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Friborg J, Jensen K, Grau C, Hansen CR. Response to the letter by Boon and colleagues. Radiother Oncol 2024; 195:110233. [PMID: 38537679 DOI: 10.1016/j.radonc.2024.110233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 03/14/2024] [Indexed: 05/18/2024]
Affiliation(s)
- J Friborg
- Danish Center of Particle Therapy, Aarhus University Hospital, Denmark; Department of Oncology, Rigshospitalet, Denmark.
| | - K Jensen
- Danish Center of Particle Therapy, Aarhus University Hospital, Denmark
| | - C Grau
- Danish Center of Particle Therapy, Aarhus University Hospital, Denmark
| | - C R Hansen
- Danish Center of Particle Therapy, Aarhus University Hospital, Denmark; Department of Oncology, Odense University Hospital, Denmark
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Hansson LS, Tognetti A, Sigurjónsson P, Brück E, Wåhlén K, Jensen K, Olsson MJ, Toll John R, Wilhelms DB, Lekander M, Lasselin J. Perception of unfamiliar caregivers during sickness - Using the new caregiver perception task (CgPT) during experimental endotoxemia. Brain Behav Immun 2024:S0889-1591(24)00379-9. [PMID: 38670241 DOI: 10.1016/j.bbi.2024.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/25/2024] [Accepted: 04/22/2024] [Indexed: 04/28/2024] Open
Abstract
Social withdrawal is a well-established part of sickness behavior, but in some contexts sick animals might gain from keeping close instead of keeping away. For instance, sick individuals are more willing to be near known individuals who can provide care and safety (close others) compared to when healthy. Yet, interactions with some strangers might also be beneficial (i.e., healthcare professionals), but it is not known how sickness interplay with social behavior towards such individuals. Here, we assessed if sickness affects perception of caregivers and developed a new task, the Caregiver Perception Task (CgPT). Twenty-six participants conducted the CgPT, once after an injection of lipopolysaccharide (LPS, 0.8 ng/kg body weight, n = 24), and once after an injection of saline (n = 25), one hour and forty-five minutes post-injection. During the task, participants watched short videeo-clips of three types of caregivers: a healthcare professional taking care of a sick individual (HP-c), a healthcare professional not taking care of a sick individual (HP-nc), and a non-healthcare professional taking care of their sick adult child or partner (NHP-c). After each videeo clip, the likability, trustworthiness, professionalism, and willingness to interact with and receive care from the caregiver were rated on visual analogue scales. Results showed that participants injected with saline rated healthcare professionals who did not take care of a sick individual less positively on all aspects compared to healthcare professionals who took care of a sick individual. Moreover, compared to saline, LPS increased the participants' willingness to receive care from healthcare professionals and non-healthcare professionals providing care, but not from healthcare professionals not providing care. Thus, our results indicate that sick individuals may approach unknown individuals with potential to provide care and support.
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Affiliation(s)
- L S Hansson
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Health, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - A Tognetti
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; CEE-M, CNRS, INRAE, Institut Agro, University of Montpellier, Montpellier, France
| | | | - E Brück
- Karolinska University Hospital, Stockholm, Sweden
| | - K Wåhlén
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - K Jensen
- Osher Center for Integrative Health, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Division of Neuro, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - M J Olsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - R Toll John
- Department of Biomedical and Clinical Sciences, Linköping University, Sweden; Department of Emergency Medicine in Linköping, Local Health Care Services in Central Östergötland, Region Östergötland
| | - D B Wilhelms
- Department of Biomedical and Clinical Sciences, Linköping University, Sweden; Department of Emergency Medicine in Linköping, Local Health Care Services in Central Östergötland, Region Östergötland
| | - M Lekander
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Health, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - J Lasselin
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Health, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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3
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Pontén M, Jonsjö M, Vadenmark V, Moberg E, Grannas D, Andersson G, Boersma K, Hedman-Lagerlöf E, Kleinstaeuber M, Weise C, Kaldo V, Ljótsson B, Andersson E, Axelsson E, Jensen K. Association between expectations and clinical outcomes in online v. face-to-face therapy - an individual participant data meta-analysis. Psychol Med 2024; 54:1207-1214. [PMID: 37905404 DOI: 10.1017/s0033291723003033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
BACKGROUND Online treatments are increasing in number and are currently available for a wide range of clinical problems. To date little is known about the role of treatment expectations and other placebo-like mechanisms in online settings compared to traditional face-to-face treatment. To address this knowledge gap, we analyzed individual participant data from randomized clinical trials that compared online and face-to-face psychological interventions. METHODS MEDLINE (Ovid) and PsycINFO (Ovid) were last searched on 2 February 2021. Randomized clinical trials of therapist guided online v. face-to-face psychological interventions for psychiatric or somatic conditions using a randomized controlled design were included. Titles, abstracts, and full texts of studies were independently screened by multiple observers. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed. Authors of the matching trials were contacted for individual participant data. Ratings from the Credibility and Expectancy Questionnaire and the primary outcome measure from each trial were used to estimate the association between expectation ratings and treatment outcomes in online v. face-to-face interventions, using a mixed-effects model. RESULTS Of 7045 screened studies, 62 full-text articles were retrieved whereof six studies fulfilled the criteria and provided individual participant data (n = 491). Overall, CEQ ratings predicted clinical outcomes (β = 0.27) at end of treatment with no moderating effect of treatment modality (online v. face-to-face). CONCLUSIONS Online treatment appears to be equally susceptible to expectancy effects as face-to-face therapy. This furthers our understanding of the importance of placebo-like factors in online treatment and may aid the improvement of healthcare in online settings.
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Affiliation(s)
- Moa Pontén
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Martin Jonsjö
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
- Medical Unit Medical Psychology, Theme Women's Health and Allied Health Professionals, Karolinska University Hospital Solna, Solna, Sweden
| | - Viktor Vadenmark
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Erica Moberg
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - David Grannas
- Biostatistics Core Facility, Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden
| | - Gerhard Andersson
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Katja Boersma
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | | | | | - Cornelia Weise
- Department of Psychology, Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Viktor Kaldo
- Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Brjánn Ljótsson
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Erik Andersson
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Erland Axelsson
- Liljeholmen Primary Health Care Center, Region Stockholm, Stockholm, Sweden
- Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden
| | - Karin Jensen
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
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Ruehr L, Blomé S, Kastrati G, Lagerbäck T, Jonsjö M, Möller H, Skorpil M, Lasselin J, Lalouni M, Gerdhem P, Jensen K. Back morphology and walking patterns mean 13.8 years after surgery for lumbar disk herniation in adolescents. Pain Rep 2024; 9:e1148. [PMID: 38500565 PMCID: PMC10948132 DOI: 10.1097/pr9.0000000000001148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 03/20/2024] Open
Abstract
Introduction In many pain conditions, there is lingering pain despite healed tissue damage. Our previous study shows that individuals who underwent surgery for lumbar disk herniation (LDH) during adolescence have worse health, more pain, and increased disk degeneration mean 13 years after surgery compared with controls. It is unclear if walking patterns segregate surgically treated LDH adolescents and controls at mean 13-year follow-up. Objectives Here, we analyzed the relationship between gait, back morphology and other health outcomes in a cohort of individuals treated surgically because of lumbar disk herniation compared with controls. Methods We analyzed gait during a walking paradigm, back morphology at the site of surgery, and standardized health outcomes, among individuals who received surgery for LDH as adolescents, "cases" (n = 23), compared with "controls" (n = 23). Results There were gait differences in head (P = 0.021) and trunk angle (P = 0.021) between cases and controls in a direction where cases exhibited a posture associated with sickness. The gait variance was explained by subjective pain and exercise habits rather than objective disk degeneration. Conclusion Over a decade after surgery for LDH during adolescence, health among cases is worse compared with controls. The head and trunk angles differ between cases and controls, indicating that the residual pain lingers and may cause changes in movement patterns long after a painful episode in early life. Gait may be a useful target for understanding maintenance of pain and disability among individuals treated surgically for LDH during adolescence.
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Affiliation(s)
- Livia Ruehr
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Max Planck School of Cognition, Leipzig, Germany
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sebastian Blomé
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Gránit Kastrati
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tobias Lagerbäck
- Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden
| | - Martin Jonsjö
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Hans Möller
- Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden
- Center for Spine Surgery in Stockholm, Stockholm, Sweden
| | - Mikael Skorpil
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - Julie Lasselin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
- Osher Center for Integrative Health, Karolinska Institutet, Stockholm, Sweden
| | - Maria Lalouni
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Paul Gerdhem
- Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden
- Department of Orthopedics and Hand Surgery, Uppsala University Hospital, Uppsala, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Karin Jensen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Pontén S, Lagerbäck T, Blomé S, Jensen K, Skorpil M, Gerdhem P. Lumbar degeneration and quality of life in patients with lumbar disc herniation: a case-control long-term follow-up study. Acta Orthop 2024; 95:92-98. [PMID: 38305634 PMCID: PMC10836153 DOI: 10.2340/17453674.2024.39944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/03/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND AND PURPOSE Adults treated surgically for lumbar disc herniation in adolescence have a higher degree of lumbar disc degeneration than controls. We aimed to establish whether the degree of lumbar degeneration differs at diagnosis or at follow-up between surgically and non-surgically treated individuals. METHODS We identified individuals with a lumbar disc herniation in adolescence diagnosed with magnetic resonance imaging (MRI) and contacted them for follow-up MRI. Lumbar degeneration was assessed according to Pfirrmann, Modic, and total end plate score (TEP score). Patient-reported outcome measures at follow-up comprised the Oswestry Disability Index (ODI), EQ-5D-3-level version, 36-Item Short Form Health Survey (SF-36), and Visual Analogue Scale (VAS) for back and leg pain. Fisher's exact test, Mann-Whitney U tests, Wilcoxon tests, and logistic regression were used for statistical analysis. RESULTS MRIs were available at diagnosis and after a mean of 11.9 years in 17 surgically treated individuals and 14 non-surgically treated individuals. Lumbar degeneration was similar at diagnosis (P = 0.2) and at follow-up, with the exception of higher TEP scores in surgically treated individuals at levels L4-L5 and L5-S1 at follow-up (P ≤ 0.03), but this difference did not remain after adjustment for age and sex (P ≥ 0.8). There were no significant differences in patient-reported outcome measures between the groups at follow-up (all P ≥ 0.2). CONCLUSION Adolescents with a lumbar disc herniation have, irrespective of treatment, a similar degree of lumbar degeneration at the time of diagnosis, and similar lumbar degeneration and patient-reported outcomes at long-term follow-up.
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Affiliation(s)
- Sebastian Pontén
- Department of Orthopaedics and Hand Surgery, Uppsala University Hospital, Uppsala; Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm
| | - Tobias Lagerbäck
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm
| | - Sebastian Blomé
- Department of Clinical Neuroscience, Division of Neuro, Karolinska Institutet, Stockholm
| | - Karin Jensen
- Department of Clinical Neuroscience, Division of Neuro, Karolinska Institutet, Stockholm
| | - Mikael Skorpil
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm; Department of Neuroradiology, Karolinska University Hospital, Stockholm
| | - Paul Gerdhem
- Department of Orthopaedics and Hand Surgery, Uppsala University Hospital, Uppsala; Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
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6
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Kirakosian R, Möllenbrink L, Zamore G, Kaptchuk TJ, Jensen K. Heresy, witchcraft, Jean Gerson, scepticism and the use of placebo controls. J R Soc Med 2024; 117:36-41. [PMID: 37991475 PMCID: PMC10858716 DOI: 10.1177/01410768231207260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Affiliation(s)
- R Kirakosian
- Germanistische Mediävistik, Albert-Ludwigs-Universität Freiburg, 79085, Germany
| | - L Möllenbrink
- Germanistisches Seminar, Universität Heidelberg, 69117 Heidelberg, Germany
| | - G Zamore
- Faculty of History, University of Cambridge, Cambridge, CB3 9EF, UK
| | - T J Kaptchuk
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - K Jensen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm 17176, Sweden
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Friborg J, Jensen K, Eriksen JG, Samsøe E, Maare C, Farhadi M, Sibolt P, Nielsen M, Andersen M, Holm AIS, Skyt P, Smulders B, Johansen J, Overgaard J, Grau C, Hansen CR. Considerations for study design in the DAHANCA 35 trial of protons versus photons for head and neck cancer. Radiother Oncol 2024; 190:109958. [PMID: 37871751 DOI: 10.1016/j.radonc.2023.109958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 08/10/2023] [Accepted: 09/26/2023] [Indexed: 10/25/2023]
Abstract
Proton radiotherapy offers a dosimetric advantage compared to photon therapy in sparing normal tissue, but the clinical evidence for toxicity reductions in the treatment of head and neck cancer is limited. The Danish Head and Neck Cancer Group (DAHANCA) has initiated the DAHANCA 35 randomised trial to clarify the value of proton therapy (NCT04607694). The DAHANCA 35 trial is performed in an enriched population of patients selected by an anticipated benefit of proton therapy to reduce the risk of late dysphagia or xerostomia based on normal tissue complication probability (NTCP) modelling. We present our considerations on the trial design and a test of the selection procedure conducted before initiating the randomised study.
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Affiliation(s)
- J Friborg
- Danish Center of Particle Therapy, Aarhus University Hospital, Denmark; Department of Oncology, Rigshospitalet, Denmark. %
| | - K Jensen
- Danish Center of Particle Therapy, Aarhus University Hospital, Denmark
| | - J G Eriksen
- Department of Oncology, Aarhus University Hospital, Denmark; Aarhus University Hospital, Department of Experimental Clinical Oncology, Denmark
| | - E Samsøe
- Department of Oncology, Zealand University Hospital Næstved, Denmark
| | - C Maare
- Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Denmark
| | - M Farhadi
- Department of Oncology, Zealand University Hospital Næstved, Denmark
| | - P Sibolt
- Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Denmark
| | - M Nielsen
- Department of Oncology, Aalborg University Hospital, Denmark
| | - M Andersen
- Department of Oncology, Aalborg University Hospital, Denmark
| | - A I S Holm
- Department of Oncology, Aarhus University Hospital, Denmark
| | - P Skyt
- Danish Center of Particle Therapy, Aarhus University Hospital, Denmark
| | - B Smulders
- Danish Center of Particle Therapy, Aarhus University Hospital, Denmark; Department of Oncology, Rigshospitalet, Denmark
| | - J Johansen
- Department of Oncology, Odense University Hospital, Denmark
| | - J Overgaard
- Aarhus University Hospital, Department of Experimental Clinical Oncology, Denmark
| | - C Grau
- Danish Center of Particle Therapy, Aarhus University Hospital, Denmark
| | - C R Hansen
- Danish Center of Particle Therapy, Aarhus University Hospital, Denmark; Department of Oncology, Odense University Hospital, Denmark; Institute of Clinical Research, University of Southern Denmark, Denmark
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Sandström A, Ellerbrock I, Tour J, Kadetoff D, Jensen K, Kosek E. Dysfunctional Activation of the Dorsolateral Prefrontal Cortex During Pain Anticipation Is Associated With Altered Subsequent Pain Experience in Fibromyalgia Patients. J Pain 2023; 24:1731-1743. [PMID: 37354157 DOI: 10.1016/j.jpain.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 04/05/2023] [Accepted: 05/08/2023] [Indexed: 06/26/2023]
Abstract
The ability to accurately predict pain is an adaptive feature in healthy individuals. However, in chronic pain, this mechanism may be selectively impaired and can lead to increased anxiety and excessive avoidance behavior. Recently, we reported the first data demonstrating brain activation in fibromyalgia (FM) patients during conditioned pain responses, in which FM patients revealed a tendency to form new pain-related associations rather than extinguishing irrelevant ones. The aim of the present study was to extend our previous analysis, to elucidate potential neural divergences between subjects with FM (n = 65) and healthy controls (HCs) (n = 33) during anticipatory information (ie, prior to painful stimulus onset). Using functional magnetic resonance imaging (fMRI), the current analyses include 1) a congruently cued paradigm of low and high pain predictive cues, followed by 2) an incongruently cued paradigm where low and high pain predictive cues were followed by an identical mid-intensity painful pressure. During incongruently cued high-pain associations, FM exhibited reduced left dorsolateral prefrontal cortex (dlPFC) activation compared to HCs, which was followed by an altered subsequent pain experience in FM, as patients continued to rate the following painful stimuli as high, even though the pressure had been lowered. During congruently cued low pain anticipation, FM exhibited decreased right dlPFC activation compared to HCs, as well as decreased brain connectivity between brain regions implicated in cognitive modulation of pain (dlPFC) and nociceptive processing (primary somatosensory cortex/postcentral gyrus [S1] and supplementary motor area [SMA]/midcingulate cortex [MCC]). These results may reflect an important feature of validating low pain expectations in HCs and help elucidate behavioral reports of impaired safety processing in FM patients. PERSPECTIVE: FM exhibited a stronger conditioned pain response for high-pain associations, which was associated with reduced dlPFC activation during the incongruent trial. During (congruent and incongruent) low pain associations, FM dlPFC brain activation remained indifferent. Imbalances in threat and safety pain perception may be an important target for psychotherapeutic interventions.
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Affiliation(s)
- Angelica Sandström
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
| | - Isabel Ellerbrock
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - Jeanette Tour
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology and Surgery, Blekinge Hospital, Karlskrona, Sweden
| | - Diana Kadetoff
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Spine Center, Löwenströmska Hospital, Upplands Väsby, Sweden
| | - Karin Jensen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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Weik E, Neuenschwander R, Edgington B, Jensen K, Tipper CM, Oberlander TF. Conditioning induced placebo-like and nocebo-like effects of thermal discomfort in adults but not in youth. Br J Pain 2023; 17:342-351. [PMID: 37538948 PMCID: PMC10395395 DOI: 10.1177/20494637231153364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
Introduction Conditioning can be used to modulate the perception of pain, in the form of placebo and nocebo effects. Previous studies show inconsistent results as to whether adolescents show similar, weaker, or non-significant conditioned placebo and nocebo effects compared to effects found in adults. There are suggestions that such differences (if any) may dependent on the cues used in the thermal conditioning paradigms. Therefore, in this current study, we utilized novel, neutral 3D-shaped visual cues to implicitly induce conditioned placebo-like and nocebo-like effects in adolescents and adults. Methods During the conditioning paradigm, distinct cues (Fribbles) were paired with low and high temperatures in 24 adults and 20 adolescents (mean age = 25.5 years). In the testing phase, these conditioned cues as well as a neutral (unconditioned) cue were presented with moderate temperatures. Results Thermal discomfort of moderate temperatures was lower when presented with the conditioned low heat cue (placebo-like effect) and higher when thermal stimuli were presented with the high heat cue (nocebo-like effect) compared to the neutral cue. The effects were driven by adults, as neither the placebo-like nor the nocebo-like effect was significant in adolescents. The difference between adolescents and adults was not explained by differences in temperature or discomfort levels, as adults and adolescents had comparable calibrated temperatures and levels of discomfort during heat stimuli. Conclusion Our findings suggest that thermal perception in adolescents is less influenced by conditioning to an engaging novel visual cue, compared to adults. Our work may have implications for better understanding the scope and limitations of conditioning as a key mechanism of placebo and nocebo effects in youth.
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Affiliation(s)
- Ella Weik
- Department of Psychiatry, BC Mental Health and Addictions Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Regula Neuenschwander
- Department of Pediatrics, BC Children’s Hospital Research Institute, University of British, Vancouver, BC, Canada
| | - Brinn Edgington
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Karin Jensen
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Christine M Tipper
- Department of Pediatrics, BC Children’s Hospital Research Institute, University of British, Vancouver, BC, Canada
| | - Tim F Oberlander
- Department of Psychiatry, BC Mental Health and Addictions Research Institute, University of British Columbia, Vancouver, BC, Canada
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Hohenschurz-Schmidt D, Vase L, Scott W, Annoni M, Ajayi OK, Barth J, Bennell K, Berna C, Bialosky J, Braithwaite F, Finnerup NB, Williams ACDC, Carlino E, Cerritelli F, Chaibi A, Cherkin D, Colloca L, Côté P, Darnall BD, Evans R, Fabre L, Faria V, French S, Gerger H, Häuser W, Hinman RS, Ho D, Janssens T, Jensen K, Johnston C, Juhl Lunde S, Keefe F, Kerns RD, Koechlin H, Kongsted A, Michener LA, Moerman DE, Musial F, Newell D, Nicholas M, Palermo TM, Palermo S, Peerdeman KJ, Pogatzki-Zahn EM, Puhl AA, Roberts L, Rossettini G, Tomczak Matthiesen S, Underwood M, Vaucher P, Vollert J, Wartolowska K, Weimer K, Werner CP, Rice ASC, Draper-Rodi J. Recommendations for the development, implementation, and reporting of control interventions in efficacy and mechanistic trials of physical, psychological, and self-management therapies: the CoPPS Statement. BMJ 2023; 381:e072108. [PMID: 37230508 DOI: 10.1136/bmj-2022-072108] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- David Hohenschurz-Schmidt
- Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Research Department, University College of Osteopathy, London, UK
| | - Lene Vase
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Denmark
| | - Whitney Scott
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London; INPUT Pain Management Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Marco Annoni
- Italian National Research Council, Interdepartmental Centre for Research Ethics and Integrity, Rome, Italy
| | - Oluwafemi K Ajayi
- Department of Arts and Music, College of Human Sciences, University of South Africa, Pretoria, South Africa
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Switzerland
| | - Kim Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, VIC, Australia
| | - Chantal Berna
- Centrer for Integrative and Complementary Medicine, Pain Center, Division of Anesthesiology, Sense Institute, Lausanne University Hospital, Lausanne University, Lausanne, Switzerland
| | - Joel Bialosky
- Department of Physical Therapy, University of Florida, Gainesville FL, USA; Brooks-PHHP Research Collaboration, Jacksonville, FL, USA
| | | | - Nanna B Finnerup
- Danish Pain Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Amanda C de C Williams
- Research Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Elisa Carlino
- Department of Neuroscience Rita Levi Montalcini, University of Turin, Turin, Italy
| | | | - Aleksander Chaibi
- Department for Interdisciplinary Health Sciences, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Dan Cherkin
- Osher Center for Integrative Health, Department of Family Medicine, University of Washington, Seattle, WA, USA
| | - Luana Colloca
- Department of Pain and Translational Symptom Science, School of Nursing; Department of Anesthesiology, School of Medicine; University of Maryland, Baltimore, MD, USA
| | - Pierre Côté
- Faculty of Health Sciences, Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, ON, Canada
| | - Beth D Darnall
- Stanford Pain Relief Innovations Lab; Stanford University School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford, CA, USA
| | - Roni Evans
- Integrative Health & Wellbeing Research Program; Center for Spirituality and Healing, University of Minnesota, Minneapolis, MN, USA
| | - Laurent Fabre
- Centre Européen d'Enseignement Supérieur de l'Ostéopathie, Paris, France
| | - Vanda Faria
- Department of Psychology, Uppsala University, Uppsala, Sweden; Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany; Brain and Eye Pain Imaging Lab, Pain and Affective Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Simon French
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW, Australia
| | - Heike Gerger
- Erasmus MC, University Medical Centre Rotterdam, Department of General Practice, Rotterdam, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Winfried Häuser
- Department Psychosomatic Medicine and Psychotherapy, Technische Universität München, Munich, Germany
| | - Rana S Hinman
- Centre for Health, Exercise & Sports Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Dien Ho
- Center for Health Humanities, School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences, Boston MA, USA
| | - Thomas Janssens
- Health Psychology, KU Leuven; Ebpracticenet, Leuven, Belgium
| | - Karin Jensen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Chris Johnston
- BC Patient Safety & Quality Council's Patient Voices Network; Health Research BC's Partnership-Ready Network; Health Standards Organization's Emergency Management Technical Committee & Working Group
| | - Sigrid Juhl Lunde
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Denmark
| | - Francis Keefe
- Duke University, School of Medicine, Durham, NC, USA
| | - Robert D Kerns
- Departments of Psychiatry, Neurology, and Psychology, Yale University, New Haven, CT, USA
| | - Helen Koechlin
- Division of Psychosomatics and Psychiatry, University Children's Hospital Zurich; Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland; Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Chiropractic Knowledge Hub, Odense, Denmark
| | - Lori A Michener
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles CA, USA
| | - Daniel E Moerman
- College of Arts, Sciences, and Letters, Behavioral Sciences, University of Michigan, Dearborn, MI, USA
| | - Frauke Musial
- National Research Centre in Complementary and Alternative Medicine, Department of Community Medicine, Faculty of Health Science UiT, Arctic University of Norway, Tromsø, Norway
| | | | - Michael Nicholas
- Pain Management Research Institute, University of Sydney Medical School (Northern) and Kolling Institute of Medical Research at Royal North Shore Hospital, Sydney, Australia
| | - Tonya M Palermo
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Sara Palermo
- Diagnostic and Technology Department, Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Department of Psychology, University of Turin, Turin, Italy
| | - Kaya J Peerdeman
- Unit Health, Medical and Neuropsychology, Leiden University, Leiden, the Netherlands
| | - Esther M Pogatzki-Zahn
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany
| | | | - Lisa Roberts
- University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Giacomo Rossettini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Campus of Savona, Savona, Italy; School of Physiotherapy, University of Verona, Verona, Italy
| | - Susan Tomczak Matthiesen
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Denmark
| | - Martin Underwood
- Warwick Clinical Trials Unit; University of Warwick, Coventry, UK; University Hospitals Coventry and Warwickshire, Coventry, UK
| | - Paul Vaucher
- School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Switzerland
| | - Jan Vollert
- Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK; Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany; Neurophysiology, Mannheim Centre of Translational Neuroscience, Medical Faculty Mannheim, Heidelberg University, Germany; Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Germany
| | - Karolina Wartolowska
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Katja Weimer
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Centre, Ulm, Germany
| | - Christoph Patrick Werner
- School of Psychology, Faculty of Science, University of Sydney, Australia; Department of Clinical Research, University Hospital Basel, Switzerland
| | - Andrew S C Rice
- Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Jerry Draper-Rodi
- Research Department, University College of Osteopathy, London, UK
- National Council for Osteopathic Research, London, UK
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Sall Hansson K, Lindqvist G, Stening K, Fohlman J, Wojanowski A, Ponten M, Jensen K, Gerdle B, Elmqvist C. Efficacy of mecobalamin (vitamin B 12) in the treatment of long-term pain in women diagnosed with fibromyalgia: protocol for a randomised, placebo-controlled trial. BMJ Open 2023; 13:e066987. [PMID: 36997252 PMCID: PMC10069488 DOI: 10.1136/bmjopen-2022-066987] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
INTRODUCTION Fibromyalgia causes long-term pain. It affects at least 2% of the population, the majority being women. In addition, extended symptoms corresponding to vitamin B12 deficiency occur. Findings from several studies have indicated that vitamin B12 may be a possible treatment for pain in fibromyalgia. The aim of the proposed study is to evaluate whether vitamin B12 decreases pain sensitivity and the experience of pain (ie, hyperalgesia and allodynia) in women with fibromyalgia. METHODS AND ANALYSIS The study is a randomised, placebo-controlled, single-blind, clinical trial with two parallel groups which are administered mecobalamin (vitamin B12) or placebo over 12 weeks. 40 Swedish women aged 20-70 years with an earlier recorded diagnosis of fibromyalgia are randomised into the placebo group or the treatment group, each consisting of 20 participants. Outcomes consist of questionnaires measured at baseline and after 12 weeks of treatment. A final re-evaluation will then follow 12 weeks after treatment ends. The primary outcome is tolerance time, maximised to 3 min, which is assessed using the cold pressor test. In order to broaden the understanding of the lived experience of participants, qualitative interviews will be conducted using a phenomenological approach on a lifeworld theoretical basis (reflective lifeworld research approach). ETHICS AND DISSEMINATION The protocol for the study is approved by the local ethical committee at Linkoping (EPM; 2018/294-31, appendices 2019-00347 and 2020-04482). The principles of the Helsinki Declaration are followed regarding oral and written consent to participate, confidentiality and the possibility to withdraw participation from the study at any time. The results will primarily be communicated through peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER NCT05008042.
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Affiliation(s)
- Karin Sall Hansson
- Department of Health and Caring Sciences, Linnaeus University, Linnaeus University Faculty of Health and Life Sciences, Växjö, Sweden
- Faculty of Health and Life Sciences, Centre of Interprofessional Cooperation within Emergency care (CICE), Linnaeus University, Växjö, Sweden
| | - Gunilla Lindqvist
- Department of Health and Caring Sciences, Linnaeus University, Linnaeus University Faculty of Health and Life Sciences, Växjö, Sweden
| | - Kent Stening
- Department of Health and Caring Sciences, Linnaeus University, Linnaeus University Faculty of Health and Life Sciences, Växjö, Sweden
| | - Jan Fohlman
- Department of Research and development, Region Kronoberg, Vaxjo, Sweden
| | - Anna Wojanowski
- Department of Research and development, Region Kronoberg, Vaxjo, Sweden
| | - Moa Ponten
- The Pain Neuroimagine Lab, Karolinska Institute, Stockholm, Sweden
| | - Karin Jensen
- The Pain Neuroimagine Lab, Karolinska Institute, Stockholm, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linkopings Universitet, Linkoping, Sweden
| | - Carina Elmqvist
- Department of Health and Caring Sciences, Linnaeus University, Linnaeus University Faculty of Health and Life Sciences, Växjö, Sweden
- Faculty of Health and Life Sciences, Centre of Interprofessional Cooperation within Emergency care (CICE), Linnaeus University, Växjö, Sweden
- Department of Research and development, Region Kronoberg, Vaxjo, Sweden
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Rushton LM, Pyragius T, Meraki A, Elson L, Jensen K. Unshielded portable optically pumped magnetometer for the remote detection of conductive objects using eddy current measurements. Rev Sci Instrum 2022; 93:125103. [PMID: 36586912 DOI: 10.1063/5.0102402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/06/2022] [Indexed: 06/17/2023]
Abstract
Electrically conductive objects can be detected using the principle of electromagnetic induction, where a primary oscillating magnetic field induces eddy currents in the object, which in turn produce a secondary magnetic field that can be measured with a magnetometer. We have developed a portable radio-frequency optically pumped magnetometer (RF OPM) working in unshielded conditions with sub-pT/Hz magnetic field sensitivity when used for the detection of small oscillating magnetic fields, setting a new benchmark for the sensitivity of a portable RF OPM in unshielded conditions. Using this OPM, we have detected the induced magnetic field from aluminum disks with diameters as small as 1.5 cm and with the disks being ∼25 cm from both the excitation coil and the magnetometer. When used for eddy current detection, our magnetometer achieves a sensitivity of a 2-6 pT/Hz. We have also detected a moving aluminum disk using our RF OPM and analyzed the magnetometer signals, which depend on the position of the disk, illustrating the potential of high sensitivity RF OPMs for remote sensing applications.
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Affiliation(s)
- L M Rushton
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
| | - T Pyragius
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
| | - A Meraki
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
| | - L Elson
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
| | - K Jensen
- School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
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Gedin F, Blomé S, Pontén M, Lalouni M, Fust J, Raquette A, Vadenmark Lundquist V, Thompson WH, Jensen K. Placebo Response and Media Attention in Randomized Clinical Trials Assessing Cannabis-Based Therapies for Pain: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2243848. [PMID: 36441553 PMCID: PMC9706362 DOI: 10.1001/jamanetworkopen.2022.43848] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IMPORTANCE Persistent pain is a common and disabling health problem that is often difficult to treat. There is an increasing interest in medicinal cannabis for treatment of persistent pain; however, the limited superiority of cannabinoids over placebo in clinical trials suggests that positive expectations may contribute to the improvements. OBJECTIVE To evaluate the size of placebo responses in randomized clinical trials in which cannabinoids were compared with placebo in the treatment of pain and to correlate these responses to objective estimates of media attention. DATA SOURCES A systematic literature search was conducted within the MEDLINE and Embase databases. Studies published until September 2021 were considered. STUDY SELECTION Cannabinoid studies with a double-blind, placebo-controlled design with participants 18 years or older with clinical pain of any duration were included. Studies were excluded if they treated individuals with HIV/AIDS or severe skin disorders. DATA EXTRACTION AND SYNTHESIS The study followed the Preferred Reporting Items for Systematic Review and Meta-analyses reporting guideline. Data were extracted by independent reviewers. Quality assessment was performed using the Risk of Bias 2 tool. Attention and dissemination metrics for each trial were extracted from Altmetric and Crossref. Data were pooled and analyzed using a random-effects statistical model. MAIN OUTCOMES AND MEASURES Change in pain intensity from before to after treatment, measured as bias-corrected standardized mean difference (Hedges g). RESULTS Twenty studies, including 1459 individuals (mean [SD] age, 51 [7] years; age range, 33-62 years; 815 female [56%]), were included. Pain intensity was associated with a significant reduction in response to placebo, with a moderate to large effect size (mean [SE] Hedges g, 0.64 [0.13]; P < .001). Trials with low risk of bias had greater placebo responses (q1 = 5.47; I2 = 87.08; P = .02). The amount of media attention and dissemination linked to each trial was proportionally high, with a strong positive bias, but was not associated with the clinical outcomes. CONCLUSIONS AND RELEVANCE Placebo contributes significantly to pain reduction seen in cannabinoid clinical trials. The positive media attention and wide dissemination may uphold high expectations and shape placebo responses in future trials, which has the potential to affect the outcome of clinical trials, regulatory decisions, clinical practice, and ultimately patient access to cannabinoids for pain relief.
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Affiliation(s)
- Filip Gedin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sebastian Blomé
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Moa Pontén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Maria Lalouni
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jens Fust
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Andreé Raquette
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - William H. Thompson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Applied Information Technology, University of Gothenburg, Gothenburg, Sweden
| | - Karin Jensen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Pittkowski R, Stoian D, Arenz M, Jensen K. Understanding the material formation of high-entropy alloy nanoparticles: in situ study using coupled X-ray diffraction/ absorption spectroscopy. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322094566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Argota-Perez R, Sharma MB, Elstrøm UV, Møller DS, Grau C, Jensen K, Holm AIS, Korreman SS. Dose and robustness comparison of nominal, daily and accumulated doses for photon and proton treatment of sinonasal cancer. Radiother Oncol 2022; 173:102-108. [PMID: 35667574 DOI: 10.1016/j.radonc.2022.05.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The aim was to evaluate and compare the dosimetric effect and robustness towards day-to-day anatomical and setup variations in the delivered dose for photon and proton treatments of sinonasal cancer (SNC) patients. MATERIALS AND METHODS Photon (VMAT) and proton (IMPT) plans were optimized retrospectively for 24 SNC patients. Synthetic CTs (synCT) were obtained by deforming the planning CT (pCT) to the anatomy of every daily cone-beam CT. Both VMAT and IMPT plans were recalculated on the synCTs. The recalculated daily dose was accumulated over the whole treatment on the pCT. Target coverage and dose to organs and risk (OARs) were evaluated for all patients for the nominal, daily and accumulated dose distribution. RESULTS In general, dose to OARs farther away from the target, including brain, chiasm and contralateral optic nerve, was lower for proton plans than photon plans. Whereas, OARs in proximity of the target received a lower dose for photon plans. For proton plans, the target coverage (volume of CTV receiving 95% of prescribed dose), V95%, fell below 99% for 9/24 patients in one or more fractions. For photon plans, 4/24 patients had one or more fractions where V95% fell below 99%. For accumulated doses, V95% was below 99% only in two cases, but above 98% for all patients. CONCLUSION Photon and proton treatment have different strengths regarding OAR sparing. The robustness was high for both treatment modalities. Patient selection for either proton or photon radiation therapy of SNC patients should be based on a case-by-case comparison.
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Affiliation(s)
- R Argota-Perez
- Department of Oncology, Aarhus University Hospital, Denmark
| | - M B Sharma
- Department of Oncology, Aarhus University Hospital, Denmark
| | - U V Elstrøm
- Danish Center for Particle Therapy, Aarhus University Hospital, Denmark
| | - D S Møller
- Department of Oncology, Aarhus University Hospital, Denmark
| | - C Grau
- Department of Oncology, Aarhus University Hospital, Denmark; Danish Center for Particle Therapy, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | - K Jensen
- Danish Center for Particle Therapy, Aarhus University Hospital, Denmark
| | - A I S Holm
- Department of Oncology, Aarhus University Hospital, Denmark.
| | - S S Korreman
- Department of Oncology, Aarhus University Hospital, Denmark; Danish Center for Particle Therapy, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
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Caira JN, Jensen K. Diversity and phylogenetic relationships of 'tetraphyllidean' Clade 3 (Cestoda) based on new material from orectolobiform sharks in Australia and Taiwan. Folia Parasitol (Praha) 2022; 69. [DOI: 10.14411/fp.2022.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/03/2022] [Indexed: 11/19/2022]
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Sojat Tarp I, Taasti V, Jensen M, Vestergaard A, Jensen K. PO-1502 The clinical benefit of range uncertainty reduction in robust optimization for proton therapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03466-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nowicka-Matus K, Friborg J, Hansen C, Andersen E, Bernsdorf M, Elstrøm U, Farhadi M, Grau C, Eriksen J, Johansen J, Nielsen M, Petersen J, Samsøe E, Sibolt P, Smulders B, Jensen K. OC-0089 Acute toxicities in proton therapy of head-neck cancer – a matched analysis of DAHANCA 35 pilot data. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02465-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Elstroem U, Noerrevang O, Jensen K. PO-1727 Robust optimization for IMPT in head and neck cancer with coupled vs. uncoupled scenarios. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03691-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bhattacharjee A, Johnson E, Perez-Pinera P, Jensen K. Development and Implementation of a Remote Enzyme Kinetics Laboratory Exercise. J Microbiol Biol Educ 2022; 23:e00286-21. [PMID: 35496683 PMCID: PMC9053035 DOI: 10.1128/jmbe.00286-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic imposed many new challenges on educational systems and increased the demand for novel strategies for effectively teaching laboratory skills without in-person instruction and without access to laboratory space, including critical specialized equipment. While this novel remote instruction modality is compatible with teaching the theory behind experimental techniques, the lack of lab activities that enable learning of laboratory skills severely limits the outcome of instruction. In order to overcome this problem and effectively supplement lectures with hands-on laboratory exercises, we developed an at-home enzyme kinetics lab that provides a safe alternative to traditional enzyme kinetics instructional labs typically performed in a laboratory setting. The combination of a simple design of the activity, accessibility of equipment used, and relatively low overall cost yields an effective exercise for teaching experimental design and basic laboratory skills remotely while providing a unique opportunity for students to learn about enzyme kinetics.
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Affiliation(s)
- Abhishek Bhattacharjee
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Eileen Johnson
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Pablo Perez-Pinera
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Cancer Center at Illinois, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Biomedical and Translational Sciences, Carle-Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Karin Jensen
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
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Vestergaard M, Jensen K, Juul-Kristensen B. Hybrid high-intensity interval training using functional electrical stimulation leg cycling and arm ski ergometer for people with spinal cord injuries: a feasibility study. Pilot Feasibility Stud 2022; 8:43. [PMID: 35193705 PMCID: PMC8862540 DOI: 10.1186/s40814-022-00997-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 01/31/2022] [Indexed: 11/22/2022] Open
Abstract
Aim The aim was to assess safety and feasibility of Hybrid High-Intensity Interval Training (HIIT) using Functional Electrical Stimulation (FES) leg cycling and arm ski ergometer in people with Spinal Cord Injuries (SCI). Method Eight outpatients (mean age 42.8 years; 7 men) with stable SCI paraplegia (mean 14.5 years since injury) participated in hybrid HIIT (90% peak watts; 4 × 4–min intervals), three times a week (over 8 weeks). Primary outcomes were Adverse Events (AE), participant acceptability, shoulder pain, training intensity (% peak watts), and attendance. Secondary outcomes were effect on peak oxygen uptake (VO2peak) during FES hybrid poling, mean watts, self-reported leisure time physical activity, quality of life, and fatigue. Results No serious AE occurred; acceptability with the training modality was high, while shoulder pain increased by 9% (SD 95.2). During training, 50% of the participants reached > 90% peak watts during the intervals, three with the legs (FES cycle) and one with the arms (Ski-Erg). Overall, mean training intensity (% peak watts) was 92% (SD 18.9) for legs and 82% (SD 10.3) for arms. Proportion of fulfilled training minutes was 82% (range 36–100%); one participant dropped out after 6 weeks due to back pain. Mean VO2peak increased by 17% (SD 17.5). Participants reported increased leisure time physical activity and health-related quality of life, besides reduced fatigue. Conclusion Hybrid HIIT was safe for people with SCI paraplegia. The majority of the criteria for feasibility were met with acceptable attendance rate, limited drop out, participants enjoyed training, and increased VO2peak and mean watts. However, the intensity of 90% peak watts was reached by < 60% of the participants despite high RPE ratings during training. The method of measuring and calculating intensity needs to be studied further before a study using this HIIT protocol is undertaken. Trial registration Clinicaltrials.gov, NCT04211311, registered 12 December 2019 retrospectively registered Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-00997-2.
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Jensen K, Caira JN. Phylogenetic analysis and diversity of peculiar new lecanicephalidean tapeworms (Eniochobothriidae) from cownose rays across the globe. INVERTEBR SYST 2022. [DOI: 10.1071/is22018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Hansen C, Friborg J, Skyt P, Smulders B, Sibolt P, Nielsen M, Samsøe E, Petersen J, Johansen J, Zukauskaite R, Andersen E, Andersen M, Farhadi M, Eriksen J, Overgaard J, Grau C, Jensen K. Photon-proton dose plan comparison in the pilot phase of the randomized clinical DAHANCA 35 trial. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00106-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lagerbäck T, Kastrati G, Möller H, Jensen K, Skorpil M, Gerdhem P. MRI Characteristics at a Mean of Thirteen Years After Lumbar Disc Herniation Surgery in Adolescents: A Case-Control Study. JB JS Open Access 2021; 6:JBJSOA-D-21-00081. [PMID: 34841186 PMCID: PMC8613359 DOI: 10.2106/jbjs.oa.21.00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to describe the prevalence of lumbar spine degeneration in adult individuals who had undergone lumbar disc herniation surgery during adolescence.
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Affiliation(s)
- Tobias Lagerbäck
- Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden.,Department of Reconstructive Orthopedics, Karolinska University Hospital, Stockholm, Sweden
| | - Gránit Kastrati
- Department of Clinical Neuroscience, Division of Neuro, Karolinska Institutet, Stockholm, Sweden
| | - Hans Möller
- Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden.,Center for Spine Surgery in Stockholm, Södra Fiskartorpsvägen, Stockholm, Sweden
| | - Karin Jensen
- Department of Clinical Neuroscience, Division of Neuro, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Skorpil
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - Paul Gerdhem
- Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden.,Department of Reconstructive Orthopedics, Karolinska University Hospital, Stockholm, Sweden
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Abstract
Background and purpose - Emerging evidence from sham-controlled trials suggest that surgical treatment entails substantial non-specific treatment effects in addition to specific surgical effects. Yet, information on surgeons' actual behaviors and beliefs regarding non-specific treatment and placebo effects is scarce. We determined surgeons' clinical behaviors and attitudes regarding placebo effects.Methods - A national online survey was developed in collaboration with surgeons and administered via an electronic link.Results - All surgical clinics in Sweden were approached and 22% of surgeons participated (n = 105). Surgeons believed it was important for them to interact and build rapport with patients before surgery rather than perform surgery on colleagues' patients (90%). They endorsed the importance of non-specific treatment effects in surgery generally (90%) and reported that they actively harness non-specific treatment effects (97%), including conveying confidence and calm (87%), building a positive interaction (75%), and making eye contact (72%). In communication regarding the likely outcomes of surgery, surgeons emphasized accurate scientific information of benefits/risks (90%) and complete honesty (63%). A majority felt that the improvement after some currently performed surgical procedures might be entirely explained by placebo effects (78%). Surgeons saw benefits with sham-controlled surgery trials, nevertheless, they were reluctant to refer patients to sham controlled trials (46%).Interpretation - Surgeons believe that their words and behaviors are important components of their professional competence. Surgeons saw the patient-physician relationship, transparency, and honesty as critical. Understanding the non-specific components of surgery has the potential to improve the way surgical treatment is delivered and lead to better patient outcomes.
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Affiliation(s)
- Annelie Rosén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lisbeth Sachs
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Amanda Ekdahl
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Westberg
- Department of Orthopedic Surgery, Capio Sankt Göran Hospital, Stockholm, Sweden
| | - Paul Gerdhem
- Department of Reconstructive Orthopedics, Karolinska University Hospital, Stockholm, Sweden,Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Ted J Kaptchuk
- Program in Placebo Studies, Beth Israel and Deaconess Hospital, Harvard Medical School, Boston, MA, USA
| | - Karin Jensen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden,Program in Placebo Studies, Beth Israel and Deaconess Hospital, Harvard Medical School, Boston, MA, USA,Correspondence: Karin Jensen, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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26
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Caira JN, Pickering M, Jensen K. Expanding known global biodiversity of Yamaguticestus (Cestoda: Phyllobothriidea) parasitizing catsharks (Pentanchidae and Scyliorhinidae). SYST BIODIVERS 2021. [DOI: 10.1080/14772000.2021.1946617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- J. N. Caira
- Department of Ecology & Evolutionary Biology, University of Connecticut, 75 N. Eagleville Rd, Storrs, CT, 06269-3043, USA
| | - M. Pickering
- Department of Biological Sciences, Meredith College, 3800 Hillsborough St, Raleigh, NC, 27607, USA
| | - K. Jensen
- Department of Ecology & Evolutionary Biology and the Biodiversity Institute, University of Kansas, 1200 Sunnyside Ave, Lawrence, KS, 66045, USA
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Argota Perez R, Sharma M, Elstroem U, Moeller D, Grau C, Jensen K, Korreman S, Holm A. OC-0203 Nominal, daily and accumulated target coverage for photon and proton treatment of sinonasal cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06818-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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28
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David B, Li J, Masood F, Blassick C, Jensen P, Jensen K. Laboratory Exercise to Measure Plasmid Copy Number by qPCR. J Microbiol Biol Educ 2021; 22:jmbe00125-21. [PMID: 34594455 PMCID: PMC8442022 DOI: 10.1128/jmbe.00125-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
Quantitative PCR (qPCR) has numerous applications in biology. In an educational setting, qPCR provides students an opportunity to better understand the PCR mechanism by providing both quantitative information about the reactions and also data to troubleshoot PCRs (e.g., melt curves). Here, we present a relatively short (2-h) laboratory activity to demonstrate qPCR to quantify plasmid copy number (CN) by measuring the cycle threshold (CT ) values for a genomic gene and a plasmid gene using transformed cells as a template. The activity can be combined with additional laboratory exercises, including bacterial transformation, to create the template to be used in the qPCRs. This lab activity is ideal for undergraduate laboratory courses that include recombinant DNA technology. (This work was presented at the 2020 Biomedical Engineering Society annual meeting).
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Affiliation(s)
- Benjamin David
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Jinbei Li
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Faisal Masood
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Caroline Blassick
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
| | - Paul Jensen
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Karin Jensen
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
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Weik E, Neuenschwander R, Jensen K, Oberlander TF, Tipper C. Placebo and nocebo effects in youth: subjective thermal discomfort can be modulated by a conditioning paradigm utilizing mental states of low and high self-efficacy. Br J Pain 2021; 16:60-70. [PMID: 35111315 PMCID: PMC8801682 DOI: 10.1177/20494637211020042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Conditioning is a key mechanism of placebo and nocebo effects in adults, but little is known about these effects in youth. This study investigated whether personalized verbal cues evoking a sense of high or low self-efficacy can induce conditioned placebo and nocebo effects on subjective discomfort of noxious heat in youth. Methods: In a structured interview, 26 adolescents (13–18 years) described personal situations in which they experienced a sense of high, low or neutral self-efficacy. Participants were then asked to recall these memories during a conditioning paradigm, in which a high thermal stimulus applied to the forearm was repeatedly paired with a low self-efficacy cue and a low thermal stimulus with a high self-efficacy cue. In a testing phase, high, low and neutral self-efficacy cues were paired with the same moderate temperature. We hypothesized that conditioned high and low self-efficacy cues would induce conditioned placebo and nocebo responses to moderate temperatures. Results: Moderate temperatures were rated as more uncomfortable when paired with the conditioned low compared with the neutral self-efficacy cue (nocebo effect). While in the whole-group analysis, there was no significant difference between ratings of moderate thermal stimuli paired with high compared with neutral self-efficacy cues (placebo effect), a sub-group of participants with a greater range of emotional valence between high and neutral self-efficacy cues revealed a significant placebo effect. The strength of the nocebo effect was associated with higher anxiety and lower hope. Conclusion: Conditioned associations using internal self-efficacy states can change subjective discomfort of thermal sensations.
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Affiliation(s)
- Ella Weik
- Department of Psychiatry, BC Mental Health and Addictions Research Institute, The University of British Columbia, Vancouver, BC, Canada
- Department of Pediatrics, BC Children’s Hospital Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - Regula Neuenschwander
- Department of Pediatrics, BC Children’s Hospital Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - Karin Jensen
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Tim F Oberlander
- Department of Pediatrics, BC Children’s Hospital Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - Christine Tipper
- Department of Psychiatry, BC Mental Health and Addictions Research Institute, The University of British Columbia, Vancouver, BC, Canada
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Abstract
Naltrexone reversibly blocks the effects of opioids and has been shown to decrease placebo analgesia. However, it is not clear (1) to what extent naltrexone affects pain modulation in a nontreatment context, for example, in response to pain cues or (2) how naltrexone given prior to pain-cue learning shapes pain responses. In a double-blind procedure prior to pain-cue conditioning, 30 healthy participants were randomized to receive an oral dose of naltrexone (50 mg) or inert pill. During functional magnetic resonance imaging, high and low pain pressures were paired with two different visual cues: a high pain cue and a low pain cue (learning sequence). During a test sequence, medium levels of pressure were used for both cues and the difference in subjective pain ratings following high and low pain cues was calculated. Results showed significant conditioned pain responses across groups (P < .001); however, no significant difference between participants receiving naltrexone or inert pill (P = .193). There was a significant correlation between the difference in high and low pain ratings during the learning sequence and the effect of high and low pain cues during the test sequence (r = .575, P = .002). Functional magnetic resonance imaging analyses revealed no significant difference in brain activation between groups. Here, we demonstrate comparable learning of pain responses in participants treated with naltrexone or inert pill. The results point to the possibility that associative learning, and conditional responding to pain cues, is not dependent on endogenous opioids. Our results, using pain-cue conditioning to create reduced pain responses, contrast previous studies where opioid antagonists significantly reduced the placebo effect in treatment of pain.
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Affiliation(s)
- Moa Pontén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jens Fust
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Joar Guterstam
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
| | - Karin Jensen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Jawad MN, Bhattacharjee A, Lehmann R, Busza A, Perez-Pinera P, Jensen K. Remote Laboratory Exercise to Develop Micropipetting Skills. J Microbiol Biol Educ 2021; 22:jmbe-22-27. [PMID: 33884063 PMCID: PMC8012033 DOI: 10.1128/jmbe.v22i1.2399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/20/2020] [Indexed: 06/12/2023]
Abstract
The rapid spread of COVID-19 has fundamentally transformed our educational system. The need to protect both students and instructors from exposure to viral infection has required the implementation of remote instructional models. Although this alternative delivery approach can be successfully implemented to teach the theoretical foundations of multiple disciplines, teaching technical skills poses a major challenge, particularly in various biology fields, where observation of biological safety guidelines and the high cost of analytical equipment represent major impediments for remote instruction. To overcome this problem, we have developed a laboratory exercise to teach students how to use micropipettes that can be completed remotely using materials that can be purchased at a fraction of the cost of the instructional equipment normally reserved for in-person instruction. Our evaluation of the effectiveness of this remote lab indicated that the majority of students who participated in a survey believed they attained the learning objectives and felt confident in their lab technique after completing the exercises. The simplicity, relatively low cost, and effectiveness of this approach makes it highly adaptable for other classrooms and educational settings.
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Affiliation(s)
- Mona Noor Jawad
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL 61801
| | | | - Riley Lehmann
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL 61801
| | - Anna Busza
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL 61801
| | - Pablo Perez-Pinera
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL 61801
- Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, IL 61801
- Cancer Center at Illinois, University of Illinois Urbana-Champaign, Urbana, IL 61801
- Department of Biomedical and Translation Sciences, Carle-Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, IL 61801
| | - Karin Jensen
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL 61801
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Sharma M, Argota Perez R, Holm A, Korreman S, Jensen K, Elstrøm U, Grau C. Air variability in maxillary sinus during radiotherapy for sinonasal carcinoma. Clin Transl Radiat Oncol 2021; 27:36-43. [PMID: 33490653 PMCID: PMC7809099 DOI: 10.1016/j.ctro.2020.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/26/2020] [Accepted: 12/28/2020] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The aim was to characterise patterns and predictability of aeration changes in the ipsilateral maxillary sinus during intensity-modulated radiotherapy (IMRT) for sinonasal cancer (SNC), and in a sample evaluate the dosimetric effects of aeration changes for both photon and proton therapy. MATERIALS AND METHODS The study included patients treated with IMRT for SNC in a single institution in 2009-2017. The volume of air in the ipsilateral maxillary sinus was recorded in 1578 daily cone beam computer tomography (CBCT) from 53 patients. Patterns of changing air volumes were categorised as 'stable', increasing', 'decreasing', or 'erratic'. For the prediction analysis, categorisation was performed based both on the entire treatment course and the first five fractions (F1-5). Photon and proton therapy plans were generated for four patients, the one from each category with the largest aeration variation. Synthetic CT images were generated for each CBCT and all plans were recalculated on the daily synthetic CTs. RESULTS The absolute volume of air varied considerably during the treatment course, ranging from 0 to 25.9 cm3. Changes within a single participant varied in the range of 0-18.7 cm3. In the categorisation of patterns, most patients had increasing aeration of the sinus. Generally, patterns of aeration could not be predicted from F1-5. Patients categorised as increasing in F1-5 had the best prediction, with 78% predicted correctly as increasing for the entire treatment course. The numeric correlation coefficients for target coverage and air volume were low for 3/4 scenarios (photons 0.03-0.23, protons 0.26-0.48). No straightforward correlation between the dosimetric effect and the volume changes could be detected in the sample test of four patients for neither photon nor proton therapy. CONCLUSION The variation of aeration was large and unpredictable. No clear dosimetric consequences of the aeration variation were evident for neither IMRT nor proton therapy for the patients investigated.
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Affiliation(s)
- M.B. Sharma
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - R. Argota Perez
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - A.I.S. Holm
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - S.S. Korreman
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - K. Jensen
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - U.V. Elstrøm
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - C. Grau
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Jensen NH, Sze-Long Lo R, Hung K, Lorentzen M, Laugesen S, Posth S, Hansen S, Jensen K, Kellett J, Graham CA, Brabrand M. Thermographic visualization of facial vasoconstriction is associated with 30-day all-cause mortality in medical patients; prospective observational two-site cohort study. Acute Med 2021; 20:101-109. [PMID: 34190736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Quick and reliable assessment of acute patients is required for accurate triage. The temperature gradient between core and peripheral temperature could possibly instantly provide information on circulatory status. METHODS Adult medical patients, who did not receive supplementary oxygen, attending two emergency departments, had a thermographic image taken on arrival. The association between 30-day mortality and gradients was tested using logistic regression. RESULTS 726 patients were studied, median age was 64 years and 14 (1.9%) died within 30 days. There was a significant association between mortality and temperature gradient, comparable to vital signs, age, and clinical intuition. CONCLUSION Temperature gradient between nose and eye had an acceptable discriminatory power for 30-day all-cause mortality.
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Affiliation(s)
- N H Jensen
- Department of Emergency Medicine, Hospital of South West Jutland, Esbjerg, Denmark
| | - R Sze-Long Lo
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
| | - Kkc Hung
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
| | - M Lorentzen
- Department of Emergency Medicine, Hospital of South West Jutland, Esbjerg, Denmark
| | - S Laugesen
- Department of Emergency Medicine, Odense University Hospital, Odense, Denmark
| | - S Posth
- Department of Emergency Medicine, Odense University Hospital, Odense, Denmark
| | - S Hansen
- Department of Emergency Medicine, Odense University Hospital, Odense, Denmark
| | - K Jensen
- Department of Emergency Medicine, Odense University Hospital, Odense, Denmark
| | - J Kellett
- Department of Emergency Medicine, Hospital of South West Jutland, Esbjerg, Denmark
| | - C A Graham
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
| | - M Brabrand
- Department of Emergency Medicine, Hospital of South West Jutland, Esbjerg, Denmark
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Samsøe E, Jensen K, Hansen C, Skyt P, Friborg J, Smulders B, Bahij I, Schouboe A, Randers P, Vestergaard A. PO-1637: Strategy for adaptive proton therapy for patients with head and neck cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01655-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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35
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Kaplan L, Hansen C, Jensen K, Friborg J, Samsøe E, Johansen J, Andersen M, Smulders B, Andersen E, Nielsen M, Eriksen J, Petersen J, Elstrøm U, Holm A, Skyt P, Vestergaard A, Lorenzen E, Nielsen M, Marseguerra R, Morthorst M, Grau C, Korreman S. OC-0107: Quantitative metrics to analyze variations and support best practices in head and neck dose plans. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00133-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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36
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Hansen C, Van den Bosch L, Van der Laan H, Friborg J, Jensen K, Samsøe E, Johnsen L, Zukauskaite R, Grau C, Maare C, Johansen J, Primdahl H, Bratland Å, Kristensen C, Andersen M, Eriksen J, Langendijk J, Overgaard J, Van der Schaaf A. OC-0575: Type 4 validation of dysphagia NTCP model for selection of HNC patients to the RCT, DAHANCA35. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00597-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pries-Heje M, Hasselbalch R, Ihleman N, Gill S, Bruun N, Elming H, Jensen K, Oestergaard L, Helweg-Larsen J, Fosboel E, Koeber L, Toender N, Moser C, Iversen K, Bundgaard H. Hemoglobin level at stabilization is associated with long-term all-cause mortality in patients with left-sided endocarditis, a POET substudy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Left-sided infectious endocarditis (IE) has a high 1-year mortality. Anemia is a common finding in patients with IE, yet little is known about frequency, severity, and associated outcomes in this setting.
Purpose
To examine the relationship between Hemoglobin (Hgb) level measured at IE stabilization (time of randomization) in the Partial Oral versus intravenous Antibiotic Treatment of Endocarditis (POET) trial - and long-term all-cause mortality.
Methods
In the POET trial, 400 patients with left-sided IE were randomized, after medical and/or surgical stabilization, to conventional antibiotic treatment or partial oral treatment. Only non-surgically treated patients were considered in this study. Patients were divided by quartiles into four groups based on Hgb level at randomization.
Results
We examined 248 patients with non-surgically treated IE. Median time from diagnosis of IE to randomization was 14 days (IQ 12–19). At long-term follow-up (median 3.2 years, IQ 2.18–4.60), 71 patients had died (28.6%). Patients in the lowest quantile (Hgb ≤6.0 mmol) had a HR of 4.17 (95% CI 1.81–9.61, p<0.001) for death compared to patients in the highest quantile (Hgb >7.5 mmol/L). This association remained significant after multivariable adjustment for age, sex, renal disease, C-Reactive Protein, and Prosthetic heart valve (HR 2.69, 95% CI 1.11–6.50); p=0.028).
Conclusion
Low Hemoglobin level at stabilization in patients with IE was associated with an increased risk of long-term mortality. Whether intensified treatment of anemia in patients with IE could improve long-term outcome requires investigation.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The Danish Heart Foundation, The Capital Regions Research Council
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Affiliation(s)
- M Pries-Heje
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | | | - N Ihleman
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - S Gill
- Odense University Hospital, Department of Cardiology, Odense, Denmark
| | - N.E Bruun
- Zealand University Hospital, Department of Cardiology, Roskilde, Denmark
| | - H Elming
- Zealand University Hospital, Department of Cardiology, Roskilde, Denmark
| | - K Jensen
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - L Oestergaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - J Helweg-Larsen
- Rigshospitalet - Copenhagen University Hospital, Department of Infectious Diseases, Copenhagen, Denmark
| | - E.L Fosboel
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - L Koeber
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - N Toender
- Hillerod Hospital, Department of Cardiology, Hillerod, Denmark
| | - C Moser
- Rigshospitalet - Copenhagen University Hospital, Department of Clinical Microbiology, Copenhagen, Denmark
| | - K Iversen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - H Bundgaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
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Sharma MB, Jensen K, Amidi A, Eskildsen SF, Johansen J, Grau C. Late toxicity in the brain after radiotherapy for sinonasal cancer: Neurocognitive functioning, MRI of the brain and quality of life. Clin Transl Radiat Oncol 2020; 25:52-60. [PMID: 33024844 PMCID: PMC7530204 DOI: 10.1016/j.ctro.2020.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/31/2020] [Accepted: 09/07/2020] [Indexed: 12/12/2022] Open
Abstract
Compared with matched normative data, impaired cognitive function was substantial. Several correlations between radiation dose and cognitive impairment were present. Radiation-induced white matter hyperintensities were present in 2/27 participants. One participant displayed radiation-induced necrosis in the temporal lobe. The domains affecting quality of life the most were fatigue and quality of sleep.
Purpose The aim of the study was to evaluate neurocognitive late effects, structural alterations and associations between cognitive impairment and radiation doses as well as cerebral tissue damage after radiotherapy for sinonasal cancer. Furthermore, the aim was to report quality of life (QoL) and self-reported cognitive capacity. Materials and methods Recurrence-free patients previously treated with intensity-modulated radiotherapy with a curative intent were eligible for the study. Study examinations comprised comprehensive neurocognitive testing, MRI of the brain, and self-reported outcomes. Results A total of 27 patients were included. Median age was 67 years (range 47–83). The majority of test outcomes were below normative values in any degree, and 37% of the participants had clinically significant neurocognitive impairment when compared with normative data. Correlations between absorbed doses to specific substructures of the brain and neurocognitive outcomes were present for Wechsler’s Adult Intelligence Scale-digit span and Controlled Oral Word Association Test-S. Structural MRI revealed macroscopic abnormalities in three patients; infarction (n = 1), diffuse white matter intensities (n = 2) and necrosis (n = 1). In the analysis of atrophy of cerebral tissue, no correlations were present with neither radiation dose to cerebral substructures nor neurocognitive impairment. The global QoL of the cohort was 75. The most affected outcomes were ‘fatigue’, ‘insomnia’, and ‘drowsiness’. A total of 59% of participants reported significantly impaired quality of sleep. Self-reported cognitive function revealed that ‘memory’ was the most affected cognitive domain. For the domains of ‘memory’ and ‘language’, self-reported functioning was associated with objectively measured neurocognitive outcomes. Conclusion Cerebral toxicity after radiotherapy for sinonasal cancer was substantial. Clinically significant cognitive impairment was present in more than one third of the participants, and several dose–response associations were present. Furthermore, the presence of macroscopic radiation sequelae indicated considerable impact of radiotherapy on brain tissue.
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Affiliation(s)
- M B Sharma
- Department of Oncology, Aarhus University Hospital, Palle Juul Jensen Boulevard 99, DK-8200 Aarhus N, Denmark
| | - K Jensen
- Danish Center for Particle Therapy, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, B420, 8200 Aarhus N, Denmark
| | - A Amidi
- Unit for Psychooncology and Health Psychology, Department of Psychology, Aarhus University, Bartholins Allé 9, Build. 1351, 8000 Aarhus C, Denmark
| | - S F Eskildsen
- Center of Functionally Integrative Neuroscience, Aarhus University, Nørrebrogade 44, Build. 1A, 8000 Aarhus C, Denmark
| | - J Johansen
- Department of Oncology, Odense University Hospital, J.B. Winsløvs Vej 4, 5000 Odense, Denmark
| | - C Grau
- Department of Oncology, Aarhus University Hospital, Palle Juul Jensen Boulevard 99, DK-8200 Aarhus N, Denmark.,Danish Center for Particle Therapy, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, B420, 8200 Aarhus N, Denmark
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David B, Masood F, Jensen K. Development and Implementation of a Virtual Cell Culture Lab Practical for an Introductory BME Lab Course. Biomed Eng Educ 2020; 1:109-114. [PMID: 38624510 PMCID: PMC7453072 DOI: 10.1007/s43683-020-00016-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/05/2020] [Indexed: 11/30/2022]
Abstract
The transition to remote learning in response to the COVID-19 pandemic necessitated the adaptation of an in-person cell culture lab practical to a virtual assessment in an introductory biomedical engineering lab course. The virtual lab practical was administered in the course LMS and implemented video, data analysis, and multiple-choice questions. Average student scores and grade distributions were comparable across in-person and virtual lab practical formats. Instructors observed fewer grading concerns for the virtual practical compared to previous in-person offerings. The virtual lab practical may be preferred over in-person lab practical in future offerings due to decreased student stress, lower cost, reduced required instructor time, and limited availability of equipment. Resources developed for the virtual practical, including video tutorials and a hemocytometer simulator to practice calculations, can be used by other educators and as supplements to existing course material.
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Affiliation(s)
- Benjamin David
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL USA
| | - Faisal Masood
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL USA
| | - Karin Jensen
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL USA
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Tang H, Nolte S, Jensen K, Yang Z, Wu J, Mueller P. Grazing mediates soil microbial activity and litter decomposition in salt marshes. Sci Total Environ 2020; 720:137559. [PMID: 32325578 DOI: 10.1016/j.scitotenv.2020.137559] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/11/2020] [Accepted: 02/24/2020] [Indexed: 06/11/2023]
Abstract
Salt marshes contribute to climate change mitigation because of their great capacity to store organic matter (OM) in soils. Most of the research regarding OM turnover in salt marshes in times of global change focuses on effects of rising temperature and accelerated sea-level rise, while effects of land-use change have gained little attention. The present work investigates the mechanisms by which livestock grazing can affect OM decomposition in salt marsh soils. In a grazing exclusion experiment at the mouth of the Yangtze estuary, China, we assessed soil microbial exo-enzyme activity (EEA) to gain insight into the microbial carbon (C) and nitrogen (N) demand. Additionally, we studied the decomposition of plant litter in soil using the Tea Bag Index (TBI), a widely used standardized litter bag assay to fingerprint soil decomposition dynamics. Based on EEAs, grazing markedly reduced microbial C acquisition, whereas microbial N acquisition was strongly increased. These opposing grazing effects were also evident in the decomposition of standardized plant litter: The decomposition rate constant (k) and the stabilization (S) of litter were not inversely related, as would be expected, but instead both were reduced by livestock grazing. Our data suggest that gazing effects on EEAs and litter decomposition can just partly be explained by grazing-driven soil compaction and resulting lower oxygen availability, which has previously been hypothesized as a main pathway by which grazing can reduce microbial activity in wetland soils. Instead, grazing effects on microbial nutrient demand occurs to be an at least equally important control on soil decomposition processes.
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Affiliation(s)
- H Tang
- Plant Ecology, Institute of Plant Science and Microbiology, Universität Hamburg, Ohnhorststr. 18, 22609 Hamburg, Germany
| | - S Nolte
- Plant Ecology, Institute of Plant Science and Microbiology, Universität Hamburg, Ohnhorststr. 18, 22609 Hamburg, Germany; School of Environmental Sciences, University of East Anglia, Norwich Research Park, NR4 7TJ Norwich, UK; Centre for Environment, Fisheries and Aquaculture Science, Pakefield Rd, Lowestoft, UK
| | - K Jensen
- Plant Ecology, Institute of Plant Science and Microbiology, Universität Hamburg, Ohnhorststr. 18, 22609 Hamburg, Germany
| | - Z Yang
- Ministry of Education Key Laboratory for Biodiversity Science and Ecological Engineering, Coastal Ecosystems Research Station of Yangtze River Estuary, Institute of Biodiversity Science and Institute of Eco-Chongming, School of Life Sciences, Fudan University, 200433 Shanghai, PR China; Liupanshui Normal University, 553000 Liupanshui, PR China
| | - J Wu
- Ministry of Education Key Laboratory for Biodiversity Science and Ecological Engineering, Coastal Ecosystems Research Station of Yangtze River Estuary, Institute of Biodiversity Science and Institute of Eco-Chongming, School of Life Sciences, Fudan University, 200433 Shanghai, PR China
| | - P Mueller
- Smithsonian Environmental Research Center, Contees Wharf Rd 647, MD 21037, Edgewater, United States.
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Ruhnke TR, Daniel V, Jensen K. Four New Species of Paraorygmatobothrium (Eucestoda: Phyllobothriidea) from Sharks of the Gulf of Mexico and the Atlantic Ocean, with Comments on Their Host Specificity. J Parasitol 2020. [DOI: 10.1645/19-129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- T. R. Ruhnke
- Department of Biology, Barron Drive, West Virginia State University, Institute, West Virginia 25112-1000
| | - V. Daniel
- Department of Biology, Barron Drive, West Virginia State University, Institute, West Virginia 25112-1000
| | - K. Jensen
- Department of Ecology and Evolutionary Biology and the Biodiversity Institute, 1200 Sunnyside Ave., University of Kansas, Lawrence, Kansas 66045
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Ruhnke TR, Daniel V, Jensen K. Four New Species of Paraorygmatobothrium (Eucestoda: Phyllobothriidea) From Sharks of the Gulf of Mexico and the Atlantic Ocean, with Comments on Their Host Specificity. J Parasitol 2020; 106:133-156. [PMID: 32048913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
Four new species of Paraorygmatobothrium are described from carcharhinid shark species from the Gulf of Mexico and the U.S. coast of the northwestern Atlantic Ocean. Paraorygmatobothrium bullardi n. sp. is described from Carcharhinus brevipinna as its type host, and from Carcharhinus acronotus and Carcharhinus limbatus. Paraorygmatobothrium campbelli n. sp. is described from Rhizoprionodon terraenovae. Paraorygmatobothrium deburonae n. sp. is described from Carcharhinus isodon as its type host, as well as from C. brevipinna, C. limbatus, and R. terraenovae. Paraorygmatobothrium mattisi n. sp. is described from R. terraenovae as its type host, and from C. brevipinna and C. limbatus. These 4 species differ from other species of Paraorygmatobothrium and from each other in bothridial microthrix shape, and in various combinations of features such as the total length of the worm, apical sucker size, bothridial musculature, proglottid number, testes number, and genital pore position. Difficulty in differentiating these 4 species from one another, and from other species of Paraorygmatobothrium, points to limitations in the use of morphology alone to recognize species diversity in this genus. A phylogenetic analysis of Paraorygmatobothrium and related genera, based on partial (D1-D3) 28S rDNA sequence data, confirms that the genus is not monophyletic. Genetic distances of COI revealed that sequence divergence between species of Paraorygmatobothrium is generally at least an order of magnitude larger than COI divergence within a species. Patterns of host use for 3 of the new species are consistent with previous findings that point to a lack of host specificity in Paraorygmatobothrium.
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Affiliation(s)
- T R Ruhnke
- Department of Biology, Barron Drive, West Virginia State University, Institute, West Virginia 25112-1000
| | - V Daniel
- Department of Biology, Barron Drive, West Virginia State University, Institute, West Virginia 25112-1000
| | - K Jensen
- Department of Ecology and Evolutionary Biology and the Biodiversity Institute, 1200 Sunnyside Ave., University of Kansas, Lawrence, Kansas 66045
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Jensen K, Gollub RL, Kong J, Lamm C, Kaptchuk TJ, Petrovic P. Reward and empathy in the treating clinician: the neural correlates of successful doctor-patient interactions. Transl Psychiatry 2020; 10:17. [PMID: 32066692 PMCID: PMC7026171 DOI: 10.1038/s41398-020-0712-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/06/2019] [Accepted: 06/22/2019] [Indexed: 12/21/2022] Open
Abstract
The goal of this study was to determine the neural correlates of successful doctor-patient interactions. We performed an experimental neuroimaging study where medical doctors (MDs) performed a treatment task while their brain activation pattern was measured, using functional magnetic resonance imaging (fMRI). MDs (25-37 years old) first performed a standardized clinical exam of a "professional patient". Unbeknownst to the doctors, the professional patient was a confederate that rated the doctors' clinical examination using the Consultation And Relational Empathy (CARE) questionnaire, a standardized protocol assessing a clinician's social interaction during a consultation. After the clinical exam, MDs were placed inside a brain scanner and the patient was placed on a chair next to the MD. MDs performed a treatment task where an analgesic device was used to alleviate the patient's pain (experimentally induced), while the MD's brain activity was measured with fMRI. MDs rated their own empathic concern (equivalent of compassion) and personal distress using the Interpersonal Reactivity Index questionnaire. The patient's rating of CARE was robustly related to the MD's own ratings of trait empathic concern and to compassion-related and reward-related activation of medial frontal brain regions during treatment. In contrast, there was no relation with MD's personal distress, nor with activation in regions associated with the aversive component of experiencing empathy. We conclude that a patient's positive experience of a medical examination is reflected in doctors' empathic concern and reward-related brain activations during treatment, suggesting that compassion and pleasure are key factors for successful doctor-patient interactions.
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Affiliation(s)
- Karin Jensen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Randy L. Gollub
- grid.38142.3c000000041936754XDepartment of Psychiatry and Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA
| | - Jian Kong
- grid.38142.3c000000041936754XDepartment of Psychiatry and Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA
| | - Claus Lamm
- grid.10420.370000 0001 2286 1424Social, Cognitive and Affective Neuroscience Unit, Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Ted J. Kaptchuk
- grid.38142.3c000000041936754XProgram in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA
| | - Predrag Petrovic
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Neuenschwander R, Weik E, Tipper CM, Jensen K, Oberlander TF. Conditioned Placebo- and Nocebo-Like Effects in Adolescents: The Role of Conscious Awareness, Sensory Discrimination, and Executive Function. Front Psychiatry 2020; 11:586455. [PMID: 33329131 PMCID: PMC7710613 DOI: 10.3389/fpsyt.2020.586455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/23/2020] [Indexed: 11/26/2022] Open
Abstract
Background: Conditioning is a key mechanism of placebo and nocebo effects in adults. Little is known about the underlying mechanisms of placebo and nocebo effects in youth and how they might be influenced by conscious awareness and cognitive abilities. In this study, the role of conditioning on thermal perception in youth was investigated. Methods: Differences in thermal ratings were assessed in response to consciously and non-consciously perceived cues that were conditioned to either low or high heat. Furthermore, we tested whether executive function mediates the effect of conditioning on thermal perception. Thirty-five high-school students (14-17 years) completed an executive function task and underwent a sensory perception paradigm. In a conditioning phase, two distinct neutral faces (conditioned cues) were coupled to either a low or a high temperature stimulus delivered to participants' forearms. In a testing phase, the conditioned cues, and novel faces (non-conditioned control cues), were paired with identical moderate thermal stimuli. In this testing phase, for half of the participants cues were presented consciously (supraliminally) and for the other half non-consciously (subliminally). Results: We found a significant main effect of cue type on thermal ratings (p = 0.003) in spite of identical heat being administered following all cues. Post-hoc analyses indicated that the nocebo-like effect (conditioned high cue compared to control) was significant (p = 0.027); the placebo-like effect (conditioned low cue compared to control) was non-significant. No difference between cues presented supra- vs. subliminally and no significant interaction effects were found. The association between sensory discrimination and the magnitude of the nocebo-like effect was mediated by executive function. Conclusions: To our best knowledge, this is the first study establishing a relationship between thermal perception, nocebo effects, and executive function in youth. Our results may have important implications for understanding cognitive/ learning processes involved in nocebo effects.
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Affiliation(s)
- Regula Neuenschwander
- Department of Pediatrics, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada.,Institute of Psychology, University of Bern, Bern, Switzerland
| | - Ella Weik
- Department of Psychiatry, BC Mental Health and Substance Use Services Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Christine M Tipper
- Department of Psychiatry, BC Mental Health and Substance Use Services Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Karin Jensen
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Tim F Oberlander
- Department of Pediatrics, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
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Shinn E, Jensen K, McLaughlin J, Garden A, Fellman B, Liang L, Peterson S. Interactive website for head and neck cancer patients: Adherence and coping program to prevent dysphagia after radiation. Internet Interv 2019; 18:100289. [PMID: 31890636 PMCID: PMC6926207 DOI: 10.1016/j.invent.2019.100289] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/19/2019] [Accepted: 10/22/2019] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Pharyngeal and laryngeal cancers are highly curable; however survivors are at high risk for long-term dysphagia after radiation. To address lack of access to preventive care in community settings, we developed a responsive web-based application to help patients adhere to preventive swallowing exercises and cope with radiation side effects. We conducted an interim study analysis to determine website usage characteristics and to examine the effect size for future trials. METHODS Pharyngeal and laryngeal cancer patients were recruited for enrollment by speech language pathologists before primary radiation and introduced to the interactive website. The program (English and Spanish) features tracking logs for preventive exercises, instructional videos, patient stories and search features. Patients' self-reported swallowing function was assessed with the MD Anderson Dysphagia Inventory (MDADI) at baseline and at 6 months. Adherence to preventive exercises was assessed during the 10 week intervention. Number of unique website visits, total duration of website exposure, and rankings of the most popular webpages were calculated. Preliminary regression models were run using adherence and MDADI as outcomes. RESULTS Of the 160 enrolled, 96 had 10-week adherence data and 61 had 6-month MDADI data. The average age was 63 (SD = 12.26), 49.4% were from rural counties, 44% had a high school education or lower, and 42% reported annual income of $30,000 or less. The average number of visits was 5.49 (SD = 9.96) and the average total time spent with the website was 41.09 min (SD =88.48). Preliminary analyses indicated that number of unique visits to the website was independently associated with increased adherence to preventive exercises (p = .001-.008). CONCLUSION Our website showed significant effects in promoting adherence to swallowing exercises. However, our return visit rate showed that the platform needs improvement in navigability and usability for this older population undergoing challenging treatment in community settings with low resources.
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Affiliation(s)
- E.H. Shinn
- Department of Behavioral Science, University of Texas M. D. Anderson Cancer Center, United States of America
| | - K. Jensen
- Texas Health Care- Head and Neck Cancer Center of Texas, THC-PLLC, United States of America
| | | | - A.S. Garden
- Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, United States of America
| | - B.M. Fellman
- Department of Biostatistics, University of Texas M. D. Anderson Cancer Center, United States of America
| | - Li Liang
- Department of Biostatistics, University of Texas M. D. Anderson Cancer Center, United States of America
| | - S.K. Peterson
- Department of Behavioral Science, University of Texas M. D. Anderson Cancer Center, United States of America
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Blassick C, David B, Storm A, Jensen P, Jensen K. Laboratory Exercise To Measure Restriction Enzyme Kinetics. J Microbiol Biol Educ 2019; 20:jmbe-20-53. [PMID: 31768213 PMCID: PMC6853781 DOI: 10.1128/jmbe.v20i3.1703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 06/18/2019] [Indexed: 06/10/2023]
Abstract
Enzymes are ubiquitous in the fields of biology and microbiology, catalyzing critical reactions and enabling a broad range of biotechnological applications. Despite the important role that enzyme catalysis plays in biological processes, undergraduate students often struggle to understand enzyme kinetics in the classroom. In an attempt to improve students’ understanding of the topic, we present a relatively short and inexpensive laboratory activity designed to give students hands-on experience with generating and manipulating enzyme kinetic data. Students perform restriction digests of DNA at various time points, visualize the reaction products on an agarose gel, and quantify their data in order to construct Lineweaver-Burk plots which compare the effects of a restriction enzyme and its engineered version. The activity may be completed in a single two-hour lab session and, unlike other enzyme assays designed for laboratory courses, does not require a microplate reader to complete. The activity allows students to see connections between a visual data set and quantitative kinetic data, in order to solidify their understanding of enzyme kinetics. Students also learn the skills of gel electrophoresis and image quantification using ImageJ software. This lab activity is ideal for undergraduate laboratory courses which address enzyme kinetics and DNA technology.
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Affiliation(s)
- Caroline Blassick
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Benjamin David
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Audra Storm
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Paul Jensen
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Karin Jensen
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801
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Hansen CR, Friborg J, Jensen K, Samsøe E, Johnsen L, Zukauskaite R, Grau C, Maare C, Johansen J, Primdahl H, Bratland Å, Kristensen CA, Andersen M, Eriksen JG, Overgaard J. NTCP model validation method for DAHANCA patient selection of protons versus photons in head and neck cancer radiotherapy. Acta Oncol 2019; 58:1410-1415. [PMID: 31432744 DOI: 10.1080/0284186x.2019.1654129] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Introduction: Prediction models using logistic regression may perform poorly in external patient cohorts. However, there is a need to standardize and validate models for clinical use. The purpose of this project was to describe a method for validation of external NTCP models used for patient selection in the randomized trial of protons versus photons in head and neck cancer radiotherapy, DAHANCA 35. Material and methods: Organs at risk of 588 patients treated primarily with IMRT in the randomized controlled DAHANCA19 trial were retrospectively contoured according to recent international recommendations. Dose metrics were extracted using MatLab and all clinical parameters were retrieved from the DAHANCA database. The model proposed by Christianen et al. to predict physician-rated dysphagia was validated through the closed testing, where change of the model intercept, slope and individual beta's were tested for significant prediction improvements. Results: Six months prevalence of dysphagia in the validation cohort was 33%. The closed testing procedure for physician-rated dysphagia showed that the Christianen et al. model needed an intercept refitting for the best match for the Danish patients. The intercept update increased the risk of dysphagia for the validation cohort by 7.9 ± 2.5% point. For the raw model performance, the Brier score (mean squared residual) was 0.467, which improved significantly with a new intercept to 0.415. Conclusions: The previously published Dutch dysphagia model needed an intercept update to match the Danish patient cohort. The implementation of a closed testing procedure on the current validation cohort allows quick and efficient validation of external NTCP models for patient selection in the future.
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Affiliation(s)
- C. R. Hansen
- Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
- Institute of Medical Physics, School of Physics, The University of Sydney, Sydney, Australia
| | - J. Friborg
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | - K. Jensen
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - E. Samsøe
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
- Department of Oncology, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - L. Johnsen
- Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark
| | - R. Zukauskaite
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - C. Grau
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - C. Maare
- Department of Oncology, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - J. Johansen
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - H. Primdahl
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Å. Bratland
- The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | | | - M Andersen
- Department of Oncology, Aalborg University Hospital, Aalborg, Denmark
| | - J. G. Eriksen
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - J. Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
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Bjarnason-Wehrens B, Nebel R, Jensen K, Hackbusch M, Grilli M, Gielen S, Schwaab B, Rauch B. Exercise-based cardiac rehabilitation in patients with reduced left ventricular ejection fraction: The Cardiac Rehabilitation Outcome Study in Heart Failure (CROS-HF): A systematic review and meta-analysis. Eur J Prev Cardiol 2019; 27:929-952. [PMID: 31177833 PMCID: PMC7272131 DOI: 10.1177/2047487319854140] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background In heart failure with reduced left ventricular ejection fraction (HFrEF)
patients the effects of exercise-based cardiac rehabilitation on top of
state-of-the-art pharmacological and device therapy on mortality,
hospitalization, exercise capacity and quality-of-life are not well
established. Design The design of this study involved a structured review and meta-analysis. Methods Evaluation of randomised controlled trials of exercise-based cardiac
rehabilitation in HFrEF-patients with left ventricular ejection fraction
≤40% of any aetiology with a follow-up of ≥6 months published in 1999 or
later. Results Out of 12,229 abstracts, 25 randomised controlled trials including 4481
HFrEF-patients were included in the final evaluation. Heterogeneity in study
population, study design and exercise-based cardiac
rehabilitation-intervention was evident. No significant difference in the
effect of exercise-based cardiac rehabilitation on mortality compared to
control-group was found (hazard ratio 0.75, 95% confidence interval
0.39–1.41, four studies; 12-months follow-up: relative risk 1.29, 95%
confidence interval 0.66–2.49, eight studies; six-months follow-up: relative
risk 0.91, 95% confidence interval 0.26–3.16, seven studies). In addition
there was no significant difference between the groups with respect to
‘hospitalization-for-any-reason’ (12-months follow-up: relative risk 0.79,
95% confidence interval 0.41–1.53, four studies), or
‘hospitalization-due-to-heart-failure’ (12-months follow-up: relative risk
0.59, 95% confidence interval 0.12–2.91, four studies; six-months follow-up:
relative risk 0.84, 95% confidence interval 0.07–9.71, three studies). All
studies show improvement of exercise capacity. Participation in
exercise-based cardiac rehabilitation significantly improved quality-of-life
as evaluated with the Kansas City Cardiomyopathy Questionnaire: (six-months
follow-up: mean difference 1.94, 95% confidence interval 0.35–3.56, two
studies), but no significant results emerged for quality-of-life measured by
the Minnesota Living with Heart Failure Questionnaire (nine-months or more
follow-up: mean difference –4.19, 95% confidence interval –10.51–2.12, seven
studies; six-months follow-up: mean difference –5.97, 95% confidence
interval –16.17–4.23, four studies). Conclusion No association between exercise-based cardiac rehabilitation and mortality or
hospitalisation could be observed in HFrEF patients but exercise-based
cardiac rehabilitation is likely to improve exercise capacity and quality of
life.
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Affiliation(s)
| | - R Nebel
- Hermann-Albrecht-Klinik Mettnau, Germany
| | - K Jensen
- Institute of Medical Biometry and Informatics, University of Heidelberg, Germany
| | - M Hackbusch
- Institute of Medical Biometry and Informatics, University of Heidelberg, Germany
| | - M Grilli
- Medical Faculty University Library, University of Mannheim-Heidelberg, Germany
| | - S Gielen
- Department of Cardiology, Angiology and Intensive Care, Klinikum Lippe, Detmold, Germany.,Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - B Schwaab
- Curschmann Klinik, Timmendorfer Strand, Germany
| | - B Rauch
- Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany
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49
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Pontén M, Ljótsson B, Jensen K. Shaping placebo analgesic responses on the Internet: a randomized experimental trial. Pain Rep 2019; 4:e698. [PMID: 31583339 PMCID: PMC6749896 DOI: 10.1097/pr9.0000000000000698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 08/07/2018] [Accepted: 09/26/2018] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The field of Internet-based treatments is expanding. However, little is known about placebo effects in online therapeutic settings. The aim of this study was to test if placebo analgesia could be induced via online communication. Exploratory analyses tested if different communication styles (empathetic/neutral) would influence the placebo effect. METHODS In this double-blind experiment, 30 healthy participants were randomized to either empathetic or neutral online communication. After completing the online modules, a face-to-face placebo analgesia experiment was performed. An independent experimenter (blinded as to communication type) performed the pain testing and treatment with a sham analgesic device (placebo). RESULTS Overall, there was a significant placebo effect, as participants rated the pain lower when the sham analgesic device was turned on, compared to off. An additional control experiment (n = 17) confirmed that pain testing with the sham analgesic device per se, without any prior communication, was not enough to induce placebo effects. Exploratory analyses indicated a significant difference in perception of the online communication between participants randomized to the empathetic and neutral groups because the empathetic group rated the interaction as more positive. Also, there was a significant difference in online compliance. Yet, exploratory analyses did not suggest any difference in placebo pain ratings between the empathetic and neutral communication groups. CONCLUSION The results in this study suggest that placebo effects can be created even when information about an analgesic treatment is delivered online. This is the first indication of a novel research line that investigates placebo effects in online treatment.
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Affiliation(s)
- Moa Pontén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Brjánn Ljótsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Karin Jensen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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50
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Argota Perez R, Sharma M, Jensen K, Vestergaard A, Petersen J, Korreman S. EP-1999 Robustness of IMPT plans towards anatomical variations for nasopharyngeal cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32419-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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