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Background With the growing US aging population, need for a health care workforce able to provide dementia care will increase. Objective To develop, deliver, and assess interactive live workshops for licensed North Dakota pharmacists in dementia care. Methods Prospective interventional study of impact of free-of-charge, interactive, five-hour workshops for pharmacists providing advanced training in Alzheimer’s disease, vascular and Parkinson’s disease dementia, dementia with Lewy bodies, and common reversible causes of cognitive impairment. The workshop was offered three times across two different locations in ND: Fargo and Bismarck. Online pre- and postworkshop questionnaires were administered to collect demographics, attendance rationale, perceived ability to provide dementia care, and workshop quality/satisfaction. A 16-item assessment instrument/ test (1 point/item) was developed to assess pre- and postworkshop competency in dementia-related care (ie, knowledge, comprehension, application, and analysis). Descriptive statistics and paired t-test were performed using Stata 10.1. Results Sixty-nine pharmacists were trained and completed the competency test assessments; 95.7% ND pharmacists completed pre-and postworkshop questionnaires. The overall competency test scores improved from 5.7 ± 2.2 to 13.0 ± 2.8 (P < 0.001) and individual scores for each disease/problem also improved significantly (P < 0.001). Increases corresponded with increased self-reported perceived ability to provide dementia care; 95.4 to 100% of participants agreed/strongly agreed learning needs were met, teaching was effective, were satisfied with content and educational material usefulness, and would recommend workshop. Conclusion Workshop had measurable, immediate benefit on knowledge and ability to apply learned information. Structured, interactive workshops are valuable for improving pharmacists’ competency in dementia care.

O objetivo deste estudo consistiu em compreender a percepção dos usuários de cadeira de rodas acerca da interferência das lesões por pressão na sua vida cotidiana. Esta pesquisa se caracteriza como aplicada, descritiva e participante, com análise e discussão de dados sob o paradigma qualitativo. O grupo de entrevistados foi constituído por 14 usuários de cadeira de rodas. Os dados foram analisados sob a perspectiva da análise de discurso, seguida de triangulação. Os resultados indicaram que os entrevistados têm ciência e entendem a complexidade do cuidado necessário diante do desenvolvimento de uma lesão por pressão, porém, nem sempre conseguem aplicá-la no cotidiano. A lesão não afeta apenas a saúde física do usuário, mas interfere profundamente no campo psicossocial, implicando em limitações e cuidados que o torna dependente de outras pessoas. Assim, nota-se a importância da realização de medidas preventivas que possam propiciar a melhora da qualidade de vida destes indivíduos.

Background and Aims Lack of clinical validation and inter-observer variability are two limitations of endoscopic assessment and scoring of disease severity in patients with ulcerative colitis [UC]. We developed a deep learning [DL] model to improve, accelerate and automate UC detection, and predict the Mayo Endoscopic Subscore [MES] and the Ulcerative Colitis Endoscopic Index of Severity [UCEIS]. Methods A total of 134 prospective videos [1550 030 frames] were collected and those with poor quality were excluded. The frames were labelled by experts based on MES and UCEIS scores. The scored frames were used to create a preprocessing pipeline and train multiple convolutional neural networks [CNNs] with proprietary algorithms in order to filter, detect and assess all frames. These frames served as the input for the DL model, with the output being continuous scores for MES and UCEIS [and its components]. A graphical user interface was developed to support both labelling video sections and displaying the predicted disease severity assessment by the artificial intelligence from endoscopic recordings. Results Mean absolute error [MAE] and mean bias were used to evaluate the distance of the continuous model’s predictions from ground truth, and its possible tendency to over/under-predict were excellent for MES and UCEIS. The quadratic weighted kappa used to compare the inter-rater agreement between experts’ labels and the model’s predictions showed strong agreement [0.87, 0.88 at frame-level, 0.88, 0.90 at section-level and 0.90, 0.78 at video-level, for MES and UCEIS, respectively]. Conclusions We present the first fully automated tool that improves the accuracy of the MES and UCEIS, reduces the time between video collection and review, and improves subsequent quality assurance and scoring.

Contagion is a function of the properties of the pathogen, social interactions, and personal relationships in the society it attacks. Filmmakers in the horror genre were inspired by the idea of rabies as a virus that could mutate into something more dangerous. Fictional epidemics of scavenging undead were often attributed to encephalitis caused by rabies or a mutated rabies virus. During the early months of the SARS-COV-2 pandemic, there was a spike in streaming of the film, Contagion, that portrays a viral infectious disease modeled after a bat virus that spreads at an alarming rate, unleashing a global public panic and a clueless governmental response. We wanted to trace how filmmakers used rabies pathology as source material for their plots. We searched internet film databases and reviewed fictional films that utilized this plot device. Many dystopic, rabies-induced pandemic scenarios – mostly from the zombie genre – reveal parallels to the COVID-19 pandemic. Many zombie films, despite their absurd premise, anticipated the realities of future pandemics.

Objectives To contribute to a more in-depth assessment of shape, volume, and asymmetry of the lower extremities in patients with lipedema or lymphedema utilizing volume information from MR imaging. Methods A deep learning (DL) pipeline was developed including (i) localization of anatomical landmarks (femoral heads, symphysis, knees, ankles) and (ii) quality-assured tissue segmentation to enable standardized quantification of subcutaneous (SCT) and subfascial tissue (SFT) volumes. The retrospectively derived dataset for method development consisted of 45 patients (42 female, 44.2 ± 14.8 years) who underwent clinical 3D DIXON MR-lymphangiography examinations of the lower extremities. Five-fold cross-validated training was performed on 16,573 axial slices from 40 patients and testing on 2187 axial slices from 5 patients. For landmark detection, two EfficientNet-B1 convolutional neural networks (CNNs) were applied in an ensemble. One determines the relative foot-head position of each axial slice with respect to the landmarks by regression, the other identifies all landmarks in coronal reconstructed slices using keypoint detection. After landmark detection, segmentation of SCT and SFT was performed on axial slices employing a U-Net architecture with EfficientNet-B1 as encoder. Finally, the determined landmarks were used for standardized analysis and visualization of tissue volume, distribution, and symmetry, independent of leg length, slice thickness, and patient position. Results Excellent test results were observed for landmark detection (z-deviation = 4.5 ± 3.1 mm) and segmentation (Dice score: SCT = 0.989 ± 0.004, SFT = 0.994 ± 0.002). Conclusions The proposed DL pipeline allows for standardized analysis of tissue volume and distribution and may assist in diagnosis of lipedema and lymphedema or monitoring of conservative and surgical treatments. Key Points • Efficient use of volume information that MRI inherently provides can be extracted automatically by deep learning and enables in-depth assessment of tissue volumes in lipedema and lymphedema. • The deep learning pipeline consisting of body part regression, keypoint detection, and quality-assured tissue segmentation provides detailed information about the volume, distribution, and asymmetry of lower extremity tissues, independent of leg length, slice thickness, and patient position.

ConspectusA decisive factor for obtaining high yields and selectivities in organic synthesis is the choice of the proper solvent. Solvent selection is often guided by the intuitive understanding of transition state-solvent interactions. However, quantum-mechanical tunneling can significantly contribute to chemical reactions, circumventing the transition state and thus depriving chemists of their intuitive handle on the reaction kinetics. In this Account, we aim to provide rationales for the effects of solvation on tunneling reactions derived from experiments performed in cryogenic matrices.The tunneling reactions analyzed here cover a broad range of prototypical organic transformations that are subject to strong solvation effects. Examples are the hydrogen tunneling probability for the

Angewandte Chemie / International edition 62(22), e202300531 (2023). doi:10.1002/anie.202300531, Published by Wiley-VCH, Weinheim

Multiple system atrophy of the parkinsonian type (MSA-P) is a rare, fatal neurodegenerative disease with sporadic onset. It is still unknown if MSA-P is a primary oligodendropathy or caused by neuronal pathophysiology leading to severe, α-synuclein-associated neurodegeneration, mainly in the striatum. In this study, we generated and differentiated induced pluripotent stem cells (iPSCs) from patients with the clinical diagnosis of probable MSA-P (n = 3) and from three matched healthy controls into GABAergic striatal medium spiny neurons (MSNs). We found a significantly elevated release and neuronal distribution for α-synuclein, as well as hypoexcitability in the MSNs derived from the MSA-P patients compared to the healthy controls. These data suggest that the striatal hypoexcitable neurons of MSA-P patients contribute to a pathological α-synuclein burden which is likely to spread to neighboring cells and projection targets, facilitating disease progression.

Arc brazing is an alternative joining technology well-suited for processing thermally sensitive materials and to produce mixed material connections. Due to the technological similarities of gas metal arc brazing to gas metal arc welding, it can be assumed that the process-related hydrogen input is of similar magnitude for both joining technologies. Since diffusible hydrogen is known to cause embrittlement in metallic materials, it is necessary to know the amount of diffusible hydrogen introduced by different manufacturing processes. Regarding the qualification of welding procedures, hydrogen ingress is an important factor to evaluate the risk of hydrogen-assisted cold cracking, especially when processing high-strength steels. For arc brazing, there is a lack of knowledge about the process-related hydrogen input. Hence, to study the influence of different brazing filler materials and varying levels of heat input on the diffusible hydrogen concentration in arc braze metal, a methodology to determine hydrogen content in arc weld metal in accordance with international standard ISO 3690 based on carrier gas hot extraction was applied to arc brazed specimens. Very low diffusible hydrogen concentrations of about HD = 0.1 to 0.3 mL/100 g were found for GMAB without significant influence of arc energy or filler metal used.

The emergence of SARS-CoV-2 and the subsequent COVID-19 pandemic necessitated the development of adequate vaccines. Despite vaccines being demonstrated to be safe and effective for preventing severe disease and death, vaccine hesitancy remains. Reasons include concerns over adverse effects on male fertility, which have not been widely investigated. Therefore, this study is aimed at determining the impact of COVID-19 vaccination on semen parameters in a retrospective cohort study of South African males undergoing fertility assessment. The patients for this study were adult men who have previously undergone routine semen analysis for fertility assessment at Androcryos Andrology Laboratory (Johannesburg, South Africa) between March 2021 and March 2022. They also received vaccination within 3 months following a semen analysis and underwent a second semen analysis any time post-COVID-19 vaccination. From 277 records analysed, 46 patients met the inclusion criteria, receiving the Pfizer-BioNTech (BNT162b1) (63%), Johnson and Johnson (JNJ-78436735/Ad26.COV2S) (34.8%), and the AstraZeneca (AZD1222) (2.2%) vaccines. Sperm concentration significantly increased postvaccination ( P = 0.0001 ), with no significant changes in semen pH, volume, total sperm count, progressive motility, normal sperm morphology, or chromatin condensation. Results were not influenced by age, type of vaccine received, and the number of days following vaccination, as depicted by multiple regression analysis. In conclusion, there is no evidence of a negative impact of COVID-19 vaccination on male semen parameters, which is consistent with the emerging literature on COVID-19 vaccination and male fertility. COVID-19 vaccinations should not be dismissed based on fear of adverse effects on male fertility parameters.

Therapy differentiation is a crucial component of psychotherapy research. It refers to whether inspected treatments differ from one another. In the history of psychoanalysis, the differentiation between psychodynamic and analytic psychotherapy was often discussed but seldom inspected empirically. In this study, we propose a set of items which should in theory offer the possibility to differentiate between psychodynamic and analytic psychotherapy on session level. We inspect these items using therapists' self-reports concerning N = 295 cases of different psychodynamic and analytic therapies. Results of an exploratory factor analysis and subsequent inspections of the psychodynamic and analytic items in different forms of therapies strengthen the usability of these items for differentiating between psychodynamic and analytic therapy. However, further studies using different perspectives (e. g., observer ratings) are essential. The presented items are a promising step towards the development of an instrument for treatment differentiation which could later be used in treatment comparison studies.Zusammenfassung Psychotherapieforschung beschäftigt sich unter anderem damit, ob zwischen verschiedenen Psychotherapieverfahren differenziert werden kann. In der Geschichte der Psychoanalyse wurden Unterschiede zwischen analytischer und tiefenpsychologisch-fundierter Psychotherapie oft diskutiert, aber nur selten empirisch untersucht. In der vorliegenden Studie wird ein Set an Items vorgeschlagen, welches theoretisch auf Stundenebene zwischen den beiden Therapieansätzen unterscheiden sollte. Diese Items werden anhand von Angaben von Therapeut:innen zu ihrem therapeutischen Vorgehen in N = 295 Fällen verschiedener tiefenpsychologischfundierter und analytischer Therapien inspiziert. Die Ergebnisse einer Faktorenanalyse und eines hiernach durchgeführten Vergleichs der analytischen und tiefenpsychologischen Items in verschiedenen Therapieverfahren sprechen für die Verwendbarkeit der entwickelten Items. In Zukunft sind jedoch andere Bewertungsmethoden (v. a. Fremdbeurteilungen durch Rater:innen) unumgänglich. Die präsentierten Items sind ein vielversprechender Schritt auf dem Weg zu einem Ratinginstrument zur Behandlungsdifferenzierung, welches in Psychotherapiestudien verwendet werden könnte.

The tropics were long considered to have few ectomycorrhizal fungi, presumably due to a paucity of ectomycorrhizal host plants relative to higher-latitude ecosystems. However, an increase in research in tropical regions over the past 30 years has greatly expanded knowledge about the occurrence of tropical ectomycorrhizal fungi. To assess their broad biogeographic and diversity patterns, we conducted a comprehensive review and quantitative data analysis of 49 studies with 80 individual data sets along with additional data from GlobalFungi to elucidate tropical diversity patterns and biogeography of ectomycorrhizal fungi across the four main tropical regions: the Afrotropics, the Neotropics, Southeast Asia, and Oceania. Generalized linear models were used to explore biotic and abiotic influences on the relative abundance of the 10 most frequently occurring lineages. We also reviewed the available literature and synthesized current knowledge about responses of fungi to anthropogenic disturbances, and their conservation status and threats. We found that /russula-lactarius and /tomentella-thelephora were the most abundant lineages in the Afrotropics, the Neotropics, and Southeast Asia, whereas /cortinarius was the most abundant lineage in Oceania, and that /russula-lactarius, /inocybe, and /tomentella-thelephora were the most species-rich lineages across all of the tropical regions. Based on these analyses, we highlight knowledge gaps for each tropical region. Increased sampling of tropical regions, collaborative efforts, and use of molecular methodologies are needed for a more comprehensive view of the ecology and diversity of tropical ectomycorrhizal fungi.

Historical research involves the construction of competing narratives around complex historical events. Getting the whole story requires having access to these narratives, which can be a challenge when the coverage of historical research in widely used databases is incomplete or biased. This paper investigates to what extent journals indexed in two historical research databases, namely Historical Abstracts and America: History and Life, are covered by the Web of Science and Scopus, as well as the national and linguistic biases in that coverage. Results show a much higher coverage of historical research in Web of Science than Scopus. However, both databases disproportionately favour indexing English language journals and journals published in the United States and the United Kingdom. That raises questions about how these imbalances in journal coverage may lead to biases in the narratives to which readers are exposed when they limit their sources to those included in large, multidisciplinary databases.

Roseburia intestinalis has received attention as a potential probiotic bacterium. Recent studies have demonstrated that changes in its intestinal abundance can cause various diseases, such as obesity, enteritis and atherosclerosis. Probiotic administration or fecal transplantation alter the structure of the intestinal flora, offering possibilities for the prevention and treatment of these diseases. However, current monitoring methods, such as 16S rRNA sequencing, are complex and costly and require specialized personnel to perform the tests, making it difficult to continuously monitor patients during treatment. Hence, the rapid and cost-effective quantification of intestinal bacteria has become an urgent problem to be solved. Aptamers are of emerging interest because their stability, low immunogenicity and ease of modification are attractive properties for a variety of applications. We report a FluCell-SELEX polyclonal aptamer library specific for R. intestinalis isolated after seven evolution rounds, that can bind and label this organism for fluorescence microscopy and binding assays. Moreover, R. intestinalis can be distinguished from other major intestinal bacteria in complex defined mixtures and in human stool samples. We believe that this preliminary evidence opens new avenues towards aptamer-based electronic biosensors as new powerful and inexpensive diagnostic tools for the relative quantitative monitoring of R. intestinalis in gut microbiomes., publishedVersion

Abstract Bacillus subtilis 3NA is a strain capable of reaching high cell densities. A surfactin producing sfp+ variant of this strain, named JABs32, was utilized in fed-batch cultivation processes. Both a glucose and an ammonia solution were fed to set a steady growth rate μ of 0.1 h-1. In this process, a cell dry weight of up to 88 g L-1 was reached after 38 h of cultivation, and surfactin titers of up to 26.5 g L-1 were detected in this high cell density fermentation process, achieving a YP/X value of 0.23 g g-1 as well as a qP/X of 0.007 g g-1 h-1. In sum, a 21-fold increase in surfactin titer was obtained compared with cultivations in shake flasks. In contrast to fed-batch operations using Bacillus subtilis JABs24, an sfp+ variant derived from B. subtilis 168, JABs32, reached an up to fourfold increase in surfactin titers using the same fed-batch protocol. Additionally, a two-stage feed process was established utilizing strain JABs32. Using an optimized mineral salt medium in this high cell density fermentation approach, after 31 h of cultivation, surfactin titers of 23.7 g L-1 were reached with a biomass concentration of 41.3 g L-1, thus achieving an enhanced YP/X value of 0.57 g g-1 as well as a qP/X of 0.018 g g-1 h-1. The mutation of spo0A locus and an elongation of AbrB in the strain utilized in combination with a high cell density fed-batch process represents a promising new route for future enhancements on surfactin production. Key points • Utilization of a sporulation deficient strain for fed-batch operations • High cell density process with Bacillus subtilis for lipopeptide production was established • High titer surfactin production capabilities confirm highly promising future platform strain

Scham und Schuld wird in der emotionspsychologischen Betrachtung psychischer Storungen eine zentrale Rolle zugeschrieben. Es werden Differenzierungen und Gemeinsamkeiten dieser beiden Affekte herausgearbeitet, insbesondere in Bezug zu ihrem Zusammenhang zum Strukturniveau und zu affektiven Dynamiken, die sich u. a. beim Selbstwert- und Schuldkonflikt finden lassen. Auch in einer empirischen Psychotherapiestudie zeigt sich, dass das subjektive Erleben von Scham und Schuld mit dem Strukturniveau, aber auch weiteren Storungsmasen, wie der Anzahl der psychischen Storungen oder der symptomatischen Gesamtbelastung, zusammenhangt. Die Verbindung von Scham und Schuld und psychischen Storungen, insbesondere Personlichkeitsstorungen, wird vor dem Hintergrund dieser theoretischen Konzepte erlautert. Zudem werden wichtige Aspekte fur die psychotherapeutische Behandlung abgeleitet, vor allem dass eine genaue Analyse von Affekt- und Abwehrdynamiken im Zusammenhang mit Schuld und Scham notwendig ist.

Introduction: Physicians spend an ever-rising amount of time to collect relevant information from highly variable medical reports and integrate them into the patient’s health condition. Objectives: We compared synoptic reporting based on data elements to narrative reporting in order to evaluate its capabilities to collect and integrate clinical information. Methods: We developed a novel system to align medical reporting to data integration requirements and tested it in prostate cancer screening. We compared expenditure of time, data quality, and user satisfaction for data acquisition, integration, and evaluation. Results: In a total of 26 sessions, 2 urologists, 2 radiologists, and 2 pathologists conducted the diagnostic work-up for prostate cancer screening with both narrative reporting and the novel system. The novel system led to a significantly reduced time for collection and integration of patient information (91%, p < 0.001), reporting in radiology (44%, p < 0.001) and pathology (33%, p = 0.154). The system usage showed a high positive effect on evaluated data quality parameters completeness, format, understandability, as well as user satisfaction. Conclusion: This study provides evidence that synoptic reporting based on data elements is effectively reducing time for collection and integration of patient information. Further research is needed to assess the system’s impact for different patient journeys.

Medicine in silent film has a long history. Although the silent era in cinema was dominated by burlesques (using escaped “lunatics”) a number of themes emerged after systematic review. The cinematic representation of medicine coincided with the discovery of X-rays. During this “roentgenomania”, short films were produced showing groundbreaking X-ray images, which fitted perfectly into needs of dramatic cinema. But soon the “cinema of narration” evolved: Starting just after the turn of the century, the short film “The Country Doctor” was able to address complex interplay between duties and limitations of the medical profession. This was followed by numerous feature films on infectious diseases, which often used tuberculosis as a centerpiece of its story. Directors often took advantage of the well-known stereotype of the omnipotent physician. But in certain medical fields, such as psychiatry or surgery, a more ambivalent figure of the doctor was portrayed, f. e. in “Hands of Orlac” (1924). Silent cinema also offered interesting ideas on the healing powers of the medium itself: in “The Mystery of the Kador Cliffs” (1912) a film screening could cure the patient of fears after reenactment. Finally, a closer look at the early era of film echoes how social conflicts where dramatized, especially in the case of nationwide birth control. How illegal abortion kept the society on its edge, was most clearly shown in the adaption of the scandalous play “Cyankali” (1930).In addition to discussing various topics in the cinematic representation of medicine, this brief overview shows that silent movies were a new and true art form, representing an exceptional resource for historians of film and medicine.

Recurrence following varicocelectomy is an important cause of treatment failure and persistence of subnormal semen parameters. This original study was combined with a systemic review and meta-analysis aiming to evaluate the efficacy of redo varicocelectomy on male fertility potential and pregnancy outcome. The retrospective study included 32 patients who underwent microsurgical subinguinal varicocelectomy for patients with recurrent varicocele. Changes in semen parameters and hormone profiles before and after surgery were compared. The literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and included seven articles in addition to our original report. Results of the original study revealed statistically significant improvements in sperm concentration, progressive motility, total motile sperm count and normal morphology following redo varicocelectomy. The meta-analysis results echoed those reported in our original study and depicted significant improvements in sperm concentration (mean difference [MD] = +20.281 million/ml, p

The inability to conceive is a baleful experience for thousands of couples worldwide. Among different well-known reproductive techniques, medicinal plants have been utilized to treat male infertility. Medicinal plants, provide a therapeutic alternative, which is available and affordable for infertile couples. We investigated the direct effect of unfermented rooibos aqueous extract on human spermatozoa. Semen samples (n = 50) collected from donors and patients consulting for fertility were reassigned as normal (n = 22) and abnormal (n = 28) samples based on the outcome of the baseline semen analysis, using the World Health Organization (WHO) cut off value. Semen samples were allowed to liquefy and subsequently washed with human tubular fluid in bovine serum albumin medium. The samples were then treated with aqueous extracts of unfermented rooibos (0, 0.15, 1.5, 15, 150 μg/ml) at 37°C for 1 h and assessed thereafter. Sperm motility, vitality, DNA fragmentation, intracellular reactive oxygen species and mitochondrial membrane potential in both groups remained unchanged (p > 0.05). However, aqueous extract of unfermented rooibos (only at 1.5 μg/ml) significantly increased capacitation and acrosome reaction in the abnormal sample group (p > 0.05). Unfermented rooibos aqueous extract had no deleterious impact on human spermatozoa's function and might be attributed to its antioxidant properties.

Four epitypes and three new species of Amanita (Amanitaceae, Agaricales, Agaricomycetes, Basidiomycota) are described from Guineo-Congolian rainforests of Cameroon. Amanita echinulata, A. fulvopulverulenta, A. robusta, and A. bingensis are epitypified based on collections that are the first since the species were described nearly a century ago. Morphological features of the epitypes are described and enumerated. Amanita minima, Amanita luteolamellata, and A. goossensfontanae are described as new and added to the known macromycota of tropical Africa. Habit, habitat, and known distribution are provided for each species. Sequence data for the internal transcribed spacer (ITS) locus are provided for types and other collections of all taxa, and a molecular phylogenetic analysis across the genus Amanita corroborates morphology-based infrageneric placement for each.

Wahrend ICD und DSM bei der Schizioden Personlichkeitsstorung von einem Fehlen von Wunschen, Beziehungen und Emotionen ausgehen, verstehen psychodynamische Modelle die Schizoidie als Schutz vor intensiven Wunschen und Affekten, die Gefahr der Desintegration bergen. Eine Auswertung der Daten der DPG-Praxisstudie ergibt, dass die Schizoide PS eher selten ist, dass aber schizoide Aspekte haufig anzutreffen sind. Zudem zeigt sich, dass Patienten mit Schizo­ider PS durchaus intensive negative Affekte erleben, dass diese aber nur schlecht reguliert werden konnen. Das Fallbeispiel in Form eines wortlichen Verbatim-Protokolls eines OPD-Interview-Ausschnitts macht deutlich, dass die Patientin durchaus den intensiven Wunsch nach nahen und tiefen Beziehungen hat, dass solche Beziehungen zu anderen Menschen aber fur die Patientin kaum regulierbar sind und sie stattdessen eine geradezu mystisch-verschmolzene Liebesbeziehung zu zwei Nagetieren entwickelt. Insgesamt wird deutlich, dass das typisch schizoide Erleben und Verhalten in erster Linie als Abwehrstrategie verstanden werden sollte und weniger als schlichtes Defizit.

Pressure ulcers can significantly affect the quality of life and social inclusion of wheelchair users, in addition to delaying the rehabilitation process and compromising the health-disease process. The aim of this study is to analyze the representation of pressure ulcers in the perception of life/death for wheelchair users. The methodological design of this research is applied, descriptive and participatory, with analysis and discussion of data under a qualitative paradigm. Seven collaborators who are wheelchair users of the Association of Spinal Cord Injuries in Rio Grande do Sul/Brazil (LEME) participated in the interviews. Data analysis was performed by using data categorization and triangulation. The results show the negative impact pressure ulcers have on users’ health and social inclusion. The fear of appearance of pressure ulcers and the associated possibility of death, overlaps other situations that may result from the condition of being a wheelchair user. Users are aware that injuries associated with a bacterial infection can lead to death. The need for constant care and dressings, in addition to the body’s own odor, become important limitations in social life. The importance of the prevention of pressure ulcers is emphasized as a way to promote social inclusion and physical and emotional well-being of users.

Even today, patients with schizophrenia often have an unfavorable outcome. Negative symptoms and cognitive deficits are common features in many patients and prevent recovery. In recent years, aerobic endurance training has emerged as a therapeutic approach with positive effects on several domains of patients’ health. However, appropriately sized, multicenter randomized controlled trials that would allow better generalization of results are lacking. The exercise study presented here is a multicenter, rater-blind, two-armed, parallel-group randomized clinical trial in patients with clinically stable schizophrenia being conducted at five German tertiary hospitals. The intervention group performs aerobic endurance training on bicycle ergometers three times per week for 40–50 min/session (depending on the intervention week) for a total of 26 weeks, and the control group performs balance and tone training for the same amount of time. Participants are subsequently followed up for 26 weeks. The primary endpoint is all-cause discontinuation; secondary endpoints include psychopathology, cognition, daily functioning, cardiovascular risk factors, and explorative biological measures regarding the underlying mechanisms of exercise. A total of 180 patients will be randomized. With currently 162 randomized participants, our study is the largest trial to date to investigate endurance training in patients with schizophrenia. We hypothesize that aerobic endurance training has beneficial effects on patients’ mental and physical health, leading to lower treatment discontinuation rates and improving disease outcomes. The study results will provide a basis for recommending exercise interventions as an add-on therapy in patients with schizophrenia.The study is registered in the International Clinical Trials Database (ClinicalTrials.gov identifier [NCT number]: NCT03466112) and in the German Clinical Trials Register (DRKS-ID: DRKS00009804).

This report summarizes findings relating to the biochemical and skeletal evidence for Treponema pallidum in an unusually old case of congenital syphilis. In 1951, the Milwaukee Public Museum acquired skeletal remains from the Surgical School of Marquette University. The male was identified as a 60-65-year-old, that was suffering from congenital syphilis. His remains are now part of the anthropological collections of Wisconsin Lutheran College (Milwaukee, Wisconsin). Venereal Disease Research Laboratory (VDRL) and Rapid Plasma Reagin (RPR) tests were used to verify the presence of the bacteria-generated antibodies, while mass spectrometry testing provided indirect evidence for the historical treatment of the disease. Notably, antibody detection in human remains of this age is rare. These initial results support what is known of syphilis and its treatment prior to the wide scale, clinical use of penicillin therapy, and describe evidence for long-term skeletal symptoms of congenital syphilis in century-old human remains.

With the advance of assisted reproduction techniques, and the trend towards blastocyst culture and single embryo transfer, gamete and embryo assessment have gained greater importance in ART treatment. Embryo quality depends mainly on gamete quality and culture conditions. Oocyte maturity identification is necessary in order to plan fertilization timing. Mature oocytes at the metaphase II stage show a higher fertilization rate compared to immature oocytes. Morphology assessment is a critical yet challenging task that may serve as a good prognostic tool for future development and implantation potential if done effectively. Various grading systems have been suggested to assess embryos at pronuclear, cleavage, and blastocyst stages. By identifying the embryo with the highest implantation potential, it is possible to reduce the number of embryos transferred without compromising the chances of a successful pregnancy. Apart from the conventional morphology assessment, there are several invasive or non-invasive methods for embryo selection such as preimplantation genetic testing, morphokinetics, proteomics, metabolomics, oxygen consumption, and measurement of oxidative stress in culture medium. Morphokinetics is a method based on time-lapse technology and continuous monitoring of embryos. In this review, we aimed to describe and compare the most effective and widely used methods for gamete and embryo assessment as well as embryo selection.

Coronavirus disease 2019 (COVID-19) mortality can be estimated based on reliable mortality data. Variable testing procedures and heterogeneous disease course suggest that a substantial number of COVID-19 deaths is undetected. To address this question, we screened an unselected autopsy cohort for the presence of SARS-CoV-2 and a panel of common respiratory pathogens. Lung tissues from 62 consecutive autopsies, conducted during the first and second COVID-19 pandemic waves in Switzerland, were analyzed for bacterial, viral and fungal respiratory pathogens including SARS-CoV-2. SARS-CoV-2 was detected in 28 lungs of 62 deceased patients (45%), although only 18 patients (29%) were reported to have COVID-19 at the time of death. In 23 patients (37% of all), the clinical cause of death and/or autopsy findings together with the presence of SARS-CoV-2 suggested death due to COVID-19. Our autopsy results reveal a 16% higher SARS-CoV-2 infection rate and an 8% higher SARS-CoV-2 related mortality rate than reported by clinicians before death. The majority of SARS-CoV-2 infected patients (75%) did not suffer from respiratory co-infections, as long as they were treated with antibiotics. In the lungs of 5 patients (8% of all), SARS-CoV-2 was found, yet without typical clinical and/or autopsy findings. Our findings suggest that underreporting of COVID-19 contributes substantially to excess mortality. The small percentage of co-infections in SARS-CoV-2 positive patients who died with typical COVID-19 symptoms strongly suggests that the majority of SARS-CoV-2 infected patients died from and not with the virus.

Background The domestication of goat (Capra hircus) started 11,000 years ago in the fertile crescent. Breed formation in the nineteenth century, establishment of herd books, and selection for specific traits resulted in 10 modern goat breeds in Switzerland. We analyzed whole-genome sequencing (WGS) data from 217 modern goats and nine wild Bezoar goats (Capra aegagrus). After quality control, 27,728,288 biallelic single nucleotide variants (SNVs) were used for the identification of runs of homozygosity (ROH) and the detection of ROH islands. Results Across the 226 caprine genomes from 11 populations, we detected 344 ROH islands that harbor 1220 annotated genes. We compared the ROH islands between the modern breeds and the Bezoar goats. As a proof of principle, we confirmed a signature of selection, which contains the ASIP gene that controls several breed-specific coat color patterns. In two other ROH islands, we identified two missense variants, STC1:p.Lys139Arg and TSHR:p.Ala239Thr, which might represent causative functional variants for domestication signatures. Conclusions We have shown that the information from ROH islands using WGS data is suitable for the analysis of signatures of selection and allowed the detection of protein coding variants that may have conferred beneficial phenotypes during goat domestication. We hypothesize that the TSHR:p.Ala239Thr variant may have played a role in changing the seasonality of reproduction in modern domesticated goats. The exact functional significance of the STC1:p.Lys139Arg variant remains unclear and requires further investigation. Nonetheless, STC1 might represent a new domestication gene affecting relevant traits such as body size and/or milk yield in goats.

To date, most bio-based products of industrial biotechnology stem from sugar-based carbon sources originating from food and feed competing resources. Exemplary for bioproducts converted from glucose, the potential C5 platform chemical itaconic acid is presently produced by the filamentous fungus Aspergillus terreus. Here, an engineered strain of the industrial platform organism Corynebacterium glutamicum ATCC 13032 was used for acetate-based production of itaconic acid to overcome current production difficulties. For this purpose, C. glutamicum ICD

Aeroallergen sensing by airway epithelial cells triggers pathogenic immune responses leading to type 2 inflammation, the hallmark of chronic airway diseases such as asthma. Tuft cells are rare epithelial cells and the dominant source of IL-25, an epithelial cytokine, and cysteinyl leukotrienes (CysLTs), lipid mediators of vascular permeability and chemotaxis. How these two mediators derived from the same cell might cooperatively promote type 2 inflammation in the airways has not been clarified. Here, we showed that inhalation of the parent leukotriene C(4) (LTC(4)) in combination with a subthreshold dose of IL-25 led to activation of two innate immune cells: inflammatory type 2 innate lymphoid cell (ILC2) for proliferation and cytokine production, and dendritic cells (DCs). This cooperative effect led to a multiple fold greater recruitement of eosinophils as well as CD4(+) T cell expansion indicative of true synergy. While lung eosinophilia was dominantly mediated through the classical CysLT receptor CysLT(1)R, type 2 cytokines and activation of innate immune cells required signaling through CysLT(1)R and partially CysLT(2)R. Tuft cell-specific deletion of Ltc4s, the terminal enzyme required for CysLT production, reduced lung inflammation and the systemic immune response after inhalation of the mold aeroallergen Alternaria; this effect was further enhanced by concomitant blockade of IL-25. Our findings identified a potent synergy of CysLTs and IL-25 downstream of aeroallergen-trigged activation of airway tuft cells leading to a highly polarized type 2 immune response and further implicate airway tuft cells as powerful modulators of type 2 immunity in the lungs.

Sulfurimonas species are among the most abundant sulfur-oxidizing bacteria in the marine environment. They are capable of using different electron acceptors, this metabolic flexibility is favorable for their niche adaptation in redoxclines. When oxygen is depleted, most Sulfurimonas spp. (e.g., Sulfurimonas gotlandica) use nitrate ($${{{{{{{\mathrm{NO}}}}}}}}_3^ -$$ NO 3 − ) as an electron acceptor to oxidize sulfur, including sulfide (HS-), S0 and thiosulfate, for energy production. Candidatus Sulfurimonas marisnigri SoZ1 and Candidatus Sulfurimonas baltica GD2, recently isolated from the redoxclines of the Black Sea and Baltic Sea respectively, have been shown to use manganese dioxide (MnO2) rather than $${{{{{{{\mathrm{NO}}}}}}}}_3^ -$$ NO 3 − for sulfur oxidation. The use of different electron acceptors is also dependent on differences in the electron transport chains embedded in the cellular membrane, therefore changes in the membrane, including its lipid composition, are expected but are so far unexplored. Here, we used untargeted lipidomic analysis to reveal changes in the composition of the lipidomes of three representative Sulfurimonas species grown using either $${{{{{{{\mathrm{NO}}}}}}}}_3^ -$$ NO 3 − and MnO2. We found that all Sulfurimonas spp. produce a series of novel phosphatidyldiazoalkyl-diacylglycerol lipids. Ca. Sulfurimonas baltica GD2 adapts its membrane lipid composition depending on the electron acceptors it utilizes for growth and survival. When carrying out MnO2-dependent sulfur oxidation, the novel phosphatidyldiazoalkyl-diacylglycerol headgroup comprises shorter alkyl moieties than when sulfur oxidation is $${{{{{{{\mathrm{NO}}}}}}}}_3^ -$$ NO 3 − -dependent. This is the first report of membrane lipid adaptation when an organism is grown with different electron acceptors. We suggest novel diazoalkyl lipids have the potential to be used as a biomarker for different conditions in redox-stratified systems.

Chirality switching of self-assembled molecular structures is of potential interest for designing functional materials but is restricted by the strong interaction between the embedded molecules. Here, we report on an unusual approach based on reversible chirality changes of self-assembled oligomers using variable-temperature scanning tunneling microscopy supported by quantum mechanical calculations. Six functionalized diazomethanes each self-assemble into chiral wheel-shaped oligomers on Ag(111). At 130 K, a temperature far lower than expected, the oligomers change their chirality even though the molecules reside in an embedded self-assembled structure. Each chirality change is accompanied by a slight center-of-mass shift. We show how the identical activation energies of the two processes result from the interplay of the chirality change with surface diffusion, findings that open the possibility of implementing various functional materials from self-assembled supramolecular structures.