Are prescribing doctors sensitive to the price that their patients have to pay in the Spanish National Health System?

[EN] Background This study aims to design an empirical test on the sensitivity of the prescribing doctors to the price afforded for the patient, and to apply it to the population data of primary care dispensations for cardiovascular disease and mental illness in the Spanish National Health System (NHS). Implications for drug policies are discussed. Methods We used population data of 17 therapeutic groups of cardiovascular and mental illness drugs aggregated by health areas to obtain 1424 observations ((8 cardiovascular groups * 70 areas) + (9 psychotropics groups * 96 areas)). All drugs are free for pensioners. For non-pensioner patients 10 of the 17 therapeutic groups have a reduced copayment (RC) status of only 10% of the price with a ceiling of €2.64 per pack, while the remaining 7 groups have a full copayment (FC) rate of 40%. Differences in the average price among dispensations for pensioners and non-pensioners were modelled with multilevel regression models to test the following hypothesis: 1) in FC drugs there is a significant positive difference between the average prices of drugs prescribed to pensioners and non-pensioners; 2) in RC drugs there is no significant price differential between pensioner and non-pensioner patients; 3) the price differential of FC drugs prescribed to pensioners and non-pensioners is greater the higher the price of the drugs. Results The average monthly price of dispensations to pensioners and non-pensioners does not differ for RC drugs, but for FC drugs pensioners get more expensive dispensations than non-pensioners (estimated difference of €9.74 by DDD and month). There is a positive and significant effect of the drug price on the differential price between pensioners and non-pensioners. For FC drugs, each additional euro of the drug price increases the differential by nearly half a euro (0.492). We did not find any significant differences in the intensity of the price effect among FC therapeutic groups. Conclusions Doctors working in the Spanish NHS seem to be sensitive to the price that can be afforded by patients when they fill in prescriptions, although alternative hypothesis could also explain the results found.

Salt stress responses in pear and quince: physiological and molecular aspects

The productivity of agricultural crops is seriously limited by salinity. This problem is rapidly increasing, particularly in irrigated lands. Like almost all the fruit tree species, Pyrus communis is generally considered a salt sensitive species, but only little information is available on its behavior under saline conditions. Previous studies, carried out in the Department of Fruit Tree and Woody Plant Science (University of Bologna), focused their attention on pear and quince salt stress responses to understand which rootstock would be the most suitable for pear in order to tolerate a salt stress condition. It has been reported that pear and quince have different ability in the uptake, translocation and accumulation of chloride (Cl-) and sodium (Na+) ions, when plants were irrigated for one season with saline water (5 dS/m). The aim of the present work was to deepen these aspects and investigate salt stress responses in pear and quince. Two different experiments have been performed: a “short-term” trial in a growth chamber and a “long-term” experiment in the open field. In the short-term experiment, three different genotypes usually adopted as pear rootstocks (MC, BA29 and Farold®40) and the pear variety Abbé Fétel own rooted have been compared under salt stress conditions. The trial was performed in a hydroponic culture system, applying a 90 mM NaCl stress to half of the plants, after five weeks of normal growth in Hoagland’s solution. During the three-weeks of salt stress treatment, physiological, mineral and molecular analyses were performed in order to monitor, for each genotype, the development of the salt stress responses in comparison with the corresponding “unstressed” plants. Farold®40 and Abbé Fétel own rooted showed the onset of leaf necrosis, due to salt toxicity, one week before quinces. Moreover, quinces displayed a significant delay in premature senescence of old leaves, while pears emerged for their ability to regenerate new leaves from apparently dead foliage with the salt stress still running. Physiological measurements, such as shoots length, chlorophyll (Chl) content, and photosynthesis, have been carried out and revealed that pears exhibited a significant reduction in water content and a wilting aspect, while for quinces a decrease in Chl content and a growth slowdown were observed. At the end of the trial, all plants were collected and organs separated for dry weight estimation and mineral analyses (Cu, Fe, Mn, Zn Mg, Ca, K, Na and Cl). Mineral contents have been affected by salinity; same macro/micro nutrients were altered in some organs or relocated within the plant. This plant response could have partially contributed to face the salt stress. Leaves and roots have been harvested for molecular analyses at four different times during stress conditions. Molecular analyses consisted of the gene expression study of three main ion transporters, well known in Arabidopsis thaliana as salt-tolerance determinants in the “SOS” pathway: NHX1 (tonoplast Na+/H+ antiporter), SOS1 (plasmalemma Na+/H+ antiporter) and HKT1 (K+ high-affinity and Na+ low-affinity transporter). These studies showed that two quince rootstocks adopted different responsive mechanisms to NaCl stress. BA29 increased its Na+ sequestration activity into leaf vacuoles, while MC enhanced temporarily the same ability, but in roots. Farold®40, instead, exhibited increases in SOS1 and HKT1 expression mainly at leaf level in the attempt to retrieve Na+ from xylem, while Abbé Fétel differently altered the expression of these genes in roots. Finally, each genotype showed a peculiar response to salt stress that was the sum of its ability in Na+ exclusion, osmotic tolerance and tissue tolerance. In the long-term experiment, potted trees of the pear variety Abbé Fétel grafted on different rootstocks (MC, BA29 and Farold®40), or own rooted and also rootstocks only were subjected to a salt stress through saline water irrigation with an electrical conductivity of 5 dS/m for two years. The purposes of this study were to evaluate salinity effects on physiological (shoot length, number of buds, photosynthesis, etc.) and yield parameters of cultivar Abbé Fétel in the different combinations and to determine the salt amount that pear is able to tolerate over the years. With this work, we confirmed the previous hypothesis that pear, despite being classified as a salt-sensitive fruit tree, can be cultivated for two years under saline water irrigation, without showing any salt toxicity symptoms or severe drawbacks on plant development and production. Among different combinations, Abbé Fétel grafted on MC resulted interesting for its peculiar behaviors under salt stress conditions. In the near future, further investigations on physiological and molecular aspects will be necessary to enrich and broaden the knowledge of salt stress responses in pear.

Sistemi riconfigurabili a basso consumo per applicazioni di monitoraggio distribuito

The term Ambient Intelligence (AmI) refers to a vision on the future of the information society where smart, electronic environment are sensitive and responsive to the presence of people and their activities (Context awareness). In an ambient intelligence world, devices work in concert to support people in carrying out their everyday life activities, tasks and rituals in an easy, natural way using information and intelligence that is hidden in the network connecting these devices. This promotes the creation of pervasive environments improving the quality of life of the occupants and enhancing the human experience. AmI stems from the convergence of three key technologies: ubiquitous computing, ubiquitous communication and natural interfaces. Ambient intelligent systems are heterogeneous and require an excellent cooperation between several hardware/software technologies and disciplines, including signal processing, networking and protocols, embedded systems, information management, and distributed algorithms. Since a large amount of fixed and mobile sensors embedded is deployed into the environment, the Wireless Sensor Networks is one of the most relevant enabling technologies for AmI. WSN are complex systems made up of a number of sensor nodes which can be deployed in a target area to sense physical phenomena and communicate with other nodes and base stations. These simple devices typically embed a low power computational unit (microcontrollers, FPGAs etc.), a wireless communication unit, one or more sensors and a some form of energy supply (either batteries or energy scavenger modules). WNS promises of revolutionizing the interactions between the real physical worlds and human beings. Low-cost, low-computational power, low energy consumption and small size are characteristics that must be taken into consideration when designing and dealing with WSNs. To fully exploit the potential of distributed sensing approaches, a set of challengesmust be addressed. Sensor nodes are inherently resource-constrained systems with very low power consumption and small size requirements which enables than to reduce the interference on the physical phenomena sensed and to allow easy and low-cost deployment. They have limited processing speed,storage capacity and communication bandwidth that must be efficiently used to increase the degree of local ”understanding” of the observed phenomena. A particular case of sensor nodes are video sensors. This topic holds strong interest for a wide range of contexts such as military, security, robotics and most recently consumer applications. Vision sensors are extremely effective for medium to long-range sensing because vision provides rich information to human operators. However, image sensors generate a huge amount of data, whichmust be heavily processed before it is transmitted due to the scarce bandwidth capability of radio interfaces. In particular, in video-surveillance, it has been shown that source-side compression is mandatory due to limited bandwidth and delay constraints. Moreover, there is an ample opportunity for performing higher-level processing functions, such as object recognition that has the potential to drastically reduce the required bandwidth (e.g. by transmitting compressed images only when something ‘interesting‘ is detected). The energy cost of image processing must however be carefully minimized. Imaging could play and plays an important role in sensing devices for ambient intelligence. Computer vision can for instance be used for recognising persons and objects and recognising behaviour such as illness and rioting. Having a wireless camera as a camera mote opens the way for distributed scene analysis. More eyes see more than one and a camera system that can observe a scene from multiple directions would be able to overcome occlusion problems and could describe objects in their true 3D appearance. In real-time, these approaches are a recently opened field of research. In this thesis we pay attention to the realities of hardware/software technologies and the design needed to realize systems for distributed monitoring, attempting to propose solutions on open issues and filling the gap between AmI scenarios and hardware reality. The physical implementation of an individual wireless node is constrained by three important metrics which are outlined below. Despite that the design of the sensor network and its sensor nodes is strictly application dependent, a number of constraints should almost always be considered. Among them: • Small form factor to reduce nodes intrusiveness. • Low power consumption to reduce battery size and to extend nodes lifetime. • Low cost for a widespread diffusion. These limitations typically result in the adoption of low power, low cost devices such as low powermicrocontrollers with few kilobytes of RAMand tenth of kilobytes of program memory with whomonly simple data processing algorithms can be implemented. However the overall computational power of the WNS can be very large since the network presents a high degree of parallelism that can be exploited through the adoption of ad-hoc techniques. Furthermore through the fusion of information from the dense mesh of sensors even complex phenomena can be monitored. In this dissertation we present our results in building several AmI applications suitable for a WSN implementation. The work can be divided into two main areas:Low Power Video Sensor Node and Video Processing Alghoritm and Multimodal Surveillance . Low Power Video Sensor Nodes and Video Processing Alghoritms In comparison to scalar sensors, such as temperature, pressure, humidity, velocity, and acceleration sensors, vision sensors generate much higher bandwidth data due to the two-dimensional nature of their pixel array. We have tackled all the constraints listed above and have proposed solutions to overcome the current WSNlimits for Video sensor node. We have designed and developed wireless video sensor nodes focusing on the small size and the flexibility of reuse in different applications. The video nodes target a different design point: the portability (on-board power supply, wireless communication), a scanty power budget (500mW),while still providing a prominent level of intelligence, namely sophisticated classification algorithmand high level of reconfigurability. We developed two different video sensor node: The device architecture of the first one is based on a low-cost low-power FPGA+microcontroller system-on-chip. The second one is based on ARM9 processor. Both systems designed within the above mentioned power envelope could operate in a continuous fashion with Li-Polymer battery pack and solar panel. Novel low power low cost video sensor nodes which, in contrast to sensors that just watch the world, are capable of comprehending the perceived information in order to interpret it locally, are presented. Featuring such intelligence, these nodes would be able to cope with such tasks as recognition of unattended bags in airports, persons carrying potentially dangerous objects, etc.,which normally require a human operator. Vision algorithms for object detection, acquisition like human detection with Support Vector Machine (SVM) classification and abandoned/removed object detection are implemented, described and illustrated on real world data. Multimodal surveillance: In several setup the use of wired video cameras may not be possible. For this reason building an energy efficient wireless vision network for monitoring and surveillance is one of the major efforts in the sensor network community. Energy efficiency for wireless smart camera networks is one of the major efforts in distributed monitoring and surveillance community. For this reason, building an energy efficient wireless vision network for monitoring and surveillance is one of the major efforts in the sensor network community. The Pyroelectric Infra-Red (PIR) sensors have been used to extend the lifetime of a solar-powered video sensor node by providing an energy level dependent trigger to the video camera and the wireless module. Such approach has shown to be able to extend node lifetime and possibly result in continuous operation of the node.Being low-cost, passive (thus low-power) and presenting a limited form factor, PIR sensors are well suited for WSN applications. Moreover techniques to have aggressive power management policies are essential for achieving long-termoperating on standalone distributed cameras needed to improve the power consumption. We have used an adaptive controller like Model Predictive Control (MPC) to help the system to improve the performances outperforming naive power management policies.

Echtzeitsuche nach Neutrinoausbrüchen von Supernovae mit dem AMANDA-II-Detektor

Der AMANDA-II Detektor ist primär für den richtungsaufgelösten Nachweis hochenergetischer Neutrinos konzipiert. Trotzdem können auch niederenergetische Neutrinoausbrüche, wie sie von Supernovae erwartet werden, mit hoher Signifikanz nachgewiesen werden, sofern sie innerhalb der Milchstraße stattfinden. Die experimentelle Signatur im Detektor ist ein kollektiver Anstieg der Rauschraten aller optischen Module. Zur Abschätzung der Stärke des erwarteten Signals wurden theoretische Modelle und Simulationen zu Supernovae und experimentelle Daten der Supernova SN1987A studiert. Außerdem wurden die Sensitivitäten der optischen Module neu bestimmt. Dazu mussten für den Fall des südpolaren Eises die Energieverluste geladener Teilchen untersucht und eine Simulation der Propagation von Photonen entwickelt werden. Schließlich konnte das im Kamiokande-II Detektor gemessene Signal auf die Verhältnisse des AMANDA-II Detektors skaliert werden. Im Rahmen dieser Arbeit wurde ein Algorithmus zur Echtzeit-Suche nach Signalen von Supernovae als Teilmodul der Datennahme implementiert. Dieser beinhaltet diverse Verbesserungen gegenüber der zuvor von der AMANDA-Kollaboration verwendeten Version. Aufgrund einer Optimierung auf Rechengeschwindigkeit können nun mehrere Echtzeit-Suchen mit verschiedenen Analyse-Zeitbasen im Rahmen der Datennahme simultan laufen. Die Disqualifikation optischer Module mit ungeeignetem Verhalten geschieht in Echtzeit. Allerdings muss das Verhalten der Module zu diesem Zweck anhand von gepufferten Daten beurteilt werden. Dadurch kann die Analyse der Daten der qualifizierten Module nicht ohne eine Verzögerung von etwa 5 Minuten geschehen. Im Falle einer erkannten Supernova werden die Daten für die Zeitdauer mehrerer Minuten zur späteren Auswertung in 10 Millisekunden-Intervallen archiviert. Da die Daten des Rauschverhaltens der optischen Module ansonsten in Intervallen von 500 ms zur Verfgung stehen, ist die Zeitbasis der Analyse in Einheiten von 500 ms frei wählbar. Im Rahmen dieser Arbeit wurden drei Analysen dieser Art am Südpol aktiviert: Eine mit der Zeitbasis der Datennahme von 500 ms, eine mit der Zeitbasis 4 s und eine mit der Zeitbasis 10 s. Dadurch wird die Sensitivität für Signale maximiert, die eine charakteristische exponentielle Zerfallszeit von 3 s aufweisen und gleichzeitig eine gute Sensitivität über einen weiten Bereich exponentieller Zerfallszeiten gewahrt. Anhand von Daten der Jahre 2000 bis 2003 wurden diese Analysen ausführlich untersucht. Während die Ergebnisse der Analyse mit t = 500 ms nicht vollständig nachvollziehbare Ergebnisse produzierte, konnten die Resultate der beiden Analysen mit den längeren Zeitbasen durch Simulationen reproduziert und entsprechend gut verstanden werden. Auf der Grundlage der gemessenen Daten wurden die erwarteten Signale von Supernovae simuliert. Aus einem Vergleich zwischen dieser Simulation den gemessenen Daten der Jahre 2000 bis 2003 und der Simulation des erwarteten statistischen Untergrunds kann mit einem Konfidenz-Niveau von mindestens 90 % gefolgert werden, dass in der Milchstraße nicht mehr als 3.2 Supernovae pro Jahr stattfinden. Zur Identifikation einer Supernova wird ein Ratenanstieg mit einer Signifikanz von mindestens 7.4 Standardabweichungen verlangt. Die Anzahl erwarteter Ereignisse aus dem statistischen Untergrund beträgt auf diesem Niveau weniger als ein Millionstel. Dennoch wurde ein solches Ereignis gemessen. Mit der gewählten Signifikanzschwelle werden 74 % aller möglichen Vorläufer-Sterne von Supernovae in der Galaxis überwacht. In Kombination mit dem letzten von der AMANDA-Kollaboration veröffentlicheten Ergebnis ergibt sich sogar eine obere Grenze von nur 2.6 Supernovae pro Jahr. Im Rahmen der Echtzeit-Analyse wird für die kollektive Ratenüberhöhung eine Signifikanz von mindestens 5.5 Standardabweichungen verlangt, bevor eine Meldung über die Detektion eines Supernova-Kandidaten verschickt wird. Damit liegt der überwachte Anteil Sterne der Galaxis bei 81 %, aber auch die Frequenz falscher Alarme steigt auf bei etwa 2 Ereignissen pro Woche. Die Alarm-Meldungen werden über ein Iridium-Modem in die nördliche Hemisphäre übertragen, und sollen schon bald zu SNEWS beitragen, dem weltweiten Netzwerk zur Früherkennung von Supernovae.

Double-stimulus sensitive (temperature and pH) self-assemblable polymers

The rheological properties of block co-polymers in water solution at different pH have been investigated. The block copolymers are based on different architectures containing poly(ethylene glycol), poly(propylene glycol) and different blocks of polymer that change their hydrophobic/hydrophilic behavior as a function of pH. The polymer chains of the starting material were extended at their functional ends with the pH-sensitive units using ATRP; this mechanism of controlled radical polymerization was chosen because of the need to minimize polydispersity and avoid transfer reactions possibly leading to homopolymeric inpurities. The starting material were modified in order to use them as macroinitiator for ATRP. The kinetic of each ATRP reaction has been investigated, in order to be able to synthesize polymers with different degree of polymerization, stopping the reaction when the desired polymers chain length has been reached. We will use polymer chains with different basicity and degree of polymerization to link any possible effect of their presence to the conditions under which they become hydrophobic. It has been shown that the rate of polymerization changes changing the type of macroinitiator and the type of monomer synthesized. The slowest rate of polymerization is the one with the most hindered monomer synthesized using the macroinitiator with the highest molecular weight. The water solubility of the synthesized polymers changes depending on the pH of the solution and on the structure of the polymers. It has been shown using 1H-NMR that some of the synthesized polymers are capable to self-aggregation in water solution. The self-aggregation and the type of aggregation is influenced from the structure of the polymer and from the pH of the solution. Changing the structure of the polymers and the pH it is possible to obtain different type of aggregates in solution. This aggregates differ for the volume occupied from them, and for their hardness. Rheological measurements have been demonstrated that the synthesized polymers are capable to form gel phases. The gelation temperature changes changing the structure of the aggregates in solution and it is possible to correlate the changing in the gelation temperature with the changing in the structure of the polymer.

Predictive Ability of NGAL as a Marker of Renal Damage: evaluation of Multiple Clinical Settings

Introduction. Neutrophil Gelatinase-Associated Lipocalin (NGAL) belongs to the family of lipocalins and it is produced by several cell types, including renal tubular epithelium. In the kidney its production increases during acute damage and this is reflected by the increase in serum and urine levels. In animal studies and clinical trials, NGAL was found to be a sensitive and specific indicator of acute kidney injury (AKI). Purpose. The aim of this work was to investigate, in a prospective manner, whether urine NGAL can be used as a marker in preeclampsia, kidney transplantation, VLBI and diabetic nephropathy. Materials and methods. The study involved 44 consecutive patients who received renal transplantation; 18 women affected by preeclampsia (PE); a total of 55 infants weighing ≤1500 g and 80 patients with Type 1 diabetes. Results. A positive correlation was found between urinary NGAL and 24 hours proteinuria within the PE group. The detection of higher uNGAL values in case of severe PE, even in absence of statistical significance, confirms that these women suffer from an initial renal damage. In our population of VLBW infants, we found a positive correlation of uNGAL values at birth with differences in sCreat and eGFR values from birth to day 21, but no correlation was found between uNGAL values at birth and sCreat and eGFR at day 7. systolic an diastolic blood pressure decreased with increasing levels of uNGAL. The patients with uNGAL <25 ng/ml had significantly higher levels of systolic blood pressure compared with the patients with uNGAL >50 ng/ml ( p<0.005). Our results indicate the ability of NGAL to predict the delay in functional recovery of the graft. Conclusions. In acute renal pathology, urinary NGAL confirms to be a valuable predictive marker of the progress and status of acute injury.

Intrazelluläre Lokalisation und synaptische Ausschüttung der Neurotrophine in hippokampalen Neuronen und die Bedeutung von BDNF bei hippokampaler synaptischer Plastizität

Die Mitglieder der Neurotrophin-Familie (NGF, BDNF, NT-3 und NT-4) sind sekretierte Neuropeptide, die eine bedeutende Rolle bei der Entwicklung von Nervenzellen und bei der Modulation der synaptischen Transmission spielen. Wenngleich eine aktivitätsabhängige Sekretion von BDNF bereits gezeigt werden konnte, wurden die subzelluläre Expression und die Ausschüttung der anderen Neurotrophine bislang nur unzureichend charakterisiert. Um die Expression und die Ausschüttung aller Neurotrophine unter identischen Bedingungen untersuchen zu können, wurde in der vorliegenden Arbeit das Expressionsmuster und die synaptische Ausschüttung GFP-markierter Neurotrophine in dissoziierten hippokampalen Neuronen mit Hilfe der konfokalen Fluoreszenz-Videomikroskopie zeitaufgelöst untersucht. Zwei Phänotypen konnten unterschieden werden: der distale vesikuläre Expressionstyp mit Neurotrophin-beinhaltenden Vesikeln in distalen Neuriten, und der proximale Expressionstyp mit einer diffusen Neurotrophin-Verteilung in den Neuriten und Neurotrophin-beinhaltenden Vesikeln im Soma des Neurons und in den proximalen Dendriten. Der distale vesikuläre Phänotyp entsprach einer Verteilung des entsprechenden Neurotrophins in die sekretorischen Granula des aktivitätsabhängigen Sekretionsweges, während der proximale Phänotyp den Transport eines Neurotrophins in den konstitutiven Sekretionsweg widerspiegelte. Alle Neurotrophine erreichten in hippokampalen Neuronen prinzipiell beide Sekretionswege. Jedoch gelangten BDNF und NT-3 mit einer größeren Effizienz in den regulierten Sekretionsweg als NT-4 und NGF (BDNF: in 98% aller Zellen, NT-3: 85%, NT-4: 23% und NGF: 46%). Neurotrophine besitzen, wie es für sekretorische Peptide üblich ist, eine Vorläufersequenz, die während der Reifung des Proteins proteolytisch abgespalten wird. Die Fusion dieser Präpro-Sequenz von BDNF mit der Sequenz des maturen NT-4 bewirkte einen effizienteren Transport von NT-4 in die sekretorischen Granula des regulierten Sekretionsweges, und zeigte die große Bedeutung der Präpro-Sequenz für das zelluläre Verteilungsmuster von Neurotrophinen. In Neuronen, in denen die Neurotrophine in den regulierten Sekretionsweg transportiert wurden, konnte eine aktivitätsabhängige Sekretion der Neurotrophine an postsynaptische Strukturen glutamaterger Synapsen beobachtet werden. Die aktivitätsabhängige postsynaptische Ausschüttung der Neurotrophine zeigte eine Heterogenität in der Kinetik der Sekretion (exponentieller Abfall des Neurotrophin-Signals mit Zeitkonstanten von tau = 121 bis 307s). Die Präinkubtion mit dem Protonen-Ionophor Monensin, welcher die Neutralisation des intragranulären pH-Wertes und somit die Solubilisierung der dicht gepackten Proteinstrukturen in den Vesikeln erzwingt, erhöhte die Geschwindigkeit der Neurotrophin-Ausschüttung auf den Wert des unter physiologischen Bedingungen schnellsten Neurotrophins NT-4. Dennoch blieb die Geschwindigkeit der Neurotrophin-Ausschüttung im Vergleich zur Neurotransmitter-Ausschüttung langsam (tau = 13 ± 2 s). Diese Daten belegen eindeutig, dass die Neutralisation der sekretorischen Granula die Geschwindigkeit der Neurotrophin-Ausschüttung kritisch determiniert und die Geschwindigkeit der Neurotrophin-Ausschüttung im Vergleich zur konventionellen Neurotransmitter-Ausschüttung langsam erfolgt. Des Weiteren konnte gezeigt werden, dass das Neurotrophin BDNF effizient in distale vesikuläre Strukturen von CA1 Pyramidenzellen organotypischer Schnittkulturen des Hippokampus sortiert wird. Die basalen elektrischen Eigenschaften von CA1 Pyramidenzellen BDNF-defizienter Mäuse sind vergleichbar zu den Eigenschaften von Wildtyp Mäusen. Sowohl das Eigenpotential der CA1 Pyramidenzellen, die Form der Aktionspotentiale als auch die evozierten Antworten der CA1 Pyramdenzellen auf eine gepaarte präsynaptische Stimulation der Schaffer-Kollateralen zeigten bei BDNF-/- -, BDNF+/- - und BDNF+/+ -Mäusen keine signifikanten Unterschiede. Die Fähigkeit der CA1 Pyramidenzellen auf eine hochfrequente Reizung mit einer Langzeitpotenzierung (LTP) der postsynaptischen Ströme zu reagieren ist jedoch bei den BDNF-defizienten Mäusen beinträchtigt. Eine verminderte Induktion von LTP war in den BDNF-defizienten Mäusen nach tetanischer Stimulation der präsynaptischen Schaffer-Kollateralen und simultaner postsynaptischer Depolarisation der CA1 Pyramidenzelle zu beobachten.

Spin-crossover in metallomesogens of iron(II)

Covalent grafting mesogenic groups to the coordination cores of the parent mononuclear low-spin and spin-crossover compounds afforded metallomesogenic complexes of iron(II). In comparison with the parent complexes the spin-crossover properties of the alkylated derivatives are substantially modified. The type of the modification was found to be dependent on the properties of the parent system and the nature of the used anion, however, the general tendency is the destabilization of the low-spin state at the favor of spin-crossover or high-spin behavior below 400 K. The structural insight revealed the micro-segregated layered organization. The effect of the alkylation of the parent compounds consists first of all in the change of the lattice to a two-dimensional lamellar one retaining significant intermolecular contacts only within the ionic bilayers. The comprehensive analysis of the structural and thermodynamic data in the homologous series pointed at the mechanism of the interplay between the structural modification on melting and the induced anomalous change of the magnetic properties. A family of one-dimensional spin-crossover polymers was synthesized and characterized using a series of spectroscopic methods, X-ray powder diffraction, magnetic susceptibility measurements and differential scanning calorimetry. The copper analogue of was also synthesized and its crystal structure solved. In comparison with the mononuclear systems, the polymeric mesogens of iron(II) are less sensitive to the glass transition, which was attributed to the moderate concomitant variation of the structure. Nevertheless, the observed increase of the magnetic hysteresis with lengthening of the alkyl substituents was ascribed to the interplay of the structural reorganization of the coordination core due to spin-crossover with the structural delay in the spatial reorganization of the mesogenic substituents. The classification of mononuclear and polymeric metallomesogens according to the interactions between the structural- and the spin-transition and analysis of the data on the reported spin-crossover metallomesogens led to the separation of three types, namely: Type i: systems with coupling between the electronic structure of the iron(II) ions and the mesomorphic behavior of the substance; Type ii: systems where both transitions coexist in the same temperature region but are not coupled due to competition with the dehydration or due to negligible structural transformation; Type iii: systems where both transitions occur in different temperature regions and therefore are uncoupled. Fine-tuning, in particular regarding the temperature at which the spin-transition occurs with hysteresis properties responsible for the memory effect, are still a major challenge towards practical implementation of spin-crossover materials. A possible answer to the problem could be materials in which the spin-crossover transition is coupled with another transition easily controllable by external stimuli. In the present thesis we have shown the viability of the approach realized in the mesogenic systems with coupled phase- and spin-transitions.

Context sensitive design of provincial road Galliera SP4.

In the past centuries and before the invention of automobile, roads consisted mainly of unpaved paths connecting only few cities. Later, in the beginning of the twentieth century, the automobile was introduced and a new type of the transportation system was born. Therefore, it was necessary to change the condition of roads to fit with the automobiles. With the spread and the development of the automobiles, roads also have developed and increased all over the world. That caused negative effects on the environment and humans’ life quality. Thus, highways associations and communities had to take some steps to reduce these effects and care about environmental and cultural issues with the traditional commitment to safety and mobility, and that is known as context sensitive design. The aim of this thesis is to use the concepts of context sensitive design to reduce the negative environmental impacts of provincial road Galliera, which connects via Colombo in city of Bologna to provincial road 3 in Argelato city. Some solutions were proposed in this thesis to reduce traffic noise, fragmentation, fauna mortality and to improve the aesthetics of the road.

Context-sensitive design in transportation infrastructure: relating tire/pavement noise with wearing course characteristics

A design can be defined as context-sensitive when it achieves effective technical and functional transportation solutions, while preserving and enhancing natural environments and minimizing impacts on local communities. Traffic noise is one of the most critical environmental impacts of transportation infrastructure and it affects both humans and ecosystems. Tire/pavement noise is caused by a set of interactions at the contact patch and it is the predominant source of road noise at the regular traffic speeds. Wearing course characteristics affect tire/pavement noise through various mechanisms. Furthermore, acoustic performance of road pavements varies over time and it is influenced by both aging and temperature. Three experimentations have been carried out to evaluate wearing course characteristics effects on tire/pavement noise. The first study involves the evaluation of skid resistance, surface texture and tire/pavement noise of an innovative application of multipurpose cold-laid microsurfacing. The second one involves the evaluation of the surface and acoustic characteristics of the different pavement sections of the test track of the Centre for Pavement and Transportation Technology (CPATT) at the University of Waterloo. In the third study, a set of highway sections have been selected in Southern Ontario with various types of pavements. Noise measurements were carried out by means of the Statistical Pass-by (SPB) method in the first case study, whereas in the second and in the third one, Close-proximity (CPX) and the On-Board Sound Intensity (OBSI) methods have been performed in parallel. Test results have contributed to understand the effects of pavement materials, temperature and aging on tire/pavement noise. Negligible correlation was found between surface texture and roughness with noise. As a general trend, aged and stiffer materials have shown to provide higher noise levels than newer and less stiff ones. Noise levels were also observed to be higher with temperature increase.

Light-sensitive polymeric nanoparticles based on photo-cleavable chromophores

Der Fokus dieser Arbeit liegt in dem Design, der Synthese und der Charakterisierung neuartiger photosensitiver Mikrogele und Nanopartikel als potentielle Materialien für Beladungs- und Freisetzungsanwendungen. Zur Realisierung dieses Konzepts wurden verschiedene Ansätze untersucht.Es wurden neuartige niedermolekulare lichtspaltbare Vernetzermoleküle auf der Basis von o-Nitrobenzylderivaten synthetisiert, charakterisiert und zur Herstellung von photosensitiven PMMA und PHEMA Mikrogelen verwendet. Diese sind unter Bestrahlung in organischen Lösungsmitteln quellbar und zersetzbar. Durch die Einführung anionischer MAA Gruppen in solche PHEMA Mikrogele wurde dieses Konzept auf doppelt stimuliresponsive p(HEMA-co-MAA) Mikrogele erweitert. Hierbei wurde ein pH-abhängiges Quellbarkeitsprofil mit der lichtinduzierten Netzwerkspaltung in wässrigen Medien kombiniert. Diese duale Sensitivität zu zwei zueinander orthogonalen Reizen stellt ein vielversprechendes Konzept zur Kombination einer pH-abhängigen Beladung mit einer lichtinduzierten Freisetzung von funktionellen Substanzen dar. Desweiteren wurden PAAm Mikrogele entwickelt, welche sowohl eine Sensitivität gegenüber Enzymen als auch Licht aufweisen. Dieses Verhalten wurde durch die Verwendung von (meth-)acrylatfunktionalisierten Dextranen als polymere Vernetzungsmoleküle erreicht. Das entsprechende stimuliresponsive Profil basiert auf der enzymatischen Zersetzbarkeit der Polysaccharid-Hauptkette und der Anbindung der polymerisierbaren Vinyleinheiten an diese über photospaltbare Gruppen. Die gute Wasserlöslichkeit der Vernetzermoleküle stellt einen vielversprechenden Ansatz zur Beladung solcher Mikrogele mit funktionellen hydrophilen Substanzen bereits während der Partikelsynthese dar. Ein weiteres Konzept zur Beladung von Mikrogelen basiert auf der Verwendung von photolabilen Wirkstoff-Mikrogel Konjugaten. In einem ersten Schritt zur Realisierung solch eines Ansatzes wurde ein neuartiges Monomer entwickelt. Hierbei wurde Doxorubicin über eine lichtspaltbare Gruppe an eine polymerisierbare Methacrylatgruppe angebunden. Für die Freisetzung hydrophober Substanzen in wässrigen Medien wurden polymere Photolack-Nanopartikel entwickelt, welche sich unter Bestrahlung in Wasser zersetzen. Die lichtinduzierte Änderung der Hydrophobizität des Polymers ermöglichte die Freisetzung von Nilrot durch das Auflösen der partikulären Struktur. Ein interessanter Ansatz zur Verhinderung einer unkontrollierten Freisetzung funktioneller Substanzen aus Mikrogelen ist die Einführung einer stimuliresponsiven Schale. In diesem Kontext wurden Untersuchungen zur Bildung von nicht-stimulisensitiven Schalen um vorgefertigte Mikrogelkerne und zur Synthese von Hydrogelkernen in vorgefertigten polymeren Schalen (Nanokapseln) durchgeführt.

Enzyme tRNA interaction and (t)RNA conformation probed via environmentally sensitive cyanine dyes

Nukleosidmodifikationen beeinflussen Dynamik und Konformation von RNArnund sind epigenetisch wirksam. Wenig verstanden sind konformationelle Dynamik und enzymatische Erkennung von tRNA, sowie der Einfluss des mutmaßlichen kovalenten Inhibitors 5-Fluorouridine (5FU) auf Y Synthasen, die Pseudouridin (Y) erzeugen. Frühere Arbeiten nutzten mit den Fluorophoren Cy3 und Cy5rnmarkierte tRNA, um diese Fragen zu adressieren.rnDie vorliegende Arbeit weitet Cy3-Cy5-Markierung auf Hefe tRNArnPhernaus undrnnutzt Thermophorese und fortschrittliche Fluoreszenzspektroskopie. In der Thermophorese zeigte sich eine hohe Toleranz gegenüber Fluoreszenzmarkierung beirngleichzeitiger Erhöhung der Cy5 Fluoreszenz durch Enzymbindung. Zudem konnte die Konformation verschiedener Mutanten human mitochondrialer tRNArnLysrnund die Bindung von SAM durch SAM-I Riboswitch RNA untersucht werden.rnUm etwaige Unterschiede in der Interaktion von Y55 Synthase TruB mit Cy5-gelabelter U55- bzw. 5FU55-tRNA aufzudecken, wurde eine Kombination ausrnThermophorese, zeit- und polarisationsaufgelöster Fluoreszenzspektroskopie undrn’gel shift’ Experimenten genutzt. Alle Ergebnisse zeigten übereinstimmend einernreversible Bindung ähnlicher Affinität für beide tRNAs und widersprechen somit einer kovalenten Inhibition durch 5FU. Folgerichtig wurde der SDS-stabilernKomplex von TruB mit 5FU-tRNA neu evaluiert, da er bisher als kovalent interpretiert wurde. Es erfolgte eine schnelle Komplexbildung in hoher Ausbeute auchrnfür schlechte Substrate, außerdem ließ sich die Komplexausbeute nicht durch andere Reaktionsbedingungen beeinflussen. Somit kann der SDS stabile Komplexrnnur den ersten, nicht-kovalenten Kontakt von Enzym und 5FU55-tRNA darstellen und repräsentiert kein kovalentes Addukt späterer Katalyse.

Screening for lupus anticoagulant: improving the performance of the lupus-sensitive PTT-LA

Introduction: The aim of the present work was to verify whether calculating a ratio between clotting times obtained with the sensitive PTT-LA and a less sensitive activated partial thromboplastin time (aPTT)-reagent may represent a valuable aPTT-based screening strategy for lupus anticoagulants (LA). Methods: For the pilot study, plasma samples from normal subjects (n = 15) and from patients with LA (n = 10), therapeutic anticoagulation with vitamin K-antagonists (VKA) (n = 15) or unfractionated heparin (n = 15), coagulation factors deficiency (n = 16), and inhibitory antibodies against factor VIII or IX (n = 11) were studied. For the evaluation study, 1553 consecutive plasma samples from nonanticoagulated patients investigated for LA between January 2005 and December 2007 at our institution were studied. Following screening strategies were employed: Pathromtin-SL (aPTT-SL), PTT-LA (aPTT-LA), ratio aPTT-LA/aPTT-SL (aPTT-ratio), and Russell's viper venom (RVV) based LA-Check. LA positive samples were identified by mixing studies and diluted RVV confirmation test (LA-Check/LA-Sure). Results: Pilot study: All screening strategies had a 100% sensitivity, and the aPTT-ratio reached the highest specificity (82%; 95%CI: 74-90%). Within the evaluation study, following sensitivities for LA screening were observed: aPTT-SL 59.0% (95%CI: 57-61%), aPTT-LA 82.1% (95%CI: 80-84%), aPTT-ratio 92.3% (95%CI: 91-94), and LA-Check 83.3% (95%CI: 82-85%). Conclusion: Calculating a ratio between the LA-sensitive PTT-LA and the less sensitive Pathromtin-SL improves the performance of the PTT-LA itself and represents a simple and sensitive aPTT-based integrated strategy for LA screening.

Sensitive and selective detection of free FXIII activation peptide: a potential marker of acute thrombotic events

Coagulation factor XIII (FXIII) stabilizes fibrin fibers and is therefore a major player in the maintenance of hemostasis. FXIII is activated by thrombin resulting in cleavage and release of the FXIII activation peptide (AP-FXIII). The objective of this study was to characterize the released AP-FXIII and determine specific features that may be used for its specific detection. We analyzed the structure of bound AP-FXIII within the FXIII A-subunit and interactions of AP-FXIII by hydrogen bonds with both FXIII A-subunit monomers. We optimized our previously developed AP-FXIII ELISA by using 2 monoclonal antibodies. We determined high binding affinities between the antibodies and free AP-FXIII and demonstrated specific binding by epitope mapping analyses with surface plasmon resonance and enzyme-linked immunosorbent assay. Because the structure of free AP-FXIII had been characterized so far by molecular modeling only, we performed structural analysis by nuclear magnetic resonance. Recombinant AP-FXIII was largely flexible both in plasma and water, differing significantly from the rigid structure in the bound state. We suggest that the recognized epitope is either occluded in the noncleaved form or possesses a structure that does not allow binding to the antibodies. On the basis of our findings, we propose AP-FXIII as a possible new marker for acute thrombotic events.

Supply sensitive services in Swiss ambulatory care: an analysis of basic health insurance records for 2003-2007

Swiss ambulatory care is characterized by independent, and primarily practice-based, physicians, receiving fee for service reimbursement. This study analyses supply sensitive services using ambulatory care claims data from mandatory health insurance. A first research question was aimed at the hypothesis that physicians with large patient lists decrease their intensity of services and bill less per patient to health insurance, and vice versa: physicians with smaller patient lists compensate for the lack of patients with additional visits and services. A second research question relates to the fact that several cantons are allowing physicians to directly dispense drugs to patients ('self-dispensation') whereas other cantons restrict such direct sales to emergencies only. This second question was based on the assumption that patterns of rescheduling patients for consultations may differ across channels of dispensing prescription drugs and therefore the hypothesis of different consultation costs in this context was investigated.