Evaluation of a male-specific psychotherapeutic program for major depressive disorder compared to cognitive behavioral therapy and waitlist: study protocol for a six-arm randomized clinical superiority trial examining depressed eugonadal and hypogonadal men receiving testosterone.

Background: Treatment of major depressive disorder (MDD) in men is complicated by the endorsement of traditional masculinity ideologies (TMI) often leading to reluctance toward psychotherapy, therapy interfering processes, or premature termination. In addition, it has been shown that men with MDD have a significantly increased risk of being hypogonadal (e.g., total testosterone levels <12.1 nmoL/L). Therefore, it is recommended to examine depressed men with regard to their testosterone status and if hypogonadism is present to combine psychotherapy with testosterone treatment (TT). Aim: This project aims to evaluate a male-specific psychotherapeutic program (MSPP) for MDD in depressed eugonadal and hypogonadal men receiving testosterone in comparison to a standard cognitive behavioral therapy (CBT) for MDD and a Waitlist. Methods: The study presents a 2×3 factorial study design. In total, 144 men aged between 25 and 50 will be stratified by testosterone status (eugonadal/hypogonadal) and then randomized into one of the three conditions (MSPP, CBT, or Waitlist). Additionally, a healthy control group of 100 men will be recruited, which will undergo only baseline assessments. Both standardized psychotherapy programs will encompass 18 sessions delivered in a weekly manner. Aligned with the TT-related medical visits of the 72 hypogonadal men, all participants will be followed up with clinical assessments and bio sampling at weeks 0, 6, 15, 24, and 36. Expected results: Compared to Waitlist control groups, treatment groups are expected to be more effective and efficacious (depression score reduction of ≥50%) at week 24 and at the follow-up at week 36. The MSPP is expected to show higher effectiveness and efficacy for depressive symptoms and higher acceptability (lower dropout rate) as compared to CBT. Discussion: This study represents the first attempt to test a male-specific psychotherapy for MDD in a single-setting compared to standard CBT and a Waitlist control condition using randomized clinical trial methodology. In addition, the potential positive adjunct effect of psychotherapy to TT in reducing depressive burden and improving quality of life in hypogonadal depressed men represents a neglected research area and might introduce new hypogonadism screening procedures in depressed men and combined treatment approaches for depressed men suffering from hypogonadism. Limitations are the rigorous inclusion and exclusion criteria, which limit the generalizability of the study results to first episode treatment naïve depressed men. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT05435222.

Babesia bicornis, Theileria bicornis and Theileria equi in metapopulations of two black rhinoceros (Diceros bicornis) subspecies in South Africa and their potential impact on conservation.

The two black rhinoceros subspecies (Diceros bicornis bicornis and D. b. minor) in South African conservation areas are managed as separate metapopulations. Since infection with Babesia bicornis can be fatal in black rhinoceroses, occurrence of this and other piroplasms in the two metapopulations was determined to assess possible risk. Blood specimens were collected from 156 black rhinoceroses: 80 from D. b. bicornis and 76 from D. b. minor. DNA was extracted; the V4 hypervariable region of the parasite 18S rRNA gene was amplified and subjected to the Reverse Line Blot (RLB) hybridization assay. There was a significant difference in occurrence of piroplasms: 18/80 (23%) in D. b. bicornis and 39/76 (51%) in D. b. minor. Theileria bicornis occurred in significantly more of the D. b. minor population (36/76; 47%) than the D. b. bicornis population (1/80; 1%); with B. bicornis the difference was not significant: D. b. bicornis 5/80 (6%) and D. b. minor 9/76 (11%). Three individuals were infected with Theileria equi. Results were confirmed using molecular characterization of the near full-length parasite 18S rRNA gene of 13 selected specimens. We identified four (Tb1, Tb2, Tb3 and Tb4) 18S rDNA sequence types for T. bicornis, two for B. bicornis (Bb1 and Bb2) and one for T. equi (Teq1). We furthermore identified T. bicornis haplotypes H1, H3 and H4 in 10 rhinoceroses; H3 was the most common haplotype identified. Rhinoceroses inhabiting more arid areas are apparently free of T. bicornis and B. bicornis, probably due to the absence or scarcity of vectors. When individuals are relocated for metapopulation management purposes, appropriate prophylactic action should be taken to minimise the risk of babesiosis, which could be fatal.

Perception of children with visible untreated and treated caries.

OBJECTIVES: This study aimed to analyse if children with untreated or treated caries (restorations/missing teeth) are perceived differently compared to children with healthy teeth and to explore possible differences in the perception by laypersons and dental experts. METHODS: Eye movements of female experts (n = 20) and laypersons (n = 18) were recorded by eye-tracking while paired images (neutral expression/teeth not visible; emotional expression/smiling, teeth visible) of children with healthy teeth, with visible untreated or treated caries (restorations/missing teeth as a consequence of caries treatment), each n = 13, were presented. First fixation, total fixation time and number of fixations on the areas of interest (eyes, nose, mouth) in the first two seconds of presentation were determined. Furthermore, the images were rated regarding arousal, valence and attractivity. Statistical analysis was performed using Mann-Whitney-U- and Kruskal-Wallis-tests (α = 0.05). RESULTS: Generally, laypersons spent more time exploring and fixating the eye region than the mouth, while dental experts more often first percept and longer and more often fixated the mouth region, especially in images with emotional expression. Dental experts, but not laypersons, were significantly longer fixating the mouth of children with untreated caries than the mouth of children with healthy teeth in images with emotional expression. When evaluating images with emotional expression, both dental experts and laypersons rated children with healthy teeth to be more attractive, pleasant and calm than children with untreated or treated caries. CONCLUSIONS: Children with visible treated and untreated caries were differently perceived by laypersons and dental experts than children with healthy teeth.

Rift Valley Fever: Does Wildlife Play a Role?

Rift Valley fever (RVF) virus (RVFV) is an emerging vector-borne pathogen that causes sporadic epizootics and epidemics with multi-year, apparently quiescent, inter-epidemic periods. The epidemiology and ecology of the virus during these inter-epidemic periods is poorly understood. There is evidence for low-level circulation of the virus in livestock and wild ruminants; however, as of yet there is no evidence to identify a specific mammalian reservoir host. Using a systematic approach, this review synthesizes results from serosurveys, attempts at viral detection, and experimental infection of wildlife. These data demonstrate there is a gap in research conducted on RVF in wild ruminants. Specifically, there is very little published data on the pathogenicity of an RVFV infection in various wildlife species, validation of diagnostic assays for exposure to RVFV and understanding of epizootic or endemic disease dynamics in wild ruminants. We recommend that future research on RVFV incorporate a more systematic approach to understand the low-level cycling of the virus during inter-epidemic periods in both wild and domestic ruminant species.

Parasites of domestic and wild animals in South Africa. XLIX. Ticks (Acari: Ixodidae) infesting white and black rhinoceroses in southern Africa.

The objectives of the study were to determine the species composition of ticks infesting white and black rhinoceroses in southern Africa as well as the conservation status of those tick species that prefer rhinos as hosts. Ticks were collected opportunistically from rhinos that had been immobilised for management purposes, and 447 white rhinoceroses (Ceratotherium simum) and 164 black rhinoceroses (Diceros bicornis) were sampled in South Africa, 61 black rhinos in Namibia, 18 white and 12 black rhinos in Zimbabwe, and 24 black rhinos in Zambia. Nineteen tick species were recovered, of which two species, Amblyomma rhinocerotis and Dermacentor rhinocerinus, prefer rhinos as hosts. A. rhinocerotis was collected only in the northeastern KwaZulu-Natal reserves of South Africa and is endangered, while D. rhinocerinus is present in these reserves as well as in the Kruger National Park and surrounding conservancies. Eight of the tick species collected from the rhinos are ornate, and seven species are regularly collected from cattle. The species present on rhinos in the eastern, moister reserves of South Africa were amongst others Amblyomma hebraeum, A. rhinocerotis, D. rhinocerinus, Rhipicephalus maculatus, Rhipicephalus simus and Rhipicephalus zumpti, while those on rhinos in the Karoo and the drier western regions, including Namibia, were the drought-tolerant species, Hyalomma glabrum, Hyalomma rufipes, Hyalomma truncatum and Rhipicephalus gertrudae. The species composition of ticks on rhinoceroses in Zambia differed markedly from those of the other southern African countries in that Amblyomma sparsum, Amblyomma tholloni and Amblyomma variegatum accounted for the majority of infestations.

Assessing secondary soil salinization risk based on the PSR sustainability framework.

Risk assessment of secondary soil salinization, which is caused in part by the way people manage the land, is an essential challenge to agricultural sustainability. The objective of our study was to develop a soil salinity risk assessment methodology by selecting a consistent set of risk factors based on the conceptual Pressure-State-Response (PSR) sustainability framework and incorporating the grey relational analysis and the Analytic Hierarchy Process methods. The proposed salinity risk assessment methodology was demonstrated through a case study of developing composite risk index maps for the Yinchuan Plain, a major irrigation agriculture district in northwest China. Fourteen risk factors were selected in terms of the three PSR criteria: pressure, state, and response. The results showed that the salinity risk in the Yinchuan Plain was strongly influenced by the subsoil and groundwater salinity, land use, distance to irrigation canals, and depth to groundwater. To maintain agricultural sustainability in the Yinchuan Plain, a suite of remedial and preventative actions were proposed to manage soil salinity risk in the regions that are affected by salinity at different levels and by different salinization processes. The weight sensitivity analysis results also showed that the overall salinity risk of the Yinchuan Plain would increase or decrease as the weights for pressure or response risk factors increased, signifying the importance of human activities on secondary soil salinization. Ideally, the proposed methodology will help us develop more consistent management tools for risk assessment and management and for control of secondary soil salinization.

Format preferences of district attorneys for post-mortem medical imaging reports: understandability, cost effectiveness, and suitability for the courtroom: a questionnaire based study.

AIMS: The objective of this study was to explore the perception of the legal authorities regarding different report types and visualization techniques for post-mortem radiological findings. METHODS: A standardized digital questionnaire was developed and the district attorneys in the catchment area of the affiliated Forensic Institute were requested to evaluate four different types of forensic imaging reports based on four cases examples. Each case was described in four different report types (short written report only, gray-scale CT image with figure caption, color-coded CT image with figure caption, 3D-reconstruction with figure caption). The survey participants were asked to evaluate those types of reports regarding understandability, cost effectiveness and overall appropriateness for the courtroom. RESULTS AND CONCLUSION: 3D reconstructions and color-coded CT images accompanied by written report were preferred regarding understandability and cost/effectiveness. 3D reconstructions of the forensic findings reviewed as most adequate for court.

Avian poxvirus epizootic in a breeding population of Lesser Flamingos (Phoenicopterus minor) at Kamfers Dam, Kimberley, South Africa.

Avian pox has a worldwide distribution, but prior to this investigation has not been reported in free-ranging flamingo populations. During observations of the first successful breeding of Lesser Flamingos on a purpose-built island, at Kamfers Dam near Kimberley, South Africa, multiple small, raised, crusted plaques on the legs and facial area were noticed on 30% of the fledgling flamingos. A diagnosis of avipoxvirus infection was made on the basis of the macroscopic, histologic, and electron microscopic features, and was further confirmed by DNA sequence analysis. The avipoxvirus detected was very similar to that previously detected in albatross and falcons.

Biochemical markers in the diagnosis of chondral defects following anterior cruciate ligament insufficiency.

PURPOSE: The aim of this study was to determine the value of systemic biochemical markers of bone turnover-urine levels of cross-linked C-terminal telopeptide I (uCTX-I), urinary C-terminal telopeptide II (uCTX-II) and serum cartilage oligomeric matrix protein (sCOMP)-in the diagnosis of chondral defects after anterior cruciate ligament (ACL) rupture. Thirty-eight patients with previous ACL rupture were included. METHODS: Magnetic resonance imaging (MRI) of the injured and the intact knee joint was performed with volumetric measurement of volume and area of cartilage (VC/AC), area of subchondral bone (cAB), and area of subchondral bone denuded and eroded (dAB). Biochemical markers were measured using commercially available enzyme-linked immunoassays. RESULTS: MRI-based volumetric cartilage measurement showed significant differences between the injured and the intact knees. uCTX-I, sCOMP and in parts uCTX-II correlated well with MRI parameters. CTX-I showed a significant correlation with VC and AC of the whole knee joint. CONCLUSIONS: The results suggest that uCTX-I, uCTX-II and sCOMP could identify patients with focal cartilage lesions from an early stage of osteoarthritis of the knee.

Reconstructive versus non-reconstructive treatment of anterior cruciate ligament insufficiency. A retrospective matched-pair long-term follow-up.

In this retrospective case series 80 patients divided in 40 matched pair groups with an arthroscopically proven ACL insufficiency were followed up for 15 years. One half was reconstructed using an autologous BTB patella graft, the other half was treated by a conservative physiotherapeutic based rehabilitation program. At follow-up the clinical scores (Lysholm, IKDC) showed no significant differences between subjects who had undergone ACL reconstruction and those who had not. Furthermore there was no detectable difference in the incidence of osteoarthritis between the cohorts. Patients having a negative pivot shift test showed significantly less signs of radiographic osteoarthritis and better functional assessment scores whether reconstructed or not. Based on these results and a review of the literature there is no clear evidence that ACL reconstruction reduces the rate of OA development or improves the long-term symptomatic outcome. Probably review of reconstruction by an anatomical approach will be more successful than operative techniques decades ago.

A transferencia em psicoterapia: compreensao e utilizacao

O presente trabalho tem por objetivo contribuir para a compreensao e utilizacao da transferencia em psicoterapia dinamica. Estuda-se o historico, a importancia e a compreensao dos diversos aspectos do conceito, especialmente aqueles desenvolvimentos por FREUD, e seu emprego em psicoterapia. Seguindo contribuicoes atuais, diferencia, por um lado, o trabalho realizado na analise consistente da neurose de transferencia, esta como uma recapitulacao da doenca original, utilizada fundamentalmente no tratamento psicanalitico, e, de outra parte, a compreensao da transferencia, visualizada como tentativa de restauracao do relacionamento, empregada em psicoterapia dinamica. Tres exemplos clinicos, muito resumidos, ilustram a necessidade de interpretar a transferencia em psicoterapia. Nas consideracoes finais, e enfocada a utilizacao da transferencia em psicoterapia dinamica.

Selecao de candidatos (contribuicao ao estudo dos ambientes dos institutos)

Trata-se de contribuicao ao tema de 'Selecao de Candidatos' estudando o ambiente dos institutos de Psicanalise onde s erealiza esta atividade muito delicada. Varios fatores podem criar determinados ambientes e estes irao influir, de alguma modo, na selecao realizada, atividade de decisiva importancia porque representa o futuro da Psicanalise. Sao considerados resumidamente os seguintes fatores imbricados: perda da traicao, luta pelo poder, narcisismo do analista didata e lideres manifestos e ocultos. Como conclusao menciona que se pode estabelecer na selecao dos analistas didatas e dos candidatos verdadeiro circulo vicioso, de dificil solucao. A esperanca esta na integridade das pessoas e na propria acao da Psicanalise.