Medicine Literature Research Articles

Association of DNA methylation of RASSF1A and SHOX2 with lung cancer risk: A systematic review and meta-analysis.

This study estimates the research upon the potential worth of Ras association domain family member 1 A (RASSF1A) and short stature homeobox 2 (SHOX2) DNA methylation in lung cancer (LC) diagnosis. Open-published research was searched through PubMed, EMBASE, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, and Chinese Biology Medicine Literature Database. Data on true positives, false positives, false negatives, and true negatives were extracted. This meta-analysis included 22 studies encompassing 4109 subjects (2427 LC patients and 1682 controls). The combined sensitivity, specificity, and area under the curve for RASSF1A and SHOX2 DNA methylation were 0.77 (95% CI: 0.71-0.81), 0.90 (95% CI: 0.87-0.92), and 0.92 (95% CI: 0.87-0.92), respectively. The pooled positive likelihood ratio and negative likelihood ratio were 7.5 (5.9-9.7) and 0.26 (0.21-0.32). The combined diagnostic odds ratio was 29 (95% CI: 20-41). RASSF1A and SHOX2 DNA methylation may emerge as potential diagnostic biomarkers for early-stage LC.

Topic Modeling Analysis of Chinese Medicine Literature on Gastroesophageal Reflux Disease: Insights into Potential Treatment.

To analyze Chinese medicine (CM) prescriptions for gastroesophageal reflux disease (GERD), we model topics on GERD-related classical CM literature, providing insights into the potential treatment. Clinical guidelines were used to identify symptom terms for GERD, and CM literature from the database "Imedbooks" was retrieved for related prescriptions and their corresponding sources, indications, and other information. BERTopic was applied to identify the main topics and visualize the data. A total of 36,207 entries are queried and 1,938 valid entries were acquired after manually filtering. Eight topics were identified by BERTopic, including digestion function abate, stomach flu, respiratory-related symptoms, gastric dysfunction, regurgitation and gastrointestinal dysfunction in pediatric patients, vomiting, stroke and alcohol accumulation are associated with the risk of GERD, vomiting and its causes, regurgitation, epigastric pain, and symptoms of heartburn. Topic modeling provides an unbiased analysis of classical CM literature on GERD in a time-efficient and scale-efficient manner. Based on this analysis, we present a range of treatment options for relieving symptoms, including herbal remedies and non-pharmacological interventions such as acupuncture and dietary therapy.

Evaluating the Acceptability and Impact of an Online, Lifestyle-Based Mental Well-Being Initiative Targeting School Communities in New York State - Lifting the School Community Project.

To determine the acceptability and impact of an online, lifestyle-based mental well-being initiative in a school-based setting. A post-program evaluation survey was administered after the intervention. Fifty-seven New York State school districts. Participating school districts invited all employees and community members to register for the intervention. A total of 4083 individuals participated, with 1060 (26%) responding to the post-program survey. The 7-week intervention (The Lift Project) incorporated strategies from lifestyle medicine, positive psychology and neuroscience literature. The ten lessons included online, video-based content and related experiential learning exercises. The post-program survey included Likert items that evaluated the participants' perceived program acceptability, mental health enhancement, self-efficacy, and skill acquisition. Inductive thematic qualitative analysis assessed the participants' likes and dislikes concerning the initiative. A high percentage of respondents indicated that the program improved their well-being (85%), enhanced their well-being-related self-efficacy (92%), and provided them with skills for supporting their long-term mental well-being (82%). Respondents liked the evidence-based, engaging content and design elements and the focus on personal well-being, community connection, and practical applicability. Some respondents desired more social connection, disliked certain design elements, lacked time and experienced technical issues. The initiative was acceptable and impactful, indicating that school districts may serve as an effective network for addressing the mental health epidemic.

Ideas of acupuncture diagnosis and treatment of stroke sequela based on the differentiation of disease location

Through collecting the relevant records of "brain" in ancient traditional Chinese medicine literature, the potential structure and function of the "motor system of brain-meridian-muscle region" and "perception system of brain-meridian-cutaneous region" of the human body are analyzed preliminarily. In view of the characteristics of the symptoms of stroke sequela, focusing on the differentiation of disease location and associated with the identification of disease property, the pathogenesis of stroke is determined, "malnutrition of the sea of marrow, dysfunction of meridian muscle region and disharmony of the nutrient and the defensive in the meridian cutaneous region", while, the basic principle of treatment is formulated, "filling up the marrow, replenishing the brain, regulating meridian muscle regions, tonifying qi and facilitating blood circulation in meridians and collaterals". Based on the above, the acupoints selected in treatment and the techniques of acupuncture and moxibustion are clarified. This article presents the references for the clinical practice of acupuncture and moxibustion and provides the individual therapeutic regimen for stroke patients.

AN ORGAN-SPECIFIC APPROACH TO THE MANAGEMENT OF GESTATIONAL HYPERTENSION - EVIDENCE VS. TRADITION.

The management of hypertensive disease in pregnancy is currently guided by practice recommendations based largely on observational data from a half century ago and has changed only superficially since that time. These recommendations are both narrowly prescriptive (women without traditional features of severe disease should all be delivered at exactly 37 weeks and 0 days,) and at the same time frustratingly ambiguous (the presence of epigastric pain unresponsive to repeat analgesics precludes expectant management at any gestational age, regardless of laboratory studies.) Guidelines which ignore recent data from the obstetric, pediatric and internal medicine literature too often lead practitioners to be more aggressive than necessary in the delivery of very premature pregnancies, and, conversely, more complacent than patient safety would support in prolonging pregnancy with advanced fetal maturity. We present here an alternative, organ-specific based approach to the management of gestational hypertension which allows and encourages practitioners to formulate a management plan based on a thoughtful and, when possible, evidence- based synthesis of the continuous variables of blood pressure, degree of organ dysfunction and response to treatment, gestational age, and patient balancing of maternal and fetal/neonatal risks. Such clinical care is more complex and nuanced than simply basing life-altering critical management decisions, including timing of delivery, on whether the patient does, or does not have any one of the conditions described by box 4 of the current American College of Obstetricians and Gynecologists practice guidelines. Nonetheless, we believe this approach will not only improve care but will also open the door to useful investigations into prevention and management of the various entities traditionally considered as the same disease process.

The crucial component(s) of Guizhi Fuling Wan in inhibiting endometriosis development

Ethnopharmacological relevanceEndometriosis is a common gynecological disorder that manifests as chronic pelvic pain and subfertility. Guizhi Fuling Wan (GFW), which contains five herbs, was first described in Chinese canonical medicine to treat qi stagnation and circulation. Although the inhibition of endometriosis by GFW has been previously demonstrated, its efficacy could potentially be improved by adjusting the dose of each component. AimThis study aimed to examine the relative importance of herbs in endometriosis treatment. Materials and methodsEndometriosis was induced in C57BL/6NCrlBltw mice, followed by treatment with H2O, GFW, all individual herbs of GFW, and GFW with sequential deletion of a single herb for 28 days. Immunohistochemistry and western blotting were performed to examine the expression of inflammatory and apoptotic markers. ResultsThe endometriosis-inhibiting effect of GFW was reduced by deletion of either Guizhi or Fuling. Guizhi, Fuling, or Taoren alone also inhibit the development of endometriosis. The reduction in intercellular adhesion molecule 1 (ICAM-1) by GFW was attenuated by deletion of Guizhi, Fuling, or Taoren, whereas either Guizhi or Fuling alone decreased ICAM-1 expression. The deletion of either Guizhi or Fuling diminished the enhancement of caspase-3 by GFW, whereas caspase-3 expression was elevated by either Guizhi or Fuling alone. ConclusionDeletion of either Guizhi or Fuling attenuated the inhibition of endometriosis development, while either Guizhi or Fuling alone maintained the endometriosis-inhibiting effect of GFW. Consistent with the description in the canonical literature of traditional Chinese medicine, this study revealed that Guizhi and Fuling are the most crucial components of GFW in treating endometriosis, as they are the emperor drugs of this formula, whereas Taoren is a minister drug.

Structure-property Relationships Reported for the New Drugs Approved in 2023.

Drug-like properties play pivotal roles in drug adsorption, distribution, metabolism, excretion, and toxicity. Therefore, efficiently optimizing these properties is essential for the successful development of novel therapeutics. Understanding the structure-property relationships of clinically approved drugs can provide valuable insights for drug design and optimization strategies. Among the new drugs approved in 2023, which include 31 small-molecule drugs in the US, the structureproperty relationships of nine drugs were compiled from the medicinal chemistry literature, in which detailed information on pharmacokinetic and/or physicochemical properties was reported not only for the final drug but also for its key analogs generated during drug development. The structure- property relationships of nine newly approved drugs are summarized, including three kinase inhibitors and three G-protein-coupled receptor antagonists. Several optimization strategies, such as bioisosteric replacement and steric handle installation, have successfully produced clinical candidates with enhanced physicochemical and pharmacokinetic properties. The summarized structure- property relationships demonstrate how appropriate structural modifications can effectively improve overall drug-like properties. The ongoing exploration of structure-property relationships of clinically approved drugs is expected to offer valuable guidance for developing future drugs.

Methodological standards in the design and reporting of pilot and feasibility studies in emergency medicine literature: a systematic review

ObjectivePilot and feasibility studies are intended to ensure that subsequent randomised controlled trials (RCTs) are feasible, economical and rigorous, especially in a challenging research environment such as emergency medicine (EM)....

Rates of Reporting and Analyzing Race and Ethnicity in Athlete-Specific Sports Medicine Research: A Systematic Review.

Race- and ethnicity-based differences in treatment access and outcomes have been reported in the orthopaedic sports medicine literature. However, the rate at which race and ethnicity are reported and incorporated into the statistical analysis of sports medicine studies remains unclear. To determine the rate at which race and ethnicity are reported and analyzed in athlete-specific sports medicine literature. Systematic review; Level of evidence, 4. Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, articles published by the 3 journals of the American Orthopaedic Society for Sports Medicine between 2017 and 2021 were considered for inclusion. Original sports medicine research studies that focused on athletes were included. Outcome measures included reporting and analysis of patient demographics (age, sex, race, ethnicity). Studies that included demographic variables in a multivariate analysis or that performed a race-/ethnicity-based stratified analyses were considered to have analyzed that variable. Studies that reported and/or analyzed patient demographics were examined. Chi-square tests were performed to determine statistical significance. A total of 5140 publications were screened, and 842 met the inclusion criteria. Age and sex were well reported (84.1% and 87.0%, respectively), while race (3.8%) and ethnicity (2.0%) were poorly reported. There was no difference in rates of reporting age, sex, race, or ethnicity between the American Journal of Sports Medicine (AJSM), the Orthopaedic Journal of Sports Medicine (OJSM), or Sports Health: A Multidisciplinary Approach (Sports Health). The rate of analysis was also calculated as a percentage of the studies that reported that variable. Of the studies that reported age, 38.5% analyzed age. Using this method, 26.2% of studies analyzed sex, 40.6% analyzed race, and 17.6% analyzed ethnicity. Although there was no difference in the overall rate at which studies from the 3 journals analyzed ethnicity, Sports Health studies analyzed age (P = .044), sex (P = .001), and race (P = .027) more frequently than studies published in AJSM and OJSM. Of the studies that analyzed race, most of those studies (8/13, 61.5%) found significant race-based differences in reported outcomes. This systematic review demonstrated that race and ethnicity are poorly reported and analyzed in athlete-specific sports medicine literature, despite the fact that a majority of studies analyzing race found significant differences between racial groups. Improved reporting of race and ethnicity can determine whether race- and ethnicity-based differences exist in patient interventions to ameliorate disparities in patient outcomes.

Straddling the Line Between In Vitro and Ex Vivo Investigations.

Tissue engineering research fundamentally relies on experiments to advance knowledge, utilizing various models for research on both humans and animals. With scientific progress, experimental models have become increasingly complex over time. This complexity sometimes blurs the distinction between categories, making terminology less consistent. In biomedical research, three overarching terms are commonly used to characterize experimental environments: in vitro, ex vivo, and invivo. While in vitro translates from Latin as "in glass," referring historically to experimental conditions in a test tube or petri dish, invivo experiments occur within a living organism's natural environment. Conversely, ex vivo originates from living tissue outside its host environment while striving to maintain conditions as close to the host surroundings as possible. In the tissue engineering and regenerative medicine (TE&RM) community, there needs to be more clarity between in vitro and ex vivo terminology, with historical definitions sometimes disregarded and new terms often introduced without rigorous scientific justification. At this juncture, the question arises of when to refer to experiments as in vitro or ex vivo or whether the terms may be used synonymously in some instances. Moreover, what criteria must ex vivo experiments meet to be legitimately defined as such? This perspective is intended to address questions that would assist the TE&RM community in better understanding the differences between in vitro and ex vivo models. Impact Statement In the tissue engineering & regenerative medicine literature, the terms "in vitro" and "ex vivo" are often used interchangeably to describe experiments. This interchangeable usage can lead to a compromised interpretation of research results and, consequently, misleading scientific conclusions and teachings. This perspective aims to provide clarity on the various definitions of experimental designs. It also highlights the issue of using terms with inconsistent meanings that have origins dating back to the distant past. It's important to note that scientific definitions constantly evolve, and there is a scientifically rooted responsibility to evaluate and rethink the current state of affairs critically.

Validating, Implementing, and Monitoring Machine Learning Solutions in the Clinical Laboratory Safely and Effectively.

Machine learning solutions offer tremendous promise for improving clinical and laboratory operations in pathology. Proof-of-concept descriptions of these approaches have become commonplace in laboratory medicine literature, but only a scant few of these have been implemented within clinical laboratories, owing to the often substantial barriers in validating, implementing, and monitoring these applications in practice. This mini-review aims to highlight the key considerations in each of these steps. Effective and responsible applications of machine learning in clinical laboratories require robust validation prior to implementation. A comprehensive validation study involves a critical evaluation of study design, data engineering and interoperability, target label definition, metric selection, generalizability and applicability assessment, algorithmic fairness, and explainability. While the main text highlights these concepts in broad strokes, a supplementary code walk-through is also provided to facilitate a more practical understanding of these topics using a real-world classification task example, the detection of saline-contaminated chemistry panels.Following validation, the laboratorian's role is far from over. Implementing machine learning solutions requires an interdisciplinary effort across several roles in an organization. We highlight the key roles, responsibilities, and terminologies for successfully deploying a validated solution into a live production environment. Finally, the implemented solution must be routinely monitored for signs of performance degradation and updated if necessary. This mini-review aims to bridge the gap between theory and practice by highlighting key concepts in validation, implementation, and monitoring machine learning solutions effectively and responsibly in the clinical laboratory.

Os cães ferais e seus impactos no meio ambiente

A feral dog is an animal that was domestic and began to live in a wild environment, either due to abandonment or escape. They have no food, water or veterinary care providers. In this way, they recover their wild instincts, depending on their own hunting and survival, which causes an impact on the environment, thus affecting animal and human health. The objective of this study was to review the impacts of wild dogs on environmental health and humans. The present work refers to a bibliographical review survey and analysis of works researched electronically through online databases. Veterinary medicine literature works in English and Portuguese, published between 1975 to 2023, were selected. Because they are large predators in nature, feral dogs have an impact on wildlife. They cause physical and temporal displacement, disturbance and response to stress in the fauna, harming the lives of the animals that live there, reducing the amount of functionally available environment that offers them food, reproduction and rest, in addition to water contamination and mortality of other species, whether direct (predation) or indirect (transmission of pathogens). These dogs compete for the same environment as those that live there, so animal activity decreases to avoid contact with dogs. They can participate in the transmission of various pathogens to humans and wild animals, such as giardiasis, distemper, parvovirus, leishmaniasis, toxoplasmosis, scabies, and they are a reservoir for rabies. They can cause accidents due to bites and risk hybridization with other species. The impacts of feral dogs should be better discussed and studied, and management strategies must be created, including programs to prevent the species from breeding in an unregulated manner. Preventive measures must be taken to avoid a greater impact in the future.

ANALYSIS OF THE PUBLICATIONS OF THE TROPICAL VETERINARIAN 2008-2012

The articles published in the volume 26-30 (2008-2012) of the Tropical Veterinarian (TV) were subjected to some bibliometric examinations on the authors, geographical spread of both authors and the articles of the contents of the literature of Animal Science and Veterinary Medicine as represented by the journal. 273 authors published severally in the 5 volumes of the tropical veterinarian. 71.9% of the publishing authors are from the South West Zone of Nigeria; the seat of the publisher of the journal, University of Ibadan. Contributions are however received from all the geographical zones of Nigeria and some from internationally located authors. 98% the periodical articles published by the T.V. were jointly authored, which conforms with the trend obtainable globally in science and technology. There is an appauling scenario in the number of the articles published in every volume as 5 articles per issue is low and calls for the attention of the editors and publishers. As an international journal interested in expounding the frontiers of knowledge in animal science and veterinary medicine, papers on the study of the literature of the subject of information science should be published.

Comparing observed and preferred instruction in robotic surgery

BackgroundThe unique setup of robotic surgery challenges the traditional instructional dynamic between surgical learners and teachers. Previous studies have posited difficulties such as reliance on observational learning and ease of takeover. However, we lack understanding of how these instructional challenges manifest and are perceived by learners. Improving instruction has the potential to optimize education and performance in robotic surgery. MethodsIn this qualitative study, we conducted robotic case observations and learner interviews focusing on instruction in robotic surgery. We deductively generated codes in a theory-informed manner after review of the instructional literature in surgery, medicine, and other fields. We applied these codes in a rigorous directed content analysis of field notes and transcripts to identify themes. ResultsThirty-eight faculty, fellows, and residents participated in 10 robotic cases and 20 semistructured interviews. Observed practices on the basis of case observations differed substantially from preferred practices on the basis of interview data. Using 37 codes, we identified 4 main themes related to instruction in robotic surgery: contextualization, individualization, autonomy, and multimodality. We contrasted observed and preferred instruction in each of these areas to generate instructional considerations that may better align preferences and practices. ConclusionsWe observed several suboptimal instructional practices that contradicted preferred ways of learning. We suggested robotic-specific instructional considerations such as using multimodality to promote active learning and to reduce ambiguity. We also provided considerations applicable to all types of surgery, such as to include rationale to promote learning consolidation and to frame operative steps to allow trainees to plan their participation.

Assessing the impact of history of medicine research: A scientometric and altmetric analysis.

After conducting a comprehensive literature search of two medical electronic databases, PubMed and Embase, as well as two citation databases, Web of Science Core Collections (WoS) and Scopus, we aimed to conduct an Altmetric and Scientometric analysis of the History of Medicine literature in medical research. The following software tools were used for analyzing the retrieved records from PubMed and Embase databases and conducting a collaboration analysis to identify the countries involved in scientific medical papers, as well as clustering keywords to reveal the trend of History of Medicine research for the future. These software tools (VOSviewer 1.6.18 and Spss 16) allowed the researchers to visualize bibliometric networks, perform statistical analysis, and identify patterns and trends in the data. Our analysis revealed 53,771 records from PubMed and 54,405 records from EMBASE databases retrieved in the field of History of Medicine by 105,286 contributed authors in WoS. We identified 157 countries that collaborated on scientific medical papers. By clustering 59,995 keywords, we were able to reveal the trend of History of Medicine research for the future. Our findings showed a positive association between traditional bibliometrics and social media metrics such as the Altmetric Attention Score in the History of Medicine literature (p < 0.05). Sharing research findings of articles in social scientific networks will increase the visibility of scientific works in History of Medicine research, which is one of the most important factors influencing the citation of articles. Additionally, our overview of the literature in the medical field allowed us to identify and examine gaps in the History of Medicine research.

Effects of CO₂ on the occurrence of decompression sickness: review of the literature.

Inhalation of high concentrations of carbon dioxide (CO₂) at atmospheric pressure can be toxic with dose-dependent effects on the cardiorespiratory system or the central nervous system. Exposure to both hyperbaric and hypobaric environments can result in decompression sickness (DCS). The effects of CO₂ on DCS are not well documented with conflicting results. The objective was to review the literature to clarify the effects of CO₂ inhalation on DCS in the context of hypobaric or hyperbaric exposure. The systematic review included experimental animal and human studies in hyper- and hypobaric conditions evaluating the effects of CO₂ on bubble formation, denitrogenation or the occurrence of DCS. The search was based on MEDLINE and PubMed articles with no language or date restrictions and also included articles from the underwater and aviation medicine literature. Out of 43 articles, only 11 articles were retained and classified according to the criteria of hypo- or hyperbaric exposure, taking into account the duration of CO₂ inhalation in relation to exposure and distinguishing experimental work from studies conducted in humans. Before or during a stay in hypobaric conditions, exposure to high concentrations of CO₂ favors bubble formation and the occurrence of DCS. In hyperbaric conditions, high CO₂ concentrations increase the occurrence of DCS when exposure occurs during the bottom phase at maximum pressure, whereas beneficial effects are observed when exposure occurs during decompression. These opposite effects depending on the timing of exposure could be related to 1) the physical properties of CO₂, a highly diffusible gas that can influence bubble formation, 2) vasomotor effects (vasodilation), and 3) anti-inflammatory effects (kinase-nuclear factor and heme oxygenase-1 pathways). The use of O₂-CO₂ breathing mixtures on the surface after diving may be an avenue worth exploring to prevent DCS.

A Review of Cold-Wet Mizaj and Phlegm Dominance Indices in Persian Medicine

Background: Personalized medicine, an emerging approach, considers individual differences to tailor treatments optimally. Persian medicine (PM) incorporates individual differences through Mizāj (temperament). A comprehensive understanding of each Mizaj type's characteristics is essential in designing standardized diagnostic tools. Objectives: This study aims to explore the attributes of one of the most significant Mizaj groups, namely cold-wet Mizaj, and its subtypes, including cold-wet Su-e-Mizaj (dystemperament), as well as phlegm dominance in PM sources. Methods: Persian medicine literature, including the Canon of Medicine, was reviewed for relevant concepts. Reliable scientific databases, including PubMed, Scopus, and MagIran, were searched using keywords such as Mizaj, temperament, Su-e-Mizaj, dystemperament, cold-wet dystemperament, phlegm, and Balgham. The obtained results were studied and categorized. Results: Out of the 196 articles obtained related to Mizaj, 16 investigated indices. No studies were found on the indices of cold-wet Mizaj and phlegm dominance separately. PM sources exhibit high congruence in describing the characteristics of cold-wet Mizaj. Specifically, emphasis is placed on characteristics such as coldness and softness of the skin to the touch, high fat mass, pale and white complexion, excessive body secretions, weakness and slowness of physical and physiological actions, low vitality, timidity, poor memory, and slow-wittedness. In cold-wet dystemperament, symptoms are more severe, and in the presence of phlegm, a feeling of heaviness is also mentioned as a specific symptom. Conclusions: By compiling indices of cold-wet Mizaj/dystemperament and phlegm dominance, this study can contribute to the development of standardized PM questionnaires, facilitating a personalized approach to the diagnosis and treatment of diseases.

Evaluation of retracted articles in the field of emergency medicine on the web of science database

BackgroundThe retraction of articles stands as the most significant mechanism employed to uphold the integrity of science, particularly in flawed studies. ObjectivesThis study aims to explore the reasons for article retractions in the field of emergency medicine and elucidate the problems arising from such retractions. The goal is to identify parameters in retracted articles that compromise scientific knowledge and raise awareness. Material and methodsRetracted articles within the emergency medicine category were analyzed and assessed using the Web of Science database. The study sought to address the following questions: 1. In which year or years were the most articles retracted? 2. In which journals were the retracted articles published? 3. What is the distribution of topics in retracted articles? 4. What are the reasons for the retraction of articles? 5. What is the time difference and citation count between the publication and retraction years of the articles? ResultsThe study delved into reasons for article retractions, types of retracted articles, and other relevant factors. A total of 61 retracted articles were examined and analyzed, revealing an increasing trend in the rate of article retractions over the years. The majority of retracted articles occurred in 2023, with the highest retraction rate identified in the “Emergency Medicine International” journal. On average, articles were retracted 356 days after publication. Reasons for retracted articles included concerns related to data, authorship issues, plagiarism, duplication, and biased or fraudulent peer review. ConclusionsThis study provided an examination of retracted articles in the field of emergency medicine, highlighting a noteworthy increase in retractions due to various reasons. Despite retractions, it was observed that the citation counts of retracted articles increased. The growing number of retracted articles and frequent citations pose potential dangers from a scientific perspective, as citing retracted articles damages scientific integrity. The study underscores the importance of understanding the reasons for retracted articles and preventing the spread of such incidents in emergency medicine literature. The results, analyzed within various variables, indicate the need for further research and solutions, guiding future research efforts and contributing to the literature.

Ziabetus (Prediabetes): A Harbinger of Critical Stage in the Continuum of Glucose Metabolism Disorder: A Review

Background: Prediabetes is a metabolic condition characterized by blood glucose levels higher than normal but below the threshold for diabetes mellitus. It represents a critical stage in the progression towards type 2 diabetes mellitus (T2DM) and is associated with an increased risk of cardiovascular disease and other complications. The two major pathophysiologic defects responsible for losing glucose tolerance are insulin resistance and β-cell glucose insensitivity, both appearing in subjects of Intermediate Hyperglycaemia. In classical literature, Unani physicians have described the initial symptoms and factors leading to the pathology, the risk factors are described in terms of ‘Su-e-mizaj’ as per the concept of Tibb. So, it is considered in the context of Ziabetus which is described as a disease that develops due to Sue-mizaj haar (abnormal hot temperament). The symptoms mentioned in Unani medicine are increased frequency of micturition (ants and flies are attracted to urine), increased thirst, nocturia, dryness of mouth and whole body, fatigue, loss of weight, malaise, and cramps in lower extremities. The modern drug-based approach for the management of Intermediate Hyperglycaemia is associated with inherent drawbacks, including toxicity, tolerability, cost, and efficacy. Objective: The purpose of this review is to provide an in-depth understanding of prediabetes concerning the classical literature of Greek medicine based on the analysis of certain parameters like etiopathophysiology, current diagnostic criteria, risk factors, and evidence-based management strategies. By synthesizing findings from epidemiological studies, and clinical trials, this paper aims to enhance understanding of prediabetes and facilitate effective preventive measures and interventions. Keywords: Prediabetes, Intermediate hyperglycaemia, Impaired Glucose Tolerance, Impaired Fasting Glucose, Insulin Resistance.

Influential literature in tennis medicine and science

This study examined the most influential peer-reviewed journal articles and books in tennis medicine and science based on citations (C). Systematic searches were performed to extract authors, titles, year, journal, C, and research focus for the top cited publications indexed in Google Scholar (GS). The top 100 articles had high numbers of citations (85 to 1,164) and citation rates (3 to 41 C/year) that were similar between tennis medicine and science, with fewer citations to tennis books. The influence of tennis research has increased over the last decade, with citations and citation rates were higher than was previously reported (Knudson, 2012). The study confirmed important research topics and journal outlets and identified influential authors. Influential tennis research continues to focus on injuries, physiological and psychological factors, with recent increases in analytics and business aspects of the sport.