Objective: To describe the prescribing trends of antiemetics in chemotherapy-induced nausea and vomiting (CINV), assess adherence to American Society of Clinical Oncology (ASCO) guidelines, and evaluate the effectiven...Objective: To describe the prescribing trends of antiemetics in chemotherapy-induced nausea and vomiting (CINV), assess adherence to American Society of Clinical Oncology (ASCO) guidelines, and evaluate the effectiveness of prescribed antiemetics. Additionally, we also sought to explore barriers that hinder clinical practice guideline (CPG) implementation. Methods: One hundred fifty-five patients between the ages of 18 and 60 who were admitted to the haematology/oncology department/clinic to receive intravenous chemotherapy, either as in-patients or outpatients, were enrolled in a prospective observational study. Relevant patient demographic data, chemotherapy protocols and antiemetics were collected. Chemotherapies were classified according to their emetogenic potential. This information was used to assess whether the antiemetic prescribed matched the emetogenic risk of treatment. The analysis of outcomes was performed using the MASCC antiemetic assessment tool. Key Findings: The results showed that 95% of antiemetic prescription pre-chemotherapy regimens did not adhere to the guidelines. The findings were use of twice the recommended dose of granisetron (87.7%), overuse granisetron (16%) and metoclopramide (62.6%), and underuse dexamethasone (27%) and corticosteroid duplication (7.7%). With respect to post-chemotherapy antiemetic prescriptions, 91% of prescriptions were not adherent to guidelines, with overuse of granisetron (81.9%) and metoclpramide (34.2%) and underuse of dexamethasone (66.5%) being the most frequently reported trends. Conclusion: This study shows a lack of conformity to antiemetic guidelines, resulting mainly in overtreatment. Although vomiting was well-managed, nausea remains under controlled and requires additional medical attention. The lack of knowledge and motivation are considered barriers to CPG implementation.展开更多
Brazing filler metals are widely applied,which serve as an industrial adhesive in the joining of dissimilar structures.With the continuous emergence of new structures and materials,the demand for novel brazing filler ...Brazing filler metals are widely applied,which serve as an industrial adhesive in the joining of dissimilar structures.With the continuous emergence of new structures and materials,the demand for novel brazing filler metals is ever-increasing.It is of great significance to investigate the optimized composition design methods and to establish systematic design guidelines for brazing filler metals.This study elucidated the fundamental rules for the composition design of brazing filler metals from a three-dimensional perspective encompassing the basic properties of applied brazing filler metals,formability and processability,and overall cost.The basic properties of brazing filler metals refer to their mechanical properties,physicochemical properties,electromagnetic properties,corrosion resistance,and the wettability and fluidity during brazing.The formability and processability of brazing filler metals include the processes of smelting and casting,extrusion,rolling,drawing and ring-making,as well as the processes of granulation,powder production,and the molding of amorphous and microcrystalline structures.The cost of brazing filler metals corresponds to the sum of materials value and manufacturing cost.Improving the comprehensive properties of brazing filler metals requires a comprehensive and systematic consideration of design indicators.Highlighting the unique characteristics of brazing filler metals should focus on relevant technical indicators.Binary or ternary eutectic structures can effectively enhance the flow spreading ability of brazing filler metals,and solid solution structures contribute to the formability.By employing the proposed design guidelines,typical Ag based,Cu based,Zn based brazing filler metals,and Sn based solders were designed and successfully applied in major scientific and engineering projects.展开更多
Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopi...Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopic procedures has increased,especially in therapeutic colonoscopies.The recent advancements in endoscopic techniques and gastrointestinal tumoral resection procedures such as endoscopic mucosal resection,endoscopic full-thickness resection,and endoscopic submucosal dissection(ESD)could be a risk factor for this increased risk.The incidence rate of mortality of serious colonoscopic perforations is 7.1%.The management plan for these perforations starts with conservative treatment in mild cases,endoscopic closure,and surgical management in severe cases.Recently,endoluminal vacuum therapy was found to be effective in the management of colorectal perforations and this has been reported in multiple case reports.This editorial provides an overview of the current guidelines for the management of iatrogenic colorectal perforations.These insights are from the perspectives of endoscopists and gastroenterologists.We also present a management algorithm based on the guidelines of the European Society of Gastrointestinal Endoscopy,the American Gastroenterological Association,and the World Society of Emergency Surgery.We also discussed in brief the use of endoluminal vacuum therapy in colorectal perforations.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
Colorectal cancer(CRC)is the most frequently diagnosed malignancy of the digestive system and the second leading cause of cancer-related deaths worldwide(1).In China,CRC ranks as the second most common cancer with inc...Colorectal cancer(CRC)is the most frequently diagnosed malignancy of the digestive system and the second leading cause of cancer-related deaths worldwide(1).In China,CRC ranks as the second most common cancer with incidence and mortality rates continuing to rise(2).The Chinese Society of Clinical Oncology(CSCO)first introduced its guidelines in 2017,and since then,they have been updated annually to incorporate the latest clinical research findings,drug availability,and expert consensus(3-8).This article presents the key updates in the 2025 edition compared to the 2024 version.展开更多
1.Introduction Adherence to 24-hour movement guidelines—which encompass regular physical activity,adequate sleep,and limited sedentary time1—significantly influences long-term health outcomes during adolescence and ...1.Introduction Adherence to 24-hour movement guidelines—which encompass regular physical activity,adequate sleep,and limited sedentary time1—significantly influences long-term health outcomes during adolescence and contributes holistically to overall health.2 However,its prospective relationship with midlife mortality remains unknown to date.Our aim was to determine the association between adherence to 24-hour movement guidelines during adolescence and premature mortality 26-27 years later.This aim was based on existing evidence3 suggesting a potential link between meeting these guidelines and reduced mortality risk among adults in an 11-year follow-up.展开更多
Malnutrition is a crucial factor affecting the prognosis of various diseases,especially among elderly,surgical and critically ill patients.With the implementation of Diagnosis Related Groups(DRGs)and Diagnosis-Interve...Malnutrition is a crucial factor affecting the prognosis of various diseases,especially among elderly,surgical and critically ill patients.With the implementation of Diagnosis Related Groups(DRGs)and Diagnosis-Intervention Packet(DIP)in China,accurate diagnosis and treatment of malnutrition is essential for enhancing clinical decision-making and patient prognosis.These guidelines were developed by multidisciplinary experts through a systematic review of evidence-based medical literature.They adopt the new international standard for malnutrition diagnosis from the Global Leadership Initiative on Malnutrition(GLIM)proposed by the Global Nutrition Organization and categorize evidence levels,providing recommendations tailored to the Chinese population’s data and characteristics.The guidelines cover the entire process of malnutrition diagnosis in adult patients,including definition,epidemiology,nutrition risk screening,multi-level nutrition assessment,and diagnostic procedures.They also propose individualized diagnostic strategies for specific patient groups,such as obese or critically ill patients,and establish a standardized process for malnutrition diagnosis.At last,the guidelines form 27 questions,38 recommendations,in order to improve the practical capacity of malnutrition diagnosis in China.展开更多
Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth reco...Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth record data from the Ghana Demographic and Health Surveys(2008,2014,and 2022)were used to analyse trends and determinants in neonatal mortality and preterm birth aligned with World Health Organization antenatal care(ANC)guidelines using Pearson’s Chi-square test and multivariate logistic regression with statistical significance at P<0.05 and 95%confidence intervals(CI).Results:Preterm birth rate and neonatal mortality rate decreased from 13.0%to 9.1%and 27.6 to 23.7 per 1000 live births from 2008 to 2022 respectively.Lack of iron supplementation(odds ratio[OR]1.127,95%CI:1.047 to 1.967)a nutritional intervention maternal assessments(moderate/severe anaemia(OR 1.423,95%CI:1.178 to 2.051),preventive measures(Untreated malaria(OR 1.449,95%CI:1.104 to 2.411)or deworming(OR 1.267,95%CI:0.970 to 1.645)were associated with increased preterm birth risk.Attending<8 ANC visits raised the odds of preterm birth(OR 1.24,95%CI:1.03 to 1.257)and neonatal mortality(OR 1.583,95%CI:1.120 to 2.480).Conclusion:Despite reductions in preterm birth and neonatal mortality rates,substantial gaps in antenatal care remain.Strengthening the implementation of World Health Organization ANC guidelines is critical to reducing preterm birth and neonatal mortality in Ghana.展开更多
Sham acupuncture,as a control intervention in acupuncture studies,has been widely conducted to eval-uate the specific effect of acupuncture.However,there was no relevant particular reporting guideline,so the reporting...Sham acupuncture,as a control intervention in acupuncture studies,has been widely conducted to eval-uate the specific effect of acupuncture.However,there was no relevant particular reporting guideline,so the reporting quality of sham acupuncture was low,which could hinder the precise understanding and interpretation of details and implementation background of sham acupuncture by researchers.In order to standardize the reporting of sham acupuncture and improve its quality,SHam Acupuncture REporting guidelines and a checklist in clinical trials(SHARE)was developed by a research team from Beijing Univer-sity of Chinese Medicine.The SAHRE standardizes the reporting of sham acupuncture from 10 categories,including brief name,rationales,details of sham acupuncture,treatment regimen of sham acupuncture,the information informed or explained to patients,practitioner information,modifications of protocol,communication between practitioner and patient,practitioner adherence and blinding.This article elab-orates the development process and key content of SHARE in order to facilitate its application by re-searchers.展开更多
The Interpretation of Nursing Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke offers comprehensive recommendations across five key domains:hospital organizational management,patient condition monitori...The Interpretation of Nursing Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke offers comprehensive recommendations across five key domains:hospital organizational management,patient condition monitoring,complication observation and management,positioning and mobility away from the bed,and quality assurance.These Guidelines encompass all the phases of intravenous thrombolysis care for patients experiencing acute ischemic stroke.This article aims to elucidate the Guidelines by discussing their developmental background,the designation process,usage recommendations,and the interpretation of evolving perspectives,thereby providing valuable insights for clinical practice.展开更多
In the past year,several advancements have been achieved in the treatment of advanced non-small cell lung cancer(NSCLC),particularly in the areas of immunotherapy and targeted therapy.These achievements have provided ...In the past year,several advancements have been achieved in the treatment of advanced non-small cell lung cancer(NSCLC),particularly in the areas of immunotherapy and targeted therapy.These achievements have provided additional options for improving patient outcomes.The 2024 Chinese Society of Clinical Oncology Guidelines for NSCLC(CSCO NSCLC),a key reference for clinical oncologists in China,have incorporated current global research and adapted recommendations for applicability in real-world scenarios in China.This update covers not only patient selection,efficacy,and safety,but also considers economics,and accessibility,with an aim to provide more precise and comprehensive treatment guidance for Chinese oncologists.展开更多
Management of portal hypertension has been the focus of the Baveno guidelines since 1990.This article explores the evolution of these recommendations and their impact on clinical practice.Initially reliant on invasive...Management of portal hypertension has been the focus of the Baveno guidelines since 1990.This article explores the evolution of these recommendations and their impact on clinical practice.Initially reliant on invasive diagnostics such as the hepatic venous pressure gradient,later editions have incorporated non-invasive methods such as elastography and serum biomarkers.Management strategies have evolved substantially.Endoscopic surveillance has shifted from routine annual endoscopy to an individualized approach based on liver stiffness and platelet count.The role of non-selective beta-blockers(NSBBs)in primary prophylaxis has expanded.Endoscopic band ligation has become the preferred alternative for patients intolerant to NSBBs.In secondary prophylaxis,Baveno II replaced sclerotherapy with band ligation,and later guidelines confirmed the superiority of NSBBs combined with ligation.Transjugular intrahepatic portosystemic shunt emerged as the preferred rescue therapy,with early use emphasized in high-risk patients.Ongoing advancements continue to refine diagnostic and therapeutic strategies,further improving patient outcomes.展开更多
Glaucoma is an eye disease characterized by pathologically elevated intraocular pressure,optic nerve atrophy,and visual field defects,which can lead to irreversible vision loss.In recent years,the rapid development of...Glaucoma is an eye disease characterized by pathologically elevated intraocular pressure,optic nerve atrophy,and visual field defects,which can lead to irreversible vision loss.In recent years,the rapid development of artificial intelligence(AI)technology has provided new approaches for the early diagnosis and management of glaucoma.By classifying and annotating glaucoma-related images,AI models can learn and recognize the specific pathological features of glaucoma,thereby achieving automated imaging analysis and classification.Research on glaucoma imaging classification and annotation mainly involves color fundus photography(CFP),optical coherence tomography(OCT),anterior segment optical coherence tomography(AS-OCT),and ultrasound biomicroscopy(UBM)images.CFP is primarily used for the annotation of the optic cup and disc,while OCT is used for measuring and annotating the thickness of the retinal nerve fiber layer,and AS-OCT and UBM focus on the annotation of the anterior chamber angle structure and the measurement of anterior segment structural parameters.To standardize the classification and annotation of glaucoma images,enhance the quality and consistency of annotated data,and promote the clinical application of intelligent ophthalmology,this guideline has been developed.This guideline systematically elaborates on the principles,methods,processes,and quality control requirements for the classification and annotation of glaucoma images,providing standardized guidance for the classification and annotation of glaucoma images.展开更多
The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published s...The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published separate guidelines for NSCLC and small cell lung cancer(SCLC)for the first time to improve clinical usability.展开更多
Objective:This study aimed to systematically evaluate the measurement characteristics and methodological quality of childbirth experience assessment tools,with a view to informing the selection of healthcare professio...Objective:This study aimed to systematically evaluate the measurement characteristics and methodological quality of childbirth experience assessment tools,with a view to informing the selection of healthcare professionals who can provide high-quality assessment tools.Method:A systematic search was performed on specific databases:PubMed,Web of Science,Embase,CINAHL,SinoMed,China National Knowledge Infrastructure(CNKI),and Wanfang,from inception to February 29,2024.The researchers retrieved studies on the measurement attributes of the childbirth experience assessment tool,and traced back the references of the included studies to supplement relevant literature.According to the inclusion and exclusion criteria,screening and data extraction were independently undertaken by two reviewers.Two researchers individually used the Consensus-based Standards for the Selection of Health Measurement Instruments(COSMIN)Risk of Bias Checklist to assess the methodological quality of the scale,applied the COSMIN criteria to evaluate the measurement properties of the scale,and used a modified Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system to assess the certainty of evidence.Result:A total of 15 studies were included to evaluate the psychometric properties of 11 childbirth experience assessment tools(including different language versions).Eight studies’methodological quality of content validity was doubtful,and the remaining studies did not report content validity.None of the tools reported measurement error,cross-cultural validity,or responsiveness.In light of the questionable or unreported content validity of the tools,the evidence quality was deemed moderate or below.Consequently,the 11 assessment tools were recommended as grade B.Conclusion:In contrast,the Questionnaire for Assessing the Childbirth Experience(QACE)is recommended for provisional use,given its relatively good methodological and measurement attributes and appropriate content for evaluation.However,further validation of other measurement properties is needed.展开更多
University students,transitioning from adolescence to adulthood,are at a critical stage where dietary habits and health behaviors are established,influencing long-term health outcomes.This study aimed to assess the di...University students,transitioning from adolescence to adulthood,are at a critical stage where dietary habits and health behaviors are established,influencing long-term health outcomes.This study aimed to assess the dietary intake and nutritional awareness of a population of Chinese university students(n=833),comparing their consumption with national dietary guidelines and reference intakes,while exploring subgroup differences.Results indicated that males had significantly higher amounts of most food categories compared to females.Except for whole grains and legumes,ethnic minorities had lower compliance with the recommended intakes for several food categories compared to Han Chinese.Han males consumed more energy,protein,and fat than their ethnic minority counterparts.Obese participants showed higher protein and fat intake compared to those with normal body mass index(BMI).Additionally,BMI-related trends in macronutrient contributions showed that protein and fat contributed more to the total energy intake of individuals with higher BMI.Han individuals also had higher energy contributions from protein and fat and lower carbohydrate contributions compared to ethnic minorities.Nutrient intake was generally below recommended levels,with low proportions of participants meeting the recommended intake for vitamin A,C,calcium and dietary fiber.High proportions of participants exceeded the tolerable upper intake levels for iron and manganese.Nutritional awareness scores were also significantly higher among Han students,as well as those with higher BMIs and higher income levels.This study highlights significant disparities in dietary intake and nutritional awareness among Chinese university students,with variations across sex,ethnicity,BMI,and income categories.展开更多
Objective:Pain management is an integral part of nursing practice.In this respect,angina management can be a serious clinical problem for nurses.The evaluation of pain management based on guidelines is one of the esse...Objective:Pain management is an integral part of nursing practice.In this respect,angina management can be a serious clinical problem for nurses.The evaluation of pain management based on guidelines is one of the essential components in quality assurance and improvement processes.One of the most necessary steps in this process to improve pain management is to analyze the existing situation.This study aimed to determine the compliance of critical care unit(CCU)nurses’care performance in angina management with evidence-based guidelines(EBGs).Methods:In this observational cross-sectional study,69 nurses working in the CCU departments of public hospitals in Bushehr province participated using the full number method,and their performance was observed 207 times.The data collection tool in this study included a demographic profile form and a 29-item checklist of nurses’performance in angina management.The performance of each nurse was evaluated three times in three different shifts.Descriptive and analytical independent t-tests and Spearman and Pearson correlation were used to analyze the data.SPSS 19 software was used to perform statistical tests.The significance level was considered to be<0.05 in all cases.Results:The findings showed that 85.5%of the participants were female and 14.5%were male,with an average age of 33.87±7.14 years.The average score for performing care functions according to the evidence-based pain management guidelines was 71.42±19.31.The highest(73.60±19.45)and lowest(63.51±28.27)average scores were related to the investigation and evaluation area,respectively.The results showed a significant negative correlation between age and care performance(p<0.03;r=−0.265).Conclusions:The results of this study showed that the average performance score of nurses in angina management based on the guidelines was higher than average.Considering that some items had little compliance,the health system planners are recommended to put the annual training methods to obtain and use the latest guidelines for pain management,especially angina,in the education program of nurses.展开更多
Background:The Canadian 24-h movement guidelines(24-HMG)emphasize the holistic consideration of physical activity(PA),sedentary behavior,and sleep in shaping health outcomes.This study aimed to examine the association...Background:The Canadian 24-h movement guidelines(24-HMG)emphasize the holistic consideration of physical activity(PA),sedentary behavior,and sleep in shaping health outcomes.This study aimed to examine the associations between meeting 24-HMG and emotion regulation-related indicators among children and adolescents.Methods:A total of 534 Chinese children and adolescents aged 12.94±1.10 years(49.81%males)participated in this study and completed self-report measures assessing 24-h movement behaviors,emotion regulation strategies,emotion regulation flexibility,and regulatory emotional self-efficacy.Results:Only 7.12% of theparticipants adhered to two or all three guidelines.The number of guidelines met was positively associated with the use of emotion regulation strategies,emotion regulation flexibility,and regulatory emotional self-efficacy.Compared with meeting none of the guidelines,participants whomet one ormore guidelines reported significantly better performance in these outcomes.Conclusion:Meeting 24-HMG was associated with superior emotion regulation in children and adolescents.The importance of engaging in regular PA,limiting recreational screen time,and getting enough sleep should be highlighted for fostering emotion regulation in this demographic.展开更多
文摘Objective: To describe the prescribing trends of antiemetics in chemotherapy-induced nausea and vomiting (CINV), assess adherence to American Society of Clinical Oncology (ASCO) guidelines, and evaluate the effectiveness of prescribed antiemetics. Additionally, we also sought to explore barriers that hinder clinical practice guideline (CPG) implementation. Methods: One hundred fifty-five patients between the ages of 18 and 60 who were admitted to the haematology/oncology department/clinic to receive intravenous chemotherapy, either as in-patients or outpatients, were enrolled in a prospective observational study. Relevant patient demographic data, chemotherapy protocols and antiemetics were collected. Chemotherapies were classified according to their emetogenic potential. This information was used to assess whether the antiemetic prescribed matched the emetogenic risk of treatment. The analysis of outcomes was performed using the MASCC antiemetic assessment tool. Key Findings: The results showed that 95% of antiemetic prescription pre-chemotherapy regimens did not adhere to the guidelines. The findings were use of twice the recommended dose of granisetron (87.7%), overuse granisetron (16%) and metoclopramide (62.6%), and underuse dexamethasone (27%) and corticosteroid duplication (7.7%). With respect to post-chemotherapy antiemetic prescriptions, 91% of prescriptions were not adherent to guidelines, with overuse of granisetron (81.9%) and metoclpramide (34.2%) and underuse of dexamethasone (66.5%) being the most frequently reported trends. Conclusion: This study shows a lack of conformity to antiemetic guidelines, resulting mainly in overtreatment. Although vomiting was well-managed, nausea remains under controlled and requires additional medical attention. The lack of knowledge and motivation are considered barriers to CPG implementation.
基金National Natural Science Foundation of China(U22A20191)。
文摘Brazing filler metals are widely applied,which serve as an industrial adhesive in the joining of dissimilar structures.With the continuous emergence of new structures and materials,the demand for novel brazing filler metals is ever-increasing.It is of great significance to investigate the optimized composition design methods and to establish systematic design guidelines for brazing filler metals.This study elucidated the fundamental rules for the composition design of brazing filler metals from a three-dimensional perspective encompassing the basic properties of applied brazing filler metals,formability and processability,and overall cost.The basic properties of brazing filler metals refer to their mechanical properties,physicochemical properties,electromagnetic properties,corrosion resistance,and the wettability and fluidity during brazing.The formability and processability of brazing filler metals include the processes of smelting and casting,extrusion,rolling,drawing and ring-making,as well as the processes of granulation,powder production,and the molding of amorphous and microcrystalline structures.The cost of brazing filler metals corresponds to the sum of materials value and manufacturing cost.Improving the comprehensive properties of brazing filler metals requires a comprehensive and systematic consideration of design indicators.Highlighting the unique characteristics of brazing filler metals should focus on relevant technical indicators.Binary or ternary eutectic structures can effectively enhance the flow spreading ability of brazing filler metals,and solid solution structures contribute to the formability.By employing the proposed design guidelines,typical Ag based,Cu based,Zn based brazing filler metals,and Sn based solders were designed and successfully applied in major scientific and engineering projects.
文摘Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopic procedures has increased,especially in therapeutic colonoscopies.The recent advancements in endoscopic techniques and gastrointestinal tumoral resection procedures such as endoscopic mucosal resection,endoscopic full-thickness resection,and endoscopic submucosal dissection(ESD)could be a risk factor for this increased risk.The incidence rate of mortality of serious colonoscopic perforations is 7.1%.The management plan for these perforations starts with conservative treatment in mild cases,endoscopic closure,and surgical management in severe cases.Recently,endoluminal vacuum therapy was found to be effective in the management of colorectal perforations and this has been reported in multiple case reports.This editorial provides an overview of the current guidelines for the management of iatrogenic colorectal perforations.These insights are from the perspectives of endoscopists and gastroenterologists.We also present a management algorithm based on the guidelines of the European Society of Gastrointestinal Endoscopy,the American Gastroenterological Association,and the World Society of Emergency Surgery.We also discussed in brief the use of endoluminal vacuum therapy in colorectal perforations.
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.
基金supported by the National Natural Science Foundation of China(No.82373415)Beijing Xisike Clinical Oncology Research Foundation(No.Ytongshu2021/ms-0003)。
文摘Colorectal cancer(CRC)is the most frequently diagnosed malignancy of the digestive system and the second leading cause of cancer-related deaths worldwide(1).In China,CRC ranks as the second most common cancer with incidence and mortality rates continuing to rise(2).The Chinese Society of Clinical Oncology(CSCO)first introduced its guidelines in 2017,and since then,they have been updated annually to incorporate the latest clinical research findings,drug availability,and expert consensus(3-8).This article presents the key updates in the 2025 edition compared to the 2024 version.
文摘1.Introduction Adherence to 24-hour movement guidelines—which encompass regular physical activity,adequate sleep,and limited sedentary time1—significantly influences long-term health outcomes during adolescence and contributes holistically to overall health.2 However,its prospective relationship with midlife mortality remains unknown to date.Our aim was to determine the association between adherence to 24-hour movement guidelines during adolescence and premature mortality 26-27 years later.This aim was based on existing evidence3 suggesting a potential link between meeting these guidelines and reduced mortality risk among adults in an 11-year follow-up.
基金funded by the National Natural Science Foundation of China (72074222)National High Level Hospital Clinical Research Funding (2022‑PUMCH‑B‑054)
文摘Malnutrition is a crucial factor affecting the prognosis of various diseases,especially among elderly,surgical and critically ill patients.With the implementation of Diagnosis Related Groups(DRGs)and Diagnosis-Intervention Packet(DIP)in China,accurate diagnosis and treatment of malnutrition is essential for enhancing clinical decision-making and patient prognosis.These guidelines were developed by multidisciplinary experts through a systematic review of evidence-based medical literature.They adopt the new international standard for malnutrition diagnosis from the Global Leadership Initiative on Malnutrition(GLIM)proposed by the Global Nutrition Organization and categorize evidence levels,providing recommendations tailored to the Chinese population’s data and characteristics.The guidelines cover the entire process of malnutrition diagnosis in adult patients,including definition,epidemiology,nutrition risk screening,multi-level nutrition assessment,and diagnostic procedures.They also propose individualized diagnostic strategies for specific patient groups,such as obese or critically ill patients,and establish a standardized process for malnutrition diagnosis.At last,the guidelines form 27 questions,38 recommendations,in order to improve the practical capacity of malnutrition diagnosis in China.
文摘Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth record data from the Ghana Demographic and Health Surveys(2008,2014,and 2022)were used to analyse trends and determinants in neonatal mortality and preterm birth aligned with World Health Organization antenatal care(ANC)guidelines using Pearson’s Chi-square test and multivariate logistic regression with statistical significance at P<0.05 and 95%confidence intervals(CI).Results:Preterm birth rate and neonatal mortality rate decreased from 13.0%to 9.1%and 27.6 to 23.7 per 1000 live births from 2008 to 2022 respectively.Lack of iron supplementation(odds ratio[OR]1.127,95%CI:1.047 to 1.967)a nutritional intervention maternal assessments(moderate/severe anaemia(OR 1.423,95%CI:1.178 to 2.051),preventive measures(Untreated malaria(OR 1.449,95%CI:1.104 to 2.411)or deworming(OR 1.267,95%CI:0.970 to 1.645)were associated with increased preterm birth risk.Attending<8 ANC visits raised the odds of preterm birth(OR 1.24,95%CI:1.03 to 1.257)and neonatal mortality(OR 1.583,95%CI:1.120 to 2.480).Conclusion:Despite reductions in preterm birth and neonatal mortality rates,substantial gaps in antenatal care remain.Strengthening the implementation of World Health Organization ANC guidelines is critical to reducing preterm birth and neonatal mortality in Ghana.
文摘Sham acupuncture,as a control intervention in acupuncture studies,has been widely conducted to eval-uate the specific effect of acupuncture.However,there was no relevant particular reporting guideline,so the reporting quality of sham acupuncture was low,which could hinder the precise understanding and interpretation of details and implementation background of sham acupuncture by researchers.In order to standardize the reporting of sham acupuncture and improve its quality,SHam Acupuncture REporting guidelines and a checklist in clinical trials(SHARE)was developed by a research team from Beijing Univer-sity of Chinese Medicine.The SAHRE standardizes the reporting of sham acupuncture from 10 categories,including brief name,rationales,details of sham acupuncture,treatment regimen of sham acupuncture,the information informed or explained to patients,practitioner information,modifications of protocol,communication between practitioner and patient,practitioner adherence and blinding.This article elab-orates the development process and key content of SHARE in order to facilitate its application by re-searchers.
文摘The Interpretation of Nursing Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke offers comprehensive recommendations across five key domains:hospital organizational management,patient condition monitoring,complication observation and management,positioning and mobility away from the bed,and quality assurance.These Guidelines encompass all the phases of intravenous thrombolysis care for patients experiencing acute ischemic stroke.This article aims to elucidate the Guidelines by discussing their developmental background,the designation process,usage recommendations,and the interpretation of evolving perspectives,thereby providing valuable insights for clinical practice.
基金supported by the Shanghai Excellent Academic Leader(Grant No.21XD1423200)。
文摘In the past year,several advancements have been achieved in the treatment of advanced non-small cell lung cancer(NSCLC),particularly in the areas of immunotherapy and targeted therapy.These achievements have provided additional options for improving patient outcomes.The 2024 Chinese Society of Clinical Oncology Guidelines for NSCLC(CSCO NSCLC),a key reference for clinical oncologists in China,have incorporated current global research and adapted recommendations for applicability in real-world scenarios in China.This update covers not only patient selection,efficacy,and safety,but also considers economics,and accessibility,with an aim to provide more precise and comprehensive treatment guidance for Chinese oncologists.
文摘Management of portal hypertension has been the focus of the Baveno guidelines since 1990.This article explores the evolution of these recommendations and their impact on clinical practice.Initially reliant on invasive diagnostics such as the hepatic venous pressure gradient,later editions have incorporated non-invasive methods such as elastography and serum biomarkers.Management strategies have evolved substantially.Endoscopic surveillance has shifted from routine annual endoscopy to an individualized approach based on liver stiffness and platelet count.The role of non-selective beta-blockers(NSBBs)in primary prophylaxis has expanded.Endoscopic band ligation has become the preferred alternative for patients intolerant to NSBBs.In secondary prophylaxis,Baveno II replaced sclerotherapy with band ligation,and later guidelines confirmed the superiority of NSBBs combined with ligation.Transjugular intrahepatic portosystemic shunt emerged as the preferred rescue therapy,with early use emphasized in high-risk patients.Ongoing advancements continue to refine diagnostic and therapeutic strategies,further improving patient outcomes.
基金Supported by Guangdong Basic and Applied Basic Research Foundation(No.2025A1515011627)San Ming Project of Medicine in Shenzhen(No.SZSM202311012).
文摘Glaucoma is an eye disease characterized by pathologically elevated intraocular pressure,optic nerve atrophy,and visual field defects,which can lead to irreversible vision loss.In recent years,the rapid development of artificial intelligence(AI)technology has provided new approaches for the early diagnosis and management of glaucoma.By classifying and annotating glaucoma-related images,AI models can learn and recognize the specific pathological features of glaucoma,thereby achieving automated imaging analysis and classification.Research on glaucoma imaging classification and annotation mainly involves color fundus photography(CFP),optical coherence tomography(OCT),anterior segment optical coherence tomography(AS-OCT),and ultrasound biomicroscopy(UBM)images.CFP is primarily used for the annotation of the optic cup and disc,while OCT is used for measuring and annotating the thickness of the retinal nerve fiber layer,and AS-OCT and UBM focus on the annotation of the anterior chamber angle structure and the measurement of anterior segment structural parameters.To standardize the classification and annotation of glaucoma images,enhance the quality and consistency of annotated data,and promote the clinical application of intelligent ophthalmology,this guideline has been developed.This guideline systematically elaborates on the principles,methods,processes,and quality control requirements for the classification and annotation of glaucoma images,providing standardized guidance for the classification and annotation of glaucoma images.
文摘The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published separate guidelines for NSCLC and small cell lung cancer(SCLC)for the first time to improve clinical usability.
文摘Objective:This study aimed to systematically evaluate the measurement characteristics and methodological quality of childbirth experience assessment tools,with a view to informing the selection of healthcare professionals who can provide high-quality assessment tools.Method:A systematic search was performed on specific databases:PubMed,Web of Science,Embase,CINAHL,SinoMed,China National Knowledge Infrastructure(CNKI),and Wanfang,from inception to February 29,2024.The researchers retrieved studies on the measurement attributes of the childbirth experience assessment tool,and traced back the references of the included studies to supplement relevant literature.According to the inclusion and exclusion criteria,screening and data extraction were independently undertaken by two reviewers.Two researchers individually used the Consensus-based Standards for the Selection of Health Measurement Instruments(COSMIN)Risk of Bias Checklist to assess the methodological quality of the scale,applied the COSMIN criteria to evaluate the measurement properties of the scale,and used a modified Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system to assess the certainty of evidence.Result:A total of 15 studies were included to evaluate the psychometric properties of 11 childbirth experience assessment tools(including different language versions).Eight studies’methodological quality of content validity was doubtful,and the remaining studies did not report content validity.None of the tools reported measurement error,cross-cultural validity,or responsiveness.In light of the questionable or unreported content validity of the tools,the evidence quality was deemed moderate or below.Consequently,the 11 assessment tools were recommended as grade B.Conclusion:In contrast,the Questionnaire for Assessing the Childbirth Experience(QACE)is recommended for provisional use,given its relatively good methodological and measurement attributes and appropriate content for evaluation.However,further validation of other measurement properties is needed.
基金supported by the National Natural Science Foundation of China(82204030)the Fellowship of China Postdoctoral Science Foundation(2024T170134,2022M710675)。
文摘University students,transitioning from adolescence to adulthood,are at a critical stage where dietary habits and health behaviors are established,influencing long-term health outcomes.This study aimed to assess the dietary intake and nutritional awareness of a population of Chinese university students(n=833),comparing their consumption with national dietary guidelines and reference intakes,while exploring subgroup differences.Results indicated that males had significantly higher amounts of most food categories compared to females.Except for whole grains and legumes,ethnic minorities had lower compliance with the recommended intakes for several food categories compared to Han Chinese.Han males consumed more energy,protein,and fat than their ethnic minority counterparts.Obese participants showed higher protein and fat intake compared to those with normal body mass index(BMI).Additionally,BMI-related trends in macronutrient contributions showed that protein and fat contributed more to the total energy intake of individuals with higher BMI.Han individuals also had higher energy contributions from protein and fat and lower carbohydrate contributions compared to ethnic minorities.Nutrient intake was generally below recommended levels,with low proportions of participants meeting the recommended intake for vitamin A,C,calcium and dietary fiber.High proportions of participants exceeded the tolerable upper intake levels for iron and manganese.Nutritional awareness scores were also significantly higher among Han students,as well as those with higher BMIs and higher income levels.This study highlights significant disparities in dietary intake and nutritional awareness among Chinese university students,with variations across sex,ethnicity,BMI,and income categories.
文摘Objective:Pain management is an integral part of nursing practice.In this respect,angina management can be a serious clinical problem for nurses.The evaluation of pain management based on guidelines is one of the essential components in quality assurance and improvement processes.One of the most necessary steps in this process to improve pain management is to analyze the existing situation.This study aimed to determine the compliance of critical care unit(CCU)nurses’care performance in angina management with evidence-based guidelines(EBGs).Methods:In this observational cross-sectional study,69 nurses working in the CCU departments of public hospitals in Bushehr province participated using the full number method,and their performance was observed 207 times.The data collection tool in this study included a demographic profile form and a 29-item checklist of nurses’performance in angina management.The performance of each nurse was evaluated three times in three different shifts.Descriptive and analytical independent t-tests and Spearman and Pearson correlation were used to analyze the data.SPSS 19 software was used to perform statistical tests.The significance level was considered to be<0.05 in all cases.Results:The findings showed that 85.5%of the participants were female and 14.5%were male,with an average age of 33.87±7.14 years.The average score for performing care functions according to the evidence-based pain management guidelines was 71.42±19.31.The highest(73.60±19.45)and lowest(63.51±28.27)average scores were related to the investigation and evaluation area,respectively.The results showed a significant negative correlation between age and care performance(p<0.03;r=−0.265).Conclusions:The results of this study showed that the average performance score of nurses in angina management based on the guidelines was higher than average.Considering that some items had little compliance,the health system planners are recommended to put the annual training methods to obtain and use the latest guidelines for pain management,especially angina,in the education program of nurses.
基金supported by Zhejiang Provincial Social Science Funding(22NDJC050YB).
文摘Background:The Canadian 24-h movement guidelines(24-HMG)emphasize the holistic consideration of physical activity(PA),sedentary behavior,and sleep in shaping health outcomes.This study aimed to examine the associations between meeting 24-HMG and emotion regulation-related indicators among children and adolescents.Methods:A total of 534 Chinese children and adolescents aged 12.94±1.10 years(49.81%males)participated in this study and completed self-report measures assessing 24-h movement behaviors,emotion regulation strategies,emotion regulation flexibility,and regulatory emotional self-efficacy.Results:Only 7.12% of theparticipants adhered to two or all three guidelines.The number of guidelines met was positively associated with the use of emotion regulation strategies,emotion regulation flexibility,and regulatory emotional self-efficacy.Compared with meeting none of the guidelines,participants whomet one ormore guidelines reported significantly better performance in these outcomes.Conclusion:Meeting 24-HMG was associated with superior emotion regulation in children and adolescents.The importance of engaging in regular PA,limiting recreational screen time,and getting enough sleep should be highlighted for fostering emotion regulation in this demographic.
