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Research within sport science disciplines seeks to enhance performance via the combination of factors that influences the team’s periodization. The current study aimed to investigate the variations in training load (TL), and the consequential changes in fitness variables, based on the use of match difficulty prediction model (MDP), level of opposition (LOP), days between matches, and match location during 12 weeks in the competitive period I. Seventeen elite soccer players (age = 17.57 ± 0.49 years; body height 1.79 ± 0.05 m; body weight 72.21 ± 6.96 kg), have completed a Yo-Yo intermittent recovery test, a running-based anaerobic sprint test, a soccer-specific repeated sprint ability, and a vertical jump test to identify changes in players fitness. TL was determined by multiplying the RPE of the session by its duration in minutes (s-RPE). Training monotony, strain, and acute:chronic workload ratio (ACWR) were also assessed. A simple regression model was conducted and the highest variances explained (R2) were used. The LOP score explained most of the variance in ACWR (r= 0.606, R2=0.37). TL declined significantly when compared the match-day by the first three days and the last three days of the week. No significant difference was found in s-RPE between the high and low MDP factor. Strong negative correlations were reported between ACWR and LOP (r=-0.714, p

Forage from small-grain cereals is an option to diversify feeding strategies in small-scale dairy systems (SSDS), due to their short cycle and ample adaptation. Mixtures of cereal species may have synergic advantages; however, grazing or ensiling are not always possible due to climatic factors, so that forage crops are left to mature and lose quality. Urea treatment of whole-crop mature cereal mixtures may be an option to salvage forage that could not be grazed or ensiled. The objective was to evaluate the performance of dairy cows fed urea-treated mature whole-crop forage mixtures of triticale (TRT), rye (RYE), and barley (BLY), in the dry season for SSDS. Treatment mixtures were TRT+RYE, TRT-BLY, and RYE+BLY. Fully mature cereal mixtures crops were treated with 4 - 6% granular urea (plus water) on a fresh basis. Forage variables were analysed with a split-plot design. Whole-crop forage yields were 3.4 ton/ha, with highest yields for RYE-BLY. Crude protein content increased two-fold in treated forages, and dry matter digestibility was moderate with a mean estimated ME content of 7.9 MJ ME/kg DM. Performance was evaluated by an on-farm 3x3 Latin square experimental design repeated 3 times with nine Holstein cows. Cows were offered daily 9.0 kg DM of urea treated forage; complemented with 4.4 kg DM of concentrate, day-grazing, and 1.5 kg of cut pasture. There were no statistical differences (P>0.05) for any of the animal variables. Urea treatment of whole-crop mature cereal mixtures resulted in a complementary moderate quality salvage forage for the dry season.

Juvenile Fibromyalgia (JFM) is a complex chronic pain condition that remains poorly understood. The study aimed to expand the clinical characterization of JFM in a large representative sample of adolescents with JFM and identify psychological factors that predict pain interference.Participants were 203 adolescents (12-17 years) who completed baseline assessments for the multi-site Fibromyalgia Integrative Training for Teens (FIT Teens) randomized control trial. Participants completed the Pain and Symptom Assessment Tool (PSAT), which includes a Widespread Pain Index (WPI, 0-18 pain locations) and Symptom Severity checklist of associated somatic symptoms (SS; 0-12) based on the 2010 ACR criteria for Fibromyalgia. Participants also completed self-report measures of pain intensity, functional impairment, and psychological functioning.Participants endorsed a median of 11 painful body sites (WPI) and had a median SS score of 9. Fatigue and nonrestorative sleep were prominent features and rated as moderate to severe by 85% of participants. Additionally, neurologic, autonomic, gastroenterological, and psychological symptoms were frequently endorsed. WPI was significantly correlated with pain intensity and catastrophizing, while SS scores were associated with pain intensity and all domains of physical and psychological functioning. Depressive symptoms, fatigue, and pain catastrophizing predicted severity of pain impairment.JFM is characterized by chronic widespread pain with fatigue, nonrestorative sleep, and other somatic symptoms. However, how diffusely pain is distributed appears less important to clinical outcomes and impairment than other somatic and psychological factors highlighting the need for a broader approach to the assessment and treatment of JFM.

The aim of this study is to discuss the role of the chiropractor in triage of a patient presenting with acute onset of worsening dizziness of unknown etiology. We present a 66-year-old-female who presented to a hospital-based chiropractic clinic with acute onset worsening dizziness with multiple comorbid conditions. Patient presented to the chiropractic clinic for routine management of low back pain; however, upon review of systems, the patient indicated symptoms as described above. The patient was immediately transported to the ED for further evaluation and work up by the appropriate medical professionals. Patient was admitted for observation with suspected intracranial hemorrhage. The role of the chiropractor in a multidisciplinary setting includes not only evaluation and management of musculoskeletal conditions, but also the identification of red flag signs and initiation of triage in efforts of providing complete and comprehensive, patient-centered care. This case report highlights the importance of detailed history, review of systems, and physical examination in an outpatient clinical setting, regardless of the specialty of the practitioner.

Objective School anxiety is a prevalent mental health concern that drives school-related disability among youth with chronic pain. The only available measure of school anxiety—the School Anxiety Inventory, Short Version (SAI-SV)—lacks content specificity for measuring school anxiety in pediatric pain populations. We aimed to refine the SAI-SV by obtaining qualitative data about unique school situations that are anxiety-provoking for youth with pain and characterizing the nature of symptoms experienced in these situations. Methods Adolescents with chronic pain (n = 16) completed a semistructured interview focused on experiences with anxiety in school-related academic and social contexts. We employed thematic analysis to extend the empirical understanding of school anxiety from the perspective of patients suffering from pain and to generate new item content. The content was refined with iterative feedback from a separate group of adolescents with chronic pain (n = 5) and a team of expert pain psychologists (n = 3). Results We identified six themes within the data and generated new items designed to capture anxiety related to negative interactions with teachers and peers, falling behind with schoolwork, and struggles with concentration and fatigue. Participants and experts rated new item content as highly relevant for use among youth with pain. The updated item bank was named the School Anxiety Inventory for Chronic Pain. Conclusions Future research is needed to complete the psychometric evaluation of the item bank and finalize items to be included in a measure that can be used in research and clinical settings. Implications for treating school-related anxiety among youth with pain are also discussed.

Objective Anxiety is common in pediatric chronic pain and is related to a higher risk for poor outcomes; thus, there is a need for effective clinical screening methods to identify youth with chronic pain and co-occurring anxiety. The Screen for Child Anxiety-related Disorders (SCARED) is a validated measure that defines clinically significant anxiety using the traditional clinical cut-off, but in pain populations, may fail to screen in youth with subclinical anxiety that may also be at increased risk. Two studies aimed to devise a clinically meaningful approach to capture anxiety severity in pediatric chronic pain. Materials and methods Study 1 (n=959) and Study 2 (n=207) were completed at 2 separate pediatric pain clinics, where the SCARED was administered along with measures of disability, activity limitations, pain intensity, quality of life, and pain catastrophizing. Groups with different levels of anxiety were compared on clinical outcomes via multivariate analyses of variance or independent samples t tests. Results A tertile solution suggested the following anxiety groupings based on the SCARED: minimal (0 to 12), subclinical (13 to 24), and clinical (≥25). Across both studies, the tertile solution was generally superior in classifying different levels of pain-related outcomes. Discussion Future directions include testing the utility of this anxiety classification system to identify youth with subclinical levels of anxiety for early intervention focused on both pain and anxiety management.

Circulating autoantibodies (auto-Abs) neutralizing high concentrations (10 ng/ml; in plasma diluted 1:10) of IFN-α and/or IFN-ω are found in about 10% of patients with critical COVID-19 (coronavirus disease 2019) pneumonia but not in individuals with asymptomatic infections. We detect auto-Abs neutralizing 100-fold lower, more physiological, concentrations of IFN-α and/or IFN-ω (100 pg/ml; in 1:10 dilutions of plasma) in 13.6% of 3595 patients with critical COVID-19, including 21% of 374 patients >80 years, and 6.5% of 522 patients with severe COVID-19. These antibodies are also detected in 18% of the 1124 deceased patients (aged 20 days to 99 years; mean: 70 years). Moreover, another 1.3% of patients with critical COVID-19 and 0.9% of the deceased patients have auto-Abs neutralizing high concentrations of IFN-β. We also show, in a sample of 34,159 uninfected individuals from the general population, that auto-Abs neutralizing high concentrations of IFN-α and/or IFN-ω are present in 0.18% of individuals between 18 and 69 years, 1.1% between 70 and 79 years, and 3.4% >80 years. Moreover, the proportion of individuals carrying auto-Abs neutralizing lower concentrations is greater in a subsample of 10,778 uninfected individuals: 1% of individuals 80 years. By contrast, auto-Abs neutralizing IFN-β do not become more frequent with age. Auto-Abs neutralizing type I IFNs predate SARS-CoV-2 infection and sharply increase in prevalence after the age of 70 years. They account for about 20% of both critical COVID-19 cases in the over 80s and total fatal COVID-19 cases. © 2021 The Authors, some rights reserved.

Objective Juvenile-onset fibromyalgia (JFM) is a chronic debilitating pain condition that negatively impacts physical, social and academic functioning. Cognitive-behavioral therapy (CBT) is beneficial in reducing functional disability among adolescents with JFM but has only a modest impact on pain reduction and does not improve physical exercise participation. This randomized controlled trial (RCT) aims to test whether a novel intervention that combines CBT with specialized neuromuscular exercise training (the Fibromyalgia Integrative Training program for Teens “FIT Teens”) is superior to CBT alone or a graded aerobic exercise (GAE) program. Design/Methods This 3-arm multi-site RCT will examine the efficacy of the FIT Teens intervention in reducing functional disability (primary outcome) and pain intensity (secondary outcome), relative to CBT or GAE. All interventions are 8-weeks (16 sessions) in duration and are delivered in small groups of 4–6 adolescents with JFM. A total of 420 participants are anticipated to be enrolled across seven sites with approximately equal allocation to each treatment arm. Functional disability and average pain intensity in the past week will be assessed at baseline, post-treatment and at 3-, 6-, 9- and 12-month follow-up. The 3-month follow-up is the primary endpoint to evaluate treatment efficacy; longitudinal assessments will determine maintenance of treatment gains. Changes in coping, fear of movement, biomechanical changes and physical fitness will also be evaluated. Conclusions This multi-site RCT is designed to evaluate whether the combined FIT Teens intervention will have significantly greater effects on disability and pain reduction than CBT or GAE alone for youth with JFM. Clinical trials.gov registration: NCT 03268421.

We determined the Fe isotope fractionation between the metal and silicate phases of two aubrite meteorites, Norton County and Mount Egerton. We find that the metallic phase is high in 57Fe/54Fe with respect to the silicate phase, with Δ57Femetal-silicate = 0.08‰ ± 0.04 for Mount Egerton and 0.09 ± 0.02‰ for Norton County. These data, combined with new measurements of 57Fe/54Fe of IIIAB iron meteorites, are used to constrain the origins of the high 57Fe/54Fe exhibited by all classes of iron meteorites. We find that if the parent bodies of the iron meteorites had chondritic bulk 57Fe/54Fe values, their cores must have been unusually small (≤8% by mass). Relaxing the constraint that the bodies were chondritic in their bulk iron isotope ratios allows for larger core mass fractions commensurate with usual expectations. In this case, the elevated 57Fe/54Fe values of iron meteorites are due in part to evaporation of melt during the accretion stages of the parent bodies and not solely the result of metal-silicate differentiation.

INTRODUCTION A variety of factors influence parent responses to pain behaviors they observe in their adolescents with chronic pain. Certain parental responses to pain, such as attention or overprotection, can adversely impact adolescent adaptive functioning and correspond to poor clinical outcomes. OBJECTIVES It was hypothesized that the relationship between adolescent pain behaviors and functional disability was mediated by maladaptive parenting (protective, monitoring, solicitousness) responses. MATERIALS AND METHODS Participants were 303 adolescents and their mothers presenting to a pain clinic. Adolescents completed measures of functional disability and pain intensity; mothers completed measures assessing adolescent pain behaviors, their own catastrophizing about their adolescent's pain, and responses to pain. A path model tested the direct and indirect associations between pain behaviors and disability via 3 parenting responses, controlling for average pain intensity and parent pain catastrophizing. RESULTS Greater pain behavior was associated with increased protective responses (α path, P

Objective Despite the availability of measures for assessing physical, psychological, and health impact in children with chronic pain, there are not established guidelines for interpretation of children’s pain outcomes following psychological treatment. The purpose of this topical review is to discuss clinical significance as a neglected area of consideration in pediatric chronic pain assessment and to make recommendations on how the field can move toward benchmarking on core outcome domains. Method We review definitions of clinical significance and examples of several methodologies that have been used in other populations or are emerging in pediatric chronic pain including anchor-based methods, distribution-based methods, or multimethod approaches. Results Few measures across pediatric chronic pain outcome domains have established clinical significance of scores to interpret meaningful change following treatment limiting the interpretability of findings from clinical trials. In the context of clinical practice, several efforts to examine clinical significance to improve the translation of evidence-based measurement into standard clinical decision-making exist. Conclusions Recommendations are provided to encourage additional validation efforts of outcome measures in pediatric chronic pain and to encourage authors to report clinical significance in clinical trials of psychological interventions for pediatric chronic pain.

Objective School anxiety is a prevalent and debilitating mental health problem among youth with chronic pain. Despite evidence that anxiety in the context of school is associated with significant school-related disability, no studies have examined specific aspects of school anxiety in a pediatric chronic pain population. Materials and methods Adolescents with chronic pain (n=30) and age-matched and sex-matched controls (n=30) and their parents completed questionnaires assessing school anxiety and functioning. Results Adolescents with chronic pain reported significantly more cognitive, behavioral, and psychophysiological symptoms of school anxiety relative to healthy controls. Youth with pain also endorsed significantly greater school anxiety in situations involving negative social evaluation and peer aggression. Exploratory analyses indicated that adolescents with chronic pain reporting school refusal behaviors more strongly endorsed behavioral and psychophysiological school anxiety symptoms, and more symptoms in social-evaluative situations. Youth with pain reporting lower school functioning endorsed more cognitive school anxiety symptoms and anxiety in situations involving academic failure relative to those reporting higher functioning. Discussion Present results offer a nuanced perspective into the underlying sources of school anxiety among adolescents with chronic pain. Our findings may inform future research efforts and targeted school functioning interventions. In particular, findings suggest that an individualized approach to the assessment of school anxiety which considers the unique sources of anxiety (eg, social vs. academic) may lay the groundwork for the refinement of school functioning interventions in pediatric chronic pain.

To evaluate whether clinical anxiety in children presenting to a pediatric pain management center is associated with a poorer treatment response for those who completed pain-focused cognitive behavioral therapy (CBT).The total sample consisted of 175 children, 40 of whom completed CBT for chronic pain. The Screen for Child Anxiety Related Emotional Disorders was completed at initial evaluation and outcome measures (average pain intensity and the Functional Disability Inventory) were collected during the initial evaluation and at the end of CBT. Group differences in outcomes were examined following CBT. The role of anxiety in CBT initiation and completion was also explored.Presence of clinical anxiety was associated with greater initiation and/or completion of pain-focused CBT but also a poorer treatment response. Specifically, the group with subclinical anxiety exhibited a substantial reduction in pain intensity, and the group with clinical anxiety exhibited a more limited response to treatment (F [1, 36] = 13.68 P.01). A similar effect was observed for Functional Disability Inventory, such that the group with clinical anxiety had a significantly smaller response to treatment (F [1, 38] = 4.33 P.05). The difference in pain and disability between groups following CBT suggest moderate effects (Cohen d = 0.77 and 0.78, respectively).Although youths with clinical anxiety are more likely to start and/or complete pain-focused CBT, anxiety has an adverse impact on CBT treatment response in children with chronic pain. Identification of patients with anxiety and use of tailored behavioral interventions may improve clinical outcomes.

Widespread musculoskeletal pain is a chronic and debilitating pain condition associated with impairment in multiple domains of functioning, with notable declines in physical functioning and difficulty tolerating basic activities such as attending school, spending time with friends, and helping with chores. Activity limitations and physical deconditioning may present challenges for mental health clinicians seeking to provide intervention. Cognitive behavioral therapy (CBT) is an evidence-based, effective treatment modality to reduce functional disability and improve pain-specific cognitions (e.g., fear of movement, pain catastrophizing) in youth with widespread musculoskeletal pain. In addition to psychoeducation and relaxation training, CBT for chronic widespread musculoskeletal pain has a strong emphasis on resuming normal physical functioning using behavioral activation, activity pacing with scheduled breaks, and cognitive restructuring for maladaptive pain-specific beliefs. Additionally, there is evidence that incorporating graded exercise training within treatment can be particularly useful to build endurance and address physical deconditioning.

Juvenile-onset fibromyalgia (JFM) is typically diagnosed in adolescence and characterized by widespread pain and marked functional impairment. The long-term impact of JFM into adulthood is poorly understood. The objectives of this study were to describe physical and psychosocial outcomes of youth diagnosed with JFM in early adulthood (~ 8-year follow-up), examine longitudinal trajectories of pain and depressive symptoms from adolescence to young adulthood, and examine the impact of pain and depressive symptoms on physical functioning over time. Participants were 97 youth with JFM enrolled in a prospective longitudinal study in which pain symptoms, physical and psychosocial functioning were assessed at four time points over approximately eight years. At the Time 4 follow-up (M(age) = 24.2 years), the majority continued to suffer from pain and impairment in physical, social, and psychological domains. However, trajectories of pain and emotional symptoms showed varying patterns. Longitudinal analysis using growth mixture modeling revealed two pain trajectories (Steady Improvement and Rapid Rebounding Improvement); whereas depressive symptoms followed three distinct trajectories (Low-Stable, Improving, and Worsening). Membership in the Worsening Depressive symptoms group was associated with poorer physical functioning over time (p < .001) compared to the Low-Stable and Improving groups. This study offers evidence that while JFM symptoms persist for most individuals, pain severity tends to decrease over time. However, depressive symptoms follow distinct trajectories that indicate subgroups of JFM. In particular, JFM patients with worsening depressive symptoms showed decreasing physical functioning and may require more intensive and consistent intervention to prevent long-term disability.

9 pags., 3 figs. -- Open Access funded by Creative Commons Atribution Licence 4.0, Three observables of interest for present and future reactors depend on the β decay properties of the fission products: antineutrinos from reactors, the reactor decay heat and delayed neutron emission. In these proceedings, we present new results from summation calculations of the first two quantities quoted above, performed with evolved independent yields coupled with fission product decay data, from various nuclear data bases or models. New TAGS results from the latest experiment of the TAGS collaboration at the JYFL facility of Jyväskylä will be displayed as well as their impact on the antineutrino spectra and the decay heat associated to fission pulses of the main actinides.

OBJECTIVE: The current study tested the utility of the PROMIS Pediatric Pain Interference (PPI) in relation to the widely-used Functional Disability Inventory (FDI) in a small-scale clinical trial. METHODS: Forty youth with juvenile fibromyalgia (JFM) were randomized to either CBT only or a combined CBT and neuromuscular exercise group (i.e., FIT Teens). Participants completed the PPI and FDI at baseline, post-treatment, and three-month follow-up. RESULTS: The PPI and FDI were significantly correlated at baseline (r = .51) and post treatment (r = .53), and demonstrated similar improvements (d PPI = .87, d FDI = 1.22, p

A key part of the oilfield scale management toolbox is the ability to determine the concentration of residual scale inhibitors and scaling ions in produced waters. This data is essential to providing correct recommendations for how to manage and inhibit scale in a particular system, as well as monitoring the efficacy of scale management processes already in place. The progression of analytical techniques over the last two decades has provided enhanced methods for accurate detection of ions and scale inhibitors to low limits of detection, however, correct detection of analytes present in a sample in the laboratory does not necessarily equal characterisation of the analytes in-system as they were present at the point of sampling. The collation of a range of preservation techniques, each appropriate to a different group of analytes, forms the basis of this paper. The results of several field applications of incorrect sample preservation are outlined and the alternative preservation technique used to correct the analysis will be detailed. The implication of using the correct preservation technique will be clearly shown to have an impact on scale management where it would lead to reduction of over treatment, leading to increased revenue, whilst also eliminating incorrectly scheduled early well interventions.

Formation of sulphate and carbonate scale is well understood within the hydrocarbon extraction industry with injection of incompatible water such as seawater into reservoir with significant concentration of barium, strontium and calcium. To overcome this challenge chemical inhibition has been utilized for many decades and in the past 15 years elimination/reduction of the sulphate ion source from injection seawater using sulphate reduction membranes has been employed. This paper present laboratory work to qualify a scale inhibitor and field results of its application to prevent scale formation when an operator had to change from low sulphate seawater (LSSW) mixed with produced water (PW) for their water injection source to a blend of LSSW/PW and full sulphate seawater (SW). The increased level of sulphate presented a significant scale risk within the topside process on fluid mixing but more significantly increased the risk of scale formation within the near wellbore region of the injector wells which were under matrix injection rather than fracture flow regime. The qualification of a suitable inhibitor required assessment of the retention of a potentially suitable vinyl sulphonate co polymer scale inhibitors to ensure it had low adsorption and was able to propagate deep into the formation before being adsorbed from the supersaturated brine. Coreflood studies using reservoir core were carried out to assess the scale risk of the LSSW/PW/SW brine, propagation and release characteristic of the short-listed scale inhibitors. The recommendation that followed the laboratory studies was to apply a batch treatment of concentrated scale inhibitor to each injector well to provide a high concentration pad of scale inhibitor that would be transported into the reservoir when the scaling LSSW/PW/SW fluid was injected. Protection was provided by continuous application of the same chemical at minimum inhibitor concentration to prevent scale formation within the topside and the desorption of the batched inhibitor within the near wellbore would prevent scale formation within this critical region. Thirteen injection wells were treated with a pad of 10% vinyl sulphonate co polymer scale inhibitor to a radial distance of 3 ft. prior to the start of LSSW/PW/SW injection. Highly scaling brine has been injected now for 16 months into the thirteen wells at an average rate of 25,000 BWPD per well with no decline in injector performance observed. The lessons learned from this study are that changes in scaling potential within a PWRI system can be controlled by carrying out an assessment of location of scale formation and adoption of more typical production well scale squeezes treatment technology to protect the critical near wellbore region around PWRI injection wells.

It has been proven that scale squeezes can be conducted effectively in the unconventional, horizontal fractured wells in the shale reservoir of the Bakken when using an optimal scale squeeze chemistry. Previous work has discussed inhibitor selection and performance testing along with early case histories and modeling work. This paper discusses new case histories and Place-iT modeling results based on several procedural variations including a range of overflush volumes in the squeeze treatment procedure and the inclusion of acid cleanouts. Novel, reduced-volume squeeze designs have successfully protected wells from scale deposition while limiting the direct and indirect costs associated with extra placement water. For unconventional shale wells in the Bakken, where produced water is typically very high in TDS and TSS, fresh water is most commonly used to execute squeezes. Reducing the total water volume reduces the costs of purchasing, transporting and storing fresh water. The amount of time and cost to pump the job is decreased. Less time and money is spent lifting the placement water, and consequently, there is less deferred production. In addition, in unconventional production acid treatments are commonly carried out in isolation to maintain production. In this work, applying acidizing stages at the front of the squeeze procedures, provides a novel "squimulation" process to fractured reservoir scale control treatments. For these unconventional horizontal wells, the use of larger water volumes—either several times full wellbore volume and/or several times daily water production—has not been shown to improve the longevity or cost-effectiveness of squeeze jobs. Contrary to conventional well applications modeled with Darcy flow, it appears diffusion is the more applicable mechanism for scale inhibitor transport in fractured shale wells. This mechanism is consistent with a reduced dependence on water volume deployed in the treatments. The lessons learned from the unconventional horizontal scale squeezes conducted in the Bakken have resulted in enhanced production and cost savings. There are significant implications for the industry as other key unconventional regions in the U.S. and around the world are looking into scale squeezes as an option for scale control.

Juvenile-onset fibromyalgia (JFM) is a chronic pain condition typically diagnosed in adolescence and characterized by widespread pain and marked functional impairment, including mood difficulties. However, the long-term impact of JFM during the period when adolescents transition into young adulthood is poorly understood. The objectives of this study were to describe physical and psychosocial outcomes of youth diagnosed with JFM in early adulthood (∼ 8-years after initial assessment), examine longitudinal trajectories of pain and depressive symptoms from adolescence to young adulthood, and examine the impact of pain and depressive symptoms on physical functioning over time. Participants were 97 youth with JFM enrolled in a prospective longitudinal study, in which pain symptoms, physical and psychosocial functioning were assessed at four time points over approximately eight years. The 8-year follow-up data were evaluated descriptively, and trajectories were identified using growth mixture modeling analyses in MPlus. At the final assessment (T4) (Mage = 24.2 years), a majority of young adults continued to suffer from pain and impairment in physical, social, and psychological domains, with 58% meeting ACR 2010 criteria for adult fibromyalgia (FM). However, trajectories of pain and emotional symptoms showed varying patterns. Longitudinal analyses revealed two pain trajectories (Steady Improvement and Rapid Rebounding Improvement). Depressive symptoms followed three distinct trajectories (Low-Stable, Improving, and Worsening). The group with worsening depressive symptoms was associated with poorer physical functioning over time (p

This paper presents the design of a total absorption γ-ray spectrometer for the determination of β-decay intensity distributions of exotic nuclear species at the focal plane of the FAIR-NUSTAR Super Fragment Separator. The spectrometer is a key instrument in the DESPEC experiment and the proposed implementation follows extensive design studies and prototype tests. Two options were contemplated, based on NaI(Tl) and LaBr3:Ce inorganic scintillation crystals respectively. Monte Carlo simulations and technical considerations determined the optimal configurations consisting of sixteen 15 × 15 × 25 cm 3 crystals for the NaI(Tl) option and one hundred and twenty-eight 5.5 × 5.5 × 11 cm 3 crystals for the LaBr3:Ce option. Minimization of dead material was crucial for maximizing the spectrometer full-energy peak efficiency. Module prototypes were build to verify constructional details and characterize their performance. The measured energy and timing resolution was found to agree rather well with estimates based on simulations of scintillation light transport and collection. The neutron sensitivity of the spectrometer, important when measuring β-delayed neutron emitters, was investigated by means of Monte Carlo simulations.

Purpose Juvenile-onset fibromyalgia (JFM) affects physical, social, and emotional functioning. Little is known about how social support and social interactions are impacted in the transition to young adulthood for patients diagnosed with JFM. Methods Young adults (M age = 21.6) diagnosed with JFM during adolescence (N = 94) and matched healthy controls (N = 33) completed measures of social network size and diversity, perceived social support, physical functioning, and depressive symptoms as part of a cross-sectional survey study. Results No difference in social network diversity was found, although JFM patients reported fewer total people within their social networks. JFM patients reported poorer emotional and tangible support and fewer positive social interactions than healthy controls. After controlling for condition and pain intensity, the level of perceived social support was a significant predictor of physical functioning and depressive symptoms, whereas social network size also contributed uniquely to physical functioning. Conclusions Given the developmental importance of social support in adolescence and young adulthood, interventions should include methods of improving social support into fibromyalgia management.