Population Genetic Analysis of Propionibacterium acnes Identifies a Subpopulation and Epidemic Clones Associated with Acne

The involvement of Propionibacterium acnes in the pathogenesis of acne is controversial, mainly owing to its dominance as an inhabitant of healthy skin. This study tested the hypothesis that specific evolutionary lineages of the species are associated with acne while others are compatible with health. Phylogenetic reconstruction based on nine housekeeping genes was performed on 210 isolates of P. acnes from well-characterized patients with acne, various opportunistic infections, and from healthy carriers. Although evidence of recombination was observed, the results showed a basically clonal population structure correlated with allelic variation in the virulence genes tly and camp5, with pulsed field gel electrophoresis (PFGE)- and biotype, and with expressed putative virulence factors. An unexpected geographically and temporal widespread dissemination of some clones was demonstrated. The population comprised three major divisions, one of which, including an epidemic clone, was strongly associated with moderate to severe acne while others were associated with health and opportunistic infections. This dichotomy correlated with previously observed differences in in vitro inflammation-inducing properties. Comparison of five genomes representing acne- and health-associated clones revealed multiple both cluster- and strain-specific genes that suggest major differences in ecological preferences and redefines the spectrum of disease-associated virulence factors. The results of the study indicate that particular clones of P. acnes play an etiologic role in acne while others are associated with health

Effects of general practitioner training and family support services on the care of home-dwelling dementia patients - Results of a controlled cluster-randomized study

<p>Abstract</p> <p>Background</p> <p>More than 90% of dementia patients are cared for by their general practitioners, who are decisively involved in the diagnosis, therapy and recommendation of support services. <it>Objective: </it>To test whether special training of general practitioners alters the care of dementia patients through their systematic recommendation of caregiver counseling and support groups.</p> <p>Method</p> <p>129 general practitioners enrolled 390 dementia patients and their informal caregivers in a prospective, three-arm cluster-randomized 2-year study. Arm A constituted usual care, in Arm B and C support groups and caregiver counseling (in Arm B one year after baseline, in Arm C at baseline) were recommended by the general practitioners. The general practitioners received arm-specific training. Diagnostic and therapeutic behavior of physicians was recorded at baseline. Informal caregivers were questioned in follow-up after 2 years about the utilization of support services.</p> <p>Results</p> <p>The diagnostic behavior of the general practitioners conforms to relevant guidelines. The procedure in newly-diagnosed patients does not differ from previously diagnosed patients with the exception of the rate of referral to a specialist. About one-third of the newly-diagnosed dementia patients are given an anti-dementia drug. The utilization of support groups and counseling increased five- and fourfold, respectively. Utilization of other support services remained low (< 10%), with the exception of home nursing and institutional short-term nursing.</p> <p>Conclusion</p> <p>Trained general practitioners usually act in conformity with guidelines with respect to diagnosing dementia, and partly in conformity with the guidelines with respect to recommended drug therapy. Recommendations of support services for informal caregivers by the general practitioner are successful. They result in a marked increase in the utilization rate for the recommended services compared to offers which are not recommended by the general practitioner.</p> <p>Trial registration</p> <p>ISRCTN68329593</p

Vergleichende Untersuchungen über vier Thrombocyten-Zählverfahren

Anhand von fünf Anforderungen an ein optimales Thrombocyten-Zählverfahren wurden vier Methoden unter Routinearbeitsbedingungen vergleichend auf Präzision in der Serie, Ergebniskorrelationen der Methoden untereinander, praktische Durchführbarkeit und Zeitbedarf pro Bestimmung überprüft. Dabei zeigten sich mäßige Präzisionen bei dem modifizierten Zählverfahren nach Fonio und bei der Kammerzählung im Phasenkontrastmikroskop, gute bei Verwendung des Coulter Thrombocounter und des Technicon AutoCounter. Ausreichende Ergebniskorrelationen mit tolerabler Streuung der linearen Regression wurden allein bei Vergleich der beiden halb- bzw. vollmechanisierten Methoden untereinander gefunden. Die Problematik der Absolutmessung wird diskutiert. Auf Grund des Zeitbedarfs pro Bestimmung können für Notfall-Einzelbestimmungen das Phasenkontrastverfahren und der Coulter-Thrombocounter, für Serienbestimmungen in größerem Umfang der Technicon AutoCounter empfohlen werden.Peer Reviewe

Analysis of the losses of industrial-type PERC solar cells

The loss analysis of state-of-the-art p-type Czochralski-grown silicon passivated emitter and rear solar cells (PERC) fabricated in a manner close to industrial production is presented in this paper. The 6-inch solar cells are featuring a homogeneous emitter on the front side, an Al2O3 passivation layer and local contacts on the rear side. The peak energy conversion efficiencies obtained are 21.1% for a standard antireflection coating (ARC) and 21.4% for a double-layer ARC. The loss analysis is based on an extended characterization of the solar cells and of special samples, which allow the separation of the contributions of each region of the solar cell including metallization. Their impact is determined experimentally on the open-circuit voltage, the short-circuit current density, and the fill factor. Based on the measurements, the devices are numerically simulated. The free energy losses are analyzed using the simulation model. Based on the results from the loss analysis, it is found that the integration of a selective emitter structure and the further improvement of the rear surface would allow for efficiencies above 22% in the short term