Dynamically disordered hydrogen bonds in the hureaulite-type phosphatic oxyhydroxide Mn5[(PO4)2(PO3(OH))2](HOH)4.

We report the temperature evolution of hydrogen bond (HB) chains and rings in Mn5[(PO4)2(PO3(OH))2](HOH)4 to reveal conduction pathways based on difference Fourier maps with neutron- and synchrotron x-ray diffraction data. Localized proton dynamics for the five distinct hydrogen sites were observed and identified in this study. Their temperature evaluation over ten orders of magnitude in time was followed by means of quasielastic neutron scattering, dielectric spectroscopy, and ab initio molecular dynamics. Two out of the five hydrogen sites are geometrically isolated and are not suitable for long-range proton conduction. Nevertheless, the detected dc conductivity points to long-range charge transport at elevated temperatures, which occurs most likely (1) over H4-H4 sites between semihelical HB chains (interchain-exchanges) and (2) by rotations of O1-H1 and site-exchanging H4-O10-O5 groups along each semihelical HB chain (intrachain-exchanges). The latter dynamics freeze into a proton-glass state at low temperatures. Rotational and site-exchanging motions of HOH and OH ligands seem to be facilitated by collective motions of framework polyhedra, which we detected by inelastic neutron scattering.

Identification of influence factors for the implementation of communication curricula in dental education.

INTRODUCTION: The aim of the study was to reveal possible obstacles or advantages for the implementation of a dental communication curriculum. It was questioned whether (i) universities with a communication curriculum in medicine realise the same development in dentistry, (ii) the existence and usage of a learning objectives catalogue is a main factor to facilitate the implementation, and (iii) it is more easy to establish with a lower number of students. MATERIAL AND METHODS: Data of two recently published surveys were taken as the basis for further analysis. The quality of the curricula was evaluated by a scoring system. Correlations were calculated between the scores and possible influence factors. A t test for paired samples was accomplished to reveal differences between medical and dental curricula, and a Mann-Whitney U test to identify differences in schools with and without the usage of a learning objectives catalogue. RESULTS: No significant correlation was found between the quality scores of medical and dental schools; t tests revealed significant differences between them (P = .004). Correlation between cohort size and quality of the curriculum was marginal. Mann-Whitney U test revealed significantly higher quality scores for dental schools using a learning objectives catalogue (P = .001). CONCLUSIONS: The existence of a learning objectives catalogue might facilitate the implementation of communication curricula at dental schools. A missing notable curriculum in the corresponding medical school should not detain from a respective campaign in the dental curriculum. Large student numbers should also not discourage from developing a communication curriculum.

Do virtual patients prepare medical students for the real world? Development and application of a framework to compare a virtual patient collection with population data.

BACKGROUND: An important aspect of virtual patients (VPs), which are interactive computer-based patient scenarios, is authenticity. This includes design aspects, but also how a VP collection represents a patient population and how a patient is presented in a VP scenario. Therefore, our aim was to analyze VP scenarios integrated into the combined internal medicine and surgery curriculum at the University of Munich (LMU) and compare the results with data from the population in Germany. METHOD: We developed a coding framework with four main categories: patient data, patient representation, diagnoses, and setting. Based on the framework we analyzed 66 VP and compared the results with data from the German healthcare system. RESULTS: Especially in the categories of patient data and patient representation, the VPs presented an unrealistic image of the real world; topics such as unemployment, disability, or migration background were almost non-existent. The diagnoses of the VPs and the onset of diseases were comparable with the healthcare data. CONCLUSIONS: An explanation for the lack of representativeness of the patient data and representation might be a trend to create VPs based on fictional patient stories with VP authors trying to minimize complexity and cognitive load for the students. We suggest raising awareness among VP authors concerning personalized representations of patients without overwhelming their students. Our framework can support educators to assess the authenticity and diversity of a VP collection.

Teaching and assessment of communication skills in undergraduate dental education - a survey in German-speaking countries.

INTRODUCTION: Teaching communication is perceived to be of importance in dental education. Several reports have been published worldwide in the educational literature describing modifications of the dental curriculum by implementing the teaching of communication skills. Surveys which evaluate the current state of training and assessment of communication skills in dental education in different countries exist already in some countries, but little information is available about German-speaking countries. MATERIAL AND METHODS: In a cross-sectional study with the aim of a census, all 36 dental schools in Germany (30), Austria (3), and Switzerland (3) were surveyed. RESULTS: The present survey revealed that at 26 of the 34 dental schools (76%), communication skills training has been implemented. Training of communication skills mainly takes place between the 6th and the 9th semester. Ten schools were able to implement a partly longitudinal curriculum, while the other sites only offer stand-alone courses. Of the 34 dental schools, six assess communication skills in a summative way. Three of those schools also use formative assessments for their students. Another seven sites only use formative assessment. From the various formats of assessment, OSCE is mentioned most frequently. CONCLUSION: The necessity to train and assess communication skills has reached German-speaking dental schools. The present survey allows an overview of the training and assessment of communication skills in undergraduate dental education in German-speaking Europe.

Randomised clinical trial: the effects of a multispecies probiotic vs. placebo on innate immune function, bacterial translocation and gut permeability in patients with cirrhosis.

BACKGROUND: Probiotics may correct intestinal dysbiosis and proinflammatory conditions in patients with liver cirrhosis. AIM: To test the effects of a multispecies probiotic on innate immune function, bacterial translocation and gut permeability. METHODS: In a randomised, double blind, placebo-controlled study, stable cirrhotic out-patients either received a daily dose of a probiotic powder containing eight different bacterial strains (Ecologic Barrier, Winclove, Amsterdam, The Netherlands) (n = 44) or a placebo (n = 36) for 6 months and were followed up for another 6 months. RESULTS: We found a significant but subclinical increase in neutrophil resting burst (2.6-3.2%, P = 0.0134) and neopterin levels (7.7-8.4 nmol/L, P = 0.001) with probiotics but not with placebo. Probiotic supplementation did not have a significant influence on neutrophil phagocytosis, endotoxin load, gut permeability or inflammatory markers. Ten severe infections occurred in total; one during intervention in the placebo group, and five and four after the intervention has ended in the probiotic and placebo group, respectively. Liver function showed some improvement with probiotics but not with placebo. CONCLUSIONS: Probiotic supplementation significantly increased serum neopterin levels and the production of reactive oxygen species by neutrophils. These findings might explain the beneficial effects of probiotics on immune function. Furthermore, probiotic supplementation may be a well-tolerated method to maintain or even improve liver function in stable cirrhosis. However, its influence on gut barrier function and bacterial translocation in cirrhotic patients is minimal.

Dispersive infrared spectroscopy measurements of atmospheric CO2 using a Fabry-Pérot interferometer sensor.

In this paper, we present the first dispersive infrared spectroscopic (DIRS) measurement of atmospheric carbon dioxide (CO2) using a new scanning Fabry-Pérot interferometer (FPI) sensor. The sensor measures the optical spectra in the mid infrared (3,900 nm to 5,220 nm) wavelength range with full width half maximum (FWHM) spectral resolution of 78.8 nm at the CO2 absorption band (~4,280 nm) and sampling resolution of 20 nm. The CO2 concentration is determined from the measured optical absorption spectra by fitting it to the CO2 reference spectrum. Interference from other major absorbers in the same wavelength range, e.g., carbon monoxide (CO) and water vapor (H2O), was taken out by including their reference spectra in the fit as well. The detailed descriptions of the instrumental setup, the retrieval procedure, a modeling study for error analysis as well as laboratory validation using standard gas concentrations are presented. An iterative algorithm to account for the non-linear response of the fit function to the absorption cross sections due to the broad instrument function was developed and tested. A modeling study of the retrieval algorithm showed that errors due to instrument noise can be considerably reduced by using the dispersive spectral information in the retrieval. The mean measurement error of the prototype DIRS CO2 measurement for 1 minute averaged data is about ±2.5 ppmv, and down to ± 0.8ppmv for 10 minute averaged data. A field test of atmospheric CO2 measurements were carried out in an urban site in Hong Kong for a month and compared to a commercial non-dispersive infrared (NDIR) CO2 analyzer. 10 minute averaged data shows good agreement between the DIRS and NDIR measurements with Pearson correlation coefficient (R) of 0.99. This new method offers an alternative approach of atmospheric CO2 measurement featuring high accuracy, correction of non-linear absorption and interference of water vapor.

Facilitating in vitro tape stripping: application of infrared densitometry for quantification of porcine stratum corneum proteins.

Infrared (IR) densitometry is a highly practical method recently proposed for protein analysis during in vivo tape stripping. However, this method has not yet been validated for the quantification of porcine stratum corneum (SC) proteins. Therefore, the aim of this study was to establish calibration curves for the analysis of adhesive tapes removed from porcine ear skin. To this end, the protein absorption (as determined via IR densitometry) was correlated with the protein content determined with the Micro BCA™ protein assay after extraction of the tapes. The obtained linear regressions confirm that IR densitometry is suitable for the quantification of not only human, but also porcine, SC proteins. The pattern of protein removal observed with porcine skin differs from that of human skin due to more pronounced corneocyte clustering and deep 'canyons', which necessitates specific evaluation of porcine skin samples and a working protocol that takes this into account. The presented data will facilitate future analysis of porcine SC proteins during in vitro tape stripping.

Ampullosporin A, a peptaibol from Sepedonium ampullosporum HKI-0053 with neuroleptic-like activity.

The potential neuroleptic-like effect of ampullosporin A, a new peptaibol, isolated from the fungus Sepedonium ampullosporum HKI-0053, was characterized using specific behavioural models and methods. Ampullosporin A (amp) disrupted the retrieval of a well-trained conditioned reaction and normalized the behavioural effects of subchronic ketamine treatment in the social interaction test in a dose which showed only inconsiderable side effects. The experiments demonstrated that the substance did not antagonize the apomorphine (apo) induced hyperactivity. On the other hand, the locomotor stimulation induced by the NMDA receptor antagonist MK-801 was nearly completely suppressed by ampullosporin A, supposing interactions with the glutamatergic system. Binding studies demonstrated no interaction with dopaminergic D(1) and D(2) receptors. However, amp can alter the activity of glutamate receptors. The results resemble characteristics of an atypical neuroleptic drug. But further experiments are necessary to validate the suggested neuroleptic-like activity.

A mimotope gene encoding the major IgE epitope of allergen Phl p 5 for epitope-specific immunization.

A gene vaccine based on a mammalian expression vector containing the sequence of a peptide mimotope of Phl p 5 was constructed. To test whether mimotope gene vaccines can induce allergen-specific antibody responses via molecular mimicry, BALB/c mice were immunized using the mimotope construct with or without a tetanus toxin T-helper epitope. Moreover, intradermal injection was compared to epidermal application via gene gun immunization. Immunization with both mimotope gene constructs elicited allergen-specific antibody responses. As expected, gene gun bombardment induced a Th2-biased immune response, typically associated with IgG1 and IgE antibody production. In contrast, intradermal injection of the vaccine triggered IgG2a antibody expression without any detectable IgE levels, thus biasing the immune response towards Th1. In an RBL assay, mimotope-specific IgG antibodies were able to prevent cross-linking of allergen-specific IgE by Phl p 5. A construct coding for the complete Phl p 5 induced T-cell activation, IFN-gamma and IL-4 production. In contrast, the mimotope-DNA construct being devoid of allergen-specific T-cell epitopes had no capacity to activate allergen-specific T cells. Taken together, our data show that it is feasible to induce blocking IgG antibodies with a mimotope-DNA construct when applied intradermally. Thus the mimotope-DNA strategy has two advantages: (1) the avoidance of IgE induction and (2) the avoidance of triggering allergen-specific T-lymphocytes. We therefore suggest that mimotope gene vaccines are potential candidates for epitope-specific immunotherapy of type I allergy.

Anti-atherosclerotic effect of microbial hyaluronate lyase from group B streptococci.

The effect of the microbial hyaluronic acid splitting enzyme hyaluronate lyase produced by Streptococcus agalactiae was investigated in vitro in human atherosclerotic plaque specimens and in vivo on Watanabe heritable hyperlipidaemic rabbits (WHHL) as an animal model for familiar hypercholesteraemia. The in vitro presence of the enzyme caused a partial destruction of the atherosclerotic plaque surfaces as well as releasing of glucuronic acid and solid calcium-containing materials from pieces of atherosclerotic plaques in human arteries. Accordingly hyaluronic acid seems to be the main component for anchoring of calcium deposits on the plaque surfaces. Repeated intravenous injections of hyaluronate lyase in WHHL rabbits resulted in a tendency of decreased formation of atherosclerotic plaques. The observed effects are discussed to be primary the result of the splitting of hyaluronic acid in the vessels.

Quercinol, an anti-inflammatory chromene from the wood-rotting fungus Daedalea quercina (Oak Mazegill).

The fungus Daedalea quercina (oak mazegill) was examined for its capability of producing antioxidative and anti-inflammatory compounds. Bioactivity guided fractionation of the extract from a mycelial culture led to the isolation of quercinol, which was identified as (-)-(2S)-2-hydroxymethyl-2-methyl-6-hydroxychromene 1 by NMR and X-ray analyses. The cryptic hydroquinone 1 shows a broad anti-inflammatory activity against cyclooxygenase 2 (COX-2), xanthine oxidase (XO), and horseradish peroxidase (HRP) at micromolar concentrations.

Antimicrobial and anti-inflammatory activity of four known and one new triterpenoid from Combretum imberbe (Combretaceae).

Combretum imberbe is used widely in Africa inter alia for treating bacterial infections. In addition to four known triterpenoids, 1alpha,3beta-dihydroxy-12-oleanen-29-oic (1), 1-hydroxy-12-olean-30-oic acid (2), 3,30-dihydroxyl-12-oleanen-22-one (3), and 1,3,24-trihydroxyl-12-olean-29-oic acid (4), a new pentacyclic triterpenoid (1alpha,23-dihydroxy-12-oleanen-29-oic acid-3beta-O-2,4-di-acetyl-L-rhamnopyranoside) 5 has been isolated through a bioassay-guided procedure from the leaves of Combretum imberbe. The structures of the compounds were elucidated on the basis of 1D and 2D NMR experiments, as well as mass spectrometric data. All compounds isolated had moderate (62 microg/ml) to strong (16 microg/ml) antibacterial activity (MIC values) against Staphylococcus aureus and Escherichia coli, with 1 and 5 being most active. Compounds 1 and 5 also showed very strong inhibition of 3alpha-hydroxysteroid dehydrogenase with an IC(50) of 0.3 microg/ml. Compound 5 indicated a moderate anti-proliferative (GI(50)=16.5 and 13.2 microg/ml) and cytotoxic activity (CC(50)=17.6 micro/ml) against K-562, L-929 and HeLa cell lines, respectively. The results of this study give credence to the ethnomedicinal use of Combretum imberbe and expand our knowledge on the biological activity of its metabolites.

Development of a method for the determination of citrinin in barley, rye and wheat by solid phase extraction on aminopropyl columns and HPLC-FLD.

A method for the determination of the mycotoxin citrinin (CT) in rye, wheat and barley is described. The proposed method is based on ethyl acetate extraction, solid phase clean-up (SPE) on aminopropyl columns and reversed phase high performance liquid chromatography with fluorescence detection (RP-HPLC-FLD). The limits of detection and quantification of CT amounted to 0.6-0.9 µg/kg and 1.7- 3.3 µg/kg with mean recovery rates in the range of 77-92% (RSD 4.8-5.5%). This method can also be used for the determination of CT in red-fermented rice.

Optimal parameters for the treatment of leg veins using Nd:YAG lasers at 1064 nm.

BACKGROUND: The treatment of large vessels such as leg veins is successfully performed in clinical practice using pulsed Nd:YAG lasers. However, it is still unclear how laser parameters such as wavelength, fluence and pulse duration influence vessel destruction in leg veins. OBJECTIVES: To elucidate the governing parameters in selective photothermolysis of large vessels. METHODS: A recently developed mathematical model for photothermolysis has been adapted for the treatment of leg veins. The model was used to analyse the effectiveness of the selective photothermolysis process in laser treatment of leg veins by Nd:YAG at 1064 nm. The efficiency of laser-induced vessel heating was defined as a ratio between the absorbed and delivered energy. RESULTS: The efficiency improved with increasing vessel diameter, in agreement with clinical findings in various studies. The pulse duration made a minor contribution for laser fluences of 100-400 J cm(-2), whereas the efficiency was better for a small spot. The use of moderate fluences of 100-200 J cm(-2) reduced excess dermis heating and pain. CONCLUSIONS: We provide reference parameters for optimal treatment of leg veins using Nd:YAG lasers at 1064 nm. Our model predicts a maximal efficiency of a range of fluences (100-200 J cm(-2)) and pulse durations (10-100 ms).

An indoor test campaign of the tomography long path differential optical absorption spectroscopy technique.

In this study we validate the two-dimensional long path DOAS tomography measurement technique by means of an indoor experiment with well-known concentration distributions. The experiment was conducted over an area of 10 m x 15 m using one and two cylindrical polycarbonate containers of diameter 2 m, respectively, filled with NO2. The setup was realized with three of the multibeam instruments recently developed by Pundt and Mettendorf (Appl. Opt., 2005, in press), which allow the simultaneous measurement along at least four light paths each. The configuration consisted of twelve simultaneous light beams, 39 horizontal light paths in total, and 18 different cylinder positions inside the field. It was found that for the discretization and inversion technique shown here reconstructions of the concentration distributions from experimental data agree well with simulated reconstructions. In order to draw conclusions for atmospheric applications, numerical studies including instrumental errors were carried out. It was found that with the presented measurement setup it is possible to measure and reconstruct one or two NO2 plumes of 600 m diameter and average concentrations above 4.2 ppbv each, on a scale of 13.5 km2. Theoretical investigations show that it should be possible to localize and quantify 600 m diameter plumes of SO2 > 1.5 ppbv, H2CO > 6.3 ppbv, HONO > 3.2 ppbv, and ozone > 46.2 ppbv. Larger plumes can be measured with higher precision.

Non-anaphylactic surface-exposed peptides of the major birch pollen allergen, Bet v 1, for preventive vaccination.

BACKGROUND: Almost 100 million allergic patients are sensitized to the major birch pollen allergen, Bet v 1, a 17 kDa protein containing most of the IgE epitopes present in pollens of trees belonging to the Fagales order and plant-derived food. OBJECTIVE: Our aim was to develop an approach for the rational design of B cell epitope-derived, non-allergenic peptide allergy vaccines. METHODS: According to the three-dimensional (3-D) structure of birch pollen allergen, Bet v 1, six peptides comprising 25-32 preferably solvent-exposed amino acids were synthesized. RESULTS: Because of lack of secondary structure, the peptides showed no allergenic activity in allergic patients. In a mouse model of birch pollen allergy, peptide vaccination induced Bet v 1-specific IgG and prevented IgE-mediated allergic sensitization to Bet v 1. The protective role of peptide-induced blocking antibodies is demonstrated by inhibition of allergic patients IgE binding to the allergen and by blocking of allergen-induced basophil degranulation. CONCLUSION: Our results indicate the mechanistic importance of blocking antibodies for allergy vaccination and present a B cell epitope-based approach for the rational design of safe peptide allergy vaccines whenever the structure of the disease-eliciting allergen is known.

Vaccines for birch pollen allergy based on genetically engineered hypoallergenic derivatives of the major birch pollen allergen, Bet v 1.

BACKGROUND: We have recently engineered recombinant derivatives of the major birch pollen allergen Bet v 1 (rBet v 1 fragments and trimer) with strongly reduced allergenic activity. OBJECTIVE: The aim of this study was the in vivo characterization of potential allergy vaccines based on Al(OH)3-adsorbed genetically modified rBet v 1 derivatives in mice. METHODS: BALB/c mice were immunized either with courses of nine injections of increasing doses of Al(OH)3-adsorbed rBet v 1 wild-type, rBet v 1 fragments, rBet v 1 trimer or Al(OH)3 alone in weekly intervals or with three high-dose injections applied in intervals of 3 weeks. Humoral immune responses to rBet v 1 wild-type and homologous plant allergens were measured by ELISA and Western blotting, and the ability of mouse antibodies to inhibit the binding of allergic patients IgE to Bet v 1 was studied by ELISA competition experiments. RESULTS: In both schemes, hypoallergenic rBet v 1 derivatives induced low IgE but high IgG1 responses against rBet v 1 wild-type. The IgG1 antibodies induced by genetically modified rBet v 1 derivatives cross-reacted with natural Bet v 1 and its homologues from alder (Aln g 1) as well as hazel (Cor a 1) and strongly inhibited the binding of birch pollen allergic patients' IgE to Bet v 1 wild-type. CONCLUSION: Genetically modified hypoallergenic rBet v 1 derivatives induce blocking antibodies in vivo. Their safety and efficacy for the treatment of birch pollen and associated plant allergies can now be evaluated in clinical immunotherapy studies.

Characterization of the protective and therapeutic efficiency of a DNA vaccine encoding the major birch pollen allergen Bet v 1a.

BACKGROUND: An estimated 100 million individuals suffer from birch pollen allergy. More than 95% of birch pollen-allergic subjects react with the major birch pollen allergen Bet v 1a, and almost 60% of them are sensitized exclusively to this allergen. OBJECTIVE: DNA immunization using the Bet v 1a gene was evaluated with respect to its prophylactic and therapeutic efficacy. METHODS: A DNA vaccine containing the entire Bet v 1a cDNA under the control of a CMV-promoter was constructed. In order to estimate the protective efficiency, animals received three injections of this vaccine prior to sensitization with recombinant Bet v 1a. Vice versa, in a therapeutic approach, sensitization was followed by treatment with the DNA vaccine. RESULTS: The Bet v 1a DNA vaccine induced strong Bet v 1-specific antibody responses with a Th1-biased response type. Animals which received the DNA vaccine were protected against a following allergic sensitization with Bet v 1a. The protective effect was characterized by suppression of Bet v 1-specific immunoglobulin (Ig)E production, lack of basophil activation and enhanced interferon (IFN)-gamma expression. In a therapeutic situation, treatment of sensitized animals with DNA vaccines decreased IgE production, IgE-mediated basophil release and drastically reduced anaphylactic activity as measured by passive cutaneous anaphylaxis assays. Concerning the cellular immune response, DNA immunization induced a sustaining and dominant shift from a Th2 type response towards a balanced Th1/Th2 type response as indicated by increased IFN-gamma but unchanged IL-5 levels in lymphoproliferation assays. CONCLUSION: The results demonstrate the allergen-specific protective and therapeutic efficacy of a DNA vaccine encoding the clinically highly relevant allergen Bet v 1a indicating the suitability of this concept for the treatment of allergic diseases.

Optimization of codon usage is required for effective genetic immunization against Art v 1, the major allergen of mugwort pollen.

BACKGROUND: As the major allergen of mugwort pollen, Art v 1 is an important target for specific immunotherapy. However, both recombinant protein as well as a gene vaccine for Art v 1 failed to be immunogenic in mice. In order to improve immunogenicity we focused on genetic immunization because interspecific differences of codon usage have been shown as an obstacle for effective induction of immune responses with gene vaccines encoding infectious pathogens. OBJECTIVE: In order to find out, whether codon usage might also be used to improve genetic immunization with allergen genes, the response against a gene vaccine expressing the wild-type gene of Art v 1 (pCMV-wtArt) was compared with a synthetic codon-optimized vector with human codon usage (pCMV-humArt). METHODS: Balb/c mice were injected intradermally with pCMV-wtArt or pCMV-humArt. In vitro expression levels of both constructs were compared in transfection experiments. Total immunoglobulin G (IgG), IgG1, IgG2a and IgE antibodies were analyzed by enzyme-linked immunosorbent assay and the anaphylactic activity of the sera was determined by allergen-specific degranulation of rat basophil leukemia-2H3 cells. RESULTS: No immune response was detectable with the gene vaccine expressing the wildtype Art v 1, but immunization with pCMV-humArt revealed a strong and allergen-specific induction of antibody responses. The antibodies recognized both the recombinant as well as the purified natural (glycosylated) Art v 1 molecule. The response type was Th1-biased, as indicated by high levels of IgG2a antibodies. Expression analysis with B16 mouse melanoma cells transfected with pCMV-humArt or pCMV-wtArt revealed an impaired expression of the wild-type vector but normal translation after recoding. CONCLUSION: The results demonstrate that optimization of codon usage offers a simple way to improve immunogenicity and therefore should be routinely considered in the development of gene vaccines for the treatment of allergy.