Study protocol for a randomised controlled trial of a cognitive-behavioural prevention programme for the children of parents with depression: the PRODO trial

Background: Depression is one of the most common psychiatric illnesses worldwide, but is nevertheless preventable. Since the children of parents who have depression are at greatest risk of developing depression themselves, prevention programmes for this population are a major public health priority. Here we report the study protocol of a randomised controlled trial of a group-based psychological intervention for families with i) at least one parent who suffers (or has suffered) from depression and ii) at least one child who has no current or previous psychiatric diagnosis. Methods/Design: Eligible families will be randomly allocated to receive either a German adaptation of the 12-session cognitive-behavioural Raising Healthy Children intervention (Gesund und glucklich aufwachsen; N = 50), or no intervention (usual care; N = 50). The primary outcome (child diagnosis of an episode of depression) will be assessed at 15-month follow-up. The secondary outcomes (child psychopathological symptoms) will be assessed immediately following completion of the intervention (6-months), as well as at 9-and 15-month follow-up. We hypothesise that children in the intervention condition, compared with those who do not receive the intervention, will show fewer symptoms of psychopathology, and be less likely to meet diagnostic criteria for a depressive episode, at follow-up. Discussion: Despite their elevated risk of developing depression, there is little formal support available for the children of parents with depression. This study provides an important step in the development of more effective depression prevention measures, which are needed if the personal, social and economic burden of depression is to be reduced

Optimale Beschaffungsentscheidungen für OP-Textilien: Ein Zusammenspiel von Hygiene, Textiltechnologie, Ökonomie und Ökologie

Dieser Beitrag gibt, basierend auf einem BMBF-Verbundvorhaben, Einblicke in die umfassende Bewertung von OPTextilien. Ziel des Vorhabens ist es, Entscheidern in Krankenhäusern Anregungen und Know-how für ihren Berufsalltag und Produzenten von OP-Textilien Impulse für die Gestaltung ihrer Produkte zu geben. Es werden die hygienischen Anforderungen zur Vermeidung nosokomialer Infektionen, die die Schutzwirkung der Textilien garantierenden textiltechnologischen Voraussetzungen sowie die zur Erfüllung der Wirtschaftlichkeit und Umweltfreundlichkeit notwendigen Anforderungen an OP-Textilien dargestellt. Der Beitrag verdeutlicht, dass die Beachtung all dieser Kriterien und deren Zusammenführung für eine bewusste Entscheidung zum Einsatz von OP-Textilien notwendig ist.This article describes a holistic assessment approach for operating room (OR) textiles, based on a joint research project funded by the German Ministry of Education and Research. The objective of the project is to ease decision processes for decision makers in hospitals and OR textile manufacturers. The hygienic demands for protection against nosocominal infections, the technological requirements to guarantee textiles their protective properties, as well as the bases for an economically and environmentally optimum decision, are discussed. To permit a holistic procurement decision regarding OR textiles, it is necessary to consider all these criteria and their integration, as proposed in this article

Hypothesis and theory : a pathophysiological concept of stroke-induced acute phase response and increased intestinal permeability leading to secondary brain damage

Gut integrity impairment leading to increased intestinal permeability (IP) is hypothesized to be a trigger of critically illness. Approximately 15–20% of human ischemic stroke (IS) victims require intensive care, including patients with impaired level of consciousness or a high risk for developing life-threatening cerebral edema. Local and systemic inflammatory reactions are a major component of the IS pathophysiology and can significantly aggravate brain tissue damage. Intracerebral inflammatory processes following IS have been well studied. Until now, less is known about systemic inflammatory responses and IS consequences apart from a frequently observed post-IS immunosuppression. Here, we provide a hypothesis of a crosstalk between systemic acute phase response (APR), IP and potential secondary brain damage during acute and subacute IS stages supported by preliminary experimental data. Alterations of the acute phase proteins (APPs) C-reactive protein and lipopolysaccharide-binding protein and serum level changes of antibodies directed against Escherichia coli-cell extract antigen (IgA-, IgM-, and IgG-anti-E. coli) were investigated at 1, 2, and 7 days following IS in ten male sheep. We found an increase of both APPs as well as a decrease of all anti-E. coli antibodies within 48 h following IS. This may indicate an early systemic APR and increased IP, and underlines the importance of the increasingly recognized gut-brain axis and of intestinal antigen release for systemic immune responses in acute and subacute stroke stages

MULTI-CRITERIA NUMERICAL OPTIMIZATION OF MECHANICAL PROPERTIES IN ULTRASONIC WELDING PROCESS PARAMETERS OF PVC-COATED HYBRID TEXTILES FOR WEATHER PROTECTION

A series of research was carried out to determine the correlation between ultrasonic welding process parameters and weld seam mechanical properties. However, multi-objective numerical optimization of coated hybrid textiles for weather protection has not been addressed. To ensure a comprehensive evaluation of ultrasonic weld seams, the research investigates the optimal solution of the multi-objective function of ultrasonic welding process parameters and formulates a single criteria objective function. Lapped and superimposed types of seams were applied based on 33 factorial designs of experiments for 6 and 12 mm welding widths. Single-criteria objective functions instead of three independent problems were developed as a generalized utility function. A single-criteria optimization method was introduced through predetermined weight and normalization within the range of acceptable/unacceptable values. Numerical and graphical optimization methods were also applied to determine possible optimal solutions through generalized utility functions. The best optimal value of the generalized utility function (0.670425 and 0.944374) was attained at welding speed (2 and 2.01564 m/min), power (93.756 and 117.973 W), and pressure force (198.803 and 239.756 N) of 6 and 12 mm welding widths, respectively. The acceptable range of satisfactory values was determined for the roof and wall of awnings and camping tents through standard, in which seam performance level indicated. Nonlinear quadratic numerical models were formulated to estimate the generalized utility function, and their results were close to the regressed diagonal line against the actual points. The statistical analysis was shown a statistically significant effect of welding process parameters on the generalized utility function

Hypothesis and Theory: A Pathophysiological Concept of Stroke-Induced Acute Phase Response and Increased Intestinal Permeability Leading to Secondary Brain Damage

Gut integrity impairment leading to increased intestinal permeability (IP) is hypothesized to be a trigger of critically illness. Approximately 15–20% of human ischemic stroke (IS) victims require intensive care, including patients with impaired level of consciousness or a high risk for developing life-threatening cerebral edema. Local and systemic inflammatory reactions are a major component of the IS pathophysiology and can significantly aggravate brain tissue damage. Intracerebral inflammatory processes following IS have been well studied. Until now, less is known about systemic inflammatory responses and IS consequences apart from a frequently observed post- IS immunosuppression. Here, we provide a hypothesis of a crosstalk between systemic acute phase response (APR), IP and potential secondary brain damage during acute and subacute IS stages supported by preliminary experimental data. Alterations of the acute phase proteins (APPs) C-reactive protein and lipopolysaccharide-binding protein and serum level changes of antibodies directed against Escherichia coli-cell extract antigen (IgA-, IgM-, and IgG-anti-E. coli) were investigated at 1, 2, and 7 days following IS in ten male sheep. We found an increase of both APPs as well as a decrease of all anti- E. coli antibodies within 48 h following IS. This may indicate an early systemic APR and increased IP, and underlines the importance of the increasingly recognized gut-brain axis and of intestinal antigen release for systemic immune responses in acute and subacute stroke stages

QOL-04. Histology, treatment, and extent of pretreatment hydrocephalus are major determents of neurocognitive outcome for survivors of pediatric posterior fossa tumors - report from the German HIT-studies [Abstract]

BACKGROUND: Cognitive impairments following pediatric brain tumors are generally attributed to tumor site, surgical intervention, complications as well as to nonsurgical treatment. We investigated impairments for patients with medulloblastoma (MB), ependymoma (EP) and low-grade glioma (LGG) of the cerebellum treated within the German pediatric brain tumor network to compare and rank major determents. PATIENTS+METHODS: Following protocol treatment, 245 patients with MB (n=106), EP (n=32), and cerebellar LGG (n=107, surgery only) were examined 2 + 5 years after diagnosis using the German “Neuropsychological-Basic-Diagnostic” (NBD) tool based on the Cattell-Horn-Carroll model for intelligence. Within this retrospective study, multiple linear regression models were applied. RESULTS: The MB+EP vs. LGG-cohort differed slightly in median age at diagnosis (8.7/6.1 years) and location (cerebellar hemispheres: 8%MB+EP/49.5%LGG), while sex-ratio, grade of resection, extent of pre-operative hydrocephalus were comparable. With smaller median tumor-volume in the MB+EP vs. LGG-cohort (34.1/44.1cm3), ranges broadly overlapped. Median scores of age-appropriate tests were in the lower normal range for all patients for fluid and crystallized intelligence, selective attention, visual-spatial processing (VSP) and verbal short-term memory (median=93-103), but distinctly below for processing speed (PS), and psychomotor speed abilities (PMS) (median=65-84). Higher doses of craniospinal irradiation (>23.4Gy/23.4Gy) resulted in lower scores for most domains for MB-patients compared to LGG-patients (e.g., PS-estimate: >23.4Gy:-27.71, p=0.026/23.4Gy:-9.93, p=0.286). EP-patients (surgery+54Gy local radiation) scored better than LGG-patients except for PS (estimate:-15.65, p=0.111). Impairments were accentuated with higher degrees of hydrocephalus (estimate:-7.64, p=0.103) in patients with incomplete resection (estimate:12.23, p=0.006) for PMS both hands. CONCLUSION: Following age-adapted comprehensive treatment, survivors of a cerebellar tumor show significant impairments of PMS abilities in our trials. Our data suggest that slow growing LGG impair neurocognitive development more than local radiotherapy for ependymoma, while craniospinal irradiation compromises VSP and PS in MB. Initial symptomatic intracranial pressure remains a strong predictor for general neuropsychological impairment

Re-emergence of enterovirus D68 in Europe after easing the COVID-19 lockdown, September 2021

We report a rapid increase in enterovirus D68 (EV-D68) infections, with 139 cases reported from eight European countries between 31 July and 14 October 2021. This upsurge is in line with the seasonality of EV-D68 and was presumably stimulated by the widespread reopening after COVID-19 lockdown. Most cases were identified in September, but more are to be expected in the coming months. Reinforcement of clinical awareness, diagnostic capacities and surveillance of EV-D68 is urgently needed in Europe

Optimale Beschaffungsentscheidungen für OP-Textilien: Ein Zusammenspiel von Hygiene, Textiltechnologie, Ökonomie und Ökologie

Dieser Beitrag gibt, basierend auf einem BMBF-Verbundvorhaben, Einblicke in die umfassende Bewertung von OPTextilien. Ziel des Vorhabens ist es, Entscheidern in Krankenhäusern Anregungen und Know-how für ihren Berufsalltag und Produzenten von OP-Textilien Impulse für die Gestaltung ihrer Produkte zu geben. Es werden die hygienischen Anforderungen zur Vermeidung nosokomialer Infektionen, die die Schutzwirkung der Textilien garantierenden textiltechnologischen Voraussetzungen sowie die zur Erfüllung der Wirtschaftlichkeit und Umweltfreundlichkeit notwendigen Anforderungen an OP-Textilien dargestellt. Der Beitrag verdeutlicht, dass die Beachtung all dieser Kriterien und deren Zusammenführung für eine bewusste Entscheidung zum Einsatz von OP-Textilien notwendig ist.This article describes a holistic assessment approach for operating room (OR) textiles, based on a joint research project funded by the German Ministry of Education and Research. The objective of the project is to ease decision processes for decision makers in hospitals and OR textile manufacturers. The hygienic demands for protection against nosocominal infections, the technological requirements to guarantee textiles their protective properties, as well as the bases for an economically and environmentally optimum decision, are discussed. To permit a holistic procurement decision regarding OR textiles, it is necessary to consider all these criteria and their integration, as proposed in this article

Optimale Beschaffungsentscheidungen für OP-Textilien Ein Zusammenspiel von Hygiene, Textiltechnologie, Ökonomie und Ökologie

Dieser Beitrag gibt, basierend auf einem BMBF-Verbundvorhaben, Einblicke in die umfassende Bewertung von OPTextilien. Ziel des Vorhabens ist es, Entscheidern in Krankenhäusern Anregungen und Know-how für ihren Berufsalltag und Produzenten von OP-Textilien Impulse für die Gestaltung ihrer Produkte zu geben. Es werden die hygienischen Anforderungen zur Vermeidung nosokomialer Infektionen, die die Schutzwirkung der Textilien garantierenden textiltechnologischen Voraussetzungen sowie die zur Erfüllung der Wirtschaftlichkeit und Umweltfreundlichkeit notwendigen Anforderungen an OP-Textilien dargestellt. Der Beitrag verdeutlicht, dass die Beachtung all dieser Kriterien und deren Zusammenführung für eine bewusste Entscheidung zum Einsatz von OP-Textilien notwendig ist.This article describes a holistic assessment approach for operating room (OR) textiles, based on a joint research project funded by the German Ministry of Education and Research. The objective of the project is to ease decision processes for decision makers in hospitals and OR textile manufacturers. The hygienic demands for protection against nosocominal infections, the technological requirements to guarantee textiles their protective properties, as well as the bases for an economically and environmentally optimum decision, are discussed. To permit a holistic procurement decision regarding OR textiles, it is necessary to consider all these criteria and their integration, as proposed in this article

Disorders of the Calcium Sensing Signaling Pathway: From Familial Hypocalciuric Hypercalcemia (FHH) to Life Threatening Conditions in Infancy

Familial hypocalciuric hypercalcemia (FHH) is a mostly benign condition of elevated calcium and PTH levels based on a hyposensitive calcium sensing receptor (CaSR) in FHH 1 or its downstream regulatory pathway in FHH2 and FHH3. In children, adolescents and young adults with FHH the main challenge is to distinguish the condition from primary hyperparathyroidism and thereby to avoid unnecessary treatments including parathyroidectomy. However, inheritance of FHH may result in neonatal hyperparathyroidism (NHPT) or neonatal severe hyperparathyroidism (NSHPT), conditions with high morbidity, and in the latter even high mortality. This review focuses on the genetic and pathophysiological framework that leads to the severe neonatal form, gives recommendations for counselling and summarizes treatment options