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AbstractWe report on the experimental observation of bright photoluminescence emission at room temperature from single unstrained GaAs quantum dots (QDs). The linewidth of a single-QD ground-state emission (≈ 8.5 meV) is comparable to the ensemble inhomogeneous broadening (≈ 12.4 meV). At low temperature (T ≤ 40 K) photon correlation measurements under continuous wave excitation show nearly perfect single-photon emission from a single GaAs QD and reveal the single photon nature of the emitted light up to 77 K. The QD emission energies, homogeneous linewidths and the thermally activated behavior as a function of temperature are discussed.

The future is unpredictable. Under these circumstances, how can we plan and construct a nuclear waste repository that is supposed to safely store the waste for up to a million years – an endeavor that may in itself take more than a hundred years? In this introduction to the special topic on the future of nuclear waste disposal, we take a first look at this question by searching the literature for answers and by giving a short overview of the current status of site selection in different countries, including possible challenges.

The future is unpredictable. Under these circumstances, how can we plan and construct a nuclear waste repository that is supposed to safely store the waste for up to a million years – an endeavor that may in itself take more than a hundred years? In this introduction to the special topic on the future of nuclear waste disposal, we take a first look at this question by searching the literature for answers and by giving a short overview of the current status of site selection in different countries, including possible challenges.

Abstract Background Walking disabilities negatively affect inclusion in society and quality of life and increase the risk for secondary complications. It has been shown that external feedback applied by therapists and/or robotic training devices enables individuals with gait abnormalities to consciously normalize their gait pattern. However, little is known about the effects of a technically-assisted over ground feedback therapy. The aim of this study was to assess whether automatic real-time feedback provided by a shoe-mounted inertial-sensor-based gait therapy system is feasible in individuals with gait impairments after incomplete spinal cord injury (iSCI), stroke and in the elderly. Methods In a non-controlled proof-of-concept study, feedback by tablet computer-generated verbalized instructions was given to individuals with iSCI, stroke and old age for normalization of an individually selected gait parameter (stride length, stance or swing duration, or foot-to-ground angle). The training phase consisted of 3 consecutive visits. Four weeks post training a follow-up visit was performed. Visits started with an initial gait analysis (iGA) without feedback, followed by 5 feedback training sessions of 2–3 min and a gait analysis at the end. A universal evaluation and FB scheme based on equidistant levels of deviations from the mean normal value (1 level = 1 standard deviation (SD) of the physiological reference for the feedback parameter) was used for assessment of gait quality as well as for automated adaptation of training difficulty. Overall changes in level over iGAs were detected using a Friedman’s Test. Post-hoc testing was achieved with paired Wilcoxon Tests. The users’ satisfaction was assessed by a customized questionnaire. Results Fifteen individuals with iSCI, 11 after stroke and 15 elderly completed the training. The average level at iGA significantly decreased over the visits in all groups (Friedman’s test, p

Introduction: The aim of this study was to analyze the results after pediatric heart transplantation (pHTx) at our single center differentiating between ABO-incompatible (ABOi) and -compatible (ABOc) procedures., Methods and Patients: We retrospectively analyzed outcomes of ABO-incompatible HTx procedures performed at our center and compared the data to ABO-compatible HTx of the same era. Eighteen children (<17 months) underwent pediatric HTx and seven of them underwent ABO-incompatible HTx between 2003 and 2015., Results: Mechanical circulatory support as bridge to transplant was necessary in 3/7 patients before ABO-incompatible HTx and in 3/11 patients before ABO-compatible HTx. Mean waiting time on the list was 36 ± 30 days for ABO-incompatible HTx and 86 ± 65 days for ABO-compatible HTx. The 5-years re-transplant free survival was 86% following ABO-incompatible and 91% after ABO-compatible. In the cohort undergoing ABO-incompatible HTx, 2 patients showed an acute cellular rejection, while early graft failure was not observed. In the cohort undergoing ABOcompatible HTx, acute cellular rejection was observed in 9/11 patients, with early graft failure occurring in nine and CVP in two. A total of ten children were listed for ABO-incompatible HTx after 2015; however, all ten underwent an ABO-compatible transplantation., Discussion: This study adds much needed information to the literature on ABOi-HTx by showing with a retrospective single center analysis that it is safe and leads to shorter waiting times. We conclude that strategies for ABOi-HTx should be elaborated further, potentially allowing more timely transplantation and thereby preventing waiting list complications such as the need for mechanical circulatory support and even death., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Rosenthal, Spickermann, Ulrich, Dalla Pozza, Netz, Haas, Schramm, Schmoeckel, Hagl, Hörer, Michel and Grinninger.)

Stress in parents has a significant impact on parenting and infant's development. However, few studies have examined cross-sectional and longitudinal links on risk and resilience of burdened families. Thus, this study aimed to investigate subjective risk and resilience factors on family well-being. Data stem from the 2015 nationwide study "Children in Germany" ("Kinder in Deutschland" - KiD 0-3). Parents of children aged zero to 3 years (N = 8.063) were recruited from random probability-sampled paediatric clinics (n = 271) across Germany. Risk and resilience variables such as parents' perceived stress (PSS-4), competence, isolation and attachment (PSI), as well as parental inner anger (items from CAP), relationship quality (DAS-4) and the child's negative emotionality (items from SGKS) were assessed at baseline in addition to demographic variables to predict parents' mental health (PHQ-4) and negative emotionality of the child at baseline (T1) and in the 2-year follow-up (T2) using linear regression models. At baseline, parents' mental health was predicted by inner anger, the child's negative emotionality and being a single parent (R 2  = 45.1%) at baseline, but only by parenting competence at the two-year-follow-up (R 2  = 25.1%). The child's negative emotionality was predicted (R 2  = 27.5%) by the child's age, and parental inner anger and competence, attachment, perceived stress, mental health as well as education background. At two-year-follow-up, the child's age, single parenthood, social welfare benefit, child's negative emotionality at baseline, relationship quality and competence were significant predictor variables (R 2  = 22.8%). This study highlights the impact of specific risk and resilience factors not only on parents' mental health but also the child's negative emotionality in the short and long-term in early childhood. Universal, but also selective prevention programs should increase parents' resilience (e.g., focusing on self-efficacy, competence, coping strategies)., (© 2024 The Authors. Stress and Health published by John Wiley & Sons Ltd.)

Aims: The aim of this study is to evaluate and compare the impact of the bicaval technique versus the biatrial technique (by Lower and Shumway) in paediatric heart transplant patients. Only a few studies investigate this matter regarding the long-term outcome after paediatric heart transplantation. We compared the two surgical methods regarding survival, the necessity of pacemaker implantation., Methods and Results: All 134 patients (aged <18 years) - (group-1) biatrial (n = 84), versus (group-2) bicaval (n = 50), who underwent heart transplantation between October 1988 and December 2021, were analysed. Freedom from events were estimated using the Kaplan-Meier method. Potential differences were analysed using the log rank test and Cox proportional hazard models. Mean ± standard deviation: Bypass time (per minutes) was higher in the group 1 as compared with group 2 (P = 0.050). Survival was not significantly different (P = 0.604) in either groups. Eighteen patients required permanent pacemaker implantation in the group 1 and only one patient required it in the group 2 (P = 0.001)., Conclusions: Paediatric heart transplantation using bicaval technique results similar long-term survival compared with the biatrial technique. The incidence of atrial rhythm disorders was significantly higher in the biatrial group, requiring a higher frequency of pacemaker implantation in this group. As a results, the bicaval technique has replaced the biatrial technique in our centre., (© 2024 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

An urban-rural comparison of family stress and early childhood intervention: Data linkage between two cross-sectional studies Abstract. Background: So far, there is insufficient information about where in Germany which families are reached by home-visiting programs and how well. One example is the provision of home-visiting program by health service professionals (LaB) in early childhood intervention. Research questions: Are there urban-rural differences in psychosocial stress among families? What differences exist in terms of expanding support services, receiving a service, and using the offered LaB? Methods: Data from a representative family survey on psychosocial stress characteristics and the use of services, and a nationwide survey of professionals on the development and expansion of early childhood intervention at the community level were linked. Analyses included descriptive statistics and regression models. Results: Most psychosocial stress characteristics were reported with similar rates in rural and urban areas. Although the LaB program is more widespread in urban regions, it was more likely to be used in rural regions when offered. LaB was more likely to be used by families with migration background, with signs of depression or anxiety of parents, and with a child with perinatal adversities, and less likely when there was a need for expansion of this service. Conclusions: The increased use in rural areas could be due to the fact that there are long distances to few centralized services. Therefore, the outreach character of the LaB program is appreciated, especially among less mobile families.

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Aim of the Study: Comparison of (stressful) living conditions and use of universal, selective and indicated prevention services in nuclear, single parent and stepfamilies with young children., Methods: Using two representative German surveys of mothers with children aged 0-3 years (KiD 0-3 2015, n=6,671, and AID:A 2019, n=1,501), mothers' reported burden and the use of various prevention services in different family types were examined descriptively and with Chi²-tests., Results: Overall, single parent families and, to some extent, stepfamilies showed increased socioeconomic stress compared to nuclear families (e. g., young motherhood, higher poverty risk). In particular, universal prevention services (e. g., prenatal classes, parent-child courses) were used less frequently by single parent families, while selective and indicated services such as family or child guidance counselling services and offers of youth welfare agencies were used more frequently., Conclusion: Increased socioeconomic stress suggests a higher need for support among single parents compared to nuclear families. Universal group offers are possibly not sufficient to meet these needs, whereas selective individual counselling offers such as pregnancy and child guidance counseling are used more frequently by single parent families and stepfamilies compared to nuclear families. There seems to be a lack of (group) offers tailored to single parent families - particularly in the first developmental phase of a child's life., Competing Interests: Die Autorinnen geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Introduction: It is now well established empirically that families and children who could not attend educational and childcare institutions during the COVID-19 pandemic experienced disadvantages. This is particularly true for families in poverty. However, little is known about the situation of families with young children. The aim of the paper is to investigate (1) to what extent families with infants and toddlers also experienced their situation during the pandemic as stressful, (2) whether there were differences depending on social class, (3) how the pandemic affected the healthy development of infants and toddlers, and (4) to what extent class-related differences can also be identified in this., Methods: The German National Centre for Early Prevention conducted a nationally representative survey of families with children of age 0 to 3 years in April to December 2022, "Kinder in Deutschland 0‑3 2022" (N = 7821). The KiD 0‑3 study combines a parent survey on family psychosocial burden and resources with pediatric documentation of child development., Results: Parents with very young children experienced their situation in the COVID-19 pandemic as stressful. A clear difference depending on social class emerged. Both from the parents' perspective and in pediatric judgment, the pandemic had a negative impact on social and affective development even in young children. These effects were more pronounced in children from families experiencing poverty than in children from families not receiving basic government benefits., Discussion: In order to mitigate the psychosocial consequences of the COVID-19 pandemic for families and to improve children's chances of growing up in a healthy way that promotes their development, it is necessary to support families in need without stigmatization., (© 2023. The Author(s).)

Background: Adverse childhood experiences (ACE) have been pointed out as risk factors for physical and mental health, with consequences extending from childhood into adulthood. Based on research regarding the effects of selected ACE as well as the accumulation of ACE, this article investigates how different types of family stressors are linked to children's negative emotionality in infancy and early childhood., Methods: Data are from the KiD 0-3 study (N = 5583) and the follow-up of a subsample after 2 years (n = 681). Based on 14 stress factors, we distinguish families with no/little stressors, socioeconomic stressors, parenting stressors, and multiple stressors., Results: Children in multiply stressed families have the highest risk of high negative emotionality (compared to unstressed families: Odds Ratios [OR] ranging from 13.00 to 6.81), controlling for demographic characteristics, child-related stress factors (e.g., excessive crying), and caregiver childhood stress. Children in families primarily characterized by parenting stress also showed a significantly increased risk of high negative emotionality (OR ranging from 8.31 to 6.95), whereas this did not hold for children from socioeconomically stressed families (without parenting stress) compared to those from unstressed families. Longitudinal analyses of the follow-up subsample showed that changes in the number of stressors were also associated with parallel changes in children's negative emotionality., Discussion: These results confirm findings from international research on ACE in Germany and for early childhood. They underline the importance of a well-developed early intervention system., (© 2023. The Author(s).)

Background: Pulmonary hypertension (PH) is diagnosed based on an invasive evaluation of the mean pulmonary artery (PA) pressure. The morphological assessment of the pulmonary arteries was only recently not feasible. With the advent of optical coherence tomography (OCT)-imaging, an accessible tool allows to study PA morphology longitudinally. The primary hypothesis was that OCT distincts the PA structure of PH patients from control subjects. The secondary hypothesis was that PA wall thickness (WT) correlates with the progression of PH., Methods: This is a retrospective monocentric study of 28 paediatric patients with (PH group) and without PH (control group) who had undergone cardiac catheterisation including OCT imaging of the PA branches. OCT parameters analysed were WT and the quotient of WT and diameter (WT/DM) and those were compared between the PH group and the control group. In addition, the OCT parameters were aligned with the haemodynamic parameters to evaluate the potential of OCT as a risk factor for patients with PH., Results: WT and WT/DM in the PH group were significantly higher compared to the control group {WT: 0.150 [0.230, range (R): 0.100-0.330] vs. 0.100 [0.050, R: 0.080-0.130] mm, P<0.001; WT/DM: 0.06 [0.05] vs. 0.03 [0.01], P=0.006}. There were highly significant correlations between WT and WT/DM with the haemodynamic parameters mean pulmonary arterial pressure (mPAP) [Spearman correlation coefficient (r s ) =0.702, P<0.001; r s =0.621, P<0.001], systolic pulmonary arterial pressure (sPAP) (r s =0.668, P<0.001; r s =0.658, P<0.001) and WT and pulmonary vascular resistance (PVR) (r s =0.590, P=0.02). Also, there was a significant correlation between WT and WT/DM and the risk factors quotient of mPAP and mean systemic arterial pressure (mSAP) (mPAP/mSAP) (r s =0.686, P<0.001; r s =0.644, P<0.001) and pulmonary vascular resistance index (PVRI) (r s =0.758, P=0.002; r s =0.594, P=0.02)., Conclusions: OCT can detect significant differences in WT of the PA in patients with PH. Furthermore, the OCT parameters correlate significantly with haemodynamic parameters and risk factors for patients with PH. More investigations are required to evaluate to what extent the impact of OCT can contribute to the clinical care of children with PH., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cdt.amegroups.com/article/view/10.21037/cdt-22-421/coif). ISN recently passed away and thus was unable to provide the form. The other authors have no conflicts of interest to declare., (2023 Cardiovascular Diagnosis and Therapy. All rights reserved.)

Background: In order for Early Childhood Intervention (ECI) to be effective, data-based information on families' resources, burden and current use of support services for families with young children, as well as on children's health and development is needed. The study Kinder in Deutschland [Children in Germany]-KiD 0-3 2022 aims at providing these data to help us understand families' situation and needs in Germany now, including families' experience of the COVID-19 pandemic., Method: The study will recruit up to 300 pediatricians who will invite parents of children aged up to 48 months to participate in the study during a well-child visit. Parents (goal N = 8,000) will complete an online-questionnaire with their own web-enabled device. Pediatricians will complete a short questionnaire about each participating family. The questionnaires cover family psychosocial burden and resources, child health and development, use of family support services, as well as the families' experiences of the COVID-19 pandemic. Data will be analyzed to assess patterns of families´ psychosocial burdens and resources, use of support services for families with young children, and children´s health and development. Concordance between parent and pediatrician report will be assessed and comparisons with the predecessor study of 2015 will be drawn., Dissemination: Findings will be disseminated through scientific conferences, open access peer-reviewed journals, and dissemination channels of the National Centre for Early Prevention., Discussion: The present study will provide parent and pediatrician reports on how families with young children are doing in Germany. These data will be used to inform Germany's early childhood intervention (ECI) program ("Frühe Hilfen") on current needs of families with young children., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Neumann et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Steep Cone Geyser is a unique geothermal feature in Yellowstone National Park (YNP), Wyoming, actively gushing silicon-rich fluids along outflow channels possessing living and actively silicifying microbial biomats. To assess the geomicrobial dynamics occurring temporally and spatially at Steep Cone, samples were collected at discrete locations along one of Steep Cone's outflow channels for both microbial community composition and aqueous geochemistry analysis during field campaigns in 2010, 2018, 2019, and 2020. Geochemical analysis characterized Steep Cone as an oligotrophic, surface boiling, silicious, alkaline-chloride thermal feature with consistent dissolved inorganic carbon and total sulfur concentrations down the outflow channel ranging from 4.59 ± 0.11 to 4.26 ± 0.07 mM and 189.7 ± 7.2 to 204.7 ± 3.55 μM, respectively. Furthermore, geochemistry remained relatively stable temporally with consistently detectable analytes displaying a relative standard deviation <32%. A thermal gradient decrease of ~55°C was observed from the sampled hydrothermal source to the end of the sampled outflow transect (90.34°C ± 3.38 to 35.06°C ± 7.24). The thermal gradient led to temperature-driven divergence and stratification of the microbial community along the outflow channel. The hyperthermophile Thermocrinis dominates the hydrothermal source biofilm community, and the thermophiles Meiothermus and Leptococcus dominate along the outflow before finally giving way to more diverse and even microbial communities at the end of the transect. Beyond the hydrothermal source, phototrophic taxa such as Leptococcus , Chloroflexus , and Chloracidobacterium act as primary producers for the system, supporting heterotrophic growth of taxa such as Raineya , Tepidimonas , and Meiothermus . Community dynamics illustrate large changes yearly driven by abundance shifts of the dominant taxa in the system. Results indicate Steep Cone possesses dynamic outflow microbial communities despite stable geochemistry. These findings improve our understanding of thermal geomicrobiological dynamics and inform how we can interpret the silicified rock record., Competing Interests: SU was employed by Arcadis, U.S., Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Rasmussen, Stamps, Vanzin, Ulrich and Spear.)

Study Aim: Psychosocial stress can complicate the first phase of life for young families. One group that has received little attention so far are families with increased parental stress and conflict potential. This paper aims to 1) classify knowledge and use of support services for families with increased parental stress and conflict potential and 2) describe the psychosocial characteristics and parenting behaviours of these families., Methods: For this purpose, data from a representative cross-sectional study in 2015 with n=7 549 families as well as the follow-up study with n=905 families were analyzed. Parents who took their child to a pediatrician's office for a screening examination (U3-U7a) completed a written questionnaire. Knowledge and use of services were assessed using four pre-defined stress groups (unstressed, socioeconomically stressed, with parental stress and conflict potential, and highly burdened)., Results: Families with increased parental stress and conflict potential are less likely to receive support offers. Despite high knowledge of selective prevention services, they use these offers less frequently than socioeconomically or highly stressed families. They are more likely to report dysfunctional parenting behaviors., Conclusion: This raises the question of whether families with increased parental stress and conflict potential receive too little support because they have no clearly visible need for help or whether they are adequately provided for due to the high socioeconomic resources, service knowledge, and use of universal medical and family education services. The results provide important information for the care of families in various stressful situations and contribute to the assessment of the need for support., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: Simulation-based medical education, an educational model in which students engage in simulated patient scenarios, improves performance. However, assessment tools including the Oxford Non-Technical Skills (NOTECHS) scale require expert assessors. We modified this tool for novice use., Methods: Medical students participated in 5 nontechnical simulations. The NOTECHS scale was modified to allow for novice evaluation. Three novices and 2 experts assessed performance, with intraclass correlation used to assess validity., Results: Twenty-two learners participated in the simulations. Novice reviewers had moderate to excellent correlation among evaluations (0.66 < intraclass correlation coefficients [ICC] < 0.95). Novice and expert reviewers had moderate to good correlation among evaluations (0.51 < ICC < 0.88)., Discussion: The modified NOTECHS scales can be utilized by novices to evaluate simulation performance. Novice assessment correlates with expert review. These tools may encourage the use of simulation-based medical education., (Copyright© Board of Regents of the University of Wisconsin System and The Medical College of Wisconsin, Inc.)

Background: Many prevention programmes for families focus parental adversities and adverse childhood experiences. Effects of such programmes are often examined in clinical trials; there is less research on effects under naturalistic conditions. The aim of this study was to examine the longitudinal association between parenting stress and child's negative emotionality, its modification through targeted prevention programmes, and to investigate the effects in the general population., Methods: Data were taken from a sample of n = 903 families with infants (mean age: 13.3 months) who participated in a baseline study (T1) and a follow-up study (T2) 2 years later. The survey included parental self-report measurements on parenting stress and child's negative emotionality (T1 and T2 each) and targeted prevention programmes (T1 only). An autoregressive cross-lagged panel design was used to analyse the association of parenting stress and the child's negative emotionality, including use of targeted prevention programmes as moderator. We also tested if targeted prevention programmes can reduce parenting stress or child's negative emotionality using Propensity Score Matching (PSM)., Results: Parenting stress at T1 affected children's negative emotionality at T2, but children's negative emotionality at T1 did not affect parenting stress at T2. When targeted prevention was included as moderator, the correlation disappeared among programme users. With PSM, there was no direct effect on parenting stress or child's negative emotionality. But a subsample of parents with high parenting stress at T1 who used targeted prevention at T1 reported less child's negative emotionality problems at T2 than parents who scored high in parenting stress but did not receive targeted prevention at T1., Conclusion: Results suggest that the spillover from parenting stress to child's negative emotionality may be modified by prevention. Prevention programmes may help to build resources and have a direct positive effect on the child, especially for parents with high parenting stress., (© 2022 The Authors. Child: Care, Health and Development published by John Wiley & Sons Ltd.)

Potentially habitable zones have been discovered on Mars today in underground areas containing perchlorate brines. Understanding the low-pressure adaptations of microorganisms is essential in learning more about what life could potentially be found on Mars today or could have existed in the distant past. Many studies have looked at low-pressure adaptations in bacteria; however, studies aimed at understanding these adaptations in archaea are scarcer. Haloferax volcanii is a species of halophilic archaea documented to tolerate high concentrations of oxidizing agents present on Mars ( i.e., perchlorates and nitrates). In this study, we expose H. volcanii to a hypobaric (2.4 kPa) and an anoxic CO 2 -enriched atmosphere in the presence of perchlorate, chlorate, and nitrate. While no growth was observed during incubation in these conditions, survivability was increased in cultures incubated in low-pressure atmospheric conditions compared to ambient Earth atmospheric pressures. Scanning electron microscopy observations showed morphological changes in low-pressure conditions not observed at ambient Earth atmospheric pressures. Results suggest that previously undocumented low-pressure adaptations in H. volcanii increase survivability in simulated subsurface martian conditions. Future experiments to understand the changes in gene expression under these conditions may be valuable to understand more about low-pressure adaptations in archaea.

Objectives: We analyzed the early and long-term survival after ABO-compatible heart transplantation in children under 3 years of age from 1991 to 2021 at our center. This retrospective and descriptive study aimed to identify serious adverse events associated with mortality after pediatric heart transplantation., Patients and Methods: 46 patients with congenital heart failure (37%) in end-stage heart failure have undergone a pediatric heart transplantation. Primary outcome of interest was survival at follow-up time., Results: Median (IQR) follow-up time (y), age (y), body-weight (kg) and BMI (kg/cm 2 ) were 13.2 (5.7-19.5), 0.9 (0.2-2.0), 6.8 (4.3-10.0) and 14.2 (12.3-15.7). Twenty-four (52%) patients were male. 15 patients (33%) had a single ventricle physiology. At 30- days survival rate was 94 ± 4%. Survival rate at 1, 5, 10 and 15 years post HTx was 87 ± 5%, 84 ± 6%, 79 ± 6% and 63 ± 8%. One child underwent re-transplantation after 4 years, and another one after 11 years - in both cases due to graft failure. Higher early mortality in patients under 3 months of age and in patients with single ventricle physiology. Transplant free survival at 15 years was in children with cardiomyopathy better (71 ± 10%) than in those with congenital heart disease (50 ± 13%). One or more previous heart surgeries prior to HTx (n = 21) were associated to more mortality., Conclusion: Pediatric heart transplantation has acceptable long-term results and is still the best therapeutic option in children with end-stage cardiac failure. Underlying anomalies and single ventricle physiology, age below 3 months had a significant impact on survival., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objectives: In the field of family health, cross-sectoral collaboration is promoted to reach vulnerable groups and overcome the prevention dilemma. To understand the extent to which these measures counteract the effects of social inequality with respect to health and social service uptake, we aim to identify socio-economic, health-related and psychosocial characteristics and patterns that are associated with the (non-)use of services., Study Design: This was a German representative cross-sectional study of 6860 mothers with a child younger than 48 months who answered the written questionnaire during child developmental examinations at paediatric practices in 2015., Methods: Associations were measured using logistic regression, and characteristics of user patterns were analysed using latent class analysis., Results: Mothers using universal services were less likely to report psychosocial stress and had more likely more socio-economic resources than mothers who did not use these services. The selective services pregnancy counselling (18.2%) were predominantly used by mothers who considered abortion during pregnancy (Odds Ratio [OR] = 3.9), mothers who received social welfare benefits (OR = 2.4), single parents (OR = 1.6) and mothers without social support (OR = 1.5). Four patterns of service use were identified: multi-service users (5.6%), low-service users (22.5%), medical service users (30.5%) and medical and social service users (41.6%). Families with less socio-economic resources were found in both the low-service group and the multi-service group; multi-users were more likely to have children with adverse perinatal characteristics and parenting stress., Conclusion: We discuss whether low-service users are hard to reach, whereas multi-users are difficult to supply. Overall, there is a need to strengthen early psychosocial support., (Copyright © 2021 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Reduced adherence after heart transplantation increases the risk for acute rejection. Therefore, the aim of this study was to evaluate the patient's satisfaction with outpatient care and quality of life (QOL) after pediatric and adult heart transplantation. Observational study after pediatric (n = 22) and adult (n = 65) heart transplantation and the parents of the pediatric patients (n = 22) to evaluate the patients' satisfaction with outpatient care and QOL. Established standardized questionnaires were used for patient satisfaction (ZAP survey) and QOL (SF36); the latter was compared with the cohort of the BGS98 survey (BGS98 cohort). ZAP score: excellent results with almost all values >80. QOL: pediatric cohort showed significantly higher values in physical functioning (P = 0.041) and role physical (P = 0.003) but significantly lower values in the sub-scale general health (P = 0.02) compared to adult cohort. In comparison with BGS98 cohort, children showed almost similar results, whereas adult cohort showed worse values in physical and emotional functioning, but higher values regarding general health. The QOL of patients after pediatric heart transplantation is comparable to a standardized reference population in Germany, whereas adult patients show reduced physical and emotional functioning, but better values regarding general health. The patients' satisfaction with the outpatient care is very high., (© 2021 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.)

Quorum sensing is a bacterial signaling system that involves the synthesis, secretion and detection of signal molecules called autoinducers. The main autoinducer in Gram-negative bacteria are acylated homoserine lactones, produced by the LuxI family of autoinducer synthases and detected by the LuxR family of autoinducer receptors. Quorum sensing allows for changes in gene expression and bacterial behaviors in a coordinated, cell density dependent manner. Quorum sensing controls the expression of virulence factors in some human pathogens, making quorum sensing an antibacterial drug target. Here we describe the design and synthesis of transition-state analogs of the autoinducer synthase enzymatic reaction and the evaluation of these compounds as inhibitors of the synthase CepI. One such compound potently inhibits CepI and constitutes a new type of inhibitor against this underdeveloped antibacterial target., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Cardiac allograft vasculopathy (CAV) and nephrotoxicity affect long-term survival after heart transplantation (HTX). Studies, mostly conducted in adults, showed a positive effect of everolimus (EVL) on these problems. We describe the effects of conversion of the immunosuppressive therapy to an everolimus including regime on CAV, renal function, and safety in heart transplanted children/adolescents., Methods: This retrospective single-center study included 36 participants (mean time after HTX 6.3 ± 4.7 years). Descriptive pre/post-comparisons were performed with an observation period partially up to 4 years. Impact on CAV was assessed based on intravascular imaging and Stanford grading. Safety analysis included cytomegalovirus (CMV)-infection and acute rejection., Results: In terms of CAV (9 out of 36 patients) four showed no progression, three an improvement, one a worsening; one new diagnosis. The average CrCl showed a significant improvement 6, 12, and 24 months after conversion regarding all patients (n = 29). There was no acute rejection or CMV-infection., Conclusion: Conversion to an EVL-based therapy after pediatric HTX is a safe immunosuppressive regime without increasing risk of acute rejection or CMV-infection. There was some evidence of reduction in progression of CAV and a significant improvement of the renal function., (© 2020 The Authors. Clinical Transplantation published by John Wiley & Sons Ltd.)

Background: Psychosocial stress in early childhood can impair children's health and development. Data on the prevalence of psychosocial stress in families with infants and toddlers in Germany are lacking. Such data could be used to determine the need for prevention and to plan the appropriate preventive measures., Methods: In 2015, a representative cross-sectional study called Kinder in Deutschland- KiD 0-3 was conducted by questionnaire in pediatricians' practices across Germany. Parents taking their children to the U3-U7a child development checks were asked to self-report information about stress in their families. The data were analyzed with descriptive statistics and chi-square tests., Results: Data from 7549 families went into the analysis. Stressful situations commonly reported by the parents included unplanned pregnancy (21.3%), parenthoodrelated stress (e.g., self-doubt as to parenting competence, 29.6%), and lack of familial and social support for problems and questions arising in relation to the child, as well as for temporary child care (19.7%). Most types of psychosocial stress varied as a function of the child's age group, as categorized by the particular examination for which the child was presenting at the time of the survey (U3-U7a). Couple distress, lack of social support, signs of depression or anxiety symptoms, or inner anger were more commonly reported by parents attending the later examina - tions. Such problems could be addressed by supportive measures (e.g., parent counseling, early child intervention)., Conclusion: Psychosocial stress affects a large percentage of the parents of small children. A large proportion of parents of small children suffer from psychosocial stress. This should be monitored for accumulation and stability across child development checks and addressed as appropriate. Family practitioners and pediatricians are important partners for effective cooperation between the social system and the health-care system, and for the provision of preventive measures where appropriate.

Background: The KiD 0-3 national main study is a cross-sectional study on adversity in early childhood and parental access to support services, conducted as part of a long-term policy program for early intervention services in Germany., Objective: To identify risk factors for child abuse, neglect and exposure to intimate partner violence (IPV) and investigate if parental use of early intervention programs or contact to child welfare services was associated with reported child maltreatment., Participants and Setting: 8063 families with infants and toddlers participated in the survey. Parents answered a written questionnaire during mandatory health checks for the child. The sampling was based on a regionally clustered model of pediatricians' practices., Methods: An automatic variable selection process was used to test risk factors and logistic regression models were employed for each outcome., Results: Significant risk factors (p < 0.05) for child abuse (1.91 %) were child age, IPV and parental stress. Neglect (0.83 %) was associated with couple distress, adverse childhood experiences, young maternal age, cramped housing, and migration history. IPV (2.98 %) was associated with child age, couple distress, depression/anxiety, harsh punishment, adverse childhood experiences, young maternal age, and poverty. Parents were more likely to use selective prevention programs in cases of child abuse and exposure to IPV., Conclusion: Child abuse is mainly associated with proximal risk factors and neglect with distal factors. Exposure to IPV violence is associated with child abuse as well as with an accumulation of adversities. The association between service use and child maltreatment is discussed., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

After publication of the original article [1] it was brought to the authors' attention that a sentence was missing in the acknowledgement section. The full acknowledgement is included in this Correction article.

Background: Although the management of patients presenting with vertigo and dizziness in primary care has been reported to be inefficient, little is known about the primary care providers' (PCPs) perspectives, needs, and attitudes regarding vertigo management. The objective of this study was to understand which challenges and barriers PCPs see when diagnosing and treating patients presenting with vertigo or dizziness. Specifically, we wanted to identify facilitators and barriers of successful guideline implementation in order to inform the development of targeted interventions., Methods: A theory-based interview structure was developed based on the implementation theory of capability, opportunity, and motivation for behaviour change (COM-B) using questions based on constructs from the Theoretical Domains Framework (TDF) and the Consolidated Framework for Implementation Research (CFIR). Transcripts of the semi-structured interviews were analysed using directed content analysis. The pathways through which guideline characteristics and supportive interventions affect the relationship between the PCPs' perceived capability, opportunity, and motivation as well as their practice of managing vertigo patients were graphically presented using the COM-B model structure., Results: Twelve PCPs from Bavaria in Southern Germany participated in semi-structured interviews. Diagnostics posed the biggest challenge in vertigo management to the PCPs. Requirements for an acceptable guideline were stakeholder involvement in the development process, clarity of presentation, and high applicability. Guideline implementation might be effectively supported through educational meetings and sustained by organisational interventions., Conclusions: From the PCPs' perspective, both guideline characteristics and interventions supporting guideline implementation may help resolve challenges in vertigo management in primary care. These results should be used to guide future interventions in the primary care setting to ensure successful and targeted patient management.

Current microbial water quality monitoring is generally limited to culture-based measurements of fecal indicator bacteria (FIB). Given the many possible sources of fecal pollution within a watershed and extra-intestinal FIB reservoirs, it is important to determine source(s) of fecal pollution as a means to improve water quality and protect public health. The principal objective of this investigation was to characterize the microbial water quality of shellfish harvesting areas in the Gulf of Nicoya, Costa Rica during 2015. In order to achieve this objective, the specificity and sensitivity of 11 existing microbial source tracking (MST) PCR assays, associated with cows (BacCow), dogs (BacCan, DogBac), domestic wastewater (PMMoV), general avian (GFD), gulls (Gull2), horses (HorseBac, HoF), humans (HF183, HPyV), and pigs (PF), were evaluated using domestic wastewater and animal fecal samples collected from the region. The sensitivity of animal-associated assays ranged from 13 to 100%, while assay specificity ranged from 38 to 100%. The specificity of pepper mild mottle virus (PMMoV) and human polyomavirus (HPyV) was 100% for domestic wastewater, as compared to 94% specificity of the HF183 Bacteroidales marker. PMMoV was identified as a useful domestic wastewater-associated marker, with concentrations as high as 1.1 × 10 5 copies/ml and 100% sensitivity and specificity. Monthly surface water samples collected from four shellfish harvesting areas were analyzed using culture-based methods for Escherichia coli as well as molecular methods for FIB and a suite of MST markers, which were selected for their specificity in the region. While culturable E. coli results suggested possible fecal pollution during the monitoring period, the absence of human/domestic wastewater-associated markers and low FIB concentrations determined using molecular methods indicated sufficient microbial water quality for shellfish harvesting. This is the first study to our knowledge to test the performance of MST markers in Costa Rica as well as in Central America. Given the lack of wastewater treatment and the presence of secondary sources of FIB, this study highlights the importance of an MST toolbox approach to characterize water quality in tropical regions. Furthermore, it confirms and extends the geographic range of PMMoV as an effective tool for monitoring domestic wastewater pollution., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Cardiac allograft vasculopathy (CAV) is a crucial problem after heart transplantation, in adults as well as in children. CAV is the main risk factor for a reduced long-term graft survival. The early diagnosis and treatment of CAV is essential for a successful long-term preservation of the donor heart. However, asymptomatic progression of CAV and concentric hyperplasia of the coronary arteries may complicate the early diagnosis by conventional measures. Intravascular imaging, such as intravascular ultrasound and optical coherence tomography (OCT), enables the diagnosis of early stage CAV. To date, there is little known about OCT in children. We present our single center experience with OCT after pediatric heart transplantation., Methods: Retrospective analysis of OCT (n=50) after pediatric heart transplantation between June 2013 and March 2016 and comparison between angiographic appearance and OCT., Results: 37 patients underwent optical coherence tomography, nine patients were examined twice and two patients tree times. The youngest patient at time of examination was 4years with a weight of 15kg (mean 50.86kg, range 15 to 88kg). There were no complications, especially no bleeding, no arrhythmias or myocardial ischemic events. Early CAV (Stanford I or II) was detected by OCT in 26 cases. Only in four of these cases, also the coronary angiography showed mild changes., Conclusion: OCT is a safe intravascular imaging method that can also be used in children after pediatric heart transplantation up to a minimum weight of 15kg without an increasing risk of a catheterization procedure., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Aims: To identify faecal pollution along the southeastern Florida coast and determine the performance of a reverse transcription-quantitative polymerase chain reaction (RT-qPCR) method for pepper mild mottle virus (PMMoV)., Methods and Results: In 2014, bimonthly surface water samples were collected from inlets, exposed to runoff and septic seepage, and coastal sites, exposed to ocean outfalls. Analysis of culturable enterococci and a suite of microbial source tracking (MST) markers (BacHum, CowM2, DogBact, HF183, HPyV, PMMoV) revealed faecal pollution, primarily of human origin, at all sites. Since PMMoV was detected more frequently than other MST markers, the process limits of quantification (undiluted to 10 -2 dilution) and detection (10 -2 dilution) for the RT-qPCR method were determined by seeding untreated wastewater into the coastal waters. Simulated quantitative microbial risk assessment, employing human norovirus as a reference pathogen, calculated a 0·286 median risk of gastrointestinal illness associated with the PMMoV limit of detection., Conclusions: All sites met the U.S. EPA recreational water criteria, despite detection of domestic wastewater-associated MST markers. PMMoV correlated only with human-associated MST markers., Significance and Impact of the Study: This study demonstrated that PMMoV is an important domestic wastewater-associated marker that should be included in the MST toolbox; therefore, future studies should thoroughly investigate the health risks associated with its detection and quantification in environmental waters., (© 2016 The Society for Applied Microbiology.)

The mitochondrial enzyme glutaminase C (GAC) catalyzes the hydrolysis of glutamine to glutamate plus ammonia, a key step in the metabolism of glutamine by cancer cells. Recently, we discovered a class of allosteric inhibitors of GAC that inhibit cancer cell growth without affecting their normal cellular counterparts, with the lead compound being the bromo-benzophenanthridinone 968. Here, we take advantage of mouse embryonic fibroblasts transformed by oncogenic Dbl, which hyperactivates Rho GTPases, together with (13)C-labeled glutamine and stable-isotope tracing methods, to establish that 968 selectively blocks the enhancement in glutaminolysis necessary for satisfying the glutamine addiction of cancer cells. We then determine how 968 inhibits the catalytic activity of GAC. First, we developed a FRET assay to examine the effects of 968 on the ability of GAC to undergo the dimer-to-tetramer transition necessary for enzyme activation. We next demonstrate how the fluorescence of a reporter group attached to GAC provides a direct read-out of the binding of 968 and related compounds to the enzyme. By combining these fluorescence assays with newly developed GAC mutants trapped in either the monomeric or dimeric state, we show that 968 has the highest affinity for monomeric GAC and that the dose-dependent binding of 968 to GAC monomers directly matches its dose-dependent inhibition of enzyme activity and cellular transformation. Together, these findings highlight the requirement of tetramer formation as the mechanism of GAC activation and shed new light on how a distinct class of allosteric GAC inhibitors impacts the metabolic program of transformed cells.

Background: Previous studies have shown that class-I histone deacetylase (HDAC) 8 mRNA is upregulated in urothelial cancer tissues and urothelial cancer cell lines compared to benign controls. Using urothelial cancer cell lines we evaluated whether specific targeting of HDAC8 might be a therapeutic option in bladder cancer treatment., Methods: We conducted siRNA-mediated knockdown and specific pharmacological inhibition of HDAC8 with the three different inhibitors compound 2, compound 5, and compound 6 in several urothelial carcinoma cell lines with distinct HDAC8 expression profiles. Levels of HDAC and marker proteins were determined by western blot analysis and mRNA levels were measured by quantitative real-time PCR. Cellular effects of HDAC8 suppression were analyzed by ATP assay, flow cytometry, colony forming assay and migration assay., Results: Efficient siRNA-mediated knockdown of HDAC8 reduced proliferation up to 45%. The HDAC8 specific inhibitors compound 5 and compound 6 significantly reduced viability of all urothelial cancer cell lines (IC₅₀ 9 - 21 μM). Flow cytometry revealed only a slight increase in the sub-G1 fraction indicating a limited induction of apoptosis. Expression of thymidylate synthase was partly reduced; PARP-cleavage was not detected. The influence of the pharmacological inhibition on clonogenic growth and migration show a cell line- and inhibitor-dependent reduction with the strongest effects after treatment with compound 5 and compound 6., Conclusions: Deregulation of HDAC8 is frequent in urothelial cancer, but neither specific pharmacological inhibition nor siRNA-mediated knockdown of HDAC8 impaired viability of urothelial cancer cell lines in a therapeutic useful manner. Accordingly, HDAC8 on its own is not a promising drug target in bladder cancer.

There is increasing interest in establishing the roles that lysine acetylation of non nuclear proteins may exert in modulating cell function. Lysine deacetylase 8 (KDAC8), for example, has been suggested to interact with α-actin and control the differentiation of smooth muscle cells. However, a direct role of smooth muscle non nuclear protein acetylation in regulating tone is unresolved. We sought to define the actions of two separate KDAC inhibitors on arterial tone and identify filament-interacting protein targets of acetylation and association with KDAC8. Compound 2 (a specific KDAC8 inhibitor) or Trichostatin A (TSA, a broad-spectrum KDAC inhibitor) inhibited rat arterial contractions induced by phenylephrine (PE) or high potassium solution. In contrast to the predominantly nuclear localization of KDAC1 and KDAC2, KDAC8 was positioned in extranuclear areas of native vascular smooth muscle cells. Several filament-associated proteins identified as putative acetylation targets colocalized with KDAC8 by immunoprecipitation (IP): cortactin, α-actin, tropomyosin, HSPB1 (Hsp27) and HSPB6 (Hsp20). Use of anti-acetylated lysine antibodies showed that KDAC inhibition increased acetylation of each protein. A custom-made antibody targeting the C-terminal acetylated lysine of human HSPB6 identified this as a novel target of acetylation that was increased by KDAC inhibition. HSPB6 phosphorylation, a known vasodilatory modification, was concomitantly increased. Interrogation of publicly available mass spectrometry data identified 50 other proteins with an acetylated C-terminal lysine. These novel data, in alliance with other recent studies, alert us to the importance of elucidating the mechanistic links between changes in myofilament-associated protein acetylation, in conjunction with other posttranslational modifications, and the regulation of arterial tone.

Charge-neutral excitons in semiconductor quantum dots (QDs) have a small finite energy separation caused by the anisotropic exchange splitting. Coherent excitation of neutral excitons will generally excite both exciton components, unless the excitation is parallel to one of the dipole axes. We present a polaron master equation model to describe two-exciton pumping using a coherent continuous wave pump field in the presence of a realistic anisotropic exchange splitting. We predict a five-peak incoherent spectrum, namely a Mollow quintuplet under general excitation conditions. We experimentally confirm such spectral quintuplets for In(Ga)As QDs and obtain very good agreement with theory.

We present both experimental and theoretical investigations of a laser-driven quantum dot (QD) in the dressed-state regime of resonance fluorescence. We explore the role of phonon scattering and pure dephasing on the detuning-dependence of the Mollow triplet and show that the triplet sidebands may spectrally broaden or narrow with increasing detuning. Based on a polaron master equation approach, which includes electron-phonon interaction nonperturbatively, we derive a fully analytical expression for the spectrum. With respect to detuning dependence, we identify a crossover between the regimes of spectral sideband narrowing or broadening. We also predict regimes of phonon-induced squeezing and anti-squeezing of the spectral resonances. A comparison of the theoretical predictions to detailed experimental studies on the laser detuning-dependence of Mollow triplet resonance emission from single In(Ga)As QDs reveals excellent agreement.

In this Letter, we present narrow line width (7 μeV), nearly background-free single-photon emission (g((2))(0) = 0.02) and highly indistinguishable photons (V = 0.73) from site-controlled In(Ga)As/GaAs quantum dots. These excellent properties have been achieved by combining overgrowth on ex situ pit-patterned substrates with vertical stacking of spectrally distinct quantum dot layers. Our study paves the way for large-scale integration of quantum dots into quantum photonic circuits as indistinguishable single-photon sources.

Phosphorylation of heat shock protein 20 (Hsp20) by protein kinase A (PKA) is now recognized as an important regulatory mechanism modulating contractile activity in the human myometrium. Thus agonists that stimulate cyclic AMP production may cause relaxation with resultant beneficial effects on pathologies that affect this tissue such as the onset of premature contractions prior to term. Here we describe for the first time that acetylation of Hsp20 is also a potent post-translational modification that can affect human myometrial activity. We show that histone deacetylase 8 (HDAC8) is a non-nuclear lysine deacetylase (KDAC) that can interact with Hsp20 to affect its acetylation. Importantly, use of a selective linkerless hydroxamic acid HDAC8 inhibitor increases Hsp20 acetylation with no elevation of nuclear-resident histone acetylation nor marked global gene expression changes. These effects are associated with significant inhibition of spontaneous and oxytocin-augmented contractions of ex vivo human myometrial tissue strips. A potential molecular mechanism by which Hsp20 acetylation can affect myometrial activity by liberating cofilin is described and further high-lights the use of specific effectors of KDACs as therapeutic agents in regulating contractility in this smooth muscle.

Detailed properties of resonance fluorescence from a single quantum dot in a micropillar cavity are investigated, with particular focus on emission coherence in the dependence on optical driving field power and detuning. A power-dependent series over a wide range reveals characteristic Mollow triplet spectra with large Rabi splittings of |Ω|≤15  GHz. In particular, the effect of dephasing in terms of systematic spectral broadening ∝Ω(2) of the Mollow sidebands is observed as a strong fingerprint of excitation-induced dephasing. Our results are in excellent agreement with predictions of a recently presented model on phonon-dressed quantum dot Mollow triplet emission in the cavity-QED regime.

A fiber optic-based distributed sensing system (DSS) has been integrated with a large volume (72 l) pressure vessel providing high spatial resolution, time-resolved, 3D measurement of hybrid temperature-strain (TS) values within experimental sediment-gas hydrate systems. Areas of gas hydrate formation (exothermic) and decomposition (endothermic) can be characterized through this proxy by time series analysis of discrete data points collected along the length of optical fibers placed within a sediment system. Data are visualized as an animation of TS values along the length of each fiber over time. Experiments conducted in the Seafloor Process Simulator at Oak Ridge National Laboratory clearly indicate hydrate formation and dissociation events at expected pressure-temperature conditions given the thermodynamics of the CH(4)-H(2)O system. The high spatial resolution achieved with fiber optic technology makes the DSS a useful tool for visualizing time-resolved formation and dissociation of gas hydrates in large-scale sediment experiments.