Interpretation and mirror of the National Health Education Standards in the United States / 中国学校卫生

Abstract@#In the context of frequent public health events, effective school health education is an important measure to improve students health literacy and public health system of China. The study examined the National Health Education Standards in the U.S., based on a literature review and comparative analysis, to provide guidance for China. Using the method of liberature riview paper interprets the curriculum of National Health Education Standards in the U.S. and provides a mirror for China. Health Education standards in the U.S. are characterized by their academic quality, standardized framework, assessment program, equity principles, and other components. A mirror for China includes promoting the construction of the standards based health education curriculum, developing the skills based health education curriculum system, and constructing a performancebased comprehensive evaluation system.

Performance of four simplified screening methods of elevated blood pressure among children and adolescents / 中国学校卫生

Objective@#To evaluate the performance of four simplified screening methods of elevated blood pressure commonly used among children and adolescents according to Chinese guidelines for prevention and treatment of hypertension (revised in 2018), so as to provide a reference for the early detection of the elevated blood pressure among children and adolescents.@*Methods@#Stratified cluster random sampling method was used to monitor the physical fitness of 5 211 children and adolescents in a city of Shanxi Province from October to November 2021. Chinese guidelines for prevention and treatment of hypertension was considered as gold standard, and sensitivity, specificity, area under the curve (AUC) and Kappa value were calculated to evaluate the screening effectiveness of formula method, height specific method, age group specific method, sex and age specific method for screening elevated blood pressure.@*Results@#The detection rates of elevated blood pressure among children and adolescents screened by gold standard, formula method, height specific method,age group specific method, sex and age specific method were 21.9%, 24.0%, 21.1%, 24.5% and 20.2%, respectively. There was no significant difference between prevalence of elevated blood pressure screened by formula method, sex and age specific method and gold standard( χ 2=1.21, 1.41, P >0.05), whereas height specific method and age group specific method had significant differences with gold standard ( χ 2=20.39, 67.09, P <0.05). AUC was the largest for height specific method [0.94(95% CI =0.93-0.95)], and the smallest for age group specific method [0.87(95% CI = 0.86 -0.88)]. The Kappa values of height specific method (0.89) and sex and age specific method (0.89) were both greater than 0.85 , which were more consistent with the screening effectiveness of gold standard. When comparing by sex, age and body mass index (BMI), the screening effectivenesses were consistent with the overall in boys, 6-11 years and normal body weight groups, while the screening effectivenesses were different in girls, 12-17 years, overweight and obese groups. The AUC (0.87), Kappa value (0.71) and sensitivity (82.33%) of age group specific method were the lowest and the screening effectiveness was the worst.@*Conclusion@#Height specific method is more effective and can be used for early identification and self detection of blood pressure abnormalities among children and adolescents.

Application of two different methods of visual acuity assessment for myopia screening among lower grade elementary school students / 中国学校卫生

Objective@#To explore two visual acuity standards for examining uncorrected visual acuity (UCVA) to define poor vision in lower grade elementary school students, and to compare the difference of screening myopia rates when combined with non cycloplegic auto refraction (NCAR), so as to provide a scientific basis for standardizing UCVA examination methods using CAR as the gold standard of authenticity and reliability.@*Methods@#From March 22nd to April 9th, 2023, a total of 549 first and second grade students aged 7-8 years from a primary school in Hefei City were selected for the study by convenient cluster sampling method. Two methods were employed for UCVA examination:the first method involved charts where the student could not make mistakes in identifying at least half of the characters per line (V1), and the second method used charts with character sizes ranging from 4.0 -4.5, 4.6-5.0 and 5.1-5.3, without allowing 1, 2 and 3 errors per line (V2). While NCAR was performed, then 187 students underwent CAR examination. Paired Wilcoxon rank-sum test and McNemar test were used to compare the differences between V1 and V2 methods in defining poor vision and screening myopia rates. Using CAR as the gold standard, the authenticity and reliability of defining screening myopia rates through the combination of V1 and V2 methods along with NCAR were evaluated.@*Results@#The UCVA examination results for V1 and V2 showed statistically significant differences in both the right eye [5.0(4.9,5.0), 4.9(4.8,5.0)] and the left eye [ 5.0 (4.9,5.0), 4.9(4.8,5.0)] ( Z=-13.95, -13.34, P <0.01). The detection rates of poor vision for the right eye were 43.53% for V1 and 63.21% for V2, and the left eye with 44.08% for V1 and 62.11% for V2, with statistically significant differences ( χ 2= 106.01 , 95.09, P <0.01). When screening myopia rates were assessed for UCNA methods combined with NCAR, the right eye rates were 21.49% for V1 and 24.59% for V2, and the left eye rates were 21.31% for V1 and 23.13% for V2, with statistically significant differences ( χ 2=15.06, 8.10, P <0.01). Using CAR as the gold standard, the detection rates in the right eye and left eye were 16.58 % and 17.11%, respectively. The Youden indices for defining screening myopia in the right eye were 0.80 for V1 and 0.79 for V2, and the left eye with 0.85 for V1 and 0.83 for V2. The agreement rates for the right eye were 91.98 % for V1 and 89.30% for V2, and the left eye with 94.12% for V1 and 91.98% for V2. The Kappa values for the right eye were 0.73 for V1 and 0.67 for V2, and the left eye with 0.81 for V1 and 0.75 for V2.@*Conclusions@#Authenticity and reliability of two UCVA examination methods combined with NCAR in defining screening myopia are higher in V1 than V2 methods. It is recommended to unify the visual acuity examination methods by requiring the correct identification of more than half of the total number of visual markers in a row.

Development and implications of physical fitness assessment for children and adolescents in Japan / 中国学校卫生

Abstract@#To help children and adolescents grow up healthily, using literature, comparative analysis and other research methods, the historical development of Japan s physical fitness assessment system for children and adolescents are analyzed for the content structure of the latest version of its physical fitness assessment system (Sports adaptability assessment Ⅱ). On the basis of this analysis, some practical suggestions are proposed for improving the National Physical Fitness Standards for Students in China, such as adding a physical fitness assessment system for preschoolers, grouping the test subjects by age and setting common test indicators for males and females. Thus, the improved National Student Physical Fitness Standard is more aligned with the physical and mental growth patterns of Chinese children and adolescents.

Comparative application of three methods for testing distance visual acuity among children / 中国学校卫生

Objective@#To understand the differences in the application of three distant vision examination methods in children, so as to provide a reference for developing a unified distant vision examination for this population.@*Methods@#The study involved 98 children aged 4 to 16 years who visited the ophthalmology department of a children s hospital in Anhui Province between August 15 and 25, 2022. Vision was measured using the distant vision test method specified in the 2014 National Student Physical Fitness and Health Survey (V1), the 2019 National Student Physical Fitness and Health Survey (V2), and Specification for Screening of Refractive Error in Primary and Secondary School Students (WS/T 663-2020) (V3). The paired samples McNemar s test and Wilcoxon test were performed to compare the detection rate of poor vision and the difference between the visual acuity test results of the three methods.@*Results@#The results of the 98 children examined according to V1, V2, and V3 showed that the M (P25, P 75 ) of the right eye were 4.8（4.6，5.0），4.8（4.7，5.0），and 4.8（4.7，5.0）while the left eye visual acuity M ( P 25 , P 75 ) were 4.8 （4.6，5.0），4.9（ 4.7 ，5.0），and 4.9（4.7，5.0），respectively. The rates of poor visual acuity detection for the right eye were 63.3%, 58.2% and 58.2 % for V1, V2, and V3, respectively, while for the left eye, they were 58.2%, 54.1% and 53.1%, respectively. McNemar test results showed that there were no statistically significant differences in the rates of poor visual acuity detection between the right and left eyes for V1 vs. V2, V1 vs. V3, and V2 vs. V3 (left eyes： χ 2=2.25，2.29，0.00，right eyes： χ 2=3.20，3.20，0.00， P >0.05).Wilcoxon test results indicated that there were statistically significant differences between the right and left eye visual acuity groups for V1 vs. V2 and V1 vs. V3 (left eyes： Z =-4.15，-4.60, right eyes： Z = -4.70，-4.99, P <0.01).@*Conclusion@#Irrespective of whether the starting visual standard starts at row 4.0 or 5.0, different standards of visual standard passage have an impact on the visual acuity results. It is recommended that existing methods of screening for distance vision are standardized.

Overweight and obesity among children and adolescents in Jinan City in 2021 and comparison with Chinese and international standards / 中国学校卫生

Objective@#To describe the prevalence of overweight and obesity among children and adolescents in Jinan City according the national and international criteria, as well as to compare the Chinese and international standards, so as to provide basic data for relevant intervention strategies.@*Methods@#From September to December 2021, using the height and weight data obtained from the health checkup reports of 746 985 primary and secondary school students in Jinan City in 2021, body mass index(BMI) was calculated to evaluate the current status of the prevalence of overweight and obesity among this sample of children and adolescents aged 6- 18 years old. The consistency of the Chinese standard, U.S. Centers for Disease Control and Prevention (CDC) standard, International Obesity Task Force (IOTF) standard, and World Health Organization (WHO) standard was compared by calculating the weighted Kappa value.@*Results@#Based on the Chinese, U.S. CDC, IOTF and WHO standards, the overweight rates of children and adolescents aged 6-18 years in Jinan were 17.3%, 16.5%, 21.1% and 13.6%, respectively, and the obesity rates were 23.1%, 19.5%, 13.5% and 6.6%, respectively. The overweight and obesity rates of boys were higher than those of girls under the four criteria (China: χ 2=1 418.48, 9 868.51, U.S. CDC: χ 2=145.78, 23 211.41, IOTF: χ 2=1 326.94, 13 615.62, WHO: χ 2=873.13, 46.41, P <0.01).The overweight rate of adolescents in the 13-18 year-old age group was higher than that of children aged 6-12 years (China: χ 2=29.13, U.S. CDC: χ 2=6.43, IOTF: χ 2=15.87, WHO: χ 2=19.48, P <0.01) and the obesity rate of the group aged 6-10 years was significantly higher than that of the group aged 11-18 years (China: χ 2=217.02, U.S. CDC: χ 2=227.54, IOTF: χ 2=171.91, WHO: χ 2=165.91, P <0.01). The rates of overweight and obesity in urban children and adolescents were slightly higher than those in rural children and adolescents (China: χ 2=25.06, 245.12, U.S. CDC: χ 2=56.13, 205.93, IOTF: χ 2= 182.34 , 22.04, WHO: χ 2=200.88, 21.61, P <0.01). The Chinese standard showed good agreement with the IOTF standard and U.S. CDC standard, with weighted Kappa values of 0.72 and 0.83, but poor agreement with the WHO standard, with a weighted Kappa value of 0.33.@*Conclusion@#The current prevalence of overweight and obesity among children and adolescents in Jinan is serious. The Chinese standard has good consistency with IOTF standard and American CDC standard, and poor consistency with WHO standard.

ICP-MS establishes blood lead reference method expected to improve detection accuracy / 中华检验医学杂志

Lead poisoning severely threatens human health with its cumulation and durability in the body. The analysis of lead in blood is vital for screening, diagnosis, treatment, and prognostication of lead poisoning and for indirectly monitoring the level of lead in the environment. Although the detection programs are available throughout our country, the accuracy and comparability of the results cannot meet the expectation. A variety of factors can affect the accuracy of blood lead testing. To promote the application of blood lead analysis in clinical trials and reduce the bias of results, a better reference system for blood lead analysis should be established to evaluate the accuracy of traditional methods, promote the standardization of blood lead analysis and achieve accurate blood lead testing.

Research progress on standardized clinical outcome of peritoneal dialysis / 中华肾脏病杂志

As a home treatment and economical and practical treatment mode, peritoneal dialysis (PD) is an effective renal replacement therapy for end-stage kidney disease. The number of PD patients in the world is increasing, and prognosis has been significantly improved. However, compared with the general population, the quality of life of PD patients is not satisfactory, and the disease burden is still very high. There is significant heterogeneity in the reports of clinical outcomes of PD in different countries and regions. The heterogeneity seriously affects the validity of clinical research evidence and the continuous improvement of the quality of PD centers. New progress has been made in the study of standardized clinical outcome of PD in recent years. The article reviews the heterogeneity of PD clinical outcome report, standardized clinical outcome classification and core outcome to standardize the report of PD clinical outcome, improve the clinical research quality and management level of PD, and finally improve the prognosis of patients.

Reflections on nomenclature and expansion of surgical indications for endoscopic spinal surgery / 国际外科学杂志

In recent years, with the development and maturity of endoscopic technique, endoscopic spinal surgery represented by water media and optical rigid endoscope has been widely used in the treatment of many disorders in the cervical, thoracic and lumbar spine. Endoscopic spinal surgery shows similar clinical effects as traditional open surgery or other minimally invasive procedures, and is favored by spinal surgeons due to its advantages of less trauma and rapid recovery after surgery. However, the large-scale application of endoscopic technique brings problems such as non-standard nomenclature and unreasonable indications. Therefore, this article will summarize the surgical nomenclature and indications of endoscopic spinal surgery, in order to provide a reference for spinal surgeons to understand and apply endoscopic technology reasonably.

Physical fitness evaluation results among students in Yunnan Province in 2019 / 中国学校卫生

Objective@#To analyze physical fitness of students aged 6-22 years old from seven ethnic groups in Yunnan Province, and to provide reference for physical fitness intervention measures.@*Methods@#The nationality, gender, grade, body shape, vital capacity, exercise quality of students were derived from the 2019 Yunnan Student Physical Health Survey Database. Comprehensive physical fitness score was calculated according to the National Student Physical Fitness Standards(revised in 2014). t test, ANOVA, and χ 2 test were used to analyze physical fitness score and level among students with different ethnic groups, gender, and school stages.@*Results@#The average comprehensive score of physical fitness among students from 7 ethnic groups in Yunnan Province was (70.02±9.69）, with the pass rate being 88.91%. The proportion of excellent was 0.93%, good was 17.90%, pass 70.09 %, and failed was 11.09%. Physical fitness score was highest in BMI (94.99 points), followed by 50 meter running (74.13 points), sitting forward bend (72.63 points), endurance running (70.43 points), standing long jump (67.77 points), sit ups ( 65.71 points) , 1 minute skipping rope (65.25 points), vital capacity (62.97 points), pull up (29.04 points). Physical fitness score and pass rate and evaluation level varied significantly by ethnicity and school stage( F =293.53，452.85， χ 2/ χ 2 trend =466.65， 412.57 ； 1 553.22 ，1 045.36， P <0.01).@*Conclusion@#The excellent rate of physical fitness among students in Yunnan Province is relatively low. Physical fitness promotion requires specific guidance and training based on ethnicity and school stage.

Current status of health standards and health management system in childcare institutions / 中国学校卫生

Abstract@#Children in childcare institutions are involved with a high degree of contact, poor personal hygiene habits, low resistance, high incidence of disease, infections diseases are easily spread without proper public health management. Compared with child care centers, the construction of national standards, industry standards and management systems for primary and secondary school health is relatively complete, while the applicability of the current hygiene standards and management systems for childcare centers is worth exploring. By reviewing the previous literature, the study sorted out the current status of hygiene standards and hygiene management system in childcare institutions, and assesse their applicability in childcare institutions, so as to provide references for the establishment of hygiene standards and hygiene management system in childcare institutions.

Imaging Assessment of Prognostic Parameters in Cases of Isolated Congenital Diaphragmatic Hernia: Integrative Review / Avaliação de fatores prognósticos por métodos de imagem em casos de hérnia diafragmática congênita isolada: Revisão integrativa

Abstract Objective Antenatal recognition of severe cases of congenital diaphragmatic hernia (CDH) by ultrasound (US) and magnetic resonance imaging (MRI) may aid decisions regarding the indication of fetal endoscopic tracheal occlusion. Methods An integrative review was performed. Searches in MEDLINE and EMBASE used terms related to CDH, diagnosis, MRI, and US. The inclusion criteria were reviews and guidelines approaching US and MRI markers of severity of CDH published in English in the past 10 years. Results The search retrieved 712 studies, out of which 17 publications were included. The US parameters were stomach and liver positions, lung-to-head ratio (LHR), observed/expected LHR (o/e LHR), and quantitative lung index. The MRI parameters were total fetal lung volume (TFLV), observed/expected TFLV, relative fetal or percent predicted lung volumes, liver intrathoracic ratio, and modified McGoon index. None of the parameters was reported to be superior to the others. Conclusion The most mentioned parameters were o/e LHR, LHR, liver position, o/e TFLV, and TFLV.

Resumo Objetivo A identificação pré-natal de casos graves de hérnia diafragmática congênita (HDC) por ultrassonografia (US) e ressonância magnética (RM) pode ajudar a decidir sobre a indicação de oclusão traqueal endoscópica fetal. Métodos Uma revisão integrativa foi realizada pesquisando nas bases MEDLINE e EMBASE comtermos relativos a HDC, diagnóstico, RM, e US. Os critérios de inclusão foram revisões e diretrizes abordando marcadores ultrassonográficos e de ressonância para a gravidade de HDC publicados em inglês nos últimos 10 anos. Resultados Foram obtidos 712 estudos, dos quais 17 foram incluídos. Os parâmetros de US foram posições do estômago e do fígado, relação pulmão-cabeça (LHR, na sigla em inglês), LHR observada/esperada (o/e LHR), e índice pulmonar quantitativo (QLI, na sigla em inglês). Os parâmetros de RM foram volume pulmonar fetal total (TFLV, na sigla em inglês), o/e TFLV, volume pulmonar fetal relativo e porcentagem predita, razão do fígado intratorácico (LiTR, na sigla em inglês) e índice de McGoon modificado. Nenhum dos parâmetros foi mencionado como superior aos demais. Conclusão Os parâmetros mais citados foram o/e LHR, LHR, posição do fígado, o/e TFLV, e TFLV.

La trazabilidad en las mediciones del laboratorio clínico: impacto en la calidad y seguridad del paciente / Traceability in clinical laboratory measurements: impact on quality and patient safety

Las mediciones confiables, trazables metrológicamente y comparables proporcionan la base racional para la evaluación de la calidad de un resultado y el fortalecimiento de las redes de laboratorios clínicos, lo cual permite mejorar la calidad de atención y la seguridad del paciente. En este documento se revisan los principios básicos que deben seguirse para garantizar la trazabilidad de las mediciones del laboratorio clínico, las ventajas de utilizar métodos trazables, el impacto de no hacerlo, y se discuten las principales limitaciones para relacionar las mediciones con los estándares de medición de referencia apropiados

Reliable, metrologically traceable, and comparable measurements provide the rationale for evaluating the quality of a result and strengthening clinical laboratory networks, thereby improving quality of care and patient safety. This document reviews the basic principles that must be followed to ensure the traceability of clinical laboratory results, the advantages of using traceable methods, the impact of not doing so, and the main limitations in relating measurements to appropriate reference standards

Translation and Validation of the Boston Technical Performance Score in a Developing Country

Abstract Introduction: The Technical Performance Score (TPS) was developed and subsequently refined at the Boston Children's Hospital. Our objective was to translate and validate its application in a developing country. Methods: The score was translated into the Portuguese language and approved by the TPS authors. Subsequently, we studied 1,030 surgeries from June 2018 to October 2020. TPS could not be assigned in 58 surgeries, and these were excluded. Surgical risk score was evaluated using Risk Adjustment in Congenital Heart Surgery (or RACHS-1). The impact of TPS on outcomes was studied using multivariable linear and logistic regression adjusting for important perioperative covariates. Results: Median age and weight were 2.2 (interquartile range [IQR] = 0.5-13) years and 10.8 (IQR = 5.6-40) kilograms, respectively. In-hospital mortality was 6.58% (n=64), and postoperative complications occurred in 19.7% (n=192) of the cases. TPS was categorized as 1 in 359 cases (37%), 2 in 464 (47.7%), and 3 in 149 (15.3%). Multivariable analysis identified TPS class 3 as a predictor of longer hospital stay (coefficient: 6.6; standard error: 2.2; P=0.003), higher number of complications (odds ratio [OR]: 1.84; 95% confidence interval [CI]: 1.1-3; P=0.01), and higher mortality (OR: 3.2; 95% CI: 1.4-7; P=0.004). Conclusion: TPS translated into the Portuguese language was validated and showed to be able to predict higher mortality, complication rate, and prolonged postoperative hospital stay in a high-volume Latin-American congenital heart surgery program. TPS is generalizable and can be used as an outcome assessment tool in resource diverse settings.

La trazabilidad en el sistema logístico de medicamentos en Cuba y el uso de las tecnologías de auto-identificación / Traceability in the logistics system of medicines in Cuba, use of auto-identification

La trazabilidad es la capacidad para rastrear la historia, aplicación o ubicación de un objeto bajo consideración. En el ámbito farmacéutico, el rastreo y seguimiento de los medicamentos, incluyendo las vacunas y otros medicamentos biológicos, a lo largo de la cadena de suministro constituye un requisito obligatorio establecido por las autoridades sanitarias a nivel internacional, que se exige en mayor o menor magnitud en las reglamentaciones vigentes. En este artículo se analiza el sistema de codificación y clasificación en el sector de la salud y su estado actual en la cadena de suministro de medicamentos de Cuba. Se presenta un procedimiento para la implementación de las tecnologías de auto-identificación e intercambio electrónico de datos, mediante el uso de GS1 en el sistema de codificación y clasificación empleado en el sector de salud, que permita la trazabilidad en toda la cadena de suministro en Cuba(AU)

Traceability is the capability to track the history, application or location of an object under consideration. In the pharmaceutical field, the tracking and monitoring of medicines, including vaccines and other biological medicines, along the supply chain constitutes a mandatory requirement established by the sanitary authorities at an international level, which is demanded to a greater or lesser extent in the regulations in force. This research was carried out involving different links in the drug supply chain in Cuba, ranging from drug suppliers, drug distribution company, to healthcare centers and pharmacies. An analysis is carried out on the current coding and classification system, detecting the ineffectiveness of the identification of the drugs as the main deficiency. A procedure is proposed for the implementation of the auto-identification and electronic data interchange technologies using GS1 in the coding and classification system used in the health sector that allows traceability throughout the supply chain in Cuba(AU)

Adherencia a las recomendaciones de tromboprofilaxis post-cesárea: estudio de corte transversal / Compliance with post-cesarean section thromboprophylaxis recommendations. A cross sectional study in 233 women

Background: Cesarean section increases four times the risk of venous thromboembolism compared to vaginal delivery. The Royal College of Obstetricians and Gynecologists guidelines are used at our service. A written alert was designed to stratify patients at high, intermediate or low risk making a suggestion for thromboprophylaxis. Aim: To assess the compliance with the guidelines and to evaluate the impact of a written alert in the thromboprophylaxis compliance in women subjected to caesarean section. Patients and Methods: Review of medical records of 233 women aged 19 to 32 years, subjected to a caesarean section in a Gynecology Service, between 2016-2017. Results: Compliance with recommendations was observed in 29% of patients (68/233), 86% in the low-risk group, 26% in the intermediate risk group and 100% in the high risk group. In 41/233 (18%) of patients, a written alert was included in the medical record. Compliance with recommendations in the presence of the written alert was 61% (25/41 women) compared to 22% (43/192) in those lacking the alert (p < 0.01). In women whose emergency caesarean section was the only risk factor, the compliance with the recommendation was 8%, compared with 30% among those who had at least one thrombotic risk factor associated with caesarean section (p < 0.01). Conclusions: In this cross-sectional study, we observed a low compliance with thromboprophylaxis guidelines in cesarean women. We observed that the use of a written alert improved the compliance with thromboprophylaxis.

Reproductibilidad de pruebas de competencia motriz y percentiles para niños y adolescentes que viven a altitud moderada del Perú / Reproducibility of motor competence tests and percentiles for children and adolescents living at moderate altitude in Peru

Objetivo. Evaluar la reproductibilidad de las pruebas de competencia motriz (CM) de transposición lateral y salto lateral, y estimar percentiles por edad y sexo para niños que viven a altitud modera del Perú.Método. Se efectuó un estudio descriptivo transversal en la provincia de Arequipa (Perú). Se evaluó el peso, la estatura y la circunferencia de cintura. Se calculó el índice de masa corporal e índice ponderal. Se evaluó la prueba de transposición lateral y salto lateral (ambas de la batería Kopfer test für Kinder).Resultados. La muestra estuvo constituida por 885 niñas y 897 niños de 6,0 a 16,9 años. El error técnico de medida intraevaluador para ambas pruebas de CM oscilaron entre 1,75 y 3,9 repeticiones en ambos sexos, mientras que el coeficiente de correlación intraclase fue de 0,77 a 0,99. Los límites de acuerdo oscilaron entre -7,3 y 6,8 repeticiones en ambas pruebas. Se estimaron percentiles 5º, 15º, 50º, 85º y 95º por el método Least-Mean-Square algorithm. Los puntos de corte adoptados para las pruebas CM fueron bajo: < p15; regular: de p15 a p85; y alto: > p85.Conclusión. Las pruebas de transposición lateral y salto lateral mostraron una elevada capacidad de reproductibilidad. Los percentiles propuestos pueden servir para valorar la CM y podrían ser incluidos y adaptados como indicadores de desempeño en la educación física.

Objective. To assess the reproducibility of two motor competence (MC) tests: moving sideways and jumping sideways, and to estimate age and sex percentiles for children living at moderate altitude in Peru.Method. This was a descriptive, cross-sectional study conducted in the province of Arequipa, Peru. Weight, height, and waist circumference were assessed. Body mass index and ponderal index were estimated. The moving sideways and jumping sideways tests were assessed (both from the Körper test für Kinder test battery).Results. The sample was made up of 885 girls and 897 boys aged 6.0-16.9 years. The intra-evaluator technical error of measurement for both MC tests ranged between 1.75 and 3.9 repetitions in both males and females, whereas the intraclass correlation coefficient was 0.77-0.99. Agreement limits ranged between -7.3 and 6.8 repetitions for both tests. The 5th, 15th, 50th, 85th, and 95th percentiles were estimated using the Least-Mean-Square algorithm. The cut-off points for MC tests were low: < p15; medium: p15-p85; and high: > p85. Conclusion. Moving sideways and jumping sideways showed a high capacity for reproducibility. The proposed percentiles may be useful to assess MC and could be included and adapted as performance indicators in physical education

¿Por qué continuamos transfundiendo dos unidades de sangre a la vez si con una sola podría ser suficiente? / Why do we keep transfusing two units of blood at the same time if just one could be enough? / Por que continuamos a transfundir duas unidades de sangue ao mesmo tempo se apenas uma pode ser o suficiente?

Resumen: La transfusión de sangre ha sido identificada como uno de los procedimientos médicos más sobreutilizados en pacientes hospitalizados. Una estrategia que permitiría reducir la exposición de los pacientes a la sangre es a través de la implementación de una política de transfusión de una sola unidad, en lugar de dos, para pacientes estables, sin hemorragia y con anemia sintomática. La decisión de transfundir sangre es compleja y depende de varios factores, además, los riesgos de la transfusión se deben sopesar contra los beneficios esperados. La transfusión de dos unidades de sangre a la vez ya no se considera una forma de tratamiento "estándar" para pacientes anémicos sin sangrado activo. Existe una gran oportunidad para reducir el uso excesivo de la transfusión y fomentar las transfusiones de una sola unidad.

Summary: Blood transfusion has been identified as one of the most overused medical procedures in hospitalized patients. One strategy that would reduce the exposure of patients to blood is through the implementation of a single-unit regime for stable patients without bleeding and with symptomatic anemia. The decision to transfuse blood is complex and depends on several factors, in addition, the risks of transfusion must be weighed against the expected benefits. Transfusion of two units of blood at the same time is no longer considered a "standard" form of treatment for anemic patients without active bleeding. There is a great opportunity to reduce the overuse of transfusion and encourage single-unit transfusions.

Resumo: A transfusão de sangue foi identificada como um dos procedimentos médicos usados de mais em pacientes hospitalizados. Uma estratégia que reduziria a exposição dos pacientes ao sangue é por meio da implantação de uma política transfusional de unidade única para pacientes estáveis, sem sangramento e com anemia sintomática. A decisão de transfundir sangue é complexa e depende de vários fatores, além disso, os riscos da transfusão devem ser analisados em relação aos benefícios esperados. A transfusão de duas unidades de sangue ao mesmo tempo não é mais considerada uma forma "padrão" de tratamento para pacientes anêmicos sem sangramento ativo. Há uma grande oportunidade de reduzir o uso excessivo de transfusões e incentivar as transfusões de uma única unidade.

How to move towards standardization for autoantibody testing / 中华检验医学杂志

Based on the fact that autoantibody plays important roles in the regulation of autoimmune disease, it is valuable to improve the accuracy of autoantibody in laboratory to achieve the better diagnosis, classification, disease assessment, effect observation and prognosis analyses of autoimmune diseases. Although the technology of antoantibody measurement is continuously developing and moving towards quantitation, automation and intelligentization in the past years, the standardization of autoimmune testing has still remained challenged. In this paper, the status and trend for autoimmune testing standardization were systematically summarized, and the approaches or strategies to realize standardization were also discussed.