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

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

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

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

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

BACKGROUND Fever is a common cause of medical consultation and hospital admission,particularly among children.Recently,the United Kingdom’s National Institute for Health and Care Excellence(NICE)updated its guidelines for assessing fever in children under five years of age.The efficient assessment and management of children with fever are crucial for improving patient outcomes.AIM To evaluate fever assessment in hospitalized children and to assess its adherence with the NICE Fever in under 5s guideline.METHODS We conducted a retrospective cohort review of the electronic medical records of children under five years of age at the Department of Pediatrics,Salmaniya Medical Complex,Bahrain,between June and July 2023.Demographic data,vital signs during the first 48 h of admission,route of temperature measurement,and indications for admission were gathered.Fever was defined according to the NICE guideline.The children were divided into five groups according to their age(0-3 months,>3-6 months,>6-12 months,>12-36 months,and>36-60 months).Patients with and without fever were compared in terms of demography,indication for admission,route of temperature measurement,and other vital signs.Compliance with the NICE Fever in the under 5s guideline was assessed.Full compliance was defined as>95%,partial compliance as 70%-95%,and minimal compliance as≤69%.Pearson’sχ^(2),Student’s t test,the Mann-Whitney U test,and Spearman’s correlation coefficient(rs)were used for comparison.RESULTS Of the 136 patients reviewed,80(58.8%)were boys.The median age at admission was 14.2[interquartile range(IQR):1.7-44.4]months,with the most common age group being 36-60 months.Thirty-six(26.4%)patients had fever,and 100(73.6%)were afebrile.The commonest age group for febrile patients(>12-36 months)was older than the commonest age group for afebrile patients(0-3 months)(P=0.027).The median weight was 8.3(IQR:4.0-13.3)kg.Patients with fever had higher weight than those without fever[10.2(IQR:7.3-13.0)vs 7.1(IQR:3.8-13.3)kg,respectively](P=0.034).Gastrointestinal disease was the leading indication for hospital admission(n=47,34.6%).Patients with central nervous system diseases and fever of unknown etiology were more likely to be febrile(P=0.030 and P=0.011,respectively).The mean heart rate was higher in the febrile group than the afebrile group(140±24 vs 126±20 beats per minute,respectively)[P=0.001(confidence interval:5.8-21.9)]with a positive correlation between body temperature and heart rate,r=0.242,n=136,P=0.004.A higher proportion of febrile patients received paracetamol(n=35,81.3%)compared to the afebrile patients(n=8,18.6%)(P<0.001).The axillary route was the most commonly used for temperature measurements(n=40/42,95.2%),followed by the rectal route(n=2/42,4.8%).The department demonstrated full compliance with the NICE guideline for five criteria:the type of thermometer used,route and frequency of temperature measurement,frequency of heart rate measurement,and use of antipyretics as needed.Partial compliance was noted for two criteria,the threshold of fever at 38°C or more,and the respiratory rate assessment in febrile patients.Minimal compliance or no record was observed for the remaining three criteria;routine assessment of capillary refill,temperature reassessment 1-2 h after each antipyretic intake,and refraining from the use of tepid sponging.CONCLUSION This study showed that fever assessment in hospitalized children under five years of age was appropriate,but certain areas of adherence to the NICE guideline still need to be improved.

Review on the Development of Cosmetic Industry from the Perspective of Group Standards

From the perspective of group standards, the dynamics of the cosmetic industry in the past few years were briefly reviewed and analyzed, including the number of group standards published, types of group standards, groups, and geographical distribution of the groups. The large number of participating groups and the wide range of geographical distribution indicated that group standards could play a positive role in the sustained and positive development of cosmetic industry. The future development of cosmetic industry was also prospected。

Formulation of Work-Study Combined and Result-Oriented Integrated Curriculum Standards

According to the Annex Technical Regulations for Integrated Curriculum Development(Trial)in Document No.30 of the General Office of the Ministry of Human Resources and Social Security(2012),this paper studies the formulation of the curriculum standards for the integration of Chinese medicinal materials production.We focus on the formulation ideas of the curriculum standards for the integration of Chinese medicinal materials production,the formulation process of the curriculum standards for the integration of Chinese medicinal materials production,including the description of typical work tasks,the determination of curriculum objectives,the analysis of study content,the description of referential study tasks,teaching implementation suggestions,assessment and evaluation suggestions,which can provide a reference for the development and research of other related integrated courses.

Analysis of Standards and Effects of Police Indirect Court of Human Rights——Taking“Akbay and Others v.Germany”as an Example

The European Court of Human Rights(ECtHR)has ruled that illegal indirect entrapment must meet three criteria simultaneously.This mixed standard requires that the previous direct entrapment violates the“essentially passive,”subsequent indirect entrapment satisfies the“reasonable foreseeability,”and police entrapment of secondary defendants to commit crimes is considered“decisive.”The legal consequences of indirect entrapment are distinguished between general indirect entrapment and illegal indirect entrapment.The basic position of the ECtHR on the consequences of illegal indirect entrapment has shifted from supporting mitigating penalties to recognizing procedural dismissal,and general indirect entrapment is considered a mitigating factor in sentencing.Against the backdrop of increasing internationalization of criminal justice standards,the above criteria and positions have strong implications for the improvement of relevant rules in China.

Analysis of Standards Establishment for the Testing of Electrical Appliances

As science and technology continue to develop,power equipment has become an indispensable part of industrial production and daily life.Whether it is the precise automation machinery utilized on production lines or the convenient electrical appliances found in households,their functionality relies heavily on electrical technology.Nonetheless,without stringent safety and performance assurances,these devices could potentially endanger lives and property.Thus,this paper explores the development strategy for establishing a standardized system within the electrical testing service industry,aiming to ensure safety and reliability.

Preliminary Study on Overseas Applicability of Chinese Architectural Design Standards:Taking China-Aided Construction Projects in Asia Since the Belt and Road Initiative as Examples

This research takes China-aided construction projects in Asia since the Belt and Road Initiative as examples to explore the applicability of Chinese architectural design standards in other Asian countries.So far,the standards demonstrated the highest applicability in South Asia is the best followed by Southeast Asia.Chinese architectural design standards for educational buildings showed the highest applicability,followed by office,medical,and sports buildings.This study puts forward some strategies to improve the applicability of Chinese architectural design standards.These strategies include integrating regionalism and local cultural traditions,optimizing energy efficiency,and aligning designs with local usage habits.This study serves as a reference for similar projects in the future.

Revitalizing case reports: Standardized guidelines and mentorship

Despite a decrease in publication,case reports remain essential in medical literature as they offer detailed descriptions of individual patient cases and valuable insights for future management.These reports adhere to a standardized structure comprising sections such as abstract,introduction,case report,discussion,and conclusion.Obtaining informed consent and adhering to guidelines is essential.Case reports contribute to evidence-based medicine by detecting new therapies and adverse events.They also facilitate clear reporting,guideline adherence,and mentorship programs.These reports are vital for documenting rare occurrences,assisting clinicians in timely management,and communicating novel information to busy medical professionals.Following case report guidelines ensures comprehensive and standardized reporting,enhancing the acceptance and quality of case reports,and advancing medical knowledge.

Management guidelines for primary lung cancer 2018: Chinese standards in clinical practice

Chinese guidelines for diagnosis and treatment of primary lung cancer 2018 are a set of clinical standards for screening, diagnosis and treatment of lung cancer in China (1). It covers the specialties of epidemiology, radiology, pathology, surgery, medical oncology, radiotherapy, endoscopy, nuclear medicine, and so on. The guidelines are referred to by physicians, medical students and patients, through providing comprehensive and detailed knowledge and recommendations in clinical practice on lung cancer diagnosis and treatment.

Guidelines and standards for comprehensive clinical diagnosis and interventional treatment for diabetic foot in China(Issue 7.0)

Diabetic foot(DF)is one of the most common complications of diabetes and is associated with high morbidity,disability,lethality and low cure-rate.The clinical diagnosis and treatment of DF need to be standardized.The Chinese Diabetic Foot Cell and Interventional Therapy Technology Alliance has released six editions of guidelines and standards for clinical diagnosis and interventional treatment of DF,which filled the gap in the domestic DF treatment standard and played an important role in improving the level of diagnosis and treatment in China.In line with the latest developments in diagnosis and treatment,the Alliance,along with other 89 institutions,developed and issued the new edition based on the sixth edition to help standardize the clinical diagnosis and treatment of DF in China.

A Study of CFL Teacher Competency in the U.S.: An Overview of Professional Guidelines, Resources, and Standards

Chinese as a foreign language (CFL) is a critical language in the United States, and the importance to have competent CFL teachers has been more and more realized. However, the literature does not show sufficient research on CFL teacher competency. To fill the gap, a series of exploratory research studies are initiated. As a part of the initiation, this study overviews the professional guidelines, resources, standards and requirements for CFL education in the U.S. at the national and state levels. The findings will be useful for designing teacher education program and teacher training program. In addition, student teachers, pre-service teachers, and in-service teachers can also use them as great references for their academic and/or professional development.

International experts consensus guidelines on robotic liver resection in 2023

The robotic liver resection(RLR)has been increasingly applied in recent years and its benefits shown in some aspects owing to the technical advancement of robotic surgical system,however,controversies still exist.Based on the foundation of the previous consensus statement,this new consensus document aimed to update clinical recommendations and provide guidance to improve the outcomes of RLR clinical practice.The guideline steering group and guideline expert group were formed by 29 international experts of liver surgery and evidence-based medicine(EBM).Relevant literature was reviewed and analyzed by the evidence evaluation group.According to the WHO Handbook for Guideline Development,the Guidance Principles of Development and Amendment of the Guidelines for Clinical Diagnosis and Treatment in China 2022,a total of 14 recommendations were generated.Among them were 8 recommendations formulated by the GRADE method,and the remaining 6 recommendations were formulated based on literature review and experts’opinion due to insufficient EBM results.This international experts consensus guideline offered guidance for the safe and effective clinical practice and the research direction of RLR in future.

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

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

Intensified, optimized and standardized management of Chinese patients with hypertension: Comments on “2018 Chinese Guidelines for Prevention and Treatment of Hypertension”

The “2018 Chinese Guidelines for Prevention and Treatment of Hypertension”[1](hereinafter referred to as the 2018 Guidelines) published in this issue was revised by the Guidelines Revision Committee which is initiated and organized by the Chinese Hypertension League.Based on the “2010 Chinese Guidelines for the Management of Hypertension” and recent evidence from domestic and international research in the field of hypertension,considering national conditions and the current situation of hypertension management in China,and reference to the latest European and American hypertension guidelines,the 2018 Guidelines make comprehensive and in-depth elaborations and recommendations of the diagnosis and assessment of hypertension,strategies and goals of prevention and treatment of hypertension and pathway of intervention,etc.The 2018 Guidelines not only provide Chinese medical personnel with guidance and reference for the clinical practice and population management of hypertension,but also serve as the latest textbook on updating concepts and knowledge in the field of hypertension.

Accuracy Assessment and Guidelines for Manual Traffic Counts from Pre-Recorded Video Data

Traffic count is the fundamental data source for transportation planning, management, design, and effectiveness evaluation. Recording traffic flow and counting from the recorded videos are increasingly used due to convenience, high accuracy, and cost-effectiveness. Manual counting from pre-recorded video footage can be prone to inconsistencies and errors, leading to inaccurate counts. Besides, there are no standard guidelines for collecting video data and conducting manual counts from the recorded videos. This paper aims to comprehensively assess the accuracy of manual counts from pre-recorded videos and introduces guidelines for efficiently collecting video data and conducting manual counts by trained individuals. The accuracy assessment of the manual counts was conducted based on repeated counts, and the guidelines were provided from the experience of conducting a traffic survey on forty strip mall access points in Baton Rouge, Louisiana, USA. The percentage of total error, classification error, and interval error were found to be 1.05 percent, 1.08 percent, and 1.29 percent, respectively. Besides, the percent root mean square errors (RMSE) were found to be 1.13 percent, 1.21 percent, and 1.48 percent, respectively. Guidelines were provided for selecting survey sites, instruments and timeframe, fieldwork, and manual counts for an efficient traffic data collection survey.

Evidence-based guidelines for greener,healthier,more resilient neighbourhoods:Introducing the 3–30–300 rule

The important contributions of urban trees and green spaces to for example,climate moderation and public health have been recognized.This paper discusses guidelines and norms that promote the benefi ts of viewing green,living amongst green,and having easy access to green spaces for recreational use.Having trees and other vegetation in sight from one’s home,place of work,or school has important mental health and performance benefi ts.Local tree canopy cover is positively associated with cooling and other aspects of climate moderation.With public green spaces in proximity to one’s home stimulates regular use of these areas and results in positive impacts on mental,physical,and social health.After analyzing existing guidelines and rules for urban green space planning and provision,a new,comprehensive guideline is presented,known as the‘3–30–300 rule’for urban forestry.This guideline aims to provide equitable access to trees and green spaces and their benefi ts by setting the thresholds of having at least 3 well-established trees in view from every home,school,and place of work,no less than a 30%tree canopy in every neighbourhood;and no more than 300 m to the nearest public green space from every residence.Current implementation of this new guideline is discussed,as well as the advantages and disadvantages of using this evidence-based but also clear and simple rules.

The impact of the Rural Minimum Living Standard Guarantee(Rural Dibao)Program on child nutrition outcomes

The Rural Minimum Living Standard Guarantee(Rural Dibao)is an important unconditional cash transfer program to alleviate poverty in rural China.Despite the importance of children’s nutrition in breaking poverty cycles,little is known about the impact of Rural Dibao on child nutrition outcomes.Using China Family Panel Studies(CFPS),this paper examines the effects of Rural Dibao on child nutrition outcomes and investigates potential pathways and heterogeneous effects.We exploit propensity score matching and difference-in-differences techniques to evaluate the effects of the Rural Dibao program on child nutrition outcomes.Our results suggest that Rural Dibao significantly impacts the nutrition outcomes of children up to 15 years of age.Specifically,our results suggest that Rural Dibao improves child height-to-age z-scores by 1.05 standard deviations and lowers the probability of stunting by 11.9 percentage points.Additional analyses suggest that increased protein intake is the main pathway through which Rural Dibao participation contributes to better nutrition outcomes.We also find that the effect of the program is more pronounced among girls,children who are non-left-behind or live with highly educated mothers,and those from low-income families and poor areas.Our findings suggest that Rural Dibao participation helps improve child nutrition outcomes through improving diet quality.

Guidelines for the application of artificial intelligence in the diagnosis of anterior segment diseases(2023)

The landscape of ophthalmology has obser ved monumental shifts with the advent of artificial intelligence(AI)technologies.This article is devoted to elaborating on the nuanced application of AI in the diagnostic realm of anterior segment eye diseases,an area ripe with potential yet complex in its imaging characteristics.Historically,AI’s entrenchment in ophthalmology was predominantly rooted in the posterior segment.However,the evolution of machine learning paradigms,particularly with the advent of deep learning methodologies,has reframed the focus.When combined with the exponential surge in available electronic image data pertaining to the anterior segment,AI’s role in diagnosing corneal,conjunctival,lens,and eyelid pathologies has been solidified and has emerged from the realm of theoretical to practical.In light of this transformative potential,collaborations between the Ophthalmic Imaging and Intelligent Medicine Subcommittee of the China Medical Education Association and the Ophthalmology Committee of the International Translational Medicine Association have been instrumental.These eminent bodies mobilized a consortium of experts to dissect and assimilate advancements from both national and international quarters.Their mandate was not limited to AI’s application in anterior segment pathologies like the cornea,conjunctiva,lens,and eyelids,but also ventured into deciphering the existing impediments and envisioning future trajectories.After iterative deliberations,the consensus synthesized herein serves as a touchstone,assisting ophthalmologists in optimally integrating AI into their diagnostic decisions and bolstering clinical research.Through this guideline,we aspire to offer a comprehensive framework,ensuring that clinical decisions are not merely informed but transformed by AI.By building upon existing literature yet maintaining the highest standards of originality,this document stands as a testament to both innovation and academic integrity,in line with the ethos of renowned journals such as Ophthalmology.