (FD) committee members at FD meetings.

Analysis of the chloroplast genome of Incarvillea younghusbandii Sprague / 生物工程学报

Incarvillea younghusbandii Sprague is a traditional tonic herb. The roots are used as herbal medicine for nourishing and strengthening, as well as treating postpartum milk deficiency and weakness. In this study, the chloroplast genome of I. younghusbandii was sequenced and assembled by the high-throughput sequencing technology. The sequence characteristics, sequence repeats, codon usage bias, phylogenetic relationships and estimated divergence time of I. younghusbandii were analyzed. The 159 323 bp sequence contained a large single copy (80 197 bp), a small single copy (9 030 bp) and two inverted repeat sequences (35 048 bp). It contained 120 genes, including 77 protein coding genes, 8 ribosomal RNA genes and 35 transfer RNA genes. AAA was the most frequent codon in the chloroplast coding sequence of I. younghusbandii. A total of 42 simple sequence repeats were identified in the chloroplast genome. Phylogenetic analysis revealed I. younghusbandii was mostly like its taxonomically close relative Incarvillea compacta. The divergence between I. younghusbandii and I. compacta was dated to 4.66 million years ago. This study was significant for the scientific conservation and development of resources related to I. compacta. It also provides a basic genetic resource for the subsequent species identification of the genus Incarvillea, and the population genetic diversity study of Bignoniaceae.

Characteristics and phylogenetic analysis of chloroplast genome of a new type of fruit Rubus rosaefolius / 生物工程学报

The genomic DNA of Rubus rosaefolius was extracted and sequenced by Illumina NovaSeq platform to obtain the complete chloroplast genome sequence, and the sequence characteristics and phylogenetic analysis of chloroplast genes were carried out. The results showed that the complete chloroplast genome of the R. rosaefolius was 155 650 bp in length and had a typical tetrad structure, including two reverse repeats (25 748 bp each), a large copy region (85 443 bp) and a small copy region (18 711 bp). A total of 131 genes were identified in the whole genome of R. rosaefolius chloroplast, including 86 protein coding genes, 37 tRNA genes and 8 rRNA genes. The GC content of the whole genome was 36.9%. The genome of R. rosaefolius chloroplast contains 47 scattered repeats and 72 simple sequence repeating (SSR) loci. The codon preference is leucine codon, and the codon at the end of A/U is preferred. Phylogenetic analysis showed that R. rosaefolius had the closest relationship with R. taiwanicola, followed by R. rubraangustifolius and R. glandulosopunctatus. The chloroplast genome characteristics and phylogenetic analysis of R. rosaefolius provide a theoretical basis for its genetic diversity research and chloroplast development and utilization.

Complete chloroplast genome sequencing and phylogeny of wild Atractylodes lancea from Yuexi, Anhui province / 中国中药杂志

This study investigated the choroplast genome sequence of wild Atractylodes lancea from Yuexi in Anhui province by high-throughput sequencing, followed by characterization of the genome structure, which laid a foundation for the species identification, analysis of genetic diversity, and resource conservation of A. lancea. To be specific, the total genomic DNA was extracted from the leaves of A. lancea with the improved CTAB method. The chloroplast genome of A. lancea was sequenced by the high-throughput sequencing technology, followed by assembling by metaSPAdes and annotation by CPGAVAS2. Bioiformatics methods were employed for the analysis of simple sequence repeats(SSRs), inverted repeat(IR) border, codon bias, and phylogeny. The results showed that the whole chloroplast genome of A. lancea was 153 178 bp, with an 84 226 bp large single copy(LSC) and a 18 658 bp small single copy(SSC) separated by a pair of IRs(25 147 bp). The genome had the GC content of 37.7% and 124 genes: 87 protein-coding genes, 8 rRNA genes, and 29 tRNA genes. It had 26 287 codons and encoded 20 amino acids. Phylogenetic analysis showed that Atractylodes species clustered into one clade and that A. lancea had close genetic relationship with A. koreana. This study established a method for sequencing the chloroplast genome of A. lancea and enriched the genetic resources of Compositae. The findings are expected to lay a foundation for species identification, analysis of genetic diversity, and resource conservation of A. lancea.

Chloroplast genomic characterization and phylogenetic analysis of Castanopsis hystrix / 生物工程学报

The structure and size of the chloroplast genome of Castanopsis hystrix was determined by Illumina HiSeq 2500 sequencing platform to understand the difference between C. hystrix and the chloroplast genome of the same genus, and the evolutionary position of C. hystrix in the genus, so as to facilitate species identification, genetic diversity analysis and resource conservation of the genus. Bioinformatics analysis was used to perform sequence assembly, annotation and characteristic analysis. R, Python, MISA, CodonW and MEGA 6 bioinformatics software were used to analyze the genome structure and number, codon bias, sequence repeats, simple sequence repeat (SSR) loci and phylogeny. The genome size of C. hystrix chloroplast was 153 754 bp, showing tetrad structure. A total of 130 genes were identified, including 85 coding genes, 37 tRNA genes and 8 rRNA genes. According to codon bias analysis, the average number of effective codons was 55.5, indicating that the codons were highly random and low in bias. Forty-five repeats and 111 SSR loci were detected by SSR and long repeat fragment analysis. Compared with the related species, chloroplast genome sequences were highly conserved, especially the protein coding sequences. Phylogenetic analysis showed that C. hystrix is closely related to the Hainanese cone. In summary, we obtained the basic information and phylogenetic position of the chloroplast genome of red cone, which will provide a preliminary basis for species identification, genetic diversity of natural populations and functional genomics research of C. hystrix.

Análise da qualidade das evidências científicas sobre a eficácia e segurança nas bulas de anticoagulantes orais diretos comercializados no Brasil / Analysis of the quality of scientific evidence on efficacy and safety in the package leaflets of direct oral anticoagulants marketed in Brazil

Objetivo: Identificar e analisar a qualidade das evidências científicas sobre a eficácia e segurança dos anticoagulantes orais direto (DOAC) disponíveis nos ensaios clínicos referenciados nas bulas dos medicamentos comercializados no Brasil. Método: Trata-se de um descritivo documental dividido em duas etapas, sendo elas: (i) identificação e análise da disponibilidade das referências bibliográficas contidas nas bulas dos DOAC e (ii) análise da qualidade dos estudos contidos nas bulas através da ferramenta da Cochrane Risk of Bias RevMan versão 5.4. Foram analisados setes domínios de importâncias para ensino clínico, sendo que cada domínio foi classificado como alto, incerto ou baixo risco de viés, segundo a avaliação dos colaboradores. Resultados: Foram analisadas 10 bulas destinadas aos profissionais da saúde. Sendo que destas, foram avaliados 25 ensaios clínicos. A análise da qualidade das evidências científicas, referenciadas nas bulas para profissionais dos DOAC, mostrou que os estudos citados apresentaram consistência metodológica. Entretanto, na maioria dos estudos, os domínios foram classificados como viés incerto, ou seja, não foi possível identificar como esses pontos foram abordados nos estudos. Conclusão: Portanto, o presente estudo evidenciou que a qualidade dos ensaios clínicos referenciados nas bulas dos DOAC apresentou incertezas metodológicas em seus ensaios. Sugere-se a necessidade de normativas que estabeleçam atualizações do conteúdo informativo presente nas bulas profissionais e estabeleçam descrição dos métodos de forma clara e coesa (AU).

Objective: Identify and analyze the quality of scientific evidence on the efficacy and safety of direct oral anticoagulants (DOAC) available in clinical trials referenced in the package leaflets of drugs marketed in Brazil. Method: This is a descriptive documentary study divided into two stages: (i) identification and analysis of the availability of the bibliographic references contained in the package leaflets of DOACs and (ii) analysis of the quality of the studies contained in the package leaflets through the Cochrane Risk of Bias RevMan tool version 5.4. Seven domains of importance for clinical teaching were analyzed, and each domain was classified as high, uncertain or low risk of bias, according to the assessment of the collaborators. Results: Ten package leaflets intended for health professionals were analyzed. Of these, 25 clinical trials were evaluated. The analysis of the quality of the scientific evidence referenced in the package leaflets for health professionals showed that the cited studies presented methodological consistency. However, in most studies, the domains were classified as uncertain bias, i.e., it was not possible to identify how these points were addressed in the studies. Conclusion: Therefore, the present study evidenced that the quality of clinical trials referenced in the package leaflets of DOACs presented methodological uncertainties in their trials. It is suggested the need for regulations that establish updates of the information content present in the professional package inserts and establish a description of the methods in a clear and cohesive way (AU).

Relationship of college students’ risk perception of COVID-19 and their anxiety and depression: A moderated mediation model / 西安交通大学学报(医学版)

【Objective】 To explore the effects of perceived risk of COVID-19 of college students on their anxiety and depression, as well as the roles of attention to negative information and perceived social support, so as to provide theoretical basis for colleges and universities to formulate corresponding intervention measures. 【Methods】 By the convenience sampling method, totally 1 404 college students from Shaanxi and Henan provinces were investigated online by using General Information Questionnaire, Perceived Risk of COVID-19 Pandemic Scale, Attention to Negative Information Scale, Patient Health Questionnaire, Generalized Anxiety Disorder and Perceived Social Support Scale. SPSS 20.0 was used for data analysis, Pearson correlation method was used to explore the correlation between variables. The mediating effect of attention to negative information and the moderating effect of perceived social support were analyzed by PROCESS. 【Results】 The scores of anxiety and depression of the 1 404 college students included in the study were 4.03±4.48 and 6.21±5.41, respectively. The detection rate of anxiety symptom was 29.9%, and that of depression symptom was 44.4%. The risk perception of COVID-19 epidemic of the college students was positively correlated with attention to negative information (r=0.373, P<0.001), anxiety (r=0.227, P<0.001), and depression (r=0.226, P<0.001). Anxiety (r=0.553, P<0.001) and depression (r=0.497, P<0.001) were positively correlated with attention to negative information, while perceived social support was negatively correlated with the risk perception of the COVID-19 (r=-0.154, P<0.001), attention to negative information (r=-0.259, P<0.001), anxiety (r=-0.321, P<0.001) and depression (r=-0.278, P<0.001). The risk perception of COVID-19 affected the anxiety and depression of the students mainly through the mediating effect of attention to negative information. The total effect of risk perception of COVID-19 and anxiety was 0.227, and the mediating effect accounted for 80.18% of the total effect. The total effect of risk perception of COVID-19 and depression was 0.228, and the mediating effect accounted for 90.35% of the total effect. Perceived social support played a moderating role in the last half of this mediating model. 【Conclusion】 Risk perception of COVID-19 indirectly affects the occurrence of anxiety and depression in college students through attention to negative information, and perceived social support plays a moderating role in this mediating model. The findings suggest that when a risk event occurs, colleges and universities should pay attention to guiding students to adjust their attentional bias to external information, and give students enough care and support to improve their mental health.

Study on performance specifications of 34 routine chemistry analytes in China / 中华检验医学杂志

Objective:The allowable total error ( TEa),allowable imprecision ( CV)and allowable bias( Bias)were recommended for 34 routine chemistry analytes in China. Methods:According to the performance specification setting mode newly determined at the Milan conference in Italy,the performance specification was derived based on components biological variation (BV)and current state of the art mode. The data(including EQA data and IQC data)of laboratories participating in the routine chemistry and lipids and lipoproteins EQA activities of the national center for clinical laboratories from 2019 to 2021 was collected through clinet-EQA. For the analytes with biological variation(BV)data,compared the'percentage difference′ of EQA data and the'in-control coefficient of variation of the month′ of IQC data of each research analyte with the three levels evaluation criteria derived based on BV,and calculated the percentage difference passing rate and CV passing rate of all batches in each year. When the passing rate reaches 80%,the performance specifications of this level met the requirements of the recommended performance specifications of the analyte. For the analytes without BV data or analytes whose performance specifications at three levels derived based on BV could not be used as recommended standards,the recommended performance specifications are derived based on the current state of the art. After obtaining the recommended TEa and allowable CV for each analyte,used the formula | Bias|≤ TEa-z? CV to derive the recommended allowable bias. Results:The results of TEa ( CV)% recommended by 34 analytes are as follows:K4.7(2),Na4(1.5),Cl4(1.4),Ca5(2),P9.6(3.9),Glu6.4(2.5),Urea8(3),UA12(4.1),Cre11(3.3),TP5(2),Alb5.2(2.4),TC8.6(2.7),TG13.5(5),HDL-C16.5(4.3),LDL-C20.5(6.2),ApoAⅠ16(5.3),ApoB 17.1(5.5),Lp(a) 24.1(10.4),TBil 12.4(5),DBil 20(7.3),ALT16(5),AST13.5(4.8),ALP17.5(4.8),AMY13.1(3.3),CK11.3(3.8),LDH11(3.9),CHE13.4(5.3),LIP20(6.9),Fe13.3(5.2),Mg14(4.5),Cu17.9(6.8),Zn15.1(6.4),γ-GGT10(3.3),α-HBDH18(5.8).The formula | Bias|≤ TEa-z? CV is used to derive the allowable bias of 34 analytes. Conclusions:For 34 clinical routine chemistry quantitative analytes,the allowable total error,allowable imprecision and allowable bias that meet the current state of the art of Chinese laboratories are recommended.

Mediating effect of negative cognitive processing bias in the relationship between pathological narcissism and interpersonal conflict in college students / 中华行为医学与脑科学杂志

Objective:To explore the mediating role of negative cognitive processing bias between pathological narcissism and interpersonal conflict of college students.Methods:The pathological narcissism, negative cognitive processing bias and interpersonal conflict of 540 college students were investigated by the super brief-PNI, negative cognitive processing bias questionnaire and NRI-relationship quality version.Descriptive analysis, correlation analysis and reliability test of the questionnaires were conducted by SPSS 27.0 software.Amos 23.0 software was used for structural equation modeling, and the nonparametric percentile Bootstrap method based on deviation correction was used for intermediary effect test.Results:The scores of pathological narcissism, negative cognitive processing bias and interpersonal conflict were (3.33±0.86), (2.41±0.60) and (2.34±0.77), respectively.Pathological narcissism, negative cognitive processing bias and interpersonal conflict were significantly positively correlated ( r=0.38-0.94, all P<0.01). Negative cognitive processing bias played full mediating role in the relationship between pathological narcissism and interpersonal conflict. The model was well fitted ( χ2/ df=2.63, CFI =0.99, NFI=0.98, IFI=0.99, TLI=0.98, RMSEA=0.05). Path analysis and mediation test showed that pathological narcissism had a significant predictive effect on the total effect of interpersonal conflict among college students ( β=0.52, P<0.001). Pathological narcissism had a significant predictive effect on negative cognitive processing bias ( β=0.64, P<0.001). Negative cognitive processing bias had a significant predictive effect on interpersonal conflict ( β=0.76, P<0.001). Pathological narcissism didn’t predict the direct effect of interpersonal conflict significantly ( β=0.03, P>0.05). Conclusion:Pathological narcissism has a positive predictive effect on interpersonal conflict among college students.Negative cognitive processing bias plays a complete intermediary role between pathological narcissism and interpersonal conflict.