Increasing the COVID-19 immunization rate through allergy testing

BACKGROUND

Vaccination of the population is required to combat the COVID-19 pandemic. Allergy testing could reduce anxiety towards COVID-19 vaccination and thereby may increase vaccination rate, however, its effectiveness remains unclear.

METHODS

One hundred and thirty prospective real-life patients in need of but not daring to get vaccinated asked for allergy workup for COVID-19 vaccine hypersensitivity in 2021/2022. Characterization of patients, identification of anxieties, decrease of patient's anxiety levels, overall vaccination rate and adverse reactions after vaccination were assessed.

RESULTS

Tested patients were characterized by being female (91.5%) and having a high rate of previous allergies (e.g. to food 55.4%, drugs 54.6%, or previous vaccinations 50%) and dermatological disease (29.2%) but not always had medical contraindications for COVID-19 vaccination. Sixty one patients (49.6%) were highly concerned (4-6, Likert scale 0-6) about vaccination and 47 (37.6%) expressed resolving thoughts about vaccinaion anaphylaxis (3-6, Likert scale 0-6). However only 35 patients (28.5%) were scared of getting COVID-19 within 2 months (4-6, Likert scale 0-6) and only 11 (9%) patients had high expectations of getting COVID-19 (4-6, Likert scale 0-6). Allergy testing significantly (p < 0.01 to p < 0.05 respectively) reduced the median anxiety of allergic symptoms following vaccination: dyspnoea (4.2-3.1), to faint (3.7-2.7), long-term consequences (3.6-2.2), pruritus (3.4-2.6), skin rash (3.3-2.6) and death (3.2-2.6). After allergy testing, most patients (108/122, 88.5%) let themselves be vaccinated within 60 days. Revaccinated patients with previous symptoms experienced a reduction of symptoms (p < 0.05) upon revaccination.

CONCLUSIONS

Patients not daring to get vaccinated have more anxiety towards vaccination than to acquire COVID-19. For those, allergy testing excludes vaccine allergy, and is a tool to increase vaccination willingness and thereby helps to combat vaccination hesitancy.

Efficacy and safety of P11-4 for the treatment of periodontal defects in dogs

Objectives

This study’s aim was to investigate the safety and performance of a self-assembling peptide matrix (SAPM) P₁₁-4 for the treatment of periodontal disease in a controlled pre-clinical study.

Materials and methods

Acute buccal bony dehiscence defects (LxW: 5 × 3 mm) were surgically created on the distal root of four teeth on one mandible side of 7 beagle dogs followed by another identical surgery 8 weeks later on the contralateral side. SAPM P₁₁-4 (with and without root conditioning with 24% EDTA (T1, T2)), Emdogain® (C) and a sham intervention (S) were randomly applied on the four defects at each time point. Four weeks after the second surgery and treatment, the animals were sacrificed, the mandibles measured by micro-computed tomography (µ-CT) and sections of the tissue were stained and evaluated histologically.

Results

Clinically and histologically, no safety concerns or pathological issues due to the treatments were observed in any of the study groups at any time point. All groups showed overall similar results after 4 and 12 weeks of healing regarding new cementum, functionality of newly formed periodontal ligament and recovery of height and volume of the new alveolar bone and mineral density.

Conclusion

A controlled clinical study in humans should be performed in a next step as no adverse effects or safety issues, which might affect clinical usage of the product, were observed.

Clinical relevance

The synthetic SAPM P₁₁-4 may offer an alternative to the animal-derived product Emdogain® in the future.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00784-021-04297-6.

Amino acid composition of nanofibrillar self-assembling peptide hydrogels affects responses of periodontal tissue cells in vitro

Background

The regeneration of tissue defects at the interface between soft and hard tissue, eg, in the periodontium, poses a challenge due to the divergent tissue requirements. A class of biomaterials that may support the regeneration at the soft-to-hard tissue interface are self-assembling peptides (SAPs), as their physicochemical and mechanical properties can be rationally designed to meet tissue requirements.

Materials and methods

In this work, we investigated the effect of two single-component and two complementary β-sheet forming SAP systems on their hydrogel properties such as nanofibrillar architecture, surface charge, and protein adsorption as well as their influence on cell adhesion, morphology, growth, and differentiation.

Results

We showed that these four 11-amino acid SAP (P11-SAP) hydrogels possessed physico-chemical characteristics dependent on their amino acid composition that allowed variabilities in nanofibrillar network architecture, surface charge, and protein adsorption (eg, the single-component systems demonstrated an ~30% higher porosity and an almost 2-fold higher protein adsorption compared with the complementary systems). Cytocompatibility studies revealed similar results for cells cultured on the four P11-SAP hydrogels compared with cells on standard cell culture surfaces. The single-component P11-SAP systems showed a 1.7-fold increase in cell adhesion and cellular growth compared with the complementary P11-SAP systems. Moreover, significantly enhanced osteogenic differentiation of human calvarial osteoblasts was detected for the single-component P11-SAP system hydrogels compared with standard cell cultures.

Conclusion

Thus, single-component system P11-SAP hydrogels can be assessed as suitable scaffolds for periodontal regeneration therapy, as they provide adjustable, extracellular matrix-mimetic nanofibrillar architecture and favorable cellular interaction with periodontal cells.

Mechanical characteristics of beta sheet-forming peptide hydrogels are dependent on peptide sequence, concentration and buffer composition

Self-assembling peptide hydrogels can be modified regarding their biodegradability, their chemical and mechanical properties and their nanofibrillar structure. Thus, self-assembling peptide hydrogels might be suitable scaffolds for regenerative therapies and tissue engineering. Owing to the use of various peptide concentrations and buffer compositions, the self-assembling peptide hydrogels might be influenced regarding their mechanical characteristics. Therefore, the mechanical properties and stability of a set of self-assembling peptide hydrogels, consisting of 11 amino acids, made from four beta sheet self-assembling peptides in various peptide concentrations and buffer compositions were studied. The formed self-assembling peptide hydrogels exhibited stiffnesses ranging from 0.6 to 205 kPa. The hydrogel stiffness was mostly affected by peptide sequence followed by peptide concentration and buffer composition. All self-assembling peptide hydrogels examined provided a nanofibrillar network formation. A maximum self-assembling peptide hydrogel dissolution of 20% was observed for different buffer solutions after 7 days. The stability regarding enzymatic and bacterial digestion showed less degradation in comparison to the self-assembling peptide hydrogel dissolution rate in buffer. The tested set of self-assembling peptide hydrogels were able to form stable scaffolds and provided a broad spectrum of tissue-specific stiffnesses that are suitable for a regenerative therapy.

Multiparameter toxicity assessment of novel DOPO-derived organophosphorus flame retardants

Halogen-free organophosphorus flame retardants are considered as replacements for the phased-out class of polybrominated diphenyl ethers (PBDEs). However, toxicological information on new flame retardants is still limited. Based on their excellent flame retardation potential, we have selected three novel 9,10-dihydro-9-oxa-10-phosphaphenanthrene-10-oxide (DOPO) derivatives and assessed their toxicological profile using a battery of in vitro test systems in order to provide toxicological information before their large-scale production and use. PBDE-99, applied as a reference compound, exhibited distinct neuro-selective cytotoxicity at concentrations ≥10 µM. 6-(2-((6-oxido-6H-dibenzo[c,e][1,2]oxaphosphinin-6-yl)amino)ethoxy)-6H-dibenzo[c,e][1,2]oxaphosphinine 6-oxide (ETA-DOPO) and 6,6′-(ethane-1,2-diylbis(oxy))bis(6H-dibenzo[c,e][1,2]oxaphosphinine-6-oxide) (EG-DOPO) displayed adverse effects at concentrations >10 µM in test systems reflecting the properties of human central and peripheral nervous system neurons, as well as in a set of non-neuronal cell types. DOPO and its derivative 6,6′-(ethane-1,2-diylbis(azanediyl))bis(6H-dibenzo[c,e][1,2]oxaphosphinine-6-oxide) (EDA-DOPO) were neither neurotoxic, nor did they exhibit an influence on neural crest cell migration, or on the integrity of human skin equivalents. The two compounds furthermore displayed no inflammatory activation potential, nor did they affect algae growth or daphnia viability at concentrations ≤400 µM. Based on the superior flame retardation properties, biophysical features suited for use in polyurethane foams, and low cytotoxicity of EDA-DOPO, our results suggest that it is a candidate for the replacement of currently applied flame retardants.

How accurate are Omron X-HJ-304-E and Yamax SW-700/701 pedometers at different speeds and various inclinations?

AIM

The purpose of this study was to investigate step count and energy expenditure accuracy of the piezoelectric Omron (Walking Style X-HJ-304-E) and spring-levered Yamax (Digi-Walker-SW-700/701) pedometers at different speeds and various inclinations.

METHODS

Thirty subjects (15 females, aged: 24 ± 3 years) completed eleven 5-min trials at different treadmill speeds and inclinations (3.24 km∙h⁻¹ [inclination: 0, 9, 20%], 4.68 km∙h⁻¹ [0, 9, 20%], 6.48 km∙h⁻¹ [0, 9%], 9 km∙h⁻¹ [0%], 10.8 km∙h⁻¹ [0%], 12.6 km∙h⁻¹ [0%]). During each trial, an investigator recorded actual steps with a hand tally counter. Actual energy expenditure was measured using a portable indirect calorimeter.

RESULTS

The Omron pedometer revealed high step count accuracy for all speeds and inclinations when worn on the hip or a backpack (Mean % of actual steps: 99.6%; Range: 95.8-101.3%). The Yamax pedometer revealed high step count accuracy (Mean % of actual steps: 99.8%; Range: 96.2-103.3%) when worn on the left hip at 6.48-12.6 km∙h⁻¹ (0%), 4.68 km∙h⁻¹ (9%, 20%), 6.48 km∙h⁻¹ (9%) and on the right hip at 10.8 km∙h⁻¹ (0%) and 6.48 km∙h⁻¹ (9%). The accuracy of the Omron and Yamax determined energy expenditure was poor (57.9-59.7%) when compared to indirect calorimetry.

CONCLUSION

The Omron pedometer provides accurate step counts when worn on the hip and backpack at all tested speeds and inclinations. We therefore suggest an accurate application of this device for walking, hiking and running at moderate speeds. Both pedometers underestimated energy expenditure.

Active vs. passive recovery during high-intensity training influences hormonal response

The aim of the present study was to compare the effects of active (A) vs. passive (P) recovery during high-intensity interval training on the acute hormonal and metabolic response. Twelve triathletes/cyclists performed four 4 min intervals on a cycle ergometer, either with A- or P-recovery between each bout. Testosterone, hGH, cortisol, VEGF, HGF and MIF were determined pre, 0', 30', 60' and 180' after both interventions. Metabolic perturbations were characterized by lactate, blood gas and spirometric analysis. A-recovery caused significant increases in circulating levels of cortisol, testosterone, T/C ratio, hGH, VEGF and HGF. Transient higher levels were found for cortisol, testosterone, hGH, VEGF, HGF and MIF after A-recovery compared to P-recovery, despite no differences in metabolic perturbations. A-recovery was more demanding from an athlete's point of view. Based on the data of testosterone, hGH and the T/C-ratio, as well as on the data of VEGF and HGF it appears that this kind of exercise protocol with A-recovery phases between the intervals may promote anabolic processes and may lead to pro-angiogenic conditions more than with P-recovery. These data support the findings that also the long term effects of both recovery modes seem to differ, and that both can induce specific adaptations.

Acute metabolic, hormonal, and psychological responses to different endurance training protocols

In the last years, mainly 2 high-intensity-training (HIT) protocols became common: first, a Wingate-based "all-out" protocol and second, a 4×4 min protocol. However, no direct comparison between these protocols exists, and also a comparison with high-volume-training (HVT) is missing. Therefore, the aim of the present study was to compare these 3 endurance training protocols on metabolic, hormonal, and psychological responses. Twelve subjects performed: 1) HVT [130 min at 55% peak power output (PPO)]; 2) 4×4 min at 95% PPO; 3) 4×30 s all-out. Human growth hormone (hGH), testosterone, and cortisol were determined before (pre) and 0', 30', 60', 180' after each intervention. Metabolic stimuli and perturbations were characterized by lactate, blood gas (pH, BE, HCO₃⁻, pO₂, PCO₂), and spirometric analysis. Furthermore, changes of the person's perceived physical state were determined. The 4×30 s training caused the highest increases in cortisol and hGH, followed by 4 × 4 min and HVT. Testosterone levels were significantly increased by all 3 exercise protocols. Metabolic stress was highest during and after 4×30 s, followed by 4×4 min and HVT. The 4×30 s training was also the most demanding intervention from an athlete's point of view. In conclusion, the results suggest that 4×30 s and 4×4 min promote anabolic processes more than HVT, due to higher increases of hGH, testosterone, and the T/C ratio. It can be speculated that the acute hormonal increase and the metabolic perturbations might play a positive role in optimizing training adaptation and in eliciting health benefits as it has been shown by previous long term training studies using similar exercise protocols.

Soft tissue volume augmentation by the use of collagen-based matrices in the dog mandible -- a histological analysis

OBJECTIVES

The aim was to test, whether or not soft tissue volume augmentation with a specifically designed collagen matrix (CM), leads to ridge width gain in chronic ridge defects similar to those obtained by an autogenous subepithelial connective tissue graft (SCTG).

MATERIAL AND METHODS

In six dogs, soft tissue volume augmentation was performed by randomly allocating three treatment modalities to chronic ridge defects [CM, SCTG and sham-operated control (Control)]. Dogs were sacrificed at 28 (n = 3) and 84 days (n = 3). Descriptive histology and histomorphometric measurements were performed on non-decalcified sections.

RESULTS

SCTG and CM demonstrated favourable tissue integration, and subsequent re-modelling over 84 days. The overall mean amount of newly formed soft tissue (NMT) plus bone (NB) amounted to 3.8 ± 1.2 mm (Control), 6.4 ± 0.9 mm (CM) and 7.2 ± 1.2 mm (SCTG) at 28 days. At 84 days, the mean NMT plus NB reached 2.4 ± 0.9 mm (Control), 5.6 ± 1.5 mm (CM) and 6.0 ± 2.1 mm (SCTG). Statistically significant differences were observed between CM/SCTG and Control at both time-points (p < 0.05).

CONCLUSION

Within the limits of this animal model, the CM performed similar to the SCTG, based on histomorphometric outcomes combining NB and NMT.

Cytologic and DNA-cytometric early diagnosis of oral cancer

OBJECTIVE

The aim of this prospective study was to report on the diagnostic accuracy of conventional oral exfoliative cytology taken from white-spotted, ulcerated or other suspicious oral lesions in our clinic. In addition we checked DNA-image cytometry as an adjuvant diagnostic tool. Our hypothesis is that DNA-aneuploidy is a sensitive and specific marker for the early identification of tumor cells in oral brushings.

STUDY DESIGN

251 cytological diagnoses obtained from exfoliative smears of 181 patients from macroscopically suspicious lesions of the oral mucosa and from clinically seemingly benign oral lesions which were excised for establishing histological diagnoses were compared with histological and/or clinical follow-ups of the respective patients. Additionally nuclear DNA-contents were measured after Feulgen restaining using a TV image analysis system.

RESULTS

Sensitivity of our cytological diagnosis on oral smears for the detection of cancer cells was 94.6%, specificity 99.5%, positive predictive value 98.1% and negative predictive value 98.5%. DNA-aneuploidy was assumed if abnormal DNA-stemlines or cells with DNA-content greater 9c were observed. On this basis the prevalence of DNA-aneuploidy in smears of oral squamous cell carcinomas in situ or invasive carcinomas was 96.4%. Sensitivity of DNA-aneuploidy in oral smears for the detection of cancer cells was 96.4%, specificity 100%, positive predictive value 100% and negative 99.0%. The combination of both techniques increased the sensitivity to 98.2%, specificity to 100%, positive predictive value to 100% and negative to 99.5%.

CONCLUSIONS

Brush cytology of all visible oral lesions, if they are clinically considered as suspicious for cancer, are an easily practicable, cheap, non-invasive, painless, safe and accurate screening method for detection of oral precancerous lesions, carcinoma in situ or invasive squamous cell carcinoma in all stages. We conclude that DNA-image cytometry is a very sensitive, highly specific and objective adjuvant tool for the early identification of neoplastic epithelial cells in oral smears.

Exhaustive soxhlet extraction for the complete removal of residual compounds to provide a nonleaching silicone elastomer

All commercially available silicone devices contain freely diffusible silicone oils, uncured oligomers, and other impurities (such as catalysts). These residuals have been found in quantities as high as 20% by weight in commercially available silicone medical devices. The fate and effects of these residuals have been the topic of much debate recently. In this study, a method for complete removal of these residual compounds was investigated. The total amount of extractable residuals was determined through exhaustive Soxhlet extraction of 5 silicone elastomers. LIM 6030 had 6.29%, LIM 6070 had 5.74%, Q7-4750 had 3.02%, Q7-4780 had 3.22%, and SE1935 had 0.13% extractables by weight. The amount of silicon containing residuals leaching from both the extracted and nonextracted samples was also evaluated for 3 and 18 days by inductively coiled plasma (ICP) analysis. A significant amount of leachable compounds, reported as microg Si/mg solid sample, was found in all nonextracted elastomers with the exception of SE1935 compared to blanks. The amount of leachable compounds found in the extracted elastomers was not found to be significantly higher than the amount found in the blanks. The residual compounds in silicone elastomers may be completely removed by exhaustive Soxhlet extraction and the resulting polymer does not leach silicon-containing compounds in vitro.

Projection on projective techniques = pathology: the problem that is not being addressed

A replication of the "levels effect" and reported correlation of "projection" and "pathology" was undertaken using a selected set of Thematic Apperception Test (Murray, 1943) cards varied for ambiguity and scored for pathology and projection. The levels effect was not found for pathology in either a normal or psychiatric group, but was found for projection in the normal group. The correlation between projection and pathology was again clearly confirmed. It was concluded that failure to take into consideration the stimulus properties of the cards and the context in which the test was administered may lead to false attribution of pathology to normal test-takers.

[Complications of allogeneic microsurgical transplantation of a limb (composite tissue), in rats]

PURPOSE

To analyze the composite tissue vascularized allotransplantation post operative complications and to identify factors associated with agents toxicity.

METHOD

The study was done across a strong histocompatibility barrier using 39 Brown-Norway rats as donors and 78 Fischer 344 as hindlimb allotransplantation recipients treated with cyclosporine and RS-61443.

RESULTS

1 (1/78: 1.28%) was eliminated owing to thrombosis; 2 (2/78: 2.56%) owing to enteritis; 1 (1/78: 1.28%) owing to autophagia and 8 (8/78: 10.42%) died owing to undiscovered cause.

CONCLUSION

Among 78 (78/78: 100%) rat limb vascularized allotransplantations, 12 (15.5%) rats died or were eliminated because of acute postoperative complications that were not related to rejection, to immunosuppressive toxicity or to opportunistic infection.

TRAM Flap Breast Reconstruction

The transverse rectus abdominus musculocutaneous flap, or TRAM flap, has revolutionized the plastic and reconstructive surgeon's approach to breast reconstruction. Since its first clinical description by Hartrampf, Schellan, and Black in 1982, the TRAM flap has become today's standard for autogenous tissue breast reconstruction. In light of the recent controversy regarding silicone breast implants, the use of autogenous tissue for breast reconstruction has become even more popular. It is the wide belief of most plastic and reconstructive surgeons that, by using autogenous tissue, the reconstructed breast has a more natural shape and contour. Furthermore, patient satisfaction is extremely high and problems inherent with implants, such as capsular contracture, are avoided. With newer technology and a stronger emphasis on self-examination and routine mammographic screening, breast cancer is currently being detected at earlier stages. Because of this, more and more women with diagnosed breast cancer are undergoing breast conserving surgery and radiotherapy. Patients with larger tumors, in more advanced stages, often require a more extensive operation, namely a modified radical mastectomy. The TRAM flap, in an immediate or delayed setting, is an ideal technique for the reconstruction of a modified radical mastectomy defect. We at the Breast Care Center of Mount Zion Medical Center of U.C. San Francisco are extremely pleased with the results of immediate breast reconstruction using the TRAM flap techniques.

Influence of performance setting, experience and difficulty of routine on precompetition anxiety and self-confidence of high school female gymnasts

This study examined changes in cognitive anxiety, somatic anxiety, and self-confidence as measured by the Competitive State Anxiety Inventory-2 in a sample of 50 female high school gymnasts prior to their performances at a practice session, dual meet, and district championship meet. The purpose of the study was to examine (1) the relationship between state anxiety and performance setting, (2) experience, and (3) difficulty of the movement task. Analysis showed that at the dual meet athletes experienced significantly greater cognitive and somatic anxiety and lower self-confidence than at the practice or district championship. State anxiety did not vary significantly with the athletes' over-all experience or the difficulty of the routines they performed. The unexpected finding that the dual meet was the most anxiety-provoking was attributed to the greater uncertainty of outcome in a competition and the fact that the dual meet occurred early in the season.

A study of the relationship between blood flow and bacterial inoculation in musculocutaneous and fasciocutaneous flaps

Regional nutrient blood flow to musculocutaneous and fasciocutaneous flaps was studied in dogs using 15-microns radiolabeled microspheres, and correlations to bacterial inoculation into closed wound spaces were sought. During the 6-day study period, no differences were found between blood flow to noinoculated versus inoculated flaps. Comparisons of blood flow to the deep surfaces of the flaps showed that blood flow to muscle in musculocutaneous flaps increased rapidly during the first 24 hours and then plateaued, while that to subcutaneous tissue plus fascia in fasciocutaneous flaps demonstrated a gradual and steady increase. The most rapid decline in bacterial counts at the undersurface of both flaps occurred within 24 hours, dropping significantly lower within musculocutaneous flaps. In addition to such surface properties of muscle as tissue ingrowth, rapid early augmentation of muscle blood flow may be largely responsible for superior bacterial suppression observed beneath musculocutaneous flaps.