Publications and communications of Nicolas Lejeune

Seyfzadehdarabad, F.* , Mat, B.* , Sanz, L., Martial, C., van der Lande, G., Lejeune, N., Thibaut, A., Boly, M., Laureys, S., & Gosseries, O. (July 2024). Prevalence of zolpidem use and its paradoxical effects on consciousness in the general population: an online survey [Poster presentation]. Association for the Scientific Study of Consciousness (ASSC27).
* These authors have contributed equally to this work.

Khosravi, M., Louras, M., Martens, G., Kaux, J.-F., Lejeune, N.* , & Thibaut, A.*. (17 February 2024). A Scoping Review on the Use of Non-invasive Brain Stimulation Techniques for persistent Post-concussive Symptoms. Biomedicines, Volume II. doi:10.3390/biomedicines12020450
* These authors have contributed equally to this work.

Fritz, P., Lejeune, N., Cardone, P., Gosseries, O., & Martial, C. (2024). Bridging the gap: (A)typical psychedelic and near-death experience insights. Current Opinion in Behavioral Sciences. doi:10.1016/j.cobeha.2023.101349

Farisco, M., Formisano, R., Gosseries, O., Kato, Y., Koboyashi, S., Laureys, S., Lejeune, N., Martial, C., Matar, A., Morrisey, A.-M., Schnakers, C., Yakufujiang, M., Yamaki, T., Veeramuthu, V., Zandalasini, M., Zasler, N., Magliacano, A., Estraneo, A., & IBIA Special Interest Group on DoCs. (January 2024). Correction to: International survey on the implementation of the European and American guidelines on disorders of consciousness. Journal of Neurology, 271 (1), 408 - 409. doi:10.1007/s00415-023-12083-5

Lejeune, N., Fritz, P., Cardone, P., Szymkowicz, E., Vitello, M., Martial, C., Thibaut, A., & Gosseries, O. (2024). Exploring the Significance of Cognitive Motor Dissociation on Patient Outcome in Acute Disorders of Consciousness. Seminars in Neurology. doi:10.1055/s-0044-1785507

Martial, C., Fritz, P., Lejeune, N., & Gosseries, O. (2024). Exploring awareness in cardiac arrest studies: Methodological challenges [Letter to the Editor]. Resuscitation. doi:10.1016/j.resuscitation.2023.109980

Thibaut, A., Aloisi, M., Dreessen, J., Alnagger, N., Lejeune, N., & Formisano, R. (2024). Neuro-orthopaedic assessment and management in patients with prolonged disorders of consciousness: A review. NeuroRehabilitation, 54 (1), 75 - 90. doi:10.3233/NRE-230137

Regnier, A., Lejeune, N., Smeyers Lauranne, Pirnay, L., AERNOUDT, E., Valérie Chavet, Elodie Guichard, Céline Aussems, Isabelle Lavennes, Thibaut, A., Kaux, J.-F., Mélotte, E.* , & Gosseries, O.*. (30 November 2023). The SWADOC: Validation of a Novel Tool to Assess Swallowing in Patients with Disorders of Consciousness [Poster presentation]. ESSD 13th Annual Congress, Toulouse, France.
* These authors have contributed equally to this work.

Farisco, M., Formisano, R., Gosseries, O., Kato, Y., Koboyashi, S., Laureys, S., Lejeune, N., Martial, C., Matar, A., Morrisey, A.-M., Schnakers, C., Yakufujiang, M., Yamaki, T., Veeramuthu, V., Zandalasini, M., Zasler, N., Magliacano, A., Estraneo, A., & IBIA Special Interest Group on DoCs. (2023). International survey on the implementation of the European and American guidelines on disorders of consciousness. Journal of Neurology. doi:10.1007/s00415-023-11956-z

Thibaut, A., Fregni, F., Estraneo, A., Fiorenza, S., Noe, E., Llorens, R., Ferri, J., Formisano, R., Morone, G., Bender, A., Rosenfelder, M., Lamberti, G., Kodratyeva, E., Kondratyev, S., Legostaeva, L., Suponeva, N., Krewer, C., Müller, F., Dardenne, N., ... IBIA DOC-SIG. (2023). Sham-controlled randomized multicentre trial of transcranial direct current stimulation for prolonged disorders of consciousness. European Journal of Neurology. doi:10.1111/ene.15974

Fritz, P., Ancion, A., Lejeune, N., van der Lande, G., Laureys, S., Ghuysen, A., Gosseries, O., & Martial, C. (26 May 2023). Uncovering episodes of (dis)connected consciousness in clinically unresponsive emergency patients: study protocol for a prospective study [Poster presentation]. 2023 Annual Meeting of the Belgian Association of Psychological Sciences, Mons, Belgium.

Sanz, L.* , Szymkowicz, E.* , Lejeune, N., Bonin, E., Sala, A., Panda, R., Thibaut, A., Dardenne, N., Dikenstein, D., Van Goethem, S., Ledoux, D., Hustinx, R., Laureys, S., & Gosseries, O. (01 April 2023). Multimodal open-label study of apomorphine in disorders of consciousness [Paper presentation]. 14th Biennial World Congress on Brain Injury, Dublin, Ireland.
* These authors have contributed equally to this work.

Cardone, P., Bonhomme, A., Bonhomme, V., Staquet, C., Lejeune, N., Van Goethem, S., Ezan, P., Alnagger, N., DEFRESNE, A., Montupil, J., Laureys, S., Thibaut, A., Martial, C., & Gosseries, O. (31 March 2023). Preliminary Results of the First Pilot of Ketamine to Treat Disorders of Consciousness [Paper presentation]. 14th Biennial World Congress on Brain Injury, Dublin, Ireland.

Regnier, A., Lejeune, N., Smeyers, L., Pirnay, L., PALUSZKIEWICZ, J., AERNOUDT, E., Chavet, V., Gichard, E., Aussems, C., Lavennes, I., Thibaut, A., Kaux, J.-F., Mélotte, E., & Gosseries, O. (31 March 2023). The validation of the SWADOC: a multicenter prospective cohort study [Paper presentation]. 14th Biennial World Congress on Brain Injury, Dublin, Ireland.

Bonin, E., Lejeune, N., Szymkowicz, E., Bonhomme, V., Martial, C., Gosseries, O., Laureys, S., & Thibaut, A. (20 March 2023). Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review. Frontiers in Systems Neuroscience, 17, 1112206. doi:10.3389/fnsys.2023.1112206

Lejeune, N., Petrossova, E., Frahm, K. S., & Mouraux, A. (February 2023). High-speed heating of the skin using a contact thermode elicits brain responses comparable to CO2 laser-evoked potentials. Clinical Neurophysiology, 146, 1 - 9. doi:10.1016/j.clinph.2022.11.008

Martens, G., Khosravi, M. H., Lejeune, N., Kaux, J.-F., & Thibaut, A. (February 2023). Gender Specificities in Sleep Disturbances following Mild Traumatic Brain Injury: A Preliminary Study. Brain Sciences, 13 (2), 323 (7. doi:10.3390/brainsci13020323

Fritz, P., Lejeune, N., CASSOL, H., Laureys, S., Gosseries, O., & Martial, C. (2023). Near-death experiences: what do we know? In C. Schnakers & S. Laureys, Coma and Disorders of Consciousness, 3rd edition (3rd). Springer; Softcover reprin. doi:10.1007/978-3-031-50563-8_13

Regnier, A., Lejeune, N., Smeyers, L., Pirnay, L., PALUSZKIEWICZ, J., AERNOUDT, E., Chavet, V., Guichart, E., Aussems, C., Lavennes, I., Thibaut, A., Kaux, J.-F., Mélotte, E., & Gosseries, O. (2023). The Validation of the SWADOC: a novel tool to assess swallowing in patients with disorders of Consciousness [Paper presentation]. BSSD 9th Annual Congress, Brussels, Belgium.

Vitello, M., Rosenfelder, M. J., Cardone, P., Niimi, M., Willacker, L., Thibaut, A., Lejeune, N., Laureys, S., Bender, A., & Gosseries, O. (2023). A protocol for a multicenter randomized and personalized controlled trial using rTMS in patients with disorders of consciousness. Frontiers in Neurology, 14, 1216468. doi:10.3389/fneur.2023.1216468

Magliacano, A., Liuzzi, P., Formisano, R., Grippo, A., Angelakis, E., Thibaut, A., Gosseries, O., Lamberti, G., Noé, E., Bagnato, S., Edlow, B. L., Lejeune, N., Veeramuthu, V., Trojano, L., Zasler, N., Schnakers, C., Bartolo, M., Mannini, A., Estraneo, A., & IBIA DoC-SIG. (27 December 2022). Predicting Long-Term Recovery of Consciousness in Prolonged Disorders of Consciousness Based on Coma Recovery Scale-Revised Subscores: Validation of a Machine Learning-Based Prognostic Index. Brain Sciences, 13 (1), 51. doi:10.3390/brainsci13010051

Sanz, L.* , Szymkowicz, E.* , Lejeune, N., Bonin, E., Sala, A., Panda, R., Thibaut, A., Dardenne, N., Dikenstein, D., Van Goethem, S., Ledoux, D., Hustinx, R., Laureys, S., & Gosseries, O. (06 September 2022). Apomorphine dopaminergic neuromodulation in severe brain- injured patients with consciousness disorders – a pilot study [Paper presentation]. GIGA day 2022, Liège, Belgium.
* These authors have contributed equally to this work.

Cardone, P., Bonhomme, A., Bonhomme, V., Staquet, C., Alnagger, N., Ezan, P., Lejeune, N., Van Goethem, S., Laureys, S., Gosseries, O.* , & Martial, C.*. (13 July 2022). Ketamine to treat disorders of consciousness: a pilot protocol [Poster presentation]. ASSC25, Amsterdam, Netherlands.
* These authors have contributed equally to this work.

Maurer-Karattup, P., Zasler, N., Thibaut, A., Poulsen, I., Lejeune, N., Formisano, R., Løvstad, M., Hauger, S., & Morrissey, A.-M. (07 June 2022). Neurorehabilitation for people with disorders of consciousness: an international survey of health-care structures and access to treatment, (Part 1). Brain Injury, 36 (7), 850 - 859. doi:10.1080/02699052.2022.2059813

Martens, G., Khosravi, M. H., Kaux, J.-F., Lejeune, N., & Thibaut, A. (June 2022). Prevalence of Sleep Disturbances Following Mild Traumatic Brain Injury: A Pilot Cross sectional Survey [Poster presentation]. Canadian Concussion Network 2nd Annual Meeting, Montréal, Canada.

Fierain, A., Gaspard, N., Lejeune, N., El Tahry, R., Speybroeck, N., Dermauw, V., & Ferrao Santos, S. (April 2022). Beware of nonconvulsive seizures in prolonged disorders of consciousness: Long-term EEG monitoring is the key. Clinical Neurophysiology, 136, 228 - 234. doi:10.1016/j.clinph.2021.12.020

Bonin, E., Binda Fossati, M. L., Filippini, M., Bornheim, S., Lejeune, N., O'Brien, A., Bodart, O., Laureys, S., Thibaut, A., & Chatelle, C. (2022). Evaluation of the effect of analgesic treatment on signs of nociception-related behaviors during physiotherapy in patients with disorders of consciousness: a pilot crossover randomized controlled trial. Pain. doi:10.1097/j.pain.0000000000002367

Cardone, P., Bonhomme, A., Bonhomme, V., Scott, G., Alnagger, N., Lejeune, N., Van Goethem, S., Carhart-Harris, R. L., Laureys, S., Martial, C.* , & Gosseries, O.*. (2022). Psychedelics to treat disorders of consciousness: protocol for a randomized clinical trial with ketamine [Paper presentation]. TSC 2022 - The Science of Consciousness Conference.
* These authors have contributed equally to this work.

Khosravi, M. H., Martens, G., Kaux, J.-F., Lejeune, N., & Thibaut, A. (2022). Prevalence and Characteristics of Sleep Disorders Following a Cerebral Concussion: A Survey of Belgian, French and Swiss Patients [Paper presentation]. 7th USERN Congress, Muscat, Oman.

Schnakers, C., Bauer, C., Formisano, R., Noé, E., Llorens, R., Lejeune, N., Farisco, M., Teixeira, L., Morrissey, A.-M., De Marco, S., Veeramuthu, V., Ilina, K., Edlow, B. L., Gosseries, O., Zandalasini, M., De Bellis, F., Thibaut, A., & Estraneo, A. (2022). What names for covert awareness? A systematic review. Frontiers in Human Neuroscience, 16, 971315. doi:10.3389/fnhum.2022.971315

Lejeune, N., Zasler, N., Formisano, R., Estraneo, A., Bodart, O., Magee, W. L., & Thibaut, A. (10 November 2021). Epilepsy in prolonged disorders of consciousness: a systematic review. Brain Injury, 35 (12-13), 1485 - 1495. doi:10.1080/02699052.2021.1973104

Mortaheb, S., Filippini, M. M., Kaux, J.-F., Annen, J., Lejeune, N., Martens, G., calderon, M. A. F., LAUREYS, S., & Thibaut, A. (September 2021). Neurophysiological Biomarkers of Persistent Post-Concussive Symptoms: A Scoping Reveiw. Frontiers in Neurology, 12, 687197. doi:10.3389/fneur.2021.687197

Sanz, L., Lejeune, N., Bonin, E., Panda, R., Sala, A., Dikenstein, D., Farber, N., Thibaut, A., Laureys, S., & Gosseries, O. (29 July 2021). Increased brain metabolism and EEG connectivity after apomorphine therapy in patients with chronic disorders of consciousness [Poster presentation]. the 2021 Virtual World Congress on Brain Injury.

Sanz, L., Lejeune, N., Bonin, E., Panda, R., Sala, A., Dikenstein, D., Farber, N., Thibaut, A., Laureys, S., & Gosseries, O. (01 June 2021). Apomorphine therapy for patients with disorders of consciousness: a multimodal open-label study [Paper presentation]. 7th Congress of the European Academy of Neurology.

Sanz, L.* , Aubinet, C.* , Cassol, H., BODART, O., Wannez, S., Bonin, E., Barra, A., Lejeune, N., Martial, C., Chatelle, C., LEDOUX, D., Laureys, S., Thibaut, A., & Gosseries, O. (2021). SECONDs administration guidelines: A fast tool for assessing consciousness in brain-injured patients. Journal of Visualized Experiments, (168), 61968. doi:10.3791/61968
* These authors have contributed equally to this work.

Aubinet, C., Chatelle, C., Gillet, S., Lejeune, N., Thunus, M., HENNEN, N., Cassol, H., LAUREYS, S., & Majerus, S. (2021). The Brief Evaluation of Receptive Aphasia test for the detection of language impairment in severely brain-injured patients. Brain Injury, 35 (705), 717. doi:10.1080/02699052.2021.1894482

Briand, M.-M., Lejeune, N., Zasler, N., Formisano, R., Bodart, O., Estraneo, A., Magee, W. L., & Thibaut, A. (2021). Management of Epileptic Seizures in Disorders of Consciousness: An International Survey. Frontiers in Neurology, 12, 799579. doi:10.3389/fneur.2021.799579

Estraneo, A., Magliacano, A., Fiorenza, S., Formisano, R., Grippo, A., Angelakis, E., Cassol, H., Thibaut, A., Gosseries, O., Lamberti, G., Noé, E., Bagnato, S., Edlow, B. L., Chatelle, C., Lejeune, N., Veeramuthu, V., Bartolo, M., Mattia, D., Toppi, J., ... Trojano, L. (2021). Risk factors for 2-year mortality in patients with prolonged disorders of consciousness: An international multicentre study. European Journal of Neurology. doi:10.1111/ene.15143

Lejeune, N., van Erp, W., Rohaut, B., Sanz, L., Laureys, S., & Chatelle, C. (2020). États de conscience altérée: soins palliatifs et décisions de fin de vie. In R. Le Berre (Ed.), Manuel de soins palliatifs (5e édition, pp. 727-743). Paris, France: Dunod.

Aubinet, C., Chatelle, C., Gillet, S., Lejeune, N., Cassol, H., HENNEN, N., Thunus, M., Laureys, S., & Majerus, S. (May 2020). The Brief Evaluation of Receptive Aphasia test for the detection of language impairment in severely brain-injured patients [Poster presentation]. 6th Congress of the European Association of Neurology, Paris, France.

Bonin, E., Lejeune, N., Thibaut, A., Cassol, H., Antonopoulos, G., Wannez, S., Martial, C., Schnakers, C., LAUREYS, S., & Chatelle, C. (2020). Nociception Coma Scale Revised allows to identify patients with preserved neural basis for pain experience. Journal of Pain. doi:10.1016/j.jpain.2019.11.004

Estraneo, A., Fiorenza, S., Magliacano, A., Formisano, R., Mattia, D., Grippo, A., Angelakis, E., Cassol, H., Thibaut, A., Gosseries, O., Lamberti, G., Noe, E., Bagnato, S., Edlow, B., Chatelle, C., Lejeune, N., Veeramuthu, V., Bartolo, M., Toppi, J., ... Trojano, L. (2020). Multicenter prospective study on predictors of short-term outcome in disorders of consciousness. Neurology. doi:10.1212/WNL.0000000000010254

Lejeune, N. (2020). Assessment of pain perception in patients with disorders of consciousness: a behavioral and neurophysiological bedside approach [Doctoral thesis, ULiège - Université de Liège]. ORBi-University of Liège. https://orbi.uliege.be/handle/2268/250201

Lejeune, N., Thibaut, A., Martens, G., Martial, C., Wannez, S., LAUREYS, S., & Chatelle, C. (2020). Can the Nociception Coma Scale-Revised be used in patients with a tracheostomy? Archives of Physical Medicine and Rehabilitation. doi:10.1016/j.apmr.2019.09.020

Martens, G., Kroupi, E., Bodien, Y., Frasso, G., Annen, J., Cassol, H., Barra, A., Martial, C., Gosseries, O., Lejeune, N., Soria-Frisch, A., Ruffini, G., Laureys, S., & Thibaut, A. (2020). Behavioral and electrophysiological effects of network-based frontoparietal tDCS in patients with severe brain injury: A randomized controlled trial. NeuroImage: Clinical. doi:10.1016/j.nicl.2020.102426

Mulders, D., de Bodt, C., Lejeune, N., Courtin, A., Liberati, G., Verleysen, M., & Mouraux, A. (2020). Dynamics of the perception and EEG signals triggered by tonic warm and cool stimulation. PLoS ONE, 15 (4), 0231698. doi:10.1371/journal.pone.0231698

Schnakers, C., Hirsch, M., Noé, E., Llorens, R., Lejeune, N., Veeramuthu, V., De Marco, S., Demertzi, A., Duclos, C., Morrissey, A.-M., Chatelle, C., & Estraneo, A. (2020). Covert Cognition in Disorders of Consciousness: A Meta-Analysis. Brain Sciences, 10 (12). doi:10.3390/brainsci10120930

Aubinet, C., Chatelle, C., Gillet, S., Lejeune, N., Cassol, H., Laureys, S., & Majerus, S. (10 December 2019). Validation of a new tool for detection of specific language impairment in severely brain-injured patients [Poster presentation]. GCPN 2019 meeting.

Sanz, L., Lejeune, N., Blandiaux, S., Bonin, E., Raimondo, F., Panda, R., Cassol, H., Farber, N., Laureys, S., & Gosseries, O. (24 October 2019). Multimodal improvements after apomorphine treatment for chronic disorders of consciousness: preliminary results [Paper presentation]. 4th Congress of the Swiss Federation of Clinical Neuro-Societies, Lausanne, Switzerland.

Sanz, L., Lejeune, N., Blandiaux, S., Bonin, E., Raimondo, F., Panda, R., Cassol, H., Camargo Fernandez Baca, A., Farber, N., Laureys, S., & Gosseries, O. (29 June 2019). Treating chronic disorders of consciousness with apomorphine: preliminary results of a multimodal clinical trial [Poster presentation]. 5th Congress of the European Academy of Neurology, Oslo, Norway.

Sanz, L., Lejeune, N., Blandiaux, S., Bonin, E., Thibaut, A., Stender, J., Farber, N., Zafonte, R., Schiff, N., Laureys, S., & Gosseries, O. (19 March 2019). Treating disorders of consciousness with apomorphine: protocol for a double-blind randomized controlled trial using multimodal assessments. Frontiers in Neurology, 10 (248). doi:10.3389/fneur.2019.00248

Lejeune, N., Thibaut, A., Martens, G., Martial, C., Wannez, S., Laureys, S., & Chatelle, C. (16 March 2019). Investigating the influence of a tracheostomy on the evaluation with the Nociception Coma Scale – Revised [Poster presentation]. 13th International Brain Injury Association Congress, Toronto, Canada.

Sanz, L., Lejeune, N., Blandiaux, S., Bonin, E., Raimondo, F., Panda, R., Cassol, H., Farber, N., Laureys, S., & Gosseries, O. (16 March 2019). Clinical and neuroimaging improvements after apomorphine treatment in a patient with chronic disorders of consciousness following brain hemorrhage [Paper presentation]. 13th World Congress on Brain Injury, Toronto, Canada.

Bonin, E., Lejeune, N., Thibaut, A., Cassol, H., Antonopoulos, G., Wannez, S., Martial, C., Schnakers, C., LAUREYS, S., & Chatelle, C. (14 March 2019). Nociception Coma Scale Revised allows to identify patients with preserved neural basis for pain experience [Poster presentation]. 13th World congress on brain injury, Toronto, Canada.

Lejeune, N., & Mouraux, A. (March 2019). Investiguer la relation entre douleur et conscience : une approche lésionnelle au moyen de l’électroencéphalographie. Douleur et Analgésie, 32 (1), 69-70.

Mulders, D., de Bodt, C., Lejeune, N., Lee, J. A., Mouraux, A., & Verleysen, M. (2019). Tensor factorization to extract patterns in multimodal EEG data. In ESANN 2019 proceedings.

Sanz, L., Lejeune, N., Thibaut, A., Blandiaux, S., Stender, J., Farber, N., Zafonte, R., Laureys, S., & Gosseries, O. (19 October 2018). Treating severely brain-injured patients with apomorphine: study protocol for a double blind randomized placebo-controlled trial using behavioral and neuroimaging assessments [Poster presentation]. Belgian Brain Congress 2018, Liège, Belgium. doi:10.3389/conf.fnins.2018.95.00065

Lejeune, N., Chatelle, C., Laureys, S., & Mouraux, A. (29 June 2018). Cold evoked potentials in patients with disorders of consciousness: a new bedside approach to probe spino-thalamic pathways in non-communicative patients [Poster presentation]. 22th Congress of the Association for the Scientific Study of Consciousness, Krakow, Poland.

Annen, J., Wolff, A., Blandiaux, S., Lejeune, N., Chatelle, C., & Laureys, S. (June 2018). A comparison of the P300 and PET in patients with disorders of consciousness in absence of response to command. European Journal of Neurology, 25 (S2).

Martens, G., Lejeune, N., O'Brien, A., Fregni, F., Martial, C., Wannez, S., Laureys, S., & Thibaut, A. (2018). Randomized controlled trial of home-based 4-week tDCS in chronic minimally conscious state. Brain Stimulation. doi:10.1016/j.brs.2018.04.021

Annen, J., Blandiaux, S., Lejeune, N., Bahri, M. A., Thibaut, A., Cho, W., Guger, C., Chatelle, C.* , & Laureys, S.*. (2018). BCI performance and brain metabolism profile in severely brain-injured patients without response to command at bedside. Frontiers in Neuroscience. doi:10.3389/fnins.2018.00370
* These authors have contributed equally to this work.

Mulders, D., De Bodt, C., Lejeune, N., Dufour, A., Verleysen, M., & Mouraux, A. (2018). Characterizing the Cortical Processes Related to the Perception of Long-Lasting Warm and Cool Sensations [Poster presentation]. "17th World Congress on Pain", Boston, United States.

Mulders, D., de Bodt, C., Lejeune, N., Mouraux, A., & Verleysen, M. (2018). Spatial Filtering of EEG Signals to Identify Periodic Brain Activity Patterns. In Y. Deville, S. Gannot, R. Mason, M. Plumbey, ... D. Ward (Eds.), LVA/ICA 2018: Latent Variable Analysis and Signal Separation. Cham, Switzerland: Springer. doi:10.1007/978-3-319-93764-9_48

Mulders, D., de Bodt, C., Lejeune, N., Mouraux, A., & Verleysen, M. (2018). Linear Periodic Discriminant Analysis of Multidimensional Signals. In L. Cheng, A. Leung, ... S. Ozawa, Neural Information Processing. ICONIP 2018.

Lejeune, N. (2016). Withdrawal of clinically assisted nutrition and hydration decisions in patients with prolonged disorders of consciousness: best interests of the patients and advance directives are the keys. Journal of Medical Ethics. doi:10.1136/medethics-2016-103813