Effects on hemodynamic enhancement and discomfort of a new textile electrode integrated in a sock during calf neuromuscular electrical stimulation.

PURPOSE: To compare fixed transverse textile electrodes (TTE) knitted into a sock versus motor point placed standard gel electrodes (MPE) on peak venous velocity (PVV) and discomfort, during calf neuromuscular electrical stimulation (calf-NMES). METHODS: Ten healthy participants received calf-NMES with increasing intensity until plantar flexion (measurement level I = ML I), and an additional mean 4 mA intensity (ML II), utilizing TTE and MPE. PVV was measured with Doppler ultrasound in the popliteal and femoral veins at baseline, ML I and II. Discomfort was assessed with a numerical rating scale (NRS, 0-10). Significance was set to p < 0.05. RESULTS: TTE and MPE both induced significant increases in PVV from baseline to ML I and significantly higher increases to ML II, in both the popliteal and femoral veins (all p < 0.001). The popliteal increases of PVV from baseline to both ML I and II were significantly higher with TTE versus MPE (p < 0.05). The femoral increases of PVV from baseline to both ML I and II were not significantly different between TTE and MPE. TTE versus MPE resulted at ML I in higher mA and NRS (p < 0.001), and at ML II in higher mA (p = 0.005) while NRS was not significantly different. CONCLUSION: TTE integrated in a sock produces intensity-dependent increases of popliteal and femoral hemodynamics comparable to MPE, but results in more discomfort at plantar flexion due to higher current required. TTE exhibits in the popliteal vein higher increases of PVV compared to MPE. TRIAL REGISTRATION: Trial_ID: ISRCTN49260430. Date: 11/01/2022. Retrospectively registered.

Neuromuscular electrical stimulation in garments optimized for compliance.

PURPOSE: Physical inactivity is associated with muscle atrophy and venous thromboembolism, which may be prevented by neuromuscular electrical stimulation (NMES). This study aimed to investigate the effect on discomfort, current amplitude and energy consumption when varying the frequency and phase duration of low-intensity NMES (LI-NMES) via a sock with knitting-integrated transverse textile electrodes (TTE). METHODS: On eleven healthy participants (four females), calf-NMES via a TTE sock was applied with increasing intensity (mA) until ankle-plantar flexion at which point outcomes were compared when testing frequencies 1, 3, 10 and 36 Hz and phase durations 75, 150, 200, 300 and 400 µs. Discomfort was assessed with a numerical rating scale (NRS, 0-10) and energy consumption was calculated and expressed in milli-Joule (mJ). Significance set to p ≤ 0.05. RESULTS: 1 Hz yielded a median (inter-quartile range) NRS of 2.4 (1.0-3.4), significantly lower than both 3 Hz with NRS 2.8 (1.8-4.2), and 10 Hz with NRS 3.4 (1.4-5.4) (both p ≤ .014). Each increase in tested frequency resulted in significantly higher energy consumption, e.g. 0.6 mJ (0.5-0.8) for 1 Hz vs 14.9 mJ (12.3-21.2) for 36 Hz (p = .003). Longer phase durations had no significant effect on discomfort despite generally requiring significantly lower current amplitudes. Phase durations 150, 200 and 400 µs required significantly lower energy consumption compared to 75 µs (all p ≤ .037). CONCLUSION: LI-NMES applied via a TTE sock produces a relevant plantar flexion of the ankle with the best comfort and lowest energy consumption using 1 Hz and phase durations 150, 200 or 400 µs.

A platform for phenotypic discovery of therapeutic antibodies and targets applied on Chronic Lymphocytic Leukemia.

Development of antibody drugs against novel targets and pathways offers great opportunities to improve current cancer treatment. We here describe a phenotypic discovery platform enabling efficient identification of therapeutic antibody-target combinations. The platform utilizes primary patient cells throughout the discovery process and includes methods for differential phage display cell panning, high-throughput cell-based specificity screening, phenotypic in vitro screening, target deconvolution, and confirmatory in vivo screening. In this study the platform was applied on cancer cells from patients with Chronic Lymphocytic Leukemia resulting in discovery of antibodies with improved cytotoxicity in vitro compared to the standard of care, the CD20-specific monoclonal antibody rituximab. Isolated antibodies were found to target six different receptors on Chronic Lymphocytic Leukemia cells; CD21, CD23, CD32, CD72, CD200, and HLA-DR of which CD32, CD200, and HLA-DR appeared as the most potent targets for antibody-based cytotoxicity treatment. Enhanced antibody efficacy was confirmed in vivo using a patient-derived xenograft model.

Regional brain shrinkage over two years: individual differences and effects of pro-inflammatory genetic polymorphisms.

We examined regional changes in brain volume in healthy adults (N=167, age 19-79years at baseline; N=90 at follow-up) over approximately two years. With latent change score models, we evaluated mean change and individual differences in rates of change in 10 anatomically-defined and manually-traced regions of interest (ROIs): lateral prefrontal cortex (LPFC), orbital frontal cortex (OF), prefrontal white matter (PFw), hippocampus (Hc), parahippocampal gyrus (PhG), caudate nucleus (Cd), putamen (Pt), insula (In), cerebellar hemispheres (CbH), and primary visual cortex (VC). Significant mean shrinkage was observed in the Hc, CbH, In, OF, and PhG, and individual differences in change were noted in all regions, except the OF. Pro-inflammatory genetic variants modified shrinkage in PhG and CbH. Carriers of two T alleles of interleukin-1ß (IL-1ß C-511T, rs16944) and a T allele of methylenetetrahydrofolate reductase (MTHFR C677T, rs1801133) polymorphisms showed increased PhG shrinkage. No effects of a pro-inflammatory polymorphism for C-reactive protein (CRP-286C>A>T, rs3091244) or apolipoprotein (APOE) ε4 allele were noted. These results replicate the pattern of brain shrinkage observed in previous studies, with a notable exception of the LPFC, thus casting doubt on the unique importance of prefrontal cortex in aging. Larger baseline volumes of CbH and In were associated with increased shrinkage, in conflict with the brain reserve hypothesis. Contrary to previous reports, we observed no significant linear effects of age and hypertension on regional brain shrinkage. Our findings warrant further investigation of the effects of neuroinflammation on structural brain change throughout the lifespan.

Synergy effects of HbA1c and variants of APOE and BDNFVal66Met explains individual differences in memory performance.

We aimed at exploring if synergy effects of Brain-Derived Neurotrophic Factor (BDNF) Val(66)Met, Apolipoprotein E (APOE) and HbA1c (glycated haemoglobin) could explain individual differences in memory performance over 10 years in a population based sample of nondemented adults (N=888, 35-85 years at baseline). Episodic memory was affected by such agents, wheras semantic memory was spared. Both age and HbA1c were associated with episodic memory decline. BDNF(66)Met carriers with higher HbA1c levels evidenced slope decline in episodic recall. We found support for joint effects of BDNFVal(66)Met×APOE×HbA1c and BDNFVal(66)Met×APOE×age on rates of episodic memory change over ten years, after controlling for age, sex, education and cardiovascular diseases. We conclude that variants of genetic polymorphisms act in synergy with long-term blood glucose control in shaping patterns of cognitive aging.

Procedures and criteria for accepting the renal patient for inclusion on the waiting list for kidney transplantation in the Nordic countries.

BACKGROUND: The overall aim of this study was to survey and analyze the selection process for patients awaiting a kidney in the Nordic countries collaborating within Scandiatransplant. METHODS: A two-parts questionnaire was sent to one senior physician at each of the 10 Scandiatransplant kidney transplantation centers that use deceased donors. The first part consisted of questions related to the evaluation of a patient for the waiting list. The second part of the questionnaire dealt with 12 borderline cases, based on experiences at seven of all centers. Answers should be given with the policy of the center in mind. The response rate was 100%. RESULTS: Some centers are stricter than others regarding limits for body mass index and cardiac ejection fraction. At three centers, human immunodeficiency virus-positive patients are not included on the list. Four centers have a policy of not including predialysis patients. All centers agreed that they would not refrain from acceptance of a patient due to the scarcity of organs, if the patient was considered to benefit medically from transplantation. Reevaluation of the patient once on the list is done at all centers, focusing on cardiovascular problems. Only a few respondents were positive to the idea of common Nordic guidelines for investigations or for limiting values. CONCLUSIONS: We concluded that there are some, mainly small, differences among Nordic countries regarding procedures and criteria for acceptance of patients on the waiting list for kidney transplantation. The interest in common guidelines is limited.

PCNs, PCDD/Fs, and non-orthoPCBs, in water and bottom sediments from the industrialized Norwegian Grenlandsfjords.

Chlorinated toxic planar aromatic compounds were analyzed in the heavily industrialized Grenlandsfjords, which is a system of silled fjords in southern Norway. Surface water samples contained 7.4-160 ng/m3 polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs), 14-410 ng/m3 polychlorinated naphthalenes (PCNs), and 0.31-2.4 ng/m3 non-orthochlorinated biphenyls (non-orthoPCBs). The concentrations of PCDD/Fs were about 300 times higher than in the Baltic Sea. Highest level of the compounds wasfound near a magnesium production plant Hepta-CDFs and penta-CNs dominated in the inner-fjord waters, and tetra-CB 77 was the major non-orthoPCB congener. Sediment samples had PCDD/F concentration of 25-730 ng/g dw. Highest concentration was detected close to the magnesium plant. Octa-CDFdominated in the fjord sediments, especially near the magnesium plant indicating a discharge-specific contamination with this congener. The isomer composition of PCDD/Fs and of PCNs, was unchanged when comparing samples from different layers of a sediment core from the deep anoxic water. This concludes that essentially zero degradation had occurred during approximately 50 years in this environment.

Horizontal transfer of tumor DNA to endothelial cells in vivo.

Tumor endothelial cells have long been regarded as genomically stable and therefore less likely to develop resistance to antiangiogenic therapies. However, recent findings have challenged this notion. We have shown that DNA can be transferred between cells through phagocytosis of apoptotic bodies by adjacent viable cells. Propagation of the ingested DNA is prevented by the activation of the p53-p21 pathway. In this study, we examined whether concomitant transfer of tumor DNA with genes that inactivate the p53 pathway could overcome the barrier to tumor DNA propagation. Our results demonstrate that fibroblasts and endothelial cells are capable of acquiring and replicating tumor DNA when the apoptotic tumor cells contain the SV40 large T antigen. Analysis of the tumor stroma of xenotransplanted tumors in severe combined immunodeficient mice revealed that a sub-population of the endothelial cells contained tumor DNA. These cells maintained the ability to form functional vessels in an in vivo assay and concurrently express tumor-encoded and endothelial-specific genes.

Black carbon-inclusive modeling approaches for estimating the aquatic fate of dibenzo-p-dioxins and dibenzofurans.

A novel black carbon (BC) inclusive modeling tool is applied to estimate the distribution and long-term fate of dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in the Norwegian Grenland Fjords. Three versions of the model were developed in which sediment-water partitioning was described using (i) an amorphous organic carbon (AOC) partitioning sorption model without BC sorption, (ii) a combined AOC and BC sorption model based on the Freundlich isotherm, and (iii) a combined BC-AOC model based on the Langmuir isotherm. The predictive ability of the three different models was evaluated for 17 PCDD/Fs by comparison of model predictions with observed organic carbon normalized sediment-water partition coefficients (K(TOC)) and with measured concentrations. All three versions of the model were able to predict concentrations that were in reasonable agreement with measured particulate concentrations (i.e., within a factor of 4 of median values). Estimated particulate concentrations were less sensitive to the model choice because the majority of the mass of these hydrophobic chemicals is associated with particulates regardless. However, for estimation of K(TOC) or dissolved water concentrations, both versions of the combined AOC and BC sorption models provided greatly improved estimates compared to the AOC-only model.

Optimising islet engraftment is critical for successful clinical islet transplantation.

Clinical islet transplantation is currently being explored as a treatment for persons with type 1 diabetes and hypoglycaemia unawareness. Although 'proof-of-principle' has been established in recent clinical studies, the procedure suffers from low efficacy. At the time of transplantation, the isolated islets are allowed to embolise the liver after injection in the portal vein, a procedure that is unique in the area of transplantation. A novel view on the engraftment of intraportally transplanted islets is presented that could explain the low efficacy of the procedure.

Silica gel as a particulate carrier of poorly water-soluble substances in aquatic toxicity testing.

Aquatic toxicity tests were originally developed for water-soluble substances. However, many substances are hydrophobic and thus poorly water-soluble, resulting in at least two major implications. Firstly, toxicity may not be reached within the range of water solubility of the tested compound(s), which may result in the formation of solids or droplets of the tested substance and consequently an uneven exposure. Secondly, because of multi-phase distribution of the tested substance it may be complicated to keep exposure concentrations constant. To overcome such problems, we have introduced silica gel as a particulate carrier in a toxicity test with the benthic copepod Nitocra spinipes. The main objective of the current study was to evaluate whether a controlled exposure could be achieved with the help of silica gel for testing single poorly water-soluble substances. A secondary objective was to evaluate whether an equilibrium mass balance model could predict internal concentrations that were consistent with the toxicity data and measured internal concentrations of two model hydrophobic substances, i.e., the polybrominated diphenyl ethers BDE-47 and BDE-99. Larval N. spinipes were exposed for 6 days to BDE-47 and BDE-99, respectively, in the silica gel test system and, for comparative reasons, in a similar and more traditional semi-static water test system. Via single initial amounts of the model substances administered on the silica gel, effects on both larval development and mortality resulted in higher and more concentration-related toxicity than in the water test system. We conclude that the silica gel test system enables a more controlled exposure of poorly water-soluble substances than the traditional water test system since the concentration-response relationship becomes distinct and there is no carrier solvent present during testing. Also, the single amount of added substance given in the silica gel test system limits the artefacts (e.g., increased chemical load in test system) that a semi-static renewal may introduce when testing substances that partition to non-water phases. However, measured and modelled internal concentrations did not match toxicity, which may indicate that chemical equilibrium was not reached during the test. Further experiments are thus needed to explain the processes behind the observed positive effects of silica gel and a kinetic model would likely also be more appropriate to describe the concentrations and distributions in the two test systems.

Modelling the long-term fate of polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs) in the Grenland Fjords, Norway.

The development and application of a predictive fate model (DIG--Dioxins in Grenland) for polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) in the marine environment of the Norwegian Grenland Fjords are described. The objective of the modelling study was to predict long-term future changes in PCDD/F concentrations in the fjord following the cessation of point source emissions. To assess the reliability of the model, the model performance was evaluated by comparing model results to field measurements collected between 1989 and 2001. Model bias (defined as the ratio of median predicted concentration and median observed concentration) for prediction of concentrations for three different PCDD/F congeners (2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), 1,2,3,6,7,8-hexadibenzofuran (HxCDF) and octachlorodibenzofuran (OCDF)) in the fjord was between 0.53 and 24, which was deemed a satisfactory result for models of this type. The model was run to determine the dynamic change in concentrations between 1950 and 2050 and to examine the key fluxes of PCDD/Fs in the fjord. Between 1990 and 2050 sediment concentrations of TCDD, HxCDF and OCDF were predicted to fall at fairly constant but gradually slowing rates to concentrations 52, 98 and 88 times lower, respectively, of their 1990 values. Losses of PCDD/Fs from the bottom sediments in the Frierfjord were predicted to be a combination of sediment burial and net resuspension to the water column. Sediment burial was shown to be relatively more important in the fjord's deep-water sediments, whereas resuspension was relatively more important in the shallow sediments. For the shallower sediments, a net water-to-sediment flux was predicted for all three congeners up until the mid-1970s, when emission reductions were initiated, and thereafter a net sediment-to-water flux was predicted. The shallow sediments acted as net sources to the deeper sediments and to the fishing areas in the outer fjord.

Selected activities in Scandiatransplant.

Scandiatransplant is the Nordic organ exchange organization. It has existed for 35 years and it is owned by all organ transplantation hospital departments in the five Nordic countries--Denmark, Finland, Iceland, Norway, and Sweden. The use of living organ donors for kidney transplantation has become a more common procedure not only in Norway but also in Sweden and Denmark. For the first time, in 2003, one transplant center performed relatively more living donor kidney transplantations than with deceased donors. The overall organ transplant activity reveals a remarkably stable situation in the area covered by Scandiatransplant. Scandiatransplant as an organ exchange organization has changed from a solely kidney exchange organization to an organization in which the more immediate vital organs as liver and heart are exchanged more commonly than kidneys.

Testing common sediment-porewater distribution models for their ability to predict dissolved concentrations of POPs in The Grenlandsfjords, Norway.

This study compares in situ observed porewater concentration of persistent organic pollutants (POPs) with predictions by common solid-water phase distribution models. Bottom sediments were sampled in The Grenlandsfjords, Norway, and the interstitial porewater was isolated from the solids by centrifugation and filtration. Both phases were analysed for polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/F), polycyclic aromatic hydrocarbons (PAH), and organic carbon. Based on the sediments' solid phase content of POPs, organic carbon, and soot carbon, we used the organic matter partitioning (OMP), and also the soot and organic matter partitioning (SOMP) model to estimate the porewater concentration. The OMP model gave better agreement to observations than the SOMP model for both PCDD/Fs and PAHs. The observed concentration of the PCDD/Fs in the sediments' porewater was much higher than in the deep water of the fjord. The logarithm of the organic matter-water partitioning coefficent (log K(OC)) in the porewater had positive linear regression on the logarithm of the octanol-water partitioning coefficient (log K(OW)). The slope of the regression model was indistinguishable from 1, except for the PAHs as a group which had a slope less than 1. This contrasts to previous studies undertaken in The Grenlandsfjords water column, where the slopes were higher than 1 for PCDD/Fs, and the K(OC) were much higher than the K(OW). One explanation may be that the influence of POPs adsorption to soots decrease because competitive sorption by other compounds in the sediment are higher than in the water column. This indicates that the sorption isotherms for these POPs need better understanding in order to be applicable in both the water column and the porewater.

Distribution of PCNs, PCBs, and other POPs together with soot and other organic matter in the marine environment of the Grenlandsfjords, Norway.

The apparently dissolved concentration of polychlorinated naphthalenes (PCNs) and three planar polychlorinated biphenyls (pPCBs) were sampled and analysed in the water column of a marine fjord system. We also measured how much of these persistent organic pollutants (POPs) were associated with suspended particles. The field observations showed that an unexpectedly high portion of the pollutants were particle-associated. The factor of deviation from model predictions had positive linear regression on the soot carbon:particulate organic carbon ratio of the particles, and on estimates of the soot-water distribution coefficient for the PCNs. The spatial distribution of surface sediment concentrations of PCNs and polycyclic aromatic hydrocarbons (PAH) were found to consistently follow the sediment content of soot (f(SC)) to a larger extent than the bulk organic matter (f(OC)). There were no systematic differences in the strength of correlation of sediments concentrations of other POPs, i.e. octachlorostyrene and organochlorine pesticides with sediment concentration to f(SC) and f(OC). Mechanisms possible of generating these types of observations, e.g. adsorption to soot carbon in the marine particle, are discussed.

Polychlorinated biphenyls in polysulfide sealants--occurrence and emission from a landfill station.

Approximately 80,000 kg polysulfide sealant containing 10,000-18,000 kg polychlorinated biphenyls (PCB) was deposited at a Swedish municipal landfill station during 1965-1973. Investigations during 1994 showed that soil layers underneath the landfill had concentration of PCB not alarmingly high. The concentration of PCB congeners in ground water samples was elevated 4-750 times compared to a reference sample. Based on samples of ground water, leachate water, and flux chambers measuring evaporation of PCB from the landfill surface, the emission of PCB was estimated to be 1 g sigmaPCB/yr. This very low rate was attributed to the high sorptive capacity of the sealant. Compared to a reference site, the evaporation flux was elevated for the most volatile congeners, but factors 20-1400 lower than from another landfill which was contaminated with PCB in paper-pulp fibres.

Two doses of daclizumab in conjunction with low-dose cyclosporine, mycophenolate mofetil and steroids resulted in a low incidence of acute rejection after renal transplantation.

Five doses of daclizumab, given initially after kidney transplantation, reduce the rate of acute rejection (AR). Without cyclosporin A (CsA), a protocol, including daclizumab, mycophenolate mofetil (MMF) and corticosteroids (CSs), has recently shown efficacy in terms of graft function and survival. The rate of AR was relatively high, however. In this single-centre study, a CsA low-dose regimen was combined with two doses of daclizumab (1 mg/kg day 0 and 14), plus MMF (2 g) and CS. Forty-three cadaver donor renal recipients were included. Following the onset of graft function, target trough levels of CsA were 150-200 ng/ml for 90 days, then 100-150 ng/ml. One year AR rate was 23% (n = 10) and events occurred at a median of 2.9 months (range from 9 days to 9.6 months). Delayed graft function (DGF) (absent spontaneous reduction of serum creatinine day 1) was 51%. Graft survival was 95% and patient survival 98% after 1 year. With respect to our previous experience, we used CsA, azathioprine and CSs (n = 223) from 1988 to 1995, and the rate of AR was 57%. From 1996 to 1998, standard CsA doses, MMF and CS (n = 67) resulted in 31% AR. Median time to AR was 0.8 and 1.0 month, and the rate of DGF was 20 and 22%, respectively. This CsA low-dose protocol, including two doses of daclizumab, MMF and CS, resulted in a reduction and delay of AR episodes and excellent graft function, graft survival and patient survival, despite an increase in DGF.

Soot-carbon influenced distribution of PCDD/Fs in the marine environment of the Grenlandsfjords, Norway.

The particle associations of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) were studied in both the water column and the surface sediments of a marine fiord system and were found to poorly obey expectations from the organic matter partitioning (OMP) paradigm. The field observations were instead consistent with the presence of a stronger sorbent subdomain such as pyrogenic soot-carbon (SC) playing an important role in affecting the environmental distribution and fate of PCDD/Fs. Solid-water distribution coefficients (Kd) of PCDD/ Fs actually observed in the water column were several orders of magnitude above predictions from a commonly used OMP model. Even when these elevated Kd values were normalized to the particulate organic carbon (POC) content (i.e., K(OC)), the variability in K(OC) for individual PCDD/ Fs at different fjord locations and seasons of factors 100-1,000 suggested that bulk organic matter was not the governing sorbent domain of the suspended particles. Further, POC-normalized particle concentrations of PCDD/ Fs (C(OC)) in a vertical profile (surface water-bottom water-surface sediment) revealed a strong increasing trend with depth. Factors of about 100 higher Coc for all PCDD/Fs in the sediment than in the surface water could not be explained by higher fugacity in the surrounding deep water nor with C:N or delta13C indexes of selective aging of the bulk organic matter. Instead this was hypothesized to reflect selective preservation of a more recalcitrant and highly sorbing, but minor, subdomain such as soot. The extent of enhanced PCDD/F sorption, above the OMP predictions, was positively correlated with the SC:POC ratio of the suspended particles in surface and deep waters. Finally, the geographical distribution of sedimentary PCDD/F concentrations were better explained by the SC content than by the bulk OC content of the sediment. Altogether, these field-based findings add to recent laboratory-based sorption studies to suggest that we need to consider both amorphous OC partitioning domains and SC particles as carriers of planar aromatic contaminants if we are to explain the environmental distribution and fate of pollutants such as PCDD/Fs.