39 research outputs found

    Microarray analysis of tumor necrosis factor α induced gene expression in U373 human glioblastoma cells

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    BACKGROUND: Tumor necrosis factor α (TNF) is able to induce a variety of biological responses in the nervous system including inflammation and neuroprotection. Human astrocytoma cells U373 have been widely used as a model for inflammatory cytokine actions in the nervous system. Here we used cDNA microarrays to analyze the time course of the transcriptional response from 1 h up to 12 h post TNF treatment in comparison to untreated U373 cells. TNF activated strongly the NF-ÎșB transcriptional pathway and is linked to other pathways via the NF-ÎșB target genes JUNB and IRF-1. Part of the TNF-induced gene expression could be inhibited by pharmacological inhibition of NF-ÎșB with pyrrolidine-dithiocarbamate (PDTC). NF-ÎșB comprises a family of transcription factors which are involved in the inducible expression of genes regulating neuronal survival, inflammatory response, cancer and innate immunity. RESULTS: In this study we show that numerous genes responded to TNF (> 880 from 7500 tested) with a more than two-fold induction rate. Several novel TNF-responsive genes (about 60% of the genes regulated by a factor ≄ 3) were detected. A comparison of our TNF-induced gene expression profiles of U373, with profiles from 3T3 and Hela cells revealed a striking cell-type specificity. SCYA2 (MCP-1, CCL2, MCAF) was induced in U373 cells in a sustained manner and at the highest level of all analyzed genes. MCP-1 protein expression, as monitored with immunofluorescence and ELISA, correlated exactly with microarray data. Based on these data and on evidence from literature we suggest a model for the potential neurodegenerative effect of NF-ÎșB in astroglia: Activation of NF-ÎșB via TNF results in a strongly increased production of MCP-1. This leads to a exacerbation of neurodegeneration in stoke or Multiple Sclerosis, presumably via infiltration of macrophages. CONCLUSIONS: The vast majority of genes regulated more than 3-fold were previously not linked to tumor necrosis factor α as a search in published literature revealed. Striking co-regulation for several functional groups such as proteasome and ribosomal proteins were detected

    Cost of installing and operating an electronic clinical decision support system for maternal health care: case of Tanzania rural primary health centres

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    Background: Poor quality of care is among the causes of high maternal and newborn disease burden in Tanzania. Potential reason for poor quality of care is the existence of a “know-do gap” where by health workers do not perform to the best of their knowledge. An electronic clinical decision support system (CDSS) for maternal health care was piloted in six rural primary health centers of Tanzania to improve performance of health workers by facilitating adherence to World Health Organization (WHO) guidelines and ultimately improve quality of maternal health care. This study aimed at assessing the cost of installing and operating the system in the health centers. Methods: This retrospective study was conducted in Lindi, Tanzania. Costs incurred by the project were analyzed using Ingredients approach. These costs broadly included vehicle, computers, furniture, facility, CDSS software, transport, personnel, training, supplies and communication. These were grouped into installation and operation cost; recurrent and capital cost; and fixed and variable cost. We assessed the CDSS in terms of its financial and economic cost implications. We also conducted a sensitivity analysis on the estimations. Results: Total financial cost of CDSS intervention amounted to 185,927.78 USD. 77% of these costs were incurred in the installation phase and included all the activities in preparation for the actual operation of the system for client care. Generally, training made the largest share of costs (33% of total cost and more than half of the recurrent cost) followed by CDSS software- 32% of total cost. There was a difference of 31.4% between the economic and financial costs. 92.5% of economic costs were fixed costs consisting of inputs whose costs do not vary with the volume of activity within a given range. Economic cost per CDSS contact was 52.7 USD but sensitive to discount rate, asset useful life and input cost variations. Conclusions: Our study presents financial and economic cost estimates of installing and operating an electronic CDSS for maternal health care in six rural health centres. From these findings one can understand exactly what goes into a similar investment and thus determine sorts of input modification needed to fit their context

    Aging of Industrial Polypropylene Surfaces in Detergent Solution and Its Consequences for Biofilm Formation

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    Cremer J, Kaltschmidt B, Kiel A, et al. Aging of Industrial Polypropylene Surfaces in Detergent Solution and Its Consequences for Biofilm Formation. Polymers. 2023;15(5): 1247.The performance of plastic components in water-bearing parts of industrial and household appliances, often in the presence of harsh environments and elevated temperatures, critically relies on the mechanical and thermal polymer stability. In this light, the precise knowledge of aging properties of polymers formulated with dedicated antiaging additive packages as well as various fillers is crucial for long-time device warranty. We investigated and analysed the time-dependent, polymer-liquid interface aging of different industrial performance polypropylene samples in aqueous detergent solution at high temperatures (95 °C). Special emphasis was put on the disadvantageous process of consecutive biofilm formation that often follows surface transformation and degradation. Atomic force microscopy, scanning electron microscopy, and infrared spectroscopy were used to monitor and analyse the surface aging process. Additionally, bacterial adhesion and biofilm formation was characterised by colony forming unit assays. One of the key findings is the observation of crystalline, fibre-like growth of ethylene bis stearamide (EBS) on the surface during the aging process. EBS is a widely used process aid and lubricant enabling the proper demoulding of injection moulding plastic parts. The aging-induced surface-covering EBS layers changed the surface morphology and promoted bacterial adhesion as well as biofilm formation of Pseudomonas aeruginosa

    Substantial reduction of inappropriate tablet splitting with computerised decision support: a prospective intervention study assessing potential benefit and harm

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    Abstract Background Currently ambulatory patients break one in four tablets before ingestion. Roughly 10% of them are not suitable for splitting because they lack score lines or because enteric or modified release coating is destroyed impairing safety and effectiveness of the medication. We assessed impact and safety of computerised decision support on the inappropriate prescription of split tablets. Methods We performed a prospective intervention study in a 1680-bed university hospital. Over a 15-week period we evaluated all electronically composed medication regimens and determined the fraction of tablets and capsules that demanded inappropriate splitting. In a subsequent intervention phase of 15 weeks duration for 10553 oral drugs divisibility characteristics were indicated in the system. In addition, an alert was generated and displayed during the prescription process whenever the entered dosage regimen demanded inappropriate splitting (splitting of capsules, unscored tablets, or scored tablets unsuitable for the intended fragmentation). Results During the baseline period 12.5% of all drugs required splitting and 2.7% of all drugs (257/9545) required inappropriate splitting. During the intervention period the frequency of inappropriate splitting was significantly reduced (1.4% of all drugs (146/10486); p = 0.0008). In response to half of the alerts (69/136) physicians adjusted the medication regimen. In the other half (67/136) no corrections were made although a switch to more suitable drugs (scored tablets, tablets with lower strength, liquid formulation) was possible in 82% (55/67). Conclusion This study revealed that computerised decision support can immediately reduce the frequency of inappropriate splitting without introducing new safety hazards.</p

    Influence of point mutations on the functionality of NK cells in interaction with Aspergillus fumigatus

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    Ziel der vorliegenden Arbeit war die Charakterisierung von Punktmutationen in ifng und ncam1 in Hinblick auf eine verĂ€nderte FunktionalitĂ€t von NK-Zellen bei der Interaktion mit A. fumigatus. Die gewonnenen Erkenntnisse sollen langfristig zur Verbesserung der Diagnostik, Prophylaxe und Therapie einer Invasiven Aspergillose, die zum Beispiel im Rahmen einer Stammzelltransplantation auftreten könnte, beitragen. In dieser Arbeit wurde die DNA von zwanzig gesunden Spendern auf einen ifng-SNP (rs2069705) und einen ncam1-SNP (rs10502171) untersucht. Von je drei ausgewĂ€hlten Spendern mit SNP und sechs Kontrollspendern wurden NK-Zellen isoliert. Diese wurden unstimuliert belassen, mit Interleukin 2/15 oder A. fumigatus stimuliert. Bei der Versuchsreihe zum ifng-SNP wurde eine qPCR zur Ermittlung der relativen Expression von ifng und ccl4, bei den Versuchen zum ncam1-SNP eine durchflusszytometrische Analyse zur Messung der Expression verschiedener OberflĂ€chenmarker durchgefĂŒhrt. Bei beiden wurde mittels ELISA die Freisetzung von IFN-gamma bzw. CCL4/MIP-1ß bestimmt. Die in dieser Arbeit gewonnenen Ergebnisse zum ifng-SNP lassen vermuten, dass das Vorliegen dieses ifng-SNP keine durch NK-Zellen vermittelten Auswirkungen auf das Risiko der Patienten, an einer Invasiven Aspergillose zu erkranken, hat. In Bezug auf den ncam1-SNP konnte die Hypothese bestĂ€tigt werden, dass der SNP die Interaktion zwischen der NK-Zelle und A. fumigatus verĂ€ndert. Der SNP korreliert zwar mit einer erhöhten Grundaktivierung von NK-Zellen, jedoch auch mit einem schwĂ€cheren Aktivierungspotential bei Stimulation mit dem Pilz.The aim of this thesis was the characterization of point mutations in ifng and ncam1 with respect to an altered functionality of NK cells during interaction with A. fumigatus. In the long term, the findings should contribute to the improvement of the diagnosis, prophylaxis and therapy of invasive aspergillosis, which can occur, for example, after stem cell transplantation. In this work, the DNA of twenty healthy donors was examined for one ifng-SNP (rs2069705) and one ncam1-SNP (rs10502171). NK cells were isolated from three donors for each SNP and six control donors. These were left unstimulated, stimulated with interleukin 2/15 or A. fumigatus. In the ifng-SNP series qPCR was performed to determine the relative expression of ifng and ccl4, in the ncam1-SNP series flow cytometric analysis was performed to measure the expression of different surface markers. In both cases the release of IFN-gamma and CCL4/MIP-1ß was determined by ELISA. The results obtained in this study on ifng-SNP suggest that the presence of this ifng-SNP has no NK cell mediated effects on the risk of patients suffering from invasive aspergillosis. With regard to the ncam1-SNP, the hypothesis that the SNP alters the interaction between the NK cell and A. fumigatus was confirmed. The SNP correlates with an increased basic activation of NK cells, but also with a weaker activation potential when stimulated with the fungus

    Development and evaluation of a computerised clinical decision support system for switching drugs at the interface between primary and tertiary care

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    Abstract Background Upon admission to a hospital patients’ medications are frequently switched to alternative drugs compiled in so called hospital drug formularies. This substitution process is a laborious and error-prone task which should be supported by sophisticated electronic tools. We developed a computerised decision support system and evaluated benefit and potential harm associated with its use. Methods Based on a multi-step algorithm we identified drug classes suitable for exchange, defined conversion factors for therapeutic interchange, built a web-based decision support system, and implemented it into the computerised physician order entry of a large university hospital. For evaluation we compared medications manually switched by clinical pharmacists with the results of automated switching by the newly developed computer system and optimised the system in an iterative process. Thereafter the final system was tested in an independent set of prescriptions. Results After iterative optimisation of the logical framework the tool was able to switch drugs to pharmaceutical equivalents and alternatives; in addition, it contained 21 different drug classes for therapeutic substitution. In this final version it switched 91.6% of 202 documented medication consultations (containing 1,333 drugs) automatically, leaving 8.4% for manual processing by clinical professionals. No incorrect drug switches were found. Conclusion A large majority (>90%) of drug switches performed at the interface between primary and tertiary care can be handled automatically using electronic decision support systems, indicating that medication errors and workload of healthcare professionals can be considerably reduced.</p

    Induced Neural Stem Cells Achieve Long-Term Survival and Functional Integration in the Adult Mouse Brain

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    SummaryDifferentiated cells can be converted directly into multipotent neural stem cells (i.e., induced neural stem cells [iNSCs]). iNSCs offer an attractive alternative to induced pluripotent stem cell (iPSC) technology with regard to regenerative therapies. Here, we show an in vivo long-term analysis of transplanted iNSCs in the adult mouse brain. iNSCs showed sound in vivo long-term survival rates without graft overgrowths. The cells displayed a neural multilineage potential with a clear bias toward astrocytes and a permanent downregulation of progenitor and cell-cycle markers, indicating that iNSCs are not predisposed to tumor formation. Furthermore, the formation of synaptic connections as well as neuronal and glial electrophysiological properties demonstrated that differentiated iNSCs migrated, functionally integrated, and interacted with the existing neuronal circuitry. We conclude that iNSC long-term transplantation is a safe procedure; moreover, it might represent an interesting tool for future personalized regenerative applications
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