https://www.selleckchem.com/products/azd9291.html 29, 95% credible interval [CrI] 1.22 to 4.25), 200 mg/day (RR=4.35, 95%CrI 2.31 to 8.01) and 300 mg/day (RR=6.02, 95%CrI 3.22 to 11.1) involved a higher risk of gastrointestinal AEs. Similarly, tramadol 100-300 mg/day showed a higher risk of CNS AEs and withdrawals. However, the risk of cardiovascular AEs remained unclear. Only tramadol 300mg/day showed minimal improvement in pain and function but with increasing AEs compared with placebo. Tramadol may not be sufficiently recommended for knee or hip OA by presented evidence, especially in patients with the risk of gastrointestinal and CNS AEs. Only tramadol 300mg/day showed minimal improvement in pain and function but with increasing AEs compared with placebo. Tramadol may not be sufficiently recommended for knee or hip OA by presented evidence, especially in patients with the risk of gastrointestinal and CNS AEs.The sport of competitive para surfing is growing internationally without established classification procedures. A classification structure is essential for equitable sport competition and worldwide sport progression. This narrative review summarizes existing knowledge on Paralympic classification and surfing biomechanics. Its primary purpose is to describe the development of an evidence-based para surfing classification structure that follows the International Paralympic Committee (IPC) Classification Code. Two databases, PubMed and Google Scholar, were searched for three themes "Paralympic classification," "performance determining factors in surfing," and "impact of impairments on surf performance." The IPC Classification Code and IPC regulations were obtained from the IPC website and official publications. Seventy-six relevant articles were utilized to guide the design of this preliminary para surfing classification structure. A conceptual framework on athlete characteristics, adaptive sport characteristics, and use of equipment is presented to build the e