Medical hypotheses最新文献_第5页

Nocturnal closed-loop transcutaneous tibial nerve stimulation: a cardio-urologic hypothesis to interrupt the bladder–heart arousal axis and extend life in older adults 夜间经皮胫神经闭环刺激：中断膀胱-心脏觉醒轴并延长老年人寿命的心-泌尿学假说

IF 0.8 4区医学

Medical hypotheses Pub Date : 2026-03-01 Epub Date: 2026-02-08 DOI: 10.1016/j.mehy.2026.111902

Rafał Bogdan Drobot

{"title":"Nocturnal closed-loop transcutaneous tibial nerve stimulation: a cardio-urologic hypothesis to interrupt the bladder–heart arousal axis and extend life in older adults","authors":"Rafał Bogdan Drobot","doi":"10.1016/j.mehy.2026.111902","DOIUrl":"10.1016/j.mehy.2026.111902","url":null,"abstract":"<div><div>This article advances a testable cardio‑urologic hypothesis: nocturnal, wearable‑triggered, closed‑loop transcutaneous tibial nerve stimulation (TTNS) delivered within the arousal‑to‑void window can interrupt a “bladder–heart arousal axis” in older adults. Nocturia is prevalent, fragments sleep, and is associated with excess cardiovascular and all‑cause mortality; yet whether treating nocturia improves survival remains untested. Sleep arousals provoke abrupt sympathetic bursts that transiently increase blood pressure (BP) and destabilize ventricular repolarization, measurable by the QT variability index (QTVI)—a phenotype linked to cardiovascular outcomes. In parallel, tibial neuromodulation (percutaneous or transcutaneous) improves overactive bladder (OAB) symptoms, including nocturia, with a favourable safety profile. The proposed innovation is to retime neuromodulation from fixed daytime sessions to the nocturnal arousal window using wearable detection, and to prespecify mechanistic mediators (arousal burden, arousal‑window QTVI, and nocturnal BP/dipping) alongside safety‑relevant outcomes (falls). A phased validation roadmap is outlined: (1) sleep‑laboratory feasibility and mechanistic studies with polysomnography, ECG‑derived QTVI, beat‑to‑beat BP, and autonomic metrics to test whether TTNS blunts arousal‑related sympathetic surges; (2) home proof‑of‑concept randomized trials powered for physiologic and symptom endpoints with prespecified mediator and subgroup analyses by nocturia etiology; and (3) pragmatic evaluations using adjudicated falls and cardiovascular events. If this hypothesis is supported, a low‑risk, scalable home therapy could reduce nocturnal urinary awakenings and their electrophysiologic and hemodynamic sequelae, potentially lowering falls and cardiovascular risk in older adults.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"208 ","pages":"Article 111902"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Virtual reality-paired opioid analgesia as contextual prophylaxis against iatrogenic opioid addiction: a hypothesis 虚拟现实配对阿片类镇痛作为预防医源性阿片类药物成瘾的情境：一个假设

IF 0.8 4区医学

Medical hypotheses Pub Date : 2026-02-01 Epub Date: 2026-01-08 DOI: 10.1016/j.mehy.2026.111874

Austin A. Barr

{"title":"Virtual reality-paired opioid analgesia as contextual prophylaxis against iatrogenic opioid addiction: a hypothesis","authors":"Austin A. Barr","doi":"10.1016/j.mehy.2026.111874","DOIUrl":"10.1016/j.mehy.2026.111874","url":null,"abstract":"<div><div>Opioid analgesics are indispensable for treating moderate-severe inpatient pain, yet even supervised use can precipitate long-term opioid use or opioid use disorder (OUD) in a small but consequential fraction of patients. Current prevention approaches emphasize screening, dosing, and duration, but rarely treat context as a modifiable risk factor. Pavlovian models show that drug effects become tightly linked to environmental cues, influencing tolerance, craving, and overdose risk; conversely, major contextual changes can disrupt addictive patterns. Virtual reality (VR) offers immersive, controllable contexts that already demonstrate analgesic and anxiolytic benefits, and can reliably engage drug-related cue learning. The present paper hypothesizes that systematically pairing inpatient opioid administration with distinctive, varied VR contexts could ‘capture’ opioid-associated learning within artificial contexts and reduce generalization of conditioned responses to post-discharge environments. Combined with VR’s intrinsic analgesic effects, which may reduce total opioid exposure, this strategy could act as a multi-level behavioral prophylaxis against persistent opioid use post-discharge. The conditioning rationale, potential risks, implementation principles, and a three-arm trial to test VR-based contextual prophylaxis during medical opioid therapy are discussed.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"207 ","pages":"Article 111874"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A hypothesis on cochlear architecture: Non-intersecting spiral geometry as a determinant of auditory function 一个关于耳蜗结构的假设：不相交的螺旋几何是听觉功能的决定因素

IF 0.8 4区医学

Medical hypotheses Pub Date : 2026-02-01 Epub Date: 2026-01-02 DOI: 10.1016/j.mehy.2026.111872

Lela Migirov

引用次数: 0

From perinatal thiamine insufficiency to growth-phase airway phenotypes: A developmental hypothesis on craniofacial growth, functional oral tongue space, and collapsibility 从围产期硫胺素不足到生长阶段气道表型：颅面生长、功能性口腔舌空间和可折叠性的发育假说

IF 0.8 4区医学

Medical hypotheses Pub Date : 2026-02-01 Epub Date: 2025-12-21 DOI: 10.1016/j.mehy.2025.111864

Björn U. Winter

{"title":"From perinatal thiamine insufficiency to growth-phase airway phenotypes: A developmental hypothesis on craniofacial growth, functional oral tongue space, and collapsibility","authors":"Björn U. Winter","doi":"10.1016/j.mehy.2025.111864","DOIUrl":"10.1016/j.mehy.2025.111864","url":null,"abstract":"<div><div>Craniofacial growth, oral posture, and airway collapsibility arise from interacting developmental, metabolic, and biomechanical factors, yet the potential contribution of perinatal micronutrient status remains underexplored. It is hypothesized that perinatal thiamine (vitaminB1) insufficiency, by constraining thiamine-dependent flux through pyruvate/α-ketoglutarate dehydrogenases and transketolase in the pentose phosphate pathway, creates a bio-energetic/redox bottleneck in cranial neural crest cells during critical windows of craniofacial morphogenesis and palatogenesis. The developmental phenotype is expected to include subtle maxillo-mandibular undergrowth and palatal shape changes that reduce functional oral tongue space, favor mouth breathing, and promote a downward resting position of the hyoid bone, thereby increasing upper airway collapsibility and sleep-disordered breathing (SDB) risk. Perinatal thiamine status is both measurable and modifiable. The model can be tested using biomarker-anchored cohorts, organoid/animal systems, and finite element simulations. Modern, highly processed diets may induce functional thiamine scarcity via increased demand, reduced availability, and increased losses, thereby priming early developmental risks even without frank deficiency. If corroborated, perinatal micronutrition plus interceptive functional/orthopedic care may lessen the burden of a hyoid-descent-prone airway phenotype while respecting SDB heterogeneity.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"207 ","pages":"Article 111864"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

DNA as life’s archive: unraveling the molecular storage of memories and information DNA是生命的档案：解开记忆和信息的分子存储

IF 0.8 4区医学

Medical hypotheses Pub Date : 2026-02-01 Epub Date: 2025-12-23 DOI: 10.1016/j.mehy.2025.111856

Akeel Abed Yasseen , Alaa Salah Jumaah , Hussein Nafakhi

{"title":"DNA as life’s archive: unraveling the molecular storage of memories and information","authors":"Akeel Abed Yasseen , Alaa Salah Jumaah , Hussein Nafakhi","doi":"10.1016/j.mehy.2025.111856","DOIUrl":"10.1016/j.mehy.2025.111856","url":null,"abstract":"<div><div>The traditional view of DNA as merely a blueprint for protein synthesis is being challenged by emerging evidence suggesting that the genome, particularly its non-coding regions, may carry subtle imprints of life experiences. Epigenetic mechanisms, including DNA methylation, histone modifications, and the regulatory actions of non-coding RNAs, are increasingly recognized as mediators of memory formation, maintenance, and potentially even intergenerational transmission of stress and trauma. These molecular processes can alter gene expression without changing the underlying DNA sequence, providing a plausible framework for how experiences might leave lasting biological marks.</div><div>This manuscript hypothesizes that the non-coding genome, coupled with epigenetic machinery, could serve as a biological record of emotionally significant events. Evidence from animal and human studies demonstrates that epigenetic changes can persist across cell divisions and, in some cases, may influence offspring through germline transmission. While robust mechanistic proof in humans remains limited, the convergence of neuroscience, molecular biology, and epigenetics suggests a tantalizing possibility: that life experiences, emotions, and even aspects of behavior could be encoded within our molecular framework.</div><div>Understanding such mechanisms would not only expand our conception of DNA function but also open new avenues for research into memory, psychological resilience, and the biological inheritance of experience. If confirmed, this hypothesis could transform approaches to mental health, trauma, and cognitive disorders, providing a molecular lens through which the imprint of life’s experiences might one day be read.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"207 ","pages":"Article 111856"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bio-integrated ultrasound emission hypothesis in engineered amoeboid cells 工程变形虫细胞的生物集成超声发射假说

IF 0.8 4区医学

Medical hypotheses Pub Date : 2026-02-01 Epub Date: 2025-12-29 DOI: 10.1016/j.mehy.2025.111871

Min Tae Kim

{"title":"Bio-integrated ultrasound emission hypothesis in engineered amoeboid cells","authors":"Min Tae Kim","doi":"10.1016/j.mehy.2025.111871","DOIUrl":"10.1016/j.mehy.2025.111871","url":null,"abstract":"<div><div>We propose a theoretical framework for engineering amoeboid cells as mobile bio-integrated ultrasonic emitters. The cells migrate within the interstitial space rather than within capillary lumens, where spatial constraints (5–8 <span><math><mi>μ</mi></math></span>m diameter) would otherwise prohibit transit. Amoebae in the 15–25 <span><math><mi>μ</mi></math></span>m size range can exploit their native locomotion mechanisms for environmental exploration, while transiently adopting an anchored state in which cytoskeletal tension stabilizes membrane resonance for efficient ultrasonic emission in the 0.5–2 MHz range. Acoustic radiation in this regime scales strongly with cell radius, enabling detectable remote signaling without requiring vascular circulation. The platform integrates genetically encoded piezoelectric or electromotile proteins (e.g., prestin variants), cytoskeletal tension tuning, and magnetoelastic nanoparticle resonators based on superparamagnetic iron oxide nanoparticles (SPIONs) to achieve controlled, directional ultrasound pulses under an external magnetic field. This dual-mode architecture — mobile sensing and anchored communication — supports distributed biological navigation, intercellular messaging, and potential therapeutic actuation. The framework establishes feasibility conditions and design parameters for future experimental realization.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"207 ","pages":"Article 111871"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Targeting conserved dynamic regions of SARS-CoV-2 spike protein identified by normal mode analysis for broad-spectrum antiviral therapy 利用正常模式分析确定的SARS-CoV-2刺突蛋白的保守动态区域进行广谱抗病毒治疗

IF 0.8 4区医学

Medical hypotheses Pub Date : 2026-02-01 Epub Date: 2026-01-02 DOI: 10.1016/j.mehy.2026.111873

Junhong Lü

{"title":"Targeting conserved dynamic regions of SARS-CoV-2 spike protein identified by normal mode analysis for broad-spectrum antiviral therapy","authors":"Junhong Lü","doi":"10.1016/j.mehy.2026.111873","DOIUrl":"10.1016/j.mehy.2026.111873","url":null,"abstract":"<div><div>The continuous emergence of SARS-CoV-2 variants challenges conventional antiviral strategies that targets highly mutable epitopes or enzymatic active sites. We propose a novel hypothesis centered on targeting the conserved dynamic regions of the SARS-CoV-2 spike (S) glycoprotein, which govern its large-scale conformational transitions. Through normal mode analysis (NMA), these regions have been identified as critical dynamic hotspots that facilitate an allosteric transition from the closed to the open, ACE2-accessible state. We hypothesize that small molecules or peptides designed to bind these hotspots could act as conformational locks, thereby providing broad-spectrum antiviral activity. The feasibility of targeting the physical dynamics of the spike protein is supported by independent studies on its mechanical vulnerability. While identifying druggable allosteric pockets and achieving experimental validation still need be overcome before practical realization, this strategy represents a paradigm shift from static, structure-based targeting to dynamic allostery. It offers a potentially variant-resilient therapeutic approach against both current and future threats from coronaviruses.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"207 ","pages":"Article 111873"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Climate change and the decline in human core body temperature: A hypothesis of physiological adaptation 气候变化与人体核心体温下降：一种生理适应假说

IF 0.8 4区医学

Medical hypotheses Pub Date : 2026-02-01 Epub Date: 2025-12-22 DOI: 10.1016/j.mehy.2025.111866

Nina Mehta , Andy Goren

引用次数: 0

Is pain perception of a change in information? 痛觉是一种信息的变化吗？

IF 0.8 4区医学

Medical hypotheses Pub Date : 2026-02-01 Epub Date: 2025-12-30 DOI: 10.1016/j.mehy.2025.111870

Paula A. Tello Prieto, David A. Miranda

引用次数: 0

Reinterpreting autism through the analogy of inflammation: a hypothesis of non-specific neurodevelopmental response 通过炎症的类比重新解释自闭症：非特异性神经发育反应的假设