Probes for INS

Facial grimaces are now commonly used to quantify spontaneous pain in mice and other mammalian species, but scoring remains subjective and relies on humans with very different levels of proficiency. Here, we developed a Mouse Grimace Scale (MGS) for black-coated (C57BL/6) mice consisting of four facial action units (orbitals, nose, ears, whiskers). We used this scale to generate ground truth data from over 70,000 images of black mice in different settings. With this large data set, we developed a deep neural network and cloud-based software platform called PainFace (http://painface.net) that accurately scores facial grimaces of black mice on a 0-8 scale. PainFace generates over two orders of magnitude more MGS data than humans can realistically achieve, and at superhuman speed. By analyzing the frequency distribution of grimace scores, we found that mice spent >7x more time in a high grimace state following laparotomy surgery relative to sham surgery controls. The analgesic carprofen reduced the amount of time animals spent in this high grimace state after surgery. Specific facial action unit score combinations were overrepresented following laparotomy surgery, suggesting that characteristic facial expressions are associated with a high grimace state. While this study is focused on mice, PainFace was designed to simplify, standardize, and scale up grimace analyses with many other mammalian species, including humans. This work was supported by a grant from the NINDS (R01NS114259) to M.J.Z. NSF GRFP awarded to R.P.P.

African Americans have been found to receive less medication and experience more pain than Caucasians. Unfortunately, many studies simply highlight the disparities that exist between African Americans and Caucasian in pain management, but there is a lack of understanding at the etiology of these disparities. The purpose of this study was to determine the adequacy of analgesia that was prescribed for African Americans with cancer pain and elucidate any potential characteristics that contributed to receiving appropriate analgesia. This was a secondary analysis of baseline data of an intervention study of African Americans with cancer pain. In order to determine the adequacy of analgesics received, the Pain Management Index (PMI) was calculated for 302 African Americans with cancer pain. Structure equation modeling was utilized to determine which patient factors (age, gender, presence of caregiver, employment status, educational level, perceived control over pain, pain-related distress, pain intensity, functional status) led to adequate analgesia. Forty percent of African Americans with cancer pain did not receive adequate analgesia based on the drug class alone. African Americans with cancer pain who reported higher levels of pain received higher levels of analgesics. Cancer metastasis (p = .03) was the only significant predictor of an increased likelihood of receiving adequate analgesia. Despite national attention to racial disparities, African Americans with cancer pain continue to receive inadequate analgesia. Forty percent of African Americans did not get the appropriate drug based on their reported pain score. The only significant predictor of receiving appropriate analgesia was cancer metastasis. Ensuing studies testing whether these results would be the same for other races will clarify if this disparity was due to race alone. Interventions should then be created and utilized to decrease these disparities.