Need For Scientific Evidence Research Articles

Pain Research and Treatment: Policy Implications

Pain is a subjective experience for which we lack a thorough mechanistic understanding. While it has often been considered a secondary symptom of a disease, research has revealed that chronic pain can be recognized as a disease of its own. Preclinical studies often use animal models to understanding the pathology and test potential therapies with clinical trials of novel analgesics often showing underwhelming results. From a clinician's perspective, pain can be challenging to treat without incurring undesirable drug effects. Pain research, diagnosis, and treatment have changed dramatically over the last two decades. This has coincided with shifts in reliance on opioid-based approaches to managing pain. Here we present an overview of recent advances in preclinical research, novel approaches to diagnosis and treatment, along with considerations for animal care. Collectively, this report may provide a guide on which to base relevant policy changes that would meet the demands of societal need and satisfy the need for scientific evidence.

Optimizing treatment of mild to moderate ulcerative colitis: CU-forum Delphi consensus

Background and objectiveUlcerative colitis (UC) clinical guidelines include the best available evidence, although not all clinical situations are answered, so their management can be controversial. The aim of this study is to identify the situations of mild to moderate UC susceptible to controversy and to evaluate the degree of agreement or disagreement with specific proposals. MethodsInflammatory bowel disease (IBD) expert discussion meetings were used to identify criteria, attitudes and opinions regarding the management of UC. A Delphi questionnaire was then developed with 60 items regarding antibiotics, salicylates and probiotics; local, systemic and topical corticosteroids; and immunosuppressants. ResultsConsensus was reached in 44 statements (73.3%); 32 in agreement (53.3%) and 12 in disagreement (20.0%). Some of them were: it is not necessary the systematic use of antibiotics despite the severity of the outbreak, being reserved when there is suspicion of infection or systemic toxicity; when faced with a mild-moderate outbreak of UC and in patients who do not respond to aminosalicylates, it is appropriate to use a dose of beclomethasone of 10 mg/day for one month and 5 mg/day for another month; it is advised that the dose of azathioprine be administered in a single dose. ConclusionsIBD experts agree on most of the proposals identified for managing mild to moderate UC and there is a need for scientific evidence in some specific situations where expert opinion may be helpful.

A discussion on practices and characteristics of science and technology diplomacy in twentieth-century China

Scientists and diplomats have significant differences in professional skills, activity time and work content, but they should work together. With the deepening impact of science and technology (S&T) on socio-economic development and international relations, S&T has become a crucial component of national strategies, particularly for diplomacy. There is a need for scientific evidence and advice, meaning that mastering more knowledge and skills in S&T would be helpful in negotiations. This paper analyses the ideas of S&T diplomacy, including a review of its 40-year history in China, its definition (with detailed connotations) and its characteristics. The paper focuses on the significant role of people-to-people communication in S&T, which may inform future work. Five suggestions are given to strengthen the strategic planning of S&T diplomacy: (1) A more clarified, strategic goal of future-oriented S&T diplomacy is required; (2) It is important to build a theoretical system for China to describe S&T diplomacy; (3) The creation of a global S&T cooperation map that adapts to the new type of international relations would be valuable; (4) Fairness and justice shall be maintained, while a reform of the global S&T governance system is promoted; (5) It is a must to adhere to bottom-line thinking and strengthen risk prediction and emergency responses.

Optimización del tratamiento de la colitis ulcerosa leve a moderada: Consenso Delphi CU-Forum

Background and objectiveUlcerative colitis (UC) clinical guidelines include the best available evidence, although not all clinical situations are answered, so their management can be controversial. The aim of this study is to identify the situations of mild to moderate UC susceptible to controversy and to evaluate the degree of agreement or disagreement with specific proposals. MethodsInflammatory bowel disease (IBD) expert discussion meetings were used to identify criteria, attitudes and opinions regarding the management of UC. A Delphi questionnaire was then developed with 60 items regarding antibiotics, salicylates and probiotics; local, systemic and topical corticosteroids; and immunosuppressants. ResultsConsensus was reached in 44 statements (73.3%); 32 in agreement (53.3%) and 12 in disagreement (20.0%). Some of them were: it is not necessary the systematic use of antibiotics despite the severity of the outbreak, being reserved when there is suspicion of infection or systemic toxicity; when faced with a mild-moderate outbreak of UC and in patients who do not respond to aminosalicylates, it is appropriate to use a dose of beclomethasone of 10mg/day for one month and 5mg/day for another month; it is advised that the dose of azathioprine be administered in a single dose. ConclusionsIBD experts agree on most of the proposals identified for managing mild to moderate UC and there is a need for scientific evidence in some specific situations where expert opinion may be helpful.

Cost-Utility of Venovenous Ecmo Associated with Protective Mechanical Ventilation in the Treatment of Patients with Acute Respiratory Distress Syndrome

Introduction: with the emergence of COVID-19 in the world, there was a race against time in the search for studies and scientific information that validated the most appropriate treatment. As a result, when caring for patients with the disease who developed ARDS and progressed to a severe condition with hospitalization in the ICU, the need for scientific evidence to guide care for these patients was even greater. Speculation about the effectiveness of using ECMO for these patients began to emerge, and with it, the need for scientific studies that would show the costs and benefits of acquiring this technology in the SUS. The dissertation that is intended to be defended is whether the use of VV ECMO associated with protective mechanical ventilation in patients with ARDS is more cost-effective compared to exclusive protective mechanical ventilation. General Objective: to analyze the cost-effectiveness of veno-venous ECMO in the treatment of patients with COVID-19 who evolve with severe Acute Respiratory Failure. Specific Objectives: review the scientific literature to summarize the best scientific evidence available on the safety and efficacy of using exclusive mechanical ventilation and venovenous ECMO in patients with acute respiratory failure, and estimate the costs associated with mechanical ventilation and the use of veno-venous ECMO. Method: Rapid systematic review for a complete health economic assessment based on a Markov model to estimate the incremental cost-effectiveness of using venovenous ECMO associated with protective mechanical ventilation in the treatment of patients with ARDS due to COVID-19. Results: Based on the estimated costs in each of the base case scenarios and the probabilities of the clinical effects resulting from the interventions, the study showed that the ECMO + protective IMV intervention offers around 0.295 AAQA compared to 0.2015 AAQA offered by the exclusive protective VMI. The incremental cost of ECMO + protective IMV is BRL 12,519.94 for 0.397 effectiveness compared to 0.215 exclusive protective IMV (incremental effectiveness of 0.182). For each qualityadjusted year of life gained, the amount of R$ 68,902.92 would have to be disbursed. Conclusion: the results showed that both veno-venous ECMO associated with protective mechanical ventilation and exclusive protective mechanical ventilation can be cost-effective alternatives for the treatment of patients with ARDS due to COVID-19 in the SUS, depending on the willingness to pay. However, in terms of effectiveness, ECMO was the most effective alternative, but with the highest cost increase.

The Basics of Dental Research Methodology

The goal of the research is to expand our knowledge. Based on the insights obtained decisions and choices can be made to organize our society. The need for scientific evidence should be the basis of clinical practice. Thus the ultimate aim of oral health research must be to accomplish this. This article summarizes basic steps types and ethics in research methodology. This article also provides an overview of the study designs how to identify a research problem about basic framework for conducting research in Dentistry and also discusses report writing in dental research.

Hypolipidemic trials in the elderly - a recent historic standpoint

In spite of the first trials on the effect of cholesterol reduction and its beneficial impact on morbidity and mortality in the elderly many have already proven the antecipated positive results. The high risk attributable to the elderly is a guarantee for an effort in primary prevention, especially when a high level of serum cholesterol is combined with other risk factors linked to coronary artery disease. There are elements of similarity for primary prevention in the elderly over 65 years of age, compared to middle-aged patients. This consideration opened the need for scientific evidence with confirmed levels of evidence. The first studies were WOSCOPS, AFCAPS/TEXCAPS, Heart Protection Study, PROSPER, ALLHAT (Antihipertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial-Lipid Lowering Trial), REVERSAL, Health Study, ASCOT (Anglo Scandinavian Cardiac Outcomes), MIRACL, Post CABG, AVERT, ACCESS, ASSET, ATGOAL, CHALLENGE, CURVES, BELLS, ARBITER, NASDAC, PROVE-IT and DEBATE. Positive evidences were shown from the first to the last trial recalled in this historical beginning.

Ethics in Masaryk’s classification of the sciences

Abstract Masaryk’s philosophical approach to reality is largely characterised by its orientation towards the positivism of Auguste Comte, which Masaryk sought to offset with the psychologism of J. S. Mill. The combination of these positivist approaches became the positive starting point for Masaryk’s ethics. But that was not the only influence on his ethics. Masaryk’s German translation of Hume’s book, titled Eine Untersuchung über die Prinzipien der Moral von David Hume (1883), reveals that the main stimuli that shaped Masaryk’s ideas about ethics came from David Hume. Although the need for scientific evidence became a fundamental principle of Masaryk’s thought, the need to objectively anchor ethics in rational theism necessitated in this area a departure from his positivist outlook. Masaryk’s lectures on practical philosophy attest to this fact. The reason for his departure from a positivist stance was due to the metaphysical nature of his concept of psychology.

Health Care Science—Why another journal and why we will be different?

<i>Health Care Science</i>—Why another journal and why we will be different?

Ethnobotanical Uses, Phytochemical Composition, Biosynthesis, and Pharmacological Activities of Carpesium abrotanoides L. (Asteraceae).

Carpesium abrotanoides L. (Asteraceae) is a medicinal plant with immense therapeutic importance and bioactivities. It is commonly encountered in various Asian regions. It has numerous ethnomedicinal uses for curing diverse ailments such as toothache, stomach ulcer, boils, tonsillitis, bronchitis, bacterial infection, bruises, swelling, virus infection, fever, and amygdalitis, as well as an anthelmintic versus round-, tape-, hook-, and pinworms. Different classes of phytoconstituents such as sesquiterpenes, sesquiterpene dimers, monoterpenes, and nitrogenous compounds have been reported from this plant. These phytoconstituents have proved to possess anti-inflammatory, cytotoxic, antimicrobial, and insecticidal capacities. The present review aims to summarize all published data on C. abrotanoides including traditional uses, phytoconstituents, bioactivities, and toxicological aspects, as well as the synthesis and biosynthesis of its metabolites through an extensive survey on various databases and various publishers. These reported data could draw the attention of various natural-metabolite-interested researchers and medicinal chemists towards the development of this plant and/or its metabolites into medicine for the prevention and treatment of certain illnesses. Despite the diverse traditional uses of C. abrotanoides, there is a need for scientific evidence to support these claims. Clinical trials are also required to further assure these data and validate this plant utilization in treating several diseases.

Fetal pain and its bioethical considerations

Medical and scientific advances have made it possible to carry out more and more early procedures involving human life within the mother's womb. Based on the above, the dilemma surrounding the perception or experience of fetal pain has emerged and its implications in various fields such as: prenatal diagnosis, fetal surgery and especially around abortion. This document seeks to carry out an approach to the embryological development of pain pathways and their components, to assess the relevance of the current definition of pain in this context, and the bioethical implications of the different interventions carried out on the fetus. We consider that despite the need for scientific evidence in this field, the available knowledge indicates that it is possible to experience pain in the mother's womb especially since the 20th week of gestation, so it is important to reflect on fetal pain and the need to become aware of this, before performing any intervention involving the fetus as a patient.

The myth of medical multiculturalism: how social closure marginalises traditional Chinese medicine in New Zealand

ABSTRACT This article uses neo-Weberian social closure theory and Bourdieu’s theory of symbolic violence to examine the epistemic tension between biomedicine and traditional Chinese medicine (TCM) in Aotearoa New Zealand (NZ), a country that aspires to a multicultural model of healthcare. Drawing on interviews with TCM practitioners and analysis of TCM practitioners’ attempt to become a regulated profession, we argue that a multicultural health model remains a myth as biomedical stakeholders deploy material and symbolic forms of social closure that limit the scope of TCM practice. Discourses of the need for scientific evidence, public safety, qualification standards and English language fluency undermine the culturally distinctive but pragmatic forms of medicine that TCM practitioners utilise. This has implications for TCM as practitioners are denied public funding, their scope of practice is limited, and the expectations for TCM to conform to a biomedical model of healthcare have created tensions within the TCM community.

Effects of Laws Expanding Civilian Rights to Use Deadly Force in Self-Defense on Violence and Crime: A Systematic Review.

Background. Since 2005, most US states have expanded civilian rights to use deadly force in self-defense outside the home. In most cases, legislation has included removing the duty to retreat anywhere one may legally be, commonly known as stand-your-ground laws. The extent to which these laws affect public health and safety is widely debated in public and policy discourse.Objectives. To synthesize the available evidence on the impacts and social inequities associated with changing civilian rights to use deadly force in self-defense on violence, injury, crime, and firearm-related outcomes.Search Methods. We searched MEDLINE, Embase, PsycINFO, Scopus, Web of Science, Sociological Abstracts, National Criminal Justice Reference Service Abstracts, Education Resources Information Center, International Bibliography of the Social Sciences, ProQuest Dissertations and Theses, Google Scholar, National Bureau of Economic Research working papers, and SocArXiv; harvested references of included studies; and consulted with experts to identify studies until April 2020.Selection Criteria. Eligible studies quantitatively estimated the association between laws that expanded or restricted the right to use deadly force in self-defense and population or subgroup outcomes among civilians with a comparator.Data Collection and Analysis. Two reviewers extracted study data using a common form. We assessed study quality using the Risk of Bias in Nonrandomized Studies of Interventions tools adapted for (controlled) before-after studies. To account for data dependencies, we conducted graphical syntheses (forest plots and harvest plots) to summarize the evidence on impacts and inequities associated with changing self-defense laws.Main Results. We identified 25 studies that estimated population-level impacts of laws expanding civilian rights to use deadly force in self-defense, all of which focused on stand-your-ground or other expansions to self-defense laws in the United States. Studies were scored as having serious or critical risk of bias attributable to confounding. Risk of bias was low across most other domains (i.e., selection, missing data, outcome, and reporting biases). Stand-your-ground laws were associated with no change to small increases in violent crime (total and firearm homicide, aggravated assault, robbery) on average across states. Florida-based studies showed robust increases (24% to 45%) in firearm and total homicide while self-defense claims under stand-your-ground law were more often denied when victims were White, especially when claimants were racial minorities.Author's Conclusions. The existing evidence contradicts claims that expanding self-defense laws deters violent crime across the United States. In at least some contexts, including Florida, stand-your-ground laws are associated with increases in violence, and there are racial inequities in the application of these laws.Public Health Implications. In some US states, most notably Florida, stand-your-ground laws may have harmed public health and safety and exacerbated social inequities. Our findings highlight the need for scientific evidence on both population and equity impacts of self-defense laws to guide legislative action that promotes public health and safety for all.Trial Registration. Open Science Framework (https://osf.io/uz68e).

Amendments with pyrolyzed agrowastes change bromacil and diuron's sorption and persistence in a tropical soil without modifying their environmental risk

Knowledge of pesticides fate in tropical soils and how it could be affected by pyrolyzed biomass as amendment is limited. Combining conventional and radiotracer methods, as well as risk assessment tools, the effects of several charred agrowastes on the sorption, persistence, and ecological risk of the herbicides bromacil (BMC) and diuron (DRN) were evaluated in a tropical agricultural soil under laboratory conditions. Pineapple stubble (PS), palm oil fiber (PF), and coffee hull (CH) were charred at 300 (torrefied) and 600 °C (biochar) and applied to the soil at 10 and 20 t ha−1 rates. The sorption coefficients (Koc) in unamended soil for BMC and DRN were 18.4 and 212.1 L kg−1, respectively. The addition of torrefied PS and PF caused a 3 to 4-fold increment in BMC sorption and a 3 to 6-fold change in DRN's sorption. The only biochar that affected the sorption was PS that increased DRN's sorption 3.5 times. The application of coffee hull materials had no significant effect. In terms of degradation (half-life, DT50), for unamended soil BMC's degradation (300 days) was limited compared to DRN (73 days). Alternatively, biodegradation (mineralization half-life time, MT50) was 1278 d for BMC and 538 for DRN. While only PF and CH torrefied increased BMC's persistence, all the torrefied affected DRN's persistence. However, despite the observed effects, the predicted ecological risk was not mitigated. Our results highlight the need for scientific evidence on the use of pyrolyzed organic amendments to assess potential benefits and prevent unintended impacts in tropical agroecosystems.

The Convergence-Divergence Evaluation of the Countries Development under the Globalization

The article considers the problem of uneven economic development in terms of processes of globalization and integration. The problem is analyzed retrospectively to estimate simultaneous convergent-divergent processes, which are characterized by the intensification of trade, investment and information flows, on the one hand, and their concentration in the hands of the powerful post-industrial countries, on the other. This causes the need for scientific evidence of uneven economic development of the global economy, what became an urgent issue of international economy. The article aims to evaluate the coefficient of variation, which was counted on the gross national income per capita, and conduct the cluster analysis. It was proven the divergence of the countries and rejected the s-convergence hypothesis, according to which the income dispersion between countries increased during the analyzed period. The cluster analysis shows the intensification of the the global inequality of the economic and social development, stratification, polarization and disproportions of the global economy. Article amplifies that the intensification of the globalization processes with its difficulties, nonlinearity and ambivalence leaded to the technological and social differentiation, in consequence of what many countries remain behind the developed ones. It is emphasized that convergent-divergent processes of the national economic development are expanding what leaded to the idea of the deglobalization. The findings are used to determine the current situation on the global economic arena and answer the question why some countries are rich and others are poor. It considers that the realization of the neoliberal model of the globalization is not effective and is accompanied together with the different destabilization tendencies. In this case institutional approach to the governmental organization of the globalization processes takes on special significance in aim to decrease the gap between rich and poor countries and to overcome present crisis.

｢디엔에이신원확인정보의 이용 및 보호에 관한 법률｣상 디엔에이신원확인정보의 채취대상에 관한 검토

Today, crime has become more intelligent and brutal, making it difficult to detect crimes, and thus the need for scientific evidence in criminal investigations and criminal proofs has increased. In most countries, DNA information is used as an important evidence for investigation. However, many argue that the collection of DNA identification information under the DNA law can violate individual privacy and other personal rights, and that it goes against the principle of presumption of innocence and the principle of excessive prohibition under the Constitution. However, the Constitutional Court confirmed that the collection of DNA identification information under the DNA Act was not a violation of the Constitution.<BR> In response, this paper reviewed the purpose of the DNA Act and discussed the target crimes and persons subject to DNA information, and argued for the expansion of its use. In other words, the collection of DNA identification information under the DNA Act does not treat the person subject to collection as a criminal. There is not much invasion of privacy in that it is only collected in terms of collecting administrative information and used as data to identify criminals in the event of a crime occurs. Therefore, it is necessary to expand the collection target of DNA identification information to suspects of all crimes except minor crimes, regardless of whether they are arrested or not, and to make them database when the sentence of imprisonment or confinement is confirmed. However, it is necessary to prepare strict regulations on the management and utilization of DNA identification information in order to minimize concerns about privacy infringement by collecting them.

The Hand as a Homunculus - A Perspective from Hand Acupuncture Therapy.

Homunculus is a term used to refer to any representation of a miniature human being. In scientific fields, the word homunculus has been used to refer to any scale model of the human body that represents physiological, psychological, or other human functions. The hand is thought as a homunculus of the body in Hand Acupuncture Therapy, a type of alternative medicine in Korea. Hand acupuncture therapists believe stimulating the hand can improve bodily health. Although there is a need for scientific evidence regarding this concept, those that perform hand acupuncture seem to recognize the importance of hand in our body.

The role of evidence in consumer choice of non-prescription medicines.

To identify factors influencing Australian consumer decision-making and attitudes towards non-prescription medicine (NPM) purchases, pharmacy's role in providing these medications and views around sources of evidence for effectiveness of these products. Cross-sectional survey of a general population sample of 1731 adults using an Australian online consumer panel stratified by gender, age and location (State/Territory). Beliefs about NPM purchases and evidence of their efficacy were assessed using a 5-point Likert scale (strongly disagree-strongly agree). Non-parametric measures (Ridit analysis and Mann-Whitney U-test) were used to explore associations between responses and previous experience with medicines. The most important factors when purchasing NPMs were effectiveness and safety. However, personal experience was the most common method of determining effectiveness. Most respondents believed buying NPMs in pharmacies gave access to advice, but were less likely to agree that pharmacies were associated with safe and effective treatments. Around half the respondents agreed that it is wrong to sell treatments lacking scientific evidence; many also agreed that it is up to consumers to decide what they want even without scientific evidence. Individuals experiencing an ineffective NPM were less likely to trust scientific evidence of efficacy as the sole source of effectiveness information; regular prescription medicine users often agreed that scientific evidence is needed to support effectiveness. Consumers have conflicting views regarding the need for scientific evidence and the desire for patient autonomy in NPM purchases. This presents a challenge for pharmacists wishing to maintain professional obligations to provide evidence-based treatments to consumers.

Classical Massage and Acupuncture in Chronic Back Pain - Non-Inferiority Randomised Trial.

Currently, there is a need for scientific evidence on the efficacy of classical massage therapy for chronic, unspecific back pain, especially for the improvement in functional impairment and long-term pain reduction. According to the National Health Care Guidelines, classical massage for nonspecific low back pain may only be prescribed in combination with exercise therapy and a share of the remuneration. Acupuncture, on the other hand, is recognised in the guidelines as an independent treatment for chronic back pain and is remunerated by health insurance companies. This raises the question of whether classical massage therapy is not inferior compared to acupuncture, based on the therapy of the GERAC study. The Clinic of Naturopathy in Blankenstein, Hattingen uses classical massage therapy subjectively successfully in patients with back pain. To objectify the success of the treatment, a randomised controlled, non-inferiority study was conducted. The efficacy of classical massage (KMT, n = 66) was compared with acupuncture therapy (AKU, n = 66) in patients with chronic back pain. The primary endpoint was the non-inferiority of classical massage compared with the acupuncture treatment in respect of the impairment in everyday life, with the help of the Hannover function questionnaire (HFAQ) and the reduction in pain ("Von Korff"-Questionnaire) at the follow-up after one month. In the per-protocol analysis during the period between enrollment in the study and follow-up, the responder rate of the KMT was 56.5% and thus tended to be inferior to the responder rate of the AKU with 62.5% (Δ = - 6%; KIΔ: - 23.5 to + 11.4%). The results show that classical massage therapy is not significantly inferior to acupuncture therapy in the period from admission to follow-up. Thus, the non-inferiority of the KMT to the AKU cannot be proven in the context of the defined irrelevance area.

The effect of Laser and taping on pain, functional status and quality of life in patients with fibromyalgia syndrome: A placebo- randomized controlled clinical trial.

Conservative treatments have been proved to be effective to control pain and optimize function in fibromyalgia, however there is need for scientific evidence to make better clinical application across various physiotherapy applications. The aim of this study was to investigate the effects of Laser and taping applications on pain, flexibility, anxiety, depression, functional status and quality of life in patients with fibromyalgia syndrome. Forty-five female patients with fibromyalgia syndrome were included to the study and randomly allocated into three treatment groups; Laser (n= 15), placebo Laser (n= 15), and taping applications (n= 15). Visual analogue scale for pain intensity, trunk flexibility, Fibromyalgia Impact Questionnaire for functional status, Short Form 36 Questionnaire for quality of life and health status, and Beck Depression Inventory for anxiety level were evaluated before and after three weeks interventions. There were decreased pain severity in activity (p= 0.028), anxiety level (p= 0.01) and improved general health status, quality of life (p= 0.01) found at Laser group, whereas there were increased trunk flexibility, flexion (p= 0.03), extension (p= 0.02) found at taping group. After interventions, there were decreased pain severity for whole groups at night for Laser group (p= 0.04), placebo Laser group (p= 0.001), taping group (p= 0.01) and improved functional status found for Laser group (p= 0.001), placebo Laser group (p= 0.001), taping group (p= 0.01). Kinesiotape application had a similar effect on parameters in FMS patient, so this method could be preferred instead of Laser application for rehabilitation program.