Brain oscillations differentially encode noxious stimulus intensity and pain intensity

Noxious stimuli induce physiological processes which commonly translate into pain. However, under certain conditions, pain intensity can substantially dissociate from stimulus intensity, e.g. during longer-lasting pain in chronic pain syndromes. How stimulus intensity and pain intensity are differentially represented in the human brain is, however, not yet fully understood. We therefore used electroencephalography (EEG) to investigate the cerebral representation of noxious stimulus intensity and pain intensity during 10 min of painful heat stimulation in 39 healthy human participants. Time courses of objective stimulus intensity and subjective pain ratings indicated a dissociation of both measures. EEG data showed that stimulus intensity was encoded by decreases of neuronal oscillations at alpha and beta frequencies in sensorimotor areas. In contrast, pain intensity was encoded by gamma oscillations in the medial prefrontal cortex. Contrasting right versus left hand stimulation revealed that the encoding of stimulus intensity in contralateral sensorimotor areas depended on the stimulation side. In contrast, a conjunction analysis of right and left hand stimulation revealed that the encoding of pain in the medial prefrontal cortex was independent of the side of stimulation. Thus, the translation of noxious stimulus intensity into pain is associated with a change from a spatially specific representation of stimulus intensity by alpha and beta oscillations in sensorimotor areas to a spatially independent representation of pain by gamma oscillations in brain areas related to cognitive and affective-motivational processes. These findings extend the understanding of the brain mechanisms of nociception and pain and their dissociations during longer-lasting pain as a key symptom of chronic pain syndromes

Emplacement characteristics, time scales, and volcanic gas release rates of continental flood basalt eruptions on Earth

Continental flood basalt provinces are the subaerial expression of large igneous province volcanism. The emplacement of a continental flood basalt is an exceptional volcanic event in the geological history of our planet with the potential to directly impact Earth's atmosphere and environment. Large igneous province volcanism appears to have occurred episodically every 10–30 m.y. through most of Earth history. Most continental flood basalt provinces appear to have formed within 1–3 m.y., and within this period, one or more pulses of great magma production and lava eruption took place. These pulses may have lasted from 1 m.y. to as little as a few hundred thousand years. Within these pulses, tens to hundreds of volumetrically large eruptions took place, each producing 103-104 km3 of predominantly pahoehoe lava and releasing unprecedented amounts of volcanic gases and ash into the atmosphere. The majority of magmatic gas species released had the potential to alter climate and/or atmospheric composition, in particular during violent explosive phases at the eruptive vents when volcanic gases were lofted into the stratosphere. Aside from the direct release of magmatic gases, magma-sediment interactions featured in some continental flood basalt provinces could have released additional carbon, sulfur, and halogen-bearing species into the atmosphere. Despite their potential importance, given the different nature of the country rock associated with each continental flood basalt province, it is difficult to make generalizations about these emissions from one province to another. The coincidence of continental flood basalt volcanism with periods of major biotic change is well substantiated, but the actual mechanisms by which the volcanic gases might have perturbed the environment to this extent are currently not well understood, and have been little studied by means of atmospheric modeling. We summarize current, albeit rudimentary, knowledge of continental flood basalt eruption source and emplacement characteristics to define a set of eruption source parameters in terms of magmatic gases that could be used as inputs for Earth system modeling studies. We identify our limited knowledge of the number and length of non-eruptive phases (hiatuses) during continental flood basalt volcanism as a key unknown parameter critical for better constraining the severity and duration of any potential environmental effects caused by continental flood basalt eruptions

Duration of untreated eating disorder and relationship to outcomes: A systematic review of the literature

Objective: This systematic review assesses the average duration of untreated eating disorder (DUED) in help‐seeking populations at the time of first eating disorder (ED) treatment and investigates the relationship between DUED and symptom severity/clinical outcomes. / Method: PRISMA guidelines were followed throughout. Selected studies provided information on either: (i) length of DUED, (ii) components of DUED, (iii) cross‐sectional associations between DUED and symptom severity, (iv) associations between DUED and clinical outcomes, or (v) experimental manipulation of DUED. Study quality was assessed. / Results: Fourteen studies from seven countries were included. Across studies, average DUED weighted by sample size was 29.9 months for anorexia nervosa, 53.0 months for bulimia nervosa and 67.4 months for binge eating disorder. A younger age at time of first treatment was indicative of shorter DUED. Retrospective studies suggest that a shorter DUED may be related to a greater likelihood of remission. Manipulation of DUED by shortening service‐related delays may improve clinical outcomes. / Conclusions: Data on length of DUED provide a benchmark for early intervention in EDs. Preliminary evidence suggests DUED may be a modifiable factor influencing outcomes in EDs. To accurately determine the role of DUED, definition and measurement must be uniformly operationalised

Water security in South Africa: perceptions on public expectations and municipal obligations, governance and water re-use

South Africa is a water-scarce country with increasing pressure on its water resources. Urgent interventions are needed to protect water security within this rapidly developing country. This paper reports on an interdisciplinary Water Security Colloquium, convened by the South African Young Academy of Science in 2014. A selected group of water professionals from academia, civil society and local government was brought together to discuss water security under three focus themes: ‘public expectations and municipal obligations’, ‘water security and governance: challenges and advances’, and ‘water re-use: health and infrastructural considerations’. Participant perceptions were generated using a focus group methodology, combined with participatory data collection methods. Under each theme, inputs were categorised as ‘challenges’, ‘gaps in knowledge’, and ‘solutions/recommendations’ and these inputs were thereafter ranked in order of importance via a ‘voting’ process. Major challenges perceived included a lack of both skills and political will in government, a need to restore citizen trust in government intention and capability to deliver water-related services, and a failure to up-scale existing water re-use technology. Participants identified understanding of the process and implications of the Green and Blue Drop Programmes, knowledge transfer to the public, and the role of educators as major knowledge gaps. The top suggestions proposed included creating public awareness around and buy-in to initiatives to improve water security, accessible and user-friendly conversion of research results to implementation, and ensuring an active role for educators in creating awareness around water security. In view of the concerns identified, participants suggested as potential solutions: improving government and public understanding around water issues, incentivising water re-use and conservation, introducing rising block tariffs and improving human capacity development in the water sector. Developing the ecological infrastructure that protects both quantity and quality of water and building strong partnerships among all stakeholders were also recognised as key.Keywords: capacity development, education, governance, water security, water re-use, water conservation, local governmen

Moving toward "laboratory-supported" criteria for psychogenic tremor.

A confident clinical diagnosis of psychogenic tremor is often possible, but, in some cases, a "laboratory-supported" level of certainty would aid in early positive diagnosis. Various electrophysiological tests have been suggested to identify patients with psychogenic tremor, but their diagnostic reliability has never been assessed "head to head" nor compared to forms of organic tremor other than essential tremor or PD. We compared baseline tremor characteristics (e.g., frequency and amplitude) as well as electrophysiological tests previously reported to distinguish psychogenic and organic tremor in a cohort of 13 patients with psychogenic tremor and 25 patients with organic tremor, the latter including PD, essential-, dystonic-, and neuropathic tremors. We assessed between-group differences and calculated sensitivity and specificity for each test. A number of tests, including entrainment or frequency changes with tapping, pause of tremor during contralateral ballistic movements, increase in tremor amplitude with loading, presence of coherence, and tonic coactivation at tremor onset, revealed significant differences on a group level, but there was no single test with adequate sensitivity and specificity for separating the groups (33%-77% and 84%-100%, respectively). However, a combination of electrophysiological tests was able to distinguish psychogenic and organic tremor with excellent sensitivity and specificity. A laboratory-supported level of diagnostic certainty in psychogenic tremor is likely to require a battery of electrophysiological tests to provide sufficient specificity and sensitivity. Our data suggest such a battery that, if supported in a prospective study, may form the basis of laboratory-supported criteria for the diagnosis of psychogenic tremor

Energy Dependence of the Delta Resonance: Chiral Dynamics in Action

There is an important connection between the low energy theorems of QCD and the energy dependence of the Delta resonance in pi-N scattering, as well as the closely related gamma^{*} N -> pi N reaction. The resonance shape is due not only to the strong pi-N interaction in the p wave but the small interaction in the s wave; the latter is due to spontaneous chiral symmetry breaking in QCD (i.e. the Nambu-Goldstone nature of the pion). A brief overview of experimental tests of chiral perturbation theory and chiral based models is presentedComment: 11 pages, 6 figures, Festschrift for S.N. yan

Intraocular pressure and ocular pulse amplitude using dynamic contour tonometry and contact lens tonometry

BACKGROUND: The new Ocular Dynamic Contour Tonometer (DCT), investigational device supplied by SMT (Swiss Microtechnology AG, Switzerland) allows simultaneous recording of intraocular pressure (IOP) and ocular pulse amplitude (OPA). It was the aim of this study to compare the IOP results of this new device with Goldmann tonometry. Furthermore, IOP and OPA measured with the new slitlamp-mounted DCT were compared to the IOP and OPA measured with the hand-held SmartLens(®), a gonioscopic contact lens tonometer (ODC Ophthalmic Development Company AG, Switzerland). METHODS: Nineteen healthy subjects were included in this study. IOP was determined by three consecutive measurements with each of the DCT, SmartLens(®), and Goldmann tonometer. Furthermore, OPA was measured three times consecutively by DCT and SmartLens(®). RESULTS: No difference (P = 0.09) was found between the IOP values by means of DCT (mean: 16.6 mm Hg, median: 15.33 mm Hg, SD: +/- 4.04 mm Hg) and Goldmann tonometry (mean: 16.17 mm Hg, median: 15.33 mm Hg, SD: +/- 4.03 mm Hg). The IOP values of SmartLens(® )(mean: 20.25 mm Hg, median: 19.00 mm Hg, SD: +/- 4.96 mm Hg) were significantly higher (P = 0.0008) both from Goldmann tonometry and DCT. The OPA values of the DCT (mean: 3.08 mm Hg, SD: +/- 0.92 mm Hg) were significantly lower (P = 0.0003) than those obtained by SmartLens(® )(mean: 3.92 mm Hg, SD: +/- 0.83 mm Hg). CONCLUSIONS: DCT was equivalent to Goldmann applanation tonometry in measurement of IOP in a small group of normal subjects. In contrast, SmartLens(® )(contact lens tonometry) gave IOP readings that were significantly higher compared with Goldmann applanation tonometer readings. Both devices, DCT and SmartLens(® )provide the measurement of OPA which could be helpful e.g. for the management of glaucoma

Drama as a pedagogical tool for practicing death notification-experiences from Swedish medical students

<p>Abstract</p> <p>Background</p> <p>One of the toughest tasks in any profession is the deliverance of death notification. Marathon Death is an exercise conducted during the fourth year of medical school in northern Sweden to prepare students for this responsibility. The exercise is designed to enable students to gain insight into the emotional and formal procedure of delivering death notifications. The exercise is inspired by Augusto Boal's work around Forum Theatre and is analyzed using video playback. The aim of the study was to explore reflections, attitudes and ideas toward training in delivering death notifications among medical students who participate in the Marathon Death exercise based on forum play.</p> <p>Methods</p> <p>After participation in the Marathon Death exercise, students completed semi-structured interviews. The transcribed interviews were analyzed using the principles of qualitative content analysis including a deductive content analysis approach with a structured matrix based on Bloom's taxonomy domains.</p> <p>Results</p> <p>The Marathon Death exercise was perceived as emotionally loaded, realistic and valuable for the future professional role as a physician. The deliverance of a death notification to the next of kin that a loved one has died was perceived as difficult. The exercise conjured emotions such as positive expectations and sheer anxiety. Students perceived participation in the exercise as an important learning experience, discovering that they had the capacity to manage such a difficult situation. The feedback from the video playback of the exercise and the feedback from fellow students and teachers enhanced the learning experience.</p> <p>Conclusions</p> <p>The exercise, Marathon Death, based on forum play with video playback is a useful pedagogical tool that enables students to practice delivering death notification. The ability to practice under realistic conditions contributes to reinforce students in preparation for their future professional role.</p

Mice with cisplatin and oxaliplatin-induced painful neuropathy develop distinct early responses to thermal stimuli

<p>Abstract</p> <p>Background</p> <p>Cisplatin has been in use for 40 years for treatment of germ line and other forms of cancer. Oxaliplatin is approved for treatment of metastatic colorectal cancer. Thirty to forty percent of cancer patients receiving these agents develop pain and sensory loss. Oxaliplatin induces distinctive cold-associated dysesthesias in up to 80% of patients.</p> <p>Results</p> <p>We have established mouse models of cisplatin and oxaliplatin-induced neuropathy using doses similar to those used in patients. Adult male C57BL6J mice were treated with daily intraperitoneal injection for 5 days, followed by 5 days of rest, for two cycles. Total cumulative doses of 23 mg/kg cisplatin and 30 mg/kg oxaliplatin were used. Behavioral evaluations included cold plate, von Frey, radiant heat, tail immersion, grip strength and exploratory behavior at baseline and at weekly intervals for 8 weeks. Following two treatment cycles, mice in the cisplatin and oxaliplatin treatment groups demonstrated significant mechanical allodynia compared to control mice. In addition, the cisplatin group exhibited significant thermal hyperalgesia in hind paws and tail, and the oxaliplatin group developed significant cold hyperalgesia in hind paws.</p> <p>Conclusion</p> <p>We have therefore established a model of platinum drug-induced painful peripheral neuropathy that reflects the differences in early thermal pain responses that are observed in patients treated with either cisplatin or oxaliplatin. This model should be useful in studying the molecular basis for these different pain responses and in designing protective therapeutic strategies.</p