Persistent musculoskeletal pain in individuals with inflammatory bowel diseases

Background: Pain affects over 70% of individuals with inflammatory bowel disease (IBD), with abdominal and musculoskeletal (MSK) pain representing the most common complaints identified by patients. To date most studies in IBD have concentrated on inflammatory arthropathies. However, recent guidelines and investigations suggest that the majority of MSK pain in IBD is likely to be non-inflammatory in nature, although the scope and nature of MSK pain in IBD remains unclear with limited understanding of underlying mechanisms and factors moderating pain experiences. Consequently, further investigation and expanded theoretical frameworks are required in order to develop effective assessment and treatment pathways to improve patient outcomes in this population. Aim: The aim of the present thesis was to explore persistent MSK pain in individuals with IBD, in order to identify shared mechanisms and factors which influence MSK pain experiences in this population. Methods: Two narrative reviews of current literature were conducted to identify fundamental concepts and models in IBD and pain pathways, in order to develop a new framework for persistent MSK pain, primary thesis domains, and thesis methodologies. Two primary thesis studies were used to investigate MSK pain within this framework, including 1) a population-based survey characterizing MSK pain in New Zealand adults through subgrouping and mediation analyses, and 2) a clinic-based investigation investigating measures of central sensitization in American adults with IBD. Results: Subgrouping analysis of Study 1 demonstrated three distinct profiles of MSK pain in individuals with IBD. These profiles indicated that individuals with worse pain experiences presented with greater symptoms related to central sensitization, increased probability of presenting with multiple pain qualities, and active IBD. Sub-analysis of Study 1 further indicated that IBD activity was a significant predictor of worse MSK pain experiences, where symptoms of central sensitization demonstrated significant mediation of this relationship. Study 2 of the present thesis indicated that assessments of somatosensory functioning did not differ between three study groups (i.e. IBD patients with MSK pain, IBD patients without MSK pain, and healthy controls). However, the burden of symptoms related to central sensitization was found to be significantly different between all study groups. Furthermore, Study 2 demonstrated association of measures of central sensitization and a range of participant features (i.e. IBD, psychological, and lifestyle factors). Conclusion: The current thesis presents a new framework to consider and explore persistent MSK pain in IBD patients. Findings from the two primary thesis studies indicated that a sub-population of IBD patients with and without MSK pain presented with features suggesting the presence central sensitization. Individuals with MSK pain and symptoms of central sensitization presented with worse IBD, HRQOL, and pain experiences. MSK pain in IBD presented as distinct profiles, suggesting influences from worse IBD severity to pain presentations and the presence of central sensitization. Measures of central sensitization in IBD were associated with a range of patient features (i.e. IBD, pain, psychological, lifestyle, and comorbidity), highlighting potential risk factors for the development of central sensitization leading to worse pain experiences in IBD patients

Investigation of Electrocatalysts Produced by a Novel Thermal Spray Deposition Method

Common methods to produce supported catalysts include impregnation, precipitation, and thermal spray techniques. Supported electrocatalysts produced by a novel method for thermal spray deposition were investigated with respect to their structural properties, elemental composition, and electrochemical performance. This was done using electron microscopy, X-ray photoelectron spectroscopy, and cyclic voltammetry. Various shapes and sizes of catalyst particles were found. The materials exhibit different activity towards oxidation and reduction of Fe. The results show that this preparation method enables the selection of particle coverage as well as size and shape of the catalyst material. Due to the great variability of support and catalyst materials accessible with this technique, this approach is a useful extension to other preparation methods for electrocatalysts

Graphene-Capped Liquid Thin Films for Electrochemical Operando X-ray Spectroscopy and Scanning Electron Microscopy

Electrochemistry is a promising building block for the global transition to a sustainable energy market. Particularly the electroreduction of CO2 and the electrolysis of water might be strategic elements for chemical energy conversion. The reactions of interest are inner-sphere reactions, which occur on the surface of the electrode, and the biased interface between the electrode surface and the electrolyte is of central importance to the reactivity of an electrode. However, a potential-dependent observation of this buried interface is challenging, which slows the development of catalyst materials. Here we describe a sample architecture using a graphene blanket that allows surface sensitive studies of biased electrochemical interfaces. At the examples of near ambient pressure X-ray photoelectron spectroscopy (NAP-XPS) and environmental scanning electron microscopy (ESEM), we show that the combination of a graphene blanket and a permeable membrane leads to the formation of a liquid thin film between them. This liquid thin film is stable against a water partial pressure below 1 mbar. These properties of the sample assembly extend the study of solid–liquid interfaces to highly surface sensitive techniques, such as electron spectroscopy/microscopy. In fact, photoelectrons with an effective attenuation length of only 10 Å can be detected, which is close to the absolute minimum possible in aqueous solutions. The in-situ cells and the sample preparation necessary to employ our method are comparatively simple. Transferring this approach to other surface sensitive measurement techniques should therefore be straightforward. We see our approach as a starting point for more studies on electrochemical interfaces and surface processes under applied potential. Such studies would be of high value for the rational design of electrocatalysts

Access to communication technologies in a sample of cancer patients: an urban and rural survey

BACKGROUND: There is a growing awareness among providers of the symptom burden experienced by cancer patients. Systematic symptom screening is difficult. Our plan was to evaluate a technology-based symptom screening process using touch-tone telephone and Internet in our rural outreach cancer program in Indiana. Would rural patients have adequate access to technologies for home-based symptom reporting? OBJECTIVES: 1) To determine access to touch-tone telephone service and Internet for patients in urban and rural clinics; 2) to determine barriers to access; 3) to determine willingness to use technology for home-based symptom reporting. METHODS: Patients from representative clinics (seven rural and three urban) in our network were surveyed. Inclusion criteria were age greater than 18, able to read, and diagnosis of malignancy. RESULTS: The response rate was 97%. Of 416 patients completing the survey (230 rural, 186 urban), 95% had access to touch-tone telephone service, while 46% had Internet access (56% of urban patients, 38% of rural patients). Higher rates of Internet access were related to younger patient age, current employment, and higher education and income. The primary barrier to Internet access was lack of interest. Use of the Internet for health related activities was less than 50%. The preferred means of symptom reporting in patients with internet access were the touch-tone telephone (70%), compared to reporting by the Internet (28%). CONCLUSION: Access to communication technologies appears adequate for home-based symptom reporting. The use of touch-tone telephone and Internet reporting, based upon patient preference, has the potential of enhancing symptom detection among cancer patients that is not dependent solely upon clinic visits and clinician inquiry

Revealing the active phase of copper during the electroreduction of CO2 in aqueous electrolyte by correlating in situ x-ray spectroscopy and in situ electron microscopy

The variation in the morphology and electronic structure of copper during the electroreduction of CO2 into valuable hydrocarbons and alcohols was revealed by combining in situ surface- and bulk-sensitive X-ray spectroscopies with electrochemical scanning electron microscopy. These experiments proved that the electrified interface surface and near-surface are dominated by reduced copper. The selectivity to the formation of the key C–C bond is enhanced at higher cathodic potentials as a consequence of increased copper metallicity. In addition, the reduction of the copper oxide electrode and oxygen loss in the lattice reconstructs the electrode to yield a rougher surface with more uncoordinated sites, which controls the dissociation barrier of water and CO2. Thus, according to these results, copper oxide species can only be stabilized kinetically under CO2 reduction reaction conditions

Surface Electron-Hole Rich Species Active in the Electrocatalytic Water Oxidation

Iridium and ruthenium and their oxides/hydroxides are the best candidates for the oxygen evolution reaction under harsh acidic conditions owing to the low overpotentials observed for Ru- and Ir-based anodes and the high corrosion resistance of Ir-oxides. Herein, by means of cutting edge operando surface and bulk sensitive X-ray spectroscopy techniques, specifically designed electrode nanofabrication and ab initio DFT calculations, we were able to reveal the electronic structure of the active IrOx centers (i.e., oxidation state) during electrocatalytic oxidation of water in the surface and bulk of high-performance Ir-based catalysts. We found the oxygen evolution reaction is controlled by the formation of empty Ir 5d states in the surface ascribed to the formation of formally IrV species leading to the appearance of electron-deficient oxygen species bound to single iridium atoms (μ1-O and μ1-OH) that are responsible for water activation and oxidation. Oxygen bound to three iridium centers (μ3-O) remains the dominant species in the bulk but do not participate directly in the electrocatalytic reaction, suggesting bulk oxidation is limited. In addition a high coverage of a μ1-OO (peroxo) species during the OER is excluded. Moreover, we provide the first photoelectron spectroscopic evidence in bulk electrolyte that the higher surface-to-bulk ratio in thinner electrodes enhances the material usage involving the precipitation of a significant part of the electrode surface and near-surface active species

On the operando structure of ruthenium oxides during the oxygen evolution reaction in acidic media

In the search for rational design strategies for oxygenevolutionreaction (OER) catalysts, linking the catalyst structure to activityand stability is key. However, highly active catalysts such as IrO x and RuO x undergostructural changes under OER conditions, and hence, structure-activity-stabilityrelationships need to take into account the operando structure ofthe catalyst. Under the highly anodic conditions of the oxygen evolutionreaction (OER), electrocatalysts are often converted into an activeform. Here, we studied this activation for amorphous and crystallineruthenium oxide using X-ray absorption spectroscopy (XAS) and electrochemicalscanning electron microscopy (EC-SEM). We tracked the evolution ofsurface oxygen species in ruthenium oxides while in parallel mappingthe oxidation state of the Ru atoms to draw a complete picture ofthe oxidation events that lead to the OER active structure. Our datashow that a large fraction of the OH groups in the oxide are deprotonatedunder OER conditions, leading to a highly oxidized active material.The oxidation is centered not only on the Ru atoms but also on theoxygen lattice. This oxygen lattice activation is particularly strongfor amorphous RuO x . We propose that thisproperty is key for the high activity and low stability observed foramorphous ruthenium oxide.Catalysis and Surface Chemistr

Surface Electron-Hole Rich Species Active in the Electrocatalytic Water Oxidation.

Iridium and ruthenium and their oxides/hydroxides are the best candidates for the oxygen evolution reaction under harsh acidic conditions owing to the low overpotentials observed for Ru- and Ir-based anodes and the high corrosion resistance of Ir-oxides. Herein, by means of cutting edge operando surface and bulk sensitive X-ray spectroscopy techniques, specifically designed electrode nanofabrication and ab initio DFT calculations, we were able to reveal the electronic structure of the active IrOx centers (i.e., oxidation state) during electrocatalytic oxidation of water in the surface and bulk of high-performance Ir-based catalysts. We found the oxygen evolution reaction is controlled by the formation of empty Ir 5d states in the surface ascribed to the formation of formally IrV species leading to the appearance of electron-deficient oxygen species bound to single iridium atoms (μ1-O and μ1-OH) that are responsible for water activation and oxidation. Oxygen bound to three iridium centers (μ3-O) remains the dominant species in the bulk but do not participate directly in the electrocatalytic reaction, suggesting bulk oxidation is limited. In addition a high coverage of a μ1-OO (peroxo) species during the OER is excluded. Moreover, we provide the first photoelectron spectroscopic evidence in bulk electrolyte that the higher surface-to-bulk ratio in thinner electrodes enhances the material usage involving the precipitation of a significant part of the electrode surface and near-surface active species

Operando Structure Activity Stability Relationship of Iridium Oxides during the Oxygen Evolution Reaction

Creating active and stable electrodes is an essential step toward efficient and durable electrolyzers. To achieve this goal, understanding what aspects of the electrode structure dictate activity and catalyst dissolution is key. Here, we investigate these aspects by studying trends in the activity, stability, and operando structure of iridium oxides during the oxygen evolution reaction. Using operando X-ray photoelectron and X-ray absorption spectroscopy, we determined the near-surface structure of oxides ranging from amorphous to crystalline during the reaction. We show that applying oxygen evolution potentials universally yields deprotonated μ2-O moieties and a μ1-O/μ1-OH mixture, with universal deprotonation energetics but in different amounts. This quantitative difference mainly results from variations in deprotonation depth: surface deprotonation for crystalline IrO2 versus near-surface deprotonation for semicrystalline and amorphous IrOx. We argue that both surface deprotonation and subsurface deprotonation modify the barrier for the oxygen evolution and Ir dissolution reactions, thus playing an important role in catalyst performance