Exploring the diverse definitions of 'evidence': a scoping review.

OBJECTIVES: To systematically collect and analyse diverse definitions of 'evidence' in both health and social sciences, and help users to correctly use the term 'evidence' and rethink what is the definition of 'evidence' in scientific research. DESIGN: Scoping review. METHODS: Definitions of evidence in the health sciences and social sciences were included. We have excluded the definition of evidence applied in the legal field, abstracts without full text, documents not published in either Chinese or English and so on. We established a multidisciplinary working group and systematically searched five electronic databases including Medline, Web of Science, EBSCO, the Chinese Social Sciences Citation Index and the Chinese Science Citation Database from their inception to 26 February 2022. We also searched websites and reviewed the reference lists of the identified studies. Six reviewers working in pairs, independently, selected studies according to the inclusion and exclusion criteria, and extracted information. Any differences were discussed in pairs, and if there was disagreement, it was resolved via discussion or with the help of a third reviewer. Reviewers extracted document characteristics, the original content for the definitions of 'evidence', assessed definitions as either intensional or extensional, and any citations for the given definition. RESULTS: Forty-nine documents were finally included after screening, and 68 definitions were obtained. After excluding duplicates, a total of 54 different definitions of 'evidence' were identified. There were 42 intensional definitions and 12 extensional definitions. The top three definiens were 'information', 'fact' and 'research/study'. The definition of 'evidence' differed between health and social sciences. The term 'research' appeared most frequently in the definitions. CONCLUSIONS: The definition of 'evidence' has gradually attracted the attention of many scholars and decision-makers in health and social sciences. Nevertheless, there is no widely recognised and accepted definition in scientific research. Given the wide use of the term, we need to think about whether, or under what circumstances, a standardised, clear, meaningful and widely applicable definition of 'evidence' might be helpful.

Various application roles for Campbell systematic reviews: a citation analysis.

OBJECTIVES: Systematic reviews (SRs) are becoming essential evidence in the decision-making process within the field of social sciences. This study aimed to investigate how Campbell SRs were cited and explore their specific application roles. STUDY DESIGN AND SETTING: We included Campbell SRs published between 2016 and 2020 by searching the Wiley online library, and retrieved the articles and documents citing Campbell SRs from the Web of Science and Google Scholar by December 31, 2021. We described the characteristics of the SRs and citations, and formulated a set of application roles by analyzing the sentences or paragraphs where the SRs were cited. RESULTS: Sixty nine Campbell SRs were published between 2016 and 2020; they were cited in 641 articles or documents a total of 1,289 times. The primary types of articles that cited Campbell SRs were cross-sectional studies (n = 226, 35.3%), SRs (n = 112, 17.5%), randomized controlled trials (n = 77, 12.0%), and policy reports (n = 57, 8.8%). Articles utilizing Campbell SRs were predominantly led by authors from the United States (n = 184, 28.7%), the United Kingdom (n = 98, 15.3%), and Australia (n = 51, 8.0%). We formulated a set of 10 application roles for the Campbell SRs, of which the most frequent were: describing the current status in the field of interest (n = 691, 53.6%), corroboration of the results (n = 140, 10.9%), identifying research gaps (n = 130, 10.1%), and providing methodological references (n = 126, 9.8%); the role of supporting policy recommendations or decisions accounted for 6.0% (n = 77) of the citations. Approximately 12% of Campbell SRs were used to support policy recommendations or decisions. CONCLUSION: Campbell SRs are widely applied, particularly in scientific research, to describe the current status in the field of interest. Although the current application of Campbell SRs in supporting policy recommendations and decisions may not be predominant, there is a growing recognition of their value in using Campbell SRs to inform decision-making.

Developing a questionnaire to evaluate the health information literacy in China.

Introduction: Health information literacy is critical for individuals to obtain, understand, screen, and apply health information. However, there is currently no specific tool available to evaluate all four dimensions of health information literacy in China. Public health emergencies can present an opportunity to evaluate and monitor the health information literacy level of residents. Therefore, this study aimed to develop a questionnaire to evaluate the level of health information literacy and to measure the reliability and validity. Methods: The development process of the questionnaire consisted of the determination of questionnaire items, expert consultation, and validation. Based on the National Residents Health Literacy Monitoring Questionnaire (2020) and the 2019 Informed Health Choices key concepts, the researchers drafted the questionnaire, including all four dimensions of health information literacy. Experts in relevant fields were invited to evaluate the draft questionnaire, and revisions were made accordingly. Finally, the reliability and validity of the finalized version were examined in Gansu Province, China. Results: The research team preliminarily formulated 14 items encompassing the four dimensions of health information literacy. After consulting with 28 experts, modifications were made. A convenience sample of 185 Chinese residents was invited to participate. Cronbach's alpha coefficient was 0.715 and McDonald's omega was 0.739 for internal consistency, and the test-retest intra-class correlation coefficient after 4 weeks was 0.906, indicating that the questionnaire content and measurement structure was relatively stable. Conclusion: This questionnaire is the first evidence-based assessment tool developed for monitoring health information literacy in China, and it has shown good reliability and validity. It can help to monitor the health information literacy levels of Chinese residents, promote evidence-based decision-making, and guide interventions to improve health information literacy.

Developing TCM clinical practice guidelines: A comparison between traditional Chinese medicine and western medicine.

Clinical practice guidelines in Traditional Chinese Medicine (CPG-TCM) is the recommendation that aims to provide the best service to users by identifying and summarizing the rules of prevention, diagnosis, treatment, rehabilitation, and regression of diseases based on systematic reviews of evidence and balancing the advantages and disadvantages of different interventions for clinical questions of Traditional Chinese Medicine. Over the past 30 years, the concept and methods of evidence-based medicine have had a significant impact on the development of clinical practice guidelines in Western Medicine (CPG-WM), and their standardized guideline development methods are being adapted and used in the development of CPG-TCM. However, the quality of CPG-TCM is far from CPG-WM, and the methodological system for developing CPG-TCM is not yet fully established. Therefore, this study aims to explore the methodological differences between CPG-TCM and CPG-WM and to inform the development of high-quality CPGTCM.

How about the evidence assessment tools used in education and management systematic reviews?

Objectives: To systematically analyze the use of evidence assessment tools in systematic reviews of management and education. Study design and setting: We systematically searched selected literature databases and websites to identify systematic reviews on management and education. We extracted general information of the included studies and information about the evidence assessment tool they applied, including whether it was used for methodological quality assessment, reporting quality assessment or evidence grading, as well as the name, reference, publication year, version and original intended use of the tool, the role of the tool in the systematic review, and whether the quality determination criteria were given. Results: A total of 299 systematic reviews were included, of which only 34.8% used evidence assessment tools. A total of 66 different evidence assessment tools were used, of which Risk of Bias (ROB) and its updated version (n = 16, 15.4%) were the most frequent. The specific roles of the evidence assessment tools were reported clearly in 57 reviews, and 27 reviews used two tools. Conclusion: Evidence assessment tools were seldom used in systematic reviews in social sciences. The understanding and reporting of evidence assessment tools among the researchers and users still needs improvement.

Characteristics of the sources, evaluation, and grading of the certainty of evidence in systematic reviews in public health: A methodological study.

Objectives: To systematically explore how the sources of evidence, types of primary studies, and tools used to assess the quality of the primary studies vary across systematic reviews (SRs) in public health. Methods: We conducted a methodological survey of SRs in public health by searching the of literature in selected journals from electronic bibliographic databases. We selected a 10% random sample of the SRs that met the explicit inclusion criteria. Two researchers independently extracted data for analysis. Results: We selected 301 SRs for analysis: 94 (31.2%) of these were pre-registered, and 211 (70.1%) declared to have followed published reporting standard. All SRs searched for evidence in electronic bibliographic databases, and more than half (n = 180, 60.0%) searched also the references of the included studies. The common types of primary studies included in the SRs were primarily cross-sectional studies (n = 132, 43.8%), cohort studies (n = 126, 41.9%), randomized controlled trials (RCTs, n = 89, 29.6%), quasi-experimental studies (n = 83, 27.6%), case-control studies (n = 58, 19.3%) qualitative studies (n = 38, 12.6%) and mixed-methods studies (n = 32, 10.6%). The most frequently used quality assessment tools were the Newcastle-Ottawa Scale (used for 50.0% of cohort studies and 55.6% of case-control studies), Cochrane Collaboration's Risk of Bias tool (50.7% of RCTs) and Critical Appraisal Skills Program (38.5% of qualitative studies). Only 20 (6.6%) of the SRs assessed the certainty of the body of evidence, of which 19 (95.0%) used the GRADE approach. More than 65% of the evidence in the SRs using GRADE was of low or very low certainty. Conclusions: SRs should always assess the quality both at the individual study level and the body of evidence for outcomes, which will benefit patients, health care practitioners, and policymakers.

Prevalence of human immunodeficiency virus, syphilis, and hepatitis B and C virus infections in pregnant women: a systematic review and meta-analysis.

BACKGROUND: At the 74th World Health Assembly, the WHO issued a strategy for the prevention and control of several major infectious diseases. To achieve the WHO-initiated targets for these infectious diseases, the elimination of mother-to-child transmission is essential. To date, a systematic review of the global and regional prevalence of infections with relevant mother-to-child transmission and outside the spectrum of congenital infections is lacking. OBJECTIVES: We aimed to systematically review the prevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis in pregnant women. DATA SOURCES: MEDLINE, Embase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure, WanFang database and China Biology Medicine disc database, and five WHO Regional Index Medicus databases. STUDY ELIGIBILITY CRITERIA: Original studies reporting the prevalence of infection or coinfection of HIV, HBV, HCV, and syphilis in pregnant women. METHODS: This systematic review followed the preferred reporting items for systematic reviews and meta-analyses 2020 checklist. We used random-effects models to generate pooled prevalence estimates for each infection. RESULTS: The global pooled prevalence in pregnant women of HIV, HBV, HCV, and syphilis was 2.9% (95% CI, 2.4-3.4%), 4.8% (3.8-5.8%), 1.0% (0.8-1.3%), and 0.8% (0.7-0.9%). The pooled prevalence of HIV, HBV, HCV, and syphilis in low-income countries was higher than the global level (HIV: 5.2% [1.6-10.5%); HBV: 6.6% (5.4-7.9%); HCV: 2.7% (1.6-4.1%); syphilis: 3.3% (2.2-4.6%]). The pooled prevalence of HIV, HBV, HCV, and syphilis in lower-middle-income countries was higher than the global level (HIV: 2.9% [0.8-6.1%]; HBV: 4.9% [3.8-6.1%]; HCV: 2.3% [1.2-3.6%]; syphilis: 1.5% [1.0-2.2%]). CONCLUSIONS: The prevalence of these infections among pregnant women was particularly high in resource-poor settings. The relevance and feasibility of current global practice guidelines for the prevention of mother-to-child transmission of these infections in lower-middle-income countries must be evaluated, including timely access to screening and therapeutics.

Structurally diverse sulphur-containing amides from Glycosmis craibii with their potential antiproliferative activities.

Fourteen new sulphur-containing amides, glycocramides A-N (1-14), as well as nine known analogues (15-23) were isolated and characterized from Glycosmis craibii Tanaka. The chemical structures of new sulphur-containing amides 1-14 were ambiguously elucidated by extensive spectroscopic methods, while the known compounds 15-23 were identified by the comparison of their experimental spectral data with those described data in the literatures. The antiproliferative effects of all isolated sulphur-containing amides were evaluated in vitro. As a result, part of sulphur-containing amides showed remarkable inhibitory effects against MGC-803 cell line with IC50 values ranging from 13.12 ± 0.10 to 20.03 ± 0.13 µM. These research results suggest that the sulphur-containing amides are potentially to be developed as a new natural anti-tumor drugs.

Phaeosphamides A and B, Cytotoxic Cyclodecadepsipeptides from the Mangrove-Derived Fungus Phaeosphaeriopsis sp. S296.

Chemical examination of the fermented broth of the mangrove-derived fungus Phaeosphaeriopsis sp. S296 resulted in the isolation of two new cyclodecadepsipeptides, namely phaeosphamides A (1) and B (2), as well as one known congener Sch 217048 (3). The structures of new metabolites, including absolute configurations, were established on the basis of extensive spectroscopic data analyses, chemical conversion, and Marfey's method. The 2-hydroxy-3-methylpentanoic acid (Hmp) moiety and pipecolic acid (Pip) unit in structures were rarely discovered in nature. Interestingly, compounds 1-3 are examples of peptides discovered from the fungal genus Phaeosphaeriopsis for the first time. All identified compounds were evaluated for their cytotoxicity against five tumor cell lines of AGS, BEL-7402, HepG2, B16, and BIU87. Among them, compound 1 showed inhibitory activities against these tumor cell lines with IC50 values ranging from 5.14 to 66.38 µM. A further mechanistic investigation found that 1 arrested AGS cells in the G2 phase and induced their apoptosis in a dose-dependent manner.

Applications of artificial intelligence in the field of air pollution: A bibliometric analysis.

Background: Artificial intelligence (AI) has become widely used in a variety of fields, including disease prediction, environmental monitoring, and pollutant prediction. In recent years, there has also been an increase in the volume of research into the application of AI to air pollution. This study aims to explore the latest trends in the application of AI in the field of air pollution. Methods: All literature on the application of AI to air pollution was searched from the Web of Science database. CiteSpace 5.8.R1 was used to analyze countries/regions, institutions, authors, keywords and references cited, and to reveal hot spots and frontiers of AI in atmospheric pollution. Results: Beginning in 1994, publications on AI in air pollution have increased in number, with a surge in research since 2017. The leading country and institution were China (N = 524) and the Chinese Academy of Sciences (N = 58), followed by the United States (N = 455) and Tsinghua University (N = 33), respectively. In addition, the United States (0.24) and the England (0.27) showed a high degree of centrality. Most of the identified articles were published in journals related to environmental science; the most cited journal was Atmospheric Environment, which reached nearly 1,000 citations. There were few collaborations among authors, institutions and countries. The hot topics were machine learning, air pollution and deep learning. The majority of the researchers concentrated on air pollutant concentration prediction, particularly the combined use of AI and environmental science methods, low-cost air quality sensors, indoor air quality, and thermal comfort. Conclusion: Researches in the field of AI and air pollution are expanding rapidly in recent years. The majority of scholars are from China and the United States, and the Chinese Academy of Sciences is the dominant research institution. The United States and the England contribute greatly to the development of the cooperation network. Cooperation among research institutions appears to be suboptimal, and strengthening cooperation could greatly benefit this field of research. The prediction of air pollutant concentrations, particularly PM2.5, low-cost air quality sensors, and thermal comfort are the current research hotspot.

Risk of COVID-19 Transmission Aboard Aircraft: An Epidemiological Analysis Based on the National Health Information Platform.

OBJECTIVES: This study aims to investigate the risk of COVID-19 transmission on aircraft. METHODS: We obtained data on all international flights to Lanzhou, China, from June 1, 2020, to August 1, 2020, through the Gansu Province National Health Information Platform and the official website of the Gansu Provincial Center for Disease Control and Prevention. We then performed the statistical analysis. RESULTS: Three international flights arrived in Lanzhou. The flights had a total of 700 passengers, of whom 405 (57.9%) were male, and 80 (11.4%) were children under the age of 14 years. Twenty-seven (3.9%) passengers were confirmed to have COVID-19. Confirmed patients were primarily male (17, 65.4%) with a median age of 27.0 years. Most confirmed cases were seated in the middle rows of economy class or near public facility areas such as restrooms and galleys. The prevalence of COVID-19 did not differ between passengers sitting in the window, aisle, or middle seats. However, compared with passengers sitting in the same row up to 2 rows behind a confirmed case, passengers seated in the 2 rows in front of a confirmed case were at a slightly higher risk of being infected. CONCLUSIONS: COVID-19 may be transmitted during a passenger flight, although there is still no direct evidence.

COVID-19 vaccine guidelines was numerous in quantity but many lack transparent reporting of methodological practices.

OBJECTIVE: To describe the current status of COVID-19 vaccine guidelines. STUDY DESIGN AND SETTING: We searched databases, Google and guideline platforms to retrieve COVID-19 vaccine guidelines published between January 1, 2020 and July 8, 2021. We worked in pairs to identify the eligible guidelines and extract data of whether the methodology, funding, and conflict of interests were assessed/reported, and so on. Results were presented descriptively. RESULTS: A total of 106 COVID-19 vaccine guidelines were included. In the first half of 2021, on average 15 guidelines were published every month. Fifty (47.2%) guidelines addressed the vaccination of people with specific medical conditions, and 18 (17.0%) guidelines focused on adverse effects after vaccination. Only 28 (26.4%) guidelines reported the methodology they used. Four (3.8%) of guidelines assessed both the quality of evidence and strength of recommendations; 42 (39.6%) and 65 (61.3%) guidelines reported their funding sources and conflict of interest, respectively. Most guidelines were published in English (n = 92, 86.8%). CONCLUSION: A high number of guidelines on COVID-19 vaccines have been published in the recent months, but most of them lack clear and transparent reporting of methodology, funding, and conflicts of interest. Rigorous methodological and reporting quality evaluation of these guidelines is needed.

A new indole alkaloid from the stems of Glycosmis puberula var. craibii.

A phytochemical investigation on the stems of Glycosmis puberula var. craibii led to the isolation of a new indole alkaloid (named glycosmiscrol A, 1), together with four known compounds (2-5). The new structure was elucidated by detailed analysis of comprehensive spectroscopic methods. All isolated compounds were evaluated for their antiproliferative activities against five human cancer cell lines: HL-60, SMMC-7721, A-549, MCF-7 and SW480 in vitro. Compounds 1-5 showed significant antiproliferative effects with IC50 values ranging from 0.16 to 8.58 µM.

Guidelines on the treatment with integrated traditional Chinese medicine and western medicine for severe coronavirus disease 2019.

Severe Coronavirus Disease 2019 (COVID-19) is characterized by numerous complications, complex disease, and high mortality, making its treatment a top priority in the treatment of COVID-19. Integrated traditional Chinese medicine (TCM) and western medicine played an important role in the prevention, treatment, and rehabilitation of COVID-19 during the epidemic. However, currently there are no evidence-based guidelines for the integrated treatment of severe COVID-19 with TCM and western medicine. Therefore, it is important to develop an evidence-based guideline on the treatment of severe COVID-19 with integrated TCM and western medicine, in order to provide clinical guidance and decision basis for healthcare professionals, public health personnel, and scientific researchers involved in the diagnosis, treatment, and care of COVID-19 patients. We developed and completed the guideline by referring to the standardization process of the "WHO handbook for guideline development", the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, and the Reporting Items for Practice Guidelines in Healthcare (RIGHT).

Phenolic glycosides from the stems of Homalium stenophyllum.

The phytochemical investigation of the stems of Homalium stenophyllum afforded seven new phenolic glycosides (1-5 and 8-9) and two known compounds (6 and 7). Their structures were elucidated by comprehensive analyses of NMR spectroscopic, mass spectrometric data and chemical hydrolysis. Additionally, their anti-inflammatory activities against the NO production in LPS-induced macrophages were evaluated.

A cross-sectional study of the epidemic situation on COVID-19 in Gansu Province, China - a big data analysis of the national health information platform.

BACKGROUND: In December 2019, a pneumonia caused by SARS-CoV-2 emerged in Wuhan, China and has rapidly spread around the world since then. This study is to explore the patient characteristics and transmission chains of COVID-19 in the population of Gansu province, and support decision-making. METHODS: We collected data from Gansu Province National Health Information Platform. A cross-sectional study was conducted, including patients with COVID-19 confirmed between January 23 and February 6, 2020, and analyzed the gender and age of the patients. We also described the incubation period, consultation time and sources of infection in the cases, and calculated the secondary cases that occurred within Gansu for each imported case. RESULTS: We found thirty-six (53.7%) of the patients were women and thirty-one (46.3%) men, and the median ages were 40 (IQR 31-53) years. Twenty-eight (41.8%) of the 67 cases had a history of direct exposure in Wuhan. Twenty-five (52.2%) cases came from ten families, and we found no clear reports of modes of transmission other than family clusters. The largest number of secondary cases linked to a single source was nine. CONCLUSION: More women than men were diagnosed with COVID-19 in Gansu Province. Although the age range of confirmed cases of COVID-19 in Gansu Province covered almost all age groups, most patients with confirmed COVID-19 tend to be middle aged persons. The most common suspected mode of transmission was through family cluster. Gansu and other settings worldwide should continue to strengthen the utilization of big data in epidemic control.

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.

A new coumarin derivative from the stems of the endangered plant Ulmus elongata.

A preliminary phytochemical investigation of the stems of the endangered plant Ulmus elongata led to the isolation of a new coumarin derivative (named ulmuselactone A, 1) and eight known compounds (2-9). The new structure was elucidated by detailed analysis of comprehensive spectroscopic methods, and its absolute configuration was established by comparing experimental and calculated electronic circular dichroism (ECD) spectra. The isolated compounds were evaluated for their antibacterial activities.