Community engagement is increasingly promoted to strengthen the ethics of medical research in low-income countries. One strategy is to use community advisory boards (CABs): semi-independent groups that can potentially...Community engagement is increasingly promoted to strengthen the ethics of medical research in low-income countries. One strategy is to use community advisory boards (CABs): semi-independent groups that can potentially safeguard the rights of study participants and help improve research. However, there is little published on the experience of operating and sustaining CABs. The Shoklo Malaria Research Unit (SMRU) has been conducting research and providing healthcare in a population of refugees, migrant workers, and displaced people on the Thai-Myanmar border for over 25 years. In 2009 SMRU facilitated the establishment of the Tak Province Community Ethics Advisory Board (T-CAB) in an effort to formally engage with the local communities both to obtain advice and to establish a participatory framework within which studies and the provision of health care can take place. In this paper, we draw on our experience of community engagement in this unique setting, and on our interactions with the past and present CAB members to critically reflect upon the CAB’s goals, structure and operations with a focus on the practicalities, what worked, what did not, and on its future directions.展开更多
Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligen...Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligence.Among its various applications,it has proven groundbreaking in healthcare as well,both in clinical practice and research.In this editorial,we succinctly introduce ML applications and present a study,featured in the latest issue of the World Journal of Clinical Cases.The authors of this study conducted an analysis using both multiple linear regression(MLR)and ML methods to investigate the significant factors that may impact the estimated glomerular filtration rate in healthy women with and without non-alcoholic fatty liver disease(NAFLD).Their results implicated age as the most important determining factor in both groups,followed by lactic dehydrogenase,uric acid,forced expiratory volume in one second,and albumin.In addition,for the NAFLD-group,the 5th and 6th most important impact factors were thyroid-stimulating hormone and systolic blood pressure,as compared to plasma calcium and body fat for the NAFLD+group.However,the study's distinctive contribution lies in its adoption of ML methodologies,showcasing their superiority over traditional statistical approaches(herein MLR),thereby highlighting the potential of ML to represent an invaluable advanced adjunct tool in clinical practice and research.展开更多
Breast cancer is the leading cause of cancer-related mortality in women globally,with its incidence continuing to rise,particularly in low-and middle-income countries,presenting a significant public health challenge w...Breast cancer is the leading cause of cancer-related mortality in women globally,with its incidence continuing to rise,particularly in low-and middle-income countries,presenting a significant public health challenge worldwide[1].According to data from the Institute for Health Metrics and Evaluation(IHME)and the World Health Organization(WHO),the gap in access to healthcare services between high-and low-income countries contributes to delayed detection,increased incidence of advanced-stage disease,and,consequently,higher mortality rates(up to 50%higher compared to high-income countries)[1,2].This translates into inequalities in access to screening and early diagnosis methods,which exacerbate the burden of this disease in low-resource settings where infrastructure,funding,and access to trained professionals are limited[3].展开更多
Background:Stretching has wide appeal,but there seems to exist some mismatch between its purported applications and what the evidence shows.There is compelling evidence for some stretching applications,but for others,...Background:Stretching has wide appeal,but there seems to exist some mismatch between its purported applications and what the evidence shows.There is compelling evidence for some stretching applications,but for others,the evidence seems heterogeneous or unsupportive.The discrepancies even affect some systematic reviews,possibly due to heterogeneous eligibility criteria and search strategies.This consensus paper seeks to unify the divergent findings on stretching and its implications for both athletic performance and clinical practices by delivering evidence-based recommendations.Methods:A panel of 20 experts with a blend of practical experience and scholarly knowledge was assembled.The panel meticulously reviewed existing systematic reviews,defined key terminologies(e.g.,consensus definitions for different stretching modes),and crafted guidelines using a Delphi consensus approach(minimum required agreement:80%).The analysis focused on 8 topics,including stretching's acute and chronic(long-term)effects on range of motion,strength performance,muscle hypertrophy,stiffness,injury prevention,muscle recovery,posture correction,and cardiovascular health.Results:There was consensus that chronic and acute stretching(a)improves range of motion(although alternatives exist)and(b)reduces muscle stiffness(which may not always be desirable);the panel also agreed that chronic stretching(c)may promote vascular health,but more research is warranted.In contrast,consensus was found that stretch training does not(a)contribute substantively to muscle growth,(b)serve as an allencompassing injury prevention strategy,(c)improve posture,or(d)acutely enhance post-exercise recovery.Conclusion:These recommendations provide guidance for athletes and practitioners,highlighting research gaps that should be addressed to more comprehensively understand the full scope of stretching effects.展开更多
Regulatory T cells are crucial immunomodulatory cells that play essential roles in both ischemic stroke and intracerebral hemorrhage.These cells are vital in post-stroke inflammation since they suppress immune respons...Regulatory T cells are crucial immunomodulatory cells that play essential roles in both ischemic stroke and intracerebral hemorrhage.These cells are vital in post-stroke inflammation since they suppress immune responses and promote tissue repair.This review thoroughly examines the dynamic changes in the number and function of regulatory T cells and highlights their distinct roles at various stages of stroke progression.In the acute phase(within 5-7 days),regulatory T cells exert neuroprotective effects primarily by reducing inflammation.In the chronic phase(7 days post-onset),these cells support neuroregeneration and functional recovery.The review also explores the emerging role of regulatory T cells in the brain-gut axis,a key mediator of the systemic immune responses following stroke,and discusses its relevance in modulating post-stroke inflammation and repair.Various strategies aimed at enhancing regulatory T cell responses include adoptive transfer of regulatory T cells,administration of pharmacological agents,and induction of mucosal tolerance.All these approaches can potentially enhance the immunomodulatory and repair functions of regulatory T cells.Nevertheless,despite the promising preclinical results,the translation of regulatory T cell-based therapies into clinical practice is associated with challenges related to optimal timing,dosage,and long-term efficacy.Overall,targeting regulatory T cells is a novel and promising immunoregulatory approach for mitigating stroke-induced injury and promoting neural repair.展开更多
Climate change is one of the most pressing global challenges and spares no nation.Bhutan,as the only carbon negative country in the world,is no exception and being in the Himalayas–a region warming faster than the gl...Climate change is one of the most pressing global challenges and spares no nation.Bhutan,as the only carbon negative country in the world,is no exception and being in the Himalayas–a region warming faster than the global average–further intensifies climate risks.This study explores how Bhutan navigates climate change through the perspectives of 41 policy influencers,including politicians,civil servants,and leaders from nongovernment organisations and the media.The findings are compared with scientific literature from the broader Himalayan region to identify shared vulnerabilities(e.g.,glacial lake outburst floods,water scarcity,and agricultural disruptions)and governance challenges(e.g.,financial constraints,geopolitical pressures,and gaps in policy implementation).The study reveals that Bhutan,like its Himalayan neighbours,prioritizes adaptation over mitigation due to immediate climate threats,despite its carbonnegative status.However,Bhutan faces unique pressures in upholding its dual commitments—maintaining 60%forest cover and carbon neutrality—amid competing development needs.While its Gross National Happiness(GNH)framework provides a holistic governance model,the analysis uncovers systemic barriers,including limited financing,transboundary climate risks,and uneven policy execution,which mirror regional struggles.The paper contributes to climate governance discourse by highlighting the risks of symbolic environmental pledges without robust implementation mechanisms,particularly for vulnerable mountain nations.It calls for integrated policies that bridge mitigation and adaptation,stronger regional cooperation,and equitable climate financing.The findings are relevant for policymakers in the Himalayas and international stakeholders advocating context-specific,justiceoriented climate strategies.展开更多
文摘Community engagement is increasingly promoted to strengthen the ethics of medical research in low-income countries. One strategy is to use community advisory boards (CABs): semi-independent groups that can potentially safeguard the rights of study participants and help improve research. However, there is little published on the experience of operating and sustaining CABs. The Shoklo Malaria Research Unit (SMRU) has been conducting research and providing healthcare in a population of refugees, migrant workers, and displaced people on the Thai-Myanmar border for over 25 years. In 2009 SMRU facilitated the establishment of the Tak Province Community Ethics Advisory Board (T-CAB) in an effort to formally engage with the local communities both to obtain advice and to establish a participatory framework within which studies and the provision of health care can take place. In this paper, we draw on our experience of community engagement in this unique setting, and on our interactions with the past and present CAB members to critically reflect upon the CAB’s goals, structure and operations with a focus on the practicalities, what worked, what did not, and on its future directions.
文摘Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligence.Among its various applications,it has proven groundbreaking in healthcare as well,both in clinical practice and research.In this editorial,we succinctly introduce ML applications and present a study,featured in the latest issue of the World Journal of Clinical Cases.The authors of this study conducted an analysis using both multiple linear regression(MLR)and ML methods to investigate the significant factors that may impact the estimated glomerular filtration rate in healthy women with and without non-alcoholic fatty liver disease(NAFLD).Their results implicated age as the most important determining factor in both groups,followed by lactic dehydrogenase,uric acid,forced expiratory volume in one second,and albumin.In addition,for the NAFLD-group,the 5th and 6th most important impact factors were thyroid-stimulating hormone and systolic blood pressure,as compared to plasma calcium and body fat for the NAFLD+group.However,the study's distinctive contribution lies in its adoption of ML methodologies,showcasing their superiority over traditional statistical approaches(herein MLR),thereby highlighting the potential of ML to represent an invaluable advanced adjunct tool in clinical practice and research.
文摘Breast cancer is the leading cause of cancer-related mortality in women globally,with its incidence continuing to rise,particularly in low-and middle-income countries,presenting a significant public health challenge worldwide[1].According to data from the Institute for Health Metrics and Evaluation(IHME)and the World Health Organization(WHO),the gap in access to healthcare services between high-and low-income countries contributes to delayed detection,increased incidence of advanced-stage disease,and,consequently,higher mortality rates(up to 50%higher compared to high-income countries)[1,2].This translates into inequalities in access to screening and early diagnosis methods,which exacerbate the burden of this disease in low-resource settings where infrastructure,funding,and access to trained professionals are limited[3].
文摘Background:Stretching has wide appeal,but there seems to exist some mismatch between its purported applications and what the evidence shows.There is compelling evidence for some stretching applications,but for others,the evidence seems heterogeneous or unsupportive.The discrepancies even affect some systematic reviews,possibly due to heterogeneous eligibility criteria and search strategies.This consensus paper seeks to unify the divergent findings on stretching and its implications for both athletic performance and clinical practices by delivering evidence-based recommendations.Methods:A panel of 20 experts with a blend of practical experience and scholarly knowledge was assembled.The panel meticulously reviewed existing systematic reviews,defined key terminologies(e.g.,consensus definitions for different stretching modes),and crafted guidelines using a Delphi consensus approach(minimum required agreement:80%).The analysis focused on 8 topics,including stretching's acute and chronic(long-term)effects on range of motion,strength performance,muscle hypertrophy,stiffness,injury prevention,muscle recovery,posture correction,and cardiovascular health.Results:There was consensus that chronic and acute stretching(a)improves range of motion(although alternatives exist)and(b)reduces muscle stiffness(which may not always be desirable);the panel also agreed that chronic stretching(c)may promote vascular health,but more research is warranted.In contrast,consensus was found that stretch training does not(a)contribute substantively to muscle growth,(b)serve as an allencompassing injury prevention strategy,(c)improve posture,or(d)acutely enhance post-exercise recovery.Conclusion:These recommendations provide guidance for athletes and practitioners,highlighting research gaps that should be addressed to more comprehensively understand the full scope of stretching effects.
基金supported by National Key R&D Program:Key Special Project on Research for the Prevention and Treatment of Common Diseases-2022 Annual Project,Nos.2022YFC2504900,2022YFC2504902(both to ZL).
文摘Regulatory T cells are crucial immunomodulatory cells that play essential roles in both ischemic stroke and intracerebral hemorrhage.These cells are vital in post-stroke inflammation since they suppress immune responses and promote tissue repair.This review thoroughly examines the dynamic changes in the number and function of regulatory T cells and highlights their distinct roles at various stages of stroke progression.In the acute phase(within 5-7 days),regulatory T cells exert neuroprotective effects primarily by reducing inflammation.In the chronic phase(7 days post-onset),these cells support neuroregeneration and functional recovery.The review also explores the emerging role of regulatory T cells in the brain-gut axis,a key mediator of the systemic immune responses following stroke,and discusses its relevance in modulating post-stroke inflammation and repair.Various strategies aimed at enhancing regulatory T cell responses include adoptive transfer of regulatory T cells,administration of pharmacological agents,and induction of mucosal tolerance.All these approaches can potentially enhance the immunomodulatory and repair functions of regulatory T cells.Nevertheless,despite the promising preclinical results,the translation of regulatory T cell-based therapies into clinical practice is associated with challenges related to optimal timing,dosage,and long-term efficacy.Overall,targeting regulatory T cells is a novel and promising immunoregulatory approach for mitigating stroke-induced injury and promoting neural repair.
文摘Climate change is one of the most pressing global challenges and spares no nation.Bhutan,as the only carbon negative country in the world,is no exception and being in the Himalayas–a region warming faster than the global average–further intensifies climate risks.This study explores how Bhutan navigates climate change through the perspectives of 41 policy influencers,including politicians,civil servants,and leaders from nongovernment organisations and the media.The findings are compared with scientific literature from the broader Himalayan region to identify shared vulnerabilities(e.g.,glacial lake outburst floods,water scarcity,and agricultural disruptions)and governance challenges(e.g.,financial constraints,geopolitical pressures,and gaps in policy implementation).The study reveals that Bhutan,like its Himalayan neighbours,prioritizes adaptation over mitigation due to immediate climate threats,despite its carbonnegative status.However,Bhutan faces unique pressures in upholding its dual commitments—maintaining 60%forest cover and carbon neutrality—amid competing development needs.While its Gross National Happiness(GNH)framework provides a holistic governance model,the analysis uncovers systemic barriers,including limited financing,transboundary climate risks,and uneven policy execution,which mirror regional struggles.The paper contributes to climate governance discourse by highlighting the risks of symbolic environmental pledges without robust implementation mechanisms,particularly for vulnerable mountain nations.It calls for integrated policies that bridge mitigation and adaptation,stronger regional cooperation,and equitable climate financing.The findings are relevant for policymakers in the Himalayas and international stakeholders advocating context-specific,justiceoriented climate strategies.
