Pain management in percutaneous nephrolithotomy — an approach rooted in pathophysiology
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Modulating neuroplasticity for chronic pain relief: noninvasive neuromodulation as a promising approach
Chronic neuropathic pain is a debilitating neuroplastic disorder that notably impacts the quality of life of millions of people worldwide. This complex condition, encompassing various manifestations, such as sciatica, diabetic neuropathy and postherpetic neuralgia, arises from nerve damage or malfunctions in pain processing pathways and involves various biological, physiological and psychological processes. Maladaptive neuroplasticity, known as central sensitization, plays a critical role in the persistence of chronic neuropathic pain. Current treatments for neuropathic pain include pharmacological interventions (for example, antidepressants and anticonvulsants), invasive procedures (for example, deep brain stimulation) and physical therapies. However, these approaches often have limitations and potential side effects. In light of these challenges, interest in noninvasive neuromodulation techniques as alternatives or complementary treatments for neuropathic pain is increasing. These methods aim to induce analgesia while reversing maladaptive plastic changes, offering potential advantages over conventional pharmacological practices and invasive methods. Recent technological advancements have spurred the exploration of noninvasive neuromodulation therapies, such as repetitive transcranial magnetic stimulation, transcranial direct current stimulation and transcranial ultrasound stimulation, as well as innovative transformations of invasive techniques into noninvasive methods at both the preclinical and clinical levels. Here this review aims to critically examine the mechanisms of maladaptive neuroplasticity in chronic neuropathic pain and evaluate the efficacy of noninvasive neuromodulation techniques in pain relief. By focusing on optimizing these techniques, we can better assess their short-term and long-term effects, refine treatment variables and ultimately improve the quality of neuropathic pain management.
Treatment modalities for patients with Persistent Spinal Pain Syndrome Type II: A systematic review and network meta-analysis
Appropriate management of patients with Persistent Spinal Pain Syndrome Type 2 (PSPS-T2) remains challenging. The need for robust evidence for treatment modalities is urgently pressing. The aim of this systematic review and network meta-analysis (NMA) is to compare different treatment modalities for patients with PSPS-T2 on pain intensity.
Effect of regional crosstalk between sympathetic nerves and sensory nerves on temporomandibular joint osteoarthritic pain
Temporomandibular joint osteoarthritis (TMJ-OA) is a common disease often accompanied by pain, seriously affecting physical and mental health of patients. Abnormal innervation at the osteochondral junction has been considered as a predominant origin of arthralgia, while the specific mechanism mediating pain remains unclear. To investigate the underlying mechanism of TMJ-OA pain, an abnormal joint loading model was used to induce TMJ-OA pain. We found that during the development of TMJ-OA, the increased innervation of sympathetic nerve of subchondral bone precedes that of sensory nerves. Furthermore, these two types of nerves are spatially closely associated. Additionally, it was discovered that activation of sympathetic neural signals promotes osteoarthritic pain in mice, whereas blocking these signals effectively alleviates pain. In vitro experiments also confirmed that norepinephrine released by sympathetic neurons promotes the activation and axonal growth of sensory neurons. Moreover, we also discovered that through releasing norepinephrine, regional sympathetic nerves of subchondral bone were found to regulate growth and activation of local sensory nerves synergistically with other pain regulators. This study identified the role of regional sympathetic nerves in mediating pain in TMJ-OA. It sheds light on a new mechanism of abnormal innervation at the osteochondral junction and the regional crosstalk between peripheral nerves, providing a potential target for treating TMJ-OA pain.
Sustainable supply chain management practices and performance: The moderating effect of stakeholder pressure
Currently, sustainable supply chain management practices have become an important strategy for firms to improve performance and gain competitive advantage. However, there is a current debate over the performance outcomes of sustainable supply chain management practices. Additionally, the role of stakeholder pressure is frequently overlooked. Drawing on Natural Resources-Based View and Stakeholder Theory, this study aims to elucidate the ambiguous connection between sustainable supply management, sustainable process management, stakeholder pressure and performance, and investigate the mediation role of sustainable process management and the moderation effect of stakeholder pressure. Our analysis, based on data collected from 235 Chinese manufacturing firms, reveals significant insights. First, stakeholder pressure positively moderates the relationship between sustainable process management and performance, while negatively moderates the relationship between sustainable supply management and performance. Second, sustainable process management has a complete mediation effect on the relationship between sustainable supply management and performance. The conclusion not only explains the inconsistent relationship between sustainable supply chain management practice and performance, but also reveals clearly the relationship between sustainable supply management and sustainable process management. Besides, it also highlights the difference in performance outcomes of sustainable supply management and sustainable process management under stakeholder pressures, and has valuable guidance to the practice of sustainable supply chain management in Chinese manufacturing firms.
Management practices and manufacturing firm responses to a randomized energy audit
Increasing the efficiency of industrial energy use is widely considered important for mitigating climate change. We randomize assignment of an energy audit intervention aimed at improving energy efficiency and reducing energy expenditures of small- and medium-sized metal processing firms in Shandong Province, China, and examine impacts on energy outcomes and interactions with firms’ management practices. We find that the intervention reduced firms’ unit cost of electricity by 8% on average. Firms with more developed structured management practices showed higher rates of recommendation adoption. However, the post-intervention electricity unit cost reduction is larger in firms with less developed practices, primarily driven by a single recommendation that corrected managers’ inaccurate reporting of transformer usage at baseline, lowering their electricity costs. By closing management-associated gaps in awareness of energy expenditures, energy audit programmes may reduce a firm’s unit cost of energy but have an ambiguous impact on energy use and climate change.
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