Attending work with chronic pain is associated with higher levels of psychosocial stress

Background & Aims Much is known about the impact of pain in terms of medical costs and missed work. Less is known about its associations when individuals are present for work. This study examines “presenteeism” by analysing the psychosocial costs of pain in the workplace, using the 2015 European Working Conditions Survey (EWCS). Methods We conducted cross-sectional analysis of 2,384 individuals with chronic pain, and 2,263 individuals without pain (matched by age and sex), using data from the European Working Condition Survey (2015). We compared groups in terms of the following psychosocial factors: Supervisor Support, Job Responsibility, Team Cohesion, Discrimination, Threats/Abuse, Job Competency, Job Reward, Sexual Harassment, Stress, and Job Security. The groups were also compared in terms of days lost due to illness. Results People with pain were 64% less likely to view their job as rewarding (OR .61, 95% CI .57-.65), 47% more likely to be subjected to threats/abuse in the workplace (OR .68, 95% CI .63-.73), 30% more likely to report poor supervisor support (OR .77, 95% CI .73-.82), and 28% more likely to perceive discrimination in the workplace (OR .78, 95% CI .71-.85). People with pain missed approximately 9 more days of work per year than the non-pain respondents

Are the New Deal target groupings well founded? an examination of job search success before the New Deal

This study examines the appropriateness of the New Deal in targeting specific groups of unemployed jobseekers. This is done using a survey of unemployed jobseekers carried out prior to the implementation of the New Deal framework in April 1998. A sample of 169 unemployed jobseekers in two Travel to Work Areas in central Scotland is divided into those who were successful and those who were unsuccessful in finding employment and each group is analysed in terms of a set of labour market related attributes. The study generates a ‘typical’ profile for those who were successful in job search and a ‘typical’ profile for those who were less successful. These are compared and contrasted with the New Deal target groups. The findings support most of the target grouping basis of the policy but not all and we conclude that the generic aim of the New Deal, to reduce social exclusion, is unlikely to be achieved as effectively if spatial priorities are allowed to supercede the needs of the individual jobseeker

A comparative evaluation of interactive segmentation algorithms

In this paper we present a comparative evaluation of four popular interactive segmentation algorithms. The evaluation was carried out as a series of user-experiments, in which participants were tasked with extracting 100 objects from a common dataset: 25 with each algorithm, constrained within a time limit of 2 min for each object. To facilitate the experiments, a “scribble-driven” segmentation tool was developed to enable interactive image segmentation by simply marking areas of foreground and background with the mouse. As the participants refined and improved their respective segmentations, the corresponding updated segmentation mask was stored along with the elapsed time. We then collected and evaluated each recorded mask against a manually segmented ground truth, thus allowing us to gauge segmentation accuracy over time. Two benchmarks were used for the evaluation: the well-known Jaccard index for measuring object accuracy, and a new fuzzy metric, proposed in this paper, designed for measuring boundary accuracy. Analysis of the experimental results demonstrates the effectiveness of the suggested measures and provides valuable insights into the performance and characteristics of the evaluated algorithms

Hyaluronate levels in donor organ washout effluents: a simple and predictive parameter of graft viability

The principal cause of primary non-function in orthotopic liver transplantation is thought to be preservation injury to the microvasculature. We, therefore, evaluated if effluent levels of hyaluronate, whose uptake is an endothelial cell marker, could predict early graft function and ultimate graft outcome in orthotopic liver transplantation. A total of 102 cases were studied in two phases. In the first phase, we attempted to determine if a correlation existed between effluent hyaluronate levels, early graft function and ultimate graft outcome. This phase of the study was also used to determine hypothetical cut-off values for hyaluronate which could discriminate between good and bad livers. Thirty-two livers orthotopically transplanted to randomly selected primary recipients were studied. After varying periods of static cold storage (4°C) in University of Wisconsin solution, the livers were reinfused with cold (4°C) lactated Ringer’s solution. The first 50 ml of the reperfusion effluent was collected from the infrahepatic vena cava. Effluent samples were analyzed for hyaluronate. Linear regression analysis demonstrated a significant correlation between effluent hyaluronate levels and post-operative aspartate and alanine aminotransferase levels (p<0.001 for both). Logistic regression demonstrated a highly significant correlation (p = 0.0056) between effluent hyaluronate levels and ultimate graft outcome. Generation of Receiver Characteristics Curves indicated that a level between 400 and 430 μg·l(−1) could possibly discriminate between good livers and those at risk of early graft failure. The authenticity of this hyaluronate cut-off level was further confirmed in the second phase of the study where 70 consecutive primary crossmatch-negative transplants were performed. A highly significant difference was observed in peak aspartate and alanine aminotransferase levels in the first week (p<0.0006 and p<0.0005, respectively) between livers with effluent hyaluronate levels≤400 μg·l(−1) and livers with hyaluronate levels higher than 400 μg·l(−1) Logistic regression revealed a highly significant correlation between effluent hyaluronate levels and graft success (p=0.0001). Since hyaluronate uptake by the microvascular endothelial cell is significantly greater than production, high hyaluronate effluent levels in failed livers would be due to decreased hyaluronate uptake by the injured microvascular endothelial cell. We therefore conclude that effluent hyaluronate levels may prove to be a reliable preoperative test to assess early graft function and outcome in clinical orthotopic liver transplantation

Social evolution in micro-organisms and a Trojan horse approach to medical intervention strategies

Medical science is typically pitted against the evolutionary forces acting upon infective populations of bacteria. As an alternative strategy, we could exploit our growing understanding of population dynamics of social traits in bacteria to help treat bacterial disease. In particular, population dynamics of social traits could be exploited to introduce less virulent strains of bacteria, or medically beneficial alleles into infective populations. We discuss how bacterial strains adopting different social strategies can invade a population of cooperative wild-type, considering public good cheats, cheats carrying medically beneficial alleles (Trojan horses) and cheats carrying allelopathic traits (anti-competitor chemical bacteriocins or temperate bacteriophage viruses). We suggest that exploitation of the ability of cheats to invade cooperative, wild-type populations is a potential new strategy for treating bacterial disease

Do “central sensitization” questionnaires reflect measures of nociceptive sensitization or psychological constructs? Protocol for a systematic review

Introduction: Central sensitization (CS) was first defined in animal studies to be increased nociceptive responsiveness due to sensitization of neurons in the central nervous system, usually the result of prolonged nociceptive input or a disease state. Recently, the concept of CS has been adopted in clinical assessments of chronic pain, but its diagnosis in humans has expanded to include the enhancement of a wide range of nociceptive, sensory, and emotional responses. Many poorly understood pain disorders are referred to as “central sensitivity syndrome,” a term associated with a broad range of hypervigilant sensory and emotional responses. Diagnosis often involves a review of medical records and an assessment of behaviour, emotional disposition, and overall sensitivity of a patient. Obviously, these assessments are unable to directly capture the responsiveness of nociceptive neurons. The purpose of this review is to ascertain whether self-report questionnaires associated with central sensitization and the diagnosis of central sensitivity syndrome are associated with enhanced nociceptive responses or whether they more validly measure sensitivity in a broader sense (ie, including emotional responses). Methods: Following the PRISMA guidelines, a detailed search of studies that involve the Central Sensitization Inventory or Pain Sensitivity Questionnaire correlated with either nociceptive sensory tests (quantitative sensory testing) or emotional hypervigilance (anxiety, depression, stress, etc) will be conducted on MEDLINE, PsychINFO, and Web of Science. Perspective: The review is expected to synthesize correlations between sensitivity questionnaires and nociceptive or emotional sensitivity to determine whether these questionnaires reflect a broadened understanding of the term “central sensitization.

Stochastic evolutionary game dynamics

In this review, we summarize recent developments in stochastic evolutionary game dynamics of finite populations.Comment: To appear in "Reviews of Nonlinear Dynamics and Complexity" Vol. II, Wiley-VCH, 2009, edited by H.-G. Schuste

Heritability of the shape of subcortical brain structures in the general population

The volumes of subcortical brain structures are highly heritable, but genetic underpinnings of their shape remain relatively obscure. Here we determine the relative contribution of genetic factors to individual variation in the shape of seven bilateral subcortical structures: the nucleus accumbens, amygdala, caudate, hippocampus, pallidum, putamen and thalamus. In 3,686 unrelated individuals aged between 45 and 98 years, brain magnetic resonance imaging and genotyping was performed. The maximal heritability of shape varies from 32.7 to 53.3% across the subcortical structures. Genetic contributions to shape extend beyond influences on intracranial volume and the gross volume of the respective structure. The regional variance in heritability was related to the reliability of the measurements, but could not be accounted for by technical factors only. These findings could be replicated in an independent sample of 1,040 twins. Differences in genetic contributions within a single region reveal the value of refined brain maps to appreciate the genetic complexity of brain structures

Neurological Disease Rises from Ocean to Bring Model for Human Epilepsy to Life

Domoic acid of macroalgal origin was used for traditional and medicinal purposes in Japan and largely forgotten until its rediscovery in diatoms that poisoned 107 people after consumption of contaminated mussels. The more severely poisoned victims had seizures and/or amnesia and four died; however, one survivor unexpectedly developed temporal lobe epilepsy (TLE) a year after the event. Nearly a decade later, several thousand sea lions have stranded on California beaches with neurological symptoms. Analysis of the animals stranded over an eight year period indicated five clusters of acute neurological poisoning; however, nearly a quarter have stranded individually outside these events with clinical signs of a chronic neurological syndrome similar to TLE. These poisonings are not limited to sea lions, which serve as readily observed sentinels for other marine animals that strand during domoic acid poisoning events, including several species of dolphin and whales. Acute domoic acid poisoning is five-times more prominent in adult female sea lions as a result of the proximity of their year-round breeding grounds to major domoic acid bloom events. The chronic neurological syndrome, on the other hand, is more prevalent in young animals, with many potentially poisoned in utero. The sea lion rookeries of the Channel Islands are at the crossroads of domoic acid producing harmful algal blooms and a huge industrial discharge site for dichlorodiphenyltrichloroethane (DDTs). Studies in experimental animals suggest that chronic poisoning observed in immature sea lions may result from a spatial and temporal coincidence of DDTs and domoic acid during early life stages. Emergence of an epilepsy syndrome from the ocean brings a human epilepsy model to life and provides unexpected insights into interaction with legacy contaminants and expression of disease at different life stages