Virtual libraries of tissue and clinical samples: potential role of a 3-D microscope.

Our international innovative teaching group from different European Universities (De Montfort University, DMU, UK; and the Spanish University of Alcalá, University Miguel Hernández and University of San Pablo CEU), in conjunction with practicing biomedical scientists in the National Health Service (UK) and biomedical researchers, are developing two complete e-learning packages for teaching and learning medical parasitology, named DMU e-Parasitology (accessible at: http://parasitology.dmu.ac.uk), and biology and chemistry, named DMU e-Biology (accessible at: http://parasitology.dmu.ac.uk/ebiology/index.htm), respectively. Both packages will include a virtual microscope with a complete library of digitised tissue images, clinical slides and cell culture slides/mini-videos for enhancing the teaching and learning of a myriad of techniques applicable to health science undergraduate and postgraduate students. Thus, these packages include detecting human parasites, by becoming familiar with their infective structures and/or organs (e.g. eggs, cysts) and/or explore pathogenic tissues stained with traditional (e.g. haematoxylin & eosin) or more modern (e.g. immunohistochemistry) techniques. The Virtual Microscope (VM) module in the DMU e-Parasitology package is almost completed (accessible at: http://parasitology.dmu.ac.uk/learn/microscope.htm) and contains a section for the three major groups of human-pathogenic parasites (Peña-Fernández et al., 2018) [1]. Digitised slides are provided with the functionality of a microscope by using the gadget Zoomify®, and we consider that they can enhance learning, as previous studies reported in the literature have reported similar sensitivity and specificity rates for identification of parasites for both digitised and real slides. The DMU e-Biology’s VM, currently in development, will provide healthy and pathological tissue samples from a range of mammalian tissues and organs. This communication will provide a description of both virtual libraries and the process of developing them. In conjunction, we will use a three-dimensional (3D) super-resolution microscopy, 3D Cell Explorer (Nanolive, Lausanne, Switzerland), to incorporate potential 3D microscopic photographs/short videos of cells to provide students with information about the spatial arrangement and morphologies of cells that are essential for life

Web-based learning and teaching resources for microscopic detection of human parasites.

DMU e-Parasitology (http://parasitology.dmu.ac.uk) presents novel web-based resources co-developed by EU academics at De Montfort University (DMU) for the teaching and learning of microscopic diagnoses of common and emerging human parasites. The package will be completed early in 2019 and presents a Virtual Laboratory and Microscope, which are equipped with engaging units for learning parasitological staining and fresh preparation techniques for detecting cysts, oocysts, eggs and spores, in conjunction with a library of digitised clinical slides. Units are equipped with short videos of academics performing the different techniques and quizzes and exercises, to provide students with the most practical experience possible

Cryptosporidium spp. in the English urban environment: a public health concern?

Several species of Cryptosporidium can infect humans and have been described as opportunistic parasites. Different outbreaks have been described in the UK as oocysts of these pathogens can spread through contaminated water and food as some species of Cryptosporidium, such as C. parvum, exhibit resistance to harsh environmental conditions. These pathogens have been found in animal faeces, thus we reported the presence of Cryptosporidium spp. in a dog faecal sample collected in a highly frequented public park in Leicester city centre (UK), after screening 9 topsoil and 18 faecal samples. As a result, and to determine potential risks to the Leicester population, we collected 132 animal faecal samples [37 deer, 13 dogs, 4 cats and 78 avian (27 uncertain due to diarrhoea, 25 pigeon, 14 waterfowl and 12 songbird)] across different parks in Leicester from June 2017 to May 2018. Animal faecal samples were appropriately screened using Kinyoun's acid-fast staining. We observed structures related to Cryptosporidium spp. in 16 faecal samples as follows: 10.3% avian (3 pigeon, 2 songbird and 3 diarrhoeic), 18.9% deer and 7.7% dog. However, and in order to characterise the risks to the local population, molecular analysis will be required to determine if the oocysts of Cryptosporidium spp. found are from anthroponotic species. Our results might highlight the relevance of performing environmental monitoring studies to determine the presence of these pathogens in the urban environment due to the unprecedented expansion of the urban media that is occurring to a global scale

Human-related microsporidia in the English urban environment: what we know so far?

The potential zoonotic transmission route of Enterocytozoon bieneusi and Encephalitozoon spp. (E. intestinalis, E. hellem and E. cuniculi) is under discussion. “Urban animals” could represent a risk to the population that should be carefully studied. Following the detection of human-related microsporidia in 2 out of 18 dog faecal samples collected in the city centre of Leicester (UK) in January 2016, 228 animal faecal samples were randomly sampled from different parks and recreational areas across the city from June 2016 to February 2017. The presence of microsporidia species were sought by real time polymerase chain reaction (RT-PCR) with melting curve analysis after extracting DNA by dysrupting the spores using Fast-Prep for soil following previous methodologies. 28 stool samples were positive for human-pathogenic microsporidia, as follows: Enterocytozoon bieneusi was detected in 2 waterfowl stool samples. A higher prevalence of Encephalitozoon spp. was identified. Thus, 26 faecal samples (14 deer, 7 avian [3 waterfowl, 2 songbird, 1 pigeon, 1 uncertain], 2 dog, 1 fox and 2 unidentified due to diarhoea) were positive for Encephalitozoon spp. Specifically, E. intestinalis/ E. hellem were detected in two samples from avian species (waterfowl and diarrhoeic sample) and E. cuniculi in 7 (6 deer and 1 fox). Our results indicate that human-related microsporidia would be present in urban parks and recreational areas in Leicester, which could represent a risk for humans. Interventions to tackle this potential risk should be applicable to a variety of animals, although more studies are needed to fully understand the potential zoonotic role of these pathogens

Introducing medical parasitology at the University of Makeni, Sierra Leone

The file attached to this record is the author's final peer reviewed version.Capacity building in Sierra Leone (West Africa) is critical to prevent potential future outbreaks similar to the 2013-16 Ebola outbreak that had devastating effects for the country and its poorly developed healthcare system. De Montfort University (DMU) in the United Kingdom (UK), in collaboration with parasitologists from the Spanish Universities of San Pablo CEU and Miguel Hernández de Elche, is leading a project to build the teaching and research capabilities of medical parasitology at the University of Makeni (UniMak, Sierra Leone). This project has two objectives: a) to introduce and enhance the teaching of medical parasitology, both theoretical and practical; and b) to implement and develop parasitology research related to important emerging human parasites such as Cryptosporidium spp. due to their public health significance. Two UniMak academics, hired to help initiate and implement the research part of the project, shared their culturally sensitive public health expertise to broker parasitology research in communities and perform a comprehensive environmental monitoring study for the detection of different emerging human parasites. The presence of targeted parasites are being studied microscopically using different staining techniques, which in turn have allowed UniMak’s academics to learn these techniques to develop new practicals in parasitology. To train UniMak’s academics and develop both parts of our project, a DMU researcher visited UniMak for two weeks in April 2019 and provided a voluntary short training course in basic parasitology, which is currently not taught in any of their programmes, and was attended by 31 students. These sessions covered basic introduction to medical parasitology and life-cycle, pathogenesis, detection, treatment and prevention of: a) coccidian parasites (Cryptosporidium, Cyclospora and Cystoisospora); b) Giardia intestinalis, Entamoeba and free-living amoebas; c) malaria and d) microsporidia. A theoretical session on common staining techniques was also provided. To facilitate the teaching and learning of these parasites, the novel resource DMU e-Parasitology was used, a package developed by the above participating universities and biomedical scientists from the UK National Health Service (NHS): http://parasitology.dmu.ac.uk/ index.htm. Following the two weeks of training, UniMak’s academics performed different curriculum modifications to the undergraduate programme ‘Public Health: Medical Laboratory Sciences’, which includes the introduction of new practicals in parasitology and changes to enhance the content of medical parasitology that will be subjected to examination. Thus, a new voluntary practical on Kinyoun stain for the detection of coccidian parasites was introduced in the final year module of ‘Medical Bacteriology and Parasitology’; eighteen students in pairs processed faecal samples from pigs provided by the Department of Agriculture and Food Security from a nearby farm. Academics at UniMak used the Kinyoun staining unit (available at http://parasitology.dmu.ac.uk/learn/lab/Kinyoun/story_html5.html; [1]) to deliver this practical. Although our project is at a preliminary stage, it has been shown to be effective in promoting the introduction and establishment of medical parasitology at UniMak and could be viewed as a case-study for other universities in low-income countries to promote the United Nations (UN) Sustainable Development Goals (SDGs) and improve public health understanding of infectious diseases

HQR-Scheme: A High Quality and resilient virtual primary key generation approach for watermarking relational data

Most of the watermarking techniques designed to protect relational data often use the Primary Key (PK) of relations to perform the watermark synchronization. Despite offering high confidence to the watermark detection, these approaches become useless if the PK can be erased or updated. A typical example is when an attacker wishes to use a stolen relation, unlinked to the rest of the database. In that case, the original values of the PK lose relevance, since they are not employed to check the referential integrity. Then, it is possible to erase or replace the PK, compromising the watermark detection with no need to perform the slightest modification on the rest of the data. To avoid the problems caused by the PK-dependency some schemes have been proposed to generate Virtual Primary Keys (VPK) used instead. Nevertheless, the quality of the watermark synchronized using VPKs is compromised due to the presence of duplicate values in the set of VPKs and the fragility of the VPK schemes against the elimination of attributes. In this paper, we introduce the metrics to allow precise measuring of the quality of the VPKs generated by any scheme without requiring to perform the watermark embedding. This way, time waste can be avoided in case of low-quality detection. We also analyze the main aspects to design the ideal VPK scheme, seeking the generation of high-quality VPK sets adding robustness to the process. Finally, a new scheme is presented along with the experiments carried out to validate and compare the results with the rest of the schemes proposed in the literature

Tratamiento sindrome coronario agudo combinado triple I

El Síndrome Coronario Agudo (SCA) es una cardiopatía coronaria que causa mortalidad en pacientes adultos mayores. Como se ha explicado en la anterior comunicación se ha elegido la antiagregación plaquetaria dual como estrategia más apropiada de tratamiento en pacientes con SCA mediante la utilización de los fármacos, ácido acetil salicílico (AAS) y clopidogrel (CLO). La Agencia Europea del Medicamento (EMA) considera que los resultados de los diferentes estudios realizados han mostrado que la asociación CLO/AAS (75 mg/100 mg) es bioequivalente a los comprimidos con la misma dosis administrada por separado. Una reacción adversa bien conocida de estos fármacos tanto en monoterapia como en asociación, son los trastornos gastrointestinales, entre las cuales destaca la hemorragia gastrointestinal, que deberá ser tratada con el antiulcerogénico, ranitidina (RAN). En este trabajo, después de seleccionar los principios activos, se propone un desarrollo farmacéutico de minicomprimidos con dos antiagregantes plaquetarios, AAS y CLO, conjuntamente, y la RAN como inhibidor de la producción de ácido clorhídrico, para tratar el riesgo de hemorragia gastrointestinal, en cápsulas duras de liberación retardada (“tablets-in-capsule”). Un reto trascendental consistió en mejorar la terapia antiagregante con riesgo de hemorragia gastrointestinal que estaba comercializada hasta este momento mediante una novedosa triple asociación terapéutica. Estas asociaciones aportan innumerables ventajas pues suponen una mejora terapéutica, una mayor comodidad posológica al permitir la administración de estos tres fármacos en una unidad de dosificación única, una mayor adherencia del paciente al tratamiento, además, de reducir la tasa de ingresos hospitalarios. La terapia triple debe programarse para un periodo determinado, pues es sabido que en la práctica diaria la atención a la seguridad es un elemento clave a considerar en este tipo de tratamientos combinados. Los minicomprimidos se dosifican en una cápsula dura de liberación retardada cuya velocidad de disolución deberá ser comparable a la de las respectivas formulaciones de referencia comercializadas. Las cápsulas que se proponen son gastrorresistentes (V caps enteric®). El proceso de llenado de los minicomprimidos se podría realizar en encapsuladoras de movimiento continuo, ya que son las más adecuadas para dicho proceso, señalando su importancia en términos de rendimiento de producción

A Double Fragmentation Approach for Improving Virtual Primary Key-Based Watermark Synchronization

Relational data watermarking techniques using virtual primary key schemes try to avoid compromising watermark detection due to the deletion or replacement of the relation's primary key. Nevertheless, these techniques face the limitations that bring high redundancy of the generated set of virtual primary keys, which often compromises the quality of the embedded watermark. As a solution to this problem, this paper proposes double fragmentation of the watermark by using the existing redundancy in the set of virtual primary keys. This way, we guarantee the right identification of the watermark despite the deletion of any of the attributes of the relation. The experiments carried out to validate our proposal show an increment between 81.04% and 99.05% of detected marks with respect to previous solutions found in the literature. Furthermore, we found out that our approach takes advantage of the redundancy present in the set of virtual primary keys. Concerning the computational complexity of the solution, we performed a set of scalability tests that show the linear behavior of our approach with respect to the processes runtime and the number of tuples involved, making it feasible to use no matter the amount of data to be protected

Studying the presence of Cyclospora and Cystoisospora in urban parks from Leicester, UK.

Cyclospora cayetanensis and Cystoisospora belli (formerly known as Isospora belli) are emerging coccidian parasites that can spread by ingesting contaminated food or water. Despite their presence is more common in tropical and subtropical regions, different studies have described domestic outbreaks due to these pathogens around the world. Zoonotic transmission of these pathogens is under discussion as they have been found in various animals and birds. We have performed a preliminary study to investigate their potential presence in an English urban environment. 132 animal faecal samples were collected between Summer 2017 and Spring 2018 from 7 different urban parks across Leicester (UK). A veterinarian confirmed animal species as: 78 avian (25 pigeon, 14 waterfowl, 12 songbird, 27 uncertain due to diarrhoea), 37 deer, 13 dogs and 4 cats. Smears were microscopically analysed by Kinyoun's acid-fast staining technique. Cyclospora spp. were observed in three faecal samples (2.3%), two from deer and one from avian (diarrheic sample); however, further analysis are required to determine if the oocysts observed are from Cyclospora cayetanensis. Contrarily, Cystoisospora spp. were not found in any of the screened stool samples. Despite our results should be considered as preliminary, the presence of Cyclospora spp. oocysts in 2.3% of the animal faecal samples collected across Leicester might represent a potential human risk that, although minor, should be throughly studied to protect the local community. Moreover, Cyclospora spp. have been found in different animal species, which may require different interventions to target those specific animals to protect the public health

Applicability of monthly CDC case studies to improve reflection in biomedical science students.

Background Academics from De Montfort University (DMU, UK) in collaboration with other EU universities, virologists and first responders are developing training for health science students to deal with biological incidents. Initially the training is being tested with final year students enrolled on the BSc Biomedical Science (Hons) and in the BMedSci Medical Science (Hons) degree programmes in 2016/17 at DMU. To improve the limited clinical skills of these students, a series of parasitology case studies have been introduced, where students will need to reflect on their knowledge and search for information from different sources to propose possible diagnoses. Reflection is an essential learning tool for developing aspects such autonomous working, critical and analytical thinking and integration of theory with practice (Quintanilla et al., 2016). Methods A series of teaching sessions (theoretical and practical) has been created related to emergency preparedness and response (Peña-Fernández et al., 2016). Students are provided with different scenarios to develop an intervention programme to protect human health in the aftermath of a biological incident involving different biological agents including emerging parasites. During the theoretical component of the training students are provided with different slides collected from the Laboratory Identification of Parasitic Diseases of Public Health Concern (DPDx) (CDC, 2016). Students, by peer group interaction, provide a possible “diagnosis” for each clinical case based on the clinical features presented and microscopic slides provided. Critical thinking is encouraged. Results Although our results are preliminary and we need to evaluate the students’ feedback, the introduction of clinical case-studies has shown to facilitate the acquisition of some clinical skills, particularly in the biomedical science cohort. This is informed by the high level of students’ interaction during these sessions and the formulation of appropriate questions. Students have also shown some gradual improvement in the resolution of clinical case studies throughout the course. Conclusions Despite the fact that student feedback will not be collected until the end of the course, students have display strong engagement and interest in these workshops through interim module level feedback. A priori, these case-studies have been shown to be effective in facilitating the acquisition of different transversal competences including critical thinking, clinical skills, communication and team work