Comparison of all completed suicides in Frankfurt am Main (Hessen) before and during the early COVID-19 pandemic.

To research the effect of the COVID-19 pandemic on mental health, the prevalence and characteristics of all completed suicides in the city of Frankfurt am Main were compared for a 10-month period before the pandemic (March 2019-December 2019) with one during the early pandemic (March 2020-December 2020). Medicolegal data collected in the context of the FraPPE suicide prevention project were evaluated using descriptive statistical methods. In total, there were 81 suicides during the early pandemic period, as opposed to 86 in the pre-pandemic period. Though statistically not significant, the proportion of male suicides (73%) was higher during the early pandemic period than before (63%). The age-at-death was comparable in the pre-pandemic and pandemic periods (average, 54.8 vs. 53.1 years). Between these two periods, there was no difference in respect to the three most commonly used suicide methods by men: fall from a height (26% vs. 22%), intoxication, and strangulation (each 24% vs. 19%). For women, there was, however, a shift in methods from strangulation (38%), intoxication (28%), and fall from a height (19%) to fall from a height (50%), strangulation (18%), intoxication, and collision with a rail vehicle (14% each). There was a trend towards more suicides among non-German nationals during the early pandemic (suicide rate/100,000 inhabitants: German, 14.3 vs. 11.5; non-German, 4.4 vs. 8.8). Before the pandemic, 54% of the suicides were known to have a mental illness in contrast to 44% during the early pandemic. Overall, no increase in completed suicides could be observed in Frankfurt am Main during the early pandemic.

[Who Hits the Mark? A Comparative Study of the Free Geocoding Services of Google and OpenStreetMap]. / Wer trifft ins Schwarze? Ein qualitativer Vergleich der kostenfreien Geokodierungsdienste von Google und OpenStreetMap.

BACKGROUND: Geocoding, the process of converting textual information (addresses) into geographic coordinates is increasingly used in public health/epidemiological research and practice. To date, little attention has been paid to geocoding quality and its impact on different types of spatially-related health studies. The primary aim of this study was to compare 2 freely available geocoding services (Google and OpenStreetMap) with regard to matching rate (percentage of address records capable of being geocoded) and positional accuracy (distance between geocodes and the ground truth locations). METHODS: Residential addresses were geocoded by the NRW state office for information and technology and were considered as reference data (gold standard). The gold standard included the coordinates, the quality of the addresses (4 categories), and a binary urbanity indicator based on the CORINE land cover data. 2 500 addresses were randomly sampled after stratification for address quality and urbanity indicator (approximately 20 000 addresses). These address samples were geocoded using the geocoding services from Google and OSM. RESULTS: In general, both geocoding services showed a decrease in the matching rate with decreasing address quality and urbanity. Google showed consistently a higher completeness than OSM (>93 vs. >82%). Also, the cartographic confounding between urban and rural regions was less distinct with Google's geocoding API. Regarding the positional accuracy of the geo-coordinates, Google also showed the smallest deviations from the reference coordinates, with a median of <9 vs. <175.8 m. The cumulative density function derived from the positional accuracy showed for Google that nearly 95% and for OSM 50% of the addresses were geocoded within <50 m of their reference coordinates. CONCLUSION: The geocoding API from Google is superior to OSM regarding completeness and positional accuracy of the geocoded addresses. On the other hand, Google has several restrictions, such as the limitation of the requests to 2 500 addresses per 24 h and the presentation of the results exclusively on Google Maps, which may complicate the use for scientific purposes.

The relationship between joint mobility and motor performance in children with and without the diagnosis of developmental coordination disorder.

BACKGROUND: The purpose of this study was to determine whether joint mobility is associated with motor performance in children referred for Developmental Coordination Disorder (DCD-group) in contrast to a randomly selected group of children between 3-16 years of age (Random-Group). METHODS: 36 children with DCD and 352 typically developing children (Random-Group) participated. Hypermobility was classified based on the Beighton score (cut-off ≥5 for 3-9 years and ≥4 for 10-16 years) using goniometry. Motor performance was assessed with the Movement Assessment Battery for Children (MABC). RESULTS: The mean Beighton score in the DCD-group was 5.0 versus 2.6 in the Random group. Prevalence of hypermobility was higher in the DCD-group than in the Random Group (64% and 33% respectively; χ2 = 16.09, p < .001). There was a significant [negative] correlation (r(p) = -.38, p = .02) between Beighton score and total MABC scores within the DCD group, but not in the Random Group (r(p)= -0.07, p = .20). More specifically, in the DCD group we found a significant negative correlation between the MABC total score and the degree of hyperextension of the knees. CONCLUSION: The extremely high prevalence of hypermobility when applying the recommended cut-off scores stresses the need for an international agreement on firm cut-off points and the use of standardized measurement of Beighton mobility manoeuvres. The results of this study show that a cut-off of 7 is more appropriate, resulting in a prevalence of 6% in children aged 3-16 years. Although in the general population motor performance and joint mobility are not related, this is the case in children referred for DCD. We argue that more mobility of the joints may be a disadvantage when motor coordination is poorly developed.

[Space-occupying parietal dural lesion]. / Duraständige Raumforderung parietal. Diagnose: Durale Manifestation eines Morbus Hodgkin.

An elderly female patient presented in our clinic with low grade hemiparesis. The history revealed that the patient had suffered from Hodgkin's disease and B non-Hodgkin's lymphoma, which were treated with radiotherapy and chemotherapy. The hemiparesis was now a symptom which required cranial magnetic resonance tomography.

Brain death: nursing roles and responsibilities.

Nurses working in an intensive care setting must be knowledgeable about the diagnosis of brain death and its ramifications to care competently for the patient and family. The medical community has identified specific physical and diagnostic findings necessary for the determination of brain death. Brain death is an irreversible state, from which recovery has never been reported. The neuroscience nurse's responsibilities include meeting the patient's physical needs and identifying the family's needs and teaching them about brain death. Not fulfilling these responsibilities could result in dysfunctional grieving for the family and loss of a potential organ donor.

Defining assessment parameters in dual injuries: spinal cord injury and traumatic brain injury.

Assessment parameters for muscle testing in the individual with a spinal cord injury (SCI) have been clearly defined by the American Spinal Injury Association (ASIA). However, the ASIA standard requires the individual's participation in reporting sensory information and he/she must be able to perform specific tasks to complete the examination. In an individual with a dual injury, a SCI and a traumatic brain injury (TBI), neurological assessment can be impeded by the individual's inability to participate in the exam. Assessment needs to incorporate both cognitive and physical parameters that will appropriately assess both injuries. This article reviews the assessment parameters for both spinal cord injury and traumatic brain injury and provides assessment guidelines for bedside evaluation of functional ability. In addition, a review of the biomechanics of injury will provide a model for understanding dual injury.

Patient requested removal of ventilatory support in high-level tetraplegia: guidelines for the health care provider.

Determining treatment and extent of care has been returned to the patient with the advent of the durable power of attorney and reinforcement of patients' rights. To a great extent, patient autonomy replaced the medical team's role of beneficence in the decision-making process. Professionals acknowledge the patient's right in the decisional process of his/her care, though there is skepticism of such decisions being made by the patient who has suffered high-level tetraplegia within the acute care arena. This article explores (a) basing decisions upon life experiences and knowledge, (b) differentiating between informed consent for withdrawing care and consent resulting from stress or depression, (c) assessing the patient's psychological balance, and (d) advocating for the patient when he/she chooses to end all treatment options. Guidelines provide assistance to the health professional and the patient through a potentially volatile ethical dilemma. These provide insight into potential problems for all involved and clearly define steps that individuals should take to assure that the decision is made with informed consent rather than emotions.

The synchrotron radiation of the 6-GeV DESY machine as a fundamental radiometric standard.

The characteristics of synchrotron radiation emitted by the 6-GeV DESY machine were studied in the spectral range 2200-5500 A. For this purpose, the synchrotron radiation was compared photoelectrically with the radiation of standardized sources in a nearly differential manner. These sources (tungsten ribbon lamp, Krefft-Rössler uv normal) were calibrated with high accuracy against a blackbody. Good agreement was found between our experimental results and the values predicted by the theory of the synchrotron radiation derived by J. Schwinger. The relative spectral distribution was verified to within about +/-2%, and the absolute values of the theoretically predicted flux were ascertained to within about +/-15%. For the application of synchrotron radiation as a radiometric standard, in most cases only the relative spectral distribution is important. If one supposes the validity of the theory also in the far uv, and if the synchrotron radiation is calibrated in the visible by a standard source, one can give the abolute flux in the far uv. In this way it is possible to calibrate photometers or sources in the far uv in absolute units with an accuracy of about +/- 3% with the aid of the synchrotron radiation.

Balloon-borne infrared telescope for absolute surface photometry of the night sky.

A dry ice cooled 15-cm ir telescope was used on board the balloon-borne gondola THISBE for absolute surface photometry of the Milky Way, the zodiacal light, and the airglow in the PbS wavelength region. The mechanical, optical, electronical, and thermal design of the instrument is described. The efficiency of the baffle system for suppression of stray light from earth and balloon is discussed in detail. Recent airglow measurements are presented.

Stimulation of protein kinase C pathway mediates endocytosis of human nongastric H+-K+-ATPase, ATP1AL1.

The human nongastric H+-K+-ATPase, ATP1AL1, shown to reabsorb K+ in exchange for H+ or Na+, is localized in the luminal plasma membrane of renal epithelial cells. It is presumed that renal H+-K+-ATPases can be regulated by endocytosis. However, little is known about the molecular mechanisms that control plasma membrane expression of renal H+-K+-ATPases. In our study, activation of protein kinase C (PKC) using phorbol esters (phorbol 12-myristate 13-acetate) leads to clathrin-dependent internalization and intracellular accumulation of the ion pump in stably transfected Madin-Darby canine kidney cells. Functional inactivation of the H+-K+-ATPase by PKC activation is shown by intracellular pH measurements. Proton extrusion capacity of ATP1AL1-transfected cells is drastically reduced after phorbol 12-myristate 13-acetate incubation and can be prevented with the PKC blocker bisindolylmaleimide. Ion pump internalization and inactivation are specifically mediated by the PKC pathway, whereas activation of the protein kinase A pathway has no influence. Our results show that the nongastric H+-K+-ATPase is a specific target for the PKC pathway. Therefore, PKC-mediated phosphorylation is a potential regulatory mechanism for apical nongastric H+-K+-ATPase plasma membrane expression.