Dawn of a New Era for JEMS: It's About 'Time'

Today, our industry is heavily data and technology driven, with CAD systems and EPCRs almost universally used. Emergency care practices are more dynamic than ever, with critical advances in patient care occurring more frequently than a monthly print publication can possibly allow. Because technology and the Web have advanced to a point that it is both instantaneous and reliable, we feel that we can better serve the EMS community by focusing our efforts on delivering JEMS content via our website www.JEMS.com and other digital platforms to allow for a more timely – and frequent – publication. So we’ve decided to advance with the times and discontinue printing JEMS in its traditional monthly magazine format, effective with our June 2018 issue, and use our web platform and mobile technology to get information to you sooner with our new digital approach. When I started at JEMS 23 years ago (in 1995), the Internet was in its infancy, having been introduced in 1991. It was a new phenomenon. It was clunky in its infancy and many thought it was just for national security purposes. Boy were they wrong. Back in 1995, JEMS received almost all of its articles and queries via the mail. We used to have to laboriously transfer written articles and documents to text to place in the magazine. Even though we had a Web page in the mid-1990s, it was not easy to upload documents and videos. JEMS and all of our newsletters were only available in print and it took weeks for interna...
Source: JEMS: Journal of Emergency Medical Services News - Category: Emergency Medicine Authors: Tags: News Administration and Leadership Source Type: news

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Recent neuroimaging studies implicate the medial temporal lobe (MTL) in nociception and pain modulation. Here, we aim to identify which subregions of the MTL are involved in human pain and to test its connectivity in a cohort of chronic low-back pain patients (CBP). We conducted 2 coordinate-based meta-analyses to determine which regions within the MTL showed consistent spatial patterns of functional activation (1) in response to experimental pain in healthy participants and (2) in chronic pain compared with healthy participants. We followed PRISMA guidelines and performed activation likelihood estimate (ALE) meta-analyses...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Accumulating evidence has shown that complicated brain systems are involved in the development and maintenance of chronic low back pain (cLBP), but the association between brain functional changes and clinical outcomes remains unclear. Here, we used resting-state functional magnetic resonance imaging (fMRI) and multivariate pattern analysis to identify abnormal functional connectivity (FC) between the default mode, sensorimotor, salience, and central executive brain networks in cLBP and tested whether abnormal FCs are related to pain and comorbid symptoms. Fifty cLBP patients and 44 matched healthy controls (HCs) underwent...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Trigeminal spinal subnucleus caudalis (Vc) neurons that project to the ventral posteromedial thalamic nucleus (VPM) and parabrachial nucleus (PBN) are critical for orofacial pain processing. We hypothesized that persistent trigeminal nerve injury differentially alters the proportion of Vc neurons that project to VPM and PBN in a modality-specific manner. Neuroanatomical approaches were used to quantify the number of Vc neurons projecting to VPM or PBN after chronic constriction injury of the infraorbital nerve (ION-CCI) and subsequent upper-lip stimulation. Male rats received injections of retrograde tracer fluorogold into...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Back pain (BP) is a common condition of major social importance and poorly understood pathogenesis. Combining data from the UK Biobank and CHARGE consortium cohorts allowed us to perform a very large genome-wide association study (total N = 509,070) and examine the genetic correlation and pleiotropy between BP and its clinical and psychosocial risk factors. We identified and replicated 3 BP-associated loci, including one novel region implicating SPOCK2/CHST3 genes. We provide evidence for pleiotropic effects of genetic factors underlying BP, height, and intervertebral disk problems. We also identified independent genetic c...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
NKTR-181, a new molecular entity, mu-opioid receptor agonist with an inherently slow rate of central nervous system (CNS) entry, was designed to provide analgesia while reducing abuse potential. This phase 3, enriched-enrollment, randomized-withdrawal trial evaluated the analgesic efficacy, safety, and tolerability of NKTR-181 in patients with chronic low-back pain (CLBP). Adults with moderate-to-severe CLBP refractory to nonopioid analgesics achieving an analgesic NKTR-181 dosage (100-400 mg twice daily) during the open-label titration period were randomized to continued NKTR-181 treatment, double-blind, or switched to pl...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
This study investigated the effects of nociceptin/orphanin FQ (N/OFQ) receptor (NOPr) ligands and the modulation of the NOP system in the preclinical mouse model of reserpine-induced fibromyalgia. The effects of administration of the natural agonist N/OFQ and the selective NOPr antagonists (UFP-101 and SB-612111) were evaluated in fibromyalgia-related symptoms in reserpine-treated mice. The expression of prepronociceptin/orphanin FQ and NOPr was assessed in central and peripheral sites at different time points after reserpine administration. Nociceptin/orphanin FQ displayed dual effects in the behavioral changes in the res...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Despite optimal medical management (OMM), low back pain (LBP) can be disabling, particularly after spinal surgery. Spinal cord stimulation (SCS) is effective in reducing neuropathic leg pain; however, evidence is limited for LBP. This prospective, open-label, parallel-group trial randomized (1:1) failed back surgery syndrome (FBSS) patients with predominant LBP to SCS plus OMM (SCS group) or OMM alone (OMM group) at 28 sites in Europe and the Americas. If trial stimulation was successful, a multicolumn SCS system was implanted. Outcomes were assessed at baseline (before randomization) and at 1, 3, 6, and 12 months after ra...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Diabetic neuropathy is an incapacitating complication in diabetic patients. The cellular and molecular mechanisms involved in this pathology are poorly understood. Previous studies have suggested that the loss of spinal GABAergic inhibition participate in painful diabetic neuropathy. However, the role of extrasynaptic α5 subunit-containing GABAA (α5GABAA) receptors in this process is not known. The purpose of this study was to investigate the role of α5GABAA receptors in diabetes-induced tactile allodynia, loss of rate-dependent depression (RDD) of the Hoffmann reflex (HR), and modulation of primary affer...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Nociception reliably elicits an autonomic nervous system (ANS) response. Because pain and ANS circuitry interact on multiple spinal, subcortical, and cortical levels, it remains unclear whether autonomic responses are simply a reflexive product of noxious stimulation regardless of how stimulation is consciously perceived or whether the experience of pain mediates ANS responses to noxious stimulation. To test these alternative predictions, we examined the relative contribution of noxious stimulation and individual pain experience to ANS responses in healthy volunteers who underwent 1 or 2 pain assessment tasks. Participants...
Source: Pain - Category: Anesthesiology Tags: Corrected and Republished Article Source Type: research
ConclusionsWe demonstrate that of the myelin specific promoters evaluated, P0 is optimal for driving expression of transgenes in schwannoma cells.
Source: Journal of Neuroscience Methods - Category: Neuroscience Source Type: research
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