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Radiation Oncology (London, England) Jun 2024Particle therapy makes a noteworthy contribution in the treatment of tumor diseases. In order to be able to irradiate from different angles, usually expensive, complex...
BACKGROUND
Particle therapy makes a noteworthy contribution in the treatment of tumor diseases. In order to be able to irradiate from different angles, usually expensive, complex and large gantries are used. Instead rotating the beam via a gantry, the patient itself might be rotated. Here we present tolerance and compliance of volunteers for a fully-enclosed patient rotation system in a clinical magnetic resonance (MR)-scanner for potential use in MR-guided radiotherapy, conducted within a prospective evaluation study.
METHODS
A patient rotation system was used to simulate and perform magnetic resonance imaging (MRI)-examinations with 50 volunteers without an oncological question. For 20 participants, the MR-examination within the bore was simulated by introducing realistic MRI noise, whereas 30 participants received an examination with image acquisition. Initially, body parameters and claustrophobia were assessed. The subjects were then rotated to different angles for simulation (0°, 45°, 90°, 180°) and imaging (0°, 70°, 90°, 110°). At each angle, anxiety and motion sickness were assessed using a 6-item State-Trait-Anxiety-Inventory (STAI-6) and a modified Motion Sickness Assessment Questionnaire (MSAQ). In addition, general areas of discomfort were evaluated.
RESULTS
Out of 50 subjects, three (6%) subjects terminated the study prematurely. One subject dropped out during simulation due to nausea while rotating to 45°. During imaging, further two subjects dropped out due to shoulder pain from positioning at 90° and 110°, respectively. The average result for claustrophobia (0 = no claustrophobia to 4 = extreme claustrophobia) was none to light claustrophobia (average score: simulation 0.64 ± 0.33, imaging 0.51 ± 0.39). The mean anxiety scores (0% = no anxiety to 100% = maximal anxiety) were 11.04% (simulation) and 15.82% (imaging). Mean motion sickness scores (0% = no motion sickness to 100% = maximal motion sickness) of 3.5% (simulation) and 6.76% (imaging) were obtained across all participants.
CONCLUSION
Our study proves the feasibility of horizontal rotation in a fully-enclosed rotation system within an MR-scanner. Anxiety scores were low and motion sickness was only a minor influence. Both anxiety and motion sickness showed no angular dependency. Further optimizations with regard to immobilization in the rotation device may increase subject comfort.
Topics: Humans; Prospective Studies; Male; Female; Magnetic Resonance Imaging; Adult; Rotation; Radiotherapy, Image-Guided; Middle Aged; Young Adult; Motion Sickness; Patient Compliance; Anxiety; Healthy Volunteers
PubMed: 38849900
DOI: 10.1186/s13014-024-02461-2 -
Biomolecules & Biomedicine May 2024Dimenhydrinate (DMH), used to alleviate motion sickness symptoms such as nausea, vomiting, dizziness, and vertigo, encounters limitations in oral pharmaceutical...
Dimenhydrinate (DMH), used to alleviate motion sickness symptoms such as nausea, vomiting, dizziness, and vertigo, encounters limitations in oral pharmaceutical formulations due to its poor water solubility and bitter taste. Our research hypothesized that inclusion complexation with β-cyclodextrin (β-CD) might address these drawbacks while ensuring that the newly formed complexes exhibit no cytotoxic or genotoxic effects on peripheral blood mononuclear cells (PBMCs). Inclusion complexes were prepared using the kneading method and the solvent evaporation method. The phase solubility analysis, attenuated total reflectance-fourier transform infrared spectroscopy (ATR-FTIR), and differential scanning calorimetry (DSC) were conducted to evaluate the complexation efficacy and stability constant of the new binary systems. The results demonstrated that both methods provided complete and efficient complexation. Cytogenotoxic analysis, including the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) assay, alkaline comet assay, and cytokinesis-block micronucleus cytome (CBMN-cyt) assay, was conducted to assess the cytogenotoxic potential of DMH-β-CD inclusion complexes, a topic previously unexamined. No cytotoxic or genotoxic effects were observed within the concentration range of 36.36 to 109.09 ng/mL. Cell viability of treated PBMCs exceeded 85% for all tested concentrations. No significant increases in DNA strand breaks were observed at any dose, and tail intensity of all complexes remained lower or up to 2.2% higher than the negative control. Parameters indicating genotoxic effects, as well as cytotoxic and cytostatic potential in the CBMN-cyt assay, did not significantly differ from untreated controls. These results suggest that inclusion complexation with β-CD might be a safe and promising solution to overcome the limitations of poor solubility and unpleasant taste of DMH, potentially providing opportunities for new and improved oral pharmaceutical dosage forms.
PubMed: 38819319
DOI: 10.17305/bb.2024.10507 -
Applied Ergonomics Sep 2024Thresholds that guide diagnoses of probable and acceptable seasickness levels on board ships are scarcely reported in literature. Motion sickness incidence and motion...
Thresholds that guide diagnoses of probable and acceptable seasickness levels on board ships are scarcely reported in literature. Motion sickness incidence and motion sickness dose value thresholds exist, but are defined for specific environments, such as naval, or offered merely as optional criteria for ship performance metrics. The presented work communicates a novel means of developing seasickness diagnostic criteria during ship operation, based on observations from shipboard measurement systems and seafarers using an innovative platform. The innovative platform provides personalised seasickness criteria that are accessible during ship operation to estimate the probable level of seasickness on board. Results are compared to that from a traditional method of data acquisition and analyses, post operation, revealing a similar trend in diagnostic threshold magnitudes (13-85 m/s) that can be applicable to voyages with different durations (0.5-6 hr) considering desired levels of seasickness (10-50 %). The seasickness criteria are envisioned to be pertinent for the prediction of probable seasickness levels based on sea state forecasts and ship motion estimation.
Topics: Humans; Motion Sickness; Ships; Male; Adult; Naval Medicine
PubMed: 38810325
DOI: 10.1016/j.apergo.2024.104316 -
Applied Ergonomics Sep 2024Motion sickness (MS) poses challenges for individuals affected, hindering their activities and travel. This study investigates the effect of a visual dynamic device,... (Review)
Review
Motion sickness (MS) poses challenges for individuals affected, hindering their activities and travel. This study investigates the effect of a visual dynamic device, forming an artificial horizon plane, on symptoms and physiological changes induced by MS. This device consists of vertical light-emitting diodes whose illumination varies according to the boat's movements. Fifteen subjects with moderate-to-severe MS susceptibility were exposed to a seasickness simulator with and without the device. Symptoms were assessed immediately after exposure. Time spent in the simulator, heart rate, and temperature were also recorded. Symptom intensity at the end of the experience did not differ, but the time spent in the simulator was significantly longer with the device (+46%). Variations in heart rate were also observed. The device delays symptom onset and can be used as a tool against MS. Further research is needed to evaluate its effects, for example, during more prolonged exposure to MS-inducing stimuli.
Topics: Humans; Motion Sickness; Male; Adult; Heart Rate; Female; Feedback, Sensory; Young Adult; Body Temperature; Ships; Middle Aged; Time Factors
PubMed: 38797015
DOI: 10.1016/j.apergo.2024.104318 -
PloS One 2024Ship design involves optimizing the hull in order to enhance safety, economic efficiency, and technical efficiency. Despite the long-term research on this problem and a...
Ship design involves optimizing the hull in order to enhance safety, economic efficiency, and technical efficiency. Despite the long-term research on this problem and a number of significant conclusions, some of its content still needs to be improved. In this study, block and midship coefficients are incorporated to optimize the ship's hull. The considered ship was a patrol vessel. The seakeeping analysis was performed employing strip theory. The hull form was generated using a fuzzy model. Though the body lines generated by the midship coefficient (CM) and block coefficient (CB) varied indecently, the other geometric parameters remained the same. Multi-objective optimization was used to optimize CB and CM. According to the results of this study, these coefficients have a significant impact on the pitch motion of the patrol vessel as well as the motion sickness index. Heave and roll motions, as well as the added resistance, were not significantly influenced by the coefficients of CM and CB. However, increasing the hull form parameters increases the maximum Response Amplitude Operator (RAO) of heave and roll motions. The frequency of occurrence of the maximum roll RAO was in direct relation with CB and CM. These coefficients, however, had no meaningful impact on the occurrence frequency of other motion indices. In the end, the CB and CM coefficients were selected based on the vessel's seakeeping performance. These findings might be used by shipbuilders to construct the vessel with more efficient seakeeping performance.
Topics: Ships; Humans; Models, Theoretical; Motion; Fuzzy Logic; Equipment Design
PubMed: 38709781
DOI: 10.1371/journal.pone.0302054 -
Ugeskrift For Laeger Apr 2024Evidence suggests that available antiemetics are equal to intravenous fluid treatment against acute nausea of other causes than motion sickness, pregnancy, anaesthesia,... (Review)
Review
Evidence suggests that available antiemetics are equal to intravenous fluid treatment against acute nausea of other causes than motion sickness, pregnancy, anaesthesia, chemo- or radiation therapy. Each antiemetic is associated with adverse effects, which include movement disorders, sedation, and QT prolongation. Intravenous fluid and treatment directed against underlying pathology is recommended as a first-line treatment against nausea in these patients. If an antiemetic is clinically warranted, ondansetron has the most favourable ratio between side effects and price, as argued in this review.
Topics: Humans; Antiemetics; Nausea; Acute Disease; Ondansetron; Fluid Therapy; Hospitalization; Female; Pregnancy
PubMed: 38704720
DOI: 10.61409/V11230735 -
BMC Neurology May 2024During episodes of benign paroxysmal positional vertigo (BPPV), individuals with migraine, compared with individuals without migraine, may experience more severe...
BACKGROUND
During episodes of benign paroxysmal positional vertigo (BPPV), individuals with migraine, compared with individuals without migraine, may experience more severe vestibular symptoms because of their hyperexcitable brain structures, more adverse effects on quality of life, and worse recovery processes from BPPV.
METHODS
All patients with BPPV were assigned to the migraine group (MG, n = 64) and without migraine group (BPPV w/o MG, n = 64) and completed the Vertigo Symptom Scale (VSS), Vertigo Dizziness Imbalance Symptom Scale (VDI-SS), VDI Health-Related Quality of Life Scale (VDI-HRQoLS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) at the time of BPPV diagnosis (baseline) and on the one-month follow-up. Headache Impact Test-6 and Migraine Disability Assessment Scale were used for an assessment of headache. Motion sickness was evaluated based on the statement of each patient as present or absent.
RESULTS
Compared with the BPPV w/o MG, the MG had higher VSS scores at baseline [19.5 (10.7) vs. 11.3 (8.5); p < 0.001] and on one-month follow-up [10.9 (9.3) vs. 2.2 (2.7), p < 0.001]; experienced more severe dizziness and imbalance symptoms based on the VDI-SS at baseline (61.9% vs. 77.3%; p < 0.001) and after one month (78.9% vs. 93.7%, p < 0.001); and more significantly impaired quality of life according to the VDI-HRQoLS at baseline (77.4% vs. 91.8%, p < 0.001) and after one month (86.3% vs. 97.6%, p < 0.001). On the one-month follow-up, the subgroups of patients with moderate and severe scores of the BAI were higher in the MG (39.2%, n = 24) than in the BPPV w/o MG (21.8%, n = 14) and the number of patients who had normal scores of the BDI was lower in the MG than in the BPPV w/o MG (67.1% vs. 87.5%, p = 0.038).
CONCLUSION
Clinicians are advised to inquire about migraine when evaluating patients with BPPV because it may lead to more intricate and severe clinical presentation. Further studies will be elaborated the genuine nature of the causal relationship between migraine and BPPV.
Topics: Humans; Male; Benign Paroxysmal Positional Vertigo; Female; Migraine Disorders; Middle Aged; Adult; Quality of Life; Recovery of Function; Follow-Up Studies; Dizziness; Aged
PubMed: 38698310
DOI: 10.1186/s12883-024-03606-2 -
Brain Stimulation 2024
Topics: Humans; Parietal Lobe; Transcranial Direct Current Stimulation; Motion Sickness; Male; Adult; Female; Virtual Reality
PubMed: 38670223
DOI: 10.1016/j.brs.2024.04.015 -
Digital Health 2024The purpose of this study was to investigate whether a virtual reality (VR) program designed and developed based on the hallucinogenic harm reduction and integration...
Feasibility and effectiveness study of applying a hallucinogen harm reduction and integration model to a mindfulness thinking intervention using virtual reality: A randomized controlled trial.
OBJECTIVE
The purpose of this study was to investigate whether a virtual reality (VR) program designed and developed based on the hallucinogenic harm reduction and integration (PHRI) clinical model could be more effective in guiding positive thinking training, improving positive thinking awareness and ability, and, to some extent, facilitating personal efficacy and emotional state compared to a traditional VR program that places users in a virtual natural ecological environment to guide positive thinking training. We also sought to understand the factors that may influence the effectiveness of VR interventions and user experience.
METHOD
Seventy-six randomly recruited participants were divided into a control group and an experimental group of 38 participants, each according to a random number table, and were trained in VR meditation for eight weeks. The experimental group used a PHRI-based mindfulness program, while the control group used a traditional mindfulness meditation program. We used The Mindful Attention Awareness Scale and the PAD emotional three-dimensional scale to assess the level of state mindfulness and changes in the emotional state before and at the end of the experiment. The Immersive Tendencies Questionnaire measured the user's sense of presence and immersion in the virtual environment. The Five Facet Mindfulness Questionnaires and the Depression Anxiety and Stress Scale (DASS-21) were used at the baseline assessment stage before and at the 4-week follow-up after the experiment to assess the change in trait mindfulness levels due to the mindfulness training. The Five Facet Mindfulness Questionnaires and the DASS-21 were used to assess changes in mindfulness and mental health trait levels.
RESULTS
At the end of the experiment, the MMSQ score was significantly lower in the control group than in the experimental group, while the ITQ score was significantly higher than in the experimental group, and both scores were statistically significant ( < 0.05). In the follow-up assessment four weeks after the end of the experiment, the FFMQ-15 score and the DASS-21 were significantly and statistically higher in the experimental group than in the control group ( < 0.05). Since the scores of the PAD scale did not obey a normal distribution, we used the Wilcoxon signed-rank test to assess the results, which proved that the experimental group had higher levels of emotional activation and arousal.
CONCLUSION
The VR positive thinking program developed based on PHRI can significantly increase the positive thinking state and emotional arousal and activation of the general population participants but does not directly lead to the growth of positive emotions. Moreover, this detached psychedelic scene brings users a weaker sense of presence and presence than traditional natural space scenes. Furthermore, it does not bring any intense simulator motion sickness symptoms. These findings suggest that VR programs developed based on PHRI have a more positive facilitation effect on the positive state and that this increase lasts longer than conventional VR-positive programs.
PubMed: 38665888
DOI: 10.1177/20552076241249869 -
JAMA Network Open Apr 2024It is usually assumed that an individual's classification as a patient or a healthy person is determined by the presence or absence of disease, but little is known about... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
It is usually assumed that an individual's classification as a patient or a healthy person is determined by the presence or absence of disease, but little is known about whether the mere awareness of being a patient or a healthy control can play an important role for reporting outcomes.
OBJECTIVE
To investigate whether assignment to the role of a patient or a healthy control has an effect on patient-reported outcomes.
DESIGN, SETTING, AND PARTICIPANTS
This single center, double-blind, 3-group randomized clinical trial included consecutive patients from a tertiary headache clinic based at a single center in Germany who were invited to participate between October 2019 and June 2023. Statistical analysis was performed from January to March 2024.
INTERVENTION
Patients with migraine were randomized into 2 groups. The first group was told that this study was centered on migraine symptoms, whereas the second group was told that healthy controls were being sought for a study about patients with vertigo. A third group of age- and sex-matched headache-free participants served as controls. All participants viewed 2 standardized roller coaster videos and provided ratings of their perceived levels of motion sickness and dizziness.
MAIN OUTCOMES AND MEASURES
The primary outcome was self-reported vestibular symptoms. Secondary outcomes included differences in motion sickness, headache burden, and migraine disability. Outcomes were assessed using standardized questionnaires.
RESULTS
The final sample included 366 participants: 122 patients with migraine assigned the role of patient (MP) (migraine as patient): mean [SD] age, 37.56 [12.93] years; 105 [86.1%] female), 122 patients with migraine assigned the role of healthy participant (MH) (migraine as healthy): mean [SD] age, 37.03 [13.10] years; 107 [87.7%] female), and 122 headache-free controls (HC): mean [SD] age, 37.55 [11.56] years; 100 [82.0%] female). The assigned role of the individuals with migraine (MP vs MH) had a significant effect on self-disclosure of (1) estimation that symptoms (dizziness) will occur under specific conditions (self-reported vestibular symptoms: 79 MP [64.8%]; 29 MH [23.8%]; 9 HC [7.4%]; P < .001), (2) the increase of such symptoms (dizziness) after viewing the roller coaster video, and (3) the reported frequency (median [IQR] self-reported monthly headache days for MP: 7 [4-15] days; for MH: 5 [2-10] days; P = .008) and severity (median [IQR] migraine disability assessment score for MP: 35 [20-64] points; for MH: 25 [11-47] points; P = .005) of migraine symptoms. Statistically significant changes were also found for self-reported headache frequency and disability caused by migraine.
CONCLUSIONS AND RELEVANCE
This randomized clinical trial found an effect of expectations regarding the role of a patient with respect to clinical and study outcomes. These findings suggest that role expectations should be taken into account when, for example, invasive treatments are discussed.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT06322550.
Topics: Humans; Migraine Disorders; Female; Male; Patient Reported Outcome Measures; Adult; Middle Aged; Double-Blind Method; Self Report; Germany; Dizziness
PubMed: 38656579
DOI: 10.1001/jamanetworkopen.2024.3223