Widersprüchliche Zeiten des Aufwachsens - Fürsorge, Zeitnot und Optimierungsstreben in Familien

"In diesem Beitrag werden Auswirkungen veränderter gesellschaftlicher Zeitverhältnisse auf die familialen Bedingungen des Aufwachsens in Kindheit und Jugend untersucht. Wie zeitgenössische Studien deutlich machen, versuchen viele Familien in hohem Maße, bestmögliche Voraussetzungen für das Heranwachsen ihrer Kinder zu schaffen. Zugleich geraten sie dabei in widersprüchliche Logiken von Fürsorge und Effizienz, von elterlichen Idealen und praktischer Zeitnot, die das angestrebte Ziel der Optimierung von Lebenschancen der Kinder konterkarieren können. Hohe Ansprüche an kindliche Förderung, Zeitdruck und Flexibilisierung schaffen neue Anforderungen an Effektivität, die auch neue Varianten von Zwängen und Optimierungsbestrebungen mit potenziell kontraproduktiven Nebenfolgen hervorbringen. Weiterhin zeigt sich, dass Zeitressourcen und Umgang mit Zeitnot mit sozialen Ungleichheiten verknüpft sind." (Autorenreferat)"This essay examines the effects of altered relationships of time in contemporary society on the familial conditions in which children and adolescents grow up. As contemporary studies clearly reveal, many families make a tremendous effort to create the best possible conditions for their children's development. At the same time, these families become trapped in the contradictory logics of care (taking time) and efficiency (saving time), of parental ideals and practical time constraints that can work against the goal of optimizing their children's life opportunities. High standards for fostering children's development, time pressure and flexibilization create new demands for effectivity, which also bring about new forms of constraint and attempts at optimization with potentially counterproductive ramifications. Time resources and means of dealing with time constraints, it is revealed, continue to be linked to social inequalities." (author's abstract

SARS-CoV-2 in Pediatric Inpatient Care: Management, Clinical Presentation and Utilization of Healthcare Capacity

This study scrutinizes management and clinical presentation of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) in pediatric inpatient care and evaluates the utilization of pediatric healthcare capacity during the pandemic. Within this retrospective cohort study, we systematically reviewed data of all 16,785 pediatric patients (<18 years admitted to our clinical center between January 2018 and June 2021). Data on SARS-CoV-2 test numbers, hospital admissions and clinical characteristics of infected patients were collected. Since January 2020, a total of 2513 SARS-CoV-2 tests were performed. In total, 36 patients had a positive test result. In total, 25 out of 36 SARS-CoV-2 positive children showed at least mild clinical symptoms while 11 were asymptomatic. Most common clinical symptoms were fever (60%), cough (60%) and rhinitis (20%). In parallel with the rising slope of SARS-CoV-2 in spring and fall 2020, we observed a slight decrease in the number of patients admitted to the pediatric department while the median duration of hospital treatment and intensive care occupancy remained unchanged. This study underlines that SARS-CoV-2 infected children most frequently exhibit an asymptomatic or mild clinical course. Noteworthy, the number of hospital admissions went down during the pandemic. The health and economic consequences need to be discussed within health care society and politics

The AMH genotype (rs10407022 T&gt;G) is associated with circulating AMH levels in boys, but not in girls

Objective: Fetal anti-Müllerian hormone (AMH) is responsible for normal male sexual differentiation, and circulating AMH is used as a marker of testicular tissue in newborns with disorders of sex development. Little is known about the mechanism of action in postnatal life. A recent genome wide association study (GWAS) reported genetic variation of AMH affecting AMH levels in young men. This study investigated the effect of genetic variation of AMH and AMH type II receptor (AMHR2) (AMHrs10407022 T>G and AMHR2rs11170547 C>T) on circulating reproductive hormone levels and pubertal onset in boys and girls. Design and methods: This study is a combined longitudinal and cross-sectional study in healthy Danish boys and girls from the general population. We included 658 boys aged 5.8–19.8 years and 320 girls aged 5.6–16.5 years. The main outcome measures were genotyping of AMH and AMHR2, pubertal staging and serum levels of reproductive hormones. Results: AMHrs10407022T>G was associated with higher serum levels of AMH in prepubertal boys (TT: 575 pmol/L vs TG: 633 pmol/L vs GG: 837 pmol/L, P = 0.002) and adolescents (TT: 44 pmol/L vs TG: 58 pmol/L vs GG: 79 pmol/L, P < 0.001). Adolescent boys carrying the genetic variation also had lower levels of LH (TT: 3.0 IU/L vs TG: 2.8 IU/L vs GG: 1.8 IU/L, P = 0.012). Hormone levels in girls and pubertal onset in either sex did not seem to be profoundly affected by the genotypes. Conclusion: Our findings support recent GWAS results in young adults and expand our understanding of genetic variation affecting AMH levels even in boys prior to the pubertal decline of circulating AMH

A Natural mtDNA Polymorphism in Complex III Is a Modifier of Healthspan in Mice

In this study, we provide experimental evidence that a maternally inherited polymorphism in the mitochondrial cytochrome b gene (mt-Cytb; m.15124A>G, Ile-Val) in mitochondrial complex III resulted in middle-aged obesity and higher susceptibility to diet-induced obesity, as well as age-related inflammatory disease, e.g., ulcerative dermatitis, in mice. As a consequence of the gene variation, we observed alterations in body composition, metabolism and mitochondrial functions, i.e., increased mitochondrial oxygen consumption rate and higher levels of reactive oxygen species, as well as in the commensal bacterial composition in the gut, with higher abundance of Proteobacteria in mice carrying the variant. These observations are in line with the previously described links of the mitochondrial complex III gene with obesity and metabolic diseases in humans. Given that these functional changes by the G variant at m.15124 in the mt-Cytb are already present in young mice that were kept under normal condition, it is plausible that the m.15124A>G variant is a disease susceptibility modifier to the diseases induced by additional stressors, i.e., dietary and/or aging stress, and that the variant results in the higher incidence of clinical diseases presentation in C57BL/6J-mt129S1/SvlmJ than C57BL/6J mice. Thus, mtDNA variants could be potential biomarkers to evaluate the healthspan

Machbarkeitsstudie für eine regelmäßige Berichterstattung gemäß § 8 Absatz 4 Wohnungslosen­berichterstattungsgesetz

Die Machbarkeitsstudie untersucht, ob und mit welchem Aufwand sich eine Berichterstattung über Formen der Wohnungslosigkeit, die weder durch die neue Bundesstatistik untergebrachter wohnungsloser Personen noch über die ergänzende empirische Erhebung zu wohnungslosen Menschen ohne Unterkunft und zu verdeckt Wohnungslosen erfasst sind, realisieren lässt. Insbesondere waren für Geflüchtete mit anerkanntem Schutzstatus, für Personen, die ohne eigene Wohnung länger als notwendig im Gesundheitssystem oder in Haftanstalten verbleiben, und für Personen in Institutionen des Gewaltschutzes die Möglichkeiten einer Berichterstattung zu prüfen. Darüber hinaus prüfte die Studie Ansatzpunkte für eine Nutzung von Datenbeständen und Statistiken der Mindestsicherungssysteme und Verwaltungsregister und unterbreitet Anregungen für die Berichterstattung über Querschnittsthemen und Vertiefungsstudien

Empirische Untersuchung zum Gegenstand nach § 8 Absatz 2 und 3 Wohnungslosenberichterstattungsgesetz

Um in Ergänzung zu der Bundesstatistik untergebrachter wohnungsloser Personen erstmals belastbare Zahlen darüber zu erzielen wie viele Menschen in Deutschland ohne Unterkunft auf der Straße oder in behelfsmäßigen Provisorien übernachten oder in verdeckter Wohnungslosigkeit bei Bekannten oder Angehörigen unterkommen, haben die GISS und Kantar Public auf Grundlage eines dreistufigen Stichprobenverfahrens zwischen dem 1. und 7. Februar 2022 eine repräsentative Auswahl von Wohnungslosen in 151 deutschen Städten und Gemeinden befragt. Die Ergebnisse der Befragung wurden in einem mehrstufigen Verfahren gewichtet und auf das gesamte Bundesgebiet hochgerechnet. Die Studie liefert genauere Informationen zu Zusammensetzung und Soziodemografie der beiden Gruppen von Wohnungslosen und zu wichtigen Aspekten ihrer Lebenslage (Dauer der Wohnungslosigkeit, gesundheitliche Beeinträchtigungen und Gewalterfahrungen, Zugang zu Trinkwasser, Nutzung von Einrichtungen der Notunterbringung)

Antigen-Specific versus Non-Antigen-Specific Immunoadsorption in ABO-Incompatible Renal Transplantation

Introduction: ABO-incompatible (ABOi) renal transplantation (RTx) from living donors is an established procedure to expand the donor pool for patients with end stage renal disease. Immunoadsorption (IA) is a standard procedure for the removal of preformed antibodies against the allograft. In this study, antigen-specific and non-antigen-specific IA in ABOi RTx were compared. Patients and Methods: 10 patients underwent antigen-specific IA (Glycosorb group) and 13 patients non-antigen-specific IA (Immunosorba group). The effects of both procedures regarding antibody reduction, number of treatments, complications, costs, as well as the allograft function and patient survival were compared between both groups. Results: Although the IgG levels were reduced equally by both procedures (p=0.82), the reduction of the IgM level was more effective in the Glycosorb group (p=0.0172). Patients in both groups required a median number of 6 IA before ABOi RTx. Allograft function at one year after AB0i RTx was similar in both groups (estimated glomerular filtration rate: 66 vs. 64 ml/min/1.73m² respectively), with a death-censored graft survival of 90.0% and 92.3% respectively. Complication rates did not differ between procedures. Due to the reuse of non-antigen-specific Immunosorba columns, costs were considerably lower in this group; however, the use of the Immunosorba-based IA was less time-efficient. Conclusion: Considering upcoming alternatives as simultaneous performance of dialysis and IA or a possible reuse of Glycosorb columns, this might become less relevant in the future

Biomarkers in Liquid Biopsies for Prediction of Early Liver Metastases in Pancreatic Cancer

Individualized diagnostics approaches in modern cancer therapy require predictive and prognostic biomarkers that are easily accessible and stratify patients for optimal and individualized treatment. Pancreatic ductal adenocarcinoma (PDAC) is still a life-threatening disease mainly because of its late diagnosis in advanced stages or rapid progress even in patients with curative resection of the primary tumor. Moreover, patients with liver metastases exhibit an even worse prognosis. Hence, this retrospective multi-center study aims to identify biomarkers in perioperative serum of PDAC patients predicting early liver metastasis. A highly sensitive biomarker analysis was performed using two different methodological approaches. Olink® analysis, which was also used to validate LEGENDplexTM results, identified significant differences in proteins involved in chemotaxis and migration of immune cells as well as cell growth in serum of patients with early versus late onset of liver metastasis. Further studies with larger cohorts are required to validate these findings for clinical translation

Glycaemic control and antidiabetic therapy in patients with diabetes mellitus and chronic kidney disease - cross-sectional data from the German Chronic Kidney Disease (GCKD) cohort

Background: Diabetes mellitus (DM) is the leading cause of end-stage renal disease. Little is known about practice patterns of anti-diabetic therapy in the presence of chronic kidney disease (CKD) and correlates with glycaemic control. We therefore aimed to analyze current antidiabetic treatment and correlates of metabolic control in a large contemporary prospective cohort of patients with diabetes and CKD. Methods: The German Chronic Kidney Disease (GCKD) study enrolled 5217 patients aged 18-74 years with an estimated glomerular filtration rate (eGFR) between 30-60 mL/min/1.73 m(2) or proteinuria >0.5 g/d. The use of diet prescription, oral anti-diabetic medication, and insulin was assessed at baseline. HbA1c, measured centrally, was the main outcome measure. Results: At baseline, DM was present in 1842 patients (35 %) and the median HbA1C was 7.0 % (25th-75th percentile: 6.8-7.9 %), equalling 53 mmol/mol (51, 63);24.2 % of patients received dietary treatment only, 25.5 % oral antidiabetic drugs but not insulin, 8.4 % oral antidiabetic drugs with insulin, and 41.8 % insulin alone. Metformin was used by 18.8 %. Factors associated with an HbA1C level >7.0 % (53 mmol/mol) were higher BMI (OR = 1.04 per increase of 1 kg/m(2), 95 % CI 1.02-1.06), hemoglobin (OR = 1.11 per increase of 1 g/dL, 95 % CI 1.04-1.18), treatment with insulin alone (OR = 5.63, 95 % CI 4.26-7.45) or in combination with oral antidiabetic agents (OR = 4.23, 95 % CI 2.77-6.46) but not monotherapy with metformin, DPP-4 inhibitors, or glinides. Conclusions: Within the GCKD cohort of patients with CKD stage 3 or overt proteinuria, antidiabetic treatment patterns were highly variable with a remarkably high proportion of more than 50 % receiving insulin-based therapies. Metabolic control was overall satisfactory, but insulin use was associated with higher HbA1C levels

Cowpox Virus Transmission from Pet Rats to Humans, Germany

We describe a cluster of cowpox virus (CPXV) infections in humans that occurred near Munich, Germany, around the beginning of 2009. Previously, only sporadic reports of CPXV infections in humans after direct contact with various animals had been published. This outbreak involved pet rats from the same litter