Identification of key factors for reducing N and P leaching from organic crop rotations

Leaching of nitrogen (N) and phosphorus (P) for different 6-year organic crop rotations was examined in separately tile-drained field plots on two different sites in southwest Sweden. On each site, two different farming systems, one with dairy cows and one without stock, were evaluated to identify parts of the crop rotations with the greatest risks of N and P leaching and to examine the scope for improvement. Although organic farming methods themselves already led to a reduction in nutrient leaching, critical periods in the crop rotation could nevertheless be identified for the two soil types. While P leaching is of major importance on clay soils, sandy soils are strongly susceptible to N leaching. From the present study it could be concluded, that key factors for reducing N and P leaching from clay soils are late ploughing, avoidance of early incorporation of clover-grass leys in order to sow a winter cereal, the use of undersown crops and an even distribution of nutrients within the crop rotation. For the sandy soil, where measures like undersown crops and spring tillage were already integrated in the studied crop rotation, potato cultivation and application of farmyard manure were identified as the main sources of N losses to the drainage water

Metocognition in obsessive-compulsive disorder

Metakognitionen bei Zwangsstörungen: In der aktuellen Literatur zu Zwang werden kognitive Theorien als bedeutsam für die Erklärung der Entstehung und Aufrechterhaltung der Zwangsstörung erachtet. Bei Wells (2000) sind dies Metakognitionen auf einer mittleren Abstraktionsebene, die "Denken über das Denken" beinhalten. In der vorliegenden Studie wurden auf der Grundlage vorhandener Literatur zehn für Zwang relevante Themenbereiche ausgewählt und dazu Items auf einer mittleren Abstraktionsebene - Einstellungen zu Gedanken und Gefühlen - formuliert. In einer Pilotstudie wurden die Items abgeändert und schließlich das Inventar "Zwangsaufrechterhaltende Überzeugungen zu Gedanken und Gefühlen" ZAGG erstellt. Zunächst wurde anhand der Daten von 215 Personen mit Zwangsstörung eine Faktorenanalyse durchgeführt mit anschließender Itemreduktion und Skalenbildung. Anschließend wurde der ZAGG-Fragebogen auf Reliabilität, externe Validität, Änderungssensitivität, Zusammenhang mit Therapieerfolg und Spezifität untersucht. In diese Berechnungen gingen die Daten von 40 Zwangspatienten, 40 Patienten mit Agoraphobie/Panikstörung, 40 Patienten mit Depression sowie 39 gesunden Kontrollpersonen ein. Besonderheit dabei war der Ausschluss von Komorbidität der jeweils anderen Erkrankungen. Ergebnisse der Studie: 1) In der Faktorenanalyse ergaben sich 5 Dimensionen, davon enthalten 3 dysfunktionale und 2 positive Einstellungen gegenüber Gedanken/Gefühlen. Die Skalen sind: (1) Schuld/Scham, (Angst, Selbstwert) (2) Kontrolle (Verantwortung, Perfektionismus) und (3) Zweifel (an Gedächtnis und Sinneswahrnehmungen), (4) Akzeptanz (gegenüber anderen) und (5) Gelassenheit (gegenüber eigenen Gedanken/Gefühlen). 2) Alle Skalen erwiesen sich als konsistent und stabil bei einem Retest-Intervall von 5 Tagen. Außerdem zeigten sie sich in hohem Maße änderungssensitiv durch die Therapie. 3) Bezüglich aller weiteren Daten unterschieden sich pathologische (Skalen 1-3) von gelassenen Einstellungen (Skalen 4+5): die Skalen Schuld, Kontrolle und Zweifel zeigten überwiegend Zusammenhänge mit der Zwangssymptomatik, insbesondere mit Zwangsgedanken. Die konvergente Validität ist gut, außerdem bestehen deutliche Zusammenhänge mit dem Therapieerfolg. Die diskriminante Validität ist nicht zufriedenstellend, die Zusammenhänge mit Ängstlichkeit und Depressivität sind genauso hoch wie mit Maßen der Zwangssymptomatik. 4) Bezüglich der Spezifität zeigte sich für diese Skalen folgendes: Gesunde haben deutlich niedrigere Werte als alle klinischen Gruppen. Die Angstpatienten wiederum haben höhere Werte als die gesunden, jedoch signifikant niedrigere Werte als Depressive und Zwangspatienten. Zwischen Zwangspatienten und Depressiven gibt es keine Unterschiede. Die Skalen Schuld, Zweifel und Kontrolle erweisen sich somit als zwangs- und depressionsrelevant. 5) Die Skalen Akzeptanz und Gelassenheit erweisen sich weder als valide, noch als psychopathologisch relevant. Diskussion und Ausblick: Die Ergebnisse weisen auf eine Gültigkeit der Theorie von Wells für Zwang und Depression hin. Die Bedeutung für aktuelle Modelle der Depression wird diskutiert. Die größere kognitive Ähnlichkeit der Zwangsstörung mit Depression als mit Agoraphobie/Panikstörung gibt Anstoß für weitere Untersuchungen zur kognitiven Verwandtschaft der drei Erkrankungen.Metacognition in OCD: In current literature about OCD dysfunctional cognitions are regarded to be important for the development and maintainance of OCD. Wells’ (2000) theory of metacognitions refers to thoughts on a medium level of abstraction: "thinking about thinking" resp. "thinking about feeling". In the present study an inventory has been developed which is called "Zwangsaufrechterhaltende Überzeugungen zu Gedanken und Gefühlen", in short: ZAGG. First of all ten cognitive themes from current literature which were regarded as relevant for OCD were chosen, for example: responsibility, guilt, perfectionism, control, thought-action fusion. In a next step items concerning these themes were formulated as attitudes towards thoughts and feelings ("I have to have 100% control over my thoughts"). Method: Factor analysis was calculated and item reduction and construction of scales were done with data of 215 persons with OCD. After that the "new" ZAGG-inventory (49 items) was examined regarding reliability, external validity, and correlation with in-patient treatment outcome and specifity. In these analysis data of 40 patients with OCD, 40 patients with depression, 40 patients with agoraphobia/panic, and 39 healthy controls were included. Special feature was the exclusion of the comorbidity of the other diagnoses respectively. Results: 1) From the factor analysis resulted 5 dimensions, 3 of them containing dysfunctional attitudes, 2 of them "positive" attitudes towards thoughts and feelings. The scales are: (1) guilt, (2) control (responsibility, perfectionism), (3) doubt (about own cognitive functioning), (4) acceptance (of everyone’s feelings and thoughts), (5) tolerance (let feelings and thoughts come and go without influencing them). 2) All scales showed high consistence (Cronbachs alphas ranged from .82 - .94), high stability after an interval of 5 days. Additionally they showed significant change in relation to in-patient treatment. 3) Concerning the following analysis dysfunctional and positive attitudes differed: The scales (1) guilt, (3) doubt and - to lower extent (2) control - showed significant correlations with measures of OCD symptoms, especially with obsessions. The convergent validity is sufficient, and correlations with treatment outcome are highly significant. Discriminant validity is not satisfactory. Correlations with anxiousness and depressiveness are as high as with measures of symptoms of OCD. Specifity of the dysfunctional attitudes (scales 1-3): Healthy controls showed the lowest scores; they differ significantly from all clinical groups. They are followed by the group of patients with agoraphobia/panic. These patients had significantly lower scores than patients with depression and patients with OCD. Against the hypothesis OCD group and depression group do not differ in any scale. The scales guilt, control, and doubt can be regarded as relevant for OCD and depression. 4) The scales (4) acceptance and (5) tolerance do not show any validity regarding OCD nor do they seem to be relevant for psychopathology. Discussion: The results of the study are an indication of the relevance of metacognitions for OCD and depression. The implications for theories of depression are discussed. The cognitive similarity of OCD and depression in contrast to agoraphobia encourages further investigation

Die Bedeutung von Metakognitionen für das Verständnis und die Psychotherapie von Zwang

The Importance of Metacognitions in the Understanding and Treatment of Obsessive Compulsive Disorder The present article discusses three cognitive approaches of Obsessive Compulsive Disorder (OCD): (1) Beck's theory of content-specificity, (2) Salkovskis' cognitive-behavioural approach and (3) Wells' more recent theory of metacognitions. Wells' approach is explained in more detail: the so called Self-Regulatory Executive Function model is presented as well as special aspects of thinking in OCD, for example the self-referential status of thinking, thinking in object mode and aspects of `thought-action fusion'. The relevance of Wells' metacognitive approach for the development and the maintenance of OCD is discussed. Furthermore, proposals are made on how to include these issues in the psychotherapy of OCD

Promoting medical competencies through a didactic tutor qualification programme – a qualitative study based on the CanMEDS Physician Competency Framework

Background: In peer-led tutorial courses, qualified medical students (“tutors”) provide their peers with opportunities to deepen their theoretical knowledge effectively and to practice clinical skills already in preclinical semesters. At the Medical Faculty of Heidelberg University, a structured medical didactic qualification programme prepares and trains future tutors for their responsibilities. This programme consists of four modules: 1. medical didactics and group leadership, 2. subject-specific training, 3. performance of tutorial courses as well as 4. collegial advice and reflection on the tutors’ activities. The aim of this study is to systematically analyse and present the development of role competencies for medical tutors based on the CanMEDS Physician Competency Framework through the didactic qualification programme. Methods: We applied a qualitative research approach to detect CanMEDS role competencies acquisition within the tutor qualification programme. The CanMEDS framework describes key competencies, grouped thematically under seven professional roles. Two tutors and three training coordinators independently assigned the individual modules of the tutor qualification programme to the key competencies of the CanMEDS framework. Tutors and training coordinators compared and discussed the allocations within the groups in a consensus finding process. All authors analysed the findings in order to find out the so-called “hidden curriculum”. The views of both groups are presented separately. Results: The training programme promotes the acquisition of competencies in all seven CanMEDS roles. The roles of the scholar and the leader are promoted in all modules. In addition, the first and fourth module focus predominately on the role of the collaborator, the second on the role of the medical expert and communicator, and the fourth on the role of the professional. Conclusions: The systematic analysis through assignment of the CanMEDS roles to the individual modules of the tutor qualification programme documents the comprehensive acquisition of competencies, not only with regard to the tutor activity, but generally with regard to the later role of the physician. The reflection on one’s own competency acquisition can support the promotion of corresponding competencies in the qualification programme and their transfer into the professional practice later

Leitlinienbasierte Standards zur Struktur- und Prozessqualität neuropsychologischer Diagnostik und Therapie

Die vorliegende Arbeit untersucht die aktuelle wissenschaftliche Evidenz zur Diagnostik und Therapie neuropsychologischer Störungen nach Hirnschädigung, wie sie bis 2020 in Leitlinien publiziert wurde. Deren Umsetzung ist nur möglich, wenn die institutionellen Rahmenbedingungen dies erlauben. Unter Einbezug der klinischen Erfahrung wurden daher auf Basis der Leitlinien Standards für eine wissenschaftlich fundierte neuropsychologische Diagnostik und Therapie erarbeitet. Es entstanden Best-Practice-Empfehlungen zu Strukturund Prozessqualität, insbesondere zu Intensität und Häufigkeit der Interventionen. Diese werden für die wichtigsten neuropsychologischen Funktionsbereiche vorgestellt. Sowohl die Deutsche Gesellschaft für Neuropsychologie e. V. (GNP) als auch die Deutsche Gesellschaft für Neurologie e. V. (DGN) unterstützen diese Empfehlungen. Sie richten sich an Neuropsycholog_innen sowie an Einrichtungsleitende und Sozialversicherungsträger und definieren die Rahmenbedingungen für eine auf den individuellen Fall angepasste leitliniengerechte neuropsychologische Behandlung.Recent years have seen the establishment of evidence-based guidelines for neuropsychological diagnostics and therapy; however, implementing these guidelines depends on structures and processes necessary to enable essential aspects like therapy frequency and intensity. The present work examines the current scientific evidence for the neuropsychological treatment of traumatic and nontraumatic brain injury, as published in guidelines up to 2020. Standards for evidence-based neuropsychological diagnostics and therapy were developed on this basis, including clinical experience and additional literature research. Best-practice recommendations on both general and specific structural and process quality emerged, especially on the intensity and frequency of interventions. These are presented for the most important neuropsychological functional areas. The German Neuropsychological Society (GNP) and the German Society for Neurology (DGN) support these recommendations. They are aimed at neuropsychologists as well as facility managers and social insurance providers, and they define the framework for guideline-based neuropsychological treatment adapted to individual cases

The nuclear envelope protein Nesprin-2 has roles in cell proliferation and differentiation during wound healing

Nesprin-2, a type II transmembrane protein of the nuclear envelope, is a component of the LINC complex that connects the nuclear lamina with the actin cytoskeleton. To elucidate its physiological role we studied wound healing in Nesprin-2 Giant deficient mice and found that a loss of the protein affected wound healing particularly at later stages during fibroblast differentiation and keratinocyte proliferation leading to delayed wound closure. We identified altered expression and localization of transcription factors as one of the underlying mechanisms. Furthermore, the actin cytoskeleton which surrounds the nucleus was altered and keratinocyte migration was slowed down and focal adhesion formation enhanced. We also uncovered a new activity of Nesprin-2. When we probed for an interaction of Nesprin-2 Giant with chromatin we observed in ChIP Seq experiments an association of the protein with heterochromatic and centromeric DNA. Through this activity Nesprin-2 can affect the nuclear landscape and gene regulation. Our findings suggest functions for Nesprin-2 at the nuclear envelope (NE) in gene regulation and in regulation of the actin cytoskeleton which impact on wound healing

Th2/Th17 cell associated cytokines found in seroma fluids after breast cancer surgery

Purpose The development of a seroma after breast cancer surgery is a common postoperative complication seen after simple mastectomy and axillary surgery. We could recently demonstrate that breast cancer patients undergoing a simple mastectomy with subsequent seroma formation developed a T-helper cell increase within the aspirated fluid measured by flow cytometry. The same study revealed a Th2 and/or a Th17 immune response in peripheral blood and seroma fluid of the same patient. Based on these results and within the same study population, we now analyzed the Th2/Th17 cell associated cytokine content as well as the best known clinical important cytokine IL-6. Methods Multiplex cytokine measurements (IL-4, IL-5, IL-13, IL-10, IL-17, and IL-22) were done on 34 seroma fluids (Sf) after fine needle aspiration of patients who developed a seroma after a simple mastectomy. Serum of the same patient (Sp) and that of healthy volunteers (Sc) were used as controls. Results We found the Sf to be highly cytokine rich. Almost all analyzed cytokines were significantly higher in abundance in the Sf compared to Sp and Sc, especially IL-6, which promotes Th17 differentiation as well as suppresses Th1 differentiation in favor of Th2 development. Conclusion Our Sf cytokine measurements reflect a local immune event. In contrast, former study results on T-helper cell populations in both Sf and Sp tend to demonstrate a systemic immune process

Stoichiometry of HLA Class II-Invariant Chain Oligomers

BACKGROUND: The HLA gene complex encodes three class II isotypes, DR, DQ, and DP. HLA class II molecules are peptide receptors that present antigens for recognition by T lymphocytes. In antigen presenting cells, the assembly of matched α and β subunits to heterodimers is chaperoned by invariant chain (Ii). Ii forms a homotrimer with three binding sites for class II heterodimers. The current model of class II and Ii structure states that three αβ heterodimers bind to an Ii trimer. METHODOLOGY/PRINCIPAL FINDINGS: [corrected] We have now analyzed the composition and size of the complexes of class II and Ii using epitope tagged class II subunits and density gradient experiments. We show here that class II-Ii oligomers consist of one class II heterodimer associated with one Ii trimer, such that the DR, DQ and DP isotypes are contained within separate complexes with Ii. CONCLUSION/SIGNIFICANCE: We propose a structural model of the class II-Ii oligomer and speculate that the pentameric class II-Ii complex is bent towards the cell membrane, inhibiting the binding of additional class II heterodimers to Ii

Decline in the number of patients with meningitis in German hospitals during the COVID-19 pandemic

BACKGROUND AND OBJECTIVES: In 2020, a wide range of hygiene measures was implemented to mitigate infections caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In consequence, pulmonary infections due to other respiratory pathogens also decreased. Here, we evaluated the number of bacterial and viral meningitis and encephalitis cases during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: In a multicentre retrospective analysis of data from January 2016 until December 2020, numbers of patients diagnosed with bacterial meningitis and other types of CNS infections (such as viral meningitis and encephalitis) at 26 German hospitals were studied. Furthermore, the number of common meningitis-preceding ear-nose-throat infections (sinusitis, mastoiditis and otitis media) was evaluated. RESULTS: Compared to the previous years, the total number of patients diagnosed with pneumococcal meningitis was reduced (n = 64 patients/year in 2020 vs. n = 87 to 120 patients/year between 2016 and 2019, all p < 0.05). Additionally, the total number of patients diagnosed with otolaryngological infections was significantly lower (n = 1181 patients/year in 2020 vs. n = 1525 to 1754 patients/year between 2016 and 2019, all p < 0.001). We also observed a decline in viral meningitis and especially enterovirus meningitis (n = 25 patients/year in 2020 vs. n = 97 to 181 patients/year between 2016 and 2019, all p < 0.001). DISCUSSION: This multicentre retrospective analysis demonstrates a decline in the number of patients treated for viral and pneumococcal meningitis as well as otolaryngological infections in 2020 compared to previous years. Since the latter often precedes pneumococcal meningitis, this may point to the significance of the direct spread of pneumococci from an otolaryngological focus such as mastoiditis to the brain as one important pathophysiological route in the development of pneumococcal meningitis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-022-11034-w

Cross-realm assessment of climate change impacts on species' abundance trends

Climate change, land-use change, pollution and exploitation are among the main drivers of species' population trends; however, their relative importance is much debated. We used a unique collection of over 1,000 local population time series in 22 communities across terrestrial, freshwater and marine realms within central Europe to compare the impacts of long-term temperature change and other environmental drivers from 1980 onwards. To disentangle different drivers, we related species' population trends to species- and driver-specific attributes, such as temperature and habitat preference or pollution tolerance. We found a consistent impact of temperature change on the local abundances of terrestrial species. Populations of warm-dwelling species increased more than those of cold-dwelling species. In contrast, impacts of temperature change on aquatic species' abundances were variable. Effects of temperature preference were more consistent in terrestrial communities than effects of habitat preference, suggesting that the impacts of temperature change have become widespread for recent changes in abundance within many terrestrial communities of central Europe.Additionally, we appreciate the open access marine data provided by the International Council for the Exploration of the Sea. We thank the following scientists for taxonomic or technical advice: C. Brendel, T. Caprano, R. Claus, K. Desender, A. Flakus, P. R. Flakus, S. Fritz, E.-M. Gerstner, J.-P. Maelfait, E.-L. Neuschulz, S. Pauls, C. Printzen, I. Schmitt and H. Turin, and I. Bartomeus for comments on a previous version of the manuscript. R.A. was supported by the EUproject LIMNOTIP funded under the seventh European Commission Framework Programme (FP7) ERA-Net Scheme (Biodiversa, 01LC1207A) and the long-term ecological research program at the Leibniz-Institute of Freshwater Ecology and Inland Fisheries (IGB). R.W.B. was supported by the Scottish Government Rural and Environment Science and Analytical Services Division (RESAS) through Theme 3 of their Strategic Research Programme. S.D. acknowledges support of the German Research Foundation DFG (grant DO 1880/1-1). S.S. acknowledges the support from the FP7 project EU BON (grant no. 308454). S.K., I.Kü. and O.S. acknowledge funding thorough the Helmholtz Association’s Programme Oriented Funding, Topic ‘Land use, biodiversity, and ecosystem services: Sustaining human livelihoods’. O.S. also acknowledges the support from FP7 via the Integrated Project STEP (grant no. 244090). D.E.B. was funded by a Landes–Offensive zur Entwicklung Wissenschaftlich–ökonomischer Exzellenz (LOEWE) excellence initiative of the Hessian Ministry for Science and the Arts and the German Research Foundation (DFG: Grant no. BO 1221/23-1).Peer Reviewe