Mega-projects are characterized by their large-scale investments, long life-cycle, and extraordinary levels of organizational, technological, and environmental complexity （Flyvbjerg, 2017）. They are naturally regard...Mega-projects are characterized by their large-scale investments, long life-cycle, and extraordinary levels of organizational, technological, and environmental complexity （Flyvbjerg, 2017）. They are naturally regarded as large, coupled human, and physical systems consisting of coupled sub-systems linked through flows of human, information, and matter; these systems evolve through time （Bakhshi et al., 2016; Kiridena and Sense, 2016）. Not about let systems be, engineering refers to ＂making things happen＂ with convergence, optimum design, and operation consistency （Mihm et al., 2003; Ottino, 2004）. Specially, mega-projects, which are regarded as typically artificial complex systems, are composed of elements with different properties; connections among those elements change invariably. Mega-project management is proposed to analyze and deal with complexity （Sheng, 2018）.展开更多
Mitochondrial dysfunction and oxidative stress are widely regarded as primary drivers of aging and are associated with several neurodegenerative diseases.The degeneration of motor neurons during aging is a critical pa...Mitochondrial dysfunction and oxidative stress are widely regarded as primary drivers of aging and are associated with several neurodegenerative diseases.The degeneration of motor neurons during aging is a critical pathological factor contributing to the progression of sarcopenia.However,the morphological and functional changes in mitochondria and their interplay in the degeneration of the neuromuscular junction during aging remain poorly understood.A defined systematic search of the Pub Med,Web of Science and Embase databases(last accessed on October 30,2024)was conducted with search terms including'mitochondria','aging'and'NMJ'.Clinical and preclinical studies of mitochondrial dysfunction and neuromuscular junction degeneration during aging.Twentyseven studies were included in this systematic review.This systematic review provides a summary of morphological,functional and biological changes in neuromuscular junction,mitochondrial morphology,biosynthesis,respiratory chain function,and mitophagy during aging.We focus on the interactions and mechanisms underlying the relationship between mitochondria and neuromuscular junctions during aging.Aging is characterized by significant reductions in mitochondrial fusion/fission cycles,biosynthesis,and mitochondrial quality control,which may lead to neuromuscular junction dysfunction,denervation and poor physical performance.Motor nerve terminals that exhibit redox sensitivity are among the first to exhibit abnormalities,ultimately leading to an early decline in muscle strength through impaired neuromuscular junction transmission function.Parg coactivator 1 alpha is a crucial molecule that regulates mitochondrial biogenesis and modulates various pathways,including the mitochondrial respiratory chain,energy deficiency,oxidative stress,and inflammation.Mitochondrial dysfunction is correlated with neuromuscular junction denervation and acetylcholine receptor fragmentation,resulting in muscle atrophy and a decrease in strength during aging.Physical therapy,pharmacotherapy,and gene therapy can alleviate the structural degeneration and functional deterioration of neuromuscular junction by restoring mitochondrial function.Therefore,mitochondria are considered potential targets for preserving neuromuscular junction morphology and function during aging to treat sarcopenia.展开更多
BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different ...BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.展开更多
BACKGROUND Robotic assistance is increasingly used for donor and recipient hepatectomy in liver transplantation,yet existing evidence is fragmented and variably indirect.AIM To evaluate clinical outcomes,surgical perf...BACKGROUND Robotic assistance is increasingly used for donor and recipient hepatectomy in liver transplantation,yet existing evidence is fragmented and variably indirect.AIM To evaluate clinical outcomes,surgical performance,and economic effects of robotic-assisted donor and recipient hepatectomy in the transplant pathway.METHODS Following Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 and a priori registration,systematic reviews were included with or without meta-analysis.Four databases were searched through July 2025.Methodological quality was appraised with a measurement tool to assess systematic reviews(AMSTAR 2),and certainty was graded with grading of recommendations assessment,development and evaluation(GRADE).Evidence overlap was calculated via a citation-matrix-based corrected covered area(CCA).Effect sizes were prespecified as risk ratios(RR)for dichotomous outcomes and mean differences for continuous outcomes.RESULTS Five reviews met the inclusion criteria,four with meta-analyses and one consensus review used only for context.Donor(direct)findings were more favorable for robotics in terms of estimated blood loss(≈-117 mL)and length of stay(≈-0.6 days),although with longer operative time(≈+105 minutes).Absolute risks for donor complications were not estimable from ratio-only data.Recipient(indirect)meta-analysis indicated robotics to be favorable in terms of conversion(RR≈0.41)and severe morbidity(RR≈0.81),with a trend toward lower overall morbidity(RR≈0.92)and no difference in 30-day mortality.Differences in length of stay and operative time were small and heterogeneous.Economic evidence(indirect,network meta-analysis)suggested higher procedural costs for robotic vs laparoscopic intervention,but lower hospitalization costs vs open intervention,with laparoscopy the least expensive overall.AMSTAR 2 ratings were moderate-to-high across the reviews,GRADE certainty was low for key donor continuous outcomes,and low-to-moderate for recipient and economic outcomes.Overlap was slight(graded-corpus CCA=0.0%;including a contextual non-transplant review increased CCA to≈1.25%).CONCLUSION Robotic donor hepatectomy confers perioperative advantages at the cost of longer operative time.Recipient and economic findings are indirect and considered hypothesis-generating.Transplant-specific,prospective comparisons using a minimum standardized dataset and uniform outcome definitions are needed to resolve remaining uncertainties and to clarify the cost-utility correlation.展开更多
Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroa...Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroacupuncture and explore its potential mechanisms in animal models of ischemic stroke.The PubMed,EMBASE,Web of Science,CENTRAL,and CINAHL databases were comprehensively searched up to May 1,2024.This review included articles on preclinical investigations of the efficacy and mechanisms of electroacupuncture in treating ischemic stroke.Data from 70 eligible studies were analyzed in Stata 18.0,using a random-effects model to calculate the standardized mean difference(Hedge’s g).The risk of bias was assessed using RevMan 5.4 software,and the quality of evidence was rated according to the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.Subgroup analyses were conducted to test the consistency of the results and sensitivity analyses were used to assess their robustness.The quality assessment revealed that most studies adequately handled incomplete data and selective reporting.However,several methodological limitations were identified:only 4 studies demonstrated a low risk of allocation concealment,26 achieved a low risk of outcome assessment bias,and 9 had a high risk of randomization bias.Additionally,there was an unclear risk regarding participant blinding and other methodological aspects.The GRADE assessment rated 12 outcomes as moderate quality and 6 as low quality.The mechanisms of electroacupuncture treatment for ischemic stroke can be categorized as five primary pathways:(1)Electroacupuncture significantly reduced infarct volume and apoptotic cell death(P<0.01)in ischemic stroke models;(2)electroacupuncture significantly decreased the levels of pro-inflammatory factors(P<0.01)while increasing the levels of anti-inflammatory factors(P=0.02);(3)electroacupuncture reduced the levels of oxidative stress indicators(P<0.01)and enhanced the expression of antioxidant enzymes(P<0.01);(4)electroacupuncture significantly promoted nerve regeneration(P<0.01);and(5)electroacupuncture influenced blood flow remodeling(P<0.01)and angiogenesis(P<0.01).Subgroup analyses indicated that electroacupuncture was most effective in the transient middle cerebral artery occlusion model(P<0.01)and in post-middle cerebral artery occlusion intervention(P<0.01).Dispersive waves were found to outperform continuous waves with respect to neuroprotection and anti-inflammatory effects(P<0.01),while scalp acupoints demonstrated greater efficacy than body acupoints(P<0.01).The heterogeneity among the included studies was minimal,and sensitivity analyses indicated stable results.Their methodological quality was generally satisfactory.In conclusion,electroacupuncture is effective in treating cerebral ischemia by modulating cell apoptosis,oxidative stress,inflammation,stroke-induced nerve regeneration,blood flow remodeling,and angiogenesis.The efficacy of electroacupuncture may be influenced by factors such as the middle cerebral artery occlusion model,the timing of intervention onset,waveform,and acupoint selection.Despite the moderate to low quality of evidence,these findings suggest that electroacupuncture has clinical potential for improving outcomes in ischemic stroke.展开更多
Three new wood-rotting fungi Peniophorella growing on Pinus yunnanensis in southwestern China,Peniophorella euryhypha,Peniophorella pinicola and Peniophorella stellata,are described based on morphology and phylogeny.T...Three new wood-rotting fungi Peniophorella growing on Pinus yunnanensis in southwestern China,Peniophorella euryhypha,Peniophorella pinicola and Peniophorella stellata,are described based on morphology and phylogeny.They all have annual resupinate basidiomata with smooth,white to cream hymenophore and clavate to cylindrical leptocystidia without resinous matter.P.euryhypha is characterized by simple septate subicular hyphae 7.5-9.5μm wide and broadly clavate to sphaeropedunculate cystidia,narrowly ellipsoid basidiospores 9.3-11×3-4.3μm.P.pinicola is characterized by encrusted hyphae and bowl-shaped stephanocysts and thick-walled cystidia,oblong-ellipsoid basidiospores 5.5-8×3.2-5μm.P.stellata is characterized by leptocystidia and sometimes hyphidia encrusted with rosette-like crystals in subhymenium and hymenium,and oblong-ellipsoid basidiospores 8-10×3.5-5μm.In addition,Peniophorella cremea is considered as a synonym of Hyphoderma transiens.A key to Chinese species of Peniophorella is provided.展开更多
The advancement of Artificial Intelligence(AI)has garnered significant attention within the academic research community,reflecting the prevailing zeitgeist.However,there is a paucity of literature that has delved into...The advancement of Artificial Intelligence(AI)has garnered significant attention within the academic research community,reflecting the prevailing zeitgeist.However,there is a paucity of literature that has delved into its connection with the higher order thinking skills of human beings.The purpose of this systematic review is to investigate the relationship between AI utilization and the development of critical thinking(CT)in the field of education.A systematic literature search was performed in two databases,Web of Science and Scopus,with a focus on empirical studies related to AI and CT.The review process followed the PRISMA framework and adopted a bottom-up approach,Ultimately,the integrated review synthesized 21 eligible studies from a total of 649 articles.The systematic review identified three relationships between AI technologies and CT.The results suggest that AI technologies can help to enhance learners’CT skills(n=13).However,excessive or inappropriate utilization of AI may hinder CT development(n=7).Moreover,the cultivation of CT skills has been shown to positively influence the effectiveness of AI utilization(n=4).This article represents the first literature review to delve into the reciprocal relationship between AI implementation and CT development within the education field,striving to illuminate the ways in which learners can enhance their higher-order thinking skills through more effective utilization of AI technologies.展开更多
Objective This systematic review aimed to identify the predictors of recovery from dysphagia after stroke in the last ten years,thereby providing an evidence-based basis for nurses to identify high-risk patients and d...Objective This systematic review aimed to identify the predictors of recovery from dysphagia after stroke in the last ten years,thereby providing an evidence-based basis for nurses to identify high-risk patients and develop individualized rehabilitation plans to improve patient prognosis.Methods Databases including the China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBMdisc),China Science and Technology Journal(VIP),WanFang,PubMed,Embase,CINAHL,Web of Science,the Cochrane Library,and Scopus were retrieved to search for literature on the predictors of recovery from dysphagia after stroke.The retrieval period was from January 2013 to December 2023.The quality of studies was assessed using the Newcastle-Ottawa Scale(NOS)and the Prediction model Risk of Bias Assessment Tool(PROBAST).Meta-analysis was performed using Revman5.3 and Stata15.1 software.The review protocol has been registered with PROSPERO(CRD42024605570).Results A total of 1,216 results were obtained,including 599 in English and 617 in Chinese.A total of 34 studies were included,involving 156,309 patients with post-stroke dysphagia,and the rate of dysphagia recovery increased from 13.53%at 1 week to 95%at 6 months after stroke.Meta-analysis results showed that older age[OR=1.06,95%CI(1.04,1.08),P<0.001],lower BMI[OR=1.28,95%CI(1.17,1.40),P<0.001],bilateral stroke[OR=3.10,95%CI(2.04,4.72),P<0.001],higher National Institutes of Health Stroke Scale(NIHSS)score[OR=1.19,95%CI(1.01,1.39),P=0.030],tracheal intubation[OR=5.08,95%CI(1.57,16.39),P=0.007]and aspiration[OR=4.70,95%CI(3.06,7.20),P<0.001]were unfavorable factors for the recovery of swallowing function in patients with post-stroke dysphagia.Conclusions The lack of standardized criteria for rehabilitation assessment of post-stroke dysphagia has resulted in reported recovery rates of swallowing function exhibiting wide variability.Nurses should take targeted preventive measures for patients aged≥70 years,low BMI,bilateral stroke,high NIHSS score,tracheal intubation,and aspiration to promote the recovery of swallowing function in patients with post-stroke dysphagia.展开更多
Objectives:Childhood and adolescent obesity are an increasing global health concern.This study aimed to evaluate the effectiveness of digital components and interaction types in counseling interventions for prevention...Objectives:Childhood and adolescent obesity are an increasing global health concern.This study aimed to evaluate the effectiveness of digital components and interaction types in counseling interventions for prevention and treatment.Methods:All studies were searched in online databases and grey literature,including PubMed(Medline),Web of Science,CINAHL,Scopus,IEEE Xplore Digital Library,Journal of Medical Internet Research(JMIR),MedNar,EBSco Open Dissertations.The search period is from inception to June 2023,and the languages are Finnish,English and Swedish.The research quality was evaluated using the web-based data management system Covidence for prevalence studies.The study protocol was registered with PROSPERO(registration number:CRD42021247595).Results:In this review,4,407 studies were screened,and 22 were included.These involved 3,433 participants and 264 child-parent pairs.The digital approaches included multicomponent elements like internet platforms,text messaging,video conferencing,online communities,wearable technology,and mobile apps,allowing one-way,two-way,and face-to-face interactions.Two studies showed statistically significant effects of treatment on BMI and waist-to-hip ratio.Most interventions reported positive outcomes,with no significant differences between groups,and none showed null effects during followup.Conclusions:Digital multicomponents like mobile apps and wearables can help obese children and adolescents adopt healthier lifestyles.While these interventions show promise for obesity management,further research is needed to assess their effectiveness,particularly regarding nurses'perspectives.展开更多
Food systems are deeply affected by climate change and air pollution,while being key contributors to these environmental challenges.Understanding the complex interactions among food systems,climate change,and air poll...Food systems are deeply affected by climate change and air pollution,while being key contributors to these environmental challenges.Understanding the complex interactions among food systems,climate change,and air pollution is crucial for mitigating climate change,improving air quality,and promoting the sustainable development of food systems.However,the literature lacks a comprehensive review of these interactions,particularly in the current phase of rapid development in the field.To address this gap,this study systematically reviews recent research on the impacts of climate change and air pollution on food systems,as well as the greenhouse gas and air pollutant emissions from agri-food systems and their contribution to global climate change and air pollution.In addition,this study summarizes various strategies for mitigation and adaptation,including adjustments in agricultural practices and food supply chains.Profound changes in food systems are urgently needed to enhance adaptability and reduce emissions.This review offers a critical overview of current research on the interactions among food systems,climate change,and air pollution and highlights future research directions to support the transition to sustainable food systems.展开更多
Vestibular Migraine (VM) is a common neurological disorder characterized by recurrent episodes of vertigo and migraine symptoms. The pathogenesis of VM is complex and involves multiple genetic and environmental factor...Vestibular Migraine (VM) is a common neurological disorder characterized by recurrent episodes of vertigo and migraine symptoms. The pathogenesis of VM is complex and involves multiple genetic and environmental factors. Recent studies have suggested that the pathogenesis of vestibular migraine may be associated with variations in the CACNA1A gene, which is an important gene target for controlling calcium ion channels. Such variations may further affect the functions of the vestibular nervous system, thereby causing a series of vestibular nervous system-related symptoms. This article will summarize the genetic association studies of vestibular migraine, vestibular function studies, and research on how to establish relevant animal models to illustrate the possible association between CACNA1A variations and the pathogenesis of VM, providing new ideas for clarifying the pathogenesis of VM.展开更多
Objectives This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors,blood pressure control,and cardiovascular risk reduction.Methods A sea...Objectives This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors,blood pressure control,and cardiovascular risk reduction.Methods A search for randomized and non-randomized control trials of digital health interventions among patients with uncontrolled hypertension was conducted from the databases of Embase,PubMed,Scopus,CINAHL,Web of Science,PsycINFO,Thai Journal Online(ThaiJO),the Faculty of Nursing Mahidol University(FON-MU)Nursing Research Database,and gray literature.After conducting the literature screening,the authors completed data extraction,and the risk of bias was assessed using the Joanna Briggs Institute randomized controlled trial checklist and the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies.Results The study included 22 articles,comprising 30 to 4,118 patients with uncontrolled hypertension.This review classified and summarized the components of digital health interventions and their effects on hypertensive outcomes.It was found that the key elements of digital health interventions include health education,reminders,self-monitoring,feedback and consultation,and instrumental support.Moreover,approximately 81.81%(n=18)of the digital health interventions involved healthcare providers participating in feedback and consultation.Additionally,digital health interventions effectively improve hypertensive outcomes such as self-management behaviors,blood pressure control,and cardiovascular risk reduction,providing cost-effectiveness.Conclusion Based on the available literature,digital health interventions have been shown to effectively enhance behavioral,clinical,and economic outcomes for individuals with uncontrolled hypertension.Moreover,the combination of digital health interventions and healthcare providers’interventions can potentially help patients with uncontrolled hypertension improve adherence to self-management when compared to stand-alone digital health interventions.Digital health interventions to support self-management interventions should be developed for patients by healthcare providers.展开更多
Nausea and vomiting are physiological responses that react to various bodily conditions and play a protective function.Medicinal and nonmedicinal methods,including complementary medicine,treat nausea and vomiting.The ...Nausea and vomiting are physiological responses that react to various bodily conditions and play a protective function.Medicinal and nonmedicinal methods,including complementary medicine,treat nausea and vomiting.The current research aims to investigate the effectiveness of foot reflexology as a complementary medicine method for nausea and vomiting.Based on PRISMA 2020,PubMed,Web of Science,and Scopus were searched until October 2,2024,using a search strategy approved by two researchers.Only randomized controlled trial studies were included in this research.No limitations or filters were applied.The inclusion criteria were selected based on the PICOS framework,and the studies were evaluated according to the National Institutes of Health quality assessment tool,which is related to controlled intervention,and were evaluated by two researchers.Finally,six studies were included in this review.Eighty-four percent of studies were conducted in Asia.Three records are from Iran,and two are from Turkey,and one is from France.The results showed that nausea and vomiting improved in all studies.In most studies(67%),four sessions or less led to improved outcomes.Rhodes index of nausea,vomiting,and retching and visual analog scale were utilized to assess nausea and vomiting.The current systematic review indicated that foot reflexology as a noninvasive intervention could improve nausea and vomiting in patients with cancer problems,pregnancy,hemodialysis,and laparoscopic cholecystectomy。展开更多
Background:Isotonic crystalloids are recommended as the first choice for fluid therapy in acute pan-creatitis(AP),with normal saline(NS)and lactate Ringer’s(LR)used most often.Evidence based recom-mendations on the t...Background:Isotonic crystalloids are recommended as the first choice for fluid therapy in acute pan-creatitis(AP),with normal saline(NS)and lactate Ringer’s(LR)used most often.Evidence based recom-mendations on the type of fluid are conflicting and generally come from small single-center randomized controlled trials(RCTs).We therefore conducted a systematic review and meta-analysis to compare the effect of balanced solutions(BS)versus NS on patient-centered clinical outcomes in AP.Methods:From four databases searched up to October 2024,we included only RCTs of adult patients with AP that compared the use of BS(including LR,acetate Ringer’s,etc.)with NS.The primary out-come was the disease advances from AP to moderately severe and severe AP(MSAP/SAP).Trial sequential analyses(TSA)were conducted to control for type-I and type-II errors and Grading of Recommendations Assessment,Development,and Evaluation(GRADE)was used to assess the quality of evidence.Results:Six RCTs were identified and included,involving 260 patients treated with BS and 298 patients with NS.Patients who received the BS had less MSAP/SAP[odds ratio(OR)=0.50,95%confidence in-terval(CI):0.29 to 0.85,P=0.01,I^(2)=0%;5 studies,299 patients],reduced the need of ICU admission(OR=0.60,95%CI:0.39 to 0.93,P=0.02,I^(2)=0%;5 studies,507 patients)and shorter length of hospital stay[mean difference(MD)=-0.88,95%CI:-1.48 to-0.28,P=0.004,I^(2)=0%;6 studies,558 patients;confirmed by TSA with high certainty]compared with those who received NS.The evidence for most of the clinical outcomes was rated as moderate to low due to the risk of bias,imprecision and inconsistency.Conclusions:BS,compared with NS,was associated with improved clinical outcomes in patients with AP.However,given the moderate to low quality of evidence for most of the outcomes assessed,further trials are warranted.展开更多
Following the discovery of bone as an endocrine organ with systemic influence,bone-brain interaction has emerged as a research hotspot,unveiling complex bidirectional communication between bone and brain.Studies indic...Following the discovery of bone as an endocrine organ with systemic influence,bone-brain interaction has emerged as a research hotspot,unveiling complex bidirectional communication between bone and brain.Studies indicate that bone and brain can influence each other’s homeostasis via multiple pathways,yet there is a dearth of systematic reviews in this area.This review comprehensively examines interactions across three key areas:the influence of bone-derived factors on brain function,the effects of brain-related diseases or injuries(BRDI)on bone health,and the concept of skeletal interoception.Additionally,the review discusses innovative approaches in biomaterial design inspired by bone-brain interaction mechanisms,aiming to facilitate bonebrain interactions through materiobiological effects to aid in the treatment of neurodegenerative and bone-related diseases.Notably,the integration of artificial intelligence(AI)in biomaterial design is highlighted,showcasing AI’s role in expediting the formulation of effective and targeted treatment strategies.In conclusion,this review offers vital insights into the mechanisms of bone-brain interaction and suggests advanced approaches to harness these interactions in clinical practice.These insights offer promising avenues for preventing and treating complex diseases impacting the skeleton and brain,underscoring the potential of interdisciplinary approaches in enhancing human health.展开更多
Background Clinical brain-computer interface(BCI)for mental disorders is an emerging interdisciplinary research field,posing new ethical concerns and challenges,yet lacking practical ethical governance guidelines for ...Background Clinical brain-computer interface(BCI)for mental disorders is an emerging interdisciplinary research field,posing new ethical concerns and challenges,yet lacking practical ethical governance guidelines for stakeholders and the entire community.Aims This study aims to establish a multidisciplinary consensus of principles for ethical governance of clinical BCI research for mental disorders and offer practical ethical guidance to stakeholders involved.Methods A systematic literature review,symposium and roundtable discussions,and a pre-Delphi(round 0)survey were conducted to form the questionnaire for the three-round modified Delphi study.Two rounds of surveys,followed by a third round of independent interviews of 25 experts from BCI-related research domains,were involved.We conducted quantitative analysis of responses and agreements among experts to reveal the consensus and differences regarding the ethical governance of mental BCI research from a multidisciplinary perspective.Results The Delphi panel emphasised important concerns of ethical review practices and ethical principles within the BCI context,identified qualified and highly influential institutions and personnel in conducting and advancing clinical BCI research,and recognised prioritised aspects in the risk-benefit evaluation.Experts expressed diverse opinions on specific ethical concerns,including concerns about invasive technology,its impact on humanity and potential social consequences.Agreement was reached that the practices of ethical governance of clinical BCI for mental disorders should focus on patient voluntariness,autonomy,long-term effects and related assessments of BCI interventions,as well as privacy protection,transparent reporting and ensuring that the research is conducted in qualified institutions with strong data security.Conclusions Ethical governance of clinical research on BCI for mental disorders should include interdisciplinary experts to balance various needs and incorporate the expertise of different stakeholders to avoid serious ethical issues.It requires scientifically grounded approaches,continuous monitoring and interdisciplinary collaboration to ensure evidence-based policies,comprehensive risk assessments and transparency,thereby promoting responsible innovations and protecting patient rights and well-being.展开更多
BACKGROUND Rheumatic immune diseases are a group of chronic inflammatory diseases charac-terized by joint and systemic multi-organ involvement,including rheumatoid arthritis,systemic lupus erythematosus,and Sjogren’s...BACKGROUND Rheumatic immune diseases are a group of chronic inflammatory diseases charac-terized by joint and systemic multi-organ involvement,including rheumatoid arthritis,systemic lupus erythematosus,and Sjogren’s syndrome,among others.The pathogenesis of these diseases is related to the abnormal activation and regulatory imbalance of the immune system.The prevalence and morbidity of rheumatic immune diseases are high,imposing a significant burden on patients'quality of life and socio-economic costs.Currently,the treatment of rheumatic immune diseases mainly relies on Western medicine,such as non-steroidal anti-inflammatory drugs,glucocorticoids,disease-modifying antirheumatic drugs,and biologics.However,the therapeutic effects of Western medicine are not ideal,some patients poorly respond or are resistant to Western medicine,and long-term use often causes various adverse reactions.AIM To systematically evaluate the efficacy and safety of Tripterygium wilfordii gly-cosides tablets combined with Western medicine in the treatment of patients with rheumatic immune diseases.METHODS This study conducted a meta-analysis to systematically evaluate the efficacy and safety of Tripterygium wilfordii glycosides tablets combined with Western medicine for patients with rheumatic immune diseases.Chinese and English databases were searched for randomized controlled trials(RCTs)on the treatment of rheumatic immune diseases with Tripterygium wilfordii glycosides tablets combined with Western medicine.The quality of the included studies was assessed using the Cochrane risk of bias assessment tool.Meta-analysis was performed using RevMan 5.4 software.RESULTS The meta-analysis included 11 RCTs involving 1026 patients with rheumatic immune diseases.The combined treatment significantly reduced the risk of disease recurrence(relative risk=1.07,95%confidence interval:1.01-1.15,P<0.05)and showed no significant heterogeneity(I2=0%,P=0.53),indicating that Tripterygium wilfordii glycosides tablets combined with Western medicine is an effective method to reduce the possibility of postoperative recurrence in patients with rheumatic immune diseases.However,due to the limited number and quality of the studies included,these results should be interpreted with caution.CONCLUSION Tripterygium wilfordii glycosides tablets combined with Western medicine is an effective and safe treatment option for patients with rheumatic immune diseases and can be considered a clinical choice.However,more high-quality research is needed to validate this conclusion and provide more solid evidence for clinical practice.展开更多
Software-related security aspects are a growing and legitimate concern,especially with 5G data available just at our palms.To conduct research in this field,periodic comparative analysis is needed with the new techniq...Software-related security aspects are a growing and legitimate concern,especially with 5G data available just at our palms.To conduct research in this field,periodic comparative analysis is needed with the new techniques coming up rapidly.The purpose of this study is to review the recent developments in the field of security integration in the software development lifecycle(SDLC)by analyzing the articles published in the last two decades and to propose a way forward.This review follows Kitchenham’s review protocol.The review has been divided into three main stages including planning,execution,and analysis.From the selected 100 articles,it becomes evident that need of a collaborative approach is necessary for addressing critical software security risks(CSSRs)through effective risk management/estimation techniques.Quantifying risks using a numeric scale enables a comprehensive understanding of their severity,facilitating focused resource allocation and mitigation efforts.Through a comprehensive understanding of potential vulnerabilities and proactive mitigation efforts facilitated by protection poker,organizations can prioritize resources effectively to ensure the successful outcome of projects and initiatives in today’s dynamic threat landscape.The review reveals that threat analysis and security testing are needed to develop automated tools for the future.Accurate estimation of effort required to prioritize potential security risks is a big challenge in software security.The accuracy of effort estimation can be further improved by exploring new techniques,particularly those involving deep learning.It is also imperative to validate these effort estimation methods to ensure all potential security threats are addressed.Another challenge is selecting the right model for each specific security threat.To achieve a comprehensive evaluation,researchers should use well-known benchmark checklists.展开更多
Wood-decaying fungi play crucial roles as decomposers in forest ecosystems.In this study,two new Lopharia species from Yunnan Province in southwest China,Lopharia minispora and Lopharia punctata,are described and illu...Wood-decaying fungi play crucial roles as decomposers in forest ecosystems.In this study,two new Lopharia species from Yunnan Province in southwest China,Lopharia minispora and Lopharia punctata,are described and illustrated based on the morphological and molecular evidence.L.minispora is characterized by its slightly brown and cracked basidiomata when dry,a monomitic hyphal system with clamp connections,and oblong-ellipsoid basidiospores measuring 5.5-6.7×2.7-3.3μm;L.punctata is characterized by its membranous,white to cream basidiomata,a monomitic hyphal system with simple-septa on generative hyphae and subglobose to globose basidiospores measuring 9.5-12×7.5-10.1μm.Sequences of ITS and nLSU rDNA markers of the studied samples were employed,and phylogenetic analyses were performed with maximum likelihood,maximum parsimony and Bayesian inference methods,ensuring the reliability of our findings.The dataset analyses showed that the two new species clustered into the genus Lopharia,in which L.minispora was sister of Lopharia erubescens;L.punctata grouped with the lineage of Lopharia ayresii and Lopharia resupinata.展开更多
A controversial taxon,Hipparion plocodus,is reviewed in the present study.Hi.plocodus has been confirmed to be a valid species with definite diagnostic characteristics,represented by cranial specimens from Baode,Shanx...A controversial taxon,Hipparion plocodus,is reviewed in the present study.Hi.plocodus has been confirmed to be a valid species with definite diagnostic characteristics,represented by cranial specimens from Baode,Shanxi Province.The phylogenetic analysis performed in the present study,with a new matrix,shows that Hi.plocodus forms a monophyletic group with a European species,Hippotherium malpassii.Actually,no close relationship between so-called Hm.malpassii and the genus Hippotherium has been identified,and the record of stratigraphic range of this genus in late stage of Late Miocene is currently absent.Herein previously Hi.plocodus and Hm.malpassii have both attributed into“Hipparion”before the discovery of better material.Evolutionary stages and correlative absolute age showed that these two species should derive independently from some primitive clade.During the late stage of the Late Miocene,the development of the Asian summer monsoon enhanced the humidity of China,with forest and wood habitats expanding considerably under this setting.As the result,one Eurasian closed-habitat lineage thus extended its range into China,which had become very suited for it,give rise to“Hi.”plocodus.展开更多
基金funded by the National Natural Science Foundation of China(Grant Nos.71390521 and 71771125)
文摘Mega-projects are characterized by their large-scale investments, long life-cycle, and extraordinary levels of organizational, technological, and environmental complexity （Flyvbjerg, 2017）. They are naturally regarded as large, coupled human, and physical systems consisting of coupled sub-systems linked through flows of human, information, and matter; these systems evolve through time （Bakhshi et al., 2016; Kiridena and Sense, 2016）. Not about let systems be, engineering refers to ＂making things happen＂ with convergence, optimum design, and operation consistency （Mihm et al., 2003; Ottino, 2004）. Specially, mega-projects, which are regarded as typically artificial complex systems, are composed of elements with different properties; connections among those elements change invariably. Mega-project management is proposed to analyze and deal with complexity （Sheng, 2018）.
基金supported by grants from Collaborative Research Fund(Ref:C4032-21GF)General Research Grant(Ref:14114822)+1 种基金Group Research Scheme(Ref:3110146)Area of Excellence(Ref:Ao E/M-402/20)。
文摘Mitochondrial dysfunction and oxidative stress are widely regarded as primary drivers of aging and are associated with several neurodegenerative diseases.The degeneration of motor neurons during aging is a critical pathological factor contributing to the progression of sarcopenia.However,the morphological and functional changes in mitochondria and their interplay in the degeneration of the neuromuscular junction during aging remain poorly understood.A defined systematic search of the Pub Med,Web of Science and Embase databases(last accessed on October 30,2024)was conducted with search terms including'mitochondria','aging'and'NMJ'.Clinical and preclinical studies of mitochondrial dysfunction and neuromuscular junction degeneration during aging.Twentyseven studies were included in this systematic review.This systematic review provides a summary of morphological,functional and biological changes in neuromuscular junction,mitochondrial morphology,biosynthesis,respiratory chain function,and mitophagy during aging.We focus on the interactions and mechanisms underlying the relationship between mitochondria and neuromuscular junctions during aging.Aging is characterized by significant reductions in mitochondrial fusion/fission cycles,biosynthesis,and mitochondrial quality control,which may lead to neuromuscular junction dysfunction,denervation and poor physical performance.Motor nerve terminals that exhibit redox sensitivity are among the first to exhibit abnormalities,ultimately leading to an early decline in muscle strength through impaired neuromuscular junction transmission function.Parg coactivator 1 alpha is a crucial molecule that regulates mitochondrial biogenesis and modulates various pathways,including the mitochondrial respiratory chain,energy deficiency,oxidative stress,and inflammation.Mitochondrial dysfunction is correlated with neuromuscular junction denervation and acetylcholine receptor fragmentation,resulting in muscle atrophy and a decrease in strength during aging.Physical therapy,pharmacotherapy,and gene therapy can alleviate the structural degeneration and functional deterioration of neuromuscular junction by restoring mitochondrial function.Therefore,mitochondria are considered potential targets for preserving neuromuscular junction morphology and function during aging to treat sarcopenia.
基金Supported by the National Natural Science Foundation of China,No.82402789Beijing Jishuitan Hospital Youcai Plan,No.KYYC202402+2 种基金Beijing Jishuitan Research Funding,No.HL202402and Beijing Natural Science Foundation,No.L232062No.L222063.
文摘BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.
文摘BACKGROUND Robotic assistance is increasingly used for donor and recipient hepatectomy in liver transplantation,yet existing evidence is fragmented and variably indirect.AIM To evaluate clinical outcomes,surgical performance,and economic effects of robotic-assisted donor and recipient hepatectomy in the transplant pathway.METHODS Following Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 and a priori registration,systematic reviews were included with or without meta-analysis.Four databases were searched through July 2025.Methodological quality was appraised with a measurement tool to assess systematic reviews(AMSTAR 2),and certainty was graded with grading of recommendations assessment,development and evaluation(GRADE).Evidence overlap was calculated via a citation-matrix-based corrected covered area(CCA).Effect sizes were prespecified as risk ratios(RR)for dichotomous outcomes and mean differences for continuous outcomes.RESULTS Five reviews met the inclusion criteria,four with meta-analyses and one consensus review used only for context.Donor(direct)findings were more favorable for robotics in terms of estimated blood loss(≈-117 mL)and length of stay(≈-0.6 days),although with longer operative time(≈+105 minutes).Absolute risks for donor complications were not estimable from ratio-only data.Recipient(indirect)meta-analysis indicated robotics to be favorable in terms of conversion(RR≈0.41)and severe morbidity(RR≈0.81),with a trend toward lower overall morbidity(RR≈0.92)and no difference in 30-day mortality.Differences in length of stay and operative time were small and heterogeneous.Economic evidence(indirect,network meta-analysis)suggested higher procedural costs for robotic vs laparoscopic intervention,but lower hospitalization costs vs open intervention,with laparoscopy the least expensive overall.AMSTAR 2 ratings were moderate-to-high across the reviews,GRADE certainty was low for key donor continuous outcomes,and low-to-moderate for recipient and economic outcomes.Overlap was slight(graded-corpus CCA=0.0%;including a contextual non-transplant review increased CCA to≈1.25%).CONCLUSION Robotic donor hepatectomy confers perioperative advantages at the cost of longer operative time.Recipient and economic findings are indirect and considered hypothesis-generating.Transplant-specific,prospective comparisons using a minimum standardized dataset and uniform outcome definitions are needed to resolve remaining uncertainties and to clarify the cost-utility correlation.
基金supported by the National Natural Science Foundation of China,Nos.82174496(to NW),82374574(to NW),82302865(to LL)Shanghai Science and Technology Committee Sailing Program,Nos.23YF1403800(to LL),23YF1405200(to YX)Shanghai Hospital Development Center Foundation-Shanghai Municipal Hospital Rehabilitation Medicine Specialty Alliance,No.SHDC22023304(to YW).
文摘Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroacupuncture and explore its potential mechanisms in animal models of ischemic stroke.The PubMed,EMBASE,Web of Science,CENTRAL,and CINAHL databases were comprehensively searched up to May 1,2024.This review included articles on preclinical investigations of the efficacy and mechanisms of electroacupuncture in treating ischemic stroke.Data from 70 eligible studies were analyzed in Stata 18.0,using a random-effects model to calculate the standardized mean difference(Hedge’s g).The risk of bias was assessed using RevMan 5.4 software,and the quality of evidence was rated according to the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.Subgroup analyses were conducted to test the consistency of the results and sensitivity analyses were used to assess their robustness.The quality assessment revealed that most studies adequately handled incomplete data and selective reporting.However,several methodological limitations were identified:only 4 studies demonstrated a low risk of allocation concealment,26 achieved a low risk of outcome assessment bias,and 9 had a high risk of randomization bias.Additionally,there was an unclear risk regarding participant blinding and other methodological aspects.The GRADE assessment rated 12 outcomes as moderate quality and 6 as low quality.The mechanisms of electroacupuncture treatment for ischemic stroke can be categorized as five primary pathways:(1)Electroacupuncture significantly reduced infarct volume and apoptotic cell death(P<0.01)in ischemic stroke models;(2)electroacupuncture significantly decreased the levels of pro-inflammatory factors(P<0.01)while increasing the levels of anti-inflammatory factors(P=0.02);(3)electroacupuncture reduced the levels of oxidative stress indicators(P<0.01)and enhanced the expression of antioxidant enzymes(P<0.01);(4)electroacupuncture significantly promoted nerve regeneration(P<0.01);and(5)electroacupuncture influenced blood flow remodeling(P<0.01)and angiogenesis(P<0.01).Subgroup analyses indicated that electroacupuncture was most effective in the transient middle cerebral artery occlusion model(P<0.01)and in post-middle cerebral artery occlusion intervention(P<0.01).Dispersive waves were found to outperform continuous waves with respect to neuroprotection and anti-inflammatory effects(P<0.01),while scalp acupoints demonstrated greater efficacy than body acupoints(P<0.01).The heterogeneity among the included studies was minimal,and sensitivity analyses indicated stable results.Their methodological quality was generally satisfactory.In conclusion,electroacupuncture is effective in treating cerebral ischemia by modulating cell apoptosis,oxidative stress,inflammation,stroke-induced nerve regeneration,blood flow remodeling,and angiogenesis.The efficacy of electroacupuncture may be influenced by factors such as the middle cerebral artery occlusion model,the timing of intervention onset,waveform,and acupoint selection.Despite the moderate to low quality of evidence,these findings suggest that electroacupuncture has clinical potential for improving outcomes in ischemic stroke.
文摘Three new wood-rotting fungi Peniophorella growing on Pinus yunnanensis in southwestern China,Peniophorella euryhypha,Peniophorella pinicola and Peniophorella stellata,are described based on morphology and phylogeny.They all have annual resupinate basidiomata with smooth,white to cream hymenophore and clavate to cylindrical leptocystidia without resinous matter.P.euryhypha is characterized by simple septate subicular hyphae 7.5-9.5μm wide and broadly clavate to sphaeropedunculate cystidia,narrowly ellipsoid basidiospores 9.3-11×3-4.3μm.P.pinicola is characterized by encrusted hyphae and bowl-shaped stephanocysts and thick-walled cystidia,oblong-ellipsoid basidiospores 5.5-8×3.2-5μm.P.stellata is characterized by leptocystidia and sometimes hyphidia encrusted with rosette-like crystals in subhymenium and hymenium,and oblong-ellipsoid basidiospores 8-10×3.5-5μm.In addition,Peniophorella cremea is considered as a synonym of Hyphoderma transiens.A key to Chinese species of Peniophorella is provided.
基金funded by Macao Polytechnic University grant number RP/FCA-08-2023.
文摘The advancement of Artificial Intelligence(AI)has garnered significant attention within the academic research community,reflecting the prevailing zeitgeist.However,there is a paucity of literature that has delved into its connection with the higher order thinking skills of human beings.The purpose of this systematic review is to investigate the relationship between AI utilization and the development of critical thinking(CT)in the field of education.A systematic literature search was performed in two databases,Web of Science and Scopus,with a focus on empirical studies related to AI and CT.The review process followed the PRISMA framework and adopted a bottom-up approach,Ultimately,the integrated review synthesized 21 eligible studies from a total of 649 articles.The systematic review identified three relationships between AI technologies and CT.The results suggest that AI technologies can help to enhance learners’CT skills(n=13).However,excessive or inappropriate utilization of AI may hinder CT development(n=7).Moreover,the cultivation of CT skills has been shown to positively influence the effectiveness of AI utilization(n=4).This article represents the first literature review to delve into the reciprocal relationship between AI implementation and CT development within the education field,striving to illuminate the ways in which learners can enhance their higher-order thinking skills through more effective utilization of AI technologies.
文摘Objective This systematic review aimed to identify the predictors of recovery from dysphagia after stroke in the last ten years,thereby providing an evidence-based basis for nurses to identify high-risk patients and develop individualized rehabilitation plans to improve patient prognosis.Methods Databases including the China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBMdisc),China Science and Technology Journal(VIP),WanFang,PubMed,Embase,CINAHL,Web of Science,the Cochrane Library,and Scopus were retrieved to search for literature on the predictors of recovery from dysphagia after stroke.The retrieval period was from January 2013 to December 2023.The quality of studies was assessed using the Newcastle-Ottawa Scale(NOS)and the Prediction model Risk of Bias Assessment Tool(PROBAST).Meta-analysis was performed using Revman5.3 and Stata15.1 software.The review protocol has been registered with PROSPERO(CRD42024605570).Results A total of 1,216 results were obtained,including 599 in English and 617 in Chinese.A total of 34 studies were included,involving 156,309 patients with post-stroke dysphagia,and the rate of dysphagia recovery increased from 13.53%at 1 week to 95%at 6 months after stroke.Meta-analysis results showed that older age[OR=1.06,95%CI(1.04,1.08),P<0.001],lower BMI[OR=1.28,95%CI(1.17,1.40),P<0.001],bilateral stroke[OR=3.10,95%CI(2.04,4.72),P<0.001],higher National Institutes of Health Stroke Scale(NIHSS)score[OR=1.19,95%CI(1.01,1.39),P=0.030],tracheal intubation[OR=5.08,95%CI(1.57,16.39),P=0.007]and aspiration[OR=4.70,95%CI(3.06,7.20),P<0.001]were unfavorable factors for the recovery of swallowing function in patients with post-stroke dysphagia.Conclusions The lack of standardized criteria for rehabilitation assessment of post-stroke dysphagia has resulted in reported recovery rates of swallowing function exhibiting wide variability.Nurses should take targeted preventive measures for patients aged≥70 years,low BMI,bilateral stroke,high NIHSS score,tracheal intubation,and aspiration to promote the recovery of swallowing function in patients with post-stroke dysphagia.
文摘Objectives:Childhood and adolescent obesity are an increasing global health concern.This study aimed to evaluate the effectiveness of digital components and interaction types in counseling interventions for prevention and treatment.Methods:All studies were searched in online databases and grey literature,including PubMed(Medline),Web of Science,CINAHL,Scopus,IEEE Xplore Digital Library,Journal of Medical Internet Research(JMIR),MedNar,EBSco Open Dissertations.The search period is from inception to June 2023,and the languages are Finnish,English and Swedish.The research quality was evaluated using the web-based data management system Covidence for prevalence studies.The study protocol was registered with PROSPERO(registration number:CRD42021247595).Results:In this review,4,407 studies were screened,and 22 were included.These involved 3,433 participants and 264 child-parent pairs.The digital approaches included multicomponent elements like internet platforms,text messaging,video conferencing,online communities,wearable technology,and mobile apps,allowing one-way,two-way,and face-to-face interactions.Two studies showed statistically significant effects of treatment on BMI and waist-to-hip ratio.Most interventions reported positive outcomes,with no significant differences between groups,and none showed null effects during followup.Conclusions:Digital multicomponents like mobile apps and wearables can help obese children and adolescents adopt healthier lifestyles.While these interventions show promise for obesity management,further research is needed to assess their effectiveness,particularly regarding nurses'perspectives.
基金supported by the National Natural Science Foundation of China(42277087,42130708,42471021,42277482,and 42361144876)the Natural Science Foundation of Guangdong Province(2024A1515012550)+3 种基金the Hainan Institute of National Park grant(KY-23ZK01)the Tsinghua Shenzhen International Graduate School Cross-disciplinary Research and Innovation Fund Research Plan(JC2022011)the Shenzhen Science and Technology Program(JCYJ20240813112106009 and ZDSYS20220606100806014)the Scientific Research Start-up Funds(QD2021030C)from Tsinghua Shenzhen International Graduate School。
文摘Food systems are deeply affected by climate change and air pollution,while being key contributors to these environmental challenges.Understanding the complex interactions among food systems,climate change,and air pollution is crucial for mitigating climate change,improving air quality,and promoting the sustainable development of food systems.However,the literature lacks a comprehensive review of these interactions,particularly in the current phase of rapid development in the field.To address this gap,this study systematically reviews recent research on the impacts of climate change and air pollution on food systems,as well as the greenhouse gas and air pollutant emissions from agri-food systems and their contribution to global climate change and air pollution.In addition,this study summarizes various strategies for mitigation and adaptation,including adjustments in agricultural practices and food supply chains.Profound changes in food systems are urgently needed to enhance adaptability and reduce emissions.This review offers a critical overview of current research on the interactions among food systems,climate change,and air pollution and highlights future research directions to support the transition to sustainable food systems.
文摘Vestibular Migraine (VM) is a common neurological disorder characterized by recurrent episodes of vertigo and migraine symptoms. The pathogenesis of VM is complex and involves multiple genetic and environmental factors. Recent studies have suggested that the pathogenesis of vestibular migraine may be associated with variations in the CACNA1A gene, which is an important gene target for controlling calcium ion channels. Such variations may further affect the functions of the vestibular nervous system, thereby causing a series of vestibular nervous system-related symptoms. This article will summarize the genetic association studies of vestibular migraine, vestibular function studies, and research on how to establish relevant animal models to illustrate the possible association between CACNA1A variations and the pathogenesis of VM, providing new ideas for clarifying the pathogenesis of VM.
基金the support provided by the 2D43 TW009883 D43 Post-Doctoral Program at the School of Nursing,University of Michigan,USA。
文摘Objectives This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors,blood pressure control,and cardiovascular risk reduction.Methods A search for randomized and non-randomized control trials of digital health interventions among patients with uncontrolled hypertension was conducted from the databases of Embase,PubMed,Scopus,CINAHL,Web of Science,PsycINFO,Thai Journal Online(ThaiJO),the Faculty of Nursing Mahidol University(FON-MU)Nursing Research Database,and gray literature.After conducting the literature screening,the authors completed data extraction,and the risk of bias was assessed using the Joanna Briggs Institute randomized controlled trial checklist and the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies.Results The study included 22 articles,comprising 30 to 4,118 patients with uncontrolled hypertension.This review classified and summarized the components of digital health interventions and their effects on hypertensive outcomes.It was found that the key elements of digital health interventions include health education,reminders,self-monitoring,feedback and consultation,and instrumental support.Moreover,approximately 81.81%(n=18)of the digital health interventions involved healthcare providers participating in feedback and consultation.Additionally,digital health interventions effectively improve hypertensive outcomes such as self-management behaviors,blood pressure control,and cardiovascular risk reduction,providing cost-effectiveness.Conclusion Based on the available literature,digital health interventions have been shown to effectively enhance behavioral,clinical,and economic outcomes for individuals with uncontrolled hypertension.Moreover,the combination of digital health interventions and healthcare providers’interventions can potentially help patients with uncontrolled hypertension improve adherence to self-management when compared to stand-alone digital health interventions.Digital health interventions to support self-management interventions should be developed for patients by healthcare providers.
文摘Nausea and vomiting are physiological responses that react to various bodily conditions and play a protective function.Medicinal and nonmedicinal methods,including complementary medicine,treat nausea and vomiting.The current research aims to investigate the effectiveness of foot reflexology as a complementary medicine method for nausea and vomiting.Based on PRISMA 2020,PubMed,Web of Science,and Scopus were searched until October 2,2024,using a search strategy approved by two researchers.Only randomized controlled trial studies were included in this research.No limitations or filters were applied.The inclusion criteria were selected based on the PICOS framework,and the studies were evaluated according to the National Institutes of Health quality assessment tool,which is related to controlled intervention,and were evaluated by two researchers.Finally,six studies were included in this review.Eighty-four percent of studies were conducted in Asia.Three records are from Iran,and two are from Turkey,and one is from France.The results showed that nausea and vomiting improved in all studies.In most studies(67%),four sessions or less led to improved outcomes.Rhodes index of nausea,vomiting,and retching and visual analog scale were utilized to assess nausea and vomiting.The current systematic review indicated that foot reflexology as a noninvasive intervention could improve nausea and vomiting in patients with cancer problems,pregnancy,hemodialysis,and laparoscopic cholecystectomy。
文摘Background:Isotonic crystalloids are recommended as the first choice for fluid therapy in acute pan-creatitis(AP),with normal saline(NS)and lactate Ringer’s(LR)used most often.Evidence based recom-mendations on the type of fluid are conflicting and generally come from small single-center randomized controlled trials(RCTs).We therefore conducted a systematic review and meta-analysis to compare the effect of balanced solutions(BS)versus NS on patient-centered clinical outcomes in AP.Methods:From four databases searched up to October 2024,we included only RCTs of adult patients with AP that compared the use of BS(including LR,acetate Ringer’s,etc.)with NS.The primary out-come was the disease advances from AP to moderately severe and severe AP(MSAP/SAP).Trial sequential analyses(TSA)were conducted to control for type-I and type-II errors and Grading of Recommendations Assessment,Development,and Evaluation(GRADE)was used to assess the quality of evidence.Results:Six RCTs were identified and included,involving 260 patients treated with BS and 298 patients with NS.Patients who received the BS had less MSAP/SAP[odds ratio(OR)=0.50,95%confidence in-terval(CI):0.29 to 0.85,P=0.01,I^(2)=0%;5 studies,299 patients],reduced the need of ICU admission(OR=0.60,95%CI:0.39 to 0.93,P=0.02,I^(2)=0%;5 studies,507 patients)and shorter length of hospital stay[mean difference(MD)=-0.88,95%CI:-1.48 to-0.28,P=0.004,I^(2)=0%;6 studies,558 patients;confirmed by TSA with high certainty]compared with those who received NS.The evidence for most of the clinical outcomes was rated as moderate to low due to the risk of bias,imprecision and inconsistency.Conclusions:BS,compared with NS,was associated with improved clinical outcomes in patients with AP.However,given the moderate to low quality of evidence for most of the outcomes assessed,further trials are warranted.
基金financially supported by the Basic Science Center Program(T2288102)the Key Program of the National Natural Science Foundation of China(32230059)+3 种基金the Foundation of Frontiers Science Center for Materiobiology and Dynamic Chemistry(JKVD1211002)the Project supported by the Young Scientists Fund of the National Natural Science Foundation of China(32401128)Postdoctoral Fellowship Program of CPSF(GZC20230793)Shanghai Post-doctoral Excellence Program(2023251).
文摘Following the discovery of bone as an endocrine organ with systemic influence,bone-brain interaction has emerged as a research hotspot,unveiling complex bidirectional communication between bone and brain.Studies indicate that bone and brain can influence each other’s homeostasis via multiple pathways,yet there is a dearth of systematic reviews in this area.This review comprehensively examines interactions across three key areas:the influence of bone-derived factors on brain function,the effects of brain-related diseases or injuries(BRDI)on bone health,and the concept of skeletal interoception.Additionally,the review discusses innovative approaches in biomaterial design inspired by bone-brain interaction mechanisms,aiming to facilitate bonebrain interactions through materiobiological effects to aid in the treatment of neurodegenerative and bone-related diseases.Notably,the integration of artificial intelligence(AI)in biomaterial design is highlighted,showcasing AI’s role in expediting the formulation of effective and targeted treatment strategies.In conclusion,this review offers vital insights into the mechanisms of bone-brain interaction and suggests advanced approaches to harness these interactions in clinical practice.These insights offer promising avenues for preventing and treating complex diseases impacting the skeleton and brain,underscoring the potential of interdisciplinary approaches in enhancing human health.
基金funded by the Shanghai Philosophy and Social Science Planning Project (2021BZX008)the National Social Science Foundation of China (23BZX110)the National Office for Philosophy and Social Science (20&ZD045).
文摘Background Clinical brain-computer interface(BCI)for mental disorders is an emerging interdisciplinary research field,posing new ethical concerns and challenges,yet lacking practical ethical governance guidelines for stakeholders and the entire community.Aims This study aims to establish a multidisciplinary consensus of principles for ethical governance of clinical BCI research for mental disorders and offer practical ethical guidance to stakeholders involved.Methods A systematic literature review,symposium and roundtable discussions,and a pre-Delphi(round 0)survey were conducted to form the questionnaire for the three-round modified Delphi study.Two rounds of surveys,followed by a third round of independent interviews of 25 experts from BCI-related research domains,were involved.We conducted quantitative analysis of responses and agreements among experts to reveal the consensus and differences regarding the ethical governance of mental BCI research from a multidisciplinary perspective.Results The Delphi panel emphasised important concerns of ethical review practices and ethical principles within the BCI context,identified qualified and highly influential institutions and personnel in conducting and advancing clinical BCI research,and recognised prioritised aspects in the risk-benefit evaluation.Experts expressed diverse opinions on specific ethical concerns,including concerns about invasive technology,its impact on humanity and potential social consequences.Agreement was reached that the practices of ethical governance of clinical BCI for mental disorders should focus on patient voluntariness,autonomy,long-term effects and related assessments of BCI interventions,as well as privacy protection,transparent reporting and ensuring that the research is conducted in qualified institutions with strong data security.Conclusions Ethical governance of clinical research on BCI for mental disorders should include interdisciplinary experts to balance various needs and incorporate the expertise of different stakeholders to avoid serious ethical issues.It requires scientifically grounded approaches,continuous monitoring and interdisciplinary collaboration to ensure evidence-based policies,comprehensive risk assessments and transparency,thereby promoting responsible innovations and protecting patient rights and well-being.
文摘BACKGROUND Rheumatic immune diseases are a group of chronic inflammatory diseases charac-terized by joint and systemic multi-organ involvement,including rheumatoid arthritis,systemic lupus erythematosus,and Sjogren’s syndrome,among others.The pathogenesis of these diseases is related to the abnormal activation and regulatory imbalance of the immune system.The prevalence and morbidity of rheumatic immune diseases are high,imposing a significant burden on patients'quality of life and socio-economic costs.Currently,the treatment of rheumatic immune diseases mainly relies on Western medicine,such as non-steroidal anti-inflammatory drugs,glucocorticoids,disease-modifying antirheumatic drugs,and biologics.However,the therapeutic effects of Western medicine are not ideal,some patients poorly respond or are resistant to Western medicine,and long-term use often causes various adverse reactions.AIM To systematically evaluate the efficacy and safety of Tripterygium wilfordii gly-cosides tablets combined with Western medicine in the treatment of patients with rheumatic immune diseases.METHODS This study conducted a meta-analysis to systematically evaluate the efficacy and safety of Tripterygium wilfordii glycosides tablets combined with Western medicine for patients with rheumatic immune diseases.Chinese and English databases were searched for randomized controlled trials(RCTs)on the treatment of rheumatic immune diseases with Tripterygium wilfordii glycosides tablets combined with Western medicine.The quality of the included studies was assessed using the Cochrane risk of bias assessment tool.Meta-analysis was performed using RevMan 5.4 software.RESULTS The meta-analysis included 11 RCTs involving 1026 patients with rheumatic immune diseases.The combined treatment significantly reduced the risk of disease recurrence(relative risk=1.07,95%confidence interval:1.01-1.15,P<0.05)and showed no significant heterogeneity(I2=0%,P=0.53),indicating that Tripterygium wilfordii glycosides tablets combined with Western medicine is an effective method to reduce the possibility of postoperative recurrence in patients with rheumatic immune diseases.However,due to the limited number and quality of the studies included,these results should be interpreted with caution.CONCLUSION Tripterygium wilfordii glycosides tablets combined with Western medicine is an effective and safe treatment option for patients with rheumatic immune diseases and can be considered a clinical choice.However,more high-quality research is needed to validate this conclusion and provide more solid evidence for clinical practice.
文摘Software-related security aspects are a growing and legitimate concern,especially with 5G data available just at our palms.To conduct research in this field,periodic comparative analysis is needed with the new techniques coming up rapidly.The purpose of this study is to review the recent developments in the field of security integration in the software development lifecycle(SDLC)by analyzing the articles published in the last two decades and to propose a way forward.This review follows Kitchenham’s review protocol.The review has been divided into three main stages including planning,execution,and analysis.From the selected 100 articles,it becomes evident that need of a collaborative approach is necessary for addressing critical software security risks(CSSRs)through effective risk management/estimation techniques.Quantifying risks using a numeric scale enables a comprehensive understanding of their severity,facilitating focused resource allocation and mitigation efforts.Through a comprehensive understanding of potential vulnerabilities and proactive mitigation efforts facilitated by protection poker,organizations can prioritize resources effectively to ensure the successful outcome of projects and initiatives in today’s dynamic threat landscape.The review reveals that threat analysis and security testing are needed to develop automated tools for the future.Accurate estimation of effort required to prioritize potential security risks is a big challenge in software security.The accuracy of effort estimation can be further improved by exploring new techniques,particularly those involving deep learning.It is also imperative to validate these effort estimation methods to ensure all potential security threats are addressed.Another challenge is selecting the right model for each specific security threat.To achieve a comprehensive evaluation,researchers should use well-known benchmark checklists.
文摘Wood-decaying fungi play crucial roles as decomposers in forest ecosystems.In this study,two new Lopharia species from Yunnan Province in southwest China,Lopharia minispora and Lopharia punctata,are described and illustrated based on the morphological and molecular evidence.L.minispora is characterized by its slightly brown and cracked basidiomata when dry,a monomitic hyphal system with clamp connections,and oblong-ellipsoid basidiospores measuring 5.5-6.7×2.7-3.3μm;L.punctata is characterized by its membranous,white to cream basidiomata,a monomitic hyphal system with simple-septa on generative hyphae and subglobose to globose basidiospores measuring 9.5-12×7.5-10.1μm.Sequences of ITS and nLSU rDNA markers of the studied samples were employed,and phylogenetic analyses were performed with maximum likelihood,maximum parsimony and Bayesian inference methods,ensuring the reliability of our findings.The dataset analyses showed that the two new species clustered into the genus Lopharia,in which L.minispora was sister of Lopharia erubescens;L.punctata grouped with the lineage of Lopharia ayresii and Lopharia resupinata.
文摘A controversial taxon,Hipparion plocodus,is reviewed in the present study.Hi.plocodus has been confirmed to be a valid species with definite diagnostic characteristics,represented by cranial specimens from Baode,Shanxi Province.The phylogenetic analysis performed in the present study,with a new matrix,shows that Hi.plocodus forms a monophyletic group with a European species,Hippotherium malpassii.Actually,no close relationship between so-called Hm.malpassii and the genus Hippotherium has been identified,and the record of stratigraphic range of this genus in late stage of Late Miocene is currently absent.Herein previously Hi.plocodus and Hm.malpassii have both attributed into“Hipparion”before the discovery of better material.Evolutionary stages and correlative absolute age showed that these two species should derive independently from some primitive clade.During the late stage of the Late Miocene,the development of the Asian summer monsoon enhanced the humidity of China,with forest and wood habitats expanding considerably under this setting.As the result,one Eurasian closed-habitat lineage thus extended its range into China,which had become very suited for it,give rise to“Hi.”plocodus.
