Colony-stimulating factor 1 receptor (CSF1R, Fms) is an integral transmembrane glycoprotein with tyrosine specific protein kinase activity that it is found on the mononuclear phagocytes to promote their survival, proliferation and differentiation. Colony-stimulating factor 1 (CSF-1), also known as M-CSF, is a protein ligand that acts on the CSF1R. There is a variable association of Fms with the stem cell marker CD34 on acute myeloid leukemia (AML) cells and this suggests different structures of the AML hierarchy in different patients. Mouse stromal cells (MS-5) were transduced with a plasmid containing human CSF-1 because mouse CSF-1 is inactive on human CSF1R. Results show that AML cells cultured with CSF-1-expressing stroma had a much better growth and survival than the control stroma, suggesting that CSF-1 might be a stimulating factor for the growth of leukemic stem cells.

Eine Vielzahl präklinischer Schlaganfallstudien zeigte die neuroprotektive und neuroregenerative Wirkung des hämatopoetischen Wachstumsfaktors G-CSF (Granulozyten-Kolonie stimulierender Faktor). Ein Wirkungsmechanismus des G-CSF ist die Mobilisation von protektiven Knochen-markzellen in die ischämische Läsion, wobei diese zeitverzögert nach G-CSF-Gabe stattfindet. Eine zusätzliche frühzeitige Transplantation mononukleärer Knochenmarkzellen (BM MNC) könnte diese therapeutische Lücke füllen. Ziel der vorliegenden Studie war es, die Wirksamkeit dieser Kombinations-therapie in einem Schlaganfallmodell der spontan hypertensiven Ratte (SHR) zu testen. Syngene BM MNC wurden aus dem Knochenmark von SHRs durch immunmagnetische Depletion der Granulozyten isoliert. Nach Verschluss der Arteria cerebri media wurde den Tieren über insgesamt 5 Tage G-CSF verabreicht und zusätzlich zu einem frühen (6h nach Schlaganfall) oder späteren (48h nach Schlaganfall) Zeitpunkt BM MNC intravenös appliziert. Unbehandelte Schlaganfalltiere sowie Tiere mit alleiniger G-CSF-Therapie dienten als Kontrolle. Das Infarktvolumen wurde weder durch die alleinige G-CSF-Gabe noch durch die zusätzliche Zelltherapie verändert. Dennoch wiesen Tiere mit G-CSF-Einzeltherapie eine anhaltende funktionelle Verbesserung des sensomotorischen Defizites auf. Während die zusätzliche frühzeitige Zelltransplantation (6h) keinen weiteren Therapieeffekt zeigte, führte die Zelltransplantation nach 48h zu einer Aufhebung des protektiven G-CSF Effektes. Die G-CSF-Therapie bewirkte erwartungsgemäß einen deutlichen Anstieg der zirkulierenden Leukozyten. Interessanterweise wurde der Granulozytengehalt im Blut und in der Milz durch die einmalige Zelltherapie nach 48h signifikant erhöht. Ein Großteil der transplantierten BM MNC (48h) konnte in der Milz nachgewiesen werden und führte dort vermutlich zu einer kompetitiven Hemmung des Granulozytenabbaus. Dies hatte sowohl den Anstieg der zirkulierenden Granulozyten als auch deren vermehrte Infiltration in das ischämische Hirngewebe zur Folge und könnte schließlich den negativen Einfluss auf die funktionelle Verbesserung erklären. Die beobachteten Interaktionsmechanismen werfen ein interessantes Licht auf die mögliche Wirkungsweise von Zelltherapien und unterstreichen die entscheidende Rolle des Immunsystems in der Pathophysiologie des Schlaganfalls.

In dieser Arbeit wird das in vivo-Verhalten der murinen Erythro- und Granulopoese, einschließlich der hämatopoetischer Stammzellen, unter dem Einfluß von exogen appliziertem G-CSF und Erythropoietin mit Hilfe eines mathematischen Kompartimentmodelles untersucht. Der Schwerpunkt liegt auf der Identifizierung von linienübergreifenden Wachstumsfaktoreffekten. Zu diesem Zweck werden experimentelle Daten mit den Modellsimulationen unter Berücksichtigung verschiedener Modellannahmen verglichen. Die experimentellen Daten für die Modellentwicklung stammen zum einem kleinen Teil aus der Literatur, hauptsächlich betrachtet wurden jedoch Daten einer kooperierenden niederländischen Arbeitsgruppe. Die beiden Wachstumsfaktoren wurden kontinuierlich und simultan mittels osmotischer Minipumpen subkutan über einen längeren Zeitraum appliziert. Die experimentellen Daten werden zunächst mit Hilfe eines nichtlinearen Regressionsmodelles analysiert und quantitativ beschrieben, wobei Interaktionseffekte zwischen den Wachstumsfaktoren besondere Berücksichtigung finden. Es wird dann ein umfassendes mathematischen Differentialgleichungsmodell der murinen Erythro- und Granulopoese unter Berücksichtigung der linienübergreifenden Wachstumsfaktoreffekte und Interaktionen aufgestellt. Es wird zunächst überprüft, ob sich die beobachteten Daten unter Simultanstimulation durch die einfache Zusammenschaltung zweier bereits existierender Einzelmodelle der Erythro- und Granulopoese ohne weitere Modellannahmen erklären lassen. Dazu werden Daten von normalen als auch splenektomierten Tieren berücksichtigt. Es zeigt sich nach Prüfung verschiedener Hypothesen, dass erst unter Annahme einer durch Erythropoietin potenzierten Amplifikation der primär G-CSF-abhängigen Zellstufe der lienalen CFU-GM die experimentell beobachteten Effekte erklärt werden können. Es wird außerdem gezeigt, daß sich mit demselben Modell und denselben Modellparametern die bei splenektomierten Tieren zu beobachtetende G-CSFabhängige Entwicklung einer EPO-resistenten Anämie gut erklärt wird. In einem zweiten Teil der Arbeit wird ein Modellkonzept erarbeitet, mit welchem sich die Effekte nach Langzeitgabe von G-CSF mittels rezeptorvermitteltem G-CSF-Abbau erklären lassen. In einem dritten Teil wird geprüft, ob sich die hämatopoetische Zellzahldynamik nach Absetzen der G-CSF-Gabe durch eine aktive Rückmigration von Progenitoren aus der Milz in das Knochenmark erklären läßt. Das in dieser Arbeit entwickelte kombinierte Modell der Erythro- und Granulopoese impliziert eine Reihe von weiteren Fragen und bedarf der Überprüfung und Weiterentwicklung anhand weiterer experimenteller Daten. Dafür werden entsprechende Vorschläge erarbeitet, die weitere Einblicke in das komplexe Systemverhalten der Hämatopoese liefern könnten.

Background: Although the growth-factor G-CSF is widely used to prevent granulotoxic side effects of cytotoxic chemotherapies, its optimal use is still unknown since treatment outcome depends on many parameters such as dosing and timing of chemotherapies, pharmaceutical derivative of G-CSF used and individual risk factors. We showed in the past that a pharmacokinetic and dynamic model of G-CSF and human granulopoiesis can be used to predict the performance of yet untested G-CSF schedules. However, only a single chemotherapy was considered so far. In the present paper, we propose a comprehensive model of chemotherapy toxicity and combine it with our cell kinetic model of granulopoiesis. Major assumptions are: proportionality of cell numbers and cell loss, delayed action of chemotherapy, drug, drugdose and cell stage specific toxicities, no interaction of drugs and higher toxicity of drugs at the first time of application. Correspondingly, chemotherapies can be characterized by a set of toxicity parameters which can be estimated by fitting the predictions of our model to clinical time series data of patients under therapy. Data were either extracted from the literature or were received from cooperating clinical study groups. Results: Model assumptions proved to be feasible in explaining granulotoxicity of 10 different chemotherapeutic drugs or drug-combinations applied in 33 different schedules with and without G-CSF. Risk groups of granulotoxicity were traced back to differences in toxicity parameters. Conclusion: We established a comprehensive model of combined G-CSF and chemotherapy action in humans which allows us to predict and compare the outcome of alternative G-CSF schedules. We aim to apply the model in different clinical contexts to optimize and individualize G-CSF treatment.

abstract: Magnetic resonance flow imaging techniques provide quantitative and qualitative information that can be attributed to flow related clinical pathologies. Clinical use of MR flow quantification requires fast acquisition and reconstruction schemes, and minimization of post processing errors. The purpose of this work is to provide improvements to the post processing of volumetric phase contrast MRI (PCMRI) data, identify a source of flow bias for cine PCMRI that has not been previously reported in the literature, and investigate a dynamic approach to image bulk cerebrospinal fluid (CSF) drainage in ventricular shunts. The proposed improvements are implemented as three research projects. In the first project, the improvements to post processing are made by proposing a new approach to estimating noise statistics for a single spiral acquisition, and using the estimated noise statistics to generate a mask distinguishing flow regions from background noise and static tissue in an image volume. The mask is applied towards reducing the computation time of phase unwrapping. The proposed noise estimation is shown to have comparable noise statistics as that of a vendor specific noise dynamic scan, with the added advantage of reduced scan time. The sparse flow region subset of the image volume is shown to speed up phase unwrapping for multidirectional velocity encoded 3D PCMRI scans. The second research project explores the extent of bias in cine PCMRI based flow estimates is investigated for CSF flow in the cerebral aqueduct. The dependance of the bias on spatial and temporal velocity gradient components is described. A critical velocity threshold is presented to prospectively determine the extent of bias as a function of scan acquisition parameters. Phase contrast MR imaging is not sensitive to measure bulk CSF drainage. A dynamic approach using a CSF label is investigated in the third project to detect bulk flow in a ventricular shunt. The proposed approach uses a preparatory pulse to label CSF signal and a variable delay between the preparatory pulse and data acquisition enables tracking of the CSF bulk flow. / Dissertation/Thesis / Doctoral Dissertation Biomedical Engineering 2017

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The increasing awareness of data mining technology, along with the attendant increase in the capturing, warehousing, and utilization of historical data to support evidence-based decision making, is leading many organizations to recognize that the effective use of data is the key element in the next generation of client-server enterprise information technology. The concept of data mining is gaining acceptance in business as a means of seeking higher profits and lower costs. To deploy data mining projects successfully, organizations need to know the key factors for successful data mining. Implementing emerging information systems (IS) can be risky if the critical success factors (CSFs) have been researched insufficiently or documented inadequately. While numerous studies have listed the advantages and described the data mining process, there is little research on the success factors of data mining. This dissertation identifies CSFs in data mining projects. Chapter 1 introduces the history of the data mining process and states the problems, purposes, and significances of this dissertation. Chapter 2 reviews the literature, discusses general concepts of data mining and data mining project contexts, and reviews general concepts of CSF methodologies. It also describes the identification process for the various CSFs used to develop the research framework. Chapter 3 describes the research framework and methodology, detailing how the CSFs were identified and validated from more than 1,300 articles published on data mining and related topics. The validated CSFs, organized into a research framework using 7 factors, generate the research questions and hypotheses. Chapter 4 presents analysis and results, along with the chain of evidence for each research question, the quantitative instrument and survey results. In addition, it discusses how the data were collected and analyzed to answer the research questions. Chapter 5 concludes with a summary of the findings, describing assumptions and limitations and suggesting future research.

Delirium, or “acute confusion” is a common and serious acute neuropsychiatric syndrome mainly affecting older people. It is associated with multiple adverse outcomes, including an increased risk of developing dementia and increased mortality. The underlying mechanisms of delirium are poorly understood, and there are currently no specific treatments. This thesis investigated the roles of the hypothalamic-pituitary adrenal axis and inflammation in the pathophysiology of delirium, persistent delirium and cognitive decline following delirium. It investigated whether levels of cortisol in blood and cerebrospinal fluid (CSF) are elevated in delirium, with elevated pro-inflammatory and reduced anti-inflammatory cytokines. It also investigated whether there is loss of cortisol diurnal rhythm (in saliva) with elevated afternoon cortisol levels. The thesis investigated whether any hypercortisolaemia was sustained during the year after delirium, and whether this was associated with deterioration in cognition during the year after hip fracture. Finally, it also tested whether there are high levels of a marker of central nervous system damage (S100B) and of a dementia marker (tau) in CSF in delirium. A prospective observational cohort study was conducted in N=108 patients aged over 60 who had sustained a hip fracture, in whom 40% developed delirium. Participants gave informed consent or if they lacked capacity to give informed consent, this was given by their next of kin. Participants were assessed regularly for delirium, according to DSM IV criteria, during the two weeks after hip fracture. A sample of CSF was collected during the spinal anaesthetic performed for the operation to repair their fracture. Samples of blood and saliva were collected during the two weeks after the hip fracture operation. Participants were visited three, six and twelve months after their hip fracture for further delirium assessment, and a cognitive test battery was completed. Further samples of blood and saliva were collected at these visits. The study found evidence of high levels of cortisol and of S100B in CSF in those with active delirium, but there were no differences in levels of tau or cytokines in CSF. Those with delirium had elevated serum cortisol during the perioperative period, and elevated afternoon salivary cortisol, suggesting flattening of cortisol diurnal rhythm with failure to reach the normal diurnal nadir. After adjusting for confounders in a multivariate logistic regression analysis, serum cortisol was still predictive of delirium, but salivary cortisol AM:PM ratio had a trend towards significance. Those who had persistent delirium features in the months after hip fracture had significantly higher serum cortisol three months after hip fracture. There was a change in serum inflammatory profile in those with delirium, with a shift towards a pro-inflammatory state. Testing the study hypotheses surrounding cognition after delirium was very challenging, due to patient attrition and other factors. Some participants showed a trajectory of cognitive improvement, which was probably due to resolution of delirium during the year after hip fracture. Those with resolved delirium had deficits in verbal and visual memory. This study has improved understanding of the mechanisms of delirium, suggested further avenues for research and identified possible new therapeutic targets.

The Kingdom of Saudi Arabia (SA) set out its Vision 2030 of itself as a significant Knowledge Economy to position itself competitively in the world and in the Gulf region. The Government charged the education sector to prepare young people and build the creativity, innovation and technical skills for the country’s future. The Ministry of Education (MOE) selected TQM and has made strategic investments to achieve this strategic transformation in education. Despite this substantial investment in the infrastructure, teaching skills, information technology and advancement programmes for women to enter the workplace, the implementation of TQM has not so far delivered the outcomes expected in secondary schools (Bank, 2008; Chapman and Miric, 2009; TIMSS, 2011). This research proposes that a programme that primarily focuses on the hard aspects of change, without participatory leadership and without integrating the people concerned (as a soft programme would), cannot achieve sustainable transformation. An empirical study was designed to investigate staff perception of TQM implementation in girls’ secondary schools in the Kingdom. The 525 respondents from 61 schools in five districts of Riyadh suggest that the most pivotal critical success factors (CSFs) limiting the development of TQM culture were Top Management Commitment; Training; Tools and Techniques; and Reward and Recognition. The perception results were then used as the baseline to design a model that integrates the hard and soft CSFs of TQM in five stages of maturity. This assessment model could be used to support the schools and the MOE in objectively assessing the readiness of schools to implement TQM and identify the next major obstacles to reaching the next stage. The design approach of a maturity model is innovative in using context perception data as the baseline for designing the stages of maturity and the success factors the progress of change, making its use appropriate for the girls’ schools in the Kingdom of Saudi Arabia.

La seguridad nacional y económica de los países depende del funcionamiento confiable de su infraestructura crítica. Las amenazas de ciberseguridad explotan la creciente complejidad de dichos sistemas, colocando la economía, la seguridad pública y la salud en riesgo. Al igual que el riesgo financiero y de reputación, el riesgo de ciberseguridad afecta a los objetivos estratégicos de una empresa. Puede aumentar los costos y afectar los ingresos. Puede dañar la capacidad de una organización para Innovar, brindar servicios, ganar y mantener a los clientes. Así mimo, la información se ha convertido en uno de los activos más importantes para cualquier organización, y el aseguramiento de la misma como un punto primordial para lograr ventajas competitivas y generación del valor, basando en el adecuado resguardo de la Confidencialidad, Disponibilidad e Integridad de la Información. El propósito del presente trabajo es desarrollar y proponer un método que permita gestionar la ciberseguridad en empresas del sector telecomunicaciones sobre la base de una adecuada gestión del riesgo y la medición de controles según un nivel de madurez. Este método propuesto se encuentra basado en el Cyber Security Framework (CSF) del National Institute of Standards and Technology (NIST) promulgada por el Presidente Obama mediante la Orden Ejecutiva (EO) 13636. / The national and economic security of the countries depends on the reliable operation of their critical infrastructure. Cybersecurity threats exploit the increasing complexity of these systems, putting the economy, public safety and health at risk. Like financial and reputation risk, cybersecurity risk affects the strategic objectives of a company. It can increase costs and affect income. It can damage the ability of an organization to innovate, provide services, earn and maintain customers. Likewise, information has become one of the most important assets for any organization, and the assurance of it as a fundamental point to achieve competitive advantages and generation of value, based on the appropriate protection of Confidentiality, Availability and Integrity of the information. The purpose of this paper is to develop and propose a method for managing cybersecurity in companies in the telecommunications sector on the basis of an adequate risk management and the measurement of controls according to a level of maturity. This proposed method is based on the Cyber Security Framework (CSF) of the National Institute of Standards and Technology (NIST) promulgated by President Obama through Executive Order (EO) 13636. / Trabajo de investigación