[Problems and thoughts in clinical safety evaluation of traditional Chinese medicine].

Amid the modernization and internationalization of traditional Chinese medicine(TCM), the safety of TCM has attracted much attention. At the moment, the government, scientific research teams, and pharmaceutical enterprises have made great efforts to explore methods and techniques for clinical safety evaluation of TCM. Although considerable achievements have been made, there are still many problems, such as the non-standard terms of adverse reactions of TCM, unclear evaluation indicators, unreasonable judgment methods, lack of evaluation models, out-of-date evaluation standards, and unsound reporting systems. Therefore, it is urgent to further deepen the research mode and method of clinical safety evaluation of TCM. Based on the current national requirements for the life-cycle management of drugs, this study focused on the problems in the five dimensions of clinical safety evaluation of TCM, including normative terms, evaluation modes, judgment methods, evaluation standards, and reporting systems, and proposed suggestions on the development of a life-cycle clinical safety evaluation method that conformed to the characteristics of TCM, hoping to provide a reference for future research.

A PubMed-Based Exploration of the Course of Yoga Research from 1948 to 2020.

Yoga research citations from 1948 to 2020 in PubMed were filtered and sorted in 10-year intervals to explore the occurrence and time frame of change in (1) the focus of research; (2) the number of randomized controlled trials (RCTs), systematic reviews (SRs), and meta-analyses (MAs); (3) health conditions researched for yoga as therapy; (4) journals with yoga research; and (5) the research on yoga from different countries. Publications on yoga between 1948 and 1970 (1.25%) focused on exceptional abilities of experienced yoga practitioners, apparently related to the spiritual goal of yoga; from 1971 to 2000 (6.87%), the focus was on yoga in health and therapy; and from 2001 to 2020 (91.88%), research publications on yoga increased and continued to focus on health and therapy, with fewer RCTs relative to the SRs and MAs on yoga in PubMed. Publications on yoga reported the following health conditions most often: from 1981 to 1990, (1) asthma, (2) stress, and (3) diabetes; from 1991 to 2000, (1) stress followed by (2) asthma, anxiety, and pain (all three with equal percentages); from 2001 to 2010, (1) depression, (2) stress, and (3) anxiety; and from 2011 to 2020, (1) stress, (2) depression, and (3) pain. The journals publishing research on yoga in PubMed have changed between 1971 and 2020 as follows: highly clinically relevant, broad-interest medical journals (1971 to 1990); journals relevant to mind-body interventions (1991 to 2000); and specialized journals for complementary and alternative medicine, particular branches of medicine, or research study designs (2001 to 2020). The highest yoga research output from 1971 to 1980 came from the United Kingdom (RCTs); from 1981 to 1990 the most research came from the United States (RCTs); from 1991 to 2000 the most research came from India (RCTs) and the United Kingdom (SRs); from 2001 to 2010 the most research came from the United States (RCTs, SRs) and the United Kingdom (MAs); and from 2011 to 2020 the most research came from the United States (RCTs, SRs, MAs). The trends in yoga research from this analysis reflect increased research related to yoga and health while suggesting areas for future research based on the strengths and gaps that have emerged.

Moving Forward in the Next Decade: Radiation Oncology Sciences for Patient-Centered Cancer Care.

In a time of rapid advances in science and technology, the opportunities for radiation oncology are undergoing transformational change. The linkage between and understanding of the physical dose and induced biological perturbations are opening entirely new areas of application. The ability to define anatomic extent of disease and the elucidation of the biology of metastases has brought a key role for radiation oncology for treating metastatic disease. That radiation can stimulate and suppress subpopulations of the immune response makes radiation a key participant in cancer immunotherapy. Targeted radiopharmaceutical therapy delivers radiation systemically with radionuclides and carrier molecules selected for their physical, chemical, and biochemical properties. Radiation oncology usage of "big data" and machine learning and artificial intelligence adds the opportunity to markedly change the workflow for clinical practice while physically targeting and adapting radiation fields in real time. Future precision targeting requires multidimensional understanding of the imaging, underlying biology, and anatomical relationship among tissues for radiation as spatial and temporal "focused biology." Other means of energy delivery are available as are agents that can be activated by radiation with increasing ability to target treatments. With broad applicability of radiation in cancer treatment, radiation therapy is a necessity for effective cancer care, opening a career path for global health serving the medically underserved in geographically isolated populations as a substantial societal contribution addressing health disparities. Understanding risk and mitigation of radiation injury make it an important discipline for and beyond cancer care including energy policy, space exploration, national security, and global partnerships.

A 53-Year Bibliometric and Scientometric Analysis of Research in Culinary and Medicinal Mushrooms.

The research field of culinary and medicinal mushrooms has been well developed since the first relevant publication in 1966. However, to date, there has been no bibliometric analysis published specifically for this field. This study aimed to assess the most influential publications as well as the research trends and important drivers in the field of culinary and medicinal mushrooms. Scopus was used to identify relevant publications and the 1000 most-cited publications were identified and analyzed. Bradford's law of scattering shows one-third of the papers were published in 14 core journals, with a total of 102 papers published in International Journal of Medicinal Mushrooms. There is an insignificant negative correlation (Pearson's correlation coefficient, r = -0.355) between the journal impact factor and publication count. VOSviewer was used to generate a country network. China represents Asia's research center in this field, having contributed 20% of the 1000 most-cited publications. A term map was also created to visualize the co-occurrence of key terms in the domain. Different biological activities such as antioxidant and antitumor properties of mushrooms appeared to be a recurring topic in this field. Wasser (2003) showed the highest citation count (n = 1282), which is almost double the second most-cited publication (n = 611). There is a weak positive correlation (r = +0.237) between the years since publication and total citation count. In conclusion, this bibliometric study will assist researchers to comprehend the current status of the research on culinary and medicinal mushrooms, and to visualize the future impact of such an important field.

Whither syndemics?: Trends in syndemics research, a review 2015-2019.

As originally conceived, syndemics refers to complex epidemics involving two types of adverse interaction - the clustering and interactions of two or more diseases or health conditions (the biological-biological interface) and social environmental factors (the biological-social interface). The theory has been widely applied in the fields of medicine, public health and anthropology, but how the concept is conceptualised and investigated in new syndemics literature remains unclear. This paper offers a scoping review of recent syndemics literature aiming to address the question: Where have scholars taken the syndemics concept? Five bibliographic databases were searched for titles containing 'syndemic[s]' revealing 334 records. A total of 143 journal articles, 23 book chapters, 21 commentaries, 2 books and 5 dissertations were assessed. Citations were classified into five categories: syndemics (n = 22), potential syndemics (n = 34), socially determined heightened burden of disease (n = 29), harmful disease cluster (n = 32) and additive adverse conditions (n = 71). The limited number of citations meeting the definition of a syndemic arrangement highlights the challenges related to describing and empirically supporting the biological-biological and biological-social relationships. Nevertheless, there is value in retaining the original, holistic, biosocial meaning of syndemics to identify and detail the casual pathways and mechanisms of interactions.

Challenges and Opportunities in Preclinical Research of Synthetic Cannabinoids for Pain Therapy.

Cannabis has been used in pain management since 2900 BC. In the 20th century, synthetic cannabinoids began to emerge, thus opening the way for improved efficacy. The search for new forms of synthetic cannabinoids continues and, as such, the aim of this review is to provide a comprehensive tool for the research and development of this promising class of drugs. Methods for the in vitro assessment of cytotoxic, mutagenic or developmental effects are presented, followed by the main in vivo pain models used in cannabis research and the results yielded by different types of administration (systemic versus intrathecal versus inhalation). Animal models designed for assessing side-effects and long-term uses are also discussed. In the second part of this review, pharmacokinetic and pharmacodynamic studies of synthetic cannabinoid biodistribution, together with liquid chromatography-mass spectrometric identification of synthetic cannabinoids in biological fluids from rodents to humans are presented. Last, but not least, different strategies for improving the solubility and physicochemical stability of synthetic cannabinoids and their potential impact on pain management are discussed. In conclusion, synthetic cannabinoids are one of the most promising classes of drugs in pain medicine, and preclinical research should focus on identifying new and improved alternatives for a better clinical and preclinical outcome.

The ethics of innovation for Alzheimer's disease: the risk of overstating evidence for metabolic enhancement protocols.

Medical practice is ideally based on robust, relevant research. However, the lack of disease-modifying treatments for Alzheimer's disease has motivated "innovative practice" to improve patients' well-being despite insufficient evidence for the regular use of such interventions in health systems treating millions of patients. Innovative or new non-validated practice poses at least three distinct ethical questions: first, about the responsible application of new non-validated practice to individual patients (clinical ethics); second, about the way in which data from new non-validated practice are communicated via the scientific and lay press (scientific communication ethics); and third, about the prospect of making new non-validated interventions widely available before more definitive testing (public health ethics). We argue that the authors of metabolic enhancement protocols for Alzheimer's disease have overstated the evidence in favor of these interventions within the scientific and lay press, failing to communicate weaknesses in their data and uncertainty about their conclusions. Such unmeasured language may create false hope, cause financial harm, undermine informed consent, and frustrate the production of generalizable knowledge necessary to face the societal problems posed by this devastating disease. We therefore offer more stringent guidelines for responsible innovation in the treatment of Alzheimer's disease.

[The significance and latest progress of extrathyroidal extension of thyroid cancer].

Extrathyroidal extension of thyroid cancer has been an important adverse factor affecting the prognosis of patients. According to the latest NCCN (National Comprehensive Cancer Network) guidelines, extrathyroidal extension is the surgical guide fortotal thyroidectomy in newly diagnosed patients, and its incidence in differentiated thyroid cancer is 5%-34%, belonging to T3-T4 stage.In the eighth edition of thyroid cancer AJCC staging, the T3 stage was first divided into T3a (tumor>4 cm and limited to the thyroid) and T3b (gross extrathyroidal extension invading only strap muscles from a tumor of any size), and the "minimal extrathyroidal extension(tumor invasion intoperithyroidal soft tissue or strap muscle invasion)"of the seventh edition was removed from the T stage and changed to the gross extrathyroidal extension invading only strap muscles, but there is still much controversy. It can be seen that different degrees of "extrathyroidal extension" have significant differences in the survival and prognosis of thyroid cancer. This article reviews the latest research progress of extrathyroidal extension, and discusses the significance and clinical research progress of it.

Recent trends in anti-obesity and anti-inflammatory studies in modern health care.

BACKGROUND: This study was planned to investigate the research trends related to naturally derived anti-inflammatory and anti-obesity components. The main purpose of this study was to find out and develop natural health cosmetic ingredients which has high effects on lipid degradation, moisturizing and elasticity enhancement. OBJECTIVE: We all hope this research provided systematic and practical data that can suggest an opportunity to further develop new products. METHODS: This is a descriptive research which classified the natural and traditional components that have important obesity management effects based on the experimental technique (in vitro and in vivo). we investigated the effects of 13 natural raw materials selected through preliminary investigation on lipid metabolism related enzyme activity. We first introduced Ainsliaea acerifolea, Onion, pear, Sanguisorba, Limonium tetragonum, Cornus walteri, Loquat, and Loquat-which have recently been shown to be effective in anti-obesity tests, and then described the research methods by showing the effects of onion extracts, Glasswort, Pine Cone (Korean white pine), Orostachys japonicus, African mangoes, Pepper, and Clathratum (sea weed), which actually had effects on anti-obesity in the in vivo experiment. RESULTS: As a result of investigating the effect of 13 natural raw materials selected through a preliminary investigation on lipid metabolism related enzyme activity, the study found nature-derived ingredients which induce anti-inflammatory and enhance the anti-obesity enzyme activity, and ingredients showing myriads of biological activities such as anti-oxidant, body fat reduction, lowering of blood cholesterol, and weight control. CONCLUSION: In this paper, we would like to delve into the possibility of using natural components with natural lipid-lowering effect, and systematically and practically study if they can actually be helpful to develop new cosmetic products.

The therapeutic dimension of research about spirituality: Particularities of cancer, mental health and infertility.

Healthcare is moving from a biomedical paradigm into a holistic paradigm, which includes all dimensions and needs of patients and families. Health conditions may trigger a spiritual journey for believers or non-believers bringing to light the nature of the human being and its vulnerable condition. Healthcare professionals are full participants in this life and health scenario and have an unquestionable duty related to the provision of spiritual care, on the basis of legislation, ethical codes, and on research evidence. Researchers are seizing better and broader knowledge about spirituality in healthcare, and research about this phenomenon is growing internationally. But, spirituality is considered complex, an area of intimacy and deep subjective meaning. These factors may raise some ethical concerns when submitting research projects to the ethics committees. In this paper, the authors share their experience in research about spirituality in the beginning of life issues/infertility and with adults with severe health conditions, and describe participants' perspectives on research engagement.

A bibliometric analysis on waste electrical and electronic equipment research.

Waste electrical and electronic equipment (WEEE) contains both toxic and valuable materials. Due to rapid development of information and communication technologies (ICT), a large amount of WEEE have been produced, leading to increasing academic efforts in this field. This study aims to depict the trends and features of WEEE-related studies through a bibliometric analysis. The results show that the total number of WEEE-related publications had sharply increased, with China as the leading country. University of Chinese Academy of Sciences is the most productive WEEE-related research institution, while Mai BX is the most productive author. As such, Waste Management, Journal of Cleaner Production, and Environmental Science & Technology are the most influential journals. The research hotspots of WEEE mainly focus on the recycling and treatment technologies, environmental impacts, and relevant policies of WEEE. By tracing the evolutionary pathway of WEEE research, it is clear that the research frontiers have switched from electronic equipment, extended producer responsibility, sediment, environment and design, risk assessment to life cycle assessment, mobile phone, and behaviors. This study provides valuable insights to those WEEE-related scholars so that they can identify their own research topics and partners. This paper is one of the first studies in WEEE research field that offers critical discussions and suggestions related to research development and future trends, and used visualized tools to present the holistic picture of this field.

[Visual analysis of research theme and capability of real world research].

As a new concept in clinical research,the real world research(RWR) has attracted the attention of researchers in the world with its unique advantages. This research mainly analyzed it through visual methods,the specific steps were as follows. Firstly,the Chinese Biomedical Literature Database,China National Knowledge Infrastructure,Wan Fang Database,Medline and EMbase were searched and RWS were included,414 articles in Chinese and 2 158 articles in English were included in this research after layer-bylayer screening; secondly,the main information was extracted and sorted by BICOMS 2 software and generated its co-occurrence matrix; the network relationship diagram was drawn by Net Draw software; the cluster analysis was carried out by using g CLUTO software;finally,this research results show that the numbers of domestic and foreign literatures have shown an overall growth trend,but compared with foreign countries,China's research on the real world started late,the overall strength of research was not as good as abroad;and the domestic and foreign research on the real world was uneven in the region,the research in China was mainly distributed in developed provinces and cities,such as Beijing,Guangdong,Shanghai,etc,and there was a lack of close cooperation between provinces and cities; the foreign research are mainly distributed in developed countries such as the United States,the United Kingdom,Germany,et al; the cooperation between countries was relatively close. And the hotspots and core directions of domestic and foreign research were also different. This research was intended to provide reference for the further research of Chinese researchers through the current description of the themes and capability of the real world research in the world.

[Regulatory effect of traditional Chinese medicine on intestinal microbiota].

As a large micro-ecosystem in the human body,the intestinal microbiota is closely associated with the occurrence of many diseases.The clinical investigations and animal experiments have showed that traditional Chinese medicine(TCM) could maintain the balance of the intestinal micro-ecological system.This review summarized the research methods and literatures on the regulation effects of TCM,including different effective ingredients,extracts and Chinese herbal formulae,on intestinal microflora in recent five years,in order to provide a reference for the further research and development of TCM.

Epigenetics and meditation.

In the last decade, epigenetics has taken center stage to explain the relationships between stress exposure, health and behavior. Acquired or inherited epigenetic changes modulate gene expression states without modifying the DNA sequence itself, they can be long-lasting, yet, they are potentially reversible. Several studies have explored whether meditation-based interventions can influence gene expression profiles towards healthier directions, identifying candidate genes and biological pathways that seem to be sensitive to contemplative practices. However, to date, the clinical implications of these molecular outcomes and their potential long-lasting epigenetic bases remain mostly unknown. The present article addresses these topics from a broad perspective and analyzes future research questions and perspectives at the crossroads of contemplative sciences and epigenetics.