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  1. Article ; Online: User Engagement and Assessment of Treatment Effectiveness in Patients Using a Novel Digital mHealth App During Spinal Cord Stimulation Screening Trials.

    Lee, Jennifer M / Woon, Rex / Ramsum, Mandy / Halperin, Daniel S / Jain, Roshini

    JMIR human factors

    2022  Volume 9, Issue 1, Page(s) e35134

    Abstract: Background: Patient outcomes and experience during a Spinal Cord Stimulation (SCS) screening trial can have a significant effect on whether to proceed with long-term, permanent implantation of an SCS device for the treatment of chronic pain. Enhancing ... ...

    Abstract Background: Patient outcomes and experience during a Spinal Cord Stimulation (SCS) screening trial can have a significant effect on whether to proceed with long-term, permanent implantation of an SCS device for the treatment of chronic pain. Enhancing the ability to track and assess patients during this initial trial evaluation offers the potential for improved understanding regarding the suitability of permanent device implantation as well as identification of the SCS-based neurostimulative modalities and parameters that may provide substantial analgesia in a patient-specific manner.
    Objective: In this report, we aimed to describe a preliminary, real-world assessment of a new, real time tracking, smart, device-based digital app used by patients with chronic pain undergoing trial screening for SCS therapy.
    Methods: This is a real-world, retrospective evaluation of 13,331 patients diagnosed with chronic pain who used the new "mySCS" mobile app during an SCS screening trial. The app design is health insurance portability and accountability act (HIPAA)-compliant and compatible with most commercially available smartphones (eg, Apple, iPhone, and Android). The app enables tracking of user-inputted health-related responses (ie, pain relief, activity level, and sleep quality) in addition to personal trial goals and a summary of overall experience during the SCS trial. A deidentified, aggregate analysis of user engagement, user-submitted responses, and overall trial success was conducted.
    Results: When provided the opportunity, the percentage of users who engaged with the tracking app for ≥50% of the time during their trial was found to be 64.43% (n=8589). Among the 13,331 patients who used the app, 58.24% (n=7764) entered a trial goal. Most patients underwent SCS screening with a trial duration of at least 7 days (n=7739, 58.05%). Of those patients who undertook a 7-day SCS trial, 62.30% (n=3456) engaged the app for 4 days or more. In addition, among all who submitted descriptive responses using the app, health-related improvements were reported by 77.84% (n=10,377) of patients who reached day 3 of the screening phase assessment and by 83.04% (n=11,070) of those who reached trial completion. A trial success rate of 91% was determined for those who used the app (versus 85% success rate for nonusers).
    Conclusions: Data from this initial, real-world examination of a mobile, digital-health-based tracking app ("mySCS"), as used during the SCS screening phase, demonstrate that substantial patient engagement can be achieved while also providing for the acquisition of more real time patient-outcome measures that may help facilitate improved SCS trial success.
    Language English
    Publishing date 2022-03-23
    Publishing country Canada
    Document type Journal Article
    ISSN 2292-9495
    ISSN (online) 2292-9495
    DOI 10.2196/35134
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Exploration of High- and Low-Frequency Options for Subperception Spinal Cord Stimulation Using Neural Dosing Parameter Relationships: The HALO Study.

    Paz-Solís, José / Thomson, Simon / Jain, Roshini / Chen, Lilly / Huertas, Ismael / Doan, Que

    Neuromodulation : journal of the International Neuromodulation Society

    2021  Volume 25, Issue 1, Page(s) 94–102

    Abstract: Objectives: Subperception spinal cord stimulation (SCS) is described mostly utilizing waveforms that require high energy. However, the necessity of these waveforms for effective subperception has not been established. We aimed to explore whether ... ...

    Abstract Objectives: Subperception spinal cord stimulation (SCS) is described mostly utilizing waveforms that require high energy. However, the necessity of these waveforms for effective subperception has not been established. We aimed to explore whether effective subperception pain relief can be achieved using frequencies below 1 kHz.
    Materials and methods: Thirty chronic pain patients implanted with SCS were enrolled as part of a multicenter, real-world, consecutive, observational case series. An effective stimulation location was determined using a novel electric field shape designed to preferentially modulate dorsal horn elements. Subsequently, programs at lower frequencies (600, 400, 200, 100, 50, and 10 Hz) were provided with pulse-width and amplitude adjusted to optimize response.
    Results: All tested frequencies (1 kHz down to 10 Hz) provided effective subperception relief, yielding a mean of 66-72% reduction in back, leg, and overall pain. It was found that to maintain analgesia, as frequency was decreased, the electrical or "neural" dose had to be adjusted according to parameter relationships described herein. With the reduction of frequency, we observed a net reduction of charge-per-second, which enabled energy savings of 74% (200 Hz) and 97% (10 Hz) relative to 1 kHz. Furthermore, pain reduction was sustained out to one year, with 85% of patients reporting a preference for frequencies of 400 Hz or below.
    Conclusions: We have derived an electric field configuration and, along with previous learnings in the kHz range, a set of neural dosing parameter relationships (10-10,000 Hz), which enable the expansion of effective subperception SCS to low frequency and achieve major energy savings.
    MeSH term(s) Chronic Pain/therapy ; Humans ; Pain Management ; Pain Measurement ; Spinal Cord ; Spinal Cord Stimulation ; Treatment Outcome
    Language English
    Publishing date 2021-02-22
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 1500372-3
    ISSN 1525-1403 ; 1094-7159
    ISSN (online) 1525-1403
    ISSN 1094-7159
    DOI 10.1111/ner.13390
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Conference proceedings: Outcomes of previously-implanted SCS chronic pain patients converted to a new SCS system – European experience

    Rigoard, Philippe / Bougeard, Renaud / Llopis, Jose Emilio / Raoul, Sylvie / Vesper, Jan / Belaid, Hayat / Pei, Yu / Jain, Roshini / Matis, Georgios

    2022  , Page(s) P209

    Title translation Ergebnisse von zuvor implantierten SCS-Patienten mit chronischen Schmerzen, die auf ein neues SCS-System umgestellt wurden: In Europa gemachte Erfahrungen
    Event/congress 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie; Köln; Deutsche Gesellschaft für Neurochirurgie; 2022
    Keywords Medizin, Gesundheit
    Publishing date 2022-05-25
    Publisher German Medical Science GMS Publishing House; Düsseldorf
    Document type Conference proceedings
    DOI 10.3205/22dgnc525
    Database German Medical Science

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  4. Article ; Online: Combination therapy with simultaneous delivery of spinal cord stimulation modalities: COMBO randomized controlled trial.

    Wallace, Mark S / North, James M / Phillips, Gregory M / Calodney, Aaron K / Scowcroft, James A / Popat-Lewis, Bindu U / Lee, Jennifer M / Washabaugh, Edward P / Paez, Julio / Bolash, Robert B / Noles, John / Atallah, Joseph / Shah, Binit / Ahadian, Farshad M / Trainor, Drew M / Chen, Lilly / Jain, Roshini

    Pain management

    2023  Volume 13, Issue 3, Page(s) 171–184

    Abstract: Aim: ...

    Abstract Aim:
    MeSH term(s) Humans ; Spinal Cord Stimulation ; Chronic Pain/therapy ; Paresthesia ; Combined Modality Therapy ; Treatment Outcome ; Spinal Cord
    Language English
    Publishing date 2023-03-03
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 2617136-3
    ISSN 1758-1877 ; 1758-1869
    ISSN (online) 1758-1877
    ISSN 1758-1869
    DOI 10.2217/pmt-2022-0101
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Cannabis use and knowledge among medical students at the University of the Free State, Bloemfontein, South Africa.

    Jain, Roshini / Chang, Ch Chiech / Koto, Mpho A / Geldenhuys, Alden N / Nichol, Richard J / Joubert, Gina

    Journal of child and adolescent mental health

    2018  Volume 30, Issue 1, Page(s) 19–26

    Abstract: Objective: The study aimed to investigate the prevalence of cannabis use among undergraduate medical students of the University of the Free State (UFS), and the extent of their knowledge about the substance.: Method: This cross-sectional study ... ...

    Abstract Objective: The study aimed to investigate the prevalence of cannabis use among undergraduate medical students of the University of the Free State (UFS), and the extent of their knowledge about the substance.
    Method: This cross-sectional study included five year groups of undergraduate medical students. A self-administered, anonymous questionnaire was used.
    Results: Of the 643 medical students, 541 (84.1%) completed the questionnaire. In total, 161 (30.9%) students reported that they had ever used cannabis. The percentage of males who had ever used cannabis was twice that of females (relative risk 2.04; 95% CI 1.56; 2.67). Of the cannabis users, less than 12% used it monthly or more often. A fifth (19.5%) of all students stated that they did not know the side effects of cannabis use. Nearly half (45.4%) indicated that they could not name any medicinal (medical) uses. The median knowledge score of students who used cannabis tended to be higher than that of students who did not use cannabis; this was statistically significant only in the third-year group.
    Conclusions: Medical students generally have a low level of knowledge about cannabis. The reported lifetime prevalence and pattern of cannabis use are similar to those reported in other South African studies published over the past 35 years.
    MeSH term(s) Cannabis ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Marijuana Use/epidemiology ; Prevalence ; South Africa/epidemiology ; Students, Medical ; Surveys and Questionnaires ; Universities
    Language English
    Publishing date 2018-04-11
    Publishing country South Africa
    Document type Journal Article
    ZDB-ID 2434930-6
    ISSN 1728-0591 ; 1728-0583
    ISSN (online) 1728-0591
    ISSN 1728-0583
    DOI 10.2989/17280583.2018.1438291
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Non-medical use of methylphenidate among medical students of the University of the Free State.

    Jain, Roshini / Chang, Ch Chiech / Koto, Mpho / Geldenhuys, Alden / Nichol, Richard / Joubert, Gina

    The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa

    2017  Volume 23, Page(s) 1006

    Abstract: Background: Faced with demanding training programmes, medical students may be more prone to use methylphenidate for non-medical purposes in order to improve concentration, alertness and academic performance.: Aim: The study aimed to investigate the ... ...

    Abstract Background: Faced with demanding training programmes, medical students may be more prone to use methylphenidate for non-medical purposes in order to improve concentration, alertness and academic performance.
    Aim: The study aimed to investigate the prevalence of the non-medical use of methylphenidate and knowledge of this drug among undergraduate medical students of the University of the Free State.
    Methods: This was a cross-sectional study. A self-administered, anonymous questionnaire was distributed during lectures to all students in the five year groups of the undergraduate medical programme.
    Results: Of the 643 undergraduate medical students, 541 completed the questionnaire (response rate: 84.1%). Approximately 11.0% of surveyed students were using methylphenidate at the time of the study, of which the majority (67.9%) used it for academic purposes and 70.6% received it from a medical health professional. Less than a third of users had been diagnosed with Attention-Deficit/Hyperactivity Disorder. Methylphenidate users' median knowledge was greater than non-users, and methylphenidate knowledge increased from first-year and second-year students to third-year to fifth-year students. Median knowledge scores per year group ranged from 52.0% to 60.0%.
    Conclusion: Methylphenidate is mainly used for non-medical purposes by medical students. Students generally have a low level of knowledge on methylphenidate. Specific information on methylphenidate should be included in lectures on stress management and study methods during the course of the medical curriculum.
    Language English
    Publishing date 2017-01-20
    Publishing country South Africa
    Document type Journal Article
    ZDB-ID 2042292-1
    ISSN 2078-6786 ; 0038-2469 ; 1608-9685
    ISSN (online) 2078-6786
    ISSN 0038-2469 ; 1608-9685
    DOI 10.4102/sajpsychiatry.v23.1006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Utilization of multiple spinal cord stimulation (SCS) waveforms in chronic pain patients.

    Berg, Anthony P / Mekel-Bobrov, Nitzan / Goldberg, Edward / Huynh, Dat / Jain, Roshini

    Expert review of medical devices

    2017  Volume 14, Issue 8, Page(s) 663–668

    Abstract: Background: Advances in spinal cord stimulation (SCS) have improved patient outcomes, leading to its increased utilization for chronic pain. Chronic pain is dynamic showing exacerbations, variable severity, and evolving pain patterns. Given this ... ...

    Abstract Background: Advances in spinal cord stimulation (SCS) have improved patient outcomes, leading to its increased utilization for chronic pain. Chronic pain is dynamic showing exacerbations, variable severity, and evolving pain patterns. Given this complexity, SCS systems that provide a broad range of stimulation waveforms may be valuable.
    Methods: The aim of this research was to characterize the usage pattern of stimulation waveforms and field shapes in chronic pain patients implanted with the Spectra System. A review of daily device usage in a cohort of 250 patients implanted for a minimum duration of one month was conducted.
    Results: With follow-ups ranging between 1 month and 1 year post-implant, 72.8% of patients used Standard Rate, 34.8% Anode Intensification, 23.2% Higher Rate, and 8.4% Burst stimulation waveforms. Collectively, 60% used 1 or more advanced waveforms, either exclusively or along with Standard Rate. A trend showed patients continuing to use up to 3 programs one year post-implant.
    Conclusion: When given a choice, SCS patients often utilize a variety of waveforms, suggesting that patients may benefit from a single system that provides multiple waveforms and field shapes to customize therapy and improve efficacy.
    Language English
    Publishing date 2017-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2250857-0
    ISSN 1745-2422 ; 1743-4440
    ISSN (online) 1745-2422
    ISSN 1743-4440
    DOI 10.1080/17434440.2017.1345621
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: A novel fast-acting sub-perception spinal cord stimulation therapy enables rapid onset of analgesia in patients with chronic pain.

    Metzger, Clark S / Hammond, M Blake / Paz-Solis, Jose F / Newton, William J / Thomson, Simon J / Pei, Yu / Jain, Roshini / Moffitt, Michael / Annecchino, Luca / Doan, Que

    Expert review of medical devices

    2021  Volume 18, Issue 3, Page(s) 299–306

    Abstract: ... ...

    Abstract Background
    MeSH term(s) Analgesia ; Chronic Pain/therapy ; Electrodes ; Female ; Humans ; Male ; Middle Aged ; Perception ; Spinal Cord Stimulation/methods ; Treatment Outcome
    Language English
    Publishing date 2021-03-03
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Observational Study
    ZDB-ID 2250857-0
    ISSN 1745-2422 ; 1743-4440
    ISSN (online) 1745-2422
    ISSN 1743-4440
    DOI 10.1080/17434440.2021.1890580
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Pain relief outcomes using an SCS device capable of delivering combination therapy with advanced waveforms and field shapes.

    Metzger, Clark S / Hammond, M Blake / Pyles, Stephen T / Washabaugh, Edward P / Waghmarae, Romanth / Berg, Anthony P / North, James M / Pei, Yu / Jain, Roshini

    Expert review of medical devices

    2020  Volume 17, Issue 9, Page(s) 951–957

    Abstract: Background: Given the range of subjective experiences reported by patients with chronic pain, Spinal Cord Stimulation (SCS) systems designed for tailored delivery of analgesic therapy may help improve treatment effectiveness and satisfaction.: ... ...

    Abstract Background: Given the range of subjective experiences reported by patients with chronic pain, Spinal Cord Stimulation (SCS) systems designed for tailored delivery of analgesic therapy may help improve treatment effectiveness and satisfaction.
    Research design and methods: This case-series evaluated 420 patients with chronic back and/or leg pain implanted with an SCS device capable of sequential or simultaneous delivery of neurostimulation (i.e. combination therapy) as well as multiple waveforms and/or field shapes. Following implantation, an array of standard programs (e.g. paresthesia-based SCS), and a custom set of sub-perception programs were provided per patient feedback. Pain scores (Numeric Rating Scale, NRS) were collected at baseline and during follow-up.
    Results: In this multicenter, observational series (n = 420, 53.1% female; Age: 64.2 ± 13.4 years), a mean overall pain score of 7.2 ± 1.8 (SD) was reported pre-trial (Baseline). At a mean follow-up duration of 208 ± 200 (SD) days, the mean overall pain score reduced to 2.4 (p < 0.0001). Overall pain was reduced by 5.1 ± 2.4 and 4.5 ± 2.4 points (NRS) at 3-months (N = 256) and at 12-months post-implant (N = 122) respectively (p < 0.0001).
    Conclusions: These results suggest that highly 'customizable' SCS approaches may allow for highly effective pain relief within the real-world clinical setting.
    MeSH term(s) Chronic Pain/therapy ; Combined Modality Therapy ; Female ; Finite Element Analysis ; Humans ; Male ; Middle Aged ; Pain Management/methods ; Spinal Cord Stimulation/instrumentation ; Treatment Outcome
    Language English
    Publishing date 2020-09-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 2250857-0
    ISSN 1745-2422 ; 1743-4440
    ISSN (online) 1745-2422
    ISSN 1743-4440
    DOI 10.1080/17434440.2020.1812383
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: External inferior colliculus integrates trigeminal and acoustic information: unit responses to trigeminal nucleus and acoustic stimulation in the guinea pig.

    Jain, Roshini / Shore, Susan

    Neuroscience letters

    2006  Volume 395, Issue 1, Page(s) 71–75

    Abstract: The external nucleus of the inferior colliculus (ICx) receives ascending projections from both auditory and somatosensory nuclei. In the guinea pig, both the spinal trigeminal nucleus (TN) and the cochlear nucleus converge in the ventrolateral region of ... ...

    Abstract The external nucleus of the inferior colliculus (ICx) receives ascending projections from both auditory and somatosensory nuclei. In the guinea pig, both the spinal trigeminal nucleus (TN) and the cochlear nucleus converge in the ventrolateral region of ICx. We investigated the function of trigeminal-collicular pathways by electrically stimulating the TN while recording unit responses from ICx. Pairing electrical stimulation with acoustic stimuli allowed us to investigate the function of converging auditory and somatosensory inputs, i.e. multisensory integration. Unit responses were recorded from ICx using a multi channel, single shank electrode. Electrical stimulation of the TN produced small changes above or below spontaneous rate, but resulted in significant suppression or enhancement of sound-evoked responses. Multisensory integration has been demonstrated in the dorsal cochlear nucleus (DCN), superior colliculus and sensory cortices and may play a role in plasticity that occurs after sensory deprivation.
    MeSH term(s) Acoustic Stimulation ; Action Potentials/physiology ; Afferent Pathways/physiology ; Animals ; Electric Stimulation ; Evoked Potentials, Auditory/physiology ; Evoked Potentials, Somatosensory/physiology ; Female ; Guinea Pigs ; Inferior Colliculi/physiology ; Neurons/physiology ; Trigeminal Nuclei/physiology
    Language English
    Publishing date 2006-02-27
    Publishing country Ireland
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 194929-9
    ISSN 1872-7972 ; 0304-3940
    ISSN (online) 1872-7972
    ISSN 0304-3940
    DOI 10.1016/j.neulet.2005.10.077
    Database MEDical Literature Analysis and Retrieval System OnLINE

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