Vulvodynia is not created equally: empirical classification of women with vulvodynia

Background: Vulvodynia classification is based on the sensory dimensions of pain and does not include psychological factors associated with the pain experience and treatment outcomes. Previous work has shown that individuals with chronic pain can be classified into subgroups based on pain sensitivity, psychological distress, mood, and symptom severity. Objective: The aim of this study was to identify distinct subgroups of women with vulvodynia enrolled in the National Vulvodynia Registry. We hypothesized that women with vulvodynia can be clustered into subgroups based on distress and pain sensitivity. Design: A cross-sectional study. Methods: We conducted an exploratory hierarchical agglomerative cluster analysis using Ward’s cluster method and squared Euclidean distances to identify unique subgroups based on baseline psychological distress and pain sensitivity. The variables included the catastrophizing subscale of the Coping Strategies Questionnaire, the Beck Depression Inventory, the State Trait Anxiety Index-Trait scale, McGill Pain Questionnaire-Affective subscale, and vulvar and pelvic muscle pressure pain sensitivity. Subjects: Eight sites enrolled women who presented with vaginal or vulval pain of at least 3-month duration. Results: Two distinct subgroups, high pain sensitivity with high distress (n=27) and low pain sensitivity with low distress (n=100), emerged from the cluster analysis. Validation indicated that subgroups differed in terms of clinical pain intensity, sensory aspects of pain, and intercourse pain. Conclusion: Empirical classification indicates that unique subgroups exist in women with vulvodynia. Providers should be aware of the heterogeneity of this condition with respect to pain-related distress and pain sensitivity

Stability of behavioral estimates of activity-dependent modulation of pain

Temporal sensory summation of pain (TSSP) is a proxy measure of windup in humans and results in increased ratings of pain caused by a repetitive, low-frequency noxious stimulus. Aftersensations (ASs) are pain sensations that remain after TSSP has been induced. We examined the within-session and across-session variability in TSSP and AS estimation in healthy participants and in participants with exercise-induced muscle pain in order to determine whether the presence of pain affected the stability of TSSP and ASs. TSSP was estimated by application of 10 repetitive, low-frequency (<0.33 Hz) thermal pulses and measured by the simple slope of pain ratings between the first and fifth pulses. ASs were measured by the presence of any remaining pain sensations up to 1 minute after TSSP was induced. TSSP estimation remained moderately stable in pain-free participants and in participants with pain within a single testing session but demonstrated low stability across sessions in pain-free participants. AS estimation was stable for all groups. Estimation of TSSP and ASs using these protocols appears to be a reliable single-session outcome measure in studies of interventions for acute muscle pain and in experimental studies with healthy participants. This article evaluates the reliability of a commonly used method of estimating TSSP and ASs in both healthy participants and in a clinically relevant model of acute pain. These protocols have the potential to be used as single-session outcome measures for interventional studies and in experimental studies

Variability of upper ocean thermohaline structure during a MJO event from DYNAMO aircraft observations

AXCTD and AXBT data used for this study are available at http://data.eol.ucar.edu/ master_list/?project5DYNAMO.The article of record as published may be found at http://dx.doi.org/10.1002/2016JC012137This paper reports upper ocean thermohaline structure and variability observed during the life cycle of an intense Madden Julian Oscillation (MJO) event occurred in the southern tropical Indian Ocean (148S–Eq, 708E–818E). Water column measurements for this study were collected using airborne expendable probes deployed from NOAA’s WP-3D Orion aircraft operated as a part of Dynamics of MJO field experiment conducted during November–December 2011. Purpose of the study is twofold; (1) to provide a statistical analysis of the upper ocean properties observed during different phases of MJO and, (2) to investigate how the upper ocean thermohaline structure evolved in the study region in response to the MJO induced perturbation. During the active phase of MJO, mixed layer depth (MLD) had a characteristic bimodal distribution. Primary and secondary modes were at 34 m and 65 m, respectively. Spatial heterogeneity of the upper ocean response to the MJO forcing was the plausible reason for bimodal distribution. Thermocline and isothermal layer depth deepened, respectively, by 13 and 19 m from the suppressed through the restoring phase of MJO. Thicker (>30 m) barrier layers were found to occur more frequently in the active phase of MJO, associated with convective rainfalls. Additionally, the water mass analysis indicated that, in the active phase of this MJO event the subsurface was dominated by Indonesian throughflow, nonetheless intrusion of Arabian Sea high saline water was also noted near the equator.This work was supported by ONR award N0001413WX20025 and partly by NSF award AGS1062300. Denny P. Alappattu was sponsored by the National Research Council research associate ship program

Observations of the Marine Atmospheric Surface Layer Gradients during the CASPER-West Field Experiment

99th American Meteorological Society Annual MeetingThe bulk of our knowledge of air-sea exchange coefficients for momentum and heat derives from single-point measurements made at some height within the marine atmospheric surface layer (MASL). These point measurements rely on assumptions regarding the vertical structure of the MASL. Foremost among these assumptions, is the validity of Monin- Obukhov Similarity Theory (MOST), which postulates that the gradient-flux relationship is a universal function of surface layer stability. Under neutral conditions, this simplifies to the familiar logarithmic profile. While MOST has been validated over land, observations of the actual gradients within the MASL remain scarce, in part due to the challenges of making near-surface profile measurements over the ocean. The Research Platform FLIP was recently deployed on the west coast for the Coupled Air-Sea Processes and Electromagnetic ducting Research field campaign (CASPER-West), a large-scale air-sea interaction study that took place offshore of Pt. Mugu, CA. FLIP remains an ideal platform for making measurements in proximity to the air-sea interface, with minimal contamination from the platform. During CASPER, a meteorological mast was installed on FLIP that resolved both the bulk and flux profiles of momentum and heat, from 3 to 16 m above the surface. This mast included 7 flux levels, 10 mean wind measurements, and over 20 temperature and humidity probes. This presentation will focus on the vertical gradients measured from FLIP’s mast, with the specific aim of using these high-resolution measurements to test the variability predicted by MOST. As a preliminary step, linear regression was used to determine the natural prevalence of the logarithmic profile. For the mean wind profiles, only 10.2% of the profiles were strongly logarithmic (r2 > 0.9). For specific humidity, this increased to 40.9% of profiles, with no temperature profiles exhibiting a strong logarithmic relationship. Mean r2 was 0.624, 0.265, and 0.853 for wind, temperature, and specific humidity respectively, which increased to 0.761, 0.362, and 0.950 for wind speeds > 6 ms-1 (12.3% of the total data set). Wind speed exhibited positive, and temperature demonstrated negative, relationships with bulk air-sea temperature difference; for example, in stable conditions the mean r2 increased to 0.783 for wind speed, and decreased to 0.145 for temperature. Further analysis will focus on comparing strongly-logarithmic profiles to the empirical gradient-flux relationships available in the literature as well as, determining environmental factors driving the majority of profiles away from the expected logarithmic behavior. This unique dataset provides an opportunity to directly evaluate the prevalence and validity of the MASL vertical structure predicted by MOST, which is assumed to be generally valid over the ocean