Average nucleotide identity of genome sequences supports the description of Rhizobium lentis sp. nov., Rhizobium bangladeshense sp. nov. and Rhizobium binae sp. nov. from lentil (Lens culinaris) nodules

Rhizobial strains isolated from effective root nodules of field-grown lentil (Lens culinaris) from different parts of Bangladesh were previously analysed using sequences of the 16S rRNA gene, three housekeeping genes (recA, atpD and glnll) and three nodulation genes (nodA, nodC and nodD), DNA fingerprinting and phenotypic characterization. Analysis of housekeeping gene sequences and DNA fingerprints indicated that the strains belonged to three novel clades in the genus Rhizobium. In present study, a representative strain from each clade was further characterized by determination of cellular fatty acid compositions, carbon substrate utilization patterns and DNA DNA hybridization and average nucleotide identity (ANI) analyses from whole-genome sequences. DNA DNA hybridization showed 50-62 % relatedness to their closest relatives (the type strains of Rhizobium etli and Rhizobium phaseoh) and 50-60 % relatedness to each other. These results were further supported by ANI values, based on genome sequencing, which were 87-92 % with their close relatives and 88-89 % with each other. On the basis of these results, three novel species, Rhizobium lentis sp. nov. (type strain BLR27(T)=LMG 28441(T)=DSM 29286(T)), Rhizobium bangladeshense sp. nov. (type strain BLR175(T)=LMG 28442(T)=DSM 29287(T)) and Rhizobium binae sp. nov. (type strain BLR195(T)=LMG 28443(T)=DSM 29288(T)), are proposed. These species share common nodulation genes (nodA, nodC and nodD) that are similar to those of the symbiovar viciae

Petrovski House in Senj; Historic and Spatial Development of the Patrician House and its Renaissance Lions’ Court

Zbog jedinstvenih značajki unutrašnjega Lavljeg dvorišta, kuća Petrovski u Senju predstavlja nezaobilazan primjer renesansne stambene arhitekture na hrvatskome dijelu sjevernoga Jadrana. Njezin je prostorni razvoj, analizom arhivskih vrela, terenskim istraživanjima i zaključcima izvedenim iz izrađene arhitektonske snimke postojećega stanja, podijeljen u etape koje opisuju izvorno stanje kuće, njezinu renesansnu pregradnju te nadgradnje i promjene izvedene tijekom 19. i 20. stoljeća.Owing to features of its Lions’ Court, the Petrovski House in Senj represents a quintessential example of Renaissance residential architecture on the Croatian part of the north Adriatic coast. Using the archival sources and conclusions drawn from the architectural survey, the spatial development of the house is described in stages spanning from its first occurrence and its Renaissance remodelling, to alterations carried out in the 19th and the 20th centuries

Acceptance of E-Mental Health Services for Different Application Purposes Among Psychotherapists in Clinical Training in Germany and Switzerland: Secondary Analysis of a Cross-Sectional Survey

Background: Despite solid evidence supporting the efficacy of electronic mental health (EMH) services, their acceptance among psychotherapists is limited and uptake rates remain low. However, the acceptance of different EMH services has yet barely been examined in future generations of psychotherapists in a differentiated manner. The aims of this study were (1) to elaborate the intention to use various EMH services for different application purposes and (2) to determine predictors of EMH service acceptance among psychotherapists in clinical training (PiT). Materials and Methods: Our paper is based on a secondary data analysis of a cross-sectional survey. Respondents were recruited via recognized educational institutions for psychotherapy within Germany and the German-speaking part of Switzerland between June and July of 2020. The survey contained items on the intention to use different EMH services (i.e., guided and unguided programs, virtual reality, psychotherapy by telephone and videoconference) for various application purposes (i.e., prevention, treatment addition, treatment substitute, aftercare). Potential predictors of EMH service acceptance (e.g., barriers and advantages) were examined based on an extension of the Unified Theory of Acceptance and Use of Technology (UTAUT). Results: Most of the n = 216 respondents were female (88.4%) and located in Germany (72.2%). General acceptance of EMH was moderate (M = 3.4, SD = 1.12, range 1–5), while acceptance of psychotherapy via videoconference was highest (M = 3.7, SD = 1.15) and acceptance of unguided programs was lowest (M = 2.55, SD = 1.14). There was an interaction effect of EMH service and application purpose (η2 = 0.21). Barriers and advantages both had a uniform influence on EMH service acceptance (Pr > 0.999), while impersonality, legal concerns, concerns about therapeutic alliance, simplified information provision, simplified contact maintenance, time flexibility, and geographic flexibility were significant predictors (all p 0.999). Conclusions: The intention to use different EMH services varied between application purposes among PiT. To increase acceptance of EMH services and reduce misconceptions, we identified predictors that should be addressed in future acceptance-facilitating interventions when educating PiT

Reliability of a novel approach for reference-based cell type estimation in human placental DNA methylation studies

The placenta is a central organ during early development, influencing trajectories of health and disease. DNA methylation (DNAm) studies of human placenta improve our understanding of how its function relates to disease risk. However, DNAm studies can be biased by cell type heterogeneity, so it is essential to control for this in order to reduce confounding and increase precision. Computational cell type deconvolution approaches have proven to be very useful for this purpose. For human placenta, however, an assessment of the performance of these estimation methods is still lacking. Here, we examine the performance of a newly available reference-based cell type estimation approach and compare it to an often-used reference-free cell type estimation approach, namely RefFreeEWAS, in placental genome-wide DNAm samples taken at birth and from chorionic villus biopsies early in pregnancy using three independent studies comprising over 1000 samples. We found both reference-free and reference-based estimated cell type proportions to have predictive value for DNAm, however, reference-based cell type estimation outperformed reference-free estimation for the majority of data sets. Reference-based cell type estimations mirror previous histological knowledge on changes in cell type proportions through gestation. Further, CpGs whose variation in DNAm was largely explained by reference-based estimated cell type proportions were in the proximity of genes that are highly tissue-specific for placenta. This was not the case for reference-free estimated cell type proportions. We provide a list of these CpGs as a resource to help researchers to interpret results of existing studies and improve future DNAm studies of human placenta.Peer reviewe

Pre-hospital management protocols and perceived difficulty in diagnosing acute heart failure

Aim To illustrate the pre-hospital management arsenals and protocols in different EMS units, and to estimate the perceived difficulty of diagnosing suspected acute heart failure (AHF) compared with other common pre-hospital conditions. Methods and results A multinational survey included 104 emergency medical service (EMS) regions from 18 countries. Diagnostic and therapeutic arsenals related to AHF management were reported for each type of EMS unit. The prevalence and contents of management protocols for common medical conditions treated pre-hospitally was collected. The perceived difficulty of diagnosing AHF and other medical conditions by emergency medical dispatchers and EMS personnel was interrogated. Ultrasound devices and point-of-care testing were available in advanced life support and helicopter EMS units in fewer than 25% of EMS regions. AHF protocols were present in 80.8% of regions. Protocols for ST-elevation myocardial infarction, chest pain, and dyspnoea were present in 95.2, 80.8, and 76.0% of EMS regions, respectively. Protocolized diagnostic actions for AHF management included 12-lead electrocardiogram (92.1% of regions), ultrasound examination (16.0%), and point-of-care testings for troponin and BNP (6.0 and 3.5%). Therapeutic actions included supplementary oxygen (93.2%), non-invasive ventilation (80.7%), intravenous furosemide, opiates, nitroglycerine (69.0, 68.6, and 57.0%), and intubation 71.5%. Diagnosing suspected AHF was considered easy to moderate by EMS personnel and moderate to difficult by emergency medical dispatchers (without significant differences between de novo and decompensated heart failure). In both settings, diagnosis of suspected AHF was considered easier than pulmonary embolism and more difficult than ST-elevation myocardial infarction, asthma, and stroke. Conclusions The prevalence of AHF protocols is rather high but the contents seem to vary. Difficulty of diagnosing suspected AHF seems to be moderate compared with other pre-hospital conditions

Expression of iNOS, CD163 and ARG-1 taken as M1 and M2 markers of microglial polarization in human glioblastoma and the surrounding normal parenchyma

Microglia and macrophages appear to be the most common cells in the GBM microenvironment. In the present study we investigated the status of macrophages/microglia activation in surgical specimens from 41 patients diagnosed with grade IV GBM. For each patient we analyzed both the center of tumor and the parenchyma surrounding the tumor. The specimens were stained for: i) IBA1, a 17-kDa EF hand protein specifically expressed in microglia/macrophages ii) CD163, a cell surface antigen associated with M2 phenotype; iii) iNOS, taken as a functional marker of M1 phenotype, and iv) ARG-I, taken as a functional marker of M2 phenotype. Staining was scored in a double-blinded score on a scale from 0 to 5. Our results suggest that CD163 expression is higher within the tumor than in surrounding periphery in both male and female patients; while iNOS is higher within the tumor in males, no significant difference was found for ARG-1. In addition, analyzing the data in TGCA database, we found that CD163 expression was significantly and inversely correlated with mean survival times, with average survival times ranging from 448 days in patients having low expression, to 319 in mid, and 353 in patients with high CD163 expressing tumors. In contrast, no significant association was found between survival time and ARG-1 or iNOS expression

App-based support for breast cancer patients to reduce psychological distress during therapy and survivorship – a multicentric randomized controlled trial

IntroductionThe negative impact of unmanaged psychological distress on quality of life and outcome in breast cancer survivors has been demonstrated. Fortunately, studies indicate that distress can effectively be addressed and even prevented using evidence-based interventions. In Germany prescription-based mobile health apps, known as DiGAs (digital health applications), that are fully reimbursed by health insurances, were introduced in 2020. In this study, the effectiveness of an approved breast cancer DiGA was investigated: The personalized coaching app PINK! Coach supports and accompanies breast cancer patients during therapy and follow-up.MethodsPINK! Coach was specifically designed for breast cancer (BC) patients from the day of diagnosis to the time of Follow-up (aftercare). The app offers individualized, evidence-based therapy and side-effect management, mindfulness-based stress reduction, nutritional and psychological education, physical activity tracking, and motivational exercises to implement lifestyle changes sustainably in daily routine. A prospective, intraindividual RCT (DRKS00028699) was performed with n = 434 patients recruited in 7 German breast cancer centers from September 2022 until January 2023. Patients with BC were included independent of their stage of diseases, type of therapy and molecular characteristics of the tumor. Patients were randomized into one of two groups: The intervention group got access to PINK! over 12 weeks; the control group served as a waiting-list comparison to “standard of care.” The primary endpoint was psychological distress objectified by means of Patient Health Questionnaire-9 (PHQ-9). Subgroups were defined to investigate the app’s effect on several patient groups such as MBC vs. EBC patients, patients on therapy vs. in aftercare, patients who received a chemotherapy vs. patients who did not.ResultsEfficacy analysis of the primary endpoint revealed a significant reduction in psychological distress (least squares estimate -1.62, 95% confidence interval [1.03; 2.21]; p<0.001) among intervention group patients from baseline to T3 vs, control group. Subgroup analysis also suggested improvements across all clinical situations.ConclusionPatients with breast cancer suffer from psychological problems including anxiety and depression during and after therapy. Personalized, supportive care with the app PINK! Coach turned out as a promising opportunity to significantly improve psychological distress in a convenient, accessible, and low-threshold manner for breast cancer patients independent of their stage of disease (EBC/MBC), therapy phase (aftercare or therapy) or therapy itself (chemotherapy/other therapy options). The app is routinely available in Germany as a DiGA. Clinical Trial Registration: DRKS Trial Registry (DRKS00028699)

Anomalous coarsening driven by reversible charge transfer at metal–organic interfaces

The unique electronic properties and functional tunability of polycyclic aromatic hydrocarbons have recently fostered high hopes for their use in flexible, green, portable, and cheap technologies. Most applications require the deposition of thin molecular films onto conductive electrodes. The growth of the first few molecular layers represents a crucial step in the device fabrication since it determines the structure of the molecular film and the energy level alignment of the metal–organic interface. Here, we explore the formation of this interface by analyzing the interplay between reversible molecule–substrate charge transfer, yielding intermolecular repulsion, and van der Waals attractions in driving the molecular assembly. Using a series of ad hoc designed molecules to balance the two effects, we combine scanning tunnelling microscopy with atomistic simulations to study the self-assembly behavior. Our systematic analysis identifies a growth mode characterized by anomalous coarsening that we anticipate to occur in a wide class of metal–organic interfaces and which should thus be considered as integral part of the self-assembly process when depositing a molecule on a conducting surface

Re-evaluating how charge transfer modifies the conformation of adsorbed molecules

The archetypal electron acceptor molecule, TCNQ, is generally believed to become bent into an inverted bowl shape upon adsorption on the coinage metal surfaces on which it becomes negatively charged. New quantitative experimental structural measurements show that this is not the case for TCNQ on Ag(111). DFT calculations show that the inclusion of dispersion force corrections reduces not only the molecule-substrate layer spacing but also the degree of predicted molecular bonding. However, complete agreement between experimentally-determined and theoretically-predicted structural parameters is only achieved with the inclusion of Ag adatoms into the molecular layer, which is also the energetically favoured configuration. The results highlight the need for both experimental and theoretical quantitative structural methods to reliably understand similar metal-organic interfaces and highlight the need to re-evaluate some previously-investigated systems

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes