Search Results (292)

Background/Objectives: Military identity serves as a foundational lens through which service members navigate the events of everyday military and civilian life. However, the very process that cultivates a sense of unity and purpose can be a double-edged sword in civilian life. Although the prevalence and transition needs are known, few studies have explored how chronic pain specifically disrupts military identity in depth. This qualitative study explores three distinct trajectories through which Veterans with chronic pain experience identity change. Methods: This study used narrative inquiry involving two sets of in-depth interviews with 20 Veterans. Reflexive thematic analysis was employed to describe and differentiate three distinct trajectories of chronic pain. Results: Veterans with chronic pain experience identity change through three overlapping pain trajectories: (1) traumatic injury -> immediate discharge; (2) misdiagnosed/non-traumatic injury -> delayed discharge; and (3) cumulative wear and tear -> gradual discharge. Regardless of trajectory, chronic pain consistently disrupted military identity and forced Veterans to confront tensions between institutional expectations of stoicism and combat readiness and the physical realities of chronic pain during military service. Those interviewed described experiencing fragmented institutional support, uneven access to care, and the systemic invalidation of pain that did not conform to military ideals. Conclusions: These findings underscore the need for Veteran-centred approaches, including responsive services, comprehensive pain science education throughout military careers, early detection of conditions that can lead to chronic pain, and flexible care pathways tailored to the nuances of each pain trajectory and grounded in military culture and lifestyle. Full article

Nanogenerators (NGs), especially triboelectric nanogenerators (TENGs), represent an emerging technology with great potential for self-powered lumbar motion monitoring. Conventional wearable systems for assessing spinal kinematics are often limited by their reliance on external power supplies, hindering long-term and real-time clinical applications. NGs can convert biomechanical energy from lumbar motion into electrical energy, providing both sensing and power-generation capabilities in a single platform. This review summarizes the fundamental working mechanisms, device architectures, and current progress of NG-based motion monitoring technologies, with a particular focus on their applications in lumbar spine research and clinical rehabilitation. By enabling high-sensitivity, continuous, and battery-free monitoring, NG-based systems may enhance the diagnosis and management of low back pain (LBP) and postoperative recovery assessment. Furthermore, the integration of NGs with wearable electronics, the Internet of Things (IoT), and artificial intelligence (AI) holds promise for developing intelligent, self-sustaining monitoring platforms that bridge biomedical engineering and spine medicine. Full article

Osteoarthritis (OA) lacks disease-modifying therapies, in part because key features of the joint microenvironment remain underappreciated. One such feature is localized acidosis, characterized by sustained reductions in extracellular pH within the cartilage, meniscus, and the osteochondral interface despite near-neutral bulk synovial fluid. We synthesize current evidence on the origins, sensing, and consequences of joint acidosis in OA. Metabolic drivers include hypoxia-biased glycolysis in avascular cartilage, cytokine-driven reprogramming in the synovium, and limits in proton/lactate extrusion (e.g., monocarboxylate transporters (MCTs)), with additional contributions from fixed-charge matrix chemistry and osteoclast-mediated acidification at the osteochondral junction. Acidic niches shift proteolysis toward cathepsins, suppress anabolic control, and trigger chondrocyte stress responses (calcium overload, autophagy, senescence, apoptosis). In the nociceptive axis, protons engage ASIC3 and sensitize TRPV1, linking acidity to pain. Joint cells detect pH through two complementary sensor classes: proton-sensing GPCRs (GPR4, GPR65/TDAG8, GPR68/OGR1, GPR132/G2A), which couple to G_s, G_q/11, and G_12/13 pathways converging on MAPK, NF-κB, CREB, and RhoA/ROCK; and proton-gated ion channels (ASIC1a/3, TRPV1), which convert acidity into electrical and Ca²⁺ signals. Therapeutic implications include inhibition of acid-enabled proteases (e.g., cathepsin K), pharmacologic modulation of pH-sensing receptors (with emerging interest in GPR68 and GPR4), ASIC/TRPV1-targeted analgesia, metabolic control of lactate generation, and pH-responsive intra-articular delivery systems. We outline research priorities for pH-aware clinical phenotyping and imaging, cell-type-resolved signaling maps, and targeted interventions in ‘acidotic OA’ endotypes. Framing acidosis as an actionable component of OA pathogenesis provides a coherent basis for mechanism-anchored, locality-specific disease modification. Full article

Conventional vibrational systems associated with proprioception are mostly equipped with a single standard frequency and amplitude. This feature often fails to show kinesthetic illusion on different subjects, as different individuals respond to different frequencies and amplitudes. Additionally, different muscle groups may also require the flexibility of frequencies and amplitudes. We developed a custom vibrational system that is equipped with flexible frequency and amplitude, adapted to a custom graphical user interface (GUI). Based on the user’s criteria, the proposed vibrational system enables a wide range of frequencies and amplitudes that can be swept under a single platform. In addition, the system uses small linear actuators that are wearable and attach to the subject without the need for restrictive straps. The vibrational system was used to model trunk proprioceptive impairment associated with low back pain. Low back pain is the leading cause of disability worldwide. It is mostly associated with impaired postural control of the trunk. For postural control, the somatosensory system transmits proprioceptive (position sense) information from the sensors in the skin, joints, muscles, and tendons. Proprioceptive studies on trunk muscles have been conducted where the application of vibration at a set amplitude and frequency across all participants resulted in altered proprioception and a kinesthetic illusion, but not in all individuals. To assess the feasibility of the system, we manipulated the trunk proprioception of five subjects, demonstrating that the vibrational system is capable of modulating trunk proprioception and the value of customizing parameters of the system to obtain maximal deficits from individual subjects. Full article

Background/Objectives: Psychoanalytic theories of destructiveness highlight its deep, unconscious origins tied to primal emotional and motivational mechanisms. Traditional psychiatric models of suicidal risk assessment focus on classic risk factors, limiting diagnostic and intervention approaches. This study examines the neuropsychoanalytic foundations of destructive tendencies, integrating sublimation and evolutionary motivational systems, redefining their role in the destruction process. Methods: A total of 480 AI-generated illustrations were assessed for interpretative accuracy. The final set was used in an online projection task with 204 respondents. Analyses included factorial exploration of the structure of the tool, assessment of psychometric properties (Cronbach α, ROC, AUC), logistic regression and analysis of intergroup differences. Results: Factor analysis identified eight subscales. Six of the eight factors showed thematic resemblance to Panksepp’s emotional systems, although this interpretation remains theory-driven and requires empirical validation. The remaining two—pursuit of destruction and its sublimation—extend beyond natural evolutionary mechanisms. Destructiveness was best explained by depression and psychological pain (OR = 1.39, 95% CI [1.26–1.52]), aggression and impulsivity (OR = 1.68, 95% CI [1.36–2.06]), and anxiety and a sense of threat (OR = 1.55, 95% CI [1.27–1.90]). Key predictors of destruction sublimation were curiosity (OR = 3.15, 95% CI [2.43–4.09]), closeness and love (OR = 3.43, 95% CI [2.48–4.76]), and pleasure and fun (OR = 3.08, 95% CI [2.26–4.20]). Analyses showed higher levels of destructiveness in individuals receiving psychological or psychiatric support, those with prior diagnoses, and students compared to employed individuals. Conclusions: Results indicate high reliability (Cronbach’s α > 0.87) and discrimination among internal subscale-defined groups (ROC > 0.7), supporting the tool’s potential in assessing destructive and sublimation tendencies within a neuropsychoanalytic framework. Future studies will explore its external validity and clinical applications. Full article

Unaccustomed eccentric exercise is well established to induce exercise-induced muscle damage (EIMD), characterized by transient strength loss, delayed onset muscle soreness (DOMS), reduced range of motion, and proprioceptive disturbances. While limb dominance has been proposed as a potential modulator of susceptibility to EIMD, evidence remains inconclusive. This exploratory study aimed to compare alterations in muscle damage indices between dominant and non-dominant knee extensors 48 h after eccentric isokinetic exercise. Eighteen physically active young women (23 ± 2 years) completed two eccentric exercise sessions (5 × 15 maximal contractions at 60°/s), one per limb, with sessions separated by 24–30 days. For all participants, testing was conducted during the early follicular phase. Muscle strength (isometric and eccentric peak torque), DOMS (palpation and pain pressure threshold), range of motion, fatigue index, and position sense were assessed pre- and 48 h post-exercise. Significant reductions in isometric and eccentric peak torque, increased DOMS, impaired position sense, and altered fatigue index were observed 48 h post-exercise in the exercised limb (p < 0.001), with no differences between dominant and non-dominant limbs across all indices. These findings demonstrate that limb dominance does not influence the magnitude of EIMD in knee extensors of young women. Practical implications include equal consideration of both limbs in eccentric training, rehabilitation, and injury prevention programs. Full article

In a strict legal sense, motive is often irrelevant in U.S. criminal law. Whether one smothered their grandmother with a pillow to ease her pain or to fraudulently collect her social security benefits, they are legally guilty of murder all the same. Yet anyone who has watched a courtroom drama or sat in the jury box knows the prominent role that establishing motive seems to play in influencing legal decision-makers. Why is motive so pivotal, so psychologically powerful for most people? We briefly review the existing literature on the psychology of motive, then introduce an adaptationist framework as a new lens for examining this question. In particular, we consider how motive assists perceivers in inferring actors’ welfare trade-off ratios, with important implications for legal judgments and willingness to punish. Full article

Three-finger toxins (3FTxs) from snake venom are the most abundant toxin family of mini non-enzymatic proteins, comprising 40–70% of the venom proteome. Despite their common three-finger structural scaffold, 3FTxs exhibit diverse pharmacological functions. Other than neurotoxins, they also include analgesic acid-sensing ion channel blockers, sodium and potassium channel modulators, integrin- and G-protein-coupled-receptor-targeting ligands, and gamma-aminobutyric acid type A receptor modulators that collectively span pain, cardiovascular, oncologic, and neurologic indications. However, in this fast-growing 3FTx family, there are several hundred 3FTxs whose functions have not yet been determined. Here, we systematically analyzed over 550 amino acid sequences of 3FTxs. Based on their structural features, we have classified them into more than 150 distinct subgroups. This updated information on this novel 3FTx toolkit will provide an unexplored library of investigational ligands and pharmacophores with potential therapeutic and diagnostic leads, as well as research tools. Thus, this review will provide new impetus in toxin research and pave the way for the design of potent, selective ligands for new sets of target receptors, ion channels, and enzymes. Full article

Background: Regulating sensations of fatigue and discomfort while performing maximal endurance exercise becomes essential for making informed decisions about persistence and/or failure during intense exercise. Athletes with a higher effort capacity have competitive advantages over those with a lower one. The microbiota–brain axis is a considered the sixth sense and a modulator of the host’s emotional stability and physical well-being. Objectives: This narrative review aims to explore and evaluate the potential mechanisms involved in regulating perceptions during endurance exercise, with a focus on the possible relationship between the gut microbiota balance and the neural system as an adaptive response to high fatigue chronic exposure. Methods: Electronic databases (PubMed, Web of Science, Google Scholar, and Scopus) were used to identify studies and hypotheses that had documented predefined search terms related to endurance exercise, gut microbiota, the central nervous system, pain, discomfort, fatigue, and tolerance to effort. Results: This narrative review shifts the focus concerning the symbiotic relationship between the gut microbiota, the vagus nerve, the central/enteric nervous system, and the regulation of afferences from different organs and systems to manage discomfort and fatigue perceptions during maximal physical effort. Consequently, the chronicity supporting fatigued exercise and nutritional stimuli could specifically adapt the microbiota–brain connection through chronic efferences and afferences. The present hypothesis could represent a new focus to be considered, analysing individual differences in tolerating fatigue and discomfort in athletes supporting conditions of intense endurance exercise. Conclusions: A growing body of evidence suggests that the gut microbiota has rapid adaptations to afferences from the brain axis, with a possible relationship to the management of fatigue, pain, and discomfort. Therefore, the host–microbiota relationship could determine predisposition to endurance performance by increasing thresholds of sensitive afferences perceived and tolerated. A richer and more diverse GM of athletes in comparison with sedentary subjects can improve the bacteria-producing metabolites connected to brain activity related with fatigue. The increase in fatigue thresholds directly improves exercise performance, and the gut–brain axis may contribute through the equilibrium of metabolites produced for the microbiota. Full article

In elective hernia surgery, the primary aim is to improve quality of life, rather than to save life. Therefore, outcome measures should emphasize domains such as pain, function, and overall satisfaction. While some principles also apply to other benign procedures, this perspective article centers on hernia repair as a paradigm for redefining surgical success. We perform hernia surgeries primarily due to quality-of-life concerns, and, consequently, it makes sense that outcome measures should emphasize quality-of-life indicators such as pain, other complaints impacting daily life, and most importantly, overall patient satisfaction with the procedure. Nonetheless, many interventional studies related to hernia disease tend to focus on tangible surgical outcomes like recurrence, infections, hospital stays, and readmissions. Therefore, we advocate for a shift in the evaluation of surgeries to prioritize more relevant patient-reported outcomes when assessing the effects of surgical procedures for benign conditions. These considerations not only apply to hernia surgery but also to other surgical interventions where the indication for surgery is based on quality-of-life issues. We urge the systematic incorporation of patient-reported outcomes into surgical practices and outcomes research to promote a more patient-centered approach, aligning surgical success with the outcomes that matter most to patients. Full article

Artificial intelligence (AI) techniques have propelled biomedical sensors beyond measuring physiological markers to interpreting subjective states like stress, pain, or emotions. Despite these technological advances, user trust is not guaranteed and is inadequately addressed in extant research. This review proposes the Cognition–Context–Contrast (CCC) conceptual framework to explain the trust and acceptance of AI-enabled sensors. First, we map cognition, comprising the expectations and stereotypes that humans have about machines. Second, we integrate task context by situating sensor applications along an intellective-to-judgmental continuum and showing how demonstrability predicts tolerance for sensor uncertainty and/or errors. Third, we analyze contrast effects that arise when automated sensing displaces familiar human routines, heightening scrutiny and accelerating rejection if roll-out is abrupt. We then derive practical implications such as enhancing interpretability, tailoring data presentations to task demonstrability, and implementing transitional introduction phases. The framework offers researchers, engineers, and clinicians a structured conceptual framework for designing and implementing the next generation of AI biosensors. Full article

Chronic visceral pain, a significant contributor to morbidity in the United States, affects millions and results in substantial economic costs. Despite its impact, the mechanisms underlying disorders of gut–brain interaction (DGBIs), such as irritable bowel syndrome (IBS), remain poorly understood. Visceral hypersensitivity, a hallmark of chronic visceral pain, involves an enhanced pain response in internal organs to normal stimuli. Various factors like inflammation, intestinal hyperpermeability, and epigenetic modifications influence its presentation. Emerging evidence suggests that persistent colonic stimuli, disrupted gut barriers, and altered non-coding RNA (ncRNA) expression contribute to the pathophysiology of visceral pain. Additionally, cross-sensitization of afferent pathways shared by pelvic organs underpins the overlap of chronic pelvic pain disorders, such as interstitial cystitis and IBS. Central sensitization and viscerosomatic convergence further exacerbate pain, with evidence showing IBS patients exhibit hypersensitivity to both visceral and somatic stimuli. The molecular mechanisms of visceral pain involve critical mediators such as cytokines, prostaglandins, and neuropeptides, alongside ion channels like transient receptor potential vanilloid 1 (TRPV1) and acid-sensing ion channels (ASICs). These molecular insights indicate potential therapeutic targets and highlight the possible use of TRPV1 antagonists and ASIC inhibitors to mitigate visceral pain. This review explores the neurophysiological pathways of visceral pain, focusing on peripheral and central sensitization mechanisms, to advance the development of targeted treatments for chronic pain syndromes, particularly IBS and related disorders. Full article

Aloin, a kind of active phenolic component, is sourced from Aloe vera. Recently, the determination of aloin has received enormous attention, owing to its positive performance (including anti-tumor, antibacterial, detoxification, liver protection, anti-stomach damage, and skin protection activities) and painful side effects (increased carcinogenicity caused by excessive use of aloin) impacting human health. This investigation was inspired by the good fluorescence properties of carbon dots (CDs); CD-based sensors have aroused a great deal of interest due to their excellent sensitivity and selectivity. Thus, it is of great significance to develop novel CD-based sensors for aloin determination. Herein, N,F-CDs were designed and synthesized through a convenient hydrothermal strategy; the synthesized N,F-CDs possessed good fluorescence performance and a small particle size (near 4.3 nm), which demonstrated the successful preparation of N,F-CDs. The resulting N,F-CDs possessed a large Stokes shift and could emit a highly stable green fluorescence. The fluorescence of the N,F-CDs could be effectively quenched by aloin through the inner filter effect. Furthermore, the synthesis procedure was easy to operate. Finally, the N,F-CD-coated test strips were fabricated and combined with a miniaturized fluorimeter for the fluorescence detection of aloin via the inner filter effect for the first time. The N,F-CD-coated test strips were fabricated and used for the fluorescence sensing of aloin, and the results were compared with a typical ultraviolet (UV) method. The N,F-CD-coated test strips exhibited high recovery (96.9~106.1%) and sensitivity (31.8 nM, n = 3), good selectivity, low sample consumption (1 μL), high speed (5 min), good stability, and anti-interference properties. The results indicate that N,F-CD-coated test strips are applicable for the quantitative determination of aloin in bovine serum, orange juice, and urine samples. Full article

Encouraging discoveries and excellent advances in the fight against cancer have led to innovative therapies such as photothermal therapy (PTT), photodynamic therapy (PDT), drug targeting (DT), gene therapy (GT), immunotherapy (IT), and therapies that combine these treatments with conventional chemotherapy (CT). Furthermore, 2,041,910 new cancer cases and 618,120 cancer deaths have been estimated in the United States for the year 2025. The low survival rate (<50%) and poor prognosis of several cancers, despite aggressive treatments, are due to therapy-induced secondary tumorigenesis and the emergence of drug resistance. Moreover, serious adverse effects and/or great pain usually arise during treatments and/or in survivors, thus lowering the overall effectiveness of these cures. Although prevention is of paramount importance, novel anticancer approaches are urgently needed to address these issues. In the field of anticancer nanomedicine, carbon nanotubes (CNTs) could be of exceptional help due to their intrinsic, unprecedented features, easy functionalization, and large surface area, allowing excellent drug loading. CNTs can serve as drug carriers and as ingredients to engineer multifunctional platforms associated with diverse treatments for both anticancer therapy and diagnosis. The present review debates the most relevant advancements about the adjuvant role that CNTs could have in cancer diagnosis and therapy if associated with PTT, PDT, DT, GT, CT, and IT. Numerous sensing strategies utilising various CNT-based sensors for cancer diagnosis have been discussed in detail, never forgetting the still not fully clarified toxicological aspects that may derive from their extensive use. The unsolved challenges that still hamper the possible translation of CNT-based material in clinics, including regulatory hurdles, have been discussed to push scientists to focus on the development of advanced synthetic and purification work-up procedures, thus achieving more perfect CNTs for their safer real-life clinical use. Full article

Background: Chronic postsurgical pain (CPSP) occurs in approximately one in five children who undergo surgery. Youth with anxiety and depressive symptoms are at greater risk of developing CPSP. Psychological interventions hold promise to prevent CPSP; however, existing psychological interventions are often brief and offered exclusively pre-surgically. Objective: The Perioperative Pain Program (PPP) was designed to address psychological risk factors for CPSP. This study aimed to explore acceptability and satisfaction with the PPP, from the perspective of youth and caregivers. Method: In this mixed-methods study, 24 youth and caregivers completed a satisfaction questionnaire, and six dyads participated in semi-structured interviews. Quantitative data was analyzed using descriptive statistics. Qualitative data was analyzed using inductive content analysis. Results: The qualitative analysis generated four categories: (1) developing support and a sense of preparedness for surgery; (2) connection matters between families and the team; (3) personal characteristics may impact intervention use; (4) the need for adaptable content and delivery. Quantitative data indicated overall satisfaction and acceptability of the intervention. Conclusions: Psychological interventions that facilitate interpersonal connections in a timely manner may be key to facilitating more meaningful engagement and help prevent CPSP in youth. Full article