INTRODUCTION:External applications historically are a part of healthcare and nursing. They encompass therapeutic interventions based on naturopathy that act on the skin and nervous system through direct or indirect touch. PROBLEM STATEMENT:Despite having been in use for many years, there is still no standard definition. METHODS:To address this gap, a definition was developed as part of an integrative literature review and agreed upon using the Policy Delphi method. RESULTS:The resulting definition comprises three key sections: 1) the characteristics of external applications, 2) their mechanisms of action, and 3) the various types of application. The findings show that external applications are complex interventions that influence physiological, psychological and social aspects of human beings and can be used in a targeted manner in professional nursing and healthcare settings. CONCLUSION:The definition developed provides a basis for further research, integration into nursing practice, and for training and quality assurance measures.
Background: Clinical Verification in Homoeopathy is a systematic scientific procedure that confirms the therapeutic utility of homoeopathic medicines. Despite its referencing in homoeopathic literature, Datura metel remains fragmentarily verified and rarely prescribed. To address this gap, the Central Council for Research in Homoeopathy (CCRH) conducted clinical verification of the medicine to assess its clinical utility and expand its therapeutic potential. Methods: A multicentric open-label single-arm study was carried out across the outpatient departments of the 14 health facilities of CCRH situated in various regions of India. 341 participants with atleast three symptoms corresponding to the proven symptomatology of Datura metel were enrolled and prescribed the medicine. Response to treatment was assessed using validated outcome measures, namely, Measure Yourself Medical Outcome Profile (MYMOP-2) and Outcome in Relation to Impact on Daily Living (ORIDL) scores. Additionally, the emergence of clinical symptoms after medicine administration was documented. Results: A statistically significant improvement was observed in the scores of MYMOP-2 and ORIDL scale (p < 0.0001****) of 211 participants who completed atleast two follow-ups. The therapeutic action of this medicine was clinically verified across a range of common clinical conditions, including rhinitis, arthralgia, dyspepsia, dysmenorrhoea, dermatitis, headache, and sinusitis. Conclusion: This study is the first systematic effort to investigate the therapeutic attributes of the homoeopathic medicine Datura metel and contributed to developing preliminary evidence on its clinical profile. Future research with more rigorous, in-depth and controlled methodologies will contribute to build up the therapeutic profile of this medicine.
INTRODUCTION:Burns are a prevalent form of injury that can be found throughout the world. The most common causes of burns are fire and flame, scalding, contact with objects, electrical, and chemical. The aim of this study was to conduct a systematic review on the efficacy of herbal medicine in the treatment of burn wounds. METHODS:This systematic review adhered to the principle set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for performing the literature search. An amount of 1,282 publications were found via searches of six literature databases. The PRISMA process was then applied to systematically review the literature, with 50 articles excluded due to duplicates. The titles and abstracts of the remaining studies were assessed for relevance, and 1,216 were found to not meet the inclusion criteria. RESULTS:After further review of the relevant literature for eligibility, a total of 16 papers were chosen for inclusion in this study. This review highlights that Aloe vera is the most commonly used plant for burn wounds, offering numerous benefits such as reducing inflammation, aiding proliferation, and supporting remodeling. CONCLUSION:This review highlights the potential of herbal therapies in burn wound healing, with herbs promoting re-epithelialization, collagen synthesis, and angiogenesis. Their bioactive compounds offer anti-inflammatory, antimicrobial, and regenerative benefits. Further research is needed to clarify their mechanisms and standardize clinical use, with the integration of herbal treatments potentially enhancing burn care and improving patient outcomes.
IMPORTANCE:Postoperative cognitive dysfunction (POCD) is a common complication in elderly patients, yet effective preventive strategies remain limited. The combined efficacy of electroacupuncture (EA) and dexmedetomidine in this context is unclear. OBJECTIVE:To investigate the effects of electroacupuncture combined with dexmedetomidine on the incidence of POCD and postoperative inflammatory factors in elderly patients undergoing hip or knee arthroplasty. METHODS:In this single-center, prospective, randomized controlled trial, 120 elderly patients were randomly assigned to three groups: the electroacupuncture (EA) group, the dexmedetomidine (D) group, and the combination (ED) group. All participants underwent elective hip or knee arthroplasty. Primary outcomes and measurements: The primary outcome was the incidence of POCD assessed by the Mini-Mental State Examination (MMSE) at 1 month postoperatively. Secondary outcomes included serum levels of S-100β, TNF-α, and IL-6, as well as postoperative Visual Analog Scale (VAS) pain scores. RESULTS:Of the 120 randomized participants (mean [SD] age, 72.9 ± 5.9 years), 113 completed the study. The incidence of POCD was significantly lower in the EA+Dex group (10%) compared with the EA group (30%) and the Dex group (32.5%) (P < 0.05). Additionally, postoperative serum levels of S-100β, TNF-α, and IL-6 were significantly reduced in the combination group compared with the monotherapy groups (P < 0.05). CONCLUSION:The findings suggest that the combined application of electroacupuncture and dexmedetomidine may be associated with a lower incidence of POCD at 1 month after hip or knee arthroplasty in elderly patients. The observed reduction in serum biomarkers indicates a potential role in modulating neuroinflammation, though further multicenter studies are warranted to validate these findings and elucidate the precise mechanisms.
INTRODUCTION:Emerging evidence has suggested complex relationships between glucose metabolism and pulmonary health. However, the nature of the association between fasting plasma glucose (FPG) and lung function remains inadequately characterized. This study aimed to explore this association and provide further evidence. METHODS:This cross-sectional study analyzed data from 6,597 adults in a Chinese health check-up cohort. Lung function was classified into two groups: normal and abnormal. Binary logistic regression was performed to identify the association between FPG and the risk of lung function abnormalities. Restricted cubic splines (RCS) were used to model the FPG-lung function relationship, stratified by sex, age, and BMI. RESULTS:A significant non-linear dose-response relationship (p < 0.05) was found between FPG and lung function abnormalities. RCS analysis showed that increasing FPG from 4.78 to 5.6 mmol/L elevated the risk of lung function abnormalities by 32.0% (OR = 1.32, 95% CI: 1.17-1.49). Gender disparities were evident, with women exhibiting a steeper risk gradient (OR = 1.43 vs. 1.29 in men). Overweight/obese individuals (BMI ≥24 kg/m²) demonstrated a stronger association (OR = 1.45) compared to those of normal weight (OR = 1.21). CONCLUSION:FPG was determined to be an independent predictor of lung function abnormalities, exhibiting a pronounced non-linear dose-response relationship. Maintaining FPG below 5.6 mmol/L may help prevent lung function impairment, underscoring the importance of early glycemic monitoring in predicting lung function.
OBJECTIVE:This study aims to clarify the effects of processing on the medicinal properties of the Herba Siegesbeckiae(HS), and to determine its regulatory on the neural-endocrine-metabolic enzymes in the rat and the attribution of its components. METHODS:D101 macroporous resin was adopted to isolate chemical component clusters (CCCs) from raw and processed HS. A neuro-endocrine-metabolic network was used to characterize medicinal properties. The indicators of antipyretic, analgesia, anti-inflammatory, and liver-tonifying and kidney-reinforcing were performed to determine medicinal flavor, while an electronic tongue was applied for gustatory taste quantification. Chemometric analyses were used to explore the influence of processing on HS and its CCCs. RESULTS:Raw HS and its CCCs suppressed neuro-endocrine-metabolic enzyme activities, corresponding to a cold medicinal property, whereas processed HS and its CCCs exerted opposite effects and displayed warm properties. The medicinal flavor results showed that S30, S70 and Z70 contributed to the pungent, bitter, sweet flavor respectively. The taste results demonstrated that the bitter taste of raw HS primarily originated from S95 and S70, and Z70 functioned as the core CCCs responsible for elevated sweetness after processing. CONCLUSIONS:Z70 acts as the pivotal component coordinating processing-triggered synchronous changes in medicinal properties and medicinal flavors of HS.
INTRODUCTION:Hyperandrogenism (HA) is a common endocrine disorder marked by excessive androgen secretion and substantial adverse effects on women's health. HA patients included both lean and obese individuals with distinct symptoms. HA was treated through diverse methods, with dietary control being a key element. However, research on diets for lean HA patients was limited. We aimed to investigate the relationship between dietary intake and the risk of HA in lean adult women. METHODS:This study conducted a secondary analysis of 2013-2016 National Health and Nutrition Examination Survey (NHANES) data to investigate diet-HA associations in reproductive-aged lean adult women (BMI <25 kg/m2) using multivariable logistic regression and restricted cubic spline modeling. RESULTS:The study cohort included 1,141 participants, with 10.95% identified as having at-risk HA. Significant differences in testosterone levels and free androgen index were observed between at-risk HA and non-risk HA groups. Intake of saturated fatty acids (SFAs) and protein was significantly lower in the at-risk HA group compared to the non-risk HA group. Weighted regression analysis revealed a significant negative correlation between SFA/protein intakes and HA risk. Restricted cubic spline analysis further demonstrated a significant nonlinear relationship between SFA intake and both at-risk HA and testosterone levels. CONCLUSION:Among lean adult women in the USA, dietary intake of SFA and protein was negatively correlated with the risk of HA. This finding may point to a potential role of SFA and protein intake in HA risk modulation among lean adult women.
INTRODUCTION:The aim of this study was to evaluate the clinical efficacy of traditional Chinese acupoint massage (TCAM) combined with tailored tai chi on pain, disability, and selected quality-of-life domains in patients with lumbar disc herniation (LDH). METHODS:Seventy-two patients with LDH and low back pain (LBP) were randomly assigned to an intervention group (IG, TCAM + tailored tai chi, n = 36) or a control group (CG, TCAM alone, n = 36). Interventions were conducted 3 times per week for 4 weeks. The primary outcome was Oswestry Disability Index (ODI). Secondary outcomes included the visual analog scale (VAS, 0-10 points) and selected domains of the 36-Item Short Form Health Survey (SF-36). Baseline participant and therapist expectation scores were recorded, and sensitivity analyses were performed adjusting for these scores. ANCOVA adjusted for baseline outcome values, age, sex, and disease duration was used for between-group comparisons. Bonferroni correction was applied for SF-36 subscales. RESULTS:The primary outcome ODI decreased significantly more in the IG than in the CG (from 26.58 ± 7.79 to 9.67 ± 3.10 vs. 28.72 ± 9.25 to 15.69 ± 4.26; adjusted mean difference = 3.88, 95% CI: 0.50-7.27, p = 0.026). VAS scores improved on the 0-10 scale from 6.47 ± 1.47 to 2.21 ± 0.96 in the IG and from 6.71 ± 1.32 to 2.92 ± 0.99 in the CG, with an adjusted between-group difference of 0.47 (95% CI: 0.18-1.43, p = 0.012). Among SF-36 subscales, significant between-group differences after Bonferroni correction were observed in physical functioning, bodily pain, vitality, and mental health. Sensitivity analyses adjusting for expectation scores yielded consistent results. The total effective rate was 94.44% in the IG vs. 83.33% in the CG (p = 0.26). CONCLUSION:TCAM combined with tailored tai chi significantly improved functional disability, pain intensity, and selected quality-of-life domains compared with TCAM alone over 4 weeks. Sensitivity analyses suggest that these effects are robust and independent of baseline expectation scores. This multimodal physical therapy may be considered a complementary conservative treatment for patients with LBP due to LDH.
INTRODUCTION:Mood disorders are a leading cause of disability, with a substantial proportion of patients failing to respond adequately to first-line medications. Complementary interventions are thus being explored to augment standard treatment strategies. This review aimed to systematically map and describe the existing literature on the therapeutic potential of gotu kola (Centella asiatica), phosphatidylcholine, and taurine - the active nutraceutical constituents of Neurotain® Plus - in mood disorders and to assess whether the available evidence is sufficient to support subsequent meta-analyses. METHODS:A scoping review was conducted in accordance with the JBI methodology and reported following the PRISMA-ScR guideline. PubMed, Web of Science, and Scopus were systematically searched for studies evaluating the mood-related behavioral effects of gotu kola, phosphatidylcholine, and taurine. The protocol for this review was prospectively registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/ETRZP). RESULTS:Of the 2,238 identified citations, 29 were included: 12 on gotu kola (three human studies, n = 91; nine animal studies), three on phosphatidylcholine (two human studies, n = 7; one animal study), and 14 on taurine (one human study, n = 130; 13 animal studies); none evaluated any combination of these compounds. Across included studies, substantial methodological heterogeneity in design, population, intervention, and outcome measures indicates that the current evidence base remains insufficient to support quantitative synthesis. For gotu kola, two randomized trials in healthy participants (n = 58) reported improvements in alertness, while an open-label study in generalized anxiety disorder patients (n = 33) reported reductions in anxiety and depressive symptoms. Animal studies consistently demonstrated antidepressant-like effects in stress-induced models, whereas effects in non-stressed rodents were generally neutral; findings for anxiety-related outcomes were variable. For phosphatidylcholine, limited human evidence from patients with bipolar disorder suggested improvements in manic symptoms and mood stability, including sustained euthymia or remission, while an animal study demonstrated antidepressant-like effects and reversal of stress-induced cognitive impairment. For taurine, a case-control study found no association between dietary taurine intake and depression. Animal studies generally demonstrated antidepressant- and anxiolytic-like effects, particularly in stress-induced models, although findings were mixed and at times context-dependent. No serious adverse events were reported in any included human study. CONCLUSION:This review identified preliminary, hypothesis-generating evidence suggesting that gotu kola, phosphatidylcholine, and taurine may exert mood-related behavioral effects individually. However, the current evidence base remains limited, consisting primarily of animal experiments and small-scale human investigations exhibiting substantial methodological limitations and heterogeneity, precluding meaningful meta-analytic synthesis. The absence of studies evaluating the full three-component Neurotain® Plus formulation or any combination of its constituents represents an important gap in the existing literature. Randomized clinical trials and mechanistic investigations are warranted to clarify the therapeutic relevance, safety, and potential interactions of these compounds.
Introduction Traditional Chinese Medicine (TCM) becomes popular in Switzerland; however, Swiss TCM research activity and scientific output have not been investigated. Methods To describe the Swiss TCM research activities and main health conditions studied, a systematic literature search of PubMed (covering databases such as MEDLINE, life science journals and online books) and Embase was performed from database inception to December 31st, 2023. Articles describing a TCM-related therapy modality in humans with at least one author affiliated with a Swiss institution. Primary outcome was the main health condition studied. Secondary outcomes are the total number of articles published over time, the TCM therapies used, and the Swiss institutions involved. Results Of the 223 published articles included in the final analysis, 68.2% originated from the top 3 of 73Swiss institutions: the University of Zurich (32.3%), University of Bern (30.0%) and University of Basel (7.6%). Overall, 116 (52.0%) articles described original studies containing primary data. The top health categories studied were pain management (16.4%). The most used TCM therapies were acupuncture or moxibustion (61.2%). Conclusion Until 2023, the total number of scientific TCM output by Swiss authors is steadily increasing but remains small. More effort to conducted TCM research and elucidate the TCM therapy effects in Switzerland is warranted.
Introduction: Parkinson’s disease (PD) is characterized by the progressive degeneration of dopaminergic neurons, leading to motor and non-motor symptoms. Current therapeutic options for PD have limited efficacy and cause significant side effects, necessitating the development of novel therapeutic strategies. In this study, we investigated the neuroprotective effects of the cortex of Albizia julibrissin Durazzini (AC) and stems and branches of Uncariae rhynchophylla (Miq.) Miq. (UR), individually and in combination, in cellular and animal models of PD. Methods: We evaluated the neuroprotective effects of the water extract of AC and UR individually in 6-hydroxydopamine (6-OHDA)-treated PC12 cells using the MTT assay. Combination index (CI) analysis was employed to determine the optimal AC:UR ratio for synergistic effects. The bioactivity of individual herbs and their optimized combination was assessed in 6-OHDA-lesioned mice through behavioral tests (pole, rotarod, and apomorphine-induced rotation) and immunohistochemical analysis of dopaminergic neurons in the striatum and substantia nigra pars compacta. Results: Both herbal remedies exhibited neuroprotective effects in 6-OHDA-treated PC12 cells. A 2:1 ratio of AC-to-UR yielded the most potent synergistic neuroprotective effect (CI = 0.38459), significantly improving motor function in 6-OHDA-lesioned mice. Immunohistochemical analysis revealed that the 2:1 AC-to-UR combination significantly protected dopaminergic neurons against 6-OHDA-induced neurodegeneration with efficacy comparable to or exceeding standard levodopa/benserazide treatment. Conclusion: Our findings establish a foundation for developing multi-target therapies based on natural products that may offer comprehensive neuroprotection with potentially fewer side effects than conventional pharmaceuticals.
INTRODUCTION:Nicotine contributes to chronic pulmonary diseases by promoting oxidative stress, inflammation, and tissue remodeling, leading to alveolar destruction, septal thickening, and fibrosis. Althaea officinalis (AO), a medicinal plant with antioxidant and anti-inflammatory properties, may counteract these effects; however, its protective role against nicotine-induced lung injury is not well characterized. This study aimed to evaluate the impact of AO on nicotine-related oxidative and histological lung damage in rats. METHODS:Thirty-two female Wistar albino rats were divided into four groups: control, AO (250 mg/kg), nicotine (0.5 mg/kg), and AO + nicotine. Treatments were administered for 14 days. Lung tissues were collected for biochemical and histopathological analyses. Oxidative stress was assessed by measuring superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels. Lung injury was evaluated using hematoxylin-eosin and Masson's trichrome staining, while apoptosis was assessed by Bax immunostaining. RESULTS:Nicotine exposure increased MDA levels, Bax expression, and histological damage, while reducing SOD activity. AO co-treatment significantly reversed these effects by lowering MDA levels, reducing Bax immunoreactivity, restoring SOD activity, and improving lung architecture, including reduced alveolar destruction and septal thickening (p < 0.05). CONCLUSION:AO demonstrated notable antioxidant and cytoprotective effects against nicotine-induced lung injury. Its ability to reduce oxidative stress, apoptosis, and tissue damage suggests therapeutic potential for preventing pulmonary oxidative injury, supporting further research for possible clinical application.
INTRODUCTION:Complementary and alternative medicine (CAM) is frequently used by individuals with chronic diseases, including diabetes mellitus. However, data regarding CAM use and attitudes among patients with diabetes in primary care settings remain limited, particularly in community-based populations. METHODS:A cross-sectional study was conducted among 363 patients aged 18 years and older who were recruited through consecutive convenience sampling at family health centers and who presented for any reason between July and August 2023. Data were collected through face-to-face interviews. Instruments included a structured questionnaire (assessing sociodemographic and clinical characteristics and CAM-related variables) and the Complementary, Alternative, and Conventional Medicine Attitudes Scale (CACMAS). RESULTS:Of the participants, 61.2% were female, the mean age was 59.8 ± 11.3 years, and the mean duration of diabetes was 9.2 ± 6.2 years. While 51.2% of participants were aware of CAM, 28.1% reported using at least one CAM modality - most frequently cupping and acupuncture - within the previous 12 months. The median CACMAS score was 97.0 (Q1-Q3: 90.0-108.0; range: 45.0-176.0). Higher CACMAS scores were observed among participants aged <65 years (p = 0.008), those with higher educational attainment (p = 0.001), higher income levels (p = 0.004), insulin users (p = 0.002), and CAM users (p < 0.001). In the multivariable regression analysis, higher monthly income remained the only variable associated with higher CACMAS scores (B = 5.82, 95% CI: 0.28-11.37, p = 0.040). CONCLUSION:In this cross-sectional primary care sample, CAM use and attitudes were associated with several sociodemographic and clinical characteristics; however, in the adjusted analysis, higher income was the only variable associated with more favorable CAM attitudes. As family physicians are often the first point of contact for individuals with diabetes, routinely inquiring about CAM use may support patient-centered care and facilitate communication between patients and healthcare providers. These findings reflect associations within the study sample rather than population-level prevalence estimates.
INTRODUCTION:Neurological disorders are increasingly prevalent among older adults in India, often resulting in significant motor and non-motor impairments. There is a rising rates of elder care homes and the aging population, burdens the Parkinson's disease (PD) rising, particularly in countries with low- and middle-income. In response to this burden of neurodegenerative conditions including PD evidence-based, culturally adapted interventions such as yoga promise to offer holistic benefits. METHODS:A controlled clinical trial will evaluate the efficacy of a customized yoga therapy module for early parkinsonism by targeting motor and non-motor symptoms. We aimed to recruit 130 participants in a 1:1 ratio, of 45-80 years from elder care homes around Mangalore, India, using cluster sampling. Both groups will receive geriatric physiotherapy as standard of care, and the intervention group will receive 1-h yoga sessions, 5 days/week, for 24 weeks. Outcomes of quality of life, cognition, postural stability, gastrointestinal dysfunction symptoms, and sleep will be assessed at baseline, 12 weeks, and 24 weeks and analyzed using SPSS v25. This study was approved by the Institutional Ethics Committee (YEC2 Protocol No.: YEC2/2024/130) and registered in the Clinical Trials Registry of India - CTRI/2025/07/090595. CONCLUSION:The Department of Geriatric Medicine will initiate PD screening at the designated study sites. A symptom-targeted, participant-specific, customized yoga module was developed, validated, and evaluated by experts.
Introduction: Fatigue is one of the most common symptoms of post-COVID syndrome. The Chinese herbal medicine Shengmai liquid has been recorded in ancient books, and modern studies have shown its ability to relieve fatigue. This study aims to assess the clinical efficacy and safety of Shengmai liquid in improving fatigue symptoms in post-COVID syndrome patients. Methods: We plan to enroll 100 eligible patients with post-COVID-19 fatigue from Beijing Ditan Hospital, randomly allocating them into either the Shengmai liquid or placebo group. Blinding will be maintained for the personnel responsible for evaluating outcomes and performing statistical analysis. The participants will be treated for 8 weeks and followed for another 30 days. We utilized the modified Fatigue Impact Scale as our main endpoint to evaluate changes in patient fatigue. The secondary outcomes will include the Traditional Chinese Medicine Syndrome Score Scale, Hamilton Depression Inventory-17 items, Hamilton Anxiety Scale, Pittsburgh Sleep Quality Scale, World Health Organization Quality-of-Life Scale, and 6-min walk distance. All the statistical analyses will use SPSS software with a 0.05 significance level and follow the intention-to-treat principle. Conclusion: This randomized, single-center, double-blind trial will provide robust clinical evidence regarding the short-term efficacy and safety of Shengmai liquid for the treatment of post-COVID-19 fatigue.
Introduction: At present, bibliometric studies focusing explicitly on traditional Chinese medicine (TCM) nursing for patients with chronic obstructive pulmonary disease (COPD) and gastrointestinal (GI) dysfunction are limited, leaving critical gaps in understanding research dynamics and knowledge evolution. This study aimed to systematically analyse literature on TCM nursing interventions for COPD complicated by GI dysfunction, using bibliometric methods to identify research trends, thematic structures, and future research directions. Methods: This study conducted a bibliometric analysis of relevant literature. Publications from 2015 to 2025 on TCM nursing for COPD with GI dysfunction were retrieved from the Web of Science, PubMed, Scopus, and China National Knowledge Infrastructure. After removing duplicates, 1,563 relevant publications were analysed. Bibliographic data were extracted and analysed using CiteSpace, VOSviewer, and bibliometrix (R package). Results: Annual publication volume exhibited steady growth, peaking in 2024. China emerged as the primary research contributor, collaborating extensively with the USA, Australia, and European nations. Institutional analysis revealed key research centres predominantly located in China, with increasing international cooperation. Core authors, such as Chen Wang and Ke Huang, significantly influenced research collaboration networks. Major thematic clusters included pulmonary rehabilitation, quality of life improvement, gut-lung interactions, and molecular mechanisms. Landmark references reflected the growing integration of TCM nursing into conventional COPD care and the increasing attention on patient-centred outcomes. Conclusion: Research in this niche is increasingly oriented towards rehabilitation-focused integrative care and mechanism-informed perspectives (gut-lung axis). Future studies should prioritise a GI-inclusive core outcome set, standardised reporting of nursing-deliverable TCM modalities, and pragmatic/hybrid effectiveness-implementation designs aligned with gut-lung-related hypotheses.
INTRODUCTION:The aim of the study was to develop and externally validate machine learning (ML) models for predicting treatment response and adverse events in children with attention-deficit/hyperactivity disorder (ADHD) receiving acupuncture combined with conventional first-line care. METHODS:In this multicentre retrospective study, demographic, clinical, behavioral, and laboratory data from 809 children with ADHD aged 6-12 years were used to develop and evaluate ten ML models. Treatment response was defined as a ≥30% reduction in the Swanson, Nolan, and Pelham-IV total score 8-16 weeks after treatment initiation, and adverse events were recorded from parent reports. Model development used repeated 10-fold cross-validation, with evaluation in an internal testing cohort and two external cohorts. Discrimination, calibration, and clinical utility were assessed, and model interpretability was examined using SHapley Additive exPlanations. RESULTS:The extreme gradient boosting model demonstrated the best discriminative performance for predicting treatment response and was retained for further analyses. For treatment response prediction, it achieved an area under the receiver operating characteristic curve (AUROC) of 0.83 in the internal testing cohort and showed stable external performance, with AUROCs ranging from 0.78 to 0.87 across both external cohorts. For adverse event prediction, discriminative performance was moderate, with external AUROCs ranging from 0.73 to 0.85. Model interpretability analyses suggested that multiple clinical feature domains contributed to model predictions. CONCLUSION:Using routinely collected clinical data, ML-based models showed reproducible discrimination for predicting treatment response and adverse events in children with ADHD receiving acupuncture as adjunctive therapy. They may support individualized benefit-risk stratification in integrative treatment settings, although prospective assessment of clinical impact is warranted.
In studies of the etiology of ancient Chinese medicine, the Qi-based theory of infectious diseases is mainly grounded in climatic explanations and has long been familiar to both scholars and the general public. With the gradual deepening of research on medical traditions such as folk medicine and religious medicine in ancient China, the worm-centered theory of infectious diseases, which focuses on biological pathogens, has become increasingly prominent. Representative of this framework are the doctrines of Gu and the Jiuchong (Nine Worms). These doctrines attribute the onset and transmission of many infectious diseases to the invasion and movement of real or hypothetical pathogenic Chong (worms). Corresponding methods were proposed to treat patients and halt disease transmission, including medicinal therapy, physical isolation, personal cultivation, and even religious rituals. Research on these theories helps to comprehensively understand how infectious diseases were perceived and managed in ancient China.
INTRODUCTION:In specialized children's hospitals, patients with acute gastroenteritis received supportive anthroposophic drug and non-drug therapies to improve the course of disease. In addition to actual effectiveness of the therapy, parents' experience of the hospital stay is an important factor in children's recovery. Both effectiveness and satisfaction were assessed by a parent survey. METHODS:The results presented here are part of a non-controlled, prospective case series study conducted between April 2018 and April 2020 in a department of integrative medicine for children and adolescents in a German anthroposophic hospital. Parents of hospitalized children were invited to participate in a prospective longitudinal survey (t1: during hospital stay; t2: 4-6 weeks after discharge). The survey covered socio-demographic data, course of symptoms, parental satisfaction and factors influencing recovery. RESULTS:Data from 60/62 (t1) and 36/62 (t2) questionnaires were analysed. There was a reduction in symptoms during hospitalization. Parents rated the effectiveness of the therapy as good (1.8 ± 0.6; 1 = very good; 6 = very bad) and were very satisfied (1.5 ± 0.5). Parents of children older than one year were more satisfied than parents of younger children. Out of all treatments, parents felt that rehydration therapy, the anthroposophic concept of the hospital and anthroposophic medicines had the most positive impact on their children's recovery. CONCLUSION:Parents were highly satisfied and felt that the anthroposophic therapy concept had beneficial effects on the course of disease.
Network meta-analysis (NMA) plays an important role in comparative effectiveness research, particularly in fields such as traditional and complementary medicine, where multiple interventions often need to be assessed within a single evidence framework. However, conducting NMA remains labor-intensive, methodologically demanding, and difficult to complete efficiently using conventional workflows. Although recent advances in large language models have created new opportunities for supporting evidence synthesis, their routine use in NMA is still constrained by limited transparency, prompt dependency, and difficulty integrating with structured analytical procedures. In this study, we introduce SmartEBM, a web-based human-AI collaborative platform designed to support the full workflow of NMA. SmartEBM provides an integrated environment for title and abstract screening, full-text screening, data extraction, risk of bias assessment, statistical analysis, and certainty of evidence assessment. The platform is organized around a human-in-the-loop model, in which AI-assisted functions support repeated and labor-intensive tasks while researchers retain oversight of methodological judgement, verification, and final decision-making. Through its six functional modules, SmartEBM offers low-code interfaces, structured outputs, and verification-oriented workspaces that help connect major steps of evidence synthesis within one platform. Rather than functioning as a stand-alone automation tool, SmartEBM is intended as a practical platform for end-to-end NMA support. This platform-oriented approach may help make evidence synthesis more manageable, traceable, and accessible in routine research practice, especially in complex review settings.
