Search

Background: Necrotising soft tissue infections (NSTI) and burn injuries pose substantial challenges in clinical management, necessitating multidisciplinary approaches. This study compares outcomes between NSTI and burn patients, emphasising the resource disparity. Methods: 93 NSTI patients admitted between January 2014 and December 2021 were matched with burns patients by total body surface area (TBSA), gender, and age. The Acute Physiology and Chronic Health Evaluation II (APACHE II) is a score utilised to predict mortality. Length of stay in hospital, length of intensive care unit (ICU) admission and disposition were also collected. Results: Our study shows higher APACHE II scores in NSTI patients (median 24 vs. 6 in burns), leading to elevated post-operative mortality (30% vs. 3% in burns) and non-operative mortality (40% vs. 8% in burns). NSTI patients had longer hospital stays and more required transfers to other facilities such as rehabilitation centres compared to burns. Conclusions: These findings highlight the substantial resource demands of managing NSTI patients, underscoring the urgent need for additional funding and optimised resource allocation to improve outcomes in this population. Level of Evidence: Level III, risk/prognostic study [ABSTRACT FROM AUTHOR]

Background: Due to climate change, extreme weather events are becoming more frequent worldwide. An example of such an extreme weather event was the flooding in Western Europe in July 2021. Currently, there are large research gaps regarding how such events, particularly those involving oil pollution, affect people's connection to nature and their perceptions of environmental problems. Perceptions and connections to nature are important factors that influence environmental behavior and decisions. This study examines the influence of the exposure of oil pollution during the 2021 floods on the perception of the natural environment (connection to nature) and of environmental problems (perception of planetary boundaries). To this end, people affected by flooding who have come into direct or indirect contact with oil pollution are examined, with people from unaffected regions serving as a control group. Results: No significant differences were found for both the connection to nature and the perception of planetary boundaries between the three groups studied. Connection to nature was at a moderate level in all three groups. In the case of planetary boundaries, it was observed that all boundaries were rated as significantly exceeded in all three groups. Especially the boundary of novel entities to which also oil pollution belongs, was evaluated as highly exceeded. Conclusions: The results suggest that extreme weather events do not negatively impact personal connection to nature. Additionally, no significant group differences were found in the assessment of planetary boundaries, which may be attributed to the inherently high assessment scores in Germany. The study provides evidence that perceptions of environmental problems and connection to nature are relatively stable in the face of an extreme weather event with a natural trigger. Further studies are needed to investigate the reasons and consequences of this stability. [ABSTRACT FROM AUTHOR]

Background: The public understanding of environmental issues, such as chemical pollution due to flooding, is reflected and shaped by media representations and how these issues are framed. This study aims to identify how local, regional, and national German newspapers pick up and frame the issue of chemical pollution and related environmental and health risks regarding the 2021 summer flood using content analysis. Results: The analysis shows that chemical pollution is rarely addressed compared to other flood-related topics. We identified 189 newspaper articles published in the months following the flood, which specifically mention chemical emissions. Of these articles, 50 report only marginally on chemical pollution, while 36 focus on the factual description of chemical emissions without addressing the consequences of pollution. The remaining 103 articles address impacts of certain pollutants such as oil, pesticides, heavy metals, or dioxins. Using content analysis, we identified four narratives that were common in their broad storylines and used to create a problem frame: (i) Highlighting severe contamination of the environment with chemical pollutants causing serious environmental damage (31 articles), (ii) describing possible contamination but with uncertainty about the extent and consequences (39 articles), (iii) tending to give the all-clear and emphasizing that there is no severe long-term contamination (25 articles), and (iv) indicating continuous contamination that does not allow the all-clear to be given (8 articles). Conclusions: The results suggest that flood-related chemical pollution does not receive much media attention. Where it does, coverage focuses primarily on the description of the "tangible parts" of pollution, and thus contamination by oil, depicted by both smell and oil streaks, is frequently addressed Articles indicating severe contamination suggest threats to human and environmental health as likely consequences. However, most articles only report the results of chemical monitoring in the contaminated regions, which are evaluated by experts. This contrasts with other topics of controversy related to the flood, such as climate change as a potential cause. In light of our study, we propose that media and science communication need to pay more attention to chemical pollution—in general and as a result of flood events. [ABSTRACT FROM AUTHOR]

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Cancer diagnoses at later stages are associated with a decrease in health-related quality of life (HRQOL). Health state utility values (HSUVs) reflect preference-based HRQOL and can vary based on cancer type, stage, treatment, and disease progression. Detecting and treating cancer at earlier stages may lead to improved HRQOL, which is important for value assessments. We describe published HSUVs by cancer type and stage. Methods: A systematic review was conducted using Embase, MEDLINE®, EconLit, and gray literature to identify studies published from January 1999 to September 2019 that reported HSUVs by cancer type and stage. Disutility values were calculated from differences in reported HSUVs across cancer stages. Results: From 13,872 publications, 27 were eligible for evidence synthesis. The most frequent cancer types were breast (n = 9), lung (n = 5), colorectal (n = 4), and cervical cancer (n = 3). Mean HSUVs decreased with increased cancer stage, with consistently lower values seen in stage IV or later-stage cancer across studies (e.g., − 0.74, − 0.44, and − 0.51 for breast, colorectal, and cervical cancer, respectively). Disutility values were highest between later-stage (metastatic or stage IV) cancers compared to earlier-stage (localized or stage I–III) cancers. Conclusions: This study provides a summary of HSUVs across different cancer types and stages that can inform economic evaluations. Despite the large variation in HSUVs overall, a consistent decline in HSUVs can be seen in the later stages, including stage IV. These findings indicate substantial impairment on individuals' quality of life and suggest value in early detection and intervention. [ABSTRACT FROM AUTHOR]

The transdisciplinary research mode has gained prominence in the research on and for sustainability transformations. Yet, solution-oriented research addressing complex sustainability problems has become complex itself, with new transdisciplinary research formats being developed and tested for this purpose. Application of new formats offers learning potentials from experience. To this end, we accompanied fourteen research projects conceptualized as real-world labs (RwLs) from 2015 to 2018. RwLs were part of a funding program on 'Science for Sustainability' in the German federal state of Baden-Württemberg. Here, we combine conceptual and empirical work to a structured collection of experiences and provide a comprehensive account of RwLs. First, we outline characteristics of RwLs as transformation oriented, transdisciplinary research approach, using experiments, enabling learning and having a long-term orientation. Second, we outline eleven success factors and concrete design notes we gained through a survey of the 14 RwLs: (1) find the right balance between scientific and societal aims, (2) address the practitioners needs and restrictions, (3) make use of the experimentation concept, (4) actively communicate, (5) develop a 'collaboration culture', (6) be attached to concrete sites, (7) create lasting impact and transferability, (8) plan for sufficient time and financial means, (9) adaptability, (10) research-based learning, and (11) recognize dependency on external actors. Characteristics and success factors are combined to illustrate practical challenges in RwLs. Third, we show which methods could be used to cope with challenges in RwLs. We conclude discussing the state of debate on RwLs and outline future avenues of research. [ABSTRACT FROM AUTHOR]

Skeletal muscle stem cells, called satellite cells and defined by the transcription factor PAX7, are responsible for postnatal muscle growth, homeostasis and regeneration. Attempts to utilize the regenerative potential of muscle stem cells for therapeutic purposes so far failed. We previously established the existence of human PAX7-positive cell colonies with high regenerative potential. We now identified PAX7-negative human muscle-derived cell colonies also positive for the myogenic markers desmin and MYF5. These include cells from a patient with a homozygous PAX7 c.86-1G > A mutation (PAX7null). Single cell and bulk transcriptome analysis show high intra- and inter-donor heterogeneity and reveal the endothelial cell marker CLEC14A to be highly expressed in PAX7null cells. All PAX7-negative cell populations, including PAX7null, form myofibers after transplantation into mice, and regenerate muscle after reinjury. Transplanted PAX7neg cells repopulate the satellite cell niche where they re-express PAX7, or, strikingly, CLEC14A. In conclusion, transplanted human cells do not depend on PAX7 for muscle regeneration. Skeletal muscle stem cells express the transcription factor Pax7. Here, the authors isolate, from human muscle, cells that are positive for the endothelial marker CLEC14A and show that despite not expressing pax7, these cells regenerate muscle and contribute to the muscle stem cell niche when transplanted into mice. [ABSTRACT FROM AUTHOR]

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Generation of a barrier in multi-layered epithelia like the epidermis requires restricted positioning of functional tight junctions (TJ) to the most suprabasal viable layer. This positioning necessitates tissue-level polarization of junctions and the cytoskeleton through unknown mechanisms. Using quantitative whole-mount imaging, genetic ablation, and traction force microscopy and atomic force microscopy, we find that ubiquitously localized E-cadherin coordinates tissue polarization of tension-bearing adherens junction (AJ) and F-actin organization to allow formation of an apical TJ network only in the uppermost viable layer. Molecularly, E-cadherin localizes and tunes EGFR activity and junctional tension to inhibit premature TJ complex formation in lower layers while promoting increased tension and TJ stability in the granular layer 2. In conclusion, our data identify an E-cadherin-dependent mechanical circuit that integrates adhesion, contractile forces and biochemical signaling to drive the polarized organization of junctional tension necessary to build an in vivo epithelial barrier. [ABSTRACT FROM AUTHOR]

Treatment of patients with Parkinson's disease in specialized units is quite common in Germany. Data on the benefit of this hospitalization of patients with Parkinson's disease on motor and non-motor symptoms in conjunction with standardized tests are rare. Objective was to determine the efficacy of this therapeutic setting. We scored disease severity and performed clinical tests, respectively, instrumental procedures under standardized conditions in consecutively referred in-patients initially and at the end of their hospital stay. There was a decrease of motor and non-motor symptoms. The extent of improvement of non-motor and motor symptoms correlated to each other. Performance of complex movement sequences became better, whereas execution of simple movement series did not ameliorate. The interval for the timed up and go test went down. We demonstrate the effectiveness of an in-patient stay in a specialized unit for Parkinson's disease. Objective standardized testing supplements subjective clinical scoring with established rating scales. [ABSTRACT FROM AUTHOR]

Unlabelled: The aim of this study was to characterize the phenotype and treatment of young patients (manifestation <30 years) with diabetes of mitochondrial origin (DMO), based on the German/Austrian DPV (Diabetes Patienten Verlaufsdokumentation) registry. Only 13 (0.02 %) of all patients with diabetes in this cohort were identified with DMO, mainly due to the Kearns-Sayre (n = 5), Pearson (n = 3), or mitochondrial myopathy, encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome (n = 2). The onset of DMO (14.2, interquartile range (IQR) 7.1-16 years) was later than diabetes onset in individuals with T1D but earlier than in T2D. At manifestation, patients exhibited a mild elevation of blood glucose concentrations (251, IQR 178-299 mg/dl) without ketoacidosis. They had lower body mass index (BMI) values (-1.39 ± 0.28 kg/m(2)) than peers with T1D or T2D (p < 0.0001) and higher triglycerides (211, IQR 134-574 mg/dl) than in T1D (p = 0.04) while there was a high rate of dyslipidemia (86 %). Insulin requirements (0.58, IQR 0.37-0.90 U/kg/d) were between T1D and T2D while glucometabolic control (glycated hemoglobin A1c (HbA1c) 7.4 ± 0.52 %) in DMO was comparable to age-matched T2D and stable over a 5-year follow-up.Conclusion: Primary mitochondrial disorders are a rare cause of juvenile diabetes and likely to be underdiagnosed. As there is clinical overlap with T1D and T2D, dyslipidemia and low body weight may help to identify further DMO cases.What Is Known: • In adults diabetes of mitochondrial origin (DMO) is a rare cause of non-autoimmune diabetes, affecting about 0.8 % of diabetes cases. • Common features are a maternal family history of diabetes, hearing loss and neurological abnormalities. What is New: • In our juvenile cohort 0.02 % of diabetes patients (age < 30 years) were affected by DMO, while Kearns Sayre, MELAS and Pearson syndrome were the most frequent entities. • Juvenile DMO patients exhibited dyslipidemia, higher triglycerides and a lower BMI than peers with T1D or T2D, while some patients also showed retinal changes. [ABSTRACT FROM AUTHOR]

Adolescence is a developmental period marked by considerable biological, social, and psychological changes, with rates of self-reported stress on the rise mirroring those of adults. Mindfulness interventions are increasingly being implemented in high schools to improve students' stress management and psychosocial outcomes. Despite the well-researched role of primary and secondary control strategies in the management of adolescent stress, the impact of mindfulness on these attributions has not been examined. The current study addressed this gap in the extant literature. A mindfulness-based martial arts program was delivered to 17 high school students at risk for self-regulation challenges. Measures of primary and secondary control and cognitive errors were completed at pre- and post-treatment and compared to a waitlist control ( n = 18). Findings suggested that students in the mindfulness program showed significant improvements in secondary control and reductions in cognitive errors from pre- to post-treatment compared to the waitlist control. No significant group by time changes were found for primary control. Findings are discussed in relation to changes in control-related attributions associated with cognitive behavioral therapy, with specific consideration of possible mechanisms by which mindfulness may improve secondary control and decrease cognitive errors. Directions for future research are discussed. [ABSTRACT FROM AUTHOR]

This study examined the frequency, nature and proximity of service contacts among victims and perpetrators of intimate partner homicide in Victoria, Australia. A retrospective review was conducted of coroner's records of 120 intimate partner homicides for the period 2000-2008. In 91 (75.8 %) of the cases, one or both parties had contact with a service in the 12 months preceding the homicide. The justice system was the most frequent point of contact among both parties, and the healthcare system was often the first and preferred point of contact for victims and perpetrators when seeking assistance individually. Overall, perpetrators were more likely to have contact with a service than victims, and the majority of all service contacts occurred within 1 month of the homicide. This paper outlines the prevention opportunities that exist within the service system and highlights the importance of interventions and treatments directed at perpetrators of family violence. [ABSTRACT FROM AUTHOR]

Purpose: Building upon the findings of a recent qualitative investigation of women's experiences with rehabilitative vaginal dilator use, the primary goal of this article is to outline a set of preliminary clinical care recommendations that health care professionals may draw upon in addressing women's unique experiences with vaginal dilator use including their multifaceted struggles with the procedure, possibly enhancing adherence to this practice. Methods: Ten women participated in in-depth interviews regarding their experiences with using the dilator as prescribed by their health care providers. Following the analysis of these interviews, members of the interdisciplinary research team met to review and discuss the development of clinical care recommendations stemming from these findings. Results: Eight care recommendations aimed at addressing the concerns expressed by the women interviewed and at improving women's overall experiences with rehabilitative dilator use emerged: (1) introduce the dilator in a light and straightforward manner; (2) enhance dilator accessibility; (3) introduce the vaginal dilator early on in treatment; (4) emphasize health maintenance over intercourse as a benefit of dilator use; (5) explore and acknowledge women's values and views of sexuality; (6) increase awareness and sensitivity to emotional reactions; (7) enhance psychoeducational resources for supporting vaginal dilator use; and (8) ensure consistent institutional practice when introducing the dilator. Conclusion: The clinical care recommendations proposed here reflect the various challenges women may encounter when using the vaginal dilator-which vary from practical to, for some, profoundly emotional-and are designed to better position health care providers to help women navigate these challenges. [ABSTRACT FROM AUTHOR]

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Unlabelled: So far in Europe, no studies have been published on the structuring of medical care for obese children and adolescents. Besides anthropometric parameters, evaluations of the cardiovascular risk factors hypertension, dyslipidaemia, impaired glucose metabolism and treatment modalities were documented in a standardised multicentre evaluation survey (APV) of 18 primarily outpatient and nine rehabilitation institutions. In total, 3837 children (aged 2-20 years) took part in the years 2000 up to March 2003, of whom 1985 were treated in outpatient institutions and 1852 in rehabilitation institutions. Of these children, 10% were overweight, 37% obese, 49% extremely obese and 4% of normal weight at initial presentation. The frequencies of diagnostic procedures performed and documented were low (measurement of blood pressure 43%, lipids 40%, glucose metabolism 21%). In the subgroup of obese children who were screened for cardiovascular risk factors, 23% suffered from hypertension, 11% displayed increased cholesterol, 9% increased low-density lipoprotein-cholesterol, 29% increased triglycerides, 11% decreased high-density lipoprotein-cholesterol and 6% had impaired glucose metabolism.Conclusion: Despite the high prevalence of cardiovascular risk factors in obese children and adolescents confirmed in this report, diagnostic procedures failed in a considerable percentage even in specialised treatment centres for obese children and adolescents. In future, the feedback based on standardised evaluation of diagnostic and treatment procedures should aim to improve the quality of medical care. [ABSTRACT FROM AUTHOR]

Identifies the barriers to community participation in road safety activities in Australia. Process of community development; Problems of health promotion and road safety programs; Strategies in reducing the barriers.

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Excess dietary fat has been implicated in the etiology of obesity. Methods: This study examined the fat intake of three weight groups, normal (20.0 < BMI < 27.0), moderately obese (27.1 < BMI < 39.9) and severely obese (BMI > 40.0). Each group contained 50 subjects. Detailed 3-day food records were used to gather the nutritional data. Anthropometric and sociodemographic information was also collected. Results: Overall fat intake was 89±42 g/day or 37 ± 10% of total energy. Total fat (g/1000 kcalories) intake was found to be significantly higher in the obese groups (p < 0.05). Subjects in the moderately and severely obese groups consumed significantly more fat and cholesterol and less carbohydrate than did normal weight subjects. Compared to the normal weight subjects, obese subjects also had higher intakes of saturated, monounsaturated and polyunsaturated fat (as a percentage of dietary energy). There was no difference in energy or protein intake, and P/S ratio among the three groups. BMI was strongly positively correlated with total fat, saturated, monounsaturated, polyunsaturated fat, cholesterol, and protein intake (as g/day only), and negatively correlated with carbohydrate intake and the CHO/FAT ratio. Energy intake was not significantly associated with BMI. Conclusion: A high fat diet may promote obesity, independently of its calorie contribution. [ABSTRACT FROM AUTHOR]

Copyright of Experientia is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)