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Aim : To compare the efficacy of different non-pharmacological methods for reducing pain in Neonates. Methodology : During the study period of one year from July, 2019 to July, 2020, a total of 70 infants were consecutively recruited and divided into two groups. One group received 2ml of EBM and other group 2ml of 25% D is administered which was given 1 minute before Venepuncture. The outcome variables are the duration of cry after Venepuncture & NIPS score for both group. Result : The duration of cry was found to be higher in the group receiving EBM. The neonates in 25%D groups had lower Neonatal Infant Pain Scale (NIPS) score than EBM group (chi-sqr-10.34 & p-0.0057). Conclusion : In our study we found 25% Dextrose to be a better non-pharmacological Analgesic as compared to EBM during painful procedure in newborn.
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Borrowing the open system interconnection (OSI) model of internet protocol and the 5W theory in communication studies, the links in the international communication of acupuncture-moxibustion can be classified into seven layers: physical layer, data link layer, network layer, transport layer, session layer, presentation layer and application layer, therefore it is built an OSI model of international communication system of acupuncture-moxibustion. It is pointed out that present international communication system of acupuncture-moxibustion is similar to the user datagram protocol (UDP) in internet technology. Evidence-based medicine (EBM) plays a key role to modernize acupuncture- moxibustion theory based upon its clinical effects. According to phenomenon-taking by classified analogy, it is found that the PICO model of EBM agrees pretty well with the "three-way handshakes" mechanism of the internet transmission control protocol (TCP), which is promising to construct an international discourse of acupuncture-moxibustion compatible with western medicine. Thus it will benefit to explore the scientific connotation of acupuncture-moxibustion theory and significantly improve the international prestige of acupuncture-moxibustion.
Subject(s)
Acupuncture , Acupuncture Therapy , Communication , Evidence-Based Medicine , MoxibustionABSTRACT
The Japan-Korea Workshop on Acupuncture and EBM is an academic exchange between the Japan Society of Acupuncture and Moxibustion (JSAM) and the Korean Acupuncture and Moxibustion Medical Society (KAMMS). The theme of the 9th and 10th Workshop was clinical practice guidelines (CPG). Three Korean and two Japanese speakers presented in the 9th Workshop held at Osaka, and two in each country did in the 10th at Jecheon, Korea. Since Korea has already developed some Korean Medicine CPGs, the present state and protocols for improvement process were reported. On the other hand, Japan has not developed such CPGs on acupuncture. The Japanese speakers therefore presented results of a survey on Japanese CPGs that include “acupuncture-moxibustion” as a treatment option and quality assessment of those CPGs. Although there are some differences on circumstances surrounding acupuncture practice between Japan and Korea, it was a good opportunity to obtain useful information for developing CPG on acupuncture in Japan and to discuss on this issue with Korean researchers preceding in this area. We reaffirmed the need for continued academic exchange between JSAM and KAAMS.
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Background: Reconstruction of customized cranial implants with a mesh structure using computer-assisted design and additive manufacturing improves the implant design, surgical planning, defect evaluation, implant-tissue interaction and surgeon's accuracy. The objective of this study is to design, develop and fabricate cranial implant with mechanical properties closer to that of bone and drastically decreases the implant failure and to improve the esthetic outcome in cranial surgery with precision fitting for a better quality of life. A customized cranial mesh implant is designed digitally, based on the Digital Imaging and Communication in Medicine files and fabricated using state of the Art-Electron Beam Melting an Additive Manufacturing technology. The EBM produced titanium implant was evaluated based on their mechanical strength and structural characterization. Results: The result shows, the produced mesh implants have a high permeability of bone ingrowth with its reduced weight and modulus of elasticity closer to that the natural bone thus reducing the stress shielding effect. Scanning electron microscope and micro-computed tomography (CT) scanning confirms, that the produced cranial implant has a highly regular pattern of the porous structure with interconnected channels without any internal defect and voids. Conclusions: The study reveals that the use of mesh implants in cranial reconstruction satisfies the need of lighter implants with an adequate mechanical strength, thus restoring better functionality and esthetic outcomes for the patients.
Subject(s)
Humans , Prosthesis Design/methods , Skull , Surgical Mesh , Titanium/chemistry , Computer-Aided Design , Plastic Surgery Procedures/instrumentation , Mechanical Phenomena , Prostheses and Implants , Porosity , Imaging, Three-Dimensional , Elasticity , ElectronsABSTRACT
Introducing information-knowledge-wisdom transformation law and its four sub processes including information acquisition,recognition,decision and implementation,the paper summarizes the process of Evidence-based Medicine (EBM) information services,analyzes the scope of carrying out EBM information services by the hospital library under the guidance of new perspective,and discusses the specific forms of EBM information services by exampling the practice of EBM information services carried out by the library of the First Affiliated Hospital of Chongqing University of Medical Sciences.
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The paper selects 4 famous foreign Evidence-based Medicine (EBM) databases-UpToDate,DynaMed,Medskills and CISMeF for analysis and comparison from 3 perspectives of the structures,retrieval methods and evidence grading standards,in order to provide reference for the construction and development of the EBM databases in China.
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A 3-dimensional top level structure module of literature characteristics, diagnosis and treatment process, and evidence level was established respectively for the information model of evidence-based medicine ( EBM) database by analyzing the demands of medical staff and investigating EBM-related standards and databases. The data sets and elements with their concepts subclassified were expressed under the top level module, and the se-mantic structure of data elements-expressed concept attributes was standardized, which showed that the semantic structure of information model for EBM database that was constructed with modularized method can help medical staff to manage and organize the clinical literature, retrieve and use the EBM information more effectively.
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A 3-dimensional top level structure module of literature characteristics, diagnosis and treatment process, and evidence level was established respectively for the information model of evidence-based medicine ( EBM) database by analyzing the demands of medical staff and investigating EBM-related standards and databases. The data sets and elements with their concepts subclassified were expressed under the top level module, and the se-mantic structure of data elements-expressed concept attributes was standardized, which showed that the semantic structure of information model for EBM database that was constructed with modularized method can help medical staff to manage and organize the clinical literature, retrieve and use the EBM information more effectively.
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Objective To study the micro-pore architecture and mechanical properties of porous titanium scaffolds with diamond molecule structure produced by 3D print technology,so as to guide the development of 3D-prinited porous titanium orthopedic implants.Methods Selective laser melting (SLM) and electron beam melting (EBM) were used to fabricate porous Ti6Al4V scaffolds with diamond molecule structure.The micro-pore architectures of those scaffolds were observed using optical microscope and scanning electron microscope (SEM),and universal material testing machine was used to conduct compressive test on the scaffolds.Results Both SLM and EBM techniques had machining error and half-melted metal particles were found on the strut surface.The relative error of strut size produced by SLM and EMB was 20.9％-35.8％ and-9.1％-46.8％,respectively.The scaffold with strut width of 0.2 mm could not be produced by EBM.The compressive strength and elastic modulus of the scaffold fabricated by SLM was 99.7-192.6 MPa and 2.43-4.23 GPa,respectively.The compressive strength and elastic modulus of the scaffold fabricated by SLM was 39.5-96.9 MPa and 1.44-2.83 GPa,respectively.Conclusions The manufacturing precision of SLM is higher than that of EBM.Porosity is the main factor that affects the compressive strength and elastic modulus of the scaffolds.In the same process,with the increase of porosity,both the compressive strength and elastic modulus decrease.When the porosities are similar,the scaffolds fabricated by SLM possess higher compressive strength and elastic modulus than those by SLM.
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Objective To study the micro-pore architecture and mechanical properties of porous titanium scaffolds with diamond molecule structure produced by 3D print technology,so as to guide the development of 3D-prinited porous titanium orthopedic implants.Methods Selective laser melting (SLM) and electron beam melting (EBM) were used to fabricate porous Ti6Al4V scaffolds with diamond molecule structure.The micro-pore architectures of those scaffolds were observed using optical microscope and scanning electron microscope (SEM),and universal material testing machine was used to conduct compressive test on the scaffolds.Results Both SLM and EBM techniques had machining error and half-melted metal particles were found on the strut surface.The relative error of strut size produced by SLM and EMB was 20.9％-35.8％ and-9.1％-46.8％,respectively.The scaffold with strut width of 0.2 mm could not be produced by EBM.The compressive strength and elastic modulus of the scaffold fabricated by SLM was 99.7-192.6 MPa and 2.43-4.23 GPa,respectively.The compressive strength and elastic modulus of the scaffold fabricated by SLM was 39.5-96.9 MPa and 1.44-2.83 GPa,respectively.Conclusions The manufacturing precision of SLM is higher than that of EBM.Porosity is the main factor that affects the compressive strength and elastic modulus of the scaffolds.In the same process,with the increase of porosity,both the compressive strength and elastic modulus decrease.When the porosities are similar,the scaffolds fabricated by SLM possess higher compressive strength and elastic modulus than those by SLM.
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Objective To study the micro-pore architecture and mechanical properties of porous titanium scaffolds with diamond molecule structure produced by 3D print technology,so as to guide the development of 3D-prinited porous titanium orthopedic implants.Methods Selective laser melting (SLM) and electron beam melting (EBM) were used to fabricate porous Ti6Al4V scaffolds with diamond molecule structure.The micro-pore architectures of those scaffolds were observed using optical microscope and scanning electron microscope (SEM),and universal material testing machine was used to conduct compressive test on the scaffolds.Results Both SLM and EBM techniques had machining error and half-melted metal particles were found on the strut surface.The relative error of strut size produced by SLM and EMB was 20.9％-35.8％ and-9.1％-46.8％,respectively.The scaffold with strut width of 0.2 mm could not be produced by EBM.The compressive strength and elastic modulus of the scaffold fabricated by SLM was 99.7-192.6 MPa and 2.43-4.23 GPa,respectively.The compressive strength and elastic modulus of the scaffold fabricated by SLM was 39.5-96.9 MPa and 1.44-2.83 GPa,respectively.Conclusions The manufacturing precision of SLM is higher than that of EBM.Porosity is the main factor that affects the compressive strength and elastic modulus of the scaffolds.In the same process,with the increase of porosity,both the compressive strength and elastic modulus decrease.When the porosities are similar,the scaffolds fabricated by SLM possess higher compressive strength and elastic modulus than those by SLM.
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The visual angle of active participation reference model was not scientific and its contents were not sys-tematic in the past EBM information service. A new EBM information service model was thus established by compa-ring the finding process of evidence and the transforming process ofinformation-knowledge-intelligence with the need of evidence-based decision making in clinicians as a logic starting point in order to provide the theory of what to do andhow to scientifically do for clinical librarians and clinicians, to effectively direct clinical librarians to perform EBM information service, and to help clinicians to scientifically make their decision.
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PICOS model-based case teaching of medical information retrieval curium is of benefit to stimulate the EBM thinking of students. The necessity of PICOS model-based case teaching of medical information retrieval curi-um was thus described, with its design, case analysis, retrieval methods, applicability and implementation studied and illustrated by examples.
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Objective:To study the fit of pure titanium single crown fabricated by electron beam melting(EBM).Methods:Pure titanium crowns were fabricated by EBM,selective laser melting(SLM),CAD/CAM(R +K and DMG)and conventional lost wax technique(LW)respectively(n =5).Marginal and internal gap was copied by light-body silicone and measured using a digital mi-croscope .The data of marginal gap(MG)and internal gap(IG)were statisticaly analysed by ANOVA and SPSS statistical package version 17.0.Results:The MG and IG(μm)of pure titanium crowns in EBM group were 38.42 ±6.72 and 105.54 ±33.18,in SLMgroup 38.63 ±6.82 and 114.63 ±52.18,in DMG CAD/CAMgroup 26.18 ±4.36 and 102.18 ±40.81,in R +K CAD/CAM group 26.98 ±4.44 and 102.24 ±25.30,in LW group were 42.61 ±5.73 and 102.98 ±45.67,respectively.The marginal fit of the EBMgroup was significantly smaller than 120 μm of the generally accepted clinical standards.In the 2 CAD/CAM groups the MG was smaller than that of other 3 groups(P 0.05).Conclu-sion:The marginal fit of titanium single crown fabricated by EBMis similar to that by SLM,better than that of LW and inferior than that of CAD/CAM.The internal fit of the crowns made by the 5 systems is similar.
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The 2012 International Research Congress on Integrative Medicine and Health was held in the US in Portland, Oregon on May 15-18, 2012. This conference was organized by the International Society for Complementary Medicine Research (ISCMR) and the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM) . There were 1000 participants at the conference, which offered 7 workshops, 8plenary sessions, 30 symposiums, 65 oral presentations, and 433posters. Many researchers with grants from NIH or NCCAM gave presentations. These presentations were not only about acupuncture but also complementary and alternative medicine in general. My attendance to this conference was sponsored by the Department of International Affairs of the Japan Society of Acupuncture and Moxibustion.
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The 6th International Congress on Complementary Medicine Research (ICCMR) was held at the Sofitel Wanda Hotel in Chengdu, China on May 7-9, 2011. A pre-conference workshop was held on the 6th at Sichuan University. This conference was organized by the International Society for Complementary Medicine Research (ISCMR). There were 400 participants at the conference, which offered 4 workshops, 12 plenary sessions, 134 oral presentations, and 287 posters. Half of total presentations were from China and also many were from South Korea. The methodology of Randomized Controlled Trial (RCT) and Systematic Review (SR) were discussed for building Evidence-Based Medicine for Complementary and Alternative Medicine (CAM) and many researches with RCT and SR were at the presentation. I attended this conference by reguest from the International Department of The Japan Society of Acupuncture and Moxibustion.
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In 1944, Dr Takeshi Itakura, director of the Eastern Therapeutics Institute, intended to perform controlled clinical trials with Kampo extracts, but gave up following the defeat in the Second World War. Japanese public insurance coverage of Kampo treatment started in 1961. Permission for medical use of six Kampo extracts was granted in 1967. This was increased to 848 products made with 148 formulas in 2000. The book, <i>Ippan-yo Kampo Shoho no Tebiki</i> (guide to general Kampo prescriptions) describing approval standards for Kampo extracts was published in 1975 and revised in 2008.The adverse effects of shosaikoto in 1996 forced the Japanese Society for Oriental medicine to establish the EBM Committee to prove that Kampo medicine was evidence-based. The first report on clinical evidence for Kampo was published in 2005. In 2001, the study of Japanese herbal medicine became compulsory in the medical education system. A petition against removing Kampo drugs from public insurance in 2009 showed that people hoped doctors would continue to be able to prescribe Kampo drugs under insurance systems.
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In 1944, Dr Takeshi Itakura, director of the Eastern Therapeutics Institute, intended to perform controlled clinical trials with Kampo extracts, but gave up following the defeat in the Second World War. Japanese public insurance coverage of Kampo treatment started in 1961. Permission for medical use of six Kampo extracts was granted in 1967. This was increased to 848 products made with 148 formulas in 2000. The book, <I>Ippan-yo Kampo Shoho no Tebiki</I> (guide to general Kampo prescriptions) describing approval standards for Kampo extracts was published in 1975 and revised in 2008.<BR>The adverse effects of shosaikoto in 1996 forced the Japanese Society for Oriental medicine to establish the EBM Committee to prove that Kampo medicine was evidence-based. The first report on clinical evidence for Kampo was published in 2005. In 2001, the study of Japanese herbal medicine became compulsory in the medical education system. A petition against removing Kampo drugs from public insurance in 2009 showed that people hoped doctors would continue to be able to prescribe Kampo drugs under insurance systems.
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[Objective]To motivate acupuncture school teachers to introduce higher-quality methodology in clinical acupuncture research.<BR>[Methods]Twenty-eight teachers from 18 acupuncture schools participated in the simulated randomized, subject and evaluator-blinded, and sham-controlled trial of acupuncture for low back pain. Twenty of them played a role as subjects, four of them were raters, and another four were therapists. Before and after conducting the trial, all the participants were asked several questions using the Visual Analogue Scale (VAS) regarding necessity of Evidence-Based Medicine (EBM) in acupuncture and their level of understanding of several terms related to a Randomized Controlled Trial (RCT),<BR>[Results]After the simulated RCT, the understanding level of all terms related to RCT increased significantly ("RCT":from 58.0 ± 27.2 to 75.5 ± 25.7, "informed consent":from 88.1 ± 15.4 to 99.2 ± 10, "recruitment":from 43.0 ± 41.0 to 74.8 ± 31.3, "random allocation":from 55.5 ± 35.0 to 78.7 ± 25.8, "masking":from 54.7 ± 35.0 to 79.0 ± 26.0) (mean ±SD). Nineteen teachers answered that they would try to conduct RCT and introduce it to their education program.<BR>[Conclusion]The results suggest that the practice of simulated RCT is effective in understanding RCT and motivating acupuncture teachers to introduce it to their education program.
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Objective; To evaluate the efficacy of Twin-block appliance in Class Ⅱ division 1 of adolescents. Methods: Several e-lectronic databases (PubMed, The Cochrane library, Embase, CBMdisk, CNKI, VIP)were searched. Abstract that appears to fulfill the initial selection criteria were selected by consensus and original articles were retrieved. Five Chinese journals were hand searched for possible missing articles. Randomized controlled trials(RCTs) that evaluate the efficacy of Twin-block appliance in Class Ⅱ division I adolescents without any surgical intervention or syndromic characteristics were considered. A comparable untreated control group was required to factor out normal growth changes. The quality of included studies was evaluated according to Cochrane Reviewers Handbook 4.2.6 Meta-analysis was performed by using RevMan 5.0.0 software. Results: Four RCTs including 289 patients were identified. The results of our meta-analysis showed a significant increase on SNB angle, Ar-Gn, Nasolabial angle and Labial-mental fold compared with control group(P<0.05). Whereas overjet, overbite, ANB angle and Ls-E had a significant decrease. In addition, SNA angle and Li-E didnt show statistical significant changes(P>0. 05). Conclusion; In Class II division 1 of adolescents, Twin-block appliance can effectively decrease their overjet, overbite, ANB angle, and induce anterior-posterior growth of mandible. The effect on restrain forward growth of the maxilla was unclear. More RCTs are required to evaluate the efficacy of Twin-block appliance.