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Mapping the clinical practice of traditional,complementary and integrative medicine in oncology in western countries:A multinational cross-sectional survey

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Journal of Integrative Medicine 2024年第1期22卷 64-71页

作者： Matthias Huemer Sandro Graca Sarah Bitsche Guenter Hofmann Mike Armour Martin Pichler Palliative Care Unit Division of OncologyDepartment of Internal MedicineMedical University of Graz8036 GrazAustria Northern College of Acupuncture York YO16LJUnited Kingdom School of health and Society Faculty of EducationHealth and WellbeingUniversity of WolverhamptonWolverhampton WV11LYUnited Kingdom National Institute of Complementary Medicine health Research Institute Western Sydney UniversityPenrith NSW 2751Australia Translational health Research Institute Western Sydney UniversityPenrith NSW 2751Australia Medical Research Institute of New Zealand Wellington 6021New Zealand Translational Oncology University Hospital of Augsburg86156 AugsburgGermany

Background Many cancer patients seek adjunctive therapies to biomedical cancer treatments at some point of their disease trajectory.While acupuncture is increasingly recommended by leading oncological associations,limited evidence exists concerning the evidence-informed practice and adherence to current guidelines of traditional complementary and integrative medicine(TCIM)practitioners treating cancer patients.Methods An international online-survey assessed the demographical data,clinical practice,and sources of information used by TCIM practitioners in Austria,Germany,United States of America,Australia,and New Zealand.Results In total,404 respondents completed the survey,of which 254(62.9%)treated cancer patients.Most practitioners were acupuncturists and herbalists(57.1%),had(16.8±9.9)years of clinical experience and see a median of 2(1,4)cancer patients per week.Breast cancer(61.8%)is the most common cancer type seen in TCIM clinics.Adjunctive TCIM treatments are frequently concurrent with the patient’s cancer specific treatment(39.9%),which is also reflected by the main goal of a TCIM treatment to alleviate side effects(52.4%).However,only 28.0%of the respondents are in contact with the treating oncologist.According to the respondents,pain is most effectively treated using acupuncture,while herbal medicine is best for cancer-related fatigue.TCIM practitioners mostly use certified courses(33.1%)or online databases(28.3%)but often believe that experts are more reliable to inform their practice(37.0%)than research publications(32.7%).Conclusion Acupuncturists and herbalists commonly treat cancer patients.Most practitioners use TCIM as an adjunct to biomedicine as supportive care and use it largely in accordance with current oncological guidelines.

关键词： Integrative medicine Acupuncture Oncology Evidence-informed practice International survey

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Connecting cellular mechanisms and extracellular vesicle cargo in traumatic brain injury

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Neural Regeneration Research 2024年第10期19卷 2119-2131页

作者： Nikita Ollen-Bittle Austyn D.Roseborough Wenxuan Wang Jeng-liang D.Wu Shawn N.Whitehead Department of Anatomy and Cell Biology Western UniversityLondonONCanada Schulich School of Medicine and Dentistry Western UniversityLondonONCanada Deparment of Clinical Neurological Sciences Western UniversityLondonONCanada

Traumatic brain injury is followed by a cascade of dynamic and complex events occurring at the cellular level. These events include: diffuse axonal injury, neuronal cell death, blood-brain barrier break down, glial activation and neuroinflammation, edema, ischemia, vascular injury, energy failure, and peripheral immune cell infiltration. The timing of these events post injury has been linked to injury severity and functional outcome. Extracellular vesicles are membrane bound secretory vesicles that contain markers and cargo pertaining to their cell of origin and can cross the blood-brain barrier. These qualities make extracellular vesicles intriguing candidates for a liquid biopsy into the pathophysiologic changes occurring at the cellular level post traumatic brain injury. Herein, we review the most commonly reported cargo changes in extracellular vesicles from clinical traumatic brain injury samples. We then use knowledge from animal and in vitro models to help infer what these changes may indicate regrading cellular responses post traumatic brain injury. Future research should prioritize labeling extracellular vesicles with markers for distinct cell types across a range of timepoints post traumatic brain injury.

关键词： axonal injury biomarkers blood-brain barrier chronic traumatic encephalopathy extracellular vesicles glial activation neuroinflammation traumatic brain injury

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Prevalence of Vitamin A Deficiency in Children Aged 6 to 17 Years—western and Central Rural Areas,China,2012–2021

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China CDC weekly 2024年第3期6卷 51-55页

作者： Peipei Xu Juan Xu Wei Cao Titi Yang Qian Gan Hongliang Wang Ruihe Luo Hui Pan Qian Zhang National Institute for Nutrition and health Chinese Center for Disease Control and PreventionBeijingChina

What is already known about this topic?Vitamin A deficiency(VAD)is a leading global nutritional concern,ranking among the top four major nutritional deficiencies worldwide.The prevalence of VAD is unevenly distributed across various regions,both within China and globally.What is added by this report?The report adds valuable insights into the vitamin A nutritional status of rural students aged 6–17 years who participated in the Nutrition Improvement Programme for Rural Compulsory Education Students(NIPRCES).Over the decade from 2012 to 2021,there was a modest improvement in vitamin A status.The prevalence of VAD and sub-clinical VAD(SVAD)declined as the students aged.Throughout the majority of the survey years,the incidence of VAD was higher among males and western regions compared to females and central regions,respectively.What are the implications for public health practice?A comprehensive approach,incorporating dietary diversification,nutrition education,and food fortification,should be implemented to prevent VAD and SVAD especially in males,younger children and children in western areas.

关键词： vitamin Rural younger

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Community-led total sanitation(CLTS)implementation in West Mamprusi Municipal Assembly in Ghana.What do communities think eleven years on?Author links open overlay panel

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Global health Journal 2024年第2期8卷 67-73页

作者： Elijah Adam Emmanuel Badu School of Media Creative and Social InquiryCurtin UniversityBentleyWestern AustraliaAustralia School of Population health Curtin UniversityBentleyWestern AustraliaAustralia

Objective Access to improved sanitation is a fundamental human right and an important aspect of Public health.However,an estimated thousands of people in Ghana especially,the West Mamprusi Municipal Assembly(WMMA)still have no access to adequate toilet facilities.This has brought untold health repercussions to the inhabitants,the community,and the environment at large.To address this menace,the community-led total sanitation(CLTS)was implemented.This study aimed to assess communities’perspectives on the implementation of CLTS and to understand the factors influencing its success and failures.Methods A mixed-method approach involving sequential qualitative and quantitative methods was employed in this study.Participants for the quantitative study were randomly selected and surveyed using questionnaires.The qualitative study employed focus group discussion involving purposively sampled participants including assembly members,opinion leaders,and assembly staff.Results The CLTS program in WMMA realized an apparent use of construction and proper use of household latrines leading to a reduction of open defecation free(ODF)and two communities achieving sanitized status in the history of the study area,enabling the training of latrine artisans and natural leaders to facilitate the CLTS expansion and sustainability,improved sanitation and hygiene,strengthened the enforcement of community rules and regulations and many others.Conclusion The CLTS program has received more widespread acceptance in the study area than the previous government policy of constructing public toilets,which was greeted with massive failures due to poor implementation.To ensure that gains achieved through CLTS implementation are sustained longer,it is recommended that chiefs and opinion leaders should be involved in the CLTS programs to ensure checks and enforcement.The entrenchment of bylaws and more education to address enduring myths and misconceptions will sustain the program.Subsidies in the form of sanitation loans for latrine construction mat

关键词： Community-led total sanitation(CLTS) Community development Ghana Sanitation

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Resection and reconstruction in high-grade pancreatic head injuries

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1467-1469页

作者： Jake Krige Eduard Jonas Andrew John Nicol Pradeep Harkson Navsaria HPB Surgery University of Cape Town Health Sciences FacultyCape Town 7925Western CapeSouth Africa Trauma Center Department of SurgeryGroote Schuur HospitalCape Town 7925Western CapeSouth Africa Department of Surgery Trauma CenterGroote Schuur HospCape Town 7925Western CapeSouth Africa

This study by Chui et al adds further important evidence in the treatment of highgrade pancreatic injuries and endorses the concept of the model of pancreatic trauma care designed to optimize treatment,minimize morbidity and enhance survival in patients with complex pancreatic injuries.Although the authors have demonstrated favorable outcomes based on their limited experience of 5 patients who underwent a pancreaticoduodenectomy(PD),including 2 patients who were“unstable”and did not have damage control surgery(DCS),we would caution against the general recommendations promoting index PD without DCS in“unstable”grade 5 pancreatic head injuries.

关键词： Pancreas Injury Surgery Pancreaticoduodenectomy

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Evaluating implicit gender bias at Canadian otolaryngology meetings through use of professional title

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第1期10卷 12-17页

作者： Kylen Van Osch Agnieszka Dzioba Khadija Ahmed Andrew MacDonald Jamila Skinner Harley Williams Julie E.Strychowsky M.Elise Graham Department of Otolaryngology-Head&Neck Surgery Schulich School of Medicine&DentistryWestern UniversityLondonOntarioCanada Department of Otolaryngology London Health Sciences Centre Children's HospitalLondonOntarioCanada Faculty of Medicine Schulich School of Medicine&DentistryWestern UniversityLondonOntarioCanada

Objectives:Increasing numbers of women enter medical school annually.The number of female physicians in leadership positions has been much slower to equalize.There are also well‐documented differences in the treatment of women as compared to men in professional settings.Female presenters are less likely to be introduced by their professional title(“Doctor”)for grand rounds and conferences,especially with a man performing the introduction.This study reviewed the Canadian Society of Otolaryngology–Head and Neck Surgery(CSOHNS)meetings from 2017 to 2020 to determine the proportion of presenters introduced by their professional title and whether this varied by gender.Methods:Recordings from CSOHNS meetings were reviewed and coded for introducer and presenter demographics,including leadership positions and gender.Chi‐squared tests of proportion and multivariate logistic regression was used to compare genders and identify factors associated with professional versus unprofessional forms of address.Results:No significant association was found between professional title use and introducer or presenter gender.Female presenters were introduced with professional title 69.6%of the time,while male presenters were introduced with professional title 67.6%of the time(P=0.69).Residents were introduced with a professional title with the most frequency(75.8%),while attending staff were introduced with a professional title with the least frequency(63.0%)(P=0.02).Conclusions:The lack of gender bias in speaker introductions at recent CSOHNS meetings demonstrates progress in achieving gender equity in medicine.Research efforts should continue to define additional forms of unconscious bias that may be contributing to gender inequity in leadership positions.

关键词： attitude of health personnel gender identity Otolaryngology women

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Male genitourinary schistosomiasis-related symptoms among long-term western African migrants in Spain: a prospective population-based screening study

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贫困所致传染病(英文) 2024年第2期13卷 1-10页

作者： Roure Sílvia Vallès Xavier Pérez-Quílez Olga López-Mu?oz Israel Chamorro Anna Abad Elena Valerio Lluís Soldevila Laura Espa?a Sergio Hegazy Alaa H. A. Fernández-Rivas Gema Gorriz Ester Herena Dolores Oliveira Mário Miralles Maria Carme Conde Carmen Montero-Alia Juan José Fernández-Pedregal Elia Miranda-Sánchez Jose Llibre Josep M. Isnard Mar Bonet Josep Maria Estrada Oriol Prat Núria Clotet Bonaventura The Schisto-Stop study group Primary health Care Unit Mataró-(Rocafonda-Palau) Barcelona North Metropolitan Health Directorate Catalan Institute for Health Camí Ral el Ravalet Mataró Barcelona Spain Barcelona North Metropolitan Primary Care Directorate Catalan Institute for Health Ctra. de Barcelona Sabadell Barcelona Spain Directorate for Innovation and Interdisciplinary Cooperation Barcelona North Metropolitan Health Directorate Catalan Institute for Health C/Can Ruti S/N Badalona Spain IrsiCaixa-AIDS Research Institute Hospital Universitari Germans Trias i Pujol University Hospital c/Can Ruti s/n Badalona Spain Infectious Diseases Directorate Barcelona North Metropolitan Health Directorate Catalan Institute for Health C/Can Ruti S/N Badalona Spain International health Program (PROSICS) Barcelona North Metropolitan Territorial Directorate for Infectious Diseases Catalan Institute for Health CAP La Salut Passatge dels Encants S/N Badalona Spain Fundació Lluita contra les Infeccions c/Can Ruti s/n Badalona Spain Infectious Diseases Department Hospital Universitari Germans Trias i Pujol c/Can Ruti s/n Badalona Spain Germans Trias i Pujol Research Institute c/Can Ruti s/n Badalona Spain Microbiology Department Germans Trias i Pujol University Hospital c/Can Ruti s/n Badalona Spain Department of Genetics and Microbiology Universitat Autònoma de Barcelona c/Can Ruti s/n Badalona Spain Faculty of Medicine University of Asyut El Fateh Assiut Governorate Egypt Department of Urology Germans Trias i Pujol University Hospital c/Can Ruti s/n Badalona Spain Canovelles Primary health Care Unit Barcelona North Metropolitan Health Directorate Catalan Institute for Health C/Indústria Canovelles Spain

Background Schistosomiasis is highly endemic in sub-Saharan Africa and frequently imported to Europe. Male urogenital manifestations are often neglected. We aimed to ascertain the prevalence of genitourinary clinical signs and symptoms among long-term African migrants in a non-endemic European country using a serology test.Methods We carried out a prospective, community-based cross-sectional study of adult male migrants from sub-Saharan Africa living in Spain.Schistosoma serology tests and microscopic urine examinations were carried out, and clinical data were obtained from an electronic medical record search and a structured questionnaire.Results We included 388 adult males, mean age 43.5 years [Standard Deviation (SD) = 12.0, range: 18–76]. The median time since migration to the European Union was 17 [Interquartile range (IQR): 11–21] years. The most frequent country of origin was Senegal (N = 179, 46.1%). Of the 338, 147 (37.6%) tested positive forSchistosoma. Parasite eggs were present in the urine of only 1.3%. Nine genitourinary clinical items were significantly associated with positiveSchistosoma serology results: pelvic pain (45.2%;OR = 1.57, 95%CI: 1.0–2.4), pain on ejaculation (14.5%;OR = 1.85, 95%CI: 1.0–3.5), dyspareunia (12.4%;OR = 2.45, 95%CI: 1.2–5.2), erectile dysfunction (9.5%;OR = 3.10, 95%CI: 1.3–7.6), self-reported episodes of infertility (32.1%;OR = 1.69, 95%CI: 1.0–2.8), haematuria (55.2%;OR = 2.37, 95%CI: 1.5–3.6), dysuria (52.1%;OR = 2.01, 95%CI: 1.3–3.1), undiagnosed syndromic STIs (5.4%), and orchitis (20.7%;OR = 1.81, 95%CI: 1.0–3.1). Clinical signs tended to cluster.Conclusions Urogenital clinical signs and symptoms are prevalent among male African long-term migrants with a positiveSchistosoma serology results. Genital involvement can be frequent even among those with long periods of non-residence in their sub-Saharan African countries of origin. Further research is needed to develop diagnostic tools and validate therapeutic approaches to chronic schistosomiasis.

关键词： Schistosomiasis Chronic schistosomiasis Urogenital schistosomiasis Male genital schistosomiasis Longterm migrant

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Asymmetric Drying and Wetting Trends in Eastern and western China

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Advances in Atmospheric Sciences 2024年第2期41卷 221-232页

作者： Wen WU Fei JI Shujuan HU Yongli HE College of Atmospheric Sciences Lanzhou UniversityLanzhou 730000China Collaborative Innovation Center for western Ecological Safety Lanzhou UniversityLanzhou 730000China

As an important factor that directly affects agricultural production, the social economy, and policy implementation,observed changes in dry/wet conditions have become a matter of widespread concern. However, previous research has mainly focused on the long-term linear changes of dry/wet conditions, while the detection and evolution of the non-linear trends related to dry/wet changes have received less attention. The non-linear trends of the annual aridity index, obtained by the Ensemble Empirical Mode Decomposition(EEMD) method, reveal that changes in dry/wet conditions in China are asymmetric and can be characterized by contrasting features in both time and space in China. Spatially, most areas in western China have experienced transitions from drying to wetting, while opposite changes have occurred in most areas of eastern China. Temporally, the transitions occurred earlier in western China compared to eastern China. Research into the asymmetric spatial characteristics of dry/wet conditions compensates for the inadequacies of previous studies, which focused solely on temporal evolution;at the same time, it remedies the inadequacies of traditional research on linear trends over centennial timescales. Analyzing the non-linear trend also provides for a more comprehensive understanding of the drying/wetting changes in China.

关键词： aridity index EEMD dry/wet conditions asymmetric evolution

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Disease Burden and Costs Associated with Multiple Sclerosis in China:A Cross-sectional Analysis of Nationwide Survey Data

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Neuroscience Bulletin 2024年第4期40卷 533-538页

作者： Yusheng Jia Xuanqi Qiao Jin Zhao Hainan Li Shanlian Hu Min Hu Department of health Economics School of Public HealthFudan UniversityShanghai200032China National health Commission Key Laboratory of health Technology Assessment Fudan UniversityShanghai200032China

DearEditors,Multiple sclerosis(MS)is a chronic,autoimmune neurological disorder characterized by inflammatory demyelination of the central nervous system;it is associated with reduced mobility,cognitive impairment,and numerous comorbidities[1].Global MS incidence(2.1 per 100,000 person-years)and prevalence(30.1 per 100,000)have increased in recent years,and its prevalence is notably higher in western countries,ranging from~30 to 200 cases per 100,000[2].In China,recent epidemiological research has shown that the crude prevalence was 2.44 per 100,000 in 2016[3],and the age-and sex-adjusted incidence was 0.235 per 100,000 person-years[4].Despite the relatively low prevalence compared with the global average,China has extensively addressed the well-being of over 30,000 MS patients,enrolling MS in China's First National List of Rare Diseases in 2018.

关键词： prevalence impairment autoimmune

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Increased number of symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged time to return to full sports performance—AWAREⅧ

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Journal of Sport and health Science 2024年第3期13卷 280-287,I0001页

作者： Carolette Snyders Marlise Dyer Nicola Sewry Esme Jordaan Martin Schwellnus Sport Exercise Medicine and Lifestyle Institute(SEMLI)Faculty of Health SciencesUniversity of PretoriaPretoria 0083South Africa Section Sports Medicine Faculty of Health SciencesUniversity of PretoriaPretoria 0083South Africa IOC Research Centre of South Africa Pretoria 0083South Africa Biostatistics Unit South African Medical Research CouncilTygerberg 7505South Africa Statistics and Population Studies Department University of the Western CapeCape Town 7535South Africa

Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods Prospective cohort study with cross sectional analysis.A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age,sex,type/level of sport,co-morbidities,pre-infection training hours,and 26 acute SARS-CoV-2 symptoms from 3 categories(“nose and throat”,“chest and neck”,and“whole body”/systemic).Data on days to RTFP were obtained by structured interviews.Factors associated with RTFP were demographics,sport participation,history of co-morbidities,pre-infection training history,and acute symptoms(type,number).Outcomes were:(a)days to RTFP(median,interquartile range(IQR))in asymptomatic(n=7)and symptomatic athletes(n=77),and(b)hazard ratios(HRs;95%confidence interval)for symptomatic athletes with vs.without a factor(univariate,multiple models).HR0.05).Factors associated with prolonged RTFP(univariate models)were:females(HR=0.57;p=0.014),endurance athletes(HR=0.41;p<0.0001),co-morbidity number(HR=0.75;p=0.001),and respiratory disease history(HR=0.54;p=0.026).In symptomatic athletes,prolonged RTFP(multiple models)was significantly associated with increased“chest and neck”(HR=0.85;p=0.017)and“nose and throat”(HR=0.84;p=0.013)symptoms,but the association was more profound between prolonged RFTP and increased total number of“all symptoms”(HR=0.91;p=0.001)and“whole body”/systemic(HR=0.82;p=0.007)symptoms.Conclusion A larger number of total symptoms and specifically“whole body”/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.

关键词： Athletes COVID-19 Performance Recovery Return to play

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