Scholars have argued that theoretical insights of critical medical anthropology should be applied to the analysis of complementary and alternative medicine in order to develop more critically engaged integrative medic...Scholars have argued that theoretical insights of critical medical anthropology should be applied to the analysis of complementary and alternative medicine in order to develop more critically engaged integrative medicine. In this essay we focus on nature cure in the context of India＇s contemporary epidemiological transition as an example of why engaged integrative medicine is important for public health, and how the institutionalization of nature cure treatment in India provides a critical framework for the development of programs focused on holistic treatment and prevention. After providing an overview of the epidemiological transition in contemporary India, we develop this argument through an examination of illustrative cases in a clinic that operates within the structure of India＇s Central Council for Research on Yoga and Naturopathy. Based on a review of recent history and contemporary practice we describe how a system of medicine that makes use exclusively of air, earth, sunlight, water and food has been institutionalized and professionalized in India. Whereas biomedical treatment for chronic non- communicable diseases is focused on the problem of curing individual diseases, nature cure establishes a regimen of personalized public healthcare for the integrated management of symptoms. We argue that nature cure is based on an ecological understanding of health, thus providing treatment that reflects a broad appreciation for the risk factors that characterize India＇s current crises of public health.展开更多
Objective To analyze the diagnostic efficacy of lipid-related insulin resistance(IR)markers in patients with non-alcoholic fatty liver disease(NAFLD)and metabolic abnormalities(MA).Method Patients with NAFLD with MA,n...Objective To analyze the diagnostic efficacy of lipid-related insulin resistance(IR)markers in patients with non-alcoholic fatty liver disease(NAFLD)and metabolic abnormalities(MA).Method Patients with NAFLD with MA,non-NAFLD patients with MA,and patients with NAFLD without MA underwent liver biopsy.Homeostasis model assessment of insulin resistance(HOMA-IR),triglyceride/high-density lipoprotein cholesterol(TG/HDL-C),visceral obesity index(VAI),lipid accumulation product(LAP),and triglyceride glucose(TyG)index were analyzed.The diagnostic efficacy of these indicators of NAFLD was also evaluated.Results In the NAFLD-MA group,BMI,HOMA-IR,LAP,VAI,TyG index,and TG/HDL-C ratio were higher than those in the non-NAFLD-MA group(P<0.001).Logistic regression indicated that BMI and TyG index were independent risk factors for NAFLD.Receiver Operating Characteristic(ROC)curves analysis revealed that the Area Under the ROC Curve(AUC)for TyG-BMI was 0.819,and the optimal cutoff for NAFLD was TyG-BMI 39.77.For patients with NAFLD with or without MA,logistic regression analysis suggested that age,TG level,and TyG index were independent risk factors.The area under the ROC curve showed that AUC for the TyG index was 0.724.The optimal cutoff for NAFLD-non MA was a TyG index of 1.580.Conclusion TyG index has diagnostic value in both types of NAFLD;however,TyG-BMI is better in patients with NAFLD with MA and may be an effective screening indicator alone in patients with NAFLD without MA.展开更多
Traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease are three distinct neurological disorders that share common pathophysiological mechanisms involving neuroinflammation. One sequela ...Traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease are three distinct neurological disorders that share common pathophysiological mechanisms involving neuroinflammation. One sequela of neuroinflammation includes the pathologic hyperphosphorylation of tau protein, an endogenous microtubule-associated protein that protects the integrity of neuronal cytoskeletons. Tau hyperphosphorylation results in protein misfolding and subsequent accumulation of tau tangles forming neurotoxic aggregates. These misfolded proteins are characteristic of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease and can lead to downstream neuroinflammatory processes, including assembly and activation of the inflammasome complex. Inflammasomes refer to a family of multimeric protein units that, upon activation, release a cascade of signaling molecules resulting in caspase-induced cell death and inflammation mediated by the release of interleukin-1β cytokine. One specific inflammasome, the NOD-like receptor protein 3, has been proposed to be a key regulator of tau phosphorylation where it has been shown that prolonged NOD-like receptor protein 3 activation acts as a causal factor in pathological tau accumulation and spreading. This review begins by describing the epidemiology and pathophysiology of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease. Next, we highlight neuroinflammation as an overriding theme and discuss the role of the NOD-like receptor protein 3 inflammasome in the formation of tau deposits and how such tauopathic entities spread throughout the brain. We then propose a novel framework linking traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease as inflammasomedependent pathologies that exist along a temporal continuum. Finally, we discuss potential therapeutic targets that may intercept this pathway and ultimately minimize long-term neurological decline.展开更多
文摘Scholars have argued that theoretical insights of critical medical anthropology should be applied to the analysis of complementary and alternative medicine in order to develop more critically engaged integrative medicine. In this essay we focus on nature cure in the context of India＇s contemporary epidemiological transition as an example of why engaged integrative medicine is important for public health, and how the institutionalization of nature cure treatment in India provides a critical framework for the development of programs focused on holistic treatment and prevention. After providing an overview of the epidemiological transition in contemporary India, we develop this argument through an examination of illustrative cases in a clinic that operates within the structure of India＇s Central Council for Research on Yoga and Naturopathy. Based on a review of recent history and contemporary practice we describe how a system of medicine that makes use exclusively of air, earth, sunlight, water and food has been institutionalized and professionalized in India. Whereas biomedical treatment for chronic non- communicable diseases is focused on the problem of curing individual diseases, nature cure establishes a regimen of personalized public healthcare for the integrated management of symptoms. We argue that nature cure is based on an ecological understanding of health, thus providing treatment that reflects a broad appreciation for the risk factors that characterize India＇s current crises of public health.
基金Beijing Research Ward Excellence Program(BRWEP2024W102170101)The National Key Research and Development Program(2022YFC2603500,2022YFC2603505)+5 种基金Beijing Municipal Health Commission high-level public health technical personnel construction project(discipline leader-03-26,discipline backbone-02-28)Capital’s Funds for Health Improvement and Research(2022-1-2172)Beijing Hospitals Authority Clinical medicine Development of special funding support(ZLRK202301)Beijing Hospitals Authority"peak"talent training program(DFL20241803)National Key Research and Development Program of China(2023YFC2306900)National Key Research and Development Program of Ministry of Science and Technology(2023YFC2308105).
文摘Objective To analyze the diagnostic efficacy of lipid-related insulin resistance(IR)markers in patients with non-alcoholic fatty liver disease(NAFLD)and metabolic abnormalities(MA).Method Patients with NAFLD with MA,non-NAFLD patients with MA,and patients with NAFLD without MA underwent liver biopsy.Homeostasis model assessment of insulin resistance(HOMA-IR),triglyceride/high-density lipoprotein cholesterol(TG/HDL-C),visceral obesity index(VAI),lipid accumulation product(LAP),and triglyceride glucose(TyG)index were analyzed.The diagnostic efficacy of these indicators of NAFLD was also evaluated.Results In the NAFLD-MA group,BMI,HOMA-IR,LAP,VAI,TyG index,and TG/HDL-C ratio were higher than those in the non-NAFLD-MA group(P<0.001).Logistic regression indicated that BMI and TyG index were independent risk factors for NAFLD.Receiver Operating Characteristic(ROC)curves analysis revealed that the Area Under the ROC Curve(AUC)for TyG-BMI was 0.819,and the optimal cutoff for NAFLD was TyG-BMI 39.77.For patients with NAFLD with or without MA,logistic regression analysis suggested that age,TG level,and TyG index were independent risk factors.The area under the ROC curve showed that AUC for the TyG index was 0.724.The optimal cutoff for NAFLD-non MA was a TyG index of 1.580.Conclusion TyG index has diagnostic value in both types of NAFLD;however,TyG-BMI is better in patients with NAFLD with MA and may be an effective screening indicator alone in patients with NAFLD without MA.
文摘Traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease are three distinct neurological disorders that share common pathophysiological mechanisms involving neuroinflammation. One sequela of neuroinflammation includes the pathologic hyperphosphorylation of tau protein, an endogenous microtubule-associated protein that protects the integrity of neuronal cytoskeletons. Tau hyperphosphorylation results in protein misfolding and subsequent accumulation of tau tangles forming neurotoxic aggregates. These misfolded proteins are characteristic of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease and can lead to downstream neuroinflammatory processes, including assembly and activation of the inflammasome complex. Inflammasomes refer to a family of multimeric protein units that, upon activation, release a cascade of signaling molecules resulting in caspase-induced cell death and inflammation mediated by the release of interleukin-1β cytokine. One specific inflammasome, the NOD-like receptor protein 3, has been proposed to be a key regulator of tau phosphorylation where it has been shown that prolonged NOD-like receptor protein 3 activation acts as a causal factor in pathological tau accumulation and spreading. This review begins by describing the epidemiology and pathophysiology of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease. Next, we highlight neuroinflammation as an overriding theme and discuss the role of the NOD-like receptor protein 3 inflammasome in the formation of tau deposits and how such tauopathic entities spread throughout the brain. We then propose a novel framework linking traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease as inflammasomedependent pathologies that exist along a temporal continuum. Finally, we discuss potential therapeutic targets that may intercept this pathway and ultimately minimize long-term neurological decline.
