Survival of the fittest: Herausforderungen an den Fremdenverkehr im Zeichen des global change

Der Globale Wandel ist im Begriff, den Tourismus zu verändern. Die Wechselwirkung von Tourismus und Klimawandel sind beidseitiger Art. Die vorliegende Arbeit zeigt Möglichkeiten der Adaption und einen wandelbaren Fremdenverkehr. Eine Übersicht der gängigen Tourismusmodelle stellt den Stand der Forschung dar. Der Fremdenverkehr ist durch drei Faktoren massiv geprägt: Die Nachfrage und Motivation, die Reisemittler und Veranstalter sowie das Destinationsangebot. Bei der Motivation wirken Motiv und Anreiz Motivationspsychologisch betrachtet auf die Reiseentscheidung deren Grundlage verarbeitete Informationen sind. Reisemittler und Veranstalter haben einen großen Einfluss auf Entscheidungsprozesse. Neue IuK Technologien haben deren Arbeit grundlegend verändert. Das Tourismusangebot wird stark durch die naturräumlichen Gegebenheiten sowie das politische System bestimmt. Überlebenswichtig für die Destination ist die evolutionstheoretisch etrachtete Fitnessmaximierung also Adaption und Wandel, um sich an geänderte Rahmenbedingungen anpassen zu können. Gerade im Bereich des Klimawandels müssen Maßnahmen ergriffen werden. Aber auch die Marktsättigung gerade in Verbindung mit der aktuellen Finanzkrise wirkt besonders schwer auf die Destination. Eine hohes Innovationsvermögen, Trendscanning und der Zusammenschluss in flexiblen Netzwerkclustern können einen Kundenmehrwert erzeugen. Die Fitnessmaximierung ist somit Überlebensziel der Destination und führt zur Kundenzufriedenheit die im Sättigungsmarkt alleinig Wachstum generieren kann.

The silent survival of Staphylococcus aureus phagocyted by HL-60 derived neutrophils

Staphylococcus aureus is a Gram positive pathogen that causes various human infections and represents one of the most common causes of bacteremia. S. aureus is able to invade a variety of non-professional phagocytes and that can survive engulfment by neutrophils, producing both secreted and surface components that compromise innate immune responses. In the contest of our study we evaluated the functional activity of vaccine specific antibodies by opsonophagocytosis killing assay (OPKA). Interestingly a low level of killing of the staphylococcal cells has been observed. In the meanwhile intracellular survival studies showed that S. aureus persisted inside phagocytes for several hours until a burst of growth after 5 hours in the supernatant. These data suggest that the strong ability of S. aureus to survive in the phagocytes could be the cause of the low killing measured by OPKA. Moreover parallel studies on HL-60 cells infected with S. aureus done by using transmission electron microscopy (TEM) interestingly showed that staphylococcal cells have an intracellular localization (endosomal vacuoles) and that they are able not only to maintain the integrity of their membrane but also to replicate inside vacuolar compartments. Finally in order to generate 3D volume of whole bacteria when present inside neutrophilic vacuoles, we collected a series of tomographic two-dimensional (2D) images by using a transmission electron microscope, generating 5 different tomograms. The three-dimensional reconstruction reveals the presence of intact bacteria within neutrophil vacuoles. The S. aureus membrane appears completely undamaged and integral in contrast with the physiological process of phagosytosis through vacuoles progression. S. aureus bacteria show a homogenous distribution of the density in all the three dimensions (X, Y, Z). All these evidences definitely explain the ability of the pathogen to survive inside the endosomal vacuoles and should be the cause of the low killing level.

In vitro characterisation and expansion of human regulatory T cells for their in vivo application in the induction of tolerance in haematopoietic stem cell and solid organ transplantation

Solid organ transplantation (SOT) is considered the treatment of choice for many end-stage organ diseases. Thus far, short term results are excellent, with patient survival rates greater than 90% one year post-surgery, but there are several problems with the long term acceptance and use of immunosuppressive drugs. Hematopoietic Stem Cells Transplantation (HSCT) concerns the infusion of haematopoietic stem cells to re-establish acquired and congenital disorders of the hematopoietic system. The main side effect is the Graft versus Host Disease (GvHD) where donor T cells can cause pathology involving the damage of host tissues. Patients undergoing acute or chronic GvHD receive immunosuppressive regimen that is responsible for several side effects. The use of immunosuppressive drugs in the setting of SOT and GvHD has markedly reduced the incidence of acute rejection and the tissue damage in GvHD however, the numerous adverse side effects observed boost the development of alternative strategies to improve the long-term outcome. To this effect, the use of CD4+CD25+FOXP3+ regulatory T cells (Treg) as a cellular therapy is an attractive approach for autoimmunity disease, GvHD and limiting immune responses to allograft after transplantation. Treg have a pivotal role in maintaining peripheral immunological tolerance, by preventing autoimmunity and chronic inflammation. Results of my thesis provide the characterization and cell processing of Tregs from healthy controls and patients in waiting list for liver transplantation, followed by the development of an efficient expansion-protocol and the investigation of the impact of the main immunosuppressive drugs on viability, proliferative capacity and function of expanded cells after expansion. The conclusion is that ex vivo expansion is necessary to infuse a high Treg dose and although many other factors in vivo can contribute to the success of Treg therapy, the infusion of Tregs during the administration of the highest dose of immunosuppressants should be carefully considered.

Survival of the warzone interpreter; behind the untold story

This dissertation examines the complicated and still little-known role of the interpreters in conflict zones. After a brief overview of the figure of the community interpreters, the thesis focuses on the interpreters in conflict zones, local civilians who risk their lives every day in the front line in order to help the Western countries in war. This dissertation shows the danger interpreters face because of their job: they are seen as traitors by their fellow citizens, the Taliban and other insurgent groups and for this reason they are hunted and killed. The purpose of this thesis is to show that Western countries are not doing enough to protect these interpreters, and in particular the United States' case will be analyzed: this country does not offer interpreters the right protection backing exchange, leaving them in the hands of the enemy once the US troops have finished their mission. The latter part of the dissertation presents the main organizations and international projects aimed at helping interpreters who are still trapped in their countries.

Temperature effects on larval growth and survival in five species of Caribbean Echinoids

Under the global change scenario, the possible effects of ocean warming were investigated on the larvae of five species of Caribbean Echinoids: Echinometra lucunter, Echinometra viridis, Clypeaster rosaceus, Tripneustes ventricosus and Lytechinus williamsi. Their thermal tolerance was evaluated rearing them for six days under different temperature regimes (26, 28, 30, 32, 34, 36°C). The larval sensitivity to the treatments was evaluated on the base of survival and growth. The rearing at higher temperatures has revealed a great suffering state of the larvae by inducing both reduction of live larvae and abnormality in their development. The extent of impact of the treatments varied from species to species, evidencing different levels of thermal tolerance. Anyway, higher temperature treatments have shown a general lethal threshold at about 34°C for most of the species. As an exception, the lethal threshold of Echinometra species was 36°C, few larvae of which being still capable of survive at the temperature of 34°C. The studies have also analyzed the effect of water warming on the larvae growth in terms of size and symmetry. The results put in evidence the presence of a critical upper temperature (about 32°C) at which the larvae of all species reveal a great suffering state that translates in the reduction of size (i.e., of body, stomach and postero-dorsal arm) and abnormalities (i.e., strong difference in the lengths of the two postero-dorsal arms). As sea surface temperatures are predicted to increase of 4-5°C by 2100, the high percentage of abnormal larvae and their scarce survival observed at 32- 34°C treatments indicate that the early stages of these species could be affected by future global warming.

Effects of acute temperature increase on performance and survival of Caribbean echinoids

Climate change is occurring at a faster rate than in the past, with an expected increase of mean sea surface temperatures up to 4.8°C by the end of this century. The actual capabilities of marine invertebrates to adapt to these rapid changes has still to be understood. Adult echinoids play a crucial role in the tropical ecosystems where they live. Despite their role, few studies about the effect of temperature increase on their viability have been reported in literature. This thesis work reports a first systematic study on several Caribbean echinoids about their tolerance to temperature rise in the context of global warming. The research - carried out at the Bocas del Toro Station of the Smithsonian Tropical Research Institute, in Panama - focalized on the 6 sea urchins Lytechinus variegatus, L. williamsi, Echinometra lucunter, E. viridis, Tripneustes ventricosus and Eucidaris tribuloides, and the 2 sand dollars Clypeaster rosaceus and C. subdepressus. Mortality and neuromuscular well-being indicators - such as righting response, covering behaviour, adhesion to the substrate, spine and tube feet movements - have been analysed in the temperature range 28-38°C. The righting time RT (i.e., the time necessary for the animal to right itself completely after inversion) measured in the 6 sea urchin species, demonstrated a clearly dependence on the water temperature. The experiments allowed to determine the “thermal safety margin” (TSM) of each species. Echinometra lucunter and E. viridis resulted the most tolerant species to high temperatures with a TSM of 5.5°C, while T. ventricosus was the most vulnerable with a TSM of only 3°C. The study assessed that all the species already live at temperatures close to their upper thermal limit. Their TSMs are comparable to the predicted temperature increase by 2100. In absence of acclimatization to such temperature change, these species could experience severe die-offs, with important consequences for tropical marine ecosystems.

Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin's lymphoma: a systematic review

Combined modality treatment (CMT) of chemotherapy followed by localized radiotherapy is standard treatment for patients with early stage Hodgkin's lymphoma. However, the role of radiotherapy has been questioned recently and some clinical study groups advocate chemotherapy only for this indication. We thus performed a systematic review with meta-analysis of randomized controlled trials comparing chemotherapy alone with CMT in patients with early stage Hodgkin's lymphoma with respect to response rate, tumor control and overall survival (OS). We searched Medline, EMBASE and the Cochrane Library as well as conference proceedings from January 1980 to February 2009 for randomized controlled trials comparing chemotherapy alone versus the same chemotherapy regimen plus radiotherapy. Progression free survival and similar outcomes were analyzed together as tumor control. Effect measures used were hazard ratios for OS and tumor control as well as relative risks for complete response (CR). Meta-analyses were performed using RevMan5. Five randomized controlled trials involving 1,245 patients were included. The hazard ratio (HR) was 0.41 (95% confidence interval (CI) 0.25 to 0.66) for tumor control and 0.40 (95% CI 0.27 to 0.59) for OS for patients receiving CMT compared to chemotherapy alone. CR rates were similar between treatment groups. In sensitivity analyses another 6 trials were included that did not fulfill the inclusion criteria of our protocol but were considered relevant to the topic. These trials underlined the results of the main analysis. In conclusion, adding radiotherapy to chemotherapy improves tumor control and OS in patients with early stage Hodgkin's lymphoma.

The choice of anesthesia influences oxidative energy metabolism and tissue survival in critically ischemic murine skin

In surgical animal studies anesthesia is used regularly. Several reports in the literature demonstrate respiratory and cardiovascular side effects of anesthesiologic agents. The aim of this study was to compare two frequently used anesthesia cocktails (ketamine/xylazine [KX] versus medetomidine/climazolam/fentanyl [MCF]) in skin flap mouse models. Systemic blood values, local metabolic parameters, and surgical outcome should be analyzed in critical ischemic skin flap models. Systemic hypoxia was found in the animals undergoing KX anesthesia compared with normoxia in the MCF group (sO(2): 89.2% +/- 2.4% versus 98.5% +/- 1.2%, P < 0.01). Analysis of tissue metabolism revealed impaired anaerobic oxygen metabolism and increased cellular damage in critical ischemic flap tissue under KX anesthesia (lactate/pyruvate ratio: KX 349.86 +/- 282.38 versus MCF 64.53 +/- 18.63; P < 0.01 and glycerol: KX 333.50 +/- 83.91 micromol/L versus MCF 195.83 +/- 29.49 micromol/L; P < 0.01). After 6 d, different rates of flap tissue necrosis could be detected (MCF 57% +/- 6% versus KX 68% +/- 6%, P < 0.01). In summary we want to point out that the type of anesthesia, the animal model and the goal of the study have to be well correlated. Comparing the effects of KX and MCF anesthesia in mice on surgical outcome was a novel aspect of our study.

Determinants of haemodialysis access survival

Vascular access patency is of vital importance for patients requiring haemodialysis. This analysis validates potential risk factors and benefits in patients undergoing vascular access procedures.

Evaluation of renal allograft function early after transplantation with diffusion-weighted MR imaging

To determine the inter-patient variability of apparent diffusion coefficients (ADC) and concurrent micro-circulation contributions from diffusion-weighted MR imaging (DW-MRI) in renal allografts early after transplantation, and to obtain initial information on whether these measures are altered in histologically proven acute allograft rejection (AR).

Reversal of established lupus nephritis and prolonged survival of New Zealand black x New Zealand white mice treated with the topoisomerase I inhibitor irinotecan

Systemic lupus erythematosus is a chronic autoimmune disorder that predominantly affects women of childbearing age. Lupus-associated glomerulonephritis is a major cause of mortality in these patients. Current treatment protocols for systemic lupus erythematosus include cyclophosphamide, prednisolone, azathioprine, and mycophenolate mofetil. However, in mice none of these agents alone or in combination were shown to reverse established proteinuria. Using New Zealand Black x New Zealand White F1 mice, we report that administration of the topoisomerase I inhibitor irinotecan from week 13 completely prevented the onset of proteinuria and prolonged survival up to at least 90 wk without detectable side effects. Furthermore, application of irinotecan to mice with established lupus nephritis, as indicated by grade 3+ (> or =300 mg/dl) and grade 4+ (> or =2000 mg/dl) proteinuria and, according to a median age of 35 wk, resulted in remission rates of 75% and 55%, respectively. Survival was significantly prolonged with 73 wk (grade 3+ and 4+ combined) versus 40 wk for control animals. Although total IgG and anti-dsDNA Abs in the serum and mesangial IgG deposits in the kidneys were not reduced in irinotecan-treated mice, subendothelial immune deposits were considerably diminished, suggesting a prevention of glomerular basement membrane disruption. This effect was accompanied by increased rates of ssDNA breaks and inhibition of renal cell apoptosis being different to what is known about irinotecan in anticancer therapy. In conclusion, our data provide evidence that irinotecan might represent an entirely new strategy for the treatment of systemic lupus erythematosus.

Validity of an automatic measure protocol in distal femur for allograft selection from a three-dimensional virtual bone bank system

Osteoarticular allograft is one possible treatment in wide surgical resections with large defects. Performing best osteoarticular allograft selection is of great relevance for optimal exploitation of the bone databank, good surgery outcome and patient’s recovery. Current approaches are, however, very time consuming hindering these points in practice. We present a validation study of a software able to perform automatic bone measurements used to automatically assess the distal femur sizes across a databank. 170 distal femur surfaces were reconstructed from CT data and measured manually using a size measure protocol taking into account the transepicondyler distance (A), anterior-posterior distance in medial condyle (B) and anterior-posterior distance in lateral condyle (C). Intra- and inter-observer studies were conducted and regarded as ground truth measurements. Manual and automatic measures were compared. For the automatic measurements, the correlation coefficients between observer one and automatic method, were of 0.99 for A measure and 0.96 for B and C measures. The average time needed to perform the measurements was of 16 h for both manual measurements, and of 3 min for the automatic method. Results demonstrate the high reliability and, most importantly, high repeatability of the proposed approach, and considerable speed-up on the planning.