Articles

<b>Objective: </b>Kratom (Mitragyna speciosa) has emerged as a widely accessible nonprescription substance that is being utilized in the United States. Kratom is commonly used for self-management of pain, psychiatric symptoms, and opioid withdrawal. Veterans receiving care within the Veterans Health Administration (VHA) represent a high-risk population due to elevated rates of chronic pain, post-traumatic stress disorder (PTSD), and substance use disorders (SUDs). Despite increasing prevalence, kratom use remains underrecognized and is not routinely assessed in clinical practice. This narrative review studies the pharmacology, patterns of use, and clinical implications of kratom among Veterans and proposes a standardized screening framework for implementation within the VHA. This will help to align with the patient centered care delivered to our Veterans related to mental health conditions often concurrent with substance use, pain management, and opioid safety. <b>Methods:</b> A targeted narrative review of the literature was conducted using PubMed, Google Scholar, and relevant federal agency reports. Search terms included “kratom,” “Mitragyna speciosa,” “substance use disorder,” “opioid withdrawal,” and “Veterans.” Articles were selected based on relevance to pharmacology, epidemiology, adverse effects, and clinical implications. Findings were synthesized and interpreted using DSM-5-TR substance use disorder criteria. <b>Results:</b> Kratom exhibits partial agonist activity at μ-opioid receptors, producing dose-dependent stimulant and opioid-like effects. According to the National Institutes of Health's National Library of Medicine, mu-opioid receptors, found in the brain and spinal cord, are primarily responsible for pain relief and other opioid-like effects such as euphoria and respiratory depression. Veterans frequently use kratom to self-manage pain, mood symptoms, and opioid withdrawal (Garcia-Romeu et al., 2020; Grundmann, 2017). Kratom use is associated with dependence, withdrawal, and increased risk of polysubstance use (Post et al., 2019). Detection remains limited due to lack of standardized screening tools and the absence of detection in routine toxicology panels. <b>Conclusions:</b> Given the rising incidence of kratom use among Veterans and associated clinical risks, implementation of a standardized screening within the VHA is an appropriate intervention. Incorporating DSM-5-TR-informed criteria into structured assessments can help improve early identification, enhance patient safety, and support evidence-based treatment strategies.

This paper is a general summary of Neuralink, a revolutionary technology set to elevate human life and neurology. Neuralink itself is a key testimonial to the evolution of neuroscience and even brain-computer interfaces, otherwise known as BCI. The original few BCI experiments were conducted on monkeys in the 1960s and 70s, in which the experiment itself narrowed down and understood brain function as a general concept [3]. More specifically, "Work on these technologies began in the early 1970s, led by computer science professor J.J. Vidal at UCLA" [12]. Science itself progresses day by day, growing rapidly in recent years, especially in neuroscience, something highlighted as a focal point in the previous statement. Moreover, recently we have seen technology go on a rampant rise in terms of popularity, inventions, and changes to the human lifestyle. The interactions humans had with technology initially developed with wearables or wearable technology, such as Apple Watches, AirPods, and Fitbits, and now they have even prompted advancements in brain-computer interfaces. Technology has had the power to advance science, but now it’s capable of changing the human mind. Going back to Neuralink, it’s a startup that began its initiative in 2016 and was approved by the FDA for clinical trials in May of 2023, ready to create a wave of change in the field of neuroscience [6]. The foremost baffling thing is how this chip plans on being placed in the somatosensory system. The somatosensory system is a part of the brain that deals with motor actions, recognition, and perception, and applying Neuralink in this area should supposedly allow for cures and treatment of amyotrophic lateral sclerosis, Parkinson’s disease, spinal cord injuries, epilepsy, autism, depression, schizophrenia, and possibly blindness [9]. Neuralink is deemed to lead to a life-changing future, and with co-founders and investors like Elon Musk, there is a lot to know about this piece of technology.

<b>Background: </b>Mechanical low back pain (MLBP) is a leading cause of disability worldwide, with well-established risk factors such as obesity, occupational ergonomics, and core muscle strength. However, the role of pes planus (flat foot) as a contributing factor remains underrecognized. This study aims to investigate the association between flat foot and MLBP using Clarke’s angle as an objective measure of foot posture.<b> Methods: </b>A case-control study was conducted in South Timor Tengah Regency, East Nusa Tenggara, Indonesia, from December 2024 to February 2025. Fifty patients diagnosed with MLBP and 50 healthy controls were enrolled. Foot type assessment was performed using Clarke’s angle, with a cutoff of ≤30° indicating flat foot. Pain severity in the LBP group was recorded using the Numerical Rating Scale (NRS). Statistical analysis was conducted using chi-square and independent t-tests, with significance set at p < 0.05.<b> Results: </b>Flat foot was significantly more prevalent in the LBP group (58%) than in the control group (18%) (p = 0.000; OR: 6.29, 95% CI: 2.52-15.69), indicating that individuals with flat feet are over six times more likely to experience MLBP. No significant differences were observed between the groups regarding BMI, age, or gender.<b> Conclusion: </b>These findings suggest that flat foot is an independent risk factor for MLBP, likely due to altered spinal biomechanics and compensatory postural changes. Clinicians should consider foot posture assessments in MLBP patients and explore targeted interventions, such as orthotic support, to mitigate symptoms.

<b>Background: </b>Electrical injuries are underreported in literature, but they can affect the peripheral and central nervous system causing permanent disability. <b>Aims and objectives: </b>This case report aims to highlight cervical spinal cord injury secondary to electrocution, a rare cause of spinal cord injury. <b>Case report:</b> We report the case of a 54-year-old housewife who presented with transient loss of consciousness and right sided hemiparesis following electrocution, while at home. <b>Results: </b>The patient met clinical critera for partial Brown- Sequard syndrome, which to our knowledge, has not been previously reported. She showed significant improvement over a month and is currently under monitoring. <b>Conclusions:</b> Electrical injury is a rare cause of normal MRI myelopathy and the potential for immediate, delayed, and long- term neurological disability.

The spiny xeromorphic shrublands on serpentine (cuabales) constitute outstanding plant formations for the conservation of Cuban biodiversity, due to their floristic richness, high number of endemic species and local endemism, as well as their economic, social, cultural value and functions environmental. In the Callejón de Los Patos of Santa Clara, there are relicts of cuabal, although they show a high level of deterioration due to human activity. This article presents the main results of an investigation, which focused on implementing actions for the development of Community Environmental Education, with emphasis on the conservation of cuabal, in Callejón de Los Patos. For the intervention process, the Community Self-Development Methodology was used, which is qualitative par excellence, and the investigative methods: document analysis, participant observation, in-depth, group and structured interviews, drawing directed, the reflective group, techniques group and triangulation of data. The main results of the research are: the diagnosis and implementation of actions, designed from the process of Community Environmental Education, which was developed at the Carlos Manuel de Céspedes National Rural School, of said settlement. During the intervention process, the development of cognitive, procedural and attitudinal knowledge for the conservation of cuabal was verified in the schoolchildren, contributing to the strengthening of the school as the most important cultural center of the community, as aspired in the Cuban National Education System.

The extensive globalization of services and rapid technological advancements driven by IT have heightened the competitiveness of organizations in introducing innovative products and services. Among the noteworthy innovations is enterprise resource planning (ERP). An integral field in computer science, known as artificial intelligence (AI), is undergoing a transformative integration into various industries. Grasping the concept of artificial intelligence and its application in diverse business applications is crucial, given its broad and intricate nature. The primary focus of this paper is to delve into the realm of artificial intelligence and its utilization within enterprise resource planning. The study not only explores artificial intelligence but also delves into related concepts such as machine learning, deep learning, and neural networks in greater detail. Drawing upon existing literature, this research examines various books and online resources discussing the intersection of artificial intelligence and ERP. The findings reveal that the impact of AI is evident as businesses attain heightened levels of analytical efficiency across different ERP domains, thanks to remarkable advancements in AI, machine learning, and deep learning. Artificial intelligence is extensively employed in numerous ERP areas, with a particular emphasis on customer support, predictive analysis, operational planning, and sales projections.

In Quantum Physics, the spin and angular momentum operators are magnitudes introduced by means of a vector transformation law. However, interpreting the eigenvalues of its Z "components" as projections on said axis leads to certain contradictions supposedly avoided by a mandatory (presented as a freely selected) Z's orientation. It is shown that an oriented physical space almost forces us to project the angular momentum's and spin's eigenvalues onto its orientation's 3-form, which sidesteps entering into inconsistencies. The final conclusion is that this "rare" magnitude called spin, downright naturally comes in and plays thanks to the orientation of our three-dimensional space.

<b>Background:</b> Neck pain is one of the most common reasons patients seek treatment in the hospital. The causes of neck pain vary widely, trigger misdiagnosis, and often result in mistreatment. Misdiagnoses and mistreatment-related neck pain diagnoses are often associated with a diagnosis of cervical herniated disc. The implication of the misdiagnosis is the use of excessive investigations and inappropriate therapy. This review aims to determine the causes of neck pain often obtained in daily practice and how to diagnose and treat it. <b>Method:</b> Search relevant articles on clinical diagnosis of neck pain with the keywords neck pain diagnostic therapy using Medline and PubMed databases. <b>Results:</b> Neck pain can be in the form of axial pain, which is mostly related to disorders of the joints and muscles of the neck, or in the form of pain in the roots and spinal cord. Investigations and therapy must be related to the clinical diagnosis of neck pain experienced by patients with a history of neck pain. <b>Conclusion:</b> Neck pain is one of the most common complaints encountered in outpatient department settings, associated with reduced quality of life. Patients may come with differing degrees of pain, various symptoms, and aetiologies making it quite challenging to treat them into complete remission. Despite being frequently encountered, some patients with neck pain are underdiagnosed and undertreated due to failure to understand the clinical symptoms before deciding possible aetiologies.

We present a case of untreated type II odontoid fracture, which evolved in severe dislocation 18 months later. Delayed dislocations in untreated type II odontoid fractures are already reported in literature. The singularity of our case is that CT-scan showed signs of fusion in the right C1-C2 articulation, which could have required a more complex surgical procedure to realign the upper cervical spine. Surprisingly, a CT scan performed in the extension position showed complete mobility of C1 and allowed us to perform a one stage posterior fixation. We want to highline both the importance of treating an Anderson type II fracture to prevent dislocation (acute or delayed), and the possibility to perform a flexion-extension CT scan to project a better surgical plan.

The aim of this study was to determine the phytochemical composition and micrographic charac-teristics of the plants consumed by Okapia johnstoni. The results indicate that each plant species has characteristic microscopic elements for its identification. These plants are rich in phenolic acids, anthocyanins, flavonoids, anthraquinones, coumarins, terpenoids and iridoids. Alchornea cordifolia is richer in total polyphenols (198.53±3.39 mg GAE/g DM) followed respectively by Musanga cer-copioides (91.87±6.71 mg GAE/g DM), Macaranga spinosa (59.65±6.54 mg GAE/g DM), Ficus val-lis-choudae (46.37±2.43 mg GAE/g DM), Cola acuminata (38.83±4.04 mg GAE/g DM), Pycnanthus angolensis (31.96±3.45 mg GAE/g DM), Alstonia boonei (31.55±1.60 mg GAE/g DM) and Trilepisium madagascariensis (25.18±0.99 mg GAE/g DM). As for flavonoids, the highest content is obtained in T. madagascariensis followed respectively by A. boonei, Pycnanthus angolensis, Cola acuminata, M. spinosa, F. vallis-choudae, M. cercopioides and A. cordifolia. The difference in the content of secondary me-tabolites is justified by the fact that their expression in the plant is a function of both abiotic and biotic factors and the specificity of each plant species linked to its genetic make-up. The charac-terization of these chemical compounds is necessary for the formulation of herbal medicines for the management of Okapi ex situ or for human health. Also, the microscopic profiles of the leaves powder of the studied plant species provide relevant information, which may be helpful for the plant authentication and for quality control of raw material.