Careful Review Research Articles

The Message behind the Syntax “There is no god but Allah, Muhammad is the Messenger of Allah” : A Study and Investigation

ABSTRACT The library holds a varied assortment of books and treatises covering multiple areas of expertise. The ancients manually transcribed and curated knowledge, dedicating their lives to facilitating its accessibility for students and scholars. One text provides a summary of knowledge rulings. The researcher was motivated by their heritage and a desire for pride, leading them to consciously choose to study and investigate methods for documenting the subject matter. Through perseverance, the researcher was able to obtain a valuable manuscript. The researcher determined that the interdisciplinary research is a valuable addition to the field after careful review. Thus, it suggests researching, validating, and sharing it with experts in the field. The study was titled "Syntax of There is no god but God, and Muhammad is the Messenger of Allah." Upon obtaining a manuscript inscribed with the declaration "There is no god but Allah, and Muhammad is the Messenger of Allah" in Arabic, the researcher felt compelled to examine its contents. The manuscript discusses the significance of monotheism in Islam.

A scoping review of surgical care for people experiencing homelessness: prevalence, access, and disparities.

Numerous studies have highlighted the inequitable access to medical and psychiatric care that people experiencing homelessness (PEH) face, yet the surgical needs of this population are not well understood. We sought to assess evidence describing surgical care for PEH and to perform a thematic analysis of the results. Ovid MEDLINE, Embase, and Web of Science were searched using the terms "surgery" AND "homelessness." Grey literature was also searched. We used a stepwise scoping review methodology, followed by thematic analysis using an inductive approach. We included 104 articles in our review. Studies were included from 5 continents; 63% originated in the United States. All surgical specialties were represented with varying surgical conditions and procedures for each. Orthopedic surgery (21%) was the most frequently reported specialty. Themes identified included characteristics of PEH receiving surgical care, homeless-to-housed participants, interaction with the health care system, educational initiatives, barriers and challenges, and interventions and future strategies. We identified significant variation and gaps, representing opportunities for further research and interventions. Further addressing the barriers and challenges that PEH face when accessing surgical care can better address the needs of this population.

P498 An expert Delphi consensus: Early identification of patients at risk of Crohn's disease in perianal fistulas and abscesses (PREFAB) and identification and management of isolated perianal Crohn's disease (ipCD) - Part B, ipCD

Abstract Background In clinical practice, some patients with ‘idiopathic’ perianal fistulae (iPAF) and no evidence of luminal IBD are labelled ‘isolated perianal Crohn’s disease’ (ipCD) and treated with IBD-directed therapies. However, there are no accepted criteria to guide which patients should be diagnosed as ipCD, or how they should be managed. This project aimed to provide a definition of ipCD, strategies for management, and a platform for building further understanding of this group. Methods An expert panel of IBD gastroenterologists, surgeons and radiologists took part in a Delphi consensus on ipCD. The first-round was an electronic survey, probing: 1) personal experience of ipCD; 2) how fistula histology may influence ipCD diagnosis; 3) patient and fistula features suggestive of ipCD; and 4) suggested management of patients with suspected-ipCD. Responses informed the creation of clinical criteria for ipCD, and statements on ipCD management, which were discussed, amended, and agreed-upon at a second-round virtual consensus meeting. Consensus was predefined as ≥70% ‘strongly agree’ or ‘agree with minor reservation’. Results >30 specialists participated. In round 1: 93% agreed ipCD is a separate Crohn’s phenotype; 83% reported having treated ipCD patients with IBD medical therapies; 73% agreed iPAF patients with fistula histology suggestive of ipCD could be labelled as histologically-confirmed ipCD; and 93% agreed histologically-confirmed ipCD with complex fistulation should be treated with IBD medical therapy (e.g., biologics). However, there was no consensus on the appropriateness of IBD medical therapy for simple fistulae. For iPAF patients without histological evidence of IBD, the panel agreed factors suggestive of ipCD. These included: family history of IBD, symptoms of IBD extraintestinal manifestations, co-existent/previous perianal lesions (fissures, anal stricture, tags), and certain fistula features. Factors were used to produce a criteria to diagnose ipCD and identify patients appropriate for a trial of medical therapy. If a trial of therapy is pursued, the panel agreed careful discussion of the risks of treatment, and known-unknowns, when treating ipCD. Optimised anti-TNF is preferred first-line (82% agreement) with a careful review of treatment response, and contemporaneous MRI, at 6-12 months (93% agree). Conclusion ipCD is a contentious label and standardisation of the diagnosis could help us better assess this group and their treatment outcomes. We present a suggested criteria for diagnosing this group, and a pragmatic approach to trialling biologic therapy. Key to managing this group is honest discussion regarding the known-unknowns of ipCD treatment, to manage patient expectations and support a joint decision-making approach.

The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study)

BackgroundThis study estimated the prevalence of evidence-based care received by a population-based sample of Australian residents in long-term care (LTC) aged ≥ 65 years in 2021, measured by adherence to clinical practice guideline (CPG) recommendations.MethodsSixteen conditions/processes of care amendable to estimating evidence-based care at a population level were identified from prevalence data and CPGs. Candidate recommendations (n = 5609) were extracted from 139 CPGs which were converted to indicators. National experts in each condition rated the indicators via the RAND-UCLA Delphi process. For the 16 conditions, 236 evidence-based care indicators were ratified.A multi-stage sampling of LTC facilities and residents was undertaken. Trained aged-care nurses then undertook manual structured record reviews of care delivered between 1 March and 31 May 2021 (our record review period) to assess adherence with the indicators.ResultsCare received by 294 residents with 27,585 care encounters in 25 LTC facilities was evaluated. Residents received care for one to thirteen separate clinical conditions/processes of care (median = 10, mean = 9.7). Adherence to evidence-based care indicators was estimated at 53.2% (95% CI: 48.6, 57.7) ranging from a high of 81.3% (95% CI: 75.6, 86.3) for Bladder and Bowel to a low of 12.2% (95% CI: 1.6, 36.8) for Depression. Six conditions (skin integrity, end-of-life care, infection, sleep, medication, and depression) had less than 50% adherence with indicators.ConclusionsThis is the first study of adherence to evidence-based care for people in LTC using multiple conditions and a standardised method. Vulnerable older people are not receiving evidence-based care for many physical problems, nor care to support their mental health nor for end-of-life care. The six conditions in which adherence with indicators was less than 50% could be the focus of improvement efforts.

Review of epilepsy care in the Democratic Republic of the Congo.

Epilepsy imposes a substantial burden on the Democratic Republic of Congo (DRC). These challenges encompass the lack of comprehensive disease surveillance, an unresolved understanding of its pathophysiology, economic barriers limiting access to essential care, the absence of epilepsy surgical capabilities, and deeply ingrained societal stigmas. Notably, the national prevalence of epilepsy remains undetermined, with research primarily concentrating on infectious factors like Onchocerca volvulus, leaving other potential causes underexplored. Most patients lack insurance, incurring out-of-pocket expenses that often lead them to opt for traditional medicine rather than clinical care. Social stigma, perpetuated by common misconceptions, intensifies the social isolation experienced by individuals living with epilepsy. Additionally, surgical interventions are unavailable, and the accessibility of anti-seizure medications and healthcare infrastructure remains inadequate. Effectively tackling these interrelated challenges requires a multifaceted approach, including conducting research into region-specific factors contributing to epilepsy, increasing healthcare funding, subsidizing the costs of treatment, deploying mobile tools for extensive screening, launching awareness campaigns to dispel myths and reduce stigma, and promoting collaborations between traditional healers and medical practitioners to enhance local understanding and epilepsy management. Despite the difficulties, significant progress can be achieved through sustained and compassionate efforts to understand and eliminate the barriers faced by epilepsy patients in the region. This review outlines essential steps for alleviating the epilepsy burden in the DRC. PLAIN LANGUAGE SUMMARY: There are not enough resources to treat epilepsy in the DRC. PWEs struggle with stigma and the lack of money. Many of them still use traditional medicine for treatment and hold wrong beliefs about epilepsy. That is why there is a need for more resources to make the lives of PWEs better in the DRC.

Frequent Errors in Modeling by Machine Learning: A Prototype Case of Predicting the Timely Evolution of COVID-19 Pandemic

Background: The development and application of machine learning (ML) methods have become so fast that almost nobody can follow their developments in every detail. It is no wonder that numerous errors and inconsistencies in their usage have also spread with a similar speed independently from the tasks: regression and classification. This work summarizes frequent errors committed by certain authors with the aim of helping scientists to avoid them. Methods: The principle of parsimony governs the train of thought. Fair method comparison can be completed with multicriteria decision-making techniques, preferably by the sum of ranking differences (SRD). Its coupling with analysis of variance (ANOVA) decomposes the effects of several factors. Earlier findings are summarized in a review-like manner: the abuse of the correlation coefficient and proper practices for model discrimination are also outlined. Results: Using an illustrative example, the correct practice and the methodology are summarized as guidelines for model discrimination, and for minimizing the prediction errors. The following factors are all prerequisites for successful modeling: proper data preprocessing, statistical tests, suitable performance parameters, appropriate degrees of freedom, fair comparison of models, and outlier detection, just to name a few. A checklist is provided in a tutorial manner on how to present ML modeling properly. The advocated practices are reviewed shortly in the discussion. Conclusions: Many of the errors can easily be filtered out with careful reviewing. Every authors’ responsibility is to adhere to the rules of modeling and validation. A representative sampling of recent literature outlines correct practices and emphasizes that no error-free publication exists.

A review of the trends in the first six years of a palliative care unit in Trinidad and Tobago

Objectives: To present key data accumulated from the first six years of a publicly funded Palliative Care Unit (PCU) in Trinidad and Tobago. Methods: This was an observational, descriptive, retrospective study. Data was sampled from five (5) service areas: admissions to the PCU, out-patient clinic, hospital consultations, family meetings and telephone calls. Demographic data, reason for referral, diagnosis, time to consultation and outcome data were collected. Results: The Palliative Care Unit was accessed by 2579 patients between 2014 – 2020. Ages ranged from 3-103 years. There were 1004 unique in-patient admissions, most of whom fell in the age range 62-82 years. 83% had a documented cancer diagnosis. 90% of patients spent less than 30 days at the PCU. Discharge rate was 25%. Most out-patient clinic referrals were for symptom management – 90.8% of these had cancer. Median time from palliative care review at out-patient clinic to death was 34 days (Interquartile range (IQR) 12-107 days). For the hospital consultation service, 82.8% had a cancer diagnosis. Median time from palliative care review to death was 11 days, Interquartile range (IQR) 4-39 days. Conclusion: The Caura PCU meets the needs of a small proportion of palliative patients in Trinidad and Tobago. The service is accessed mostly by patients with cancer, and referrals are frequently made late in the disease trajectory. This service needs to be expanded to include a community/home-based service and a paediatric service. Palliative care needs to become integrated throughout the health service in Trinidad and Tobago.

Psychiatric in-patient care in England: as safe as it can be? An examination of in-patient suicide between 2009 and 2020.

Psychiatric in-patients have a greatly elevated risk of suicide. We aimed to examine trends in in-patient suicide rates and determine if characteristics of in-patients who died by suicide have changed over time. We identified all in-patients in England who died by suicide between 2009 and 2020 from the National Confidential Inquiry into Suicide and Safety in Mental Health. Suicide rates were calculated using data from Hospital Episodes Statistics. The rate of in-patient suicide per 100 000 bed days fell by 41.9% between 2009-2011 and 2018-2020. However, since 2016 the rate has remained static with no significant fall. Rates fell in men, those aged 30-59, and those with schizophrenia and other delusional disorders or personality disorder. Rates also fell for suicide by hanging (including hanging on the ward) and jumping. No falls were seen in suicide rates among women, younger and older age groups, and those with affective disorder. There was no indication of a transfer of risk to the post-discharge period or to home treatment/crisis care. More in-patients in the latter part of the study were aged under 25, were on authorised leave, and had psychiatric comorbidity. In-patient suicide has significantly fallen since 2009, suggesting patient safety may have improved. The recent slowdown in the fall in rates, however, highlights that renewed preventative efforts are needed. These should include a greater focus on women, younger and older patients, and those with affective disorder. Careful reviews prior to granting leave are important to ensure a safe transition into the community.

A protocol for a systematic review and meta-analysis of tuberculosis care around the time of pregnancy.

Tuberculosis is estimated to cause 1.5 million deaths annually and is most common during the reproductive years. Despite that fact, we found that tuberculosis screening, prevention or care recommendations for people around the time of pregnancy were absent from some national policy recommendations and varied in others. To address the apparent gaps and inconsistencies in policy, we aim to design a systematic review and meta-analysis of the original research evidence informing tuberculosis care around the time of pregnancy. With assistance from librarians at the Biomedical library of the University of Gothenburg, Pubmed, CINAHL and Scopus databases will be searched. Search terms will aim to identify studies generating original research evidence informing care for tuberculosis around the time of pregnancy. Evidence may include: the outcome of TB and/or of pregnancy; the cost-effectiveness or acceptability of any intervention; the sensitivity and specificity of any assessment, selection, diagnostic or test criterion. The output from these literature searches will be screened by two independent reviewers to select the eligible studies for inclusion. Discrepancies will be resolved with a third reviewer. Firstly, publications that provide contextual data will be tabulated, summarising their main contributions. Secondly, studies that provide evidence directly guiding patient care will be our focus and will be considered to be key. The key studies will be subject to quality assessment, data extraction and when possible, meta-analysis. This systematic review and meta-analysis aims to guide policy, practice and future research priorities concerning tuberculosis care around the time of pregnancy.

Management of Neurologic Complications in Patients with Brain and Spine Tumors.

Patients with brain and spine tumors represent a distinct population with unique needs. We provide a practical review of neurologic care in this group with an emphasis on familiarizing the general neurologist to the nuances of neuro-oncologic supportive care. We review the management of cerebral edema, steroid dosing, and pertinent side effects. We discuss seizure management, including choice of anticonvulsants, putative antitumor effects, and important seizure mimics like drop attacks. We review the presentation and symptomatology of stroke-like migraine attack after radiation therapy (SMART syndrome). We describe the signs and symptoms that should prompt concern for metastatic spinal cord compression, as well as both acute and definitive treatment options. Finally, we discuss the underappreciated incidence of venous thromboembolic events, particularly in patients with gliomas, and review the data on management.

Current Understanding of PCSK9 and Its Relevance to Cancer Prognosis and Immune Therapy: A Review.

The effectiveness of immunotherapy for most cancer patients remains low, with approximately 10-30% of those treated surviving. Thus, much effort is being put into finding new ways to improve immune checkpoint therapy. Our review concludes that inhibition of proprotein convertase subtilisin/Kexin type 9 (PCSK9), which plays a critical role in regulating cholesterol metabolism, can cause movement of T cells toward tumors, with increased sensitivity to immune checkpoint therapies. We searched PubMed, NCBI, Scopus, and Google Scholar for the published articles without limitations on publication dates. We used the following terms: "PCSK9", "Cancer", "Immune Checkpoint", and "Cancer Prognosis" in the title and/or abstract. Our search initially revealed 600 records on the subject and stored them in the used databases under EndNote X8 management software. A total of 161 articles were selected and through a careful review, 76 were included in our research. We concluded that PCSK9 reduces the number of LDL receptors (LDL-R) on the cell surface, which is linked to its ability to regulate cholesterol levels in the body. Also, we discuss how suppressing PCSK9 leads to the MHC-1 accumulation on the surface of cancer cells, which results in T lymphocyte invasion. Finally, we believe that inhibiting PCSK9 may be an effective strategy for improving cancer immunotherapy.

An irony and an idyll: stylistic unity of two worlds in S. Andrukhovich’s short novel “Milena’s Summer”

An important feature of Ukrainian literature, especially in the period after the collapse of the Soviet Union, has been the search for the Self, the awareness and reflection of one’s own post-colonial traumatic experience, and the search for ways to understand and survive it. The generation of young writers of Ukraine is in the process of shaping a new non-Soviet identity, and the study of this process is of particular importance. Thus, the subject of this research is the first short novel “Milena’s Summer” (2002) by Sofia Andrukhovich, a young author from the generation of the authors of the 2000s. Literary criticists wrote positive, but very careful review, and now it is very important for us to revisit “Milena’s Summer”. Firstly, this short novel marks the beginning of Sofia Andrukhovich’s literary career, offering a glimpse into her evolving style; secondly, we aim to situate it in the context of Ukrainian postmodernism and other young Ukrainian postmodern authors; finaly, we seek to analyse as a stylistic and postcolonialistic guest of a young Ukrainian writer, striving to find a new non-Soviet identity. The main objective of the article is to examine postcolonial postcoloniality as a stylistic element of the novel. The methodology of the article is based on the methods of postcolonial criticism (Tamara Gundorova, Marko Pavlyshyn, Edward Said) and the semiotic approach to style (Umberto Eco), which help to broadly reveal such important components as the play with the text, the play with the idyll genre, irony, and to describe the author’s techniques This study aims to draw attention to the early creative achievements of Sofia Andrukhovych, as there has not been a comprehensive and in-depth study of her novels yet. It identifies and shows postcolonialism as a stylistic dominant, describes the role of hyperbole in shaping the artistic worlds of the work, and creates the effect of unrealism. Futhermore, article’s main objective is to examine postcoloniality as a stylistic element that shapes the novel. The methodology of the article draws on the methods of postcolonial criticism (Tamara Gundorova, Marko Pavlyshyn, Edward Said) and the semiotic approach to style (Umberto Eco), which help to broadly reveal such important components as the play with the text, the play with the idyll genre, irony, and to describe the author’s techniques. This study aims to draw attention to the early creative achievements of Sofia Andrukhovych, as there has not yet been a comprehensive and in-depth study of her novels. It identifies and shows postcolonialism as a stylistic dominant, describes the role of hyperbole in shaping the artistic worlds of the work, and creates the effect of unrealism. Furthermore, the study and analysis of the early works of the now well-known and ‘mature’ Ukrainian writer offers promising avenues for further research. This applies both to Sofia Andrukhovych’s first novels and short stories, which can be analysed in this way, and to her contemporary works, as it may facilitate a broader and deeper understanding and appreciation of her contemporary work.

Fifth World Congress of Sports Physical Therapy Scientific Abstracts.

The International Journal of Sports Physical Therapy is pleased to publish abstracts from the 5th World Congress of Sports Physical Therapy, which will take place in Oslo, Norway, June 14-15, 2024. The theme of the Congress is "From Science To Clinical Practice." The variety of presentations during this congress are examples of the contemporary sports physical therapy research activities taking place around the world. The abstracts presented in the following pages were selected by the Scientific Committee, which included members from the International Federation of Sports Physical Therapy. It should be noted that abstracts have not been reviewed by the Editorial Board, Associate Editors or Editor-in-Chief of the International Journal of Sports Physical Therapy. After careful review by an international team of reviewers, research abstracts will be presented by authors at the World Congress. Each abstract presents only a brief summary of a research project / presentation and does not permit full assessment of the scientific rigor with which the work was conducted. While the abstracts offer only preliminary results that may require further refinement and future validation, they do serve an important role of sharing new research ideas from around the world. This sharing of ideas helps to encourage worldwide dialogue among researchers, clinicians, and educators that will ultimately contribute to the sports physical therapy body of knowledge. Notice: The abstracts below are presented as prepared by the authors. The accuracy and content of each abstract remain the responsibility of the authors.

Legal aspects of generative artificial intelligence and large language models in examinations and theses.

The high performance of generative artificial intelligence (AI) and large language models (LLM) in examination contexts has triggered an intense debate about their applications, effects and risks. What legal aspects need to be considered when using LLM in teaching and assessment? What possibilities do language models offer? Statutes and laws are used to assess the use of LLM: - University statutes, state higher education laws, licensing regulations for doctors - Copyright Act (UrhG) - General Data Protection Regulation (DGPR) - AI Regulation (EU AI Act) LLM and AI offer opportunities but require clear university frameworks. These should define legitimate uses and areas where use is prohibited. Cheating and plagiarism violate good scientific practice and copyright laws. Cheating is difficult to detect. Plagiarism by AI is possible. Users of the products are responsible. LLM are effective tools for generating exam questions. Nevertheless, careful review is necessary as even apparently high-quality products may contain errors. However, the risk of copyright infringement with AI-generated exam questions is low, as copyright law allows up to 15% of protected works to be used for teaching and exams. The grading of exam content is subject to higher education laws and regulations and the GDPR. Exclusively computer-based assessment without human review is not permitted. For high-risk applications in education, the EU's AI Regulation will apply in the future. When dealing with LLM in assessments, evaluation criteria for existing assessments can be adapted, as can assessment programmes, e.g. to reduce the motivation to cheat. LLM can also become the subject of the examination themselves. Teachers should undergo further training in AI and consider LLM as an addition.

A Scoping Review of Dementia and Diabetes Co-Morbidity Care

Diabetes mellitus is a common co-morbidity with dementia. Diabetes is usually a self-managed condition requiring an individual to have a high level of cognitive functioning; hence dementia makes managing diabetes very challenging for the individual with dementia and their caregivers. The purpose of this literature review was to synthesise what is currently known about diabetes and dementia co-morbidity care outcomes. Online databases (AMED, CINAHL, PROQUEST, EBM Reviews, TRIP, Medline and PsycINFO) were searched for the period 2012 – 2023, from which we selected 27 publications. Of the 27 publications 8 were literature reviews/expert discussion of the literature, 1 audit, 1 case report, 5 cohort studies, 2 cross sectional studies, 4 mixed methods studies, 2 realist reviews, 1 longitudinal observation study and 3 qualitative studies. Selected literature was from the UK, USA, Canada, Japan, Austria, Germany, France and Poland. Five themes permeated this literature: key principles of care, challenges of diabetes management as a consequence of dementia, complexity of care, quality of care and workforce issues. This review highlights the complexity of care for those with co-morbid diabetes and dementia, which are both progressive diseases which change over time. There is a need to develop the underpinning evidence base in order to provide guidelines for best practice, to support staff to deliver appropriate care to people living with this co-morbidity

From Etiology to Intervention: A Holistic Review of Bunion Pathophysiology and Care.

In this review paper, we present the common etiology, presentation, diagnosis, and management of the following three common bunion formations: dorsal bunion, tailor's bunion, and hallux valgus (HV). Bunions are common pathologies that present to a variety of clinics, so it is important for providers to have a base understanding of these in order to provide the best care to patients. Many of these bunion formations have a variety of causes which allow providers to manage them before surgical intervention is required. The aim of this review paper is to bring attention and expanded insight on these common bunion presentations in order to minimize morbidity early on. The information provided in this review will allow both primary care and subspecialty physicians with the knowledge to accurately diagnose and optimally manage these bony deformities of the lower extremity.

Toward the Future: Circular Economy Models for Sustainable Waste Management

This research aims to investigate and analyze the role of the circular economy model in developing a sustainable waste management system. With a focus on the concept of striving toward the future, this research explores how circular economy models have been applied in the context of waste management to reduce environmental impacts and encourage sustainable economic growth. Through a careful literature review, this study presents an in-depth understanding of the circular economy concept and its implementation in waste management. In addition, this research also describes the role of society, government, and the industrial sector in building effective and sustainable circular economy models. This research method includes qualitative analysis of case studies and existing best practices in various countries and sectors. By noting the challenges and opportunities associated with implementing circular economy models, this study offers valuable insights for practitioners, policymakers, and academics in their efforts to advance sustainability principles in waste management. The findings of this research highlight the importance of cross-sector collaboration and active participation of various stakeholders in designing and implementing successful circular economy models. This study also shows that sustainable waste management plays a crucial role in realizing overall sustainable development goals. In conclusion, this research confirms that the development of circular economy models for waste management is an important step toward a sustainable future. By involving all relevant parties and implementing a collaborative approach, we can create a waste management system that is not only economically efficient but also environmentally friendly, paving the way to a brighter future for future generations.

Custom Glenoid Implant in Total Shoulder Arthroplasty: Case Report of Two Patients

Glenohumeral arthritis is typically treated with shoulder arthroplasty, however in younger patients with complex glenoid pathology this can become more challenging. Considerations surrounding surgical management strive to provide a functional, stable shoulder, while maintaining options for revision in the future. Custom glenoid implants have emerged as a promising option for patients in this challenging population, however there is a lack of literature surrounding their use for addressing glenoid bone loss for anatomic total shoulder arthroplasty. This case report highlights the course of treatment for 2 patients with severe glenoid bone deficiency and debilitating shoulder pain. A custom glenoid implant was used after careful consideration and review of available options. The use of a convertible custom glenoid implant for these patients allowed for improved function and decreased pain, while preserving options for treatment in the future.

A Comparative Analysis of Generic Drug Assessment and Regulatory Approval in the USA, Europe and India.

The Abbreviated New Drug Application (ANDA) is used for the regulatory submission of generic drugs, which are pharmaceutical equivalents to brand-name drugs and distributed without patent protection. Different countries have their own regulatory requirements for the approval of generic drugs, enforced by authorities such as the CDSCO in India, EDQM in Europe, and USFDA in the United States. This review aims to compare the regulatory processes and requirements for generic drug approval in India, Europe, and the US, highlighting key differences and challenges. The involvement of regulatory authorities in the drug development process is crucial for expediting approval and addressing queries, helping to minimize delays. The Common Technical Document (CTD) format is employed across regions to harmonize submission requirements. This study underscores the differences in dossier submission for generics across the three regions, illustrating India's position in the global generic drug approval landscape. By comparing approval requirements, this work provides insight into the hurdles India must overcome to streamline its approval process. The ANDA allows generic manufacturers to submit bioequivalence studies, using the original innovator's safety and efficacy data. However, obtaining approval simultaneously from multiple regulatory authorities remains a challenging task. Careful review of regulatory documents by skilled personnel can reduce regulatory queries, ultimately accelerating the market launch of generic drugs. This review provides a comprehensive overview of the generic drug approval process, emphasizing the need for harmonization and improved efficiency in India's regulatory framework.

Japan Society of Gynecologic Oncology 2022 guidelines for uterine cervical neoplasm treatment.

The Japan Society of Gynecologic Oncology (JSGO) Guidelines 2022 for the Treatment of Uterine Cervical Cancer are revised from the 2017 guideline. This guideline aimed to provide standard care for cervical cancer, indicate appropriate current treatment methods for cervical cancer, minimize variances in treatment methods among institutions, improve disease prognosis and treatment safety, reduce the economic and psychosomatic burden of patients by promoting the performance of appropriate treatment, and enhance mutual understanding between patients and healthcare professionals. The guidelines were prepared through the consensus of the JSGO Guideline Committee, based on a careful review of evidence gathered through the literature searches and the medical health insurance system and actual clinical practice situations in Japan. The guidelines comprise seven chapters and 5 algorithms. The main features of the 2022 revision are as follows: 1) added discussed points at the final consensus meeting; 2) revised the treatment methods based on the International Federation of Gynecology and Obstetrics 2018 staging system; 3) examined minimally invasive surgery based on Laparoscopic Approach to Cervical Cancer trial; 4) added clinical question (CQ) for treatments of rare histological types, gastric type, and small-cell neuroendocrine carcinoma; 5) added CQ for intensity-modulated radiation therapy; 6) added CQ for cancer genomic profiling test; and 7) added CQ for cancer survivorship. Each recommendation is accompanied by a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here, we present the English version of the JSGO Guidelines 2022 for the Treatment of Uterine Cervical Cancer.