While the majority of previous studies assessing pain-related variables in psychopaths used electric shocks, little is known about the effectiveness of alternative pain-inducing methods to increase emotional responses such as fear and anxiety. A small sample of healthy undergraduate men (N = 15) was recruited to assess the effectiveness of a heat stimulus to induce pain in an immediate versus delayed punishment paradigm. Although pain catastrophizing, anxiety, and threat of pain did not increase throughout the experiment, participants experienced a significant increase of fear of pain and pain intensity, indicating that the heat stimulus was effective in inducing pain. Furthermore, subjects were slower in initiating the pain stimulus during the first five trials, but no time difference was found during the 15 remaining trials. No correlation was found between psychopathic traits and pain-related variables, with the exception of inconsistent results within the Fearless Dominance factor. Findings are discussed in terms of improvement for a larger scale study involving psychopathic individuals.

Background: The laryngeal mask airway Vision Mask (LMA VM) is a supraglottic airway device (SAD) with vision guidance system. The ideal head and neck position for direct laryngoscopy is known, but the ideal position for placing a LMA is not. The objective of this study is to evaluate and compare the optimal position for placement of a video laryngeal mask airway. Methods: This was a prospective observational, transversal and analytical study of 72 consecutive patients. In the same patient, laryngeal vision was first assessed with the head and neck in the sniffing position and then with the head in the neutral position. Procedures were filmed and performed by the same investigator. Assessment of the laryngeal view was performed using two classifications: modified Cormack-Lehane classification and Brimacombe classification. Device placement was considered adequate when the Cormack-Lehane rating was scored from 1 to 2 and the Brimacombe rating was from 2 to 4. Results: 72 patients were included in this study. In the assessment of the glottis using the Cormack Lehane classification for fiberoptic view, laryngeal visibility was adequate in 64 (88.89%) patients in the neutral position and in 65 (90,28%) patients in the sniffing position (p>0,05). In the fiberoptic view of the glottis, assessed using the Brimacombe classification, laryngeal visibility was adequate in 68 (93%) patients in the neutral position and in 69 (95%) patients in the sniffing position, (p>0,05). There was no statistically significant difference in the rate of success between the sniffing position (70 patients, 97.22% success rate) and the neutral position (67 patients, 93.06% success rate) during the first insertion attempt. Two patients required a second attempt in the sniffing position, while five patients required a second attempt in the neutral position. Conclusion: An adequate sniffing position did not result in a better glottic view than neutral position, and the number and type of additional maneuvers were equal in both positions.

Secure development is a proactive approach to cyber security. Rather than building a technological solution and then securing it in retrospect, secure development strives to embed good security practices throughout the development process and thereby reduces risk. Unfortunately, evidence suggests secure development is complex, costly, and limited in practice. This article therefore introduces security-focused prototyping as a natural precursor to secure development that embeds security at the beginning of the development process, can be used to discover domain specific security requirements, and can help organisations navigate the complexity of secure development such that the resources and commitment it requires are better understood. Two case studies–one considering the creation of a bespoke web platform and the other considering the application layer of an Internet of Things system–verify the potential of the approach and its ability to discover domain specific security requirements in particular. Future work could build on this work by conducting case studies to further verify the potential of security-focused prototyping and even investigate its capacity to be used as a tool capable of reducing a broader, socio-technical, kind of risk.

Research indicates that painful experiences can significantly affect the fear of cancer recurrence among cancer survivors, which is a distressing concern that influences both physiological and psychological recovery. Yet, the role of potential factors and mechanisms in these relationships is not fully known. This cross-sectional study aimed to advance our comprehension of the associa-tions between total pain and the fear of recurrence in post-treatment cancer patients by examining two potential mediators: psychological flexibility and mentalization. Three hundred and thirty-five participants (aged 22 to 88, 49.1% female) who had finished their cancer treatment completed self-report assessments of total pain, fear of recurrence, psychological flexibility, and mentalization. The serial mediation analysis showed that all dimensions of total pain were positively related to the fear of recurrence indirectly through psychological flexibility and mentalization, in serial. Additionally, gender moderated these serial mediational effects. In line with the psychological flexibility model, personal capacities to face difficult internal/external problems and interpret one’s behaviour in motivational terms can counterbalance patients’ negative emotions and feelings related to the illness.

Iron is an essential nutrient for humans and microbes, such as bacteria. Iron deficiency occurs commonly in critically ill patients, but iron replacement therapy is not considered during the acute phase of critical illness, since it increases iron availability for invading microbes and oxidative stress. However, persistent iron deficiency in the recovery phase is harmful with potential adverse outcomes such as cognitive dysfunction, fatigue and cardiopulmonary dysfunction. Therefore, it is important to treat iron deficiency timely and efficiently. This article reviews current knowledge about iron-related biomarkers in critically ill patients and provides possible criteria to guide decision-making for iron supplementation in the recovery phase of critical illness.

Abstract Background The advent of monoclonal antibodies (mAbs) targeting calcitonin gene-related peptide (CGRP) pathway has transformed the management of migraine, offering newfound optimism for clinicians and individuals with episodic migraine (EM) and chronic migraine (CM). While randomized controlled trials (RCTs) have provided crucial insights into the effectiveness and safety profiles of these treatments, their translation into real-world clinical practice remains a e challenge. Objective This review aims to conduct a comprehensive assessment of real-world studies, offering valuable insights tailored for practical application in clinical settings. Methods We conducted a comprehensive literature search in PubMed, SCOPUS, and MEDLINE for real-life studies on erenumab, fremanezumab, and galcanezumab. Abstracts underwent rigorous screening by two reviewers for relevance. Data extraction from selected articles was performed using a standardized form, with verification by a second reviewer. Data synthesis was narrative, following PRISMA guidelines. Results Our search included 55 pertinent studies conducted between 2019 and 2023. Real-world study designs demonstrated notable variability in the selection and inclusion of migraine patients, influenced by factors such as attack frequency, data collection criteria, and primary/secondary objectives. Key findings commonly reported considerable improvements in efficacy outcomes (migraine frequency, analgesic use, pain severity, disability), high responder rates, and optimal safety and tolerability profiles. Conclusion Real-world evidence underscores the role of anti-CGRP mAbs as targeted therapies for both CM and EM patients. The overall results indicate that the effectiveness and tolerability of anti-CGRP mAbs in real-world applications may exceed those observed in RCTs, an unprecedented finding in clinical neurology.

This study investigates job satisfaction, burnout, and well-being among first-generation migrant physicians in anesthesia and intensive care medicine in Germany, comparing them to their native German counterparts. Utilizing a cross-sectional survey design, the study collected data from 513 physicians, 110 of whom identified as having a migration background. Job satisfaction was measured using the German version of the Warr-Cook-Wall (WCW) Job Satisfaction Scale, burnout was assessed with the Copenhagen Burnout Inventory (CBI), and well-being was evaluated using the WHO-5 Well-Being Index. The job satisfaction ratings revealed no significant differences between migrant and German physicians in most dimensions, including physical workload, freedom to choose work methods, satisfaction with colleagues, responsibility, income, skill utilization, and variety in work tasks. However, migrant physicians reported significantly higher satisfaction with recognition received for their work and lower dissatisfaction with working hours. Burnout assessments showed that migrant physicians experienced higher psychological strain, perceiving every work hour as more exhausting and having significantly less energy for family and friends. Notably, migrant physicians reported higher difficulty and frustration in working with patients. Well-being ratings indicated that migrant physicians felt less energetic and active but found their daily life more filled with interesting activities. The findings underscore the unique challenges faced by migrant physicians, particularly in terms of recognition and patient-related burnout. These results highlight the need for targeted interventions to support migrant physicians, including cultural competence training and flexible working hours to enhance their job satisfaction and overall well-being. Addressing these issues is crucial for maintaining the quality of patient care and the occupational health of migrant physicians in Germany.

Background. The possible interactions between anger and fear have not been widely explored in the psychological literature. Fear and anger are currently beginning to be studied by looking at their interrelationships, rather than seeing them as simply opposing emotions. Furthermore, there is a tendency to think that anger is more typical of men and fear of women. Our contribution proposes a particular perspective of affective neuroscience. The objectives of the study are: 1) To assess possible differences in affective systems, states, and traits of anger in relation to biological sex; 2) To assess correlations between ANGER, FEAR, and PANIC, state and trait anger in both a female and male sample; 3) To assess possible differences in basic affective systems in relation to different levels of ANGER, FEAR, and PANIC, state and trait anger, in sample of female and in sample of male. Methods. A non-clinical sample of 339 females and 99 males completed the ANPS 3.1 to assess basic affective states and the STAXI 2 to assess anger states and traits. Results. No significant differences were found for ANGER and FEAR scores and for state and trait scores between the male and female samples. Clear correlations emerged (p < .01) between FEAR. PANIC and FEAR in both the female and male samples. Among the differences that emerged in the affective systems, we emphasise that in the female group as FEAR increases, there are significant variations in systems of SEEKING, PLAY, and CARE. Furthermore, only in the female sample as PANIC increases, PLAY progressively decreases, and CARE shows an irregular trend. Discussion. Given the importance of the SEEKING and PLAY systems for well-being and gender equality the hypoactivation of these systems to increases in FEAR and PANIC highlights the need to monitor conditions that may trigger these affective systems.

Abstract: Laryngoscopy for tracheal intubation has been developed for many decades. Among various conventional laryngoscopes, videolaryngoscopes (VL) have been applied in different patient populations, including difficult airways. The safety and effectiveness of VL have been repeatedly studied in both normal and difficult airways. The superiority of VL then has been observed and is advocated as the standard of care. In contrast to laryngoscopy, the development of video-assisted intubating stylet (VS, also named as styletubation) has been noticed two dec-ades ago. Since then, sporadic clinical experiences of use have appeared in literature. In this re-view article, we presented our vast use experiences of the styletubation (more than 55,000 pa-tients since 2016). We found this technique is swift (the time to intubate: from 3 s to 10 s), smooth (first-attempt success rate: 100%), safe (no airway complications), and easy (high subjective satis-faction and fast learning curve for the novice trainees) in both normal and difficult airway sce-narios. We therefore propose styletubation technique can be feasibly applied as universal rou-tine use for tracheal intubation.

Detection and measurement of pain are crucial in designing effective pain management interventions to alleviate suffering and prevent functional decline in the medical domain. Traditional methods of pain identification rely on verbal patient reports or observable signs, which can be imprecise or subjective due to variability in patient self-assessments. Hence, there is a pressing need for automated methods to standardize pain measurement procedures. This paper proposes a novel facial expression-based automated pain assessment system as a behavioral indicator for pain evaluation. Our system integrates a fusion structure comprising Convolutional Neural Networks (CNNs) and Tensor-based extended Quantitative Expression Descriptors Analysis (TXQEDA). This innovative approach allows for joint learning of robust pain-related facial expression features from raw facial images, combining RGB appearance with shape-based latent representation. We extensively evaluated our proposed model using the UNBC-McMaster dataset for pain classification and intensity estimation. Our results demonstrate the efficacy of the proposed technique, achieving an impressive accuracy of 99.10% for pain level classification. Furthermore, our system excels in pain intensity estimation, showcasing its potential to provide precise and reliable assessments of pain severity. Overall, our research underscores the importance of automated pain assessment systems in improving patient care and clinical outcomes. By leveraging advanced deep learning techniques and fusion strategies, our proposed model offers a promising approach for standardizing pain measurement procedures and enhancing the quality of pain management interventions.

Depression, anxiety, and pain are part of a common phenomenon that requires to be studied together when evaluating patients with chronic pain. The aim of the study was to examine the correlations between depression, anxiety and pain intensity in patients with chronic pain and how they change when a depressive episode was added. A sample of 120 patients with chronic pain (age: 51.90±11.94; 81.7% female; 18.3% male) was studied in two stages with a three-month period between them. Patients with a depressive episode (n=61) were treated with antidepressants and analgesics, while a patient without depression (n=59) was treated only with analgesics. The scales used to achieve the objectives were: HAM-D-17, Spielberger‘s STAI and VAS. Insignificant correlations were found between depression, state and trait anxiety, and pain intensity (p&lt;0,05) in the group without depression, except for a significant one between depression and state anxiety (p&lt;0,01) in the second stage. Significant correlations were identified between all indicators (p&lt;0,01) in the group with depression at the two stages. Those in the second stage were stronger. The interrelations between sensory and affective aspects of pain were stronger when a depressive episode occurs, the severity of which determines their dynamics.

Iron plays a critical role in lung infections due to its function in the inflammatory immune response but also as an important factor for bacterial growth. Iron chelation represents a potential therapeutic approach to inhibit bacterial growth and pathologically increased pro-inflammatory mediator production. The present study was designed to investigate the impact of the iron chelator, DIBI, in murine lung infection induced by intratracheal Pseudomonas aeruginosa (strain PA14) administration. DIBI (80mg/kg) was given by intraperitoneal injection either as a single dose immediately after PA14 administration or a double dose (second dose 4 h after PA14 administration). The results showed that lung NF-κBp65 levels, as well as levels of various inflammatory cytokines (TNFα, IL-1β, IL-6) both in lung tissue and bronchoalveolar lavage fluid (BALF), were significantly increased 24h after PA14 administration. Single-dose DIBI did not affect the bacterial load or inflammatory response in the lungs or BALF. However, two doses of DIBI significantly decreased bacterial load, attenuated NF-κBp65 upregulation, reduced inflammatory cytokines production, and relieved lung tissue damage. Our findings support the conclusion that the iron chelator, DIBI, can reduce lung injury induced by P. aeruginosa, via its anti-bacterial and anti-inflammatory effects.

In this non-exhaustive review, we discuss the importance of invariant vectors in atomic physics, such as the Laplace-Runge-Lenz vector, the Redmond vector in the presence of an electric field, the Landau-Avron-Sivardière vector when the system is subject to a magnetic field, and the supergeneralized Runge-Lenz vector for the two-center problem. Application to Stark and Zeeman effects are outlined. The existence of constants of motion in the charge-dyon system is also briefly mentioned.

With the increasing occurrence of rotator cuff injuries every year, there is a great need for a reliable treatment option. Wharton’s Jelly contains several components that can positively impact the replacement and repair of musculoskeletal defects. The overall objective of this study is to evaluate the improvement of patient-reported pain scales after applying Wharton’s Jelly (WJ) in rotator cuff defects. Eighty-seven patients with rotator cuff defects who failed at least eight weeks of conservative treatment were selected from the retrospective repository. 2cc of WJ flowable allograft was applied to the specific affected anatomy, the most common being supraspinatus tendon, biceps tendon insertion, labral tear, and subscapularis tear. No adverse reactions were reported. Statistically significant improvements were found from the initial to Day 90 in all scales. Patient satisfaction was calculated using minimal clinically important differences. No statistically significant differences were found in mean changes between gender, BMI, and age. Scanning Electron Microscopy images reveal the similarities between the collagen matrix in WJ and the rotator cuff. The significant improvement in patient outcomes coincides with current literature analyzing WJ applications with other structural defects around the body. WJ is a promising alternative for musculoskeletal defects when the standard of care fails.

Knee osteoarthritis (KO) is an important health condition, affecting one third of the people aged 65 years or more. Pain is the main cause of disability. Pain management in KO includes pharmacological and non-pharmacological modalities. Patient education, lifestyle changes, physical exercise and physical agents are prescribed as a first approach for pain control. Laser therapy is part of many therapeutical protocols, with two forms, low-level laser therapy (LLLT) and high-intensity laser therapy (HILT). The paper aimed at stressing the advantages of HILT, based on a greater wavelength, higher energy delivery and deeper tissue penetration. Research on 23 published trials revealed that analgesic effect is rapid, cumulative and long lasting. Compared to sham, to LLLT or to other associations of therapeutical modalities, HILT provided significantly better results on pain reduction and functional improvement. Ultrasound examination showed reduction of intraarticular inflammation.

Many studies utilize sensors to measure foot plantar pressure and analyze gait patterns, often focusing on assessing weight-bearing symmetry or asymmetry compared to control groups. However, a critical question arises: does the selection of the control group significantly impact study outcomes? Does chronic low back pain affect foot plantar pressure measurements? This experimental study involved 23 participants, including healthy individuals and those without foot disorders but with chronic low back pain. Dynamic foot pressure measurements were conducted using the Ortopiezometr, and data were analyzed using the "Steps" program. Participants were divided into two groups: Group 1 comprised completely healthy individuals, while Group 2 consisted of individuals without foot problems but with moderate chronic low back pain. The findings highlight a prevalence of energy release in the forefoot sensors compared to the hindfoot for both the right and left legs in most cases. Even among healthy volunteers, achieving perfect symmetry in the maximum values on the sensors for the right and left feet was a challenge. Results showed no statistically significant differences in energy released on specific sensors or duration of gait phases between the groups. Essentially, this suggests that foot pressure patterns are comparable between healthy individuals and those with low back pain. The use of sensor-equipped inserts for pedobarographic examinations indicates that, in cases of degenerative changes in the lumbar and sacral spine without accompanying acute pain, gait patterns resemble those of the healthy population.

Keywords: olfactory rehabilitation; chronic pain; fMRI;

There is an anecdotal impression that teenage patients report exaggerated postoperative pain scores that do not correlate with their actual level of pain. Nurse and parental perception of teenagers' pain can be complemented by knowledge of patient pain behavior, pain catastrophizing thoughts, anxiety, and mood level. Two hundred two patients completed the study: 56.4% female, 89.6% White, 5.4% Black, and 5% other race. Patient ages ranged from 11 to 17 years (mean = 13.8, SD = 1.9). The patient, the parent, and the nurse completed multiple questionnaires on day one after laparoscopic surgery to assess patient pain. Teenagers and parents (r=0.56) have a high level of agreement, and teenagers and nurses (r=0.47) have a moderate level of agreement on pain scores (p &lt;0.05). The correlation between patient APBQ (Adolescent Pain Behavior Questionnaire) and teenager VAS (Visual Analog Scale ) and between nurse APBQ and teenager VAS, while statistically significant (p &lt; 0.05), is weaker (r range = 0.14-0.17). There is a moderate correlation between teenagers' pain scores and their psychological assessments of anxiety, catastrophic thoughts, and mood (r range= 0.26 – 0.39; p &lt;0.05). A multi-modal evaluation of postoperative pain can be more informative than only assessing self-reported pain scores.

Neuropathic pain (NeP) is a complex and debilitating condition that impacts millions of people globally. Although various treatment options exist, their effectiveness is often limited, and they can be accompanied by significant side effects. In recent years, there has been increasing interest in targeting the N-methyl-D-aspartate receptor (NMDAR) as a potential therapeutic approach to alleviate different types of neuropathic pain. This narrative review aims to provide a comprehensive examination of NMDAR antagonists, specifically ketamine, memantine, methadone, amantadine, carbamazepine, valproic acid, phenytoin, dextromethorphan, riluzole, and levorphanol, in the management of NeP. By analyzing and summarizing current preclinical and clinical studies, this review seeks to evaluate the efficacy of these pharmacologic agents in providing adequate relief for NeP.

The prolonged static sitting at the workplace is considered as one of the main risks for development of musculoskeletal disorders (MSDs) and adverse health effects. Factors such as poor posture and extended sitting are perceived to be a reason for conditions such as lumbar hyperlordosis and lower back pain (LBP), even though the scientific explanation of this relationship is still unclear and raises disputes in the scientific community. This publication proposes the low back pain assessment (LBPA) dataset collected through experiment with 100 participants and consisting of photogrammetric images with intentionally placed body markers, calculated postural angles and tags correct and incorrect posture assessed by habilitated rehabilitator, as well as questionnaire-based self-reports regarding the occurrence of LBP and similar symptoms among the participants. Machine learning models trained with this data are employed for recognizing incorrect body postures. Two scenarios have been elaborated for modeling purposes: scenario 1, based on natural body posture tagged as correct and incorrect, and scenario 2, based on incorrect body postures, corrected additionally by the rehabilitator. The achieved accuracies of respectively 75.3% and 85% for both scenarios reveal the potential for future research in enhancing awareness and actively managing posture-related issues that elevate the likelihood of developing lower back pain symptoms.

Drug-induced liver disease represents one of the main problems in the therapeutic field. As with most pathologies, also in this case various risk factors can be recognised, such as age, sex, but also the gut microbiota. Therefore all drugs on the market can, in fact, cause hepatotoxicity of varying degrees. Drugs used in the treatment of IBD can also cause these adverse effects and even lead to DILI. In this review, the various classes of drugs used in the treatment of IBD were taken into consideration and the various adverse effects on the liver were illustrated. In particular, a major role has emerged regarding hepatotoxicity of immunosuppressants. Biological drugs, however, seem to be responsible for these complications to a much lesser extent.

Background: Chronic pelvic pain is a debilitating condition affecting quality of life. Endometriosis is one of the leading causes of CPP, but recent studies highlighted the role of interstitial cystitis/bladder pain syndrome (IC/PBS) in causing CPP. Only some studies addressed the coexistence between these two conditions, which seems more frequent than what is supposed, leading to diagnostic delays and unnecessary surgeries. This systematic review aimed to evaluate the estimate of the coexistence of endometriosis and IC/PBS. Methods: We performed a systematic review of the literature indexed on PubMed, Scopus, ISI Web of Science, and Cochrane using a combination of keywords and text words represented by “painful bladder syndrome”, “endometriosis”, “interstitial cystitis”, “bladder pain syndrome”. We performed a meta-analysis of the results. Results: Meta-analysis shows that the coexistence of endometriosis and IC/PBS in women with CPP ranges between 15,5-78,3%, which is higher than the prevalence of IC/PBS in the general population. Conclusions: Women with CPP need a multidisciplinary approach and a referral to centers with specific expertise. In cases of endometriosis unresponsive to treatment, other reasons for CPP need to be ruled out, above all in women not responsive to treatment.

Endometriosis is known to be a chronic, debilitating disease. The pathophysiological mechanisms of endometriosis development include local chronic inflammation and a certain degree of local immune deficit. We investigated the relationship between the endometriosis severity, IL-8, IL-10, BDNF, VEGF-A serum and tissue levels, patient-related pain, and physical activity in a cohort of 46 patients diagnosed with endometriosis who underwent surgery. The same panel of biomarkers was investigated in a control group of 44 reproductive-aged patients with non-endometriotic gynecological pathology who underwent surgical intervention. Our data show a high statistical significance between tissue expression of IL-8, IL-10, patient-related pain and the severity of endometriosis. No relationship was identified between serum or tissue levels of VEGF-A and BDNF and the severity of endometriosis. These results validate the presence of local chronic inflammation and immune deficit, thereby creating, alongside other studies in the field, an opportunity for the development of innovative and personalized treatment approaches in endometriosis.

In this study, we aimed to explore the oral bacteria and fungi that can help discern oral squamous cell carcinoma (OSCC) and investigate the correlations between multiple key pathogens. Methods: Twelve participants (8 females and 4 males; mean age, 54.33 ± 20.65 years) were prospectively recruited into three groups: Group 1: healthy control, Group 2: patients with stomatitis, and Group 3: patients with OSCC, with 4 individuals in each group. Unstimulated whole saliva samples from these participants were analyzed using real-time PCR to assess the presence and abundance of 14 major oral bacterial species and Candida albicans. Results: The analysis revealed significant differences for certain microorganisms, namely Treponema denticola (T. denticola), Lactobacillus casei (L. casei), and Candida albicans. T. denticola was most abundant in the OSCC group (5,358,692.95 ± 3,540,767.33), compared to the stomatitis (123,355.54 ± 197,490.86) and healthy control (9,999.21 ± 11,998.40) groups. L. casei was undetectable in the healthy control group, but was significantly more abundant in the stomatitis group (1,653.94 ± 2,981.98) and even higher in the OSCC group (21,336.95 ± 9,258.79) (p = 0.001). A similar trend was observed for C. albicans, with DNA copy numbers rising from the healthy control (464.29 ± 716.76) to the stomatitis (1,861.30 ± 1,206.15) to the OSCC group (9,347.98 ± 5,128.54) (p = 0.006). The amount of T. denticola was positively correlated with L. casei (r=0.890, p<0.001) and C. albicans (r=0.724, p=0.008). L. casei's DNA copy number was strongly correlated with C. albicans (r=0.931, p<0.001). These three oral microbes exhibited strong positive correlations with each other and had various direct or indirect relationships with other species. Conclusions: In the OSCC group, T. denticola, L. casei, and C. albicans exhibited strong positive correlations with one another, further emphasizing the need for a deeper understanding of the complex microbial interactions in the OSCC environment.

Vascular anomalies are a diverse group of abnormal blood vessel developments that can occur at birth or shortly afterward. Embolization and sclerotherapy have been utilized as a treatment option for these malformations but may cause moderate to severe pain. This study aims to evaluate the utilization of peripheral nerve blocks in opioid consumption, pain scores, and length of stay. A retrospective chart review was conducted at the UPMC Children's Hospital of Pittsburgh for all patients who underwent embolization and sclerotherapy between 2011 and 2020. Patient data was collected to compare opioid consumption, pain scores, and length of stay. Eight hundred fifty-four procedures were performed on 347 patients. The morphine milligram equivalent per kilogram mean ratio between groups was 0.9 (0.86, 0.95) with a p-value of &lt;0.001. The pain score mean ratio was –1.17 (–2.2, -0.1) and a p-value of 0.027. Length of stay had a mean ratio of 0.94 (0.4, 2) and a p-value of 0.875. By decreasing opioid consumption and postoperative pain scores, peripheral nerve blocks may have utility in patients undergoing embolization and sclerotherapy while not clinically increasing the length of stay for patients. Their use should be individualized and carefully discussed with the interventional radiologist.

Confusion, fear and mixed sentiments prevail in the minds of people towards what is arguably one of the most important of dynamics of modern human society: Artificial Intelligence (AI). This study aims to explore the contributions of news media towards this phenomenon - we analyze nearly seventy thousand recent news headlines on AI, using natural language processing (NLP) informatics methods, machine learning (ML) and large language models (LLMs) to draw insights and discover dominant themes. Our theoretical framework was derived from extant literature which posits the power of fear producing articles and news headlines which produce significant impacts on public behavior even when available in small quantities. We applied extensive textual informatics methods using word and phrase frequency analytics, sentiment analysis and human experts based thematic analysis to discover insights on AI phobia inducing news headlines. Our rigorous analysis of nearly seventy thousand headlines using multiple validation methods in NLP (exploratory informatics including BERT, Llama 2 and Mistral based topic identification), ML (supervised informatics) and LLMs (neural nets for sentiment classification, with BERT, Llama 2 and Mistral) demonstrates the presence of an unreasonable level of emotional negativity and fear inducing verbiage in AI news headlines. The framing of AI as being dangerous or as being an existential threat to humanity can have a profound impact on public perception, and the resulting AI phobia and confusion in public perceptions are inherently detrimental to the science of AI. Furthermore, this can also impact AI policy and regulations, and harm society. We conclude with a discussion deducing implications for society and make recommendations for education and policies that could support human identity and dignity.

This review article discusses the involvement of the Brain-Derived Neurotrophic Factor (BDNF) in the control of pain. BDNF, a neurotrophin known for its essential role in neuronal survival and plasticity, has garnered significant attention for its potential implications as a modulator of nociception and pain. This comprehensive review aims to provide insights into the multifaceted interactions between BDNF and pain pathways, encompassing both physiological and pathological pain conditions. I delve into the molecular mechanisms underlying BDNF's involvement in pain processing and discuss potential therapeutic applications of BDNF and its mimetics in managing pain. Furthermore, I highlight recent advancements and challenges in translating BDNF-related research into clinical practice.

Background and Objectives: The complications seen after lower impacted third molar surgery affect the quality of life of the patients. The aim of the study was to investigate the efficacy of a single preoperative dose of deflazacort on pain, swelling and trismus following impacted lower third molar surgery. Materials and Methods: This randomised, prospective, double-blind, split-mouth clinical study included 30 healthy individuals with bilaterally impacted lower third molars that was removed for orthodontic purposes between September 2017 and September 2018. Group 1 was given a placebo (single dose vitamin C tablet) and group 2 was given a single 30 mg dose of deflazacort 1 hour prior to the surgery. Pain was evaluated using the visual analog scale for 1 week postoperatively. Edema (in mm) and trismus (in mm) were evaluated preoperatively and on postoperative days 2 and 7. The Mann-Whitney U test was applied for group analysis. p values < 0.05 were considered statistically significant. Results: When postoperative pain scores were evaluated, a significant difference was found between the groups only at the 6th and 12th hours (p0.05). Even high trismus values were recorded on the 2nd day, it was observed that the trismus resolved on the 7th day. There were no significant differences in trismus between the groups at any time point (p>0.05). Evaluation of swelling showed that there was no statistically significant difference between the study and control groups at any time point (p>0.05). No side effect was detected in both the study and the control groups. Conclusions: This was the first split-mouth study evaluating the anti-inflammatory effect of deflazacort after lower impacted third molar surgery. A single dose of 30 mg deflazacort was shown to be effective in reducing pain at 6 and 12 hours postoperatively.

Background: Perinatal anxiety and related disorders are common (20%), distressing and impairing. Fear of childbirth (FoB) is a common type of perinatal anxiety associated with negative mental health, obstetrical, childbirth and child outcomes. Screening can facilitate treatment access for those most in need. Objectives: The purpose of this research was to evaluate the accuracy of the Childbirth Fear Questionnaire (CFQ) and the Wijma Delivery Expectations Questionnaire (W-DEQ) of FoB as screening tools for specific phobia, FoB. Methods: A total of 659 English-speaking pregnant women living in Canada and over the age of 18 were recruited to the study. Participants completed an online survey of demographic, current pregnancy, and reproductive history information, as well as the CFQ and the W-DEQ, and a telephone interview to assess specific phobia FoB. Results: Symptoms meeting full and subclinical diagnostic criteria for specific phobia, FoB were reported by 3.3% and 7.1% of participants, respectively. The W-DEQ met or exceeded the criteria for a “good enough” screening tool across several analyses, whereas the CFQ only met these criteria in one analysis, and came close in three others. Conclusions: The W-DEQ demonstrated high performance as a screening tool for specific phobia, FoB, with accuracy superior to that of the CFQ. Additional research, to ensure the stability of these findings, is needed.

Introduction: Anterior cervical discectomy and fusion (ACDF) for cervical disc herniation (CDH) is commonly performed. Specific postoperative complications include dysphagia, dysphonia, cervicalgia, adjacent segment disorder, cage subsidence, and infections. However, interscapular pain is commonly reported by these patients after surgery, although its mechanisms have been not clarified yet. Methods: This retrospective series of 31 patients undergoing ACDF for CDH at a single Academic Hospital. Baseline and postoperative clinical, radiological, and surgical data were analyzed. The linear regression analysis was conducted to identify any factor independently influencing the occurrence rate of postoperative interscapular pain. Results: The mean age was 57.6±10.8 years, and the M:F ratio was 2.1. The preoperative mean VAS-arm was 7.15±0.81 among the 20 patients reporting brachialgia, and the mean VAS-neck was 4.36±1.43 among those 9 patients reporting cervicalgia. At 1 month interscapular pain was still reported by 8 out of the 17 patients who experienced it postoperatively, and it was recovered in all patients after 2 months. The regression analysis showed how the interscapular pain was not directly associated to age(p=0,74), gender(p=0,46), smoking status(p=0,44), diabetes(0,42), preoperative brachialgia(p=0,21) or cervicalgia(p=0,48), symptoms duration(p=0,13), baseline VAS-arm(p=0,11), VAS-neck(p=0,93), or mJOA(p=0,63) scores, or disc height modification(p=0,90). However, the postoperative increase of the mean zygapophyseal joint rims distance was identified as an independent factor in determining interscapular pain (p=0,02). Conclusions: Our study revealed that the onset of interscapular pain following ACDF may be determined by over-distraction of the zygapophyseal joints rim. Then, proper sizing of prosthetic implants could reduce this painful complication.

Palmitoylethanolamide (PEA) has been prescribed for neuropathic pain for several years. This study is mainly addressed to summarize what has been published on the topic in the last decades, and how appropriate the numerous prescriptions are. Among others, it examines the innovative EquiPEA^® patent, which aims to address obstacles encountered with conventional PEA formulations. EquiPEA^® seems to partially ameliorate the bioavailability and the targeted distribution. It seems to introduce novel advancements that have the potential to enhance the therapeutic effectiveness of PEA in terms of its anti-inflammatory, antioxidant, and analgesic properties. The deep literature analysis aims to examine the potential advantages of this innovative formulation, in the context of several pathological conditions that may benefit from this molecule. In particular, it investigates the potential enhanced bioavailability and targeted delivery system of EquiPEA^®. Also, it tries to understand if it can modernize the field of therapy based on PEA, thus offering a better treatment option for individuals with long-term inflammation, oxidative stress, and neuropathic or mixed pain with a neuropathic component. The study examines the possible impact of EquiPEA^® on personalized medicine strategies and its potential for translation into clinical practice. It analyses the possibilities that EquiPEA^® has in enhancing patient outcomes in a range of central nervous system and inflammatory conditions. This narrative review makes a valuable contribution to the ongoing comprehension of PEA therapy. It establishes a foundation for further exploration in research and potential uses in clinical settings.

Background: Low-level physical activity (PA) among Chronic Low Back Pain (cLBP) is associated with various biopsychosocial factors. This research aimed to study the predictors of PA behavior among cLBP patients. Methods: In the present study 300 eligible patients with cLBP who referred to comprehensive health service centers in the Shahid Beheshti University of Medical Sciences (SBUMS) in Tehran, Iran were random selected.To diagnose the predictors of PA behavior, all the Theory of Reasoned Action (TRA) constructs were examined as risk factors to see if they influence on the probability of PA behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 280 cLBP patients with mean age of 57.07 ±13.09 years old participated in the study. This study showed that motivation to comply significant predictor the cLBP patients for subjective norm OR (%95CI): 2.095(0.116-2.792), p-value<0.001), intention was significant predictor for perform the PA behavior OR (%95CI): 1.431(0.138-1.538), p-value <0.001), behavior beliefs could predictor for attitude OR (%95CI): 1.276(0.106-1.355), p-value= 0.002). attitude, normative beliefs, subjective norm ,and evaluation outcome behavior could predictors the cLBP patients for intention to perform the PA behavior OR (%95CI): 1.188(0.032-1.312), p-value<0.001)., OR (%95CI): 1.158(0.076-2.208), p-value=0.003) ., OR (%95CI): 1.104(0.076-1.128), p-value<0.001) ., OR (%95CI): 0.814(0.301-1.440), p-value=0.007). Conclusions: This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm).

Peritoneal fluid is an ovarian exudate from the growing follicle or corpus luteum. Therefore, the free concentrations of estrogens and progesterone are always much higher than in plasma, especially after ovulation. The peritoneum is not vascularised, and peritoneal implants and the superficial portion of deep endometriosis are likely influenced mainly by peritoneal fluid. Follicular phase progesterone concentrations are as high as during the luteal phase in plasma. This explains that most peritoneal implants are rarely proliferative and out of phase with the endometrium. From some 5 mm of depth onwards, endometriosis is rather influenced by plasma hormone concentra-tions, and the deeper parts can be proliferative as the endometrium. Because of these progesterone concentrations, progesterone resistance has to be postulated, permitting endometriosis lesions to initiate and develop. This opens the discussion of whether endometriosis is similar to the basal endometrium. These peritoneal fluid concentrations are important to understand the natural history and medical therapy of endometriosis. Most medical therapies decrease ovarian function and affect peritoneal fluid steroid hormone concentrations. It is suggested that the efficacy of medical therapy for endometriosis-associated pain is a consequence of the decreased estrogen concentrations in the peritoneal cavity and that the local effect of progestins may not be determinant for pain relief. If this is true, a history of endometriosis should not be considered a contraindication for hormone re-placement therapy.

Freezing of Gait (FoG) is a disabling motor complication in Parkinson’s disease (PD), affecting approximately 50% of advanced PD patients. It is characterized by sudden and transient inability to initiate or maintain walking, leading to falls and reduced quality of life. This study investigates the relationship between white matter integrity and step initiation impairments in FoG. Forty-three PD patients (26 with FoG) underwent diffusion-weighted imaging to assess white matter DTI metrics and kinematic analysis during step initiation tasks. Multiple regression analyses were conducted to explore the connection between white matter tract integrity and step initiation behavior. The multiple regression analysis shows that (1) Right Inferior Longitudinal Fasciculus RD explained 31% of APA duration’s variance; (2) Corpus Callosum Forceps Major explained 25% of the step length's variance. There was a positive correlation between the Right Inferior Longitudinal Fasciculus RD and APA duration and a negative correlation between Corpus Callosum Forceps Major RD and step length. The findings suggest that compromised white matter integrity in RILF and CC contributes to impaired motor control during step initiation in FoG. These regions are critical for inhibitory control and interhemispheric coordination, crucial for APA execution and step length regulation.

Spinal cord stimulation (SCS) is a therapeutic modality for the treatment of various chronic pain conditions that has rapidly evolved over the past 50 years. Unfortunately, over time, patients implanted with SCS undergo a habituation phenomenon leading to decreased pain relief. Consequently, discovery of new stimulation waveforms and SCS applications have shown to prolong efficacy and reduce explantation rates. This article explores various SCS waveforms, their applications and proposes a graded approach to habituation mitigation. We suspect the neural habituation phenomenon parallels that seen in pharmacology. Consequently we urge further exploration of early introduction of these stimulation strategies to abate spinal cord stimulation habituation.

Introduction: Low back pain (LBP) is the leading cause of lost productivity, absenteeism, disability, and early retirement worldwide. LBP treatment should be comprehensive, including prevention, education, diagnosis, and various treatment methods. Treatment can be divided into pharmacological and non-pharmacological. The role of physiotherapy in the comprehensive treatment of LBP is very important. Elastic therapeutic tape, also called kinesiology tape or therapeutic kinesiology tape, has been used for about 50 years. Purpose: The aim of this study was to evaluate the effectiveness of Kinesio taping in patients suffering from (LBP) and its possible effect on the swing of the center of pressure (COP), balance, gait, improvement of coordination, and pain reduction. Material and methods: A total of 60 patients aged 20 to 83 years (54% women) were examined, all of whom met the inclusion and exclusion criteria. In the experimental group, in addition to comprehensive rehabilitation, kinesiotaping of the L1-L5 spine was used. The control group underwent balance control training. The research tools used included the Bohannon single-leg standing test, the FAC scale - Functional Ambulatory Category, the Podsiadlo and Richardson Standing and Walking Test - Timed Up and Go (TUG), lumbar spine mobility assessment, Lasegue's sign and examination of neurological deficit symptoms. and self-assessment of pain using the Visual Analogue Scale (VAS). Results: Kinesio taping has a statistically significant effect on postural control, balance, gait, coordination, and pain. The main parameter with a statistically significant effect on the effects of Kinesio taping was age (below 55 years), which was also observed in the control group. Conclusions: Kinesio taping is an effective method in the treatment of LBP. It improves postural control, balance, gait, coordination, and pain.

Background/Objectives: Intervertebral disc degeneration is the most common cause of low back pain (LBP) and lumbosciatica is a major challenge to healthcare systems worldwide. For years, ozone therapy has been used with excellent results in intervertebral disc disease and in patients with LBP. In vitro studies have demonstrated the positive action of porcine collagen in extracellular matrix remodeling and homeostasis. These tissue changes, associated with LBP, may suggest an indication for combined ozone/collagen treatment in patients with LBP. However, no studies have been reported regarding this combination of treatments. Methods: The present work compared, retrospective data of two treatment groups (each of 10 LBP patients): A) Oxygen-Ozone Therapy (OOT) vs. B) OOT plus porcine collagen type 1 injections (COL I). Pain intensity and physiological function were assessed by the numerical rating scale (NSR) method. The Roland-Morrison questionnaire was used to assess disability. Patient data were acquired before, during and at six months of follow-up. Significant differences were assessed by ANOVA and T-Student test. Results: The analyses revealed significant statistical differences comparing the two arms, where, the OOT COL I treatment demonstrated a booster efficacy in pain, while the questionnaire revealed a reduction in disability. Conclusions: Therefore, this combination therapy might be a promising approach for the management of patients with LBP.

Back-care knowledge and behaviour may play a vital role in preventing musculoskeletal current and future discomfort and injuries. The aim of the current survey was to explore the level of knowledge regarding ergonomics and posture together with postural behaviour and the incidence of musculoskeletal pain (MSP) in university students in the northeast of England. A mixed methods survey was conducted on a convenience sample of 55 university students. The 32-item valid and reliable questionnaire contains questions on socio-demographics, MSP, knowledge regarding ergonomics and posture (8 closed ended and 8 open-ended items) as well as postural behaviour. Nearly 1.8%, 20% and 78.2% of the university students had poor, fair and good knowledge of ergonomics and posture respectively. Among the 37 students who carried a backpack, 51.4% were found to have poor postural behaviour, 37.8% had fair behaviour and 10.8% had good postural behaviour. Of the 18 students who did not carry a backpack, 55.6% were found to have poor postural behaviour, 27.8% had fair behaviour and 16.6% had good postural behaviour. 70.9% of the students experienced MSP with the most prevalent site of pain being the lower back region. The key themes that emerged from qualitative data (8 open-ended questions) were: “Comfortable posture”, “Correct spinal alignment”, “Spine support”, “less pain and injuries”, “Use knees not the back”, “Keep the object close to body”, “Hands on desk”, “Feet flat on floor” as well as “eyes at screen level”. The findings of this study can be used to develop targeted interventions aimed at educating university students about ergonomics and posture in order to prevent the incidence of MSP. Future research in this field with a large and more representative sample of the university students’ population is strongly recommended to fully understand their knowledge of ergonomics and posture, postural behaviour as well as incidence of MSP.

Headache is considered to be one of the most common causes of medical treatment and evaluation worldwide in both acute and outpatient settings. It is the most common neurological symptom seen worldwide affecting all genders, ages, ethnicities, and socioeconomic levels. It’s impact is noted in educational decline in school-aged children and decreased productivity through sick leave in adults. Its overall burden is well documented in well-resourced countries but limited data is seen low resourced countries. While many underlying causes bring about secondary headaches, primary headaches and more specifically migraines have been more widely explored. Migraines have a distinct criterion that is inclusive of one day duration (4 hours to 7 days, unilateral distribution, nausea and vomiting and disability as a few examples. However, migraines can vary and proper documentation through a migraine diary can help to guide treatment. Management of migraines can vary. Lifestyle modification is a key factor in the overall prevention and reduction of triggers in migraines. In addition to this, pharmacotherapy can be given in a tier-based approach based on overall severity and frequency of the migraine. Interventions have progressed from botox injection and have seen the advent of new medications such as nasal sprays to novel formulations of pre-existing drug formulations. Nonetheless, there is great room for further studies of headaches and migraines. Research specifically in low-resource countries can prove to beneficial.

Objective: This analysis investigates patient experiences regarding pain management during gynecological procedures through a comprehensive survey, aiming to address the lack of clear guidelines in the clinical landscape and emphasize the importance of effective pain management strategies in enhancing patient care and satisfaction. Design: A cross-sectional survey with 258 respondents assessed pain management experiences during gynecological procedures. The survey was distributed via Qualtrics, and 258 responses were obtained. Participants/Materials, Setting, Methods: Participants provided demographic information and responded to questions regarding contraceptive methods, procedures undergone, pain management discussions, anxiety levels, and willingness to accept pain management interventions. Confidentiality and informed consent protocols were strictly observed throughout the study. Results: Most female respondents reported diverse contraceptive methods and procedures. Pain management discussions and provisions varied, with a significant portion reporting never being offered pain management. Many experienced anxiety and pain during procedures, with varying intensities, that were not addressed or discussed by their treating provider. Most expressed willingness to accept pain management interventions. Limitations: This study relies on self-reported data, potentially introducing recall bias, and has limited generalizability due to its cross-sectional design. Conclusions: Findings reveal a significant gap in pain management provision and discussion during gynecological procedures. Improved guidelines and practices are necessary to address patient discomfort effectively. Standardized pain management protocols are crucial to enhance patient experiences and outcomes, with further research needed to tailor strategies to individual patient needs.

Background: The transversus abdominis plane (TAP) block has gained increasing importance as a very effective pain relief in for caesarean section. This study aimed to compare bupivacaine (Group B), bupivacaine with dexmedetomidine (Group BD) and bupivacaine with dexamethasone (Group BDx) applied in ultrasound-guided TAP block in the treatment of CS postoperative pain. Material and Method: American Society of Anesthesiologists I and II pregnant women who underwent cesarean section were included in the study. Forty patients were admitted in each group. All patients were applied TAP block with ultrasound guidance by administering the medications of the group in which they were included. Results: Body mass index (BMI) and operation duration were higher in Group B (p*=0.01 and 0.004, respectively). Instant tramadol requirement and amount were higher in Group B at some of follow up times. Patient satisfaction scale were better in Group BD and Group BDx. Conclusion: TAP block significantly reduces pain after cesarean section, prolongs the time to first analgesic request, and reduces the need for additional opioid analgesics. The addition of adjuvant to the TAP block usually improves the postoperative clinical condition. However, some special conditions such as body mass index (BMI) may negatively affect the clinical situation. Comprehensive, standardized, randomized controlled studies are needed to compare results under different conditions.

Fucoidans, known for their diverse biological properties such as anti-inflammatory, antiviral, antitumor, and immune-stimulatory effects, have recently gained attention for their potential benefits in exercise endurance, muscle mass, and anti-fatigue. However, the mechanisms by which fucoidans enhance exercise performance are still unclear. To investigate these effects, we administered 400 mg/kg/day of fucoidan extract derived from Undaria pinnatifida to sixty-four C57BL/6J mice over ten weeks. We evaluated changes in running activity, mitochondrial-related gene expression in skeletal muscle, and alterations in the intestinal microbiome. Our results showed that fucoidan supplementation significantly increased daily running distance and muscle mass by 25.5% and 10.4%, respectively, in mice on a standard chow diet, and with more modest effects observed in those on a high-fat diet (HFD). Additionally, fucoidan supplementation led to a significant increase in beneficial gut bacteria, including Bacteroides/Prevotella, Akkermansia muciniphila, and Lactobacillus, along with a notable reduction in the Firmicutes/Bacteroidetes ratio, indicating improved gut microbiome health. Mechanistically, fucoidan supplementation upregulated the mRNA expression of key genes related to mitochondrial biogenesis and oxidative capacity, such as COX4, MYH1, PGC-1α, PPAR-γ, and IGF1, in both standard chow and HFD-fed mice. Our findings suggest that fucoidan supplementation enhances exercise performance, improves muscle function, and positively modulates the gut microbiome in mice, regardless of diet. These effects may be attributed to fucoidans' potential prebiotic role, promoting the abundance of beneficial gut bacteria and contributing to enhanced exercise performance, increased muscle strength, and improved recovery.

Abstract Background: Occipital neuralgia is a debilitating condition and traditional treatments often provide limited or temporary relief. Recently, ultrasound-guided hydrodissection of the greater occipital nerve (GON) has emerged as a promising minimally invasive approach. Objectives: To describe two novel ultrasound-guided hydrodissection with 5% dextrose for GON and discuss their advantages, disadvantages, and considerations. Methods: Two case reports are presented. Case 1 describes a lateral decubitus approach for hydrodissecting the GON between the semispinalis capitis (SSC) and obliquus capitis inferior (OCI) muscles. Case 2 details a cranial-to-caudal approach for hydrodissecting the GON within the SSC and upper trapezius (UT) muscles when the GON pass through these two muscles. Results: Both patients experienced significant and sustained pain relief with improvements in function and quality of life. Conclusions: Ultrasound-guided GON hydrodissection using 5% dextrose is a promising treatment for occipital neuralgia. The lateral decubitus and cranial to caudal approaches provide additional options to address patient-specific anatomical considerations and preferences.

Low back pain (LBP) is one of the most common musculoskeletal conditions, resulting in continuous pain and disability. However, reliable evidence exists for only a few existing therapies for LBP. This study aimed to determine the efficacy of a newly designed cutting-edge massage device that uses a mechanical sequential ascending method. Fifteen individuals with LBP underwent mechanical sequential ascending massage method with thermal therapy (AM-TH), thermal therapy (TH), rotating roller massage method with thermal therapy (RM-TH), and clinical assessments. We analysed the participants’ biomechanical muscle properties, pain, satisfaction, and disability measured immediately before and after treatment. There was a significant decline in tone and stiffness in the upper and lower regions of the paraspinal muscles when AM-TH was administered on three or more occasions (p &lt; 0.05). AM-TH was more effective than RM-TH in reducing pain, with a significant reduction in pain over time (p &lt; 0.05). Participants were most satisfied with RM-TH; over time, RM-TH was effective in improving participants’ disabilities (p &lt; 0.05). AM-TH has been demonstrated to be effective in individuals with LBP, improving muscle tone and stiffness and reducing pain. Therefore, it may be a useful treatment for LBP.

Ulcerative colitis (UC) is a chronic autoimmune disorder affecting the colonic mucosa. UC is a subtype of inflammatory bowel disease along with Crohn’s disease and presents with varying extraintestinal manifestations. No single etiology for UC has been found, but a combination of genetic and environmental factors is suspected. Research has focused on the role of intestinal dysbiosis in the pathogenesis of UC, including the effects of dysbiosis on the integrity of the colonic mucosal barrier, priming and regulation of the host immune system, chronic inflammation, and progression to tumorigenesis. Characterization of key microbial taxa and their implications in the pathogenesis of UC and colitis-associated cancer (CAC) may present opportunities for modulating intestinal inflammation through microbial-targeted therapies. In this review, we will discuss the microbiota-immune crosstalk in UC and CAC, as well as the evolution of microbiota-based therapies.

Fear can sometimes paralyze us, and it can sometimes be exciting; for some people, fear is so crippling it can significantly mix up their lifes! We understand a little bit about how the brain acts when we are afraid, mainly by studying the brains of animals. Recently, surprising findings were made using a humble animal, the zebrafish – a small aquarium fish that in the past has helped scientists figure out how our organs develop. Zebrafish are useful because they develop quickly, reproduce richly, and have brains which are similar to ours. They also produce what we call an “alarm substance” that alerts shoalmates when one of them has been injured; when they smell this substance in the water they act as if they are very scared. When this happens, they release serotonin in their brains, a neurotransmitter that acts as a light switch, making them less afraid but more cautious – as if trying to figure out if a predator is there or not. Hopefully, finding more about how the zebrafish brains process this serotonin signal can help scientists develop better treatments for mental disorders that are associated with fear.

Introduction: During the COVID-19 pandemic, many countries implemented restrictions, social distancing measures, and lockdowns to limit the spread of the disease. The lockdowns have affected children’s screen time (ST), pain, and physical activity (PA) levels. The present study aimed to explore the relationships between several personal factors during the COVID-19 pandemic. Methods: The caregivers of 329 children (median age=8 years) filled out an online self-reported survey about the children’s PA, ST, and pain before, during, and after the COVID-19 curfew. Spearman’s rank correlation coefficient was used to explore the associations between these variables. Results: After the curfew, pain that existed before the pandemic had a weak negative relationship with PA intensity (-0.11, p=0.04) and a weak positive relationship with ST (r=+0.12, p=0.04). There was a strong positive relationship between ST in all time periods (p&gt;0.01). PA and ST had a weak negative relationship (p&gt;0.05) during the curfew and after the curfew but not before the COVID-19 pandemic. Age had a weak positive correlation with ST in all time periods (p&gt;0.01). In addition, ST was affected by the curfew. Conclusion: The study findings indicated that young children had longer ST during the curfew and after the curfew compared with before the curfew. Increasing PA could lessen children’s ST, which could, in turn, increase the probability that their general pain would decrease.

Background: Physiotherapy and chronic low back pain (CLBP) form a broad and fast developing research area. The aim of the article was to holistically, thematically and chronologically analyze and synthesise literature production and identify most prolific research entities and research themes. Methods: The article quantitatively and quantitatively analyzed research literature production harvested from the Scopus bibliometric database. using a triangulation of bibliometric and thematic analysis. For this, Excell and VOSwiever software were used. Results: In the Scopus database, 2843 data sources were found, which were published between 1974 and February 26, 2024. The growth trend has been linearly positive since the beginning of publication, and after 2018, exponential growth began. A review of the most prolific entities showed that the most literature was published in America, Europe and Australasia. The thematic analysis of the information sources identified six main themes, while the chronological analysis revealed three main areas of developments: assessment tools, CLBP processing and study methodology. Conclusions: The results of the bibliometric study presents a good starting point for further research providing Taxonomy and research landscapes as a holistic framework offering multidisciplinary knowledge about CLBP, while chronological analysis provides a basis for identifying prospective research trends.

Pain is a multifaceted multisystem disorder that adversely affects neuro-psychological processes. This study compares the effectiveness of central-stimulation (tDCS) and peripheral-stimulation (TENS) in pain-inhibition during a cognitive-task in healthy volunteers and to observe potential neuro-cognitive improvements. Healthy eighty volunteers went through a complete experimental protocol comprising pain-induction (CPT), administration of tDCS/TENS, EEG-data acquisition, and cognitive assessments. The protocol for this study is categorized into 04-groups: G1(Control), G2(TENS), G3(Anodal-tDCS), and G4(Cathodal-tDCS). Paired t-tests (p

This study aims to provide an updated overview of the systematic evaluation and management of Post-Traumatic trigeminal neuropathic pain (PTTN) resulting from dental procedures or trauma. PTTN arises following an injury to the trigeminal nerve, which is responsible for sensory and motor functions in the maxillofacial region. The etiology encompasses various dental procedures and craniofacial trauma, leading to a spectrum of symptoms, from tingling to severe pain. Diagnostic challenges stem from the absence of standardized criteria and the overlap with focal neuralgia, necessitating comprehensive evaluation. Misdiagnosis can result in prolonged suffering and unnecessary procedures. Successful management hinges on prompt diagnosis and interdisciplinary collaboration, with early intervention crucial in mitigating chronicity. While nerve recovery post-trauma is challenging, preventive measures through accurate evaluation and treatment are paramount.  Management for PTTN includes non-invasive and surgical interventions. Non-invasive intervention includes systematic and local pharmacological management. This review enhances uniformity in PTTN evaluation and treatment approaches despite standardized study limitations.

Background: Reproductive coercion and abuse (RCA) is a hidden form of violence against women. It includes behaviours intended to control or dictate a woman’s reproductive autonomy, for the purpose of either preventing or promoting pregnancy. Main text: In this commentary, we argue that there is a lack of conceptual clarity around RCA that is a barrier to developing a robust evidence base. Furthermore, we suggest that there is a poor understanding of the way that RCA intersects with other types of violence (intimate partner violence; sexual violence) and – as a result – inconsistent definition and measurement in research and practice. To address this, we propose a new way of understanding RCA that centres perpetrator intent and the presence of fear and control. Recommendations for future research are also discussed. Conclusion: We suggest that IPV and SV are the mechanisms through which RCA is perpetrated. In other words, RCA cannot exist without some other form of co-occurring violence in a relationship. This has important implications for research, policy and practice including for screening and identification of women in reproductive healthcare settings.

This study investigated the associations of imageability with fear reactivity. Imageability ratings of four word classes: positive and negative (i) emotional and (ii) propriosensitive, neutral and negative (iii) theoretical and (iv) neutral concrete filler, and fear reactivity scores – degree of fearfulness towards different situations (TF score) and total number of extreme fears and phobias (EF score), were obtained from 171 participants. Correlations between imageability, TF and EF scores were tested to analyze how word categories and their valence were associated with fear reactivity. Imageability ratings were submitted to recursive partitioning. Participants with high TF and EF scores had higher imageability for negative emotional and negative theoretical words. The correlations between imageability of negative emotional words and negative theoretical words for EF score were significant. Males showed stronger correlations for imageability of negative emotional words for EF and TF scores. High imageability for positive emotional words was associated with lower fear reactivity in females. These findings were discussed with regard to negative attentional bias theory of anxiety, influence on emotional systems, and gender-specific coping styles. This study provides insight into cognitive functions involved in mental imagery, semantic competence for mental imagery in relation to fear reactivity, and a potential psycholinguistic instrument assessing fear tendency.

Background: Colorectal cancer (CRC) can significantly impact mental health, increasing suicide risk. Variables such as pain and threat perception may be crucial. This study aims to identify predictors of suicide risk in individuals with CRC. Methods: A total of 71 participants (76.06% men) aged 27 to 88 years (M = 65.18, SD = 12.02) were assessed using the SF-36 for pain, the Brief Illness Perception Questionnaire (B-IPQ) for threat perception, the Hospital Anxiety and Depression Scale (HADS) for emotional distress, and the Plutchik suicide risk scale for suicide risk. Descriptive, comparative, and correlational analyses were performed, followed by a linear regression analysis. Results: Nearly 20% of participants exhibited high suicide risk. There was a moderate to high association between suicide risk and the perception of threat, pain, and emotional distress. The linear regression model explained 39% of the variance in suicide risk, with threat perception, pain, and emotional distress as significant predictors. Conclusions: These results indicate the need for multidisciplinary care for individuals with CRC, including emotional support from health psychologists, and holistic, human-centered care from nursing and medical professionals. Future research is necessary to further explore these relationships and improve patient care strategies.

Machine Learning (ML) has revolutionized healthcare by enhancing diagnostic capabilities because of its ability to analyze large datasets and detect minor patterns often overlooked by humans. This is beneficial, especially in pain recognition, where patient communication may be limited. However, ML models often face challenges such as memorization and sensitivity to adversarial examples. Regularization techniques like mixup, which trains models on convex combinations of data pairs, address these issues by enhancing model generalization. While mixup has proven effective in image, speech, and text datasets, its application to time-series signals like electrodermal activity (EDA) is less explored. This research uses ML for pain recognition with EDA signals from the BioVid Heat Pain Database to distinguish pain by applying mixup regularization to manually extracted EDA features and using a Support Vector Machine (SVM) for classification. Results showed that this approach achieved an average accuracy of 75.87% using leave-one-subject-out cross-validation (LOSOCV) compared to 74.61% without mixup. This demonstrates the mixup’s efficacy in improving ML model accuracy for pain recognition from EDA signals. This study highlights the potential of mixup in ML as a promising approach to enhance pain assessment in healthcare.

Many people in the USA have lost their lives or become addicted to opioids via prescription opioids given for chronic pain. The chronic pain epidemic has emerged due to a convergence of factors, including the medicalization of pain as well as injuries happening in the workplace, in the home, or during recreation. Opioid prescriptions rose precipitously from the late 1990’s through to approximately 2020, and despite public awareness, still are increasing. This review examines literature on integrative approaches to chronic pain as delineated by pain type. The review is organized by the most common causes of chronic pain, and randomized controlled trials, meta-analyses and systematic reviews are extracted for each cause of chronic pain. Several promising interventions may alleviate chronic pain of some causes, and some interventions may work across pain causes. Lowering inflammation through dietary or lifestyle regimens may be a general way of reducing pain. Pain can be alleviated through several adjunctive and integrative treatment approaches, which may serve to lower the need for opioid medication.

Balanced fear supports human rational decision making and useful behavioral responses. In contrast, overwhelming, persistent, and unbalanced fear can paralyze the individual and result in heightened anxiety, lack of cognitive flexibility, fear-based public compliance and serious mental health issues. Psychobiotics research has established that a healthy microbiome is required for balanced fear and mental health protection via control of fear extinction. The recent Covid-19 pandemic featured daily, persistent, fear-of-a single contagion conditioning on a global scale paired with various behavioral mandates (e.g., lockdowns of the healthy, masks, isolation from environmental microbes and each other) that degraded the human microbiome and isolated us from each other and useful environmental microbes. It also ignored the historic role of secondary bacterial pathobionts, in pandemic deaths. This narrative review examines how institutional promotion of fear-of-a single contagion, lack of balanced risk communication, and appalling disregard of our fundamental nature (as majority-microbial human superorganisms) resulted in problems rather than solutions. This review concludes that government-public health-media promotion of pervasive fear and microbiome-degrading behaviors: 1) increased public compliance, 2) reduced cognitive flexibility, and 3) increased risk of mental health conditions. It further argues that microbiome-first public health should be embraced to ensure that human freedom, rather than paralyzing fear, dominates our future.

Hydrotherapy, including the use of therapeutic showers and bathtubs, has been studied for its potential benefits in labor pain management. Previous research has indicated that hydrotherapy can alleviate pain, but comparative studies between therapeutic showers and bathtubs are scarce. Objective: This study aims to compare the effects of therapeutic showers and bathtubs on pain perception, labor duration, use of epi-dural analgesia, and maternal and neonatal outcomes during labor. Methods: A total of 124 pregnant women were included in this study. Participants were divided into two groups: those who used a thera-peutic shower and those who used a bathtub during labor. Pain levels were measured using a visual analog scale (VAS). Labor duration, use of epidural analgesia, types of delivery, maternal outcomes (postpartum hemorrhage, perineal status, maternal hypotension, fever, and breastfeeding), and neonatal outcomes (APGAR scores, fetal heart rate, complications, and neonatal unit admissions) were recorded and analyzed. Results: Both the therapeutic shower and the bathtub effectively reduced pain perception, with the bathtub showing a greater reduction in VAS scores. The therapeutic shower group experienced a signifi-cantly shorter labor duration compared to the bathtub group. The majority of participants in both groups did not require epidural analgesia, with no significant differences between the groups. There were no sig-nificant differences in the types of delivery. Maternal outcomes indicated a lower incidence of perineal tears and episiotomies in the therapeutic shower group. Neonatal outcomes, including APGAR scores and fetal heart rate, were similar between the groups, with no significant differences in complications or neo-natal unit admissions. Conclusions: Both therapeutic showers and bathtubs are effective for pain relief during labor, with the bathtub showing a higher reduction in pain intensity. The therapeutic shower is as-sociated with a shorter labor duration and a lower incidence of perineal tears and episiotomies. Both meth-ods are safe for neonatal well-being, making hydrotherapy a viable non-pharmacological option for pain management in labor. However, the therapeutic shower may offer additional benefits in terms of labor du-ration and maternal outcomes.

Several studies have shown that non-pharmacologic treatments such as photobiomodulation (PBMT) and swimming (SW) have been increasingly used as adjuncts to clinical practice. The aim of this work is to evaluate whether SW associated or not with PBMT has its effects potentialized on different kind of pain and motor aspects in a model of chronic constriction injury and if the treatments have any improvement on morphometry of the skeletal striated muscle. Our results have demonstrated a beneficial effect on pain and motor response for animals treated with the therapies isolated, and an even better response when we associate them. Regarding muscle tissue, we observed an improvement in inflammatory cells quantification and on the collagen expression on the muscle after each isolated treatment or in combination. These findings contribute to enhancing for individuals suffering from neuropathic pain conditions, offering a promising avenue for integrated care approaches that prioritize both symptom alleviation and functional recovery. Such insights are crucial for advancing treatment strategies in pain management since the currently available treatments are not completely effective to treat all the pain and also promotes several side effects on the patients’ health.

The clinical practice implies a research translation that helps the use of scientific data and thera-peutic evidence for patient benefits. This review critically summarizes the potential impact of cannabinoids in concomitance with other drugs in the following chronic diseases as Epilepsy, Au-tism Spectrum Disorders (ASD), Oncology, Multiple Sclerosis, and Chronic Pain. The potential in-teractions can change the predicted clinical outcomes of therapeutic protocols and need to be evaluated. Some of the effects would be additive, synergistic or antagonistic, but can also enroll changes in absorption, distribution, metabolism, particularly via cytochrome P450 (CYP) isoen-zymes (e.g CYP2C9 and CYP3A4) and excretion. For instance, the combination of canna-bis-derived compounds and the antifungal drug ketoconazole, a CYP3A4 inhibitor, increases plasma concentration of Δ-9-tetrahydrocannabinol (THC) and CBD (CBD). Opposable, rifampic-in, a CYP3A4 inducer, stands out for the approximately 20-40% reduction in plasma THC levels and 50% to 60% for CBD. Other CYP3A4 inhibitors and inducers are likely to have a similar effect on plasma concentrations if co-administered. Indeed, pharmacokinetic interactions have been also reported with antiseizure drugs. Moreover, pharmacodynamic interactions between cannabinoids and drugs with sympathomimetic effects (eg tachycardia, hypertension), central nervous system depressants (eg drowsiness, ataxia), and anticholinergics (eg tachycardia and drowsiness) are also expected. Even though pending further studies, there is currently clinical evidence supporting drug interaction with cannabinoids, demanding doctors evaluate the risk of drug combinations with cannabinoids. The tables herein provided were designed to facilitate the identification of bi-orelevant interactions that may compromise therapeutic efficacy and toxicity.

The definition of patients with Special Needs (SN) is used in the literature to refer to individuals with mental and physical disorders for whom the usual perioperative pathways are not applicable due to lack of cooperation, regardless of age. Studies in the literature recognize the appropriateness of general anesthesia for performing day surgery dental care in this type of patient. The present retrospective, single-center, observational study involved 41 uncooperative patients aged between 3 and 17 undergoing dental surgery under general anesthesia. The main objective was to assess the possible incidence of difficult airway management, understood as difficulty ventilating and/or intubating the patient. A secondary objective was to highlight the influence of general anesthesia on patient outcomes by testing the incidence of perioperative complications. Tracheal intubation was successfully completed in all of the patients considered, and in no case did the patient have to be woken up because of difficulty in airway management. No perioperative complications attributable to anesthesia were found in any patients. From the present experience, it can be concluded that general anesthesia is a suitable option for performing dental care in pediatric subjects with special needs, and that although the peculiar peri-operative management of these patients might increase the risk of possible anesthesia-related side effects, no complications have been encountered in any case.

Sleep disturbances and chronic pain are prevalent and interrelated conditions that significantly impact individuals' quality of life. Understanding the intricate dynamics between sleep and pain is crucial for developing effective treatments that enhance the well-being of affected individuals and reduce the economic burden of these debilitating conditions. This narrative review examines the complex relationship between sleep disturbances and chronic pain. We describe the prevalence and types of sleep disturbances and sleep disorders in chronic pain patients. Posteriorly we critically review the clinical and experimental evidence investigating the relationship between sleep disturbances and chronic pain aiming to clarify the impact of chronic pain on sleep and, conversely, the impact of sleep disturbances on pain perception. We conclude that a bidirectional relationship between chronic pain and sleep disturbances is almost a consensus in the literature, however, the strength of each direction of the association is less clear. As of now, the literature suggests that sleep impairment is a stronger predictor of pain than pain is a predictor of sleep impairment. Additionally, addressing sleep disturbances in chronic pain patients is crucial, as poor sleep has been linked to higher levels of disability, depression, and pain-related catastrophizing.

As the necessity for safety and aesthetic of nightscape have arisen, the importance of nightscapes (i.e., nighttime landscape) planning has garnered the attention of mainstream consciousness. Therefore, this study is to suggest the guideline for nightscape planning using electroencephalography (EEG) technology and survey for recognizing the characteristics of a nightscape. Furthermore, we verified the EEG method as a tool for landscape evaluation. This study analyzed the change of relative alpha power and relative beta power and self-reporting of participants in order to investigate the correlation between EEG and fear according to twelve nightscape settings. Our findings indicated the corresponding measures of fear vary accordance with whether there was people or not, and the environmental settings (Built Nightscape Images; BNI vs Natural Nightscape Images; NNI). Based on our physiological EEG experiment, we provided a new analytic view of the nightscape. The approach we utilized enables a deeper understanding of emotional perception and fear among human subjects by identifying the physical environment which impacts how they experience nightscapes.

The objective of this study was to evaluate the pain and inflammatory response in soft tissues using healing and prosthetic abutments of different diameters and lengths. Methods: The study population was rehabilitated with Astra tech EV single implants (Dentsply Sirona, Atlantis, Dentsply Sirona S.A., Barcelona, Spain), 4.2 and 4.8 millimetres in diameter in upper and lower maxilla and loaded with custom abutments digitally designed with the software of the company Dentsply Sirona (Atlantis WebOrder, Dentsply Sirona S.A., Barcelona, Spain), version 4.6.5, with a larger diameter than the healing abutment, to account for biomarkers through ELISA. Results: Rehabilitations in mandible and with healing abutments below 4.29 millimetres and rehabilitators below 2.18 millimetres elicited higher pain and inflammatory responses, and in turn higher interleukin 1β values. Conclusions: Greater inflammation was evident in cases in which healing abutments with reduced diameter were used in relation to the same subsequent rehabilitation with prosthetic abutments of larger diameter.

Having valid and reliable tools that help health professionals to assess fear in children undergoing medical procedures is essential to offer humanized and quality of care in the paediatric population. The aim of this study was to develop the cross-cultural adaptation and the evaluation of the psychometric properties of the Spanish version of the “Child Medical Fear Scale” in its shortened version (CMFS-R). The design consisted of two phases, first of cross-cultural adaptation and second of the psychometric validation of the CMFS-R with a sample of 262 children from Spain. Confirmatory factor analysis was conducted to assess construct validity and the Cronbach alpha and the adjusted item-total score correlation coefficients were performed to study reliability. The results confirmed internal consistency and construct validity of the Spanish version of the CMFS-R, indicating that the scale has an acceptable level of validity and reliability. Therefore, this study brings a new version of the scale to assess fear related to medical procedures for use in the Spanish paediatric population.

Background: Interleukin-6 is dysregulated in multiple pathological conditions, e.g. cancer and inflammatory diseases. Aim: To investigate new mechanisms for regulation of pathological IL-6 production. Methods: PBMC produce interleukin-6 (IL-6) stimulated by cancer serum factors or specific peptides. Immunoregulatory albumin neo-structures and peptides were identified with 2D-gel electrophoresis and MALDI-TOF-MS analyses. Il-6 and albumin neo-structures were determined by ELISA. Results: Conformational changes of normal serum albumin by proteolytic degradation generates an IL-6 inducing neo-structure, IL-6 inducing factor (IL-6IF), which is immunogenic eliciting production of autoantibodies. IL-6 production induced by IL-6IF and cancer patient sera is inhibited by specific antibodies. The serum concentration of IL-6IF, is significantly higher in advanced cancer stages and its presence is significantly correlated to the survival of the patients. Conclusion: A new mechanism for induction IL-6 synthesis is presented. Based on this mechanism the pathological IL-6 production related to an enhanced proteolytic activity can be diagnosed and selectively inhibited by specific antibodies. Such antibodies have been identified and purified. Thus, the neo-structure, inducing pathological IL-6 production, associated with a reduced survival of cancer patients can be selectively removed by therapeutic administration of antibodies leaving the function of IL-6 needed for the normal activity of the immune system intact.

This brief report investigates the potential correlation between manual labor and opioid addiction, focusing on contributing factors such as chronic pain, regular exercise, healthcare access, and housing stability. Although manual labor is associated with higher rates of work-related injuries and chronic pain, the review finds no strong, direct correlation between manual labor and increased opioid addiction rates. The relationship is complex and influenced by a range of socio-economic factors. The findings highlight the need for further research, particularly longitudinal studies, to explore these dynamics in depth and develop targeted interventions for at-risk populations.

Passive plasma spectroscopy is a well-established non-intrusive diagnostic technique. Depending on the emitter and its environment which determine the dominant interactions and effects governing emission line shapes, passive spectroscopy allows the determination of electron densities, emitter and perturber temperatures as well as other quantities like abundances. However, using spectroscopy needs appropriate line shape codes retaining all the physical effects governing the emission line profiles. This requires for line shape code developers to continuously correct or improve them to increase their accuracy when applied for diagnostics. This is exactly the aim expected from code-code and code-data comparisons. In this context, the He I 492 nm emitted in a helium corona discharge at room temperature represents an ideal case since its profile results from several broadening mechanisms: Stark, Doppler, resonance and van der Waals. The importance of each broadening mechanism depends on the plasma parameters. Here the profiles of the He I 492 nm in a helium plasma computed by various codes are compared for a selected set of plasma parameters. In addition, preliminary results related to plasma parameter determination using experimental spectra from a helium corona discharge at low pressure 1- 2 bars, are presented.

Interventional management of neuropathic pain (NP) is available to the many patients who do not attain satisfactory outcomes with pharmacotherapy, but evidence supporting this is sparse and fragmented. We attempted to summarize and critically appraise the existing data to identify strategies that yield maximum benefit, orient clinicians, and identify areas that merit further investigation. A two-round Delphi survey that involved pain clinic specialists with experience in the research and management of NP was done over an ad hoc 26-item questionnaire prepared by the authors. Consensus on each statement was defined as either at least 80% endorsement or rejection after the second round. Thirty-five and 29 panelists participated in the first and second round, respectively. Consensus was reached in 20 out of 26 statements. There is sufficient basis to treat postherpetic neuralgias and complex regional pain syndromes with progressive levels of invasiveness and failed back surgery syndrome with neuromodulation. Radiculopathies and localized NP could be treated with peripheral blocks and neuromodulation, or pulsed radiofrequency. Non-ablative radiofrequency and non-paresthetic neuromodulation are efficacious and better tolerated than ablative and suprathreshold procedures. A graded approach, from least to most invasive interventions has the potential to improve outcomes in many patients with common refractory NP conditions. Preliminary promising data warrant further research on new indications, and technical advances might enhance the safety and efficacy of current and future therapies.

In this paper, the authors seek to discuss some of the complexities involved in cross-cultural working in relation to the communication and management of pain in older people. Specifically, the paper addresses the culture construction of ageing and how pain is often constructed as a natural part of ageing. The authors also suggests that with the rise of the ideology of active-ageing many older people who are disabled or living in chronic pain, may feel a moral imperative to hide pain and ill-health. The discussion extends into looking at the impact of culture and the communication of pain, including specific idioms of distress, somaticize and the lay-management of pain through stoicism.

Detecting and evaluating pain in people with cognitive impairment, especially dementia, is a challenge. Their ability to accurately report pain and comprehend related questions decreases the reliability of their self-report. This has contributed to the fact that pain is underdiagnosed and undertreated in this population, which can lead to involuntary ageism. The design and assessment of this training capsule under the context of the European COST-Action TD1005 responds to the need for education and training in "Pain Assessment In Cognitive Impairment, especially dementia" and the development of the internationally agreed observational PAIC15 scale. The 3-hour capsule, intended for healthcare workers and caregivers, consists of theoretical-practical levels: 1) basic concepts and challenges in pain in aging, cognitive impairment/dementia, 2) available scales and PAIC15, 3) video presentation of clinical cases illustrating a 3×2 matrix of situations (rest, transfer and experimental pain) and stages of disease (mild and moderate). The objectives focused on training the ability to observe, detect, and assess the signs of pain using PAIC15 and its feasibility. The pre-post analysis in a Master educational setting showed agreement with the results obtained in the Spanish national survey on 1) scarce knowledge of observational tools and their use, and 2) uncertainty in the identification of signs of pain and feasibility in moderate/severe scenarios. The capsule improved the ability to identify and evaluate the pain items, especially facial expressions, and their confidence on observational tools. Debriefings highlighted the relevance of observational scales in dementia and the gain obtained using the new observational instrument.

A high proportion of dogs and cats are fearful during veterinary visits, which in some cases may escalate into aggression. Here, we discuss factors that contribute to negative emotions in a veterinary setting and how these can be addressed. The set-up of the waiting area (e.g. spatial dividers; elevated places for cat carriers), tailoring the examination and the treatment to the individual, considerate handling (minimal restraint when possible, avoiding leaning over or cornering animals) and offering high-value food or toys throughout the visit can promote security and, ideally, positive associations. Desensitisation and counterconditioning are highly recommended both to prevent and address existing negative emotions. Some negative experiences such as short-term pain from injections can be minimised by using tactile and cognitive distractions. Preemptive analgesia is recommended for known painful procedures. Recommendations for handling fearful animals to minimise aggressive responses are discussed. However, anxiolytics or sedation should be used whenever there is a risk of traumatising an animal or for safety reasons. Stress-reducing measures can decrease stress and fear in patients and consequently their owners – thus strengthening the relationship with the clients as well as increasing the professional satisfaction of veterinary staff.

The work presented in this paper makes multiple scientific contributions related to the investigation of the global fear associated with COVID-19 by performing a comprehensive analysis of a dataset comprising survey responses of participants from 40 countries. First, the results of subjectivity analysis of responses where participants indicated their biggest concern related to COVID-19 showed that the average subjectivity in responses by the age group of 41-50 decreased from April 2020 to June 2020, the average subjectivity in responses by the age group of 71-80 drastically increased from May 2020, and the age group of 11-20 indicated the least level of subjectivity in their responses between June 2020 to August 2020. Second, subjectivity analysis also revealed the percentage of highly opinionated, neutral opinionated, and least opinionated responses per age-group where the analyzed age groups were 11-20, 21-30, 31-40, 41-50, 51-60, 61-70, 71-80, and 81-90. For instance, the percentage of highly opinionated, neutral opinionated, and least opinionated responses by the age group of 11-20 were 17.92%, 16.24%, and 65.84%, respectively. Third, data analysis of responses from different age groups showed that the highest percentage of responses indicating that they were very worried about COVID-19 came from individuals in the age group of 21-30. Fourth, data analysis of the survey responses also revealed that in the context of taking precautions to prevent contracting COVID-19, the percentage of individuals in the age group of 31-40 taking precautions was higher as compared to the percentages of individuals from the age groups of 41-50, 51-60, 61-70, 71-80, and 81-90. Finally, a deep learning model was developed to detect if the survey respondents were seeing or planning to see a psychologist or psychiatrist for any mental health issues related to COVID-19. The deep learning model used the responses to multiple questions in the context of fear, preparedness, and response related to COVID-19 from the dataset and achieved an overall performance accuracy of 91.62% after 500 epochs.

Deepfake technologies are known for the creation of forged celebrity pornography, face and voice swaps, and other fake media content. Despite the negative connotations the technology bears, the underlying machine learning algorithms have a huge potential that could be applied to not just digital media, but also to medicine, biology, affective science, and agriculture, just to name a few. Due to the ability to generate big datasets based on real data distributions, deepfake could also be used to positively impact non-human animals such as livestock. Generated data using Generative Adversarial Networks, one of the algorithms that deepfake is based on, could be used to train models to accurately identify and monitor animal health and emotions. Through data augmentation, using digital twins, and maybe even displaying digital conspecifics where social interactions are enhanced, deepfake technologies have the potential to increase animal health, emotionality, sociality, animal-human and animal-computer interactions and thereby animal welfare, productivity, and sustainability of the farming industry.

This study investigated the prevalence and associated risk factors of Lower Back Pain (LBP) among medical students of Alfaisal University, Riyadh, Saudi Arabia. A cross-sectional style was employed where 331 medical students were evaluated using the Oswestry Disability Index (ODI) supplemented with demographic and lifestyle questions. Data analysis allowed identification of LBP-risk factor relationships. The study revealed a 73.4% prevalence of LBP among Alfaisal University medical students with a 4.61 average severity. Female students, those who spent long hours on computers, and those who did not exercise were more likely to experience LBP. Higher disability degree was associated with participants aged &gt;21, used their devices for extended periods, and insufficient sleep. LBP is highly prevalent with several risk factors existing. These findings highlight the need for targeted interventions such as ergonomic/lifestyle improvements and reduced device use.

With the rapid development of society and the deteriorating natural environment, there has been an increase in public events. This study aimed to explore how sadness and fear in the context of public emergency influence moral judgments. This research first induced feelings of sadness and fear by videos about public events and music, and then used moral scenarios from the CNI model to assess participants’ moral thinking. In Study 1, participants were divided into sadness group and neutral group, while in Study 2, participants were divided into fear group and neutral group. During the experiment, participants were exposed to different videos related to public events to induce the corresponding emotions, and emotional music was continuously played throughout the entire experiment. Participants were then asked to answer questions regarding moral judgments. The results showed that based on CNI model, sadness induced in the context of public events significantly increased C parameter, without affecting N or I parameter. Fear increased I parameter, without affecting C or I parameter. That is, sadness and fear induced in the context of public events can influence moral judgments. Specifically, sadness increases individuals’ sensitivity to consequence, and fear increases the general preference for inaction in moral judgments.

Background/Objectives: Transforaminal endoscopic lumbar discectomy (TELD) under local anesthesia is a promising minimally invasive surgical option for intractable lumbar disc herniation (LDH). However, our understanding of access pain prediction during foraminal pathological procedures is limited. To our knowledge, no predictive rules for access pain during TELD have been established for foraminal or extraforaminal LDH. This study, with its potential to predict access pain during TELD and to discuss strategies for pain prevention and management, could significantly impact the field of endoscopic spine surgery. Methods: This observational study included 73 consecutive patients who underwent TELD for foraminal or extraforaminal LDH between January 2017 and December 2022. Preoperative clinical and radiographic factors affecting significant access pain and the impact of access pain on clinical outcomes were evaluated. Results: The rate of significant access pain was 13.70% (10 of 73 patients). Extraforaminal LDH tended to cause more severe pain than foraminal LDH during TELD under local anesthesia (p &lt; 0.05). Although the degree of access pain was not related to global outcomes, increased pain was strongly associated with a prolonged operative time and length of hospital stay (p &lt; 0.05). Conclusions: TELD can be an effective surgical option for foraminal or extraforaminal LDH under local anesthesia. More access pain may develop during TELD for extraforaminal LDH. The extraforaminal component of LDH can narrow the safety working zone. Significant access pain may prolong the duration of surgery and hospitalization. Thus, a specialized technique is required for the clinical success of TELD.

Severe cancer pain significantly diminishes patients' quality of life, leading to increased reliance on caregivers. Although opioid analgesics are effective, they may induce opioid-induced bowel dysfunction (OIBD) with symptoms such as nausea, vomiting, drowsiness, and constipation. While controlled-release oxycodone is a viable option, its prolonged use can lead to opi-oid-induced constipation (OIC). Addressing this, a relative novel formulation - a fixed 2:1 ratio of oxycodone and naloxone in prolonged release - aims to provide analgesia while alleviating OIC. This review critically assesses the evidence on the efficacy, safety, and patient experience of ox-ycodone/naloxone prolonged release in managing severe cancer pain, emphasizing the necessity for a targeted approach in this patient population.

Information on the nutritive value and in vitro fermentation characteristics of native shrubs in New Zealand is scant. This is despite their potential as alternatives to exotic trees and shrubs for sup-plementary fodder, and mitigation of greenhouse gas and soil erosion on hill country sheep and beef farms. The objectives of this study were to measure the in vitro fermentation gas production, predict parameters of in vitro fermentation kinetics and to estimate in vitro fermentation of volatile fatty acids (VFA), microbial biomass (MBM) and greenhouse gases of four native shrubs (Coprosma robusta, Griselinia littoralis, Hoheria populnea and Pittosporum crassifolium) and an exotic fodder tree species, Salix schwerinii. Total in vitro gas production was higher (p<0.05) for natives than S. schwerinii. Prediction using the single pool model resulted in biologically incorrect negative in vitro total gas production from the immediately soluble fraction of the native shrubs. However, the dual pool model better predicted in vitro total gas production and was in alignment with measured in vitro fermentation end products. In vitro VFA and greenhouse gas production from fermentation of leaf and stem material were higher (p<0.05), and MBM lower (p<0.05), for native shrubs com-pared to S. schwerinii. The lower in vitro total gas production, VFA and greenhouse gases produc-tion, and higher MBM of S. schwerinii may be explained by the presence of condensed tannins (CT), although this was not measured and requires further study. In conclusion, results from this study suggests that when consumed by ruminant livestock, the browsable native shrubs can provide adequate energy and microbial protein, and that greenhouse gas production from these species is within ranges reported for typical New Zealand pastures.

This study examines the relationship of fear of missing out (FOMO) with heavy social networking among Turkish university students (aged 17 - 55). The perception of the possible role of parental supervision on online activities is also investigated. Factor analysis of FOMO scale led us to evaluate the construct under two dimensions as (1) fear of missing experience and (2) fear of missing activity. The results revealed that fear of missing activity increases social media intrusion while fear of missing experience is found to have no significant effect. The reverse relationship is also valid: an urge to use social media predicts fear of missing out (activity and experience). Fear of missing experience is associated with problematic social media use (PSMU) and a high desire to use social media. The results additionally demonstrate that students aged 30 and older believe more in the requirement of parental control than those aged 17-22.

A good management of diabetes requires at the same time self-regulation behaviour and a balanced involvement of family components. This study’s aims were: understanding fear of injections and perceptions of family conflicts in preadolescents and adolescents with type 1 diabetes mellitus and their mothers, comparing their perceptions, and identifying the risk factors impacting patients’ quality of life. Participants were one hundred and two patients (Mean age = 14.63, SD = 2.43; age range = 10-19 years; Females = 52) and their mothers (Mean age = 46.94, SD = 6.2, age range = 27-63 years), who filled in self and proxy-report questionnaires. Twenty % of patients and 14.7% of their mothers reported clinical score for fear of self-injection and blood testing. Mothers reported higher fear of injecting and family conflicts compared with the patients. Age, fear of injecting and family conflicts impacted significantly on patients’ quality of life perceptions. Clinical consideration and recommendations are given basing on the empirical results.

The trigeminal nerve is responsible for innervating the periorbita. Ultrasound-guided trigeminal block is employed in humans for trigeminal neuralgia or periorbital surgery. There are no studies evaluating this block in dogs. This study aims to evaluate and compare two approaches (coronoid and temporal) of the trigeminal nerve block. We hypothesized superior staining with the coronoid approach. Thirteen dog heads were used. After a preliminary anatomical study, two ultrasound-guided injections per head (right and left, coronoid and temporal approach, randomly assigned), with an injectate volume of 0.15 mL cm-1 of cranial length were performed (iodate contrast and tissue dye mixture). The ultrasound probe was placed over the temporal region, visualizing the pterygopalatine fossa. For the temporal approach, the needle was advanced from the medial aspect of the temporal region in a dorsoventral direction. For the coronoid approach, it was advanced ventral to the zygomatic arch in a lateromedial direction. CT scans and dissections were conducted to assess and compare the position of the needle, spread of injectate, and nerve staining. No significant differences were found. Both approaches demonstrated effective interfascial distribution of injectate, with some minimal intracranial spread. Although the coronoid approach did not yield superior staining as hypothesized, it presents a viable alternative to the temporal approach. Studies in live animals are warranted to evaluate clinical efficacy and safety.

Motor control, movement impairment and postural control recovery targeted in rehabilitation could be affected by pain. The main objective of this comprehensive review is to provide a synthesis of the effect of experimental and chronic pain on postural control throughout the available literature. After presenting the neurophysiological pathways of pain, we demonstrated that pain, preferentially localized at low back or in the leg induced postural control alteration. While proprioceptive and cortical excitability seems modified with pain, spinal modulation assessment might provide new understanding of the pain phenomenon related to postural control. Literature highlight that the motor control of trunk muscles in patient presenting with low back pain could be dichotomized in two populations, where the first one over-activate trunk muscles, the second one under-activate trunk muscles, and both generating increase of tissues loading. Taking account all this findings, will help clinician to provide adapted treatment for managing both pain and postural control.

This study investigates the impact of real-time emotional feedback on the quality of teamwork conducted over videoconferencing. We developed a framework that provides real-time feedback through a virtual mirror based on facial and voice emotion recognition. In an experiment with 28 teams (84 participants), teams collaborated over Zoom to set up a virtual Mars station using custom simulation software. Participants were divided into 14 experimental teams which were shown the virtual mirror, and 14 control teams without it. Team performance was measured by the improvement in the Mars simulation output quality. Our analysis using correlation, multilevel regression, and machine learning revealed that fewer interruptions but an increasing number over time correlated with higher performance. Higher vocal arousal and happiness also enhanced performance. We confirmed that female presence in teams boosts performance. SHAP values indicated that high variability in happiness, head movement, and positive facial valence—an “emotional rollercoaster”—positively predicted team performance. The experimental group outperformed the control group, suggesting that virtual mirroring improves virtual teamwork and that interrupting each other more, while speaking less, leads to better results.

PurposeThis study was designed to characterize the psychometric properties of the Persian version of the Fear of Hospitalization Scale (P-FHS).Design and methodsIn order to evaluate the validity and reliability of the translated scale, a cross-sectional design was employed. Ten experts evaluated the content validity of the Fear of Hospitalization Scale (FHS) after it had been back-translated into Persian. With 612 patients having emergency surgery, construct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The STROBE checklist for cross-sectional studies was followed.FindingsThe results of EFA (n = 306) showed that the fear of hospitalization had three factors. These three factors accounted for 45.28% of the total variance. Also, these factors were confirmed by CFA (n = 306) (root-mean-square error of approximation = (90%. confidence interval) = 0.050 [0.041, 0.058], goodness-of-fit index = 0.945, comparative fit index = 0.968, Non-Normal Fit Index = 0.948, incremental fit index = 0.968, Tucker-Lewis Index = 0.959). The coefficients of Cronbach’s alpha, McDonald’s omega, composite reliability, and maximum reliability for all three factors were greater than 0.7, demonstrating satisfied internal consistency.Practice implicationAccording to the published results, the P-FHS is effective at measuring hospitalization anxiety in patients undergoing emergency surgery. It is advised that nurses in Iranian culture use a legitimate and trustworthy technique to pinpoint the causes of hospitalization anxiety in patients undergoing emergency surgery to give optimal care.

Low back pain (LBP) is a health problem that affects 70-80% of the population in Western countries. Because of the biomechanical relationship between the lumbar region and the hip, it is thought that strengthening the muscles of this joint could improve the symptoms of people with LBP. The objective of the study is to evaluate the current evidence on the efficacy of hip strengthening exercises to reduce pain and disability in people with LBP. Clinical trials were collected from PubMed, PEDro, and Scopus databases published up to September 2022. Based on Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and using CASpe and PEDro tools for methodological quality assessment, we selected studies that included hip strengthening exercises as part of LBP treatment and measured pain and/or disability parameters. Among the 966 records identified in the search, a total of 7 studies met the established selection criteria. Overall, participants who performed hip strengthening exercises had significantly improved in pain and disability. The methodological quality of the included studies was assessed as “good”. In conclusion, the addition of hip muscle strengthening exercises iterating LBP effectively improving pain and disability.

Chronic pain has increasingly become a significant health challenge, not just as a symptomatic manifestation but also as a pathological condition with profound socioeconomic implications. Despite the expansion of medical interventions, the prevalence of chronic pain remains remarkably persistent, prompting a turn towards non-pharmacological treatments, such as therapeutic education, exercise and cognitive-behavioral therapy. With the advent of cognitive neuroscience, pain is often presented as a primary output derived from the brain, aligning with Engel's Biopsychosocial Model which views disease not solely from a biological perspective but also considering psychological and social factors. This paradigm shift, brings forward potential misconceptions and over-simplifications. The current review delves into the intricacies of nociception and pain perception. It questions long-standing beliefs like the cerebral-centric view of pain, the forgotten role of the peripheral nervous system in pain chronification, misconceptions around central sensitization syndromes, the controversy about the existence of a dedicated pain neuromatrix, the consciousness of the pain experience and the possible oversight of factors beyond the nervous system. In re-evaluating these aspects, the review emphasizes the critical need for understanding the complexity of pain, urging the scientific and clinical community to move beyond reductionist perspectives and consider the multifaceted nature of this phenomenon.

Myofascial pain is the most common cause of chronic pain in the masticatory region and can be assessed through clinical analysis and muscle palpation. Generally, it appears with headache and orofacial pain associated with sensitive points (trigger points) due to the excessive contraction of the masticatory muscle fibres. The study aims to evaluate how a correct treatment of myofascial pain can improve the life quality of the affected patients. In this case series, 300 patients with myofascial pain were divided into two groups: 150 with intra- and extra-articular disorder and 150 with the only extra-articular disorder. Each group included 75 males and 75 females. All the patients were treated with gnathological therapy through passive aligners and biofeedback exercises for 4 months. They underwent pain assessment (through a visual analogue scale and muscular palpation test) before, during and after the treatment, and nuclear magnetic resonance of the temporomandibular joint before and after the gnathological treatment. The treatment considerably reduced the pain in all patients, without drugs, in 4 months, according to the visual analogue scales and the palpation test. The temporomandibular magnetic resonance in each patient was similar before and after the gnathological treatment. The improvement in pain did not depend on a change in the relationship between the articular condyle and the disc.

(1) Background: Research has shown that thoughts about pain are important for the management of chronic pain in children. In order to monitor changes in thoughts about pain over time and evaluate the efficacy of treatments, we need valid and reliable measures. The aims of this study were to develop a questionnaire to assess a child’s concept of pain and to evaluate its psychometric properties; (2) Methods: This is a cross-sectional, two-phase, mixed-method study. A total of 324 individuals aged 8 to 17 years old responded to the newly created questionnaire. The Survey of the Concept of Pain (SOCOPA) was calibrated using the Rasch model. The chi-square test was used for the fit statistics. Underfit and overfit of the model were determined and a descriptive analysis of infit and outfit was conducted to identify who responded erratically. Internal consistency was measured using the Person Separation Index (PSI); (3) Results: Fit to the Rasch model was good. Suitable targeting indicated which items were simple to answer; Person Fit identified 9.56% children who responded erratically; PSI=0.814; (4) Conclusions: The findings suggest that SOCOPA is a measure of a child’s concept of pain that is easy to administer and respond to. It has a good fit and a good internal consistency.

The ability to efficiently recognize the emotions on others’ faces is something that most of us take for granted. Children with callous-unemotional (CU) traits and impulsivity/conduct problems (ICP), such as attention-deficit hyperactivity disorder, have been previously described as being “fear blind”. This is also associated with looking less at the eye regions of fearful faces, which are highly diagnostic. Previous attempts to intervene into emotion recognition strategies have not had lasting effects on participants’ fear recognition abilities. Here we present both (a) additional evidence that there is a two-part causal chain, from personality traits to face recognition strategies using the eyes, then from strategies to rates of recognizing fear in others; and (b) a pilot intervention that had persistent effects for weeks after the end of instruction. Further, the intervention led to more change in those with the highest CU traits. This both clarifies the specific mechanisms linking personality to emotion recognition and shows that the process is fundamentally malleable. It is possible that such training could promote empathy and reduce the rates of antisocial behavior in specific populations in the future.

The physiological mechanisms that underlie the generation and maintenance of pain are diverse. There are afferent fibers that receive sensory information and transfer the information to the central nervous system. However, when trying to classify and determine their molecular characteristics, it becomes a difficult task due to the variety of markers that they share. With current technological advances, it is possible to specifically modulate the fibers that process pain signaling through optogenetics and chemogenetics. Nonetheless, to accomplish this aim it is necessary a specific identification of each neuron subtypes involved. This review addresses the molecular markers present in the nociceptive fibers responsible for sensory signals and the use of these molecular markers as optogenetics targets to modulate nociceptive behavior.

As neck and/or shoulder pain (NSP) frequently occur together with tension-type headache (TTH) and migraine, we explored how concomitant NSP affects perceived treatment responses to an analgesic. An anonymous survey was performed among 895 TTH and migraine sufferers who used the analgesic 400 mg ibuprofen/100 mg caffeine. NSP was relatively abundant among patients (42.4% for TTH; 39.2% for migraine), and associated with &gt;1 additional day with headache per month. Reported pain reduction was independent from NSP for TTH and migraine. More patients became pain-free at 2 h in migraine with NSP (42.9%) compared to migraine without NSP (32.2%), which is different from TTH with NSP (60.6%) and TTH without NSP (71.4%). For both, migraine and TTH, a recurrence of headache on the same day was more prevalent in those with concomitant NSP leading to a greater likelihood of taking a second dose of the analgesic. NSP frequently occurs together with TTH and migraine patients. In migraine, NSP seems to be associated with a better treatment response at 2 h. The more frequent recurrence of pain in those with concomitant NSP indicates that NSP makes both headache types worse. Further studies are needed to substantiate these effects.

The correlation between pain and emotional status in subjects with temporomandibular disorders (TMD) is known. Regardless of that up to date these findings were seldomly confronted with the objective assessment of pain using a digital algometer on the mastication muscles. The aim of the study was to investigate the relationship between the emotional status, chronic pain pain pressure threshold (PPT). 38 subjects were screened for the existence of temporomandibular disorders with the 3Q/TMD questionnaire, for chronic pain (GCPS) and emotional status (PHQ-9 and GAD-7). The results were confronted with the PPT measured with the digital algometer on the masseter muscles. Each subject was examined three times (after 1 month and after 7 months from the initial exami-nation session. Chronic pain scores (GCPS) were found to be higher in the TMD group in all three examination sessions (p<0,05). The pain, depression and anxiety levels were higher in females de-spite the existence of TMD, but only some were significant.A correlation between chronic orofacial pain scores and PPT was found in 2 out of 3 examination sessions. The PPT scores on the masseter muscles did not correlate with the emotional state in the study population.

Migraine and neuropathic pain (NP) are evocative of painful, disabling, chronic conditions which exhibit resembling symptoms and thus considered to share a common etiology. Calcitonin gene-related peptide (CGRP) has gained credit as a target for migraine management; nevertheless, the efficacy and the applicability of CGRP modifiers warrant search for more effective therapeutic targets for pain management. This scoping review overviews human studies of common pathogenic factors in migraine and NP to explore potential novel therapeutic targets. CGRP causes inflammation in the meninges; monoclonal antibodies and inhibitors target CGRP. Gluta-mate-induced hyperexcitability and subsequent sensitization are closely linked to an alteration of the tryptophan (Trp)-kynurenine (KYN) metabolic system; the Trp-KYN system may serve as a potential target. Microglial overaction is observed in migraine and NP; modifying the microglial activity may be a possible approach. Cytokine-induced inflammation is a leading hypothesis of the pathogenesis of the conditions; alleviating neuroinflammation may complement a pain-relieving armamentarium. Transient receptor potential (TRP) ion channels evoke the release of several substances; TRP ion channels may potentially emerge as new targets. The endocannabinoid system plays a major role in the pain trafficking pathway; modification of the system may open a new path toward discovery of new analgesics. Here we highlight the mechanism of those common pathogenic factors to explore therapeutic targets for innovative pain management in migraine and NP.

Pain is a natural bioassay for detecting and quantifying biological activities of venoms. The painfulness of stings delivered by ants, wasps, and bees can be easily measured in the field or lab using the stinging insect pain scale that rates the pain intensity from 1 to 4, with 1 being minor pain, and 4 being extreme, debilitating, excruciating pain. The painfulness of stings of 96 species of stinging insects and the lethalities of the venoms of 90 species was determined and utilized for pinpointing future promising directions for investigating venoms having pharmaceutically active principles that could benefit humanity. The findings suggest several under- or unexplored insect venoms worthy of future investigations, including: those that have exceedingly painful venoms, yet with extremely low lethality – tarantula hawk wasps (Pepsis) and velvet ants (Mutillidae); those that have extremely lethal venoms, yet induce very little pain – the ants, Daceton and Tetraponera; and those that have venomous stings and are both painful and lethal – the ants Pogonomyrmex, Paraponera, Myrmecia, Neoponera, and the social wasps Synoeca, Agelaia, and Brachygastra. Taken together, and separately, sting pain and venom lethality point to promising directions for mining of pharmaceutically active components derived from insect venoms.

Background/Objectives: Intervertebral disc degeneration is the most common cause of low back pain (LBP) and lumbosciatica is a major challenge to healthcare systems worldwide. ''For years, ozone therapy has been used with excellent results in intervertebral disc disease and in patients with LBP, thanks to its anti-inflammatory and pain-relieving action.'' At the other side, the repair effect fulfilled by porcine collagen, is a novelty to approach this pathology. In vitro studies have demonstrated the positive action of porcine collagen in extracellular matrix remodeling and homeostasis These tissue changes, associated with LBP, may suggest an indication for combined ozone/collagen treatment in patients with LBP. However, no studies have been reported regarding this combination of treatments. Methods: The present work compared two treatment groups (each of 10 LBP patients): A) Oxygen-Ozone Therapy (OOT) vs. B) OOT plus porcine collagen type 1 injections (COL I). Pain intensity and physiological function were assessed by the numerical rating scale (NSR) method. The Roland-Morrison questionnaire was used to assess disability. Patient data were acquired before, during and at six months of follow-up. Significant differences were assessed by ANOVA and T-Student test. Results: The analyses revealed significant statistical differences comparing the two arms, where, the OOT COL I treatment demonstrated a booster efficacy in pain, while the questionnaire revealed a reduction in disability. Conclusions:. The combination of these two therapies could be effective for the management of LBP. However no studies have been reported in literature regarding this therapeutic combination.

Background: Alarming data indicates that low back pain (LBP) affected around 619 million people globally in 2020, that presenting significant health and economic burden. Importantly, the chronic LBP (cLBP) strongly impairs quality of life and leads to disability and premature retirement thus emphasizing the urgent need for providing deeper insight into the factors that affect treatment outcomes and offer thorough guidance for the assessment and management of this disease. Taking into consideration the rising prevalence of cLBP and knowledge gap referring to the overall health benefits of balneotherapy (BT), the aim of this study was to assess the effects of BT on functional status, quality of life and psychological symptoms in patients with cLBP. Methods: A total 210 patients were recruited and divided into two groups: patients receiving conventional pharmacological therapy (CT) and receiving BT. The effectiveness of the treatment was assessed on the basis of Visual Analog Scale for pain intensity, EuroQol (EQ-5D) for the patient’s self-rated health and Work Ability Index Questionnaire to evaluate functional ability. In order to provide deeper insight into the quality of life and also factors associated with the functional status and mental health affected by BT, we also used the Short Form Health Survey Questionnaire and Center of Epidemiologic Studies Depression Scale. Results: Our findings suggest that BT significantly contributed to reduction of pain, better functionality and disability perception status. Conclusions: Understanding the association between individual perceptions of functionality, emotional and social elements provides basis for providing comprehensive guidelines and recommendations for cLBP management.

Disruptive selection arises when extreme phenotypes have a fitness advantage compared to more intermediate phenotypes. Theory and evidence suggest that intraspecific resource competition is a key driver of disruptive selection. However, while competition can be indirect (exploitative) or direct (interference), the role of interference competition in disruptive selection has not been tested, and most models of disruptive selection assume exploitative competition. We experimentally investigated whether the type of competition affects the outcome of competitive interactions using a system where disruptive selection is common: Mexican spadefoot toads (Spea multiplicata). Spea tadpoles develop into alternative resource-use phenotypes: carnivores, which consume fairy shrimp and other tadpoles, and omnivores, which feed on algae and detritus. Tadpoles intermediate in phenotype have low fitness when competition is intense, as they are outcompeted by the specialized tadpoles. Our experiments revealed that the presence of carnivores significantly decreased foraging behavior in intermediate tadpoles, and that intermediate tadpoles had significantly lower growth rates in interference competition treatments with carnivores but not with omnivores. Interference competition may therefore be important in driving disruptive selection. As carnivore tadpoles are also cannibalistic, the ‘fear’ effect may have a greater impact on intermediate tadpoles than exploitative competition alone, similarly to non-consumptive effects in predator-prey or intraguild relationships.

Fear extinction requires coordinated neural activity within the amygdala and medial prefrontal cortex (mPFC). Any behavior has a transcriptomic signature that is modified by environmental experiences, and specific genes are involved in functional plasticity and synaptic wiring during fear extinction. Here, we investigated the effects of optogenetic manipulations of prelimbic (PrL) pyramidal neurons on amygdala gene expression to analyze the specific transcriptional pathways involved in adaptive and maladaptive fear extinction. To this aim, transgenic mice were (or not) fear-conditioned and during the extinction phase they received optogenetic (or sham) stimulations over PrL pyramidal neurons. At the end of behavioral testing, electrophysiological (neural cellular excitability and Excitatory Post-Synaptic Currents) and morphological (spinogenesis) correlates were evaluated in the PrL pyramidal neurons. Furthermore, transcriptomic cell-specific RNA-analyses (differential gene expression profiling and functional enrichment analyses) were performed in amygdala pyramidal neurons. Our results show that the optogenetic activation of PrL pyramidal neurons in fear-conditioned mice induces fear extinction deficits, reflected in an increase of cellular excitability, excitatory neurotransmission, and spinogenesis of PrL pyramidal neurons, and in strong modifications of the transcriptome of amygdala pyramidal neurons. Understanding the electrophysiological, morphological and transcriptomic architecture of fear extinction may facilitate the comprehension of fear-related disorders.

The COVID-19 pandemic has had a profound impact on the mental health, adjustment, and psychological well-being of young adults. Despite extensive research conducted in this area, eudaimonic well-being, one specific form of psychological well-being focusing on self-knowledge and self-realization within existential challenges, has received comparatively less attention. The current study aimed to investigate the potential linkages between two key psychological factors, psychological inflexibility and fear of death, with eudaimonic well-being among young adults in the context of the Covid-19 pandemic. One year after the outbreak, 317 young Italian adults (18-34 yrs.) participated in an online survey, including measures of psychological inflexibility (AAQ-II), fear of death (CL-FODS), and eudaimonic well-being (PWB). Results showed that psychological inflexibility was negatively associated with all the dimensions of Ryff’s model of eudaimonic well-being, while fear of death of others was found to be associated with three of these dimensions (autonomy, environmental mastery, and self-acceptance). Results also indicated a mediation role of psychological inflexibility in the association between fear of death and eudaimonic well-being. These findings expand our knowledge of the potential factors that may influence eudaimonic well-being and provide insights for clinical work with young adults challenged by uncertain times.

Diabetes mellitus is the global epidemic of the 21st century affecting millions worldwide. Usually, patients with long-standing type one diabetes (T1D) or type two diabetes (T2D) tend to develop complications. A common complication is the degenerative of the nerves in the peripheral nervous system (PNS). This complication is known as distal symmetric polyneuropathy or just diabetic neuropathy. A variety of symptoms can be experienced with this complication, including pain and numbness. One characterization of this complication is the sensory loss that begins in the lower extremities and spreads substantially to the fingers and hand. There is no clear mechanism for how this happens in diabetic patients. Studies have shown that nerve damage from this complication can be due to oxidative stress, sorbitol accumulation, and advanced glycation end products (AGEs). Some of the most common medications being provided for diabetic neuropathic pain (DNP) include amitriptyline and desipramine. Other medications also include gabapentin and duloxetine. There are noninvasive options, such as acupuncture, that could provide beneficial data if rigorous studies are conducted. A number of new studies are being completed to identify more effective treatments for this condition.