Harnessing the placebo effect: Exploring the influence of physician characteristics on placebo response

Reports an error in "Harnessing the placebo effect: Exploring the influence of physician characteristics on placebo response" by Lauren C. Howe, J. Parker Goyer and Alia J. Crum (Health Psychology, 2017[Nov], Vol 36[11], 1074-1082). In the original article, changes were needed to clarify the timeframe over which allergic reactions were measured after the skin prick test (SPT) and the administration of the placebo cream, which was erroneously misrepresented in some cases being “0 to 6 minutes after cream application” when it should have stated “3 to 9 minutes after cream application.” Corrections have been made to reflect this in the “Analytic Strategy for Physiological Results” section and in Figures 2 and 3 and the Figure Notes that accompany them. An additional supplemental figure (Figure S7) has also been added to the supplemental material available online to further clarify the timing of measurements, both in terms of time post-SPT and time post-cream application. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2017-10534-001). Objective: Research on placebo/nocebo effects suggests that expectations can influence treatment outcomes, but placebo/nocebo effects are not always evident. This research demonstrates that a provider’s social behavior moderates the effect of expectations on physiological outcomes. Methods: After inducing an allergic reaction in participants through a histamine skin prick test, a health care provider administered a cream with no active ingredients and set either positive expectations (cream will reduce reaction) or negative expectations (cream will increase reaction). The provider demonstrated either high or low warmth, or either high or low competence. Results: The impact of expectations on allergic response was enhanced when the provider acted both warmer and more competent and negated when the provider acted colder and less competent. Conclusion: This study suggests that placebo effects should be construed not as a nuisance variable with mysterious impact but instead as a psychological phenomenon that can be understood and harnessed to improve treatment outcomes

Diffusion MRI : from basic principles to clinical applications

Diffusion MRI (dMRI) is widely used by clinicians and radiologists to diagnose neurological disorders, in particular stroke. The most commonly encountered diffusion technique in the clinic is simple diffusion weighted imaging and apparent diffusion coefficient (ADC) mapping. However, dMRI can tap into a wealth of data that is usually overlooked by clinicians. While most of this ‘additional’ information is primarily used in a research setting, it is beginning to permeate the clinic. Despite the widespread use of dMRI, clinicians who do not have radiological training may not feel comfortable with the basic principles that underlie this modality. This paper’s aim is to make the fundamentals of the technique accessible to doctors and allied health practitioners who have an interest in dMRI and who use it clinically. It progresses to discuss how these measures can be used.peer-reviewe

A structural connectivity convergence zone in the ventral and anterior temporal lobes: Data-driven evidence from structural imaging.

The hub-and-spoke model of semantic cognition seeks to reconcile embodied views of a fully distributed semantic network with patient evidence, primarily from semantic dementia, who demonstrate modality-independent conceptual deficits associated with atrophy centred on the ventrolateral anterior temporal lobe. The proponents of this model have recently suggested that the temporal cortex is a graded representational space where concepts become less linked to a specific modality as they are processed farther away from primary and secondary sensory cortices and towards the ventral anterior temporal lobe. To explore whether there is evidence that the connectivity patterns of the temporal lobe converge in its ventral anterior end the current study uses three dimensional Laplacian eigenmapping, a technique that allows visualisation of similarity in a low dimensional space. In this space similarity is encoded in terms of distances between data points. We found that the ventral and anterior temporal lobe is in a unique position of being at the centre of mass of the data points within the connective similarity space. This can be interpreted as the area where the connectivity profiles of all other temporal cortex voxels converge. This study is the first to explicitly investigate the pattern of connectivity and thus provides the missing link in the evidence that the ventral anterior temporal lobe can be considered a multi-modal graded hub

Using in vivo probabilistic tractography to reveal two segregated dorsal 'language-cognitive' pathways in the human brain

Primate studies have recently identified the dorsal stream as constituting multiple dissociable pathways associated with a range of specialized cognitive functions. To elucidate the nature and number of dorsal pathways in the human brain, the current study utilized in vivo probabilistic tractography to map the structural connectivity associated with subdivisions of the left supramarginal gyrus (SMG). The left SMG is a prominent region within the dorsal stream, which has recently been parcellated into five structurally-distinct regions which possess a dorsal–ventral (and rostral-caudal) organisation, postulated to reflect areas of functional specialisation. The connectivity patterns reveal a dissociation of the arcuate fasciculus into at least two segregated pathways connecting frontal-parietal-temporal regions. Specifically, the connectivity of the inferior SMG, implicated as an acoustic-motor speech interface, is carried by an inner/ventro-dorsal arc of fibres, whilst the pathways of the posterior superior SMG, implicated in object use and cognitive control, forms a parallel outer/dorso-dorsal crescent

Inhibition of CD26/DPP-IV enhances donor muscle cell engraftment and stimulates sustained donor cell proliferation

<p>Abstract</p> <p>Background</p> <p>Transplantation of myogenic stem cells possesses great potential for long-term repair of dystrophic muscle. In murine-to-murine transplantation experiments, CXCR4 expression marks a population of adult murine satellite cells with robust engraftment potential in <it>mdx </it>mice, and CXCR4-positive murine muscle-derived SP cells home more effectively to dystrophic muscle after intra-arterial delivery in <it>mdx^5cv</it>mice. Together, these data suggest that CXCR4 plays an important role in donor cell engraftment. Therefore, we sought to translate these results to a clinically relevant canine-to-canine allogeneic transplant model for Duchenne muscular dystrophy (DMD) and determine if CXCR4 is important for donor cell engraftment.</p> <p>Methods</p> <p>In this study, we used a canine-to-murine xenotransplantation model to quantitatively compare canine muscle cell engraftment, and test the most effective cell population and modulating factor in a canine model of DMD using allogeneic transplantation experiments.</p> <p>Results</p> <p>We show that CXCR4 expressing cells are important for donor muscle cell engraftment, yet FACS sorted CXCR4-positive cells display decreased engraftment efficiency. However, diprotin A, a positive modulator of CXCR4-SDF-1 binding, significantly enhanced engraftment and stimulated sustained proliferation of donor cells <it>in vivo</it>. Furthermore, the canine-to-murine xenotransplantation model accurately predicted results in canine-to-canine muscle cell transplantation.</p> <p>Conclusions</p> <p>Therefore, these results establish the efficacy of diprotin A in stimulating muscle cell engraftment, and highlight the pre-clinical utility of a xenotransplantation model in assessing the relative efficacy of muscle stem cell populations.</p

Implementation Of The Eighth Joint National Committee Guidelines Of Hypertension By The Primary Care Provider

Hypertension is a widespread disease process and well-known risk factor for coronary artery disease, stroke, heart failure, and renal failure. Proper diagnosis and treatment of hypertension is crucial to reducing these adverse patient outcomes. The Eighth Joint National Committee (JNC 8) released their most recent guidelines of the diagnosis and management of hypertension in December 2013 with implementation to take effect in January 2014. The JNC 8 guidelines of hypertension include the following: proper diagnosis of hypertension (\u3e140/90 for patients \u3c 60 years of age and those with diabetes and/or chronic kidney disease and \u3e150/90 in patients \u3e 60 years of age), lifestyle modifications to be initiated with every hypertensive patient, and newly diagnosed hypertensive patients should follow-up one-month after initial diagnosis and treatment. It is important for primary care providers to abide by these recommendations because of the evidence-based research behind the guidelines released by the Eighth Joint National Committee. This study is significant to education, nursing, and further research because of the prevalence of hypertension. This study was a quantitative, retrospective chart review that analyzed electronic medical records of adult patients newly diagnosed with hypertension with or without diabetes and/or chronic kidney disease. Following approval by the Institutional Review Board (IRB), a standardized data collection tool and legend was used to collect information such as: age, gender, race/ethnicity, blood pressure classification according to the JNC 8 guidelines, diagnosed comorbidities of diabetes and/or chronic kidney disease, pharmacologic management of hypertension, one-month follow-up with the primary care provider, documented need of lifestyle modifications, type of primary care provider and insurance of the patient. A total of 328 patients’ charts met the researchers’ criteria of 18 years of age or older and newly diagnosed with hypertension after January 1, 2014 for inclusion in the study. After compiling the data, the researchers determined the majority of primary care providers do follow the JNC 8 guidelines to diagnose and treat hypertension. Also, in congruence with the JNC 8 guidelines, pharmacological therapy was initiated for each patient diagnosed with hypertension. There was significant statistical difference in recommendation of lifestyle modifications in patients with comorbidities, and diet modifications was the most common lifestyle modification utilized by primary care providers. While primary care providers are likely to follow the JNC 8 guidelines in diagnosing and initiating pharmacological treatment in hypertensive patients, this study concluded that primary care providers do not educate on all recommended lifestyle modifications of the JNC 8 guidelines which include healthy diet, weight control, regular exercise, and smoking cessatio

Point-of-Use Water Treatment and Use among Mothers in Malawi

A national household survey was conducted in Malawi to determine awareness and use of a socially marketed water treatment product. In all, 64% of mothers were aware of the product, and 7% were using it. Both poor and rural mothers had lower awareness and use rates. Targeting promotion to rural populations could enhance program effectiveness

Estimating Physical Activity and Sleep using the Combination of Movement and Heart Rate: A Systematic Review and Meta-Analysis

International Journal of Exercise Science 16(7): 1514-1539, 2023. The purpose of this meta-analysis was to quantify the difference in physical activity and sleep estimates assessed via 1) movement, 2) heart rate (HR), or 3) the combination of movement and HR (MOVE+HR) compared to criterion indicators of the outcomes. Searches in four electronic databases were executed September 21-24 of 2021. Weighted mean was calculated from standardized group-level estimates of mean percent error (MPE) and mean absolute percent error (MAPE) of the proxy signal compared to the criterion measurement method for physical activity, HR, or sleep. Standardized mean difference (SMD) effect sizes between the proxy and criterion estimates were calculated for each study across all outcomes, and meta-regression analyses were conducted. Two-One-Sided-Tests method were conducted to meta-analytically evaluate the equivalence of the proxy and criterion. Thirty-nine studies (physical activity k = 29 and sleep k = 10) were identified for data extraction. Sample size weighted means for MPE were -38.0%, 7.8%, -1.4%, and -0.6% for physical activity movement only, HR only, MOVE+HR, and sleep MOVE+HR, respectively. Sample size weighted means for MAPE were 41.4%, 32.6%, 13.3%, and 10.8% for physical activity movement only, HR only, MOVE+HR, and sleep MOVE+HR, respectively. Few estimates were statistically equivalent at a SMD of 0.8. Estimates of physical activity from MOVE+HR were not statistically significantly different from estimates based on movement or HR only. For sleep, included studies based their estimates solely on the combination of MOVE+HR, so it was impossible to determine if the combination produced significantly different estimates than either method alone

Optimization of quantitative susceptibility mapping for regional estimation of oxygen extraction fraction in the brain

From Wiley via Jisc Publications RouterHistory: received 2020-10-06, rev-recd 2021-03-05, accepted 2021-03-08, pub-electronic 2021-03-29, pub-print 2021-09Article version: VoRPublication status: PublishedFunder: GE Healthcare; Id: http://dx.doi.org/10.13039/100006775Funder: Engineering and Physical Sciences Research Council; Id: http://dx.doi.org/10.13039/501100000266; Grant(s): EP/M005909/1Purpose: We sought to determine the degree to which oxygen extraction fraction (OEF) estimated using quantitative susceptibility mapping (QSM) depends on two critical acquisition parameters that have a significant impact on acquisition time: voxel size and final echo time. Methods: Four healthy volunteers were imaged using a range of isotropic voxel sizes and final echo times. The 0.7 mm data were downsampled at different stages of QSM processing by a factor of 2 (to 1.4 mm), 3 (2.1 mm), or 4 (2.8 mm) to determine the impact of voxel size on each analysis step. OEF was estimated from 11 veins of varying diameter. Inter‐ and intra‐session repeatability were estimated for the optimal protocol by repeat scanning in 10 participants. Results: Final echo time was found to have no significant effect on OEF. The effect of voxel size was significant, with larger voxel sizes underestimating OEF, depending on the proximity of the vein to the superficial surface of the brain and on vein diameter. The last analysis step of estimating vein OEF values from susceptibility images had the largest dependency on voxel size. Inter‐session coefficients of variation on OEF estimates of between 5.2% and 8.7% are reported, depending on the vein. Conclusion: QSM acquisition times can be minimized by reducing the final echo time but an isotropic voxel size no larger than 1 mm is needed to accurately estimate OEF in most medium/large veins in the brain. Such acquisitions can be achieved in under 4 min

Acute low-volume high-intensity interval exercise and continuous moderate-intensity exercise elicit a similar improvement in 24-h glycemic control in overweight and obese adults

Background: Acute exercise reduces postprandial oxidative stress and glycemia; however, the effects of exercise intensity are unclear. We investigated the effect of acute low-volume high-intensity interval-exercise (LV-HIIE) and continuous moderate-intensity exercise (CMIE) on glycemic control and oxidative stress in overweight and obese, inactive adults.Methods: Twenty-seven adults were randomly allocated to perform a single session of LV-HIIE (9 females, 5 males; age: 30 &plusmn; 1 years; BMI: 29 &plusmn; 1 kg&middot;m&minus;2; mean &plusmn; SEM) or CMIE (8 females, 5 males; age: 30 &plusmn; 2.0; BMI: 30 &plusmn; 2.0) 1 h after consumption of a standard breakfast. Plasma redox status, glucose and insulin were measured. Continuous glucose monitoring (CGM) was conducted during the 24-h period before (rest day) and after exercise (exercise day).Results: Plasma thiobarbituric acid reactive substances (TBARS; 29 &plusmn;13%, p &lt; 0.01; mean percent change &plusmn;90% confidence limit), hydrogen peroxide (44 &plusmn; 16%, p &lt; 0.01), catalase activity (50 &plusmn; 16%, p &lt; 0.01), and superoxide dismutase activity (21 &plusmn; 6%, p &lt; 0.01) significantly increased 1 h after breakfast (prior to exercise) compared to baseline. Exercise significantly decreased postprandial glycaemia in whole blood (&minus;6 &plusmn; 5%, p &lt; 0.01), irrespective of the exercise protocol. Only CMIE significantly decreased postprandial TBARS (CMIE: &minus;33 &plusmn; 8%, p &lt; 0.01; LV-HIIE: 11 &plusmn; 22%, p = 0.34) and hydrogen peroxide (CMIE: &minus;25 &plusmn; 15%, p = 0.04; LV-HIIE: 7 &plusmn; 26%; p = 0.37). Acute exercise provided a similar significant improvement in 24-h average glucose levels (&minus;5 &plusmn; 2%, p &lt; 0.01), hyperglycemic excursions (&minus;37 &plusmn; 60%, p &lt; 0.01), peak glucose concentrations (&minus;8 &plusmn; 4%, p &lt; 0.01), and the 2-h postprandial glucose response to dinner (&minus;9 &plusmn; 4%, p &lt; 0.01), irrespective of the exercise protocol.Conclusion: Despite elevated postprandial oxidative stress compared to CMIE, LV-HIIE is an equally effective exercise mode for improving 24-h glycemic control in overweight and obese adults