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A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world

Journal of Sport and Health Science 2024年第4期13卷 472-483,F0003页

作者： Kelly R.Evenson Wendy J.Brown Alison K.Brinson Emily Budzynski-Seymour Melanie Hayman Department of Epidemiology Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNC 27599-8050USA Faculty of Health Sciences and Medicine Bond UniversityGold CoastQLD 4226Australia School of Human Movement and Nutrition Sciences The University of QueenslandBrisbaneQLD 4072Australia Department of Anthropology University of North Carolina at Chapel HillChapel HillNC 27599-3115USA Carolina Population Center University of North Carolina at Chapel HillChapel HillNC 27599-8120USA Faculty of Sport Health and Social SciencesSolent UniversitySouthamptonSO140YNUK Appleton Institute School of HealthMedical and Applied SciencesCentral Queensland UniversityRockhamptonQLD 4701Australia

Background:The period following pregnancy is a critical time window when future habits with respect to physical activity(PA)and sedentary behavior(SB)are established;therefore,it warrants guidance.The purpose of this scoping review was to summarize public health-oriented country-speciﬁc postpartum PA and SB guidelines worldwide.Methods:To identify guidelines published since 2010,we performed a(a)systematic search of 4 databases(CINAHL,Global Health,PubMed,and SPORTDiscus),(b)structured repeatable web-based search separately for 194 countries,and(c)separate web-based search.Only the most recent guideline was included for each country.Results:We identiﬁed 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB guidelines.The continents with guidelines included Europe(n=12),Asia(n=5),Oceania(n=2),Africa(n=1),North America(n=1),and South America(n=1).The most common beneﬁts recorded for PA included weight control/management(n=10),reducing the risk of postpartum depression or depres-sive symptoms(n=9),and improving mood/well-being(n=8).Postpartum guidelines speciﬁed exercises to engage in,including pelvicﬂoor exercises(n=17);muscle strengthening,weight training,or resistance exercises(n=13);aerobics/general aerobic activity(n=13);walking(n=11);cycling(n=9);and swimming(n=9).Eleven guidelines remarked on the interaction between PA and breastfeeding;several guidelines stated that PA did not impact breast milk quantity(n=7),breast milk quality(n=6),or infant growth(n=3).For SB,suggestions included limiting long-term sitting and interrupting sitting with PA.Conclusion:Country-speciﬁc postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing speciﬁc guidance to public health practitioners.

关键词： Breastfeeding Caesarean section guidelines Postnatal Recommendations

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Chinese Society of Cardiology guidelines on the diagnosis and treatment of adult fulminant myocarditis

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Science China(Life Sciences) 2024年第5期67卷 913-939页

作者： Chinese Society of Cardiology,Chinese Medical Association,Writing Group Jiangang Jiang Hongyang Shu Dao Wen Wang Rutai Hui Chenze Li Xiao Ran Hong Wang Jing Zhang Shaoping Nie Guanglin Cui Dingcheng Xiang Qun Shao Shengyong Xu Discussion experts:Ning Zhou Yuming Li Wei Gao Yuguo Chen Yuan Bian Guoping Wang Liming Xia Yan Wang Chunxia Zhao Zhiren Zhang Yuhua Zhao Jianan Wang Shaoliang Chen Hong Jiang Jing Chen Xianjin Du Mao Chen Yinxian Sun Sheng Li Hu Ding Xueping Ma Hesong Zeng Li Lin Shenghua Zhou Likun Ma Ling Tao Juan Chen Yiwu Zhou Xiaomei Guo 不详 Tongji Hospital Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Fuwai Hospital National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Zhongnan Hospital of Wuhan University Wuhan 430062China Fuwai Huazhong Cardiovascular Hospital Zhengzhou 450003China Beijing Anzhen Hospital Capital Medical UniversityBeijing 100029China Guangzhou General Hospital of Guangzhou Military Command Guangzhou 510010China Harbin Medical University Cancer Hospital Harbin 150081China Union Hospital Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Taida Hospital Tianjin 300457China Peking University Third Hospital Beijing 100191China Qilu Hospital of Shandong University Jinan 250012China Kanghua Hospital DongguanGuangzhou 523080China Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310003China Nanjing First Hospital Nanjing Medical UniversityNanjing 210006China Renmin Hospital of Wuhan University Wuhan 430060Wuhan West China Hospital Sichuan UniversityChengdu 610044China First Hospital of China Medical University Shenyang 110002China General Hospital of Ningxia Medical University Yinchuan 750003China The Second Xiangya Hospital Central South UniversityChangsha 410012China The First Affiliated Hospital of USTC University of Science and Technology of ChinaHefei 230002China The First Affiliated Hospital of Air Force Medical University Xi’an 710032China Central Hospital of Wuhan City Wuhan 430014China Tongji Medical College Huazhong University of Science and TechnologyWuhan 430030China

Fulminant myocarditis is an acute diffuse inflammatory disease of myocardium.It is characterized by acute onset,rapid progress and high risk of death.Its pathogenesis involves excessive immune activation of the innate immune system and formation of inflammatory storm.According to China’s practical experience,the adoption of the“life support-based comprehensive treatment regimen”(with mechanical circulation support and immunomodulation therapy as the core)can significantly improve the survival rate and long-term prognosis.Special emphasis is placed on very early identification,very early diagnosis,very early prediction and very early treatment.

关键词： fulminant myocarditis guidelines life support-based comprehensive treatment regimen diagnosis treatment cytokine storm overactivation of immunity

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Impact of glucagon-like peptide receptor agonists on endoscopy and its preoperative management: guidelines, challenges, and future directions

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World Journal of Gastrointestinal Endoscopy 2024年第6期16卷 292-296页

作者： Sahib Singh Vishnu Charan Suresh Kumar Ganesh Aswath Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Division of Gastroenterology and Hepatology State University of New York Upstate Medical UniversitySyracuseNY 13210United States

Glucagon-like peptide receptor agonists(GLP-1RA)are used to treat type 2 diabetes mellitus and,more recently,have garnered attention for their effect-iveness in promoting weight loss.They have been associated with several gastrointestinal adverse effects,including nausea and vomiting.These side effects are presumed to be due to increased residual gastric contents.Given the potential risk of aspiration and based on limited data,the American Society of Anesthesi-ologists updated the guidelines concerning the preoperative management of patients on GLP-1RA in 2023.They included the duration of mandated cessation of GLP-1RA before sedation and usage of“full stomach”precautions if these medications were not appropriately held before the procedure.This has led to additional challenges,such as extended waiting time,higher costs,and increased risk for patients.In this editorial,we review the current societal guidelines,clinical practice,and future directions regarding the usage of GLP-1RA in patients undergoing an endoscopic procedure.

关键词： Glucagon-like peptide receptor agonists Endoscopy Adverse events Intubation Aspiration Semaglutide Healthcare burden guidelines

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Clinical practice guidelines for full-cycle standardized management of bone health in breast cancer patients

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Cancer Innovation 2024年第1期3卷 1-28页

作者： Committee of Full-cycle Standardized Management of Bone Health in Breast Cancer Patients Fei Ma 不详 Department of Medical Oncology National Cancer CenterNational Clinical Research Center for CancerCancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

Bone health management for breast cancer spans the entire cycle of patient care,including the prevention and treatment of bone loss caused by early breast cancer treatment,the adjuvant application of bone-modifying agents to improve prognosis,and the diagnosis and treatment of advanced bone metastases.Making good bone health management means formulating appropriate treatment strategies and dealing with adverse drug reactions,and will help to improve patients'quality of life and survival rates.The Breast Cancer Expert Committee of the National Cancer Center for Quality Control organized relevant experts to conduct an in-depth discussion on the full-cycle management of breast cancer bone health based on evidence-based medicine,and put forward reasonable suggestions to guide clinicians to better deal with health issues in bone health clinics.

关键词： bone health bone-modifying drugs breast cancer guidelines

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Fever assessment in children under five: Are we following the guidelines?

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World Journal of Clinical Pediatrics 2024年第1期13卷 62-72页

作者： Hasan M Isa Ahmed J Isa Murtadha A Alnasheet Mahmood M Mansoor Department of Pediatrics Salmaniya Medical ComplexManama 26671Bahrain Department of Pediatrics Arabian Gulf UniversityManama 26671Bahrain Department of General Surgery Salmaniya Medical ComplexManama 26671Bahrain

BACKGROUND Fever is a common cause of medical consultation and hospital admission,particularly among children.Recently,the United Kingdom’s National Institute for Health and Care Excellence(NICE)updated its guidelines for assessing fever in children under five years of age.The efficient assessment and management of children with fever are crucial for improving patient outcomes.AIM To evaluate fever assessment in hospitalized children and to assess its adherence with the NICE Fever in under 5s guideline.METHODS We conducted a retrospective cohort review of the electronic medical records of children under five years of age at the Department of Pediatrics,Salmaniya Medical Complex,Bahrain,between June and July 2023.Demographic data,vital signs during the first 48 h of admission,route of temperature measurement,and indications for admission were gathered.Fever was defined according to the NICE guideline.The children were divided into five groups according to their age(0-3 months,>3-6 months,>6-12 months,>12-36 months,and>36-60 months).Patients with and without fever were compared in terms of demography,indication for admission,route of temperature measurement,and other vital signs.Compliance with the NICE Fever in the under 5s guideline was assessed.Full compliance was defined as>95%,partial compliance as 70%-95%,and minimal compliance as≤69%.Pearson’sχ^(2),Student’s t test,the Mann-Whitney U test,and Spearman’s correlation coefficient(rs)were used for comparison.RESULTS Of the 136 patients reviewed,80(58.8%)were boys.The median age at admission was 14.2[interquartile range(IQR):1.7-44.4]months,with the most common age group being 36-60 months.Thirty-six(26.4%)patients had fever,and 100(73.6%)were afebrile.The commonest age group for febrile patients(>12-36 months)was older than the commonest age group for afebrile patients(0-3 months)(P=0.027).The median weight was 8.3(IQR:4.0-13.3)kg.Patients with fever had higher weight than those without fever[10.2(IQR:7.3-13.0)vs 7.1(IQR:3.8-13.3)kg,respectively](P=0.034).Gastro

关键词： Fever Pediatrics Admission patterns Temperature measurement guidelines Bahrain

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Optimizing nutrition in hepatic cirrhosis:A comprehensive assessment and care approach

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World Journal of Gastroenterology 2024年第10期30卷 1313-1328页

作者： Osvely Mendez-Guerrero Anaisa Carranza-Carrasco Luis Alberto Chi-Cervera Aldo Torre Nalu Navarro-Alvarez Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Clínica de Especialidades Gastrointestinales y Hepáticas Hospital Star MedicaMerida 97133YucatanMexico Molecular Biology Universidad Panamericana School of MedicineCampus MéxicoMexico City 03920Mexico Department of Surgery University of Colorado Anschutz Medical CampusDenverCO 80045United States

Cirrhosis is considered a growing cause of morbidity and mortality,which represents a significant public health problem.Currently,there is no effective treatment to reverse cirrhosis.Treatment primarily centers on addressing the underlying liver condition,monitoring,and managing portal hypertension-related complications,and evaluating the potential for liver transplantation in cases of decompensated cirrhosis,marked by rapid progression and the emer-gence of complications like variceal bleeding,hepatic encephalopathy,ascites,malnutrition,and more.Malnutrition,a prevalent complication across all disease stages,is often underdiagnosed in cirrhosis due to the complexities of nutritional assessment in patients with fluid retention and/or obesity,despite its crucial impact on prognosis.Increasing emphasis has been placed on the collaboration of nutritionists within hepatology and Liver transplant teams to deliver compre-hensive care,a practice that has shown to improve outcomes.This review covers appropriate screening and assessment methods for evaluating the nutritional status of this population,diagnostic approaches for malnutrition,and context-specific nutrition treatments.It also discusses evidence-based recommendations for supplementation and physical exercise,both essential elements of the standard care provided to cirrhotic patients.

关键词： Cirrhosis Nutritional diagnosis Treatment Diet guidelines

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Update in lean metabolic dysfunction-associated steatotic liver disease

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World Journal of Hepatology 2024年第3期16卷 452-464页

作者： Karina Sato-Espinoza Perapa Chotiprasidhi Mariella R Huaman Javier Díaz-Ferrer Division of Gastroenterology and Hepatology Department of MedicineMayo ClinicRochesterMN 55902United States Obesity and Metabolic Center for Obesity and Metabolic HealthLima 02002LimaPeru Hepatology Service Department of Digestive DiseasesHospital Nacional Edgardo Rebagliati MartinsLima 02002LimaPeru Medicine Faculty Universidad San Martin de PorresLima 02002LimaPeru Gastroenterology Service Clinica InternacionalLima 02002LimaPeru

BACKGROUND A new nomenclature consensus has emerged for liver diseases that were previously known as non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease(MAFLD).They are now defined as metabolic dysfunction-associated steatotic liver disease(MASLD),which includes cardiometabolic criteria in adults.This condition,extensively studied in obese or overweight patients,constitutes around 30%of the population,with a steady increase worldwide.Lean patients account for approximately 10%-15%of the MASLD population.However,the pathogenesis is complex and is not well understood.AIM To systematically review the literature on the diagnosis,pathogenesis,characteristics,and prognosis in lean MASLD patients and provide an interpretation of these new criteria.METHODS We conducted a comprehensive database search on PubMed and Google Scholar between January 2012 and September 2023,specifically focusing on lean NAFLD,MAFLD,or MASLD patients.We include original articles with patients aged 18 years or older,with a lean body mass index categorized according to the World Health Organization criteria,using a cutoff of 25 kg/m2 for the general population and 23 kg/m2 for the Asian population.RESULTS We include 85 studies in our analysis.Our findings revealed that,for lean NAFLD patients,the prevalence rate varied widely,ranging from 3.8%to 34.1%.The precise pathogenesis mechanism remained elusive,with associations found in genetic variants,epigenetic modifications,and adaptative metabolic response.Common risk factors included metabolic syndrome,hypertension,and type 2 diabetes mellitus,but their prevalence varied based on the comparison group involving lean patients.Regarding non-invasive tools,Fibrosis-4 index outperformed the NAFLD fibrosis score in lean patients.Lifestyle modifications aided in reducing hepatic steatosis and improving cardiometabolic profiles,with some medications showing efficacy to a lesser extent.However,lean NAFLD patients exhibited a worse prognosis compared to the obese

关键词： Lean Non-obese Non-alcoholic fatty liver disease Metabolic dysfunction-associated fatty liver disease Metabolic dysfunction-associated steatotic liver disease guidelines Diagnosis Management Pathogenesis Treatment

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Systematic Security Guideline Framework through Intelligently Automated Vulnerability Analysis

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Computers, Materials & Continua 2024年第3期78卷 3867-3889页

作者： Dahyeon Kim Namgi Kim Junho Ahn Computer Information Technology Korea National University of TransportationChungju27469Korea Department of AI Computer Science and Engineering Kyonggi UniversitySuwon16227Korea

This research aims to propose a practical framework designed for the automatic analysis of a product’s comprehensive functionality and security vulnerabilities,generating applicable guidelines based on real-world software.The existing analysis of software security vulnerabilities often focuses on specific features or modules.This partial and arbitrary analysis of the security vulnerabilities makes it challenging to comprehend the overall security vulnerabilities of the software.The key novelty lies in overcoming the constraints of partial approaches.The proposed framework utilizes data from various sources to create a comprehensive functionality profile,facilitating the derivation of real-world security guidelines.Security guidelines are dynamically generated by associating functional security vulnerabilities with the latest Common Vulnerabilities and Exposure(CVE)and Common Vulnerability Scoring System(CVSS)scores,resulting in automated guidelines tailored to each product.These guidelines are not only practical but also applicable in real-world software,allowing for prioritized security responses.The proposed framework is applied to virtual private network(VPN)software,wherein a validated Level 2 data flow diagram is generated using the Spoofing,Tampering,Repudiation,Information Disclosure,Denial of Service,and Elevation of privilege(STRIDE)technique with references to various papers and examples from related software.The analysis resulted in the identification of a total of 121 vulnerabilities.The successful implementation and validation demonstrate the framework’s efficacy in generating customized guidelines for entire systems,subsystems,and selected modules.

关键词： Framework automation vulnerability analysis security guidelines

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guidelines for management of pediatric acute hyperextension spinal cord injury

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Chinese Journal of Traumatology 2023年第1期26卷 2-7页

作者： Lian Zeng Yu-Long Wang Xian-Tao Shen Zhi-Cheng Zhang Gui-Xiong Huang Jamal Alshorman Tracy Boakye Serebour Charles H.Tator Tian-Sheng Sun Ying-Ze Zhang Xiao-Dong Guo on behalf of Chinese Orthopaedic Association,Spinal Cord Injury and Rehabilitation Group,Chinese Association of Rehabilitation Medicine,Group of Spinal Injury and Functional Reconstruction,Neuroregeneration&Neurorestoration Professional Committee,Association of Chinese Research Hospital,Sino-Canada Spinal and Spinal Cord Injury Center Department of Orthopaedics Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China Department of Orthopedics Wuhan No.1 HospitalWuhan Integrated TCM&Western Medicine HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Department of Pediatric Orthopaedic Surgery Wuhan Children's HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430016China Toronto Western Research Institute Toronto Western Hospital and University of TorontoTorontoOntarioCanada Department of Orthopedics The Seventh Medical Center of Chinese PLA General HospitalBeijing100700China Department of Orthopedic Surgery The Third Hospital of Hebei Medical UniversityShijiazhuang 050051China

Pediatric acute hyperextension spinal cord injury(SCI)named as PAHSCI by us,is a special type of thoracolumbar SCI without radiographic abnormality and highly related to back-bend in dance training,which has been increasingly reported.At present,it has become the leading cause of SCI in children,and brings a heavy social and economic burden.Both domestic and foreign academic institutions and dance education organizations lack a correct understanding of PAHSCI and relevant standards,specifications or guidelines.In order to provide standardized guidance,the expert team formulated this guideline based on the principles of science and practicability,starting from the diagnosis,differential diagnosis,etiology,admission evaluation,treatment,complications and prevention.This guideline puts forward 23 recommendations for 14 related issues.

关键词： Spinal cord injury Pediatric acute hyperextension spinal cord injury SCIWORA Pediatric back bend paralysis Diagnosis and treatment guidelines

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guidelines from an expert panel for the management of diabetic macular edema in the Malaysian population

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International Journal of Ophthalmology(English edition) 2023年第5期16卷 712-720页

作者： Nor Fariza Ngah Nor Asiah Muhamad Shelina Oli Mohamed Roslin Azni Abdul Aziz Nur Hasnah Ma’amor Nor Azita Ahmad Tarmidzi Hanizasurana Hashim Hamisah Ishak Wan Norliza Wan Muda Rosiah Muda Azian Adnan Rafidah Md Saleh Wong Hon Seng Nurfahzura Mohd Jamil Tara Mary George Adrian Koh Institute for Clinical Research National Institutes of HealthMinistry of HealthSelangor 40170Malaysia Department of Ophthalmology Shah Alam HospitalMinistry of HealthSelangor 40000Malaysia Sector for Evidence-based Healthcare National Institutes of HealthMinistry of HealthSelangor 40170Malaysia Department of Ophthalmology Kuala Lumpur HospitalMinistry of HealthFederal Territory 50586Malaysia Department of Ophthalmology Selayang HospitalMinistry of HealthSelangor 61800Malaysia Department of Ophthalmology Tengku Ampuan Afzan HospitalMinistry of HealthPahang 25100Malaysia Department of Ophthalmology Sultanah Nur Zahirah HospitalMinistry of HealthKuala Terengganu 20400Malaysia KPJ Selangor Specialist Hospital Selangor 40300Malaysia Sultan Abdul Aziz Shah Hospital Selangor 43400Malaysia Gleneagles Kuala Lumpur Federal Territory 50450Malaysia Department of Ophthalmology Sungai Buloh HospitalMinistry of HealthSelangor 47000Malaysia Sunway Medical Centre Selangor 47500Malaysia Camden Medical Centre Singapore 248649Singapore

AIM:To derive a Malaysia guideline and consensus as part of the Malaysia Retina Group's efforts for diagnosis,treatment,and best practices of diabetic macular edema(DME).The experts'panel suggests that the treatment algorithm to be divided into groups according to involvement the central macula.The purpose of DME therapy is to improve edema and achieve the best visual results with the least amount of treatment load.METHODS:On two different occasions,a panel of 14 retinal specialists from Malaysia,together with an external expert,responded to a questionnaire on management of DME.A consensus was sought by voting after compiling,analyzing and discussion on first-phase replies on the round table discussion.A recommendation was deemed to have attained consensus when 12 out of the 14 panellists(85%)agreed with it.RESULTS:The terms target response,adequate response,nonresponse,and inadequate response were developed when the DME patients'treatment responses were first characterized.The panelists reached agreement on a number of DME treatment-related issues,including the need to classify patients prior to treatment,firstline treatment options,the right time to switch between treatment modalities,and side effects associated with steroids.From this agreement,recommendations were derived and a treatment algorithm was created.CONCLUSION:A detail and comprehensive treatment algorithm by Malaysia Retina Group for the Malaysian population provides guidance for treatment allocation of patients with DME.

关键词： diabetic macular edema guidelines consensus diabetic retinopathy Malaysia

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