Acupuncture for Spasticity after Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The aim of this systematic review was to determine how effective acupuncture or electroacupuncture (acupuncture with electrical stimulation) is in treating poststroke patients with spasticity. We searched publications in Medline, EMBASE, and the Cochrane Library in English, 19 accredited journals in Korean, and the China Integrated Knowledge Resources Database in Chinese through to July 30, 2013. We included randomized controlled trials (RCTs) with no language restrictions that compared the effects of acupuncture or electroacupuncture with usual care or placebo acupuncture. The two investigators assessed the risk of bias and statistical analyses were performed. Three RCTs in English, 1 in Korean, and 1 in Chinese were included. Assessments were performed primarily with the Modified Ashworth Scale (MAS). Meta-analysis showed that acupuncture or electroacupuncture significantly decreased spasticity after stroke. A subgroup analysis showed that acupuncture significantly decreased wrist, knee, and elbow spasticity in poststroke patients. Heterogeneity could be explained by the differences in control, acupoints, and the duration after stroke occurrence. In conclusion, acupuncture could be effective in decreasing spasticity after stroke, but long-term studies are needed to determine the longevity of treatment effects

Detection of Single Nanoparticles inside a Single Terahertz Resonator

With the rapid advancement of 5G/6G communications using millimeter wavelengths, the concomitant usage of these long wavelength radiation for remote sensing and monitoring of biological and chemical agents is anticipated. However, the ability to detect and identify these agents with sizes ranging from nanometers to microns is hampered by its millimeter wavelength, which drastically reduces the interaction cross-section. Herein, it is reported that single gold nanoparticles (NPs) drop-casted on the nanoresonator can be observed by monitoring the far-field transmitting spectra of individual terahertz (THz) nanoresonators, which enhance the electric field hundreds of times on the nanoscale. Despite the enormous mismatch in length scales, full-wave 3D numerical modeling of the single THz nanoresonator is also performed to interpret the experimental results, indicating the possibility to turn off the resonance using only one NP embedded in the hotspot of the nanoresonator. Such NP detection becomes the most sensitive when the particle, whose size is comparable to the gap width, is tightly fitted into the nanoresonator. This work unveils the potential associated with refractive index sensing and hyperspectral absorption spectroscopy for detecting and fingerprinting ultra-low density of bio/chemical molecules such as viruses, lipid vesicles, and explosives

Development and Implementation of Clinical Practice Guidelines: Current Status in Korea

Documentation of unexplained geographic variations in medical practices and use of inappropriate interventions has led to the proliferation of clinical practice guidelines. With increased enthusiasm for guidelines, evidence exists that clinical practice guidelines often influence clinical practices or health outcomes. Their successful implementation may improve the quality of care by decreasing in appropriate variation and expediting the application of effective advances to healthcare practices. In Korea, physicians and healthcare professionals have begun to take interests in clinical practice guidelines. Currently, over 50 practice guidelines have been developed through professional academic organizations or via other routes; however, the quality of the guidelines is unsatisfactory, implementation in clinical settings is incomplete, and there is insufficient infrastructure to develop clinical practice guidelines. Korea must develop policies and invest resources to enhance the development and implementation of clinical practice guidelines

Analysis of COVID-19 Guideline Quality and Change of Recommendations: A Systematic Review.

Background Hundreds of coronavirus disease 2019 (COVID-19) clinical practice guidelines (CPGs) and expert consensus statements have been developed and published since the outbreak of the epidemic. However, these CPGs are of widely variable quality. So, this review is aimed at systematically evaluating the methodological and reporting qualities of COVID-19 CPGs, exploring factors that may influence their quality, and analyzing the change of recommendations in CPGs with evidence published. Methods We searched five electronic databases and five websites from 1 January to 31 December 2020 to retrieve all COVID-19 CPGs. The assessment of the methodological and reporting qualities of CPGs was performed using the AGREE II instrument and RIGHT checklist. Recommendations and evidence used to make recommendations in the CPGs regarding some treatments for COVID-19 (remdesivir, glucocorticoids, hydroxychloroquine/chloroquine, interferon, and lopinavir-ritonavir) were also systematically assessed. And the statistical inference was performed to identify factors associated with the quality of CPGs. Results We included a total of 92 COVID-19 CPGs developed by 19 countries. Overall, the RIGHT checklist reporting rate of COVID-19 CPGs was 33.0%, and the AGREE II domain score was 30.4%. The overall methodological and reporting qualities of COVID-19 CPGs gradually improved during the year 2020. Factors associated with high methodological and reporting qualities included the evidence-based development process, management of conflicts of interest, and use of established rating systems to assess the quality of evidence and strength of recommendations. The recommendations of only seven (7.6%) CPGs were informed by a systematic review of evidence, and these seven CPGs have relatively high methodological and reporting qualities, in which six of them fully meet the Institute of Medicine (IOM) criteria of guidelines. Besides, a rapid advice CPG developed by the World Health Organization (WHO) of the seven CPGs got the highest overall scores in methodological (72.8%) and reporting qualities (83.8%). Many CPGs covered the same clinical questions (it refers to the clinical questions on the effectiveness of treatments of remdesivir, glucocorticoids, hydroxychloroquine/chloroquine, interferon, and lopinavir-ritonavir in COVID-19 patients) and were published by different countries or organizations. Although randomized controlled trials and systematic reviews on the effectiveness of treatments of remdesivir, glucocorticoids, hydroxychloroquine/chloroquine, interferon, and lopinavir-ritonavir for patients with COVID-19 have been published, the recommendations on those treatments still varied greatly across COVID-19 CPGs published in different countries or regions, which may suggest that the CPGs do not make sufficient use of the latest evidence. Conclusions Both the methodological and reporting qualities of COVID-19 CPGs increased over time, but there is still room for further improvement. The lack of effective use of available evidence and management of conflicts of interest were the main reasons for the low quality of the CPGs. The use of formal rating systems for the quality of evidence and strength of recommendations may help to improve the quality of CPGs in the context of the COVID-19 pandemic. During the pandemic, we suggest developing a living guideline of which recommendations are supported by a systematic review for it can facilitate the timely translation of the latest research findings to clinical practice. We also suggest that CPG developers should register the guidelines in a registration platform at the beginning for it can reduce duplication development of guidelines on the same clinical question, increase the transparency of the development process, and promote cooperation among guideline developers all over the world. Since the International Practice Guideline Registry Platform has been created, developers could register guidelines prospectively and internationally on this platform

Long-term strategies for thyroid health monitoring after nuclear accidents : recommendations from an Expert Group convened by IARC

International audience[No abstract available

Thyroid Health Monitoring After Nuclear Accidents : IARC Expert Group on Thyroid Health Monitoring After Nuclear Accidents

This Technical Publication contains the forward-looking recommendations of a multidisciplinary, international Expert Group on long-term strategies for thyroid health monitoring after a nuclear power plant accident. As a basis for the recommendations, this publication also summarizes the available scientific evidence on thyroid cancer and experiences from past nuclear accidents. The recommendations are intended to specifically address whether thyroid health monitoring should be implemented in a resident population in the vicinity of a nuclear accident and, if so, how such thyroid health monitoring should be prepared for and implemented in the context of general emergency preparedness for and response to nuclear accidents. This publication was developed with the intention to serve as a reference primarily for the government officials, policy-makers, and health professionals who would be involved in the decision-making, planning, or implementation of thyroid health monitoring in case of a nuclear accident. Because such decision-making may also involve considerations other than the scientific evidence, these recommendations should be used as a reference; the final decision should be made by the government, the relevant authorities, and the society affected by the nuclear accident. This Technical Publication consists of five chapters: the executive summary (Chapter 1), the introduction (Chapter 2), the Expert Group’s recommendations and considerations related to thyroid health monitoring in the context of preparedness for and response to nuclear accidents (Chapter 3), summaries and syntheses of the scientific evidence base used by the Expert Group when developing the recommendations (Chapter 4), and the identified gaps in scientific knowledge (Chapter 5).4

Régularisation spatiale de représentations distribuées de mots

Stimulée par l’usage intensif des téléphones mobiles, l’exploitation conjointe des don-nées textuelles et des données spatiales présentes dans les objets spatio-textuels (p. ex. tweets)est devenue la pierre angulaire à de nombreuses applications comme la recherche de lieux d’attraction. Du point de vue scientifique, ces tâches reposent de façon critique sur la représentation d’objets spatiaux et la définition de fonctions d’appariement entre ces objets. Dans cet article,nous nous intéressons au problème de représentation de ces objets. Plus spécifiquement, confortés par le succès des représentations distribuées basées sur les approches neuronales, nous proposons de régulariser les représentations distribuées de mots (c.-à-d. plongements lexicaux ou word embeddings), pouvant être combinées pour construire des représentations d’objets,grâce à leurs répartitions spatiales. L’objectif sous-jacent est de révéler d’éventuelles relations sémantiques locales entre mots ainsi que la multiplicité des sens d’un même mot. Les expérimentations basées sur une tâche de recherche d’information qui consiste à retourner le lieu physique faisant l’objet (sujet) d’un géo-texte montrent que l’intégration notre méthode de régularisation spatiale de représentations distribuées de mots dans un modèle d’appariement de base permet d’obtenir des améliorations significatives par rapport aux modèles de référence