Perspectives on next steps in classification of oro-facial pain - part 1: role of ontology

The purpose of this study was to review existing principles of oro-facial pain classifications and to specify design recommendations for a new system that would reflect recent insights in biomedical classification systems, terminologies and ontologies. The study was initiated by a symposium organised by the International RDC/TMD Consortium Network in March 2013, to which the present authors contributed. The following areas are addressed: problems with current classification approaches, status of the ontological basis of pain disorders, insufficient diagnostic aids and biomarkers for pain disorders, exploratory nature of current pain terminology and classification systems, and problems with prevailing classification methods from an ontological perspective. Four recommendations for addressing these problems are as follows: (i) develop a hypothesis-driven classification structure built on principles that ensure to our best understanding an accurate description of the relations among all entities involved in oro-facial pain disorders; (ii) take into account the physiology and phenomenology of oro-facial pain disorders to adequately represent both domains including psychosocial entities in a classification system; (iii) plan at the beginning for field-testing at strategic development stages; and (iv) consider how the classification system will be implemented. Implications in relation to the specific domains of psychosocial factors and biomarkers for inclusion into an oro-facial pain classification system are described in two separate papers

US and MR imaging features of benign cystic mesothelioma of the liver: A diagnostic dilemma

Cystic mesotheliomas are benign neoplasms, often seen in the parietal and visceral peritoneum, omentum and pelvic organs, and are exceedingly rare in the liver. It is however important to be familiar with the radiological findings of this tumour because the signal-intensity and enhancement pattern of this tumor are unusual and not typical for any of the more frequently seen mass lesions. In our patient, characteristic imaging findings on dynamic contrast-enhanced MRI and histopathological confirmation with appropriate immunohistochemical markers facilitated a correct diagnosis. We herein describe the clinical, imaging and histopathological features, pathogenesis, differential diagnosis and treatment of benign cystic mesothelioma involving posterior segment of the right lobe of the liver

An International Multi-Stakeholder Delphi Survey Study on the Design of Disease Modifying Parkinson’s Disease Trials

Background: Design of disease modification (DM) trials for Parkinson’s disease (PD) is challenging. Successful delivery requires a shared understanding of priorities and practicalities. Objective: To seek stakeholder consensus on phase 3 trials’ overall goals and structure, inclusion criteria, outcome measures, and trial delivery and understand where perspectives differ. Methods: An international expert panel comprising people with Parkinson’s (PwP), care partners (CP), clinical scientists, representatives from industry, funders and regulators participated in a survey-based Delphi study. Survey items were informed by a scoping review of DM trials and PwP input. Respondents scored item agreement over 3 rounds. Scores and reasoning were summarized by participant group each round until consensus, defined as≥70% of at least 3 participant groups falling within the same 3-point region of a 9-point Likert scale. Results: 92/121 individuals from 13 countries (46/69 PwP, 13/18 CP, 20/20 clinical scientists, representatives from 8/8 companies, 4/5 funders, and 1/1 regulator) completed the study. Consensus was reached on 14/31 survey items: 5/8 overall goals and structure, 1/8 Eligibility criteria, 7/13 outcome measures, and 1/2 trial delivery items. Extent of stakeholder endorsement for 428 reasons for scores was collated across items. Conclusions: This is the first systematic multi-stakeholder consultation generating a unique repository of perspectives on pivotal aspects of DM trial design including those of PwP and CP. The panel endorsed outcomes that holistically measure PD and the importance of inclusive trials with hybrid delivery models. Areas of disagreement will inform mitigating strategies of researchers to ensure successful delivery of future trials

Perspectives on next steps in classification of oro-facial pain - part 2: role of psychosocial factors

This study was initiated by a symposium, in which the present authors contributed, organised by the International RDC/TMD Consortium Network in March 2013. The purpose of the study was to review the status of biobehavioural research - both quantitative and qualitative - related to oro-facial pain (OFP) with respect to the aetiology, pathophysiology, diagnosis and management of OFP conditions, and how this information can optimally be used for developing a structured OFP classification system for research. In particular, we address representation of psychosocial entities in classification systems, use of qualitative research to identify and understand the full scope of psychosocial entities and their interaction, and the usage of classification system for guiding treatment. We then provide recommendations for addressing these problems, including how ontological principles can inform this process

EUS assessment for intermediate risk of choledocholithiasis after a negative magnetic resonance cholangiopancreatography

© 2020 SPRING MEDIA PUBLISHING CO. LTD | PUBLISHED BY WOLTERS KLUWER - MEDKNOW 291. Background and Aims: Guidelines recommend either EUS or magnetic resonance cholangiopancreatography (MRCP) for intermediate risk of choledocholithiasis. There is a lack of evidence that supports proceeding with EUS if the MRCP is negative and if clinical suspicion still exists. Methods: This is a retrospective study of all patients who underwent EUS to assess for choledocholithiasis at a tertiary care referral center from July 2013 to October 2019. Results: A total of 593 patients underwent EUS for evaluation for choledocholithiasis. Of the 593 patients, 35.2% (209/593) had an MRCP. 73.2% (153/209) had a negative MRCP while 26.8% (56/209) had a positive MRCP. Of the group of patients who underwent EUS with a negative MRCP, 15% (23/153) were positive for choledocholithiasis on EUS. Of these, 91% (21/23) were also positive for sludge or stones on endoscopic retrograde cholangiopancreatography and thus 14% (21/153) of the EUS were \u27true positives.\u27 There were no clinical or laboratory factors predictive of choledocholithiasis on univariate analysis in the EUS plus negative MRCP group. When further analyzing the MRCP negative group into MRCP-/EUS+ and MRCP-/EUS-subgroups, a total bilirubin \u3e3 mg/dL predicted a bile duct stone (55% vs. 32%, P = 0.05). Conclusion: The diagnostic yield of EUS for suspected choledocholithiasis in the setting of a negative MRCP is 14% in our cohort. EUS should be considered in patients with intermediate risk of choledocholithiasis with a negative MRCP if the clinical suspicion is still present, and especially if the total bilirubin is above 3 mg/dL

An International Multi-Stakeholder Delphi Survey Study on the Design of Disease Modifying Parkinson\u27s Disease Trials

\ua9 2023 - The authors. Published by IOS Press. Background: Design of disease modification (DM) trials for Parkinson\u27s disease (PD) is challenging. Successful delivery requires a shared understanding of priorities and practicalities. Objective: To seek stakeholder consensus on phase 3 trials\u27 overall goals and structure, inclusion criteria, outcome measures, and trial delivery and understand where perspectives differ. Methods: An international expert panel comprising people with Parkinson\u27s (PwP), care partners (CP), clinical scientists, representatives from industry, funders and regulators participated in a survey-based Delphi study. Survey items were informed by a scoping review of DM trials and PwP input. Respondents scored item agreement over 3 rounds. Scores and reasoning were summarized by participant group each round until consensus, defined as≥70% of at least 3 participant groups falling within the same 3-point region of a 9-point Likert scale. Results: 92/121 individuals from 13 countries (46/69 PwP, 13/18 CP, 20/20 clinical scientists, representatives from 8/8 companies, 4/5 funders, and 1/1 regulator) completed the study. Consensus was reached on 14/31 survey items: 5/8 overall goals and structure, 1/8 Eligibility criteria, 7/13 outcome measures, and 1/2 trial delivery items. Extent of stakeholder endorsement for 428 reasons for scores was collated across items. Conclusions: This is the first systematic multi-stakeholder consultation generating a unique repository of perspectives on pivotal aspects of DM trial design including those of PwP and CP. The panel endorsed outcomes that holistically measure PD and the importance of inclusive trials with hybrid delivery models. Areas of disagreement will inform mitigating strategies of researchers to ensure successful delivery of future trials

Nonequilibrium dynamics of mixtures of active and passive colloidal particles

We develop a mesoscopic field theory for the collective nonequilibrium dynamics of multicomponent mixtures of interacting active (i.e., motile) and passive (i.e., nonmotile) colloidal particles with isometric shape in two spatial dimensions. By a stability analysis of the field theory, we obtain equations for the spinodal that describes the onset of a motility-induced instability leading to cluster formation in such mixtures. The prediction for the spinodal is found to be in good agreement with particle-resolved computer simulations. Furthermore, we show that in active-passive mixtures the spinodal instability can be of two different types. One type is associated with a stationary bifurcation and occurs also in one-component active systems, whereas the other type is associated with a Hopf bifurcation and can occur only in active-passive mixtures. Remarkably, the Hopf bifurcation leads to moving clusters. This explains recent results from simulations of active-passive particle mixtures, where moving clusters and interfaces that are not seen in the corresponding one-component systems have been observed.Comment: 17 pages, 3 figure

Relativistic Turbulence: A Long Way from Preheating to Equilibrium

We study, both numerically and analytically, the development of equilibrium after preheating. We show that the process is characterised by the appearance of Kolmogorov spectra and the evolution towards thermal equilibrium follows self-similar dynamics. Simplified kinetic theory gives values for all characteristic exponents which are close to what is observed in lattice simulations. The resulting time for thermalization is long, and temperature at thermalization is low, $T \sim 100$ eV in the simple $\lambda \Phi^4$ inflationary model. Our results allow a straightforward generalization to realistic models.Comment: 4 pages, 3figures, LaTe

Enhancing individual animal resilience to environmental disturbances to address low productivity in dairy cattle performing in sub-Saharan Africa

The current review examines potential solutions to enhance the sustainability and productivity of the dairy sector in sub-Saharan Africa (SSA) with an emphasis on breeding for resilience. Additionally, the paper explores various indicators for measuring resilience and provides insights into the data that can be utilized to quantify resilience in SSA’s dairy production systems. Dairy production contributes significantly to food and nutritional security and employment in SSA. However, besides the general lack of enabling policy and institutional environments, production is negatively affected by environmental challenges such as high temperatures and heat stress, diseases and parasites, unreliable rainfall patterns, shortages of feeds and forages and undue preference for taurine cattle breeds regardless of their poor adaptability to prevailing local conditions. Fostering the resilience capacity of dairy animals is imperative to combat climate-related adversities and maintain productivity. This can only be achieved if reliable and practical methods for quantifying and analyzing resilience in SSA are described and undertaken. This study has reviewed variance of deviations, root mean square of deviations, autocorrelation of deviations, skewness of deviations, slope of the reaction norm and its absolute value as possible indicators of resilience in SSA. While previous research has reported genetic variation and favorable correlations of these indicators with health, fitness, and fertility traits, their potential in SSA environments requires further investigation. Besides, labor- and cost-effective phenotypic data collection is essential for characterization of resilience using these indicators. Through this study, we propose frequently collected data on milk production traits, body fat-related traits, and activity patterns as suitable in the sub-Saharan Africa context. The African Asian Dairy Genetic Gains Project by the International Livestock Research Institute (ILRI) offers a valuable opportunity to collate data from diverse dairy systems in SSA for testing the potential of these indicators. Insights from this study are helpful in improving resilience of dairy animals in SSA, which would contribute to poverty alleviation, animal welfare improvement, and better preparedness in lieu of climate change in SSA.</p