Search Results (1,718)

Much of the interoception literature assumes that people can accurately detect their heart rate, stomach contractility, muscle tension, and other biological cues. This is not true. Instead, interoception is an active integrative psychological process where the feeling of one’s internal state emerges from physiological signals, contextual cues, and the social and cultural experiences of living in a body. Thinking of interoception this way shifts the focus from measuring accuracy at detecting biological signaling to studying lived experience. One such experience is the widespread objectification of women’s bodies. Living in a body that is chronically evaluated creates a particular form of self-consciousness. Here, we propose that self-objectification redirects attention toward the body, potentially reshaping both the allocation of attention to internal sensations and their interpretation and thereby offering a theoretical account of paradoxes in the interoception literature, such as women’s lower detection accuracy but higher symptom reporting, and mismatches between subjective and physiological reports of menopausal hot flashes. We consider implications for women’s health, including reproductive health, ACL injury risk, and chronic pain. Our framework suggests that “feeling like a woman” reflects an interoceptive experience shaped significantly by objectification, with important consequences for well-being. Full article

Adverse Drug Reactions (ADRs) represent a major public health concern due to their impact on patient safety. In Spain, the Spanish Agency of Medicines and Medical Devices, through the FEDRA database, coordinates the reporting of suspected ADRs under real-world conditions of use, contributing to the continuous updating of safety information. In this context, community pharmacist, through Professional Pharmaceutical Care Services, plays a key role in the early detection of ADRs and Drug-Related Problems (DRPs). This article describes the case of a 70-year-old polymedicated woman included in a Personalized Dosage System (PDS). Following the substitution of diazepam with clonazepam and an increase in the dose of semaglutide, the patient developed urinary incontinence, nausea and abdominal pain. Coordinated intervention between the community pharmacy and primary care enabled adjustment of the clonazepam dose, optimization of semaglutide administration and discontinuation of unnecessary naproxen use. These measures resulted in improved treatment tolerance and safety, as well as optimization of pharmacotherapy. Full article

Background: Epidural obstetric analgesia is the standard of care for labor pain relief; however, its impact on neonatal cerebral oximetry remains debated. Objective: We aimed to evaluate whether epidural analgesia modifies cerebral regional oxygen saturation (CrSO₂), measured by near-infrared spectroscopy (NIRS), in term neonates from low-risk deliveries. Methods: We conducted a prospective comparative observational cohort study, including 48 term newborns: 25 delivered under epidural analgesia (EA) and 23 without epidural analgesia (NE). CrSO₂ was monitored using NIRS (INVOS 5100C, Somanetics/Medtronic, Troy, MI, USA; OxyAlert NIRSensor Cerebral/Somatic Infant–Neonatal Sensor CNN/SNN) during the neonatal transition up to 15 min after birth (primary outcome), and its relationship with neonatal well-being parameters (umbilical cord pH, Apgar score, and other analytical and obstetric indicators) was explored. Results: Median CrSO₂ at 15 min was 79.52 [76.40–82.64] in the EA group and 78.65 [74.21–83.09] in the NE group. Both groups exhibited a similar temporal pattern characterized by a progressive increase, a peak at 10 min, and stabilization by 15 min. Mean (SD) CrSO₂ in EA/NE were: 2 min, 57.64 (14.8)/60.04 (14.4); 5 min, 79.56 (10.9)/79.39 (12.2); 10 min, 82.28 (8.1)/81.13 (9.7); 15 min, 79.52 (7.6)/78.65 (10.3). No significant between-group differences were detected at any time point using a linear mixed model (p-values: 2 min, 0.57; 5 min, 0.96; 10 min, 0.66; 15 min, 0.74). Conclusions: These findings indicate that epidural obstetric analgesia does not alter cerebral oximetry parameters in term neonates from low-risk deliveries during the early transitional period. Full article

Sit-to-stand (STS) transitions are clinically informative indicators of functional independence and are sensitive to compensatory strategies associated with physical decline and pain. This study presents a non-contact, non-visual framework for quantitative STS assessment using a 60 GHz frequency-modulated continuous-wave (FMCW) radar in a residential setting. We developed a signal-processing pipeline that converts intermediate-frequency radar data into range–time intensity (RTI) maps, tracks dominant torso motion, and extracts temporal, kinematic, and spectral features. Experiments were conducted across two sensing orientations (subject-facing and side-facing), five mounting heights (45–153 cm), and three execution speeds, with approximately 30 repeated cycles per condition. For normal non-compensated STS transitions, radar-derived metrics reflected expected biomechanical scaling: mean full-cycle duration decreased from $23.90$ s (slow) to $13.95$ s (medium) and $7.98$ s (fast), while peak ascent velocity increased from $0.311$ m/s to $0.358$ m/s and dominant cadence increased from 0.0416 Hz to 0.125 Hz. Simulated abnormal transitions produced distinct and quantifiable deviations. Preparatory rocking introduced an additional oscillatory phase (mean rocking duration 2.36 s), prolonging the standing transition to 4.80 s and altering trajectory regularity. Across configurations, subject-facing mid-torso mounting provided the most continuous and separable STS signatures, whereas side-facing placement and extreme heights reduced effective radial motion or introduced clutter artifacts. These findings establish practical deployment guidelines and demonstrate that radar-derived STS metrics can serve as candidate digital biomarkers for unobtrusive, privacy-preserving detection of mobility decline, compensatory pain behaviors, and functional impairment in real-world home environments. Full article

Background: Ischemic cholangiopathy (IC) is an under-recognized complication after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). Our goal was to estimate the incidence, timing, clinical presentation, and management of IC after drug-eluting bead TACE. Methods: Single-center retrospective cohort of consecutive drug-eluting bead TACE procedures (1 January 2020–31 December 2023) with imaging follow-up to 31 December 2024 was conducted. IC was defined radiologically as bile duct dilatation without mechanical obstruction, biloma formation, biliary strictures, or ischemic cholecystitis occurring after TACE. The primary outcome was the incidence of IC. Secondary outcomes included clinical presentation, need for hospitalization, and management. Results: Among 106 patients, 14 developed IC (13.2%). Imaging abnormalities were detected a mean of 3.1 months after TACE. Six patients (42.9%) were asymptomatic. Among symptomatic patients, the most common manifestations were abdominal pain (n = 6) and fever (n = 4). Five patients required hospitalization, including 2 with infected bilomas requiring antibiotics and/or drainage. Subsequent HCC therapy was feasible in most cases; no deaths were directly attributed to IC. Conclusions: IC after TACE is not rare and is frequently asymptomatic, often detected incidentally on routine CT follow-up. Systematic biochemical monitoring and selective MRCP could improve detection, particularly when TACE sessions are closely spaced. Full article

Colorectal cancer (CRC) develops gradually from precancerous adenomas and is highly curable when detected early. In Malaysia, however, most cases are diagnosed at advanced stages, leading to poorer outcomes despite the availability of screening programmes such as the immunological Faecal Occult Blood Test (iFOBT). Limited screening uptake and poor adherence contribute to delayed diagnosis. Therefore, effective non-invasive and patient-friendly screening tools are essential. Background/Objectives: This study aims to validate the diagnostic performance of the multi-target stool DNA (mt-sDNA) test. Methods: This cross-sectional validation study was conducted at the Endoscopic Center, Hospital Canselor Tuanku Muhriz (HCTM), from January 2024 to September 2025. Adults aged 18–75 years undergoing elective or emergency colonoscopy were included. Results: Among 246 patients, most were male (56.5%), Malay (65.2%), and aged 55–75 years (91.3%). CRC prevalence was 8.5%. A significant association was observed between age group and colonoscopy findings (p = 0.005), with older individuals more likely to have CRC or adenomatous lesions. Most CRC (90.4%) and advanced adenoma (84.6%) cases occurred in symptomatic patients; however, this difference did not demonstrate a significant association with colonoscopy outcomes (p = 0.069). Per rectal bleeding, constitutional symptoms, altered bowel habit, abdominal pain and constipation were significantly associated with CRC and adenomatous lesions. The mt-sDNA test showed a sensitivity of 63.2%, specificity of 85.0%, positive predictive value of 36.4%, and negative predictive value of 94.4%. Conclusions: Preliminary findings indicate that mt-sDNA demonstrates good specificity and high negative predictive value, but moderate sensitivity and low positive predictive value. Full article

Both the productive efficiency and physical health of sika deer are strongly linked to their body conformation phenotypes. Breeding sika deer with excellent growth traits using molecular breeding technologies has become essential. Phenotypic data of 12 body conformation traits were measured for 613 sika deer across three age groups, including body traits and cephalic traits. Genetic typing was performed using the Sika Deer 100K SNP Liquid Chip, and genetic parameters were estimated through animal models to obtain the heritability and genetic correlation of traits within each age group. Single-trait and multi-trait GWASs were conducted, using GEMMA software to identify gene variants significantly associated with sika deer body conformation traits. Most of the 12 body conformation traits exhibited moderate to high heritability. The single-trait GWAS identified 49 SNPs (38 candidate genes), while multi-trait GWAS detected 134 SNPs (80 candidate genes), including 114 novel loci. A total of 163 SNPs and 196 candidate genes were identified, with 17 genes detected by both methods. These genes may be involved in pain perception, cell cycle regulation, immune response, and protein ubiquitination. Two significant KEGG pathways were enriched: steroid hormone biosynthesis and drug metabolism–cytochrome P450. Collectively, these detected loci and genes may serve as potential genetic resources for marker-assisted breeding, contributing to subsequent genetic improvement of body conformation in sika deer. Full article

Background/Objectives: Copeptin, a marker of endogenous stress, has been used for the early detection of non-ST elevation myocardial infarction (NSTEMI) in combination with conventional cardiac troponin. However, its incremental diagnostic value, when combined with high-sensitivity troponin, is not well defined. This study seeks to assess the diagnostic performance for NSTEMI of a Dual Marker Strategy (DMS) [copeptin and high-sensitivity cardiac troponin T (hs-cTnT)] measured upon presentation to the Emergency Department (ED) and compare it to the hs-cTnT 0h/1h and 0h/2h algorithms recommended by the European Society of Cardiology (ESC). Methods: This prospective observational study enrolled 102 patients presenting to the ED with chest pain of <6 h duration; patients with ST elevation myocardial infarction (STEMI) were excluded. Copeptin and hs-cTnT were measured upon patient presentation (time 0 h, DMS) in the whole cohort. hs-cTnT was subsequently repeated either at 1 h (n = 51) or 2 h (n = 51). The diagnostic performance of the DMS, assessed in terms of sensitivity, specificity, and negative (NPV) and positive predictive value (PPV), was compared to that of the ESC-recommended hs-cTnT algorithms 0h/1h and 0h/2h for NSTEMI. Results: Of the total population, 59.8% were men, with a mean age of 57.7 ± 18.4 years; 8.8% of the patients were eventually di agnosed with NSTEMI. The DMS (cut-offs: copeptin < 10 pmol/L and hs-cTnT < 14 ng/L) demonstrated a sensitivity of 88.9% (95% CI: 51.75–99.72) and an NPV of 98.5% (90.94–99.76). On the other hand, the hs-cTnT 0h/1h algorithm showed a sensitivity of 60% (14.66–94.73) and an NPV of 95.6% (88.06–98.45), while the hs-cTnT 0h/2h algorithm exhibited a sensitivity of 75% (19.41–99.37) and an NPV of 95.8% (85.22–98.93). In ROC analysis, copeptin yielded an AUC of 0.702 (p = 0.046) and hs-cTnT at 0h showed an AUC of 0.736 (p = 0.02), whereas their combination demonstrated an AUC of 0.730 (p = 0.023) for the detection of NSTEMI. Conclusions: The copeptin/hs-cTnT DMS has comparable diagnostic performance to the hs-cTnT 0h/1h and 0h/2h algorithms for the early rule-out of NSTEMI. Full article

Aiming at the technical pain points of traditional manhole covers with low intelligence high cost and excessive power consumption, this study designs a TENG-based alarm device to enhance the safety and maintenance efficiency of urban infrastructure. The device integrates a water immersion sensor and a displacement sensor enabling real-time status monitoring through a unique TENG mechanism. The solid–liquid mode water immersion sensor detects seepage through the triboelectrification effect. Water droplets contact electrodes on the surface of FEP film and generate electric energy to trigger the detection circuit. The displacement sensor adopts the independent layer mode of TENG and combines with a mechanical tumbler mechanism to realize displacement detection. External force-induced manhole cover displacement drives internal balls to roll and rub against electrodes. Electric energy is then generated to activate the detection circuit. On the basis of the two sensors, an efficient and reliable intelligent alarm system is constructed. The system receives and analyzes displacement and water immersion-sensing signals in real time. It rapidly identifies potential safety hazards including displacement offset water accumulation and leakage. Signal analysis and early warning prompts are completed synchronously. This system provides accurate and real-time data support for public facility monitoring, pipe network operation and maintenance, and regional security in smart cities. It helps achieve early detection and early disposal of hidden dangers and improves the intelligent and refined level of smart city monitoring. Full article

Background and Clinical Significance: Nonbacterial thrombotic endocarditis (NBTE) is a sterile fibrin-platelet valvular condition associated with malignancy and hypercoagulable states. It produces friable vegetations prone to systemic embolization, often presenting as multifocal ischemic stroke. While modestly linked to advanced adenocarcinomas, its association with melanoma is exceedingly rare; Case Presentation: We present a 43-year-old man with recently diagnosed metastatic melanoma who presented with fever, confusion and abdominal pain. Brain magnetic resonance imaging (MRI) revealed multifocal bilateral acute infarcts. Additional imaging demonstrated splenic and bilateral renal infarcts. Transesophageal echocardiography (TEE) revealed an 8 mm × 7 mm multilobar lesion on the posterior mitral valve leaflet. Blood cultures remained persistently negative; autoimmune and infectious workup were unrevealing, and positron emission tomography-computed tomography (PET-CT) showed no cardiac hypermetabolism. Despite empiric antibiotics for suspected infective endocarditis (IE), progressive embolic infarcts occurred. After exclusion of infection, NBTE was considered, and therapeutic enoxaparin was initiated, resulting in clinical stabilization without hemorrhagic conversion; Conclusions: Distinguishing NBTE from IE remains challenging due to overlapping and nonspecific imaging findings. TEE is the preferred diagnostic modality because of its high sensitivity for detecting small valvular vegetations. Adjunctive imaging modalities such as brain MRI and PET-CT may support the diagnosis by demonstrating embolic patterns or excluding metabolically active infectious vegetations. Management primarily relies on systemic anticoagulation, while percutaneous vegetation aspiration may represent a potential diagnostic and therapeutic strategy. Clinicians should maintain high suspicion of this condition in patients with advanced melanoma and other malignancies presenting with multifocal embolic phenomena and negative cultures to enable timely anticoagulation. Full article

Background/Objectives: Burning mouth syndrome (BMS) is a chronic idiopathic orofacial pain disorder characterized by persistent intraoral burning in the absence of detectable mucosal alterations. Diagnosis is challenging due to the lack of specific biomarkers and the need to exclude numerous systemic and local conditions that can mimic oral burning. This literature review aims to summarize current and emerging therapeutic strategies for BMS. Methods: A structured and filtered search of PubMed, Scopus, and Web of Science identified studies evaluating pharmacological, phytotherapeutic, and non-pharmacological interventions. Results: Various antidepressants, anticonvulsants, benzodiazepines, H2 receptor antagonists, and low-dose naltrexone have demonstrated varying degrees of symptom reduction, while alpha lipoic acid (ALA) and phytomedicines such as capsaicin, Hypericum perforatum, Catuama, lycopene, crocin, and melatonin show mixed clinical benefits. Non-pharmacological approaches, including photobiomodulation (PBM), oral cryotherapy, neuromodulation techniques, and cognitive behavioral therapy, also provide meaningful symptom improvement in many patients. Conclusions: Across all modalities, therapeutic responses remain heterogeneous and generally incomplete, underscoring the absence of a universally effective treatment. Current evidence supports an individualized and multidisciplinary approach that integrates pharmacological, psychological, and adjunctive therapies to address the multifactorial nature of BMS. Full article

A 47-year-old woman with metastatic pancreatic adenocarcinoma, diagnosed five months earlier and treated with palliative chemotherapy, was admitted with fever, jaundice, and right upper quadrant pain consistent with ascending cholangitis. Treatment with antibiotics was initiated and an endoscopic retrograde cholangiography was performed, whereby a biliary stent was placed to relieve malignant biliary obstruction. Physical examination revealed moderate ascites. Careful inspection of the umbilicus revealed a small nodular lesion located within the umbilical fold that became visible only after eversion of the umbilicus. The lesion had developed gradually over several weeks. Computed tomography confirmed the known pancreatic malignancy with metastatic disease and ascites. On re-review of the images, a small soft tissue nodule replacing the umbilicus was also visible. The lesion was clinically consistent with a Sister Mary Joseph nodule, an umbilical metastasis most commonly associated with advanced gastrointestinal or gynecologic malignancies. These lesions may arise through lymphatic or hematogenous spread or through direct extension into the umbilicus. This case highlights that umbilical metastases may be subtle and located within the umbilical fold, requiring careful physical examination to be detected. Full article

Background: The peroneal tubercle demonstrates substantial morphologic variability and may influence peroneal tendon mechanics. This study evaluated whether peroneal tubercle morphology and size are associated with MRI-detected peroneal tendon abnormality in patients undergoing ankle MRI for ankle pain without documented lateral malleolar/retromalleolar or peroneal tendon-specific symptoms. Methods: In this retrospective cross-sectional study, 487 ankle MRI examinations obtained between 2020 and 2023 were analyzed after excluding cases with lateral ankle/peroneal symptoms, clinically significant acute trauma, prior ankle surgery, or systemic inflammatory disease. Two orthopedic surgeons independently classified peroneal tubercle morphology (single-convex vs. double-convex) and measured tubercle height and anteroposterior length. Peroneal tendon abnormality was defined as MRI features consistent with tendinopathy and/or tenosynovitis. Inter- and intraobserver reliability were assessed using intraclass correlation coefficients and Cohen’s kappa. Unadjusted associations were assessed using Fisher’s exact test and point-biserial correlation. Multivariable logistic regression was performed to evaluate independent associations after adjustment for age, sex, BMI, and hindfoot alignment. Results: Mean age was 43.6 ± 15.6 years; 226 participants were male, and 261 were female. Peroneal tendon abnormality was present in 227/487 examinations (46.6%). Double-convex morphology showed a higher prevalence of abnormality than single-convex morphology (69.6% vs. 43.6%; unadjusted OR 2.97, 95% CI 1.63–5.41; p < 0.001). In the adjusted model, double-convex morphology remained independently associated with peroneal tendon abnormality (OR 2.85, 95% CI 1.52–5.34; p = 0.001). Tubercle height showed a modest independent association (OR 1.12 per mm, 95% CI 1.04–1.20; p = 0.002), whereas tubercle length was not associated (OR 1.008, 95% CI 0.981–1.036; p = 0.541). Reliability was excellent for tubercle height, tubercle length, and hindfoot alignment measurements and substantial to excellent for categorical ratings. Conclusions: In this non-lateral referral cohort, double-convex peroneal tubercle morphology was independently associated with higher odds of MRI-detected peroneal tendon abnormality. These findings reflect cross-sectional imaging associations rather than causation and should be interpreted with caution, given the heterogeneous MRI endpoint and the routine clinical MRI protocol. Full article

Pain is a profoundly stressful experience that significantly impacts an individual’s daily life. In many situations, people can express the intensity of pain via some observable physical actions like crying or shouting. However, in cases where the patient is non-communicative, they cannot convey their feelings through these actions. In both scenarios, automatically monitoring pain intensity using technology presents a considerable challenge. In the literature, researchers have presented numerous techniques for automatic pain monitoring using multiple approaches. This technological survey paper aims to provide an overview of current advancements in the field of automatic pain monitoring. In this paper, we present a taxonomy that summarizes our survey on the utilization of technology areas for monitoring pain automatically. Those technologies are based on Internet of Things (IoT), computer vision, and multimodal techniques. These technologies utilize various modalities, including physiological signals, facial expressions, vocalizations, and behavioral patterns, to detect and quantify pain. The paper discusses the advantages and limitations of each modality, as well as the challenges faced in developing accurate and reliable pain monitoring systems. Additionally, the paper surveys the current state of research in this field, including the development of machine learning algorithms and wearable devices for pain monitoring. Overall, this paper provides a comprehensive overview of the current state of automatic pain monitoring technology and highlights areas for future research and development. This paper also creates a keyword map that will serve as a valuable resource for researchers, enabling them to refine their investigations by identifying frequently used terms and emerging trends within each domain. Full article

Background: Isolated gallbladder injuries are rare, especially when initial imaging is normal. Advanced imaging is required to detect delayed complications. Moreover, it is necessary to make an appropriate diagnosis while selecting the most suitable treatment option. Case Presentation: A 49-year-old man fell while cycling and developed worsening abdominal pain. Initial contrast-enhanced computed tomography (CT) scans showed no abnormalities. However, the patient later developed cholangitis and cholecystitis caused by biliary obstruction from a delayed gallbladder hematoma. Magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) were used to diagnose this condition. The patient was initially managed conservatively with antibiotics, which led to temporary symptomatic improvement. Notably, the patient developed a delayed recurrence of suspected acute cholangitis (Grade I) on Day 12 due to hematoma migration. After recurrence, endoscopic nasobiliary drainage was performed as a step-up approach, in accordance with the Tokyo Guidelines 2018 management bundle, to achieve biliary decompression, followed by elective laparoscopic cholecystectomy. Pathological examination revealed chronic cholecystitis with hematoma. Conclusions: Isolated gallbladder injuries should be considered in patients with blunt abdominal trauma. Delayed hematoma formation can lead to biliary obstruction, even without initial CT findings. In such cases, early implementation of MRI and MRCP, along with close clinical monitoring for delayed recurrence, is essential. A strategic “step-up approach” incorporating endoscopic drainage is a safe and effective management option prior to definitive surgery. Full article