Floor Cleaners as Helper Pets: Projecting Assistive Robots' Agency on Zoomorphic Affordances

Care of ageing adults has become a dominant field of application for assistive robot technologies, promising support for ageing adults residing in care homes and staff, in dealing with practical routine tasks and providing social and emotional relieve. A time consuming and human intensive necessity is the maintenance of high hygiene quality in care homes. Robotic vacuum cleaners have been proven effective for doing the job elsewhere, but-in the context of care homes-are counterproductive for residents' well-being and do not get accepted. This is because people with dementia manifest their agency in more implicit and emotional ways, while making sense of the world around them. Starting from these premises, we explored how a zoomorphic designed vacuum cleaner could better accommodate the sensemaking of people with dementia. Our design reconceptualises robotic vacuum cleaners as a cat-like robot, referring to a playful behaviour and appearance to communicate a non-threatening and familiar role model. Data from an observational study shows that residents responded positively to our prototype, as most of them engaged playfully with it as if it was a pet or a cat-like toy, for example luring it with gestures. Some residents simply ignored the robot, indicating that it was not perceived as frightening or annoying. The level of activity influenced reactions; residents ignored our prototype if busy with other occupations, which proves that it did not cause significant disturbance. We further report results from focus group sessions with formal and informal caregivers who discussed a video prototype of our robot. Caregivers encouraged us to enhance the animal like characteristics (in behaviour and materiality) even further to result in richer interactions and provoke haptic pleasure but also pointed out that residents should not mistake the robot for a real cat.

Iota-Carrageenan Inhibits Replication of SARS-CoV-2 and the Respective Variants of Concern Alpha, Beta, Gamma and Delta

The COVID-19 pandemic continues to spread around the world and remains a major public health threat. Vaccine inefficiency, vaccination breakthroughs and lack of supply, especially in developing countries, as well as the fact that a non-negligible part of the population either refuse vaccination or cannot be vaccinated due to age, pre-existing illness or non-response to existing vaccines intensify this issue. This might also contribute to the emergence of new variants, being more efficiently transmitted, more virulent and more capable of escaping naturally acquired and vaccine-induced immunity. Hence, the need of effective and viable prevention options to reduce viral transmission is of outmost importance. In this study, we investigated the antiviral effect of iota-, lambda- and kappa-carrageenan, sulfated polysaccharides extracted from red seaweed, on SARS-CoV-2 Wuhan type and the spreading variants of concern (VOCs) Alpha, Beta, Gamma and Delta. Carrageenans as part of broadly used nasal and mouth sprays as well as lozenges have the potential of first line defense to inhibit the infection and transmission of SARS-CoV-2. Here, we demonstrate by using a SARS-CoV-2 spike pseudotyped lentivirus particles (SSPL) system and patient-isolated SARS-CoV-2 VOCs to infect transgenic A549ACE2/TMPRSS2 and Calu-3 human lung cells that all three carrageenan types exert antiviral activity. Iota-carrageenan exhibits antiviral activity with comparable IC₅₀ values against the SARS-CoV-2 Wuhan type and the VOCs. Altogether, these results indicate that iota-carrageenan might be effective for prophylaxis and treatment of SARS-CoV-2 infections independent of the present and potentially future variants.

Lectin from Triticum vulgaris (WGA) Inhibits Infection with SARS-CoV-2 and Its Variants of Concern Alpha and Beta

Even in the face of global vaccination campaigns, there is still an urgent need for effective antivirals against SARS-CoV-2 and its rapidly spreading variants. Several natural compounds show potential as antiviral substances and have the advantages of broad availabilities and large therapeutic windows. Here, we report that lectin from Triticum vulgaris (Wheat Germ Agglutinin) displays antiviral activity against SARS-CoV-2 and its major Variants of Concern (VoC), Alpha and Beta. In Vero B4 cells, WGA potently inhibits SARS-CoV-2 infection with an IC₅₀ of <10 ng/mL. WGA is effective upon preincubation with the virus or when added during infection. Pull-down assays demonstrate direct binding of WGA to SARS-CoV-2, further strengthening the hypothesis that inhibition of viral entry by neutralizing free virions might be the mode of action behind its antiviral effect. Furthermore, WGA exhibits antiviral activity against human coronavirus OC43, but not against other non-coronaviruses causing respiratory tract infections. Finally, WGA inhibits infection of the lung cell line Calu-3 with wild type and VoC viruses with comparable IC₅₀ values. Altogether, our data indicate that topical administration of WGA might be effective for prophylaxis or treatment of SARS-CoV-2 infections.

The Saliva of Probands Sucking an Iota-Carrageenan Containing Lozenge Inhibits Viral Binding and Replication of the Most Predominant Common Cold Viruses and SARS-CoV-2

PURPOSE

The aim of this study was to investigate whether sucking of an iota-carrageenan containing lozenge releases sufficient iota-carrageenan into the saliva of healthy subjects to neutralize representatives of the most common respiratory virus families causing common cold and SARS-CoV-2.

PATIENTS AND METHODS

In this monocentric, open label, prospective clinical trial, 31 healthy subjects were included to suck a commercially available iota-carrageenan containing lozenge. Saliva samples from 27 subjects were used for ex vivo efficacy analysis. The study's primary objective was to assess if the mean iota-carrageenan concentration of the saliva samples exceeded 5 µg/mL, which is the concentration known to reduce replication of human rhinovirus (hRV) 1a and 8 by 90%. The iota-carrageenan concentration of the saliva samples was analyzed by UV-Vis spectroscopy. The antiviral effectiveness of the individual saliva samples was determined in vitro against a panel of respiratory viruses including hRV1a, hRV8, human coronavirus OC43, influenza virus A H1N1pdm09, coxsackievirus A10, parainfluenza virus 3 and SARS-CoV-2 using standard virological assays.

RESULTS

The mean iota-carrageenan concentration detected in the saliva exceeds the concentration needed to inhibit 90% of hRV1a and hRV8 replication by 134-fold (95% CI 116.3-160.8-fold; p < 0.001). Thus, the study met the primary endpoint. Furthermore, the iota-carrageenan saliva concentration was 60 to 30,351-fold higher than needed to reduce viral replication/binding of all tested viruses by at least 90% (p < 0.001). The effect was most pronounced in hCoV OC43; in case of SARS-CoV-2, the IC90 was exceeded by 121-fold (p < 0.001).

CONCLUSION

Sucking an iota-carrageenan containing lozenge releases sufficient iota-carrageenan to neutralize and inactivate the most abundant respiratory viruses as well as pandemic SARS-CoV-2. The lozenges are therefore an appropriate measure to reduce the viral load at the site of infection, hereby presumably limiting transmission within a population as well as translocation to the lower respiratory tract.

TRIAL REGISTRATION

NCT04533906.

Promoting mental health literacy in schools

Background

Adolescence is the most suitable time for health promotion and prevention programs regarding mental illness to start. Given that, about half of the mental illnesses will develop by the age of 14, addressing this issue early in the life course is a particular public health goal in Europe. Mental health literacy is considered a key determinant of good mental health, as it comprises adequate knowledge positive attitudes towards mental health and help-seeking behavior. School-based interventions aimed at increasing mental health literacy are a promising method to reach most young people, at least in countries were school attendance is mandatory. The goal of our project is to evaluate a mental health school program, adapted from a Curriculum originating in Canada, in regard to its ability to increase the mental health literacy of adolescents and young adults within the German school setting.

Methods

Data is currently being collected within the school setting from adolescents and young adults attending regular secondary schools and vocational schools in Germany at three different time points: (T0) before the intervention, (T1) afterwards and (T2) 2-3 months later. A control group will be questioned as well. Data collection takes place between February and December 2020.

Results

Till October 2020 a sample size of about 200 to 400 participants will be reached. It is expected that the intervention group will have a significantly higher increase in mental health literacy, more positive attitudes towards help-seeking and a decrease in stigmatizing attitudes towards mental illness compared to the control group.

Conclusions

It is expected that, the mental health Curriculum will show to be an effective way of promoting the mental health literacy of young people attending different school forms in Germany. A national wide implementation might be a promising public health measure for fostering good mental health and mental health literacy in adolescents and young people.

Radiographic outcomes in the coronal plane with iASSIST™ versus optical navigation for total knee arthroplasty: A preliminary case-control study

BACKGROUND

The new navigation system iASSIST™ for total knee arthroplasty (TKA) relies on accelerometers and gyroscopes. The objective of this prospective study was to compare the accuracy of iASSIST™ to that of the conventional optical navigation system Navitrack™ by determining the rate of mechanical axis restoration (±3°), postoperative mean mechanical alignment, rate of adequate femoral and tibial component positioning, mean operative time, and occurrence of navigation-related adverse events.

HYPOTHESIS

The rate of mechanical axis restoration (±3°) is not lower with iASSIST™ than with the conventional navigation system Navitrack™.

MATERIAL AND METHODS

Of 40 patients who underwent primary TKA between October 2013 and March 2014, 20 had navigation using iASSIST™ and 20 using Navitrack™. Six months after TKA, an independent observer measured three parameters on coronal radiographs: the hip-knee-ankle angle (HKA), the mechanical lateral distal femoral angle (mLDFA), and the mechanical medial proximal tibial angle (mMPTA).

RESULTS

The two groups showed no significant differences for the rates of HKA restoration (P=0.3), adequate coronal positioning of the femoral component (P=0.12) and tibial component (P=0.12), or optimal success (P=0.09). Significant differences in favour of iASSIST™ were demonstrated for the values and angular deviations of the HKA (P=0.02) and mMPTA (P=0.01), whereas no significant difference was found for mLDFA. There were no significant differences regarding the mean operative time (P=0.06) or the occurrence of navigation-related adverse events (P=0.18).

DISCUSSION

The iASSIST™ system provides a neutral mechanical axis and optimal component position in the coronal plane in 95% of cases, indicating that it is as accurate as the optical navigation system Navitrack™.

LEVEL OF EVIDENCE

III, prospective case-control study.

Reversible 2D Phase Transition Driven By an Electric Field: Visualization and Control on the Atomic Scale

We report on a reversible structural phase transition of a two-dimensional system that can be locally induced by an external electric field. Two different structural configurations may coexist within a CO monolayer on Cu(111). The balance between the two phases can be shifted by an external electric field, causing the domain boundaries to move, increasing the area of the favored phase controllable both in location and size. If the field is further enhanced new domains nucleate. The arrangement of the CO molecules on the Cu surface is observed in real time and real space with atomic resolution while the electric field driving the phase transition is easily varied over a broad range. Together with the well-known molecular manipulation of CO adlayers, our findings open exciting prospects for combining spontaneous long-range order with man-made CO structures such as "molecule cascades" or "molecular graphene". Our new manipulation mode permits us to bridge the gap between fundamental concepts and the fabrication of arbitrary atomic patterns in large scale, by providing unprecedented insight into the physics of structural phase transitions on the atomic scale.

The Intranasal Application of Zanamivir and Carrageenan Is Synergistically Active against Influenza A Virus in the Murine Model

BACKGROUND

Carrageenan is a clinically proven and marketed compound for the treatment of viral upper respiratory tract infections. As infections caused by influenza virus are often accompanied by infections with other respiratory viruses the combination of a specific anti-influenza compound with the broadly active antiviral polymer has huge potential for the treatment of respiratory infections. Thus, the combination of the specific anti-influenza drug Zanamivir together with carrageenan in a formulation suitable for intranasal application was evaluated in-vitro and in-vivo.

PRINCIPAL FINDINGS

We show in-vitro that carrageenan and Zanamivir act synergistically against several influenza A virus strains (H1N1(09)pdm, H3N2, H5N1, H7N7). Moreover, we demonstrate in a lethal influenza model with a low pathogenic H7N7 virus (HA closely related to the avian influenza A(H7N9) virus) and a H1N1(09)pdm influenza virus in C57BL/6 mice that the combined use of both compounds significantly increases survival of infected animals in comparison with both mono-therapies or placebo. Remarkably, this benefit is maintained even when the treatment starts up to 72 hours post infection.

CONCLUSION

A nasal spray containing carrageenan and Zanamivir should therefore be tested for prevention and treatment of uncomplicated influenza in clinical trials.

Mobile-bearing versus fixed-bearing total knee implants. Results of a series of 100 randomised cases after 9 years follow-up

HYPOTHESIS

Mobile-bearing total knee arthroplasty (TKA) implants were developed as an alternative to fixed-bearing implants because of their theoretical advantages related to wear and range of motion. For all that, none of the short-term and medium-term studies published so far have reported a significant clinical improvement related to these mobile bearings. The goal of this study was to compare the outcomes of fixed and mobile bearings in the same type of TKA model after a longer follow-up.

MATERIAL AND METHODS

This series initially comprised 100 patients with a mean age of 73 years who were operated by a single surgeon. The patients were randomised to receive either a fixed bearing TKA implant or a mobile one; their outcomes evaluated after a mean of 9 years (7.2-12.2) follow-up. Twenty-two patients died before the final review, 15 were lost to follow-up and 2 were excluded. This resulted in 30 patients with a mobile-bearing knee and 31 with a fixed-bearing knee being available for analysis.

RESULTS

There were no significant clinical differences between the groups receiving a fixed or mobile bearing in terms of the range of motion, subjective outcomes or validated outcomes measured, such as the self-reported Oxford or the IKS. Conversely, there was a significantly higher rate of osteolysis in the fixed-bearing group, but it was not clinically relevant.

CONCLUSION

This study, which has the longest published follow-up, confirms the results found in the seven randomised studies published up to now: there are no significant differences in the clinical outcomes between fixed-bearing and mobile-bearing inserts of the same TKA model. Although the mobile bearing knees had a better radiographic appearance, this did not translate to better clinical outcomes. In practice, the superiority of mobile bearings is solely theoretical.

LEVEL OF EVIDENCE II

Prospective randomised study.

Effects of silver nanoparticles on primary mixed neural cell cultures: uptake, oxidative stress and acute calcium responses

In the body, nanoparticles can be systemically distributed and then may affect secondary target organs, such as the central nervous system (CNS). Putative adverse effects on the CNS are rarely investigated to date. Here, we used a mixed primary cell model consisting mainly of neurons and astrocytes and a minor proportion of oligodendrocytes to analyze the effects of well-characterized 20 and 40 nm silver nanoparticles (SNP). Similar gold nanoparticles served as control and proved inert for all endpoints tested. SNP induced a strong size-dependent cytotoxicity. Additionally, in the low concentration range (up to 10 μg/ml of SNP), the further differentiated cultures were more sensitive to SNP treatment. For detailed studies, we used low/medium dose concentrations (up to 20 μg/ml) and found strong oxidative stress responses. Reactive oxygen species (ROS) were detected along with the formation of protein carbonyls and the induction of heme oxygenase-1. We observed an acute calcium response, which clearly preceded oxidative stress responses. ROS formation was reduced by antioxidants, whereas the calcium response could not be alleviated by antioxidants. Finally, we looked into the responses of neurons and astrocytes separately. Astrocytes were much more vulnerable to SNP treatment compared with neurons. Consistently, SNP were mainly taken up by astrocytes and not by neurons. Immunofluorescence studies of mixed cell cultures indicated stronger effects on astrocyte morphology. Altogether, we can demonstrate strong effects of SNP associated with calcium dysregulation and ROS formation in primary neural cells, which were detectable already at moderate dosages.

Biomimetic synthesis of chiral erbium-doped silver/peptide/silica core-shell nanoparticles (ESPN)

Peptide-modified silver nanoparticles have been coated with an erbium-doped silica layer using a method inspired by silica biomineralization. Electron microscopy and small-angle X-ray scattering confirm the presence of an Ag/peptide core and silica shell. The erbium is present as small Er(2)O(3) particles in and on the silica shell. Raman, IR, UV-Vis, and circular dichroism spectroscopies show that the peptide is still present after shell formation and the nanoparticles conserve a chiral plasmon resonance. Magnetic measurements find a paramagnetic behavior. In vitro tests using a macrophage cell line model show that the resulting multicomponent nanoparticles have a low toxicity for macrophages, even on partial dissolution of the silica shell.

Prognostic significance of low volume sentinel lymph node disease in early-stage cervical cancer

OBJECTIVE

Evaluate prognostic significance of low volume disease detected in sentinel nodes (SN) of patients with early stages cervical cancer. Although pathologic ultrastaging of SN allows for identification of low volume disease, including micro-metastasis and isolated tumor cells (ITC), in up to 15% of cases, prognostic significance of these findings is unknown.

METHODS

A total of 645 records from 8 centers were retrospectively reviewed. Enrolled in our study were patients with early-stage cervical cancer who had undergone surgical treatment including SN biopsy followed by pelvic lymphadenectomy and pathologic ultrastaging of SN.

RESULTS

Macrometastasis, micrometastasis, and ITC were detected by SN ultrastaging in 14.7%, 10.1%, and 4.5% patients respectively. False negativity of SN ultrastaging reached 2.8%. The presence of ITC was not associated with significant risk, both for recurrence free survival and overall survival. Overall survival was significantly reduced in patients with macrometastasis and micrometastasis; hazard ratio for overall survival reached 6.85 (95% CI, 2.59-18.05) and 6.86 (95% CI, 2.09-22.61) respectively. Presence of micrometastasis was an independent prognostic factor for overall survival in a multivariable model.

CONCLUSION

Presence of micrometastasis in SN in patients with early stage cervical cancer was associated with significant reduction of overall survival, which was equivalent to patients with macrometastasis. No prognostic significance was found for ITC. These data highlight the importance of SN biopsy and pathologic ultrastaging for the management of cervical cancer.

Equine behaviour and heart rate in temperament tests with or without rider or handler

The aim of the present study was to compare horses' heart rate (HR), heart rate variability (RMSSD, pNN50) and behaviour in the same temperament test when being ridden, led, and released free. Behavioural measurements included scores and linear measurements for reactivity (R), activity (A), time to calm down (T) and emotionality (E), recorded during the approach (1) and/or during confrontation with the stimulus (2). Sixty-five horses were each confronted 3 times (1 ridden, 1 led, 1 free running in balanced order) with 3 novel and/or sudden stimuli. Mixed model analysis indicated that leading resulted in the lowest (P<0.05 throughout) reactions as measured by A1, A2, E1, E2, R2, and pNN50 while riding produced the strongest (A1, T2, HR, RMSSD, pNN50) or medium (E1, E2, R2) reactions. Free running resulted either in the strongest (A2, E1, E2, R2) or in the lowest (A1, T2, HR, RMSSD, pNN50) reactions. The repeatability across tests for HR (0.57), but not for RMSSD (0.23) or pNN50 (0.25) was higher than for any behavioural measurement: the latter ranged from values below 0.10 (A1, A2, T2) to values between 0.30 and 0.45 (E1, E2, R2). Overall, the results show that a rider or handler influences, but not completely masks, the horses' intrinsic behaviour in a temperament test, and this influence appeared to be stronger on behavioural variables and heart rate variability than on the horses' heart rates. Taking both practical considerations and repeatabilities into account, reactivity appears to be the most valuable parameter. Emotionality and heart rate can also yield valid results reflecting additional dimensions of temperament although their practical relevance may be less obvious. If a combination of observed variables is chosen with care, a valid assessment of a horse's temperament may be possible in all types of tests. However, in practice, tests that resemble the practical circumstances most closely, i.e. testing riding horses under a rider, should be chosen.

Application of laser postionization secondary neutral mass spectrometry/time-of-flight secondary ion mass spectrometry in nanotoxicology: visualization of nanosilver in human macrophages and cellular responses

Silver nanoparticles (SNP) are the subject of worldwide commercialization because of their antimicrobial effects. Yet only little data on their mode of action exist. Further, only few techniques allow for visualization and quantification of unlabeled nanoparticles inside cells. To study SNP of different sizes and coatings within human macrophages, we introduce a novel laser postionization secondary neutral mass spectrometry (Laser-SNMS) approach and prove this method superior to the widely applied confocal Raman and transmission electron microscopy. With time-of-flight secondary ion mass spectrometry (TOF-SIMS) we further demonstrate characteristic fingerprints in the lipid pattern of the cellular membrane indicative of oxidative stress and membrane fluidity changes. Increases of protein carbonyl and heme oxygenase-1 levels in treated cells confirm the presence of oxidative stress biochemically. Intriguingly, affected phagocytosis reveals as highly sensitive end point of SNP-mediated adversity in macrophages. The cellular responses monitored are hierarchically linked, but follow individual kinetics and are partially reversible.

Silicification of peptide-coated silver nanoparticles--A Biomimetic soft chemistry approach toward chiral hybrid core-shell materials

Silica and silver nanoparticles are relevant materials for new applications in optics, medicine, and analytical chemistry. We have previously reported the synthesis of pH responsive, peptide-templated, chiral silver nanoparticles. The current report shows that peptide-stabilized nanoparticles can easily be coated with a silica shell by exploiting the ability of the peptide coating to hydrolyze silica precursors such as TEOS or TMOS. The resulting silica layer protects the nanoparticles from chemical etching, allows their inclusion in other materials, and renders them biocompatible. Using electron and atomic force microscopy, we show that the silica shell thickness and the particle aggregation can be controlled simply by the reaction time. Small-angle X ray scattering confirms the Ag/peptide@silica core-shell structure. UV-vis and circular dichroism spectroscopy prove the conservation of the silver nanoparticle chirality upon silicification. Biological tests show that the biocompatibility in simple bacterial systems is significantly improved once a silica layer is deposited on the silver particles.

MGOUN1 encodes an Arabidopsis type IB DNA topoisomerase required in stem cell regulation and to maintain developmentally regulated gene silencing

Maintenance of stem cells in the Arabidopsis thaliana shoot meristem is regulated by signals from the underlying cells of the organizing center, provided through the transcription factor WUSCHEL (WUS). Here, we report the isolation of several independent mutants of MGOUN1 (MGO1) as genetic suppressors of ectopic WUS activity and enhancers of stem cell defects in hypomorphic wus alleles. mgo1 mutants have previously been reported to result in a delayed progression of meristem cells into differentiating organ primordia (Laufs et al., 1998). Genetic analyses indicate that MGO1 functions together with WUS in stem cell maintenance at all stages of shoot and floral meristems. Synergistic interactions of mgo1 with several chromatin mutants suggest that MGO1 affects gene expression together with chromatin remodeling pathways. In addition, the expression states of developmentally regulated genes are randomly switched in mgo1 in a mitotically inheritable way, indicating that MGO1 stabilizes epigenetic states against stochastically occurring changes. Positional cloning revealed that MGO1 encodes a putative type IB topoisomerase, which in animals and yeast has been shown to be required for regulation of DNA coiling during transcription and replication. The specific developmental defects in mgo1 mutants link topoisomerase IB function in Arabidopsis to stable propagation of developmentally regulated gene expression.

Efficacy and safety of intranasal xylometazoline and ipratropium in patients with common cold

BACKGROUND

Many over-the-counter medications are available to treat common cold nasal symptoms, but patients may be unsure which one to use.

METHODS

This review assesses two widely used intranasal treatments for nasal congestion and rhinorrhea in the common cold: xylometazoline hydrochloride and ipratropium bromide.

RESULTS

Xylometazoline quickly and effectively relieves nasal congestion, while ipratropium is effective at reducing rhinorrhea. When used in combination, a novel approach to treatment, nasal congestion and rhinorrhea are treated simultaneously, providing effective relief from two of the most troublesome symptoms of the common cold Both drugs are well tolerated, with only mild to moderate, nasal-related side effects.

CONCLUSIONS

The efficacy and safety of the combination product suggest that it should be used first-line in the symptomatic relief of nasal congestion and rhinorrhea, before the use of oral treatments.

Peptide-coated silver nanoparticles: synthesis, surface chemistry, and pH-triggered, reversible assembly into particle assemblies

Simple tripeptides are scaffolds for the synthesis and further assembly of peptide/silver nanoparticle composites. Herein, we further explore peptide-controlled silver nanoparticle assembly processes. Silver nanoparticles with a pH-responsive peptide coating have been synthesized by using a one-step precipitation/coating route. The nature of the peptide/silver interaction and the effect of the peptide on the formation of the silver particles have been studied via UV/Vis, X-ray photoelectron, and surface-enhanced Raman spectroscopies as well as through electron microscopy, small angle X-ray scattering and powder X-ray diffraction with Rietveld refinement. The particles reversibly form aggregates of different sizes in aqueous solution. The state of aggregation can be controlled by the solution pH value. At low pH values, individual particles are present. At neutral pH values, small clusters form and at high pH values, large precipitates are observed.

EWI-2/CD316 is an inducible receptor of HSPA8 on human dendritic cells

The activation of dendritic cells is marked by changes both on their cell surfaces and in their functions. We define EWI-2/CD316 as an early activation marker of dendritic cells upregulated by Toll-like receptor ligands clearly before CD86 and CD83. By expression cloning, human heat shock protein A8 (HSPA8), a member of the hsp70 family, was identified as the ligand for EWI-2. Soluble EWI-2 bound both to cells expressing HSPA8 and also to immobilized HSPA8 protein. Although heat shock proteins are evolutionarily well conserved, other members of this class, including human hsp60 and mycobacterial hsp65, did not bind to EWI-2. The ligation of EWI-2 enhanced the CCL21/SLC-dependent migration of activated mature dendritic cells but attenuated their antigen-specific stimulatory capacities. Important functions of recently activated dendritic cells are thus critically modulated by the newly discovered HSPA8-EWI-2 interaction.

[Computer assisted orthopedics surgery]

Computer-assisted surgery has become commonplace in orthopedic surgery. The number of applications grows steadily as does the number of patients benefiting from these new techniques. The hearty debates heard when these techniques were first introduced have now given way to more evidence-based evaluation. Our objective here is to continue this approach by presenting our six-year experience with navigation. We will not discuss the theoretical background of these technologies nor attempt to present an exhaustive review of the literature but rather focus attention on surgical skills acquired by a group of surgeons working in a wide range of areas. The common point is that all have now integrated computer-assisted navigation into their routine surgical practices including: a) first-intention and revision knee arthroplasty; b) hip arthroplasty; c) anterior cruciate ligament surgery; d) proximal tibial osteotomy; e) shoulder arthroplasty. We will terminate this round table with a presentation of future technological advances and propose our advice for an increasingly widespread use of these new techniques.

Impaired cortical inhibition in adult ADHD patients: a study with transcranial magnetic stimulation

The aim of this study was to analyze motor inhibition and facilitation of adult ADHD patients using double pulse transcranial magnetic stimulation (TMS). Twenty-six right handed adult ADHD patients according to DSM-IV were investigated and compared to 26 age and sex-matched controls. In the left hemisphere, mean motor inhibition was 0.53 +/- 0.33 (mean +/- SD) in ADHD patients and 0.34 +/- 0.16 (mean +/- SD) in controls (p = 0.012). There were no significant differences in motor excitability concerning facilitation or in the right hemisphere. Decreased motor inhibition correlated with a higher symptom score derived from the Wender Reimherr Interview (WRI) (p = 0.28; p = 0.04) and also with self rated hyperactivity/impulsivity symptoms (p = 0.30; p = 0.03). In conclusion, decreased motor inhibition in adult ADHD corroborate similar findings in children with ADHD (Moll et al., 2000) and reflect disturbed impulsivity and hyperactivity on a neurophysiological level.

Absorption characteristics of EC-MPS – an enteric-coated formulation of mycophenolic sodium

Enteric-coated mycophenolate sodium is an advanced formulation delivering mycophenolic acid (MPA), designed to improve MPA-related upper gastrointestinal adverse events by delaying MPA release until the small intestine.

OBJECTIVE

Two studies were undertaken to identify the absolute bioavailability and dose-proportionality of enteric-coated mycophenolate sodium in stable renal transplant patients receiving cyclosporine.

METHODS

Study 1: The mean MPA AUC(0-t) was shown to be greater after MPA infusion than after oral enteric-coated mycophenolate sodium (42.1 vs. 28.9 microg x h/ml). Mean absolute bioavailability was 0.71 +/- 0.21 (SD). Study 2: The AUC(0-t) and C(max) for MPA were proportional to the dose of enteric-coated mycophenolate sodium, similarly mean AUC(0-infinity) and C(max) for MPA glucuronide were proportional to dose administered.

RESULTS AND CONCLUSIONS

In patients receiving cyclosporine the absolute bioavailability of MPA provided by enteric-coated mycophenolate sodium is equivalent to that provided by mycophenolate mofetil when administered in combination with cyclosporine, and exhibits dose-proportionality. Enteric-coated mycophenolate sodium was well tolerated from 180 - 2,160 mg with no serious adverse events reported.

Absence of histamine-induced nitric oxide release in the human radial artery: implications for vasospasm of coronary artery bypass vessels

Radial artery (RA) bypass grafts can develop severe vasospasm. As histamine is known to induce vasospasm, its effect on RA was assessed compared with the classic bypass vessels internal mammary artery (MA) and saphenous vein (SV). The vessels were examined in organ chambers for isometric tension recording. Histamine induced contractions on baseline; the sensitivity was higher in RA and SV than MA. After precontraction with norepinephrine, histamine did not evoke relaxations of RA but induced relaxations of MA and less of SV at lower concentrations; it induced contractions at higher concentrations, reaching similar levels in all three vessels. Indomethacin did not affect the response of MA and RA but potentiated relaxations and reduced contractions of SV. Endothelium removal, Nω-nitro-l-arginine methyl ester (l-NAME), or the H2-receptor blocker cimetidine did not affect the response of RA, but inhibited relaxations and enhanced contractions in MA and inhibited relaxations in SV; in the latter, only l-NAME enhanced contractions. Real-time PCR detected much lower expression of endothelial H2-receptor in RA than MA or SV. Western blots revealed similar endothelial nitric oxide (NO) synthase expression in all three vessels. Relaxations to acetylcholine were identical in RA and MA. Thus histamine releases NO by activating the endothelial H2-receptor, the expression of which is much lower in RA than MA or SV. H2-receptor activation also releases prostaglandins in SV, partially antagonizing NO. The lack of histamine-induced NO production represents a possible mechanism of RA vasospasm.

CD45 isoform expression is associated with different susceptibilities of human naive and effector CD4+ T cells to respond to IL-4

Interleukin-4 (IL-4) is the major factor promoting the development of T helper type 2 (Th2) cells from naive precursor T cells. Minute amounts of IL-4 produced by naive T cells seem to be sufficient; however, the molecular mechanisms explaining this efficient utilization of IL-4 are not yet known. Here, we show that human CD4+ CD45RA+ naive T cells, in contrast to CD4+ CD45R0+ effector T cells, show responsiveness to endogenous as well as exogenous IL-4 to proliferate and differentiate towards Th2 cells in vitro. Despite production levels of IL-4 below conventional detection limits, CD45RA+ T cell-derived IL-4 could clearly activate STAT6. Although the expression levels of IL-4R and STAT6 were not different between naive and effector T cells, only naive T cells responded to IL-4 in a STAT6-dependent reporter gene assay. Transfecting a trans-dominant negative form of STAT6 abrogated IL-4-induced proliferation in CD45RA+ cells. A significantly higher protein tyrosine phosphatase (PTPase) activity was detected in CD45R0+ T cells as compared to CD45RA+ T cells. Cross-linking CD45 potently reduced PTPase activity in CD45R0+ T cells and restored their ability to proliferate in response to IL-4. Thus, CD45 PTPase activity contributes to the susceptibility of naive and memory T cells to respond to IL-4.

Deficient translocation of c-Rel is associated with impaired Th1 cytokine production in T cells from atopic dermatitis patients

Decreased production of T helper type 1 (Th1) cytokines, such as interferon-gamma (IFN-gamma) or interleukin-2 (IL-2), is a hallmark of atopic diseases. While accessory signals from antigen-presenting cells may be missing, T cells themselves may be suppressed in their ability to produce substantial amounts of Th1 cytokines. We show, in this study, that T cell receptor (TCR)-activated T cells from atopic dermatitis (AD) patients proliferate less than control T cells and produce lower amounts of IFN-gamma and IL-2, but comparable amounts of IL-4. Because mice lacking the nuclear factor kappa B (NF-kappaB) transcription factors - p65 or c-Rel - show reduced Th1, but undisturbed Th2 responses, we investigated the role of c-Rel and p65 for Th1 cytokine production in T cells from healthy and severe AD patients. TCR-activated primary T cells from healthy donors treated with c-Rel antisense oligonucleotides produced lower levels of IL-2 and IFN-gamma and proliferated less efficiently than the corresponding control T cells. Moreover, transfection of primary T cells with c-Rel or p65 enhanced proliferation and production of IL-2 and IFN-gamma. Nuclear extracts of activated primary T cells from AD donors bound weakly to NF-kappaB-specific oligonucleotides, compared to extracts from healthy control T cells. Western blotting studies revealed that nuclear, but not cytosolic, extracts from T cells of AD patients lacked significant amounts of c-Rel and p65. T cell clones derived from AD patients failed to sufficiently translocate c-Rel and p65 into the nucleus following activation. Thus, impaired nuclear translocation of c-Rel and p65 may determine an impaired Th1 cytokine response in AD.

[Bioterrorism - a challenge for public health services]

Within the range of highly contagious diseases there are well-known diseases, and those caused by newly detected infectious agents (i. e. SARS) or, in the worst case, bioterror agents. Public Health Services as well as clinicians and practitioners will be confronted with a new paradigm of infectious disease control: not only the infectious agent itself, the constitution of the host or the environment will influence the spread of a disease, but also globalization, mobile societies and new communication systems. Thus, the emergence, respectively the re-emergence of such diseases demands new or better skills in management of infectious diseases. Finally, the demonstration of national and federal plans for smallpox control focuses on organisational, logistical and financial problems following the implementation of such plans.

Efficacy of laser treatment of tattoos using lasers emitting wavelengths of 532 nm, 755 nm and 1064 nm

BACKGROUND

Multifunctional laser devices can be used to treat tattoos successfully.

OBJECTIVES

To report the efficacy of laser treatment in professional, amateur, accidental and permanent make-up tattoos from our own experience and to compare it with the literature.

METHODS

We retrospectively studied 74 consecutive patients with professional, amateur, make-up and accidental tattoos between June 1998 and November 2000. Patients were treated with a Q-switched Nd:YAG laser (wavelengths of 532 nm and 1064 nm), a Q-switched alexandrite laser (755 nm) and a variable pulse Nd:YAG laser (532 nm).

RESULTS

Fourteen patients (19%) achieved a complete response (>95% lightening of treated tattoos), 23 (31%) an excellent response (76-95% lightening) and 21 (28%) a good response (51-75% lightening). Sixteen patients (22%) showed only a slight improvement (< or =50% lightening). Make-up tattoos and blue-black professional tattoos were most successfully treated. Multicoloured professional tattoos needed more treatments (mean +/- SD 5.7 +/- 5.4) in comparison with single-colour tattoos (3.5 +/- 2.0). The amateur tattoos needed fewer treatments (2.8 +/- 1.1) in comparison with professional tattoos. With accidental tattoos the results depended on the particles which had penetrated the skin. In contrast to literature reports, newer tattoos showed a trend to better treatment results than older tattoos.

CONCLUSIONS

Using modern Q-switched lasers, tattoos are removed successfully with minimal risk of scarring and permanent pigmentary alterations. Even multicoloured tattoos can be treated successfully and with a low rate of side-effects.

Interleukin 10 regulates cell surface and soluble LIR-2 (CD85d) expression on dendritic cells resulting in T cell hyporesponsivenessin vitro

Dendritic cells (DC) are unique in their ability to stimulate naive T cells to proliferate and to differentiate into effector T cells. DC, however, can also inhibit T cell activation and play a role in central and peripheral tolerance. IL-10 has been shown to render DC tolerogenic by unknown mechanisms. Using a combined monoclonal antibody/retroviral expression cloning approach, we show here that the inhibitory receptor LIR-2 (leukocyte immunoglobulin-like receptor-2, CD85d) is specifically up-regulated by IL-10 on maturing human DC. LPS-stimulated, LIR-2-transfected DC inhibited the proliferation of T cells in autologous, as well as allogeneic culture systems in vitro. In addition, overexpression of LIR-2 on resting T cells, which lack LIR-2 expression, inhibited T cell proliferation induced by TCR activation. A novel soluble form of LIR-2 was detected in culture supernatants of maturing DC. IL-10 treatment of DC potently inhibited the production of soluble LIR-2. Recombinant soluble LIR-2 was able to completely restore the proliferation of T cells activated with LPS-plus IL-10-treated DC. Thus, IL-10 renders DC hypostimulatory by up-regulating cell surface LIR-2 and by inhibiting soluble LIR-2 in vitro.

Bioequivalence study of a valsartan tablet and a capsule formulation after single dosing in healthy volunteers using a replicated crossover design

AIM

Two formulations of valsartan (Diovan), 320 mg tablets and marketed 160 mg capsules, were evaluated for bioequivalence after single dosing.

METHODS

The study was designed as a single-center, open-label, 2-treatment, 3-period, repeated-measure (replicated), randomized crossover comparison in 40 healthy volunteers, all of whom completed the study successfully. Valsartan was determined in plasma by HPLC with fluorescence detection after solid-phase extraction.

RESULTS

Comparing the new 320 mg tablet with 2 x 160 mg of the marketed valsartan capsules taken at the same time, the ratios of the least square means for AUC(0-t), AUC(all), AUC(0-infinity) and Cmax were 1.11, 1.10, 1.10 and 1.09, respectively. The 90% confidence intervals of the AUC and Cmax parameters were within the range of 0.80-1.25.

CONCLUSIONS

Bioequivalence of the new 320 mg tablet with 2 marketed 160 mg capsules was demonstrated.

Pro- and retrospective memory in late adulthood

Everyday tasks, such as getting groceries en route from work, involve two distinct components, one prospective (i.e., remembering the plan) and the other retrospective (i.e., remembering the grocery list). The present investigation examined the size of the age-related performance declines in these components, as well as the relationship between these components and age-related differences in processing resources. The subjects were 133 community-dwelling adults between 65 and 95 years of age. They completed a large battery of tests, including tests of pro- and retrospective memory as well as tests for indexing processing resources. The results showed similar age-related declines in pro- and retrospective memory. There was only a weak relationship between pro- and retrospective memory, and the age-related decline in processing resources was related more strongly to retro- than prospective memory.

Prospective memory: a new focus for research

Prospective memory is required for many aspects of everyday cognition, its breakdown may be as debilitating as impairments in retrospective memory, and yet, the former has received relatively little attention by memory researchers. This article outlines a strategy for changing the fortunes of prospective memory, for guiding new research to shore up the claim that prospective memory is a distinct aspect of cognition, and to obtain evidence for clear performance dissociations between prospective memory and other memory functions. We begin by identifying the unique requirements of prospective memory tasks and by dividing memory's prospective functions into subdomains that are analogous to divisions in retrospective memory (e.g., short- versus long-term memory). We focus on one prospective function, called prospective memory proper; we define this function in the spirit of James (1890) as requiring that we are aware of a plan, of which meanwhile we have not been thinking, with the additional consciousness that we made the plan earlier. We give an operational definition of prospective memory proper and specify how it differs from explicit and implicit retrospective memory and how it might be empirically assessed.