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
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
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
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
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
Dempster-Shafer evidence theory is broadly employed in the research of multi-source information fusion.Nevertheless,when fusing highly conflicting evidence it may pro-duce counterintuitive outcomes.To address this iss...Dempster-Shafer evidence theory is broadly employed in the research of multi-source information fusion.Nevertheless,when fusing highly conflicting evidence it may pro-duce counterintuitive outcomes.To address this issue,a fusion approach based on a newly defined belief exponential diver-gence and Deng entropy is proposed.First,a belief exponential divergence is proposed as the conflict measurement between evidences.Then,the credibility of each evidence is calculated.Afterwards,the Deng entropy is used to calculate information volume to determine the uncertainty of evidence.Then,the weight of evidence is calculated by integrating the credibility and uncertainty of each evidence.Ultimately,initial evidences are amended and fused using Dempster’s rule of combination.The effectiveness of this approach in addressing the fusion of three typical conflict paradoxes is demonstrated by arithmetic exam-ples.Additionally,the proposed approach is applied to aerial tar-get recognition and iris dataset-based classification to validate its efficacy.Results indicate that the proposed approach can enhance the accuracy of target recognition and effectively address the issue of fusing conflicting evidences.展开更多
Case reports,often overlooked in evidence-based medicine(EBM),play a pivotal role in healthcare research.They provide unique insights into rare conditions,novel treatments,and adverse effects,serving as valuable educa...Case reports,often overlooked in evidence-based medicine(EBM),play a pivotal role in healthcare research.They provide unique insights into rare conditions,novel treatments,and adverse effects,serving as valuable educational tools and generating new hypothesis.Despite their limitations in generalizability,case reports contribute significantly to evidence-based practice by offering detailed clinical information and fostering critical thinking among healthcare professionals.By acknowledging their limitations and adhering to reporting guidelines,case reports can contribute significantly to medical knowledge and patient care within the evolving landscape of EBM.This editorial explores the intrinsic value of case reports in EBM and patient care.展开更多
Nonalcoholic fatty liver disease(NAFLD)is a global epidemic,affecting more than half of the people living with type 2 diabetes(T2D).The relationship between NAFLD and T2D is bidirectional and the presence of one perpe...Nonalcoholic fatty liver disease(NAFLD)is a global epidemic,affecting more than half of the people living with type 2 diabetes(T2D).The relationship between NAFLD and T2D is bidirectional and the presence of one perpetuates the other,which significantly increases the hepatic as well as extrahepatic complications.Until recently,there was no approved pharmacological treatment for NAFLD/nonalcoholic steatohepatitits(NASH).However,there is evidence that drugs used for diabetes may have beneficial effects on NAFLD.Insulin sensitizers acting through peroxisome proliferator-activated receptor(PPAR)modulation act on multiple levels of NAFLD pathogenesis.Pioglitazone(PPARγ agonist)and saroglitazar(PPARα/γagonist)are particularly beneficial and recommended by several authoritative bodies for treating NAFLD in T2D,although data on biopsyproven NASH are lacking with the latter.Initial data on elafibanor(PPARα/δ agonist)and Lanifibranor(pan PPAR agonist)are promising.On the other hand,incretin therapies based on glucagon-like peptide-1(GLP-1)receptor agonists(GLP-1RA)and dual-and triple-hormone receptor co-agonists reported impressive weight loss and may have anti-inflammatory and antifibrotic properties.GLP-1 RAs have shown beneficial effects on NAFLD/NASH and more studies on potential direct effects on liver function by dual-and triple-agonists are required.Furthermore,the long-term safety of these therapies in NAFLD needs to be established.Collaborative efforts among healthcare providers such as primary care doctors,hepatologists,and endocrinologists are warranted for selecting patients for the best possible management of NAFLD in T2D.展开更多
Objective:Evidence-based practices(EBPs)have been taught to students by identifying the best evidence/evidence from research results.However,the experiences of Indonesian nurse preceptors in helping students implement...Objective:Evidence-based practices(EBPs)have been taught to students by identifying the best evidence/evidence from research results.However,the experiences of Indonesian nurse preceptors in helping students implement research findings have not been explored thoroughly.This study aimed to explore Indonesian nurse preceptors in guiding nursing students to use research findings.Methods:This study used interpretive phenomenology analysis that involves 9 nurse preceptors from hospitals in West Kalimantan,Indonesia.Semi-structured in-depth interviews were recorded and then transcribed verbatim.Results:Three themes were generated during the analysis:“types of student supervision,”“issues during supervision,”and“the need for research literacy and supervision.”Conclusions:Nurse preceptors need support to supervise the nursing students to use research findings.In addition to upgrading nursing skills,nurse preceptors must receive training in research and its utilization.Developing an appropriate strategy to assist students in using research findings will enhance the promotion of evidence-based nursing practices on a daily basis.展开更多
Cognitive Reliability and Error Analysis Method(CREAM)is widely used in human reliability analysis(HRA).It defines nine common performance conditions(CPCs),which represent the factors thatmay affect human reliability ...Cognitive Reliability and Error Analysis Method(CREAM)is widely used in human reliability analysis(HRA).It defines nine common performance conditions(CPCs),which represent the factors thatmay affect human reliability and are used to modify the cognitive failure probability(CFP).However,the levels of CPCs are usually determined by domain experts,whichmay be subjective and uncertain.What’smore,the classicCREAMassumes that the CPCs are independent,which is unrealistic.Ignoring the dependence among CPCs will result in repeated calculations of the influence of the CPCs on CFP and lead to unreasonable reliability evaluation.To address the issue of uncertain information modeling and processing,this paper introduces evidence theory to evaluate the CPC levels in specific scenarios.To address the issue of dependence modeling,the Decision-Making Trial and Evaluation Laboratory(DEMATEL)method is used to process the dependence among CPCs and calculate the relative weights of each CPC,thus modifying the multiplier of the CPCs.The detailed process of the proposed method is illustrated in this paper and the CFP estimated by the proposed method is more reasonable.展开更多
Objective The extent to which the association between hypertension and chronic pain in observational studies is either causally linked or influenced by other shared risk factors has not been substantially addressed.In...Objective The extent to which the association between hypertension and chronic pain in observational studies is either causally linked or influenced by other shared risk factors has not been substantially addressed.In the present study,Mendelian randomization(MR)was employed to examine the potential causal relationship between hypertension and risk of chronic pain.Methods The study data were derived from the pooled dataset of the genome-wide association study(GWAS),enabling the evaluation of the causal effects of hypertension on various types of chronic pain including chronic headache as well as chest,abdominal,joint,back,limb,and multisite chronic pain.We performed a bidirectional two-sample MR analysis using random effect inverse variance weighting(IVW),MR-Egger,weighted median,and weighted mode,quantified by odds ratio(OR).Results Genetically predicted essential hypertension was associated with an increased risk of chronic headache(OR=1.007,95%CI:1.003-1.011,P=0.002)and limb pain(OR=1.219,95%CI:1.033-1.439,P=0.019).No potential causal associations were identified between chronic pain and essential hypertension in the reverse direction MR(P>0.05).In addition,there was no potential causal association between secondary hypertension and chronic pain(P>0.05).Conclusion This study provided genetic evidence that a unidirectional causal relationship exists between essential hypertension and the increased risks of chronic headache and limb pain,and no causal relationship was found between secondary hypertension and chronic pain.These findings offer theoretical underpinnings for future research on managing hypertension and chronic pain.展开更多
Hydrogen is the new age alternative energy source to combat energy demand and climate change.Storage of hydrogen is vital for a nation’s growth.Works of literature provide different methods for storing the produced h...Hydrogen is the new age alternative energy source to combat energy demand and climate change.Storage of hydrogen is vital for a nation’s growth.Works of literature provide different methods for storing the produced hydrogen,and the rational selection of a viable method is crucial for promoting sustainability and green practices.Typically,hydrogen storage is associated with diverse sustainable and circular economy(SCE)criteria.As a result,the authors consider the situation a multi-criteria decision-making(MCDM)problem.Studies infer that previous models for hydrogen storage method(HSM)selection(i)do not consider preferences in the natural language form;(ii)weights of experts are not methodically determined;(iii)hesitation of experts during criteria weight assessment is not effectively explored;and(iv)three-stage solution of a suitable selection of HSM is unexplored.Driven by these gaps,in this paper,authors put forward a new integrated framework,which considers double hierarchy linguistic information for rating,criteria importance through inter-criteria correlation(CRITIC)for expert weight calculation,evidence-based Bayesian method for criteria weight estimation,and combined compromise solution(CoCoSo)for ranking HSMs.The applicability of the developed framework is testified by using a case example of HSM selection in India.Sensitivity and comparative analysis reveal the merits and limitations of the developed framework.展开更多
Upper Ordovician-Lower Silurian Wufeng-Longmaxi Formation is the most developed strata of shale gas in southern China.Due to the complex sedimentary environment adjacent to the Kangdian Uplift,the favorable area for o...Upper Ordovician-Lower Silurian Wufeng-Longmaxi Formation is the most developed strata of shale gas in southern China.Due to the complex sedimentary environment adjacent to the Kangdian Uplift,the favorable area for organic-rich shale development is still undetermined.The authors,therefore,focus on the mechanism of accumulation of organic matter and the characterization of the sedimentary environment of the Wufeng-Longmaxi Shales to have a more complete understanding and new discovering of organic matter enrichment and favorable area in the marginal region around Sichuan Basin.Multiple methods were applied in this study,including thin section identification,scanning electron microscopy(SEM)observations and X-ray diffraction(XRD),and elemental analysis on outcrop samples.Five lithofacies have been defined according to the mineralogical and petrological analyses,including mudstone,bioclastic limestone,silty shale,dolomitic shale,and carbonaceous siliceous shale.The paleo-environments have been reconstructed and the organic enrichment mechanism has been identified as a reduced environment and high productivity.The Wufeng period is generally a suboxic environment and the early Longmaxi period is a reducing environment based on geochemical characterization.High dolomite content in the study area is accompanied by high TOC,which may potentially indicate the restricted anoxic environment formed by biological flourishing in shallower water.And for the area close to the Kangdian Uplift,the shale gas generation capability is comparatively favorable.The geochemical parameters implied that new favorable areas for shale gas exploration could be targeted,and more shale gas resources in the mountain-basin transitional zone might be identified in the future.展开更多
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.
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 National Natural Science Foundation of China(61903305,62073267)the Fundamental Research Funds for the Central Universities(HXGJXM202214).
文摘Dempster-Shafer evidence theory is broadly employed in the research of multi-source information fusion.Nevertheless,when fusing highly conflicting evidence it may pro-duce counterintuitive outcomes.To address this issue,a fusion approach based on a newly defined belief exponential diver-gence and Deng entropy is proposed.First,a belief exponential divergence is proposed as the conflict measurement between evidences.Then,the credibility of each evidence is calculated.Afterwards,the Deng entropy is used to calculate information volume to determine the uncertainty of evidence.Then,the weight of evidence is calculated by integrating the credibility and uncertainty of each evidence.Ultimately,initial evidences are amended and fused using Dempster’s rule of combination.The effectiveness of this approach in addressing the fusion of three typical conflict paradoxes is demonstrated by arithmetic exam-ples.Additionally,the proposed approach is applied to aerial tar-get recognition and iris dataset-based classification to validate its efficacy.Results indicate that the proposed approach can enhance the accuracy of target recognition and effectively address the issue of fusing conflicting evidences.
文摘Case reports,often overlooked in evidence-based medicine(EBM),play a pivotal role in healthcare research.They provide unique insights into rare conditions,novel treatments,and adverse effects,serving as valuable educational tools and generating new hypothesis.Despite their limitations in generalizability,case reports contribute significantly to evidence-based practice by offering detailed clinical information and fostering critical thinking among healthcare professionals.By acknowledging their limitations and adhering to reporting guidelines,case reports can contribute significantly to medical knowledge and patient care within the evolving landscape of EBM.This editorial explores the intrinsic value of case reports in EBM and patient care.
文摘Nonalcoholic fatty liver disease(NAFLD)is a global epidemic,affecting more than half of the people living with type 2 diabetes(T2D).The relationship between NAFLD and T2D is bidirectional and the presence of one perpetuates the other,which significantly increases the hepatic as well as extrahepatic complications.Until recently,there was no approved pharmacological treatment for NAFLD/nonalcoholic steatohepatitits(NASH).However,there is evidence that drugs used for diabetes may have beneficial effects on NAFLD.Insulin sensitizers acting through peroxisome proliferator-activated receptor(PPAR)modulation act on multiple levels of NAFLD pathogenesis.Pioglitazone(PPARγ agonist)and saroglitazar(PPARα/γagonist)are particularly beneficial and recommended by several authoritative bodies for treating NAFLD in T2D,although data on biopsyproven NASH are lacking with the latter.Initial data on elafibanor(PPARα/δ agonist)and Lanifibranor(pan PPAR agonist)are promising.On the other hand,incretin therapies based on glucagon-like peptide-1(GLP-1)receptor agonists(GLP-1RA)and dual-and triple-hormone receptor co-agonists reported impressive weight loss and may have anti-inflammatory and antifibrotic properties.GLP-1 RAs have shown beneficial effects on NAFLD/NASH and more studies on potential direct effects on liver function by dual-and triple-agonists are required.Furthermore,the long-term safety of these therapies in NAFLD needs to be established.Collaborative efforts among healthcare providers such as primary care doctors,hepatologists,and endocrinologists are warranted for selecting patients for the best possible management of NAFLD in T2D.
基金supported by Universitas Tanjungpura Pontianak,Indonesia(No.2377/UN22.9/PG/2022,2022)。
文摘Objective:Evidence-based practices(EBPs)have been taught to students by identifying the best evidence/evidence from research results.However,the experiences of Indonesian nurse preceptors in helping students implement research findings have not been explored thoroughly.This study aimed to explore Indonesian nurse preceptors in guiding nursing students to use research findings.Methods:This study used interpretive phenomenology analysis that involves 9 nurse preceptors from hospitals in West Kalimantan,Indonesia.Semi-structured in-depth interviews were recorded and then transcribed verbatim.Results:Three themes were generated during the analysis:“types of student supervision,”“issues during supervision,”and“the need for research literacy and supervision.”Conclusions:Nurse preceptors need support to supervise the nursing students to use research findings.In addition to upgrading nursing skills,nurse preceptors must receive training in research and its utilization.Developing an appropriate strategy to assist students in using research findings will enhance the promotion of evidence-based nursing practices on a daily basis.
基金Shanghai Rising-Star Program(Grant No.21QA1403400)Shanghai Sailing Program(Grant No.20YF1414800)Shanghai Key Laboratory of Power Station Automation Technology(Grant No.13DZ2273800).
文摘Cognitive Reliability and Error Analysis Method(CREAM)is widely used in human reliability analysis(HRA).It defines nine common performance conditions(CPCs),which represent the factors thatmay affect human reliability and are used to modify the cognitive failure probability(CFP).However,the levels of CPCs are usually determined by domain experts,whichmay be subjective and uncertain.What’smore,the classicCREAMassumes that the CPCs are independent,which is unrealistic.Ignoring the dependence among CPCs will result in repeated calculations of the influence of the CPCs on CFP and lead to unreasonable reliability evaluation.To address the issue of uncertain information modeling and processing,this paper introduces evidence theory to evaluate the CPC levels in specific scenarios.To address the issue of dependence modeling,the Decision-Making Trial and Evaluation Laboratory(DEMATEL)method is used to process the dependence among CPCs and calculate the relative weights of each CPC,thus modifying the multiplier of the CPCs.The detailed process of the proposed method is illustrated in this paper and the CFP estimated by the proposed method is more reasonable.
文摘Objective The extent to which the association between hypertension and chronic pain in observational studies is either causally linked or influenced by other shared risk factors has not been substantially addressed.In the present study,Mendelian randomization(MR)was employed to examine the potential causal relationship between hypertension and risk of chronic pain.Methods The study data were derived from the pooled dataset of the genome-wide association study(GWAS),enabling the evaluation of the causal effects of hypertension on various types of chronic pain including chronic headache as well as chest,abdominal,joint,back,limb,and multisite chronic pain.We performed a bidirectional two-sample MR analysis using random effect inverse variance weighting(IVW),MR-Egger,weighted median,and weighted mode,quantified by odds ratio(OR).Results Genetically predicted essential hypertension was associated with an increased risk of chronic headache(OR=1.007,95%CI:1.003-1.011,P=0.002)and limb pain(OR=1.219,95%CI:1.033-1.439,P=0.019).No potential causal associations were identified between chronic pain and essential hypertension in the reverse direction MR(P>0.05).In addition,there was no potential causal association between secondary hypertension and chronic pain(P>0.05).Conclusion This study provided genetic evidence that a unidirectional causal relationship exists between essential hypertension and the increased risks of chronic headache and limb pain,and no causal relationship was found between secondary hypertension and chronic pain.These findings offer theoretical underpinnings for future research on managing hypertension and chronic pain.
文摘Hydrogen is the new age alternative energy source to combat energy demand and climate change.Storage of hydrogen is vital for a nation’s growth.Works of literature provide different methods for storing the produced hydrogen,and the rational selection of a viable method is crucial for promoting sustainability and green practices.Typically,hydrogen storage is associated with diverse sustainable and circular economy(SCE)criteria.As a result,the authors consider the situation a multi-criteria decision-making(MCDM)problem.Studies infer that previous models for hydrogen storage method(HSM)selection(i)do not consider preferences in the natural language form;(ii)weights of experts are not methodically determined;(iii)hesitation of experts during criteria weight assessment is not effectively explored;and(iv)three-stage solution of a suitable selection of HSM is unexplored.Driven by these gaps,in this paper,authors put forward a new integrated framework,which considers double hierarchy linguistic information for rating,criteria importance through inter-criteria correlation(CRITIC)for expert weight calculation,evidence-based Bayesian method for criteria weight estimation,and combined compromise solution(CoCoSo)for ranking HSMs.The applicability of the developed framework is testified by using a case example of HSM selection in India.Sensitivity and comparative analysis reveal the merits and limitations of the developed framework.
基金jointly funded by the National Key Laboratory of Oil and Gas Reservoir Geology and Exploitation(PLC20210104)China Geological Survey(DD20221661)China National Science and Technology Major Project“Test and Application of Shale Gas Exploration and Evaluation Technology(2016ZX05034004)”。
文摘Upper Ordovician-Lower Silurian Wufeng-Longmaxi Formation is the most developed strata of shale gas in southern China.Due to the complex sedimentary environment adjacent to the Kangdian Uplift,the favorable area for organic-rich shale development is still undetermined.The authors,therefore,focus on the mechanism of accumulation of organic matter and the characterization of the sedimentary environment of the Wufeng-Longmaxi Shales to have a more complete understanding and new discovering of organic matter enrichment and favorable area in the marginal region around Sichuan Basin.Multiple methods were applied in this study,including thin section identification,scanning electron microscopy(SEM)observations and X-ray diffraction(XRD),and elemental analysis on outcrop samples.Five lithofacies have been defined according to the mineralogical and petrological analyses,including mudstone,bioclastic limestone,silty shale,dolomitic shale,and carbonaceous siliceous shale.The paleo-environments have been reconstructed and the organic enrichment mechanism has been identified as a reduced environment and high productivity.The Wufeng period is generally a suboxic environment and the early Longmaxi period is a reducing environment based on geochemical characterization.High dolomite content in the study area is accompanied by high TOC,which may potentially indicate the restricted anoxic environment formed by biological flourishing in shallower water.And for the area close to the Kangdian Uplift,the shale gas generation capability is comparatively favorable.The geochemical parameters implied that new favorable areas for shale gas exploration could be targeted,and more shale gas resources in the mountain-basin transitional zone might be identified in the future.
