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BackgroundVascular access is essential for the efficient treatment of critically ill children, but it can be difficult to obtain. Our study was conducted to analyze the feasibility and short-term safety of intraosseous access (IO) use as well as factors influencing its success and the incidence of complications in pediatric emergencies and resuscitation. This dataset of systematically documented intraosseous access attempts constitutes one of the largest published in the literature.MethodsTwo-year nationwide prospective surveillance study in Germany from July 2017 to June 2019. Pediatric hospitals anonymously reported the case data of all children aged 28 days to 18 years who arrived with or were treated with an intraosseous access to the German Pediatric Surveillance Unit (GPSU). The main outcomes were the occurrence of complications, overall success and success at the first attempt. The influence of individual factors on outcomes was evaluated using multivariate regression models.ResultsA total of 417 patients underwent 549 intraosseous access attempts. The overall rates of success and success at the first attempt were 98.3% and 81.9%, respectively. Approximately 63.6% of patients were successfully punctured within 3 min from the time of indication. Approximately 47.7% of IO access attempts required patient resuscitation. Dislocation [OR 17.74 (5.32, 59.15)] and other complications [OR 9.29 (2.65, 32.55)] occurred more frequently in the prehospital environment. A total of 22.7% of patients experienced minor complications, while 2.5% of patients experienced potentially severe complications.ConclusionWe conclude that intraosseous access is a commonly used method for establishing emergency vascular access in children, being associated with a low (age-dependent) rate of severe complications and providing mostly reliable vascular access despite a relatively high rate of dislocation.

ABSTRACT Magnetotactic bacteria (MTB) produce magnetosomes, which are sensory organelles consisting of nanocrystals of a magnetic iron mineral enclosed by membranes. In the well-characterized Magnetospirillum species of the Alphaproteobacteria, magnetosomes align and form highly ordered chains along filaments that consist of the bacterial actin homolog MamK. The MamK protein is part of a multi-component “magnetoskeleton” that controls the concatenation, positioning, and partitioning of the magnetosome chains (MCs) which serve as cellular compass for efficient navigation in the Earth’s magnetic field. MamK is highly conserved in all MTB; however, it is unknown whether its magnetoskeletal function is preserved, especially in those MTB which exhibit distinct and more complex architectures of MCs and often contain additional putative magnetoskeletal constituents such as the actin-like protein Mad28 with as yet-unknown functions. Here, we studied the ability of magnetosome-associated actins from a wide range of diverse MTB to rescue well-characterized magnetoskeleton mutants of the model Magnetospirillum gryphiswaldense. We found that MamK orthologs from Alpha-, Delta-, Candidatus Etaproteo-, and Nitrospirota-MTB as well as a resurrected MamK LUCA version restored MC assembly to varying degrees and exhibited filamentous localization in M. gryphiswaldense and E. coli. We also identified a novel magnetosome-related protein from the magnetotactic alphaproteobacterium Magnetovibrio blakemorei that substitutes the function of the well-characterized MamJ protein as a molecular adaptor tethering magnetosomes to MamK filaments. Moreover, we demonstrate that Mad28 orthologs from Thermodesulfobacteriota and Nitrospirota are actin-like proteins that can functionally complement mamK mutants of M. gryphiswaldense and which form filamentous structures in vivo and in vitro. IMPORTANCE To efficiently navigate within the geomagnetic field, magnetotactic bacteria (MTB) align their magnetosome organelles into chains, which are organized by the actin-like MamK protein. Although MamK is the most highly conserved magnetosome protein common to all MTB, its analysis has been confined to a small subgroup owing to the inaccessibility of most MTB. Our study takes advantage of a genetically tractable host where expression of diverse MamK orthologs together with a resurrected MamK LUCA and uncharacterized actin-like Mad28 proteins from deep-branching MTB resulted in gradual restoration of magnetosome chains in various mutants. Our results further indicate the existence of species-specific MamK interactors and shed light on the evolutionary relationships of one of the key proteins associated with bacterial magnetotaxis.

Background: Team-sport players have a particularly high injury risk. Although female sex is considered a risk factor, it is still unknown whether female and male team-sport players, in fact, differ in their injury rates. We aimed to compare injury rates between female and male players by systematically reviewing and meta-analyzing injury surveillance studies of both sexes in order to evaluate sex-specific differences in team-sport injuries. Methods: Studies that prospectively collected injury data for high-level female and male players (age ≥16 years) in basketball, field hockey, football (soccer), handball, rugby (union and sevens), and volleyball were included. Two reviewers (AZ and ALR) independently assessed study quality and extracted data for overall, match, training, and severe injuries (>28 days’ time loss) as well as data regarding injury locations and types. Incidence rate ratios (IRRs) were pooled in a meta-analysis, and meta-regression analysis was performed when 10 or more studies were available. Results: Of 20 studies, 9 studies reported injury data from football, 3 studies from rugby, 3 studies from handball, 1 study from basketball, 1 study from field hockey, 2 studies from volleyball, and 1 study from basketball and field hockey. For overall injuries, the pooled IRR = 0.86 (95% confidence interval (95%CI): 0.76−0.98) indicated significantly more injuries in male than in female players. For injury location, the pooled IRR showed higher injury rates in male athletes than in female athletes for upper extremity, hip/groin, thigh, and foot injuries. Female players had a significantly higher rate of anterior cruciate ligament injuries (IRR = 2.15, 95%CI: 1.27−3.62) than male players. No significant sex-specific differences in IRR were found for match, training, severe injuries, concussions, or ankle sprains. Conclusion: Our meta-analysis provides evidence for sex-specific differences in the injury rates in team sports. Further epidemiological studies including both sexes in sports other than football are needed in order to strengthen the evidence.

BackgroundThis was a prospective surveillance study to investigate reports on the safety and frequency of use of intraosseous (IO) access in neonates.MethodsOver a two-year period, paediatric hospitals in Germany were asked to report all cases of IO access to the nationwide Surveillance Unit for Rare Paediatric Diseases (ESPED). Hospitals reporting a case submitted responses via an anonymised electronic questionnaire, providing details on indication, success rate, system used, location, duration to first successful IO access, complications, alternative access attempts and short-term outcome. We present a subset of data for IO use in infants of less than 28 days.ResultsA total of 161 neonates (145 term and 16 preterm born infants) with 206 IO access attempts were reported. In 146 neonates (91%), IO access was successfully established, and success was achieved with the first attempt in 109 neonates (75%). There was no significant impact of gestational age or provider’s educational level on success rates. In 71 infants with successful IO access (79%), the estimated duration of placement was less than 3 min. The proximal tibia was the predominant site used. A semiautomatic battery-driven device was used in 162 attempts (88%). The most often applied medications via IO access were crystalloid fluid and adrenaline. Potentially severe complications occurred in 9 patients (6%).ConclusionWithin this surveillance study, IO access in neonates was feasible and safe. IO access is an important alternative for vascular access in neonates.

Whereas the world around us changes radically, innovations in the school system tend to be extremely slow. In the era of digitalization this is particularly unfortunate, since kids urgently need to acquire skills that teachers were not prepared to teach. This situation calls for new models of education. This case study is about implementing one such model, namely applying the Stanford Design Thinking Method to let pupils design elements of their life like schoolbags, classrooms and robots, and implement prototypes using technologies such as Minecraft, Micro:bit, and Lego Education. In the innovative educational intervention 'MadeByKids', the DaVinci Lab, an external organization, worked with pupils (at grade K2 to K6, in sum about 450 children), in a series of three workshops at 17 Austrian schools. We researched the workshops via a case study on essential features of the intervention and by quantitative and qualitative pre-test and post-test questionnaires of pupils. Results show that pupils learn meaningfully regarding programming as well as social competences and most of them enjoy this kind of active learning. Results also indicate clearly that - even though the intervention is centered at children - their teachers need to be intensively included, otherwise a remarkable share of them may experience a loss of control over their class and remain skeptical. Besides discussing the results of the survey, the authors address the challenge of sustainability and share important learnings from the project.

ABSTRACT Magnetotactic bacteria (MTB) are of special scientific interest due to the formation of magnetosomes, intracellular membrane-enveloped magnetite crystals arranged into a linear chain by a dedicated cytoskeleton. Magnetotaxis relies on the formation and proper inheritance of these unique magnetic organelles, both of which need to be coordinated with the segregation of other cellular content such as chromosomes or motility and chemotaxis related structures. Thus, elaborated mechanisms are required in MTB to coordinate and maintain a high level of spatial and temporal subcellular organization during cytokinesis. However, thus far, underlying mechanisms and polarity determinants such as landmark proteins remained obscure in MTB. Here, we analyzed an ortholog of the polar organizing protein Z in the alphaproteobacterium Magnetospirillum gryphiswaldense termed PopZMgr. We show that deletion of the popZMgr gene causes abnormal cell elongation, minicell formation, DNA missegregation, and impairs motility. Overproduction of PopZMgr results in PopZ-rich regions near the poles, which are devoid of larger macromolecules, such as ribosomes, chromosomal DNA, and polyhydroxybutyrate (PHB) granules. Using superresolution microscopy, we show that PopZMgr exhibits a bipolar localization pattern throughout the cell cycle, indicating that the definition of new poles in M. gryphiswaldense occurs immediately upon completion of cytokinesis. Moreover, substitution of PopZ orthologs between M. gryphiswaldense and the related alphaproteobacterium Caulobacter crescentus indicated that PopZ localization depends on host-specific cues and that both orthologs have diverged to an extent that allows only partial reciprocal functional complementation. Altogether, our results indicate that in M. gryphiswaldense, PopZ plays a critical role during cell division and segregation of cellular content. IMPORTANCE Magnetotactic bacteria (MTB) share the unique capability of magnetic navigation, one of the most complex behavioral responses found in prokaryotes, by means of magnetosomes, which act as an internal compass. Due to formation of these unique nanoparticles, MTB have emerged as a model to study prokaryotic organelle formation and cytoskeletal organization in conjunction with complex motility systems. Despite the high degree of subcellular organization required in MTB, less is known about cell-cycle-related factors or proteins responsible for spatiotemporal polarity control. Here, we investigate the function of the polar organizer PopZ in the magnetotactic alphaproteobacterium Magnetospirillum gryphiswaldense. Although PopZ is widely distributed among the alphaproteobacteria, its function in MTB belonging to this class has remained unexplored. Our results suggest that in M. gryphiswaldense, PopZ has a key role during cell division and subcellular organization. Furthermore, we show that PopZ localization and function differ from other nonmagnetotactic alphaproteobacterial model organisms.

Die Vorstellung unterschiedlicher Möglichkeiten des Einsatzes von digitalen Spielen für soziale Inklusion bildet den Fokus dieses Artikels. In dem Zusammenhang wird beschrieben, was soziale Inklusion ist und das Potenzial von digitalen Spielen für soziale Inklusion umrissen. Anschließend werden erprobte Unterrichtsszenarien vorgestellt. Diese setzen sich zusammen aus, dem Setting, dem Ablauf und den zentralen Elementen der Szenarien sowie digitalen Spielen und spielbasierter Dialoge. Es wird gezeigt, wie sich Spiele und spielbasierte Dialoge kombinieren lassen und welche didaktischen Verläufe im Unterricht einsetzbar sind. Abschließend werden erste Forschungsergebnisse zum Einsatz von digitalen Spielen für soziale Inklusion diskutiert. Die Erprobung der inklusiven Unterrichtsszenarien hat gezeigt, dass der Einsatz von Spielen in Kombination mit spielbasierten Dialogen einen wichtigen Anstoß für die Thematisierung von zentralen Problemlagen gibt bzw. geben kann. Gleichzeitig hilft das Herstellen einer spielerischen und angenehmen Atmosphäre, frei über die Auswirkungen von Krisen auf die persönliche Lebenswelt sowie den Schulalltag zu sprechen. Spiele bieten dabei einen Anlass, bestehende Konflikte in der Klasse sichtbar zu machen. Gleichzeitig kann dadurch sichergestellt werden, dass eine handhabbare Eskalationsstufe nicht überschritten wird. Spielbasierte Dialoge sind dabei ein unverzichtbarer Bestandteil von inklusiven Unterrichtsszenarien, weil in dieser Phase zentrale Emotionen, Problemlagen, Bedürfnisse und Konflikte, die in den Spieleinheiten aufgekommen sind, thematisiert und ggf. aufgelöst werden können. Gleichzeitig bieten die spielbasierten Dialoge einen Anlass, die spielerische und lustvolle Atmosphäre in der gemeinsamen Diskussion weiterzuführen und weiterhin Freude aneinander zu haben.