Chondrocyte Isolation from Loose Bodies-An Option for Reducing Donor Site Morbidity for Autologous Chondrocyte Implantation.

Loose bodies (LBs) from patients with osteochondritis dissecans (OCD) are usually removed and discarded during surgical treatment of the defect. In this study, we address the question of whether these LBs contain sufficient viable and functional chondrocytes that could serve as a source for autologous chondrocyte implantation (ACI) and how the required prolonged in vitro expansion affects their phenotype. Chondrocytes were isolated from LBs of 18 patients and compared with control chondrocyte from non-weight-bearing joint regions (n = 7) and bone marrow mesenchymal stromal cells (BMSCs, n = 6) obtained during primary arthroplasty. No significant differences in the initial cell yield per isolation and the expression of the chondrocyte progenitor cell markers CD44 + /CD146+ were found between chondrocyte populations from LBs (LB-CH) and control patients (Ctrl-CH). During long-term expansion, LB-CH exhibited comparable viability and proliferation rates to control cells and no ultimate cell cycle arrest was observed within 12 passages respectively 15.3 ± 1.1 mean cumulative populations doublings (CPD). The chondrogenic differentiation potential was comparable between LB-CH and Ctrl-CH, but both groups showed a significantly higher ability to form a hyaline cartilage matrix in vitro than BMSC. Our data suggest that LBs are a promising cell source for obtaining qualitatively and quantitatively suitable chondrocytes for therapeutic applications, thereby circumventing donor site morbidity as a consequence of the biopsies required for the current ACI procedure.

Digital age and the Public eHealth perspective: Prevailing health app use among Austrian Internet users.

New technological developments affect almost every sector of our daily lives including the healthcare sector. Successful adoption and sustainable integration of eHealth and telemedicine in Public Health strategies (also known as Public eHealth) depend on knowledge and constant evaluation of consumers' needs, proficiencies, and preferences. We therefore assessed how the general Austrian population perceived innovative Public eHealth solutions. The online survey on 562 Austrian adults (58.9% females) collected self-reported data on current and expected use of smartphone-based health applications (apps) of digital natives (35 years and younger) and digital immigrants (aged 35+). In total, 26.7% (95% CI 23.0-30.4) of participants already used health apps, especially lifestyle-associated apps for monitoring exercise habits and nutritional habits. We found substantial digital age group differences; compared to digital immigrants digital natives were more likely to use mobile devices and health apps. Health apps have the potential to improve community health and prevent lifestyle diseases cost-effectively and efficiently, and thus build an important pillar of Public eHealth. With regard to aging societies, healthcare providers could take advantage of consumer-oriented health apps by assessing individual needs of specific target groups such as elderly people.

Digital Natives Versus Digital Immigrants: Influence of Online Health Information Seeking on the Doctor-Patient Relationship.

Ubiquitous Internet access currently revolutionizes the way people acquire information by creating a complex, worldwide information network. The impact of Internet use on the doctor-patient relationship is a moving target that varies across sociodemographic strata and nations. To increase scientific knowledge on the patient-Web-physician triangle in Austria, this study reports findings regarding prevailing online health information-seeking behavior and the respective impact on doctor-patient interactions among a nonprobability convenience sample of Internet users. To investigate digital age group-specific influences, we analyzed whether digital natives and digital immigrants differed in their perspectives. The questionnaire-based online survey collected sociodemographic data and online health information-seeking behavior from a sample of 562 respondents (59% females, mean age 37 ± 15 years, 54% digital natives). Most respondents (79%) referred to the Internet to seek health information, making it the most commonly used source for health information, even more prevalent then the doctor. We found similar predictors for using the Internet as a source for health-related information across digital age groups. Thus, the overall generational gap seems to be small among regular Internet users in Austria. However, study participants expressed a rather skeptical attitude toward electronic exchange of health data between health care professionals and patients, as well as toward reliability of online health information. To improve adoption of electronic doctor-patient communication and patient empowerment, public education and awareness programs are required to promote consumer-centered health care provision and patient empowerment.

Prevailing Opinions on Connected Health in Austria: Results from an Online Survey.

New technological developments affect almost every sector of our daily lives, including the healthcare sector. We evaluated how connected health applications, subsumed as eHealth and telemedicine, are perceived in relation to socio-demographic characteristics. The current cross-sectional, online survey collected self-reported data from a non-probability convenience sample of 562 Austrian adults (58.9% females). The concept of eHealth and telemedicine was poorly established among the study population. While most participants already used mobile devices, they expressed a quite low desirability of using various telemedicine applications in the future. Study participants perceived that the most important overall benefits for implementing connected health technology were better quality of healthcare, location-independent access to healthcare services, and better quality of life. The respective three top-ranked overall barriers were data security, lack of acceptance by doctors, and lack of technical prerequisites. With regard to aging societies, healthcare providers, and users alike could take advantage of inexpensive, consumer-oriented connected health solutions that address individual needs of specific target groups. The present survey identified issues relevant for successful implementation of ICT-based healthcare solutions, providing a compilation of several areas requiring further in-depth research.

beta-Catenin and TGFbeta signalling cooperate to maintain a mesenchymal phenotype after FosER-induced epithelial to mesenchymal transition.

Several signalling pathways contribute to the regulation of epithelial to mesenchymal transition (EMT), either during developmentally regulated processes or in cancer progression and metastasis. Induction of EMT in fully polarized mouse mammary epithelial cells (EpH4) by an inducible c-fos estrogen receptor (FosER) oncoprotein involves loss of E-cadherin expression, nuclear translocation of beta-catenin, and autocrine production of TGFbeta. Reporter assays demonstrate that both beta-catenin/LEF-TCF- and TGFbeta-Smad-dependent signalling activities are upregulated, probably coregulating mesenchymal-specific gene expression during EMT. Stable expression of E-cadherin in mesenchymal FosER cells decreased beta-catenin activity and reduced cell proliferation. However, these cells still exhibited a defect in epithelial polarization and expressed E-cadherin/beta-catenin complexes in the entire plasma membrane. On the other hand, inhibition of TGFbeta-Smad signalling in mesenchymal FosER cells induced flat, cobblestone-like clusters of cells, which relocalized beta-catenin to the plasma membrane but still lacked detectable E-cadherin. Interestingly, inhibition of TGFbeta signalling in the E-cadherin-expressing mesenchymal FosER cells caused their reversion to a polarized epithelial phenotype, in which E-cadherin, beta-catenin, and ZO-1 were localized at their correct lateral plasma membrane domains. These results demonstrate that loss of E-cadherin can contribute to increased LEF/TCF-beta-catenin signalling, which in turn cooperates with autocrine TGFbeta signalling to maintain an undifferentiated mesenchymal phenotype.