History of biological, mechanistic, and clinical understanding of concussion.

The history behind the biological, mechanistic, and clinical insights into concussion provides awareness of the current understanding and future areas for study. Although the initial description of concussion appeared in the 10th century, the potential long-term structural consequences were first defined by Harrison Martland, M.D., who performed a postmortem study of former boxers in 1928. He found evidence of perivascular microhemorrhage that he believed eventually evolved into a "replacement gliosis" underlying a clinical syndrome that he named "punch drunk," which was characterized by acute confusion with chronic cognitive and physical symptoms developing in those with prolonged exposure. Further research into the potential long-term consequences of repetitive concussions, particularly in athletics and the military, led to an understanding of chronic traumatic encephalopathy. To ameliorate possible long-term risks, research has been focused on preventative and therapeutic measures for concussion. In this review article, the authors present the history of concussion and the long-term sequelae of repeated head injury. Specifically, they consider how the understanding of concussion has evolved from antiquity into the modern era, and how this change in understanding of head injury has led to an appreciation of the fact that its long-term implications sometimes manifest as the clinical and histopathological entity of chronic traumatic encephalopathy.

[Textual research on the evolution of therapeutic indications of Fenglong (ST 40): discussion on the related articles for "Fenglong (ST 40) for phlegm" published in Chinese Acupuncture and Moxibustion].

Based on Huangdi Neijing (Yellow Emperor's Internal Classic), combined with the Huangdi Mingtang Jing JiJiao (Compilation and Correction of Yellow Emperor's Mingtang Classic) and unearthed Tianhui Yijian (Tianhui Medical Bamboo Slips), it is recognized that the therapeutic indications of Fenglong (ST 40) were recorded repeatedly in many medical works of the Qin and Han dynasties; and the treatments mostly focus on "upward reversion of qi ". In Huangdi Mingtang Jing (Yellow Emperor's Mingtang Classic), a part of symptoms were re-described textually, which affects the understanding on the indications of Fenglong (ST 40) in the medical works of the later generations. On the basis of the construction of phlegm theory in the Sui and Tang dynasties, the scholars of Song, Jin and Yuan dynasties had placed the emphasis on the relationship between phlegm and qi movement. In acupuncture works by Dou Hanqing, Fenglong (ST 40) was selected in treatment of phlegm dampness and phlegm-induced asthma, which is also based on the pathogenesis, "upward reversion of qi ", rather than "phlegm" itself. This view can be understood by the proof of "reducing Zusanli (ST 36) for eliminating wind". The relationship between Fenglong (ST 40) and phlegm was emphasized in Yulong Ge (Jade Dragon Verse) and Zhenfang Liuji (Six Sets of Acupuncture Methods), after which, the understanding, " Fenglong (ST 40), the key point for phlegm disorders", had been formed gradually since the Ming dynasty. The formation and evolution of the therapeutic indications of Fenglong (ST 40) are influenced comprehensively by the errors in textual duplication, cultural background, changes in the term expressions of disorders, and the clinical experience of medical practitioners.

[Understanding and enlightenment of theoretical construction of Huatuo Jiaji (EX-B 2)].

The theory of Huatuo Jiaji (EX-B 2) is the representative of the knowledge construction of ancient anatomy, reflecting the academic thought of Huatuo's school. Through deeply analyzing the classic theory of acupuncture and its cultural and historical materials, it is believed that the five-body constituents are the structural basis of Huatuo Jiaji (EX-B 2), qi and blood are the material one, while biaoben (the sites where meridian qi gathers and diffuses) and qijie (the common pathways through which meridian qi gathers) indicate its functions. Huatuo Jiaji (EX-B 2) reveals the rules of the transverse distribution of meridian points and the relevant indications, providing the theoretic foundation for acupuncture treatment. It highlights the importance of the anatomical knowledge in acupuncture effect and proposes a new idea for establishing an effective classification system of meridian points.

[Xuezheng Quanji, the earliest monograph on blood disorder].

Xuezheng Quanji(«¼) written by Sun Guangyu, a doctor in the Ming Dynasty, is the first known book on blood disorders in China. The book mainly deals with bleeding. The book begins with a collection of the Neijing and the treatises of the sages, focusing on systematically summarizing the theories and experiences of the past dynasties in the treatment of bleeding, interspersed with Sun's own opinions.The main part discusses four types of bleeding, summarizing Sun's profound experience in clinical practice, and many of his personal creative opinions.In terms of causes,Sun believed that there are three causes of bleeding and more due to heat. In terms of treatment,he opposed the abuse of bitter cold and attached great importance to nourishing yin and strengthening kidney and proposed four treatment methods of dispelling stasis, nourishing Yin and suppressing Yang, regulating Qi and blood, and tonifying deficiency. He advocated that bleeding should not be treated quickly, and emphasized that the disease should be judged according to the bleeding location and bleeding color to use herbs flexibly.Special attention should be paid to daily life care during and after illness as well.

[A brief history of the use of Gypsum in orthopedics].

Humans processed gypsum for their everyday use at least 7000 years ago. They have been using fixed limb methods for fracture treatment for nearly 5000 years. Hippocrates recognized the importance of the splint and the "roller bandage" for fracture treatment, and made the bandage hard by adding wax, pitch, lard or resin to the multi-layer cloth bandage, but not gypsum. Arabian physician El Zahrawi (936 -1013) also described a clay glue mixture, and flour and egg white as fracture fixation materials. From 970, Persian physician Muwafak used gypsum as the exclusive material for fracture fixation. The rudimentary form of modern plaster bandages was developed in the mid-19th century and spread widely after that, using methods from the Russian Pyrogov by soaking canvas in a gypsum slurry and Dutchman Massson wrapped gypsum powder in cotton cloth strips.

The evolution of ancient healing practices: From shamanism to Hippocratic medicine: A review.

In the ever-evolving healthcare landscape, ancient healing traditions cast a profound shadow, offering insights and inspirations that resonate with modern medical practice. This paper explores the enduring influence of shamanic and Hippocratic healing traditions on contemporary healthcare, examining their contributions to holistic health approaches, diagnostic techniques, and ethical standards. The Hippocratic emphasis on observation, clinical experience, and ethical principles laid the foundation for modern Western medicine, while shamanic practices highlight the importance of spiritual and psychological dimensions in healing. The comparative analysis reveals both commonalities and distinctions among various ancient practices, such as Ayurveda, Traditional Chinese Medicine, and indigenous healing systems, emphasizing their holistic understanding of health and the use of natural remedies. Cross-cultural exchanges, from the Silk Road to the Islamic Golden Age and beyond, facilitated the integration and dissemination of medical knowledge, enriching global medical traditions. The paper also discusses the impact of these ancient practices on contemporary healthcare systems, highlighting the resurgence of holistic and integrative medicine, the validation and incorporation of herbal remedies, and the challenges of cultural appropriation and scientific validation. By embracing the wisdom of ancient healing traditions and fostering collaboration between traditional and modern medicine, contemporary healthcare can enhance therapeutic options, promote patient-centered care, and address global health challenges with a more inclusive and compassionate approach. This integration holds promise for the future of healthcare, benefiting individuals and communities worldwide.

[Discussion on reference sample research of traditional Chinese medicine compound preparations developed from catalogued ancient classical prescriptions].

The concept of reference sample was put forward in the Guidance on CMC of Traditional Chinese Medicine Compound Preparations Developed from Catalogued Ancient Classical Prescriptions(Interim). The research on reference sample is a key link in the research and development of traditional Chinese medicine(TCM) compound prescriptions from catalogued ancient classical prescriptions(known as Category 3.1 TCM). This paper discusses the content of research on reference sample by analyzing the characteristics of Category 3.1 TCM and the purpose of research on reference sample. Furthermore, suggestions on the research of reference sample are proposed according to the development and evaluation practice of Category 3.1 TCM and research achievements of TCM regulatory science, aiming to provide reference for colleagues in this industry.

The Genesis of Multidisciplinary Health Professionals Teams for Pain Management. A History from the Hellenic Antiquity to Modern Palliative Medicine.

The aim of our article is to highlight the history of pain management. The multidisciplinary team (MDT) concept in confronting pain was first conceptualized by the Hippocratics, and has evolved through time and become a trend in medicine over recent decades. Documentary research was conducted to unveil the story of the evolution of MDTs. From the early 1950's the idea of an MDT approach to deal with various types of pain was sporadically introduced in medicine. Studies encouraged health institutions to support this concept by providing health professionals with training, alongside the necessary facilities and resources. Specialized care programs started with Dame Cicely Mary Strode Saunders as one of the pioneers. CONCLUSIONS: Team work and continuous interdisciplinary treatment of pain have rendered MDTs essential for health systems. Barriers in flexibility, information flow and personal issues give rise to the need for better organization and training. Pain and terminal disease palliation call for MDTs, and educated leaders to run them. Present and future health MDTs are considered necessary in all medical fields.

The chronology of the human colonization of the Canary Islands.

The human colonization of the Canary Islands represents the sole known expansion of Berber communities into the Atlantic Ocean and is an example of marine dispersal carried out by an African population. While this island colonization shows similarities to the populating of other islands across the world, several questions still need to be answered before this case can be included in wider debates regarding patterns of initial colonization and human settlement, human-environment interactions, and the emergence of island identities. Specifically, the chronology of the first human settlement of the Canary Islands remains disputed due to differing estimates of the timing of its first colonization. This absence of a consensus has resulted in divergent hypotheses regarding the motivations that led early settlers to migrate to the islands, e.g., ecological or demographic. Distinct motivations would imply differences in the strategies and dynamics of colonization; thus, identifying them is crucial to understanding how these populations developed in such environments. In response, the current study assembles a comprehensive dataset of the most reliable radiocarbon dates, which were used for building Bayesian models of colonization. The findings suggest that i) the Romans most likely discovered the islands around the 1st century BCE; ii) Berber groups from western North Africa first set foot on one of the islands closest to the African mainland sometime between the 1st and 3rd centuries CE; iii) Roman and Berber societies did not live simultaneously in the Canary Islands; and iv) the Berber people rapidly spread throughout the archipelago.

Stone axes throw new light on Baltic stone age mortuary rites.

Despite their ubiquity, Mesolithic lithic tools given as funerary offerings have rarely been studied in detail. Whereas personal ornaments (e.g. beads, pendants) are commonly interpreted as markers of social identity and status, archaeologists have struggled to understand the stone tools, commonly regarded as "utilitarian" items. As a result, this class of grave goods has not received the same level of attention, leaving a significant gap in our understanding of Mesolithic mortuary behaviours. Our research challenges long-lasting perceptions of lithic tools as strictly utilitarian objects and draws on studies of one of the most substantial stone axe funerary collections from one of the largest Stone Age cemeteries in Europe-Zvejnieki, Latvia. Evidence suggests the selection of unused axes as grave offerings, while unusual wear traces on an axe found in a female grave (no 57) raises questions about its use in the burial rites. Using a multi-proxy approach, we compare life histories of axes placed in burials to those recovered from contemporary, nearby settlement contexts. Finally, a strong correlation between axes and women and children at Zvejnieki challenges gendered stereotypes of stone tools, historically regarded as possessions of the adult male members of Stone Age societies.

An 8000 years old genome reveals the Neolithic origin of the zoonosis Brucella melitensis.

Brucella melitensis is a major livestock bacterial pathogen and zoonosis, causing disease and infection-related abortions in small ruminants and humans. A considerable burden to animal-based economies today, the presence of Brucella in Neolithic pastoral communities has been hypothesised but we lack direct genomic evidence thus far. We report a 3.45X B. melitensis genome preserved in an ~8000 year old sheep specimen from Mentese Höyük, Northwest Türkiye, demonstrating that the pathogen had evolved and was circulating in Neolithic livestock. The genome is basal with respect to all known B. melitensis and allows the calibration of the B. melitensis speciation time from the primarily cattle-infecting B. abortus to approximately 9800 years Before Present (BP), coinciding with a period of consolidation and dispersal of livestock economies. We use the basal genome to timestamp evolutionary events in B. melitensis, including pseudogenization events linked to erythritol response, the supposed determinant of the pathogen's placental tropism in goats and sheep. Our data suggest that the development of herd management and multi-species livestock economies in the 11th-9th millennium BP drove speciation and host adaptation of this zoonotic pathogen.

Giant stem tetrapod was apex predator in Gondwanan late Palaeozoic ice age.

Current hypotheses of early tetrapod evolution posit close ecological and biogeographic ties to the extensive coal-producing wetlands of the Carboniferous palaeoequator with rapid replacement of archaic tetrapod groups by relatives of modern amniotes and lissamphibians in the late Carboniferous (about 307 million years ago). These hypotheses draw on a tetrapod fossil record that is almost entirely restricted to palaeoequatorial Pangea (Laurussia)1,2. Here we describe a new giant stem tetrapod, Gaiasia jennyae, from high-palaeolatitude (about 55° S) early Permian-aged (about 280 million years ago) deposits in Namibia that challenges this scenario. Gaiasia is represented by several large, semi-articulated skeletons characterized by a weakly ossified skull with a loosely articulated palate dominated by a broad diamond-shaped parasphenoid, a posteriorly projecting occiput, and enlarged, interlocking dentary and coronoid fangs. Phylogenetic analysis resolves Gaiasia within the tetrapod stem group as the sister taxon of the Carboniferous Colosteidae from Euramerica. Gaiasia is larger than all previously described digited stem tetrapods and provides evidence that continental tetrapods were well established in the cold-temperate latitudes of Gondwana during the final phases of the Carboniferous-Permian deglaciation. This points to a more global distribution of continental tetrapods during the Carboniferous-Permian transition and indicates that previous hypotheses of global tetrapod faunal turnover and dispersal at this time2,3 must be reconsidered.

Combining traceological analysis and ZooMS on Early Neolithic bone artefacts from the cave of Coro Trasito, NE Iberian Peninsula: Cervidae used equally to Caprinae.

Few studies have combined the analysis of use-wear traces, traceology, and the proteomic taxonomic identification method Zooarchaeology by Mass Spectrometry (ZooMS). Traceology provides information on the usage, in this case, of bone artefacts, while ZooMS allows for taxonomic identifications where diagnostic features are otherwise gone. The approaches therefore offer complementary information on bone artefacts, allowing for insights into species selection strategies in bone tool manufacture and their subsequent use. Here we present a case study of 20 bone artefacts, mainly bone points, from the Early Neolithic cave site of Coro Trasito located on the southern slope of the Central Pyrenees. Hitherto, studies on Early Neolithic bone artefacts from the Iberian Peninsula have suggested based on morphological assessments that Ovis aries/Capra hircus constituted the majority of the bone material selected for bone tool production. However, the taxonomic identification in this study suggests that, at this site, Cervidae was selected equally to that of O. aries/C. hircus. Furthermore, bone artefacts made from Cervidae specimens seem to be utilised in a wider range of artefact types compared to O. aries/C. hircus. Coro Trasito's bone artefact species composition is probably site-specific to some degree, however, morphological assessments of bone artefacts might not be representative and could be biased towards certain species. Therefore, research on bone artefacts' usage could possibly gain new insights by implementing ZooMS in combination with traceology.

Geographic origin, ancestry, and death circumstances at the Cornaux/Les Sauges Iron Age bridge, Switzerland.

Cornaux/Les Sauges (Switzerland, Late Iron Age) revealed remnants of a wooden bridge, artifacts, and human and animal skeletal remains. The relationship between the collapsed structure and the skeletal material, whether it indicates a potential accident or cultural practices, remains elusive. We evaluate the most plausible scenario for Cornaux based on osteological, taphonomic, isotopic, and paleogenomic analysis of the recovered individuals. The latter amount to at least 20 individuals, mostly adult males. Perimortem lesions include only blunt force traumas. Radiocarbon data fall between the 3rd and 1st c. BCE, although in some cases predating available dendrochronological estimates from the bridge. Isotopic data highlight five to eight nonlocals. No close genetic relatedness links the analyzed skeletons. Paleogenomic results, the first for Iron Age Switzerland, point to a genetic affinity with other Central and Western European Iron Age groups. The type of skeletal lesions supports an accidental event as the more plausible explanation. Radiocarbon data and the demographic structure of the sample may suggest a sequence of different events possibly including executions and/or sacrifices. Isotopic and paleogenomic data, while not favoring one scenario over the other, do support earlier interpretations of the last centuries BCE in Europe as a dynamic period from a biocultural perspective.

Paleolithic eyed needles and the evolution of dress.

Eyed needles are among the most iconic of Paleolithic artifacts, traditionally seen as rare indicators of prehistoric clothing, particularly tailoring. However, recent finds across Africa and Eurasia show that other technologies like bone awls also facilitated the creation of fitted garments. Nonetheless, the advent of delicate eyed needles suggests a demand for more refined, efficient sewing. This refinement may signify two major developments: the emergence of underwear in layered garment assemblages, and/or a transition in adornment from body modification to decorating clothes, as humans covered themselves more completely for thermal protection. Archaeological evidence for underwear is limited, but the Upper Paleolithic saw an increase in personal ornaments, some sewn onto clothing. Eyed needles may mark a pivotal shift as clothes acquired the social functions of dress, decoupling clothing from climate and ensuring its enduring presence.