Updating beliefs about pain following advice: Trustworthiness of social advice predicts pain expectations and experience

Prior expectations influence pain experience. These expectations, in turn, rely on prior pain experience, but they may also be socially influenced. Yet, most research has focused on self rather than social expectations about pain, and hardly any studies examine their combined effects on pain. Here, we adopted a Bayesian learning perspective to investigate how explicitly communicated social expectations (‘advice about pain tolerance’) affect own pain expectations, and ultimately pain tolerance, under varying conditions of social epistemic uncertainty (trustworthiness of the advice). N = 72 female participants took part in a coldpressor (cold water) task before (self-learning baseline) and after (socially-influenced learning) receiving advice about their likely pain tolerance from a confederate, the trustworthiness of whom was experimentally manipulated. We used path analysis to test the hypothesis that social advice from a highly trustworthy confederate would influence own expectations about pain more than advice from a less trustworthy source, and that the degree of this social influence would in turn predict pain tolerance. We further used a simplified, Bayesian learning, computational approach for explicit belief updating to examine the role of latent parameters of precision optimisation in how participants subsequently changed their future pain expectations (prospective posterior beliefs) based on the combined effect of the confederate’s advice on their own pain expectations, and their own task experience. Results confirmed that participants adjusted their pain expectations towards the confederate’s advice more in the high vs. low trustworthiness condition, and this advice taking predicted their pain tolerance. Furthermore, the confederate’s trustworthiness influenced how participants weighted the confederate’s advice in relation to their own expectations and task experience in forming prospective posterior beliefs. When participants received advice from a less trustworthy confederate, their own sensory experience was weighted higher than their socially-influenced prior expectations. Thus, explicit social advice appears to impact pain by influencing one’s own pain expectations, but low social trustworthiness leads to these expectations becoming more malleable to novel, sensory learning

Updating Prospective Self-Efficacy Beliefs About Cardiac Interoception in Anorexia Nervosa: An Experimental and Computational Study.

Patients with anorexia nervosa (AN) typically hold altered beliefs about their body that they struggle to update, including global, prospective beliefs about their ability to know and regulate their body and particularly their interoceptive states. While clinical questionnaire studies have provided ample evidence on the role of such beliefs in the onset, maintenance, and treatment of AN, psychophysical studies have typically focused on perceptual and 'local' beliefs. Across two experiments, we examined how women at the acute AN (N = 86) and post-acute AN state (N = 87), compared to matched healthy controls (N = 180) formed and updated their self-efficacy beliefs retrospectively (Experiment 1) and prospectively (Experiment 2) about their heartbeat counting abilities in an adapted heartbeat counting task. As preregistered, while AN patients did not differ from controls in interoceptive accuracy per se, they hold and maintain 'pessimistic' interoceptive, metacognitive self-efficacy beliefs after performance. Modelling using a simplified computational Bayesian learning framework showed that neither local evidence from performance, nor retrospective beliefs following that performance (that themselves were suboptimally updated) seem to be sufficient to counter and update pessimistic, self-efficacy beliefs in AN. AN patients showed lower learning rates than controls, revealing a tendency to base their posterior beliefs more on prior beliefs rather than prediction errors in both retrospective and prospective belief updating. Further explorations showed that while these differences in both explicit beliefs, and the latent mechanisms of belief updating, were not explained by general cognitive flexibility differences, they were explained by negative mood comorbidity, even after the acute stage of illness

Two-Loop g -> gg Splitting Amplitudes in QCD

Splitting amplitudes are universal functions governing the collinear behavior of scattering amplitudes for massless particles. We compute the two-loop g -> gg splitting amplitudes in QCD, N=1, and N=4 super-Yang-Mills theories, which describe the limits of two-loop n-point amplitudes where two gluon momenta become parallel. They also represent an ingredient in a direct x-space computation of DGLAP evolution kernels at next-to-next-to-leading order. To obtain the splitting amplitudes, we use the unitarity sewing method. In contrast to the usual light-cone gauge treatment, our calculation does not rely on the principal-value or Mandelstam-Leibbrandt prescriptions, even though the loop integrals contain some of the denominators typically encountered in light-cone gauge. We reduce the integrals to a set of 13 master integrals using integration-by-parts and Lorentz invariance identities. The master integrals are computed with the aid of differential equations in the splitting momentum fraction z. The epsilon-poles of the splitting amplitudes are consistent with a formula due to Catani for the infrared singularities of two-loop scattering amplitudes. This consistency essentially provides an inductive proof of Catani's formula, as well as an ansatz for previously-unknown 1/epsilon pole terms having non-trivial color structure. Finite terms in the splitting amplitudes determine the collinear behavior of finite remainders in this formula.Comment: 100 pages, 33 figures. Added remarks about leading-transcendentality argument of hep-th/0404092, and additional explanation of cut-reconstruction uniquenes

Two-loop QCD corrections to the helicity amplitudes for H → 3 partons

Many search strategies for the Standard Model Higgs boson apply specific selection criteria on hadronic jets observed in association with the Higgs boson decay products, either in the form of a jet veto, or by defining event samples according to jet multiplicity. To improve the theoretical description of Higgs-boson-plus-jet production (and the closely related Higgs boson transverse momentum distribution), we derive the two-loop QCD corrections to the helicity amplitudes for the processes H → ggg and H → qoverline q g in an effective theory with infinite top quark mass. The helicity amplitudes are extracted from the coefficients appearing in the general tensorial structure for each process. The coefficients are derived from the Feynman graph amplitudes by means of projectors within the conventional dimensional regularization scheme. The infrared pole structure of our result agrees with the expectation from infrared factorization and the finite parts of the amplitudes are expressed in terms of one- and two-dimensional harmonic polylogarithms

Two loop QCD helicity amplitudes for e+ e- to three jets

We compute the two-loop QCD helicity amplitudes for the process . The amplitudes are extracted in a scheme-independent manner from the coefficients appearing in the general tensorial structure for this process. The tensor coefficients are derived from the Feynman graph amplitudes by means of projectors, within the conventional dimensional regularization scheme. The actual calculation of the loop integrals is then performed by reducing all of them to a small set of known master integrals. The infrared pole structure of the renormalized helicity amplitudes agrees with the prediction made by Catani using an infrared factorization formula. We use this formula to structure our results for the finite part into terms arising from the expansion of the pole coefficients and a genuine finite remainder, which is independent of the scheme used to define the helicity amplitudes. The analytic result for the finite parts of the amplitudes is expressed in terms of one- and two-dimensional harmonic polylogarithms

Polymorphonuclear elastase as a diagnostic marker of acute pyelonephritis in children

Objective. Experimental evidence suggests that neutrophils and their metabolites play an important role in the pathogenesis of pyelonephritis. The aim of this study was to investigate the diagnostic value of polymorphonuclear elastase-a(1)-antitrypsin complex (E-a(1)-Pi) for the detection of acute pyelonephritis in children. Methods. Eighty-three patients, 29 boys and 54 girls, 25 days to 14 years of age, with first-time symptomatic urinary tract infection were prospectively studied. Fifty-seven healthy children served as controls. Dimercaptosuccinic acid (DMSA) scan and voiding cystourethrography were performed in all patients. Plasma and urinary E-a(1)-Pi, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), neutrophil count, urinary N-acetyl-beta-glucosaminidase (NAG), N-acetyl-beta-glucosaminidase b (NAG b), and creatinine levels were measured in all patients on admission and 3 days after the introduction of antibiotics. The same markers were also measured in the control subjects. Results. Planar DMSA scintigraphy demonstrated changes of acute pyelonephritis in 30 of 83 children (group A). It was normal in the remaining 53 children (group B). The sex and age distributions were not significantly different between the 2 groups, as well as between the patients and the control subjects (group C). Nineteen of the 53 children with a normal DMSA had body temperature greater than or equal to 38 degrees C, whereas all but 4 children with abnormal DMSA had temperature greater than or equal to 38 degrees C. Therefore, the temperature was significantly different between these 2 groups. The sensitivity and specificity of fever (greater than or equal to 38 degrees C) as an indicator of renal involvement based on isotopic findings were 86% and 64%, respectively. Given the significant number of the febrile children with normal DMSA scintiscans, group B was subdivided into B-1 with 19 febrile children (14 boys and 5 girls) and B-2 with 34 children whose body temperature was below 38 degrees C (8 boys and 26 girls). The sex and age distribution was significantly different between groups B-1 and B-2. The mean age of group B-1 was .78 years (range: 28 days to 9 years; median: .25 years; standard deviation: 2.1). All but 1 child in this group were younger than 1 year of age. In contrast, in group B-2, there were only 4 infants, the remaining 30 children were older than 2.5 years (mean age: 6 years; median: 7 years; standard deviation: 3.5; range: 34 days to 12 years). The mean duration of fever before hospital admission was 2.8 days for group A and 1.8 days for group B-1. This difference was not statistically significant. Similarly, body temperature was not significantly different between these 2 groups. The distribution of plasma E-a(1)-Pi values was normal in the control subjects. The sensitivity and specificity of plasma E-a(1)-Pi, as an indicator of renal involvement, were 96% and 50%, respectively, taking the 95th percentile of the reference range as a cutoff value. However, considering as a cutoff value the level of 72 mu g/dL (95th percentile of group B-2), its sensitivity and specificity were 74% and 86%, respectively. Plasma E-a(1)-Pi levels were significantly elevated in group A compared with group B and in both groups, the plasma E-a(1)-Pi values were significantly higher than in the control subjects. A significant difference also was noticed between group A and each of the subgroups B-1 and B-2 and also between the subgroups themselves. Plasma E-a(1)-Pi concentrations correlated significantly with neutrophil count in groups A (r = .3), B (r = .4), and B-2 (r = .46), but the correlation was not significant in group B-1. ESR levels showed, among the different groups, similar differences with those of E-a(1)-Pi values. Unlike E-a(1)-Pi, CRP levels were comparable between groups A and B-1, which both consisted of febrile children. Neutrophil count was not significantly different between subgroups B-1 and B-2. Considering 20 mg/dL as a cutoff level for CRP, its sensitivity and specificity for identifying the urinary tract infection site were 69% and 57%, respectively. The sensitivity and specificity of ESR, using 30 mm/hour as a cutoff value, were 90% and 59%, respectively. The comparison of febrile infants with a normal DMSA scan (all but 1 child of group B-1) with those with an abnormal one (a subpopulation of group A) showed significant difference of plasma E-a(1)-Pi and ESR but not of CRP and neutrophils. Urinary E-a(1)-Pi, as well as NAG and NAG b/creatinine values, showed no significant difference between groups A and B. NAG and NAG b levels were significantly higher in group B-1 compared with group B-2 but they were similar with those of group A. Reflux was noticed in 16/83 children (19%), 9/30 children with an abnormal DMSA (30%) and 7/53 with a normal DMSA scan (13%); this difference was not statistically significant. The sensitivity and specificity of reflux, as an indicator for renal lesions on the DMSA scan, were 30% and 86%, respectively. The follow-up investigation on the third day revealed that plasma E-a(1)-Pi levels, as well as CRP, were significantly lower compared with their levels on admission within each group. Despite the fact that ESR levels were lower on the third day, the difference was not significant. Conclusions. Plasma E-a(1)-Pi is a sensitive but not a specific marker for the detection of acute pyelonephritis. Urinary E-a(1)-Pi levels cannot be used for this purpose

Unsuspected extralymphocutaneous dissemination in febrile cat scratch disease

Cat scratch disease (CSD) commonly manifests as regional self-limited lymphadenitis. However, dissemination of the infection to distant multiple sites may occur even in immunocompetent patients. We report a series of 11 children with fever and extralymphocutaneous manifestations of CSD, in order to highlight potential multiorgan involvement in patients with febrile CSD. To be eligible for enrolment, patients had to present with involvement of sites other than regional lymph nodes. The diagnosis was based on suggestive clinical criteria, histological findings and positive serology. The utilization of ultrasound imaging revealed hepatic lesions in 3 children and splenic lesions in 8 children, whereas osteolytic lesions were observed in 4 children by bone scan. Hepatic or splenic involvement was not suggested by clinical signs or biochemical investigation in 2/3 and 6/8 children, respectively. Bone involvement was supported either by relative symptoms or signs. Our findings indicate that, in the presence of fever, extralymphocutaneous manifestations have to be anticipated in patients with clinically suspected CSD. The systematic use of imaging modalities in patients with serologically documented Bartonella henselae infection could contribute to a better understanding of the clinical spectrum of CSD

Moya moya syndrome in a child with pyruvate kinase deficiency and combined prothrombotic factors

A 13-year-old Greek girl with pyruvate kinase deficiency and moya moya angiographic pattern is reported. She also had raised serum lipoprotein (a) concentration and was homozygous for the C677T mutation of the methylenetetrahydrofolate reductase gene. She presented with neonatal onset of anemia, hemolytic and aplastic crises, especially during infections, stroke, and also progressive motor and mental deterioration. A digital cranial angiography at 13 years revealed the typical angiographic findings of moya moya angiopathy. This is likely the first patient with pyruvate kinase deficiency and moya moya syndrome and also the combination of elevated serum lipoprotein (a) concentration and the C677T mutation of the methylenetetrahydrofolate reductase gene to be reported. In patients with pyruvate kinase deficiency and moya moya syndrome, a search for raised serum lipoprotein (a) concentrations and the C677T mutation of the methylenetetrahydrofolate reductase gene should be considered