School Burnout after COVID-19, Prevalence and Role of Different Risk and Protective Factors in Preteen Students.

BACKGROUND: Current data show an increase in stress among youth since the COVID-19 pandemic, raising the question of the measures to be put in place to limit it. AIM: The aim of this study is to measure the prevalence of burnout and the different risk and protective factors of burnout among students and to compare the mean scores obtained with those collected in a similar sample in 2014. METHOD: Perceived health, school burnout, and the different risk and protective factors among students were measured by self-reported questionnaires among a sample of 184 students (11-13 years old). RESULTS: The results indicate significantly higher burnout scores than in 2014. Different variables were predictive of school burnout: 1. At the individual level, a low academic achievement in mathematics, somatic symptoms, and the expressed stress; 2. At the interpersonal level, lack of support from peers, teachers, and parents and a negative classroom climate; 3. At the pandemic level, the increased workload related to the consequences of COVID-19. The factors with the greatest impact are confidence in the future, perceived stress, parental supports, and mathematics results. CONCLUSIONS: An intervention program targeting these four factors among burned out students would be relevant to set up in order to reduce its prevalence.

Prosocial behavior in students with intellectual disabilities: Individual level predictors and the role of the classroom peer context.

Prosocial behavior at school, such as helping and sharing, contributes to positive individual development, peer relations, and classroom climate. Students with intellectual disabilities (ID) may have difficulty to demonstrate prosocial behavior, but little is known about the levels of prosocial behavior and its predictors in this population. This study aims to describe the prosocial behavior of students with ID attending special needs schools and related individual (i.e., age, sex, and general functioning) and classroom level (i.e., classmates' mean prosocial behavior) predictors. School staff members assessed prosocial behavior of 1022 students with ID (69.5% boys; Mage = 11.34 years, SD = 3.73, range: 4-19 years) at the beginning and the end of a schoolyear. We found that students with ID on average demonstrated moderate levels of prosocial behavior, this was lower compared to norms of typically developing students. Correlations within each timepoint proved that prosocial behavior was more present in older students, girls, and students with higher general functioning. Using a longitudinal multilevel model, we found that, prosocial behavior increased more over the schoolyear in older students and in students with higher general functioning. Classmates' mean levels of prosocial behavior did not affect later individual prosocial behavior. We conclude that prosocial behavior in students with ID depends on several individual characteristics, but less on the levels of prosocial behaviors in their special needs classroom peer context.

Image Quality of Lumbar Spine Imaging at 0.55T Low-Field MRI is Comparable to Conventional 1.5T MRI - Initial Observations in Healthy Volunteers.

RATIONALE AND OBJECTIVES: To assess the potential of 0.55T low-field MRI system in lumbar spine imaging with and without the use of additional advanced postprocessing techniques. MATERIALS AND METHODS: The lumbar spine of 14 volunteers (32.9 ± 3.6 years) was imaged both at 0.55T and 1.5T using sequences from clinical routine. On the 0.55T scanner system, additional sequences with simultaneous multi-slice acquisition and artificial intelligence-based postprocessing techniques were acquired. Image quality of all 28 examinations was assessed by three musculoskeletal radiologists with respect to signal/contrast, resolution, and assessability of the spinal canal and neuroforamina using a 5-point Likert scale (1 = non-diagnostic to 5 = perfect quality). Interrater agreement was evaluated with the Intraclass Correlation Coefficient and the Mann-Whitney U test (significance level: p < 0.05). RESULTS: Image quality at 0.55T was rated lower on the 5-point Likert scale compared to 1.5T regarding signal/contrast (mean: 4.16 ± 0.29 vs. 4.54 ± 0.29; p < 0.001), resolution (4.07 ± 0.31 vs. 4.49 ± 0.30; p < 0.001), assessability of the spinal canal (4.28 ± 0.13 vs. 4.73 ± 0.26; p < 0.001) and the neuroforamina (4.14 ± 0.28 vs. 4.70 ± 0.27; p < 0.001). Image quality for the AI-processed sagittal T1 TSE and T2 TSE at 0.55T was also rated slightly lower, but still good to perfect with a concomitant reduction in measurement time. Interrater agreement was good to excellent (range: 0.60-0.91). CONCLUSION: While lumbar spine image quality at 0.55T is perceived inferior to imaging at 1.5T by musculoskeletal radiologists, good overall examination quality was observed with high interrater agreement. Advanced postprocessing techniques may accelerate intrinsically longer acquisition times at 0.55T.

Big mitral annular calcification: a case report of a dynamic liquefaction necrosis as a potential source of embolism.

BACKGROUND: Mitral annular calcification (MAC) is a degenerative, mostly asymptomatic abnormality usually in elderly patients. Caseous MAC (cMAC) is a rare form with central liquefaction necrosis, which typically involves the posterior annulus of the mitral valve and can cause serious sequelae. However, optimal management of patients with cMAC is not clearly defined. CASE SUMMARY: In a 71-year-old female patient, MAC was incidentally detected. Tissue characterization with cardiac magnetic resonance (CMR) revealed a cMAC and a conservative approach was chosen. Six months after cMAC diagnosis, the patient developed an acute hemi-occlusion of a retinal artery with cholesterol embolism. At this time, CMR showed a liquefied cavity of the cMAC. Except for atherosclerotic plaques in the aorta and carotid arteries, further stroke work-up was negative. Therefore, the conservative approach was continued. During follow-up, the liquefied cavity regressed completely after another 6 months and the patient was free from further events (total follow-up 3 years since diagnosis of cMAC). DISCUSSION: A clear diagnosis and quantitative assessment of dynamic processes, such as cMAC, are made possible by performing CMR with multi-parametric tissue characterization. Dynamic changes in cMAC may have serious clinical implications, such as mitral regurgitation or systemic embolization. Among cardiac tumours, thrombus and abscess, cMAC should be included in the differential diagnosis of an intracardiac mass of the posterior mitral annulus in order to avoid further inappropriate diagnostic interventions.

Gender Differences in Peer Influence on Autistic Traits in Special Needs Schools-Evidence From Staff Reports.

Children and adolescents with an intellectual disability (ID) and autistic traits often attend special needs schools where they are surrounded by peers with diverse characteristics. Given the role that peers can play in social development, we examined whether autistic traits development in students with ID and high levels of such characteristics are influenced by the level of autistic traits among the schoolmates they like most. Furthermore, we investigated the degree to which this peer influence susceptibility depends on students' gender. A longitudinal design, with data collection points at the beginning and the end of a school year, was used. Staff reported on 330 students with high levels of autistic traits (20.6% girls; age 10.17 years, SD = 3.74) who attended 142 classrooms in 16 Swiss special needs schools. Results showed that students' future individual level of autistic traits (T2) was not predicted by the autistic traits level of preferred peers (T1), controlling for individual autistic traits at T1, level of general functioning, gender, and age. However, the peer effect was significantly moderated by students' gender, indicating that girls but not boys were susceptible to peer influence. These findings are discussed in terms of implications for understanding autistic traits development and directions of support for children and adolescents in their peer context.

Correction: Providing open-label placebos remotely-A randomized controlled trial in allergic rhinitis.

[This corrects the article DOI: 10.1371/journal.pone.0248367.].

Peer influence on problem behaviors among students with intellectual disabilities.

BACKGROUND: Students with intellectual disabilities (ID) exhibit increased rates of problem behaviors compared to those without ID. AIMS: Given the evidence of peer influence in typical development, we examined the impact of classmates' characteristics on problem behaviors of students with ID. We expected higher levels of problem behaviors in special needs classrooms will influence individual development of such behaviors. METHODS: A longitudinal design with measurements at the beginning and the end of a school year was applied. Staff reported on problem behaviors of 1125 students with ID (69 % boys; age 11.30 years,SD = 3.75) attending 16 Swiss special needs schools. RESULTS: The peer influence hypothesis was not supported for an overall problem behavior score. However, exploratory analyses suggested that peer influence did occur for the domains anxiety, problems in relating socially, and communication disturbances (not disruptive/antisocial, self-absorbed and other types of problem behaviors). The influence of classmates on anxiety was lower when there was more variability in anxiety within the classroom. The development of communication skills benefitted from attending a classroom that was heterogeneous in the level of communication problems. CONCLUSION: Our results suggest that the influence of peers on problem behaviors in special needs schools is not universal but varies between domains and depends on classroom characteristics.

Providing open-label placebos remotely-A randomized controlled trial in allergic rhinitis.

BACKGROUND: Placebos can reduce physical symptoms even when provided with full honesty and disclosure. Yet, the precise mechanisms underlying the effects of "open-label placebos" (OLPs) have remained subject of debate. Furthermore, it is unclear whether OLPs are similarly effective when provided remotely, as is sometimes required e.g. in the current COVID-19 pandemic. METHODS: In a randomized-controlled trial, we examined the effects of OLP plus treatment as usual (TAU) compared to TAU alone on symptom reduction in people with allergic rhinitis (N = 54) over the course of two weeks. Due to the COVID-19 pandemic, OLP was provided remotely (i.e. sent via postal service). To investigate the potential influence of the clinical encounter on the effects of OLP, we manipulated the perception of the virtual clinical encounter, both with respect to verbal and nonverbal factors (augmented vs. limited encounter). RESULTS: The results of the manipulation check confirmed that the augmented clinical encounter was evaluated more positively than the limited encounter, in terms of perceived warmth of the provider. Participants from all treatment groups showed significant symptom reduction from baseline to two weeks later, but OLP had no incremental effect over TAU. Participants benefitted more from OLP when they did not take any other medication against allergic symptoms than when taking medication on demand. When controlling for baseline symptoms, a significant treatment by encounter interaction was found, pointing to greater symptom improvement in the OLP group when the encounter was augmented, whereas the control group improved more when the encounter was limited. DISCUSSION: The study demonstrates that providing OLP and enhancing the encounter remotely is possible, but their effectiveness might be lower in comparison to previous studies relying on physical patient-provider interaction. The study raises questions for future research about the potential and challenges of remote placebo studies and virtual clinical encounters. The study has been registered as a clinical trial at ISRCTN (record number: 39018).

AI-based detection and classification of distal radius fractures using low-effort data labeling: evaluation of applicability and effect of training set size.

OBJECTIVES: To evaluate the performance of a deep convolutional neural network (DCNN) in detecting and classifying distal radius fractures, metal, and cast on radiographs using labels based on radiology reports. The secondary aim was to evaluate the effect of the training set size on the algorithm's performance. METHODS: A total of 15,775 frontal and lateral radiographs, corresponding radiology reports, and a ResNet18 DCNN were used. Fracture detection and classification models were developed per view and merged. Incrementally sized subsets served to evaluate effects of the training set size. Two musculoskeletal radiologists set the standard of reference on radiographs (test set A). A subset (B) was rated by three radiology residents. For a per-study-based comparison with the radiology residents, the results of the best models were merged. Statistics used were ROC and AUC, Youden's J statistic (J), and Spearman's correlation coefficient (ρ). RESULTS: The models' AUC/J on (A) for metal and cast were 0.99/0.98 and 1.0/1.0. The models' and residents' AUC/J on (B) were similar on fracture (0.98/0.91; 0.98/0.92) and multiple fragments (0.85/0.58; 0.91/0.70). Training set size and AUC correlated on metal (ρ = 0.740), cast (ρ = 0.722), fracture (frontal ρ = 0.947, lateral ρ = 0.946), multiple fragments (frontal ρ = 0.856), and fragment displacement (frontal ρ = 0.595). CONCLUSIONS: The models trained on a DCNN with report-based labels to detect distal radius fractures on radiographs are suitable to aid as a secondary reading tool; models for fracture classification are not ready for clinical use. Bigger training sets lead to better models in all categories except joint affection. KEY POINTS: • Detection of metal and cast on radiographs is excellent using AI and labels extracted from radiology reports. • Automatic detection of distal radius fractures on radiographs is feasible and the performance approximates radiology residents. • Automatic classification of the type of distal radius fracture varies in accuracy and is inferior for joint involvement and fragment displacement.

Correction: Frequency of infections in 948 MPN patients: a prospective multicenter patient-reported pilot study.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

An isotope dilution LC-MS/MS-based candidate reference method for the quantification of androstenedione in human serum and plasma.

The accurate measurement of androstenedione in human serum and plasma is required for steroid profiling to assure the appropriate diagnosis and differential diagnosis of hyperandrogenism. In this work, we introduce an isotope dilution liquid chromatography-tandem mass spectrometry (LC-MS/MS) candidate reference measurement procedure for the quantification of androstenedione in human serum and plasma. The performance of the procedure enables its use in the evaluation and standardization of routine assays and for the evaluation of patient samples to ensure the traceability of individual patient results. As the primary standard, a certified reference material from NMIA (National Measurement Institute, Australia) was used. Additionally, a quantitative nuclear magnetic resonance (qNMR) method was developed for the value assignment of the primary reference material, which ensures the direct traceability to SI units, as well as the independence from the availability of reference materials. 13C3-labeled androstenedione was used as the internal standard. The introduced method allows the measurement of androstenedione in the range of 0.05-12 ng/mL, and the assay imprecision was found to be <2% between 5 and 12 ng/mL, 3.5% at 1.5 ng/mL, and 5.2% at 0.05 ng/mL, with an accuracy of 95-105% for the serum and 91-103% for the plasma matrix. The transferability to a second laboratory was validated by method comparison based on 112 patient samples. The comparison of the results obtained from the presented method and an LC-MS/MS routine assay, using 150 native patient samples, showed a good correlation with a bias of the routine method of ≤4.0%.

Quantitative enhancement thresholds and machine learning algorithms for the evaluation of renal lesions using single-phase split-filter dual-energy CT.

PURPOSE: To establish thresholds for contrast enhancement-based attenuation (CM) and iodine concentration (IOD) for the quantitative evaluation of enhancement in renal lesions on single-phase split-filter dual-energy CT (tbDECT) and combine measurements in a machine learning algorithm to potentially improve performance. MATERIAL: 126 patients with incidental renal cysts (both hypo- and hyperdense cysts) or high suspicion for renal cell carcinoma (312 total lesions) undergoing abdominal, portal venous phase tbDECT were initially included in this retrospective study. Gold standard was pathological confirmation or follow-up imaging (MRI or multiphasic CT). CM, IOD, and ROI size were recorded. Thresholds for CM and IOD were identified using Youden-Index of the empirical ROC curves. Decision tree (DTC) and random forest classifier (RFC) were trained. Sensitivities, specificities, and AUCs were compared using McNemar and DeLong test. RESULTS: The final study cohort comprised 40 enhancing and 113 non-enhancing renal lesions. Optimal thresholds for quantitative iodine measurements and contrast enhancement-based attenuation were 1.0 ± 0.0 mg/ml and 23.6 ± 0.3 HU, respectively. Single DECT parameters (IOD, CM) showed similar overall performance with an AUC of 0.894 and 0.858 (p = 0.541) (sensitivity 90 and 80%, specificity 88 and 92%, respectively). While overall performance for the DTC (AUC 0.944) was higher than RFC (AUC 0.886), this difference (p = 0.409) and comparison to CM (p = 0.243) and IOD (p = 0.353) was not statistically significant. CONCLUSIONS: Enhancement in incidental renal lesions on single-phase tbDECT can be classified with up to 87.5% sensitivity and 94.6% specificity. Algorithms combining DECT parameters did not increase overall performance.

Interscanner and Intrascanner Comparison of Virtual Unenhanced Attenuation Values Derived From Twin Beam Dual-Energy and Dual-Source, Dual-Energy Computed Tomography.

OBJECTIVE: The aim of the current study was to evaluate the reliability and comparability of virtual unenhanced (VUE) attenuation values derived from scans of a single-source, dual-energy computed tomography using a split-filter (tbDECT) to a dual-source dual-energy CT (dsDECT). MATERIALS AND METHODS: In this retrospective study, comparisons for tbDECT and dsDECT were made within and between different dual-energy platforms. For the interscanner comparison, 126 patients were scanned with both scanners within a time interval of 224 ± 180 days; for the intrascanner comparison, another 90 patients were scanned twice with the same scanner within a time interval of 136 ± 140 days. Virtual unenhanced images were processed off of venous phase series. Attenuation values of 7 different tissues were recorded. Disagreement for VUE HU measurements greater than 10 HU between 2 scans was defined as inadequate. RESULTS: The interscanner analysis showed significant difference between tbDE and dsDE VUE CT values (P < 0.01) for 6 of 7 organs. Percentage of cases that had more than 10 HU difference between tbDE and dsDE for an individual patient ranged between 15% (left kidney) and 62% (spleen).The intrascanner analysis showed no significant difference between repeat scans for both tbDECT and dsDECT (P > 0.05). However, intrascanner disagreements for the VUE HU measurements greater than 10 HU were recorded in 10% of patients scanned on the tbDECT and 0% of patients scanned on the dsDECT. The organs with the highest portion of greater than 10 HU errors were the liver and the aorta (both 20%). CONCLUSIONS: Dual-energy techniques vary in reproducibility of VUE attenuation values. In the current study, tbDECT demonstrated higher variation in VUE HU measurements in comparison to a dsDECT. Virtual unenhanced HU measurements cannot be reliably compared on follow-up CT, if these 2 different dual-energy CT platforms are used.

Avoiding antisocial behavior among adolescents: The positive influence of classmates' prosocial behavior.

INTRODUCTION: Prior research has shown that classmates' behavior serves as a descriptive norm for adolescents' individual behavior. While earlier studies primarily focused on negative peer influence, classmates' prosocial behavior might be associated with positive individual development. We hypothesized more classroom-level prosocial behavior predicts a lower likelihood of future antisocial behavior of individual students over and above the effect of classmates' antisocial behavior. We further assumed this effect is mediated by adolescents' attitudes toward antisocial behavior. METHODS: To test our hypotheses, we used three data collection points from a longitudinal study among lower secondary school students in Switzerland (N = 864; mean age at T1: 13.81 years; male gender: 52%). Participants completed self-reported assessments on prosocial behavior, antisocial behavior, and antisocial attitudes. Data were analyzed using multilevel models. RESULTS: Results indicated higher levels of prosocial behavior among classmates predict lower levels of individual students' future antisocial behavior. However, the effect of classmates' prosocial behavior was not mediated by individual attitudes toward antisocial behavior. CONCLUSIONS: While in the context of antisocial behavior the peer group is often assumed a risk, our results indicate that school peers can also exert positive influence. Hereby our finding of an effect of prosocial peer norms over and above antisocial peer norms suggests that building up prosocial behaviors in the classroom may be a promising approach for the prevention of antisocial behavior.

A conserved acidic motif is crucial for enzymatic activity of protein O-mannosyltransferases.

Protein O-mannosylation is an essential modification in fungi and mammals. It is initiated at the endoplasmic reticulum by a conserved family of dolichyl phosphate mannose-dependent protein O-mannosyltransferases (PMTs). PMTs are integral membrane proteins with two hydrophilic loops (loops 1 and 5) facing the endoplasmic reticulum lumen. Formation of dimeric PMT complexes is crucial for mannosyltransferase activity, but the direct cause is not known to date. In bakers' yeast, O-mannosylation is catalyzed largely by heterodimeric Pmt1p-Pmt2p and homodimeric Pmt4p complexes. To further characterize Pmt1p-Pmt2p complexes, we developed a photoaffinity probe based on the artificial mannosyl acceptor substrate Tyr-Ala-Thr-Ala-Val. The photoreactive probe was preferentially cross-linked to Pmt1p, and deletion of the loop 1 (but not loop 5) region abolished this interaction. Analysis of Pmt1p loop 1 mutants revealed that especially Glu-78 is crucial for binding of the photoreactive probe. Glu-78 belongs to an Asp-Glu motif that is highly conserved among PMTs. We further demonstrate that single amino acid substitutions in this motif completely abolish activity of Pmt4p complexes. In contrast, both acidic residues need to be exchanged to eliminate activity of Pmt1p-Pmt2p complexes. On the basis of our data, we propose that the loop 1 regions of dimeric complexes form part of the catalytic site.