Analgesic purchases among older adults - a population-based study

Background: Pain is a frequent and inevitable factor affecting the quality of life among older people. Several studies have highlighted the ineffectiveness of treating chronic pain among the aged population, and little is known about the prevalence of analgesics administration among community-dwelling older adults. The objective was to examine older adults' prescription analgesic purchases in relation to SF-36 pain in a population-based setting. Methods: One thousand four hundred twenty community-dwelling citizens aged 62-86 years self-reported SF-36 bodily pain (pain intensity and pain-related interference) scores for the previous 4 weeks. The Social Insurance Institution of Finland register data on analgesic purchases for 6 months prior to and 6 months after the questionnaire data collection were considered. Special interest was focused on factors related to opioid purchases. Results: Of all participants, 84% had purchased prescription analgesics during 1 year. NSAIDs were most frequently purchased (77%), while 41% had purchased paracetamol, 32% opioids, 17% gabapentinoids, and 7% tricyclic antidepressants. Age made no marked difference in purchasing prevalence. The number of morbidities was independently associated with analgesic purchases in all subjects and metabolic syndrome also with opioid purchases in subjects who had not reported any pain. Discussion: Substantial NSAID and opioid purchases emerged. The importance of proper pain assessment and individual deliberation in terms of analgesic contraindications and pain quality, as well as non-pharmacological pain management, need to be highlighted in order to optimize older adults' pain management.Peer reviewe

Adalimumab and sulfasalazine in alleviating sacroiliac and aortic inflammation detected in PET/CT in patients with axial spondyloarthritis : PETSPA

Publisher Copyright: © 2021 The Authors. Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.Aim: Inflammatory signals in the sacroiliac (SI) joints and the aorta of patients with axial spondyloarthritis (axSpA) were graded by positron emission tomography/computed tomography (PET/CT) imaging before and after treatment with sulfasalazine (SSZ) or adalimumab (ADA). Methods: Patients with axSpA, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 4, were recruited. Disease-modifying antirheumatic drug-naïve patients started SSZ for 12 weeks, whereas those with prestudy treatment with or contraindication to SSZ commenced ADA for 16 weeks. In addition, those patients in the SSZ group with insufficient response commenced ADA for 16 weeks. 18F-fluorodeoxyglucose PET/CT was performed after inclusion and after treatment with SSZ and ADA. Maximum standardized uptake value (SUVmax) was assessed for the aorta and the SI joints, and maximal target-to-blood-pool ratio (TBRmax) only for the aorta. Results: Among five SSZ patients, mean ± SD BASDAI was 4.7 ± 1.6 before and 3.5 ± 1.4 after treatment (p =.101). In 13 ADA patients, the BASDAI decreased from 5.4 ± 1.6 to 2.8 ± 2.2 (p <.001). Among the SSZ patients, SUVmax in SI joints decreased from 2.35 ± 0.55 to 1.51 ± 0.22 (−35.8%, p =.029). Aortic TBRmax decreased from 1.59 ± 0.43 to 1.26 ± 0.26 (−33.2%, p =.087). In the ADA patients, SUVmax in the SI joints was 1.92 ± 0.65 before and 1.88 ± 0.54 after treatment (−1.8%, p =.808) and TBRmax in the aorta 1.50 ± 0.60 before and 1.40 ± 0.26 after treatment (−6.7%, p =.485). Conclusions: Our small open-label study showed that SSZ may reduce PET-CT-detectable inflammation in the SI joints, with a trend towards a reduction in the aorta.Peer reviewe

Order structure, multipliers, and Gelfand representation of vector-valued function algebras

Abstract We continue the study begun by the third author of $C^*$-Segal algebra valued function algebras, with an emphasis on the order structure. Our main result is a characterization theorem for $C^*$-Segal algebra valued function algebras with an order unitization. As an intermediate step, we establish a function algebraic description of the multiplier module of arbitrary Segal algebra valued function algebras. We also consider Gelfand representation of these algebras in the commutative case

Inter-subject correlation of brain hemodynamic responses during watching a movie: localization in space and frequency

Cinema is a promising naturalistic stimulus that enables, for instance, elicitation of robust emotions during functional magnetic resonance imaging (fMRI). Inter-subject correlation (ISC) has been used as a model-free analysis method to map the highly complex hemodynamic responses that are evoked during watching a movie. Here, we extended the ISC analysis to frequency domain using wavelet analysis combined with non-parametric permutation methods for making voxel-wise statistical inferences about frequency-band specific ISC. We applied these novel analysis methods to a dataset collected in our previous study where 12 subjects watched an emotionally engaging movie “Crash” during fMRI scanning. Our results suggest that several regions within the frontal and temporal lobes show ISC predominantly at low frequency bands, whereas visual cortical areas exhibit ISC also at higher frequencies. It is possible that these findings relate to recent observations of a cortical hierarchy of temporal receptive windows, or thatthe types of events processed in temporal and prefrontal cortical areas (e.g., social interactions) occur over longer time periods than the stimulus features processed in the visual areas. Software tools to perform frequency-specific ISC analysis, together with a visualization application, are available as open source Matlab code. IntroductionPeer reviewe

A hierarchical cluster analysis to determine whether injured runners exhibit similar kinematic gait patterns

Previous studies have suggested that runners can be subgrouped based on homogeneous gait patterns, however, no previous study has assessed the presence of such subgroups in a population of individuals across a wide variety of injuries. Therefore, the purpose of this study was to assess whether distinct subgroups with homogeneous running patterns can be identified among a large group of injured and healthy runners and whether identified subgroups are associated with specific injury location. Three‐dimensional kinematic data from 291 injured and healthy runners, representing both sexes and a wide range of ages (10‐66 years) was clustered using hierarchical cluster analysis. Cluster analysis revealed five distinct subgroups from the data. Kinematic differences between the subgroups were compared using one‐way analysis of variance (ANOVA). Against our hypothesis, runners with the same injury types did not cluster together, but the distribution of different injuries within subgroups was similar across the entire sample. These results suggest that homogeneous gait patterns exist independent of injury location and that it is important to consider these underlying patterns when planning injury prevention or rehabilitation strategies.peerReviewe

Imaging connected porosity of crystalline rock by contrast agent-aided X-ray microtomography and scanning electron microscopy

We set out to study connected porosity of crystalline rock using X‐ray microtomography and scanning electron microscopy with energy dispersive X‐ray spectroscopy (SEM‐EDS) with caesium chloride as a contrast agent. Caesium is an important radionuclide regarding the final deposition of nuclear waste and also forms dense phases that can be readily distinguished by X‐ray microtomography and SEM‐EDS. Six samples from two sites, Olkiluoto (Finland) and Grimsel (Switzerland), where transport properties of crystalline rock are being studied in situ, were investigated using X‐ray microtomography and SEM‐EDS. The samples were imaged with X‐ray microtomography, immersed in a saturated caesium chloride (CsCl) solution for 141, 249 and 365 days and imaged again with X‐ray microtomography. CsCl inside the samples was successfully detected with X‐ray microtomography and it had completely penetrated all six samples. SEM‐EDS elemental mapping was used to study the location of caesium in the samples in detail with quantitative mineral information. Precipitated CsCl was found in the connected pore space in Olkiluoto veined gneiss and in lesser amounts in Grimsel granodiorite. Only a very small amount of precipitated CsCl was observed in the Grimsel granodiorite samples. In Olkiluoto veined gneiss caesium was found in pinitised areas of cordierite grains. In the pinitised areas caesium was found in notable excess compared to chloride, possibly due to the combination of small pore size and negatively charged surfaces. In addition, elevated concentrations of caesium were found in kaolinite and sphalerite phases. The findings concerning the location of CsCl were congruent with X‐ray microtomography.peerReviewe

Rethinking innovation and the role of stakeholder engagement in sport and exercise medicine

In sport and exercise medicine, increasing pressure to improve athlete health outcomes and performance with limited resources has prompted an emphasis on innovation. A key component to innovation is stakeholder participation and engagement, that is, the involvement of those affected by the outcomes, such as end users and actors (the person(s) performing the required actions/behaviour change), of the research process. Several research frameworks in sport and exercise medicine highly recommend stakeholder engagement as part of the research process. There are, however, different levels to how engaged a stakeholder can be in a research project, and this level of engagement may be dependent on the researchers’ goals. Stakeholder engagement can be organised on a continuum based on the stakeholder’s relationship to the research and how involved they are in the project’s decision-making process. This continuum can be used as a rating scale to evaluate and monitor the degree of perceived stakeholder participation in a research project. There are different paths to innovation in research, which are interlinked, and ideas and knowledge flow between them. Considering the continuum of stakeholder engagement and paths to innovation, this article highlights how different research types require different degrees of stakeholder engagement

Precision exercise medicine : predicting unfavourable status and development in the 20-m shuttle run test performance in adolescence with machine learning

Objectives: To assess the ability to predict individual unfavourable future status and development in the 20m shuttle run test (20MSRT) during adolescence with machine learning (random forest (RF) classifier). Methods: Data from a 2-year observational study (2013‒2015, 12.4±1.3 years, n=633, 50% girls), with 48 baseline characteristics (questionnaires (demographics, physical, psychological, social and lifestyle factors), objective measurements (anthropometrics, fitness characteristics, physical activity, body composition and academic scores)) were used to predict: (Task 1) unfavourable future 20MSRT status (identification of individuals in the lowest 20MSRT tertile after 2 years), and (Task 2) unfavourable 20MSRT development (identification of individuals with 20MSRT development in the lowest tertile among adolescents with baseline 20MSRT below median level). Results: Prediction performance for future 20MSRT status (Task 1) was (area under the receiver operating characteristic curve, AUC) 83% and 76%, sensitivity 80% and 60%, and specificity 78% and 79% in girls and boys, respectively. Twenty variables showed predictive power in boys, 14 in girls, including fitness characteristics, physical activity, academic scores, adiposity, life enjoyment, parental support, social status in school and perceived fitness. Prediction performance for future development (Task 2) was lower and differed statistically from random level only in girls (AUC 68% and 40% in girls and boys). Conclusion: RF classifier predicted future unfavourable status in 20MSRT and identified potential individuals for interventions based on a holistic profile (14‒20 baseline characteristics). The MATLAB script and functions employing the RF classifier of this study are available for future precision exercise medicine research.peerReviewe

Novel stress corrosion testing method for high‐strength steels

Abstract This paper presents a novel TFT (tuning fork test) stress corrosion testing method, which was developed for classifying martensitic high‐strength steels. The novel method was developed by applying finite element calculations to optimize a tuning fork geometry to enable accurate stress adjustment with simple inexpensive equipment. Different steels were exposed to cathodic hydrogen charging conditions with various elastic tensile stress levels that were achieved by displacement control. All steels exhibited hydrogen‐induced stress corrosion cracking after exceeding a material‐specific threshold stress level that decreased linearly with increasing hardness