Volume 30, Issue 169, March 2026

About the Cover

A complex TTFL underlies circadian rhythms of transcription and translation (TTFL), which acts as the main molecular oscillator in cells. This system has two parts. Firstly, there are positive regulatory elements, which include the heterodimeric transcription factors CLOCK and BMAL1. These activate the expression of core clock genes and their protein products. Secondly, a delayed negative feedback mechanism is in place, in which protein products e.g. PER and CRY, accumulate, form complexes, and move to the nucleus to inhibit CLOCK:BMAL1 activity. This stops them making more copies of themselves. The feedback loop fluctuates. This movement takes about 24 hours to complete. This ~24-hour cycle maintains physiological homeostasis. Secondly, we have found that certain proteins (nuclear receptors) work together to control the rhythm of the clock genes, making them more stable and efficient. Clock-controlled genes regulate key processes (e.g., metabolism) via rhythmic expression. This is because these genes are aligned with time-of-day cues. The accuracy of the molecular clock pauses ensures pauses in various processes, including transcription, translation, protein synthesis and breakdown, as well as post-translational modifications e.g., phosphorylation. This architecture elucidates clock disruption effects. This is because it helps us to understand how disruptions to the body's clock affect metabolic diseases.

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REVIEW

Circadian rhythm disorders and metabolic diseases - current state of knowledge

Kamila Kałamarz, Maja Kondratowicz, Aleksandra Figzał, Kinga Żmuda, Maciej Świerczyna, Maja Czerniachowska, Marcin Kaniewski, Martyna Wojnowska, Wiktoria Polkowska, Michał Grabek

A complex TTFL underlies circadian rhythms of transcription and translation (TTFL), which acts as the main molecular oscillator in cells. This system has two parts. Firstly, there are positive regulatory elements, which include the heterodimeric transcription factors CLOCK and BMAL1.

Medical Science, 2026, 30, e46ms3793

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Primary aldosteronism in patients with resistant hypertension – diagnostic challenges and clinical implications

Aleksandra Lisowska, Oliwia Jerzyńska, Pola Sitek, Dariusz Szołtys, Karolina Zygoń Komendarczyk, Katarzyna Oberska, Michalina Adamczyk, Sandra Olewińska, Tola Kotkiewicz, Yelyzaveta Petrenko

Primary aldosteronism (PA) has become increasingly recognised as a frequent and clinically important cause of resistant hypertension. In the past, the importance of PA was marginalised

Medical Science, 2026, 30, e47ms3806

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ARTICLE

Foot Health and its Association with Quality of Life Among Adults in the Makkah Region: A Cross-Sectional Study

Zainah S Alammari, Ibrahim S Aljulaymi

Introduction: Foot problems are highly prevalent and encompass a broad spectrum of conditions affecting individuals across all age groups. These conditions can substantially impair mobility, limit daily functional activities, and ultimately reduce overall quality of life (QoL).

Medical Science, 2026, 30, e48ms3829

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REVIEW

Glucagon-Like Peptide-1 Receptor Agonist potential in AUD treatment. Neurobiological Mechanisms and Clinical Evidence

Paulina Wądołowska, Patryk Pindlowski, Ewelina Komorowska, Jakub Szyszkowski, Zuzanna Zgrzywa, Brygida Tucka, Natalia Kriese, Izabela Zawadzka, Bartłomiej Kowalski, Jakub Jaworski

Alcohol Use Disorder (AUD) constitutes a significant global health challenge, with standard pharmacological treatments constrained by limited long-term efficacy and poor patient adherence.

Medical Science, 2026, 30, e49ms3791

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A review of the literature on viral infections and the development of chronic metabolic diseases

Michał Grabek, Maja Kondratowicz, Kamila Kałamarz, Kinga Żmuda, Maciej Świerczyna, Maja Czerniachowska, Marcin Kaniewski, Martyna Wojnowska, Wiktoria Polkowska, Aleksandra Figzał

Introduction: Viruses often trigger chronic conditions such as diabetes, obesity, and NAFLD by disrupting metabolism. The present review examines recent evidence on how viral pathogens alter the body's energy processing mechanisms and the subsequent impact on host metabolism

Medical Science, 2026, 30, e50ms3798

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REPORT

Adolescent Mental Health in Europe: Correlations between Self-Reported Emotional Well-being and Suicide Mortality Among Adolescents

Fryderyka Orawczak, Agata Olecka, Julia Gałązka, Tomasz Karwowski, Zuzanna Czuba, Mateusz Mazurek, Maciej Świerczyna, Mikołaj Kotusiewicz, Filip Gałązka, Jakub Majcherek

Objective: Adolescent mental health is a critical public health issue. In Europe, suicide is one of the leading causes of death among young people, with a rising trend observed in recent years

Medical Science, 2026, 30, e51ms3750

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REVIEW

The role of sleep chronotype in mental and metabolic health - a review of current evidence

Zuzanna Czuba, Mateusz Mazurek, Filip Gałązka, Julia Gałązka, Agata Olecka, Maciej Świerczyna, Fryderyka Orawczak, Jakub Majcherek, Mikołaj Kotusiewicz, Tomasz Karwowski

Chronotype is an individual's preferred time of day for being active and asleep. Chronotype refers to how well one's behaviour aligns with their internal bodily rhythms

Medical Science, 2026, 30, e52ms3755

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AI-driven interpretation of electrocardiograms in the diagnosis of common cardiovascular disorders: a systematic review

Anna Mazur, Julia Brodziak, Wiktoria Ciszewska, Michał Dworak, Katarzyna Fojcik, Zofia Kosztyła-Czech, Marta Kowalska, Mateusz Matyja, Wiktor Werenkowicz, Tomasz Wiśniewski

Electrocardiography (ECG) is widely used in everyday cardiology practice, but its interpretation can be difficult, especially when electrical abnormalities are mild or atypical.

Medical Science, 2026, 30, e53ms3794

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ARTICLE

Knowledge Level of Sexually Transmitted Infections among Adolescents and Students

Izabella Prządo, Patrycja Patronik, Łukasz Karaś, Sabina Krupa-Nurcek

Introduction: Sexually transmitted diseases (STD) are a major public health challenge worldwide due to their high prevalence, diverse etiology, and potential for serious complications, including oncogenic risk (HPV) and chronic multiorgan damage

Medical Science, 2026, 30, e54ms3807

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REVIEW

Timing of complementary feeding: Introduction and the risk of atopic dermatitis in infants: A review of the literature

Izabella Zawadzka, Jakub Szyszkowski, Natalia Kriese, Bartłomiej Kowalski, Zuzanna Zgrzywa, Ewelina Komorowska, Zofia Szpunar, Brygida Tucka, Paulina Wądołowska, Jakub Jaworski

Atopic dermatitis (AD) is a long-term inflammatory disease with many causes. It manifests itself with typical eczematous lesions and severe itching. Genetically or immunologically determined skin barrier dysfunction

Medical Science, 2026, 30, e55ms3786

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Impact of diet and lifestyle interventions on core molecular longevity pathways and the human healthspan: a mechanistic review

Zuzanna Zgrzywa, Brygida Tucka, Jakub Szyszkowski, Izabella Zawadzka, Paulina Wądołowska, Bartłomiej Kowalski, Natalia Kriese, Ewelina Komorowska, Jakub Jaworski, Tomasz Kucharski

Aging is a complex, multifactorial biological process and the primary risk factor for chronic disease. While genetic factors play a role, environmental interventions— specifically diet and lifestyle—profoundly impact the rate and quality of human aging.

Medical Science, 2026, 30, e56ms3805

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Rheumatoid Arthritis and the Gut Microbiota: Findings from Recent Studies (2017-2025)

Wiktoria Polkowska, Maja Kondratowicz, Kamila Kałamarz, Kinga Żmuda, Maciej Świerczyna, Maja Czerniachowska, Marcin Kaniewski, Martyna Wojnowska, Aleksandra Figzał, Michał Grabek

Rheumatoid arthritis (RA) is one of the most common autoimmune conditions, characterized by persistent joint inflammation. Recent studies have examined the gut microbiota in patients with RA and in individuals assessed before clinical symptoms appear.

Medical Science, 2026, 30, e57ms3811

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ARTICLE

The knowledge of nurses, skills, and personal attributes for providing competent health education practice, and its influencing factors: a crosssectional study in Saudi Arabia

Adel Jamaan Alzahrani, Ahmed Abdullah Alghamdi, Ahamed Mohammed Alghamdi, Mohammed Abaid Alharbi, Abdullah Tareq Alhemiary

Background: Nurses play a key role in delivering health education in hospital and community settings; however, their competence is influenced by various personal and institutional factors

Medical Science, 2026, 30, e58ms3840

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REVIEW

Botulinum Toxin Type A and Other Non-Surgical Modalities in Hypertrophic and Keloid Scar Management: A Review of Clinical Evidence

Ewelina Roksana Wojna, Karolina Górowska, Aleksandra Korżel, Kamil Źródłowski, Patrycja Anita Kobrzyńska, Jędrzej Mogilany, Julia Niedźwiecka, Gabriela Ragan

Hypertrophic scars and keloids are one of the most challenging scars to treat, as their high rate of relapse, functional disability, and their psychosocial effects on patients make their management a formidable task

Medical Science, 2026, 30, e59ms3814

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The latest reports about sodiumglucose cotransporter-2 inhibitors – a literature review

Aleksandra Rusak-Sobolewska, Gabriela Krych, Joanna Oklińska, Michał Skóra, Klaudia Jadczak, Bartłomiej Kazimierski, Weronika Gniado, Dawid Mądry

Sodium-glucose cotransporter-2 (SGLT2) inhibitors are currently one of the most widely prescribed anti-hyperglycaemic drugs, and their popularity is rapidly increasing.

Medical Science, 2026, 30, e60ms3839

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Therapeutic potential of intermittent fasting regimens in type 2 diabetes mellitus: A literature review

Mandalian A, Malinowski M, Zadrożna K, Żelichowska N

Type 2 diabetes mellitus (T2DM) is a global medical problem. While Continuous Energy Restriction (CER) is the standard dietary intervention, it is frequently impeded by poor long-term adherence

Medical Science, 2026, 30, e61ms3845

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ARTICLE

Knowledge, attitude, and practice of frailty management among clinical nurses in Saudi Arabia: A crosssectional study

Meshari Awwadh Alharthi, Aziz Hamad Alhazli, Salah Salem Alsaedi, Hassan Mohammed Alharthi, Saleem Zaidan Alharbi, Sultan Yahya Mobarki

Background: Frailty is becoming a bigger problem for public health because it causes disabilities, falls, longer hospital stays, and higher medical costs. Because nurses are always with their patients, they can spot early signs of frailty and give them the right care.

Medical Science, 2026, 30, e62ms3848

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REVIEW

Association Between Vitamin D, DHA, Folic Acid, Iodine and Zinc Supplementation During Pregnancy and Offspring Development: A Systematic Review and Meta-analysis

Ewa Gloc, Mateusz Mierniczek, Maria Mierniczek, Dominika Dmowska, Aleksandra Bilińska, Paweł Zdebski, Rafał Ejsner, Daniel Załęski, Urszula Marzec

Low-level status of crucial microelements in pregnant women may expose the offspring to suboptimal conditions during fundamental phases of fetal development, and it may have long-term effects on their health outcomes

Medical Science, 2026, 30, e63ms3828

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