An Oligomeric Sulfated Hyaluronan and Silk-Elastinlike Polymer Combination Protects against Murine Radiation Induced Proctitis

Semisynthetic glycosaminoglycan ethers (SAGEs) are short, sulfated hyaluronans which combine the natural properties of hyaluronan with chemical sulfation. In a murine model, SAGEs provide protection against radiation induced proctitis (RIP), a side effect of lower abdominal radiotherapy for cancer. The anti-inflammatory effects of SAGE have been studied in inflammatory diseases at mucosal barrier sites; however, few mechanisms have been uncovered necessitating high throughput methods. SAGEs were combined with silk-elastinlike polymers (SELPs) to enhance rectal accumulation in mice. After high radiation exposure to the lower abdominal area, mice were followed for 3 days or until they met humane endpoints, before evaluation of behavioral pain responses and histological assessment of rectal inflammation. RNA sequencing was conducted on tissues from the 3-day cohort to determine molecular mechanisms of SAGE–SELP. After 3 days, mice receiving the SAGE–SELP combination yielded significantly lowered pain responses and amelioration of radiation-induced rectal inflammation. Mice receiving the drug–polymer combination survived 60% longer than other irradiated mice, with a fraction exhibiting long term survival. Sequencing reveals varied regulation of toll like receptors, antioxidant activities, T-cell signaling, and pathways associated with pain. This investigation elucidates several molecular mechanisms of SAGEs and exhibits promising measures for prevention of RIP.

Comparison of Selected Distraction Techniques to Alter Pain Responses among Children Receiving Immunization

Background: Immunization plays a vital role in global health for children. Children should have taken routine immunization universally for the prevention of diseases. While receiving immunization, most children are experiencing pain and show anxiety and sadness. In this study, the more effective distraction techniques between toys and music was compared which will also be necessary to apply to children in the forthcoming. Objectives: 1) To assess the alter pain response by toys as a distraction technique among children receiving immunization. 2) To assess the alter pain response by music as a distraction technique among children receiving immunization. 3) To compare the alter pain responses by toys and music as a distraction technique among children receiving immunization. 4) To associate the alter pain responses with selected demographic variables. Methods and Materials: An interventional research approach was used in this study with experimental research design. 60 samples were selected by Simple Random Sampling Technique. A structured demographic questionnaire and FLACC Pain Scale were used to collect the data. Follow-up period was not required as the response of the pain in both groups were immediately assessed during immunization. Data were analyzed using SPSS Software 22.0 and Chi square was used to find the association between the alter pain responses with demographic variables. Results: The finding shows that the mean score of music was 4.33 with SD of ±1.32 when compared to toys 3.70 with SD of ±1.36. The measured ‘t’ value i.e. 2.07 was less than the tabulated value at 5% level of significance. Therefore, toys were more effective when compared to music as a distraction technique (P<0.05) to alter pain responses among children receiving immunization. There were no association between the alter pain responses with demographic variables. Conclusion: As toys were found to be more effective to alter pain responses than music, a related study can be conducted to compare the alter pain responses between male and female children during immunization. This study recommends that a similar study can be replicated to compare and analyze the distraction techniques between male and female to alter pain responses among children.

Implementasi Convolutional Neural Network Untuk Deteksi Nyeri Bayi Melalui Citra Wajah Dengan YOLO

Pain in a baby is difficult to detect is because the method for detecting pain is self-reporting even though babies themselves still cannot describe the pain verbally, then by observing changes in behavior in the form of facial expressions. Statistically, it is also recorded that about 80% of the world's population pays less attention to pain assessment, especially for children, even though this pain gives children a bad experience so that it can interfere with pain responses in the future or psychological trauma. Based on these problems, a prototype system was made using the NVIDIA Jetson Nano Developer kit to help detect pain, especially in infants 0-12 months by using the Convolutional Neural Network (CNN) model with the PyTorch framework and the You Only Look Once (YOLO) algorithm with three detection classification is sad, neutral and sick. From the results of the study, it was found that the YOLO algorithm was able to detect the three classifications with a sad mAP value of 77.8%, neutral 76.7%, in pain 68.9%. With a precision value of 71.4%, recall 62.5% and f1-score 66.6%. The average value of Confidence is 53.57%.

Efficacy of EMLA™ cream for reducing pain associated with venepuncture in felines

PICO question In adult cats undergoing a venepuncture procedure, does the application of a topical lidocaine based anaesthetic to the skin at the venepuncture site reduce the severity of signs associated with pain when compared to no topical anaesthetic? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Four papers were critically reviewed. Three were prospective, double-blind, randomised, controlled clinical trials, and one was a prospective, double-blind, controlled experimental trial Strength of evidence Moderate Outcomes reported The application of Eutectic Mixture of Local Anaesthetics (EMLA™) cream to clipped skin over the procedure site, a minimum of 30 minutes prior to the venepuncture procedure, significantly reduced the severity of pain-associated behaviours during jugular phlebotomy in healthy, conscious feline patients when compared to a placebo1,2. In felines sedated with dexmedetomidine and either methadone or nalbuphine, the administration of EMLA™ cream to clipped skin for 20 minutes significantly decreased the severity of pain responses during intravenous (IV) cephalic vein catheterisation when compared to no treatment3. In clinically unwell feline patients, the use of EMLA™ cream on clipped skin at the site of jugular catheterisation 60 minutes prior demonstrated reduced pain responses compared to a placebo, but further investigation with a larger sample size is required to verify statistical significance4 Conclusion The available evidence moderately supports the hypothesis that EMLA™ cream is an effective and noninvasive treatment for providing enhanced pain-relief during jugular and cephalic vein phlebotomy for the purposes of blood collection and catheterisation, respectively. The areas for treatment should be clipped free of hair, and the cream applied for a minimum of 30 minutes in non-sedated cats and 20 minutes in cats sedated with dexmedetomidine and either methadone or nalbuphine. Moreover, when applied to normal, intact skin and covered by an occlusive bandage to avoid ingestion, it is well supported by supplementary evidence that EMLA™ cream has a wide safety margin for topical use in cats4,5 How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.