Subjective Cognitive Dysfunction in Patients With and Without Fibromyalgia:Prevalence, Predictors, Correlates, and Consequences

Background: Subjective cognitive dysfunction (SCD) is common in fibromyalgia (FM), where it has been called 'fibrofog.' But its predictors and correlates are not well understood, including the extent to which SCD is present in fibromyalgia and non-fibromyalgia clinical populations. In addition, there are no studies available concerning SCD and fibromyalgia in the general population. We investigated these issues in a longitudinal rheumatic disease research databank and two cross-sectional general population studies. Methods: 11,150 unselected patients with rheumatoid arthritis completed an assessment of FM and cognitive severity (CS) status using the full 0-3 fibromyalgia 2016 criteria assessment. In addition, CS was dummy coded as present/absent (CS+). Assessments of SCD and fibromyalgia prevalence were available in two German general population studies. Results: Fibromyalgia was present (FM+) in 2,493 (21.7%) of clinical subjects and absent (FM-) in 9,017 (78.3%) by FM 2016 criteria. Cognitive severity was present in 1,304 (52.3%) of those with fibromyalgia and 1,009 (11.2%) of non-fibromyalgia subjects (FM-). In two general population studies, 42.0% to 52.3% of those with fibromyalgia were CS+ as were 1.4% to 5.5% of FM- subjects. Patients with CS+ had more abnormal scores for every measure of rheumatoid arthritis (RA) severity, fibromyalgia severity, and general health. The presence of CS+ was strongly related to somatic and non-somatic symptoms scores and less strongly to pain variables. The best predictor of CS+ in the clinic and the general population was the symptom severity scale (SSS), a criterion of fibromyalgia. Conclusions: Persons with SCD have high counts of somatic and psychological symptoms. Subjective cognitive dysfunction is best predicted by a simple symptoms score, and not by pain extent scores. Although SCD is called fibrofog in patients with FM, 43.6% of CS+ cases occurred in FM- subjects. Fibromyalgia and CS are correlated but appear to be different parts of a symptom severity continuum. 'Fibrofog' as a phenomenon linked only to fibromyalgia is a misnomer because it can be identified in many non-fibromyalgia patients as well

Validation of the Patient-Doctor-Relationship Questionnaire (PDRQ-9) in a representative cross-sectional German population survey

The patient-doctor relationship (PDR) as perceived by the patient is an important concept in primary care and psychotherapy. The PDR Questionnaire (PDRQ-9) provides a brief measure of the therapeutic aspects of the PDR in primary care. We assessed the internal and external validity of the German version of the PDRQ-9 in a representative cross-sectional German population survey that included 2,275 persons aged≥14 years who reported consulting with a primary care physician (PCP). The acceptance of the German version of this questionnaire was good. Confirmatory factor analysis demonstrated that the PRDQ-9 was unidimensional. The internal reliability (Cronbach's α) of the total score was .95. The corrected item-total correlations were≥.94. The mean satisfaction index of persons with a probable depressive disorder was lower than that of persons without a probable depressive disorder, indicating good discriminative concurrent criterion validity. The correlation coefficient between satisfaction with PDR and satisfaction with pain therapy was r = .51 in 489 persons who reported chronic pain, indicating good convergent validity. Despite the limitation of low variance in the PDRQ-9 total scores, the results indicate that the German version of the PDRQ-9 is a brief questionnaire with good psychometric properties to assess German patients' perceived therapeutic alliance with PCPs in public health research

Monte Carlo Simulation Calculation of Critical Coupling Constant for Continuum \phi^4_2

We perform a Monte Carlo simulation calculation of the critical coupling constant for the continuum {\lambda \over 4} \phi^4_2 theory. The critical coupling constant we obtain is [{\lambda \over \mu^2}]_crit=10.24(3).Comment: 11 pages, 4 figures, LaTe

What causes Fibromyalgia? An online survey of patient perspectives.

Fibromyalgia is a severe chronic pain condition that affects every aspect of life. Causes of the condition remain unclear, and quantitative research cannot account for patients’ personal illness narratives and perceptions. This online survey gathered qualitative accounts of the perceived causes of their condition from 596 people with Fibromyalgia, which were analyzed thematically. Themes were 'Bodily Assault, Ill-health and Change;' 'Emotional Trauma and Distress;' 'Stress and Vulnerability' and 'Explaining and Authenticating Fibromyalgia.' Discussion focuses on the complexity of causation, the importance of understanding and having symptoms validated, and the potential for benefiting from patient expertise in building better practitioner-client relationships

Cluster Expansion Approach to the Effective Potential in Φ2+14\Phi^4_{2+1}-Theory

We apply a truncated set of dynamical equations of motion for connected equal-time Green functions up to the 4-point level to the investigation of spontaneous ground state symmetry breaking in $\Phi^4_{2+1}$ quantum field theory. Within our momentum space discretization we obtain a second order phase transition as soon as the connected 3-point function is included. However, an additional inclusion of the connected 4-point function still shows a significant influence on the shape of the effective potential and the critical coupling.Comment: 1 compressed uuencoded postscript file with 5 figures included, 21 page

Increased AT 1 receptor expression and mRNA in kidney glomeruli of AT 2 receptor gene-disrupted mice

The proposed feedback between angiotensin II AT2 and AT1 receptors prompted us to study AT1 receptor expression in kidneys of male AT2 receptor-gene disrupted mice (agtr2 −/y). In wild-type (agtr2 +/y) mice, AT1 receptor binding and mRNA is abundant in glomeruli, and AT1 receptor binding is also high in the inner stripe of the outer medulla. AT2 receptors are scarce, primarily associated to cortical vascular structures. In agtr2 −/y mice, AT1 receptor binding and mRNA were increased in the kidney glomeruli, and AT1 receptor binding was higher in the rest of the cortex and outer stripe of the outer medulla, but not in its inner stripe, indicating different cellular regulation. Although AT2 receptor expression is very low in male agtr 2 +/y mice, their gene disruption alters AT1 receptor expression. AT1 upregulation alone may explain the AT2 gene-disrupted mice phenotype such as increased blood pressure, higher sensitivity to angiotensin II, and altered renal function. The indirect AT1/AT2 receptor feedback could have clinical significance because AT1antagonists are widely used in medical practice.Fil: Saavedra, Juan M.. National Institute of Mental Health; Estados UnidosFil: Häuser, Walter. National Institute of Mental Health; Estados UnidosFil: Ciuffo, Gladys Maria. National Institute of Mental Health; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis. Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis; ArgentinaFil: Egidy, Giorgia. National Institute of Mental Health; Estados UnidosFil: Hoe, Kwang Lae. National Institute of Mental Health; Estados UnidosFil: Jöhren, Olaf. National Institute of Mental Health; Estados UnidosFil: Sembonmatsu, Takaaki. Vanderbilt University; Estados UnidosFil: Inagami, Tadashi. Vanderbilt University; Estados UnidosFil: Armando, Inés. National Institute of Mental Health; Estados Unido

On Semiclassical Limits of String States

We explore the relation between classical and quantum states in both open and closed (super)strings discussing the relevance of coherent states as a semiclassical approximation. For the closed string sector a gauge-fixing of the residual world-sheet rigid translation symmetry of the light-cone gauge is needed for the construction to be possible. The circular target-space loop example is worked out explicitly.Comment: 12 page

Connected Green function approach to ground state symmetry breaking in Φ1+14\Phi^4_{1+1}-theory

Using the cluster expansions for n-point Green functions we derive a closed set of dynamical equations of motion for connected equal-time Green functions by neglecting all connected functions higher than $4^{th}$ order for the $\lambda \Phi^4$-theory in $1+1$ dimensions. We apply the equations to the investigation of spontaneous ground state symmetry breaking, i.e. to the evaluation of the effective potential at temperature $T=0$. Within our momentum space discretization we obtain a second order phase transition (in agreement with the Simon-Griffith theorem) and a critical coupling of $\lambda_{crit}/4m^2=2.446$ as compared to a first order phase transition and $\lambda_{crit}/4m^2=2.568$ from the Gaussian effective potential approach.Comment: 25 Revtex pages, 5 figures available via fpt from the directory ugi-94-11 of [email protected] as one postscript file (there was a bug in our calculations, all numerical results and figures have changed significantly), ugi-94-1

Ultrafast optically induced spin transfer in ferromagnetic alloys

The vision of using light to manipulate electronic and spin excitations in materials on their fundamental time and length scales requires new approaches in experiment and theory to observe and understand these excitations. The ultimate speed limit for all-optical manipulation requires control schemes for which the electronic or magnetic subsystems of the materials are coherently manipulated on the time scale of the laser excitation pulse. In our work, we provide experimental evidence of such a direct, ultrafast, and coherent spin transfer between two magnetic subsystems of an alloy of Fe and Ni. Our experimental findings are fully supported by time-dependent density functional theory simulations and, hence, suggest the possibility of coherently controlling spin dynamics on subfemtosecond time scales, i.e., the birth of the research area of attomagnetism