To address the issue of incorrect fusion results caused by conflicting evidence due to inaccurate evidence and incomplete recognition frameworks in radar airborne target tactical intention recognition,a spatiotemporal...To address the issue of incorrect fusion results caused by conflicting evidence due to inaccurate evidence and incomplete recognition frameworks in radar airborne target tactical intention recognition,a spatiotemporal evidence fusion algorithm is proposed.To resolve the conflict evidence fusion problem caused by inaccurate evidence,the algorithm performs discounting of evidence from both spatial and temporal dimensions.Spatial discounting is influenced by both inter-evidence inconsistency and intra-evidence inconsistency,while temporal discounting is determined by time intervals and information entropy.For the problem of conflicting evidence fusion due to an incomplete recognition framework,an open recognition architecture based on dynamic composite focal elements is proposed.This approach allocates some conflicting information to temporary composite focal elements,avoiding excessive basic probability assignment(BPA)of the empty set after fusion,which can lead to deviations from the actual fusion results.Simulation experiments comparing various methods indicate that the proposed method can effectively improve target intention recognition accuracy and demonstrates good stability.展开更多
Objective:To systematically summarize and evaluate the evidence on discharge preparation services for patients undergoing total knee arthroplasty,providing an evidence-based foundation for developing scientific and st...Objective:To systematically summarize and evaluate the evidence on discharge preparation services for patients undergoing total knee arthroplasty,providing an evidence-based foundation for developing scientific and standardized discharge preparation intervention programs in clinical practice.Methods:Following the“5S”evidence model,literature such as guidelines,expert consensuses,evidence summaries and randomized controlled trials related to discharge preparation services for total knee arthroplasty patients were retrieved from relevant websites and databases,both domestic and international,from database inception to August 31,2025.Two researchers independently screened the literature,conducted quality appraisals,and extracted and synthesized the evidence.Results:A total of 15 articles were included,comprising 3 guidelines,4 expert consensuses,3 evidence summaries,3 systematic reviews and 2 randomized controlled trials.Ultimately,23 pieces of evidence were summarized across five aspects.Conclusion:This study synthesizes the evidence on discharge preparation services for patients undergoing total knee arthroplasty.It is recommended that healthcare professionals apply this evidence in clinical practice,considering specific circumstances and patient needs.展开更多
Molecular hydrogen(H2)demonstrates selective antioxidant and anti-inflammatory properties with therapeutic potential across musculoskeletal conditions including osteoarthritis,rheumatoid arthritis,exercise-induced mus...Molecular hydrogen(H2)demonstrates selective antioxidant and anti-inflammatory properties with therapeutic potential across musculoskeletal conditions including osteoarthritis,rheumatoid arthritis,exercise-induced muscle damage,chronic pain syndromes,tendinopathies,and muscle atrophy.This review critically evaluates preclinical and clinical evidence for H2 therapy and identifies research gaps.A comprehensive search of PubMed,EMBASE,and Cochrane Library(up to April 2025)yielded 45 eligible studies:25 preclinical and 20 clinical trials.Preclinical models consistently showed reductions in reactive oxygen species,inflammatory cytokines,and improved cell viability.Clinical trials reported symptomatic relief in osteoarthritis,decreased Disease Activity Score 28 in rheumatoid arthritis,and accelerated clearance of muscle damage markers.Delivery methods varied-hydrogen-rich water,gas inhalation,and saline infusion-hindering direct comparison.Mechanistic biomarkers were inconsistently reported,limiting understanding of target engagement.Common limitations included small sample sizes,short durations,and protocol heterogeneity.Despite these constraints,findings suggest H2 may serve as a promising adjunctive therapy via antioxidant,anti-inflammatory,and cytoprotective mechanisms.Future research should prioritize standardized delivery protocols,robust mechanistic endpoints,and longer-term randomized trials to validate clinical efficacy and optimize therapeutic strategies.展开更多
1.Introduction Artificial intelligence(AI)is rapidly reshaping geoscience,from Earth observation interpretation and hazard forecasting to subsurface characterisation and Earth system modelling(Kochupillai et al.,2022;...1.Introduction Artificial intelligence(AI)is rapidly reshaping geoscience,from Earth observation interpretation and hazard forecasting to subsurface characterisation and Earth system modelling(Kochupillai et al.,2022;Sun et al.,2024).These capabilities emerge at a time when geoscientific evidence is increasingly informing high-stakes decisions about climate adaptation,resource development,and disaster risk reduction(McGovern et al.,2022).展开更多
Background:Cyclin-dependent kinase 4/6(CDK4/6)inhibitors have transformed the management of hormone receptor–positive/HER2–negative(HR+/HER2–)advanced breast cancer,yet evidence for elderly or poor-performance pati...Background:Cyclin-dependent kinase 4/6(CDK4/6)inhibitors have transformed the management of hormone receptor–positive/HER2–negative(HR+/HER2–)advanced breast cancer,yet evidence for elderly or poor-performance patients remains limited.This study examined real-world outcomes of palbociclib plus endocrine therapy in Asian patients,with additional subgroup analyses by age and performance status.Methods:We retrospectively analyzed 46 consecutive Asian patients with recurrent or de novo HR+/HER2−breast cancer treated with first-line palbociclib plus ET between April 2021 and March 2025.The primary endpoint was progression-free survival(PFS).Secondary endpoints included overall response rate(ORR),disease control rate(DCR),and safety.Subgroup analyses were performed by age(<70 vs.≥70 years)and performance status(PS;0–1 vs.2–3).Results:The median PFS was 26.6 months(range,1.4–69.5).Stratified by age,median PFS was 26.9 months in patients<70 years and 26.2 months in those≥70 years(p=0.760).By PS,PFS was 26.9 months for PS 0–1 and 17.8 months for PS 2–3(p=0.099).ORR was 60.9%and DCR 93.5%;notably,all PS 2–3 patients achieved disease control.Hematologic toxicities were common,with neutropenia(80.4%)and leukopenia(86.7%)predominating,but grade≥3 anemia was rare(2.2%).Elderly patients experienced anemia more frequently,while overall toxicity remained manageable.Dose reductions occurred in 47.8%without loss of efficacy.Conclusions:In routine Japanese practice,palbociclib plus ET provided prolonged PFS and high disease control consistent with pivotal trials and international real-world evidence.Importantly,elderly patients tolerated treatment well,and selected PS 2–3 patients also derived clinical benefit.These findings indicate that neither age nor PS alone should preclude the use of palbociclib in carefully monitored real-world patients.展开更多
Financial expenses Of China’s textile machinery in fiscal year 2008 rose 28.81%due to higher indebtedness(60.57%of indebtedness rate).Analysts anticipated animminent weakening of momentum for China’s textile machine...Financial expenses Of China’s textile machinery in fiscal year 2008 rose 28.81%due to higher indebtedness(60.57%of indebtedness rate).Analysts anticipated animminent weakening of momentum for China’s textile machinery markets owing toweaker consumer spending and easing export growth.展开更多
According to the latest statistics released by China TextileMachinery & Accessories Association(CTMA),the export value offoreign-funded enterprises from Jan.to Oct.2008,reached 0.502billion US dollars,a year-on-ye...According to the latest statistics released by China TextileMachinery & Accessories Association(CTMA),the export value offoreign-funded enterprises from Jan.to Oct.2008,reached 0.502billion US dollars,a year-on-year increase of 0.08 percent.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
Leveraging unique resource advantages of traditional Chinese medicine(TCM)to achieve innovative breakthroughs in research constitutes a core strategic imperative for its inheritance,innovation and development.At prese...Leveraging unique resource advantages of traditional Chinese medicine(TCM)to achieve innovative breakthroughs in research constitutes a core strategic imperative for its inheritance,innovation and development.At present,the academic advances and scientific achievements in TCM serve as a key driving force for industry growth and advancement of the inheritance and innovation of TCM.To continuously strengthen the leading role of academic research,the China Association of Chinese Medicine(CACM)attaches great importance to the latest research directions and academic results in TCM,and spotlights key advances and emerging trends in TCM scholarship.Since 2020,CACM has conducted the selection and release of the“top 10 academic advances in traditional Chinese medicine”on a yearly basis.The selection of“top 10 academic advances in traditional Chinese medicine in 2024”prioritized research that addresses clinical needs,answers scientific questions and drives industrial development.Highlighting exploratory,forward-looking,innovative and groundbreaking achievements,the following 10 breakthroughs were selected through a process of collection,systematic review and expert evaluation:New advances in prevention and treatment of digestive system diseases with“brain-gut”cross-organ strategy,high-level evidence support for prevention and treatment of cardiovascular disease(CVD)continuum with TCM,important breakthrough in the research on prevention and treatment of acute radiation injury with TCM,elucidation of molecular mechanisms underlying“excellent shape and high quality”variation in cultivated American ginseng through domestication,biosynthesis of trace active ingredients such as benzylisoquinoline alkaloids,pilot application of artificial intelligence(AI)technology,research technology for unelucidated constituents of TCM,new drug delivery system in TCM,and establishment and preliminary application of integrated evidence chain-based effectiveness evaluation of TCM(iEC-Eff).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
Birch mice(family Sicistidae)are small dipodoid rodents distributed in regions surrounding the Qinghai-Xizang Plateau and extending across the Palearctic.In China,members of the genus Sicista are rarely recorded,and t...Birch mice(family Sicistidae)are small dipodoid rodents distributed in regions surrounding the Qinghai-Xizang Plateau and extending across the Palearctic.In China,members of the genus Sicista are rarely recorded,and their systematics remain poorly resolved.As part of the Second Xizang Plateau Expedition by the Kunming Institute of Zoology,Chinese Academy of Sciences,systematic surveys conducted in southern Xizang and the western Tianshan Mountains yielded two previously unrecognized species.Two specimens from southern Xizang were found to occupy a deeply divergent phylogenetic position within Sicistidae.Morphological assessments and molecular phylogenetic analyses of both extant and fossil Sicistidae,along with total-evidence dating and ancestral distribution reconstruction,identified these specimens as representatives of an ancient extant lineage that diverged from Sicista approximately 20.38 million years ago.This lineage is designated as a new genus,defined by the new species Breviforamen shannanensis gen.et sp.nov.Furthermore,11 specimens from the Tianshan Mountains are described as a second new species,Sicista brevicauda sp.nov.,based on diagnostic morphological and genetic features.Ancestral distribution reconstructions,combined with fossil records,indicate an early Miocene origin for Sicistidae across a broad region spanning the“Gobi”Desert to parts of North America.Climatic deterioration and increasing desertification during the mid-Miocene likely drove southward dispersal of Breviforamen gen.nov.into southern Xizang prior to the complete formation of the Yarlung Zangbo River.Overall,these findings broaden current understanding of Sicistidae diversity,elucidate the origin and dispersal patterns of the family,and highlight the presence of an ancient relict lineage in China.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
Depression is a complex mental health disorder that significantly impairs quality of life and affects millions globally.Emerging evidence underscores a potential link between macronutrient imbalances and depression on...Depression is a complex mental health disorder that significantly impairs quality of life and affects millions globally.Emerging evidence underscores a potential link between macronutrient imbalances and depression onset or progression.This review explores how macronutrients—carbohydrates,fats,and proteins—may influence depressive symptoms.For example,excessive sugar consumption is associated with heightened depressive risk,likely due to its effects on insulin resistance and inflammation.Conversely,sufficient protein intake appears to mitigate depression risk,with studies reporting that a 10%increase in caloric intake from protein correlates with a significant reduction in depression prevalence.However,diets rich in saturated fats and proteins may slightly elevate depressive risk.This review emphasizes the critical importance of dietary balance in promoting mental health.Although some studies have suggested that maintaining specific macronutrient ratios may be associated with a reduced risk of depression,given the diversity of evidence and contradictory findings among studies,further research is needed to clarify the exact effects.Future research should aim to elucidate the molecular mechanisms underlying these associations,providing a robust foundation for dietary interventions in the prevention and treatment of depression.展开更多
Background:The bibliometrics of acupuncture are growing rapidly.However,the absence of reporting guidelines may lead to significant duplication and waste,thereby undermining the research’s value.To address this,a kno...Background:The bibliometrics of acupuncture are growing rapidly.However,the absence of reporting guidelines may lead to significant duplication and waste,thereby undermining the research’s value.To address this,a knowledge mapping was generated based on published studies to investigate the characteristics of bibliometric studies on acupuncture and the extent of duplicate publications,with the overarching goal of providing a comprehensive overview of the knowledge structure in this field.Methods:This cross-sectional study used three databases(PubMed,Web of Science,and Scopus)to identify relevant studies up to May 1,2024.In addition,the reference lists were retrieved as a supplement.To track research trends,we employed Microsoft Excel and R software to extract,code,and analyze information.Study selection,data extraction,and validation were performed independently by at least two reviewers.The reporting quality of included studies was assessed using the Preliminary guideline for reporting bibliometric reviews of the biomedical literature(BIBLIO).Results:Among the 6,221 bibliometric reviews examined,113 relevant publications were identified,80 focusing on various diseases/conditions.The annual number of publications has gradually increased,with the output in the past four years being 3.52 times higher than that before 2020.China(106)and Chengdu University of Traditional Chinese Medicine(16)have the highest number of publications.The most prolific author is Fan-Rong Liang,with six articles.The first bibliometric study,by Hai-Yan Li,was published in 2010.Journal of Pain Research,with 36 articles,holds the most publications.The top three diseases:diseases of the nervous system;symptoms,signs,or clinical findings not elsewhere classified;and mental,behavioral,or neurodevelopmental disorders.There may be potential duplication in research on 13 diseases/conditions,notably stroke,migraine,pain/analgesia,cancer pain,shoulder pain,facial paralysis/bell’s palsy,chronic pain,and cognitive impairment.In BIBLIO,the most frequently missing items are issues/topics(item 2),quality assessment(item 11),and descriptive findings(item 13).Conclusion:This study demonstrates that acupuncture bibliometrics is actively utilized to identify dominant diseases/conditions,aiding scholars in understand the knowledge structure and main topics.Although the number of related studies is increasing,with an average of 25 studies annually,overlap in some areas highlights the need for adherence to reporting guidelines and careful topic selection to ensure truly valuable insights and knowledge contributions.The adherence to BIBLIO’s 20 proposed items across analyzed articles,highlighting important in reporting practices.展开更多
Climate change is a pressing global environmental issue^([1]).The gradual rise in global surface temperature is the most immediate and direct among its public health impacts.Influenza,the leading cause of human respir...Climate change is a pressing global environmental issue^([1]).The gradual rise in global surface temperature is the most immediate and direct among its public health impacts.Influenza,the leading cause of human respiratory viral infections,remains a substantial public health concern owing to its considerable disease burden,particularly in highrisk groups.Mounting epidemiological evidence has linked influenza to extreme heat and cold weather^([2–4]).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
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
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
Meta-analysis plays a crucial role in synthesizing evidence across studies,yet its application in the context of rare diseases poses unique methodological challenges.A major limitation is the small sample size typical...Meta-analysis plays a crucial role in synthesizing evidence across studies,yet its application in the context of rare diseases poses unique methodological challenges.A major limitation is the small sample size typical of rare disease studies,which undermines statistical power and increases uncertainty in pooled estimates.Publication bias is particularly pronounced,as studies with non-significant or negative results are less likely to be published,distorting the overall evidence base.High heterogeneity in study designs,populations,and outcomes-especially between observational studies and randomized controlled trials-further complicates the integration of findings.Additionally,rare disease datasets are often characterized by sparse data,including zero-event studies,which are difficult to analyse using traditional meta-analytic approaches.The frequent use of inappropriate statistical methods,such as fixed-effects models in the presence of heterogeneity or continuity corrections for zero-event data,can yield misleading results.These issues collectively limit the generalisability of meta-analytic conclusions to broader patient populations.This article critically evaluates these problems and highlights the need for advanced statistical techniques,rigorous study selection,and transparent reporting standards to enhance the validity and utility of metaanalyses in rare disease research.展开更多
基金supported by the Key Research and Development Program of Shaanxi Province(2023-GHZD-33)the Open Project of the State Key Laboratory of Intelligent Game(ZBKF-23-05)the National Nature Science Foundation of China(62003267)。
文摘To address the issue of incorrect fusion results caused by conflicting evidence due to inaccurate evidence and incomplete recognition frameworks in radar airborne target tactical intention recognition,a spatiotemporal evidence fusion algorithm is proposed.To resolve the conflict evidence fusion problem caused by inaccurate evidence,the algorithm performs discounting of evidence from both spatial and temporal dimensions.Spatial discounting is influenced by both inter-evidence inconsistency and intra-evidence inconsistency,while temporal discounting is determined by time intervals and information entropy.For the problem of conflicting evidence fusion due to an incomplete recognition framework,an open recognition architecture based on dynamic composite focal elements is proposed.This approach allocates some conflicting information to temporary composite focal elements,avoiding excessive basic probability assignment(BPA)of the empty set after fusion,which can lead to deviations from the actual fusion results.Simulation experiments comparing various methods indicate that the proposed method can effectively improve target intention recognition accuracy and demonstrates good stability.
文摘Objective:To systematically summarize and evaluate the evidence on discharge preparation services for patients undergoing total knee arthroplasty,providing an evidence-based foundation for developing scientific and standardized discharge preparation intervention programs in clinical practice.Methods:Following the“5S”evidence model,literature such as guidelines,expert consensuses,evidence summaries and randomized controlled trials related to discharge preparation services for total knee arthroplasty patients were retrieved from relevant websites and databases,both domestic and international,from database inception to August 31,2025.Two researchers independently screened the literature,conducted quality appraisals,and extracted and synthesized the evidence.Results:A total of 15 articles were included,comprising 3 guidelines,4 expert consensuses,3 evidence summaries,3 systematic reviews and 2 randomized controlled trials.Ultimately,23 pieces of evidence were summarized across five aspects.Conclusion:This study synthesizes the evidence on discharge preparation services for patients undergoing total knee arthroplasty.It is recommended that healthcare professionals apply this evidence in clinical practice,considering specific circumstances and patient needs.
文摘Molecular hydrogen(H2)demonstrates selective antioxidant and anti-inflammatory properties with therapeutic potential across musculoskeletal conditions including osteoarthritis,rheumatoid arthritis,exercise-induced muscle damage,chronic pain syndromes,tendinopathies,and muscle atrophy.This review critically evaluates preclinical and clinical evidence for H2 therapy and identifies research gaps.A comprehensive search of PubMed,EMBASE,and Cochrane Library(up to April 2025)yielded 45 eligible studies:25 preclinical and 20 clinical trials.Preclinical models consistently showed reductions in reactive oxygen species,inflammatory cytokines,and improved cell viability.Clinical trials reported symptomatic relief in osteoarthritis,decreased Disease Activity Score 28 in rheumatoid arthritis,and accelerated clearance of muscle damage markers.Delivery methods varied-hydrogen-rich water,gas inhalation,and saline infusion-hindering direct comparison.Mechanistic biomarkers were inconsistently reported,limiting understanding of target engagement.Common limitations included small sample sizes,short durations,and protocol heterogeneity.Despite these constraints,findings suggest H2 may serve as a promising adjunctive therapy via antioxidant,anti-inflammatory,and cytoprotective mechanisms.Future research should prioritize standardized delivery protocols,robust mechanistic endpoints,and longer-term randomized trials to validate clinical efficacy and optimize therapeutic strategies.
基金supported by the Natural Science Foundation of Jiangsu Province,China(Grant No.BK20240937)the Natural Science Foundation of Shandong Province(Grant No.ZR2021QE187)+2 种基金the Shandong Higher Education“Young Entrepreneurship Talents Introduction and Cultivation Program”Project(Grant No.ZXQT20221228001)the Natural Science Foundation of China(Grant No.42502273)the Science and Technology Innovation Program of Hunan Province(Grant No.2022RC4028).
文摘1.Introduction Artificial intelligence(AI)is rapidly reshaping geoscience,from Earth observation interpretation and hazard forecasting to subsurface characterisation and Earth system modelling(Kochupillai et al.,2022;Sun et al.,2024).These capabilities emerge at a time when geoscientific evidence is increasingly informing high-stakes decisions about climate adaptation,resource development,and disaster risk reduction(McGovern et al.,2022).
文摘Background:Cyclin-dependent kinase 4/6(CDK4/6)inhibitors have transformed the management of hormone receptor–positive/HER2–negative(HR+/HER2–)advanced breast cancer,yet evidence for elderly or poor-performance patients remains limited.This study examined real-world outcomes of palbociclib plus endocrine therapy in Asian patients,with additional subgroup analyses by age and performance status.Methods:We retrospectively analyzed 46 consecutive Asian patients with recurrent or de novo HR+/HER2−breast cancer treated with first-line palbociclib plus ET between April 2021 and March 2025.The primary endpoint was progression-free survival(PFS).Secondary endpoints included overall response rate(ORR),disease control rate(DCR),and safety.Subgroup analyses were performed by age(<70 vs.≥70 years)and performance status(PS;0–1 vs.2–3).Results:The median PFS was 26.6 months(range,1.4–69.5).Stratified by age,median PFS was 26.9 months in patients<70 years and 26.2 months in those≥70 years(p=0.760).By PS,PFS was 26.9 months for PS 0–1 and 17.8 months for PS 2–3(p=0.099).ORR was 60.9%and DCR 93.5%;notably,all PS 2–3 patients achieved disease control.Hematologic toxicities were common,with neutropenia(80.4%)and leukopenia(86.7%)predominating,but grade≥3 anemia was rare(2.2%).Elderly patients experienced anemia more frequently,while overall toxicity remained manageable.Dose reductions occurred in 47.8%without loss of efficacy.Conclusions:In routine Japanese practice,palbociclib plus ET provided prolonged PFS and high disease control consistent with pivotal trials and international real-world evidence.Importantly,elderly patients tolerated treatment well,and selected PS 2–3 patients also derived clinical benefit.These findings indicate that neither age nor PS alone should preclude the use of palbociclib in carefully monitored real-world patients.
文摘Financial expenses Of China’s textile machinery in fiscal year 2008 rose 28.81%due to higher indebtedness(60.57%of indebtedness rate).Analysts anticipated animminent weakening of momentum for China’s textile machinery markets owing toweaker consumer spending and easing export growth.
文摘According to the latest statistics released by China TextileMachinery & Accessories Association(CTMA),the export value offoreign-funded enterprises from Jan.to Oct.2008,reached 0.502billion US dollars,a year-on-year increase of 0.08 percent.
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 Cooperation 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 Project of Map of Scientific and Technological Talents in the Field of Traditional Chinese Medicine(No.XMSB20240923106).
文摘Leveraging unique resource advantages of traditional Chinese medicine(TCM)to achieve innovative breakthroughs in research constitutes a core strategic imperative for its inheritance,innovation and development.At present,the academic advances and scientific achievements in TCM serve as a key driving force for industry growth and advancement of the inheritance and innovation of TCM.To continuously strengthen the leading role of academic research,the China Association of Chinese Medicine(CACM)attaches great importance to the latest research directions and academic results in TCM,and spotlights key advances and emerging trends in TCM scholarship.Since 2020,CACM has conducted the selection and release of the“top 10 academic advances in traditional Chinese medicine”on a yearly basis.The selection of“top 10 academic advances in traditional Chinese medicine in 2024”prioritized research that addresses clinical needs,answers scientific questions and drives industrial development.Highlighting exploratory,forward-looking,innovative and groundbreaking achievements,the following 10 breakthroughs were selected through a process of collection,systematic review and expert evaluation:New advances in prevention and treatment of digestive system diseases with“brain-gut”cross-organ strategy,high-level evidence support for prevention and treatment of cardiovascular disease(CVD)continuum with TCM,important breakthrough in the research on prevention and treatment of acute radiation injury with TCM,elucidation of molecular mechanisms underlying“excellent shape and high quality”variation in cultivated American ginseng through domestication,biosynthesis of trace active ingredients such as benzylisoquinoline alkaloids,pilot application of artificial intelligence(AI)technology,research technology for unelucidated constituents of TCM,new drug delivery system in TCM,and establishment and preliminary application of integrated evidence chain-based effectiveness evaluation of TCM(iEC-Eff).
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 Second Qinghai-Xizang Plateau Scientific Expedition and Research Program(2024QZKK0200,2019QZKK05010100)Survey of Wildlife Resources in Key Areas of Xizang(ZL202203601,ZL202303601)。
文摘Birch mice(family Sicistidae)are small dipodoid rodents distributed in regions surrounding the Qinghai-Xizang Plateau and extending across the Palearctic.In China,members of the genus Sicista are rarely recorded,and their systematics remain poorly resolved.As part of the Second Xizang Plateau Expedition by the Kunming Institute of Zoology,Chinese Academy of Sciences,systematic surveys conducted in southern Xizang and the western Tianshan Mountains yielded two previously unrecognized species.Two specimens from southern Xizang were found to occupy a deeply divergent phylogenetic position within Sicistidae.Morphological assessments and molecular phylogenetic analyses of both extant and fossil Sicistidae,along with total-evidence dating and ancestral distribution reconstruction,identified these specimens as representatives of an ancient extant lineage that diverged from Sicista approximately 20.38 million years ago.This lineage is designated as a new genus,defined by the new species Breviforamen shannanensis gen.et sp.nov.Furthermore,11 specimens from the Tianshan Mountains are described as a second new species,Sicista brevicauda sp.nov.,based on diagnostic morphological and genetic features.Ancestral distribution reconstructions,combined with fossil records,indicate an early Miocene origin for Sicistidae across a broad region spanning the“Gobi”Desert to parts of North America.Climatic deterioration and increasing desertification during the mid-Miocene likely drove southward dispersal of Breviforamen gen.nov.into southern Xizang prior to the complete formation of the Yarlung Zangbo River.Overall,these findings broaden current understanding of Sicistidae diversity,elucidate the origin and dispersal patterns of the family,and highlight the presence of an ancient relict lineage in China.
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.
文摘Depression is a complex mental health disorder that significantly impairs quality of life and affects millions globally.Emerging evidence underscores a potential link between macronutrient imbalances and depression onset or progression.This review explores how macronutrients—carbohydrates,fats,and proteins—may influence depressive symptoms.For example,excessive sugar consumption is associated with heightened depressive risk,likely due to its effects on insulin resistance and inflammation.Conversely,sufficient protein intake appears to mitigate depression risk,with studies reporting that a 10%increase in caloric intake from protein correlates with a significant reduction in depression prevalence.However,diets rich in saturated fats and proteins may slightly elevate depressive risk.This review emphasizes the critical importance of dietary balance in promoting mental health.Although some studies have suggested that maintaining specific macronutrient ratios may be associated with a reduced risk of depression,given the diversity of evidence and contradictory findings among studies,further research is needed to clarify the exact effects.Future research should aim to elucidate the molecular mechanisms underlying these associations,providing a robust foundation for dietary interventions in the prevention and treatment of depression.
基金supported by the Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(ZYYCXTD-C-202006)the High-level traditional Chinese medicine key subject construction project of National Administration of Traditional Chinese Medicine-Evidence-based Traditional Chinese Medicine(ZYYZDXK-2023249).
文摘Background:The bibliometrics of acupuncture are growing rapidly.However,the absence of reporting guidelines may lead to significant duplication and waste,thereby undermining the research’s value.To address this,a knowledge mapping was generated based on published studies to investigate the characteristics of bibliometric studies on acupuncture and the extent of duplicate publications,with the overarching goal of providing a comprehensive overview of the knowledge structure in this field.Methods:This cross-sectional study used three databases(PubMed,Web of Science,and Scopus)to identify relevant studies up to May 1,2024.In addition,the reference lists were retrieved as a supplement.To track research trends,we employed Microsoft Excel and R software to extract,code,and analyze information.Study selection,data extraction,and validation were performed independently by at least two reviewers.The reporting quality of included studies was assessed using the Preliminary guideline for reporting bibliometric reviews of the biomedical literature(BIBLIO).Results:Among the 6,221 bibliometric reviews examined,113 relevant publications were identified,80 focusing on various diseases/conditions.The annual number of publications has gradually increased,with the output in the past four years being 3.52 times higher than that before 2020.China(106)and Chengdu University of Traditional Chinese Medicine(16)have the highest number of publications.The most prolific author is Fan-Rong Liang,with six articles.The first bibliometric study,by Hai-Yan Li,was published in 2010.Journal of Pain Research,with 36 articles,holds the most publications.The top three diseases:diseases of the nervous system;symptoms,signs,or clinical findings not elsewhere classified;and mental,behavioral,or neurodevelopmental disorders.There may be potential duplication in research on 13 diseases/conditions,notably stroke,migraine,pain/analgesia,cancer pain,shoulder pain,facial paralysis/bell’s palsy,chronic pain,and cognitive impairment.In BIBLIO,the most frequently missing items are issues/topics(item 2),quality assessment(item 11),and descriptive findings(item 13).Conclusion:This study demonstrates that acupuncture bibliometrics is actively utilized to identify dominant diseases/conditions,aiding scholars in understand the knowledge structure and main topics.Although the number of related studies is increasing,with an average of 25 studies annually,overlap in some areas highlights the need for adherence to reporting guidelines and careful topic selection to ensure truly valuable insights and knowledge contributions.The adherence to BIBLIO’s 20 proposed items across analyzed articles,highlighting important in reporting practices.
基金supported by a Grant-inAid for Scientific Research(KAKENHI)from the Japan Society for the Promotion of Science(grant no.22J23183)。
文摘Climate change is a pressing global environmental issue^([1]).The gradual rise in global surface temperature is the most immediate and direct among its public health impacts.Influenza,the leading cause of human respiratory viral infections,remains a substantial public health concern owing to its considerable disease burden,particularly in highrisk groups.Mounting epidemiological evidence has linked influenza to extreme heat and cold weather^([2–4]).
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.
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.
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Meta-analysis plays a crucial role in synthesizing evidence across studies,yet its application in the context of rare diseases poses unique methodological challenges.A major limitation is the small sample size typical of rare disease studies,which undermines statistical power and increases uncertainty in pooled estimates.Publication bias is particularly pronounced,as studies with non-significant or negative results are less likely to be published,distorting the overall evidence base.High heterogeneity in study designs,populations,and outcomes-especially between observational studies and randomized controlled trials-further complicates the integration of findings.Additionally,rare disease datasets are often characterized by sparse data,including zero-event studies,which are difficult to analyse using traditional meta-analytic approaches.The frequent use of inappropriate statistical methods,such as fixed-effects models in the presence of heterogeneity or continuity corrections for zero-event data,can yield misleading results.These issues collectively limit the generalisability of meta-analytic conclusions to broader patient populations.This article critically evaluates these problems and highlights the need for advanced statistical techniques,rigorous study selection,and transparent reporting standards to enhance the validity and utility of metaanalyses in rare disease research.
