Hopping species and borders: detection of Bartonella spp. in avian nest fleas and arctic foxes from Nunavut, Canada.

BACKGROUND: In a warmer and more globally connected Arctic, vector-borne pathogens of zoonotic importance may be increasing in prevalence in native wildlife. Recently, Bartonella henselae, the causative agent of cat scratch fever, was detected in blood collected from arctic foxes (Vulpes lagopus) that were captured and released in the large goose colony at Karrak Lake, Nunavut, Canada. This bacterium is generally associated with cats and cat fleas, which are absent from Arctic ecosystems. Arctic foxes in this region feed extensively on migratory geese, their eggs, and their goslings. Thus, we hypothesized that a nest flea, Ceratophyllus vagabundus vagabundus (Boheman, 1865), may serve as a vector for transmission of Bartonella spp. METHODS: We determined the prevalence of Bartonella spp. in (i) nest fleas collected from 5 arctic fox dens and (ii) 37 surrounding goose nests, (iii) fleas collected from 20 geese harvested during arrival at the nesting grounds and (iv) blood clots from 57 adult live-captured arctic foxes. A subsample of fleas were identified morphologically as C. v. vagabundus. Remaining fleas were pooled for each nest, den, or host. DNA was extracted from flea pools and blood clots and analyzed with conventional and real-time polymerase chain reactions targeting the 16S-23S rRNA intergenic transcribed spacer region. RESULTS: Bartonella henselae was identified in 43% of pooled flea samples from nests and 40% of pooled flea samples from fox dens. Bartonella vinsonii berkhoffii was identified in 30% of pooled flea samples collected from 20 geese. Both B. vinsonii berkhoffii (n = 2) and B. rochalimae (n = 1) were identified in the blood of foxes. CONCLUSIONS: We confirm that B. henselae, B. vinsonii berkhoffii and B. rochalimae circulate in the Karrak Lake ecosystem and that nest fleas contain B. vinsonii and B. henselae DNA, suggesting that this flea may serve as a potential vector for transmission among Arctic wildlife.

Regulation of Hepatitis C Virus Genome Replication by Xrn1 and MicroRNA-122 Binding to Individual Sites in the 5' Untranslated Region.

UNLABELLED: miR-122 is a liver-specific microRNA (miRNA) that binds to two sites (S1 and S2) on the 5' untranslated region (UTR) of the hepatitis C virus (HCV) genome and promotes the viral life cycle. It positively affects viral RNA stability, translation, and replication, but the mechanism is not well understood. To unravel the roles of miR-122 binding at each site alone or in combination, we employed miR-122 binding site mutant viral RNAs, Hep3B cells (which lack detectable miR-122), and complementation with wild-type miR-122, an miR-122 with the matching mutation, or both. We found that miR-122 binding at either site alone increased replication equally, while binding at both sites had a cooperative effect. Xrn1 depletion rescued miR-122-unbound full-length RNA replication to detectable levels but not to miR-122-bound levels, confirming that miR-122 protects HCV RNA from Xrn1, a cytoplasmic 5'-to-3' exoribonuclease, but also has additional functions. In cells depleted of Xrn1, replication levels of S1-bound HCV RNA were slightly higher than S2-bound RNA levels, suggesting that both sites contribute, but their contributions may be unequal when the need for protection from Xrn1 is reduced. miR-122 binding at S1 or S2 also increased translation equally, but the effect was abolished by Xrn1 knockdown, suggesting that the influence of miR-122 on HCV translation reflects protection from Xrn1 degradation. Our results show that occupation of each miR-122 binding site contributes equally and cooperatively to HCV replication but suggest somewhat unequal contributions of each site to Xrn1 protection and additional functions of miR-122. IMPORTANCE: The functions of miR-122 in the promotion of the HCV life cycle are not fully understood. Here, we show that binding of miR-122 to each of the two binding sites in the HCV 5' UTR contributes equally to HCV replication and that binding to both sites can function cooperatively. This suggests that active Ago2-miR-122 complexes assemble at each site and can cooperatively promote the association and/or function of adjacent complexes, similar to what has been proposed for translation suppression by adjacent miRNA binding sites. We also confirm a role for miR-122 in protection from Xrn1 and provide evidence that miR-122 has additional functions in the HCV life cycle unrelated to Xrn1. Finally, we show that each binding site may contribute unequally to Xrn1 protection and other miR-122 functions.

The modified medical office assistant role in rural diabetes care.

INTRODUCTION: Diabetes care in Canada is usually provided in family practice offices, which may not have nurses to provide planned, proactive care as recommended by guidelines. The use of medical office assistants (MOAs) to do key tasks in diabetes care may improve the effectiveness of care and reduce costs. We sought to determine whether an expanded MOA role in a rural practice was beneficial to patients and the practice. METHODS: We systematically evaluated the provision of diabetes care as measured by key indicators, patient and provider satisfaction, and use of health care services. RESULTS: Involvement by MOAs improved adherence to selected aspects of guideline-based care, and patient and provider satisfaction was high. The actual outcomes of the surrogate markers measured in care and downstream use of acute care services appeared to be unchanged during this study. CONCLUSION: Use of MOAs to help provide team-based diabetes care in family practice resulted in improved performance of key indicators for diabetes care.

INTRODUCTION: Les soins aux personnes atteintes de diabète au Canada sont habituellement fournis par des pratiques de médecine familiale qui ne disposent pas nécessairement d'infirmières pour dispenser les soins proactifs planifiés recommandés par les lignes directrices. Le recours aux adjointes de bureau médical (ABM) pour effectuer des tâches clés en soin du diabète peut améliorer l'efficacité des soins et réduire les coûts. Nous avons cherché à déterminer si un rôle élargi pour les ABM dans une pratique rurale était bénéfique pour les patients et la pratique. MÉTHODES: Nous avons évalué systématiquement la prestation de soins aux personnes atteintes de diabète telle que mesurée par des indicateurs clés, par la satisfaction des patients et des fournisseurs et par l'utilisation des services de santé. RÉSULTATS: L'intervention des ABM a amélioré l'observation de certains aspects des soins basés sur les lignes directrices, et la satisfaction des patients et des fournisseurs était élevée. Les résultats concrets au niveau des marqueurs substituts mesurés pour les soins et l'utilisation en aval des services de soins actifs n'ont pas semblé changer au cours de l'étude. CONCLUSION: Le recours aux ABM pour aider à fournir les soins du diabète en équipe dans une pratique de médecine familiale a amélioré le rendement d'indicateurs clés en soin du diabète.