Involvement of lactate and pyruvate in the anti-inflammatory effects exerted by voluntary activation of the sympathetic nervous system

We recently demonstrated that the sympathetic nervous system can be voluntarily activated following a training program consisting of cold exposure, breathing exercises, and meditation. This resulted in profound attenuation of the systemic inflammatory response elicited by lipopolysaccharide (LPS) administration. Herein, we assessed whether this training program affects the plasma metabolome and if these changes are linked to the immunomodulatory effects observed. A total of 224 metabolites were identified in plasma obtained from 24 healthy male volunteers at six timepoints, of which 98 were significantly altered following LPS administration. Effects of the training program were most prominent shortly after initiation of the acquired breathing exercises but prior to LPS administration, and point towards increased activation of the Cori cycle. Elevated concentrations of lactate and pyruvate in trained individuals correlated with enhanced levels of anti-inflammatory interleukin (IL)-10. In vitro validation experiments revealed that co-incubation with lactate and pyruvate enhances IL-10 production and attenuates the release of pro-inflammatory IL-1β and IL-6 by LPS-stimulated leukocytes. Our results demonstrate that practicing the breathing exercises acquired during the training program results in increased activity of the Cori cycle. Furthermore, this work uncovers an important role of lactate and pyruvate in the anti-inflammatory phenotype observed in trained subjects.</p

Assistive technology design and development for acceptable robotics companions for ageing years

© 2013 Farshid Amirabdollahian et al., licensee Versita Sp. z o. o. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs license, which means that the text may be used for non-commercial purposes, provided credit is given to the author.A new stream of research and development responds to changes in life expectancy across the world. It includes technologies which enhance well-being of individuals, specifically for older people. The ACCOMPANY project focuses on home companion technologies and issues surrounding technology development for assistive purposes. The project responds to some overlooked aspects of technology design, divided into multiple areas such as empathic and social human-robot interaction, robot learning and memory visualisation, and monitoring persons’ activities at home. To bring these aspects together, a dedicated task is identified to ensure technological integration of these multiple approaches on an existing robotic platform, Care-O-Bot®3 in the context of a smart-home environment utilising a multitude of sensor arrays. Formative and summative evaluation cycles are then used to assess the emerging prototype towards identifying acceptable behaviours and roles for the robot, for example role as a butler or a trainer, while also comparing user requirements to achieved progress. In a novel approach, the project considers ethical concerns and by highlighting principles such as autonomy, independence, enablement, safety and privacy, it embarks on providing a discussion medium where user views on these principles and the existing tension between some of these principles, for example tension between privacy and autonomy over safety, can be captured and considered in design cycles and throughout project developmentsPeer reviewe

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

The affective respiration device: Towards embodied bio-feedforward in healthcare

In this paper, we discuss the Affective Respiration Device, its rationale and elaborate a few lessons learned from our attempt to embed this technology in the flow of everyday life. The device captures the respiratory behaviour of its viewer and provides bio-feedback and feedforward that enables people to come to terms with their breathing and activity in an engaging manner. After briefly discussing the theory, related work, and the system design we provide a use-scenario to highlight the experiential consequences of using the affective device. We further reflect on few learning points derived from a walk-through. This work aims to inspire design-thinking for patient’s home monitoring to shift from the cognitive approach towards an embodied bio-feedback

Exploring Movement Qualities in a Reciprocal Engagement

In this paper we present three behaviour designs for a robot's movement that extend and explore qualities of the perceptual-crossing paradigm in relation to functional purposes. As defined by [1], perceptual-crossing is related to the perception of how the behaviour of an entity/object and its perception relate to interacting entities/actors. Within three simple scenarios, movement behaviour designs are applied that negotiate the behaviour of both actors in interaction. For instance, when a robot and a person face a door and they both intend to go through it, a designed behaviour negotiates who is to go first in appropriate manner, either the human or the robot. The work is presented on the level of both theoretical and practical application, followed by an experimental activity. With this work we hope to inspire design thinking to shift from discrete, procedural design mechanisms to continuous and action-driven mechanisms when addressing interaction between humans and systems

How to design for transformation of behavior through interactive materiality

This paper presents a design approach tackling the transformation of behavior through ‘interactive materiality’ from a phenomenological perspective. It builds upon the Interaction Frogger framework that couples action to reaction for intuitive mapping in intelligent product interaction. Through the discussion of two research-through-design cases, the augmented speed-skate experience and affective pen, it highlights the opportunities for design of an action-perception loop. Consequently, an approach is suggested that defines three steps to be incorporated in the design process: affirming and appreciating current behavior; designing continuous mapping for transformation; and fine-tuning sensitivities in the interactive materiality. Thereby, it discusses how behavior transformation through interactive materiality derived from a theoretical level, can contribute to design knowledge on the implementation level. The aim of this paper is to inspire design-thinking to shift from the cognitive approach of persuasion, to a meaningful and embodied mechanism respecting all human skills, by providing practical insights for designers

Mapping the Continuous to the Discrete : Interaction Aesthetics in Complex Products and Systems

This research proposes to explore the consequences of a phenomenological approach on designing for the aesthetics of interaction. Highly complex products in a ‘digital’ world, enlisting complex functions, hierarchies, system architectures, procedures and so on,are designed to be used by humans. We approach designing intelligent systems, products and related services as designing for behaviour for societal transformation. Human-product interaction is essentially about mapping the products or systems to our human capabilities. In our context, it means to map the digital to the continuous. This theory inspired design research project departs from basic principles of phenomenology, and ecological psychology, and investigates its interaction aesthetics and system architectural consequences for designing intelligent products and systems. The research delivers knowledge, methods and tools, which contribute to the general body of knowledge about the relationship between phenomenology, interaction and system design. This is investigated through experiential prototyped hypotheses and explorations placed in context, such as smart environments, and contextual aware systems