A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV) infected pneumonia(standard version)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

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.

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.

Levels of evidence and grades of recommendation supporting European society for medical oncology clinical practice guidelines

Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically investigated.This study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer settings.Methods:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each CPG.We examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer types.Results:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR A.Overall,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous versions.The proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current version.In the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)recommendations.Significant variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer types.Conclusion:One-third of the current ESMO CPG recommendations are supported by the highest level of evidence.More well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.

Systematic Security Guideline Framework through Intelligently Automated Vulnerability Analysis

This research aims to propose a practical framework designed for the automatic analysis of a product’s comprehensive functionality and security vulnerabilities,generating applicable guidelines based on real-world software.The existing analysis of software security vulnerabilities often focuses on specific features or modules.This partial and arbitrary analysis of the security vulnerabilities makes it challenging to comprehend the overall security vulnerabilities of the software.The key novelty lies in overcoming the constraints of partial approaches.The proposed framework utilizes data from various sources to create a comprehensive functionality profile,facilitating the derivation of real-world security guidelines.Security guidelines are dynamically generated by associating functional security vulnerabilities with the latest Common Vulnerabilities and Exposure(CVE)and Common Vulnerability Scoring System(CVSS)scores,resulting in automated guidelines tailored to each product.These guidelines are not only practical but also applicable in real-world software,allowing for prioritized security responses.The proposed framework is applied to virtual private network(VPN)software,wherein a validated Level 2 data flow diagram is generated using the Spoofing,Tampering,Repudiation,Information Disclosure,Denial of Service,and Elevation of privilege(STRIDE)technique with references to various papers and examples from related software.The analysis resulted in the identification of a total of 121 vulnerabilities.The successful implementation and validation demonstrate the framework’s efficacy in generating customized guidelines for entire systems,subsystems,and selected modules.

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 identity 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 depressive symptoms(n=9),and improving mood/well-being(n=8).Postpartum guidelines specified exercises to engage in,including pelvic floor 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.

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.

Research on the development methodology for clinical practice guidelines for organic integration of traditional Chinese medicine and Western medicine

Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.

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.

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.

The Impact of International Accounting Standards Board （IASB）＇s Guidelines for Preparing Management Commentary （MC）： Evidence From Italian Listed Firms

This paper investigates the Italian firms＇ disclosure in response to the new guidance on the management commentary （MC） contained in the International Financial Reporting Standard （IFRS） practice statement issued by International Accounting Standards Board （IASB） in 2010. The study is organized as follows. After reviewing the relevant literature on financial disclosure and MC, this paper examines the content of the Italian management＇s report-----known as ＂Relazione sulla Gestione＂ and that of the recent IASB＇s IFRS practice statement. Hence, it applies a self-constructed disclosure index and a multiple correspondence analysis （MCA） on MC of a sample of 66 Italian non-financial listed firms. The results show that the level of disclosures provided by the Italian listed firms does not seem to be affected by the IASB＇s guidelines. However, the survey highlights large differences in the level and type of disclosure provided in MC among the sectors and firms. This paper aims to contribute to the financial reporting debate by understanding the IASB＇s guidelines and their impacts on the voluntary disclosure practices of Italian listed firms.

Guidelines for diagnosis and treatment of advanced breast cancer in China(2022 edition)

Breast cancer is the most common cancer among women worldwide.It has been estimated that about 416000 new cases and over 117000 deaths of breast cancer occurred in China in 2020.Among the new cases of breast cancer diagnosed each year,3-10%have distant metastasis at the time of initial diagnosis.In addition,approxi-mately 30%of patients with early-stage breast cancer may eventually experience recurrence or metastases.The 5-year survival rate of patients with advanced breast cancer is only 20%with a median overall survival of 2-3 years.Although advanced breast cancer remains incurable at present,new therapeutic options and multidisci-plinary treatment could be utilized to alleviate symptoms,improve quality of life,and prolong patients’survival.The choice of treatment regimens for patients with advanced breast cancer is very important,and the optimal treatment strategy beyond the first-and second-line therapy is often lacking.Herein,the China Advanced Breast Cancer Guideline Panel discussed and summarized recent clinical evidence,updated the guidelines for the diag-nosis and treatment of advanced breast cancer based on the 2020 edition,and formulated the“Guidelines for diagnosis and treatment of advanced breast cancer in China(2022 edition)”for clinicians’reference.

Development of rapid advice guideline and standard and continuous updating guideline:experiences and practice

We published rapid advice guidelines and updated guidelines for coronavirus disease 2019(COVID-19)management on February 6,2020,and September 4,2020,respectively.These two guidelines vary widely in their developmental background,type of evidence,grade of recommendation and so on.We shared our experience for the development of these two guidelines to help clinical practitioners better understand and implement guidelines and to help guideline developers facilitate communication and discussion for guideline development during the pandemic.

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.

Considerations of treatment standardization from the procession of NCCN guideline of esophagealcancer

Esophageal carcinoma is one of the most common malignant tumors, especially in China which is the high incidence area. As a result of mild symptoms of early-stage esophageal cancer, the majority of patients cannot be diagnosed until they develop to advanced cancer, and the treatment outcome of surgery or chemoradiotherapy is still unsatisfactory at present. The guidelines of esophageal cancer issued by National Comprehensive Cancer Network (NCCN) are regarded as important reference tools by clinical oncologists, and provide uniform criteria for the diagnosis and treatment of esophageal carcinoma. However, the guidelines are not always suitable for Chinese patients because the data come from European and American population which have significant ethnical difference from Chinese. We retrospectively analyzed the changes of treatment strategy of esophageal cancer in NCCN guidelines and the advance of treatment for esophageal carcinoma in China, aiming to provide our oncologists with new research ideas. We also hope to set up clinical cancer cooperation organizations, and release our own cancer guidelines to serve Chinese patients and oncologists.

COMPARATIVE ANALYSIS OF GREEN ROOF GUIDELINES AND STANDARDS IN EUROPE AND NORTH AMERICA

The German FLL Guidelines for green roofs are designed to inform about state-of-the-art performance expectations for green roofs.North America is experiencing steady growth in the green roof market and has no single-source set of standards or guidelines;therefore there is a need to identify what type of guidance may be lacking.Seven domains of knowledge from the FLL Guidelines are compared to similar areas of content in North American documents.It was found that although there are several North American green roof guidelines in use,compared to the FLL Guidelines there are areas where knowledge is lacking:guidance for compatibility of system components,slope application,filter fabrics,root barriers,surface and subsurface drainage,growth media,and erosion control,as well as standards or postconstruction testing requirements for fabrics,bulk density of growth media,root barrier performance,drainage media,and growth media.A case study of the Chicago City Hall green roof examines its content compliance with FLL performance standards.Recommendations for further advancement of North American guidelines include the need for more collaborative research and development in efforts to advance existing and new guidelines across ecoregions.

Application of Statistic Analysis on the Selection of Quantitative Characteristics Listed in the DUS Test Guideline of Tagetes L.

[Objective] This paper researched how to use specific approach to select quantitative characteristics which would be listed in the DUS Test Guideline of Tagetes L. [Method] With the aid of statistic analysis, the uniformity, stability and correlation of 14 pre-selected characteristics were analyzed. [Result] The expression of peduncle length of terminal flower had low uniformity within a variety; the expres- sion of main stem thickness was not stable in continuous growing cycles; there were four pairs of quantitative characteristics which are （very） significantly correlated, namely, leaf length and leaf width, diameter of flower head and length of outer ligu- late floret, number of ligulate floret whorls and number of ligulate floret, leaf width and width of terminal leaflet of pinnate leaves. Based on the requirements of char- acteristic selection and the results of statistic analysis, five characteristics including peduncle length of terminal flower, thickness of the main stem, leaf width, length of outer ligulate floret and number of ligulate floret were deleted. [Conclusion] For the first time, this paper introduced the application of statistic analysis on the selection of quantitative characteristics.

Selection of Example Varieties Used in the DUS Test Guideline of Tagetes L.

[Objective] Taking the characteristic of flower diameter of Tagetes L.as an example,this study aimed to select example varieties used in the DUS Test Guideline of Tagetes L.[Method] Two continuous years of measurements of flower diameter of 25 varieties were collected and then analyzed by using the box plot to illustrate the uniformity and stability of flower diameter of each variety.[Result] According to the information of variability,distribution symmetry of measurements and outliers of flower diameter of varieties provided by box plots,variety 16,2 and 4 were selected as the example varieties for the three expression states with respective flower diameter of 3.0-4.4,6.0-7.4 and 9.0-10.4 cm.[Conclusion] The box plot is an efficient method for the general analysis of varieties,which provides information covering the actual and possible expression range,median and outliers of measurements of flower diameter of each variety.It also provides references for selecting example varieties for other quantitative characteristics and evaluating the quality of varieties.

Analysis on the Functions and Properties of the Preliminarily Determined Characteristics Listed in DUS Test Guideline of Tagetes L.

[Objective] This study aimed to investigate the functions and properties of the preliminarily determined characteristics listed in DUS test guideline of Tagetes L., and explore the representativeness and comprehensiveness of this group of characteristics in DUS test. [Method] Based on the functions and properties of the characteristics, the described plant part （s）, observation stage, expression pattern and observation method of each characteristic were analyzed to illustrate the representativeness and comprehensiveness of the combination of this group of characteristics in above functions and properties. [Result] As for described plant part（s）, there are 5 characteristics describing plant as a whole, 3 characteristics describing stem, 6 characteristics describing leaf, 23 characteristics describing flower and 1 characteristic describing physiological feature. As for observation stage, there are 1 characteristic needing to be observed in the stage of seedling, 1 characteristic in the stage of beginning of flowering and other 36 characteristics in the stage of fully flowering. As for the expression pattern, there are 10 qualitative characteristics, 9 pseudo-qualitative characteristics and 19 quantitative characteristics. As for the observation method, there are 30 characteristics using VG as the observation method, and 8 characteristics using MS. [Conclusion] In view of the variation and morphological properties of marigold, this group of characteristics are representative and comprehensive, and ensure the accuracy and easiness of DUS test of Tagetes L., thereby achieving the reasonable combination of characteristics in described plant parts, observation stages, expression patterns and observation methods.