Usability assessment of the MoliCare absorbent continence products by nursing specialists.

BACKGROUND: Incontinence is a common disorder among older adults with a higher prevalence in nursing home settings than in community dwellings. There is a wide variety of absorbent continence products on the market used to manage continence. AIM: The study aimed to investigate the experience of caregivers of residents with incontinence in care home settings using the new MoliCare Premium Form design and to compare some of the product features with the previous design. METHOD: A questionnaire focusing on the key performance characteristics of the product was developed and administered to 74 nurses in Germany to obtain their opinions on the use of MoliCare Premium Form products. FINDINGS: More than 90% of respondents rated each key performance aspect of the new product design as 'good' and 'OK'. More than 60% of the caregivers found the new product design to be better performing and 93% preferred the new design to the previous version. CONCLUSION: The newly redesigned continence pad performed very well on each of the individual performance features, indicating the high quality and optimised design of the product. The new design was found to be suitable and effective for individuals with incontinence.

Smooth Muscle Specific Ablation of CXCL12 in Mice Downregulates CXCR7 Associated with Defective Coronary Arteries and Cardiac Hypertrophy.

The chemokine CXCL12 plays a fundamental role in cardiovascular development, cell trafficking, and myocardial repair. Human genome-wide association studies even have identified novel loci downstream of the CXCL12 gene locus associated with coronary artery disease and myocardial infarction. Nevertheless, cell and tissue specific effects of CXCL12 are barely understood. Since we detected high expression of CXCL12 in smooth muscle (SM) cells, we generated a SM22-alpha-Cre driven mouse model to ablate CXCL12 (SM-CXCL12-/-). SM-CXCL12-/- mice revealed high embryonic lethality (50%) with developmental defects, including aberrant topology of coronary arteries. Postnatally, SM-CXCL12-/- mice developed severe cardiac hypertrophy associated with fibrosis, apoptotic cell death, impaired heart function, and severe coronary vascular defects characterized by thinned and dilated arteries. Transcriptome analyses showed specific upregulation of pathways associated with hypertrophic cardiomyopathy, collagen protein network, heart-related proteoglycans, and downregulation of the M2 macrophage modulators. CXCL12 mutants showed endothelial downregulation of the CXCL12 co-receptor CXCR7. Treatment of SM-CXCL12-/- mice with the CXCR7 agonist TC14012 attenuated cardiac hypertrophy associated with increased pERK signaling. Our data suggest a critical role of smooth muscle-specific CXCL12 in arterial development, vessel maturation, and cardiac hypertrophy. Pharmacological stimulation of CXCR7 might be a promising target to attenuate adverse hypertrophic remodeling.

Single step synthesis and organization of gold colloids assisted by copolymer templates.

We report here an original single-step process for the synthesis and self-organization of gold colloids by simply incorporating gold salts into a solution prepared using polystyrene (PS)-polymethylmethacrylate copolymer and thiolated PS with propylene glycol methyl ether acetate as a solvent. The spin-coating and annealing of this solution then allows the formation of PS domains. Depending on the polymer concentration of the as-prepared solution, there can be either one or several gold nanoparticles (Au NPs) per PS domain. For high concentrations of Au NPs in PS domains, the coupling between plasmonic NPs leads to the observation of a second peak in the optical extinction spectrum. Such a collective effect could be relevant for the development of optical strain sensors in the near future.

Roxadustat Attenuates Adverse Remodeling Following Myocardial Infarction in Mice.

Activation of the CXCL12/CXCR4/ACKR3 axis is known to aid myocardial repair through ischemia-triggered hypoxia-inducible factor-1α (HIF-1α). To enhance the upregulation of HIF-1α, we administered roxadustat, a novel prolyl hydroxylase inhibitor (PHI) clinically approved by the European Medicines Agency 2021 for the treatment of renal anemia, with the purpose of improving LV function and attenuating ischemic cardiomyopathy. METHODS: We evaluated roxadustat's impact on HIF-1 stimulation, cardiac remodeling, and function after MI. Therefore, we analyzed nuclear HIF-1 expression, the mRNA and protein expression of key HIF-1 target genes (RT-PCR, Western blot), inflammatory cell infiltration (immunohistochemistry), and apoptosis (TUNEL staining) 7 days after MI. Additionally, we performed echocardiography in male and female C57BL/6 mice 28 days post-MI. RESULTS: We found a substantial increase in nuclear HIF-1, associated with an upregulation of HIF-1α target genes like CXCL12/CXCR4/ACKR3 at the mRNA and protein levels. Roxadustat increased the proportion of myocardial reparative M2 CD206+ cells, suggesting beneficial alterations in immune cell migration and a trend towards reduced apoptosis. Echocardiography showed that roxadustat treatment significantly preserved ejection fraction and attenuated subsequent ventricular dilatation, thereby reducing adverse remodeling. CONCLUSIONS: Our findings suggest that roxadustat is a promising clinically approved treatment option to preserve myocardial function by attenuating adverse remodeling.

Human polymorphonuclear neutrophils express RANK and are activated by its ligand, RANKL.

The receptor activator of NF-κB (RANK) is especially well studied in the context of bone remodeling, and RANK and its ligand, RANKL, are key molecules in the induction of bone resorbing osteoclasts. We now report that polymorphonuclear neutrophils (PMNs) contain preformed RANK, stored in secretory vesicles and in specific granules. Upon stimulation of PMNs in vitro, RANK was translocated to the cell membrane. In patients with persistent bacterial infections, RANK surface expression was enhanced compared with that of healthy individuals. The functional activity of RANK was assessed by determining migration of PMNs toward RANKL. A time- and dose-dependent migration was seen, leading to the conclusion that RANK on PMNs is functional. We presume that regulated RANK expression contributes to the fine tuning of PMN migration, for example, on and through inflamed endothelium that is known to express RANKL.

Shape-altering flexible plasmonics of in-situ deformable nanorings.

Nanorings (NRs) with their intrinsic cavities have attracted interest as plasmonic nanoparticles for years, due to the uniform electric field enhancement inside the cavity, lower plasmon damping effects and comparatively high refractive index sensitivities. In the present work, we successfully fabricated a series of Au NR arrays on flexible polydimethylsiloxane substrates by taking advantage of state-of-the-art fabrication methods such as electron beam lithography and wet-etching transfer techniques. In-situ optical measurements on these flexible systems are enabled by implementing a homemade micro-stretcher inside an optical reflection spectroscopy setup. The corresponding dark-field spectra of thin-walled NR arrays exhibit a strong shift to longer wavelengths (i.e., ~ 2.85 nm per 1% strain) under polarization perpendicular to the traction, mainly resulting from the increasing shape deformation of the NRs under strain. Moreover, numerical simulations illustrate that the shifting plasmonic mode has a radially-symmetric charge distribution of the bonding mode and is rather sensitive to the tuning of the NRs' shape as confirmed by a subsequent in-situ scanning electron microscope characterization. These results explore the possibilities of shape-altering flexible plasmonics for nanoparticles with a cavity and indicate potential applications for plasmonic colors and biochemical sensing in future work.

Inhibition of osteoclast generation: a novel function of the bone morphogenetic protein 7/osteogenic protein 1.

Monocytes have the potential to differentiate to either macrophages, dendritic cells, or to osteoclasts. The microenvironment, particularly cytokines, directs the monocyte differentiation. Receptors of NFκB (RANK) ligand, tumor necrosis factor (TNF) α, or interleukin- (IL-) 8 have be identified as inducers of osteoclastogenesis, whereas others, such as IL-10 or transforming growth factor (TGF)ß inhibit osteoclast generation or induce differentiation towards a dendritic cell type. We now describe that bone morphogenetic protein (BMP) 7/osteogenic protein- (OP-) 1 inhibited the differentiation of human CD14+ monocytes to osteoclasts. In the presence of BMP7/OP-1 the transcription factors c-Fos and NFATc1, though upregulated and translocated to the nucleus in response to either RANKL or IL-8, did not persist. In parallel, MafB, a transcription factor expressed by monocytes and required for differentiation to macrophages but inhibiting osteoclast generation, was preserved. Because both persistence of NFATc1 and downregulation of MafB are crucial for osteoclastogenesis, we conclude that BMP7/OP-1 inhibits the generation of osteoclasts by interfering with signalling pathways.

The scientific publication score - a new tool for summarizing evidence and data quality criteria of biomedical publications.

The number of biomedical research articles increases by over 2.5 million publications each year, making it difficult to stay up to date. In this study, we introduce a standardized search and evaluation tool to combat this issue. Employing crowdsourcing, a large database of publications is gathered. Using a standardized data entry format, coined the "scientific publication score" (SPS), specific publication results can be easily aggregated, thereby allowing fast and accurate comparisons for clinical questions. The SPS combines two quality dimensions. The first captures the quality of evidence of the study using the evidence criteria defined by the Centre for Evidence-Based Medicine, Oxford, UK. The second is more fine-grained and considers the magnitude of statistical analyses on individual and specific results. From 2014 to 2019, experts of the European Bone and Joint Infection Society (EBJIS) were asked to enter data of relevant publications about prosthetic joint infection. Data and evidence levels of specific results were averaged, summarized and ranked. A total of 366 publications were divided into two groups: (I) risk factors (e.g., host-related factors, pre- and postoperative issues) with 243 publications and (II) diagnostic methods (e.g., laboratory tests, imaging methods) with 123 publications. After ranking, the highest score for risk factors of prosthetic joint infection were calculated by the SPS for anemia (mean 3.50 ±  SD 0.91), malignancy (mean 3.17 ±  SD 0.29) and previous alloarthroplasty (mean 3.00 ±  SD 0.35). A comparison of the full SPS ranking with the ranking determined at the 2018 International Consensus Meeting (ICM) on Musculoskeletal Infection resulted in a Spearman rank correlation coefficient of 0.48 and a p  value of 0.0382. The diagnostic methods ranked highest by the SPS were aspirate leucocyte count (mean 3.15 ±  SD 1.21), interleukin 6 (mean 3.14 ±  SD 1.07) and aspirate (neutrophils over 80 %) (mean 3.12 ±  SD 0.63). The comparison to the ICM ranking yielded a Spearman rank correlation coefficient of 0.91 and a p  value of 0.0015. Our pilot study evaluated a new tool for the quality assessment of specific results based on the quality of the source publication. The SPS is suitable for a ranking of specific results by evidence and data quality criteria important for systematic reviews.

Infectiological, functional, and radiographic outcome after revision for prosthetic hip infection according to a strict algorithm.

BACKGROUND AND PURPOSE: Successful treatment of prosthetic hip joint infection (PI) means elimination of infection and restored hip function. However, functional outcome is rarely studied. We analyzed the outcome of the strict use of a treatment algorithm for PI. PATIENTS AND METHODS: The study groups included 22 hips with 1-stage exchange for PI (group 1), 22 matched hips revised for aseptic loosening (controls), and 50 hips with 2-stage exchange (group 2). Relapse of infection, Harris hip score (HHS), limping, use of crutches, reoperations, complications, and radiographic changes were compared between the groups. RESULTS: There was 1 relapse of infection, which occurred in group 2. In group 1, the mean HHS was 84; 4 of 19 patients were limping and 2 required 2 crutches, which was similar to the control results. In group 2, scores were lower and complication rates higher. The use of a Burch-Schneider ring and the presence of a deficient trochanter impaired function. There were no differences in radiographic outcome between the groups. INTERPRETATION: With the algorithm used, infection can be cured with high reliability. With a 1-stage procedure, mobility is maintained. After 2-stage procedures, function was impaired due to there being more previous surgery and more serious infection.

Escherichia coli variants in periprosthetic joint infection: diagnostic challenges with sessile bacteria and sonication.

The diagnostic yield of prosthetic joint-associated infection is hampered by the phenotypic change of bacteria into a sessile and resistant form, also called biofilm. With sonication, adherent bacteria can be dislodged from the prosthesis. Species identification may be difficult because of their variations in phenotypic appearance and biochemical reaction. We have studied the phenotypic, genotypic, and biochemical properties of Escherichia coli variants isolated from a periprosthetic joint infection. The strains were collected from synovial fluid, periprosthetic tissue, and fluid from the explanted and sonicated prosthesis. Isolates from synovial fluid revealed a normal phenotype, whereas a few variants from periprosthetic tissue and all isolates from sonication fluid showed different morphological features (including small-colony variants). All isolates from sonication fluid were beta-galactosidase negative and nonmotile; most were indole negative. Because of further variations in biochemical properties, species identification was false or not possible in 50% of the isolates included in this study. In contrast to normal phenotypes, variants were resistant to aminoglycosides. Typing of the isolates using pulsed-field gel electrophoresis yielded nonidentical banding patterns, but all strains were assigned to the same clonal origin when compared with 207 unrelated E. coli isolates. The bacteria were repeatedly passaged on culture media and reanalyzed. Thereafter, most variants reverted to normal phenotype and regained their motility and certain biochemical properties. In addition, some variants displayed aminoglycoside susceptibility after reversion. Sonication of an explanted prosthesis allows insight into the lifestyle of bacteria in biofilms. Since sonication fluid also reveals dislodged sessile forms, species identification of such variants may be misleading.

SERS-Active Pattern in Silver-Ion-Exchanged Glass Drawn by Infrared Nanosecond Laser.

The irradiation of silver-to-sodium ion-exchanged glass with 1.06-µm nanosecond laser pulses of mJ-range energy results in the formation of silver nanoparticles under the glass surface. Following chemical removal of ~25-nm glass layer reveals a pattern of nanoparticles capable of surface enhancement of Raman scattering (SERS). The pattern formed when laser pulses are more than half-overlapped provides up to ~105 enhancement and uniform SERS signal distribution, while the decrease of the pulse overlap results in an order of magnitude higher but less uniform enhancement.

ZMPSTE24 Is Associated with Elevated Inflammation and Progerin mRNA.

Lamins are important filaments forming the inner nuclear membrane. Lamin A is processed by zinc metalloproteinase (ZMPSTE24). Failure to cleave a truncated form of prelamin A-also called progerin-causes Hutchinson-Gilford progeria syndrome a well-known premature aging disease. Minor levels of progerin are readily expressed in the blood of healthy individuals due to alternative splicing. Previously, we found an association of increased progerin mRNA with overweight and chronic inflammation (hs-CRP). Here, we aimed to elucidate correlations of ZMPSTE24, lamin A/C and progerin with the inflammatory marker hs-CRP. In this retrospective, cross-sectional study we analyzed blood samples from 110 heart failure patients for quantitative mRNA expression of ZMPSTE24, lamin A/C, progerin and hs-CRP protein. Spearman correlations and linear regression analyses including adjustments for age, gender and ejection fraction showed a significant positive correlation of lnprogerin with lnZMPSTE24 (n = 110; r = 0.33; p = 0.0004) and lnlamin A/C (n = 110; r = 0.82, p < 0.0001), whereas no association was observed between lnlamin A/C and lnZMPSTE24 expression. Further analyses showed a significant positive correlation of lnhs-CRP with lnZMPSTE24 (n = 110; r = 0.21; p = 0.01) and lnlamin A/C (n = 110; r = 0.24; p = 0.03). We conclude that chronic inflammation is associated with increased expression of ZMPSTE24 and lamin A/C mRNA. Both markers also positively correlate with increased expression of the premature aging marker progerin which may be linked to cardiovascular aging.

[PSMA-PET/CT has to be performed in every patient with biochemical recurrence following radical prostatectomy for early tumor detection]. / "Das PSMA-PET/CT soll bei allen Patienten mit biochemischem Progress nach radikaler Prostatektomie für eine frühe Tumordetektion eingesetzt werden.".

The debate refers the known evidence for PSMA-PET/CT in biochemical recurrence of prostate cancer and consider carefully interdisciplinary in which situation which patient needs imaging to choose the adequate therapeutic option. General aspects for the care of cancer patients are taken into consideration.

Temperature dependence of metal-enhanced fluorescence of photosystem I from Thermosynechococcus elongatus.

We report the temperature dependence of metal-enhanced fluorescence (MEF) of individual photosystem I (PSI) complexes from Thermosynechococcus elongatus (T. elongatus) coupled to gold nanoparticles (AuNPs). A strong temperature dependence of shape and intensity of the emission spectra is observed when PSI is coupled to AuNPs. For each temperature, the enhancement factor (EF) is calculated by comparing the intensity of individual AuNP-coupled PSI to the mean intensity of 'uncoupled' PSI. At cryogenic temperature (1.6 K) the average EF was 4.3-fold. Upon increasing the temperature to 250 K the EF increases to 84-fold. Single complexes show even higher EFs up to 441.0-fold. At increasing temperatures the different spectral pools of PSI from T. elongatus become distinguishable. These pools are affected differently by the plasmonic interactions and show different enhancements. The remarkable increase of the EFs is explained by a rate model including the temperature dependence of the fluorescence yield of PSI and the spectral overlap between absorption and emission spectra of AuNPs and PSI, respectively.

Plasmonic mode interferences and Fano resonances in Metal-Insulator-Metal nanostructured interface.

Metal-insulator-metal systems exhibit a rich underlying physics leading to a high degree of tunability of their spectral properties. We performed a systematic study on a metal-insulator-nanostructured metal system with a thin 6 nm dielectric spacer and showed how the nanoparticle sizes and excitation conditions lead to the tunability and coupling/decoupling of localized and delocalized plasmonic modes. We also experimentally evidenced a tunable Fano resonance in a broad spectral window 600 to 800 nm resulting from the interference of gap modes with white light broad band transmitted waves at the interface playing the role of the continuum. By varying the incident illumination angle shifts in the resonances give the possibility to couple or decouple the localized and delocalized modes and to induce a strong change of the asymmetric Fano profile. All these results were confirmed with a crossed comparison between experimental and theoretical measurements, confirming the nature of different modes. The high degree of control and tunability of this plasmonically rich system paves the way for designing and engineering of similar systems with numerous applications. In particular, sensing measurements were performed and a figure of merit of 3.8 was recorded ranking this sensor among the highest sensitive in this wavelength range.

Guinea pigs in hypersensitivity testing.

The aim of the present paper is to mention steps of development of predictive guinea pig animal models for contact sensitization evaluation in parallel with the development of understanding the mechanism of contact sensitization. The guinea pigs methods are reviewed and the presently accepted methods (Buehler test, Maximization test) are discussed in details. Influences on the outcome of guinea pig sensitization assays are mentioned too. The predictability of the guinea pig methods is compared with predictive methods in mice, with human tests (human repeated insult patch test, HRIPT) and epidemiological data. In the last part, a testing strategy and steps for risk assessment of contact sensitizing potential is proposed.

Continuous subacromial bupivacaine infusion for postoperative analgesia after open acromioplasty and rotator cuff repair: preliminary results.

Shoulder surgery is often associated with severe postoperative pain. Previous results in which single or continuous subacromial infiltration of local anesthetics was used as a method of postoperative pain relief have been contradictory. This study was initiated to evaluate the postoperative analgesic effect of a subacromial continuous 0.25% bupivacaine infusion at a rate of 6 mL/h after elective open shoulder surgery. We hypothesized that this procedure would improve postoperative analgesia while reducing morphine requirements. By use of a prospective, double-blind, randomized study design, 50 consecutive patients undergoing acromioplasty and rotator cuff repair surgery received a multiorifice catheter placed in the subacromial space. Twenty patients received 0.25% bupivacaine (group 1), and twenty-two patients received saline solution (group 2). The primary endpoints in the two groups were total morphine consumption administered by patient-controlled analgesia and the patient's subjective pain level evaluated by a visual analog scale during the first 48 postoperative hours. No major technical or pharmacologic side effects were noticed, and the indwelling pain catheter was well tolerated by all patients. There was no statistically significant difference (P < .05) either in total cumulative morphine consumption microg/48 h (73.2 +/- 43.1 vs 60.9 +/- 35.9) or in subjective pain perception 10-point visual analog scale (3.2 +/- 1.4 vs 3.1 +/- 1.5) between the two study groups. The continuous subacromial infiltration of 0.25% bupivacaine at a rate of 6 mL/h is concluded to be ineffective in providing pain relief supplementary to patient-controlled analgesia after open rotator cuff repair and acromioplasty surgery.