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COVID-19 might be a risk factor for various chronic diseases. However, the association between COVID-19 and the risk of incident diabetes remains unclear. We aimed to meta-analyze evidence on the relative risk of incident diabetes in patients with COVID-19. In this systematic review and meta-analysis, the Embase, PubMed, CENTRAL, and Web of Science databases were searched from December 2019 to June 8, 2022. We included cohort studies that provided data on the number, proportion, or relative risk of diabetes after confirming the COVID-19 diagnosis. Two reviewers independently screened studies for eligibility, extracted data, and assessed risk of bias. We used a random-effects meta-analysis to pool the relative risk with corresponding 95 % confidence intervals. Prespecified subgroup and meta-regression analyses were conducted to explore the potential influencing factors. We converted the relative risk to the absolute risk difference to present the evidence. This study was registered in advance (PROSPERO CRD42022337841). Ten articles involving 11 retrospective cohorts with a total of 47.1 million participants proved eligible. We found a 64 % greater risk (RR = 1.64, 95%CI: 1.51 to 1.79) of diabetes in patients with COVID-19 compared with non-COVID-19 controls, which could increase the number of diabetes events by 701 (558 more to 865 more) per 10,000 persons. We detected significant subgroup effects for type of diabetes and sex. Type 2 diabetes has a higher relative risk than type 1. Moreover, men may be at a higher risk of overall diabetes than women. Sensitivity analysis confirmed the robustness of the results. No evidence was found for publication bias. COVID-19 is strongly associated with the risk of incident diabetes, including both type 1 and type 2 diabetes. We should be aware of the risk of developing diabetes after COVID-19 and prepare for the associated health problems, given the large and growing number of people infected with COVID-19. However, the body of evidence still needs to be strengthened. [Display omitted] • Eleven cohorts involving 47.1 million participants were included. • A 64 % greater risk of diabetes was found in patients with COVID-19. • A significant association was found for both type 1 diabetes and type 2 diabetes. • Subgroup analysis and sensitivity analyses proved the robustness. [ABSTRACT FROM AUTHOR]

Novel Li1.5Mn0.75Ni0.15Co0.10O2+δ microspheres with hierarchical multilayer shells were rationally designed and successfully prepared through a layer-by-layer self-assembly deposit with a co-precipitation process. The microsphere with multilayer shells consists of a Li1.5Mn0.75Ni0.25O2+δ inner core and hierarchical multilayer shells. The structure and electrochemical properties of the spherical Li1.5Mn0.75Ni0.15Co0.10O2+δ cathode material with multilayer shells are evaluated and compared to those of the conventional Li1.5Mn0.75Ni0.15Co0.10O2+δ cathode material with the same chemical composition as the multilayer spherical cathode material. The results show that the spherical cathode material with multilayer shells delivers a high discharge capacity of 257.8 mA h g−1 at a rate of 0.1 C with an outstanding capacity retention of 96.1% after 100 cycles at 0.5 C between 2.0 and 4.6 V. Especially, the spherical cathode material with multilayer shells exhibits an improved rate capability with a capacity of 102.7 mA h g−1 even at a high discharge rate of 10 C, and it is apparently superior to the conventional Li1.5Mn0.75Ni0.15Co0.10O2+δ cathode material (64.9 mA h g−1). Thus, the reasonable design for function and structure of cathode materials will be significant for improving the lithium ion battery performance. [ABSTRACT FROM AUTHOR]

Background: Multiple studies and meta-analyses have reported the diagnostic value of C-reactive protein (CRP) in several diseases. However, the precision, and influence of potential bias regarding the diagnostic values of existing evidence may have implications for clinical practice.Methods: We performed an umbrella review of diagnostic test accuracy studies of CRP for diseases by searching PubMed, Embase, China National Knowledge Infrastructure, and WanFang databases up to March 7, 2021. Five independent reviewers evaluated eligibility, extracted data, and assessed methodological quality. We descriptively analyzed the diagnostic accuracy of CRP for multiple diseases, heterogeneity between studies, and publication bias.Results: Seventy-four meta-analyses were included, with 13 diseases classified according to the International Classification of Diseases-11 (ICD-11). The methodological quality of the included meta-analyses was mostly low, with only 16 meta-analyses rated as moderate or high, including seven diseases classified by ICD-11. CRP had a relatively greater diagnostic accuracy for two of these diseases. For postoperative infectious complications after bariatric surgery, sensitivity and specificity were 0.81 (0.34-1) and 0.91 (0.73-1), respectively. For anastomotic leakage after colorectal surgery, sensitivity and specificity were 0.95 (0.75-0.99) and 0.95 (0.75-0.99), respectively.Conclusions: The diagnostic accuracy of CRP for multiple diseases has been extensively studied; however, most studies have low methodological quality. Evidence indicates that CRP has a relatively greater diagnostic accuracy for inflammation and infection diseases, especially for postoperative infectious complications after bariatric surgery and anastomotic leakage after colorectal surgery. [ABSTRACT FROM AUTHOR]

LiMn[sub 1/3]Ni[sub 1/3]Co[sub 1/3]O[sub 2] microspheres covered by a nanosized Li[sub 2]TiO[sub 3]-based shell are prepared by a facile synthesis method. First, a controllable TiO[sub 2] nano-layer is grown on the surface of a spherical Mn[sub 1/3] Ni[sub 1/3]Co[sub 1/3]CO[sub 3] precursor, and then the resultant TiO[sub 2]@LiMn[sub 1/3]Ni[sub 1/3]Co[sub 1/3]O[sub 2] hybrid is synchronously transformed in situ into a hierarchical Li[sub 2]TiO[sub 3]@LiMn[sub 1/3]Ni[sub 1/3]Co[sub 1/3]O[sub 2] microsphere through a solid-phase reaction. It has been found that the hierarchical Li[sub 2]TiO[sub 3]@LiMn[sub 1/3]Ni[sub 1/3]Co[sub 1/3]O[sub 2] microspheres exhibit a good rate capability with a discharge capacity of 92.3 mA h g[sup -1] even at higher rates of 20 C between 3.0 and 4.3 V. Besides, they possess excellent cyclic stability especially at high rates, with a capacity retention of 90.3% after 500 cycles at a 20 C rate. The enhanced electrochemical performance of the hierarchical Li[sub 2]TiO[sub 3]@LiMn[sub 1/3]Ni[sub 1/3]Co[sub 1/3]O[sub 2] at high rates is attributed to the stable and fast Li[sup +]-conductor characteristic of the nanosized Li[sub 2]TiO[sub 3]-based shell. Thus, the Li[sub 2]TiO[sub 3]@LiMn[sub 1/3]Ni[sub 1/3]Co[sub 1/3]O[sub 2] microspheres will be a promising cathode material for lithium-ion batteries with high power density and excellent cycling performance. [ABSTRACT FROM AUTHOR]

Characteristics of magnetic-levitation systems are studied using dynamic models that include motion-dependent lift, drag, slip, and roll motions. The contact constraint between the vehicle and the track is modeled using a compliant contact model, and inelastic restitution is modeled using damping. Unknown numerical parameters are identified using an optimization technique and experimental data. The numerical tests are focused on the damping characteristics, stability in lifting and slip motions, the lifting efficiency, and the contact behavior with the track. It turns out that the suspension system does not have any inherent damping in the lifting direction. However, a stable behavior is observed in the traveling direction. The model also shows that the system has a strong concentric force that stabilizes the vehicle in the slip motion as well as in the rolling motion. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion The application of large language models (LLMs) in medicine has received increasing attention, showing significant potential in teaching, research, and clinical practice, especially in knowledge extraction, management, and understanding. However, the use of LLMs in Traditional Chinese Medicine (TCM) has not been thoroughly studied. This study aims to provide a comprehensive overview of the status and challenges of LLM applications in TCM.A systematic search of five electronic databases and Google Scholar was conducted between November 2022 and April 2024, using the Arksey and O'Malley five‐stage framework to identify relevant studies. Data from eligible studies were comprehensively extracted and organized to describe LLM applications in TCM and assess their performance accuracy.A total of 29 studies were identified: 24 peer‐reviewed articles, 1 review, and 4 preprints. Two core application areas were found: the extraction, management, and understanding of TCM knowledge, and assisted diagnosis and treatment. LLMs developed specifically for TCM achieved 70% accuracy in the TCM Practitioner Exam, while general‐purpose Chinese LLMs achieved 60% accuracy. Common international LLMs did not pass the exam. Models like EpidemicCHAT and MedChatZH, trained on customized TCM corpora, outperformed general LLMs in TCM consultation.Despite their potential, LLMs in TCM face challenges such as data quality and security issues, the specificity and complexity of TCM data, and the nonquantitative nature of TCM diagnosis and treatment. Future efforts should focus on interdisciplinary talent cultivation, enhanced data standardization and protection, and exploring LLM potential in multimodal interaction and intelligent diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Objective: A systematic review/meta‐analysis was conducted to investigate the effect of cannabinoid type‐1 receptor (CB1R) regulation on the sleep‐wake cycle of rats and to provide new ideas and evidence‐based basis for clinical research on the treatment of sleep disorders. Methods: We searched Cochrane Library, PubMed, Web of Science, Embase, Chinese Biomedicine Literature Database (CBM), China National Knowledge Infrastructure, WanFang, and VIP databases for relevant papers, about the effects of CB1R agonists/antagonists on sleep‐wake cycle in rats, from inception to November 2023. Two reviewers performed study screening, data extraction, and risk of bias assessment using the SYRCLE's risk of bias tool. Meta‐analysis was performed using RevMan 5.3 software. Heterogeneity test was performed on the included studies (Test standard α = 0.1). I2 value was used to evaluate the heterogeneity. Forest plot was drawn, and p ≤ 0.05 indicates statistically significant difference. Results: A total of 16 trials involving 484 experimental rats were included. The methodological quality evaluation results showed that the overall quality of the included studies was low. The results of the meta‐analysis showed that single administration of CB1R agonists could shorten the wakefulness (W) time in the first 6 h (h) (standardized mean difference (SMD) = –2.52, 95% confidence interval (CI) (–3.83, –1.22), p = 0.0002) and 24 h (SMD = –0.84, 95% CI (–1.31, –0.36), p = 0.0005) after administration, prolong nonrapid eye movement sleep (NREM) time (SMD = 1.75, 95% CI (0.54, 2.95), p = 0.005) and rapid eye movement sleep (REM) time (SMD = 1.76, 95% CI (0.26, 3.26), p = 0.02), and increase REM frequency after administration (SMD = 1.67, 95% CI (0.98, 2.35), p < 0.00001), these results were all statistically different. There were no significant differences in sleep latency and average duration of REM. Single administration of CB1R antagonists prolonged the first 6 h W time after administration (SMD = 1.36, 95%CI (0.29, 2.43), p = 0.01), shortened the first 6 h NREM time (SMD = –1.73, 95% CI (–2.88, –0.57), p = 0.003) and REM time (SMD = –2.07, 95% CI (–3.17, –0.96), p = 0.0003) after administration, and increased the frequency of W after administration (SMD = 3.57, 95% CI (1.42, 5.72), p = 0.001). There was no statistical difference in the average duration of W. REM time and REM frequency increased after continuous CB1R agonist withdrawal. Conclusions: According to the existing evidence, CB1R played a pivotal role in regulating the sleep‐wake cycle in rats. CB1R agonists tended to reduce W time, increase NREM and REM sleep times, boost REM frequency, and promote sleep. Conversely, CB1R antagonists could increase the duration and frequency of W, shorten NREM and REM sleep times, and promote W. [ABSTRACT FROM AUTHOR]

AbstractA plethora of systematic reviews with meta-analyses (SRMAs) evaluating sodium intake on cardiovascular health have been published. However, the quality of the SRMAs, that report absolute estimates of effect for major cardiovascular events and the corresponding certainty of the evidence has not been explicitly summarized. We conducted an umbrella review to assess the strength and validity of associations between lower sodium intake and cardiovascular outcomes. We used a modified, more stringent, version of the AMSTAR 2 instrument and the GRADE approach to assess SRMA methodological quality and evidence certainty, respectively. Across three cardiovascular risk strata, we computed the absolute risk reduction (ARR) for binary outcomes. We included 56 SRMAs. In various cardiovascular risk populations, moderate to high certainty evidence suggested that lower sodium intake reduced systolic blood pressure (BP) by −8.69 to −2.00 mmHg, and had concordant but smaller effects on diastolic BP. Salt substitutes conferred a small but important reduction in all-cause and cardiovascular mortality [ARR 12 fewer per 1000; 9 fewer per 1000; respectively], and had little to no effect on the risk of stroke [ARR 1 fewer per 1000]. Moderate to high certainty evidence suggested that lower sodium intake is probably beneficial for the prevention of major cardiovascular events, especially in low cardiovascular risk populations. [ABSTRACT FROM AUTHOR]

Lumbar spinal stenosis is one of the most common causes of low back and leg pain. However, there is a lack of evidence-based guidelines for the treatment of lumbar spinal stenosis with integrated traditional Chinese medicine and western medicine. To standardize the diagnosis and treatment of lumbar spinal stenosis with a combination of traditional Chinese medicine and western medicine, this guideline strictly followed the relevant guiding principles for the development of guidelines both domestically and internationally. A multidisciplinary working group was established. We adopted the GRADE approach to grade the quality of evidence and the strength of recommendation. Finally recommendations on the treatment of lumbar spinal stenosis with integrated traditional Chinese medicine and western medicine were formed, aiming to standardize clinical practice. This guideline is for patients with all degrees of lumbar spinal stenosis.

Background The effective evaluation of scientific and technological achievements in traditional Chinese medicine (TCM) is of great significance in promoting the innovative development of TCM. Previous evaluations of scientific and technological achievements in TCM often used a generalized evaluation method, leading to problems such as inappropriate indicators and limited dimensions, which is not conducive to reflecting the multiple values of achievements in a scientific and comprehensive way. Consequently, there is an urgent need to establish categorized and multi-dimensional evaluation index system for the evaluation of scientific and technological achievements in TCM in the new period. Objective To establish a scientific, categorized, reliable and comprehensive evaluation index system that reflects the principles of TCM and highlights its unique advantages aiming at the scientific and technological achievements in TCM, in accordance with the contemporary requirements for scientific and technological evaluation in China. Methods This study began in November 2022 and was completed in May 2023. A preliminary index framework was developed through literature review and focus group discussions. Delphi expert consultation was then conducted over two rounds to determine the evaluation indexes and points. The hierarchical analysis method was used to calculate the weight of each index. Results The final evaluation index system of scientific and technological achievements in TCM clinical research comprised 10 threshold indicators, 4 primary indicators, 17 secondary indicators, and 17 evaluation points. After testing, the positive coefficient of experts in both rounds of Delphi method implementation was 100%, the authority coefficient was 0.94 and 0.93, respectively. The Kendall's W consistency test for each level of indicators yielded two-tailed significance (P

Objective: Clinical practice guidelines (CPGs) for Integrated Traditional Chinese and Western Medicine (TCM and WM) are important medical documents used to assist medical decision‐making and are of great significance for standardizing clinical pathways. However, due to the constraints of text format, it is difficult for Integrated TCM and WM CPGs to play a real role in medical practice. In addition, how to standardize the structure and semantic relationships between Integrated TCM and WM CPG knowledge, and realize the construction of computable, sharable and reliable CPGs, remains an urgent issue to be addressed. Therefore, we are proposing an ontology of CPGs for Integrated TCM and WM. Methods: We first initialized domain concepts and relationships to ensure the accuracy of the ontology knowledge structure. We then screened CPGs that meet the standards for Integrated TCM and WM, analyzed and classified the contents, and extracted the common structures. Based on the seven‐step ontology construction method combined with inference‐complement, referring to the representation methods and hierarchical relationships of terms and concepts in MeSH, ICD‐10, SNOMED‐CT, and other ontologies and terminology sets, we formed the concept structure and semantic relationship tables for the ontology. We also achieved the matching and mapping between the ontology and reference ontologies and term sets. Next, we defined the aspects and constraints of properties, selected multiple Integrated TCM and WM CPGs as instances to populate, and used ontology reasoning tools and formulated defined inference rules to reason and extend the ontology. Finally, we evaluated the performance of the ontology. Results: The content of the Integrated TCM and WM CPGs is divided into nine parts: basic information, background, development method, clinical question, recommendation, evidence, conclusion, result, and reason for recommendations. The Integrated TCM and WM CPG ontology has 152 classes and defines 90 object properties and 114 data properties, with a maximum classification depth of 4 layers. The terms of disease, drug and examination item names in the ontology have been standardized. Conclusions: This study proposes an Integrated TCM and WM CPG ontology. The ontology adopts a modular design, which has both sharing and scaling ability, and can express rich guideline knowledge. It provides important support for the semantic processing and computational application of guideline documents. [ABSTRACT FROM AUTHOR]

Hydrocotyle sibthorpioides Lam. is a widespread and important Chinese medicinal plant. In this study, we have sequenced the complete chloroplast genome of H. sibthorpioides, which is 152,880 bp in length with large (LSC 84,064 bp) and small (SSC 18,690 bp) single-copy regions separated by a pair of inverted repeats (IRs 25,063 bp) and contains 113 unique genes with 17 genes duplicated in the IR making a total of 130 genes. The phylogenetic analysis strongly supports the position of H. sibthorpioides and indicates it belongs to the Araliaceae family, potential to facilitate a better understanding of population and phylogenetic studies in Apiales. [ABSTRACT FROM AUTHOR]

Summary: Software‐defined networking (SDN) decouples the control and data planes to simplify network management and function deployment. SDN provides a solution for managing large‐scale virtual networks in the cloud environment. However, in the process of SDN network update, various attacks can lead to network state inconsistency. In this paper, a comprehensive and efficient verification scheme is proposed to defend the security threats and guarantee the network state consistency in the cloud environment. The scheme verifies the consistency of network update from two stages of network update request and response. Firstly, the flow path model and the security space are abstracted to quickly verify whether the network request is allowed. Then, a novel forwarding path probing and verification method is designed to validate the actual forwarding path and locate the abnormal path in real time. With the two‐stage verification, the scheme can prevent the spread of illegal flow rules and ensure the correct delivery and execution of flow rules. Finally, we carry out a series of experiments in OpenStack. The results show that the proposed scheme can detect security threats and label the abnormal forwarding path in real time to ensure the network state consistency, while introducing negligible performance overhead. [ABSTRACT FROM AUTHOR]

Growing evidence indicates that insomnia may be associated with mortality. However, these findings have been inconsistent. We systematically searched MEDLINE and EMBASE to identify prospective cohort studies that assessed the association between insomnia disorder/individual insomnia symptoms and the risk of mortality among adults aged ≥18 yrs. We addressed this association using summary hazard ratios (HRs) and 95% confidence intervals (CIs) calculated using random-effects meta-analysis, and the GRADE approach to rate the certainty of evidence. Twenty-nine cohorts including 1,598,628 individuals (55.3% men; mean age 63.7 yrs old) with a median follow-up duration of 10.5 yrs proved eligible. Difficulty falling asleep (DFA) and non-restorative sleep (NRS) were associated with an increased risk of all-cause mortality (DFA: HR = 1.13, 95%CI 1.03 to 1.23, p = 0.009, moderate certainty; NRS: HR = 1.23, 95%CI 1.07 to 1.42, p = 0.003, high certainty) and cardiovascular disease mortality (DFA: 1.20, 95%CI: 1.01, 1.43; p = 0.04, moderate certainty; NRS: HR = 1.48, 95%CI 1.06 to 2.06, p = 0.02, moderate certainty). Convincing associations between DFA and all-cause mortality were restricted to the mid to older-aged population (moderate credibility). Insomnia disorder, difficulty maintaining sleep, and early morning awakening proved to be unassociated with all-cause and cardiovascular disease mortality. No insomnia symptoms proved to be associated with cancer-related mortality. [ABSTRACT FROM AUTHOR]

Objective: Alteplase is the current standard of care for acute ischemic stroke. Tenecteplase is a newer fibrinolytic agent with preferable administration and lower costs; however, its comparative effectiveness to alteplase remains uncertain. We set out to perform a systematic review and meta-analysis to establish the benefits and harms of tenecteplase versus alteplase for acute ischemic stroke. Methods: We searched PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov from inception to April 2023 for randomized and non-randomized studies that compared tenecteplase versus alteplase for acute ischemic stroke. Paired reviewers independently assessed risk of bias and extracted data. We performed both conventional meta-analyses and Bayesian network meta-analyses (NMA) with random-effects models and used the GRADE approach to evaluate the certainty of evidence. Our primary efficacy outcome was excellent functional outcome at 3 months, defined as a score of 0–1 on the modified Rankin Scale. Our primary safety outcomes were symptomatic intracranial hemorrhage and all-cause mortality. Results: Thirty-six studies were eligible for review, including 12 randomized (n = 5533) and 24 non-randomized studies (n = 44,956). Moderate certainty evidence showed that there was no difference between tenecteplase and alteplase in increasing the proportion of patients achieving excellent functional outcome at 3 months (odds ratio [OR], 1.10; 95% CI 0.98–1.23; risk difference [RD] 2.4%, 95% CI − 0.5 to 5.2), while moderate certainty evidence from NMA suggested that 0.25 mg/kg tenecteplase significantly improved excellent functional outcome at 3 months (OR, 1.16; 95% credible interval 1.02–1.32). Moderate certainty evidence showed that, compared to alteplase, tenecteplase may make little to no difference in the prevalence of symptomatic intracranial hemorrhage (OR, 1.12; 95% CI 0.79–1.59; RD 0.3%, 95% CI − 0.5 to 1.4), and probably reduces all-cause mortality (adjusted odds ratio [aOR], 0.44; 95% CI 0.30–0.64; RD − 4.6%; 95% CI − 5.8 to − 2.9). Conclusions: Moderate certainty evidence suggested that there was little to no difference between tenecteplase and alteplase in increasing the proportion of patients achieving excellent functional outcome at 3 months and the risk of symptomatic intracranial hemorrhage, while compared to alteplase, tenecteplase probably reduce all-cause mortality. Administration of 0.25 mg/kg tenecteplase after acute ischemic stroke is suggestive of increasing the proportion of patients that achieve excellent functional outcome at 3 months. [ABSTRACT FROM AUTHOR]

Tanreqing injection (TRQI) is an intravenous herbal preparation derived from 5 types of traditional Chinese medicines including Scutellariae Radix, Lonicerae Japonicae Flos, Forsythiae Fructus, bear bile powder and goral horn, incorporating baicalin, chlorogenic acid, ursodeoxycholic acid, and goose deoxycholic acid and other compounds known for anti-inflammatory properties, is widely used in China to treat cough caused by acute trachea-bronchitis disease (ATB). To investigate the clinical efficacy and safety of Tanreqing injection (TRQI) with and without Western medicine (WM) for cough caused by acute trachea-bronchitis (ATB). We systematically searched eight databases, including CENTRAL, Embase, PubMed, Science Direct, Wiley, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and WanFang, from inception to August 2023 for randomized clinical trials (RCTs) on TRQI for cough caused by ATB. The critical outcomes of interest were time to symptom disappearance, including time for cough symptom to disappear and time to improve cough and sputum production. Important outcomes included symptom disappearance rate, adverse events (AEs) and lung function. We carried out random-effects meta-analysis using Review Manager 5.4 and assessed the certainty of evidence utilizing the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. A total of 2872 citations were identified by our search, of which 26 eligible RCTs enrolled 2731 participants. Low to moderate certainty evidence showed that when compared with WM, TRQI plus WM treatment was associated with a favorable effect on the time for cough symptom to disappear (MD -2.21 d, 95% CI −2.64 to −1.78), time to improve cough and sputum production (MD −0.68 d, 95% CI −0.83 to −0.53), symptom disappearance rate (RR 1.37, 95% CI 1.20 to 1.55), forced vital capacity, and forced expiratory volume in 1 s (MD 0.38 L, 95% CI 0.26 to 0.50; MD 2.92%, 95% CI 1.29 to 4.56, respectively). In terms of AEs, there was no association between TRQI plus WM and WM (RR 0.55, 95% CI 0.14 to 2.21; low-certainty evidence). Very low certainty evidence showed that TRQI alone was associated with reduced time to improve cough and sputum (MD -0.14 d, 95% CI −0.26 to −0.02) and increased symptom disappearance rate (RR 1.89, 95% CI 1.24 to 2.88; low certainty evidence) compared to WM. The overall efficacy of TRQI or WM for ATB cough is better than that of WM, and TRQI also effectively improve symptoms in patients with similar adverse events. However, due to the lack of methodological rigor of included studies, the present findings should be interpreted with caution. We advocate better high-quality and convincing clinical studies to be performed to prove the effectiveness and safety of TRQIs. [Display omitted] • This study was in accordance with PRISMA to ensure higher reporting quality. • The study used the GRADE approach to rate the certainty of evidence, which is an easy-to-understand approach for clinician. • Our study showed that the overall efficacy of Tanreqing injection or with western medicine for ATB cough is better than western medicine. [ABSTRACT FROM AUTHOR]

Pharmacotherapy provides an option for adults with overweight and obesity to reduce their bodyweight if lifestyle modifications fail. We summarised the latest evidence for the benefits and harms of weight-lowering drugs. This systematic review and network meta-analysis included searches of PubMed, Embase, and Cochrane Library (CENTRAL) from inception to March 23, 2021, for randomised controlled trials of weight-lowering drugs in adults with overweight and obesity. We performed frequentist random-effect network meta-analyses to summarise the evidence and applied the Grading of Recommendations Assessment, Development, and Evaluation frameworks to rate the certainty of evidence, calculate the absolute effects, categorise interventions, and present the findings. The study was registered with PROSPERO, CRD 42021245678. 14 605 citations were identified by our search, of which 132 eligible trials enrolled 48 209 participants. All drugs lowered bodyweight compared with lifestyle modification alone; all subsequent numbers refer to comparisons with lifestyle modification. High to moderate certainty evidence established phentermine–topiramate as the most effective in lowering weight (odds ratio [OR] of ≥5% weight reduction 8·02, 95% CI 5·24 to 12·27; mean difference [MD] of percentage bodyweight change −7·98, 95% CI −9·27 to −6·69) followed by GLP-1 receptor agonists (OR 6·33, 95% CI 5·00 to 8·00; MD −5·79, 95% CI −6·34 to −5·25). Naltrexone–bupropion (OR 2·69, 95% CI 2·10 to 3·44), phentermine–topiramate (2·40, 1·68 to 3·44), GLP-1 receptor agonists (2·22, 1·74 to 2·84), and orlistat (1·71, 1·42 to 2·05) were associated with increased adverse events leading to drug discontinuation. In a post-hoc analysis, semaglutide, a GLP-1 receptor agonist, showed substantially larger benefits than other drugs with a similar risk of adverse events as other drugs for both likelihood of weight loss of 5% or more (OR 9·82, 95% CI 7·09 to 13·61) and percentage bodyweight change (MD −11·40, 95% CI −12·51 to −10·29). In adults with overweight and obesity, phentermine–topiramate and GLP-1 receptor agonists proved the best drugs in reducing weight; of the GLP-1 agonists, semaglutide might be the most effective. 1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University. [ABSTRACT FROM AUTHOR]

To evaluate the timing, duration and incidence of bacteremia following invasive dental procedures (IDPs) or activities of daily living (ADL). Eight databases were searched for randomized (RCTs) and nonrandomized controlled trials (nRCTs) evaluating bacteremia before and after IDPs or ADL in healthy individuals. The risk of bias was assessed by RoB 2.0 and ROBINS‐I. For the meta‐analysis, the primary outcomes were the timing and duration of bacteremia. The secondary outcome was the incidence of bacteremia, measuring the proportion of patients with bacteremia within 5 min after the end of the procedure compared with baseline. We included 64 nRCTs and 25 RCTs. Peak bacteremia occurred within 5 min after the procedure and then decreased over time. Dental extractions showed the highest incidence of bacteremia (62%–66%), followed by scaling and root planing (SRP) (44%–36%) and oral health procedures (OHP) (e.g., dental prophylaxis and dental probing without SRP) (27%–28%). Other ADL (flossing and chewing) (16%) and toothbrushing (8%–26%) resulted in bacteremia as well. The majority of studies had some concerns RCTs or moderate risk of bias nRCTs. Dental extractions, SRP and OHP, are associated with the highest frequency of bacteremia. Toothbrushing, flossing, and chewing also caused bacteremia in lower frequency. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to systematically evaluate the methodological quality of massage-related clinical practice guidelines (CPGs)/consensus on massage using the Appraisal of Guidelines Research and Evaluation (AGREE II) instrument and to summarize the current status of recommendations in the CPGs. Methods: The Chinese National Knowledge Infrastructure (CNKI), WanFang Data, China Science and Technology Journal Database (VIP), China Biology Medicine disc (CBM), PubMed, Embase, and guideline websites (such as the Chinese Medical Ace Base, the China Association of Chinese Medicine, the World Health Organization, Guideline International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network) were searched from inception to October 31, 2022. In addition, the reference lists of relevant studies were reviewed to identify domestic and overseas massage CPGs/consensus. The search terms adopted a combination of subject words and free words, mainly including traditional Chinese medicine, complementary therapies, Tuina, massage, manipulation, chiropractic/osteopathic, spinal, acupressure, guideline, and consensus. Two researchers independently completed the eligible records and extracted the data. Before the formal research, calibrations were performed twice on AGREE II, and all reviewers completed the pilot test three times until they understood and reached an agreement on the assessment items. Three researchers appraised the methodological quality of the included guidelines using the AGREE II instrument and calculated the overall intraclass correlation coefficient (ICC) of agreement. Results: The evaluation results showed that among the 49 eligible CPGs/consensus, 4 (8.2%) CPGs/consensus were considered "recommended", 15 (30.6%) CPGs/consensus were considered "recommended with modifications", and 30 (61.2%) CPGs/consensus were considered "not recommended", while the consensus was considered "not recommended". Generally, the scores in the six domains of the guidelines were all higher than the consensus. Evaluation results for the overall quality of 36 CPGs showed that 4 (11%) were "good quality", 15 (42%) were "sufficient quality" and 17 (47%) were "lower quality". The AGREE II quality scores of domains ranged from 0.30 to 0.75 ([ICC = 0.993, 95% CI (0.992, 0.995)]). The domain of scope and purpose (domain 1), with a median score of 0.75 (0.52~0.91), performed best in the guidelines with AGREE II, and stakeholder involvement (domain 2) [median 0.39 (0.31~0.56)] and application (domain 5) [median 0.30 (0.17~0.47] obtained lower scores. The consensus score of domain 1 was better at 26.0 (21.6~44.8), followed by rigor of development (domain 3) with a score of 18.0 (10.0~28.9). A total of 119 massage-related recommendations were extracted from 49 guidelines/consensuses, including "in favor" (102, 85.7%), "against" (9, 7.6%), and "did not make recommendations" (8, 6.7%). Conclusion: The overall quality of the included guidelines was low, and most of the guidelines were not "recommended". In future guideline updates, the existing evidence should be used, the professional composition of members of the expert group should be enriched, and patients' values and preferences should be fully considered. It is necessary to clearly propose recognizable recommendations and strengthen the rigor and standardization of guideline formulation. Thus, clear standard guidelines can be formulated to better guide clinical practice. [ABSTRACT FROM AUTHOR]

To summarize the evidence of various exercise modalities on population with insomnia disorders. PubMed, Embase, Cochrane Library, and Web of Science were searched for eligible studies published from inception to October 2022 and updated on September 2023. Systematic reviews with meta-analyses and randomized controlled trials designed to investigate the effect of various exercise modalities on population with insomnia were eligible. A total of 4 SRs with (very) low methodological quality and 1034 participants in 10 network meta-analyses explored the association between different types and intensity exercise modalities with insomnia disorders. Various exercise modalities could significantly improve total sleep time and sleep quality and alleviate insomnia severity. Compared to passive control, moderate aerobic exercise, moderate aerobic exercise combined with light intensity strength and mind-body exercise can improve sleep efficiency and reduce wake after sleep onset by objectively measured. Moderate intensity strength, light intensity strength and mind-body exercise can improve sleep efficiency subjectively measured; mind-body exercise can reduce sleep onset latency and wake time after sleep onset, and increase total sleep time; moderate aerobic exercise can reduce sleep onset latency. Moderate intensity strength, light intensity strength, mind body exercise and moderate aerobic exercise combined with light intensity strength can the severity of insomnia and improv sleep quality. Exercise had a positive effect on relief insomnia and improve sleep quality. Moderate aerobic exercise, mind-body exercise and moderate aerobic exercise combined with light intensity strength play an important role in improving the sleep quality in people with insomnia disorders. • Exercise has a positive effect on relieving the insomnia disorders. • Effect of various intensities, types of exercise in improving insomnia are different. • Exercise can alleviate the severity of insomnia and improve sleep quality. • The evidence on the effect of exercise on insomnia is low in quantity and quality. • In the future, more high-quality studies are needed. [ABSTRACT FROM AUTHOR]

The Consolidated Framework for Implementation Research (CFIR) is a commonly used theoretical framework in the field of implementation science, which helps researchers identify potential and actual influencing factors of the progress and effectiveness of implementation. CFIR was firstly proposed in 2009 with a 13-year history of development. In 2022, the CFIR development team updated CFIR based on user feedback, adding 21 constructs and 19 subconstructs to the original framework structure, adjusting some of the constructs and redefining certain concepts, resulted in CFIR 2.0 which is more practical and general. This paper aims to provide a reference for domestic researchers to understand and use CFIR 2.0 by reviewing and introducing the development background, origin, and update content of CFIR.

White rice is the food more than half of the world's population depends on. White rice intake can significantly increase the glycemic load of consumers and bring some adverse health effects. However, the quality of evidence implicating white rice in adverse health outcomes remains unclear. To evaluate the association between white rice consumption and the risk of cardiometabolic and cancer outcomes, a systematic review and dose-response meta-analysis of the relevant publications were performed. Twenty-three articles including 28 unique prospective cohorts with 1,527,198 participants proved eligible after a comprehensive search in four databases. For the risk of type 2 diabetes mellitus (T2DM), the pooled RR was 1.18 (16 more per 1000 persons) for comparing the highest with the lowest category of white rice intake, with moderate certainty evidence. Females presented a higher risk (23 more per 1000 persons) in subgroup analysis. And every additional 150 grams of white rice intake per day was associated with a 6% greater risk of T2DM (5 more per 1000 persons) with a linear positive trend. We found no significant associations between white rice intake and risk of cardiovascular diseases (CVD), CVD mortality, cancer, and metabolic syndrome. In conclusion, moderate certainty evidence demonstrated that white rice intake was associated with T2DM risk, with a linear positive trend. However, low to very low certainty of evidence suggested that no substantial associations were found between white rice intake and other cardiometabolic and cancer outcomes. More cohorts are needed to strength the evidence body. [ABSTRACT FROM AUTHOR]

A systematic review and meta-analysis of 14 randomized trials with 34,570 patients was conducted to evaluate the efficacy of molnupiravir for the treatment of non-severe COVID-19. The results showed that molnupiravir was associated with a reduction in the risk of hospitalization, risk of mechanical ventilation, and time to symptom resolution. The review also found that molnupiravir was most effective in non-severe patients, particularly those at highest risk of hospitalization. However, no significant differences were found in adverse events, all-cause mortality, rate and time to viral clearance, or duration of hospitalization. The authors acknowledge the limitations of their review and emphasize the need for more large-sample studies to clarify the true efficacy of molnupiravir. They also express the importance of exploring other drugs that have the potential to treat COVID-19 and improve important outcomes such as mortality and viral clearance. [Extracted from the article]