Complex Systems & CAM
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Pain. 2008 Jun;136(3):407-18. Epub 2008 Mar 11.
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- Comment in:
- Pain. 2008 Jun;136(3):230-1.
Acupuncture modulates resting state connectivity in default and sensorimotor brain networks.
MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Boston, MA 02129, USA.
Previous studies have defined low-frequency, spatially consistent networks in resting fMRI data which may reflect functional connectivity. We sought to explore how a complex somatosensory stimulation, acupuncture, influences intrinsic connectivity in two of these networks: the default mode network (DMN) and sensorimotor network (SMN). We analyzed resting fMRI data taken before and after verum and sham acupuncture. Electrocardiography data were used to infer autonomic modulation through measures of heart rate variability (HRV). Probabilistic independent component analysis was used to separate resting fMRI data into DMN and SMN components. Following verum, but not sham, acupuncture there was increased DMN connectivity with pain (anterior cingulate cortex (ACC), periaqueductal gray), affective (amygdala, ACC), and memory (hippocampal formation, middle temporal gyrus) related brain regions. Furthermore, increased DMN connectivity with the hippocampal formation, a region known to support memory and interconnected with autonomic brain regions, was negatively correlated with acupuncture-induced increase in a sympathetic related HRV metric (LFu), and positively correlated with a parasympathetic related metric (HFu). Following verum, but not sham, acupuncture there was also increased SMN connectivity with pain-related brain regions (ACC, cerebellum). We attribute differences between verum and sham acupuncture to more varied and stronger sensations evoked by verum acupuncture. Our results demonstrate for the first time that acupuncture can enhance the post-stimulation spatial extent of resting brain networks to include anti-nociceptive, memory, and affective brain regions. This modulation and sympathovagal response may relate to acupuncture analgesia and other potential therapeutic effects.
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Conf Proc IEEE Eng Med Biol Soc. 2007;2007:2023-6.
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Exploratory analysis of functional connectivity network in acupuncture study by a graph theory mode.
Life Science Research Center, Xidian University, Xi’an, Shaanxi, China. bailj0603@yahoo.com.cn
Neuroimaging studies involved acupuncture have already demonstrated its significant modulatory effects on the limbic system, paralimbic and subcortical gray structures. These structures with presumably intimated relationships with acupuncture may constitute a network. In this study, we employed a network mode from the graph theory to evaluate the functional connectivity among multiple brain regions in the resting brain. Evidence from our findings clearly supported the existence of a large functional connectivity network constructed during a resting condition with fMRI. We concluded that acupuncture stimulation may induce the modulation of the ‘acupuncture-related’ network to exert its influence on the therapeutic effects, presented by significant changes of functional connectivity of some brain regions. Our study may provide a further step to the exploration of the underlying mechanism of acupuncture effects.
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Evid Based Complement Alternat Med. 2008 Sep 30. [Epub ahead of print]
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The Influence of Acupressure at Extra 1 Acupuncture Point on the Spectral Entropy of the EEG and the LF/HF Ratio of Heart Rate Variability.
Multidisciplinary Pain Centre, Aichi Medical University, School of Medicine, 21 Karimata, Nagakutecho, Aichigun, Aichi, 480-1195, Japan. arainon@aichi-med-u.ac.jp.
Acupressure applied on the Extra 1 acupuncture point results in sedation, thereby reducing bispectral index (BIS) values. Mental status and hypnotic agents influence the autonomic nervous system. We hypothesized that acupressure at the Extra 1 point would induce sedation and change sympatho-parasympathetic nerve balance. We investigated the effect of acupressure at the Extra 1 point on the EEG spectral entropy values and heart rate variability (HRV). Forty-eight volunteers (24 males and 24 females) were randomly assigned to the control or Extra 1 group. The control group received acupressure at a sham point and the Extra 1 group received acupressure at the Extra 1 point. Acupressure was applied for 5 min. The record of the EEG spectral entropy values and HRV started 5 min before acupressure and stopped 5 min after acupressure. Acupressure significantly reduced the EEG spectral entropy values in both groups, but the values of the Extra 1 group were significantly smaller than those of the control group (P < 0.01). Acupressure significantly decreased the LF/HF ratio of HRV in both groups (P < 0.05). When divided upon gender, although acupressure tended to decrease the LF/HF ratio, the ratio significantly decreased during and after acupressure only in females of the Extra 1 group (P < 0.05). We concluded that acupressure on the Extra 1 point significantly reduced the EEG spectral entropy in both the genders, but affected the LF/HF ratio of HRV only in females.
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Evid Based Complement Alternat Med. 2007 Jun;4(2):149-163. Epub 2007 Feb 5.
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Immunology and Homeopathy. 5. The Rationale of the ‘Simile’
Department of Scienze Morfologico-Biomediche, University of Verona, Piazza L. A. Scuro, 37134 Verona, Association for Integrative Medicine ‘Giovanni Scolaro’, Department of Basic and Applied Biology, University of L’Aquila and Department of Medicina e Sanità Pubblica, University of Verona, Italy.
The foundation of homeopathic medicine is the ‘Similia Principle’, also known as the ‘Principle of Similarity’ or also as the ‘Simile’, which reflects the inversion of pharmacological effects in healthy subjects as compared with sick ones. This article describes the inversion of effects, a widespread medical phenomenon, through three possible mechanisms: non-linearity of dose-response relationship, different initial pathophysiological states of the organism, and pharmacodynamics of body response to the medicine. Based on the systemic networks which play an important role in response to stress, a unitary and general model is designed: homeopathic medicines could interact with sensitive (primed) regulation systems through complex information, which simulate the disorders of natural disease. Reorganization of regulation systems, through a coherent response to the medicine, could pave the way to the healing of the cellular, tissue and neuro-immuno-endocrine homeodynamics. Preliminary evidence is suggesting that even ultra-low doses and high-dilutions of drugs may incorporate structural or frequency information and interact with chaotic dynamics and physical-electromagnetic levels of regulation. From the clinical standpoint, the ’simile’ can be regarded as a heuristic principle, according to which the detailed knowledge of pathogenic effects of drugs, associated with careful analysis of signs and symptoms of the ill subject, could assist in identifying homeopathic remedies with high grade of specificity for the individual case.
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Evid Based Complement Alternat Med. 2008 Sep;5(3):273-9.
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Entropy-based model for interpreting life systems in traditional chinese medicine.
Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100080 and Bioinformatics Division, TNLIST and Department of Automation, Tsinghua University, Beijing 100084, P. R. China.
Traditional Chinese medicine (TCM) treats qi as the core of the human life systems. Starting with a hypothetical correlation between TCM qi and the entropy theory, we address in this article a holistic model for evaluating and unveiling the rule of TCM life systems. Several new concepts such as acquired life entropy (ALE), acquired life entropy flow (ALEF) and acquired life entropy production (ALEP) are propounded to interpret TCM life systems. Using the entropy theory, mathematical models are established for ALE, ALEF and ALEP, which reflect the evolution of life systems. Some criteria are given on physiological activities and pathological changes of the body in different stages of life. Moreover, a real data-based simulation shows life entropies of the human body with different ages, Cold and Hot constitutions and in different seasons in North China are coincided with the manifestations of qi as well as the life evolution in TCM descriptions. Especially, based on the comparative and quantitative analysis, the entropy-based model can nicely describe the evolution of life entropies in Cold and Hot individuals thereby fitting the Yin-Yang theory in TCM. Thus, this work establishes a novel approach to interpret the fundamental principles in TCM, and provides an alternative understanding for the complex life systems.
Abstracts of articles on whole systems of CAM and complex adaptive systems models
(from http://www.ncbi.nlm.nih.gov/pubmed/):
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Artif Intell Med. 2007 Oct;41(2):87-104. Epub 2007 Sep 5.
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Integrative mining of traditional Chinese medicine literature and MEDLINE for functional gene networks.
China Academy of Chinese Medical Sciences, Beijing 100700, China. zxz@mail.cintcm.ac.cn
OBJECTIVE: The amount of biomedical data in different disciplines is growing at an exponential rate. Integrating these significant knowledge sources to generate novel hypotheses for systems biology research is difficult. Traditional Chinese medicine (TCM) is a completely different discipline, and is a complementary knowledge system to modern biomedical science. This paper uses a significant TCM bibliographic literature database in China, together with MEDLINE, to help discover novel gene functional knowledge. MATERIALS AND METHODS: We present an integrative mining approach to uncover the functional gene relationships from MEDLINE and TCM bibliographic literature. This paper introduces TCM literature (about 50,000 records) as one knowledge source for constructing literature-based gene networks. We use the TCM diagnosis, TCM syndrome, to automatically congregate the related genes. The syndrome-gene relationships are discovered based on the syndrome-disease relationships extracted from TCM literature and the disease-gene relationships in MEDLINE. Based on the bubble-bootstrapping and relation weight computing methods, we have developed a prototype system called MeDisco/3S, which has name entity and relation extraction, and online analytical processing (OLAP) capabilities, to perform the integrative mining process. RESULTS: We have got about 200,000 syndrome-gene relations, which could help generate syndrome-based gene networks, and help analyze the functional knowledge of genes from syndrome perspective. We take the gene network of Kidney-Yang Deficiency syndrome (KYD syndrome) and the functional analysis of some genes, such as CRH (corticotropin releasing hormone), PTH (parathyroid hormone), PRL (prolactin), BRCA1 (breast cancer 1, early onset) and BRCA2 (breast cancer 2, early onset), to demonstrate the preliminary results. The underlying hypothesis is that the related genes of the same syndrome will have some biological functional relationships, and will constitute a functional network. CONCLUSION: This paper presents an approach to integrate TCM literature and modern biomedical data to discover novel gene networks and functional knowledge of genes. The preliminary results show that the novel gene functional knowledge and gene networks, which are worthy of further investigation, could be generated by integrating the two complementary biomedical data sources. It will be a promising research field through integrative mining of TCM and modern life science literature.
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Neurosci Lett. 2009 Jan 2;449(1):6-9. Epub 2008 Oct 25.
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An fMRI study of acupuncture using independent component analysis.
Life Science Research Center, School of Electronic Engineering, Xidian University, Xi’an, Shaanxi 710071, China.
In this paper, we studied the brain functional networks corresponding to the traditional multiple-block acupuncture task paradigm. Due to the complexity and sustainability seen during acupuncture, we wanted to investigate whether or not the effects during acupuncture are changing according to the multiple-block paradigm. We introduced the data driven method of independent component analysis (ICA) to identify brain functional networks activated during the course of acupuncture and to isolate different networks likely related to different aspects of the acupuncture experience. The comparisons between different resting states disclosed the discrepancies between the pre- and post-needling effects in the brain. Furthermore, the distinction between needle stimulation and the resting state indicated that there existed different functional brain networks. These results also portray time variability during the course of acupuncture.
PMID: 18977409 [PubMed - in process]
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J Transl Med. 2008 Sep 9;6:48.
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Whole genome expression and biochemical correlates of extreme constitutional types defined in Ayurveda.
Genomics and Molecular Medicine, Functional Genomics Unit, Institute of Genomics and Integrative Biology, CSIR, Delhi, India. bhavana.p@igib.res.in
BACKGROUND: Ayurveda is an ancient system of personalized medicine documented and practiced in India since 1500 B.C. According to this system an individual’s basic constitution to a large extent determines predisposition and prognosis to diseases as well as therapy and life-style regime. Ayurveda describes seven broad constitution types (Prakritis) each with a varying degree of predisposition to different diseases. Amongst these, three most contrasting types, Vata, Pitta, Kapha, are the most vulnerable to diseases. In the realm of modern predictive medicine, efforts are being directed towards capturing disease phenotypes with greater precision for successful identification of markers for prospective disease conditions. In this study, we explore whether the different constitution types as described in Ayurveda has molecular correlates. METHODS: Normal individuals of the three most contrasting constitutional types were identified following phenotyping criteria described in Ayurveda in Indian population of Indo-European origin. The peripheral blood samples of these individuals were analysed for genome wide expression levels, biochemical and hematological parameters. Gene Ontology (GO) and pathway based analysis was carried out on differentially expressed genes to explore if there were significant enrichments of functional categories among Prakriti types. RESULTS: Individuals from the three most contrasting constitutional types exhibit striking differences with respect to biochemical and hematological parameters and at genome wide expression levels. Biochemical profiles like liver function tests, lipid profiles, and hematological parameters like haemoglobin exhibited differences between Prakriti types. Functional categories of genes showing differential expression among Prakriti types were significantly enriched in core biological processes like transport, regulation of cyclin dependent protein kinase activity, immune response and regulation of blood coagulation. A significant enrichment of housekeeping, disease related and hub genes were observed in these extreme constitution types. CONCLUSION: Ayurveda based method of phenotypic classification of extreme constitutional types allows us to uncover genes that may contribute to system level differences in normal individuals which could lead to differential disease predisposition. This is a first attempt towards unraveling the clinical phenotyping principle of a traditional system of medicine in terms of modern biology. An integration of Ayurveda with genomics holds potential and promise for future predictive medicine.
PMID: 18782426 [PubMed - indexed for MEDLINE]
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J Altern Complement Med. 2008 Jun;14(5):571-6.
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Ayurvedic genomics: establishing a genetic basis for mind-body typologies.
University of Pune, Interdisciplinary School of Health Sciences, Pune, India. bhushan@unipune.ernet.in
BACKGROUND: Ayurveda, India’s natural health care tradition, has a unique way of classifying human population based on individual constitution or prakriti. Ayurveda’s tridosha theory identifies principles of motion (vata), metabolism (pitta), and structure (kapha) as discrete phenotypic groupings. Patwardhan et al. (2005) hypothesized in a paper published in this journal that there is a genetic connotation to prakriti and as proof of this concept showed a correlation between HLA alleles and prakriti type, establishing a rationale and preliminary experimental support for the concept of an association between HLA alleles and the Ayurvedic tridosha theory of individual prakriti types. This work is both part of and a catalyst for a wider revolution in the scientific investigation of Ayurveda in India, referred to as “Ayurvedic biology” and “AyuGenomics.” Subsequently, Chen et al. (2007) reported a similar study in this journal using a classification based on Traditional Chinese Medicine (TCM) theory. CONCLUSIONS: The findings of a genetic basis for both Ayurvedic and TCM classifications indicate a commonality between Asia’s great medical traditions in their diagnostic typologies and a genetic basis for Asian traditional medicine’s theory of discrete and discernable groupings of psycho-physiologic differences. Accordingly, new horizons have opened for collaborative East-East research and for an individualized approach to disease management and activation of the full range of human potential, as articulated in Ayurveda and TCM.
PMID: 18564959 [PubMed - indexed for MEDLINE]
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J Transl Med. 2008 Mar 18;6:14.
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Merger of ayurveda and tissue culture-based functional genomics: inspirations from systems biology.
National Institute of Advanced Industrial Science & Technology (AIST), Central 4, 1-1-1 Higashi, Tsukuba, Ibaraki 305-8562, Japan. custerd@biochem.taiiku.tsukuba.ac.jp
Ayurveda is one of the ancient systems of health care of Indian origin. Roughly translated into “Knowledge of life”, it is based on the use of natural herbs and herb products for therapeutic measures to boost physical, mental, social and spiritual harmony and improve quality of life. Although sheltered with long history and high trust, ayurveda principles have not entered laboratories and only a handful of studies have identified pure components and molecular pathways for its life-enhancing effects. In the post-genomic era, genome-wide functional screenings for targets for diseases is the most recent and practical approach. We illustrate here the merger of ayurveda and functional genomics in a systems biology scenario that reveals the pathway analysis of crude and active components and inspire ayurveda practice for health benefits, disease prevention and therapeutics.
PMID: 18348714 [PubMed - indexed for MEDLINE]
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Conf Proc IEEE Eng Med Biol Soc. 2008;2008:1108-11.
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An analysis of EEG when acupuncture with wavelet entropy.
School of electronic engineering and automation, Tianjin University, CO 300072 China.
Wavelet energy entropy derived from wavelet multi-revolution decomposition, reconstruction and Shannon entropy can signify the complexity of unsteady EEG signals in both time domain and frequency domain. Firstly, the paper gives an introduction of the methods about wavelet energy entropy. Then the EEG signals when acupuncture is analyzed and some conclusions are addressed by using wavelet energy entropy, relative wavelet energy entropy and the time evolution of them.
PMID: 19162857 [PubMed - in process]
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Integr Cancer Ther. 2006 Dec;5(4):293-307.
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Models for the study of whole systems.
Department of Family, Program in Integrative Medicine, University of Arizona College of Medicine, Tucson, AZ 85719, USA. ibell@u.arizona.edu
This article summarizes a network and complex systems science model for research on whole systems of complementary and alternative medicine (CAM) such as homeopathy and traditional Chinese medicine. The holistic concepts of networks and nonlinear dynamical complex systems are well matched to the global and interactive perspectives of whole systems of CAM, whereas the reductionistic science model is well matched to the isolated local organ, cell, and molecular mechanistic perspectives of pharmaceutically based biomedicine. Whole systems of CAM are not drugs with specific actions. The diagnostic and therapeutic approaches of whole systems of CAM produce effects that involve global and patterned shifts across multiple subsystems of the person as a whole. For homeopathy, several characteristics of complex systems, including the probabilistic nature of attractor patterns, variable sensitivity of complex systems to initial conditions, and emergent behaviors in the evolution of a system in its full environmental context over time, could help account for the mixed basic science and controlled clinical trial research findings, in contrast with the consistently positive outcomes of observational studies in the literature. Application of theories and methods from complex systems and network science can open a new era of advances in understanding factors that lead to good versus poor individual global outcome patterns and to rational triage of patients to one type of care over another. The growing reliance on complex systems thinking and systems biology for cancer research affords a unique opportunity to bridge between the CAM and conventional medical worlds with some common language and conceptual models.
PMID: 17101758 [PubMed - indexed for MEDLINE]
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Homeopathy. 2005 Apr;94(2):86-91.
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Histamine at high dilution reduces spectral density in delta band in sleeping rats.
Laboratorio de Biofísica, Instituto de Física y Matemáticas, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, México. ruizvega@ifm.umich.mx
Histamine is a central neurotransmitter, it increases arousal via H1 receptors. This study examines the effect of ultra-diluted histamine on arousal through changes in the sleep pattern of Wistar rats. The spectral density in delta (0.5-2.5 Hz) band, one of the three major spectral components of the sleep-electroencephalogram, was analyzed against time. Rats were randomized to receive histamine 30c (histamine 30c, 0.05 ml every 20 min during the first 2 h orally), histamine intraperitoneal pre-treatment/histamine 30c (histamine 6mg/kg i.p., followed by histamine 30c) or solvent control. The mean delta band spectral density was lower in the histamine 30c and histamine pretreatment/histamine 30c groups than the control group. Significant differences between histamine 30c and baseline during the first 2 h imply an immediate effect. These results also suggest a dynamic process in which the system spontaneously evolves between two locally stationary states according to a power law. From the time perspective, the system approaches, asymptotically, an equifinal state.
PMID: 15892488 [PubMed - indexed for MEDLINE]
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J Altern Complement Med. 2004 Oct;10(5):791-801.
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Acupuncture as a complex intervention: a holistic model.
MRC Health Services Research Collaboration, Department of Social Medicine, University of Bristol, Bristol B58 2PR, UK. C.Paterson@briston.ac.uk
OBJECTIVES: Our understanding of acupuncture and Chinese medicine is limited by a lack of inquiry into the dynamics of the process. We used a longitudinal research design to investigate how the experience, and the effects, of a course of acupuncture evolved over time. DESIGN AND OUTCOME MEASURES: This was a longitudinal qualitative study, using a constant comparative method, informed by grounded theory. Each person was interviewed three times over 6 months. Semistructured interviews explored people’s experiences of illness and treatment. Across-case and within-case analysis resulted in themes and individual vignettes. SUBJECTS AND SETTINGS: Eight (8) professional acupuncturists in seven different settings informed their patients about the study. We interviewed a consecutive sample of 23 people with chronic illness, who were having acupuncture for the first time. RESULTS: People described their experience of acupuncture in terms of the acupuncturist’s diagnostic and needling skills; the therapeutic relationship; and a new understanding of the body and self as a whole being. All three of these components were imbued with holistic ideology. Treatment effects were perceived as changes in symptoms, changes in energy, and changes in personal and social identity. The vignettes showed the complexity and the individuality of the experience of acupuncture treatment. The process and outcome components were distinct but not divisible, because they were linked by complex connections. The paper depicts these results as a diagrammatic model that illustrates the components and their interconnections and the cyclical reinforcement, both positive and negative, that can occur over time. CONCLUSIONS: The holistic model of acupuncture treatment, in which “the whole being greater than the sum of the parts,” has implications for service provision and for research trial design. Research trials that evaluate the needling technique, isolated from other aspects of process, will interfere with treatment outcomes. The model requires testing in different service and research settings.
PMID: 15650468 [PubMed - indexed for MEDLINE]
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J Altern Complement Med. 2004 Feb;10(1):123-31.
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Strength of vital force in classical homeopathy: bio-psycho-social-spiritual correlates within a complex systems context.
Department of Medicine and Program in Integrative Medicine, University of Arizona, Tucson, 85724-5153, USA. ibell@u.arizona.edu
OBJECTIVE: To explore associations between a global rating for the classical homeopathic construct of vital force and clinician and patient ratings on previously validated bio-psycho-social-spiritual questionnaires. METHODS: Sixty-two (62) community-recruited patients with fibromyalgia (FM) were assessed at baseline prior to a clinical trial of individualized homeopathy. Two homeopaths jointly performed case-taking interviews. A conventional medical provider independently evaluated patients with a standardized history and physical examination. Homeopaths rated each patient’s vital force (five-point Likert scale, with 1 = very weak to 5 = very strong). Homeopaths and the conventional medical provider rated their Clinical Global Impression (CGI) of the severity of illness (1 = normal; 7 = among the most extremely ill). Patients completed self-rating scales on pain, global health, mood, quality of life, coping style, health locus of control, multidimensional well-being, spirituality, sense of coherence, positive states of mind, and social desirability. RESULTS: Greater vital force ratings (mean 2.9 standard deviation [SD] 0.6) correlated moderately (p < or = 0.005) with less severe CGI illness ratings by the homeopaths (r =-0.59), decreased patient-rated mental confusion (r =-0.43), higher vigor (r = 0.38), and greater positive states of mind (r = 0.36). Vital force also showed correlations (p < 0.05) with lower CGI ratings by the conventional medical provider (r =-0.32), better selfrated quality of life (r = 0.33), lesser fatigue (r =-0.31), better global health (r = 0.29), greater sense of coherence (r = 0.28), powerful-others health locus of control (r = 0.27), increased emotional well-being (r = 0.27), and higher social desirability (r = 0.27), but not with age, pain, or illness duration. CONCLUSION: Homeopathic vital force ratings reflect better perceived mental function, energy, and positive dimensions of the individual, beyond absence of disease.
PMID: 15025886 [PubMed - indexed for MEDLINE]
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Homeopathy. 2003 Oct;92(4):203-12.
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Complexity science and homeopathy: a synthetic overview.
Dipartimento di Scienze Morfologico-Biomediche, University of Verona Ospedale Policlinico, Piazza L.A. Scuro, 37134 Verona, Italy. paolo.bellavite@univr.it
Homeopathy is founded on ‘holistic’ and ‘vitalistic’ paradigms, which may be interpreted–at least in part–in terms of a framework provided by the theory of dynamic systems and of complexity. The conceptual models and some experimental findings from complexity science may support the paradoxical claims of similia principle and of dilution/dynamization effects. It is argued that better appreciation of three main properties of complex systems: non-linearity, self-organization, and dynamicity, will not only add to our basic understanding of homeopathic phenomena but also illuminate new directions for experimental investigations and therapeutic settings.
PMID: 14587687 [PubMed - indexed for MEDLINE]
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Altern Ther Health Med. 2002 May-Jun;8(3):58-66.
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Translating a nonlinear systems theory model for homeopathy into empirical tests.
Department of Psychiatry, University of Arizona, Tucson, USA.
Various investigators have proposed that nonlinear systems theory, notably chaos and complexity theory, provides a heuristically useful modelfor conceptualizing the way in which complementary and alternative medicine therapies, which purport to modify subtle energies, effect change throughout the individual as a whole. In this paper we apply this theory to classical homeopathy and outline an empirical approach for testing the resultant hypotheses. Such research may advance understanding of the mechanisms of homeopathic remedy effects and provide a direction for homeopathic research that expands the previous emphasis on clinical trials and the remedies themselves. In refocusing attention on the dynamics of the patient as a nonlinear complex system, the proposed research program is consistent with the homeopathic emphasis on the individual rather than the disease. This approach may have additional applications that can elucidate similar effects of other energy medicine modalities (eg, acupuncture) on the healing process of the person as a unified whole.
PMID: 12017501 [PubMed - indexed for MEDLINE]
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Homeopathy. 2002 Apr;91(2):89-94.
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- Comment in:
- Homeopathy. 2002 Apr;91(2):61-2.
Homeopathic effect: a network perspective.
Instituto de Fisica y Matematicas, Universidad Michoacana, Morelia, Mexico. jltorres@ifm1.ifm.umich.mx
There are two aspects to the problem of describing the homeopathic effect in physical terms: the nature of the therapeutic agent, and the system on which it acts. The latter can be considered as a network, which provides a conceptual framework that throws new light on long-standing questions, based on generic results such as the enhanced susceptibility of networks near critical states. It suggests a characterisation of health and disease in terms of distance from a critical state. The Internet provides a concrete analogy. This predicts a limiting condition on the acceptable loss of highly connected nodes in the system, and suggests a procedure to measure its connectivity and related parameters.
PMID: 12371463 [PubMed - indexed for MEDLINE]
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Homeopathy. 2002 Jul;91(3):145-9.
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Oscillatory effects in a homeopathic clinical trial: an explanation using complexity theory, and implications for clinical practice.
Department of Psychology, University of Plymouth, UK. mhyland@plymouth.ac.uk
Four double-blind, randomised, placebo-controlled clinical trials of asthma or rhinitis treated with homeopathic immunotherapy (HIT) at a 30C potency have been published. The most recent study, involving house dust mite allergic asthmatics, failed to confirm a therapeutic improvement at the end of the study, but did provide preliminary evidence for an oscillation in outcome (both physiological and subjective) in with verum treatment to placebo. In this paper we show how such an oscillation is consistent with a complexity theory interpretation of how the body functions as a whole, and speculate on why different studies have produced different results. If the complexity theory interpretation is correct, then this will have a significant impact on the design of clinical trials in homeopathy and, possibly, other complementary medical interventions.
PMID: 12322867 [PubMed - indexed for MEDLINE]
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Homeopathy. 2002 Jan;91(1):26-31.
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Vitalism, complexity and the concept of spin.
Department of Chemistry, Imperial College of Science, Technology and Medicine, London, UK. l.milgrom@ic.ac.uk
Vital Force is a concept that has suffered at the hands of the current medical model. An attempt is made to show how it might be possible to explain Vital Force in terms of complexity theory. A metaphor is introduced for the operation of Vital Force in terms of gyroscopic motion.
PMID: 12371447 [PubMed - indexed for MEDLINE]
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Evid Based Complement Alternat Med. 2007 Sep;4(3):279-285.
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Evaluating Complex Healthcare Systems: A Critique of Four Approaches.
University of Toronto Canada, University of York UK, Oregon College of Oriental Medicine USA, University Hospital of North Norway Norway, University of Arizona USA, National Research Center in Complementary and Alternative Medicine, University of Tromsø Norway and University of Northampton UK.
The purpose of this paper is to bring clarity to the emerging conceptual and methodological literature that focuses on understanding and evaluating complex or ‘whole’ systems of healthcare. An international working group reviewed literature from interdisciplinary or interprofessional groups describing approaches to the evaluation of complex systems of healthcare. The following four key approaches were identified: a framework from the MRC (UK), whole systems research, whole medical systems research described by NCCAM (USA) and a model from NAFKAM (Norway). Main areas of congruence include acknowledgment of the inherent complexity of many healthcare interventions and the need to find new ways to evaluate these; the need to describe and understand the components of complex interventions in context (as they are actually practiced); the necessity of using mixed methods including randomized clinical trials (RCTs) (explanatory and pragmatic) and qualitative approaches; the perceived benefits of a multidisciplinary team approach to research; and the understanding that methodological developments in this field can be applied to both complementary and alternative medicine (CAM) as well as conventional therapies. In contrast, the approaches differ in the following ways: terminology used, the extent to which the approach attempts to be applicable to both CAM and conventional medical interventions; the prioritization of research questions (in order of what should be done first) especially with respect to how the ‘definitive’ RCT fits into the process of assessing complex healthcare systems; and the need for a staged approach. There appears to be a growing international understanding of the need for a new perspective on assessing complex healthcare systems.
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Biol Psychol. 2009 Mar;80(3):325-32. Epub 2008 Dec 3.
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Effects of stress on heart rate complexity–a comparison between short-term and chronic stress.
Clinical Department of Medical Psychology, Innsbruck Medical University, Innsbruck, Austria. christian.schubert@i-med.ac.at
This study examined chronic and short-term stress effects on heart rate variability (HRV), comparing time, frequency and phase domain (complexity) measures in 50 healthy adults. The hassles frequency subscale of the combined hassles and uplifts scale (CHUS) was used to measure chronic stress. Short-term stressor reactivity was assessed with a speech task. HRV measures were determined via surface electrocardiogram (ECG). Because respiration rate decreased during the speech task (p<.001), this study assessed the influence of respiration rate changes on the effects of interest. A series of repeated-measures analyses of covariance (ANCOVA) with Bonferroni adjustment revealed that short-term stress decreased HR D2 (calculated via the pointwise correlation dimension PD2) (p<.001), but increased HR mean (p<.001), standard deviation of R-R (SDRR) intervals (p<.001), low (LF) (p<.001) and high frequency band power (HF) (p=.009). Respiratory sinus arrhythmia (RSA) and LF/HF ratio did not change under short-term stress. Partial correlation adjusting for respiration rate showed that HR D2 was associated with chronic stress (r=-.35, p=.019). Differential effects of chronic and short-term stress were observed on several HRV measures. HR D2 decreased under both stress conditions reflecting lowered functionality of the cardiac pacemaker. The results confirm the importance of complexity metrics in modern stress research on HRV.
