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

Focus group to create a virtual case study model unit for the DMU e-Parasitology.

De Montfort University (DMU, Leicester, UK) is leading a teaching innovation project for the creation of a complete package for teaching and learning human parasitology in collaboration with the Spanish universities: San Pablo CEU and Miguel Hernández, and practicing Biomedical Scientists from the UK National Health Service. The DMU e-Parasitology package will be freely available on the DMU website (http://parasitology.dmu.ac.uk/) late in 2018 and present three modules: a theoretical unit for the study of medical parasitic diseases; a virtual laboratory and microscope sections with a complete collection of clinical slides for the study of these major diseases. To provide the user of this novel package with a holistic and complete experience for the learning of medical parasitology we have started the development of a fourth section, which will hold highly interactive virtual case studies in which the user will be provided with a medical history and different clinical slides to identify the parasites and their structures. The user will need to reflect and critically think to suggest potential diagnoses, additional diagnostic techniques, treatment and prevention techniques for that parasitic disease. A first virtual case study has been created in the DMU e-Parasitology here: http://parasitology.dmu.ac.uk/learn/case_studies/cs1/story_html5.html, as described in Peña-Fernández et al. (2018) [1]. The degree of difficulty is medium-high, so a background in parasitology is needed to resolve it. Comprehensive student feedback is being collected to improve this case study, which will be used as a model unit to develop future case studies for this section. To determine the feasibility of this case study to train postgraduate students, DMU students attending the MSc Advanced Biomedical Science have completed the case study during a workshop session specially delivered this academic course 2017/18 (n=9). We collected the following results: 100% students indicated that the eParasitology is interactive (71.4% agreed, 28.57 strongly agreed), and the case-study presented was appropriate for their studies (57.1% agreed, 42.9% strongly agreed). In relation to the content, all students highlighted that it was relevant for their studies (42.9% agreed, 57.1% strongly agreed), and indicated that the exercises presented were easy to understand (71.43% agreed, 28.57% strongly agreed). In the free-open questions available in the questionnaire, postgraduate students demanded more case studies and mini-formative assessments within the theoretical units that they reviewed to answer the virtual case study (free-living amoebas and Entamoeba histolytica). Finally, they suggested the provision of the correct answers throughout the case study instead of at the end

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

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

Interventions to enhance the teaching status of parasitology.

Recent surveys have highlighted an erosion of the teaching of parasitology in medical and veterinary schools across Europe and other developed countries, despite reports of increasing instances of food and water borne parasitic infections in these regions. To facilitate the teaching of this subject, essential to develop future health care professionals, we are performing different interventions at De Montfort University (DMU, UK). Briefly, these include: a) curriculum modifications to increase the time dedicated to the study of parasitology; and b) implementation of web-based resources in the curricula for enhancing teaching (e.g. through introduction of blended learning) and to encourage self-learning and participation among the students. Thus, DMU is leading the development of an on-line package for teaching and learning parasitology named DMU e-Parasitology in collaboration with different European academics and clinicians. This package has four sections: a theoretical section with mini e-learning modules to study major human parasitic diseases; virtual laboratory describing major techniques used in parasitology; a microscopy section with resources to enhance the study of parasites; a section with virtual clinical case studies to encourage self-learning. To assess the effectiveness of DMU e-Parasitology as a learning resource, we have done preliminary testing with final year BSc Biomedical Science students at DMU (n=194; 2017/18). 94.5% of students highlighted they gained appropriate knowledge of the pathology, prevention and treatment of some parasitic diseases; and 93.1% indicated that they learnt basic skills to investigate parasitic disease. The interventions and resources described could be used to improve the teaching status of medical parasitology in human health degrees

Evaluation of a novel digital environment for learning medical parasitology.

open access articleEukaryotic parasites represent a serious human health threat requiring health professionals with parasitology skills to counteract this threat. However, recent surveys highlight an erosion of teaching of parasitology in medical and veterinary schools, despite reports of increasing instances of food and water borne parasitic infections. To address this we developed a web-based resource, DMU e-Parasitology®, to facilitate the teaching and learning of parasitology, comprising four sections: theoretical; virtual laboratory; virtual microscopy; virtual clinical case studies. Testing the package was performed using a questionnaire given to ninety-five Pharmacy students in 2017/18 to assess effectiveness of the package as a teaching and learning tool. 89.5% of students reported appropriate acquisition of knowledge of the pathology, prevention and treatment of some parasitic diseases. 82.1% also welcomed the clinical specialism of the package as it helped them to acquire basic diagnostic skills, through learning infective features/morphology of the parasites

Big Area Additive Manufacturing of High Performance Bonded NdFeB Magnets

Additive manufacturing allows for the production of complex parts with minimum material waste, offering an effective technique for fabricating permanent magnets which frequently involve critical rare earth elements. In this report, we demonstrate a novel method - Big Area Additive Manufacturing (BAAM) - to fabricate isotropic near-net-shape NdFeB bonded magnets with magnetic and mechanical properties comparable or better than those of traditional injection molded magnets. The starting polymer magnet composite pellets consist of 65 vol% isotropic NdFeB powder and 35 vol% polyamide (Nylon-12). The density of the final BAAM magnet product reached 4.8 g/cm3, and the room temperature magnetic properties are: intrinsic coercivity Hci = 688.4 kA/m, remanence Br = 0.51 T, and energy product (BH)max = 43.49 kJ/m3 (5.47 MGOe). In addition, tensile tests performed on four dogbone shaped specimens yielded an average ultimate tensile strength of 6.60 MPa and an average failure strain of 4.18%. Scanning electron microscopy images of the fracture surfaces indicate that the failure is primarily related to the debonding of the magnetic particles from the polymer binder. The present method significantly simplifies manufacturing of near-net-shape bonded magnets, enables efficient use of rare earth elements thus contributing towards enriching the supply of critical materials

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

VIRTUAL CASE STUDIES IN THE NOVEL RESOURCE DMU E-PARASITOLOGY

A novel on-line package for teaching and learning human parasitology, named DMU e-Parasitology, is being co-developed by academics from De Montfort University (DMU, Leicester, UK) and the Spanish universities: University of San Pablo CEU and Miguel Hernández University, in conjunction with practicing Biomedical Scientists from the UK National Health Service. The DMU e-Parasitology [1] package will be freely available on the DMU website (http://parasitology.dmu.ac.uk/) late in 2018 and content/sections currently covered: a theoretical unit for the study of eukaryotic parasites that represent serious human health threats; a virtual laboratory and microscope sections for the study of these major diseases. However, for promoting active learning and increasing engagement, we are in the process of developing a fourth section with a series of virtual case studies in medical parasitology, in which students will need to reflect and critically think to reach diagnoses, propose additional diagnostic techniques and appropriate treatment. The virtual case studies will be created following a preliminary study performed by our group [2,3], in which we observed that the introduction of mini- case studies in Medical Microbiology lectures [BSc Biomedical Science (BMS), DMU] last academic course were shown to be effective in facilitating the acquisition of transversal competences including clinical skills. These mini-case studies were based on those developed by the Laboratory Identification of Parasitic Diseases (DPDx) of the Centers for Disease Control and Prevention (CDC, USA) [4] and final year BMS students enrolled in this module were able to complete the case studies during the different lectures in a very short period of time. Contrarily, the virtual case studies for the DMU e- Parasitology will be highly interactive and students will need to use the different resources of this package, including the virtual microscope, to resolve them. Moreover, these case studies will be longer and will present different questions that the user will be able to answer depending on their clinical and parasitology skills. Between the many advantages of a virtual microscope described in the literature, including remote access to slides of high clinical quality for all users, this technological resource could facilitate the acquisition of problem-solving skills and hence the rationale of using it to resolve the case studies of the DMU e-Parasitology. This paper describes the first virtual case study created, which is available at: http://parasitology.dmu.ac.uk/learn/case_studies/cs1/story_html5.html [5]. Briefly: students are presented with a short medical history of an HIV positive male university student severely affected by bloody diarrhoea, malaise and fever; and a series of clinical slides in which trophozoites of Entamoeba histolytica and Acanthamoeba spp. can be observed. The “amoebas” virtual case study is student-friendly; so students can navigate through the case study following a series of questions with different degrees of difficulty related to these human pathogens. Students enrolled in the Medical Microbiology module in 2017/18 (n=193) have answered the amoebas case study during small workshops delivered to groups of 27/28 students during November 2017. Comprehensive student feedback is being collected to improve this case study, as it will be used as a model to complete this section of the DMU e-Parasitology

First detection of microsporidia in deer faecal samples in England.

Background: Animals infected with human-pathogenic microsporidia (Encephalitozoon spp., Enterocytozoon bieneusi) can release spores into the environment through their faeces representing a public health concern. However, information on their presence in wild animals in the United Kingdom (UK) is very limited despite wildlife living close to densely populated urban areas. Two species of deer can be found in Bradgate Park, a public park in the northwest of Leicester (UK): the red deer and fallow deer. The aim of this study was to determine the presence of human-pathogenic microsporidia in deer as information on their presence in deer is limited in the literature. Materials/methods: A total of 68 deer faecal samples were collected during winter 2016/17; a qualified veterinarian confirmed the source. Fresh faecal smears were immediately prepared and stained using Weber’s modified trichrome stain following previous methodologies. Two microscopists screened the slides for these species. Results: Nine of the 68 faecal samples collected (13.2%) were found to be positive for spores of Encephalitozoon spp. via coprological analysis. These positive results are being confirmed using PCR. These results are in agreement with a pilot study performed by our group in the same park in summer 2016 in which we detected Encephalitozoon spp. in 25%deer faecal samples collected. Conclusions: To our knowledge, this is the first study showing the presence of Encephalitozoon spp. in deer and in an English region. Previous studies have reported spores of microsporidia in deer but for Enterocytozoon bieneusi, in a similar study performed in faeces from sika and red deer in China (Zhao et al., 2014). Our results, although preliminary, could highlight the role of deer as a reservoir and source of environmental contamination for potential zoonotic Encephalitozoon spp. infections. We have also detected Encephalitozoon spp. and Enterocytozoon bieneusi in faecal samples from fox, waterfowl and pigeon collected in the same period but in different parks across Leicester, which could indicate a certain distribution of microsporidia in the Leicester urban environment with different animal species involved in their life cycle. Due to their potential as human pathogens, these reservoirs represent a potential health risk for the Leicester population