Hormonal and Clinical Predictors for Post-egg Retrieval Pain in Women Undergoing Assisted Reproductive Technology Procedures

OBJECTIVES The intensity of post-egg retrieval pain is underestimated, with few studies examining post-procedural pain and predictors to identify women at risk for severe pain. We evaluated the influence of pre-procedural hormonal levels, ovarian factors, as well as mechanical temporal summation (mTS) as predictors for post-egg retrieval pain in women undergoing in vitro fertilization (IVF). METHODS Eighteen women scheduled for ultrasound-guided egg retrieval under standardized anesthesia and post-procedural analgesia were enrolled. Pre-procedural mTS, questionnaires, clinical data related to anesthesia and the procedure itself, post-procedural pain scores and pain medication for breakthrough pain were recorded. Statistical analysis included Pearson product moment correlations, Mann-Whitney U tests and multiple linear regressions. RESULTS Average peak post-egg retrieval pain during the first 24 hours was 5.0±1.6 on an NRS scale (0=no pain, 10=worst pain imaginable). Peak post-egg retrieval pain was correlated with basal antimullerian hormone (AMH) (r=0.549, P=0.018), pre-procedural peak estradiol (r=0.582, P=0.011), total number of follicles (r=0.517, P=0.028) and number of retrieved eggs (r=0.510, P=0.031). Ovarian hyperstimulation syndrome (OHSS) (n=4) was associated with higher basal AMH (P=0.004), higher peak pain scores (P=0.049), but not with peak estradiol (P=0.13). The mTS did not correlate with peak post-procedural pain (r=0.266, P=0.286), or peak estradiol level (r=0.090, P=0.899). DISCUSSION Peak post-egg retrieval pain intensity was higher than anticipated. Our results suggest that post-egg retrieval pain can be predicted by baseline AMH, high peak estradiol, and OHSS. Further studies to evaluate intra- and post-procedural pain in this population are needed, as well as clinical trials to assess post-procedural analgesia in women presenting with high hormonal levels.

Is Parkinson's disease of early onset a separate disease entity?

Two groups of patients suffering from Parkinson's disease were studied. The first group consisted of 23 patients with an onset age before 40 years; in the second group of 21 patients the onset was after age 50. The clinical findings and the course of the disease were very similar in each group. In spite of a longer disease duration in the patients with early onset of the disease there was no difference in motor impairment; the younger patients did better in mental testing and they were taking less dopaminergic medication. These differences are thought to be due to the age difference rather than to the existence of different disease entities. In the early onset group more familial cases (mostly affecting siblings) were found than in the older ones. The points in favour of there being a hereditary subgroup of early onset Parkinson's disease or of environmental factors causing the disease are reviewed.

Information-Centric Content Retrieval for Delay-Tolerant Networks

The shift from host-centric to information-centric networking (ICN) promises seamless communication in mobile networks. However, most existing works either consider well-connected networks with high node density or introduce modifications to {ICN} message processing for delay-tolerant Networking (DTN). In this work, we present agent-based content retrieval, which provides information-centric {DTN} support as an application module without modifications to {ICN} message processing. This enables flexible interoperability in changing environments. If no content source can be found via wireless multi-hop routing, requesters may exploit the mobility of neighbor nodes (called agents) by delegating content retrieval to them. Agents that receive a delegation and move closer to content sources can retrieve data and return it back to requesters. We show that agent-based content retrieval may be even more efficient in scenarios where multi-hop communication is possible. Furthermore, we show that broadcast communication may not be necessarily the best option since dynamic unicast requests have little overhead and can better exploit short contact times between nodes (no broadcast delays required for duplicate suppression).

Mapping spectroscopic uncertainties into prospective methane retrieval errors from Sentinel-5 and its precursor

Sentinel-5 (S5) and its precursor (S5P) are future European satellite missions aiming at global monitoring of methane (CH4) column-average dry air mole fractions (XCH4). The spectrometers to be deployed onboard the satellites record spectra of sunlight backscattered from the Earth's surface and atmosphere. In particular, they exploit CH4 absorption in the shortwave infrared spectral range around 1.65 mu m (S5 only) and 2.35 mu m (both S5 and S5P) wavelength. Given an accuracy goal of better than 2% for XCH4 to be delivered on regional scales, assessment and reduction of potential sources of systematic error such as spectroscopic uncertainties is crucial. Here, we investigate how spectroscopic errors propagate into retrieval errors on the global scale. To this end, absorption spectra of a ground-based Fourier transform spectrometer (FTS) operating at very high spectral resolution serve as estimate for the quality of the spectroscopic parameters. Feeding the FTS fitting residuals as a perturbation into a global ensemble of simulated S5- and S5P-like spectra at relatively low spectral resolution, XCH4 retrieval errors exceed 0.6% in large parts of the world and show systematic correlations on regional scales, calling for improved spectroscopic parameters.