Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease worldwide,affecting about 1/4th of the global population and causing a huge global economic burden.To date,no drugs have been approved for the treatment of NAFLD,making the correction of unhealthy lifestyles the principle method of treatment.Identifying patients with poor adherence to lifestyle correction and attempting to improve their adherence are therefore very important.AIM To develop and validate a scale that can rapidly assess the adherence of patients with NAFLD to lifestyle interventions.METHODS The Exercise and Diet Adherence Scale(EDAS)was designed based on com-pilation using the Delphi method,and its reliability was subsequently evaluated.Demographic and laboratory indicators were measured,and patients completed the EDAS questionnaire at baseline and after 6 months.The efficacy of the EDAS was evaluated in the initial cohort.Subsequently,the efficacy of the EDAS was internally verified in a validation cohort.RESULTS The EDAS consisted of 33 items in six dimensions,with a total of 165 points.Total EDAS score correlated significantly with daily number of exercise and daily reduction in calorie intake(P<0.05 each),but not with overall weight loss.A total score of 116 was excellent in predicting adherence to daily reduction in calorie intake(>500 kacl/d),(sensitivity/specificity was 100.0%/75.8%),while patients score below 97 could nearly rule out the possibility of daily exercise(sensitivity/specificity was 89.5%/44.4%).Total EDAS scores≥116,97-115,and<97 points were indicative of good,average,and poor adherence,respectively,to diet and exercise recommendations.CONCLUSION The EDAS can reliably assess the adherence of patients with NAFLD to lifestyle interventions and have clinical application in this population.

Scale offers the possibility of identifying adherence to lifestyle interventions in patients with non-alcoholic fatty liver disease

Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disorder,and dietary and lifestyle interventions remain the mainstays of NAFLD therapy.Zeng et al established a prediction system to evaluate adherence to lifestyle interventions in patients with NAFLD and choose optimal management.Here,we discuss the application scenarios of the scale and the areas warranting further attention,aiming to provide a possible reference for clinical recommend-ations.

Management of non-alcoholic fatty liver disease:Lifestyle changes

In this editorial,we commented on a recently released manuscript by Zeng et al in the World Journal of Gastroenterology.We focused specifically on lifestyle changes in patients with non-alcoholic fatty liver disease(NAFLD).NAFLD is a hepatic manifestation of the metabolic syndrome,which ultimately leads to advanced hepatic fibrosis,cirrhosis,and hepatocellular carcinoma and affects more than 25%of the population globally.Existing therapeutic strategies against NAFLD such as pharmacologic therapies focus on liver protection,anti-inflammation,and regulating disease-related metabolic disorder symptoms.Although several drugs are in late-stage development,potent drugs against the diseases are lacking.Additionally,existing surgical approaches such as bariatric surgery are not routinely used to treat NAFLD.Intervening in patients’unhealthy lifestyles,such as weight loss through dietary changes and exercises to ameliorate patientassociated metabolic disorders and metabolic syndrome,is the first-line treatment for patients with NAFLD.With sufficient intrinsic motivation and adherence,the management of unhealthy lifestyles can reduce the severity of the disease,improve the quality of life,and increase the survival expectancy of patients with NAFLD.

Validation of adherence prediction system for lifestyle interventions in nonalcoholic fatty liver disease

This editorial delves into the research article by Zeng et al published in the latest issue of World Journal of Gastroenterology.The manuscript contributes significantly to addressing the global health issue of nonalcoholic fatty liver disease(NAFLD)by introducing and validating the Exercise and Diet Adherence Scale(EDAS).The article effectively conveys the importance of the study,highlighting the prevalence of NAFLD,the lack of approved drugs for its treatment,and the crucial role of lifestyle correction.The use of the Delphi method for scale development and the subsequent evaluation of its reliability add scientific rigor to the methodology.The results demonstrate that the scale is correlated with key lifestyle indicators,which makes it a promising tool for assessing patient adherence to interventions.The identification of specific score thresholds for predicting adherence to daily calorie intake and exercise adds practical value to the scale.The differentiation among scores indicative of good,average,and poor adherence enhances its clinical applicability.In conclusion,the manuscript introduces EDAS,a valuable instrument that can contribute substantially to the field of NAFLD research and clinical practice.

Exploring multifaceted factors in chronic kidney disease risk: A comprehensive analysis of biochemistry, lifestyle, and inflammation in elderly Chinese individuals

This letter praises a recent article in the World Journal of Clinical Cases(Roles of biochemistry data,lifestyle,and inflammation in identifying abnormal renal function in old Chinese),examining factors affecting abnormal renal function in elderly Chinese using advanced machine learning.It highlights the importance of uric acid,age,hemoglobin,body mass index,sport hours,and systolic blood pressure.The study's holistic approach,integrating lifestyle and inflammation,offers a nuanced understanding of chronic kidney disease risk factors.The letter suggests exploring mechanistic pathways of hyperuricemia,the link between anemia and renal function,and the connection between body mass index and estimated glomerular filtration rate.It advocates investigating physical activity's impact on renal health and the independent effects of blood pressure.The study significantly contributes to chronic kidney disease understanding,proposing avenues for further exploration and interventions.Commendations are extended to the authors and the journal.

An Analysis of the Lifestyle and Mental Health Status of Adult People Living in Dhaka City: A Cross-Sectional Study in Post COVID-19 Era

Introduction: The Novel Coronavirus or COVID-19 affected all the megacities of the world and made the mental health and lifestyle of people paralyzed. According to different studies, such difficulties were different in scale in different cities depending on the demographic attributes of the people. This phenomenon has created the essence of the current study to examine the health conditions in terms of their mental health, lifestyle, and demographic attributes during and immediate past of the COVID-19 era. Method: It was a cross-sectional study covering the people of Dhaka City Corporation. For this purpose, a multistage sampling method was applied, under which the respondents were selected randomly and a self-administered structured questionnaire was used to collect data. The questionnaire was developed based on the DASS 21, as it was suitable to measure the components of mental health in the form of depression, anxiety, and stress. Descriptive analysis and cross-tabulation were applied to find out the association between dependent and independent variables, whereas, a chi-square test was performed to examine the hypothesis. Finally, multivariate analysis was done to find out the risk factors. Three logistic regression models were developed for three dependent variables. Result: The findings of the analysis revealed that the lifestyle of people had severely influenced the components of their mental health conditions during and immediate past of COVID-19 in the Dhaka City Corporation, which varies to some extent depending on the demographic attributes of those. Conclusion: The above findings are statistically significant enough to conclude about the essence of taking preventive measures regarding mental health issues in the future. However, the limitations of this study-keeping it within the urban areas and the educated people, have also created the venue for future researchers to move with their research endeavors in the rural areas nationwide and thus generalize the results.

The Impact of Lifestyle Factors on Migraine Frequency and Severity in Neurology

Objective: This systematic review examines the impact of lifestyle factors on migraine frequency and severity through a comprehensive analysis of lifestyle factors such as diet, physical activity, sleep patterns, stress, mental health, and environmental influences. Methods: We thoroughly searched Google Scholar, PUBMED, Scopus, and Web of Science databases using keywords related to migraines and lifestyle factors. Keywords incorporated the Boolean operator “and” to narrow search results. Following the PRISMA guidelines, we identified, screened, and evaluated studies for inclusion, resulting in nine studies meeting the eligibility criteria. Results: A total of 4917 records were initially identified from Scopus (2786), PubMed (854), and Web of Science (1277). Following deduplication, 3657 records underwent title screening, with 382 additionally screened by abstract. Ultimately, 88 full-text articles were assessed, resulting in 9 studies meeting eligibility for qualitative synthesis: 7 prospective and 2 retrospective studies. Our findings highlight the multifaceted role of lifestyle factors in migraine pathophysiology and management. Dietary habits, such as high-calorie, high-fat, and gluten-containing diets were linked to migraine triggers. Moderate physical activity showed beneficial effects on migraine management, while intense exercise could exacerbate symptoms. Poor sleep hygiene and insomnia were strongly associated with increased migraine frequency and severity. Chronic stress and poor mental health significantly contributed to migraine exacerbation, with stress management techniques proving beneficial. Environmental factors, including light, sound, weather changes, and allergens, were also identified as significant migraine triggers. Conclusions: Personalized lifestyle modifications, tailored to individual patient profiles, are crucial in managing migraines. Evidence-based recommendations include balanced diets, moderate physical activity, improved sleep hygiene, stress management techniques, and environmental adaptations.

A Study on the Relationship Between Skin Sensitivity and Lifestyle, Skin Conditions

Investigate the self-assessment of the skin sensitivity degree of Chinese cosmetic consumers,and explore the differences in lifestyle and skin conditions among consumers with different degrees of skin sensitivity.The study selected 716 female participants from different cities,and collected relevant data through questionnaire surveys,instrument tests,and other methods.The results found that the participants who self-assessed as having sensitive skin had a lower average age,frequency of skin care,frequency of makeup,and years of makeup.The proportion of choosing medical cosmetology and staying up late was higher,the skin was more elastic,the skin tone was more biased towards red,there were more red areas,and the skin texture was better(p<0.05).The research results can be used to guide the development of cosmetics to meet the needs of consumers with different degrees of skin sensitivity.

Health awareness and lifestyle toward healthcare-seeking behavior among students in Universitas Advent Indonesia

Objective:Healthcare-seeking behavior(HSB)would affect the prevalence of morbidity and mortality.There are various factors that affect one's HSB.This study aimed to determine if health awareness and lifestyle might relate to HSB.Methods:A cross-sectional study was applied by using three questionnaires to determine par ticipants'health awareness,lifestyle,and HSB.This study took place in Universitas Advent Indonesia and the students were recruited to be par ticipants.Results:There were 39 par ticipants joined in this study.Most of the par ticipants were females,third-year students,and from Accounting major.Almost all participants were aware of their low risk of health issues,had a fine lifestyle,and had moderate HSB.Conclusions:One's urge to seek health care facilities was not related to their health awareness and lifestyle.There was no fur ther study to contradict with this finding at this moment.

Analysis of the Relationship between Eating and Swallowing Function and Lifestyle of the Elderly Living in the Community-A Secondary Publication

Objectives:The relationship between eating and swallowing function,and lifestyle among community-dwelling elderly people has not been extensively studied.This study aimed to analyze the characteristics of eating and swallowing function and their association with the lifestyle among the elderly.Methods:A self-administered questionnaire survey was conducted on 419 elderly people who participated in the oral function improvement project operated by the Community Comprehensive Support Center.A total of 288 valid responses(58 males,230 females,average age 73.6 years)were analyzed.The survey items included basic demographics,health status,lifestyle,and eating and swallowing functions.The chi-square(χ2)test was used to compare for a difference in the risk of dysphagia.Results:72 patients(25.0%)were judged to be at risk for dysphagia,and 216(75.0%)were judged to be not at risk for dysphagia using the revised dysphagia risk assessment scale.The mean score for oral preparatory dysphagia was the highest,while the mean score for pharyngeal dysphagia was the lowest.The group at risk of dysphagia had significant difficulty in chewing and had bad sleep quality as compared to the group that was not at risk.Conclusion:Concerning the risk of dysphagia,there is a need to maintain and improve masticatory function.In addition,improving the swallowing function of the elderly may prevent insomnia and improve sleep quality.

Successful lifestyle modifications may underlie umbilical cordmesenchymal stromal cell effects in type 2 diabetes mellitus

Type 2 diabetes mellitus(T2DM)is a lifelong condition and a grave threat to human health.Innovative efforts to relieve its detrimental effects are acutely needed.The sine qua non in T2DM management is consistent adherence to a prudent lifestyle and nutrition,combined with aerobic and resistance exercise regimens,together repeatedly shown to lead to complete reversal and even longterm remission.Non-adherence to the above lifestyle adjustments condemns any treatment effort and ultimately the patient to a grim fate.It is thus imperative that every study evaluating the effects of innovative interventions in T2DM objectively compares the novel treatment modality to lifestyle modifications,preferably through double-blind controlled randomization,before claiming efficacy.

Roles of biochemistry data, lifestyle, and inflammation in identifying abnormal renal function in old Chinese

BACKGROUND The incidence of chronic kidney disease(CKD)has dramatically increased in recent years,with significant impacts on patient mortality rates.Previous studies have identified multiple risk factors for CKD,but they mostly relied on the use of traditional statistical methods such as logistic regression and only focused on a few risk factors.AIM To determine factors that can be used to identify subjects with a low estimated glomerular filtration rate(L-eGFR<60 mL/min per 1.73 m^(2))in a cohort of 1236 Chinese people aged over 65.METHODS Twenty risk factors were divided into three models.Model 1 consisted of demographic and biochemistry data.Model 2 added lifestyle data to Model 1,and Model 3 added inflammatory markers to Model 2.Five machine learning methods were used:Multivariate adaptive regression splines,eXtreme Gradient Boosting,stochastic gradient boosting,Light Gradient Boosting Machine,and Categorical Features+Gradient Boosting.Evaluation criteria included accuracy,sensitivity,specificity,area under the receiver operating characteristic curve(AUC),F-1 score,and balanced accuracy.RESULTS A trend of increasing AUC of each was observed from Model 1 to Model 3 and reached statistical significance.Model 3 selected uric acid as the most important risk factor,followed by age,hemoglobin(Hb),body mass index(BMI),sport hours,and systolic blood pressure(SBP).CONCLUSION Among all the risk factors including demographic,biochemistry,and lifestyle risk factors,along with inflammation markers,UA is the most important risk factor to identify L-eGFR,followed by age,Hb,BMI,sport hours,and SBP in a cohort of elderly Chinese people.

Effect of lifestyle modification on hepatocellular carcinoma incidence and mortality among patients with chronic hepatitis B

BACKGROUND Research exploring the influence of healthier lifestyle modification(LSM)on the risk of hepatocellular carcinoma(HCC)in patients with chronic hepatitis B(CHB)is limited.AIM To emulate a target trial to determine the effect of LSM on HCC incidence and mortality among patients with CHB by large-scale population-based observational data.METHODS Among the patients with CHB enrolled in the Korean National Health Insurance Service between January 1,2009,and December 31,2017,those aged≥20 years who drank alcohol,smoked cigarettes,and were sedentary were analyzed.Exposure included at least one LSM,including alcohol abstinence,smoking cessation,and regular exercise.The primary outcome was HCC development,and the secondary outcome was liver-related mortality.We used 2:1 propensity score matching to account for covariates.RESULTS With 48766 patients in the LSM group and 103560 in the control group,the adjusted hazard ratio(HR)for incident HCC and liver-related mortality was 0.92[95%confidence interval(CI):0.87-0.96]and 0.92(95%CI:0.86-0.99)in the LSM group,respectively,compared with the control group.Among the LSM group,the adjusted HR(95%CI)for incident HCC was 0.84(0.76-0.94),0.87(0.81-0.94),and 1.08(1.00-1.16)for alcohol abstinence,smoking cessation,and regular exercise,respectively.The adjusted HR(95%CI)for liver-related mortality was 0.92(0.80-1.06),0.81(0.72-0.91),and 1.15(1.04-1.27)for alcohol abstinence,smoking cessation,and regular exercise,respectively.CONCLUSION LSM lowered the risk of HCC and mortality in patients with CHB.Thus,active LSM,particularly alcohol abstinence and smoking cessation,should be encouraged in patients with CHB.

Improved lifestyle is associated with improved depression,anxiety and wellbeing over time in UK healthcare professionals during the COVID-19 pandemic:insights from the CoPE-HCP cohort study

Background One potential modifiable factor to improve the mental health of healthcare professionals(HCPs)during the pandemic is lifestyle.Aims This study aimed to assess whether an improved lifestyle during the pandemic is associated with improved mental health symptoms and mental well-being in HCPs over time.Methods This was a cohort study involving an online survey distributed at two separate time points during the pandemic(baseline(July–September 2020)and follow-up(December 2020–March 2021))to HCPs working in primary or secondary care in the UK.Both surveys assessed for major depressive disorder(MDD)(Patient Health Questionnaire-9(PHQ-9)),generalised anxiety disorder(GAD)(Generalised Anxiety Disorder-7(GAD-7)),mental well-being(Short Warwick-Edinburgh Mental Well-being Score(SWEMWBS))and self-reported lifestyle change(compared with the start of the pandemic)on multiple domains.Cumulative scores were calculated to estimate overall lifestyle change compared with that before the pandemic(at both baseline and follow-up).At each time point,separate logistic regression models were constructed to relate the lifestyle change score with the presence of MDD,GAD and low mental well-being.Linear regression models were also developed relating the change in lifestyle scores from baseline to follow-up to changes in PHQ-9,GAD-7 and SWEMWBS scores.Results 613 HCPs completed both baseline assessment and follow-up assessment.Consistent significant cross-sectional associations between increased lifestyle change scores and a reduced risk of MDD,GAD and low mental well-being were observed at both baseline and follow-up.Over the study period,a whole unit increase in the change in novel scores(ie,improved overall lifestyle)over 4 months was inversely associated with changes in PHQ-9(adjusted coefficient:−0.51,95%confidence interval(CI):−0.73 to−0.30,p<0.001)and GAD-7 scores(adjusted coefficient:−0.32,95%CI:−0.53 to−0.10,p=0.004)and positively associated with the change in SWEMWBS scores(adjusted coefficient:0.37,95%CI:0.18 to 0.55,p<0.001).Conclusions Improved lifestyle over time is associated with improved mental health and mental well-being in HCPs during the pandemic.Improving lifestyle could be a recommended intervention for HCPs to help mitigate the mental health impact during the current and future pandemics.

Integrative proteomic-transcriptomic analysis revealed the lifestyles of Lactobacillus paracasei H4-11 and Kluyveromyces marxianus L1-1 under co-cultivation conditions

Compared with the rice-acid soup inoculated with single starter,the synergistically intensifi ed rice-acid soup inoculated with Lactobacillus paracasei H4-11(L.paracasei H4-11)and Kluyveromyces marxianus L1-1(K.marxianus L1-1)contained more fl avor compounds.Organic acids mainly included L-lactic acid and the main volatile fl avor component was ethyl acetate.Moreover,the signal intensity of astringency and bitterness and the total concentration of volatile sulfur compounds were reduced.The combined analysis results of RNA sequencing(RNA-seq)technology and 4D label-free quantitative(4D LFQ)proteomics explained the fl avor formation pathways in rice-acid soup inoculated with L.paracasei H4-11 and K.marxianus L1-1.In L.paracasei H4-11,L-lactate dehydrogenase,phosphoglucomutase,acetate kinase,alcohol dehydrogenase and acetyl-CoA were up-regulated and D-lactate dehydrogenase and N-Acetyltransferase were down-regulated.In K.marxianus L1-1,Acetyl-CoA,acetaldehyde dehydrogenase,acyl-coenzyme A,N-acetyltransferase,and L-lactate dehydrogenase were up-regulated and hexokinase,alcohol dehydrogenase,and alcohol O-acetyltransferase were down-regulated.The above up-regulation and down-regulation synergistically promoted the formation of characteristic fl avor compounds(mainly L-lactic acid and ethyl acetate).Enzyme-linked immunoassay(ELISA)and parallel reaction monitoring(PRM)quantitative analysis respectively verifi ed that 5 key metabolic enzymes and 27 proteins in L.paracasei H4-11 and K.marxianus L1-1 were associated with the characteristic fl avor of rice-acid soup,as confi rmed by the quantitative results of 4D LFQ.

Daily Lifestyle Habits as Risk Factors for Plaque-Induced Gingivitis and Periodontitis Severity and Grading among Samples of Dental Students at King Khalid University

Objective: To assess daily lifestyle habits as risk factors for plaque-induced gingivitis and periodontitis severity and grading among samples of dental students at King Khalid University. Material and Methods: This study included 150 male participants. They were divided according to the levels into three equal groups: levels 5, 6, and 7 (group I), levels 8, 9, 10 (group II) and levels 11, 12, and interns (group III). This study consisted of questions related to age, gender, educational level, father’s education, mother’s education, home ownership, brushing teeth more than or twice a day, in addition to daily lifestyle habits that were daily smoking, daily use of sugary drinks, and daily use of sugary foods. Some clinical parameters of plaque-induced gingivitis and periodontitis and the percentage of radiographic bone loss were recorded. All data were collected and analyzed using Tukey’s test and Chi-square test. A P-value of less than 0.5 (p Results: One hundred fifty male dental students of different levels in the college of dentistry at King Khalid University participated in the study in three groups (I, II, and III). The mean age of group III is more than that of group II and group I, with highly statistically significant differences (p 30%) were more among the participants in group I than the participants in groups III and II. There was an increase in the percentage of affected participants with stages III and IV of clinical attachment loss (CAL), periodontal pocket depth (PPD), radiographic bone loss (%RBL), tooth mobility, as well as glycated hemoglobin (HbA1c) test values (>7%), and the number of cigarettes smoked per day (>10 cigs) in group III more than in group II and I. Conclusion: We conclude that the severity and grading of plaque-induced gingivitis were higher among the participants in group I, while the severity and grading of periodontitis were higher among the participants in group III due to the different impact of their daily lifestyle habits.

Lifestyle Habits and Dietary Diversity among Medical Students at Université Gaston Berger (UGB) of Saint-Louis in 2023

Introduction: At university, habits, particularly eating habits, can negatively impact well-being. This study aimed to describe lifestyle habits and dietary diversity among medical students. Methodology: This was a cross-sectional, descriptive study, carried out at the UFR 2S of the University Gaston Berger from May 23 to June 3, 2023. The collection tool focused on sociodemographic characteristics, lifestyle habits and dietary diversity. Statistical analyzes were carried out using R software. Results: A total of 471 students participated in this study. Which corresponds to a participation rate of 89.2% with a M/F sex ratio of 1.66. The age of participants, varying from 18 to 32 years, had a median of 23 years and a mean of 22.4 years with a standard deviation of 2.2 years. Among the participants, 67.2% skipped breakfast, and 28.5% did not practice any physical sports activity. Alcohol and tobacco were consumed by 2.5% and 0.6% of participants, respectively. The most consumed foods were starchy foods (97.5% of men and 98.4% of women);and the least consumed were dark green leafy vegetables (21.9% of men and 15.1% of women) and offal (16.9% of men and 11.9% of women). The dietary diversity score was low for 31.9% of men and 28.7% of women. Conclusion: Certain lifestyle habits (skipping breakfast, dining late at night, lack of sports practice) of Medicine students at UGB can prove deleterious to their well-being. These students are at risk of developing several deficiencies in terms of food groups that are underrepresented in their diet. Awareness sessions on good lifestyle habits and diet would be relevant recommendations for improving the health of these students.

A Review on Sustainable Product Design, Marketing Strategies and Conscious Consumption of Bamboo Lifestyle Products

Conscious consumption is a trend that is here to stay since consumers are becoming more aware of their purchasing decision and its impact on their health & environment. To sustain in the market on the move towards sustainability and meet the demands, companies need to re-examine their footprints and incorporate green practices in their products and organization. Using eco-friendly material & processes is one of the remedies to come up with this, and bamboo is one of the most versatile, green and renewable natural resources on planet earth. Traditionally bamboo has been exploited to a large extent but cutting-edge options available for bamboo are still limited and have a scope of indulging fully in the lifestyle of people in India. The global market size of bamboo was valued at UED 53.28 billion in 2020, and it is expected to grow at compound annual growth rate of 5.7% from 2022 to 2028. There is increasing demand for sustainable construction, and furniture and handicraft products also have considerable weightage. Manny brands and craft clusters of bamboo are realizing and promoting this green quotient of bamboo to the market to attract the eco-conscious audience and trying to cope up with the advancement of sustainability, like certifications of being a green organisation. Despite the exceptional qualities of bamboo, it is considered as a marginalized material due to low production rate, high competition with the non-eco-friendly or cheaper alternatives, aesthetics and marketing gaps. There is a gap between willingness to purchase and an actual purchase when it comes to the sustainable products and marketing plays a major role in conversions. The main purpose of the research is to study and understand the product, craft, design, production processes and marketing practices of bamboo lifestyle products and how conscious consumption patterns influence the bamboo products and the industry in relevance to the sustainability. Exploratory research method was applied with the literature survey and reviewing of the research papers from the peer reviewed journals. They were classified and reviewed based on the areas relevant to the bamboo products. The research outcome revealed the research gaps and the results were discussed and presented with the perspectives of product design, conscious consumption and marketing strategies in relevant to the sustainability of bamboo lifestyle products.

Lifestyle: an underrated but potentially important influencing factor on semen quality

Lifestyle factors play a crucial role in the influence of semen quality,and they are especially significant in the context of traditional Chinese medicine(TCM)clinical treatment for poor semen quality.TCM theory emphasizes the importance of healthy lifestyle habits for overall well-being.Therefore,it is essential to consider lifestyle factors in the clinical management of TCM and semen quality.Lifestyle can act as a bias factor that affects research quality,making it vital to pay special attention to its impact in clinical trial research on male semen quality.This article aims to improve the quality and design of clinical research on male sperm quality by examining the effects of various lifestyle factors on semen quality,including physical activities,dietary patterns,smoking,alcohol consumption,coffee intake,sleep,and psychological stress.Each lifestyle factor has its own distinct influence on semen quality,and there is a synergistic effect when multiple lifestyle factors are combined.These findings emphasize the need for careful consideration of lifestyle factors and their interactions in the design and implementation of TCM clinical trial research.

Importance must be attached to correcting unhealthy lifestyles in prevention and control of hypertension

On the macro level,the ‘2018 Chinese Guidelines for Prevention and Treatment of Hypertension’[1] provides a detailed overview on the population strategies for hypertension prevention as well as the principles and methods of community standardized management for hypertension control,with particular emphasis on the significance of correcting unhealthy lifestyles for the prevention and control of hypertension and its complications.?