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Healthy lifestyles and good living habits are effective strategies and important approaches to prevent chronic non-communicable diseases. With the development of evidence-based medicine, the evidence translation system has made some achievements in clinical practice. There is, however, no comprehensive, professional and efficient system for translating lifestyle evidence globally. Therefore, the Health Lifestyle Evidence (HLSE) Group of Lanzhou University constructed the HLSE Evidence Translation System (https://hlse.cn/), with the aim of synthesizing, evaluating, translating, and applying lifestyle-related evidence resources. This paper aims to introduce the functional module design of the evidence translation system, the system development process and testing, introduce the interface design and function demonstration, and explain the significance of constructing the HLSE.

Objective To systematically construct a guideline to provide a methodological guide for researchers to develop patient decision aids. Methods Through a literature review of international methodological guidance for developing patient decision aids, sorting out the similarities and differences in the processes and methods for developing patient decision aids, and combining them with the topic discussion of the working group, the initial guideline was drafted. Results A total of 13 guidances was included, with the initial version containing 3 phases, 13 steps, and 48 points. We invited 19 multidisciplinary domain experts for forming consensus. The final version of the guideline contains 3 phases, 11 steps, and 24 points. Conclusions The guideline has great potential to guide the development of patient decision aids in China and is expected to fill the methodological gap in the field. In the future, several rounds of pilot testing of the guideline based on specific decision issues will be conducted, and the guideline will be further revised and improved.

Objective To systematically assess the applicability of the clinical practice guidelines (CPGs) integrating Chinese and western medicine, thereby providing reference for enhancing their future usability. Methods PubMed, Web of Science, Embase, SinoMed, WanFang Data, and CNKI databases were searched for guidelines for the integration of Chinese and western medicine. Supplementary searches of Chinese Medical Association, Chinese Medicine Administration, MedSci websites, Website of China Association of Chinese Medicine, Medlive, Website of Dangdang, Chinese Association of Integrative Medicine and World Federation of Traditional Chinese Medicine Societies were conducted. The search time frame was from inception of the databases to December 31, 2022. Four reviewers independently evaluated the implementability of clinical practice guidelines by using 'Clinical Practice Guideline (CPG) implementation evaluation tool'. Results A total of 61 integrative Chinese and western medicine guidelines were included. Of the guidelines assessed, 9 guidelines(14.75%) exhibited strong implementability, 40(65.57%) demonstrated average implementability, and 12 (19.67%) demonstrated poor implementability. Among the 5 domains, the dimensions of 'accessibility' and 'implementability' were found to be of high quality, while those of 'communication', 'ease of identification' and 'applicability' were relatively poor. Notably, compared to guidelines published between 2006—2016, those published between 2017—2022 showed improvements in the areas of 'identification' and 'application'. Conclusions The implementabilityof the existing clinical practice guidelines of the integrative Chinese and western medicine is average and needs to be improved. In the future, emphasis should be placed on the integration of medical education and research, publicity of the guidelines, continuous medical education and training, a more concise form of recommendations, application of the guidelines by clinicians, and the implementability of the integrative Chinese and western medicine guideline.

In the era of evidence-based medicine, it is necessary to explore the unique advantages of traditional Chinese medicine (TCM) based on standardized technical methods and operating procedures in order to achieve the modernization and internationalization of TCM and benefit all humanity. The proposal of a three-pronged evidence system combining TCM theory, human experience and experimental evidence marks an important progress in the thinking method of the TCM evaluation system. The multi-evidence body integrated through appropriate methods provides a strong support for the clinical guideline recommendations and evidence-based health decision-making in TCM. Based on the current methodological progress of international evidence synthesis and grading, this paper proposes a novel approach for integrating multi-evidence in TCM: the MERGE framework. The aim is to establish a solid foundation for the development of this methodology and provide guidance for the advancement of evidence-based medicine framework in TCM.

The aims of developing rapid and living guidelines is to keep the recommendations in the guideline up-to-date. Compared with the conventional guideline, the rapid and living guideline can make better use of the existing evidence and apply and transform the evidence in a timely manner. This paper introduces the advantages and usage of rapid and living guidelines, the development process and existing challenges, and offers some insights, in order to provide reference for domestic organizations and scholars engaged in guideline development.

Adaptive design, with advantages such as dynamically adjusting trial plans, reducing resource waste, and improving trial efficiency, has broken through the competitive situation of new drug development and gradually met the needs of clinical research. In recent years, the use of adaptive design in platform trials as an innovative research model has added impetus to new drug development. This article outlines the research progress, contents and characteristics, common design types, statistical analysis, and case interpretation of adaptive design, and introduces the concept, types, and applications of adaptive platform trials, with the hope of providing scientific reference for further exploration of clinical trials and new drug development.

Transplanting human neural progenitor cells is a promising method of replenishing the lost neurons after spinal cord injury (SCI), but differentiating neural progenitor cells into the diverse types of mature functional spinal cord neurons in vivo is challenging. In this study, engineered human embryonic spinal cord-like tissues with dorsal and ventral neuronal characters (DV-SC) were generated by inducing human neural progenitor cells (hscNPCs) to differentiate into various types of dorsal and ventral neuronal cells on collagen scaffold in vitro. Transplantation of DV-SC into complete SCI models in rats and monkeys showed better therapeutic effects than undifferentiated hscNPCs, including pronounced cell survival and maturation. DV-SC formed a targeted connection with the host's ascending and descending axons, partially restored interrupted neural circuits, and improved motor evoked potentials and the hindlimb function of animals with SCI. This suggests that the transplantation of pre-differentiated hscNPCs with spinal cord dorsal and ventral neuronal characteristics could be a promising strategy for SCI repair.

Artificial intelligence(AI) empowers the development of the medical industry, providing precise and intelligent assistance for clinical diagnosis, treatment, and rehabilitation.AI has the potential to facilitate shared decision making (SDM), but AI interventions used for SDM are currently in their infancy, presenting both challenges and opportunities. This paper aims to describe the application of AI in SDM, explore the problems and challenges of AI-based decision aid used for SDM, and propose possible solutions, aiming to provide a guide for the development and implementation of AI-based decision aid.

The development of clinical practice guidelines involves a series of evidence-based decision-making processes, of which the formation of recommendations is particularly challenging. It demands decision-makers to have a thorough and precise understanding of the evidence, weigh the potential benefits and risks of interventions, and make valuable judgments and clinical choices. Compared to traditional approaches of presenting evidence information, the use of visualization tools can facilitate the communication and analysis of evidence, simplify information interpretation, and improve the efficiency of decision-making. Based on previousstudies, this paper proposes a visualization tool, vitruvian plot, for summarizing evidence and provides illustrative examples to demonstrate its usage and effects, with the aim of offering valuable guidance for researchers.

To research the influence of moisture on the oxidation characteristics of coal, the coal spontaneous combustion experiment was carried out to determine the composite index gas that can predict the spontaneous combustion of coal, and then the temperature-programing experiments were carried out to test the changes of composite gas index during the oxidation process of coal samples with different moisture content, the change law of the composite gas index generated under the influence of moisture was researched, and the influence law and mechanism of coal sample moisture content on coal oxidation characteristics were discussed. The results of research show that the spontaneous combustion temperature of coal has an obvious relationship with CO/CH4, C2H6/CO, CO/CO2 and Graham index. The influence moisture content on the temperature rise process of coal oxidation presents different stage characteristics at different temperatures: at 30−120 ℃, moisture has both catalytic and inhibitory effects on the coal oxidation reaction, and the inhibitory effect is dominant, showing the moisture content with the best inhibitory effect is 20%; at 120−140 ℃, the inhibitory effect of moisture on coal oxidation reaction is reduced, and moisture participates in the coal oxidation reaction as a reactant, and then shows the promotion effect of moisture on coal oxidation. At this time, the moisture in the coal oxidation reaction is mainly chemically promoted, and the moisture content with the best promotion effect is 10%; at 120−140 ℃, the original pore volume of the coal sample increases due to the evaporation of water and new coal samples are produced. The tiny pores become more conducive to the occurrence of coal oxidation reaction, and then show an indirect promotion effect on the reaction. The moisture content with the best promotion effect is 15%. It was finally determined that under the influence of moisture, the composite index gas that can more accurately predict the spontaneous combustion of coal are CO/CH4, C2H6/CO and Graham index. The research results can enrich the parameters of actual coal spontaneous combustion on site, increase the mining safety of high-humidity coal seams and the accuracy of spontaneous combustion prediction, and effectively reduce and prevent the occurrence of coal spontaneous combustion accidents.

As an important guidance of medical practice, clinical practice guideline of integrative Chinese medicine (ICM-CPG) plays an extremely important role in showing the respective advantages of Chinese and Western medicine and in promoting the integrated Chinese and Western medicine. However, the research status on ICM-CPG is faced with the problem of emphasizing development but neglecting implementation. The establishment of ICM-CPG implementation model based on the theoretical framework of implementation science is conducive to promoting the implementation of ICM-CPG and advancing the integration and development of Chinese and Western medicine. In this paper, by sorting out and analyzing the knowledge to action (KTA) framework, we discuss the implementation framework development of ICM-CPG in order to provide reference for future research.

Abstract Objectives A growing body of data indicates that the kynurenine pathway may play a role in the pathogenesis of postpartum depressive symptoms (PDS). Kynurenic aminotransferase (KAT) is an important kynurenine pathway enzyme, catalyzing kynurenine (KYN) into kynurenic acid (KYNA). This study investigated as to whether genetic variations in KAT are associated with PDS. Methods A cohort of 360 Chinese women scheduled to undergo cesarean delivery was enrolled into this study. PDS was determined by an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 13. A total of eight KAT single nucleotide polymorphisms (SNPs) were genotyped and their association with PDS investigated. Serum concentrations of KYN, KYNA, and quinolinic acid (QUIN) in women with or without PDS were also measured. This allowed the determination of the KYNA/KYN ratio, which is reflective of KAT activity. Results Postpartum depressive symptoms incidence was 7.2%. Advanced maternal age, lower education, antenatal depression, and postpartum blues were risk factors for PDS (p

BackgroundMembers of the aging population who undergo surgery are at risk of postoperative cognitive dysfunction (POCD). Exploring an effective and reliable early predictor of POCD is essential to the identification of high-risk patients and to making prospective decisions. The purpose of this study was to examine whether preoperative insulin resistance is an independent predictor of POCD.MethodsA total of 124 patients aged 60 years and older and who were scheduled for gastrointestinal surgery were enrolled in a prospective observational clinical study. All participants completed a battery of neuropsychological tests before surgery and 7 days later. POCD was defined as a decline of at least 1.5 SD on two or more of neuropsychological tests. Plasma concentration of the tumor necrosis factor α (TNF-α), C-reactive protein (CRP), and S-100β protein were measured. The status of insulin resistance was assessed by Homeostasis Model Assessment–Insulin Resistance (HOMA-IR). The relationship between HOMA-IR and POCD was assessed by Multivariable logistic regression models and the receiver operating characteristic (ROC) curve.ResultsFifty one patients (41.1%) were diagnosed with POCD at 7 days after surgery. Preoperative HOMA-IR values of the POCD group were significantly higher than the non-POCD group. Furthermore, CRP and TNF-α levels of the POCD group were significantly higher at each postoperative time point (P < 0.05). The preoperative HOMA-IR value was an independent predictor of POCD (adjusted OR 1.88, 95% CI, 1.18–2.99) even after adjust for confounding variables, and when dichotomized, individuals above the HOMA-IR threshold (HOMA-IR > 2.6) had a three-times higher risk of POCD (OR 3.26; 95% CI, 1.07–9.91) compared to individuals below the threshold. The areas under the ROC curve of HOMA-IR was 0.804 (95% CI, 0.725–0.883; P < 0.001). The optimal cut-off value was found to be 0.583, with a sensitivity of 84.3% and specificity of 74%. The HOMA-IR value was positively associated with the TNF-α concentration at baseline (R2 = 0.43, P < 0.01) and 1 day after surgery (R2 = 0.3861, P < 0.01).ConclusionPreoperative insulin resistance is an effective predictor for the occurrence of POCD. Targeted prevention and treatment strategies of insulin resistance may be effective interventions of patients at risk for POCD.

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]

Delayed publication of systematic reviews increases the risk of presenting outdated data. To date, no studies have examined the time and review process from title registration and protocol publication to the final publication of Campbell systematic reviews. This study aims to examine the publication time from protocol to full review publication and the time gap between database searches and full review publication for Campbell systematic reviews. All Campbell systematic reviews in their first published version were included. We searched the Campbell systematic review journals on the Wiley Online Library website to identify all completed studies to date. We manually searched the table of contents of all Campbell systematic reviews to obtain the date of title registration from the journal's website. We used SPSS software to perform the statistical analysis. We used descriptive statistics to report publication times which were calculated stratified by characteristics, including year of review publication, type of reviews, number of authors, difference in authors between protocol and review, and Campbell Review Groups. Non‐normal distributed data were reported as medians, interquartile range, and range, and normal distributed data will be reported as mean ± standard deviation. And we also visualized the overall publication time and the distribution of data. Approximately 18% of reviews were published within one to 2 years, faster than the aims set by Campbell systematic review policies and guidelines, which was 2 years. However, more than 40% of the reviews were published more than 2 years after protocol publication. Furthermore, over 50% of included reviews were published with a time gap of more than 2 years after database searches. There was no significant difference between Campbell coordinating groups' median publication times and time gap from searches of databases to full review publication existed. However, the methods group only published one full review with almost a 3‐year time gap from searches of databases to review publication. And there was a major difference between specific types of review. Systematic reviews had the longest median publication time of 2.4 years, whereas evidence and gap maps had the lowest median publication time of 13 months. Half of Campbell reviews were published more than 2 years after protocol publication. Furthermore, the median time from protocol publication to review publication varied widely depending on the specific type of review. [ABSTRACT FROM AUTHOR]