Microscopic and molecular analyses on digenean trematodes in red deer (Cervus elaphus)

Digene Trematoden sind parasitische Plattwürmer aus der Gruppe der Metazoa, die sich durch obligatorischen Wirts- und Generationswechsel auszeichnen. In der Regel ist der Zwischenwirt eine Schnecke und der Endwirt ein Wirbeltier. Ziel dieser Studie war, die Prävalenz von Trematoden in Rotwild (Cervus elaphus) im Gebiet des Nationalparks Donau-Auen festzustellen. Besonderes Augenmerk wurde auf den natürlich vorkommenden Großen Leberegel Fasciola hepatica und den eingeschleppten Amerikanischen Riesenleberegel Fascioloides magna sowie die Unterscheidung dieser zwei Spezies gelegt. Während F. magna nur für tierische Populationen eine bedeutende Rolle spielt, stellt F. hepatica auch für den Menschen eine Bedrohung dar. Von Mai bis November 2008 wurde ein Monitoring der Trematodeninfektionen von Rotwild im Gebiet des Nationalparks Donau-Auen durchgeführt. Im Zuge dessen wurden 158 Rot- und Rehwildlosungen von 13 verschiedenen Standorten gesammelt, mittels Sedimentation aufbereitet und mikroskopisch untersucht. Außerdem wurden 109 ausgewählte Proben mit molekularbiologischen Methoden untersucht. Die Proben wurden homogenisiert, die DNA mittels zwei verschiedener Extrahierungskits isoliert und anschließend mit drei verschiedenen PCRs getestet. Die Proben wurden anschließend zur Artbestimmung sequenziert. Bei der mikroskopischen Untersuchung der 158 Proben konnten in 49 Fällen (31%) Trematoden-Eier nachgewiesen werden, in 6 Proben (4%) wurden nicht eindeutig bestimmbare Eier gefunden. Bei der molekularbiologischen Untersuchung der ausgewählten 109 Proben konnten in 35 Proben (32%) Trematoden nachgewiesen werden. Die am häufigsten gefundene Trematodenart waren Vertreter der Familie der Fasciolide (29 Proben) und Paramphistomidae (elf Proben). Bei einer Probe handelte es sich um Dicrocoeliidae und elf Proben enthielten mehr als eine Art von Trematodenspezies. Die gesamte Trematodenlast im untersuchten Gebiet war 37%. Da eine gewisse Parasitenlast in Wildtieren durchaus üblich ist, war diese relative hohe Durchseuchungsrate nicht überraschend. Allerdings zeigt der hohe Prozentsatz der Fascioloides magna Infestationen das gefährliche Potential dieses eingeschleppten Parasiten. F. hepatica konnte in keiner Probe nachgewiesen werden.Digenean trematodes are a large group of internal metazoan parasites that are characterized by a complex life cycle including mollusc and vertebrate hosts. This study focuses on trematodes of the red deer (Cervus elaphus) in the Danube backwater forests southeast of Vienna. Particular emphasis was given to the naturally occurring liver fluke Fasciola hepatica and the introduced American liver fluke Fascioloides magna and the species specific differentiation between these two species. The former is a pathogen of medical and veterinary, the latter only of veterinary relevance. Between May and November 2008, a F. magna-monitoring was performed within the area of the „Nationalpark Donau-Auen‟. Altogether, 158 faecal samples of deer were collected from 13 sites. All samples were processed for microscopy with a modified Benedek sedimentation method and subsequently screened for trematode eggs. 109 samples were chosen for molecular biological analysis, which were homogenized, the DNA was extracted by two different types of DNA-extraction kits and subjected to three different kinds of PCR (trematodes, F. magna, F. hepatica). Species-specific differentiation was achieved by sequencing. In 49 of 158 samples (31%) trematode eggs were found by microscopical means. Additionally, in six samples eggs were found that could not be specified. With molecular methods, 35 of 109 samples (32%) were positive in PCRs. The most frequent trematode species found were members of the family Fasciolidae (29 samples), followed by Paramphistomidae (eleven samples). One sample contained eggs of Dicrocoeliidae and eleven samples showed eggs/DNA of more than one trematode species. The overall trematode burden in the investigated area was 37%. However, this relatively high percentage is not surprising concidering that a low constant parasite load is normal in wild living ruminants. However, the remarkably high percentage of positive F. magna samples points out the hazardous potential of an introduced parasite. No sample was positive with F. hepatica

Tsr4 and Nap1, two novel members of the ribosomal protein chaperOME

Dedicated chaperones protect newly synthesized ribosomal proteins (r-proteins) from aggregation and accompany them on their way to assembly into nascent ribosomes. Currently, only nine of the ∼80 eukaryotic r-proteins are known to be guarded by such chaperones. In search of new dedicated r-protein chaperones, we performed a tandem-affinity purification based screen and looked for factors co-enriched with individual small subunit r-proteins. We report the identification of Nap1 and Tsr4 as direct binding partners of Rps6 and Rps2, respectively. Both factors promote the solubility of their r-protein clients in vitro. While Tsr4 is specific for Rps2, Nap1 has several interaction partners including Rps6 and two other r-proteins. Tsr4 binds co- translationally to the essential, eukaryote-specific N-terminal extension of Rps2, whereas Nap1 interacts with a large, mostly eukaryote-specific binding surface of Rps6. Mutation of the essential Tsr4 and deletion of the non-essential Nap1 both enhance the 40S synthesis defects of the corresponding r-protein mutants. Our findings highlight that the acquisition of eukaryote-specific domains in r-proteins was accompanied by the co-evolution of proteins specialized to protect these domains and emphasize the critical role of r-protein chaperones for the synthesis of eukaryotic ribosomes

Clinical informatics to improve quality of care: a population-based system for patients with diabetes mellitus

Background The prevalence of diabetes mellitus is increasing in the USA. However, control of intermediate outcome measures remains substandard. Recently, significant emphasis has been placed on the value of electronic medical records and informatics systems to improve the delivery of health care. Objective To determine whether a clinical informatics system improves care of patients with diabetes mellitus. Methods In this quality improvement pilot initiative, we identified 48 patients with diabetes mellitus who were due for their annual haemoglobin A1c (HbA1c), low-density lipoprotein (LDL) and microalbumin tests. Through our newly developed clinical informatics initiative, patients were reminded to schedule tests and a physician appointment. Seventy-five patients without reminders served as controls. Results A significant improvement in LDL control was achieved in the intervention group (35.4% vs 13.3%; P=0.004). The intervention group had a greater percentage of patients who underwent the three tests, and members of this group also showed greater control of haemoglobin A1c, but these differences were not statistically significant. Conclusions A clinical informatics system, used to deliver proactive, co-ordinated care to a population of patients with diabetes mellitus, can improve process and also quality outcome measures. Larger studies are needed to confirm these early findings

Extracellular matrix protein-1 as a mediator of inflammation-induced fibrosis after myocardial infarction

Irreversible fibrosis is a hallmark of myocardial infarction (MI) and heart failure. Extracellular matrix protein-1 (ECM-1) is up-regulated in these hearts, localized to fibrotic, inflammatory, and perivascular areas. ECM-1 originates predominantly from fibroblasts, macrophages, and pericytes/vascular cells in uninjured human and mouse hearts, and from M1 and M2 macrophages and myofibroblasts after MI. ECM-1 stimulates fibroblast-to-myofibroblast transition, up-regulates key fibrotic and inflammatory pathways, and inhibits cardiac fibroblast migration. ECM-1 binds HuCFb cell surface receptor LRP1, and LRP1 inhibition blocks ECM-1 from stimulating fibroblast-to-myofibroblast transition, confirming a novel ECM-1-LRP1 fibrotic signaling axis. ECM-1 may represent a novel mechanism facilitating inflammation-fibrosis crosstalk

Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention.

PURPOSE: To determine the effectiveness of a shared decision-making (SDM) tool versus guideline-informed usual care in translating evidence into primary care, and to explore how use of the tool changed patient perspectives about diabetes medication decision making. METHODS: In this mixed methods multicenter cluster randomized trial, we included patients with type 2 diabetes mellitus and their primary care clinicians. We compared usual care with or without a within-encounter SDM conversation aid. We assessed participant-reported decisions made and quality of SDM (knowledge, satisfaction, and decisional conflict), clinical outcomes, adherence, and observer-based patient involvement in decision-making (OPTION12-scale). We used semi-structured interviews with patients to understand their perspectives. RESULTS: We enrolled 350 patients and 99 clinicians from 20 practices and interviewed 26 patients. Use of the conversation aid increased post-encounter patient knowledge (correct answers, 52% vs. 45%, p = 0.02) and clinician involvement of patients (Mean between-arm difference in OPTION12, 7.3 (95% CI 3, 12); p = 0.003). There were no between-arm differences in treatment choice, patient or clinician satisfaction, encounter length, medication adherence, or glycemic control. Qualitative analyses highlighted differences in how clinicians involved patients in decision making, with intervention patients noting how clinicians guided them through conversations using factors important to them. CONCLUSIONS: Using an SDM conversation aid improved patient knowledge and involvement in SDM without impacting treatment choice, encounter length, medication adherence or improved diabetes control in patients with type 2 diabetes. Future interventions may need to focus specifically on patients with signs of poor treatment fit. CLINICAL TRIAL REGISTRATION: ClinicalTrial.gov: NCT01502891

Digital Storytelling: An Integration of Participatory Culture, Education and Narrative

University of Minnesota master's thesis. Spring 2013. Degree: Master of Liberal Studies. Advisor: Virajita Singh. 1 computer file (PDF)Engaging students who depend more than ever on digital technology and the Internet is an increasing burden for higher education in the 21st century. What rules today is a highly participatory culture relying on being “plugged-in” constantly. This project proposes Digital Storytelling (DST) as a cross-disciplinary activity to harness digital technology for educating media literate citizens able to put technology to use productively and meaningfully. In short, digital stories are brief narratives constructed digitally that combine the power of storytelling with still and moving imagery and a soundtrack to and convey meaning creatively

Therapy Outcomes in a Multidisciplinary Training Clinic

Patient-focused research has been offered as one means of bridging the gap between clinical practice and research in psychology. Tracking individual progress within a course of psychotherapy via process monitoring measures represents one type of patient-focused research. In this study, the Outcome Questionnaire-45 was used as a process measure to monitor client progress within a university-affiliated multidisciplinary training clinic. The survival analysis sample was comprised of 264 adult psychotherapy clients, of which 47.4% were male and 69.4% were Caucasian. After accounting for outliers, time-to-event analysis indicated that 14 sessions were needed for 50% of clients to achieve reliable change and 25 sessions were needed for 50% of clients to achieve clinically significant change. While 47.4% (n = 125) were classified as unchanged during a course of psychotherapy, 26.5% (n = 70) were recovered and an additional 9.5% (n = 25) were reliably improved. Results are compared with other available research involving process monitoring measures; implications for future research and limitations are also discussed

Gebäudeintegrierte Photovoltaik : Lebenszyklus und Ökobilanz ausgewählter Photovoltaik-Systeme

Gebäudeintegrierte Photovoltaik bildet in ihrer technischen Anwendung eine Schnittstelle zwischen der Bautechnik und der Haustechnik - Photovoltaik als Element der Bautechnik, welches Strom erzeugt. In der gegenständlichen Arbeit werden Photovoltaik-Systeme auf Basis kristalliner Photovoltaik-Zellen, Dünnschichtzellen mit Cadmiumtellur als Halbleitermaterial sowie Farbstoffzellen untersucht. Ziel ist es, eine differenzierte Sicht auf die Anforderungen gebäudeintegrierter Photovoltaiklösungen im Vergleich zur "klassischen" Photovoltaik zu erreichen. Dazu werden die technischen und wirtschaftlichen Potentiale untersucht und die Anforderungen an gebäudeintegrierte Photovoltaik beschrieben. Planung und Umsetzung sind dabei immer unter dem Aspekt des Lebenszyklus von Produkten durchzuführen. Zur Ermittlung der Umweltwirkung der ausgewählten Photovoltaik-Systeme soll in der vorliegenden Arbeit die Methode der Ökobilanz angewendet werden. Ziel dieser ökologischen Betrachtung ist ein Verständnis dafür zu entwickeln, welche Parameter im Rahmen einer Ökobilanz für Photovoltaikanlagen erfüllt sein müssen, um auf Basis der Ergebnisse Produktvergleiche zu ermöglichen. Die detaillierte Untersuchung und Modellierung der Herstellungsphase von Photovoltaik-Modulen mit der Analyse des Rohstoff-, Material- und Energieeinsatzes ist dabei ein wesentlicher Schritt der Ergebnisermittlung. Gebäudeintegrierte Photovoltaik hat aus Sicht des Autors neben dem technischen auch das volkswirtschaftliche Potential an Bedeutung zu gewinnen, wenn es gelingt, die vielfältigen Einsatzmöglichkeiten durch wirtschaftlich konkurrenzfähige und technisch flexible Produkte umzusetzen. Die Substitution von Fassaden- und Dachelementen durch gebäudeintegrierte Photovoltaik-Elemente bringt eine Änderung der Funktionsanforderung, des sogenannten "funktionalen Äquivalentes", mit sich. Bei der Berechnung der Ökobilanz von gebäudeintegrierten Photovoltaik-Modulen sind bei der standortbezogenen Berechnung neben der Nennleistung jedenfalls auch der Aufstellungsort, Orientierung und Neigung sowie die Ausführungsart und Einbausituation zu berücksichtigen. Die Beachtung länderspezifischer Energieressourcen spielt dabei ebenfalls eine entscheidende Rolle. Die Auswertungen der Ökobilanz unterschiedlicher Photovoltaik-Systeme zeigen, dass die Wahl der Systemgrenzen einen erheblichen Einfluss auf die Ergebnisse hat. In der Gesamtbetrachtung zeigen die Ergebnisse dieser Arbeit jedoch keinen eindeutigen Vorteil für ein Photovoltaik-System. Die Berechnung der ganzheitlichen Umweltwirkungen eines Photovoltaik-Systems kann daher nur im Kontext mit dem konkreten Anwendungsfall erfolgen.11