Towards engineering heart tissues from bioprinted cardiac spheroids.

Currentin vivoandin vitromodels fail to accurately recapitulate the human heart microenvironment for biomedical applications. This study explores the use of cardiac spheroids (CSs) to biofabricate advancedin vitromodels of the human heart. CSs were created from human cardiac myocytes, fibroblasts and endothelial cells (ECs), mixed within optimal alginate/gelatin hydrogels and then bioprinted on a microelectrode plate for drug testing. Bioprinted CSs maintained their structure and viability for at least 30 d after printing. Vascular endothelial growth factor (VEGF) promoted EC branching from CSs within hydrogels. Alginate/gelatin-based hydrogels enabled spheroids fusion, which was further facilitated by addition of VEGF. Bioprinted CSs contracted spontaneously and under stimulation, allowing to record contractile and electrical signals on the microelectrode plates for industrial applications. Taken together, our findings indicate that bioprinted CSs can be used to biofabricate human heart tissues for long termin vitrotesting. This has the potential to be used to study biochemical, physiological and pharmacological features of human heart tissue

Conclusion: Asking the Right Questions

The dyadic relation between a person in need and a person who provides help is one of the core elements of care. Nonetheless, identifying core elements of care alone cannot supply simple solutions to the challenges that are rooted in the ambivalences and tensions of the notion of care in healthcare. Care practices are extensive, situated, and complex. Questions concerning ambivalences and tensions within care include: Can care practices include coercion? Is care compatible with exclusion? Can it be passive or invisible? Can it be incorporated into standardised and regulated routines? Can care and its vocabulary be adjusted to clinical procedures and medical terminology

Implementation and evaluation of an algorithm for the management of scabies outbreaks

Abstract Background Infestations with scabies mites are a global burden affecting individuals of all ages, classes and ethnicities. As poor sanitation and overcrowding favor the transmission of this highly contagious disease, epidemic outbreaks are frequently observed among displaced persons and asylum seekers. Due to the growing influx of refugees during the last years, public health authorities in host countries are frequently confronted with the challenge to treat individuals with diagnosed or suspected scabies promptly and effectively to avoid further spreading of the infestation. This study aimed to establish a straightforward and efficient algorithm for rapid screening and treatment of large numbers of patients with confirmed or suspected scabies infestations. Methods Forty-eight individuals (58% males, mean age 22.4 yrs.) from Syria with suspected scabies infestation were allocated to 3 colour-coded groups: (1) no signs or symptoms of infestation, (2) itch only, and (3) itch and typical skin lesions. Patients were treated with a single (group 1) or two doses of oral ivermectin at an interval of 7 days (group 2), or with a combination of 2 doses of ivermectin plus 2 applications of permethrin ointment at an interval of 7 days (group 3). Follow-ups were performed 4 weeks after initial treatments. Results All individuals with signs and/or symptoms of infestation had improved skin lesion; in 10/11 (90.9%) lesion had completely resolved. All individuals with initial itch only (n = 32) reported improvement of its intensity or complete resolution. None of the patients of group 1 developed itch or skin lesions. The algorithm was reapplied in 4 individuals (8.3%) after 4 weeks and the outbreak was completely controlled after 8 weeks. Colour-coding ensured fast flow of information between health-care providers at the interfaces of the algorithm. Conclusions Our algorithm proved to be both highly efficient for treatment of large numbers of patients with suspected or diagnosed scabies infestation as well as for prevention of spreading of the disease. Hence, this algorithm is well suited for the management of scabies mass outbreaks

Evaluation of 24-h urine collection quality in the Swiss Kidney Stone Cohort-NCCR Kidney.CH

Background Kidney stone affect one in ten adults in Switzerland. Diet plays a key role in the development and management of kidney stones. We collected data on the dietary habits of stone formers and controls using two consecutive 24-h dietary recalls and 24-h urine collections as well as blood chemistry. We explored the quality and completeness of 24-hour urine collections of participants prior to using 24-h urinary electrolytes and urea excretions as biomarkers of dietary intakes. Methods The Swiss Kidney Stone Cohort (SKSC) is a multicentric cohort of stone formers. A control group, free of kidney stone on CT-scan, was recruited in the general adult population. The SKSC includes 803 kidney stones formers and 207 controls (table 1). We evaluated the quality of the 24-h urine collection at baseline using urinary creatinine excretion (μmol/kg/24h). We also used a multiple linear regression model, including age, sex, BMI and linguistic region as covariates, to explore whether urinary volume and creatinine excretion differed between cases and controls. Results Of the 1882 urinary collections available, 631(33,5%) were outside the 10th-90th percentiles of the expected urinary creatinine excretion values. Mean 24-h urinary volume (day 1) was 1809±786ml (SKSC) and 2078±827ml (controls). After adjusting for age, sex, BMI and linguistic region, controls have a higher urinary volume than cases (+263±66ml, p <0.001). Swiss Germans have higher urinary volumes (+153±52ml, p <0.01). Adjusted mean 24-h urinary creatinine excretion (day 1) was similar in cases (164±52μmol/kg/24h) and controls (166±43μmol/kg/24h, p = 0.6). Conclusions The percentage of inadequate collections falls within a range previously described in the literature. Patients have lower 24-h urinary volume, but similar creatinine excretion than controls. Swiss Germans have higher urinary volumes. Further analysis will be conducted using 24-h urinary electrolytes (sodium, potassium) and urea excretions to assess the dietary intake of the participants. (Table Presented)

Dietary consumption in the Swiss Kidney Stone Cohort-NCCR Kidney.CH

Background: Kidney stones are a frequent condition, with a prevalence around 5-10% in Europe. Previous studies showed associations between kidney stones and diet. Thus, studying kidney stone formers' diet is of key importance to establish efficient dietary measures for the prevention and management of kidney stones. Methods: The Swiss Kidney Stone Cohort (SKSC) is a multicentric cohort of stone formers. Participants were seen at baseline, 3 months, 1 year and once a year during 3 years. A control group of non-stone formers was recruited in the general adult population. Repeated consecutive 24-h dietary recalls and 24-h urines were collected. We used two consecutive 24-h dietary recalls at baseline to describe the diet in the stone and non-stone former groups. For each participant, we used the average consumption of 19 food groups from the two recalls as response variables in two-part models that estimate separately the kidney stone status influence on the probability of consumption (logistic regression) and on the amount reported by consumers (linear regression). The covariables in the models were kidney stone status, age, sex, BMI, linguistic region and education level. Results: The characteristics of the 458 participants with two 24-h dietary recalls at baseline are summarized in Table 1. The sex-specific mean consumed amounts for each food group were similar between the two groups, except for vegetables and alcoholic beverages (Table 2). In the two-part model (Table 3), the kidney stone status was significantly associated with the probability of consuming nuts and seeds, cakes and biscuits as well as alcoholic beverages. Among consumers, kidney stone formers reported smaller amounts of vegetables and alcoholic beverages than non-formers. Conclusions: Overall, the diets of kidney stone formers and non-formers are similar. We observed associations of kidney stone status with vegetables and alcoholic beverages consumption. This data helps guiding food recommendations in stone formers in Switzerland