Race/Ethnicity and Retention in Traumatic Brain Injury Outcomes Research: A Traumatic Brain Injury Model Systems National Database Study

Objective: To investigate the contribution of race/ethnicity to retention in traumatic brain injury (TBI) research at 1 to 2 years post-injury. Setting: Community. Participants: 5548 Whites, 1347 Blacks, and 790 Hispanics enrolled in the Traumatic Brain Injury Model Systems National Database with dates of injury between October 1, 2002 and March 31, 2013. Design: Retrospective database analysis. Main Measure: Retention, defined as completion of at least one question on the follow-up interview by the person with TBI or a proxy. Results: Retention rates 1-2 years post-TBI were significantly lower for Hispanic (85.2%) than for White (91.8%) or Black participants (90.5%) and depended significantly on history of problem drug or alcohol use. Other variables associated with low retention included older age, lower education, violent cause of injury, and discharge to an institution versus private residence. Conclusions: The findings emphasize the importance of investigating retention rates separately for Blacks and Hispanics rather than combining them or grouping either with other races or ethnicities. The results also suggest the need for implementing procedures to increase retention of Hispanics in longitudinal TBI researc

Treatments perceived to be helpful for neuropathic pain after traumatic spinal cord injury: A multicenter cross-sectional survey study.

DESIGN: Cross-sectional survey. OBJECTIVE: To evaluate the perceived helpfulness of pharmacological and non-pharmacological interventions and their combinations for neuropathic pain (NeuP) and subcategories of NeuP after spinal cord injury (SCI). SETTING: Six Spinal Cord Injury Model System Centers. METHODS: Three hundred ninety one individuals at least one year post traumatic SCI were enrolled. A telephone survey was conducted to determine the pharmacologic and non-pharmacologic treatments used in the last 12 months for each participant\u27s three worst pains, whether these treatments were helpful , and if currently used, each treatments\u27 effectiveness. RESULTS: Two hundred twenty participants (56%) reported 354 distinct NeuPs. Pharmacological treatments rated helpful for NeuP were non-tramadol opioids (opioids were helpful for 86% of opioid treated NeuPs), cannabinoids (83%), and anti-epileptics (79%). Non-pharmacological treatments rated helpful for NeuP were massage (76%), body position adjustment (74%), and relaxation therapy (70%). Those who used both opioids and exercise reported greater NeuP treatment helpfulness compared to participants using opioids without exercise (P = 0.03). CONCLUSIONS: Opioids, cannabinoids, and massage were reported more commonly as helpful than treatments recommended as first-line therapies by current clinical practice guidelines (CPGs) for NeuP after SCI (antiepileptics and antidepressants). Individuals with SCI likely value the modulating effects of pharmacological and non-pharmacological treatments on the affective components of pain in addition to the sensory components of pain when appraising treatment helpfulness

Cationic molybdenum imido alkylidene N‐heterocyclic carbene complexes confined in mesoporous silica : tuning transition states towards Z‐selective ring‐opening cross‐metathesis

We recently reported a method for selective macro(mono)cyclization of dienes utilizing catalysts confined inside the pores of mesoporous silica, which we believe occurs due to suppression of oligomerization due to pore size. We hypothesized, however, that the system of cationic molybdenum imido alkylidene N‐heterocyclic carbene (NHC) catalysts immobilized selectively inside the mesopores of silica materials could address much more subtle selectivity differences, such as E/Z selectivity in ring‐opening/cross‐metathesis (ROCM). Upon investigation, we observed that surface‐bound cationic molybdenum imido alkylidene NHC catalysts indeed display an increased Z‐selectivity, especially during the early stages of the reaction. This effect was present when the catalyst was confined inside a pore, as well as when the catalyst was bound to non‐porous silica, which led us to conclude it is an effect caused by the catalyst being bound directly to the surface of a silica material where the proximity of the catalyst to the surface governs the transition state. Kinetic investigations revealed that significant post‐metathesis olefin isomerization occurs, the amount of which seems to be governed by the rate of diffusion of the product away from the active catalyst, with smaller pore sizes resulting in higher Z‐selectivity at higher conversion, attributable to faster diffusion of the product out of the pore than diffusion back into the pore.Deutsche Forschungsgemeinschaf

Botulinum toxin A decreases neural activity in pain-related brain regions in individuals with chronic ocular pain and photophobia

IntroductionTo examine the effect of botulinum toxin A (BoNT-A) on neural mechanisms underlying pain and photophobia using functional magnetic resonance imaging (fMRI) in individuals with chronic ocular pain.MethodsTwelve subjects with chronic ocular pain and light sensitivity were recruited from the Miami Veterans Affairs eye clinic. Inclusion criteria were: (1) chronic ocular pain; (2) presence of ocular pain over 1 week recall; and (3) presence of photophobia. All individuals underwent an ocular surface examination to capture tear parameters before and 4–6 weeks after BoNT-A injections. Using an event-related fMRI design, subjects were presented with light stimuli during two fMRI scans, once before and 4–6 weeks after BoNT-A injection. Light evoked unpleasantness ratings were reported by subjects after each scan. Whole brain blood oxygen level dependent (BOLD) responses to light stimuli were analyzed.ResultsAt baseline, all subjects reported unpleasantness with light stimulation (average: 70.8 ± 32.0). Four to six weeks after BoNT-A injection, unpleasantness scores decreased (48.1 ± 33.6), but the change was not significant. On an individual level, 50% of subjects had decreased unpleasantness ratings in response to light stimulation compared to baseline (“responders,” n = 6), while 50% had equivalent (n = 3) or increased (n = 3) unpleasantness (“non-responders”). At baseline, several differences were noted between responders and non-responders; responders had higher baseline unpleasantness ratings to light, higher symptoms of depression, and more frequent use of antidepressants and anxiolytics, compared to non-responders. Group analysis at baseline displayed light-evoked BOLD responses in bilateral primary somatosensory (S1), bilateral secondary somatosensory (S2), bilateral anterior insula, paracingulate gyrus, midcingulate cortex (MCC), bilateral frontal pole, bilateral cerebellar hemispheric lobule VI, vermis, bilateral cerebellar crus I and II, and visual cortices. BoNT-A injections significantly decreased light evoked BOLD responses in bilateral S1, S2 cortices, cerebellar hemispheric lobule VI, cerebellar crus I, and left cerebellar crus II. BoNT-A responders displayed activation of the spinal trigeminal nucleus at baseline where non-responders did not.DiscussionBoNT-A injections modulate light-evoked activation of pain-related brain systems and photophobia symptoms in some individuals with chronic ocular pain. These effects are associated with decreased activation in areas responsible for processing the sensory-discriminative, affective, dimensions, and motor responses to pain

Urine selenium concentration is a useful biomarker for assessing population level selenium status

Plasma selenium (Se) concentration is an established population level biomarker of Se status, especially in Se-deficient populations. Previously observed correlations between dietary Se intake and urinary Se excretion suggest that urine Se concentration is also a potentially viable biomarker of Se status. However, there are only limited data on urine Se concentration among Se-deficient populations. Here, we test if urine is a viable biomarker for assessing Se status among a large sample of women and children in Malawi, most of whom are likely to be Se-deficient based on plasma Se status. Casual (spot) urine samples (n = 1406) were collected from a nationally representative sample of women of reproductive age (WRA, n =741) and school aged children (SAC, n=665) across Malawi as part of the 2015/16 Demographic and Health Survey. Selenium concentration in urine was determined using inductively coupled plasma mass spectrometry (ICP-MS). Urinary dilution corrections for specific gravity, osmolality, and creatinine were applied to adjust for hydration status. Plasma Se status had been measured for the same survey participants. There was between-cluster variation in urine Se concentration that corresponded with variation in plasma Se concentration, but not between households within a cluster, or between individuals within a household. Corrected urine Se concentrations explained more of the between-cluster variation in plasma Se concentration than uncorrected data. These results provide new evidence that urine may be used in the surveillance of Se status at the population level in some groups. This could be a cost-effective option if urine samples are already being collected for other assessments, such as for iodine status analysis as in the Malawi and other national Demographic and Health Surveys

Heterocellular OSM-OSMR signalling reprograms fibroblasts to promote pancreatic cancer growth and metastasis

Pancreatic ductal adenocarcinoma (PDA) is a lethal malignancy with a complex microenvironment. Dichotomous tumour-promoting and -restrictive roles have been ascribed to the tumour microenvironment, however the effects of individual stromal subsets remain incompletely characterised. Here, we describe how heterocellular Oncostatin M (OSM) - Oncostatin M Receptor (OSMR) signalling reprograms fibroblasts, regulates tumour growth and metastasis. Macrophage-secreted OSM stimulates inflammatory gene expression in cancer-associated fibroblasts (CAFs), which in turn induce a pro-tumourigenic environment and engage tumour cell survival and migratory signalling pathways. Tumour cells implanted in Osm-deficient (Osm(−/−)) mice display an epithelial-dominated morphology, reduced tumour growth and do not metastasise. Moreover, the tumour microenvironment of Osm(−/−) animals exhibit increased abundance of α smooth muscle actin positive myofibroblasts and a shift in myeloid and T cell phenotypes, consistent with a more immunogenic environment. Taken together, these data demonstrate how OSM-OSMR signalling coordinates heterocellular interactions to drive a pro-tumourigenic environment in PDA

The sero-epidemiology of Neospora caninum in cattle in northern Tanzania

Neospora caninum is a protozoan intracellular parasite of animals with a global distribution. Dogs act as definitive hosts, with infection in cattle leading to reproductive losses. Neosporosis can be a major source of income loss for livestock keepers, but its impacts in sub-Saharan Africa are mostly unknown. This study aimed to estimate the seroprevalence and identify risk factors for N. caninum infection in cattle in northern Tanzania, and to link herd-level exposure to reproductive losses. Serum samples from 3,015 cattle were collected from 380 households in 20 villages between February and December 2016. Questionnaire data were collected from 360 of these households. Household coordinates were used to extract satellite derived environmental data from open-access sources. Sera were tested for the presence of N. caninum antibodies using an indirect ELISA. Risk factors for individual-level seropositivity were identified with logistic regression using Bayesian model averaging (BMA). The relationship between herd-level seroprevalence and abortion rates was assessed using negative binomial regression. The seroprevalence of N. caninum exposure after adjustment for diagnostic test performance was 21.5% [95% Credibility Interval (CrI) 17.9–25.4]. The most important predictors of seropositivity selected by BMA were age greater than 18 months [Odds ratio (OR) = 2.17, 95% CrI 1.45–3.26], the local cattle population density (OR = 0.69, 95% CrI 0.41–1.00), household use of restricted grazing (OR = 0.72, 95% CrI 0.25–1.16), and an increasing percentage cover of shrub or forest land in the environment surrounding a household (OR = 1.37, 1.00–2.14). There was a positive relationship between herd-level N. caninum seroprevalence and the reported within-herd abortion rate (Incidence Rate Ratio = 1.03, 95% CrI 1.00–1.06). Our findings suggest N. caninum is likely to be an important cause of abortion in cattle in Tanzania. Management practices, such as restricted grazing, are likely to reduce the risk of infection and suggest contamination of communal grazing areas may be important for transmission. Evidence for a relationship between livestock seropositivity and shrub and forest habitats raises questions about a potential role for wildlife in the epidemiology of N. caninum in Tanzania