Commentary on 2022 Guidelines on Clinical Trial Design in Cluster Headache and Further Suggestions

BACKGROUND: New guidelines for cluster headache clinical trials were recently published. We welcome these new guidelines and raise additional considerations in trial methodologies. MAIN BODY: We present non-inferiority trials to overcome ethical issues with placebo use, and additionally discuss issues with trial recruitment. CONCLUSIONS: We highlight some possible issues and solutions to be considered with the recently published cluster headache trial guidelines

Debate:Challenges in sports cardiology; US versus European approaches

For practitioners working with elite athletes, the field of sports cardiology provides clinical, academic, administrative and fiscal challenges. These challenges are exemplified and reinforced by the lack of consistency and consensus both in the literature and academic presentations. Through thepresentation of a series of clinical questions, this debate attempts to ‘cut to the chase’ on cardiovascular issues relevant to the clinician dealing with elite athletes. In so doing, we hope to crystallize some of the most important elements of the complex cardiological management of elite athletes, in a concise, readable format. Frequently over the last 10 years, many of the controversies in this field have been (rightly or wrongly) presented in aEurope versus USA paradigm. We have chosen to test whether there really are polarised views across the Atlantic, by deliberately pitting specialists from the USA against those from the UK. Professors Levine and Thompson are both internationally recognised sports cardiologists, with immense academic and clinical credibility, and who will represent the ‘US approach’. Professor Whyte and Doctor Wilson are cardiac physiologists with a wealth of experience in the testing, evaluation and screening of elite athletes, and who have equally impressive academic credibility and for the purposes of this debate, they will be representing the ‘European approach’. To initiate this process, each team was required to provide a concise answer (circa 200–300 words) to a series of fiveclinical conundrums. Subsequently, each team had the opportunity to provide a rebuttal to the opposing team’s answers, and the following reflects the consolidation of those answers

A touchy subject: an assessment of cutaneous allodynia in a chronic migraine population

Background: Cutaneous allodynia (CA) is a common feature of migraine, which has a complex underlying pathophysiology that is not well understood. In addition to pain, photophobia, phonophobia, osmophobia, nausea, and vomiting, CA can contribute to the overall disability caused by migraine. The presence of CA can be established via a validated questionnaire. Validated questionnaires and other tests are rarely performed in clinical practice. As such, current prevalence estimates for CA may be an underestimation. Methods: Utilizing a validated questionnaire, we assessed the presence of CA in consecutive patients (n=44) presenting with chronic migraine at a tertiary headache center. Results: CA appears to be quite prevalent, at ~90%, among female patients with chronic migraine. Conclusion: CA prevalence in chronic migraine may be underestimated in the literature, and larger studies may better demonstrate a more accurate estimate of its prevalence

PLA/WOOD BIOCOMPOSITES: IMPROVING COMPOSITE STRENGTH BY CHEMICAL TREATMENT OF THE FIBERS

A resol type phenolic resin was prepared for the impregnation of wood particles used for the reinforcement of PLA. A preliminary study showed that the resin penetrates wood with rates depending on the concentration of the solution and on temperature. Treatment with a solution of 1 wt% resin resulted in a considerable increase of composite strength and decrease of water absorption. Composite strength improved as a result of increased inherent strength of the wood, but interfacial adhesion might be modified as well. When wood was treated with resin solutions of larger concentrations, the strength of the composites decreased, first slightly, then drastically to a very small value. A larger amount of resin results in a thick coating on wood with inferior mechanical properties. At large resin contents the mechanism of deformation changes; the thick coating breaks very easily leading to the catastrophic failure of the composites at very small loads

Decoding the X-ray flare from MAXI J0709-159 using optical spectroscopy and multi-epoch photometry

We present a follow-up study on the recent detection of two X-ray flaring events by MAXI/GSC observations in soft and hard X-rays from MAXI J0709-159 in the direction of HD 54786 (LY CMa), on 2022 January 25. The X-ray luminosity during the flare was around 10^(37) erg/s (MAXI), which got reduced to 10^(32) erg/s (NuSTAR) after the flare. We took low-resolution spectra of HD 54786 from HCT and VBT facilities in India, on 2022 February 1 and 2. In addition to H-alpha emission, we found emission lines of He I in the optical spectrum of this star. By comparing our spectrum of the object with those from literature we found that He I lines show variability. Using photometric study we estimate that the star is having effective temperature of 20000 K. Although HD 54786 is reported as a supergiant in previous studies, our analysis favours it to be evolving off the main sequence in the Color-Magnitude Diagram. We could not detect any infrared excess, ruling out the possibility of IR emission from a dusty circumstellar disc. Our present study suggests that HD 54786 is a Be/X-ray binary system with a compact object companion, possibly a neutron star.Comment: 9 pages, 5 figures, 1 table, accepted for publication in ApJ

Education and Decision Making at the Time of Triptan Prescribing: Patient Expectations vs Actual Practice

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106941/1/head12308.pd

Recommendations for repositories and scientific gateways from a neuroscience perspective

Digital services such as repositories and science gateways have become key resources for the neuroscience community, but users often have a hard time orienting themselves in the service landscape to find the best fit for their particular needs. INCF (International Neuroinformatics Coordinating Facility) has developed a set of recommendations and associated criteria for choosing or setting up and running a repository or scientific gateway, intended for the neuroscience community, with a FAIR neuroscience perspective. These recommendations have neurosciences as their primary use case but are often general. Considering the perspectives of researchers and providers of repositories as well as scientific gateways, the recommendations harmonize and complement existing work on criteria for repositories and best practices. The recommendations cover a range of important areas including accessibility, licensing, community responsibility and technical and financial sustainability of a service.Comment: 10 pages, submitted to Scientific Dat

An Evaluation of 10 Percent and 20 Percent Benzocaine Gels in Patients With Acute Toothaches: Efficacy, Tolerability and Compliance With Label Dose Administration Directions

Background The authors evaluated the efficacy and tolerability of 10 percent and 20 percent benzocaine gels compared with those of a vehicle (placebo) gel for the temporary relief of toothache pain. They also assessed the compliance with the label dose administration directions on the part of participants with toothache pain. Methods Under double-masked conditions, 576 participants self-applied study gel to an open tooth cavity and surrounding oral tissues. Participants evaluated their pain intensity and pain relief for 120 minutes. The authors determined the amount of gel the participants applied. Results The responders’ rates (the primary efficacy parameter), defined as the percentage of participants who had an improvement in pain intensity as exhibited by a pain score reduction of at least one unit on the dental pain scale from baseline for two consecutive assessments any time between the five- and 20-minute points, were 87.3 percent, 80.7 percent and 70.4 percent, respectively, for 20 percent benzocaine gel, 10 percent benzocaine gel and vehicle gel. Both benzocaine gels were significantly (P ≤ .05) better than vehicle gel; the 20 percent benzocaine gel also was significantly (P ≤ .05) better than the 10 percent benzocaine gel. The mean amount of gel applied was 235.6 milligrams, with 88.2 percent of participants applying 400 mg or less. Conclusions Both 10 percent and 20 percent benzocaine gels were more efficacious than the vehicle gel, and the 20 percent benzocaine gel was more efficacious than the 10 percent benzocaine gel. All treatments were well tolerated by participants. Practical Implications Patients can use 10 percent and 20 percent benzocaine gels to temporarily treat toothache pain safely

Optimal model complexity for terrestrial carbon cycle prediction

The terrestrial carbon cycle plays a critical role in modulating the interactions of climate with the Earth system, but different models often make vastly different predictions of its behavior. Efforts to reduce model uncertainty have commonly focused on model structure, namely by introducing additional processes and increasing structural complexity. However, the extent to which increased structural complexity can directly improve predictive skill is unclear. While adding processes may improve realism, the resulting models are often encumbered by a greater number of poorly determined or over-generalized parameters. To guide efficient model development, here we map the theoretical relationship between model complexity and predictive skill. To do so, we developed 16 structurally distinct carbon cycle models spanning an axis of complexity and incorporated them into a model–data fusion system. We calibrated each model at six globally distributed eddy covariance sites with long observation time series and under 42 data scenarios that resulted in different degrees of parameter uncertainty. For each combination of site, data scenario, and model, we then predicted net ecosystem exchange (NEE) and leaf area index (LAI) for validation against independent local site data. Though the maximum model complexity we evaluated is lower than most traditional terrestrial biosphere models, the complexity range we explored provides universal insight into the inter-relationship between structural uncertainty, parametric uncertainty, and model forecast skill. Specifically, increased complexity only improves forecast skill if parameters are adequately informed (e.g., when NEE observations are used for calibration). Otherwise, increased complexity can degrade skill and an intermediate-complexity model is optimal. This finding remains consistent regardless of whether NEE or LAI is predicted. Our COMPLexity EXperiment (COMPLEX) highlights the importance of robust observation-based parameterization for land surface modeling and suggests that data characterizing net carbon fluxes will be key to improving decadal predictions of high-dimensional terrestrial biosphere models.</p