A smartphone-based health care chatbot to promote self-management of chronic pain (SELMA) : pilot randomized controlled trial

Background: Ongoing pain is one of the most common diseases and has major physical, psychological, social, and economic impacts. A mobile health intervention utilizing a fully automated text-based health care chatbot (TBHC) may offer an innovative way not only to deliver coping strategies and psychoeducation for pain management but also to build a working alliance between a participant and the TBHC. Objective: The objectives of this study are twofold: (1) to describe the design and implementation to promote the chatbot painSELfMAnagement (SELMA), a 2-month smartphone-based cognitive behavior therapy (CBT) TBHC intervention for pain self-management in patients with ongoing or cyclic pain, and (2) to present findings from a pilot randomized controlled trial, in which effectiveness, influence of intention to change behavior, pain duration, working alliance, acceptance, and adherence were evaluated. Methods: Participants were recruited online and in collaboration with pain experts, and were randomized to interact with SELMA for 8 weeks either every day or every other day concerning CBT-based pain management (n=59), or weekly concerning content not related to pain management (n=43). Pain-related impairment (primary outcome), general well-being, pain intensity, and the bond scale of working alliance were measured at baseline and postintervention. Intention to change behavior and pain duration were measured at baseline only, and acceptance postintervention was assessed via self-reporting instruments. Adherence was assessed via usage data. Results: From May 2018 to August 2018, 311 adults downloaded the SELMA app, 102 of whom consented to participate and met the inclusion criteria. The average age of the women (88/102, 86.4%) and men (14/102, 13.6%) participating was 43.7 (SD 12.7) years. Baseline group comparison did not differ with respect to any demographic or clinical variable. The intervention group reported no significant change in pain-related impairment (P=.68) compared to the control group postintervention. The intention to change behavior was positively related to pain-related impairment (P=.01) and pain intensity (P=.01). Working alliance with the TBHC SELMA was comparable to that obtained in guided internet therapies with human coaches. Participants enjoyed using the app, perceiving it as useful and easy to use. Participants of the intervention group replied with an average answer ratio of 0.71 (SD 0.20) to 200 (SD 58.45) conversations initiated by SELMA. Participants’ comments revealed an appreciation of the empathic and responsible interaction with the TBHC SELMA. A main criticism was that there was no option to enter free text for the patients’ own comments. Conclusions: SELMA is feasible, as revealed mainly by positive feedback and valuable suggestions for future revisions. For example, the participants’ intention to change behavior or a more homogenous sample (eg, with a specific type of chronic pain) should be considered in further tailoring of SELMA

Bioreactor cultivation of CHO DP-12 cells under sodium butyrate treatment – comparative transcriptome analysis with CHO cDNA microarrays

Klausing S, Krämer O, Noll T. Bioreactor cultivation of CHO DP-12 cells under sodium butyrate treatment – comparative transcriptome analysis with CHO cDNA microarrays. BMC Proceedings. 2011;5(Suppl 8)

Clinical Utility of Red Cell Distribution Width in Alcoholic and Non-alcoholic Liver Cirrhosis

Red blood cell distribution width (RDW) is a measure of the variation of red blood cell width that is reported as a part of standard complete blood count. Red blood cell distribution width results are often used together with mean corpuscular volume (MCV) results to figure out mixed anemia. The aim of our study was to compare the values of RDW in alcoholic and non-alcoholic liver cirrhosis and to determine if RDW follows the severity of disease according to Child-Pugh score. We retrospectively analyzed 241 patients (176 men and 65 women) with liver cirrhosis and anemia, defined as a hemoglobin value <130 g/L in men and <120 g/L in women, which were hospitalized in our Division in a period between 2006 and 2008. Patients were divided in two groups; in first were patients with alcoholic liver cirrhosis, and in second with non-alcoholic cirrhosis. Severity of disease was determined according to Child-Pugh score. Red blood cells distribution width Normal reference range is 11–15%. Alcoholic liver cirrhosis had 204 patients (85%) while non-alcoholic cirrhosis had 37 patients (15%). In group of alcoholic cirrhosis the average RDW was 16.8%. In relation to severity of disease the average RDW for Child-Pugh A was 16.80%, for Child-Pugh B was 16.92%, for Child-Pugh C was 17.10%. In the group of non-alcoholic cirrhosis the average RDW was 16.73% and in relation to severity of disease for Child-Pugh A was 16.25%, for Child-Pugh B 17.01% and for Child-Pugh C was 16.87%. We didn’t find statistically significant difference of RDW between alcoholic and non alcoholic cirrhosis (p>0.05) and we didn’t proved any statistically significant increase of RDW in relation to severity of disease in group of alcoholic cirrhosis (p=0.915) nor in group of patients with non-alcoholic cirrhosis (p=0.697). Our study showed that RDW had not any clinical value in differentiation of anemia neither in alcoholic and non-alcoholic liver cirrhosis nor in severity of liver disease

Generation of the CRISPR/Cas9-mediated KIF1C knock-out human iPSC line HIHRSi003-A-1

Bi-allelic loss-of-function mutations in the gene encoding the motor protein KIF1C are associated with Hereditary Spastic Paraplegia (HSP) type SPG58, a slowly progressive neurodegenerative motoneuron disease. The biological role of KIF1C is incompletely understood. We used a protein-based CRISPR/Cas9 genome editing approach to generate a homozygous KIF1C knock-out iPSC line (HIHRSi003-A-1) from a healthy control. This iPSC-KIF1C$^{-/-}$ line and the corresponding isogenic control are a useful model to study the physiological function of KIF1C and the pathophysiological consequences of KIF1C dysfunction in human disease

Screening Arrays of Laminin Peptides on Modified Cellulose for Promotion of Adhesion of Primary Endothelial and Neural Precursor Cells

Neural precursor cells (NPC) are primary cells intensively used in the context of research on adult neurogenesis and modeling of neuronal development in health and diseased states. Substrates that can facilitate NPC adhesion will be very useful for culturing these cells. Due to the presence of laminin in basal lamina as well as their involvement in differentiation, migration, and adhesion of many types of cells, surfaces modified with laminin-derived peptides are focused upon and compared with the widely used fibronectin-derived Arg-Gly-Asp (RGD) peptides. An array of 46 peptides is synthesized on cellulose paper (SPOT) to identify laminin-derived peptides that promote short-term adhesion of murine NPC and human primary endothelial cells. Various previously reported peptide sequences are re-evaluated in this work. Initial adhesion experiments show NPC preferred several laminin-derived peptides by up to 5-time higher cell numbers, compared to the well-known promiscuous integrin binding RGD peptide. Importantly, screening of cell adhesion has revealed a synergetic effect of filamentous matrix, peptide sequence, surface property, ligand density, and the dynamic process of NPC adhesion. © The Authors. Advanced Biology published by Wiley-VCH Gmb

Insights from Multimodal Preclinical Imaging in Immunocompetent Nude Mice

Hydrogels based on gelatin have evolved as promising multifunctional biomaterials. Gelatin is crosslinked with lysine diisocyanate ethyl ester (LDI) and the molar ratio of gelatin and LDI in the starting material mixture determines elastic properties of the resulting hydrogel. In order to investigate the clinical potential of these biopolymers, hydrogels with different ratios of gelatin and diisocyanate (3-fold (G10_LNCO3) and 8-fold (G10_LNCO8) molar excess of isocyanate groups) were subcutaneously implanted in mice (uni- or bilateral implantation). Degradation and biomaterial-tissue- interaction were investigated in vivo (MRI, optical imaging, PET) and ex vivo (autoradiography, histology, serum analysis). Multimodal imaging revealed that the number of covalent net points correlates well with degradation time, which allows for targeted modification of hydrogels based on properties of the tissue to be replaced. Importantly, the degradation time was also dependent on the number of implants per animal. Despite local mechanisms of tissue remodeling no adverse tissue responses could be observed neither locally nor systemically. Finally, this preclinical investigation in immunocompetent mice clearly demonstrated a complete restoration of the original healthy tissue

MRM2 and MRM3 are involved in biogenesis of the large subunit of the mitochondrial ribosome

Defects of the translation apparatus in human mitochondria are known to cause disease, yet details of how protein synthesis is regulated in this organelle remain to be unveiled. Ribosome production in all organisms studied thus far entails a complex, multistep pathway involving a number of auxiliary factors. This includes several RNA processing and modification steps required for correct rRNA maturation. Little is known about the maturation of human mitochondrial 16S rRNA and its role in biogenesis of the mitoribosome. Here we investigate two methyltransferases, MRM2 (also known as RRMJ2, encoded by FTSJ2) and MRM3 (also known as RMTL1, encoded by RNMTL1), that are responsible for modification of nucleotides of the 16S rRNA A-loop, an essential component of the peptidyl transferase center. Our studies show that inactivation of MRM2 or MRM3 in human cells by RNA interference results in respiratory incompetence as a consequence of diminished mitochondrial translation. Ineffective translation in MRM2- and MRM3-depleted cells results from aberrant assembly of the large subunit of the mitochondrial ribosome (mt-LSU). Our findings show that MRM2 and MRM3 are human mitochondrial methyltransferases involved in the modification of 16S rRNA and are important factors for the biogenesis and function of the large subunit of the mitochondrial ribosome

Seelische Migrationsprozesse – «uufbreche – aacho»: Vorschau auf die Tagung vom 10. 9. 2021

Sandra Rumpel und Antonia Stulz-Koller berichten über die besondere Gefährdung von Babys, (Klein-)Kindern und Jugendlichen sowie jungen Müttern gegenüber traumatischen Erfahrungen, die Flucht und Migration oft mit sich bringen, bedingt durch die kritischen Entwicklungsphasen, die es zu bewältigen gilt. Die «aacho-Projekte» (Schweizerdeutsch für «Ankommen») versuchen für diese verletzlichen Menschen ein spezifisches gruppenpsychotherapeutisches Umfeld zu gestalten.Aus der Perspektive der Ethnopsychoanalyse und des Psychodramas als Methode in der Arbeit mit traumatisierten Menschen weist Ursula Hauser Grieco, im Zusammenhang mit inneren und äusseren Migrationsprozessen, auf die Wichtigkeit der Gegenübertragung seitens der Therapeut*innen hin. Die spezifischen kulturellen und sozialen Unterschiede beinhalten Konflikte und unbewusste Verhaltensweisen des im sozialpsychologischen Bereich tätigen Teams. Zudem wird die Problematik der Macht und des möglichen Missbrauchs der «Hilfe» thematisiert, was in der Gruppensupervision besprochen und bewusst gemacht werden muss.Marianne Leuzinger-Bohleber nimmt sich der Thematik der Pandemie als besonders bedrohlich für traumatisierte Flüchtlinge und Projekte wie «aacho» an. Die Pandemie trifft, wie immer, vulnerable Menschen besonders hart. Dazu gehören auch traumatisierte Geflüchtete und Migrantinnen. Im Beitrag werden psychoanalytische Überlegungen zur Reaktivierung spezifischer «embodied memories» durch COVID-19 bei uns allen formuliert. Anhand einiger Beispiele aus Psychotherapien mit Geflüchteten wird diskutiert, ob und in welcher Weise die Psychoanalyse zur Bewältigung erneuter traumatogener Erfahrungen bei den Geflüchteten, aber auch bei den Psychotherapeutinnen und Betreuerinnen beitragen und ihr Wissen in öffentliche Debatten dazu eingebracht werden kann

Transient elastography (FibroScan®) with controlled attenuation parameter in the assessment of liver steatosis and fibrosis in patients with nonalcoholic fatty liver disease - Where do we stand?

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. Currently, the routinely used modalities are unable to adequately determine the levels of steatosis and fibrosis (laboratory tests and ultrasonography) or cannot be applied as a screening procedure (liver biopsy). Among the non-invasive tests, transient elastography (FibroScan®, TE) with controlled attenuation parameter (CAP) has demonstrated good accuracy in quantifying the levels of liver steatosis and fibrosis in patients with NAFLD, the factors associated with the diagnosis and NAFLD progression. The method is fast, reliable and reproducible, with good intra- and interobserver levels of agreement, thus allowing for population-wide screening and disease follow-up. The initial inability of the procedure to accurately determine fibrosis and steatosis in obese patients has been addressed with the development of the obese-specific XL probe. TE with CAP is a viable alternative to ultrasonography, both as an initial assessment and during follow-up of patients with NAFLD. Its ability to exclude patients with advanced fibrosis may be used to identify low-risk NAFLD patients in whom liver biopsy is not needed, therefore reducing the risk of complications and the financial costs