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Cases of surgical treatment of basal cell skin carcinoma of the lower eyelid are rarely described in the world literature. Perhaps this is due to the search for new non-surgical treatment methods or to the fact that this localization is poorly represented in the total incidence of basal cell skin cancer. However, the operative method, recommended as the main line of treatment by both domestic and foreign clinical recommendations, is still recognized as the most radical and aesthetically acceptable method of treatment. Non-radical treatment of the tumor leads, in turn, to relapses of the disease, to the emergence of systemic metastatic foci due to the lymphogenic and hematogenic spread of tumor cells. In the article we describe the experience of surgical treatment of patients suffering from basal cell skin carcinoma of the lower eyelid of varying degrees of extension.

BACKGROUND: Ocular prosthetics remains an important and actual task in the rehabilitation of patients with anophthalmos of various origins. AIM: To increase the effectiveness of cosmetic prosthetics in patients at the formation of a primary and/or delayed supporting stump with simultaneous reconstructive procedures on the orbital bone structures. MATERIALS AND METHODS: A retrospective analysis of patients with subatrophy and anophthalmos with deformities of the orbital walls was carried out. Results were analyzed according to the criteria for the severity of clinical signs enophthalmos, deepening of the superior orbitopalpebral sulcus, prosthesis mobility. RESULTS: 22 patients with orbital bone deformities were operated and examined; they underwent surgery on the orbital walls in combination with evisceration with posterior scleral pole resection, neurectomy and implantation of a spherical endoprosthesis (in modifications) in 12 patients and delayed stump plasty in 10 patients with anophthalmos. It was possible to eliminate enophthalmos in 18 patients, to correct the retraction of the upper eyelid on the prosthesis side in 19 patients, and to significantly increase the mobility of the prosthesis in 9 patients. CONCLUSIONS: Carrying out a combined surgical procedure aimed at restoring a voluminous mobile primary or delayed supporting stump and eliminating the deformation of the orbital walls with restoring the lost volume creates conditions for optimal individual ocular prosthetics, significantly reduces prosthesis enophthalmos, increases its mobility and improves cosmetic results of rehabilitation.

BACKGROUND: Nowadays the problem of orbital trauma remains extremely relevant. Combined damage of several anatomical structures, globe injury, various clinical manifestations, the necessity of optimal surgical treatment require high-quality, timely diagnostics. Considering the current development of diagnostic equipment, postprocessing of CT data acquires the key role in order to obtain objective diagnostic information in patients with orbital trauma. AIM: Evaluation of the effectiveness of the developed methods for CT data assessing in patients with orbital trauma. MATERIALS AND METHODS: From 2016 to 2021 a total of 107 patients (100%) with orbital injuries were examined in Sechenov University clinics. All patients were distributed depending on the injury occurrence time: 50 patients (47%) in acute and subacute periods, 30 patients (28%) in the period of formation of post-traumatic deformities, 27 patients (25%) in the period of formed post-traumatic deformities. All patients (n = 107; 100%) underwent CT data analysis according to the developed protocol: analysis of bone and soft tissue trauma using a specialized algorithm, assessment of orbital volumes, evaluation of defects in the inferior orbital wall, examination of the globe position and of changes in the density of the orbital soft tissues. RESULTS: In the preoperative period the developed algorithm for orbital volumes measuring additionally revealed a post-traumatic increase in orbital volume in 21 patients (19%). The technique for the globe position assessing additionally revealed the risk of enophthalmos in 9 patients (8.1%), and in 1 case (0.9%) the suspicion of globe displacement was not confirmed. The defects of the inferior orbital wall were classified into small (n = 18; 17%), medium (n = 31; 29%) and large/total (n = 38; 35% and n = 20; 19%, respectively). In 88 patients (82%), the ratio of the defect to the entire inferior orbital wall was more than 6.65%, in 19 patients (18%) less than 6.65%. Changes in the density of the orbital soft tissues were as follows: soft tissue edema n = 60 (56%), soft tissue atrophy n = 28 (27%), hematoma of the orbital soft tissues n = 10 (9%), density was not changed n = 9 (8%). In the postoperative period, the developed methods for CT data processing revealed incomplete restoration of the orbital volume in 31 cases (29%), incomplete coverage of the inferior orbital wall defect in 38 cases (35%), globe displacement in 14 cases (13%), which was not determined by the standard CT data assessment without the specialized technique. In 7 cases (6%), a suspicion of an increase in the orbital volume was not confirmed by the developed methodology. CONCLUSION: The developed methods for measuring orbit volumes, assessing defects in the lower orbital wall, the globe position, and the condition of the orbital soft tissues provide statistically reliable additional diagnostic information about the patients condition and personalized approach for preoperative planning for each patient.

Fibromyalgia is a long-term pain disorder that has been related to autonomic dysfunctions and reduced cardiovascular reactivity. We aimed to assess the dynamic short-term cardiovascular responses to postural changes in fibromyalgia. Thirty-eight women with fibromyalgia and thirty-six healthy women underwent the "Chronic Pain Autonomic Stress Test". Electrocardiogram, blood pressure and impedance cardiography were continuously recorded during active standing and lying down. Second-by-second values were derived over the first 30 s of each posture. Lower reactivity during the beginning of each position was observed in fibromyalgia sufferers compared to healthy women, with smaller responses seen during stand up in heart rate, blood pressure, cardiac output, total peripheral resistance, and pre-ejection period, and smaller changes during lying down in heart rate, cardiac output and total peripheral resistance. The magnitude of the autonomic adjustments to postural changes was inversely associated with the severity of clinical pain. These findings indicate an early impaired autonomic cardiovascular response to orthostatic and clinostatic challenges in fibromyalgia, suggesting less autonomic flexibility and adaptability to situational demands and challenges. Short-term second-by-second cardiovascular measures may be useful in the clinical assessment of fibromyalgia.

Supplementary material with aseries of analyses related to a manuscript titled"Impact of a homeostatic body’s hydration status as risk or resiliency factor, evaluated by hemodynamic measures, on different types of pain sensitization as pathways to a chronic pain syndrome" were conducted for indicating impact of de- and re-hydration events (evoked by within-subject ortho- and clino-static challenges) and hypo- and hyper-hydration states (assessed primary by between-subject variance in averaged cardiac output associated with age and body mass variances in the sample, and secondary by between-subject variance in the hair cortisol concentration) on blood volume-related cardiac and vascular mechanisms regulating blood pressure level.

A lack of personalized approaches in non-medication pain management has prevented these alternative forms of treatment from achieving the desired efficacy. One hundred and ten female patients with fibromyalgia syndrome (FMS) and 60 healthy women without chronic pain were assessed for severity of chronic or retrospective occasional pain, respectively, along with alexithymia, depression, anxiety, coping strategies, and personality traits. All analyses were conducted following a ‘resource matching’ hypothesis predicting that to be effective, a behavioral coping mechanism diverting or producing cognitive resources should correspond to particular mechanisms regulating pain severity in the patient. Moderated mediation analysis found that extraverts could effectively cope with chronic pain and avoid the use of medications for pain and mood management by lowering depressive symptoms through the use of distraction mechanism as a habitual (‘out-of-touch-with-reality’) behavior. However, introverts could effectively cope with chronic pain and avoid the use of medications by lowering catastrophizing through the use of distraction mechanism as a situational (‘in-touch-with-reality’) behavior. Thus, personalized behavior management techniques applied according to a mechanism of capturing or diverting the main individual ‘resource’ of the pain experience from its ‘feeding’ to supporting another activity may increase efficacy in the reduction of pain severity along with decreasing the need for pain relief and mood-stabilizing medications.

The paper presents results of comprehensive experimental studies into high-temperature adhesive compositions and foaming paste on bismaleimide base, and characterizes their properties from the standpoint of the manufacturing process (thixotropy, foaming coefficient, volatile content, degree of cure, spreadability and fluidity) and mechanical strength (ultimate strength for shear, uniform tear and compression). The effect of accelerated environmental tests and irradiation on mechanical properties was studied and, and the level of offgassing in vacuum was determined for the adhesive compositions and the the foaming paste. Key words: high-temperature adhesive compositions, film adhesive, thixotropy, foaming coefficient, degree of cure, spreadability, fluidity, mechanical tests, fracture behavior, accelerated climatic tests, irradiation.

The article raises the question of the heuristic potential of the theory of socioeconomic formations. The author tries to challenge the opinion shared by many researchers that this theory was an exclusively ideological product aimed at justifying the political regime that prevailed in the USSR. Behind dogmatic template-like judgments the lively discussions aimed at elucidating the universal laws of social development were hidden. The results of these discussions do not lose their relevance today as many scientists are discussing again the prospects of a post-capitalist society. The theory of socioeconomic formations is aimed at finding relevant criteria for highlighting the historical stages of social development within the framework of a materialistic understanding of history. As such a criterion, the prevailing forms of ownership, historical types of technology, and the specifics of relations of production are proposed. At the same time, the article substantiates that each of these criteria had produced many problems. Thus, the traditional Eurocentric scheme for changing the prevailing forms of ownership was poorly coordinated with the social processes taking place in the East. The technical and technological criterion turned out to be extremely difficult in terms of identifying the qualitative stages of scientific and technological development. The emphasis on the specifics relations of production led to poorly consistent conclusions that there was a fundamental difference between Soviet socialism and Western industrial capitalism. The article attempts to discard obsolete dogmatic and ideological constructions from the theory of social formations. At the same time, it proposes using such a criterion for highlighting social formations as the prevailing sources of consumer values (natural processes, controlled natural processes, labor, and creativity). This criterion allows to connect qualitatively a quantitative technical and technological criterion with political and legal phenomena, such as prevailing forms of ownership, systems of relations of power, exploitation and exclusion, etc., into a single causal scheme. An attempt was made to redefine social formations (pre-class, class-class, class, personalist), based on the corresponding prevailing sources of consumer values. The conclusion is made that the historical forms of socialism and capitalism are different modifications of the class socioeconomic formation (based on labor as the predominant source of consumer values). The emergence of a personalistic socioeconomic formation based on creativity as the main source of consumer values is an extremely controversial process. This formation will have its internal logic and contradictions; therefore, the categories characterizing it should not be confused with the categories of a class socioeconomic formation that is gradually fading into the past.

The view that the cardiovascular system and systems regulating pain perception are closely interrelated was predicted by a variety of findings in the 1970s. This early viewpoint was later confirmed in numerous experimental, clinical, populational, and prospective studies. It is now evident that acute and persistent noxious stimuli and conditioned pain-related behavior, feelings, and thoughts may affect mechanisms regulating cardiovascular activity (e.g., provoke hypertension development). Moreover, the regulation of individual unconditioned and conditioned responses to noxious stimuli may be modified by common mechanisms also regulating cardiovascular and metabolic activity (e.g., by a central inhibition mechanism determining baroreflex bradycardia and by energy supply mechanisms in active and relaxing conditions determining coupling of the heart beating with muscle and respiration activities, respectively). Numerous baroreflex and related cardiovascular variables are suggested for predicting and indicating (as a pain-o-meter) pain severity, its duration and frequency along with pain coping (adaptation and resilience) mechanisms to improve profiling and correct management of individuals with chronic pain syndromes. Moreover, the baroreflex mechanisms are now used in pain control and management. This chapter discusses the history and modern viewpoints on mechanisms of the relationships between pain and cardiovascular systems.

Regioselectivity of the Chan–Lam coupling of ambident nitropyrazoles with trans-styrylboronic acid depends on the base and catalyst nature and can vary the N(1)/N(2)-isomer ratio from ∼2 : 1 to ∼1 : 2. 2-Methyl-4-nitro- and 2,4-dinitroimidazoles are unreactive in this reaction. The structure of N(1)/N(2) isomers was elucidated by NOE measurements and by the comparison of experimental and DFT calculated 13C NMR chemical shifts.

The authors have requested that this preprint be removed from Research Square.

Situational or persistent body fluid deficit (i.e., de- or hypo-hydration) is considered a significant health risk factor. Bioimpedance analysis (BIA) has been suggested as an alternative to less reliable subjective and biochemical indicators of hydration status. The present study aimed to compare various BIA models in the prediction of direct measures of body compartments associated with hydration/osmolality. Fish (n = 20) was selected as a biological model for physicochemically measuring proximate body compartments associated with hydration such as water, dissolved proteins, and non-osseous minerals as the references or criterion points. Whole-body and segmental/local impedance measures were used to investigate a pool of BIA models, which were compared by Akaike Information Criterion in their ability to accurately predict the body components. Statistical models showed that ‘volumetric-based’ BIA measures obtained in parallel, such as distance2/Rp, could be the best approach in predicting percent of body moisture, proteins, and minerals in the whole-body schema. However, serially-obtained BIA measures, such as the ratio of the reactance to resistance and the resistance adjusted for distance between electrodes, were the best fitting in predicting the compartments in the segmental schema. Validity of these results should be confirmed on humans before implementation in practice.

The soils of East Antarctica have no rhizosphere with the bulk of organo-mineral interactions confined to the thin microbial and cryptogamic crusts that occur in open or cryptic niches and are collectively known as biological soil crust (BSC). Here we demonstrate that cryptic hypolithic varieties of BSC in the Larsemann Hills of East Antarctica contribute to the buildup of soil organic matter and produce several types of continuous organogenous horizons within the topsoil with documented clusters of at least 100 m2. Such hypolithic horizons accumulate 0.06–4.69% of organic carbon (TOC) with isotopic signatures (δ13Corg) within the range of −30.2 – −24.0‰, and contain from 0 to 0.38% total nitrogen (TN). The properties of hypolithic organic matter alternate between cyanobacteria- and moss-dominated horizons, which are linked to the meso- and microtopography patterns and moisture gradients. The major part of TOC that is stored in hypolithic horizons has modern or centenary 14C age, while the minor part is stabilized on a millennial timescale through shallow burial and association with minerals. Our findings suggest that hypolithic communities create a “gateway” for organic carbon to enter depauperate soils of the Larsemann Hills and contribute to the carbon reservoir of the topsoil at a landscape level.

Two approaches for the synthesis of D-A chromophores containing arylhydrazonocyclopentadiene acceptor moieties were developed. The first approach includes the decarboxylative azo coupling reaction between penta(methoxycarbonyl)cyclopentadienyl potassium or sodium and aryldiazonium salts to give products containing four ester groups at the acceptor moiety. The second one includes the reaction of 1,3-dimethoxycarbonyl-4,5-diphenylcyclopentadienone with arylhydrazine hydrochlorides into arylhydrazonocyclopentadienes with two ester and two phenyl groups. Both series of compounds were investigated by means of absorption spectroscopy and the solvatochromic behavior of two representatives of each series was investigated in various dielectric environments. Both compounds demonstrated relative independence on the environment although the product with the stronger acceptor part was less stable and exhibited a slight hypsochromic shift in polar media. However, the optical properties of this product were strongly affected by the basicity of the medium due to the deprotonation of the NH-group. Quantum chemical modeling of the synthesized products adsorption spectra using different density functionals has shown that PBE0-D3/def2TZVP is an optimal method (out of three tested) for all compounds both in non-vibrationally-resolved and vibrationally-resolved TD-DFT calculations. Accounting for vibronic coupling in TD-DFT calculations is necessary to achieve good agreement with the experiment for compounds synthesized herein.

In this article, treatment analysis of 81 patients (98 eyes) with optic nerve pathologic conditions using an author-developed method of continuous optic nerve electromagnetic stimulation (neuromodulation) is compared to traditional in-patient therapy. Authors present an original method of electrode implantation and show the dynamics of visual functional changes, as a result of treatment including visual acuity, electrophysiology testing results, and visual fields. The neuromodulation method enables stimulation therapy to be performed in out-patients; continuous stimulation regimen use causes an important and longstanding therapeutic effect without any negative impact on surrounding tissues.

Objectives Although progress has been made in the regulation of hypertension over the past decades, the USA and some other countries have faced a significant rise in incidence of chronic pain management cases during the same period. Studies of the relationship between pain and blood pressure (BP) regulations propose that these two processes may be interconnected. Studies of effects of antihypertensive treatment on pain in general and its chronification have never been reviewed. Methods A narrative review of respective studies with analysis of credibility of the findings was conducted. Results Some studies have suggested that aggressive reduction of high BP may contribute to a return in pain symptoms and may require more aggressive, long-term pain management. Other studies propose that long-term antihypertensive medication could also increase the risk for new cases of chronic pain. Pain initiates a central neuroplastic resetting of the baroreceptor activation accounting for sustained increase of BP with an adaptive 'pain-killing' or maladaptive 'pain-complication' effect associated with pain chronification, and these mechanisms may be moderated by antihypertensive medications. However, different antihypertensive drugs and nondrug treatments may diversely affect pain mechanisms at different stages of treatments. Conclusion Uncontrollable reduction of high BP in some patients with hypertension could increase the risk for chronic pain incidence and its severity. Practical recommendations in BP control should be reconsidered to take into account patients' chronic pain. Further research is needed of moderation effects of different antihypertensive manipulations on pain to improve pain management in these patients.

Modification of benzotriazoles with iodonium salts [diphenyl- and ( E )-styrylphenyliodonium tosylates] occurs at the N 1 -position in the presence of K 2 CO 3 as a base and CuI as a catalyst in CH 2 Cl 2 , whereas in the presence of stoichiometric amount of [Cu 2 (TMEDA) 2 (OH) 2 ]Cl 2 complex regioselective N 2 -modification proceeds. Two new Cu I complexes based on benzotriazoles were synthesized and their crystal structures were determined by X-ray powder diffraction analysis.

The article is devoted to understanding the prospects for the post-capitalist society formation. The author substantiates the thesis that the process of folding post-capitalist social relations has been going on for a long time, however, many of these processes fall out of the view of researchers, since they are easily confused with the negative manifestations of capitalism. According to the author, the future post-capitalist society will be even more controversial than the bourgeois one. It should be about the formation of a new antagonistic social formation.

Background Different physical exercise interventions for pain and other related symptoms largely follow non-personalized guidelines and show a high degree of variability in outcome. These interventions are considered to have different pathways toward improvement in autonomic regulation of energy metabolism. The current pilot study was conducted to assess the predictive value of individual cardiovascular (CV) activity markers at rest to predict clinical outcomes for two popular exercise-based interventions (walking and yoga) in patients with Irritable Bowel Syndrome (IBS). Methods Twenty-seven adult participants with IBS were randomly assigned to a 16-biweekly Iyengar yoga or walking program. They completed pre- and post-treatment assessments on IBS symptom severity, affective and somatic complaints, and various measures of resting autonomic function including blood pressure (BP), heart rate and its variability, baroreceptor sensitivity (BRS) to activations and inhibitions with gains of brady- and tachycardiac baro-responses, and BP start points for these spontaneous baroreflexes. Results Pretreatment BRS was differentially related to clinical response for the treatment groups. Specifically, a significant decrease in pain severity was found in response to yoga for those participants who had lower resting BRS to activations, but decreased pain severity was associated with higher resting BRS for those in the walking group. The effect was not related to affective symptom relief. Other CV measures showed similar associations with clinical outcomes for both groups. Conclusions The data suggest therefore that CV based phenotypes may be useful in personalizing clinical interventions for IBS. They may also point to autonomic mechanisms that are targets for such interventions.

Previous clinical and elderly population studies have found that affective well-being can be assessed by clino-orthostatic cardiovascular reactivity. This study explored this relationship in a young healthy sample, and with respect to cognitive appraisals of well-being. Four successive readings of blood pressure (BP) and heart rate (HR) after lying down (clinostatic probe) followed by four successive readings after standing up (orthostatic probe) were obtained from 52 healthy students along with questionnaire-reported well-being. Analyses indicated that a deeper drop of systolic BP (SBP) and mean arterial (MAP) pressure during supine was related to higher positive mood, but higher and more stable orthostatic MAP and HR response were related to lower negative mood. A higher diastolic BP while standing upright and lower SBP in general were associated with higher optimism and higher global life satisfaction, respectively. The findings confirm previous results and indicate that cognitive appraisals of well-being are also related to BP regulation.

The Pd/Al 2 O 3 -catalysed N -modification of symmetrically substituted benzotriazoles using diaryl-, alkenyl- and ethynyliodonium salts took place regioselectively at the N -1-position of the benzotriazole ring.

Objective Objective markers of chronic pain severity are needed when examining and treating patients with chronic pain whose suffering may be overstated or underestimated. This study tested a hypothesis that the strength of cardiovascular (CV) reactivity in response to a social evaluative threat and orthostatic challenge is a reliable index of severity of pain-related complaints. Methods Measurement of CV reactivity and response styles in 34 men and 16 women with chronic pain from different bodily injuries, were retrieved from a larger database of patients. Measurement of CV reactivity in response to a postural challenge was repeated twice (sessions 1 and 2) on the same day of a medical examination which includes a psychosocial evaluation. Results A decrease in systolic blood pressure (SBP) from session 1 to session 2 was found in subjects with low pain severity scores, but not in those with high pain severity scores. High scores for pain catastrophizing/magnification and pain-related emotional distress were independently associated respectively with a SBP increase at an early-point in time and a SBP decrease at a mid-point in time after standing up from lying down. Stronger heart rate reactivity responses to orthostatic challenge indicated greater protection against the presence of these chronic pain symptoms. Conclusions This biobehavioral protocol enables measurement of chronic pain suffering and protection in three dimensions: physical, emotional, and cognitive.

Monitoring of active layer thawing depth and active layer thickness (ALT), using mechanical pronging and continuous temperature data logging, has been undertaken under the Circumpolar Active Layer Monitoring – South (CALM-S) program at a range of sites across Antarctica. The objective of this study was to summarize key data from sites in different Antarctic regions from 2006 to 2015 to review the state of the active layer in Antarctica and the effectiveness of the CALM-S program. The data from 16 sites involving 8 CALM-S and another 8 boreholes across the Antarctic have been used in the study. Probing for thaw depth, while giving information on local spatial variability, often underestimates the maximum ALT of Antarctic soils compared to that determined using continuous temperature monitoring. The differences are likely to be caused by stones limiting probe penetration and the timing of probing not coinciding with the timing of maximum thaw, which varies between seasons. The information on the active layer depth is still sparse in many regions and the monitoring needs to be extended and continued to provide a better understanding of both spatial and temporal variability in Antarctic soil thermal properties.

The geographical distribution of mammoth fauna was based not only on the optimal climatic range and suitable grass-rich ecosystems, but also on stable and sufficient pool of mineral nutrition in the seasonal cycle. Widespread high-latitude steppes or tundra-steppes were the landscape basis for the Beringia herbivores. Now patches of the relict steppes persist only on steep slopes with southern aspects. Numerous palynological, carpological, isotopic, and DNA data from the Pleistocene plant remains show that relict steppes are similar to mammoth steppe in many ways. A six-year study of ash and plant mineral contents of two types of steppes and grass-herb ecosystems at the Kolyma Lowland, Arctic Siberia has been carried out. The comparative content of essential mineral nutrients (Ca, P, K, Mg, Mn, Na, Fe, S) and the important element ratios in different vegetation types were analyzed. Results indicated that the ash and Ca, Mg contents are higher for the steppe vegetation. High Ca : P ratio and optimal K : (Ca+Mg) or tetanic ratio in steppe plants are within the recommended range for large herbivores. Mineral nutrient contents are higher for herbs vs grasses for steppe taxa. Generally accumulation of essential mineral elements of the Siberian Arctic steppes is comparable to those in the Asian temperate steppes. The research results can be used for better understanding of such an important issues of paleoecology of large grazers as availability, sufficiency and equilibration of mineral nutrient elements of grass-rich ecosystems – one of the significant factors of megafauna existence.

Variations in heart rate variability (HRV) have been associated with major depressive disorder (MDD), but the relationship of baseline HRV to treatment outcome in MDD is unclear. We conducted a pilot study to examine associations between resting baseline HRV and MDD treatment outcome. We retrospectively tested several parameters of HRV in an MDD treatment study with escitalopram (ESC, N=26) to generate a model of how baseline HRV related to treatment outcome, and cross-validated the model in a separate trial of MDD treatment with Iyengar yoga (IY, N=16). Lower relative power of very low frequency (rVLF) HRV at baseline predicted improvement in depressive symptoms when adjusted for age and gender (R2>.43 and p

This study was conducted to test the hypothesis that differences in alexithymia would moderate coupling in physiological and subjective-experiential responses to two affective films, which were shown to induce a common negative (sad) feeling, but to provoke different hyper- or hypo-arousal physiological responses (e.g., heart rate acceleration or deceleration) associated with antipathic or empathic context, respectively (Davydov, Zech, & Luminet, 2011). Only women were studied as persons showing more reactivity to sad films than men. Reactivity was evaluated for facial behaviour, physiological arousal, and subjective experience. Some other affective and cognitive disposition factors (e.g., depression and defensiveness) were considered for evaluating their probable mediation of the alexithymia’s effects. While subjective experience was not affected by alexithymia, high scorers on the externally-oriented thinking factor showed reduced physiological reactivity in both film conditions. These effects were mediated through different disposition factors: either low affectivity (low depressed mood), which mediated alexithymia's effect on hyper-arousal responses (e.g., decrease of heart rate acceleration), or impression management (other-deception), which mediated alexithymia's effect on hypo-arousal responses (e.g., decrease of heart rate deceleration).

This commentary is in response to Drs. Feinberg and Brigham’s request for reader feedback of their 2014 revision of their 2006 “Guide to the Guides…” [1]. They teach that its use improves rating accuracy. We concur. Their 2014 revision generates impairment rating protocols in injured workers that are based on the AMA Guides to the Evaluation of Permanent Impairment, 5th Edition (GUIDES) [2]. In response to their request for feedback, we wish to bring attention to published rating inaccuracies in the GUIDES and the unreliability of measuring chronic pain based only on self-report [3–6]. We have two goals. One is to introduce a neuroscience-based metric and related protocol that eliminates all identified GUIDES defects when rating chronic pain whole-person impairment. A second is to stimulate evaluation of this neuroscience-based assessment protocol as a potential gold-standard diagnostic benchmark in chronic pain medicine that currently does not exist. The search for a reliable chronic pain metric is the “holy grail” in all of pain medicine that challenges pain medicine practitioners, patients, drug developers, and the medical-legal community at large [6]. Historically we learn that the GUIDES is developed, “ To enable physicians to evaluate functional impairment in an objective and consistent manner… ” (p. 286 [5]). Seabury et al. challenge its “ …controversial use when measuring impairment versus disability. ” They, along with others, identify numerous “Catch 22s” that question GUIDES-derived impairment ratings as reliable and address them in detail [3–5]. As an example, we cite Dr. Rondinelli’s 2010 “Commentary” [4]. He writes “…that the ratings themselves remain largely consensus-based …and subject to various stakeholder priorities and biases… (p. 1204 [4])” In our experience this invites speculative expert examiner opinions. Our first goal is to …

Previous studies are inconclusive with regard to the relationship between variations in blood pressure (BP) and affect. In the present study we evaluated the hypothesis that inconsistencies in previous findings may be attributed to the moderating role of variations in psychological or physical conditions during BP measurement. Change in depressive symptoms was examined in 1046 individuals at two points in time, at inclusion into the study, when BP was measured repeatedly under higher (standing posture or anticipation of interview) and lower (supine posture or recovery after interview) arousal conditions, and at 4year follow-up. We observed that higher systolic BP levels measured under high arousal conditions and lower systolic BP levels measured under low arousal conditions at inclusion were both associated with a decrease in depressive mood across time in the study sample. The results suggest that higher or lower cardiovascular activity as indexed by systolic BP corresponds with higher or lower negative mood as a function of situation-specific arousal levels. This biobehavioural association between mood and BP might be related to the moderating effect of adaptive processes on physiological activity in different situations, which may in turn be associated with resilience to adversity.

Gender difference in intensity of emotional response depending on the cognitive disclosure of the emotions were analyzed in detail. Texts with emotionally negative content were presented to the subjects, and the parameters of their cardiovascular activity were recorded either before or after filling a special checklist to assess the impression caused by the texts and to reveal changes in the physiological activation of the subjects in response to these texts. Unlike women, men intensified their affective involvement into processing the content of the texts after filling the checklist. The results are interpreted in the context of current research on physiological emotional processes during their cognitive disclosure; the role of gender differences in the regulation of these processes was also studied.

Objectives: Previous research suggests that mechanisms related to afferent and efferent components of the baroreflex are associated with blood pressure level and mood, and that mood as a component of subjective well-being may be mediated by changes in blood pressure. This study examines these mechanisms in 213 healthy women and men. Methods: Evaluation of spontaneous baroreflex activity using the sequence technique under resting conditions in the laboratory was followed by 2 days of 24-h ambulatory blood pressure recording and diary ratings of mood. Results: Patterns of components of the baroreflex loop were significant predictors of 24-h ambulatory blood pressure mean level, its circadian variability, and daily ratings of mood. Three mechanisms were found to be involved in the regulation: (1) interaction between gains of afferent and efferent cardiac components of the baroreflex, (2) gain of afferent signals related to fast cardiac responses to baroreceptor activation, and (3) gain of afferent signals related to late cardiac responses to baroreceptor inhibition. The interaction of afferent/efferent components of baroreflex loop appears to independently determine mean levels of systolic blood pressure and positive (happy) mood. The effect of the baroreceptor activation mechanism on subjective well-being (indexed by happy and alert moods) was mediated by the wake/sleep systolic blood pressure difference. Additionally, the baroreceptor inhibitory mechanism effect on subjective well-being (indexed by stressed and sleepy moods) was mediated by the wake/sleep diastolic blood pressure difference. Conclusions: Evaluation of the baroreflex components and their interaction provides important information about blood pressure and mood beyond that provided by baroreflex sensitivity and potential for the evaluation of risk for hypertension and mood disturbance in healthy people.

Objective This study was conducted to present evidence of differences in autonomic regulation of cardiovascular activity and its role in the severity of specific (disease-related) and non-specific (negative affect and chronic pain-related) symptoms in individuals with Irritable Bowel Syndrome (IBS). Methods Seventy-eight female patients with IBS and 27 healthy women age 18–62 years were assessed for IBS symptoms, negative affect, and baroreceptor sensitivity (BRS), blood pressure (BP), heart rate, and heart rate variability (HRV) at rest. Direct and indirect regression effects were examined with application of the bootstrap procedure to validate findings. Results IBS was reliably related to lower resting BRS, higher BP, and higher negative affect compared to healthy controls. Longer disease duration (chronicity) was related to BRS decrease coupled with systolic BP increase (95% CIs = − 0.14 to − 0.01). Three autonomic mechanisms associated with BRS decrease were found to further regulate severity of IBS symptoms. Lower BRS was related to higher IBS severity in general if the effect was transferred through the decrease of low frequency power of HRV (e.g., 95% CIs = − 0.039 to − 0.001 for abdominal pain severity). However, lower BRS was related to lower IBS severity in general if the effect was transferred through diastolic BP increase (95% CIs = 0.01–0.11 for abdominal pain severity). Lower BRS was related to higher abdominal pain severity coupled with high negative affect if the effect was transferred through the decrease of higher frequency power of HRV (95% CIs = − 0.026 to − 0.003). Conclusions These findings indicate that different cardiovascular mechanisms are associated with IBS development and the increase and decrease of severity of IBS symptoms. Their assessment suggests ways to personalize treatment of IBS.

Hypothesis Previous studies provide evidence that glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG) should not be considered as interchangeable alternatives in the diagnosis of the same type 2 diabetes, but as indicators of its different pathogenetic subtypes. This study was conducted to determine whether a particularly high amount of glucose in either HbA1c form or in fasting plasma would be found in diabetic patients genetically predisposed for either intensive cognitive or intensive muscle metabolic activity, respectively. Methods HbA1c and FPG levels, polymorphisms of genes indicating the predisposition to different cognitive activity (the dopamine D2 receptor (DRD2/ANKK1)), muscle activity (peroxisome proliferator-activated receptor gamma, coactivator 1 alpha (PGC1A(PPARGC1A))), and vascular regulation of general metabolic activity (the angiotensin 1 converting enzyme (ACE)) were assessed in diabetic patients and nondiabetic controls. Results DRD2/ANKK1 polymorphism that affects baseline central arousal determined HbA1c variations uncorrelated with FPG in total and clinical groups. The mutation of PGC1A mainly affecting peripheral glucose metabolism had an effect on FPG correlated or uncorrelated with HbA1c depending on the effect assessment in the total sample or in the nondiabetic group, respectively. ACE insertion/deletion (I/D) gene polymorphism was associated with both HbA1c and FPG fluctuations, but only in diabetic patients. Conclusion The findings provide evidence that the HbA1c and FPG may predict the risks for different subtypes of type 2 diabetes associated with either brain or muscle metabolic activity in genetically vulnerable people.

Objective This study examined women's mood responsiveness associated with patterns of stress hormone levels in everyday situations. Methods Self-reports of negative, positive, and energy dimensions of mood were obtained from 203 nurses throughout the day on a workday and on an off-work day during the luteal and follicular phases of the menstrual cycle. Individual differences in daytime norepinephrine and cortisol were assessed. Results Patterns of norepinephrine and cortisol levels were associated with ratings of the following moods: tired, sad, and happy. Phase of the menstrual cycle and the day factor (workday, off-work day) modified the association of mood ratings and stress hormone patterns. Conclusion The experience of negative mood is associated with both hypoarousal and hyperarousal conditions. A homeostatic arousal-related concept of mood regulation is discussed.

Preliminary findings support the potential of yoga as a complementary treatment of depressed patients who are taking anti-depressant medications but who are only in partial remission. The purpose of this article is to present further data on the intervention, focusing on individual differences in psychological, emotional and biological processes affecting treatment outcome. Twenty-seven women and 10 men were enrolled in the study, of whom 17 completed the intervention and pre- and post-intervention assessment data. The intervention consisted of 20 classes led by senior Iyengar yoga teachers, in three courses of 20 yoga classes each. All participants were diagnosed with unipolar major depression in partial remission. Psychological and biological characteristics were assessed pre- and post-intervention, and participants rated their mood states before and after each class. Significant reductions were shown for depression, anger, anxiety, neurotic symptoms and low frequency heart rate variability in the 17 completers. Eleven out of these completers achieved remission levels post-intervention. Participants who remitted differed from the non-remitters at intake on several traits and on physiological measures indicative of a greater capacity for emotional regulation. Moods improved from before to after the yoga classes. Yoga appears to be a promising intervention for depression; it is cost-effective and easy to implement. It produces many beneficial emotional, psychological and biological effects, as supported by observations in this study. The physiological methods are especially useful as they provide objective markers of the processes and effectiveness of treatment. These observations may help guide further clinical application of yoga in depression and other mental health disorders, and future research on the processes and mechanisms.

BACKGROUND: Recent studies have shown that depressive disorder is associated with impaired baroreceptor or baroreflex sensitivity, which is proposed to be a predisposing factor for sudden death in patients with manifest cardiac disease. These studies have not evaluated the afferent and efferent components of the cardiac baroreflex loop or other baroreflex mechanisms that regulate target processes (cardiac metabolism and blood pressure variability) related to the impairment. The objective of this study was to gain more insight into autonomic functioning in depressive disorder to more fully examine the potential basis for increased cardiac mortality. METHODS: The subjects were 28 women and men with unipolar major depression who were taking antidepressant medications and who were in partial remission and free of cardiovascular or other serious disease, and 28 healthy control subjects matched for sex, age, and ethnicity. The two samples were compared for negative affective dispositions (anger expression, hostility, defensiveness, anxiety), spontaneous (closed-loop) baroreflex activity, heart rate, heart rate variability, systolic blood pressure, and heart rate-systolic blood pressure double product under resting conditions. RESULTS: Depressed patients showed a general disposition to anger suppression coupled with higher hostility and anxiety, and lower defensiveness. The patients showed higher general sympathetic activity (high levels of blood pressure, low-frequency heart rate variability) and lower parasympathetic-related activity (high heart rate and reduced high frequency heart rate variability) with affected cardiac metabolism estimated by the double product. Depressed patients had lower baroreflex sensitivity related to a higher gain of the afferent component of the baroreflex without respective gain adjustment of its efferent component (reflex gain 'de-afferentation'). It was coupled with a compensatory higher number of effective baroreflex reactions (reflex gating 're-afferentation'). Antidepressant agents and depressed mood had additional independent effects on baroreflex sensitivity through the efferent component of the cardiac baroreflex loop. CONCLUSIONS: The data indicate that different baroreflex components and mechanisms may be impaired in patients with depression and may contribute to their increased cardiac risk.

It was recently shown that cognitive functions requiring more widespread brain integration relate to slower EEG activity, whereas cognitive performance supported by local brain integration is associated with faster EEG components (Von Stein & Sarnthein, 2000). Associations were studied between performance on WAIS and resting EEG spectral parameters in heroin abusers and normal young males. The most prominent associations between WAIS and EEG variables were consistently registered in polar and lateral frontal/temporal derivations. WAIS subtests predominantly loading on retrieval from long-term memory stores were significantly associated with delta bands mean frequencies. Subtests with strong working memory component related to theta2 mean frequency at temporal leads. Subtests requiring problem-solving operations correlated with alpha bands parameters, whereas psychomotor speed was associated with beta power. The data are in agreement with the hypothesis of Von Stein & Sarnthein (2000).

Objective: This study examined women’s moods on work and off days during different phases of the menstrual cycle. Method: Self-reports of the moods angry, happy, sad, stressed, tired, and anxious were obtained on two work and two off days during the luteal and follicular phases of the menstrual cycle in 203 nurses. Individual differences in anger expression, anxiety, and hostility were assessed. Results: Ratings of anxious, stressed, and tired were higher and happy and sad were lower on the workday than the off day. Menstrual cycle phase was associated with mood differences depending on the day (work, off work) and individual differences in personality traits. Conclusions: The experience of moods in everyday life is affected by overall levels of stress and phase of the menstrual cycle. The findings suggest the need to refine sociopsychobiological and clinical models of mood regulation and of risk for disease.

From the standpoint of the social and behavioral sciences, hypertension has attracted a great deal of attention. It forms the backbone of the growing fields of health psychology and behavioral medicine. The evidence is supportive of the role and significance of psychosocial factors in the etiology, course, and treatment of hypertension. This knowledge has the potential for deepening our understanding of the mechanisms involved in hypertension, improving the effectiveness of both drug and non-drug treatment, and facilitating efforts for prevention. There is great need for further systematic research and especially for theoretical and empirical integration of psychosocial and biological knowledge of the disorder.

BACKGROUND Objective measures of pain severity remain ill defined, although its accurate measurement is critical. Reciprocal baroreflex mechanisms of blood pressure (BP) control were found to impact differently on pain regulation, and thus their asymmetry was hypothesized to also connect to chronic pain duration and severity. METHODS Seventy-eight female patients with irritable bowel syndrome (IBS) and 27 healthy women were assessed for IBS severity and chronicity, negative affect, and various measures of resting autonomic function including BP, heart rate and its variability (HRV), baroreceptor-sensitivity to activations and inhibitions, gains of brady- and tachy-cardiac baro-responses, gains of BP falls/rises, and BP start points for these spontaneous baroreflexes. KEY RESULTS IBS directly and indirectly (through increased negative affect) was associated with asymmetry between baroreceptor activations/inhibitions compared to symmetrical baroreflex reciprocity in the healthy women. In the IBS group, independently of specific IBS symptoms, pain chronicity was associated with (i) decreased BP falls coupled with either (a) decreased tachycardia associated with lower disease severity (earlier "pain resilience" mechanism), or (b) decreased bradycardia associated with higher disease severity (later "pain decompensation" mechanism), or (ii) increased BP start point for baroreceptor activations coupled with either (a) BP increase (delayed "pain adaptation" mechanism) or (b) affect-related HRV decrease (delayed "pain aggravation" mechanism). CONCLUSION AND INFERENCES We anticipate the findings to be a starting point for validating these autonomic metrics of pain suffering and pain coping mechanisms in other chronic pain syndromes to suggest them as biomarkers of its severity and duration for profiling and correct management of chronic pain patients.

A major challenge presently is not only to identify the genetic polymorphisms increasing risk to diseases, but to also find out factors and mechanisms, which can counteract a risk genotype by developing a resilient phenotype. The objective of this study was to examine acquired and innate vagal mechanisms that protect against physical challenges and haemorrhages in 19 athletes and 61 non-athletes. These include examining change in heart rate variability (HF-HRV; an indicator of vagus activity) in response to orthostatic challenge, platelet count (PLT), mean platelet volume (MPV) and single-nucleotide polymorphisms in genes that encode several coagulation factors, PAI-1 and MTHFR. Individual differences in PLT and MPV were significant predictors, with opposite effects, of the profiles of the HF-HRV changes in response to orthostasis. Regular physical training of athletes indirectly (through MPV) modifies the genetic predisposing effects of some haemostatic factors (PAI-1 and MTHFR) on vagal tone and reactivity. Individual differences in vagal tone were also associated with relationships between Factor 12 C46T and Factor 11 C22771T genes polymorphisms. This study showed that genetic predispositions for coagulation are modifiable. Its potential significance is promoting advanced protection against haemorrhages in a variety of traumas and injuries, especially in individuals with coagulation deficits.

The importance of certain neurotrophic proteins found in maternal blood and milk for breastfed infants has remained ambiguous. This study was conducted to present evidence of the impact of an induced deficit of active S100B protein on neonate development. Newborn mice from two groups of mothers, immunized or sham-immunized against S100B, were subjected to various behavioral tests, and the development of their morphological characteristics was recorded from birth until weaning. Morphological problems, including weight gain and fur coating, a delay in the maturation of neurobehavioral systems and a deficit in neuromotor functions, including visual abilities, somato-sensory and posture reactions, muscular strength, locomotion, and fear/orienting processes, were observed in pups of immunized mothers. The S100B protein of external or internal origin in infants may be considered to be a specific factor that determines neuro- and morphological development and a risk-avoidance ('homeward-bent' or fearful) phenotype. The suppression of activity of the S100B protein results in a slower neonatal development and the formation of a risk-tolerant (fearless) phenotype of the offspring. This study thus considers the mechanism of neuroplastic regulation on the extent of sensation-seeking or risk-taking (homeless-like or fearless) and sensation- or risk-avoidance (home-bound or fearful) features in individual phenotypes.

The crystal structure of the title complex, [Cu2(OH)2(TMEDA)2]Cl2 (TMEDA is N,N,N′,N′-tetra­methyl­ethyl­ene­di­amine, C6H16N2), has been characterized by X-ray powder diffraction. The cation is a binuclear complex with a Cu⋯Cu distance of 3.031 (7) A and occupies a special position of 222 symmetry, while the chloride anions are on a twofold axis. There is a hydrogen bond linking a bridging hydroxy group with the anion [O⋯Cl = 2.993 (14) A].

It has been suggested that high alexithymia scorers have an 'augmenter' profile which amplifies their physiological and subjective responses to highly arousing stimuli. The aim of this study was to test this theory using several physiological measures. Participants listened to musical excerpts either in a 'weak-to-strong' or a 'strong-to-weak' order of arousing levels of stimuli. The results show that alexithymia was associated with an augmenter profile for subjective reports for the most arousing stimulus and with stronger skin conductance level responses in the 'strong-to-weak' order. These results partially support the augmenter profile and reveal that alexithymia may be associated with higher anticipation for the most arousing excerpt.

This study was conducted to test the hypothesis that two films that induce a sad feeling would elicit different physiological responses depending on an additional context of the film contents related to either avoidance (disgust) or attachment (tenderness). Reactivity was evaluated for facial behavior, heart rate, pulse transit time, skin conductance, and subjective experience. Participants reported feeling less happy and showed increased facial activity related to the sad content of both films. The sad film related to avoidance induced an increase in skin conductance level and response rate. In contrast, the sad film related to attachment induced a decrease in amplitude of skin conductance responses and heart rate. The study showed that while the common sad content of both films disturbed mood or provoked negative feelings, additional affective contexts induced either a decrease or an increase in physiological arousal.