Effect of Open-label Placebo on Children and Adolescents With Functional Abdominal Pain or Irritable Bowel Syndrome: A Randomized Clinical Trial

Although it is widely believed that concealment or deception is required to elicit a placebo response, recent studies with adults suggest that open-label placebo (OLP) (ie, honestly prescribed placebos) can yield significant benefits. No studies of OLP have been performed with children. To evaluate the efficacy of OLP for the treatment of children and adolescents with functional abdominal pain or irritable bowel syndrome. This multicenter crossover randomized clinical trial was conducted from July 1, 2015, to June 15, 2018, at 3 US centers among children and adolescents aged 8 to 18 years with functional abdominal pain or irritable bowel syndrome defined per Rome III criteria. Statistical analysis was performed from March 1, 2019, to September 30, 2020, on an intention-to-treat basis. Patients completed 1 week of observation prior to randomization to 1 of 2 counterbalanced groups: OLP for 3 weeks followed by a 3-week control period or control period for 3 weeks followed by OLP for 3 weeks. During the OLP period, participants took 1.5 mL of an inert liquid placebo twice a day. A standardized method for explaining the OLP was used, and the interaction with clinicians had the same duration and style for both time periods. Hyoscyamine was allowed as a rescue medication. The primary outcome was the mean daily pain score during each of the interventions, measured on a 0- to 100-mm visual analog scale, where higher scores indicated greater pain. The number of rescue medications taken during each intervention served as an objective secondary measure. Thirty patients (mean [SD] age, 14.1 [3.4] years; 24 female participants [80.0%]; 16 [53.3%] with functional abdominal pain and 14 [46.7%] with irritable bowel syndrome) completed the study. The mean (SD) pain scores were significantly lower during OLP treatment compared with the control period (39.9 [18.9] vs 45.0 [14.7]; difference, 5.2; 95% CI, 0.2-10.1; P = .03). Patients took nearly twice as many hyoscyamine pills during the control period compared with during the OLP period (mean [SD] number, 3.8 [5.1] pills vs 2.0 [3.0] pills; difference, 1.8 pills; 95% CI, 0.5-3.1 pills). During OLP, patients with functional abdominal pain or irritable bowel syndrome reported significantly less pain and took significantly fewer pain medications. Open-label placebo may be an effective treatment for children and adolescents with functional abdominal pain or irritable bowel syndrome. ClinicalTrials.gov Identifier: NCT02389998

A Lightweight Remote Sensing Payload for Wildfire Detection and Fire Radiative Power Measurements

Small uncrewed aerial systems (sUASs) have the potential to serve as ideal platforms for high spatial and temporal resolution wildfire measurements to complement aircraft and satellite observations, but typically have very limited payload capacity. Recognizing the need for improved data from wildfire management and smoke forecasting communities and the potential advantages of sUAS platforms, the Nighttime Fire Observations eXperiment (NightFOX) project was funded by the US National Oceanic and Atmospheric Administration (NOAA) to develop a suite of miniaturized, relatively low-cost scientific instruments for wildfire-related measurements that would satisfy the size, weight and power constraints of a sUAS payload. Here we report on a remote sensing system developed under the NightFOX project that consists of three optical instruments with five individual sensors for wildfire mapping and fire radiative power measurement and a GPS-aided inertial navigation system module for aircraft position and attitude determination. The first instrument consists of two scanning telescopes with infrared (IR) channels using narrow wavelength bands near 1.6 and 4 µm to make fire radiative power measurements with a blackbody equivalent temperature range of 320–1500 °C. The second instrument is a broadband shortwave (0.95–1.7 µm) IR imager for high spatial resolution fire mapping. Both instruments are custom built. The third instrument is a commercial off-the-shelf visible/thermal IR dual camera. The entire system weighs about 1500 g and consumes approximately 15 W of power. The system has been successfully operated for fire observations using a Black Swift Technologies S2 small, fixed-wing UAS for flights over a prescribed grassland burn in Colorado and onboard an NOAA Twin Otter crewed aircraft over several western US wildfires during the 2019 Fire Influence on Regional to Global Environments and Air Quality (FIREX-AQ) field mission