There were no external sources of funding for this study. The authors have no conflict of interest to declare.

The use of the radial pulse as a diagnostic tool is an integral part of the Traditional Chinese Medicine (TCM) patient evaluation. In spite of its long history of use, there is little systematic information available to support the many claims about the relationship between pulse qualities and physiological condition contained in the ancient Chinese texts and echoed in modern pulse terminology. This study reports the development of a reliable means of measuring and recording pulse characteristics. This was achieved by reporting on the physical sensations that are detected under the fingertips when the radial pulse is palpated, rather than attempting to translate these into the complex and typically ambiguously defined TCM pulse qualities. The study involved development of a standardised pulse taking procedure and development of concrete operational definitions for each of the characteristics of the pulse being measured. The inter-rater reliability of the pulse taking procedure and operational definitions was assessed by determining agreement levels between two independent pulse assessors for each characteristic. Inter-rater agreement averaged 80% between the two assessors in both the initial data collection (66 subjects) and in a replication collection (30 subjects) completed two months later. Demonstrating reliability of the procedure represents an essential first step for examining the validity of TCM pulse diagnosis assumptions.

Objective: Detection of delirium in hospitalised older adults is recommended in national and international guidelines. The 4 'A's Test (4AT) is a short (<2 min) instrument for delirium detection that is used internationally as a standard tool in clinical practice. We performed a systematic review and meta-analysis of diagnostic test accuracy of the 4AT for delirium detection. Methods: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, clinicaltrials.gov and the Cochrane Central Register of Controlled Trials, from 2011 (year of 4AT release on the website www.the4AT.com) until 21 December 2019. Inclusion criteria were: older adults (≥65y); diagnostic accuracy study of the 4AT index test when compared to delirium reference standard (standard diagnostic criteria or validated tool). Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled estimates of sensitivity and specificity were generated from a bivariate random effects model. Results: 17 studies (3702 observations) were included. Settings were acute medicine, surgery, a care home, and the emergency department. Three studies assessed performance of the 4AT in stroke. The overall prevalence of delirium was 24.2% (95% CI 17.8-32.1%; range 10.5-61.9%). The pooled sensitivity was 0.88 (95% CI 0.80-0.93) and the pooled specificity was 0.88 (95% CI 0.82-0.92). Excluding the stroke studies, the pooled sensitivity was 0.86 (95% CI 0.77-0.92) and the pooled specificity was 0.89 (95% CI 0.83-0.93). The methodological quality of studies varied but was moderate to good overall. Conclusions: The 4AT shows good diagnostic test accuracy for delirium in the 17 available studies. These findings support its use in routine clinical practice in delirium detection.

This project studied the lowering blood lipids effect in atherosclerotic ApoE-deficient mice. Group A mice (n = 6), fed with a normal diet, served as the negative control. The experimental groups used mice fed with a high cholesterol diet (HCD) for eight weeks, and then selected for inclusion in the study on the basis of high blood lipid levels and the formation of atherosclerotic lesion plaque, which was indicated by an ultrasound biomicroscopy test. Eighteen mice met the selection criteria (atherosclerotic mice with high blood lipid levels) and these were randomly assigned into three groups B, C and D (n = 6). Group B fed with a HCD, served as the positive control. The intervention Group C was fed with HCD and Simvastatin. The intervention Group D was fed with a HCD and Hawthorn fruit compound (HFC includes Hawthorn and Kiwi fruit extract) for eight weeks. The results showed that after feeding on a HCD, Group B had significantly higher blood lipid levels compared to Group A and this confirmed the validity of Group A and Group B controls in this study. The results also showed that compared to Group B, in both Group C and D, there was a significant reduction in triglyceride and in the ratio between low-density lipoprotein cholesterol (LDL-C) and serum cholesterol. Moreover a reduction of LDL-C was evident in Group D, whereas a similar effect did not occur in Group C. The results indicate that HFC can be considered for the treatment of hyperlipidemia and prevention of atherosclerosis.