Establishment of a reference interval for total carbon dioxide using indirect methods in Chinese populations living in high-altitude areas: A retrospective real-world analysis.

BACKGROUND: Hypoxia leads to different concentrations of the bicarbonate buffer system in Tibetan people. Indirect methods were used to establish the reference interval (RI) for total carbon dioxide (tCO2) based on big data from the adult population of Tibet, a high-altitude area in Western China. METHODS: Anonymous tCO2 test data (n = 442,714) were collected from the People's Hospital of the Tibet Autonomous Region from January 2018, to December 2021. Multiple linear regression and variance component analyses were performed to assess the effects of sex, age, and race on tCO2 levels. Indirect methods, including Hoffmann, Bhattacharya, expectation maximization (EM), kosmic and refineR, were used to calculate the total RI and ethnicity-partitioned RI. RESULTS: A total of 230,821 real-world tCO2 test results were eligible. Sex, age, and race were significantly associated with the tCO2 levels. The total and ethnically-partitioned RIs estimated using the five indirect methods were comparable. The total RI of tCO2 was 14-24 mmol/L (calculated using Hoffmann and refineR) and 15-24 mmol/L (Bhattacharya, EM and kosmic). For Han nationality, the RIs were 14-25 mmol/L (calculated using Hoffmann and Bhattacharya), 16-23 mmol/L (EM), 15-24 mmol/L (kosmic), and 14.2-24.5 mmol/L (refineR). For the Tibetan population, the RIs were 14-24 mmol/L (calculated using Hoffmann and refineR), 15-24 mmol/L (Bhattacharya and kosmic), and 15-23 mmol/L (EM). The established RIs were significantly lower than those living at lower altitudes area (22-29 mmol/L) that was provided by the manufacturer. CONCLUSION: The tCO2 RI of the populations living on the Tibetan Plateau was significantly lower than those at the lower altitudes. The RIs established using indirect methods are suitable for clinical applications in Tibet.

How Do Determiners of Job Performance Matter During COVID-19? The Conservation of Resource Theory.

During the COVID-19 pandemic, business managers are facing many challenges from a severe challenge. Many organizations have changed their original management mode and organizational behavior to improve employees' organizational citizenship behavior, thus reducing their sense of anxiety and incapability. Thereinto, job performance of the employees also affects the growth and development of the organization. To explore how to fragment employees' positive psychology and job performance, this study discusses the influence on employees' subjective wellbeing and job performance from relevant factors at the organizational and individual levels. Also, to explore the influence of organizational support and occupation self-efficacy on job performance and the mediating role of subjective wellbeing during COVID-19, a total of 618 valid questionnaires were collected from all walks of life in 2020. Hypotheses were tested by structural equation modeling and Bootstrap technology. The results show that: (1) Professional self-efficacy and subjective wellbeing have a significant positive impact on job performance; (2) Subjective wellbeing plays a complete mediating role between organizational support and job performance, and subjective wellbeing plays a partial mediating role between professional self-efficacy and job performance; (3) Compared with the sense of organizational support, the positive effect of self-efficacy on job performance is more significant.