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Clinical practice guidelines can standardize medical behaviors, improve the quality of medical services, rationalize resource allocation, and safeguard the rights of patients. However, all of these are achieved based on the rigorous design, scientific formulation, and standardized reporting of guidelines. With the nation's high attention to the standardization of traditional Chinese medicine, many clinical practice guidelines for traditional Chinese medicine or integrated traditional Chinese and Western medicine have been published. Traditional Chinese medicine orthopedics, as a discipline with obvious advantages in specialization in the field of traditional Chinese medicine, is witnessing a rapid increase in the number of clinical practice guidelines, prompting the discipline to gradually move towards standardization, modernization, and internationalization. However, many issues are increasingly emerging in this context, attracting widespread attention from researchers. This article systematically reviews and summarizes the current status and challenges of the development of clinical practice guidelines in orthopedics of traditional Chinese medicine, and proposes targeted strategies. Currently, the development of clinical practice guidelines in orthopedics of traditional Chinese medicine faces many challenges, including inaccurate positioning of clinical problems, a lack of high-quality clinical evidence, insufficient standardization in guideline formulation, a shortage of multidisciplinary talent development, and various issues regarding guideline updating and implementation. In future research, professional societies/associations should strengthen guidance on guideline formulation. Researchers should focus on improving the quality of original research, enhance learning and research in guideline methodology, prioritize guideline updating and adaptation, and promote the dissemination and implementation of guidelines, aiming to develop high-quality guidelines and promote the standardization of orthopedics of traditional Chinese medicine.

Background Establishing the advantageous diseases in the field of traditional Chinese orthopedics treated with manual therapy will promote the development of manual techniques and dominant discipline. However, the current evaluation and selection lack a quantitative evaluation process based on evidence-based medicine. Objective To systematically review systematic reviews of diseases in the field of traditional Chinese orthopedics treated with manual therapy using evidence mapping methodology and explore the advantageous diseases in this field. Methods Computerized searches were conducted in PubMed, Embase, Cochrane Library, Web of Science, SinoMed, China National Knowledge Infrastructure, Wanfang Data, and VIP database to collect systematic reviews of diseases in the field of traditional Chinese orthopedics treated with manual therapy from inception to March 5, 2023. The evidence distribution characteristics were presented using a combination of charts and text. Results A total of 126 systematic reviews published from 2003 to 2023 were included, showing an overall increasing trend in the quantity of relevant studies both domestically and internationally. Methodological quality assessment results indicated that 13 reviews were of moderate quality, 64 were of low quality, and 49 were of very low quality. The evidence map showed that the research evidence in the field of traditional Chinese orthopedics treated with manual therapy mainly focused on 18 clinical diseases, including cervical spondylosis, low back pain, knee osteoarthritis, lumbar disc herniation, ankle sprain, adhesive capsulitis of the shoulder, cervicogenic headache, atlantoaxial subluxation, distal radius fracture, lateral epicondylitis of the humerus, carpal tunnel syndrome, lumbar sprain, scoliosis, hip osteoarthritis, fibromyalgia syndrome, myofascial pain syndrome, rotator cuff injury, and supracondylar fracture of the humerus, demonstrating beneficial or potentially beneficial effects. Conclusion Manual therapy is widely used in the clinical practice of traditional Chinese orthopedics. However, due to methodological shortcomings and a lack of research evidence on safety and cost-effectiveness, future efforts should focus on multi-level inter-agency cooperation to establish sound evaluation standards and systems, improve research quality, update research evidence, and further explore the advantages of manual therapy in the field of traditional Chinese orthopedics.

Ammonia-oxidizing archaea (AOA) are among the most ubiquitous and abundant archaea on Earth, widely distributed in marine, terrestrial, and geothermal ecosystems. However, the genomic diversity, biogeography, and evolutionary process of AOA populations in subsurface environments are vastly understudied compared to those in marine and soil systems. Here, we report a novel AOA order Candidatus (Ca.) Nitrosomirales which forms a sister lineage to the thermophilic Ca. Nitrosocaldales. Metagenomic and 16S rRNA gene-read mapping demonstrates the abundant presence of Nitrosomirales AOA in various groundwater environments and their widespread distribution across a range of geothermal, terrestrial, and marine habitats. Terrestrial Nitrosomirales AOA show the genetic capacity of using formate as a source of reductant and using nitrate as an alternative electron acceptor. Nitrosomirales AOA appear to have acquired key metabolic genes and operons from other mesophilic populations via horizontal gene transfer, including genes encoding urease, nitrite reductase, and V-type ATPase. The additional metabolic versatility conferred by acquired functions may have facilitated their radiation into a variety of subsurface, marine, and soil environments. We also provide evidence that each of the four AOA orders spans both marine and terrestrial habitats, which suggests a more complex evolutionary history for major AOA lineages than previously proposed. Together, these findings establish a robust phylogenomic framework of AOA and provide new insights into the ecology and adaptation of this globally abundant functional guild.

Regarding social class differences in redistributive preferences, previous research demonstrated the explanations of self-interest perspective were limited. From an ideology perspective, the present study uncovered that attributions for rich-poor gap could mediate the relation between social class and redistributive preferences. In study 1, we conducted a measurement-of-mediation design among adults (N = 448) with the results showing that compared with those from lower social classes, higher-class individuals were more likely to make internal attributions for rich-poor gap, in turn, had lower redistributive preferences. And these associations held controlling for self-interest. In study 2, we conducted an experimental-causal-chain design with the results showing that the experimentally induced higher social class increased internal attributions for rich-poor gap (study 2A, N = 128), and priming internal attributions for rich-poor gap lowered redistributive preferences (study 2B, N = 155). These findings expand the understanding of the psychological mechanisms of class-based policy preferences and shed some light on how to reduce social inequality., Author(s): Jie Bai [sup.1] , Bu-Xiao Xu [sup.2] , Shen-Long Yang [sup.3] , Yong-Yu Guo [sup.1] Author Affiliations: (1) grid.260474.3, 0000 0001 0089 5711, School of Psychology, Nanjing Normal University, [...]

Patients diagnosed with soft tissue sarcoma (STS) often present at intermediate to advanced stages, with inherently limited therapeutic options available. There is an urgent need to identify novel therapeutic targets. In this study, by screening STS data from the Cancer Genome Atlas (TCGA) and Genotype Tissue Expression (GTEx) databases, KIFC1 is identified as a potential biomarker and a promising therapeutic target for STS. Notably, a significant increase in KIFC1 levels, which exhibited a strong correlation with a poor prognosis in STS patients is observed. The findings revealed that knockout of KIFC1 suppressed STS growth both in vitro and in vivo. Furthermore, KIFC1 is found to regulate cellular senescence in STS, which has not been reported before. that targeting KIFC1 induced cellular senescence via interacting with FXR1, an RNA‐binding protein is discovered, thereby further stabilizing MAD2L1 mRNA in an m6A‐dependent manner. Additionally, the suppression of KIFC1 markedly diminished the growth of patient‐derived xenografts (PDX) and triggered senescence. This study provides the first evidence that KIFC1 inhibition induces cellular senescence through MAD2L1, underscoring KIFC1 as a novel prognostic biomarker and a potential therapeutic target for STS. [ABSTRACT FROM AUTHOR]

BACKGROUND: Coronary artery segmentation is a prerequisite in computer-aided diagnosis of Coronary Artery Disease (CAD). However, segmentation of coronary arteries in Coronary Computed Tomography Angiography (CCTA) images faces several challenges. The current segmentation approaches are unable to effectively address these challenges and existing problems such as the need for manual interaction or low segmentation accuracy. OBJECTIVE: A Multi-scale Feature Learning and Rectification (MFLR) network is proposed to tackle the challenges and achieve automatic and accurate segmentation of coronary arteries. METHODS: The MFLR network introduces a multi-scale feature extraction module in the encoder to effectively capture contextual information under different receptive fields. In the decoder, a feature correction and fusion module is proposed, which employs high-level features containing multi-scale information to correct and guide low-level features, achieving fusion between the two-level features to further improve segmentation performance. RESULTS: The MFLR network achieved the best performance on the dice similarity coefficient, Jaccard index, Recall, F1-score, and 95% Hausdorff distance, for both in-house and public datasets. CONCLUSION: Experimental results demonstrate the superiority and good generalization ability of the MFLR approach. This study contributes to the accurate diagnosis and treatment of CAD, and it also informs other segmentation applications in medicine. [ABSTRACT FROM AUTHOR]