Background Opioid abuse in chronic pain patients is a major public health issue, with rapidly increasing addiction rates and deaths from unintentional overdose more than quadrupling since 1999. Purpose This study seeks to determine the predictability of aberrant behavior to opioids using a comprehensive scoring algorithm incorporating phenotypic risk factors and neuroscience-associated single-nucleotide polymorphisms (SNPs). Patients and methods The Proove Opioid Risk (POR) algorithm determines the predictability of aberrant behavior to opioids using a comprehensive scoring algorithm incorporating phenotypic risk factors and neuroscience-associated SNPs. In a validation study with 258 subjects with diagnosed opioid use disorder (OUD) and 650 controls who reported using opioids, the POR successfully categorized patients at high and moderate risks of opioid misuse or abuse with 95.7% sensitivity. Regardless of changes in the prevalence of opioid misuse or abuse, the sensitivity of POR remained >95%. Conclusion The POR correctly stratifies patients into low-, moderate-, and high-risk categories to appropriately identify patients at need for additional guidance, monitoring, or treatment changes.

Background Fibromyalgia (FM) is a complex, centralized pain condition that is often difficult to diagnose and treat. FM is considered to have a genetic background due to its familial aggregation and due to findings from multiple candidate-gene studies implicating catecholaminergic and serotonergic neurotransmitter systems in chronic pain. However, a multi-factorial analysis of both genetic and environmental risk factors is lacking. A better characterization of the interplay of risk factors may assist in understanding the pathophysiology of FM, its clinical course, and assist in early diagnosis and treatment of the disorder. Methods This retrospective study included 60,367 total participants from 237 clinics across the USA. Of those, 2713 had been diagnosed with fibromyalgia, as indicated by ICD code. Logistic regression was used to test for associations of diagnosed FM in study subjects with COMT SNPs and COMT haplotypes, which were previously found to be linked with pain sensitivity, as well as demographics such as age, sex, and ethnicity. The minor allele frequencies of COMT SNPs in the FM population were compared with 1000 Genomes data using a χ2 test to determine significant deviations from the estimated population allelic frequencies. Results FM diagnosis was strongly associated with sex, age, and ethnicity. Females, those between 49 and 63 years, and non-Caucasians were at higher risk of FM. Females had 1.72 increased odds of FM ( p = 1.17 × 10 − 30 ). African-Americans were 1.52 times more likely to have a diagnosis of FM compared to Caucasians ( p = 3.11 × 10 − 12 ). Hispanics were less likely to have a diagnosis of FM compared to Caucasians ( p = 3.95 × 10 − 7 ). After adjusting for sex and ethnicity, those in the low age group and mid age group had 1.29 (p = 1.02 × 10 − 5 ) and 1.60 ( p = 1.93 × 10 − 18 ) increased odds of FM, respectively, compared to the high age group, where age was categorized by tertile (low (< 49), mid (49–63), and high (> 63)). The COMT haplotypes associated with pain sensitivity were not associated with FM, but African-Americans were 11.3 times more likely to have a high pain sensitivity COMT diplotype, regardless of FM diagnosis. However, the minor alleles of COMT SNPs rs4680 , rs4818 , rs4633 and rs6269 were overrepresented in the FM population overall, and varied when compared with ethnically-similar populations from 1000 Genomes. Conclusions ...

Background and Aim: In COVID-19 pandemic, a global emergency, there is a scarcity of resources including workforce in health-care system. Budding nurses as additional workforce are being utilized in COVID-19 units, where their knowledge and perception about COVID-19 plays a key role in patient care as well as for their safety. There is a paucity of regional data on knowledge and perception of budding nurses about COVID-19. The present study was conducted with an aim to assess the knowledge and perception of budding nurses about COVID-19. Materials and Methods: In this online survey, 380 budding nurses participated. A 26-item semi-structured (9) knowledge and (10) perception-based questionnaire was responded by participants. Descriptive and inferential statistics were used to analyze the findings. Results: A significant number of participants were passably aware of the basic element of COVID-19, that is, etiological factor, incubation period, clinical symptoms, transmission, prevention, and treatments and majority (52.89%) budding nurses have shown positive perception toward COVID-19. Conclusion: The findings of this study revealed that knowledge and perception of budding nurses were significantly adequate and positive about COVID-19; however, in some areas, there was a substantial gap in knowledge; hence, periodic educational sessions regarding COVID-19 to budding nurses will help in curtailing the gap and they can be utilized as a better resource in a time of pandemic to overcome the shortage of manpower.

Background:Opioid abuse in chronic pain patients is a major public health issue. Primary care providers are frequently the first to prescribe opioids to patients suffering from pain, yet do not always have the time or resources to adequately evaluate the risk of opioid use disorder (OUD).Purpose:This study seeks to determine the predictability of aberrant behavior to opioids using a comprehensive scoring algorithm (“profile”) incorporating phenotypic and, more uniquely, genotypic risk factors.Methods and Results:In a validation study with 452 participants diagnosed with OUD and 1237 controls, the algorithm successfully categorized patients at high and moderate risk of OUD with 91.8% sensitivity. Regardless of changes in the prevalence of OUD, sensitivity of the algorithm remained >90%.Conclusion:The algorithm correctly stratifies primary care patients into low-, moderate-, and high-risk categories to appropriately identify patients in need for additional guidance, monitoring, or treatment changes.

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