Trends in Bullying Victimization and Social Unsafety for Sexually and Gender Diverse Students.

Research has documented trends in bullying victimization for sexually diverse adolescents in the US, but trends regarding school social unsafety are understudied and there is a dearth of research examining these trends for gender diverse adolescents. This study aimed to identify disparities in bullying victimization and feelings of social unsafety in schools for sexually and gender diverse adolescents. Data stem from the 2014 (N = 15,800; M age = 14.17, SD = 1.50), 2016 (N = 22,310; M age = 14.17, SD = 1.49), and 2018 (N = 10,493; M age = 14.02, SD = 1.52) survey cycles of the Social Safety Monitor, a Dutch cross-sectional school-based study. Findings indicate that sexual orientation disparities remained relatively small, but stable over time, while gender diverse adolescents remained more likely to be victimized and feel unsafe in school, with larger disparities overall. Monitoring these trends is highly relevant, especially considering recent negative developments regarding societal acceptance of sexual and gender diversity.

A Young Man With Severe and Disabling Complications of Septic Shock.

A young man had severe septic shock with multiorgan failure due to necrotizing fasciitis caused by group A streptococcus after endoscopic repair of a preperitoneal inguinal hernia. He was treated with surgical exploration and antibiotics and resuscitated with fluids, vasopressors, and inotropic agents. He survived this critical illness, but when he woke up from sedation, his vision was lost in both eyes. Ophthalmological evaluation revealed minimal peripapillary retinal hemorrhages without signs of papillary edema. Visually evoked potentials were negative. Magnetic resonance imaging did not show a cause of the visual damage. The patient had bilateral ischemic optic neuropathy diagnosed. Two weeks later, unilateral sudden deafness also developed. The acquired blindness and hearing loss were unchanged after more than 1 year and seem to be permanent, severely disabling this young survivor of septic shock.

[Physical examination--measurement of muscle strength]. / Fysische diagnostiek--het meten van spierkracht.

Measuring muscle strength and establishing paretic symptoms are done first of all by having the patient perform actions or movements that require normal muscle strength. Measuring or grading the strength of separate muscle groups is usually done by means of the so-called Medical Research Council (MRC) scale that runs from 0 to 5, with the movement against gravity as an important criterion. This scale is not very valid in tract 4 (more strength than needed to overcome gravity, but still subnormal). Using a manual dynamometer or a fixed dynamometer it is possible to measure the strength of most clinically important muscle groups of the extremities and to compare them with values found in a normal population. For following the individual patient with a neuromuscular disorder, strength measurement with the dynamometer is more reliable than grading using the MRC scale.

Use and misuse of nitrogen in agriculture: the German story.

Nitrogen (N) fertilization in agriculture has been discussed controversially in Germany for almost two centuries. The agronomist Carl Sprengel, who published his theory on the mineral nutrition of plants in 1828, advocated the use of mineral N fertilizers. Chemist Justus von Liebig, on the other hand, vehemently denied around 1850 the need for N fertilization. Although it soon became evident that Sprengel was right and Liebig was wrong, not much synthetic N fertilizer was used in German agriculture until around 1915, when the Haber-Bosch technique enabled the commercial production of NH3. The use of N fertilizers since then has grown, especially since 1950. To increase agricultural productivity, German governments have promoted, directly and indirectly, the use of N in crop and in animal production. Unfortunately, it was overlooked that N surpluses in agriculture increased rapidly; around 1980 they amounted yearly to more than 100 kg ha(-1). The extensive use of N in agriculture is causing environmental damage and is contributing substantially to the external costs of present agriculture. The main N compounds that affect the environment are N2O, NH3, and NO3. These compounds are considered to contribute one third to the external costs of agriculture. Additionally, the high rate of human intake of animal proteins and lipids has adversely affected the health of the country's population. Fundamental corrections in German farm policy appear inevitable.

Elbe river flood peaks and postwar agricultural land use in East Germany.

Collectivization of farmland since the 1950s has changed the agricultural land use in former East Germany. Single fields on the collective farms became increasingly large and were cultivated with increasingly heavy farm equipment. This led to large-scale physical degradation of arable soils, enhancing the formation of surface runoff in periods with prolonged and excessive precipitation. The extent to which this development may have affected the discharge behavior of the main East German river, the Elbe, has so far not been studied. We analyzed the flood peaks of the Elbe during the past century (1900-2000). The flood discharge behavior of the Elbe has apparently changed significantly since the 1950s. Although climate changes may be involved, we conclude that the Elbe flood peaks, recorded since 1950, are related to the changes in postwar agricultural land use in former East Germany. To restore the degraded farmland soils, a change in agricultural land use may be necessary.

The influence of handedness on the distribution of muscular weakness of the arm in facioscapulohumeral muscular dystrophy.

The strength of 10 muscle groups in both arms was measured using hand-held myometry to determine the influence of handedness on left-right differences of muscle strength in facioscapulohumeral muscular dystrophy (FSHD). Two groups of subjects were studied: 24 healthy volunteers (19 right-handed), and 53 patients (42 right-handed) with autosomal dominant FSHD. An opposite left-right difference of strength of shoulder and arm muscles was found: right-handed volunteers were stronger on the right side, right-handed patients were stronger on the left side. This opposite left-right difference was statistically significant for the supraspinatus muscle, the wrist extensors and the shoulder internal rotators. The number of left-handed subjects was too small for statistical analysis. The relation between handedness and increased muscle weakness in right-handed FSHD patients suggests that mechanical factors may play a distinct role in the progression of muscle weakness in FSHD.

Hand-held myometry: reference values.

In thirteen major muscle groups of 50 healthy females and 50 males, aged 20-60 years, maximum voluntary contraction was measured with a hand-held dynamometer. The intrasession variation, the left-right variation, and the fifth and fiftieth centile values were calculated. The ratio of two observations within one session ranged from 0.85 to 1.18 and the ratio of left to right ranged from 0.82 to 1.22 (95% reference limits). In 20 volunteers the repeatability was tested after one week. The ratio of averages of three measurements in two successive weeks ranged from 0.82 to 1.23 (95% reference limits). There were only small differences between muscle groups concerning these ratios. A significant relation with age and weight/Quetelet Index could be demonstrated in some muscle groups. The mean strength of females is approximately two thirds of the strength of males. The data may be useful as reference values in the application of hand-held myometry.

The "make/break test" as a diagnostic tool in functional weakness.

Strength was measured in four major muscle groups with a hand-held dynamometer. The "make" and "break" technique was used with and without encouragement, and fatiguability was tested in patients with organic weakness and patients with functional weakness. Patients with functional weakness could be distinguished from the other two groups by an increase in strength greater than 20% with the break compared with the make technique. Additionally they tend to show larger increases in strength with encouragement and their "fatiguability" was less.

Tizanidine versus baclofen in the treatment of spasticity in multiple sclerosis patients.

Sixteen patients suffering from spasticity due to multiple sclerosis were treated with baclofen and tizanidine in a partially blind cross-over study. No significant difference in efficacy was found. The most striking difference was seen in the side-effects: baclofen frequently caused more or less severe muscle weakness and even falling during walking and standing. Treatment with tizanidine produced an apparent improvement of mobility in some patients suffering from moderate or marked paresis associated with a marked spasticity of their legs. Isometric muscle strength did not show any significant changes during either treatment. The different impact of baclofen and tizanidine on mobility and weight support seems to be related to their different site of action in spasticity.

Measuring muscle strength.

A dynamometer that can be held in the hand and that was designed to measure muscle strength in a simple way in the range 2-5 of the MRC scale, was tested in order to establish to what extent differences in results can be attributed to the observer, the subject and replication. Observers learned the technique quickly and their results agreed with each other to a considerable extent. The subjects showed a small learning effect in three of the four muscles tested. Normal muscle strength was measured in one hundred 18-year-old men.