Change in pain severity with open label venlafaxine use in patients with a depressive symptomatology: an observational study in primary care

PURPOSE: Venlafaxine has shown benefit in the treatment of depression and pain. Worldwide data are extensively lacking investigating the outcome of chronic pain patients with depressive symptoms treated by venlafaxine in the primary care setting. This observational study aimed to elucidate the efficacy of venlafaxine and its prescription by Swiss primary care physicians and psychiatrists in patients with chronic pain and depressive symptomatology. SUBJECTS AND METHODS: We studied 505 patients with depressive symptoms suffering from chronic pain in a prospective naturalistic Swiss community based observational trial with venlafaxine in primary care. These patients have been treated with venlafaxine by 122 physicians, namely psychiatrists, general practitioners, and internists. RESULTS: On average, patients were treated with 143+/-75 mg (0-450 mg) venlafaxine daily for a follow-up of three months. Venlafaxine proved to be beneficial in the treatment of both depressive symptoms and chronic pain. DISCUSSION: Although side effects were absent in most patients, physicians might have frequently omitted satisfactory response rate of depression by underdosing venlafaxine. Our results reflect the complexity in the treatment of chronic pain in patients with depressive symptoms in primary care. CONCLUSION: Further randomized dose-finding studies are needed to learn more about the appropriate dosage in treating depression and comorbid pain with venlafaxine.

On-chip non-invasive and label-free cell discrimination by impedance spectroscopy

OBJECTIVES: Many flow-cytometric cell characterization methods require costly markers and colour reagents. We present here a novel device for cell discrimination based on impedance measurement of electrical cell properties in a microfluidic chip, without the need of extensive sample preparation steps and the requirement of labelling dyes. MATERIALS AND METHODS, RESULTS: We demonstrate that in-flow single cell measurements in our microchip allow for discrimination of various cell line types, such as undifferentiated mouse fibroblasts 3T3-L1 and adipocytes on the one hand, or human monocytes and in vitro differentiated dendritic cells and macrophages on the other hand. In addition, viability and apoptosis analyses were carried out successfully for Jurkat cell models. Studies on several species, including bacteria or fungi, demonstrate not only the capability to enumerate these cells, but also show that even other microbiological life cycle phases can be visualized. CONCLUSIONS: These results underline the potential of impedance spectroscopy flow cytometry as a valuable complement to other known cytometers and cell detection systems.

Finnish Fighting Words: Printing the Työmies Translation Project

The Työmies translation project involves the translation of that newspaper’s accounts of significant events from Michigan’s 1913-1914 Copper Strike. Työmies was a Finnish-language newspaper, published in Hancock, Michigan, whose socialist-unionist perspective on the strike differed markedly from that of the local English-language newspapers. This project is the first time significant portions of Työmies have been translated into English. In June of 2013, the presenter printed the translation of the Työmies account of the strike’s first day on a hand-operated Chandler & Price platen press. Thus, the presentation describes this unique project: the translation itself, the presenter’s search for necessary type and equipment, and the printing of the broadsides. The presentation will include a history of Työmies and the Strike, with an emphasis on ways in which human culture and language is reflected in the material culture of printing.

CRITERIA FOR SUSTAINABLE PRODUCT DESIGN WITH 3D PRINTING IN THE DEVELOPING WORLD

The demand for consumer goods in the developing world continues to rise as populations and economies grow. As designers, manufacturers, and consumers look for ways to address this growing demand, many are considering the possibilities of 3D printing. Due to 3D printing’s flexibility and relative mobility, it is speculated that 3D printing could help to meet the growing demands of the developing world. While the merits and challenges of distributed manufacturing with 3D printing have been presented, little work has been done to determine the types of products that would be appropriate for such manufacturing. Inspired by the author’s two years of Peace Corps service in the Tanzania and the need for specialty equipment for various projects during that time, an in-depth literature search is undertaken to better understand and summarize the process and capabilities of 3D printing. Human-centered design considerations are developed to focus on the product desirability, the technical feasibility, and the financial viability of using 3D printing within Tanzania. Beginning with concerns of what Tanzanian consumers desire, many concerns later arise in regards to the feasibility of creating products that would be sufficient in strength and quality for the demands of developing world consumers. It is only after these concerns are addressed that the viability of products can be evaluated from an economic perspective. The larger impacts of a product beyond its use are vital in determining how it will affect the social, economic, and environmental well-being of a developing nation such as Tanzania. Thus technology specific criteria are necessary for assessing and quantifying the broader impacts that a 3D-printed product can have within its ecosystem, and appropriate criteria are developed for this purpose. Both sets of criteria are then demonstrated and tested while evaluating the desirability, feasibility, viability, and sustainability of printing a piece of equipment required for the author’s Peace Corps service: a set of Vernier calipers. Required for science educators throughout the country, specialty equipment such as calipers initially appear to be an ideal candidate for 3D printing, though ultimately the printing of calipers is not recommended due to current restrictions in the technology. By examining more specific challenges and opportunities of the products 3D printing can produce, it can be better determined what place 3D printing will have in manufacturing for the developing world. Furthermore, the considerations outlined in this paper could be adapted for other manufacturing technologies and regions of the world, as human centered design and sustainability will be critical in determining how to supply the developing world with the consumer goods it demands.

Liraglutide once a day versus exenatide twice a day for type 2 diabetes: a 26-week randomised, parallel-group, multinational, open-label trial (LEAD-6)

BACKGROUND: Unlike most antihyperglycaemic drugs, glucagon-like peptide-1 (GLP-1) receptor agonists have a glucose-dependent action and promote weight loss. We compared the efficacy and safety of liraglutide, a human GLP-1 analogue, with exenatide, an exendin-based GLP-1 receptor agonist. METHODS: Adults with inadequately controlled type 2 diabetes on maximally tolerated doses of metformin, sulphonylurea, or both, were stratified by previous oral antidiabetic therapy and randomly assigned to receive additional liraglutide 1.8 mg once a day (n=233) or exenatide 10 microg twice a day (n=231) in a 26-week open-label, parallel-group, multinational (15 countries) study. The primary outcome was change in glycosylated haemoglobin (HbA(1c)). Efficacy analyses were by intention to treat. The trial is registered with ClinicalTrials.gov, number NCT00518882. FINDINGS: Mean baseline HbA(1c) for the study population was 8.2%. Liraglutide reduced mean HbA(1c) significantly more than did exenatide (-1.12% [SE 0.08] vs -0.79% [0.08]; estimated treatment difference -0.33; 95% CI -0.47 to -0.18; p<0.0001) and more patients achieved a HbA(1c) value of less than 7% (54%vs 43%, respectively; odds ratio 2.02; 95% CI 1.31 to 3.11; p=0.0015). Liraglutide reduced mean fasting plasma glucose more than did exenatide (-1.61 mmol/L [SE 0.20] vs -0.60 mmol/L [0.20]; estimated treatment difference -1.01 mmol/L; 95% CI -1.37 to -0.65; p<0.0001) but postprandial glucose control was less effective after breakfast and dinner. Both drugs promoted similar weight losses (liraglutide -3.24 kg vs exenatide -2.87 kg). Both drugs were well tolerated, but nausea was less persistent (estimated treatment rate ratio 0.448, p<0.0001) and minor hypoglycaemia less frequent with liraglutide than with exenatide (1.93 vs 2.60 events per patient per year; rate ratio 0.55; 95% CI 0.34 to 0.88; p=0.0131; 25.5%vs 33.6% had minor hypoglycaemia). Two patients taking both exenatide and a sulphonylurea had a major hypoglycaemic episode. INTERPRETATION: Liraglutide once a day provided significantly greater improvements in glycaemic control than did exenatide twice a day, and was generally better tolerated. The results suggest that liraglutide might be a treatment option for type 2 diabetes, especially when weight loss and risk of hypoglycaemia are major considerations.

3D-Printing mit der PolyJet-Technologie von Objet

Objet Geometries Ltd entwickelt und produziert Rapid Prototyping Systeme und Materialien auf Basis der Polyjet-Technologie und bietet diese im internationalen Markt an. Objet ist der „Pionier“ in der Entwicklung der Polyjet-Technologie zur schnellen Erstellung von hochwertigen Modellen aus den 3D-Daten der Design- und CAx-Systeme. Die Oberflächenqualität, die schnelle Reinigung des Supportmaterials mit Hilfe eines Wasserstrahls, die Bauteilqualität hinsichtlich der Genauigkeit sowie die einfache Bedienung der Systeme zu einem hervorragenden Preis/Leistungsverhältnis zeichnen Objet als Marktführer dieser Technologie aus. Die Systeme von Objet sind insbesondere für den Anwender in Design und Engineering konzipiert und können in einer Büroumgebung betrieben werden. Die verwendeten Materialien sind für den Anwender ohne jegliche Gefahr einsetzbar und sind von einem deutschen Institut mit entsprechenden Zertifikaten dokumentiert. Die Produktlinie von Objet ermöglicht im Design und Engineering die Zeiten in der Produktentwicklung erheblich zu reduzieren. Kunden von Objet sind in Nordamerika, Europa, Asien und Australien zu finden, viele von ihnen sind bedeutende Unternehmen aus den Märkten Automobilindustrie, Elektronik/Elektrotechnik, Spielwaren, Medizin, Konsumerprodukte, Schuhindustrie, Schmuckindustrie und vielen anderen Branchen. Objet wurde 1998 gegründet und befindet sich im privaten Besitz. Das Unternehmen wird von Investoren wie der Scitex Corporation sowie von weiteren privaten Investoren, Unternehmer-Kapitalfonden and Kooperationen in USA, Japan, Europa und Israel unterstützt. Aus Wettbewerbsgründen werden Unternehmenszahlen derzeit nicht öffentlich zur Verfügung gestellt. Das Unternehmen beschäftigt zur Zeit weltweit ca. 75 Mitarbeiter und verfügt über eigene Vertriebs- und Servicecenter in den USA und Europa, sowie Vertriebspartnern in der ganzen Welt. Seit Mitte 2001 wurden über 170 Systeme weltweit vermarktet und installiert. Der Vortrag anlässlich der RapidTech wird diese noch recht „junge“ Technologie, deren Vorteile für den Anwender sowie die möglichen Applikationen an Hand von konkreten Beispielen im Detail erläutern.

3D printing and its applications

Eine zunehmende Anzahl von Artikeln in Publikumszeitschriften und Journalen rückt die direkte Herstellung von Bauteilen und Figuren immer mehr in das Bewusstsein einer breiten Öffentlichkeit. Leider ergibt sich nur selten ein einigermaßen vollständiges Bild davon, wie und in welchen Lebensbereichen diese Techniken unseren Alltag verändern werden. Das liegt auch daran, dass die meisten Artikel sehr technisch geprägt sind und sich nur punktuell auf Beispiele stützen. Dieser Beitrag geht von den Bedürfnissen der Menschen aus, wie sie z.B. in der Maslow’schen Bedürfnispyramide strukturiert dargestellt sind und unterstreicht dadurch, dass 3D Printing (oder Additive Manufacturing resp. Rapid Prototyping) bereits alle Lebensbereiche erfasst hat und im Begriff ist, viele davon zu revolutionieren.