Inflammatory bowel diseases (IBD) comprise two major forms Crohn's disease and ulcerative colitis. The diagnosis of IBD is based on clinical symptoms combined with results found in endoscopic and radiological examinations. In addition, the discovery of biomarkers has significantly improved the diagnosis and management of IBD. Several potential genetic, serological, fecal, microbial, histological and immunological biomarkers have been proposed for IBD, and they have been evaluated for clinical routine and clinical trials. Ileocolonoscopy, especially with biopsy collection, has been considered the standard method to diagnose IBD and to assess clinical activity of the disease, but it is limited to the colon and terminal ileum and is considered invasive. For this reason, non-invasive biomarkers are necessary for this type of chronic inflammatory disease, which affects mostly young individuals, as they are expected to have a long follow-up.The total defence (TD) concept aims to provide an effective crisis response structure by increasing society resilience. However, the complexity of its structure regarding resource mobilization and management process highlights the need for a complexity-oriented approach in the operationalising of TD. We study the application of TD during the COVID-19 crisis and explore what makes the TD a viable system with resilience capabilities in the face the crisis. We apply the Viable Systems Model as a methodology to compare the viability of the United Kingdom and Norwegian TD systems, both of which use systems networks to achieve resilience, and contrast the different outcomes of each country. Our analysis highlights that Managing the complexity of the TDS requires that all of the involved agencies proactively adopt a transparent approach to a joint decision making. This demands a wide range of sources of innovative solutions at different levels. Joint exercises, developed by the responsible agencies, enhance mutual understating of roles and responsibilities and crisis response structure. This calls for institutionalized support to dedicate resources. To avoid communications challenges, involved agencies in the TDS need to adopt an open messaging strategy, highlighting how to deal with uncertainties in communicating of decisions and action.The Precision Medicine Initiative of 2015, together with a growing focus on patient-centered care, has challenged the U.S. health care system to provide the correct treatment to the correct individual patient rather than to a collective population. This demonstrates that acupuncture-with its history as an individualized therapy and with growing evidence-based clinical findings-is the ideal model for personalized medicine within oncology care. The current author and colleagues used previously conducted oncology acupuncture trials for pain, hot flashes, and insomnia to demonstrate that precise delivery of acupuncture might depend on a patient's genetics. Individual preferences and perceived evidence surrounding treatments might also factor into patient treatment choices. Further effectiveness evidence comparing acupuncture to drugs or cognitive-behavioral therapy provides insight on the relative benefit or harm of each treatment, which, in turn, can help clinicians and patients to choose the best treatment plans centered on patients' goals. To advance precision oncology acupuncture research, appropriate biomarkers and psychologic attributes should be incorporated into adequately powered and well-designed clinical trials to evaluate how acupuncture can be delivered to the correct patients.A neurochemical hypothesis of acupuncture analgesia suggests that the pain relief effect of acupuncture is primarily due to activation of a central endorphin system. It has been shown that the primary afferent sensory fibers, a mesolymbic neural circuit, and a descending inhibitory pathway are critical in acupuncture analgesia. The therapeutic effects of electroacupuncture (EA) and related techniques, such as transcutaneous electroacupoint stimulation (TEAS), are frequency-dependent different frequencies of EA activate different brain regions and release different neuropeptides. EA and TEAS have been used successfully to treat heroin addiction. Activation of endorphin gene expression and release by TEAS can explain the dramatic attenuation of withdrawal syndrome and prolongation of retention time during and after detoxification treatment in patients who are addicted to heroin. However, repeated EA at high intensity should be avoided because it can induce a gradual loss of the analgesic effect. Opioid-receptor desensitization occurs and is manifested as decreased ligand-binding affinity and second-messenger detachment. Repeated large doses of morphine induce morphine tolerance.  https://www.selleckchem.com/products/sb290157-tfa.html  Cross-tolerance between morphine and EA suggests similar underlying mechanisms. Recent studies have demonstrated that excessive activation of cholecystokinin (CCK), an antiopioid peptide, appears to be responsible. CCK-receptor subtype B (CCKBR) and opioid μ-receptor are co-expressed in the dorsal-horn neurons. Activation of CCKBR promotes formation of heteromerization of morphine-receptor and CCKBR. Interaction of the third transmembrane domain between the 2 receptors resulted in the reduced binding affinity of the opioid receptor.Acupuncture consists of multiple components, and neuroimaging studies are beginning to tease apart potential brain-based mechanisms supporting this nonpharmacologic intervention. Brain imaging in patient populations is important for the acupuncture neuroimaging field, and recent studies have incorporated neuroimaging into a clinical trial framework for improved ecological validity in extending results to be more relevant for clinical practice. For instance, functional magnetic resonance imaging (fMRI) research with patients suffering from carpal tunnel syndrome has suggested cortical plasticity as a mechanism supporting acupuncture analgesia. In turn, the patient-acupuncturist relationship is another important aspect of acupuncture analgesia, and recent hyperscan fMRI research has begun to explore brain-based mechanisms underlying therapeutic alliance between patient and clinician, and how this might impact acupuncture analgesia. Ultimately, neuroimaging has shown great promise in the past several decades in opening a window into brain function to better appreciate the mechanisms supporting acupuncture.