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BackgroundAlterations in the brain’s oxytocinergic system have been suggested to play an important role in the pathophysiology of autism spectrum disorder (ASD), but insights from pediatric populations are sparse.MethodsWe examined salivary oxytocin in school-aged children with (n=80) and without (n=40) ASD (boys/girls 4/1), as well as characterizations of DNA methylation (DNAm) of the oxytocin receptor gene (OXTR). Cortisol levels were also assessed to examine links between the oxytocinergic system and hypothalamic-pituitary-adrenal (HPA) axis signaling.ResultsChildren with ASD displayed altered (diminished) oxytocin levels in the morning, but not in the afternoon, after a mildly stress-inducing social interaction session. Notably, in the control group, higher oxytocin levels were predictive of lower stress-induced cortisol, likely reflective of aprotectivestress-regulatory mechanism for buffering HPA stress activity. In children with ASD, on the other hand, a morereactivestress regulatory mechanism was evident, involving a significant rise in oxytocin levels from the morning to the afternoon upon stress-induced cortisol release, i.e., to reactively cope with heightened HPA activity.Regarding epigenetic modifications, no overall pattern ofOXTRhypo- or hypermethylation was evident in ASD. In control children, a notable association betweenOXTRmethylation and levels of cortisol was evident, likely indicative of a compensatory downregulation ofOXTRmethylation (higher oxytocin receptor expression) in children with heightened HPA axis activity.ConclusionTogether, these observations bear important insights into altered oxytocinergic signaling in ASD, which may aid in establishing relevant biomarkers for diagnostic and/or treatment evaluation purposes targeting the oxytocinergic system in ASD.

Supplemental material, sj-pdf-4-cre-10.1177_02692155211006865 for Effectiveness of perioperative pain science education on pain, psychological factors and physical functioning: A systematic review by Elien Van der Gucht, Lore Dams, Vincent Haenen, Lode Godderis, Bart Morlion, Koen Bernar, Margaux Evenepoel, Tessa De Vrieze, Thomas Vandendriessche, Anne Asnong, Inge Geraerts, Nele Devoogdt, An De Groef and Mira Meeus in Clinical Rehabilitation

Supplemental material, sj-pdf-3-cre-10.1177_02692155211006865 for Effectiveness of perioperative pain science education on pain, psychological factors and physical functioning: A systematic review by Elien Van der Gucht, Lore Dams, Vincent Haenen, Lode Godderis, Bart Morlion, Koen Bernar, Margaux Evenepoel, Tessa De Vrieze, Thomas Vandendriessche, Anne Asnong, Inge Geraerts, Nele Devoogdt, An De Groef and Mira Meeus in Clinical Rehabilitation

Supplemental material, sj-pdf-2-cre-10.1177_02692155211006865 for Effectiveness of perioperative pain science education on pain, psychological factors and physical functioning: A systematic review by Elien Van der Gucht, Lore Dams, Vincent Haenen, Lode Godderis, Bart Morlion, Koen Bernar, Margaux Evenepoel, Tessa De Vrieze, Thomas Vandendriessche, Anne Asnong, Inge Geraerts, Nele Devoogdt, An De Groef and Mira Meeus in Clinical Rehabilitation

Supplemental material, sj-pdf-1-cre-10.1177_02692155211006865 for Effectiveness of perioperative pain science education on pain, psychological factors and physical functioning: A systematic review by Elien Van der Gucht, Lore Dams, Vincent Haenen, Lode Godderis, Bart Morlion, Koen Bernar, Margaux Evenepoel, Tessa De Vrieze, Thomas Vandendriessche, Anne Asnong, Inge Geraerts, Nele Devoogdt, An De Groef and Mira Meeus in Clinical Rehabilitation

Refereed/Peer-reviewed Purpose: Here, we describe the development and pilot study of a personalized eHealth intervention containing a pain science education program and self-management support strategies regarding pain and pain-related functioning in female survivors of breast cancer. First, we aimed to evaluate the eHealth intervention’s acceptability, comprehensibility, and satisfaction; second, we aimed to assess its preliminary efficacy. Methods: A mixed-method study design was used. Breast cancer survivors with persistent pain were recruited. After 6 weeks of engagement with the eHealth intervention, acceptability, comprehensibility, and satisfaction were measured quantitatively with a self-constructed questionnaire and described qualitatively using focus groups. A joint display was used to present the meta-interferences between data. Efficacy was assessed via mixed effects models with repeated measures (outcomes assessed at baseline, 6 weeks, and 12 weeks). Results: Twenty-nine women with persistent pain after breast cancer surgery participated. Overall, the eHealth program was well received and experienced as easy to use and helpful. The eHealth intervention seems useful as an adjunct to comprehensive cancer aftercare. Efficacy estimates suggested a significant improvement in pain-related functioning, physical functioning, and quality of life. Conclusion: A personalized eHealth intervention appears valuable for persistent pain management after breast cancer surgery. A large controlled clinical trial to determine effectiveness, and a full process evaluation, seems warranted.

To investigate the variables per International Classification of Functioning, Disability and Health (ICF)-domain that are associated with upper limb (UL) function in women after breast cancer surgery. PubMed and Web of Science were searched until 7 January 2020. Eligibility criteria were: prospective investigation of an association between one or more variables of the ICF model and UL function in women after breast cancer surgery. PRISMA guidelines were used to conduct and report the systematic review. The Quality In Prognosis Studies tool (QUIPS) was used to evaluate risk of bias. Twelve studies were included (2244 participants). Risk of bias of the included studies was low to moderate. Variables at the ICF-function level that were systematically associated with decreased UL function across multiple included papers were: increased UL pain, decreased shoulder range of motion, decreased handgrip strength and a higher number of comorbidities. Results on the association between UL function and variables at other ICF-domains were conflicting. UL function was associated with certain variables at the ICF-function level. Variability in disease stages, treatment and measurement methods might explain inconsistent associations with other variables. Only limited studies investigated associations between UL function and psychosocial factors.IMPLICATIONS FOR REHABILITATIONThis paper gives an overview of associations between different variables of the ICF model and UL dysfunctions in women after breast cancer surgery.Identified associated factors are situated at the ICF function level, i.e., UL pain, decreased handgrip strength and shoulder (abduction) ROM.These factors are modifiable and should be monitored, prevented and treated in physical therapy practice.UL dysfunction is not consistently associated with treatment-related variables.The role of psychosocial personal factors in UL dysfunctions should be considered and further explored. This paper gives an overview of associations between different variables of the ICF model and UL dysfunctions in women after breast cancer surgery. Identified associated factors are situated at the ICF function level, i.e., UL pain, decreased handgrip strength and shoulder (abduction) ROM. These factors are modifiable and should be monitored, prevented and treated in physical therapy practice. UL dysfunction is not consistently associated with treatment-related variables. The role of psychosocial personal factors in UL dysfunctions should be considered and further explored.