A novel type of neighbour perception elicits reproductive plasticity in an annual plant with a mixed mating system

Plants display various forms of phenotypic plasticity in anticipation of changing conditions, many of which are influenced by information obtained from neighbouring plants. Here, we tested the hypothesis that cleistogamic Lamium amplexicaule plants can adaptively modify production of chasmogamous (CH) and cleistogamous (CL) flowers based on the perception of conspecific neighbours. The production and proportion of CH and CL flowers was examined in individual L. amplexicaule grown at varying densities or treated with root leachates from plants grown at different densities. When growing at high density or treated with root leachates from high-density pots, L. amplexicaule increased production of more expensive, potentially outcrossing CH flowers. In contrast, single plants or plants treated with root leachates from empty pots or single-source plants predominantly developed cheaper, self-pollinated CL flowers. The results demonstrate a novel root-based neighbour-perception modality that enables plants to adaptively adjust production of CH and CL flowers in response to the presence of potential reproductive partners. Further research is needed to explore the broader ecological implications of this novel interplant cueing on reproductive bet-hedging and plasticity in natural settings, as well as to identify the involved cues and their mode of operation.

Towards optimal use of antithrombotic therapy of people with cancer at the end of life: A research protocol for the development and implementation of the SERENITY shared decision support tool

BACKGROUND

Even though antithrombotic therapy has probably little or even negative effects on the well-being of people with cancer during their last year of life, deprescribing antithrombotic therapy at the end of life is rare in practice. It is often continued until death, possibly resulting in excess bleeding, an increased disease burden and higher healthcare costs.

METHODS

The SERENITY consortium comprises researchers and clinicians from eight European countries with specialties in different clinical fields, epidemiology and psychology. SERENITY will use a comprehensive approach combining a realist review, flash mob research, epidemiological studies, and qualitative interviews. The results of these studies will be used in a Delphi process to reach a consensus on the optimal design of the shared decision support tool. Next, the shared decision support tool will be tested in a randomised controlled trial. A targeted implementation and dissemination plan will be developed to enable the use of the SERENITY tool across Europe, as well as its incorporation in clinical guidelines and policies. The entire project is funded by Horizon Europe.

RESULTS

SERENITY will develop an information-driven shared decision support tool that will facilitate treatment decisions regarding the appropriate use of antithrombotic therapy in people with cancer at the end of life.

CONCLUSIONS

We aim to develop an intervention that guides the appropriate use of antithrombotic therapy, prevents bleeding complications, and saves healthcare costs. Hopefully, usage of the tool leads to enhanced empowerment and improved quality of life and treatment satisfaction of people with advanced cancer and their care givers.

Nutritional composition of substitutes for meats and sausages on the German market

Background

Substitutes for meats and sausages are growing both in demand and supply in Germany. Monitoring their nutritional composition helps characterise this novel product group in terms of its dietary contribution.

Methods

Data on substitutes for meats and sausages were collected in a baseline survey in 2016 and an in-depth follow-up survey in 2021. In both surveys, mandatory nutrition declaration (“Big 7”) and other packaging information were collected via online research and supermarket visits. Products were categorised according to the substituted animal products and their contents of energy, fat, saturated fatty acids, and salt investigated. Changes in energy and nutrient contents between baseline and follow-up survey were assessed statistically using Welch’s t-test.

Results

The follow-up survey included 421 meat substitutes and 292 sausage substitutes, split into 27 subgroups. Substitutes for meat products like meat strips and schnitzel show widely varying energy contents. Sausage substitutes show higher medians for fat, saturated fatty acids and salt than meat substitutes; spans of salt content (0,1-4,0 g per 100 g product) and saturated fatty acids (0,1 g - 23,0 g per 100 g product) are particularly wide. Relative to the baseline survey, which included 69 meat substitutes and 61 sausage substitutes, the follow-up revealed significantly higher contents of energy and saturated fatty acids overall and in some subgroups (e.g. nuggets and burger patties). The sole significant reduction was seen for energy in substitutes of precooked sausages.

Conclusions

The observed wide spans of energy and nutrient content imply 1) the potential to reformulate substitutes for meats and sausages at the top end of the spectrum 2) the availability of healthier choices within the various subgroups. The increases shown in energy and saturated fatty acids content warrant further monitoring.

Key messages

• Wide spans of energy and nutrient contents reveal the potential for the development of more nutritionally favourable substitutes for meats and sausages.

• As substitutes for meats and sausages are perceived to have nutritional advantages the observed increases in energy and saturated fatty acids contents over time should be further monitored.

Data Literacy in Medical Education - An Expedition into the World of Medical Data

With the advancing digitization in medicine, digital medical data is playing an increasingly important role in health care and research, which is why data literacy must already be taught in medical education. To this end, a 28-hour online elective for medical students - following a constructivist approach - has been implemented. It teaches learners different aspects of data literacy for a critical collection and use of sensitive medical data. The assessment of the learners' reflections on the course topics shows, on the one hand, the importance of data literacy from learners' perspective and, on the other hand, the importance of taking an overarching and coherent view of medical data. In further curricular courses, such as medical ethics, and statistics, special themes are to be deepened in an application-oriented manner.

The Podcast "Digitization of Medicine" as a Form of Science Communication

The aim of the podcast Digitization of Medicine is to interest a broader audience and, in particular, young women, in research and work in the field of medical informatics. This article presents the usage figures and discusses their significance for further research on the success of science communication. By 24/02/2022, a total of 24,351 downloads had been made. There were slightly more female than male listeners, and they tended to be younger. Despite the importance podcast are gaining for science communication, little is known about the respective user group and further research is needed. In this context, this paper aims to help make the effectiveness of podcasts comparable.

Cooperative Chain Dynamics of Tracer Chains in Highly Entangled Polyethylene Melts

By neutron spin echo spectroscopy, we have studied the center of mass motion of short tracer chains on the molecular length scale within a highly entangled polymer matrix. The center of mass mean square displacements of the tracers independent of their molecular weight is subdiffusive at short times until it has reached the size of the tube d; then, a crossover to Fickian diffusion takes place. This observation cannot be understood within the tube model of reptation, but is rationalized as a result of important interchain couplings that lead to cooperative chain motion within the entanglement volume ∼d^{3}. Thus, the cooperative tracer chain motions are limited by the tube size d. If the center of mass displacement exceeds this size, uncorrelated Fickian diffusion takes over. Compared to the prediction of the Rouse model we observe a significantly reduced contribution of the tracer's internal modes to the spectra corroborating the finding of cooperative rather than Rouse dynamics within d^{3}.

Self-Similar Dynamics of Large Polymer Rings: A Neutron Spin Echo Study

This work clarifies the self-similar dynamics of large polymer rings using pulsed-field gradient nuclear magnetic resonance and neutron spin echo spectroscopy. We find center of mass diffusion taking place in three dynamic regimes starting (i) with a strongly subdiffusive domain ⟨r^{2}(t)⟩_{com}∼t^{α} (0.4≤α≤0.65); (ii) a second subdiffusive region ⟨r^{2}(t)⟩_{com}∼t^{0.75} that (iii) finally crosses over to Fickian diffusion. While the t^{0.75} range previously has been found in simulations and was predicted by theory, we attribute the first to the effect of cooperative dynamics resulting from the correlation hole potential. The internal dynamics at scales below the elementary loop size is well described by ring Rouse motion. At larger scales the dynamics is self-similar and follows very well the predictions of the scaling models with preference for the self-consistent fractal loopy globule model.

Teamwork, communication and exchange despite Covid-19 - experiences from a digital elective in human medicine studies as part of the HiGHmed project

Introduction: In order to promote training and further education on topics related to the digitization of medicine, the HiGHmeducation consortium is developing online learning modules. These modules could also be offered across locations. For students of human medicine, an elective for the acquisition of data literacy has been implemented. Originally designed as a blended learning offer, the elective was then carried out completely online due to the Covid-19 pandemic. Despite the lack of classroom teaching, the aim was to achieve intensive cooperation between the students. Project description: In the elective, the students worked on a total of 14 learning tasks, so-called e-tivities, which stimulate collaborative work and thus promote the examination of the learning content. These asynchronous learning activities were supplemented by video conferences, in which the students also took on the role of presenters. The teachers accompanied this learning process as e-moderators. Results: In April/May 2020, the elective course was carried out with 12 students entirely online. Despite a workload that was experienced as high, the elective was rated very well by the students. Discussion: The didactic concept of the elective enabled an active engagement with the learning material and the social interaction between the learners. With the digital learning offers, the learners were able to gain new experiences which are also of professional relevance. Conclusion: The didactic concept of the elective can be transferred to other courses. Future studies must show which long-term learning effects can be generated by digital teaching based on teamwork, communication and exchange.

The HiGHmed Didactical Framework for Online Learning Modules on Medical Informatics: First Experiences

Within the HiGHmeducation consortium various online learning modules shall be developed by members of the consortium to address the increasing need for skilled professionals in a networked and digitalized healthcare system. Transferability of these modules to other locations is one main objective for the design of online learning modules. Thus, a didactical framework for online learning modules was developed. To ensure feasibility of the framework, the participating universities were analyzed concerning availability of e-learning support structures and infrastructures including learning management systems (LMS). The analysis especially focuses on the various LMS learning tools and their suitability for the framework. The framework is the basis for 12 HiGHmeducation online learning modules of which a part has firstly been conducted in winter 2019/20 and leads to a comparable structure of the modules.

Maternal serum glycosylated fibronectin as a short-term predictor of preeclampsia: a prospective cohort study

Background

Preeclampsia is a major pregnancy complication that results in significant maternal and infant mortality, most of which occurs in low and middle-income countries. The accurate and timely diagnosis of preeclampsia is critical in management of affected pregnancies to reduce maternal and fetal/neonatal morbidity and mortality, yet difficulties remain in establishing the rigorous diagnosis of preeclampsia based on clinical parameters alone. Biomarkers that detect biochemical disease have been proposed as complements or alternatives to clinical criteria to improve diagnostic accuracy. This cohort study assessed the performance of several biomarkers, including glycosylated fibronectin (GlyFn), to rule-in or rule-out preeclampsia within 4 weeks in a cohort of women at increased risk for preeclampsia.

Methods

151 women with risk factors for or clinical signs and symptoms of preeclampsia were selected from a prospective cohort. Maternal serum samples were collected between 20 and 37 weeks of gestation. Clinical suspicion of preeclampsia was defined as presence of new-onset proteinuria, or clinical symptoms of preeclampsia. Subjects with a clinical diagnosis of preeclampsia at the time of enrollment were excluded. GlyFn, pregnancy-associated plasma protein-A2 (PAPPA2), placental growth factor (PlGF), and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured by immunoassay. GlyFn was also determined using a rapid point-of care (POC) test format. Receiver-operating characteristic (ROC) curves derived from logistic regression analysis were used to determine the classification performance for each analyte.

Results

32 of 151 (21%) women developed a clinical diagnosis of preeclampsia within 4 weeks. All biomarkers exhibited good classification performance [GlyFn (area under the curve (AUROC) = 0.94, 91% sensitivity, 86% specificity); PAPPA2 AUC = 0.92, 87% sensitivity, 77% specificity; PlGF AUC = 0.90, 81% sensitivity, 83% specificity; sFlt-1 AUC = 0.92, 84% sensitivity, 91% specificity. The GlyFn immunoassay and the rapid POC test showed a correlation of r = 0.966.

Conclusions

In this prospective cohort, serum biomarkers of biochemical disease were effective in short-term prediction of preeclampsia, and the performance of GlyFn in particular as a POC test may meet the needs of rapid and accurate triage and intervention.

Direct Assessment of Tube Dilation in Entangled Polymers

A key ingredient within theories focusing on the rheology of entangled polymers is the way how the topological constraints of an entangled chain are lifted by unconstrained segments, i.e., how the constraining tube is dilated. This important question has been addressed by directly measuring the tube diameter d at the scale of the tube by neutron spin echo spectroscopy. The tube diameter d and plateau modulus G_{N}^{0} of highly entangled polyethylene oxide (PEO) chains of volume fraction c that are diluted by low molecular PEO show a concentration dependence d∝c^{a/2} and G_{N}^{0}∝c^{1+a} with an exponent a close to 4/3. This result allows the clear discrimination between different theoretical models that predict 4/3 or other values between 1 and 2 and provides an important ingredient to tube model theories.

Diagnostic Accuracy of Different Soluble fms-Like Tyrosine Kinase 1 and Placental Growth Factor Cut-Off Values in the Assessment of Preterm and Term Preeclampsia: A Gestational Age Matched Case-Control Study

Introduction: The objective was to investigate the diagnostic accuracy of different thresholds of the soluble vascular endothelial growth factor receptor-1 (sFlt-1) and the placental growth factor (PlGF) in preterm (≤37 weeks) and term (>37 weeks) preeclampsia (PE). Materials and Methods: A nested case-control study was performed from a high-risk Swiss cohort. Only blood samples on the day of PE diagnosis were included. The primary outcome was to verify the diagnosis using the recently proposed cut-off values for PE (sFlt-1:PlGF ratio of ≥85 in ≤ 34 weeks or ≥110 in >34 weeks), and the gestational age dependent centiles. Results: Thirty-four women with preterm PE were matched with 64 controls and 25 women with term PE with 45 controls. The test performance of the sFlt-1:PlGF ratio in preterm PE was very good (AUROCC of 0.95). The sFlt-1:PlGF ratio could adequately predict adverse fetal or neonatal outcome. In term PE, sFlt-1 alone showed a slightly better diagnostic accuracy with an AUROCC of 0.84. Almost all women with a sFlt-1:PlGF ratio above threshold delivered during the following week. Discussion: In pregnant women with high risk of developing PE, the sFlt-1:PlGF ratio and sFlt-1 levels help clinicians to confirm the diagnosis of imminent preterm PE and can additionally be used to rule out PE at term.

Die sonographische Untersuchung des vorderen Augenabschnittes beim Kleintier

Gegenstand: Diese zweiteilige Arbeit beschreibt den Einsatz eines hochauflösenden Linear-Array-Schallkopfes mit einer Mittelfrequenz von 12 MHz zur Darstellung des vorderen Augenabschnittes und der Netzhaut-Glaskörper-Peripherie beim Kleintier. Material und Methoden: Im ersten Teil der Studie wurden die Adnexe und der vordere Augenabschnitt bei gesunden Hunden und Katzen sonographisch erfasst. Zusätzlich erfolgte eine Untersuchung des gesamten Bulbus, der Adnexe sowie der Orbita von gesunden Kaninchen und Meerschweinchen. Die Sonographie wurde unter Lokalanästhesie, in Sedation oder Allgemeinnarkose durchgeführt. Ergebnisse: Im Anschluss an die Untersuchungen traten in keinem Fall durch die Sonographie bedingte Komplikationen auf. Mit der hochauflösenden Ophthalmosonographie ließen sich anteriore und bulbuswandständige Strukturen des Augapfels und die okulären Adnexe beurteilen. Die entstehenden Bilder ähnelten histologischen Schnittbildern niedriger Vergrößerung, ohne jedoch deren Präparationsartefakte aufzuweisen. Zusätzlich konnten dabei der gesamte Bulbus und seine Adnexe sowie die Orbita mit einem Ultraschallgerät untersucht werden. Schlussfolgerung und klinische Relevanz: Die hochauflösende Ophthalmosonographie liefert Bilder vom gesunden Hunde-, Katzen-, Kaninchenund Meerschweinchenauge, die mit konventionellen Geräten bisher nicht zu erreichen sind. Limitiert ist der Einsatz der Sonde durch deren Größe, vor allem in der vertikalen Schnittebene.

Die sonographische Untersuchung des vorderen Augenabschnittes beim Kleintier

Gegenstand und Ziel: Überprüfung des Einsatzes der hochauflösenden Ophthalmosonographie bei krankhaften Zuständen am Auge. Material und Methoden: Bei 125 Hunden und 36 Katzen wurden pathologische Veränderungen des vorderen Augenabschnittes und der Netzhaut-Glaskörper-Peripherie mit einem hochauflösenden Linear-Array-Schallkopf mit einer Mittelfrequenz von 12 MHz dargestellt. Zusätzlich wurden Veränderungen des gesamten Bulbus, der Adnexe und der Orbita von zwei Meerschweinchen und drei Kaninchen untersucht. Bei allen Augen, die enukleiert werden mussten, erfolgte zum Vergleich eine histologische Untersuchung. Ergebnisse: Die hochauflösende Ophthalmosonographie erlaubte die detaillierte Beurteilung anteriorer und bulbuswandständiger Läsionen des Augapfels und der okulären Adnexe. Die nicht invasive Untersuchungsmethode wurde von den Tieren gut toleriert. Beim Vergleich der eingesetzten Methode mit dem in der Humanmedizin verwendeten Ultraschallbiomikroskop zeigte sich Letzteres zwar in der Darstellung feinster Gewebsstrukturen überlegen, doch stellt der verwendete Schallkopf durch seine höhere Eindringtiefe, die leichtere Anwendbarkeit und die flexiblen Einsatzmöglichkeiten für tiermedizinische Fragestellungen insgesamt eine geeignete Alternative dar. Klinische Relevanz: Mit dieser Technik gelangen Darstellungen, die mit konventionellen Geräten bisher nicht erreicht werden konnten. Als Einsatzschwerpunkte sind Läsionen im Bereich von Iris, Ziliarkörper und Linse, die Glaukomdiagnostik, Traumata, Verlaufskontrollen und die Überprüfung des Operationsergebnisses von Linsenextraktionen und Kunstlinsenimplantationen zu nennen.

An exploratory analysis on how geographic, socioeconomic, and environmental drivers affect the diversity of livestock breeds worldwide

This study investigates the relationships between various environmental and geographic, demographic, and socioeconomic factors with the diversity of livestock breeds reported within countries across the world. Statistical analyses were performed considering the numbers of breeds reported by 158 countries for 4 livestock mammalian species (cattle, sheep, goats, and pigs). Organization for Economic Cooperation and Development (OECD) countries reported more breeds than non-OECD countries in general. Strong and positive correlations were found between agricultural area, human population size, species population size, and number of breeds per country. When considering regression models, the species population size was found as the most important explanatory factor for the number of breeds reported by countries in the 4 species. Diversity of production systems in the country had a significant association with the number of breeds reported for sheep, goats, and pigs. The number of ruminant breeds was positively associated with the size of agricultural area and the diversity of land cover in the country. While demographic and cultural importance of a given species is a major factor associated with the number of livestock breeds within countries, this diversity is also connected to the variability in environmental and production conditions.

Twenty-five-year-old Woman with Bilateral Borderline Ovarian Tumour Desiring to Preserve Fertility - Case Report and Literature Review on the Current State of Fertility Preservation in Women with Borderline Ovarian Tumours

Borderline ovarian tumours are semimalignant tumours occurring unilaterally or bilaterally with a peak incidence among women of reproductive age. Since the affected women often wish to preserve fertility, particular precautions must be taken when counselling the patient and obtaining consent prior to planning an individual treatment. Options for preserving fertility include an organ-sparing surgical procedure and cryopreservation of oocytes and/or ovarian tissue. In this article, we report on a 25-year-old patient with a bilateral seromucinous borderline tumour who desired all fertility-preserving options. In order to perform the procedure without delay, we opted to perform luteal phase stimulation prior to oocyte retrieval. We conclude by discussing the current literature on the state of fertility preservation in the treatment of borderline ovarian tumours.

Microwave-mediated Newman–Kwart rearrangement in water

For the first time the unimolecular Newman–Kwart rearrangement is performed in pure water.

Rare phenotypes in domestic animals: unique resources for multiple applications

Preservation of specific and inheritable phenotypes of current or potential future importance is one of the main purposes of conservation of animal genetic resources. In this review, we investigate the issues behind the characterisation, utilisation and conservation of rare phenotypes, considering their multiple paths of relevance, variable levels of complexity and mode of inheritance. Accurately assessing the rarity of a given phenotype, especially a complex one, is not a simple task, because it requires the phenotypic and genetic characterisation of a large number of animals and populations and remains dependent of the scale of the study. Once characterised, specific phenotypes may contribute to various purposes (adaptedness, production, biological model, aesthetics, etc.) with adequate introgression programmes, which justifies the consideration of (real or potential) existence of such characteristics in in situ or ex situ conservation strategies. Recent biotechnological developments (genomic and genetic engineering) will undoubtedly bring important changes to the way phenotypes are characterised, introgressed and managed.

Fertility Protection in Female Oncology Patients: How Should Patients Be Counseled?

Protecting the fertility of patients with oncologic disease is becoming more and more important, as fulfilling the wish to have children is increasingly occurring at a later stage in life and long-term survival rates after cancer are continuing to improve. A number of fertility-preserving options exist. In addition to techniques which have been around for some time such as medical ovarian suppression, ovarian transposition, and organ-preserving surgery, there are other, more recent, innovative methods which have developed over the last few years such as cryopreservation of oocytes or ovarian tissue transplantation after completing cancer therapy. As every procedure has its specific advantages and disadvantages, informed patient consent is essential. The physician's aim must be to select the optimal procedure for each patient. The extent of patients' information about the options to preserve fertility in women with oncologic disease remains limited. One of the main reasons for this is that clinicians are not sure how to inform patients about existing procedures and methods. The aim of this review article is to provide help in clinical practice.

Comparison of Whole Ovary Cryotreatments for Fertility Preservation

The goal of this study was to compare a traditional slow-freeze method (TF) with an open unidirectional slow freeze cooling system (UF) for whole ovary cryopreservation. Therefore, whole pig ovaries were randomly assigned to (A) fresh control, (B) traditional slow freeze (TF) or (C) unidirectional slow freeze (UF). Ovaries were perfused with 10% DMSO in Krebs-Ringer. For TF, whole ovaries were placed in specimen jars containing 10% DMSO and placed into a specialized container for freezing filled with propan-2-ol. For UF, whole ovaries were placed within a specially designed container containing 10% DMSO and transferred to a specialized freezing machine (CTE 920). Histological evaluation demonstrated intact morphology of follicles in all groups; however, an overall decrease of follicle numbers in TF (46%) and UF (50%) compared to fresh control. Live/dead assay indicated significantly lower populations of live cells in both TF (60%) and UF (58%) compared to fresh tissue (74%). TUNEL assay confirmed a difference in percentage of apoptotic follicles between fresh and TF, but there was no significant difference between fresh and UF. To improve the structural and functional integrity of whole ovaries, further investigation, especially into directional freezing, is needed. Whole ovary cryopreservation could provide opportunities for women facing fertility loss due to chemo- or radiotherapy treatment.