TY - GEN A1 - Sánchez, Alba A1 - Thomas, Christine A1 - Deeken, Friederike A1 - Wagner, Sören A1 - Klöppel, Stefan A1 - Kentischer, Felix A1 - von Arnim, Chrstine A. F. A1 - Denkinger, Michael A1 - Conzelmann, Lars O. A1 - Biermann-Stallwitz, Janine A1 - Joos, Stefanie A1 - Sturm, Heidrun A1 - Metz, Brigitte A1 - Auer, Ramona A1 - Skrobik, Yoanna A1 - Eschweiler, Gerhard W. A1 - Rapp, Michael Armin T1 - Patient safety, cost-effectiveness, and quality of life BT - reduction of delirium risk and postoperative cognitive dysfunction after elective procedures in older adults—study protocol for a stepped-wedge cluster randomized trial (PAWEL Study) T2 - Postprints der Universität Potsdam Humanwissenschaftliche Reihe N2 - Background Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients’ age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective. Methods The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures. Discussion Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances. Trial registration German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 535 KW - Cross-sectoral care KW - Delirium prevention KW - Postoperative cognitive dysfunction KW - Dementia KW - Older patients KW - Elective surgery KW - Quality of life KW - Cost-effectiveness Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-424883 SN - 1866-8364 IS - 535 ER - TY - GEN A1 - Heinz, A. A1 - Kluge, U. A1 - Rapp, Michael Armin T1 - Heritability of living in deprived neighbourhoods T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 313 Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-103770 ER - TY - GEN A1 - Kaminski, Jakob A. A1 - Schlagenhauf, Florian A1 - Rapp, Michael Armin A1 - Awasthi, Swapnil A1 - Ruggeri, Barbara A1 - Deserno, Lorenz A1 - Banaschewski, Tobias A1 - Bokde, Arun L. W. A1 - Bromberg, Uli A1 - Büchel, Christian A1 - Quinlan, Erin Burke A1 - Desrivières, Sylvane A1 - Flor, Herta A1 - Frouin, Vincent A1 - Garavan, Hugh A1 - Gowland, Penny A1 - Ittermann, Bernd A1 - Martinot, Jean-Luc A1 - Paillère Martinot, Marie-Laure A1 - Nees, Frauke A1 - Papadopoulos Orfanos, Dimitri A1 - Paus, Tomáš A1 - Poustka, Luise A1 - Smolka, Michael N. A1 - Fröhner, Juliane H. A1 - Walter, Henrik A1 - Whelan, Robert A1 - Ripke, Stephan A1 - Schumann, Gunter A1 - Heinz, Andreas T1 - Epigenetic variance in dopamine D2 receptor BT - a marker of IQ malleability? T2 - Postprints der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe N2 - Genetic and environmental factors both contribute to cognitive test performance. A substantial increase in average intelligence test results in the second half of the previous century within one generation is unlikely to be explained by genetic changes. One possible explanation for the strong malleability of cognitive performance measure is that environmental factors modify gene expression via epigenetic mechanisms. Epigenetic factors may help to understand the recent observations of an association between dopamine-dependent encoding of reward prediction errors and cognitive capacity, which was modulated by adverse life events. The possible manifestation of malleable biomarkers contributing to variance in cognitive test performance, and thus possibly contributing to the "missing heritability" between estimates from twin studies and variance explained by genetic markers, is still unclear. Here we show in 1475 healthy adolescents from the IMaging and GENetics (IMAGEN) sample that general IQ (gIQ) is associated with (1) polygenic scores for intelligence, (2) epigenetic modification of DRD2 gene, (3) gray matter density in striatum, and (4) functional striatal activation elicited by temporarily surprising reward-predicting cues. Comparing the relative importance for the prediction of gIQ in an overlapping subsample, our results demonstrate neurobiological correlates of the malleability of gIQ and point to equal importance of genetic variance, epigenetic modification of DRD2 receptor gene, as well as functional striatal activation, known to influence dopamine neurotransmission. Peripheral epigenetic markers are in need of confirmation in the central nervous system and should be tested in longitudinal settings specifically assessing individual and environmental factors that modify epigenetic structure. T3 - Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe - 950 KW - genome-wide association KW - reward anticipation KW - human intelligence KW - human brain KW - stress KW - metaanalysis KW - striatum KW - psychopathology KW - prediction KW - volume KW - epigenetics and behaviour KW - human behaviour KW - learning and memory Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-425687 SN - 1866-8372 IS - 950 ER - TY - GEN A1 - Wuertz-Kozak, Karin A1 - Roszkowski, Martin A1 - Cambria, Elena A1 - Block, Andrea A1 - Kuhn, Gisela A. A1 - Abele, Thea A1 - Hitzl, Wolfgang A1 - Drießlein, David A1 - Müller, Ralph A1 - Rapp, Michael Armin A1 - Mansuy, Isabelle M. A1 - Peters, Eva M. J. A1 - Wippert, Pia-Maria T1 - Effects of Early Life Stress on Bone Homeostasis in Mice and Humans T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Bone pathology is frequent in stressed individuals. A comprehensive examination of mechanisms linking life stress, depression and disturbed bone homeostasis is missing. In this translational study, mice exposed to early life stress (MSUS) were examined for bone microarchitecture (μCT), metabolism (qPCR/ELISA), and neuronal stress mediator expression (qPCR) and compared with a sample of depressive patients with or without early life stress by analyzing bone mineral density (BMD) (DXA) and metabolic changes in serum (osteocalcin, PINP, CTX-I). MSUS mice showed a significant decrease in NGF, NPYR1, VIPR1 and TACR1 expression, higher innervation density in bone, and increased serum levels of CTX-I, suggesting a milieu in favor of catabolic bone turnover. MSUS mice had a significantly lower body weight compared to control mice, and this caused minor effects on bone microarchitecture. Depressive patients with experiences of childhood neglect also showed a catabolic pattern. A significant reduction in BMD was observed in depressive patients with childhood abuse and stressful life events during childhood. Therefore, future studies on prevention and treatment strategies for both mental and bone disease should consider early life stress as a risk factor for bone pathologies. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 670 KW - psychosocial stress KW - bone pathologies KW - osteoporosis KW - bone mineral density KW - childhood KW - neuroendocrine Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-485324 SN - 1866-8364 IS - 670 ER -