Search

UnlabelledPersistent pain following breast cancer surgery is a significant clinical problem. Although immune mechanisms may play a role in the development and maintenance of persistent pain, few studies have evaluated for associations between persistent breast pain following breast cancer surgery and variations in cytokine genes. In this study, associations between previously identified extreme persistent breast pain phenotypes (ie, no pain vs severe pain) and single nucleotide polymorphisms (SNPs) spanning 15 cytokine genes were evaluated. In unadjusted analyses, the frequency of 13 SNPs and 3 haplotypes in 7 genes differed significantly between the no pain and severe pain classes. After adjustment for preoperative breast pain and the severity of average postoperative pain, 1 SNP (ie, interleukin [IL] 1 receptor 2 rs11674595) and 1 haplotype (ie, IL10 haplotype A8) were associated with pain group membership. These findings suggest a role for cytokine gene polymorphisms in the development of persistent breast pain following breast cancer surgery.PerspectiveThis study evaluated for associations between cytokine gene variations and the severity of persistent breast pain in women following breast cancer surgery. Variations in 2 cytokine genes were associated with severe breast pain. The results suggest that cytokines play a role in the development of persistent postsurgical pain.

Purpose of the researchTo attempt to replicate the associations found in our previous study of patients and family caregivers between interleukin 6 (IL6) and nuclear factor kappa beta 2 (NFKB2) and sleep disturbance and to identify additional genetic associations in a larger sample of patients with breast cancer.Methods and samplePatients with breast cancer (n = 398) were recruited prior to surgery and followed for six months. Patients completed a self-report measure of sleep disturbance and provided a blood sample for genomic analyses. Growth mixture modeling was used to identify distinct latent classes of patients with higher and lower levels of sleep disturbance.Key resultsPatients who were younger and who had higher comorbidity and lower functional status were more likely to be in the high sustained sleep disturbance class. Variations in three cytokine genes (i.e., IL1 receptor 2 (IL1R2), IL13, NFKB2) predicted latent class membership.ConclusionsPolymorphisms in cytokine genes may partially explain inter-individual variability in sleep disturbance. Determination of high risk phenotypes and associated molecular markers may allow for earlier identification of patients at higher risk for developing sleep disturbance and lead to the development of more targeted clinical interventions.

Children’s understanding of numbers is often assessed using a number-line task, where the child is shown a line labeled with 0 at one end, and a higher number (e.g., 100) at the other end. The child is then asked where on the line some intermediate number (e.g., 70) should go. Performance on this task changes predictably during childhood, and this has often been interpreted as evidence of a change in the child’s psychological representation of integer quantities. The present paper presents theoretical and empirical evidence that the change in number-line performance actually reflects the development of measurement skills used in the task. We compare two versions of the number-line task: the bounded version used in the literature and a new, unbounded version. Results indicate that it is only children’s performance on the bounded task (which requires subtraction or division) that changes markedly with age. In contrast, children’s performance on the unbounded task (which requires only addition) remains fairly constant as they get older. Thus, developmental changes in performance on the traditional, bounded number-line task likely reflect the growth of task-specific measurement skills, rather than changes in the child’s understanding of numerical quantities.

A cloud‐resolved storm and chemistry simulation of a severe convective system in Oklahoma constrained by anvil aircraft observations of NOx was used to estimate the mean production of NOx per flash in this storm. An upward ice flux scheme was used to parameterize flash rates in the model. Model lightning was also constrained by observed lightning flash types and the altitude distribution of flash channel segments. The best estimate of mean NOx production by lightning in this storm was 80–110 mol per flash, which is smaller than many other literature estimates. This result is likely due to the storm having been a high flash rate event in which flash extents were relatively small. Over the evolution of this storm a moderate negative correlation was found between the total flash rate and flash extent and energy per flash. A longer‐term simulation at 36‐km horizontal resolution with parameterized convection was used to simulate the downwind transport and chemistry of the anvil outflow from the same storm. Convective transport of low‐ozone air from the boundary layer decreased ozone in the anvil outflow by up to 20–40 ppbv compared with the initial conditions, which contained stratospheric influence. Photochemical ozone production in the lightning‐NOx enhanced convective plume proceeded at a rate of 10–11 ppbv per day in the 9–11 km outflow layer over the 24‐hr period of downwind transport to the Southern Appalachians. Photochemical production plays a large role in the restoration of upper tropospheric ozone following deep convection. Plain Language Summary: Nitrogen oxides are important precursors for tropospheric ozone, an important greenhouse gas. The global amount of nitrogen oxides produced by lightning remains highly uncertain, primarily because of uncertainty in the amount produced per flash. In this paper we use an approach that involves cloud‐resolved modeling with chemistry, constrained by observed flash rates and aircraft measurements of nitrogen oxides, to make an estimate of the mean production per flash for an observed severe storm over Oklahoma. We estimate that the mean production rate was 80–110 mol per flash for this high flash rate storm, which is at the lower end of the range reported in the literature. We use a regional model to follow the outflow of the Oklahoma storm downwind to estimate the amount of ozone produced in the upper tropospheric outflow plume by the lightning‐generated nitrogen oxides. Our estimate is in the range found in previous studies, and we note that the ozone production by photochemistry is an important process in restoring upper tropospheric ozone following storms that lofted low values of ozone from the layer of air near the surface. Key Points: Mean lightning NOx production was 80–110 mol flash−1 for a high flash rate storm, based on a model constrained by flash and NOx observationsNet O3 production in the upper outflow of a high flash rate storm was at a rate of 10–11 ppbv day−1 during 24 hr of downwind transportProduction of O3 due to lightning NOx contributed to the recovery of upper tropospheric O3 following reductions due to convective transport [ABSTRACT FROM AUTHOR]

Cleft alveolar bone graft surgery is technically challenging to perform as well as difficult to learn and teach. A high-fidelity cleft alveolar bone graft simulator was previously developed. However, further evaluation of the simulator is necessary to assess its efficacy. Two cleft simulation workshops were conducted in which participants were led through a simulated cleft alveolar bone graft. The first simulation workshop involved six plastic surgery trainees. The second workshop involved 43 practicing cleft surgeons. The participants were provided with a Likert-type questionnaire assessing the simulators' features, realism, and value as a training tool. The change in self-reported confidence was assessed by providing each participant with a pre- and post-simulation confidence questionnaire. There was overall agreement in the realism of the simulators' features (average score of 4.67 and 3.80 out of 5 for the trainees and surgeons, respectively). There was overall agreement to strong agreement in the simulators value as a training tool (average score of 5 and 4.43 out of 5 for the trainees and surgeons, respectively). The self-reported confidence increased for all questionnaire items for both the trainees and surgeons. This was significant (p < 0.05) for five out of eight and all questionnaire items for the trainees and surgeons, respectively. The magnitude of the confidence increase was generally greater for less experienced participants. The cleft alveolar bone graft simulator was found to be realistic and valuable as a training platform. Use of the simulator improved self-reported confidence in cleft alveolar bone graft surgery. [ABSTRACT FROM AUTHOR]

Background Randomized clinical trials (RCTs) generally assess efficacy and safety separately, with the conclusion of whether a treatment is beneficial based solely on the efficacy endpoint. However, assessing and combining efficacy and safety domains, using a single composite outcome measure, can provide a more comprehensive assessment of the overall effect of a treatment. Furthermore, composite outcomes can incorporate information regarding the relationship between the individual outcomes. In fact, such outcomes have been suggested in the clinical trials literature for at least 15 years. Objectives To (1) identify whether recent primary publications of chronic pain RCTs from major pain journals included a composite outcome measure of benefits and harms and (2) discuss the potential benefits of such outcomes in various stages of treatment development, including as outcome measures in RCTs, and to support decisions of Data and Safety Monitoring Boards and ordering of treatments in the context of treatment guidelines. Evidence review RCTs published in 6 major pain journals published between 2016 and 2021 that investigated interventions for chronic pain were reviewed. Findings Of 73 RCTs identified, only 2 included a composite outcome measure of benefits and harms. Both of these articles compared 2 active treatments. Conclusions Composite outcomes of benefits and harms are underutilized in chronic pain RCTs. The advantages and challenges of using such outcomes are discussed. [ABSTRACT FROM AUTHOR]

Low-temperature scanning probe microscopes (SPMs) are critical for the study of quantum materials and quantum information science. Due to the rising costs of helium, cryogen-free cryostats have become increasingly desirable. However, they typically suffer from comparatively worse vibrations than cryogen-based systems, necessitating the understanding and mitigation of vibrations for SPM applications. Here we demonstrate the construction of two cryogen-free dilution refrigerator SPMs with minimal modifications to the factory default and we systematically characterize their vibrational performance. We measure the absolute vibrations at the microscope stage with geophones and use both microwave impedance microscopy and a scanning single-electron transistor to independently measure tip-sample vibrations. Additionally, we implement customized filtering and thermal anchoring schemes and characterize the cooling power at the scanning stage and the tip electron temperature. This work serves as a reference to researchers interested in cryogen-free SPMs, as such characterization is not standardized in the literature or available from manufacturers. [ABSTRACT FROM AUTHOR]

Purpose of the researchTo identify distinct latent classes of individuals based on ratings of morning and evening fatigue; evaluate for differences in phenotypic characteristics, as well as symptom and quality of life scores, among these latent classes; and evaluate for an overlap in morning and evening fatigue class membership.Patients and methodsIn a sample of 167 oncology outpatients and 85 of their FCs, growth mixture modeling was used to identify distinct latent classes based on ratings of morning and evening fatigue obtained before, during, and after radiation therapy. Analyses of variance and Chi Square analyses were used to evaluate for differences among the morning and evening fatigue latent classes.ResultsThree distinct latent classes for morning fatigue were identified. Participants in the High Morning Fatigue class (47%) were younger and had lower functional status. Three distinct latent classes for evening fatigue were identified. Participants in the High Evening Fatigue class (61%) were younger, more likely to be female, more likely to have children at home, and more likely to be a FC. Only 10.3% of participants were classified in both the Very Low Morning and Low Evening Fatigue classes and 41.3% were classified in both the High Morning and High Evening Fatigue classes.ConclusionsDifferent characteristics were associated with morning and evening fatigue, which suggests that morning and evening fatigue may be distinct but related symptoms. Additional research is needed to elucidate the mechanisms that may underlie diurnal variability in fatigue.

PurposeDepressive symptoms are common in cancer patients and their family caregivers (FCs). While these symptoms are characterized by substantial interindividual variability, the factors that predict this variability remain largely unknown. This study sought to confirm latent classes of oncology patients and FCs with distinct depressive symptom trajectories and to examine differences in phenotypic and genotypic characteristics among these classes.MethodAmong 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 of their FCs, growth mixture modeling (GMM) was used to identify latent classes of individuals based on Center for Epidemiological Studies-Depression (CES-D) scores obtained prior to, during, and for four months following completion of radiation therapy. One hundred four single nucleotide polymorphisms (SNPs) and haplotypes in 15 candidate cytokine genes were interrogated for differences between the two largest latent classes. Multivariate logistic regression analyses assessed effects of phenotypic and genotypic characteristics on class membership.ResultsFour latent classes were confirmed: Resilient (56.3%), Subsyndromal (32.5%), Delayed (5.2%), and Peak (6.0%). Participants who were younger, female, non-white, and who reported higher baseline trait and state anxiety were more likely to be in the Subsyndromal, Delayed, or Peak groups. Variation in three cytokine genes (i.e., interleukin 1 receptor 2 [IL1R2], IL10, tumor necrosis factor alpha [TNFA]), age, and performance status predicted membership in the Resilient versus Subsyndromal classes.ConclusionsFindings confirm the four latent classes of depressive symptom trajectories previously identified in a sample of breast cancer patients. Variations in cytokine genes may influence variability in depressive symptom trajectories.