Narrative Overview Research Articles

Epidemiology of metabolic syndrome.

The global increase of overweight and obesity in children and adults is one of the most prominent public health threats, often accompanied by insulin resistance, hypertension, and dyslipidemia. The simultaneous occurrence of these health problems is referred to as metabolic syndrome. Various criteria have been proposed to define this syndrome, but no general consensus on the specific markers and the respective cut-offs has been achieved yet. As a consequence, it is difficult to assess regional variations and temporal trends and to obtain a comprehensive picture of the global burden of this major health threat. This limitation is most striking in childhood and adolescence, when metabolic parameters change with developmental stage. Obesity and related metabolic disorders develop early in life and then track into adulthood, i.e., the metabolic syndrome seems to originate in the early life course. Thus, it would be important to monitor the trajectories of cardio-metabolic parameters from early on. We will summarize selected key studies to provide a narrative overview of the global epidemiology of the metabolic syndrome while considering the limitations that hinder us to provide a comprehensive full picture of the problem. A particular focus will be given to the situation in children and adolescents and the risk factors impacting on their cardio-metabolic health. This summary will be complemented by key findings of a pan-European children cohort and first results of a large German adult cohort.

A Narrative Review of Cardiometabolic Profiles among U.S. Adults: Temporal Trends and Implications.

To provide a narrative overview of trends and disparities in the cardiometabolic profiles of U.S. adults by synthesizing findings from nationally representative studies conducted between 1999 and 2020. During the study period, the cardiometabolic profiles of U.S. adults displayed a complex mix of trends. While there were notable improvements in specific risk factors, such as reductions in total cholesterol, triglycerides, and low-density lipoprotein cholesterol levels, other aspects of cardiometabolic health worsened. The mean body mass index and hemoglobin A1c levels increased, accompanied by significant rises in the prevalence of obesity, type 2 diabetes, and metabolic syndrome. Despite some progress in blood pressure and lipid profiles, the overall cardiometabolic health of the population declined, with only a small percentage of adults maintaining optimal health by 2018. Furthermore, significant disparities persisted across racial and socioeconomic groups, with non-Hispanic Black participants and those with lower education and income facing higher cardiometabolic risks compared to their counterparts. Despite improvements in certain aspects of cardiometabolic profiles among U.S. adults, significant challenges remain, particularly with the rising rates of obesity, type 2 diabetes, and metabolic syndrome. Persistent disparities in cardiometabolic health across sociodemographic groups emphasize the need for comprehensive public health strategies that address medical care, lifestyle factors, and social determinants of health. Future efforts should prioritize reducing these disparities and enhancing health equity to mitigate the overall burden of cardiometabolic disease.

Narrative overview of possible preventive measures for differentiated thyroid carcinomas.

There is compelling evidence that although the increased availability of sensitive imaging is the main cause of the increasing incidence of differentiated thyroid cancer, particularly the papillary type, there are other factors involved. Despite the acknowledged role of genetic and certain lifestyle factors, comprehensive studies delineating the interactions between multiple risk factors and the mechanistic pathways involved are scarce. A greater understanding of both modifiable and non-modifiable risk factors for thyroid cancer is critical to prevent and manage the disease and could provide a scientific basis for future research into more appropriate lifestyles and living environments for people at high risk. We reviewed the main endogenous factors that, although considered non-modifiable, can help identify at-risk individuals. In addition, we offer a narrative review of other putative causes and make recommendations for measures to prevent the emergence of new cases of differentiated thyroid cancer.

A Narrative Overview of Retinoid X Receptor Inhibitors in Chronic Disease Management

Abstract: The Retinoid X Receptor (RXR) is a member of the nuclear receptor superfamily and regulates gene transcription as well as diverse cellular processes like metabolism, inflammation, and cell differentiation. As an attractive therapeutic target, RXR inhibitors have garnered attention for their potential in alleviating chronic diseases. RXR inhibitors have the potential to modulate inflammation and immune responses and manage diseases like rheumatoid arthritis, inflammatory diseases, metabolic disorders such as diabetes and dyslipidemia, cancer progression, solid tumors, and hematologic malignancies. Understanding the molecular mechanisms behind their therapeutic effects is crucial for optimizing their use in different disease contexts. While RXR inhibitors hold promise, some challenges and questions necessitate further research. Future directions include refining the understanding of specific pathways affected by RXR inhibition and addressing potential side effects along with tailoring treatment approaches based on individual patient characteristics, as this would improve outcomes. Exploring the potential synergies of RXR inhibitors with other therapeutic agents could enhance their efficacy and broaden their applicability.

Graphic Paper: Promoting generalisation in qualitative nursing research using the multiple case narrative approach: a methodological overview.

The ability to generalise research generated findings to different contexts is a significant, yet overlooked, feature in qualitative studies conducted in nursing, where evidence-based clinical practice is highly regarded. The multiple case narrative is a constructivist-narrative approach, claimed to not only have the potential for analytical and case-to-case generalisation but also sample-to-population generalisation. This paper provides an overview of multiple case narrative by comparing it with similar methodologies, reviewing studies that have used this approach and critically evaluating its capacity for producing generalisable results. The multiple case narrative approach addresses limitations of collective case study, case survey and meta-ethnography by employing greater sample sizes and more generalisable results. Most studies previously using this approach have been performed in the education field and with the purpose of overcoming sample size limitations in qualitative research. The approach offers a uniquely systematic approach to analysis by finding associations between categories generated from collective analysis of large number of cases and providing the potential for sample to population generalisation. Multiple case narrative, which to date has been underutilised, is a systematic approach with characteristics that make it an efficient research technique to provide valid qualitative evidence.

Could Motor Imagery Training Provide a Novel Load Management Solution for Athletes? Recommendations for Sport Medicine and Performance Practitioners.

Athletes often face the dual challenge of high training loads with insufficient time to recover. Equally, in any team, sports medicine and performance staff are required to progress training loads in healthy athletes and avoid prolonged reductions in training load in injured athletes. In both cases, the implementation of a well-established psychological technique known as motor imagery (MI) can be used to counteract adverse training adaptations such as excessive fatigue, reduced capacity, diminished performance, and heightened injury susceptibility. Narrative overview. Level 5. MI has been shown to enhance performance outcomes in a range of contexts including rehabilitation, skill acquisition, return-to-sport protocols, and strength and conditioning. Specific performance outcomes include reduction of strength loss and muscular atrophy, improved training engagement of injured and/or rehabilitating athletes, promotion of recovery, and development of sport-specific skills/game tactics. To achieve improvements in such outcomes, it is recommended that practitioners consider the following factors when implementing MI: individual skill level (ie, more time may be required for novices to obtain benefits), MI ability (ie, athletes with greater capacity to create vivid and controllable mental images of their performance will likely benefit more from MI training), and the perspective employed (ie, an internal perspective may be more beneficial for increasing neurophysiological activity whereas an external perspective may be better for practicing technique-focused movements). We provide practical recommendations grounded in established frameworks on how MI can be used to reduce strength loss and fear of reinjury in athletes with acute injury, improve physical qualities in rehabilitating athletes, reduce physical loads in overtrained athletes, and to develop tactical and technical skills in healthy athletes.

Forensic Neuropsychology Goes from Nowhere to Almost Everywhere: Lessons Learned During Decades of Practice.

To provide a narrative overview of the development of forensic neuropsychology (FN) in the last 40-plus years. Personal history description, highlighted by key data-based publications. Anecdotal and relevant data-based findings converge to present a perspective of a wealth of FN resources currently available to the well-documented growing numbers of practitioners. The de facto subspecialty of FN is now a visible and prominent part of the landscape of clinical neuropsychology.

Ethnic Rhinoplasty in the Brazilian Population: Current Concepts.

The large mixture of races in Brazil gives the nose its distinctive composition, which makes rhinoplasty difficult for these patients. Every patient should have their anatomy thoroughly examined on an individual basis, as there is no unique strategy that works for all situations. This is a narrative overview of the last 10 years' worth of literature that describes the ethnic traits of each nose, with a particular emphasis on the Brazilian nose, and talks about the major surgical approaches that can be applied in these situations. The low dorsum, broad nasal bones, thick skin, and bulbous tip are the primary features of the Brazilian nose. Many times, lateral osteotomies, root grafting, isotretinoin treatment for skin thickness, and neodomus formation are required. The Brazilian nose presents a surgical challenge that calls for the mastery of multiple procedures, not simply structured rhinoplasty. In certain cases, preservation rhinoplasty may even be used. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Maternity protection in pneumology: considerations for a positive list

It seems difficult to continue to employ expectant/breastfeeding mothers in interventional medical fields due to numerous risks involved, such as in handling infectious agents or anaesthetic gases. Pregnancy for female doctors is thus often associated with a ban on employment and is therefore synonymous with a delay in their professional career. The aim of this article was to develop a positive list that allows pregnant women to continue working during their pregnancy at low risk and provides employers with a guide for drawing up risk assessment for specific occasions. The brief narrative overview is based on the recommendations drawn up by both professional associations and the Maternity Protection Committee. It is intended to provide assistance for the preparation of an event-related risk assessment after notification of a pregnancy in the speciality of pneumology in order to be able to continue to employ female doctors working in interventional medicine at low risk.

Potential Role of Soundscape and Music Interventions in post-Intensive Care Rehabilitation

Background Post Intensive Care Unit (ICU) survivors face physical, psychological, and cognitive impairments during their recovery phase, adversely affecting their quality of life. Given the scarcity and barriers to access to post-ICU care worldwide, patient-centered adjuncts are worth exploring. Although music interventions have gained recognition as non-pharmacological approaches in the acute phase of critical illness; exploration of their potential benefits in the post-ICU is scarce. Objective This paper examines the potential of sound and music interventions as an adjunct therapeutic modality to improve the well-being of adults post-ICU patients, through a narrative overview of published research evidence regarding post-ICU recovery and other relevant post-acute conditions, such as post-traumatic disorder and anxiety. Results The effectiveness of sound/ music interventions on several key outcomes including reduced anxiety, stress, pain, and PTSD, improved sleep, and enhanced mood and emotional well-being have been studied. Research indicates that music-based approaches to physical and psychological well-being reduce emotional distress, foster connectedness, and improve overall well-being. The importance of tailoring sound and music interventions to the individual needs and preferences of post-ICU patients is emphasized. Conclusion The potential benefits of sound and music interventions, both in terms of physiological and psychological well-being, encourage further investigation into their potential application and implementation into post-ICU care and rehabilitation. Ultimately, this therapeutic approach could contribute to enhancing the overall quality of life and empowerment of post-ICU patients on their path to recovery.

The deer mouse (Peromyscus maniculatus bairdii) as a model organism to explore the naturalistic psychobiological mechanisms contributing to compulsive-like rigidity: A narrative overview of advances and opportunities

Deer mice (Peromyscus maniculatus bairdii), a wildtype species native to North America, have been investigated for their spontaneous compulsive-like behaviour. The repetitive and persistence nature of three unique compulsive-like phenotypes in deer mice, i.e., high stereotypy (HS), large nesting behaviour (LNB) and high marble burying (HMB), are characterized by behavioural and cognitive rigidity. In this narrative review, we summarize key advances in the model's application to study obsessive-compulsive disorder (OCD), emphasizing how it may be used to investigate neurobiological and neurocognitive aspects of rigidity. Indeed, deer mice provide the field with a unique naturalistic and spontaneous model system of behavioural and cognitive rigidity that is useful for investigating the psychobiological mechanisms that underpin a range of compulsive-like phenotypes. Throughout the review, we highlight new opportunities for future research.

Clinical Effectiveness of Bee Venom Acupuncture for Bone Fractures and Potential Mechanisms: A Narrative Overview.

Bee venom acupuncture, a type of herbal acupuncture, combines the pharmacological actions of bioactive compounds from bee venom with the mechanical stimulation of meridian points. Bee venom acupuncture is gaining popularity, particularly in the Republic of Korea, primarily for pain relief of various conditions. This study aimed to summarize and evaluate the available evidence on the use of bee venom acupuncture for recovery after bone fractures. Electronic literature searches for experimental studies and clinical trials were conducted using the PubMed, China Academic Journals (CAJ), and OASIS databases. The search revealed 31 studies, of which six met our criteria. These studies demonstrated that bee venom acupuncture can be effective in treating bone fractures, suggesting a promising area for future research. However, evidence supporting its efficacy in this context is limited. Rigorous trials with large sample sizes and robust designs are needed to clarify the role of bee venom acupuncture for these indications. In addition, future studies should explore the optimal dosage and concentration of bee venom acupuncture.

Clinical management model for impulse control disorders in Parkinson's disease.

Over the last decade, we have gained a better understanding of impulse control disorder in Parkinson's disease (PD-ICD), a medication complication in PD. Researchers were aware of its complexity and took efforts to learn more about its diagnostic and treatment possibilities. Nevertheless, clinical management for it is currently neglected. We conducted a narrative overview of literature published from 2012 to October 2023 on various aspects of clinical management for PD-ICD. A potential "susceptibility-catalytic-stress" model in the development of PD-ICD was proposed and a profile encoding predictors for PD-ICD was created. Based on these predictors, some methods for prediction were recently developed for better prediction, such as the polymorphic dopamine genetic risk score and the clinic-genetic ICD-risk score. A variety of treatment options, including dose reduction of dopamine receptor agonists (DAs), DAs removal, DAs switch, and add-on therapy, are investigated with inconsistent reports. Based on current findings, we developed a clinical management model prototype centered on prevention, consisting of prediction, prevention, follow-up and monitoring, therapy, and recurrence prevention, for clinical reference, and further proposed 4 key clinical management principles, including standardization, prediction centered, persistence, and whole course.

Digital Device Usage and Childhood Cognitive Development: Exploring Effects on Cognitive Abilities.

The present narrative overview explored the complex relationship between digital device usage and cognitive development in childhood. We conducted a comprehensive literature search across multiple databases, including PubMed, Embase, Scopus, and Web of Science, to critically assess cognitive domains such as attention, memory, executive functions, problem-solving skills, and social cognition. Incorporating over 157 peer-reviewed studies published between 2001 and 2024, we used strict inclusion and exclusion criteria to ensure scientific rigor. The review integrated empirical findings with established theoretical frameworks, particularly from cognitive development and media psychology, to highlight both the advantages and risks of early, frequent exposure to technology. The potential for digital devices to enhance cognitive skills, such as multitasking and information processing, was weighed against risks such as cognitive overload, diminished attention spans, and impaired social skills. We also examined psychological and behavioral outcomes, including identity formation, emotional regulation, and maladaptive behaviors associated with excessive screen time. Additionally, we identified strategies to mitigate negative effects, emphasizing structured digital engagement and parental involvement to support healthy cognitive and psychological growth. Our findings provided actionable recommendations for parents, educators, and policymakers, promoting optimal digital practices that enhanced cognitive development while safeguarding against potential harms. The review offered essential insights for stakeholders in child development, education, and policy-making, highlighting the need for balanced integration of digital tools in childhood learning environments.

The Potential of Tele-Ultrasound, Handheld and Self-Operated Ultrasound in Pregnancy Care: A Systematic Review.

To explore the use of tele-ultrasound and handheld or self-operated ultrasound in pregnancy. A systematic search provided 31 studies. The risk of bias for each study was assessed. Results were analyzed and presented in a narrative overview in four domains: tele-ultrasound, patient-operated ultrasound, handheld devices and low- and middle-income countries (LMIC). The quality of studies was generally low or fair based on the NIH Quality Assessment Tools. Fetal tele-ultrasound services (11 studies) are feasible and especially helpful in rural areas or with increased centralization of specialist care. Three studies with patient-operated ultrasound concluded its feasibility with good-to-high experiences. The use of handheld devices in pregnancy (eight studies) showed similar ultrasound results when compared to standard devices. In LMICs, innovative use of ultrasound (nine studies) can facilitate access to obstetric care performed by trained as well as unskilled caregivers combined with remote evaluation by an expert. Innovations in ultrasound in pregnancy care have shown promising results for application. Although most studies demonstrated benefits for pregnant women or care providers, high-level evidence is scarce. High-quality studies on innovations are needed to assess medical outcomes, patient and provider experiences and costs.

Running Shoes of the Postmodern Footwear Era: A Narrative Overview of Advanced Footwear Technology.

The modern era of running shoes began in the 1960s with the introduction of simple polymer midsole foams, and it ended in the late 2010s with the introduction of advanced footwear technology (AFT). AFT is characterized by highly compliant, resilient, and lightweight foams with embedded, rigid, longitudinal architecture. This footwear complex improves a runner's efficiency, and it introduced a step change in running performance. Purpose: This review serves to examine the current state of knowledge around AFT-what it is and what we know about its ingredients, what benefits it confers to runners, and what may or may not mediate that benefit. We also discuss the emerging science around AFT being introduced to track-racing spikes and how it is currently regulated in sporting contexts. Conclusions: AFT has changed running as a sport. The construction of AFT is grossly understood, but the nature of the interacting elements is not. The magnitude of the enhancement of a runner's economy and performance has been characterized and modeled, but the nuanced factors that mediate those responses have not. With these knowns and unknowns, we conclude the review by providing a collection of best practices for footwear researchers, advice for runners interested in AFT, and a list of pertinent items for further investigation.

A Literature-based Overview of Current Narratives on the Capacitation of Community Leaders in Addressing the Challenges of Climate Change Mitigation and Adaptation

In most many countries worldwide, community leaders (CLs) are expected to play an important role in mobilising and soliciting contributions from others for the proactive implementation of climate change adaptation strategies. Due to a lack of capacity at the local leadership level, several local-level climate change mitigation and adaptation initiatives have not been effectively actioned with most of them frequently excluding local decision-makers, and key community stakeholders. Basing assessment on what is available in the literature, it is evident that there is urgent need for the scientific community to develop innovative strategies that facilitate the meaningful implementation of informed climate change policies. To successfully address the challenges of climate change, this paper posits that it is necessary for researchers, policy makers and planistrators must endeavour to explore and implement actionable local-level climate change mitigation and adaptation strategies. The take-home message from this paper is that the time to act is now and refrain from doing so until it is too late to do so for tomorrow may never come. The likely implications for the benefits of proactive and effective community leaders are considered against this backdrop and insights from literature-based multi-level governance, participatory learning, action-oriented transformative leadership initiatives that were sourced from the literature.

A narrative overview of undergraduate geriatric medicine education worldwide.

There is a mismatch between the healthcare needs of the ageing population worldwide and the amount of education medical students receive in geriatric medicine. In 2014, Mateos-Nozal et al. published a systematic review of all undergraduate education surveys in geriatric medicine-a decade on, it is timely for an up-to-date overview of the state of undergraduate geriatric medicine education globally. In this review, we outline the international evidence in the field, exploring the results of national and multi-national teaching surveys, and discussing the relative strengths and weaknesses of nationally recommended curricula. We set these findings in the context of ageing population demographics, concluding with recommendations for the future of education and educational research in geriatric medicine, that aims to build capacity in the healthcare workforce and improve quality of care for older people.

Vector-Borne Zoonotic Lymphadenitis-The Causative Agents, Epidemiology, Diagnostic Approach, and Therapeutic Possibilities-An Overview.

In addition to common skin pathogens, acute focal lymphadenitis in humans can, in rare cases, be caused by a zoonotic pathogen. Furthermore, it can develop in the absence of any direct or indirect contact with infected animals, in cases when the microorganism is transmitted by a vector. These clinical entities are rare, and therefore often not easily recognized, yet many zoonotic illnesses are currently considered emerging or re-emerging in many regions. Focal zoonotic vector-borne lymphadenitis and its numerous causative agents, with their variegated clinical manifestations, have been described in some case reports and small case series. Therefore, we summarized those data in this narrative overview, with the aim of raising clinical awareness, which could improve clinical outcomes. This overview briefly covers reported pathogens, their vectors and geographic distribution, and their main clinical manifestations, diagnostic possibilities, and recommended therapy. Vector-borne tularemia, plague, bartonellosis, rickettsioses, borreliosis, and Malayan filariasis are mentioned. According to the existing data, when acute focal bacterial vector-borne zoonotic lymphadenitis is suspected, in severe or complicated cases it seems prudent to apply combined aminoglycoside (or quinolone) plus doxycycline as an empirical therapy, pending definite diagnostic results. In this field, the "one health approach" and further epidemiological and clinical studies are needed.

Reproductive health in trans and gender diverse patients: Transgender medicine: contextual trans gynecology.

This manuscript aims to promote an understanding of the special needs of transgender and gender-diverse people by putting trans gynecology into context. By definition, medical interventions for transgender people are not different from the treatment of cisgender people but cannot be singled out as gender-affirmative treatment. Treatment is dedicated to an overarching goal beyond medicine, namely to enable and maintain social functioning under the signs of the social gender. It is therefore that this narrative overview intensively deals with the requirements of trans gynecology. Also, various gynecological disorders are touched upon, provided they are relevant to trans people. The different significance of gynecological symptoms for either trans men or trans women, and the effects of supraphysiological androgen treatment on hormone-sensitive tissue, are stressed. Transgender health care is not just gender-affirmative transitional care but is committed to a superior objective, often beyond a medical perspective: to create and maintain physical conditions for social functioning under the signs of the individually appropriate sex and to contribute to significantly reducing gender dysphoria. For these purposes, it is a prerequisite to have a distinct contextual understanding of the complex reality of transpeople and knowledge about the numerous facets of transgender healthcare. Gynecology for transgender and gender-diverse people does not differ greatly from gynecology for cisgender female patients except in goals and context. Relief from complaints derived from genital organs is, of course important, but for transpeople there always is an overarching gender dimension that sometimes complicates treatment and might give rise to misunderstandings. Also, minority stress caused by societal factors frequently impacts the mental and physical state of health negatively and needs to be considered. This paper focuses on the context of trans gynecology and addresses various contentual aspects for both transmale patients having left genital organs in situ and transfemale patients with gynecological demands. Gynecological topics are addressed, highlighting their relevance for transgender and gender-diverse people (TGD), including the effects of supra-physiological androgen exposure on ovaries and uterus, vaginal bleeding, pelvic pain under testosterone treatment, screening policies, and benign gynecological disorders as clinical manifestations may appear differently and treatment may be more burdensome.