Disposable Hearing Aid Battery Management: Survey Assessment of Providers and Qualitative Interviews of Patients.

Purpose The purpose of this study was to better understand the behaviors that hearing aid users engage in to manage batteries. Method Two arms of research, a survey of audiologists (n = 110) and qualitative interviews with adult hearing aid users (n = 13), were conducted. Surveys were distributed and collected both via paper and online methods. Descriptive analyses of survey results were conducted to report on common threads. Qualitative interviews were conducted with video recording for transcription purposes. These transcripts were then coded thematically to identify shared themes across participants. Results Results of this study highlight the variability in behavior between provider-recommended strategies (preemptive battery management) and the reactive/delay strategies that are implemented by users. Patient reports indicate several challenges related to changing their batteries including limited information on hearing aid batteries, physical/sensory challenges to the act, and the social impact of having to change hearing aid batteries. Concurrently, patients express a wide range of strategies to address other challenges including engaging in cost-conscious behaviors when managing batteries (both purchasing and deciding to replace) and maintaining a collection of easily accessible batteries for use. Conclusions Hearing aid batteries are a topic that reflect social and economic factors in a patient's life. While providers may report they cover these topics sufficiently, challenges related to batteries may need specific elucidation by the clinician to ensure adherence to recommendations and functioning devices.

Correlative light and electron microscopy of wall formation in Eimeria nieschulzi.

Coccidian parasites possess complex life cycles involving asexual proliferation followed by sexual development leading to the production of oocysts. Coccidian oocysts are persistent stages which are secreted by the feces and transmitted from host to host guaranteeing life cycle progression and disease transmission. The robust bilayered oocyst wall is formed from the contents of two organelles, the wall-forming bodies type I and II (WFBI, WFBII), located exclusively in the macrogametocyte. Eimeria nieschulzi has been used as a model parasite to study and follow gametocyte and oocyst development. In this study, the gametocyte and oocyst wall formation of E. nieschulzi was analyzed by electron microscopy and immuno-histology. A monoclonal antibody raised against the macrogametocytes of E. nieschulzi identified a tyrosine-rich glycoprotein (EnGAM82) located in WFBII. Correlative light and electron microscopy was used to examine the vesicle-specific localization and spatial distribution of GAM82-proteins during macrogametocyte maturation by this monoclonal antibody. In early and mid-stages, the GAM82-protein is ubiquitously distributed in WFBII. Few hours later, the protein is arranged in subvesicular structures. It was possible to show that the substructure of WFBII and the spatial distribution of GAM82-proteins probably represent pre-synthesized cross-linked materials prior to the inner oocyst wall formation. Dityrosine-cross-linked gametocyte proteins can also be confirmed and visualized by fluorescence microscopy (UV light, autofluorescence of WFBII).

Risk Evaluation of Passive Transmission of Animal Parasites by Feeding of Black Soldier Fly (Hermetia illucens) Larvae and Prepupae.

HIGHLIGHTS: Black soldier fly larval intestine extracts do not affect coccidian oocysts or nematode eggs. Studied parasites passed through black soldier fly larvae or attached to the larval surface. Black soldier fly larvae as animal feed may pose a risk of parasite transmission. Larval washing is not sufficient for removing parasites; further hygiene steps are needed.

Distribution and Processing of Eimeria nieschulzi OWP13, a New Protein of the COWP Family.

Eimeria species are important veterinary coccidian parasites and are transmitted between hosts via oocysts. The infectious sporozoites are protected by the oocyst and sporocyst wall. Tyrosine-rich proteins are well-known components of the Eimeria oocyst wall. Recently, cysteine motif containing proteins (COWP family), as described in Toxoplasma gondii and Cryptosporidium spp., have also been characterized in Eimeria. Here, we identified a novel COWP-related protein, EnOWP13, and tracked it via transfection technology in Eimeria nieschulzi. The subsequent analysis suggests that the mCherry-tagged EnOWP13 localizes to the wall-forming bodies I and the outer wall. Immunohistochemical analysis confirmed the distribution of wall-forming bodies similar to avian Eimeria species and revealed that the wall-forming bodies I show peroxidase activity. The EnOWP13 amino acid composition and FITC-cadaverine-positive wall-forming bodies I suggest a participation of an enzyme with transglutaminase activity. This is the first description and characterization of this novel outer oocyst wall protein, which is also orthologous to other Eimeria species and Toxoplasma gondii, suggesting a new potential cross-linking mechanism of wall-forming proteins via isopeptide bonds.

Identification and analysis of Eimeria nieschulzi gametocyte genes reveal splicing events of gam genes and conserved motifs in the wall-forming proteins within the genus Eimeria (Coccidia, Apicomplexa).

The genus Eimeria (Apicomplexa, Coccidia) provides a wide range of different species with different hosts to study common and variable features within the genus and its species. A common characteristic of all known Eimeria species is the oocyst, the infectious stage where its life cycle starts and ends. In our study, we utilized Eimeria nieschulzi as a model organism. This rat-specific parasite has complex oocyst morphology and can be transfected and even cultivated in vitro up to the oocyst stage. We wanted to elucidate how the known oocyst wall-forming proteins are preserved in this rodent Eimeria species compared to other Eimeria. In newly obtained genomics data, we were able to identify different gametocyte genes that are orthologous to already known gam genes involved in the oocyst wall formation of avian Eimeria species. These genes appeared putatively as single exon genes, but cDNA analysis showed alternative splicing events in the transcripts. The analysis of the translated sequence revealed different conserved motifs but also dissimilar regions in GAM proteins, as well as polymorphic regions. The occurrence of an underrepresented gam56 gene version suggests the existence of a second distinct E. nieschulzi genotype within the E. nieschulzi Landers isolate that we maintain.

Passive immunization with Eimeria tenella gametocyte antigen 56 (EtGAM56) specific antibodies and active immunization trial with the epitope containing peptide.

Eimeria species cause avian coccidiosis leading to substantial economic losses in the poultry industry. Hence, anticoccidial drugs and vaccines have been used to combat this devitalizing disease. An effective vaccine based on gametocyte recombinant proteins would be very useful in terms of cost, labor and ethics (no animal experimentation). A mouse derived monoclonal antibody against Eimeria tenella gametocyte antigen 56 (EtGAM56) was used to immunize peritoneally E. tenella infected chicken a reduction of oocyst shedding by up to 78% was observed. The epitope recognized by the monoclonal antibody was mapped, recombinant expressed and used to immunize chicken (rEtGAM56N). After rEtGAM56N intramuscular immunization and parasite challenge, clinical parameters like faecal oocyst output, body weight gain, lesion score, feed conversion rate and serum antibody response were assessed to test the efficacy of vaccination against experimental infection with E. tenella. Chicken immunized with rEtGAM56N and challenged with E. tenella oocysts showed a robust antibody response against the rEtGAM56N peptide but no considerable effects on oocyst output and clinical parameters (weight gain, lesion score, feed conversion rate) compared to the mock control group. This study demonstrates the complexity of an effective vaccination. The immunoprotective epitope might be a conformational epitope that was recognized by the monoclonal mouse antibody but only weakly by the antibodies produced against the linear peptide leading to a divergent outcome between the passive and active immunization.

Two COWP-like cysteine rich proteins from Eimeria nieschulzi (coccidia, apicomplexa) are expressed during sporulation and involved in the sporocyst wall formation.

BACKGROUND: The family of cysteine rich proteins of the oocyst wall (COWPs) originally described in Cryptosporidium can also be found in Toxoplasma gondii (TgOWPs) localised to the oocyst wall as well. Genome sequence analysis of Eimeria suggests that these proteins may also exist in this genus and led us to the assumption that these proteins may also play a role in oocyst wall formation. METHODS: In this study, COWP-like encoding sequences had been identified in Eimeria nieschulzi. The predicted gene sequences were subsequently utilized in reporter gene assays to observe time of expression and localisation of the reporter protein in vivo. RESULTS: Both investigated proteins, EnOWP2 and EnOWP6, were expressed during sporulation. The EnOWP2-promoter driven mCherry was found in the cytoplasm and the EnOWP2, respectively EnOWP6, fused to mCherry was initially observed in the extracytoplasmatic space between sporoblast and oocyst wall. This, so far unnamed compartment was designated as circumplasm. Later, the mCherry reporter co-localised with the sporocyst wall of the sporulated oocysts. This observation had been confirmed by confocal microscopy, excystation experiments and IFA. Transcript analysis revealed the intron-exon structure of these genes and confirmed the expression of EnOWP2 and EnOWP6 during sporogony. CONCLUSIONS: Our results allow us to assume a role, of both investigated EnOWP proteins, in the sporocyst wall formation of E. nieschulzi. Data mining and sequence comparisons to T. gondii and other Eimeria species allow us to hypothesise a conserved process within the coccidia. A role in oocyst wall formation had not been observed in E. nieschulzi.

Development of Eimeria nieschulzi (Coccidia, Apicomplexa) Gamonts and Oocysts in Primary Fetal Rat Cells.

The in vitro production of gametocytes and oocysts of the apicomplexan parasite genus Eimeria is still a challenge in coccidiosis research. Until today, an in vitro development of gametocytes or oocysts had only been shown in some Eimeria species. For several mammalian Eimeria species, partial developments could be achieved in different cell types, but a development up to gametocytes or oocysts is still lacking. This study compares several permanent cell lines with primary fetal cells of the black rat (Rattus norvegicus) concerning the qualitative in vitro development of the rat parasite Eimeria nieschulzi. With the help of transgenic parasites, the developmental progress was documented. The selected Eimeria nieschulzi strain constitutively expresses the yellow fluorescent protein and a macrogamont specific upregulated red tandem dimer tomato. In the majority of all investigated host cells the development stopped at the second merozoite stage. In a mixed culture of cells derived from inner fetal organs the development of schizont generations I-IV, macrogamonts, and oocysts were observed in crypt-like organoid structures. Microgamonts and microgametes could not be observed and oocysts did not sporulate under air supply. By immunohistology, we could confirm that wild-type E. nieschulzi stages can be found in the crypts of the small intestine. The results of this study may be helpful for characterization of native host cells and for development of an in vitro cultivation system for Eimeria species.

Chimeric fluorescent reporter as a tool for generation of transgenic Eimeria (Apicomplexa, Coccidia) strains with stage specific reporter gene expression.

Progress in transfection of Eimeria sporozoites leads to transformed oocysts, however the output of mutants after passages in the host animals is low. Further enrichment of transgenic oocysts was dependent on fluorescent activated cell sorting and could not be achieved by drug selection. In this study, we fused the Toxoplasma gondii DHFR-TSm2m3 pyrimethamine resistance gene with the yellow fluorescent protein (YFP) encoding sequence to provide continuous pyrimethamine resistance and fluorescence in the Eimeria parasite from a single transcript. The permanent YFP signal of transgenic parasites allows differentiating transgenic parasites from wild type parasites throughout the entire life cycle. The output of transformed oocysts increased up to more than 30% after initial transfection and completion of the life cycle in the host animal. Within three passages under pyrimethamine treatment, a strain with 100% transformed sporulated oocysts of the parasite could be isolated. This new method provides the potential to produce and monitor transgenic Eimeria strains without additional fluorescence activated cell sorting (FACS). The chimeric fluorescent reporter can be utilized as a continuous internal control for plasmids containing stage specific promoter. By this means we utilized an Eimeria tenella gamogony gene specific regulatory sequence to confer macrogamont specific tandem dimer tomato (tdtomato) reporter gene expression in Eimeria nieschulzi.

New insights into the excystation process and oocyst morphology of rodent Eimeria species.

In this study, the mechanism of excystation of the rodent parasites Eimeria nieschulzi, from rats, and Eimeria falciformis, from mice, was investigated. In vitro, oocysts of both species are susceptible to the protease pepsin, and sporocysts and sporozoites can be excysted in a similar way. Scanning electron microscopy (SEM) revealed a collapse of the oocysts wall at both polar ends after pepsin treatment. This occurs without any visible damage of the outer wall. Using fluorescence and transmission electron microscopy (TEM) we observed that pepsin enters sporulated oocysts at both polar ends and causes degradation of the inner oocyst wall. Using scanning electron microscopy we could identify two polar caps in both investigated rodent Eimeria species, but only one is harbouring the micropyle. Thus the polar caps are the entry site for the pepsin. Furthermore, we provide evidence that the oocyst cap and micropyle are functionally different structures. This study complements the morphological description of both Eimeria species and is of relevance for other coccidian species.

Reporter gene expression in cell culture stages and oocysts of Eimeria nieschulzi (Coccidia, Apicomplexa).

The rat parasite Eimeria nieschulzi is a suitable model for transfection studies and was used as an additional model organism for the genus Eimeria. We describe the transfection of this apicomplexan parasites and the cultivation of transformed stages in cell culture and in vivo. The beta-galactosidase or yellow fluorescent protein was expressed in all parasitic stages up to the second merozoite generation in vitro under control of the heterologous promoter region of Eimeria tenella mic1 gene previously described for E. tenella transfection. Pyrimethamine resistant E. nieschulzi parasites were obtained in vitro after transfection with a plasmid encoding the Toxoplasma gondii dhfr/ts-m2m3 gene. Co-transfection experiments with an YFP-plasmid resulted in pyrimethamine resistant and fluorescent parasitic stages. Infection of rats with transfected E. nieschulzi sporozoites directed to expression of beta-galactosidase or YFP in oocysts. Co-transfection with YFP/DHFR-TS allowed selection of resistant parasites in vivo. Excreted transgenic oocysts showed arrangement of YFP expression which lead to questions about meiotic recombination frequency and mechanisms.

Improved excystation protocol for Eimeria nieschulzi (Apikomplexa, Coccidia).

Large numbers of sporozoites are a crucial prerequisite for in vitro experiments with Eimeria species. There are no protocols to obtain high amounts of vital purified sporozoites of Eimeria nieschulzi; therefore, an improved excystation protocol is urgently needed. Most excystation procedures for Eimeria oocysts use a mechanical disruption method for the release of sporocysts, assuming that oocyst disruption of Eimeria does not require enzymes (proteases). However, rodent Eimeria oocysts are susceptible to pepsin digestion (Kowalik S, Zahner H (1999) Eimeria separata: method for the excystation of sporozoites. Parasitol Res 85:496-499). Here, we describe a method that combines enzymatic treatment of oocyst walls before the mechanical disruption with glass beads. Using this protocol, we achieved an up to fivefold increase of free viable sporozoites of E. nieschulzi and could significantly shorten the time of excystation. These results confirm the assumption that rodent Eimeria species, in contrast to Eimeria species of birds, possess protease sensitive oocysts.

Characterization of the spv locus in Salmonella enterica serovar Arizona.

Salmonella enterica serovar Arizona (S. enterica subspecies IIIa) is a common Salmonella isolate from reptiles and can cause serious systemic disease in humans. The spv virulence locus, found on large plasmids in Salmonella subspecies I serovars associated with severe infections, was confirmed to be located on the chromosome of serovar Arizona. Sequence analysis revealed that the serovar Arizona spv locus contains homologues of spvRABC but lacks the spvD gene and contains a frameshift in spvA, resulting in a different C terminus. The SpvR protein functions as a transcriptional activator for the spvA promoter, and SpvB and SpvC are highly conserved. The analysis supports the proposal that the chromosomal spv sequence more closely corresponds to the ancestral locus acquired during evolution of S. enterica, with plasmid acquisition of spv genes in the subspecies I strains involving addition of spvD and polymorphisms in spvA.