Abstract Objective This study investigated the criterion validity of the WHO-Five Well-Being Index (WHO-5) in screening for depression in pediatric care. Method A total of 446 children aged 9 to 12 ...and 324 adolescents aged 13 to 16, recruited from pediatric hospitals, completed the WHO-5 and a structured diagnostic interview serving as the gold standard. Diagnoses of depressive disorder included major depression and minor depression. Criterion validity was analyzed using the area under the receiver operating curve (AUC). Sensitivity and specificity were computed for optimal cutoffs. Additionally, unaided clinical diagnoses of depression made by the attending pediatricians were assessed. Results Diagnoses of depressive disorder were established for 3.6% of children and 11.7% of adolescents. AUCs were .88 for the child and .87 for the adolescent sample. A cutoff score of 10 for children maximized sensitivity (.75) and specificity (.92). For the adolescent sample, decreasing the cutoff score to 9 yielded optimal sensitivity (.74) and specificity (.89). Sensitivity of the unaided clinical diagnosis of depression was .09, while specificity was .96. Conclusions The WHO-5 demonstrated good diagnostic accuracy for both age groups. Further evidence is needed to support the feasibility of the WHO-5 as a depression screening instrument used in pediatric care.
In the research project presented in this paper, the effects of welding width, pressure force, power, and speed of ultrasonic welding parameters on hydrostatic pressure resistance were examined. A ...flexible and lightweight PVC-coated hybrid textile material with uniform thickness was used for weather protection purposes. Three main welding parameters at three different levels were selected based on the preliminary test results involving welding widths of 6 and 12 mm. A lapped type of seam was applied for ultrasonic welding and conventional joining techniques. A conventionally sewn zigzag seam was produced using three main factors at two different levels according to the application area. To avoid seam permeability, the conventional seam was sealed with tape by means of hot-air tape welding and subsequently investigated regarding its hydrostatic pressure resistance. The hydrostatic pressure resistance value of the conventional seam was then compared with ultrasonic weld seams of 6 and 12 mm welding width, and its parametric influence on the quality of the seam was analyzed. The result shows that the ultrasonic weld seam with a 12 mm welding width provided a higher hydrostatic pressure resistance than the 6 mm welding width and the conventionally sewn seam. Statistical analyses were also carried out to prove the significant effect of welding process parameters on hydrostatic pressure resistance, whereby the obtained results were statistically significant. A suitable nonlinear numerical model was also developed to predict the hydrostatic pressure resistance.
A study of polyvinylchloride-coated woven polyester fabric welding potential was conducted using continuous ultrasonic welding machines. The effect of cooling air, anvil wheel status, anvil wheel ...width, material surface contact, and welding gap on seam strength was studied. Three main welding parameters with different levels were selected based on 5 and 10 mm welding widths using old and new anvil wheels with and without cooling air. A lapped type of seam was applied under full factorial design. A microstructure was captured to examine the formation of welding joints, and seam tensile properties were determined. Comparative analysis of comparable welding parameters was analyzed for a gap against pressure and amplitude against power. The actual weld phenomenon was also analyzed based on the recorded machine parameters. The results showed that auxiliary parameters had a significant effect on seam strength. A microscopic image of a welded seam indicated that cooling air reduced the number and size of holes produced. Weld seam with controlled pressure or power provided higher seam strength than that of the controlled gap or amplitude. The actual phenomenon of welding parameters was important to evaluate weld seam quality, whereby the obtained results indicated good quality at lower power and pressure.
Ultrasonic welding is a universal, clean, and secure alternative joining method. Alternative joining technologies are used increasingly to fulfill specific functional requirements of the seam, such ...as fluid impermeability to achieve positive bonding during the assembly of technical textiles. In this research, the effect of important ultrasonic welding parameters on peel strength and weld seam thickness was investigated for flexible and lightweight textile material, which is a valuable innovative hybrid textile for technical applications like architectural, construction, and protective textiles. Three main welding parameters with three different levels were selected based on the preliminary test results of 6 and 12 mm welding widths, and a superimposed type of seam was applied. Light scanning microscopic images were used to examine the effective weld locations and their morphology at the joining interface. The parametric influence of ultrasonic welding technique on-seam quality and their tendencies in the relationship were analyzed. Optimized peel strength yielding parametric levels were also assessed numerically. The result shows that the optimal peel strength value was obtained at a welding speed of 2.318 m/min, power of 119.382 W, and pressure force of 349.729 N for a 12 mm welding width. The weld seam thickness had an inverse relationship with the peel strength, and a higher amount of thickness was reduced to 12 mm welding width than 6 mm. Microscopic cross-sectional image of weld seam indicated that a compressed yarn between the coating material at higher welding power and pressure force in lower welding speed. A nonlinear quadratic numerical model was developed to predict the peel strength, and their results were close to the regressed diagonal line against the actual points. The statistical analysis was carried out to show the significant effect of process parameters on peel strength, whereby the obtained results were statistically significant.
In many textiles and fiber structures, the behavior of the material is determined by the structural arrangements of the fibers, their thickness and cross-section, as well as their material ...properties. Textiles are thin plates made of thin long yarns in frictional contact with each other that are connected via a rule defined by a looping diagram. The yarns themselves are stretchable or non-stretchable. All these structural parameters of a textile define its macroscopic behavior. Its folding is determined by all these parameters and the kind of the boundary fixation or loading direction. The next influencing characteristic is the value of the loading. The same textile can behave similar to a shell and work just for bending, or behave as a membrane with large tension deformations under different magnitudes of the loading forces. In our research, bounds on the loading and frictional parameters for both types of behavior are found. Additionally, algorithms for the computation of effective textile properties based on the structural information are proposed. Further focus of our research is the nature of folding, induced by pre-strain in yarns and some in-plane restriction of the textile movements, or by the local knitting or weaving pattern and the yarn’s cross-sections. Further investigations concern different applications with spacer fabrics. Structural parameters influencing the macroscopic fabric behavior are investigated and a way for optimization is proposed. An overview of our published mathematical and numerical papers with developed algorithms is given and our numerical tools based on these theoretical results are demonstrated.
Although there is good evidence to support the effectiveness of cognitive behavioral therapy (CBT) for the outpatient treatment of adolescent major depressive disorder (MDD), evidence-based manuals ...for the inpatient setting are lacking. This pilot study sought to (i) adapt an existing CBT manual (treatment of adolescent depression; TADS) to an inpatient setting (TADS-in), (ii) test its effectiveness at symptom reduction and remission of MDD in a pre-post design, and (iii) assess the strengths and limitations of the manual via a focus-group with clinicians.
Twenty nine adolescents aged 12-17 years with a primary ICD-10 diagnosis of MDD being treated as inpatients at a psychiatric clinic were included. Embedded in the regular inpatient treatment course (8 weeks), patients received 12 sessions of the TADS-in manual. Quantitative assessment of symptom reduction and remission of MDD was conducted using a non-controlled pre-post design. The quantitative results were supplemented by a focus group with participating psychotherapists.
Of the 29 patients included in the study at the beginning, 19 (65.5%) remained in the study at week 8. Symptoms of depression were statistically significantly lower at the end of treatment than at baseline according to self- (
= 1.38; mean change = 19.88; 95% CI = 12.48-27.28) and other reports (
= 0.64, mean change = 0.35; 95% CI = 0.08-0.62). Clinicians ratings of improvement (CGI-I) suggested that at the end of treatment, 15.8% were very much improved, 68.4% much improved, and 15.8% were minimally improved. According to diagnostic interviews with patients conducted at the end of treatment, 73.3% were in remission. The qualitative analysis showed that on the whole, the TADS-in manual is suitable for the inpatient setting. However, clinicians believed the effectiveness of TADS-in was limited by patient comorbidity and the fact that the inpatients were unable to practice incorporating techniques learnt into everyday life.
This study is the first to adapt the TADS manual to the inpatient setting. The sample of depressed adolescents showed reduced symptomology following treatment, although these findings require replicating in a randomized controlled trial before effects can be attributed to the TADS-in manual specifically. This pilot study informs further development of the manual as well as representing an important first step in the evaluation of the inpatient treatment of adolescent depression.The study was retrospectively registered (DRKS00017308) and received no external funding.
Abstract Objective This is the first study to validate and to compare the Children's Depression Inventory (CDI) and its short version (CDI:S) as screening tools for medically ill children. Methods A ...sample of 406 pediatric hospital patients, aged 9 to 12 years (56.2% male, 77.1% inpatients), completed the German CDI. Criterion validity of the 26-item CDI and the 10-item CDI:S was calculated by receiver operating characteristic (ROC) curves. DSM-IV diagnoses of depression based on the structured diagnostic interview for mental disorders in children and adolescents (Kinder-DIPS) served as the reference standard. Areas under the ROC curves as well as sensitivities and specificities for the optimal cutoffs were compared for both versions. Results Diagnoses of major or minor depression were established for 7.4% of the children. Areas under the curve for the 26-item CDI (87.7%) and the 10-item CDI:S (88.2%) were comparable. For the CDI, the cutoff ≥ 12 yielded the best balance between sensitivity (83.3%) and specificity (82.7%). At the optimal cutoff ≥ 3, the CDI:S resulted in a high sensitivity of 93.3% and a specificity of 70.7%. Thus, the CDI:S proved to be as sensitive as the CDI, but was less specific than the full-length version. Conclusion Both the CDI and the CDI:S are valid screening instruments for depression in medically ill children. The sensitive and brief CDI:S is a promising tool in time-pressed settings such as pediatric care, but has to be followed by a thorough diagnostic assessment to rule out false positive cases.
Background
This study examines the criterion validity of the Patient Health Questionnaire 9‐item (PHQ‐9) and 2‐item (PHQ‐2) version as a depression‐screening instrument for adolescents.
Methods
Three ...hundred twenty‐two adolescents aged 13–16 were recruited from pediatric hospitals. Criterion validity of the PHQ‐9 and PHQ‐2 was assessed against diagnoses of any depressive disorder provided by a structured diagnostic interview. Areas under the receiver operating characteristics curve (AUCs) and sensitivities and specificities at optimal cutoff points were computed for both versions of the PHQ. Besides the dimensional algorithm, a categorical algorithm was applied for the PHQ‐9. Validity measures of both scoring procedures of the PHQ‐9 as well as PHQ‐2 were compared statistically. In addition, unaided clinical depression diagnoses by the attending pediatricians were evaluated.
Results
Using the dimensional algorithm, the AUCof the PHQ‐9 (93.2%) was significantly higher than that of the PHQ‐2 (87.2%). At optimal cutoffs, there was no significant difference in sensitivity (PHQ‐9: 90.0%, PHQ‐2: 85.0%), but in specificity (PHQ‐9: 86.5%, PHQ‐2: 79.4%). Although the categorical algorithm of the PHQ‐9 was most specific (94.7%), sensitivity was just above chance (52.5%). The unaided clinical diagnoses yielded a sensitivity of 12.5% and a specificity of 96.0%.
Conclusions
The dimensional algorithm of the PHQ‐9 demonstrated high criterion validity, whereas the categorical algorithm should not be applied due to its low sensitivity. Even though the PHQ‐2 performed well, validity of the PHQ‐9 was still superior. Hence, the PHQ‐9 can be recommended as depression screener for adolescents to improve recognition rates in pediatric care.
Abstract
A series of research has been conducted to analyze the quality of weld seams by non-destructive testing methods. Research on defect analysis using the actual ultrasonic welding phenomenon ...has not been addressed yet. To ensure a comprehensive quality evaluation, this research estimates the size and location of artificial weld seam defects by the actual ultrasonic welding phenomenon without conventional inspection systems. The welding parameters (power, pressure force, and speed) were carefully selected to ensure optimal bond strength. A superimposed type of seam was produced longitudinally by PVC-coated hybrid textiles in rough to smooth surface contact for two welding groups, using a welding width of 10 mm with an activated cooling air effect. Artificial defects were introduced across the weld seam at five different locations spaced 50 mm apart using Teflon films of 3 and 5 mm width. The actual weld phenomenon of ultrasonic welding process parameters was determined after the recorded machine parameters were converted. The effect of welding process parameters on the seam quality was also analyzed, comparing the weld seam quality between different welding groups and Teflon widths. Based on the discovered graph of the actual welding phenomenon, the location and extent of artificial weld seam defects were estimated. The artificial weld seam defect with a thickness of 0.059 mm at a width of 3.85 mm was estimated at an interval of 50.77 mm using 275 N welding pressure force and 120 W welding power at 2 m min
−1
welding speed for 3 mm Teflon width. The results showed that the estimated values closely align with the actual size and position of defects. Overall, this research contributes to the development of a non-destructive testing approach for detecting weld seam defects in ultrasonic welding, emphasizing the importance of these techniques for online inspection and control of weld seam quality.
Warp-knitted spacer fabrics are considered, which are plates or shells composed of two knitted plane layers connected by vertical beams. Our aim is to compute the effective stiffness and permeability ...of such spacer fabrics on the basis of their structure and properties of yarns and the monofil. In order to reduce the computational effort and simplify the computational model, homogenization and dimension reduction techniques are applied. They replace the fabric by an equivalent two-dimensional plate or shell with effective elastic properties. To compute the effective permeability, the fluid simulation is done on the fully resolved micro-structure. The paper demonstrates the algorithm on application examples. We compute the elastic properties of a spacer fabric and its effective permeability for different outer-plane compression stages. Numerical examples were performed by applying the multi-scale simulation tools, developed at Fraunhofer ITWM and by comparing with the corresponding experimental results, based on measurements performed at the TU Dresden. The developed algorithms and simulation tools enable a full virtualisation of the material design adapted to exposure scenarios in various technical application cases, i.e. infiltration processes with polymers in the field of fiber reinforced composites, which enables new discoveries for the designing and manufacturing process of 3D warp-knitted spacer fabrics.
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