The energy biology of European Mistletoe (Viscum album)

The hemiparasitic European mistletoe (Viscum album) is known for its extraordinary way of life. Not only its huge genome of about 90 Gbp is noticeable, but also the absence of mitochondrial complex I of the Oxidative Phosphorylation system. Since a large genome indicates a high energy demand during cellular division, absence of complex I, which strongly contributes to the proton gradient across the inner mitochondrial membrane and thus to ATP production, is to be considered remarkable. How can V. album accomplish its energy metabolism? This is the central research question of this thesis. To this end, the transcriptome of V. album was first sequenced to provide the basis for efficient proteome analysis. RNA was isolated from mistletoe leaves, flowers, and stems harvested in summer and winter. The RNA was next transcribed into cDNA and sequenced as a pooled sample via the PacBio sequencing strategy. The resulting initial Viscum album Gene Space (VaGs) database showed 78% completeness based on Benchmarking Universal Single-Copy Orthologs (BUSCO) analysis. To further develop this database, additional Illumina sequencing of the individual samples (summer and winter) was performed. The resulting Viscum album Gene Space database II (VaGsII) has a completeness of 93% and contains sequences of 90,039 transcripts. Based on these sequences, a GC content of 50% could be calculated. This is an unusually high GC content, as in other dicotyledonous plants the GC content usually ranges between 43-45 %. Due to the resulting enhanced stability of the DNA, an increased energy requirement must also be anticipated for DNA replication and transcription. In addition to the absence of the mitochondrial genes encoding subunits of complex I, the absence of almost all nuclear genes encoding complex I subunits could be shown. Furthermore, by re-evaluating an existing complexome dataset of V. album mitochondria using the new VaGs II database, more than 1,000 additional mitochondrial proteins could be identified with respect to the original evaluation. Besides the mitochondria, also the chloroplasts were examined in more detail to determine their contribution to the energy metabolism of V. album cells through photosynthesis and photophosphorylation. In the course of this examination, a complete absence of the NDH complex (NADH dehydrogenase- like complex, chloroplast pendant of mitochondrial complex I), which contributes to cyclic electron transport around photosystem I, was proven on the proteome level. In addition, PGR5 and PGRL1, two proteins which were shown to be alternatively involved in cyclic electron transport around photosystem I, were found to be of reduced abundance in V. album compared to the model plant Arabidopsis thaliana. Abundance of the chloroplast ATP synthase complex is comparable to A. thaliana; however, its stability clearly is increased in V. album. Also, the photosystem II is of similar abundance in A. thaliana and V. album, in contrast to the photosystem I, which is of comparatively low abundance in V. album. It can be concluded that both, linear and cyclic electron transport and thus ATP synthesis by photophosphorylation are comparatively low in V. album. In summary, it can be concluded that: 1. V. album has an even higher energy demand than previously thought due to its high GC content. 2. ATP production in mitochondria and chloroplasts is limited due to the absence or reduced abundance of some of the involved proteins and protein complexes. How sufficient amounts of ATP are provided in V. album cells is therefore still not entirely clear. It is hypothesized that the slow growth and reduced cell division rate of V. album might reduce its energy demand. In addition, sugar compounds transported in the host xylem in spring may be a source of energy for V. album. This may also explain the strong growth rate of V. album in spring. Further research is needed to understand the way of life of this very particular plant

Integrating the Pharmacist into Cancer Medication Management

Aim: The present study aimed at evaluating the integration of the pharmacist in multiprofessional cancer care. Methods: Part I: Two pharmaceutical care services for cancer patients were compared. One was provided by a pharmacist on an on-demand basis (on-demand pharmacist (OP)), the other was provided by a pharmacist integrated in the cancer care team (integrated pharmacist (IP)). Part II: Focus group meetings were held to identify relevant tasks in multiprofessional cancer medication management (MCMM). With the Delphi technique these tasks were allocated to physicians, pharmacists and nurses. The acceptance of the proposed MCMM model and the perceptions on multiprofessional teamwork was explored via an online questionnaire. Part III: The MCMM tasks defined in part II were allocated according to part I and the resulting distribution was compared with the MCMM model regarding the role of the pharmacist. Results: Part I: The OP identified less drug-related problems and the difference in interventions indicated a more team- and medication-related role of the IP. Both types of pharmacists were a highly recognized and valued source of information for the cancer patients. The patient satisfaction with information was equally high and the patients’ quality of life was stable in both groups. Part II: 38 tasks necessary in cancer medication management were identified and the allocation to physician, pharmacist and nurse resulted in 27 shared responsibilities. It was perceived that the pharmacist should take responsibility for tasks concerning patient education and counseling as well as prevention of drug-related problems. Professionals accepted the proposed MCMM model and rated it to be reasonable (79%), feasible (68%) and quality-enhancing (67%). Barriers and benefits to multiprofessional teamwork concerned patient-, team-, therapy-, structure-, resources-related categories or were not seen. Part III: Concerning the pharmacist 32% of task responsibilities in part I differed from the allocation in the proposed MCMM model in part II. Conclusions: The present study showed that the integration of the pharmacist into the health care team can facilitate the detection and solution of DRPs going along with high patient recognition and valuation of the pharmacist as an information source. The proposed MCMM model established the pharmacist’s responsibilities in patient education and counseling as well as prevention of drug-related problems and might serve as a tool to trigger local changes in cancer medication management regarding the allocation and completion of necessary tasks in the multiprofessional team

The Utah Statesman, February 23, 2011

Weekly student newspaper of Utah State University in Logan.https://digitalcommons.usu.edu/newspapers/1142/thumbnail.jp