A detailed phenotypic analysis of immune cell populations in the bronchoalveolar lavage fluid of atopic asthmatics after segmental allergen challenge

BACKGROUND: Atopic asthma is characterized by intermittent exacerbations triggered by exposure to allergen. Exacerbations are characterized by an acute inflammatory reaction in the airways, with recruitment of both innate and adaptive immune cells. These cell populations as well as soluble factors are critical for initiating and controlling the inflammatory processes in allergic asthma. Detailed data on the numbers and types of cells recruited following allergen challenge is lacking. In this paper we present an extensive phenotypic analysis of the inflammatory cell infiltrate present in the bronchoalveolar lavage (BAL) fluid following bronchoscopically directed allergen challenge in mild atopic asthmatics. METHODS: A re-analysis of pooled data obtained prior to intervention in our randomized, placebo controlled, double blinded study (costimulation inhibition in asthma trial [CIA]) was performed. Twenty-four subjects underwent bronchoscopically directed segmental allergen challenge followed by BAL collection 48 hours later. The BAL fluid was analyzed by multi-color flow cytometry for immune cell populations and multi-plex ELISA for cytokine detection. RESULTS: Allergen instillation induced pro-inflammatory cytokines (IL-6) and immune modulating cytokines (IL-2, IFN-γ, and IL-10) along with an increase in lymphocytes and suppressor cells (Tregs and MDSC). Interestingly, membrane expression of CD30 was identified on lymphocytes, especially Tregs, but not eosinophils. Soluble CD30 was also detected in the BAL fluid after allergen challenge in adult atopic asthmatics. CONCLUSIONS: After segmental allergen challenge of adult atopic asthmatics, cell types associated with a pro-inflammatory as well as an anti-inflammatory response are detected within the BAL fluid of the lung

Health Monitoring From Home: Legal Considerations of Wearable Technology in Telemedicine

The COVID-19 pandemic created the necessity to access medical care from one’s home, giving rise to a new standard of healthcare through “telemedicine.” However, although efficient in many ways, the most significant limitation of telemedicine was the inability of doctors to monitor their patients’ conditions remotely. Wearable devices, also known as “wearables,” provide a way to bridge the gap. Over the last five years, wearables grew to be one of the fastest-growing industries in healthcare, seeing over $5 billion in growth. However, this also came with a myriad of legal concerns that may prevent wearables from being utilized efficiently. This case note discusses three legal issues that arise from the utilization of wearable technology in telemedicine: the effects of wearables in cases of medical malpractice and the scope of liability of doctors, the effects on the standard of care and the traditional doctor-patient relationship, and privacy and confidentiality concerns from utilizing third-party wearables to collect patient data. In order to fully utilize the potential of wearables in the healthcare industry, specific regulatory frameworks should be adopted to address such concerns

Measurement of perceived conflict between members in American higher education merged library and information technology departments

This survey study is designed to examine how mergers impact the perceived conflict levels of two occupational groups, library and IT professionals. The anticipated outcomes are as follows: a) to re-assess the psychometric properties of the ROCI-I, b) to determine the perceived conflict levels of merged library and information services department employees as determined by the ROCI-I, and c) to determine if difference exists between perceived conflict levels of library and IT professionals. The most common higher education departmental merger is that of the library and the information technology department (Hardesty, 1998). Unfortunately, the merger of these two departments has been cited as a source of conflict within the organization (Renaud, 2001; Wagner, 2000). No quantitative evidence existed regarding the actual levels of perceived conflict between these two groups or the degree to which levels of conflict differ between the two groups. It was further unknown whether the instrument used to measure conflict levels still possessed adequate reliability and validity given that the last psychometric tests involved data from 1983. In addition, this study also verified the reliability and validity of the ROCI-I in assessing perceived conflict levels among library and IT professional populations. For these reasons this study is significant in that it will both add previously unknown quantitative data to the library and IT merger discussion and inform conflict researchers as to the psychometric properties of the ROCI-I

Plasma inflammatory mediator concentrations at ICU admission in dogs with naturally developing sepsis

Background Identifying biomarkers to aide in the diagnosis and prognostication of sepsis in dogs would be valuable to veterinarians. Objective To compare plasma inflammatory mediator concentrations among dogs with sepsis, noninfectious systemic inflammatory response syndrome (NSIRS), and healthy dogs. Animals Dogs with sepsis (n = 22), NSIRS (n = 23), and healthy dogs (n = 13) presenting to the intensive care unit (ICU) at a veterinary teaching hospital. Methods Prospective observational study. Clinical parameters were recorded for each dog and plasma tumor necrosis factor (TNF) bioactivity and concentrations of interleukin (IL)‐6, CXC chemokine ligand (CXCL)‐8 and IL‐10 were determined at ICU presentation. Results Dogs with sepsis and NSIRS were significantly more likely to have measurable TNF activity (sepsis 20/22; NSIRS 19/20; healthy 0/13) and IL‐6 concentration (sepsis 12/22; NSIRS 15/23; healthy 2/13), than healthy dogs. Healthy dogs (9/13) were significantly more likely to have measurable plasma IL‐10 concentrations than dogs with sepsis (4/19), but not NSIRS (7/20). None of the inflammatory mediators evaluated had optimal sensitivity or specificity for the diagnosis of sepsis. Twelve of 22 dogs with sepsis and 15/23 dogs with NSIRS survived to discharge; none of the measured biomarkers correlated with survival to discharge. Conclusions and Clinical Importance Sepsis and NSIRS are associated with increased production of the proinflammatory cytokines TNF and IL‐6. In addition, sepsis is associated with decreased production of the anti‐inflammatory cytokine IL‐10. Despite this, plasma TNF, IL‐6, CXCL‐8, and IL‐10 measured at ICU presentation do not appear to be valuable biomarkers to differentiate sepsis from NSIRS, or predict hospital outcome

Evaluation of serum NT-pCNP as a diagnostic and prognostic biomarker for sepsis in dogs

Background: There is a need for diagnostic biomarkers that can rapidly differentiate dogs with sepsis from dogs with noninfectious forms of systemic inflammatory response syndrome (NSIRS). Objectives: To compare serum NT‐pCNP concentrations among dogs with various forms of sepsis, NSIRS, and healthy controls and to evaluate the use of serum NT‐pCNP for the diagnosis of various forms of sepsis in dogs. Animals: One hundred and twelve dogs including 63 critically ill dogs (sepsis n = 29; NSIRS n = 34) and 49 healthy control dogs. Methods: Prospective clinical investigation. Serum samples were collected for NT‐pCNP measurement from dogs with sepsis or NSIRS within 24 hours of intensive care unit admission or at the time of presentation for healthy dogs. Dogs with sepsis were subclassified based on the anatomic region of infection. Serum NT‐pCNP concentrations were compared among sepsis, NSIRS and healthy groups as well as among sepsis subgroups. The area under the curve (AUC), sensitivity, and specificity for identifying dogs with sepsis were determined. Results: Using a cut‐off value of 10.1 pmol/L, AUC, sensitivity, and specificity of NT‐pCNP for differentiating dogs with sepsis from dogs with NSIRS or healthy control dogs were 0.71 (95% CI, 0.58–0.85), 65.5% (45.7–82.1%), and 89.2% (80.4–94.9%), respectively. Serum NT‐pCNP had poor sensitivity for peritoneal sources of sepsis; AUC [0.92 (0.81–1.0)], sensitivity [94% (71–100%)], and specificity [89% (80–95%)] improved when these dogs were excluded. Serum NT‐pCNP concentration was not associated with survival in the sepsis group. Conclusions and Clinical Importance: Serum NT‐pCNP is a promising diagnostic biomarker for sepsis but is a poor indicator of septic peritonitis

Modulation of neurofibromatosis type 1 gene expression during in vitro myoblast differentiation

Neurofibromin, the protein product of the neurofibromatiosis type 1 (NF1) gene, has two alternate isoforms which are generated by alternative splicing of two exons. One of these isoforms containing exon 48a is expressed at highest levels in muscle. Since neurofibromin is a p21-ras regulator and has been recently shown to be modulated during Schwann cell differentiation, we examined the expression of the NF1 gene product during in vitro muscle differentiation. Previous work demonstrated that C 2 © 1994 Wiley-Liss, Inc. C 12 murine myoblast cell differentiation could be blocked by the introduction of an activated p21-ras protein. Using this model system, we demonstrate that differentiationg C 2 C 12 cells upregulate the expression of NF1 mRNA by 2 days of serum starvation concomitant with increased expression of nicotinic acetylcholine receptor mRNA. This upregulation of mRNA expression paralleled an increase in neurofibromin and N-ras levels, but no change in the relative abundance of the isoforms containing exon 23a or exon 48a was observed during in vitro myoblast differentiation. The increase in neurofibromin levels paralleled a decrease in the levels of activated p21-ras as assayed by in vivo 32 Porthophosphate incorporation into p21-ras. These results suggest that in vitro C 2 C 12 cell differentiation is associated with a concomitant increase in NF1 gene expression and decrease in the proportion of activated p21-ras. © 1994 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/50229/1/490370312_ftp.pd