In order to further improve the prediction accuracy of typhoon simulation method for extreme wind speed in typhoon prone areas, an improved typhoon simulation method is proposed by introducing the Latin hypercube sampling method into the traditional typhoon simulation method. In this paper, the improved typhoon simulation method is first given a detailed introduction. Then, this method is applied to the prediction of extreme wind speeds under various return periods in Hong Kong. To validate this method, two aspects of analysis is carried out, including correlation analysis among typhoon key parameters and prediction of extreme wind speeds under various return periods. The results show that the correlation coefficients among typhoon key parameters can be maintained satisfactorily with this improved typhoon simulation method. The results show that the improved typhoon simulation method can generate the correlations among all typhoon key parameters satisfactorily. Compared with the traditional typhoon simulation method, the improved typhoon simulation method has higher accuracy in predicting the typhoon extreme wind speed in Hong Kong, increasing by about 8% and 11% respectively at 200 m height and gradient height. The southeast coastal region of China is the typhoon-prone region of the Northwest Pacific area2. Thus, to ensure the safety of wind -sensitive structures in these areas, it is essential to determine extreme wind speeds of structures for a given return period which can provide support for the structure design and safety assessment4.Typhoon is the most often extreme weather on earth and gives a massive threat to the safety of wind-sensitive structures, such as tall buildings, long-span bridges and other unique buildings10. Within this method, historical typhoon wind data is first used directly or indirectly to determine the probability distributions of typhoon key parameters. Then, a series of typhoon key parameters are generated by Monte Carlo simulation method, and these typhoon key parameters are substituted into the typhoon model for a series of typhoon simulation. Finally, extreme wind speed analysis is used to obtain the extreme wind speeds under different return periods in the specific areas. This method was first proposed by Russell9 and applied to the prediction of extreme wind speeds in Texas coast. Subsequently, Batt et al.5, Shapiro11 and Georgiou et al.6 also predicted extreme wind speeds with the typhoon simulation method. But different typhoon models developed by themselves were used in these studies. Later, Vickery and Twisdale10 obtained typhoon extreme wind speeds under different return periods along the typhoon-prone coastline of the United States by incorporating its developed typhoon model and filling model into typhoon simulation method. Ishihara and Yamaguchi12 obtained extreme wind speeds over complex terrain with the typhoon simulation method and measure-correlate-predict method. Kim and Lee13 developed a typhoon simulation method based on models for genesis, intensity, tracks and wind field to estimate the extreme wind speed of future typhoons.In past years, many researchers have carried out a series of studies on the prediction of typhoon extreme wind speed. The typhoon simulation method has been developed gradually and widely used to predict typhoon extreme wind speedAlthough the above research improves the application of typhoon simulation method in extreme wind speed prediction by developing typhoon model, increasing sample length and other related aspects, continuous efforts are still required to establish more accuracy typhoon simulation method. To cater for this need, this paper presents an improved typhoon simulation method by incorporating Latin hypercube sampling method into the traditional typhoon simulation method. The proposed method is able to reproduce the correlation among typhoon key parameters accurately and thus can improve the prediction accuracy of extreme wind speed in the typhoon-prone regions. The proposed method is utilized to the prediction of extreme wind speed in different periods in Hong Kong. The effectiveness of this method is verified by comparing the historical typhoon wind data, the improved typhoon simulation method and the traditional typhoon simulation method.The steps for the improved typhoon simulation method are summarized as follows.p0, the translation velocity c, the moving direction θ, the minimum of closest distance dmin and the radius to maximum winds rm obtained from the historical typhoon wind data are expressed by a vector {x}, as follows:Typhoon key parameters including the central pressure difference ∆S] and [R] can be calculated according to Eqs. ..S] and [n in Eq. .2\docume−1 (the inverse of the upper triangular matrix [T]) and the typhoon key parameter vector{x}, as shown in Eq.  and n random values for n equaling intervals can be generated14. Then, the vector In vector {z}, the independent typhoon key parameters represented by each column of data correspond to vector {x}. The central pressure difference ∆T] can be multiplied by the above vector In order to obtain the simulated typhoon key parameter vector 7, by using Latin hypercube sampling method, the correlations among typhoon key parameters can be maintained satisfactorily in generating the simulated typhoon key parameters.Unlike the Monte Carlo simulation methodc is always maintained until it disappears. The model proposed by Vickery and Twisdale10 was used to calculate the central differential pressure ∆p0, and the central differential pressure ∆p0 remains unchanged. This study adopts the empirical typhoon model proposed by Ishihara et al.15, which is described in detail in Huang et al.16, but I will not elaborate on it here.In order to obtain an initial typhoon position, we bring the simulated typhoon key parameters into the typhoon wind field model. Then, it is assumed that the typhoon moves in a straight path, and the moving speed 17 to calculate the typhoon extreme wind speed.This paper uses the typhoon extreme wind speed theoryv is Fv, if the maximum score of a typhoon is U, the probability that the U in n typhoons is less than v is recorded asAssuming that the probability that the wind speed of a typhoon is less than a specific wind speed U < v in τ years, Eq.  satisfies the Poisson distribution, and the Eq.  Distribution is used in this study and can be written in the form:mentclasspt{minimaHong Kong is used as the concerned area for the prediction of extreme wind speeds in this study.This article uses the typhoon historical data from 1949 to 2019 observed by the Shanghai Typhoon Research Institute of the China Meteorological Administration to select the typhoon data 250 km away from Hong Kong to obtain the key parameters of the typhoon.4 found that there is a certain correlation between the different typhoon key parameters. Therefore, this study conducted a correlation analysis on the key parameters of historical typhoons observed in Hong Kong, and the results are shown in Table p0 and radius to maximum wind rmax with correlation coefficient − 0.52. Therefore, It is important to simulate a better typhoon key parameter correlation to simulate a better typhoon wind field.Xiao et al.By performing procedures for generating the simulated typhoon key parameters with Latin hypercube sampling method as shown in section 2.1, thousands of simulated typhoon key parameters for Hong Kong can be generated and they can be used in the correlation analysis. Through the correlation analysis of the key parameters of the typhoon obtained by the simulation, the correlation coefficients are obtained, as shown in Table λ to simulate the maximum annual wind speed sequence and show in Fig. The maximum annual wind speed sequence of the typhoon at 200 m height and gradient height are important for the simulation of typhoon wind field. This paper uses the key parameters of the simulated typhoon in the previous section, combined with the typhoon model and the typhoon annual incidence Based on annual maximum wind speed, the Gumbel distribution in conjunction with the extreme wind speed analysis method shown in Sect. 1.3 is used to obtained typhoon extreme wind speed. By using three different typhoon simulation methods , the typhoon extreme wind speeds under different return periods are calculated and shown in Table An improved typhoon simulation method was proposed by introducing Latin hypercube sampling method into traditional typhoon simulation method. This method includes generating the simulated typhoon key parameters with Latin hypercube sampling method, generating typhoon wind field with typhoon model and performing extreme wind speed analysis. Then, this method was validated through correlation analysis among typhoon key parameters and prediction of typhoon extreme wind speed in Hong Kong. The results show that the improved typhoon simulation method can generate the correlations among all typhoon key parameters satisfactorily. The maximum difference of correlation coefficient for typhoon key parameters obtained from the traditional typhoon simulation method and historical typhoon wind data is 1.33. The corresponding relative error of the correlation coefficient is about 102%. Compared with the traditional typhoon simulation method, the improved typhoon simulation method has higher accuracy in predicting height and gradient height. Thus, the improved typhoon simulation method has better simulation results for the extreme wind speed of the typhoon.


N = 1,076) suggest good to very good psychometric properties and moderate to excellent internal consistencies. Confirmatory factor analysis (CFA) models suggest a very good model fit for the first-order, four factor models of the Carver-White BIS/BAS scales, Reinforcement Sensitivity Theory – Personality Questionnaire (RST-PQ), the two-factor model of revised Reinforcement Sensitivity Theory-Questionnaire (rRST-Q) and for the bifactor model of the Conflict Monitoring Questionnaire (CMQ-44). The CMQ-44 extends the psychometric measurement of previous trait-(r)BIS and trait-BAS scales. Factor scores of CMQ-44 cognitive demand correlate positively with factor scores of Carver-White BIS and all Carver-White BAS subfactors except RST-PQ-Impulsivity suggesting that CMQ-44 cognitive demand addresses Carver-White trait-BIS specifically and more generally the trait-BAS core. CMQ-44 anticipation of negative consequences and response adaptation correlate negatively with trait-BAS, whereas the second-order factor performance monitoring extends the rRST trait-space and correlates positively with trait-BAS.This study highlights psychometric properties and evidence of construct validity on parcel-level for questionnaires on the original and revised reinforcement sensitivity theory. Our data ( The reinforcement sensitivity theory RST,  and its a priori predicted convergent and discriminant construct validity RST-related questionnaires examined in this study, psychometric properties have been reported as a part of the construct validation . In termThe Carver and White BIS/BAS scales  with theThe factorial validity of the German Carver-White BIS/BAS scales, the RST-PQ, and the rRST-Q has been confirmed by means of CFAs . FurtherAs a new development, the conflict monitoring questionnaire CMQ,  investigEffects of measurement equivalence have been rarely addressed in previous CFA studies on (r)RST questionnaires. Beyond CFA modeling, effects of gender and/or age groups have been reported on the scale-level for the German version of the Carver-White BIS/BAS scales  and the Additionally, none of the (r)RST CFA studies investigated a hierarchical structure of the BIS/BAS sub-scales. As Previous studies revealed positive inter-correlations between trait-BIS scales of the Carver-White BIS/BAS scales , the RSTCognitive demand has been discussed in the context of the conflict-monitoring-theory  as a detThe CMQ-44 response adaptation scale is thought to be positively related to previous (r)RST-related trait-BIS scales because CMQ-44 response adaptation can serve to inhibit behavior especially when response adaptation occurs in a less adaptive manner. When CMQ-44 response adaptation is performed in a reactive, more flexible manner, higher scores of the CMQ-44 response adaptation scale could also correlate positively with trait-BAS scales and negatively with previous trait-(r)BIS scales. If the CMQ-44 response adaptation correlates negatively with previous trait-(r)BIS scales this would indicate that response adaptation extends previous trait-BIS scales by measuring a more flexible, reactive adaptation of responses instead of a fixed, proactive adaptation of responses .CMQ-44 uncertainty of reinforcement measures the tendency to be sensitive for situations that are ambiguously reinforcing because situations are rewarding as well as punishing or they are so complex for the decision process that the reinforcing value cannot be defined. CMQ-44 uncertainty of reinforcement should enhance behavioral inhibition tendencies and, therefore, correlates positively with (r)RST-related trait-BIS scales. Moreover, higher scores of CMQ-44 uncertainty of reinforcement should reduce behavioral approach tendencies and, therefore, -if at all- is negatively related to (r)RST trait-BAS scales. Presuming that people take the risk of errors into account, higher scores of CMQ-44 uncertainty of reinforcement could be positively related to approach behavior as measured with trait-BAS scales. The predictions of the CMQ-44 subscales with previous (r)RST-related trait-BIS and trait-BAS scales are summarized in a priori which items are thought to measure the latent constructs or at least parts of those constructs  because item misspecifications are ignored otherwise. The argument probably neglects the fact that items for the measurement of personality traits and intelligence have been sometimes constructed in an inductive, empirical manner rather than in a theory-driven approach as recommended by means of facet theory . To investigate construct validity in a test-fair manner for all (r)RST questionnaires in this study, items of all (r)RST questionnaires have been parceled with regard to their a priori defined construct content RST questionnaires – except the CMQ-44 – have been mainly investigated on the item-level. Parceling items  has beennstructs . In this critics . Marsh et theory . Thus, i content . This pra priori predicted convergent and discriminant validity (Based on prior findings we investigate the following research questions. (1) Are psychometric properties for the (r)RST-related questionnaires comparable to prior findings? (2) Can factorial validity of the four German (r)RST questionnaires  be confirmed based on the parcel level? (3) Are (r)RST latent factors equivalent across gender? (4) Do the factor scores for the best fitting CFA models provide evidence of validity ?N = 1,127 participants took part in a Unipark survey that was performed in collaboration with Respondi AG1 between November 2020 and January 2021 (n = 88 were assessed via Unipark by a research assistant in the team of the first author). The psychometric survey along with the research questions was approved in September 2020 by the Ethics committee of the Medical Faculty at the University of Kiel, Germany. Hypotheses in a priori . We recruited participants in three examination intervals via Respondi AG. The first examination was performed between 24-November-2020 and 13-December-2020 with n = 44 participants in a pre-test and n = 471 participants in the main test. The second examination interval included n = 2 participants in the pre-test and n = 523 in the main test lasting from 13-January-2021 until 25-January-2021. The third Unipark assessment started on 17-December-2020 and ended on 20-February-2021 with n = 5 participants in a pre-test and n = 83 participants who took part in the main test (n = 88 see above). Overall, of the N = 1,128 participants we excluded n = 51 pre-test participants because pre-tests included slight changes in the Unipark programming. One participant younger than 18 years was excluded.A total of N = 1,076 participants aged between 18 and 66 years  for statistical analysis. We planned a widely equal recruitment of four age groups between 18 and 28 years (n = 317), 29 and 39 years (n = 250), 40 and 50 years (n = 286), and 51 and 66 years (n = 223). A total of n = 514 female and n = 559 male participants took part in this study (for gender proportions in Germany2). Three participants classified their gender as diverse. Participants received a reimbursement credit via Respondi AG redirects of about 5 €. The study plan was pre-registered in Hogrefe Verlag, Germany . Data acquisition was funded by the University of Kiel, Germany.The final sample comprised Participants were asked to answer demographic variables . Afterward participants answered the items of four questionnaires in German language in the following sequence: (1) Conflict monitoring questionnaire CMQ-44 , (2) ReiThe CMQ originally includes 60 items with a 6-point Likert response scale: 1 = trifft überhaupt nicht zu , 2 = trifft überwiegend nicht zu (does mainly not correspond), 3 = trifft eher nicht zu (does rather not correspond), 4 = trifft eher zu (does rather correspond), 5 = trifft überwiegend zu (does mainly correspond), 6 = trifft vollständig zu (does completely correspond). The CMQ incorporates four latent factors named as structs in terms of facet theory . Two latThe German version of the RST-PQ  includesn = 88 who were recruited and reimbursed at the University of Kiel, Germany, in the team of the first author).At the start of the Unipark link, participants were informed about the study, duration per examination (about 30–40 min), and contact persons who were prepared to answer questions on the study. Participants were instructed to answer the items in a well-lit, quiet room with no disturbance during item answering and no participation of others. When participants gave written informed consent, they obtained demographic and questionnaire items for answering. Respondi AG handled the recruitment and reimbursement  of most participants  and for trait-BAS in the Carver-White BIS/BAS two factor model  with women (n = 514) and individuals who classified themselves as diverse (n = 3) showing higher trait-BIS and higher trait-BAS values than men (n = 559). In the Carver-White BIS/BAS four factor model, female and diverse individuals showed higher trait-BIS, trait-BAS-reward reactivity and trait-BAS-drive values than men .Effects of measurement equivalence across gender have not been predicted p < 0.01) and higher trait-BAS values  than men. Regarding the RST-PQ four-factor models for trait-BIS and trait-BAS, respectively, women and individuals who classified themselves as diverse scored higher than men for all four trait-BIS subscales . For the trait-BAS subfactors exclusively Goal-drive persistence and Reward reactivity were higher for female and diverse participants compared to men .For the RST-PQ two-factor model, women revealed higher trait-BIS values , whereas no gender differences were observed for trait-BAS . Finally, for the CMQ-44, women and participants who classified themselves as diverse reported higher Cognitive demand values than men . Men showed higher CMQ-44 anticipation of negative consequences values than women and individuals who classified themselves as diverse . Response adaptation was higher in female and diverse participants compared to male participants . Moreover, Performance monitoring (G) was higher in male individuals compared to female and diverse participants . No significant gender differences were observed for CMQ-44 uncertainty of reinforcement . For the CMQ-28, gender differences were not robust compared with CMQ-44 . In contrast to the CMQ-44, CMQ-28 uncertainty of reinforcement indicated higher factor scores for female and diverse participants compared to male participants . Comparable to the CMQ-44, CMQ-28 performance monitoring revealed higher path coefficient for men compared to women and diverse individuals .For the rRST-Q, women and individuals who classified themselves as diverse indicated higher trait-BIS values than men RST questionnaires that indicated the best model fit in terms of two or even three model fit indices see . We indiCognitive demand correlated positively exclusively with the Carver-White BIS factor score . ContrarWe observed positive and mainly significant inter-correlations of CMQ-44 cognitive demand with the factor scores of the other trait-BAS factors revealing that CMQ-44 cognitive demand facilitates reward-related behavior . NegativThe present study investigated psychometric properties (research question 1), evidence of factorial validity of (r)RST questionnaires (research question 2), effects of measurement equivalence for the latent (r)RST factors (research question 3), evidence of convergent and discriminant validity (research question 4). Our data reveal comparable and convincing evidence for the psychometric properties of the (r)RST questionnaires. Factorial validity has been confirmed for all (r)RST questionnaires. Best model fits have been observed for the four factor models of the Carver-White BIS/BAS scales , the four trait-BIS and four trait-BAS factors of the RST-PQ, the two-factor model of the RST-Q and for the CMQ-44 as well as CMQ-28 bifactor models. Gender effects were found for all inserted (r)RST questionnaires limiting measurement equivalence of the latent factors. Convergent validity for CMQ-44 cognitive demand has been exclusively observed with the Carver-White trait-BIS scales. Overall, the other CMQ-44 factors  rather extend the previous trait-BIS and trait-BAS space.Correlating positively with most of the previous trait-BAS factors, the CMQ-44 cognitive demand factor appeared to be a BAS-facilitating factor . A similExperimental studies investigating neural activations  will elucidate the contextual foundations and individual differences of the CMQ-44 factors to further our understanding on changes between checking and control mode of the BIS . For theThe present data motivate further research on emic and etic issues of (r)RST questionnaires in English-speaking samples. As (r)RST questionnaires have been applied in clinical samples , forensiThe present data suggest that the Carver-White BIS/BAS scales, the RST-PQ, the rRST-Q and the CMQ-44/28 are promising personality questionnaires for the (r)RST trait space with sufficient psychometric properties. Confirmatory factor models have been mainly confirmed for trait-BIS and trait-BAS. Gender effects matter for the assessment of trait-BIS and trait-BAS. We provide evidence that factor scores are a promising tool compared to unit-weighted sum scales to elucidate convergent and discriminant validity of the trait-BIS and trait-BAS factors. These data are promising to investigate changes of the BIS from checking to control , to predhttps://osf.io/9vu8e/?view_only=9655b511443c4c5e95f9393fcb15622c.As all inventories are part of an on-going construct validation process original data, code books, or program code will be made available in PsyArxiv upon request to the first author and depending on further validation studies: The studies involving human participants were reviewed and approved by Ethics Committee of the Medical Faculty, University of Kiel, Germany. The participants provided their written informed consent to participate in this study.AL: conceptualization, data curation and collection with team support and data processing, analysis, and wrote the manuscript. UE, MR, and PC: co-authors of the previous questionnaires for measuring the personality traits of (revised) reinforcement sensitivity theory, read, and commented on the manuscript prior to submission.


Dietary Guidelines for Americans. NESR’s systematic review methodology is rigorous, protocol-driven, and highly collaborative. NESR’s systematic reviews examine the complex interplay between diet and health with input and support from various collaborators, including Federal stakeholders, expert groups, and public stakeholders. Implementing NESR’s rigorous methodology ensures that the appropriate steps are taken to minimize conflict of interest, producing systematic reviews that are high-quality, trustworthy, and useful to end users who make decisions based on their findings. This article describes how NESR’s systematic review process leverages a diversity of expertise and experience, while managing potential conflicts of interest. It describes the groups who collaborate to conduct NESR systematic reviews, their expertise, and why their involvement is critical for ensuring the rigor and utility of NESR’s work.U.S. Department of Agriculture’s (USDA) Nutrition Evidence Systematic Review (NESR) Branch develops food-and nutrition-related systematic reviews and other evidence synthesis products. NESR has established itself as a key resource for the Federal government when making evidence-informed decisions related to public health nutrition, such as the development of the  Dietary Guidelines for Americans.In 2008, the U.S. Department of Agriculture’s (USDA), Food and Nutrition Service, Center for Nutrition Policy and Promotion (CNPP) launched the Nutrition Evidence Systematic Review (NESR) Branch to develop food-and nutrition-related systematic reviews and other evidence synthesis products. NESR was created to support CNPP’s mission of improving the health of Americans by developing and promoting dietary guidance that links scientific research to the nutrition needs of consumers. Public health nutrition decision-making is strengthened when informed by scientific evidence – and NESR has established itself as a key resource for the Federal government when making evidence-informed decisions related to public health nutrition, such as the development of the NESR systematic review projects uphold the Data Quality Act , which mNESR’s systematic review methodology is rigorous, protocol-driven, and highly collaborative. NESR’s systematic reviews examine the complex interplay between diet and health with input and support from various collaborators, including Federal stakeholders, expert groups, and public stakeholders. Implementing NESR’s rigorous methodology ensures that the appropriate steps are taken to minimize bias, producing systematic reviews that are high-quality, trustworthy, and useful to end users who make decisions based on their findings. To help meet goals for transparency and reproducibility, complete documentation of NESR’s work is made accessible to the public on the NESR website.This article serves as an opportunity to describe how NESR’s systematic review process leverages a diversity of expertise and experience, while managing potential conflicts of interest (COI). It describes the groups who collaborate to conduct NESR systematic reviews, their expertise, and why their involvement is critical for ensuring the rigor and utility of NESR’s work.The NESR Branch consists of a team of career Federal scientists, including analysts and librarians. Given that the NESR branch is housed within the USDA, the team adheres to USDA’s Scientific Integrity Policy and other Agency and Federal government standards of ethical conduct .NESR analysts are scientists with doctoral  or master’s  degrees in nutritional science or related fields such as public health, biochemistry, or biology. Some also have a registered dietitian (RD) or registered dietitian nutritionist (RDN) credential. NESR analysts have demonstrated expertise in conducting research on a range of diet and health-related topics . They alNESR librarians are information specialists with master’s degrees in library and information science. NESR librarians have extensive training and expertise in methodology and technology  for a range of diet and health-related topics. Specifically, they also have knowledge of bibliographic databases , including search terms appropriate for each database, and search refinements, such as search filters.NESR systematic reviews are conducted with input and support from various collaborators, including Federal stakeholders, expert groups, and public stakeholders. Having the input and support of diverse collaborators, who each provide informed and unique perspectives, helps maintain the rigor, integrity, and trustworthiness of NESR systematic reviews as well as the overall process. NESR’s systematic review process and methodology leverage collaborators’ expertise, while clearly delineating roles and responsibilities, and managing potential COI throughout. Federal stakeholders encompass a broad range of Federal career staff from agencies with nutrition-related work in one or more of their mission areas, such as the USDA, U.S. Department of Health and Human Services (HHS), U.S. Department of Veterans Affairs, U.S. Environmental Protection Agency, U.S. Department of Defense, and the U.S. Agency for International Development. Federal stakeholders may be scientists, nutritionists, program-and policy analysts, or guideline developers who have an interest in NESR systematic reviews and/or the evidence supporting them. Federal stakeholders may have advanced degrees in nutritional science or a related field, subject matter expertise in topics related to diet and health, knowledge of the operations and needs of Federal guidance or nutrition-related programs, experience with systematic reviews or evidence synthesis methods, or oversight of research funding. As employees of the U.S. government, Federal stakeholders must adhere to relevant scientific integrity policies within their agency, as well as other statutes, regulations, and agency policies governing ethical conduct .all expert group members is used to make decisions, such that a range of diverse viewpoints and subject matter expertise are considered and balanced when evaluating the evidence.Expert groups consist of nationally recognized scientific experts with demonstrated subject matter expertise on the topic (s) addressed in the NESR systematic review project. These scientific experts have advanced degrees in nutritional science, medicine, and/or a closely related field. Experts may be health professionals , researchers , and/or have specific methodology expertise . Expert group members are selected based on their scientific expertise, while also ensuring that membership is balanced and diverse in terms of points of view, expertise, experience, education, and institutional affiliation, as well as race and ethnicity, gender, and geographic location. They may be Federal employees or external to the Federal government. Potential COI are also assessed and taken into consideration when forming expert groups to determine whether anything could potentially bias the technical contributions of an individual or give the appearance of bias. If such potential conflicts are found, the individual expert may not be invited to participate, or, the individual may participate, but their conflicts are managed by the NESR team. Management of COI involves ensuring that the input of NESR collaborates with two types of expert groups, a Technical Expert Collaborative (TEC), or a Federal Advisory Committee (FAC) known as the Dietary Guidelines Advisory Committee.A TEC is a group of approximately six to eight subject matter experts convened by NESR to conduct one or more systematic reviews on a specific topic. TEC members are identified by NESR and other Federal stakeholders, may be internal or external to the Federal government, and serve without pay for a period of 1–2 years, depending on the size and scope of the project. TEC members disclose potential COI prior to their appointment and periodically during the project, which are reviewed by the USDA Office of Ethics to ensure members have no financial COI that would prohibit serving on the TEC or that would require management by the NESR team. TEC members collaborate with NESR to conduct systematic reviews  that desDietary Guidelines for Americans every 5 years, the USDA and HHS convene a Dietary Guidelines Advisory Committee (the Committee). This Committee consists of approximately 20 members, external to the Federal government, with expertise related to the topics and questions to be addressed. Members are nominated by the public, serve for up to 2 years without pay, and provide the USDA and HHS with independent, science-based advice and recommendations on a broad range of important diet and public health related topics. Committee members must complete the U.S. Office of Government Ethics Form 450 Confidential Financial Disclosure Report , includes definitions for key terms, identifies key confounders and other factors that could affect the relationships examined, and helps ensure that important contributing elements in the causal chain will be examined and evaluated.The synthesis plan specifies how the evidence will be explored, synthesized, and organized in the systematic review based on each question of interest. In addition, the synthesis plan specifies the type of approaches to be used  and confirms visualization methods that will inform the synthesis .Inclusion and exclusion criteria specify characteristics of studies that lead to inclusion or exclusion from the body of evidence used to answer each systematic review question. Criteria are tailored to each systematic review question, and include study characteristics such as study design, publication date, population, country where research was conducted, intervention or exposure of interest, and outcome.Each systematic review protocol includes an analytic framework, synthesis plan, and inclusion and exclusion criteria:The expert group, facilitated by NESR analysts, develops and refines systematic review protocols that are appropriately tailored to ensure that the body of evidence is: applicable to the U.S. population, relevant to U.S. Federal public health nutrition policies and programs, and rigorous and strong from a scientific perspective. Expert groups may build upon a systematic review conducted by a previous expert group and verify the rigor and relevance of the existing protocols. NESR analysts may also solicit input from Federal stakeholders or conduct evidence scans to support protocol development and refinement to ensure the protocol is appropriate for its intended end-use. NESR analysts also monitor and manage potential COI during protocol development.Literature search strategies are developed, implemented, and documented by NESR librarians, with input from NESR analysts and the expert group. Search results are screened, and a manual search is conducted by NESR analysts. The goal of the literature search and screening process is to objectively identify the most complete and relevant body of evidence available to answer the systematic review question.A literature search strategy identifies bibliographic databases, and constructs a search strategy optimized for each database  that returns the complete body of relevant evidence while minimizing irrelevant results. NESR librarians develop, implement, and document a comprehensive literature search strategy using the expert group’s protocol. The expert group and NESR analysts may assist the NESR librarians in developing the search strategy by providing help on subject or topic terminology and technical terms to aid in choosing the most appropriate and comprehensive set of search terms possible. A second designated peer review librarian, who may be from NESR or from another Federal agency , provides comprehensive feedback on the search strategy’s accuracy, as well as usage of search operators, terms, subject headings, and databases. The peer review process provides additional rigor to the NESR process. NESR librarians use the feedback from the peer review librarian to finalize the search strategies and shares the revised search strategy with the expert group and NESR analyst (s) for final approval.all criteria are included in the systematic review. NESR analysts also conduct a manual search to find peer-reviewed published studies not retrieved through electronic databases by hand searching reference sections of included studies and related systematic reviews and meta-analyses. The expert group may also help with manual searches by suggesting potential articles for which NESR should search reference sections. To provide transparency and reproducibility of the systematic review, NESR analysts support NESR librarians in documenting the entire literature search strategy and results according to PRISMA standards  is extracted using a standardized data extraction template. A second NESR analyst reviews the extracted data for completeness, accuracy, and consistent presentation and formatting. Any discrepancies noted by the second analyst are discussed and resolved, in consultation with a third NESR analyst and/or the expert group when needed. NESR analysts use the extracted data to create evidence tables that consistently and objectively present the key data from all studies included in the systematic review. Expert groups provide input on the types and format of data to be extracted and presented in evidence tables and figures.Two NESR analysts independently complete risk of bias assessments for each included article using study-design specific tools . The anaEvidence is synthesized by the expert group, and the process is facilitated and documented by NESR analysts.Evidence synthesis involves describing, comparing and contrasting, and combining all included studies to examine whether the intervention or exposure is related to the outcome in the population of interest. It aims to find overarching themes from the findings, identify and explain similarities and differences between studies, and determine whether certain factors may have affected the relationships being examined.The expert group synthesizes the evidence according to the synthesis plan, which is developed as part of the protocol to help guide how the evidence would be prioritized, organized, synthesized, and presented in the systematic review. The expert group reviews and examines the body of evidence, considering study design, risk of bias assessments, characteristics of PICO elements, and key relationships between the intervention/exposure and outcome(s) of interest, looking for patterns of agreement and disagreement among the reported relationships. The expert group also determines whether methodological differences between the studies may help explain variations in effect sizes or degrees of association. NESR analysts facilitate discussions, monitor and manage potential COI, capture and integrate input from all members, resolve points of uncertainty, and document decisions of the expert group as they synthesize the evidence. NESR analysts also provide additional transparency to the expert group’s synthesis by drafting and/or refining visual presentations of the data.Conclusion statements are developed and the strength of evidence is graded by the expert group, a process facilitated and documented by NESR analysts.Evidence synthesis results in development of a conclusion statement, which is one or more summary statements carefully constructed to answer the systematic review question. Conclusion statements reflect only the evidence reviewed and synthesized as outlined by the protocol and do not take evidence from other sources into consideration. Conclusion statements do not draw implications and should not be interpreted as dietary guidance.The strength of evidence underlying each conclusion statement is graded to communicate the level of certainty in the conclusions . GradingThe expert group develops conclusion statements, focusing on general agreement among studies, acknowledges areas of disagreement if and where they exist, and/or identifies relevant parameters when appropriate . The expert group then assigns a grade to each conclusion statement using the NESR grading rubric to ensure that the final grade reflects consideration of all the grading elements. This grading process promotes consistency across systematic reviews, and allows the expert group to transparently document the strength of evidence underlying their conclusion statement. NESR analysts facilitate discussions to ensure compliance with NESR methodology, and document decisions of the expert group as they develop conclusion statements and grade the evidence underlying each conclusion statement. For reviews conducted with a Dietary Guideline Advisory Committee, the Committee describes their findings, synthesis, conclusion statements and grades during periodic public meetings and considers public comments throughout the review process. The public can attend public meetings to hear the Committee’s deliberation, and are able to submit comments on the Committee’s work through an web-based database. All public comments are collected by the agencies and shared with the Committee for careful consideration and incorporation into the process as feasible.Research recommendations are identified and documented by the expert group and NESR analysts.The expert group and NESR analysts identify gaps and methodological limitations in the evidence throughout the review process. NESR analysts facilitate discussions and document decisions of the expert group as they recommend future research. Research recommendations describe the studies, data, and methodological advances that are needed to strengthen the body of evidence on a particular topic.NESR systematic reviews are peer-reviewed to ensure that the graded conclusion statements are supported by the evidence synthesized. The peer review described in this section is specific to the draft systematic review report; posting of the protocol and peer review of literature search strategies is described and discussed in previous sections. Different approaches to peer review are used depending on the project and may involve peer review coordinated by the journal to which a systematic review manuscript has been submitted, or it may involve peer review by Federal or non-Federal subject matter experts. During the 2020–2025 Dietary Guidelines, the peer review process was coordinated and managed by the USDA’s Agricultural Research Service. Regardless of the approach taken, peer reviewers are individuals who are external to, or not involved in, the systematic review project and who have either subject matter or methodological expertise. NESR analysts are responsible for submitting the draft systematic review for peer review. When peer reviewer comments are returned, the NESR team evaluates the comments and addresses any that are editorial in nature. Substantive comments are reviewed and discussed by the expert group. The NESR team documents revisions and responses, and provides them back to the peer reviewing entity, who then assesses the responses and ensures that the reviewer comments are adequately addressed.NESR systematic reviews are made accessible online . Each systematic review includes a plain language summary, a technical abstract, and a full systematic review containing complete documentation of each step of the review process. The systematic review also presents the literature search strategy, the list of articles that were excluded at the full-text level, and the funding for the systematic review. In some cases, a peer-reviewed publication is also prepared by NESR and the expert group.NESR analyst and librarians are responsible for ensuring that the systematic review documents each step of the review process, including all substantive decisions made by the expert group. The NESR team also ensures that the report is in compliance with Federal agency directives by making sure the document is accessible to people with disabilities . The expThe main output of a NESR systematic review is one or more graded conclusion statements that document the current state of science. When NESR works with a TEC, the input of the TEC stops with the graded conclusion statement (s). And, because a TEC is not a FAC, it does not draw implications from the review or integrate findings from multiple reviews to provide recommendations to the government on the basis of their review. The TEC’s individual completed systematic reviews are provided to the Federal stakeholders who commissioned the work and are responsible for using the review to support decision-making, including the development of nutrition education materials, research agendas and funding priorities, and policy decisions.not the next edition of the Dietary Guidelines for Americans. The Departments consider this report which, along with input from Federal agencies and the public, informs the development of the next edition of the Dietary Guidelines for Americans issued jointly by the Secretaries of USDA and HHS.When NESR works with a FAC, such as the Dietary Guidelines Advisory Committee, the Committee’s work extends beyond that of a TEC. As a FAC, the Committee is tasked with not only reviewing the science, but also integrating the findings from multiple approaches  and drawing implications based on that integration in the Scientific Advisory Report. This report includes independent, science-based advice and recommendations for HHS and the USDA and is Every NESR project is commissioned with the intent that it will be used by Federal stakeholders to inform evidence-based policy and program decisions. It is rare that a single NESR systematic review is used to make a decision; rather, decisions are often informed by an integration of evidence from multiple NESR systematic reviews and other sources of information.Dietary Guidelines for Americans. As an entity that specializes in conducting systematic reviews, NESR is unique in that every NESR review is commissioned with the specific intent of providing Federal stakeholders with information needed to make public health-related decisions. Given the impact that these decisions have on the health of Americans, NESR takes the rigor of its work seriously, producing systematic reviews that are high-quality, trustworthy, and useful to end users.NESR has established itself as a key resource for the Federal government’s evidence-informed decisions related to public health nutrition, such as the development of the The NESR systematic review process, by design, leverages the input and support of its collaborators, including Federal and public stakeholders, as well as two different types of expert groups (TEC or Dietary Guidelines Advisory Committee). NESR utilizes collaborator expertise while maintaining division of responsibilities and managing potential biases and COI throughout the process. Federal stakeholders provide crucial input early in the process to define the scope of the systematic review project and the decisions it will inform. NESR works with expert groups, who develop the protocol, synthesize the evidence, draw conclusion statements, and grade the strength of the evidence. The NESR team supports these expert groups by objectively executing the protocol, completing resource intensive steps such as data extraction and risk of bias assessments, and documenting the systematic review. In this way, the expert group is fully responsible for the results of the systematic reviews. Given the expert group’s large scope of work and tight timeline, having a trained and qualified team like NESR to help with execution ensures that the work is accomplished in a timely manner. NESR supports the most time and resource intensive steps of the systematic review process, which helps to preserve the expert group’s time and expertise for later steps of the process.not be completely isolated from those developing guidelines. However, the National Academies of Sciences, Engineering, and Medicine report, “Redesigning the Process for Establishing the Dietary Guidelines for Americans,” (There are no existing consensus best practices that specify who should play what roles in conducting systematic reviews, particularly those that are commissioned with the intent of informing guidelines or other types of decisions. A Committee of the National Academy of Sciences acknowledged,” it was not appropriate to prescribe a specific model by which systematic reviews are conducted” . This rericans,”  called fricans,”  – which Across organizations that conduct systematic reviews, one area in which there is clear agreement is the need for both methodological and subject matter expertise of the team who conducts the systematic review , 41–44. While there are a variety of collaborative approaches used by evidence synthesis organizations to conduct systematic reviews, there is consistent recognition about the need to manage potential or perceived COI among those involved in the review process. Perceived direct or indirect COI, such as intellectual, financial, or institutional, are commonplace in science . NESR taIn general, NESR takes the view that within the field of systematic review, there is not a single, consensus, “gold standard” method that all organizations should seek to adopt or emulate. Rather, organizations who conduct systematic reviews require flexibility to adapt to the evolving field of systematic review science, with a focus on aligning with best practices. It is NESR’s view that “best practices” applies to the context in which an organization conducts its reviews. Thus, “best practices” are not a one-size-fits-all approach, but rather the development and use of methods that are rigorous, transparent, and minimize bias – and that are tailored to the specific purpose and context of the work. As indicated above, it is critical that a systematic review team with the appropriate content and methodological expertise be assembled and engaged at appropriate points of the process. And that steps be taken to prevent and manage potential COI. This article describes NESR’s process in sufficient detail such that it could be adopted or adapted by other organizations or governments based on their purposes and resources, but is not a formal recommendation to do so.NESR plans to continue learning and collaborating with a broad range of systematic review organizations as it develops and advances its methodology, taking care to understand the rationale underlying various methodological approaches. Future advancements should focus on conducting research and evaluations that can inform the development of best practices for determining who should play each role in conducting systematic reviews, and how potential COI should be identified and managed. There is a need for more publicly available information from systematic review organizations detailing their operating procedures and specifying who completes specific tasks in their systematic review process, and evidence to understand whether different models of collaboration impact the quality or trustworthiness of the a review.NESR’s systematic review process leverages a diversity of expertise and experience, while identifying and managing potential biases and COI. NESR systematic reviews relies on input from many different collaborators, whose expertise and involvement are critical for ensuring the rigor and utility of NESR’s work.JO, RR, NC, LE, MH, and JS are responsible for the design, writing, and final content of the paper. CB, EC, AF, JK, BK, JN, SS-M, AW, and ES provided feedback on the manuscript. All authors contributed to the article and approved the submitted version.Funding for NESR projects come from Federal agencies’ appropriated funds.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


It has been about 30 years since the first health literacy instrument was developed. This study aimed to review all existing instruments to summarize the current knowledge on the development of existing measurement instruments and their possible translation and validation in other languages different from the original languages.The review was conducted using PubMed, Web of Science, Scopus, and Google Scholar on all published papers on health literacy instrument development and psychometric properties in English biomedical journals from 1993 to the end of 2021.The findings were summarized and synthesized on several headings, including general instruments, condition specific health literacy instruments (disease & content), population- specific instruments, and electronic health. Overall, 4848 citations were retrieved. After removing duplicates (n = 2336) and non-related papers (n = 2175), 361 studies  were selected for the final review. The original instruments included 39 general health literacy instruments, 90 condition specific (disease or content) health literacy instruments, 22 population- specific instruments, and 11 electronic health literacy instruments. Almost all papers reported reliability and validity, and the findings indicated that most existing health literacy instruments benefit from some relatively good psychometric properties.This review highlighted that there were more than enough instruments for measuring health literacy. In addition, we found that a number of instruments did not report psychometric properties sufficiently. However, evidence suggest that well developed instruments and those reported adequate measures of validation could be helpful if appropriately selected based on objectives of a given study. Perhaps an authorized institution such as World Health Organization should take responsibility and provide a clear guideline for measuring health literacy as appropriate. The term ‘health literacy’ was first used in 1974 in a paper entitled ‘health education as a social policy’ . The WorHealth literacy is believed to have a vital impact on public health through access to and use of health services , 6. Low Therefore, measuring health literacy is fundamental and needs appropriate measures. Among health literacy instruments, the Rapid Assessment of Adult Literacy in Medicine (REALM) , the TesIn a review of the literature from 1999 to 2013, 51 instruments were identified. Of these, 26 were general health literacy instruments, 15 were condition specific (disease or content), and 10 were health literacy instruments in a specific population . In a reThe electronic databases searched included PubMed, Scopus, Web of Science, and Google Scholar. The aim was to review all full publications in biomedical journals between 1993 and 2021. The search was updated twice: once in January 2022 and once in early February 2022. The year 1993 was chosen since the first standard instrument was reported in 1993.The search strategy was limited to health literacy instruments whose psychometric information was accurately and transparently presented. Papers were retrieved using different combinations of keywords and MeSH terms including; ‘Health literacy’, ‘eHealth literacy’, ‘e-Health literacy’, ‘e Health literacy’, ‘electronic Health literacy’, ‘Tool’, ‘Instrument’, ‘Scale’, ‘Questionnaire’, ‘Measure’ and ‘Inventory’ in the title and abstract of papers.All potentially relevant publications were extracted and reviewed independently by two authors (SM and FZ). Discrepancies between authors were resolved by consensus with the first investigator (MT). Then, qualified studies were obtained for full‐text screening. The three authors extracted the data in order to identify eligible studies. After the final evaluation, the required data were extracted and recorded.The Iranian Academic Center for Education, Culture, and Research (ACECR) approved the study (Code of Ethics approved: IR.ACECR.IBCRC.REC.1397.014).This study included all original papers reporting psychometric properties of health literacy  instruments published in English. Papers only published in journals remained in the study, and books and pamphlets, dissertations, papers presented at conferences, etc., were excluded. All publications were screened using the PRISMA guideline .The quality of papers was evaluated using the Consensus-based Standards for the selection of the health status Measurement Instrument (COSMIN) checklist. The COSMIN initiative aims to improve the selection of health measurement instruments . For theThe data for each paper were extracted and summarized. The summary then was tabulated by a topic. The following information was provided: author(s)’ name, year of publication, validity, and reliability, and type of instruments, including: ‘general health literacy instruments’, ‘condition (disease or content) specific instruments’, instruments that were developed for ‘specific populations’ , and e-HThe study flowchart is presented in There were 39 instruments for measuring general health literacy. Historically among the general instruments, the most frequently used instruments were the REALM , the TOFThere were 90 condition specific (disease & content) instruments. Measuring health literacy for chronic non-communicable diseases, especially diabetes mellitus, has been considered more frequently. At least nine instruments assess health literacy in diabetes. Infectious diseases  were the second topic of interest in developing health literacy measures. These instruments have also been well-reviewed and validated in relevant studies in terms of validity and reliability .Among the instruments with special content, the most frequently used were oral/dental health literacy and mental health literacy. The parental and maternal, insurance, occupational, complementary, and alternative medicine, the responsiveness of primary care practices, weight-specific childhood, overweight, social determinants of health, and non-specific neck pain health food, were other specific content measures .A number of health literacy instruments were designed for a specific population- or specific demographic population (n = 22). The grouping was based on age  or nationality . A list of instruments and their psychometric properties are shown in There were 11 electronic health literacy instruments. Of these, the instrument developed by Norman et al.  was usedThere were a number of instruments that translated and validated in other nations with different demographic backgrounds (n = 199). A list of these instruments is presented in As indicated in the methods section, all papers under review were assessed for quality. The results are shown in Numerous instruments have been developed during the past thirty years for measuring health literacy. This review could provide information on 162 instruments. Of these, there were two well-developed instruments:HLQ, which avoided the use of prevailing theories until the later development process, and great care was taken to fully understand the experiences and lives of people, professionals, and healthcare providers .HLS-EU-Q47, which used conceptual-based, multi-faceted attributes .However, they reported limited psychometric properties. Of the remaining instruments, 15 instruments reported proper psychometric properties needed. In addition, there were a number of instruments that were translated and validated to other languages more frequently. A list of instruments is presented in This bibliometric review covered the literature for about thirty years. The present review extracted and reported a wide range of health literacy instruments in several sections and perhaps could be a good reference for investigators who wish to use an instrument for measuring health literacy. In addition, the current study might help to avoid adding yet another measure to a rather long list of existing instruments.Some general health literacy instruments have multiple versions used in different languages and populations. For instance, there were 16 versions for the REALM , 15 versDespite a large number of general health literacy assessment instruments and specific topics, currently having a unique and international instrument for measuring health literacy is one of the concerns of public health professionals. This study showed that one of the most widely used instruments at the international level is the European Health Literacy Survey (HLS-EU-Q) . During Many instruments were developed to measure health literacy among specific diseases . With the widespread prevalence of chronic non-communicable, there was a strong desire to develop such instruments. As shown in Development and psychometric evaluation of health literacy instruments was observed in different countries. We recognized health literacy instruments in different languages such as Korean, Taiwanese, English, Spanish, American, Australian, German, Switzerland, Finnish, Iranian, Chinese, Japanese, Brazilian, Philippines, and Vietnamese. As shown in One of the unique features of this study is the reporting of e-health literacy instruments. There were eleven instruments available for measuring e-health literacy . The exihttps://qol.eortc.org/quality-of-life-group/).Finally, one should note that the most important question is, do we need so many instruments for measuring health literacy? Although one could not prevent investigators from developing new instruments, it is evident that such haphazard development of instruments is not helpful. It seems that we need a core global general health literacy instrument for use around the globe. Then perhaps it is possible to add a few contents/disease-specific, population- specific, or e-health literacy items to the general instruments according to their use. The experience of the European Organization for Research and Treatment of Cancer-EORTC  might be useful to be adapted Click here for additional data file. 19 Feb 2022AttachmentResponse to Editor.docxSubmitted filename: Click here for additional data file. 2 May 2022
 PONE-D-22-04494

 Measuring health literacy: A systematic review and bibliometric analysis of instruments from 1993 to 2021

 PLOS ONEDear Dr. Ali Montazeri,

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Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes**********  2. Has the statistical analysis been performed appropriately and rigorously?   Reviewer #1: Yes**********  3. Have the authors made all data underlying the findings in their manuscript fully available?PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.  The Reviewer #1: Yes**********  4. Is the manuscript presented in an intelligible fashion and written in standard English?  PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.Reviewer #1: No**********  5. Review Comments to the Author  Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. Reviewer #1: Professor Montazeri’s and colleague’s study appears to do something quite unusual: reviewing the literature on measurement instrument construction for the or concept of health literacy. His own sentence differs slightly: “This study aimed to review all existing instruments to summarize the current knowledge on the topic .” This reads to me as if either the development of measurement instruments was the subject of the review, or the instruments themselves or rather their interrelationship with outcomes, the precise nature of which would remain in the dark,The results and conclusions formulate rather unspectacular assertions, such as there are enough suitable measures of health literacy, there is a strong tradition of disease-specific, group-specific and technology-specific instruments, A minor problem is that of choosing the right measure. The authors forward the idea that the WHO might set some standards for that.The question arises: Do we need a costly systematic review for results and conclusions like those mentioned. And if we go back to the original ideas behind systematic reviewing, One of the purposes of systematic reviewing is to come to a decision if there is evidence, say, for the efficacy of treatment A as well as for treatment B. If review studies of quality exist on the issue, they will tell you which is better, A or B. Nothing of this urgency do we find in the study to be reviewed. And moreover, the authors do not review all of the evidence, deliberately. They include only publications about the development of a measure, or its transfer to another country,Study presentation, explanation, structure and language are fine, though.**********  6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.If you choose “no”, your identity will remain anonymous but your review may still be made public.Do you want your identity to be public for this peer review? 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The PLOS ONE style templates can be found athttps://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf andhttps://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdfThank you. Done.http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. 2. We note that you have indicated that data from this study are available upon request. PLOS only allows data to be available upon request if there are legal or ethical restrictions on sharing data publicly. For more information on unacceptable data access restrictions, please see In your revised cover letter, please address the following prompts:a) If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail  and who has imposed them . Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent.http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories.b) If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings as either Supporting Information files or to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. For a list of acceptable repositories, please see We will update your Data Availability statement on your behalf to reflect the information you provide.Data availability was revised and now reads as follows:Data Availability The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper.Review Comments to the AuthorReviewer #1 Professor Montazeri’s and colleague’s study appears to do something quite unusual: reviewing the literature on measurement instrument construction for the or concept of health literacy. His own sentence differs slightly: “This study aimed to review all existing instruments to summarize the current knowledge on the topic.” This reads to me as if either the development of measurement instruments was the subject of the review, or the instruments themselves or rather their interrelationship with outcomes, the precise nature of which would remain in the dark.Thank you for your comment. The sentence was revised.This study aimed to review all existing instruments to summarize the current knowledge on the development of existing measurement instruments and their possible translation and validation in other languages different from the original languages.The results and conclusions formulate rather unspectacular assertions, such as there are enough suitable measures of health literacy, there is a strong tradition of disease-specific, group-specific and technology-specific instruments, a minor problem is that of choosing the right measure. The authors forward the idea that the WHO might set some standards for that.The question arises: Do we need a costly systematic review for results and conclusions like those mentioned. And if we go back to the original ideas behind systematic reviewing, one of the purposes of systematic reviewing is to come to a decision if there is evidence, say, for the efficacy of treatment A as well as for treatment B. If review studies of quality exist on the issue, they will tell you which is better, A or B. Nothing of this urgency do we find in the study to be reviewed. And moreover, the authors do not review all of the evidence, deliberately. They include only publications about the development of a measure, or its transfer to another country, Study presentation, explanation, structure and language are fine, though.Thank you for your thoughtful comment. It was useful, and it has led us to think more carefully in summarizing the evidence. Indeed, we now fully revised the following section and added a table for more clarity. Also, we rewrote the previous synthesis of findings and moved it with some corrections to the end of the discussion. We also revised the conclusion to reflect the critics by the respected reviewer:A: synthesis of findingsNumerous instruments have been developed during the past thirty years for measuring health literacy. This review could provide information on 162 instruments. Of these, there were two well-developed instruments: 1. HLQ, which avoided the use of prevailing theories until the later development process, and great care was taken to fully understand the experiences and lives of people, professionals, and healthcare providers [55].2. HLS-EU-Q47, which used conceptual-based, multi-faceted attributes [56]. However, they reported limited psychometric properties. Of the remaining instruments, 15 instruments reported proper psychometric properties needed. In addition, there were a number of instruments that were translated and validated to other languages more frequently. A list of instruments is presented in Table 9.B: Discussion https://qol.eortc.org/quality-of-life-group/).Finally, one should note that the most important question is, do we need so many instruments for measuring health literacy? Although one could not prevent investigators from developing new instruments, it is evident that such haphazard development of instruments is not helpful. It seems that we need a core global general health literacy instrument for use around the globe. Then perhaps it is possible to add a few contents/disease-specific, population-specific, or e-health literacy items to the general instruments according to their use. The experience of the European Organization for Research and Treatment of Cancer-EORTC  might be useful to be adapted (C: ConclusionThis review highlighted that there were more than enough instruments for measuring health literacy. In addition, we found that a number of instruments did not report psychometric properties sufficiently. However, evidence suggest that well developed instruments and those reported adequate measures of validation could be helpful if appropriately selected based on objectives of a given study. Perhaps an authorized institution such as World Health Organization should take responsibility and provide a clear guideline for measuring health literacy as appropriate.AttachmentResponse to Reviewers. R2.docxSubmitted filename: Click here for additional data file. 5 Jul 2022Measuring health literacy: A systematic review and bibliometric analysis of instruments from 1993 to 2021PONE-D-22-04494R1Dear Dr. Ali Montazeri,We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org.An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at onepress@plos.org.If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact Kind regards,Carlos Miguel Rios-González, Ph.DAcademic EditorPLOS ONE 7 Jul 2022PONE-D-22-04494R1 Measuring health literacy: A systematic review and bibliometric analysis of instruments from 1993 to 2021 Dear Dr. Montazeri:I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! 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This result is explained by the unique frequency-independent ‘platform’ region in the relaxation time of in-plane phonons. Moreover, we conducted a comparative study of thermal conductivity between 2D h-BAs and h-GaN, because both of them have a similar mass density. The thermal conductivity of h-BAs is one order of magnitude higher than that of h-GaN (16 W m−1 K−1), which is governed by the different phonon scattering process attributed to the opposite wavevector dependence in out-of-plane optical phonons. Our findings provide new insight into the physics of heat conduction in 2D materials, and demonstrate h-BAs to be a new thermally conductive 2D semiconductor.The cubic boron arsenide (BAs) crystal has received extensive research attention because of its ultra-high thermal conductivity comparable to that of diamond. In this work, we performed a comprehensive study on the diffusive thermal properties of its two-dimensional (2D) counterpart, the monolayer honeycomb BAs (h-BAs), through solving the phonon Boltzmann transport equation combined with first-principles calculation. We found that unlike the pronounced contribution from out-of-plane acoustic phonons (ZA) in graphene, the high thermal conductivity (181 W m The cubic boron arsenide (BAs) crystal has received extensive research attention because of its ultra-high thermal conductivity comparable to that of diamond. The decreasing dimension from three-dimensional diamond to two-dimensional (2D) graphene can change the phonon population distribution, and introduces emerging physical phenomena. For example, the high Debye temperature and the strong anharmonicity of flexural ZA (out-of-plane acoustic) phonon modes around the Γ point result in remarkable phonon hydrodynamics in graphene.3,4 Moreover, Lindsay et al.5 found a special selection rule in graphene, in which only three-phonon processes having an even number of ZA phonons are allowed, while other processes (involving one or three ZA phonons) are forbidden.6,7 This is one of the underlying mechanisms for the higher thermal conductivity in graphene exceeding diamond. The anomalous length-dependent thermal conductivity is also observed in graphene, revealing its promising perspective in thermal management.8With the rapid development of miniaturization and high-power density of the electronic and optoelectronic devices, the demand for thermal management is becoming more and more important.9 the researches on thermal transport in low-dimensional system have attracted extensive attention.10–16 The decreased dimension induces quantum confinement effect and alters the phonon dispersion, which further results in unique lattice thermal transport features.17 In addition to graphene, Sahin et al.18 has proposed 13 different 2D III–V compounds of honeycomb lattice, seven of which  have planer structure like graphene. In planer structures, phonons obey the unique phonon scattering selection rule5,19,20 in which three-phonon processes having an odd number of ZA phonons are forbidden. This mechanism can reduce phonon scattering rate by suppressing scattering channels, and consequently enhance thermal conductivity.Inspired by the ultra-high thermal conductivity of graphene,21–23 Recently, it is demonstrated24,25 that monolayer honeycomb BAs (h-BAs) nanosheet is an excellent candidate for both electrically functional material and thermally functional material. For example, Zhang et al.24 reported the appropriate band gap (1.18 eV), high carrier mobility and strain tunable electronic property of h-BAs. Manoharan and Subramanian25 reported the I–V characteristics of h-BAs, and the potential application in short-wavelength optoelectronic devices was discussed. More interesting, recent theoretical26–28 and experimental29–31 works demonstrate high thermal conductivity in bulk BAs crystal (c-BAs), origins partially from the large frequency gap between acoustic and optical phonon modes. Naturally, it raises up some questions, for example, what is the thermal conductivity of its 2D counterpart (h-BAs)? Which phonon modes play dominant contribution to thermal conductivity? Compared with other 2D III–V honeycomb lattice, what is the unique phonon scheme in h-BAs? Although preliminary literatures reported high thermal conductivity of h-BAs,32,33 compared with the extensive studies of thermal conductivity of graphene and h-BN, there are still many open questions. Obviously, a better knowledge of thermal conductivity of h-BAs is highly important not only for fundamental physics of low-dimensional thermal transport, but also for technological applications such as thermal management of nanoscale integrated devices.Within these III–V compounds of honeycomb lattice, the most famous one is honeycomb BN (h-BN), which exhibits good thermal transport property.In this paper, based on first-principle calculation, the abnormal high thermal conductivity of h-BAs was revealed by solving phonon Boltzmann transport equation (BTE). We found the main contribution to thermal conductivity is from in-plane acoustic phonons and a frequency-independent ‘platform’ appearing in relaxation time of in-plane modes. By analyzing phonon dispersion and considering phonon selection rule, we explained our calculation results and found that phonon selection rule not only affects out-of-plane phonons but also plays an important role for in-plane phonons. Furthermore, the comparison of thermal transport of h-BAs with h-GaN highlights the effect of phonon spectrum on thermal transport.2.αβ direction at temperature T can be expressed as the sum of contributions from each phonon modes λ:N, V, fλ, ν and τ are the number of wave vector q points in the Brillouin zone, volume of the unit cell, the equilibrium Boltzmann distribution depending on phonon angular frequency ωλ, phonon group velocity and phonon relaxation time, respectively. Under relaxation time approximation (RTA), phonon relaxation time can be described as:Wλλ′ is the isotope scattering rate and Wλλ′λ′′± are scattering rate of three-phonons absorption (+) and emission (−) processes, and modes λ, λ′ and λ′′ satisfy quasi-momentum conservation. Wλλ′λ′′± can be calculated from the Fermi's golden rule as follow:Vλλ′λ′′± are scattering matrix elements depending on the third-order anharmonic force constants (3rd IFCs).By solving phonon BTE, thermal conductivity tensor element of Ab initio Simulation Package (VASP)34 within the generalized gradient approximation (GGA) functional of the Perdew–Burke–Ernzerhof (PBE).35 The convergence criteria for energies was set to 10−7 eV and a Γ-centered k-mesh of 21 × 21 × 1 is used to sample the Brillouin Zone (BZ) of primitive unit cell. The structure was fully relaxed until interatomic force is less than 10−5 eV Å−1 with a cutoff energy of 550 eV. The Gaussian smearing of 0.2 eV was used to calculate the electronic occupation. To solve the phonon Boltzmann transport equation, ShengBTE code36 was used. Both the 2nd and the 3rd IFCs were calculated via finite displacement method. 7 × 7 × 1 supercells and 3 × 3 × 1 k-mesh were used to ensure the convergence of calculation. To ensure the convergence of thermal conductivity, we considered the interactions up to the 7th nearest neighbors (corresponding to the cutoff distance of 0.68 nm) and chosen a 101 × 101 × 1 q-mesh for phonon–phonon scattering calculation. Furthermore, we also calculated Born effective charges and dielectric constants based on the density functional perturbation theory (DFPT) to correct the dynamical matrix by considering the long-range electrostatic interactions. Because van der Waals (vdW) diameter of As atom is less than that of B atom, we chose vdW diameter (0.426 nm) of B atom as the effective thickness of the monolayer h-BAs. In our calculation, the phonon scattering by isotopic doping is considered, with the natural isotope abundance of 19.78% 10B, 80.22% 11B, and 100% 75As.The first principle calculation was performed based on density functional theory (DFT) as implemented in Vienna 3.3.1.18,24,25,33 Considering the long-range electrostatic interactions, it is found that the LO –TO  splitting appears at Brillouin Zone (BZ) center, which results in a slight frequency gap of 0.31 THz. This slight shift of LO branch stems from the similar electronegativity of B and As atom. The Born effective charge and dielectric constants are given in Z(B)xx = 1.744e, Z(B)yy = 1.743e, for As ion is Z(As)xx = −1.744e, Z(As)yy = −1.743e, respectively, where e (positive) is elementary charge. The in-plane charge transfer between B and As atoms is comparable with that in other 2D materials, for example, InSe (2.33e), MoS2 (1.34e).37 On the other side, the charge transfer in the z direction is only 0.051e, much smaller than InSe (0.27e) and MoS2 (0.14e), because its ideal planar geometry. The main differences in phonon spectrum of h-BAs from most other planer hexagonal III–V compounds are the flat ZA branch and upward ZO branch. In h-BAs, the maximum frequency of ZA branch is only 1.81 THz, indicating ZA phonons exhibit slow group velocity and out-of-plane vibration is very weak. This result can be understood by the large atomic density of h-BAs  and weak B–As bonding along the out-of-plane direction. As a comparison, the IFCs of bonding atoms in graphene, h-BN and h-BAs are given in Φzz of B–As is much smaller than in-plane matrix elements and those of the other two materials. In planer honeycomb boron compounds with group-V elements, h-BAs has an unusual upward ZO branch, which results in a wide frequency-gap between ZA and ZO branch. Due to the important role of out-of-plane modes in thermal transport for planer structure, in the following sections, the effect of this frequency-gap on the three-phonon scattering processes will be discussed.The fully optimized structure and corresponding phonon dispersion are illustrated in 3.2.−1 K−1, higher than many other narrow-gap semiconductors such as monolayer MoS2 (−1 K−1), stanene39 (11.6 W m−1 K−1) and phosphorene40 . We also investigate the isotope scattering effect on the thermal conductivity of h-BAs. The calculated results show that the thermal conductivity of pure h-BAs is only 3.7% higher than the natural one , which is much lower than that in h-BN (∼40%).41 The weak isotopic effect in h-BAs can be explained by Matthiessen's rule. h-BAs has remarkably stronger phonon–phonon scattering strength than that in h-BN. The thermal conductivity of h-BAs is mainly determined by the phonon anharmonicity and isotope scattering effect has a minor influence on the thermal conductivity. In addition, the solution of thermal conductivity under RTA is about 72% of the iterative one, which is a common phenomenon because the normal (N) processes are treated resistive. As phonon hydrodynamics in h-BAs is weak, it is not our major focus in the present work. In the following, all the results and discussion are based on RTA calculation.The iterative solution of thermal conductivity as well as the one under relaxation time approximation (RTA) are illustrated in yer MoS2   modes play dominant role in thermal conductivity (76%) of h-BAs. To get the insight into the unusual phonon thermal transport property, we extract the phonon relaxation time and group velocity, as shown in 3 m s−1 in long-wavelength limit. The remarkable gap of group velocity between LA an ZA phonons implies the in-plane (σ) bonding is much stronger than out-of-plane (π) bonding. This result is consistent with the analysis of interatomic force constants of B–As bond as given in 2, its group velocity is comparable with the longitudinal sound velocity of MoS2, which is around 7 × 103 m s−1 measured experimentally.43 The relative slow group velocity in h-BAs cannot explain the abnormal high thermal conductivity. Therefore, next we focus on another critical factor, the phonon relaxation time.Unlike other monolayer hexagonal structure such as graphene and h-BN in which ZA modes dominates the thermal conductivity due to the phonon scattering selection rule, h-BAs presents a relative low contribution from ZA modes (23%) as shown in 2 ps. In versus frequency, namely, ), which has two obvious peaks. The first one just covers low frequency range, indicating the major contribution of low frequency phonons. The second one has higher peak value and appears within the platform region, which demonstrate the unusually high contribution of corresponding IA modes to thermal conductivity.Unexpectedly, we found a frequency-independent “platform region” in relaxation time of TA and LA modes. The “platform” for TA (LA) branch, occurs at about 3.47 (3.61) THz, and vanishes at 4.16 (4.86) THz, respectively. In the platform region, the magnitude of relaxation time increases up to 10ωZA1 + ωZA2 = ωLA (ωTA), this phonon scattering process is greatly suppressed, in particular for LA or TA phonons with frequency higher than 3.62 THz. This is the underlying mechanism for the high relaxation time in the ‘platform’ region.To further understand the high thermal conductivity of h-BAs and explain the forming of platform, we consider the following scattering processes in low-frequency region: ZA + ZA → IA. As shown in 3.3.Although h-BAs has higher atomic density, its thermal conductivity is comparable with that of h-BN. Next, we compare it with another III–V semiconductor, h-GaN, because both of them have the similar atomic density. To make a comparative study, in the calculation of thermal conductivity of h-GaN, all the DFT calculation parameters, size of supercells and BTE calculation parameters are in line with those of h-BAs. The only difference is the effective thickness which is 0.37 nm in h-GaN.−1 K−1 (see The phonon dispersion of h-GaN is shown in  K−1 see , respectrd IFCs of each other. This operation can fix the phonon–phonon scattering channels and only change the scattering matrix elements Vλλ′λ′′. This method has been used to provide physical insights of the thermal transport in fully filled skutterudite.44 By comparing the results before and after exchanging the 3rd IFCs, we can clarify whether 2nd IFCs or 3rd IFCs plays the major role in the thermal conductivity. As shown in rd IFCs, the thermal conductivity of h-BAs is reduced by 33.2% and that of h-GaN is increased by 37.5%. This demonstrates that the 3rd IFCs is not the major origin of difference in thermal conductivity between h-BAs and h-GaN.Comparing with h-BAs, 2D h-GaN has the same honeycomb planar structure, comparable average atomic mass and in-plane bonding stiffness, but much lower thermal conductivity. To explore the physical insights attribute to this abnormal phenomenon, we calculated the phonon group velocity and relaxation time of h-GaN. As shown in Comparing the phonon dispersion of h-BAs and h-GaN in low frequency regions as shown in 4.−1 K−1, obviously larger than that of h-GaN with 16 W m−1 K−1. This abnormal high thermal conductivity originates from the unexpected platform region with long phonon relaxation time of IA modes. Based on the selection rule, we found this platform in phonon relaxation time stems from suppressed ZA + ZA → IA scattering channel. Moreover, IA modes make major contribution to thermal conductivity, different from that of graphene and h-BN. This is not only because the IA modes have long relaxation time and high group velocity, but also the flat ZA branch due to weak π-bond strength. Comparing the phonon dispersion of h-BAs with h-GaN, the main difference is that ZO branch of h-GaN has an obvious downward trend from the BZ center to boundary, which increases the phase space of ZA + IA → ZO scattering, leading to the low thermal conductivity.In summary, by solving BTE based on first principle calculation, we revealed the abnormal diffusive thermal transport behaviors in h-BAs and compared the thermal conductivity of h-BAs with h-GaN. At 300 K, the thermal conductivity of h-BAs is up to 181 W mThere are no conflicts to declare.