Search

Zusammenfassung Hintergrund Die COVID-19-Pandemie hat das Lernen und die Gesundheit von Kindern und Jugendlichen beeinflusst. Ziel des Beitrags ist, psychische Auffälligkeiten von SchülerInnen im Pandemieverlauf, familiäre Belastungen sowie Unterstützungsbedarf in Abhängigkeit von der Schulform zu untersuchen. Ansätze schulischer Prävention und Gesundheitsförderung werden diskutiert. Methodik Datengrundlage sind die bevölkerungsbezogene COPSY(COrona und PSYche)-Studie (T1: 05/2020 – T4: 02/2022) und die BELLA-Studie (T0, präpandemischer Vergleich). Je Messzeitpunkt (T) wurden etwa 1600 Familien mit Schulkindern im Alter von 7 bis 19 Jahren befragt. Psychische Auffälligkeiten wurden mittels SDQ erfasst, familiäre Belastungen und Unterstützungsbedarfe mittels Einzelitems im Elternbericht. Ergebnisse Psychische Auffälligkeiten haben bei SchülerInnen aller Schulformen zugenommen und stabilisieren sich seither auf hohem Niveau. Besonders betroffen sind GrundschülerInnen (Anstieg von 16,9 % präpandemisch auf 40,0 % zu T2), v. a. bei Verhaltensauffälligkeiten (11,7 % auf 24,6 %) und Hyperaktivität (13,9 % auf 34,0 %). SchülerInnen der Haupt‑/Real‑/Gesamtschule zeigen ebenfalls verstärkte psychische Auffälligkeiten (21,4 % auf 30,4 %). Pandemiebedingte Belastungen sind durchgehend hoch, ebenso der Unterstützungsbedarf von Familien, der sich v. a. an Schule/Lehrende sowie ExpertInnen richtet. Diskussion Es besteht ein hoher Bedarf an Maßnahmen der psychischen Gesundheitsförderung und Prävention im Setting Schule. Diese sollten ab dem Grundschulalter im Sinne eines Whole School Approach auf verschiedenen Ebenen ansetzen und außerschulische Akteure einbeziehen. Es bedarf verbindlicher gesetzlicher Vorgaben in allen Bundesländern, um Rahmbedingungen und Strukturen der schulischen Gesundheitsförderung und Prävention, einschließlich der dafür benötigten Ressourcen, zu schaffen.

Analyzing COVID-19-related stress in children with affective dysregulation (AD) seems especially interesting, as these children typically show heightened reactivity to potential stressors and an increased use of maladaptive emotion regulation strategies. Children in out-of-home care often show similar characteristics to those with AD. Since COVID-19 has led to interruptions in psychotherapy for children with mental health problems and to potentially reduced resources to implement treatment strategies in daily life in families or in out-of-home care, these children might show a particularly strong increase in stress levels. In this study, 512 families of children without AD and 269 families of children with AD reported on COVID-19-related stress. The sample comprised screened community, clinical, and out-of-home care samples. Sociodemographic factors, characteristics of child and caregiver before the pandemic, and perceived change in external conditions due to the pandemic were examined as potential risk or protective factors. Interestingly, only small differences emerged between families of children with and without AD or between subsamples: families of children with AD and families in out-of-home care were affected slightly more, but in few domains. Improvements and deteriorations in treatment-related effects balanced each other out. Overall, the most stable and strongest risk factor for COVID-19-related stress was perceived negative change in external conditions—particularly family conditions and leisure options. Additionally, caregiver characteristics emerged as risk factors across most models. Actions to support families during the pandemic should, therefore, facilitate external conditions and focus on caregiver characteristic to reduce familial COVID-19-related stress. Trial registration: German Clinical Trials Register (DRKS), ADOPT Online: DRKS00014963 registered 27 June 2018, ADOPT Treatment: DRKS00013317 registered 27 September 2018, ADOPT Institution: DRKS00014581 registered 04 July 2018.

The categorical approach of diagnosing mental disorders entails the problem of frequently occurring comorbidities, suggesting a more parsimonious structure of psychopathology. In this study, we therefore aim to assess how affective dysregulation (AD) is associated with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) in children. To assess AD in children aged 8–12 years (n = 391), we employed the parent version of a newly constructed parent rating scale. Following item reduction, we conducted exploratory and confirmatory factor analyses to establish a factorial structure of AD. One core dimension was identified, comprising irritability and emotional impulsivity, and two smaller dimensions, comprising positive emotionality and exuberance. Subsequently, we examined five different latent factor models – a unidimensional model, a first-order correlated factor model, a second-order correlated factor model, a traditional bifactor model, and a bifactor S-1 model, in which the first-order factor AD-Irritability/Emotional Impulsivity (II) was modeled as the general reference factor. A bifactor S-1 model with the a priori defined general reference domain AD-II provided the best fit to our data and was straightforward to interpret. This model showed excellent model fit and no anomalous factor loadings. This still held true, when comparing it to bifactor S-1 models with ADHD/ODD-related reference factors. Differential correlations with emotion regulation skills and the established Parent Proxy Anger Scale validate the interpretation of the different dimensions. Our results suggest that irritability/emotional impulsivity might be a common core feature of ADHD and ODD.

The Gallbladder Reporting and Data System (GB-RADS) ultrasound (US) risk stratification is proposed to improve consistency in US interpretations, reporting, and assessment of risk of malignancy in gallbladder wall thickening in non-acute setting. It was developed based on a systematic review of the literature and the consensus of an international multidisciplinary committee comprising expert radiologists, gastroenterologists, gastrointestinal surgeons, surgical oncologists, medical oncologists, and pathologists using modified Delphi method. For risk stratification, the GB-RADS system recommends six categories (GB-RADS 0–5) of gallbladder wall thickening with gradually increasing risk of malignancy. GB-RADS is based on gallbladder wall features on US including symmetry and extent (focal vs. circumferential) of involvement, layered appearance, intramural features (including intramural cysts and echogenic foci), and interface with the liver. GB-RADS represents the first collaborative effort at risk stratifying the gallbladder wall thickening. This concept is in line with the other US-based risk stratification systems which have been shown to increase the accuracy of detection of malignant lesions and improve management. Graphical abstract: [Figure not available: see fulltext.].

Gender differences in mental health emerge as early as in childhood and adolescence, highlighting the potential need for gender-specific child and adolescent mental health care. However, it is unclear how gender-specific child and adolescent mental health care is implemented and whether its’ approaches are useful. Therefore, this study reviews gender-specific interventions and their effectiveness for child and adolescent mental health. Five databases were searched for articles published between 2000 and 2021. In total, 43 studies were included. Most interventions were conducted in school (n = 15) or community settings (n = 8). Substance-related disorders (n = 13) and eating disorders (n = 12) were addressed most frequently. Most interventions targeted girls (n = 31). Various gender-specific aspects were considered, including gender-specific risk and protective factors (n = 35) and needs (n = 35). Although most interventions yielded significant improvements in mental health outcomes (n = 32), only few studies reported medium or large effect sizes (n = 13). Additionally, there was a lack of strong causal evidence derived from randomized controlled trials, calling for more rigorous trials in the research field. Nevertheless, our findings indicate that gender-specific mental health care can be a promising approach to meet gender-specific mental health needs.

Background The present study aimed at the translation and cross-cultural adaptation of six PROMIS® pediatric self- and proxy- item banks and short forms to universal German: anxiety (ANX), anger (ANG), depressive symptoms (DEP), Fatigue (FAT), pain interference (P) and peer relationships (PR). Methods Using standardized methodology approved by the PROMIS Statistical Center and in line with recommendations of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) PRO Translation Task Force, two translators for each German-speaking country (Germany, Austria, and Switzerland) commented on and rated the translation difficulty and provided forward translations, followed by a review and reconciliation phase. An independent translator performed back translations, which were reviewed and harmonized. The items were tested in cognitive interviews with 58 children and adolescents from Germany (16), Austria (22), and Switzerland (20) for the self-report and 42 parents and other caregivers (Germany (12), Austria (17), and Switzerland (13)) for the proxy-report. Results Translators rated the translation difficulty of most items (95%) as easy or feasible. Pretesting showed that items of the universal German version were understood as they were intended, as only 14 out of 82 items of the self-report and 15 out of 82 items of the proxy-report versions required minor rewording. However, on average German translators rated the items more difficult to translate (M = 1.5, SD = 0.20) than the Austrian (M = 1.3, SD = 0.16) and the Swiss translators (M = 1.2, SD = 0.14) on a three-point Likert scale. Conclusions The translated German short forms are ready for use by researchers and clinicians (https://www.healthmeasures.net/search-view-measures).

Sclerotium rolfsii Sacc causes serious yield loss of Pippali (Piper longum Linn.). Catkin, the fruit of Pippali is directly used in medicinal industry so, use of chemical fungicides is not encourages for the cultivation of Pippali. The present study was carried out to bring orgnaic management strategy of the crop. Six native isolates of fungal and bacterial antagonists were tested against S. rolfsii and found T. harzianum was found as the best agents. In in vitro studies, sclerotial production was found drastically reduced when exposed to biocontrol agents. Result on field experiment showed that soil application of mustard oil cake (MOC) @ 1 kg/2X2 m2 plot fortified with T. harzianum @ 5 ml/m2 found effective in managing the basal rot with disease reduction upto 10.65% with increased plant growth parameters. This was followed by soil application of T. harzianum @ 5 ml/m2 with disease incidence of 14.98%.

Background The Symptom Checklist (SCL) developed by the Health Behaviour in School-aged Children (HBSC) study is a non-clinical measure of psychosomatic complaints (e.g., headache and feeling low) that has been used in numerous studies. Several studies have investigated the psychometric characteristics of this scale; however, some psychometric properties remain unclear, among them especially a) dimensionality, b) adequacy of the Graded Response Model (GRM), and c) measurement invariance across countries. Methods Data from 229,906 adolescents aged 11, 13 and 15 from 46 countries that participated in the 2018 HBSC survey were analyzed. Adolescents were selected using representative sampling and surveyed by questionnaire in the classroom. Dimensionality was investigated using exploratory graph analysis. In addition, we investigated whether the GRM provided an adequate description of the data. Reliability over the latent variable continuum and differential test functioning across countries were also examined. Results Exploratory graph analyses showed that SCL can be considered as one-dimensional in 16 countries. However, a comparison of the unidimensional with a post-hoc bifactor GRM showed that deviation from a hypothesized one-dimensional structure was negligible in most countries. Multigroup invariance analyses supported configural and metric invariance, but not scalar invariance across 32 countries. Alignment analysis showed non-invariance especially for the items irritability, feeling nervous/bad temper and feeling low. Conclusion HBSC-SCL appears to represent a consistent and reliable unidimensional instrument across most countries. This bodes well for population health analyses that rely on this scale as an early indicator of mental health status.

Acyclovir may cause acute kidney injury (AKI) due to the accumulation of relatively insoluble acyclovir crystals in renal tubules. The aim of this study was to evaluate risk factors associated with acyclovir-related AKI in children. Between January 2010 and December 2019, pediatric recipients of intravenous (IV) acyclovir were evaluated retrospectively. There were a total of 472 patients [249 (52.7%) boys] of which 32 (6.8%) had AKI [15 (46.8%) boys]. Patients with AKI had greater mean age, baseline creatinine level, and duration of treatment compared to patients without AKI (p 100.5 months, 1500 mg/m2/day dosage, concomitant use of nephrotoxic drugs). Acyclovir dosing should be evaluated in prospective, multicenter studies in order to identify the lowest possible therapeutic doses that do not increase AKI risk. What is Known: • Although acyclovir is mostly well tolerated, nephrotoxicity may be seen due to the accumulation of acyclovir crystals in renal tubules. • Older age, obesity, and concomitant use of other nephrotoxic drugs are reported to be risk factors for acyclovir-induced AKI in children. What is New: • In this study, pediatric patients with acyclovir-induced AKI were older, received treatment longer, received concomitant nephrotoxic drugs more commonly, and had higher acyclovir dosage and baseline creatinine levels compared to those without AKI. • Being older than 100.5 months of age, use of 1500 mg/m2/day dosage and use of nephrotoxic drugs concomitantly appear to be the prominent risk factors for AKI development in children treated with acyclovir.

This study aims to investigate the best route to increase the recovery of oxide-sulfide copper ore. Among various methods, using nanoparticles is more desirable because of their high efficiency. So, ZnO nanoparticles were synthesized and surface modified via anionic sodium dodecyl sulfate (SDS) surfactants. The results showed a recovery increased increase from 27.37 to 38% using the ZnO nanoparticles. Moreover, it was observed that changing pH could leads to some changes in the recovery value. According to the results, because of changing the surface charge of ZnO nanoparticles with pH and anionic SDS, the recovery will vary in various PH values. Besides, it was found that increasing the concentration of nanoparticles modified with SDS (from 2.25 to 7.5 ml) leads to an increase in the recovery (from 77 to 88%), indicating the synergistic effect of SDS on nanoparticles.

The National Cancer Institute (NCI) Genomic Data Commons (GDC) contains more than 2.9 petabytes of genomic and associated clinical data from more than 60 NCI-funded and other contributed cancer genomics research projects. The GDC consists of five applications over a common data model and a common application programming interface.

We describe the cytokine profiles of a large cohort of hospitalized patients with moderate to critical COVID-19, focusing on IL-6, sIL2R, and IL-10 levels before and after receiving immune modulating therapies, namely, tocilizumab and glucocorticoids. We also discuss the possible roles of sIL2R and IL-10 as markers of ongoing immune dysregulation after IL-6 inhibition. We performed a retrospective chart review of adult patients admitted to a tertiary care center with moderate to critical SARS-CoV-2 infection. Disease severity was based on maximum oxygen requirement during hospital stay to maintain SpO2 > 93% (moderate, 0–3 L NC; severe, 4–6 L NC or non-rebreather; critical, HFNC, NIPPV, or MV). All patients were treated using the institution’s treatment algorithm, which included consideration of tocilizumab for severe and critical disease. The most common cytokine elevations among all patients included IL-6, sIL2R, IFN-γ, and IL-10; patients who received tocilizumab had higher incidence of IL-6 and sIL2R elevations. Pre-tocilizumab IL-6 levels increased with disease severity (p = .0151). Both IL-6 and sIL2R levels significantly increased after administration of tocilizumab in all severity groups; IL-10 levels decreased in severe (p = .0203), but not moderate or critical, patients after they received tocilizumab. Cluster analysis revealed association between higher admission IL-6, sIL2R, and CRP levels and disease severity. Mean IL-6, sIL2R, and D-dimer were associated with mortality, and tocilizumab-treated patients with elevated IL-6, IL-10, and D-dimer were more likely to also receive glucocorticoids. Accessible clinical cytokine panels may be useful for monitoring response to treatment in COVID-19. The increase in sIL2R post-tocilizumab, despite administration of glucocorticoids, may indicate the need for combination therapy in order to modulate more than one hyperinflammatory pathway in COVID-19. We also discuss the role of cytokines as potential biomarkers for use of adjunct glucocorticoid therapy.

Subdural empyema (SDE) is a rare condition which can appear secondary to meningitis in childhood, especially in infants. This study was planned to evaluate and compare clinical and laboratory features, treatment, and outcome of children with SDE to those with acute bacterial meningitis (ABM) without SDE. The electronic medical files of 266 patients diagnosed with ABM between January 2009 and December 2019 were evaluated. Patients' demographic and clinical features, laboratory results, cranial imaging findings, treatment, and outcomes were recorded. SDE was identified in 10 patients, 3.7% of all diagnosed with meningitis. The etiology of SDE was identified in eight (80%). The most common responsible pathogen was Streptococcus pneumoniae. Cranial imaging was performed between the 2nd and 13th days of admission, and the most common reason of performing cranial imaging was persistence of fever. Two patients were healed with 4-6 weeks of antibiotic treatment without surgery, eight (80%) needed surgical intervention.Conclusion: The clinical signs and symptoms of SDE may be subtle. If the fever persists or focal neurological findings are seen during the treatment of bacterial meningitis, SDE should be suspected. Furthermore, patients with ABM who are determined to have a protein-to-glucose ratio in the cerebrospinal fluid above 4.65 should be carefully monitored for SDE development. What is known: • Subdural empyema may develop subsequently to meningitis, especially in the infant age group in whom very little is known in terms of disease characteristics. • Delay in diagnosis and treatment can cause long-term neurologic sequelae and mortality. What is new: • Persistence or relapse of fever during the treatment of acute meningitis is an important warning sign for SDE even if there are no other symptoms. • Children with subdural empyema secondary to bacterial meningitis have higher protein-to-glucose ratio in the CSF, and a threshold of ˃ 4.65 was determined to demonstrate 100% sensitivity and 50.7% specificity.

A novel nanosheet-structured material, namely graphene oxide anchored with sulfonic acid-functionalized glycerin (GO@Gl-SO3H), was prepared and characterized by FTIR, EDS, FESEM, TEM and XRD analyses. Afterward, its catalytic performance was examined for the synthesis of N,N′-alkylidene bisamides through the reaction of benzamide (2 eq.) and arylaldehydes (1 eq.) under solvent-free conditions. GO@Gl-SO3H was a highly effective catalyst for the reaction and afforded the products in high yields and short reaction times.

The critical behaviors of the antiferromagnetic spin-3/2 Ising model are studied by using the exact recursion relations (ERR) in the presence of a random crystal field on the Bethe lattice (BL). The sublattice order parameters, magnetizations, and quadrupolar moments are obtained in terms of ERRs under the effect of random crystal field which was either turned on or off with probability p and 1 - p, respectively, in a bimodal form. The nature of phase transitions, thus, the phase diagrams of the model are calculated on the (H, T) planes for the randomly changing crystal field values with probability p for the coordination numbers q = 3 and 4. It is found that the model exhibits both second- and first-order phase transitions in addition to some critical points, i.e., tricritical point (TCP), critical end point, double critical point, and isolated end point. We have also observed the reentrant behavior for some values of our system parameters.

In this study, interfacial fracture toughness was investigated experimentally and numerically in laminated composite plates with different fiber reinforcement angles bonded with adhesive. The composite plates are four-layered and the layer sequence is [0o/θ]s. DCB test was applied to composite plates reinforced with epoxy resin matrix and unidirectional carbon fiber. The experimental sample model for the DCB test was made using the ANSYS finite element package program. In the numerical study, four layered composites were prepared in three dimensions. Under critical displacement value; mode I fracture toughness at the crack tip was calculated using VCC (virtual crack closure) technique. Numerical values consistent with experimental results have presented in graphical forms. At 60o and 75° the greatest fracture toughness was obtained. In addition, numerical results have shown that fiber orientation prevents the uniform distribution of stress on the interface crack tip and causes stress accumulation, especially at the edge of the plate.

Cholecystectomy is one of the commonest general surgical procedures performed all over India. The risk of bile duct injury (BDI) during laparoscopic cholecystectomy is two to three times higher than during open cholecystectomy. The worldwide incidence of bile duct injury is 0.5% or 1 in 200 cases. BDI and its consequences result in significant morbidity and may even cause mortality. BDI increases the cost of treatment and is a common reason for a medicolegal suit against the surgeons. To minimize the incidence of BDI and to manage it timely and appropriately, a set of guidelines was deemed necessary by a group of senior surgeons during a Society of Endoscopic and Laparoscopic Surgeons of India (SELSI) meeting in 2016. Guidelines for “Safe Laparoscopic Cholecystectomy” and bile duct injury management formulated by other international societies are already available. The applicability of these guidelines to Indian subjects especially in small peripheral centers was limited. Hence, a decision was taken to form a set of guidelines for general surgeons with basic laparoscopic skills with little or no advanced laparoscopic skills. Those working in a solo practice, nursing homes, and small private hospitals at talukas or districts should have “Safe Cholecystectomy” guidelines and management of BDI suitable to their situation. These guidelines were formed after three consensus meetings and have been approved by a SELSI Expert Group.

Laparoscopic surgeries are a risk factor for raised intracranial **pressure and neurological complications. Even though rare, the consequences may be severe. One hundred and one patients of laparoscopic cholecystectomy were enrolled and were randomized into two groups: low-pressure 8 mm Hg (Group A) and high-pressure 14 mm Hg (Group B) carbon dioxide pneumoperitoneum during surgery. Fifty patients were in group A and 51 patients were in group B. Intracranial pressure was measured by measuring the optic nerve sheath diameter (ONSD) using ultrasound examination. Baseline ONSD was recorded followed by ONSD recording at various intervals: at the induction of anesthesia; 30 min, 45 min, at the end of surgery; and 30 min post surgery. The groups were comparable in terms of demographics and comorbidities. The mean age of group A was 45 years and for group B it was 45.75 years. Most common indication for surgery was symptomatic gall stone disease. Baseline ONSD in group A was 0.427 ± 0.0459 mm, whereas it was 0.412 ± 0.0412 mm in group B. There was a significant rise of ONSD (p

In the present study, qualitative simulation model of reservoir and genetic algorithm optimization model were combined based on fuzzy logic to determine the trade off curve with stochastic quantitative and qualitative objectives. According to contradictory utilities of decision makers with respect to the obtained optimum trade off curve, a model of group conflict resolution was developed in order to determine the best point on the trade off curve from the perspective of decision makers. Using the outcome of conflict resolution model which was indicative of acceptable water quality for all decision makers, the optimization model was re-run, and time series of monthly water opeartion was determined for the agreed quality of beneficiaries. Finally, with the aim of formulating timely policies of operation of the reservoir, the use of probabilistic support vector machines that have the ability to create output possibilities was suggested. The proposed model was used for the operation of 15-Khordad Dam Reservoir, Iran. The results demonstrate the efficiency and accuracy of the fuzzy optimization model as well as the importance of using group conflict resolution model to provide the utility of decision makers in the operation of the reservoir.

In this study, the pre-buckling and post-buckling behaviors of layered composite plates which were made of woven carbon fiber fabric with a circular hole in the middle were investigated experimentally and numerically. Firstly, load-displacement graphs of composite plates with different hole diameters were experimentally obtained under compressive load. Then the numerical load-displacement graphs of the plates were found with the ANSYS package program which used the finite element method. As a result, after linear buckling experimental and numerical results were found to be compatible with each other. In addition, damage behavior of plates after buckling with the aid of Tsai-Wu damage criterion was obtained similar to experimental results. The increase in hole diameter did not change the load-displacement behavior characteristics of the plates after buckling. However, it has reduced maximum damage load and maximum failure displacement. The stress at the perimeter of the hole increased significantly with the increase of the vertical displacement with immediately after the buckling but later was not significantly affected by this increase.