Background:Numerous systematic reviews and meta-analyses have been published that evaluate the association between periodontal disease and systemic diseases,many of which address similar topics.Moreover,their quality ...Background:Numerous systematic reviews and meta-analyses have been published that evaluate the association between periodontal disease and systemic diseases,many of which address similar topics.Moreover,their quality requires assessment.Therefore,we performed a cross-sectional analysis to examine the evidence on the relationship between periodontal disease and systemic diseases.Methods:The PubMed,Embase,Web of Science,and the Cochrane Library databases were systematically searched to identify relevant systematic reviews and meta-analyses.Only studies that considered periodontal disease as the exposure factor and various systemic diseases as the outcome were included.The basic characteristics and pertinent data from the selected studies were extracted.The modified version of A Measurement Tool to Assess Systematic Reviews 2(AMSTAR 2)was employed for quality assessment,while R software was used for statistical analysis.Results:Among the 212 relevant systematic reviews and meta-analyses,57 were finally included in our analysis.These studies involved 75 diseases and 81 disease-related outcomes,with cancer(19/81)being the most frequently addressed topic.Of the 81 outcomes,67 demonstrated a significant association.Notably,the highest risk estimate was found for head and neck cancer[odds ratio(OR)=3.17,95%confidence interval(CI)1.78-5.64],while the lowest was observed for premature rupture of the amniotic sac[relative risk(RR)=1.10,95%CI 1.08-1.12].The methodological quality ratings indicated that approximately 71.93%of included studies were classified as“Critically low”,with another 17.54%rated as“Low”,and only about 10.53%categorized as“Moderate”.Conclusions:Periodontal disease significantly elevates the risks associated with 15 cancer-related,8 cardiovascular-related,8 metabolic-related,and 5 neurological-related outcomes.However,the overall methodological quality of existing systematic reviews and meta-analyses is generally suboptimal and requires enhancement to generate higher-quality evidence in the future.展开更多
Dear Editor,We read with a great interest the recently published systematic review by Shamsikhani and Hosseini titled,“Foot reflexology on nausea and vomiting:A systematic review.”[1]While the authors provided a com...Dear Editor,We read with a great interest the recently published systematic review by Shamsikhani and Hosseini titled,“Foot reflexology on nausea and vomiting:A systematic review.”[1]While the authors provided a comprehensive qualitative synthesis of six studies meeting their inclusion criteria,we believe that additional quantitative analysis would strengthen the evidence base for foot reflexology in managing nausea and vomiting.We conducted a complementary meta-analysis to provide quantitative evidence supporting the qualitative findings presented in the systematic review.展开更多
Traditional Chinese medicine(TCM)represents a paradigmatic approach to personalized medicine,developed through the systematic accumulation and refinement of clinical empirical data over more than 2000 years,and now en...Traditional Chinese medicine(TCM)represents a paradigmatic approach to personalized medicine,developed through the systematic accumulation and refinement of clinical empirical data over more than 2000 years,and now encompasses large-scale electronic medical records(EMR)and experimental molecular data.Artificial intelligence(AI)has demonstrated its utility in medicine through the development of various expert systems(e.g.,MYCIN)since the 1970s.With the emergence of deep learning and large language models(LLMs),AI’s potential in medicine shows considerable promise.Consequently,the integration of AI and TCM from both clinical and scientific perspectives presents a fundamental and promising research direction.This survey provides an insightful overview of TCM AI research,summarizing related research tasks from three perspectives:systems-level biological mechanism elucidation,real-world clinical evidence inference,and personalized clinical decision support.The review highlights representative AI methodologies alongside their applications in both TCM scientific inquiry and clinical practice.To critically assess the current state of the field,this work identifies major challenges and opportunities that constrain the development of robust research capabilities—particularly in the mechanistic understanding of TCM syndromes and herbal formulations,novel drug discovery,and the delivery of high-quality,patient-centered clinical care.The findings underscore that future advancements in AI-driven TCM research will rely on the development of high-quality,large-scale data repositories;the construction of comprehensive and domain-specific knowledge graphs(KGs);deeper insights into the biological mechanisms underpinning clinical efficacy;rigorous causal inference frameworks;and intelligent,personalized decision support systems.展开更多
Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsist...Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.展开更多
Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of CO...Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of COPD.Methods:A descriptive nature research method was adopted.An interview outline was formulated based on the theoretical domain framework.From October to December 2024,15 medical staff from the respiratory department of a tertiary hospital in Shaanxi Province were selected for semi-structured interviews.The interview data were analyzed using the Colaizzi 7-step analysis method.Result:The analysis of this study found that the obstructive factors for medical staff to implement respiratory rehabilitation include five theoretical domains.The problems are respectively the lack of knowledge about respiratory rehabilitation and insufficient training intensity,the insufficient self-recognition of implementing respiratory rehabilitation,the low awareness rate of patients and the low cooperation degree,the insufficient provision of instruments and facilities,the lack of rehabilitation training venues and respiratory rehabilitation clinics,and the lack of scientific and standardized respiratory rehabilitation management processes.Conclusion:There are many obstructive factors affecting the implementation of respiratory rehabilitation by medical staff.Clinical managers should take corresponding measures,continuously improve the rehabilitation management strategies for COPD,and promote the clinical application of the best evidence for respiratory rehabilitation.展开更多
The biological species concept defines species as groups of actually or potentially interbreeding natural populations that are reproductively isolated from other such groups(Mayr,1942).Reproductive isolation,whether p...The biological species concept defines species as groups of actually or potentially interbreeding natural populations that are reproductively isolated from other such groups(Mayr,1942).Reproductive isolation,whether prezygotic or postzygotic,plays a central role in maintaining species boundaries.However,hybridization between closely related taxa can challenge these boundaries and provide insight into speciation,gene flow,and evolutionary processes(Coyne and Orr,2004).展开更多
High-quality clinical evidence is the basis of evidence-based medical practice.Acupuncture is the most widely used complementary and alternative medicine in the world.However,the improvement in the quality of acupunct...High-quality clinical evidence is the basis of evidence-based medical practice.Acupuncture is the most widely used complementary and alternative medicine in the world.However,the improvement in the quality of acupuncture clinical research does not match the rapid increase in the number of acupuncture clinical research in recent years.At present,the number of high-quality acupuncture clinical research in the world remains low.Taking the trial of acupuncture for chronic spontaneous urticaria published in Annals of Internal Medicine as an example,this paper discusses the factors that contribute to producing high-quality clinical evidence for acupuncture from the aspects of selecting the topic of study,formulating the study method,designing the study plan,controlling the study process,writing the study report,and selecting the journal in the process of before,during,and after the research.It emphasizes the necessity to start from the benefit of global people's health,take practical clinical problems as guidance,cleverly choose the research entry point,and conduct high-quality research with clinical value.After the accomplishment of the study,the results must be faithfully described,the scientific conclusions accurately sublimated,and appropriate scientific journals selected for publication.展开更多
Complex evidence theory is a generalized Dempster-Shafer evidence theory,which has the ability to express uncertain information.One of the key issues is the uncertainty measure of Complex Basic Belief Assignment(CBBA)...Complex evidence theory is a generalized Dempster-Shafer evidence theory,which has the ability to express uncertain information.One of the key issues is the uncertainty measure of Complex Basic Belief Assignment(CBBA).However,the research on the uncertainty measure of complex evidence theory is still an open issue.Therefore,in this paper,first,the Fractal-based Complex Belief(FCB)entropy as a generalization of Fractal-based Belief(FB)entropy,which has superiority in uncertainty measurement of CBBA,is proposed.Second,on the basis of FCB entropy,we propose Fractal-based Supremum Complex Belief(FSCB)entropy and Fractal-based Infimum Complex Belief(FICB)entropy,with FSCB entropy as the upper bound and FICB entropy as the lower bound.They are collectively called the proposed FCB entropy.Furthermore,we analyze the properties,physical interpretation and numerical examples to prove the rationality of the proposed method.Finally,a practical information fusion application is proposed to prove that the proposed FCB entropy can reasonably measure the uncertainty of CBBA.The results show that,the proposed FCB entropy can handle the uncertainty measure of CBBA,which can be a reasonable way for uncertainty measure in complex evidence theory.展开更多
Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to ...Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.展开更多
With the civilization and modernization of human society,occupational health has emerged as a fundamental goal of social justice,as highlighted in the United Nations'Sustainable Development Goals(SDGs)since 2016.S...With the civilization and modernization of human society,occupational health has emerged as a fundamental goal of social justice,as highlighted in the United Nations'Sustainable Development Goals(SDGs)since 2016.Specifically,"SDG Goal 1:No Poverty","SDG 3:Good Health and Well-being",and"SDG 8:Decent Work and Economic Growth",are interconnected with other SDGs to support the pursuit of occupational health.展开更多
Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideli...Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideline websites,and professional society websites were systematically searched for literature on intradialytic hypotension guidance,including clinical decisions,guidelines,evidence summaries,systematic reviews,and expert consensuses,from database inception to October 1,2024.Evidence was extracted after literature quality evaluation.Results:A total of 11 publications were included:2 clinical decisions,7 guidelines,1 systematic review,and 1 expert consensus.38 pieces of evidence were summarized across 4 themes:pre-dialysis assessment and prevention,monitoring and management during dialysis,medication use,and patient self-management.Conclusion:The best evidence for prevention and management of intradialytic hypotension in maintenance hemodialysis patients is scientific and comprehensive.Healthcare professionals are advised to apply this evidence judiciously in conjunction with clinical realities to ensure patient safety.展开更多
Burden of disease research plays a pivotal role in global and national health policy by quantifying the impact of illnesses, injuries, and risk factors on populations. Through metrics such as disabilityadjusted life y...Burden of disease research plays a pivotal role in global and national health policy by quantifying the impact of illnesses, injuries, and risk factors on populations. Through metrics such as disabilityadjusted life years (DALYs), years of life lost (YLLs),and years lived with disability (YLDs), it provides a comprehensive assessment of health loss, enabling evidence-based decision-making[1].展开更多
Diabetic Gastroparesis(DGP)is one of the common chronic complications of diabetes mellitus,with main clinical manifestations such as nausea,vomiting,postprandial fullness,and delayed gastric emptying.It seriously affe...Diabetic Gastroparesis(DGP)is one of the common chronic complications of diabetes mellitus,with main clinical manifestations such as nausea,vomiting,postprandial fullness,and delayed gastric emptying.It seriously affects patients’quality of life and nutritional status.This paper systematically sorts out the application evidence of Traditional Chinese Medicine(TCM)nursing in DGP,verifies its effectiveness from three aspects:evidence from ancient literature,modern clinical studies,and results of Meta-analyses.It also elaborates on specific nursing methods including Syndrome Differentiation-Based Nursing,characteristic technical nursing,and health guidance,analyzes the existing problems in current research,and puts forward future development directions,so as to provide a reference for the clinical promotion and standardization of TCM nursing for DGP.展开更多
The continued need to develop less invasive alternatives to surgical and radiologic interventions has driven the development of endoscopic ultrasound(EUS)-guided treatments.These include EUS-guided drainage of pancrea...The continued need to develop less invasive alternatives to surgical and radiologic interventions has driven the development of endoscopic ultrasound(EUS)-guided treatments.These include EUS-guided drainage of pancreatic fluid collections,EUS-guided necrosectomy,EUS-guided cholangiography and biliary drainage,EUSguided pancreatography and pancreatic duct drainage,EUS-guided gallbladder drainage,EUS-guided drainage of abdominal and pelvic fluid collections,EUS-guided celiac plexus block and celiac plexus neurolysis,EUSguided pancreatic cyst ablation,EUS-guided vascular interventions,EUS-guided delivery of antitumoral agents and EUS-guided fiducial placement and brachytherapy.However these procedures are technically challenging and require expertise in both EUS and interventional endoscopy,such as endoscopic retrograde cholangiopancreatography and gastrointestinal stenting.We undertook a systematic review to record the entire body of literature accumulated over the past 2decades on EUS-guided interventions with the objective of performing a critical appraisal of published articles,based on the classification of studies according to levels of evidence,in order to assess the scientific progress made in this field.展开更多
Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic ...Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic eczema(AE)using evidence mapping of randomized controlled trials(RCTs),systematic reviews(SRs),and metaanalyses.Methods:We searched eight databases from inception to October 30,2021,for RCTs,SRs,and metaanalyses of acupuncture for patients with AE.Two reviewers screened the papers,before extracting the data and assessing the quality of the included studies.The basic and clinical characteristics,and quality of assessment of the studies were assessed using descriptive statistics and qualitative analyses.A bubble plot was used to visualize the evidence map to indicate the relationship between the type and frequency of outcomes,the quality and overall effects of acupuncture,and the outcomes of the studies.Results:Forty-five studies(Forty RCTs,five SRs,and meta-analyses)were included.The number of publications increased rapidly after 2013 and peaked in 2019.The most frequently applied intervention was one type of acupuncture therapy.The most frequent comparison was between acupuncture and active medicine.The symptomatic outcome was the most commonly used,and the quality of the included studies was relatively low.All included studies showed a significantly better outcome in the acupuncture group compared to the control group(P<0.05).Most outcomes in the included studies were of low or critically low quality.Several symptomatic outcomes and health-related quality of life outcomes in the included RCTs indicated moderate quality,while some symptomatic outcomes and global symptom improvement in the included SRs and meta-analyses indicated low quality.Conclusion:The majority of studies related to acupuncture for AE indicated promising results,but with relatively low quality;thus,further studies with more robust designs should be conducted to validate the results.展开更多
Severe fever with thrombocytopenia syndrome(SFTS),caused by SFTS virus(SFTSV)infection,was first reported in 2010 in China with an initial fatality of up to 30%.The laboratory confirmation of SFTSV infection in terms ...Severe fever with thrombocytopenia syndrome(SFTS),caused by SFTS virus(SFTSV)infection,was first reported in 2010 in China with an initial fatality of up to 30%.The laboratory confirmation of SFTSV infection in terms of detection of viral RNA or antibody levels is critical for SFTS diagnosis and therapy.In this study,a new luciferase immunoprecipitation system(LIPS)assay based on p REN2 plasmid expressing SFTSV NP gene and tagged with Renilla luciferase(Rluc),was established and used to investigate the levels of antibody responses to SFTSV.Totally 464 serum samples from febrile patients were collected in the hospital of Shaoxing City in Zhejiang Province in 2019.The results showed that 82 of the 464 patients(17.7%)had antibody response to SFTSV,which were further supported by immunofluorescence assays(IFAs).Further,q RT-PCR and microneutralization tests showed that among the 82 positive cases,15 patients had viremia,10 patients had neutralizing antibody,and one had both(totally 26 patient).However,none of these patients were diagnosed as SFTS in the hospital probably because of their mild symptoms or subclinical manifestations.All the results indicated that at least the 26 patients having viremia or neutralizing antibody were the missed diagnosis of SFTS cases.The findings suggested the occurrence of SFTS and the SFTS incidence were higher than the reported level in Shaoxing in 2019,and that LIPS may provide an alternative strategy to confirm SFTSV infection in the laboratory.展开更多
In this paper,we propose a novel Intrusion Detection System (IDS) architecture utilizing both the evidence theory and Rough Set Theory (RST). Evidence theory is an effective tool in dealing with uncertainty question. ...In this paper,we propose a novel Intrusion Detection System (IDS) architecture utilizing both the evidence theory and Rough Set Theory (RST). Evidence theory is an effective tool in dealing with uncertainty question. It relies on the expert knowledge to provide evidences,needing the evidences to be independent,and this make it difficult in application. To solve this problem,a hybrid system of rough sets and evidence theory is proposed. Firstly,simplification are made based on Variable Precision Rough Set (VPRS) conditional entropy. Thus,the Basic Belief Assignment (BBA) for all evidences can be calculated. Secondly,Dempster’s rule of combination is used,and a decision-making is given. In the proposed approach,the difficulties in acquiring the BBAs are solved,the correlativity among the evidences is reduced and the subjectivity of evidences is weakened. An illustrative example in an intrusion detection shows that the two theories combination is feasible and effective.展开更多
According to fault type diversity and fault information uncertainty problem of the hydraulic driven rocket launcher servo system（HDRLSS） , the fault diagnosis method based on the evidence theory and neural network e...According to fault type diversity and fault information uncertainty problem of the hydraulic driven rocket launcher servo system（HDRLSS） , the fault diagnosis method based on the evidence theory and neural network ensemble is proposed. In order to overcome the shortcomings of the single neural network, two improved neural network models are set up at the com-mon nodes to simplify the network structure. The initial fault diagnosis is based on the iron spectrum data and the pressure, flow and temperature（PFT） characteristic parameters as the input vectors of the two improved neural network models, and the diagnosis result is taken as the basic probability distribution of the evidence theory. Then the objectivity of assignment is real-ized. The initial diagnosis results of two improved neural networks are fused by D-S evidence theory. The experimental results show that this method can avoid the misdiagnosis of neural network recognition and improve the accuracy of the fault diagnosis of HDRLSS.展开更多
Network intrusion forensics is an important extension to present security infrastructure,and is becoming the focus of forensics research field.However,comparison with sophisticated multi-stage attacks and volume of se...Network intrusion forensics is an important extension to present security infrastructure,and is becoming the focus of forensics research field.However,comparison with sophisticated multi-stage attacks and volume of sensor data,current practices in network forensic analysis are to manually examine,an error prone,labor-intensive and time consuming process.To solve these problems,in this paper we propose a digital evidence fusion method for network forensics with Dempster-Shafer theory that can detect efficiently computer crime in networked environments,and fuse digital evidence from different sources such as hosts and sub-networks automatically.In the end,we evaluate the method on well-known KDD Cup1999 dataset.The results prove our method is very effective for real-time network forensics,and can provide comprehensible messages for a forensic investigators.展开更多
基金supported by the Lanzhou Science and Technology Project(2022-3-8)the Natural Science Foundation of Chongqing(CSTB2024NSCQMSX0043 and cstc2020jcyj-msxmX0079)the Key Scientific Research Project of Education Department of Henan Province(22A320038).
文摘Background:Numerous systematic reviews and meta-analyses have been published that evaluate the association between periodontal disease and systemic diseases,many of which address similar topics.Moreover,their quality requires assessment.Therefore,we performed a cross-sectional analysis to examine the evidence on the relationship between periodontal disease and systemic diseases.Methods:The PubMed,Embase,Web of Science,and the Cochrane Library databases were systematically searched to identify relevant systematic reviews and meta-analyses.Only studies that considered periodontal disease as the exposure factor and various systemic diseases as the outcome were included.The basic characteristics and pertinent data from the selected studies were extracted.The modified version of A Measurement Tool to Assess Systematic Reviews 2(AMSTAR 2)was employed for quality assessment,while R software was used for statistical analysis.Results:Among the 212 relevant systematic reviews and meta-analyses,57 were finally included in our analysis.These studies involved 75 diseases and 81 disease-related outcomes,with cancer(19/81)being the most frequently addressed topic.Of the 81 outcomes,67 demonstrated a significant association.Notably,the highest risk estimate was found for head and neck cancer[odds ratio(OR)=3.17,95%confidence interval(CI)1.78-5.64],while the lowest was observed for premature rupture of the amniotic sac[relative risk(RR)=1.10,95%CI 1.08-1.12].The methodological quality ratings indicated that approximately 71.93%of included studies were classified as“Critically low”,with another 17.54%rated as“Low”,and only about 10.53%categorized as“Moderate”.Conclusions:Periodontal disease significantly elevates the risks associated with 15 cancer-related,8 cardiovascular-related,8 metabolic-related,and 5 neurological-related outcomes.However,the overall methodological quality of existing systematic reviews and meta-analyses is generally suboptimal and requires enhancement to generate higher-quality evidence in the future.
文摘Dear Editor,We read with a great interest the recently published systematic review by Shamsikhani and Hosseini titled,“Foot reflexology on nausea and vomiting:A systematic review.”[1]While the authors provided a comprehensive qualitative synthesis of six studies meeting their inclusion criteria,we believe that additional quantitative analysis would strengthen the evidence base for foot reflexology in managing nausea and vomiting.We conducted a complementary meta-analysis to provide quantitative evidence supporting the qualitative findings presented in the systematic review.
基金supported by the National Key Research and Development Program(No.2023YFC3502604)the National Natural Science Foundation of China(Nos.U23B2062,82274352,82174533,82374302,82204941)+3 种基金the Noncommunicable Chronic Diseases-National Science and Technology Major Project(No.2023ZD0505700)the Beijing-Tianjin-Hebei Basic Research Co〓〓operation Project(No.22JCZXJC00070)the State Key Laboratory on Technologies for Chinese Medicine Pharmaceutical Process Control and Intelligent Manufacture(No.SKL2024Z0102)Key R&D project of Ningxia Autonomous Region(No.2022BEG02036)。
文摘Traditional Chinese medicine(TCM)represents a paradigmatic approach to personalized medicine,developed through the systematic accumulation and refinement of clinical empirical data over more than 2000 years,and now encompasses large-scale electronic medical records(EMR)and experimental molecular data.Artificial intelligence(AI)has demonstrated its utility in medicine through the development of various expert systems(e.g.,MYCIN)since the 1970s.With the emergence of deep learning and large language models(LLMs),AI’s potential in medicine shows considerable promise.Consequently,the integration of AI and TCM from both clinical and scientific perspectives presents a fundamental and promising research direction.This survey provides an insightful overview of TCM AI research,summarizing related research tasks from three perspectives:systems-level biological mechanism elucidation,real-world clinical evidence inference,and personalized clinical decision support.The review highlights representative AI methodologies alongside their applications in both TCM scientific inquiry and clinical practice.To critically assess the current state of the field,this work identifies major challenges and opportunities that constrain the development of robust research capabilities—particularly in the mechanistic understanding of TCM syndromes and herbal formulations,novel drug discovery,and the delivery of high-quality,patient-centered clinical care.The findings underscore that future advancements in AI-driven TCM research will rely on the development of high-quality,large-scale data repositories;the construction of comprehensive and domain-specific knowledge graphs(KGs);deeper insights into the biological mechanisms underpinning clinical efficacy;rigorous causal inference frameworks;and intelligent,personalized decision support systems.
基金supported by the China Postdoctoral Science Foundation(Grant No.2021M703366)Shenzhen Science and Technology Program(Grant No.KQTD20190929172835662).
文摘Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.
基金Shaanxi Provincial People’s Hospital Science and Technology Development Incubation Fund Program 2023(Project No.:2023HL-12)。
文摘Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of COPD.Methods:A descriptive nature research method was adopted.An interview outline was formulated based on the theoretical domain framework.From October to December 2024,15 medical staff from the respiratory department of a tertiary hospital in Shaanxi Province were selected for semi-structured interviews.The interview data were analyzed using the Colaizzi 7-step analysis method.Result:The analysis of this study found that the obstructive factors for medical staff to implement respiratory rehabilitation include five theoretical domains.The problems are respectively the lack of knowledge about respiratory rehabilitation and insufficient training intensity,the insufficient self-recognition of implementing respiratory rehabilitation,the low awareness rate of patients and the low cooperation degree,the insufficient provision of instruments and facilities,the lack of rehabilitation training venues and respiratory rehabilitation clinics,and the lack of scientific and standardized respiratory rehabilitation management processes.Conclusion:There are many obstructive factors affecting the implementation of respiratory rehabilitation by medical staff.Clinical managers should take corresponding measures,continuously improve the rehabilitation management strategies for COPD,and promote the clinical application of the best evidence for respiratory rehabilitation.
基金supported by the National Natural Science Foundation of China(No.32161143024,31970405)Iran National Science Foundation,Iran-China(INSF-NSFC)joint project(No.4002006).
文摘The biological species concept defines species as groups of actually or potentially interbreeding natural populations that are reproductively isolated from other such groups(Mayr,1942).Reproductive isolation,whether prezygotic or postzygotic,plays a central role in maintaining species boundaries.However,hybridization between closely related taxa can challenge these boundaries and provide insight into speciation,gene flow,and evolutionary processes(Coyne and Orr,2004).
基金Supported by Sichuan Province science and technology education joint fund project:2024NSFSC1976Science and Technology Research Project of Sichuan Ad-ministration of Traditional Chinese Medicine:2021MS320.
文摘High-quality clinical evidence is the basis of evidence-based medical practice.Acupuncture is the most widely used complementary and alternative medicine in the world.However,the improvement in the quality of acupuncture clinical research does not match the rapid increase in the number of acupuncture clinical research in recent years.At present,the number of high-quality acupuncture clinical research in the world remains low.Taking the trial of acupuncture for chronic spontaneous urticaria published in Annals of Internal Medicine as an example,this paper discusses the factors that contribute to producing high-quality clinical evidence for acupuncture from the aspects of selecting the topic of study,formulating the study method,designing the study plan,controlling the study process,writing the study report,and selecting the journal in the process of before,during,and after the research.It emphasizes the necessity to start from the benefit of global people's health,take practical clinical problems as guidance,cleverly choose the research entry point,and conduct high-quality research with clinical value.After the accomplishment of the study,the results must be faithfully described,the scientific conclusions accurately sublimated,and appropriate scientific journals selected for publication.
基金supported by the National Natural Science Foundation of China (No. 62473067)Chongqing Talents: Exceptional Young Talents Project, China (No. cstc2022ycjh-bgzxm0070)Chongqing Overseas Scholars Innovation Program, China (No. cx2022024)
文摘Complex evidence theory is a generalized Dempster-Shafer evidence theory,which has the ability to express uncertain information.One of the key issues is the uncertainty measure of Complex Basic Belief Assignment(CBBA).However,the research on the uncertainty measure of complex evidence theory is still an open issue.Therefore,in this paper,first,the Fractal-based Complex Belief(FCB)entropy as a generalization of Fractal-based Belief(FB)entropy,which has superiority in uncertainty measurement of CBBA,is proposed.Second,on the basis of FCB entropy,we propose Fractal-based Supremum Complex Belief(FSCB)entropy and Fractal-based Infimum Complex Belief(FICB)entropy,with FSCB entropy as the upper bound and FICB entropy as the lower bound.They are collectively called the proposed FCB entropy.Furthermore,we analyze the properties,physical interpretation and numerical examples to prove the rationality of the proposed method.Finally,a practical information fusion application is proposed to prove that the proposed FCB entropy can reasonably measure the uncertainty of CBBA.The results show that,the proposed FCB entropy can handle the uncertainty measure of CBBA,which can be a reasonable way for uncertainty measure in complex evidence theory.
文摘Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.
文摘With the civilization and modernization of human society,occupational health has emerged as a fundamental goal of social justice,as highlighted in the United Nations'Sustainable Development Goals(SDGs)since 2016.Specifically,"SDG Goal 1:No Poverty","SDG 3:Good Health and Well-being",and"SDG 8:Decent Work and Economic Growth",are interconnected with other SDGs to support the pursuit of occupational health.
文摘Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideline websites,and professional society websites were systematically searched for literature on intradialytic hypotension guidance,including clinical decisions,guidelines,evidence summaries,systematic reviews,and expert consensuses,from database inception to October 1,2024.Evidence was extracted after literature quality evaluation.Results:A total of 11 publications were included:2 clinical decisions,7 guidelines,1 systematic review,and 1 expert consensus.38 pieces of evidence were summarized across 4 themes:pre-dialysis assessment and prevention,monitoring and management during dialysis,medication use,and patient self-management.Conclusion:The best evidence for prevention and management of intradialytic hypotension in maintenance hemodialysis patients is scientific and comprehensive.Healthcare professionals are advised to apply this evidence judiciously in conjunction with clinical realities to ensure patient safety.
文摘Burden of disease research plays a pivotal role in global and national health policy by quantifying the impact of illnesses, injuries, and risk factors on populations. Through metrics such as disabilityadjusted life years (DALYs), years of life lost (YLLs),and years lived with disability (YLDs), it provides a comprehensive assessment of health loss, enabling evidence-based decision-making[1].
文摘Diabetic Gastroparesis(DGP)is one of the common chronic complications of diabetes mellitus,with main clinical manifestations such as nausea,vomiting,postprandial fullness,and delayed gastric emptying.It seriously affects patients’quality of life and nutritional status.This paper systematically sorts out the application evidence of Traditional Chinese Medicine(TCM)nursing in DGP,verifies its effectiveness from three aspects:evidence from ancient literature,modern clinical studies,and results of Meta-analyses.It also elaborates on specific nursing methods including Syndrome Differentiation-Based Nursing,characteristic technical nursing,and health guidance,analyzes the existing problems in current research,and puts forward future development directions,so as to provide a reference for the clinical promotion and standardization of TCM nursing for DGP.
文摘The continued need to develop less invasive alternatives to surgical and radiologic interventions has driven the development of endoscopic ultrasound(EUS)-guided treatments.These include EUS-guided drainage of pancreatic fluid collections,EUS-guided necrosectomy,EUS-guided cholangiography and biliary drainage,EUSguided pancreatography and pancreatic duct drainage,EUS-guided gallbladder drainage,EUS-guided drainage of abdominal and pelvic fluid collections,EUS-guided celiac plexus block and celiac plexus neurolysis,EUSguided pancreatic cyst ablation,EUS-guided vascular interventions,EUS-guided delivery of antitumoral agents and EUS-guided fiducial placement and brachytherapy.However these procedures are technically challenging and require expertise in both EUS and interventional endoscopy,such as endoscopic retrograde cholangiopancreatography and gastrointestinal stenting.We undertook a systematic review to record the entire body of literature accumulated over the past 2decades on EUS-guided interventions with the objective of performing a critical appraisal of published articles,based on the classification of studies according to levels of evidence,in order to assess the scientific progress made in this field.
基金Supported by China Academy of Chinese Medical Sciences Innovation FundC12021A03503National Natural Science Fund of China81973968+1 种基金Fundamental Research Funds for Central Public Welfare Scientific Research InstitutesZZ13-024-9"The Belt and Road"TCM Cooperation Project of China Academy of Chinese Medical Sciences in 2019GH201901。
文摘Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic eczema(AE)using evidence mapping of randomized controlled trials(RCTs),systematic reviews(SRs),and metaanalyses.Methods:We searched eight databases from inception to October 30,2021,for RCTs,SRs,and metaanalyses of acupuncture for patients with AE.Two reviewers screened the papers,before extracting the data and assessing the quality of the included studies.The basic and clinical characteristics,and quality of assessment of the studies were assessed using descriptive statistics and qualitative analyses.A bubble plot was used to visualize the evidence map to indicate the relationship between the type and frequency of outcomes,the quality and overall effects of acupuncture,and the outcomes of the studies.Results:Forty-five studies(Forty RCTs,five SRs,and meta-analyses)were included.The number of publications increased rapidly after 2013 and peaked in 2019.The most frequently applied intervention was one type of acupuncture therapy.The most frequent comparison was between acupuncture and active medicine.The symptomatic outcome was the most commonly used,and the quality of the included studies was relatively low.All included studies showed a significantly better outcome in the acupuncture group compared to the control group(P<0.05).Most outcomes in the included studies were of low or critically low quality.Several symptomatic outcomes and health-related quality of life outcomes in the included RCTs indicated moderate quality,while some symptomatic outcomes and global symptom improvement in the included SRs and meta-analyses indicated low quality.Conclusion:The majority of studies related to acupuncture for AE indicated promising results,but with relatively low quality;thus,further studies with more robust designs should be conducted to validate the results.
基金supported by the National Program on Key Research Project of China(2018YFE0200400,2019YFC1200700)the National Natural Science Foundation of China(U20A20135)+1 种基金the Strategic Biological Resources Capacity Building Project of Chinese Academy of Sciences(KFJ-BRP-017-06)the Key deployment projects of Chinese Academy of Sciences(KJZD-SW-L11)
文摘Severe fever with thrombocytopenia syndrome(SFTS),caused by SFTS virus(SFTSV)infection,was first reported in 2010 in China with an initial fatality of up to 30%.The laboratory confirmation of SFTSV infection in terms of detection of viral RNA or antibody levels is critical for SFTS diagnosis and therapy.In this study,a new luciferase immunoprecipitation system(LIPS)assay based on p REN2 plasmid expressing SFTSV NP gene and tagged with Renilla luciferase(Rluc),was established and used to investigate the levels of antibody responses to SFTSV.Totally 464 serum samples from febrile patients were collected in the hospital of Shaoxing City in Zhejiang Province in 2019.The results showed that 82 of the 464 patients(17.7%)had antibody response to SFTSV,which were further supported by immunofluorescence assays(IFAs).Further,q RT-PCR and microneutralization tests showed that among the 82 positive cases,15 patients had viremia,10 patients had neutralizing antibody,and one had both(totally 26 patient).However,none of these patients were diagnosed as SFTS in the hospital probably because of their mild symptoms or subclinical manifestations.All the results indicated that at least the 26 patients having viremia or neutralizing antibody were the missed diagnosis of SFTS cases.The findings suggested the occurrence of SFTS and the SFTS incidence were higher than the reported level in Shaoxing in 2019,and that LIPS may provide an alternative strategy to confirm SFTSV infection in the laboratory.
基金Supported by the National Natural Science Foundation of China (No. 60774029)
文摘In this paper,we propose a novel Intrusion Detection System (IDS) architecture utilizing both the evidence theory and Rough Set Theory (RST). Evidence theory is an effective tool in dealing with uncertainty question. It relies on the expert knowledge to provide evidences,needing the evidences to be independent,and this make it difficult in application. To solve this problem,a hybrid system of rough sets and evidence theory is proposed. Firstly,simplification are made based on Variable Precision Rough Set (VPRS) conditional entropy. Thus,the Basic Belief Assignment (BBA) for all evidences can be calculated. Secondly,Dempster’s rule of combination is used,and a decision-making is given. In the proposed approach,the difficulties in acquiring the BBAs are solved,the correlativity among the evidences is reduced and the subjectivity of evidences is weakened. An illustrative example in an intrusion detection shows that the two theories combination is feasible and effective.
文摘According to fault type diversity and fault information uncertainty problem of the hydraulic driven rocket launcher servo system（HDRLSS） , the fault diagnosis method based on the evidence theory and neural network ensemble is proposed. In order to overcome the shortcomings of the single neural network, two improved neural network models are set up at the com-mon nodes to simplify the network structure. The initial fault diagnosis is based on the iron spectrum data and the pressure, flow and temperature（PFT） characteristic parameters as the input vectors of the two improved neural network models, and the diagnosis result is taken as the basic probability distribution of the evidence theory. Then the objectivity of assignment is real-ized. The initial diagnosis results of two improved neural networks are fused by D-S evidence theory. The experimental results show that this method can avoid the misdiagnosis of neural network recognition and improve the accuracy of the fault diagnosis of HDRLSS.
基金supported by the National Natural Science Foundation of China under Grant No.60903166 the National High Technology Research and Development Program of China（863 Program） under Grants No.2012AA012506,No.2012AA012901,No.2012AA012903+9 种基金 Specialized Research Fund for the Doctoral Program of Higher Education of China under Grant No.20121103120032 the Humanity and Social Science Youth Foundation of Ministry of Education of China under Grant No.13YJCZH065 the Opening Project of Key Lab of Information Network Security of Ministry of Public Security（The Third Research Institute of Ministry of Public Security） under Grant No.C13613 the China Postdoctoral Science Foundation General Program of Science and Technology Development Project of Beijing Municipal Education Commission of China under Grant No.km201410005012 the Research on Education and Teaching of Beijing University of Technology under Grant No.ER2013C24 the Beijing Municipal Natural Science Foundation Sponsored by Hunan Postdoctoral Scientific Program Open Research Fund of Beijing Key Laboratory of Trusted Computing Funds for the Central Universities, Contract No.2012JBM030
文摘Network intrusion forensics is an important extension to present security infrastructure,and is becoming the focus of forensics research field.However,comparison with sophisticated multi-stage attacks and volume of sensor data,current practices in network forensic analysis are to manually examine,an error prone,labor-intensive and time consuming process.To solve these problems,in this paper we propose a digital evidence fusion method for network forensics with Dempster-Shafer theory that can detect efficiently computer crime in networked environments,and fuse digital evidence from different sources such as hosts and sub-networks automatically.In the end,we evaluate the method on well-known KDD Cup1999 dataset.The results prove our method is very effective for real-time network forensics,and can provide comprehensible messages for a forensic investigators.
