Posts tagged with "RCT"

The app teaching anorexics to eat

More patients go into long-term remission by re-learning how to eat,
than through CBT or drugs

The Mandometer app connects to a weighing scale, and guides patients’ eating behavior by providing visual feedback. Redistributed under CC BY-NC-ND 3.0 from J Vis Exp. 2018; (135): 57432.

Swedish scientists say that eating disorders should be considered just that – eating disorders, rather than mental disorders. The proof, they say, is in the eating.

“Anorexic patients can learn to eat at a normal rate by adjusting food intake to feedback from a smartphone app,” says Per Södersten, Professor at the Karolinska Institute and lead author of an article in Frontiers in Neuroscience defending his pioneering method. “And in contrast to failing standard treatments, most regain a normal body weight, their health improves, and few relapse.”

The approach is based on the theory that slow eating and excessive physical exertion, both hallmarks of anorexia, are evolutionarily conserved responses to short food supply that can be triggered by dieting – and reversed by practicing normal eating.

Which came first: the diet or the anorexia?

Attempts to treat anorexia as a mental illness have largely failed, claim the authors.

“The standard treatment worldwide, cognitive behavioral therapy (CBT), targets cognitive processes thought to maintain the disorder,” explains Södersten. “The rate of remission from eating disorders is at most 25% one year after CBT, with unknown outcomes in the long-term. Psychoactive drugs have proven even less effective.”

Instead, they say, we need to flip our perspective: to target eating behaviors that maintain dysfunctional cognitive processes.

“This new perspective is not so new: nearly 40 years ago, it was realized that the conspicuous high physical activity of anorexia is a normal, evolutionarily conserved response – i.e., foraging for food when it is in short supply – that can be triggered dietary restriction.

“In striking similarity to human anorexics, rats and mice given food only once a day begin to increase their running activity and decrease their food intake further to the point at which they lose a great deal of body weight and can eventually die.”

More recently, the theory has been elaborated and validated by studies of brain function.

“We find that chemical signaling in the starved brain supports the search for food, rather than eating itself,” reports Södersten.

How to eat

To prove that the evolutionary perspective works in practice, Södersten and his team have put their money where their (patient’s) mouth is. Their private clinics – which reinvest 100% of profits into research and development – are now the largest provider of eating disorders services in Sweden.

“We first proposed teaching anorexics to eat back in 1996. At the time, it was thought that this was misplaced and even dangerous; today, no-one can treat patients with eating disorders in the Region of Stockholm without a program for restoring their eating behavior.”

At the Mandometer clinics, the control of eating behavior is outsourced to a machine that provides feedback on how quickly to eat.

“Subjects eat food from a plate that sits on a scale connected to their smartphone. The scale records the weight loss of the plate during the meal, and via an app creates a curve of food intake, meal duration and rate of eating,” explains Södersten. “At regular intervals, a rating scale appears on the screen and the subject is asked to rate their feeling of fullness.”

“A reference curve for eating rate and a reference curve for the feeling of fullness are also displayed on the screen of the smartphone. The subject can thus adapt their own curves in real time to the reference curves, which are based on eating behavior recorded in healthy controls.”

Through this feedback, patients learn to visualize what normal portions of food look like and how to eat at a normal rate.

Satisfying results

The method has now been used to treat over 1500 patients to remission by practicing eating.

“The rate of remission is 75% in on average one year of treatment, the rate of relapse is 10% over five years of follow-up and no patient has died.”

This appears to be a vast improvement compared to the current best standard treatment of CBT. All the more so, considering that overall Södersten’s patients started off sicker than average.

“The difference in outcome is so big that, according to our medical statistician, a randomized control trial [RCT] is now redundant. Nevertheless, we invite a head-to-head RCT by independent researchers – so far, there are no takers.”

The Quail × A Motorsports Gathering

The premier automotive event will welcome four featured classes — “The Great Lancias,” “50th Anniversary of the Espada & Islero,” “70 Years of the Iconic Porsche 356” and “The Alois Ruf Reunion” — during its Monterey Car Week Event held at Quail Lodge & Golf Club on August 24, 2018

Today, The Quail, A Motorsports Gathering has officially announced four featured classes for its 16th-anniversary celebration on Friday, August 24, 2018. Recognizing Italian heritage and German innovation, the special selection will include “The Great Lancias,” “50th Anniversary of the Espada & Islero,” “70 Years of the Iconic Porsche 356” and “The Alois Ruf Reunion.”

“The Great Lancias” class will be highlighted by notable models that exemplify the Italian manufacturer’s strong rally heritage. Key vehicles will include a 1974 Stratos HF Group IV, a 1955 Aurelia B24S and a 1988 Delta Intergrale 8V.

Meanwhile, the “50th Anniversary of the Espada & Islero” class will pay tribute to two of Lamborghini’s most timeless V12-powered touring cars: the low-production Islero GT and the 2+2 Espada that became one of Sant’Agata’s best-selling models. Half a century after both models debuted at the Geneva Motor Show, 21 of these iconic vehicles will be on display.

The Quail will also celebrate German automotive history and legacy through the special “70 Years of the Iconic Porsche 356” class. The display will include noteworthy examples of the marque’s first production sports cars such as a 1951 356 Pre-A Split Window, a 1958 356 A Speedster, a 1965 356 C Coupe and other seminal vehicles from the legendary marque.

“The Alois Ruf Reunion” will focus on German innovation through a selection of sports cars from the legendary Pfaffenhausen manufacturer and tuner. Included in the class will be the 1988 CTR “Yellowbird” #001, freshly restored by RUF themselves. The car will be presented alongside the new 710 horsepower CTR, making its North American debut. Along with the old and new CTR, several other prominent RUF vehicles will grace the event — from the CTR2 to the RCT and many more.

“To amp up the anticipation surrounding The Quail, we are featuring four new classes for car enthusiasts from around the world to enjoy,” said Gordon McCall, Director of Motorsports for The Peninsula Signature Events. “Guests of the show will be delighted to see a remarkable selection of cars that represent the Italian and German perspectives of automotive excellence.”

Keeping with tradition, these featured classes will complement the familiar roster of pre- and post-war classes as they line the prestigious greens of Quail Lodge & Golf Club.

In addition to the world-class selection of vehicles, The Quail will offer an array of culinary pavilions, award-winning wines and spirits and a Fireside Chat Series in the elegant yet family- and pet-friendly environment. Guests will also be invited to attend the Bonhams Quail Lodge Auction taking place concurrently on the Quail Lodge Farm Field.

The event is sold out; however, if an individual has missed the opportunity to purchase tickets, they may submit a waitlist request online. Other options for admission include The QuailHelicopter Ticket and The QuailCharitable Patron Ticket, which are still available for purchase. For more information about these ticket options, please click here. To learn more about the event, please visit the event website and follow the action on Facebook, Instagram, and Twitter.

About The Peninsula Signature Events

The Peninsula Signature Events is organized by The Peninsula Hotels, dedicated to creating world-class bespoke events at its properties in Hong Kong, Shanghai, Tokyo, Beijing, New York, Chicago, Beverly Hills, Bangkok, Manila and Paris – future openings, Yangon and London. Quail Lodge & Golf Club is home to the following Peninsula Signature Events: The Quail Ride, The Quail Motorcycle Gathering, The Quail Rally and The Quail, A Motorsports Gathering. http://signatureevents.peninsula.com.

RUF Makes US Debut

The German sports car manufacturer will have a special class at The Quail, A Motorsports Gathering on Friday, August 24, 2018 and debut its latest CTR alongside the freshly restored legendary 1989 “Yellowbird” CTR #001.

Ruf Automobile GmbH, manufacturer and engineer of bespoke sports cars, will be honored in a special class at The Quail, A Motorsports Gathering entitled “The Alois Ruf Reunion”. The event will make the first North American appearance of the new RUF CTR alongside the completely restored RUF 1989 “Yellowbird” CTR #001 owned by an automobile enthusiast, connoisseur and car collector Bruce Meyer.

“The Alois Ruf Reunion” will bring together a handful of notable cars from throughout the marque’s history, reuniting them with Alois and Estonia Ruf on the manicured lawns of The Quail Lodge in Carmel-by-the-Sea, California. Other RUF cars that will be on display include the CTR Clubsport, CTR2 and RCT.

“When we began building our own automobiles in 1974 it was all for the thrill of the drive,” said Alois Ruf, owner of RUF Automobile GmbH. “We are honored to have been given a special class at The Quail, but we recognize that this is a celebration of RUF owners and their passion for driving as much as it is the RUF brand. RUF is not a car or a company, it’s an all-encompassing experience of which we are just a part. We share this honor with all of the members of the RUF community.”

The 1987 RUF CTR “Yellowbird” took the automotive world by storm when it out-paced every other production car in the world, topping out at an unprecedented 211 mph at the Ehra-Lessien test track in Germany. Along with its top-speed record, the CTR also became the first production car to break the 200-mph barrier. RUF commemorated the 30th anniversary of the “Yellowbird” with the release of the new CTR, an entirely bespoke high performance sports car developed and built in RUF’s Pfaffenhausen, Germany facilities. Among other engineering achievements, the new CTR is the first carbon fiber monocoque production car with a rear-engine layout. The turbo charged RUF is only equipped with minimalistic electronic driving aids, such as ABS and slip-control, resulting in one of the purest driving experiences available in a modern car. Production of the new CTR is expected to begin in late 2018.

The celebration will also include a private event for RUF owners at a separate location during the week. For more information on RUF automobiles, visit the RUF website at ruf-automobile.de/en.

ABOUT RUF AUTOMOBILE GMBH
In 1939, Alois Ruf Sr. first formed his company, AUTORUF, as a general service garage. The company grew and in 1949 Ruf Sr. added a gas station to the company complex. By 1955, Ruf Sr. recognized a need in Germany for a full-size tourist bus and challenged himself to build his own to run this as a separate business. In 1963, the company began specializing in Porsche vehicles, a direction that Alois Ruf Jr. vowed to continue when he assumed ownership of the company in 1974. In the following year, the first RUF-enhanced Porsche model made its debut.

In 1982 RUF has been approved by the German authorities as a car manufacturer in its own right, which meant that RUF cars were identified by their own VIN. In 1987 RUF achieved the approval from NHTSA and EPA in the United States. Now it is still family run by Alois and Estonia Ruf.