Influence of fear of pain and coping strategies on health-related quality of life and patient-anticipated outcomes in patients with chronic pain: cross-sectional study protocol

Published 08.09.17Background: Fear of pain and coping strategies are emotional-behavioral responses to pain and are known to play an important role in the development and maintenance of pain. It is highly likely that fear of pain and coping strategies influence each other, potentially affecting the course of chronic pain. To our knowledge, the relationship between pain, fear of pain and coping strategies, and how they influence patient-anticipated outcomes and health-related quality of life, have not been investigated. Objective: The aims of this study are to test (1) if both fear of pain and/or coping strategies are sufficient causes for maintaining pain; and (2) whether fear of pain influences coping strategies and pain intensity. The study will also examine the impact of fear of pain and coping strategies on health-related quality of life and patient-anticipated outcomes. Methods: The cross-sectional study will be conducted using an online survey. The Fear of Pain Questionnaire-III (FPQ-III), the Brief Coping Inventory (COPE), and EuroQoL-5d (EQ-5D) validated questionnaires will be used to collect data. Information pertaining to demographic factors, pain-related factors, and patient-anticipated outcomes will also be collected. The study has ethics approval from the Human Research Ethics Committee of the University of Adelaide. Study participants will be individuals aged 18 years and above who are experiencing chronic pain (ie, pain lasting more than 6 months). Effect measure modification technique (EMMM) will be used to examine if fear of pain acts as a moderator or mediator between coping strategies and pain. Simple and multinomial logistic regression analysis will be used to examine the effect of fear of pain and coping strategies on health-related quality of life and patient-anticipated outcomes. Results: Recruitment began July 2017 and it is anticipated that data collection will be completed by October 2017. Findings from this study will help to extend our understanding of fear of pain and coping strategies, their interaction, and their impact on health-related quality of life and patient-anticipated outcomes. Conclusions: Fear of pain and coping strategies have significant influence on the experience of chronic pain and its course. This study will help enhance our understanding of the relationship between fear of pain and coping strategies, which may help in developing patient-centered care practices.Manasi Murthy Mittinty, David S Brennan, Cameron L Randall, Daniel W McNeil, Murthy N Mittinty, Lisa Jamieso

Monte Carlo and Renormalization Group Effective Potentials in Scalar Field Theories

We study constraint effective potentials for various strongly interacting $\phi^4$ theories. Renormalization group (RG) equations for these quantities are discussed and a heuristic development of a commonly used RG approximation is presented which stresses the relationships among the loop expansion, the Schwinger-Dyson method and the renormalization group approach. We extend the standard RG treatment to account explicitly for finite lattice effects. Constraint effective potentials are then evaluated using Monte Carlo (MC) techniques and careful comparisons are made with RG calculations. Explicit treatment of finite lattice effects is found to be essential in achieving quantitative agreement with the MC effective potentials. Excellent agreement is demonstrated for $d=3$ and $d=4$, O(1) and O(2) cases in both symmetric and broken phases.Comment: 16 pages, 4 figures appended to end of this fil

Enzymatic glyceride synthesis in a foam reactor

We report the results of our study on Rhizomucor miehei lipaseâ catalyzed lauric acidâ glycerol esterification in a foam reactor. A satisfactory yield of glyceride synthesis can be achieved with an unusually high initial water content (50% w/w). We found that product formation could be regulated by controlling foaming. Foaming was a function of the air flow rate, reaction temperature, pH value, ionic strength, and substrate molar ratio. Monolaurin and dilaurin, which constituted nearly 80% of the total yield, were the two dominant products in this reaction; trilaurin was also formed at the initial stages of the reaction. A study of pH and ionic strength effects on an independent basis revealed that they affect the interfacial mechanism in different manners. On varying the ratio of lauric acid and glycerol, only a slight change in the degree of conversion was detected and the consumption rate of fatty acid was approximately the same.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141443/1/aocs0643.pd

Anal cancer incidence in men with HIV who have sex with men: are black men at higher risk?

Objective:To assess differences in anal cancer incidence between racial/ethnic groups among a clinical cohort of men with HIV who have sex with men.Design:Clinical cohort studyMethods:We studied men who have sex with men (MSM) in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) who initiated antiretroviral therapy (ART) under HIV care in CNICS. We compared anal cancer incidence between Black and non-Black men and calculated hazard ratios controlling for demographic characteristics (age, CNICS site, year of ART initiation), HIV disease indicators (nadir CD4+, peak HIV RNA), and co-infection/behavioral factors including hepatitis B virus (HBV), hepatitis C virus (HCV), tobacco smoking and alcohol abuse.Results:We studied 7473 MSM with HIV who contributed 41 810 person-years of follow-up after initiating ART between 1996 and 2014 in CNICS. Forty-one individuals had an incident diagnosis of anal cancer under observation. Crude rates of anal cancer were 204 versus 61 per 100 000 person-years among Black versus non-Black MSM. The weighted hazard ratio for anal cancer in Black MSM (adjusting for demographics, HIV disease factors, and co-infection/behavioral factors) was 2.37 (95% confidence interval: 1.17, 4.82) compared to non-Black MSM.Conclusions:In this large multicenter cohort, Black MSM were at significantly increased risk for anal cancer compared to non-Black MSM. Further detailed studies evaluating factors impacting anal cancer incidence and outcomes in Black men with HIV are necessary. Inclusion of more diverse study cohorts may elucidate modifiable factors associated with increased anal cancer risk experienced by Black MSM

Defining the interval for monitoring potential adverse events following immunization (AEFIs) after receipt of live viral vectored vaccines

Live viral vectors that express heterologous antigens of the target pathogen are being investigated in the development of novel vaccines against serious infectious agents like HIV and Ebola. As some live recombinant vectored vaccines may be replication-competent, a key challenge is defining the length of time for monitoring potential adverse events following immunization (AEFI) in clinical trials and epidemiologic studies. This time period must be chosen with care and based on considerations of pre-clinical and clinical trials data, biological plausibility and practical feasibility. The available options include: (1) adapting from the current relevant regulatory guidelines; (2) convening a panel of experts to review the evidence from a systematic literature search to narrow down a list of likely potential or known AEFI and establish the optimal risk window(s); and (3) conducting “near real-time“ prospective monitoring for unknown clustering's of AEFI in validated large linked vaccine safety databases using Rapid Cycle Analysis for pre-specified adverse events of special interest (AESI) and Treescan to identify previously unsuspected outcomes. The risk window established by any of these options could be used along with (4) establishing a registry of clinically validated pre-specified AESI to include in case-control studies. Depending on the infrastructure, human resources and databases available in different countries, the appropriate option or combination of options can be determined by regulatory agencies and investigators

Defining the interval for monitoring potential adverse events following immunization (AEFIs) after receipt of live viral vectored vaccines

Live viral vectors that express heterologous antigens of the target pathogen are being investigated in the development of novel vaccines against serious infectious agents like HIV and Ebola. As some live recombinant vectored vaccines may be replication-competent, a key challenge is defining the length of time for monitoring potential adverse events following immunization (AEFI) in clinical trials and epidemiologic studies. This time period must be chosen with care and based on considerations of pre-clinical and clinical trials data, biological plausibility and practical feasibility. The available options include: (1) adapting from the current relevant regulatory guidelines; (2) convening a panel of experts to review the evidence from a systematic literature search to narrow down a list of likely potential or known AEFI and establish the optimal risk window(s); and (3) conducting “near real-time“ prospective monitoring for unknown clustering's of AEFI in validated large linked vaccine safety databases using Rapid Cycle Analysis for pre-specified adverse events of special interest (AESI) and Treescan to identify previously unsuspected outcomes. The risk window established by any of these options could be used along with (4) establishing a registry of clinically validated pre-specified AESI to include in case-control studies. Depending on the infrastructure, human resources and databases available in different countries, the appropriate option or combination of options can be determined by regulatory agencies and investigators

Flow boiling in microchannels: Fundamentals and applications

The rapid advances in performance and miniaturization of electronics and high power devices resulted in huge heat flux values that need to be dissipated effectively. The average heat flux in computer chips is expected to reach 2–4.5 MW/m2 with local hot spots 12–45 MW/m2 while in IGBT modules, the heat flux at the chip level can reach 6.5–50 MW/m2. Flow boiling in microchannels is one of the most promising cooling methods for these and similar devices due to the capability of achieving very high heat transfer rates with small variations in the surface temperature. However, several fundamental issues are still not understood and this hinders the transition from laboratory research to commercial applications. The present paper starts with a discussion of the possible applications of flow boiling in microchannels in order to highlight the challenges in the thermal management for each application. In this part, the different integrated systems using microchannels were also compared. The comparison demonstrated that miniature cooling systems with a liquid pump were found to be more efficient than miniature vapour compression refrigeration systems. The paper then presents experimental research on flow boiling in single tubes and rectangular multichannels to discuss the following fundamental issues: (1) the definition of microchannel, (2) flow patterns and heat transfer mechanisms, (3) flow instability and reversal and their effect on heat transfer rates, (4) effect of channel surface characteristics and (5) prediction of critical heat flux. Areas where more research is needed were clearly mentioned. In addition, correlations for the prediction of the flow pattern transition boundaries and heat transfer coefficients in small to mini/micro diameter tubes were developed recently by the authors and presented in this paper