Orexin receptor antagonism, a new sleep-enabling paradigm: a proof-of-concept clinical trial

The orexin system is a key regulator of sleep and wakefulness. In a multicenter, double-blind, randomized, placebo-controlled, two-way crossover study, 161 primary insomnia patients received either the dual orexin receptor antagonist almorexant, at 400, 200, 100, or 50 mg in consecutive stages, or placebo on treatment nights at 1-week intervals. The primary end point was sleep efficiency (SE) measured by polysomnography; secondary end points were objective latency to persistent sleep (LPS), wake after sleep onset (WASO), safety, and tolerability. Dose-dependent almorexant effects were observed on SE , LPS , and WASO . SE improved significantly after almorexant 400 mg vs. placebo (mean treatment effect 14.4%; P < 0.001). LPS (–18 min (P = 0.02)) and WASO (–54 min (P < 0.001)) decreased significantly at 400 mg vs. placebo. Adverse-event incidence was dose-related. Almorexant consistently and dose-dependently improved sleep variables. The orexin system may offer a new treatment approach for primary insomnia.

Ethnosciences - A step towards the integration of scientific and non-scientific forms of knowledge in the management of natural resources for the future

Integration of indigenous knowledge and ethnoscientific approaches into contemporary frameworks for conservation and sustainable management of natural resources will become increasingly important in policies on an international and national level. We set the scene on how this can be done by exploring the key conditions and dimensions of a dialogue between ‘ontologies’ and the roles, which ethnosciences could play in this process. First, the roles which ethnosciences in the context of sustainable development were analysed, placing emphasis on the implications arising when western sciences aspire to relate to indigenous forms of knowledge. Secondly, the contributions of ethnosciences to such an ‘inter-ontological dialogue’ were explored, based on an ethnoecological study of the encounter of sciences and indigenous knowledge in the Andes of Bolivia, and reviewed experiences from mangrove systems in Kenya, India and Sri Lanka, and from case-studies in other ecosystems world-wide.

One-year outcomes of repeated adjunctive photodynamic therapy during periodontal maintenance: a proof-of-principle randomized-controlled clinical trial

BACKGROUND: Single photodynamic therapy (PDT) has been effective in initial periodontal therapy, but only improved bleeding on probing (BoP) in maintenance patients after a single use. Repeated PDT has not been addressed. OBJECTIVES: To study the possible added benefits of repeated adjunctive PDT to conventional treatment of residual pockets in patients enrolled in periodontal maintenance. MATERIAL AND METHODS: Ten maintenance patients with 70 residual pockets [probing pocket depth (PPD)>or=5 mm] were randomly assigned for treatment five times in 2 weeks (Days 0, 1, 2, 7, 14) with PDT (test) or non-activated laser (control) following debridement. The primary outcome variable was PPD, and the secondary variables were clinical attachment level (CAL) and BoP. These were assessed at 3, 6 and 12 months following the interventions. RESULTS: Greater PPD reductions were observed in the test (-0.67 +/- 0.34; p=0.01) compared with the control patients (-0.04 +/- 0.33; NS) after 6 months. Significant CAL gain (+0.52 +/- 0.31; p=0.01) was noted for the test, but not in the control (-0.27 +/- 0.52; NS) patients after 6 months. BoP percentages decreased significantly in test (97-64%, 67%, 77%), but not control patients after 3, 6 and 12 months. CONCLUSIONS: Repeated (five times) PDT adjunctive to debridement yielded improved clinical outcomes in residual pockets in maintenance patients. The effects were best documented after 6 months.

Repigmentation by outer-root-sheath-derived melanocytes: proof of concept in vitiligo and leucoderma

BACKGROUND: Treatment of depigmented skin is an unmet medical need. OBJECTIVE: Melanocytes or stem cells thereof residing in the outer root sheath (ORS) of hair follicles might be used to repigment skin. METHODS: After de-epidermisation, autologous ORS cell solutions were applied to 5 patients with vitiligo and 1 with leucoderma. RESULTS: Stable repigmentation in a variable percentage was documented in all the patients. CONCLUSION: Applying ORS-derived melanocytes is a promising technology to improve autologous melanocyte transplantation.

Transdisciplinary co-production of knowledge in the development of organic agriculture in Switzerland

The present study analyses transdisciplinary co-production of knowledge in the development of organic farming in Switzerland by using Fleck's theory of thought styles and thought collectives. Three different phases can be identified throughout the historical development. The initial phase lasting from the beginning of the 1920s to the early 1970s contains numerous characteristics of diverse well-established definitions and concepts of transdisciplinarity and represents a successful transdisciplinary process, which has not been perceived as such in the past and present scientific discussion. The second and third phases show an increasing segregation of thought collectives, caused by internal changes such as the establishment of specialised research institutions and external processes like agriculture policy and market development. These developments led to a decreasing degree of transdisciplinarity. We observe an ambiguous trend: the continuously growing and today well-established positive societal recognition of an initially rather little accepted newcomer movement is associated with the gradual loss of its very valuable forms of knowledge co-production and the related philosophical background. In order to maintain the various forms of transdisciplinary co-production of knowledge, one has to reflect not only their results or outcome but also the whole cooperation process, which has led to these results. The understanding of the historical development and characteristic features of knowledge co-production as presented in this study will help to reinforce transdisciplinary research in organic agriculture and research on transdisciplinarity in general.