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Sexual dimorphism in neurological function after SCI is associated with disrupted neuroinflammation in both injured spinal cord and brain.

Whereas human spinal cord injury (SCI) is more common in men, the prevalence is growing in women. However, little is known about the effect of biological sex on brain dysfunction and injury mechanisms. To model the highest per capita rate of injury (ages between 16 and 30 years old) in humans, in the present study, young adult or a young/middle-aged male and female C57BL/6 mice were subjected to moderate contusion SCI. When mice were injured at 10-12-week-old, transcriptomic analysis of inflammation-related genes and flow cytometry revealed a more aggressive neuroinflammatory profile in male than females following 3 d SCI, ostensibly driven by sex-specific changes myeloid cell function rather than cell number. Female mice were generally more active at baseline, as evidenced by greater distance traveled in the open field. After SCI, female mice had more favorable locomotor function than male animals. At 13 weeks post-injury, male mice showed poor performance in cognitive and depressive-like behavioral tests, while injured female mice showed fewer deficits in these tasks. However, when injured at 6 months old followed by 8 months post-injury, male mice had considerably less inflammatory activation compared with female animals despite having similar or worse outcomes in affective, cognitive, and motor tasks. Collectively, these findings indicate that sex differences in functional outcome after SCI are associated with the age at onset of injury, as well as disrupted neuroinflammation not only at the site of injury but also in remote brain regions. Thus, biological sex should be considered when designing new therapeutic agents.

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Final efficacy analysis, interim safety analysis, and immunogenicity of a single dose of recombinant novel coronavirus vaccine (adenovirus type 5 vector) in adults 18 years and older: an international, multicentre, randomised, double-blinded, placebo-cont

The Ad5-nCoV vaccine is a single-dose adenovirus type 5 (Ad5) vectored vaccine expressing the SARS-CoV-2 spike protein that was well-tolerated and immunogenic in phase 1 and 2 studies. In this study, we report results on the final efficacy and interim safety analyses of the phase 3 trial.

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[From gut feeling to visceral pain : Effects of negative expectations in the context of the gut-brain axis].

Disturbances of the gut-brain axis are characterized by complex dysfunctions on peripheral and central nervous system levels, which can contribute to visceral hypervigilance and hyperalgesia and imprint visceral pain. Numerous cognitive, emotional and psychoneurobiological factors are involved in visceral pain modulation, which in the psychosocial treatment concept can have a positive as well as a negative impact on the experience of visceral pain. Nocebo effects induced by negative expectations are of high clinical relevance in acute and especially in chronic visceral pain but the underlying mechanisms remain insufficiently understood. Verbal instructions, previous experiences and learning processes as well as emotional factors, such as fear and stress contribute to the development and maintenance of negative expectation effects. Targeted communication strategies, a sensitive use of information in the clarification and positive environmental context conditions can contribute to establishing an adequate expectation management and minimize negative expectation effects in the clinical practice. At the same time, translational research approaches are required to gain further insights into the mediators and moderators of negative expectation effects and to transfer these into clinical practice. In this way the treatment of patients with disorders of the gut-brain communication can be improved.

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Association between autism spectrum disorder and inflammatory bowel disease: A systematic review and meta-analysis.

Children with autism spectrum disorder (ASD) are frequently diagnosed with co-occurring medical conditions including inflammatory bowel disease (IBD). To investigate the association, we conducted a systematic review registered in PROSPERO (ID:CRD42021236263) with a random-effects meta-analysis. We searched PubMed, Embase, and PsycInfo (last search on January 25, 2021), and manually searched relevant publications. We included observational studies measuring the association between ASD and IBD. The primary outcome was the association (odds ratio, OR) between ASD and later development of IBD. Sensitivity analyses were conducted by quality, confounding adjustment, and study design. We performed meta-regression analyses and assessed heterogeneity, publication bias, and quality of studies with the Newcastle-Ottawa Scale. Overall, we included six studies consisting of eight datasets, including over 11 million participants. We found that ASD was significantly associated with subsequent incident IBD (any IBD, OR = 1.66, 95% confidence interval[CI] = 1.25-2.21, p < 0.001; ulcerative colitis, OR = 1.91, 95%CI = 1.41-2.6, p < 0.001; Crohn's disease, OR = 1.47, 95%CI = 1.15-1.88, p = 0.002). ASD and IBD were also associated regardless of temporal sequence of diagnosis (any IBD, OR = 1.57, 95%CI = 1.28-1.93, p < 0.001; ulcerative colitis, OR = 1.7, 95%CI = 1.36-2.12, p < 0.001; Crohn's disease, OR = 1.37, 95%CI = 1.12-1.69, p = 0.003). Sensitivity analyses confirmed the findings of the main analysis. Meta-regression did not identify any significant moderators. Publication bias was not detected. Quality was high in four datasets and medium in four. In conclusion, our findings highlight the need to screen for IBD in individuals with ASD, and future research should identify who, among those with ASD, has the highest risk of IBD, and elucidate the shared biological mechanisms between ASD and IBD.

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The effect of chronic pain on voluntary and involuntary capture of attention: An event-related potential study.

Although the interrupting effect of chronic pain on voluntary-directed attention is well-documented, research on the impact of chronic pain on involuntary-directed attention remains incomplete. This study aimed to investigate the influence of chronic pain on involuntary as well as voluntary allocation of attention as, respectively, indexed by the P3a and P3b components in the event-related potential derived from the electroencephalogram. Both involuntary and voluntary captures of attention were compared between 33 patients with chronic pain and 33 healthy controls using an auditory three-stimulus oddball task (with standard, target, and unexpected distractor tones). The results revealed a reduced P3a amplitude as well as a reduced P3b amplitude in patients with chronic pain compared to healthy controls, indicating a detrimental effect of chronic pain on involuntary and voluntary attention, respectively. This study extends the picture of the impairing effects of chronic pain on attentional allocation to a current task and attentional allocation to information outside the focus of attention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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Optimizing interdisciplinary virtual pain care and buprenorphine initiation during COVID-19: a quality improvement study.

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Are Changes in Sleep Quality/Quantity or Baseline Sleep Parameters Related to Changes in Clinical Outcomes in Patients with Non-specific Chronic Low Back Pain? A Systematic Review.

Sleep disturbance is prevalent among patients with chronic low back pain (CLBP). This systematic review aimed to summarize the evidence regarding the: (1) temporal relations between changes in sleep quality/quantity and the corresponding changes in pain and/or disability; and (2) role of baseline sleep quality/quantity in predicting future pain and/or disability in patients with CLBP.

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Are Reports of Pain, Disability, Quality of Life, Psychological Factors and Central Sensitization Related to Outcomes of Quantitative Sensory Testing in Patients Suffering from Chronic Whiplash Associated Disorders?

Chronic Whiplash Associated Disorders (CWAD) are characterized by long-lasting symptoms of neck pain occurring after an acceleration-deceleration injury. Central sensitization (CS) has been suggested as the possible underlying mechanism for these symptoms, and is characterized by changes in the central nervous system. Besides CS, psychological factors are believed to play an important role in the experience of (chronic) pain.

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Pain And Suicide: What Should We Tell Our Trainees?

This paper will emphasize the necessity to improve education about pain, its close relationship with suicide, and effective suicide screening as well as management strategies for medical providers.

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UK Medical Cannabis Registry: an analysis of clinical outcomes of medicinal cannabis therapy for chronic pain conditions.

To explore pain-specific, general health-related quality of life (HRQoL), and safety outcomes of chronic pain patients prescribed cannabis-based medicinal products (CBMPs).

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