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Anne Marie McKenzie-Brown,1 David W Boorman,1 Kristen R Ibanez,2 Ezihe Agwu,3 Vinita Singh1 1Department of Anesthesiology, School of Medicine, Emory University, Atlanta, GA, USA; 2School of Medicine, University of Central Florida, Orlando, FL, USA; 3Department of Anesthesiology, Vassar Brothers Medical Center, Poughkeepsie, NY, USACorrespondence: Anne Marie McKenzie-Brown, Emory University Department of Anesthesiology, Emory University Hospital, 1364 Clifton Road, NE. Tower 5T58A, Atlanta, GA, USA, 30322, Tel +1 404-778-3900, Fax +1 404-778-5194, Email amckenz@emory.eduPurpose: Low-dose naltrexone (LDN) has increased in popularity as a non-opioid medication that may decrease chronic pain symptoms. LDN is most commonly used to treat fibromyalgia, complex regional pain syndrome (CRPS), and painful diabetic neuropathy. Other studies suggest that LDN provides general symptom reduction in inflammatory conditions such as Crohn’s disease and multiple sclerosis. We reviewed our experience with patients to whom we have prescribed LDN to see what types of painful conditions were most responsive to LDN in our patient population.Patients and Methods: Charts from patients who came to the Pain Center between 2014 and 2021 were reviewed.Results: Of the n = 137 patients who were prescribed LDN, 44% had no evidence of ever filling the prescription, and 4.4% of the responses were not charted. Of the remaining who took LDN (n = 70), 64% had some relief and were designated as ‘Responders’. The most common pain diagnosis was neuropathic pain which, when added to the diagnosis of complex regional pain syndrome, accounted for 51% of responders to LDN. Patients who experienced greater than 50% pain relief from LDN were more likely to have the diagnosis of neuropathic pain or complex regional pain syndrome (p = 0.038, Fisher’s Exact Test). There was a significant difference in the diagnosis of patients who responded to LDN. Patients with spondylosis were much less likely to respond to LDN when compared with other diagnoses (p = 0.00435, Chi-Square Test).Conclusion: Patients with all types of neuropathic pain, including CRPS, were significantly more likely to have pain relief from LDN than patients with spondylosis (p=0.018). The diagnosis of spondylosis was more often associated with a lack of response to LDN than any other diagnosis. Patients may need to have a trial of several weeks before analgesic effects are seen with LDN.Keywords: low-dose naltrexone, chronic pain, non-opioid analgesia

Climate change increases the occurrence and severity of droughts due to increasing temperatures, altered circulation patterns, and reduced snow occurrence. While Europe has suffered from drought events in the last decade unlike ever seen since the beginning of weather recordings, harmonized long-term datasets across the continent are needed to monitor change and support predictions. Here we present soil moisture data from 66 cosmic-ray neutron sensors (CRNSs) in Europe (COSMOS-Europe for short) covering recent drought events. The CRNS sites are distributed across Europe and cover all major land use types and climate zones in Europe. The raw neutron count data from the CRNS stations were provided by 24 research institutions and processed using state-of-the-art methods. The harmonized processing included correction of the raw neutron counts and a harmonized methodology for the conversion into soil moisture based on available in situ information. In addition, the uncertainty estimate is provided with the dataset, information that is particularly useful for remote sensing and modeling applications. This paper presents the current spatiotemporal coverage of CRNS stations in Europe and describes the protocols for data processing from raw measurements to consistent soil moisture products. The data of the presented COSMOS-Europe network open up a manifold of potential applications for environmental research, such as remote sensing data validation, trend analysis, or model assimilation The dataset could be of particular importance for the analysis of extreme climatic events at the continental scale. Due its timely relevance in the scope of climate change in the recent years, we demonstrate this potential application with a brief analysis on the spatiotemporal soil moisture variability. The dataset, entitled "Dataset of COSMOS-Europe: A European network of Cosmic-Ray Neutron Soil Moisture Sensors", is shared via Forschungszentrum Julich: https://doi.org/10.34731/x9s3-kr48 (Bogena and Ney, 2021)., Earth System Science Data, 14 (3), ISSN:1866-3516, ISSN:1866-3508