Co-induction of neuronal interferon-gamma and nitric oxide synthase in rat motor neurons after axotomy: a role in nerve repair or death?

Induction of an interferon-gamma-like molecule, previously isolated from neurons (N-IFN-gamma), and of the neuronal isoform I of the synthetic enzyme of the free radical nitric oxide, nitric oxide synthase I, as well as of NADPH-diaphorase, were examined in axotomized dorsal motor vagal and hypoglossal neurons. Unilateral transection of the vagal and hypoglossal nerves was performed in the same rat and an induction of N-IFN-gamma and nitric oxide synthase I immunostaining as well as NADPH-diaphorase histochemical positivity was observed in the ipsilateral motoneurons after 2-4 days. The immuno- and enzyme-histochemical positivities were much stronger in the dorsal motor vagal neurons than in hypoglossal neurons. Two and 4 weeks after axotomy N-IFN-gamma immunoreactivity and NADPH-diaphorase positivity persisted in the former, but started to decrease in the latter neurons. Previous data have shown that 23 weeks after nerve transection the majority of the dorsal motor vagal neurons are lost, while the major ity of the hypoglossal neurons survive. The high and persistent expression of N-IFN-gamma and nitric oxide synthase I after axotomy in the dorsal motor vagal neurons, that are largely destined to die, indicates that the co-induction of these two molecules may be implicated in the pathogenesis of neuronal degeneration

The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals

The healthcare sector in general and hospitals in particular represent a main application area for Data Envelopment Analysis (DEA). This paper reviews 262 papers of DEA applications in healthcare with special focus on hospitals and therefore closes a gap of over ten years that were not covered by existing review articles. Apart from providing descriptive statistics of the papers, we are the first to examine the research purposes of the publications. These research goals can be grouped into four distinct clusters according to our proposed framework. The four clusters are (1) Pure DEA efficiency analysis, i.e. performing a DEA on hospital data, (2) Developments or applications of new methodologies, i.e. applying new DEAy approaches on hospital data, (3) Specific management question, i.e. analyzing the effects of managerial specification, such as ownership, on hospital efficiency, and (4) Surveys on the effects of reforms, i.e. researching the impact of policy making, such as reforms of health systems, on hospital efficiency. Furthermore, we analyze the methodological settings of the studies and describe the applied models. We analyze the chosen inputs and outputs as well as all relevant downstream techniques. A further contribution of this paper is its function as a roadmap to important methodological literature and publications, which provide crucial information on the setup of DEA studies. Thus, this paper should be of assistance to researchers planning to apply DEA in a hospital setting by providing information on a) what has been published between 2005 and 2016, b) possible pitfalls when setting up a DEA analysis, and c) possible ways to apply the DEA analysis in practice. Finally, we discuss what could be done to advance DEA from a scientific tool to an instrument that is actually utilized by managers and policymakers