Does the model of additive effect in placebo research still hold true? A narrative review

Personalised and contextualised care has been turned into a major demand by people involved in healthcare suggesting to move toward person-centred medicine. The assessment of person-centred medicine can be most effectively achieved if treatments are investigated using ‘with versus without’ person-centredness or integrative study designs. However, this assumes that the components of an integrative or person-centred intervention have an additive relationship to produce the total effect. Beecher’s model of additivity assumes an additive relation between placebo and drug effects and is thus presenting an arithmetic summation. So far, no review has been carried out assessing the validity of the additive model, which is to be questioned and more closely investigated in this review. Initial searches for primary studies were undertaken in July 2016 using Pubmed and Google Scholar. In order to find matching publications of similar magnitude for the comparison part of this review, corresponding matches for all included reviews were sought. A total of 22 reviews and 3 clinical and experimental studies fulfilled the inclusion criteria. The results pointed to the following factors actively questioning the additive model: interactions of various effects, trial design, conditioning, context effects and factors, neurobiological factors, mechanism of action, statistical factors, intervention-specific factors (alcohol, caffeine), side-effects and type of intervention. All but one of the closely assessed publications was questioning the additive model. A closer examination of study design is necessary. An attempt in a more systematic approach geared towards solutions could be a suggestion for future research in this field.

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Cardiovascular Disease Self-Care Interventions

Nursing Research and Practice ◽

10.1155/2013/407608 ◽

2013 ◽

Vol 2013 ◽

pp. 1-16 ◽

Cited By ~ 8

Author(s):

Victoria Vaughan Dickson ◽

Jill Nocella ◽

Hye-Won Yoon ◽

Marilyn Hammer ◽

Gail D’Eramo Melkus ◽

...

Keyword(s):

Cardiovascular Disease ◽

Intervention Studies ◽

Self Care ◽

Future Research ◽

Inclusion Criteria ◽

Care Intervention ◽

Rigorous Study ◽

Study Designs ◽

Combined Interventions

Background. Cardiovascular disease (CVD) is a major cause of increased morbidity and mortality globally. Clinical practice guidelines recommend that individuals with CVD are routinely instructed to engage in self-care including diet restrictions, medication adherence, and symptom monitoring.Objectives. To describe the nature of nurse-led CVD self-care interventions, identify limitations in current nurse-led CVD self-care interventions, and make recommendations for addressing them in future research.Design. Integrative review of nurse-led CVD self-care intervention studies from PubMed, MEDLINE, ISI Web of Science, and CINAHL. Primary studies (n=34) that met the inclusion criteria of nurse-led RCT or quasiexperimental CVD self-care intervention studies (years 2000 to 2012) were retained and appraised. Quality of the review was assured by having at least two reviewers screen and extract all data.Results. A variety of self-care intervention strategies were studied among the male (57%) and Caucasian (67%) dominated samples. Combined interventions were common, and quality of life was the most frequent outcome evaluated. Effectiveness of interventions was inconclusive, and in general results were not sustained over time.Conclusions. Research is needed to develop and test tailored and inclusive CVD self-care interventions. Attention to rigorous study designs and methods including consistent outcomes and measurement is essential.

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Assessing the effectiveness of actionable nutrigenomics and lifestyle genomics interventions for weight management in clinical practice: A critical, scoping review with directions for future research

Nutrition and Health ◽

10.1177/0260106020928667 ◽

2020 ◽

Vol 26 (3) ◽

pp. 167-173 ◽

Cited By ~ 2

Author(s):

Justine Horne ◽

Jason Gilliland ◽

Janet Madill

Keyword(s):

Clinical Practice ◽

Weight Management ◽

Scoping Review ◽

Genetic Risk ◽

Future Research ◽

Use Of Self ◽

Lifestyle Advice ◽

Inclusion Criteria ◽

Body Of Knowledge ◽

Study Designs

Background: The use of nutrigenomics and lifestyle genomics in clinical practice has the potential to optimize weight-related outcomes for patients. Aim: A scoping review was conducted to summarize and evaluate the current body of knowledge related to the effectiveness of providing DNA-based lifestyle advice on weight-related outcomes, with the aim of providing direction for future research. Method: Primary studies were included if they were written in English, evaluated weight-related and/or body mass index and/or body composition outcomes, and provided participants with an actionable genetic-based lifestyle intervention; interventions that only provided information on genetic risk for diseases/conditions were excluded. Data was extracted from each article meeting inclusion criteria ( N=3) and the studies were critically appraised for methodological limitations. Results: Research in this area is promising, but limited. Specific limitations relate to study designs, the nature of the recommendations provided to participants, small (underpowered) sample sizes, the use of self-reported weight/BMI data and lack of consideration of important confounding factors. Conclusions: Therefore, the effectiveness of nutrigenomics and lifestyle genomics interventions for weight management in clinical practice cannot yet be conclusively determined. Recommendations for future research are detailed in the present manuscript.

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RECLAMATION AND CULVERT CROSSINGS MADE OF CORRUGATED PIPES ON SPAWNING STREAMS

Prirodoobustrojstvo ◽

10.26897/1997-6011-2020-5-68-77 ◽

2020 ◽

pp. 68-77

Author(s):

O.N. CHERNYKH ◽

◽

A.V. RBURLACHENKO

Keyword(s):

Single Point ◽

Experimental Studies ◽

Fish Passage ◽

Future Research ◽

Fish Stocks ◽

Metal Structures ◽

Natural Reproduction ◽

Spiral Shape ◽

Corrugated Metal ◽

Spawning Streams

Recommendations are presented for solving issues that arise in the design and operation of tubular transport crossings of corrugated metal structures through spawning streams while ensuring the safety and natural reproduction of fish stocks. There are discussed the results of experimental studies of culverts made of metal corrugated pipes with a normal and spiral shape of corrugation the bottom of which is buried and filled with suitable granular material to the level of the natural channel of a small watercourse. It is established that when 10% of the area of the corrugated pipe is occupied by stone filling, its throughput is reduced by about 10-12%. Based on the review of the existing literature and the results of laboratory experiments, data is provided to estimate the values of the roughness coefficients of the composite cross-section of a single-point junction and directions for future research on culvert reclamation are outlined. Studying of the structure of the velocity distribution in culverts can lead to the improved conditions for fish passage without installing special structural elements in the transit path of the fish passage structure.

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Amruthapala (Decalepis arayalpathra (J. Joseph and V. Chandras.) Venter): A Comprehensive Review on Diversity, Therapeutic Uses, and Valorization of Bioactive Constituents

Current Pharmaceutical Biotechnology ◽

10.2174/1389201020666190318115504 ◽

2019 ◽

Vol 20 (5) ◽

pp. 376-389 ◽

Cited By ~ 1

Author(s):

Sonali Mishra ◽

Nupur Srivastava ◽

Velusamy Sundaresan ◽

Karuna Shanker

Keyword(s):

Secondary Metabolite ◽

Current Knowledge ◽

Experimental Studies ◽

Critical Discussion ◽

Future Research ◽

Bioactive Constituents ◽

Medicinal Uses ◽

Comprehensive Review ◽

Therapeutic Uses ◽

Decalepis Arayalpathra

Background: Decalepis arayalpathra (J. Joseph and V. Chandras.) Venter is used primarily for nutrition besides its therapeutic values. Traditional preparations/formulations from its tuber are used as a vitalizer and blood purifier drink. The folklore medicinal uses cover inflammation, cough, wound healing, antipyretic, and digestive system management. A comprehensive review of the current understanding of the plant is required due to emerging concerns over its safety and efficacy. Objective: The systematic collection of the authentic information from different sources with the critical discussion is summarised in order to address various issues related to botanical identity, therapeutic medicine, nutritional usage, phytochemical, and pharmacological potentials of the D. arayalpathra. Current use of traditional systems of medicine can be used to expand future research opportunities. Materials and Methods: Available scripted information was collected manually, from peered review research papers and international databases viz. Science Direct, Google Scholar, SciFinder, Scopus, etc. The unpublished resources which were not available in database were collected through the classical books of ‘Ayurveda’ and ‘Siddha’ published in regional languages. The information from books, Ph.D. and MSc dissertations, conference papers and government reports were also collected. We thoroughly screened the scripted information of classical books, titles, abstracts, reports, and full-texts of the journals to establish the reliability of the content. Results: Tuber bearing vanilla like signature flavor is due to the presence of 2-hydroxy-4-methoxybenzaldehyde (HMB). Among five other species, Decalepis arayalpathra (DA) has come under the ‘critically endangered’ category, due to over-exploitation for traditional, therapeutic and cool drink use. The experimental studies proved that it possesses gastro-protective, anti-tumor, and antiinflammatory activities. Some efforts were also made to develop better therapeutics by logical modifications in 2-Hydroxy-4-methoxy-benzaldehyde, which is a major secondary metabolite of D. arayalpathra. ‘Amruthapala’ offers the enormous opportunity to develop herbal drink with health benefits like gastro-protective, anti-oxidant and anti-inflammatory actions. Results: The plant has the potential to generate the investigational new lead (IND) based on its major secondary metabolite i.e. 2-Hydroxy-4-methoxy-benzaldehyde. The present mini-review summarizes the current knowledge on Decalepis arayalpathra, covering its phytochemical diversity, biological potentials, strategies for its conservation, and intellectual property rights (IPR) status. Chemical Compounds: 2-hydroxy-4-methoxybenzaldehyde (Pubchem CID: 69600), α-amyrin acetate (Pubchem CID: 293754), Magnificol (Pubchem CID: 44575983), β-sitosterol (Pubchem CID: 222284), 3-hydroxy-p-anisaldehyde (Pubchem CID: 12127), Naringenin (Pubchem CID: 932), Kaempferol (Pubchem CID: 5280863), Aromadendrin (Pubchem CID: 122850), 3-methoxy-1,2-cyclopentanedione (Pubchem CID: 61209), p-anisaldehyde (Pubchem CID: 31244), Menthyl acetate (Pubchem CID: 27867), Benzaldehyde (Pubchem CID: 240), p-cymene (Pubchem CID: 7463), Salicylaldehyde (Pubchem CID: 6998), 10-epi-γ-eudesmol (Pubchem CID: 6430754), α -amyrin (Pubchem CID: 225688), 3-hydroxy-4-methoxy benzaldehyde (Pubchem CID: 12127).

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Dietary Supplementation for Para-Athletes: A Systematic Review

Nutrients ◽

10.3390/nu13062016 ◽

2021 ◽

Vol 13 (6) ◽

pp. 2016

Author(s):

Keely A. Shaw ◽

Gordon A. Zello ◽

Brian Bandy ◽

Jongbum Ko ◽

Leandy Bertrand ◽

...

Keyword(s):

Spinal Cord ◽

Dietary Supplements ◽

Sports Medicine ◽

Spinal Cord Injuries ◽

Sport Performance ◽

Future Research ◽

Inclusion Criteria ◽

Supplement Use ◽

Sport Supplements ◽

Cord Injury

The use of dietary supplements is high among athletes and non-athletes alike, as well as able-bodied individuals and those with impairments. However, evidence is lacking in the use of dietary supplements for sport performance in a para-athlete population (e.g., those training for the Paralympics or similar competition). Our objective was to examine the literature regarding evidence for various sport supplements in a para-athlete population. A comprehensive literature search was conducted using PubMed, SPORTDiscus, MedLine, and Rehabilitation and Sports Medicine Source. Fifteen studies met our inclusion criteria and were included in our review. Seven varieties of supplements were investigated in the studies reviewed, including caffeine, creatine, buffering agents, fish oil, leucine, and vitamin D. The evidence for each of these supplements remains inconclusive, with varying results between studies. Limitations of research in this area include the heterogeneity of the subjects within the population regarding functionality and impairment. Very few studies included individuals with impairments other than spinal cord injury. Overall, more research is needed to strengthen the evidence for or against supplement use in para-athletes. Future research is also recommended on performance in para-athlete populations with classifiable impairments other than spinal cord injuries.

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Children’s outdoor active mobility behaviour and neighbourhood safety: a systematic review in measurement methods and future research directions

International Journal of Health Geographics ◽

10.1186/s12942-020-00254-w ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Roula Zougheibe ◽

Jianhong (Cecilia) Xia ◽

Ashraf Dewan ◽

Ori Gudes ◽

Richard Norman

Keyword(s):

Three Dimensional ◽

Measurement Methods ◽

Future Research ◽

Inclusion Criteria ◽

Eligibility Criteria ◽

Research Directions ◽

Spatial Locality ◽

Mobility Behaviour ◽

Health Studies ◽

Future Research Directions

Abstract Background Numerous studies have examined the association between safety and primary school-aged children’s forms of active mobility. However, variations in studies’ measurement methods and the elements addressed have contributed to inconsistencies in research outcomes, which may be forming a barrier to advancing researchers’ knowledge about this field. To assess where current research stands, we have synthesised the methodological measures in studies that examined the effects of neighbourhood safety exposure (perceived and measured) on children’s outdoor active mobility behaviour and used this analysis to propose future research directions. Method A systematic search of the literature in six electronic databases was conducted using pre-defined eligibility criteria and was concluded in July 2020. Two reviewers screened the literature abstracts to determine the studies’ inclusion, and two reviewers independently conducted a methodological quality assessment to rate the included studies. Results Twenty-five peer-reviewed studies met the inclusion criteria. Active mobility behaviour and health characteristics were measured objectively in 12 out of the 25 studies and were reported in another 13 studies. Twenty-one studies overlooked spatiotemporal dimensions in their analyses and outputs. Delineations of children’s neighbourhoods varied within 10 studies’ objective measures, and the 15 studies that opted for subjective measures. Safety perceptions obtained in 22 studies were mostly static and primarily collected via parents, and dissimilarities in actual safety measurement methods were present in 6 studies. The identified schematic constraints in studies’ measurement methods assisted in outlining a three-dimensional relationship between ‘what’ (determinants), ‘where’ (spatial) and ‘when’ (time) within a methodological conceptual framework. Conclusions The absence of standardised measurement methods among relevant studies may have led to the current diversity in findings regarding active mobility, spatial (locality) and temporal (time) characteristics, the neighbourhood, and the representation of safety. Ignorance of the existing gaps and heterogeneity in measures may impact the reliability of evidence and poses a limitation when synthesising findings, which could result in serious biases for policymakers. Given the increasing interest in children’s health studies, we suggested alternatives in the design and method of measures that may guide future evidence-based research for policymakers who aim to improve children’s active mobility and safety.

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Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116176 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6176

Author(s):

Tomasz Kuligowski ◽

Anna Skrzek ◽

Błażej Cieślik

Keyword(s):

Manual Therapy ◽

Functional Outcomes ◽

Web Of Science ◽

Current Knowledge ◽

Controlled Trial ◽

Future Research ◽

Lumbar Radiculopathy ◽

Inclusion Criteria ◽

Randomized Controlled ◽

The Mean

The aim of this study was to describe and update current knowledge of manual therapy accuracy in treating cervical and lumbar radiculopathy, to identify the limitations in current studies, and to suggest areas for future research. The study was conducted according to PRISMA guidelines for systematic reviews. A comprehensive literature review was conducted using PubMed and Web of Science databases up to April 2020. The following inclusion criteria were used: (1) presence of radiculopathy; (2) treatment defined as manual therapy (i.e., traction, manipulation, mobilization); and (3) publication defined as a Randomized Controlled Trial. The electronic literature search resulted in 473 potentially relevant articles. Finally, 27 articles were accepted: 21 on cervical (CR) and 6 in lumbar radiculopathy (LR). The mean PEDro score for CR was 6.6 (SD 1.3), and for LR 6.7 (SD 1.6). Traction-oriented techniques are the most frequently chosen treatment form for CR and are efficient in reducing pain and improving functional outcomes. In LR, each of the included publications used a different form of manual therapy, which makes it challenging to summarize knowledge in this group. Of included publications, 93% were either of moderate or low quality, which indicates that quality improvement is necessary for this type of research.

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Local Anesthetics and Recurrence after Cancer Surgery-What’s New? A Narrative Review

Journal of Clinical Medicine ◽

10.3390/jcm10040719 ◽

2021 ◽

Vol 10 (4) ◽

pp. 719

Author(s):

Sarah D. Müller ◽

Jonathan S. H. Ziegler ◽

Tobias Piegeler

Keyword(s):

Tumor Cells ◽

Circulating Tumor Cells ◽

Local Anesthetics ◽

Experimental Studies ◽

Perioperative Period ◽

Cancer Surgery ◽

Narrative Review ◽

Future Research ◽

Inflammatory Stress ◽

Research Activities

The perioperative use of regional anesthesia and local anesthetics is part of almost every anesthesiologist’s daily clinical practice. Retrospective analyses and results from experimental studies pointed towards a potential beneficial effect of the local anesthetics regarding outcome—i.e., overall and/or recurrence-free survival—in patients undergoing cancer surgery. The perioperative period, where the anesthesiologist is responsible for the patients, might be crucial for the further course of the disease, as circulating tumor cells (shed from the primary tumor into the patient’s bloodstream) might form new micro-metastases independent of complete tumor removal. Due to their strong anti-inflammatory properties, local anesthetics might have a certain impact on these circulating tumor cells, either via direct or indirect measures, for example via blunting the inflammatory stress response as induced by the surgical stimulus. This narrative review highlights the foundation of these principles, features recent experimental and clinical data and provides an outlook regarding current and potential future research activities.

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Opportunistic Large Array Propagation Models: A Comprehensive Survey

Sensors ◽

10.3390/s21124206 ◽

2021 ◽

Vol 21 (12) ◽

pp. 4206

Author(s):

Farhan Nawaz ◽

Hemant Kumar ◽

Syed Ali Hassan ◽

Haejoon Jung

Keyword(s):

Energy Efficient ◽

Large Scale ◽

Performance Metrics ◽

Experimental Studies ◽

Cooperative Transmission ◽

Analytical Models ◽

Future Research ◽

Large Array ◽

Propagation Models ◽

Comprehensive Survey

Enabled by the fifth-generation (5G) and beyond 5G communications, large-scale deployments of Internet-of-Things (IoT) networks are expected in various application fields to handle massive machine-type communication (mMTC) services. Device-to-device (D2D) communications can be an effective solution in massive IoT networks to overcome the inherent hardware limitations of small devices. In such D2D scenarios, given that a receiver can benefit from the signal-to-noise-ratio (SNR) advantage through diversity and array gains, cooperative transmission (CT) can be employed, so that multiple IoT nodes can create a virtual antenna array. In particular, Opportunistic Large Array (OLA), which is one type of CT technique, is known to provide fast, energy-efficient, and reliable broadcasting and unicasting without prior coordination, which can be exploited in future mMTC applications. However, OLA-based protocol design and operation are subject to network models to characterize the propagation behavior and evaluate the performance. Further, it has been shown through some experimental studies that the most widely-used model in prior studies on OLA is not accurate for networks with networks with low node density. Therefore, stochastic models using quasi-stationary Markov chain are introduced, which are more complex but more exact to estimate the key performance metrics of the OLA transmissions in practice. Considering the fact that such propagation models should be selected carefully depending on system parameters such as network topology and channel environments, we provide a comprehensive survey on the analytical models and framework of the OLA propagation in the literature, which is not available in the existing survey papers on OLA protocols. In addition, we introduce energy-efficient OLA techniques, which are of paramount importance in energy-limited IoT networks. Furthermore, we discuss future research directions to combine OLA with emerging technologies.

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Osteopathic manipulative treatment and the Spanish flu: a historical literature review

Journal of Osteopathic Medicine ◽

10.1515/jom-2020-0112 ◽

2021 ◽

Vol 121 (2) ◽

pp. 181-190

Author(s):

Francesca Baroni ◽

Damiana Mancini ◽

Silvia Clara Tuscano ◽

Simone Scarlata ◽

Christian Lunghi ◽

...

Keyword(s):

Healthy Lifestyle ◽

Influenza Pandemic ◽

Future Research ◽

Osteopathic Manipulative Treatment ◽

Inclusion Criteria ◽

Medical Subject Headings ◽

National Library ◽

Hand Search ◽

Spanish Flu ◽

Osteopathic Physicians

Abstract Context The Spanish flu pandemic of 1918 was approached with a variety of management techniques available at that time, including osteopathic care in addition to standard medical care. Objective To analyze the osteopathic manipulative treatment (OMT) techniques used for the management of patients affected by the Spanish flu according to four themes: the principles and procedures used, frequency and length of OMT, reported side effects, and advice for patients. Methods A structured review of the literature was performed by hand-searching texts at the Museum of Osteopathic Medicine International Center for Osteopathic History in Kirksville, Missouri, and online via PubMed (National Library of Medicine), ScienceDirect (Elsevier), and Google Scholar (Google, Inc). The literature search was carried out between February and March 2020. Three keywords were selected from the medical subject headings database of the National Library of Medicine: manipulation, osteopathic; influenza pandemic, 1918–1919; epidemics. Articles were then reviewed for relevance by screening for articles published between 1900 and 1940 that contained at least 1 of the following keywords in their title: Spanish influenza, flu, epidemic, grippe, pneumonia, or osteopathic management/treatment. All articles that provided information about OMT and advice met the inclusion criteria. Articles that did not report descriptions of manipulative intervention were excluded. Results Our search yielded 63 articles: 23 from the hand-search and 40 from the electronic search. No electronic source was selected for the review because none met inclusion criteria. A total of 16 articles from the hand-searched set met inclusion criteria and were analyzed according to the four main themes stated in the objective. The range of OMT approaches reported to be administered to patients with Spanish flu suggests that early osteopathic physicians treated patients with this disease using OMT in addition to offering advice on healthy lifestyle behaviors. Conclusion Conclusions from this study are limited by the historical and descriptive nature of the data gathered, which lacked the rigor of modern-day scientific studies. However, this review could lead to future research inquiries on the effectiveness of these approaches. Osteopathic physicians and osteopaths should embrace their historical osteopathic heritage by continuing the work of our predecessors and combining their hands-on experience and osteopathic principles with modern medical treatment and rigorous scientific standards.

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