Dynamic Interactive Social Cognition Training in Virtual Reality (DiSCoVR) versus Virtual Reality Relaxation (VRelax) for People With a Psychotic Disorder: A Single-Blind Multicenter Randomized Controlled Trial.

BACKGROUND AND HYPOTHESIS: Social cognition training (SCT), an intervention for social cognition and social functioning, might be improved by using virtual reality (VR), because VR may offer better opportunities to practice in a potentially more realistic environment. To date, no controlled studies have investigated VR-SCT. This study investigated a VR-SCT, "DiSCoVR". We hypothesized that DiSCoVR would improve social cognition and social functioning. STUDY DESIGN: Participants were randomized to DiSCoVR (n = 41) or VR relaxation ('VRelax', n = 40), an active control condition, and completed 16 twice-weekly sessions. Three assessments (baseline, posttreatment, and 3-month follow-up) were performed by blinded assessors. The primary outcome was social cognition (emotion perception and theory of mind). Secondary outcomes included social functioning (measured with an interview and experience sampling), psychiatric symptoms, information processing, and self-esteem. Data were analyzed using mixed-models regression analysis. Treatment effects were evaluated by the time by condition interaction terms. STUDY RESULTS: No significant time by condition interactions were found for any of the outcome variables, indicating an absence of treatment effects. Between-group effect sizes ranged from negligible to moderate (Cohen's d < |0.53|). Main effects of time were found for several outcomes. CONCLUSIONS: These results suggest that DiSCoVR was not effective, possibly because of inadequate simulation of emotional expressions in VR. This lack of efficacy may indicate that current SCT protocols are relatively unsuitable for improving social functioning. Previous studies showed small to moderate effects on higher order social cognition, but the SCT approach may need critical reevaluation, as it may not sufficiently lead to functional improvement.

Operative treatment of acute Achilles tendon rupture: Open end-to-end-reconstruction versus reconstruction with Mitek-anchors.

PURPOSE: To retrospectively compare the open end-to-end repair versus repair using the Mitek-anchor system in acute Achilles tendon rupture. METHOD: Forty-seven consecutive patients with Achilles tendon rupture, all operated on between 2004 and 2005, were included. Their medical records were reviewed and they were interviewed for surveillance of post-operative function at follow-up. Functional outcome was determined using an adapted VISA tendinopathy questionnaire and by testing the isometric ankle plantar flexion strength. Post-operative complications and recurrence rate of rupture were noted. RESULTS: Seven patients were lost to follow-up. From a total of 40 patients, twenty-eight (68% of total) underwent classic repair and 12 (32%) were treated by the Mitek-anchor system. Median age was 43 years (range 29-63). Median post-operative follow-up was 29 months (range 17-40). Median time to resume work was nine weeks in the classic group versus 12 weeks in the Mitek-group. Median time to resume sports was 19 versus 31 weeks respectively. Wound infections occurred in five percent of the total (one in each group) and rupture recurrence rate was three percent of the total (nil in classic group, one in Mitek-group). Loss of strength in the injured leg compared to the non-injured leg was greater in the Mitek-group than in the classic group. CONCLUSION: We conclude that in comparing classical end-to-end repair of acute Achilles tendon ruptures with repair using Mitek-anchors, it took patients in the Mitek-group longer to return to work and sport activities than in the classic group. Greater loss of strength in the injured leg was seen in the Mitek-group. Therefore we do not advocate the use of Mitek-anchors for the repair of acute ruptured Achilles tendons.

Deficiency of nitric oxide in allergen-induced airway hyperreactivity to contractile agonists after the early asthmatic reaction: an ex vivo study.

1. Using a guinea-pig model of allergic asthma, we investigated the role of nitric oxide (NO) in allergen-induced airway hyperreactivity after the early asthmatic reaction, by examining the effects of the NO-synthase inhibitor N omega-nitro-L-arginine methyl ester (L-NAME) on the responsiveness to methacholine and histamine of isolated perfused tracheae from unchallenged (control) animals and from animals 6 h after ovalbumin challenge. 2. All animals developed airway hyperreactivity to inhaled histamine at 6 h after ovalbumin challenge, with a mean 3.11 +/- 0.45 fold increase in sensitivity to the agonist (P < 0.001). 3. In perfused tracheal preparations from the ovalbumin-challenged guinea-pigs, the maximal responses (Emax) to methacholine and histamine were significantly enhanced compared to controls, both after intraluminal (IL) and extraluminal (EL) administration of the contractile agonists. In addition, a small but significant increase in the pD2 (-log10 EC50) for IL and EL methacholine and for IL histamine was observed. As a consequence, the delta pD2 (EL-IL) for histamine was slightly decreased from 1.67 +/- 0.13 to 1.23 +/- 0.14 (P < 0.05). However, the delta pD2 for methacholine was unchanged (1.85 +/- 0.11 and 1.77 +/- 0.12, respectively; NS). 4. Incubation of control tracheae with 100 microM L-NAME (IL) significantly enhanced the Emax for both IL and EL methacholine and histamine to approximately the same degree as observed after ovalbumin challenge, with no effect on the pD2 and delta pD2 for both agonists. On the contrary, L-NAME had no effect on Emax and pD2 values of tracheal preparations from ovalbumin-challenged guinea-pigs. 5. L-NAME (10 microM-1 mM) had no effect on methacholine-induced contraction of isolated tracheal strip preparations obtained from control animals, indicating that L-NAME has no antimuscarinic effect on tracheal smooth muscle. 6. Histological examination of the intact tracheal preparations indicated epithelial and subepithelial infiltration of eosinophils after ovalbumin challenge. However, no apparent damage of the airway epithelium was observed in these preparations. 7. The results indicate that a deficiency of NO contributes to allergen-induced airway hyperreactivity after the early asthmatic reaction and that this deficiency appears not to be due to epithelial shedding.

A poly(HEMA) sponge for restoration of articular cartilage defects.

The properties of poly(HEMA) sponges have been studied after implantation in the weight-bearing articular surfaces of young and adult rabbit knees. Only sponges with small pores (less than 50 micrometer) were able to withstand weight-bearing. After 12 weeks, the implants were overgrown by cartilaginous or fibrocartilaginous tissue, and the ingrowth of chondroid tissue into the sponges was observed.

Improved cements containing phosphate polymers.

The mechanical properties of two commercially available dental cements, a zinc phosphate cement and a carboxylate cement, were substantially improved by adding a polymeric phosphate acid to the cement liquids. The improvements can be explained in terms of the change in physico-chemical nature of the modified cements.

Analysis and purification of 2-hydroxyethyl methacrylate by means of thin-layer chromatography.

Poly(2-hydroxyethyl methacrylate) is nowadays accepted as a biocompatible, safe and stable hydrogel for medical use. In this paper, the use of thin-layer chromatography for the analysis and small-scale preparation of the initial monomer, 2-hydroxyethyl methacrylate, is described. Development on silica gel, with n-hexane-diethyl ether (1:1, v/v) and/or n-hexane-isobutyl methyl ketone-n-octanol (9:2:1, v/v; saturated with 25% nitric acid) is recommended for qualitative analysis. Preparative-scale work is preferably carried out on sulphuric acid-impregnated silica gel, with n-hexane-diethyl ether (1:1, v/v) as mobile phase. Inhibitors are detected by thin-layer chromatography and a drop-test procedure with diazotised sulphanilic acid. The nature of the contaminants present in several commercial samples of 2-hydroxyethyl methacrylate is discussed. n20D values are reported for the system 2-hydroxyethyl methacrylate-water.