Ergonomic comparison of different incontinence products and effects on time and physical demands on carers.

BACKGROUND: Caregivers are at a high risk of musculoskeletal injuries. Efficiency in handling and changing patients' absorbent incontinence products may reduce the burden of caring. AIMS: This study aimed to compare various types of absorbent incontinence products from an ergonomic perspective and assess the length of time required for handling these products and the physical demand on caregivers' backs, hands and fingers. METHODS: A within-subject design was selected for two studies involving 64 experienced nurses. The first study was conducted at a test centre in Germany, while the second was performed at a hospital in France. Objective data, such as the time required to apply or change a product and physical stress on the back and hands/wrists, as well as users' subjective assessment of product handling were investigated. FINDINGS: Both objective and subjective assessments showed that elastic slips were superior to other slip products. The traditional and belted slips were the second-best products in the objective and subjective assessments respectively. CONCLUSION: Choice of incontinence product influences the time required and the physical demands associated with handling. Both aspects can be considerably reduced with the use of appropriate absorbent incontinence products.

Charlotte Bühler and her emigration to the United States: A clarifying note regarding the loss of a professorship at Fordham University.

Although Charlotte Bühler (1893-1974) was one of the most prominent female psychologists during the first half of the last century, she never received a full professorship in a psychology department. In this paper, we discuss possible reasons for this failure and focus on problems related to an offer from Fordham University in 1938 that never materialized. Our analysis based on unpublished documents indicates that Charlotte Bühler provided incorrect reasons for the failure in her autobiography. Moreover, we found no evidence that Karl Bühler ever received an offer from Fordham University. Overall, our reconstruction of events indicates that Charlotte Bühler came very close to her goal of receiving a full professorship at a research university, but unfavorable political developments and her suboptimal decisions were involved in the unfortunate outcome. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Single-cell transcriptomics reveals common epithelial response patterns in human acute kidney injury.

BACKGROUND: Acute kidney injury (AKI) occurs frequently in critically ill patients and is associated with adverse outcomes. Cellular mechanisms underlying AKI and kidney cell responses to injury remain incompletely understood. METHODS: We performed single-nuclei transcriptomics, bulk transcriptomics, molecular imaging studies, and conventional histology on kidney tissues from 8 individuals with severe AKI (stage 2 or 3 according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria). Specimens were obtained within 1-2 h after individuals had succumbed to critical illness associated with respiratory infections, with 4 of 8 individuals diagnosed with COVID-19. Control kidney tissues were obtained post-mortem or after nephrectomy from individuals without AKI. RESULTS: High-depth single cell-resolved gene expression data of human kidneys affected by AKI revealed enrichment of novel injury-associated cell states within the major cell types of the tubular epithelium, in particular in proximal tubules, thick ascending limbs, and distal convoluted tubules. Four distinct, hierarchically interconnected injured cell states were distinguishable and characterized by transcriptome patterns associated with oxidative stress, hypoxia, interferon response, and epithelial-to-mesenchymal transition, respectively. Transcriptome differences between individuals with AKI were driven primarily by the cell type-specific abundance of these four injury subtypes rather than by private molecular responses. AKI-associated changes in gene expression between individuals with and without COVID-19 were similar. CONCLUSIONS: The study provides an extensive resource of the cell type-specific transcriptomic responses associated with critical illness-associated AKI in humans, highlighting recurrent disease-associated signatures and inter-individual heterogeneity. Personalized molecular disease assessment in human AKI may foster the development of tailored therapies.

The development of metacognitive knowledge from childhood to young adulthood: Major trends and educational implications.

In this chapter, major trends in the development of metacognitive competences and its relationship to various aspects of cognitive/academic performance are described, with a focus on metamemory and reading comprehension. In a first step, classic and more recent theoretical models of metacognitive competences are presented that elaborate on the development of the declarative and procedural components of metacognition. The declarative component focuses on explicit and verbalizable knowledge, whereas the procedural component deals with monitoring and self-regulation processes. Common measures of both components are presented next, followed by a description of major developmental trends, as indicated by cross-sectional and longitudinal studies on developmental differences and changes in declarative knowledge, memory and comprehension monitoring, and self-regulation. Furthermore, research findings illustrating the relationship between metacognitive competences and cognitive performance in childhood and adolescence are presented for the domains of memory and reading comprehension, respectively. The final section focuses on educational implications of research on metacognition, underlining the importance of teacher behavior in the classroom and special instruction programs for students' acquisition of metacognitive competences.

The role of metacognitive competences in the development of school achievement among gifted adolescents.

Gifted underachievers perform worse in school than would be expected based on their high intelligence. Possible causes for underachievement are low motivational dispositions (need for cognition) and metacognitive competences. This study tested the interplay of these variables longitudinally with gifted and non-gifted students from Germany (N = 341, 137 females) in Grades 6 (M = 12.02 years at t1) and 8 (M = 14.07 years). Declarative and procedural metacognitive competences were assessed in the domain of reading comprehension. Path analyses showed incremental effects of procedural metacognition over and above intelligence on the development of school achievement in gifted students (ß = .139). Moreover, declarative metacognition and need for cognition interactively predicted procedural metacognition (ß = .169), which mediated their effect on school achievement.

Plankton respiration in the Atacama Trench region: Implications for particulate organic carbon flux into the hadal realm.

Respiration is a key process in the cycling of particulate matter and, therefore, an important control mechanism of carbon export to the ocean's interior. Most of the fixed carbon is lost in the upper ocean, and only a minor amount of organic material sustains life in the deep-sea. Conditions are particularly extreme in hadal trenches, and yet they host active biological communities. The source of organic carbon that supports them and the contribution of these communities to the ocean carbon cycle, however, remain uncertain. Here we report on size-fractionated depth profiles of plankton respiration assessed from the activity of the electron transport system in the Atacama Trench region, and provide estimates of the minimum carbon flux (FC) needed to sustain the respiratory requirements from the ocean surface to hadal waters of the trench and shallower nearby sites. Plankton < 100 µm contributed about 90% to total community respiration, whose magnitude was highly correlated with surface productivity. Remineralization rates were highest in the euphotic zone and declined sharply within intermediate oxygen-depleted waters, remaining fairly constant toward the bottom. Integrated respiration in ultra-deep waters (> 1000 m) was comparable to that found in upper layers, with 1.3 ± 0.4 mmol C m-2 d-1 being respired in the hadopelagic. The comparison between our FC models and estimates of sinking particle flux revealed a carbon imbalance through the mesopelagic that was paradoxically reduced at greater depths. We argue that large fast-sinking particles originated in the overlying surface ocean may effectively sustain the respiratory carbon demands in this ultra-deep marine environment.

Matched retrospective analysis of three different fixation devices for chevron osteotomy.

Chevron osteotomy with consecutive fixation is a commonly performed operative treatment option for hallux valgus deformities. The present retrospective study aims to compare the clinical and radiological outcome of novel bioabsorbable magnesium screw fixation with metal screw and Kirschner wire fixation. Eighteen matched triplets were assembled according to the following criteria: female gender, age difference less than 5 years, date of operation within 4 months, difference in preoperative intermetatarsal angle less than 5°, and equal experience of the first and second surgeon. These patients, between 18 and 85 years of age and with a minimum follow-up period of 12 months, were invited to a follow-up examination, of which only 16 matched triplets of patients entirely kept the appointment. Thus, 48 feet of 44 patients were clinically evaluated using the American Orthopaedic Foot & Ankle Society scale, Foot Function Index, University of California and Los Angeles Activity Score, as well as a visual analogue scale for pain, satisfaction, cosmetic results, and functional impairment. Radiographical assessment included measuring intermetatarsal angle and first metatarsophalangeal angles. All occurring complications and revision surgeries were noted. Significant differences were observed for postoperative intermetatarsal angle between magnesium screw and pin fixation (p = 0.009). Moreover, patients receiving magnesium screw were significantly more prone to undergo the same procedure again (p = 0.03). In conclusion, if the advantages of bioabsorbable magnesium screws outweigh the drawbacks of increased costs and a higher surgical demand, this implant might serve as possible chevron osteotomy fixation method. Compression screws and Kirschner wires also show comparable satisfactory outcomes. LEVEL OF EVIDENCE: III retrospective comparative study.

A source of isotopically light organic carbon in a low-pH anoxic marine zone.

Geochemical and stable isotope measurements in the anoxic marine zone (AMZ) off northern Chile during periods of contrasting oceanographic conditions indicate that microbial processes mediating sulfur and nitrogen cycling exert a significant control on the carbonate chemistry (pH, AT, DIC and pCO2) of this region. Here we show that in 2015, a large isotopic fractionation between DIC and POC, a DIC and N deficit in AMZ waters indicate the predominance of in situ dark carbon fixation by sulfur-driven autotrophic denitrification in addition to anammox. In 2018, however, the fractionation between DIC and POC was significantly lower, while the total alkalinity increased in the low-pH AMZ core, suggesting a predominance of heterotrophic processes. An isotope mass-balance model demonstrates that variations in the rates of sulfur- and nitrogen-mediated carbon fixation in AMZ waters contribute ~7-35% of the POC exported to deeper waters. Thus, dark carbon fixation should be included in assessments of future changes in carbon cycling and carbonate chemistry due to AMZ expansion.

[New AWMF guidelines for medicolegal assessment of mental and psychosomatic disorders]. / Neue AWMF-Leitlinie zur Begutachtung psychischer und psychosomatischer Störungen.

The guidelines, which were first published in 2012, were fundamentally revised by a panel of experts from 9 medical and psychological societies and published on the website of the Association of the Scientific Medical Societies in Germany in December 2019 (AWMF registration number 051-029). The guidelines contribute to interdisciplinary quality assurance when assessing applicants for insurance or other compensation benefits who claim psychological or psychosomatic illnesses with resulting functional disorders. The guidelines are divided into 3 separate parts: part I describes specific aspects of the expert examination, part II describes the criteria for assessing occupational performance capacity in terms of different legal fields and part III deals with questions of causality in cases of claimed posttraumatic mental disorders.

Executive Functions and Fine Motor Skills in Kindergarten as Predictors of Arithmetic Skills in Elementary School.

The present longitudinal study focused on domain-general predictors of arithmetics in elementary school. The role of executive functions (EFs) and fine motor skills for the prediction of arithmetic skills in 1st/2nd grade was examined. Data from N = 173 kindergarten children were included. Age, socioeconomic status, fluid intelligence, and processing speed were controlled. Regression analyses revealed that fine motor skills predicted arithmetic skills. When EFs were added, fine motor skills did not contribute to the prediction of arithmetic skills. Visuospatial working memory and interference control were significant predictors. Findings indicate an important role of EF as predictors of arithmetic skills.

A patient with chronic kidney disease, primary biliary cirrhosis and metabolic acidosis.

Autoimmune disorders such as rheumatoid arthritis or Sjögren's syndrome can be associated with impaired renal acid excretion. Only few cases of patients with primary biliary cirrhosis (PBC) and distal renal tubular acidosis (dRTA) have been described. Here, we present the case of a 60-year-old woman with PBC and dRTA. Her kidney biopsy showed an absence of markers of acid-secretory Type A intercalated cells (A-ICs) and expression of aquaporin-2, a marker of principal cells, in all cells lining the collecting duct. Moreover, the serum of the patient contained antibodies directed against a subset of cells of the collecting duct. Thus, PBC-related autoantibodies may target acid-secretory A-ICs and thereby impair urinary acidification.

Talent Development in Achievement Domains: A Psychological Framework for Within- and Cross-Domain Research.

Achievement in different domains, such as academics, music, or visual arts, plays a central role in all modern societies. Different psychological models aim to describe and explain achievement and its development in different domains. However, there remains a need for a framework that guides empirical research within and across different domains. With the talent-development-in-achievement-domains (TAD) framework, we provide a general talent-development framework applicable to a wide range of achievement domains. The overarching aim of this framework is to support empirical research by focusing on measurable psychological constructs and their meaning at different levels of talent development. Furthermore, the TAD framework can be used for constructing domain-specific talent-development models. With examples for the application of the TAD framework to the domains of mathematics, music, and visual arts, the review provided supports the suitability of the TAD framework for domain-specific model construction and indicates numerous research gaps and open questions that should be addressed in future research.

Kidney transplant monitoring by urinary flow cytometry: Biomarker combination of T cells, renal tubular epithelial cells, and podocalyxin-positive cells detects rejection.

Creatinine and proteinuria are used to monitor kidney transplant patients. However, renal biopsies are needed to diagnose renal graft rejection. Here, we assessed whether the quantification of different urinary cells would allow non-invasive detection of rejection. Urinary cell numbers of CD4+ and CD8+ T cells, monocytes/macrophages, tubular epithelial cells (TEC), and podocalyxin(PDX)-positive cells were determined using flow cytometry and were compared to biopsy results. Urine samples of 63 renal transplant patients were analyzed. Patients with transplant rejection had higher amounts of urinary T cells than controls; however, patients who showed worsening graft function without rejection had similar numbers of T cells. T cells correlated with histological findings (interstitial inflammation p = 0.0005, r = 0.70; tubulitis p = 0.006, r = 0.58). Combining the amount of urinary T cells and TEC, or T cells and PDX+ cells, yielded a significant segregation of patients with rejection from patients without rejection (all p < 0.01, area under the curve 0.89-0.91). Urinary cell populations analyzed by flow cytometry have the potential to introduce new monitoring methods for kidney transplant patients. The combination of urinary T cells, TEC, and PDX-positive cells may allow non-invasive detection of transplant rejection.

Tidally Forced Saltwater Intrusions might Impact the Quality of Drinking Water, the Valdivia River (40° S), Chile Estuary Case.

The Valdivia River estuary (VRE) located in south-central Chile is known as one of the largest estuarine ecosystems on the Pacific coast. This research aims to determine the intra-tidal and sub-tidal variability of saline intrusions into the VRE between November 2017 and March 2019 derived from salinity sensors located along the VRE. Complementary hydrographic measurements were conducted during flood and ebb conditions of the spring and neap tides for each of the four seasons of the year along the central axis of the VRE. The results of the salinity time series showed that saline intrusions (values greater than 0.5 Practical Salinity Units) occurred ~20 km from the estuary mouth, when the total flow of the Cruces and Calle-Calle rivers (main tributaries of the estuary) was low, around 280-300 m3 s-1. During the same period, the best co-variability was observed between the saline intrusions and the mixed-semidiurnal tide and the fortnightly and monthly periods of the tide. Regression analyses indicated that salinity intrusion length (L) is best correlated to discharge (D) with a fractional power model L α D-1/2.64 (R2 = 0.88). The decreasing discharge trend, found between 2008-2019, implies that saline water intrusions would negatively impact the Valdivia's main drinking water intake during the low rainfall season under future climate conditions.

A differentiation program induced by bone morphogenetic proteins 4 and 7 in endodermal epithelial cells provides the molecular basis for efficient nutrient transport by the chicken yolk sac.

BACKGROUND: The mammalian yolk sac provides nutrients for the growing fetus during critical early developmental processes such as neural tube closure, which precedes the functional maturation of the placenta. In contrast, oviparous species such as the chicken rely solely on the yolk sac for transfer of nutrients from the yolk to the developing embryo. However, the molecular mechanisms that provide the yolk sac with nutrient transfer competence remain poorly understood. RESULTS: We demonstrate that the chicken endodermal epithelial cells (EEC), which are in close contact with the yolk, gain their nutrient-transport competence by a paracrine crosstalk with the blood-vessel forming mesodermal cell layer. Bone morphogenetic proteins (BMP) 4 and 7 produced by ectodermal and mesodermal cell layers likely initiate a differentiation program of EECs during the transition from the area vitellina to the area vasculosa. BMPs, by inducing SMAD signaling, promote the up-regulation of endocytic receptor expression and thereby provide the EECs with the molecular machinery to produce triglyceride-rich lipoprotein particles. CONCLUSION: This paracrine signaling cascade may constitute the basis for the EEC-mediated mechanism underlying the efficient uptake, degradation, resynthesis, and transfer of yolk-derived nutrients into the embryonic circulation, which assures proper energy supply and development of the growing fetus.

Circulating soluble LR11, a differentiation regulator for vascular cells, is increased during pregnancy and exaggerated in patients with pre-eclampsia.

BACKGROUND: Pre-eclampsia is a pregnancy-specific disease characterized by onset of hypertension and proteinuria, sometimes progressing into damaging other organs. Here, we investigated the pathological significance of the soluble fragment of LR11 (sLR11), a cell differentiation regulator, in comparison to circulating IL-6 and TNF-α, in pre-eclampsia. METHODS: The study was conducted in a cross-sectional research design with fourteen pre-eclampsia patients and fifty healthy pregnant subjects. Pre-eclampsia was defined as hypertensive disorders in pregnancy at over 20 weeks of gestation with proteinuria. RESULTS: Plasma levels of sLR11 as well as IL-6 in pre-eclampsia were increased compared with those in the healthy pregnant subjects at the first, the second, and the third trimester. Receiver operating characteristic analysis for the detection of pre-eclampsia among third-trimester subjects showed that the areas under the curves of sLR11 and IL-6 were equivalent. sLR11 and IL-6 correlated positively with TNF-α in healthy pregnant subjects. In the pre-eclampsia patients, there was neither a correlation between sLR11 and IL-6 nor between sLR11 and TNF-α. CONCLUSIONS: sLR11 increases during pregnancy, with levels further exaggerated in pre-eclampsia, and may be related to the pathology of pre-eclampsia.

Motor Coordination and Executive Functions as Early Predictors of Reading and Spelling Acquisition.

The role of motor coordination and executive functions in kindergarten for reading/spelling in 1st/2nd grade was examined in the light of other domain-general predictors. N = 173 children were included in the final analyses. A structural equation model with motor coordination, fluid intelligence, age and self-concept as predictors of reading/spelling fitted well. When EF were included, motor coordination and fluid intelligence were not associated with reading/spelling performance. A final model with EF, age and self-concept fitted best. Findings indicate an important role of EF for the development of reading and spelling and for the link between motor coordination and reading/spelling.