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Abstract Background Though evidence-based research about system constellations (SCs) appears marginal, it is applied in many psychiatric, psychological, and psychotherapeutic institutions as well as in different contexts of organizational counseling. To date, only one randomized controlled trial (RCT) has been conducted to assess the short- to long-term efficacy of SCs, which entail clients meeting at the same location in person. This study is to investigate the feasibility of a RCT investigating SCs in virtual reality (VR), and to calculate the number of clients needed for a confirmatory RCT. Design We will perform a prospective, monocentric, parallel-group, feasibility RCT with subsequent intervention. A total of 128 clients of 3-day group-based SC-VR seminars will be randomized to either the intervention group (IG; n = 64) or wait-list group (WLG; n = 64), which receives SCs in VR after 4 months. Feasibility and acceptability of the (1) research methodology and (2) intervention as well as the (3) estimation of effect sizes will be assessed using qualitative and quantitative data. Based on the model of a general mental health, the proposed primary outcome includes the SC-VR adherence, and the proposed secondary outcomes refer to psychological functioning (OQ-45.2), social system functioning (EXIS), psychological distress (FEP-2), motivational incongruence (INK-SF), and goal attainment (GAS). We plan to investigate the short-term efficacy at 2-week and 4-month follow-up within the RCT design (n = 128), and mid-term efficacy at 8- and 12-month follow-up for the intervention group (n = 64). Discussion The study is expected to be the first study on the feasibility of SC-VR. We will reflect on successfully implemented study procedures, and we will provide recommendations for changes considering the design, rationale, analyses, and interpretation of the study results where they became necessary. The discussion will conclude with an evaluation whether a confirmatory RCT on SC-VR is worth the investment of future resources, including the calculated number of clients needed based on the efficacy trends derived from this feasibility study. Trial registration ClinicalTrials.gov: ID = N CT05557890; date of registration: September 23, 2022; https://clinicaltrials.gov/ct2/show/NCT05557890 .

Abstract Borna disease virus 1 (BoDV-1) is the causative agent of Borna disease, a fatal neurologic disorder of domestic mammals and humans, resulting from spill-over infection from its natural reservoir host, the bicolored white-toothed shrew (Crocidura leucodon). The known BoDV-1-endemic area is remarkably restricted to parts of Germany, Austria, Switzerland and Liechtenstein. To gain comprehensive data on its occurrence, we analysed diagnostic material from suspected BoDV-1-induced encephalitis cases based on clinical and/or histopathological diagnosis. BoDV-1 infection was confirmed by RT-qPCR in 207 domestic mammals, 28 humans and seven wild shrews. Thereby, this study markedly raises the number of published laboratory-confirmed human BoDV-1 infections and provides a first comprehensive summary. Generation of 136 new BoDV-1 genome sequences from animals and humans facilitated an in-depth phylogeographic analysis, allowing for the definition of risk areas for zoonotic BoDV-1 transmission and facilitating the assessment of geographical infection sources. Consistent with the low mobility of its reservoir host, BoDV-1 sequences showed a remarkable geographic association, with individual phylogenetic clades occupying distinct areas. The closest genetic relatives of most human-derived BoDV-1 sequences were located at distances of less than 40 km, indicating that spill-over transmission from the natural reservoir usually occurs in the patient´s home region.

BackgroundAlthough commercially developed automated insulin delivery (AID) systems have recently been approved and become available in a limited number of countries, they are not universally available, accessible, or affordable. Therefore, open-source AID systems, cocreated by an online community of people with diabetes and their families behind the hashtag #WeAreNotWaiting, have become increasingly popular. ObjectiveThis study focused on examining the lived experiences, physical and emotional health implications of people with diabetes following the initiation of open-source AID systems, their perceived challenges, and their sources of support, which have not been explored in the existing literature. MethodsWe collected data from 383 participants across 29 countries through 2 sets of open-ended questions in a web-based survey on their experience of building and using open-source AID systems. Narratives were thematically analyzed, and a coding framework was identified through iterative alignment. ResultsParticipants consistently reported improvements in glycemia, physical health, sleep quality, emotional impact on everyday life, and quality of life. Knowledge of open-source AID systems was largely obtained through the #WeAreNotWaiting community, which was also the primary source of practical and emotional support. The acquisition of the components to build an open-source AID system and the technical setup were sometimes problematic. ConclusionsThe #WeAreNotWaiting movement represents a primary example of how informed and connected patients proactively address their unmet needs, provide peer support to each other, and obtain results through impactful, user-driven solutions. Alongside providing evidence on the safety and efficacy of open-source AID systems, this qualitative analysis helps in understanding how patients’ experiences and benefits range from psychosocial improvements to a reduction in the burden of managing diabetes. International Registered Report Identifier (IRRID)RR2-10.2196/15368

An 18-year-old male patient from Ukraine, living in Germany for 2 years, presented with a painless subcutaneous swelling on the left cheek that had been present for several months. Finally, the diagnosis of subcutaneous dirofilariasis caused by Dirofilaria repens was confirmed by 12S rRNA gene PCR and sequencing from tissue by nematode-specific PCRs followed by sequencing after surgical resection of the lesion. Microfilaremia was ruled out and no further treatment was required. Subcutaneous filariasis continues to spread in Central Europe due to climate change, the expansion of vector mosquitoes and the mobility of humans and dogs.

The purpose of this study is to explore individual predictors of support for peace agreements after their implementation. The aim is to test if individual differences in Social Dominance Orientation (SDO) temper the effect of exposure to violence on support for peace agreements. One hundred and eighty participants completed measures surveying their SDO, exposure to violence and voting behavior four years after the peace agreement between the Colombian government and the FARC in 2016. Results show that SDO lowers support for the peace agreement four years after it was signed among those who experienced violence but has a smaller effect on those who did not experience violence. The implications of the interaction between SDO and exposure to violence are discussed.

Borna disease virus 1 (BoDV-1) was just recently shown to cause predominantly fatal encephalitis in humans. Despite its rarity, bornavirus encephalitis (BVE) can be considered a model disease for encephalitic infections caused by neurotropic viruses and understanding its pathomechanism is of utmost relevance. Aim of this study was to compare the extent and distribution pattern of cerebral inflammation with the clinical course of disease, and individual therapeutic procedures. For this, autoptic brain material from seven patients with fatal BVE was included in this study. Tissue was stained immunohistochemically for pan-lymphocytic marker CD45, the nucleoprotein of BoDV-1, as well as glial marker GFAP and microglial marker Iba1. Sections were digitalized and counted for CD45-positive and BoDV-1-positive cells. For GFAP and Iba1, a semiquantitative score was determined. Furthermore, detailed information about the individual clinical course and therapy were retrieved and summarized in a standardized way. Analysis of the distribution of lymphocytes shows interindividual patterns. In contrast, when looking at the BoDV-1-positive glial cells and neurons, a massive viral involvement in the brain stem was noticeable. Three of the seven patients received early high-dose steroids, which led to a significantly lower lymphocytic infiltration of the central nervous tissue and a longer survival compared to the patients who were treated with steroids later in the course of disease. This study highlights the potential importance of early high-dose immunosuppressive therapy in BVE. Our findings hint at a promising treatment option which should be corroborated in future observational or prospective therapy studies.ABBREVIATIONS: BoDV-1: Borna disease virus 1; BVE: bornavirus encephalitis; Cb: cerebellum; CNS: central nervous system; FL: frontal lobe; GFAP: glial fibrillary acid protein; Hc: hippocampus; Iba1: ionized calcium-binding adapter molecule 1; Iba1act: general activation of microglial cells; Iba1nod: formation of microglial nodules; IL: insula; Me: mesencephalon; Mo: medulla oblongata; OL: occipital lobe; pASS: per average of 10 screenshots; patearly: patients treated with early high dose steroid shot; patlate: patients treated with late or none high dose steroid shot; Po: pons; So: stria olfactoria; Str: striatum

The main human echinococcal infections are caused by Echinococcus granulosus sensu lato, which causes cystic echinococcosis (CE), and E. multilocularis, which causes alveolar echinococcosis (AE). The parasites have different life [...]

In September 2023, a patient in Italy who had never traveled abroad was referred for testing for suspected hepatic cystic echinococcosis. Lesions were incompatible with cystic echinococcosis; instead, autochthonous alveolar echinococcosis was confirmed. Alveolar echinococcosis can be fatal, and awareness must be raised of the infection’s expanding distribution.

Postencephalitic parkinsonism (PEP) is suggested to show a virus-induced pathology, which is different from classical idiopathic Parkinson’s disease (PD) as there is no α-synuclein/Lewy body pathology. However, PEP shows a typical clinical representation of motor disturbances. In addition, compared to PD, there is no iron-induced pathology. The aim of this preliminary study was to compare PEP with PD regarding iron-induced pathology, using histochemistry methods on paraffin-embedded post-mortem brain tissue. In the PEP group, iron was not seen, except for one case with sparse perivascular depositions. Rather, PEP offers a pathology related to tau-protein/neurofibrillary tangles, with mild to moderate memory deficits only. It is assumed that this virus-induced pathology is due to immunological dysfunctions causing (neuro)inflammation-induced neuronal network disturbances as events that trigger clinical parkinsonism. The absence of iron deposits implies that PEP cannot be treated with iron chelators. The therapy with L-Dopa is also not an option, as L-Dopa only leads to an initial slight improvement in symptoms in isolated cases.

Tomato (Solanum lycopersicum L.) is one of the most popular and widely consumed vegetable fruits all over the world. Given the vast area (about 2200 hectares) under cultivation of this crop in Golestan province (north of Iran) and the importance of replacing old open-pollinated cultivars with new high-yielding hybrid cultivars, a field study was carried out by evaluating the new determinate tomato hybrid genotypes suitable for outdoor cultivation named A-Z15 and A-Z16 along with Mahdis (control) hybrid cultivar. A-Z16 consisted of two treatments of without and with treating seeds with Probio 96 bacteria named A-Z16a and A-Z16-b, respectively. This study was carried out during 2022 in two agricultural research stations of Golestan, Gorgan and Gonbad Experiments carried out as complete block designs with three replications. Characteristics such as fruit yield/hectare, average weight of fruit, number of fruit carpel, percentage of fruit size (small, medium, large), diameter and length of fruit, number of fruit cavity, fruits/plant, pH of fruit juice, amount of total soluble solids, proportion of fruits with white layer and shelf life of fruit after harvest were recorded and measured. The results of analysis of variances showed significant differences in most of the examined traits in two experimental locations. Based on mean comparisons, cultivar Mahdis (control) was superior in fruit yield and fruits/plant, but this cultivar in qualitative characteristics such as shelf life of fruit, the lower proportion of fruits with white layer and total soluble solids was ranked last. The highest average weight of fruit and shelf life of fruit belonged to A-Z16-b. After Mahdis, A-Z16-b produced highest fruit yield. In conclusion, Mahdis (control) and in a lesser extent A-Z16-b (A-Z16-a treated with Probio 96 bacteria) showed better fruit yield attributes compared to others.

BackgroundThe parasitic disease loiasis is associated with significant morbidity and mortality. Individuals with hyper-microfilaremia (greater than 20,000 microfilariae per mL of blood) may suffer from serious treatment-related or spontaneous adverse events. Diagnosing loiasis remains complex and primarily relies on direct parasite detection. In this study, we analyzed the performance of various diagnostic tests and the influence of parasitological and clinical factors on test outcomes in samples from individuals living in an endemic region.MethodsData and samples were collected from rural Gabon. Loiasis was defined as either detectable microfilaremia, or a positive history of eyeworm as assessed by the RAPLOA questionnaire. Diagnostic testing included a quantitative PCR (qPCR) for detection of Loa loa DNA in blood samples, an in-house crude L. loa antigen IgG ELISA, and a rapid test for antibodies against the Ll-SXP-1 antigen (RDT). Sensitivity and specificity were determined for each test and factors potentially influencing outcomes were evaluated in an exploratory analysis.ResultsELISA, RDT and qPCR results were available for 99.8%, 78.5%, and 100% of the 1,232 participants, respectively. The ELISA and RDT had only modest diagnostic accuracy. qPCR was specific for L. loa microfilaremia and Cycle threshold values correlated with microfilarial density. Anti-L. loa IgG levels were highest in occult loiasis, and antibody levels correlated inversely with L. loa microfilarial density as did RDT line intensities. Only 84.6% and 16.7% of hyper-microfilaremic individuals tested positive by ELISA (11/13) and RDT (2/12), respectively.ConclusionNone of the tests demonstrated high sensitivity and specificity for loiasis. Indirect diagnostic assays were characterized by low specificity. Additionally, hyper-microfilaremic individuals often tested negative by RDT and ELISA, indicating that these tests are not suitable for individual case management in endemic populations.

Abstract Although carbonates are the primary form of carbon subducted into the mantle, their fate during recycling is debated. Here we report the first coupled high‐precision Zn and Mo isotope data for Cenozoic intraplate basalts from western China. The exceptionally high δ66Zn values (+0.39 to +0.50‰) of these lavas require involvement of recycled carbonates in the mantle source. Variable δ98Mo compositions (−0.39 to +0.27‰) are positively correlated with Mo/Ce, best interpreted as mixing between isotopically light Mo from dehydrated oceanic crust and heavy Mo from recycled carbonates, which is also supported by positive coupling between δ66Zn and δ98Mo. Modeling reveals that involvement of ≤5% carbonate‐bearing oceanic crust fully resolves the observed δ66Zn–δ98Mo mantle heterogeneity probed by intracontinental basalts. Our study demonstrates that combined δ66Zn–δ98Mo data sets for mantle‐derived magmas can track recycled surficial carbonates in Earth's interior, providing a powerful geochemical tool for deep carbon science.