Redoxtrons – An experimental system to study redox processes within the capillary fringe

Spatiotemporal characterisation of the soil redox status within the capillary fringe (CF) is a challenging task. Air-filled porosities (ε), oxygen concentration (O2) and soil redox potential (EH) are interrelated soil variables within active biogeochemical domains such as the CF. We investigated the impact of water table (WT) rise and drainage in an undisturbed topsoil and subsoil sample taken from a Calcaric Gleysol for a period of 46 days. We merged 1D (EH and matric potential) and 2D (O2) systems to monitor at high spatiotemporal resolution redox dynamics within self-constructed redoxtron housings and complemented the data set by a 3D pore network characterization using X-ray microtomography (X-ray μCT). Depletion of O2 was faster in the organic matter- and clay-rich aggregated topsoil and the CF extended >10 cm above the artificial WT. The homogeneous and less-aggregated subsoil extended only 4 cm above the WT as indicated by ε–O2–EH data during saturation. After drainage, 2D O2 imaging revealed a fast aeration towards the lower depths of the topsoil, which agrees with the connected ε derived by X-ray μCT (εCT_conn) of 14.9% of the total porosity. However, small-scaled anoxic domains with O2 saturation <5% were apparent even after lowering the WT (down to 0.25 cm2 in size) for 23 days. These domains remained a nucleus for reducing soil conditions (EH < −100 mV), which made it challenging to characterise the soil redox status in the CF. In contrast, the subsoil aeration reached O2 saturation after 8 days for the complete soil volume. Values of εCT_conn around zero in the subsoil highlighted that soil aeration was independent of this parameter suggesting that other variables such as microbial activity must be considered when predicting the soil redox status from ε alone. The use of redoxtrons in combination with localised redox-measurements and image based pore space analysis resulted in a better 2D/3D characterisation of the pore system and related O2 transport properties. This allowed us to analyse the distribution and activity of microbiological niches highly associated with the spatiotemporal variable redox dynamics in soil environments

Luminescence spectroscopy of singlet oxygen enables monitoring of oxygen consumption in biological systems consisting of fatty acids

The interaction of singlet oxygen (1O2) generated in a photosensitized process with well-known reference photosensitizers Perinaphthenone (PN) and TMPyP is investigated in a model system consisting of fatty acids and the respective exogenous photosensitizer (PS) in solution by direct detection of the luminescence photons of 1O2 at 1270 nm. Such a model system is a first approach to mimic the complex environment of 1O2 in a biological cell which consists mainly of water, proteins, sugars and lipids. Firstly, the important issue of oxygen consumption is evaluated which has to be considered during luminescence detection of 1O2. It is known that the luminescence signal of 1O2 is dependent on the oxygen concentration of the environment. Cellular components such as lipids represent oxygen consumers due to peroxidation of their unsaturated double bonds. Secondly, the experimental conditions for this model system regarding oxygen consumption are optimized to estimate the rates and rate constants of the coupled system. Thirdly, the triplet decay of the PS can provide more precise information about the actual oxygen concentration close to the PS and can be used, therefore, as a more precise method to determine the oxygen concentration in more complex systems such as a biological cell. The aim is to get a better understanding of photosensitized reactions of 1O2 with cellular components to further improve methodologies, in particular at a cellular level using luminescence spectroscopy. In conclusion, luminescence detection might be a helpful tool to monitor precisely and promptly changes in oxygen concentration in a complex environment

Praxiseinsatz Elektronischer Patientenakten: Erkenntnisse aus 2 Versorgungsprojekten in Zentren für Seltene Erkrankungen

An electronic patient record offers opportunities for digital networks between medical care providers and for the digital communication between health service providers and their patients. Patients with rare diseases benefit from a diagnosis and treatment information at an early stage and receive precise treatment on the basis of multiprofessional case management. Regarding the patient care and medical research in rare diseases, electronic patient records can help to collect all data in a structured manner and to digitally map the workflows in registration, admission, diagnosis, and treatment. This can reduce costs in our healthcare system, as diagnosis and treatment can be targeted better at the patients and unnecessary medical examinations can be reduced. In two pilot projects, first experiences with electronic patient records for patients with rare diseases were gathered. In cooperation with several medical care providers, the projects BASE-Netz and TRANSLATE-NAMSE analyzed the requirements of an electronic patient record, demonstrated the technical and legal feasibility, and evaluated the practicability for medical care providers and patients. The participating centers for rare diseases see benefits in the structured registration of the patients and the simplification of cross-institutional patient management, as patients can fulfil more tasks on their own and the health professionals can easily share data. The development of the Telematikinfrastructure of the Gematik offers opportunities to ease the digital connection between doctors’ offices and the center for rare diseases. In particular, constant clarification and transparency are essential in order to provide information on data protection issues. Training and support should also be provided to promote patients‘ digital skills. Elektronische Patientenakten (EPA) bieten zahlreiche Chancen für die digitale Vernetzung der Leistungserbringer untereinander und für die digitale Kommunikation mit den Patienten. Für Menschen mit Seltenen Erkrankungen (SE) können sich dadurch verschiedene Vorteile ergeben, wie eine frühere Diagnose und eine gezieltere Behandlung z. B. auf Grundlage eines multiprofessionellen Fallmanagements. Für die Patientenversorgung und Forschung bei Seltenen Erkrankungen kann eine EPA die Daten der Patienten strukturiert erfassen und darauf aufbauend die Arbeitsabläufe von der Anmeldung über die Aufnahme bis zu Behandlung und Monitoring digital abbilden. Für das Gesundheitswesen erhofft man sich durch EPA eine Kostenersparnis, da Diagnose- und Behandlungsprozesse zielgerichteter angeboten und unnötige Untersuchungen und Termine reduziert werden können. In 2 Pilotprojekten konnten erste Erfahrungen mit EPA für Menschen mit Seltenen Erkrankungen gesammelt werden. Die Projekte „BASE-Netz“ und „TRANSLATE-NAMSE“ haben in Zusammenarbeit mit mehreren Leistungserbringern die Anforderungen an eine EPA erfasst, die technische und rechtliche Machbarkeit aufgezeigt und die Praktikabilität für Leistungserbringer und Patienten untersucht. Während die Patienten überwiegend positive Resonanz zeigten, erwies sich die Anbindung der niedergelassenen Arztpraxen als Herausforderung. Vereinfachend könnte hierbei zukünftig der Ausbau der Telematikinfrastruktur wirken. Unerlässlich sind stetige Aufklärungen und Transparenz, um insbesondere über datenschutzrechtliche Fragen zu informieren. Auch sollten Schulungen und Unterstützung angeboten werden, um die digitalen Kompetenzen der Patienten zu fördern

UVA and endogenous photosensitizers – the detection of singlet oxygen by its luminescence

UVA irradiation (320–400 nm) comprises about 95 percent of incident midday solar ultraviolet irradiation. It penetrates skin much deeper than UVB irradiation. The absorption of UVA irradiation in endogenous chromophores frequently leads to the generation of reactive oxygen species such as singlet oxygen (1O2). 1O2 is an important biochemical intermediate in multiple biological processes. Beside other procedures, the direct detection of 1O2 by its luminescence is a powerful tool that helps to understand the generation of 1O2 during UVA exposure in solution, in vitro and in vivo. This article describes the endogenous photosensitizers, their ability to generate 1O2 under UVA irradiation, and the detection technology to visualize the action of 1O2

Membrane damage as mechanism of photodynamic inactivation using Methylene blue and TMPyP in Escherichia coli and Staphylococcus aureus

The worldwide threat of antibiotic resistance requires alternative strategies to fight bacterial infections. A promising approach to support conventional antibiotic therapy is the antimicrobial photodynamic inactivation (aPDI). The aim of this work was to show further insights into the antimicrobial photodynamic principle using two photosensitizers (PS) of different chemical classes, Methylene Blue (MB) and TMPyP, and the organisms Escherichia coli and Staphylococcus aureus as Gram-negative and Gram-positive representatives. Planktonic cultures of both species were cultured under aerobic conditions for 24 h followed by treatment with MB or TMPyP at various concentrations for an incubation period of 10 min and subsequent irradiation for 10 min. Ability to replicate was evaluated by CFU assay. Accumulation of PS was measured using a spectrophotometer. The cytoplasmic membrane integrity was investigated by flow cytometry using SYBR Green and propidium iodide. In experiments on the replication ability of bacteria after photodynamic treatment with TMPyP or MB, a killing rate of 5 log10 steps of the bacteria was achieved. Concentration-dependent accumulation of both PS was shown by spectrophotometric measurements whereby a higher accumulation of TMPyP and less accumulation of MB was found for S. aureus as compared to E. coli. For the first time, a membrane-damaging effect of TMPyP and MB in both bacterial strains could be shown using flow cytometry analyses. Furthermore, we found that reduction of the replication ability occurs with lower concentrations than needed for membrane damage upon MB suggesting that membrane damage is not the only mechanism of aPDI using MB

Antibacterial efficacy of cold atmospheric plasma against Enterococcus faecalis planktonic cultures and biofilms in vitro

Nosocomial infections have become a serious threat in our times and are getting more difficult to handle due to increasing development of resistances in bacteria. In this light, cold atmospheric plasma (CAP), which is known to effectively inactivate microorganisms, may be a promising alternative for application in the fields of dentistry and dermatology. CAPs are partly ionised gases, which operate at low temperature and are composed of electrons, ions, excited atoms and molecules, reactive oxygen and nitrogen species. In this study, the effect of CAP generated from ambient air was investigated against Enterococcus faecalis, grown on agar plates or as biofilms cultured for up to 72 h. CAP reduced the colony forming units (CFU) on agar plates by > 7 log10 steps. Treatment of 24 h old biofilms of E. faecalis resulted in CFU-reductions by ≥ 3 log10 steps after CAP treatment for 5 min and by ≥ 5 log10 steps after CAP treatment for 10 min. In biofilm experiments, chlorhexidine (CHX) and UVC radiation served as positive controls and were only slightly more effective than CAP. There was no damage of cytoplasmic membranes upon CAP treatment as shown by spectrometric measurements for release of nucleic acids. Thus, membrane damage seems not to be the primary mechanism of action for CAP towards E. faecalis. Overall, CAP showed pronounced antimicrobial efficacy against E. faecalis on agar plates as well as in biofilms similar to positive controls CHX or UVC

The Optimal Effective Concentration Combination (OPECC) as a Novel Method for Evaluating the Effects of Binary Application of Antibacterial Compounds

Combination therapies appear to be beneficial for preventing bacterial resistance to antibacterial approaches. The aim of this study was to define and determine an optimal effective concentration combination (OPECC) for binary application of antibacterial compounds. The antiseptics chlorhexidine (CHX), benzalkonium chloride (BAC), and cetylpyridinium chloride (CPC), as well as the antibiotic ciprofloxacin (CIP), were tested against planktonic Escherichia coli in binary combinations by applying a checkerboard assay, and then evaluated according to the established synergism principles. Extending the checkerboard method, the optical density (OD) of the wells was measured photometrically. On the borderline between effective (OD = 0) and non-effective (OD > 0) eradication of the bacterial cultures, the OPECC was determined. Binary combinations of CPC or CHX with BAC were assessed as either synergistic or indifferent, respectively, while there was no OPECC to calculate. For all other binary combinations, an OPECC was derivable, and these were assessed as either synergistic or indifferent. In conclusion, the evaluation of the binary combination application of antibacterial compounds based on the checkerboard method was refined to such an extent that it was possible to determine at least one concentration pair that could be defined and considered as an OPECC, independently of the evaluation of the system according to the different synergy principles. In general, the method presented herein for determining an OPECC can be applied to any conceivable method or system aimed at the eradication of a pathogen

Antimicrobial efficacy of irradiation with visible light on oral bacteria in vitro: a systematic review

AIM: Resistances to antibiotics employed for treatment of infectious diseases have increased to alarming numbers making it more and more difficult to treat diseases caused by microorganisms resistant to common antibiotics. Consequently, novel methods for successful inactivation of pathogens are required. In this instance, one alternative could be application of light for treatment of topical infections. Antimicrobial properties of UV light are well documented, but due to its DNA-damaging properties use for medical purposes is limited. In contrast, irradiation with visible light may be more promising. METHODS: Literature was systematically screened for research concerning inactivation of main oral bacterial species by means of visible light. RESULTS: Inactivation of bacterial species, especially pigmented ones, in planktonic state showed promising results. There is a lack of research examining the situation when organized as biofilms. CONCLUSION: More research concerning situation in a biofilm state is required

Resistance Toward Chlorhexidine in Oral Bacteria – Is There Cause for Concern?

The threat of antibiotic resistance has attracted strong interest during the last two decades, thus stimulating stewardship programs and research on alternative antimicrobial therapies. Conversely, much less attention has been given to the directly related problem of resistance toward antiseptics and biocides. While bacterial resistances toward triclosan or quaternary ammonium compounds have been considered in this context, the bis-biguanide chlorhexidine (CHX) has been put into focus only very recently when its use was associated with emergence of stable resistance to the last-resort antibiotic colistin. The antimicrobial effect of CHX is based on damaging the bacterial cytoplasmic membrane and subsequent leakage of cytoplasmic material. Consequently, mechanisms conferring resistance toward CHX include multidrug efflux pumps and cell membrane changes. For instance, in staphylococci it has been shown that plasmid-borne qac (“quaternary ammonium compound”) genes encode Qac efflux proteins that recognize cationic antiseptics as substrates. In Pseudomonas stutzeri, changes in the outer membrane protein and lipopolysaccharide profiles have been implicated in CHX resistance. However, little is known about the risk of resistance toward CHX in oral bacteria and potential mechanisms conferring this resistance or even cross-resistances toward antibiotics. Interestingly, there is also little awareness about the risk of CHX resistance in the dental community even though CHX has been widely used in dental practice as the gold-standard antiseptic for more than 40 years and is also included in a wide range of oral care consumer products. This review provides an overview of general resistance mechanisms toward CHX and the evidence for CHX resistance in oral bacteria. Furthermore, this work aims to raise awareness among the dental community about the risk of resistance toward CHX and accompanying cross-resistance to antibiotics. We propose new research directions related to the effects of CHX on bacteria in oral biofilms

Improved Spectral Purity of 222‐nm Irradiation Eliminates Detectable Cyclobutylpyrimidine Dimers Formation in Skin Reconstructs even at High and Repetitive Disinfecting Doses

UVC222 nm has germicidal effects with potential clinical applications. However, UVC irradiation is capable of inducing DNA damage like cyclobutylpyrimidine dimers (CPD). Although new devices have emission peaks in the short-wavelength region of UVC (~222 nm), the remaining “collateral” radiation at longer wavelengths could be harmful to human health. We investigated the DNA damage caused by far-UVC 222 nm KrCl exciplex radiation on human skin reconstructs after additional filtering using silica filters. The skin reconstructs were irradiated with 100 mJ cm−2, 500 mJ cm−2, and 3 × 500 mJ cm−2 unfiltered and filtered (230–270 nm suppressed) far-UVC or UVB (308 nm) radiation. UVB and non-filtered UVC irradiation induced a significant amount of CPDs, compared with the background. Filtered far-UVC lowered the CPD amount compared with unfiltered UVC and UVB treatments. Repetitive UVC irradiation did not result in the accumulation of CPDs compared with UVB treatment. Reduction in excess of 99.9% of E. coli, S. aureus and C. albicans was detected after applying far-UVC radiation. This identifies a therapeutic window in which microorganisms are killed but tissue is still alive and not damaged, which could give rise to new clinical applications