Attention toward interpersonal stimuli in individuals with and without chronic daily headache

Attentional capture of threat is a normal and adaptive process, although facilitated processing of mildly threatening stimuli irrelevant to current goals may result in attentional interference and compromised performance. In the field of chronic pain, attentional biases towards pain-related information have been commonly found. Pain is inexorably connected with emotion however, and a transdiagnostic approach elucidating similar mechanisms underlying pain and mood disorders has been advocated. One such mechanism may be repetitive thinking on negative themes, including worry and rumination. Attentional biases for threatening (e.g., angry faces) and negative (e.g., sad faces) information have been observed in anxious and depressed populations, although to date it has not been fully established whether biases for such information are heightened in individuals with chronic pain relative to healthy individuals. In this study, attentional biases for angry, sad and also happy facial expressions, at 500 and 1250 ms presentation times, were assessed via visual-probe task in chronic daily headache (n = 20) and healthy control (n = 26) groups. Results showed participants to demonstrate significant bias towards angry and sad expressions at 500 and 1250 ms, and happy expressions at 1250 ms. No significant differences in attentional bias were found between chronic daily headache and healthy control groups. These results suggest that attentional biases towards interpersonal threat are not specifically heightened in individuals with chronic daily headache. While similar mechanisms such as rumination may underlie biases in different disorders, this does not translate to heightened biases for the same specific content

Internet-delivered attentional bias modification training (iABMT) for the management of chronic musculoskeletal pain: A protocol for a randomised controlled trial

Introduction Chronic musculoskeletal pain is a complex medical condition that can significantly impact quality of life. Patients with chronic pain demonstrate attentional biases towards pain-related information. The therapeutic benefits of modifying attentional biases by implicitly training attention away from pain-related information towards neutral information have been supported in a small number of published studies. Limited research however has explored the efficacy of modifying pain-related biases via the internet. This protocol describes a randomised, double-blind, internet-delivered attentional bias modification intervention, aimed to evaluate the efficacy of the intervention on reducing pain interference. Secondary outcomes are pain intensity, state and trait anxiety, depression, pain-related fear, and sleep impairment. This study will also explore the effects of training intensity on these outcomes, along with participants' perceptions about the therapy. Methods and analysis The study is a double-blind, randomised controlled trial with four arms exploring the efficacy of online attentional bias modification training versus placebo training theorised to offer no specific therapeutic benefit. Participants with chronic musculoskeletal pain will be randomised to one of four groups: (1) 10-session attentional modification group; (2) 10-session placebo training group; (3) 18-session attentional modification group; or (4) 18-session placebo training group. In the attentional modification groups, the probe-classification version of the visual-probe task will be used to implicitly train attention away from threatening information towards neutral information. Following the intervention, participants will complete a short interview exploring their perceptions about the online training. In addition, a subgroup analysis for participants aged 16-24 and 25-60 will be undertaken. Ethics and dissemination This study has been approved by the University of Southampton Research Ethics Committee. Results will be published in peer-reviewed journals, academic conferences, and in lay reports for pain charities and patient support groups. Trial registration number NCT02232100; Pre-results

A rapid systematic review of breakthrough pain definitions and descriptions

Background Breakthrough pain is common in life-limiting conditions and at end-of-life. Despite over 30 years of study, there is little consensus regarding the definition and characteristics of breakthrough pain. Objective This study aims to update and expand a 2010 systematic review by Haugen and colleagues to identify (1) all definitions of breakthrough pain and (2) all descriptions and classifications of breakthrough pain reported by patients, caregivers, clinicians, and experts. Design This rapid systematic review followed the Cochrane Rapid Review Methods Group guidelines. A protocol is published on PROSPERO (CRD42019155583). Data sources CINAHL, MEDLINE, PsycINFO, and the Web of Science were searched for breakthrough pain terms from the inception dates of each database to 26th August 2022. Results We identified 65 studies that included data on breakthrough pain definitions, descriptions, or classifications from patients ( n = 30), clinicians ( n = 6), and experts ( n = 29), but none with data from caregivers. Most experts proposed that breakthrough pain was a sudden, severe, brief pain occurring in patients with adequately controlled mild-moderate background pain. However, definitions varied and there was no consensus. Pain characteristics were broadly similar across studies though temporal factors varied widely. Experts classified breakthrough pain into nociceptive, neuropathic, visceral, somatic, or mixed types. Patients with breakthrough pain commonly experienced depression, anxiety, and interference with daily life. Conclusions Despite ongoing efforts, there is still no consensus on the definition of breakthrough pain. A compromise is needed on breakthrough pain nomenclature to collect reliable incidence and prevalence data and to inform further refinement of the construct

A protocol for a systematic review and meta-analysis to identify measures of breakthrough pain and evaluate their psychometric properties.

INTRODUCTION: Breakthrough pain is common in children and adults with cancer and other conditions, including those approaching end-of-life, although it is often poorly managed, possibly partly due to a lack of validated assessment tools. This review aims to (1) identify all available instruments measuring breakthrough pain in infants, children, adolescents or adults and (2) critically appraise, compare and summarise the quality of the psychometric properties of the identified instruments using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. METHODS AND ANALYSIS: Two searches will be carried out between October 2019 and January 2020, one for each aim of the review. The Cochrane Library, International Prospective Register of Systematic Reviews, Embase, Cumulative Index of Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online (MEDLINE), PsycINFO, Web of Science Core Collection, Google Scholar, the ProQuest Dissertations & Theses Database, Evidence Search and OpenGrey databases will be searched from database inception until the date the search is conducted. Reference lists of eligible articles will be screened and authors in the field contacted. For search 1, articles will be screened by two reviewers by abstract, and full-text where necessary, to identify if a breakthrough pain assessment was used. Search 2 will then be conducted to identify studies evaluating measurement properties of these assessments. Two reviewers will screen articles from search 2 by title and abstract. All potentially relevant studies will be screened by full text by both reviewers. For search 2, data will be extracted in parallel with the quality assessment process, as recommended by COSMIN. Two reviewers will assess methodological quality using the COSMIN Risk of Bias checklist and the COSMIN updated criteria for good measurement properties. Findings will be summarised and, if possible, data will be pooled using meta-analysis. The quality of the evidence will be graded and summarised using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines. ETHICS AND DISSEMINATION: Results of this review will be submitted for publication in a peer review journal and presented at conferences. PROSPERO REGISTRATION NUMBER: CRD42019155583

Vertical structure of plankton communities in areas of European eel larvae distribution in the Sargasso Sea

The subtropical convergence zone (STCZ) in the Sargasso Sea is an important spawning ground for the European and American eels, and the region is also strongly influenced by front and eddy formations and subsducsion of different water masses. This study was conducted to understand the physical and biological forcing that affect larval eels. European eel larvae showed pronounced diel vertical migration, which matched the distribution patterns of small hydrozoans, suggesting a predator-prey link between the two. Strong variations of the hydrographic conditions and distinct vertical distributions of other plankton groups were also observed within the upper 300 m, creating diverse niches for planktivorous fishes within the water column

Early Detection of SARS-CoV-2 Omicron BA.4 and BA.5 in German Wastewater

Wastewater-based SARS-CoV-2 epidemiology (WBE) has been established as an important tool to support individual testing strategies. The Omicron sub-variants BA.4/BA.5 have spread globally, displacing the preceding variants. Due to the severe transmissibility and immune escape potential of BA.4/BA.5, early monitoring was required to assess and implement countermeasures in time. In this study, we monitored the prevalence of SARS-CoV-2 BA.4/BA.5 at six municipal wastewater treatment plants (WWTPs) in the Federal State of North Rhine-Westphalia (NRW, Germany) in May and June 2022. Initially, L452R-specific primers/probes originally designed for SARS-CoV-2 Delta detection were validated using inactivated authentic viruses and evaluated for their suitability for detecting BA.4/BA.5. Subsequently, the assay was used for RT-qPCR analysis of RNA purified from wastewater obtained twice a week at six WWTPs. The occurrence of L452R carrying RNA was detected in early May 2022, and the presence of BA.4/BA.5 was confirmed by variant-specific single nucleotide polymorphism PCR (SNP-PCR) targeting E484A/F486V and NGS sequencing. Finally, the mutant fractions were quantitatively monitored by digital PCR, confirming BA.4/BA.5 as the majority variant by 5 June 2022. In conclusion, the successive workflow using RT-qPCR, variant-specific SNP-PCR, and RT-dPCR demonstrates the strength of WBE as a versatile tool to rapidly monitor variants spreading independently of individual test capacities

Tracking Down Abstract Linguistic Meaning: Neural Correlates of Spatial Frame of Reference Ambiguities in Language

This functional magnetic resonance imaging (fMRI) study investigates a crucial parameter in spatial description, namely variants in the frame of reference chosen. Two frames of reference are available in European languages for the description of small-scale assemblages, namely the intrinsic (or object-oriented) frame and the relative (or egocentric) frame. We showed participants a sentence such as “the ball is in front of the man”, ambiguous between the two frames, and then a picture of a scene with a ball and a man – participants had to respond by indicating whether the picture did or did not match the sentence. There were two blocks, in which we induced each frame of reference by feedback. Thus for the crucial test items, participants saw exactly the same sentence and the same picture but now from one perspective, now the other. Using this method, we were able to precisely pinpoint the pattern of neural activation associated with each linguistic interpretation of the ambiguity, while holding the perceptual stimuli constant. Increased brain activity in bilateral parahippocampal gyrus was associated with the intrinsic frame of reference whereas increased activity in the right superior frontal gyrus and in the parietal lobe was observed for the relative frame of reference. The study is among the few to show a distinctive pattern of neural activation for an abstract yet specific semantic parameter in language. It shows with special clarity the nature of the neural substrate supporting each frame of spatial reference

The time course and specificity of attentional bias in individuals with chronic headache

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