Insatisfação com a imagem corporal e baixa aderência ao padrão alimentar ocidental em escolares: um estudo transversal / Body image dissatisfaction and low adherence to the Western dietary standard among schoolchildren: a cross-sectional study

Resumo Este estudo objetivou identificar padrões alimentares e avaliar a associação entre percepção da imagem corporal e esses padrões em escolares. Um estudo transversal foi conduzido em 385 escolares (ambos os sexos, 10-17 anos de idade) de 4 escolas públicas de Salvador, Brasil. Dois recordatórios alimentares de 24h não consecutivos foram aplicados e o padrão alimentar foi determinado por Análise Fatorial Exploratória, após ajuste dos dados dietéticos pelo Multiple Source Method. Para avaliar percepção da imagem corporal, nós usamos uma escala brasileira de silhuetas. Avaliamos as associações entre percepção da imagem corporal e padrões alimentares usando o modelo de regressão logística politômica ajustado para covariáveis. Três padrões alimentares foram obtidos: "padrão ocidental", "padrão saudável" e "comidas típicas/junk food". Após ajuste, adolescentes que desejavam uma silhueta menor (2,48 [IC95%: 1,04-6,11], 3,49 [IC95%: 1,35-9,05] e 2,87 [IC95%: 1,13-7,26]) tinham mais chances de aderir aos quintis de menor consumo do padrão ocidental, comparados àqueles satisfeitos com sua imagem corporal. Nenhuma associação foi identificada nos outros dois padrões alimentares. Adolescentes insatisfeitos com seus corpos tendem a aderir menos a padrões alimentares não saudáveis.

Abstract This study aimed to identify dietary patterns and to evaluate the association between body image perception and these patterns among schoolchildren. A cross-sectional study was conducted on 385 schoolchildren (both sexes, 10-17 years old) from four public schools in Salvador, Brazil. Two non-consecutive 24-hour dietary recalls were applied, and the dietary pattern was determined by Exploratory Factor Analysis after adjustment of dietary data using the Multiple Source Method. To evaluate body image perception, the Brazilian body shape silhouette was used. The associations between body image perception and dietary patterns using the polytomous logistic regression model adjusted for covariables was assessed. Three dietary patterns were obtained: "Western standard," unhealthy, "healthy pattern" and "typical dishes/ junk food." After adjustment, adolescents who wished for a slimmer silhouette (2.48 [95%CI: 1.04-6.11], 3.49 [95%CI: 1.35-9.05] and 2.87 [95%CI: 1.13-7.26]) were more likely to adhere to the quintiles with the lowest consumption of the Western standard, compared to those satisfied with their body image. No associations were identified in the other two dietary patterns. Adolescents dissatisfied with their bodies tend to adhere less to unhealthy dietary patterns.

Microbial contamination status of swimming places for infants and young children in Shijia-zhuang City and comparison with other public places, 2021–2022 / 环境与职业医学

Background At present, China's Public places health management regulations list 7 categories and 28 sub-categories of public places, but infant and young child swimming places are not in the list yet. Objective To understand the microbial pollution status in commercial infant and young child swimming places in Shijiazhuang City, compare with the microbial pollution in other five types of public places, and find the potential safety hazards in infant and young child swimming places. Methods A total of 3438 microbial samples were collected from the environment of infant and young child swimming places and 5 types of public places (hotels, barber stores, waiting rooms, shopping malls and supermarkets, and conventional swimming places) in Shijiazhuang City from 2021 to 2022. Sampling and monitoring were carried out according to the requirements of Examination methods for public places—Part 6: Technical specifications of health monitoring (GB/T 18204.6-2013). Chi-square test was used to compare hygiene qualification by microbial indicators, and Kruskal-Wallis H test was used to compare overall distributions of total bacterial counts on the surface of public articles. Results From 2021 to 2022, the highest qualified rate of microbial indicators on the surface of public articles was Staphylococcus aureus (100%) for all tested public places in Shijiazhuang City, followed by coliforms (99.44%), and that of total bacterial count was relative low (92.83%). The qualified rate of total bacterial count on the surface of public articles in the swimming places for infants and young children was 87.76%, and the qualified rates in hotels, barber stores, waiting rooms, shopping malls and supermarkets were all above 92%, and the difference among the 5 types of places was statistically significant (P<0.001). The highest value of total bacterial count on the surface of public articles in the swimming places for infants and young children was 80000 CFU·(25 cm2)−1 [100 CFU·(25 cm2)−1=4 CFU·cm−2]; that in 4 types of public places such as hotels (except mouthwash cups), barber stores, waiting rooms, and shopping malls or supermarkets was 2500 CFU·(25 cm2)−1. The difference of total bacteria count on the surface of public articles was statistically significant in comparing infant and young child swimming places with hotels (except mouthwash cups) or barber stores (H=5.432, H=2.997, both Ps<0.05); but the difference was not significant in comparing with waiting rooms and shopping malls or supermarkets (P>0.05). The qualified rates of total bacteria count and coliforms in pool water of infant and young child swimming places were 45.99% and 74.69% respectively, and the two indicators in pool water of conventional swimming places were 94.57% and 98.91% respectively; both showed significant differences between the two types of public places (χ2=162.532, χ2=71.910, both Ps<0.001). Conclusion Compared to conventional swimming places, hotels, barber stores, waiting rooms, and shopping malls or supermarkets, the infant and young child swimming places are not optimistic in hygiene condition; therefore, there is an urgent need to formulate national health standards for infants and young child swimming places, and include them in standard management to further improve their hygiene condition.

HL7 un estándar de interoperabilidad en salud: Revisión sistemática de la literatura

Introducción: Las aplicaciones informáticas en la práctica médica han permitido el desarrollo de novedosas formas de comunicación en la atención del Sistema de Salud. La estandarización representa un elemento necesario para la sostenibilidad y escalabilidad del software desarrollado. En sistemas para la salud existen diversas aplicaciones del estándar HL7. Objetivo: Realizar una Revisión Sistemática de la Literatura (RSL) sobre el estándar de interoperabilidad HL7. Materiales y métodos: Para la definición y ejecución del presente estudio se empleó la propuesta metodológica establecida por Petersen la cual plantea cinco pasos secuenciales: definición de las preguntas de investigación; definición de los criterios de búsqueda; definición de los criterios de selección de estudios primarios; determinación del esquema de clasificación; y extracción de datos y mapeo de estudios. Resultados: Se obtuvieron como resultado preliminar 428 569 entradas posibles. Aplicando el primer filtro de inclusión y exclusión sobre el título, resumen y palabras clave, quedaron 864 documentos, de los cuales solo 276 cumplieron con haber sido publicados en el período que se analiza (2017-2022). De ellos sólo 72 permitían acceso completo a la documentación y al ser analizados se descartan 51 por no ofrecer información acorde al tema de investigación. Resultaron un total de 21 artículos para un análisis a mayor profundidad. Conclusiones: A partir de la revisión sistemática se pudo constatar que en la optimización de los procesos comunicativos es preciso el uso de estándares que armonicen el intercambio de información y provean un lenguaje común para todos los agentes involucrados.

Introduction: Computer applications in medical practice have allowed the development of novel forms of communication in the Health Care System. Standardization represents a necessary element for the sustainability and scalability of the developed software. In health systems there are various applications of the HL7 standard. Objective: To perform a Systematic Review of Literature (RSL) on the HL7 interoperability standard. Methods: The methodological proposal established by Petersen, which proposes five sequential steps such as: definition of research questions, definition of search criteria, definition of the selection criteria of primary studies, determination of the classification scheme, and data extraction and mapping study, was used for the definition and implementation of this study. Results: A total of 428,569 possible entries were obtained as a preliminary result. Applying the first inclusion and exclusion filter on the title, abstract and keywords, 864 documents remained, of which only 276 complied with having been published in the period under analysis (2017-2022). Only 72 of them allowed full access to the documentation and when analyzed, 51 were excluded for not offering information according to the research topic. A total of 21 articles were selected for further analysis. Conclusions: Based on the systematic review, it was possible to verify that in the optimization of communication processes, standards must be used to harmonize the exchange of information and provide a common language for all the agents involved.

ESTIMATION OF HETEROSIS FOR YIELD AND YIELD RELATED COMPONENTS USING DIVERSE TESTERS IN PEARL MILLET [PENNISETUM GLAUCUM (L.) R. BR.]

Experiment comprised of twenty six female type parents and seven restorer parents of pearl millet and their 182 hybrids was conducted at two locations viz., ICRISAT, Patancheru (Latitude 17.52° N; Longitude 78.26° E and Altitude 522 m) and research farm of Super seeds Pvt Ltd., Hisar (Latitude 29.15° N; Longitude 75.72° E and Altitude 215 m) during rainy 2018, for studying the extent of hybrid vigour in F1 for grain yield and its components. For days to 50% owering, top cross hybrid MBL-5 X MOPT-31 (-13.37**) showed highest signicant and positive heterosis over check 86M86. The top cross hybrid MBL-17 X MOPT-33 (45.21**) highest, signicant standard heterosis in positive direction over check 86M86 for panicle length (cm). The single cross hybrid MBL-3 X MIT-29 (14.12*) exhibited signicant and positive standard heterosis over 86M86 for panicle girth (cm). for productive tillers, single cross hybrid MBL-8 X MIT-28 (98.34**) showed highest signicant positive standard heterosis over check 86M86 and the single cross hybrid MBL-24 X MIT-28 (18.42) showed positive standard heterosis over check 86M86

¿Qué es el test de latencia múltiple de sueño y cuál es su uso en pediatría? / What is the multiple sleep latency test and what is its use in pediatrics?

La prueba de latencia múltiple del sueño nos permite evaluar objetivamente las variaciones normales y patológicas en la somnolencia y el estado de alerta. Es una prueba que evalúa qué tan rápido una persona se duerme en condiciones estandarizadas que facilitan el sueño, y se repite a intervalos de 2 horas durante todo el día. Es el estándar para documentar el inicio del sueño REM (SOREMP), que es un síntoma de narcolepsia y en la somnolencia idiopática podría ser útil. Su uso está ampliamente descrito en adultos, pero la prueba no es tan común en niños. En esta revisión, se analizan los valores en adultos y niños, y su utilidad, a partir de la historia de la prueba.

The multiple sleep latency test allows us to objectively assess normal and pathological variations in sleepiness and alertness. It is a test that assesses how quickly a person falls asleep under standardized conditions that facilitate sleep and is repeated at 2-h intervals throughout the day. is the standard for documenting sleep onset REM (SOREMP), which is a symptom of Narcolepsy and idiopathic sleepiness could be useful. Its use is widely described in adults, but the test is not so common in children. In this review, we analyze the values in adults and children, and their usefulness, based on from the history of the test.

Estimación de brechas de geriatras en Chile / Estimation of geriatrician gaps in Chile

Antecedentes: el envejecimiento de la población chilena y la transición epidemiológica que atraviesa el país, ha incrementado la necesidad de formar, entre otros especialistas, a médicos geriatras. Objetivo: estimar la brecha de geriatras en Chile de acuerdo con necesidades epidemiológicas de la población de 65 años y más. Método: se realizó una estimación de brecha de horas de geriatra para la red de salud, a partir de una consulta a 57 geriatras de laboralmente activos de un total de 156 geriatras registrados a enero del 2021. En dicha consulta se indagó sobre tiempo de duración de consulta y frecuencia de consultas ideales de acuerdo con la capacidad funcional de las personas mayores a nivel nacional y por región obtenida de la encuesta Casen 2017. Resultados: a febrero del 2022 existe un total de 162 geriatras en Chile, cifra que equivale a un geriatra por cada 15.806 personas de 65 años y más. De acuerdo con la estimación realizada, se requeriría en Chile, un total de 1.244.689 horas de geriatra anual, equivalentes a la existencia de 589 geriatras a nivel nacional. Conclusión: según los resultados del estudio, a nivel nacional se necesitarían de un total de 589 geriatras para cubrir las necesidades de atención de las personas mayores con algún nivel de dependencia. De acuerdo con estas cifras, al primer trimestre del 2022 el país presentaría una brecha de 427 geriatras. Ante lo elevada de esta brecha, se cree necesario avanzar en estrategias de formación general en geriatría y gerontología en los equipos de salud y socio-sanitarios.

Background:The ageing between the Chilean population and the epidemiological transition that the country is going through has increased the need to train, among other specialists, geriatric doctors.Objective: To estimate the gap between geriatricians in Chile according to the epidemiological needs of the population aged 65 years and over. Method:An estimate of the gap in geriatrician hours was made for the health network based on a consultation of 57 active geriatricians out of 156 registered as of January 2021. In this consultation, the duration and frequency of ideal consultations were inquired according to the functional capacity of the elderly at the national level and by region obtained from the Casen 2017 survey.Results: as of February 2022, there are 162 geriatricians in Chile, equivalent to one geriatrician for every 15,806 people aged 65 years and over. According to the estimate, a total of 1,244,689 hours of annual geriatrician would be required in Chile, equivalent to 589 geriatricians nationwide. Conclusion:According to the study's results, at the national level, a total of 589 geriatricians would be needed to cover the care needs of older people with some level of dependen-ce. According to these figures, in the first quarter of 2022, the country would present a gap of 427 geriatricians. Given the highness of this gap, it is believed necessary to advance general training strategies in geriatrics and gerontology in health and socio-health teams

PHARMACOVIGILANCE IN INDIA: PAST, PRESENT, AND FUTURE PERSPECTIVE

Its start a decade ago, pharmacovigilance (PV) experienced tremendous development. There have been significant attempts in recent years to transform the current pharmacovigilance systems to meet future expectations. Adverse drug reactions (ADRs) are increasing in frequency, severity, and complexity as novel medication therapies are coming to market more quickly as a result of better laws and regulations. India is the second most popular nation in the world, with around 1 billion active and prospective consumers of pharmaceuticals. Despite being a member of the Uppsala Monitoring Centre, our nation has almost little commitment to the database. This problem is brought on by the inadequate ADR (adverse drug reaction) monitoring system and lack of knowledge among pharmacy associates and medical professionals. The primary objectives of the PV program are patient care, patient safety, and monitoring of negative medication reactions. There is a need for additional clinical preliminary exams and clinical assessments in India to accurately practice PV. A fully functional PV system is essential for the safe and responsible administration of medicines. This review gives a systematic review of pharmacovigilance in India from its origin to its current scenario and also discusses the various strategies and proposals to build, maintain and implement a robust pharmacovigilance system for India in coming years.

Update of the Brazilian consensus recommendations on Duchenne muscular dystrophy / Atualização das recomendações do consenso brasileiro para distrofia muscular de Duchenne

Abstract In the last few decades, there have been considerable improvements in the diagnosis and care of Duchenne muscular dystrophy (DMD), the most common childhood muscular dystrophy. International guidelines have been published and recently reviewed. A group of Brazilian experts has developed a standard of care based on a literature review with evidence-based graded recommendations in a two-part publication. Implementing best practice management has helped change the natural history of this chronic progressive disorder, in which the life expectancy for children of the male sex in the past used to be very limited. Since the previous publication, diagnosis, steroid treatment, rehabilitation, and systemic care have gained more significant insights with new original work in certain fields. Furthermore, the development of new drugs is ongoing, and some interventions have been approved for use in certain countries. Therefore, we have identified the need to review the previous care recommendations for Brazilian patients with DMD. Our objective was to create an evidence-based document that is an update on our previous consensus on those topics.

Resumo Nas últimas décadas, houve progressos significativos no diagnóstico e no tratamento da distrofia muscular de Duchenne (DMD), considerada a distrofia muscular mais comum na infância. Diretrizes internacionais foram publicadas e revisadas recentemente. Um grupo de especialistas brasileiros desenvolveu um padrão de atendimento baseado em revisão de literatura, com recomendações graduadas pautadas em evidências compiladas em uma publicação dividida em duas partes. A implementação de melhores práticas de manejo ajudou a modificar a história natural desta doença crônica, progressiva, que, no passado, oferecia uma expectativa de vida muito limitada para crianças do sexo masculino. Desde a publicação desse consenso anterior, o diagnóstico, o tratamento com esteroides, a reabilitação e os cuidados sistêmicos ganharam novas possibilidades a partir da divulgação dos resultados de trabalhos originais em algumas dessas áreas. Além disso, as pesquisas e o desenvolvimento de novos fármacos estão em andamento, e algumas intervenções já foram aprovadas para uso em determinados países. Nesse contexto, identificamos a necessidade de rever as recomendações anteriores sobre o manejo dos pacientes brasileiros com DMD. Nosso objetivo principal foi elaborar uma atualização baseada em evidências sobre esses tópicos do consenso.

A comparison of absolute, ratio standard and allometric approaches for bench press performance assessment in men over 60 / Comparação das abordagens absoluta, razão padrão e alométrica para a performance no supino em homens acima de 60 anos

ABSTRACT Body mass is known to affect muscle strength and the outcome of some functional tests, so that heavier and taller people will be stronger than lighter and smaller ones. Ratio standard (RS) has been widely used to remove the body mass effect, despite long date criticism due to its inadequacy. Allometry (ALLO), in turn, has been applied as an efficient method for normalizing muscular strength. As the bench press (BP) is a well-recognized strength and conditioning exercise for older adults, the aim of the present study was to verify the influence of body mass on the performance assessment of a group of older men in the BP, by comparing the absolute, RS and ALLO approaches. Sixteen healthy old men (65.5±5.13 years old; 75.42±9.78Kg; 1.73±5.98m; 25.11±2.71 kg/m2; 24.76±4.10 %fat) volunteered to participate in the study. Maximum dynamic load was verified by individual one-repetition maximum (1-RM) tests. Comparisons of means revealed that significant 1-RM difference between lighter (54.9±8.85Kg) and heavier (66.2±8.86Kg) participants was identified only in absolute approach (p<0.05; ES=0.57). RS failed in completely remove the body mass effect, allowing correlation between normalized muscular strength and BM (r=0.23), in contraire of ALLO (r=0.03 and 0.06). Kendall's concordance coefficient revealed an absolute lack of agreement between approaches when compared their respective ordinal classifications (kw=0.003; p>0.05). In line with previous research, ALLO has shown to be the only suitable method to remove adequately the body mass effect and to provide appropriated performance scores for the older men evaluated in this study.

RESUMO Sabe-se que a massa corporal afeta a força muscular e o resultado de alguns testes funcionais, de modo que pessoas mais pesadas e altas serão mais fortes que as mais leves e menores. A razão-padrão (RP) tem sido largamente utilizada para remover o efeito da massa corporal, apesar de críticas conhecidas há muito tempo devido sua inadequação. Alometria (ALO), do contrário, tem sido aplicada como um método eficiente para normalizar a força muscular. Como o supino é um exercício de força e condicionamento bem reconhecido para idosos, o objetivo deste estudo foi verificar a influência da massa corporal sobre a avaliação do desempenho de um grupo de idosos no supino, comparando as abordagens absoluta (AB), RP e ALO. Dezesseis idosos saudáveis (65,5±5,13 anos de idade; 75,42±9,78Kg; 1,73±5,98m; 25,11±2,71 kg/m2; 24,76±4,10 %gordura) se voluntariaram para participar no estudo. A máxima carga dinâmica foi verificada pelos testes de 1 repetição máxima (1RM). Na comparação das médias, a diferença significante do 1RM entre os participantes leves (54,9±8,85Kg) e pesados (66,2±8,86Kg) foi identificada apenas na abordagem ABS (p<0,05; ES=0,57). A RP falhou em remover completamente o efeito da massa corporal, permitindo correlação entre a força muscular e a massa corporal normalizadas (r=0,23), ao contrário da ALO (r=0,23 e 0,06). O coeficiente de Kendall revelou ausência de concordância entre as abordagens quando comparadas as suas respectivas classificações ordinais (kw=0,003; p>0,05). Em linha com pesquisas anteriores, ALO tem se mostrado como o único método viável para remover adequadamente o efeito da MC e para oferecer escores de desempenho mais apropriados para homens idosos, como os avaliados por este estudo.

Determinantes das irregularidades na gestão pública municipal: o caso dos municípios do estado de São Paulo / Determinantes de las irregularidades en la gestión pública municipal: el caso de los municipios del estado de São Paulo / Determinants of irregularities in municipal public management: the case of municipalities in the state of São Paulo

Resumo O controle externo municipal exercido pelos Tribunais de Contas permite, por meio da divulgação dos relatórios de auditoria, conhecer as irregularidades encontradas nas contas dos governos municipais. Elas têm sido analisadas empiricamente, do ponto de vista de sua classificação em termos de gravidade, mas poucos são os estudos que visam identificar os fatores que influenciam tais falhas. Constatada essa lacuna, o principal objetivo deste estudo é identificar fatores que possam influenciar lapsos na gestão pública municipal apontados pela auditoria do Tribunal de Contas. Este artigo contribui para aprofundar a pesquisa em torno desse tema e para a melhoria da gestão nos municípios. Trata-se de uma análise exploratória, baseada em modelos econométricos para dados em painel. A amostra inclui 179 municípios paulistas, com dados relativos aos anos de 2011, 2013, 2015, 2017 e 2019. Os resultados sugerem que as recomendações e as determinações do Tribunal de Contas, bem como lacunas nos controles internos, influenciam irregularidades em municípios pequenos, médios e grandes. O volume de transferências legais e constitucionais recebidas influenciam os municípios pequenos e médios, ao passo que o produto interno bruto (PIB) municipal tem influência nos municípios médios.

Resumen El control municipal externo que ejercen los Tribunales de Cuentas permite, a través de la divulgación de informes de auditoría, conocer las irregularidades encontradas en las cuentas de los gobiernos municipales. Estas han sido analizadas empíricamente, desde el punto de vista de su clasificación en términos de gravedad, pero existen pocos estudios que tengan como objetivo identificar los factores que influyen en tales fallas. Verificada esta brecha, el objetivo principal de este estudio es identificar factores que puedan influir en las fallas en la gestión pública municipal señalados por la auditoría del Tribunal de Cuentas. Este artículo contribuye a profundizar en la investigación sobre este tema y a mejorar la gestión en los municipios. Se trata de un análisis exploratorio, basado en modelos econométricos para datos de panel. La muestra incluye 179 municipios de São Paulo, con datos de los años 2011, 2013, 2015, 2017 y 2019. Los resultados sugieren que las recomendaciones y determinaciones del Tribunal de Cuentas, así como las lagunas en los controles internos, influyen en las irregularidades en los municipios, pequeños, medianos y grandes. El volumen de transferencias legales y constitucionales recibidas influye en los municipios pequeños y medianos, mientras que el producto interno bruto (PIB) municipal influye en los municipios medianos.

Abstract The municipal external control exercised by the Courts of Accounts reveals the irregularities found in the accounts of municipal governments through the disclosure of audit reports. They have been empirically analyzed from the point of view of their classification in terms of severity, but few studies aim to identify the factors that influence such failures. Having verified this gap, the main objective of this study is to identify factors that may influence lapses in municipal public management pointed out by the audit of the Court of Accounts. This article contributes to further research on this topic and to improving management in municipalities. This is an exploratory analysis based on econometric models for panel data. The sample includes 179 municipalities in São Paulo, with data for 2011, 2013, 2015, 2017, and 2019. The results suggest that the recommendations and determinations of the Court of Accounts and gaps in internal controls influence irregularities in small, medium, and large municipalities. The volume of legal and constitutional transfers received influences small and medium-sized municipalities, while the municipal gross domestic product (GDP) influences medium-sized municipalities.

Evaluation and analysis on diagnostic criteria for common occupational radiation-induced diseases among radiation workers in some provinces and cities of China / 中华放射医学与防护杂志

Objective:To investigate the application of diagnostic criteria for common occupational radiation-induced diseases to radiation workers, in order to provide a basis for the revision, publicity and standardization of the standards.Methods:Radiation workers were selected from 1 city, 7 provinces and 1 corporation by using cluster random sampling method from January 2021 to May 2021. Awareness of the criteria and the effects of ionizing radiation, and the suggestions for diagnostic works were investigated and analyzed.Results:A total of 2 839 radiation workers were investigated. There were differences in the awareness of different diagnostic criteria, the inclusions in complex diagnostic criteria, the materials required for applying for diagnosis, and the ways of knowing the diagnostic criteria( χ2=416.06, 2 924.14, 83.45, 895.67, 815.94, P<0.001). The correct understanding rates of deterministic effects and stochastic effects were 80.63% and 43.64%, respectively. The acceptance rates in applicable materials were 96.79% for occupational exposure history, 94.72% for occupational health monitoring records and 93.55% for individual monitoring of occupational exposure, respectively. Pre-employment training rate was 80.20%, on-job training rate was 81.19%, and untrained rate was 3.77%. The suggestions to the diagnosis of occupational radiation-induced diseases are to strengthen training, pay attention to individual monitoring, occupational health examination, and strengthen health supervision and law enforcement. Conclusions:Radiation workers have a low awareness rate of certain diagnostic standards and a high awareness rate of diagnostic procedures. Publicity and training of health effects of ionizing radiation and diagnostic criteria of occupational radiation-induced diseases should be strengthened. Diagnostic procedure should be optimized.

Discussion on application of control level of radioactive contamination on personnel′s body surface in a nuclear and radiological emergency / 中华放射医学与防护杂志

There are differences and inconsistencies to some degree in the radioactive contamination control level of personnel′s body surface availiable in many national standards, thus puzzling the users. Therefore, it is proposed to compare the applicable scope, conditions and differences between relevant national standards, and combine with similar clinical nuclear medicine standards of radiological protection content to presevent recommendations on the contamination control level that should be correctly applied in an event of nuclear and radiological emergency. Based on the discussion of similar standards, the contaminated personnel with α of 0.04-10 Bq/cm 2 and β of 0.4-100 Bq/cm 2 are advised to be treated in the institutions with higher than secondary medical insititution. Both α econtamination control levels less than 0.04 Bq/cm 2 and β levels less than 0.4 Bq/cm 2 could be achivable, if fully decontaminated.

Construction of a follow-up evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019) based on Delphi method and analytic hierarchy process / 中华地方病学杂志

Objective:To construct a follow-up evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019), and provide a reference basis for the next revision and improvement of the standard.Methods:The evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019) was preliminarily established by consulting relevant references and materials. The experts in the field of diagnosis, treatment, prevention and control of brucellosis were selected, and two rounds of expert consultation were carried out in the form of questionnaires using the Delphi method. The necessity and availability of evaluation indicators were scored, and suggestions for modifying and adding indicators were put forward. Based on this, a standard follow-up evaluation index system was established. At the same time, a judgment matrix was constructed combined with the Saaty scale, and the analytic hierarchy process was used to calculate the weight of each index in the system.Results:After 2 rounds of expert ( n = 10) consultation, a standard follow-up evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019) was constructed with 3 first-level indexes, 8 second-level indexes and 21 third-level indexes. The positive coefficients of experts in 2 rounds of questionnaires were both 100%; the coefficient of authority of experts was 0.82; the Kendall's coefficients of concordance of first-level, second-level and third-level indexes were 0.722, 0.260, and 0.181, respectively, with P < 0.05. Among the first-level indexes, the weight of standard quality evaluation was the highest (0.364), and the weight of standard implementation status was the lowest (0.278); among the second-level indexes, the combined weight of social benefits was the highest (0.186), and the combined weight of advanced nature was the lowest (0.043); among the third-level indexes, the combined weight of timely diagnosis rate was the highest (0.096), and the combined weight of consistency with technical data was the lowest (0.009). Conclusions:The constructed follow-up evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019) is scientific and reliable, which evaluated qualitatively and quantitatively, reduces the defects of a single evaluation, and provides a basis for subsequent revision and improvement of the standard.

Application of the CBL combined with TBL based on SP teaching method in clinical teaching of department of intensive care medicine / 中华医学教育探索杂志

Objective:To study the teaching effect of the teaching method of case-based learning (CBL) combined with team-based learning (TBL) based on the standard patient (SP) in the clinical teaching of department of intensive care medicine.Methods:A total of 60 medical students clinically studying in the department of intensive care medicine were randomly divided into 2 groups, with 30 students in each group. The two groups received the clinical teaching through the lecture-based learning (LBL) teaching method and the CBL combined with TBL based on SP teaching method respectively. By evaluating the clinical synthesis ability of the students of two groups and the satisfaction survey of the two teaching methods, the teaching effect was evaluated. SPSS 19.0 statistical software was used to perform Chi-square test and t-test. Results:Compared with LBL teaching method, the students who accepted the CBL combined with TBL based on SP teaching method had significantly better clinical comprehensive ability ( P < 0.05), mainly in their clinical thinking ability [(4.18±0.55) vs. (3.66±0.47)], clinical skills [(4.03±0.61) vs. (3.59±0.52)] and communication ability with patients [(4.11±0.58) vs. (3.74±0.50)]. In addition, student satisfaction with teaching methods was also higher ( P <0.05), especially in the satisfaction of learning interest [(4.38 ± 0.72) vs. (3.65±0.56)], self-learning ability [(4.24±0.71) vs. (3.91±0.52)], clinical thinking ability [(4.09±0.66) vs. (3.22±0.54)], communication ability [(4.42±0.60) vs. (3.67±0.48)], and team cooperation spirit [(4.15±0.58) vs. (3.78±0.51)]. Conclusion:The teaching method of CBL combined with TBL based on SP is feasible and has good teaching effect in the clinical teaching of department of intensive care medicine.

Progress and prediction of multicomponent quantification in complex systems with practical LC-UV methods / 药物分析学报

Complex systems exist widely,including medicines from natural products,functional foods,and bio-logical samples.The biological activity of complex systems is often the result of the synergistic effect of multiple components.In the quality evaluation of complex samples,multicomponent quantitative analysis(MCQA)is usually needed.To overcome the difficulty in obtaining standard products,scholars have proposed achieving MCQA through the"single standard to determine multiple components(SSDMC)"approach.This method has been used in the determination of multicomponent content in natural source drugs and the analysis of impurities in chemical drugs and has been included in the Chinese Pharmacopoeia.Depending on a convenient(ultra)high-performance liquid chromatography method,how can the repeatability and robustness of the MCQA method be improved?How can the chromatography conditions be optimized to improve the number of quantitative components?How can computer software technology be introduced to improve the efficiency of multicomponent analysis(MCA)?These are the key problems that remain to be solved in practical MCQA.First,this review article summarizes the calculation methods of relative correction factors in the SSDMC approach in the past five years,as well as the method robustness and accuracy evaluation.Second,it also summarizes methods to improve peak capacity and quantitative accuracy in MCA,including column selection and two-dimensional chromatographic analysis technology.Finally,computer software technologies for predict-ing chromatographic conditions and analytical parameters are introduced,which provides an idea for intelligent method development in MCA.This paper aims to provide methodological ideas for the improvement of complex system analysis,especially MCQA.

Índices fisiológicos não hiperêmicos ­ base teórica, aplicações clínicas e limitações / Non-hyperemic pressure ratios ­ theoretical basis, clinical applications, and limitations

A fisiologia coronariana tornou-se o padrão de tratamento para avaliar o significado funcional da doença aterosclerótica coronariana. Ela permite identificar isquemia miocárdica em nível de vaso, discriminar os padrões funcionais da doença aterosclerótica e orientar a necessidade de revascularização; complementar o planejamento da intervenção coronária percutânea e confirmar o sucesso funcional dessa última. Em uma edição anterior do Journal of Transcatheter Interventions, apresentamos uma revisão abrangente sobre o fluxo fracionado de reserva do miocárdio. Apesar do robusto corpo de evidências que apoiam seu uso, a aceitação clínica do fluxo fracionado de reserva é variável e excessivamente baixa em muitas áreas do mundo. O aumento percebido no tempo do procedimento, o uso de agentes hiperêmicos com seus correspondentes custos e desconforto do paciente, e a dificuldade de interpretação dos resultados em determinadas situações anatômicas contribuíram para a adoção limitada do método. A introdução do índice de fluxo instantâneo no período livre de ondas superou a maioria dessas limitações. Apoiada por uma validação técnica sólida e dados de desfechos clínicos, o índice de fluxo instantâneo no período livre de ondas recebeu as mesmas indicações clínicas que o fluxo fracionado de reserva nas recomendações mais recentes das diretrizes. Isso foi seguido pela introdução de outros índices pressóricos não hiperêmicos, já comercialmente disponíveis. Neste artigo, revisamos as bases fisiológicas que justificam o uso de índices pressóricos não hiperêmicos, sua validação técnica e clínica e dados de desfechos clínicos, além de discutirmos suas aplicações em situações anatômicas específicas, com exemplos de casos dos autores, sempre que aplicável.

Coronary physiology has become the standard of care to assess the functional significance of coronary atherosclerotic disease. It allows for identification of myocardial ischemia on a vessel level, discrimination of the functional patterns of atherosclerotic disease, guidance for the need of revascularization, complements the planning of percutaneous coronary intervention and verification of the functional success of percutaneous coronary intervention. On a previous issue of the Journal of Transcatheter Interventions, we presented a comprehensive review about fractional flow reserve. Despite the robust body of evidence supporting its use, the clinical use of fractional flow reserve is variable, and unreasonably low in many areas around the globe. The perceived increase in procedure time, the use of hyperemic agents with its related costs and patient discomfort, and difficulty in interpreting results in certain anatomical scenarios have contributed to the limited adoption of fractional flow reserve. The introduction of instantaneous wave-free ratio overcame most of these limitations. Supported by sound technical validation, and clinical outcomes data, instantaneous wave-free ratio received the same clinical indications as fractional flow reserve in the most recent guidelines recommendations. This was followed by the introduction of other non- hyperemic pressure ratios for commercial use. In the current manuscript we review the physiological basis that supports the use of non-hyperemic pressure ratios, their technical and clinical validation, clinical outcomes data, and discuss its applications on specific anatomic scenarios, with examples of cases from the authors, whenever applicable.

Determination of suspended erythrocyte volume range and establishment of its internal control standard / 中国输血杂志

【Objective】 To determine the volume range of suspended erythrocyte and establish its internal control standard. 【Methods】 The theoretical value of suspended erythrocyte volume was calculated according to the screening criteria of healthy blood donors and Quality Requirements for Whole Blood and Blood Components. A total of 2 410 bags of 1 U and 2 U suspended erythrocyte were randomly selected and weighed, and the volume range were formulated by ±2S and ±10% respectively and then compared to determine the volume range in line with the actual situation of our center. 【Results】 The theoretical volume range of 1 U and 2 U suspended erythrocyte were 117-160 mL vs 234-320 mL, and the actual volume range were 142-180 mL vs 276-393 mL. The volume range of 1 U and 2 U suspended erythrocyte formulated by ±2S were 145-181 mL vs 298-358 mL, and by ±10% were 147-179 mL vs 295-361 mL. The hematocrit and hemoglobin content of suspended erythrocyte within the actual volume range met the quality requirements. There were fluctuations in the volume of suspended erythrocyte from different regions. 【Conclusion】 Based on the actual situation of our center and the sampling results of suspended erythrocytes in recent two years, 163 mL±10% and 328 mL±10% were determined as the internal control standards of 1 U and 2 U suspended erythrocyte, respectively. Blood centers should establish accurate and feasible standard of suspended erythrocyte according to the actual situation.

Factors influencing hemolysis rate of leukocyte-reduced red blood cells at the end of preservation period in blood donors / 中国输血杂志

【Objective】 To compare the current standards and explore the influencing factors for hemolysis rate of leukocyte-reduced red blood cells at the end of the preservation period, in order to formulate reasonable internal control indicators. 【Methods】 A retrospective analysis was performed on hemolysis rate of 427 samples of leukocyte-reduced red blood cells at the end of the preservation period in Nanning Blood Center from 2015 to 2022. Compared with the current standard for hemolysis rate at the end of the preservation period (GB 18469-2012 Quality Requirements for Whole Blood and Component Blood), the differences were analyzed, and the factors influncing the hemolysis rate were analyzed in terms of different blood donor groups. 【Results】 1) Among the 427 samples, the hemolysis rate of 418 (97.89%) did not exceed 0.4%, all lower than 0.8%; 2)the hemolysis rate of the male group was higher than that of the female group; 3) the hemolysis rate of the 18-29 years old group was lower than that of the 30-39 year old group and the 40-60 year old group, with statistically significant difference; 4) in terms of occupation, the hemolysis rate of students was the lowest, and the differences between groups were statistically significant; 5) no statistical significance was found in ethnicity and blood type. 【Conclusion】 Statistics indicated that gender, age, blood donation volume and occupation of blood donors were the influencing factors of hemolysis rate. The current standard is obviously higher in the qualified range of blood quality control in Nanning. It is advisable to formulate a reasonable quality control strategy with internal control index of hemolysis rate set <0.4%, which is conducive to making accurate evaluation of internal quality control and ensuring blood safety.

Assessment of Radiation Shielding Requirements for Radiotherapy Room—Part 2: Radiotherapy Room of Electron Linear Accelerators (GBZ/T 201.2—2011): A survey of relevant personnel in medical institutions / 中国辐射卫生

Objective To investigate the awareness of the Radiation Shielding Requirements for Radiotherapy Room–Part 2: Radiotherapy Room of Electron Linear Accelerators (GBZ/T 201.2—2011) among relevant practitioners in medical institutions as well as its implementation and application situation and collect relevant problems and suggestions for an evaluation of the scientificalness, standardization, and timeliness of the standard, and to provide a scientific basis for the further revision and implementation of the standard. Methods An online questionnaire survey was conducted among relevant employees in medical institutions providing medical linear accelerator radiotherapy across 22 provinces of China, which investigated the awareness, training, application, and revision suggestions related to GBZ/T 201.2—2011. The questionnaires were collected and analyzed. Results A total of 340 relevant practitioners filled out the questionnaire. Of the participants, 66.80% were physicists; 79.11% had an awareness of the standard; 56.18% ever participated in the standard-related training; but the survey results showed that the practitioners did not have a good knowledge of the standard’s content, and the training and promotion were not enough; 83.24% thought that the standard had been widely used; 17.60% thought that the standard needed to be revised; 76.76% thought that there was a need to add calculation examples; 88.82% thought that neutron shielding needed to be considered for the 10 MV X-ray accelerator room. Conclusion The standard has been widely known in the field of radiotherapy protection. With the development of radiotherapy technology, the standard should be revised to add calculation examples and consider neutron shielding in the 10 MV X-ray accelerator room. The standard is highly technical and difficult to grasp, so the promotion and implementation goals should be appropriate for different personnel groups, the training for employees at key posts should be strengthened, and the methods recommended in the standard should be uniformly used throughout the country.

Establishment of HPLC fingerprint and content determination of 8 components in Jianpi huayu decoction / 中国药房

OBJECTIVE To establish the HPLC fingerprint of Jianpi huayu decoction， and to determine the contents of 8 components. METHODS Thermo Hypersil Gold C18 column was used with mobile phase consisted of methanol-0.05% phosphoric acid aqueous solution （gradient elution） at the flow rate of 1.0 mL/min. The column temperature was 30 ℃， the injection volume was 5 μL. The detection wavelength of matrine was 211 nm， and the other components’ detection wavelength was 283 nm. The similarity evaluation of HPLC fingerprints for 10 batches of Jianpi huayu decoction was performed by using the Similarity Evaluation System of Chromatographic Fingerprint of Traditional Chinese Medicine （2012 edition）. The contents of chlorogenic acid， vanillic acid， p-coumaric acid， ferulic acid， hesperidin， quercetin， bergapten and matrine in the samples were determined by HPLC. RESULTS HPLC fingerprint of Jianpi huayu decoction was established. A total of 27 common peaks were identified， and 8 components were identified. The similarity between 10 batches of samples and the control map ranged from 0.942-0.999. RSDs of precision， repeatability and stability tests were less than 3% （n＝6）. The average recoveries of chlorogenic acid， vanillic acid， p-coumaric acid， ferulic acid， hesperidin， quercetin， bergapten and matrine were 99.48%， 101.32%， 101.18%， 100.79%， 101.12%， 99.19%， 99.81% and 102.46%， respectively； RSDs were 1.34%， 0.93%， 1.90%， 1.84%， 0.54%， 1.53%， 1.33% and 1.01%， respectively （n＝6）. The contents were 0.021-0.061， 0.025-0.034， 0.116-0.295， 0.006- 0.062， 0.014-0.053， 0.017-0.026， 0.014-0.027 and 14.05-24.11 mg/g， respectively. CONCLUSIONS The established fingerprint and content determination method can provide a reference for the quality control and subsequent preparation development for Jianpi huayu decoction.