Measuring the effects of acupuncture and homoeopathy in general practice: An uncontrolled prospective documentation approach

BACKGROUND: Despite the increasing demand for acupuncture and homoeopathy in Germany, little is known about the effects of these treatments in routine care. We set up a pragmatic documentation study in general practice funded within the scope of project launched by a German health insurer. Patients were followed-up for up to four years. METHODS: The aim of the project was to study the effects and benefits of acupuncture and/or homoeopathy, and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture and over 900 homoeopathy patients. As data sources, we used the documentation made available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36); these were complemented by questions concerning the patient's medical history and by questions on patient satisfaction. The health insurer provided us with data on work absenteeism. RESULTS: Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire SF-36 and about 1 point improvement on a rating scale of effects, given by doctors. Data on the treatment and the patients' and physicians' background suggests chronically ill patients treated by fairly regular schemes. CONCLUSION: Since the results showed evidence of a subjective benefit for patients from acupuncture and homoeopathy, this may account for the increase in demand for these treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previously

Classical homeopathy in the treatment of cancer patients - a prospective observational study of two independent cohorts

BACKGROUND: Many cancer patients seek homeopathy as a complementary therapy. It has rarely been studied systematically, whether homeopathic care is of benefit for cancer patients. METHODS: We conducted a prospective observational study with cancer patients in two differently treated cohorts: one cohort with patients under complementary homeopathic treatment (HG; n = 259), and one cohort with conventionally treated cancer patients (CG; n = 380). For a direct comparison, matched pairs with patients of the same tumour entity and comparable prognosis were to be formed. Main outcome parameter: change of quality of life (FACT-G, FACIT-Sp) after 3 months. Secondary outcome parameters: change of quality of life (FACT-G, FACIT-Sp) after a year, as well as impairment by fatigue (MFI) and by anxiety and depression (HADS). RESULTS: HG: FACT-G, or FACIT-Sp, respectively improved statistically significantly in the first three months, from 75.6 (SD 14.6) to 81.1 (SD 16.9), or from 32.1 (SD 8.2) to 34.9 (SD 8.32), respectively. After 12 months, a further increase to 84.1 (SD 15.5) or 35.2 (SD 8.6) was found. Fatigue (MFI) decreased; anxiety and depression (HADS) did not change. CG: FACT-G remained constant in the first three months: 75.3 (SD 17.3) at t0, and 76.6 (SD 16.6) at t1. After 12 months, there was a slight increase to 78.9 (SD 18.1). FACIT-Sp scores improved significantly from t0 (31.0 - SD 8.9) to t1 (32.1 - SD 8.9) and declined again after a year (31.6 - SD 9.4). For fatigue, anxiety, and depression, no relevant changes were found. 120 patients of HG and 206 patients of CG met our criteria for matched-pairs selection. Due to large differences between the two patient populations, however, only 11 matched pairs could be formed. This is not sufficient for a comparative study. CONCLUSION: In our prospective study, we observed an improvement of quality of life as well as a tendency of fatigue symptoms to decrease in cancer patients under complementary homeopathic treatment. It would take considerably larger samples to find matched pairs suitable for comparison in order to establish a definite causal relation between these effects and homeopathic treatment

The Changing Eigenfrequency Continuum during Geomagnetic Storms:Implications for Plasma Mass Dynamics and ULF Wave Coupling

Geomagnetic storms are one of the most energetic space weather phenomena. Previous studies have shown that the eigenfrequencies of ultralow frequency (ULF) waves on closed magnetic field lines in the inner magnetosphere decrease during storm times. This change suggests either a reduction in the magnetic field strength and/or an increase in its plasma mass density distribution. We investigate the changes in local eigenfrequencies by applying a superposed multiple‐epoch analysis to cross‐phase spectra from 132 geomagnetic storms. Six ground magnetometer pairs are used to investigate variations from approximately 3 4, the eigenfrequencies decrease by as much as 50% relative to their quiet time values. Both a decrease in magnetic field strength and an increase in plasma mass density, in some locations by more than a factor of 2, are responsible for this reduction. The enhancement of the ring current and an increase in oxygen ion density could explain these observations. At L < 4, the eigenfrequencies increase due to the decrease in plasma mass density caused by plasmaspheric erosion

The therapeutic effect of clinical trials: understanding placebo response rates in clinical trials – A secondary analysis

BACKGROUND AND PURPOSE: Placebo response rates in clinical trials vary considerably and are observed frequently. For new drugs it can be difficult to prove effectiveness superior to placebo. It is unclear what contributes to improvement in the placebo groups. We wanted to clarify, what elements of clinical trials determine placebo variability. METHODS: We analysed a representative sample of 141 published long-term trials (randomized, double-blind, placebo-controlled; duration > 12 weeks) to find out what study characteristics predict placebo response rates in various diseases. Correlational and regression analyses with study characteristics and placebo response rates were carried out. RESULTS: We found a high and significant correlation between placebo and treatment response rate across diseases (r = .78; p < .001). A multiple regression model explained 79% of the variance in placebo variability (F = 59.7; p < 0.0001). Significant predictors are, among others, the duration of the study (beta = .31), the quality of the study (beta = .18), the fact whether a study is a prevention trial (beta = .44), whether dropouts have been documented (beta = -.20), or whether additional treatments have been documented (beta = -.17). Healing rates with placebo are lower in the following diagnoses; neoplasms (beta = -.21), nervous diseases (beta = -.10), substance abuse (beta = -.14). Without prevention trials the amount of variance explained is 42%. CONCLUSION: Medication response rates and placebo response rates in clinical trials are highly correlated. Trial characteristics can explain some portion of the variance in placebo healing rates in RCTs. Placebo response in trials is only partially due to methodological artefacts and only partially dependent on the diagnoses treated

Subitizing with Variational Autoencoders

Numerosity, the number of objects in a set, is a basic property of a given visual scene. Many animals develop the perceptual ability to subitize: the near-instantaneous identification of the numerosity in small sets of visual items. In computer vision, it has been shown that numerosity emerges as a statistical property in neural networks during unsupervised learning from simple synthetic images. In this work, we focus on more complex natural images using unsupervised hierarchical neural networks. Specifically, we show that variational autoencoders are able to spontaneously perform subitizing after training without supervision on a large amount images from the Salient Object Subitizing dataset. While our method is unable to outperform supervised convolutional networks for subitizing, we observe that the networks learn to encode numerosity as basic visual property. Moreover, we find that the learned representations are likely invariant to object area; an observation in alignment with studies on biological neural networks in cognitive neuroscience

Emergence of qualia from brain activity or from an interaction of proto-consciousness with the brain: which one is the weirder? Available evidence and a research agenda

This contribution to the science of consciousness aims at comparing how two different theories can explain the emergence of different qualia experiences, meta-awareness, meta-cognition, the placebo effect, out-of-body experiences, cognitive therapy and meditation-induced brain changes, etc. The first theory postulates that qualia experiences derive from specific neural patterns, the second one, that qualia experiences derive from the interaction of a proto-consciousness with the brain\u2019s neural activity. From this comparison it will be possible to judge which one seems to better explain the different qualia experiences and to offer a more promising research agenda

Statistical comparison of electron loss and enhancement in the outer radiation belt during storms

The near-relativistic electron population in the outer Van Allen radiation belt is highly dynamic and strongly coupled to geomagnetic activity such as storms and substorms, which are driven by the interaction of the magnetosphere with the solar wind. The energy, content and spatial extent of electrons in the outer radiation belt can vary on timescales of hours to days, dictated by the continuously evolving influence of acceleration and loss processes. While net changes in the electron population are directly observable, the relative influence of different processes is far from fully understood. Using a continuous 12-year dataset from the Proton Electron Telescope (PET) on board the Solar Anomalous Magnetospheric Particle Explorer (SAMPEX), we statistically compare the relative variations of trapped electrons to those in the bounce loss cone. Our results show that there is a proportional increase in flux entering the bounce loss cone outside the plasmapause during storm main phase and early recovery phase. Loss enhancement is sustained on the dawnside throughout the recovery phase while loss on the duskside is enhanced around minimum Sym-H and quickly diminishes. Spatial variations are also examined in relation to geomagnetic activity, making comparisons to possible causal wave modes such as whistler-mode chorus and plasmaspheric hiss

Incommensurable worldviews? Is public use of complementary and alternative medicines incompatible with support for science and conventional medicine?

Proponents of controversial Complementary and Alternative Medicines, such as homeopathy, argue that these treatments can be used with great effect in addition to, and sometimes instead of, ?conventional? medicine. In doing so, they accept the idea that the scientific approach to the evaluation of treatment does not undermine use of and support for some of the more controversial CAM treatments. For those adhering to the scientific canon, however, such efficacy claims lack the requisite evidential basis from randomised controlled trials. It is not clear, however, whether such opposition characterises the views of the general public. In this paper we use data from the 2009 Wellcome Monitor survey to investigate public use of and beliefs about the efficacy of a prominent and controversial CAM within the United Kingdom, homeopathy. We proceed by using Latent Class Analysis to assess whether it is possible to identify a sub-group of the population who are at ease in combining support for science and conventional medicine with use of CAM treatments, and belief in the efficacy of homeopathy. Our results suggest that over 40% of the British public maintain positive evaluations of both homeopathy and conventional medicine simultaneously. Explanatory analyses reveal that simultaneous support for a controversial CAM treatment and conventional medicine is, in part, explained by a lack of scientific knowledge as well as concerns about the regulation of medical research