Objective:This intervention has been shown to be clinically efficacious and safe.The aim of this study was to determine the effect of different intervention times on the efficacy of gastroparesis external application ...Objective:This intervention has been shown to be clinically efficacious and safe.The aim of this study was to determine the effect of different intervention times on the efficacy of gastroparesis external application prescription versus placebo for the treatment of gastrointestinal tumor postoperative,postsurgical gastroparesis.Methods:A multicenter,randomized,double-blind,placebo controlled phaseⅢclinical trial was designed to demonstrate superiority and conducted at four grade 3A hospitals in Beijing.Patients diagnosed with gastrointestinal tumor postsurgical gastroparesis and local cold syndrome in the abdomen were enrolled and received conventional treatment(nutritional support,gastrointestinal decompression,and prokinetic medication).Treatment and control groups respectively received gastroparesis external application prescription or placebo acupoint application over a treatment course of 14 days or until the primary efficacy endpoint(clinical efficiency)was achieved.Results:A total of 120 patients were enrolled in the treatment and control groups(n Z 60 per group),and 15 patients dropped out of the study because of skin allergies(n Z 7)or poor efficacy(nZ8).The efficacy among patients in Class B of Group A(treatment group)was marginally better than that of Group B(control group)(64.28%vs.55.56%)although the difference between the two groups was not significant.However,the efficacy among patients in Class C of Group A was significantly better than that of Group B(79.49%vs.43.33%).For Group A,the time for patients in the three classes to achieve the efficacy endpoint increased significantly with disease progression(3.00,6.78,and 8.29 days for Class A,B,and C,respectively).Conclusions:Gastroparesis external application prescription can effectively treat gastrointestinal tumor postsurgical gastroparesis and may be more efficacious in progressive disease compared placebo.Patients with gastrointestinal tumor postsurgical gastroparesis should therefore undergo intervention at an earlier stage.展开更多
BACKGROUND Critical time intervention(CTI)is an evidence-based model of practice that is time-limited and aims to provide support for most susceptible individuals during a transition period.AIM To examine the signific...BACKGROUND Critical time intervention(CTI)is an evidence-based model of practice that is time-limited and aims to provide support for most susceptible individuals during a transition period.AIM To examine the significance of fostering the mental health of diabetes patients through CTI using the scoping review methodology.METHODS As part of the scoping review process,we followed the guidelines established by the Joanna Briggs Institute.The search databases were Google Scholar,PubMed,Scopus,PsycINFO,Reference Citation Analysis(https://www.referencecitation-analysis.com/),and Cochrane Library.From these databases,77 articles were retrieved with the aid of carefully selected search terms.However,19 studies were selected after two reviewers appraised the full texts to ensure that they are all eligible for inclusion,while 54 papers were excluded.RESULTS This study revealed that diabetic patients who had experienced homelessness were at higher risk of being diagnosed with mental illness and that social support services are impactful in the management of the comorbidity of diabetes and mental health problems.In addition,this review reveals that CTI is impactful in enhancing the mental health of homeless patients during the transitional period from the hospital through social support services.CONCLUSION CTI is a promising intervention for alleviating mental health symptoms in homeless patients.Empirical studies are needed across the globe,involving both hospitalized and community-based patients,to determine how clinically effectively CTI is in managing the mental health of diabetics.展开更多
Left main (LM) stenting is considered by many to be one of the last frontiers of interventional cardiology. Beginning with the VA cooperative study published in 1976 demonstrating a mortality benefit for patients ... Left main (LM) stenting is considered by many to be one of the last frontiers of interventional cardiology. Beginning with the VA cooperative study published in 1976 demonstrating a mortality benefit for patients undergoing coronary artery bypass grafting (CABG), i the standard of care for treatment of left main coronary artery disease has been surgical.The most recent 2005 update of the ACC/AHA/SCAI Practice Guidelines on PCI 2 again notes that "CABG using IMA grafting is the 'gold standard' for treatment of unprotected left main disease and has proven benefit on long-term outcomes."……展开更多
Background:Early control of haemorrhage and optimisation of physiology are guiding principles of resuscitation after injury.Improved outcomes have been previously associated with single,timely interventions.The aim of...Background:Early control of haemorrhage and optimisation of physiology are guiding principles of resuscitation after injury.Improved outcomes have been previously associated with single,timely interventions.The aim of this study was to assess the association between multiple timely life-saving interventions(LSIs)and outcomes of traumatic haemorrhagic shock patients.Methods:A retrospective cohort study was undertaken of injured patients with haemorrhagic shock who presented to Alfered Emergency&Trauma Centre between July 01,2010 and July 31,2014.LSIs studied included chest decompression,control of external haemorrhage,pelvic binder application,transfusion of red cells and coagulation products and surgical control of bleeding through angio-embolisation or operative intervention.The primary exposure variable was timely initiation of≥50%of the indicated interventions.The association between the primary exposure variable and outcome of death at hospital discharge was adjusted for potential confounders using multivariable logistic regression analysis.The association between total pre-hospital times and pre-hospital care times(time from ambulance at scene to trauma centre),in-hospital mortality and timely initiation of≥50%of the indicated interventions were assessed.Results:Of the 168 patients,54(32.1%)patients had≥50%of indicated LSI completed within the specified time period.Timely delivery of LSI was independently associated with improved survival to hospital discharge(adjusted odds ratio(OR)for in-hospital death 0.17;95%confidence interval(CI)0.03–0.83;p=0.028).This association was independent of patient age,pre-hospital care time,injury severity score,initial serum lactate levels and coagulopathy.Among patients with pre-hospital time of≥2 h,2(3.6%)received timely LSIs.Pre-hospital care times of≥2 h were associated with delayed LSIs and with in-hospital death(unadjusted OR 4.3;95%CI 1.4–13.0).Conclusions:Timely completion of LSI when indicated was completed in a small proportion of patients and reflects previous research demonstrating delayed processes and errors even in advanced trauma systems.Timely delivery of a high proportion of LSIs was associated with improved outcomes among patients presenting with haemorrhagic shock after injury.Provision of LSIs in the pre-hospital phase of trauma care has the potential to improve outcomes.展开更多
Light plays an essential role in psychobiological and psychophysiological processes,such as alertness.The alerting effect is influenced by light characteristics and the timing of interventions.This meta-analysis is th...Light plays an essential role in psychobiological and psychophysiological processes,such as alertness.The alerting effect is influenced by light characteristics and the timing of interventions.This meta-analysis is the first to systematically review the effect of light intervention on alertness and to discuss the optimal protocol for light intervention.In this meta-analysis,registered at PROSPERO(Registration ID:CRD42020181485),we conducted a systematic search of the Web of Science,PubMed,and PsycINFO databases for studies published in English prior to August 2021.The outcomes included both subjective and objective alertness.Subgroup analyses considered a variety of factors,such as wavelength,correlated color temperature(CCT),light illuminance,and timing of interventions(daytime,night-time,or all day).Twenty-seven crossover studies and two parallel-group studies were included in this meta-analysis,with a total of 1210 healthy participants(636(52%)male,mean age 25.62 years).The results revealed that light intervention had a positive effect on both subjective alertness(standardized mean difference(SMD)=-0.28,95%confidence interval(CI):-0.49 to-0.06,P=0.01)and objective alertness in healthy subjects(SMD=-0.34,95%CI:-0.68 to-0.01,P=0.04).The subgroup analysis revealed that cold light was better than warm light in improving subjective alertness(SMD=-0.37,95%CI:-0.65 to-0.10,P=0.007,I2=26%)and objective alertness(SMD=-0.36,95%CI:-0.66 to-0.07,P=0.02,I2=0).Both daytime(SMD=-0.22,95%CI:-0.37 to-0.07,P=0.005,I2=74%)and night-time(SMD=-0.32,95%CI:-0.61 to-0.02,P=0.04,I2=0)light exposure improved subjective alertness.The results of this meta-analysis and systematic review indicate that light exposure is associated with significant improvement in subjective and objective alertness.In addition,light exposure with a higher CCT was more effective in improving alertness than light exposure with a lower CCT.Our results also suggest that both daytime and night-time light exposure can improve subjective alertness.展开更多
The UK is the most important partner of the EU in terms of economic and other fields due to the geographical proximity.It was one of the largest economies in the EU and its per capita income is higher than the EU aver...The UK is the most important partner of the EU in terms of economic and other fields due to the geographical proximity.It was one of the largest economies in the EU and its per capita income is higher than the EU average,so it is a net contributor to the EU.With UKs membership of the EU ended on 31 January 2019,there are concerns that the Brexit may have a significant impact on the EU,resulting in social,economic,political,and institutional changes,etc.in EU.While the impact of Brexit on the UK has always been the subject of considerable scholarly interest in recent years,there is relatively little literature on the impact of Brexit on the EU.This paper focuses on the evaluation of the impact of Brexit on the EU economy and other relevant aspects along three dimensions:GDP,PPP,Quarterly GDP growth.Employing powerful quantitative analysis technology that includes vector autoregression model,multivariate time series model with intervention variables,and autoregression integrated moving average,this paper obtains the important and novel evidence about the potential impact of Brexit on the EU economy,pointing out that Brexit is of far-reaching significance to the EU.This analysis uses several statistical models to screen out several key influencing factors,which can be used to predict the total GDP of EU in the next five years.The results show that EU economy will react negatively to"no-deal"Brexit,and its growth rate of economy will slow down significantly in next 5 years.Finally,we put forward relevant policy suggestions on how to deal with the negative impact of Brexit on EU.展开更多
基金This study was supported by“Clinical Study of TCM Treating Gastroparesis and Other Tumor Postsurgical Complications”(Project No.:D131100002213003)a key project of the Beijing Municipal Science and Technology Commission and Combining traditional Chinese and Western medicine:Cancer Collaborative Innovation Center of Beijing University of Chinese Medicine(Project No.:2013-XTCX-05).
文摘Objective:This intervention has been shown to be clinically efficacious and safe.The aim of this study was to determine the effect of different intervention times on the efficacy of gastroparesis external application prescription versus placebo for the treatment of gastrointestinal tumor postoperative,postsurgical gastroparesis.Methods:A multicenter,randomized,double-blind,placebo controlled phaseⅢclinical trial was designed to demonstrate superiority and conducted at four grade 3A hospitals in Beijing.Patients diagnosed with gastrointestinal tumor postsurgical gastroparesis and local cold syndrome in the abdomen were enrolled and received conventional treatment(nutritional support,gastrointestinal decompression,and prokinetic medication).Treatment and control groups respectively received gastroparesis external application prescription or placebo acupoint application over a treatment course of 14 days or until the primary efficacy endpoint(clinical efficiency)was achieved.Results:A total of 120 patients were enrolled in the treatment and control groups(n Z 60 per group),and 15 patients dropped out of the study because of skin allergies(n Z 7)or poor efficacy(nZ8).The efficacy among patients in Class B of Group A(treatment group)was marginally better than that of Group B(control group)(64.28%vs.55.56%)although the difference between the two groups was not significant.However,the efficacy among patients in Class C of Group A was significantly better than that of Group B(79.49%vs.43.33%).For Group A,the time for patients in the three classes to achieve the efficacy endpoint increased significantly with disease progression(3.00,6.78,and 8.29 days for Class A,B,and C,respectively).Conclusions:Gastroparesis external application prescription can effectively treat gastrointestinal tumor postsurgical gastroparesis and may be more efficacious in progressive disease compared placebo.Patients with gastrointestinal tumor postsurgical gastroparesis should therefore undergo intervention at an earlier stage.
文摘BACKGROUND Critical time intervention(CTI)is an evidence-based model of practice that is time-limited and aims to provide support for most susceptible individuals during a transition period.AIM To examine the significance of fostering the mental health of diabetes patients through CTI using the scoping review methodology.METHODS As part of the scoping review process,we followed the guidelines established by the Joanna Briggs Institute.The search databases were Google Scholar,PubMed,Scopus,PsycINFO,Reference Citation Analysis(https://www.referencecitation-analysis.com/),and Cochrane Library.From these databases,77 articles were retrieved with the aid of carefully selected search terms.However,19 studies were selected after two reviewers appraised the full texts to ensure that they are all eligible for inclusion,while 54 papers were excluded.RESULTS This study revealed that diabetic patients who had experienced homelessness were at higher risk of being diagnosed with mental illness and that social support services are impactful in the management of the comorbidity of diabetes and mental health problems.In addition,this review reveals that CTI is impactful in enhancing the mental health of homeless patients during the transitional period from the hospital through social support services.CONCLUSION CTI is a promising intervention for alleviating mental health symptoms in homeless patients.Empirical studies are needed across the globe,involving both hospitalized and community-based patients,to determine how clinically effectively CTI is in managing the mental health of diabetics.
文摘 Left main (LM) stenting is considered by many to be one of the last frontiers of interventional cardiology. Beginning with the VA cooperative study published in 1976 demonstrating a mortality benefit for patients undergoing coronary artery bypass grafting (CABG), i the standard of care for treatment of left main coronary artery disease has been surgical.The most recent 2005 update of the ACC/AHA/SCAI Practice Guidelines on PCI 2 again notes that "CABG using IMA grafting is the 'gold standard' for treatment of unprotected left main disease and has proven benefit on long-term outcomes."……
文摘Background:Early control of haemorrhage and optimisation of physiology are guiding principles of resuscitation after injury.Improved outcomes have been previously associated with single,timely interventions.The aim of this study was to assess the association between multiple timely life-saving interventions(LSIs)and outcomes of traumatic haemorrhagic shock patients.Methods:A retrospective cohort study was undertaken of injured patients with haemorrhagic shock who presented to Alfered Emergency&Trauma Centre between July 01,2010 and July 31,2014.LSIs studied included chest decompression,control of external haemorrhage,pelvic binder application,transfusion of red cells and coagulation products and surgical control of bleeding through angio-embolisation or operative intervention.The primary exposure variable was timely initiation of≥50%of the indicated interventions.The association between the primary exposure variable and outcome of death at hospital discharge was adjusted for potential confounders using multivariable logistic regression analysis.The association between total pre-hospital times and pre-hospital care times(time from ambulance at scene to trauma centre),in-hospital mortality and timely initiation of≥50%of the indicated interventions were assessed.Results:Of the 168 patients,54(32.1%)patients had≥50%of indicated LSI completed within the specified time period.Timely delivery of LSI was independently associated with improved survival to hospital discharge(adjusted odds ratio(OR)for in-hospital death 0.17;95%confidence interval(CI)0.03–0.83;p=0.028).This association was independent of patient age,pre-hospital care time,injury severity score,initial serum lactate levels and coagulopathy.Among patients with pre-hospital time of≥2 h,2(3.6%)received timely LSIs.Pre-hospital care times of≥2 h were associated with delayed LSIs and with in-hospital death(unadjusted OR 4.3;95%CI 1.4–13.0).Conclusions:Timely completion of LSI when indicated was completed in a small proportion of patients and reflects previous research demonstrating delayed processes and errors even in advanced trauma systems.Timely delivery of a high proportion of LSIs was associated with improved outcomes among patients presenting with haemorrhagic shock after injury.Provision of LSIs in the pre-hospital phase of trauma care has the potential to improve outcomes.
基金supported by the National Natural Science Foundation of China,No.82172530(to QT)Science and Technology Program of Guangdong,No.2018B030334001(to CRR)Guangzhou Science and Technology Project,No.202007030012(to QT).
文摘Light plays an essential role in psychobiological and psychophysiological processes,such as alertness.The alerting effect is influenced by light characteristics and the timing of interventions.This meta-analysis is the first to systematically review the effect of light intervention on alertness and to discuss the optimal protocol for light intervention.In this meta-analysis,registered at PROSPERO(Registration ID:CRD42020181485),we conducted a systematic search of the Web of Science,PubMed,and PsycINFO databases for studies published in English prior to August 2021.The outcomes included both subjective and objective alertness.Subgroup analyses considered a variety of factors,such as wavelength,correlated color temperature(CCT),light illuminance,and timing of interventions(daytime,night-time,or all day).Twenty-seven crossover studies and two parallel-group studies were included in this meta-analysis,with a total of 1210 healthy participants(636(52%)male,mean age 25.62 years).The results revealed that light intervention had a positive effect on both subjective alertness(standardized mean difference(SMD)=-0.28,95%confidence interval(CI):-0.49 to-0.06,P=0.01)and objective alertness in healthy subjects(SMD=-0.34,95%CI:-0.68 to-0.01,P=0.04).The subgroup analysis revealed that cold light was better than warm light in improving subjective alertness(SMD=-0.37,95%CI:-0.65 to-0.10,P=0.007,I2=26%)and objective alertness(SMD=-0.36,95%CI:-0.66 to-0.07,P=0.02,I2=0).Both daytime(SMD=-0.22,95%CI:-0.37 to-0.07,P=0.005,I2=74%)and night-time(SMD=-0.32,95%CI:-0.61 to-0.02,P=0.04,I2=0)light exposure improved subjective alertness.The results of this meta-analysis and systematic review indicate that light exposure is associated with significant improvement in subjective and objective alertness.In addition,light exposure with a higher CCT was more effective in improving alertness than light exposure with a lower CCT.Our results also suggest that both daytime and night-time light exposure can improve subjective alertness.
基金by the National Natural Science Foundation of China(No.11861042)the China Statistical Research Project(No.2020LZ25).
文摘The UK is the most important partner of the EU in terms of economic and other fields due to the geographical proximity.It was one of the largest economies in the EU and its per capita income is higher than the EU average,so it is a net contributor to the EU.With UKs membership of the EU ended on 31 January 2019,there are concerns that the Brexit may have a significant impact on the EU,resulting in social,economic,political,and institutional changes,etc.in EU.While the impact of Brexit on the UK has always been the subject of considerable scholarly interest in recent years,there is relatively little literature on the impact of Brexit on the EU.This paper focuses on the evaluation of the impact of Brexit on the EU economy and other relevant aspects along three dimensions:GDP,PPP,Quarterly GDP growth.Employing powerful quantitative analysis technology that includes vector autoregression model,multivariate time series model with intervention variables,and autoregression integrated moving average,this paper obtains the important and novel evidence about the potential impact of Brexit on the EU economy,pointing out that Brexit is of far-reaching significance to the EU.This analysis uses several statistical models to screen out several key influencing factors,which can be used to predict the total GDP of EU in the next five years.The results show that EU economy will react negatively to"no-deal"Brexit,and its growth rate of economy will slow down significantly in next 5 years.Finally,we put forward relevant policy suggestions on how to deal with the negative impact of Brexit on EU.
