Douleur Neuropathique 4 (DN4) stratifies possible and definite neuropathic pain after surgical peripheral nerve lesion

Douleur Neuropathique 4 (DN4) is a screening questionnaire to help identify neuropathic pain (NP) in clinical practice and research. We tested the accuracy of the DN4 questionnaire in stratifying possible NP (pNP) and definite NP (dNP) in patients operated for breast cancer. We studied 163 patients from a longitudinal cohort of breast cancer operated patients 4-9 years after surgery. pNP or dNP were classified according to the NP grading system. Surgeon-verified intercostobrachial nerve resection was used as a confirmatory test for dNP. A receiver-operating characteristic (ROC) curve analysis was performed and the area under the curve (AUC) was calculated to test the diagnostic accuracy (sensitivity, specificity, positive and negative predictive values) of the DN4. Additionally, we studied clinical factors that associated with a positive screening outcome in the interview part of the DN4 (DN4i). DN4i and DN4 showed significant accuracy in stratifying patients with pNP or dNP with cut-off scores 3 and 4 resulting to sensitivity of 66.2% and 79.4% and specificity of 77.8% and 92.6%, respectively. pNP and dNP patients showed differences in sensory descriptors of pain according to DN4i items. Screening positive on DN4i associated with dNP and younger age. Full DN4 could stratify pNP and dNP patients in a chronic postsurgical NP patient group operated for breast cancer. Additionally, DN4i showed significant accuracy in stratifying pNP and dNP, but an examination is necessary to obtain proper accuracy. Demographic factors may have an impact on the screening outcome of DN4i

#Nokia : fantasiat Nokian ja Microsoftin välisen yrityskaupan jälkeisessä Twitter-keskustelussa

Nokian matkapuhelinliiketoiminnan myyminen Microsoftille herätti paljon keskustelua Suomessa ja julkisuudessa esitettiin erilaisia arvioita suomalaisten suhtautumisesta yrityskauppaan. Nokiaa pidetäänkin yleisesti poikkeuksellisena menestystarinana, johon liittyy monia pienempiä tarinoita. Tarinoiden on todettu olevan yhteydessä ihmisten tunteisiin, joten suomalaisten suhtautumista yrityskauppaan tarkasteltiin heidän jakamiensa tarinoiden kautta. Tutkielman näkökulma perustui symbolisen konvergenssin teoriaan, joka keskittyy tarkastelemaan ihmisten välisessä vuorovaikutuksessa esiintyviä fantasioita eli tarinoita ja tarinallisia aineksia. Tutkimuskontekstiksi valittiin sosiaalisen median palvelu Twitter, jonka käyttäjien on todettu hyödyntävän palvelua ajankohtaisten aiheiden kommentoimiseen. Tutkielman tavoitteena oli havaita käyttäjien välistä symbolista konvergenssia, kuvailla vuorovaikutuksessa esiintyneet fantasiat ja muodostaa niiden avulla käsitys käyttäjien suhtautumisesta yrityskauppaan. Tutkimusmenetelmänä käytettiin laadulliseen sisällönanalyysiin perustuvaa fantasia-aiheiden analyysia. Tutkielman aineisto koostui käyttäjien Twitterissä aikavälillä 3.9.-10.9.2013 julkaisemista, avainsanan #nokia sisältäneistä suomenkielisistä tviiteistä, joita oli yhteensä 1471 kappaletta. Tulosten perusteella käyttäjät käsittelivät yrityskauppaa samanlaisten tarinallisten ainesten avulla eli käyttäjien välillä havaittiin symbolista konvergenssia. Kaikkiaan #nokia-keskustelusta tulkittiin 21 fantasia-aihetta ja yhdeksän retorista näkemystä. Niiden perusteella vaikutti siltä, että käyttäjillä oli monia eri tapoja suhtautua yrityskauppaan. Merkittävimmiksi niistä tulkittiin turhautuminen ja vähättely, joka kohdistui muun muassa yrityskaupan merkittävyyteen. Muiksi suhtautumistavoiksi tulkittiin trollaaminen, välinpitämättömyys, toiveikkuus, pelko, realistisuus, pettymys, katkeruus ja haikeus. Tutkielman tulokset olivat vain osittain saman suuntaisia julkisuudessa suomalaisten suhtautumisesta esitettyjen arvioiden kanssa

Static mechanical allodynia in post-surgical neuropathic pain after breast cancer treatments

Objectives: Static mechanical allodynia (SMA), i. e., pain caused by normally non-painful static pressure, is a prevalent manifestation of neuropathic pain (NP). Although SMA may significantly affect the patient's daily life, it is less well studied in the clinical context. We aimed to characterize SMA in women with chronic post-surgical NP (CPSNP) after breast cancer surgery. Our objective was to improve understanding of the clinical picture of this prevalent pain condition. This is a substudy of a previously published larger cohort of patients with intercostobrachial nerve injury after breast cancer surgery (Mustonen et al. Pain. 2019;160:246-56). Methods: We studied SMA in 132 patients with CPSNP after breast cancer surgery. The presence, location, and intensity of SMA were assessed at clinical sensory examination. The patients gave self-reports of pain with the Brief Pain Inventory (BPI). We studied the association of SMA to type of surgery, oncological treatments, BMI, other pains, and psychological factors. General pain sensitivity was assessed by the cold pressor test. Results: SMA was prevalent (84%) in this cohort whereas other forms of allodynia were scarce (6%). Moderate-to-severe SMA was frequently observed even in patients who reported mild pain in BPI. Breast and the side of chest were the most common locations of SMA. SMA was associated with breast surgery type, but not with psychological factors. Severe SMA, but not self-reported pain, was associated with lower cold pain tolerance. Conclusions: SMA is prevalent in post-surgical NP after breast cancer surgery and it may represent a distinct NP phenotype. High intensities of SMA may signal the presence of central sensitization. Implications: SMA should be considered when examining and treating patients with post-surgical NP after breast cancer surgery.Peer reviewe

Douleur Neuropathique 4 (DN4) stratifies possible and definite neuropathic pain after surgical peripheral nerve lesion

Background Douleur Neuropathique 4 (DN4) is a screening questionnaire to help identify neuropathic pain (NP) in clinical practice and research. We tested the accuracy of the DN4 questionnaire in stratifying possible NP (pNP) and definite NP (dNP) in patients operated for breast cancer. Methods We studied 163 patients from a longitudinal cohort of breast cancer operated patients 4-9 years after surgery. pNP or dNP were classified according to the NP grading system. Surgeon-verified intercostobrachial nerve resection was used as a confirmatory test for dNP. A receiver-operating characteristic (ROC) curve analysis was performed and the area under the curve (AUC) was calculated to test the diagnostic accuracy (sensitivity, specificity, positive and negative predictive values) of the DN4. Additionally, we studied clinical factors that associated with a positive screening outcome in the interview part of the DN4 (DN4i). Results DN4i and DN4 showed significant accuracy in stratifying patients with pNP or dNP with cut-off scores 3 and 4 resulting to sensitivity of 66.2% and 79.4% and specificity of 77.8% and 92.6%, respectively. pNP and dNP patients showed differences in sensory descriptors of pain according to DN4i items. Screening positive on DN4i associated with dNP and younger age. Conclusions Full DN4 could stratify pNP and dNP patients in a chronic postsurgical NP patient group operated for breast cancer. Additionally, DN4i showed significant accuracy in stratifying pNP and dNP, but an examination is necessary to obtain proper accuracy. Demographic factors may have an impact on the screening outcome of DN4i. Significance DN4 stratifies possible and definite postsurgical peripheral neuropathic pain. DN4i may also show this, but full DN4 is more accurate. We confirm DN4i as a valid screening tool for NP.Peer reviewe

Symbolisen konvergenssin teoria Twitter-tutkimuksen välineenä:tapaus #nokia

Tarinat ovat osa sosiaalisia todellisuuksia, jotka rakentuvat ihmisten välisessä vuorovaikutuksessa. Näistä tarinoista yhä useampi syntyy nykyään sosiaalisessa mediassa, koska sen merkitys ihmisten vuorovaikutukselle kasvaa jatkuvasti. Tässä artikkelissa pyrimme osoittamaan tarinoita fantasioiksi kutsuvan symbolisen konvergenssin teorian tarjoamat mahdollisuudet viestinnän tutkimukselle. Sovellamme teoriaa sosiaalisen median palvelu Twitteriin. Keskitymme niin sanottuun #nokia-keskusteluun, jota käytiin Twitterissä Nokian ja Microsoftin välisen yrityskaupan julkistamisen jälkeen syyskuussa 2013. Esittelemme teoriaa ja analysoimme keskustelua rinnakkain teorian keskeisten käsitteiden kautta. Lopuksi arvioimme teoriaa ja mahdollisuuksia hyödyntää sitä viestinnän tutkimukseen myös jatkossa.Tarinat ovat osa sosiaalisia todellisuuksia, jotka rakentuvat ihmisten välisessä vuorovaikutuksessa. Näistä tarinoista yhä useampi syntyy nykyään sosiaalisessa mediassa, koska sen merkitys ihmisten vuorovaikutukselle kasvaa jatkuvasti. Tässä artikkelissa pyrimme osoittamaan tarinoita fantasioiksi kutsuvan symbolisen konvergenssin teorian tarjoamat mahdollisuudet viestinnän tutkimukselle. Sovellamme teoriaa sosiaalisen median palvelu Twitteriin. Keskitymme niin sanottuun #nokia-keskusteluun, jota käytiin Twitterissä Nokian ja Microsoftin välisen yrityskaupan julkistamisen jälkeen syyskuussa 2013. Esittelemme teoriaa ja analysoimme keskustelua rinnakkain teorian keskeisten käsitteiden kautta. Lopuksi arvioimme teoriaa ja mahdollisuuksia hyödyntää sitä viestinnän tutkimukseen myös jatkossa

Effect of the exhaust gas side fouling on the performance of a plate and shell type heat exchanger

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What makes surgical nerve injury painful? A 4-year to 9-year follow-up of patients with intercostobrachial nerve resection in women treated for breast cancer

Nerve injury during breast cancer surgery can cause neuropathic pain (NP). It is not known why some, but not all, patients develop chronic postsurgical neuropathic pain (CPSNP) after the same nerve injury. In this study, we examined 251 breast cancer survivors with surgeon-verified intercostobrachial nerve resection to identify factors that associate with CPSNP. The patients were recruited from a previous study of 1000 women treated for breast cancer in 2006 to 2010. This enabled us to analyze preoperative factors that associate with future CPSNP. The patients were re-examined in 2014 to 2016 to diagnose CPSNP using the revised NP diagnostic criteria. Preoperative assessments were pain in the area to be operated on, any chronic pain condition, depressive symptoms, anxiety, sleep, and experimental cold pain sensitivity using the cold pressor test (CPT). Follow-up assessments were CPT, psychological factors, sleep, any chronic pain, and basic laboratory tests. One hundred thirty-seven (55%) patients with intercostobrachial nerve resection fulfilled CPSNP diagnostic criteria after 4 to 9 years. Of them, 30 patients (22%) had moderate to severe pain in self-reports and 86 (63%) presented moderate to severe evoked pain at examination. Preoperative pain in the surgical area, other chronic pains, and breast-conserving surgery were associated with future CPSNP. Other chronic pains, increased psychological burden, and insomnia, both before surgery and at the follow-up, were associated with CPSNP. Preoperative CPT did not associate with future CPSNP. Patients with established CPSNP showed increased pain sensitivity in CPT and higher levels of inflammatory markers, suggesting that central sensitization and inflammation may associate with the maintenance of CPSNP.Peer reviewe

Ultrasound-Navigated MANTA™ deployment after Removal of Extracorporeal Membrane Oxygenation Cannula

The case provided suggests that ultrasound-navigated MANTA™ works well closing percutaneously the peripheral arterial ECMO cannulation site. Ultrasound use during ECMO decannulation can further diminish the possible device related technical failures (toggle or collagen protrusion through the vessel wall, toggle stacking into calcifications, or delivery failure of the collagen pad) leading to bleeding and vascular complications. Further studies are needed on this topic.Peer reviewe

Changes in global gene expression of Vibrio parahaemolyticus induced by cold- and heat-stress

Background Vibrio (V.) parahaemolyticus causes seafood-borne gastro-intestinal bacterial infections in humans worldwide. It is widely found in marine environments and is isolated frequently from seawater, estuarine waters, sediments and raw or insufficiently cooked seafood. Throughout the food chain, V. parahaemolyticus encounters different temperature conditions that might alter metabolism and pathogenicity of the bacterium. In this study, we performed gene expression profiling of V. parahaemolyticus RIMD 2210633 after exposure to 4, 15, 20, 37 and 42 °C to describe the cold and heat shock response. Methods Gene expression profiles of V. parahaemolyticus RIMD 2210633 after exposure to 4, 15, 20, 37 and 42 °C were investigated via microarray. Gene expression values and RT-qPCR experiments were compared by plotting the log2 values. Moreover, volcano plots of microarray data were calculated to visualize the distribution of differentially expressed genes at individual temperatures and to assess hybridization qualities and comparability of data. Finally, enriched terms were searched in annotations as well as functional- related gene categories using the Database for Annotation, Visualization and Integrated Discovery. Results Analysis of 37 °C normalised transcriptomics data resulted in differential expression of 19 genes at 20 °C, 193 genes at 4 °C, 625 genes at 42 °C and 638 genes at 15 °C. Thus, the largest number of significantly expressed genes was observed at 15 and 42 °C with 13.3 and 13 %, respectively. Genes of many functional categories were highly regulated even at lower temperatures. Virulence associated genes (tdh1, tdh2, toxR, toxS, vopC, T6SS-1, T6SS-2) remained mostly unaffected by heat or cold stress. Conclusion Along with folding and temperature shock depending systems, an overall temperature-dependent regulation of expression could be shown. Particularly the energy metabolism was affected by changed temperatures. Whole-genome gene expression studies of food related pathogens such as V. parahaemolyticus reveal how these pathogens react to stress impacts to predict its behaviour under conditions like storage and transport