Publications by authors named "Ursula Wolf"

78 Publications

Warm Footbaths with or Enhance Self-Reported Vitality in Healthy Adults More than Footbaths with Warm Water Only: A Randomized, Controlled Trial.

Evid Based Complement Alternat Med 2021 12;2021:9981183. Epub 2021 Jul 12.

Institute of Complementary and Integrative Medicine, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland.

Objectives: To examine the effects of warm footbaths with thermogenic medicinal powders on vitality and heart rate variability in healthy adults. . Seventeen healthy young adults (22.1 ± 2.4 years, 11 females) received three footbaths (WA: warm water only; GI: warm water and ginger; MU: warm water and mustard) in randomized order with a crossover design. We assessed vitality with the Basler Befindlichkeit questionnaire (BBS) and heart rate variability (HRV) before (0), immediately after (1), and 10 minutes following footbaths (2). The primary outcome measure was self-reported vitality, measured via the BBS, at 1.

Results: The primary outcome measure, self-reported vitality, was higher after GI and tended to be higher after MU compared to WA with medium effect sizes (GI vs. WA, mean difference -2.47 (95% CI -5.28 to 0.34), =0.048,  = 0.74), MU vs. WA, -2.35 (-5.32 to 0.61), =0.30,  = 0.50). At 2, the standard deviation of beat-to-beat intervals (SDNN) of HRV increased, and the stress index tended to decrease after all three footbath conditions with small to medium effect sizes (0.42-0.66).

Conclusion: There is preliminary evidence that footbaths with thermogenic agents GI and MU may increase self-reported vitality during a short-time period with a more pronounced effect with GI. After a short follow-up, all three conditions tended to shift the autonomic balance towards relaxation. Future research should investigate these effects in clinical samples with a larger, more diverse sample size.
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http://dx.doi.org/10.1155/2021/9981183DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8292049PMC
July 2021

Long-Term Blue Light Exposure Changes Frontal and Occipital Cerebral Hemodynamics: Not All Subjects React the Same.

Adv Exp Med Biol 2021 ;1269:217-222

University of Bern, Institute of Complementary and Integrative Medicine, Bern, Switzerland.

Background: In modern society, we are increasingly exposed to numerous sources of blue light, including screens (e.g., TVs, computers, laptops, smartphones, tablets) and light from fluorescent and LED lamps. Due to this wide range of applications, the effects of blue light exposure (BLE) on the human physiology need to be thoroughly studied.

Aim: To investigate the impact of long-term BLE on frontal and occipital human cerebral hemodynamics and oxygenation using functional near-infrared spectroscopy (fNIRS) neuroimaging.

Materials And Methods: 32 healthy right-handed subjects (20 females, 12 males; age: 23.8 ± 2.2 years) were exposed to blue LED light for 15 minutes. Before (baseline, 8 min) and after (recovery, 10 min) the BLE, subjects were in darkness. We measured the concentration changes of oxyhemoglobin ([OHb]) and deoxyhemoglobin ([HHb]) at the prefrontal cortex (PFC) and visual cortex (VC) by fNIRS during the experiment. Subjects were then classified into different groups based on their hemodynamic response pattern of [OHb] at the PFC and VC during BLE.

Results: On the group level (32 subjects), we found an increase in [OHb] and a decrease in [HHb] at both cortices during BLE. Evoked changes of [OHb] were higher at the VC compared to the PFC. Eight different hemodynamic response patterns were detected in the subgroup analysis, while an increase of [OHb] in both cortices was the most common pattern (8 out of 32 cases, 25%) during BLE.

Discussion And Conclusion: Our study showed that the hemodynamic and oxygenation changes at the PFC and VC during BLE (i) were generally higher in the VC compared to the PFC, (ii) showed an intersubject variability with respect to their magnitudes and shapes, and (iii) can be classified into eight groups. We conclude that blue light affects humans differently. It is essential to consider this when assessing the impact of the BLE on society.
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http://dx.doi.org/10.1007/978-3-030-48238-1_34DOI Listing
May 2021

Color-dependent changes in humans during a verbal fluency task under colored light exposure assessed by SPA-fNIRS.

Sci Rep 2021 May 6;11(1):9654. Epub 2021 May 6.

University of Bern, Institute of Complementary and Integrative Medicine, Fabrikstrasse 8, 3012, Bern, Switzerland.

Light evokes robust visual and nonvisual physiological and psychological effects in humans, such as emotional and behavioral responses, as well as changes in cognitive brain activity and performance. The aim of this study was to investigate how colored light exposure (CLE) and a verbal fluency task (VFT) interact and affect cerebral hemodynamics, oxygenation, and systemic physiology as determined by systemic physiology augmented functional near-infrared spectroscopy (SPA-fNIRS). 32 healthy adults (17 female, 15 male, age: 25.5 ± 4.3 years) were exposed to blue and red light for 9 min while performing a VFT. Before and after the CLE, subjects were in darkness. We found that this long-term CLE-VFT paradigm elicited distinct changes in the prefrontal cortex and in most systemic physiological parameters. The subjects' performance depended significantly on the type of VFT and the sex of the subject. Compared to red light, blue evoked stronger responses in cerebral hemodynamics and oxygenation in the visual cortex. Color-dependent changes were evident in the recovery phase of several systemic physiological parameters. This study showed that the CLE has effects that endure at least 15 min after cessation of the CLE. This underlines the importance of considering the persistent influence of colored light on brain function, cognition, and systemic physiology in everyday life.
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http://dx.doi.org/10.1038/s41598-021-88059-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102618PMC
May 2021

Individual Differences in Hemodynamic Responses Measured on the Head Due to a Long-Term Stimulation Involving Colored Light Exposure and a Cognitive Task: A SPA-fNIRS Study.

Brain Sci 2021 Jan 5;11(1). Epub 2021 Jan 5.

Institute of Complementary and Integrative Medicine, University of Bern, 3012 Bern, Switzerland.

When brain activity is measured by neuroimaging, the canonical hemodynamic response (increase in oxygenated hemoglobin ([OHb]) and decrease in deoxygenated hemoglobin ([HHb]) is not always seen in every subject. The reason for this intersubject-variability of the responses is still not completely understood. This study is performed with 32 healthy subjects, using the systemic physiology augmented functional near-infrared spectroscopy (SPA-fNIRS) approach. We investigate the intersubject variability of hemodynamic and systemic physiological responses, due to a verbal fluency task (VFT) under colored light exposure (CLE; blue and red). Five and seven different hemodynamic response patterns were detected in the subgroup analysis of the blue and red light exposure, respectively. We also found that arterial oxygen saturation and mean arterial pressure were positively correlated with [OHb] at the prefrontal cortex during the CLE-VFT independent of the color of light and classification of the subjects. Our study finds that there is substantial intersubject-variability of cerebral hemodynamic responses, which is partially explained by subject-specific systemic physiological changes induced by the CLE-VFT. This means that both subgroup analyses and the additional assessment of systemic physiology are of crucial importance to achieve a comprehensive understanding of the effects of a CLE-VFT on human subjects.
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http://dx.doi.org/10.3390/brainsci11010054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7824905PMC
January 2021

"": Therapeutic Uses of Tobacco in Peruvian Amazonian Medicine Exemplified by the Work of a .

Front Pharmacol 2020 7;11:594591. Epub 2020 Oct 7.

Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland.

Introduction: Harmful usage of tobacco is a public health problem of global concern and, in many countries, the main risk factor for non-communicable diseases. Yet, in the Peruvian Amazon, the geographical region believed to be tobacco's historical birthplace, this plant is associated with a strikingly different usage and repute: Tobacco (especially L.) in this area is described as a potent medicinal plant, used topically or ingestion to treat a variety of health conditions. The goal of this transdisciplinary field study was to investigate clinical applications of the tobacco plant as per Amazonian medicine exemplified in the practice of a reputed , an Amazonian traditional healer whose medical specialization focuses on tobacco-based treatments.

Methods: Using a transdisciplinary clinical approach, we conducted in-depth interviews with the tabaquero applying the systematizing expert interview method, in order to map modes of preparation and administration, indications, contraindications, effects, risks, adverse effects, and systemic aspects of tobacco-based remedies.

Results: The informant's descriptions revealed refined knowledge on this plant's therapeutic properties and scope, safety profile, and application techniques. The main indications mentioned included "problems of the mind," of the respiratory system, parasitic illnesses (intestinal/skin), gout, and Amazonian epistemic conditions described as spiritual-energetic in nature. A liquid remedy taken orally was his most commonly used preparation, with acute/sub-acute effects involving a pronounced psychoactive component (altered state of consciousness) and physiological response (emesis, nausea). A skilled tabaquero that knows how to dose, administer, and intervene in case of adverse effects was considered imperative for safe treatment delivery.

Conclusions: To our knowledge, this is the first study employing a transdisciplinary clinical approach to examine therapeutic applications of tobacco by an Amazonian tabaquero. Our findings significantly contribute to the growing research literature on Amazonian medicine and emergent psychedelic-assisted therapies and could, in the long-term, open new treatment avenues in several domains. Forthcoming studies should assess toxicity/safety and clinical outcomes of patients receiving Amazonian tobacco-based treatment.
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http://dx.doi.org/10.3389/fphar.2020.594591DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576958PMC
October 2020

Euphrasia Eye Drops in Preterm Neonates With Ocular Discharge: A Randomized Double-Blind Placebo-Controlled Trial.

Front Pediatr 2020 11;8:449. Epub 2020 Aug 11.

Anthroposophically Extended Medicine, Institute of Complementary and Integrative Medicine, University of Bern, Bern, Switzerland.

To investigate whether the early administration of Euphrasia eye drops® in preterm neonates presenting with ocular discharge fosters the resolution of the ocular discharge and reduces the need for topical antibiotic therapy, as compared to placebo. We conducted a randomized double-blind placebo-controlled trial at the University Children's Hospital Bern, Switzerland. Preterm neonates with white, yellow, or green ocular discharge were included. Infants were randomly assigned (1:1) to the Euphrasia arm (Euphrasia eye drops®, Weleda AG, Arlesheim) or the placebo arm (NaCl 0.9%). Euphrasia or placebo was administrated at a dose of one drop in each eye four times a day over a period of 96 h. The primary outcome was the treatment success, defined as no ocular discharge at 96 h and no use of topical antibiotic therapy during the 96-h intervention. A total of 114 neonates were screened and 84 were randomized. Among neonates in the Euphrasia arm, 22 (55.0%) achieved our primary outcome compared to 21 (51.2%) in the placebo arm ( = 0.85). In the Euphrasia arm, time to resolution of reddening tended to fall within the shorter bracket of 24 to 48 h (24 (92.3%) vs. 12 (80.0%) in the placebo arm, = 0.34) and relapse or first signs of reddening during the 96-h intervention tended to be lower [3 (7.9%) eyes vs. 8 (18.2%) eyes in the placebo arm, = 0.17]. Tearing at 96 h tended to be lower in the Euphrasia arm [5 (12.8%) eyes in the Euphrasia arm vs. 12 (27.3%) eyes in the placebo arm, = 0.10]. Euphrasia did not significantly improve treatment success, defined as no ocular discharge at 96 h and no use of topical antibiotic therapy during the 96-h intervention. However, results suggest that Euphrasia may be of benefit for symptoms such as reddening and tearing, and thus improve the comfort of patients. The trial is registered at the US National Institutes of Health (ClinicalTrials.gov) NCT04122300 and at the portal for human research in Switzerland SNCTP000003490.
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http://dx.doi.org/10.3389/fped.2020.00449DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431947PMC
August 2020

Eurythmy therapy versus slow movement fitness in the treatment of fatigue in metastatic breast cancer patients: study protocol for a randomized controlled trial.

Trials 2020 Jul 6;21(1):612. Epub 2020 Jul 6.

Institute of Complementary and Integrative Medicine, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland.

Background: Cancer-related fatigue (CRF) is the most taxing symptom for many breast cancer patients during and after therapy. In patients with metastatic disease, the prevalence of CRF exceeds 75%. Currently, there is no gold standard for the treatment of CRF. Physical activity can reduce CRF and is recommended during and after cancer treatment, but may be too burdensome for patients with metastatic breast cancer. The aim of this study is to assess the effect on fatigue of eurythmy therapy (ERYT) compared to slow movement fitness (CoordiFit) in metastatic breast cancer patients.

Methods: The ERYT/CoordiFit study is a randomized controlled, open-label, two-arm, multi-center Swiss clinical trial. A sample of 196 patients presenting with CRF will be recruited by oncologists from the departments of clinical oncology at each local study site. All participants will be randomly allocated to the intervention or control group in a 1:1 ratio. The control group is an active control intervention (CoordiFit) in order to control for potential non-intended effects such as therapist-patient interaction and participation in a program. Both ERYT and CoordiFit exercises are easy to learn, and the training sessions will follow the same frequency and duration schedule, i.e., 13 standardized therapy sessions of 45 min (once a week for 6 weeks and then once every second week) during the total intervention period of 20 weeks. The primary endpoint of the study is the change from baseline over the whole intervention period (i.e., including measurements at baseline, weeks 8, 14, and 20) in the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) subscale score.

Discussion: This study is the first-known randomized clinical trial assessing eurythmy therapy in the treatment of fatigue in metastatic breast cancer patients. Given the distress that fatigue causes patients, it is important to validate treatment options. If eurythmy therapy proves beneficial in CRF as part of this randomized controlled clinical trial, the study may be very impactful with implications not only for metastatic breast cancer patients but also for other cancer patients, health care personnel, scientists, and funding and regulatory bodies.

Trial Registration: The ERYT/CoordiFit trial was registered at the US National Institutes of Health (ClinicalTrials.gov) on July 18, 2019, #NCT04024267 , and in the portal for human research in Switzerland on December 3, 2019, #SNCTP000003525 .
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http://dx.doi.org/10.1186/s13063-020-04542-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336433PMC
July 2020

Frontal cerebral oxygenation asymmetry: intersubject variability and dependence on systemic physiology, season, and time of day.

Neurophotonics 2020 Apr 23;7(2):025006. Epub 2020 Jun 23.

University of Bern, Institute of Complementary and Integrative Medicine, Bern, Switzerland.

Our study reveals that frontal cerebral oxygenation asymmetry (FCOA), i.e. a difference in the oxygenation between the right and left prefrontal cortex (PFC), is a real phenomenon in healthy human subjects at rest. To investigate FCOA, we performed a study with 134 healthy right-handed subjects with the systemic physiology augmented functional near infrared spectroscopy (SPA-fNIRS) approach. Subjects were measured 2 to 4 times on different days resulting in an unprecedented number of 518 single measurements of the absolute values of tissue oxygen saturation ( ) and total hemoglobin concentration ([tHb]) of the right and left PFC. Measurements were performed with frequency-domain functional near-infrared spectroscopy. In addition, the cardiorespiratory parameters were measured simultaneously. We found that (i) subjects showed an FCOA (higher on the right PFC), but not for tHb; (ii) intrasubject variability was excellent for both and tHb, and fair for FCOA; (iii)  correlated significantly with blood concentration, [tHb] with heart rate, respiration rate (RR), and the pulse-respiration quotient (PRQ), and FCOA with RR and PRQ; (iv) FCOA and were dependent on season and time of day, respectively; (v) FCOA was negatively correlated with the room temperature; and (vi)  and tHb were not correlated with the subjects mood but with their chronotype, whereas FCOA was not dependent on the chronotype. Our study demonstrates that FCOA is real, and it provides unique insights into this remarkable phenomenon.
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http://dx.doi.org/10.1117/1.NPh.7.2.025006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310879PMC
April 2020

Right-Left Asymmetry of Prefrontal Cerebral Oxygenation: Does it Depend on Systemic Physiological Activity, Absolute Tissue Oxygenation or Hemoglobin Concentration?

Adv Exp Med Biol 2020 ;1232:105-112

Institute of Complementary and Integrative Medicine, University of Bern, Bern, Switzerland.

Background: We have repeatedly observed a right-left asymmetry (RLA) of prefrontal cerebral oxygenation of subjects during the resting state.

Aim: To clarify if the RLA is a reliably observable phenomenon at the group level and whether it is associated with systemic physiology, absolute tissue oxygen saturation (StO) or total hemoglobin concentration ([tHb]).

Material And Methods: StO and [tHb] values at the right and left prefrontal cortex (PFC) were calculated for two 5- min resting phases based on data from 76 single measurements (24 healthy adults, aged 22.0 ± 6.4 years). StO and [tHb] were measured with an ISS OxiplexTS frequency domain near-infrared spectroscopy device. In addition, end-tidal CO (PCO), heart rate (HR), respiration rate (RR) and the pulse-respiration quotient (PRQ = HR/RR) were measured and analyzed for the two phases.

Results: On the group level it was found that i) StO was higher at the right compared to the left PFC (for both phases), ii) RLA of StO (∆StO = StO (right)-StO (left) was independent of PCO, HR and PRQ, and iii) ∆StO was associated with absolute StO and [tHb] values (positively and negatively, respectively).

Discussion And Conclusion: This study shows that i) RLA of StO at the PFC is a real phenomenon, and that ii) ∆StO at the group level does not depend on PCO, HR, RR or PRQ, but on absolute StO and [tHb]. We conclude that the RLA is a real effect, independent of systemic physiology, and most likely reflects genuine properties of the brain, i.e. different activity states of the two hemispheres.
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http://dx.doi.org/10.1007/978-3-030-34461-0_15DOI Listing
January 2020

Physicochemical Investigations of Homeopathic Preparations: A Systematic Review and Bibliometric Analysis-Part 2.

J Altern Complement Med 2019 Sep 19;25(9):890-901. Epub 2019 Jul 19.

Institute of Complementary and Integrative Medicine, Faculty of Medicine, University of Bern, Bern, Switzerland.

In Part 1 of the review of physicochemical research performed on homeopathic preparations the authors identified relevant publications of sufficient reporting quality for further in-depth analysis. In this article, the authors analyze these publications to identify any empirical evidence for specific physicochemical properties of homeopathic preparations and to identify most promising experimental techniques for future studies. After an update of the literature search up to 2018, the authors analyzed all publications in terms of individual experiments. They extracted information regarding methodological criteria such as blinding, randomization, statistics, controls, sample preparation, and replications, as well as regarding experimental design and measurement methods applied. Scores were developed to identify experimental techniques with most reliable outcomes. The publications analyzed described 203 experiments. Less than 25% used blinding and/or randomization, and about one third used adequate controls to identify specific effects of homeopathic preparations. The most promising techniques used so far are nuclear magnetic resonance (NMR) relaxation, optical spectroscopy, and electrical impedance measurements. In these three areas, several sets of replicated high-quality experiments provide evidence for specific physicochemical properties of homeopathic preparations. The authors uncovered a number of promising experimental techniques that warrant replication to assess the reported physicochemical properties of homeopathic preparations compared with controls. They further discuss a range of experimental aspects that highlight the many factors that need to be taken into consideration when performing basic research into homeopathic potentization. For future experiments, the authors generally recommend using succussed (vigorously shaken) controls, or comparing different homeopathic preparations with each other to reliably identify any specific physicochemical properties.
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http://dx.doi.org/10.1089/acm.2019.0064DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6760181PMC
September 2019

Swiss paediatrician survey on complementary medicine.

Swiss Med Wkly 2019 Jun 16;149:w20091. Epub 2019 Jun 16.

Institute of Complementary and Integrative Medicine, University of Bern, Switzerland.

Background: In Switzerland, complementary medicine (CM) is officially recognised within the healthcare system and mainly practised in an integrative manner, in conjunction with conventional medicine. As in other countries, there is high demand for and use of CM with children. However, there has so far been no research into the attitude towards, training in and offer of CM among paediatricians in Switzerland. Our study addresses this gap by investigating these topics with an online survey of paediatricians in Switzerland.

Methods: We conducted a national online survey using a 19-item, self-reporting questionnaire among all ordinary and junior members of the Swiss Society of Paediatrics (SSP). A comparison of the study sample with the population of all paediatricians registered with the Swiss Medical Association (FMH) allowed an assessment of the survey’s representativeness. The data analysis was performed on the overall group level as well as for predefined subgroups (e.g. sex, age, language, workplace and professional experience).

Results: 1890 paediatricians were approached and 640, from all parts of Switzerland, responded to the survey (response rate 34%). Two thirds of respondents were female, were aged between 35 and 55 years, trained as paediatric generalist and worked in a practice. Apart from young paediatricians in training, the study sample was representative of all Swiss paediatricians. 23% had attended training in CM, most frequently in phytotherapy, homeopathy, acupuncture/traditional Chinese medicine (TCM) and anthroposophic medicine. 65% were interested in CM courses and training. 16% provide CM services to their patients and almost all paediatricians (97%) are asked by patients/parents about CM therapies. More than half of the responding paediatricians use CM for themselves or their families. 42% were willing to contribute to paediatric CM research.

Conclusions: In a representative sample of paediatricians in Switzerland, their personal attitude towards CM is positive, emphasised by great interest in CM training, a willingness to contribute to CM research and a high rate of paediatricians who use CM for themselves and their families. In contrast, the percentage of paediatricians offering CM is currently rather low despite strong demand for CM for children. This study provides key pointers for the future development of complementary and integrative medicine for children in Switzerland.
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http://dx.doi.org/10.4414/smw.2019.20091DOI Listing
June 2019

Treatment of hyperemesis gravidarum with anthroposophic complex therapy in 3 case reports.

Complement Ther Med 2019 Jun 15;44:14-17. Epub 2019 Feb 15.

University of Bern, Institute of Complementary and Integrative Medicine, Switzerland.

Background: Hyperemesis gravidarum (HG) is generally characterized by intractable nausea and vomiting which interferes with daily life. As the cause of HG has not yet been clearly identified, conventional medicine therapies address only the symptoms. Conventional treatment is also effective for a comparatively short time and may have unfavorable side effects. Given that the condition affects more than 1% of pregnant women, there is a significant need for effective long-lasting treatments with limited side effects.

Case Reports: This paper is based on three case reports of pregnant women suffering from HG. They received inpatient treatment based exclusively on anthroposophic medical approaches at the Paracelsus Hospital Richterswil, Switzerland. Treatments were selected individually based on the specific patient profiles and included infusion therapy with Nux vomica, Solum uliginosum compositum and Bryophyllum pinnatum as well as art therapy (wet-on-wet painting), eurythmy therapy and rhythmical massage therapy. Anthroposophic complex therapies induced an improvement in symptoms of nausea and vomiting within one week in all three cases.

Conclusion: Anthroposophic complex therapy is a valuable option in the treatment of HG. Well-tolerated and long-lasting, it represents a holistic and causal approach that does not only address symptoms.
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http://dx.doi.org/10.1016/j.ctim.2019.02.011DOI Listing
June 2019

The Pulse-Respiration Quotient: A Powerful but Untapped Parameter for Modern Studies About Human Physiology and Pathophysiology.

Front Physiol 2019 9;10:371. Epub 2019 Apr 9.

Institute of Complementary and Integrative Medicine, University of Bern, Bern, Switzerland.

A specific and unique aspect of cardiorespiratory activity can be captured by dividing the heart rate (HR) by the respiration rate (RR), giving the (PRQ = HR/RR). In this review article, we summarize the main findings of studies using and investigating the PRQ. We describe why the PRQ is a powerful parameter that captures complex regulatory states of the cardiorespiratory system, and we highlight the need to re-introduce the use of this parameter into modern studies about human physiology and pathophysiology. In particular, we show that the PRQ (i) changes during human development, (ii) is time-dependent (ultradian, circadian, and infradian rhythms), (iii) shows specific patterns during sleep, (iv) changes with physical activity and body posture, (v) is linked with psychophysical and cognitive activity, (vi) is sex-dependent, and (vii) is determined by the individual physiological constitution. Furthermore, we discuss the medical aspects of the PRQ in terms of applications for disease classification and monitoring. Finally, we explain why there should be a revival in the use of the PRQ for basic research about human physiology and for applications in medicine, and we give recommendations for the use of the PRQ in studies and medical applications.
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http://dx.doi.org/10.3389/fphys.2019.00371DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465339PMC
April 2019

The Contribution of Complementary and Alternative Medicine to Reduce Antibiotic Use: A Narrative Review of Health Concepts, Prevention, and Treatment Strategies.

Evid Based Complement Alternat Med 2019 3;2019:5365608. Epub 2019 Feb 3.

University of Freiburg, Faculty of Medicine, Breisacher Str. 115b, 79106 Freiburg, Germany.

Aim: The aim of this narrative review was to explore the potential contributions of CAM to reduce antibiotic use.

Methods: We searched PubMed, Embase, and Cochrane Database of Systematic Reviews with a specific, limited set of search terms and collected input from a group of expert CAM researchers to answer the question: What is known about the contribution of CAM health and health promotion concepts, infection prevention, and infection treatment strategies to reduce antibiotic use? The worldview-related CAM health concepts enable health promotion oriented infection prevention and treatment aimed at strengthening or supporting the self-regulating ability of the human organism to cope with diseases. There is some evidence that the CAM concepts of health (promotion) are in agreement with current conceptualization of health and that doctors who practice both CAM and conventional medicine prescribe less antibiotics, although selection bias of the presented studies cannot be ruled out. There is some evidence that prevention and some treatment strategies are effective and safe. Many CAM treatment strategies are promising but overall lack high quality evidence.

Conclusions: CAM prevention and treatment strategies may contribute to reducing antibiotic use, but more rigorous research is necessary to provide high quality evidence of (cost-)effectiveness.
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http://dx.doi.org/10.1155/2019/5365608DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378062PMC
February 2019

Effect of person-centred care on antipsychotic drug use in nursing homes (EPCentCare): a cluster-randomised controlled trial.

Age Ageing 2019 05;48(3):419-425

Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.

Background: antipsychotic drugs are regularly prescribed as first-line treatment for neuropsychiatric symptoms in persons with dementia although guidelines clearly prioritise non-pharmacological interventions.

Objective: we investigated a person-centred care approach, which has been successfully evaluated in nursing homes in the UK, and adapted it to German conditions.

Design: a 2-armed 12-month cluster-randomised controlled trial.

Setting: nursing homes in East, North and West Germany.

Methods: all prescribing physicians from both study arms received medication reviews for individual patients and were offered access to 2 h of continuing medical education. Nursing homes in the intervention group received educational interventions on person-centred care and a continuous supervision programme. Primary outcome: proportion of residents receiving at least one antipsychotic prescription after 12 months of follow-up. Secondary outcomes: quality of life, agitated behaviour, falls and fall-related medical attention, a health economics evaluation and a process evaluation.

Results: the study was conducted in 37 nursing homes with n = 1,153 residents (intervention group: n = 493; control group: n = 660). The proportion of residents with at least one antipsychotic medication changed after 12 months from 44.6% to 44.8% in the intervention group and from 39.8 to 33.3% in the control group. After 12 months, the difference in the prevalence was 11.4% between the intervention and control groups (95% confidence interval: 0.9-21.9; P = 0.033); odds ratio: 1.621 (95% confidence interval: 1.038-2.532).

Conclusions: the implementation of a proven person-centred care approach adapted to national conditions did not reduce antipsychotic prescriptions in German nursing homes.

Trial Registration: ClinicalTrials.gov NCT02295462.
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http://dx.doi.org/10.1093/ageing/afz016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6503937PMC
May 2019

Development of a whole plant bioassay to test effects of potentized calcium carbonate in pillule formulation.

Complement Ther Med 2018 Oct 30;40:13-21. Epub 2018 Jun 30.

Institute of Complementary Medicine, Fabrikstrasse 8, University of Bern, 3012 Bern, Switzerland; Institute of Integrative Medicine, University of Witten/Herdecke, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany. Electronic address:

Objectives: From a pharmaceutical point of view, we see a need to develop stable preclinical test systems to identify and investigate effects of potentized remedies as used in Anthroposophic Medicine and Homeopathy. We evaluated a plant bioassay regarding its capacity to distinguish homeopathic remedies from placebo, applied as sucrose pillules.

Methods: Pea seed (Pisum sativum L) was soaked for 24 hours in water with dissolved homeopathic or placebo pillules, or in water only. Shoot length was measured 14 days after planting and treatment groups were compared by analysis of variance (ANOVA). The stability of the system was validated by systematic negative control experiments.

Results: The system is suitable to test a common application form - sucrose pillules - of a potentized preparation without influence of the pharmaceutical carrier substance. A screening of 13 potentized preparations revealed Calcium carbonicum to affect pea shoot growth (p < 0.05). Three independent series of main experiments were performed with potentized Calcium carbonicum to assess reproducibility. Meta-analysis of all data revealed significant effects of Calcium carbonicum 12c and 30c on pea shoot growth (p < 0.05), which were however dependent on the date of experiment and/or the experimental series.

Conclusions: Potentized Calcium carbonicum, applied as sucrose pillules, influenced pea shoot growth in the assay investigated. However, due to the small effect size and due to the modulation of the effects by still unknown external factors, further optimization of this bioassay is necessary to be used in pharmaceutical quality control or in investigating the biological or pharmaceutical mode of action of potentized preparations.
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http://dx.doi.org/10.1016/j.ctim.2018.06.005DOI Listing
October 2018

Long-Term Changes in Optical Properties (μ, μ', μ and DPF) of Human Head Tissue During Functional Neuroimaging Experiments.

Adv Exp Med Biol 2018;1072:331-337

Institute of Complementary Medicine, University of Bern, Bern, Switzerland.

Frequency-domain near-infrared spectroscopy (FD-NIRS) enables to measure absolute optical properties (i.e. the absorption coefficient, μ, and the reduced scattering coefficient, [Formula: see text]) of the brain tissue. The aim of this study was to investigate how the optical properties changed during the course of a functional NIRS experiment. The analyzed dataset comprised of FD-NIRS measurements of 14 healthy subjects (9 males, 5 females, aged: 33.4 ± 10.5 years, range: 24-57 years old). Each measurement lasted 33 min, i.e. 8 min baseline in darkness, 10 min intermittent light stimulation, and 15 min recovery in darkness. Optical tissue properties were obtained bilaterally over the prefrontal cortex (PFC) and visual cortex (VC) with FD-NIRS (Imagent, ISS Inc., USA). Changes in μ and [Formula: see text] were directly measured and two parameters were calculated, i.e. the differential pathlength factor (DPF) and the effective attenuation coefficient (μ). Differences in the behavior of the optical changes were observed when comparing group-averaged data versus single datasets: no clear overall trend was presented in the group data, whereas a clear long-term trend was visible in almost all of the single measurements. Interestingly, the changes in [Formula: see text] statistically significantly correlated with μ, positively in the PFC and negatively in the VC. Our analysis demonstrates that all optical brain tissue properties (μ, [Formula: see text], μ and DPF) change during these functional neuroimaging experiments. The change in [Formula: see text] is not random but follows a trend, which depends on the single experiment and measurement location. The change in the scattering properties of the brain tissue during a functional experiment is not negligible. The assumption [Formula: see text] ≈ const during an experiment is valid for group-averaged data but not for data from single experiments.
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http://dx.doi.org/10.1007/978-3-319-91287-5_53DOI Listing
January 2019

Absolute Values of Optical Properties (μ, μ΄, μ and DPF) of Human Head Tissue: Dependence on Head Region and Individual.

Adv Exp Med Biol 2018;1072:325-330

University of Bern, Institute of Complementary Medicine, Bern, Switzerland.

Background: Absolute optical properties (i.e., the absorption coefficient, μ, and the reduced scattering coefficient, [Formula: see text]) of head tissue can be measured with frequency-domain near-infrared spectroscopy (FD-NIRS).

Aim: We investigated how the absolute optical properties depend on the individual subject and the head region.

Materials And Methods: The data set used for the analysis comprised 31 single FD-NIRS measurements of 14 healthy subjects (9 men, 5 women, aged 33.4 ± 10.5 years). From an 8-min measurement (resting-state; FD-NIRS device: Imagent, ISS Inc.; bilateral over the prefrontal cortex, PFC, and visual cortex, VC) median values were calculated for μ and [Formula: see text] as well as the effective attenuation coefficient (μ) and the differential pathlength factor (DPF). The measurement was done for each subject one to three times with at least 24 h between the measurements.

Results: (i) A Bayesian ANOVA analysis revealed that head region and subject were the most significant main effects on μ, [Formula: see text] and μ, as well as DPF, respectively. (ii) At the VC, μ, [Formula: see text] and μ had higher values compared to the PFC. (iii) The differences in the optical properties between PFC and VC were age-dependent. (iv) All optical properties also were age-dependent. This was strongest for the properties of the PFC compared to the VC.

Discussion And Conclusion: Our analysis demonstrates that all optical head tissue properties (μ, [Formula: see text], μ and DPF) were dependent on the head region, individual subject and age. The optical properties of the head are like a 'fingerprint' for the individual subject. Assuming constant optical properties for the whole head should be carefully reconsidered.
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http://dx.doi.org/10.1007/978-3-319-91287-5_52DOI Listing
January 2019

Synchronized Oscillations of Arterial Oxygen Saturation, Cerebral Tissue Oxygenation and Heart Rate in Preterm Neonates: Investigation of Long-Term Measurements with Multiple Einstein's Cross Wavelet Analysis.

Adv Exp Med Biol 2018 ;1072:157-161

Biomedical Optics Research Laboratory (BORL), Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Background: In preterm neonates, the cardiovascular and cerebral vascular control is immature, making the brain vulnerable to an increased incidence of hypoxic and hyperoxic episodes.

Aim: The aim of the study was to apply the recently developed multiple Einstein's cross wavelet analysis (MECWA) to quantify the coupling of fluctuations of peripherally measured arterial oxygen saturation (SpO), cerebral tissue oxygen saturation (StO) and heart rate (HR).

Methods: Two long-term measurements on preterm neonates with a gestational age at birth of 26.4 and 26.8 weeks and a postnatal age of 2.1 and 3.9 weeks were analyzed. MECWA was applied to SpO, StO and HR.

Results: MECWA showed that the fluctuations of SpO, StO and HR were synchronized in the low-frequency range with periods of ~1 h and ~0.5 h. The amplitudes of the synchronization frequencies were dependent on the individual neonate.

Discussion: MECWA is a useful novel tool to assess the coupling of physiological signals. The parameters determined by MECWA seem to be related to the chronobiological processes, as well as constant regulations of the cardiovascular and cerebral perfusion state.

Conclusion: MECWA was able to identify long-term synchronization of the cardiovascular and cerebral perfusion state in preterm neonates with periods of ~1 h and ~0.5 h.
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http://dx.doi.org/10.1007/978-3-319-91287-5_25DOI Listing
January 2019

Impact of Changes in Systemic Physiology on fNIRS/NIRS Signals: Analysis Based on Oblique Subspace Projections Decomposition.

Adv Exp Med Biol 2018;1072:119-125

Institute of Complementary Medicine, University of Bern, Bern, Switzerland.

Measurements of cerebral and muscle oxygenation (StO) and perfusion ([tHb]) with functional near-infrared spectroscopy (fNIRS) and near infrared spectroscopy (NIRS), respectively, can be influenced by changes in systemic physiology. The aim of our study was to apply the oblique subspace projections signal decomposition (OSPSD) to find the contribution from systemic physiology, i.e. heart rate (HR), electrocardiography (ECG)-derived respiration (EDR) and partial pressure of carbon dioxide (pCO) to StO and [tHb] signals measured on the prefrontal cortex (PFC) and calf muscle. OSPSD was applied to two datasets (n = 42, n = 79 measurements) from two fNIRS/NIRS speech studies. We found that (i) all StO and [tHb] signals contained components related to changes in systemic physiology, (ii) the contribution from systemic physiology varied strongly between subjects, and (iii) changes in systemic physiology generally influenced fNIRS signals on the left and right PFC to a similar degree.
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http://dx.doi.org/10.1007/978-3-319-91287-5_19DOI Listing
January 2019

Speech-guided breathing retraining in asthma: a randomised controlled crossover trial in real-life outpatient settings.

Trials 2018 Jun 25;19(1):333. Epub 2018 Jun 25.

Institute of Complementary Medicine, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland.

Background: Breathing retraining techniques have received increased attention in the management of asthma, because there is growing evidence of the usefulness of such methods in improving quality of life, reducing symptoms and reducing bronchodilator use. Our study investigated the effect of anthroposophic therapeutic speech (ATS), which uses sounds and syllabic rhythm to improve articulation, breathing and cardiorespiratory interaction, in patients with asthma in a real-life outpatient setting.

Methods: In a randomised controlled crossover trial, patients with asthma in three centres in Switzerland and Germany were randomised to either receive 11 ATS sessions or to wait. Subsequently, patients changed either to wait or to receive ATS. Primary outcomes were changes from the beginning to the end of each phase in the Asthma Quality of Life Questionnaire (AQLQ) and spirometry parameters. Secondary outcomes were changes in inhaled glucocorticoids, the Asthma Control Test (ACT), peak flow and asthma exacerbations.

Results: Altogether, 63 patients were randomised, of which 56 were enrolled and 49 completed the study. Statistically significant differences between the ATS groups and waiting control groups were found for the overall AQLQ score (d = 0.86, p = 0.001) and the domain scores for symptoms, activity limitation and emotional function as well as ACT score (d = 0.53, p = 0.048). No significant differences were observed in spirometry parameters, inhaled glucocorticoids, peak flow and days without asthma exacerbation per week. No serious adverse events occurred during ATS sessions.

Conclusions: ATS significantly improves asthma control and quality of life in patients with asthma. Whether ATS may improve lung function remains to be shown.

Trial Registration: ClinicalTrials.gov NCT02501824 . Retrospectively registered on 8 July 2015.
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http://dx.doi.org/10.1186/s13063-018-2727-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019518PMC
June 2018

Heart Rate Variability as a Prognostic Factor for Cancer Survival - A Systematic Review.

Front Physiol 2018 29;9:623. Epub 2018 May 29.

Institute of Complementary Medicine, University of Bern, Bern, Switzerland.

An increasing cancer incidence affecting any age and social class is putting serious strain on populations and health care systems around the world. This systematic literature search aims (i) to examine the correlation of heart rate variability (HRV) and cancer patients' prognosis, (ii) to examine the relationship of HRV and clinicopathological features, and (iii) to compare HRV between different patient groups, and between patient and control groups. We conducted a systematic literature review following the PRISMA Statement. We searched the PubMed and EMBASE databases for publications released by December 2017. The search terms were: "cancer" AND "heart rate variability" AND "human" NOT "animal" NOT "review." A total of 19 studies were finally included in this review. Most publications were high-quality observational studies. The studies showed that higher HRV correlated positively with patients' progression of disease and outcome. Thus, we conclude that individuals with higher HRV and advanced coping mechanisms seem to have a better prognosis in cancer progression. HRV appears to be a useful aspect to access the general health status of cancer patients.
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http://dx.doi.org/10.3389/fphys.2018.00623DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986915PMC
May 2018

Tissue oximetry by diffusive reflective visible light spectroscopy: Comparison of algorithms and their robustness.

J Biophotonics 2018 09 10;11(9):e201700367. Epub 2018 May 10.

Department of Neonatology, University Hospital Zurich, Zurich, Switzerland.

It is essential to measure tissue oxygen saturation (StO ) locally and in thin layers of tissue, for example, the bronchial mucosa, skin flaps and small bones. Visible light spectroscopy (VLS) with a shallow penetration depth is suitable method. Although several VLS algorithms have been developed and described, they have not yet been compared to each other. This hinders attempts to compare the clinical results obtained by different algorithms. To address this issue, we compared the algorithms of Harrison, Knoefel, Pittman-Duling, Sato and our OxyVLS oximeter, which applies the algorithm from Wodick and Lübbers, in a liquid phantom with optical properties of human tissue. We generally observed considerable differences between the algorithms, which were StO dependent. Exceptions were OxyVLS and Sato, showing a high level of agreement with negligible StO dependency. In spite of the considerable deviation between the other algorithms, the difference of StO between them in clinically normal StO was <10%. We did not observe any dependency of the algorithms on hemoglobin content of the phantom or temperature.
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http://dx.doi.org/10.1002/jbio.201700367DOI Listing
September 2018

Physicochemical Investigations of Homeopathic Preparations: A Systematic Review and Bibliometric Analysis-Part 1.

J Altern Complement Med 2018 May 29;24(5):409-421. Epub 2018 Jan 29.

1 Institute of Complementary Medicine, University of Bern , Bern, Switzerland .

Objectives: The last systematic review of physicochemical research performed on homeopathic preparations was published in 2003. The aim of the study is to update and expand the current state of knowledge in the area of physicochemical properties of homeopathic preparations. In part 1 of the study, we aim to present an overview of the literature with respect to publication quality and methods used. In part 2, we aim to identify the most interesting experimental techniques. With this, we aim to be in a position to generate meaningful hypotheses regarding a possible mode of action of homeopathic preparations.

Methods: A two-step procedure was adopted: (1) an extensive literature search, followed by a bibliometric and quality analysis on the level of publications and (2) a thorough qualitative analysis of the individual physicochemical investigations found. In this publication, we report on step (1). We searched major scientific databases to find publications reporting physicochemical investigations of homeopathy from its origin to the end of 2015. Publications were assessed using a scoring scheme, the Manuscript Information Score (MIS). Information regarding country of origin of the research and experimental techniques used was extracted.

Results: We identified 183 publications (compared to 44 in the last review), 122 of which had an MIS ≥5. The rate of publication in the field was ∼2 per year from the 1970s until 2000. Afterward, it increased to over 5.5 publications per year. The quality of publications was seen to increase sharply from 2000 onward, whereas before 2000, only 12 (13%) publications were rated as "high quality" (MIS ≥7.5); 44 (48%) publications were rated as "high quality" from 2000 onward. Countries with most publications were Germany (n = 42, 23%), France (n = 29, 16%), India (n = 27, 15%), and Italy (n = 26, 14%). Techniques most frequently used were electrical impedance (26%), analytical methods (20%), spectroscopy (20%), and nuclear magnetic resonance (19%).

Conclusions: Physicochemical research into homeopathic preparations is increasing both in terms of quantity and quality of the publications.
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http://dx.doi.org/10.1089/acm.2017.0249DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5961874PMC
May 2018

Effect of short-term colored-light exposure on cerebral hemodynamics and oxygenation, and systemic physiological activity.

Neurophotonics 2017 Oct 20;4(4):045005. Epub 2017 Nov 20.

University of Bern, Institute of Complementary Medicine, Bern, Switzerland.

There is not yet a comprehensive view of how the color of light affects the cerebral and systemic physiology in humans. The aim was to address this deficit through basic research. Since cerebral and systemic physiological parameters are likely to interact, it was necessary to establish an approach, which we have termed "systemic-physiology-augmented functional near-infrared spectroscopy (SPA-fNIRS) neuroimaging." This multimodal approach measures the systemic and cerebral physiological response to exposure to light of different colors. In 14 healthy subjects (9 men, 5 women, age: [Formula: see text] years, range: 24 to 57 years) exposed to red, green, and blue light (10-min intermittent wide-field visual color stimulation; [Formula: see text] blocks of visual stimulation), brain hemodynamics and oxygenation were measured by fNIRS on the prefrontal cortex (PFC) and visual cortex (VC) simultaneously, in addition with systemic parameters. This study demonstrated that (i) all colors elicited responses in the VC, whereas only blue evoked a response in the PFC; (ii) there was a color-dependent effect on cardiorespiratory activity; (iii) there was significant change in neurosystemic functional connectivity; (iv) cerebral hemodynamic responses in the PFC and changes in the cardiovascular system were gender and age dependent; and (v) electrodermal activity and psychological state showed no stimulus-evoked changes, and there was no dependence on color of light, age, and gender. We showed that short-term light exposure caused color-dependent responses in cerebral hemodynamics/oxygenation as well as cardiorespiratory dynamics. Additionally, we showed that neurosystemic functional connectivity changes even during apparently stress-free tasks-an important consideration when using any of the hemodynamic neuroimaging methods (e.g. functional magnetic resonance imaging, positron emission tomography, and fNIRS). Our findings are important for future basic research and clinical applications as well as being relevant for everyday life.
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http://dx.doi.org/10.1117/1.NPh.4.4.045005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5695650PMC
October 2017

[Einstellung von Ärzten gegenüber Komplementärmedizin in einer ländlichen Region der Schweiz: Ergebnisse einer Umfrage].

Complement Med Res 2017;24(5):310-316. Epub 2017 Sep 7.

Hausärztliche Praxis, Rapperswil-Jona, Schweiz.

Fragestellung: Im Zusammenhang mit der Einführung ambulanter KM-Sprechstunden am Regionalspital Burgdorf wurde die ärztliche Einstellung zu Komplementärmedizin (KM) untersucht. Weiterhin wurden der Anteil der Ärzte mit KM-Angeboten im Versorgungsgebiet des Regionalspitals, deren KM-Erfahrungen sowie der Einfluss dieser Erfahrungen auf die Einstellung gegenüber KM untersucht. Material und Methoden: Alle Ärzte jeglicher Fachrichtung (n = 170) im Versorgungsgebiet wurden 2011 und 2012 schriftlich zu ihrer Einstellung gegenüber KM (Befürwortung/Ablehnung und Ambivalenz), ihrem KM-Angebot und ihren KM-Erfahrungen befragt (Rücklaufquote 45% bzw. 36%). Ergebnisse: Die Einstellung gegenüber KM war im Durchschnitt neutral (M = 2,47, Standardabweichung (SD) = 0,61; Befürwortung von KM von 1 = «stimme völlig zu» bis 4 = «stimme überhaupt nicht zu») und klar (M = 1,59, SD = 0,46; Einstellungsambivalenz von 1 = «habe klare Meinung» bis 4 = «bin mir sehr unsicher in meiner Meinung»). Die höchste Zustimmung erhielten die Forderungen nach wissenschaftlicher Untersuchung der KM (M = 2,10, SD = 0,95) und nach zertifizierter ärztlicher KM in der Grundversicherung (M = 2,53, SD = 1,15). Knapp ein Drittel der Ärzte bot KM an, und 77% bzw. 69% überwiesen Patienten zu KM-Behandlungen. Die wichtigsten Prädiktoren der KM-Befürwortung waren eine zertifizierte KM-Ausbildung und unerwartete positive bzw. negative Verläufe unter einer KM-Behandlung (R22011 = 0,44, p < 0,001). 25% der Ärzte hatten Erfahrungen mit der neuen KM-Sprechstunde, die überwiegend positiv waren. Schlussfolgerung: Die teilnehmenden Ärzte aus einer ländlichen Region der Schweiz zeigten im Durchschnitt eine neutrale und klare Einstellung zur KM, die sich im eigenen KM-Angebot bzw. in der Überweisungspraxis spiegelte.
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http://dx.doi.org/10.1159/000480332DOI Listing
May 2019

Reproducibility and comparison of oxygen-enhanced T1 quantification in COPD and asthma patients.

PLoS One 2017 16;12(2):e0172479. Epub 2017 Feb 16.

Department of Diagnostic & Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.

T1 maps have been shown to yield useful diagnostic information on lung function in patients with chronic obstructive pulmonary disease (COPD) and asthma, both for native T1 and ΔT1, the relative reduction while breathing pure oxygen. As parameter quantification is particularly interesting for longitudinal studies, the purpose of this work was both to examine the reproducibility of lung T1 mapping and to compare T1 found in COPD and asthma patients using IRSnapShotFLASH embedded in a full MRI protocol. 12 asthma and 12 COPD patients (site 1) and further 15 COPD patients (site 2) were examined on two consecutive days. In each patient, T1 maps were acquired in 8 single breath-hold slices, breathing first room air, then pure oxygen. Maps were partitioned into 12 regions each to calculate average values. In asthma patients, the average T1,RA = 1206ms (room air) was reduced to T1,O2 = 1141ms under oxygen conditions (ΔT1 = 5.3%, p < 5⋅10-4), while in COPD patients both native T1,RA = 1125ms was significantly shorter (p < 10-3) and the relative reduction to T1,O2 = 1081ms on average ΔT1 = 4.2%(p < 10-5). On the second day, with T1,RA = 1186ms in asthma and T1,RA = 1097ms in COPD, observed values were slightly shorter on average in all patient groups. ΔT1 reduction was the least repeatable parameter and varied from day to day by up to 23% in individual asthma and 30% in COPD patients. While for both patient groups T1 was below the values reported for healthy subjects, the T1 and ΔT1 found in asthmatics lies between that of the COPD group and reported values for healthy subjects, suggesting a higher blood volume fraction and better ventilation. However, it could be demonstrated that lung T1 quantification is subject to notable inter-examination variability, which here can be attributed both to remaining contrast agent from the previous day and the increased dependency of lung T1 on perfusion and thus current lung state.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172479PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312969PMC
September 2017

Modelling confounding effects from extracerebral contamination and systemic factors on functional near-infrared spectroscopy.

Neuroimage 2016 Dec 31;143:91-105. Epub 2016 Aug 31.

University College London, Department of Medical Physics and Biomedical Engineering, Biomedical Optics Research Laboratory, Gower Street, London WC1E 6BT, United Kingdom. Electronic address:

Haemodynamics-based neuroimaging is widely used to study brain function. Regional blood flow changes characteristic of neurovascular coupling provide an important marker of neuronal activation. However, changes in systemic physiological parameters such as blood pressure and concentration of CO can also affect regional blood flow and may confound haemodynamics-based neuroimaging. Measurements with functional near-infrared spectroscopy (fNIRS) may additionally be confounded by blood flow and oxygenation changes in extracerebral tissue layers. Here we investigate these confounds using an extended version of an existing computational model of cerebral physiology, 'BrainSignals'. Our results show that confounding from systemic physiological factors is able to produce misleading haemodynamic responses in both positive and negative directions. By applying the model to data from previous fNIRS studies, we demonstrate that such potentially deceptive responses can indeed occur in at least some experimental scenarios. It is therefore important to record the major potential confounders in the course of fNIRS experiments. Our model may then allow the observed behaviour to be attributed among the potential causes and hence reduce identification errors.
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http://dx.doi.org/10.1016/j.neuroimage.2016.08.058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139986PMC
December 2016
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