A summary of the evidence and evaluation of the effectiveness of nonpharmacological interventions for mild cognitive impairment

Objective: To summarize and evaluate the evidence of guidelines and systematic reviews(SRs) of nonpharmacological interventions for mild cognitive impairment(MCI) to support the development of future guidelines and clinical decisions for MCI patients.Methods: Scottish Intercollegiate Guideline Network(SIGN), National Institute for Health and Clinical Excellence(NICE), American Academy of Neurology(AAN), Registered Nurses Association of Ontario(RNAO), Web of Science, PubMed, Cochrane Library, CNAHL, VIP, China National Knowledge Infrastructure(CNKI), and Wanfang Database were searched for relevant publications, including guidelines and SRs, from January 2014 to March 2019. Two authors independently screened articles, extracted data, and assessed the publications for adherence to the inclusion criteria. Appraisal of Guidelines for Research and Evaluation(AGREE II) was used to assess the quality of the guidelines, and Assessment of Multiple Systematic Reviews(AMSTAR 2) was used to assess the quality of SRs. In addition, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) approach was used to evaluate the quality of outcomes.Results: Thirty-two articles were retrieved, including 1 guideline and 31 SRs. Fourteen SRs of physical exercise for MCI, six articles describing cognitive interventions, four articles describing acupuncture, and seven articles assessing dietary interventions(including four articles employing a Mediterranean diet, one article using vitamin B supplementation, and two articles assessing the effects of tea, coffee, and caffeine) were included. The quality of the articles was very low for 4(13%), low for 10(32%), and moderate for 17(55%).Conclusions: Based on the evidence available to date, nonpharmacological interventions may improve the current cognitive function of persons with MCI. In particular, physical exercise, cognitive interventions, and acupuncture exerted promising effects. However, due to the limited number and quality of the included publications, additional high-quality reviews are needed to further confirm.

Rationalising animal research synthesis in orthopaedic literature

Systematic reviews in orthopaedic literature are frequently criticised for offering inconsistent conclusions.On top of that,high-quality randomized human evidence on crucial orthopaedic topics is more often than not lacking.In this situation,pooling animal literature could offer an excellent insight into unanswered critical clinical questions,thus potentially improving healthcare.In this paper,we sought to present the rationale and basic principles governing meta-analysis of animal research.More specifically,we elaborated on the available evidence-based methods to achieve a scientifically sound animal data synthesis.In addition,we discussed result interpretation,strength of recommendations and clinical implications based on the results of these meta-analytic modalities.

Assessment Framework of Green Intelligent Transformation of Small Hydropower in China

With the comprehensive promoted construction of the establishment of green small hydropower,the defects of existing small hydropower station are gradually emerging,and it is necessary to implement green intelligent transformation to promote the construction of energy internet in China.This study focuses on constructing a green intelligent planning and transforming assessment framework,and assists management department to filtrate the small hydropower stations which can be transformed reasonably.Firstly,power station economy,ecological environment,technical safety management and social benefits are involved in the assessment index system.Secondly,multi-expert judgment aggregation based on fuzzed comparison scale is put forward to calculate the index value,and evidence synthesis is used to comprehensively assess the feasibility of green and intelligent planning and transformation for several small hydropower stations.The simulation case analysis shows the constructed assessment framework can reflect the actual situation of objectives properly and would provide decision-making basis for green and intelligent planning and transformation of small hydropower stations.