J-PET is a detector optimized for registration of photons from the electron–positron annihilation via plastic scintillators where photons interact predominantly via Compton scattering. Registration of both primary and scattered photons enables to determinate the linear polarization of the primary photon on the event by event basis with a certain probability. Here we present quantitative results on the feasibility of such polarization measurements of photons from the decay of positronium with the J-PET and explore the physical limitations for the resolution of the polarization determination of 511 keV photons via Compton scattering. For scattering angles of about 82 Polarization is with no doubt one of the most interesting physical properties photons exhibit. It has been utilized to show several of the most basic foundations of quantum mechanics, where mainly optical (low energetic—few eV) photons were generated. However, thus far there were no studies where the degree of polarization was explored in measurements of high energy photons (in the range of MeV) originating from annihilations of positronium atoms. Polarization of such photons cannot be determined with optical methods. Here we show how it can be estimated via Compton scattering based on the well-known Klein–Nishina formula  and receMeasurement of the polarization degree of freedom of photons from positronium decay may open new possibilities in testing the discrete symmetries  in the leptonic sector since they provide a new class of operators . In addiThe photon is a transverse electromagnetic wave and Compton scattering occurs most likely in the plane perpendicular to the electric vector of the photon , 7. Thusattering , namely entclass1pt{minimaThe J-PET detector is built of plastic scintillator strips consisting mostly from carbon and hydrogen. Due to the low atomic number of these elements photons from the positronium annihilation interact in plastic scintillators predominantly via the Compton effect and a significant fraction of them may undergo two or even more subsequent scatterings in different strips. A picture of the present prototype of the detector is shown in Fig. he strip . The posmentclasspt{minimahe strip , 14. Forhe strip –17. The he strip –20. Thoucument}∘ . Presentr of 1.5 . Future In this article we explore first the possibility of the determination of the polarization of annihilation photons in the case of an ideal detector system. Section E is the energy of initial photon, Angular distributions of photons scattered on an electron are described by the Klein–Nishina differential cross section , 71\docuentclass1pt{minimasee Fig. , namely E and Compton scattering angle Due to different values of the cross section for photons scattered under various Compton angles =k^×k′^  . When usIn the previous section we discussed the limitations of determining the direction of the single-photon polarization with respect to the scattering plane, when the measurement is based on the Compton scattering formula. In this section we will extend this discussion to explore the possibilities of measurements of the relative angle between polarization directions of maximally entangled photon pairs originating from the decay of para-positronium. The Bose-symmetry and the parity conservation in the decay of para-positronium  impThus we have to simulate events of two emitted photons assuming that for each event at the moment of Compton scattering (the measurement act) the relative angle between the polarization directions of photons 1 and 2 is equal to In the previous section, it was shown that the polarization direction mentclass2pt{minimIn Fig. The lower panel presents results for the case when In order to quantify the effect we have performed Monte-Carlo simulations of mentclass2pt{minimt}V, Eq. , at \docA, B and Here in order to calculate the visibility as a function of scatterings angles, for each pair of A contour plot of In order to study the feasibility of the measurement of entclass1pt{minimamentclasspt{minimaIt is important to emphasize that events corresponding to a given pair of scattering angles (The simulations were performed using the GATE package. GATE (Geant4 Application for Tomographic Emission) is a Monte Carlo simulation platform developed by the OpenGATE collaboration –26 basedIn the simulations the full geometry of the J-PET detector and the composition of the detector material were taken into account. The interactions of gamma photons in the scintillators were simulated by GATE which utilizes the Klein–Nishina formula . In the The relative angle between the scattering planes Results presented in Figs. As an estimator of the average relative angle between polarization direction of the back-to-back photons, a parameter equation  to the eLast but not least let us comment on the theoretically predicted entanglement of the two gammas. Assuming an entangled state would result in a double as big total visibility than observed in Figs. Measurements of optical photon’s polarization have a long successful history in physics, constituting the basis for investigations of phenomena connected with quantum entanglement of photons such as quantum teleportation or quantum cryptography. In this article we explored the possibility of estimating the polarization of high energetic photons originating from the decays of positronium atoms with the novel technology of the J-PET detector. For the first time, polarization studies become possible in this energy regime and, by that, studies of photonic entanglement five orders of magnitude beyond the optical wavelength regime.J-PET is the first PET tomograph built from plastic scintillators in which annihilation photons are measured via Compton scattering. We have shown that the polarization of photon, at the moment when it scatters on electron via Compton effect, can be estimated on an event by event basis. We have studied possibilities of estimating the photon’s linear polarization at the moment of its interaction with the electron by the cross product of the momentum vectors d between interaction larger than 12 cm and the energy deposit for each interaction larger than 50 keV the total detection efficiency amounts to about Our simulations indicated that, for the ideal detector, due to the nature of the Compton effect, the resolution (visibility of the polarization) strongly depends on the scattering angle, achieving a standard deviation of  package –26, inclyer Fig.  and the ays Fig. . Thus as polymer . This wiFinally, we have shown that the angular resolution achievable with the J-PET detector, for the determination of the relative mean angle between the linear polarization of the back-to-back propagating annihilation photons is equal to about P, time reversal T and charge-conjugation–parity CP, via operators T or the CP invariance in purely leptonic systems has never been seen so far [T, CP and CPT violations are at the level of 10The results are encouraging and show that it is feasible to perform measurements of the quantum entanglement of photons from positronium annihilation , 4 with  vectors , 29. Vion so far . The expument}-9 , 32 1 Thument}-3 , 29) whe


Sourdough fermented bread has been suggested to have beneficial health effects, in part mediated by increased satiety in the postprandial phase, but only limited research has been conducted to verify this. The current study aimed to investigate the effect of the amounts of sourdough and rye in soft bread on postprandial appetite. On 6 occasions, 23 healthy volunteers consumed 5 different test breads, with varying amount of rye and sourdough, and a yeast-fermented refined wheat control bread as part of a breakfast meal. The sourdough ranged between 9–51% of dough weight and rye content between 35–48% of flour weight. Appetite was recorded using visual analogue scales from immediately before breakfast and every 30 min the following 4 h. An ad libitum lunch was served 4 h after the breakfast meal, from which voluntary energy intake was measured. While some of the test breads resulted in lower hunger ratings and increased sense of fullness compared to the refined wheat bread, there were no differences between the test breads. The content of rye in the test breads differed within a narrow range, which might explain the lack of a consistent effect of rye on appetite. Microstructural examination of the test breads showed an increased aggregation of proteins in the breads with high content of sourdough, indicating additional changes to the breads, beyond change in pH, which may counteract the potential effect of decreased pH in the bread on appetite. In conclusion, our study does not support an effect of sourdough on appetite and ad libitum food intake. Overconsumption of foods and beverages and subsequent excessive energy intake lead to overweight and obesity, which are important components of many lifestyle-related and metabolic diseases ,2. One aRye breads have repeatedly been demonstrated to induce satiety and reduce hunger compared to wheat breads ,7. This Sourdough fermentation has been hypothesized as a way of producing a healthier bread, potentially through improvement in appetite sensations . The proIn contrast, there are also studies which did not support this potential effect of sourdough in reducing appetite response. A study comparing a yeast-fermented bread to a bread made with a propionate rich sourdough found no effect on appetite ratings or subsequent food intake . SimilarThe current study was conducted to investigate the effect of breads with different contents of rye and sourdough on subjective appetite ratings as a primary outcome, and subsequent ad libitum food intake as a secondary outcome. Breads with different content of sourdough and proportion of whole grain rye were compared against each other and with a refined yeast-fermented wheat bread (control). No studies have yet compared breads with different amounts of sourdough and rye. Such data is crucial to improve our understanding of the role of sourdough in appetite regulation and can in a longer-term help identify future directions for the development of healthy rye breads.The study was designed as a six-way, randomized, cross-over meal study. In total, 23 volunteers consumed 5 test breads and a refined wheat control bread in randomized order, following a Latin square design, as part of a breakfast meal on 6 separate occasions, at least one week apart. On the day before each test, participants were instructed to avoid vigorous physical activity, alcohol, and high-fiber foods. Participants arrived fasted (≥12 h) at the Department of Molecular Sciences at Uppsala BioCentrum, Ultuna, in the morning between 7:30–8:00. Upon arrival they were served breakfast, as well as an ad libitum lunch meal 4 h later. Participants answered questions about their appetite every 30 min, starting right before consumption of breakfast, until right before consumption of the lunch. Additionally, participants filled in a palatability questionnaire after consuming the breakfast.Participants were allowed to return to their everyday work/activities during the time in between breakfast and lunch, but were instructed to refrain from any vigorous physical activity during that time and to refrain from consumption of any food or beverages.The study was conducted under the guidelines laid down in the Declaration of Helsinki, all participants gave informed consent in writing. Since none-invasive methods were used and because no subject data could be traced back to a specific individual, the study did not need any approval from the local ethics review board. All meal tests were conducted in May–June 2016.2 were invited to participate in the study. Participants were recruited through emails sent to employees and students at the Swedish University of Agricultural Sciences, Uppsala. Exclusion criteria were regular use of tobacco, performance of sports on an elite level, weight change of more than 10% of current bodyweight within the past 6 months, as wells as pregnancy, planning of pregnancy within the duration of the study, and lactation. Participants were only included if they were used to eating gluten, dairy, and foods of animal origin. Furthermore, participants were required to have a regular meal pattern, with regular consumption of breakfast, lunch and dinner. Before inclusion, participants completed a three factor eating questionnaire (TFEQ-R21) [Males and females between the ages of 20–70 years, with a body mass index (BMI) of 18–25 kg/mFEQ-R21)  to ensurDue to the appearance of the breads and the nature of the questions, it was not possible to blind the participants to the difference between rye breads and the wheat control bread. However, the participants were not aware that the amount of rye and sourdough differed between the rye breads.The test breads and refined wheat control bread were served as part of a breakfast meal consisting of 100 g bread with 15 g margarine and 20 g cheese, 100 g orange juice, and 150 g coffee or tea. On the first occasion, participants were given the choice of coffee or tea, which was kept the same for the remaining occasions. On request, 10 g of milk (1.5% fat) could be added to the coffee/tea on all occasions. The margarine, cheese, and orange juice amounted to 695 kJ, 10 g carbohydrate, 6 g protein, and 12 g fat.The five test breads were produced in a factorial design with 2 different levels of sourdough  and 2 different levels of rye , as well as a center point with medium content of both sourdough (30% of dough weight) and rye (42% of flour weight) . The amoLactobacillus brevis A6 and 10 g yeast Saccharomyces cerevisiae TY08M, which is a natural mutant with increased freeze tolerance, created by classical ultraviolet mutagenesis and selection. The parental wild-type strain S. cerevisiae TY08, (GenBank Accession number FJ972212 CBS 11440), used for mutagenesis was originally isolated from the Tanzanian fermented food togwa [Sourdough included in all recipes was made from 52 kg whole grain rye flour mixed with 78 kg water at a temperature of 35 °C. In total, 28 g sourdough culture was added and the mix was incubated at 30 °C for 24 h before use in the baking. The sourdough cultures used consisted of 18 g od togwa . TY08 waDough was prepared by a professional baker, divided into 90 g pieces that were frozen before fermentation and stored in a −21 °C freezer for four days. The doughs were then thawed at room temperature for 80 min, fermented in a proofing chamber (38 °C and 75% RH) for 60 min and baked in a rotational oven. Baking (15 min) was initiated at 230 °C with 8 s of steam, and then immediately lowered to 180 °C. Breads were then frozen again and stored at −21 °C until the test days. A commercially available refined wheat bread  was used as a control. Although this is a yeast fermented bread, it did contain a small amount of sourdough (3%) which was likely added as flavoring agent.Bread samples were freeze dried and then milled with a cyclone sample mill . Dietary fiber content was analyzed according to the Uppsala method . FructanLactic acid and acetic acid were determined enzymatically . Briefly, 10 g of sample was mixed with 100 mL distilled water and homogenized. The mixture was heated to 60 °C and kept there for 5 min and then cooled to room temperature in an ice bath. pH was adjusted to 7 with sodium hydroxide (NaOH) and the mixture put in an ultrasonic bath for 5 min. The samples were then centrifuged and filtered through a 0.2 µ membrane filter and stored at −20 °C until analysis. All samples were analyzed in duplicate .The breads were examined microscopically in order to examine potential structural differences between the breads. Bread samples were embedded as described by Johansson et al.  and the Appetite was measured on a handheld computer , with a program specially designed for appetite assessment that has been validated against traditional pen and paper method . At eachThe questions were presented one at a time on the screen, and participants did not have access to see previously answered questions, preventing participants from referring to previous questions when answering. Participants were provided with questions on paper and instructed to answer the questions on paper if problems occurred with the computers (8.8% of data points were collected on paper).The lunch was an ad libitum meal of Swedish hash, which is a mix of potatoes, pork and onions chopped in small pieces and fried, served with pickled beetroots and a glass of water. Each participant was served 600 g Swedish hash fried in 6 g rapeseed oil , 90 g pickled beet roots and 200 mL water. Participants were instructed to eat until they felt comfortably full and instructed to ask for more food if needed. After the participants had left, leftover food was weighed and recorded.Participants were asked to rate 5 aspects of the breakfast meals on a VAS with words anchored at the end and answers were recorded as a value between 0 and 100 measured from the left. The questions (and anchored words) were; “Taste (bad/good)”, “Smell (not appetizing/appetizing)”, Appearance (not appetizing/appetizing)”, “Off taste (none/much)”, and “How appetizing is it ? (Not appetizing/appetizing)”.In SAS software, Proc Mixed procedure ANCOVA models were used to evaluate the difference between bread types, here referred to as diet, on fullness, hunger and desire to eat. A repeated statement was included in all models to consider the cross-over design of the study.p ≥ 0.05).First, a within subject repeated measures ANCOVA (referred to as model A) including subject as random factor and diet, time and occasion as fixed factors and baseline (time 0) as a covariate as well as diet x time and diet x occasion interactions, was applied. Interaction terms and occasion were removed if they were not significant (p ≥ 0.05).Secondly, area under the curve (AUC) of appetite assessment  was calculated using the trapezoid method. In case of missing values, a value corresponding to the mean of the diet group was assigned (1.8% of data points were missing). AUC data was analyzed in an ANCOVA model (referred to as model B) with subject as a random factor and diet and occasion as fixed factors and baseline (time 0) as a covariate, as well as diet x time and diet x occasion interactions. Interaction terms and occasion were removed when not significant ” and “rye (high vs. low content)” in model A and B. The reference bread and medium sourdough/medium rye bread (MS/MR) were excluded from the analysis of the factorial design.p < 0.05 was considered statistically significant. No formal power calculation was conducted for this investigation, since previous studies have estimated the number of subjects needed under similar conditions [Tukey adjustment for multiple comparisons was applied to all results and nditions . StatistEight men and 15 women were included in the study and all participants completed all parts of the study, with the exception of one subject who did not participate in the lunch test after consuming bread type mid/mid for reasons unrelated to the study . The par2, respectively). All the statistical analyses were conducted both with and without the inclusion of these two subjects. For the majority of the outcomes this did not qualitatively affect the outcome of the analysis and the two participants were therefore included to increase power, but it is clearly specified throughout the manuscript in those cases when exclusion of the subjects significantly affected the outcome of the statistical tests.During the study, it was discovered that two subjects had BMI outside the inclusion criteria (17.3 and 29.3 kg/mProtein (colored green) was observed to form continuous networks surrounding the starch (colored purple/violet) in all breads . In the There was no apparent difference between any of the sourdough rye breads with regards to cell wall structure as visualized by staining of β-glucan with calcofluor .p = 0.008; model B: p = 0.002), desire to eat  and hunger, although only borderline significant for model A  (Diet had an effect on both fullness (model A: = 0.023) .Pairwise comparisons showed that medium sourdough/medium rye (MS/MR), high sourdough/high rye (HS/HR), and low sourdough/high rye (LS/HR) resulted in higher fullness rating, compared to the reference bread. The subjects’ desire to eat were lower after consumption of HS/HR and LS/HR compared to reference bread. MS/MR and LS/HR resulted in lower hunger ratings, compared to refined bread, according to model B, while there was only a tendency according to model A .p = 0.051; model B: p = 0.057).Excluding the two subjects with BMI outside the desired range did not alter the conclusions with regards to hunger and fullness, but reduced the effect of diet on desire to eat to a tendency (model A: p = 0.032), with a 0.5 MJ reduction in energy intake following consumption of LS/LR and LS/HR at breakfast, compared to the reference bread (p = 0.319).Analysis of the amount of energy consumed in the ad libitum lunch test revealed an effect of diet  and possibly also rye (p = 0.065) increased the off taste rating (data not shown).Ratings of taste, smell, appearance and overall impression did not differ between any of the test breads. Evaluation of the factorial design showed that increased content of sourdough  of the dough weight to the lowest being 35% (22.5 g/serving) of the flour weight. In retrospect, the range between high and low rye content could have been larger to better investigate potential dose/response effects of rye on appetite responses. Though the amount of sourdough in the refined wheat bread was small, it cannot be ruled out that it may have affected the results, and in future studies it might be favorable to produce a wheat bread without addition of sourdough, to allow for more controlled conditions.In conclusion, this study does not support an effect of sourdough on appetite response, despite a generally high and variable sourdough content among the rye breads. We suggest that the observed lack of effect may be due to comparably low content of organic acids, insufficient to affect gastric emptying and subsequent glycaemia and appetite. It could also be attributed to structural changes in the bread when increasing the amount of sourdough, counteracting potential direct pH-effects on gastric emptying. Moreover, the different amounts of rye did not affect appetite responses, possibly as a consequence of a relatively small range in amounts of rye in the tested breads.


Collective marketing campaigns may feature goals that are not shared equally by all customers, such as a fundraiser for an environmental cause. For such campaigns, how can marketers encourage broad participation? The present research demonstrates that the framing of collective progress in such campaigns can broaden participation by highlighting the “large area” of progress toward the goal, emphasizing progress achieved for campaigns in their late stages and progress remaining in their early stages. We tested this large area hypothesis in the context of a waste reduction drive, examining the reactions of Democrats and Republicans who might be more or less inclined to support the drive respectively. Study 1 examined these processes when the drive was nearing completion, finding that an accumulating frame (focusing on progress achieved) increased motivation to participate for Republicans to levels comparable with Democrats. Study 2 evaluated these processes at earlier stages in the drive’s progress. In these circumstances, a remaining frame (focusing on contributions still needed) increased motivation to participate among Republicans to a similar level as Democrats. These findings indicate framings that highlight the large area in collective progress broaden participation in collective marketing campaigns, suggesting that marketers should highlight remaining contributions needed early on and accumulated contributions received later in collective marketing campaigns. When conducting a collective campaign such as a fundraiser or a donation drive, campaigners often create a graphical measure, like a thermometer, to publicly track contributions. The first thermometer to be used as a campaign tracker was for a 1905 YMCA fundraiser that raised $4 million in less than 1 month . SimilarWhile this approach is effective when the goals are shared among all participants, it remains unclear whether the same is true when participants are less likely to share a collective goal equally. For example, fundraising for the local police department might face skepticism from the Black Lives Matter community and a campaign to reduce a business’s carbon footprint might meet resistance from climate change skeptics. Previous research has investigated how information about progress toward achieving a goal can motivate behavior in individual goal pursuit  or colleTo address this issue, the current paper investigated how the presentation of campaign progress affects broad participation in a collective marketing campaign when a subset of consumers are less likely to support the goal. In recent years, Americans have become more polarized based on political identity, with ramifications for a range of consumer preferences including brand preferences , varied Findings revealed that highlighting the larger area of the progress bar tracking collective contributions had the effect of broadening participation in the campaign by motivating Republicans to levels of participation similar to Democrats, who despite not necessarily sharing the drive’s goal remained sensitive to the framing of collective progress. This broader participation arises due to goal desirability, perceptions of the impact of one’s participation, and desire to help the community. These findings enrich theories of goal pursuit in the social domain and indicate that marketers can broaden participation in collective marketing campaigns by highlighting the larger area of progress bars used to track contributions.We first provide a theoretical background of the psychological processes underlying goal pursuit and articulate our hypotheses regarding collective goals that are not shared by all consumers. We then report the results from two experiments testing these hypotheses and discuss the theoretical contributions of this work as well as the managerial implications.Prior literature has highlighted two fundamental components of goal pursuit: goal commitment and goal progress . Goal coIn contrast, goal progress refers to the concrete progress made toward achieving a goal . TypicalResearch in judgment and decision making shows that perceptions are sensitive to relative comparisons . By highH1 Those who share the collective campaign’s goal will be motivated to participate in the drive regardless of progress framing.H2 In the end stages of collective campaigns, highlighting the large area (accumulated progress) will increase motivation to participate among those who are less likely to share the campaign’s goal to levels similar to those who are more likely to share the campaign’s goal.On the other hand, at the beginning stages of a collective campaign, when overall motivation is often low , we predH3 During the early stages of a collective campaign, the large area (remaining frame) will increase motivation to participate among those who are less likely to share the goal to levels similar to those who are more likely to share the campaign’s goal.As outlined earlier, we posit that three psychological processes underlie the broadened participation observed when an accumulating progress frame is employed near goal completion: perceived goal desirability, perceived impact of participation, and feelings of helping the community. First, observing others’ high overall participation leads to judgments that the goal is desirable to pursue. Desirability refers to the value of the end state of an action . ParticuH4 As a collective campaign nears completion, the accumulating frame motivates participation among those who are less likely to share a collective goal by enhancing the perceived desirability of the drive’s goal.Second, perceptions of the impact of one’s actions also likely increase motivation to participate in collective campaigns as they near completion. The perceived impact of one’s participation increases as greater progress is made toward achieving the goal , and peoH5 As a collective campaign nears completion, the accumulating frame motivates participation among those who are less likely to share a collective goal by enhancing their perceptions of the impact of their participation.Third, increasing participation by others in a collective campaign signals that the goal is shared by the general community, thus increasing perceptions that one’s participation would contribute to the community. Research across multiple domains of consumption e.g.,  suggest H6 As a collective campaign nears completion, the accumulating frame motivates participation among those who are less likely to share a collective goal by enhancing their feelings of helping the community.We conducted two studies to test our hypotheses in the context of an environmentally-friendly waste reduction drive. Consumer attitudes toward pro-environmental initiatives have been found to vary based on political party affiliation , so giveStudy 1 examined how progress framing alters motivation to participate as the drive nears completion, while Study 2 examined the drive in its early stages. Taken together, these experiments investigate how framing collective progress can broaden participation in such drives, examining the psychological processes that shape willingness to participate among those who are more or less likely to support the goals of a collective marketing campaign.Study 1 examined people’s motivation to participate in a waste reduction drive as it neared completion. This campaign used collective progress to highlight either accumulating progress achieved or remaining progress necessary. While we anticipated Democrats’ motivation would be high regardless of framing given the alignment between party environmental attitudes and the waste reduction drive, we expected Republicans’ motivation would depend upon the framing of collective progress, with accumulating frames promoting participation.Mage = 36.1, SD = 18.8) were recruited from Amazon Mechanical Turk for an online experiment. Participants were based in the United States with an approval rate of at least 97% on Amazon Mechanical Turk having completed at least 100 HITs. Participants were instructed to imagine they received an incomplete loyalty card for a local café from a friend who was moving away from the area .Study 1 tested a 2  × 2 (frame of collective progress: accumulating vs. remaining) × 2  interaction effect on the motivation of participation in a collective goal. While the overall amount of collective progress was identical in all conditions, the framing of collective progress was manipulated to highlight either accumulating progress  or remaining progress . To ensure that effects of collective progress framing generalized across different levels of individual progress, we also manipulated the number of existing stamps on the loyalty card . We asked an attention check question on a seven-point scale, “If you are paying attention to this survey, select the second button.” It was a single question and participants were not forced to respond. There is a one seventh (14.3%) chance that a participant inadvertently passes the question. Forty-eight participants answered this question incorrectly and were removed from all analyses. To avoid priming identities, political party affiliation was measured at the end of the survey. As political party affiliation was used to infer predispositions toward the environmentally-friendly goal, data were analyzed only from participants who identified as Republican or Democrat  and the extent to which they felt Green Café’s goal to decrease waste was desirable . Participants also responded to a six-item scale survey regarding the perceived impact of their participation by evaluating the extent to which getting one stamp makes progress toward reducing waste . They also rated how much they felt participating would help their community . To confirm that the framing of collective progress did not change perceptions that the waste reduction drive would be successful, participants completed a three-item scale of the campaign’s likelihood of success  than Republicans , as expected. The interaction between individual progress and political affiliation was also significant . Additionally, we found that there was a larger difference between Democrats and Republicans when the loyalty card already had two stamps  than when it had five stamps . Importantly, the analyses yielded the predicted interaction between progress framing and political affiliation . This is the typically expected pattern, as Democrats are generally more supportive of environmentally-friendly efforts than Republicans. However, in the accumulating frame condition, both Democrats and Republicans rated the goal as similarly desirable , supporting Hypothesis 2. The accumulating frame enhanced Republicans’ evaluation of the desirability of waste reduction, causing them to perceive the waste reduction goal as favorably as Democrats did. No other effects or interactions were significant.Ratings of the desirability of the goal of the waste reduction drive were analyzed using an ANOVA with the between-subjects factors of collective progress framing (accumulating or remaining), individual progress (2 or 5 stamps), and political affiliation (Republican or Democrat). Democrats rated the goal as more desirable  = 5.38, p = 0.021; see Maccumulating = 4.6, SD = 1.14 vs. Mremaining = 4.7, SD = 1.28; t(182) = 0.67, p = 0.501], whereas Republicans rated the perceived impact greater in the accumulating frame  compared to the remaining frame . No other effects or interactions were significant. These results indicate that the accumulating frame is more effective at enhancing Republicans’ judgments of the impact of their participation, consistent with our hypotheses.Building on these findings, we next examined the extent to which participating in the drive made one feel as if they were contributing to the drive’s success. Ratings of the perceived impact of participation were submitted to the same between-subjects ANOVA used to examine effects on perceptions of the drive’s desirability. Supporting Hypotheses 1 and 2, the results revealed a significant interaction between progress framing and political affiliation , while Republicans reported marginally greater feelings of helping in the accumulating frame  than in the remaining frame . No other effects or interactions were significant. These findings are consistent with our hypotheses that the accumulating frame would boost judgments regarding the collective appeal of the waste reduction drive and engender a social norm to participate, therein enhancing Republicans’ judgments of the drive.Third, we conducted a similar analysis examining participants’ ratings of the extent to which participating made them feel they were helping their community. In alignment with our other analyses, the interaction between collective progress framing and political affiliation was significant , consistent with previous research , this finding indicates an indirect-only mediation  and the perceived impact of participation  mediate the effect of progress framing on participation. The 95% CI obtained for the index of moderated mediation of feelings of helping (−0.11 and 0.33) included zero, which suggests that the indirect effect was absent when the three mediators were tested together. Thus, Republican participants were more likely to participate in the accumulating frame due to increased perceived desirability of the drive’s goal and a higher perceived impact of their participation.In Study 1, we found that the accumulating frame of collective progress increases Republicans’ motivation to participate by enhancing the desirability of the goal, the perceived impact of participation, and feelings of helping the community. However, it remains unclear whether similar effects would emerge for collective goals at earlier stages, with lower amounts of accumulated progress. This is particularly important from a managerial perspective, as marketers often desire to boost participation for new campaigns. Therefore, Study 2 tests Hypothesis 3 by examining how progress framing shapes participation and perceptions of the brand conducting the drive when the waste reduction drive is at earlier stages of progress.Mage = 37.0, SD = 12.1) were recruited through Amazon Mechanical Turk and randomly assigned to one of four conditions in a 2 (frame of collective progress: accumulating or remaining) × 2  design. As individual progress did not interact with our key findings from Study 1, in this experiment, we did not manipulate individual progress and all participants viewed a reward card with three stamps. Participants were based in the United States with an approval rate of at least 97% on Amazon Mechanical Turk having completed at least 100 HITs, and participants who had completed our previous study were excluded from participation. We asked participants to answer the same attention check question used in Study 1. Fifty-nine participants who did not pass the attention check were removed from all analyses.Three hundred eighty-five US participants , and feelings of helping the environment . As in Study 1, participants completed a three-item scale of the campaign’s likelihood of success .Participants followed the same procedure of Study 1. After learning about the waste reduction drive, participants rated their motivation to participate in the drive, how long it would take them to complete the reward card, brand liking  = 3.55, p = 0.061]. As expected, Democrats’ intentions to participate  were higher than Republicans’ in the accumulating frame  but did not differ in the remaining frame , supporting hypothesis 3. No other main effects or interactions were significant. In sum, when overall participation is low, Democrats remain consistently motivated to participate in the goal. However, the remaining frame promoted Republicans’ willingness to participate in the campaign, such that their indicated willingness to participate did not differ from Democrats’.Ratings of the intention to participate in the drive and bring one’s own mug to the café were analyzed using an ANOVA with the between-subjects factors of collective progress framing (accumulating or remaining), drive stage , and political affiliation (Republican or Democrat). Analyses revealed a marginally significant interaction between framing and political affiliation on one’s motivation to participate in the drive . The interaction between collective progress framing and political affiliation was significant . However, in the remaining frame, participants rated the brand favorably regardless of political affiliation . No other main effects or interactions were significant. The interaction reveals attitudes toward the brand are favorable in the remaining frame across political affiliations, whereas only Democrats liked the brand in the accumulating frame. Similar results were found examining feelings of helping the environment using the same ANOVA approach. There was a marginally significant interaction between collective progress frame and political affiliation . In sum, the remaining frame increased Republicans’ feelings of helping the environment, whereas the goal framing did not change Democrats’ feelings.We next examined ratings of brand liking using a similar ANOVA. There was a marginally significant main effect of political affiliation, as Democrats evaluated the brand more favorably (To summarize, findings from Study 2 support the large area hypothesis. When highlighting the remaining progress needed, which is a larger area in the progress bar, Republicans rated the brand as favorably as Democrats and reported similar feelings of helping the environment if they participated. Overall, the remaining frame was most effective for broadening support for these earlier stage drives.The present research examines how framing collective campaign progress affects participation in a marketing campaign. In the context of a waste reduction drive, we find that Democrats’ interest in participating is generally high regardless of how collective progress toward achieving the goal is framed. However, Republicans are sensitive to collective progress framing. Overall, framing feedback about collective goal progress to signal information of the large contributions made by others at the end stage and the large need for progress at the beginning stage of a campaign served to broaden participation. Near the end of the campaign, this large area effect was mediated by changes in Republican participants’ perceptions of goal desirability, the impact of their participation, and feelings of helping.The current research expands understanding of the social processes influencing collective goal pursuit. Previous studies have typically focused on non-controversial social goals, such as donations to charities that most consumers would support , while tThe present findings also contribute to a growing literature examining how political identities shape consumer behavior. In the present research, we used political affiliation as a proxy for likely support of the goal of the waste reduction drive, a context in which support is broad among liberal consumers and likely more variable among conservative consumers. One interesting avenue for future research is to examine whether the present findings are shaped by cognitive and attitudinal differences between liberals and conservatives, such as sensitivity to different appeals , adherenAnother possibility is that effects of framing on participation may be similar for both liberals and conservatives, but may be driven by different underlying psychological processes. For example, conservative consumers may be more likely to consider the reaction of an in-group to their behavior, while liberals may be more likely to consider the fairness of their actions to others . InterroOne interesting aspect of the individual goal pursuit literature is the finding that motivation may be at its lowest in the middle of goal progress . This efThe present findings have important practical implications for brands orchestrating collective marketing campaigns. First, we demonstrate that the framing of collective progress broadens participation in collective marketing campaigns. Organizations seeking to spur participation in such campaigns should thus highlight remaining contributions needed early in the campaign and accumulated contributions received later in the campaign. Second, these findings are timely, given the growing trend for brands to incorporate more political considerations into their advertising . The curThe present research does, however, have a few limitations. First, the campaign scenarios employed here are hypothetical. We used this approach to avoid associations with actual brands or stores which might confound the findings, but future work should examine these processes in an incentive-compatible design. Second, it would be ideal if we had examined both early and late stage campaigns within the same experiment to allow for more direct comparison of the underlying psychological mechanisms. Third, while we used political party affiliation as a proxy for likely support of the campaign goal, it would be helpful if future research employed a more direct index of participants’ initial commitment to the communal goal. Finally, the campaign employed in the present research included a direct benefit to those who chose to participate in the campaign, as they moved closer to earning a free beverage. Future research could examine more altruistic campaigns, such as charitable donations, where participation does not produce a tangible direct benefit.In conclusion, the present experiments demonstrate that framing information regarding others’ actions shapes motivation to participate in a collective marketing campaign. Highlighting remaining progress needed earlier in a campaign and accumulated progress achieved later in a campaign broadens its appeal to consumers who might otherwise have been unlikely to share the campaign’s goal. Perceptions of goal desirability, the impact of one’s contributions, and feelings of helping appear to underlie this broadened motivation. These findings can inform both marketers and policymakers seeking to conduct successful collective campaigns.http://osf.io/akm8g/.The datasets for this study can be found in the Open Science Framework: The studies involving human participants were reviewed and approved by the Temple University Institutional Review Board. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.YK and CR jointly designed, analyzed, wrote up this manuscript, and undertook all data collection.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Adult attention-deficit/hyperactivity disorder (ADHD) is a serious and frequent psychiatric disorder of multifactorial pathogenesis. Several lines of evidence support the idea that ADHD is, in its core, a disorder of dysfunctional brain connectivity within and between several neurofunctional networks. The primary aim of this study was to investigate associations between the functional connectivity within resting state brain networks and the individual severity of core ADHD symptoms .Resting state functional magnetic resonance imaging (rs-fMRI) data of 38 methylphenidate-naïve adults with childhood-onset ADHD  were analyzed using independent component analysis (FSL’s MELODIC) and FSL’s dual regression technique. For motion correction, standard volume-realignment followed by independent component analysis-based automatic removal of motion artifacts (FSL’s ICA-AROMA) were employed. To identify well-established brain networks, the independent components found in the ADHD group were correlated with brain networks previously found in healthy participants . To investigate associations between functional connectivity and individual symptom severity, sex, and age, linear regressions were performed.Decomposition of resting state brain activity of adults with ADHD resulted in similar resting state networks as previously described for healthy adults. No significant differences in functional connectivity were seen between women and men. Advanced age was associated with decreased functional connectivity in parts of the bilateral cingulate and paracingulate cortex within the executive control network. More severe hyperactivity was associated with increased functional connectivity in the left putamen, right caudate nucleus, right central operculum and a portion of the right postcentral gyrus within the auditory/sensorimotor network.The present study supports and extends our knowledge on the involvement of the striatum in the pathophysiology of ADHD, in particular, in the pathogenesis of hyperactivity. Our results emphasize the usefulness of dimensional analyses in the study of ADHD, a highly heterogeneous disorder.ISRCTN12722296 (10.1186/ISRCTN12722296).The online version of this article (10.1186/s12888-019-2031-9) contains supplementary material, which is available to authorized users. Attention-deficit/hyperactivity disorder (ADHD) is a common and impairing psychiatric disorder characterized by varying degrees of inattention, hyperactivity, and impulsivity. ADHD is not limited to children and adolescents. In 40–60% of children with ADHD, the disorder persists into adulthood . In adulThe pathogenesis of ADHD is incompletely understood. Clinical, genetic and experimental evidence suggests that ADHD is a multifactorial disorder, associated with neurochemical , anatomiOne way to investigate the circuitry of the brain is to perform resting state functional magnetic resonance imaging (rs-fMRI). In contrast to task-based fMRI, rs-fMRI measurements record the spontaneous fluctuations of brain activity during wakeful rest, i.e. in the absence of an experimental task or stimulation. Using rs-fMRI, several distinct resting state networks (RSNs) have been identified in health and disease .Both in children and adults with ADHD, a dysfunction of the default mode network (DMN) has been postulated. The DMN is a set of brain regions, including the posterior cingulate cortex, precuneus, and medial prefrontal cortex, which are active during rest and become deactivated with the initiation of a task , 12. A pSince then, a large number of studies on rs-fMRI in individuals with ADHD have been published . Most ofOur primary interest lies in adults with ADHD , 19. ForTo study functional connectivity within neural networks, we performed a group independent component analysis (ICA) with dual regression. The group ICA identifies a set of independent component maps that are common to our entire sample. Dual regression is a mathematical approach that uses these independent component maps as network templates to identify the corresponding functional connectivity maps, indicating the strength of functional connectivity in each subject .The aims of the present study are twofold. First, we will characterize well-established resting state networks, previously described in healthy individuals, in our sample of adults with ADHD. Second, we will investigate potential associations between the functional connectivity in these networks and the individual severity of core ADHD symptoms . We hypothesized that functional connectivity within the default mode network will be smaller in individuals with ADHD with increased symptom severity.This study is part of a larger project on structural and functional changes of the brain in adults with ADHD. Structural MRIs from this project were analyzed using surface-based morphometry . ResultsResting state fMRI data sets from 59 adults with ADHD were analyzed for this study. Data sets were taken from a randomized controlled trial that compared the efficacy of a mindfulness training program (mindfulness awareness practice) to an active control condition (structured psychoeducation) in adult ADHD . A contrAfter head motion correction using FSL’s MCFLIRT , 21 indiThe clinical trial is registered in the ISRCTN registryRecruitment of participants has been described previously , 24. In The diagnosis of ADHD was performed by experienced psychiatrists following DSM-IV criteria as described previously –25. ADHD3. For the resting state measurement, T2*-weighted BOLD images were obtained with a voxel size of 3 × 3 × 3 mm3 and 36 axial slices with a slice thickness of 3 mm . The field of view covered the entire cerebrum, but only the most rostral parts of the cerebellum in most participants. All participants were instructed to lie quietly and keep the eyes closed without falling asleep. The resting state measurement was preceded by the T1-weighted image and 2 runs of a 1-back working memory task (time of acquisition: 6:16 min each) and 2 runs of a stop signal task (time of acquisition: 6:09 min each). These task-based fMRI measurements were not included in the present study. The results of the 1-back working memory task have been reported by Bachmann et al. [Structural and functional images of the brain were acquired on a 3 Tesla Siemens Magnetom Trio with a 12-channel head coil at the Freiburg Brain Imaging Center as described earlier , 24. In Preprocessing of resting state FMRI data was carried out using FMRIB’s Software Library fsl_regfilt command [After performing standard data preprocessing, without temporal filtering, independent component analysis-based automatic removal of motion artifacts (FSL’s ICA-AROMA version 0.3 beta) command . ICA-ARO command , 39. ICAThe de-noised data sets were then high-pass filtered with a cutoff of 150 s (0.007 Hz). Registration of functional to high resolution structural images was carried out using boundary-based registration  in FLIRT6n = 38, preprocessed and de-noised with ICA-AROMA as described above) were concatenated in temporal order to create a single data set. This concatenated data set was then decomposed into 20 spatially independent components using group ICA with MELODIC. A low-dimensional decomposition was chosen to facilitate the comparison of RSNs in adult ADHD with those identified in healthy adults [To identify RSNs common to adults with ADHD, all data sets  was used [To investigate the associations between RSNs and clinical data , FSL’s was used , 43. In randomise (version 2.9) was used with 5000 permutations [To identify differences between women and men within the 10 canonical networks, a voxel-wise two-sample unpaired t-test with age as regressor of no interest was performed on the participant-specific spatial maps for each network using a general linear model. To identify associations between age and functional connectivity within the 10 canonical networks, age was used as regressor of interest with sex as regressor of no interest in the general linear model. To identify associations between ADHD symptom severity and functional connectivity within the 10 canonical networks, the individual scores on the inattention/memory problems, hyperactivity/restlessness, and impulsivity/emotional lability CAARS subscales were used as separate regressors of interest with sex and age as regressors of no interest. For non-parametric permutation testing, FSL’s utations , 45. Stautations  and a faFigure After low-dimensional decomposition with MELODIC, the following RSNs, described by Smith et al. , were alAdditional file An independent t-test with age as covariate of no interest did not reveal significant differences in functional connectivity between women and men in our sample.In ADHD participants with advanced age, a significant decrease of functional connectivity was found in the executive control network (IC 6), covering parts of the bilateral anterior cingulate cortex and the bilateral paracingulate cortex Fig. .Fig. 4ReIn ADHD participants with higher scores on the CAARS hyperactivity/restlessness subscale, increased functional connectivity was found within the auditory/sensorimotor RSN IC 5). These areas cover parts of the left putamen, right caudate nucleus, right central operculum and a portion of the right postcentral gyrus  to determine cortical thickness and subcortical gray matter volumes using surface-based morphometry and subcortical segmentation as implemented in FreeSurfer [To the best of our knowledge, the association between functional connectivity and age has not been investigated in adults with ADHD before. Here, we found a decrease of functional connectivity in the bilateral cingulate and paracingulate cortices within the executive control network in older ADHD participants Fig. . In a preeSurfer . InteresChanges in functional connectivity as a function of age have been described previously in healthy aging , 48. ThuWe also found increased functional connectivity in parts of the bilateral striatum , right central operculum and right postcentral gyrus in participants with higher scores on the CAARS hyperactivity/restlessness subscale Fig. . The basDysfunction of the basal ganglia and fronto-striatal circuits has long been suggested to be one of the core pathomechanisms of ADHD. This notion has been supported by the dopaminergic effects of methylphenidate, the major pharmacological treatment for ADHD. The reduction of subcortical gray matter in children with ADHD –6 appearFunctional MRI of inhibitory control in adult ADHD led to inconsistent results . SebastiA recent study by Mostert et al.  comparedThe aforementioned studies performed categorical comparisons between individuals with ADHD and healthy controls. ADHD, however, is characterized by a remarkable phenotypic and genetic heterogeneity , 55 and In a large sample of adolescents with ADHD, Oldehinkel et al.  performeContrary to our initial hypothesis, no significant associations between functional connectivity within the ventral and dorsal DMNs and the symptom severity scores were identified in the present study. This result is also in contrast to previous studies in childhood, adolescent and adult ADHD, describing weaker connectivity within the DMN in individuals with ADHD vs. controls . In adulOur study comprises a clinically-well characterized sample of 38 methylphenidate-naïve adults with ADHD. Many studies in the field include participants with long-term stimulant medication as well  .This study corroborates and extends our knowledge on the involvement of the striatum in the pathophysiology of ADHD, in particular, in the pathogenesis of hyperactivity. Moreover, we found, for the first time, a decrease of functional connectivity in the bilateral cingulate and paracingulate cortices within the executive control network in older individuals with ADHD. Significant associations between functional connectivity in the default mode network and symptom severity, sex or age were not found. Our results emphasize the usefulness of dimensional analyses with individual symptom severity and age as regressors in the study of ADHD, a highly heterogeneous disorder.Additional file 1:Appendix 1. Overview of the 10 independent components that were not used for further analysis. (PDF 309 kb)


Bartonella spp. bacteria can be found around the globe and are the causative agents of multiple human diseases. The most well-known infection is called cat-scratch disease, which causes mild lymphadenopathy and fever. As our knowledge of these bacteria grows, new presentations of the disease have been recognized, with serious manifestations. Not only has more severe disease been associated with these bacteria but also Bartonella species have been discovered in a wide range of mammals, and the pathogens’ DNA can be found in multiple vectors. This review will focus on some common mammalian reservoirs as well as the suspected vectors in relation to the disease transmission and prevalence. Understanding the complex interactions between these bacteria, their vectors, and their reservoirs, as well as the breadth of infection by Bartonella around the world will help to assess the impact of Bartonellosis on public health. Bartonella spp. have been linked to emerging and reemerging human diseases , or B. rochalimae [B. rochalimae but did not appear to be reservoirs of the remaining Bartonella species [Bartonella species [Cats have also been discovered as reservoirs for other oehlerae ,21,22. B disease ,23,24. Bcarditis ,18,24. Ichalimae . The stu species . The aut species .Bartonella usually have asymptomatic bacteremia that can last for many months. A transmission to humans occurs directly from a cat scratch and may occur through the cat flea Ctenocephalides felis [B. henselae DNA has been isolated from cat saliva, although there has been no evidence that a cat bite has led to cat-scratch disease directly [Bartonella quintana DNA was detected from both the woman and the cat that bit her; however, the woman admitted to daily exposure to biting flies and mosquitoes, with an occasional exposure to ticks and fleas, as well as having been bitten by a dog earlier that day, so the source of the bacteria could not be determined [C. felis has been shown experimentally [B. henselae. In this case, Ixodes ricinus ticks removed from a cat that had anti-B. henselae IgG antibodies also tested positive by PCR for B. henselae DNA [B. henselae must be performed to definitively claim that ticks are a vector in transmitting this pathogen.Cats infected with es felis ,9,26,27.directly . Also, itermined . A transelae DNA . AlthougB. henselae, B. vinsonii subsp.berkhoffii, B. koehlerae, B. clarridgeiae, B. elizabethae, B. washoensis, B. quintana, B. bovis, B. volans-like, and B. rochalimae [Bartonella species. Infections with these pathogens result in endocarditis, myocarditis, vasculitis, and granulomatous disease in dogs, similar to the disease caused in humans [Dogs have been infected with chalimae ,33,34,35n humans ,37.Bartonella including B. henselae, and B. vinsonii subsp. Berkhoffii [Bartonella has been isolated from stray and domestic dogs in Chile, Sri Lanka, Brazil, and Columbia, with asymptomatic dogs exhibiting high infection rates with B. henselae and B. vinsonii subsp. berkhoffii [Although a majority of these infections are thought to be accidental, dogs are most likely a reservoir of a few species of rkhoffii . Bartonerkhoffii ,32,33. Bartonella between dogs is probably through vectors such as fleas and ticks [B. bovis, B. rochalimae, B chomelii, B. henselae, B. phoceensis, B. queensladensis, B. rattimassiliensis, and B. elizabethae has been isolated from ticks removed from dogs [B. vinsonii subsp. berkhoffii along with their dog was documented [Bartonella to humans, B. henselae, B. bovis, B. quintana, and B. vinsonii subsp. berkhoffii DNA have been isolated through PCR in dog saliva [Bartonella DNA has been detected in saliva, more evidence is needed to substantiate the notion of a direct transmission from dogs to humans. The most likely mode of transmission is through a vector such as fleas or ticks.The transmission of nd ticks ,38,39. Dcumented . The fatcumented . Althougg saliva . TherefoB. henselae [Bartonella infection has been investigated through an experimental infection and a naturally occurring infection in horses [B. henselae-infected horses developed acute bacteremia with no long-term effects and B. bovis-infected horses mostly were unaffected (1 horse had acute bacteremia) [Bartonella spp. Of note, B. henselae, B. vinsonii subsp. berkhoffii, and novel Bartonella have been identified in horses by utilizing an enrichment culture developed by the Breitschwerdt lab [Bartonella spp. found in horses cause disease in humans, horses may be accidental hosts and may potentially aid in the spread of infection through arthropod vectors.In 2007, a novel study found that two horses were infected with henselae . Since tn horses ,43. Whenteremia) . SubsequB. bovis, B. schoenbuchensis, and B. chomelii [Bartonella spp. have been identified as human pathogens. The transmission between cattle occurs through many different vectors. In one study, B. henselae was identified in 12% of cows from Israel [Bartonella spp. Cattle are reservoirs of chomelii ,45,46,47m Israel . AlthougMelophagus ovinus) are a reservoir and vector, respectively, of B. melophagi [B. melophagi can only be found in domestic sheep species and does cause disease in humans [Sheep and sheep keds  can be infected with Bartonella species [Leptopsylla taschenbergi, fleas associated with small mammals, have been collected from the wild and are infected with Bartonella species as well [Ctenophthalmus nobilis, rodent fleas collected from an area with a high Bartonella prevalence, experimentally transmitted B. taylorii and B. grahamii to Bartonella-free bank voles [Bartonella are important to observe; as humans colonize more discrete areas of the world, the emergence of vector-borne disease increases due to our arrival into the life cycle of these pathogens.Other flea species have also been associated with  species ,62,63,64 as well . Ctenophnk voles . Links bBartonella quintana since the 1920s, after World War I [B. quintana bacteria as an experimental system were found to replicate in the louse gut, and viable bacteria were also found in the feces of Pediculus humanus after the lice fed on an infected rabbit [B. quintana is less well-understood. In Africa, head and body lice were collected from 37 mono-infested individuals. The findings showed that 48 of 143 body lice and only 6 of 31 head lice harbored B. quintana [B. quintana was found in the feces, but there was a higher amount of viable B. quintana in body lice than in head lice [B. quintana due to louse feces, so the smaller frequency of infection caused by head lice makes sense, with fewer viable bacteria present in head lice feces. While fleas and lice are well-established vectors for transmitting different strains of Bartonella, increasing evidence links many other vectors to Bartonella spp. Lice have been documented as transmitting ld War I . Many sold War I ,71,72,73d rabbit . The rolquintana . One repead lice . Most huBartonella species has been widely debated. Evidence exists to support the transmission of Bartonella through many different species of ticks. Ixodid ticks, also known as hard ticks, appear to be the main type of tick associated with these bacteria. Tick cell lines have been used to show that Bartonella can replicate and survive within Amblyoma americanum, Rhipicephalus sanguineus, and Ixodes scapularis cells [Ixodes pacificus, Dermacentor occidentalis, and Dermacentor variabilis were collected when in the adult and nymphal stages and tested for Bartonella by PCR for the citrate synthase gene. [Bartonella DNA, although in varying percentages and locations. These data alone do not prove that ticks can transmit Bartonella spp. Bacteria; however, the results do show Bartonella DNA occurring naturally in these wild ticks. In Palestine, Hyalomma spp., Haemphysalis spp., and Rhipicephalus spp. ticks were collected from domestic animals and tested by PCR for the Bartonella intergenic transcribed spacer (ITS) region [Bartonella: B. rochalimae, B. chomelii, B. bovis, and B. koehlerae [Over the last 10 years, the topic of ticks transmitting is cells . In Calise gene. . All typ) region . These toehlerae . While tIxodes scapularis and Dermacentor variabilis) and rodents (Peromyscus leucopus) from southern Indiana, the midgut contents of the tick species and rodent blood were analyzed by 16S sequencing. Bartonella was present in a moderate percentage (26% in D. variabilis and 13.3% in I. scapularis) of larvae and nymphs of both tick species, even those scored as unengorged, but was present in the majority (97.8%) of the rodents tested [Bartonella henselae in Ixodes ticks was 2.5% [Borrelia spp. (63.2%) and B. henselae (10.3%) was found in Ixodes affinis ticks collected from North Carolina. Ixodes ricinus has been the focus of studies that support tick transmission of Bartonella spp. in Europe. This is because I. ricinus is an important vector for tick-borne diseases in Europe [I. ricinus have been collected in the larval, nymphal, and adult stages in Austria [Bartonella spp., with the highest rate in ticks derived from Vienna (with a 7.5% infection rate), and that adult ticks had a higher prevalence than other stages [B. henselae, B. doshiae, and B. grahamii DNA were amplified, and this was the first study to find Bartonella-infected ticks in Austria [Bartonella indicated that the overall presence of Bartonella in ticks (combining evidence from multiple surveillance studies) was approx. 15% [B. henselae DNA has also been isolated from I. ricinus removed from an infected cat. However, whether the cat gave the tick Bartonella or vice versa cannot be established, so the vector competence of these ticks for transmission cannot be determined [I. ricinus and Bartonella transmission. One study focused on the ability of ticks to maintain infection from one life stage to the next and tested a vertical transmission from adults to eggs. The authors used B. henselae and found that a transstadial transmission was possible and that a transovarial transmission was not likely [I. ricinus by amplifying B. henselae DNA from the salivary glands of infected ticks and by amplifying DNA from blood 72 h after infected ticks fed through an artificial system [I. ricinus to transmit Bartonella birtlesii [B. birtlesii through an intravenous injection via a tail vein, and once mice were infected, naïve ticks were fed on the mice and kept for 3 months to molt. Nymphal ticks were shown to transmit B. birtlesii to naïve mice, and adult ticks were shown to infect blood through a feeder method [B. birtlesii was identified in the blood of the recipient mice through PCR and immunofluorescence [I. ricinus’ ability to transmit a very specific strain of Bartonella, B. birtlesii, which is not linked to human disease. Concerns such as these related to vector competence and transmission can only be quelled by repeated studies utilizing multiple strains of Bartonella and differing tick species. In a sampling of ticks , and mites (1.7%) [Bartonella infection rates. This is important to distinguish because the route of transmission from rats to humans is poorly understood in Bartonella infections but likely is due to a vector. In Thailand, several studies have been performed on the persistence of a zabethae . In 2015pp. rats . In the s (1.7%) . It was Bartonella DNA [B. henselae [Bartonella containing unique sequences, with a close relation to B. elizabethae, B. tribocorum, B. rattimassiliensis, B. vinsonii subsp. arupensis, and B. tamiae [Bartonella tamiae was first sequenced from humans exhibiting febrile illness and has since been sequenced from chiggers removed from rats and directly from rats [A serological survey in Thailand found 20 out of 261 human samples contained ella DNA . After ahenselae . The rem. tamiae . Bartonerom rats ,94. Bartonella spp. bacteria. In the country of Georgia, a woman developed lymphadenopathy and fever due to a Bartonella species related to B. tribocorum and B. elizabethae [Bartonella DNA and 37.2% were positive by culture [Rattus spp. rats in urban populations had Bartonella, whereas only 13% rats in a rural location had Bartonella [Bartonella to humans, with rats in particular. However, much knowledge regarding the means of transmission from rodents to humans remains unknown. The relationship of rodents and the transmission of Bartonella should be studied closer and more thoroughly with controlled experiments to determine the exact routes of transmission between rodents, the transmission between rodents and their vectors, as well as the transmission between rodents to humans to determine risk of Bartonella infections to humans. Other areas of the world have surveyed rodent populations for the presence of zabethae . When th culture . In Kenyrtonella . All theBartonella mayotimonensis, which caused culture-negative endocarditis in a male patient, has been linked to bats [Bartonella spp. Bats are common mammals that have a large geographic distribution, with links to emerging pathogens . Specifi to bats ,101. SinBartonella isolated from bats in Georgia were sequenced, and analyses of homology identified strains related to those isolated from dogs in Thailand and a relationship to strains isolated from humans in Poland [Bartonella has also been isolated from bats in France, Spain, Brazil, Argentina, Thailand, Romania, Hungary, and Nigeria [n Poland . Ectoparn Poland . Bartone Nigeria ,105,106.Bartonella between bats. However, studies have shown that, although bat flies do test positive for Bartonella DNA, the strains typically differ from those isolated from bat host populations [Bartonella sp. isolated from these ectoparasites supports a shared evolution and suggests that a horizontal transmission may be occurring [Bat flies, in particular, are implicated as the most likely vector transmitting ulations . The genccurring . Bartonella prevalence, and human populations in the surrounding area were also surveyed for Bartonella infections. A novel species, named Bartonella rousetti, was isolated from bats and bat flies. In addition, 8 out of 204 persons surveyed were seroreactive to B. rousetti [Bartonella infections, although the direct link to human disease is unclear. One interesting study determined a link between bats and humans. Twice a year, an African population goes into a bat cave to collect bats for consumption . Bats anrousetti . This stBartonella, there has been more evidence gathered to support coinfection of Bartonella with other vector-borne pathogens. Most evidence has occurred through serological surveys conducted in an effort to estimate the incidence of human coinfection. Several studies have also focused on the detection of pathogens within questing ticks. Although it is difficult to determine whether these coinfections occurred with one vector or transmission event or over the course of multiple events, one aspect is clear: A coinfection with these pathogens leads to difficulty clearing either infection and the antibiotic treatment should differ for individuals infected with multiple pathogens. Equivalent to the debate on whether ticks transmit B. bacilliformis, including Salmonella spp., Shigella dysenteriae, Staphlococcus aureus, Enterobacter spp., Toxoplasma spp., Histoplasma spp., Pneumocystis carinii, and Plasmodium vivax malaria [B. bacilliformis and Mycobacterium spp. [Bartonella. In a Peruvian retrospective study, 35% of patients with Carrion’s disease had coinfections with  malaria . Althoug malaria . Anotherium spp. . While nBartonella spp. and Rickettsia typhi [Bartonella spp., while none were positive for Rickettsia spp., implicating other factors in this particular coinfection among the homeless in Bogotá [Bartonella spp. and Rickettsia spp. [Coxiella burnetii, Spotted Fever Group and Typhus Group Rickettsiae, and Bartonella henselae. While B. henselae exposure (2.9%) was the rarest of the those tested, over 20% of donors had been exposed to two or more pathogens, which was positively correlated with occupations involving animals [Coxiella burnetii, which causes Q fever in humans, in particular, could produce more serious complications as a coinfection [Borrelia burgdorferi, Anaplasma phagocytophilum, Bartonella spp., and Babesia microti [Bartonella [Bartonella and B. burgdorferi with 9.2% of forestry workers and 7.7% of farmers coinfected. The other coinfections observed were Bartonella spp. and A. phagocytophilum (1.7% forestry workers) and Bartonella spp. and B. microti (0.8% forestry workers). A small percentage (1.3%) of forestry workers even experienced triple infections with Borrelia burgdorferi, Bartonella spp., and A. phagocytophilum, and one individual had a quadruple infection with all pathogens investigated [Bartonella coinfections in humans with multiple pathogens transmitted by a variety of vectors.One serological survey conducted among the homeless in Columbia found 13.1% of enrolled individuals had IgG to both ia typhi . Lice con Bogotá . From a sia spp. . A study animals . Althougnfection . In 2012 microti . The serrtonella . A coinfstigated . These dIxodes scapularis ticks collected, 6.55% were infected with Bartonella henselae and 1.19% were coinfected with B. henselae and Borrelia burgdorferi [B. henselae and B. burgdorferi in New Jersey in 2001 [I. scapularis ticks were obtained from one of the patient’s household and tested positive for B. henselae and Borrelia burgdorferi DNA using PCR [In 2006, a study conducted in New Jersey found that out of 168 questing gdorferi . Interes in 2001 . I. scapsing PCR . These psing PCR . There iI. ricinus ticks transmit many diseases. Studies have been conducted whereby questing ticks were collected and serological data was analyzed in regions to determine the risk for coinfections with Borrelia. In France in 2011, a survey showed that, with a 32% I. ricinus rate of infection with B. burgdorferi, only about 0.1% demonstrated a coinfection with Bartonella, which was identified to be B. birtlesii [I. ricinus ticks were found to be infected with Bartonella and 25% of those ticks were coinfected with Borrelia burgdorferi [I. ricinus ticks collected to be coinfected with Bartonella henselae and Borrelia burgdorferi [Bartonella henselae. These data support the possibility of a coinfection through a vector such as ticks. However, the occurrence of infections could have been either simultaneous or consecutive. In Europe, irtlesii . In othegdorferi . A survegdorferi . Most regdorferi . DependiBartonella appears to be very broad, as these pathogens can utilize multiple vectors and cam infect a diverse range of hosts. Given the complex clinical manifestations and difficulty in effective treatments, the impact of these bacteria on human health may be more significant than is currently appreciated. These factors warrant further research on Bartonella prevalence, risks for infection, and pathobiology in mammalian hosts. In summary, the prevalence of


Bartonella infections, although publications have predominantly focused on the North American perspective. Currently, clinico-pathological data from Europe are more limited, suggesting that bartonellosis may be an infrequent or underdiagnosed infectious disease in cats and dogs. Research is needed to confirm or exclude Bartonella infection as a cause of a spectrum of feline and canine diseases. Bartonella spp. can cause acute or chronic infections in cats, dogs and humans. On a comparative medical basis, different clinical manifestations, such as periods of intermittent fever, granulomatous inflammation involving the heart, liver, lymph nodes and other tissues, endocarditis, bacillary angiomatosis, peliosis hepatis, uveitis and vasoproliferative tumors have been reported in cats, dogs and humans. The purpose of this review is to provide an update and European perspective on Bartonella infections in cats and dogs, including clinical, diagnostic, epidemiological, pathological, treatment and zoonotic aspects.Bartonellosis is a vector-borne zoonotic disease with worldwide distribution that can infect humans and a large number of mammals including small companion animals (cats and dogs). In recent years, an increasing number of studies from around the world have reported  Bartonella is a genus of Alphaproteobacteria within the family Bartonellaceae. Bartonella spp. are small, thin, short and slightly curved, gram-negative, hemotropic and rod-shaped bacteria [Bartonella spp. are fastidious, slow growing and facultative intracellular pathogens that are highly adapted to a broad spectrum of mammalian reservoir hosts and are mainly transmitted by arthropod vectors [Bartonella species have been isolated or detected from humans or from domestic and wild animals including bats, birds, canids, cattle, deer, felids, horses, marine mammals, rodents, sheep and reptiles [Bartonella spp. are distributed throughout the world. In recent years, an increasing number of studies from around the world have reported canine and feline Bartonella infections. The purpose of this review is to provide an update while emphasizing European literature relative to Bartonella spp. infections in cats and dogs, including clinical, diagnostic, epidemiological, pathological, treatment and zoonotic aspects.bacteria . They arbacteria . Bartone vectors , 3. Thirreptiles –10. BartBartonella species or subspecies have been recognized as agents of human disease, three species are reportedly responsible for the majority of clinical illness: B. bacilliformis, B. quintana and B. henselae [Bartonella spp. is rarely performed in human medicine and due to difficulties associated with isolation or PCR amplification of these bacteria from patient specimens, it is possible that B. koehlerae [B. vinsonii berkhoffii, as well as other species are under-recognized as a cause of human illness [At least thirteen henselae . Becauseoehlerae , 13, B.  illness , 15.Bartonella species infecting cats and dogs with zoonotic potential are listed in Table B. clarridgeiae, B. elizabethae, B. henselae, B. koehlerae, B. quintana, B. rochalimae and B. vinsonii berkhoffii. All of these species have been associated with severe illnesses in cats or dogs and all have zoonotic potential [Bartonella spp. appears to have co-evolved with a specific primary reservoir host which poses a source of infection for accidental hosts under natural exposure conditions [Primary reservoirs, accidental hosts and the confirmed or suspected vectors for the main otential , 17. Eacnditions .Table 1BFelis catus) is the primary but not sole reservoir for B. henselae [B. clarridgeiae and B. koehlerae. Infected cats are thought to rarely develop clinical signs [B. bovis (ex weissii) and B. quintana, but the role of domestic cats in the epidemiology of these two Bartonella species has not been clearly established [The cat  may also be a host for B. henselae and canines are considered the primary reservoirs for B. vinsonii berkhoffii, causing endocarditis in dogs and humans [Canis latrans) in California and potentially domestic dogs have been described as main reservoir hosts for B. vinsonii berkhoffii, as prolonged bacteremia also occurs in these animals [Bartonella henselae, first isolated from a dog in Gabon in 2003 may be the Bartonella spp. that most often infects pet dogs [B. clarridgeiae, B. elizabethae, B. koehlerae, B. quintana, B. rochalimae and B. washoensis, potentially causing similar disease manifestations as reported in humans, including bacillary angiomatosis, endocarditis, granulomatous hepatitis and granulomatous lymphadenitis, myocarditis, peliosis hepatis and others [The dog  [bidities . Infectiod donor . Bartonee type I , hallucie type I , endocare type I  and othee type I . Bartonesymptoms , 24. Barody lice . Howevercarditis  and healcarditis , 40, catcarditis , 42 and mulatta) , 44.Bartonella organisms within the bloodstream are ingested by blood-sucking arthropod vectors, mainly fleas, lice, sand flies, biting flies and ticks, after which they are transmitted to a primary reservoir or to an accidental host [Bartonella-contaminated arthropod feces via animal scratches or bites or by self-inflected contamination of wounds induced by the host scratching irritating arthropod bites. These are important modes of transmission among primary reservoir and accidental hosts, including cats, dogs and humans [Lutzomyia verrucarum sand flies, the vector of B. bacilliformis among humans [in vitro model, Ixodes ricinus ticks were able to infect mammalian blood with B. henselae [Bartonella spp. DNA, particularly B. henselae, has been well documented in questing ticks from Europe and other continents [Bartonella infection to dogs or humans in the absence of other vectors or known modes of transmission [B. henselae by cat fleas  has been demonstrated experimentally [Intra-erythrocytic tal host  (Table 1d humans –47. (ii)g humans . Experimhenselae . Furtherntinents –52. Ticksmission –56. Intementally , but addmentally  or by blmentally –62.Bartonella spp. seroprevalence rates are high in cats in European Mediterranean countries, where temperature and humidity are favorable for flea and tick infestations [Bartonella antibody prevalence in cats ranges from 0% in Norway [B. clarridgeiae, B. henselae and B. koehlerae often approach 50–75% in feral cat populations worldwide [Serology, PCR or culture-based clinico-epidemiological studies in cats and dogs in Europe are summarized in Tables stations  Fig. 1)Bartonelln Norway  to 71.4%n Norway   had antibodies against B. henselae only, 34 (33.3%) had antibodies against B. clarridgeiae only, 2 (2.0%) had antibodies against B. vinsonii berkhoffii only and 30 (29.4%) had antibodies against a combination of these antigens [Bartonella spp. indirect immunofluorescence assay (IFA) most likely under estimates overall seroprevalence, IFA specificity appears to approach 100% [Bartonella seroprevalence data is more limited in Europe and other continents in dogs when compared to North America , as well as a high molecular prevalence (7.9%) using Bartonella alpha proteobacteria growth medium (BAPGM)/PCR [B. quintana antigen (11.2%) and the highest, against B. vinsonii berkhoffii genotype III antigen (56%). Infection with B. henselae, B. vinsonii berkhoffii genotypes I and III, and B. quintana DNA was documented [B. henselae seroprevalence in cat owners, and blood donors was 28.9 and 5.9%, respectively [The annual number of human cases of CSD in the USA is estimated to be 12,000 outpatients and 500 inpatients . Compara and 30% , 103. A PGM)/PCR . Interescumented . In a prectively .Bartonella spp. is initiated by colonization of the still enigmatic primary niche where the bacteria reside, persist and are periodically seeded into the bloodstream to cause the typical relapsing Bartonella spp. bacteremia [Bartonella spp. have been isolated from mammals [Bartonella henselae has been shown to infect erythrocytes, endothelial cells, macrophages, microglial cells and even human CD 34+ progenitor cells [Bartonella tribocorum subcutaneous inoculated in rats led to bloodstream invasion through the lymphatic circulation [In animal models, mainly cat and mouse, after initial inoculation the infection cycle of cteremia . Endothe mammals –112. Baror cells –116. In culation , a findiBartonella tribocorum was able to resist macrophage phagocytosis and to inhibit pyroptosis at an early stage of infection [Bartonella spp. for endothelial cells in conjunction with their proximity to the bloodstream suggest that endothelial cells are an important constituent of the primary niche [Bartonella spp. infection is characterized by chronic intraerythrocytic bacteremia whereas in accidental hosts the bacteria are less frequently documented in association with intraerythrocytic bacteremia, potentially due to a very low-level infection of erythrocytes [Bartonella spp. are able to colonize endothelial cells in both, accidental and reservoir hosts [+ progenitor cells in the bone marrow, as well as circulating erythrocytes and monocytes [nfection . Endothenfection . The trory niche . In mammhrocytes , 119. Bair hosts . The endonocytes .B. vinsonii berkhoffii can induce vascular endothelial growth factor (VEGF) endothelial cell proliferations, as reported for B. bacilliformis, B. henselae and B. quintana in human patients [in vitro evidence that B. vinsonii berkhoffii genotypes I, II and III are capable of inducing activation of hypoxia inducible factor-1 and production of VEGF, thereby providing mechanistic evidence as to how these bacteria could contribute to the development of vasoproliferative lesions [Bartonella spp. may contribute to the pathogenesis of systemic reactive angioendotheliomatosis and hemangiopericytomas in animals [B. bacilliformis, B. henselae and B. quintana [Bartonella spp. infections range from low to no morbidity , to occasional mortality (e.g. B. quintana infection), to substantial mortality in Peru due to the severe hemolytic anemia associated with B. bacilliformis [In dogs, patients  leading patients  and vasopatients . There i lesions . For thi animals , 122. Inquintana  leading quintana  and vasoquintana . Moreoveliformis .Bartonella spp. infections continues to expand, yet remains incompletely characterized in many domestic and wild animals [Bartonella infections are probably self-limiting, persistent infections appear to be associated with a wide variety of clinical signs and pathological abnormalities in cats, dogs, and humans. Bartonella infections manifest from subclinical bacteremia  to encephalitis, fever of unknown origin, lymphadenomegaly, endocarditis and myocarditis, ocular disease , skin inflammation and many other less common disease manifestations [Bartonella spp. and strains, mode of transmission, differences in the host immune response, concurrent infectious or non-infectious diseases, immunosuppression and malnutrition [The spectrum of disease manifestations associated with  animals . Althougstations . Some fautrition , 125.B. henselae, B. koehlerae and B. vinsonii berkhoffii are the three Bartonella spp. most frequently associated with pathology in cats, dogs and humans. As reservoir host for B. henselae and B. koehlerae, cats can be sub clinically infected for months and even years [Bartonella spp. for which cats are accidental hosts, appear to result in enhanced pathogenicity  and parenchymal vasoproliferative lesions of the liver, spleen (bacillary peliosis), and less frequently other tissues, particularly in immunosuppressed individuals including transplant recipients, and HIV and cancer patients [Currently, dogs appear to be an accidental rather than reservoir host for ick dogs . Bartonesarcomas . To dated humans , 131. Bags Table  such as patients , 133  dogs with blood culture-negative endocarditis [B. henselae was detected in a dog with a monoclonal gammopathy and Bartonella species DNA was amplified from splenic tissue [To date, few cases of canine bartonellosis have been reported from Europe Fig.  or otherom Italy . Bartone England . In Franadenitis  as well henselae . In Spaicarditis  and B. rcarditis . In anotc tissue .Bartonella infections remains challenging. Currently there is no diagnostic technique for which a negative result assures the absence of infection. The most frequently used techniques for the detection of acute and chronic infections are specialized microbiological culture techniques, polymerase chain reaction (PCR), immunohistochemistry (IHC) and serology [Accurate diagnosis of serology .Bartonella infection. Optimal samples for microbiological culture include blood, cerebrospinal fluid [Bartonella spp. can be cultured successfully with agar plates containing 5% defibrinated rabbit or sheep blood, that are maintained at 35 °C in a high humidity chamber with 5% CO2 concentration. Agar plate isolation requires prolonged incubation times: bacterial colonies may not be visible until 10–56 days after inoculation of the agar plate [Bartonella spp. are fastidious, slow-growing bacteria, a negative blood culture or biopsy culture after a long incubation period does not exclude suspected Bartonella infection [B. henselae experimental infections [Bartonella as reported in humans [Bartonella spp. prior to attempted subculture bacterial isolation. The BAPGM, prior to PCR testing, has been used to increase sensitivity for documentation of infection, thereby facilitating a diagnosis of bartonellosis in cats, dogs and humans [Bartonella spp. [B. henselae and B. clarridgeiae can often be isolated effectively using agar plates; however, isolation of the same Bartonella spp. from sick cats, dogs, horses or human blood samples using an identical isolation approach lacks sensitivity. Although additional optimization of Bartonella spp. isolation is needed, the introduction of BAPGM has facilitated the successful isolation of B. henselae and several other Bartonella spp. from dog, horse, human and wildlife blood samples [Specialized culture techniques including lysis centrifugation, cell culture isolation and growth enrichment in insect biochemical composition growth media are the “gold standard” for confirmation of al fluid , joint fal fluid , patholoal fluid  and tissal fluid . In resear plate . Becausenfection . Furtherfections , 112. Sin humans . BAPGM, d humans . The BAPlla spp. . When te samples –145.Bartonella detection by PCR is peripheral blood. However, PCR for Bartonella spp. detection and characterization can be also performed after DNA extraction from cerebrospinal fluid, joint fluid, bacterial cultures, oral swabs, lymph node or other tissue samples or aspirates depending on each individual clinical case. To avoid DNA denaturation by formalin fixation, it is advisable to store tissues for future testing or submit fresh or fresh frozen specimens for PCR amplification of Bartonella DNA. Once the PCR is positive for the genus Bartonella, the species can be determined using species-specific primers or optimally by DNA sequencing [The most employed tissue for quencing –149.Bartonella spp. infection by documenting a four-fold rise in antibody titer over a 2–3-week period [Bartonella DNA directly from blood [B. henselae antibodies appears to be predictive of the absence of bacteremia in healthy cats [Bartonella spp. antibodies, for reasons that remain unclear [B. vinsonii berkhoffii and 25% of dogs infected with B. henselae have Bartonella specific IFA antibody reactivity to the respective organism. PCR amplification of organism-specific gene fragments is often diagnostically useful for Bartonella cases in which culture and serology results are negative [Seroconversion can be used to confirm acute k period . To datek period . Serologk period . Serologk period , 150. Inom blood . Alternathy cats , but sim unclear . It is inegative .Bartonella spp. as well as other bacteria such as Helicobacter pylori or Legionella pneumophila can be visualized in biopsied tissues using Warthin-Starry staining [Bartonella immunohistochemistry, fluorescent in situ hybridization (FISH) and PCR can be used to confirm that the bacteria observed by Warthin-Starry staining of histopathological lesions are Bartonella spp. [Studies to date indicate that inflammatory lesions (e.g. pyogranulomatous inflammation) can be severe; however, few organisms are normally visualized . Therefostaining . For thilla spp. .Bartonella spp. in cat, dog and human tissues [B. henselae monoclonal antibodies (MAb) documented the intra-erythrocytic localization of this bacterium in three blood culture positive cats. That study concluded that direct fluorescence with a specific MAb is a sensitive, rapid and simple technique which could be useful for detecting Bartonella infections in healthy cats [Immunohistochemistry, including confocal immunohistochemistry, has been used for the detection of  tissues , 153–157 tissues . An immuthy cats .Bartonella infection should be investigated using both serology, culture and/or molecular methods (PCR) in healthy pets when: (i) screening cats and dogs as blood donors [Bartonella infection has been diagnosed or is suspected in a pet owner [The definitive diagnosis of bartonellosis in cats, dogs and, based upon more recent literature, humans , 104 remd donors ; (ii) ind donors ; (iii) Bet owner ; and  [Bartonella spp. are confirmed diagnostically and compatible disease entities  are suspected or confirmed  , 164–166ampicin) , 168. Seampicin) . Treatmesmission . HoweverBartonella spp. infection in dogs has also not been established. Use of an antibiotic capable of crossing lipid membranes and reaching high intracellular concentrations, such as amoxicillin, azithromycin, doxycycline and enrofloxacin is recommended [B. henselae strains. Once genetically-mediated (mutation) resistance developed, B. henselae isolates were resistant to all macrolides [Bartonella endocarditis or myocarditis in cats and dogs. A combination of doxycycline and amikacin represents a treatment option for Bartonella endocarditis in cats and dogs [An optimal protocol for treatment ommended –170. Maccrolides . For dogcrolides . Aminogland dogs . For dogand dogs .Diagnostic confirmation of clinical bartonellosis is recommended or a very high index of suspicion.Prolonged treatment periods (4–6 weeks) are recommended to avoid bacterial drug resistance and to achieve disease resolution.Antibiotics are currently the mainstay of treatment.It is not recommended to use macrolides as the first therapy option.Bartonella infections.Antibiotics combinations with various mechanisms of action, achieving therapeutic drug concentrations within cells and within plasma are needed to eradicate General treatment recommendations for feline and canine bartonellosis based upon the literature and the authors’ experiences are summarized below:B. henselae and B. vinsonii berkhoffii and thereby decrease reservoir potential and zoonotic risks.As vaccines are not available to prevent infection, flea and tick control are the only successful measures to prevent this vector-borne infection in healthy animals , to decrBartonella spp. bacteremic pet [In households with immunosuppressed persons or young children, if their pets are determined as bacteremic, antibiotic treatment and routine acaricide use are recommended for these pets. When acquiring a new cat or dog, into a household with immunocompromised individuals and children, choosing an adult animal will lower the possibility of acquiring a emic pet , 65.Bartonella infections. Screening of blood donors for Bartonella infections, should be considered [Blood transfusion has also been identified as a risk factor for the transmission of nsidered , 60.Bartonella spp. in hosts such as bats [Bartonella spp., in conjunction with their respective reservoir host and vector, will be described. Furthermore, as Bartonella spp. transmission routes are not fully understood, research efforts should focus on modes of transmission so that appropriate control measures can be implemented to prevent the pathogen transmission between animals and from animals to humans. Bartonella spp. seroprevalence rates in cats and dogs in Europe and other parts of the world do not correspond with the low number of reported clinical cases, especially in dogs, potentially because Bartonella infections are underdiagnosed. The limited number of reported cases of Bartonella spp. infection compromises our collective ability to establish a complete list of clinical conditions or specific pathologies related to this infection. In conclusion, more efforts are needed in both research and clinical settings to characterize the medical importance of Bartonella spp. infections in cats and dogs. Additionally, randomized case control studies are needed to assess treatment efficacy and to establish an optimal protocol for the treatment of chronic bartonellosis in cats, dogs and humans. Efforts to develop safe and effective vaccines are needed to protect pets and their families.Based upon the recent and ongoing discovery of novel  as bats , 173 and as bats , it is l