Re-examining the Mysterious Role of the Cerebellum in Pain

Pain is considered a multidimensional experience that embodies not merely sensation, but also emotion and perception. As is appropriate for this complexity, pain is represented and processed by an extensive matrix of cortical and subcortical structures. Of these structures, the cerebellum is gaining increasing attention. Although association between the cerebellum and both acute and chronic pain have been extensively detailed in electrophysiological and neuroimaging studies, a deep understanding of what functions are mediated by these associations is lacking. Nevertheless, the available evidence implies that lobules IV-VI and Crus I are especially pertinent to pain processing, and anatomical studies reveal that these regions connect with higher-order structures of sensorimotor, emotional, and cognitive function. Therefore, we speculate that the cerebellum exerts a modulatory role in pain via its communication with sites of sensorimotor, executive, reward, and limbic function. On this basis, in this review, we propose numerous ways in which the cerebellum might contribute to both acute and chronic pain, drawing particular attention to emotional and cognitive elements of pain. In addition, we emphasise the importance of advancing our knowledge about the relationship between the cerebellum and pain by discussing novel therapeutic opportunities that capitalize on this association.

Gene expression changes in the cerebellum are associated with persistent post-injury pain in adolescent rats exposed to early life stress

Chronic pain develops following injury in approximately 20% of adolescents, at twice the rate in females than males. Adverse childhood experiences also increase the risk for poor health outcomes, such as chronic pain. Emerging literature suggests the cerebellum to be involved in pain processing, however detailed explorations into how the cerebellum contributes to pain are lacking. Therefore, this study aimed to characterise chronic pain outcomes and cerebellar gene expression changes following early life stress and injury in both sexes. The adverse childhood experience of neglect was modelled using a maternal separation (MS) paradigm, which was combined with a subsequent injury (mild traumatic brain injury (mTBI) or plantar incision surgery) in adolescent male and female Sprague-Dawley rats. We measured behavioural nociceptive sensitivity, systemic modulators of pain such as calcitonin gene-related protein (CGRP) and Substance P, as well as gene expression of IL1β, GFAP, GR, MR, GABRA1, CNR1, MAOA, and DAT1 in the cerebellum to examine associations between pain and neuroinflammation, the stress response, inhibitory neurotransmission, and monoaminergic function. We found increases in mechanical nociceptive sensitivity following plantar incision surgery. Sex differences were observed in anxiety-like behaviour and neuroinflammation, whereas systemic pain modulators showed cumulative effects with the addition of stressors. Most interestingly however, the increases in nociceptive sensitivity were associated with the suppressed expression of cerebellar genes that regulate stress, inhibition, cannabinoid function, and dopaminergic function, alongside sex-dependent distinctions for genes involved in inflammation and injury. This study highlights a novel link between nociception and molecular function in the cerebellum. Further investigation into how the cerebellum contributes to pain in males and females will facilitate novel therapeutic insights and opportunities.

[Deepening the Action on Salt Reduction in China-suggestions on strategy and implementation plan]

Excessive sodium/salt intake is the leading dietary risk factor for the loss of healthy life in the Chinese population. The "Healthy China 2030" Action Plan set the goal of reducing salt intake by 20% by 2030. However, salt intake in China is still at a very high level in the world, with adults reaching 11 g/d, more than twice the recommended limit of 5 g/d. The current policies and action plans of China have targeted catering workers, children, adolescents, and home chefs in salt, oil, and sugar reduction actions. However, there are still obvious deficiencies in the coordinated promotion and implementation. This study, therefore, proposed a set of comprehensive strategies (named CHRPS that is composed of communication and education, salt reduction in home cooking, salt reduction in restaurants, reducing salt content in pre-packaged food, and surveillance and evaluation) and key implementation points for further deepening the salt reduction action in China. These strategies were developed based on the main sources of dietary sodium for Chinese residents, the status of"knowledge, attitude and practice"in salt reduction, evidence of effective intervention measures, existing policies and requirements, and the salt reduction strategies of the World Health Organization and experience from some other countries. As a scientific reference, the CHRPS strategies will help the government and relevant organizations quickly implement salt reduction work and facilitate the earlier realization of China's salt reduction goal.

Extended theory of planned behaviour for promoting construction waste recycling in Hong Kong

Changing individual's recycling attitude and behaviour is of utmost importance in achieving sustainable construction and demolition (C&D) waste management, yet it has often been underachieved. To understand the motivations for recycling, this study identifies and prioritizes the key factors that affect C&D waste recycling behaviour of various stakeholders in Hong Kong (i.e., representatives from construction-waste-related organizations, environmental consultants and contractors, and government engineers) in a quantitative manner using statistical tools. Different from traditional C&D waste behavioural determinants studies, this paper utilizes an integrated analytical method through semi-structured interviews and survey questionnaire on the basis of Theory of Planned Behaviour (TPB). Qualitative thematic analysis and quantitative frequency analysis were performed to analyse responses from semi-structured interviews and questionnaires, followed by correlation analysis to quantify the relationships between factors. Results indicated that four key factors: (i) regulatory compliance, (ii) economic incentives, (iii) accreditation scheme, and (iv) logistics and management incentives directly influenced recycling behaviour of individuals. Regulatory compliance was the most determining factor for consultants, contractors, experts, and government officials, whereas economic incentives were of great concern to the public. Under the factor of economic incentives, strong positive relationships were identified between disposal costs and collection and sorting costs, thus increasing waste disposal charging fee may promote recycling behaviour. In comparison, accreditation scheme deserved better recognition to facilitate a closed-loop material flow in the construction industry. These findings help to devise more effective and stakeholder-oriented policy tools to raise awareness and encourage behavioural change towards C&D waste recycling, and assist policy makers to establish regulations and practices for sustainable resource management.

[Experience of Sun's procedure for chronic type B dissection with aortic arch involvement]

Objective: To study the surgical treatment of chronic type B dissection with aortic arch involvement using Sun's procedure. Methods: Between February 2009 and December 2015, 29 patients [20 males, 9 females, with a mean age of (41±12) years, range 24-64 years] with type B dissection with aortic arch involvement underwent Sun's procedure. Sixteen patient had a history of hypertension. Marfan syndrome was observed in 9 cases, coronary artery disease in 3 cases, mitral regurgitation in 3 patients, cerebrovascular disease in one patient. Twenty-two patients suffered proximal aortic arch disease, 4 cases experienced history of aortic root procedure and 2 subjects had history of pregnancy. Four patients had aortic arch malformation. Results: One case suffered from massive cerebral infarction after surgery and died in another hospital. Concomitant procedures included mitral valve replacement in 3 cases, coronary artery bypass grafting in 3 patients, reconstruction of the right aberrant subclavian artery in one patient. Ventilator support exceeding 24 hours obseved in 2 patients. One of them recieved continuous renal replacement therapy and recovered before discharge. Spinal cord injury was obseved in one case, brain infarction in one patient and pericardial drainage in one case. Two patients required tracheotomy. During 12-94 (43±23) months' follow-up, thoracoabdominal aortic replacment was performed in 4 patients, thoracic endovascular aortic repair (TEVAR) in 2 subjects and repair of perivalvular leakage in one patient. Conclusions: Sun's procedure obtained satisfactory results in patients with chronic type B dissection with aortic arch involvement. Concomitant repair of proximal aortic arch lesions and distal type B dissection can be adopted using Sun's procedure.

Quantum efficiency enhancement in selectively transparent silicon thin film solar cells by distributed Bragg reflectors

This work demonstrated a-Si:H thin-film solar cells with backside TiO(2) / SiO(2) distributed Bragg reflectors (DBRs) for applications involving building-integrated photovoltaics (BIPVs). Selectively transparent solar cells are formed by adjusting the positions of the DBR stop bands to allow the transmission of certain parts of light through the solar cells. Measurement and simulation results indicate that the transmission of blue light (430 ~500 nm) with the combination of three DBR mirrors has the highest increase in conversion efficiency.

Contrast and efficiency enhancement in organic light-emitting devices utilizing high absorption and high charge mobility organic layers

Organic light-emitting devices utilizing copper phthalocyanine (CuPc) and C(60) as the hole- and electron-injection layers were reported. Compared with a conventional device without CuPc and C(60) layers, the improvement of the contrast is more than 100% under 140-lx ambient lighting at a brightness of 300 cd/m(2). A maximum current efficiency of 3.93 cd/A, which is higher than 3.62 cd/A for a conventional device, was obtained at 9 V. The device has a maximum luminance of 17170 cd/m(2) at 15 V. The high contrast and high efficiency of the device are attributed to the high absorption and high charge mobility of CuPc and C(60) films.